emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
FIRST NATIONAL eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
  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 …

28th February 2012, Tuesday

Is it time to stop using sulfonylureas?

The American College of Physicians has detailed a guideline regarding use of oral agents in type 2 diabetes entitled "Oral pharmacologic treatment of type 2 diabetes mellitus: a clinical practice guideline from the American College of Physicians."

Earlier guidelines

  • AACE/ACE guideline: metformin is probably best, but you can start with whatever you want,
  • for sulfonylurea.
  • ADA: start with metformin and then add either SU, TZD or insulin.

ACP’s three recommendations

  • Recommendation 1: use medications in patients diagnosed with type 2 diabetes when lifestyle modifications are not working.
  • Recommendation 2: Start with metformin in most patients with type 2 diabetes
  • Recommendation 3: Add a second agent when metformin alone is not enough.

Physicians, after starting on metformin, can choose a second agent based on properties of those specific agents that may be beneficial to a particular patient (i.e. GLP–1 analogues for overweight patients), avoid agents with unwanted side effects (i.e. not using TZDs in patients with fluid overload) as well as other factors such as cost and patient preference.

  1. The evidence shows that most diabetes medications reduced HbA1c levels to a similar degree.
  2. Metformin was more effective than other medications as monotherapy as well as when used in combination therapy.
  3. The risk for hypoglycemia with sulfonylureas exceeds the risk with metformin or thiazolidinediones.
  4. Physicians should start with metformin, then add something else (TZD, DPP4, GLP–1, SGLT–2 –when available), but probably not sulfonylurea, since it clearly causes more hypoglycemia then anything else.
  5. SUs are effective, but not good medications. They cause significant hypoglycemia. They cause weight gain. The "burn out" the pancreas. All of the others do not cause hypoglycemia.
  6. All except for TZD’s are weight neutral or cause weight loss.
  7. All the other appear to preserve beta cell function.
  8. The only reason to use SU’s in 2012 is due to cost.
  9. Sulfonylureas should today be used only as 3rd or 4th line agent.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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Is it time to stop using sulfonylureas?

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    Photo Feature (from the HCFI Photo Gallery)

First Mega Ajmer Health Camp – Pathlab Facilities

800 laboratory test were done by Religare and other organizations and over 25,000 free hemoglobin checkups were done.

 
Dr K K Aggarwal
 
    National News

WHO takes India off polio list

NEW DELHI: India’s name has been struck off a shame list that the country hopes will not include it in the future. The World Health Organization (WHO) has taken India, which in 2009 had more polio cases than any other nation in the world, off its polio endemic list after not a single case of the crippling disease was reported for over a year. Health minister Ghulam Nabi Azad made the announcement on Saturday at a function where Prime Minister Dr Manmohan Singh was also present. Now, only Pakistan, Nigeria and Afghanistan are on the list as India has achieved a hard–fought success after years of sustained effort by the government, international agencies and dedicated medical professionals. (Source: TOI, Feb 26, 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

FDA advisors recommend approval of obesity drug Qnexa

The Food and Drug Administration (FDA) Endocrinologic and Metabolic Drugs Advisory Committee voted overwhelmingly in favor of approving the obesity drug Qnexa (Vivus, Mountain View, CA), a combination of phentermine and controlled–release topiramate. (Source: Medscape)

Removing polyps cuts colorectal cancer deaths

Deaths from colorectal cancer were only half as common among people who had precancerous intestinal polyps removed during colonoscopy as in the general population, researchers said. (Source: Medpage Today)

Molecular signature may distinguish DCIS

A 9–molecule signature differentiates ductal carcinoma in situ (DCIS) from invasive breast cancer, according to researchers from Ohio State University in Columbus. The team also found that the high expression of one of these microRNA molecules correlated with tumor aggressiveness and with time to metastasis and overall survival. These findings were published online February 6 in the Proceedings of the National Academy of Sciences. (Source: Medscape Medical News)

ACIP calls for universal Tdap vaccination

A government vaccine advisory panel voted 14–to–1 on Wednesday that all adults 65 and older –– not just those who come into contact with infants –– should receive the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine. The vote by the CDC’s Advisory Committee on Immunization Practices (ACIP) effectively establishes a recommendation of "universal" Tdap vaccination for all patients ages 19 and up. Currently, Tdap is recommended in a single booster dose every 10 years for adults ages 19 to 64, and in those 65 and older who are likely to come in contact with infants younger than 12 months, such as grandparents and healthcare workers. (Source: Medpage Today)

Increased risk of anal cancer with HIV infection

Anal cancer rates are much higher in HIV–infected individuals, new data show. HIV–positive men who have sex with men (MSM) had the highest anal cancer rates –– but HIV–infected men and women in general still had more anal cancer than people in the general population, according to Dr. Michael J. Silverberg from Kaiser Permanente Northern California, Oakland. (Source: Medscape Medical News)

 
    Twitter of the Day

@DrKKAggarwal: Dr Naresh Trehan on Ajmer Health Camp 11–12 Feb 2012:http://youtu.be/E–p_cSHe_1s via @youtube

@DeepakChopra: My mother always told me "Pursue the goddess of wisdom & knowledge & the goddess of abundance will pursue you.

 
    Spiritual Update

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

Understanding the needs

Everyone behaves according to his or her needs. Every behavior is justified medically as every action is performed according to one’s own psyche, which in turn depends upon the needs. The most primitive needs of a person are that of food, shelter and procreation. Most thefts, minor criminal acts, eve teasing, rapes, etc are to fulfill these needs. These needs satisfy the physical body.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

How is hirsutism treated?

Medical therapy for hirsutism includes the following:

Birth control pills (oral contraceptives): Birth control pills are the most commonly suggested hormonal treatment for hirsutism. They prevent ovulation and decrease androgen production by the ovaries. Estrogen in the pills causes the liver to produce and release more of a protein (sex hormone-binding globulin) that binds to androgens and reduces their action.

Antiandrogen medications: Spironolactone, a diuretic or "water pill," is often prescribed in combination with birth control pills. It directly blocks the effects of androgens in hair follicles. Side effects may include dry skin, heartburn, headaches, irregular vaginal bleeding, and fatigue.

Steroid medications: Low doses of steroids may be prescribed for overactive adrenal glands. Some women taking them experience dizziness during the day or have difficulty falling asleep although these complaints generally improve after the first few days. These drugs may have serious side effects, including weight gain, thinning of the skin and bones, and decreased defense against infection.

GnRH analogs: Severe forms of hyperandrogenism may be treated by medications called GnRH analogs. These medications treat hirsutism by suppressing ovarian androgens to very low levels. They also suppress estrogen and may cause menopausal–like symptoms.

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

A little boy wanted to meet God. He knew it was a long trip to where God lived, so he packed his suitcase with a bag of potato chips and a six–pack of root beer and started his journey.

When he had gone about three blocks, he met an old woman. She was sitting in the park, just staring at some pigeons. The boy sat down next to her and opened his suitcase. He was about to take a drink from his root beer when he noticed that the old lady looked hungry, so he offered her some chips. She gratefully accepted it and smiled at him.

Her smile was so pretty that the boy wanted to see it again, so he offered her a root beer. Again, she smiled at him. The boy was delighted! They sat there all afternoon eating and smiling, but they never said a word.

As twilight approached, the boy realized how tired he was and he got up to leave. But before he had gone more than a few steps, he turned around, ran back to the old woman, and gave her a hug. She gave him her biggest smile ever. When the boy opened the door to his own house a short time later, his mother was surprised by the look of joy on his face. She asked him, "What did you do today that made you so happy?" He replied, "I had lunch with God." But before his mother could respond, he added, "You know what? She’s got the most beautiful smile I’ve ever seen!"

Meanwhile, the old woman, also radiant with joy, returned to her home. Her son was stunned by the look of peace on her face and he asked, "Mother, what did you do today that made you so happy?" She replied! "I ate potato chips in the park with God." However, before her son responded, she added, "You know, he’s much younger than I expected."

Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around. People come into our lives for a reason, a season, or a lifetime! Embrace all equally!

Have lunch with God………bring chips. Send this to people who have touched your life in a special way. Let them know how important they are.

God still sits on the throne. You may be going through a tough time right now but God is getting ready to bless you in a way that only He can. Keep the faith. My instructions were to pick four people that I wanted God to bless, and I picked you.

P.S.: Wisdom and kindness make a person attractive.

For comments and archives

 
    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

Waist size is the best predictor of cardiovascular health

Health experts have long predicted that waist size is a better way to estimate heart disease and mortality risk than BMI. Now a new review article published in the Journal of the American College of Cardiology adds to the list of evidence in favor of measuring waist size. The article, which reviews and analyzes results from several major studies, declares that waist size provides a far more accurate way to predict a heart patient’s chances of dying at an early age from a heart attack or other causes.

Researchers analyzed data from just under 16,000 heart patients who had participated in previous studies. More than one–third of the patients died during the studies, which lasted from six months to eight years. The researchers found that heart patients with a high ratio of waist–to–hip circumference or a large waist size (> 35 inches for women or > 40 inches for men) were 70 percent more likely to die during the study period than those with smaller waists. The combination of a large waist and a high BMI upped the risk of death even more, indicating that overall body weight does play a part, although it’s to a lesser extent. In order to keep your waistline down, aim to exercise or be active on most days of the week.

For comments and archives

 
   Cardiology eMedinewS

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

India Live 2012

Vulnerable Plaque – Renu Virmani

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Cath Imaging Other Than Angiograpgy – Gary Mintz

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Technical Issues In Stenting – Dr Praveen Chandra

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Bio–Absorbable Stents (Alexandre A Abizaid)

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IABP Before Stenting – Dr Ravi Nair

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Radial Stenting (Dr Rony Mathew, Dr S Chugh, Dr M KW Krucoff)

Read More

Thrombus Management in AMI – Dr Praveen Chandra

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   Pediatric eMedinewS

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

More Blood, Worse Outcomes For Kids’ Heart Transplants

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Soon, Hib Vaccination For All Kids

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Transfusions May Increase Risk Of Neonatal Necrotizing Enterocolitis

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EMR, Computer Tools Assist In Pediatric Obesity Evaluation

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    IJCP Special

Dr Good Dr Bad

Situation: A patient with positive malaria came with severe thrombocytopenia.
Dr Bad: This is classical malaria.
Dr Good: Also investigate for dengue.
Lesson: Malaria and dengue may coexist in the same patient

For comments and archives

Make Sure

Situation: A patient with dengue developed acute lung injury after platelet transfusion.
Reaction: Oh my God! Why were platelets transfused?
Lesson: Make sure that no platelets are transfused unless there is significant spontaneous bleeding.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

To the word you might be one person, but to one person you might be the world.

 
    Mind Teaser

Read this…………………

All the following are true regarding abscess of the spleen except:

a) Majority of splenic abscesses result from hematogenous spread from other sites.
b) Both Gram positive and gram negative organisms are responsible for abscess of spleen.
c) Splenomegaly (enlargement of spleen) is present in most of the patients.
d) Two–thirds of the splenic abscess are solitary in adults.

Yesterday’s Mind Teaser: plans
                                      plasn
                                      plsna
                                      plsna
Answer for Yesterday’s Mind Teaser: Changing plans.

Correct answers received from: Sagar, Dr Rakesh Bhasin, Dr Amit Kochar, Dr KV Sarma, Dr Rashmi Chhibber, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Raju Kuppusamy, Anil Bairaria, Dr Neelam Nath, Dr Rakesh Bhasin.

Answer for 26th February Mind Teaser: Split Hair

Correct answers received from: Sudipto Samaddar, Muthumperumal Thirumalpillai, Raju Kuppusamy, Anil Bairaria, Dr Neelam Nath, Dr Rakesh Bhasin.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr Chandresh Jardosh)

An airlines launched a scheme/where a husband can take his wife free, on Business Trip.

The scheme was a huge success. Later, the airline sent letters to all the wives asking about their experience?

99% wives replied: Which trip? When?? What Scheme???

 
  Medicolegal Update

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

Autopsy findings in manual strangulation

  • The autopsy findings fall into two groups: Local signs of violence, and the signs of the mechanism of death
  • Bruising on the neck is the result of the assailant’s attack, whereas abrasions may be from either the victim or assailant. The bruises are mainly discoid, but may run together into larger areas of neck bruising. The discoid marks are from finger–pads and are about 1–2 cm in size, though, longer, irregular marks may occur where the fingers skid across the skin surface, especially along the jaw margins. The bruises tend to cluster at the sides of the neck, often high up under the angles of the jaw. Some may overlap the jaw line and trespass on the chin, but others can be lower on the neck spreading down to the inner ends of the clavicles.
  • As a result of the shifting grip, often caused by the struggles of the victim, bruising can occur anywhere, even at the posterolateral sides of the neck, and on the upper chest over the sternum and collar bones. Some may be seen in the grooves on either side of the larynx, over the anterior edge of the stern mastoid. They are also common over the prominence of the larynx and at the level of the cricoid.
  • Abrasions on the neck: scratches may be caused by the assailant or the victim, usually from fingernails. As with bruising, rough finger pads, especially from a male hand on the delicate skin of a female neck, may abrade the epidermis and underlying bruises may be overlain by diffuse abrasions, again often seen along the margin of the jaw line.
  • Linear scratches are the hallmark of fingernails and when a woman strangles a child, the often longer nails of the woman may leave obvious marks. Whether male or female, the scratches are of two types: when the pressure is static, straight or curved marks up to a centimeter in length are made; when the nails skid down the skin, linear lines may result, sometimes several centimeters in length.
  • The alleged assailant should always be examined medically to correlate any injuries that may have been inflicted on him by the fingernails of the victim such as facial or hand scratches by the fingernails of the victim. If he/she is examined soon after the offence, his own fingernail scrapings should be taken, especially if the victim has neck abrasions, so that comparison studies can be made between any debris found and the tissue types of the victim.

(Ref: Bernard Knight Forensic Pathology 3rd edition)

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)

Top 10 Ways to Keep the Kidneys Healthy

We all want our kidneys to last for a lifetime. We all should show our love for kidneys by adopting 10–step program for protecting kidney health, said Padma Shri and Dr B C Roy Awardee Dr KK Aggarwal President Heart Care Foundation of India.

One should begin with monitoring blood pressure and controlling weight and then move on to the rest of the kidney-healthy tips.

  1. Monitor blood pressure and cholesterol.
  2. Control weight.
  3. Don’t overuse over–the–counter painkillers.
  4. Monitor blood glucose.
  5. Get an annual physical exam.
  6. Know if chronic kidney disease (CKD), diabetes or heart disease runs in your family. If so, you may be at risk.
  7. Don’t smoke.
  8. Exercise regularly.
  9. Follow a healthful diet.
  10. Get tested for chronic kidney disease if you’re at risk.
 
    Readers Response
  1. Dear Sir, I have been a silent reader to the emedinews for past few months. I wanted to express my gratitude to you for helping the whole community with this great service. The holistic approach in your ideology makes your blog very special and different from the rest. Thank you sir.
 
    Forthcoming Events
Dr K K Aggarwal


Dr K K Aggarwal

National Summit on "Stress Management" and Workshop on "How to be happy and Healthy"

Date: Saturday 2PM–Sunday 4PM, 21–22 April 2012
Venue: Om Shanti Retreat Center, Bhora Kalan, on Pataudi Road, Manesar
Course Directors: Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal and BK sapna
Organisers: Heart Care Foundation of India, Prajapati Brahma Kumari Ishwariya Vidyalaya and eMedinewS
Fee: No fee, donations welcome in favour of Om Shanti Retreat Center
Facilities: Lodging and boarding provided ( One room per family or one room for two persons). Limited rooms for first three registrants.
Course: Meditation, Lectures, Practical workshops,
Atmosphere: Silence of Nature, Pyramid Meditation, Night Walk,
Registration: Rekha 9899974439 rekhapapola@gmail.com, BK Sapna 9350170370 bksapna@hotmail.com

Study Camp on ‘Mind–Body Medicine and Beyond’

16–23 June 2012, Nainital Centre (Van Nivas)

Sri Aurobindo Ashram – Delhi Branch will organize the 5th Study Camp on ‘Mind–Body Medicine and Beyond’ for doctors, medical students and other health professionals at its Nainital Centre (Van Nivas) from 16–23 June 2012. The camp, consisting of lectures, practice, and participatory and experiential sessions, will help the participants get better, feel better, and bring elements of mind–body medicine into their practice. The camp will be conducted by Prof. Ramesh Bijlani, M.D., former Professor, AIIMS, founder of a mind–body medicine clinic at AIIMS, and the author of Back to Health through Yoga and Essays on Yoga. For more details, send an e–mail to the Ashram (aurobindo@vsnl.com) or to Dr. Bijlani (rambij@gmail.com).

BSNL Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
http://www.heartcarefoundation.org

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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    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