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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 …

18th December 2011, Sunday

Rheumatology Update 2011 (ACR)

  1. Treatment with hydroxychloroquine in SLE was significantly protective against the development (50%) of renal failure (Dr Michele Petri, of Johns Hopkins University in American College of Rheumatology meeting 2011).
  2. Monotherapy with etanercept can keep some rheumatoid arthritis (RA) patients in long–term remission. Combination therapy with etanercept and methotrexate is considered standard of care for RA. (Dr Roy Fleischmann, of University of Texas Southwestern Medical School in Dallas at American College of Rheumatology annual meeting 2011).
  3. Treatment with the oral Janus kinase inhibitor tofacitinib resulted in statistically significant and clinically meaningful improvements in all rheumatoid arthritis patient–reported outcomes (Dr Vibeke Strand, of Stanford University in Palo Alto, Calif).
  4. Treatment of early RA with glucosteroids provides relief of symptoms, but the therapy comes with a price – worrisome changes in body fat composition that are significantly increased within the first year (Dr Michael Nurmohamed, at Jan van Breemen Research Institute/Reade, in Amsterdam)
  5. Long–term treatment with the biologic agent etanercept reduces a RA patient’s risk of heart attack and malignancy, and may also reduce the risk of death, when compared with therapy using disease–modifying anti–rheumatic drugs (Dr Duncan Porter, of the University of Glasgow in Scotland).
  6. Long–term treatment with the biologic agent etanercept reduces a RA patient’s risk of heart attack and malignancy, and may also reduce the risk of death, when compared with therapy using disease–modifying anti–rheumatic drugs (Dr Duncan Porter, of the University of Glasgow in Scotland).
  7. RA patients try almost anything to relieve symptoms –– including special jewelry, household oils and even homemade concoctions. Dr Ashutosh Tamhane, at University of Alabama at Birmingham, found that 76% of patients used store–bought lotions for treatment of RA, and 80% utilized heat treatments. About 21% of patients took fish oil supplements; 27% utilized jewelry such as copper chains; 19% tried garlic; and 4% took raisins soaked in vodka or gin for relief (American College of Rheumatology 2011).
  8. A strategy of methotrexate–based tight control in early RA was more effective in preventing joint damage if the initial regimen also included low–dose prednisone. Among patients who received methotrexate plus prednisone, 78% were erosion–free at two years compared with 67% of those who received methotrexate plus placebo, reported Johannes W.G. Jacobs, MD, of University Medical Center Utrecht in the Netherlands, and colleagues.
  9. Even short courses of glucocorticoids in conditions such as lupus, RA, and many other diseases can be associated with the development of osteonecrosis (Steven C. Vlad, MD, of Boston University School of Medicine, at the annual meeting of the American College of Rheumatology 2011)
  10. Patients with rheumatoid arthritis who respond well initially to methotrexate monotherapy may be able to maintain a good outcome on that drug alone, with no radiographic progression (Dr James R. O’Dell, of the University of Nebraska Medical Center in Omaha). (Source: Medpage)

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

Rheumatology Update 2011 (ACR)

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011
Anmol–A Health Festival for Children with Special Needs

This unique event is organized every year to spread the message in the community that disabled children are differently able.

Dr K K Aggarwal
    National News

Japanese encephalitis threat looms over Capital

NEW DELHI: In what has sent alarm bells ringing in the administration, 20% of the blood samples taken from pigs across the city have tested positive for Japanese encephalitis, indicating that the disease is likely to spread in Delhi. Japanese encephalitis, which is endemic to eastern UP and Bihar where it claimed around 1,000 lives this year, is transmitted from pigs to humans by mosquitoes. The blood samples, 81 in all, were collected by MCD following reports of the disease from localities such as Shahdara, Rohini and Shastri Park, among others. The viral disease surfaced for the first time in the city after four people tested positive in October this year. A total of 14 people have been found to carry the virus till date. (Source: TOI, Dec 16, 2011)

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

ASH: Don’t wait to treat smoldering myeloma

The classic clinical approach to smoldering multiple myeloma is watchful waiting, but immediate treatment offers a better outcome for some patients, a researcher said. (Source: Medpage Today)

For comments and archives

ASH: Mental deficits show up early in sickle cell

Kids with sickle cell disease frequently show cognitive impairment while they are still toddlers, and before there is evidence of hemodynamic abnormalities or silent strokes, researchers said.

For comments and archives

HIV: Sooner is better for treatment

For people with early HIV infection, immediate antiretroviral therapy appears to be more beneficial than deferring treatment until patients meet clinical guidelines, researchers reported.

For comments and archives

Diabetes, obesity overshadow lower CV death rate

The U.S. death rate from cardiovascular disease and stroke has been declining, but that trend could be overshadowed by increasing rates of diabetes and obesity, the American Heart Association’s annual update on heart disease and stroke showed.

For comments and archives

    Cardiology eMedinewS

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

Cardiology 2011

Read More

Management of Heart Failure: Dr Mandeep Mehra

Read More

Intra Coronary Glycoprotein

Read More

Remove IVC Filters When Not Needed

Read More

    Twitter of the Day

@DrKKAggarwal: Antidotes of the deadly five passionshttp://blog.kkaggarwal.com/2011/12/16/antidotes–of–the–deadly–five–passions/

@DeepakChopra: #BehappyMakehappy Make someone happy and be happy. Share your happiness here.

    Spiritual Update

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

Antidotes of the deadly five passions

The 5 deadly passions are kama, krodha, lobha, moha and ahankaar. Kama denotes passion for sex, refined carbohydrate food, and wealth; krodha for anger; lobha for greed; moha for undue attachments for material things; and ahankaar for vanity or egoism.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

The Oak and the Reeds

There is an old fable in which the mighty oak tree which stood for over one hundred years finally was blown over by a storm. The tree feel into a river that floated it downstream until it came to rest among the reeds growing along the riverbank. The fallen giant asked the reeds in amazement, "How is it that you were able to weather the storm that was too powerful for me, an oak tree, to withstand?"

The reeds replied, "All these years you stubbornly resisted the winds that swept your way. You took such pride in your strength that you refused to yield, even a little bit. We, on the other hand, have not resisted the winds, but have always bent with them. We recognized the superior power of the wind and so, the harder the wind blew the more we humbled ourselves before it."

Always remember to bend with the wind, and you won’t be blown over by the storm!

For comments and archives

    Fitness Update

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

6 Tips To Stay Healthy During The Winter

Now that temperatures have dropped and we are bundling up our little ones as they leave for school in the morning, it’s important to remember that cold and flu season is here. School–age kids are particularly vulnerable to the spread of colds, viral and bacterial infections. But there are steps you can take to make sure your kids stay healthy throughout the winter season.

Wash Hands Frequently

Proper hand washing is an effective way to avoid spreading germs. Just 15 to 20 seconds of hand washing (or enough time to sing Happy Birthday twice), using water and soap can reduce the risk of transmitting diseases. According to the Centers for Disease Control, hand washing is the single most important means of preventing infection from spreading. If you don’t have access to a sink, hand sanitizer is another good option.

For comments and archives

    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Near visual acuity can be measured with the Rosenbaum pocket vision screening card or by having the older patient read a newspaper or magazine held 14 inches (at arm’s length) from the eyes. Generally newspaper type is equivalent to 20/40 on the Snellen near visual acuity chart.

    Medicine Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta)

Chronic pancreatitis: Etiology

In children, chronic pancreatitis is usually associated with genetic conditions such as typical or atypical cystic fibrosis or hereditary pancreatitis or is idiopathic. In adults, chronic pancreatitis is usually associated with alcoholism (70%) or is idiopathic.

Current thinking regarding chronic pancreatitis is that it begins as acute pancreatitis and progresses to end stage fibrosis. Both genetic and environmental factors influence the rate of progression. Genetic susceptibility factors include PRSSI, SPINKI and CFRT mutations. Hereditary pancreatitis carriers a high risk of malignancy in future. The anatomic variants predisposing to chronic pancreatitis are thought be post traumatic pancreatic duct scars, pre ampullary duodenal wall cysts, sphincter of Oddi disorders (controversial), pancreatic divisum (controversial) and autoimmune pancreatitis. Chronic pancreatitis either in isolation or associated with other syndromes such as Sjogren’s, inflammation bowel disease has also been described. The etiological factors described for acute pancreatitis such as toxins, drugs and metabolic disorders such a hyper calcemia hyperparathryroidism etc., hyyperlipidimia, could also lead to chronic pancreatitis.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient on intergrilin therapy had high grade fever.
Dr Bad: Give injection paracetamol.
Dr Good: Give tablet paracetamol.
Lesson: Minimize procedures including arterial and venous punctures, IM injections, nasogastric tubes, etc. while the patient is on intergrilin therapy.

For comments and archives

Make Sure

Situation: A diabetic hypertensive was denied a beta–blocker because of the traditional teachings.
Reaction: Oh my God! You should have used nebivolol.
Lesson: Make Sure that diabetics are not denied beta–blockers when indicated. Nebivolol has no side effect on glucose metabolism unlike atenolol.

For comments and archives

    Quote of the Day

(Dr GM Singh)

How wonderful it is that nobody need wait a single moment before starting to improve the world. Anne Frank

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


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.

For comments and archives

    Mind Teaser

Read this…………………

Either weigh or whey

Yesterday’s Mind Teaser: 1234

Answer for Yesterday’s Mind Teaser: Count on us

Correct answers received from: Yogindra Vasavada, Dr Prabha Sanghi,
Dr Amit Kochar, Dr Shukla Das, Dr PC Das, Dr Rakesh Bhasin, Raju Kuppusamy, Anil Bairaria, Dr NeelamNath.

Answer for 16th December Mind Teaser: c. Hepatitis B e antigen
Correct answers received from: Dr NeelamNath, Dr Rakesh Bhasin, Raju Kuppusamy, Anil Bairaria, Dr NeelamNath.

Send your answer to ijcp12@gmail.com

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emedinews revisiting 2011
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   Laugh a While

(Dr GM Singh)

Two mental patients were having a discussion. One was telling the other that he can climb anything. So the other grabbed a torch light and, shining the beam in the air, told the other, "Ok, climb that", whereupon, the other retorted, "You think I'm foolish, when I get up there, you’ll turn off the light and cause me to fall down."

    Medicolegal Update

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

Grievous injury Section 320 Indian Penal Code

  1. Emasculation: It means depriving a male of masculine power.
  2. Permanent privation of sight of either eye: The gravity lies in the permanency because it deprives a person the use of the organ of sight.
  3. Permanent privation of the hearing of either ear: It deprives a man of his sense of hearing. Injury to the tympanum or auditory nerve or by thrusting something into the ear which causes deafness.
  4. Privation of any member or joint: The term ‘member’ means an organ or a limb being part of man capable of performing a distinct function. It includes, nose, mouth, hands, feet, phalanges etc.
  5. Destruction or permanent impairing of the powers of any member or joint: the use of limbs and joints of body are essential to the discharge of the normal functions of the body. Their deprivation causes lifelong crippling and makes the person defenseless and miserable.
  6. Permanent disfiguration of the head or face: The word ‘disfigure’ means to cause some external injuries which detracts from his personal appearance but does not weaken him
  7. Fracture or dislocation of a bone or tooth: It is not necessary that a bone should be cut through and through cut should be up to the medulla. If there is a break by cutting or splintering of the bone or there is a rupture or fissure in it, it would amount to a fracture but the doctor must document the dimension of fracture and duration/age correlation with age of injury. Dislocation means displacement. Mere looseness of teeth will not amount to dislocation. It has to prove that the tooth was originally not loose and that there was fracture or dislocation by the injury.
  8. Any hurt which endangers life or which causes the victim to be in severe bodily pain or unable to follow his ordinary pursuits for a period of 20 days: A wound may cause intense pain, prolonged disease or long lasting body injury but does not fall under any of the seven clauses. A body injury/beating may not mutilate the sufferer or fracture his bones but may be so harsh and painful may cause even death. The eighth clause provides for such hurts. Under this, three different clauses of hurt are included. These are:
    1. Any hurt which endangers life
    2. Any hurt which causes the victim to be in severe bodily pain for a period of 20 days
    3. Any hurt which prevents the victim from following his ordinary pursuits for a period of 20 days

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    Public Forum

(Press Release for use by the newspapers)

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Controlling diabetes and high blood pressure can prevent kidney disease

Uncontrolled high blood pressure and diabetes are the two main causes of silent kidney damage said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Presence of proteins in the urine, persistently high uric acid levels in the blood and a low estimated kidney filtration rate can be the early markers of kidney damage.

The cheapest screening test is to get the urine tested for presence of proteins or a blood creatinine level done. One can calculate the estimated kidney filtration by the following formula: (140 minus age multiplied by weight in kg) and divided by (72 multiplied by the serum creatinine level). The value will be 0.85 times in women. Normal filtration is more than 100.

Patients with kidney disease may present with different clinical presentations. Some may present with blood in the urine, flank pain and others with edema and high blood pressure. Many patients may remain asymptomatic and are detected on routine examination to have an elevated plasma creatinine concentration or an abnormal urinalysis.

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    Readers Responses
  1. Dear Sir, Emedidnews is really very informative newspaper. Regards: Dr Suman
    DR. K.K. Study Circle

CME class on 18th Dec. 2011 . Sun 9am to 10 am. Family Picnic has been postponed. Please note.
DR. Pawan Gupta DR. Dinesh Negi

    Forthcoming Events

Lecture on Buddism and Astronomy

By Prof. Trinh X. Thuan

UNESCO Kalinga Awardee, 2009; Prof. of Astronomy, University of Virginia, USA; UNESCO Kalinga Awardee for Popularisation of Science by UNESCO, Kalinga Chair awardee by Department of Science & Technology, Government of India.

Organised by Heart Care Foundation of India in association with Nehru Planetarium on behalf of RVPSP, Dept. of Science & Technology Govt.of India

At Nehru Planetarium Chankyapuri New Delhi on 27th Dec 2011 at 10.30 am

No fee, to register email to drkakroo@gmail.com, 9810301261

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3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews "Doctor of the Year Award" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.com

3rd eMedinewS Revisiting 2011

Dr Ajay Kriplani (Surgical management of diabetes); Dr N K Bhatia ( What’s new in transfusion medicine); Dr Kaberi Banerjee (Fertility update); Dr Amit Bahrgava (Cancer update 2011), Onco Radiation update (Rajiv Gandhi Cancer Institute); Dr Ambrish Mithal (Vitamin D update), Dr Praveen Chandra (Interventional Cardiology update); Revisting 2011 (Dr K K Aggarwal), Portfolio management (Central Bank of India); Insurance update (LIC India); General Insurance (Doogar Associates)


The Annual conference of Indian Menopause Society is to be held from 17 to 19th Feb 2012 in Hotel The Claridges, Surajkund Faridabad. It is multidisciplinary approach to the problems of midlife onwards in women. This conference has participation of British Menopause Society and South Asian Federation Of Menopause Societies and opportunity to hear from international faculties.

For information Contact Dr. Maninder Ahuja (Organizing Chairperson) 9810881048 down load forms from web sit http://indianwoman35plus.com/ or Indianmenopausesociety.org or http://fogsi.org/

Contact at ahuja.maninder@gmail.com
Call for free papers and posters on theme topics of conference.

Early Registration till 30th Dec 2011

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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