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  Address:  39 Daryacha, Hauz Khas Villege, New Delhi, India. e-Mail: drkk@ijcp.com , Website: http://www.ijcpgroup.com

Dr K K Aggarwal

Dr KK Aggarwal
Dr BC Roy Awardee
Sr Physician and Cardiologist,
Moolchand Medcity
President, Heart Care
Foundation of India
Gp Editor-in-Chief,
IJCP Group
Delhi Medical Council
Director, IMA AKN Sinha Institute (08-09)



19th November Thursday

Dear Colleague,

  Off Mammography until Age 50

 Women younger than 50 do not need routine screening mammography for breast cancer, and women ages 50 to 74 need a screening mammogram only every two years, according to new recommendations, from U.S. Preventive Services Task Force recommendation statement published in Nov. 17 issue of Annals of Internal Medicine,  which constitute a departure from other clinical guidelines for breast cancer prevention.

Women at high risk for breast cancer should talk to their physicians about the most appropriate screening schedule.

The task force found insufficient evidence to assess the benefits and harms of screening mammography in women ages 75 and older.

The task force 2002 statement recommended screening mammography every one to two years for all women ages 40 and older, consistent with the American Cancer Society (ACS) recommendation.

The task force based its new recommendations on a systematic review of evidence that has come to light since the 2002 recommendation statement. The review included randomized controlled trials that had breast cancer mortality outcomes for screening effectiveness. Various types of studies were used to assess potential harms related to breast cancer screening.

The review showed that:
1. ammographic screening reduces breast cancer mortality in women ages 39 to 69
2. Data on screening mammography in older women are lacking
3. Radiation exposure from mammography is low
4. Adverse events are common but do not affect screening practices
5. Screening leads to over diagnosis rates of 1% to 10%
6. False positive results are more common in younger women
7. Breast self examination does not reduce mortality but does increase the rate of negative biopsies

The findings led the task force to recommend starting mammographic screening at age 50 and screening every two years for average risk women. 

Dr KK Aggarwal


Study Links Yo Yo Dieting to Addiction
Yo Yo dieting, a common habit of many chronic dieters, generates dependence, as per Dr Cottone, an assistant professor Boston University School of Medicine. And when people who typically overeat stop overeating, stress hormones in their brain jump into action, potentially leading to anxiety, decreased motivation and rejection of other food alternatives.

Even paracetamol can cause asthma
An analysis of 19 studies provides additional evidence of increased asthma risk in children and adults given paracetamol. Paracetamol  affects inflammatory cells in the airway, said Dr. J. Mark FitzGerald of the Vancouver Coastal Health Research Institute in British Columbia. But even if the medication does boost asthma risk, he added, it's likely only one factor in the rise in asthma prevalence seen in recent years. Asthma has become increasingly common worldwide, and some investigators have suggested that more widespread paracetamol use could be one contributing factor, given that the drug lowers levels of an antioxidant called glutathione found in lung tissue, FitzGerald and his team note in the journal CHEST.

Quitting smoking after surgery can heal the wound better: As per
The American Society of Anesthesiologists surgery provides an ideal opportunity for someone to quit smoking altogether because surgery patients are told to stop for as long as possible before and after their operation. Surgery related reasons to quit, include:
1. Better healing after surgery. One study found that half of the people who continued smoking after surgery developed complications; the number fell to 20 percent among those who quit.
2. Within hours of quitting the body will begin to heal. Within less than a day, blood flow throughout the body will get better, boosting the chances of avoiding complications from surgery.

For elderly advise them to walk fast

A French study published in BMJ has found that seniors who walk slowly are three times more likely to die from cardiovascular disease than are fast walkers. Seniors with the slowest walking speed were 44 percent more likely to die than the fastest walkers. The slowest walkers also had a three-fold higher risk of cardiovascular death. The increased risk of cardiovascular death was found in both women and men, in younger as well as older seniors and in those with low or usual physical activity levels. There was no link between walking speed and risk of death from cancer. (Nov. 10 in BMJ)

Constipation tips
When you feel the need to have a bowel movement, don't put it off.
 Schedule time each day to have a bowel movement, such as after a meal. Boost your fiber intake.  Drink plenty of water: aim for eight glasses each day.  Don't rely on laxatives, as taking them too frequently can worsen constipation. Get regular exercise.  Avoid sugary and high fat foods that can contribute to constipation. 


"Doctor, doctor, I keep thinking I'm a pack of cards.
I'll deal with you later."

N. Palsy by injection 
A 6-week infant was taken to a private clinic for DPT vaccination. The paramedic on duty gave the injection on the right gluteal region. Three to 4 hours later the mother noticed that the child was not moving his right lower leg and had developed a flail foot.

The situation can be easily explained in view of the fact that injections in gluteal region in children can lead to sciatic N. palsy and hence should be avoided. The preferred site being antero lateral aspect of the thigh. Similar situation can arise in adults if the injection in the arm is given at an incorrect site leading to radial or ulnar N. paralysis and hence precaution and knowledge of the correct site and technique of i.m. injection is of extreme importance in clinical practice.



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 Does frequent masturbation affect male fertility?

No. Frequent male masturbation does not reduce sperm count or affect the ability to achieve an erection. Actually, not having an orgasm (ejaculating) for several days or more may lower fertility. It may lower the number of sperm with normal shape and motility. Having sexual intercourse with ejaculation several times a week maximize  chances of getting your partner pregnant, whether you masturbate or not. (Mayo Clinic) 

Letters to the editor 

1. Dear Dr Aggarwal: Its been an addiction for me to read emedinews. I start my day by reading this on my blackberry. This is very important to keep ourselves up to date but sometimes this is not possible for a physician to read each and every bit from books  due to hectic schedule  and moreover, what is happening in current scenario cannot be obtained from books. So, I thank you for the initiation you have taken to enlighten the medical fraternity. Regards, Dr N Nishchal, Director Altius Healthcare
2.  Dear Prof Aggarwal: I congratulate you of the excellent idea of starting emedinews. I am a hospital administrator but I never miss reading emedinews which i get on my email daily. This is an excellent   and easy way to get yourself updated by spending few minutes daily. I forward this emedinews to all my residents and faculty of deptt of hospital administration on regular basis through group email so that they also are updated without spending any money.  Pl keep it up.with best wishes and warm regards: Dr Shakti Gupta
3. Dear friends: Ronald Laporte from Pittus burgh University in USA has started a wonderful initiative called supercourse which has a mamoth collection of lectures from all over the world that are free for academic use please do log into the website so that you will know what a wonderful initiative this is if you have some good lectures you have made and would like to share with people you can send them and they will be uploaded on this website. www.pitt.edu/~super1/ Dr Swati Y Bhave Executive Director AACCI

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emedinews: revisiting 2009

IJCP Group is organizing emedinews: Revisiting 2009, a day long conference on 10th Jan  2010 at Maulana Azad Auditorium. It will be attended by over 1500 doctors. Topics will be happenings in the year 2009. There is no registration fee however advanced registration is required.  Top experts will deliver lectures. CME will be followed by lively cultural evening, doctors of the year award, dance and dinner. For regiatration mail  emedinews@gmail.com. We have crossed 700 registrations.

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