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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

  Editorial …

27th February, 2011, Sunday                                 eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

FDA orders new cautions on antipsychotic drugs

All antipsychotic drugs, including older agents as well as second–generation products, must contain new label information regarding their use in pregnancy. In particular, the new labeling will address the risk of extrapyramidal symptoms (EPS) and withdrawal syndromes in newborns.

FDA has updated the Pregnancy section of drug labels for the entire class of antipsychotic drugs to include consistent information about the potential risk for EPS and/or withdrawal symptoms in newborns whose mothers were treated with these drugs during the third trimester of pregnancy. The FDA has identified 69 episodes of neonatal EPS or withdrawal in adverse event reports submitted to the agency through October 2008. Among the symptoms listed in the reports: agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, and feeding disorder. Onset of symptoms ranged from birth to one month later, and the severity varied as well.

The FDA indicated that some infants recovered within hours while others needed intensive care and prolonged hospitalization.

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
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  eMedinewS Audio PostCard

  Treating Diabetes Post 2010

Dr Ambrish Mithal speaks on
Adverse effects of current treatments of type 2 diabetes:Sulfonylureas

Audio PostCard
  SMS of the Day

(By Dr GM Singh)

Oil and potatoes both grow underground so french fries may have eventually produced themselves, had they not been invented. ~ A.J. Esther

    Photo Feature (from the HCFI Photo Gallery)

2nd eMedinewS: Revisiting 2010: Excellence Award

Dr Vinay Sanghi was presented the eMedinewS Medical Doctor of the Year 2010 Award at the 2nd eMedinewS: Revisiting 2010 held on 9th January this year at Maulana Azad Medical College, New Delhi

Dr K K Aggarwal
    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

Centre to go by ICMR advice on Endosulfan

NEW DELHI: The Centre will go by the recommendations of the Indian Council of Medical Research (ICMR) in deciding whether or not to ban Endosulfan, a pesticide which had adversely affected some cashew–growing districts in Kerala. Responding to a question in the Lok Sabha here on Tuesday, Union Agriculture Minister Sharad Pawar said the government would accept the recommendations of the committee, which had been set up by the ICMR to look into the adverse impact of this pesticide on health, following complaints and media reports over the hazards posed by it. However, Mr. Pawar said the Centre had no objection to the Karnataka government’s decision to ban the use of Endosulfan across the State, following reports of its adverse consequences, particularly in the Dakshina Kannada district. Four expert committees had been set up since 1991, and all of them had advised against the ban. (Source: The Hindu, Feb 23, 2011)

Cashless facility for patients

Moolchand is proud to have been selected by India’s leading insurance companies (National Insurance Company Ltd., United India Insurance Company Ltd., The New India Assurance Company Ltd. and The Oriental Insurance Company Ltd.) to extend cashless facility for patients

    International News

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

February is Heart Health Month

Have a hearty laugh. Very few things in life are better than a good laugh and it turns out that laughing heartily is good for the heart. One recent study even demonstrated that laughing during mealtime reduces the surge in blood sugar levels. May you enjoy the lighter side of life with family and friends.

(Dr Monica and Brahm Vasudev)

Breast cancer risk higher with hormone therapy started close to menopause, study indicates

Women who begin taking hormone therapy near menopause have a higher risk for breast cancer than those who start taking it later, a new study reports. Researchers looked at the U.K. Million Women Study to examine whether the timing of hormone therapy initiation affected breast cancer risk. Data on 1,129,025 postmenopausal women with 4.05 million woman–years of follow–up were included. The study results were published early online Jan. 28 by the Journal of the National Cancer Institute and will appear in the Feb. 16 print issue.

Diabetic patients may have increased risk for kidney cancer

Patients with diabetes have a significantly increased risk for developing kidney cancer compared with nondiabetics, according to a meta–analysis in the journal Diabetologia.

Elevated levels of high–sensitivity CRP associated with pre diabetes

According to a study published online in the journal Diabetologia, having an elevated level of high–sensitivity C–reactive protein (hsCRP), a known marker of inflammation, is associated with the presence of prediabetes. After evaluating data from two large Asian cohorts, namely the Singapore Prospective Study Programme (SP2; n=4,252) and the Singapore Malay Eye Study (SiMES; n=2,337), doctors found that having a moderately high (1–3 mg/l) to high (3 mg/l or above) level of hsCRP was associated with the presence of prediabetes, even after adjusting for confounding factors.

FDA okays first 3–D mammogram device

The FDA has approved the first x–ray mammography device that provides 3–D images of the breast. Approval of the Selenia Dimensions System was based on two studies asking radiologists to review 2–D and/or 3–D images from over 300 mammographies. Radiologists who viewed the 2–D and 3–D models were 7% more accurate in distinguishing cancerous and noncancerous cases than those who only used a 2–D image. Combined use of the 2–D and 3–D imaging systems approximately doubles the radiation dose a patient receives but the combination increases cancer risk by less than 1.5% relative to natural cancer risk, and by less than 1% compared with the use of 2–D imaging alone. According to a study published online Feb. 9 in the Journal of Clinical Endocrinology & Metabolism, treatment of type 2 diabetes patients with once–weekly rather than twice–daily exenatide results in superior glycemic control and reduced side–effects.

    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What looks promising, in the future, for the treatment of infertility?

There are many new and exciting studies underway. Cytoplasmic transfer, where cytoplasm from a donor’s egg is used with the mother’s own genetic information, looks very promising for women with premature ovarian failure or otherwise diminished ovarian reserve. There are new treatments for women with polycystic ovaries, and much hope for women with endometriosis.

For queries contact: banerjee.kaberi@gmail.com

    Hepatology Update

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

What are the signs and symptoms of liver abscess in children?

Common symptoms are fever often with chills, abdominal pain specially in right upper quadrant and tender hepatomegaly. Other symptoms are nausea and vomiting , anorexia, unexplained anemia, cough with breathing difficulty, fever etc. Liver abscesses of amoebic aetiology can have afebrile presentations. Clinical presentations do not distinguish amoebic from a bacterial etiology unless there is an obvious precipitating source for eg. abdominal infections. It is uncommon to get a positive history of colitic diarrhoea from patients of amebic liver abscesses.

For queries contact: drneelam@yahoo.com

    Medicolegal Update

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

A death from respiratory failure in surgery Hypoxia is a potent precipitating factor in cardiac arrest.

Text mentions that the cardiac arrest is mainly neurogenic and any irritation of the respiratory tract, such as laryngoscope or intubations may cause a lightly anesthetized patient to have a cardiac arrest.

  • Hypoxia is a factor either from faults in the apparatus or more commonly due to inexperienced anesthetist, especially in handling the equipments with which he is not familiar. An overdose of the anesthetic agent depresses the respiratory centre and begins a descending spell of hypoxia.
  • Airway obstruction is another danger which may be blood, teeth, and dentures inside the tract or faults ion the connecting tube, laryngeal spasm, swabs and an abnormal posture of neck.
  • From the autopsy surgeon’s point of view the finding of gastric contents in the airways must be backed up some clinical evidence of its ante–mortem origins before making any conclusion because many bodies has some gastric contents in some part of the air passage at the time of autopsy, mostly as a result of postmortem transfer that is a consequence of the dying process and not a cause of death.
  • Some physical faults in the anesthetic equipment may cause death like faults in the connecting tube which may be internal delaminating not seen from outside.
  • Flow–meter errors occur, but a more common one is the confusion of bottled or pipe gas supplies or the connection of an empty cylinder.
  • Any electric appliance is potentially dangerous and defective cauterizes, defibrillators and diathermy equipments have all caused death. Explosion from inflammable gases and vapors during intervention.
    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

The Society, under government control, does not give PF details or interest to employees and does not answer grievances or respond to permission to form an association. What to do?

We are employees of a teaching hospital run by a society registered under the Societies Registration Act, 1860, which is under government control. Can you please respond to the following problems?

  • Provident Fund is deducted from our salary and deposited in an unknown bank account without any contribution from the employers on the stated ground that they have yet to form a policy regarding this. No information is given regarding the balance in our PF account. When an employee resigns, he is given only the amount that was deducted from salary without any interest.
  • Collective grievance/complaint is not allowed. Employees are asked to raise queries/complaints individually and fight individually.
  • The employer does not allow its employees to form an employee’s association which is the only legal way of raising our grievances. We had submitted a request for issuing us a "No objection certificate" for forming our association but the employer is silent on our request.


  1. It appears that your employer is a state within the meaning of Article 12 of the Constitution, meaning thereby that it is under government control.
  2. As regards A, it is very clear that the employer is indulging in illegal bungling of your money. Employees should demand in writing a statement of PF account about the following particulars: Copy of individual PF account transactions year–wise from the date of joining till date; details of salary deductions and interest accrued; Rate of interest; Name of bank and account no. along with the title of the account; Copy of rules regarding withdrawals and advances from the PF account; Details of the total/collective PF account along with balance and investments year–wise.
  3. As regards B, all employees can submit individual but identical complaints etc. There is no bar to this.
  4. As regards C, no permission is needed to form an association under the Societies Registration Act, 1860.
  5. It appears that the employees are unnecessarily afraid. If you continue to be afraid, you will lose what is your due. You can also get information under the RTI Act, 2005.
    Useful Website

(Dr Surendernikhil Gupta)


The Determinants Of Food Aid To Africa And The Developing World


    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


Increased: renal failure, hypothyroidism, severe dehydration, lithium intoxication, antacids, Addison’s disease.

Decreased: hyperthyroidism, aldosteronism, diuretics, malabsorption, hyperalimentation, nasogastric suctioning, chronic dialysis, renal tubular acidosis, drugs (aminoglycosides, cisplatin, ampho B), hungry bone syndrome, hypophosphatemia, intracellular shifts with respiratory or metabolic acidosis.

    Medi Finance Update

Salaried persons

Under terms of employment, dearness allowance and dearness pay should form part of basis salary as this will minimize tax incidence on house rent allowance, gratuity and commuted pension. Similarly, commission paid at a fixed percentage of turnover achieved by the employee will help to reduce tax incidence as it also forms part of salary.

Our Contributors

  Docconnect Dr Veena Aggarwal
  Docconnect Dr Arpan Gandhi
  Docconnect Dr Aru Handa
  Docconnect Dr Ashish Verma
  Docconnect Dr A K Gupta
  Docconnect Dr Brahm Vasudev
  Docconnect Dr GM Singh
  Docconnect Dr Jitendra Ingole
  Docconnect Dr. Kaberi Banerjee
  Docconnect Dr Monica Vasudev
  Docconnect Dr MC Gupta
  Docconnect Dr. Neelam Mohan
  Docconnect Dr. Naveen Dang
  Docconnect Dr Prabha Sanghi
  Docconnect Dr Prachi Garg
  Docconnect Rajat Bhatnagar
  Docconnect Dr Sudhir Gupta

    Drug Update

List of approved drug from 01.01..2010 to 31.8.2010

Drug Name


DCI Approval Date

Trabectedin powder for Conc. solution for infusion (Additional Indication)

In combination with pegylated liposomal doxorubicin, it is indicated for the treatment of patients with relapsed platinum–sensitive ovarian cancer


    IMSA Update

International Medical Science Academy (IMSA) Update

Tolvaptan in Hyponatremia

The long–term tolvaptan is safe and effective among patients with chronic hyponatremia.
(Ref: Berl T, et al. Oral tolvaptan is safe and effective in chronic hyponatremia. J Am Soc Nephrol 2010;21:705).

    IJCP Special

Dr Good Dr Bad

Situation: A patient with diabetic nephropathy was found to have a high homocysteine levels.
Dr Bad: Homocysteine has no correlation with nephropathy.
Dr Good: You should control your homocysteine levels.
Lesson: Results of a nested case–control study suggest that hyperhomocysteinemia has an etiologic role in the pathogenesis of diabetic nephropathy. In the study, baseline plasma homocysteine concentrations and mean HbA1C levels during follow–up were significantly higher in patients who developed microalbuminuria than in those who remained normoalbuminuric. Multivariate logistic regression analysis showed that baseline plasma homocysteine level and mean HbA1C were independent predictors of microalbuminuria in type 2 diabetes.

Make Sure

Situation: A diabetic patient died of flu pneumonia.
Reaction: Oh my God! Why was flu vaccine not given?
Lesson: Make sure that all diabetics are given flu vaccine every year.

Five common eye myths dispelled

Myth: It’s best not to wear glasses all the time. Taking a break from glasses or contact lenses allows your eyes to rest.
Fact: If you need glasses for distance or reading, use them. Attempting to read without reading glasses will simply strain your eyes and tire them out. Using your glasses won’t worsen your vision or lead to any eye disease.

    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Anupam Sethi Malhotra)

Do Not Bite Off More Than You Can Chew

This maxim needs to be remembered constantly. We often tend to take more responsibilities than we are capable of carrying out. This is done to satisfy our ego. Know your limitations. Why take on additional loads that may create more worries? You cannot gain peace of mind by expanding your external activities. Reduce your material engagements and spend time in prayer, introspection and meditation. This will reduce those thoughts in your mind that make you restless. Uncluttered mind will produce greater peace of mind

— — — — — — — — — —

Mind Teaser

Read this   ………………… 


Yesterday’s Mind Teaser: gone let gone
                                      gone be gone

Answer for yesterday’s Mind Teaser:
Let bygones be bygones

Correct answers received from: Dr Susheela Gupta, Dr Vinay Sakhuja, Dr K P Rajalakshmi, Dr Muthumperumal Thirumalpillai, Dr Neelam Nath, Dr Sudipto Samaddar, Dr Rashmi Chhibber, Dr Shirish Singhal, Dr Rajshree Aggarwal, Dr Rajiv Dhir, Dr Anil Bairaria, Dr Rajiv Kohli, Dr R S Bajaj

Answer for 25th February Mind Teaser: Space Invaders
Correct answers received from: Dr Raju Kuppusamy, Dr Rakesh Bhasin

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr GM Singh)

A Horoscope For The Workplace

TECHNOLOGY: Unable to control anything in your personal life, you are instead content to completely control everything that happens at your workplace. Often even YOU don’t understand what you are saying, but who the heck can tell?! It is written that the geeks shall inherit the Earth.

— — — — — — — — — —

Knowledge is amusing

In the last 4000 years, no new ANIMALS have been domesticated.

    Readers Responses
  1. Hi Dr KK, Went through this edition of emedinews. I just wanted to point out the error in IMSA update. The BP goal in diabetes and CVD is <130/80 and not 140/90 as mentioned – Please refer to ADA and CDA guidelines. Regards: Dr Sreeja
    eMedinewS responds: We regret for the error
  2. Dear Editor, with reference to Dr Akash Deep comments on pathlogy lab.
  • What will be situation in district where there is no Pathologist.
  • All biochemical tests are carried out using auto analyzers with no role of pathologist Hematology, immunology and hormones have the same status.
  • Rapid diagnostic tests do not require any pathologist.
  • A health worker is tarined to do that.
  • In USA Rapid diagnostic kits are used by patients themselves to carry out tests
  • Pathologists are definitely required for biopsies, peripheral smear and supervision of biochemist and medical doctors.

Regards: Dr Anil Varshney

    Public Forum

(Press Release for use by the newspapers )

Flex your mental muscles too

Just as you like to exercise your muscles you need to exercise your brain and flex your mental muscles, said Dr. KK Aggarwal, Padma Shri & Dr. B.C. Roy National Awardee and President, Heart Care Foundation of India.

The benefits of mind games like bridge, chess, musical instruments, solving crossword puzzles, playing brain teasing games, board games or other activities or games that challenge the mind and make you use the mental muscles have been shown in several studies to prevent or delay dementia and Alzheimer’ disease.

Mental activity should start at the age of 40 and continue for life.

Apart from mental activity one should keep the blood pressure within normal limits as abnormal blood pressure readings, either too high or too low, have been associated with an increased risk of dementia.

People who have higher levels of social, mental and physical activity have less risk of dementia.

    eMedinewS Special

1. eMedinewS audio lectures

2. eMedinewS ebooks

    Forthcoming Events

ICC Cricket World Cup 2011

World Cup Schedule… very very creative


6th Annual Conference of Indian Academy of Nephrology (IANCON–2011)

Date: March 12–13, 2011
Venue: Taj Deccan, Banjara Hills, Hyderabad–34
Faculty: Dr MS Amarsen, Dr KV Jhony, Dr SC Dash, Dr Kashivishweswaran, Dr V Sakhuja, Dr RK Sharma, Dr Girishnarayan, Dr Anuradha, Dr SK Agarwal, Dr P Sundarajan, Dr P Keshivya, Dr Ravi Raju, Dr Dilip Pahari, Dr LC Sharma, Dr Sanjeev Saxena, Dr Sanjay Gupta, Dr Abhijit Tarapdhar, Dr PP Verma, Dr Harun Rashid, Dr Sampath Kumar, Dr Sanjib Sharma, Dr S Padmanabhan.
Topics: CKD Symposium (From India, Nepal, Bangladesh), Newer concepts in the pathogenesis of hypertension, Fluid and Electrolyte & AKI, RAAS in treatment of Diabetic Nephropathy, Primary Prevention of CKD: Trials & tribulation in Indian condition, Vitamin–D andchronic kidney disease, Mycophenolate Vs Cyclyophosphamide in Lupus nephritis, Individual zinganemia therapy, How to monitor Immunosuppression minimization, Obesity Diabetes epidemic, Life Style changes & therapeutics, BKV and CMV Nephropathy, Leptospira and Acute Kidney Injury, HIV Nephropathy, Hypophosphatemia and Renal Disease, Immunosuppressant and risk of Malignancy, Pregnancy ARF, Expanding Dialysis services in Andhra Pradesh, Making kidney transplant easier for less privileged, Cardiovascular risk reduction in CKD

Organizing Secretary: Dr Sree Bhushan Raju, Associate Professor, Dept of Nephrology, NIMS, Hyderabad
Contact: Mob: 09848492951, sreebhushan@hotmail.com
Website: www.ian2011.in
Note: "Prof SC Dash oration in Nephrology" from this year onwards. Three awards each in oral, poster and imaging in Nephrology sessions

Registration for Delegates Amount
Up to 15th February 2011
Rs. 1500/–
Up to 5th March 2011
Rs. 2000/–
Spot registration
Rs. 2500/–
Rs. 500/–

DD/Cheque in favor of "IANCON– 2011" payable at Hyderabad. Add Rs 100/– for outstation cheque.

eMedinewS Events: Register at emedinews@gmail.com

Medifinance Conference On Portfolio Management for Doctors and update on Budget 2011

Date: 13th March 2011
Time: 10 Am – 5 Pm
Speakers: Top of line from finance sector. The speakers to be chosen from the industry will be experts in each field to be covered in this conference

Separate sessions for portfolio management, insurance, mediclaim, banking sector, investments primary market, secondary market, taxation, loans for setting up hospitals, nursing homes, labs, etc. all under one roof.

No entry fee, the number of participants will be limited to 100 on first cum first serve basis. advance registration by mail to hcfi.1986@gmail.com /drkk@ijcp.com or by phone on 9899974439/9873716235.

World Fellowships of Religions and Perfect Health Parade

First ever Conference which will talk about science behind all Religions, Dharmas and Pathies under one roof
Subject: Global Warming, Ethnic Crises, How to be Healthy
Date: Sunday 3rd April, 2011
Venue: Maulana Azad Medical College Auditorium, New Delhi
Time: 8 AM – 4 PM Parade through tableaus to be flagged off at 10 am from outside MAMC to move till 5 pm on different predefined routes in Delhi to create awareness about health matters.

Parade Route: Vikas Marg – Shahdara – Seemapuri – Guru Tegh Bhadur Hospital – Seelampur Pusta – Gandhinagar, to ISBT Kashmiri Gate – Civil Lines – Delhi University North Campus – Azadpur – Punjabi Bagh – Mayapuri – Raja Garden – Janakpuri – Tilak Nagar – Tihar Jail Road – Delhi Cantt. – R.K Puram – Munirka – IIT Gate – Panchsheel Park – Chirag Delhi Flyover – Nehru Place – Modi Mill Flyover – Ashram – Nizamuddin – Sunder Nagar – Pragati Maidan – ITO – finally culminate at Maulana Azad Medical College at 4pm.

Full day conference on ethnic crisis and global warming. Pre lunch session to be addressed by religious representatives who would talk on what each religion has to say. Post lunch to be addressed by doctors from all streams of medicinal practice (allopathy, ISM)
Register: rekhapapola@gmail.com

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