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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 ...

25th October 2010, Monday

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

First babies born using improved pre-IVF screening method

A pilot study of microarray-based comparative genomic hybridization, a new technique to detect most known genetic diseases prior to in vitro fertilization (IVF) undertaken to determine its clinically feasibility has recorded the first live births; twin girls born to a German woman and a baby Italian boy.
According to a statement from the European Society of Human Reproduction and Embryology (ESHRE), these children are the first to be born after oocyte polar bodies from their mothers were tested in the 23-chromosome assay. It said that the two successful deliveries are the final stage in the 'proof of principle' that the screening of oocytes and embryos before transfer in IVF can increase birth rates.
Around two-thirds of attempted embryo implants fail to produce pregnancies, often because of chromosomal defects. The comparative genomic hybridization assay tests all 23 chromosome pairs in a polar body, extracted from an oocyte fertilized via IVF. The error rate is ≤10%.
This new technique does away with the need to extract cells from an embryo, a time-consuming step and may be potentially damaging to the embryo. Also, chromosome mosaicism may render the genome of an individual cell unrepresentative of the embryo as a whole. Another potential advantage is that, because the assay may lead to higher viability rates of fertilized embryos, more women can have implants of only one embryo, reducing the chances of multiple births.
ESHRE plans to organize a larger international trial to begin next year if the several additional pregnancies in the pilot trial that have not yet reached term are also successful.

Dr KK Aggarwal
Editor in Chief
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  Chikungunya Update

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

Infection during pregnancy

  • Mother to fetus transmission can occur
  • Reported between 3 to 4.5 months of gestation
  • Maternal IgG develops in 2 weeks after CHIKV. This passes through placenta –confers protection.
  • Intra-partum risk is 48% if mother has viremia.
  • Neonatal infections are very mild; full recovery
  • No miscarriages or congenital malformations
  Photo Feature (from the HCFI Photo Gallery)

 Inauguration of the 17th MTNL Perfect Health Mela 

The 17th MTNL Perfect Health Mela was formally inaugurated by the Health Minister, Delhi, Prof. Dr.  Kiran Walia. 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.
In the Photo: Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela, Prof. Dr.  Kiran Walia and other dignitaries.

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Treatment of recurrent pregnancy loss

A large randomized trial found that neither aspirin alone nor aspirin + heparin improved the live-birth rate of women with unexplained recurrent pregnancy loss (RPL). In this trial, 364 women with unexplained RPL after a thorough evaluation were randomly assigned to receive daily aspirin (80 mg), aspirin plus nadroparin (2850 international units), or placebo during pregnancy. The live-birth rates for combination therapy, aspirin alone, and placebo were not significantly different: 69, 62, and 67 %, respectively.

(Ref: Kaandorp, SP, Goddijn, M, van der, Post JA, et al. Aspirin plus heparin or aspirin alone in women with recurrent miscarriage. N Engl J Med 2010;362:1586).

  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

Lancet, WHO at odds over malaria deaths in India

A row has emerged between prestigious medical journal, the Lancet, and the World Health Organisation (WHO) over conflicting figures of malaria deaths in India. A study published online by the Lancet says that between 1,25,000 and 2,77,000 deaths in India each year are due to malaria. The figures were derived from field reports on 1,22,000 deaths and reviewed by a team of physicians. According to the WHO estimates, only 15,000 deaths occur in the country as a result of malaria and one lakh cases of deaths reported to the disease worldwide.

Both of those estimates should be “reconsidered,” the new study says. “Despite uncertainty as to which unattended febrile deaths are from malaria, even the lower bound greatly exceeds the WHO estimate of only 15,000 malaria deaths per year in India (5,000 early childhood, 10,000 thereafter). This low estimate should be reconsidered, as should the low WHO estimate of adult malaria deaths worldwide,” the Lancet interpretation of the research report said.

Disputing the Lancet study, the WHO said in a statement, “Although the present malaria estimation procedures have their limitations, the WHO has serious doubts about the high estimate of 200,000 malaria deaths in India obtained by Dingra et al (Lancet researchers).” The WHO disputed verbal autopsy method as the same is suitable only for diseases with distinctive symptoms and not for malaria. (The Pioneer)

  International News

(Dr Monica and Brahm Vasudev)

Tool predicts postop problems from sleep apnea

A simple, 8-item questionnaire may be an effective way to identify patients at risk for postoperative complications because of hidden obstructive sleep apnea syndrome. Patients with high scores on the STOP-BANG questionnaire were significantly more likely to have postoperative complications than those with low scores (19.6% versus 1.3%, P<0.001), according to Tajender Vasu, MD, of Thomas Jefferson University Hospital in Philadelphia, and colleagues.

Certolizumab heals Crohn's ulcers

Findings of healing with certolizumab pegol (Cimzia) in Crohn's disease patients that were observed by local endoscopists were confirmed when the same recordings were reviewed by central readers, researchers said here. According to Xavier Hebuterne, MD, professor of medicine at University Hospital Nice, mucosal healing in these patients was uncommon, perhaps due to the severity of the illness. The study findings were presented at the annual meeting of the American College of Gastroenterology.

Low sodium may boost fracture risk

Low serum sodium may be a risk factor for fractures in the elderly. In a long-running cohort study in Holland, mild hyponatremia was associated with an increased risk of nonvertebral fractures and prevalent vertebral fractures, according to Carola Zillikens, MD, of Erasmus Medical Center in Rotterdam.

Treating GERD improves sleep, performance

Nighttime dyspepsia and associated sleep disturbance improved significantly during treatment with a proton pump inhibitor, which in turn improved alertness on a simulated driving test  according to a new study reported at the meeting of the American College of Gastroenterology.

  Hepatology Update

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

Inflammatory Bowel Disease

Liver What are the characteristics of IBD?

Ulcerative Cloitis (UC) is characterized by diffuse mucosal inflammation limited to the colon. Disease extent can be divided into distal or more extensive disease.

• ‘‘Distal’’ disease refers to colitis confined to the rectum (proctitis) or rectum and sigmoid colon (proctosigmoiditis). More extensive disease includes ‘‘left sided colitis’’ (up to the splenic flexure),
• ‘‘extensive colitis’’ (up to the hepatic flexure), and pancolitis (affecting the whole colon)in around 60-80% of the children.

In contrast to UC, Crohn’s disease is characterized by patchy, transmural inflammation, which may affect any part of the gastrointestinal tract. It may be defined by location (terminal ileal, colonic, ileocolic, upper gastrointestinal), or by pattern of disease (inflammatory, fistulating, or stricturing)

  Infertility Update

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

Do I need endometriosis surgery if I am already planning to pursue IVF? 

The question of endometriosis surgery prior to IVF is a somewhat controversial area of reproductive medicine. Most reproductive endocrinologists do not recommend surgery prior to IVF unless the woman has advanced endometriosis, in particular, an ovarian endometrioma.

IVF is associated with excellent pregnancy rates (even without surgery) in women who have only mild to moderate endometriosis. When advanced endometriosis is present, such as an ovarian endometrioma, its surgical removal prior to IVF may enhance the chances for a successful IVF outcome and may decrease infectious complications related to egg collection. Thus, in such cases, most reproductive endocrinologists often recommend the removal of advanced endometriosis prior to treatment using IVF.

  Books to read

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

Better (By Atul Gawande)

Written in very lucid and simple English language for lay man and medical professionals, the author Atul Gawande, who is a surgeon himself in US, tries to explain intricacies of Medical profession by giving real life examples. His style is peculiar: He starts with real life patient story and intersperse it with his thoughts, why a particular event occurs; the behavior of persons involved; their reactions and so on. Experience yourself! 

  Medicolegal Update

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

What steps can be taken to prevent poisoning?

It is important to handle all chemicals safely, not just the ones you know to be poisons. Many chemicals that you might not think are poisonous could make someone ill or cause burns. It is very important to protect children, because they cannot protect themselves and they do not understand that some things can be poisonous. Many poisonings could be prevented if chemicals were kept safely, used safely and disposed off safely.

  • Do keep medicines, cleaners and pesticides where children cannot see or reach them.
  • Do not keep chemicals you no longer need.
  • Do not put chemicals in containers that once contained food or drink; people may eat or drink the chemicals by mistake.
  • Do use medicines, cleaners, pesticides and other chemicals in the right way, and use the right amount neither more nor less. Read the label and follow carefully the instructions for use. A person who cannot read it should find someone who can. It may be dangerous to use chemicals from unlabeled containers. Ask the supplier for another container with a label.
  • Do find out whether it is better to bury or burn the chemicals you want to get rid of. Choose a place to bury or burn chemical waste where there will be as little danger as possible to the people living nearby or to the environment.
  • Do find out from environmental health officers or community leaders the local arrangements for getting rid of chemical waste. Seek professional advice about how to get rid of large amounts of unwanted chemicals.
  • Do not use empty bottles, cans or other containers that have been used for storing chemicals to store or cook food or drink. Do not give them to children to play with.
  • Do not leave left-over chemicals or empty containers where children might find them.
  •   Do not throw left-over chemicals or empty containers near a river, pond or spring. Chemicals might get into the water and poison fish, or poison people or animals that drink the water or wash in it. This may also happen if chemical waste is poured into drains that empty into waterways.
  Medi Finance Update

The person extending the loan, certifies that such interest is payable in respect of the amount advanced for acquisition or construction of the house or as refinance of the principal amount outstanding under an earlier loan taken for such acquisition or construction. If the conditions stated above are not satisfied, then the interest on borrowed capital is deductible upto Rs 30,000.

  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

Combination of anabolic Steroids with other drugs

  Lab Update

Prothrombin time (PT)

Done in a person with hepatitis or suspected hepatitis. Coagulation factors (proteins used in the formation of a blood clot) are mostly produced by the liver, and prolonged PT may indicate the severity of liver damage.

emedinews 3D echocardography
  IJCP Special

Dr Good Dr Bad

Situation: A patient with pain in abdomen was found to have a TLC > 20000
Dr Good: Rule out liver abscess
Dr Bad: Get TLC repeated
Lesson: Liver abscess typically has TLC > 15000

Make Sure

Situation: A patient with dengue fever developed shock.
Reaction: Oh My God! Why was the blood pressure 90/70 ignored?
Lesson: Make sure that a pulse pressure of less than 20 is not ignored, it is an impending sign that the patient is going into shock.

Quote of the Day (Dr Chandresh Jardosh)
"Some people succeed because they are destined to, but most people succeed because they are determined to."

Mind Teaser

Read this…………………


Answer for yesterday’s Mind Teaser: "The good, the bad, and the ugly"

Correct answers received from: Dr Virender Prakash Gautam, Dr. K. P. Rajalakshmi, Dr. Hiren Shah, Dr Neelam Nath

Answer for 23rd October Mind Teaser is: "A little on the large side"
Correct answers received from: Dr Sukanta Sen, Dr AK Sharma.

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Anuj Goyal)

Just because someone doesn't love you the way you want them to, doesn't mean they don't love you with all they have.  Ralph and Edna were both patients in a mental hospital.  One day while they were walking past the hospital swimming pool Ralph suddenly jumped into the deep end. He sank to the bottom of the pool and stayed there.

Edna promptly jumped in to save him.  She swam to the bottom and pulled him out.  When the Head Nurse Director became aware of Edna's heroic act she immediately ordered her to be discharged from the hospital, as she now considered her to be mentally stable.

When she went to tell Edna the news she said, 'Edna, I have good news and bad news.  The good news is you're being discharged, since you were able to rationally respond to a crisis by jumping in and saving the life of the person you love....  I have concluded that your act displays sound mindedness. The bad news is, Ralph hung himself in the bathroom with his bathrobe belt right after you saved him..  I am so sorry, but he's dead.'

Edna replied, 'He didn't hang himself, I put him there to dry....How soon can I go home?'

  An Inspirational Story

(Contributed by Dolly Aggarwal)

10 virtually instant ways to improve your life

Many of our problems come from within our own minds. They aren’t caused by events, bad luck, or other people. We cause them through our own poor mental habits. Here are 10 habits you should set aside right away to free yourself from the many problems each one will be causing you.

  1. Stop jumping to conclusions: There are two common ways this habit increases people’s difficulties.
        * First, they assume that they know what is going to happen, so they stop paying attention and act on their assumption instead. Human beings are lousy fortune-tellers. Most of what they assume is wrong. That makes the action wrong too.
        * The second aspect of this habit is playing the mind-reader and assuming you know why people do what they do or what they’re thinking. Wrong again, big time. More relationships are destroyed by this particular kind of stupidity than by any other.
  Readers Responses
  1. Dear Dr KK Aggarwal, The perfect health Mela has completed a journey of 16 year. My Best wishes for 17th Perfect Health Mela. Hats off to you for the tremendous effort, hard work put into make this event a grand success for the last so many years Dr Anupam.
  Public Forum

(Press Release for use by the newspapers)

17th MTNL Perfect Health Mela Inaugurated 

Inaugurating the annual popular Health Carnival, the 17th MTNL Perfect Health Mela, Smt Sheila Dikshit, Chief Minister, Delhi, in her message said that lifestyle disorders are on the rise in the country in general and Delhi in particular. She expressed concern about the rising lifestyle disorders amongst the middle class and upper lower class people. Eating junk food and not exercising are the two major reasons which are affecting this population.
The Mela is being organized by Heart Care Foundation of India in association with various departments of Delhi Government and is providing free entry, Checkups, Consultations and Participation in competitions. It will end on 31st October, Sunday.
Sh. S Y Qureshi, Chief Election Commissioner said that the rising epidemic of obesity in the country is a matter of concern. He appealed to the public to adopt a healthy lifestyle with balanced food and regular exercise.
The Health Minister, Delhi, Prof. Dr.  Kiran Walia, said that Delhi Government would soon be launching a lifestyle awareness campaign. Sh. Prithvi Raj Sawhney, Mayor of Delhi said that anemia is rampant in the society and needs to be controlled. MCD is also conducting a general public survey and distributing iron tablets to people with anemia. Sh. Rakesh Mehta, Chief Secretary, Delhi Government, said that the only way to treat lifestyle disorders is to adopt a holistic lifestyle. He said that both medication as well as meditation are important for health.
Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela said that the Mela will be a perfect picnic spot for public to understand everything about health.
Sh. Kuldeep Singh CMD, MTNL said that the SMS is a new effective way of health communication. Sh Parimal Rai, Chairman NDMC, laid importance of making Delhi clean and green for better health. Dr T Ramasami, Secy., DST, said that every health communication must be based on science.
Sh. H Ratnakara Hegde, Executive Director, Oriental Bank of Commerce and Sh. V K Sinha, Zonal Manager, LIC in a joint statement called upon the financial institutions to include peoples’ health as a part of their working agenda. They should do so not just in the urban areas, but in the rural segments where 70% of India lives.
Ms Nalini Kamalani, Mr Ashok Chakradhar, Ms Surender Khanna who were the Special Guests of the day, in a joint statement said that health is not merely absence of diseases but a state of physical, social, mental and spiritual wellbeing.
The first day of the Mela
More than 10000 people visited the Mela on the first day and availed free checkups. Live performance was given by Punjabi Academy.
Over 350 Children with Special Needs participated in a special competitions organized for them by the foundation in association with Balwant Ray Mehta Vidhya Bhawan.
Today's attractions
On Monday Dr Sadhna International Women Rights Protection trust will organize a seminar on Women Empowerment 9 am - 1 pm. Dr Kaberi Banerjee, Ms Sandhya Bajaj, Mr Amod Kanth, Ms Kiran Chopra, Hasya Kavi, Mr Ashok Chakradhar will be amongst the speakers.

Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

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

29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
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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