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


eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

  Editorial …

7th November 2011, Monday

New guidelines for the treatment of SSA

The SpondyloArthritis International Society working group has updated its guidelines for use of tumor necrosis factor (TNF) inhibitors in patients with axial spondyloarthritis, including ankylosing spondylitis.

There are three important changes in the updated guidelines.

  • The new ASAS criteria for axial spondyloarthropathy allow for the use of these agents in patients without radiographic changes who meet magnetic resonance imaging criteria for sacroiliitis.
  • The updated guidelines continue to recommend that TNF inhibitors be used only after an inadequate response to NSAIDs, although the duration needed to establish lack of efficacy of NSAIDs was reduced from three months to four weeks.
  • Patients with peripheral arthritis (but not those with axial disease alone) should have also had an inadequate response to another disease–modifying drug (DMARD) before using a TNF inhibitor.
  • Drugs other than sulfasalazine can now also be considered in establishing that the patient has had an inadequate response.


van der Heijde D, Sieper J, Maksymowych WP, et al. 2010 Update of the international ASAS recommendations for the use of anti–TNF agents in patients with axial spondyloarthritis. Ann Rheum Dis 2011;70:905.

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 on

New guidelines for the treatment of SSA

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011– Eco Fest – An Inter School Eco Club’s Health Festival

Purpose of this competition is not only to have a competition but to learn preventive strategies so that the children in future can become healthy adults.

Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


Haze in Delhi sets off air pollution alarm

NEW DELHI: A thick haze over Delhi on Friday has set the alarm bells ringing over growing air pollution in the city. While pollution normally rises during winter, Friday’s level at places was more than 10 times the prescribed limits. For instance, levels of oxides of nitrogen (NOx), the prescribed standard for which is 80 micrograms/cubic metre, were 811 and 760, respectively, at R K Puram and Punjabi Bagh at 7pm. Experts said usually such high pollution levels are not seen till later in the season. "About 80% of NOx and NO2 come from vehicles. At 7pm, when shockingly high levels of NOx were recorded, Delhi normally witnesses its highest traffic movement. The PM2.5 level at 5 pm was also almost seven times the prescribed levels and this is very worrying," said Anumita Roychowdhury, director of Centre for Science and Environment’s clean air programme. (Source: TOI, Nov 5, 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

FDA opens opioid education ‘Blueprint’ for comment

The US Food and Drug Administration (FDA) today released a draft "blueprint" to guide the development of prescriber training modules for the use of long–acting and extended–release opioid drugs. (Source: Medscape Medical News)

For comments and archives

AASLD: HCV testing by birth cohort cost–effective

Birth–cohort screening for hepatitis C virus (HCV) infection proved highly cost–effective, even when adjusted for universal treatment with direct–acting antiviral therapy, according to a study reported here. (Source: Medpage Today)

For Comments and archives

Physicians worry about misinformed patients in Internet age

The Internet puts solid health information at a patient’s fingertips, but 2 new studies suggest that too many of those fingertips stray into questionable territory. In a survey from Wolters Kluwer Health, 78% of physicians said that lack of time is one of the most common challenges for physician–patient communication. The next biggest problem in this regard — cited by 53% of physicians — is misinformed patients. (Source: Medscape Medical News)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: #AJCC FDA approves device for non–surgical aortic valve repair The FDA has approved the Sapien Transcatheter… fb.me/1a64NqGye

@DeepakChopra: Gaps occur in places where love has been excluded.

    Spiritual Update

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

Science behind Devothani (Dev Uthani) Ekadashi The start of the marriage season

Ekadashi of Shukla Paksha in Kartik month is celebrated as Devothani Ekadashi (Prabhodhani Ekadashi). In Mythology it is said that on this day, Lord Vishnu concludes his four months rest starting on the Ekadashi of Bhadra Pada. Auspicious functions including marriages can now take place in the society.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

My Sunshine

It was May 2003. I knew something was wrong. I felt my body weakening as the days progressed.
Finally it gave out and I collapsed. I was posted to my bed for months. The pain my body felt was indescribable. I could barely stand and gasped for every breath. One would think in the sick body I was in, depression would take over. But I was blessed. Truly blessed. My illness became a blessing. Due to my illness I was not able to attend my religious meetings. I would listen to them over the phone on the days the medication didn’t consume my body leaving me numb. This particular day there was a problem with the sound system. One of the members of the congregation was trying zealously to connect me, but was unsuccessful. That same day he decided to pay me a visit.

His visit was God sent. His words of encouragement and comfort were what I needed. Those visits progressed and helped with my recovery. As we grew to know each other, we realized how much we had in common, that our lives were parallel. Our friendship blossomed at full speed, creating a powerful bond. We became a source of comfort for each other. As my body healed, our outings became frequent. We spent most of the time together, going places and talking on the phone for hours. He became the sunshine in my day. My mornings were filled with his early phone calls. My evenings were filled with his warmth. Not a day went by when he wasn't a part of it.

One Sunday evening we were watching a movie on my couch. He put his arms around me and I knew there was more he was feeling. That night we experienced our first kiss. He was confused on what he felt. In his eyes I was beautiful in every way. However, our lives were headed in different directions. Love between us was impossible. I begged him to not end our friendship. I just couldn’t imagine not having him in my life. Weeks went by and he distanced himself from me. He didn’t know how to handle what had happened. We spoke about it but there was no solution. Throughout the months we tried to mend the friendship, but the attraction would take over bringing us back to moments of passion; beautiful moments where I expressed my deepest love for him. Our bodies would intertwine leaving me breathless. Sadly those moments would only remind us of our impossible love.

We decided to accept reality. It took all the strength in me to end it. I was heartbroken. The void of his loss consumed me. I tried lying to myself saying I didn't need him or miss him and that life will be OK without him. But I had to give in to what I truly felt. My heart was aching. But I had to do the right thing and stay away. Two months later I received a phone call from one of my close friend. She didn’t want to tell me over the phone what had happened and drove me to the hospital. I found my dear Chris being prepared for surgery. He fell and smashed his foot. My heart was in pieces. I visited him in the hospital every day and our feelings were awakened. We spent those days in the hospital holding each other. I couldn’t stop telling him how much I had missed him. It was a sigh of relief being together again.

Then it was time for him to go home and begin his recovery. I helped care for him as much as I could. The love I felt for him only deepened. But again reality struck. We couldn’t continue seeing each other. It was only making the departure harder to bear. Again we ended it leaving me devastated. He was sick and I couldn’t be there for him as he was for me. I had to walk away with my heart shredded to pieces…again.

Occasionally I called to see if he was OK. But things were never the same again. I lost my best friend and my soulmate. Even though I knew it was for the best, the pain was unbearable at times. Seeing him at church didn’t help either. It only reminded me of the loss. Throughout the months that followed there were moments in which we spoke. We spoke of our desire for one another, which only help build it even stronger. There were moments of deeper passion that followed those conversations but they lead nowhere. What we had was what he called a "dead end."I was tired of the roller coaster. I needed my inner peace. This time we ended it for good. Now he is a memory; someone who will always hold a special place in my heart. I live remembering the loss every day. He never leaves my mind and heart.

I don’t know what turns our lives will take, but I wish him happiness. He taught me to always remember the good – a lesson I will carry with me to my grave. I live each day grateful for our encounter even though it was brief. He will always be the sunshine in my day. All I have to do is remember.

For comments and archives

  Fitness Update

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

Children become less active as they grow older: An update

Research shows that children’s physical activity tends to decline as they age. This is important because many studies show that the amount of activity that children engage in is an accurate predictor for whether they will exercise as adults. However, until now, very few studies have separated measures of organized activities from free time activities, and no studies have evaluated these changes in physical activity in children below the age of 18. Researchers from the National Center for Chronic Disease Prevention and Health Promotion along with researchers from the Emory School of Public Health sought to do just that.

Researchers studied a nationally representative sample of 1623 children ages 9–13 in 2002, and followed them for five years. These children were participants of the Centers for Disease Control and Prevention’s (CDC) Youth Media Campaign Longitudinal Survey, which was conducted from 2002 to 2006. They completed a survey on their frequency of participation in free–time and organized physical activities outside school. Children were instructed to include activities that "got their body moving," such as sports, physical activity lessons, or playing actively with their friends, and to exclude activities during the school day, such as physical education or recess. The analysis of the study data revealed, not surprisingly, that physical activity declines from the age of 9 until the age of 13. It’s still not clear how early the decline starts, however.

For comments and archives

    Healthy Driving

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

If you do need to use a cellular phone urgently, take the following precaution:

Be familiar with the phone’s keypad – use speed dial if possible.

For comments and archives

    Medicine Update

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

Is there any increased risk of epilepsy in children with febrile seizures later in life?

Self–limited generalized convulsion lasting less than 15 minutes is not associated with any long–term effects on brain function or intelligence. If more than a single febrile seizure in a life time, caregiver can be informed that the risk of a child developing this condition after a single simple febrile seizure is very low. In the large British birth cohort study, the background rate of epilepsy was 0.4% by 10 years of age. Children who had a simple febrile seizure had 1% risk. Although this represents a significantly increased relative risk, the overall prevalence remains low. To emphasize this, parents can be told that there is a 99% chance that their child will not have epilepsy.

For comments and archives

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)



  • Hypocalcemia must be interpreted in relation to serum albumin concentration (Some laboratories report a "corrected calcium" or "adjusted calcium" which relate the calcium assay to a normal albumin. The normal albumin, and hence the calculation, varies from laboratory to laboratory).
  • True decrease in the physiologically active ionized form of Ca++ occurs in many situations, including hypoparathyroidism, vitamin D deficiency, chronic renal failure, magnesium deficiency, prolonged anticonvulsant therapy, acute pancreatitis, massive transfusion, alcoholism, etc. Drugs producing hypocalcemia include most diuretics, estrogens, fluorides, glucose, insulin, excessive laxatives, magnesium salts, methicillin, and phosphates.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A pregnant lady developed amniotic fluid embolism syndrome (AFES).
Dr Bad: It’s a self–limiting disease.
Dr Good: Give symptomatic treatment.
Lesson: There is no specific treatment for AFES. The goal of therapy is to correct hypoxemia and hypotension, so that ischemic consequences (e.g., hypoxic brain injury, acute kidney injury) in the mother are prevented and adequate oxygen delivery to the fetus is ensured. This may require mechanical ventilation, vasopressors, inotropes, intravenous fluids, and blood products.

For comments and archives

Make Sure

Situation: A patient with hiatus hernia developed severe symptoms after eating a ‘Paan’.
Reaction: Oh my God! Why was he given a peppermint?
Lesson: Make sure patients with reflex esophagitis are not given any food which can relax GI sphincter.

For comments and archives

  Quote of the Day

(Dr GM Singh)

Overall development of children should be nurtured within a safe, well–maintained indoor and outdoor environment.

    Mind Teaser

Read this…………………

A body is brought for autopsy with history of poisoning. On postmortem examination, there is dark brown postmortem staining and garlic odor in stomach. In this case the poisoning is most likely due to ?

A) Hydrocyanic acid
B) Carbon dioxide
C) Aniline dye
D) Phosphorus

Yesterday’s Mind Teaser:  Which of the following is the most common cause of death in Crohn's disease of small intestine?

a) Malignancy
b) Sepsis
c) Electrolyte disorders
d) Thromboembolic phenomenon

Answer for Yesterday’s  Mind Teaser: a) Malignancy

Correct answers received from:  Arundhati Dasgupta, Dr Ragavan Sivaramakrishnan, Dr.Sukanta Sen, Jayaraman T.P, Dr.Mohit Sharma, Dr.A.K..Kela, Anil Bairaria, Dr.Chandresh Jardosh, Muthumperumal Thirumalpillai, Raju Kuppusamy, Dr Jainendra Upadhyay, Dr.Krishna Kavita

Answer for 5th November Mind Teaser: (C) hCG increased, AFP decreased, estriol decreased
Correct answers received from: Manisha Gadre, Dr.Chandresh Jardosh, Muthumperumal Thirumalpillai, Raju Kuppusamy, Dr Ajay Gandhi, Dr. John C Mathew, Dr. P. C. Das, yogindra vasavada

Send your answer to ijcp12@gmail.com

Our Social
Network sites
… Stay Connected

  > Dr K K Aggarwal
  > eMedinewS
  > Hcfi NGO
  > IJCP Group

  > Dr K K Aggarwal
  > eMedinewS
  > IJCP Group

  > Dr K K Aggarwal
  > eMedinewS
  > IJCP Group

        You Tube
  > Dr K K Aggarwal
  > eMedinewS

emedinews revisiting 2011
emedinews revisiting 2011
eMedinewS Apps
    Laugh a While

(Dr GM Singh)

The difference between a neurotic and a psychotic is that, while a psychotic thinks that 2 + 2 = 5, a neurotic knows the answer is 4, but it worries him.

    Medicolegal Update

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

Crescent abrasions due to fingernails are found in the neck in throttling cases

  • Abrasion is one of the most superficial injuries and it means the destruction of the superficial layers of the skin, caused by pressure of fingers/nails/fall on a rough surface, or by being dragged by a vehicular accident. Based on the pattern of the causative force, abrasions can be termed as scratch, grazes, pressure, impact or imprint abrasions. Mechanical momentum means mass with velocity discharged into the human body by a moving object or weapon or it is due to impact of moving body against a surface produces injuries over the body.
  • In the first case, the counterforce is provided by the body and in the second case, by the rigidity of the object/weapon/surface/wall against which the victim falls itself or is forced to fall by external reason. In most cases it is seen that the mechanical injuries produced over the body are due to a combination of two above forces.
  • The duration of abrasion roughly estimated as fresh when it is bright Red /½ day – 1day – Bright Scab (covering) 2 –3days – Reddish brown covering and on 7th day – Almost normal. The doctor on his evaluation and certification of abrasion helps the legal investigation.
  • In throttling cases, crescent abrasions due to fingernails are found in the neck; however, 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 around 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.

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)

Smoking women can increase the risk of colorectal cancer

Women who smoke are at twice the risk of developing cancer of the rectum and the risk goes up with the increase in number of cigarettes smoked per day, smoke duration and older age at smoking cessation, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. K K Aggarwal, President, Heart Care Foundation of India.

Quoting a study published in the Journal of National Cancer Institute, Dr. KK Aggarwal said that women should never smoke. Current smokers are 95% more likely to develop rectal cancer. Younger adults can develop colorectal cancer, but the chances increase markedly after age 50. More than 9 out of 10 people diagnosed with colorectal cancer are older than 50.

History of adenomatous polyps (adenomas), especially if they are large, increase the risk of cancer.

If you have had colorectal cancer, even though it has been completely removed, you are more likely to develop new cancers in other areas of the colon and rectum. The chances of this happening are greater if you had your first colorectal cancer when you were younger.

Though the no. 1 cancer in women in urban areas is breast cancer and in rural areas is cancer of the cervix, the cancer of the rectum is on the rise.

For comments and archives

    Readers Response

Thanx Dr saheb gud information on scientific parameters, first time i got this. Regards:Brijmohan Gulati 

    Forthcoming Events

CSI 2011

63rd Annual Conference of the Cardiological Society of India

Date: December 8–11, 2011.
Venue: NCPA Complex, Nariman Point, Mumbai 400021

Organizing Committee

B. K. Goyal – Patron
Samuel Mathew – President CSI
Ashok Seth – President Elect & Chairman Scientific Committee
Lekha Adik Pathak – Chairperson
Satish Vaidya & C. V. Vanjani – Vice Chairman
N. O. Bansal – Organizing Secretary
B. R. Bansode – Treasurer
Ajit Desai , Ajay Mahajan , G. P. Ratnaparkhi – Jt. Org. Secretaries
Shantanu Deshpande , Sushil Kumbhat , Haresh Mehta – Asst. Org. Secretaries
D. B. Pahlajani, A. B. Mehta , M. J. Gandhi , G. S. Sainani, Sushil Munsi, GB Parulkar, KR Shetty – Advisory Committee

Contact: Dr. Lekha Adik Pathak, Chairperson, CSI 2011; Dr. Narender O. Bansal, Org. Secretary, CSI 2011 Tel: 91 – 22 – 2649 0261/2649 4946, Fax: 91 – 22 – 2640 5920/2649 4946.
Email: csi2011@ymail.com, csimumbai2011@gmail.com Website: www.csi2011mumbai.com

eMedinewS Events: Register at emedinews@gmail.com

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

    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

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

4. eMedinewS ebooks (This may take a few minutes to open)

Activities eBooks


  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

    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