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  From the Desk of Editor–in–Chief
Dr KK Aggarwal

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


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  Editorial …

4th November 2011, Friday

Obesity reduces life expectancy

Obesity in adulthood is associated with a striking reduction in life expectancy for both men and women. Among 3457 subjects in the Framingham Study, done in the United States, those who were obese (Body Mass Index or BMI ≥30 kg/m2) at age 40 years lived 6 to 7 years less than those who were not (BMI ≤24.9 kg/m2).

Those who were overweight (BMI 25 to 29.9 km/m2) at age 40 years lived about three years less, and those who were both obese and smoked lived 13 to 14 years less than normal–weight nonsmokers. The steady rise in life expectancy during the past two centuries may come to an end because of the increasing prevalence of obesity. Being overweight during adolescence also increase the risk of premature death as an adult. The analysis of Nurses’ Health Study has shown the risk of premature death increases with higher BMIs at age 18 years. For a BMI at age 18 of 18.5 to 21.9, 22 to 24.9, 25 to 29.9, and ≥30 kg/m2, the hazard ratio for premature death were 0.98, 1.18, 1.66, and 2.79, respectively.

A prospective study from the United States, at National Cancer Institute, National Institutes of Health, Bethesda, valuated the relationship between BMI and risk of death over a maximum follow–up period of 10 years among over 500,000 men and women aged 50 to 71 years. Among the subset of individuals 50 years of age (when prevalence of chronic disease is low) who had never smoked, an increased risk of death was associated with being either overweight (20 to 50 percent increase in those between 26.5 to 29.9 kg/m2) or obese (two– to over threefold increase in those ≥30 kg/m2). Overweight and obesity, (when analyzed together), is associated with increased mortality from diabetes and kidney disease.

Obesity, when analyzed alone, is associated with increased cardiac mortality and cancers considered to be obesity–related (colon, breast, esophageal, uterine, ovarian, kidney, and pancreatic cancer), but not with mortality from other cancers or non–cardiac mortality.

There are some recent studies, which showed that obese people live longer. Overweight was shown to be associated with reduced mortality from non cancer, non–cardiovascular causes, but not with cancer or cardiovascular mortality. In them being underweight was associated with increased mortality from non cancer and non–cardiac causes, but not cancer and cardiac CVD causes. Obesity and increased central fat are associated with increased morbidity in addition to mortality.

Overweight and obese individuals have a higher relative risk of hypertension, hypercholesterolemia, and diabetes mellitus compared with normal weight individuals. The risk of hypertension and diabetes increases with increasing BMI.

In the Nurses’ Health and the Health Professionals Studies, the risk of developing a chronic disease (gallstones, hypertension, heart disease, colon cancer, and stroke (in men only) increased with increasing BMI, even in those in the upper half of the healthy weight range (BMI 22.0 to 24.9 kg/m2).

Obesity is measured by using a measurement called Body Mass Index – calculated by divide a person’s weight in kilograms by the square of their height in metres. A BMI of 18.5 to 23 is considered normal (Asians). One below 18.5 is considered underweight and 25 or above is considered obese.

(Source: Uptodate)

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal on

Obesity reduces life expectancy

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011–HarmonyAn Inter School Health Festival

Competitions like slogan writing was organized on the spot in the recently concluded Perfect Health Mela in which various School took active part.

Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook – Twitter


India on verge of eliminating syphilis

NEW DELHI: India is on the verge of eliminating syphilis, one of the most common sexually transmitted diseases (STD) in the country. According to the National Aids Control Organization (NACO), syphilis, which earlier used to affect about 8% of pregnant women, has been reduced to less than 1%. Among female sex workers, it affects about 4% as against 30% till a few years ago. There has also been a massive dip in chancroid infections. Till a decade ago, India recorded 1.2 lakh cases of chancroid infections that have come down to less than 3,000. Chancroid causes high numbers of genital ulcers. Around 14% of all genital ulcers were caused by Chancroid, which has since come down to less than 0.1%. (Source: TOI, Nov 2, 2011)

For comments and archives

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology: Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    International News

Family history of BRCA mutation not cancer risk factor

Women who test negative for a BRCA mutation that runs in their family aren’t more likely to develop breast cancer than otherwise suggested by a family history alone, a study affirmed. Such women showed no significant difference in breast cancer risk compared with those in breast cancer–affected families without identified BRCA1 or BRCA2 mutations, Alice S. Whittemore, PhD, of Stanford University in Palo Alto, Calif., and colleagues found. (Source: Medpage Today)

For comments and archives

ACG: Tests help tell GERD from esophagitis

Two tests –– major basic protein (MBP) and eotaxin–3 –– can help physicians distinguish between eosinophilic esophagitis and gastroesophageal reflux disease (GERD), a researcher said here. (Source: Medpage Today)

For comments and archives

FDA approves device for nonsurgical aortic valve repair

He FDA approved the Sapien Transcatheter Heart Valve for treatment of patients too sick to undergo open–heart surgery to repair calcified aortic valves. The Sapien valve, from Edwards Lifesciences, is a replacement valve that doesn’t require major surgery. The Sapien valve is approved for patients who are not eligible for open–heart surgery for replacement of their aortic valve and have a calcified aortic annulus. The product label advises that a heart surgeon should be involved in determining if the Sapien valve is an appropriate treatment for the patient. It is not approved for patients who can be treated by open–heart surgery. (Source: Medpage Today)

For comments and archives

   Twitter of the Day

@DrKKAggarwal: Most used alhabet "A" does not appear in spelling of 1 to 999. it comes 1st time in 1000 and continue, so succes needs patience and faith.

@DeepakChopra: Consciousness & Biology http://bit.ly/svFZY4

    Spiritual Update

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Should doctors or nurses prey with their patients?

With medical tourism booming a lot of International patients are coming for treatment. With that it is becoming important for the doctors to understand their spiritual needs.

For comments and archives

   An Inspirational Story

A story of appreciation

This is a powerful message in our modern society. We seemed to have lost our bearing and our sense of direction.

One young academically excellent person went to apply for a managerial position in a big company. He passed the first interview, the director did the last interview, made the last decision. The director discovered from the CV that the youth’s academic achievements were excellent all the way, from the secondary school until the postgraduate research, never had a year when he did not score. The director asked, "Did you obtain any scholarships in school?" The youth answered "None".

The director asked, "Was it your father who paid for your school fees?" The youth answered, "My father passed away when I was one year old, it was my mother who paid for my school fees. The director asked, "Where did your mother work?" The youth answered, "My mother worked as clothes cleaner.

The director requested the youth to show his hands. The youth showed a pair of hands that were smooth and perfect.

The director asked, "Have you ever helped your mother wash the clothes before?" The youth answered, "Never, my mother always wanted me to study and read more books. Furthermore, my mother can wash clothes faster than me. The director said, "I have a request. When you go back today, go and clean your mother’s hands, and then see me tomorrow morning. The youth felt that his chance of landing the job was high. When he went back, he happily requested his mother to let him clean her hands. His mother felt strange, happy but with mixed feelings, she showed her hands to the kid. The youth cleaned his mother’s hands slowly. His tear fell as he did that. It was the first time he noticed that his mother’s hands were so wrinkled, and there were so many bruises in her hands. Some bruises were so painful that his mother shivered when they were cleaned with water.

This was the first time the youth realized that it was this pair of hands that washed the clothes everyday to enable him to pay the school fee. The bruises in the mother’s hands were the price that the mother had to pay for his graduation, academic excellence and his future. After finishing the cleaning of his mother hands, the youth quietly washed all the remaining clothes for his mother. That night, mother and son talked for a very long time. Next morning, the youth went to the director’s office. The Director noticed the tears in the youth’s eyes, asked, "Can you tell me what have you done and learned yesterday in your house?" The youth answered, "I cleaned my mother’s hand, and also finished cleaning all the remaining clothes". The Director asked, "Please tell me your feelings."

The youth said, Number 1, I know now what is appreciation. Without my mother, there would not the successful me today. Number 2, by working together and helping my mother, only I now realize how difficult and tough it is to get something done. Number 3, I have come to appreciate the importance and value of family relationship. The director said, "This is what I am looking for to be my manager. I want to recruit a person who can appreciate the help of others, a person who knows the sufferings of others to get things done, and a person who would not put money as his only goal in life. You are hired.

Later on, this young person worked very hard, and received the respect of his subordinates. Every employee worked diligently and as a team. The company’s performance improved tremendously.

A child, who has been protected and habitually given whatever he wanted, would develop "entitlement mentality" and would always put himself first. He would be ignorant of his parent’s efforts. When he starts work, he assumes that every person must listen to him, and when he becomes a manager, he would never know the sufferings of his employees and would always blame others. For this kind of people, who may be good academically, may be successful for a while, but eventually would not feel sense of achievement. He will grumble and be full of hatred and fight for more.

If we are this kind of protective parents, are we really showing love or are we destroying the kid instead?

You can let your kid live in a big house, eat a good meal, learn piano, watch a big screen TV. But when you are cutting grass, please let them experience it. After a meal, let them wash their plates and bowls together with their brothers and sisters. It is not because you do not have money to hire a maid, but it is because you want to love them in a right way. You want them to understand, no matter how rich their parents are, one day their hair will grow gray, same as the mother of that young person. The most important thing is your kid learns how to appreciate the effort and experience the difficulty and learns the ability to work with others to get things done.

For comments and archives

    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

12 Indian foods that cut fat


An effective fat–burning food, garlic contains the sulfur compound allicin, which has anti–bacterial effects and helps reduce cholesterol and unhealthy fats.

For comments and archives

    Medicine Update

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

What are the presentations of hepatitis C infection?

In most cases of chronic HCV infection, the only abnormality to be found will be mildly abnormal aminotransferase levels (usually <100 IU/l). In one–third of patients, the liver function tests (LFT) will be normal.

For comments and archives

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

BUN:Creatinine ratio

BUN:Creatinine ratio The BUN:creatinine ratio is usually >20:1 in prerenal and postrenal azotemia, and <12:1 in acute tubular necrosis. Other intrinsic renal disease characteristically produces a ratio between these values.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient had a strong family history of cancer.
Dr Bad: Just get regular check ups.
Dr Good: Take low–dose aspirin.
Lesson: A new observational analysis published online in the Lancet reports that long–term daily aspirin may prevent cancer deaths (Lancet 2011 Jan 1;377(9759):31–41).

For comments and archives

Make Sure

Situation: A patient with acid peptic disease was denied any painkiller for his distressing illness.
Reaction: Oh, my God! Why did you not give him nimesulide?
Lesson: Make Sure to prescribe nimesulide as it is safe in acid peptic disease.

For comments and archives

  Quote of the Day

(Dr GM Singh)

True Friendship For Ever

When daylight turns to a darkened hue, The lovely stars hinting at u, ur heartbeat tells u something true, That someone IS badly missing you.


Turn a blind eye: Refuse to acknowledge something you know is real or legit.

    Mind Teaser

Read this…………………

What is not true for HNPCC.

a) It is the most common hereditary colorectal cancer syndrome in USA.
b) It is associated with MMR gene mutation.
c) It is associated with APC mutation.
d) It is associated with carcinoma colon and extraintestinal cancers.

Yesterday’s Mind Teaser: Which of the following is not a congenital abnormality associated with juvenile polyps?

a) Malrotation
b) Meckel’s diverticulum
c) Macrocephaly
d) Mesenteric lymphangioma

Answer for yesterday’s Mind Teaser: c) Macrocephaly

Correct answers received from: yj vasavada, Dr Selva Pandian,
Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay, Anil Bairaria, Alpana Bhatnagar, Dinesh Yadav, Dr Shashi Saini, Dr Prabha Sanghi, Dr Ragavan Moudgalya.

Answer for 2nd November Mind Teaser: a) Bronchus
Correct answers received from: Dinesh Yadav, John C Mathew, Gita Arora.

Send your answer to ijcp12@gmail.com

    Laugh a While


Two patients in a psychiatry ward were having a discussion. One was telling the other that he can climb anything. So the other grabbed a torch light and, shining the beam in the air, told the other, "Ok, climb that", whereupon, the other retorted, "You think I’m foolish, when I get up there, you’ll turn off the light and cause me to fall down."

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emedinews revisiting 2011
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    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

What is hide and die syndrome?

  • There is a peculiar aspect to some cases of hypothermic deaths in that it is associated with the victim undressing and hiding away from sight. The subject is usually an old person, man or woman.
  • The person is usually found dead at home partly or even completely without clothing even in winter or in a cold environment. The victim may have burrowed his or her way into some corner or cupboard or alternatively pulled down furniture or household article into the body.
  • The house may be in such a situation of disorder that when police break in and find a dead body among such a chaos, they may naturally suspect a case of robbery and murder.
  • The sign of hypothermia is usually present during autopsy.
  • There is variation in the adrenaline/noradrenaline ratio, a manifestation of stress induced by low temperature along with other biomedical markers of hypothermia.

(Ref: Knight’s Forensic Pathology)

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Patients with low heart functions should not ignore the winter

All heart patients should know the pumping status of their heart, which is called ejection fraction. If low these patients are at risk of sudden cardiac death during winter season, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

The guidelines from American College of Cardiology and American Heart Association for device–based therapy of cardiac rhythm abnormalities suggest that an internal electric shock devise called an ICD therapy is indicated in all patients with heart functioning called LVEF of less than 35% due to prior heart attack (post 40 days) and who are symptomatic.

The guidelines further suggest that ICD therapy is indicated in patients with non–ischemic dilated cardiomyopathy (enlarged heart) who have an LVEF less than or equal to 35% and who are symptomatic.

ICD therapy is also indicated in patients with heart dysfunction due to prior heart attack who are at least 40 days post heart attack with LVEF less than 30% even if they have no symptoms.

ICD therapy is also indicated in patients post heart attack with LVEF less than 40% if they have irregular heart abnormality of non–sustained VT (Ventricular tachycardia) on 24–hour ECG monitoring or inducible abnormal heart rhythm called VF (Ventricular fibrillation) or sustained VT at electrophysiological study.

For comments and archives

    Readers Responses

Dear Dr. KK ji, Thanks for "APT" advice on Platelet Transfusion in Dengue. I do hope Clinical Friends will follow it. I have received several complaints from friends that inspite of transfusing enough number of Platelets (both Random Donor or Single Donor), but still the patients did not respond. My suggestions have been:-

  1. Please do not unnecessary transfuse platelets. Thrombocytopaenia may happen in many Viral disesses, not only Dengue
  2. Patients are known to develop Platelet Refractoriness mainly (75%) times due to HLA Antigens incompatibility and only (25%) times due to Platelet Antigens mismatch.
  3. Please properly calculate the amount of Platelet Transfusion required and work out for every patient. just asking for 2-3 Units of RDPs' or a unit of SDP is not the answer.
  4. We the Blood Transfusion people are always available for any help.

    Forthcoming Events

CSI 2011

63rd Annual Conference of the Cardiological Society of India

Date: December 8–11, 2011.
Venue: NCPA Complex, Nariman Point, Mumbai 400021

Organizing Committee

B. K. Goyal – Patron
Samuel Mathew – President CSI
Ashok Seth – President Elect & Chairman Scientific Committee
Lekha Adik Pathak – Chairperson
Satish Vaidya & C. V. Vanjani – Vice Chairman
N. O. Bansal – Organizing Secretary
B. R. Bansode – Treasurer
Ajit Desai , Ajay Mahajan , G. P. Ratnaparkhi – Jt. Org. Secretaries
Shantanu Deshpande , Sushil Kumbhat , Haresh Mehta – Asst. Org. Secretaries
D. B. Pahlajani, A. B. Mehta , M. J. Gandhi , G. S. Sainani, Sushil Munsi, GB Parulkar, KR Shetty – Advisory Committee

Contact: Dr. Lekha Adik Pathak, Chairperson, CSI 2011; Dr. Narender O. Bansal, Org. Secretary, CSI 2011 Tel: 91 – 22 – 2649 0261/2649 4946, Fax: 91 – 22 – 2640 5920/2649 4946.
Email: csi2011@ymail.com, csimumbai2011@gmail.com Website: www.csi2011mumbai.com

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews “Doctor of the Year Award “ function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.com

    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

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  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta