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Dr KK Aggarwal

From the Desk of Editor in Chief
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 ...

20th October 2010, Wednesday

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

FDA adds femur fracture warning to bisphosphonate labels

Bisphosphonates approved for osteoporosis will now bear a label warning about the risk for 2 types of atypical femur fractures, as per US FDA. One type of break, subtrochanteric femur fracture, occurs just below the hip joint. Another type, diaphyseal femur fracture, is in the long part of the bone. Both are very uncommon, accounting for less than 1% of all hip and femur fractures overall, according to the agency.

In a report released last month, the American Society for Bone and Mineral Research task force said that of 310 cases of atypical femur fractures under study, 94% of the patients had been taking bisphosphonates, most for more than 5 years. The task force stopped short of declaring that the medications cause the fractures. The warning applies only to bisphosphonates approved for osteoporosis such as alendronate and risedronate sodium. Bisphosphonates approved for the treatment of Paget’s disease and high blood calcium levels caused by cancer are unaffected.

Dr KK Aggarwal
Editor in Chief
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  Chikungunya Update

(RP Vashist, Consultant and Head Public Health, Govt. of Delhi)

High–risk population groups

  • Pregnant women
  • Elderly people
  • Newborns
  • Women
  • Diabetics
  • Immunocompromised patients
  • Patients with severe chronic illnesses
  Photo Feature (from the HCFI Photo Gallery)

Perfect Health Parade 2009

Perfect Health Parade is an annual mega event of HCFI organized with the primary objective of spreading health education among the general public. On May, 31, 2009 HCFI organized the Perfect Health Parade, in coordination with Dept of Health and Family Welfare, Govt of Delhi. Dr Kiran Walia was Chief Guest for the occasion.
In the photo: Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President HCFI, Dr Kiran Walia, Health Minister Delhi, Acharya Sadhvi Dr Sadhna Ji

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Antiplatelet therapy and drug–eluting stents

An analysis from two randomized trials in patients with drug–eluting stents showed no benefit to continuing dual antiplatelet therapy, compared with switching at one year to aspirin monotherapy.

(Ref: Park SJ, et al. Duration of dual antiplatelet therapy after implantation of drug–eluting stents. N Engl J Med. 2010 Apr 15;362(15):1374–82)

  National News

IMA Election (for a CHANGE)

Emedinews requests all its readers to support our editor Dr. K.K. Aggarwal, Padma Shri and Dr. B C Roy National Awardee who is contesting for the post of Vice President of the National Indian Medical Association (IMA). Members of Central Council of IMA, Working Committee Members, Presidents and Secretaries of IMA in addition to all office bearers are the voters in this election. Dr. Aggarwal is well–known for his work in the field of academics.

Certificate courses in 2D and 3D Echocardiography/ Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

Hospitals told to computerise postmortem reports

Following a Delhi court’s suggestion on computerising postmortem and medical reports, the government has directed its hospitals to do away with manual reports, often written in illegible handwriting. Additional Secretary, Health and Family Welfare S S Sidhu informed Additional Sessions Judge Sanjeev Aggarwal that an order has been issued to all eight hospitals authorised to conduct postmorterm examinations. The hospitals where computerised postmortem reports will be issued included Deen Dayal Upadhyay, Guru Teg Bahadur, Lok Nayak and Baba Saheb Ambedkar hospitals. The court noted, "The incorporation of the photograph in the MLC would lead to transparency in the criminal justice system as no accused will be able to take the advantage of wrong MLCs in court, which will also be useful for his identification." (Source: Indian Express)

  International News

(Dr Monica and Brahm Vasudev)

Kidney disease patients with large upper arm muscles may gain improved health, survival

Kidney disease patients are healthier and live longer if they’ve beefed up their muscles, according to a study to be published in an upcoming issue of the Clinical Journal of the American Society of Nephrology.

Watermelon extract may lower blood pressure

According to a study published in the American Journal of Hypertension, there is evidence that eating watermelon could reduce blood pressure. Eating 6 grams of watermelon extract a day for six weeks lowered blood pressure in all nine middle–aged subjects with prehypertension. Watermelon may prevent prehypertension from progressing to full–blown hypertension.

Protein urine test may signal prostate cancer

According to scientists from the Cancer Research UK Cambridge Research Institute and the Institute of Cancer Research (ICR), microseminoprotein–beta or MSMB, a protein, is found at reduced levels in men diagnosed with the prostate cancer and are also lower in men with more aggressive forms of the cancer.

Paracetamol no asthma trigger after all?

In August, researchers studying toddlers in Ethiopia said it was "increasingly likely" that paracetamol had triggered much of the wheezing that troubled eight percent of those children. And another study hinted it might be fueling a large part of the worldwide increase in asthma. In a letter to the editor of the Journal of Allergy and Clinical Immunology, however, researchers from Germany say there is no cause for alarm. Using long-term data for more than 3,000 children, they report that the link between asthma and Paracetamol only held when the medication was used to treat airway infections, not stomach flu or urinary tract infections.

  Hepatology Update

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

What happens after surgery for biliary atresia?

The aim of treatment after surgery is to encourage normal growth and development.
  • If bile flow is good, the child is given a regular diet.
  • If bile flow is reduced, a low fat diet is recommended as bile is required to aid in the absorption of fats and vitamins. Multiple vitamins, vitamin B complex, and vitamins E, D, and K can be given as supplements.
  Infertility Update

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

What are some less common causes of infertility?

Although still regarded "uncommon" by many practitioners, there is evidence that many cases of "unexplained" infertility are actually the result of malfunction of the immune system. These problems can range from antisperm antibodies to an outright rejection of a developing fetus. On the brighter side, greatly improved testing is now available to screen for these problems, and new treatment protocols are resulting in unprecedented success rates.

  ENT Update

Dr. Aru Handa MS, DNB (Department Co–ordinator and Senior Consultant Deptt. Of ENT Moolchand Medcity)

Which is the radiological investigation of choice for sinusitis and when should it be done?

The diagnosis of acute sinusitis is based mainly on history and clinical examination. Non contrast CT of paranasal sinuses (NCCT PNS) is the radiological investigation of choice for evaluating sinusitis.  It gives an idea about the type of the disease, the extent of the disease, helps in planning the treatment of sinusitis and also provides a road map for surgery by providing the anatomical details of the sinuses. Contrast – enhanced CT is useful in evaluating vascular lesions and tumors, especially those spreading beyond sinuses.

The timing of the CT scan is important. All patients of acute sinusitis show varying degree of involvement of sinuses on CT scan. There is no point in getting CT done in acute phase as the findings are quite predictable and the treatment of uncomplicated acute sinusitis is mainly medical. CT scans are done in acute sinusitis if there is a suspicion of impending complication, sinusitis with complications or sinusitis not responding to adequate medical therapy.

In chronic and recurrent sinusitis, the CT scan should be done after adequate treatment of acute episode or after receiving appropriate medical therapy for few weeks. The CT scan should be done during maximum wellness period, after treating reversible disease with medication, so that only irreversible changes requiring surgical treatment are picked up.

  Medicolegal Update

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

Private Doctors can treat and report in MLC Cases: High Court

MLCs has been extended to the private doctors also

The foremost legal and ethical duty of doctor is to attend and treat the injuries and health of the patient/person produced before him. His primary effort should always be to save the life of the patient and then inform the police; but, all the injuries/findings observed by him must be document clearly in medico legal cases (MLCs). This means that the duty of the doctor to provide medical aid, even in MLCs, has been extended to the private doctors and has also also authenticated in many government orders and honorable courts.

The private doctors should not hesitate to entertain MLC. But, after the completion of medical examination/treatment a medicolegal report should be prepared as early as possible to avoid after–thought allegation. They should be prepared in duplicate, preferably with a ball–point–pen, in a clear and legible hand. Cutting/ overwriting, etc. should be avoided as much as possible and all corrections should be properly initialed. Abbreviations of any sort should be avoided. A medicolegal register should be maintained in the casualty of every hospital and details of all MLCs should be entered in this register, including the time and date of examination and the name of the doctor who is dealing with the case. This would be of immense help for future reference, when the patient through the court/ the police, requests for a copy of the medico legal report.

(Ref: Pattipati Venkaiah Vs State of Andhra Pradesh. 1985)

  Medi Finance Update

Stock Market

  • In stock market, there is high risk but also high returns.
  • One should learn to think globally, then only one can achieve something in life.
  • Law of Economics, when the bank interest rate reduces, then stock market has to rise and vice versa. When the interest rate reduces, the profit increases.
  Drug Update

List of drugs prohibited for manufacture and sale through gazette notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

Drugs prohibited from the date of notification

Methapyrilene, its salts

  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


To help monitor your over time, especially if it is not possible to monitor using the A1C test; to help determine the effectiveness of changes to your diabetic treatment plan.

MTNL Perfect Health Mela
  IJCP Special

Dr Good Dr Bad

Situation: An asymptomatic patient with no obvious underlying cardiac disease shows ventricular premature contractions (VPCs).
Dr Bad: Anti-arrhythmics should be given.
Dr Good: No treatment is needed.
Lesson: In the absence of cardiac disease, isolated asymptomatic VPCs regardless of configuration and frequency need no treatment.

Make Sure

Situation: A patient with fever developed malena.
Reaction: Oh My God! why was platelet count not done?
Lesson: Make sure in all patients with fever platelet counts are done.

Quote of the Day (Dr Chandresh Jardosh)
"A teacher affects eternity: he can never tell where his influence stops." Henry Adams

  Mind Teaser

Read this…………………


Answer for yesterday’s Mind Teaser: "once upon a time"

Correct answers received from: Dr Ajmer Singh, Dr. G. Padmanabhan, Dr Rashmi Chhibber, Dr S. Upadhyaya, Dr Chandresh Jardosh, Dr Sanjiv Kacker, Dr Muthumperumal Thirumalpillai, Dr. Amlendu Yadav, Dr Neelam Nath, Dr Sudha Nayyar, Dr. Susheela Gupta, Dr Kalpana Mohan, Dr. K.P. Rajalakshmi, Dr.Lakshmi Iyer, Dr.K.Raju, Dr Virender Prakash Gautam, Dr.Amritpal Bhatia, Dr Prabha Sanghi.

Answer for 18th October Mind Teaser is: "Tally–ho!"
Correct answers received from: Dr Virender Prakash Gautam

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr G M Singh)

Interesting 911 Calls

Dispatcher: Nine-one-one What's the nature of your emergency?

Caller: My wife is pregnant and her contractions are only two minutes apart.

Dispatcher: Is this her first child? Caller: No, you idiot! This is her husband.

  An Inspirational Story

Smart Game!!! Enjoy…!! (Dr Jagjit Singh)

There once lived a great mathematician in a village outside Ujjain. He was often called by the local king to advice on matters related to the economy. His reputation had spread as far as Taxila in the North and Kanchi in the South. So it hurt him very much when the village headman told him, "You may be a great mathematician who advises the king on economic matters but your son does not know the value of gold or silver. The mathematician called his son and asked, "What is more valuable – gold or silver?" "Gold," said the son. "That is correct. Why is it then that the village headman makes fun of you, claims you do not know the value of gold or silver? He teases me every day. He mocks me before other village elders as a father who neglects his son. This hurts me. I feel everyone in the village is laughing behind my back because you do not know what is more valuable, gold or silver. Explain this to me, son."

So the son of the mathematician told his father the reason why the village headman carried this impression. "Every day on my way to school, the village headman calls me to his house. There, in front of all village elders, he holds out a silver coin in one hand and a gold coin in other. He asks me to pick up the more valuable coin. I pick the silver coin. He laughs, the elders jeer, and everyone makes fun of me. And then I go to school. This happens every day. That is why they tell you I do not know the value of gold or silver."

The father was confused. His son knew the value of gold and silver, and yet when asked to choose between a gold coin and silver coin always picked the silver coin. "Why don’t you pick up the gold coin?" he asked. In response, the son took the father to his room and showed him a box. In the box were at least a hundred silver coins. Turning to his father, he said, "The day I pick up the gold coin the game will stop. They will stop having fun and I will stop making money."

The bottom line is… Sometimes in life, we have to play the fool’s role because our seniors and our peers, and sometimes even our juniors like it. That does not mean we lose in the game of life. It just means allowing others to win in one arena of the game, while we win in the other arena of the game. We have to choose which arena matters to us and which arenas do not.

The only constant in LIFE is CHANGE…

  Readers Responses
  1. Dear Dr KK Aggarwal, Greetings from Jammu. It is indeed a mammoth job to provide interesting, well compiled medical information, that too every day. This requires a lot of dedication & commitment. Please accept my congratulations for the same. Regards & best wishes, Dr Rekha Harish, Prof & HOD Pediatrics, GMC, Jammu
  2. Under Diabetes Update there is a mention that HbA1c is not employed for diagnosis of DM. I understand that according to most recent guidelines, HbA1c is useful tool even for diagnosis. Please ask your expert to check this. Thanks Prof .C V Raghuveer, MD, DCP, FICP (Path)
    eMedinewS responds: We regret this error.
  Public Forum

(Press Release for use by the newspapers)

High–fat diet cancer prone

Diets high in saturated fat may increase the risk of prostate cancer said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Free medical check-ups, Speciality Clinics and Health Awareness Campaigns will be major activities of the forthcoming 17th MTNL Perfect Health Mela to be held from 23rd to 31st October at NDMC Grounds, Laxmi Bai Nagar, New Delhi. The Mela would also provide free dietary counseling and subsidized Laboratory tests.

As per a report from University of Texas M. D. Anderson Cancer Center in Houston, men who consumed higher amounts of saturated fat, mostly from steaks, burgers, cheese, ice cream, salad dressings, and mayonnaise were nearly two-times more likely to experience progression of disease after surgery than men with lower saturated fat intake. The study is published in the International Journal of Cancer.

Diet before surgery, especially saturated fat, may modulate patient outcome after surgery. There was also a significantly shorter "disease-free" survival times among obese men who ate high amounts of saturated fat compared with non-obese men consuming diets low in saturated fat.

• Obese men with a high saturated fat intake had the shortest survival time free of prostate cancer (19 months), while non-obese men with low intake survived the longest time free of the disease (46 months).

• Non-obese men with high intake and obese men with low intake had "disease-free" survival of 29 and 42 months, respectively.

The study concluded that intake of saturated fat plays a role in prostate cancer progression.

  Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

17th MTNL Perfect Health Mela 2010

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to 10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

Dr. Sood Nasal Research Foundation Announces

Rhinology Update 11th to 15th November
22nd National Endoscopic Sinus Surgery Course on 11th & 12th November, 2010 2010 at Dr. Shroff’s Eye & ENT Hospital, New Delhi
Cadaveric Sessions on 13th November, 2010 at Lady Hardinge Medical College.
33rd All India Rhinoplasty Course, on 14th & 15th November, 2010, at Metro Hospital, Preet Vihar, Vikas Marg, New Delhi.

For information contact: Dr. V P Sood, Course Chairman, Ear, Nose & Throat Center, 212, Aditya Arcade, 30, Community Center, Preet Vihar, Vikas Marg, Delhi–110092 (India). Tel: 011–22440011, 42420429. E–mail:drvpsood@gmail.com,vpsood@drsoodnasalfoundation.com
Website: www.drsoodnasalfoundation.com

eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

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