eMedinewS14th July 2014, Monday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); 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);
For updates follow at :  www.twitter.com/DrKKAggarwal, www.facebook.com/Dr KKAggarwal

Researchers find reason why many vein grafts fail

NIH intramural–led study uncovers biology behind improper graft remodeling

National Institutes of Health researchers have identified a biological pathway that contributes to the high rate of vein graft failure following bypass surgery. Using mouse models of bypass surgery, they showed that excess signaling via the Transforming Growth Factor Beta (TGF–Beta) family causes the inner walls of the vein to become too thick, slowing down or sometimes even blocking the blood flow that the graft was intended to restore. Inhibition of the TGF–B signaling pathway reduced overgrowth in the grafted veins.

The team, led by Manfred Boehm, M.D., chief of the Laboratory of Cardiovascular Regenerative Medicine at NIH’s National Heart, Lung, and Blood Institute, identified similar properties in samples of clogged human vein grafts, suggesting that select drugs might be used in reducing vein graft failure in humans.

Endothelial cells not only form the inner lining of a blood vessel, but also contribute to blood vessel narrowing as shown in this mouse vein graft model. Endothelial cells lose their typical morphology and become more like smooth muscle cells. This change in cellular properties indicates that endothelial–to–mesenchymal transition (EndMT) is operative in vein graft stenosis.

This study will be published March 12 in Science Translational Medicine.

News Around The Globe

  • Anti–interleukin 17A antibody secukinumab appears to be a promising therapeutic option for moderate-to-severe plaque psoriasis, suggest 2 phase 3 clinical trials. In the ERASURE trial, 81.6% of patients receiving a 300-mg dose of secukinumab had a reduction of 75% or more over baseline in scores on the PASI 75 compared with 71.6% of those receiving a 150–mg dose and 4.5% of patients receiving placebo. The findings are published online July 9 in the New England Journal of Medicine. An updated draft of the guidance on obesity from the UK National Institute for Health and Care Excellence (NICE) has suggested lowering of the body mass index (BMI) threshold at which obese patients with recent onset type 2 diabetes can be considered for weight–loss procedures like bariatric surgery, from 35 to 30 kg/m2. In addition, Asians may qualify at even lower BMIs, says the updated draft. Thus, access to bariatric surgery will become easier if the draft guidance is put into practice.
  • The US Food and Drug Administration (FDA) on July 7 approved an antifungal called tavaborole 5% solution for the topical treatment of toenail onychomycosis. Tavaborole is the first oxaborole–class topical antifungal for the toenail version of this infection.
  • A new research has suggested that patients with active eosinophilic esophagitis (EoE) have increased small intestinal permeability that returns to normal in remission. The report is published online in Gut.
  • Researchers from the Mayo Clinic have reported that "charged–particle therapy," which includes proton–beam therapy, may be more effective than traditional photon therapy in sinonasal cancers. The meta–analysis, published online in the Lancet Oncology, revealed that at 5 years, pooled overall survival and disease–free survival were significantly better with charged–particle therapy than with photon therapy.

Rabies News (Dr A K Gupta)

What is the importance of pre-exposure vaccination?

Pre–exposure vaccination simplifies post–exposure vaccination because after bite, those who have received full pre–exposure vaccination require only two doses of vaccine at Days 0 & 3. RIG is not required (WHO 2007).

Cardiology eMedinewS

  • Cardiologists at UT Southwestern Medical Center have stated that sedentary behaviors may lower cardiorespiratory fitness levels. Their report suggests that two hours of sedentary behavior can be just as harmful as 20 minutes of exercise is beneficial. The study is published in the online edition of Mayo Clinic Proceedings.
  • A new study, published in Psychotherapy and Psychosomatics, has substantiated the finding that temperament is associated with high blood pressure. Researchers noted that patients with cardiac complications (CC) scored higher on the cyclothymic temperament scale than those without such complications. Also, cyclothymic temperament significantly predicted CC independently of depression, age, gender and smoking in hypertensive outpatients.

Pediatrics eMedinewS

  • Placenta previa was associated with a 2–fold increased risk for impaired fetal growth for Finnish women who had given birth previously, even after accounting for other known risk factors, and was not a risk factor for first–time mothers, reported a cross–sectional survey, published online July 8 in Obstetrics & Gynecology. Additionally, infants born to mothers with placenta previa were more likely to be delivered before 37 weeks of gestation, to be stillborn, or to die shortly after birth.
  • An updated evaluation of the TOBY trial, published July 10 in the New England Journal of Medicine, has revealed that the benefits of hypothermia treatment for newborns deprived of oxygen at birth persist at age six and seven. Study authors noted that babies whose perinatal asphyxial encephalopathy was treated with hypothermia were 31% more likely to have an IQ above 84 and 60% more likely to be free of neurologic problems.

Dr K K Spiritual Blog

Mindfulness meditation

Sit on a straight–backed chair or cross–legged on the floor.

Focus on an aspect of your breathing, such as the sensation of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale.

Once you’ve narrowed your concentration in this way, begin to widen your focus. Become aware of sounds, sensations, and ideas.

Embrace and consider each thought or sensation without judging it good or bad. If your mind starts to race, return your focus to your breathing. Then expand your awareness again.

Wellness Blog

Supplements May Cut LDL in Older Women

Postmenopausal women taking calcium and vitamin D supplements had improved lipid profiles compared with those taking placebo as per a new study.

In an analysis of data from the Women’s Health Initiative, the level of LDL cholesterol was lower by an average of 4.46 mg/dL in the women on active treatment reported Peter F. Schnatz, DO, of Reading Hospital in Pennsylvania in the journal menopause.

In addition, higher concentrations of 25–hydroxyvitamin D3 (25(OH)D3) were associated with higher levels of HDL cholesterol and lower levels of LDL cholesterol and triglycerides.

Inspirational Story

The perfectionist sculptor

A gentleman once visited a temple under construction where he saw a sculptor making an idol of God. Suddenly he noticed a similar idol lying nearby. Surprised, he asked the sculptor, "Do you need two statues of the same idol?"

"No," said the sculptor without looking up, "We need only one, but the first one got damaged at the last stage." The gentleman examined the idol and found no apparent damage. "Where is the damage?" he asked.

"There is a scratch on the nose of the idol." said the sculptor, still busy with his work. "Where are you going to install the idol?" The sculptor replied that it would be installed on a pillar twenty feet high.

"If the idol is that far, who is going to know that there is a scratch on the nose?" the gentleman asked. The sculptor stopped his work, looked up at the gentleman, smiled and said, "I know it and God knows it!"

Moral: The desire to excel should be exclusive of the fact whether someone appreciates it or not. Excellence is a drive from inside, not outside. Excel at a task today – not necessarily for someone else to notice but for your own satisfaction.

ePress Release

Artificial sweeteners in sweets may be harmful

The American Heart Association and the American Diabetes Association have issued a joint scientific statement giving a cautious recommendation to the use of nonnutritive sweeteners to help people maintain a healthy body weight and for diabetics to aid glucose control. These products should be considered like a nicotine patch. They are appreciably better than the real product (sugar), but not part of an optimal diet, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

The term nonnutritive sweeteners cover six sweeteners including aspartame, acesulfame K, neotame, saccharin, sucralose, and plant–derived stevia. These nonnutritive substances have zero calories.

Two thinks may happen in terms of compensation

1. Physiological, where the body might be expecting more calories and so the individual may be hungrier and therefore may eat more

2. Psychological, where the individual thinks they are allowed to eat more sugar–rich food because they had a diet soda instead of a full-sugar soda.

When real people use sweeteners there is compensation. The key is how much? Partial compensation is ok but people often completely compensate or even overcompensate, so these sweeteners have to be used smartly to be successful.

Compensation seems less of a problem when these sweeteners are consumed in beverages as opposed to food.

People don’t really notice the lack of calories in a diet soda and so don’t tend to eat more, whereas if they consume a low–calorie foodstuff, they do tend to eat more as compensation.

Its better when sweeteners are used in beverages and not sweets or other foods.

One is not completely sure about the safety of these products, because their long-term use in humans has not been studied fully.

However, the artificial sweeteners on the market are almost certainly safer than consuming large amounts of sugar, which has definite harm when consumed in large amounts. This harm, particularly when consumed in beverage form such as soda, includes increases in risks of obesity, diabetes, cardiovascular disease, and gout.

A concern, though, is that just replacing sugar with artificial sweeteners leaves a person, especially children, conditioned to high levels of sweetness, which is likely to influence their food choices adversely.

eMedi Quiz

Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionisation of the drug in the stomach. Which of the following statements is not correct example:

1. Absorption of digoxin is delayed by the presence of food.
2. Concurrent food intake may severely reduce the rate of absorption of phenytoin.
3. Presence of food enhances the absorption of hydrochlorthiazide.
4. Anitimalarial drug halofantrine is more extensively absorbed if taken with food.

Yesterday’s Mind Teaser: A middle aged male comes to the outer patient department (OPD) with the only complaint of hoarseness of voice for the past 2 years. he has been a chronic smoker for 30 years. On examination, a reddish area of mucosal irregularity overlying a portion both cords was seen. Management would include all except:

1. Cessation of smoking.
2. Bilateral cordectomy.
3. Microlaryngeal surgery for biopsy.
4. Regular follow–up

Answer for yesterday’s Mind Teaser: 2. Bilateral cordectomy.

Correct answers received from: Dr Poonam Chablani, Dr Jainendra Upadhyay, Dr.K.V.Sarma, Dr.K.Raju, Dr Gopal Shinde, Dr Chandresh Jardosh, Dr Avtar Krishan, Dr Ajay Gandhi, Dr.Bitaan Sen & Dr. Jayashree Sen

Answer for 12th July Mind Teaser: 4. Gentamicin.

Correct answers received from: Dr Gopal Shinde

Send your answer to ijcp12@gmail.com



Zee News – Health Wealth Shows

Cancer Prevention
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Fluid Intake


Total CPR since 1st November 2012 – 94595 trained

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

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VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

emedipicstoday emedipics

Health Check Up and CPR 10 Camp at NP Primary School, Kamraj Marg–11th July 2014

press release

Vowel chanting produces aspirin in my body

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IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :


Make Sure

Situation: A dengue patient with BP 100/90 developed shock.
Reaction: Oh my God! Why was rapid fluid challenge not given?
Lesson: Make sure that pulse pressure (upper minus lower blood pressure) is maintained above 40 in all patients with dengue

eMedinewS Humor

Daughter in College

Did you hear about the banker who was recently arrested for embezzling $100,000 to pay for his daughter’s college education?

As the policeman, who also had a daughter in college, was leading him away in handcuffs, he said to the banker, "I have just one question for you. Where were you going to get the rest of the money?"

Quote of the Day

Determine what specific goal you want to achieve. Then dedicate yourself to its attainment with unswerving singleness of purpose, the trenchant zeal of a crusader. Paul J. Meyer

Twitter of the Day

Dr KK Aggarwal: Weight gain precedes the onset of diabetes Weight gain after age of 18 years in women and 20 years in men (cont) http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Who is the most powerful person in your life? What are the characteristics of a powerful person? #CosmicConsciousness


medicolegal update

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medicolegal update

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  1. Dear Sir, Thanks for the information. Regards: Dr Tarun
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