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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


eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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  Editorial …

24th October 2011, Monday

Breast cancer screening

Lifetime breast cancer risk below 15 percent

  • Women between the ages of 50 and 70 should be screened with mammography.
  • Information about the risk of breast cancer and the benefits and harms of screening should be reviewed.
  • Discussion of the risks and benefits of mammography between women age 40 to 50 and their clinician. Mammography decision should be determined by individual patient risk and values through shared decision making.
  • Women over the age of 70 are screened with mammography if their life expectancy is at least 10 years.
  • Screening mammography should be done every 1 to 2 years.
  • Women being screened for breast cancer should also undergo clinical breast examination.
  • Breast self-examination (BSE) should only be performed as an adjunct to mammography and clinical breast examination, not as a substitute for these screening methods.

Lifetime breast cancer risk 20-25 percent or higher

  • Women at high risk for breast cancer (lifetime risk ≥20 to 25 percent) should be referred for genetic counseling, to determine the likelihood of a BRCA mutation and to decide on management options.
  • Women with a lifetime risk of breast cancer ≥20 to 25 percent (mutation carriers and others) who choose intensified surveillance for breast cancer, should go for annual mammography and MRI, as well as clinical breast examinations every 3 to 6 months, and monthly breast self examinations.
  • Screening should be initiated at age 25 for these women. Mild to moderately increased lifetime breast cancer risk (≥15 percent and < 20 to 25 percent) Women with mild to moderately increased breast cancer risk follow the recommendations for women at average risk. (Risk score at http://www.cancer.gov/bcrisktool/)

For More editorials…

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

Thinking Differently

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011 – Heritage Inter Dancing School Festival

'LIC Heritage', an inter classical dance school competition was held in the ongoing MTNL Perfect Health Mela 2011. Classical dancing is like meditation and reduces chances of future heart attacks.

Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


IAP for focus on prevention of pneumonia

NEW DELHI: A national level body aimed at reforming surgical education and practices - College of Surgeons of India (CSI) - was launched by Union human resource development minister Kapil Sibal at Asian Institute of Medical Sciences in Faridabad on Wednesday. "The CSI will strengthen the future of surgery with an agenda to bring reforms in surgical curriculum, education, training, practices and the surgical examination system," CSI president Dr N K Pandey said. He said CSI is on the lines of the American College of Surgeons and the Royal Colleges in the UK which standardize the examination system, curriculum, training and assessment of surgeons. "Under this new initiative, surgery students will be trained and certificates will be awarded. Accreditation of hospitals for training surgeons will be granted on basis of the hospital having adequate infrastructure, bed strength and faculty. Initially, we will start the CSI from Asian Institute of Medical Sciences in Faridabad ,and gradually we will cover other zones such as south, west, etc by identifying hospitals with adequate infrastructure for training, hosting and conducting surgical exams," said the CSI president. (Source: TOI, Oct 20, 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

(Dr Monica and Brahm Vasudev)

Higher urinary BPA levels associated with increased diabetes risk

According to a study published online Sept. 28 in the Journal of Clinical Endocrinology & Metabolism, people whose urine contains higher levels of bisphenol A (BPA) may have an increased risk for diabetes.

For comments and archives

Optimal duration for antiplatelet Tx

The optimal duration for dual antiplatelet therapy (DAPT) after PTCA remains undefined, but newer-generation stents may require less time on the medications. Discontinuation of DAPT following drug-eluting stent ranges from 14% at 30 days to more than 80% beyond one year, suggesting the need to use a stent that appears safe with shorter DAPT duration. An analysis of five studies involving a zotarolimus-eluting stent (Endeavor) found no significant difference in ischemic event rates between those on DAPT for six months and beyond a year, according to the analysis published in the October issue of JACC: Cardiovascular Interventions.

For Comments and archives

MI, blood draws linked with anemia

For patients hospitalized with an acute myocardial infarction, an increasing volume of blood drawn for diagnostic tests was associated with a greater risk of developing anemia. For every 50 mL of blood drawn, the risk of developing moderate-to-severe anemia in the hospital rose by 15% reports Dr Mikhail Kosiborod in Archives of Internal Medicine. Hospital-acquired anemia may be preventable by implementing strategies to limit blood loss from laboratory testing.

For comments and archives

  Twitter of the Day

@DrKKAggarwal: Dilli Aaj Tak Live, MTNL Perfect Health Mela, October 20, 2011...http://fb.me/KHOxIUae" http://fb.me/1ccESVj2U

@DeepakChopra: Evanston-20111021-00475.jpg Good Morning from Chicagohttp://twitpic.com/73invw

    Spiritual Update

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

The spiritual science behind Illusion

When you see real as unreal or unreal as real, medically it is termed illusion. In illusion, once you are told about the reality, you correct yourself. On the other hand, in delusion though one is also away from the reality but stays in that state without correcting oneself. For example a person by mistake thinks a snake as a rope. A psychotic will persist that it is a rope and not snake but the person in illusion will immediate correct himself once he goes near by and actually sees a snake. .

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

Most Popular Vs the Right Decision

A group of children were playing near two railway tracks, one still in use while the other disused. Only one child played on the disused track, the rest on the operational track. The train is coming, and you are just beside the track interchange. You can make the train change its course to the disused track and save most of the kids. However, that would also mean the lone child playing by the disused track would be sacrificed. Or would you rather let the train go its way?

Let's take a pause to think what kind of decision we could make........Most people might choose to divert the course of the train, and sacrifice only one child. You might think the same way, I guess. Exactly, I thought the same way initially because to save most of the children at the expense of only one child was rational decision most people would make, morally and emotionally. But, have you ever thought that the child choosing to play on the disused track had in fact made the right decision to play at a safe place?

Nevertheless, he had to be sacrificed because of his ignorant friends who chose to play where the danger was. This kind of dilemma happens around us everyday. In the office, community, in politics and especially in a democratic society, the minority is often sacrificed for the interest of the majority, no matter how foolish or ignorant the majority are, and how farsighted and knowledgeable the minority are. The child who chose not to play with the rest on the operational track was sidelined. And in the case he was sacrificed, no one would shed a tear for him. The great critic Leo Velski Julian who told the story said he would not try to change the course of the train because he believed that the kids playing on the operational track should have known very well that track was still in use, and that they should have run away if they heard the train's sirens.

If the train was diverted, that lone child would definitely die because he never thought the train could come over to that track! Moreover, that track was not in use probably because it was not safe. If the train was diverted to the track, we could put the lives of all passengers on board at stake! And in your attempt to save a few kids by sacrificing one child, you might end up sacrificing hundreds of people to save these few kids.

While we are all aware that life is full of tough decisions that need to be made, we may not realize that hasty decisions may not always be the right one. “Remember that what's right isn't always popular... and what's popular isn't always right." Everybody makes mistakes; that's why they put erasers on pencils.

For comments and archives

  Fitness Update

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

When it comes to fitness, age is just a number

Although conventional wisdom would lead one to believe that older people become less fit as they age, it's not always the case. New research from the Norwegian University of Science and Technology shows that when it comes to fitness, age is just a number. According to their study, a 50-year-old can be as physically fit as someone up to 30 years younger. However, as you may have guessed, exercise is a key factor.

For this study, researchers examined information from 4,631 healthy men and women (ages 20-90) from Norway's biggest health database, to determine their level of fitness. All participants underwent laboratory tests in to check their peak oxygen uptake, which is the most reliable measure of cardiovascular fitness. They found that some avid exercisers who were in their fifties were more fit than people in their twenties, who barely exercised or were sedentary. They key, according to researchers, was to maintain a regular physical activity regimen, even for older people.

For comments and archives

    Malaria Update

AC Dhariwal, Hitendrasinh G Thakor, Directorate of NVBDCP, New Delhi

What the National Drug Policy of India says

Diagnosis of severe malaria

The diagnosis should be confirmed by microscopy or RDT. Treatment should be guided by microscopy. High parasite density indicates poor prognosis. Severe malaria in the absence of microscopic evidence of asexual P. falciparum or P. vivax is very rare. In such cases, all efforts should be done to identify an alternative cause. If microscopy is negative and RDT is positive for P. falciparum, it is possible that antigen is persisting from an earlier infection. However, if the symptoms clearly point to severe malaria and there is no alternative explanation, such a case can be recorded as having severe malaria. Such occurrences are possibly more common in patients, who have started an ACT (Artemisinin-based combination therapy) treatment a few days before.

For comments and archives

    Medicine Update

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

What is the recommendation for post exposure prophylaxis for contacts following needle prick from a known HBsAg negative case?

For a patient who is exposed to a known HBsAg-negative source

• Administer Hepatitis B vaccine series, if unvaccinated
• No treatment otherwise needed

For comments and archives

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


Hypophosphatemia can be seen in a variety of biochemical derangements, including acute alcohol intoxication, sepsis, hypokalemia, malabsorption syndromes, hyperinsulinism, hyperparathyroidism, and as result of drugs, e.g., acetazolamide, aluminum-containing antacids, anesthetic agents, anticonvulsants, and estrogens (including oral contraceptives). Citrates, mannitol, oxalate, tartrate, and phenothiazines may produce spuriously low phosphorous by interference with the assay.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was found to have an A1c of 7.4%.
Dr Bad: This is ok.
Dr Good: I want to bring it to <7%.
Lesson: A1c <7% is equivalent to fasting glucose 70 to 130 mg/dL (3.89 to 7.22 mmol/l) and postprandial glucose (90 to 120 minutes after a meal) <180 mg/dL (10 mmol/L). (Source: Diabetologia 2008;51:8)

For comments and archives

Make Sure

Situation: An HIV patient died after sulfa prophylaxis
Reaction: Oh my God! You should have known that he was sulfa sensitive.
Lesson: Make sure that patients with a history consistent with Stevens Johnson syndrome and toxic epidermal necrolysis or an exfoliative dermatitis due to a sulfonamide medication should strictly avoid the culprit drug and other agents in the same sulfonamide group. Re-exposure to the same agent may be fatal.

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  Quote of the Day

(Dr GM Singh)

Three things cannot be long hidden: the sun, the moon and the truth.


Sixth Sense: A paranormal sense that allows you to communicate with the dead.

    Mind Teaser

Read this…………………

What is not true about blind loop syndrome?

a) It manifests as diarrhea, weight loss and deficiency of fat-soluble vitamins.
b) Megaloblastic anemia is commonly seen.
c) Surgery is almost always required to correct small bowel syndrome.
d) Broad spectrum antibiotics are the treatment of choice.

Yesterday’s Mind Teaser:  What word in the English Language is always spelled incorrectly

Answer for Yesterday’s  Mind Teaser: Incorrectly

Correct answers received from: Dr. Sukla Das, Dr. P. C. Das, Satyanarayana Akupatni, Dr Dinesh Yadav, Dr.K.Raju, Dr.Neelam Nath, Dr Rawat Purushottam Singh

Answer for 22nd October Mind Teaser: b. ACIP recommends it for males and females aged 9 to 26 years
Correct answers received from: Dr Dinesh Yadav, Dr.Neelam Nath , Dr Jainendra Upadhyay, Dr. Sukla Das, Dr. P. C. Das, Muthumperumal Thirumalpillai, Dr.K.Raju

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Santa Singh to Banta, " Ma aur Biwi mein Kya Fark Hota hai "
Banta Singh, " Nahi pata...Kya Hota hai "
Santa Singh, " Ma, Bolna Sikhati hai aur Biwi, Chup rahna "

    Medicolegal Update

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

What is the meaning of Death for the common people?

  • The recent development in medical science/techniques has posed a number of improvements, whereas for so many years it was accepted that death has occurred if respiration and circulation have ceased for more than 10 minutes.
  • Now it is possible for methods such as cooling the whole body to 15oC or 59oF or less to stop the heart and respiration for an hour or longer and restart them again at will. During this period, ECG and EEG show no electrical activity and body looks like a corpse.
  • This leads to the view that it is not the cessation of the respiration or circulation but it is their failure to return that indicates death. Thus we are driven from a positive to negative approach. Therefore, the doctor while taking decision must satisfy himself that not only respiration and circulation has stopped, but their failure has persisted to such a period that under no circumstances it is possible for the person to come to life again.
  • This is the form of death referred to in common people. Death is said to have occurred when a final expiration is followed by continuous immobility of the chest, loss of pulse and alteration of the features. These changes indicate that respiration and circulation have been stopped and the brain will stop functioning if it has not been so.
  • Residual heart movement is not of practical importance as they are insufficient to maintain the circulation. Somatic death can be detected by ECG that will stop within minutes.

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    Public Forum

(Press Release for use by the newspapers)

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 MTNL Perfect Health Mela Ends 

Health information should be added to all events, said Dr Sadhvi Sadhna Ji Maharaj Chairperson World Fellowship of Religions during the closing ceremony of ten day long MTNL Perfect Health Mela.

Padmashri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India said that one line health messages can only be communicated to the people using the modules of infotainment.

Dr P K Sharma MOH NDMC showed concern about the rising lifestyle disorders amongst middle class and upper lower class people. Eating junk food and not exercising are the two main reasons which are affecting this population.

Dr Vinod Khetrapal President DMA said that the only way to treat lifestyle disorders is to adopt a holistic lifestyle. He said that both medication and meditation are important for health.

Dr N V Kamath DHS said that one should listen to music for 20 minutes every day for inner peace and happiness.

Mr. Anuj Sinha said that lifestyle disorders are on the rise in the country in general and Delhi in particular.

Mr J Sarangi Special Secretary Health said that soon Delhi Government will be launching a lifestyle awareness campaign.

Dr S K Thakur GI specialist said that the rising epidemic of obesity in the city affecting almost 35% of the population is a matter of concern. He further said that anaemia is rampant in the society and needs to be controlled.

The mela was a perfect picnic spot for public to understand everything about health.

Mr Manjeet Singh ED MTNL said that the SMS is a new effective way of health communication.

Dr Ramesh Kumar from NDMC laid importance of making Delhi clean and green for better health.

Mr Ranjeet from DST said that every health communication must be based on science.

Special guests of the day, Sh. Ashok Chakradhar and Eminent Bharatnatyam exponent Ms Komlavardhan in a joint statement said that health is not merely absence of diseases but a state of physical, social, mental and spiritual wellbeing. Gayatri Pariwar was also seen participating actively during the mela.

Health Tambola at Health Mela

Tambola is a traditional and popular game, which attracts a lot of crowd.

The health tambola, an innovative game designed by Dr. K K Aggarwal, has become a popular mode of creating health awareness in the ongoing MTNL Perfect Health Mela. Instead of talking about numbers it talks about a health message hidden behind the message.

For example instead of saying number three, one says “time to have your blood sugar check up done, once in three years, number 3”. Instead of saying one fat lady one says, “The weight of prostate in grams - 8 grams, Number 8”. Other examples are: Percentage of protein in soya beans - 43 Number 43, the length of Larynx in mm - 44 Number 44, the average age of menopause is - 45 Number 45, total pair of spinal nerves in a human body is 31 – Number 31, the length of small intestine in meters is 6 metres – Number 6 etc.

For comments and archives

    Readers Response

Very good work sir. Keep it up. Sarbjit Singh Takhar

    Forthcoming Events

GP CON 2011

1. National Conference of IMA CGP
Date: October 29th-30th, 2011
Venue: Savera, Chennai
IMA CGP HQ is organizing a two day CME, Group discussion and Workshop pertaining to Family Medicine Concept, Which will be a “Reincarnation” of the traditional Family Doctor Concept in India.
More details Contact Conference Secretariat, Dr TN Ravisankar, email:imacgp.chennai@yahoo.com;

2. IMSCON 2012 in Hotel Claridges Surajkund Faridabad from 17-19 Feb 2012.
It has sessions from British Menopause Society and South Asian Federation Of Menopause Societies and International faculty like Prof. Mary Ann Lumsden (UK), Dr. Nick Panay (UK), Prof Studd (UK), Prof. Rubina Hussain (Pakistan) and many more.
It is a multidisciplinary approach to the problems of Mid life Women with theme topics being Gyne Oncology, Gyne Endocrinology, skeletal and joint problems, diabetes and other related comorbidities, Scientific programme is a feast with contributions from international Faculty from UK and South Asian countries and noted National Faculty.
This is in the picturesque surrounding of Surajkund hill areas with a cultural programme bonanza thrown in.
Early bird registration is till 31st October. Call for abstracts, free papers, posters.
Please block your dates and your accommodation and avail of early bird registration
Web Site :Indianmenopausesociety.org for all the details or
contact Dr. Maninder Ahuja 9810881048 email :Ahuja.maninder@gmail.com

for complete programme details

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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