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



13th December Sunday

Dear Colleague,

 Use of Mobile Phones Risky While Driving

A British study has shown that talking on a mobile phone while driving is more hazardous than operating a vehicle while under the influence of alcohol. Tests conducted by UK scientists involved 20 subjects using a driving simulator to test reaction times and driving performance. Researchers tested how driving impairment was affected when drivers were talking on a handheld mobile phone or a hands free phone, and when drivers had consumed enough alcohol to register above the legal blood alcohol limit.

1. Drivers reaction times were, on average, 30 percent slower when talking on a handheld mobile phone than when legally drunk. And 50 percent slower than under normal driving conditions (no alcohol).
2. Drivers talking on phones were less able than drunk drivers to maintain a constant speed, and they had greater difficulty keeping a safe distance from the car in front.
3. Using a handheld mobile phone had the greatest impact on driving performance. On average, it took handheld mobile phone users half a second longer to react than normal and a third of a second longer to react compared to when they were drunk.  At 70 mph, this half second difference is equivalent to traveling an additional 46 feet before reacting to a road hazard. 
4. Hands free mobile was no safer.
5. Clearly the safest course of action is to not use a cell phone while driving.
6. Remember the combination will be the worst.

Dr KK Aggarwal



 From Dr Brahm Vasudeva and Dr Monica Vasudeva

Diet high in salt and more tan 2 artificially sweetened drinks per day may increase risk of kidney function decline

A diet high in salt or artificially sweetened drinks increases the risk of kidney function decline  according to studies presented at the American Society of Nephrology's annual meeting. Researchers found that in women with well preserved kidney function, higher dietary sodium intake was associated with greater kidney function decline, which is consistent with experimental animal data that high sodium intake promotes progressive kidney disease. In the second study, the team found an association between two or more servings per day of artificially sweetened soda and a two-fold increased risk of faster kidney function decline. However another study also showed that drinking regular soda was not associated with development of CKD, hyperuricemia. Researchers from Columbia University examined data from 15,745 participants in the Atherosclerosis Risk in Communities (ARIC) study, each of whom completed a baseline dietary questionnaire and was followed for nine years. The investigators found no significant association between sugared soda consumption and the development of hyperuricemia or chronic kidney disease.

2. Healthy people should not take aspirin to prevent heart attack

The use of aspirin to ward off heart attacks and strokes in those who do not have obvious cardiovascular disease should be abandoned, researchers say. After carrying out a review of studies, Dr. Ike Iheanacho, the editor of the journal Drug and Therapeutics Bulletin, has found that the beneficial effects of aspirin are small in healthy people and are heavily outweighed by the risk of potentially deadly stomach bleeding.

3.  FDA adds new indication, updates warning label for Exenatide: The US FDA has expanded the indication and prescribing language for the type 2 diabetes drug exenatide extending its approval to use as monotherapy for glycemic control in adults. The drug updated warning label includes a pancreatitis caution, including nonfatal hemorrhagic or necrotizing pancreatitis, and an expansion of an existing warning for patients with renal impairment.

4. Febuxostat safe, effective treatment for gout in patients with renal impairment: According to research presented at the American Society of Nephrology meeting, febuxostat is more effective and as safe as allopurinol, the gold standard gout treatment, for patients with gout and preexisting mild to moderate renal impairment.

5.  Children of Alzheimer's patients may be at increased risk for hypertension at midlife: according to a study published in the Nov. issue of the journal Archives of General Psychiatry, middle aged adults whose parents have Alzheimer's disease are at increased risk for high blood pressure, evidence of arterial disease, and markers of inflammation, all of which may be associated with later development of Alzheimer's.

6. One fifth of dialysis patients undergoing PCI may be given contraindicated anti thrombotics: According to a study published in the Journal of the American Medical Association, investigators looked at data on 22,778 dialysis patients who underwent PCI. Altogether, 5,084 patients (22.3 percent) received a contraindicated antithrombotic. Patients who received the antiplatelet agent eptifibatide or the anticoagulant enoxaparin, which are renally cleared and therefore not recommended for dialysis patients, had higher unadjusted rates of inhospital bleeding than patients who received recommended antithrombotics. Compared with dialysis patients who were given alternative antithrombotics, those given agents with a dialysis contraindication or warning in their labeling, were more likely to die in the hospital.

7.  Adults with type 2 diabetes and depression at risk for micro macrovascular complications: Adults with type 2 diabetes who have major depression face a greater risk for life altering microvascular and macrovascular complications regardless of their self care habits or the degree to which their disease is controlled, according to research published online Nov. 23 in Diabetes Care. Participants who reported major depression had a 36 percent increased risk of developing advanced microvascular complications and a 25 percent greater risk of developing significant macrovascular issues, compared with those with mild or no depression.

8.  Severe hypoglycemia may raise vehicular accident risk: Diabetics who keep their blood sugar tightly controlled run the risk of having traffic accidents due to low blood sugar, according to a University of Toronto study in PLoS Medicine. In fact, the risk was substantial, accounting for almost 50 percent of the accidents experienced by 795 diabetic drivers. The accidents were mostly related to severe hypoglycemia in association with strict blood sugar control.

9.  Medtronic's brain stimulation device may cut number of seizures in patients with epilepsy: in a study of Medtronic Inc.'s brain-stimulation device, researchers found that patients with epilepsy experienced fewer seizures with the technology. The results were presented at the American Epilepsy Society's annual meeting. The company is seeking FDA approval for use in patients with epilepsy. The device is intended for patients who have failed previous attempts at drug therapies.

10.  Coffee consumption may lower prostate cancer risk: Harvard scientists have discovered that drinking coffee may lower the risk of developing the deadliest form of prostate cancer. In fact, the five percent of study participants who drank six or more cups a day had a 60 percent lower risk of developing the advanced form of the disease than those who didn't consume any.

11. Research explores role exercise could play in fight against prostate cancer. A presentation made at the Frontiers in Cancer Prevention Research conference an analysis of activity levels among 2,686 prostate cancer patients showed that men who jogged, played tennis, or participated in other comparable exercise for an average of three or more hours per week had 35% lower mortality rates than those who exercised less frequently or not at all. As for walking, those who did so for four or more hours per week had overall mortality rates [that] were 23% lower than those of men who walked for fewer than 20 minutes per week.

12. Postpartum depression may also affect fathers: About 10 percent of women plummet into severe postpartum depression after giving birth. Now, it turns out that men can also have postpartum depression. A study conducted by psychiatrist Paul G. Ramchandani, of the UK's Oxford University, found that four percent of fathers had clinically significant depressive symptoms within eight weeks of the birth of their children.

13.  Psychosocial work stress may double risk for type 2 diabetes in middle aged women: According to a study published in Diabetes Care, psychosocial work stress doubles the risk for type 2 diabetes in middle-aged women. In a prospective analysis of 5,895 white middle-aged men (n=4,166) and women (n=1,729) who were free from type 2 diabetes, in women, the team found that the presence of job strain (high demands/low control) and iso-strain were associated with a significant 60 percent and 94 percent increased relative risk for type 2 diabetes, respectively.

14. BMI, waist circumference may be equally predictive of cardiovascular disease events, mortality: A large prospective study of more than 20,000 Dutch people has shown that body-mass index (BMI) and waist circumference (WC)-- accurately measured by trained staff -- were equally predictive of cardiovascular disease events and mortality (European Journal of Cardiovascular Prevention and Rehabilitation). Elevated  WC and obesity each were associated with three- to four-fold higher rates of cardiovascular death and nearly a doubling in nonfatal cardiovascular disease over 10 years in those under age 65. Earlier studies had suggested that obesity roughly doubled the chances of dying from heart disease.

15. Low BMD, osteoporosis may be independent risk factors for stroke, death: A study in Cerebrovascular Diseases as shown that low bone mineral density (BMD) and osteoporosis are independent risk factors for stroke and death. Baseline BMD at the femoral neck was associated with subsequent stroke, with a hazard ratio (HR) of 1.23 for each standard-deviation (SD) increase.


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 Clinical Tip from Dr Mukesh Bhatia

Nornal BP is systolic < 120 AND diastolic less than 80 and not systolic less than 120 OR diastolic less than 80

Humor (krishan13629@yahoo.co.in)
Sir: What is difference between Orange and Apple?
Santa: Color of Orange is orange, but color of Apple is not APPLE

Letter to the editor

Dear Dr Aggarwal: I must congratulate you for doing exemplary work in dissemination the Medical Education through your regular e medinews.  Just to remind the emedinews readers about the Upcoming Medicine Update 2009 being organized by Department of Medicine, Maulana Azad Medical College from  21-23rd Dec,2009 at MAMC Auditorium
DR  NP SINGH(Nanu),Professor of Medicine,Maulana Azad Medical College.

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