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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 …

18th February, 2011, Friday                                eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Energy drinks – harmful to children

Energy drinks are under–studied, overused and can be dangerous for children and teens. The potential harms, caused mostly by too much caffeine or similar ingredients, include heart palpitations, seizures, strokes and even sudden death, according to a study published in the journal Pediatrics.

Surveys show that 30% to 50% of teens and young adults consume energy drinks, but we didnt see evidence that drinks have beneficial effects in improving energy, weight loss, stamina, athletic performance and concentration, said study author Steven Lipshultz, chair of pediatrics at the University of Miami School of Medicine.

Dr KK Aggarwal
Editor in Chief
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  eMedinewS Audio PostCard

  2nd eMedinewS Revisiting 2010

Revisiting the Year 2010 with Dr KK Aggarwal
ADA revises diabetes guidelines

Audio PostCard
  Quote of the Day

(By Dr GM Singh)

If there is any kindness I can show, or any good thing I can do to any fellow being, let me do it now, and not deter or neglect it, as I shall not pass this way again.

William Penn

    Photo Feature (From the HCFI File)

2nd eMedinewS Revisiting 2010

Shri Sundeep Gulati, was felicitated as the ‘Guest of Honor’ in 2nd eMedinewS Revisiting 2010 held at Maulana Azad Medical College on 9th January 2011

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

Palliative care body to draw national policy

The Indian Association of Palliative Care (IAPC) has named a committee to formulate a national policy for it. The committee will submit the drafted policy to the Centre and request that it be adopted across the country. The decision was taken by the Executive Council of the Association, which met on Saturday at the Sanjay Gandhi Post Graduate Institute of Medical Science, Lucknow, during its 10th Annual Conference. "The committee was formed by the Executive Council, which met here yesterday. The chairman of the committee is Dr Stanley Macaden, a palliative care specialist at Bangalore," said Dr Anil Agarwal, Professor of Anesthesiology, SGPGI and Executive Council Member of IAPC. The four–member committee is expected to submit its first draft within three months. (Source: Indian Express, Feb 14, 2011)

    International News

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

Heart Health: Diet, exercise are key

There are numerous aspects to personal living that help create a healthy heart, and over the past 30 years a tremendous amount of research has been dedicated to finding the ideal combination of diet, lifestyle, and physical fitness that will elicit positive heart health benefits. Eating a balanced, well–rounded diet, low in saturated fats is known to be integral in decreasing the risk of blockages in blood vessels. Avoidance or cessation of smoking cigarettes decreases the risk of hardening of the arteries known as atherosclerosis. Living a more relaxed, less stressful lifestyle decreases the amount of stress hormones released that can negatively affect vascular tone and normal cardiac rhythm. Physical fitness, specifically cardiovascular training, improves all of those three aspects in and of itself. Regular exercise performed at a moderate intensity has been shown to raise HDL (good cholesterol), decrease total triglycerides (fat) in the blood, decrease blood pressure, and decrease resting heart rate. Yet, a large portion of the population still avoids any significant daily activity.

Here are some common excuses people have for not exercising.

I don’t like to exercise and would rather just change my eating habits: The best way to positively affect HDL numbers in your blood is through exercise. Certainly, altering your diet can increase HDL numbers, but exercise is considered superior, and much simpler. In fact, a number of the diet modifications have to be combined in order to achieve the same benefits as exercise. Aside from a reduction in sodium (generally resulting in lower blood pressure), exercise provides more benefits for decreasing blood pressure and increasing the strength of the heart than diet modifications.

I don’t have the time to work out: As little as 20 minutes of moderate intensity exercise performed three to four times a week can produce benefits. That is less time than a typical sitcom. Blood pressure will decrease, vascular tone will improve, stroke volume (heart efficiency) will improve, and you will burn anywhere from 70 to 250 calories depending upon intensity. For every 10 minutes of additional time you can spend performing physical activity, the benefits increase even more. In simple math, with 40 minutes of exercise, three to four times per week over a three to four month period, your HDL levels could increase enough to decrease your risk of heart disease by 15 percent, your blood pressure could decrease 10 points for both numbers, and your resting heart rate could drop by as much as 20 beats per minute.

There is a misconception between aerobic training and cardiovascular training. Aerobic training involves a specific energy system for lower intensity, endurance activities. Cardiovascular training involves exercising to elevate your heart rate to a given level. There are many modes of exercise that can achieve cardiovascular fitness without ever getting on a treadmill or elliptical. Simple circuit training with weights, completed with little to no rest between sets of complimentary exercises will elicit a heightened heart rate. Even an upper body workout involving alternating sets of pushing and pulling activities with limited rest can elevate the heart rate to 60 percent of heart rate maximum provided the program is designed properly.

(Dr Monica and Brahm Vasudev)

Increasing maternal BMI associated with more adverse outcomes in pregnancy

Current US guidelines may overestimate the amount of weight that severely obese women need to gain during pregnancy, according to a study presented at the Society for Maternal–Fetal Medicine annual meeting. In a study of 73,977 women, researchers found that extremely obese women who gained less than the Institute of Medicine–recommended amount of weight during the second and third trimester of pregnancy suffered no ill effects, nor did their babies. But, obese and non–obese women who gained less than the recommended amount of weight did experience problems, including a higher likelihood of delivering a baby that is small for gestational age.

Benign tumor analysis reveals gene mutations that may cause hypertension

The MedPage Today (2/14) reports, A genetic analysis of a set of benign tumors that cause hypertension has revealed mutations that may lie at the root of high blood pressure, according to a study in Science. The study, which used whole exome sequencing of the tumors yielded two mutations in a gene (KCNJ5) involved in moving potassium in and out of cells. The findings arose from a genetic analysis of tumors from patients with aldosterone–producing adenoma of the adrenal cortex, which leads to high levels of the hormone aldosterone (resulting in hypertension), and low potassium levels. Neither mutation – G151R and L168R –– is contained in major databases; and sequencing 900 KCNJ5 alleles from controls did not turn them up, the study authors noted.

Ranibizumab injection improves vision in patients with diabetic vision loss

A clinical trial showed that Lucentis (ranibizumab injection) is effective as a treatment for macular edema bought on by diabetes.

    IMT Update

IMT increases in patients with aortic stenosis (AS). The greatest IMT values are observed in patients with both AS and coronary artery disease (CAD). In AS, suspect CAD if IMT> 1.2 mm. (J Ultrasound Med 2005 Apr;24(4):461–7)

    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is the major cause of infertility worldwide. PID comprises a variety of infections caused by different bacteria that affect the reproductive organs, appendix, and parts of the intestine that lie in the pelvic area. The sites of infection most often implicated in infertility are in the fallopian tubes, a specific condition referred to as salpingitis. PID may result from many different conditions that cause infections.

  • Sexually transmitted diseases (cause of most PIDs). Chlamydia trachomatis is an infectious organism that causes 75% of infertility in the fallopian tubes. Gonorrhea is responsible for most of the remaining cases. These diseases are often widely under–diagnosed and undertreated.
  • Pelvic tuberculosis (a growing global problem as tuberculosis cases increase)
  • Nonsterile abortions
  • Ruptured appendix
  • Herpesvirus (suggested for some cases, but not confirmed as a causal agent)

For queries contact: banerjee.kaberi@gmail.com

    Pediatric Update

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

How can asthmatic medications be delivered to a child?

In pediatric asthma, inhaled treatment is the cornerstone of asthma management. Inhaler devices currently used broadly fall into the following four categories:

  • Pressurized metered dose inhaler (pMDI): Propellant used to dispense medication when canister is pressed manually.
  • Dry powder inhaler (DPI): Does not require hand–breath coordination to operate.
  • Breath–actuated pMDI: Propellant used to dispense medication when patient inhales.
  • Nebulized solution devices

In pediatrics, the inhaler device must be chosen on the basis of age, cost, safety, convenience, and efficacy of drug delivery.

  • The preferred device for children younger than 4 years is a pMDI with spacer and age–appropriate mask.
  • Children aged 4–6 years should use a pMDI plus a valved holding chamber or spacer.
  • Children older than 6 years can use either a pMDI, a DPI, or a breath–actuated pMDI.

For all 3 groups, a nebulizer with a valved holding chamber (and mask in children younger than 4 years) is recommended as alternate therapy.

For queries contact: drneelam@yahoo.com

    Medicolegal Update

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

Medical examination of a person accused of firing a firearm

It may be necessary to examine a person suspected of shooting by doctor and the investigating agency take measures for their medical examination as many corroborative scientific evidences may be collected in medical examination.

  • Any scuffle injuries, intoxication will be revealed in medical examination
  • The firearm discharge residues on the hands and face may be present for some time, although they may remain on clothing for several days which may be clinching evidence.
  • If a revolver is fired, the escaping powder pressure between the cylinder and barrel may be expected to fall upon the hands that grasp the weapon and pull the trigger. This material, which may deposit upon the hand, consists of: powder particles in various stages of decomposition; bits of bullet material, if the cylinder and bore are not correctly aligned; ignition products of the primer; combustion products of propellant, primer, and cartridge case.
    Useful Websites

(Dr Surendernikhil Gupta)


Self learning courses in public health/the year in polio/harvard college global health review/child undernutrition, tropical enteropathy, toilets, and handwashing


    Rabies Update

(Dr. AK Gupta)
Author of "RABIES – the worst death"

What are the symptoms of rabies in human beings?

Hydrophobia is the best known clinical feature of rabies and is typically unique to human beings. It is due to a violent jerky contraction of the diaphragm and the accessory muscles of inspiration that is triggered by the patient’s attempt to swallow liquid. The incubation period of the virus, that is the time interval between the bite and the onset of hydrophobia, is usually from 3 weeks to 3 months (rarely 04 days to 02 years).

Prodromal syndrome (Lasts for 2–10 days)

  • Pain at the site of bite in association with
  • Fever, malaise, nausea and vomiting.
  • The skin is sensitive to changes of temperature, especially air currents. About 10 days later, the CNS stage begins.

Neurologic stage (Lasts for 2–7 days)

  • Aphasia
  • Incoordination
  • Paresis
  • Paralysis
  • Mental status changes
  • Hyperactivity

Late symptoms

  • Hypotension
  • Coma
  • Disseminated intravascular coagulation (DIC)
  • Cardiac arrhythmias
  • Cardiac arrest
  • Fatality
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


  • Increased: acute pancreatitis, pancreatic duct obstruction, alcohol ingestion, mumps, parotitidis, renal disease, cholecystitis, peptic ulcers, intestinal obstruction, mesenteric thrombosis, postop abdominal surgery.
  • Decreased: Liver damage, pancreatic destruction (pancreatitis, cystic fibrosis)
Our Contributors
  Docconnect Dr Veena Aggarwal
  Docconnect Dr Arpan Gandhi
  Docconnect Dr Aru Handa
  Docconnect Dr Ashish Verma
  Docconnect Dr A K Gupta
  Docconnect Dr Brahm Vasudev
  Docconnect Dr GM Singh
  Docconnect Dr Jitendra Ingole
  Docconnect Dr. Kaberi Banerjee
  Docconnect Dr Monica Vasudev
  Docconnect Dr MC Gupta
  Docconnect Dr. Neelam Mohan
  Docconnect Dr. Naveen Dang
  Docconnect Dr Prabha Sanghi
  Docconnect Dr Prachi Garg
  Docconnect Rajat Bhatnagar
  Docconnect Dr Sudhir Gupta
    Medi Finance Update

(By Dr. GM Singh)

What is a non–performing investment?

A non–performing investment is a part of the portfolio investment of a debt fund which is not making interest payment or principal amount repayments in time.

    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
DCI Approval Date
Drosperinone 3mg + Ethinyl Estradiol 0.02mg tablets
For the treatment of symptoms of premenstrual dysphoric disorders (PMDD) in women (additional indication)
    IMSA Update

International Medical Science Academy (IMSA) Update

Prophylactic platelet transfusions

A randomized trial of the dose of prophylactic platelets transfused in hospitalized patients with platelet counts ≤ 10,000/microL found similar rates of bleeding with low, moderate, or high doses of platelets.

(Ref: Slichter SJ, et al. Dose of prophylactic platelet transfusions and prevention of hemorrhage. N Engl J Med 2010 Feb 18;362(7):600–13)

    IJCP Special

Dr Good Dr Bad

Situation: A patient of CAD developed dengue.
Dr Bad: Start paracetamol.
Dr Good: Start paracetamol and stop low–dose aspirin.
Lesson: In dengue, lose–dose aspirin needs to be stopped.

Make Sure

Situation: A patient after receiving 40 units of insulin developed severe hypoglycemia.
Reaction: Oh my God! The order was 4 units.
Lesson: Make sure that 4 unit is not written as 4.0 units as it may be read incorrectly as 40.

Exercise tips

Aerobic exercise is the centerpiece of any fitness program. Nearly all of the research regarding the disease–fighting benefits of exercise revolves around cardiovascular activity, which includes walking, jogging, swimming, and cycling.

    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr. Anupam Sethi Malhotra)

Trust in god

During World War II, a US marine was separated from his unit on a Pacific island. The fighting had been intense, and in the smoke and the crossfire he had lost touch with his comrades. Alone in the jungle, he could hear enemy soldiers coming in his direction. Scrambling for cover, he found his way up a high ridge to several small caves in the rock. Quickly he crawled inside one of the caves. Although safe for the moment, he realized that once the enemy soldiers looking for him swept up the ridge, they would quickly search all the caves and he would be killed.

As he waited, he prayed, Lord, if it be your will, please protect me. Whatever your will though, I love you and trust you. Amen. After praying, he lay quietly listening to the enemy begin to draw close.

He thought, well, I guess the Lord isn’t going to help me out of this one. Then he saw a spider begin to build a web over the front of his cave. As he watched, listening to the enemy searching for him all the while, the spider layered strand after strand of web across the opening of the cave. Hah, he thought. What I need is a brick wall and what the Lord has sent me is a spider web. God does have a sense of humour.

As the enemy drew closer he watched from the darkness of his hideout and could see them searching one cave after another. As they came to his, he got ready to make his last stand. To his amazement, however, after glancing in the direction of his cave, they moved on. Suddenly, he realized that with the spider web over the entrance, his cave looked as if no one had entered for quite a while. Lord, forgive me, prayed the young man. I had forgotten that your spider’s web is stronger than a brick wall.

We all face times of great trouble. When we do, it is so easy to forget the victories that God would work in our lives, sometimes in the most surprising ways.

Remember: Whatever is happening in your life, with God, a mere spiders web can become a brick wall of protection. Believe He is with you always and you will see His great power and love for you.

— — — — — — — — — —

Mind Teaser

Read this…………………

Left out Field

Yesterday’s Mind Teaser: XQQME
Answer for yesterday’s Mind Teaser:
Excuse me

Correct answers received from: Dr Neelam Nath, Dr Shashi Chabra, Dr Bina Sawhney, Dr C M Mehta, Dr Rakesh Bhasin, Dr K.P.Rajalakshm, Dr Anmol Nagpal, Dr T.Samraj, Dr Sudipto Samaddar, Dr Rohini Vaswani, Dr K.Raju, Dr H.L. Kapoor, Dr Asim Kumar Sen, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr Sudipto Samaddar

Answer for 16th February Mind Teaser: Search high and low
Correct answers received from: Dr Muthumperumal Thirumalpillai, Dr Anil Bairaria

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr GM Singh)

Flight Time

A blonde calls Delta Airlines and asks, "Can you tell me how long it’ll take to fly from San Francisco to New York City?" The agent replies, "Just a minute…"

"Thank you," the blonde says, and hangs up.

— — — — — — — — — —

Knowledge is amusing

Wearing HEADPHONES for just an hour will increase the bacteria in your ear by 700 times.

— — — — — — — — — —

    Readers Responses
  1. Dear Sir, eMedinewS is fabulious. During the 19th century, women in childbirth were dying at alarming rates in Europe and the United States. Up to 25% of women who delivered their babies in hospitals died from childbed fever (puerperal sepsis), later found to be caused by Streptococcus pyogenes bacteria. Regards: Dr GM Singh
    Public Forum

(Press Release for use by the newspapers)

Cleaning your home may worsen asthma

Scrubbing the kitchen floor or doing other cleaning chores around the home may trigger asthma said Dr. K.K. Aggarwal Padma Shri and Dr B C Roy National Awardee and President Heart Care Foundation of India.

Both cleaning and cleaning agent exposures are major risks for asthma and asthma exacerbations. In a 12–week study, Bernstein and colleagues from the University Of Cincinnati College of Medicine compared the health effects of household cleaning among 25 asthmatic and 19 non–asthmatic women who reported that they were the primary cleaners in their homes. After cleaning, they observed a statistically significant increase in the number of respiratory symptoms in asthmatic women compared with non–asthmatic women. Doctors should caution women with asthma about the potential respiratory health effects of cleaning activities and exposure to cleaning agents.

    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

International Conference– cum– Workshop "Building Partnerships in Community Mental Health"

Date: February 17–19, 2011
Venue: National Institute of Health and Family Welfare, Teaching Block, Baba Gang Nath Singh Marg, Munirka, New Delhi

In joint collaboration with Directorate General of Health Services, Ministry of Health and Family Welfare, Govt of India, Asia Australia Mental Health & National Institute of Health and Family Welfare, New Delhi

Cricket world cup 2011 schedule very very creative

World Cup Schedule


Delhi Medical Council Inaugural CME on Managing Common Emergencies

Date: Sunday, February 20, 2011
Programme – 1.00 PM – 4.00 PM
1.00 PM 1.30 PM Lunch
1.30 PM 1.45 PM Inauguration
1.45 PM 4.00 PM Scientific Programme

Topics Time Speakers Chairpersons
RTA, Emerging Epidemic
1:45 PM – 2.05 PM
Dr MC Misra
Dr BK Dhaon, Dr Praveen Bhatia, Dr Chander Prakash
Acute Febrile Illness
2.05 PM – 2.25 PM
Dr N.P Singh
Dr OP Kalra, Dr SP Byotra,
Dr B Gupta
Haematuria – Red Alarm
2.25 PM – 2.45 PM
Dr Anil Goyal
Dr P.N Dogra, Dr. Rajeev Sood
Managing PPH – Saving Lives
2.45 PM – 3.05 PM
Dr Reva Tripathi
Dr Sharda Jain
Panel Discussion of Update of Lt. Side chest pain 3.05 PM – 3.50 PM Dr Purshottam Lal,
Dr Naresh Gupta
Dr PS Gupta, Dr K K Aggarwal, Dr Ashok Seth

Vote of Thanks: 3.50 PM – 4.00 PM

Followed by Tea

Please Note: Prior Registration is Mandatory (No Registration Charges)

For Registration e–mail to delhimedbalcouncil@gmail.com
If you are not registered with DMC you can get registered on the spot

Organization: President: Dr Arun Aggarwal, Vice President: Dr Vinay Aggarwal, Secretary: Dr Girish Tyagi, Organizing Chairman: Dr Anil Goyal, CME Committee Members: Dr Anil Bansal, Dr Manoj Singh, Dr NP Singh, Dr Praveen Bhatia

World Fellowships of Religions and Perfect Health Parade
First ever Conference which will talk about science behind all Religions, Dharmas and Pathies under one roof
Subject: Global Warming, Ethnic Crises, How to be Healthy
Date: Sunday 3rd April, 2011
Venue: Maulana Azad Medical College, New Delhi
Time: 8 AM – 4 PM
Register: rekhapapola@gmail.com

4th Study Camp on ‘Mind–Body Medicine and Beyond’
Organizer: Sri Aurobindo Ashram – Delhi Branch
Venue: Nainital Centre (Van Nivas)
Day: July 2–9, 2011

A Camp for doctors, medical students and other health professionals at its from. The camp, consisting of lectures, practice, and participatory and experiential sessions, will help the participants get better, feel better, and bring elements of mind-body medicine into their practice. The camp will be conducted by Prof. Ramesh Bijlani, M.D., former Professor, AIIMS, founder of a mind-body medicine clinic at AIIMS, and the author of Back to Health through Yoga.

For more details, contact the Ashram reception in Delhi (011–26567863) or e–mail Dr. Bijlani (rambij@gmail.com).

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