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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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Photos of 1st Mega Ajmer Health Camp 2012

  Editorial …

19th April 2012, Thursday

Five Things Physicians and Patients should question (Part 9)

American Society of Nuclear Cardiology

  1. Don’t perform stress cardiac imaging or coronary angiography in patients without cardiac symptoms unless high-risk markers are present. Asymptomatic, low-risk patients account for up to 45% of inappropriate stress testing. Testing should be performed only when the following findings are present: diabetes in patients older than 40 years old, peripheral arterial disease, and greater than 2 percent yearly coronary heart disease event rate.
  2. Don’t perform cardiac imaging for patients who are at low risk: Chest pain patients at low risk of cardiac death and myocardial infarction (based on history, physical exam, electrocardiograms and cardiac biomarkers) do not merit stress radionuclide myocardial perfusion imaging or stress echocardiography as an initial testing strategy if they have a normal electrocardiogram (without baseline ST-abnormalities, left ventricular hypertrophy, pre-excitation, bundle branch block, intra-ventricular conduction delay, paced rhythm or on digoxin therapy) and are able to exercise.
  3. Don’t perform radionuclide imaging as part of routine follow-up in asymptomatic patients: Performing stress radionuclide imaging in patients without symptoms on a serial or scheduled pattern (e.g., every one to two years or at a heart procedure anniversary) rarely results in any meaningful change in patient management. This practice may lead to unnecessary invasive procedures and excess radiation exposure without any proven impact on patients’ outcomes. An exception to this rule would be for patients more than five years after a bypass operation.
  4. Don’t perform cardiac imaging as a pre-operative assessment in patients scheduled to undergo low- or intermediate-risk non-cardiac surgery: Non-invasive testing is not useful for patients undergoing low-risk non-cardiac surgery or with no cardiac symptoms or clinical risk factors undergoing intermediate-risk non-cardiac surgery. These types of testing do not change the patient’s clinical management or outcomes and will result in increased costs. Therefore, it is not appropriate to perform cardiac imaging procedures for non-cardiac surgery risk assessment in patients with no cardiac symptoms, clinical risk factors or who have moderate to good functional capacity.
  5. Use methods to reduce radiation exposure in cardiac imaging, whenever possible, including not performing such tests when limited benefits are likely. The key step to reduce or eliminate radiation exposure is appropriate selection of any test or procedure for a specific person, in keeping with medical society recommendations, such as appropriate use criteria. Health care providers should incorporate new methodologies in cardiac imaging to reduce patient exposure to radiation while maintaining high-quality test results.

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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

Five Things Physicians and Patients
should question

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

National council of teacher education begins revamp of teaching education system in country

ALLAHABAD: The National council of teacher education (NCTE) has taken an initiative to reform and revamp teaching education system in the country. Following the implementation of the Right of Children to Free and Compulsory Education-2009, the government is now gearing up to reform the teaching education system with an aim to improve the quality of procedures and practices. Following the exercise, all courses of teacher education like BEd, MEd, NTT (Nursery Teachers Training), BPEd and MPEd will get revised. Speaking on the issue, member of NCTE northern regional committee and AU public relation officer Prof PK Sahoo said, "The revamp is being carried out as per the NCERT curriculum framework and is aimed at improving the teacher education system." (Source: TOI, Apr 16, 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

Walking could be a useful tool in treating depression

LONDON: Walking can play a vital role in fighting depression, a study has claimed. The study in the journal Mental Health and Physical Activity showed walking had a "large effect" on depression. Vigorous exercise has already been shown to alleviate symptoms of depression, but the effect of less strenuous activities was unclear. One in 10 people may have depression at some point in their lives. The condition can be treated with drugs, but exercise is commonly prescribed by doctors for mild symptoms. (Source: TOI, Apr 14, 2012)

For comments and archives

FDA Panel OKs ultrasound to screen dense breasts

An FDA advisory panel unanimously voted in favor of an automated ultrasound device for breast cancer screening after a negative mammogram in women with dense breasts. But in Wednesday's 13-0 vote, the Radiological Devices Advisory Panel recommended that the expanded indication include a restriction that the device be used only for such women who have not had a prior breast intervention, such as needle biopsy or breast cancer treatment. The somo-v Automated Breast Ultrasound System (ABUS) is currently FDA approved as an adjunct to mammography in diagnosing breast cancer but not for screening. (Source: Medpage Today)

For comments and archives

DNA repair genes may predict ovarian cancer survival

A high score based on the expression of 23 genes involved in repairing DNA damage after platinum-based chemotherapy for ovarian cancer was associated with a 5-year survival of 40% versus 17% for women who had a low score, investigators reported. (Source: Medpage Today)

For comments and archives

Group OKs new criteria for Sjogren's

An expert panel of international researchers has developed a set of objective classification criteria for Sjögren's syndrome that encompasses the autoimmune, ocular, and salivary components of the disorder. For a formal diagnosis of Sjögren's syndrome, patients must meet two of the following three criteria:

  • Positive serum autoantibodies, either anti-SSA and/or anti-SSB; or positive rheumatoid factor and a titer of antinuclear antibody (ANA) =1:320
  • Labial salivary gland biopsy showing inflammation with focal lymphocytic sialadenitis and a minimal focus score of =1/4 mm2
  • Ocular staining score =3 for keratoconjunctivitis sicca

The American College of Rheumatology has approved the criteria, which were published in the April issue of Arthritis Care & Research. (Source: Medpage Today)

For comments and archives

Mental, physical health go hand in hand

Individuals with mental illnesses are more likely to report chronic health conditions and to use healthcare, a national survey affirmed. Those who reported having any mental illness or a major depressive episode were more likely than others to have high blood pressure, diabetes, asthma, heart disease, and stroke, according to a report from the Substance Abuse and Mental Health Services Administration. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Low-calorie soup good for health.

@DeepakChopra: Whether the Democrats and Republicans like it or not, they are in bed together and may as well be married.

    Spiritual Update

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

The Buddha Description of a Disease: Desire, Hatred and Ignorance

According to Buddhism, the three negative emotions that cause a disease are “ignorance, hatred and desire”. According to Buddha’s philosophy, physical sickness are classified into three main types.

1. Disorders of desire (Ayurvedic equivalent of Vata imbalance): These are due to disharmony of the wind or energy. The seed of these disorders are located in the lower part of the body. It has cold preferences and is affected by mental desires. In this, the person mainly suffers from the disorders of movement functions.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What are IUDs?

Intrauterine devices (IUDs) are safe and effective forms of long-term reversible contraception. There are two available IUDs: one containing a progestin (a hormone) and the other containing copper. A doctor places the device in the woman's uterus and it can be used for either five (progestin containing) or 10 (copper) years. Failure rates with IUDs range from 0.1% to 0.8%. Both types of IUDs work by preventing the egg from developing normally. They also impair sperm movement when the sperm enter the uterus, which decreases the chances that an egg will be fertilized. The IUD may also cause changes to the lining of the uterus that could prevent a fertilized egg from implanting. The side effects include a slight increased risk of pelvic infection caused by placement of the IUD.

For comments and archives

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

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

Who is a healthy donor?

A healthy donor is any person within the age group of 18 - 60 years with minimum body weight of 45 kgs, and hemoglobin level of 12.5 gm/dL (minimum).

How frequently a donor can donate blood?

It takes about 6-8 weeks for the hemoglobin to be synthesized in the body. Three months is a very safe interval.

For comments and archives

    An Inspirational Story


The Three Fishes

There were three big fishes living in a lake who were very close friends. All three of them were very different from one another. The first one believed in fate. He thought things cannot be changed and what had to happen will happen no matter what. The second one was intelligent. He thought he knew how to solve a problem if he had one, with his intelligence. The third one was the wise one. It thought long and hard before acting.

So one day, the wise fish was happily playing around in the water, when it over heard a fishermen talking to another. "Look at that one, what a big fish... This lake is full of big fishes like this one. Let us come tomorrow and catch them."

It hurriedly swam to it's friends to tell the news. "Let us get out of this lake before those fishermen come back. A canal I know can take us to another lake," the wise one said.

The intelligent fish said, “I know what to do if the fishermen come and catch me."

The fish which believed in fate said, "Whatever to happen will happen, I was born in this lake and I am not going to leave it."

The wise fish didn't want to risk its life, so he took the canal and went to another lake.

The fishermen came back the next morning and cast their net. The rest of the two friends were caught in it along with many other fishes.

The intelligent fish thought of a way to escape, it acted as if it were dead. The fishermen threw him along with other dead fish back into the lake. But the other fish which believed in fate was still jumping in the net and the fishermen struck him dead.

Story moral: Intelligence wins over might.

A Panchatantra story

For comments and archives

    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, www.mymonavie.com/sonraj)

Association of leisure time physical activity and cardiovascular risk factors in women

Studies have shown that many people in Western cultures are sleep-deprived, and lack of sleep has been associated with obesity and overeating in several studies. American women often find themselves juggling work, exercise, and family on a daily basis and may have to choose between sleep and exercise. A recent review of data from the Women on the Move Through Activity and Nutrition Study looked at the associations between sleep and leisure-time physical activity and cardiovascular risk factors in women.

The results showed that sleep duration and quality did not differ significantly between women with high and low levels of physical activity. However, more active women had lower levels of abdominal fat and total fat, and physical activity was associated with higher levels of HDL cholesterol (the good cholesterol). This suggests that for women, being more physically active will improve your risk factors for heart disease, regardless of sleep habits.

For comments and archives

    Cardiology eMedinewS

Older Varieties Of Fruits, Vegetables Were Healthier Read More

FDA: Medtronic CRT–Ds Get NYHA 2 HF indication Read More

Ecg Picks Up Heart Trouble In Healthy Seniors Read More

    Pediatric eMedinewS

Extremely Preterm Toddlers At Risk For Hypertension Read More

Nutrition Cycling No Help Against Cholestasis In Vlbw Infants Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with heart failure needed a beta-blocker.
Dr. Bad: Start any beta-blocker.
Dr. Good: Start metoprolol succinate.
Lesson: Only carvedilol, bisoprolol and metoprolol succinate are approved for heart failure.

For comments and archives

Make Sure

Situation: A patient with suspected pneumonia and normal x–ray died 12 hours after admission.
Reaction: Oh my God! Why were antibiotics not started?
Lesson: Make sure that all patients with suspected pneumonia are given antibiotics at the first suspicion as x–ray can be normal in the first 24 hours.

For comments and archives

    Legal Question of the day

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

Q. I have the following qualifications: B.Sc. (MLT), P.G.D.C.P; M.Sc. (Micro). Can I start my own diagnostic laboratory? Dr. ABC

Ans. It seems you do not have a medical qualification. The so called PGDCP, if it means Post Graduate Diploma in Clinical Pathology, is probably a misnomer and is not a recognised qualification and has been probably given by an unrecognised institution. You do not seem to be entitled to put the prefix Dr. before your name.

In view of the above, you are not legally competent to start your own diagnostic laboratory independently because that amounts to practice of pathology which is a medical specialty.

However, you can own the laboratory and can employ a pathologist or enter into a partnership with him with an arrangement that he medically supervises the laboratory and interprets and signs the reports.

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  Quote of the Day

(Dr GM Singh)

Take the attitude of a student, never be too big to ask questions, never know too much to learn something new. Og Mandino

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Beta 2 microglobulin

  • To evaluate the severity and prognosis of multiple myeloma, leukemia, or lymphoma
  • To distinguish between kidney disorders and to detest kidney damage
    Mind Teaser

Read this…………………

How often should you have a Pap smear?

A. Once a year after puberty.
B. Once a year after either turning 21 or having sexual intercourse for the first time.
C. Once a year after age 21 and every two years after 30.
D. Once a year if you’re not in a monogamous relationship.
E. Once a year unless you’ve been vaccinated against the human papillomavirus (HPV). Then the screening is not necessary.

Yesterday’s Mind Teaser: You’ve had yeast infections before, but in the past year they haven’t really gone away. This could be a sign of:

A. Diabetes
B. Emphysema
C. Stomach ulcers
D. Depression
E. Food allergies

Answer for Yesterday’s Mind Teaser: A. Diabetes

Correct answers received from: Dr. B. B. Aggarwal, y. J. Vasavada, Dr Prabha Sanghi, Dr Anjali Dhawan, Dr. Deepali chatterjee, Dr. P. C. Das, Dr.Ragavan Sivaramakrishnan Moudgalya, Dr. Thakor Hitendrsinh G, Raju Kuppusamy, Muthumperumal Thirumalpillai, DrValluri Ramarao, Dr Jainendra Upadhyay, Dr Lc Dhoka, Dr U Gaur.

Answer for 17th April Mind Teaser: B. Their eggs have begun to degenerate.

Correct answers received from:
: Dr Anjali Dhawan

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

A lady on phone: "Hello sir, I want to meet and talk to you. you are the father of one of my kids."

Stunned and shocked, the man screamed: "Oh my God! I am married and so careful with modern prevention tactics and how could this happen to you? You can ruin me"

Are you Soni? Lady replied, "No."

Then Pramila? No, No.

Mita? No, No, No

Rupali? No, No, No, No.

Sunita? No, No, No, No, No.

Kamali? No...........................................................oo.

The lady in confusion scolded the man: “Sir, I am The Class Teacher of your son."

    Medicolegal Update

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

What is the approach to acute ethanol and isopropanol poisoning?

  • Do a full medical examination to exclude other causes of the patient’s condition, such as head injury
  • Correct fluid and electrolyte imbalance.
  • Hypoglycemia should be treated with oral or intravenous glucose.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

A slight move is all that matters

Middle-aged women who move around more in their daily life have lower levels of intra-abdominal fat, a risk factor for heart disease, said Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal and President, Heart Care Foundation of India. A minor modification in daily routine: Reducing the time watching TV or increasing the walk time to work can make a difference in the long-term health.

Visceral fat is a hot topic because of metabolic syndrome, which predisposes people to diseases.

Intra-abdominal fat, or the fat that wraps around the organs in the abdomen and chest, tends to accumulate at midlife and can contribute to developing diabetes, hypertension and heart disease. The fat around the organs is known to be more related to heart disease and diabetes. A woman does not need to appear outwardly heavy to have a potentially troublesome extra "tire" around her organs.

Exercise for long has been known to reduce the amount of intra-abdominal fat.

    Readers Responses
  1. Dear Sir, eMedinews is really very informative. Regards: Dr JP Dutta
    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

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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