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  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

  Editorial …

3rd May 2011, Tuesday                                eMedinewS Present Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Death of Osama and the 8–year cycle of Chanakya

The death of Osama Bin Laden reminds me of Chanakya Niti wherein Chanakya wrote that the cycle of corruption does not last for more than eight years. He said that people who acquire money by unethical means will have to pay back to the society within eight years. Right or wrong, whether you believe in Chanakya Niti or not, it provides a good message for the youngsters in the society to follow the right path of truthfulness.

Lord Krishna in Bhagwad Gita has written that everybody has to pay the price of his bad deeds or karmas sooner or later. It is the sum total of bad and good karmas which decides the ultimate fate. Chanakya probably meant that all those who keep on earning money by unethical means and simultaneously not doing good deeds will have to suffer within eight years.

Apart from this fact of Chanakya, the 8–year cycle is also seen in public ‘bhedchal’ (mass imitation). Public cannot be befooled for more than eight years in a succession. Here, eight is an arbitrary number and this could even mean six years or 10 years. If we look at the past, we can see the public behavior changing every 6–10 years as far as their preference for a particular type of health wave is concerned.

There was the time of Sherry Lewis weight management program which came like a storm, stayed in the market for 6 to 8 years and then vanished all together. At that time everyone was crazy about managing their weight the Sherry Lewis way. Then came the era of Personal Point, which saw a chain of weight management programmes lasting for a few years. This was followed by weight management the Vandana Luthra way. She is persisting in the market as she keeps on diversifying into another fields.

Weigh management era was followed by the era of "Reiki". During this period all the newspapers were full of reiki advertisements and every second person in the family wanted to become a reiki master.

The latest craze is for drinking ‘ghiya’ (Bottle gourd) juice and doing alom–vilom Pranayama as advocated by Ramdev. How long will this last, only time will tell. He is using all principles of marketing, PR and advertising in this campaign. There was a craze of yoga in the 70s when Dhirendra Brahmachari did the same through the TV media. But it was short lasting as he did not apply the principles of advertisement, marketing and PR at that time.

In terms of spirituality, one also saw a wave of transcendental meditation by Maharishi Mahesh Yogi but the movement did not last long as he quickly realized that selling spirituality in India was not easy and the time for the same was not ripe.

In terms of public behavior, there have been phases of cycling, exercising, jogging, aerobic dancing, western dancing etc.

Dr KK Aggarwal
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    Changing Practice – Evidence which has changed practice in last one year

Ipilimumab for metastatic melanoma

  • For patients with metastatic melanoma who have received prior chemotherapy, START ipilimumab.
  • For patients with metastatic melanoma who have not received prior chemotherapy but are not candidates for high–dose IL–2 therapy, start ipilimumab.

Ipilimumab was approved by the US Food and Drug Administration on March 26, 2011.

  eMedinewS Audio PostCard

Rheumatoid arthritis Update

Dr Harvinder S Luthra Speaks on
‘Diagnosis of RA: Rheumatoid factor’

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day 2011

Students of Delhi Public School, Mathura Road, in a skit carrying various message to save the Earth.

Dr K K Aggarwal
    National News

Need to improve children’s nutrition, reveals survey

NEW DELHI: Children prefer snacking on chips, burgers, noodles, pasta, samosas and other junk foods being sold in schools canteens, leading to lifestyle diseases, an ASSOCHAM survey has found. Releasing the survey, "Rise in consumption pattern of junk food in school", ASSOCHAM Health Committee chairman Dr. B. K. Rao said there was a need to improve children’s nutrition by setting health standards for snacks and beverages sold in school canteens. The survey was conducted in 25 private and public school canteens in Delhi and the National Capital Region among 5,000 children. It found that kids preferred junk food like pizzas, burgers, chowmein, samosas, pasta which are heavy in fats, salt and sugar. Due to this, many children develop lifestyle diseases. "Not just parents but the school management should urge canteens to sell healthy snacks instead of junk foods as children spend more time in school," said Dr. Rao.The survey found that children buy food from the canteen at least four times a week. Half the children surveyed said they eat eggs, pulses and nuts only once a week. Most of the children said they feel extremely tired by the end of the day and can only jog for 10 minutes at a stretch. (Source: The Hindu, Apr 26, 2011)

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

    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

Fit Facts and Tips

Children and Adolescents

It is important to encourage young people to participate in physical activities that are appropriate for their age, that are enjoyable, and that offer variety. Children and adolescents should do 60 minutes or more of physical activity per day.

  • Aerobic: Most of the 60 or more minutes per day should be either moderate–or vigorous–intensity aerobic physical activity, and should include vigorous–intensity physical activity at least three days per week.
  • Muscle–strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include muscle–strengthening physical activity on at least 3 days of the week.
  • Bone–strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include bone–strengthening physical activity on at least 3 days of the week.

(Dr Monica and Brahm Vasudev)

Low vitamin D levels may double diabetes risk

Low vitamin D levels may increase the risk of developing diabetes, according to a study in the journal Diabetes Care.

Ketogenic diet alone may reverse diabetic nephropathy, study in mice suggests

A study in the journal PLoS ONE of "mice suggest that consumption of a ketogenic diet may be sufficient to reverse the symptoms of diabetic nephropathy.

Early morning heart attacks may be more severe

If you suffer a heart attack in the morning, it is likely to be more severe than having one at any other time of day, according to a study published online in the journal Heart.

Low serum–amylase levels may indicate increased risk for metabolic syndrome, diabetes

People with low serum amylase levels have an increased risk for cardiometabolic conditions, such as the metabolic syndrome and diabetes, according to a study in the journal Cardiovascular Diabetology.

    Spiritual Update

Hanuman Chalisa

Jai Hanumana Gyan Guna Sagar
Jai Kapis Tihun Lok Ujagaar

Meaning: Victory to Hanumana, ocean of knowledge and good qualities. Victory to the lord of the Vanaras. His fame echoes through the three worlds.

Spiritual Significance: By doing regular Pranayama and meditating on Hanumana, one can acquire power and qualities of Hanumana. Getting connected with the inner consciousness through breathing Prana Vayu, one gets connected to ocean of knowledge. Hanumana is the Lord of Vanars which means by regular Pranayama, one can control thoughts which are like monkeys. By regular Pranayama, one can also control all three physical, causal and subtle bodies.

    IJCP Special

Dr Good Dr Bad

Situation: A 32–year–old man with sustained fever of 102°F for 2 weeks in whom the diagnosis is not apparent after 3 days of diagnostic studies is admitted in the hospital.
Dr Bad: Manage him as a case of PUO.
Dr Good: Investigate further. Don’t diagnose PUO yet.
Lesson: Pyrexia of unknown origin (PUO) is said to occur in patients with sustained fever of 101° F or more for 3 weeks in whom the diagnosis is not apparent after 1 week of diagnostic studies.

Make Sure

Situation: A patient on amlodipine developed severe gum hypertrophy.
Reaction: Oh my God! Why was amlodipine not stopped?
Lesson: Make sure that all patients on amlodipine are watched for gum hypertrophy as its side effect.

    Gyne Update

(Dr Maninder Ahuja, Secretary General IMS)

Definition of Menopause

Menopause is defined as cessation of menstruation for one year. That is why it is a retrospective diagnosis.

Menopause occurs because of depletion of ovarian follicles and age is mainly genetically programmed. The average age of menopause is about 46.5 years in India and about 51–52 years for our western counterparts.

Premature menopause is when menopause occurs before 40 years of age.

Perimenopause is the period of 4–5 years surrounding menopause when hormonal irregularities begin as a result of which have irregular periods or AUB (abnormal uterine bleeding) and other symptoms.

    An Inspirational Story

(Dr Prachi Garg)

Life in the fast lane

A young and successful executive was traveling down a neighborhood street, going a bit too fast in his new Jaguar. He was watching for kids darting out from between parked cars and slowed down when he thought he saw something. As his car passed, no children appeared. Instead, a brick smashed into the Jag’s side door! He slammed on the brakes and spun the Jag back to the spot from where the brick had been thrown.

He jumped out of the car, grabbed a kid and pushed him up against a parked car shouting, "What was that all about and who do you think you are? Just what the heck are you doing?" Building up a head of steam he went on. "That’s a new car and the repairs are going to cost a lot of money! Why did you do it?"

"Please, mister, please. I’m sorry, I didn’t know what else to do," pleaded the youngster. "I threw the brick because no one else would stop." Tears were dripping down the boy’s chin as he pointed around the parked car. "It’s my brother," he said. "He rolled off the curb and fell out of his wheelchair and I can’t lift him up." Sobbing, the boy asked the man, "Would you please help me get him back into his wheelchair? He’s hurt and he’s too heavy for me."

Moved beyond words, the driver tried to swallow the rapidly swelling lump in his throat. He lifted the young man back into the wheelchair and took out his handkerchief and wiped the scrapes and cuts, checking to see that everything was going to be okay.

"Thank you and may God bless you," the grateful child said to him. The man then watched the little boy push his brother down the sidewalk toward their home. It was a long walk back to his Jaguar, a long, slow walk.

He never did repair the side door. He kept the dent to remind him not to go through life so fast that someone has to throw a brick at you to get your attention. God whispers in your soul and speaks to your heart. Sometimes when you don’t have time to listen, He has to throw a brick at you.

It’s your choice: Listen to the whisper or wait for the brick.

    Pediatric Update

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

GERD: Clinical Presentation

The diagnosis of GERD is often made clinically based on the bothersome symptoms or signs that may be associated with GER symptom descriptions are unreliable in infants and children younger than 8 to 12 years of age, and many of the purported symptoms of GERD in infants and children are nonspecific. There is a continuum between GER and GERD with no cutoff separation between the Physiological Reflux (GER) and Pathological Reflux (GERD). A third type of GER exists which is secondary to pyloric stenosis, neurological impairment, nasogastric tubes, and food allergy.

    Medicolegal Update

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

Government of India/MCI should give Statutory Rules or Executive Instructions on medical negligence – Supreme Court of India

The honorable apex court said "So long as it is not done we propose to lay down certain guidelines for the future which should govern the prosecution of doctors for offences of which criminal rashness or criminal negligence is an ingredient."

  • A private complaint may not be entertained unless the complainant has produced prima facie evidence before the Court in the form of a credible opinion given by another competent doctor to support the charge of rashness or negligence on the part of the accused doctor.
  • The investigating officer should, before proceeding against the doctor accused of rash or negligent act or omission, obtain an independent and competent medical opinion preferably from a doctor in government service qualified in that branch of medical practice That doctor can normally be expected to give an impartial and unbiased opinion applying Bolam’s test to the facts collected in the investigation.
  • A doctor accused of rashness or negligence, may not be arrested in a routine manner simply because a charge has been leveled against him.
  • The doctor should never be arrested in case of medical negligence since the basic rule of mens rea means any criminality to harm the patient always remains absent.
  • The exceptional ground and necessity of arrest of doctor is required to be deliberated and must be transparent/well justified before the police, if unavoidable for furthering the investigation or for collecting the evidence or unless the investigation officer feels satisfied that the doctor proceeded against would not make him available to face the prosecution unless arrested, the arrest may be withheld.
    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

International Diabetes Federation (IDF) Study Highlights

  • People with obesity often struggle not only with health and physical consequences but also with discrimination at work, socially, and in the healthcare system.
  • Bariatric surgery is associated with significant health benefits in severely obese patients with type 2 diabetes.
  • Benefits are gained through weight reduction, improved glycemic control, reduced hypertension, and improved health–related quality of life.
  • A 2009 Cochrane systematic review concluded that bariatric surgery was more effective than conventional treatment of weight loss in patients with class I obesity (BMI > 30 kg/m2) as well as those with severe obesity.
  • The Swedish Obese Subjects study demonstrated prevention and remission of type 2 diabetes in 2037 patients with type 2 diabetes and severe obesity who had bariatric surgery compared with control subjects.
  • A randomized trial specifically focused on treatment of type 2 diabetes showed a remission of 73% for patients who underwent bariatric surgery vs 13% in control participants who received a comprehensive management program.
  • Bariatric surgery should be considered an accepted option in those with type 2 diabetes and a BMI of 35 kg/m2 or higher.
  • Surgery should be considered an alternative treatment option in patients with a BMI of between 30 and 35 kg/m2 when type 2 diabetes cannot be adequately controlled by an optimal medical regimen, especially in the presence of other cardiovascular risk factors.
  • The morbidity and mortality risks associated with bariatric surgery are low and are similar to well–accepted procedures such as elective gallbladder or gallstone surgery.
  • Bariatric surgery in severely obese patients is associated with a reduced mortality risk.
    Mind Teaser

Read this…………………
(Dr GM Singh)


Yesterday’s Mind Teaser: What is not true about the immune mechanism in the small intestine?

a. Intestine contains more than 70% of IgA producing cells in the body.
b. Ig A acts by activating the complement pathway.
c. Ig A is produced by plasma cells in the lamina propria.
d. Approximately 60% of the lymphoid cells are T cells.

Answer for Yesterday’s Mind Teaser: b.

Correct answers received from: Dr K Raju, Dr Anupam, Dr Priya, Dr Shweta, Dr AK Sinha.

Answer for 1st May Mind Teaser: No
Correct answers received from: Dr Jainendra Upadhyay, Dr Richa.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr. GM Singh)


I couldn’t find my luggage at the airport baggage area. So I went to the lost luggage office and told the woman there that my bags never showed up. She smiled and told me not to worry as they were trained professionals and I was in good hands. "Now," she asked me, "has your plane arrived yet?"

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Porphyrin Tests: Indications

When a patient has symptoms that suggest an acute neurologic/psychiatric porphyria, such as abdominal pain, tingling in hands or feet, and/or confusion or hallucinations, or a cutaneous porphyria, such as reddening, blistering, or scarring on sun–exposed skin

    Medi Finance Update

(Dr GM Singh)

Understanding Mutual Funds

Balanced funds invest in a mix of stocks, bonds, and cash investments. The mix will change as market conditions change, but it usually stays within predetermined ranges. (For example, stocks 40–60%, bonds 30–50%, cash 0–30%).

    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
DCI Approval Date
Dexketoprofen1.25% w/w + Linseed Oil 3.0%w/w + Menthol 5%w/w + Methyl Salicylate 10%w/w (12.5mg)
For the topical treatment of acute musculoskeletal pain
    IMSA Update

International Medical Science Academy (IMSA) Update

Attention deficit hyperactivity disorder

A retrospective study of 1470 children receiving pharmacotherapy for attention deficit hyperactivity disorder demonstrated that electrocardiography (ECG) was not a cost–effective screening test for cardiac disease.

  Quote of the Day

(Dr GM Singh)

Blessed is the season which engages the whole world in a conspiracy of love. Hamilton Wright Mabie

    Readers Responses
  1. Dear Dr KK Aggarwal thanks for your article about castration. It is very useful for treating our patients. In psychiatry practice sexual problems are very common. I would like to know what drugs to be given for women patients who have abnormal sexual urge and craving invariably resulting in premarital, extramarital and one of the causes for HIV Dr R Mani.
  2. Dear Dr Agarwal: In today’s emedinews – In Dr Good and Bad Column it has been mentioned that positive Mx test in a child of less than 2 years is to be considered as guideline to start anti TB medication which is not the case. I wish to bring to your notice the following explanation. Sincerely: Dr R S Bajaj, Consultant Pediatrician, Rohini. Is a positive Mantoux test an indication for treatment? A. Following a successful BCG injection at birth, all individuals should normally be positive when tested for a Mantoux reaction. Therefore, giving treatment based only on a Mantoux test does not sound appropriate. In order for anti TB treatment to be given, there should be some clinical indications of active infection, even if positive proof in the form of demonstration of the AFB bacteria is not possible. (Answered by: Vidya Gupta, Consultant Paediatrician & Neonatologist, Indraprastha Apollo Hospital, New Delhi, Thursday, 13 March 2003)
    Public Forum

(Press Release for use by the newspapers)

Doctors advised to carry inch measuring tapes

Measuring tapes are as important as a BP instrument or a stethoscope in clinical practice, said Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal and President, Heart Care Foundation of India.

One should be concerned about abdominal obesity. He said that as per American Journal of Clinical Nutrition, for every one inch increase in the waist circumference in men or women, the risk for–

  • High blood pressure increases by 10%
  • High total cholesterol increases by 8%
  • Low HDL cholesterol increases by 15%
  • High triglycerides increases by 18%
  • Metabolic syndrome increases by 18%

A healthy waist gain should be lower than 33 inches in women and 35 inches for men.

    eMedinewS Special

1. eMedinewS audio PPT (This may take a few minutes to download)

2. eMedinewS audio lectures (This may take a few minutes to open)

3. eMedinewS ebooks (This may take a few minutes to open)

Activities eBooks


  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

  Towards Well Being


    Forthcoming Events

May 7–8, 2011, National Seminar On Stress Prevention

A Stress Prevention Residential Seminar cum spiritual retreat with Dr KK Aggarwal and Experts from Brahma Kumaris.
Co–organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, IMA New Delhi Branch and IMA Janak Puri Branch, IMSA (Delhi Chapter)
Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.
Timings: Saturday 7th May (2 pm onwards) and Sunday 8th May (7 am–4 pm). There will be no registration charges, limited rooms, kindly book in advance; stay and food (satvik) will be provided. Voluntary contributions welcome. For booking e–mail and SMS to Dr KK Aggarwal: 9899974439, emedinews@gmail.com, rekhapapola@gmail.com; BK Sapna: 9811796962, bksapna@hotmail.com.


September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA
Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
• Provisional Scientific Program at http://worldcon2011.org/day1.html
• Provisional program for Pre Congress CME at http://worldcon2011.org/Pre_Conference_CME.html
• Abstract submission at http://worldcon2011.org/scientificprogram.html
• Important dates at http://worldcon2011.org/importantDates.html
• Congress website at http://www.worldcon2011.org
• Entertainment – Kingdom of Dreams at http://worldcon2011.org/Pre_Post_Tours.html

Key Contacts
Dr. (Col.) Satish Parashar, President Organizing Committee, + 91 9810146231
Dr. Rakesh Gupta, Secretary General, + 91 9811013246

Congress Secretariat: Rajat Khurana, C–1 / 16, Ashok Vihar – Phase II, Delhi 110 052, INDIA., Phone: + 91–11–2741–9505, Fax: + 91–11–2741–5646, Mobile: + 91 9560188488, 9811911800,
Email: worldcon2011@gmail.com, jrop2001@yahoo.com, worldcon2011@in.kuoni.com


Medifilmfest (1st International Health Film Festival in Delhi)

October 14–23, 2011, As part of 18th MTNL Perfect Health Mela 2011(Screening of films October 14–17, Jury Screening at Jamia Hamdarad University Auditorium October 18–19, award winning films at TalKatora Stadium October 19–23, 2011)
Organized by: Heart Care Foundation of India, World Fellowships of Religions, FACES, Bahudha Utkarsh Foundation and Dept of Health and Family Welfare Govt of NCT of Delhi.
Entries Invited: from feature films, Ad Films, Serials, Documentary Films, Cartoon Films, Animation Films, Educational films; films on Yoga, Siddha, Ayurveda, Unani, Homeopathy; Indigenous Healing, Films promoting the Bio–cultural Diversity, Medical Tourism, Visual and Medical Anthropology, Gender sensitization, awareness drive on socio–medical issues and health journalism. The films can be of variable durations (0–1 minute, upto 3 minutes, upto ten minutes, upto 45 minutes and upto an hour and beyond).
Separate entries are also invited for "factual mistakes in feature films concerning health". This can be in the form of 1–5 minutes footages.

Categories:Competitive category/ Non Competitive category/ Special screening
Sub Categories:

1. General: Documentaries, animation films, corporate films, Ad films, TV health programs/reports, health chat shows.

2. Special: Short instances of “depiction of wrong health messages” through the films.

Subjects: Health, disease, sanitation, yoga, spiritual health, environment, social issues, food, better living, Indigenous healing, medical tourism, visual & medical anthropology, gender sensitization, health journalism. Duration: 0-10 seconds; < 30 minutes, 30-60 minutes, 1-3 hours. Language: English or Hindi, or sub tilled in English/Hindi. Fee: No fees from participants. Entry to the film show free. Format: Any format duly converted into DVD (compatible to the latest players/systems) Boarding, Lodging and Travel Expenses: Own, the participants may raise their own sponsorships

For details contact: Dr KK Aggarwal/Dr Kailash Kumar Mishra/Mr M Malik at


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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr AK 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 Naveen Dang, Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr Rajiv Parakh, Dr Sudhir Gupta.