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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; Member 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


Dear Colleague

30th March, 2010 Tuesday

Women may need at least an hour of exercise daily to avoid weight gain

A major new study published in the Journal of the American Medical Association found that without making changes in diet, women need a lot of exercise just to keep their weight stable. The investigators found that at least an hour of moderate activity every day is needed for older women who are at a healthy weight and who aren’t dieting. Overweight women require even more exercise to avoid gaining weight without eating less. It’s uncertain whether the results would apply to men. As they age, people often put on weight because their metabolism slows down. For those who cannot do so much, an average of 35 minutes a day, seven days a week, is probably sufficient. Others advise doing at least 150 minutes of moderate–intensity physical activity each week.

Dr KK Aggarwal
Chief Editor

Stop Press

Padma Awards to be given tomorrow

The highest civilian Padma Awards will be given by Her Excellency Hon’ble President of India Smt. Pratibha Patil tomorrow at Rashtrapati Bhawan. The function will be attended by Dr. Manmohan Singh, Hon’ble Prime Minister of India, Hon’ble Vice-president of India Shri Hamid Ansari; and Shri P. Chidambaram, Hon’ble Union Home Minister.

Dr. K K Aggarwal, Editor-in-chief Emedinews, Sr. Consultant at Moolchand Medcity and President Heart Care Foundation of India is one of the recipients. Dr. Aggarwal was also given Dr. B.C. Roy Award by the President of India two years back. The Padma Awards rehearsal will be held at Rashtrapati Bhawan today. It is a total replica of the actual award ceremony with one of the officiating staff playing the role of President of India.  



Photo feature

Dr KK Aggarwal being honored with DMA Swasthya Ratna Award – 2009 on 28th March 2010, during Delhi Medical Association (DMA) Annual Day Celebration.

Dr k k Aggarwal

News and Views

Combining weight–focused counseling, medication helps women quit smoking

For women smokers worried about their weight, combining cognitive behavioral therapy, which addresses weight concerns along with bupropion, appears more effective than counseling alone to help them quit smoking (March 22, 2010 Archives of Internal Medicine)

Risky drinkers less likely to take good care of themselves and seek medical care

Women and men who engage in frequent heavy drinking report significantly worse health–related practices (Kaiser Permanente Center for Health Research study in the journal Addiction Research & Theory)

Meeting Notes

American College of Cardiology; Atlanta, GA • March 14 – 16, 2010

1. Radial artery matches saphenous vein for cABG

Coronary artery bypass grafts taken from the radial artery provide short–term patency that is just as good as standard saphenous vein grafts. Radial artery grafts remained open at one week in 99% of patients, compared with 97% for saphenous vein grafts. The rates were identical at 89% after one year. (Dr Steven Goldman, Tucson VA Hospital in Arizona)

2. New anticoagulants signal start of post–warfarin era

Atrial fibrillation is both a major stroke risk and a looming public health problem since the risk of a fibrillation increases with age. The warfarin, standard treatment, is often a clinical management challenge. But a number of investigational therapies suggest that a post–warfarin era is beginning. American College of Cardiology president Ralph Brindis, MD, of the University of California San Francisco, says that two new compounds, betrixaban and dabigatran, have raised the threshold for anticoagulation therapy. However, neither compound has been approved for clinical use.

3. Genotyping improves warfarin outcomes

Genetic testing to guide early warfarin dosing appears to reduce hospitalizations. Patients genotyped for the warfarin metabolism gene CYP2C9 and the vitamin K blood clotting activator gene VKORC1 had a relative 28% fewer hospitalizations for bleeding and thromboembolism than historical controls. Giving physicians the genotype results with interpretation for dosing also appeared to reduce total hospitalization risk by an adjusted 31% compared with the historical controls. (Dr Robert S. Epstein, Medco Health Solutions, Franklin Lakes, NJ)

What’s New: Glargine and cancer

Data regarding use of insulin analogs and risk of cancer are conflicting for insulin glargine and, pending more data, there is insufficient evidence to make a recommendation against glargine. (Hemkens LG, Grouven U, Bender R, et al. Risk of malignancies in patients with diabetes treated with human insulin or insulin analogues: a cohort study. Diabetologia 2009;52:1732.)

Diabetes Fact

Hypoglycemia is not diabetic complication but complication of treatment

Public Forum (Press Release)

Blood donors have less chances of getting cancers and heart attacks

People who donate blood show lower cancer and mortality rates than their non–donating peers said Dr K K Aggarwal, President, Heart Care Foundation of India and Editor eMedinewS, quoting an article published in the Journal of the National Cancer Association.

In the past it has also been shown that frequent blood donations are associated with less chances of heart attacks. Excess iron stores have been tied to heart disease and certain types of cancer, so people who regularly have their blood drawn may be depleting these stores and thus improving their health.

In the study, the researchers looked at data from the Swedish and Danish blood banks and transfusion clinics containing records of individuals who donated blood at least once between 1968 and 2002, a total of 1,110,212 people.

They found no relationship between how frequently a person gave blood and their risk of cancer. However, among male donors, the risk of liver, lung, colon, stomach and throat cancers declined as the frequency of donations increased, which suggests that iron depletion may reduce cancer risk. (Journal of the National Cancer Institute)

Sutra: Blood donors have less chances of getting heart attacks and the cancers of liver, lung, colon, stomach and throat (Journal National Cancer Institute).

Question of the day

What is the mechanism of action of radiosurgery?

Cells are made of carbohydrate, protein, lipids and nucleic acids, which in turn contain atoms made of carbon, hydrogen, oxygen and other elementary atoms. These atoms in turn contain protons, neutrons and electrons. Protons and neutrons are, which constitute the nucleus of the atoms, exert gravitational pull on the electrons The electrons of these atoms are the target of radiosurgery the It targets these electrons by its own electrons vibrating above 3.8 million cycles per second. These vibrating electrons lead to tissue heat and vaporization of the target atoms and in turn the cells containing them. But according to the law of physics, matter cannot be created nor destroyed. So probably in clinical practice we target the pathological skin and convert it to water and carbon, which are released into atmosphere only to be recycled into living organism by the circle of life.In radiosurgery the electrodes remain cold but the tissue or water in contact is heated.

In radiosurgery the electrodes remain cold but the tissue or water in contact is heated.

Unlike electrocautery wherein the electrode becomes red hot, in radiosurgery the heat is generated by electrons in tissues but the electrode remains cold.

Quote of the Day (Dr Mayur Jain)

Laugh when you can, apologize when you should, let go of what you can’t change and have no regrets.


SMS of the Day (Dr Ingole, MD)

We don’t realize how much we create reality through language............. if we say life is hard, then well, it will b hard!

Fall update (Dr G M Singh)

What types of exercise classes are most appropriate for people who falls?

Dr G M Singh Exercise interventions should be evidence–based. To be most effective, exercise for groups at risk of falls should be:

  • Individually prescribed

  • At least twice a week for at least six months

  • Have a highly challenging balance element i.e narrowing the base of support, avoiding use of arms and movement of the centre of mass.

Although walking does offer a range of health benefits, it does not work as a measure to prevent falls.

For those over 80 or with muscle weakness, there should be a component of progressive muscle strengthening using resistance.

It is also important to market the exercise to patients in the right way. They are much more likely to attend if exercise is seen as positively promoting independence and health rather than to stop falls.

Exercise interventions that are well supported by an instructor and accessible by transport or close to home are also more likely to be taken up.


eMedinewS Try this it Works

How to elicit a deep breath

Call attention to the paper towel dispenser located on a counter several feet away. Tell patients to take a good breath and try to make the paper towel move. Listen to much better inspiratory and expiratory effort.

Dr Good Dr Bad

Situation: A diabetic with foot ulcer and low testosterone levels came for prescription.
Dr Bad: Just keep your sugar under control.
Dr Good: You will need testosterone replacement.
Lesson: In men with a diabetic foot and whose serum testosterone levels were subnormal, administration of testosterone has favorable effects on healing of diabetic foot. There was an improvement of hyperglycemia, a decrease of leukocytes and of fibrinogen levels, an increase of antithrombin III activity and of tissue oxygen pressure and the wound showed granulation. Beneficial effects of testosterone may be due to improved vascularization and to anti-inflammatory action. (Cardiovasc Diabetol 2009;8:19.)

Make Sure

Situation: A terminally ill patient who develops bed sores, is given systemic antibiotics only.
Reaction: Please change the position of the patient frequently and keep the skin clean and dry.

Make sure good nursing care and maintenance of skin hygiene should be advised first to patients with bed sores, along with topical antibiotics.

Punjab & Sind Bank
Central Bank of India

Laughter the best medicine

One afternoon, a man went to his doctor and told him that he hadn’t been feeling well lately. The doctor examined the man, left the room, and came back with three different bottles of pills.

The doctor said, "Take the green pill with a big glass of water when you wake up. Take the blue pill with a big glass of water after you eat lunch. Then just before going to bed, take the red pill with another big glass of water."

Startled to be put on so much medicine, the man stammered, "Doc, exactly what is my problem?"

The doctor replied, "You’re not drinking enough water."

Formulae in Critical Care

Predicted endotracheal tube size for age

Formula: = 4 + (age/4) for pediatric age group.

Comments: The approximate size of the intubation tube is the size of little finger of the patient.

Milestones in Medicine

1543 A.D. The first scientific textbook on human anatomy was published by Andreas Vesalius, physician and professor of medicine at the University of Padua. Vesalius based his work on dissection of human cadavers.

Mistakes in Clinical Practice

Blood sampling if done incorrectly can lead to lot of complications like thrombosis, thrombophlebitis, pain, etc. Hence, it is very important to remember the basic rules of sampling:

  • Preferred site for venous sampling–cubital fossa
  • Tourniquet at level of mid arm
  • Clean the site of the vein; the vein should be seen or palpated.
  • Insert the needle at an angle of 15°.
  • Open the tourniquet
  • Take the sample
  • Apply pressure at the site for 1 min. with spirit swab.

Lab Test (Dr Naveen Dang)

CD4 and CD8 test is done to measure the strength of the immune system usually in patients diagnosed with HIV infection.

List of Approved drug from 1.01.2009 to 31.10.2009

Drug Name


Approval Date

Saxagliptin (as HCl) 2.5mg/ 5mg Tablets

As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. (It should not be used for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis, as it would not be effective in these settings.


(Advertorial section)


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Advertising in eMedinewS

eMedinewS is the first daily emedical newspaper of the country. One can advertise with a single insertion or 30 insertions in a month.

Contact: drkk@ijcp.com or emedinews@gmail.com

eMedinewS–PadmaCon 2010 

Will be organized at Maulana Azad Medical College, New Delhi on July 4, 2010, Sunday to commemorate Doctors’ Day. The speakers, chairpersons and panelists will be doctors from NCR, who have been past and present Padma awardees.

eMedinewS–revisiting 2010

The second 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.

NATIONAL SEMINAR ON STRESS PREVENTION (17 – 18 April). Over 400 registrations already done.

A Stress Prevention Residential Seminar cum spiritual retreat with Dr KK Aggarwal and Experts from Brahma Kumaris will be organized from April 17–18, 2010.

Co–organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, IMA New Delhi Branch and IMA Janak Puri Branch, IMSA (Delhi Chapter)

Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.

Timings: On Saturday 17th April (2 pm onwards) and Sunday 18th April (7 am–4 pm). There will be no registration charges, limited rooms, kindly book in advance; stay and food (satvik) will be provided. Voluntary contributions welcome. For booking e–mail and SMS to Dr KK Aggarwal: 9811090206, emedinews@gmail.com BK Sapna: 9811796962, bksapna@hotmail.com


Delhi Medical Council Presents

An interaction with

Dr Ketan Desai, President, Medical Council of India, 
Mr Mukul Rohtagi, Senior Advocate, Supreme Court of India, &
Dr A K Aggarwal, President, Delhi Medical Council

Topic: Medical Ethics & Doctor–Pharma Relationship – New MCI Amendments

Date: April 10, 2010, Saturday

Time: 6 pm – 9 pm

Venue: Maulana Azad Medical College Auditorium, Dilli Gate, New Delhi

Dr KK Aggarwal: Moderator and Member Delhi Medical Council

Dr Girish Tyagi: Registrar, Delhi Medical Council

For Registration SMS to Dr KK Aggarwal : 9811090206

Also, if you like emedinews you can FORWARD it to your colleagues and friends. Please send us a copy of your forwards

Readers Responses

  1. Dear Dr. Aggarwal: firstly many congratulations for the award. I wish I could be there. Thanks regards and heartiest congratulations once again. Dr Anupam Sethi Malhotra

  2. Dear Dr. Aggarwal, Really you are good. Your emedinews enriches our members about recent developments in Modern Medicine. People are lazy to refer books and this medinews will be of help for them. Dr. Alex Franklin