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Dr KK Aggarwal

From the Desk of Editor in Chief
Padma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Member Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR


Dear Colleague

1st April, 2010. Thursday

Padma Award Rehearsal – An innovative experience

When I got a call from the Home Ministry that I would be receiving my Padma Shri Award on 31st March and I also needed to come on the 30th for a dress rehearsal, at 10.30 am in Ashoka Hall in Rashtrapati Bhawan. This reminded me of the day I received my Dr BC Roy Award when a similar briefing was done an hour before the actual award ceremony.

I asked the Joint Secretary whether it was a necessary to attend the dress rehearsal, He said that the Ministry and the President House prefers that everybody attend, however, the dress rehearsal is optional as I had earlier experienced an award ceremony – the Dr BC Roy Award.

I reached Ashoka Hall in Rashtrapati Bhawan sharp at 10.30 am and by 11 am over 95 percent of the Padma awardees took their seats. On one side, Padma Vibhushan and Padma Bhushan awardees were seated and on the other side, there were Padma Shri awardees. A proper briefing was given by the Rashtrapati Bhawan staff and actual one–hour dress rehearsal took place at the Rashtrapati Bhawan.

Mr. Charanjit, who has been playing the role of dummy President of India for the last 13 years, yet again played his part to perfection and conducted the award ceremony. A major briefing point was that you get not more than a few seconds as a photo opportunity. We were briefed about – when to face the President and when and how to face the media for a photograph.

The Padma Shri award consists of a medallion and a certificate. A small replica of the medallion is also given which one is allowed to wear in State functions and other ceremonies as a mark of respect. During the ceremony, we also came to know that Padma Awards are not a degree. They are to be used with a respect. One can write Padma Shri Awardee before or after his or her name but not prefix Padma Shri before or after the name.

I noticed only difference when I compared it to the Dr B C Roy Award ceremony is that the citation was not read. Awardees were called one by one and the awards given.

Dr KK Aggarwal
Chief Editor

Photo feature

Dr KK Aggarwal receiving the nation’s fourth highest national civilian award, the Padma Shri, by President Smt. Pratibha Devi Singh Patil.

Dr k k Aggarwal  get Media Award

News and Views
(Dr Brahm Vasudeva and Dr Monica Vasudeva)

1. Basal insulin requirements less on day after dialysis

According to a study published March 9 in the journal Diabetes Care, basal insulin requirements may be less on the day after maintenance hemodialysis in type 2 diabetic patients with end–stage renal disease (ESRD). Dr Eugene Sobngwi, from University of Yaoundé in Yaoundé, Cameroon, and colleagues found a significant 25% reduction in basal insulin requirements the day after dialysis compared to the day before.

2. ED predict all–cause mortality, cardiovascular events

Erectile dysfunction (ED) is a robust predictor of all–cause mortality and cardiovascular events in men with cardiovascular disease or those with risk factors. All–cause mortality occurred in 11.3% of the men with ED at baseline vs. 5.6% of the men with no or mild ED at baseline. Composite primary outcome of cardiovascular death, myocardial infarction, stroke, and hospitalization for heart failure occurred in 16.2% of the men with ED vs. 10.3% of the men with no or mild ED.

3. Obesity may increase cancer risk

Overweight and obese people are more likely to develop cancer of various kinds. One theory is that extra weight boosts the body’s production of hormones such as estrogen, insulin, and insulin–like growth factor 1 –– all of which have the potential to promote the growth of certain tumors. Obesity may also contribute to cancer growth by causing cells to divide more rapidly.

4. Bone marrow transplants for severe, therapy–resistant asthma

Researchers at the National Institutes of Health are exploring a radical solution for asthyma–bone marrow transplants. Asthmatic mice who received such transplants had significantly decreased reactions to ragweed.

5. C. difficile infection rate surpasses MRSA in study of 28 hospitals

Infections from Clostridium difficile are surpassing MRSA infections. As per Duke researchers, deaths from C. difficile traditionally have been rare, but a more dangerous form has emerged in the last ten years.

Views ( Dr G M Singh)

The American Diabetes Association describes these common warning signs of ketoacidosis:

  • Feeling very thirsty or having a very dry mouth. Urinating frequently.

  • High blood sugar (glucose).

  • High ketone levels in the urine.

  • Persistent fatigue. Being confused or having difficulty paying attention.

  • Flushed or dry skin.

  • Feeling nauseous, vomiting, or having pain in the abdomen.

  • Difficulty breathing, and having breath that emits a fruity smell.



Renoprotective effect of the hydro-alcoholic extract of Rubia cordifolia roots:

Protective effect of the hydro-alcoholic extract of roots of Rubia cordifolia Linn. (HARC) against ethylene glycol induced urolithiasis has been described. Ethylene glycol feeding resulted in hyperoxaluria, hypocalciuria as well as increased renal excretion of phosphate. Supplementation with HARC significantly prevented change in urinary calcium, oxalate and phosphate excretion dose–dependently. The increased calcium and oxalate levels and number of calcium oxalate crystals deposits in the kidney tissue of calculogenic rats were significantly reverted by HARC treatment. The HARC supplementation also prevents the impairment of renal functions. (Divakar K, Pawar AT, Chandrasekhar SB, et al. Food Chem Toxicol. 2010 Apr;48(4):1013–8. )

What’s New: Gliptins and pancreatitis

Acute pancreatitis in patients using sitagliptin has been reported in postmarketing reports. Pancreatitis should be considered in patients with persistent severe abdominal pain and sitagliptin should be discontinued in such patients. (www.fda.gov/ Drugs/ DrugSafety/ PostmarketDrugSafety InformationforPatientsandProvi ders/ DrugSafetyInformationfor HeathcareProfessionals/ ucm183764.htm (Accessed October 5, 2009).

Diabetes Fact

DPP IV inhibitors are sitagliptin, saxagliptin, vildagliptin and alogliptin.

Public Forum (Press Release)

Summer precautions

Summer brings in disorders like heat cramps, heat exhaustion, heat stroke, typhoid, jaundice and diarrhea. The answer lies in prevention said Dr K K Aggarwal, President Heart Care Foundation of India and Editor eMedinewS. Heat disorders are caused by too much heat production or by too little heat loss.

Do’s and Don’ts

  • Strenuous exertion in a very hot environment should be avoided.

  • The best summer dress is light, loose–fitting clothing made of cloth that breathes such as cotton.

  • Fluids and salts lost through sweating can be replaced by consuming lightly salted foods and beverages, such as salted lemon water.

  • To replace adequate amounts of fluids, continue to drink fluids must continue even after thirst is quenched.

  • When exertion in a hot environment cannot be avoided, drinking plenty of fluids and frequently cooling the skin can help keep body temperature near normal.

  • People engaged in outdoor activities who drink large quantities of water may dilute sodium in the blood. Consuming salt can alleviate this problem.

  • Enclosed, poorly ventilated spaces, such as a car, can heat up rapidly. In hot weather, the interior of a closed car can heat from 80 to 120° F in 15 minutes. Children and pets should never be left in such an environment, even for a few minutes.

  • Maintain food and water hygiene during this season.

  • Do not eat cut fruits and vegetables that are left open.

  • Remember the formula: cook it, boil it, peel it, heat it or forget it.

Question of the day

How is osteoporosis best identified and diagnosed in primary care? (Dr GM Singh)

Osteoporosis is a chronic, asymptomatic condition, the acute outcome of which is a fragility fracture. It can be likened to hypercholesterolemia or hypertension, which are managed in primary care, the acute events of which are MI and stroke – managed in secondary care. Osteoporosis is diagnosed using dual–X–ray absorptiometry (DXA), which measures bone mineral density (BMD), expressed as T–scores – standard deviations of BMD away from that of a young adult of the same sex.

The cut–off T–score of –2.5 SD or lower, which defines osteoporosis, was never intended as a therapeutic threshold. Indeed, more patients experience fragility fractures with a BMD in the osteopenic range than with osteoporosis, because there are more people in the osteopenic range. The Z score compares the BMD of the patient to that of age – and sex–matched peers. The gold standard to diagnose osteoporosis is axial DXA to study vertebral and hip BMD, but peripheral DXA – for example in the forearm – can be used if this is not available. Ultrasound cannot diagnose osteoporosis but a low result is a risk factor for fracture.

Quote of the Day

Anyone can give up, it’s the easiest thing in the world to do. But to hold it together when everyone else would understand if you fell apart, that’s true strength.

SMS of the Day (Dr Ingole, MD)

Golden words of Success: See the clock only when you are working on. Clock is a lock for success!......(Bill Gates)

eMedinewS Try this it Works

Central line insertion

When placing a central line in the internal jugular vein, first use a thin, small–bore (e.g. 22–gauge) needle to puncture the vein. Making sure of a good return of the blood, keep this needle in place, along with the syringe. Now use this needle to guide placement of the larger central–line needle. Once free flow of blood is established in the central–line needle, remove the small needle. This method is less traumatic for the patient and reduces the number of attempts needed to place the central line.

Dr Good Dr Bad

Situation: A diabetic elderly came with low HDL levels.

Dr Bad: In elderly it has no significance.

Dr Good: Its an important risk factor.

Lesson: Lower HDL cholesterol is an important risk factor for not only IHD but also CVD, especially in diabetic elderly individuals. (Diabetes Care 2009;32(7):1221–3.)

Make Sure

Situation: A patient of pulmonary kochs talking ATT complains of numbness in fingers and toes.

Reaction: Oh my God! I forgot to prescribe vitamin b complex

Make sure that in patients talking ATT (including INH) B–complex vitamins (especially vitamin B6) are prescribed to prevent neuropathy . addition of antioxidants and multivitamins also boost the immune system.


Laughter the best medicine

The patient went to his Intensivist doctor for a checkup, and the Intensivist wrote out a prescription for him in his usual illegible writing. The patient put it in his pocket, but he forgot to have it filled. Every morning for two years, he showed it to the conductor as a railroad pass. Twice, it got him into the movies, once into the baseball park, and once into the symphony. He got a raise at work by showing it as a note from the boss. One day, he mislaid it. His daughter picked it up, played it on the piano, and won a scholarship to a conservatory of music.

Formulae in Critical Care

Plasma oxygen concentration

Formula: = Po2 × 0.0031

Milestones in Medicine

1800s AD Florence Nightingale, through her work during the Crimean War, established the foundation of modern nursing.

Mistakes in Clinical Practice

Medicines to be written in order of priority: the patient should know that the anti hypertensive drug for example, was the most important medicine for him and would have bought it before any other drug. Again a mistake which can be easily avoided by a little care on the part of the doctor.

Lab Test (Dr Naveen Dang)

Anticardiolipin antibodies are used to help investigate inappropriate blood clot formation, to determine the cause of recurrent miscarriage, or as part of an evaluation of antiphospholipid syndromes.

List of Approved drug from 1.01.2009 to 31.10.2009

Drug Name


Approval Date

Octinoxate 7.5% + Avobenzone 3% + Oxybenzone 3% + Titanium dioxide 2% lotion

As sunscreen lotion for prevention of sunburn skin


(Advertorial section)


Zen Immune Beauty helps improve the brittleness of nails and increase the hair tensile strength, thus preventing hair loss. It stimulates regeneration of hair roots, helps prevention of comedone formation and post comedone skin scarring in acne vulgaris.

Advertising in eMedinewS

eMedinewS is the first daily emedical newspaper of the country. One can advertise with a single insertion or 30 insertions in a month.

Contact: drkk@ijcp.com or emedinews@gmail.com

eMedinewS–PadmaCon 2010 

Will be organized at Maulana Azad Medical College, New Delhi on July 4, 2010, Sunday to commemorate Doctors’ Day. The speakers, chairpersons and panelists will be doctors from NCR, who have been past and present Padma awardees.

eMedinewS–revisiting 2010

The second eMedinewS–revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, cultural hungama and live webcast. Suggestions are invited.

NATIONAL SEMINAR ON STRESS PREVENTION (17 – 18 April). Over 400 registrations already done.

A Stress Prevention Residential Seminar cum spiritual retreat with Dr KK Aggarwal and Experts from Brahma Kumaris will be organized from April 17–18, 2010.

Co–organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, IMA New Delhi Branch and IMA Janak Puri Branch, IMSA (Delhi Chapter)

Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.

Timings: On Saturday 17th April (2 pm onwards) and Sunday 18th April (7 am–4 pm). There will be no registration charges, limited rooms, kindly book in advance; stay and food (satvik) will be provided. Voluntary contributions welcome. For booking e–mail and SMS to Dr KK Aggarwal: 9811090206, emedinews@gmail.com BK Sapna: 9811796962, bksapna@hotmail.com

Also, if you like emedinews you can FORWARD it to your colleagues and friends. Please send us a copy of your forwards


Delhi Medical Council Presents

An interaction with

Dr. Ketan Desai, President, Medical Council of India, 
Mr. Mukul Rohtagi, Senior Advocate, Supreme Court of India, &
Dr A K Aggarwal, President, Delhi Medical Council

Topic: Medical Ethics & Doctor–Pharma Relationship – New MCI Amendments

Date: April 10, 2010, Saturday

Time: 6 pm – 9 pm

Venue: Maulana Azad Medical College Auditorium, Dilli Gate, New Delhi

Dr KK Aggarwal: Moderator, and Chairman Ethical Committee Delhi Medical Council

Dr Girish Tyagi: Registrar, Delhi Medical Council

For Registration SMS to Dr KK Aggarwal: 9811090206 , No fee or email to emedinews@gmail.com

Readers Responses

  1. Dear Dr. Aggarwal, Heartiest congratulations for the Padam Shri Award which you are going to receive today from the country’s President. I addtion I am indeed pleased to read your expert comments on matters of daily concern to the physicians and e–medicine news are very enlightening. Please keep it up. Dr. K.L.Gupta. Professor of Nephrology, PGI Chandigarh

  2. Dear Dr Aggarwal, God Bless you. Keep it up a very well deserved Award. Dr Arvind Garg and Dr Suneela Garg