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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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

18th March 2013, Monday

Niacin May harm

At the American College of Cardiology's annual meeting in San Francisco, results from the landmark HPS2-THRIVE study has shown that niacin has dubious value in preventing heart disease and may even cause harm.

There had been high hopes for the extended-release niacin/laropiprant used in THRIVE. Studies showed it significantly raises high density lipoprotein (HDL) without causing the flushing that makes other forms of niacin difficult to tolerate. HPS2-THRIVE dashed that hope.

In the study, 25,673 high-risk patients were randomized to either placebo or Tredaptive (extended-release niacin plus laropiprant, an anti-flushing agent), in addition to background therapy with simvastatin or simvastatin/ezetimibe.

LDL levels dropped an average of 10 mg/dL and triglycerides fell 33 mg/dL. HDL levels increased 6 mg/dL. Such lipid changes might translate into a 10% to 15% reduction in vascular events. That didn't happen. Major vascular events, a composite of nonfatal MI or coronary death, any stroke, or any arterial revascularization occurred in 13.2% and 13.7% of the niacin and placebo patients, respectively (P=0.29).

Worse, there were 31 serious adverse events for every 1,000 niacin-treated patients over 3.9 years of follow-up. These were serious adverse events were a significant increase in hemorrhagic stroke, serious infections, and new onset diabetes. (Source Dr Sanjay Gupta)

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

FDA OKs first drug-eluting stents for use in MI

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

4th eMedinewS Revisiting 2012

A daylong conference, eMedinewS Revisiting 2012, was organized by eMedinewS, Heart Care Foundation of India and World Fellowship of Religions.

Dr K K Aggarwal
    National News

10% of the Indian population suffers from chronic kidney diseases

MUMBAI: 10% of the Indian population suffers from chronic kidney diseases (patients who are suffering for more than 3 months) and this figure is expected to increase. Indians are clearly at a higher risk of developing kidney diseases because of the surge in the number of patients suffering from diabetes and high blood pressure. 60% of the patients suffering from chronic kidney diseases in India are either diabetic or suffer from high blood pressure. With constant lifestyle changes amongst teens and youngsters is leading to an early onset of kidney related ailments. Consumption of fast food, sedentary way of living with little or no exercise is an important cause for the rise in cases of diabetes, hypertension, gastrointestinal and obesityin our country and this in turn has led to increasing incidence of kidney disease. Dr Bharat Shah, Nephrologist, Global Hospital said, "About 3-4 lakh people require kidney transplant in India every year, but only 1% actually gets a successful kidney transplant. People suffering from diabetes and blood pressure are especially vulnerable to kidney diseases. It's unfortunate that many are clueless about the deadly association of diabetes and chronic kidney diseases. With a little bit of awareness and education, people with diabetes will have the power to control their condition and enjoy a full life. On World Kidney Day, I would also like to advice people to stop taking pain killers without consulting a medical practitioner. With increasing abuse of pain killers, it is observed that kidney diseases are on the rise". The need of the hour is strong proactive steps taken by Government which can help in bringing the increasing number of people suffering from kidney ailments: (Source: TOI, Mar 15, 2013)

  • Simpler and Shorter procedure for a kidney transplant as the delay leads to fatal situations
  • Countrywide awareness about Lifestyle Disorders like Diabetes, High Blood Pressure, Gastrointestinal problems, Use of Drugs specially painkillers without prescriptions
  • Accurate screening programs for lifestyle diseases
  • Educating kids about healthy food, eating habits, should be made part of the school syllabus
  • Govt should increase parks and jogging tracks and introduce cycle tracks and should spread awareness about health living.

For comments and archives

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


79% of the child abuse cases involve physical abuse

An abused child has as much as 50% chances of undergoing further abuse and 10% chances of dying if abuse is not detected at the initial presentation.

For comments and archives

    Valvular Heart Disease Update

Echocardiographic screening of first degree relatives of patients with bicuspid aortic valve and a positive family history and in those with a dilated aorta is recommended

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Rabies death linked to organ transplant

Three transplant recipients who got organs from the same donor are getting rabies shots after a fourth died of the disease more than a year after the transplant, the CDC reported. The cause of death of the Maryland resident has been confirmed to be rabies of the same type found in tissue samples from the organ donor, the agency said in a news release. (Source: Medpage Today)

For comments and archives

Hormone replacement: Timing is everything say new guidelines

Authors of a new consensus statement on menopausal hormone therapy (MHT) conclude that it is the most effective treatment for menopausal symptoms and that benefits are likely to outweigh the risks if it is prescribed before the age of 60 years or within 10 years after menopause. The statement was published in the April issue of Climacteric and also in Maturitas. (Source: Medscape)

For comments and archives

Low albumin ups surgical risk in Gyn cancers

Postoperative mortality increased significantly in women who had low albumin levels prior to surgery for gynecologic malignancies, analysis of a large surgical database showed. (Source: Medpage Today)

For comments and archives

Clopidogrel/atorvastatin protect in carotid stenting

A 600-mg clopidogrel loading dose reduced periprocedural ischemic cerebral events and rates of transient ischemic attack (TIA) and stroke at 30 days in patients undergoing carotid stenting in the ARMYDA-9 CAROTID (Efficacy of Two Different Pre-Intervention Therapeutic Strategies with Clopidogrel and Atorvastatin for the Prevention of Cerebral Damage During Carotid Artery Stenting) study. (Source: Medscape)

For comments and archives

Specialists agree HRT best for menopause symptoms

Hormone replacement therapy (HRT) is the most effective available treatment for menopause symptoms, according to a consensus statement issued by seven major professional societies. Signatories included the American Society for Reproductive Medicine, the Asia Pacific Menopause Federation, the Endocrine Society, the European Menopause and Andropause Society, the International Menopause Society, the International Osteoporosis Foundation, and the North American Menopause Society. (Source: Medpage Today)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: HIV can have functional cure Early and effective HIV therapy can lead to (cont) http://tl.gd/lal53s

@DrKKAggarwal: Perception is the ultimate magical trick/illusion that bamboozles people into the superstition of materialism

    Spiritual Update

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

Quantum Interactions Happen 10,000 Times Faster Than Light

A team of physicists led by Juan Yin at the University of Science and Technology of China in Shanghai has found in an experiment involving entangled photons, or photons that remain intimately connected, even when separated by vast distances that quantum interactions happen 10,000 times faster than light. They wanted to see what would happen if you tried assigning a speed to what Einstein called "spooky action at a distance."

For comments and archives

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

How should you tell your child about gamete donation?

You should tell your child at a young age. Later disclosure, when the child is a teenager or adult may make it more difficult for your child to integrate this information into his or her identity. Giving information in a calm and loving manner will set the tone for open family communication later. If you don't know how to begin a conversation about disclosure, there are books that provide scripts to give you some idea.

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

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

What is blood and how much blood does a human body contain?

Blood is the red-colored fluid in a human, flowing continuously in our body in the circulatory system. Each healthy individual has about 1/12 of his body weight as blood. On an average, about 5–6 liters of blood is present in every human being.

For comments and archives

    An Inspirational Story

Remembering Dad

When I was four years old: My daddy can do anything.

5 years old: My daddy knows a whole lot.

6 years old: My dad is smarter than your dad.

8 years old: my dad doesn’t know exactly everything.

10 years old: In the olden days, when my dad grew up, things were sure different.

12 years old: Oh, well, naturally, Dad doesn’t know anything about that, he is too old to remember his childhood.

14 years old: Don’t pay any attention to my dad, he is so old–fashioned.

21 years old: Him? My Lord, he’s hopelessly out of date.

25 years old: Dad knows about it, but then he should, because he has been around so long.

30 years old: Maybe we should ask Dad what he thinks, after all, he’s had a lot of experience.

35 years old: I’m not doing a single thing until I talk to Dad.

40 years old: I wonder how Dad would have handled it, he was so wise.

50 years old: I’d give anything if Dad were here now so I could talk this over with him.

Too bad I didn’t appreciate how smart he was, I could have learned a lot from him.

For comments and archives

  Cardiology eMedinewS

National Workshop of transplant coordinators provides guidelines Read More

BP drug flops in heart failure Read More

  Pediatric eMedinewS

AAN takes a position on 'neuroenhancement' in children Read More

Fluid resuscitation ups mortality risk in children Read More

    Rabies Update

(Dr. A. K. Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

Is there any advantage of PCEC vaccine with Pitman-Moore (PM) strain?

Compared to other continuous cell lines-based rabies vaccines, PCEC vaccine with Pitman-Moore (PM) strain has several advantages, these includes:

  • This method provides vaccine with high yield, greater potency and immunogenicity which makes the vaccine comparatively cost effective and unique.
  • It is more readily scalable to large scale commercial vaccine production.
    IJCP Special

Dr Good Dr Bad

Situation: A 25–year–old male with normal body mass index (BMI) came with mild abdominal obesity.
Dr Bad: Do not worry.
Dr Good: Rule out diabetes.
Lesson: Indians are susceptible to diabetes at a younger age and at a relatively lower BMI compared to the white Caucasians. This is partly explained by the fact that the thin–looking Indians are quite adipose (higher body fat percent).

Make Sure

Situation: A patient with acute chest pain died before reaching the hospital. Reaction: Oh my God! Why was water–soluble aspirin not given?
Lesson: Make sure that at the onset of acute heart attack and chest pain, water–soluble aspirin is chewed to reduce chances of sudden death.

  Quote of the Day (Dr GM Singh)

If you’re not using your smile, you’re like a man with a million dollars in the bank and no checkbook. Les Giblin

  Legal Question of the Day

(Dr MC Gupta, Advocate & Medico-legal Consultant)

Q. A patient is posted for elective surgery. The attendant refuses to get done routine investigations which are necessary before surgery. Can the surgeon refuse surgery?


  1. If the patient is not an indoor patient, the question of refusing surgery does not arise. The patient has to be properly worked up. If this is not done, there is no question of operating upon him or refusing surgery.
  2. If the patient is an indoor patient:
    • He should not have been admitted, if possible, without prior investigations.
    • He should be discharged forthwith with proper documentation that the reason for discharge is the refusal of the patient or his attendant to comply with the required and necessary protocol, with the advice that he should report back after getting the necessary investigations done.
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    Mind Teaser

Read this…………………

A male client is scheduled for a renal clearance test. Nurse Maureen should explain that this test is done to assess the kidneys’ ability to remove a substance from the plasma in:

a. 1 minute
b. 30 minutes
c. 1 hour
d. 24 hours

Yesterday’s Mind Teaser: Nurse Lea is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention?

a. Rashes on the palms of the hands and soles of the feet
b. Cauliflower-like warts on the penis
c. Painful red papules on the shaft of the penis
d. Foul-smelling discharge from the penis

Answer for Yesterday’s  Mind Teaser: d. Foul-smelling discharge from the penis

Correct answers received from: Dr PC Das, Rajiv Kohli, Dr Arpan Gandhi, Dr KP Chandra, Dr (Maj. Gen.) Anil Bairaria, Dr D P Yadav, Dr N K Singh,  Muthumperumal Thirumalpillai, Dr Deepali Chatterjee, Dr. K. Raju, Dr. Sushma Chawla, Dr.Jayashree Sen & Dr. Bitaan Sen

Answer for 16th March Mind Teaser: b. Urine pH of 3.0

Correct answers received from: Dr S P Yadav, Dr N K Singh,

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

How much is two plus two?

A university committee was selecting a new dean. They had narrowed the candidates down to a mathematician, an economist and a lawyer.

Each was asked this question during their interview: "How much is two plus two?"

The mathematician answered immediately, "Four."

The economist thought for several minutes and finally answered, "Four, plus or minus one."

Finally the lawyer stood up, peered around the room and motioned silently for the committee members to gather close to him. In a hushed, conspiratorial tone, he replied, "How much do you want it to be?"

    Medicolegal Update

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

What is the treatment of poisonous bites and stings?

  • Antivenom should only be given in a hospital or medical center where resuscitation can be given, because the patient may develop an allergic reaction. Antivenin should be used, if there are signs of severe systemic envenoming. It should not be used when there are no signs of systemic envenoming. To decide whether venom has been injected, and how serious the poisoning is, look for these signs:
    • Swelling and local tissue injury at the site of the bite
    • Blood that does not clot, causing bleeding from gums, nose, wounds and injection sites
    • Shock caused by circulatory failure
    • Neurotoxic paralysis (ptosis, ophthalmoplegia, dysarthria, peripheral muscle weakness, respiratory distress)
    • Generalized muscle pain and local tissue damage
    • Kidney failure, red or black urine
    • Tender swollen lymph nodes near the bite site
  • To test clotting time of whole blood: Place 2–3 ml of whole venous blood in a clean, dry, glass test–tube and leave undisturbed for 20 minutes at room temperature. Normal blood should have clotted by this time. Tip the tube to see if the blood is still liquid.
  • If the wound becomes infected, treat as for any other local infection. Use antibiotics if needed.
  • If there is local tissue injury, do not cover the wound, instead leave it open.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Weight gain after quitting smoking does not increase the risk of heart disease

In a study published in Journal of American Association, researchers from Switzerland have shown that in non-diabetics, weight gain after quitting smoking does not take away the cardiovascular benefits of quitting smoking.

Commenting on the study, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and National Vice-President (Elect) IMA, said that there is a net cardiovascular benefit of smoking cessation despite subsequent weight gain. Smoking cessation is always beneficial for smokers.

People gain 6-8 pounds of weight after quitting smoking. In the study, quitting smoking was also linked with a decreased risk of heart attack or cardiac death compared to smokers.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 31145 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

    Readers Response
  1. Dear Sir, Very nice spiritual blog. Regards: Dr KP Shah
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