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  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


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  Editorial …

14th August 2011, Sunday

Weight loss may improve sexual health of obese diabetics

Weight loss improves the sexual health of obese men with type 2 diabetes, according to a study published in the Journal of Sexual Medicine.

A modest weight loss of 5% can lead to an easing of erectile dysfunction and improvement in sexual desire within eight weeks and positive effects continue to improve in the next 12 months. The typical weight reduction diet involves consuming low-calorie diet or a low-fat, high-protein, reduced-carbohydrate diet meant to decrease calorie intake by 600 calories a day.

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Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal on

Weight loss may improve sexual health of
obese diabetics

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    Photo Feature (from the HCFI Photo Gallery)

National Conference on Insight on
Medicolegal Issues

Dr Sanjiv Malik presented his views on Doctor–pharma relationship during the National Conference on Insight on Medicolegal Issues held on 10th July, 2011.

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


65–yr–old man undergoes rare surgery for hernia of spinal cord

NEW DELHI: Doctors at AIIMS here have conducted on a 65–year–old man a surgery for hernia of the spinal cord, a very rare medical condition. The man was brought to the hospital with the whole of his spinal cord practically protruding out of its covering (dura) through a small opening, said Dr Sarat Chandra, a neurosurgeon with AIIMS. "This is an extremely rare condition called hernia of the spinal cord. There are less than 10 cases reported worldwide on this entity. He is recovering well," Dr Chandra said. Due to this condition the man started developing progressive paraparesis with sensory loss in both lower limbs, he said. During surgery, doctors cut the cover of the cord. "The incision was made carefully around the herniated cord and this portion was then freed along with the spinal cord. Following this the dura was carefully repaired to avoid any further problems." (Source: TOI, Aug 11, 2011)

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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

(Dr Monica and Brahm Vasudev)

Herceptin heart risks clarified for older patients

Older breast cancer patients with heart disease or diabetes have a significantly increased risk of cardiotoxicity when treated with trastuzumab (Herceptin), according to data from a single–center chart review. (Source: Medpage Today)

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Indian spice turmeric to treat arthritis

An international team of researchers has found that a derivative of a common culinary spice found in Indian curries could offer a new treatment hope for sufferers of the painful condition tendinitis. The researchers at The University of Nottingham and Ludwig Maximilians University in Munich have suggested that curcumin, which also gives the spice turmeric its trademark bright yellow colouring, can be used to suppress biological mechanisms that spark inflammation in tendon diseases. Dr Ali Mobasheri of the University’s School of Veterinary Medicine and Science, who co–led the research, said: "Our research is not suggesting that curry, turmeric or curcumin are cures for inflammatory conditions such as tendinitis and arthritis." However, we believe that it could offer scientists an important new lead in the treatment of these painful conditions through nutrition. Further research into curcumin, and chemically–modified versions of it, should be the subject of future investigations and complementary therapies aimed at reducing the use of non–steroidal anti–inflammatory drugs, the only drugs currently available for the treatment of tendinitis and various forms of arthritis," added Mobasheri. The research will be published in the Journal of Biological Chemistry. (Source: TOI, Aug 10, 2011)

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New ‘biomarker’ blood test could improve prostate cancer detection

A new DNA–based "biomarker" blood test that complements the currently offered prostate–specific antigen (PSA) test, could greatly improve the accuracy of prostate cancer detection before recommending patients for an invasive biopsy, according to a new study. University of Cincinnati (UC) researchers conducted a meta–analysis of existing published data related to DNA methylation in bodily fluids. The goal was to evaluate a specific cancer biomarker–known as GSTP1–as a screening tool for prostate cancer. Wu determined that GSTP1 was a statistically significant biomarker for prostate cancer and could increase the specificity of prostate cancer diagnosis by up to 70 percent as compared to using the PSA test alone. "The PSA test is highly sensitive, but it cannot differentiate between prostate cancer and benign prostatic conditions such as benign prostatic hyperplasia, leading many men to have unnecessary biopsies," says Wu. "Measuring GSTPI in plasma or urine is an easy and non–invasive test. This biomarker will give physicians reassurance regards to whether to conduct biopsies in selected patients," she added. The study will be published in the British Journal of Cancer.
(Source: http://www.thehindu.com/health/medicine–and–research/article2342367.ece, Aug 10, 2011)

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    Fitness Update

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

Focusing on neurobehavioral processes, not personal choice, may improve obesity counseling

Current approaches to dietary counseling for obesity are heavily rooted in the notion of personal choice and will power – the ability to choose healthy foods and portion sizes consistent with weight loss while foregoing sweets and comfort foods. According to preventive medicine and behavioral experts at Rush University Medical Center, research supports a new counseling approach that views obesity as a result of neurobehavioral processes – ways in which the brain controls eating behavior in response to cues in the environment.

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    Twitter of the Day

@DrKKAggarwal: #IJMD Root canal procedure is a difficult procedure in itself; but when canal is obstructed by a foreign body it… http://fb.me/1cRhjOfKz

@DeepakChopra: #CosmicConsciousness The particular is the universal from a unique perspective

    Dr KK Answers

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

Can CT cause cancer?

Use of CT may account for 1.5–2% of all future cancers in the United States. The 2006 Biological Effects of Ionizing Radiation VII lifetime attributable cancer risk model predicts that 1 in 1000 persons exposed to 10 mSv (single diagnostic CT scan of the neck, chest, abdomen, or pelvis) will develop cancer due to that single exposure. The lifetime attributable cancer mortality risk attributable to a single radiation exposure in a one year–old child is 1 in 550 following an abdominal CT and 1 in 1500 following a brain CT.

It has been estimated that 29,000 future cancers could be attributed to CT scans performed in the US in 2007 alone. 1 in 500 women and 1 in 660 men will develop cancer from their abdominal CT scan if the procedure is performed at the age of 20.A 45 year–old adult undergoing one single full–body CT procedure would accrue an additional lifetime attributable cancer mortality risk of 0.08% from a single scan. The lifetime attributable cancer mortality risk is 1.9% lifetime for 30 years of annual scans.

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    Spiritual Update

Lessons from Vaidya Sushena

A medical doctor is accorded a status next to God as he or she has a duty to heal the sick irrespective of their caste, creed, race or financial status. The classical description of the duty of a doctor was depicted in the Hindi Bolywood movie ‘Achanak’ by Gulzar in 1973. In the movie, Vinod K

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    An Inspirational Story

(Ms Ritu Sinha)

The true winner

A story is related about Puryaye Vali who is considered a great world champion as well as a symbol of manliness and bravery. Once he visited another country for a wrestling contest with its champion. In the street he came across an old woman who was offering people sweets as charity and asking them to pray for her son. She approached Puryaye and offered him the sweets. He asked her what they were for. She said, "My son is a wrestler who is being challenged by a champion from another country. We live on the income he gets from wrestling matches and if he loses this contest we will have nothing to live on." Puryaye says he was at cross roads whether to show his strength or manliness at the contest the next day. Although he was far stronger than his opponent he wrestled in such a way as to let his opponent win. He says that at that moment he suddenly felt as though his heart had been opened and he was surrounded with peace.

"The strongest person is he who has conquered his desires."

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    Pediatric Update

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

Causes of obesity in adolescents

  • More reliance on school canteen
  • Junk/fried food (burgers, pizzas, samosas, pakoras)
  • Cokes
  • Inactivity
  • Watching too much TV, sitting on computer

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  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


Increased levels are seen in: Hyperaldosteronism (primary or secondary).

Decreased levels are seen in: Adrenal insufficiency, panhypopituitarism.

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    IJCP Special

Dr Good Dr Bad

Situation: A patient came with severe secondary MR with refractory end–stage heart failure.
Dr. Bad: Go for mitral valve repair.
Dr. Good: Try biventricular pacing.
Lesson: As per 2005 ACC/AHA heart failure guidelines, effectiveness of mitral valve repair or replacement for severe secondary mitral regurgitation in refractory end–stage HF is not established (Circulation 2009;119:e391).

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Make Sure

Situation: A 13–year–old girl complained of epigastric pain, fatigue and anorexia. Elevated serum gastric level (900 MIU/l) raised the suspicion of gastrinoma.
Reaction: Oh my God! Why did you not put her on triple therapy for H. pylori infection?
Lesson: Make sure to remember that H. pylori infection is the most important cause of hypergastrinemia other than gastrinoma in childhood.

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  Quote of the Day

(Dr GM Singh)

If you do not change direction, you may end up where you are heading.
Lao Tzu

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(Ms Ritu Sinha)

Devil’s Advocate: Someone who takes a position for the sake of argument without believing in that particular side of the argument. It can also mean one who presents a counter argument for a position they do believe in, to another debater.

    Medicolegal Update

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

A medicolegal case must be informed to the nearest police

A doctor not informing the police is a criminal offence under IPC Sections 177 and 201

A medicolegal report is prepared for the purpose of litigation, imminent or prospective, by the treating doctor. The responsibility to label any case as a medicolegal case (MLC) rests solely with the attending medical practitioner in absence of police or any other legal references. According to the Hon’ble Supreme Court, whenever any MLC comes to the hospital, the government doctor on duty or private doctor attending the case should start the treatment of the patient and if he thinks that the case needs to be reported to the police, he should do so without fail and without any justified delay to the police on duty, giving the name, age, sex of the patient and the place of occurrence of the incident. It will be the duty of the said Constable/duty officer of police station to inform the nearest concerned police station/higher police functionaries for further action.

  • Section 177 IPC states that giving false information is punishable criminal offence and if proved the doctor may be punished up to six months.
  • Section 201 IPC deals with causing disappearance of evidence of offence or giving false information to screen the offender. This is a graver offence and imprisonment depends on the gravity of case.

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    Mind Teaser

Read this…………………

All of the following are true for patients of ulcerative colitis associated with primary sclerosing cholangitis (PSC), except:

1. They may develop biliary cirrhosis.
2. May have raised alkaline phosphatase.
3. Increased risk of hilar cholangiocarcinoma.
4. PSC reverts after a total colectomy.

Yesterday’s Mind Teaser: Q. The most common complication seen in hiatus hernia is:

1 Oesophagitis.
2 Aspiration pneumonitis.
3 Volvulus.
4 Esophageal stricture.

Answer for Yesterday’s Mind Teaser: 1 Oesophagitis.

Correct answers received from: Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay, Dr S Kant Gupta, Dr Anupama, Dr Shreyesh, Dr Priya, Dr Tapan, Dr Gunjan.

Answer for 12th August Mind Teaser: A bird in the hand is worth two in the bush
Correct answers received from: Dr Pramod M Kulkarni, Dr Shirish Singhal, Dr Theogaraj Samraj,
Dr SK Bansal, Dr BB Aggarwal, Dr Rajiv Kohli, Dr Shashi Saini, Dr S Kant Gupta, Dr Amit Kochar.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr Chandresh Jardosh)

Once upon a time there was a loving couple. The were both poets and for some strange reason when they had a fight, it was very poetic. Here is a sample of an exchange between the two:

Twinkle twinkle little star
You should know what you are
And once you know what you are
Mental hospital is not so far

The rain makes all things beautiful.
The grass and flowers too.
If rain makes all things beautiful
Why doesn’t it rain on you?

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    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name
DCI Approval Date
S-Bupivacaine Hydrochloride Injection 2.5mg/5mg/7.5mg per ml
For surgical anaesthesia in adults for epidural (including caesarean section), intrathecal, peripheral nerve block.
    Public Forum

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Premature heart disease

Premature or early heart attack is when a man gets it before age 55 or a woman before age 65, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India & MTNL Perfect Health Mela. The mean age for premature heart attack is 53 to 54 yrs.

Family history of premature heart disease is positive if any of the first–degree relatives i.e. father, mother, brother or sister had suffered from an earlier or premature heart attack.

Having one first–degree relative with a heart attack below age 55 increases the risk in the subsequent generation by 33% and having two relatives increase the risk by 50%.

In addition, offsprings of patients with premature heart disease are more likely to have coronary risk factors than those without such a family history. These include excess body weight and elevations in higher levels of serum cholesterol, glucose and insulin. These offsprings are also more likely to have evidence of vascular disease such as endothelial dysfunction and increased carotid artery intima–media thickness.

Younger patients with heart disease more often have a family history of premature heart disease.

It is estimated that a family history unrelated to conventional risk factors can account for 15 percent of heart attacks.

Compared to no parental history of a heart attack, a maternal history, a paternal history, and both maternal and paternal history are associated with a relative risk of future heart attack of 1.71, 1.40, and 1.85 respectively in men and 1.46, 1.15, and 2.05 respectively in women.

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    Readers Responses
  1. (eMedinews, 28/07/2011: Dr K K Answers: Can garlic lower cholesterol?)
    In reference to above column, It seems that different studies show different results. Health Benefits of Garlic/Clinical Studies: A study by Silagy and Neil (1994) showed that that garlic supplements have an important part to play in the treatment of high cholesterol. Overall, a 12% reduction in total cholesterol was shown over a placebo and that this reduction was normally evident after only 4 weeks treatment and was considered likely to persist for as long as the study was in progress. The largest study so far was conducted in Germany where 261 patients from 30 general practices were given either garlic powder tablets or a placebo. After a 12 week treatment period mean serum cholesterol levels dropped by 12% in the garlic treated group and triglycerides dropped by 17% compared to the placebo group. from: http://ayurvediccure.com/garlic.htm. Regards: Marek Rozenberg
    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & National Icons in the field of Cardiology & Echocardiography will form the teaching faculty.



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