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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 …

7th April 2012, Saturday

Today is World Healh Day

Healthy ageing: Eat less to live more

Adhering to a calorie–restricted diet over the long term ameliorates the normal age–related decline in diastolic function of the heart in healthy, non–obese adults. The cardiac beneficial effects of caloric restriction are mediated by reductions in blood pressure, systemic inflammation, and myocardial fibrosis as per a study published in January issue of the Journal of the American College of Cardiology.

It is the first study in humans that strongly suggests that calorie restriction may delay primary aging. Calorie restriction has previously been shown to slow aging and increase lifespan in small mammals. Dr. Fontana, from Washington University in St. Louis, performed Doppler echocardiography and measured inflammatory markers in 25 healthy adults who followed a severely calorie–restricted, nutritionally balanced diet for an average of 6.5 years. Results were compared with those from 25 matched control subjects consuming a typical Western diet.

The calorie–restricted diet consisted of roughly 1,671 kcal per day derived approximately 23% protein, 49% complex carbohydrates, and 28% fat (including 6% saturated fat). The Western diet consisted of roughly 2,445 kcal per day made up of about 17% protein, 52% carbohydrates, and 31% fat (11% saturated fat).

The calorie–restricted diet included at least 100% of the recommended daily intake for all nutrients, and it was lower in salt than the Western diet.

People who followed a severe calorie–restricted diet but with optimal nutrition had a younger heart in terms of diastolic function, which is a well–accepted marker of primary aging because, independently of disease, as you get older your diastolic function gets worse and worse.

Mean systolic and diastolic blood pressures were significantly lower in the calorie–restricted group (102/61 vs. 131/83 mm Hg), as were levels of the inflammatory markers C–reactive protein, TNF–α, and TGF–β1.

‘Eat less to live more’ has its origin in Vedas. The Ayurvedic text from Atharvaveda defines the limit of food intake in a particular meal. It says one should not eat more than what can be accommodated in an outstretched palm.

According to the Jain philosophy there are 12 types of penance. Two of them are Anshan (fast) and Unodari. Unodari is for those people who cannot fast and it is eating less than what is needed to satisfy one’s hunger.

Deepak Chopra in his book perfect health says that one should eat to a scale of 7 from a hunger scale of 10.

Yogashastra says that one who eats one meal in a day is yogi; one who eats twice a day is bhogi; who eats thrice a day is rogi. The common Sanskrit saying is "ekabhattam cha bhoyanam" which means if one takes only one meal a day then there will be no illnesses.

Controlled diet conserves one’s energy. Samana vayu, the vital energy produced around the naval, remains in balance if one eats less. Over eating reduces this energy.

Another way of eating less is vritti samkshepa. It involves limited number of items eaten and not to eat same particular items on particular days. Traditional Indians "vrata" (fast) also are based on this type of penance. Many "vrata" restricts eating particular items on that day.

Another way of eating less is penance of "raso parityaga", which means avoiding of certain tastes of food. One should not eat items with all taste on all days. The Friday fast of Santoshi Maa involves not eating sour food on that particular day.

Many religions insist on not eating after the sunset. One of the phrases in Yoga Shastra is "astangate divanathe" which means that the digestive system becomes inactive after the sunset. It is also the philosophy of Ayurveda. As sun is the greatest source of energy. Body’s vital, physical and digestion remains active in presence of sun. While Jainism talks about not eating at all after sun set, Ayurveda says one should have dinner lighter than lunch and to avoid artificial food as well as semi digestive foods in the night. Eating curd has been prohibited in Ayurveda after sunset. People living in South also do not eat fermented food items like idli, dosa, etc. after sunset.

According to Ayurvedic philosophy any food that is eaten after sunset does not get properly transformed into juices. Such food, therefore, are not helpful for health as they are not converted into energy.

In modern medicine over eating now is classified as a type of malnutrition. Obesity, high blood pressure, heart disease, high cholesterol, cancer, gall stones, etc. are as a result of over eating.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

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    Photo Feature (from the HCFI Photo Gallery)

Communication skills for Health Care Professionals

Padma Shri Awardee Dr KK Aggarwal presenting a lecture on Communication skills for Health Care Professionals at Pushpanjali Crosslay Hospital, Kaushambi, Ghaziabad

Dr K K Aggarwal
    National News

In a first, antibiotics bar on food-producing animals

NEW DELHI: The Union health ministry has, for the first time, quantified a timeframe for which "food–producing animals" or marine products have to be kept off antibiotics before they enter the human food chain. The insertion to Rule 37 of the Drugs and Cosmetics Act, 1945, which came into force from January 17, the withdrawal period "shall be less than seven days for egg and milk, 28 days for meat from poultry and mammals, including fat and offal, before they enter the human food chain. For fish, it is 500 degree days (taken into account both the temperature of water and the number of days)". The parameters shall be put down on the labels of the container. (Source: TOI, Apr 6, 2012)

For comments and archives

India’s young nation status is fast withering: WHO

"A good society is one that takes care of its vulnerable, its aged, its poor and its sick," said Dr Nata Menabde, World Health Organisation (WHO) Representative to India, on Tuesday in New Delhi, ahead of the World Health Day on April 7. India, which is often seen as the only young country in an ageing economy, may lose its advantage, as the WHO has projected India's 60 years and above population at 300 million by 2050. The United Nations body said this population was likely to form 17 per cent of the Indian population by 2050, up from 7.4 per cent at 77 million in 2001. What’s more, the population over 65 years is likely to outnumber children below five by 2017 and will be larger than the number of children below 14 by 2050! (Source: http://www.thehindubusinessline.com/industry-and-economy/article3277811.ece, April 3, 2012)

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

Cervical pessary may prevent preterm birth

Using a cervical pessary could be an effective strategy to prevent preterm birth in pregnant women with a short cervix, according to a study published online April 3 in the Lancet. The Spanish study, called Pesario Cervical par Evitar Prematuridad (PECEP), is the first multicenter randomized trial to test the use of a cervical pessary in women at high risk for preterm birth. (Source: Medscape)

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COPD Combo fares well in trials

An investigational product for chronic obstructive pulmonary disease (COPD), combining a long–acting beta–agonist with an anticholinergic bronchodilator, met study goals in three pivotal trials, its manufacturer said. In one of the three trials, the product, called QVA149, was significantly more effective than either of its components alone, placebo, or open–label tiotropium bromide in increasing trough levels of forced expiratory volume in one second (FEV1). (Source: Medpage Today

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PSA Drop Seen with New Prostate Ca Drug

Half of a group of men with castration–resistant prostate cancer (CRPC) had biochemical responses to treatment with an investigational androgen receptor modulator, data from a preliminary clinical study showed. (Source: Medpage Today)

For comments and archives

Tyrosine kinase inhibitors safe in dialysis patients with metastatic kidney cancer

Hemodialysis does not preclude use of tyrosine kinase inhibitors (TKI) for metastatic renal cell carcinoma, a retrospective analysis suggests. Sunitinib and sorafenib were safe and relatively effective in 24 such patients, Italian doctors reported online February 24th in BJU International. Both TKIs are approved for treating advanced renal cell carcinoma (RCC). (Source: Medscape)

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  Twitter of the Day

@DrKKAggarwal: Exercise impact on the knee Different exercises produce different impacts on the knee joints.

@DeepakChopra: We are the consciousness in which body, mind & universe simultaneously co–arise & evolve

    Spiritual Update

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

Non violence in action, thoughts and actions can prevent heart attacks

Mahavir Jayanti is the birthday of Mahavira. During Mahavir Jayanti celebration, devotees and practitioners go to Jain temple to pay respect, by bathing Mahavira statues, then proceed to offer prayers and meditate. Monks lead special services and teach the virtuous path. Donations and other charitable acts are encouraged on this day.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

When do I need to see an Infertility Counselor?

Counseling is consider if you are feeling depressed, anxious, or so preoccupied with your infertility that you feel it is hard to enjoy life. You may also want to consider counseling if you are feeling "stuck" and need to sort out your options and alternatives. Counseling include:

  • Persistent feelings of sadness, guilt, or worthlessness
  • Social isolation
  • Loss of interest in usual activities and relationships
  • Depression
  • Agitation and anxiety
  • Increased mood swings
  • Constant preoccupation with infertility
  • Marital discord
  • Difficulty concentrating and remembering
  • Increased use of alcohol or drugs
  • A change in appetite, weight, or sleep patterns
  • Thoughts about suicide or death
  • Difficulty with scheduled intercourse

For comments and archives

    Hepatitis A Update

(Dr Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation, Medanta – The Medicity Hospital, Gurgaon)

Who should not get or who should wait for the hepatitis A vaccine. (CDC guidelines)

  • Anyone who has ever had a severe (life threatening) allergic reaction to a previous dose of hepatitis A vaccine should not get another dose.
  • Anyone who has a severe (life threatening) allergy to any vaccine component should not get the vaccine.
  • All hepatitis A vaccines contain alum, and some hepatitis A vaccines contain 2–phenoxyethanol.
  • Anyone who is moderately or severely ill at the time the shot is scheduled should probably wait until they recover. People with a mild illness can usually get the vaccine.

For comments and archives

    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

What is a unit of blood?

The blood is collected in plastic bags. They contain a watery fluid, which prevents the blood from getting coagulated. On an average we draw about 350 or 450 ml. of blood from a person depending on his body weight and this blood plus the amount of anticoagulant present in the bag is known as one unit of blood.

Can blood of animals be transfused to human beings?

Scientists have attempted plenty but so far they have not been successful. Only the blood of a human being can be transfused to another human patient.

For comments and archives

    Medi Finance Update

(Tarun Kumar, Chartered Accountant)

Judicial precedents reversed by retrospective amendments


Definition of royalty amended retrospectively from 01 June 1976 to specifically cover the use or right to use computer software (including granting of a licence). Medium of transfer not relevant for determining taxability.

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    An Inspirational Story

(Ms Ritu Sinha)

The Burning Desire

A young man asked Socrates the secret to success. Socrates told the young man to meet him near the river the next morning. They met.

Socrates asked the young man to walk with him toward the river. When the water got up to their neck, Socrates took the young man by surprise and ducked him into the water. The boy struggled to get out but Socrates was strong and kept him there until the boy started turning blue. Socrates pulled his head out of the water and the first thing the young man did was to gasp and take a deep breath of air.

Socrates asked, "What did you want the most when you were there?" The boy replied, "Air." Socrates said, "That is the secret to success. When you want success as badly as you wanted the air, then you will get it." There is no other secret.

A burning desire is the starting point of all accomplishment. Just like a small fire cannot give much heat, a weak desire cannot produce great results…


For comments and archives

    Microbial World: The Good and the Bad They Do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta – The Medicity)

Microbial flora of stomach and GIT

At birth, the stomach and GIT are usually not colonized. The first intake of food results in colonization by bacteria. Breast–fed babies are most commonly colonized with bifidobacteria. Once the bottled milk is started the intestinal flora changes to include enteric bacteria, bacteroides, enterococci, lactobacilli, and clostridia. The factors that influence the makeup of bacterial flora of the human stomach and gastrointestinal tract include diet, age, cultural conditions, and the use of antibiotics. In particular, the use of antibiotics can greatly change the composition of the normal gut flora. However, the following bacteria are almost always present in the gastrointestinal tract of humans: Escherichia coli, Clostridium perfringens, Enterococci, Lactobacilli, and Bacteroides.

Studies on the structure and function of the digestive tracts of normal animals and notobiotic (no bacterial flora) animals have shown that intestines in the notobiotic animals are less efficient in processing food and absorbing nutrients. The normal microbial flora also manufactures essential vitamins, helps in processing and digestion of food, stimulates the development and activity of immunological tissues and prevents colonization by undesirable microbes. In return the normal microbial flora gets to colonize in protected, nutritionally rich, secure environment of the GIT. Thus, the GIT microbial flora is very important to the health of humans.
Studies have shown that some bacteria normally present in colon e. g. Bacteroides spp produce some metabolites, which are carcinogenic and may be related to colon cancer.

For comments and archives

  Cardiology eMedinewS

Dual Role Of RHO Kinase Inhibitor Y 27632 In Endothelium Under

Shear Stress Read More

Novel Cardiomyocyte Enriched Microrna, mir-378, Targets Igf1 r: Implications in Post Natal Cardiac Remodeling and Cell Survival
Read More

Cardiomyocyte Hypertrophy Is Dependent On The Activation Of A Caspase 3 Signaling Pathway Read More

  Pediatric eMedinewS

Maternal Caffeine Intake Unrelated To Infant Sleep Problems Read More

Use Waistline To Predict Teens’ Heart Risk Read More

No Outdoor Play For Many Kids Read More

    IJCP Special

Dr Good Dr Bad

Situation: An elderly male came with low back pain after a minor trauma.
Dr Bad: Take this painkiller.
Dr Good: Get an x–ray spine done.
Lesson: A history of even minor trauma in an elderly patient presenting with back pain raises the red flag of suspicion for fracture and is sufficient reason to order plain radiograph of the spine.

For comments and archives

Make Sure

Situation: A 40–year–old mild hypertensive complained of ED after a beta blocker.
Reaction: Oh my god! What was the need of starting the drug so early?
Lesson: Make sure that all mild hypertensives are first advised lifestyle modifications like exercise, low salt diet, high fiber diet, decreasing stress, etc. before advising anti hypertensive medications.

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  Quote of the Day

(Dr GM Singh)

All earthly delights are sweeter in expectation than in enjoyment; but all spiritual pleasures more in fruition than in expectation. Francois Fenelon

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Platelet Count

Also known as thrombocyte count

  • Done as a part of routine complete blood count (CBC)
  • For evaluation of unexplained or prolonged bleeding
  • To diagnose/monitor a bone marrow/blood disease
  • In evaluation of fever (especially dengue)
  • Management of immuno–inflammatory disorders (where the count is increased)
    Mind Teaser

Read this…………………

Which of these drugs has been shown to improve labyrinthine blood flow and to re equilibrate central vestibular imbalance and is considered useful in treatment of patients with vascular disease of the vestibular system?

a. Propranolol
b. Amitriptyline
c. Cinnarizine
d. None of above

Yesterday’s Mind Teaser: i i

Answer for Yesterday’s Mind Teaser: dark under eye

Correct answers received from: Yogindra Vasavada, Dr Amit Kochar, Dr PC Das, Ritu Sinha,
Dr Rakesh Bhasin, Sudipto Samaddar, Raju Kuppusamy, Neelam Nath, Dr Chandresh Jardosh,
Dr Hitendrasinh Thakor, Dr Valluri Ramarao, Anil Bairaria.

Answer for 5th April Mind Teaser: a. 50–80
Correct answers received from: Dr Gopal Shinde.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Feline Physics

Law of Cat Inertia

A cat at rest will tend to remain at rest, unless acted upon by some outside force – such as the opening of cat food, or a nearby scurrying mouse.

    Medicolegal Update

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

Legal medicine: Doctor in witness box under oath

When a doctor is called in witness box of Court of Law, Oath has to be administered before he tenders his evidence.
A doctor as witness while administered the oath has to repeat, while standing… ‘the evidences which I shall give to the honorable court shall be the truth, the whole truth and nothing but the truth, so help me the almighty God".

If a Doctor wishes to give his evidence on solemn affirmation, he has to say that I solemnly affirm that the evidences which I shall give to the honorable court shall be the truth, the whole truth and nothing but the truth.

The main objective of the oath is to find truthful statement and if any doctor/witness speaks a lie after administration of oath he is liable for punishment of perjury a criminal offence in our country as well as abroad.

The Medical opinion of the doctor must be supported by reason/science and it is the reasons and not ipse dixit (meaning he himself said (it)) which is of importance in assessing the merit of the doctor’s opinion in the court of law.

For comments and archives

    Public Forum

Public Forum (Press Release for use by the newspapers)

Paracetamol can cause fatal liver damage

Although Paracetamol is remarkably safe when taken at usual therapeutic doses, overdose of Paracetamol has been recognized to cause fatal and nonfatal hepatic necrosis. It is available in the market as 500 or 1000 mg tablets. Even repeated therapeutic or slightly excessive doses can be hepatotoxic in susceptible individuals, such as alcoholics, said Dr. K.K. Aggarwal, Padma Shri and Dr B C Roy National Awardee and President, Heart Care Foundation of India.

Paracetamol poisoning is the most common cause of acute liver failure in the United States.The therapeutic dose is 10 to 15 mg/kg per dose in children and 325 to 1000 mg per dose in adults, given every 4 to 6 hours, with a maximum recommended daily dose of 80 mg/kg in children or 4 g in adults.

Toxicity is unlikely to result from a single dose of less than 150 mg/kg in a child or 7.5 to 10 g for an adult. Toxicity is likely to occur with single ingestions greater than 250 mg/kg or those greater than 12 g over a 24–hour period.

Virtually all patients who ingest doses in excess of 350 mg/kg develop severe liver toxicity (defined as peak SGOT or SGPT liver enzymes levels greater than 1000 IU/L) unless appropriately treated. (60 kg man, 21 tablets of 1000g paracetamol)

In contrast to chronic alcoholics with an isolated ingestion, chronic alcoholics are at increased risk for hepatotoxicity following ingestion of multiple supratherapeutic doses of paracetamol.

The effect of chronic ethanol ingestion in conjunction with repeated, therapeutic doses (up to 4 g/day) of paracetamol is controversial. One report from George Washington University, Washington showed that 161 regular users of alcohol developed hepatotoxicity following acetaminophen ingestion with therapeutic intent. In the report 54 percent had ingested 6 grams or less per day and 30 percent had taken less than 4 g/day, the overall mortality rate reached 20 percent.

Delayed recognition of toxicity and continued use of the drug likely account for much of the morbidity in this patient population.

The outcome of paracetamol intoxication is nearly always good if the antidote, N-acetylcysteine (NAC), is administered in a timely fashion.

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  1. Dear Sir, eMedinewS provides useful information. Regards: Dr JP Sharma
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A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

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