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  Address:  39 Daryacha, Hauz Khas Villege, New Delhi, India. e-Mail: drkk@ijcp.com , Website: http://www.ijcpgroup.com 

Dr K K Aggarwal

Dr KK Aggarwal
Dr BC Roy Awardee
Sr Physician and Cardiologist,
Moolchand Medcity
President, Heart Care
Foundation of India
Gp Editor-in-Chief,
IJCP Group
Delhi Medical Council
Director, IMA AKN Sinha Institute (08-09)



12th November Thursday 

Dear Colleague,

 Dengue and the SMOG

Ever since smog took over Delhi, suddenly we saw a large drop in number of dengue cases in the city. Has smog anything to do with this?

This year dengue was different. It remained at its peak even after Diwali. The routine Diwali short lived mosquitoes were noted for their absence. The fever was abrupt and high grade and most of the patient's had Hepatitis as a predominant feature as against eye pain on movement in the earlier years. We have never seen in the past SGOT or SGPT crossing 700 in dengue hepatopathy.  Also this year, most of the patients' platelet count dropped less than 10,000. The NICD should have by this time or at least now come out and inform the strain of dengue we are dealing with. Is it secondary dengue phenomenon or dengue 2 which is more virulent?

Early morning the best time to do colonoscopy

A new study published in November issue of Clinical Gastroenterology and Hepatopathy has shown that early morning colonoscopy detects more polyps than done later in the day. A study of 477 people who did their colonoscopy once in a year showed that screening that started at 8.30 am or earlier detected 271 more polyps per patient than colonoscopy performed at a later time. As the day progressed, the reporting of polyps went on decreasing. The doctors speculated that more polyps are found earlier in the day because of the better bowel preparation night before by the patients and fatigue of the physicians and assistants.

Delhi Medical Council Update?

The process for election/nomination of 21 members of Delhi Medical Council is still not over. The Council has already elecetd Dr. K.K. Aggarwal, Dr. Chandan Prakash, Dr. Vinay Aggarwal, Dr. Anil Goyal, Dr. Anil Bansal, Dr. Ajay Gambhir, Dr. N.P. Singh, Dr. Praveen Bhatia (Direct elected members); D. Ashwini Dalmia (DMA Representative);  Dr. O.P. Kalra (UCMS); Dr. G.K. Sharma (LHMC); Dr. Bhupender Gupta (Vardhman Medical College); Dr. Manoj Singh (AIIMS), Dr. Vinay Rai (Army Medical College) and Dr. A.K. Agrawal (MAMC).

Four nominated members are still to be officially announced though we have unconfirmed news about their names. We may only disclose once they are confirmed.  Apart DMC will have DHS ( Dr S Bhattacharjee) and Dean Faculty ( Dr Kiran Mishra) as members.

11th was the last date for the completion of the term for the last DMC and it is likely in the next couple of days, Delhi Government will issue a notification for the new council formation.

In the meantime, there has been a complaint by Dr. Hem Gupta challenging the DMA election process. The same is with the Directorate of Health Services. The new Council will soon meet and elect its president and vice president. In all likely Dr. A.K. Agrawal, the sitting President, DMC may recontest for the President for another five years.

 Dr K K Aggarwal


 Binge alcohol dangerous
In a study published in April, researchers from San Diego reported that young people who binge drink can seriously damage the white matter in their brain, which is crucial for relaying information between brain cells. The death toll from alcohol has been rising among U.S. college students. According to the U.S. National Institute on Alcohol Abuse and Alcoholism, alcohol-related deaths have increased in this group from 1,440 in 1998 to 1,825 less than a decade later, in 2005


Pay Less for Prescription Drugs

Most Indians can not afford the rising costs of the drugs  but several options are available.
1. In some cases, tablet splitting can help reduce costs. But not all medications can be split. Patients should check with their pharmacist or physician before using this approach. This means instead of buying 25mg of a tablet, buy 50 mg one and split it into half. For this always look for a scored tablet which can be divided into half.
2. First, talk to your doctor for the cheaper yet effective generic drug or an alternative
3. Many chemists have low cost options.
4. Go to a reduced-cost or free clinic, where health care providers are trained to consider lower-cost alternatives and may be able to provide prescriptions at reduced cost or no cost.
5.  Look into drug manufacturer or government programs. Some drug makers offer discount cards or programs for brand-name medications at reduced-cost.
6.  Lifestyle changes, such as getting more exercise and eating healthier foods, may reduce the need for medications.

Phosphorus Levels May Predict Heart Disease (Dr Prachi Garg)
Elevated blood levels of phosphorus are associated with a higher risk of heart disease. US researchers studied the link between phosphorus levels and coronary artery calcification (CAC) in nearly 900 healthy adults in the Spokane Heart Study, a long-term investigation of heart disease risk factors. CAC is an early sign of hardening of the arteries. At the start of the study, 28 percent of participants had CAC. After six years of follow-up, another 33 percent had developed CAC, and the level of CAC increased among those who already had the condition. The association between phosphorus levels and CAC was strong even after the researchers adjusted for other factors. (Society of Nephrology, news release, Nov. 5, 2009)

Red, processed meats linked to prostate cancer
Men who eat a lot of red meat and processed meats may have a higher risk of developing prostate cancer than those who limit such foods. Researchers at the National Cancer Institute found that among more than 175,000 men they followed for nine years, those who ate the most red and processed meats had heightened risks of developing any stage of prostate cancer, or advanced cancer in particular. The findings, reported in the American Journal of Epidemiology, add to a conflicting body of research on meat intake and prostate cancer risk. Because studies over the years have come to different conclusions, experts generally consider the evidence linking red and processed meats to the disease to be limited and inconclusive.

Health Tip: Keep a Health Journal and should include
1. Any injuries you've had or illnesses for which you've been treated.
2. Any time you were hospitalized, including when and why.
3. Any allergies you have to foods, medications, household items, pollens, etc.
4. Any past surgeries or procedures.
5. All prescription and over-the-counter medications, vitamins or supplements taken. Be sure to include the dose and how often you take them.
6. Diseases, illnesses or health conditions that have affected immediate family members. 


Folate Levels in Pregnancy Tied to ADHD in Offspring
Low folate levels during pregnancy are associated with higher odds for attention deficit/hyperactivity disorder in offspring aged 7 to 9, new research has found. The findings seem to support the long-held belief that folate (folic acid) levels in expectant mothers influence their children's nervous system development.
The researchers also found that children of mothers with low folate levels had notably smaller head circumference at birth, which may indicate a slower rate of prenatal brain growth. The study was released online Oct. 28 in advance of publication in an upcoming print issue of the Journal of Child Psychology and Psychiatry.

Aspirin May Prevent Prostate Cancer Recurrence
The use of anti-clotting drugs, including aspirin, appears to lower the odds that cancer will recur in men undergoing radiation treatment for prostate cancer, researchers report.
"We found that taking an anticoagulant lowers the risk [of recurrence] by almost half," says Kevin S. Choe, MD, PhD, a radiation oncologist at the University of Chicago.
The anti-clotting medications, or anticoagulants, studied were Coumadin, Plavix, and aspirin.

Oral Contraceptives May Help Treat Asthma
Treatment with oral contraceptives may benefit premenopausal women with asthma, even if their asthma symptoms are not strongly linked to their monthly menstrual cycles. In a small but rigorously designed study, researchers from the University of Alberta confirmed that fluctuating levels of the sex hormones estrogen and progesterone have a direct impact on markers of airway inflammation.

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Letter to the Editor 

  • Many heartfelt thanks for raising the issue of registration to MCI. I still wish to get my situation transparent from you. Please help. I have done my MBBS(1980), DCH(1984) and MD(1986) from Calcutta university. I have been registered with West Bengal Medical Council in 1982 after completion of internship and later PGs were also included in 'Upgraded 1994' certificate with the same Registration number. Now on joining here at Sikkim-Mnipal Institute of Medical Sciences, the honorable Sikkim Medical Council had issued an order to all doctors with Registration number outside Sikkim that we have to re-register with Sikkim Medical Council(SMC) again with a fee of Rs 1000 for MBBS and Rs 500 each for each PG qualification. At the direction of our authority we had to comply this order with immediate effect and now I have two separate 'viable' Registration numbers for all the qualifications. Whichever I have to use now? If I again join in any college at Delhi, shall I have to again obtain an another Registration number from DMC?
    Moreover in last MCI visit the honorable MCI inspectors was asking our authority that every PG qualification should be registered with main MCI body even though the individuals have more than one 'viable' Registration numbers. Precisely send your opinion for future communications. With warm personal regards. Professor (Dr.) RANABIR PAL

        Thanks: the matter is a dispute between the councils and the MCI. The central act is usually the supreme. One would need to challenge the state council in the court of law for the clarification and decision. (Editor)

  • It is a very good initiative taken by you. Congratulations. Regards. Dr Umesh Gupta


Patient: Doctor, my wife thinks I'm crazy because I like sausages.
Psychiatrist: Nonsense! I like sausages too.
Patient: Good, you should come and see my collection. I've got hundreds of them.

 Mistake to be avoided

Never write 8 2 8 for to be taken at 8am 2pm 8pm. The patient may end up taking 8 tablets in the morning, 2 in the afternoon and 8 in the evening.

Formula to know
Maximum heart rate: 220 -age

HR Reserve = maximum heart rate - restimng heart rate

Clinical Pearl : Try this also ( Dr Prachi Garg)
A NEW TWIST ON PAP SMEARS: Many of us get our Pap smear samples returned because of inadequate endocervical cells. Try this. Rotate the cytobrush in the opposite direction of that used to brush across the slide plate. For example, if you move the brush across the plate from left to right, rotate the brush counterclockwise. 

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