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emedinews is now available online on www.emedinews.in or www.emedinews.org
Dr KK Aggarwal

From the Desk of Editor in Chief
Padmashri 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

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Dear Colleague

3rd March 2010, Wednesday

10 Small Steps for Better Heart Health

Here are 10 small steps, as reported by Harvard Health Newsletter, to get one on the road to better health in 2010.

  1. Take a 10–minute walk. If you don’t exercise at all, a brief walk is a great way to start. If you do, it’s s a good way to add more exercise to your day.

  2. Give yourself a lift. Lifting a hardcover book or a two–pound weight a few times a day can help tone your arm muscles. When those become a breeze, move on to heavier items or join a gym.

  3. Eat one extra fruit or vegetable a day. Fruits and vegetables are inexpensive, taste good, and are good for everything from your brain to your bowels.

  4. Make breakfast count. Start the day with some fruit and a serving of whole grains, like oatmeal, bran flakes, or whole-wheat toast.

  5. Stop drinking your calories. Cutting out just one sugar–sweetened soda or calorie–laden latte can easily save you 100 or more calories a day. Over a year, that can translate into a 10–pound weight loss.

  6. Have a handful of nuts. Walnuts, almonds, peanuts, and other nuts are good for your heart. Try grabbing some instead of chips or cookies when you need a snack, adding them to salads for a healthful and tasty crunch, or using them in place of meat in pasta and other dishes.

  7. Sample sea food. Eat fish or other types of seafood instead of red meat once a week. It’s good for the heart, the brain, and the waistline.

  8. Breathe deeply. Try breathing slowly and deeply for a few minutes a day. It can help you relax. Slow, deep breathing may also help lower blood pressure.

  9. Wash your hands often. Scrubbing up with soap and water often during the day is a great way to protect your heart and health. Flu, pneumonia, and other infections can be very hard on the heart.

  10. Count your blessings. Taking a moment each day to acknowledge the blessings in your life is one way to start tapping into other positive emotions. These have been linked with better health, longer life, and greater well–being, just as their opposites — chronic anger, worry, and hostility — contribute to high blood pressure and heart disease.

    Dr KK Aggarwal
    Chief Editor

News and Views

Nitoglycerin for prostate cancer

Treatment of prostate cancer with very low dose of nitroglycerin may slow and even halt the progression of the disease, Queen’s University researchers report. The 24–month, phase II study targeted 29 men with increasing levels of prostate–specific antigen (PSA) following prostate surgery or radiation. PSA levels are a key predictor of cancer progression. As per Robert Siemens, the leader of the study and a Professor of Urology at Queen’s University and urologist at Kingston General Hospital, the men were treated with a low–dose, slow–release nitroglycerin skin patch and their PSA levels were monitored. Of the 17 patients who completed the study, all but one showed a stabilization or decrease in the rate of cancer progression, as measured by their PSA Doubling Time. This trial was based on a key finding from pre–clinical research carried out at Queen’s, which showed that decreases in nitric oxide play an important role in tumor progression and that this progression can be stopped by low–dose nitroglycerin. (Urology 2009;74(4):878–83)

What is Schizophrenia?

Schizophrenia is a complex, life–shortening, and frequently debilitating neuropsychiatric disorder characterized by early onset, high comorbidity rates, poor medication adherence, significant morbidity, and a relapsing–remitting course that often includes hospitalization. most commonly manifests as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking with significant social or occupational dysfunction.

Radiation from airport scanners too low to pose danger

An editorial published in the BMJ states that consumers need not worry about the radiation dose from an airport scanner. The machines produce so little low intensity X–ray radiation that a person would have to undergo 1,000 to 2,000 screens to receive radiation similar to one chest X–ray. The machines are even safe for children and pregnant women.

Consuming large amounts of fat may raise stroke risk for women over 50

There is 30% greater risk of stroke among women eating the most trans fats, which is common in stick margarine, fried foods, crackers, and cookies. Study determines cervical cancer vaccine may not be benefit women over 40. A new study published in the Journal of the National Cancer Institute has determined that the vaccine for HPV may not be very beneficial for women older than 40.

Stroke rising among younger adults, decreasing among elderly

More and more young people (<45 yrs) these days have strokes while older people are reporting fewer such episodes. The average age of stroke patients in 2005 was nearly three years younger than the average age of stroke patients in 1993–1994. The percentage of people 20 to 45 having a stroke was up to 7.3 percent in 2005 from 4.5 percent in 1993–1994. (Dr Brett M. Kissela, Associate Professor, Co–Director of the Neurology Residency Program, and Vice–Chair of Education and Clinical Services at the University of Cincinnati Neuroscience Institute)

Stop the sale of electronic mosquito repellents

A campaign to stop the sale of electronic mosquito repellents by major airlines is beginning to bear fruit with the immediate withdrawal of the products from KLM flights. These electronic repellents, sold to airline passengers, many on their way to malaria endemic countries, just don’t work.

Treat egg allergies with eggs

Children with egg allergies, who consume increasingly higher doses of egg protein, appear to gradually overcome their allergies, tolerating eggs better over time and with milder symptoms, according to research conducted at Johns Hopkins Children’s Center.

Most deviations from guidelines may be correct

According to an observational study published in the journal Annals of Internal Medicine, physician–recorded medical exceptions are correct most of the time. In the setting of a large internal medicine practice, physicians recorded 650 standardized medical exceptions i.e. documenting medical reasons for deviating from recommendations put forth by guidelines, during a period of seven months. The reporting tool was used without any medical reason 36 times (5.5%). Of the remaining 614 exceptions, a peer–review panel classified 93.6% as medically appropriate, 3.1% as inappropriate, and 3.3% as having uncertain appropriateness. After physicians received direct feedback about inappropriate exceptions, 8 of 19 (42%) changed management. (Source: Ann Intern Med 2010;152:225–231)

FDA approves Norvir in Tablet formulation

The tablet form of Norvir (ritonavir) has been approved by the FDA. Norvir is indicated for treatment of HIV infection. Norvir has been previously available in soft–gel–capsule and oral–solution formulations. Norvir tablets are to be taken with meals, while capsules are not required to be taken with meals. Also, unlike the capsules, the new 100–mg Norvir tablets are heat–stable and do not require refrigeration.


Conference Calendar

PCOS & The Syndrome X
Date: March 19–21, 2010
Venue: Goa Marriott Resort, Miramar Beach, Goa, India

Quote of the Day

Who rises from prayer a better man, his prayer is answered. (George Meredith)

Diabetes Fact

Alpha–glucosidase inhibitors can be given in diabetes Type 1 and in post prandial hyperglycemia. It causes flatulence. Miglitol and acarbose are alpha–glucosidase inhibitors.

Public Forum (Press Release)

Guidelines about Eating

Malnutrition and wrong dietary habits have been identified as major risk factors for ill health, including heart attacks. Most people below the poverty line suffer from malnutrition due to lack of calories, proteins and vitamins in their food. In the affluent society overeating or eating wrong food results in overnutrition, a form of malnutrition leading to heart blockages.

In this context Heart Care Foundation of India (HCFI) has formulated guidelines about eating said Dr. K K Aggarwal, President, Heart Care Foundation of India and Editor eMedinewS.

These include:

  1. Eat only when you are hungry.

  2. Do not eat for pleasure, social obligations or emotional satisfaction.

  3. Eat at a slow pace

  4. Eat less; dinner less than lunch.

  5. Take small mouthfuls each time, chew each morsel well, swallow it and only then take the next morsel.

  6. Do not eat while watching television, driving a car or watching sports events. The mind is absorbed in these activities and one does not know what and how much one has eaten.

  7. Do not talk while eating and never enter into heated arguments. The stomach has ears and can listen to your conversation. It will accordingly send signals to the mind and heart.

  8. Plan and decide in advance what and how much food you will be eating.

  9. Use low fat or skimmed mild dairy products. For cooking, use oils which are liquid at room temperature.

  10. Do not take red meat and if you are a non-vegetarian, you may take poultry meat or fish.

Question of the day

How is the temperature of a child measured? (DR G M Singh)

Normal temperature is 98.40F. Do not give much thought to such exact readings as it may show mild deviation between 36° and 36.8° C (97.7° to 99.1°F). Temperature can be taken by placing the thermometer into the child’s mouth, under their arm or using strips that are placed on the forehead. The thermometer under the tongue will take two to three minutes to read the temperature. If the child has just eaten anything hot or cold, wait for 10 minutes before an accurate temperature can be taken. This method is not suitable for a young child. They may bite the thermometer and break it, which is very dangerous. Thermometer strips, which can be placed on the child's forehead, have become very popular, but their readings are not very precise and they are not recommended. The temperature of their surroundings very easily affects a child's body temperature.

eMedinewS Try this it Works

Ethyl chloride substitute found in office product

Ethyl chloride is often used to anesthetize the skin before incision and drainage of small skin abscesses. Tetrafluoroethane in a canister, used to remove dust from personal computers, can serve as a handy substitute.

Dr Good Dr Bad

Situation: A diabetic of 20-year duration came for a routine check up. Dr Bad: Get blood sugar done.
Dr Good: Also, get your sugar, eye and kidney check up done. Lesson: The risk of cataract increases with increasing diabetes duration and severity of hyperglycemia. Data from the Beaver Dam Eye Study, the Blue Mountains Eye Study, and the Visual Impairment Project, have documented associations between diabetes and cataract. (Source: Diabetes Care 2008;31:1905–1912)

Make Sure

Situation: A diabetic hypertensive was denied a beta–blocker because of traditional teaching.
Reaction: Oh my God! You should have used nebivolol.
Make sure that diabetics are not denied beta–blockers when indicated. Nebivolol has no effect on glucose metabolism unlike atenolol. (Source: Am J Hypertens 2005;18 (12, pt. 2):169S–176S)

Medi Finance
(BUDGET 2010–2011)


Income tax slabs for any other individual taxpayers to be as follows:

Income upto Rs 1.6 lakh Nil
Income above Rs 1.6 lakh and upto Rs. 5 lakh 10 %
Income above Rs.5 lakh and upto Rs. 8 lakh 20 %
Income above Rs. 8 lakh 30 %
Punjab & Sind Bank
Central Bank of India

Laughter the best medicine

Actual medical record: On the second day the knee was better and on the third day it had completely disappeared.

Formulae in Critical Care

Oxygen delivery per minute (DO2)
Formula: DO2 = Cardiac output × CaO2
Comment: Normal value is 1 L/min.

Milestones in Neurology

Hans Berger (1873 –1941) was born in Neuses near Coburg, Thuringia, Germany. He is known as the first to record electroencephalograms from human subjects and is the discoverer of the rhythmic Alpha brain waves.

Mistakes in Clinical Practice

Do not use abbreviations of drug names—not everyone uses the same abbreviations.

11th March World Kidney Day (Dr N P Singh)

Kidney diseases are Common, Harmful and Treatable

1–7 April Prostate Disease Awareness Week: Prostate SMS of the Day (Dr Anil Goyal)

All enlargements of prostate do not encroach upon the urinary passage. Interference with urination occurs only in 50% of person with enlarged prostate gland and in many, disturbance is of minor degree.

Lab test (Dr Navin Dang)

No serology test like TB, ELISA or TB gold (gamma interferon) or Mantoux is conclusive for tuberculosis.

List of Approved drug from 1.01.2009 to 31.10.2009

Drug Name


Approval Date

Milnacipran 25/50mg Caps (Addl. Indication)

For the management of fibromylagia


(Advertorial section)


Zen Immune Power – a known immunity booster with ability to help reduce absorption of aluminum from the GI tract and enhance excretion through kidneys and is a key to eliminate aluminum toxicity and the related systemic involvement.

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. 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.

Stress Management Workshop (April 17–18)

A Stress Management Workshop with Dr KK Aggarwal and Experts from Brahma Kumaris will be organized on April 17–18, 2010.

Organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, in association with IMA New Delhi Branch and IMA Janak Puri Branch

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

Timings: On Saturday (2pm onwards) and Sunday (7am 4pm). There will be no registration charges, limited rooms, kindly book in advance, stay and food (satvik) will be provided. For booking e–mail to emedinews@gmail.com or sms to Dr KK Aggarwal 9811090206/ BK Sapna 9811796962

Stroke Update Workshop for GPs

Indian Stroke Association and International Stroke Conference is organizing a Stroke Update Workshop on March 13–14, 2010 at AIIMS Auditorium. eMedinewS has tied up with the conference for free registration for the first 200 GPs of NCR. Organizer: Dr Padma, Prof of Neurology, AIIMS, New Delhi. SMS for free registration to 9717298178 or email to isacon2010@gmail.com

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

Readers Responses

  1. Dear Sir, Deeply impressed by the highly enlightening interpretation of ‘Holika’, thanx a lot for the same! Yours: Dr. Gurdev Singh

  2. Dear Dr. KK ji: Holy description of Holi is marvelous. Regards: Dr. NK Bhatia

  3. Heartiest congratulations for the brilliant achievement in Prestigious Padmashree and being elected member of MCI. Congrats once more. Keep it up: Dr Rajesh and Dr Swati Makashir

  4. Dear Dr. KK Aggarwal thanks for printing the news of Madras High court asking state government to take action against quacks, physiotherapists etc using prefix ‘Dr’ with their name. Yesterday, DMC had raided two clinics outside GTB Hospital where quacks were performing Ultrasounds and were arrested. This news has been printed in today’s Hindustan Times and the Hindi daily, Hindustan: Dr. Anil Bansal, IMA Senior Joint Secretary