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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

10th March 2010, Wednesday

Top 10 Ways to Keep the Kidneys Healthy

March is National Kidney Month and March 11 is World Kidney Day. We all want our kidneys to last for a lifetime. We all should show our love for kidneys by adopting 10–step program for protecting kidney health.

One should begin with monitoring blood pressure and controlling weight and then move on to the other kidney–healthy tips.

1. Monitor blood pressure and cholesterol.

2. Control weight.

3. Don’t overuse over–the–counter painkillers.

4. Monitor blood glucose.

5. Get an annual physical exam.

6. Know if chronic kidney disease (CKD), diabetes or heart disease runs in your family. If so, you may be at risk.

7. Don’t smoke.

8. Exercise regularly.

9. Follow a healthful diet.

10. Get tested for for chronic kidney disease if you’re at risk.

(With inputs from Dr NP Singh, Professor of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital. New Delhi).

Dr KK Aggarwal
Chief Editor

News and Views (Dr G M Singh)

1. Specific recommendations for identifying and diagnosing hyperglycemic disorders in pregnancy:–

  • At the first prenatal visit, all or only high–risk women should undergo testing of fasting plasma glucose (FPG), hemoglobin A1c, or random plasma glucose

  • Thresholds for diagnosis of overt diabetes during pregnancy are fasting plasma giocoso of at least 7.0 mmol/L (126 mg/dL); hemoglobin A1c level of at least 6.5% (Diabetes Control and Complications Trial/UK Prospective Diabetes Study standardized); or random plasma glucose at least 11.1 mmol/L (200 mg/dL), plus confirmation.

  • If this testing result indicates overt diabetes, treatment and follow–up should be the same as for preexisting diabetes.

  • If testing is not diagnostic of overt diabetes and FPG is at least 5.1 mmol/L (92 mg/dL) but less than 7.0 mmol/L (126 mg/dL), gestational diabetes mellitus (GDM) should be diagnosed.

  • If FPG is less than 5.1 mmol/L (92 mg/dL), the patient should be tested for GDM from 24 to 28 weeks of gestation with a 75–g oral glucose tolerance test (OGTT).

  • To diagnose GDM at 24 to 28 weeks of gestation, a 2–hour, 75–g OGTT should be performed after overnight fast on all women not previously found to have overt diabetes or GDM during testing earlier in this pregnancy.

  • Overt diabetes is diagnosed if fasting plasma glucose level is at least 7.0 mmol/L (126 mg/dL).

  • GDM is diagnosed if one or more values equal or exceed thresholds of FPG of 5.1 mmol/L (92 mg/dL), 1–hour plasma glucose level of 10.0 mmol/L (180 mg/dL), and/or a 2–hour plasma glucose level of 8.5 mmol/L (153 mg/dL).

  • Normal test results are defined as all values on OGTT less than these thresholds.

  • Insufficient studies have been done to determine whether there is a benefit of generalized testing to diagnose and treat GDM before the usual window of 24 to 28 weeks of gestation.

All women diagnosed with GDM or overt diabetes during pregnancy should undergo postpartum glucose testing.

2. Varicose veins: risk factors

  • Aging

  • Having a family history of varicose veins, or weak vein valves

  • Changes in hormones caused by pregnancy, puberty, menopause or taking certain medications

  • Pregnancy itself

  • Obesity, an injury to the leg, or other factors that weaken vein valves

  • Significant sun exposure

3. It’s time to visit the doctor if an animal bite shows the following signs:

  • Heat or warmth to the touch

  • Swelling around the bite

  • Pain around the bite

  • Pus discharge

  • Red skin surrounding a bite

  • Difficulty straightening or bending a finger

  • Numbness at the tip of a finger

4. The Nemours Foundation offers the following list of common triggers for eczema:

  • Allergens such as animal dander, dust, mold or pollen

  • Cold, dry winter air, or severe heat

  • Dry skin

  • Harsh soaps or detergents

  • Irritating fabrics such as wool, or fabrics with a coarse weave

  • Perfume, cologne and some skin care products, especially those with alcohol

  • Tobacco smoke

  • Some foods, commonly dairy foods and those that are highly acidic

  • Emotional stress

  • Sweating

  • Sore throat

Conference Calendar

Medical Fair India 2010 – (16th International Exhibition on Conference on Diagnostic, Medical Equipment and Technology). Date: March 12–14, 2010 . Venue: Hall V, Bombay Exhibition Centre, Mumbai, Maharashtra.

Quote of the Day

Sunbeams out of the clouds, Faith out of all my doubt. (Emme Woodhull–Bäche)

Public Forum (Press Release)

Hepatitis A, E and Typhoid, the hygienic markers of cleanliness of a city

Jaundice with hepatitis A in children and E in adults, typhoid, cholera and gastroenteritis reflects the hygienic status of a city and not the occurrence of dengue and malaria, said Padma Shri awardee Dr. K K Aggarwal, President, Heart Care Foundation of India, and Editor eMedinewS.

Dr. Aggarwal said that food and water–borne diseases can be eradicated by the following public awareness formulas:

1) When in doubt follow the principle "heat it, boil it, cook it, warm it, peel it or forget it". Giving an example, Dr. Aggarwal said that in an unhygienic environment one can take orange or banana but not tomato or apple.

2) One should not take salad that has been left over for more than 2 hours even if it is washed properly.

3) One should not take cooked food left on the table for more than two hours.

4) Vegetables grown under the ground or over the surface of the ground should be washed properly before eating them raw. They may be the biggest source of causation of worms in the brain, a condition called neurocysticercosis.

5) Boiled water is the safest water to drink.

6) Ice made from unhygienic water can be the source of most water–borne diseases. It is our duty to keep our home and city (extended house) as clean as possible. The city is our extended home, the gardens in the city our farm houses, the roads are our personal walking tracks.

Most food–and water–borne diseases are self–inflicted and can be managed by a simple step of washing the hands before and after toiletry and before and after consuming any food.

Question of the day

Can appendectomy protect against development of UC?

A number of studies have suggested that appendectomy may protect against the development of UC.1–6


A cohort study, for example, included 212,963 patients who underwent appendectomy between 1964 and 1993.4–5 The risk of developing ulcerative colitis was decreased by about 55%4 in those who underwent appendectomy before they were 20 years old for an inflammatory condition (appendicitis or lymphadenitis) but not for nonspecific abdominal pain.

A case report documented improvement in the histologic and immunologic profile in a patient following appendectomy.5 No effects of appendectomy have been observed in the development of CD. Neonatal appendectomy had a beneficial prophylactic effect upon the development of disease in a "genetic" murine model of colitis.6


  1. Sandler RS. Appendicectomy and ulcerative colitis. Lancet 1998;352:1797.

  2. Rutgeerts P, D’Haens G, Hiele M, et al. Appendectomy protects against ulcerative colitis. Gastroenterology 1994;106:1251.

  3. Andersson RE, Olaison G, Tysk C, Ekbom A. Appendectomy and protection against ulcerative colitis. N Engl J Med 2001;344:808.

  4. Andersson RE, Ekbom A. Appendectomy and protection against ulcerative colitis (letter). N Engl J Med 2001;345:223.

  5. Okazaki K, Onodera H, Watanabe N, et al. A patient with improvement of ulcerative colitis after appendectomy. Gastroenterology 2000;119:502.

  6. Mizoguchi A, Mizoguchi E, Chiba C, et al. Role of appendix in the development of inflammatory bowel disease in TCR–alpha mutant mice. J Exp Med 1996;184:707.

eMedinewS Try this it Works

Heat for candidiasis

Candidal organisms do not thrive without moisture: Rash may persist in both adults and children because the ointments they use hold moisture to the skin. Expose the skin to medium heat from a hair dryer or 100–watt bulb. Do it two or three times a day for 10 to 20 minutes. It works.

Dr Good Dr Bad

Situation: A patient with gestational diabetes came for a follow up 2 months after delivery.
Dr Bad: There are no chances of your developing diabetes.
Dr Good: Get your OGTT done.
Lesson: All women with previous gestational diabetes mellitus should have a regular assessment of their glucose tolerance in the years after pregnancy. The first OGTT should be performed around 2 months postpartum in order to diagnose women already diabetic and to identify women with the highest risk for later development of overt diabetes. (Source: Dan Med Bull 1998;45(5):495–509)

Make Sure

A 62–year–old diabetic with coronary artery disease, on treatment for the same, comes for follow up.
Oh My God! Why didn’t you put him on antioxidants?
Make Sure to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects.

Medi Finance :(BUDGET 2010–2011)


Rate of Minimum Alternate Tax (MAT) increased from the current rate of 15% to 18%. Limits for turnover for Tax Audit increased to Rs. 60 lakh for businesses and to Rs. 15 lakh for professions.

Punjab & Sind Bank
Central Bank of India

Laughter the best medicine

Actual medical record:
On the second day the knee was better and on the third day it had completely disappeared.

Formulae in Critical Care

Vital capacity (VC)
Formula: VC = TV + IRV + ERV
TV = Tidal volume, IRV = Inspiratory reserve volume, ERV = Expiratory reserve volume.

Milestones in Neurology

Ugo Cerletti (1877–1963) was an Italian neurologist who discovered the method of electroconvulsive therapy in psychiatry.

Mistakes in Clinical Practice

Include a brief note on purpose of the medication.

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

Serum creatinine: Creatinine is a waste product in your blood that comes from muscle activity. It is normally removed from your blood by your kidneys, but when kidney function slows down, the creatinine level rises. Your doctor can use the results of your serum creatinine test to calculate your kidney function, or GFR.

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

Enlargement of prostate can occur in any individual after 40 years of age. There is evidence of positive correlation between obesity and prostate size, but not between obesity and symptoms severity.

Lab test (Dr Navin Dang)

In 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

Zoledronic Acid Solution for Infusion Addl. Indication

Prevention of clinical fractures after hip fracture in men and women


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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.

NATIONAL SEMINAR ON STRESS PREVENTION (17–18 April) . Over 300 registrations done already.

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

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Readers Responses

  1. Respected Sir: Emedinews is an amazing effort by you. I thank you for thinking so deeply for future of medicine. I wish to permanently enroll my name in your mailing list, Thanks. drkpalsingh@sify.com. drkpsinghmailbox@rediffmail.com

  2. Sir, Hearty congratulation on receiving india’s most prestigious award: Dr Golmei JD.

  3. Very informative and intersting newsletter – I go though it before starting my practice everyday. ‘An Old story’ by Dr. Suman Sinha included here gives a good message in a humurous way: Dr. Parvesh Sablok, Paonta Sahib (HP)