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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; 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 ...

30th September, 2010, Thursday

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

100th Monkey Phenomenon

The success of advertising or rumors is based on the principle of collective consciousness. It is nothing but the critical mass above which the generated message spreads like fire. It has been scientifically observed and proven that rumors spread like wild fire once the critical mass of 1% in the general population is achieved. Advertisements in newsprints and in electronic media also work on the same principle.This observation is based on famous 100th-monkey phenomenon. “Long time back there was a monkey called Emo in a far off village in Japan. Monkeys at that time used to eat apples lying in the gardens full of dust. One day Emo by mistake washed the apple in the pond before eating. And from next time onwards he washed every apple he ate. From one monkey the message went to the second monkey and then to the third and so on. Many monkeys started washing apples before eating. After sometime, some neighboring monkeys from other villages also started washing apples before eating. The day the 100th monkey washed the apple and ate it, a strange phenomenon was observed all over the country. Monkeys all over the country started washing apples before eating. The critical mass in that area therefore was 100. Once the critical mass was achieved, the information spread like wild fire to each and every monkey and everybody started washing apples before eating.
Politicians make use of this principle during campaigning and make sure that the critical mass is achieved to start with. In local political meetings also, the same principle of 1% critical mass is used. For a gathering of 1000 people, politicians make sure that they have minimum 10 of their own people sitting in the audience to initiate clapping. When 10 people clap, the rest 990 will also follow and clap. Similarly, for a gathering of 2000 they will need 20 people and for 10,000 they will need 100 people.
Rumours also work on the similar principle of 1% or critical mass. You can plant 1% of the people and start spreading rumors. The only precaution that you should take is to cross 1% of the number.

Dr KK Aggarwal
Editor in Chief
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  Photo Feature (from the NET)

Weird X-rays

X-ray is one of the most useful medical advancements in history. But as these images show they can also reveal some of the most gruesome and bizarre results. This X-ray shows (front view) of the chest of a 60-year-old patient with schizophrenia, showing a foreign body (24mm diameter) inhaled into an airway (bronchus) of the lung.

(Contributed by Dr Mukul Tiwari)

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Prostate cancer

A randomized trial has shown that dutasteride prophylaxis reduces the risk of low Gleason score prostate cancers but not higher risk cancers.

(Reference: Andriole GL, et al. Effect of dutasteride on the risk of prostate cancer. N Engl J Med 2010;362:1192).

  National News

Dr Ketan Desai gets bail

Dr Ketan Desai, Former President of MCI granted bail by the Kolkatta High Court. Presently he is in his Ahmedabad house.

Conference announcement – CPLD 2010

Dept. of Gastroenterology & Human Nutrition, AIIMS and Dept. of Gastroenterology, PGIMER, Chandigarh are jointly organizing a conference on Current Perspective in Liver Diseases (CPLD) on the 15th and 16th of October at AIIMS, New Delhi. The theme of CPLD-2010 is “Management of End Stage Liver Disease”.
This conference would be providing a comprehensive coverage of issues related to end stage liver disease including variceal bleeding, ascites, sepsis in liver disease, hepatocellular carcinoma and liver transplantation. The interaction with eminent national and international speakers would definitely enrich the experience of practicing physicians and will provide them with an opportunity to update themselves with current management strategies in end stage liver diseases. The registration fee for conference is nominally placed at Rs 500/- for the delegates registering before 30 September 2010 and Rs 750/- for those registering afterwards. 
Contact: Dr S. K. Acharya, Dept.  of Gastroenterology, Room 3105, 3rd Floor, Teaching Block, AIIMS, New Delhi 110029, e-mail: subratachary@hotmail.com; subratacharya2004@yahoo.com, Tel: 91-11-26589130; 26594934; Telefax: 91-11-26589130

IMA Election

Emedinews requests all its readers to support our editor Dr. K.K. Aggarwal, Padma Shri and Dr. B C Roy National Awardee who is contesting for the post of Vice President of the National Indian Medical Association. Members of Central Council of IMA, Working Committee Members, Presidents and Secretaries of IMA in addition to all office bearers are the voters in this election. Dr. Aggarwal is well–known for his work in the field of academics.

  International News

(Dr Monica and Brahm Vasudev)

B–type natriuretic peptide may benefit certain patients with heart failure

According to a study presented at the meeting of the Heart Failure Society of America, patients with moderately severe heart failure had structural and functional improvements after two months of treatment with subcutaneous B–type natriuretic peptide (BNP, Nesiritide). Left ventricular (LV) volumes and mass improved significantly (P<0.05) with active therapy as compared to placebo. Measures of diastolic function and quality of life also improved in patients treated with BNP compared with placebo.

FDA safety review of diabetes drug

The Food and Drug Administration has initiated a safety review of Actos (pioglitazone), the antidiabetes drug, examining possible associations between longer term exposure to the drug and an increased risk for bladder cancer.

Adenovirus 36 may be linked to childhood obesity

The obesity epidemic may also be due to a virus that causes common gastrointestinal and respiratory infections. Research in animals and adults points out that AD–36, or adenovirus 36, has the ability to infiltrate fat cells.

Electrical stimulation of occipital nerve may ease migraine pain

A small pilot study reported in the journal Cephalalgia states that electrical stimulation of the occipital nerve can relieve chronic migraine in some patients for whom other forms of treatment are unsuccessful. 39% of patients who received the electrostimulation device had at least a 50% decrease in the number of headache days per month or a significant decrease in pain intensity during the three months of the study.

  Hepatology Update

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

What are the features of physical examination of chronic liver disease in children?
  • Firm – hard hepatomegaly
  • Moderate – massive splenomegaly
  • Growth failure
  • Significant ascites, pedal edema, prominent abdominal veins, clubbing, muscles wasting, CLD signs
  Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

A young couple married for last 4 months has visited an infertility specialist for treatment. They are very stressed. How should we counsel them?
Firstly we have to ascertain that there are no gross medical problems in the couple. We have to ensure that there is no problem in performing regular intercourse. The lady’s menstrual cycle should be regular. Once this is ascertained the couple should be reassured that the chances of getting pregnant per month in a healthy couple is about 15-20%. The fertile period should be explained which is usually between day 12 and day 18 of a regular menstrual cycle. Infertility will only be defined once they are unable to conceive after trying for more than a year. The couple should be able to return in 6 months if conception does not occur. A basic semen analysis may also be done.

  Ortho Update: Question of the Day

Is Rheumatoid factor important to diagnose childhood arthritis? (Dr Sujata Sawhney)

Rheumatoid factor (Rf) is an IgM immunoglobulin that is produced against native IgG. Classic Rfs occurs most frequently in children with polyarthritis than in any other subcategory of JIA. The rheumatoid factor is seen in children who are older, have subcutaneous nodules and articular erosions. Rf positivity has been reported in 3–5% of children with JIA. Thus rheumatoid factor per se is a very poor diagnostic test for childhood arthritis. This test is negative in the vast majority of children with juvenile arthritis, but is positive in patients who have diseases other than JIA such as Sjogrens, MCTD, SLE, and juvenile dermatomyositis. It is also a false positive in certain infections such as tuberculosis. To summarize, rheumatoid factor positivity in a child who has symmetrical polyarthritis is of prognostic value and suggests aggressive, erosive and progressive disease. It has a very poor diagnostic yield as a screening test for childhood arthritis.

  Medicolegal Update

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

Fire wound – accidental, suicidal or homicidal?

Suicidal wounds: If a revolver or pistol is found firmly grasped in the hand of the deceased it is a strong presumptive evidence of suicide. The finding of a weapon beside the body, however, is not necessarily indicative of suicide as a murderer may leave a weapon at the scene of the crime to simulate suicide. Conversely a person committing suicide may have had sufficient time to dispose of the weapon provided that the wound was not immediately incompatible with life. Suicidal bullet wounds usually occur at contact or close range. It has been seen that more than two–thirds of people who shoot themselves aim for the brain, either through the roof of the mouth, at the temple or through the forehead however almost all the rest aim for the heart’.
Homicidal wounds: These can occur at any range and may be situated in any region of the body. It is uncommon to find a suicidal bullet injury with an entrance wound in the back. Existence of several bullet wounds on the body suggests a homicidal origin but does not exclude suicide.

  Medi Finance Update

Investments normally represent diversion of funds for non–core activities, unless it is a balance sheet of a finance and investment company. Therefore in a good balance sheet, investments should be restricted to the minimum.

  Drug Update

Drugs prohibited for manufacture, sale and distribution from subsequent date

Drug Formulation

Effective date


Fixed dose combination of Phenobarbitone with Hyoscin and/or Hyoscyamine

Jan 1,2002

GSR 170(E) dt.12.3.01

  Lab Update

Serum Amylase (Dr Arpan Gandhi and Dr Navin Dang)

Serum amylase is the most common blood test to diagnose and monitor acute or chronic pancreatitis.

  • Firm Acute pancreatitis: Amylase increases from 2 to 12 hours after the beginning of symptoms and peaks at 12 to 72 hours. It may rise to 5 to 10 times the normal level and will usually return to normal within a week.
  • Chronic pancreatitis: Amylase are often moderately elevated but gradually decrease with progressive damage of the pancreas.
  IJCP Special

Dr Good Dr Bad

Situation: A diabetic HIV patient came with A1C report of 6.5.
Dr Bad: It’s perfect.
Dr Good: It is not 700 reliable for your situation.
Lesson: A1C may not be accurate for assessing glycemia among HIV–infected patients on NRTI–based therapy, especially those with macrocytosis or those on abacavir. In a prospective study evaluating the accuracy of A1C in HIV–infected patients with diabetes, glucose levels were significantly higher than anticipated by A1C levels when compared with HIV–uninfected control subjects and established reference values. Relative to the control subjects, A1C underestimated glucose by 29 ± 4  in the HIV–infected subjects. (Diabetes Care 2009;32(9):1591–3).

Make Sure

Situation: A 28–year–old male presents with increased frequency and occasional blood in urine. Urine examination shows sterile pyuria.
Reaction: Oh my God! Why didn’t you check for TB?
Lesson: Make Sure to rule out TB in patients with frequency, dysuria, hematuria. A sterile pyuria is the first clue to diagnosis.

Quote of the Day (Dr G M singh)

"The purpose of life is not to be happy. It is to be useful, to be honorable, to be compassionate, to have it make some difference that you have lived and lived well." Ralph Waldo Emerson

  Mind Teaser

Read this…………………

I’M you

Answer for yesterday’s Mind Teaser: "Parallel bars ".

Correct answers received from: Dr Sudha Nayyar, Dr. S.K.Verma, Dr Chandresh Jardosh, Dr.G.Padmanabhan, Dr Meera Rekhari, Dr Virender Prakash Gautam, Dr.Susheela Gupta,  Dr.K.P.Rajalakshmi, Dr. Nagendra Gupta,Dr Muthumperumal Thirumalpillai,Dr.K.V.Sarma, Dr Vijay Kansal

Answer for 27th Sept Mind Teaser is: "Too bad".
Correct answers received from: Dr Prabha Sanghi, Dr Shashi Saini, Dr.Satish Gunawant, Dr Rashmi Chhibber, Dr Anurag Jain, DR R S Bajaj, Dr Virender Prakash Gautam, Dr. S.K.Verma

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr G M Singh)
Patient to doctor: I’ve got a terrible backache. Please help me.
"Have you been to any other doctor before you came to see me?" asked the grouchy medic.
"No sir," replied the meek patient, "I went to a druggist."
"That shows how much sense some people have! growled the doctor. And what sort of idiotic advice did he give you?"
"He told me to come to see you."

You are an Indian if you (Anuj Goel)
Try and reuse gift wrappers, gift boxes, and of course, aluminium foil.

  An Inspirational Story

The Ant and the Contact Lens
Brenda was a young woman who was invited to go rock climbing. Although she was scared to death, she went with her group to a tremendous granite cliff.
In spite of her fear, she put on the gear, took a hold on the rope, and started up the face of that rock. Well, she got to a ledge where she could take a breather. As she was hanging on there, the safety rope snapped against Brenda’s eye and knocked out her contact lens. Well, here she is on a rock ledge, with hundreds of feet below her and hundreds of feet above her. Of course, she looked and looked and looked, hoping it had landed on the ledge, but it just wasn't there. Here she was, far from home, her sight now blurry. She was desperate and began to get upset, so she prayed to the Lord to help her to find it.
When she got to the top, a friend examined her eye and her clothing for the lens, but there was no contact lens to be found. She sat down, despondent, with the rest of the party, waiting for the rest of them to make it up the face of the cliff. She looked out across range after range of mountains, thinking of that Bible verse that says, "The eyes of the Lord run to and fro throughout the whole earth." She thought, "Lord, You can see all these mountains. You know every stone and leaf, and You know exactly where my contact lens is. Please help me."
Finally, they walked down the trail to the bottom. At the bottom there was a new party of climbers just starting up the face of the cliff. One of them shouted out, "Hey, you guys! Anybody lost a contact lens?" Well, that would be startling enough, but you know why the climber saw it? An ant was moving slowly across the face of the rock, carrying it.
Brenda told me that her father is a cartoonist. When he told him the incredible story of the ant, the prayer, and the contact lens, he drew a picture of an ant lugging that contact lens with the words, "Lord, I don’t know why You want me to carry this thing. I can’t eat it, and it’s awfully heavy. But if this is what You want me to do, I’ll carry it for You."
I think it would probably do some of us good to occasionally say, "God, I don’t know why you want me to carry this load. I can see no good in it and it’s awfully heavy. But if you want me to carry it, I will." God doesn’t call the qualified, He qualifies the called.

  Readers Responses
  1. Congrts to Dr. Neelam Mohan for her Great Feat............I know her from my days of working as JMS in SGRH. She is AN ASSET to our Profession. God bless her with many many more such FEATHERS IN HER CAP............We are all PROUD. Regards: Dr. N.K. Bhatia, Medical Director, Rotary Noida Blood Bank
  Public Forum

(Press Release for use by the newspapers)

Longer the waist line shorter the brain size

For every excess pound piled on the body, the brain gets a little bit smaller, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India & MTNL Perfect Health Mela.
A research from UCLA neuroscientist Paul Thompson, has found that elderly individuals who were obese or overweight had significantly less brain tissue than individuals of normal weight. The brains of obese people looked 16 years older than their healthy counterparts while those of overweight people looked 8 years older.
Much of the lost tissue was in the frontal and temporal lobe regions of the brain, the seat of decision–making and memory, among other things. These have serious implications for aging, overweight or obese individuals, including a heightened risk of Alzheimer’s. Obesity thus may accelerate ageing.
The researchers studied brain images of 94 people in their 70s. None of the participants had dementia or other cognitive impairments. They were followed for five years. Clinically obese people had 8 percent less brain tissue, while the overweight had 4 percent less brain tissue compared to normal–weight individuals.

  Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

17th MTNL Perfect H ealth Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi 24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to 10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

Dr. Sood Nasal Research Foundatio: Rhinology Update 11th to 15th November
22nd National Endoscopic Sinus Surgery Course on 11th & 12th November, 2010 2010 at Dr. Shroff’s Eye & ENT Hospital, New Delhi
Cadaveric Sessions on 13th November, 2010 at Lady Hardinge Medical College.
33rd All India Rhinoplasty Course, on 14th & 15th November, 2010, at Metro Hospital, Preet Vihar, Vikas Marg, New Delhi.
For information contact:drvpsood@gmail.com,vpsood@drsoodnasalfoundation.com
Website: www.drsoodnasalfoundation.com

 eMedinews Revisiting 2010

The 2nd 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.

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