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  Address:  39 Daryacha, Hauz Khas Villege, New Delhi, India. e-Mail: drkk@ijcp.com , Website: http://www.ijcpgroup.com 

Dr K K Aggarwal

Dr KK Aggarwal
Dr BC Roy Awardee
Sr Physician and Cardiologist,
Moolchand Medcity
President, Heart Care
Foundation of India
Gp Editor-in-Chief,
IJCP Group
Delhi Medical Council
Director, IMA AKN Sinha Institute (08-09)


31st October

Dear Colleague,

President Emeritus at IMA

Dr Ketan Desai President Medical Council of India was unanimously by a resolution made the president emeritus of IMA in recognition for taking over as the president elect of World Medical Association. It was further resolved in the 202nd working committee of IMA that this post will be reserved for any one from IMA who takes over as the president of the WMA.    He will take over as president in Vancouver next year. Dr Ved Prakash Mishra from MCI called Dr Desai as the Vivekananda of the modern era.

Addressing the working committee Dr Desai narrated the success mantra. It was Dr Prem Aggarwal in 20021 who floated the idea to Dr Ketan Desai than President and Dr Sanjiv Malik than Secretary to start exploring WMA. The journey started the same year when Dr Deasai decided to fight for the president post. An appeal was made over night; 50 cents were paid to hotel staff to deliver it to 200 members. But by morning on the advice of a senior international member Dr Desai withdrew from the election.

Again in 2005 in South Africa, WMA was attended by Dr Desai, Dr Vinay Aggarwal and Dr S Malik Another effort was made for the election as an exercise to make their presence felt. By this time a repo was made with the US Association. In 2006 in Denmark, attended by Dr Desai, Dr Ajay Kumar and Dr Vinay Aggarwal it was decided as what may happen they will make their presence felt at the WMA assembly. It was studied that WMA has only three areas of work, ethics, finance and social medicine. Dr Desai took the responsibility of ethics, Dr Ajay of social medicine and Dr Vinay of that of finance. Subsequently in every agenda of WMA IMA presence was made strategically. And one saw the results in Delhi.

The message for success is to have an intense desire to have a success and a strong voracious appetite for that desire. Second mantra he gave was to have a helping nature. He narrated two stories for the same. 
Story 1: a man wanted to know from Socrates the key to success. The Socrates took him to water and made him drown till he became blue. At last the man put all his effort to come out and succeeded. When asked what his last desire was when he was in water drowning, he said the desire was only to come out. The success therfore lays in one point determination in what you want to achieve in life.

Story 2: A Scottish farmer saves a drowning boy's life, but refuses a reward from the boy's nobleman father.  The nobleman then offers to provide an education for the farmer's son.  The son grows up to become Sir Alexander Fleming, the discoverer of penicillin.  Years later, the nobleman's son is stricken with pneumonia but saved by penicillin.  That nobleman's son is Winston Churchill. Message what ever good you do in life it comes back to you.

Dr KK Aggarwal

 Winter the month of sudden cardiac death: So its time to revise CPR.

New mantra for CPR: just do hands only CPR
A new US ad campaign aims to demystify cardiopulmonary resuscitation by focusing on pushing fast and hard on a patients chest rather than worrying about mouth to mouth resuscitation, of which some 45 percent of adults remain wary. Sponsored by the Ad Council and New York ad agency Gotham Inc., the campaign will reach people through various mediums, encouraging them to perform hands only CPR on victims of cardiac arrest and follows CPR guidelines from the American Heart Associations Emergency Cardiovascular Care Committee updated in 2008.  In fact, there are only two steps, the ads say: call emergency number and push hard and fast in the center of the patient's chest.

Campaign 100: Just compress it

Gasping, gurgling, moaning or any other noisy breathing increases the chances for survival when someone is suffering sudden cardiac arrest. Gasping is a sign that there's still blood flow to the brain, and the person can be saved even though the heart has stopped.

The first aid involves starting compressing the chest, 100 times a minute. A Phoenix study published in Circulation, of 1,218 cases, showed better survival when abnormal breathing, gasping, was noted. After gasping one may have 4-5 minutes before the breathing stops and these 4-5 minutes are crucial.

Gasping is present in 40% of the cases of sudden cardiac arrest. After timely CPR as many as 39 percent of the gaspers will survive as against 9.4 percent of the non-gaspers. If no CPR is done 21.1 percent for gaspers and 6.7 percent of non-gaspers survive.

High salt reduces the effect of BP drugs
Not only does a high-salt diet contribute to hypertension, but it can also reduce the effectiveness of blood pressure medications. What is striking about these results is the degree of the effect, reports Dr. David A. Calhoun, a professor of medicine at the University of Alabama at Birmingham, in the July 20 online issue of Hypertension.

Diabetics advised to eat more pulses and nuts

A study presented at the World Diabetes Congress reported that a diet rich in pulses and nuts can improve glycemic control in type 2 diabetes patients to within ranges seen with pharmaceutical intervention. A meta-analyses of 41 trials demonstrated that pulses, alone or in low-GI or high-fiber diets, improve markers of longer term glycemic control in humans. According to the authors of the study, dietary pulses such as chickpeas, beans, lentils, and peas have a low glycemic index, high fiber content, high levels of amylase and resistant starches, and vegetable protein, and various other antinutrients, which may act as enzyme inhibitors. The net effect is decreased digestion and absorption of starch and consequently postprandial glycemia. Out of the 41 trials, eleven examined consumption of pulses alone, which noted an overall decrease in standardized mean difference (SMD) of 0.71 in fasting blood glucose and 0.62 in serum insulin. Nineteen trials studied consumption of pulses in low glycemic index diets and observed an SMD decrease of 0.28 in glycosylated blood proteins i.e. either hemoglobin A1c or fructosamine. SMD reductions in fasting blood glucose of 0.32 and in FBG of 0.27 were observed in 11 trials investigating pulses in high-fiber diets. Dr. Sievenpiper of St. Michael?s Hospital?s risk factor modification center, Toronto said that based on these results, a 0.48% reduction in HbA1c is expected, and this level of benefit approaches that seen with acarbose, exceeds the FDA  proposed clinically meaningful threshold of 0.3%, and lies at the lower limit of efficacy of what you might expect for oral agents.

Womb transplants possible in two years

Some British scientists hope to conduct a first-ever successful womb transplant within two years from now. Data was presented at a US fertility conference. If this comes about, it would serve as the best other option possible to adoption or surrogacy for women whose wombs have been rendered functionless by diseases such as cervical tumor. The scientists carried out their latest research on rabbits and transplanted a womb using a ?vascular patch technique? that connected the major blood vessels. Out of these five rabbits, two lived upto 10 months and tests showed that the transplants were successful.

Stroke tissue damage reduced by supplemental oxygen

An Indian-origin researcher has revealed in a new study that giving supplemental oxygen during the active period of the stroke greatly reduced the death of neurons and prevented the damage that free radicals can cause to lipids that help protect those brain cells. But, she also stressed that the timing of delivery of 100 percent oxygen, either in a hyperbaric chamber or by mask, is important to achieve the benefit. The study noted that animals give oxygen supplementation while blood flow was blocked had a significantly smaller amount of tissue damage than animals who received oxygen after the blood flow was restored in the brain.

Gold finds another use ?.to detect cancer
Gold is no longer just a glittering adornment that women love to show off. Gold nanoparticles can now be used to detect prostate specific antigens (PSA) that are at much lower levels which canot be detected with existing blood tests. PSA is the leading indicator of prostate cancer. PSA levels are raised in men with prostate cancer. According to Chad Mirkin, a professor at Northwestern University and a co-author of the study, after prostate cancer is removed, the PSA levels fall to zero. But, this number is actually below what can be currently detected and not really zero. The study was published in the Proceedings of the National Academy of Sciences.
H1N1 Flu India update

With four H1N1 flu deaths reported on 22.10.09, the death toll in the country has risen to 431. The total number of people affected with the flu increased to 13,142 with 112 new cases. With 185 deaths, Maharashtra records the highest deaths in the country.

Thought of the Day

We are what we repeatedly do. Excellence, therefore, is not an act but a habit?  Aristotle

Laugh a while?

It's always darkest before dawn. So if you're going to steal the neighbor's newspaper, that's the time to do it.

Several newer anticoagulants are under clinical development.

Recently two of them, Dabigatran etexilate/Pradaxa and Rivaroxaban/Xarelto obtained marketing authorization in Europe and Canada for the prevention of thromboembolic events following major orthopedic surgery such as total hip and knee replacement.

Many other small antithrombotic molecules including a new generation of low molecular weight heparins, are currently in different stages of clinical development.

In addition to being administered orally, the newer anticoagulant agents have a more balanced benefit/risk ratio and wider therapeutic window. They have a rapid onset of action, a predictable anticoagulant effect that does not require routine laboratory monitoring. They have minor food and drug interactions, including those with cytochrome P450 and P.gp. They are highly specific and targeted to a single coagulation factor, and could carry similar or less hemorrhagic risks compared to the older anticoagulant agents. Finally, they may be used in a broader variety of patients, especially the medically ill patients with advanced cancer, and the elderly without any dosage adjustment, regardless of the patient age, gender, body weight, or in patients with mild renal impairment. Their use in the general world will hopefully confirm the promising results of clinical trials. [Journal of Thrombosis and Thrombolysis (Oct 2009)

Advertising in emedinews

emedinews is a new venture of IJCP Group and is the first daily emedical newspaper of the country. One can advertise with a singe insertion or with 30 insertions in a month. For details contact drkk@ijcp.com.

emedinews: revisiting 2009
IJCP Group is organizing emedinews: Revisiting 2009, a day-long medical conference on 10th January, 2010 at Maulana Azad Auditorium. It will be attended by over 1000 doctors from across the city. The topics will include top happenings in the year 2009. There will be no registration charges. However advanced registration information will be required.  Top experts of the city will be delivering lectures. It will be followed with lively cultural evening, doctors of the year award, dance and dinner. For regiatration maiol to emedinews@gmail.com

Letters to the editor

1. I do not have words to express my gratitude  and the immense respect you have gained in my mind for initiating this wonderful idea of constantly updating with the latest and the most current day to day problems one faces in the  clinics. I am practicing as a general physician in a rural area far away from any medical library and for me this kind of constant day to day CME is the best way to keep uptodate  with the latest and most relevant.  Please accept my "congratulations" for this initiative and "Saadar Pranam" for teaching me.
Yours sincerely. Dr Prashant rampalp@yahoo.com

2. You are an excellent educator and I heartily congratulate you on your recently introduced venture "E-medinews" by which medium you are enlightening and educating thousands  of doctors all over the country ,by imparting latest information in all fields of medicine and keeping their knowledge up to date and keeping them prepared to face any impending epidemic I heartily congratulate you on this initiative. K.Kanwar

Forthcoming events
I CAN WIN WALK and Cancer Screening to mark the WORLD CANCER AWARENESS DAY.
7th November: Cancer Awareness Campaign
8th November: Cancer Awareness Walk and screening for Oral and Breast Cancer
Venue: Spice mall Sector 25A, Noida


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