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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 ...

24th November 2010, Wednesday

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

Regular exercise reduces 24 health risks

Regular exercise can reduce 24 physical and mental health conditions including some cancers and dementia and slow down how quickly the body ages, according to a research review summarizing the key findings of 40 papers published between 2006 and 2010, reports ScienceDaily.

An extensive research review, by Physiotherapist and lecturer Leslie Alford from the University of East Anglia, published in the December issue of IJCP, the International Journal of Clinical Practice, says that apart from not smoking, being physically active is the most powerful lifestyle choice any individual can make to improve their health. 

Health benefits identified by the review

  • Regular moderate to intense physical activity is associated with decreased risk of coronary heart disease and ischemic and hemorrhagic stroke.
  • A growing body of evidence suggests that increasing physical activity can also reduce the risk of certain types of cancers, osteoporosis, type 2 diabetes, depression, obesity and high blood pressure.
  • Evidence of the beneficial effects of physical activity in the primary prevention and management of cancer is growing and there is an association between higher levels of physical activity and lower cancer death rates.
  • Research has found that walking or cycling for at least half–an–hour a day is associated with a reduction in cancer and that when this is increased to an hour cancer incidence falls by 16%.
  • Evidence is mixed when it comes to specific cancers. Research has shown a strong relationship between increased physical activity and reduced colon cancer in both sexes. And men who are more active at work –– not just sitting at a desk –– have lower rates of prostate cancer.
  • Other cancer studies show that physical activity after diagnosis can aid recovery and improve outcomes.
  • Studies have also shown that men who are physically active are less likely to experience erection problems.
  • There is growing evidence that physical activity could decrease the risk of dementia in the elderly.

Recommendations identified by the review

  • Healthy adults aged between 18 and 65 should aim for 150 minutes of moderate intensity physical activity a week, such as 30 minutes of brisk walking, five days a week.
  • And people who undertake more vigorous intensity exercise, such as jogging, should aim for 20 minutes three days a week.
  • Healthy adults should aim for two strength–training sessions a week that work with the body’s major muscle groups.
  • Older people can benefit from exercise that helps to maintain their balance and flexibility.
  • People who are physically active should continue to exercise even when they become middle aged or elderly and those who aren’t should increase their physical activity.
  • Not smoking and following a healthy diet is also important.
Dr KK Aggarwal
Editor in Chief
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  SMS of the Day

(By Dr. G.M.Singh)

"Everyone is gifted – but some people never open their package."

    Photo Feature (from the HCFI Photo Gallery)

 Medico Masti 2010

Students from different colleges participated in large numbers in the painting competition as a part of Medico Masti, a College and Youth Festival in the 17th MTNL Perfect Health Mela>

Dr K K Aggarwal
    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

Awards and Laurels

Dr V P Sood, our guest editor for Asian Journal of ENT was selected & acclaimed as the Best ENT Doctor and was honored along with other top selected Doctors of various specialties of our country. The selection was done by a Jury of nine eminent medical personalities with impeccable record and unquestioned integrity who selected one specialist in each specialty. Zee News presented ‘Swastha Bharat Samman’ in the specialty of ENT to Dr VP Sood in a Grand Felicitation Ceremony held on 15th November.

Prevalence of HIV/AIDS in India

(Contributed by Dr. Surender N. Gupta, MBBS; PGDHHM; PGDMCH; PGCHFWM; FAIMS; FIMS; MA (Phil); MAE (Epidemiology) Faculty, Regional Health and Family Welfare Training Centre, Chheb, Kangra–Himachal Pradesh, India)

As per the HIV estimations 2010, India is estimated to have 23.9 lakh people infected with HIV in 2009 at an estimated adult HIV prevalence of 0.31%. Adult HIV prevalence among men is 0.36%, while among women, it is 0.25%.

The State–wise details of HIV prevalence among men and women and estimated number of HIV infections among men, women and children are annexed. Click: http://pib.nic.in/release/rel_print_page.asp?relid=67292

    International News

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

Resistance exercise may offer different cardio benefits

As reported by HealthDay News, a new study has found that resistance exercise such as weight training affects blood vessels differently than aerobic exercise and offers other cardiovascular benefits. Researchers at the Appalachian State University in Boone, N.C., compared blood vessel (vascular) responses to two types of moderate–intensity workouts: three sets of 10 repetitions of eight resistance exercises and 30 minutes of aerobic cycling. There were significant differences in the vascular responses to the two types of exercises. Resistance exercise produced greater increases in blood flow to the limbs, while aerobic exercise reduced arterial stiffness, but without an increase in blood flow. Resistance exercise also led to a longer-lasting decrease in blood pressure after exercise, compared to aerobic exercise.

(Dr Monica and Brahm Vasudev)

Smokers Urged to Join Thursday’s Great American Smokeout

Get ready, get set, quit! Thursday marked the annual Great American Smokeout, sponsored by the American Cancer Society, which urged all smokers to lay off the habit for at least 24 hours. There have been dramatic changes in attitudes about smoking and a large decrease in smoking rates since the Smokeout was first held in 1977. The annual event included local and nationwide events meant to encourage smokers to quit for at least one day in the hope that they may decide to permanently kick the habit. Smokers who took part are asked to quit smoking for 24 hours. Even if they don’t quit permanently, they learned that they can kick the habit for a day and that they have plenty of support if they decide to quit in the future, according to the American Cancer Society. The day included events such as parades, rallies, athletic activities and ceremonial cigarette burials and bonfires.

FDA Warning Letters issued to four makers of caffeinated alcoholic beverages

The U.S. Food and Drug Administration has warned four companies that the caffeine added to their malt alcoholic beverages is an "unsafe food additive" and said that further action, including seizure of their products, is possible under federal law.

Regenerative stem cell therapy offers new hope for treating cardiovascular disease

ScienceDaily: Northwestern Medicine physician researchers are revolutionizing treatment of cardiovascular disease by utilizing patients’ own stem cells to regenerate heart and vascular tissue. Northwestern Medicine is the lead site for a study examining stem cell transplantation as treatment for critical limb ischemia. (Dr Douglas Losordo, director of the Program in Cardiovascular Regenerative Medicine at Northwestern Memorial Hospital and the Eileen M. Foell Professor of Heart Research of Northwestern University’s Feinberg School of Medicine at the American Heart Association’s Scientific Sessions in Chicago, on November 17).

Avoid contracting pneumonia

The University of Maryland Medical Center suggests how to help prevent pneumonia:

  • Wash your hands often, especially after you use the toilet, change a diaper, prepare or eat food, or blow your nose.
  • Don’t smoke.
  • Get vaccinated for pneumonia and flu.
  • Children also should get an Hib vaccine.
  • In some children younger than 24 months, the drug palivizumab may be prescribed to help avoid pneumonia as a complication from another respiratory condition. [medlineplus]
    Infertility Update

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

What causes infertility in women?

The most common female infertility factor is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis. Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids are associated with repeated miscarriages. Aging is also an important factor in female infertility. The ability for ovaries to produce eggs declines with age, especially after age 35.

For queries contact: banerjee.kaberi@gmail.com

    Hepatology Update

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

How is Alagille’s diagnosed?

Diagnosing Alagille can be difficult in the young baby when the condition may appear very similar to other forms of liver disease, such as biliary atresia. Any one or a combination of the following may be required.

  • Blood tests: These are done so as to rule out some other conditions and show a high conjugated bilirubin (the chemical in the body which causes jaundice)
  • DISIDA scan of the liver: Shows reduced excretion of bile.
  • Liver biopsy: Particular features can be seen under microscope; bile duct paucity is seen on liver biopsy.
  • Special tests of the eyes and heart and X–rays of the spine to look for associated features
    Medicolegal Update

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

Death of a person admitted as medicolegal case

The following are the do’s and don’ts in case a person admitted as a medicolegal case expires.

  • A water proof identity slip must be tagged carefully on deceased body.
  • Inform the police immediately.
  • Send the body to the hospital mortuary for preservation, till the legal formalities are completed and the police releases the body to the lawful heirs.
  • Request a medicolegal postmortem examination.
  • Do not issue a death certificate even if the patient was admitted. Make a death summary for postmortem surgeon.
  • The dead body should never be released to the relatives; it should only be handed over to the police.
    Interesting Books to Read

Dr Jitendra Ingole, MD Internal Medicine, Asst Professor (Medicine), SKN Medical College, Pune

The Power of Now

Author: Eckhart Tolle

Why you should read it:

The author describes very simplistically that to achieve happiness; one must stay in the present moment fully without any botheration of past or worrying about future. Whilst this concept may seem old, but when one reads the book, reader gets new perspective of the same concept. Recommended for everyone to read!

    ENT Update

Dr. Aru Handa MS, DNB (Department Co–coordinator and Senior Consultant Deptt. Of ENT Moolchand Medcity)

Can medicines cause cough?

Angiotensin-converting enzyme inhibitors (ACEI) are well known to cause dry, non productive cough. Patients complain of irritation or scratchy feeling in the throat leading to cough. The incidence of ACEI-induced cough is 5 to 39% in patients taking ACEIs. This class of medicine is given to patients for hypertension and certain other cardiac conditions.
The onset of cough may be few days to weeks after starting the medication but sometimes may start even after a year. Many patients undergo extensive and expensive work up and treatment before the diagnosis of ACEI as the offending agent is made. The best way to manage is to stop the medication and change to some other suitable medicine. Many agents like inhaled sodium cromoglycate, theophylline, sulindac, indomethacin, calcium-channel antagonists (amlodipine and nifedipine), iron supplements, and the thromboxane receptor antagonist picotamide have been described as effective in managing this cough. Few sudies have shown good results also with agents like γ-aminobutyric acid agonist baclofen, the thromboxane synthetase inhibitor ozagrel, and aspirin, 500 mg/day (low-dose therapy with aspirin was found to be ineffective).
The cough subsides after 1 to 4 weeks of cessation of treatment but sometimes it may take as long as three months. The newer class II ACEI like telmasartan can also cause cough but the incidence is much less compared to class I drugs.
(Ref: Dicpinigaitis PV. Angiotensin-converting enzyme inhibitor-induced cough: ACCP evidence-based clinical practice guidelines. Chest 2006 Jan;129(1 Suppl):169S-173S).

    Lab Update

(Dr Naveen Dang and Dr Arpan Gandhi)

Beta 2 microglobulin

  • To evaluate the severity and prognosis of multiple myeloma, leukemia, or lymphoma
  • To distinguish between kidney disorders and to detest kidney damage
    Medi Finance Update

Personal Accident individual

Risk Group III

Persons working in underground mines, explosive magazines, workers involved in electrical installation with high tension supply, jockeys, circus personnel, persons engaged in activities like racing on wheels or horse back, big game, hunting, mountaineering, winter sports, skiing, ice hockey, ballooning, polo and persons engaged in occupations/activities of similar hazard.

    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

List of drugs prohibited for import


    IMSA Update

International Medical Science Academy (IMSA) Update

Toxicology update

The number of severe and/or fatal button battery ingestions has increased almost sevenfold since 1985 with serious sequelae or death occurring in 2.7 percent of all button battery ingestions. Ingestion of large diameter (≥20 mm) lithium cell batteries is strongly associated with major outcomes (eg, esophageal burn, perforation, or fistula) and death.

(Ref: Litovitz T, et al. Emerging battery-ingestion hazard: Clinical implications. Pediatrics 2010;125:1168).

    IJCP Special

Dr Good Dr Bad

Situation: A patient with heart failure needed a beta blocker.
Dr. Bad: Start any beta blocker.
Dr. Good: Start metoprolol succinate.
Lesson: Only carvedilol, bisoprolol and metoprolol succinate are approved for heart failure.

Make Sure

Situation: A patient with suspected pneumonia and normal x–ray died 12 hours after admission.
Reaction: Oh my God! Why were antibiotics not started?
Lesson: Make sure that all patients with suspected pneumonia are given antibiotic at the first suspicion as x–ray can be normal in the first 24 hours.

    Lighter Side of Reading

An Inspirational Story

How much to give?

One recalls the famous incident from history.

Rana Pratap was reeling after defeat from the Mughals. He had lost his army, he had lost his wealth, and most important he had lost hope, his will to fight. At that time in his darkest hour, his erstwhile minister Bhama Shah came seeking him and placed his entire fortune at the disposal of Rana Pratap. With this, Rana Pratap raised an army and lived to fight another day. The answer to this question how much to give is: "Give as much as you can!"


Mind Teaser

Read this…………………

Either weigh or whey  

Yesterday’s Mind Teaser: "EZ iii"

Answer for yesterday’s Mind Teaser: "Easy on the eyes"

Correct answers received from: Dr.K.P.Rajalakshmi, Dr Vijay Kansal,  Dr.K.V.Sarma

Answer for 22nd November Mind Teaser: "under cover cop"
Correct answers received from: Dr Rashmi Chhibber, Dr. Satish Gunawant, Dr U Gaur, Dr Amlendu Yadav, Dr Vijay Kansal, Dr. Apurva Koirala.

Send your answer to ijcp12@gmail.com


Laugh a While
(Contributed by Dr G M Singh)

Two snakes were out taking a stroll when the son snake turns to the mother snake and asks: "Mommy! Are we poisonous?" "Why, yes we are", says the second. Again the baby snake asks, "Are you sure we’re poisonous?" "Yes, we are very poisonous."

The baby snake becomes very upset. Again, he asks, "Are we really really poisonous?" "Yes we are really really poisonous. In fact we’re the most poisonous snakes in the world. Why do you ask?"

"I just bit my lip!!!"


    Readers Responses
  1. New Horizons in Medical Education - UC, Irvine: Dear All, the University of California has launched the most advanced methodology for teaching medical students with latest technologies. It is an interesting read to go through the link: www.zotzine.uci.edu/2010_11/imed.php Not sure if MCI would like to take some tips for revolution needed in our medical education settings. Best wishes: Dr Vivek Chhabra
    Public Forum

(Press Release for use by the newspapers)

ECG not reliable marker for predicting heart disease

Doing an ECG is of little use in predicting future heart problems for people who are examined because of chest pain, 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.

Both angina and heart attacks increase during winter months. Chest pain is the most common reason people seek medical attention for possible heart trouble, and an ECG, is a common test for such people. ECG, can be normal in the first six hours even in frank heart attacks. Missing the diagnosis of heart attack on ECG is the commonest mistake done in the emergency rooms. The most important parameters still continue to be the classical history and physical findings.

  • Chest pain which can be pinpointed by a finger is not a heart pain.
  • Pain lasting less than 30 seconds is not a heart pain.
  • Heart pain is diffuse in the center of the chest, lasts more than minutes and manifests as heaviness, burning, discomfort, heaviness or pain often precipitated by physical or mental exertion.

When in doubt one should do an exercise stress test and if negative these patients should be reassessed for risk factors.

If the patient is at high risk even with negative treadmill he/she should undergo risk reduction management for prevention of future heart attacks.

High risk patients are smokers, presence of blood pressure, obesity, high cholesterol and diabetes.

    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Workshop on Kidney Transplant

International Medical Science Academy, eMedinewS, Moolchand Medcity Board of Medical Education, IMA New Delhi Branch and IMA Janak Puri Branch

Date: Sunday 28th November 2010
Venue: Moolchand Medcity Auditorium, 9 – 12 noon

Chairperson: Dr (Prof) S C Tiwari, Director Fortis Institute of Renal Sciences & Kidney Transplant Moderators: Dr KK Aggarwal, Dr Kamlesh Chopra, Dr Sanjay Sood, Dr A K Kansal, Dr Archna Virmani

9.00 – 9.30 AM: Kidney Transplant: What every one should know: Dr Ramesh Hotchandani, Senior Nephrologist, Moolchand Medicity
9.30 – 10.00 AM: Kidney transplant scenario in India: Dr Sandeep Guleria, Transplant Surgeon, AIIMS
10.00 – 10.30 AM: Transplant immunobiology and immunosuppression. Dr Monica Vasudev, Assistant Professor Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee
10.30 – 11.00 AM: Kidney Transplant: managing difficult cases. Dr Brahm Vasudev, Assistant Professor of Medicine, Division of Nephrology, Director, Nephrology Fellowship Program, Medical College of Wisconsin
11.00 – 12.00 AM: Panel discussion

1. Dr. (Prof.) S C Tiwari
2. Dr. K K Aggarwal
3. Dr. S V Kotwal
4 .Dr. Ambar Khaira
5. Dr. Saurabh Misra
6 All Speakers

12.00 Noon: Lunch

(Registration free: email to emedinews@gmail.com

eMedinewS Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 08–09, 2011.

January 08, 2011, Saturday, 6 PM – 9 PM – Opening Ceremony, Cultural Hungama and eMedinewS Doctor of the Year Awards. For registration contact – emedinews@gmail.com

January 09, 2011, Sunday, 8 AM – 6 PM – 2nd eMedinewS revisiting 2010, A Medical Update

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