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  From the Desk of Editor–in–Chief
Dr KK Aggarwal

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; Chairman Ethical Committee 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

  Editorial …

4th February, 2011, Friday                                eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

Today is World Cancer Day

Cancer is a leading cause of death around the world. WHO estimates that 84 million people will die of cancer between 2005 and 2015 without intervention. Each year on 4 February, WHO supports International Union Against Cancer to promote ways to ease the global burden of cancer. Preventing cancer and raising quality of life for cancer patients are recurring themes.

7 Danger Signs and Symptoms of Cancer

Any person with the following classical 7 danger signals of cancer and with back ground of exposure to carcinogenic factors /lifestyles should be subjected to thorough investigations.

  1. Unusual bleeding or discharge
  2. A lump or thickening in the breast or any other part of the body
  3. A sore throat that does not heal
  4. Change in bowel or bladder habits
  5. Persistent hoarseness or cough
  6. Persistent indigestion or difficulty swallowing.
  7. Change in a mole or wart

Cancer data: BRAIRCH, AIIMS

  • Cancer is the largest cause of preventable death and illness globally.
  • 8–9 lakhs deaths are attributed to tobacco/year i.e. it outnumbers those caused by AIDS, malaria, tuberculosis combined.
  • Bidi kills 6 lakhs/year.
  • 3 lakh cancer cases are tobacco–related cancer (TRC).
  • > 2,200 die/day due to tobacco.
  • 40% of all cancers and 95% of oral cancers are TRC.
  • Oral cancer is the commonest TRC and Rs 3.5 lakhs are spent for treatment/case and 70% recur after treatment
  • 13% of all deaths (premature) by 2020 (>38.4 million beedi smokers and 13.2 million cigarette smokers are likely to die prematurely)
  • Increasing taxes on cigarettes to 78 percent of retail price will avert 3.4 million premature tobacco-related deaths, while increasing Rs.146.3 billion in additional revenues each year.
  • Economic costs related to treatment of tobacco related ailments are 16% higher than annual tax generated from tobacco. A recent paper on Economic Cost of Tobacco Use in India, 2004 reveals that the "direct medical costs of treating tobacco related diseases in India amounted to Rs.4125 crore for smoked tobacco and Rs. 1296 crore for smokeless tobacco. The indirect morbidity costs of tobacco use, which includes the cost of caregivers and value of work loss due to illness, amounted to Rs. 1810 crore for smoked tobacco and Rs. 473 crore for smokeless tobacco. The total economic cost of tobacco use amounted to Rs 7731 crore."
Dr KK Aggarwal
Editor in Chief
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  eMedinewS Audio PostCard

  2nd eMedinewS Revisiting 2010

Revisiting the Year 2010 with Dr KK Aggarwal
New MCI regulations – Endorsements

Audio PostCard
  Quote of the Day

(By Dr GM Singh)

"Children find everything in nothing; men find nothing in everything."

Giacomo Leopardi

    Photo Feature

2nd eMedinewS Revisiting 2010

Dr Ajit Saxena recieving eMedinewS Excellence Awards of the year 2010 in the 2nd eMedinewS revisiting 2010 on 9th January 2011 at Maulana Azad Medical College.

Dr K K Aggarwal
    National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

Infant mortality rate shows decline

The Infant Mortality Rate (IMR) in India has come down to 50 (deaths per 1,000 live births) from 53, showing a reduction of three points as compared to 2008, and eight points since 2005, when the national average was 58. The latest data released by the Registrar–General of India (RGI) in its Sample Registration System for the calendar year of 2009 shows a nine-point decline in rural IMR during 2005–2009 compared to six points in cities and towns. The IMR is the lowest in Goa at 11, though it was 10 in 2008, followed by Kerala at 12. The worst performers are Madhya Pradesh at 67, Orissa at 65, Uttar Pradesh at 63, and Assam at 61. In Tamil Nadu, the IMR has come down from 31 in 2008 to 28 in 2009. The States and Union Territories that have recorded a four–point decline in the IMR in 2009 compared to 2008 are Bihar, Jammu and Kashmir, Karnataka, Orissa, Rajasthan, U.P., the Andaman and Nicobar Islands, Daman and Diu, and Lakshadweep. The States that recorded a three–point decline in 2009 compared to 2008 are Andhra Pradesh, Assam, Chhattisgarh, Haryana, Madhya Pradesh, Punjab, Tamil Nadu, Tripura, Uttarakhand, and Puducherry. (Source: http://www.thehindu.com/health/policy–and-issues/article1130983.ece)

    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC http://www.isfdistribution.com)

February 4th is National Wear Red Day

February 4th is National Wear Red Day. Everyday, women are dying at the rate of almost one per minute. Show your support for the fight against heart disease by wearing Red. It’s easy to be a part of this national movement. Simply ask your staff to wear red to work at the gym that day.

(Dr Monica and Brahm Vasudev)

CK–MB best indicator of PCI complications

Troponin I appears to be a relatively poor marker for detecting necrosis relating to percutaneous coronary interventions versus myocardial infarction –– whereas creatine kinase–myocardial band (CK–MB) may be "more clinically relevant," researchers reported. Based on results of a 32–patient prospective trial, "CK–MB should currently be the preferred biomarker" for periprocedural injury related to PCI, a research group declared in the Feb. 8 issue of the Journal of the American College of Cardiology. (Medpage Today)

FDA says no to weight–loss combo drug

A pill combining bupropion and naltrexone for weight loss (Contrave) won’t receive the FDA’s approval until its manufacturer, Orexigen, conducts a new clinical trial evaluating its cardiovascular risks, the company said. In an unusual move, the agency went against the recommendation of its advisory committee on endocrine and metabolic drugs, which voted 13–7 in December in favor of approval. (Medpage Today)

‘Selective’ imaging recommended for low back pain

Diagnostic imaging is overused in routine treatment of low back pain for various reasons and should be reserved for patients with specific risk factors, according to a new guideline from the American College of Physicians. To reduce the unnecessary expense and radiation exposure, clinicians should order imaging scans "only in selected, higher–risk patients who have severe or progressive neurologic deficits or are suspected of having a serious or specific underlying condition. Factors that call for imaging studies include the following:

  • Major risk factors for cancer, such as history of cancer combined with new onset of back pain
  • Risk factors for spinal infections
  • Severe neurologic deficits
  • Signs or risk factors associated with cauda equina syndrome, such as new–onset urine retention or fecal incontinence

On the other hand, patients with symptoms or risk factors for other spinal conditions such as ankylosing spondylitis or radiculopathy should first have a trial of therapy before resorting to imaging studies. (Medpage Today)

More Parkinson genes uncovered

Five new genomic variants associated with Parkinson’s disease were discovered in a reanalysis of data from five earlier genome–wide scans –– which also confirmed six other variants linked to the disease in the earlier studies. In what was described as the largest genetic analysis of Parkinson’s disease to date –– encompassing more than 5,000 Parkinson’s patients and over 12,000 controls –– the 11 genomic variants accounted for 60.3% of the population–attributable risk for Parkinson’s disease in the study samples (95% CI 43.7% to 69.3%), researchers reported online in The Lancet. (Medpage Today)

    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

We have been trying for a baby for three years and I was diagnosed as having endometriosis. Will test–tube baby treatment solve my problem?

IVF is the treatment of choice in women with severe or moderate endometriosis. However, depending on the severity of the endometriosis, surgery, intrauterine insemination can also be used.

We were told that we need IVF treatment, what is our chance of achieving a live birth?

The overall live birth rate per treatment cycle is in the region of 20–30%.

For queries contact: banerjee.kaberi@gmail.com

    Pediatric Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity

What is the recommendation for post exposure prophylaxis for contacts following needle prick from an unknown case?

If the HBsAg status of the source is unknown

  • Unvaccinated exposed patient: Hepatitis B vaccine Series
  • Exposed patient with known response to vaccine: No treatment
  • Exposed patient with known failed response to vaccine: Treat source as HBsAg positive if high risk
  • Exposed patient with unknown response to vaccine
    • Test for antibody to HBsAg: If Adequate antibody, No treatment.
    • Inadequate antibody: Hepatitis B vaccine initial and booster dose; recheck titer in 1 to 2 months.
    Rabies Update

Dr A K Gupta, Author of "RABIES – the worst death"

Is there any seasonal variation in dog bite cases?

It was noted in a study that majority of dog bite cases were reported in winter season. Dogs tend to behave aggressively during winter season due to the fact that they tend to protect their offspring from human beings.

    Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

Place where pregnancy may be terminated

No termination of pregnancy shall be made in accordance with this act at any place other than:

  • a hospital established or maintained by the Government, or
  • a place for the time being approved for the purpose of this Act by Government or a District Level Committee constituted by that government with the Chief Medical Officer or District Health Officer as the Chairperson of the said Committee:
  • The District Level Committee shall consist of not less than three and not more than five members including the Chairperson, as the Government shall specify from time to time.
  • Under section4, before its substitution by the present section by the Medical Termination of Pregnancy (Amendment) Act, 2002, no termination of pregnancy could be made in accordance with the act at any place other than a hospital established or maintained by the government, or
  • a place for being approved for the purpose of the Act by the government.

(Ref: MTP Act 1971)

    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Q. Doctors registered under the PNDT Act have to keep record of pregnant and nonpregnant women separately. If they can’t perform sonography on non– pregnant then what is the idea of having a separate register for nonpregnant patients?


  • A doctor registered under the PNDT Act is not barred from performing ultrasonography on non-pregnant women or on men if he is competent to do so by virtue of his qualifications, such as MD in Radiology/ Radiodiagnosis.
  • The PNDT authorities are concerned only with ultrasounds done on pregnant women and not with other ultrasounds. That may be the reason why doctors registered under the PNDT Act have to keep record of pregnant and nonpregnant women separately.
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Uric Acid

  • Increase in serum uric acid is seen idiopathically and in renal failure, disseminated neoplasms, toxemia of pregnancy, psoriasis, liver disease, sarcoidosis, ethanol consumption, etc. Many drugs elevate uric acid, including most diuretics, catecholamines, ethambutol, pyrazinamide, salicylates, and large doses of nicotinic acid.
  • Decreased serum uric acid level may not be of clinical significance. It has been reported in Wilson’s disease, Fanconi’s syndrome, xanthinuria, and (paradoxically) in some neoplasms, including Hodgkin’s disease, myeloma, and bronchogenic carcinoma.
    Medi Finance Update

Money Market Funds

The rate of return of money market funds tends to be lower than that of funds that are managed for long–term gains, but they are a very low–risk investment.

    Drug Update

LIST OF APPROVED DRUG FROM 01.01.2010 TO 31.8.2010

Drug Name
DCI Approval Date
Lornoxicam 4mg/4mg + Thiocolchicoside 4mg/8mg tablets
For the treatment of patients with acute painful musculoskeletal conditions
Our Contributors
  Docconnect Dr Veena Aggarwal
  Docconnect Dr Arpan Gandhi
  Docconnect Dr Aru Handa
  Docconnect Dr Ashish Verma
  Docconnect Dr A K Gupta
  Docconnect Dr Brahm Vasudev
  Docconnect Dr GM Singh
  Docconnect Dr Jitendra Ingole
  Docconnect Dr. Kaberi Banerjee
  Docconnect Dr Monica Vasudev
  Docconnect Dr MC Gupta
  Docconnect Dr. Neelam Mohan
  Docconnect Dr. Naveen Dang
  Docconnect Dr Prabha Sanghi
  Docconnect Dr Prachi Garg
  Docconnect Rajat Bhatnagar
  Docconnect Dr Sudhir Gupta
    IMSA Update

International Medical Science Academy (IMSA) Update

Lumbar spinal stenosis surgery

A review of data related to lumbar spine surgery found an association between an increased frequency of complex fusion procedures and the incidence of major complications and 30–day mortality.

(Reference: Deyo RA, et al. Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA 2010 Apr 7;303(13):1259–65)

    IJCP Special

Dr Good Dr Bad

Situation: A patient was diagnosed with HIV–AIDS.
Dr Bad: You will die within ten years.
Dr Good: You can live a fairly normal life span.
Lesson: In the 1980s, a young adult diagnosed with AIDS typically survived less than one year. Today, a similar person can expect to live to age 70 or beyond if he or she is diagnosed with HIV infection early, has access to and receives appropriate therapy, and can tolerate the drugs and their side effects.

Make Sure

Situation: A patient on 10 units of insulin developed hypoglycemia after taking a light breakfast.
Reaction: Oh my God! Why was the insulin dose not reduced?
Lesson: Make sure that insulin dose is correct. The formula is 500/total daily dose. The value will be the amount of sugar fluctuation with 10 gms of carbohydrates.

    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr. Prachi Garg)

House of 1000 Mirrors

Long ago in a small, far away village, there was place known as the House of 1000 Mirrors. A small, happy little dog learned of this place and decided to visit.

When he arrived, he bounced happily up the stairs to the doorway of the house. He looked through the doorway with his ears lifted high and his tail wagging as fast as it could. To his great surprise, he found himself staring at 1000 other happy little dogs with their tails wagging just as fast as his. He smiled a great smile, and was answered with 1000 great smiles just as warm and friendly. As he left the House, he thought to himself, "This is a wonderful place. I will come back and visit it often."

In this same village, another little dog, who was not quite as happy as the first one, decided to visit the house. He slowly climbed the stairs and hung his head low as he looked into the door. When he saw the 1000 unfriendly looking dogs staring back at him, he growled at them and was horrified to see 1000 little dogs growling back at him. As he left, he thought to himself, "That is a horrible place, and I will never go back there again."

All the faces in the world are mirrors. What kind of reflections do you see in the faces of the people you meet?

— — — — — — — — — —

Mind Teaser

Read this…………………


Yesterday’s Mind Teaser: OHOLENE
Answer for yesterday’s Mind Teaser:
Hole in one

Correct answers received from: Dr Meera Rekhari, Dr Rakesh Bhasin, Dr K.Raju, Dr Chandresh Jardosh, Dr H.L. Kapoor, Dr Anil Bairaria

Answer for 2nd February eQuiz: The correct answer is B.
Correct answers received from: Dr Jainendra Upadhyay, Dr Gattani RK

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr GM Singh)

There were these two friends, Bill and Bob, and they both loved baseball. So, they made a promise to each other, the first one to die, will come back and let the other know if there's baseball in heaven. Well, the day comes and Bob passes. Weeks turn to months while Bill is still waiting to hear from his friend.

Then one day, Bill is walking down the street, and Bob appears. Bill all excited, says: "I’ve been waiting forever! So tell me, is there or isn’t there Baseball in heaven?" Bob kinda perks up and says: "I’ve got good news and bad news." "1st, there is Baseball in heaven! The bad news is you’re pitching Friday!"

Knowledge is amusing

DRAWING ROOM was actually a ‘withdrawing room’ where people withdrew after Dinner. Later the prefix ‘with’ was dropped.

— — — — — — — — — —

    Readers Responses
  1. Respected sir, Can a MD Medicine perform GI endoscopy? Regards: Dr Harinder Miglani eMedinewS Responds: Yes, endoscopy can be performed by all MD physicians as long as they sign it as Physician and Gasteroenterologist.
    Public Forum

(Press Release for use by the newspapers)

Snorers at risk of sudden death

The interrupted nighttime breathing of sleep apnea increases the risk of dying said Senior Consultant Moolchand Medcity, President Heart Care Foundation of India Dr. KK Aggarwal, Padma Shri & Dr. B.C. Roy National Awardee. Sleep apnea is a common problem in which one has pauses in breathing or shallow breaths during sleep.

Studies have linked sleep apnea during snoring to increased risk for death. Most studies were done in sleep centers rather than in the general community. Now a new Australian study, published in Aug. 1 edition of Sleep, suggests that the risk is present among all people with obstructive sleep apnea.

The study researcher Nathaniel Marshall, from Woolcock Institute of Medical Research in Sydney, said that the size of the increased mortality risk is surprisingly large. The study showed a six–fold increase, which means that having significant sleep apnea at age 40 gives you about the same mortality risk as somebody aged 57 who does not have sleep apnea.

For the study, Marshall’s team collected data on 380 men and women, 40 to 65 years old, who participated in the Busselton Health Study. Among these people, three had severe obstructive sleep apnea, 18 had moderate sleep apnea, and 77 had mild sleep apnea. The remaining 285 people did not suffer from the condition. During 14 years of follow–up, about 33 percent of those with moderate to severe sleep apnea died, compared with 6.5 percent of those with mild sleep apnea and 7.7 percent of those without the condition. For patients with mild sleep apnea, the risk of death was not significant and could not be directly tied to the condition.

People who have, or suspect that they have, sleep apnea should consult their physicians about diagnosis and treatment options.

Another study by researchers from the University of Wisconsin has also shown that severe sleep apnea was associated with a three-fold increased risk of dying. In addition, for those with moderate to mild sleep apnea, the risk of death was increased 50 percent compared with people without sleep apnea. Sleep apnea is also linked to future heart attacks and with thickened wall thickness of the neck artery.

Moolchand Medcity is running a special awareness campaign to detect neck artery wall thickness in the month of February.

    Forthcoming Events

Maulana Azad Medical College SPIC-MACAY chapter is organizing a festival of music & dance

Date: 2nd to 5th February, 2011. 
All are invited


2nd February, Wednesday   3:00 pm– 4:00 pm    Panchavadyam by Vidwans – Auditorium Inauguration – Dr Sonal Mansingh (Odissi Dance) Pandit Hariprasad Chaurasia (Flute)
3rd February, Thursday, 10:00 am –Madhubani Painting Workshop – by Smt. Shanti Devi – Old Girl’s Hostel
4th February, Friday, 4:00 pm –Qawwalli by Qadir Niazi and troupe– Auditorium
5th February, Saturday, 9:00 am –Heritage walk by Dr. Ramji Narayan  –(Ferozshah Kotla)
Meeting point college fountain

We look forward to having you with us during this festival.

*Please be seated 15 minutes before the event,
*We request you to switch off your cellphones during the programmes.
*No flash photography and videography allowed during the programme.

Maulana Azad Medical College has been organizing such programmes for students, staff, faculty and doctors. The aim being to experience the beauty of our culture and enrich lives with beautiful moments.  The programmes are extremely relaxing for all. Such programmes are important as they help decrease stress, something which all doctors experience in routine.

eMedinewS Events: Register at emedinews@gmail.com

Conference Column

Workshop on Fetal and Paedatric Echocardiography Pre and perinatal management of heart disease

13th February 2011, Sunday, Moolchand Medcity

  1. Fetal Echocardiography–How to get it right: Dr Vandana Chaddha
  2. Fetal Cardiac Spectrum– abnormal cases with interactive session: Dr Vandana Chaddha
  3. Neonatal Cardiac Cases– Hits and misses inetractive session: Dr Savitri Srivastava
  4. Intima Media Thickness and Plaque Volume, New Marker for Atherosclerosis Regression: Dr KK Aggarwal

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