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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


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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 …

8th April 2012, Sunday

Lifestyle choices in controlling blood pressure

  • Try lifestyle management for up to 6 months. It can alone control blood pressure if initial BP is <160/100 mmHg.
  • Lifestyle interventions have effects similar to single drug therapy.
  • Combinations of two (or more) lifestyle modifications can achieve even better results.
  • One should maintain normal body weight. One can achieve a reduction of 5–20 mmHg of BP for every 10 kg weight loss.
  • One should consume a diet rich in fruits, vegetables, and low fat dairy products with a reduced content of saturated and total fat. It can reduce a blood pressure of 8–14 mmHg.
  • One should reduce dietary sodium intake to no more than 100 mmol per day (2.4 g sodium or 6 g sodium chloride). It can alone reduce blood pressure by 2–8 mmHg.
  • One should engage in regular aerobic physical activity such as brisk walking (at least 30 min per day, most days of the week). It can alone reduce blood pressure by 4–9 mmHg.
  • One should limit consumption of alcohol to no more than 2 drinks (1 oz or 30 mL ethanol; e.g., 24 oz beer, 10 oz wine, or 3 oz 80–proof whiskey) per day in most men and to no more than 1 drink per day in women and lighter weight persons. It can alone reduce blood pressure by 2–4 mmHg.

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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 – Pathlab Facilities

800 laboratory test were done by Religare and other organizations and over 25,000 free hemoglobin checkups were done.

Dr K K Aggarwal
    National News

2,471 new cancer cases in Himachal

SHIMLA: Himachal Pradesh is witnessing rise in number of cancer patients. While the state has 23,241 cancer patients during last financial year alone, 2,471 new cases have been registered. The state government has started Rs 7.34 crore national cancer control programme in the remote Chamba, KInnaur and Lahaul–Spiti districts since 2011. The state health minister Dr Rajiv Bindal informed the state assembly in Thursday, while replying to a question by BJP MLA Inder Singh. Bindal said the state had 16,405 cancer patients in 2009 that increased to 19,705 in 2010, while the number increased to 23,241 by 2011–12. Bindal said of the new cases, registered during financial year 2011–12, included 179 cases of oral cancer, 478 of digestive track, 623 cases of respiratory and intra–thoracic organ cancer, 302 of bone, skin and breast cancer, 519 cases of genito urinary organ and 370 of other types of cancer. He said the tobacco consumption has emerged as one of the main reasons for cancer after which a major awareness drive has been launched in the state. (Source: TOI, Apr 6, 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

Tweaking the escalated BEACOPP regimen for Hodgkin’s lymphoma

The intense chemotherapy regimen used in the treatment of advanced Hodgkin’s disease, known as escalated BEACOPP, can be reduced from 8 to 6 cycles of treatment, according to a new study. Six cycles of this regimen are more effective and less toxic than 8 cycles, and should now be considered the treatment of choice for advanced–stage Hodgkin’s lymphoma, say the authors, headed by Andreas Engert, MD, from the University Hospital of Cologne in Germany. The conclusions come from the HD15 trial, conducted by the German Hodgkin Study Group, and are published online today in the Lancet. (Source: Medscape)

For comments and archives

Levemir assigned more reassuring pregnancy risk category

The US Food and Drug Administration (FDA) on March 29 gave insulin detemir (rDNA origin) injection (Levemir, Novo Nordisk) a more reassuring risk category for pregnant women with diabetes. Before then, the FDA had assigned insulin detemir to pregnancy category C, which means that animal reproductive studies have shown an adverse effect on the fetus, there are no adequate and well–controlled studies in humans, and potential benefits may warrant the drug’s use in pregnant women despite potential downsides. Insulin detemir is now in pregnancy category B. Drugs receive this rating if adverse effects emerge in animal studies, but adequate and well–controlled trials with pregnant women fail to demonstrate a risk to the fetus during the first trimester, and there is no evidence of risk in later trimesters. (Source: Medscape)

For comments and archives

Mammography screening linked to overdiagnosis of cancer

Mammography screening is linked to overdiagnosis of breast cancer, according to findings from the Norwegian Screening Program reported in the April 3 issue of the Annals of Internal Medicine. The investigators suggest that overdiagnosis not only poses a significant ethical dilemma but also burdens the patient and the healthcare system. (Source: Medscape)

For comments and archives

FDA approves Rotigotine Transdermal System

A once-daily continuous delivery dopamine agonist patch, a rotigotine transdermal system (Neupro, UCB), has been approved by the US Food and Drug Administration for the treatment of Parkinson’s disease (PD) and restless legs syndrome (RLS). Specifically, the rotigotine transdermal system is now indicated for the treatment of the signs and symptoms of advanced–stage idiopathic PD and for treatment of moderate–to–severe primary RLS. The rotigotine patch was previously indicated only for the signs and symptoms of early–stage idiopathic PD. (Source: Medscape)

For comments and archives

AAA repair weaker for women

Women don’t gain the same advantages as men from endovascular repair of abdominal aortic aneurysms (AAAs), a large series found. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Power: The New Medicine on the Block or Power: Reviving the Ailing Politicians http://blog.kkaggarwal.com/2012/04/01/power–the–new–medicine–on–the–block–or–power–reviving–the-ailing–politicians/

@DeepakChopra: Total self acceptance is empowering. It means allowing others to see you as they choose without being offended.

    Spiritual Update

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

Good Friday – The Day Of Sacrifice

Good Friday commemorates the final hours of Jesus’ life, his crucifixion, and death, as described in the Christian Bible. Christians attend special church services or pray. Some fast or abstain from meat. It’s a day of sadness, in which churches are empty and dark. Services are held in the afternoon. Many churches have a bitter drink prepared from leaves, vinegar, and other ingredients. This drink is for everyone to taste after the service. The day represents the sacrifices and suffering in Jesus’s life.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What is ICSI?

Before a man’s sperm can fertilize a woman’s egg, the head of the sperm has to attach to the outside of the egg. Then it pushes through the outer layer of the egg to the inside of the egg (cytoplasm). Sometimes the sperm cannot penetrate the outer layer. A procedure called intracytoplasmic sperm injection (ICSI) can help fertilize the egg by injecting the sperm directly into the egg.

For comments and archives

    Hepatitis A Update

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

What are the risks from hepatitis A vaccine? (CDC guidelines)

A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of hepatitis A vaccine causing serious harm, or death, is extremely small. Getting hepatitis A vaccine is much safer than getting the disease. Soreness at the site of the injection, headache, loss of appetite and tiredness are few minor side effects. These usually last 1 or 2 days.

For comments and archives

    Tat Tvam Asi………and the Life Continues……

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

Can blood of animals be transfused to human beings?

Scientists have tried a lot but so far they are not successful. Only blood of a human being can be transfused to a human patient.

For comments and archives

    Medi Finance Update

(Tarun Kumar, Chartered Accountant)

Judicial precedents reversed by retrospective amendments

Bandwidth/Satellite transmission

The term "process" used in the definition of royalty has been clarified to include transmission by satellite, cable, optic fibre or by any other similar technology, whether or not such process is secret. Effective retrospectively from 01 June 1976.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

Every success story is also a story of great failure

Failure is the highway to success. Tom Watson Sr. said, "If you want to succeed, double your failure rate."

If you study history, you will find that all stories of success are also stories of great failures. But people don’t see the failures. They only see one side of the picture and they say that person got lucky: "He must have been at the right place at the right time."

Let me share someone’s life history with you. This was a man who failed in business at the age of 21; was defeated in a legislative race at age 22; failed again in business at age 24; overcame the death of his sweetheart at age 26; had a nervous breakdown at age 27; lost a congressional race at age 34; lost a senatorial race at age 45; failed in an effort to become vice–president at age 47; lost a senatorial race at age 49; and was elected president of the United States at age 52.

This man was Abraham Lincoln. Would you call him a failure? He could have quit. But to Lincoln, defeat was a detour and not a dead end.

In 1913, Lee De Forest, inventor of the triodes tube, was charged by the district attorney for using fraudulent means to mislead the public into buying stocks of his company by claiming that he could transmit the human voice across the Atlantic. He was publicly humiliated. Can you imagine where we would be without his invention?

A New York Times editorial on December 10, 1903, questioned the wisdom of the Wright Brothers who were trying to invent a machine, heavier than air that would fly. One week later, at Kitty Hawk, the Wright Brothers took their famous flight.

Colonel Sanders, at age 65, with a beat–up car and a $100 check from Social Security, realized he had to do something. He remembered his mother’s recipe and went out selling. How many doors did he have to knock on before he got his first order? It is estimated that he had knocked on more than a thousand doors before he got his first order. How many of us quit after three tries, ten tries, a hundred tries, and then we say we tried as hard as we could?

As a young cartoonist, Walt Disney faced many rejections from newspaper editors, who said he had no talent. One day a minister at a church hired him to draw some cartoons. Disney was working out of a small mouse infested shed near the church. After seeing a small mouse, he was inspired. That was the start of Mickey Mouse.

Source: http://great–motivational–stories.blogspot.in/2008/03/every–success–story–is-also–story–of.html

For comments and archives

    Microbial World: The Good and the Bad They Do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta – The Medicity)

Microbial flora of the large intestine

The large intestine is heavily colonized and bacterial numbers can reach 100 billion per milliliter of fluid. The anaerobic bacteria like anaerobic lactic acid bacteria, Bacteroides, and Bifidobacterium bifidum are predominant in large intestines. The exact composition of flora in different parts of intestines is different as has been shown by sampling and culture methods. Also, different bacteria attach to different cells of gut by different mechanism. All this is for the mutual benefit of microbes and the host.

For comments and archives

    Cardiology eMedinewS

Mitogen-activated protein kinases in the regulation of the cardiac fibroblast cell cycle Read More

Clinical trial units: what are they and why are they needed? Read More

Current ethical issues in biomedical research in India Read More

    Pediatric eMedinewS

Stinky urine in young children linked to possible UTI Read More

Measles vaccines not associated with febrile seizure risk Read More

Multiple infections may be behind severe bronchiolitis Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient on oral contraceptives came with amenorrhea.
Dr Bad: I need to investigate you.
Dr Good: Get a Pregnancy test done.
Lesson: A Woman may say that she is taking oral contraceptives and still be pregnant. No contraception is 100% effective.

For comments and archives

Make Sure

Situation: A patient with acute rheumatic fever was directly put on penicillin prophylaxis.
Reaction: Oh my God! Why was the full initial course of penicillin not given?
Lesson: Make sure that patients with acute rheumatic fever are initiated on antibiotic therapy as delineated for eradication of streptococcal pharyngitis, whether or not pharyngitis is present at the time of diagnosis.

For comments and archives

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    Quote of the Day

(Dr GM Singh)

An optimist is the human personification of spring. Susan J. Bissonette

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Anticardiolipin antibodies

Anticardiolipin antibodies are used to help investigate inappropriate blood clot formation, to determine the cause of recurrent miscarriage, or as part of an evaluation of antiphospholipid syndromes.

    Mind Teaser

Read this…………………


Yesterday’s Mind Teaser: Which of these drugs has been shown to improve labyrinthine blood flow and to re equilibrate central vestibular imbalance and is considered useful in treatment of patients with vascular disease of the vestibular system?

a. Propranolol
b. Amitriptyline
c. Cinnarizine
d. None of above

Answer for Yesterday’s Mind Teaser: a. Propranolol

Correct answers received from: Dr Deepali chatterjee, Dr Ragavan Sivaramakrishnan Moudgalya, yj vasavada, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Avtar Krishan, Anil Bairaria, Dr Nagar mal Goyal.

Answer for 6th April Mind Teaser: dark under eye
Correct answers received from: Dr Anupam Sethi Malhotra, Dr Prabha Sanghi.

Send your answer to ijcp12@gmail.com

   Laugh a While

(Dr GM Singh)

Feline Physics

Law of Cat Motion – A cat will move in a straight line, unless there is a really good reason to change direction.

    Medicolegal Update

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

Shotgun Wounds

When a shotgun cartridge is fired the pellets begin to disperse soon after the cartridge has left the weapon. This dispersion increases with the range of fire but it also depends upon the degree of ‘choking’ of the barrel of the weapon. ‘Choking’ refers to the restriction of the bores of certain shotguns at their muzzle ends. The degree of constriction is maximal in the ‘full choke’ weapon and is of lesser extent in the ‘half choke’ weapon. The purpose of the ‘choking’ device is to keep the charge of shot in a single mass for some distance before dispersion commences. In these circumstances, a single large irregular lacerated wound is produced. Burning, blackening, and tattooing are seen around and in the depth of the wound. The wad is often found in the wound. As the range of fire increases to a few yards, the burning, blackening and tattooing disappear, while the charge of shot begins to spread.

  • Separate pellets entering the skin: appear around the central opening caused by the main mass of shot. In addition, an independent injury may be caused by the wad.
  • Dispersion of shot increases at greater ranges: the greater the dispersion the greater the range.
  • Actual spread depends upon the type of boring of the weapon.
  • Direction of fire of a shotgun can only be determined from the entrance wound in close range injuries.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Healthy ageing eat less to live more

Eat less to live more said Dr. K.K. Aggarwal, Padma Shri and Dr B C Roy National Awardee and President, Heart Care Foundation of India while delivering a lecture on healthy ageing organized by Delhi Medical association at Meridian Hotel.

Dr Aggarwal said that adhering to a calorie–restricted diet over long term ameliorates the normal age–related decline in diastolic relaxation function of the heart in healthy, non–obese adults. The cardiac beneficial effects of caloric restriction are mediated by reductions in blood pressure, systemic inflammation, and myocardial fibrosis as per a study published in January issue of the Journal of the American College of Cardiology. It is the first study in humans that strongly suggests that calorie restriction may delay primary aging. Calorie restriction has previously been shown to slow aging and increase lifespan in small mammals.

Dr. Fontana, from Washington University in St. Louis, performed Doppler echocardiography and measured inflammatory markers in 25 healthy adults who followed a severely calorie–restricted, nutritionally balanced diet for an average of 6.5 years. Results were compared with those from 25 matched control subjects consuming a typical Western diet.

The calorie–restricted diet consisted of roughly 1,671 kcal per day derived approximately 23% protein, 49% complex carbohydrates, and 28% fat (including 6% saturated fat). The Western diet consisted of roughly 2,445 kcal per day made up of about 17% protein, 52% carbohydrates, and 31% fat (11% saturated fat). The calorie–restricted diet included at least 100% of the recommended daily intake for all nutrients, and it was lower in salt than the Western diet.

People who followed a severe calorie–restricted diet but with optimal nutrition had a younger heart in terms of diastolic function, which is a well–accepted marker of primary aging because, independently of disease, as you get older your diastolic function gets worse and worse. Mean systolic upper and diastolic lower blood pressures were significantly lower in the calorie–restricted group (102/61 vs. 131/83 mm Hg), as were levels of the inflammatory markers C-reactive protein, TNF–α, and TGF–β1.

Earlier in the day, while talking to 2000 school children at Mount Abu School at Rohini, Dr Aggarwal said that ‘Eat less to live more’ has its origin in Vedas. The Ayurvedic text from Atharvaveda defines the limit of food intake in a particular meal. It says one should not eat more than what can be accommodated in an outstretched palm.

According to the Jain philosophy there are 12 types of penance. Two of them are Anshan (fast) and Unodari. Unodari is for those people who cannot fast and it is eating less than what is needed to satisfy one’s hunger. Deepak Chopra in his book perfect health says that one should eat to a scale of 7 from a hunger scale of 10.

Speaking to a gathering of over 300 people at the Baisakhi festival celebrations at Radha Krishnan Vidya Niketan, Pushp Vihar later in the day, Dr Aggarwal said that Yogashastra says that one who eats one meal in a day is ‘yogi’; one who eats twice a day is ‘bhogi’; who eats thrice a day is ‘rogi’. There is a common Sanskrit saying "Ekabhattam Cha Bhoyanam", which means if one takes only one meal a day then there will be no illnesses.

Controlled diet conserves one’s energy. Samana Vayu, the vital energy produced around the naval, remains in balance if one eats less. Overeating reduces this energy. Another way of eating less is "Vritti samkshepa". It involves limited number of items eaten and not to eat same particular items on particular days. Traditional Indians "Vrata" (fast) also are based on this type of penance. Many "Vrata" restricts eating particular items on that day.

Another way of eating less is penance of "raso parityaga", which means avoiding of certain tastes of food. One should not eat items with all taste on all days. The Friday fast of Santoshi Maa involves not eating sour food on that particular day. Many religions insist on not eating after the sunset.

One of the phrases in Yoga Shastra is "astangate divanathe" which means that the digestive system becomes inactive after the sunset. It is also the philosophy of Ayurveda. As sun is the greatest source of energy. Body’s vital, physical and digestion remains active in presence of sun. While Jainism talks about not eating at all after sun set, Ayurveda says one should have dinner lighter than lunch and avoid artificial foods as well as semi digested foods in the night. Eating curd has been prohibited in Ayurveda after sunset. People living in South also do not eat fermented food items like idli, dosa, etc. after sunset.

According to Ayurveda philosophy any food that is eaten after sunset does not get properly transformed into juices. Such food, therefore, are not helpful for health as they are not converted into energy. In modern medicine over eating now is classified as a type of malnutrition. Obesity, high blood pressure, heart disease, high cholesterol, cancer, gall stones, etc. are as a result of over eating.

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    Forthcoming Events
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Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001

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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