emedinews
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FIRST NATIONAL eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
  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 (07–08); 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

 

eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

 
  Editorial …

22nd November 2011, Tuesday

Varenicline go ahead in heart patients

In June 2011, the US FDA said that varenicline may increase the risk of adverse cardiovascular events in patients with known cardiovascular disease (1).

This was based on a randomized trial that found a non–statistically significant increase in cardiovascular events in 714 smokers with stable CVD treated with varenicline (2).

Though the rate of cardiovascular mortality was lower and smoking cessation rates were higher in the varenicline group.

A subsequent meta–analysis of 14 randomized placebo–controlled trials of varenicline in 8216 smokers with no or stable CVD found a statistically significant increase in the risk of myocardial ischemia, arrhythmia, heart failure, sudden death, or cardiovascular–related death for the varenicline group (3). Twenty–eight patients with stable CVD would need to be treated with varenicline for one year to cause one additional serious cardiovascular event while 10 patients would need to be treated for one additional patient to quit smoking.

Over long term benefits of smoking cessation will likely outweigh potential short-term harms of varenicline in CVD patients

References

  1. http://www.fda.gov/Drugs/DrugSafety/ucm259161.htm (Accessed on June 16, 2011).
  2. Rigotti NA, Pipe AL, Benowitz NL, et al. Efficacy and safety of varenicline for smoking cessation in patients with cardiovascular disease: a randomized trial. Circulation 2010;121:221.
  3. Singh S, Loke YK, Spangler JG, Furberg CD. Risk of serious adverse cardiovascular events associated with varenicline: a systematic review and meta–analysis. CMAJ 2011;183:1359.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

Varenicline go ahead in heart patients

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011–Medico Masti–An Inter College Health Festival at Perfect Health Mela

Infotainment is a new concept of creating health education where education is inter linked with entertainment.

 
Dr K K Aggarwal
 
    National News

Beat diabetes, vow over

BANGALORE: Escalating the war on diabetes, over 8,000 Bangaloreans braved Sunday morning blues and turned up at the crack of dawn at Kanteerava Stadium to participate in a walkathon to spread awareness about the disorder. Presented by Lifestyle and supported by The Times of India, the second edition of Beat Diabetes Walkathon was the culmination of a 10–day–long campaign during which 23,000 people, including 3,000 policemen and army men, were tested for blood sugar levels. Participants donning blue T–shirts and cutting across all age groups started off from the stadium and went around Cubbon Park before returning to the stadium, where kiosks for checking blood sugar levels had been set up. "In the fight against this lifestyle disease, awareness plays a vital role. Beat Diabetes aims to spread this message and encourage people to embrace healthy eating habits, exercise every day and get regularly tested for the condition," Kabir Lumba, MD, Lifestyle told the walkers. (Source: TOI, Nov 21, 2011)

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

Why we forget things midway

If you forget what you were going to do, or get, or find, after entering a room, then blame your doorways. University of Notre Dame Psychology Professor Gabriel Radvansky has suggested that passing through doorways is the cause of these memory lapses. "Entering or exiting through a doorway serves as an ‘event boundary’ in the mind, which separates episodes of activity and files them away," Radvansky explained. "Recalling the decision or activity that was made in a different room is difficult because it has been compartmentalized," she stated. (Source: Hindustan Times, November 19, 2011)

For comments and archives

FDA approves Eylea for macular degeneration

The FDA has approved a first–in–class drug, aflibercept (Eylea), for "wet" age–related macular degeneration, its manufacturer announced. Aflibercept, also known as VEGF Trap–Eye, is a peptide drug that soaks up vascular endothelial growth factor molecules, which help drive the abnormal growth of retinal blood vessels responsible for wet AMD. The drug includes fragments of human IgG and the VEGF receptor protein and scavenges placental growth factor as well as VEGF. (Source: Medpage Today)

For comments and archives

AHA: Exercise, stents best for claudication

Compared with usual care for moderate to severe claudication, walking improved most with supervised exercise, but stenting won more quality–of–life points, researchers from the CLEVER trial found. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: The greatest remedy for anger is delay. ~ Seneca

@DeepakChopra: The world is as we are. What we see we become. Choose your seeing wisely.

 
    Spiritual Update

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

Why is Gayatri Mantra one of the Main Mantras in any Pooja?

Any activity should always engage the 3 H model – of Heart, Head, and the Hand. The same has been advocated by the western scholars of today. The concept means that while doing any work one should ask the head for choices and then refer these choices to the heart to choose one and finally order the hands to do the action.

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

Selfishness

A Sufi mystic lived in a wild and dangerous dark forest in a very small hut along with his wife. It was a very thick forest with spooky noises. One day there was torrential rain throughout the day, which continued in the night also. In the middle of the night somebody knocked at the door. The wife was sleeping near the door. There was not much space inside, just enough for two persons to sleep.

The husband said, "The night is dark, the forest has many wild animals. Somebody might have lost his way. Open the door. He certainly needs refuge." "But there is no space inside our hut, only for two of us to sleep" retorted his wife. Laughing over it, the mystic said, "It is not a palace of a king, however big the palace may be, it is always smaller than a poor mystic’s hut. If two can sleep, three can sit perfectly well. We will sit, talk and tell stories, and sing songs. It is a beautiful night. Even the rain is creating certain music. Open the door!"

When the wife opened the door, there entered a visitor drenched with water and said, "I am sorry to disturb you. I got lost, and there is no light except in this hut. I know it is small, but there was no other way. Outside life is full of danger as the wild animals are roaming everywhere." The mystic heartily said, "No problem, two can sleep, three can sit. You are welcome. We will know many things from you about the world; and we will offer you our songs, and the night will pass this way. Please close the doors and be at ease. You have graced us; you have given us a chance to welcome a guest; you have made us richer."

All of them sat together, while the mystic sang a melodious song. Just then there was again a knock at the door. The mystic said, "You are close to the door, please open it. Somebody needs refuge." But the man, who was asking for refuge just a few minutes before, became angry. He said, "What do you mean? There is no space."
The mystic replied, "It is not a palace of a king, which is always short of space. It is a small hut of a mystic. We three can sit comfortably, but four will have to sit a little tight, more close to each other. And it is really a joy to feel each other’s warmth and love, and anyhow the cold night is almost half way through. So you open the doors! And remember, a few minutes before you were in the same position."

Now as there was no alternative left, the man opened the door. Another man who had lost his way in the forest said, "Excuse me, I am absolutely helpless; otherwise I would not have given you trouble. I can see that such a small space is already overcrowded."
The mystic said, "No problem. We will sit a little close to each other. The gaps between the three can be adjusted to accommodate the four. You are welcome. Sit down and close the door." Now the hut was completely packed. The mystic started singing another song, while there was another knock on the door, this time it was a different one.

Everyone was shocked. They now knew very well that whoever was outside the hut would be accommodated by the mystic. "Open the door," said the mystic, "he is one of my friends, a wild donkey." All the guests and the wife were irritated as they said, "This is beyond tolerance. Do you want to bring in a donkey in this place where there is no space left even for sitting comfortably?"

The mystic said, "How many times do I have to remind you that this is a poor mystic’s hut. There is always space. One has just to find it. Now we are sitting; it’s just a matter of time that the last quarter of this night will also pass. Soon there will be sunrise, open the door!" The last man who came in was nearest to the door, reluctantly opened it, and a donkey drenched with water entered.

The mystic said, "Remember perfectly well – you were in the same state just a few minutes before."

Selfishness blinds you of other’s needs!

For comments and archives

 
   Cardiology eMedinewS

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

CSI News

Catheter Induced Pseudoaneurysm of Femoral Artery–Detection and Treatment

For comments and archives

BMV safe in Juvenile mitral stenosis

For comments and archives

40% of patients with AMI develop AF in 2 years

For comments and archives

AHA Update: Low vitamin D linked to heart disease in children

For comments and archives

AHA Update: Early surgery for endocarditis

 
    Fitness Update

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

Exercise frequency and intensity matters when it comes to diabetes prevention

Physical activity is considered by medical experts to be a key factor for the prevention and treatment of type 2 diabetes. However, research has not yet clarified how much exercise is needed to have an effect, or whether the effect on insulin resistance is dose–dependent, meaning that an increase in the amount of exercise performed would equal to an improvement in insulin resistance. Researchers from the University of Pittsburgh set out to investigate whether exercise – and at which dose – would help prevent type 2 diabetes and improve outcomes.

For their study, which was published in the journal Medicine & Science in Sports & Exercise, researchers recruited 55 healthy volunteers. These volunteers participated in a 16–week supervised endurance exercise program with screenings before and after the intervention. Insulin sensitivity, peak oxygen uptake and body composition were all assessed using laboratory methods. The exercise program involved 3 to 5 sessions per week, and sessions lasted 45 minutes. The researchers were able to measure exercise dose by calculating the average energy (calories) expended per week. They also measured exercise intensity, duration and frequency. The results clearly showed that exercise improved insulin sensitivity, and there was a significant dose response relationship. Thus, more frequent and intense exercise sessions led to improved insulin sensitivity. Those who did not exercise as frequently or as intensely did reduce their risk of developing type 2 diabetes, but to a lesser degree.

For comments and archives

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    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Should Old Patients Drive?

Despite a moderate decline in mental, motor, optic and auditory functions with ageing, most older people drive safely.

 
    Medicine Update

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

Clinical Presentation

The diagnosis of GERD is often made clinically based on the bothersome symptoms or signs that may be associated with GER symptom descriptions are unreliable in infants and children younger than 8 to 12 years of age, and many of the purported symptoms of GERD in infants and children are nonspecific. There is a continuum between GER and GERD with no cutoff separation between the physiological reflux (GER) and pathological reflux (GERD). A third type of GER exists which is the Secondary to pyloric stenosis, neurological impairment, nasogastric tubes, and food allergy.

For comments and archives

 
    Legal Question of the Day

(Dr M C Gupta)

What are your comments regarding the non–participation of AIIMS in the NEET and the demand of several states that the examination should be held in Indian languages also?

  1. Many States are not ready, for various reasons, to participate in the all–India NEET (National Entrance–cum–Eligibility Test) for MBBS Admission scheduled for 13 May 2012.
    • Tamil Nadu and Andhra Pradesh have already taken stay from the High Court.
    • Maharashtra has moved the SC.
    • Gujarat and West Bengal and Karnataka want NEET in vernacular languages also.
    • AIIMS refuses to participate in NEET (UG) for MBBS admission.
  2. It is arrogant and unjustified on the part of AIIMS to keep out of the NEET. It is my alma mater and I spent 18 years on its faculty. However, one needs to call a spade a spade.
  3. There is nothing wrong in demanding that students should be able to take the examination in Indian languages. If the All India Public Services examination can be held in various languages by the UPSC, there is no reason why NEET cannot be similarly held. In fact, it is the need of the day. Why should those not proficient in English be denied the opportunity and legitimate right to take the exam in the language of their choice?

For comments and archives

 
    IJCP Special

Dr Good Dr Bad

Situation: A 32–year–old man with sustained fever of 102°F for 2 weeks with no apparent diagnosis after 3 days of diagnostic studies is hospitalized.
Dr Bad: Manage him as a case of PUO.
Dr Good: Investigate further. Don’t diagnose PUO yet.
Lesson: Pyrexia of unknown origin (PUO) is said to occur in patients with sustained fever of 101°F or more for 3 weeks in whom the diagnosis is not apparent after one week of diagnostic studies.

For comments and archives

Make Sure

Situation: A patient on amlodipine developed severe gum hypertrophy.
Reaction: Oh my God! Why was amlodipine not stopped.
Lesson: Make sure that all patients on amlodipine are watched for gum hypertrophy as its side effect.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

Of all forms of caution, caution in love is perhaps the most fatal to true happiness. Bertrand Russell

 
    Mind Teaser

Read this…………………

What is the management of choledochal cyst adherent to portal vein?

a) Excision and Roux en Y hepaticojejunostomy
b) Internal drainage into Roux en Y jejunal limb
c) Hepatic lobectomy
d) The internal lining of the cyst can be excised, leaving the external portion of the cyst wall intact.

Yesterday’s Mind Teaser: T M
                                      A U
                                      H S
                                      W T

Answer for Yesterday’s Mind Teaser: What comes up must come down

Correct answers received from: Rajiv Kohli, Dr Anupam Sethi Malhotra, Anil Bairaria, Bina Sawhney, Dr Rakesh Bhasin, Dr Rajshree Aggarwal, yogindra vasavada, Dr Chandresh Jardosh, Raju Kuppusamy, Muthumperumal Thirumalpillai, Dr NeelamNath.

Answer for 20th November Mind Teaser: b. 311 nm
Correct answers received from: Dr PC Das, Dr Sukla Das, Dr KV Sarma, Dr HL Kapoor, yogindra vasavada, Dr Thakor Hitendrasinh G, Dr Alexander Daniel Sunad, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Raju Kuppusamy, Dr Jainendra Upadhyay, Anil Bairaria.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Too drunk

A police officer pulls over this guy who had been weaving in and out of the lanes. He goes up to the guy’s window and says "Sir, I need you to blow into this breathalyzer tube."

The man says, "Sorry officer I can’t do that. I am an asthmatic. If I do that I’ll have a really bad asthma attack."

"Okay, fine. I need you to come down to the station to give a blood sample."

"I can’t do that either, I am a hemophiliac. If I do that, I’ll bleed to death."

"Well, then we need a urine sample."

"I’m sorry officer I can’t do that either. I am also a diabetic. If I do that I’ll get really low blood sugar."

"Alright then I need you to come out here and walk this white line."
"I can’t do that, officer."

"Why not?"
"Because I’m too drunk to do that.

 
  Medicolegal Update

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

Embalming

  • Embalming is the process of chemically treating a dead body, developed by the ancient Egyptians, to preserve a person’s body after death.
  • Embalming delays decomposition of the body, restores it to an acceptable physical appearance and reduces presence and growth of bacteria to prevent foul smell and adds fragrance to the corpse.
  • Embalming is done by injecting chemicals directly into the bloodstream, chest cavity and abdominal cavity to preserve the corpse’s appearance.
  • The most commonly used chemicals for embalming are formaldehyde and ethanol. A combination of these two chemicals is sufficient to preserve the body for a short time i.e. up to a week.
  • To keep the corpse in good condition for a longer period i.e. up to a month, a solution made up almost entirely of formaldehyde is used.
  • There are several steps involved in modern embalming. First, the embalming fluid is injected directly into the deceased’s blood vessels, and pushed through the body with a mechanical pump. Next, the internal organs are hollowed of their contents and filled with embalming fluid. The chemicals are then injected beneath the skin wherever necessary, followed by a final surface embalming on injured areas of the body.
  • Embalming certificate is required by law in certain circumstances like air/rail transportation.

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)

Carotid neck ultrasound the only way to check regression of heart blockages

In people with type 2 diabetes, intensive drug therapy can significantly lower bad LDL cholesterol and reduce the thickness of the neck carotid arteries supplying oxygen to the brain, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

He was interacting with the public at the Heart Care Foundation of India stall in the Ministry of Health and Family Welfare pavilion at the IITF, Pragati Maidan.

Quoting a study published in Journal of the American College of Cardiology, Dr Aggarwal said that every effort should be made to bring down the bad LDL cholesterol to less than 80mg/dL.

The Stop Atherosclerosis in Native Diabetics Study (SANDS) trial tested the value of aggressively lowering bad LDL cholesterol to 70 mg/dL or lower, and non HDL cholesterol to 100 mg/dL.

The standard treatment group had standard goals (100 mg/dL for LDL and less than 130 mg/dL for non HDL Cholesterol).

The study involved 427 type 2 diabetic Native Americans who were aged 40 or older and who had no history of heart attack or other heart–related event. There were 204 people in the standard treatment group and 223 in the aggressive treatment group. Ultrasound tests showed that neck artery thickness got worse, or progressed, in the standard treatment group and regressed in the aggressive treatment groups.

The test called intima media thickness of the carotids is the only cost–effective test to know whether or not the heart blockages are shrinking or progressing as the thickening in carotids goes hand in hand with the thickening in the heart arteries.

For comments and archives

 
    Readers Response
  1. Excellent effort and real hard work, informations are very useful for all concerned. Keep it up.... D.P.Shrivastav. Indore
 
    Forthcoming Events

CSI 2011

63rd Annual Conference of the Cardiological Society of India

Date: December 8–11, 2011.
Venue: NCPA Complex, Nariman Point, Mumbai 400021

Organizing Committee

B. K. Goyal – Patron
Samuel Mathew – President CSI
Ashok Seth – President Elect & Chairman Scientific Committee
Lekha Adik Pathak – Chairperson
Satish Vaidya & C. V. Vanjani – Vice Chairman
N. O. Bansal – Organizing Secretary
B. R. Bansode – Treasurer
Ajit Desai , Ajay Mahajan , G. P. Ratnaparkhi – Jt. Org. Secretaries
Shantanu Deshpande , Sushil Kumbhat , Haresh Mehta – Asst. Org. Secretaries
D. B. Pahlajani, A. B. Mehta , M. J. Gandhi , G. S. Sainani, Sushil Munsi, GB Parulkar, KR Shetty – Advisory Committee

Contact: Dr. Lekha Adik Pathak, Chairperson, CSI 2011; Dr. Narender O. Bansal, Org. Secretary, CSI 2011 Tel: 91 – 22 – 2649 0261/2649 4946, Fax: 91 – 22 – 2640 5920/2649 4946.
Email: csi2011@ymail.com, csimumbai2011@gmail.com Website: www.csi2011mumbai.com

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews "Doctor of the Year Award" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.com

 
    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

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  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

 
    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