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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 (07–08c); 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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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of 1st Mega Ajmer Health Camp 2012

  Editorial …

21st March 2012, Wednesday

School Health Education

In a meeting of the advisory working group for the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), Dr Jagdish Prasad DGHS hinted that the government is thinking of suggesting the HRD ministry of making school health education on lifestyle a must.

If the proposal meets acceptance, all school children from 5th class onwards would have lifestyle as a special subject in their curricula. Also, yoga will become compulsory in schools.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

School Health Education

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

First Mega Ajmer Health Camp – Checkups

Both general and specialty consultations were available incorporating all pathies.

Dr K K Aggarwal
    National News

Now, H1N1 testing only for high–risk, category A patients

PUNE: From Monday, only high risk patients with flu–like symptoms and those suffering from severe symptoms like breathlessness and high–grade fever (defined as category A) will be tested for swine flu infection in the city. This was decided at high–level technical committee’s meeting convened against the backdrop of sudden spurt in H1N1 cases in Pune and neighbouring Pimpri Chinchwad on Sunday. The meeting was held to assess the need to revise the prevailing guidelines for detection and treatment of H1N1 influenza cases. "Only patients down with influenza–like symptoms but having associated illnesses like diabetes, hypertension and other chronic illnesses as well as those falling in category A, irrespective of whether they have other co–morbid conditions or not, will be tested for swine flu infection," Pravin Shingare, director, department of Medical Education and Research (DMER) said. (Source: TOI, Mar 19, 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

FDA approves first pill for heavy menstrual bleeding

Estradiol valerate and estradiol valerate/dienogest (Natazia, Bayer HealthCare Pharmaceuticals Inc) oral contraceptive tablets were approved March 14 for the treatment of heavy menstrual bleeding (HMB). According to a company press release, this agent is the first and only oral contraceptive indicated for the treatment of HMB. (Source: Medscape)

For comments and archives

EMA recommends new warnings on osteoporosis drug

The European Medicines Agency’s (EMA’s) Committee for Medicinal Products for Human Use (CHMP) today recommended that the osteoporosis drug strontium ranelate (Protelos/Osseor, Les Laboratoires Servier) no longer be used in immobilized patients or patients with venous thromboembolism (VTE). The committee also recommended updated warnings regarding serious skin reactions with strontium ranelate. A final decision on this opinion "will be issued in due course," the EMA notes in a news release. (Source: Medscape)

For comments and archives

Leukemia arises from ‘founding clones’ in MDS

Acute myeloid leukemia (AML) arises from "founding clones" of cells that cause myelodysplastic syndromes (MDS), suggesting that targeted therapies should be directed at mutations in the original clones, investigators reported. (Source: Medpage Today)

For comments and archives

Warming, rain raise risk of waterborne disease

Global warming is apparently behind an increase in storms delivering torrential rains resulting in contamination of drinking water –– so much so that there has been an increase in diseases caused by waterborne pathogens, according to a new report. More than half of all outbreaks of waterborne diseases in the U.S. occur in the aftermath of heavy rains, which are only increasing as the world is getting warmer, according to a report issued Thursday by the nonprofit Union of Concerned Scientists (UCS). (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: #AJCC A soda a day raises heart disease risk by 20% Sugary drinks are associated with an increased risk of… http://fb.me/1r1HWKEZo

@DeepakChopra: Consciousness is designed to lead to solutions. All that is needed is to let it unfold naturally and spontaneously.

    Spiritual Update

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

Have Depression, Encourage Others

Student says: I am very discouraged. What should I do?

Guru says, "Encourage others"

The above is a classical Buddhist teaching and the same principles are used today in counseling and allopathic psychiatry. Whatever you want in life, give it to other. The more you give, the more you will receive. You will only get respect in life if you learn to give respect.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

If I have hydrosalpinx, can I have a baby?

If your fallopian tubes are completely blocked, an egg cannot travel through them to your womb. You will need to be treated by a doctor before you can get pregnant. If there is too much damage to the tubes, an egg might not be able to travel through them even if they are opened. You will need treatments that do not involve the tubes to help you get pregnant. One of these treatments is called vitro fertilization (IVF). In this procedure, your egg and the man’s sperm are joined (fertilized) in the laboratory. Then the doctor places the fertilized eggs (embryos) into your womb.

For comments and archives

    Tat Tam Asi………and the Life Continues……

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

Blood Donation – Gift of Liquid Love

Blood is the lifeline for any hospital. In India we need about 9 million units of blood every year. But unfortunately only about 7 million units are collected every year. Thus there is a shortage of more than 25–30%. The gap between the demand and supply is increasing. Therefore, lakhs and lakhs of patients suffer due to non–availability of proper blood at proper time.

Under the directive of Honourable Supreme Court of India it is illegal to take blood from any professional donor. It is best to take blood from non–remunerative voluntary donors.

Blood and Blood components are vital to the health care system of a country. In addition, the Thalassemics, hemophilic, anemic and leukemia patients require regular blood transfusions. Blood is also required in cases of accidents and surgical operations. Obviously the question arises as to wherefrom all the blood comes and also how are we going to cope up with the load of growing demands and requirements.

The only way is to request and motivate more and more of volunteers to come forward and they pour out their small Ahuties in this Maha Yagna of Voluntary Blood Donation Movement.

During the past almost three decades, I have realized that although there are many people willing to donate blood, yet they are fearful and hesitate to come forward to do so.

Socially the inadequate awareness amongst general population regarding blood donation is responsible in making this commodity very scarce.

Due to the paucity of funds, adequate amounts of educative programs for promoting voluntary blood donations are not available. Thus one is unable to reach the masses in making them come forward to donate blood.

A greater stress has been laid on voluntary (non–remunerated) blood donation since the hazards of commercial blood has resulted in endangering the life of the recipient from dreadful diseases like hepatitis and AlDS.

The major aim of blood transfusion has been to make the transfusion safe and beneficial. The other aims of improvement in blood have been in prolongation of the shelf life of blood, its optimum utilization and development of synthetic substances to supplement the human source. Through better understanding of red cell metabolism, the red cell preservatives now improvised, can preserve the red cells for transfusion unto 49 days as against 21 days earlier.

The development of cryobiology has enabled the preservation of cells and plasma for prolonged storage for years, in frozen state. The emphasis is now rightly put on the use of various components of blood based on the requirement of the patients, since this helps to utilize one unit of donated blood for more than one patient.

With the use of the cell separators, the pheresis procedures help separate and collect platelets, granulocytes and plasma in enough quantity from a single donor. Therapeutic applications of these cell separators have also enabled clinicians to reduce morbidity and mortality from many diseases

  • Improved serological techniques have reduced the incidence of transfusion reactions.
  • Introduction of new and more sensitive methods for screening of donors has helped in prevention of transmission of diseases such as hepatitis and AIDS.
  • Efforts are now on the way for use of artificial substitutes for specific components of blood. Perfluorochemical emulsion Fluosol–DA and polymerized stroma free hemoglobin solutions have been tried as red cell substitutes.
  • Genetic engineering techniques have isolated recombinant-DNA clones for adequate and safe production of plasma proteins especially factor VIII.
  • The dependence of human source for the reagents will also be reduced if the hybridoma technology is applied for preparation of reagents.
  • Recent advances in medical knowledge have significantly increased the volume and complexity of the work of the hospital blood bank.
  • Surgical techniques are becoming increasingly sophisticated and complex procedures more numerous.
  • Cancer surgery, reconstructive operations, open–heart procedures, and organ transplantation all make special demands upon the blood bank.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

It is the little things that make a big difference

There was a man taking a morning walk at the beach. He saw that along with the morning tide came hundreds of starfish and when the tide receded, they were left behind and with the morning sun rays, they would die. The tide was fresh and the starfish were alive. The man took a few steps, picked one and threw it into the water. He did that repeatedly.

Right behind him there was another person who couldn’t understand what this man was doing. He caught up with him and asked, "What are you doing? There are hundreds of starfish. How many can you help? What difference does it make?"

This man did not reply, took two more steps, picked up another one, threw it into the water, and said, "It makes a difference to this one."

What difference are we making? Big or small, it does not matter. If everyone made a small difference, we’d end up with a big difference, wouldn’t we?

For comments and archives

    Fitness Update

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

Physical activity and insulin: Why you should move daily

A multitude of research has linked physical inactivity with higher rates of obesity and poorer cardiovascular health. Development of type 2 diabetes, caused by the body’s declining ability to respond to and utilize insulin produced by the body, has also been linked to a sedentary lifestyle.

A study by Dunstan et al, published in the journal Diabetes Care, showed that people who watch ≥4 hours of television per day had shorter life spans than those who watched less. Now, those authors have found that taking short breaks from sitting to walk and move around can reduce blood glucose and insulin spikes after meals. Their study measured the glucose and insulin levels of 19 overweight adults after drinking a high fat, high sugar beverage over a 7–hour period while sedentary or engaging in moderate or vigorous levels of activity. Results showed a 24% decrease in glucose spike when participants got up to move compared to being sedentary, and a 30% decrease in glucose levels when they moved a bit more vigorously. Similar trends occurred in insulin levels. Barry Braun at the University of Massachusetts Amherst, who is not affiliated with the study, advises that a good rule of thumb is to get up every 15 minutes for a short walk around the room.

For comments and archives

    Cardiology eMedinewS

Cortisol may cause multiple health problems Read More

Most stroke patients may undergo both CT, MRI scans Read More

Can a cardiologist dispense medicines? Read More

    Pediatric eMedinewS

US death rates fall 60% in 75 years, and 94% in toddlers Read More

Guidelines often not followed for pregnant women with herpes Read More

Breast–feeding advice should be realistic, not idealistic Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient came with first–onset atrial fibrillation.
Dr Bad: Get an Echo done.
Dr Good: Also get T3 T4 and TSH done.
Lesson: Subclinical hyperthyroidism is also associated with an increased risk of atrial fibrillation (N Engl J Med 1994; 331:1249).

For comments and archives

Make Sure

Situation: A patient after receiving 40 units of insulin developed severe hypoglycemia.
Reaction: Oh my God! The order was for 4 units.
Lesson: Make sure that 4 unit is not written as 4.0 units.

For comments and archives

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    Microbial World: The Good and the Bad they do

(Dr Sunil Sharma, Senior Consultant Microbiology, Medanta The Medicity)

Minimizing the harm caused by resident normal oral bacterial flora

Our diet consists of carbohydrates, fats, proteins, vitamins, minerals and trace elements. Carbohydrates (Starch, glucose, sucrose, fructose) are broken down by bacteria, lactic acid is produced and as a result the pH in mouth drops to 4–5. This acid and the low pH harm the enamel and dentine and caries develops. Hence, a carbohydrate–rich diet is cariogenic. Proteins are important for matrix components of enamel, dentin and cementum. A low protein diet causes weakness of these structures, increase in cariogenic activity and defective matrix formation.

Fats in diet are rather good as they decrease the cariogenic activity. An in vitro experiment wherein oleic acid was applied on the tooth and this tooth was placed in a mixture of saliva plus acid, the result showed less decalcification of this tooth compared to control tooth without application of oleic acid. Inclusion of cod liver oil in diet reduces cariogenic activity.

Another thing which we can do is reduce the caries causing bacterial load in the oral cavity. Mutans streptococci and lactobacilli involved in causing caries can be reduced by oral application of chlorhexidine containing gels in individuals at risk. The chlorhexidine gels have been shown to be safe.

To sum up: Infections caused by resident oral bacterial flora can be prevented by drinking enough water/fluids to ensure good salivary flow; take balanced diet containing less carbohydrates/avoid eating sticky carbohydrate rich foods; maintain good general health; maintain good oral health; maintain healthy life style and consult Dental surgeon for any specific interventions which may be required in individual cases. Use oral rinse and chlorhexidine containing gels as recommended by Dental Surgeons.

For comments and archives

  Quote of the Day

(Dr GM Singh)

We give up leisure in order that we may have leisure, just as we go to war in order that we may have peace. Aristotle

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Prostate specific antigen (PSA)

Prostate biopsy may elevate PSA levels by a median of 7.9 ng/mL within 4 to 24 hours following the procedure. Levels will remain elevated for 2 to 4 weeks.

    Mind Teaser

Read this…………………

Which of the following is not fermented by colonic bacteria?

a) Lignin
b) Pectin
c) Cellulose

Yesterday’s Mind Teaser: What is not true for HNPCC (Hereditary nonpolyposis colorectal cancer)?

a) It is the most common hereditary colorectal cancer syndrome in USA.
b) It is associated with MMR gene mutation.
c) It is associated with APC mutation.
d) It is associated with carcinoma colon and extraintestinal cancers.

Answer for yesterday’s Mind Teaser: c) It is associated with APC mutation

Correct answers received from: Dr Mrs S Das, Dr PC Das, Yogindra Vasavada, Raju Kuppusamy,
Dr Jainendra Upadhyay, Anil Bairaria, yogindra vasavada.

Answer for 19th March Mind Teaser: b) Central breast tumor mass

Correct answers received from: Dr Priya, Shipra, Sandy, Dr SN Sahu.

Send your answer to ijcp12@gmail.com

For comments and archives

    Laugh a While

(Dr GM Singh)

First day at School

A school teacher injured his back and had to wear a plaster cast around the upper part of his body. It fit under his shirt and was not noticeable at all.

On the first day of the term, still with the cast under his shirt, he found himself assigned to the toughest students in school. Walking confidently into the rowdy classroom, he opened the window as wide as possible and then busied himself with desk work.

When a strong breeze made his tie flap, he took the desk stapler and stapled the tie to his chest.

He had no trouble with discipline that term.

    Medicolegal Update

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

What is the Dr Hawley Harvey Crippen murder case?

The most notorious and famous murder case in British history

Hawley Harvey Crippen was hanged to death in London in one of the most notorious and famous murder cases in British history for the murder of his wife Cora Henrietta Crippen, on November 23, 1910 on the basis of forensic evidence. For nearly a century, Crippen, a doctor, was thought to have poisoned his wife with an obscure toxin, and buried. He was labeled "one of the most dangerous and remarkable men who have lived in this century." Researchers have now cast doubts on this conviction. Now forensic science at Michigan State University is producing evidence that his execution was a mistake. David Foran, a forensic expert and director of MSU’s forensic science program, partnering with clinical and forensic toxicologist John Harris Trestrail the managing director of the regional poison center in Grand Rapids, is combining state–of–the–art DNA analysis with solid sleuthing to show the remains buried in Crippen’s basement couldn’t have been his wife

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

New guidelines to prevent sudden death

New guidelines for treatment of heart failure have been issued by the American Heart Association and the American College of Cardiology. These guidelines are published in the Journal of the American College of Cardiology and in the Heart Association Journal Circulation.

Giving the details, Dr. KK Aggarwal, Padma Shri & Dr. B.C. Roy National Awardee and President, Heart Care Foundation of India, said that internal electric shock machine or ICD should be implanted in all patients with heart pumping action or EF less than or equal to 35% and mild to moderate symptoms of heart failure and in whom survival with good functional capacity is otherwise anticipated to extend beyond one year.

This should be done after demonstrating that there is sustained reduction of heart pumping action or EF (ejection fraction) despite a course of adequate drugs which includes beta–blockers and ACE inhibitors or ARBs.

The device should not be put in patients with refractory heart failure or in patients with concomitant diseases that would shorten their life expectancy independent of heart failure.

Patients and families should clearly understand that the device does not improve clinical function or delay heart failure progression.

Other guidelines

In all patients with heart pumping action or EF less than or equal to 35%, a QRS duration greater than or equal to 0.12 seconds in ECG, in sinus or atrial fibrillation rhythm, biventricular pacing (three leads pacemaker) with or without an electric shock device (ICD) is indicated for patients with class III or IV heart failure with optimal recommended medical therapy. If such patients are on single or double lead pacemaker and are dependent on pace maker the third lead device should be put.

The device is not indicated for asymptomatic patients with reduced pumping function of the heart in the absence of other indications for pacing.

It is also not indicated for patients whose functional status and life expectancy are limited predominantly by chronic non cardiac conditions.

    Readers Responses
  1. Regarding rural posting of young doctors. only long–term planning will help build good roads to PHCs, social security of families and reasonable schools for children, only then a youngster can live in rural area, otherwise the whole program will keep on failing. Vivek Kumar, Varanasi.
    Forthcoming Events
Dr K K Aggarwal

National Summit on "Stress Management" and Workshop on "How to be happy and Healthy"

Date: Saturday 2PM–Sunday 4PM, 21–22 April 2012
Venue: Om Shanti Retreat Center, Bhora Kalan, on Pataudi Road, Manesar
Course Directors: Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal and BK sapna
Organisers: Heart Care Foundation of India, Prajapati Brahma Kumari Ishwariya Vidyalaya and eMedinewS
Fee: No fee, donations welcome in favour of Om Shanti Retreat Center
Facilities: Lodging and boarding provided ( One room per family or one room for two persons). Limited rooms for first three registrants.
Course: Meditation, Lectures, Practical workshops,
Atmosphere: Silence of Nature, Pyramid Meditation, Night Walk,
Registration: Rekha 9899974439 rekhapapola@gmail.com, BK Sapna 9350170370 bksapna@hotmail.com

Study Camp on ‘Mind–Body Medicine and Beyond’

16–23 June 2012, Nainital Centre (Van Nivas)

Sri Aurobindo Ashram – Delhi Branch will organize the 5th Study Camp on ‘Mind–Body Medicine and Beyond’ for doctors, medical students and other health professionals at its Nainital Centre (Van Nivas) from 16–23 June 2012. The camp, consisting of lectures, practice, and participatory and experiential sessions, will help the participants get better, feel better, and bring elements of mind–body medicine into their practice. The camp will be conducted by Prof. Ramesh Bijlani, M.D., former Professor, AIIMS, founder of a mind–body medicine clinic at AIIMS, and the author of Back to Health through Yoga and Essays on Yoga. For more details, send an e–mail to the Ashram (aurobindo@vsnl.com) or to Dr. Bijlani (rambij@gmail.com).

BSNL 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

    eMedinewS Special

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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