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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

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eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

1st April 2013, Monday

Multivitamins and cancer

Observational studies have not shown a consistent decrease in cancer risk with multivitamin use.

  • A large randomized trial of multivitamins, involving over 14,000 men has demonstrated a small, statistically-significant reduction in total cancer risk in the multivitamin group (1). The study included male physicians 50 years and older at recruitment. At a mean follow-up of 11.2 years, there was a reduction in total cancer from 18.3 to 17.0 events per 1000 person-years but there was no impact on cancer mortality.
  • In the past a systematic review of 38 studies found that neither vitamin C nor vitamin E supplementation was beneficial for prevention of cancers (2).
  • A 2006 NIH consensus concluded that “present evidence is insufficient to recommend either for or against the use of multivitamin supplements by the American public to prevent chronic disease” (3).
  • A long-term randomized trial in women found no evidence that supplementation with vitamin C, E, or beta-carotene decreased cancer incidence or mortality (4).
  • Two long term observational studies found no association between multivitamin use and risk of cancer. (5,6)

Currently it has not been established that multivitamin and mineral supplements provide added benefit to a balanced, healthful diet for most individuals.


  1. Gaziano JM, Sesso HD, Christen WG, et al. Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA 2012;308:1871.
  2. Coulter ID, Hardy ML, Morton SC, et al. Antioxidants vitamin C and vitamin e for the prevention and treatment of cancer. J Gen Intern Med 2006;21:735.
  3. NIH State-of-the-Science Panel. National Institutes of Health State-of-the-science conference statement: multivitamin/mineral supplements and chronic disease prevention. Ann Intern Med 2006; 145:364.
  4. Lin J, Cook NR, Albert C, et al. Vitamins C and E and beta carotene supplementation and cancer risk: a randomized controlled trial. J Natl Cancer Inst 2009;101:14.
  5. Neuhouser ML, Wassertheil-Smoller S, Thomson C, et al. Multivitamin use and risk of cancer and cardiovascular disease in the Women’s Health Initiative cohorts. Arch Intern Med 2009;169:294.
  6. Park SY, Murphy SP, Wilkens LR, et al. Multivitamin use and the risk of mortality and cancer incidence: the multiethnic cohort study. Am J Epidemiol 2011;173:906.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Depression linked to paralysis

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Another live saved by CPR 10

Ms Gitanjali a teacher of SD public school saved life by using the technique of CPR10

Dr K K Aggarwal
    National News

In male-dominated Indian society, sex discrimination begins in womb: study

Women in India are more likely to get prenatal care when pregnant with male babies, according to a groundbreaking study that has implications for girls' health and survival in patriarchal societies. The study by Leah Lakdawala of Michigan State University and Prashant Bharadwaj of the University of California, San Diego, suggests sex discrimination begins in the womb in male-dominated societies such as India. "It paints a pretty dire picture of what's happening," said Lakdawala, MSU assistant professor of economics. In India, while it's illegal for a doctor to reveal the sex of an unborn baby or for a woman to have an abortion based on the baby's sex, both practises are common, Lakdawala said. However, knowing the sex of the baby through an ultrasound also can lead to discrimination for those pregnancies that go full-term, she said in a statement. In studying the national health-survey data of more than 30,000 Indians, the researchers found that women pregnant with boys were more likely to go to prenatal medical appointments, take iron supplements, deliver the baby in a health-care facility – as opposed to in the home – and receive tetanus shots. Tetanus is the leading cause of neonatal deaths in India. According to the study, children whose mothers had not received a tetanus vaccination were more likely to be born underweight or die shortly after birth. The researchers – the first to study sex discrimination in prenatal care – also looked at smaller data sets from other countries. In other patriarchal nations of China, Bangladesh and Pakistan, evidence of sex-discrimination in the womb existed. But in Sri Lanka, Thailand and Ghana, which are not considered male-dominated, no such evidence existed. (Source: The Indian Express, Mar 28 2013)

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


A total of 63 infanticide case were reported in India in the year 2011

The incidence decreased in the year 2011 (63 cases) from 100 cases in the year 2010. A total of 132 cases of feticide were reported in the country in the year 2011 as compared to total 111 cases in the year 2010. 0.222% children presenting in emergency care are victims of child abuse.

In the United States alone, up to 2500 children die of inflicted injuries annual with children under one year of age affected disproportionately. Higher rates of child abuse are reported from minority children.

For comments and archives

    Valvular Heart Disease Update

Bicuspid aortic valve can be associated with ventricular or atrial septal defect, hypoplastic left heart syndrome, patent ductus arteriosus, bicuspid pulmonic valve and Ebstein’s anomaly.

(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 Monica and Brahm Vasudev)

WHI: Combo HRT, breast cancer risk linked

The use of combined estrogen plus progestin among postmenopausal women was associated with an increased risk of breast cancer, a longer-term analysis of data from the observational Women's Health Initiative (WHI) suggested. (Source: Medpage Today)

For comments and archives

Pregnancy loss associated with a later risk of atherosclerosis

Pregnant women who have a miscarriage or stillbirth delivery have a significantly increased risk of developing atherosclerosis, according to a new Danish analysis. (Source: Medscape)

For comments and archives

Acid-suppressing antihistamines may up hospital C diff risk

Hospitalized patients taking gastric acid–suppressing antihistamines are at greater risk than the general population for infection from diarrhea-causing Clostridium difficile (C diff), especially if they are also taking antibiotics, according to a study published online March 4 in PLoS One. (Source: Medscape)

For comments and archives

New glaucoma drug may be more effective than latanoprost

An experimental medication for glaucoma, BOL 303259-X (Bausch and Lomb), lowers intraocular pressure as effectively and safely as the gold standard, latanoprost, and might be more potent, say investigators. (Source: Medscape)

For comments and archives

Dietary fiber nibbles down stroke risk

Eating more fiber may modestly reduce the risk of stroke, although details remain uncertain and it might just be a surrogate for other healthy behaviors, a meta-analysis determined. (Source: Medpage Today)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: Herbal medicines causing kidney failure, bladder cancer in India These types of news are common in the media and... http://fb.me/1DHaAnJYU

@DrKKAggarwal: What makes us human? Please read this excerpt from Lothar Schafer's new book Infinite Potential http://tinyurl.com/c3ufhrf

    Spiritual Update

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

Why do We Ring the Bell in a Temple?

The vibrations of the ringing bell also produce the auspicious primordial sound ‘Om’, thus creating a connection between the deity and the mind. As we start the daily ritualistic worship (pooja), we ring the bell, chanting:

For comments and archives

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

What do you understand by natural family planning?

The time during which the egg moves from the ovary to the uterus lasts a few days and is the only time in which a woman can become pregnant. Couples who use natural family planning have to determine when the woman is ovulating and avoid having sex during that time. There are ways by which you can tell if you are ovulating and should not have sex:

  • Keeping track of menstrual periods: Ovulation occurs two weeks before the next menstrual period. Therefore, having a calendar of 3-4 cycles will provide an estimate of when ovulation may take place.
  • Recording body temperature each morning: Basal body temperature falls prior to ovulation with a rise after ovulation
  • Observing cervical mucus: It will be thinner and "stretchier" right before ovulation.
  • Breastfeeding: Women may not ovulate when they are breastfeeding. This may depend on the frequency of breastfeeding.
    Tat Tvam Asi………and the Life Continues……

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

Standard blood infusion sets

Standard blood infusion sets have inline filters (pore size: 1170-260 microns), drop chambers and tubing in a variety of configuration. Sets should be primed according to the manufacturer’s directions, using either the component itself or a blood compatible solution. For optimal flow rates and performance, filters should be fully wetted and drip chambers filled no more than half full.

Many institutions have a policy of changing sets after every transfusion or of limiting their use to several unit or several hours in order to reduce the risks of bacterial contamination. A reasonable time limit is 4 hours. Filters can ordinarily be used for 2 to 4 units of blood, but if the first unit required 4 hours for infusion, the filter should not be reused. The filter traps cells, cellular debris, and coagulated protein, resulting in a high protein concentration at the filter surface. The combination of high protein milieu and room temperature conditions promotes multiplication of any bacteria that might be present. Accumulated material also slows the tare of flow.

For comments and archives

    An Inspirational Story

Take the son

Years ago, there was a very wealthy man who, with his devoted young son, shared a passion for art collecting. Together they traveled around the world, adding only the finest art treasures to their collection. Priceless works by Picasso, Van Gogh, Monet, and many others adorned the walls of their family estate. The widowed elderly man looked on with satisfaction as his only child became an experienced art collector. The son's trained eye and sharp business mind caused his father to beam with pride as they dealt with art collectors around the world.

As winter approached, war engulfed their nation, and the young man left to serve his country. After only a few short weeks, the elderly man received a telegram that his beloved son was missing in action. The art collector anxiously awaited more news, fearing he would never see his son again. Within days his fears were confirmed. The young man had died while rushing a fellow soldier to a medic. Distraught and lonely, the old man faced the upcoming Christmas holidays with anguish and sadness.

The joy of the season-a season that he and his son had so looked forward to in the past-would visit his house no longer. On Christmas morning, a knock on the door awakened the depressed old man. As he walked to the door, the masterpieces of art on the walls only reminded him that his son was not coming home. He opened the door and was greeted by a soldier with a large package in his hand. The soldier introduced himself to the old man by saying, "I was a friend of your son. I was the one he was rescuing when he died. May I come in for a few moments? I have something to show you." As the two began to talk, the soldier told of how the man's son had told every one of his-and his father's-love of fine art work. "I'm also an artist," said the soldier, "and I want to give you this." As the old man began to unwrap the package, paper gave way to reveal a portrait of the man's son.

Though the world would never consider it a work of genius, the painting featured the young man's face in striking detail. Overcome with emotion, the old man thanked the soldier, promising to hang the portrait above the fireplace. A few hours later, after the soldier had departed, the old man set about his task. True to his word, the painting went above the fireplace, pushing aside thousands of dollars worth of paintings. And then the old man sat in his chair and spent Christmas gazing at the gift he had been given. During the days and weeks that followed, the man learned that his son had rescued dozens of wounded soldiers before a bullet stilled his caring heart. As the stories of his son's gallantry continued to reach him, fatherly pride and satisfaction began to ease his grief, as he realized that, although his son was no longer with him, the boy's life would live on because of those he had touched. The painting of his son soon became his most prized possession, far eclipsing any interest in the priceless pieces for which museums around the world clamored. He told his neighbors it was the greatest gift he had ever received. The following spring, the old man became ill and passed away. The art world was in anticipation, since, with the old man's passing, and his only son dead, those paintings would be sold at an auction. According to the will of the old man, all of the art works would be auctioned on Christmas Day, the way he had received his greatest gift.

The day finally arrived and art collectors from around the world gathered to bid on some of the world's most spectacular paintings. Dreams could be fulfilled this day; greatness could be achieved as some could say," I have the greatest collection." The auction began with a painting that was not on any museum list... It was the painting of the old man's son. The auctioneer asked for an opening bid, but the room was silent.

"Who will open the bidding with $100?" he asked. Moments passed as no one spoke. From the back of the room came, "Who cares about that painting? It's just a picture of his son. Let's forget it and get on to the good ones." More voices echoed in agreement. "No, we have to sell this one-first," replied the auctioneer. "Now who will take the son?" Finally, a friend of the old man spoke. "Will you take $10 for the painting? That's all I have. "Will anyone go higher?" called the auctioneer. After more silence he said, "Going once, going twice... Gone!" The gavel fell. Cheers filled the room and someone shouted; "Now we can get on with it and bid on these treasures!"

The auctioneer looked at the audience and announced that the auction was over. Stunned disbelief quieted the room. Then someone spoke up and asked, "What do you mean it's over? We didn't come here for a portrait of some old man's son! What about all of the other paintings? There are millions of dollars worth of art work here. We demand an explanation!" The auctioneer replied, "It's very simple. According to the will of the father, whoever takes the son...gets it all."
Just as the art collectors discovered on that day...The message is still the same...the love of the Father....a Father whose son gave his life for others...And because of that Father's love...Whoever takes the Son gets it all.

For comments and archives

  Cardiology eMedinewS

Heavy smoking may be genetic Read More

Sticking to meds for heart disease pays dividends Read More

  Pediatric eMedinewS

No evidence multiple vaccines raise autism risk, CDC says Read More

Novel T cell therapies lead to remission in aggressive ALL Read More

    Rabies Update

(Dr. A. K. Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

Can rabies vaccine be given to a child with chicken pox or measles?

As rabies is 100% fatal, there is no contraindication for antirabies vaccination. Rabies vaccine can be given to a child with chicken pox or measles and it is effective. If possible administration of measles vaccine should be postponed by a fortnight after the completion of antirabies immunization.

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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

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    IJCP Special

Dr Good Dr Bad

Situation: A patient with fever and low TSH had ESR > 100.
Dr Bad: It’s TB.
Dr Good: Its thyroiditis.
Lesson: Typically thyroiditis has very high ESR and low TSH.

Make Sure

Situation: A patient was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA?
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2, an ongoing trial suggest that this intervention is much better than thrombolytic therapy in such patients.

  Quote of the Day (Dr GM Singh)

The question is not what you look at, but what you see. Henry David Thoreau

    Mind Teaser

Read this…………………

A client is frustrated and embarrassed by urinary incontinence. Which of the following measures should nurse Bea include in a bladder retraining program?

a. Establishing a predetermined fluid intake pattern for the client
b. Encouraging the client to increase the time between voidings
c. Restricting fluid intake to reduce the need to void
d. Assessing present elimination patterns of erythropoietin.

Yesterday’s Mind Teaser: Dr. Marquez prescribes norfloxacin (Noroxin), 400 mg P.O. twice daily, for a client with a urinary tract infection (UTI). The client asks the nurse how long to continue taking the drug. For an uncomplicated UTI, the usual duration of norfloxacin therapy is:

a. 3 to 5 days.
b. 7 to 10 days.
c. 12 to 14 days.
d. 10 to 21 days.

Answer for Yesterday’s  Mind Teaser: b. 7 to 10 days.

Correct answers received from: Dr K P Chandra, Dr shashi saini, Dr. B.B. Gupta, Muthumperumal Thirumalpillai, Dr kanta jain, DR ARPAN GANDHI, Dr Pankaj Agarwal, drjella, DeGajveer, Dr Chandresh Jardosh, Dr. Thakor Hitendrsinh G, Dr.K.Raju, Dr Avtar Krishan, Dr Jainendra Upadhyay

Answer for 30th March Mind Teaser: a. confusion, headache, and seizures.

Correct answers received from: Dr Pankaj Agarwal, drjella, Dr Jainendra Upadhyay

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Computer Power

The businessman dragged himself home and barely made it to his chair before he dropped, exhausted.

His sympathetic wife was right there with a tall cool drink and a comforting word.

"My, you look tired," she said. "You must have had a hard day today. What happened to make you so exhausted?"

"It was terrible," her husband said, "The computer broke down and all of us had to do our own thinking."

    Medicolegal Update

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

What is conduct money for doctors?

In criminal cases, no fee is paid to any witness, including the doctor, at the time of serving the summons. The summoned doctor must attend the Court and give evidence because of the interest of the State in securing truth/justice, otherwise the doctor will be charged with contempt of Court. However, in criminal cases, conveyance charges and daily allowance can be claimed by the doctor according to Government rules.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Every arthritis is not same

Every arthritis is not the same. While osteoarthritis, also called as green arthritis, may require only painkillers and rehabilitation exercises, the red inflammation arthritis called rheumatoid arthritis, if not treated early and aggressively can end up with serious deforming complications, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

Any arthritis in young women of child-bearing age should not be ignored, especially if it is worse in the morning and improves by movement. Most of them will have high platelet count on blood examination. These patients require aggressive treatment with disease-modifying drugs within days of the onset of symptoms and diagnosis. Approximately 1-2% of population may have this type of disease.

Osteoarthritis, on the other hand, is a disease of age 50+ and is due to wear and tear of various joints in the body and break down of the cartilage cushion in the joints. It mainly affects the weight-bearing joints like the knees, hips, neck and lower back joints. Inflammation is not a major feature of osteoarthritis. The experts said that another form of joint disorder is due to gout which is never seen in people below 40 years of age and is almost never seen in young women before the onset of menopause unless there is a known underlying kidney disease and never seen in children.

The progression of osteoarthritis can be arrested with appropriate exercises, weight reduction and preventing posture and movement that worsen the disease.

Typical wear and tear of osteoarthritis is caused by sitting cross legged, doing Padmasana, squatting, other non physiological postures, sitting on low level surface like floor and low chairs, doing push ups, going up and down on stairs, etc.

Most yoga postures should be done under medical supervision and should follow with a counter yoga exercise.

Most patients of serious arthritis end up with treatment with other systems of medicines or with quacks.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 31680 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

    Readers Response
  1. Dear Sir, Inspirational stories are really very mind blowing. Regards: Taranjeet
    Forthcoming Events
Dr K K Aggarwal

IMA Annual Day Function

Date: 7th April 2013
Time: 8AM – 2 PM
Venue: Apollo Hospital Auditorium, Sarita Vihar, New Delhi.

The IMA –NDB is organizing its Annual Function on Sunday April, 7, 2013

at Inderprastha Apollo Hospital New Delhi. The New Delhi Branch is honored to

Invite you to attend the function

S.No Topic Speaker Chairman Co Chairman Panelist
1 Valvular Heart Diseases Dr K K Aggarwal Dr IPS Kalra

Dr H K Chopra

Dr Mohan Bhargava

Dr Sudesh Ratan

Dr Ish Kathpalia

Dr PPS Sethi

Dr Rajnish Sardana

Dr Sanjay Sood

Dr B S Thind

2 Liver Transplant Dr Manav Wadhawan Dr Sandeep Mukherjee Dr S K Sama

Dr D P S Toor

Dr Tarun Gupta

Dr Asha Ahooja

Dr Geeta Mehta

Dr Anil Saxena

Dr V Gopal

Dr Venkatesh B G

3 Hyperbaric oxygen Dr Tarun Sahni Dr Shubnam singh Dr Pradeep Saxena

Dr Sadhna Mehta

Dr J S Batra

Dr Satish Mehta

Dr P Mukherjee

Dr Ramona Gupta

Dr Neeraj Gupta

4 Kidney update Dr Ramesh Hottchandani Dr Kiran Kumar Dr Usha Sabbarwal

Dr Rajiv Garg

Dr Dinesh Negi

Dr Kusum Chaudhary

Dr Somshekher

Dr P P S Sethi

5 In vitro Fertilization Dr Surveeen Ghumman Sindhu Dr Urmil Sharma

Dr S K Das

Dr Kaberi Banerji

Dr Raj Bokeria

Dr Veena Aggarwal

Dr Anupma Kathpalia

Dr Vandana Chaddha

Dr Shivani Aggarwal

6 Sleep Aponea Dr S S Sindhu Dr Rajiv Garg Dr Neeraj Gupta

Dr D P S Rekhi

Dr Anil Chaudhary


Oration Lectures

Dr K B Sharma

Dr J J Sood


Dr M C Vaidya

Dr S K Das

Hony. Secretary
Dr. Sandeep Sindhu
Dr. Satish K. Mehta
Dr KK Aggarwal

Please send your latest contact details including Mobile No. and mail id to sandeepsindhu@hotmail.com, drsudeshratan@gmail.com, emedinews@gmail.com

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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, Dr Usha K Baveja