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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 & 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 9 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 December 2012, Tuesday

Maharashtra tops high blood pressure tally

Health statistics: The ministry has rolled out the diabetes screening programme in 21 states with a target to check 150 million people in 100 districts for diabetes and hypertension

  1. Seven percent of 1.06 crore people tested have diabetes and 6.1% have high BP.
  2. Maharashtra has the lowest prevalence of diabetes (2.5%) but the highest prevalence of people suffering from high BP (18%).
  3. Punjab recorded the lowest BP (0.8%).
  4. Hill states of Sikkim, Himachal Pradesh, Jammu and Kashmir and Uttarakhand have recorded high rates of diabetes or high BP.
  5. Sikkim recorded the highest prevalence of diabetes (14%).
  6. Himachal Pradesh recorded the second highest prevalence of hypertension (14.2%).
  7. J&K recorded 8.9% prevalence of diabetes.
  8. Eight percent population in Uttarakhand was found to have high BP.
  9. Tamil Nadu (11.7%) recorded the second highest prevalence of diabetes followed by Karnataka (10.3%), West Bengal (9.8%), Kerala (9.3%), Orissa (9%), J&K (8.8%), Punjab (8.5%) and Andhra Pradesh (8.3%).
  10. States which recorded a comparatively lower prevalence of diabetes include Madhya Pradesh (2.9%), Assam (3.7%), Chhattisgarh (3.9%), Haryana (4%), Jharkhand (4.6%), Uttarakhand (5.7%) and Uttar Pradesh (5.9%).
  11. States like Andhra Pradesh (13.3%), Orissa (9%), Chhattisgarh (8.4%) and Gujarat (6.7%) recorded the highest prevalence while Assam and Rajasthan (1.4%), Kerala (2.4%), Bihar (2.7%), Madhya Pradesh (2.8%) and Uttar Pradesh (3.6%) recorded low prevalence p0f hypertension.
  12. International Diabetes Federation: 44 lakh Indians in their most productive years — aged 20 to 79 years aren't aware that they have diabetes, which killed 10 lakh Indians in the year 2011.
  13. Contrary to popular belief, the report said diabetes affects more people in rural India (34 million) than affluent urban India (28 million).
  14. The IDF said while 33 million Indian men are diabetic; 29 million women are affected by high blood sugar.
  15. IDF estimates India is presently home to a whopping 63 million diabetics.
  16. 'DiabCare study' conducted by Novo Nordisk: average age at onset of diabetes among Indians was 46 years with their average body mass index being 26.5. 1
  17. Around 31.3% of the people with diabetes were hypertensive.
  18. Risk factors showed 57% of those surveyed did not exercise at all.
  19. Almost 38% had a family history of diabetes.
  20. The number of complications increased with the mean duration of diabetes from one complication over 6.6 years to six complications at 9.7 years duration of diabetes.
  21. Nearly 52% of Indians are not aware that they are suffering from high blood sugar. India is presently home to 63 million diabetics — an increase by nearly 2 million in just one year. (Source Times of India)

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

   Constipation Update

Irritable bowel syndrome with predominant constipation (IBS-C) is characterized by abdominal pain with altered bowel habits. These patients may or may not have slow colonic transit or dyssynergia, and many have visceral hypersensitivity. Abdominal pain in IBS can vary but should NOT be associated with weight loss, rectal bleeding, anemia, and should not be nocturnal or progressive. Patients may note diarrhea, constipation, or both.

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Weight loss may improve sexual health of
obese diabetes

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela 2012

Children from various schools participated with great enthusiasm in learning the technique of CPR 10 - hands-only cardio pulmonary resuscitation.

Dr K K Aggarwal
    National News

Dear Colleague, Let’s celebrate New Year by learning CPR-10 and saving the life of a person

Watch English or Hindi Video @http://emedinews.in/videos/cpr/index.html

Dr K K Aggarwal

PHFI launches diabetes management program

NEW DELHI: The Public Health Foundation of India (PHFI) on Friday launched 'Uday'- an intensive five year programme to fight the rising burden of non-communicable diseases (NCD) in India, with an initial focus on improving outcomes for people with diabetes and High Blood Pressure (HBP). K Srinath Reddy, President, PHFI said the programme aims to demonstrate cost-effective scalable approaches for effective diabetes and high blood pressure management. "In the first phase, the project will be implemented in Vizag (Andhra Pradesh) and Sonepat (Haryana), with intent to strengthen the diabetes and HBP care capabilities in terms of prevention, detection and effective management," he said. According to the PHFI President diabetes and its complications represent a rapidly expanding public health concern that is expected to affect 552 million people by 2030 with devastating health and economic consequences. "Diabetes is no longer a disease of the rich. It affects a large number of lower middle class individuals and the poor. Diabetes over a long term affects all organs of the body and is linked to heart attacks, stroke, some cancers and several infections," he said. D Prabhakaran, Director Centre for Chronic Disease Control and PHFI said, "Preventive strategies are urgently required to curb the anticipated 50% increase in premature death due to diabetes in the next decade. These include both health promotion to adapt the right life style and utilizing simple yet effective management strategies for treating manifest diabetes." (Source: TOI, Dec 16, 2012)

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

Bicuspid aortic valve

  • Valve re-replacement with a homograft is reasonable in patients with active prosthetic valve endocarditis.
  • The evidence was considered less well established for a bioprosthesis in women of childbearing age.
  • Mechanical valve may be recommended for patients with small aortic roots in whom annular enlargement is high risk or contraindicated.

(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)

    International News

(Contributed by Dr GM Singh)

Subpontic osseous hyperplasia

Subpontic osseous hyperplasia (also known as subpontic hyperostosis) is a bony growth on the crest of the alveolar ridge apical to a pontic in a fixed partial denture. The etiology of this bony growth has been suggested as gingival irritation due to poor oral hygiene, genetic predisposition, and increased functional load to the tissues. Removal of a fixed partial denture has shown remission of the subpontic osseous hyperplasia, but it can recur if another fixed partial denture is placed with increased functional load to the tissues. Management of the area is increased oral hygiene around the area of the fixed partial denture and continued monitoring. Surgical removal of the bony growth should not be required as the growth is self-limiting

(Contributed by Dr Monica and Brahm Vasudev)

Weight loss achieved by 2 lifestyle interventions

Two different lifestyle interventions modeled after those delivered in the Diabetes Prevention Program (DPP) produced significant weight loss among overweight or obese adults in a primary care setting, according to a study published online December 10 in the Archives of Internal Medicine by Jun Ma, MD, PhD, from the Department of Health Services Research, Palo Alto Medical Foundation Research Institute, and the Department of Medicine Stanford University School of Medicine, Stanford, California, and colleagues. The Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care trial design is a 3-group, randomized study that compared both a coach-led, in-person weekly group intervention and a self-directed DVD intervention with usual care. (Source: Medscape)

After-hours access to clinicians tied to Fewer ED visits

Patients who have an easier time reaching their primary care clinician after regular office hours visit the hospital emergency department (ED) less often, according to a new study published online December 12 in Health Affairs. (Source: Medscape)

Rivaroxaban stands up to standard anticoagulation for VTE treatment

New data from a pooled analysis of the EINSTEIN-DVT and EINSTEIN-PE in the treatment of deep venous thrombosis (DVT) or pulmonary embolism suggests that rivaroxaban (Xarelto, Bayer/ Janssen) is similarly effective in preventing recurrence of venous thromboembolism (VTE) as enoxaparin followed by a vitamin-K antagonist and may be associated with less bleeding. In addition, subgroup analysis showed reassuring results in specific high-risk populations such as elderly, fragile patients, those with cancer, and those with large clots. The data was presented at the American Society of Hematology (ASH) 2012 Annual Meeting by Dr Harry Buller (Academic Medical Center, Amsterdam, The Netherlands). (Source: Medscape)

HPV infections may return to haunt older women

Reactivation of latent human papillomavirus (HPV) infection in older women could obscure an age-related increase in HPV detection at menopause, data from a prospective cohort study suggested. (Source: Medpage Today)

    Twitter of the Day

@DrKKAggarwal: Fast food is good for children Distributing prizes for the baby show held at winter carnival organised by Bal... http://fb.me/PrvixxhH

    Spiritual Update

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

Understanding gossip

Gossip is a way of non-violent communication and is common cause of creating misunderstanding between people and relational harmony. The gossip is a stress related risk factor for developing of heart diseases. Gossip has the following three main characteristics:

For Comments and archives…

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

How is an ectopic pregnancy management?

  • Methotrexate is a drug that stops the ectopic pregnancy from continuing to develop. Your doctor will give you this medicine by injection. To determine if methotrexate has worked, the doctor will do a series of blood tests for hCG. Your doctor will follow the hCG levels until they are negative, which will indicate that the pregnancy has ended. If you receive a methotrexate injection, you should avoid alcohol, vitamins, drugs like ibuprofen, and food containing folate and folic acid to make sure the medicine works correctly.
  • Laparoscopy: It is called a minimally invasive surgery because the doctor makes very small incisions in your lower belly. A small telescope attached to a camera is placed into one incision, and the doctor can look for the ectopic pregnancy. The doctor will insert small instruments through the incisions and remove the ectopic pregnancy. If the fallopian tube is damaged, the doctor may have to remove the tube.
  • Laparotomy: It is a surgery during which an abdominal incision is made. Laparotomy to treat ectopic pregnancy is often performed in emergency situations when a woman has excessive internal bleeding from an ectopic pregnancy.
    Tat Tvam Asi………and the Life Continues……

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

Blood Donation - Gift of Liquid Love

Developments over the last three decades in the field of renal dialysis, cancer therapy, cardio-vascular surgery, transplantation surgery, treatment of hemophilia and related disorders have put enormous burden on the blood transfusion services, not just for whole blood, but for products not available earlier, namely blood components or blood selectively depleted of specific cellular components.

As a consequence three major changes have taken place in the blood transfusion services throughout the globe.

For Comments and archives…

    An Inspirational Story

The story of an ant

One morning I wasted nearly an hour watching a tiny ant carry a huge feather across my back terrace. Several times it was confronted by obstacles in its path and after a momentary pause it would make the necessary detour. At one point the ant had to negotiate a crack in the concrete about 10mm wide. After brief contemplation the ant laid the feather over the crack, walked across it and picked up the feather on the other side then continued on its way.

I was fascinated by the ingenuity of this ant, one of God’s smallest creatures. It served to reinforce the miracle of creation. Here was a minute insect, lacking in size yet equipped with a brain to reason, explore, discover and overcome. But this ant, like the two-legged co-residents of this planet, also shares human failings. After some time the ant finally reached its destination – a flower bed at the end of the terrace and a small hole that was the entrance to its underground home. And it was here that the ant finally met its match. How could that large feather possibly fit down that small hole? Of course it couldn’t. So the ant, after all this trouble and exercising great ingenuity, overcoming problems all along the way, just abandoned the feather and went home.

The ant had not thought the problem through before it began its epic journey and in the end the feather was nothing more than a burden. Isn’t life like that! We worry about our family, we worry about money or the lack of it, we worry about work, about where we live, about all sorts of things. These are all burdens – the things we pick up along life’s path and lug them around the obstacles and over the crevasses that life will bring, only to find that at the destination they are useless and we can’t take them with us.

For comments and archives

   Cardiology eMedinewS

Short-term vs long-term antiarrhythmic therapy in AF Read More

CABG vs stenting in DM and multivessel CAD Read More

   Cardiology eMedinewS

Evidence supports psychological therapies for PTSD kids Read More

Childhood adversity, including hunger, may protect cognition Read More

    IJCP Special

Dr Good Dr Bad

Situation: JR to SR: In how many patient of DVT does embolization occur?
Dr Bad: Rare!
Dr Good: Common!
Lesson: Embolization occurs in about 50% of patients with proximal vein DVT.

Make Sure

Situation: A patient with pyogenic meningitis developed complications.
Reaction: Oh my God! Why was an antibiotic not given when meningitis was suspected?
Lesson: Make sure that the first dose of antibiotic is given at the time when meningitis is suspected.

  Quote of the Day (Dr GM Singh)

It's up to an individual to decide how he uses his emotions. Which way will you decide? Life is like an unsolved puzzle. No one can define what life is because it is a very complex thing.

    Mind Teaser

Read this…………………

Thrombus formation is a danger for all postoperative clients. The nurse should act independently to prevent this complication by:

A. Encouraging adequate fluids
B. Applying elastic stockings
C. Massaging gently the legs with lotion
D. Performing active-assistive leg exercises

Yesterday’s Mind Teaser: Which of the following would be inappropriate to include in a diabetic teaching plan?

A. Change position hourly to increase circulation
B. Inspect feet and legs daily for any changes
C. Keep legs elevated on 2 pillows while sleeping
D. Keep the insulin not in use in the refrigerator

Answer for Yesterday’s Mind Teaser: C. Keep legs elevated on 2 pillows while sleeping

Correct answers received from: Dr Kanta Jain, Prabha Sanghi, Dr PC Das,
Dr Jella, Archna Parwani, Dr Pankaj Agarwal, Prakash Krishnamurthy,
Dr KV Sarma, Dr Jainendra Upadhyay, Prakash Krishnamurthy, Muthumperumal Thirumalpillai , Dr Thakor Hitendrsinh G, Dr Avtar Krishan, Dr Arpan Gandhi,
Dr B K Agarwal, Dr Thakor Hitendrsinh G.

Answer for 15th December Mind Teaser: B. Urinary drainage will be dependent on a urethral catheter for 24 hours

Correct answers received from: Dr Arvind Khanijo, Dr PC Das.

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

When death came

Death came to a guy and said, “My friend today is your day...”. The guy said, “But I am not ready!”

Then death said, “Well your name is the next on my list...”

So the guy told death, “Ok, why don't you take a seat and I will get you something to eat before we go?”

Death said, “All right...” The guy gave death some food with sleeping pills in it; death finished eating and fell into a deep sleep. The guy took the list & removed his name from top of the list to the bottom of the list.

When death woke up he said to the guy, “I will start from the bottom of the list because you have been so very nice to me...”.

  Medicolegal Update

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

What is panic disorder?

  • It is a condition of vulnerability to stress with repeated sudden attacks of panic with sustained anxiety and recurrence of panic. It is a period of distress and apprehension, with somatic symptoms of feeling of choking, breathing trouble, trembling with a fearful feeling that he may go insane or may even die.
  • The attack may last for a few seconds to a few hours; usually the peak of distress is felt by about 10 minutes after starting.
  • Recurrence is also sudden; it can be said to be a part of anxiety, phobia and stress disorder syndrome.
  • It is treated by psychotherapy, benzodiazepine group of drugs, encouraging thoughts to be free from anxiety.

For comments and archives

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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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    Public Forum

(Press Release for use by the newspapers)

Heart patients should be more cautious during Xmas time

In the emergency room, heart attacks can be both over and under diagnosed. About 10% of heart attacks are over diagnosed and an equivalent number can be missed as the ECG can be normal in the first six hours after a heart attack, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Most heart attacks occur during winter all over the world including India. Missing heart attacks during this period in the early hours of the morning can lead to spurts in number of cases of sudden cardiac death.

Moreover, most senior doctors maybe on vacation during Xmas further worsening the situation for the common man.

Every effort should be taken to reduce the number of false positive or false negative diagnosis of heart attack.

In a study published in JAMA, Henry and coauthors studied the medical records of 1,345 people treated for suspected heart attacks in a regional system between 2003 and 2006, looking at emergency room decisions. All patients had classical heart attack called STEMI, a heart attack characterized by a specific ECG pattern. About 14 % of heart attacks were overdiagnosed.

Men and women have about the same adjusted in-hospital death rate for heart attack — but women are more likely to die if hospitalized for a more severe type of heart attack

    Readers Response
  1. Dear Dr K K Aggarwal, I read one of your editorial articles from daily eMedinewS about ‘Norepinephrine in septic shock.’ It was a wonderful article with a lot of information for the reader. I highly appreciate your knowledge and the wonderful article. I have read a lot of your articles earlier too. I am a pain physician at Fortis Hospital, Noida. And you will also agree with me that chronic pain management is very difficult to treat and manage. I have a lot of vision to start Pain Education Program for the public and physicians in the society. Thanks and Regards: Dr Shiv Pratap Singh Rana, Pain Physician, Fortis Hospital, Noida.
    Forthcoming Events
Dr K K Aggarwal

4th eMedinews Revisiting 2012

(a day long single hall medical conference on 2012 happenings, followed by doctors of the year 2012 awards)

Sunday 20th January 2013, Maulana Azad Medical College Auditorium

Dilli Gate Delhi


Dr KK Aggarwal
Padmashri and Dr B C ROY National Awardee President

Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman

Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

4th eMedinewS Revisiting 2012

The 4th eMedinewS–revisiting 2012 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 20th 2013.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2012. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. All delegates will get Registration Kit, Attractive gifts, Certificates. Morning snacks and lunch will be provided.

Register at: www.emedinews.in/


4th eMedinewS Doctor of the Year Awards

Nominations invited for 4th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2012.

pls send his/her Biodata at: 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)

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  Playing Cards

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  Perfect Health Mela

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  Dil Ki Batein

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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