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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

  Editorial ...

22nd October 2010, Friday

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

FDA warns makers of chelation treatments

The U.S. FDA is cracking down on the over–the–counter sale of so–called chelation products that claim to treat conditions such as autism, heart disease and Alzheimer’s by removing heavy metals from the body.

The FDA said it sent warning letters to eight companies telling them their products were unapproved drugs and devices, and any claims about treating medical conditions with these products violated federal law. These products are dangerously misleading because they are targeted to patients with serious conditions and limited treatment options, said Deborah Autor, director of the Office of Compliance in the FDA's Center for Drug Evaluation and Research. Although there are FDA-approved chelation drugs that are used in cases of heavy metal poisoning with a prescription, no chelation therapy products are approved for sale over the counter or on the Internet. Serious safety issues have been linked with chelation products, which can alter the levels of certain substances in the blood. Even when used under medical supervision, these products can cause serious harm, including dehydration, kidney failure and death. One child died while being treated for autism with an intravenous chelation product, FDA said.

Some claim to treat autism spectrum disorder, cardiovascular diseases, Parkinson’s disease, Alzheimer’s disease, macular degeneration – a major cause of blindness –– and other serious conditions, the FDA said.

The letters were issued to the following companies: World Health Products LLC; Hormonal Health LLC; Evenbetternow LLC; Maxam Nutraceutics/Maxam Laboratories; Cardio Renew Inc; Artery Health Institute LLC; Longevity Plus, and Dr. Rhonda Henry, a nutritionist.

Dr KK Aggarwal
Editor in Chief
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  Chikungunya Update

(RP Vashist, Consultant and Head Public Health, Govt. of Delhi)

Rare manifestation/s of Chikungunya observed in outbreaks in India

Pedal edema (swelling of legs) is observed in many patients, the cause of which remains obscure as it is not related to any cardiovascular, renal or hepatic abnormalities.

  Photo Feature (from the HCFI Photo Gallery)

The 17th MTNL Perfect Health Mela 2010

A press meet was organised on the eve of the 17th MTNL Perfect Health Mela 2010. The Mela will be formally inaugurated on Sunday, 24th October, 2010 at 11 a.m. Ms Shovana Narayan, the noted Kathak exponent released various activities being conducted at the Mela. In the Photo: Mr Pravin Aggarwal, Coca Cola India, Ms Shovana Narayan, Padma Shri and Dr BC Roy Awardee Dr KK Aggarwal, President HCFI, Dr KK Dwivedi, NCSTC, DST, Dr Veena Aggarwal, Joint MD and Group Executive Editor, and Dr. NK Yadav, MHO MCD


Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Imaging blunt abdominal trauma

Two prospective observational studies identified traits that made abdominal injury unlikely, obviating the need for Multidetector computed tomography (MDCT). These traits included:

  • Glasgow coma scale ≥14
  • No hypotension (SBP <90 mmHg)
  • No abdominal or costal margin tenderness
  • No abnormalities on chest radiograph
  • No femur or pelvic fracture
  • Hematocrit ≥30 %
  • No hematuria (<25 red blood cells/high powered field)


  1. Holmes JF, et al. Clinical prediction rules for identifying adults at very low risk for intra–abdominal injuries after blunt trauma. Ann Emerg Med 2009;54:575.
  2. Deunk J, et al. Predictors for the selection of patients for abdominal CT after blunt trauma: a proposal for a diagnostic algorithm. Ann Surg 2010;251:512.
  National News

IMA Election (for a CHANGE)

Emedinews requests all its readers to support our editor Dr. K.K. Aggarwal, Padma Shri and Dr. B C Roy National Awardee who is contesting for the post of Vice President of the National Indian Medical Association (IMA). Members of Central Council of IMA, Working Committee Members, Presidents and Secretaries of IMA in addition to all office bearers are the voters in this election. Dr. Aggarwal is well–known for his work in the field of academics.

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

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

Govt renews fight against iodine deficiency

The Union health ministry has upped its fight against mental retardation by increasing iodised salt production and promoting its consumption, concerned with iodine deficiency affecting over 10 per cent of the population in 263 districts. The government is promoting iodine consumption by arming Ashas (Accredited Social Health Activists) with testing kits to identify non-iodised salt still being sold in some parts of the country. The Centre banned the sale of non-iodised salt in May 2006, but low production and poor implementation of the ban has led to widespread iodine deficiency disorders, which are the most common cause of preventable mental retardation and cretinism in India. About 150 micrograms of this essential micronutrient is needed for normal growth and development. The aim is to bring the prevalence of iodine deficiency disorders below 10 per cent of the population by 2012. (Source: Hindustan Times)

65 new dengue cases

Sixty–five new cases of dengue were reported in city on Tuesday, taking the total number of people affected by the disease to 4,679 this season. About 33 chikungunya cases have been reported in the capital so far. Eight persons have died due to dengue this season. Rohini zone has reported the highest number of dengue cases at 596, followed by central zone (553) and Shahdara–north (543). (Source: The Times of India)

  International News

(Dr Monica and Brahm Vasudev)

Yoga may benefit fibromyalgia patients who get no relief from prescription drugs

Fibromyalgia patients who aren’t getting relief from prescription drugs and are in too much pain to exercise may want to try yoga, according to a study published in the journal Pain.

Watermelon extract may lower blood pressure

According to a study from Florida State University published in the American Journal of Hypertension, there is vidence that eating watermelon could reduce…blood pressure.

Nontoxic molecular therapy may help treat triple negative breast cancer

A University of Arizona researcher has patented a nontoxic molecular therapy that stopped tumor growth and metastasis in lab and animal trials without affecting other cells.

Researchers say experimental blood–thinner may work quickly in patients who have surgery to unblock an artery

Final-stage testing of the experimental blood thinner elinogrel is to begin after researchers found that it worked quickly in patients who had surgery to unblock an artery.

Studies funded by drug industry more likely to show positive results

A review of 546 drug trials found that industry-funded trials reported positive outcomes 85% of the time, compared with 50% of the time for government–funded trials and 72% of the time for trials funded by nonprofits or non–federal organizations. Among the nonprofit or non–federal studies, those that received industry contributions were more likely to be positive (85%), compared with those that did not have any industry support (61%).

  Hepatology Update

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

What are the complications of biliary atresia?

Complications following portoenterostomy in patients with biliary atresia include both acute and chronic problems.

  • In the early postoperative phase, an unsuccessful anastomosis with failure to achieve adequate bile drainage is the most common complication. Adequacy of bile flow may be then predicted by the preoperative liver histology and the caliber of bile ductular remnants in the porta hepatis. In one third of all patients, bile flow is inadequate following surgery, and these children succumb to complications of biliary cirrhosis in the first few years of life unless orthotopic liver transplantation is performed.
  • Later in the course of the disease, complications related to progressive liver disease and portal hypertension occur in more than 60% of infants who achieved initial surgical success.
  • Cholangitis develops in 50% of patients following portoenterostomy.
  • Hepatocellular carcinoma may be a risk for those patients with cirrhosis and no clinical evidence of portal hypertension. Progressive fibrosis and biliary cirrhosis develop in children who do not drain bile, and liver transplantation is the only option for long–term survival.
  Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

What are the most common treatments for infertility?

Unfortunately, the most common treatment prescribed by non–experts is clomiphene citrate. This is unfortunate because there is a 12–cycle lifetime maximum recommended use of clomiphene, and many physicians prescribe this drug without first testing the male partner. Further, failure to monitor the woman using clomiphene often makes its use highly questionable. In fact, it may even be counterproductive in one–third of users by causing hostile cervical mucus which can kill sperm on contact. This is not to say that clomiphene is not a wonderful and effective drug for many couples suffering from infertility. But its use should always be administered and monitored by a practitioner who is experienced at treating infertility patients.
Only about 8% of couples with a barrier to pregnancy move to IVF as their treatment protocol. This means that more than 90% are assisted with other, lower tech and less expensive treatments. Such treatments range from ovulation induction drugs to IntraUterine Inseminations (IUIs) to combinations of the two.

  Question of the Day

What is low–renin essential hypertension? (Sukumar Mukherjee, Ajoy Biswas)

Meta–Analysis adds to evidence favoring compression–only CPR by bystanders

This is a widely recognized classification validated by clinical features, including salt-sensitivity of blood pressure and diuretic responsiveness; constitutes around 20% of patients with essential hypertension, mostly of African descent, in diabetics and the elderly. There are data to suggest that this low–renin state confers a beneficial natural history compared to patients with normal– or high–renin hypertension. Hypothesis of expanded extracellular fluid volumes, or sodium retention and renin suppression due to excessive production of mineralocorticoid have not been substantiated in various trials.1 Besides circulating RAS, existence of tissue RAS in blood vessels, heart, kidneys and the brain has pointed to an important role in BP control and cardiovascular (CV) structure. The local RAS in CV system provides a control mechanism for regulating the concentration of AG II in peripheral tissues which in turn is involved in regional blood flow, maintenance of fluid and sodium status, modulation of local sympathetic activity and stimulation of growth and hypertrophy and thus CV structure and function.2 ACEI and diuretics are particularly of use in this group.


  1. Gomes Sanchez CE, et al. Urinary free 19-nor deoxy corticosterone and deoxy corticosterone in human hypertension. J Clin Endocrinol Metab 1985;60:234-38.
  2. Johnstone CI. Tissue ACE in cardiac and vascular hypertrophy, repair and remodelling. Hypertension 1994;23:258-68.
  Medicolegal Update

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

What is an abrasion injury?

Abrasion is one of the most superficial injuries and involves destruction of the superficial layers of the skin, caused by fall on a rough surface, or being dragged by a vehicle. Abrasions are of different types based on the pattern of the causative force viz. scratches, grazes, pressure, impact or imprint abrasions. A doctor can help legal investigation by his description and documentation of abrasions as enumerated below.

  • They give an idea about the site of impact and direction of the force.
  • They may be the only external signs of a serious internal injury.
  • Patterned abrasions may help in relating the wound to the object which produced them.
  • The age of the injury can be determined, which helps to corroborate with the alleged time of assault.
  • Dirt, dust, grease, sand in the open wounds may connect the injuries to the scene of crime.
  • Character and manner of the injury may be known from its distribution.
    • In throttling, crescent abrasions due to fingernails are found in the neck
    • In smothering, abrasions may be seen around the mouth or nose.
    • In sexual assaults, abrasions may be found on the breasts, genitals, inside of the thighs, and around the anus.
    • Abrasions on the face of the assailant indicate a struggle.
    • Abrasions on the victim may show whether the fingernails of the assailant were long, irregular or even broken.
  Medi Finance Update
  • Keep a reasonable amount of liquid cash to meet your expenses. Always look at your savings account whether any surplus money is lying and learn to invest it.
  • Every individual within high income bracket should have a key man insurance policy, as it is a good investment in the long run.
  • Profit on paper has no value unless it is easily available.
  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

Oxytetracycline Liquid Oral preparations

  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Iron deficiency anemia

Iron deficiency anemia is the most common cause of anemia. Tests include:

  • Complete blood count (CBC) with a detailed blood smear report
  • Serum iron,
  • Serum ferritin
  • Total iron–binding capacity (TIBC)
  • Serum transferrin
  • Fecal occult blood test (FOBT)
mtnl perfect health mela
emedinews 3D echocardography
  IJCP Special

Dr Good Dr Bad

Situation: A patient with positive malaria came with severe thrombocytopenia.
Dr Bad: This is classical malaria.
Dr Good: Also investigate for dengue.
Lesson: Malaria and dengue may co exist in the same patient

Make Sure

Situation: A patient with dengue developed acute lung injury after platelet transfusion
Reaction: Oh My God! Why were platelets transfused?
Lesson: Make sure that no platelets are transfused unless there is significant spontaneous bleeding.

Quote of the Day (Dr G M Singh)
"The two foes of human happiness are pain and boredom." Arthur Schopenhauer

  Mind Teaser

Read this…………………

Hi Way

Answer for yesterday’s Mind Teaser: "Getting away from it all"

Correct answers received from: Dr. Vishanji Karani, Dr.K P Rajalakshmi, Dr Sudipto Samaddar, Dr Rashmi Chhibber

Answer for 20th October Mind Teaser is: "Foreign language"
Correct answers received from: Dr. Ashok Kumar, Dr B Marak.

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr G M Singh)

Visiting the Zoo

Three mischievous boys skipped school one day and instead went to the zoo one day for an outing. They decided to visit the elephant cage first, but soon enough, they were picked up by a zoo security officer for causing a commotion.
The officer hauled them off to the Security Office for questioning. The supervisor in charge asked each of them to give their names and tell what they were doing at the elephant cage.
The first boy innocently said, "Okay, my name is Gary, and I was just throwing peanuts into the elephant cage." The second added, "My name is Larry, and all I was doing was throwing peanuts into the elephant cage."
The third boy was a little more shaken up than his buddies and said, "Well, my name is Peter, but my friends call me Peanuts."

  An Inspirational Story

(Contributed by Dr Ashish Sabharwal)

The Buzzard
If you put a buzzard in a pen that is 6 feet by 8 feet and is entirely open at the top, the bird, in spite of its ability to fly, will be an absolute prisoner. The reason is that a buzzard always begins a flight from the ground with a run of 10 to 12 feet. Without space to run, as is its habit, it will not even attempt to fly, but will remain a prisoner for life in a small jail with no top.

The bat
The ordinary bat that flies around at night, a remarkable nimble creature in the air, cannot take off from a level place. If it is placed on the floor or flat ground, all it can do is shuffle about helplessly and, no doubt, painfully, until it reaches some slight elevation from which it can throw itself into the air. Then, at once, it takes off like a flash.

The bumblebee
A bumblebee, if dropped into an open tumbler, will be there until it dies, unless it is taken out. It never sees the means of escape at the top, but persists in trying to find some way out through the sides near the bottom. It will seek a way where none exists, until it completely destroys itself.

In many ways, we are like the buzzard, the bat, and the bumblebee. We struggle about with all our problems and frustrations, never realizing that all we have to do is look at things differently and innovate and Change! That's the answer, the escape route and the solution to any problem!

Just look at things differently and look for bringing a CHANGE in the situation/circumstances/thinking…

  Readers Responses
  1. Dear Sir, Wonderful and very informative, congratulations. Please keep it up. May God bless you: Dr. N. Gemawat.
  Public Forum

(Press Release for use by the newspapers)

 MTNL Perfect Health Mela to open tomorrow

The 17th MTNL Perfect Health Mela will open for the general public tomorrow for public at 8 am. The mela is being organized by Heart Care Foundation of India jointly with Health Department - Delhi Government, NDMC, World Fellowship of Religions, MCD, NDMC, DHS, MTNL, DST, LIC, Coca Cola India Ltd. And Oriental Bank of Commerce  at NDMC Grounds, Laxmi Bai Nagar, New Delhi which is being held from 23-31 October, 2010.  It is a mix of health exhibitions, competitions, checkups, entertainment incorporating all pathies under one roof.

Giving the details, Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela said that the mela will provide 140 hours of community service in terms of free education, entertainment, checkups, infotainment and competitions. Free checkups will be available on various specialties from all pathies.

The mela will also focus on anti quackery activities, said Dr. Aggarwal. There are 50000 quacks in the city of Delhi alone. Most emergencies need to be tackled within specified window period and if not tackled in time they can lead to fatalities. It is, therefore,important that quackery be eradicated from the city.  On blood donation, Dr. Aggarwal said that Maheshwari Club will organize on the spot blood donation camp and the collected  blood will be for the usage to the poor.

Regarding elderly, Dr. Aggarwal said that there will be special provisions for checkups for the elderly. Dr. Aggarwal said that with advances in treatment and prevention, it is now possible to live up to 80 years of age. Even an elderly needs vaccination. Special guidance will be provided at the mela venue for various vaccination.  

The Mela will be a reproducible module of providing health awareness to people from all sections of the society incorporating all pathies under one roof through the medium of infotainment and one liner health sutras.  Noteworthy activities at the Mela will be daily competitions in poster making, painting, slogan writing, cartoon and collage making, all relating to health. They will be a apart of inter school, inter college and inter nursing school competitions. Various cultural activities will also be staged in the Mela to provide health messages through fun and entertainment like magic shows, nukkad nataks, kavi sammelans, etc.

Dengue and Chickengunia OPD at Perfect Health Mela

In view of the ongoing dengue and chickengunia epidemic, a special OPD has been started in the mela added Dr Aggarwal. Apart from consultation, on the spot facilities will be available for hemogram test which will include platelet count and hematocrit. These tests can be done on a registration cost of Rs. 25. Highly subsidized, chickenguinea and dengue serology test will also be available. After dengue, chickengunea is on its increase in the city. Its patients present with high grade fever with severe joint pain, rashes and itching. The joint pain can be debilitating.

The special attraction on Sunday at the mela ground will be the presence of Smt. Sheila Dikshit, Hon’ble Chief Minister of Delhi, Shri S.Y. Qureshi, Chief Election Commissioner of India, Prof. Dr. Kiran Walia, City Health Minister at the inaugural function. The mela will be formally inaugurated on Sunday, 24th October, 2010 at 11 oclock.

It is a perfect picnic spot for public. Competitions like interschool, inter nursing school/college, inter dancing school, interschool for children with special needs etc. are organized during the mela.

Seminar on women empowerment and another on global warming and ethnic crisis is also being organized. On 24th and 31st October, 2010, there are special sessions for general practitioners on chest pain and obesity respectively.

The mela is being organized by Heart Care Foundation of India jointly with various departments of Delhi Government at NDMC Grounds, Laxmi Bai Nagar, Opp. Nari Niketan and will be open to public from 8 am to 10 pm till 31st October, 2010.

  Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

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

17th MTNL Perfect Health Mela 2010

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
17th MTNL Perfect Health Mela 2010 day programme
Dr. Sood Nasal Research Foundation Announces

Rhinology Update 11th to 15th November
22nd National Endoscopic Sinus Surgery Course on 11th & 12th November, 2010 2010 at Dr. Shroff’s Eye & ENT Hospital, New Delhi
Cadaveric Sessions on 13th November, 2010 at Lady Hardinge Medical College.
33rd All India Rhinoplasty Course, on 14th & 15th November, 2010, at Metro Hospital, Preet Vihar, Vikas Marg, New Delhi.

For information contact: Dr. V P Sood, Course Chairman, Ear, Nose & Throat Center, 212, Aditya Arcade, 30, Community Center, Preet Vihar, Vikas Marg, Delhi–110092 (India). Tel: 011–22440011, 42420429. E–mail:drvpsood@gmail.com,vpsood@drsoodnasalfoundation.com
Website: www.drsoodnasalfoundation.com

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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