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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 (07–08); 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 …

22nd January, 2011, Saturday                                eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

FDA Warns of Suicide Risk for Tramadol

The US FDA has added a warning of suicide risk to the labels of tramadol hydrochloride and tramadol hydrochloride/paracetamol. The revised labels instruct

  • Not to prescribe tramadol to who are suicidal or addiction–prone
  • Exercise caution in prescribing to those who consume alcohol excessively, suffer from emotional disturbance or depression, or take tranquilizers or antidepressants.
  • Tramadol–related deaths have occurred in patients with previous histories of emotional disturbances or suicidal ideation or attempts as well as histories of misuse of tranquilizers, alcohol, or other (central nervous system–active) drugs.
  • Tramadol, an opioid, can intensify the effects of other opioids as well as alcohol and illicit drugs that depress the central nervous system.
  • People with addiction disorders may seek out tramadol and cited the risk of criminal diversion.

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
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  eMedinewS Audio PostCard

 2nd eMedinewS revisiting 2010

Revisiting the year 2010 with Dr KK Aggarwal "Botulinum toxin for watering of eyes"


Audio PostCard
  SMS of the Day

(By Dr GM Singh)

"Man may dismiss compassion from his heart, but God never will."

William Cowper

    Photo Feature (from the HCFI Photo Gallery)

2nd eMedinewS Revisiting 2010

Dr Ajay Kriplani talks on "Newer Advances in Obesity Surgery" in 2nd eMedinewS Revisiting 2010 at Maulana Azad Medical College on 9th January 2011.

    National News

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

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

FSSAI guidelines for healthy food in midday meal on anvil

With several incidents of food poisoning due to sub–standard midday meals served to students coming to the fore and in view of school cafeterias selling junk food, the Food Safety and Standards Authority of India (FSSAI) is in the process of framing a set of guidelines to ensure standard norms for nutritious diet to all. The proposed guidelines will be based on scientific parameters and reliable survey data on the food habits of schoolchildren, besides food handling and hygienic practices in school kitchens.

The move follows the premier food watch body's concern at the quality of food presently being served to the students under the midday meal schemes and the sale of junk food like greasy pizzas and French fries being sold in the cafeterias of the schools, especially the private ones. "The need for healthy food for the students is being increasingly felt in view of various studies, which have shown that children who eat nutritious food report better standardised test scores, better behavior and are less hyperactive than children eating unhygienic or junk food," a senior official from FSSAI told The Pioneer. (Source: January 19, 2011)

    International News

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

Incidence of coronary heart disease is 150% lower among women who exercise as compared to women who don’t

The important Nurse’s Health Study collected data on 88,393 women aged 34–59, who were monitored for 20 years. Those who exercised regularly more than 3.5 hours per week enjoyed enormous benefits in reduced heart disease risk compared to women who did not exercise at all.

(Dr Monica and Brahm Vasudev)

Celiac Patients Can Eat Hydrolyzed Wheat Flour, Study Finds

Baked goods made from hydrolyzed wheat flour are not toxic to celiac disease patients, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.

Novel Antibiotic Combinations Fight Resistance Genes

The combination the antibiotic ceftazidime plus the compound NXL104 is active against bacterial pathogens containing genes that confer resistance to multiple carbapenems, according to two papers published in the January 2011 issue of the journal Antimicrobial Agents and Chemotherapy.

Possible New Treatment for Severe 2009 H1N1 Infection

Convalescent plasma therapy –– using plasma from patients who have recovered from an infection to treat those with the same infection –– has been used to treat multiple diseases. However, the efficacy of this treatment in patients with severe 2009 H1N1 influenza is unknown. A study published in the February 15 issue of Clinical Infectious Diseases suggests that convalescent plasma may reduce the death rate in patients severely ill with this type of influenza.

Eating More Fruit and Vegetables Is Linked to a Lower Risk of Dying from Ischemic Heart Disease

A European study investigating the links between diet and disease has found that people who consume more fruit and vegetables have a lower risk of dying from ischaemic heart disease –– the most common form of heart disease and one of the leading causes of death in Europe. However, the authors point out that a higher fruit and vegetable intake occurs among people with other healthy eating habits and lifestyles, and that these factors could also be associated with the lower risk of dying from IHD. The study is published online on January 19 in the European Heart Journal.

    Infertility Update

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

What is intracytoplasmic sperm injection?

ICSI has revolutionized the treatment and improved the prognosis for fertility of men with very severe oligospermia, asthenospermia (low sperm motility), teratospermia (a higher rate of abnormal sperm morphology), and even azoospermia. This technique involves the direct injection of a single spermatozoon into the cytoplasm of a human oocyte, usually obtained from follicles produced under controlled ovarian hyperstimulation. This technique has also been successful in men with nonmosaic Klinefelter syndrome where spermatozoa are obtained from testicular biopsies.

For queries contact: banerjee.kaberi@gmail.com

    Pediatrics Update

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

What is the prevalance of chronic hepatitis B in India?

In the meta–analysis of hepatitis B prevalence studies in India, the point prevalence among nontribal populations is 2.4% (corresponding to a chronic carrier rate of 1.9%) and the point prevalence among tribal populations is 15.8%. These figures may be useful in estimation of the burden of the disease in the country and for projecting the cost-benefits of immunization.

    Medicolegal Update

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

Contravention of PNDT Act may lead to Imprisonment up to 3 years

  • The name of the registered medical practitioner who has been convicted by the court under sub–section (1), shall be reported by the Appropriate Authority to the respective State Medical Council for taking necessary action including the removal of his name from the register of the Council for a period of two years for the first offence and permanently for the subsequent offence.
  • Any person who seeks the aid of a genetic counseling center or genetic laboratory or genetic clinic or of a medical geneticist, medical gynecologist or registered medical practitioner for conducting pre–natal diagnostic techniques on any pregnant woman (including the woman unless she was compelled to undergo such diagnostic technique) for purposes other than those specified in clause(2) of section 4, shall be punishable with imprisonment for a term which may extend to 3years and with a fine which may extend up to ten thousand rupees and on any subsequent conviction with imprisonment which may extend to five years and with fine which may extend up to fifty thousand rupees.
    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Q. Is a gynecologist, who has undergone USG training at a FOGSI accredited center, legally competent to perform USG at her clinic for infertility treatment?


  • In terms of Rule 3 (3) (1) (b) of the PC & PNDT Rules, 1996, the person performing the US examination should be "A sonologist, Imaging specialist, Radiologist, or Registered Medical Practitioner having postgraduate degree or diploma or six months training or one year experience in sonography or image scanning".
  • As per MCI, "Ultrasonography can be undertaken by a specialist who possesses postgraduate qualification in the specialty of Radio–Diagnosis. However, specialist doctor in their speciality can also undertake Ultrasonography for the purpose of certification subject to the condition that he/she has undergone orientation training in the ultrasonography in the department of Radio–diagnosis in a recognized medical institution under recognized medical teacher for a minimum period of 6 months wherein he has not only observed the procedure of Ultrasonography but also has undergone hands on training to enable him to practice in the field of Ultrasonography for the diagnostic purposes pertaining to his/her speciality." (MCI Executive Committee dated 27.4.2009).
  • The combined effect of the two provisions above is as follows:
    a. "A postgraduate qualification in radiology" entitles one to perform sonography both for the purpose of the PNDT Act or otherwise. (Note - With regard to the preamble of the PNDT Act, performing USG for the purpose of the PNDT Act would mean performing USG in women in relation to conception).
    b. "Six months training or one year experience in sonography or image scanning" entitles one to perform sonography for the purpose of the PNDT Act.
    c. "Orientation training in ultrasonography in the department of Radio-diagnosis in a recognized medical institution under recognized medical teacher for a minimum period of 6 months (wherein he has not only observed the procedure of Ultrasonography but also has undergone hands on training to enable him to practice in the field of Ultrasonography for the diagnostic purposes pertaining to his/her speciality)" entitles a specialist to undertake Ultrasonography for the purpose of certification related to the specialty.
  • In view of the foregoing, a gynecologist performing USG in relation to infertility would be deemed to do so in relation to conception. Her case would be covered by ‘b’ above. She would be legally competent for performing USG if her USG training at a FOGSI accredited centre was for a period of six months.
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


Markedly increased triglycerides (>500 mg/dL) usually indicate a nonfasting patient (i.e., one having consumed any calories within 12–14 hour period prior to specimen collection). If patient is fasting, hypertriglyceridemia is seen in hyperlipoproteinemia types I, IIb, III, IV, and V. Exact classification theoretically requires lipoprotein electrophoresis, but this is not usually necessary to assess a patient’s risk to atherosclerosis (See "Assessment of Atherosclerosis Risk," above). Cholestyramine, corticosteroids, estrogens, ethanol, miconazole (intravenous), oral contraceptives, spironolactone, stress, and high carbohydrate intake are known to increase triglycerides. Decreased serum triglycerides are seen in abetalipoproteinemia, chronic obstructive pulmonary disease, hyperthyroidism, malnutrition, and malabsorption states.

    Medi Finance Update

If any expenditure is incurred to keep the plant and machinery uptodate, then what will be its treatment?

Doctor can claim such expense as a deduction u/s. 37(1) against the profit for that year.

Our Contributors
  Docconnect Dr Veena Aggarwal
  Docconnect Dr Arpan Gandhi
  Docconnect Dr Aru Handa
  Docconnect Dr Ashish Verma
  Docconnect Dr A K Gupta
  Docconnect Dr Brahm Vasudev
  Docconnect Dr GM Singh
  Docconnect Dr Jitendra Ingole
  Docconnect Dr. Kaberi Banerjee
  Docconnect Dr Monica Vasudev
  Docconnect Dr MC Gupta
  Docconnect Dr. Neelam Mohan
  Docconnect Dr. Naveen Dang
  Docconnect Dr Prabha Sanghi
  Docconnect Dr Prachi Garg
  Docconnect Rajat Bhatnagar
  Docconnect Dr Sudhir Gupta
    Rabies Update

Dr AK Gupta, APCRI, Author of "RABIES – the worst death"

What should be done if there is a human rabies case?

The patient should be admitted in a quiet isolation room and must be sedated along with administration of antipyretics, analgesics, antihistamines, and anticonvulsant. Intravenous rehydration is a must. The cerebral edema has to be managed with mannitol. Mechanical ventilation of lungs, cardiac pacemaker, and intensive nursing care are indicated.

    Drug Update

LIST OF APPROVED DRUG FROM 01.01.2010 TO 31.8.2010

Drug Name


DCI Approval Date

Aliskiren 150/160mg + Valsartan 300/320mg tablets

For the treatment of hypertension


    IMSA Update

International Medical Science Academy (IMSA) Update

Newborn screening

In January 2010, the United States Advisory Committee for Heritable Disorders in Newborns and Children recommended adding severe combined immunodeficiency (SCID) and other disorders with T cell deficiency to the uniform newborn screening panel using this screening method. Earlier diagnosis by newborn screening should prevent infections associated with live virus vaccines, especially those given in early infancy before the diagnosis of SCID is suspected clinically

    IJCP Special

Dr Good Dr Bad

Situation: A patient with Chikungunya was found to have high ESR.
Dr. Bad: It may not be Chikungunya.
Dr. Good: It is Chikungunya.
Lesson: High ESR is seen in Chikungunya.

Make Sure

Situation: A patient died after receiving penicillin injection.
Reaction: Oh my God! Why was anaphylaxis not suspected?
Lesson: Make sure that each time a patient is given penicillin injection, anti anaphylaxis measures are available.

    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Prabha Sanghi)

Life Throws a Brick at You

How many times did life throw a brick at you to get your attention. I guess that we are all too easily distracted. TV, commercials, radio and advertisement and toys – too much of these things have drowned out life’s voice.

A young and successful executive was traveling down a neighborhood street, going a bit too fast in his new Jaguar. He was watching for kids darting out from between parked cars and slowed down when he thought he saw something. As his car passed, no children appeared, instead, a brick smashed into the Jaguar’s side door. He slammed on the brakes and spun the Jaguar back to the spot from where the brick had been thrown.

He jumped out of the car, grabbed some kid and pushed him up against a parked car, shouting, "What was that all about and who are you? Just what the heck are you doing?" Building up a head of steam, he went on. "That’s a new car and that brick you threw is going to cost a lot of money. Why did you do it?"

"Please, mister, please, I’m sorry. I didn’t know what else to do!" pleaded the youngster. "I threw the brick because no one else would stop." Tears were dripping down the boy’s chin as he pointed around the parked car. "It’s my brother," he said. "He rolled off the curb and fell out of his wheelchair and I can't lift him up." Sobbing, the boy asked the executive, "Would you please help me get him back into his wheelchair? He’s hurt and he’s too heavy for me."

Moved beyond words, the driver tried to swallow the rapidly swelling lump in his throat. He lifted the young man back into the wheelchair and took out his handkerchief and wiped the scrapes and cuts, checking to see that everything was going to be okay.

"Thank you, sir. And God bless you," the grateful child said to him. The man then watched the little boy push his brother to the sidewalk toward their home. It was a long walk back to his Jaguar… a long, slow walk. He never did repair the side door. He kept the dent to remind him not to go through life so fast that someone has to throw a brick at you to get your attention.

— — — — — — — — — —

Mind Teaser

Read this…………………


Yesterday’s Mind Teaser: rodiamondugh
Answer for Yesterday’s Mind Teaser: Diamond in the rough

Correct answers received from: Dr Sudipto Samaddar, Dr Anil Kumar, Dr.K.Raju, Dr Chandresh Jardosh, Dr Shirish Singhal, Dr Rajiv Dhir, Dr Ashwani Khanna

Answer for 20th January Mind Teaser: Feeling under the weather
Correct answers received from: Dr U Gaur.

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr G M Singh)

Traffic policeman: "Didn’t you hear my whistle, madam?"
Woman driver: "Yes, but I don’t like flirting while I'm driving."

    Readers Responses
  1. Dear Sir, eMedinewS is really very informative. Regards: Dr Anupam
    Public Forum

(Press Release for use by the newspapers)

TV Watching-Erectile Dysfunction Link

People who are couch potatoes, junk food junkies and TV devotees have more chances of having erectile dysfunction said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Quoting a US study published in American Journal of Medicine, Dr. Aggarwal said that in 18% of U.S. men age 20 and above, who suffer from erectile dysfunction, the dysfunction is linked to a sedentary lifestyle of little physical exercise, poor diet and lots of television.

Half of the men in the study who had diabetes also had erectile dysfunction. Nearly 90 percent of men with erectile dysfunction had risk factors for cardiovascular disease, including diabetes, high blood pressure, poor cholesterol levels.

Men who watched three or more hours of TV per day were much more likely to have erectile dysfunction than men who watched less than an hour per day. And men with erectile dysfunction were less likely to have done vigorous physical activity in the previous 30 days than other men.

There is a strikingly high prevalence in men with diabetes, obesity and high blood pressure. Staying active -- moving more and eating less -- and staying healthy, in addition to being good for your cardiovascular health may also be good for your sexual health.

    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Conference Column

Workshop on Fetal and Paedatric Echocardiography Pre and perinatal management of heart disease

13th February 2011, Sunday, Moolchand Medcity

  1. Fetal Echocardiography–How to get it right: Dr Vandana Chaddha
  2. Fetal Cardiac Spectrum– abnormal cases with interactive session: Dr Vandana Chaddha
  3. Neonatal Cardiac Cases– Hits and misses inetractive session: Dr Savitri Srivastava
  4. Intima Media Thickness and Plaque Volume, New Marker for Atherosclerosis Regression: : Dr KK Aggarwal

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