e-Medinews A service of IJCP Publications Pvt. Ltd.
     In This Issue...
Dr K K Aggarwal

Dear Colleague,


  • A new study has shown heparin can cause skin lesions that are harmless in most cases but could indicate a life-threatening condition (Canadian Medical Association).
  • A Duke study has shown that regular exercise may help protect men from prostate cancer.
  • Diabetic patients on pioglitazone may be at higher risk of bone fractures (UK Study, PLOS Medicine)
  • Although PSA test can detect prostate cancer, it cannot predict which cancers are aggressive and which are slow growing that they do not need to be treated. (Archives of Internal Medicine).

Pharma Update
Pregnancy: a wonder experience 
New Research
Onco Update
News you can use
In the Spotlight
ECG Formulae in Clinical Practice
IPC- Indian Penal codes to know
Stop and Ponder
Spirometry in Clinical Practice
  • A study published in Diabetic Care has shown that women with type 2 diabetes have 26% increased risk of developing atrial fibrillation.
  • As per a Danish report, women who take anti-depressants during the first three months of pregnancy may have a slightly increased risk of giving birth to babies with heart defects.
  • Alcohol abuse, obesity and depression are interlinked in women as per a report in General Hospital Psychiatric September issue.
  • World Health Organization has warned that malarial parasite is becoming increasingly resistant to artemisinin. 

DMC elections: Only two days are left for one of the most talked about elections of the city where eight members from Registered Medical Practitioners of Delhi would be elected to the Delhi Medical Council. Remember.... these eight members will represent all of you and will work for the benefit of the medical profession in general, and each one of you in particular. We, the contestants, are only your representatives.

Kindly cast your valuable vote to the Faith Team to which I also belong. The other members of the Faith Team are: Dr. Sanjeev Malik, Dr. Chandar Prakash, Dr. Ashwini Dalmia, Dr. Naresh Chawla, Dr. Ramesh Dutta, Dr. Vinod Khetarpal and Dr. H.S. Kukreja.


Dr K K Aggarwal


Pharma Update

New drug kills cancer like a vampire slayer

Lead researcher Dr. Ronit Satchi-Fainaro believes that a novel drug that delivers anti-cancer compounds straight to the tumor may alleviate cancers like osteosarcomas and bone metastases. According to Satchi-Fainaro, the innovative drug delivery system injects compounds like Taxol known to stop blood vessel growth to cancerous tumors. Most of us have small tumors in our body at all times. They start the size of a pinhead and usually remain at that size as dormant and asymptomatic tumors. Then, at some point, cancer cells proliferate and the tumor grows in mass.

Source: http://www.newkerala.com/nkfullnews-1-114599.html


Antidiabetic drug linked to fracture risk

A research published in the journal, PLoS Medicine, suggests that there is an association between thiazolidinediones and bone fracture. Thiazolidinediones are antidiabetic drugs to treat type 2 diabetes. The researchers identified a group of individuals above 40 years age who had a recorded bone fracture and who had been prescribed a thiazolidinedione at least once. Almost one and half times as many fractures occurred when people were taking thiazolidinediones than when they were not taking these drugs. Both men and women faced increased risk of fracture That applied to a wide range of fracture sites on the body. The study also found that the risk of fracture increased as the duration of treatment with the drug increased.


Pregnancy: a wonder experience

Motherhood: A boon for the body? 

Kim Clijsters made a fairytale comeback by winning this year's US Open on her return to Grand Slam tennis after giving birth to her daughter. Clijsters' success is being regarded as further supporting the theory that pregnancy can in fact enhance sporting prowess, at least among those who had some to start with. During pregnancy, almost every organ of the mother's body works harder. Blood volume increases dramatically to carry oxygen to the womb. Once the baby is born, the red blood cells created - rich in hemoglobin - remain in the woman's body for some time, potentially improving oxygen flow to the muscles. According to Dr James Pivarnik of Michigan University, who has studied pregnant athletes, the hormone relaxin loosens the hips in preparation for childbirth; it may also give the athlete added flexibility. The agony of childbirth increases the pain threshold, boosting the mind to cope amid intense physical adversity. It has also been suggested that motherhood sharpens mental agility, making a woman more vigilant and alert. 

Source: http://news.bbc.co.uk/2/hi/health/8257087.stm


New Research

Curing color blindness using gene therapy

Until now scientists had not thought it was possible to introduce therapeutic genes into the light-sensing cells at the back of the eye of adult male squirrel monkeys. The therapeutic genes contained the necessary DNA code to enable the light-sensing cells to distinguish between red and green - something lacking in the male monkeys. Tests revealed the gene therapy was a success. They are hopeful that a similar therapy could benefit people who are color blind.



Hepatitis B vaccine at birth 'reduces liver cancer cases'

According to a new study there has been a dramatic drop in liver cancer cases among Taiwanese children following the use of hepatitis B vaccine at birth. The team analyzed the data from almost 2000 patients with hepatocellular carcinoma who were aged 6-29 years over a period of 20 years. The study showed that 64 cases of hepatocellular carcinoma were found among people vaccinated in almost 38 million person-years compared to 444 cancers among unvaccinated people in almost 80 million person-years. The result suggests that the effectiveness of the universal HBV immunization program to prevent hepatocellular carcinoma has extended beyond childhood and into young adulthood over the past two decades. 


Scientists reveal how HIV cripples immune cells

Dr. Oliver Fackler, a Virologist from the Heidelberg University Hospital examined the movement of cells in living zebra fish embryos, and showed that cell mobility is inhibited by the HIV Nef protein. The team further said that cell cultures showed Nef to cause a short circuit of two cellular mechanisms, thus inhibiting the cell's ability to move. Consequently the affected immune cells could no longer perform their function. The importance of Nef for the disease has become clearer in treating AIDS.

Source: http://www.newkerala.com/nkfullnews-1-113654.html


Onco Update

Adding flaxseed to juices, salads, jellies can help fight prostate cancer

Omega 3 fatty acids and lignan present in flaxseed led scientists to look for its prostate cancer prevention properties. "Cancer cells migrate by attaching onto other cells. The omega 3 fatty acids found in flaxseed keep cells from binding together and attaching to blood vessels," said Demark-Wahnefried, a professor of behavioral science. Experts also added that lignan might reduce testosterone and other hormone levels, which subsequently reduce chances of getting prostate cancer. Grinding flaxseed makes it more digestible and increases the amount of nutrients absorbed.

Source: http://www.newkerala.com/nkfullnews-1-113046.html


News you can use

Delay in becoming a mum may be risky

A team at the University of Cambridge found women who started menstruation early (12 years) were more likely to require medical assistance during childbirth such as forceps, or a Caesarean section. The effect was taken care of, if these women began a family at an early age. But such was not the case for older mothers. Risk shot up with a woman's age at the time of her first birth. A healthy lifestyle with normal body weight was suggested, as high BMI during pregnancy is itself associated with poor uterine contractions and an increased need for operative delivery.



MTNL Perfect Health Mela 2009

Eating durian with alcohol can actually kill you

The age-old Asian folklore that eating durian, known as the 'king of fruits', along with alcohol can kill you, holds some truth, say researchers from Japan. They believe that the lethal side effects might be due to the fruit's high sulphur content which impairs alcohol breakdown. The experiments have shown that durian extract turned off the activity of aldehyde dehydrogenase by up to 70%. This enzyme plays a vital role in clearing toxic breakdown products.


Simple ways to quieten ordinary snoring

Snoring is caused by relaxed and sagging tissues of the throat and roof of the mouth (soft palate). During sleep, as air is inhaled or exhaled through the narrowed opening, the relaxed tissues of the soft palate vibrate. The result is snoring. Experts advise to lose weight as extra bulk narrows airways. Alcohol consumption can cause excessive muscle relaxation. Using nasal sprays can help reduce nasal obstruction. Snorers can learn to sleep comfortably in other positions. Smoking is associated with an increased risk of snoring. Surgery is considered a last resort to cure snoring.




In the Spotlight

Stem cells technology comes to heart patient's rescue

September 27th was the World Heart Day. In a befitting commemoration, a heart patient, Loannis Manolopoulos underwent a unique surgical procedure at Ahepa University Hospital in Greece, and has made an amazing recovery. In an innovative procedure, a cardiac pump was placed into his heart and then six million of the patient own stem cells were injected into the heart muscles to repair damage. According to the surgeon Dr Kyriakos Anastasiadis, the major goal of the procedure was to enable the patient to lead a normal life. Not only would the device itself give quality of life, the injected stem cells would give an extra strength to the result of this pump.


ECG Formulae in Clinical Practice

ST Segment and T wave

In a sense, the term "ST segment" is a misnomer, because a discrete ST segment distinct from the T wave is usually absent.

More often the ST-T-wave is a smooth, continuous-waveform beginning with the J-point (end of QRS), slowly rising to the peak of the T and followed by a rapid descent to the isoelectric baseline or the onset of the U wave. This gives rise to an asymmetrical T wave.
In some normal individuals, particularly women, the

T wave is symmetrical and a distinct, horizontal ST segment is present.

The normal T wave is usually in the same direction as the QRS except in the right precordial leads.

Rule: In the normal ECG, the T wave is always upright in leads I, II, V3-6, and always inverted in lead aVR.


IPC- Indian Penal codes to know

IPC 324

Voluntarily Causing Hurt by Dangerous Weapons or Means

Whoever, except in the case provided for by Section 334, voluntarily causes hurt by means of any instrument for shooting, stabbing or cutting, or any instrument which, used as a weapon of offence, is likely to cause death, or by means of fire or any heated substance, or by means of any poison or any corrosive substance, or by means of any explosive substance or by means of any substance which it is deleterious to the human body to inhale, to swallow, or to receive into the blood, or by means of any animal, shall be punished with imprisonment of either description for a term which may extend to three years, or with fine, or with both.

Comments: The code needs to be known to Emergency room Physicians.


Stop and Ponder

A rough day at office? No excuse to skip your walk

If you feel too drained out to exercise after a hard day at work, blame your limited willpower.

As per a study published in the Psychology and Health, if you use your willpower to do one task, it depletes you of the willpower to do an entirely different task. Kathleen Martin Ginis, associate professor of kinesiology at McMaster University, and lead author of the study said that cognitive tasks, and emotional tasks such as regulating one?s emotions, can deplete your self-regulatory capacity to exercise. A Stroop test was used to deplete the self-regulatory capacity of volunteers in the study. Subjects were asked to say the colour on the screen, trying to resist the temptation to blurt out the printed word instead of the colour itself. A Stroop test consists of words associated with colors but printed in a different color. The more people "slogged" after the cognitive task, they were more likely to bunk their exercise sessions over the next eight weeks. But, this should be no excuse for people to be lazy, she added. There are strategies to help people rejuvenate after their self-regulation is depleted.


Patient Information


What is tuberculosis?
Tuberculosis, or TB, is a disease caused by bacteria (germs). It usually attacks the lungs, but it can also attack other parts of your body, such as the brain, bones, and kidneys. If not treated, TB can cause serious illness or death.

How is it spread?
When people with active TB disease cough, the germs may spread through the air. Other people can become infected if they breathe in these germs. It's not easy for a healthy person to become infected with TB. You usually have to be around someone with active TB disease many times before you get the infection.

How do I know if I have it?
The most common test to find out if you have TB is the TB skin test. If the skin test is positive, it means  that you are infected with the TB germs. Your doctor will then find out if you have the active disease or a latent infection. Your doctor may ask if you have any symptoms of active TB disease, such as fever or cough. Your doctor may also order tests, such as a chest x-ray. If your skin test is positive and the other tests are negative, you have latent TB infection.

What is latent TB infection?
There is a difference between having latent TB infection and having active TB disease. People with active disease are sick and can spread the germs to other people. People with latent infection have the TB germs in their body, but they are not sick. A person with latent TB infection can't spread the germs to other people.

Why is it important to treat latent TB infection?
If you have latent TB infection, there is a one in 10 chance that it will turn into active TB disease, even if you are healthy. Getting treatment can lower this chance. The risk of getting active TB disease is highest in the first two years after getting latent TB infection, so it is important to start treatment right away.

How is latent TB infection treated?
Latent TB infection is treated with medicines that kill the TB germs. Usually, a medicine called isoniazid  is used once a day for nine months. There are other medicines available, so ask your doctor about your options. It is important to take the medicine exactly the way your doctor tells you. You will need to visit your doctor every month while taking the medicine to check for side effects.

Can I still get active TB disease after treatment?
Even after nine months of taking medicine for latent TB infection, there's still a small chance that you could get active TB disease. Symptoms of active disease include tiredness, weight loss, a cough that won't go away, fevers, and night sweats. If you have any of these symptoms, you should see your doctor right away. The treatment for active TB disease is different from the treatment for latent TB infection.

Source: Am Fam Physician 2009


Spirometry in Clinical Practice

Peak Expiratory Flow Rate (PEFR)

This is a simple method of measuring airway obstruction and classifies mild, moderate or severe disease. The marker must always be reset to zero before PEFR is measured.

Height (cm)PEFR (l/min)*

 *Mean: 2 SD = 100
A high PEFR variability is indicative of increased severity of asthma.

 Peak Flow Zones

 Green (80-100% of target PEFR): No asthma symptoms are present. Asthma medicines can be reduced. 
 Yellow (50-80% of target PEFR) signals caution, an episode of asthma may require a temporary increase (Step-up) in  medication. Yellow means that asthma is not under sufficient control.
 Red (<50% of target PEFR) signals a Medical Alert. A fast-acting bronchodilator should be used immediately and the physician should be notified if PEFR does not return to and remains in the yellow or green zone.



Called up for the war, a boy had to undergo an ophthalmological examination.
"Can you distinguish the letters on the chart?" the doctor asked.
"Not from here."
And closer up, like this?"
"Again no." 
Finally, half a meter away, the boy managed to read out the letters.
"Very good," said the doctor. "You can do hand-to-hand fighting.

As the doctor approached the school boy to give him an injection, the boy yelled out loud with pain. "What's the matter?" said the doctor crossly. "I haven't touched you yet."
"You're standing on my foot!" answered the boy.

"Doctor, are you sure I'm suffering from pneumonia? I've heard about a doctor treating someone with pneumonia and finally he died of typhus."
"Don't worry, it won't happen to me. If I treat someone with pneumonia he will die of pneumonia."

A psychotic thinks that two and two are five. A neurotic knows two and two are four....but he hates it.

Head Office: Daryacha 39, Hauz Khas Villege New Delhi -110 016, Ph.26965874 / 75. e-mail: editorial@ijcp.com



Delhi Medical Council Needs A Visionary Leadership  

Dear Colleagues,


                   The  medical profession in the country is passing through trying times. We are faced with the challenge  of positioning our country and capital city as the global capital of health. We are also faced with the reality of a society  more hostile, litigious and suspicious of the medical  profession. Every day one hears of assaults on the profession. Every hour we face the  increasing menace of quackery breathing down our necks. AND every minute we are facing the wrath of innumerable authorities unaware of the realities of the profession.

The Delhi Medical Council (DMC) as the statutory body is responsible to provide protection to its members in discharging duties; ensure that no unqualified person practises modern scientific medicine in addition to receiving complaints form public against misconduct or negligence by doctors and take disciplinary action as deemed fit.

After the recent judgment by Hon'ble Supreme Court of India, it has become mandatory for Consumer Fora, Criminal Court and the police to first refer the matter to a compeptent doctor or committee of doctors, and only after that doctor or committee report that there is  a prima facie case of medical negligence can  notice be then issued to the concerned  doctor/hospital. Most of such cases are referred to DMC for opinion.


The  role of the DMC has thus become paramount.


With the elections for DMC already scheduled, we are now going to elect our next council for a five-year-term. It is in the interest of the medical profession and the society  at large to elect a dedicated team of professionals with  proven track record; vision and a pro-active and forward looking approach. It is these elected 8 representatives (plus 1 elected from amongst DMA members) who would represent you all and take care of the interests of the profession. 


Friends, we have been approached by innumerable colleagues in Delhi to field a team which fulfills the above. In all humility we offer ourselves to represent you in the DMC for the ensuing half a  decade. It is the under mentioned group of your representatives in DMA who have been responsible for the recent enactment of 'Delhi Medicare Service Personnel & Medical Service institution  (Prevention of Violence ) Act' by Delhi Assembly as well as the recent Supreme Court judgment protecting interests of Nursing Homes &  Medical Establishment in Delhi.



We Commit, that if elected we shall take care of the interests of the medical profession in Delhi to the best of our abilities.


Foremost amongst our AGENDA would be:


  1. To ensure that the DMC functions in a manner most transparent, positive and profession friendly.

  2. To Provide unstinted protection to medical professionals in  Delhi in discharging their professional duties.

  3. To root out the menace of quackery from Delhi by ensuring that no unqualified person  practies modern scientific system of  medicine.To adopt practical strategies for the above rather than keep making hue and cry on paper.

  4. To adopt  profession friendly strategies and prescribe a code of ethics for regulating the professional conduct of practitioners. To constantly update the profession  on issues: Legal, statutory, ethics-related which they must know.

  5. To fight for abolition of fees for Renewal of Registration in DMC.

The date of elections would be announced shortly. We shall also communicate the same to you. We look forward to your suggestions, and indulgence in this process. It's only our active indulgence today which would carve out a better future for all of us tomorrow.

Kind Regards 

Dr. Sanjiv Malik (mob. 9810026796)


Dr. Naresh Chawla (mob. 9811035060) 


Dr. Ashwini Dalmiya (mob. 9811542055)


Dr. K. K. Aggarwal (mob. 9811090206)


Dr. Chander Prakash (mob. 9810029000)


Dr. H. S. Kukreja (mob. 9810064847)


Dr. Vinod Khetarpal (mob. 9811054945)


Dr. Ramesh Dutta (mob. 9811086688) 


Contact Us at: dmcforprofession@gmail.com 


Delhi Medical Council


To unsubscribe click here.