Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 22 th March, 2019

Mard ko dard nahi hota: Congenital insensitivity to pain – CIP

CIP or congenital analgesia is one or more rare conditions in which a person cannot feel (and has never felt) physical pain. CIP is an extremely dangerous condition and it is common for people with the condition to die in childhood due to injuries or illnesses going unnoticed. Burn injuries are among the more common injuries.


1. Cognition and sensation are otherwise normal

2. Patients can still feel discriminative touch (though not always temperature)

3. There are generally no detectable physical abnormalities.

4. Children with this condition often sustain oral cavity or fractures to bones.

5. Unnoticed infections and corneal damage due to foreign objects in the eye are also seen.

Two types of non-response

1. Insensitivity to pain means that the painful stimulus is not even perceived: a patient cannot describe the intensity or type of pain.

2. Indifference to pain means that the patient can perceive the stimulus, but lacks an appropriate response: they do not flinch or withdraw when exposed to pain.


1. Increased production of endorphins in the brain.

2. In this case, naloxone may be a treatment

3. Voltage-gated sodium channel SCN9A (Nav1.7) disorder. Patients with such mutations are congenitally insensitive to pain and lack other neuropathies.


Congenital insensitivity to pain is found in Vittangi, a village in Kiruna Municipality in northern Sweden, where nearly 40 cases have been reported.

Congenital insensitivity to pain with anhidrosis (CIPA), or hereditary sensory and autonomic neuropathy type IV

CIPA is the fourth type of hereditary sensory and autonomic neuropathy (HSAN), known as HSAN IV.

A person with CIPA cannot feel pain or differentiate even extreme temperatures and does not sweat.

In the absence of sweating these people can have dangerous dehydration


1. Mard ko dard nahi hota

2. Documentarian Melody Gilbert follows the daily lives of three girls -- a 3-year-old Minnesotan, a 7-year-old Norwegian and a 10-year-old German.

3. Many Bollywood movies on this subject

9 Movies That Introduced us to rare illnesses

1. Black (2005): Alzheimer’s disease.

2. Taare Zameen Par (2007): dyslexia

3. Ghajini (2008): Anterograde amnesia or commonly called as short-term memory loss.

4. Paa (2009): Progeria

5. My Name is Khan (2010): Asperger’s syndrome

6. Guzaarish (2010): Quadriplegia.

7. Shubh Mangal Saavdhan (2017): Erectile dysfunction.

8. Hichki (2018): Tourette Syndrome

9. Mard Ko Dard Nahi Hota (2018): Congenital Insensitivity to Pain (CIP)

Video Games

1. Video games are fun, educational and increasingly therapeutic.

2. Video games have become a vital learning tool for children struggling with dyslexia and other learning challenges and are being used to help treat Alzheimer’s patients.

3. Teen girls who play video games are three times more likely to pursue a STEM degree.

4. Through playing video games, college students can improve their communication, adaptability and resourcefulness, which are essential skills needed to earn a college degree.

5. Video games bring people together and have a positive impact on our daily lives.

Other side

World Health Organization (WHO) has proposed the addition of “gaming disorder” to its global disease classification handbook. This proposal sets a harmful precedent by stigmatizing people who enjoy playing video games and downplaying the real consequences of other recognized mental health disorders.

Abdominal breathing

Most of us take quick, shallow "chest breaths" that can leave us feeling tense and drained.

Abdominal belly breathing, is a basic yoga breath that combats the effects of chest breathing. The technique emphasizes breathing deeply to create abdominal movement. It's essential for those beginning a yoga practice, but everyone can benefit from learning it, yogi or not.

Abdominal breathing is best learned while lying on your back, with one or both of your hands on your abdomen. To take an abdominal breath, inhale slowly and deeply, drawing air into the lowest part of your lungs so your hand rises.

The belly should expand and rise as you inhale, then contract and lower as you exhale. One way to think of this is to imagine your lungs as two glasses of water — with each breath, you should fill them from the bottom up, but empty them from the top down.

Once you're comfortable doing abdominal breathing in a reclining position, you can try it while sitting or standing.

Mediterranean diet

· Switch from whatever fats you use now to extra virgin olive oil: Start by using olive oil in cooking. Finally, use olive oil in place of butter on your crusty bread.

· Eat nuts and olives: as a healthy replacement for processed snacks.

· Add whole-grain bread or other whole grains to the meal. Select dense, chewy, country-style loaves without added sugar or butter.

· Begin or end each meal with a salad

· Add more and different vegetables to the menu: Add an extra serving of vegetables to both lunch and dinner, aiming for three to four servings a day. Try a new vegetable every week.

· Eat at least three servings a week of legumes: Options include lentils, chickpeas, beans, and peas.

· Eat less meat

· Substitute wine in moderation for other alcoholic beverages. Replace beer or liquors with wine — no more than two 5-ounce glasses per day for men, and one glass per day for women.

· Cut out sugary beverages. Replace soda and juices with water.

· Eat less high-fat, high-sugar desserts. Poached or fresh fruit is best. Aim for three servings of fresh fruit a day. Save cakes and pastries for special occasions.

· Seek out the best quality food available [Harvard]

Dated: 22 th March, 2019

Current Temperature Status and Warning for next 24 hours

Heat Wave and Temperatures Observed Yesterday (Past 24 hours from 0830 hrs IST of 21 st March to 0830 hrs IST of 22 nd March, 2019)

Heat Wave:

.Yesterday, No heat wave conditions were observed.

Maximum Temperatures Recorded at 1730 Hours IST of 21st March, 2019:

• Maximum Temperature more than 40.0°C was recorded at isolated places over Rayalaseema. (Annexure-1).

• Maximum temperature departures as on 21-03-2019: Maximum temperatures are above normal (1.6°C to 3.0°C) at a few places over Kerala, Tamilnadu and Rayalaseema; at isolated places over Jammu & Kashmir, Punjab, Uttar Pradesh and East Madhya Pradesh. They are appreciably below normal (-3.1°C to -5.0°C) at isolated places over Himachal Pradesh; below normal (-1.6°C to -3.0°C) at isolated places over Gujarat state, Konkan & Goa, Vidarbha, Telangana, Odisha, West Bengal & Sikkim., Chhattisgarh and Assam & Meghalaya. (Annexure-2).

Yesterday, The highest maximum temperature of 41.1°C recorded at Anantapur (Rayalaseema) over the country.

Heat Wave Warnings for Next 24 hours(From 0830 hrs IST of 22 nd to 0830 hrs IST of 23rd March 2019):-


Rs 36 lakh awarded as compensation for medical negligence

Is it always negligent to miss a significant fetal anomaly on a routine ultrasound scan at 20 weeks?

Consumer Commission Order

Judges: Retired Justice Sunil Hali and retired District and Sessions Judge DK Kapoor

Complainants: Seema Kumari and her husband Atish Kumar


Dr KC Sharma and his wife Dr Uma Sharma were running an ultrasound scanning centre and nursing home at Udhampur "without adequate qualification, expertise and recognition from Medical Council of India".


Hydrocephalous; it could have been detected earlier, if the sonographers/sonologists were experienced and suitably qualified. ...read more

24th March is World TB Day (2)

Face masks and respirators: Personal respiratory protective equipment for TB prevention

As per the CDC, there are three levels of TB infection control in health-care settings.

The first level "administrative controls" should minimize the number of areas where exposure to Mycobacterium tuberculosis may occur.

The second level "environmental controls" should reduce the concentration of airborne TB bacteria in areas where exposure may occur. ...read more


What are the Ethics of Vidur Niti?