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emedinews is now available online on www.emedinews.in or www.emedinews.org
Dr KK Aggarwal

From the Desk of Editor in Chief
Padmashri 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

9th March 2010, Tuesday

Why we prohibit starting new work for 8 days before Holi but not before Dusshera

Nine days before Dussehra and Ramnavami we celebrate Navratras, a period where starting any new work is considered auspicious. From Dussehra to Diwali 20 days period is again considered auspicious.

However, 8 days before Holi, a period called as Holastak, is considered inauspicious for doing or starting any good work including marriage, graha pravesh or starting a new business. Both Holi and Dusshera are major festivals in Hindu dharma. 

Any festival in India consists of rituals which directly or indirectly teach the society how to remain happy and healthy. The aim of life, as per vedic philosophy, is to be in touch with one's consciousness; a shift from sympathetic to para sympathetic mode; learning to control over the mind, intellect and ego and acquiring inner happiness.

Over years of living all of us acquire friends and enemies. For acquiring inner happiness one need to learn to sustain friendship with friends and try to win over the enemies.

The festival of Diwali and Dussehra are aimed at sustaining and rebuilding friendship. Apart from internal cleansing process, the Navratras, Dussehra and Diwali rituals involve meeting friends and distributing love (represented by sweets) to each other. This festival brings joy and redefines friendship. As one is dealing with only friends doing or starting any work at this time is considered auspicious as every friend invariably helps in these ventures.

On the contrary, Holi as a festival is so designed as to remove negativity from the mind of our enemies. During this period one make a wilful efforts to win over the enemies.

Every effort is made to meet people we have in our action, thought or speech, annoyed sometimes in the past. The wilful efforts involve meeting and communicating with them. The process of winning involves days of persistent efforts and in vedic language the same may take up to 8 days.

Succesful winning over enemies is represented by burning of negativities from the mind (burning of Holika). The re-union of friends (with enemies) occur on the day of Holi represented by throwing colours on each other.

During these 8 days of purification of the body and removing negativity, it is possible that there is transient exacerbation of aggressive behaviour, more negativity and even abuse i.e. the main reason why starting any work during that period is considered inauspicious.

Because the very purpose of this 8-day purification is to remove negativity from the mind of our enemies and during this period if  we call only friends for a function the purpose of purification will not be served and if we call everyone (friends and non-friends), by that time if the negativity is not removed it may end up in unwanted scenes.

In allopathic language, purification is a journey from sympathetic tom parasympathetic mode. Acquiring happiness is acquiring para sympathetic mode. The transient exacerbation of negativity is sympathetic over activity. In Yogic language parasympathetic system is represented by Ida and sympathetic by Pingla nadis in the spinal cord. (Note: eight days after holi is the festival Basoda or Sheetal Asthmi and eight days later starts the Ramnavmi Navratras). 

Dr KK Aggarwal
Chief Editor

News and Views (DR G M Singh)

  1. Endometriosis: Laparoscopy remains the gold standard for the diagnosis and management of endometriosis. Laparoscopic appearance of endometriosis may include any of the following

    • The classical ‘powder–burn’ or bueberry lesion
    • White lesions that mimic scar tissue
    • Clear or slightly brown–colored papillary lesions
    • Strawberry or flame–like lesions which are hormonally active
    • Peritoneal pockets, which contain endometrial implants
    • Ovarian endometriomas or chocolate cysts

  2. Dyslexia: It is a reading disability that can affect people of any age. But the initial signs often appear in early childhood. The possible early warning signs may include:

    • Difficulty learning to speak and say longer words
    • Problems with rhyming
    • Difficulty learning the alphabet, days of the week, numbers, recognizing colors and shapes
    • Struggling to write or read his or her own name
    • Problems with syllables or saying certain sounds
    • Transposing letters when reading or spelling some words
    • Trouble with handwriting
    • Lacking fine motor skills

  3. About 70 percent of vascular disease patients take aspirin, mainly for secondary prevention. While some non–aspirin users take other antithrombotic agents, almost 15 percent of patients take no antithrombotic agent at all, according to a research published in the Feb. 15 American Journal of Cardiology.

History, physical exam may discern low risk for bacterial conjunctivitis

A study reported in the March 3 issue of the Archives of Pediatrics & Adolescent Medicine, has identified 4 clinical factors that may enable clinicians to identify children at low risk for bacterial conjunctivitis: Age 6 years or older, presentation in April through November, no or watery discharge, and no sticky eye in the morning. The combination of these four factors was found to be independently associated with a negative conjunctival culture, thus reducing the need for antibiotics. If three factors were present, 76.4% of patients had a negative culture. Presence of all 4 factors was associated with 92.3% of patients with negative culture. (Source: Arch Pediatr Adolesc Med 2010;164:263–267)

FDA approves new somatropin injection pen for growth hormone disorders

An updated version of the NordiFlex pen, the Norditropin FlexPro, Novo Nordisk, Inc has received FDA approved for the treatment of growth hormone disorders in adult and pediatric patients. Norditropin FlexPro is a prefilled somatropin (rDNA origin) injection pen. It is expected to be available in the second quarter of 2010. The user–friendly design makes it easy to learn and use, and an audible click confirms each dose dispensed. There is no need for drug reconstitution or loading of cartridges. Once started, the 5–, 10–, and 15–mg/mL pens may be left at room temperature for up to three weeks without spoiling.

The indications for recombinant somatropin in pediatric age group include short stature associated with Noonan and Turner syndromes, long–term treatment of growth failure resulting from growth hormone deficiency and short stature in small–for–gestational–age children with no catch–up growth by age 2 to 4 years. Adult– or childhood–onset growth hormone deficiency may also be suitable candidates.

Contraindications to somatropin: hypersensitivity to any component/s of the product, acute critical illness following open–heart surgery, abdominal surgery, or multiple accidental traumas, diabetic retinopathy, acute respiratory failure, children with Prader–Willi syndrome who are severely obese, sleep apnea, active malignancy.

Conference Calendar

CIPM 2010 (Comprehensive Interventional Pain Management – III) Date: March 11 – 14, 2010
Venue: Hotel United 21, Thane, Maharashtra.

Quote of the Day

Prayer must never be answered: if it is, it ceases to be prayer and becomes correspondence. (Oscar Wilde)

Diabetes Fact

Drugs which increase GIP and GLP–1 (analogs) therefore will increase insulin and reduce sugar. Exenatide, liraglutide, are GIP and GLP–1 agonists. Both are available as injections.

Public Forum (Press Release)

Cancer and heart disease linked

CRP, a protein that signals inflammation and heart disease may also indicate that a person has a high risk of cancer, said Dr KK Aggarwal President, Heart Care Foundation of India and Editor eMedinewS.

CRP or C–reactive protein is associated with inflammation –– an activation of the immune system. Measurements of CRP should be part of a regular health check.

People with high levels of C–reactive protein have a 30 percent higher risk of cancer. Cancer patients with the highest CRP levels are 80 percent more likely to die early.

Dr. Kristine Allin and colleagues at the University of Copenhagen studied more than 10,000 people who had their CRP levels measured and who were then followed for 16 years. About 1,600 developed cancer over this time and if they had high CRP levels at the beginning of the study, they were 30 percent more likely to be in this group of cancer patients.

And if a person developed cancer and also had high CRP levels, they were 80 percent more likely to die, whether from the cancer or something else, regardless of whether the cancer spread in their bodies.

The study published in the Journal of Clinical Oncology concluded that five years after cancer diagnosis, 40 percent of patients with high CRP levels were alive, compared with 70 percent of patients who had low CRP levels.

Question of the day

What are the recommendations for screening colon cancer in the average–risk patient?

Indian recommendations are currently being developed. The recommendations will be looking at screening high–risk individuals. For the average–risk person, a properly done fecal occult blood test is the important first step. If positive, the patient should have a colonoscopy or a combination of flexible sigmoidoscopy and a good air contrast barium enema. Barium enemas have their limitations, however, such as quality control and the fact that lesions can’t be removed or biopsied with this technique.

eMedinewS Try this it Works

Glue for split skin

Split skin at the ends of fingers is a problem in winter when the air is dry. Prevention with a moisturizer is recommended, but for the occasional split, superglue can be used to decrease pain and prevent enlargement of the split. Try it only if the split is superficial and there is no bleeding. Make sure that the patients do not put their fingers together or touch their eyes before the glue dries.

Dr Good Dr Bad

Situation: A diabetic patient came with winter high cholesterol levels. Dr Bad: Cholesterol levels have nothing to do with season.
Dr Good: You need adjustment of anti cholesterol dose.
Lesson: In patients with diabetes on treatment, blood pressure, pre prandial glucose, A1C, and LDL cholesterol vary seasonally, with higher values in the winter and lower values in the summer.
(Source: Diabetes Care 2007;30:2501–2502)

Make Sure

Situation: A patient with renal failure came to a doctor.
Reaction: Oh, my god! Why were painkillers given to him?
Make sure to avoid painkillers in renal failure as most painkillers (barring nimesulide) are not kidney–friendly drugs.

Medi Finance : (BUDGET 2010–2011): CORPORATE

No change in tax rates.

Surcharge reduced to 7.5% from 10% in case of domestic companies.

Punjab & Sind Bank
Central Bank of India

Laughter the best medicine cum MORAL

1st year students of MBBS were attending their 1st anatomy class.
They all gathered around the surgery table with a real dead dog.
The Professor started class by telling two important qualities as a Doctor.
He inserted his finger in dog’s mouth & on drawing back tasted it in his own mouth.

Then he said them to do the same.
The students hesitated for several minutes.
But eventually everyone inserted their fingers in dog’s mouth & then tasted it.
When everyone finished, the Professor looked at them and said:
The most important 2nd quality is OBSERVATION, I inserted my Middle finger but tasted the Index finger.
Now learn to pay attention.


Life is tough but it’s a lot tougher when you are not paying attention (Source: drprashantkadhi@yahoo.co.in)

Formulae in Critical Care

Nitrogen balance (g)
Formula: Protein intake in g/6.25 – urine urea nitrogen
(g) + 2.5

Milestones in Neurology

Sir James Crichton–Browne (1840 –1938) was a British psychiatrist celebrated for his scientific study of brain tissue in cases of psychiatric disorder, for his concepts of mental illness in relation to evolutionary theory and for the development of medical psychology in public health and education.

Mistakes in Clinical Practice

Write out ‘Units’ not U; U often is misinterpreted and read as the number 0, leading to massive overdoses. We have seen patients getting 40 units of insulin instead of 4u. 

11th March World Kidney Day (Dr N P Singh)

Testing for kidney disease: A simple test can be done to detect protein in your urine. Persistent protein in the urine is an early sign of chronic kidney disease. The results of serum creatinine are used  to calculate overall kidney function, or glomerular filtration rate (GFR) and  blood sugar to rule out diabetes. Early detection and treatment of CKD not only slows or halts the progression of patients to end–state renal disease, but can also significantly reduce the increased incidence of cardiovascular diseases, the most common cause of premature deaths worldwide.

1–7 April Prostate Disease Awareness Week: Prostate SMS of the Day (Dr Anil Goyal)

IPSS Score : (i) 0–7 point – mildly symptomatic (ii) 8 – 19 point – moderately symptomatic (iii) 20 – 35 point – severe symptomatic

Lab test (Dr Navin Dang)

Lipid Profile: Insist that the lab provides a direct estimated LDL value and not a calculated LDL value for more accurate results.

List of Approved drug from 1.01.2009 to 31.10.2009

Drug Name


Approval Date

Clozapine Tablet 200mg (Addl. Strength)

Indicated in the management of Schizophrenic patients


(Advertorial section)


Zen Immune Power – a known immunity booster with ability to help reduce absorption of aluminum from the GI tract and enhance excretion through kidneys and is a key to eliminate aluminum toxicity and the related systemic involvement.

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 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.


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

Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.

Timings: On Saturday 17th April (2pm onwards) and Sunday 18th April (7am–4pm). 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

Stroke Update Workshop for GPs

Indian Stroke Association and International Stroke Conference are organizing a Stroke Update Workshop on March 13–14, 2010 at AIIMS Auditorium. eMedinewS has tied up with the conference for free registration for the first 200 GPs of NCR. Organizer: Dr Padma, Prof of Neurology, AIIMS, New Delhi. SMS for free registration to 9717298178 or email to isacon2010@gmail.com

Also, if you like emedinews you can FORWARD it to your colleagues and friends. Please send us a copy of your forwards

Readers Responses

1. Dear Dr Agarwal, It is a matter of great pleasure and pride for all of us that you were recently awarded Padma Shri by Govt of India. I am sorry to send you my wishes belatedly. With personal regards and best wishes: Roop K Khar, Professor Department of Pharmaceutics Ex–Dean and HOD Faculty of Pharmacy Jamia Hamdard (Hamdard University) Editor–in–Chief Journal of Pharmacy & BioAllied Sciences www.jpbsonline.org

2. To, Padma Shri and Dr. B C Roy National Awardee Dr KK Aggarwal : Sir, Heartiest congratulations for achieving Padma Shri award. I got my first opportunity to meet you during Glaxo–IJCP InterMedical college essay competition prize ceremony during my undergraduate days at Delhi. Congratulations for your innovative, timely relevant initiative "FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA". Presently I am working as an Assistant Professor in the Dept of Pharmacology and also an Associate Editor in a monthly medical magazine "Medicoz Lemon".  With regards: Dr. Sukanta Sen, Assistant Professor, Dept of Pharmacology, Index Medical College, Indore; Mob–09893633424

3. Dear Dr K K :I totally oppose the concept of rural medical diplomas. My suggestion to motivate MBBS graduates for rural serving is to get a bond of huge amount 20 to 30 lakhs which people are spending to get degree from private colleges & this bond has to be strictly enforced (I remember rural service bond was also taken from all my batchmates but no authority bothered about that at the time of completion of degree): Dr V K Goyal, MBBS;MD (Ped)