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eMedinewS is now available online on www.emedinews.in or www.emedinews.org
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 ...

21st September 2010, Tuesday

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

Calcium supplements may increase cardiovascular risk

Calcium supplements may increase risk for cardiovascular events in patients with or at risk for osteoporosis. A meta–analysis of randomized, placebo–controlled trials published in the BMJ in July this year looked at use of calcium supplements of over 500 mg/d in patients older than age 40. Trials that examined calcium supplementation plus vitamin D were excluded. Primary end points were time to first myocardial infarction (MI), first stroke, and first composite end point event (MI, stroke or sudden death). All–cause mortality was the secondary end point. The meta–analysis included 15 trials involving more than 12,000 patients. Five trials had patient–level data and 11 had trial–level data. In the patient–level data, the hazard ratio for MI was 1.31 for patients who took calcium versus those who took placebo, and incidence of stroke, the composite end point, and all–cause mortality saw nonsignificant increases in this group. In the trial–level data, the pooled relative risk for MI associated with calcium supplementation was 1.27.

  • The results cannot be generalized to include calcium supplementation plus vitamin D
  • Calcium supplements are associated with an increased MI risk that could translate to a substantial disease burden, given their widespread use.
  • The role of calcium supplements in osteoporosis management should be reassessed
  • Benefit of calcium supplements are not definitively proven
  • Any risk associated with their use is not warranted.

Patients with osteoporosis should generally not be treated with calcium supplements, either alone or combined with vitamin D, unless they are also receiving an effective treatment for osteoporosis for a recognized indication.

Dr KK Aggarwal
Editor in Chief
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  Photo Feature (from the Net)

Weird X- rays

X-ray is one of the most useful medical advancements in history. But as these images show they can also reveal some of the most gruesome and bizarre results. This X-ray shows an object (safety pin) lodged in the esophagus of a woman.

(Contributed by Dr Mukul Tiwai)

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

MMR vaccine

Monovalent vaccines are no longer available in the United States for measles, mumps or rubella. (AAP News 2009;30:9)

  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. 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.

Govt panel wants more medical seats

The seven-member committee that replaced the Medical Council of India has recommended far-reaching reforms, including a hundred extra seats in every medical college, raising teachers' retirement age and easing land requirement norms for campuses and hostels. The recommendations are aimed at addressing the acute shortage of doctors in the country — 7.5 lakh according to one estimate. Most medical colleges have at present about 150 seats and the proposal envisages increasing the number to 250. The committee, headed by Dr S K Sarin, met in Delhi on Saturday and also recommended doing away with the mandatory 25-acre land requirement to start a medical college. The committee also decided to reduce the mandatory number of beds from 1,500 to 900 for a teaching hospital with 250 students. (Source: The Times of India)

India’s first mathematics centre will come up at IIT–Bombay

Two premier research institutes from the country – the Indian Institute of Technology, Bombay (IIT–B) and Tata Institute of Fundamental Research (TIFR) — have come together to set up the India’s first mathematics centre. Located in the IIT–B campus, the National Centre for Mathematics will be modelled on the world’s first mathematics centre — the Oberwolfach Mathematics Research Institute in Germany. (Source: The Hindustan Times)

  International News

(Dr Monica and Brahm vasudev)

Anemia drugs may endanger some kidney patients

A team of international researchers has reported in the Sept. 16 issue of the New England Journal of Medicine that patients who showed the worst response to erythropoiesis–stimulating agents (ESAs) had a 31% rise in the risk of cardiovascular complications and a 41% increased risk of death.

Experimental drug shows promise for bone marrow disorder

INCB018424, an experimental oral drug has given encouraging results in patients with myelofibrosis, a bone marrow disorder. The patients reported some relief from symptoms, inflammation with the drug. The study findings are reported in the Sept. 16 issue of the New England Journal of Medicine.

Even very low dose of regular aspirin wards off bowel cancer: Study

Even the lowest possible dose of aspirin (75 mg) can keep bowel cancer at bay, if taken regularly, reports a study published online in the journal Gut.

Mild memory loss is not a part of normal aging

Researchers at the Rush Alzheimer’s Disease Center state that just advancing in years is not the cause of mild memory lapses often called senior moments. The study observed that even the very early mild changes in memory that are much more common in old age than dementia are caused by the same brain lesions associated with Alzheimer’s disease and other dementias. The study is published in the September 15, 2010, online issue of Neurology.

  Nutrition Update

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

Complimentary feeding practices between 6 and 24 months

  • Seek appropriate health care for fever, diarrhea, respiratory infections, malaria, hookworm, and other infections.
  • Encourage children’s psycho–social development by providing them with opportunities for exploration and autonomy.
  • Ensure adequate maternal nutrition and micronutrient status to improve women’s health and support optimal breastfeeding.
  • Give mothers a high–dose vitamin A supplement (200,000 IU) immediately after delivery or within 8 weeks post-partum in areas where vitamin A deficiency occurs.
  • Practice family planning that does not interfere with breastfeeding to space children and allow for maternal recuperation.
  • Use condoms, consistently and correctly, to prevent transmission of HIV.


  1. Brown KH, Dewey KG, Allen LH. Complementary Feeding of Young Children in Developing Countries: A Review Of Current Scientific Knowledge. WHO/ UNICEF, 1998.
  2. Dewey KG. Guiding principles for complementary feeding of the breastfed child. PAHO/ WHO, 2003.
  3. WHO. Complementary feeding: family foods for breastfed children. Geneva: World Health Organization, 2000
  Infertility Update

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

How do I know if I am a candidate for IVF or ICSI?

IVF is indicated for blocked tubes and failure of conventional infertility treatment. ICSI is indicated for poor sperm count or function or failure of fertilization in previous IVF.

What is a typical IVF calendar?

The sequence of events depends on the treatment protocol that has been planned for you. Usually OPD–based injections are started on Day 20 of previous menses, further gonadotrophins with follicular monitoring and blood tests start from 2nd day of menses for about 10 days. You may need daycare admission for oocyte retrieval as you will be administered anesthesia. Two days later you will come back for Embryo transfer which is an OPD USG–guided procedure. In a different protocol, stimulation starts from Day 2/3 of period and collection is done around day 15 after 10–12 days of stimulation.

  Neurology Update: Question of the Day

What are the accepted evidence–based guidelines for pharmacological treatment of migraine headache in children and adolescents?

The practice parameter recommends that for children over 6 years, ibuprofen is effective and acetaminophen is probably effective and either can be considered for the acute treatment of migraine.For adolescents above 12 years of age, sumatriptan nasal spray is effective and should be considered for the acute treatment of migraine. For preventive therapy, flunarizine is probably effective and can be considered. There is insufficient or conflicting data regarding other drugs so no other recommendations can be made for the preventive therapy of migraine in children and adolescents.

(Reference: Lewis D, et al. Practice parameter: pharmacological treatment of migraine headache in children and adolescents: report of theAmerican Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society. Neurology 2004;63(12):2215–24).

  Medicolegal Update

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

What is Poison Information Center?

There are poisons centers in India and many countries, which give advice about the treatment and prevention of poisoning. They also disseminate information about medicines, pesticides, poisonous plants, venomous animals, and household products, and chemicals used at work. The doctor at the center can tell you what to do when someone has swallowed or breathed in a chemical, spilt it on the skin, or splashed it in the eyes. Most poisons centers can be contacted at any time of day or night by telephone or, in some countries, by radio. They may have supplies of special antidotes. In India, the National Poison Information Center (NPIC) is at AIIMS, New Delhi. The NPIC was set up in the Dept. of Pharmacology at AIIMS in 1995. The NPIC functions round–the–clock, 365 days in year and provides information on various poisonings and treatment protocols on telephone, Fax, e–mail and in person. It has a back–up of latest literature on poisonings due to a variety of products viz. household items, agricultural and industrial chemicals, drugs, environmental toxins including plants, animal bites and stings and other miscellaneous products. The data received by Centre is compiled and analyzed for knowing the trend.

National Poisons Information Centre
AIIMS, New Delhi
Ph No: 26589391, 26593677
Email: npicaiims@hotmail.com

  Medi Finance Update

Gift Tax

Direct cross gifts are not allowed, but indirect cross gifts are advisable and a better option, for e.g. Dr X can give gift to Dr Y’s wife and Dr Y’s father can give to Dr X’s wife. Gift can be given to major children, father and mother.

  Drug Update

Drugs prohibited for manufacture, sale and distribution from subsequent date

Drug Formulation

Effective date




GSR 191(E)

  Lab Update

Prostate specific antigen (PSA)

Some experts recommend doubling the measured PSA value before interpreting the result for patients on finasteride. Longitudinal results from the Prostate Cancer Prevention Trial suggest that PSA values be corrected by a factor of 2 for the first two years of finasteride therapy, and by 2.5 for longer term use.

  IJCP Special

Dr Good Dr Bad

Situation: An infant was found to have high blood sugar.
Dr Bad: He can’t have diabetes.
Dr Good: This can be diabetes.
Lesson: Diabetes can occur in infants as well as older children.

Make Sure

Situation: During evening round in a renal unit, a doctor comes across a patient complaining of headache.
Reaction: Give him a tablet of Nimesulide.
Lesson: Make sure to remember that nimesulide, a selective COX–2 antagonist has minimal potential for renal toxicity.

Quote of the Day

"My life is an indivisible whole, and all my attitudes run into one another; and they all have their rise in my insatiable love for mankind." Mohandas K. Gandhi

Hypertension Alert

Lifestyle modifications

  • A 1,600 mg sodium DASH eating plan has effects similar to single drug therapy. Combinations of two (or more) lifestyle modifications can achieve even better results.
  • One should maintain normal body weight. A reduction of 5–20 mmHg of BP can be achieved for every 10 kg weight loss.
  Mind Teaser

Read this…………………

13579 AZ

The answer for yesterday’s Mind Teaser: "Big fish in a little pond".

Correct answers received from: Dr. Suman Kumar Sinha, Dr. ANJANI KUMAR, Dr Muthumperumal Thirumalpillai, Dr. R.K .Goel,   Dr Kalpana Mohan, Dr Chandresh Jardosh, Dr.K.Raju, CMA Sudhir Sharma, Dr Rawat Purushottam Singh, Dr Jayashree B Keshav, In Charge - Scientific Publications, The Himalaya Drug Company, "Dr. Rajiv Dhir, Dr Virender Prakash Gautam, Dr. Rohini, Dr Sudha nayyar, Dr Nilesh Kale, Dr Rohini, DR. Nagendra Gupta, Dr.Susheela Gupta, Dr Meera Rekhari , Dr.A.K.Saxena, Dr Mukesh Bhandari, Dr.K.P.Rajalakshmi, Dr.Satish Gunawant, Dr Prabha Sanghi, Dr Anupam Sethi Malhotra

Answer for 19th Sept Mind Teaser is: “An eye for an eye”.

Correct answers received from: Dr S. Upadhyaya, Dr Rajeev Sethi, Dr Parvesh Sablok, Dr.K.V.Sarma, Dr Rashmi Chhibber, Dr R Raju, Dr. Rohini Dhillon, Dr Jayashree B Keshav, In Charge - Scientific Publications, The Himalaya Drug Company, Dr Suparna Khera

Correct Answer received for 15th September Mind Teaser from: Dr.Satish Gunawant

Send your answer to ijcp12@gmail.com

  Humor Section

How to stop people from bugging you about getting married

Old aunts used to come up to me at weddings, poking me in the ribs and cackling, telling me, ‘You’re next.’ They stopped after I started doing the same thing to them at funerals.
(Contributed by Dr Dewat Ram Nakipuria)

Important laws which the great Newton forgot to state......

Law of Mechanical Repair
After your hands become coated with grease, your nose will begin to itch.
(Contributed by Dr. Chandresh Jardosh)

  An Inspirational Story

Discouragement – A Tool of the Devil

Once upon a time it was announced that the devil was going out of business and would sell all his equipment to those who were willing to pay the price.

On the big day of the sale, all his tools were attractively displayed. There were Envy, Jealousy, Hatred, Malice, Deceit, Sensuality, Pride, Idolatry, and other implements of evil display. Each of the tools was marked with its own price tag.

Over in the corner by itself was a harmless looking, wedge–shaped tool very much worn, but still it bore a higher price than any of the others. Someone asked the devil what it was, and he answered,"That is Discouragement." The next question came quickly,"And why is it priced so high even though it is plain to see that it is worn more than these others?"

Because replied the devil,"It is more useful to me than all these others. I can pry open and get into a man’s heart with that when I cannot get near him with any other too Once I get inside, I can use him in whatever way suits me best. It is worn well because I use it on everybody I can, and few people even know it belongs to me."

This tool was priced so high that no one could buy it, and to this day it has never been sold. It still belongs to the devil, and he still uses it on mankind.

  Readers Responses
  1. Its  pathetic to see dependence and underconfidence of medical fraternity. Why it has to copy some bar council in mending its members? The primary job of MCI itself is medical education and the standardization. It's true that all colleges have their own methods or system, not every college is AIIMS or KGMC and cannot be. But then in the name of uniformity which offlate politicians have got the habit of applying it superflously how and why anyone thinks that an LLB course is even close to an MBBS? MBBS is a professional course with much wider standard or difficulty level. After doing MBBS if its under norms of MCI an individual is deemed capable of patient care, how many exams they want to impose and why only for doctors, it's populist game played for no reason.
    I believe medical field has got lot many things missing, the codes, the hierarchy, the integrity, the self confidance and the sacrifice that's why they are easily trapped by fleshmongers. Its us who have to think of where we are lacking in our education and it's indeed teaching only. similarly the over reaction and reflexive response of medical fraternity towards gift. receiving gifts is one thing and giving a compromised services to the patients is another. It can be unrelated and medical communiity has to stick to its values. Although we all know ultimately everyone falls in this ditch and falls even further, but he control has to be ensured by the medical fraternity time to time keeping one hosp\college in target. Don't let media create hoopla on baseless isues and ultimately bring down the dignity at parallel with anything else in this country where they can just blabber out.
    Dr Shailesh Gupta
    IMS, BHU. Asst Prof Department of Physiology, Clinical neurophysiology & Sleep studies
    Lifestyle Clinic, Sports medicine
    Banaras Hindu University, Varanasi, India 221005
  2. Reading the news of "1st Indian Website on Kidney disease in Hindi" transported me back to old times when everything was read and written in Hindi. I am quite excited to see this website working successfully, when languages have gone under a sea change. In addition, I would also like to request you to carry out one special section on Nephrology similar to Cardiology Update, Infertility Update. Dr G M Singh.
  Public Forum

(Press Release for use by the newspapers)

Grapes can lower blood pressure, so can green tea, cocoa, tomatoes, almonds and walnuts

Grapes have been shown to lower blood pressure and improve heart function in lab rats fed an otherwise salty diet, as per a U.S. report published in the Journal of Gerontology said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India, BSNL Dil Ka Darbar & MTNL Perfect Health Mela. Grapes have a direct impact on cardiovascular risk, beyond the simple blood pressure–lowering impact known from a diet rich in fruits and vegetables.

In the study some of the rats ate a diet containing a powder from red, green and purple table grapes and a high–salt diet. After 18 weeks, the rats that ate the grape–enriched diet had lower blood pressure, better heart function, reduced inflammation throughout their bodies, and fewer signs of heart muscle damage than rats that ate a salty diet but no grapes. Flavonoids, found in grapes, green tea, cocoa and tomatoes, could have an effect on blood pressure. Flavonoids have been shown in other studies to have heart–health benefits.

Studies on chocolate, almond and walnut have shown similar heart benefits, including reducing inflammation in blood vessels and lowering the risk of heart attacks and stroke.

Grape powder comprised about three percent of the rats’ diet. For humans, that would be about nine servings of grapes a day. One serving is about 15 grapes. (135 grapes)

  Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

26th September: Sunday–BSNL Dil ka Darbar A daylong interaction with top cardiologists of the city. 8 AM  5 PM at MAMC Auditorium, Delhi Gate.

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi 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, 2010, at Dr. Shroff’s Eye & ENT Hospital, New Delhi.
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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