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     In This Issue...
Dr K K Aggarwal

Dear Colleague,

We hereby produce some important web medinews.

  1. Statins may benefit patients with high levels of inflammation: Statins could be as beneficial for people with acceptable cholesterol readings but high levels of inflammation as they are for those with high cholesterol levels, according to research published in the journal Circulation.
  2. Changes in temperature or humidity could exacerbate asthma: Many patients with asthma know that their illness can vary with the seasons. However, a new study appearing in the Annals of Allergy, Asthma & Immunology suggests that it's not just pollen counts or cold weather that can trigger an asthma attack. It is any change in temperature or humidity. 

H1N1 Flu Update
New Research
Pharma Update
In the Spotlight
Indian Penal Codes to Know
Formulae in ECG
Formulae in Diabetology
A 10% increase in humidity two days before the admission day was associated with one additional visit to the ED. For temperature, an interday change of 10 degrees one day before the admission resulted in two additional visits.
  1. Timing of CABG does not appear to influence outcomes: According to a study published in the journal Anesthesiology, timing isn't anything, at least when it comes to elective coronary bypass surgery. The success rate was constant, regardless of the time of day, the day of the week, the month of the year and the phase of the moon.
  2. DMC Elections: are on 4th October from 9-5 pm at Pusa Institute Auditorium. You need to bring any govt. identity proof and your DMC registration number. It's important to have FAITH in DMC and come for voting. Your FAITH in DMC only can look after the interest of medical profession.

Dr K K Aggarwal



H1N1 Flu Update

2009 H1N1 vaccines tolerated, induce strong immune response

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health in the U.S., has revealed that early data from recent trials suggest that 2009 H1N1 influenza vaccines are well tolerated, and induce a strong immune response in most healthy adults, when administered in a single unadjuvanted 15-microgram dose. However, for adults aged 65 and older, the immune response to 2009 H1N1 influenza vaccine is somewhat less robust.

Source: www.medindia.net/news/Immune-Response-58006-1.htm


Tamiflu to be available in chemist shops in a week

Tamiflu, the drug used in the treatment of swine flu, will be available in the open market within a week, a health ministry official said. The ministry of health and family welfare issued a notification allowing 'restricted sale' of tamiflu (Oselatamivir) and Zanamivir. The retail sale of tamiflu was banned by the central government and its distribution was permissible only through public health institutions. However, there was no restriction on the sale of Zanamivir.

Source: http://www.newkerala.com/nkfullnews-1-113270.html


New Research

Gene find 'may curb lung mucus'

It's not clear why lungs of people with conditions such as asthma and cystic fibrosis have often clogged up with thick mucus. Lead researcher Dr Jeffrey Whitsett said a way to combat excessive mucus production would potentially be a significant step that could lead to new treatment. They used a protein from egg whites to induce an allergic reaction in inflammation in the animals' lungs, and showed that SPDEF (a gene key to the process of mucus production) activity soared in the affected tissues. But when the gene was switched off, inflammation; excessive mucus production did not occur. Mice lacking SPDEF were unable to increase mucus production or develop goblet cells. The finding of SPDEF could lead to effective treatments for those millions with chronic lung disease in the world.

Source: http://news.bbc.co.uk/2/hi/health/8254020.stm

Robots 'to revolutionize surgery'

Scientists are working on the real possibility of building a robot inside a person by Ares (Assembling Reconfigurable Endoluminal Surgical System). There would be several modules which are very small like pills that can combine together inside. The idea is to introduce these robots from the mouth or anus or the umbilicus. It sounds fantastic, but prototypes are already in existence that can crawl and swim inside the body taking pictures of difficult to access areas. This is the dream. At the moment it is not so advanced to satisfy the dream but it's the direction.

Source: http://news.bbc.co.uk/2/hi/health/8238088.stm

How people lose muscles as they get older

As age catches up, it becomes harder to keep muscles healthy. They get smaller which decreases strength and increases the likelihood of falls and fractures. Researchers have already shown that when older people eat, they cannot make muscle as fast as the young, and now they have found that the suppression of muscle breakdown, which also happens during feeding, is blunted with age. They believe that a 'double setback' affects people aged over 65. But the team thinks that weight training may 'rejuvenate' muscle blood flow, and help retain muscle for older people.

Source: http://www.newkerala.com/nkfullnews-1-110798.html

Second child within a year 'increases breast cancer risk'

A research involving 30,000 women, each of whom had given birth to five or more children, has shown that those with a gap of less than 12 months were 5.2 times more likely to develop the advanced ductal breast cancer than women who had a gap of three or more years. Although it is unclear that why the risk increases, researchers believe hormones might be involved. But this does not mean that women who had their first two births close together worry because the study's results are not conclusive.

Source: http://www.newkerala.com/nkfullnews-1-111474.html

Difficulties in performing daily activities linked to dementia

Mild cognitive impairment is recognized as a risk factor for dementia. During the study, Dr. Sarah Tomaszewski Farias of the University of California, and colleagues studied 111 individuals with mild cognitive impairment. During an average of 2.4 years of follow-up, 28 individuals progressed from mild cognitive impairment to dementia, including 23 from the clinic and five from the community. Other than recruitment source, the only factor associated with conversion from mild cognitive impairment to dementia was the degree of functional impairment.


Engineered human fusion protein stops HIV-1 replication in mice

Owl monkeys make a fusion protein (AoT5Cyp) that potently blocks HIV-1 infection. Therefore scientists at the University of Geneva in Switzerland have engineered a human HIV-1 inhibitor modeled after AoT5Cyp, by fusing human cyclophilin A to human TRIM5 (hT5Cyp) because humans do not make the T5Cyp fusion protein. The researchers said that the human fusion protein blocks HIV-1 infection of human macrophage and T cell lines, without disrupting normal cell function.


Pharma Update

Natalizumab drug improves quality of life of MS patients

A new study has found that multiple sclerosis patients taking Tysabri (Natalizumab) experienced a significant improvement. Dr William Stuart, medical director of the Multiple Sclerosis Center of Atlanta said that after six TYSABRI infusions, patients reported statistically significant improvement in disease-specific quality of life (QoL), which measures the physical impact of MS in terms of mobility and self care, as well as the psychological impact of MS in terms of anxiety/depression.



Common pain cream could protect heart during attack

Keith Jones, PhD, and colleague have found that applying capsaicin to specific skin locations in mice caused sensory nerves in the skin to trigger signals in the nervous system. These signals activate cellular 'pro-survival' pathways in the heart which protect the muscle. Capsaicin is the main component of chili peppers and produces a hot sensation. It is also the active ingredient in several topical medications used for temporary pain relief. It is approved for use by the U.S. FDA. They observed an 85% reduction in cardiac cell death when capsaicin was used.


Dysport Approved for Cervical Dystonia Pain

The FDA has approved the Biologics License Application for Dysport (abobotulinumtoxin A; Ipsen) for the treatment of cervical dystonia. Dysport, an acetylcholine release inhibitor and a neuromuscular blocking agent, reduces the severity of abnormal head positions and neck pain in adults. Ipsen expects to launch Dysport for cervical dystonia in the second half of 2009. For more information, go to Ipsen.com.

Source: Pain Medicine News 2009;7(6):5


In the Spotlight

World's first patient with smallest neurostimulator completes a year

One year ago, former U.S. Army parachutist Adam Hammond became the first patient in the world to have been implanted with an Eon Mini neurostimulator. Adam got the chronic pain after a skydiving accident when his parachute deployed incorrectly. The accident left him dependent on a wheelchair. But today, the picture has completely changed. He is active and exercising as well as studying law. Over 60,000 St. Jude Medical neurostimulation devices have been implanted in patients in 35 countries around the world.

Source: http://www.newkerala.com/nkfullnews-1-110622.html


Indian Penal Codes to Know

IPC 323

Punishment for Voluntarily Causing Hurt

Whoever, except in the case provided for by Section 334, voluntarily causes hurt, shall be punished with imprisonment of either description for a term which may extend to one year, or with fine which may extend to one thousand rupees, or with both.



            All Emergency room Physicians should know about this code.
MTNL Perfect Health Mela 2009


Formulae in ECG

Differential Diagnosis of  ST Segment Depression

Normal variants or artifacts

  • Pseudo-ST-depression (wandering baseline due to poor skin-electrode contact)
  • Physiologic Junctional depression with sinus tachycardia (most likely due to atrial repolarization)
  • Hyperventilation-induced ST segment depression

Ischemic heart disease

  • Subendocardial ischemia (exercise-induced or during angina attack)

Nonischemic causes of ST depression

  • RVH (right precordial leads) or LVH (left precordial leads, I, aVL)
  • Digoxin effect on ECG
  • Hypokalemia
  • Mitral valve prolapse (some cases)
  • CNS disease
  • Secondary ST segment changes with IV conduction abnormalities (e.g. RBBB, LBBB, WPW, etc.)

Formulae in Diabetology

Sliding Scale

Starting dose of insulin
Type 1 diabetes mellitus = 0.6 - 0.7 u/kg/d
Type 2 diabetes mellitus = 0.3 u/Kg/d

Lower doses

  • Low weight Type 1 diabetes mellitus
  • Renal Failure (Insulin 50% renal excretion)

Sliding Scales

B. Very low schedule (Insulin-sensitive)
              1. BG 150-199: 0.5 unit bolus Insulin (regular or RA)
            2. BG 200-249: 1 units bolus Insulin
            3. BG 250-299: 1.5 units bolus Insulin
            4. BG 300-349: 2 units bolus Insulin
            5. BG Over 350: 2.5 units bolus Insulin

C. Low schedule
            1. BG 150-199: 1 unit bolus Insulin (regular or RA)
            2. BG 200-249: 2 units bolus Insulin
            3. BG 250-299: 3 units bolus Insulin
            4. BG 300-349: 4 units bolus Insulin
            5. BG Over 350: 5 units bolus Insulin

Higher doses

  • Heavy weight Type II Diabetes Mellitus
  • Corticosteroid use 
  • Sepsis or severe illness

D. Medium schedule
            1. BG 150-199: 2 unit bolus Insulin (regular or RA)
            2. BG 200-249: 3 units bolus Insulin
            3. BG 250-299: 5 units bolus Insulin
            4. BG 300-349: 7 units bolus Insulin
            5. BG Over 350: 8 units bolus Insulin

E.High schedule (Insulin-resistant)
            1. BG 150-199: 3 unit bolus Insulin (regular or RA) 
            2. BG 200-249: 4 units bolus Insulin
            3. BG 250-299: 7 units bolus Insulin
            4. BG 300-349: 10 units bolus Insulin
            5. BG Over 350: 12 units bolus Insulin



Doctor: I have some bad news and some very bad news.
Well, might as well give me the bad news first.
Doctor: The lab called with your test results. They said you have 24 hours to live.
Patient: 24 HOURS! That?s terrible!! WHAT could be WORSE?
What's the very bad news?

I've been trying to reach you since yesterday. A man speaks frantically into the phone, "My wife is pregnant, and her contractions are only 2 minutes apart!" "Is this her first child?" the doctor queries. "No, No!" the man shouts. "This is her husband!"


Head Office: Daryacha 39, Hauz Khas Villege New Delhi -110 016, Ph.26965874 / 75. e-mail: editorial@ijcp.com



Delhi Medical Council Needs A Visionary Leadership  

Dear Colleagues,


                   The  medical profession in the country is passing through trying times. We are faced with the challenge  of positioning our country and capital city as the global capital of health. We are also faced with the reality of a society  more hostile, litigious and suspicious of the medical  profession. Every day one hears of assaults on the profession. Every hour we face the  increasing menace of quackery breathing down our necks. AND every minute we are facing the wrath of innumerable authorities unaware of the realities of the profession.

The Delhi Medical Council (DMC) as the statutory body is responsible to provide protection to its members in discharging duties; ensure that no unqualified person practises modern scientific medicine in addition to receiving complaints form public against misconduct or negligence by doctors and take disciplinary action as deemed fit.

After the recent judgment by Hon'ble Supreme Court of India, it has become mandatory for Consumer Fora, Criminal Court and the police to first refer the matter to a compeptent doctor or committee of doctors, and only after that doctor or committee report that there is  a prima facie case of medical negligence can  notice be then issued to the concerned  doctor/hospital. Most of such cases are referred to DMC for opinion.


The  role of the DMC has thus become paramount.

With the elections for DMC already scheduled, we are now going to elect our next council for a five-year-term. It is in the interest of the medical profession and the society  at large to elect a dedicated team of professionals with  proven track record; vision and a pro-active and forward looking approach. It is these elected 8 representatives (plus 1 elected from amongst DMA members) who would represent you all and take care of the interests of the profession. 

Friends, we have been approached by innumerable colleagues in Delhi to field a team which fulfills the above. In all humility we offer ourselves to represent you in the DMC for the ensuing half a  decade. It is the under mentioned group of your representatives in DMA who have been responsible for the recent enactment of 'Delhi Medicare Service Personnel & Medical Service institution  (Prevention of Violence ) Act' by Delhi Assembly as well as the recent Supreme Court judgment protecting interests of Nursing Homes &  Medical Establishment in Delhi.



We Commit, that if elected we shall take care of the interests of the medical profession in Delhi to the best of our abilities.


Foremost amongst our AGENDA would be:


  1. To ensure that the DMC functions in a manner most transparent, positive and profession friendly.

  2. To Provide unstinted protection to medical professionals in  Delhi in discharging their professional duties.

  3. To root out the menace of quackery from Delhi by ensuring that no unqualified person  practies modern scientific system of  medicine.To adopt practical strategies for the above rather than keep making hue and cry on paper.

  4. To adopt  profession friendly strategies and prescribe a code of ethics for regulating the professional conduct of practitioners. To constantly update the profession  on issues: Legal, statutory, ethics-related which they must know.

  5. To fight for abolition of fees for Renewal of Registration in DMC.

The date of elections would be announced shortly. We shall also communicate the same to you. We look forward to your suggestions, and indulgence in this process. It's only our active indulgence today which would carve out a better future for all of us tomorrow.

Kind Regards 

Dr. Sanjiv Malik (mob. 9810026796)


Dr. Naresh Chawla (mob. 9811035060) 


Dr. Ashwini Dalmiya (mob. 9811542055)


Dr. K. K. Aggarwal (mob. 9811090206)


Dr. Chander Prakash (mob. 9810029000)


Dr. H. S. Kukreja (mob. 9810064847)


Dr. Vinod Khetarpal (mob. 9811054945)


Dr. Ramesh Dutta (mob. 9811086688)



Contact Us at:



Delhi Medical Council


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