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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 7 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

18th October 2012, Thursday

Statins and Diabetes Risk

Use of statins was associated with a slight increase in fasting glucose levels in patients at increased risk of type 2 diabetes in a new observational study published September 13, 2012, in BMJ by Dr Nina Rautio at Pirkanmaa Hospital, Tampere, Finland. The findings suggest statin use might have unfavorable effects on glucose metabolism and hamper beneficial effects of lifestyle in people at high risk of type 2 diabetes. Intensive Lifestyle Intervention therefore is the Key.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Carnitine Update


  • Deficiencies in thiamine, selenium and L-carnitine have been reported to produce heart failure and replacement therapy results in improvement in cardiac function.
  • Carnitine deficiency impairs the oxidation of fatty acids, resulting in lipid accumulation in the myocyte cytoplasm. This problem is reversed with L-carnitine replacement.

What is hypertrophic cardiomyopathy?

Hypertrophic cardiomyopathy is a condition characterized by unexplained LV hypertrophy associated with nondilated ventricular chambers in the absence of another cardiac or systemic disease. It is one of the most common causes of sudden cardiac death. A small proportion of patients with HCM who survive the early risk of sudden death develop progressive myocardial wall thinning, a reduction in systolic performance, and an increase in left ventricular dimensions in the long term, resembling the morphologic and functional features of dilated cardiomyopathy.

For Comments and archives…

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Fibrates have been shown to increase creatinine levels in randomized trials

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela to train 10,000 people in compression only CPR

Addressing a press conference, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that more than 10,000 members of the public would be certified in compression only CPR during the Mela.

Dr K K Aggarwal
    National News

Ganga water can cause cancer: Study

New Delhi: The river Ganga, lifeline to millions of Indians and the most holy river to Hindus, has become a source of carcinogens as well. With pollutants being continuously dumped into the river, a study has found that people living along its course are more susceptible to cancer than anywhere else in the country.

According to the National Cancer Registry Programme (NCRP), the river is suffused with heavy metals and poisonous chemicals, especially along the stretches in Uttar Pradesh, Bihar and West Bengal. “Ganga water is now laced with toxic industrial discharge such as arsenic, chloride, fluoride and other heavy metals,” Jaideep Biswas, director of Chittaranjan National Cancer Institute, an associate of the National Cancer Registry Programme, was quoted saying to a leading newspaper. Gallbladder cancer cases in these areas are the second highest in the world and prostate cancer highest in the country. The research revealed that of every 10,000 people surveyed, 450 men and 1,000 women were gallbladder cancer patients. Other forms of cancer were also found among the people living along the river course, such as kidney, oesophagus, liver, urinary bladder and skin cancer. “Those who've been bathing in this poison river are equally at danger,” said Biswas.
(Source: http://zeenews.india.com/news/eco-news/ganga-water-can-cause-cancer-study_806068.html, October 17, 2012)

For comments and archives

My Profession My Concern

Quality Measures related to heart failure

  • Evaluation of left ventricular systolic function: The percentage of heart failure patients with documentation that an evaluation of the left ventricular systolic (LVS) function was performed before arrival, during hospitalization, or is planned for after discharge. US National average performance is 98 percent.
  • Angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor (ARB) for left ventricular systolic dysfunction: The percentage of heart failure patients with left ventricular systolic dysfunction and without contraindications who are prescribed an ACE inhibitor or an ARB at hospital discharge. US National average performance is 95 percent.
  • Discharge instructions: The percentage of heart failure patients discharged home with written instructions or educational material given to patient or care giver addressing all of the following: activity level, diet, discharge medications, follow-up appointment, weight monitoring, and what to do if symptoms worsen. US National average performance is 89 percent.
  • Smoking cessation advice/counseling: The percentage of heart failure patients with a history of smoking cigarettes who are given smoking cessation advice or counseling during a hospital stay. US National average performance is 99 percent.

For comments and archives

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    Valvular Heart Disease Update

Low gradient aortic stenosis: Role of dobutamine stress echocardiography

In patients with low gradient aortic stenosis (thought to be related to low flow), it can be useful to determine the transvalvular pressure gradient and calculate the valve area and resistance during a baseline state and again during exercise or other hemodynamic stress, including dobutamine infusion. The valve area may increase during an increase in the cardiac output in some patients with low gradient aortic stenosis. If dobutamine produces an increment in cardiac output, an increase in valve area, and a decrease in resistance, it is likely that the baseline calculations produced an overestimation of the stenosis severity.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Prehospital shock index predicts emergency blood transfusion

The prehospital shock index — a measurement obtained while the patient is en route to a trauma center — can predict the need for emergency blood transfusion, according to a study from investigators at the Shock Trauma and Anesthesiology Research Center (STAR) of the University of Maryland, in Baltimore. The approach can be lifesaving, but its advantages go beyond this, according to Peter F. Hu, who presented the study at Anesthesiology 2012: American Society of Anesthesiologists (ASA) 2012 Annual Meeting. (Source: Medscape)

For comments and archives

Routine physicals don't save lives

Patients who had regular general health checkups died of cardiovascular disease and cancer at virtually the same rate as those who did not have checkups, results of a systematic review and meta-analysis showed. (Source: Medpage Today)

For comments and archives

COPES: Post-ACS enhanced depression care is worth the cost

The total costs of treating patients after an acute coronary syndrome can be reduced with aggressive treatment of depression, a new study shows. In the Coronary Psychosocial Evaluation Studies (COPES), Dr Joseph Ladapo (New York University, NY) and colleagues randomized 157 post-ACS patients with at least three months of depression to either usual care or enhanced depression care with a stepped-care algorithm that included problem-solving psychotherapy, antidepressant medication, or both. Results of their study are published October 15, 2012 as a research letter in the Archives of Internal Medicine. (Source: Medscape)

For comments and archives

Anticonvulsant aids weight loss

The anticonvulsant drug zonisamide (Zonegran), in combination with dietary and lifestyle changes, can help obese people lose weight, researchers reported. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Elissa Epel discusses the mind-body connection in relation to wellness & healing. http://tinyurl.com/9ad7s7b

@DeepakChopra: Is The Mind What The Brain Does Or Is The Brain What The Mind Does? Please watch my #askdeepak video reply: http://tinyurl.com/8qnvaul

    Spiritual Update

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

On 1st Navratri Let Go Your Desires

Navratri is the detoxification of body, mind and soul. Body detoxification involves Navratri diet containing

  1. Eating less.
  2. No cereals. You can take wheat grass juice.
  3. Eating once if possible.
  4. Satvik lifestyle.

For comments and archives

    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

Will intracytoplasmic sperm injection work?

According to western figures, intracytoplasmic sperm injection (ICSI) fertilizes 50-80% of eggs. But the following may occur after the use of ICSI:

  • The ICSI procedure might damage some eggs
  • The egg might not grow into an embryo even after it is injected with sperm
  • The embryo may stop growing.

For comments and archives

    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Blood groups

Whereas the ABO system and ’Rh factor” were almost the only considerations of clinical significance a generation ago, we now recognize more than a dozen major blood group systems, each many times more complex than originally conceived, with some 400 blood group antigens defined as of this writing.

For comments and archives

    Liver Abscess Update

(Dr Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation Medanta – The Medicity Hospital)

What are the indicators for poor prognosis?

  • Jaundice
  • Liver failure
  • Acute abdomen and sepsis
  • Bilirubin levels >3.5 mg/dl
  • Encephalopathy
  • Large volume of abscess
  • Multiple abscesses
  • Hypoalbuminemia (<2 mg/dl)
    An Inspirational Story (Ms Ritu Sinha)

Grandfather’s experience

A grandfather talking to his grandson about a tragedy he witnessed: “I feel as if I have two wolves fighting in my heart. One is the vengeful, angry, violent one. The other wolf is the loving, compassionate one.”

“Grandfather, which wolf will win the fight in your heart?” asked his Grandson.

Grandfather answered, “The one I feed.”

For comments and archives

    Cardiology eMedinewS

White blood cell count prognostic in HF Read More

Regular physical activity can relieve premature cardiovascular aging caused by type 2 diabetes Read More

    Pediatric eMedinewS

Prepregnancy anxiety linked to excessive infant crying Read More

Hepatitis C point-of-care tests are highly accurate Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with diabetes was found to have high insulin levels.
Dr. Bad: It has no significance.
Dr. Good: It is related to cognitive dysfunction.
Lesson: A prospective Japanese study has suggested that higher insulin and glycohemoglobin levels may be associated with diabetes-related cognitive dysfunction. Dement Geriatr Cogn Disord Extra 2011 Jan;1(1):1-9.

For comments and archives

Make Sure

Situation: A 20–year–old college student complained of dysuria, frequency and pyuria.
Reaction: Oh my God! Why did you not advise macrolide?
Lesson: Make sure to remember that macrolides are very effective against E. coli, S. saprophyticus and C. trachomatis infection.

For comments and archives

    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

T3 uptake

This test measures the amount of thyroxine–binding globulin (TBG) in the patient’s serum. When TBG is increased, T33 uptake is decreased, and vice versa. T3 uptake does not measure the level of T3 or T4 in serum.

  • Increased T3 uptake (decreased TBG) in euthyroid patients is seen in chronic liver disease, protein–losing states, and with use of the following drugs: androgens, barbiturates, bishydroxycoumarin, chlorpropamide, corticosteroids, danazol, d–thyroxine, penicillin, phenylbutazone, valproic acid and androgens. It is also seen in hyperthyroidism.
  • Decreased T3 uptake (increased TBG) may occur due to the effects of exogenous estrogens (including oral contraceptives), pregnancy, acute hepatitis, and in genetically-determined elevations of TBG. Drugs producing increased TBG include clofibrate, lithium, methimazole, phenothiazines and propylthiouracil. Decreased T3 uptake may occur in hypothyroidism.
  Quote of the Day (Dr GM Singh)

Every great dream begins with a dreamer. Always remember, you have within you the strength, the patience, and the passion to reach for the stars to change the world. Harriet Tubman.

    Mind Teaser

Read this…………………

Joy, an obese 32 year old, is admitted to the hospital after an automobile accident. She has a fractured hip and is brought to the OR for surgery.

After surgery Joy is to receive a piggy-back of Clindamycin phosphate (Cleocin) 300 mg in 50 ml of D5W. The piggyback is to infuse in 20 minutes. The drop factor of the IV set is 10 gtt/ml. The nurse should set the piggyback to flow at:

A. 25 gtt/min
B. 30 gtt/min
C. 35 gtt/min
D. 45 gtt/min

Yesterday’s Mind Teaser: The nurse is assisting in planning care for a client with a diagnosis of immune deficiency. The nurse would incorporate which of the following as a priority in the plan of care?

A. Providing emotional support to decrease fear
B. Protecting the client from infection
C. Encouraging discussion about lifestyle changes
D. Identifying factors that decreased the immune function

Answer for Yesterday’s Mind Teaser: B. Protecting the client from infection

Correct answers received from: Prabha Sanghi, Dr KV Sarma, Dr PC Das,
Dr Pankaj Agarwal, Dr K Raju, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Dr Thakor Hitendrsinh G, Dr Avtar Krishan, Dr Gopal M Shinde,
Dr Chandresh Jardosh.

Answer for 16th October Mind Teaser: B. Before log rolling, remove the pillow from under the client's head and use no pillows between the client's legs.

Correct answers received from:
Dr Kanta Jain, Dr B K Agarwal.

Send your answer to ijcp12@gmail.com

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Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Doctor’s Day Celebration

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    Laugh a While (Dr GM Singh)

The perfect dieting diet ice cream

A man went into a restaurant and the waitress came over to ask him what he wanted. The man said, 'I'll have some vanilla ice cream and some strawberry ice cream, some lemon ice cream and some banana ice cream.'

“OK, sir.' said the waitress, 'Will there be anything else?”

“Er, yes...' said the man, “Do you have any chocolate sauce?”

“Yes, sir. We do,” replied the waitress. “Great, I'll have double chocolate sauce on that.”

“Anything else, sir?”

“Oh, yes, do you have any cream?”

“Certainly sir.” “And,” continued the man, “I'll have extra cream on all of those.”

“Yes sir,” said the waitress, writing down the whole order, “And would you like any nuts on top?”

“Nuts?” said the man, horrified, “Oh, no! I won't have any nuts. I'm on a diet.”

    Medicolegal Update

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

Most important advances in the arena of medical practice have been the use of technologies

  • Medical professionals today rely on a number of different types of equipment every day, from heart defibrillators to IV pumps to CT scans to automated breathing apparatuses. When any of these devices fail, the results can be disastrous, resulting in the injury or death of a patient.
  • When the medical devices fail, as all machines generally have a tendency to do, the risks have major consequences and are dangerous for human health.
  • Medical equipment failure can result from both manufacturing defects or human error i.e. it was used incorrectly by the medical staffer involved and the concept of product liability develops.
  • Medical professionals should keep a constant eye on the equipment/s to ensure that it is working properly and be adequately trained to use the device safely.
  • A register of maintenance of medical equipment must be maintained with signature of all stake holders for record. Failure to do so is a form of negligence that places the hospital and its staff at liability.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

B12 deficiency can present with recent memory loss

If you are forgetting things instead of worrying that you are going towards dementia get your vitamin B 12 levels done said Padma Shri and Dr C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

Animal products (meat and dairy products) provide the only dietary source of B12 (Cbl) for humans. Strict vegans avoid all animal products, and are at risk of developing nutritional Cbl deficiency. The usual western diet contains 5 to 7 micrograms of cobalamin per day, while the minimum daily requirement is 6 to 9 micrograms per day. Total body stores of Cbl are 2 to 5 milligrams and one-half of which is in the liver. It takes years to develop vitamin B12 deficiency after absorption of dietary B12 ceases.

There is a link between infection with Helicobacter pylori (as seen in peptic ulcer) and low serum B12 levels. Mild and usually subclinical cobalamin deficiency can also occur in 24% of the elderly. 10 to 30 percent of patients taking metforminj (diabetics, obesity, polycystic ovarian disease) have impaired Cbl absorption and lower B12 levels, which can be reversed with supplemental oral calcium. Prolonged use of omeprazole (given for acidity) can result in Cbl deficiency. Women who are only moderate vegetarians may become Cbl deficient during pregnancy and lactation; their infants may also be Cbl deficient.

    Readers Responses
  1. Dear Sir, You are doing fabulous service to mankind. Regards:Dr Sikha
    Forthcoming Events

19th MTNL Perfect Health mela 2012 Programe

Dr K K Aggarwal
Dr K K Aggarwal
    eMedinewS Special

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    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