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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

  Editorial …

11th January, 2011, Tuesday                                eMedinewS Presents Audio News of the Day

2nd eMedinewS – revisiting 2010 at http://www.docconnect.com on 9th January 2011

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

Propoxyphene Withdrawn

  • US FDA has removed propoxyphene from US market.
  • It puts patients at risk for potentially serious or even fatal heart rhythm abnormalities.
  • Standard therapeutic dose can be harmful to the heart.
  • It’s an opioid to treat mild to moderate pain.
  • First approved by the FDA in 1957.
  • Phased withdrawal of propoxyphene is already underway in Europe.

Calcium Supplements Boost Heart–Attack Risk: Meta–Analysis

  • Calcium supplements without co–administered vitamin D is associated with an increased risk of MI.
  • Meta–analysis of 15 randomized trials and up to 11 921 participants, warrants a reassessment of the role of calcium supplements in the management of osteoporosis
Dr KK Aggarwal
Editor in Chief
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  eMedinewS Audio PostCard

  MEDICON 2010, 26 December
53rd Annual Delhi State Medical Conference

Dr Rahul Bhargava speaks on ‘What the GP should know about Aplastic Anemia’

Audio PostCard
  Quote of the Day

(By Dr GM Singh)

"Tears are the safety valve of the heart when too much pressure is laid on it."

Albert Smith

    Photo Feature (from the HCFI Photo Gallery)

2nd eMedinewS Revisiting 2010

The day long CME was was inaugurated by, Mr. Rakesh Mehta, Chief Secretary of Delhi, Chief Guest of the function Sardar Buta Singh, former Union Home Minister and Guest of Honour Acharya Dr. Sadhvi Sadhna Ji Maharaj, Chairperson, World Fellowship of Religions, Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Dr K K Aggarwal
    National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email:emedinews@gmail.com

Delhi may get new medical college in Dwarka

With the Delhi Development Authority (DDA) sanctioning additional land close to the proposed Dwarka hospital, the Delhi government is now considering converting the hospital into a medical college. Delhi Health Minister Kiran Walia said: "The DDA has sanctioned us 10 acres of additional land. We have been laying emphasis on propagating medical education. This is another step towards this goal." The government is now discussing the possibilities of developing this medical college on a Public Private Partnership (PPP) model. (Source: Indian Express, Jan 08 2011)

Subodh Gupta to create ‘The Tree’ for NDMC in heart of city

It’s an attempt to give back something new to Delhi on its 100th year as capital of India and highlight the city’s legacy. The New Delhi Municipal Council's (NDMC) public art policy hopes to put Delhi on the international map in terms of arts and aesthetics so that it is identified by its public art. The first installation of its kind will be seen at the New Delhi City Centre (NDCC) complex of the civic body in the heart of Connaught Place. The sculpture, ‘The Tree’, will be created by renowned artist Subodh Gupta and will be installed at the complex lawns in another nine months. (Source: The Times of India, Jan 8, 2011)

    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC http://www.isfdistribution.com)

3 % weight loss during marathon raises chance of winning the race

If you are in a marathon running race and lose at least 3% of your body weight during the competition, your chances of getting to the end faster are significantly higher, South African researchers reveal in the British Journal of Sports Medicine. Their findings clash with experts and sporting authorities who say that any weight loss over 2% during a competition undermines athletic performance. The researchers gathered data on 643 competitors, 560 male and 83 female, who completed the Mont Saint Michel Marathon race in France in 2009. They ran 42 kilometers (26.0975 miles). They were all weighed moments before the race began and straight after it ended. Their aim was to see what impact weight loss might have on their finishing times.

(Dr Monica and Brahm Vasudev)

FDA launches a new web initiative

The FDA has launched a new Web–based resource that industry can use to keep abreast of the regulatory status for drugs, devices, food, and cosmetics. The Web page –– www.fda.gov/ForIndustry/FDABasicsforIndustry –– includes the kind of basic information about the regulatory process that is often requested by drug, device, and biologic companies.

SSRI may promote post–stroke gains in motor function

Researchers have reported online in The Lancet Neurology that early prescription of fluoxetine (Prozac) to patients with ischemic stroke who had moderate to severe motor deficits resulted in greater return of function than placebo. The mean improvement in score on the Fugl–Meyer Assessment of motor function was 9.8 points greater in the fluoxetine group (34 vs 24.3 points out of 100, P=0.003) after three months of treatment; this advantage was significant for both the upper and lower limbs.

Lower, not higher, doses of folic acid may reduce homocysteine levels

A randomized, dose–finding trial has found that doses of folic acid higher than 0.2 mg/day may not be needed to lower homocysteine levels. The trial is reported in the January issue of the American Journal of Clinical Nutrition.

First–in–Class Antibiotic Has High Risk of Adverse Events and Death

Results of a meta–analysis published in the December 20 online issue of the journal Antimicrobial Agents and Chemotherapy say that the usefulness of tigecycline for severe infections comes at a price: a high risk of adverse events and mortality. The authors recommend that this drug should be used carefully. Tigecycline (Tygacil; Pfizer) is an expanded broad–spectrum glycylcycline that is active against pathogens that are susceptible and resistant to other antibiotics.

Respiratory drug boosts diabetes risk

Inhaled corticosteroids modestly increase the risk of diabetes onset and progression, especially when given at high doses. Samy Suissa, PhD, of Jewish General Hospital in Montreal, and coauthors noted a 34% higher incidence of diabetes in patients with respiratory diseases was among those on inhaled corticosteroids. The study is reported in the November issue of the American Journal of Medicine.

    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What are the causes of infertility?

In about one–third of the couples, infertility is because of male factor; in one–third, it is because of female factor and in one–third, it is unexplained. The reasons of infertility could be male, female or unexplained. In males, the causes can be defective sexual function or absent low sperm count or poor sperm quality. In women, it could be blocked tubes, ovarian factors like polycystic ovarian disease and endometriosis or uterine factors like thin endometrium. In the rest one–third cases, there is no identified problem and so they are labeled as unexplained.

For queries contact: banerjee.kaberi@gmail.com

    Nutrition Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity

Vitamin E supplementation for prevention of morbidity and mortality in preterm infants

Giving extra vitamin E to preterm babies can provide some benefits, but it increases the risk of life–threatening infections. Preterm babies (born before 37 weeks) can develop a range of problems because their organs are not mature. Vitamin E may be able to help prevent or limit some of these problems, but it can potentially also have harmful effects. Breast milk of a woman who has given birth prematurely has higher than usual levels of vitamin E. Preterm babies can be given extra vitamin E as vitamin drops, in vitamin E–enriched formula, in intravenous fluids, or by injection into their muscles. A review of studies of vitamin E supplements published in the Cochrane database found that while extra vitamin E reduces the chances of some complications (including disease of the retina), the risk of life–threatening infection is increased. The risk of bleeding in the brain is increased when extra vitamin E is given intravenously but decreased when the extra vitamin E is given by other routes. Vitamin E supplementation in preterm infants reduced the risk of intracranial hemorrhage but increased the risk of sepsis. In very low birth weight infants, vitamin E increased the risk of sepsis, and reduced the risk of severe retinopathy and blindness among those examined. Evidence does not support the routine use of vitamin E supplementation by intravenous route at high doses or aiming at serum tocopherol levels greater than 3.5 mg/dl.

    Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

Sudden death – Autopsy

Left ventricular hypertrophy is the second leading cause of sudden cardiac death in adults in India

  • Longstanding raised high blood pressure causes secondary damage to the wall of the left ventricle, the main pumping chamber of the heart. Hypertrophy is associated with cardiac arrhythmias.
  • The mechanism of death in a majority of patients dying of sudden cardiac death is ventricular fibrillation and as a consequence there may be no prodromal symptoms associated with the death.
  • These patients may be going about their daily business and suddenly collapse without the typical features of myocardial infarction such as chest pain and shortness of breath. There are a number of cases in which patients feel the effect of myocardial ischaemia. (Myocardial ischaemia is associated with referred pain, classically to the front of the chest, the left arm and the jaw. Patients may feel generally unwell, with nausea, dizziness and vomiting).
  • These symptoms may precede the death for any length of time between a few minutes and several hours.

I had conducted the postmortem examination of four cases who were found dead in toilet during daily pursuits; these were cases of left ventricular hypertrophy that led to sudden death.

    Women’s Health: Preventing Top 10 Threats (Mayo Clinic)

Kidney disease

Kidney failure is often a complication of diabetes or high blood pressure. If you have diabetes or high blood pressure, keep them under control. In addition:

  • Eat a healthy diet. Limit the amount of salt you consume.
  • Include physical activity in your daily routine.
  • Lose excess pounds, if you’re overweight.
  • Take medications as prescribed.
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Porphyrin Test: Indications

When a patient has symptoms that suggest an acute neurologic/psychiatric porphyria, such as abdominal pain, tingling in hands or feet, and/or confusion or hallucinations, or that suggest a cutaneous porphyria, such as reddening, blistering, or scarring on sun–exposed skin.

    Medi Finance Update

Understanding Mutual Funds

Balanced funds invest in a mix of stocks, bonds, and cash investments. The mix will change as market conditions change, but it usually stays within predetermined ranges. For example, stocks 40–60%, bonds 30–50%, cash 0–30%.

    Drug Update

List of Approved drugs from 01.01.2010 TO 30.4.2010

Drug Name
DCI Approval Date
Pramipexole dihydrochloride monohydrate ER Tablet 0.375/0.75/1.5/3/4.5 mg
For the treatment of the sign and symptoms of idiopathic Parkinson’s disease
    IMSA Update

International Medical Science Academy (IMSA) Update

Daily chest radiographs on mechanically ventilated patients (to check endotracheal tube position) are routine in many clinical centers. A trial randomly assigned 21 intensive care units (ICUs) to perform routine daily or as–needed chest radiographs on mechanically ventilated patients’. The number of chest radiographs was significantly lower in the as–needed group without worsening clinical outcomes including mortality, length of ICU stay, or duration of mechanical ventilation.

Our Contributors
  Docconnect Dr Veena Aggarwal
  Docconnect Dr Aru Handa
  Docconnect Dr Ashish Verma
  Docconnect Dr A K Gupta
  Docconnect Dr Brahm Vasudev
  Docconnect Dr GM Singh
  Docconnect Dr Jitendra Ingole
  Docconnect Dr. Kaberi Banerjee
  Docconnect Dr Monica Vasudev
  Docconnect Dr MC Gupta
  Docconnect Dr. Neelam Mohan
  Docconnect Dr. Naveen Dang
  Docconnect Dr Prabha Sanghi
  Docconnect Dr Prachi Garg
  Docconnect Rajat Bhatnagar
  Docconnect Dr Sudhir Gupta
    IJCP Special

Dr Good Dr Bad

Situation: A patient with Mediclaim wanted angiography.
Dr. Bad: Get admitted for 24 hours.
Dr. Good: You can go after six hours.
Lesson: If you can justify that due to technological advances, hospitalization is required for less than 24 hours, Mediclaim will be applicable.

Make Sure

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

    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Prachi Garg)

The Power of Belief

After the teams for the 2003–2004 MBHL Hockey Season our team was thought to be the worst team in the league. My team battled throughout the whole season losing to teams large amounts. Everyone got down on themselves and thought that we couldn’t do it. With six games left in the season we had to win all of them to make it to the playoffs. Our coach told us that if we wanted to show everyone that we were a good team we had to make it to the playoffs. My team battled hard and we did it we made it to the playoffs.

We made two huge upsets in the playoffs to make it to the League Championship against the #1 team who was undefeated and had beaten us 12-0. Before the game our coach got us motivated and prepared for the biggest game of our lives.

We came out with heart and we were determined to win and we did 3–2 in overtime and we shocked the whole league. We had pulled a huge upset and won the 2003-2004 League Championship with heart, hard work and never losing sight of our dream.


Mind Teaser

Read this…………………


Yesterday’s Mind Teaser: he art

Answer for Yesterday’s Mind Teaser:
Broken heart

Correct answers received from: Dr Satyoban Ghosh, Dr K.P.Rajalakshmi, Dr K.Raju, Dr S Upadhyaya, Dr Muthumperumal Thirumalpillai, Dr Chandresh Jardosh, Dr Neelam Nath, Dr Suman Kumar Sinha, Dr Chandresh Jardosh,

Answer for 8th January Mind Teaser: Somewhere over the rainbow
Correct answers received from: Dr Sudipto Samaddar, Dr Apurva Koirala, Dr Muthumperumal Thirumalpillai

Send your answer to ijcp12@gmail.com


Laugh a While
(Contributed by Dr GM Singh)

There are two elderly men that meet in the park on Saturdays and talk about old times. One day one said to the other: "I think it time for me to go. Everything hurts, nothing works right with my body and I am ready to go." He then asks the other man how he felt. He says: "I feel like a brand new baby." The other asks: "What? Why?" The man replies: "Well, I got no teeth, no hair and I think I just wet myself."

    Readers Responses
  1. It was very educative watching live webcast of emedinews conference. Although time constraint curtailed the speech duration of last few speakers, overall it was a very well organised event. Thanks to all those who made it so successful. Regards: Raghavendra Singh
    Public Forum

(Press Release for use by the newspapers)

Most uncontrolled asthmatics think they are controlled

Two thirds of patients with uncontrolled asthma think their disease is well under control, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Asthmatics on proper medicines can not only lead a normal life but also reduce their future complications. Drugs include those medicines that keep the disease at bay as well as those that are used when a flare–up occurs. Uncontrolled asthmatics will invariably end up with right heart complications due to persistent lack of oxygenation in the blood.

Most asthmatics fail to perceive their level of disease control and with an uncontrolled state they often feel that their asthma is under control.

Dr. Eric van Ganse, of University of Lyon, France, in a study published in the Annals of Allergy, Asthma, and Immunology, examined 1,048 subjects with inadequate asthma control. When asked how they would rate their asthma control over the past 14 days, nearly 69 percent considered themselves to be completely or well controlled. Failure to perceive inadequate asthma control was more likely to be found in patients between the ages of 41 and 50 years.

In severe asthma, low blood oxygen levels might impair a person's ability to assess their own breathing difficulty.

Another reason is that the notion of asthma control seems poorly understood by asthmatic patients. Also, mild to moderate asthma limits the activities of a person and they over a period of time take that as their normal limits.

    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

IMSA Workshop on Rheumatoid Arthritis

Date: Sunday, January 16, 2011; Venue: Moolchand Medicity, New Delhi ; Time: 10–12 Noon


  1. Understanding Biologics: Dr Rohini Handa, Former Head Rheumatology, AIIMS
  2. All what a practitioner should know about rheumatoid arthritis: Dr Harvinder S Luthra, Chief of Rheumatology, Mayo Clinic, Rochester USA

No fee. Register emedinews@gmail.com or sms 9899974439

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