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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 November 2010, Saturday

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

Lead poisoning treatment less effective for mercury

Mercury poisoning can be dangerous and even fatal. Children might be exposed to mercury from several sources, but the majority of exposure in the US comes in the form of methylmercury, found in certain fish. Methylmecury is known to be toxic to fetuses. Thimerosal, a preservative previously used in vaccines, contains another form of mercury called ethylmercury.

Some believe that the low levels of mercury once used in vaccines can affect development of the nervous system and contribute to autism. However, extensive research has found no conclusive evidence that any part of a vaccine or combination of vaccines causes autism. Even so, aside from some flu vaccines, mercury compounds aren’t used anymore in routine childhood vaccines. Although it’s not approved by the U.S. FDA to reduce mercury, a drug called succimer is reportedly being used as an alternative therapy for autism. Succimer is a chelating agent shown to effectively remove lead from the body and is commonly used to treat lead poisoning.

A research team led by Dr. Walter Rogan at NIH’s National Institute of Environmental Health Sciences (NIEHS) sought to investigate whether succimer can also remove mercury from the blood. The team used blood samples and data from 767 children, aged 12 to 33 months, who participated in an earlier clinical trial of children who were treated for high blood levels of lead. The research team measured mercury concentrations in blood samples collected prior to treatment, a week after beginning treatment with succimer or placebo, and again after 3 month-long courses of treatment. The researchers found that, after 1 week, succimer lowered blood concentrations of mercury by 8%. In contrast, it reduced blood lead concentration by 42%. After 5 months, those taking succimer had blood mercury concentrations about 20% lower than the control group. "Succimer is effective for treating children with lead poisoning, but it does not work very well for mercury," Rogan says. "Although succimer may slow the increase in blood mercury concentrations, such small changes seem unlikely to produce any clinical benefit." (NIH News)  

Dr KK Aggarwal
Editor in Chief
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  Quote of the Day

(Contributed by Dr. G.M.Singh)

" An angry man is seldom reasonable, A reasonable man is seldom angry. "

    Photo Feature (from the HCFI Photo Gallery)

 Divya Jyoti

17th MTNL Perfect health Mela 2010

More than 3000 nurses from various hospitals, across Delhi and the NCR participated in the festival participated in Divya Jyoti, a Festival of Nurses in the 17th MTNL Perfect Health Mela 2010.

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

UN to vaccinate 134 million Indian children from measles

UNICEF will vaccinate 134 million children against measles in a joint drive with the World Health Organisation. "The highly contagious disease claims the lives of some 400 children every day, and in 2008, three out of four children who died of measles were from India," UN spokesperson Farhan Haq said on Tuesday. "The campaign now under way in 14 high-risk Indian states aims to prevent up to 1,00,000 child deaths annually," he said. (Source: Indian Express)

    International News

(Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

Obesity is contagious, says study

As reported by The Money Times, a recent Harvard study has predicted that obesity figures in America are likely to reach 42 % before stabilizing. The study results are in contrast to the earlier forecasts made by Center for Disease Control and Prevention (CDC) in which it was predicted that obesity among adults has stabilized at 32 %, a figure where it was standing for the last five years. The study also showed that people who are not obese are likely to become obese after they come in contact with obese people. This way obesity has a cascading effect on non–obese people, and the chances of them becoming obese increase the more they stay in contact with obese people.

(Dr Monica and Brahm Vasudev)

Beneficial effects of testosterone for frailty in older men are short–lived

The beneficial effects of six months of testosterone treatment on muscle mass, strength and quality of life in frail elderly men are not maintained at six months post–treatment, according to a study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM). (ScienceDaily)

Asthma drug prevents spread of breast cancer

Tranilast, a drug commonly used in Japan and Korea to treat asthma has been found to stop the spread of breast cancer cells traditionally resistant to chemotherapy, according to a new study led by St. Michael’s pathologist Dr. Gerald Prud'homme. (ScienceDaily)

A ‘brand’ new world: attachment runs thicker than money

Can you forge an emotional bond with a brand so strong that, if forced to buy a competitor’s product, you suffer separation anxiety? According to a new study from the USC Marshall School of Business, the answer is yes. In fact, that bond can be strong enough that consumers are willing to sacrifice time, money, energy and reputation to maintain their attachment to that brand. (ScienceDaily)

    Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

What are the treatment options for infertility?

Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following.

  • If the sperm are of good quality and the mechanics of the woman’s reproductive structures are good (patent fallopian tubes, no adhesions or scarring), physicians may start by prescribing a course of ovarian stimulating medication. The physician may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor introduces sperm into the uterus during ovulation, via a catheter. In these methods, fertilization occurs inside the body.
  • If conservative medical treatments fail to achieve a full term pregnancy, the physician may suggest the patient undergo in vitro fertilization (IVF). IVF and related techniques (ICSI, ZIFT, and GIFT) are called assisted reproductive technology (ART) techniques. ART techniques generally start with stimulating the ovaries to increase egg production. After stimulation, the physician surgically extracts one or more eggs from the ovary, and unites them with sperm in a laboratory setting, with the intent of producing one or more embryos. Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman’s reproductive tract, in a procedure called embryo transfer.
  • Other techniques are e.g. tuboplasty, assisted hatching, and preimplantation genetic diagnosis.

For queries contact: banerjee.kaberi@gmail.com

    Gastro Update

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

What causes cystic fibrosis liver disease?

In cystic fibrosis, focal biliary cirrhosis appears to be the end result of bile duct obstruction caused by defective ion transport from CFTR dysfunction. The absence of functional CFTR protein on the biliary epithelial cells is believed to promote a cascade of abnormal ductular secretion, decreased bile flow, and bile duct plugging by thickened secretions, eventually leading to inflammation and fibrosis within the focal portal tracts. Although obstruction due to defective ion transport appears to be necessary for the development of CF liver disease, other factors may be involved. Presence of an altered bile acid physiology has also been implicated as predisposing a patient to CF liver disease.

The reason why only a small number of CF patients develop significant liver disease despite all having abnormal or absent biliary epithelial CFTR function is still not understood. Although this difference may partially be explained by the variability in the definition and detection of liver disease in this population, it is also likely that genetic factors contribute to the pathogenesis of CF liver disease. Unlike pancreatic insufficiency, which appears to be dictated in part by CFTR genotype, no genotype–phenotype correlation has been identified in patients with CF–related liver.

    Medicolegal Update

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

Ancient Indian medical college get derecognized by British

The 6-member British Committee after inspection of native Indian medical schools submitted a report on October 20, 1834. The Committee recommended that the state establish a medical college ‘for the education of the natives’. The various branches of medical science cultivated in Europe should be taught in this Indian medical college. The intending candidates should possess a reading and writing knowledge of the English language. This recommendation, soon followed by Macaulay’s Minute on Indian education and Bentinck’s Resolution, sealed the fate of the school for native doctors and medical classes at the two leading oriental institutions of Calcutta. The NMI was abolished meaning that Ancient Indian medical college were derecognized in the terminology of the Medical Council of India today and the medical classes at the Sanskrit colleges and Madarasas were discontinued by the government order on 28th of January 1835. The valuable Indian medical heritage was lost in British India.

    Inf Update: Question of the Day

What are WHO criteria for clinical diagnosis of malaria?

The signs and symptoms of malaria are non–specific. Malaria is clinically diagnosed mostly on the basis of fever or history of fever. The following World Health Organization (WHO) recommendations are still considered valid for clinical diagnosis:

  • In general, in settings where the risk of malaria is low, clinical diagnosis of uncomplicated malaria should be based on the degree of exposure to malaria and a history of fever in the previous 3 days with no features of other severe diseases.
  • In settings where the risk of malaria is high, clinical diagnosis should be based on a history of fever in the previous 24 hours and/or the presence of anemia, for which pallor of the palms appears to be the most reliable sign in young children.

Suggested reading

WHO Expert Committee on Malaria. Twentieth report. World Health Organization Geneva, 2000 (WHO Technical Report Series, No. 892).

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Renal Biopsy, Light Microscopy

For clinical evaluation and management of patients with undiagnosed kidney disease; the clinical setting may include acute renal failure, nephrotic syndrome, asymptomatic proteinuria and hematuria.

Optimal interpretation of a kidney biopsy requires integration of clinical and laboratory results with light microscopic, immunofluorescent histology, and electron microscopy findings.

    Medi Finance Update

Tax planning

The additional surcharge called the ‘Education Cess on Income Tax’ to be levied at 3% on the amount of tax payable inclusive of surcharge.

    Drug Update

List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

Drugs prohibited from the date of notification

Liquid Oral antidiarrhoeals or any other dosage form for pediatric use containing Diphenoxylate Lorloperamide or Atropine or Belladona including their salts or esters or metabolites Hyoscyamine or their extracts or their alkaloids.

    IMSA Update

International Medical Science Academy (IMSA) Update

Diagnosis of rheumatoid arthritis

A systematic review and meta–analyses found that second generation anti–cyclic citrullinated peptide (anti–CCP) antibodies had the best test characteristics for diagnosing rheumatoid arthritis, with higher specificity and similar sensitivity to rheumatoid factor.

(Ref: Whiting PF, et al. Systematic review: accuracy of anti–citrullinated Peptide antibodies for diagnosing rheumatoid arthritis. Ann Intern Med 2010;152:456).

    IJCP Special

Dr Good Dr Bad

Situation: A type 1 diabetic came with A1C of 7.2%.
Dr Bad: Its ok.
Dr Good: You need better control.
Lesson: Blood sugar control can minimize risks for retinopathy, nephropathy and neuropathy in both type 1 and type 2 diabetes, and cardiovascular disease in type 1 diabetes.

Make Sure

Situation: A patient after sublingual Nitrate developed fainting attack.
Reaction: Oh My God! Why was the Systolic Murmur missed on auscultation?
Lesson: Make sure that patient with LVOT obstruction are not given sublingual Nitrates.

    Lighter Side of Reading

An Inspirational Story

You Are

One day not too long ago the employees of a large company in St. Louis, Missouri returned from their lunch break and were greeted with a sign on the front door. The sign said: "Yesterday the person who has been hindering your growth in this company passed away. We invite you to join the funeral in the room that has been prepared in the gym."

At first everyone was sad to hear that one of their colleagues had died, but after a while they started getting curious about who this person might be. The excitement grew as the employees arrived at the gym to pay their last respects. Everyone wondered: "Who is this person who was hindering my progress? Well, at least he’s no longer here!"

One by one the employees got closer to the coffin and when they looked inside it they suddenly became speechless. They stood over the coffin, shocked and in silence, as if someone had touched the deepest part of their soul. There was a mirror inside the coffin: everyone who looked inside it could see himself. There was also a sign next to the mirror that said:

"There is only one person who is capable to set limits to your growth: it is YOU." YOU are the only person who can revolutionize your life.
YOU are the only person who can influence your happiness, your realization and your success. YOU are the only person who can help yourself.

Your life does not change when your boss changes, when your friends change, when your parents change, when your partner changes, when your company changes. Your life changes when YOU change, when you go beyond your limiting beliefs, when you realize that YOU ARE the only one responsible for your life.

Mind Teaser

Read this…………………


Yesterday's Mind Teaser :

g rosey i

Answer for yesterday’s eQuiz: "Ring around the rosey "
Correct answers received from:
Dr Sudipto Samaddar, Dr.K.P.Rajalakshmi

Answer for 11th November Mind Teaser: "Six of one, a half dozen of another."
Correct answers received from:

Send your answer to ijcp12@gmail.com

Humor Section
(Joke by Dr G M Singh)

Doctor, Doctor I keep thinking there is two of me.
One at a time please.

    Readers Responses
  1. Recent research has indicated that some people are just more genetically predisposed to being heavy than others. And researchers at Harvard University say that America will soon have a 42 percent obesity rate (although others claim we’ve topped out at 34 percent), blaming the climb on obese friends making people feel more comfortable about also being obese.
    So it’s probably no wonder that researchers have been working on an obesity vaccine and pills to control weight. One company in the United States has just been awarded a project grant to develop an anti-obesity vaccine.
    I’m not against helping those who have a predisposition to being heavy get a little helping hand to increase their chances of living at a more healthy weight. I’m just concerned that the word “vaccine”implies that the vaccinated person then has no reason to do anything to make themselves fit. An obesity vaccine would only be the start of an obese person’s new health and fitness routine. Being healthy isn’t just about not being obese. It’s also about having a strong heart, which comes from cardiovascular workouts. It’s also about having strong muscles and bones, which come from strength training. It’s also about being flexible, which comes from stretching. It’s also about core strength, lowered stress, good balance and so much more. Granted, an anti-obesity vaccine may never happen, but if it does, will that be good for the true health and fitness of an increasingly obese society? What do you think? Rajat Bhatnagar, International Sports & Fitness Distribution, LLC
    Public Forum

(Press Release for use by the newspapers)

Heart Care Foundation of India to create awareness about lifestyle at International Film Festival at Marwah Studios Noida

The Heart Care Foundation of India will create a live exhibition of lifestyle management during the 3-day International Film Festival being held at Marwah Studios, Noida.
Giving the details, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal said that the seeds of heart diseases are bowed during adolescence. Heart attack cannot be gifted or accepted as it takes minimum ten years to work against the laws of nature to develop blockages in the arteries supplying blood to the heart. To prevent heart disease, the interventions must start right in the college age. Correct lifestyle involves eating less, exercising more and living a happy life.
The three days’ exhibition will focus on how to remain healthy.
Heart Care Foundation of India exhibition at IITF 2010
Heart Care Foundation of India will have a special stall at the Ministry of Health and Family Welfare and Health Care Pavilion near Gate no. 1 in the forthcoming India International Trade Fair 2010 being held from November 14-27, 2010 at Pragati Maidan.
Giving the details Dr. Aggarwal, said that Heart Care Foundation of India will have a special exhibition on how to remain healthy without heart attack up to the age of 80 years. The ‘Formula of 80’ developed and recommended by the Foundation will be prominently displayed at the stall. An On-the-Spot quiz will also be played.
A special game ‘Worms & Ladder’ will also be displayed. A brainchild of Heart Care Foundation of India, Dr. KK Aggarwal, President of the Foundation, said that the game is a modified version of the popular ‘Snakes and Ladder’ game. A health educational tool, this game will create awareness among the masses about the ‘Dos & Don’ts’ of preventing worm infestations. In India, everybody should chew deworming tablet to reduce the worm infestations in the society.
Worms are responsible for most of the abdominal disorders and for long-standing anemia, shortage of blood in the body.

    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Workshop on Kidney Transplant

International Medical Science Academy, eMedinewS , Moolchand Medcity Board of Medical Education, IMA New Delhi Branch and IMA Janak Puri Branch

Date: Sunday 28th November
Venue: Moolchand Medcity Auditorium, 9 – 12 noon
Moderators: Dr KK Aggarwal, Dr Kamlesh Chopra, Dr Sanjay Sood, Dr A K Kansal, Dr Archna Virmani

9.00 – 9.30 AM: Kidney transplant scenario in India: Dr Sandeep Guleria, Transplant Surgeon, AIIMS
9.30 – 10.00 AM: Kidney Transplant: What every one should know: Dr Ramesh Hotchandani, Senior Nephrologist, Moolchand Hospital
10.00– 10.30 AM: Transplant immunobiology and immunosuppression. Dr Monica Vasudev, Assistant Professor Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee
10.30–11.00 AM:
Kidney Transplant: managing difficult cases. Dr Brahm Vasudev, Assistant Professor of Medicine, Division of Nephrology, Director, Nephrology Fellowship Program, Medical College of Wisconsin
11.00 – 12.00 AM: Panel discussion
12.00 Noon: Lunch

(Registration free: email to emedinews@gmail.com)

eMedinewS Revisiting 2010

The 2nd eMedinewS  – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 08–09, 2011.

January 08, 2011, Saturday, 6 PM – 9 PM – Opening Ceremony, Cultural Hungama and eMedinewS Doctor of the Year Awards. For registration contact – emedinews@gmail.com

January 09, 2011, Sunday, 8 AM – 6 PM – 2nd eMedinewS revisiting 2010, A Medical Update

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