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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

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

  Editorial …

25th November 2011, Friday

Life expectancy shorter after TIA

Nine years after discharge, the survival of patients hospitalized with a transient ischemic attack (TIA) was 20% lower than expected in the general population. Before a decade had passed, 50% of TIA patients had died; the mortality rate was minimal among patients younger than 50, but significant among those older than 65, Melina Gattellari, PhD, of the University of New South Wales, and colleagues reported online in Stroke.

Many with coronary artery disease not on statins

Despite evidence from clinical trials that statins help prevent cardiovascular event, many patients with obstructive coronary artery disease (CAD) are not being treated with statin medications. Of patients in the study with obstructive heart disease, 30,160 were being treated with statins, another 2,042 had been prescribed only nonstatin lipid–lowering medications, and 6,441 got both. The remaining 6,575 were untreated (Dr Suzanne V. Arnold, from St. Luke’s Mid America Heart Institute in Kansas City, Mo.)

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

Life expectancy shorter after TIA

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011–Eco Fest–An Inter School Eco Club’s Health Festival

Purpose of this competition is not only to have a competition but to learn preventive strategies so that the children in future can become healthy adults.

Dr K K Aggarwal
    National News

Apollo Hospital launches web portal on diabetes

CHENNAI: The Apollo group of hospitals on Wednesday launched a web portal (www.sugar24X7.com) that promises to provide comprehensive diabetes management services to patients. The web portal helps a patient keep track of his test records, appointment with doctors, consultations and prescriptions. The patient can enter their blood glucose levels on the website through their mobile phones and get immediate feedback on what they should do to bring it to normal. "Diabetes management is very important and this portal will make sure that patients can lead a better quality of life by spending just five minutes every day to track their glucose levels," said Dr Prathap C Reddy, chairman, Apollo Group of Hospitals. (Source: TOI, Nov 24, 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

Teens tend to skip fruits and veggies, survey shows

U.S. high school students do not eat their fruits and vegetables very often –– and certainly not in the recommended daily amounts, researchers found. In a school–based survey, 28.5% of students said they ate fruit less than once a day and one–third said they ate vegetables infrequently, according to Sonia Kim, PhD, of the CDC’s Division of Nutrition, Physical Activity, and Obesity in Atlanta, and colleagues. Only 16.8% consumed fruits and 11.2% ate vegetables at least four times daily, the researchers reported in the November 25 issue of Morbidity and Mortality Weekly Report. (Source: Medpage Today)

For comments and archives

4 drugs cause most adverse–event hospital stays for seniors

Adverse drug events (ADEs) cause an estimated 100,000 emergency hospitalizations for seniors each year, yet two thirds involve just a handful of anticoagulants and diabetes medications, according to a study published in the November 24 issue of the New England Journal of Medicine. The study, by researchers from the US Centers for Disease Control and Prevention (CDC), singles out 4 drugs and drug classes — warfarin, oral antiplatelet medications, insulins, and oral hypoglycemic agents. Alone or together, they account for 67% of emergency ADE hospitalizations of adults 65 years and older. Warfarin was implicated in 33%, lead author Daniel Budnitz, MD, MPH, director of the CDC’s Medication Safety Program, and coauthors write. (Source: Medscape Medical News)

For comments and archives

Glucose control no guarantee against HF

For patients with type 2 diabetes, tight glycemic control does not reduce the risk of heart failure, according to a large meta–analysis. Indeed, one class of drugs used to control glucose – the thiazolidinediones – may actually increase the risk, according to John McMurray, MD, of the University of Glasgow in Glasgow, Scotland, and colleagues. The findings appear to contradict epidemiological evidence that has suggested a link between blood glucose, as measured by glycated hemoglobin (HbA1c) levels, and heart failure, McMurray and colleagues reported in the November issue of the American Heart Journal. (Source: Medpage Today)

For comments and archives

   Twitter of the Day

@DrKKAggarwal: 1. Life isn’t about finding yourself. Life is about creating yourself. 2. You cannot find peace by avoiding life.

@DeepakChopra: #CosmicConsciousness Take away all your labels & you remain the infinite being.

    Spiritual Update

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

What is the Importance of Agni in Pooja and in the Phera Ceremony?

Hinduism accepts Fire as the symbol of purity and the Deity is called Agni Devta who is worshipped in all Hindu rituals, like havans, yagnas, ahutis, sankalpa, marriage ceremonies (saptpadi or seven pheras around the fire). Fire destroys impurities without it being affected.

For comments and archives

   An Inspirational Story

(Ms Ritu Sinha)

Some thing you keep

Some things you keep; like good teeth, warm coats and bald husbands. They’re good for you, reliable and practical and so sublime that to throw them away would make the garbage man a thief. So you hang on, because something old is sometimes better than something new, and what you know often better than a stranger.

These are my thoughts. They make me sound old; old and tame and dull at a time when everybody else is risky and racy and flashing all that’s new and improved in their lives. New spouses, new careers, new thighs, new lips.

The world is dizzy with trade–ins. I could keep track, but I don’t think I want to. I grew up in the fifties with practical parents – a mother, God bless her who washed aluminum foil after she cooked in it, then re–used it– and still does. A father who was happier getting old shoes fixed than buying new ones.

They weren’t poor, my parents, they were just satisfied. Their marriage was good, their dreams focused. Their best friends lived barely a wave away.

I can see them now; Fifties couples in Bermuda shorts and Banlon sweaters, lawn mower in one hand, tools in the other. The tools were for fixing things – a curtain rod, the kitchen radio, screen door, the oven door, the hem in a dress. Things you keep.

It was a way of life, and sometimes it made me crazy. All that re–fixing, re–heating, renewing, I wanted just once to be wasteful. Waste meant affluence. Throwing things away meant there’d always be more.

But then my father died, and on that clear autumn night, in the chill of the hospital room, I was struck with the pain of learning that sometimes there isn’t any ‘more’. Sometimes what you care about most gets all used up and goes away, never to return.

So, while you have it, it’s best to love it and care for it and fix it when it’s broken and heal it when it’s sick. That’s true for marriage and old cars and children with bad report cards and dogs with bad hips.

You keep them because they’re worth it, because you’re worth it. Some things you keep.

For comments and archives

   Cardiology eMedinewS

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

CSI News

Prosthetic heart valves – Follow up as important as surgery itself

For comments and archives

CSPF the cause of ASCS in patients with normal coronary arteries

For comments and archives

Complete versus incomplete revascularization in CABG:

For comments and archives

New test to measure PAH prognosis

For comments and archives

    Fitness Update

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

Cardio vs Weights for FAT loss!

Every day we hear quotes such as the following: "I want to lose fat, so I will start doing cardio for the first six months and then I will start the weights AFTER I lose the fat", or my all time favorite, "I just do cardio to keep the fat off". The problem with these statements is that they disregard basic principles of exercise physiology that state that there exists a balance of these two exercise modes.

Cardiovascular exercise and Resistance training exercise have different outcomes on the human body. A proper balance is needed to ensure fat–loss is maximized. The following is a general starting guide for you to consider:

  • Beginners (less than 6 months weight training): 3–6 days cardio and 2–3 days of weight training
  • Intermediate: 50/50 split between the two modes of exercise. For example weights on Mon/Wed/Fri and Cardio on Tue/Thur/Sat
  • Advanced: Favor more resistance training to optimize hormonal balance and maintain metabolism. For example weight training 5 days a week and cardio 2 days a week. This will ensure you stay on the fat burning fast track.
    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Older drivers are involved in more fatal car crashes per miles driven than any other age group except teenagers. Drivers over the age of 75 years also have more traffic violations and nonfatal collisions than younger drivers.

    Medicine Update

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

How is a patient of chronic hepatitis B treated?

  • Consensus guidelines for the treatment of chronic HBV in children have not been established, and indications for antiviral therapy in adults with chronic HBV infection may not be applicable to children.
  • Factors that are predictive of a positive response to interferon (IFN) or nucleoside analogs include high pretreatment levels of aminotransferase (>2 × ULN), low pretreatment HBV DNA levels (<105 copies/mL or 20,000 IU/mL), late acquisition of HBV infection, and higher hepatocellular inflammation.
  • Treatment should be considered if patients have persistently elevated ALT levels >2 × ULN and evidence of active viral replication (HBeAg seropositive, and/or HBV DNA levels >105 copies/mL or 20,000 IU/mL in their serum) for more than 3 months.
  • Treatment aims to achieve long term remission so that the chance of hepatocellular carcinoma and chronic liver disease is decreased.
  • Symptomatic children with ongoing viral replication and active liver disease need treatment. Therapy aims to prevent HBV replication and decrease inflammation and normalize transaminases.
  • According to the American guidelines, the pediatric patients should be referred to pediatric liver specialist for development of strategy for monitoring, treatment, and/or cancer evaluation.
  Legal Question of the Day

(Dr M C Gupta)

Can an RMP prescribe drugs not approved by the DCGI but in respect of which clinical trials have been held and published?

  • Informing him in writing that the drug is not approved by the DCGI;
  • Informing him the background of the drug proposed to be used, along with pros and cons and reasons for suggesting its use;
  • Taking an informed consent from him that he has understood the above and has given consent knowingly and voluntarily.
  1. It is illegal to prescribe or give a drug to patients if it has not been approved by the Drug Controller General of India. A doctor has been punished by MCI for this reason in one of my cases. The drug in question is an approved drug to be used in a certain manner but the doctor had used it in an unapproved manner. The consequences are likely to be graver if the drug is not approved at all.
  2. When there are reasonable and justifiable grounds for using an unapproved drug, it may be used for a patient or prescribed to him AFTER the following:
    IJCP Special

Dr Good Dr Bad

Situation: A patient with fever was found to have raised SGOT, SGPT levels with SGOT>SGPT.
Dr. Bad: It is classical viral hepatitis.
Dr. Good: This can be dengue fever.
Lesson: Mild elevations in SGOT/SGPT are common in both dengue fevers and dengue hemorrhagic fever (DHF). However levels are significantly higher in patients with DHF. Elevated SGOT levels are noted earlier in illness and normal SGOT levels is a strong negative predictor of dengue hemorrhagic fever in the first three days of illness (J Infect Dis 1997;176:313)

Make Sure

Situation: A rape victim developed HIV infection.
Reaction: Oh my God! Why was she not given post exposure ART prophylaxis? Lesson: Make sure all rape victims are counseled for HIV post exposure ART prophylaxis.

For comments and archives

  Quote of the Day

(Dr GM Singh)

Anything is valuable only in two situations: First before getting it and secondly, after getting it. In between, you do not realize its value.

    Mind Teaser

Read this…………………

Which of the following is false for brown pigment stones?

a) They are earthy
b) Stones seen in Asian population
c) Easily breakable
d) All the above

Yesterday’s Mind Teaser: What is not true regarding laparoscopic biliary injuries?

a) As surgeon’s experience goes beyond twenty cases, rate of bile duct injury decreases.
b) The rate of laparoscopic bile duct injury is approximately 0.8%.
c) Most of the injuries are due to errors of judgement and skill.

Answer for yesterday’s Mind Teaser: c) Most of the injuries are due to errors of judgement and skill.

Correct answers received from: Dr Prabha Sanghi, Anil Bairaria, Raju Kuppusamy, Muthumperumal Thirumalpillai, Dr Chandresh Jardosh, yogindra vasavada, Dr Sukla Das, Dr PC Das, Neelam Nath, Dr Jainendra Upadhyay,
Dr Sukla Das.

Answer for 23rd November Mind Teaser: b) Involves the bifurcation without involvement of secondary intrahepatic ducts.
Correct answers received from: Dr PC Das, Dr Sukla Das, Dr PC Das,
Neelam Nath, Dr Jainendra Upadhyay, Dr Sukla Das.

Send your answer to ijcp12@gmail.com

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emedinews revisiting 2011
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    Laugh a While


Blind man in a store

A blind man walks into a store with his seeing eye dog. All of a sudden, he picks up the leash and begins swinging the dog over his head. The manager runs up to the man and asks, "What are you doing?!!" The blind man replies, "Just looking around."

    Medicolegal Update

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

Drowning submersion is followed by struggle and subsides with exhaustion

  • The survival rate from potentially fatal salt water submersion is about 80% whereas in fresh water it is less than 50%.
  • In drowning, breath holding lasts until carbon dioxide accumulation stimulates respiration resulting in inhalation of water.
  • Gulping of water, coughing and vomiting is rapidly followed by loss of consciousness. Profound unconsciousness and convulsions are associated with involuntary respiratory movements and the aspiration of water.
  • Death within 2 to 3 minutes may be called “Instantaneous deaths" and the death is almost invariable when the period of submersion exceeds 10 minutes.
  • There are no pathological findings that are pathognomonic of drowning. Consequently obtaining proof that the victim was alive on entering the water and excluding natural, traumatic and toxicological causes of death are critically important.
  • Some pathological changes are characteristic of drowning but the diagnosis is largely one of exclusion. A fine white froth or foam is seen exuding from the mouth and nostrils. The froth is sometimes tinged with blood producing a pinkish color. If the foam is wiped away then pressure on the chest wall will cause more foam to exude from the nostrils and mouth.
  • The foam is a mixture of water, air, mucus and possibly surfactant whipped up by respiratory efforts. Thus it is a vital phenomenon and indicates that the victim was alive at the time of submersion

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Smoking and Obesity Do Not Go Together

Obese people should not smoke as the combination may be deadly, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India.

Smoking and obesity are independent predictors of mortality, but smoking and being obese especially increase the mortality risk as per the American Journal of Clinical Nutrition.

Obese smokers have a six to eight times greater risk of dying compared with normal weight people who never smoke.

Among smokers with a large waist, the risk of dying is five times greater than among people with the smallest waists who never smoke.

If you are overweight and smoke, fixing either one can markedly improve your chances for a normal life span. Fix both, and the probability of benefit is huge.

If one is obese and smokes and has to choose between weight loss and smoking cessation to improve health, the latter will have a greater protective effect. Smoking cessation is associated with significantly lower mortality risk in every weight group. Smoking cessation has a great effect on lowering risk of dying, one which far outweighs the slight increased risk from the associated increase in weight.

For comments and archives

    Readers Responses
  1. Dr KK Aggarwal, is a messenger who has to pass on light of knowledge to others, to the whole medical community around to preserve the sanctity of body, mind and soul, to protect it from the ensnarling clutches of bewitching worldly chains. Dr G M Singh
    Forthcoming Events

CSI 2011

63rd Annual Conference of the Cardiological Society of India

Date: December 8–11, 2011.
Venue: NCPA Complex, Nariman Point, Mumbai 400021

Organizing Committee

B. K. Goyal – Patron
Samuel Mathew – President CSI
Ashok Seth – President Elect & Chairman Scientific Committee
Lekha Adik Pathak – Chairperson
Satish Vaidya & C. V. Vanjani – Vice Chairman
N. O. Bansal – Organizing Secretary
B. R. Bansode – Treasurer
Ajit Desai , Ajay Mahajan , G. P. Ratnaparkhi – Jt. Org. Secretaries
Shantanu Deshpande , Sushil Kumbhat , Haresh Mehta – Asst. Org. Secretaries
D. B. Pahlajani, A. B. Mehta , M. J. Gandhi , G. S. Sainani, Sushil Munsi, GB Parulkar, KR Shetty – Advisory Committee

Contact: Dr. Lekha Adik Pathak, Chairperson, CSI 2011; Dr. Narender O. Bansal, Org. Secretary, CSI 2011 Tel: 91 – 22 – 2649 0261/2649 4946, Fax: 91 – 22 – 2640 5920/2649 4946.
Email: csi2011@ymail.com, csimumbai2011@gmail.com Website: www.csi2011mumbai.com

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews “Doctor of the Year Award “ function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.com

    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

Activities eBooks


  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

    Our Contributors

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