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Dr KK Aggarwal

From the Desk of Editor in Chief
Dr B C Roy National Awardee,

Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant and Dean Medical Education, Moolchand Medcity; Member, Delhi Medical Council; Past President, Delhi Medical Association; Past President, IMA New Delhi Branch; Past Hony Director. IMA AKN Sinha Institute, Chairman IMA Academy of Medical Specialities & Hony Finance Secretary National IMA; Editor in Chief IJCP Group of Publications & Hony Visiting Professor (Clinical Research) DIPSAR

Dear Colleague

4th February 2010, Thursday

Practice Changing Updates: Change in heparin potency
One should increase vigilance in monitoring unfractionated heparin effects, since heparin products manufactured after October 8, 2009 are 10 percent less potent.
This reduction in potency has clinical significance in situations where heparin is administered as a bolus intravenous dose and an immediate anticoagulant effect is clinically important.
Monitoring therapeutic doses of UFH via the aPTT is of critical importance in determining the overall effect. (Source:www.fda.gov/Safety/MedWatch/Safety Information/Safety Alertsfor Human Medical Products/ucm 184687.htm.)

 Dr KK Aggarwal
Chief Editor

News and Views

1. Monitoring two types of immune cells in kidney transplant recipients might identify patients with an increased risk of skin cancer. Increased levels of T-regulatory cells (Tregs) more than doubled the risk of squamous cell cancer of the skin. Decreased levels of natural killer (NK) cells were associated with more than a five-fold increased risk of skin cancer. Both immune parameters had substantially greater predictive power than a history of squamous-cell skin cancer, according to an online report in the Journal of the American Society of Nephrology by a team of Oxford University investigators.

2. Transient elastography (TE) accurately measured levels of liver stiffness, an indication of the amount of fibrosis, in more than 97% of patients with a body mass index below 30 kg/m2 and in 75% of obese patients, according to a report in the February issue of Hepatology.

3. Sexual function declines in the first two years after external beam radiation therapy for prostate cancer but stabilizes thereafter, according to data from a prospective cohort study. All parameters of sexual function declined significantly in the first two years after external-beam radiation therapy (EBRT). (Richard Valicenti, University of California, Davis.)

4. The addition of trastuzumab (Herceptin) before and after surgery significantly improved event-free survival compared with neoadjuvant chemotherapy alone in women with HER2-positive locally advanced or inflammatory breast cancer, investigators in a multicenter European trial reported. Patients treated with trastuzumab had a 40% reduction in the hazard ratio for the composite endpoint of recurrence, progression, or death from any cause.(January 30, The Lancet)

5. The hand impairment experienced by many patients with rheumatoid arthritis did not significantly interfere with their computer use. On average, a group of patients with longstanding rheumatoid arthritis had only mild impairments on the Keitel Hand Function Index, which assesses active range of motion, according to Nancy A. Baker, ScD, and Joan C. Rogers, PhD, from the University of Pittsburgh. Participants' mean score was 21.8 on this index, which includes scores ranging from 4 to 52, with higher scores indicating greater impairment. The study findings are reported in the Feb. 15 issue of Arthritis Care & Research.

+ 92 is Pakistani code and not Dubai code

Recently, there have been a spate of calls received on Airtel phones from numbers with +92 area code. The callers claim to be from Airtel Dubai or Calcutta and say that you have won an obnoxious amount of money through some lottery. To avail the cash prize, they ask you to purchase some Dish TV coupons and ask for personal details including bank account numbers etc so that they can transfer you the money. It?s all fraud. There is no Airtel office in Dubai. Airtel is not running any such lottery scheme. Dish TV coupons are apparently useless. In fact, the +92 area code is for Pakistan! This could very well be an elaborate terror plot where your phone number or bank account could be used for committing horrible crimes. If you are an Airtel user, you must try to avoid taking these calls in the first place. In case you do, be sure to avoid giving out any personal details. Please also lodge a complaint with Airtel and intimate the police. A letter in writing from both sources might help you clear you if your name is wrongly utilized ever.

Readers Responses
1. Sir, congratulations for getting the award. We are proud of you: Sanjay Rai
2. Hearty congratulations. I feel so happy and so proud: Dr. Rissam
3. Hardwork, dedication, selfless service and of course, your intelligence has been recognized. We feel proud of you: Dr. Arti and J C Pathak
4. Heartiest congratulations to you for the prestigious National Award. You very richly reserved it: Dr. Hem C. Gupta
5. Many Many Many Many Many Congratulations for receiving PADMASHRI award: Dr. Pramod Lokegaonkar, Manager, Medical Cell, Sandu Pharmaceuticals Ltd.
6. Great News. Congratulations. Regards: Gurmeet
7. Respected Sir, Namaskar, Heartiest Congratulations to you Sir for the prestigious Padmashri Award. You really deserve it. You are doing excellent work not only in the field of Medicine but otherwise also.
8. As suggested by emedinews, Sir, my brother had gone to AIIMS. But the doctors their mentioned that Swapping Kidney Donation Law has not been passed by the Delhi Govt as yet. The patient is my sister's son and so my sister is ready for swap donation. We had also got the registration done in AIIMS for cadaver donor, but there are already many patients before our patient. With warm Regards. Thanks a lot Sir: Indu Sharma
9.Congratulations to Dr KK Aggarwal for receiving the awards for excellence: Abha Bhatnagar
10. Hi Kissu, Congratulations for this award too. We all are so proud of you. I feel great myself being associated with you. Regards: Amal (Dolly)

11. Dear Dr.K.K. Aggarwal, Central Govt. and  MCI are planning to introduce a  3 1/2 year Medical degree for providing Health care to the poor Villagers in India. I am sure it is not because of love and affection towards the rural people but with some ulterior motives involving the Central  Govt.  I just don't know why  eMedi News  is intentionally keeping quiet? Dr.M.Bhaskaran, CWC member , Kerala
Response: As a newspaper we have been carrying most of the responses of our readers.

12. Dear Dr Aggarwal, Many congratulations to you for the honour well deserved, Emedinews is a god idea.Please keep it goind, Dr Geeta

Conference Update
Researchers from Israel reported that a simple test for blood levels of the CD24 protein is more than 90% sensitive and specific for detecting colorectal cancer, and more than 80% accurate at identifying adenomas. The CD24 protein is a cell-surface protein and P-selectin ligand that is involved in cell adhesion and metastasis, and has previously been associated with colorectal cancer (CRC). It is elevated in the majority of patients with CRC or adenomas and may serve as a biomarker for early detection and surveillance of CRC. (Sarah Kraus, Tel Aviv Souraski Medical Center, Israel) In another study, an immunoassay, which identifies and quantifies serum PAM4 protein showed promise for detecting early-stage pancreatic cancer with a high degree of accuracy. PAM4 protein is an antigen that is present in nearly 90% of pancreatic cancers but is not typically observed in association with benign lesions or other malignancies. (David V. Gold, Garden State Cancer Center, Belleville, New Jersey) (2010 Gastrointestinal Cancers Symposium: Abstracts OP162 and 135)

Conference Calendar
Frontiers in Carcinogenesis and Cancer Prevention Research: Scientific Advances and Public Health Initiatives
February 5-7, 2010
Venue: Dhirubai Ambani Life Sciences Centre, Navi Mumbai,

Mumbai, Maharashtra

Public Forum
Press Release

Family Meals - The Best Way To Acquire Mental Health

Teenagers who have two or fewer family meals weekly are twice as likely to smoke and drink as teens eating five such dinners a week, according to a study by the National Center on Addiction and Substance Abuse at Columbia, said Dr. KK Aggarwal, President, Heart Care Foundation of India and Editor eMedinewS. Eating together always provides grounding for family members.

A national study of kids between 3 and 12 has shown that more meal time at home is the single strongest predictor of better achievement scores, ahead of time studying or in church. Researchers has shown a strong link between eating at least five dinners a week with a parent and children who are less likely to use drugs and develop good eating habits. Best meals are enjoyed at home with the television off and that children should be encouraged to chat, not badgered to eat broccoli or explain poor grades.

Punjab & Sind Bank
Central Bank of India

Question of the Day
Is intramuscular quinine as effective as intravenous quinine?

One RCT in children found no significant difference between IM and IV quinine in recovery times or death. However, the study may have lacked the power to detect clinically important differences between treatments.

Suggested reading: Pasvol G, et al. Quinine treatment of severe falciparum malaria in African children: A randomized comparison of three regimens. Am J Trop Med Hyg 1991;45:702?13.

eMedinewS Try this it Works
The formula of lucky seven
Once-daily IV aminoglycoside protocol (Hartford Hospital, Hartford, Connecticut). Dosing regimen for gentamicin or tobramycin sulfate:

  • Give 7 mg/kg (unless patient is morbidly obese).
  • Check the drug level, 7 hours after the start of infusion.
  • If the serum level is less than 7 mg/L, give the drug every 24 hours. (If the serum level is more than 7 mg/L, check the nomogram for dosing interval)

Dr Good Dr Bad
Situation: A diabetic patient was found to have an A1C of 7.4%
Dr Good: I want to bring it to < 7%.
Dr Bad: It's ok.
Lesson: A1C < 7% is equivalent to fasting glucose 70 to 130 mg/dL (3.89 to 7.22 mmol/l) and postprandial glucose (90 to 120 minutes after a meal) <180 mg/dL (10 mmol/L). (Source: Diabetologia 2008;51:8)

Make Sure
An HIV patient died after sulfa prophylaxis
Reaction: Oh my God! You should have known that he was sulfa sensitive.
Make sure that patients with a history consistent with Stevens Johnson syndrome and toxic epidermal necrolysis or an exfoliative dermatitis due to a sulfonamide medication should strictly avoid the culprit drug and other agents in the same sulfonamide group. Re-exposure to the same agent may be fatal.

Laughter the Best Medicine
I was sitting in the waiting room of the hospital after my wife had gone into labour and the nurse walked out and said to the man sitting next to me, "Congratulations sir, you're the new father of twins!" The man replied, "How about that, I work for the Doublemint Chewing Gum Company." The man then followed the woman to his wife's room.
About an hour later, the same nurse entered the waiting room and announced that Mr. Smith's wife has just had triplets. Mr. Smith stood up and said, "Well, how do ya like that, I work for the 3M Company." The gentleman that was sitting next to me then got up and started to leave. When I asked him why he was leaving, he remarked, "I think I need a breath of fresh air." The man continued, "I work for 7-UP."

Formulae in Imaging
Decubitus pleural fluid measurements can be quantified as 'small' (<1.5 cm), 'moderate' (1.5 to 4.5 cm) and 'large' (>4.5 cm). (Source: Am J Radiol 1987;148:681-3)

ENT Facts
The management of acute otitis media (AOM) should include an assessment of pain.

SMS Anemia
In leukocytosis with anemia, rule out presence of infection, inflammation, or a hematologic malignancy.

Milestones in Neurology
Walter Russell Brain (October 23, 1895- December 29, 1966) was a British neurologist. He was principal author of the standard work of neurology, Brain's Diseases of the Nervous System, and longtime editor of the neurological medical journal titled Brain. He is also eponymised with 'Brain's reflex', a reflex exhibited by humans when assuming the quadripedian position.

Mistakes in Critical Care
Use generic names when possible; beware of sound-alike brand names.

Complaint is the largest tribute heaven receives and the sincerest part of our devotion. (Jonathan Swift)

List of Approved Drug From 01.01.2009 TO 31.10.2009

Drug Name Indication Approval Date
Acebrophylline Syrup 10mg/ ml
For the treatment of adult patients with chronic obstructive pulmonary disease (COPD) and bronchial asthma

(Advertorial section)

Green Tea ( CAMELLIA SINENSIS ) when used along with Unique Health Supplements like Sodium Meta silicate, Sodium,
Phosphate and Ammonium Chloride  may help boost Body Metabolism to aid weight loss, block allergic response, slow down the growth of tumours, protect bones, fight bad breath, Improve Skin, Protect against Alzheimer,s  and Parkinson,s Disease and even delay the onset of Diabetes. The Combination is known to Reduce the VLDL and LDL Levels and thus Reduce the Incidence of Stroke and Heart Disease.

Advertising in emedinews
emedinews is the first daily emedical newspaper of the country. One can advertise with a singe insertion or 30 insertions in a month. Contact: drkk@ijcp.com. emedinews@gmail.com 

eMedinewS-PadmaCon 2010 
Will be organized at MAMC on 4th?July Sunday to commomorate Doctors' day. The speakers, chairpersons and panelists will be various past and present medical Padma awardees of NCR.

eMedinewS-revisiting 2010
The second eMedinewS-revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on 2nd January 2011. The event will have a day-long CME, doctor of the year awards, cultural hangama and live webcast. Suggestions are invited.

Also, if you like emedinews you can FORWARD it to your colleagues and friends. Please send us a copy of your forwards.