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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

  Editorial ...

16th November 2010, Tuesday

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

Will drinking help my heart or harm my health?

While heavy drinking will raise blood pressure and cause many other health problems, moderate drinking does not lead to hypertension; moderate "dose" amounts to one to two drinks a day, counting 5 ounces of wine, 12 ounces of beer, or 11/2 ounces of liquor as one drink.  

  • A Harvard study evaluated 5,164 male physicians with hypertension but no other cardiovascular diseases.
  • The study began in 1982 and lasted next 26 years.
  • Moderate drinking was associated with a reduced risk of heart attacks, even in these hypertensive men.
  • As compared with their non–drinking peers, men who averaged five to seven drinks a week experienced a 22% lower risk of heart attacks, while men who averaged over eight drinks a week enjoyed a 43% lower risk.
Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
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  SMS of the Day

(By Dr. G.M.Singh)

"The way to win is to work, work, work, work, and hope to have a few insights. And you’re probably not going to be smart enough to find thousands in a lifetime. And when you get a few, you really load up. It’s just that simple."

Charlie Munger

    Photo Feature (from the HCFI Photo Gallery)

 Inauguration – 17th MTNL Perfect Health Mela

Prof. Dr. Kiran Walia Health Minister, Delhi inaugurated the 17th MTNL Perfect Health Mela. She said in her message that Delhi Government would soon be launching a lifestyle awareness campaign

Dr K K Aggarwal
    National News

Certificate courses in 2D and 3D Echocardiography/ Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

Bid to nip diseases in the bud

In an attempt to reduce the global impact of chronic non–communicable diseases one community at a time, non–government organisation Arogya World launched the framework for its ‘Healthy Schools and Healthy Workplace–Seal of Approval" here (New Delhi) on Thursday. The programme has been developed in partnership with HRIDAY–SHAN, Centre for Chronic Disease Control (CCDC) and Public Health Foundation of India (PHFI), all prominent Delhi–based public health organisations. As part of the programme, schools and workplaces in India will be invited to participate in this initiative and will be recognised for their health promotion efforts. (Source: The Hindu)

    International News

(Contributed by Rajat Bhatnagar International Sports & Fitness Distribution, LLC)

New findings contradict CDC predictions on obesity.

Researchers at Harvard University say America’s obesity epidemic won’t plateau until at least 42 percent of adults are obese, an estimate derived by applying mathematical modeling to 40 years of Framingham Heart Study data. Their work, published this week in the journal PLoS Computational Biology, runs counter to recent assertions by some experts that the obesity rate, which has been at 34 % for the past five years, may have peaked. An additional 34 % of American adults are overweight but not obese, according to the federal government’s Centers for Disease Control and Prevention. The Harvard scientists say that their modeling shows that the proliferation of obesity among American adults in recent decades owes in large part to its accelerating spread via social networks. "Our analysis suggests that while people have gotten better at gaining weight since 1971, they haven’t gotten any better at losing weight," says lead author Alison L. Hill, a graduate student in Harvard’s Program for Evolutionary Dynamics, Biophysics Program, and at the Harvard–MIT Division of Health Sciences and Technology. "Specifically, the rate of weight gain due to social transmission has grown quite rapidly."

The projections by Hill and colleagues are a best–case scenario, meaning that America’s obesity rate could rise above 42 % of adults. One silver lining is that their model suggests the U.S. population may not reach this level for another 40 years, making the future rate of increase much more gradual than over the past 40 years. Only 14 % of Framingham Heart Study participants were obese in 1971.

(Dr Monica and Brahm Vasudev)

Stroke risk may increase within an hour of drinking coffee

Stroke risk increases in the hour after drinking a cup of coffee, researchers found after evaluating 390 individuals. Occasional coffee drinkers or those who drink one or fewer cups of coffee a day are at a higher risk. This risk reverses itself within two hours. The study is published in the journal Neurology.

Forcing food manufacturers to reduce salt in processed food may help cut heart disease rates

Forcing food manufacturers to cut salt levels in processed food could help cut heart disease rates, say Australian researchers from the University of Queensland.

Omega–3 fatty acid supplements may not improve memory of patients with Alzheimer’s

A major study published Nov. 3 in the Journal of the American Medical Association found that omega–3 fatty acid supplements, also known as fish oil pills, do not improve the memory of older patients with the disease.

    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What are the complementary and alternative treatments of infertility? 


In a German study published in 2002, acupuncture performed 25 minutes before and after IVF embryo transfer increased IVF pregnancy rates. In a similar study conducted by The University of South Australia in 2006, the acupuncture group’s odds (although not statistically significant) were 1.5 higher than the control group. Although definitive results of the effects of acupuncture on embryo transfer remain a topic of discussion, study authors state that it appears to be a safe adjunct to IVF.

For queries contact: banerjee.kaberi@gmail.com

    Gastro Update

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

How do you monitor cystic fibrosis liver disease?


Given the challenges in diagnosing cystic fibrosis (CF) liver disease, periodic monitoring for hepatobiliary disease is recommended for all patients with CF. Annual monitoring should include physical examination for liver span, texture, and spleen size, as well as laboratory studies such as complete blood count, liver tests, and fat–soluble vitamin status. Further, because hepatobiliary disease may be a presenting feature in a small percentage of patients, sweat test or mutational analysis should be performed in any patient with undefined liver or biliary disease, even those without overt symptoms of CF.

    Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

Paracetamol poisoning

Paracetamol, which is also known as acetaminophen, is the most widely prescribed drug by doctors to treat fever, pain, colds and influenza. Paracetamol in large doses can damage to the liver, kidneys and result in poisoning and unconscious or drowsy.

  • If the paracetamol has been swallowed < 15 hours ago and the patient is fully awake and breathing normally, give methionine as an antidote. The dose of methionine is
    • Adults: 2.5 g by mouth, every 4 hours for 4 doses.
    • Children: 1 g by mouth, every 4 hours for 4 doses.
    • The first dose of methionine should not be given > 15 hours after the paracetamol was taken. If the patient vomits within 1 hour of taking methionine, repeat the dose once.
    • Monitor fluid, electrolytes, blood glucose, and liver and kidney function. Supportive care should be given as needed and fluid and electrolyte balance should be corrected.
  • Acetylcysteine may be used if the paracetamol was swallowed < 24 hours ago. It can be given IV or orally. It may cause nausea and vomiting when given by the oral route. IV acetylcysteine may cause nausea, flushing, skin reactions and, rarely, angioedema, wheezing, and respiratory distress.
    • If serious reactions occur, stop the infusion, give antihistamine then either restart the infusion or give methionine instead.
    • Dose for adults and children: – 150 mg/kg of body weight in 200 ml of 5% dextrose, by slow IV infusion over 15 minutes; then 50 mg/kg of body weight by IV infusion in 500 ml of 5% dextrose over 4 hours; then 100 mg/kg of body weight in 1000 ml of 5% dextrose over 16 hours. This gives a total dose of 300 mg/kg of body weight, given over 20 hours 15 minutes.
  • If you do not have a preparation of acetylcysteine that can be given IV, preparations meant for treating chronic asthma can be given by mouth. These are usually 10% or 20% solutions of acetylcysteine. They should be diluted immediately before use with fruit juice, soft drink or water to make a 5% solution.
    MCI Column

Prof. M C Gupta, MD (Medicine), MPH, LL.M., Advocate & Medico-legal Consultant www.writing.com/authors/mcgupta44

New MCI guidelines diluting the faculty requirements in forensic medicine departments.

Q: The MCI has recently issued new guidelines whereby the required faculty strength in forensic medicine departments in the medical colleges has been diluted. This will result in lowering the standards of medical education in India. What should be done?

A: It is the Constititutional duty of the central government to uphold the standards of medical education in India. It is the legal duty of the MCI to act as the watchdog for such standards. If medical standards are likely to be diluted by any action of the government or the MCI, a writ petition to the court may result in appropriate remedy. Such a writ petition can be filed only when a proper legally drafted representation has been made to the authorities concerned in this regard but the same has been ignored by them. I suggest that the Indian Academy of Forensic medicine or some other forensic association or some other association of doctors or some individual should, as the first step, send such a representation.

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum calcium
As part of a routine metabolic, electrolyte panel, in persons with kidney, bone, or nerve disease, or when symptoms of significantly increased or decreased calcium concentrations are present.

    Medi Finance Update

Personal Accident Insurance

  • Medical or surgical treatment (except where such treatment is rendered necessary within the scope the policy).
  • Aviation other than as a passenger (fare-paying or otherwise) in any duly licensed standard type of aircraft any where in the world.
  • Nuclear radiation of nuclear weapons materials.
    Drug Update

List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

Drugs prohibited from the date of notification

Fixed dose combination of Oxyphenbutazone or Phenylbutazone with any other drug

    IMSA Update

International Medical Science Academy (IMSA) Update

Oocyte triggering in antagonist assisted reproductive technology cycles

A Cochrane review recommends against routine use of GnRH agonists as a final oocyte maturation trigger in fresh autologous cycles because of lowered live birth rates and ongoing pregnancy rates. An exception could be made for women with high risk of OHSS, after appropriate counseling.

(Ref: Youssef MA, et al. Gonadotropin–releasing hormone agonist versus HCG for oocyte triggering in antagonist assisted reproductive technology cycles. Cochrane Database Syst Rev 2010 Nov 10;11:CD008046.

    IJCP Special

Dr Good Dr Bad

Situation: An elderly type 2 diabetic patient with cancer lung came with A1c of 7.5%.
Dr Bad: This is high. You need insulin therapy.
Dr Good: This result is ok.
Lesson: As per the 2007 American College of Physicians (ACP) guidelines, A1C goal is > 7% for type 2 diabetic patients who are elderly or frail or have a limited lifespan due to comorbid condition.

Make Sure

Situation: A patient with diabetes shows deteriorating kidney function.
Reaction: Oh my God! His HbA1c is very high!
Lesson: Make sure that strict glycemic control is maintained in patients with type 2 diabetes in order to delay vascular complications.

    Lighter Side of Reading

An Inspirational Story

(Contributed by Rajat Bhatnagar)

Positive differences in the kids in your life

How they spend their time

If you want to maximize your child's health, it's important to monitor how they spend their time. Many American kids spend four hours each day watching TV and/or playing video games. Limit the amount of time they are allowed to carry out idle activities to no more than two hours each day. They may fight it at first, but keep encouraging them to go outside and be physically active, and above all, be consistent.

Don’t give in just because they whine and get upset. Be firm and they will eventually realize you mean business, and they’ll find ways to entertain themselves that don’t require an electric outlet or batteries. Again, the best way to influence your child’s behavior is through modeling. Be active together as a family and they will learn to be active on their own.


Mind Teaser

Read this…………………


Yesterday’s Mind Teaser: "go it it it it"
Answer for yesterday’s eQuiz:
"Go for it "

Correct answers received from: Dr Virender P Gautam, Dr. Rajiv Dhir, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr Sudha Nayyar, Dr Avdhesh Shukla, Dr Sudipto Samaddar, Dr. K. P. Rajalakshmi, Dr Sanjit Saha, Dr R S Bajaj, Dr. Rohini, Dr. Satish Gunawant, Dr Aditya Rattan, Dr.K.Raju,Dr Nageshwar Rao, Dr Prabha Sanghi

Answer for 14th November Mind Teaser: "You’re under arrest"
Correct answers received from: B.Krishnan, Dr Avdhesh Shukla, Dr Sudipto Samaddar, Dr Anurag Jain, Dr Bhavisha Brahmbhatt, Dr.K.Raju, Dr Meera Rekhari, Dr Virender P Gautam

Send your answer to ijcp12@gmail.com


Laugh A While
(Contributed by Dr G M Singh)

Writing Home from College

One woman was bragging to her next–door neighbor about her son, a college student at the University of Illinois. "Why, our son is so brilliant, every time we get a letter from him we have to go to the dictionary."

"You're lucky," the neighbor said. "Every time we get a letter from our son in college, we have to go to the bank!"

    Readers Responses
  1. Dear Sir, eMedinewS is really very informative. Your editorial ‘How much salt is too much?’ is very helpful and also timely in view of the high prevalence of diseases such as hypertension, which in turn increases the chances of heart attack or stroke. My best wishes to you. Regards: Dr Prachi
    Public Forum

(Press Release for use by the newspapers)

Eat less to remember more

Eat less is the new prescription for the elderly said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.
Calorie restriction boosts memory and cognition by reducing insulin resistance and inflammation, which may be linked to age related cognitive decline. Improvements in memory could be especially important, because memory losses are an early indication of Alzheimer's disease and its precursor, mild cognitive impairment.
Dr Aggarwal further said that one should eat less and weigh less. Cutting calories leads to long term weight loss. The body's energy requirements progressively decline with age, energy intake must mirror that decrease or weight gain occurs. Women who practice eating restraint avoid the significant weight gain commonly observed in middle age.

Eating less doesn't just boost physical health. In elderly people, it also improves memory.

Tips for better eating: Record what you eat and how much. Put less food on your plate. Eat more fruits and vegetables. The U.S. food pyramid recommends at least five servings each day.

    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Workshop on Kidney Transplant

International Medical Science Academy, eMedinewS, Moolchand Medcity Board of Medical Education, IMA New Delhi Branch and IMA Janak Puri Branch

Date: Sunday 28th November
Venue: Moolchand Medcity Auditorium, 9 – 12 noon

Chairperson: Dr (Prof) S C Tiwari, Director Fortis Institute of Renal Sciences & Kidney Transplant

Moderators: Dr KK Aggarwal, Dr Kamlesh Chopra, Dr Sanjay Sood, Dr A K Kansal, Dr Archna Virmani
9.00 – 9.30 AM: Kidney transplant scenario in India: Dr Sandeep Guleria, Transplant Surgeon, AIIMS
9.30 – 10.00 AM: Kidney Transplant: What every one should know: Dr Ramesh Hotchandani, Senior Nephrologist, Moolchand Hospital
10.00 – 10.30 AM: Transplant immunobiology and immunosuppression. Dr Monica Vasudev, Assistant Professor Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee
10.30 – 11.00 AM: Kidney Transplant: managing difficult cases. Dr Brahm Vasudev, Assistant Professor of Medicine, Division of Nephrology, Director, Nephrology Fellowship Program, Medical College of Wisconsin
11.00 – 12.00 AM: Panel discussion
12.00 Noon: Lunch

(Registration free: email to emedinews@gmail.com

eMedinewS Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 08–09, 2011.

January 08, 2011, Saturday, 6 PM – 9 PM – Opening Ceremony, Cultural Hungama and eMedinewS Doctor of the Year Awards. For registration contact – emedinews@gmail.com

January 09, 2011, Sunday, 8 AM – 6 PM – 2nd eMedinewS revisiting 2010, A Medical Update

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