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  Address:  39 Daryacha, Hauz Khas Villege, New Delhi, India. e-Mail: drkk@ijcp.com , Website: http://www.ijcpgroup.com 

Dr K K Aggarwal

Dr KK Aggarwal
Dr BC Roy Awardee
Sr Physician and Cardiologist,
Moolchand Medcity
President, Heart Care
Foundation of India
Gp Editor-in-Chief,
IJCP Group
Delhi Medical Council
Director, IMA AKN Sinha Institute (08-09)


29th October

Dear Colleague,

 Breaking News : Liver Fat More Bad than Tummy Fat

A new study has shown that fat in the liver is more dangerous than in the abdomen. According to Washington University scientists, fatty liver make more triglycerides which are released from the liver into the blood increasing the changes of heart attacks. They are more likely resistant to the action of their own insulin, meaning their body does not regulate blood sugar properly which can lead to type 2 diabetes. Radical lifestyle changes may delay addition of insulin to oral drugs. Boston doctors are advocating that diabetics should undergo radical lifestyle changes incorporating rigorous diet and exercise regimes. This can delay the addition of insulin to existing oral treatment.

 Today is Stroke Day. As doctors, we must understand that stroke is as dangerous as heart attack. In fact, the new name for stroke is brain stroke and, therefore, it has to be treated and managed on the same lines as heart attack. Also it needs to be given the same emergency importance as is being given to heart attack.
In Delhi only, more than 20 people die of paralysis everyday. The risk factors, prevention and treatment modalities are same for both heart attack and brain attack. The important is to anticipate and treat early.

TIA is now defined as transient reversible neurological deficit and the window must be less than 1 hour. Therefore, between 1 to 4.5 hours if a patient comes with the complaint of paralysis, he needs immediate CT scan to rule out cerebral bleeding and  if absent, patient needs immediate tPA thrombolysis.Let this Stroke Day be awakening for all of us to save patients from stroke mortality and morbidity.

Dr KK Aggarwal

Multidrug-Resistant Hospital Acquired Infections
Nosocomial infections constitute the greatest risk the hospital environment poses to patients, and they are by far the most common complication associated with hospitalization. Up to 10% of patients admitted to acute care hospitals acquire at least one infection, with 2 million patients affected per year.

Coffee slows the progression of advanced liver disease in people with chronic hepatitis C
766 patients infected with hepatitis C virus were asked to report their intake of coffee, green tea and black tea. The patients were seen every three months during the nearly four-year study, and liver biopsies were taken at 18 months and 3.5 years to determine the progression of liver disease. Patients who drank three or more cups of coffee per day were 53 percent less likely to have liver disease progression than those who did not drink coffee. Green and black tea did not appear to have an effect, but tea consumption was low among the study participants (November Hepatology).

Statins might slightly boost diabetes risk
Statins do not reduce the risk of diabetes and might modestly elevate the chances of developing the condition, researchers found in a pooled analysis of trial data published in the journal Diabetes Care.

Smoking more harmful in women
Women may be more vulnerable than men to the carcinogens and other noxious substances in cigarette smoke. In a Swiss study of nearly 700 people with lung cancer, experts found that women tended to be younger when they received the diagnosis, even though they smoked less than the men who developed lung cancer. In another study, Harvard researchers evaluated more than 950 men and women with COPD. The women with COPD were younger when they got the diagnosis and had smoked less than the men with the respiratory ailment.

Aggressive lipid lowering more effective in carotid plaque stabilization
Atherosclerotic plaque stabilization is a promising strategy to prevent cerebrovascular events in patients with carotid atherosclerosis. Vascular calcification inhibitors, known osteopontin (OPN) and osteoprotegerin (OPG), have emerged as novel cardiovascular biomarkers. Among patients with moderate carotid stenosis, an aggressive atorvastatin regimen enhanced carotid plaque echogenicity and reduced serum OPN and OPG levels to a greater extent than respective moderate atorvastatin therapy. Most importantly, those atorvastatin-induced effects were associated with OPN and OPG suppression in a dose-dependent manner. [Source: Journal of Vascular Surgery Oct 2009]

Ipratropium bromide for acute asthma exacerbations
Since the 1970s, when inhaled anti cholinergic agents were first introduced as adjunct therapies for the immediate treatment of paediatric asthma exacerbations; several trials have shown varying degrees of benefit from their use as bronchodilators in combination with inhaled short-acting beta-adrenergic agonists and systemic corticosteroids. Ipratropium bromide specifically has emerged as the overwhelming choice because of its limited systemic absorption from the lungs when given as an inhaled preparation. [Pediatric Emergency Care 25 (10), 687-92 (Oct 2009)]

Lidocaine Patch Bests Pregabalin for Diabetic Nerve Pain
A dermal patch containing 5% lidocaine proved as effective as pregabalin in relieving neuropathic pain in diabetic patients with dramatically fewer side effects. Only 3.8% of patients treated with the patch suffered drug-related adverse events, compared with 36.2% of those taking oral pregabalin in a 210-patient, four-week randomized trial (P<0.0001). ) [Tacken, European Association for the Study of Diabetes meeting]

Basal insulin better in diabetes
Patients with type 2 diabetes who require insulin on top of oral therapy to control glycated hemoglobin may do better if they start on a basal insulin versus biphasic insulin or prandial insulin. Three-year results from the open-label 4-T (Treating to Target in Type 2 Diabetes) study found that fewer patients in the biphasic group achieved HbA1c levels of 6.5% or lower compared with the basal group (43.2% versus 39.5% P=0.03) [Rury Holman, Diabetes Trials Unit at the University of Oxford].


My doctor charges so much, when he gets sick, he can't afford himself.

Formula to know

Normal ESR in mm in 1 hr = age in years divided by 2 in men and age in years plus 10 divided by 2 in women. [Wallach J. Interpretation of Laboratory Tests, 6th edition. Little Brown and Company. 1996. page 75]

You can advertise in emedinews

emedinews is the first emedical newspaper of the country. Advertisement opportunities are available. One can advertise with a singe insertion or with 30 insertions in a month (contact drkk@ijcp.com)

Medinews Doctor of the Year Awards
Will be given on 10th Jan 2010 to eminent doctors who have done outstanding work in the year 2009. The award will be a part of day long CME: MEDINEWS 2009 ? Revisiting 2009. The award will carry a citation, shawl, coconut kalash, scenery and a memento.


Letter to the editor
rhythma.kaul@hindustantimes.com: This is in reference to your news item published yesterday regarding MCD statement of Delhi facing lowest number of dengue cases. This may be true on MCD records, but not in the hospital settings.

1. Over 70 centres in Delhi have platelet apharesis machines. We talked to two of the centres. One is White cross Blood Bank (Dr. K.K. Kohli 9811106882). On an average, the bank has been issuing 15 platelet bags to dengue pts on daily basis. Second is Apollo Hospital (Dr. Raina 9810125105) they have been issuing 15 platelet bags everyday over the last few weeks.
2. Moolchand Hospital Pathological Lab has been reporting on an average 50 patients everyday with fever and platelet counts lower than 1 lakh. Unless proved otherwise, a patient with high grade fever in this season with platelet count less than 1 lakh and liver SGOT more than SGPT is dengue, whether or not dengue serology is done.

Thanks for the emedinews which is very informative. Above all it keeps us abreast with all the latest updates.Thanks again for all the help you are giving to the medical fraternity by passing the news.[Dr Revti Raman Kaul] 


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