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eMedinewS is now available online on www.emedinews.in or www.emedinews.org
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 ...

31 st October 2010, Sunday

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

Bid Adieu…… 17th Perfect Health Mela

The 17th Perfect Health Mela comes to a successful end today. The 10-day Mela, an annual event of the Heart Care Foundation of India saw a huge turnout of the public, including participants from schools, colleges of Delhi and NCR. The focus this year was on ‘Lifestyle disorders’. Since its inception in 1993, this mega community service event has been a time-tested health awareness module not only for the public but also the participating students.

Health Model Display, Poster cum Slogan making, Skit, Debate and Collage making on various Health Topics were few such activities.

This 10-day journey started with Swagat (inaugural function) followed by ‘Anmol’, a festival for children with special needs. In this journey, several other events Harmony (inter school festival), Heritage (inter dancing school festival), Divya Jyoti (inter nursing school festival), Medico Masti (inter medical college and college festival), Health Darbar (public audience with medical experts) were our major milestones.

The last session of the Mela ‘eMedinewS Update’ will see participation of top doctors of the city. Various health topics that are relevant today will be discussed.

Bid Adieu, the valedictory function will be held today evening to mark the closing of the Mela. Prizes for the ‘Best Stall’ would be awarded.

I thank all the participants Depts. of Govt. of Delhi, NGOs, Public Sector Undertakings, Schools and Colleges for their wholehearted efforts and contribution in making this Mela informative and entertaining.

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
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  Photo Feature (from the HCFI Photo Gallery)

 17th Perfect Health Mela 2010
Divya Jyoti Nurses festival

Fun is an integral part of maintaining health. The  nurses and university college students participated in Nurses youth festival (Russian ballet ).

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Anti-TB treatment and antiretroviral drugs

An open-label randomized trial showed that patients initiated on treatment for HIV during treatment for tuberculosis had lower mortality than patients in whom antiretroviral treatment was delayed until completion of TB treatment.

(Ref: Abdool Karim SS. Timing of initiation of antiretroviral drugs during tuberculosis therapy. N Engl J Med. 2010 Feb 25;362(8):697-706).

  National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email:emedinews@gmail.com

More students aged 13-15 using tobacco: study 

The percentage of students aged 13-15 years using tobacco is only increasing, despite better information on the dangers of smoking, concludes the second phase of the Global Youth Tobacco Survey (GYTS). The study, set in two phases (the first was completed in 2006), observed a total of 24,000 students in about 180 schools categorised into six geographical regions – Northern, Central, Eastern, North Eastern, Western, and Southern. The percentage of users of tobacco products in the age group rose from 13.7 in 2006 to 14.6 in 2009. This includes smoking cigarettes, bidis, and use of chewable tobacco. Individually also, the percentage of users of these products has increased among boys mostly, pushing up the average. (Source: The Hindu)

Common exam: Health Ministry retracts nod in SC

A revolutionary decision to hold a common entrance test for admission to top medical and engineering colleges hit a roadblock on Friday, with the Union Health and Human Resources Development Ministries crossing swords in the Supreme Court. Stung by the difference of opinion within the Government departments, an anxious Bench of Justices RV Raveendran and AK Pattnaik wondered if the objection of the Health Ministry to the proposal was guided by “genuine grievance” in the interest of students or a result of “departmental difference”. (Source: The Pioneer).

  International News

(Dr Monica and Brahm Vasudev)

Typical hip fractures decrease as atypical hip fractures increase

According to a study presented at the American Society for Bone and Mineral Research 2010 Annual Meeting, the number of typical hip fractures in people older than 65 years between 1996 and 2007 has declined considerably in the US. On the other hand, the number of atypical hip fractures has risen. These findings were stronger in women. These findings were based on analysis of data from the Medical Expenditure Panel Survey, which encompassed some 372,000 respondents, and the Nationwide Inpatient Sample, which included a total of 619,044 hospitalizations for surgery for either a typical hip fracture or an atypical hip fracture.

Rheumatoid arthritis patients need better Screening Tool for Early Heart Disease

The fact that many patients with rheumatoid arthritis (RA) are not smokers, have normal lipid levels, are not overweight, and do not have a family history of heart disease does not mean that they are not at high risk for cardiovascular disease. According to Dr. Sherine E. Gabriel, professor of medicine and epidemiology at the Mayo Clinic, Rochester, Minn, patients with RA should be screened more closely for CVD risks than they have generally been. RA as an inflammatory disease imparts an elevated risk for CVD. The patient who is positive for rheumatoid factor and always has an elevated level of C-reactive protein and a high erythrocyte sedimentation rate needs early intervention. However, at present, clinicians lack a screening tool that is finely tuned to the risk factors for this population. The Framingham Heart Study risk score, a widely used screening tool, is inadequate in predicting the CVD risk in this patient group. Dr. Gabriel is developing just such a tool for screening RA patients, which is still being tested.

Rapid thromboelastography test provides coagulopathy results in 5 minutes 

In a preliminary study, rapid thromboelastography identified trauma-induced coagulopathy within 5 minutes. It produced results that correlated well with the traditionally done coagulation tests, and also predicted the early need for blood products. According to Dr. Bryan A. Cotton of the surgery faculty in the division of acute care surgery at the University of Texas at Houston, the median time to view early rapid thromboelastography (rapidTEG) results, including activated clotting time, R value, and K time, was 5.2 minutes (interquartile range [IQR], 4.3-7.1 minutes), vs 23 minutes (IQR, 18-50) for platelet count and 27 minutes (IQR, 19-69) for prothrombin time, activated partial thromboplastin time, and international normalized ratio (INR). The study involved 272 adults treated at a trauma center over a period of five months.

FDA gives trastuzumab the green signal for HER2-positive gastric cancer

The US FDA has approved trastuzumab, along with chemotherapy, to treat metastatic HER2-positive gastric cancers in people who have not been previously treated for metastatic disease. In the US and Europe, trastuzumab is already approved for the treatment of HER2-overexpressing breast cancers, works by blocking the HER2 (human epidermal growth factor 2) protein on the surface of some cancer cells, possibly interrupting signals that make them grow.

Olmesartan delays time to microalbuminuria in type 2 diabetes patients

Results of the Randomized Olmesartan and Diabetes Microalbuminuria Prevention (ROADMAP) Trial state that olmesartan significantly reduced the time to microalbuminuria. The trial evaluated more than 4000 patients with type 2 diabetes who had at least one other cardiovascular risk factor but who had normal albumin excretion at baseline. The cumulative incidence of microalbuminuria (>35 mg albumin/g urine creatinine for women; >25 mg albumin/g urine creatinine for men in morning spot urine) was 8.2% of the olmesartan patients vs 9.8% of the placebo group, giving a highly significant risk reduction of 23%

  Gastro Update

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

What is the approach to diagnosis of a case of IBD? 

History and Examination

  •  History: A complete history inclusive of recent travel, medication, dietary and family history, and a detailed bowel history with stool frequency, consistency, urgency, and presence of blood, mucus, or pus per rectum. Abdominal pain, malaise, fever, weight loss, and symptoms of extraintestinal manifestations of IBD (joint, cutaneous, and eye) should be asked for.
  • General examination includes well-being, weight and height centiles, pubertal status using Tanner staging, pulse rate, BP, abdominal examination for tenderness, distension, masses including inspection of perianal area for skin tags, fissures, ulcers, and/or edema suggesting Crohn’s disease.
  Infertility Update

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

Does IVF always leave us with twin or triple pregnancies?  What is the average number of embryos transferred?  Please explain.

The doctor will make the decision after discussing this with you. Generally, two or three embryos will be transferred, but the number may vary slightly depending on the quality of the embryos and the age of the female partner.

How much does IVF cost?

This varies enormously between different clinics in the same country.  Generally, it costs between Rs.1 to 1.5 lakh rupees.
  Cardio Update : Question of the Day

How important a risk factor is systolic blood pressure?

Impressive evidence has accumulated to warrant greater attention to the importance of SBP as a major risk factor for CVD. The rise in SBP continues throughout life, in contrast to DBP, which rises until approximately 50 years age, tends to level off over the next decade and may remain the same or fall later in life.1,2 Diastolic HT predominates before 50 years of age, either alone or in combination with SBP elevation. The prevalence of systolic HT increases with age, and above the age of 50 years, systolic HT represents the most common form of HT. DBP is a more potent cardiovascular risk factor than SBP until age 50; thereafter, SBP is more important.3 Clinical trials have demonstrated that control of isolated systolic HT reduces total mortality, cardiovascular mortality, stroke and HF events.4-6


  1. Burt VL, et al. Hypertension 1995;25:305-313.
  2. Franklin SS, et al. Circulation 1997;96:308-315.
  3. Franklin SS, et al. Circulation 2001;103:1245-1249.
  4. Kostis JB, et al. JAMA 1997;278:212-216.
  5. SHEP Cooperative Research Group. JAMA 1991;265:3255-3264.
  6. Staessen JA, et al. JAMA 1999;282:539-546.
  Medicolegal Update

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

Medical Council India its constitution and medical education in British India

Medical council of India has been constituted with head office in New Delhi in accordance with the MCI Act 1956, an act of Indian democratic parliament, which was amended in 1958, 1964, 1993 and 2001 to regulate ethical medical practice of English medicine and standard of English medical education of this great Indian nation.  The practice of English medicine began from the era of British India particularly when Calcutta native medical Institution was established in 1824 to train the medics and paramedics to act as medical men to assist European medicine professionals who used to provide medical/surgical care mainly to the British and army officers. Later on this institution was established as first medical college in the name of Calcutta Medical School in 1835 followed by Madras Medical College in 1835 in British India.

  Medi Finance Update

Company Size

Many funds restrict the types of stocks they buy for the fund based on the size of the company. The size of the company is measured by its market capitalization (market cap - measures the company’s worth by multiplying its stock price by the number of shares outstanding). Generally, small cap funds are more risky than large cap funds as minor changes in a small cap company’s stock price can have a major impact on its market cap. However, if you can take the ups and downs, there can be greater rewards for investors in small cap funds.

  Drug Update

List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

Drugs prohibited from the date of notification

Fixed dose combination of Ethambutol with INH other than the following: INH   Ethambutol 200 mg. 600 mg. 300 mg. 800 mg

  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Plasma Free Metanephrine

  • To help diagnose or rule out pheochromocytoma
  • Related tests: Catecholamines, Plasma and Urine; Urine Metanephrines; Vanillylmandelic acid (VMA)
emedinews 3D echocardography
  IJCP Special

Dr Good Dr Bad

Situation: A 30-year-old female with a diabetic mother came for a check-up
Dr Bad: You are also at risk of heart disease.
Dr Good: You cannot be at risk.
Lesson: As per results of the Fremantle Diabetes Study, a maternal family history of diabetes confers relative protection against cardiovascular disease in female patients but not in male patients with type 2 diabetes. Paternal family history is associated with risks equivalent to those without a family history of diabetes.

Make Sure

Situation: A patient of gross ascites presents with complaints of difficulty in breathing on lying down.
Reaction: Oh my God! Why did you drain so much ascitic fluid?
Lesson: Make sure, to evaluate the patient thoroughly and only moderately tap the ascitic fluid since over-enthusiastic tapping can be life threatening.

Quote of the Day (Dr GM Singh)
" Life is like a wheelbarrow, It stands still unless you push it."

Mind Teaser

Read this…………………

hea dac he

Answer for yesterday’s Mind Teaser: "A little misunderstanding between two friends. "

Correct answers received from: Dr Sudipto Samaddar,  Dr.K.V.Sarma, Dr Ajmer Singh, Dr N C Prajapati, Dr Chandresh Jardosh,  Dr Muthumperumal Thirumalpillai, Dr.K.Raju, Dr.Mamta Sharma,   Dr K.P.Rajalakshmi

Answer for 29th October Mind Teaser is: "The whole nine yards"
Correct answers received from: Dr Neelam Nath, Dr. Hiren Shah, Dr Meera Rekhari, Dr.K.Raju, Dr.Satish Gunawant, Dr Umesh Mehta

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr G M Singh)

A man goes to the eye doctor. The receptionist asks him why he is there. The man complains, "I keep seeing spots in front of my eyes."
The receptionist asks, "Have you ever seen a doctor?" and the man replies, "No, just spots."

  An Inspirational Story

(Contributed by Dolly Aggarwal)

10 virtually instant ways to improve your life

Many of our problems come from within our own minds. They aren't caused by events, bad luck, or other people. We cause them through our own poor mental habits. Here are 10 habits you should set aside right away to free yourself from the many problems each one will be causing you.

Don’t let life get you down

Keep practicing being optimistic. If you expect bad things in your life and work, you’ll always find them. A negative mind-set is like looking at the world through distorting, grimy lenses. It’s amazing what isn’t there until you start to look for it. Of course, if you decide to look for signs of positive things, you’ll find those too.

Don’t hang on to the past

This is the important suggestion of all: let go and move on. Most of the anger, frustration, misery, and despair in this world come from people clinging to past hurts and problems. The more you turn them over in your mind, the worse you’ll feel and the bigger they’ll look. Don’t try to fight misery. Let go and move on. Do that and you’ve removed just about all its power to hurt you.

  Readers Responses
  1. Respected Dr. KK Aggarwal, I congratulate you for bringing out well informative eMedinewS Appreciations for the great work done sir. Regards Dr Prachi.
  Public Forum

(Press Release for use by the newspapers)

Doctors’ Masti at MTNL Perfect Health Mela

Over 5000 members from the youth including doctors, nurses and university college students participated in Medico Masti youth festival. Giving details, Padma Shri and Dr. B C Roy National Awardee, Dr. K K Aggarwal, who is also President, Heart Care Foundation of India, said that fun is an integral part of maintaining health. Public should devote half an hour everyday in fun related activities.

The star attraction of Medico Masti was noted pop singer Mr Vipin Aneja. Addressing the gathering Mr. Aneja said that dancing is a type of aerobic activity and should be done atleast twice a week.

Poor knowledge about vaccine
In a quiz vaccine survey at the Mela it was found that the public had poor knowledge about adult vaccination. Even adults need to be vaccinated.

  1. Typhoid – every 3 years
  2. Tetanus injection – every 10 years
  3. Hepatitis – 0, 1-2 months, 4-6 months
  4. Pneumonia – every 5 years
  5. Flu – every year

If all heart patients takes flu vaccination the mortality can be reduced to a substantial degree.
Snoring OPD at the Mela
There are special provisions at the Mela for people who are snorers. People who snore do not have deep sleep but interrupted poor sleep. If not controlled in time snoring can be the cause of sudden cardiac death.

Obesity OPD at the Mela
In a preliminary survey at the Mela it has been found that more than 37% people visiting Mela have pot belly obesity. Normal weight obesity was present in more than 20% of people. Pot belly obesity is associated with future heart attack, paralysis, blood pressure and diabetes. The on-going Mela will end today.

Addressing medical students Dr. S S Aggarwal and Dr. A K Aggarwal from DIPSAR and Maulana Azad Medical College, respectively, in a joint statement said that medical students should learn to write in legible hand writing to prevent prescription errors.

Various entertainment programmes performed by the youth included choreography, western dance, fashion show, rock band, etc.

Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists
17th MTNL Perfect Health Mela 2010 day programme
Dr. Sood Nasal Research Foundation Announces

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: Dr. V P Sood, Course Chairman, Ear, Nose & Throat Center, 212, Aditya Arcade, 30, Community Center, Preet Vihar, Vikas Marg, Delhi–110092 (India). Tel: 011–22440011, 42420429. E–mail: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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