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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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  Editorial …

11th August 2011, Thursday

Do not smoke the 1st cigarette in the first hour of waking

Results from two linked studies reported in the journal Cancer by Joshua E. Muscat, PhD, of Penn State College of Medicine in Hershey state that smokers who smoke their 1st cigarette within half an hour of waking are at 59% higher risk of head and neck cancer and 79% elevated lung cancer risk compared with those who smoke their 1st cigarette after an hour of waking up. Those who started on their first cigarette 31 to 60 minutes after waking were at significantly elevated risk as well (42% and 31%, respectively), the group reported in two linked studies appearing online in Cancer.

While any smoking boosts cancer risk, an early start in the day is particularly risky because it signals stronger nicotine dependence.

  • The first study described results among 1,055 head and neck cancer patients and 795 controls. Cancers were 2.11–fold more likely with smoking within 30 minutes of waking and 1.63–fold more likely with a first cigarette within 31 to 60 minutes of waking.
  • The other study described analysis of 4,775 newly–diagnosed lung cancer cases and 2,835 controls. Current smoking and greater number of cigarettes smoked per day were linked to higher lung cancer risk. There was 2.64–fold higher risk of cancer with smoking within 30 minutes of waking and 1.58–fold higher risk with smoking 31 to 60 minutes after waking.

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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 on

Do not smoke the 1st cigarette in the
first hour of waking

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

National Conference on Insight on
Medico Legal Issue

Dr Ranjit Roy Chaudhary presenting his views in the National Conference on Insight on Medicoleagl Issues held on 10th July, 2011.

Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


Atlanta centre to train India’s top scientists to contain public health threats

NEW DELHI: India’s top scientists are going back to school to become "disease detectives". Beginning 2012, around 10 Indian scientists will be trained at the Centers for Disease Control and Prevention (CDC), Atlanta's special "Epidemic Intelligence Service Programme" (EIS), which was started in 1951 following biological warfare concerns triggered by the Korean War. This elite two–year post doctoral training programme gives special attention to field work, and will train the scientists on how to investigate and contain serious public health threats. "Our top doctors will go through this course. This project is part of the Global Disease Prevention pact signed between US President Barack Obama and Prime Minister Manmohan Singh last year," said CDC Atlanta director Dr Thomas R Frieden in an exclusive interview to TOI. (Source: TOI, Aug 10, 2011)

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

(Dr Monica and Brahm Vasudev)

VTE risk increased among siblings

Having a sibling with a history of venous thromboembolism (VTE) is an important risk factor for the development of this health problem, Swedish researchers reported. (Source: Medpage Today)

For comments and archives

Risk factors for osteoporosis in men

As per American Academy of Orthopaedic Surgeons the risk factors are

  • Drinking excessive amounts of alcohol or using tobacco.
  • Not exercising regularly.
  • Having a low body–mass index.
  • Getting insufficient vitamin D and calcium.
  • Taking certain medications, including anticonvulsants, oral glucocorticoids or heparin.
  • Getting older.
  • Having a family history of fractures related to fragile bones.
  • Certain health conditions, including asthma, thyroid disorders or rheumatoid arthritis.
  • Having low levels of certain hormones, including testosterone or estrogen.

For comments and archives

Combo chemo better for some lung cancer patients

Elderly patients with advanced non–small–cell lung cancer live longer with combination chemotherapy than with currently recommended monotherapy, researchers reported. In a randomized trial, older patients getting platinum–based doublet chemotherapy –– the standard of care for fit but younger patients –– had a 36% reduction in the risk of death over a median two–and–a–half–year followup period, compared with those getting monotherapy, according to Elisabeth Quoix, MD, of the University Hospitals of Strasbourg in Strasbourg, France, and colleagues. They also had a significantly longer period of progression–free survival, although they were more likely to report toxic side effects, Quoix and colleagues reported online in The Lancet. (Source: Medpage Today)

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Fetal DNA in mom’s blood predicts baby’s sex

Testing for free–floating fetal DNA in the mother’s blood can accurately predict the child’s sex, researchers found. In a review and meta–analysis, detection of Y–chromosome sequences had a sensitivity of about 95% and a specificity of nearly 99%, Stephanie Devaney, PhD, of the National Institutes of Health in Bethesda, Md., and colleagues reported in the August 10 issue of the Journal of the American Medical Association. (Source: Medpage Today)

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    Fitness Update

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

Strength training authority brings expertise to new iPhone app

Increasing muscle mass may be one of the toughest goals for weightlifters to achieve, but highly regarded strength training authority Nick Evans is making it easy to succeed. His new iPhone app, Men’s Body Sculpting: Muscle Mass Generator (Human Kinetics, 2011), details a specific program designed for lean muscle mass development and provides users with all the exercises and nutritional guidelines they need to achieve their goals.

Evans’ customizable app, which serves as a complement to his book, Men’s Body Sculpting, Second Edition (Human Kinetics, 2011) features 26 exercises mixing body–weight, free weights, and machine weights, each accompanied by two full–color photos and a video demonstration to ensure proper and safe execution. Also included is a way for users to receive detailed information about their caloric needs, broken down by nutrients, and sample menus that eliminate any guesswork, helping them eat right while training hard. The special progress tracker, meanwhile, allows users to utilize the camera on their iPhone, iPad, or iPod Touch to keep a photo log for a time lapse view of their results.

Whether training to improve looks or working to add muscle mass for a particular sport, Men’s Body Sculpting: Muscle Mass Generator will help weightlifters transform their bodies. It is now available through the iPhone App Store for $2.99. For more information about Human Kinetics, visit www.HumanKinetics.com

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    Twitter of the Day

@DrKKAggarwal: Yoga does not means you can not suffer from a disease read.................http://lnkd.in/fcq5VV http://lnkd.in/P376Fx

@DeepakChopra: #CosmicConsciousness is becoming self aware through the human nervous system on planet earth

    Dr KK Answers

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

How risky is carotid stenting or surgery?

Both endarterectomy and carotid stenting are associated with an increased 30–day risk of stroke and death. These are in the range of 2.3 to 3.7 percent for endarterectomy.

For comments and archives

    Spiritual Update

Rome was not built in a Day

With ‘Abhyas’ or constant practice, one can conquer all the obstacles in life. The sutra "Rome was not built in a day" has a deep spiritual meaning. In the path for self–realization, regular practice is the principle behind all paths: Bhakti, Karma or the Gnana marg. Persistence is the key in any spiritual attainment.

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    An Inspirational Story

(Ms Ritu Sinha)

A most important lesson

During my second month of nursing school, our professor gave us a pop quiz. I was a conscientious student and had breezed through the questions, until I read the last one: "What is the first name of the woman who cleans the school?" Surely, this was some kind of joke.

I had seen the cleaning woman several times. She was tall, dark–haired and in her 50s, but how would I know her name? I handed in my paper, leaving the last question blank. Just before class ended, one student asked if the last question would count toward our quiz grade. "Absolutely," said the professor.

"In your careers, you will meet many people. All are significant. They deserve your attention and care, even if all you do is smile and say ‘hello’."

"I’ve never forgotten that lesson. I also learned her name was Dorothy.
Moral: Every person no matter who it is should be considered equal… something that we all forget so easily. To value a person regardless of their status is the highest noble work.

For comments and archives

    Pediatric Update

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

What is CMV?

CMV or the Cytomegalovirus is a DNA virus and belongs to the beta herpesvirus group. It causes a range of diseases in humans.

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    Infertility Update

(Dr. Kaberi Banerjee, Infertility and IVF Specialist)

What are some less common causes of infertility?

Although still regarded "uncommon" by many practitioners, there is evidence that many cases of "unexplained" infertility are actually the result of malfunction of the immune system. These problems can range from antisperm antibodies to an outright rejection of a developing fetus. On the brighter side, greatly improved testing is now available to screen for these problems, and new treatment protocols are resulting in unprecedented success rates.

For comments and archives

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


  • To help monitor your over time, especially if it is not possible to monitor using the A1C test
  • To help determine the effectiveness of changes to your diabetic treatment plan.

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    IJCP Special

Dr Good Dr Bad

Situation: An asymptomatic patient with no obvious underlying cardiac disease shows ventricular premature contractions (VPCs).
Dr Bad: Anti–arrhythmics should be given.
Dr Good: No treatment is needed.
Lesson: In the absence of cardiac disease, isolated asymptomatic VPCs regardless of configuration and frequency need no treatment.

For comments and archives

Make Sure

Situation: A patient with fever developed melena.
Reaction: Oh my God! why was platelet count not done?
Lesson: Make sure to do platelet counts in all patients with fever.

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  Quote of the Day

(Dr GM Singh)

The mind is its own place, and in itself, can make heaven of Hell, and a hell of Heaven. John Milton


(Ms Ritu Sinha)

Dark horse: One who was previously unknown and is now prominent.

    Medicolegal Update

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

Sudden death–autopsy–four cases found dead in toilet during daily pursuits

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

  • The longstanding raised high blood pressure which has caused secondary damage to the wall of the main pumping chamber of the heart, the left ventricle. Once again, 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 found dead in toilet during daily pursuits the cases of left ventricular hypertrophy resulted into sudden death.

For comments and archives

    Mind Teaser

Read this…………………

i i

Yesterday’s Mind Teaser: Pancreatitis, pituitary tumor and phaeochromocytoma may be associated with:

1. Medullary carcinoma of thyroid
2. Papillary carcinoma of thyroid
3. Anaplastic carcinoma of thyroid
4. Follicular carcinoma of thyroid

Answer for Yesterday’s Mind Teaser: 1. Medullary carcinoma of thyroid

Correct answers received from: Dr Priyanka Sharma, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay, Dr Neelam Nath, Dr TP Jayaraman, Dr Surendra Bahadur Mathur,
Dr Anil Bairaria, Dr Madhavi Tripathi, Dr Sukanta Sen, Dr Dilip Kumar Jha.

Answer for 9th August Mind Teaser
: 4. Appendix
Correct answers received from: Dr Anupam, Dr Prachi, Dr Anil kumar jain.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr Chandresh Jardosh)

A boy asks: Dad, where did my intelligence come from?

Dad: U must have got it from ur mother.

Mother: Oh Darling why do u say so?

Dad: Cause I still have mine

For comments and archives

    Medi Finance Update

(Dr GM Singh)

What is earnings per share (EPS)?

It is profit after tax/number of shareholders. This indicates the portion of a company’s profit allocated to each outstanding share of common stock and remains a key indicator of the company’s profitability. There are 2 types of EPS: Basic & Diluted; Basic EPS keeps the calculation simple by using the net PAT and the number of shareholders at the end of the period. On the other hand, diluted EPS expands on basic EPS by including the shares of convertibles or warrants outstanding, as part of the outstanding shares number.

For comments and archives

    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name
DCI Approval Date
Tapentadol Hydrochloride Tablets 50mg/75mg/100mg
For relief of moderate to severe acute pain in adults 18 years of age or older.


    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Depression and Diabetes

Depression is implicated in diabetes said Padmashri & Dr B C Roy National Awardee, Dr K K Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

For many years it was thought that depression was a complication of diabetes. More recent research, however, points to depression as a possible trigger.

A Kaiser Permanente study of 1,680 subjects found that those with diabetes were more likely to have been treated for depression within six months before their diabetes diagnosis. About 84 percent of diabetics also reported a higher rate of earlier depressive episodes.

A 2004 Johns Hopkins study tracking 11,615 initially non diabetic adults aged 48-67 over six years found that "depressive symptoms predicted incident type 2 diabetes."

According to an evaluation of 20 studies over the past 10 years, the prevalence rate of diabetics with major depression is three to four times greater than in the general population. While depression affects maybe three or five percent of the population at any given time, the rate is between 15 and twenty percent in patients with diabetes, according to the American Diabetic Association. Women, in particular are at greater risk.

Whether a cause or an effect, the combination of diabetes and depression can be deadly. Because of physiologic and behavioral interactions between diabetes and depression, each becomes more difficult to control, increasing the risks of cardiovascular disease, diabetic retinopathy causing blindness, neuropathy and other complications.

Obesity is a risk factor for macrovascular disease. Depressed people tend to eat more and exercise less, which results in weight gain and sabotages efforts at controlling blood sugar levels. Depressed adults with diabetes have significantly higher body mass indexes than nondepressed adults with diabetes.

Depression in diabetics is a greater risk factor for heart disease than high blood sugar.

If depression can trigger diabetes or make it much worse, it stands to reason that effectively managing one's depression can help bring one's diabetes under control.

The take home message is

  1. If you have diabetes get screened for depression
  2. and if you have depression get screened for diabetes

For comments and archives

    Readers Responses
  1. Dear Sir, great information on Early and Mild Rheumatoid arthritis. Regards: Dr Anupama.
    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & National Icons in the field of Cardiology & Echocardiography will form the teaching faculty.



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Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta