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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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  Editorial …

16th August 2011, Tuesday

Cigarettes hurt women’s hearts more than men’s

As per the results from a large systematic review and meta-analysis compared with nonsmokers, women smokers have a 25% greater relative risk of coronary heart blockages than men who smoke independent of other cardiovascular risk factors.

The study in Lancet by Rachel R. Huxley, DPhil, from the University of Minnesota in Minneapolis, and Mark Woodward PhD, from Johns Hopkins University in Baltimore, further shows that the risk increases by 2% for every additional year of study follow-up.

Women might extract a greater quantity of carcinogens and other toxic agents from the same number of cigarettes than men. This explains why women who smoke have double the risk of lung cancer compared with their male counterparts.

Men who quit smoking also fared better than women who quit.

Although more men than women smoke, those women who do smoke have a greater risk of coronary heart disease and therefore targeting of both sexes is imperative for smoking prevention.

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Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Cigarettes hurt women’s hearts more than men’s

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    Photo Feature (from the HCFI Photo Gallery)

National Conference on
Insight on Medico Legal Issues

Dr HS Risam, Board of Director, MCI, presenting his views on Professional misconduct and professional ethics in the National Conference on Insight on Medicolegal Issues held on 10th July, 2011.

Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


Muddling with water sources may invite imprisonment

Those found polluting drinking water sources might find themselves behind bars if a Parliamentary panel’s recommendations are accepted by the Government. Taking serious note of the fact that poor water quality in the country is taking a toll on common man’s health, the Public Accounts Committee (PAC) has sought making pollution of drinking water sources an offence through a legislation. It has asked the Central Government to frame a draft bill within the next six months. Such a suggestion is not without reason given that the health burden due to poor water quality in the country is enormous with around 37.7 million Indians being affected by waterborne diseases annually and 1.5 million children estimated to die of diarrhoea alone. Headed by senior BJP leader Murli Manohar Joshi, the PAC has suggested making testing of water quality through labs a mandatory provision in the Accelerated Rural Water Supply Programme (ARWSP) guidelines. Besides, it has also recommended the Rural Development Ministry to "ensure that labs are functional at all times". To begin with, the Ministry should pay more emphasis on water testing aspect and should increase the frequency of monitoring the quality of water…and instruct the states to test all drinking water sources at least twice a year and for chemical contamination at least four times in a year ie every quarterly, it maintained. (Source: The Pioneer, August 13, 2011)

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

(Dr Monica and Brahm Vasudev)

Fungal disease increasing problem in older adults

Opportunistic fungal infections increasingly are being seen among older adults, even among those who reside outside endemic areas, a retrospective study showed. (Source: Medpage Today)

For comments and archives

FDA okays another once–daily HIV pill

The FDA has approved a second once–daily tablet for HIV –– this one combining three medications: emtricitabine, rilpivirine, and tenofovir. The pill, manufactured by Gilead Sciences, combines that company’s Truvada –– itself a combination of the two nucleoside reverse transcriptase inhibitors emtricitabine and tenofovir –– with rilpivirine (Edurant), a recently approved non–nucleoside reverse transcriptase inhibitor made by Tibotec Pharmaceuticals. The new pill will be called Complera. (Source: Medpage Today)

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Early promise for CLL therapy

Three patients with refractory chronic lymphocytic leukemia (CLL) responded following infusion of autologous T–cells with genetically modified antigen receptor, investigators reported. The receptor–modified T–cell population increased by more than 1,000–fold from initial engraftment and remained at high levels for six months in one of the patients. Remission was ongoing after 10 months of follow–up, as reported online in the New England Journal of Medicine. (Source: Medpage Today)

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Men, leaner folks less likely to be treated for High BP

Men and patients who are leaner and generally healthier are less likely to have their hypertension treated, researchers said. Male sex, body mass index (BMI) below 25 kg/m2, lack of chronic kidney disease, lower heart disease risk, and making fewer visits to the doctor were associated with high blood pressure going untreated, Brent Egan, MD, of the Medical University of South Carolina in Charleston, and colleagues reported online in Circulation: Journal of the American Heart Association. (Source: Medpage Today)

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    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

Being active prevents cognitive decline in aging populations: An update

A new study published in the journal Archives of Internal Medicine reaffirms previous findings that physical activity helps slow cognitive decline in older adults. However, previous studies relied solely on self–report questionnaires of physical activity, which can be variable, or accelerometers, which are effective tools, yet do not take into account total energy expenditure. For this study, researchers used more objective measures of physical activity and energy expenditure in order to ensure that their findings were more precise.

Researchers studied a group of 178 men and women with an average age of 75 years. They measured resting metabolic rate via indirect calorimetry and energy expenditure using doubly labeled water. Both are laboratory methods used to calculate precise physiologic measurements and were used to calculate the amount of energy expended during exercise. Then, participants were given cognitive and memory tests. The researchers followed the study participants for a new test every year. While sedentary participants scored significantly worse over the years on tests of memory and cognitive function, the most active group showed very little decline. Approximately 90 percent of the group of most active participants scored nearly the same on a follow up test administered two to five years after their original test.

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    Twitter of the Day

@DrKKAggarwal: #IJMD The use of the lingual technique for forced eruption enhance acceptance of orthodontic treatment by adult… http://fb.me/1ePJglzeV

@DeepakChopra: #CosmicConsciousness The Big Bang was actually a big cosmic germination of a living universe

    Dr KK Answers

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

What is the incidence of heart disease in young?

The data comes from International US autopsy based study published in the journal Circulation of 760 young victims of unnatural death occurring between the age of 15 to 34. Advance coronary blockages were seen in 2% of men and zero percent in women aged 15-29 years. An advance disease was present in 20% of men and 8% of women aged 30 and 34 years respectively. 19% of men and 8% of women had more than 40% narrowing of the left coronary artery. This incidence represents data of silent heart disease in young people. The data from India is not available.

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    Spiritual Update

The Spiritual significance of Indian Flag – Tiranga

Tiranga Uncha Rahe Hamara

The Indian National flag is symbolic representation of the rich Vedantic heritage of our country. Different colours with a chakra in the center are the gist of Vedas. The flag consist of three colours; saffron (orange) on top, white in the middle and green at the bottom. In the center of the white colour, there is a chakra with 24 lines..

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

Trust your friends

Once I had to walk on a rope bridge. It was very high, I was scared. I saw my friend on the other side and called out to him for help but there was no reply. I somehow managed and crossed the bridge. There I was shocked to see my friend holding the end of the broken bridge.

Sometimes we wonder why a friend is quiet when we call for help. He may not help you in crossing the bridge but he might be holding the broken bridge for you. Trust your friends in every situation, because they are your real assets.

For comments and archives

    Pediatric Update

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

Can celiac disease present with constipation?

Yes, celiac disease may manifest with constipation, though diarrhea is the commonest manifestation. In western data, constipation may be seen in around 5% of children.

For comments and archives

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


Increased total: Hepatic damage (hepatitis, toxins, cirrhosis), biliary obstruction, hemolysis, fasting.
Increased direct (conjugated): Biliary obstruction/cholestasis, drug induced cholestasis.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient came with deranged liver functions.
Dr Bad: We need to rule out viral hepatitis.
Dr Good: We need to rule out hemochromatosis.
Lesson: All diabetic patients with abnormal liver enzymes should be screened for hemochromatosis. Hemochromatosis is present in 1–2% of all diabetic patients, and often diabetes is the first clinical manifestation of the condition. Liver function abnormalities are the most frequent finding leading to a diagnosis (Clinical Diabetes 2004;22:101–2).

For comments and archives

Make Sure

Situation: A 70–year–old male with antibiotic–associated diarrhea and TLC of 24000 died.
Reaction: Oh my God! Why was surgery not considered in this case?
Lesson: Make sure that urgent surgical evaluation is done in patients with acute gastroenteritis who are =65 years and have a white blood cell count =20,000 cells/microL and/or a plasma lactate between 2.2 and 4.9 mEq/L.

For comments and archives

  Quote of the Day

(Dr GM Singh)

You can fool some of the people all of the time, and all of the people some of the time, but you cannot fool all of the people all of the time. Abraham Lincoln


(Ms Ritu Sinha)

Down to the wire: Something that ends at the last minute or last few seconds.

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    Medicolegal Update

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

Snake Venom is a very complex mixture of proteins and toxins. Snakes use their venom to immobilize, and in some cases, digest their prey–How snake bites could be avoided?

  • The snake will usually try to get away when a person and a snake meet if given the chance.
  • Snakes bite only when they are surprised by a sudden movement and cannot get away. Cobras and the Russel’s viper are responsible for the close to 20,000 yearly snake bite deaths in India.
  • Inland taipan is the world’s most venomous land snake. Its bite is synonymous with death. Maximum survival time recorded after Taipan’s bite is not more than few hours. Without prompt medical assistance its victim has rarest chance of recovery.
  • Do not sleep on the ground. You might roll over onto a snake while asleep, or a snake may move next to you to get warm.
  • Do wear shoes when walking outdoors. Tall leather boots give the best protection for walking in long grass or undergrowth. Wear them with long trousers hanging outside the boots.
  • Do learn about the poisonous snakes in your area. Learn what they look like and where they live. Most snakes live on the ground but some live in trees or bushes. Find out if there are any snakes that spit venom and how they attack.
  • Do take care at night because that is when many snakes are active. Tell children to wear shoes and use a torch when walking around at night. Teach them to leave snakes alone.
  • Do not go near snakes. Run away if you can. If you cannot run away, do not make sudden movements.
  • Do not touch a snake even if it looks dead. Some snakes pretend to be dead to avoid attack.
  • Do not turn over stones or logs, or put your hand or foot into a hole in the ground. Before stepping over a log look for snakes on the other side.

For comments and archives

    Mind Teaser

Read this…………………

Risk factor for cervical cancer include:

a. Smoking
b. Multiple sexual partners
c. HIV infection
d. All of the above

Yesterday’s Mind Teaser: agebeauty

Answer for Yesterday’s Mind Teaser: age before beauty

Correct answers received from: Dr Sudipto Samaddar, Dr.S.K.Bansal, Dr Chandresh  Jardosh, Dr Muthumperumal Thirumalpillai, Dr Neelam Nath, Dr Seema, Dr Rajat, Dr Tushar, Dr Eisha

Answer for 14th August Mind Teaser: 4. PSC reverts after a total colectomy.
Correct answers received from: Dr Valluri Ramarao, Dr.Ragavan Sivaramakrishanan, Dr Anupam, Dr Shwetal, Dr Jatin, Dr Priya, Dr Surubhi, Dr Sheetal, Dr Tapan

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Patient: These tablets have a very funny effect on my bowels.
Surgeon: What are they?
Patient: Ferocious sulphate.

For comments and archives

    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name
DCI Approval Date
Besifloxacin Ophthalmic Suspension 0.6% w/v
For the treatment of bacterial conjunctivitis.
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Hospital–acquired anemia can increase mortality in acute heart attack

For patients hospitalized with an acute heart attack an increasing volume of blood drawn for diagnostic tests is associated with a greater risk of developing anemia. For every 50 mL of blood drawn, the risk of developing moderate–to–severe anemia in the hospital rises by 18%, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

It is possible to reduce this risk by

  1. Reviewing the necessity for routine vein puncture
  2. Reducing the volume of blood obtained during a hospitalization.
  3. Enlisting the minimum amount of blood required for each test
  4. Limiting scheduled phlebotomy
  5. Using pediatric blood tubes for blood collection
  6. Using 2 or 5 ml syringes instead of 10 ml syringes
  7. Using stored serum specimens or storing the first sample of the patient till the day of hospitalization.
  8. Rationalization of the routine testing

According to Dr Mikhail Kosiborod, of Saint Luke’s Mid America Heart and Vascular Institute in Kansas who published their data in the Archives of Internal Medicine, hospital–acquired anemia in patients with acute heart attack is associated with poorer outcomes including higher mortality. He evaluated 17,676 patients with acute heart attack from 57 U.S. hospitals. The patients had normal hemoglobin levels at admission. Overall, 20.1% of the patients developed moderate–to–severe anemia (a decline in hemoglobin from normal values to less than 11 g/dL) during their hospital stay. The mean volume of blood drawn was significantly higher in patients who developed moderate–to–severe anemia (173.8 versus 83.5 mL). Those who developed the condition were also more likely to have more than 300 mL drawn (12.5%) and more than 500 mL drawn (3.8%).

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    Readers Responses
  1. Dear Sir, A Very Happy Independence Day To You... May Our Country win its battle against corruption...Thanks & warm regards: Om Prakash Jain
    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & National Icons in the field of Cardiology & Echocardiography will form the teaching faculty.



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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