Head Office: 39 Daryacha, Hauz Khas Village, New Delhi, India. e-Mail: drkk@ijcp.com, Website: www.ijcpgroup.com
emedinews is now available online on www.emedinews.in or www.emedinews.org
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

7th April, 2010 Wednesday: Today is World Health Day

Pledge: Let us all take a pledge today to make our city a clean, green and hygienic city. Let us treat our parks as our farm houses; rivers and lakes as our swimming pools; metro buses as our personal five star cars and community halls as our personal drawing rooms AND keep them as clean as our own houses. Let us treat each international visitor during commonwealth games as our personal guest.

Breaking News: Screen for ‘pre–CKD’ among pre–diabetics

Chronic Kidney Disease(CKD) screening should be extended to patients with prediabetes, and clinicians should consider the concept of ‘pre–CKD, i.e. identifying patients in the early stages of CKD when it’s preventable or reversible. Current doctors recommend annual CKD screening only in those with diabetes.

In US alosne 1.3 crore adults have undiagnosed or pre-diabetes and chronic kidney disease (CKD). A CDCstudy analyzed 8,188 Americans from the National Health and Nutrition Examination Survey from 1996 to 2006. Published in the Clinical Journal of the American Society of Nephrology the study showed that the CKD prevalence was 39.6% and 41.7% in those with diagnosed and undiagnosed diabetes, respectively. In those with prediabetes, CKD was 17.7%, compared with 10.6% in non–diabetics.

Of those with diagnosed diabetes and CKD, 39% had stage 3 or 4 CKD, and for those with undiagnosed diabetes and CKD, 40.6% had stage 3 or 4 CKD. Among prediabetics, 56.2% had stage 3 or 4 CKD.

Among those with stage 3 or 4 CKD, evidence of albuminuria and reduced kidney function was present in 19.4%, 20.7%, 18.0%, and 14.5% of those with diagnosed diabetes, undiagnosed diabetes, prediabetes, and no diabetes, respectively.

Lesson: all patients with fasting blood sugar between 90 and 126 should undergo not only tests for preclinical atherosclerosis but also for pre clinical CKD ( rule out underlying silent heart and kideny diseases in them)  

Dr KK Aggarwal
Padmashri Awardee and Chief Editor

News and views

Medpage Meeting Notes: American College of Cardiology
Atlanta, GA  • March 14 – 16, 2010

1. Degree of rate control questioned in atrial fibrillation trial

For patients with permanent atrial fibrillation, lenient control of heart rate does not result in worse outcomes than stricter control. Through three years, the rate of adverse outcomes was similar in the two groups. (Dr Isabelle Van Gelder, University Medical Center Groningen in the Netherlands)

2. Old trumps new in stent comparison

For patients with chronic stable coronary artery disease, the first–generation sirolimus–eluting stent (Cypher) was better than the second–generation zotarolimus–eluting stent (Endeavor) for preventing major adverse cardiac events. Through nine months, the rate of cardiac death, myocardial infarction, and target vessel revascularization was doubled in the zotarolimus group compared with the sirolimus group. (Dr Michael Maeng, Aarhus University Hospital in Denmark).

3. Novel ablation system improves atrial fibrillation outcomes

An investigational cryoablation system was substantially better than antiarrhythmics in treating paroxysmal atrial fibrillation, a multicenter, randomized STOP–AF trial has shown.Through one year, 69.9% of patients who underwent cryoablation remained free from treatment failure, compared with just 7.3% of those on medical therapy, (Dr Douglas Packer, Mayo Clinic in Rochester, Minn).

4. Mixed results for intensive initial dosing for acute HF

More aggressive loop diuretic dosing early in the treatment of acute heart failure appears safe and may provide some clinical benefit. But continuous infusion provided no advantage over 12–hour boluses in a randomized clinical trial (Dr G. Michael Felker, Duke University)

5. Verruciform xanthoma (VX) is a hyperplastic condition of the mouth and sometimes of the genitalia with accumulation of lipids within macrophages, underneath the epithelium. The etiology is unknown, but it probably represents an unusual immune response to epithelial damage. It is typically seen in white patients as a well–demarcated, soft, painless, papillary, slightly elevated mass in the gingiva. There may be multiple masses. The treatment is conservative excision, and recurrence is rare. (Dr G M Singh)

What’s New: Tight BP Control

The Cardio–Sis trial compared the effects of tight systolic blood pressure control (target <130 mmHg) and usual control (target <140 mmHg) among patients with cardiovascular disease or an additional cardiovascular risk factor. Patients with the lower target had a decreased prevalence of left ventricular hypertrophy and decreased risk of new onset atrial fibrillation and coronary revascularization. (Verdecchia P, Staessen JA, Angeli F, et al. Usual versus tight control of systolic blood pressure in non–diabetic patients with hypertension (Cardio–Sis): an open–label randomized trial. Lancet 2009;374:525.)

Mnemonic of the Day (Dr Prachi Garg)

3rd Heart Sound FIPPY

F ailure

I ncompetence (mitral/tricuspid)

P regnancy/Pill/Pericardial effusion/Pericarditis

Y outh


At what age does celiac disease occur?

Celiac disease can occur at any age from childhood to adulthood – nine months to ninety years.

Diabetes Fact

High TLC (white count) with fever think of infection in Diabetic Ketoacidosis.

Public Forum
(Press Release)  Today is World Health Day

10th Perfect Health Parade to be officially flagged of by Suresh Kalmadi

New Delhi: Wednesday, 7th April 2010: The two days 10th Perfect Health Parade organized by Heart Care Foundation of India jointly with the Loomba Trust and Health Dept Delhi Govt. which started today at Rajghat will officially be flagged of by Shri Suresh Kalmadi, Chairman, Commonwealth Games 2010 from outside Commonwealth Games Office on Tursday 8th April at 10am.

Speaking on the occasion Padmashri Awardee Dr. K.K. Aggarwal said that the focus of the parade is on the welfare and health of the widows and their children. 200 widows and their children will assemble at the parade venue who will be addressed by Shri Suresh Kalmadi and then a free health check-up will be organized for the widows and their children.

Talking on WHO Day theme, Dr. Aggarwal said that we have to set an example and make  Delhi as clean, green and hygienic city to cater to the need of the 1 lakh international visitors during commonwealth games in the month of October.

In his message, Shri Rakesh Mehta, Chief Secretary, Delhi Government appealed to the citizens of Delhi to help in making Delhi city clean and said that the same is only possible if each one of us learns and practices discipline of personal hygiene along with civic hygiene.


Question of the day

Is Microdermabrasion safe?

Microdermabrasion is a safe, effective and popular medical cosmetic procedure, which is well accepted by patients throughout the world. It is a painless, predictable and a true lunch–hour peel without redness or irritation. Also, it is an affordable alternative to laser and surgical procedures.

eMedinewS Try this it Works

Stickers can aid fundus examination

Place a glow–in–the–dark sticker of any object (eg, pumpkin face, rocket ship, the moon) on a wall a few feet from the exam table at about eye height to a sitting child. Instruct the patient to look at the glow as you turn off the lights.

Dr Good Dr Bad

Situation: A diabetic with foot ulcer and low testosterone levels came for prescription.

Dr Bad: Just keep your sugar under control.

Dr Good: You will need testosterone replacement.

Lesson: In men with a diabetic foot and whose serum testosterone levels were subnormal, administration of testosterone has favorable effects on healing of diabetic foot. There was an improvement of hyperglycemia, a decrease of leukocytes and of fibrinogen levels, an increase of antithrombin III activity and of tissue oxygen pressure and the wound showed granulation. Beneficial effects of testosterone may be due to improved vascularization and to anti-inflammatory action. (Cardiovasc Diabetol 2009;8:19.)

Make Sure

Situation: A patient on dialysis and on oral antacid developed aluminium toxicity.

Reaction: You should have put him on magaldrate preparations

Lesson: Magaldrate preparations do not cause aluminium toxicity in patients undergoing dialysis.


Laughter the best medicine

A pipe burst in a doctor’s house. He called a plumber. The plumber arrived, unpacked his tools, did mysterious plumber–type things for a while, and handed the doctor a bill for Rs 1600.

The doctor exclaimed, "This is ridiculous! I don’t even make that much as a doctor!"

The plumber quietly answered, "Neither did I when I was a doctor".

Formulae in Critical Care

Predicted endotracheal tube size for age

Formula: = 4 + (age/4) for pediatric age group.

Comments: Approximate size of the intubation tube is
the size of little finger of the patient.

Milestones in Medicine

1865 A.D. Joseph Lister introduces antiseptic methods to surgery during a time when close to half of all surgical patients died of postoperative infection.

Lab Test (Dr Naveen Dang)

H-pylori IgG antibodies are used to diagnose an infection with Helicobacter pylori that causes peptic ulcer.

List of Approved drug from 1.01.2009 to 31.10.2009

Drug Name


Approval Date

Cefovecin (as sodium) 80mg/ ml Lyophilised powder for injection (Veterinary)

For the treatment of skin bacterial infections in dogs and cats.


(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 500 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, email to emedinews@gmail.com

No fee

Readers Responses

  1. Dear Dr. KK Aggarwal ji, Congratulations for receiving Padma Shri award: Dr GS Lavekar, Former DG, CCRAS Mobile:09868284364, gslavekar@gmail.com

  2. Congratulations! It feels so nice to see you with the President. Keep up the great work. We are proud of you: Dolly (Amal)

  3. Dear KK, many many congratulations. I am proud to be a member of eMedinews family: Dr Archna Diwan

  4. Dear sir, we all Congratulate you on being conferred with the nation’s fourth highest award – Padma Shri: Dr.Anita Taparwal–ESI Hospital, Noida. Mobile–9818544434; Dr.Ranjan Kumar Nag–Apollo Hospital, Noida. Mobile 9818776287; DR.Devi Durga Das–ESI Hospital, Jhilmil. Mobile–9810703632; Dr Dipankar Sankar Mitra–BL Kapoor Hospital, Delhi Mobile–9810703632

  5. Respected Sir, Congratulation on being awarded most prestigious award – Padam Shri.With regards: Dr Monika Maheshwari (MD,DNB) Assistant professor, J L N Medical College, Ajmer 9413742609