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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


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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of 1st Mega Ajmer Health Camp 2012

  Editorial …

26th March 2012, Monday

Rosuvastatin more effective than atorvastatin in ACS

The lipid–modifying effects of rosuvastatin are stronger than atorvastatin in patients with acute coronary syndrome (ACS), according to new data from the LUNAR trial published in the American Journal of Cardiology in February this year. The LUNAR trial involved 825 adults with coronary artery disease who were hospitalized for ACS within 48 hours of first symptoms. They were randomly assigned to once–daily rosuvastatin 20 or 40 mg or atorvastatin 80 mg for 12 weeks.

Rosuvastatin 40 mg was significantly more effective at lowering LDL cholesterol compared to atorvastatin 80 mg (with decreases of 46.8% vs 42.7%; p=0.02). Efficacy was similar with rosuvastatin 20 mg and atorvastatin 80 mg.

Increases in HDL cholesterol were also significantly greater with rosuvastatin 40 mg (11.9%; p<0.001) and rosuvastatin 20 mg (9.7%; p<0.01) than with atorvastatin 80 mg (5.6%).

Still, the finding that rosuvastatin 20 mg was as effective as atorvastatin 80 mg in decreasing LDL cholesterol with a similar safety profile suggests that this dose of rosuvastatin might be considered an alternative to atorvastatin 80 mg in patients with ACS. (HeartWire)

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Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

Stay Tuned with Dr Rashmi Singh

Crime Against Women - part 3

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

First Mega Ajmer Health Camp – Distribution of devices

11,700 devices were distributed including hearing aids, spectacles, crutches, wheel chairs, tricycles and walking sticks etc.

Dr K K Aggarwal
    National News

Swine flu: 5 more test positive, total cases now 33

JAIPUR: Five more persons tested positive for swine flu in various parts of the state on Saturday taking the number of cases to 33 in the last 24 days. In March only, the flu claimed five persons in state. Fifty five–year–old Satish, a resident of C–Scheme tested positive for flu in city. So far, 18 people have been diagnosed with H1NI influenza in Jaipur during this month. (Source: TOI, Mar 24, 2012)

For comments and archives

One–year–old is eighth swine flu victim in Pune

PUNE: A one–year–old girl died at a civic–run hospital in Pimpri two days ago, becoming the eighth victim of swine flu in Pune district and the second in the Pimpri–Chinchwad area in the last ten days. The throat swab report of the girl returned positive for the contagion on Friday. The girl, Sania Rathod, of Vidyanagar in Chinchwad, died at the YCM hospital in Pimpri at 9.30 pm on March 21, said Milind Jawale, medical officer of the Pimpri Chinchwad Municipal Corporation (PCMC). Meanwhile, 16 more people tested positive for swine flu on Friday. Fourteen of them are from Pune and two from Pimpri–Chinchwad. With this, the number of swine flu infected people in Pune has gone up to 112 and to 14 in Pimpri–Chinchwad, officials said. (Source: TOI, Mar 24, 2012)

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

BP often high in kids on dialysis

Many children receiving dialysis continue to have poor blood pressure control even when on antihypertensive treatment, a cross–sectional study found. (Source: Medpage Today)

For comments and archives

Hold off on antibiotics for sinus infection, guidelines urge

Between 90% and 98% of sinus infections won’t respond to antibiotics, so doctors should hesitate before reaching for the prescription pad, according to new guidelines for the treatment of rhinosinusitis from the Infectious Diseases Society of America. Although most cases are viral, the guidelines suggest suspecting a bacterial cause when:

  • Symptoms or signs are persistent, lasting at least 10 days without any evidence of clinical improvement.
  • The disease onset is characterized by severe symptoms or signs of high fever (of at least 39° C or 102° F) and purulent nasal discharge or facial pain lasting for at least three or four days.
  • The disease gets worse with a new onset of fever, headache, or increase in nasal discharge following a typical viral upper respiratory infection that lasted five or six days and had appeared to be improving.
  • Where a bacterial cause is likely, the guidelines suggest prompt treatment with an antibiotic. (Source: Medpage Today)

For comments and archives

Wide surgical margins best for DCIS

Lumpectomy for ductal carcinoma in situ (DCIS) should aim for wide margins to keep recurrence risk low even if the woman is getting radiotherapy, according to the conclusions of a heavily criticized meta–analysis. (Source: Medpage Today)

For comments and archives

Care of genital melanoma still problematic

Melanoma of the female genitalia continues to have an unfavorable prognosis, particularly thicker lesions that are not amenable to surgery, according to data from one of the largest clinical series ever reported. (Source: Medpage Today)

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  Twitter of the Day

@DrKKAggarwal: #AJOG Aerobics may ease menopause symptoms: Study: In a small study of Finnish women who had recently entered… http://fb.me/1djFP81I2

@DrKKAggarwal: Every day is a new world.

    Spiritual Update

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

2nd Chaitra Navratri (Maa Brahmacharini)

"Spiritual summary: Purify the mind (white clothes) with continuous efforts (japa mala) by accepting the things and situations as they are (kamalandu) and building humility in the mind (egoless state)". This can be assisted by chanting VAM focusing on 2nd gonadal chakra.

Navratri is the detoxification of body, mind and soul. The nine–day purification process is observed twice in a year, at the start of summer and winter. Chaitra Navratri is observed at the start of the summer for preparing the body to tolerate summer.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the causes of intrauterine adhesions?

The most common cause of intrauterine adhesions is trauma to the uterine cavity. This may occur following dilation and curettage (D&C), an outpatient surgical procedure during which the cervix is dilated and the tissue contents of the uterus are emptied. Prolonged use of an intrauterine device (IUD), infections of the endometrium (endometritis) and surgical procedures involving the uterus (such as removal of fibroids) also may lead to the development of intrauterine adhesions.

For comments and archives

    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Blood Donation – Gift of Liquid Love

Introduction of Disposable Plastic Bags

In 1960, the changeover from glass bottles to plastic bags revolutionized the working of the blood banks. This helped in the use of the components to a much greater extent and also helped in better safety procedures. The introduction of disposable too helped in much safer transfusion procedures. The added advantages of the disposables are:

  • Convenience in storage and transportation
  • No breakage
  • Ease to transfuse
  • Less risk of transfusion reactions
  • Facilitates various blood components separation

Greater clinical appreciation of hematological physiology is reflected in requests for specific blood components, and the modern blood bank dispenses a wide variety of blood products tailored to specific patient needs. An array of techniques unknown to blood bank workers even a few years ago has come into routine use, ranging from radioimmunoassay to cytotoxicity testing.

Simultaneously with advances in clinical medicine has come an explosive increase in our knowledge of immunohematology.

Whereas the ABO system and "Rh factor" were almost the only considerations of clinical significance a generation ago, we now recognize more than a dozen major blood group systems, each many times more complex than originally conceived, with some 400 blood group antigens defined as of this writing.

Immunoglobulin structure and the role of complement in red blood cell sensitization are now understood with considerable insight, and this knowledge has led to increase appreciation of the mechanisms of antibody–mediated red blood cell destruction.

Increased understanding of the mechanisms of blood coagulation and clot lysis has resulted in major changes in the approach to the patient with a bleeding disorder.

This sophistication, however, has not been without its drawbacks. Burgeoning demands for blood products have posed problems in obtaining sufficient supplies.

Transfusions of 20 pints of blood to a single patient are now commonplace and 100 pints or more have been given in 24 hours to save a life.

Widespread transfusion has caused widespread blood group sensitization, with resultant problems in antibody identification and procurement of blood of special types.

Blood transfusion is a broadly based discipline that overlaps and intersects many other medical, scientific and managerial fields, including hematology, immunology, genetics, histocompatibility, cellular function and metabolism protein structure and function, cryobiology, disposable equipment, bioengineering, statistics, data–processing, public relations, logistics and standardization.

Coordinated long–range planning is needed for the development and integration of such diverse activities, together with careful consideration of priorities and optimal use of resources. This is particularly important in developing countries where financial and other resources are very limited.

Challenge and responsibility are the daily substance of blood bank work; stimulation and gratification are the reward.

For comments and archives

    Celiac Disease Update

(Dr Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation, Medanta – The Medicity Hospital, Gurgaon)

Is wheat allergy and Celiac disease same?

They are NOT the same: Wheat Allergy is a severe sudden onset allergic reaction to a certain protein component of wheat i.e. it’s an autoimmune response of the body. Usual symptoms are immediate coughing, asthma, breathing difficulties, and/or projectile vomiting. It can cause life–threatening responses in allergic people. Wheat allergy is quite rare (less than half percentage of population). These patients must observe a strict wheat–free diet to remain healthy.

Celiac disease is a intolerance to gluten, a protein present in wheat. It is a chronic disease, which affects the small intestine and can present as chronic diarrhea and failure to thrive. It is not a life–threatening disease but can have significant morbidities if not treated properly.

For comments and archives

    Medi Finance Update

(Tarun Kumar, Chartered Accountant)

Budget Overview

Normal Income tax rates: Individual



Up to Rs. 1,80,000/–


Up to Rs. 2,00,000/–


Rs. 1,80,000/– to Rs. 5,00,000/–


Rs. 2,00,000/– to Rs. 5,00,000/–


Rs. 5,00,000/– to Rs. 8,00,000/–


Rs. 5,00,000/– to Rs. 10,00,000/–


Above Rs. 8,00,000/–


Above Rs. 10,00,000/–


For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

A Pound of Butter

There was a farmer who sold a pound of butter to the baker. One day the baker decided to weigh the butter to see if he was getting a pound and he found that he was not. This angered him and he took the farmer to court. The judge asked the farmer if he was using any measure. The farmer replied, Your Honor, I am primitive. I don’t have a proper measure, but I do have a scale."

The judge asked, "Then how do you weigh the butter?" The farmer replied "Your Honor, long before the baker started buying butter from me, I have been buying a pound loaf of bread from him. Every day when the baker brings the bread, I put it on the scale and give him the same weight in butter. If anyone is to be blamed, it is the baker."

What is the moral of the story? We get back in life what we give to others. Whenever you take an action, ask yourself this question: Am I giving fair value for the wages or money I hope to make? Honesty and dishonesty become a habit. Some people practice dishonesty and can lie with a straight face. Others lie so much that they don't even know what the truth is anymore. But who are they deceiving? Only themselves.

For comments and archives

  Cardiology eMedinewS

Diabetes Risk Increased by 3 Independent Factors Read More

More Evidence That ARBs Have Cognitive Benefits Read More

Thrombosis Risk Lower with Xience Stent Read More

  Pediatric eMedinewS

Added Complications with More Dental Sedatives For Children Read More

New Preterm Birth Risk Guidelines Address Cervical Length Read More

    Microbial World: The Good and the Bad they do

(Dr Sunil Sharma, Senior Consultant Microbiology, Medanta The Medicity)

Transfer of resistance

Once the resistant gene is present, it transfers to other bacteria in the population. This transfer is facilitated by environmental conditions (like presence of antibiotic). There are three major methods of transfer of genes in bacteria:

  • Bacterial conjugation: A bacterial cell transfers genetic material to another cell by direct cell–to–cell contact.
  • Transformation: The genetic material is directly taken up from the environment and integrated in its own nucleoid.
  • Transduction: The bacterial DNA is moved from one bacterium to another by a virus (a bacteriophage, or phage).

This genetic material could be part of the chromosome or on a plasmid (small copies of several genes) or on a transposon (very small copies of genes not stable on its own).

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A female with rheumatoid arthritis became pregnant while taking leflunomide.
Dr. Bad: Continue it.
Dr. Good: Stop it immediately.
Lesson: In women with rheumatoid arthritis who become pregnant while taking leflunomide, healthy pregnancy outcomes usually occur, if the drug is discontinued at the earliest and a cholestyramine drug elimination procedure is done (Arthritis Rheum 2010;62:1494).

For comments and archives

Make Sure

Situation: A 40–year–old male developed acute heart attack after playing squash.
Reaction: Oh my God! Why was a cardiac test not done?
Lesson: Make sure that anybody going for anaerobic games after the age of 40 should first get a cardiac clearance.

For comments and archives

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  Quote of the Day

(Dr GM Singh)

God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. Reinhold Niebuhr

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Calculative Values

VLDL Cholesterol = Triglycerides/5

    Mind Teaser

Read this…………………

Treatment of Biliary stricture following pancreatitis

a) Surgery
b) Endoscopic stenting
c) No treatment required

Yesterday’s Mind Teaser: Which is not true regarding portacaval shunts?

a) Used for intractable ascites.
b) It can be made selective by using 8 mm interposition graft.
c) It is a partial shunt.
d) Distal splenorenal shunt does not involves splenectomy.

Answer for Yesterday’s  Mind Teaser: c) It is a partial shunt.

Correct answers received from: yogindra vasavada, Atul Soreng, vedatrayee pramanik, Dr Jainendra Upadhyay, Anil Bairaria, Dr. Thakor Hitendrsinh G

Answer for 24th March Mind Teaser: d. Carotene
Correct answers received from:
Dr Jaimeet, y. j. vasavada, Papa Dasari, Dr. Mrs. S. Das, Dr. P. C. Das

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Kiss Per Yard

Walking up to a department store’s fabric counter, a pretty girl asked, "I want to buy this material for a new dress. How much does it cost?"

"Only one kiss per yard," replied the smirking male clerk. "That’s fine," replied the girl. "I’ll take ten yards."

With expectation and anticipation written all over his face, the clerk quickly measured out and wrapped the cloth, then teasingly held it out.

The girl snapped up the package and pointed to a little old man standing beside her. "Grandpa will pay the bill," she smiled.

    Medicolegal Update

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

WMA declaration of Malta on hunger strikers – Guidelines for medical management

The doctor must assess the mental capacity of the individual. This involves verifying that an individual intending to fast does not have a mental impairment that would seriously undermine the person’s ability to make health care decisions. Individuals with seriously impaired mental capacity cannot be considered to be hunger strikers. They need to be given treatment for their mental health problems rather than allowed to fast in a manner that risks their health.

As early as possible, physicians should acquire a detailed and accurate medical history of the person who is intending to fast. The medical implications of any existing condition should be explained to the individual. Physicians should verify that hunger strikers understand the potential health consequences of fasting and forewarn them in plain language of the disadvantages. Physicians should also explain how damage to health can be minimized or delayed by, for example, increasing fluid intake. Since the person’s decisions regarding a hunger strike can be momentous, ensuring full patient understanding of the medical consequences is critical. Consistent with best practices for informed consent in health care, the physician should ensure that the patient understands the information conveyed by asking the patient to repeat back what they understand.

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)

Quantity and frequency of drinking influence mortality risk

Somrasa or Shiva’s drink is not beneficial for all. The susceptible may end up with complications, said Dr. K.K. Aggarwal, Padma Shri and Dr B C Roy National Awardee and President, Heart Care Foundation of India.

Conditions that generally contraindicate any alcohol use include personal or strong family history of alcoholism, previous hemorrhagic stroke, hepatic or pancreatic disease, uncontrolled hypertension, uncontrolled diabetes, underlying low functioning heart, children and adolescents, individuals of any age who cannot restrict their drinking to moderate levels, women who may become pregnant or who are pregnant, individuals who plan to drive, operate machinery, or take part in other activities that requires attention, skill, or coordination, individuals taking prescription or over–the–counter medications that can interact with alcohol and persons recovering from alcoholism. Alcohol use should be limited in patients with other conditions, including active gastritis, esophagitis, pre–malignant GI lesions such as Barrett’s esophagus, or a strong family history of breast cancer.

According to a study by researchers at the National Institutes of Health (NIH) published in the journal Alcoholism: Clinical and Experimental Research, alcohol frequency and quantity had opposite effects on cardiovascular mortality in men. The greater the amount of alcohol that men consumed on drinking days, the greater was their risk for death from cardiovascular disease.

Men who had five or more drinks on drinking days had a 30 percent greater risk for cardiovascular mortality than men who had just one drink per drinking day. Alcohol quantity was also associated with increased mortality from cancer among men.

On the other hand, frequency of drinking was associated with decreased risk for death from cardiovascular disease among men — those who reported drinking 120 to 365 days per year had about 20 percent lower cardiovascular mortality than men who drank just one to 36 days per year.

Among women, frequent drinking was associated with a significantly increased risk of cancer, while increased quantity was associated with risk for mortality from all causes.

Regular drink is 30 ml (10 gms) of whisky and a large Patiala drink is 60 ml (20gms) of whisky.

A large drink is 45 ml (American peg, 15 gms alcohol). This is equal to 12 fluid ounces (360 ml) of regular beer, 5 fluid ounces (150 ml) of wine, and 1.5 fluid ounces (45 ml) of 80–proof distilled spirit. An ideal dose (safe limit) of alcohol is 6 grams per day for men and 4 grams for the women.

Drinking in moderation is defined as having no more than 1 drink per day for women and no more than 2 drinks per day for men (American peg). This definition of moderation is not intended as an average over several days but rather as the amount consumed on any single day.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines "at risk" or binge drinking as consuming greater than 14 drinks per week or four drinks per occasion (over 2 hours) for men and greater than 7 drinks per week or three drinks per occasion for women. This brings the blood alcohol concentration (BAC) level to 0.08% or above.

Heavy drinking is consuming an average of more than 2 drinks per day (more than 90 ml of whisky). For women, consuming an average of more than 1 drink per day (more than 45 ml of whisky).

Any drinking less than moderate is light drinking. Alcoholic beverages supply calories but provide few essential nutrients. 500 calories takes extra every day can increase the weight by 2 kg per month.

    Readers Response
  1. Dear Editor, ‘Pledging eye donation on death’ is a noble cause that needs to be adopted by everyone as it not only provides vision to those blinded by corneal diseases but is also not against any religion or social practice. But pledging eye donation just for the sake of showing off or to add to the numbers does not serve any purpose; there is a need for family members of the deceased to inform the nearest eye bank, or call at 1919 as suggested, as soon as possible because otherwise the ‘pledge’ will be go waste. Dr. Narendra Kumar.
    Forthcoming Events
Dr K K Aggarwal

BSNL Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

    eMedinewS Special

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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, Dr Usha K Baveja