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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 & 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 & Hony. Visiting Professor (Clinical Research) DIPSAR


For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1–7
DD Take Care Holistically Video 1–4 Chat with Dr KK On life Style Disorders
Health Update Video 1–15 Science and Spirituality
Obesity–Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

21st August 2012, Tuesday

MCI amendments reproduced again in view of recent health ministers remarks. :

“6.8 Code of Conduct for doctors and professional association of doctors in their relationship with pharmaceutical and allied health sector industry, 6.8.1. In dealing with pharmaceutical and allied health sector industry, a medical practitioner shall follow and adhere to the stipulations given below:-

  • Gifts: A medical practitioner shall not receive any gift from any pharmaceutical or allied health care industry and their sales people or representatives.
  • Travel Facilities: A medical practitioner shall not accept any travel facility inside the country or outside, including rail, air, ship, cruise tickets, paid vacations, etc. from any pharmaceutical or allied healthcare industry or their representatives for self and family members for vacation or for attending conferences, seminars, workshops, CME programme etc. as a delegate.
  • Hospitality: A medical practitioner shall not accept individually any hospitality like hotel accommodation for self and family members under any pretext.
  • Cash or Monetary Grants: A medical practitioner shall not receive any cash or monetary grants from any pharmaceutical and allied healthcare industry for individual purpose in individual capacity under any pretext. Funding for medical research, study etc. can only be received through approved institutions by modalities laid down by law/rules/guidelines adopted by such approved institutions, in a transparent manner. It shall always be fully disclosed.
  • Medical Research: A medical practitioner may carry out, participate in, work in research projects funded by pharmaceutical and allied healthcare industries. A medical practitioner is obliged to know that the fulfillment of the following items (i) to (vii) will be an imperative for undertaking any research assignment/project funded by industry for being proper and ethical. Thus, in accepting such a position a medical practitioner shall:-
    • Ensure that the particular research proposal (s) has the due permission from the competent concerned authorities;
    • Ensure that such a research project (s) has the clearance of national/state/institutional ethics committee/bodies;
    • Ensure that it fulfills all the legal requirements prescribed for medical research;
    • Ensure that the source and amount of funding is publically disclosed at the beginning itself;
    • Ensure that proper care and facilities are provided to human volunteers, if they are necessary for the research project (s);
    • Ensure that undue animal experimentations are not done and when these are necessary they are done in a scientific and a humane way;
    • Ensure that while accepting such an assignment a medical practitioner shall have the freedom to publish the results of the research in the greater interest of the society by inserting such a clause in the MoU or any other document/agreement for any such assignment.
  • Maintaining Professional Autonomy: In dealing with pharmaceutical and allied healthcare industry a medical practitioner shall always ensure that there shall never be any compromise either with his/her own professional autonomy and/or with the autonomy and freedom of the medical institution.
  • Affiliation: A Medical practitioner may work for pharmaceutical and allied healthcare industries in advisory capacities as consultants, as researchers as treating doctors or in any other professional capacity. In doing so, a medical practitioner shall always:
    Ensure that his professional integrity and freedom are maintained.
    Ensure that patient’s interests are not compromised in any way.
    Ensure that such affiliations are within the law.
    Ensure that such affiliation/employments are fully transparent and disclosed.
  • Endorsement: A medical practitioners shall not endorse any drug or product of the industry publically. Any study conducted on the efficacy or otherwise of such products shall be presented to and /or through appropriate scientific bodies or published in appropriate scientific journals in a proper way”

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

    A doctor faces death sentence for ordering an unrequired scan…

This story was published in August 20, 2012 issue of eMedinewS. As soon as we read this, most of us questioned it. Such a judgment cannot be. Yes, it indeed cannot be. This story was sourced from ‘Medscape Humor’. Yet, a very thought provoking story … The 3-strikes law is correct and is in place in some states in the US, though it is a hotly-debated issue. The time may yet come, when the scenario enacted in the story may well turn into reality.

  eMedinewS Audio PostCard

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

Trimetazidine for heart failure

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Seminar on Health and Happiness

A seminar was organized jointly by Heart Care Foundation of India and Bharatiya Vidya Bhavan.

Dr K K Aggarwal
    National News

New trauma center for dental emergencies in Delhi soon

NEW DELHI: Delhi state health department has approved Rs 45 crore for the construction of a new building within the premises of Maulana Azad Institute of Dental Sciences (MAIDS) to establish a 24x7 dental trauma centre. The dental college was the nodal centre for dental emergencies during the Commonwealth Games 2010 and since then it has been running a round-the-clock emergency. Doctors at MAIDS say that they have been flooded with dental emergency cases and are doing close to 40 surgeries every month. "The decision to start a dental trauma centre was taken after MAIDS saw heavy rush in its emergency, which was started on an experimental basis three months back. We get 10-15 patients everyday with fracture of teeth and jaws. Some dental injuries like tooth fracture - where the tooth is dispensed in the airway - can lead to respiration problem can lead to death," said Dr Mahesh Verma, Director, MAIDS. He said that majority of patients are referred Lok Nayak hospital and other neighbouring hospitals. Verma added that till now, dental emergencies were not given priority in accident cases. "Patients come to us after they have recovered completely from other injuries. But in most cases it is too late to fix the dental damages. In this trauma centre, we will be able to attend patients immediately and minimize the damage,'' Verma said. In this trauma centre, there will be dedicated operation theatres, ICU and wards ^25-bedded ward each for male and female. ``It is a welcome move. It will help expand our existing dental services,'' said Kiran Walia, Delhi health minister. The new center will also have research and development wing. MAIDS has developed the cheapest dental implant under the New Millennium Indian Technology Leadership Initiative by the Ministry of Science and Technology. Human trials are under process. (Source: TOI, Aug 19, 2012)

My Profession My Concern
(Dr G. M. Singh)

A Mother Deals with Charges of Murder and Feticide

In December 2010, a near term pregnant lady (33 weeks) in Indiana (USA) attempted suicide by ingesting rat poison.

Seventeen months later she was released from jail after serving 14 months of being held without bond and now awaits trial on charges of murder and feticide, or murder for the death of the mother’s fetus.

The lady became pregnant after having an affair with a married man. Shortly after learning of the pregnancy, the father of the baby broke off the affair.

She took the rat poison, was taken to the hospital, delivered a premature baby girl who died three days later of intra cerebral hemorrhage.

The Indiana Court of Appeals makes no mention of whether she was suffering from depression at the time she ingested the rat poison. Her decision to attempt suicide was researched, planned and executed with precision. All of which could lead to a presumption that she was very conscious of what she was doing and was not, in fact, suffering from depression.

Indiana has chosen to classify the knowing and intentional killing of a fetus that has reached viability as murder—even if that act is committed by the mother.

The United States Supreme Court long ago held that a fetus that obtains viability gains rights that must be weighed against the mother’s rights. Just because she decided to commit suicide does not absolve her of liability for the death of her fetus.

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

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

(Contributed by Dr Monica and Brahm Vasudev)

Study: No PSA tests, advanced cancer triples

Elimination of PSA testing would triple the number of men who have advanced prostate cancer at diagnosis, authors of a retrospective review concluded. (Source: Medpage Today)

Despite edema, ambrisentan effective in PAH

Edema is a common side effect of ambrisentan, but it doesn't prevent patients with pulmonary arterial hypertension (PAH) from benefiting from the drug, researchers say. In a report funded by Gilead Sciences, Dr. Shelley Shapiro of the David Geffen University of California, Los Angeles, and colleagues note that studies have shown an overall rate of peripheral edema of 17% in ambrisentan-treated patients versus 11% with placebo. Bosentan, another endothelin receptor antagonist, has also been associated with edema, the researchers add in a paper online August 1 in the American Journal of Cardiology. (Source: Medscape)

Mental distress can be killer

Even at low levels, psychological distress was significantly associated with an increased risk of mortality from several causes, researchers found. A meta-analysis of 10 British cohort studies showed that the risk of all-cause mortality in adults with the lowest level of psychological distress -- termed subclinically symptomatic -- was significantly higher than that of asymptomatic adults at an age- and sex-adjusted hazard ratio of 1.20 (95% CI 1.13 to 1.27), Tom Russ, MRCPsych, of the National Health Service Scotland, and colleagues wrote online in BMJ. (Source: Medpage Today)

An apple a day keeps high cholesterol at bay?

Women who eat dried apple every day for a year see a persistent decrease in their cholesterol levels, according to a new study. In comparison, women who ate prunes daily maintained steady levels over a year, suggesting that the fruit could keep cholesterol numbers from rising. "Both apples and dried plum are pretty powerful in keeping the cholesterol at bay," said Dr. Bahram Arjmandi, the lead author of the study and the chair of the department of Nutrition, Food, and Exercise Sciences at Florida State University. (Source: Medscape)

Does CRP protect families from dementia?

Healthy aging -- and cognitive health in particular -- may run in families and may be linked to high levels of an important marker for cardiovascular disease, researchers reported. (Source: Medpage Today)

New test requires less blood to diagnose TB

A new interferon-gamma release assay (IGRA) for diagnosing tuberculosis performs as well as an earlier test, but uses only a third of the blood, researchers have found. Childhood TB is a huge problem," Dr. Pernille Ravn from University Hospital Hillerod in Denmark told Reuters Health by email. "IGRAs are an improvement compared to the tuberculin skin test (TST), but the use is still limited by cost, infrastructure, and the lack of ability to discriminate between active and latent TB." Dr. Ravn and colleagues compared the new Quantiferon Microtube (QFT-MT) assay, a prototype that uses only 0.9 mL blood, with the Quantiferon-TB (QFT-IT) assay, which is commercially available and requires 3 mL of blood. They recruited 152 children with suspected TB and 87 adults with confirmed TB from Muheza designated district hospital in Tanga, Tanzania. (Source: Medscape)

    Twitter of the Day

@DrKKAggarwal: Diabetics should take pneumonia vaccine Diabetes is associated with a 25–75% increase in the relative risk of... http://fb.me/1gsQr8FpH

@DeepakChopra: See the possibilities in whatever happens. Find the stream of joy.

    Spiritual Update

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

Brahma Satyam Jagat Mithya

As a living body we like to hug, kiss, touch and feel. But what happens when the person is dead. We do not like to touch it. If we do so also, we go and wash our hands and take a bath. We do not want to transport a dead body back home in our own car; instead, we hire a hearse van. From the hospital too, many do not want to take the body back home but prefer to keep it in the

For Comments and archives…

    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

When should egg donation be opted for?

Egg donation initially was intended for women with ovarian failure. Typically, women were prematurely menopausal as a result of disease, chemotherapy, radiation therapy, or surgical removal of their ovaries. Egg donation is appropriate for women who were born without ovaries. Egg donation may be offered to women who are known to be affected by or be the carrier of a significant genetic disease who would prefer not to pass this disease onto their offspring.

For Comments and archives…

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

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

Administration of blood/components

Starting transfusion

  • Ensure that red cell component is not exposed to temperature above 10°C kept at room temperature before starting of transfusion. Generally in air-conditioned room it takes about 30 minutes to raise the temperature of red cell component (kept at room temperature) above 10° C.
  • Ensure taking Informed Consent from patient/guardian
  • After checking all the identifying information, the transfusionist must sign the compatibility certificate to indicate that the identification was correct. He will also document; who has started the transfusion with date and time.
  • In addition to informing the patient of the procedure and checking all identification steps, the transfusionist should record the patient’s pretransfusion vital signs, i.e., temperature, blood pressure, pulse, respiration rate etc.

Delay in starting transfusion

  • Start transfusion immediately after receiving of blood/blood components.
  • All blood components should be ordered at time when it is required. Blood/blood component should not be left at room temperature or stored in an unmonitored refrigerator in ward.
  • Although the blood once issued should not be taken back by blood bank but if blood bank protocols permits, blood can be taken back by blood bank.
  • If the transfusion cannot be initiated promptly, the blood should be returned (if protocols permits) to the blood bank for proper storage as per the guidelines given below–
Dr K K Aggarwal

For Comments and archives…

    An Inspirational Story (Ms Ritu Sinha)

Value and invest in yourself

If you are into financial investment, you’re probably very familiar with Mr. Warren Buffet (1951–present). He is the most successful investor in the world. His investment strategies are legendary and many people seek to learn after him. Even more respectable, he pledged to give away 99% of his wealth (more than $30 billion at the time of the pledge in 2006) to non-profit foundations, mostly to Bill Gates Foundation.

Mr. Buffet often travels to universities to give speeches to educate and motivate students. Here is one of his speeches to teach us the value of our body, to invest in ourselves, in education for a great future. Imagine that a Genie offers you any car in the world. The catch is that it is the only car you will ever own. What would you do?

You would read the manual ten times, change the oil twice as often as required, and you would take fastidious care so that that car remained the car of your dreams forever. Think about what this tells you about your body.

You get only one mind and one body–the same ones you will have at 20, 40, 60, etc.

Take care of them and maximize their potential. It will be too late to take care of your body and mind (and car) later on. You can maintain them, but it is hard or impossible to undo big mistakes or negligence later on. You do not want to end up with a wreck on your hands.

Your main asset in life is yourself.

Treat yourself as a valuable asset. I often explain to students that I would be willing to pay today for a percentage of the future earnings of good students. If you value yourself, and invest in yourself, you will be worth a great deal throughout your lifetime, both to yourself and to your community.

For comments and archives

   Cardiology eMedinewS

Black stroke patients have BP troubles Read More

FDA OKs clot remover Read More

   Pediatric eMedinewS

Young drinking tied to drinking problems later Read More

FDA warns of deaths with postop codeine in children Read More

    IJCP Special

Dr Good Dr Bad

Situation: A heart patient wanted to know if he could meditate under a pyramid.
Dr Bad: You cannot do it.
Dr Good: Go ahead.
Lesson: The effect of meditation under a pyramid as twice as strong as meditating outside the pyramid.

For comments and archives

Make Sure

Situation: A diabetic patient with BP of 130/90 developed acute heart pain.
Reaction: Oh my God! Why was his BP not kept below 120/80.
Lesson: Make sure that all patients with diabetes should have a goal BP of less than 120/80.

For comments and archives

  Quote of the Day (Mr Vivek Kumar)

Most of our troubles are due to poor implementation….wrong priorities and unattainable targets.

  Legal Question of the Day (Dr MC Gupta)

Q. A 15-year-old girl presented with bleeding per vaginum and retained placenta following attempted abortion (whether self- attempt by taking MTP pills; or, abortion attempted by some other unknown doctor). Should the police be informed? Should an MLC be made? Will the answer be different if the age is 18 years?


  1. The police needs to be informed when it appears that there is possibility of crime.
  2. Sexual intercourse with a female less than 15 years of age, even if married, amounts to rape in terms of section 375, IPC.
  3. Sexual intercourse with a female less than 15 years of age is also a crime under the Protection Of Children From Sexual Offences Act, 2012, which was published in the gazette on 20-6-2012 and is likely to be notified shortly.
  4. Self-attempted abortion is a crime under section 312, IPC.
  5. Attempted abortion by a doctor is a crime if the doctor concerned and the place of abortion were not registered under the MTP Act, 1971.
  6. In view of the above, the police should be informed. MLC should be made.
  7. The answer would remain the same if the age is 18 years in view of 4 and 5 above. However, if the adult woman gives in writing that she does not want the police to be informed and if it appears unlikely that a more serious crime like rape has been committed, the doctor may not inform the police and may not make the MLC. But, even though no formal MLC is made, all medical records should be carefully made as if it were an MLC because such cases are likely to result in civil or criminal litigation later and records of treatment may be demanded from the hospital later by the police/court/parties.

For comments and archives

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

Photos of Doctor’s Day Celebration

eMedinewS Apps
  Ophthal Update (Dr S K Verma, Consultant Ophthalmologist, New Delhi)

Journey of Cataract Surgery - From Couching to Femtolaser (Part 1)

Cataract surgery, removal of opaque lens from the eye, in its simplest form is one of the most frequently performed and successful surgery in the world today. Cataract, i.e. clouding of normally transparent crystalline lens of eye due to denaturing of protein of lens, which is suspended in its place by thousands of filamentary strands called zonules, is a result of aging, metabolic changes, injury, radiation, toxic chemicals or drugs. The history of evolution of cataract surgery goes back to at least 4000 years from today. When we look in the past we see many milestones in this history.

  • Couching: Couching for cataract was the earliest procedure at about 2000 BC and was practiced in India, Japan and Tigris/Euphrates area of Babylon (present Iraq). The earliest records are from Susruta in India, The Bible and Dead Sea scrolls. Couching is a technique of dislodging the opaque lens from its place which enables the patients to see better. The vision was, however, still blurred due to unavailability of correcting glasses. Technique is to employ a sharp instrument such as thorn or needle to pierce the eye at limbus and push the opaque lens backward in the vitreous cavity making the pupil clear. Sometimes this technique breaks up lens or lens capsule gaining the access of aqueous humor leading to the absorption of lens material and clear pupil. Couching is still practiced in sub Saharan Africa due to ignorance and lack of modern medical facility and heavy monetary investment.
  • Extracapsular lens extraction: In 1748, Jacques of Paris introduced this surgery in which inner lens contents were removed through an incision at the limbus leaving the lens capsule in its place.
  • Intracapsular lens extraction: Five years later in 1853 Samuel Sharp of London introduced this surgery by using pressure with his thumb on the lower part of eye to remove the entire lens intact with its capsule through an incision. In later days the pressure at the lower limbus and counter pressure behind the upper limbal incision was applied by tiny metal instruments. In 1880 Smith introduced a new technique of intracapsular lens extraction. After upper limbal section and iridectomy with pupil dilated, lower part of the anterior capsule of the lens was grasped by forceps with cupped tips and by some side to side movements, the zonule, by which the lens is suspended from ciliary muscles all around were broken and the lens was taken out through incision. This technique was prevalent in major part of India till 2000 AD and is still practiced in few rural pockets due to high monetary investment in newer techniques.
  • Cryoextraction: In 1961, Krawicz of Poland introduced cryosurgery that removed the lens by freezing and adherence of a small probe on the lens surface and then its removal by pulling the frozen lens through the incision.
  Lab Update (Dr Arpan Gandhi and Dr Navin Dang)

Inorganic phosphorus

Hyperphosphatemia may occur in myeloma, Paget’s disease of bone, osseous metastases, Addison’s disease, leukemia, sarcoidosis, milk–alkali syndrome, vitamin D excess, healing fractures, renal failure, hypoparathyroidism, diabetic ketoacidosis, acromegaly, and malignant hyperpyrexia. Drugs causing serum phosphorous elevation include androgens, furosemide, growth hormone, hydrochlorothiazide, oral contraceptives, parathormone, and phosphates.

    Mind Teaser

Read this…………………

Immediately after cholecystectomy, the nursing action that should assume the highest priority is:

A. Encouraging the client to take adequate deep breaths by mouth
B. Encouraging the client to cough and deep breathe
C. Changing the dressing at least BID
D. Irrigate the T-tube frequently

Yesterday’s Mind Teaser: A man built a rectangular house, each side having a southern view. He spotted a bear. What color was the bear?

Answer for Yesterday’s Mind Teaser: White. Only at the North Pole can all four walls be facing South.

Correct answers received from: Dr. P. C. Das, Dr.K.Raju, Dr Avtar Krishan, Dr. Thakor Hitendrsinh G, y. j. vasavada, DR KANTA JAIN, Dr.(Maj. Gen.) Anil Bairaria,, Dr Pankaj Agarwal, TJ

Answer for 19th August Mind Teaser: Your left hand, forearm or elbow.
Correct answers received from: Dr S. Upadhyaya, Dr roshan rao, Rakesh Goel, Dr. B. B. Aggarwal, Bharat Bhushan Aggarwal,

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Baby Wrap

Part of my job as a public-health nurse is teaching new parents how to care for their infants. As I was demonstrating how to wrap a newborn, a young Asian couple turned to me and said, "You mean we should wrap the baby like an egg roll?"

"Yes," I replied, "That is a good analogy."

"I don't know how to make egg rolls," another mother said anxiously. "Can I wrap my baby like a burrito?

  Medicolegal Update

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

What is Sec 312 of the IPC?

Criminal and legal Abortions

Sec 312 of the IPC, 1860 under the heading "causing miscarriage" says that whoever voluntarily causes a woman with child to miscarry, shall, if such miscarriage be not caused in good faith for saving the life of the woman, be punished with imprisonment of either description of a term which may extend to three years, or with fine, or with both; and, if the woman be quick with the child, shall be punished with imprisonment of either description of a term which may extend to seven years or shall also be liable to fine. Explanation to this section: a woman who causes herself to miscarry, is also punishable thereunder.

  • In Dr. Akhil Kumar v. State of M.P., 1992 LJ 2029(MP), a woman living separately from her husband for 3 to 4 years conceived as a result of illicit intercourse with her distant cousin. When her pregnancy was of 24 weeks she approached a medical practitioner who pushed Menstrogen Forte injection into her which caused her death. The literature of Menstrogen Forte clearly stated that the effect of such injection could be miscarriage. The plea of the accused physician that he had pushed that injection to determine if she was pregnant was not believed because the six month old pregnancy was writ large on her abdomen discernible from outside and the doctor was convicted for attempt to cause miscarriage.
  • The deceased mother of four children, having become pregnant was taken by her son–in–law to a quack for abortion. She was later found dead and was buried. The dead body was exhumed after about 12 days and the quack was prosecuted under Sec. 314 and convicted thereunder on circumstantial evidence. (In Maideen Sab v. State of Karnataka, 1993 Cri LJ 1430 (Kar)

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Diabetic or hypertensive: get your albumin check up done

Microalbuminuria or presence of albumin in the urine in micro amounts is a sign of early kidney damage. This predicts the increase in the risk of major cardio or cerebrovascular events and even death.

Current guidelines advocate annual screening in patients with diabetes and wherever possible in non-diabetic patients with hypertension said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India. Early detection of high-risk patients allows selection of aggressive treatment to slow disease progression.

Antihypertensive agents providing angiotensin II blockade are recommended for the treatment of hypertensive patients with microalbuminuria, regardless of diabetes and/or early or overt nephropathy. Treatment with these drugs provides effective reduction of microalbuminuria and blood pressure, and long-term prevention of CV events beyond blood pressure reduction.

Even very low levels of microalbuminuria strongly correlate with cardiovascular risk. Albumin excretion rates as low as 4.8 µg/min, well below the microalbuminuria thresholds stated in current clinical guidelines, are associated with increased risk of cardiovascular and cerebrovascular disease, independent of the presence of other risk factors.

    Readers Response
  1. Dear sir, Point well made. We should not be doing unnecessary scans. But many times there could not be a decision to scan in black and white and there is ample room for discretion and also involves patents comfort level and choice. But is not this article published in medical humour page of Medscape? I hope this is not being taken as a true case in US by the emedinews readers!!! This sort of law is not there even in the Arab world let alone the developed world. Regards: Suman
    Forthcoming Events
Dr K K Aggarwal

Dr K K Aggarwal

Dr K K Aggarwal

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 public. Event will be promoted through hoardings, our publications and the press. Public health discussions

    eMedinewS Special

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    Our Contributors

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