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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 ...

15th November 2010, Monday

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

How much salt is too much?

Salt plays many roles in food, from acting as a preservative or a binder to helping yeast rise. It is also a cheap way to make food tastier. The US Institute of Medicine has recommended that the US FDA decrease the amount of salt in commercially prepared food. 

  • Reducing Americans’ salt intake could save at least 100,000 lives a year.
  • Most of the salt in the diet is put by someone else — a food company, chef, or cook.
  • Every day, an average person takes 8.5 gms (8,500 mg) of salt or 3,400 mg of sodium.
  • Recommended for healthy people by the federal Dietary Guidelines for Americans: 5,700 mg of salt (2,300 mg of sodium)
  • American Heart Association recommends (3,800 mg of salt, or 1,500 mg of sodium) for older people or those with borderline high blood pressure, heart conditions, kidney trouble, or diabetes. Most of the salt consumed is "hidden" salt.
  • Hidden salt: breakfast cereals (1 cup of Raisin Bran, 354 mg of sodium), a tuna sandwich (1,300 mg), a cup of cottage cheese (900 mg), prepared cookies (3 Oreos, 190 mg).
Dr KK Aggarwal
Editor in Chief
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  Quote of the Day

(By Dr. G.M.Singh)

"Listen to what you know instead of what you fear."

Richard Bach

    Photo Feature (from the HCFI Photo Gallery)


17th MTNL Perfect Health Mela

Anmol, a festival for children with special needs was organized for the sixth consecutive year.

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

India in grip of obesity epidemic

India is now in the grip of an obesity epidemic and the trend needs to be immediately arrested by taxing junk food, restricting food ads and making food labelling clearer, according to a study. The study that looked at the burden of overweight citizens in six countries –– Brazil, China, India, Mexico, Russia and South Africa –– has found that between 1998 and 2005, India’s overweight rates increased by 20%. Currently, almost 1 in 5 men and over 1 in 6 women are overweight. In some urban areas, the rates are as high as 40%. Published in the Lancet on Thursday by the Organisation for Economic Co–operation and Development (OECD), the study warns that low-income countries cannot cope with the health consequences of wide scale obesity. (Source: The Times of India)

Delhi school students most obese: Study

Children studying in Delhi schools are the most obese, compared to those studying in other cities such as Mumbai, Jaipur, Agra and Dehradun. The study, which was launched by the National Diabetes, Obesity and Cholesterol Foundation (N–DOC) in 2006, found that childhood obesity was increasing in urban cities, with the highest incidence being observed in Delhi. The study also revealed that the incidence of obesity is significantly more in private schools, when compared to government schools. (Source: Indian Express)

Applications are invited for the post of Secretary in the Medical Council of India office.


    International News

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

Hit the gym if you want to prevent cold!

A U.S. researcher from Appalachian State University in North Carolina states that one of the best ways to avoid a cold is to exercise about 30 minutes almost every day. In other words, get those immune cells going! Dr. David Nieman is the director of the Human Performance Laboratory (HPL) at Appalachian State University, in Kannapolis, North Carolina. Nieman and his HPL colleagues state that regular exercise forces immune cells in the body to move more. And, the more that these immune cells move, the more they are able to fight the common cold. Specifically, they found that people who exercise 5 or more times per week, on a regular basis, get fewer colds and less severe colds than those who work out once a week or don’t exercise at all.

(Dr Monica and Brahm Vasudev)

How JAMA managed to avoid becoming an advertising platform for the pharmaceutical companies

In July 2005, JAMA began to require industry–supported studies to undergo independent statistical analysis. To see if this requirement affected the number of industry-sponsored studies publicized in JAMA, Wager et al. (October 2010) looked for all randomized controlled trials (RCTs) published in JAMA from 1 July 2002 to 30 June 2008. They classified the trials according to their funding sources: Industry funded (IF), joint industry plus non industry funding (J), industry supported (IS) (the pharma companies provide the materials but don’t design or execute the studies), non–commercial (N) and funding not stated (NS). The broad ‘industry’ category included the IF, J and IS studies. The Lancet and NEJM were used as control (these journals don’t have the same requirement). Both the total number of RCTs and the proportion of industry RCTs decreased in JAMA after July 2005. In the mean time, the proportion of industry RCTs in NEJM and The Lancet rose significantly. The number of industry–supported and jointly funded studies in JAMA went down about as much as the number of solely industry–funded studies. In light of these findings, the authors wonder (and rightly so) whether the pharma industry ‘boycott’ JAMA in response to its policy and what, exactly, it means about the RCTs published in The Lancet and NEJM? (Ref: Wager E, Mhaskar R, Warburton S, et al. JAMA published fewer industry–funded studies after introducing a requirement for independent statistical analysis. PLoS One 2010 Oct 22;5(10):e13591).

Bypass surgery patients show insulin resistant profile

Patients undergoing multi–vessel coronary artery bypass graft (CABG) surgery appear to be profoundly insulin resistant –– with an insulin profile identical to diabetic patients, according to a small study reported at a poster presentation at the World Congress on Insulin Resistance, Diabetes and Cardiovascular Disease. (Medpage Today)

Lifestyle intervention for overweight patients with diabetes provides long–term benefits

An intensive lifestyle intervention help individuals with type 2 diabetes lose weight and keep it off, along with improving fitness, control of blood glucose levels and risk factors for cardiovascular disease, according to a report in the September 27 issue of Archives of Internal Medicine.

    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What are the complementary and alternative treatments for infertility?

Complementary or alternative female infertility treatments have been scientifically tested, with results published in peer–reviewed medical journals. A 2000 Harvard Medical School study examined the effects of group psychological intervention on infertile women (trying to conceive duration of one to two years). The two intervention groups—a support group and a cognitive behavior group—had statistically significant higher pregnancy rates than the control group.

For queries contact: banerjee.kaberi@gmail.com

    Gastro Update

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

How is hepatobiliary disease diagnosed in cystic fibrosis?

Ultrasound may be useful in screening but does not reliably diagnose early liver disease. When used alone, a normal ultrasound scan result does not rule out the existence of significant liver fibrosis.

Liver biopsy may help determine whether steatosis or focal biliary cirrhosis is the predominant lesion, histological assessment can be misleading because of the heterogeneous distribution of hepatic lesions in CF.

    Medicolegal Update

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

What are the basic issues involved in biomedical research involving human subjects?

In biomedical research, it is important to make a fundamental distinction between medical research in which the aim is essentially diagnostic or therapeutic for a patient, and medical research, the essential object of which is purely scientific and without direct diagnostic or therapeutic value to the person subjected to the research. The World Medical Association (WMA) has issued recommendations as a guide to every doctor in biomedical research involving human subjects. It must be stressed that the standards as drafted are only a guide to physicians all over the world. Doctors are not relieved from criminal, civil and ethical responsibilities under the laws of land applicable to them.

    Interesting Websites to know

Dr Jitendra Ingole, MD Internal Medicine, Asst Professor (Medicine), SKN Medical College, Pune


Written by: Jeffrey Parks, MD
General Surgeon, Cleveland

Frequent topics: Life lessons learned in the hospital; the value of bedside manner; surgical play–by–plays.
Why you should read it: To get to know the ins and outs of the OR, should you ever need to go there. And for the humanity Parks brings to the table.
Sample dose: "The second–guessing never stops, incessantly tormenting your sleepless nights…searching to no avail for that instant when you could have done something better, another stitch, a different technique, another instrument, a sign or symptom you missed, a less risky maneuver… We all have these cases… The ones that deny it are either liars or they don’t operate nearly enough."

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Tumor marker tests: Tumor markers are chemicals made by tumor cells that can be detected in your blood. But they are also produced by some normal cells in the body and so levels may be significantly high in noncancerous conditions. This limits the potential for tumor marker tests to help in diagnosing cancer. The best ways to use tumor markers in diagnosing cancer hasn’t been determined. And the use of some tumor marker tests is controversial.
Some tumor markers:

  1. Prostate–specific antigen (PSA) for prostate cancer
  2. Cancer antigen 125 (CA 125) for ovarian cancer
  3. Calcitonin for medullary thyroid cancer
  4. Alpha–fetoprotein (AFP) for liver cancer
  5. Human chorionic gonadotropin (HCG) for germ cell tumors, such as testicular cancer and ovarian cancer
    Medi Finance Update

Personal Accident Insurance

The Policy does not cover death, injury or disablement resulting from: Service on duty with any Armed Force. Intentional self injury, suicide or attempted suicide, insanity, venereal disease or the influence of intoxicating drink or drugs

    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

Fixed dose combination of antidiarrhoeals with electrolytes

    IMSA Update

International Medical Science Academy (IMSA) Update

Treatment of acute flares in gouty arthritis

Canakinumab 150 mg provides rapid and sustained pain relief in patients with acute gouty arthritis, and significantly reduces the risk of recurrent flares compared with triamcinolone acetonide.

(Ref: So A, et al. Canakinumab for the treatment of acute flares in difficult–to–treat gouty arthritis: Results of a multicenter, phase II, dose–ranging study. Arthritis Rheum 2010 Oct;62(10):3064–76.

    IJCP Special

Dr Good Dr Bad

Situation: A pregnant diabetic came with A1c 7%.
Dr Bad: Very good control.
Dr Good: You need further control.
Lesson: The A1C goal is <6 % for individual patients with type 1 diabetes and during pregnancy.

Make Sure

Situation: A female patient C/O lower abdominal pain, fever and had uterine tenderness on bimanual palpation.
Reaction: You should do cervical swabs and consider starting antibiotics.
Lesson: Make Sure that a woman with such symptoms may have endometritis, requires prompt diagnosis and may respond to doxycycline and metronidazole.

    Lighter Side of Reading

(Contributed by Rajat Bhatnagar)

Positive differences in the kids in your life

What are three major things that affect a child’s health and wellness?

The foods they eat

Unhealthy food choices are available everywhere. Trans fats, sugars, fillers, hormones, preservatives, and artificial colors and flavors all contribute to low food quality. Fast food and prepackaged foods are the most obvious culprits, but we must also be aware of what goes into the foods we buy at the grocery like meat and dairy products. Even some fresh fruits and vegetables are treated with harmful pesticides. The best way to ensure your family eats healthy is to keep lots of fresh, organic produce on hand. Another thing you can do immediately is limit the amount of soda pop your kids are allowed to drink. The best way is not to buy it, but if you must have it in the house, set a limit on how many a day your child can drink. Be aware that your kids will model your behavior, so if you drink three sodas a day, it will be harder to limit your children to just one or none at all.

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Mind Teaser

Read this…………………

go it it it it  

Yesterday’s Mind Teaser: "arrest yore"
Answer for yesterday’s eQuiz: "You’re under arrest"

Correct answers received from: Dr Bhavisha Brahmbhatt, Dr.K.Raju, Dr Meera Rekhari, Dr Kalpana Mohan,  Dr.K.P.Rajalakshmi, Dr. Rohini. Vaswani, Dr. Amlendu Yadav, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai

Answer for 13th November Mind Teaser:"ALLworld"
Correct answers received from: Dr.K.Raju

Send your answer to ijcp12@gmail.com

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Laugh a while
(Contributed by Dr G M Singh)

Doctor, Doctor, some days I feel like a tee–pee and other days I feel like a wigwam.
You’re too tents.

    Readers Responses
  1. Can a practicing pathologist certify death or issue a medical certificate?
    A pathologist can give a death certificate if he has treated the patient during the last course of illness. Not only pathologist, any MBBS doctor who has treated the patient during his last course of illness can give the death certificate. Even  BAMS, BHMS or BUMS (Ayurvedic, Homeopathy or Unani) graduates can give death certificate if they have treated the patient for illness before his death. A dental doctor (BDS) cannot give a death certificate as they do not treat the diseases pertaining to whole body; they treat only the diseases of teeth: Dr Kiran J, Prof & Head, Dept. of Forensic Medicine, Sri Devaraj Urs University, Karnataka mail: drkiranj@yahoo.com You can do all that for which a M.B.B.S. doctor is permitted/ entitled: Dr. Sher Singh Kashyotia, M.B.B.S., M.D., LL.B., LL.M., Public Health Specialist, Directorate General of Health Services
    Public Forum

(Press Release for use by the newspapers)

World Diabetes Day & Children’s Day Health Games at IITF

The Heart Care Foundation of India has set up live health games at Family Welfare Pavilion, India International Trade Fair at Pragati Maidan. Games like Ludo and ‘Worms & Ladders’ are on display and played virtually by visitors themselves as pawns. Giving the details, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India, said that most children enjoy playing games and if health information is added to them, they can become educational too.

The Foundation has also organized an exhibition on how to prevent lifestyle disorders through the formula of 80. Talking on the occasion of World Diabetes Day and Children’s Day, he stated a Formula of 80 which could be remembered by all.

  • Keep fasting blood sugar <80 mg%.
  • Keep the lower BP <80 mmHg.
  • Keep bad LDL cholesterol <80 mg%.
  • Keep abdominal girth <80 cm.
  • Keep resting pulse <80/minute.
  • Keep good HDL cholesterol >40 (half of 80).
  • Keep bad triglyceride levels <160 mg% (double of 80).
  • Walk 80 minutes a day.
  • Whenever possible, walk with a speed of 80 steps per minute.
  • Eat less, preferably not more than 80 grams of caloric food per meal.
  • Do not drink alcohol or restrict it to less than 80 ml/day or 80 grams per week.
  • Do 80 pranayams a day.
  • Clap 80 times.
    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

Chairperson: Dr (Prof) S C Tiwari, Director Fortis Institute of Renal Sciences & Kidney Transplant
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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