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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

9th April, 2010 Friday

Sexuality in later life (Health Beat)

Middle–aged and older adults no longer accept such myths as "Sex is only for young people" and "Sex isn’t important to older adults." As per a study conducted by AARP, "Sexuality at Midlife and Beyond"

  1. Five out of six of the respondents disagreed with the statement that "Sex is only for younger people."

  2. Six out of 10 people stated that sexual activity was a crucial part of a good relationship.

  3. Only 10% of adults reported that they don’t particularly enjoy sex.

  4. Just 12% agreed that they would be quite happy never having sex again.

Dr KK Aggarwal
Padma Shri Awardee and Chief Editor


Photo feature

Shri Suresh Kalmadi, Chairman, Commonwealth Games 2010, flagging off the Perfect Health Parade, 2010 (organized by Heart Care Foundation of India and The Loomba Trust in association with Healthy Dept Delhi Govt, MCD, NDMC, IMA NDB, Janak Puri Branches, WFR, DTC, Dept of prohibition DG). Also in the picture Padma Shri Awardee Dr K K Aggarwal, Mr Raj Loomba, Nalini Kathak Dancer and other dignitaries. 'SHEERA' the official mascot of the common wealth games was the attraction of the Parade.

Dr k k Aggarwal

News and views

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

1. No benefit from ventricular reconstruction

Surgical ventricular reconstruction during a coronary artery bypass graft (CABG) does not appear to benefit any subgroup of patients, a secondary analysis of a randomized trial showed. The STICH (Surgical Treatment of Ischemic Heart Failure) trial randomized 1,000 patients with ischemic cardiomyopathy to CABG with or without surgery to decrease the size of the ventricle and give it a more natural shape.The main results, reported last year at the meeting of the American College of Cardiology and subsequently published in the New England Journal of Medicine, showed that there was no difference between the two groups on the primary outcome of death or cardiac hospitalization (HR 0.99, 95% CI 0.84 to 1.17).

2. The agony of long-distance runners –– coronary plaque

A group of elite long–distance runners had less body fat, better lipid profiles, and better heart rates than people being tested for cardiac disease, but, paradoxically, the runners had more calcified plaque in their heart arteries, according to a study reported here. (Dr Robert Schwartz, Minneapolis Heart Institute and Foundation)

3. Intensive statin treatment cuts CVEs in kidney disease patients

Intensive statin therapy was associated with a marked decrease in cardiovascular events and a modest improvement in renal function among heart patients with metabolic syndrome complicated by chronic kidney disease. The reduction in major cardiovascular events was 35% (P=0.0026) when patients were treated 80 mg of atorvastatin (Lipitor) versus 10 mg. (Dr Daniel J. Wilson, Senior Medical Director Pfizer)

4. Triglycerides decreased with rosuvastatin therapy

In a study that specifically scrutinized the effects of statin therapy on triglycerides, researchers said that rosuvastatin significantly reduced the blood lipid that has been linked to coronary artery disease better than placebo. (Dr Juan Talavera, Instituto Mexicano del Seguro Social, Mexico City)

5. Chronic kidney disease patients fare well in statin trial

Chronic kidney disease patients in the landmark JUPITER trial achieved a 44% reduction in mortality if they were assigned to the potent cholesterol-lowering agent rosuvastatin when compared with patients who were on placebo. In JUPITER (Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin), more than 18,000 participants with low levels of LDL cholesterol but with elevated levels of C-reactive protein, a marker of inflammation, were treated with either rosuvastatin 20 mg or a placebo.

What’s New: Do not combine ACE with ARB (COOPERATE data retracted) 

Because of concerns about the data, most of the cardiologists were not relying on the COOPERATE trial when making decisions about using combination therapy with ACE inhibitors and ARBs in treating patients with chronic kidney disease, however some doctors kept on using the combination based on results from COOPERATE. Lancet has now formally retracted its publication of the COOPERATE trial.

The Editors of The Lancet. Retraction Combination treatment of angiotensin-II receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease (COOPERATE): a randomised controlled trial. (Lancet 2009; 374:1226

Mnemonic of the Day (Maj Dr Prachi Garg)

Myocardial infarct- complications ABCDE × 2

A rrhythmias / Aneurysm

B radycardia / ↓BP

C ardiac, failure / cardiac tamponade

D ressler’s / Death!

E mbolism / Extra (VSD, pap muscle rupture)

Celiac Disease (Dr Ishi Khosla)

Is celiac disease similar to egg allergy or milk allergy or soy allergy?

No it is not. In other allergies there is no damage to intestine and therefore no malnutrition or risk of any other associated illness. While, celiac disease damages the intestines.

Diabetes Fact

Pseudohyponatremia in Diabetic Ketoacidosis (other causes high lipids, high proteins, technical low Na, not true low). DKA can have high TG and high amylase (but with normal lipase). Potassium can be high or later low. Both urea and BUN are high.

Public Forum
(Press Release)

Heart Patients Beware of Summer

Dehydration can precipitate heart attack in susceptible individuals. The normal fluid requirement is 30 ml per kg weight, but the same needs to be increased in the summer because of the loss of fluid from sweating. Apart from water, Sodium or salt is also lost. A person, therefore, needs to take more fruits intake during summer period.

Not passing urine in eight hours, dry armpits, feeling exhausted or feeling week are suggestive of underlying dehydration said Padma Shri and Dr B C Roy Awardee Dr K K Aggarwal, President Heart Care Foundation of India. Dehydration can make the blood thick and precipitate heart attack in patients with uncontrolled blood pressure or diabetes.

Walking is a necessity for heart patients and the same should be continued even during peak summer but the timing should be so chosen that peak heat periods are avoided. One can walk early in the morning or late in the evening. People taking anti-allergic pills should take special precautions as they are more likely to get heat stroke.

Heat stroke is a medical emergency leading to charring of organs because of extreme internal heat. A person’s temperature may be more than 105°F.

Preventing Summer Disorders

The most common summer disorders are dehydration, heat cramps, heat exhaustion and heat stroke on one hand and acidity, infections, diarrhea, cholera, typhoid and jaundice on the other hand.

Heat cramps, exhaustion and stroke all result from prolonged exposure to heat but differ in the severity of the illness. Heat cramp is a milder form of illness where a person ends up with weakness, dehydration, and salt deficiency. The treatment, is replacing fluid and salt orally.

Heat exhaustion, on the other hand, is a relatively serious condition with fever, dehydration, weakness but presence of sweating. If not diagnosed and treated in time with rapid fluid replacement, heat exhaustion can end–up into heat stroke where the body’s thermoregulatory mechanisms fail leading to a sudden rise in internal temperature and charring of organs and ultimate death.

Heat stroke, therefore, is a medical emergency and requires bringing down of temperature within minutes. Absence of sweating, dry armpit, non-passing of urine for eight hours or presence of high grade fever in summer season should not be ignored and medical attention taken immediately.

Diarrhea, Cholera, Typhoid and Jaundice are all food and water-born diseases due to poor hygiene and shortage of water supply in the community. All of them can become serious if not attended in time. Of these diarrhea and cholera are infections of the small intestine and require replacing with lemon water mixed with sugar and salt. The deficiency of fluid may be upto 6 to 8 liters. A person needs to be hospitalized only if the loose motions are more than 12 in number. For prevention of these diseases, one needs to follow the principle – Heat it, Boil it, Cook it, Peel it or Forget it.

Question of the day

How many sittings are required for laser hair removal and what are the expected results?

Generally 6 to 10 sittings are needed for laser hair removal.
Expected results (end point) should not be and cannot be total disappearance of hair but thin hair with no significant pigment and hence cosmetically is not very disturbing.

The gap between sittings is determined by duration of hair growth cycle in the given area. It is 4 to 6 weeks for face and longer elsewhere.

The regrowing hair after each sitting is thinner and hence less amenable to further treatment, thus needing adjustments in choice of fluence and pulse width in subsequent sittings.

Laser hair removal does not treat the cause of growth of unwanted hair and patient must be told clearly as to why growth on untreated areas cannot be attributed as a failure of treatment.

Lastly treatment should be restricted to only those areas with unwanted hair as there are some reports suggesting that laser energy could modulate the vellous hair in such a way as to make it grow longer and darker.

eMedinewS Try this it Works

Relief of cough

For refractory cough add 0.5 mg/kg of lidocaine to 0.3 mL of albuterol solution in 3 mL of normal saline solution and administer the combination by aerosol nebulization. Lidocaine suppresses the cough reflex while the sympathomimetic agent relieves the bronchospasm. Try even for ACE inhibitor–induced coughs.

Dr Good Dr Bad

Situation: A prediabetic with mild hypertension came with mild cognitive dysfunction.

Dr Bad: Its unrelated to diabetes.

Dr Good: It is related to diabetes.

Lesson: Cognitive dysfunction in type 2 diabetes is related to the cumulative effects of long–term exposure to hypertension, even in pre–DM stages. Patients with poor cognition had a 14–18 mmHg higher systolic blood pressure than patients with good cognition. (Diabetes Metab Res Rev 2009;25(7):657–64.)

Make Sure

Situation: A 50–year–old patient, highly stressed at work and a hypertensive as well complained of acid eructations and indigestion

Reaction: Oh my God! He has hyperacidity. Put him on magaldrate

Make sure, patients who are suffering from stress, diabetes and/or hypertension and who have hyperacidity/GERD/peptic ulcers, are put on magaldrate which is safe and effective as an antacid.


Laughter the best medicine

Late one night the doctor’s wife was home alone, after her husband had been called to the hospital for an emergency. The doorbell rings, and she answers.

"Is the doctor at home?" asks the man at the door, in a very hoarse and quiet voice due to his aching throat.

"No, c’mon in!" whispers the doctor’s wife in return.

Formulae in Critical Care

PEFR in females

Formula: {Height (in inches) × 0.0254 × 3.72} + 2.24)
– {Age (in years) × 0.03}) × 60

Milestones in Medicine

circa 1840 A.D. Americans Crawford Long and William Morton independently discovered that ether gas can be used as a general anesthetic, allowing doctors to perform operations never possible before.

Lab Test (Dr Naveen Dang)

Procalcitonin helps to diagnose sepsis, to determine the risk of sepsis leading to septic shock and to distinguish bacterial from non bacterial infection.

List of Approved drug from 1.01.2009 to 31.10.2009

Drug Name


Approval Date

Valganciclovir Powder for Oral Solution 50mg/ml

For the treatment of cytomegalovirus (CMV) retinitis in AIDS patients and for prevention of CMV disease in solid organ transplant patients at high risk


(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 400 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

DMC Interaction on ‘Medical Ethics & Doctor–Pharma Relationship – New MCI Amendments' postponed till further information

Readers Responses

  1. Respected Sir, Regards, Please accept my Heartiest Congratulations for receiving Padma Shri Award from the President of India: Davinder Singh, Pharmacist.

  2. Dear Dr Aggarwal, Heartiest congratulations May God bless you with more fame. We are proud of you: Raj Kumar Ahuja.

  3. Congratulations on being worthy to receive the national honour. Keep on with the good work. Love & regards: Ravi Khanna.

  4. Heartiest congratulations. Leena Kochar.