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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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 ...

24th September, 2010, Friday

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

Aging gracefully

Age-related changes in our facial appearance are unavoidable.

1. Sun protection. Protecting face from the sun is the single best way of keeping it youthful. Much of the damage comes from the UVA part of the light spectrum, so you need to put on sunscreen that protects against it and UVB light, which causes sunburn.

2. Creams and lotions. Moisturizers soothe dry skin and may temporarily make wrinkles less noticeable. Moisturizers for the face contain water to make them less greasy, and many have substances -glycerin, for example-that may help bind water to the skin. Exfoliant creams can improve the appearance of older skin by getting rid of dead skin cells that don't slough off as readily as they did when we were young. Several prescription creams have been shown to reduce wrinkles and so-called liver spots caused by sun exposure. These FDA-approved creams contain retinoids, compounds related to vitamin A that seem to work by inducing collagen production in the dermis and altering melanin, the pigment that causes liver spots. There are several varieties of retinoids. Tazarotene and tretinoin are the ones used in the FDA-approved products.

3. Botulinum toxin injections. These injections are used to treat the expression lines of the forehead and between the brows. They work by partially immobilizing the muscles that form expression lines so the skin smoothes out, although some deep expression lines may not go away. Botox is the familiar brand name. Other FDA-approved botulinum toxins are Myobloc and Dysport. The FDA issued a new warning in 2009 about the botulinum toxin spreading from injection sites, although there have been no reports of that happening when the injections were for expression lines.

4. Dermal fillers. Dermal fillers are used to treat lines created by lost collagen and fat. After botulinum toxin injections, dermal filler injections are the most common cosmetic procedure performed in the United States. Prime locations for the injections are two sets of parentheses: the pair of lines that extend down from the nose to the corners of the mouth, known as the nasolabial folds, and another pair that extends down from the corners of the mouth to the chin, known as marionette lines. Many different materials are used as dermal filler. Collagen has fallen out of favor. Currently, the most popular one is hyaluronic acid, a complex sugar found naturally in many tissues. Hyaluronic acid is more expensive than collagen, but lasts longer  up to six months in the nasolabial folds. Like botulinum toxin injections, the effect of the dermal filler shots wears off after several months how long depends on the injection site  but with repeat injections it seems to last a little longer.

5. Laser treatments. Lasers can be used to home in on certain pigments: brown, if the goal is to get rid of freckles and liver spots, red if the target is broken capillaries. They e also used for wholesale resurfacing of facial skin. The uppermost layers are stripped away, and with them, wrinkles from sun damage and scars from acne. The energy from some nonablative resurfacing lasers passes through the outer layer of the skin to work at a deeper level, in the dermis, to stimulate inflammation, which leads to collagen formation. Skin needs time to recover after most laser treatments. It can take a couple of weeks to heal, depending on the type and extent of the treatment. The nonablative treatments tend to heal a bit faster.

(Source Harvard Newsletter)

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

Media Interaction

Heart Care Foundation of India organized a media interaction with Dr Jean Audouze, UNESCO 2004 Kalinga Award winner for Popularization of Science on September 20, 2005. The event was catalyzed and supported by RVPSP (Rashtriya Vigyan Evam Prodyogiki Sanchar Parishad), Dept. of Science and Technology, Govt. of India
In the photo: Dr Shashi Ahuja, Scientist DST, GOI; Dr Jean Audouze and Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President HCFI.

 
Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Screening for cervical cancer

Two randomized trials of cervical cancer screening showed that HPV testing led to earlier detection of high-grade cervical lesions but identified large numbers of women, especially at younger ages, with lesions that would regress without treatment.

References

1. Kitchener HC, et al. HPV testing in combination with liquid-based cytology in primary cervical screening (ARTISTIC): a randomised controlled trial. Lancet Oncol 2009;10:672.

2. Ronco G, et al. Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial. Lancet Oncol 2010;11:249.

  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.

1000 kids, elders participate in drawing contest

Mangalore: KMC Hospital, Attavar, organized a drawing competition `Art of Young Hearts' on the theme `I Work with Heart' here on Saturday. The competition was held for students of classes four to 10 along with their senior partners, namely their grandparents, parents, relatives, friends, who were above 45 years old. Over 1,000 students and seniors from across the city took part in this drawing competition and contributed to its success. The hospital distributed complementary cardiac health check-up coupons to all the elders who accompanied the children for the competition. Prizes worth Rs 25,000 will be distributed to the winners at the valedictory function of `World Heart Day' run being organized by the KMC Hospitals on September 26. (Source: The Times of India)

  International News

(Dr Brahm and Dr Monica Vasudev)

FDA panels vote against plan to reduce opioid abuse

Two US FDA advisory panels voted against the FDA's plan for reducing abuse of long-acting and extended-release opioid drugs in July this year.

Stopping Epoetin regulates high hemoglobin levels

Stopping epoetin in patients on hemodialysis is more effective in normalizing the raised hemoglobin levels as compared to decreasing the dose reports a study published online July 22 in the Clinical Journal of the American Society of Nephrology.

FDA: Daptomycin may increase eosinophilic pneumonia risk

The US FDA has requested addition of a possible increased risk of eosinophilic pneumonia in patients receiving daptomycin to the drug label.

AHA Meeting report

A study reported at the Basic Cardiovascular Sciences 2010 Scientific Sessions Technological and Conceptual Advances in Cardiovascular Disease of the American Heart Association (AHA) states that a technique that combines nanotechnology with adult stem cells appears to destroy atherosclerotic plaque and rejuvenate the arteries, according to. In the study, nanoparticles (microscopic particles with at least one dimension less than 80 nm) were infused into the heart of pigs along with adult stem cells. Heating of the nanoparticles with laser light burned away arterial plaque. But, nanoparticles were not so effective at eliminating plaque if not combined with adult stem cells.

Vitamin B may not safeguard against second stroke, heart attack

Vitamin B supplements taken to reduce homocysteine levels may not protect stroke patients from a second episode or heart attacks. Studies have shown an association between homocysteine (an amino acid) in the blood, and an increased risk for stroke and heart attack. Vitamin B supplements lower homocysteine levels. According to Dr. Graeme J. Hankey, head of the stroke unit at Royal Perth Hospital in Western Australia and the lead researcher, B vitamins are safe, but they were not, statistically, significantly more effective than placebo in preventing major vascular events among stroke and TIA patients. These vitamins have not been proven to have a role in secondary stroke prevention. The study is published in the Aug. 4 online edition of The Lancet Neurology.

  Gastro Update

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

Can celiac disease present with constipation?

Yes, celiac disease may manifest with constipation, though diarrhea is the commonest manifestation. In western data, constipation may be seen in around 5% of children.

  Infertility Update

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

Can semen be collected at home?

Yes, but it must be brought to the lab within 30 min to an hour. The specimen must be collected in a container provided at the centre.

What is the time taken to prepare sperms?

Native raw semen sample cannot be used for IUI or intra-uterine insemination. Depending on the method of preparation (Swim up or Swim down) it may take anywhere between 30 min to one and a half hour to complete the wash.

  Gastro Update: Question of the Day

How is the disease severity of ulcerative colitis classified? (Dr SK Thakur, Sr. Gastroenterologist, Moolchand Medcity, New Delhi)

Initial treatment is based upon the clinical severity in combination with the endoscopic severity and extent of the disease. Patients with left-sided colitis or proctitis often present with clinical symptoms of mild, moderate or severe disease.
Mild clinical disease: Patients often present insidiously with intermittent rectal bleeding associated with the passage of mucus and mild diarrhea with < 4 small loose stools per day. Mild crampy pain, tenesmus and periods of constipation are also common. Severe abdominal pain, profuse bleeding, fever and weight loss are not part of the spectrum of mild disease.
Moderate clinical disease: Patients may have frequent loose, bloody stools (upto eight per day), mild anemia not requiring blood transfusions, abdominal pain that is not severe and low grade fever. Adequate nutrition is usually maintained.
Severe or fulminant clinical disease: Patients have extensive colonic involvement often but not always extending to the cecum (pancolitis). These patients typically have frequent loose stools (>10 per day) with severe cramps, fever upto 39.5C and bleeding often requiring blood transfusion. They often suffer rapid weight loss, leading to a poor nutritional state.

  Medicolegal Update

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

How is the lung exposed to poison?

Poisons in the form of gas, vapor, dust, fumes, smoke or fine spray droplets may go down the air passages into the lungs by way of breathing through the mouth and nose. Only those particles that are too small to be seen can enter into the lungs. Larger particles are trapped in the mouth, throat and nose and may be swallowed. A person may breathe in poison when working with a poisonous substance inside a building without fresh air, or when spraying pesticide without wearing adequate protection. Oil or gas heaters, cookers, and fires give off poisonous fumes which may reach dangerous concentrations if the smoke cannot get outside or if the room does not have a good supply of fresh air. Poisons that enter the lungs pass into the blood vessels very quickly as the air passages in the lungs have thin walls and a good blood supply.

  Medi Finance Update

Goals of the Mutual Fund

Many funds are designed to invest in companies that meet specific investor goals, like growth, value, dividend or income to name a few. Only companies that meet certain criteria will be included in the fund. For example, a growth fund looks for companies with significant, untapped growth potential, whereas a value fund will look for companies that are undervalued by the market as a way to increase investor returns. Both of these types of funds are designed for long-term capital appreciation.

  Drug Update

Drugs prohibited for manufacture, sale and distribution from subsequent date

Drug Formulation

Effective date

Notification

Valdecoxib and it's formulation

Dec 25,2005

GSR 510(E)
dt. 25.07.05

  Lab Update

Urine cytology

Examining a urine sample under a microscope may reveal cancer cells that could come from the bladder, ureters or kidneys. This is an important screening test.
(Contributed by Dr Arpan Gandhi and Dr Navin Dang)

  IJCP Special

Dr Good Dr Bad

Situation: A patient with dengue came with a platelet count of 1000.
Dr Bad: You need platelet transfusions immediately.
Dr Good: Just watch and take enough fluids.
Lesson: No platelets unless there is active bleeding.

Make Sure

Situation: An alcoholic reacted to disulfiram.
Reaction: Oh my God! Why was the drug given to him?
Lesson: Make sure that the use of disulfiram is reserved for individuals, who are highly motivated to maintain abstinence, and are either treatment-adherent or take the medication in a supervised setting.

Quote of the Day

A 'No' uttered from the deepest conviction is better than a 'Yes' merely uttered to please, or worse, to avoid trouble. Mahatma Gandhi
(Contributed by Dr GM Singh )

Hypertension Alert

Regular aerobic physical activity such as brisk walking (at least 30 min per day, most days of the week) alone can reduce blood pressure by 49 mmHg.

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  Mind Teaser

Read this…………………

belt
hitting

The answer for yesterday’s Mind Teaser: "Breaking a custom"

Correct answers received from: Dr Antara Sablok, Dr.Asim Kumar Sen, Dr Meera Rekhari, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr.K.Raju, Dr.K.V.Sarma, Dr Aruna Tyagi, Dr. Rohini Vaswani, Dr .K.P.Rajalakshmi, Dr. Alok Deb, Dr Vikas Kumar

Answer for 22nd Sept Mind Teaser is: "All in all".
Correct answers received from: Dr Suruchi Aditya, Dr.K.Raju, Dr Anurag Jain, Dr Meera Rekhari

Send your answer to ijcp12@gmail.com

  Humor Section
Dr K K Aggarwal
Contributed by: Rashmi Gupta, Senior Research Associate, LBS Hospital & Fluorosis Research, Delhi- 92  
 
  An Inspirational Story

Are You God's Wife?

New York City: It's a cold day in December. A little boy about 10-year-old was standing before a shoe store on Broadway, barefooted, peering through the window, and shivering with cold. A lady approached the boy and said, "My little fellow, why are you looking so earnestly in that window?"
"I was asking God to give me a pair of shoes," was the boy's reply.

The lady took him by the hand and went into the store, and asked the clerk to get a half dozen pairs of socks for the boy. She then asked if he could give her a basin of water and a towel. He quickly brought them to her. She took the little fellow to the back part of the store and, removing her gloves, knelt down, washed his little feet, and dried them with a towel.

By this time the clerk had returned with the socks. Placing a pair upon the boy's feet, she then purchased him a pair of shoes, and tying up the remaining pairs of socks, gave them to him. She patted him on the head and said, "No doubt, my little fellow, you feel more comfortable now?"
As she turned to go, the astonished lad caught her by the hand, and looking up in her face, with tears in his eyes, answered the question with these words: "Are you God's wife?"

  Readers Responses
  1. What a speech by Bryan of Coca Cola. We forget that most of the time we are working hard and extra for family and future. Good family members appreciate this and reciprocate these feelings by small gestures like sending fruit juice in the busy OPD or sending coffee and biscuits in a busy schedule, sending small cards on your success and remain by your side in your failures. Vivek Kumar, Varanasi.
  2. Thanks. Dr KK Aggarwal for providing daily medical news bulletin to every email provider at free of cost without any disturbances. Dr KP Singh
  Public Forum

(Press Release for use by the newspapers)

Dr. K.K. Aggarwal talks on Science behind Indian Mythology
 
Padma Shri & Dr. B. C. Roy National Awardee Dr K.K.Aggarwal delivered a lecture on Science behind Indian Mythology, organised by Rotary Club of Delhi attended by Rotarians. Dr. Aggarwal who is an expert in allopathic aspects of Indian Mythology has written a book ‘Alloveda’ which combines Vedic knowledge with allopathy. Dr. Aggarwal said that chanting of vowels produces painkillers and chanting of nasal consonants produces Tranquilizers. Dr. Aggarwal said that AUM chanted in spirituality is a combination of a vowel with a nasal consonant. He said that Bhagwad Gita was the first text book of counseling and first introduction to cardiac resuscitation was in the Satyawan Savitri era.

When in trouble one requires multiple counseling sessions and not one. Arjuna in Bhagwad Gita required 18 such sessions. In the first chapter of Bhagwad Gita, Krishna uses the principals of patience listening. He does not utter a word and lets Arjuna come out with his emotions. In the second session, Krishna talks in great detail. Second chapter of the Bhagwad Gita is the longest chapter. From 3 to 17 chapters – Krishna re-discusses, gives reason for every word, reassures all the time and yet creates fear in Arjun’s mind while doing continuous counseling and in 18th chapter, he revises the whole teaching. These today form the principles of conjunctive behavior therapy. Dr. Aggarwal also talked of every God, religion, dharma, festival and rituals in allopathic language. 

The forthcoming BSNL Dil Ka Darbar being held on Sunday 26th at Maulana Azad Medical College will also focus on Indian mythology and heart.

BSNL Dil Ka Darbar to screen patients for metabolic syndrome

Dr Aggarwal also said that the forthcoming BSNL Dil Ka Darbar will also screen patients for metabolic syndrome. Facilities for free blood tests and ECG on the spot will be available. People can get a number of the tests done and need not come fasting.

Metabolic syndrome is associated with a more than doubled risk of cardiovascular disease and stroke, and a 1.5-fold increase in the risk of all-cause mortality. Even in patients without type 2 diabetes, metabolic syndrome was associated with a 62% increased risk of heart attack and 86% increased risk for stroke.  

Metabolic syndrome is when one has three or more of five cardiovascular risk factors

1. Central obesity
2. High triglyceride levels in the blood
3. Decreased HDL cholesterol levels in the blood
4. Systemic hypertension
5. High fasting glucose levels in the blood

  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
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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