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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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10-13); National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

4th April 2013, Saturday

Low cholesterol linked to anxiety, depression, suicide, hemorrhagic stroke and cancers

People with very low cholesterol levels are at increased risk of developing stomach cancer, according to a study published in the International Journal of Cancer.

The study involved 2,600 residents of Hisayama, Japan, who were followed for 14 years. Gastric cancers developed in 97 subjects. After accounting for age and gender, stomach cancer rates rose significantly with descending cholesterol level. For example, among subjects with the highest cholesterol levels, the gastric cancer rate was the equivalent of 2.1 cases per 1000 persons per year; among those with the lowest cholesterol, the rate was 3.9 per 1000 persons per year.

Patients with low serum cholesterol should consider periodic gastrointestinal examination for the prevention of stomach cancer.

Low cholesterol has been earlier linked to depression, anxiety and suicide in both men and women. Another earlier report has also shown that people with cholesterol level below 180 had twice the risk of brain hemorrhage as compared to those with cholesterol levels of 230.

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

Rapid flu test more accurate when positive

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Heart Care Foundation of India
organized an event with His Holiness
Sri Sri Swami Parmanand Ji Maharaj
on Sunday 28th April 2013.

Dr K K Aggarwal
    National News

Time limit of abortions raised to nine weeks

The time limit for abortions has been increased from seven to nine weeks to facilitate family planning, the Drug Controller General of India has said. Nozer Sherian, secretary general of the Federation of Obstetric and Gynaecological Societies (FOGSI), said here Friday: "The Drug Controller General has increased the time limit of abortions to 63 days, that is nine weeks." In the last two years, 332,000 medical abortions were carried out, which show that if given a choice, women want to limit their families. "This is very important as around eight percent of maternal deaths take place due to unsafe abortions," he said.

FOGSI is promoting medical abortions along with Intrauterine Medical Devices (IUD) to help people plan their families. Hema Diwakar, president of FOGSI, said that women are now given a choice of post-placental IUD as soon as they give birth. The family planning initiative taken up by the FOGSI and the Population Services International (PSI) is called 'Pehel'. It is run mostly in urban slums. It covers 30 districts in Rajasthan, Uttar Pradesh and Delhi. Ten additional districts in these three states would be covered in the next phase. "Pehel Phase 3 will continue to complement the government's efforts to reduce maternal mortality and increase the contraceptive prevalence rate," said Pritpal Marjara, director of PSI. According to government data, every year about 78,000 women die during pregnancy, child birth or within 43 days of delivery in India. (Source: The Pioneer, 26 April 2013)

For comments and archives

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, every Thursday 4:30 PM in DD India

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


All about child sexual abuse

  1. Children who are victims of sexual abuse should receive a thorough evaluation.
  2. Evaluation should include careful questioning and a complete physical examination.
  3. Evidence-collection procedures, and/or specialized examination techniques may be required.

For comments and archives

    Valvular Heart Disease Update

How common is MS in the elderly?

Mitral stenosis is relatively uncommon in elderly adults. Mitral annular calcification occasionally causes mitral obstruction. For patients with symptomatic mitral stenosis, percutaneous balloon valvotomy is the procedure of choice if valvular morphology is favorable but it is not indicated in patients with mitral obstruction due to mitral annular calcification.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

COPD: CDC report suggests progress in prevention

Prevention of chronic obstructive pulmonary disease (COPD) has improved in the United States during the last decade, according to CDC surveillance results published online April 25 and in the July issue of Chest. (Source: Medscape)

For comments and archives

ECG alarm alerts docs to silent killer

An institution-wide, computer-based alert system for irregular heart rhythms identified and characterized patients at risk of death, researchers found. Patients identified by the alert system with a greater than 500 ms corrected interval between the Q and T waves of their ECG cycle had a significantly higher risk of death compared with a QTc interval less than 500 ms (19% versus 5%). (Source: Medpage Today)

For comments and archives

FDA okays Kcentra to reverse anticoagulation, stop bleeding

The US Food and Drug Administration (FDA) today approved a plasma-derived product for the urgent reversal of vitamin K antagonist (VKA) anticoagulation in adults with acute major bleeding. (Source: Medscape)

For comments and archives

Eczema: Evening primrose oil, borage oil not helpful

Evening primrose oil (EPO) and borage oil (BO) provide little benefit for the relief of atopic eczema compared with placebo, according to a new review published in the April issue of the Cochrane Database of Systematic Reviews. (Source: Medscape)

For comments and archives

PFO stroke risk may be overstated

Among healthy older adults who were followed for more than a decade, the presence of a patent foramen ovale (PFO) was not associated with ischemic stroke or subclinical cerebrovascular disease. (Source: Medpage Today)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: Heart disease may present with asthma like symptoms http://bit.ly/YiCZIw #Health

@DeepakChopra: Success also requires risk-taking, intuitive leaps, innovation, and thinking outside the box. My article http://tinyurl.com/bvkqmwy

    Spiritual Update

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

Why are coconut and the kalash used in all poojas?

If nature wanted you to drink coconut water in non-coastal areas it would not have grown coconuts in the coastal areas is a common naturopathic saying. Coconut water is the treatment for most humidity-related illness in costal areas. It is sterile water and has been used in surgical practice as a sterile fluid. It is also used as a replacement for oral rehydration solution. Hence, because of its many uses it is regarded as the ‘Tree of Life’.

For comments and archives

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the side effects of using gonadotropins?

  • Ovarian hyperstimulation syndrome (OHSS): It is characterized by enlarged ovaries and fluid accumulation in the abdomen after ovulation or egg retrieval. It can be either mild or severe. The mild form occurs in 10-20% of cycles and results in some discomfort but almost always resolves without complications. When severe, it can result in blood clots, kidney dysfunction, twisting of an ovary (torsion), fluid collections in the chest and abdomen and rarely even death. Most patients who are at high risk for severe OHSS are identified by closely monitoring ovulation induction cycles with the daily use of ultrasounds and/or serum estradiol levels. When serum estradiol levels are rising rapidly and/or are too high, or excessive numbers of ovarian follicles develop, one strategy for prevention of severe OHSS is to withhold further gonadotropin stimulation and delay hCG administration until estradiol levels plateau or decline.
  • Multiple gestations: Up to 30% of pregnancies, which result from cycles involving gonadotropin stimulation, are multiple, in contrast to a rate of 1-2% without fertility medications.

    The risk of multiple gestations is dependent upon the number of mature eggs released in an ovulation induction cycle and the number of embryos transferred in an IVF cycle. While most of these pregnancies are twins, a significant percentage (up to 5%) are triplets or higher. Twins and high order (>2) multiple gestation pregnancy are associated with an increased risk of pregnancy loss, premature delivery, infant abnormalities, handicap due to the consequences of very premature delivery, pregnancy-induced hypertension, hemorrhage and other significant maternal complications.
    Tat Tvam Asi………and the Life Continues……

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

Whole blood

Definition: Whole blood contains 350 ml. of donor blood plus anticoagulants.

Volume: 350 ml.

Storage: Between 2°C to 6°C in approved Blood Bank refrigerator

Shelf Life: 35 days

For comments and archives

    An Inspirational Story

Arms and legs for others

Bob Butler lost his legs in a 1965 land mine explosion in Vietnam. He returned home a war hero. Twenty years later, he proved once again that heroism comes from the heart.

Butler was working in his garage in a small town in Arizona, USA on a hot summer day; when he heard a woman’s screams coming from a nearby house. He began rolling his wheelchair toward the house but the dense shrubbery wouldn’t allow him access to the back door. So he got out of his chair and started to crawl through the dirt and bushes.

“I had to get there”, he says. “It didn’t matter how much it hurt”. When Butler arrived at the pool there was a three-year-old girl named Stephanie Hanes lying at the bottom. She had been born without arms and had fallen in the water and couldn’t swim. Her mother stood over her baby screaming frantically. Butler dove to the bottom of the pool and brought little Stephanie up to the deck. Her face was blue; she had no pulse and was not breathing.

Butler immediately went to work performing CPR to revive her while Stephanie’s mother telephoned the fire department. She was told the paramedics were already out on a call. Helplessly, she sobbed and hugged Butler’s shoulder.

As Butler continued with his CPR, he calmly reassured her. Don’t worry, he said. “I was her arms to get out of the pool. It’ll be okay. I am now her lungs. Together we can make it”.

Seconds later the little girl coughed, regained consciousness, and began to cry. As they hugged and rejoiced together the mother asked Butler how he knew it would be okay. The truth is, “I didn’t know”, he told her. “But when my legs were blown off in the war, I was all alone in a field. No one was there to help except a little Vietnamese girl. As she struggled to drag me into her village, she whispered in broken English, ‘It okay. You can live. I be your legs. Together we make it’ “. Her kind words brought hope to my soul and I wanted to do the same for Stephanie.

There are simply those times when we cannot stand alone. There are those times when we need someone to be our legs, our arms, our friend.

For comments and archives

  Cardiology eMedinewS

More proof soft drinks tied to diabetes Read More

  Pediatric eMedinewS

Guidelines: Preterm infants require vitamin D supplement Read More

    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

Can the IM and ID routes of vaccination be used interchangeably?

It is recommended by many internationally reputed experts that the phenomenon of mixing of IM and ID schedules is not to be practiced and must be avoided as far as possible.

    IJCP Special

Dr Good Dr Bad

Situation: A patient had a strong family history of cancer.
Dr Bad: Just get regular check ups.
Dr Good: Take low dose aspirin.
Lesson: A new observational analysis published online in the Lancet reports that long–term daily aspirin reduced death due to several common cancers. (Ref: Rothwell PM, et al. Effect of daily aspirin on long–term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet 2011 Jan 1;377(9759):31-41)

Make Sure

Situation: A patient on 10 units of insulin developed hypoglycemia with 11 units of insulin.
Reaction: Oh by God! Why was additional insulin given?
Lesson: Make sure that the insulin dose is correctly calculated. The formula is 1500/total daily dose. The value will be the amount of sugar fluctuation with one unit of insulin.

  Quote of the Day (Dr GM Singh)

A total commitment is paramount to reaching the ultimate in performance. Tom Flores

    Mind Teaser

Read this…………………

Nurse Agnes is reviewing the report of a client’s routine urinalysis. Which value should the nurse consider abnormal?

a. Specific gravity of 1.03
b. Urine pH of 3.0
c. Absence of protein
d. Absence of glucose

Yesterday’s Mind Teaser: Nurse Lea is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention?

a. Rashes on the palms of the hands and soles of the feet
b. Cauliflower-like warts on the penis
c. Painful red papules on the shaft of the penis
d. Foul-smelling discharge from the penis

Answer for Yesterday’s Mind Teaser: d. Foul-smelling discharge from the penis

Correct answers received from: Dr Jayashree Sen & Dr Bitaan Sen, Rajiv Kohli, Raju Kuppusamy, Dr Suresh Arora, Dr BB Gupta, Dr Santha Kumari,
Dr Raghavendra Jayesh, Dr Pankaj Agarwal, Dr Nageswara Rao Patnala,
Dr Jainendra Upadhyay, Dr U Gaur, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, drjella, Dr Avtar Krishan, Dr KV Sarma, Deepali Chatterjee, Arundhati Malviya, Dr PK Sahu, Dr Kanta Jain, Dr BK Agarwal

Answer for 2nd May Mind Teaser: b. Weight loss

Correct answers received from: Dr BK Agarwal, Dr KP Chandra.

Send your answer to ijcp12@gmail.com

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    Laugh a While (Dr GM Singh)

The Vicious Circle

The boss calls his secretary and says, “Get ready for the weekend. We are going on a business trip."

The secretary calls husband and says, "Me and my boss are going on a business trip for 2 days so take care of yourself"

The husband calls his mistress and says, "My wife is going on a business trip. Come home we can have fun"

The mistress calls the boy to whom she gives tuition, “No tuition this weekend."

The boy calls his grandfather, “Grandpa at last we can spend this weekend together."

Grandpa (The boss) calls his secretary and says, "Business trip is canceled. I'm going to spend weekend with my grandson."

The secretary calls husband, "I won't be going"

The husband calls his mistress, "I am sorry My wife is not going"

The mistress calls boy, "You have tuition"

Boy calls his grandpa and says, "Sorry grandpa I've classes"

The grandpa calls secretary and...

    Medicolegal Update

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

What is lucid interval?

Lucid interval is the period during which the mentally unsound person behaves very much like a normal person. During this period all the signs and symptoms of insanity are absent. The person is responsible for all his acts performed during the period of lucid interval.

For comments and archives

    Public Forum

Public Forum (Press Release for use by the newspapers)

Benefits of smoking cessation

The benefits of quitting cigarette smoking are formally established, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA. In those with heart disease, reduction in cardiac events associated with smoking cessation range from 7 to 47%. Similar benefits are noted with patients with heart disease.

The earlier you quit, greater the benefits

  1. People who quit smoking before the age of 50 reduce their risk of dying over the next 15 years as compared to those who continue to smoke.
  2. Cigarette smoking increases the risk of developing heart disease and smoking cessation can rapidly reduce this risk.
  3. One year after quitting smoking, the risk of dying from heart disease is reduced by 50% and if continued, the risk could decline further overtime.
  4. The risk of heart attack is reduced to that of non-smokers within two years of quitting smoking.
  5. In patients with asthma and COPD, stopping smoking can reduce further damage to lungs.
  6. Cigarette smoking is responsible for 90% of lung cancers. Smoking cessation reduces the risk of lung cancers by five years and to that of non–smokers by 15 years.
  7. The risk of osteoporosis is reduced to that of non-smokers by 10 years.
  8. Weight gain can occur while trying to quit smoking because people tend to eat more after stopping. It is typically 2–5 pounds in the first two weeks followed by an additional 4–7 pounds over the next 4–5 months. The average weight gain is 8–10 pounds.

    Smoking cessation, therefore, should be associated with exercise programme and a proper diet plan to minimize weight gain. However, it should be emphasized that the benefits of quitting smoking are far greater than the risk of gaining weight.

Smoking and Heart

  1. Smoking 20 cigarettes a day increases the risk of heart attack in women by 6 folds.
  2. Smoking 20 cigarettes a day increases the risk of heart attack in men by 3 folds.
  3. Smoking is responsible for 36% patients of first heart attack.
  4. Heart patients who continue smoking have more chances of second heart attack, increased risk of death and sudden cardiac death.
  5. Persistent smoking after bypass surgery leads to increased mortality, cardiac deaths and re–bypass.
  6. Persistent smoking after angioplasty leads to greater risk of death and heart attack.
  7. In patients with heart functioning of less than 35%, smoking leads to high mortality.
  8. Blood pressure medications may not work properly in patients who continue to smoking.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 47982 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

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  1. Dear Sir, emedinews is very useful. Regards:Dr Raman
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