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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 October 2010, Sunday

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

A new drug for osteoporosis found to be safe after a 4-year trial

An investigational drug odanacatib for osteoporosis was found to be safe and well-tolerated over four years, according to the results of a phase II study presented at the annual meeting of the American Society for Bone and Mineral Research (ASBMR) held in Toronto from October 15-19.
According to Neil Binkley, MD, of the University of Wisconsin Madison, odanacatib, a cathepsin K inhibitor, also produced continued increases in bone mineral density. There was a prompt loss of bone mineral density when patients stopped taking the drug.
To begin with, the study randomized patients to placebo or one of four doses of the drug for a two-year trial. In the third year of the study, patients were re-randomized to receive odanacatib 50 mg per week or placebo. During the fourth year, patients who had been on placebo during the trial or who had been given the lowest dose of odanacatib (3 mg/week) were switched to 50 mg per week of the drug. Other participants remained on their year-three assignment. The researchers found:

  • For patients who had been on 50 mg of odanacatib for four years, spinal bone mineral density continued to rise, reaching 10.7% higher than baseline. In the fourth year, they experienced an average increase of 2.8%.
  • For those who had been on the drug and were switched to placebo, there was a "prompt loss" that left patients only 0.4% above baseline on average.
  • For those who had been on placebo and were switched to the drug, there was a 4.8% increase, similar to what had been seen in the original trial.

The drug also led to a sustained reduction in markers of bone resorption and modest decline in the markers of bone formation that tended toward baseline over time. According to Dr Binkley, only four patients, all in the odanacatib arm dropped out because of adverse events. There were more adverse events involving the skin in the odanacatib arm (9% vs 4.9%), but there were no cases of scleroderma or morphea-like lesions, he added.

Dr KK Aggarwal
Editor in Chief
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  Chikungunya Update

(RP Vashist, Consultant and Head Public Health, Govt. of Delhi)

Mortality with Chikungunya fever

A few deaths have been reported that were thought to be due mainly to

  • Inappropriate use of antibiotics and NSAIDs 
  • Virus can cause thrombocytopenia
  • These drugs can cause gastric erosions, leading to fatal upper GI bleed 
  • Use of steroids for joint pains and inflammation. This is dangerous and completely unwarranted.
  Photo Feature (from the HCFI Photo Gallery)

 Anmol 2010 

Painting competition for children with special need organized by HCFI during MTNL 17th Perfect Health Mela 2010, to encourage the talent of these special children. Anmol, a festival for children with special needs, coordinated by Balwant Ray Mehta, Vidya Bhawan. It is a festival is being organized for the sixth consecutive year. 

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Exercise BP and future cardiovascular outcome

A study in more than 4800 asymptomatic normotensive individuals found that a hypertensive response to treadmill testing was associated with an increased risk for cardiovascular death.

(Ref: Weiss SA, et al. Exercise blood pressure and future cardiovascular death in asymptomatic individuals. Circulation 2010;121:2109).

  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

IIT-Kharagpur medical college in two years

The Indian Institute of Technology, Kharagpur, is upbeat about the medical school they believe will come up in the next two years. According to senior officials of IIT-Kgp, the Centre is likely to introduce a bill in the Parliament in the next session to change IIT Act so that the institute can run a medical college. “We have decided to name the medical college Bidhan Chandra Institute of Medical Sciences in the honour of the first chief minister of the state,” Damodar Acharya, the director of IIT-Kgp said. Acharya said the institute which will come up in 2012 will have an investment of Rs 500 crore. Recently the institute, with support from the Indian Railways, tied up with the 250-bed Railway hospital at Kharagpur. “We plan to use the Railway hospital as a teaching hospital. For medical research, we need to connect with a hospital that has a steady number of patients. This hospital gets about  1 lakh patients every year and will help us in research,” he said. (Source: Indian Express)

  International News

 (Dr Monica and Brahm Vasudev)

Low testosterone associated with early death in men with heart disease

Low testosterone may be linked to early death in men with heart disease, according to a study published online Oct. 20 in the journal Heart.

Boehringer wins FDA approval for blood-thinning drug

FDA approved Boehringer Ingelheim GmbH's blood-thinning drug Pradaxa (dabigatran) to prevent strokes in patients with irregular heart rhythms.

FDA declines to approve Bydureon, calls for more studies

The US FDA declined to approve the potential diabetes drug, Bydureon (exenatide-LAR), saying it wants more testing to be done.

Aspirin use before heart surgery may be linked to fewer heart attacks after procedure

Patients who took aspirin before heart surgery suffered fewer heart attacks, stroke and other problems after their operations," according to study presented at the annual meeting of the American Society of Anesthesiologists.

Retinal camera diagnoses glaucoma; spots early signs of diabetes, hypertension

Canon's new CR-2 digital retina camera can take images of the back of the inside of your eye that can be used to diagnose conditions such as glaucoma.
  Hepatology Update

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

Inflammatory bowel disease

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) encompasses two related but distinct disorders of as yet unknown etiology. Crohn’s disease (CD) is a chronic, idiopathic transmural inflammation, which can affect one or several segments of the digestive tract. Ulcerative colitis (UC) is a chronic idiopathic inflammation of the rectum extending continuously over a variable length of the colon from the distal to the proximal end. In 10-15% of children with colitis, a clear diagnosis of CD or UC is not possible. Such cases are termed as having Indeterminate Colitis (IC).

  Infertility Update

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

What are the potential risks of fertility drugs?

Fertility drugs come with potential risks and side effects. To look at their brighter side, fertility drugs can create miracles, making parenthood a reality. They are also generally effective. However, it is important to know what can go wrong, and how to possibly lower your chances of complications. While you should be educated about the risks, the goal isn't to scare you out of going through with treatments. Remember that reading about potential risks can increase your anxiety during treatment. Ideally, you should take what you learn here and use the information to make smarter decisions about your treatment. There are ways to reduce your risks.

  Pediatrics Update: Question of the Day

 (Dr Anjali Kulkarni)

How do you determine that a baby is jaundiced?

Jaundice is a clinical sign and therefore rather subjective. The American Academy of Pediatrics (AAP) in its algorithm on the management of jaundice recommends measurement of an infant’s total serum bilirubin (TSB) if the jaundice is clinically significant. The problem with this recommendation is that the ability of the clinician to diagnose “clinically significant” jaundice varies widely and in some cases may be erroneous. In addition, whether the TSB level is “clinically significant” depends both on the actual TSB level as well as the infant’s age, in hours. Nevertheless, newborns whose TSB levels exceed 12 mg/dl are always identified as “jaundiced.”

  Medicolegal Update

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

How should a medicolegal report be prepared?

The doctor is an eye witness as well as a medical expert. The Medico-legal reports are prepared in duplicate, in clear and legible handwriting. Cutting/overwriting must be properly initialed. Complete medical terms should be used. Acronyms such as NAD used to indicate ‘no abnormality detected’ should be avoided as it has vague meaning and may cause embarrassment during cross examination in the court of law. A medicolegal report should include the following:

  • Name of the patient, his residential address, occupation
  • Name of the person(s)/police official accompanying, the date, time and place of examination
  • DD Entry/FIR No., informed consent of the person being examined, 
  • Marks of identification should be documented or thumb impression should be obtained in MLR.
  • Complete description including dimensions of the injuries/fracture
    • Smell of alcohol any other findings present; any investigations/referrals, etc., asked for.
    • Nature of the injury: whether simple /grievous/dangerous.
    • Weapon/Force used: whether blunt or sharp or fire-arms or burns, etc. 
    • Duration of the injuries: based on the characteristics of the external injuries.
    • All investigation reports, X-rays, should be marked/numbered as MLC on the top
  • Biological evidences/sample or clothings as required and collected should be recorded with details
  • Any other additional information of the case
    If the opinion about nature of injury, its duration or weapon etc. has been kept pending in the report by the doctor, the same must be documented properly in the appropriate column with justification for doing so. The doctor must sign with date and write his name, designation and address in the prepared MLR.
  Medi Finance Update

Taxation Tips

In a nursing home, always have X-ray, path lab, wards, etc. in the names of separate family members.
Create separate income tax files. If your income is high, always be the consultant and never be on salary. You can claim expenses. 

  Drug Update

List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

Drugs prohibited from the date of notification

Demeclocycline Liquid Oral preparations

  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum aminotransferasess 

  • Alanine aminotransferase (ALT/ SGPT): Enzyme found mainly in the liver; the one of the best test for detecting hepatitis.
  • Aspartate aminotransferase (AST/ SGOT): Enzyme found in the liver and also in the heart and other muscles.
mtnl perfect health mela
emedinews 3D echocardography
  IJCP Special

Dr Good Dr Bad

Situation:  A patient with vivax malaria came with high fever
Dr Bad: Start artesunate.
Dr Good: Start chloroquine.
Lesson: Vivax is mostly sensitive to chloroquine

Make Sure

Situation: A 40-year-old male developed acute heart attack after playing squash.
Reaction: Oh My God! Why was a cardiac test not done?
Lesson: Make sure after the age of 40 anybody going for anaerobic games gets a cardiac clearance done first.

Quote of the Day (Dr G M Singh)
"Your only obligation in any lifetime, Is to be true to yourself." Richard Bach

  Mind Teaser

Read this…………………

Fairy, Wolf and Duckling

Answer for yesterday’s Mind Teaser: "A little on the large side"

Correct answers received from: Dr. K. P. Rajalakshmi, Dr. Susheela Gupta, Dr  Nageshwar Rao, Dr S. Upadhyaya, Dr. Gitanjali Arora,

Answer for 22nd October Mind Teaser is: "Highway overpass"
Correct answers received from: Dr Chandresh Jardosh, Dr. K.Raju, Dr. Manjesha, Dr Vijay Kansal, Dr Anurag Jain, Dr R S Bajaj 

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr G M Singh)


A policeman stops a lady and asks for her license. He says "Lady, it says here that you should be wearing glasses."

The woman answered "Well, I have contacts."

The policeman replied "I don't care who you know! You're getting a ticket!"

  An Inspirational Story

(Contributed by Dr Nirmala Agarwal)

The Socrates Triple Filter Test

In ancient Greece, Socrates was reputed to hold knowledge in high esteem. One day an acquaintance met the great philosopher and said, "Do you know what I just heard about your friend?" Hold on a minute," Socrates replied. "Before telling me anything, I'd like you to pass a little test. It's called the Triple Filter Test."

Triple filter?" That's right," Socrates continued. "Before you talk to me about my friend, it might be a good idea to take a moment and filter what you're going to say. That's why I call it the triple filter test.

The first filter is TRUTH. Have you made absolutely sure that what you are about to tell me is true?"
No," the man said, "actually I just heard about it and..."

All right," said Socrates. "So you don't really know if it's true or not. Now let's try the second filter, the filter of GOODNESS. Is what you are about to tell me about my friend something good?" No, on the contrary..."

So," Socrates continued, "you want to tell me something bad about him, but you're not certain it's true. You may still pass the test though, because there's one filter left: the filter of USEFULNESS. Is what you want to tell me about my friend going to be useful to me?" “No, not really."

Well," concluded Socrates, "if what you want to tell me is neither true nor good nor even useful, why tell it to me at all?"

This is why Socrates was a great philosopher and held in such high esteem. Use this triple filter each time you hear loose talk about any of your near and dear friends.

  Readers Responses
  1. Respected Sir, Every day, every issue, every line, every word in the e medinews is a source of inspiration. No words to thank you , sir , God Bless you sir with more strength do continue with the good work. Dr.S Sahuja
  Public Forum

(Press Release for use by the newspapers)

 MTNL Perfect Health Mela opens – Formally Inaugurate Today

The popular, city’s MTNL Perfect Health Mela opened to the public on the 23rd and was formally inaugurated today at 11 am by Smt. Sheila Dikshit, the Hon’ble Chief Minister of Delhi. The Mela is being organized by Heart Care Foundation of India in association with various departments of Government of Delhi and various public sector undertakings.
The attraction of the Mela on the first day was Anmol, a festival for children with special needs, which was coordinated by Balwant Ray Mehta, Vidya Bhawan. Anmol as a festival is being organized for the sixth consecutive year. More than 300 children participated in dancing, singing and painting competitions.

Giving details, Padma Shri & Dr. B. C. Roy National Awardee, Dr. KK Aggarwal, President, said that children with special needs are not disabled but are only differently abled.
Distributing awards to the winners, Dr. V. K. Monga, Chairman Health Committee, MCD said that children with special needs, on losing one sense, invariably attain enhanced activity of other senses.
Over a thousand people got their medical checkups done on the first day of the Mela. Large number of patients suffering from Dengue and Chikungunya were seen and given on the spot treatment in the OPD.

  Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

17th MTNL Perfect Health Mela 2010

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
17th MTNL Perfect Health Mela 2010 day programme
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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