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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 …

29th March 2012, Thursday

White rice linked to diabetes in Asians

A previous study of Chinese American mothers and their children by Chen (published in June 2009 issue of the Journal of Immigrant and Minority Health) found that high household income was associated with higher consumption of fat and sweets on the part of the mother, and a high level of maternal acculturation was associated with a low body mass index among children.

In a recent study, Emily A Hu and colleagues reports that high levels of rice consumption were associated with an increased risk for type 2 diabetes among Asian, but not Western, populations. The analysis of data from 4 studies, including 7 prospective cohort analyses in Asian (China and Japan) and Western (Australia and US) populations, was published March 15 in the British Medical Journal by Hu from the Dept. of Nutrition, Harvard School of Public Health, Boston, Massachusetts.

Using summary data from these studies, the authors conclude that the pooled relative risk for type 2 diabetes associated with highest vs lowest white rice intake was 1.55 (95% confidence interval (CI), 1.20 – 2.01) among Asian populations and 1.12 (95% CI, 0.94 – 1.33) in Western populations. The researchers conclude, "for each serving per day increment of white rice intake, the relative risk of type 2 diabetes was 1.11 ((95% CI,) 1.08–1.14) (P for linear trend<0.001)."

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Communication skills for Health care Professionals part 2 at Pushpanjali Hospital

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

First Mega Ajmer Health Camp – Tele–consultation facilities

For the first time, 7 major hospitals from outside Ajmer were connected to the camp live through tele–services and provided over 200 tele–consults.

Dr K K Aggarwal
    National News

India contests WHO figures for multi–drug resistant TB

The government on Tuesday contested the WHO figures that put the number of Multi–Drug Resistant Tuberculosis (MDR–TB) cases in India at 63,000, saying there were only 10,267. As many as 38,287 suspected cases were examined till the end of 2011 and of them, 10,267 have been diagnosed with MDR–TB and 6,994 put on treatment, according to TB India–2012 — the annual status report of the Revised National TB Control Programme (RNCTP) brought out by the Health Ministry. (Source: The Hindu, March 28, 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

Protocols for Cath Labs Published

For the first time, cardiac catheterization laboratory managers will have a document that codifies a cath lab’s operational processes from beginning to end of the patient’s stay.

The expert consensus document on best practices emphasizes the natural patient flow from preprocedure to discharge, Srihari S. Naidu, MD, from Winthrop University Hospital in Mineola, New York, and colleagues reported online in Catheterization and Cardiovascular Interventions.

The sample time–out checklist provided in the document includes these six items:

  1. Patient’s name and medical record number
  2. Procedure to be performed (e.g., left heart catheterization, coronary angiography, right heart catheterization)
  3. Route to be used (e.g., right femoral artery)
  4. Confirmation that the equipment needed is available or alternatives are available including intended stent type for PCI or cath–possible patients
  5. Patient’s allergies and pre–medication if appropriate (e.g., heparin–induced thrombocytopenia, contrast allergy)
  6. Special laboratory or medical conditions (e.g., elevated international normalized ratio, chronic kidney disease)

After the procedure, the experts encourage the use of automated electronic systems that send procedure notes to referring physicians. (Source: Medpage Today)

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ACC: TAVI deaths mostly noncardiac

Noncardiac health issues, including chronic kidney disease and frailty, were responsible for a fairly high death rate at four years in older high–risk patients who underwent transcatheter aortic valve implantation (TAVI), researchers found. (Source: Medpage Today)

For comments and archives

ACC: Reopro shrinks infarct size in STEMI

Among patients with a large anterior ST–segment elevation MI (STEMI), those who received abciximab (Reopro) directly at the site of the infarct during angioplasty had modestly reduced infarct size at 30 days, a randomized trial showed. (Source: Medpage Today)

For comments and archives

ACC: Stem cells flop in heart failure study

An injection of bone marrow stem cells into the heart doesn’t boost its performance in chronic ischemic heart failure, according to an early phase randomized trial. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Good news for ageing Indian patients with aortic valve disease This year’s WHO slogan focuses on http://tl.gd/glllc8 via @DrKKAggarwal

@DeepakChopra: A creative mind and a blissful body indicate pure awareness.

    Spiritual Update

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

5th Navratri (Skanda Mata Worship)

Spiritual Significance: One should gain knowledge of detached attachment as the main principle of spirituality.

  1. Skanda Mata is worshipped on the fifth Day of Navratri.
  2. She is holding her son ‘Skandaa or Kartikaya’ on her lap.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

How is hyperprolactinemia treated?

The treatment depends on the cause. If your doctor cannot identify cause or you have a microadenoma or a macroadenoma in the pituitary gland, the primary treatment is with medication. The most commonly used medications are bromocriptine and cabergoline. The treatment continues until you get pregnant. The most common side effects of bromocriptine include lightheadedness, nausea and headache. Other side effects include nasal congestion, dizziness, constipation, abdominal cramps, fatigue, vomiting, and, rarely, neurologic symptoms such as hallucinations. Slowly increasing the dose helps reduce side effects. Bromocriptine can also be taken as a vaginal suppository or tablet at bedtime.

For comments and archives

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

(Dr.(Prof.) Sandeep Guleria, Senior Consultant Surgeon, General Surgery, GI Surgery and Transplantation, Indraprastha Apollo Hospitals)

A recent article in Transplant International has confirmed that the long–term consequences of renal donation are negligible. It does not impact survival, medical condition or psychological status in the long term.
The article (Very long-term follow–up of living kidney donors. Transplant International April 2012;25:385–39 doi:10.1111/j.1432–2277.2012.01439) examines 398 persons who had donated a kidney between 1952 and 2008 at Necker hospital.

Among the 310 donors who were located, the survival probabilities for this population were similar to those of the general population and end stage renal disease incidence was 581 per million population per year. All located donors still alive were asked to complete a medico–psychosocial questionnaire and give samples for serum creatinine and urinary albumin assays. Among the 204 donors who responded to the questionnaire, mean eGFR was 64.4 ± 14.6 ml/min per 1.73 m2 and mean microalbuminuria was 27.0 ± 83 mg/g. Most donors never regretted the donation and consider that it has no impact on their professional or social lives. Among the 59 donors who gave a kidney more than 30 years ago (mean 40.2 years, range 30–48 years) had a mean eGFR of 67.5 ± 17.4 mol/l, a mean microalbuminuria level of 44.8 ± 123.2 mg/g and none was dialyzed. In conclusion, living kidney donation does not impact survival, kidney function, medical condition or psychological or social status over the very long–term.

For comments and archives

    Celiac Disease Update

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

What are the atypical presentations of celiac disease in India?

Atypical CD is not uncommon in India. Near 20–30% of celiac disease may present with atypical manifestations. Children with atypical CD present at an older age. Likelihood of finding CD is high in children with anemia, short stature and rickets.

For comments and archives

    Medi Finance Update

(Tarun Kumar, Chartered Accountant)

Income from Other Sources

Consideration for issue of shares, in excess of the fair market value, received by a company in which public is not substantially interested, shall be treated as income liable to tax in the hands of such company.

For comments and archives

    An Inspirational Story

(Dr GM Singh)

The Professor and the Jar

A professor stood before his philosophy class and had some items in front of him. When the class began, wordlessly, he picked up a very large and empty jar and proceeded to fill it with golf balls. He then asked the students if the jar was full. They agreed that it was. So the professor then picked up a box of small pebbles and poured them into the jar. He shook the jar lightly. The pebbles rolled into the open areas between the golf balls. He then asked the students again if the jar was full. They agreed it was.

The professor next picked up a box of sand and poured it into the jar. Of course, the sand filled up everything else. He asked once more if the jar was full. The students responded with a unanimous "Yes." The professor then produced two cans of beer from under the table and poured the entire contents into the jar, effectively filling the empty space between the sand. The students laughed.

"Now", said the professor, as the laughter subsided, "I want you to recognize that this jar represents your life. The golf balls are the important things – your family, your children, your health, your friends, your favorite passions – things that, if everything else was lost and only they remained, your life would still be full. The pebbles are the other things that matter like your job, your house, your car.

The sand is everything else – the small stuff. If you put the sand into the jar first" he continued, "there is no room for the pebbles or the golf balls. The same goes for life. If you spend all your time and energy on the small stuff, you will never have room for the things that are important to you. Pay attention to the things that are critical to your happiness. Play with your children. Take time to get medical checkups. Take your partner out to dinner. There will always be time to clean the house, and fix the rubbish. Take care of the golf balls first, the things that really matter. Set your priorities. The rest is just sand".

One of the students raised her hand and inquired what the beer represented. The professor smiled. "I’m glad you asked. It just goes to show you that, no matter how full your life may seem, there’s always room for a couple of beers".

For comments and archives

    Cardiology eMedinewS

RESET: Three Months of DAPT with Endeavor Stent Safe As Conventional DAPT Read More

FOCUS–CCTRN: Negative Trial, But Hints For Future Of Cell Therapy In Heart Failure Read More

Anti–inflammatory Bindarit Cuts In–Stent Late Loss With Bare–Metal Stents Read More

TRA 2°P–TIMI 50: Future Possible For Vorapaxar In Patients With Prior MI
Read More

    Pediatric eMedinewS

Iron Deficiency Protects Children against Malaria Read More

Serious Allergic Food Reactions Higher In Tree Pollen Season Read More

Watch Out For TB in Children Read More

    IJCP Special

Dr Good Dr Bad

Situation: A non fasting patient came for cholesterol test.
Dr. Bad: You cannot get it done as you are not fasting.
Dr. Good: Get total cholesterol and HDL cholesterol done.
Lesson: For total and HDL cholesterol fasting is not a pre–requisite.

For comments and archives

Make Sure

Situation: A patient with human bite developed infection in the wound.
Reaction: Oh my God! why were antibiotics not started in time?
Lesson: Make sure all patients with human bite are put early on amoxicillin–clavulanic group of antibiotics.

For comments and archives

  Quote of the Day

(Dr GM Singh)

Three Rules of Work: Out of clutter find simplicity; From discord find harmony; In the middle of difficulty lies opportunity. Albert Einstein

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    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Transferrin saturation or index

A low serum iron to predict iron deficiency is less specific. It also occurs in the anemia of chronic disease or anemia of chronic inflammation (ACD/ACI). In this setting, however, there is usually a parallel reduction in the TIBC, resulting in a near normal percent saturation. However, about 20% of patients with ACD/ACI have transferrin saturations in the iron deficiency range because of an inability to access their normal or even increased marrow iron stores.

    Mind Teaser

Read this…………………

The most common complication of Bevacizumab is:

a) Hypertension
b) Hyperglycemia
c) Rashes
d) Gastrointestinal perforations

Yesterday’s Mind Teaser: Prophylactic surgery for asymptomatic cholelithiasis is done in:

a) Diabetes
b) Hemolytic anemia
c) Hypertensives
d) Stone size more than 1.5 cm

Answer for Yesterday’s Mind Teaser: b) Hemolytic anemia

Correct answers received from: Dr PC Das, Dr.Ragavan Sivaramakrishnan Moudgalya, yogindra vasavada, Dr Thakor Hitendrsinh G, Raju Kuppusamy, Dr BB Aggarwal, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Anil Bairaria.

Answer for 27th March Mind Teaser
: a) Steroid enema
Correct answers received from: Anil Bairaria, yogindra vasavada, Dr Mrs Sukla Das, Dr PC Das.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

A Leave application by a student

As my headache is paining please grant me leave for the day

    Medicolegal Update

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

False accusations of sexual assault

Allegations of sexual assault can be made easily, hard to prove but even harder to disprove

The sexual offenses which are recognized in our legal system are rape, sodomy, oral sex, drug–related sexual assault such as the molestation, inappropriate touching, forced kissing, forced oral, anal, vaginal penetration by fingering/fisting or any means, child sex abuse, sexual torture or any other form of complain as selling and buying of minor girls for illicit sexual intercourse, adultery, incest etc. In almost all of the above cases, a medical examination of accused and victim is required and the medical report as well as collected biological samples are very crucial and provide the strongest scientific evidence of the case since in crime of sexual offenses. An eye witness is rarely found.

The investigator/examining doctor should keep the possibility of false accusation of rape in mind and find out the truth. Medical examination must be conducted in a transparent manner in the interest of truth and justice without fear and favor as an obligation of medical ethics.

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)

Cancer survival rates can increase the anxiety

One of the first questions many people ask when first diagnosed with cancer is about their prognosis. They might want to know whether the cancer is relatively easy or more difficult to cure. The doctor cannot predict the future, but often he/she gives the estimates based on the experiences of other people with the same cancer. Survival statistics can be confusing and frightening. Survival rates cannot tell about the situation specifically. The statistics may be impersonal and not very helpful, said Dr. K.K. Aggarwal, Padma Shri and Dr B C Roy National Awardee and President, Heart Care Foundation of India.

Cancer survival rates or survival statistics indicate the percentage of people who survive a certain type of cancer for a specific amount of time. Cancer statistics often use a five–year survival rate. For instance, the five–year survival rate for prostate cancer is 99 percent. That means that of all men diagnosed with prostate cancer, 99 of every 100 lived for five years after diagnosis. Conversely, one out of every 100 will die of prostate cancer within five years. Cancer survival rates are based on research that comes from information gathered on hundreds or thousands of people with cancer. An overall survival rate includes people of all ages and health conditions diagnosed with the cancer, including those diagnosed very early and those diagnosed very late. Only the treating doctor may be able to give more specific statistics based on the stage of cancer. For instance, 49 percent, or about half, of people diagnosed with early–stage lung cancer live for at least five years after diagnosis. The five–year survival rate for people diagnosed with lung cancer that has spread (metastasized) to other areas of the body is 2 percent. Overall and relative survival rates don't specify whether cancer survivors are still undergoing treatment at five years or if they’ve become cancer free (achieved remission). The five year survival rates for all men is 47.3–66%% and for all women is 55.8–63%

Other terms

  • Disease–free survival rate. This is the number of people with cancer who achieve remission. That means they no longer have signs of cancer in their bodies.
  • Progression–free survival rate. This is the number of people who still have cancer, but their disease isn’t progressing. This includes people who may have had some success with treatment, but their cancer hasn’t disappeared completely.
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    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

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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