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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


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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of 1st Mega Ajmer Health Camp 2012

  Editorial …

16th April 2012, Monday

Five Things Physicians and Patients Should Question (Part 6)

American Gastroenterological Association

  1. For pharmacological treatment of patients with gastroesophageal reflux disease (GERD), long–term acid suppression therapy (proton pump inhibitors or histamine2 receptor antagonists) should be titrated to the lowest effective dose needed to achieve therapeutic goals: The main identifiable risk associated with reducing or discontinuing acid suppression therapy is an increased symptom burden. It follows that the decision regarding the need for (and dosage of) maintenance therapy is driven by the impact of those residual symptoms on the patient’s quality of life rather than as a disease control measure.
  2. Do not repeat colorectal cancer screening (by any method) for 10 years after a high–quality colonoscopy is negative in average–risk individuals. A screening colonoscopy every 10 years is the recommended interval for adults without increased risk for colorectal cancer, beginning at age 50 years. Published studies indicate the risk of cancer is low for 10 years after a high–quality colonoscopy fails to detect neoplasia in this population. Therefore, following a high–quality colonoscopy with normal results the next interval for any colorectal screening should be 10 years following that normal colonoscopy.
  3. Do not repeat colonoscopy for at least five years for patients who have one or two small (< 1 cm) adenomatous polyps, without high grade dysplasia, completely removed via a high–quality colonoscopy. The timing of a follow–up surveillance colonoscopy should be determined based on the results of a previous high–quality colonoscopy. Evidence–based (published) guidelines provide recommendations that patients with one or two small tubular adenomas with low grade dysplasia have surveillance colonoscopy five to 10 years after initial polypectomy. "The precise timing within this interval should be based on other clinical factors (such as prior colonoscopy findings, family history, and the preferences of the patient and judgment of the physician)."
  4. For a patient who is diagnosed with Barrett’s esophagus, who has undergone a second endoscopy that confirms the absence of dysplasia on biopsy, a follow–up surveillance examination should not be performed in less than three years as per published guidelines. In patients with Barrett’s esophagus without dysplasia (cellular changes) the risk of cancer is very low. In these patients, it is appropriate and safe to exam the esophagus and check for dysplasia no more often than every three years because if these cellular changes occur, they do so very slowly.
  5. For a patient with functional abdominal pain syndrome (as per ROME III criteria) CT scans should not be repeated unless there is a major change in clinical findings or symptoms. There is a small, but measurable increase in one’s cancer risk from x–ray exposure. An abdominal CT scan is one of the higher radiation exposure x–rays — equivalent to three years of natural background radiation. Due to this risk and the high costs of this procedure, CT scans should be performed only when they are likely to provide useful information that changes patient management.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

World Congress on Insulin Resistance, Diabetes & Cardiovscular Disease Meeting

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

First Mega Ajmer Health Camp – Tele–consultation facilities

For the first time, 7 major hospitals from outside Ajmer were connected to the camp live through tele–services and provided over 200 tele–consults.

Dr K K Aggarwal
    National News

Gujarat to have India’s first egg–sperm–embryo bank

AHMEDABAD: The country’s first bank for freezing women’s eggs, sperms and embryos will be set up in Ahmedabad. The bank, to be operational in three month’s time, is the first to be set up following guidelines of Assisted Reproductive Technology (ART) Bill, draft of which has got the union health ministry’s nod. The bill is yet to be passed in Parliament. The ART bank would be set up through a joint partnership between Ahmedabad–based Nova Pulse IVF and IVI, a chain of IVF clinics headquartered in Spain. IVI has pioneered the technique of freezing eggs called vitrification which allows women to freeze their eggs which can be used even years later without compromising on their quality. (Source: TOI, Apr 13, 2012)

For comments and archives

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology: Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    International News

GLP–1 is a good choice for glycemic control

The top 3 drugs for the reduction of glycated hemoglobin A1c (A1C) levels are biphasic insulin, glucagon–like peptide 1 (GLP–1) analogs, and basal insulin. Although most oral antidiabetic drugs had a similar effect on A1C, GLP–1 analogs had the additional advantages of weight reduction in the absence of an increased risk for hypoglycemia. (Source: Medscape)

For comments and archives

Bevacizumab beats laser therapy in macular edema trial

A 2–year randomized controlled trial suggests that bevacizumab (Avastin, Genentech) is more effective than macular laser therapy in patients with diabetic macular edema. Ranjan Rajendram, MD, FRCOphth, from the Department of Medical Retina, Moorfields Eye Hospital, and the University College London Institute of Ophthalmology, London, United Kingdom, and colleagues reported the result of their trial in an article published online April 9 in the Archives of Ophthalmology. (Source: Medscape)

For comments and archives

FDA warns of clot risk with Yaz, other OCs

Labels for oral contraceptives that contain drospirenone will now note that studies have shown as much as a threefold increase in risk of blood clots compared with other birth control pills, the FDA said. Following a safety review that began last May, the agency "has concluded that drospirenone–containing birth control pills may be associated with a higher risk for blood clots than other progestin–containing pills." (Source: Medpage Today)

For comments and archives

Climate change tied to death rate in elderly

Increased variability in summer temperatures is likely to raise mortality rates among older people with chronic diseases, a large analysis of U.S. cities found. (Source: Medpage Today)

For comments and archives

Eye tremors may be early sign of Parkinson’s

Eye tremors are pervasive in Parkinson’s disease and could be an early warning sign of the neurodegenerative movement disorder, according to a case–control study. (Source: Medpage Today)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: Mom’s Obesity May Sway Child's Risk For Autism

@DrKKAggarwal: Most people do not realize that the challenges they experience in their life are there for a spiritual reason

    Spiritual Update

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Baisakhi and Sikh Spirituality

Baisakhi is the day when their 10th Guru, Guru Gobind Singhji started ‘Khalsa Panth’. Khalsa means a baptized Sikh (pure one or GURU’s very own). It is the way of pure living. After the line of corporeal gurus was brought to an end by Guru Gobind Singh, the Khalsa Panth was installed its own leader under the abiding guidance of Guru Granth Sahib.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

How does contraception work?

Contraceptive agents are usually divided into those that are either hormonal or non hormonal. Most of the hormonal contraceptives work by changing a woman’s hormone levels to mimic a pregnancy, therefore preventing eggs from being able to be released from the ovary. In contrast, non hormonal contraceptive agents or devices work by preventing a man’s sperm from joining a woman’s egg.

For comments and archives

    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

What special diets should a donor take after giving blood?

A donor is given some liquid (fluid) to take. It may be a cup of coffee or milk or fruit juice etc. along with a few biscuits or fruit. The donor needs no other special diet. The blood is replenished quantitatively within 24–48 hours with the routine balanced diet, which we take normally.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

You are unique!

Think what a remarkable, unduplicable, and miraculous thing it is to be you! Of all the people who have come and gone on the earth, since the beginning of time, not ONE of them is like YOU!

No one who has ever lived or is to come has had your combination of abilities, talents, appearance, friends, acquaintances, burdens, sorrows and opportunities.

No one’s hair grows exactly the way yours does. No one’s finger prints are like yours. No one has the same combination of secret inside jokes and family expressions that you know.

The few people who laugh at all the same things you do, don’t sneeze the way you do. No one prays about exactly the same concerns as you do. No one is loved by the same combination of people that love you – NO ONE!

No one before, no one to come. You are absolutely unique!

Enjoy this uniqueness. You do not have to pretend in order to seem more like someone else. You weren’t meant to be like someone else. You do not have to lie to conceal the parts of you that are not like what you see in anyone else.

You were meant to be different. Nowhere ever in all of history will the same things be going on in anyone’s mind, soul and spirit as are going on in yours right now.

If you did not exist, there would be a hole in creation, a gap in history, something missing from the plan for humankind.

Treasure your uniqueness. It is a gift given only to you. Enjoy it and share it!

No one can reach out to others in the same way that you can. No one can speak your words. No one can convey your meanings. No one can comfort with your kind of comfort. No one can bring your kind of understanding to another person.

No one can be cheerful and lighthearted and joyous in your way. No one can smile your smile. No one else can bring the whole unique impact of you to another human being.

Share your uniqueness. Let it be free to flow out among your family and friends and people you meet in the rush and clutter of living wherever you are. That gift of yourself was given you to enjoy and share. Give yourself away!

See it! Receive it! Let it tickle you! Let it inform you and nudge you and inspire you! YOU ARE UNIQUE!

Source: http://academictips.org/blogs/you–are–unique/

For comments and archives

    Microbial World: The Good and the Bad They Do

(Dr Sunil Sharma, Senior Consultant Microbiology, Medanta The Medicity)

Modes of transmission of microbes

Other sources of infections

Transmission of infection from other sources like contaminated water, contaminated fluids, fomites, etc. can also occur. In addition the vector–borne infection can also be transmitted in a healthcare facility like anywhere else through different vectors.

Transmissible infections amongst HCW include air–borne infections such as tuberculosis, varicella, measles, influenza, and respiratory syncytial virus infection; blood–borne infections such as human immunodeficiency virus, hepatitis B virus, hepatitis C virus, Ebola, Lhasa viruses; infections transmitted through the feco–oral route such as salmonella, hepatitis A virus, and those spread through direct contact (herpes simplex virus, Sarcoptes scabiei).

For comments and archives

  Cardiology eMedinewS

Soy Helps Reduce Blood Pressure Read More

Lack of Sleep and Risk of Diabetes Read More

Hard Arteries Linked to Diabetes Read More

  Pediatric eMedinewS

Combining Targeted Treatment Boosts Efficacy In Ewing’s Sarcoma
Read More

Proposed New Definition Of Autism Stirs Controversy Read More

More Protein Improves Energy Balance In Critically Ill Children Read More

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    IJCP Special

Dr Good Dr Bad

Situation: A patient with heart failure came with chronic anemia.
Dr. Bad: You need a blood transfusion.
Dr. Good: You need to be investigated.
Lesson: Patient with heart failure and chronic anemia do not urgently need correction of anemia by the use of transfusion or erythropoiesis stimulating agents. Iron supplements are recommended only when clinically indicated.

For comments and archives

Make Sure

Situation: A female patient complained of lower abdominal pain, fever and had uterine tenderness on bimanual palpation.
Reaction: Oh my God! You should have done cervical swabs and consider starting antibiotics.
Lesson: Make sure to remember that women with such symptoms may have endometritis, which requires prompt diagnosis. It may respond to doxycycline and metronidazole.

For comments and archives

  Legal Question of the day

(Prof. M C Gupta Advocate & Medico–legal Consultant)

Q. A doctor diagnoses anemia and advises blood transfusion. The patient comes to a hospital asking for blood transfusion. My queries are:

a. Can the hospital transfuse blood on the recommendation of somebody else.?
b. Can the hospital charge consultation charges, bed charges and transfusion charges?
c. What will be the responsibility of the hospital?
d. Who will be responsible for the transfusion related problems?


  1. A hospital is not supposed to act mechanically like a technician at the bidding of somebody else. Nothing prevents the person advising blood transfusion from doing it under his own supervision and responsibility. If he refers the patient to a higher facility, neither the patient nor the referring physician should think that the higher facility/hospital will act with close eyes and mind at the bidding of the referring physician.
  2. The hospital has no business giving blood transfusion merely because someone else advised it. Blood transfusion is a serious thing and can lead to litigation demanding huge amounts of money in compensation for any mishaps. The hospital should give blood transfusion after assessing independently the patient’s health/disease condition; cause and type and severity of anemia; need for blood transfusion if at all there is a need (after considering other modes of treatment. If blood transfusion is given, it should be after explaining the pros and cons and only after obtaining a written informed consent.
  3. The hospital can certainly charge money for the above assessment and can certainly raise a bill for consultation charges, bed charges and transfusion charges.
  4. The responsibility for some mishap will be of the hospital. If it can be proved that the blood bank was also at fault, some liability may fall on the blood bank also.

For comments and archives

  Quote of the Day

(Dr GM Singh)

HATRED weakens the liver; GRIEF weakens the lungs; WORRYING weakens the stomach; STRESS weakens both the heart and the brain; and FEAR fails the kidneys…so stay HAPPY! Look good, feel good and do good!

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Rheumatoid Factor

To help diagnose rheumatoid arthritis (RA) and Sjogren’s syndrome: When a patient has fatigue, joint pain, weakness, or dry eyes or dry mouth then your doctor may suspect it to be due to RA or Sjogren’s syndrome.

    Mind Teaser

Read this…………………

When should you have your first cholesterol screening?

A. At age 10.
B. At age 20.
C. At age 35.
D. At age 40.
E. It depends on your risk factors.

Yesterday’s Mind Teaser: What’s the leading cause of death for women?

A. Cancer
B. Heart disease
C. Stroke
D. Accidental injuries
E. Diabetes

Answer for Yesterday’s  Mind Teaser: B. Heart disease

Correct answers received from: Dr Jainendra Upadhyay, Raju Kuppusamy, Dr. Thakor Hitendrsinh G, Dr U.Gaur, Muthumperumal Thirumalpillai

Answer for 14th April Mind Teaser: Lignin
Correct answers received from: Dr. P. C. Das

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Law of Random Comfort Seeking – A cat will always seek, and usually take over, the most comfortable spot in any given room.

    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

What are the reasons for the maximum range of tattooing?

The larger the caliber the greater the distance to which the powder is discharged

In a firearm missile wound, the amount of tattooing and the maximum distance to which the powder particles can be discharged depend upon the barrel length and the nature of the cartridge, both in its caliber and in its power load. I have seen during postmortem examination of a firearm missile victim that the larger the caliber, the greater the distance to which the powder is discharged. Tests to determine the maximum possible distance to which the powder particles can be discharged are done by ballistic experts, not doctors in all cases where it is important to ascertain the range of fire with the weapon used at the crime and with similar ammunition. The range of fire of a firearm cannot be scientifically determined in cases where the weapon is discharged beyond the range of powder grain deposit.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Vegetables & fruits lower chances of getting some cancers

Vegetables and fruits help lower your chances of getting head, neck, breast, ovarian and pancreatic cancers. Even one additional serving of vegetables or fruits could help lower the risk of head and neck cancer. The more fruits and vegetables you can consume, the better.

Quoting an International Study from National Cancer Institute, Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal and President, Heart Care Foundation of India, said that those who eat six servings of fruits and vegetables per 1,000 calories have a 29% decreased risk relative to those who have 1.5 servings. In the study, after adjusting the data to account for smoking and alcohol use – known head and neck cancer risk factors – the researches found that those who consumed the most fruits and vegetables had the lowest risk for head and neck cancers. Vegetables appeared to offer more cancer prevention than fruits alone did. Adding just one serving of fruit or vegetables per each 1000 calories consumed daily resulted in a 6% reduction of risk.

In another study, broccoli and soy protein were found to protect against the more aggressive breast and ovarian cancers. When consumed together, digesting broccoli and soy forms a compound called di–indolylmethane (DIM). In lab experiments, the researchers found that DIM could affect the motility of breast and ovarian cancer cells, which could help keep cancers from spreading. Soy, acts like estrogen and is a nutritious, healthy food, and should be eaten in moderation.

Yet another study compared intake of flavonols to their risk of pancreatic cancer. Flavonols are protective compounds found in fruits and vegetables, such as onions, apples, berries, kale and broccoli. Those who had the highest consumption of flavonols reduced their risk of pancreatic cancer by 23%. The benefit was even greater for people who smoked. Smokers with high levels of flavonols reduced their risk of pancreatic cancer by 59%.

    Readers Response
  1. Dear Sir, We are enjoying eMedinewS a lot. Regards: Dr Supriya
  2. Dear Sir, Emedinews is really very good source of information. Regards:Dr JS Khanna
    Forthcoming Events
Dr K K Aggarwal

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

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3. eMedinewS audio lectures (This may take a few minutes to open)

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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Dr Usha K Baveja