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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 …

13th February, 2011, Sunday                                 eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Warming injections may take out the sting

An injection of local anesthetic can be made much less painful if it is warmed beforehand. Canadian researchers reviewed 18 studies that included a total of 831 patients and found that pre–warming injections led to a "clinically meaningful reduction in pain," regardless of: whether the anesthetic had been buffered or not; whether the shot was administered subcutaneously (under the skin) or intradermally (into the skin); or whether the amount injected was large or small. The injections were warmed a number of ways, including controlled water baths, incubators, fluid warmers, baby food warmers, a warming tray and a syringe warmer. There are anecdotal reports that some emergency doctors use their hands to warm injections, according to the study published online Feb. 8 in the Annals of Emergency Medicine.

Updated recommendations issued on antiviral agents for influenza

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) has released updated recommendations for antiviral treatment in patients with confirmed or suspected influenza.

  • Early antiviral treatment is recommended for patients with suspected influenza or clinically or laboratory–confirmed influenza who have severe, complicated, or progressive illness or require hospitalization, and for outpatients with confirmed or suspected influenza at higher risk for complications because of their age or underlying medical conditions.
  • Oseltamivir and zanamivir are recommended because almost all currently circulating influenza virus strains are sensitive to them.
  • Amantadine and rimantadine should not be used because of high resistance among circulating influenza A viruses.
  • Oseltamivir may be used for treatment or chemoprophylaxis in infants younger than 1 year when indicated.
  • Antiviral treatment within 48 hours of illness onset may be considered on the basis of clinical judgment for any outpatient with confirmed or suspected influenza but no known risk factors for severe illness.
  • Clinicians should monitor their local data on antiviral resistance, since patterns can change over time.

(Jan. 21 in the CDC’s Morbidity and Mortality Weekly Report)

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
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  eMedinewS Audio PostCard

  2nd eMedinewS revisiting 2010

Revisiting the Year 2010 with Dr KK Aggarwal Propoxyphene withdrawn

Audio PostCard
  Quote of the Day

(By Dr GM Singh)

A theory can be proved by experiment; but no path leads from experiment to the birth of a theory.

Albert Einstein

    Photo Feature (from the HCFI Photo Gallery)

2nd eMedinewS Revisiting 2010

Dr NK Bhatia answers the questions from the audience during the 2nd eMedinewS revisiting 2010 at Maulana Azad Medical College on 9th January 2011.

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

Meeting the Prime Minister

Kerala State IMA leaders met the Prime Minister Shri Manmohan Singh on 11th February at7.30 pm in Raj Bhawan, Kerala State as directed by the National IMA President. The meeting was very cordial and discussions lasted for 20 minutes. The leaders presented a memorandum on behalf of National IMA President. The meeting was a 100% success and could convince him and he assured his intervention in our favor. During the discussion he said he never knew that the BRHC is another version of LMP which has been stopped before independence. He promised it would not be repeated. We have to be thankful to Sri Remesh Chennithala, the KPCC President of Kerala who arranged this meeting with earnest interest otherwise it would not have taken place. (Dr. Alex Franklin, Thiruvananthapuram)

Poor sanitation makes EWS kids vulnerable to parasitic worms’

The number of schoolchildren from slums and rural areas, infected by deadly parasitic worms such as tapeworms and round worms, is increasing in the country due to poor sanitation and unclean water. The children of the age group of 6 to 14 years are most vulnerable to the deadly parasitic worms. At least 25 per cent of the children in the country are infected with the parasitic worms that affects their all round development, said Dr Sarman Singh, professor and head of Clinical Microbiology Department, AIIMS citing a recent survey conducted by an international NGO "Deworm the World" in Government schools of Bihar. The survey found that many kids were infected with parasitic worms causing stunted growth, school absenteeism and anemia. "We had conducted a pilot study in Patna and Supaul, the two districts having high prevalence of worms amongst school age children", he said.

To reach out to these children, the NGO with the support of the State Government, has launched a mass school–based deworming programmes in three phases to be kicked off from Monday till April 11. "The programme would be rolled out in over 67,000 schools in all 38 districts of the State. In this process, nearly 1,40,000 teachers and 20,000 ANMs and other health staff would be trained to implement and monitor the programme", Lesley Drake, the DTW’s executive director, said. These children would be administered deworming tablets (alebendazole), she said noting that such cost–effective methods could improve the health of a child and school attendance rate.

"Similar programme has been planned in Delhi later this year, once a large–scale prevalence study which is underway across slums and schools is completed", Prerna Makkar, regional director of DTW’s south Asia wing, said. She pointed out that adequate sanitation, hygienic living conditions, and safe drinking water are other key approaches to the deworming plan.Underlining the need for such deworming programmes, Makkar pointed that worldwide, over 400 million schoolchildren are estimated to be infected with the worms’ infections. (Source: The Pioneer, February 07, 2011)

    International News

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

February is Heart Health Month. Today’s tip

If you have a dog, think of the dog as an exercise machine with fur. A "brisk walk" with the dog is good for both of your hearts. Make it a part of your daily routine.

(Dr GM Singh)

Key signs of gum diseases

  • Red, swollen, sore gums
  • Gums that bleed easily
  • Abscesses or pockets of infection
  • Loose teeth
  • Shrunken, receding gum line
  • Pain during chewing
  • Pus oozing from the gums or between the teeth

(Dr Monica and Brahm Vasudev)

Many with asthma, emphysema may misuse inhalers

Many people with asthma or emphysema could be taking their inhaled medicines incorrectly. Overall, patients misused metered–dose inhalers nearly nine out of 10 times, and Diskus inhalers seven out of 10 times, the researchers report in the Journal of General Internal Medicine.

Stem Cells for Burned Skin

The University of Pittsburgh scientists have developed a device which sprays stem cells on to burned skin, allowing the healthy skin to grow again. In the procedure, the stem cells are isolated from healthy parts of the burn victim's skin and are added to a water solution. The stem cells are then loaded into the spray gun, and the cells are sprayed directly onto the wound, and the process allows the healthy skin to grow again. According to scientists, the new method has been successfully used to treat 12 patients and it can significantly reduce the healing time from months to days.

FDA approves Dermatitis Gel

A new skin care gel, Epicyn HydroGel, has been FDA–approved as treatment for burning, itching, and pain associated with atopic dermatitis and radiation dermatitis, as well as pain from first– and second–degree burns. The gel also maintains "a moist wound and skin environment" to help treat dry and waxy skin.

ASA: Strokes, eye disorder may go hand in hand

Hemorrhagic stroke appears more likely with advanced age–related macular degeneration (AMD), perhaps because of common underlying risk factors, a population–based study showed. Hemorrhagic stroke risk was significantly higher –– nearly seven–fold –– in older adults with stage 4 AMD than in those who did not have AMD in the analysis presented at the American Stroke Association’s International Stroke Conference. Ischemic stroke showed no significant link with AMD, and neither type of stroke held significant correlations with earlier AMD stages, whether wet or dry. Stage 4 AMD independently predicted a 1.56–times greater risk of any type of stroke among older adults after adjustment for age, sex, and other key risk factors (95% confidence interval 1.08 to 2.26), Renske G. Wieberdink, MD, of Erasmus Medical Center in Rotterdam, the Netherlands, and colleagues reported. (Medpage Today)

    IMT Update

PREVEND IT (Prevention of REnal and Vascular ENdstage Disease Intervention Trial (PREVEND IT): IMT is a predictor of cardiovascular events in patients with increased urinary albumin excretion (UAE) ranging from 15–300 mg/24 hours.

    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

How many people are affected by infertility?

Estimates are that one in six couples are affected by some degree of infertility. However, this number may be very misleading. Many couples choose to lead child–free lives rather than seek treatment for their infertility; such couples are rarely included in infertility estimates. Others suffer recurrent pregnancy losses which are, in a way, a form of infertility and are not technically considered "infertile" because they are able to conceive. INCIID (InterNational Council on Infertility Information Dissemination) is in the process of creating a survey designed to provide new insights about who is infertile, what kinds of infertility they are experiencing, what kinds of treatments have been successful for specific diagnoses, and much more. This survey will be conducted online, and is expected to be a source of important clinical information for practitioners as well as consumers.

For queries contact: banerjee.kaberi@gmail.com

    Pediatric Update

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

What is the role of chest radiograph in diagnosis of asthma?

A baseline chest X–Ray is advisable in every case to exclude other diagnostic possibilities mimicking asthma e.g. congenital anomalies, foreign body. Repeat radiographs at frequent intervals or with every exacerbation are not required. In most cases, the chest X–Ray is normal between episodes. Evidence of generalized hyperinflation may be present in those with severe symptoms or in poorly controlled cases. If an asthmatic is not responding to the usual treatment than a radiograph of chest is important to rule out consolidation, collapse, foreign body or pneumothorax.

For queries contact: drneelam@yahoo.com

    Medicolegal Update

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

What is the Native American Graves Protection and Repatriation Act 1990?

Doctors and scientists have long sought to understand life in early civilizations through the excavation of burial grounds and exhumation of human remains. In the United States the attempt to understand early cultures led to the exhumation of the remains of Native Americans, many of which ended up in the nation’s museums and archaeology labs. In an attempt to prevent the desecration of Native American graves, the Native American Graves Protection and Repatriation Act was introduced in Congress in July 1990 and subsequently passed into law.

  • The bill states that any human remains and objects found on federal or tribal lands after the date of enactment are to be considered owned or controlled by lineal descendants, the tribe on whose land it was found, the tribe having the closest cultural affiliation, or the tribe which aboriginals occupied the area. Anyone who discovers items covered by the bill must cease his or her activity, notify the federal land manager responsible and the appropriate tribe, and make a reasonable effort to protect the items.
  • Anyone who violates the provisions of the bill may be fined, imprisoned not more than one year, or both. The penalty may increase to five years for a second violation.
  • The act further states that all federal agencies and museums receiving federal funds that have control over any of the items covered in the bill are to, within five years, inventory and identify the items, notify the affected tribes, and make arrangements to return such items if the appropriate tribe made a request. If an item was acquired with the consent of the tribe or if the item was part of a scientific study which was expected to be of major benefit to the country, the request for repatriation (i.e., return) could be denied.
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Tests for Adrenal Insufficiency & Addison’s Disease

Adrenocorticotropic hormone (ACTH): A pituitary hormone that signals the adrenal glands to produce cortisol. This test is primarily ordered as a baseline test to evaluate whether or not the pituitary is producing appropriate amounts of ACTH. In a patient with adrenal insufficiency, low ACTH levels indicate secondary adrenal insufficiency, while high levels indicate primary adrenal insufficiency (Addison’s disease). The ACTH test is often ordered along with the ACTH stimulation test.

ACTH stimulation test: This test involves measuring the level of cortisol in a patient’s blood before and after an injection of synthetic ACTH.

    Medi Finance Update
  • No investment in equity shares is safe.
  • A real estate investment is always viable. However, it is tough and one should be able to judge the right locality and the cash involved.
  • One should not have an Abhimanyu approach in investing, i.e. know how to enter, but don’t know how to get out of it.
    Drug Update

LIST OF APPROVED DRUG FROM 01.01.2010 TO 31.8.2010

Drug Name


DCI Approval Date

Faropenem Sodium Extended Release Tablet 225/300/450 mg

For the treatment of respiratory tract infections, urinary tract infection, skin and skin structure infections and gynaecological infections


    IMSA Update

International Medical Science Academy (IMSA) Update

Exercise blood pressure and cardiovascular outcome

A study of over 4800 asymptomatic normotensive individuals found that a hypertensive response to treadmill testing was associated with an increased risk for cardiovascular death.

    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was found unconscious.
Dr Bad: He has suffered a stroke.
Dr Good: First rule out hypoglycemia.
Lesson: In diabetics, sudden loss of consciousness is hypoglycemia unless proved otherwise.

Make Sure

Situation: A patient with pygenic meningitis developed complications.
Reaction: Oh my God! Why were antibiotics not given when the meningitis was suspected?
Lesson: Make sure that first dose of antibiotics is given at the time meningitis is suspected.

Our Contributors

  Docconnect Dr Veena Aggarwal
  Docconnect Dr Arpan Gandhi
  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

    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Prachi Garg)

John Glenn – The First Septuagenarian Astronaut

John Glenn Jr. (born July 18, 1921) is a former American astronaut, Marine Corps fighter pilot, ordained Presbyterian elder, corporate executive, and politician. He was the third American to fly in space and the first American to orbit the earth. He also served as a United States Senator from Ohio (1974 – 1999). In November 1998, at the age of 77, John became the first septuagenarian astronaut to go into space. It was 36 years after his previous orbit of Earth. This time round, there were 250,000 spectators watching the liftoff.

It’s an advantage up here for older folks because in zero–G you can move around much more easily: John Glenn, the 77–year–old NASA pioneer said in a transmission from space.

It was found that:

  1. The decade during which the men were between 60 and 70 contained 35% of the world’s greatest achievements
  2. Between the ages of 70 to 80, contained 23% of the world’s greatest achievements
  3. In the years after 80, contained 8% of the world’s greatest achievements

Physical beauty is like a bottle of coke, it turns stale with time. The mind is like a bottle of wine, the longer it is kept the better it becomes.

— — — — — — — — — —

Mind Teaser

Read this   ………………… 


Yesterday’s Mind Teaser: MAKE – MAKE = ZERO

Answer for yesterday’s Mind Teaser:
Makes no difference

Correct answers received from: Dr K.P.Rajalakshmi, Dr Rawat Purushottam Singh, Dr Sudipto Samaddar, Dr H.L. Kapoor,

Answer for 11th February Mind Teaser: I over-ate
Correct answers received from: Dr Sudipto Samaddar

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr GM Singh)

Lil’ Johnny was sitting in front of a party store, with him he had a German Shepherd dog. A man came up and asked Johnny: "Does your dog bite?" Johnny said: "No." So the man went to pet the dog and he bit the man’s arm. The man said: "I thought you said your dog don’t bite." "He doesn’t, said Johnny, but this isn’t my dog."

— — — — — — — — — —

Knowledge is amusing

The strongest muscle in the body is the TONGUE

Check it out

This is really an interesting online clock

    Readers Responses
  1. Sir, I really thank you for your regular magazine with balanced proportion of medical information. I find it interesting and informative. Regards Dr Prachi
    Public Forum

(Press Release for use by the newspapers)

14th February Valentine’s Day

Good news for people with sexual dysfunction: New drug for premature ejaculation

Up till now, no specific drugs were available for premature ejaculation and most people who had this problem used to go to the quacks or ended up with addictive medicines. A new drug dapoxetine from the SSRI Group is now available in the country which can be taken a few hours before the sexual act and it can help young people with premature ejaculation, said Senior Consultant Moolchand Medcity and President Heart Care Foundation of India, Dr. KK Aggarwal, Padma Shri & Dr. B.C. Roy National Awardee.

14th Feb is also World Impotence Day

14th February is Valentines Day as well as awareness about impotence and erectile dysfunction day. Dr. Aggarwal said that Valentines Day is a reminder of relationship between two individuals which can be at the level of body, mind, intellect, ego and / or soul. Unless all relationships are fulfilled, they cannot be labeled as made for each other.

Quite often people develop relationships with others to satisfy any of the above needs. To summarize, the needs may be to satisfy physically, to ease out mentally, to share intellect, to share power (ego) or to share happiness (spiritual needs.) It is, therefore, common for a person to have different relationships with different people, e.g., husband for physical needs, a guru for spiritual needs, a friend for mental or intellectual needs, and a partner to satisfy ego needs.

Valentine’s Day should not be misused as a day to satisfy one's physical needs. Young girls should be careful against the misuse of date-rape drugs. Date-rape drugs are easily available in the market. They are colorless, tasteless, odorless and can make one person, while remaining conscious, unaware of the surroundings.

Giving example, Dr. Aggarwal said that a female under the influence of date-rape drugs may actually be under rape but feel as if she is in a date and after the effect of drug is over, she will have retrospective amnesia or memory loss about the event.

Dr. Aggarwal said that extra marital sex is dangerous for heart patients as it is often done in unusual circumstances, places, locations, timings and often with a partner who is 20 years younger. Performance anxiety can precipitate dangerous rise in heart rate and BP leading to heart attack and in some cases, sudden cardiac death. The dictum for heart patients, therefore, has been that sleeping with your wife or with someone with whom you have prolonged relationship prolongs life.

There is no age bar for males to have sexual act and as a result, a man can be active sexually till the age of 70 years. With the availability of Viagra and like drugs, it is possible for the elderly persons to enjoy sexual relationships with their partner.

The sale of Viagra drugs increases near Valentine’s Day. However these drugs should not be misused by heart patients who are on nitrates as they can precipitate BP.

Viagra group of drugs should also not be taken by individuals as a licence to attempt multiple sexual attempts in one sitting as any unaccustomed exercise by heart patients with underlying severe blockages can precipitate heart attack and sudden cardiac death.

    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Workshop on Fetal and Paedatric Echocardiography Pre and perinatal management of heart disease

13th February 2011, Sunday, Moolchand Medcity, 8AM –10AM

  1. Fetal Echocardiography–How to get it right: Dr Vandana Chaddha
  2. Fetal Cardiac Spectrum– abnormal cases with interactive session: Dr Vandana Chaddha
  3. Neonatal Cardiac Cases– Hits and misses inetractive session: Dr Savitri Srivastava
  4. Intima Media Thickness and Plaque Volume, New Marker for Atherosclerosis Regression in Children: Dr KK Aggarwal

Delhi Medical Council Inaugural CME on Managing Common Emergencies
Date: Sunday, 20 Feb., 2011
Programme – 1.00PM – 4.00PM
1.00 PM 1.30PM Lunch
1.30 PM 1.45PM Inauguration
1.45 PM 4.00PM Scientific Programme

Topics Time Speakers Chairpersons
RTA, Emerging Epidemic
1:45 PM – 2.05 PM
Dr MC Misra
Dr BK Dhaon, Dr Praveen Bhatia, Dr Chander Prakash
Acute Febrile Illness
2.05 PM – 2.25 PM
Dr N.P Singh
Dr OP Kalra, Dr SP Byotra,
Dr B Gupta
Haematuria – Red Alarm
2.25 PM – 2.45 PM
Dr Anil Goyal
Dr P.N Dogra, Dr. Rajeev Sood
Managing PPH – Saving Lives
2.45 PM – 3.05 PM
Dr Reva Tripathi
Dr Sharda Jain
Panel Discussion of Update of Lt. Side chest pain 3.05 PM – 3.50 PM Dr Purshottam Lal,
Dr Naresh Gupta
Dr PS Gupta, Dr K.K Aggarwal, Dr Ashok Seth

Vote of Thanks: 3.50 PM – 4.00 PM

Followed by Tea

Please Note: Prior Registration Is Mandatory (No Registration Charges)

For Registration e–mail to delhimedbalcouncil@gmail.com, SMS to Secretary – 9868116494 & Organizing Chairman – 9811101454

Organization: President: Dr Arun Aggarwal, Vice President: Dr Vinay Aggarwal, Secretary: Dr Girish Tyagi, Organizing Chairman: Dr Anil Goyal, CME Committee Members: Dr Anil Bansal, Dr Manoj Singh, Dr NP Singh, Dr Praveen Bhatia.

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