Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
  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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Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of 1st Mega Ajmer Health Camp 2012

  Editorial …

18th March 2012, Sunday

Vitamin D intake associated with reduced risk for Crohn’s disease

Increased intake of vitamin D may significantly reduce the risk for Crohn’s disease (CD) in women, according to an article published online December 12 and in the March issue of the journal Gastroenterology.

  • This study involved 72,719 women who returned the 1986 questionnaire. They had data on both vitamin D intake and physical activity and did not have a history of CD or UC.
  • Diagnosis of CD was based on a typical history of 4 weeks or longer and was confirmed by radiologic, endoscopic, or surgical evaluation.
  • The diagnosis of ulcerative colitis (UC) was based on typical clinical presentation of 4 weeks or more and endoscopic, radiologic, or surgical evaluation.
  • Mean age of the participants at baseline was 53 years, mean body mass index (BMI) was 25.4 kg/m2, mean physical activity was 13.2 metabolic hours per week, 94.5% were white and 36.6% never smoked.
  • A documented 122 cases of CD and 123 cases of UC were recorded during 1,492,811 person–years of follow–up. The median predicted 25(OH)D level was 27.6 ng/mL.
  • Women in the lowest quartile of predicted 25(OH)D level compared with those in the highest quartile had a higher body mass index, were less active, tended to reside in the Northern or Midwestern regions of the United States, and had lower intake levels of dietary or supplemental vitamin D. The median age of diagnosis of CD was 64.0 years; for UC, it was 63.5 years.
  • The median interval between assessment of plasma 25(OH) D levels and disease diagnosis was 12 years for UC and 10 years for CD.
  • For every 1 ng/mL increase in predicted 25(OH)D level, the risk for CD was reduced by 6%.
  • For UC, there was also a reduction in risk, but it was non-significant at 4%.
  • Women in the highest two quartiles of 25(OH)D levels had multivariate HRs of 0.50 and 0.55, respectively, for CD
  • Each 100 IU/day increase in total intake resulted in a 10% reduction in UC risk and a 7% reduction in CD risk.
  • For vitamin D intake from diet and supplements based on quartile distribution, there was a significant linear inverse trend for vitamin D intake and UC risk, but this trend was weaker for CD.
  • Intakes of 800 IU/day or higher resulted in greater reductions in the risks for UC and CD
  • Vitamin D intake was inversely associated with the risks for CD and UC, vitamin D insufficiency or deficiency was an important mediator in the pathogenesis of UC and CD, and assessment of vitamin D status should be a part of the assessment of inflammatory bowel diseases.

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

Vitamin D intake associated with reduced risk for Crohn’s disease

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Yadein, the musical concert was organized in the memory of Legendary Ghazal Maestro Shri Jagjit Singh as well as to create awareness about prevention of brain hemorrhage. Padma Shri and Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India, and Ms Geeta Thakur (Roshini), President Humkhayal welcomes Mr Tauseef Akhtar, Singer of the night

Dr K K Aggarwal
    National News

Budget 2012: Experts differ over healthcare tax relief

The proposal to allow tax relief of up to Rs.5,000 for preventive health check–up is among the few health–friendly measures in the Budget. But expert opinion on its likely impact is divided. The industry welcomed the proposal. Super Religare Laboratories CEO Sanjeev K. Chaudhry said the tax relief on preventive checkups and larger outlay for the health sector augurs well for the diagnostics industry. But public health experts disagree on the tax relief measure. Public Health Foundation of India chairman Dr K. Srinath Reddy said: "There is a danger of people getting trapped in a spiral of unnecessary testing." Dr D. Prabhakaran of Centre for Chronic Disease Control said: "Awareness being low, how many will use this exemption? And how many have access to preventive care in India? In such a situation, it may increase unwanted procedures in the absence of strict guidelines."
(Source: http://indiatoday.intoday.in/story/budget–2012–experts–differ–over–healthcare–tax-relief/1/178154.html)

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

    Free Eye camp held

(Dr. Balraj Singh Yadav, Krishna Medicare Centre, Friends Colony, Jharsa Road, Gurgaon)

A Free Eye camp was held March 16 at Village Mohanpur in association with AIIMS Delhi on 15 March 2012. Forty three patients in the camp were selected for IOL to be operated in AIIMS free of cost. Eighty patients will be given free spectacles.

    International News

Adding COX–2 inhibitor helps relieve severe depression

In a pilot study of 66 patients with major depression, the cyclooxygenase–2 (COX–2) inhibitor cimicoxib, when added to standard sertraline therapy, showed beneficial effects in a subgroup of 23 patients with severe depression (20th European Congress of Psychiatry). (Source: Medscape)

No benefit seen for device closure of patent foramen ovale

Closing a patent foramen ovale with a percutaneous device was no better than medical therapy alone for preventing recurrent strokes or transient ischemic attacks (TIAs) among patients with cryptogenic stroke, a randomized trial showed. (Source: Medpage Today)

Laquinimod slows progression in MS: ALLEGRO published

Results of a phase 3 randomized trial show treatment with laquinimod, a still–investigational oral agent, reduced annualized relapse rates and delayed disability progression compared with placebo in patients with relapsing–remitting multiple sclerosis (MS). Final results of the Assessment of Oral Laquinimod in Preventing Progression in Multiple Sclerosis (ALLEGRO) trial are published in the March 15 issue of the New England Journal of Medicine. Findings were first presented last year at the American Academy of Neurology’s 63rd Annual Meeting and reported by Medscape Medical News at that time. (Source: Medscape)

Natural pain relief an option in childbirth

Nonpharmacologic pain management appears to be safe for mother and baby, although there is limited published evidence to explain its efficacy, according to a Cochrane Review. On the other hand, there is more data to support the ef?cacy of pharmacologic pain management, such as epidurals and opioids, but these methods lead to more adverse effects, wrote James Neilson, MD, of the University of Liverpool in England, and colleagues in the Cochrane Database of Systematic Reviews. (Source: Medpage Today)

    Twitter of the Day

@DrKKAggarwal: I have posted 375 photos on Facebook in the album "Yadein – the musical concert" http://fb.me/1JfN3ifWR

@DeepakChopra: Consciousness is designed to lead to solutions. All that is needed is to let it unfold naturally and spontaneously.

    Spiritual Update

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

From E–Mail to Eye Mail

Social Intelligence is the ability to get along well with others, and to get them to cooperate with you. Also called "people skills," social intelligence, includes an awareness of situations and the social dynamics that govern them, and knowledge of interaction styles and strategies that can help a person achieve his or her objectives in dealing with others.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What is hyperprolactinemia?

Hyperprolactinemia is a condition in which too much prolactin is present in the blood of women who are not pregnant and in men. In women, this results in a decline in the body’s production of progesterone after ovulation which, in turn, can lead to irregular ovulation and infrequent menstruation, cause you to stop menstruating altogether, or cause your breasts to start producing milk, a condition called galactorrhea. Men also can experience galactorrhea. High prolactin levels in men can also lead to impotence, reduced libido, and infertility.

For comments and archives

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

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

Timeline of successful transplants

  • 1981: First successful heart/lung transplant by Bruce Reitz (Stanford, USA)
  • 1983: First successful lung lobe transplant by Joel Cooper (Toronto, Canada)
  • 1984: First successful double organ transplant by Thomas Starzl and Henry T. Bahnson (Pittsburgh, USA)
  • 1986: First successful double–lung transplant (Ann Harrison) by Joel Cooper (Toronto, Canada)

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

Story of Appreciation

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’s 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?

For comments and archives

    Fitness Update

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

Effect of exercise on depressive symptoms in patients with a chronic illness

Inactive lifestyle and associated depressive symptoms can be common among patients with a long term, chronic illness. Several studies have shown the promising benefits of exercise in reducing some of these symptoms. A study featured in the Archives of Internal Medicine reviewed 90 articles from multiple online data sources. Articles covered 10,534 physically inactive patients with chronic disease, and involved randomization of patients to an exercise or non–exercise program. Findings showed that exercise significantly decreases depressive symptoms in people with chronic illness. The greatest effects were observed in patients who had the highest score for depressive symptoms at baseline, patients who met the recommended levels of physical activity, and patients who saw improvements in overall function.

For comments and archives

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    Cardiology eMedinewS

FDA News on Statins Read More

Taurine May Reduce Heart Disease Read More

Matrix Metalloproteinase: A Potential Target In Treatment Of Cardiovascular Complications Of Diabetes Read More

    Pediatric eMedinewS

Factors Predict Post–NICU Death in Tiniest Babies Read More

Home Births Associated With More Seizures, Lower Apgar Scores Read More

    IJCP Special

Dr Good Dr Bad

Situation: A diabetic with A1c 6% had a BP of 130/88 mmHg.
Dr Bad: This is very good control of diabetes.
Dr Good: This is very good control but we also need to control BP.
Lesson: Cardiovascular morbidity can only be reduced with aggressive management of hypertension, cholesterol (LDL <100 mg/dL) and aspirin (75–150 mg/day) in patients with or at high risk for cardiovascular disease.

For comments and archives

Make Sure

Situation: A patient with fever and cough develops complications after he was given antibiotics.
Reaction: Oh my God! What was the need of giving the antibiotics?
Lesson: Make sure a patient with fever and cough is not given antibiotics as presence of cough is mostly due to viral infection.

For comments and archives

    Microbial World: The Good and the Bad they do

(Dr Sunil Sharma, Senior Consultant Microbiology, Medanta The Medicity)

Antibiotics per se do not produce resistance but selects the resistant strains.

In 1952, Joshua and Esther Lederberg showed that penicillin–resistant bacteria existed before penicillin treatment. Joshua Lederberg and Norton Zinder also demonstrated preexistent bacterial resistance to streptomycin. In 1962, penicillinase was detected in dormant Bacillus licheniformis endospores, isolated from the soil on the roots of plants, in the British Museum preserved since 1689. Six strains of Clostridium, isolated from the bowels of two members of Franklin Expedition in 1845, showed resistance to cefoxitin and clindamycin.

When penicillinase–rich Staphylococcus aureus and penicillin–producing Trichophyton are part of a common environment, it is suggested that penicillinase may have emerged as a defense mechanism for the bacteria in such a habitat. Such strategy is in line with Sir Charles Darwin’s theory of ‘Survival of the fittest’.

Antibiotic resistance gene may originate as point mutations in the pathogen genome at a rate of about 1 in 108 per chromosomal replication. A single cell through binary fission in 25 rounds can produce a population size of 33,554,432 cells! If the time between generations is 30 minutes, this population size would be achieved in 12.5 hours!

For comments and archives

    Quote of the Day

(Dr GM Singh)

Thousands of candles can be lit from a single candle, and the life of the candle will not be shortened. Happiness never decreases by being shared. Buddha

    12 Most Common Technology Hazards (Part 9)

Anesthesia dangers from mistakes in pre–use inspection

Serious problems with anesthesia equipment occur frequently. Reports include misconnected breathing circuits, ventilator leaks, and empty gas cylinders. In practice, pre–use inspections can be inconsistent and incomplete. Hospital staffs sometimes conduct checks using obsolete or generic procedures, says Keller. Staff may skip a portion of the inspection if they don’t understand its importance.

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Iron deficiency anemia

In iron deficiency anemia, the serum iron concentration is reduced, and the level of transferring also measured as total iron binding capacity (TIBC) is elevated; the latter finding reflects the reciprocal relationship between serum iron and transferrin gene expression in most nonerythroid cells.

    Mind Teaser

Read this…………………

Which is false for GIST (Gastrointestinal stromal tumor) of stomach?

a. It is the same as leiomyoma and leiomyosarcoma as described previously.
b. Origin is from mucosa from the interstitial cells of Cajal.
c. Associated with C–Kit Mutation.
d. Imatinab is a new effective drug for adjuvant therapy.

Yesterday’s Mind Teaser: Polyps are generally managed endoscopically. Which of the following is not an indication for resectional surgery?

a) Lymphovascular invasion
b) Poor differentiation
c) Flat or ulcerated lesion
d) Lesion in upper one–third of submucosa

Answer for Yesterday’s Mind Teaser: d) Lesion in upper one–third of submucosa

Correct answers received from: Chandra Pal Singh, Raju Kuppusamy, Dr Thakor Hitendrasinh G,
Dr Jainendra Upadhyay.

Answer for 16th March Mind Teaser: b) Poor differentiation
Correct answers received from: Chanchal Das, Priya, Smita, SD Sharma, Dr KP Sharama.

Send your answer to ijcp12@gmail.com

   Laugh a While

(Dr GM Singh)

I Could Use a Little Money

Dear Father, $chool i$ really great. I am making lot$ of friend$ and $tudying very hard. With all my $tuff, I $imply can’t think of anything I need, $o if you would like, you can ju$t $end me a card, a$ I would love to hear from you. Love, Your $on.

After receiving his son’s letter, the father immediately replies by sending a letter back.

Dear Son, I kNOw that astroNOmy, ecoNOmics, and oceaNOgraphy are eNOugh to keep even an hoNOr student busy. Do NOt forget that the pursuit of kNOwledge is a NOble task, and you can never study eNOugh. Love, Dad.

    Medicolegal Update

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

World Medical Association (WMA) guidelines for medical doctors in biomedical research involving human subjects

  • Doctors should abstain from engaging in research projects involving human subjects unless they are satisfied that the hazards involved are believed to be predictable. Doctors should cease any investigation if the hazards are found to outweigh the potential benefits.
  • In publication of the results of his or research, the doctor is obliged to preserve the accuracy of the results. Reports of experimentation not in accordance with the principles laid down in this Declaration should not be accepted for publication.
  • In any research on human beings, each potential subject must be adequately informed of the aims, methods, anticipated benefits and potential hazards of the study and the discomfort, it may entail. He or she should be informed that he or she is at liberty to abstain from participation in the study and that he or she is free to withdraw his or her consent to participation at any time. The doctor should then obtain the subject’s freely given informed consent, preferably in writing.
  • When obtaining informed consent for the research project the doctor should be particularly cautious if the subject is in a dependent relationship to him or her or may consent under duress. In that case the informed consent should be obtained by a doctor who is not engaged in the investigation and who is completely independent of this official relationship.
  • In case of legal incompetence, informed consent should be obtained from the legal guardian in accordance with national legislation. Where physical or mental incapacity makes it impossible to obtain informed consent, or when the subject is a minor, permission from the responsible relative replaces that of the subject in accordance with national legislation.
  • The research protocol should always contain a statement of the ethical consideration involved and should indicate that the principles enunciated in the present Declaration are complied with.

(Ref: 18th World Medical Assembly, Helsinki, Finland, 1964 and revised by the 29th World Medical Assembly, Tokyo, Japan, 1975).

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)

Act fast: You can reduce the Damage and Death from Heart Attack if……?

Water–soluble aspirin and clot–dissolving drugs can stop most heart attacks in progress, reduce disability and save lives. They work best if given within one hour of when signs of heart attack begin to appear. It is therefore important to recognize the warning signs of a heart attack and act right away, said Dr. K.K. Aggarwal, Padma Shri and Dr B C Roy National Awardee and President, Heart Care Foundation of India.

Every year, over 24 lakh people die of heart attacks in India. About half of those deaths take place within one hour of the onset of warning signs and before the patient even reaches a hospital.
The 5 Warning Signs of a Heart Attack, which everyone must know are:

  • Pain or discomfort in the jaw, neck or back
  • Feeling weak, lightheaded or faint
  • Chest pain or discomfort
  • Pain or discomfort in the arms or shoulder
  • Shortness of breath

Act Fast

  • Take a 300 mg water–soluble aspirin and chew it if you suspect a heart attack.
  • Get yourself rushed to a nearest heart centre for clot–dissolving therapy.
  • You may require an emergency angiography and angioplasty to remove the clot.
  • If there is a cardiac arrest, the bystander should give chest compression, 100 per minute, over the centre of the chest for the next 10 minutes.
    Readers Responses
  1. Dr Ashok Seth /TAVI Team deserve Heartiest congrats ! Prof M E Yeolekar, Mumbai.
    Forthcoming Events
Dr K K Aggarwal

National Summit on "Stress Management" and Workshop on "How to be happy and Healthy"

Date: Saturday 2PM–Sunday 4PM, 21–22 April 2012
Venue: Om Shanti Retreat Center, Bhora Kalan, on Pataudi Road, Manesar
Course Directors: Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal and BK sapna
Organisers: Heart Care Foundation of India, Prajapati Brahma Kumari Ishwariya Vidyalaya and eMedinewS
Fee: No fee, donations welcome in favour of Om Shanti Retreat Center
Facilities: Lodging and boarding provided ( One room per family or one room for two persons). Limited rooms for first three registrants.
Course: Meditation, Lectures, Practical workshops,
Atmosphere: Silence of Nature, Pyramid Meditation, Night Walk,
Registration: Rekha 9899974439 rekhapapola@gmail.com, BK Sapna 9350170370 bksapna@hotmail.com

Study Camp on ‘Mind–Body Medicine and Beyond’

16–23 June 2012, Nainital Centre (Van Nivas)

Sri Aurobindo Ashram – Delhi Branch will organize the 5th Study Camp on ‘Mind–Body Medicine and Beyond’ for doctors, medical students and other health professionals at its Nainital Centre (Van Nivas) from 16–23 June 2012. The camp, consisting of lectures, practice, and participatory and experiential sessions, will help the participants get better, feel better, and bring elements of mind–body medicine into their practice. The camp will be conducted by Prof. Ramesh Bijlani, M.D., former Professor, AIIMS, founder of a mind–body medicine clinic at AIIMS, and the author of Back to Health through Yoga and Essays on Yoga. For more details, send an e–mail to the Ashram (aurobindo@vsnl.com) or to Dr. Bijlani (rambij@gmail.com).

BSNL Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001

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

    eMedinewS Special

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

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    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