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Address: 39 Daryacha, Hauz Khas Villege, New Delhi, India. e-Mail: , Website:


Dr KK Aggarwal
Dr BC Roy Awardee
Sr Physician and Cardiologist,
Moolchand Medcity
President, Heart Care
Foundation of India
Gp Editor-in-Chief,
IJCP Group
Delhi Medical Council
Director, IMA AKN Sinha Institute (08-09)



8th December Tuesday 

Dear Colleague,

                                            H1N1 Pandemic

Most disease outbreaks in non American countries do not end up into same mania as it would occur if it happens in US. One has seen the American 9/11 mania when the World Trade Centre Towers were attacked by terrorists. The same mania response is never seen when such incidences happen in India or other non US countries.

Any US outbreak, howsoever small, is an opportunity for commercial exploitation. The present H1N1 pandemic should have made many US based companies rich by 10 to 15%. On the other hand developing countries would go down in their economy. One may recall that Ministry of Health, Gov. of India had to purchase  H1N1 kits and Tamiflu drugs worth hundreds of crores to manage the US origin H1N1 mania.

Swine flu is much milder a disease than seasonal flu. In Delhi alone  40 people die everyday of heart attack and 3 to 6 die of seasonal flu in winter. The deaths from swine flu are hardly any.

Those private hospitals (which run on US philosophy) are the only gainers by this mania. A private hospital certified by the Government to manage H1N1 cases would charge around Rs. 15000  for H1N1 test, 42000 (for five days) for hospital stay in a single room with H1N1 treatment facilities,  15000 for doctors fee and Rs. 10000 for other lab testings. Apart, once one H1N1 case is diagnosed, the family is made to go for H1N1 test for the contacts. An average 5 members in a family would mean spending Rs. 75000 on them for the additional tests. The drug tamiflu would also cost Rs. 3000 (Rs. 500 per person for the patient and five contacts).

In the rich circle which is 1% of the population of any city it would account to spending 1.5 to 2 lakhs per H1N1 positive case. One can imagine the economic loss which the country would face on this count

Dr KK Aggarwal


Snippets by Dr Monica Vasudeva

Diabetes cases projected to nearly double in next 25 years.
As per a study published in Nov. 27 in the journal Diabetes Care, diabetes cases will nearly double in the US in the next 25 years and the cost of treating the disease will almost triple

Rituximab seen as promising for type 1 diabetes. Nov. 26 issue of the New England Journal of Medicine has reported that arthritis and lymphoma medicine Rituxan [rituximab] cut the need for insulin treatment among patients with type 1 diabetes after a year.

Debate continues over cancer screenings.
There is growing evidence that cancer screenings are not  always helpfuland can sometimes be harmful, according Lisa Schwartz and Steve Woloshin of the Veterans Affairs Outcomes Group. Experts have revised their recommendations over the years as they have learned more about cancer and the unintended side effects of treatment.

On Nov. 16, the 16 members of the independent US Preventive Services Task Force recommended that most women delay routine mammograms until age 50 (instead of 40, as the panel advised in 2002). AMA news reports that for its part, the American Medical Association did not issue a statement on the guidelines, but it has existing policy calling for annual mammograms starting at age 40.
Many medical students sustain needle stick injuries. 
According to research appearing in the Dec. issue of the journal Academic Medicine, medical students often come in too close contact with needles, possibly putting them at risk for contracting HIV or hepatitis C.
The survey of  699 surgeons in training at 17 general surgery residency programs, showed that  almost 60 percent said they sustained a needle   stick injury as a medical student, with many suffering two injuries.

CDC finds link between H1N1 and bacterial infections.
Federal health officials linked the H1N1 flu epidemic to a sharp rise in the number of severe bacterial infections. In a briefing with reporters, CDC flu specialist Dr. Anne Schuchat called the pattern worrisome, but said it had been anticipated as a result of previous pandemics.
Use of the Pneumovax vaccine, which protects against 23 strains of the most common pneumonia bacteria, is routinely given to adults over 65.

Studies show health benefits of cutting carbon emissions.
Research published in the Lancet on Wednesday suggests that slashing carbon dioxide emissions could save millions of lives, mostly by reducing preventable deaths from heart and lung diseases.
According to the studies in the Lancet, walking and cycling more, driving less, switching to cleaner burning stoves in developing countries and reducing meat and dairy consumption are among the easiest ways people can lower the output of carbon dioxide and methane gases that also curb the global disease burden.

Study finds rapid heartbeat may not indicate problems in people without heart disease.
While previous studies had found a link between nonsustained ventricular tachycardia, and sudden death in people who had prior heart attacks  a new report, presented last week at an American Heart Association scientific session, suggests that people without underlying heart disease may have little to fear.

FDA approves seasonal flu shot.
FDA cleared Novartis seasonal flu vaccine Agriflu for sale. It is given as a single shot, and is approved for seasonal flu subtypes A and B in people age 18 and older.

Ranbaxy begins selling Valtrex generic in US.
Ranbaxy Laboratories, Ltd. began selling a generic version of GlaxoSmithKline Plc's Valtrex [valacyclovir hydrochloride] drug in the US.

Job satisfaction high among pediatricians, geriatricians.
The happiest doctors care for children and the elderly, according to a study on physician job satisfaction published in BMC Health Services Research.

Most physicians do not discuss treatment costs with patients. Research suggests that while physicians and patients recognize cost is a significant factor for whether a patient will follow a given treatment, and that physicians know they should talk about cost, most visits omit that critical conversation. (according to a paper published in the Journal of Family Practice).


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medinews: revisiting 2009

IJCP Group is organizing emedinews: Revisiting 2009, a day long conference on 10th Jan  2010 at Maulana Azad Auditorium. It will be attended by over 1500 doctors. Topics will be happenings in the year 2009. There is no registration fee however advanced registration is required.  Top experts will deliver lectures. CME will be followed by lively cultural evening, doctors of the year award, dance and dinner. For regiatration mail We have crossed 1200 registrations.

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Letters to the editor
Dear   Dr Aggarwal, Is Medical Records the Property of a Patients or the Hospital ?
I am writing to you again on the subject because your comment has far reaching implications. I am not satisfied with your answer. Your opinion or my opinion or the discussion in the MCI quoted by you, does not lend it any authority to be quoted.
Your comment would be only misleading all those  readers to whom you send your bulletin. Since you gave this unsubstantiated information in your bulletin you have the responsibility to take the point to its logical conclusion. Either you should issue an amendment or you should substantiate your comment by the exact written authority ( official decision taken, signed and communicated ) by the MCI. I am sure MCI could not have taken such an illogical decision. Dr S K Joshi

Emedinews comments: In person i agree with your comments. But the council has taken a view on many cases just the opposite. even i  the last council meeting it was discussed
the minutes of the also council meeting will come for confirmation next month.
2. Dear sir: ghar baithe aap hame padha rahe hain. isko kahte hain prabhu krpa. bhagwan aap ko sari khushiyan de. Thanks is a very small word. Dr.A.K.Saxena, Jodhpur-342003

3. Dear Dr Aggarwal, Thank you for your updates. They are interesting and refreshing. Samir

4. Dear Dr Aggarwal, I am 63 years old.wt-63 kg. ht -182cm. bp-110/70 mm. no untoward family history .lifestyle simple vegetarian nonsmoker , occasional drinks, regular exercises and morning walker. One year back my serum cholesterol was 215 mg%. LDL 47 and HDL 48 and after taking 10 mg of statin daily now it is 174,115 &44mg%. My query is about continuation of statin tab Should I continue?  How long?  Any side effects?  Is it advisable to be taken by normal person also? Dr S L Jain Old Rajinder Nagar
Emedinews comments:  At the age of 63, should we continue Statins in patient who are otherwise asymptomatic, is a matter of debate. However, I, in such cases, would do intima media thickness of carotids and high sensitivity CRP test. If IMT is more than 0.7 ml and/or CRP is more than 2, I would continue Statins.

Humor (

After returning back from a foreign trip, Banta asked his wife,
Do I look like a foreigner?
Wife: No! Why?
Santa: In London a lady asked me Are you a foreigner?

One tourist from U.S.A. asked Santa
Any great man born in this village???
Santa: no sir, only small Babies!!!

Best Traffic Ad of the year…………….
Lord Ganesha says….. “Care for your head…..not everyone gets a replacement like me! Wear Helmet!”

Dengue watch

Out of four types of dengue in the city it was Den 1 and Den 3 which caused epidemic in 2006. 2007 & 2008 were relatively silent period but again in 2009, the Dengue epidemic has involved Den 3 and Den 1 viruses. The figures from NICD, AIIMS (Dr. S. Broor) and MAMC (Dr. A Chakraborty) have confirmed these serotypes. As per Dr. Lalita Chugh of IGIB, a division of CSIR, the dengue virus seen in Delhi this time had immunological similarities to the one seen in Indonesia and Thailand. The T cell response to helper cell is different. The immunological different response is probably responsible for more liver toxicity seen in the present dengue epidemic.

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