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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 ...

26th October 2010, Tuesday

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

Smokers in the house, a risk factor for
hospitalization of children with flu

A large retrospective case-control study reported at the annual meeting of the Infectious Diseases Society of America (IDSA) says that having smokers in the house increases the possibility of a young child with flu needing inpatient care.
Data from more than 1,300 laboratory-confirmed cases of children with influenza, collected by 10 sites in the CDC's Emerging Infections Program in 2005 to 2008 were analyzed to identify risk factors for hospitalization associated with laboratory-confirmed influenza.
Analysis showed that if more than half of household members were smokers it doubled the chances a child would have a serious case of flu. According to Nila Dharan, MD, of the division of infectious diseases at the NYU School of Medicine in New York City, a family member who had been vaccinated against flu was protective, even if the child was not fully protected by immunizations. The study included 290 children ages six to 59 months (median age 20 months) with serious cases of flu; 1,089 age- and zip code-matched children with the flu who did not need inpatient care during the three influenza seasons acted as controls. The salient observations were as below.
Age of the mother: if ≤26 years, the odds were doubled. The odds ratio was 2.1, with a 95% confidence interval from 1.3 to 3.4.

The risk was increased if the child's vaccinations were not up to date. The odds ratio was 1.7, with a 95% confidence interval from 1.1 to 2.7.

If more than half of household members smoked, the child's risk of needing inpatient care was doubled. The odds ratio was 2.3, with a 95% confidence interval from 1.0 to 5.3. The risk was similar to having any pulmonary condition, including asthma.

If the child was not fully vaccinated for the flu, having any household member immunized was protective. The odds ratio was 0.5, with a 95% confidence interval from 0.3 to 0.8.
Underlying medical conditions also had an important role; presence of a hematologic or oncologic condition increased the risk by a factor of 12.
According to Dr Dharan, other researchers have examined a possible association between exposure to smoking and a child's risk of needing inpatient care for flu, but this is the largest study to date.

Dr KK Aggarwal
Editor in Chief
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  Chikungunya Update

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

Laboratory Diagnosis

IgM capture ELISA
•    Not commercially available
•    Available at NIV –Pune and NCDC –Delhi
•    Positive after 5-10 days & lasts up to 6 months
•    HI Antibody appears on day 3 or 4
RT –PCR confirmatory –before the 5 th day
•    Real Time PCR scores over conventional PCR
•    Positive in the phase of viremia –up to 5 days
•    Transportation of sample to be at 2o to 8oc
•    It is a confirmatory test with high specificity
•    Its sensitivity is very high; detects even 1 copy
•    After the viremia ceases –it will be negative

  Photo Feature (from the HCFI Photo Gallery)

 17th Perfect Health Mela 2010
"Women Empowerment" 

A seminar on "Women Empowerment" was organized by Dr. Sadhna International Women’s Rights Protection Trust and Heart Care Foundation of India on Monday 25th October 2010.  Acharya Dr. Sadhvi Sadhna Ji Maharaj, Chairperson, World Fellowship of Religions, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal and other dignitaries participated in the discussion

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

PPIs and fractures

Several studies have raised concerns regarding an association between chronic use of proton pump inhibitors and an increased risk of fractures. One should consider a lower dose or shorter duration of therapy.

1. Targownik LE, et al. Proton-pump inhibitor use is not associated with osteoporosis or accelerated bone mineral density loss. Gastroenterology 2010;138:896-904.
2. Corley DA, et al. Proton pump inhibitors and histamine-2 receptor antagonists are associated with hip fractures among at-risk patients. Gastroenterology 2010;139(1):93-101.

  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

Call to recognise mental health as health issue

The community must recognise mental health as an important health issue, Shekhar Saxena, director, Department of Mental Health and Substance Abuse, WHO, said. Delivering the Sneha Silver Jubilee Oration on 'Suicide Prevention - Towards Evidence-based Community Action,' Dr. Saxena, the first Indian to head the mental health division at the WHO, said communities also need to work with the government to establish prevention policies at the local, provincial and national level. Specifying a role for non-specialised health care providers (including nurses and general practitioners) in suicide prevention, Dr. Saxena said they too need to be aware that suicide is an issue. Reduction of access to means of suicide is proven to be a good deterrent for those contemplating suicide. This is a key element of the WHO's resource series on preventing suicide, as part of the Mental Health Gap Action Programme. (Source: The Hindu)

  International News

(Dr Monica and Brahm Vasudev)

No hard evidence supports supplements', vitamins' promise in slowing cognitive decline

A seemingly steady stream of new research purports to show supplements' and vitamins' promise in preventing or slowing cognitive decline, but in reality no hard evidence supports taking any of them. The article discussed claims regarding omega 3 fatty acid fish oils, gingko biloba, and vitamin E for preserving cognition, pointing out that studies have found inconclusive or mixed benefits for each of these supplements

Many hormonal changes, neurochemical reactions occur only during sleep

New findings by Harvard researchers at Brigham and Women's Hospital show that a vast number of hormonal changes and neurochemical reactions occur only while you sleep, and many have serious implications for your weight, health, and fitness. Sleep deprivation and obesity are often bedfellows, because two weight-regulating hormones -- ghrelin and leptin -- are greatly controlled by the amount of time you sleep. Meanwhile, sleeping less also alters your thyroid metabolism by decreasing your pituitary gland's production of thyrotropin, a thyroid-stimulating hormone.

FDA approves 'Mini' Dose Oral Contraceptive

The FDA has approved an oral contraceptive (Lo Loestrin Fe) that reduces estrogen exposure but maintains efficacy. It contains estrogen 10 mcg, which is the lowest estrogen dose approved by the FDA as an oral contraceptive. But despite the low dose, the drug is contraindicated in patients with a high risk of arterial or venous thrombotic diseases, present or past breast or other estrogen- or progestin-sensitive cancer, liver tumors or liver disease, abnormal uterine bleeding, and pregnancy, The new pill was developed by Warner Chilcott.

High resting heart rate, low heart rate variability may be related to renal impairment

High resting heart rate and low heart rate variability are both related to the development of renal impairment, Johns Hopkins researchers reported in Journal of the American Society of Nephrology.

  Gastro Update

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

Inflammatory Bowel Disease

What is the epidemiology of IBD?

It's one of the most significant chronic diseases to affect adolescents in West. Peak incidence of Crohn's disease is observed in late adolescence or young adulthood. The highest incidence of ulcerative colitis in children is noted between the ages of 10 and 18 years and the incidence among females exceeds that among males by 20% - 30%. The worldwide distribution of CD and UC are similar. The mean age at diagnosis of IBD in children is approximately 12 years. It affects both the sexes equally. Recently even in India the incidence of IBD in children and adolescent is increasing.

  Infertility Update

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

Can semen be collected at home? 

Yes, but it must be brought to the  lab within half an hour to an hour. The specimen must be collected in a container provided at the centre.

What is the time taken to prepare sperms?  

Native raw semen sample cannot be used for IUI. Depending on the method of preparation (Swim up or Swim down) it will take anywhere between half an hour to one and a half hour to complete the wash.

  Interesting Website to know

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


Child development website providing articles on wide range of child-related subjects such as what Indian foods to give for weaning, games/toys for a particular age group, teaching manners to child, how to organize birthday party etc. You can also receive monthly updates on your email.  

  Medicolegal Update

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

What is Bruise or Contusion?

Injury due to blunt force leads to bleeding due to rupture of blood vessels under the skin. There is no rupture of skin hence bleeding is not seen externally. Such an injury is called contusion or bruise.

A bruise heals by destruction and removal of the extravagated blood. The more vascular the area, the smaller the contusion, and the healthier the individual, the more rapid will be the healing.  The red blood cells disintegrate by hemolytis and the hemoglobin is enzymatically broken down into hemosiderin, hemotodin and bilirubin. The color change is very variable, starts at the periphery and extends inwards to the center. The duration of bruise is determined by its color changes as follows: Fresh – Red; Few hours to 3 days – Blue; 4th day - Bluish black to brown; 5 to 6 days – Greenish; 7 to 12 days: Yellow. The color becomes normal in about 2 weeks. But when the bruising is extensive and deeply situated the color takes a longer time to appear externally. It is difficult to estimate the exact age of a bruise with any degree of certainty.

The more vascular area, the smaller the contusion, and the healthier the individual, the more rapid will be the healing of bruise. In the elderly, healing of bruises is very slow.

Subconjunctival ecchymoses do not undergo usual color change. They are at first bright red and then yellow before disappearing. A bruise sustained at the time of carbon monoxide poisoning is likely to have a bright red color.

  Medi Finance Update

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

We spend most of our time and effort earning money, and hardly any managing and growing it.

The key to growing wealth lies in knowledge. Lack of knowledge means lack of understanding. And lack of understanding makes us oblivious to the myriad opportunities around us. Many of us are fearful of the complexity managing money brings. Managing money is not to be feared, but to be understood. And if we do not have the time or resources to understand how to manage money, do not feel shy to engage the services of an expert. Besides losing money, the biggest detriment to financial freedom is to let our wealth stagnate.

Then there is the challenge of managing our emotions. A task easier said than done. From Dalal Street to Wall Street, greed and fear are the two most powerful words which can make you lose a fortune. But as wise person said: "Be greedy when others are fearful; be fearful when others are greedy." Be rational in your approach - research before you invest, not after. And once you have done so; have the conviction to stick to your game plan.

We live today in exciting times. The Next Trillion Dollars of India's GDP growth presents us with once-in-a-lifetime opportunity for creating and growing wealth. Sixty-three years ago, the founders of our nation helped us achieve freedom. Today, it's time for us to achieve a different kind of freedom - Financial Freedom.

In subsequent sections, we will see step by step, how we can better manage money, just as an astute clinician manages his patient.

  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

Fixed dose combination of Oestrogen and Progestin (other than oral contraceptive) containing per tablet estrogen content of more than 50 mcg (equivalent to Ethinyl Estradiol) and progestin content of more than 3 mg (equivalent to Norethisterone Acetate) and all fixed dose combination injectable preparations containing synthetic Oestrogen and Progesterone. (Subs. By Noti. No. 743 (E) dt 10-08-1989)

  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Stool Examination

Diarrhea is a common symptom of a gastrointestinal disturbance.
O&P (Ova and Parasite) testing:  A microscopic evaluation of stool for parasites and the ova (eggs, cysts) of parasites. A basic test but very important!

emedinews 3D echocardography
  IJCP Special

Dr Good Dr Bad

Situation: A patient of CAD developed dengue.
Dr Bad: Start paracetamol.
Dr Good: Start paracetamol and stop low-dose aspirin.
Lesson: In dengue, lose-dose aspirin needs to be stopped.

Make Sure

Situation: A patient died after receiving 30 ml IV KCL bolus.
Reaction: Oh my God! Why was KCL given as bolus?
Lesson: Make sure that IV KCL is not given more than 10 mEq per hour.

Quote of the Day (Dr Chandresh Jardosh)
"A friend will joyfully sing with you, when you are on the mountain top, and silently walk beside you through the valley."

Mind Teaser

Read this…………………


Answer for yesterday’s Mind Teaser: "Partly cloudy "

Correct answers received from: Dr Virender Prakash Gautam, Dr. Rajiv Dhir, Dr Ajmer Singh,  Dr. K.P.Rajalakshmi, Dr.K.Raju, Dr Deepti Katyal Uppal, Dr Virender Prakash Gautam, Dr.Susheela Gupta, Dr Vishanji Karani, Dr.K.V.Sarma, Dr S. Upadhyaya

Answer for 24th October Mind Teaser is: "The good, the bad, and the ugly"
Correct answers received from: Dr Virender Prakash Gautam

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr G M Singh)

Dumb Instructions

"Warning: May contain nuts." On a package of peanuts.
"Do not eat." On a slip of paper in a stereo box, referring to the styrofoam packing.
"Access hole only - not intended for use in lifting box." On the sides of a shipping carton, just above cut-out openings which one would assume were handholds.
"Warning: May cause drowsiness." On a bottle of sleeping pills.
"Warning: Misuse may cause injury or death." Stamped on the metal barrel of a .22 calibre rifle.
"Do not use orally after using rectally." In the instructions for an electric thermometer.
"Turn off motor before using this product." On the packaging for a chain saw file, used to sharpen the cutting teeth on the chain.
"Not to be used as a personal flotation device." On a 6x10 inch inflatable picture frame.
"Do not put in mouth." On a box of bottle rockets.
"Please remove before driving." On the back of a cardboard windshield (for keeping the car from getting too hot when parked).
"Remove plastic before eating." On the wrapper of a Fruit Roll-Up snack.
"Not dishwasher safe." On a remote control for a TV. "For lifting purposes only." On the box for a car jack.
"Do not put lit candles on phone." On the instructions for a cordless phone. "Do not recharge, put in backwards, or use." On a battery

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.

Don't dramatize

Lots of people inflate small setbacks into life-threatening catastrophes and react accordingly. This habit makes mountains out of molehills and gives people anxieties that either don't exist or are so insignificant they aren't worth worrying about anyway. Why do they do it? Who knows? ...Maybe to make themselves feel and seem more important. Whatever the reason, it's silly as well as destructive.

  Readers Responses
  1. Dear Sir, I want to know about the Certificate Course in 2D and 3D Echocardiography and the Fellowship Dip in Noninvasive Cardiology. I would be grateful if you could send me the prospectus. Thanking you, with best regards, Julian. My email id: julian_antony@yahoo.com, 9811087297
  Public Forum

(Press Release for use by the newspapers)

Seminar on Child and Women Healthcare at the Perfect Health Mela

Inaugurating a seminar on Child and Women healthcare issues, Dr. Girija Vyas, Chairperson National Commission for Women, said that women need to be accorded the same strata in the society as that of men.

The seminar was organized by Dr. Sadhna International Women’s Rights Protection Trust and Heart Care Foundation of India as part of the ongoing 17th MTNL Perfect Health Mela being organized by Heart Care Foundation of India in association with various departments of Delhi Government at NDMC Grounds, Laxmi Bai Nagar, Near Nari Niketan.

Presiding over the function, Prof. Kiran Chopra, Chairperson, Varishtha Nagrik Sangh, said that with the increase in longevity in the society, elderly women need special care, especially as regards their health. Shri Amod Kanth, IPS, Chairperson of Delhi Commission for Protection of Child Rights said that child abuse is one of the major problems faced by the country, particularly, in the slum areas.

Dr. Kaberi Banerjee, Infertility Specialist at Max Healthcare, said that infertility is a totally manageable problem and need not be a social concern.

Dr. Gurutirath Kaur, Senior Advocate; Dr. Monika Rastogi, and Dr. Mamta Jain in a joint statement said that women should not ignore their health as it is now well known that today more women die of heart attack than breast cancer.

Dr. Sandhya Bajaj from National Commission for Protection of Women Rights said that efforts should be made to provide a crime-free society so that women can move out of their homes without any fear of being assaulted or abused.

Acharya Dr. Sadhvi Sadhna Ji Maharaj, Chairperson, World Fellowship of Religions, said that women should restart their weekly fast as now it has been scientifically shown that keeping a weekly fast reduces insulin resistance and future chances of heart diseases and diabetes.

Discussion on Dengue, Malaria and Chikungunya

A Live discussion was held on Chikungunya, Malaria and Dengue. The participants were Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, Dr. Anupama Sethi Malhotra, Dr. Ashok Damir, Dr. J.K. Mitha, Dr. Shweta and Dr. Yadav.

Following were the highlights:

1. A person can have malaria on multiple occasions, Chikungunya only once and dengue four times in his/her lifetime. Mumbai has seen an epidemic of a false malaria this year. It is possible that Delhi may see a similar epidemic in the next two years.
2. In no pathy has, goat milk been mentioned for treatment of dengue and Chikungunya
3. The correct word is ‘Chikungunya’ and not ‘Chickenguiena’. It has nothing to do with hen or chicken.

Bharatnatyam Inter Dancing School Festival was held in the junior category. The results were declared as under

Special provision for women for Karva Chauth

The Mela will have special discussions and sessions for women on the subject of Karva Chauth. Padma Shri & Dr. B. C. Roy National Awardee, Dr. KK Aggarwal said that Karva Chauth as a festival is a journey from the Navratras to Diwali. He cautioned that women who are observing the fast should just not end up in doing feast-fast-feast.

Vishwa Dharma Sammelan today

A major attraction of the Mela today will be Vishwa Dharma Sammelan, where over 300 dharma gurus will collect under one banner and deliberate on the subject of Global Warming and Ethnic Crisis. The
seminar has been organized by World Fellowship of Religions.

Bharatnatyam Inter Dancing School Festival was held in the junior category. The results were declared as under

Deepkshita Venkatesh  - Nritya Bharti - I Prize
Binni Jackson - Creative Rhythm - II Prize
Sonali Chakraborty - Nritya Bharti - III Prize
Sadvi Sudersan - Nritya Bharti - Consolation Prize
Anshruta Deep Kumar - Ganesha Natyalaya - Consolation Prize

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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