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Dr KK Aggarwal

From the Desk of Editor in Chief
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

19th July, 2010, Monday

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

Testing for low back flexion

Schober test measures the forward flexion of the lumbar spine in a patient with suspected or proven ankylosing spondylitis.

In this test, with the patient standing erect, a mark is made over the spinous process of the 5th lumbar vertebra or at the level of an imaginary line joining the two posterior superior iliac spines.

Another mark is made 10 cm above it in the midline. The patient is then asked to touch his toes. The distance between the two points normally exceeds 15 cm. If this distance increases lese than 5 cm, then this indicates a limited flexion of the lower back.

Testing for low 

back flexion

Dr KK Aggarwal
Editor in Chief

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Photo Feature (From HCFI file)

Healthex 2010


India’s first wide range international exhibition on Medical, Surgical & Diagnostic equipments, Technology, Materials, Supplies and Allied Services – had a grand opening with a high–profile inauguration by several luminaries from industry and the government.

Dr k k Aggarwal

Mr. Ramchandra Gowda (Minister Medical Education, Govt. of Karnataka), Padma Vibhushan Dr. Prathap Reddy (Chairman Healthex, Cll & Apollo Group), Mr. JN Godrej (Chairman, BIEC) and Mr. Anjan Bose (VP & Head, Philip Electronics India Ltd.) at the inauguration


News and Views (Dr Brahm and Monica Vasudeva)

High resting heart rate, low heart rate variability may be related to renal impairment.

High resting heart rate and low heart rate variability are both related to the development of renal impairment, researchers from Johns Hopkins note in their study published in Journal of the American Society of Nephrology.

FDA cautions against using malaria drug for leg cramps

The Food and Drug Administration on Thursday has cautioned consumers against using quinine (Qualaquin). This drug is used for nocturnal leg cramps. The FDA warns that the drug could cause severe side effects, including death. Its effectiveness in reducing incidence of cramps by one-third to one-half has been documented in studies. But, as many as one in every 25 users can suffer serious side effects.

Surgeon says his study shows breast cancer treatment for women over 70 is ineffective

Dr. Kevin S. Hughes, co–director of the Avon Comprehensive Breast Evaluation Center at Massachusetts General Hospital and a surgeon at Newton–Wellesley Hospital, said his recent study on breast cancer treatment for women over 70 found that the radiation was ineffective as regards preserving the breast, survival, or anything.

Cyberbullying linked to teen psychiatric, social issues

A study in the July issue of the Archives of General Psychiatry states that being a "cyberbully" (bullying others via electronic means) or a "cybervictim" (being the target of cyberbullying) –– and especially being both –– is associated with psychiatric and psychosomatic problems among adolescents.


Legal Column

Forensic Column (Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS)

Medical Testimony of Doctor in the Court of law

When a doctor appears as a medical witness in the court of law, he must strive to achieve respect, good/reasonable medical understanding and credibility before the honorable judge. He must give the appearance of being an independent medical witnesses of truth based on medical science with neutrality, impartiality and authentic characteristics.

"If the law has made you a witness, remain a man of science. You have no victim to avenge, no guilty or innocent person to convict or save – you must bear testimony within the limits of science." Dr. P.C.H. Brouardel, 19th Century French Medico–legal expert



Experts’ Views

Interesting Tips in Hepatology & Gastroenterology

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

Nutrient Needs of Adolescents

Causes of Obesity in Adolescents

  • More reliance on school canteen
  • Junk/fried food (burgers, pizzas, samosas, pakoras)
  • Cokes
  • Inactivity
  • Watching too much TV & sitting on computer

Question of the Day

How do you diagnose peripheral neuropathy? (Dr Shashank Joshi, Mumbai)

Diagnosis of peripheral neuropathy is based on clinical features, electrophysiologic findings, and exclusion of other conditions. Electrophysiologic findings may show slowing of motor and sensory nerves distally as seen in symmetric diabetic peripheral neuropathy, confirming an associated generalized neuropathy. Prolongation of femoral nerve motor latency and decreasing amplitude of compound muscle action potential may be seen. Needle electromyography (EMG) shows a neurogenic pattern in the affected muscles. Needle EMG of the paraspinal muscles shows denervation changes in distribution of multiple roots. Muscle biopsy shows neurogenic features.


Public Forum (Press Release for use by the newspapers)

Unconventional use of drugs

Heart Care Foundation released a list of common drugs used unconventionally for conditions other than those approved by the FDA. Off-label use of drugs is a common practice all over the world said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India & MTNL Perfect Health Mela.

  1. Asthma drug for smell disorder: An asthma drug, theophylline, shows promise in restoring the sense of smell in those who have lost that precious ability. About 20 million people in the United States have some degree of hyposmia, or loss of the sense of smell, affecting their ability to enjoy the flavor of artichokes and the fragrance of azaleas. Many things can cause this problem. The most common causes are viruses, head trauma, severe allergies or some kind of anatomic obstruction in the nose or nasal polyps. According to a study in the June issue of the American Journal of the Medical Sciences, there are not many effective treatments.

  2. Epilepsy drug for wound: The common epilepsy drug, phenytoin, is used to heal wounds as it causes hypertrophy of the granulation tissue. The main side effect of the drug, gingival hyperplasia, is now used as a therapy point.

  3. BP drug for kidney stones: Nifedipine, a common blood pressure drug, is now used to pass out small ureteric stones smaller than 10 mm.

  4. ED drug for COPD: Viagra, the erectile drug, has now been used in the treatment of pulmonary hypertension in patients with COPD.

  5. Depression drug for premature ejaculation: The SSRI drug sertraline is approved as an antidepressant. It is also commonly prescribed off–label to help men suffering from premature ejaculation.

  6. Cancer drug for pregnancy: Methotrexate, approved for the treatment of choriocarcinoma, is frequently used for the medical treatment of an unruptured ectopic pregnancy.

  7. 'Fits' drug for tremors: Gabapentin, approved for treatment of fits and post herpetic neuralgia in adults, is used off–label for bipolar disorder, essential tremors, hot flashes, migraine, neuropathic pains, phantom limb and restless leg syndrome.

An Inspirational Story

Bad Temper

There once was a little boy who had a bad temper. His father gave him a bag of nails and told him that every time he lost his temper, he must hammer a nail into the back of the fence. The first day, the boy had driven 37 nails into the fence. Over the next few weeks, as he learned to control his anger, the number of nails hammered daily gradually dwindled down. He discovered it was easier to hold his temper than to drive those nails into the fence.

Finally the day came when the boy didn’t lose his temper at all. He told his father about it and the father suggested that the boy now pull out one nail for each day that he was able to hold his temper. The days passed and the boy was finally able to tell his father that all the nails were gone.

The father took his son by the hand and led him to the fence. He said, "You have done well, my son, but look at the holes in the fence. The fence will never be the same. When you say things in anger, they leave a scar just like this one. You can put a knife in a man and draw it out. It won’t matter how many times you say I’m sorry the wound is still there. A verbal wound is as bad as a physical one."


IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was found unconscious.
Dr Bad: It is stroke.
Dr Good: First rule out hypoglycemia.
Lesson: In diabetics, sudden loss of consciousness is usually hypoglycemia unless proved otherwise.

Make Sure

Situation: A patient developed sever anaphylaxis after IV iron sucrose.
Rection: Oh My God: Why was sensitivity test not done?
Lasson: Make sure that a sensitivity test is done for all parenteral iron preparations. Even iron sucrose can cause hypersensitivity.

Quote of the Day (Dr. Santosh Sahi)

"Empty pockets never held anyone back. Only empty heads and empty hearts can do that." Norman Vincent Peale

Are you fit to fly? Can pregnant females fly?

  1. Any patient in her first trimester with abdominal pain or bleeding should be evaluated and ectopic pregnancy ruled out prior to flight.

  2. Any patient at risk for premature delivery (e.g. prior history, multiple gestations, cervical incompetence), with a condition that lowers placental respiratory reserve (eg, intrauterine growth retardation), or who is considered high risk (eg, preeclampsia, placenta previa) should probably not fly.

Myths about Aging

Myth: The pain and disability caused by arthritis is inevitable as you get older.

Milestones in Urology

Dr Willem Johan (Pim) Kolff (1911-2009) was a pioneer of hemodialysis as well as in the field of artificial organs. Kolff is considered as the 'Father of Artificial Organs', and now regarded as one of the most important physicians of the twentieth century. In 2002, he recieved the highest honor in American medicine, Albert Lasker Award for Clinical Research, for his work on development of kidney dialysis, which changed kidney failure from a fatal to a treatable disease.


International Medical Science Academy Update (IMSA)

Drugeluting stents (DES) significantly reduce the incidence of target vessel revascularization compared to baremetal stents (BMS) and have become the stent of choice for the treatment of a majority of lesions. However, their utility has been limited by concerns about stent thrombosis and the requirement for long term dual antiplatelet therapy.


Drug Update

List of Approved drugs from 1.01.2009 to 31.10.2009

Drug Name


DCI Approval Date

Oxcarbazepine 150/300/600mg Tablet (Addl. Indication)

Treatment of generalized tonicclonic seizures in adults and children



Medi Finance

Q. What are the necessary steps to make a hospital a charitable trust?

Ans. Register the hospital under the Charitable Trust Act and also apply for its registration with Commissioner of Income Tax as a charitable trust under section 12AA.


Lab Medicine (Dr Arpan Gandhi and Dr Navin Dang)

Uric acid

To rule out gout

To monitor uric acid levels when undergoing chemotherapy or radiation treatment.


Humor Section

Joke: Eye Surgery:

While my friend was working as a receptionist for an eye surgeon, a very angry woman stormed up to her desk. "Someone stole my wig while I was having surgery yesterday," she complained.

The doctor came out and tried to calm her down. "I assure you that no one on my staff would have done such a thing," he said. "Why do you think it was taken here?"

"After the operation, I noticed the wig I was wearing was cheaplooking and ugly."

"I think" explained the surgeon gently, "that means your cataract operation was a success."

Medical bloopers on medical charts!

Outpatient…………………………A person who has fainted


Forthcoming Events

eMedinews Events: Register at emedinews@gmail.com

5th September: 3 PM to 5 PM A dialogue with His Holiness Dalai Lama at Parliament Street Annexe in association with Acharya Sushil Muni Ahimsa Peace Award Trust

12th September: BSNL Dil ka Darbar A daylong interaction with top cardiologists of the city.
8 AM – 5 PM at MAMC Auditorium, Dilli Gate.

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM

30th October, Saturday: eMedinewS Update from 8 AM to 5 PM

29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama

30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to 10 PM

31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

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