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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 …

19th February, 2011, Saturday                                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

Fruit salad and blood sugar meters don’t mix

Invisible bits of fruit on the hands can mess up the finger–prick blood tests, making the blood sugar level look higher than it really is. That’s because sugars from fruit will stay on the fingers until you wash them with tap water. Even alcohol swabs don't solve the problem. Peeling fruit right before you use a blood sugar meter, or eating some juicy fruit with the hands, could lead to an inaccurate reading even if you rub your finger with alcohol first. (Journal Diabetes Care, Dr. Takahisa Hirose of the Juntendo University Graduate School of Medicine in Tokyo)

When fruit peeling was followed by hand washing, blood sugar readings were the same as before volunteers had peeled any fruit. But when volunteers peeled fruit and took a blood sugar reading right away, the levels shown by the blood sugar meter shot up (from baseline 90) –– to about 170 mg/dL on average after peeling an orange, 180 mg/dL after peeling a kiwi, and 360 mg/dL after peeling a grape. And if the peelers swabbed their finger with alcohol in between peeling and finger pricking, the readings were still higher than normal. Even swabbing five times didn’t produce correct results. In the directions that come with blood sugar meters, the manufacturers generally tell users to wipe their finger with an alcohol swab before taking a reading.

Earlier tPA in hospital saves lives

Thrombolysis within an hour of a stroke patient’s arrival at the emergency boosts its survival advantage. Administration of tissue plasminogen activator (tPA) within an hour was associated with lower inhospital mortality (adjusted odds ratio 0.78, P<0.0003) and less frequent symptomatic intracranial hemorrhage (4.7% versus 5.6%, P<0.0017) than getting it later. Every 15 minute reduction in door–to–needle time predicted a 5% lower odds of inhospital mortality (adjusted OR 0.95, P=0.0007) in a multivariate model, Gregg C. Fonarow, MD, of UCLA Medical Center, and colleagues reported here at the American Stroke Association’s International Stroke Conference and simultaneously online in Circulation: Journal of the American Heart Association. (Medpage)

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
Time is brain

Audio PostCard
  SMS of the Day

(By Dr GM Singh)

A book is a gift you can open again and again.

    Photo Feature (from the HCFI Photo Gallery)

2nd eMedinewS Revisiting 2010

Dr N Subramanium delivering a lecture in the 2nd eMedinewS revisiting 2010 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

Cashless facility for patients

Moolchand is proud to have been selected by India's leading insurance companies (National Insurance Company Ltd., United India Insurance Company Ltd., The New India Assurance Company Ltd. and The Oriental Insurance Company Ltd.) to extend cashless facility for patients.

India’s first stem cell trial to take place in Bangalore

The Drugs Controller General of India (DCGI) has given permission to a Bangalore–based company, Stempeutics Research, for carrying out Phase–II clinical trials to find out the efficacy of stem cell therapy. The safety of "Stempeucel" was established in an earlier trial. "The trial will begin in April in Bangalore, Delhi and Kochi in association with hospitals. Patients will be given the stem cell therapy for six months. The results will be analysed subsequently and patients will be under observation for two years," B N Manohar, chief executive officer of Stempeutics told Deccan Herald. (Source: Deccan Herald, Feb 15, 2011)

    International News

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

The Incredible edible egg: less cholesterol than previously thought, lots of vitamin D

Eggs’ nutritional value has been re–examined by the USDA, and the findings are promising for egg lovers. Eggs in actuality contain 14% less cholesterol than the story previous examinations have told. In addition, eggs turn out to be a huge supplier of Vitamin D, which was the most ingested single vitamin pill in 2010. Vitamin D came out the big winner in 2010 as the "most used single vitamin" at 56.2% usage amongst those surveyed, and also won the "most improved" category with a 52% increase in usage since 2008.

The average amount of cholesterol in one large egg is 185 mg, and large eggs now contain 41 IU of vitamin D, an increase of 64%. Vitamin D promotes calcium absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and to prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Vitamin D sufficiency prevents rickets in children and osteomalacia in adults. Together with calcium, vitamin D also helps protect older adults from osteoporosis. Vitamin D has other roles in the body, including modulation of cell growth, neuromuscular and immune function, and reduction of inflammation. Many genes encoding proteins that regulate cell proliferation, differentiation, and apoptosis are modulated in part by vitamin D.

(Dr Monica and Brahm Vasudev)

Preliminary study suggests need to monitor stroke patients post–tPA treatment

Stroke patients treated with a tissue plasminogen activator (tPA) should be considered for 24–hour heart monitoring to rule out new onset atrial fibrillation, said Paul Blackburn, MD, of the University of British Columbia, Vancouver, at the American Stroke Associations International Stroke Conference.

Simple test may help detect concussions accurately

A quick, simple test done on the sidelines of sports events can accurately detect concussion. According to a study in the journal Neurology, the King–Devick screening test is superior to current sideline tests. It asks athletes to read single digit numbers on index–sized cards, and suggests the athlete has suffered a concussion if the delay is more than five seconds longer than the athletes baseline test time.

Strength training may provide benefits beyond increasing muscle

A growing body of research shows that working out with weights has health benefits beyond simply bulking up ones muscles and strengthening bones.

Early birth may increase respiratory, other health risks even if lungs are fully developed

Even if their lungs are mature, babies delivered at 36 to 38 weeks are at significantly increased risk for respiratory and other health problems, according to a study presented Friday at the Society for Maternal–Fetal Medicine annual meeting.

    IMT Update

Severe carotid, subclavian, or vertebral stenosis was present in 16.6% of TVD patients. IMT increases with advancing CAD, patients with mean IMT> 1.15 mm have a 94% likelihood of having CAD. (Heart. 2004 Nov;90(11):1286–90)

    Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

What is the time taken to prepare sperms?

Native raw semen sample cannot be used for IUI. Depending on the method of preparation (Swim up or Swim down) it will take anywhere between half an hour to one and a half hour to complete the wash.

For queries contact: banerjee.kaberi@gmail.com

    Pediatrics Update

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

What is Sick euthyroid syndrome?

  • Any abnormal thyroid function test (TFT) in the setting of non-thyroidal illness (NTI) or  systemic stress. Most commonly seen in seriously or critically ill patients. These changes can be detected as soon as two hours after onset of stress!
  • Currently, the preferred term is “non-thyroidal illness syndrome” (NTIS) as some patients may, in fact, be hypothyroid
  • The initial value that most commonly leads to further workup is an elevated TSH. Occasionally, the TSH can be low.
  • Hypothyroidism is a strong possibility if TSH is >25-30. (will be above 20 only 3% of the time in NTI)

For queries contact: drneelam@yahoo.com

    Medicolegal Update

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

How can the firearm discharge residue on hands of accused be collected by the doctor?

Nitrate and nitrite residue may be found on medical examination and can be recovered from the skin by occlusion in a layer of melted paraffin during medical examination. Another test for skin residue involving paraffin as the collecting medium is for metallic elements in trace amounts, which result from primer residue. The analyses are made with neutron activation by ballistic expert.

  • The test is known as the ‘dermal residue test’ or ‘paraffin glove test’. The important factor is to place the responsibility of interpretation of results in the hands of the forensic scientist, not the doctor
  • Atomic absorption and x–ray dispersive energy spectrometry methods are also useful in identifying and quantifying metallic residues from weapon firing.
  • Currently, a screening technique is used to check the hands, clothing and other objects where circumstances warrant the examination. The main element examined for is lead, which appears to originate chiefly from the primer composition
  • Swabs are taken from appropriate areas on small clean cotton cloth squares moistened with a few drops of 1% lead–free hydrochloric acid and air dried.
  • A few drops of reagent are applied to the swab area on the cloth which is again dried. If the lead is present it is indicated by the development of a characteristic purplish–blue color.
  • The interpretation of such results should be left to an experienced examiner as positive results do not necessarily prove the subject fired a gun nor a negative result wholly precludes the firing.
    Useful Websites

(Contributed by Dr Surendernikhil Gupta)

The epidemiology of polio deconstructed


    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

    Medi Finance Update

What all does total income include?

Ans. Total income includes income from various heads like:

  • Salary
  • Rental income
  • Capital gains
  • Business and profession
  • Income from other sources e.g.interest, etc.
    Drug Update

LIST OF APPROVED DRUG FROM 01.01.2010 TO 31.8.2010

Drug Name


DCI Approval Date

Miglitol 25 mg + Metformin 500mg tablets

Additional Strength


    IMSA Update

International Medical Science Academy (IMSA) Update

PPIs and fractures

A population–based case–control study in Taiwan provided evidence that PPIs use is associated with an increased risk of hip fracture in a dose–response manner.

(Ref: Chiu HF, et al. Use of proton pump inhibitors increased the risk of hip fracture: a population–based case–control study. Pharmacoepidemiol Drug Saf 2010 Nov;19(11):1131–6).

    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 died after receiving 30 ml IV KCL bolus.
Reaction: Oh my God! Why was KCL given as bolus?
Lesson: Make sure that IV KCL is not given at a rate of more than 10 mEq per hour

Exercise tips

Experts recommend working out at moderate intensity when you perform aerobic exercise

  • Brisk walking that quickens your breathing is one example. This level of activity is safe for almost everyone and provides the desired health benefits. Additional health benefits may flow from increased intensity.
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
    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Anupam Sethi Malhotra)


A man once visited a temple under construction where he saw a sculptor making an idol of God. Suddenly he noticed a similar idol lying nearby. Surprised, he asked the sculptor, "Do you need two statues of the same idol?" "No," said the sculptor without looking up, "We need only one, but the first one got damaged at the last stage." The gentleman examined the idol and found no apparent damage. "Where is the damage?" he asked. "There is a scratch on the nose of the idol." said the sculptor, still busy with his work.

"Where are you going to install the idol?" The sculptor replied that it would be installed on a pillar twenty feet high. "If the idol is that far, who is going to know that there is a scratch on the nose?" the gentleman asked. The sculptor stopped his work, looked up at the gentleman, smiled and said, "I will know it."

The desire to excel is exclusive of the fact whether someone else appreciates it or not."Excellence" is a drive from inside, not outside. Excellence is not for someone else to notice but for your own satisfaction and excellence.

— — — — — — — — — —

Mind Teaser

Read this…………………

egg egg

Yesterday’s Mind Teaser: Left out Field
Answer for Yesterday’s Mind Teaser: Out in left field

Correct answers received from: Dr K P Rajalakshmi, Dr Sudipto Samaddar, Dr Rakesh Bhasin, Dr Muthumperumal Thirumalpillai

Answer for 17th February Mind Teaser: Excuse me
Correct answers received from: Dr Vijay Kansal, Dr Girish Cally, Dr Satyanarayana Akupatni

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr G M Singh)

Math Class

The test I gave my math class covered everything we’d studied all year –– fractions, percentages and portions of whole units.
But maybe I could have explained things better. To the question "What portion of a foot is six inches?"
One student answered, "The toes?"

— — — — — — — — — —

Knowledge is amusing

The "sixth sick sheik’s sixth sheep’s sick" is said to be the toughest tongue twister in the English language.

    Readers Responses
  1. Sir, The story of World war II is mind blowing. Thanks. Often we forget the ALMIGHTY. Exactly same thing happened in 620 AD when Prophet was forced to leave Mecca for Medina and hid in a cave on a mountain for 3 days , a spider made a web in the entrance and people following him said ' he could not possibly would hide in this old cave'. Regards: Fazlur Rahman
    Public Forum

(Press Release for use by the newspapers)

Avoid chocolate for heartburn

The sale of chocolate increases around the Valentine’s Day and even after the D–day, because of its association with love and people with a sweet tooth keep having it. But people with heartburn should avoid chocolate as it can worsen the heartburn said Dr. K.K. Aggarwal Padma Shri and Dr B C Roy National Awardee and President Heart Care Foundation of India.

One should also avoid other reflux–inducing foods (fatty foods, peppermint, and excessive alcohol, which may reduce lower esophageal sphincter pressure).

A number of beverages have a very acidic pH and can exacerbate symptoms. These include colas, red wine, and orange juice (pH 2.5 to 3.9).

Promotion of salivation by either chewing gum or use of oral lozenges may also be helpful in mild heartburn. Salivation neutralizes refluxed acid, thereby increasing the rate of esophageal acid clearance. Smoking is deleterious in part because it diminishes salivation. Restriction of alcohol use and elimination of smoking also reduces heartburn.

    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Pediatric Nephrology Update 2011

Organised by: Pediatric Nephrology Division, Institute of Child Health, Sir Ganga Ram Hospital
In association with Indian Academy of Pediatrics, Delhi Branch,
Date: Sunday, 10th April 2011,
Venue: Working Women’s Hostel Auditorium, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi – 110060, from 9:30 AM to 4:30 PM

ICC Cricket World Cup 2011

World Cup Schedule… very very creative


Delhi Medical Council Inaugural CME on Managing Common Emergencies

Date: Sunday, February 20, 2011
Maulana Azad Medical College, New Delhi
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 delhimedicalcouncil@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

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