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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; 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

  Editorial ...

1st September, 2010, Wednesday

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

Every wednesday the newspapre goes to extra 20,000 health readers aprt from 40,000 doctors daily 

The Spiritual Message from the Childhood of Krishna
(From Srimad Bhagwat)

The birth of Krishna: Krishna was born on Janmaashtmi at 12 midnight at Mathura, where, he lived his childhood. On his way after birth, while crossing the river, his father Vasudeva is blessed by Vishnu. Later Lord Shiva gives blessings to his foster mother, Yashoda.

Krishna is the awareness and the consciousness. It is the highest State of awareness. It represents the pure soul.

GOD stands for Generator, Organizer and Destroyer (the union of Brahma, Vishnu and Mahesha). Krishna represents GOD consciousness. At birth, therefore, he gets the blessings from both Vishnu and Shiva.

Krishna, the child: Here Krishna represents pure love. He is ‘makhan chor’. Makhan, means unconditional love. He has no negative thoughts in his mind. He only spreads love. During this state of awareness, one is blend with the GOD consciousness.

Krishna meets Radha: Radha means, the body, the external desires through the five senses. Meeting of Krishna with Radha signifies exposure of the child to external environment and the external influences. For the first time, the mind, intellect and the ego faculties come into the picture.

Krishna controls Kalia: Here ‘kalia’ represents the disturbed mind. To control the mind Krishna has to win over Kalia, and he does this by dancing over its head.

Holi Milan: Once the negative mind is controlled, the mind works in symphony with the thoughts. The brain wave coherence is in symphony. There is no spontaneous flow of negative thoughts. This is represented by Holi Milan, where Krishna dances with the Gopis; Gopi stands for a thought. Here Krishna is shown in blue color with a flute in his hand wearing yellow clothes. Blue means everything is possible (infinite possibilities), Yellow means vigour (I can do it), and Flute or bansuri (a hollow wood) represents being devoid of ego, a state of humility. One can do anything in life with humility (namrata) and politeness (or madhurta).

The Intellect, the other part of the disturbed mind: By now, the mind is under control but not the intellect. It gets activated in the next phase of childhood. It is the discriminative faculty of the mind. It can be very destructive. It is the main cause of ignorance. External desires and the uncontrolled 5 senses are responsible for it. Kama, Krodha, Lobha, Moha are the causative factors. The scene wherein Krishna asks his mother Yashoda, "Radha kyo gori Mein kyu kala", represents ignorance as to why the external thing looks more shining and the consciousness looks like darkness. Here the mother replies that so long the external looks beautiful you cannot start your inner journey.

Krishna wins over the intellect: Intellect here is the ruler, King Indra, the one who controls the indriyas, the senses. Govardahn pooja is the example of winning over the ego.

Ras Lila: Once the mind and the intellect are mastered, one goes to the last state of God awareness, GOD is everywhere. The example is ‘Ras Lila’ where Krishna dance with every gopi. Krishna is in multiple forms here and the state of awareness is "Kan Kan Me Bhagwan". According to Upanishads, there are four levels of awareness of God:

1. GOD is there
2. GOD is one
3. GOD is everywhere and everybody
4. I am GOD.

Kansa Vadh: Once the Intellect is controlled, you have to win over the ego which is represented by Kansa Vadh. Once the ego is controlled one is merged with the parmatma and you are one. This is the last stage of GOD realization’ I am GOD’ (Aham Brahmasmi). Madhurta is a part and parcel of your nature and then one does not need Radha and the flute as they merge with you. And from here you (Krishna) go to the next ashram of your life, Grahastha Ashram, to Dwarka.

Dr KK Aggarwal
Editor in Chief
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  Photo Feature

The Heart Care Foundation of India (HCFI) joined hands with Asian Academy of Film and Television (AAFT), the premier film, TV and media school of India to create awareness on the issues of ‘Good Health’. Dr. KK. Aggarwal conducted his press conference on July 29th, 2009 at Marwah Studios and announced this wonderful association with the internationally reputed film school.
In the photo: Sandeep Marwah, President of AAFT and Marwah Studios and Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President HCFI

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Optimal rate for patients in atrial fibrillation

One should go for a lenient rate control goal of <110 beats/min, compared to a stricter rate control goal of <80 beats/min and heart rate during moderate exercise <110 beats per minute, for patients in atrial fibrillation in whom a rate control strategy has been chosen. The randomized RACE II trial showed no significant difference between the two groups in the primary composite outcome (cardiovascular death, hospitalization for heart failure, and stroke, systemic embolism, bleeding, and life–threatening arrhythmic events) at three years.

1. Van Gelder IC, Groenveld HF, Crijns HJ, et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med 2010; 362:1363–73.

  National News

More than 200 Die of Encephalitis in UP

At least 211 people, mostly children, have died in an outbreak of Japanese encephalitis in an impoverished region of northern Indian and the death toll is likely to soar. Eastern parts of India's most populous state are ravaged by encephalitis each year as malnourished children succumb to the virus which is transmitted by mosquitoes from pigs to humans but this is one of the worst outbreaks, officials said. Most of the deaths have occurred in the Gorakhpur district of Uttar Pradesh state since the monsoon struck the region in July, according to regional health officer U.K. Srivastava.

  International News

Treatment options in trigeminal neuralgia (Dr G M Singh)

The etiology and pathophysiology of trigeminal neuralgia (TN) is not clear. The incidence is 4.3 per 100,000 persons per year. Women have somewhat higher incidence (5.9/100,000) vs men (3.4/100,000). Though various options are available, treatment of TN can be very challenging. This multitude of treatment options poses the question as to which treatment fits which patient best. The preferred medical treatments include anticonvulsant drugs, muscle relaxants and neuroleptic agents. For patients refractory to medical therapy, Gasserian ganglion percutaneous techniques, gamma knife surgery and microvascular decompression are the most promising invasive treatment options.

Common red blood cell variations not predictor of adverse outcomes for hemodialysis patients (Dr Monica and Dr Brahm Vasudev)

According to results of a study to be published in a forthcoming issue of Journal of the American Society of Nephrology, although hemoglobin variability is common in kidney disease patients, it does not appear to increase their likelihood of dying early.

Cinnamon may help prevent diabetes, heart disease

A study of 22 pre–diabetic obese individuals’ reports that cinnamon–water solution which contains antioxidants can cut the chances of getting diabetes and heart disease by up to 23 percent. The study is published in the Journal of the American College of Nutrition.

Asian black rice health–friendly

Black rice is full of antioxidant–rich bran, which is found in the outer layer that gets removed during the milling process to make white rice. The bran of black rice also contains the antioxidants known as anthocyanins, purple and reddish pigments (also found in blueberries, grapes, and acai) that have been found to have an association with a reduced risk of heart disease and cancer, improvements in memory, and other beneficial health effects.

  Dengue Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta Medicity

Q. What are the criteria for severe dengue?

• Severe plasma leakage leading to:

◊ Shock (dengue shock syndrome or DSS)
◊ Fluid accumulation with respiratory distress

• Severe bleeding as evaluated by clinician

◊ Severe organ involvement
◊ Liver: AST or ALT =1000
◊ CNS: Impaired consciousness

  Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

Q: How common is infertility?
A. About 10% of all couples trying to conceive suffer from infertility.

  Cardio Update: Question of the day

Q. Which patients with paroxysmal or chronic atrial fibrillation should be treated with aspirin, oral anticoagulants or neither?
(Dr. V. Parameshvara, Bangalore)

The following patients should be treated:
• Age <60, no heart disease, lone AF: Treat with aspirin.
• Age <60, with heart disease but no risk factors: Treat with aspirin.
• Age >60 but no risk factors: Treat with aspirin.
• With diabetes/and CAD: Treat with warfarin.
• Age >75: Treat with warfarin.
• Patients with mitral stenosis, prosthetic heart valves, prior thromboembolic event and persistent atrial thrombus: Treat with warfarin.
• Patients undergoing cardioversion (electrical or pharmacological): Anticoagulants 3–4 weeks before and 3–4 weeks after cardioversion.

Suggested reading
1. Texas Heart Institute Journal 2005;32(2).

  Legal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

What are close–range and contact wounds?

Close–range wounds: When a firearm is discharged very close to or in contact with the skin surface, the gases produced by the explosion pass into the tissues with the bullet and cause considerable laceration of the skin and subcutaneous tissues. The entrance wound has a ragged appearance, especially over the skull where it may be stellate in appearance. There is usually some blackening and tattooing of the skin around the bullet entrance wound, while the hair in the region of the wound may be singed. Some skin burning and abrasion in relation to the hot gases may be present.

Contact wounds: In these wounds, the discharge passes into the tissues through the bullet entrance opening and powder deposits as well as blackening may be observed in the depths of the wound. The doctor attending the case must document all the findings in clinical sheet/medico–legal report.

  Medi Finance Update

Q. Is any tax rebate available on arrears of salary received?

Ans. Yes, Section 89 (1) of Income Tax Act allows rebate in respect of arrears of salary received as difference between the tax calculated on receipts basis and accrual basis by making year wise calculations.

  Drug Update

List of Approved drugs from 01.01.2010 TO 30.4.2010

Drug Name


DCI Approval Date

Drosperinone 3mg + Ethinyl Estradiol 0.02mg tablets

For the treatment of symptoms of premenstrual dysphoric disorders (PMDD) in women (additional indication)


  Lab Calculator

Iron deficiency anemia

In iron deficiency anemia (IDA), the serum iron concentration is reduced, and the level of transferrin (also measured as total iron binding capacity [TIBC]) is elevated; the latter finding reflects the reciprocal relationship between serum iron and transferrin gene expression in most nonerythroid cells.

  IJCP Special

Dr Good Dr Bad

Situation: A patient with high cholesterol wanted to know that whether he could take milk products?
Dr. Bad: You can have them.
Dr. Good: Take soya milk products.
Lesson: Foods of plant origin contain no cholesterol.

Make Sure

Situation: A patient on treatment for tension type headache was found to have brain tumor on CT scan.
Reaction: Oh my God, why was the brain tumor not suspected early?
Lesson: Make sure that all patients with tension type headache are thoroughly investigated to rule out brain tumor.

Quote of the Day

Golo Mann …"Man is always more than he can know of himself; consequently, his accomplishments, time and again, will come as a surprise to him."

Asthma Alert

Triggers of asthma

Triggers that are important to certain subsets of patients include:

  • Stress and extremes of emotion
  • Hormonal fluctuations
  • Certain weather events (e.g., thunderstorms)
  • Drugs (e.g., NSAIDs, nonselective beta–blockers)
  • Additives (sulfites) in commercially–prepared foods

SMS of the Day

Practice Makes Man Perfect.

Then What About Woman?


Any Guesses?
She is BORN Perfect!

(Contributed by Dr Chandresh Jardosh)

  Mind Teaser

Read this………………


The answer for yesterday’s Mind Teasure : "Making up for Lost Time"

Correct answers received from: Dr Jayashree B Keshav, In Charge - Scientific Publications The Himalaya Drug Company Dr.K.V.Sarma, Dr Anurag Jain, Dr.R.K.Goel, Dr Kalpana Mohan, Muthumperumal Thirumalpillai, Dr Simran Singh, Dr. M M Siddiqui,Dr Mukesh Bhandari, Dr Nilesh Kale, Dr Yogesh Saxena, Dr Suparna Khera, Dr. Nagendra Gupta, Dr GIRISH CALLY, Dr Shashi Saini, Dr Anupama Sethi Malhotra,
Correct answers received for 30th August Puzzle from: Dr. Ashok Kumar, Dr S.Margekar, Dr. G. Padmanabhan, Dr Yogesh Saxena, Dr Aditya Rattan
Correct answers received for 28th August Puzzle from: Dr. Ashok Kumar

Send your answer to ijcp12@gmail.com

  Humor Section

A man goes to his doctor and says that he’s not feeling well.
The doctor gives him three bottles of pills.
Doctor: Take the green pill with two glass of water, in the morning, when you wake up. Take the blue pill in afternoon with two glass of water. Take the red pill with two glass of water at night before going to bed room.
Man: (scared): What’s wrong with me?
Doctor: You’re not drinking enough water!!!!

(Contributed by Dr G M Singh)

Funny One Liner
Conference: The confusion of one man multiplied by the number present.

  An Inspirational Story

Here’s a little mathematical formula

If: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
is represented as: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26   Then

H–A–R–D–W–O–R– K 8+1+18+4+23+15+18+11 = 98%      And

K–N–O–W–L–E–D–G–E 11+14+15+23+12+5+4+7+5 = 96%    But,

A–T–T–I–T–U–D–E       =     1+20+20+9+20+21+4+5 = 100%

 (Contributed by Dr Rajeev Gupta) 

  Readers Responses
  1. If you are prone to migraines, there are many steps to take to prevent or diminish the attacks: Identify triggers so you can avoid them. That can take some time and real detective work. Keep to a regular, stress–reducing schedule that includes a full night’s rest, balanced meals, and exercise. Wearing blue- or green–tinted glasses can help fend off an attack in people with light sensitivity. Try medications, such as beta–blockers, tricyclic antidepressants, and anticonvulsants. All have side effects, so they should be taken at low doses and only if migraines are frequent. Dr. G.M. Singh
  2.  Dear Sir, Congratulations for this excellent daily medical news service.I would like to suggest that apart from the great job your team is doing, kindly also look into the interests of the doctors involved in the CWG. You can use your powers to ensure that they are treated fairly and their basic needs like food,security etc are looked after.This will win you the confidence of the entire group of Drs in the Delhi Govt (Dr Archana Singla)
  Public Forum

(Press Release for use by the newspapers)


TB is one of the leading causes of mortality in India - killing 2 persons every three minute, nearly 1,000 every day, 3.7 lac every year, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India, BSNL Dil Ka Darbar & MTNL Perfect Health Mela. Estimated incidence is 1.8 million new cases annually, 0.8 million new smear-positive cases annually, 75 new smear positive lung TB cases/1lakh population per year. Estimated 5% of TB patients are HIV infected.

In the current flu mania TB may further increase
1. TB cough patients will go for flu check and if negative may go for TB check.
2. TB cough patients may line up with flu suspects and transmit the infection to them.


1. NO TB isolation rooms. Negative pressure is employed to prevent the escape of droplet nuclei. To accomplish this goal, doors must be kept closed and negative pressure should be verified daily. There must be at least six air exchanges per hour; 12 or more exchanges per hour are preferred and are required for any renovation or new construction. Air should be exhausted to the exterior, far removed from any intake vents; if recirculation to general ventilation is unavoidable, HEPA filters must be installed in the exhaust ducts.

2. NO respiratory protection masks available in the hospitals. These masks must filter particles 1 micron in diameter with at least 95 percent efficiency (N95) given flow rates up to 50 L per minute, must fit to a person's face with less than 10 percent seal leakage, and should be available in several sizes to optimize fit. Health care workers who are unable to use an N95 mask due to poor fit (eg, bearded individuals and those in whom facial structure precludes a tight seal) should use a powered air purifying respirator (PAPR). Multiple sizes of N95 masks should be available close to aII rooms to ensure proper usage.

Masks should be worn under the following circumstances:
1. Persons entering a TB isolation room when the patient is present
2. Persons present during a cough-inducing or aerosol-inducing procedure on such patients, such as bronchoscopy, induced sputum collection, or administration of aerosolized pentamidine
3. Persons in other settings where administrative and environmental controls are unlikely to be protective (eg, in emergency transport vehicles).
4. These devices are designed to filter air before it is inhaled; thus, patients with known or suspected TB should not wear these masks. Instead, when required to be outside TB isolation rooms, such patients should wear surgical masks, which are designed to prevent the respiratory secretions of the person wearing the mask from entering the environment.
5. RNTCP Program is for early detection and treatment- The focus should change to prevention.

  Conference Calendar

A day for Tibet

The India– Tibet Coordination Office and Medical Humanities Group, UCMS is organizing ‘A day for Tibet’ under the CONFLUENCE series.

Date: 14th September, 2010 between 12.30-2.30 pm
Venue: Conference hall, Library block, GTB Hospital, Dilshad Garden, Delhi–95

Contact person: Dr Satendra Singh, email: dr.satendra@gmail.com

  Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

26 th September: Sunday– BSNL Dil ka Darbar A daylong interaction with top cardiologists of the city. 8 AM  5 PM at MAMC Auditorium, Delhi Gate.

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to
10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

eMedinews Revisiting 2010

The 2nd 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.

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