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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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10-13); National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal
    Health Videos…
eMediTube (videos), eMedipics, eMediSlide, eMediLaw

14th June 2013, Friday

About Thyroid gland

  • Low functioning thyroid is a new epidemic of the society affecting more than 3% of people. If thyroid function is low, it causes weight gain, loss of energy, cold intolerance and menstrual irregularities in women.
  • All people who are aged 50 and above should have their thyroid profile (TSH test) done to look for thyroid deficiency.
  • In younger people, or in the cases of infertility, menstrual irregularity, pregnancy, weight gain, one should check for thyroid deficiency.
  • Iodized salt should be used to prevent thyroid deficiency.
  • Non-iodized salt is only used in two conditions: firstly in patient with thyroid inflammation and secondly, while doing Jalneti in naturopathy, a yoga-related nasal wash technique.
  • In pregnancy, even mild thyroid deficiency can affect the growth of fetus hence dose requirement of thyroid medicine is much higher in pregnancy than in non-pregnancy.
  • In the elderly, the dose of thyroid medicine to be started is always low as compared to one in the adults.
  • If thyroid deficiency is untreated, osteoporosis (thickening of bone) and/or atrial fibrillation (irregular and fast heart rate) may result. Osteoporosis can cause recurrent fractures and atrial fibrillation may cause brain paralysis.
  • In Allopathic medicine, thyroid deficiency is treated by synthetic T4 hormone replacement. In TFSP, thyroid extracts are available, which contain both T4 and T3 potential drugs.
  • In Ayurveda, thyroid stimulant drugs are available but they are effective only if some amount of thyroid gland is available.
  • As per Ayurveda, eating soya and drinking water from copper vessel is good for thyroid.

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

DVT risk starts early, stays long
after acute stroke

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Excessive use of mobile phone can be injurious to your health

A press conference was organised by Heart Care Foundation of India on the occasion of World Environment Day.

Dr K K Aggarwal
    National News

Govt. bans painkiller

New Delhi: The government has banned the manufacture, sale and distribution of painkiller drug dextropropoxyphene, a drug that has been banned in various countries. “...Central Government hereby suspends manufacture for sale, sale and distribution of the drug with immediate effect,” a government notification said. Dextropropoxyphene, an opioid analgesic, was suspended under Section 26A of the Drugs and Cosmetic Act, 1940. (Source: The Hindu, June 13, 2013)

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, every Thursday 4:30 PM in DD India

    Valvular Heart Disease Update

Valvular heart disease and CKD

Valvular heart disease is common in patients undergoing maintenance dialysis. Predisposing factors include secondary hyperparathyroidism, an elevated calcium-phosphorus product, vascular calcification, hypercalcemia, uremic milieu and hyperphosphatemia.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

    Be Human Stop Child Abuse (Team IMA for CMAAO)


What is trafficking?

Trafficking is the moving, selling or buying of woman and children for prostitution within and outside a country for monetary or other consideration with or without the consent of the person subjected to trafficking. (SAARC Convention on Preventing and Combating Trafficking in Woman and Children for Prostitution).

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Alzheimer biomarkers linked to sleep-disordered breathing

Sleep-disordered breathing in healthy elderly subjects is associated with several biomarkers for Alzheimer's disease, leading researchers to think that sleep-disordered breathing might be a risk factor for the development of dementia. (Source: Medscape)

New immune disease cripples white cells

A newly-described immunodeficiency syndrome of neutrophil defects, bone marrow fibrosis, nephromegaly, and life-threatening infections arises from a genetic mutation that impairs movement of proteins within cells, researchers found. (Source: Medpage Today)

CDC updates HIV preexposure prophylaxis guidelines

The Centers for Disease Control and Prevention (CDC) has updated its recommendations on the use of preexposure prophylaxis (PrEP) in individuals at high risk of acquiring HIV to include its use in injection drug users (IDUs) as well as those with high-risk sexual behaviors, the agency announced. The recommendations follow the results of a clinical trial, published online June 12 in the Lancet, that showed that a daily oral dose of 300 mg of tenofovir disoproxil fumarate (TDF) is effective at reducing HIV infection acquisition among injection drug users. (Source: Medscape)

Low vitamin D causes high BP, study shows

A genetic study of more than 150,000 individuals internationally has confirmed a causal association between low levels of vitamin D and hypertension, researchers reported. Source: Medpage Today)

FDA: New boxed warning for clot risk with immune globulin

New data have further strengthened the link between human immune globulin products and the risk for thrombosis, prompting action by the US Food and Drug Administration (FDA). (Source: Medscape)

   Twitter of the Day

@DrKKAggarwal: Nine modifiable risk factors for heart attack http://blog.kkaggarwal.com/2013/06/nine-modifiable-risk-factors-for-heart-attack-2/ …

@DeepakChopra: My intent is to be sensitive to the thoughts & feelings of all I come into contact with. Support me at @Intentdotcom http://bit.ly/12n6tIK

    Spiritual Update

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

Significance of lighting a lamp in any worship?

I prostrate to the dawn/dusk lamp; whose light is the Knowledge Principle (the Supreme Lord), which removes the darkness of ignorance & by which all can be achieved in life.

For comments and archives

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

Dr. Kaberi Banerjee, Director Precious Baby Foundation

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 includes:

  • 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
   An Inspirational Story

The paradox of our time

The paradox of our time in history is that we have taller buildings, but shorter tempers; wider freeways, but narrower viewpoints. We spend more, but have less; we buy more, but enjoy it less. We have bigger houses and smaller families; more conveniences, but less time. We have more degrees but less sense; more knowledge, but less judgment; more experts, yet more problems; more medicine, but less wellness.

We drink too much, smoke too much, spend too recklessly, laugh too little, drive too fast, get too angry too quickly, stay up too late, get up too tired, read too little, watch TV too much, and pray too seldom. We have multiplied our possessions, but reduced our values. We talk too much, love too seldom and hate too often.

We’ve learned how to make a living, but not a life. We’ve added years to life, not life to years. We’ve been all the way to the moon and back, but have trouble crossing the street to meet the new neighbor. We’ve conquered outer space, but not inner space. We’ve done larger things, but not better things. We’ve cleaned up the air, but polluted the soul. We’ve split the atom, but not our prejudice. We write more, but learn less. We plan more, but accomplish less. We’ve learned to rush, but not to wait. We build more computers to hold more information, to produce more copies than ever, but we communicate less and less.

These are the times of fast foods and slow digestion; big men, and small character; steep profits, and shallow relationships. These are days of two incomes, but more divorce; fancier houses, but broken homes. These are days of quick trips, disposable diapers, throwaway morality, one night stands, overweight bodies, and pills that do everything from cheer, to quiet, to kill.

It is a time when there is much in the show window and nothing in the stockroom….a time when technology can bring this letter to you, and a time when you can choose either to share this insight, or to just hit delete.

Remember; spend some time with your loved ones, because they are not going to be around forever. Remember to say a kind word to someone who looks up to you in awe, because that little person soon will grow up and leave your side. Remember to hold hands and cherish the moment for someday that person will not be there again. Give time to love, give time to speak, and give time to share the precious thoughts in your mind.

And always remember, life is not measured by the number of breaths we take, but by the moments that take our breath away.

For comments and archives

   Cardiology eMedinewS

Low diastolic pressure linked to brain atrophy Read More

   Pediatric eMedinewS

Kids' high BP tied to arterial stiffness as adults Read More

    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

Can rabies be transmitted through sexual intercourse?

Rabies virus is present in the semen and to some extent in vaginal secretions. Priapism, increased sexual libido and indulgence are seen both in male and female rabies cases. Hence, in the exposed person, a full course of rabies post-exposure vaccination either by Intramuscular (IM) or Intradermal (ID) route should be given. If there is any doubt of category III exposures, that is, abrasion on penis or in vagina, then RIG must also be given by IM route.

    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.

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.

  Quote of the Day (Dr GM Singh)

Let us follow our destiny, ebb and flow. Whatever may happen, we master fortune by accepting it. Virgil

    Mind Teaser

Read this…………………

A focused examination for fibromyalgia includes assessment for:

1. Autonomic changes, peripheral neuropathy, and skin fold tenderness.
2. Morning fatigue, widespread body pain, and focal tenderness.
3. Skin rashes, edema, and constipation.
4. Unilateral weakness, hyperesthesia and allodynia.

Yesterday’s Mind Teaser: Which medication is the best choice to treat breakthrough pain for a patient who is currently receiving methadone, 10 mg, every 8 hours?

1. Methadone
2. Immediate release morphine
3. Sustained release morphine
4. Transdermal fentanyl

Answer for yesterday’s Mind Teaser: Immediate release morphine

Correct answers received from: Shailaja Boregowda, Tukaram Pagad, Prabha Sanghi, Dr BK Agarwal, Dr BB Gupta, Dr Bharat Bhushan Aggarwal,
Dr PC Das, Dr K Raju, Dr Arpan Gandhi, Dr Kanta Jain, Dr Pankaj Agarwal,
Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Dr Chandresh Jardosh, Dr Bitaan Sen & Dr Jayashree Sen.

Answer for 11th June Mind Teaser: Guided imagery

Correct answers received from: Muthumperumal Thirumalpillai, Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

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    Laugh a While (Dr GM Singh)

Everything is funny as long as it is happening to somebody else. Will Rogers

    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

(Press Release for use by the newspapers)

Do not ignore joint pain

Joint pains need immediate diagnosis and proper treatment Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President-Elect IMA.

Checklist for joint pain

  • Which joint hurts, and which parts of the body are affected.
  • Has the pain just begun, and whether you've felt it before.
  • Did the pain start suddenly or slowly, and is it persistent or fluctuates.
  • Any recent injuries, fevers or illnesses.
  • What makes the pain feel better, and what makes it feel worse.
  • Any other symptoms, including numbness or stiffness.
  • Times of day when the pain is better, and times when it feels worse.

Any joint pain which improves with exercise, is more in the morning, is associated with joint deformity, should be reported to doctor immediately.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 54572 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

    Readers Response
  1. Dear Dr KK Aggarwal,

    I always find e-Medinews very informative and useful.

    Regarding your section on IJCP special, you have rightly directed the treatment of possible endometritis and minimal PID in a woman with typical symptoms and signs. However apart from doxycycline and metronidazole, two more things are important:

    1. Counseling and advice regarding HIV and other RTIs (I don’t know if it is implied, but it must be executed invariably, particularly in premenopausal women, if one wants to prevent serious illnesses, sometimes life threatening)

    2. Treatment of the male partner, which was not included in your general management, if an STI is suspected

    There are several STIs and only 30-50% of these may be symptomatic. One of the major causes of Pelvic Inflammatory Diseases is re-infections. Hence contacting, counseling and treating the male partner will go a long way in preventing complications such as infertility, ectopic gestation, menorrhagia, pelvic pain, dyspareunia and sometimes cervical cancer. Complications can also arise in the males, but are much less common.

    Even if the male partner cannot be contacted physically, talking to them on the phone does help. We usually tell the male partners that the RTI/STIs are sometimes acquired through unhygienic conditions like common toilets etc. and some of these infections are transmitted through sexual contact. We inform them of some major complications and also tell them that the women will have recurrence unless both are treated. Male complications are also hinted at. We have found more that 90% of men co-operate and undergo treatment.

    Negligence by general physicians, surgeons, ayurvedic physicians, homeopathic physicians in couple management can cause misery to several women as the common men and women are not aware of these complications. Not only should the male partners of symptomatic women be counseled, also male patients with genitourinary complaints should be advised to get their female partners treated in order to prevent recurrences and complications in women.

    Lastly genital tract infections can cause pregnancy loss, diseases of the neonates, premature births, low birth weights, mental retardation etc, and can affect future generations even if they are asymptomatic.

    Hence we request that all physicians irrespective of specialty to treat RTIs/STIs with as much care (including couple management) as much as is possible.

    Thanks for the e-journal, and for the patience to read this answer if you have read it completely.

    Regards Dr Jayashree Joshi
    Forthcoming Events

ZOONOSIS – 2013-Conference on Prevention of Diseases
Communicable from Animals to Human

Saturday, 6th July, 9.30 am – 5 pm

Venue: New Delhi

(All About Flu, Malaria, Dengue, Chikungunya, Japanese Encephalitis, Rabies, Neurocysticercosis, Leptospirosis, Food Allergies etc.)

For Free Registration:

Email: rekhapapola@gmail.com
Phone: 9899974439 (Rekha Papola), 9810301261 (Dr Uday Kakroo)

Enrollment for workshop

Heart Care Foundation of India under the aegis of Perfect Health Mela is organizing a series of skill workshops in the month of Oct as per the following programmes

Communication Skills 23rd October, Wednesday
8 am
Constitution Club of India
4 hours
Handling Media crisis Saturday 26th October
2 pm
Constitution Club of India
1 hour
Conflict Management 24th October Thursday
10 am
Constitution Club of India
2 hours
Organizational Behavior 24th October Thursday
8 am
Constitution Club of India
2 hours
Team Building 25th October, Friday
8 am
Constitution Club of India
2 hours
Time Management 25th October, Friday
10 am
Constitution Club of India
2 hours

The workshops will have experts interacting both theoretically and with practical demonstrations and interactions. If interested, kindly confirm your registration at rekhapapola@gmail.com. You can also forward this information to your interested friends and colleagues for a registration.

Dr KK Aggarwal
Padma Shri and Dr B.C. Roy National Awardee
President of Heart Care foundation of India

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