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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; Member 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


Dear Colleague

5th April, 2010, Monday

Can too much calcium pose a health risk?

Calcium is the most plentiful mineral in the human body. Although most of it is locked into bone, every cell in the body also needs small amounts of calcium.

But calcium sometimes builds up where it shouldn’t, such as in the breast tissue or arteries. When this happens, one may wonder if one is getting too much calcium from food and supplements.

Not to worry, says the March 2010 issue of Harvard Women’s Health Watch. So far, researchers haven’t identified any direct links between the amount of calcium taken in from food and supplements and calcium accumulation in the breast or coronary arteries.

How does calcium get deposited beyond the bones? Benign breast calcifications can form as a response to injury. When any part of the breast is damaged, fat cells die, releasing fatty acids that combine with calcium to form deposits.

Calcium can also accumulate in the cholesterol–rich plaque that develops after an injury to an artery wall. The plaque is usually soft to begin with, but eventually tends to harden and become calcified. In addition, blood vessel cells themselves sometimes convert into bone–forming osteoblasts, producing extra calcium on the spot.

Current nutrition guidelines recommend that women between the ages of 19 and 50 get a total of 1,000 milligrams of calcium a day; women over age 50 should get 1,200 milligrams. With calcium, as with almost everything else, more does not mean better.

Dr KK Aggarwal
Chief Editor

News and views

When to scree for diabetes

The current practice has been to start screening for Type 2 diabetes at age 45, especially, for those who are overweight, but new research is recommending to start screening at age 35. (American Diabetic Association, Richard Khan of University of North Carolina)

Medpage Meeting Notes : American College of Cardiology: Atlanta, GA  •  March 14 – 16, 2010

1. FDA announces review of ACCORD Data

The FDA said it will conduct a full review of findings from a study which concluded that neither aggressive lipid–lowering therapy nor tight blood pressure control reduced cardiovascular events in persons with diabetes. The study, known as ACCORD, investigated the addition of fenofibrate to statin therapy. It was this add–on therapy that appears to have triggered the FDA review. The addition of fenofibrate did not reduce cardiovascular events, the study found, although there was a non–significant trend toward a benefit in a subset of patients.

2. Vitamin D not linked to myalgia in TNT study

Researchers could not find a link between levels of vitamin D and the incidence of myalgias among patients treated with atorvastatin. Myalgias occurred infrequently in the Treating to New Targets (TNT) study, and it didn’t seem to differ between groups of patients with low levels of vitamin D or those with high levels of the drug (Dr Vera Bittner, University of Alabama at Birmingham)

3. Statin Rx based on C–Reactive proteins Cost–effective

Treating people with normal low–density lipoprotein cholesterol but elevated levels of C–reactive protein with statins would be cost–effective. {data from the landmark JUPITER trial (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin)}

4. Renin inhibitor fails to improve post–MI outcomes

When added to optimal medical therapy, aliskiren, a direct renin inhibitor, did not improve outcomes for patients who had had a myocardial infarction accompanied by left ventricular dysfunction. After 36 weeks, the reduction in left ventricular end–systolic volume, the primary endpoint, was not significantly different between those receiving aliskiren and those receiving placebo. (Dr Scott Solomon, Brigham and Women’s Hospital, Boston).

What’s New: Ultrasound better than alpha–fetoprotein screening

A new guideline from the American Association for the Study of Liver Diseases re–emphasizes that screening patients with hepatitis B for hepatocellular carcinoma should be performed by obtaining an ultrasound every six months rather than by measuring serum alpha–fetoprotein.

Celiac Disease (Dr Ishi Khosla)

How common is celiac disease?

According to estimated it affects 1% of the population. However, 97%of them are estimated to be undiagnosed; the ones who are diagnosed are the 25% who manifest with typical symptoms. The silent and atypical cases which usually go undiagnosed. A celiac iceberg represents the situation. The tip of the iceberg shows the diagnosed cases.

Diabetes Fact

Diabetic foot earliest feature is : Callous formation

Public Forum
(Press Release)

75 mg aspirin the best

75 mg daily aspirin is best for the long–term prevention of cardiovascular disease and stroke without causing serious side effects, said Dr K K Aggarwal, Padmashri and Dr BC Roy Awardee and President, Heart Care Foundation of India.

Higher doses of aspirin, which are commonly prescribed, don’t offer better protection and are associated with increased risks of gastrointestinal bleeding.

More than 5 crore adults in the United States take aspirin regularly for long–term prevention against heart attack and stroke. Typically, doses are either 81 milligrams a day or 325 milligrams a day. The appropriate long-term daily dose remains a matter of contention.

In a study published in the Journal of the American Medical Association doctors reviewed 11 clinical trials and found that aspirin doses as low as 30 milligrams a day are effective in inhibiting clot–causing platelets from accumulating, although doses as high as 1,300 milligrams a day are approved for use.

In the United States, 81 milligrams a day of aspirin is the most commonly prescribed dose, accounting for 60 percent of prescriptions. This is followed by 325 milligrams a day, accounting for 35 percent of all prescriptions.

There was no evidence that a higher dose of aspirin provided more efficacy than lower doses of aspirin. On the contrary, every trend is to see more bleeding on higher doses.

People at risk for a first or second heart attack should take no more than 81 milligrams of aspirin a day.

Question of the day

How is Microdermabrasion performed?

Microdermabrasion is an office–based procedure. A normal procedure should take about 15–30 minutes, depending on the skin condition and area treated. The Microdermabrader equipment consists of a tabletop unit that uses a delicate tubular hand–piece through which air is circulated through small hoses to force a stream of small abrasive particles that sandblasts the surface of the skin. This leads to exfoliation, clarity, renewal, refinement and firming of the skin.

eMedinewS Try this it Works

Is it ester or amide?

True allergic reactions to local anesthetics are rare and usually involve an ester agent. Allergic reactions are seldom caused by amide anesthetic agents.

An easy way to determine whether an agent is an amide or an ester is to look at the spelling of the generic name. Any "–caine" anesthetic containing the letter i (as in amide) in the prefix is an amide agent (eg, prilocaine). The ester agents do not contain an i in the prefix.

Dr Good Dr Bad

Situation: A postmenopausal female came for routine evaluation.

Dr Bad: Get routine blood test done.

Dr Good: Also get A1C done.

Lesson: Postmenopausal women had greater percentage body fat and intra–abdominal visceral fat than premenopausal women, suggesting that the former group would be more susceptible to diabetes than the latter group. The Santiniketan Women study evaluated the Indian diabetes risk score (IDRS) according to menopausal status in Asian Indian women. Of the 102 premenopausal women, 9% were categorized as high risk, whereas of the 34 postmenopausal women, 38% were considered to be high risk. (J Diabetes 2009;1:140–1.)

Make Sure

Situation: A technician working in hemodialysis unit developed jaundice which was found to be positive for hepatitis B.

Reaction: Oh My God! Why did you not receive prophylaxis against hepatitis B?

Make sure to vaccinate all health workers engaged in renal dialysis unit, liver, unit, hemophilia and oncology units, for hepatitis B.


Laughter the best medicine

Why did the guru refuse Novocaine when he went to his dentist?

He wanted to transcend dental medication.


Formulae in Critical Care

Venous oxygen content (CvO2)

Formula: CvO2 = (1.34 × SvO2 × Hb) + (0.0031 × PvO2)

SvO2 – percentage saturation of oxygen in venous blood.

Comment: Normal values are 14.5–15.5 ml/100 ml of blood.


Milestones in Medicine

300s B.C. The Romans built a sewerage system. Their aqueducts carried 300 million gallons of fresh water a day – contributing significantly to public health.


List of Approved drug from 1.01.2009 to 31.10.2009

Drug Name


Approval Date

Zolmitriptan...5.0% w/v Benzalkonium Chloride NF ... 0.01% w/v Nasal spray

For the acute treatment of migraine with or without aura in adults.


(Advertorial section)


Zen Immune Beauty helps improve the brittleness of nails and increase the hair tensile strength, thus preventing hair loss. It stimulates regeneration of hair roots, helps prevention of comedone formation and post comedone skin scarring in acne vulgaris.

Advertising in eMedinewS

eMedinewS is the first daily emedical newspaper of the country. One can advertise with a single insertion or 30 insertions in a month.

Contact: drkk@ijcp.com or emedinews@gmail.com

eMedinewS–PadmaCon 2010 

Will be organized at Maulana Azad Medical College, New Delhi on July 4, 2010, Sunday to commemorate Doctors’ Day. The speakers, chairpersons and panelists will be doctors from NCR, who have been past and present Padma awardees.

eMedinewS–revisiting 2010

The second 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.

NATIONAL SEMINAR ON STRESS PREVENTION (17 – 18 April). Over 400 registrations already done.

A Stress Prevention Residential Seminar cum spiritual retreat with Dr KK Aggarwal and Experts from Brahma Kumaris will be organized from April 17–18, 2010.

Co–organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, IMA New Delhi Branch and IMA Janak Puri Branch, IMSA (Delhi Chapter)

Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.

Timings: On Saturday 17th April (2 pm onwards) and Sunday 18th April (7 am–4 pm). There will be no registration charges, limited rooms, kindly book in advance; stay and food (satvik) will be provided. Voluntary contributions welcome. For booking e–mail and SMS to Dr KK Aggarwal: 9811090206, emedinews@gmail.com BK Sapna: 9811796962, bksapna@hotmail.com

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

Delhi Medical Council Presents

An interaction with

Dr. Ketan Desai, President, Medical Council of India 
Mr. Mukul Rohtagi, Senior Advocate, Supreme Court of India
Dr A K Aggarwal, Dr A K Aggarwal, President, Delhi Medical Council

Topic: Medical Ethics & Doctor–Pharma Relationship – New MCI Amendments

Date: April 10, 2010, Saturday

Time: 6 pm – 9 pm

Venue: Maulana Azad Medical College Auditorium, Dilli Gate, New Delhi

Dr KK Aggarwal: Moderator, and Chairman Ethical Committee Delhi Medical Council

Dr Girish Tyagi: Registrar, Delhi Medical Council

For Registration SMS to Dr KK Aggarwal: 9811090206, or email to emedinews@gmail.com

No fee

Readers Responses

  1. Dear Kishen, Congratulations once again for this great honour on a great person!! My family joins in sharing this joy with you and your family. Dr Ahmed Qureshi, Consultant and Head, ENT & HN Department, Medinat Zayed Hospital, Ministry of Health, AbuDhabi, UAE

  2. Dear Sir, Congragulations! Regards, AnithaVijay, Client Service Representative, Informatics (India) Limited No. 194, R V Road, Basavanagudi, Bangalore 560 004,Karnataka, INDIA

  3. Congrats for receiving padma Shri award from the President of India: Dr A. Selvarajan

  4. Good morning: Dr g tusi great ho tohfu kabul karo. Heartfelt congrats...... U r my source of inspiration since the time i hv known u evn though with d stressful lifestyle v all r going through u found ur way 2 reach upto us......emedinews....... ur thought n compassion to reach out to everyone makes u Unique n Worthy human being.... I feel connected to u as my guide n my daily guidance comes in form of experts in ur emedinews. Keep going.....such tht v keep movng. God bless...... Tk cr. Sonia

  5. Dear Dr KK Aggrawal, Heartiest Congratulations, for receiving PADMA SHRI Award. Your achievements make us very proud & happy. Good wishes for a future with greater successes and Happiness. Kind regards. ShivrupTiwari

Lighten to Enlighten!

This batch, Our batch 1975 Stars each one of them,

Out of this world, Born on earth Slated to be together,Together at ‘Sewagram’

Humane touch, humane reasons!

One of them all A super-doc,

A super being, Shone brightly,

Got things right, Clicked in the world

With a work,

Incomparable and impeccable, Enlightened the beings all over,

Got the best of the land;

Raised the name of -

This batch Our Batch “1975”.

For most he is Krishan, But for a few “He” is ‘Kissu’,

The ‘Torch Bearer’ of The Batch 1975!

Dr Rajesh Chauhan (1975 Batch MGIMS, Now Sr. Anaesthetist at Escorts Heart Hospital)