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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 (07–08c); 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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Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of 1st Mega Ajmer Health Camp 2012

 
  Editorial …

4th April 2012, Wednesday

Exercise impact on the knee

Different exercises produce different impacts on the knee joints. The best and safest exercises that cause minimum impact on the knee in patients post knee replacement or knee arthritis are walking, biking, hiking, riding an exercise bike, riding an elliptical trainer and walking on the treadmill. In sports, one can play doubles tennis but not singles. One can also participate in downhill or cross–country skiing. Jogging and golf swings produce maximum stress.

Impact

  • Biking generate the least force, producing impact of about 1.3 times the person’s body weight.
  • Treadmill walking is the next best, producing forces of 2.05 the body weight.
  • Walking on level ground generate forces of 2.6 times the body weight.
  • Tennis produces forces of 3.1 to 3.8 times the body weight, with serving producing the highest impact.
  • Jogging produces forces of 4.3 times body weight.
  • Golf swings produces forces of 4.5 times body weight on the forward knee and 3.2 times body weight in the opposite knee.

Positions and activities placing excessive pressure on the knee joint

  • Squatting and kneeling
  • Twisting and pivoting
  • Repetitive bending (multiple flights of stairs, getting out of a seated position, clutch and pedal pushing, etc.)
  • Jogging
  • Aerobics, dancing
  • Playing stop and go sports (basketball, sports that use racquets)
  • Swimming using the frog or whip kick

Exercise equipment placing excessive pressure on the knee

  • Stair stepper
  • Stationary bicycle
  • Rowing machine
  • Universal gym utilizing leg extensions

The preferred exercise equipment for the knee should provide smooth motion of the knee, maximal toning of the front and back thigh muscles (quadriceps and hamstring muscles), minimal jarring and impact to the joint and the least amount of bending to accomplish toning.

Activities that are acceptable alternatives to the above:

  • Fast walking
  • Water aerobics
  • Swimming using the crawl stroke
  • Cross country ski machines
  • Soft platform treadmill
  • Trampoline

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
    eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Exercise impact on the knee

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

First Mega Ajmer Health Camp

Yoga facilities were provided to the patients as a part of prevention.

 
Dr K K Aggarwal
 
    National News

Culex menace: The sting that triggers encephalitis

NEW DELHI: The sudden spurt in the number of Culex mosquito has sent alarms bells ringing among the authorities concerned. NVBDCP has deputed an eight–member team to visit different regions of Delhi between 5am and 7am on Tuesday morning to collect female Culex specimens in order to quantify its density. NVBDCP says the male Culex mosquito feeds solely on plant nectar through its two–week existence. It’s the female Culex that requires a blood meal to nourish her eggs before she lays them. The female lays 100 to 300 eggs at a time that hatch two days later. A female lays a raft of eggs every third night during its life span. MCD medical officer Dr N K Yadav told TOI, "Unlike mosquitoes like Aedes or Anopheles that breed in fresh water, Culex breeds in stagnant dirty water in drains. As part of our strategy finalized in our meeting last week with health officials and vets from in and around Delhi, we will try and cover as many open drains as possible. We will use BTI in drains we can’t shut to blast the larvae." (Source: TOI, Apr 3, 2012)

For Comments and archives

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

 
    International News

This World Health Day, focus on ageing and health

With nearly eight percent of southeast Asia’s population above the age of 60 years, the World Health Organisation (WHO) Monday said it will draw global attention to ageing to highlight it as a rapidly emerging priority that most countries in the region have yet to address adequately. The number of aged people will double by 2025 and triple by 2050, the global health body said ahead of World Health Day April 7. "Older women outnumber and outlive older men. Gender discrimination and widowhood has a considerable impact on the health of elderly women," said Samlee Plianbangchang, WHO’s Regional Director for South–East Asia. "Poor nutrition in the womb leads to disease in adulthood. Preventing diseases through immunization, good nutrition, and healthy lifestyles will result in an elderly population that is a rich resource for families, communities and nations," Plianbangchang added. National policies to promote healthy ageing exist in Bangladesh, DPR (North) Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka and Thailand. But there is an urgent need to focus attention on issues such as economic effects of ageing on the health care system, ways of ensuring independence in old age, quality of life and health problems of elderly females and very old persons, the WHO says. (Source: TOI, Apr 2, 2012)

For comments and archives

FDA OKs test for HTLV screening, diagnosis

The FDA has approved a test that screens a donor’s blood and blood components for antibodies to viruses that can cause leukemia and neurologic diseases. The Avloq HTLV–I/II Microelisa System is the first test approved for both scanning blood for antibodies to human T–lymphotropic virus type I and II (HTLV–I and –II), and helping diagnose infection with them, an FDA statement said. The test was approved for live donors’ blood, as well as for testing serum and plasma specimens of potential organ donors and as an aid in diagnosis of HTLV–I and –II infection and related diseases. The system is not approved for non–living patients or for cord blood screening. (Source: Medpage Today)

For comments and archives

HPV infection rate down after vaccine approval

The prevalence of infection with cancer–causing strains of human papillomavirus (HPV) declined among women during the period that coincided with the introduction of HPV vaccine, investigators reported at the Society of Gynecologic Oncology meeting. (Source: Medpage Today)

For comments and archives

Statins alter predictive value of LDL

Among patients taking statins, on–treatment levels of non–high–density lipoprotein (non–HDL) cholesterol may be best for predicting future cardiovascular events, according to a meta–analysis. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: #IJMD Comparison of shear bond strength of three different company composites cured with plasma arc curing light…

@DeepakChopra: Your life has a purpose. That purpose is unfolding continually, becoming richer and deeper.

 
    Spiritual Update

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Power: The New Medicine on the Block or Power: Reviving the Ailing Politicians

What keeps politicians alive? Undoubtedly, it’s luck that saves them from the militant’s bullet and the wonder of POWER.

It’s the power that makes the heart of these aged politicians beat. The love for limelight and not VIAGRA, gives them that extra horsepower.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the psychological aspects of hirsutism and PCOS?

Dealing with hirsutism and PCOS can be emotionally difficult. You may feel unfeminine, uncomfortable, or self–conscious about your excessive hair growth or weight, as well as worry about your ability to have children. Even though you may be embarrassed to share these feelings with other people, it is very important that you talk to your physician as soon as possible to explore the medical and cosmetic treatments available to treat these disorders.

For comments and archives

 
    Celiac Disease Update

(Dr Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation, Medanta – The Medicity Hospital, Gurgaon)

What is refractory celiac disease?

A tiny minority of patients suffer from refractory disease, which means they do not improve on a gluten–free diet. This may be because the disease has been present for so long that the intestines are no longer able to heal on diet alone, or because the patient is not adhering to the diet, or because the patient is consuming foods that are inadvertently contaminated with gluten. If alternative causes have been eliminated, steroids or immunosuppressants (such as azathioprine) may be considered in this scenario.

For comments and archives

 
    Tat Tam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Q: What is hemoglobin?

Hemoglobin is a substance present in the red cells. It helps in carrying the oxygen and carbon dioxide. On an average, it should be between 14 – 16 gm% in a healthy male and about 12 ’ 14 gm% in a female. This is also being daily synthesized and new one is replacing the old stock.

Q: What are the various blood groups?

Every individual has two types of blood groups. First is called the ABO Grouping and the second type is called Rh grouping.

In the ABO Group, there are four categories namely "A", "B", "O" and "AB".

In the Rh Group, the individual is either Rh–positive, or Rh–negative. Rh is a factor called as Rhesus factor that has come to us from our ancestors called Rhesus monkeys.

Thus each and very human being will fall in one of the following groups.

  • A positive or A negative
  • B positive or B negative
  • O positive or O negative
  • AB positive or AB negative

There are certain subgroups also. But, for all practical purposes this should suffice.

For comments and archives

 
    Medi Finance Update

(Tarun Kumar, Chartered Accountant)

Other amendments

  • Time limit for completion of assessment, re–assessments, revisions and appellate proceedings extended.
  • Closely held companies to explain the nature and source of money in the hands of shareholders, for any sums received from them as Share application/share capital/share premium.
  • Time limit for issue of notice for reopening assessments is enhanced to 16 years where income relating to assets situated outside India has escaped assessment.
  • Limit for Tax audit increased from:
    • Rs. 60 lakhs to 100 lakhs for business
    • Rs. 15 lakhs to Rs.25 lakhs for professionals
  • Exemption available to Hotels u/s 35 AD for capital expenditure will be allowed to the owners of the hotel, even if operation thereof is transferred to another franchisee. Amendment is explanatory in nature.
  • In the cases of search initiated after 01.07.2012, Penalty on undisclosed income will be levied as follows, If undisclosed income

• Admitted during the search subject to fulfillment of certain conditions

10%

• Not admitted during the search, but disclosed in the return of Income filed after the search subject to fulfillment of certain conditions

20%

• Not admitted as above but found during assessment

30% to 90%

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

Different Things Motivate Different People

There was a young boy who used to come for regular practice but always played in the reserves and never made it to the soccer eleven. While he was practicing, his father used to sit at the far end, waiting for him.

The matches had started and for four days, he didn’t show up for practice or the quarter or semifinals. All of a sudden he showed up for the finals, went to the coach and said, "Coach, you have always kept me in the reserves and never let me play in the finals. But today, please let me play."

The coach said, "Son, I’m sorry, I can’t let you. There are better players than you and besides, it is the finals, the reputation of the school is at stake and I cannot take a chance." The boy pleaded, "Coach, I promise I will not let you down. I beg of you, please let me play." The coach had never seen the boy plead like this before. He said, "OK, son, go, play. But remember, I am going against my better judgment and the reputation of the school is at stake. Don’t let me down."

The game started and the boy played like a house on fire. Every time he got the ball, he shot a goal. Needless to say, he was the best player and the star of the game. His team had a spectacular win. When the game finished, the coach went up to him and said, "Son, how could I have been so wrong in my life. I have never seen you play like this before. What happened? How did you play so well?"

The boy replied, "Coach, my father is watching me today." The coach turned around and looked at the place where the boy’s father used to sit. There was no one there. He said, "Son, your father used to sit there when you came for practice, but I don't see anyone there today." The boy replied, "Coach, there is something I never told you. My father was blind. Just four days ago, he died. Today is the first day he is watching me from above."

Self motivation is the key of success…………

For comments and archives

 
    Legal Question of the Day

(Prof. M C Gupta, Advocate & Medico–legal Consultant)

Q. I have a BAMS degree and am registered under Indian Medical Practitioners Act, 1963 & Indian Medicine Central Council Act, 1970. Can I practice allopathy? Please answer with a positive approach.

Ans.

  1. There is no Act like Indian Medical Practitioners Act, 1963. You probably mean Maharashtra Medical Practitioners Act, 1961.
  2. There is no relevance of the Maharashtra Medical Practitioners Act, 1961 after the Indian Medicine Central Council Act, 1970, came into force.
  3. The irrationality of the Maharashtra Medical Practitioners Act, 1961, is obvious from the following unbelievable definition of a Medical Practitioner as given in section 2(2) of the Act––

    "(2) For the purposes of Chapter VI, a person shall be deemed to practice any system of medicine who holds himself out as being able to diagnose, treat; operate or prescribe medicine or other remedy or to give medicine for any ailment, disease, injury, paid, deformity or physical condition or who, by any advertisement, demonstration, exhibition or teaching offers or undertakes, by any means or method whatsoever to diagnose, treat, operate or prescribe medicine or other remedy or to give medicine for any ailment, disease, injury, pain, deformity or physical condition".
  4. None of the two Acts mentioned by you allow a BAMS to practice allopathy. Such practice is illegal in terms of many Supreme Court judgments.
  5. There is no question of answering your question with a positive or negative approach. Law knows only one approach—the correct one.

For comments and archives

 
    Fitness Update

(Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, www.mymonavie.com/sonraj)

Physical activity has minimal impact on the risk of obesity in TV viewing youth

Time spent watching television among children and adolescents has grown exponentially in the past twenty years. Most households in the United States have at least one, if not multiple, television sets. A recent study in Europe looked at data from 2200 young people in 10 different cities, assessing physical activity levels, TV watching, habits, and obesity rates. The study found that that watching TV both during the week and on weekends, eating while watching TV, and having a TV in the bedroom increased the risk of obesity, independent of physical activity levels.

Research has consistently shown that physical activity is important for children. Given these results, physical activity should be complemented with moderate TV viewing. Authors recommend that parents avoid placing TV sets in a child’s bedrooms and keep the TV off during mealtimes.

For comments and archives

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    Cardiology eMedinewS

Frequent Chocolate Consumption Linked To Lower BMI Read More

ACC: Checklist Cuts HF Readmissions Read More

Bypass Surgery Bests Stents In Real-World Survival Read More

Lung-Protective Ventilation Linked To Improved Survival Read More

 
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Frequent Chocolate Consumption Linked To Lower BMI Read More

Antibiotic Use In CF May Have Down Side Read More

Girls Born ‘Big’ Face CVD Risk As Teens Read More

Kids Recover More Easily From Intracapsular Vs Total Tonsillectomy Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A female with diabetic kidney disease wanted to know if she could take OCP (oral contraceptive pills).
Dr Bad: You can.
Dr Good: You cannot.
Lesson: There is a link between OCP and diabetic kidney disease.

For comments and archives

Make Sure

Situation: A diabetic patient died of flu pneumonia.
Reaction: Oh my God! Why was flu vaccine not given?
Lesson: Make sure that all diabetics are given flu vaccine every year.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

The future has many names: For the weak, it means the unattainable. For the fearful, it means the unknown. For the courageous, it means opportunity. Victor Hugo

 
    Mind Teaser

Read this…………………

Polyps are generally managed endoscopically. Which of the following is not an indication for resectional surgery?

a) Lymphovascular invasion
b) Poor differentiation
c) Flat or ulcerated lesion
d) Lesion in upper one-third of submucosa

Yesterday’s Mind Teaser: Which of the following is not true for malignancy of familial adenomatous polyposis?

a) Adrenals
b) Thyroid
c) Astrocytomas
d) Hepatoblastomas

Answer for yesterday’s Mind Teaser: c) Astrocytomas

Correct answers received from: Gopal Shinde, Dr Mrs S Das, Dr PC Das, Yogindra Vasavada, Raju Kuppusamy, Dr Chandresh Jardosh, Anil Bairaria, Dr Valluri Ramarao.

Answer for 2nd April Mind Teaser: ONE WORD

Correct answers received from: Dr N Sandhya, Dr Jainendra Upadhyay, Anil Bairaria, Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

For comments and archives

 
    Laugh a While

(Dr GM Singh)

Doctor, Doctor Have you got something for a bad headache?

Doc: Of course. Just take this hammer and smash yourself in the head.
Then you’ll have a bad headache.

 
    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

Postmortem examination in death due to Adverse Events Following Immunization (AEFI)

The detailed history of the patient is included in the autopsy form that is submitted to the team (Autopsy Surgeon/Pathologist/Forensic Specialist) conducting autopsy. The additional specific information to the autopsy team will help them look for any underlying disease/pathologies in the deceased which may be cause of death or contributed in the cause of death.

  • It is recommended that an autopsy in a death suspected to be due to an AEFI be performed as soon as possible (within 72 hours) to avoid tissue damage, development of postmortem artifacts and autolysis of the adrenal glands, which can alter diagnosis.
  • Samples for both histopathological and toxicological examination should be sent to approved and accredited government reference laboratories through investigating police agencies. The samples should be collected and transported to forensic laboratories as early as possible to avoid loss of biological samples due to decomposition.
  • All samples should be labeled with the name, number and autopsy report/form number along with the necessary documents requesting the examination and investigation, and the conclusions from the autopsy, which should list the cause of death, utilizing International Classification of Disease (ICD 10) and, if possible, the causative agents/drugs.
  • Sampling for histopathology examination to be sent to pathologist for underlying disease/pathologies in the deceased which may be the cause of death or contributed in the cause of death: The samples should be representative of the suspicious area of disease/pathology; however, in general 80 to 100 gms of liver, 100 gms of brain with meninges, fragments from both adrenal glands, half of transverse section of kidneys, half of Spleen and whole heart should be taken.
  • All the visceral specimens should be collected in separate containers, a wide – mouthed bottle as prescribed and 10% formalin should be added as preservatives. The quantity of the formalin should be sufficient to cover all the pieces of specimen viscera in bottle.
  • The specimens should be sealed, signed, labeled by the doctor/autopsy surgeon and should be handed over to police/investigating officer for further pathological examination.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Tips for patients with family history of high cholesterol

Premature heart disease is when heart disease occurs before 55 years in men and 65 years in women. In premature heart disease the prevalence of dyslipidemia (high cholesterol levels without symptoms) is 75–85%, said Dr. K.K. Aggarwal, Padma Shri and Dr B C Roy National Awardee and President, Heart Care Foundation of India.

Fifty–four percent of all patients with premature heart disease and 70% of those with a lipid abnormality have a familial disorder. Screening for lipids is therefore recommended for first–degree relatives of patients with MI (particularly if premature). Screening should begin with a standard lipid profile and if normal, further testing should be done for Lp(a) and apolipoproteins B and A–I.

Approximately 25% patients with premature heart disease and a normal standard lipid profile will have an abnormality in Lp(a) or apo B. Elevated apo A–1 and HDL are likewise associated with decreased CHD risk.

First–degree relatives refer to brothers, sisters, father, mother; second–degree relatives are aunts, uncles, grandparents, nieces, or nephews. The third–degree relatives refer to first cousins, siblings, or siblings of grandparents.

Familial hypercholesterolemia (FH) is a genetic disorder, characterized by high cholesterol, specifically very high LDL (or the bad cholesterol) levels, and premature heart disease. Patients may develop premature cardiovascular disease at the age of 30 to 40. Heterozygous FH is a common genetic disorder, occurring in 1:500 people in most countries. Homozygous FH is much rarer, occurring in 1 in a million births. Heterozygous FH is normally treated with drugs. Homozygous FH often does not respond to medical therapy and may require apheresis or liver transplant.

To detect familial high cholesterol levels one must do universal screening at age 16. The cholesterol levels in heterozygous patients are between 350 to 500 mg/dL, and in homozygous, the levels are between 700 to 1,200 mg/dL.

 
    Readers Responses
  1. Dear Sir, The Spiritual blog was really a meaningful reading. Regards: Dr Seema
 
    Forthcoming Events
Dr K K Aggarwal


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BSNL Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
http://www.heartcarefoundation.org

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

 
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