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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 …

3rd November 2012, Saturday

Expired Drugs Potent Up to Decades

As per a new analysis of 8 drugs, published in study in October 8 in the Archives of Internal Medicine, most of the active ingredients in the drugs are present in adequate amounts decades after the drugs' expiration dates.

As per US FDA standards, adequate means that an active ingredient must be present in 90% to 110% of the amount indicated on the label. Normally drug expiration dates are set for 1-5 years after production.

In the study Lee Cantrell, PharmD, from the California Poison Control System tested drugs which had expired 28 to 40 years ago.

In the study tested, 12 of the 14 active ingredients persisted in concentrations that were 90% or greater of the amount indicated on the label. These 12 compounds retained their full potency for 336 months or longer. Eight of them retained potency for at least 480 months.

Only aspirin and amphetamine fell below the 90% cutoff. Three compounds persisted in greater than 110% of the labeled contents: methaqualone, meprobamate, and pentobarbital.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Chronic idiopathic constipation or functional constipation is a common condition affecting the GI tract, with a prevalence of between 4% and 20% (Ford AC, Suares NC. Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis. Gut 2011;60:209-18).

For Comments and archives…

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Healthcare worker fatigue and patient safety

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Lifestyle changes should start in childhood

Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India providing trainee to School Children organized at Ryan International School, Vasant Kunj as a part of the 19th MTNL Perfect Health Mela being organized by the Heart Care Foundation of India in association with Department of Health, Government of Delhi.

Dr K K Aggarwal
    National News

19th MTNL Perfect Health Mela 2012 From 1st November to 11th November 2012

click for Programme

Today’s Program

DD India Recording Program
Date: 3rd November, Saturday
Venue: DD Kendra, Asiad Village, Siri Fort Road
Time: 3-5 PM
Audience Based Show
Topics: Stroke Prevention Cancer Prevention

Spices lower lifestyle-related diseases: Expert

Mysore: Spices used in Indian cuisine not only make it tastier and aromatic but also provide an array of health benefits, said K Srinivasan, senior scientist and head of the department biochemistry and nutrition, CFTRI. Speaking on World Food Day organized by Indian Medical Association here on Tuesday, Srinivasan said "Indians were the first to know the benefits of spices and started using it. The importance of spices was discovered during the Vedic age." Spices increase the nutritional quality of food and reduce the need for other less healthy flavours like salt, fat and sugar. Spices reduce the need for sodium, he added. Spices are also known to check obesity and cholesterol. Dr Srinivasan attributed the higher incidence of lifestyle diseases in the West to the meager use of spices in their cuisine. Spices have more disease-fighting antioxidants. Curry powders prepared out of spices has more beneficial properties, he added. (Source: TOI, Oct 31, 2012)

For comments and archives

My Profession My Concern

Quality control

Administration of IV infusions to treat shock

  • It was universally felt that the administration of IV infusions was a life saving procedure. As hemorrhage was the commonest cause of maternal mortality, the administration of 3ml of fluid for every ml of blood lost could keep the woman alive during the time it took to transport her to the nearest CHC/FRU where blood transfusion facility was available
  • As of now, the ANMs are neither trained nor allowed by the regulatory authorities to establish an IV line. After the discussion, it was decided that:
    • If the ANM is trained to give IV infusion, she should administer wherever feasible, even at home.
    • The ANM should start infusion with Ringer Lactate or Dextrose Saline.
    • If an IV infusion was being started in cases of PPH, it was recommended the IV fluid should be augmented with 20U of Oxytocin for every 500 ml bottle of fluid. This could be continued throughout transportation.
  • However, the logistics and feasibility of the ANM being able to carry IV infusion sets and IV fluids to homes need to be explored, and ensured.

For comments and archives

Medical mistakes in Indian movies

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

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

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

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

    Valvular Heart Disease Update

Mitral stenosis in the elderly

Concurrent tricuspid valve surgery with chronic MR surgery

  • Tricuspid valve repair in patients with severe TR (Grade 1C).

(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)

Thick drinks key to feeling full

Thicker drinks are more likely to make you feel fuller and feel full longer for the same amount of calories than thin drinks, an experimental study suggested. Creaminess also boosted people's ratings of how full a drink would make them, but didn't have an impact on expectations about satiety in comparison to solid food, Keri McCrickerd, a PhD student at the University of Sussex in Brighton, England, and colleagues found. Their results on varying the thickness, creaminess, and amount of calories in a yogurt drink were reported online in Flavour. (Source: Medpage Today)

For comments and archives

Diabetes surgery tops medical innovation list

Bariatric surgery for diabetes treatment was selected as the most important medical innovation for 2013 in a poll of Cleveland Clinic physicians and researchers. Participants in the survey, conducted for a conference on healthcare technology development taking place this week at the clinic, also voted femtosecond laser surgery for cataracts, mass spectrometry for diagnosing bacterial infections, and Medicare reform legislation pending in Congress into the top 10 on a list of exciting innovations. The list was selected by Cleveland Clinic staff from 150 nominations of emerging technologies judged to have high probability of commercial success, according to a clinic press release. (Source: Medpage Today)

For comments and archives

Pertussis diagnosed with voice-recognition technology

The paroxysmal phase of a pertussis cough is so distinctive that, using voice-recognition technology, researchers have developed a system that can accurately classify a case, or at least assign a probability of it being pertussis, after just a few seconds of coughing. The technology can accurately distinguish pertussis coughs from croup and nonpertussis coughs, Philip Polgreen, MD, MPH, associate professor of internal medicine at the University of Iowa in Iowa City, and director of the Infectious Diseases Society of America's Emerging Infections Network, explained here at ID Week 2012. (Source: Medscape)

For comments and archives

Novel drug helps statins cut cholesterol

A monoclonal antibody -- currently known as SAR236553 -- boosted the effectiveness of atorvastatin in both low and high doses in patients with primary hypercholesterolemia, results of a phase II trial indicated. (Source: Medpage Today)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: How to revive a person after sudden death: Video:

@DeepakChopra: Consciousness is universal. Perspective is personal.

    Spiritual Update

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

Understanding the Gunas

The mental state of a person in Vedic language is described in terms of gunas. The present state of mind of any person is a result of mixing of three gunas of nature called tamas, rajas and satoguna. In terms of states of mind they are called tamas, rajas and sattva and the nature of a person is called tamsik, rajsik and satwik.

For comments and archives

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

In how many cycles does the hair grow?

Hair growth occurs in cycles. While some grow, others rest, and still other are shed. Hormonal changes, such as those associated with oral contraceptives (birth control pills) or pregnancy may synchronize hair growth and make it appear to grow and shed more than usual. However, hair growth patterns usually return to normal within six to 12 months.

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

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

Primary reason for transfusing blood

  • To restore or maintain oxygen supply to body tissues
  • To prevent massive blood loss e.g. traumatic accidents
  • To treat blood disorders e.g. anemia
  • To treat hemolytic disease of the newborn (pregnant women develop antibodies that destroy the newborn’s red blood cells)

For comments and archives

    An Inspirational Story (Ms Ritu Sinha)

The Secret of Success!

A young man asked Socrates, an ancient Greek philosopher, the secret of Success. Socrates told the young man to meet him near the river the next morning. They met. Socrates asked the young man to walk with him toward the river.

When the water got up to their necks, Socrates took the young man by surprise and ducked him into the water. The man struggled to get out but Socrates was strong and kept him under water until he started turning blue.

The young man struggled hard and finally managed to get up. The first thing he did was to gasp and take a deep breath. Socrates asked, “What did you want the most when you were under the water?”

The man replied “Air”.

Socrates said: “That’s the most secret to success. When you want success as badly as you want air, you will get it. There is no other secret”.

Reflection: A burning desire is the starting point of all accomplishments. Just like a small fire cannot give much heat, a weak desire cannot produce great results…

For comments and archives

  Cardiology eMedinewS

Coronary artery bypass grafting better that percutaneous coronary intervention, five-year comparative registry shows Read More

EXCELLA II three-year results show lower re-intervention rates with DESyne stent Read More

  Pediatric eMedinewS

Infantile hemangioma: propranolol more effective than corticosteroids?
Read More

Pre-pregnancy weight, smoking status tied to heavy kids Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with albumin in the urine was to go for bypass surgery.
Dr Bad: There is no risk.
Dr Good: There is a risk of kidney injury.
Lesson: A simple urine test for presence of proteins before heart surgery can predict which patients may develop kidney–related complications, according to a study published in the Journal of the American Society of Nephrology.

Make Sure

Situation: A child with sore throat and the large lymph nodes developed fever.
Reaction: Oh my God! Why were antibiotics not given in time?
Lesson: Make Sure that all children with sore throat and enlarged lymph nodes are given antibiotics as such sore throats are Streptococcal unless proved otherwise.

    Legal Question of the Day (Dr M C Gupta)

Need, purpose, efficacy and changes needed in the PC&PNDT Act

There is lot of criticism about the PC&PNDT Act. Some critiques want it to be scrapped on the ground that it has resulted in harassment of doctors and has led to corruption and has been ineffective in improving the sex ratio. Others agree with the grounds of criticism but want the Act to be amended rather than scrapped. Let us examine the issue.

Q. Is there any conceptual flaw in the PC&PNDT Act?


Even after the Act has been in place, the 2001 Census revealed alarming trends as regards sex ratio, which showed further decline in the 0 to 6 age group in states like Haryana, Punjab, Himachal Pradesh, Maharashtra, Gujarat and Tamil Nadu.

The Act is based on the false assumption that control of the misuse of such techniques for the purpose of pre-natal sex determination will result in reduction in the incidence of female feticide. Such assumption has been proven false by the fact that the 0-6 year child sex ratio in India was 945 (1991 data) before the commencement of the Act and 927 (2001 data) after 7 years of implementation of the Act—
http://india.unfpa.org/drive/Bibloigraphy.pdf It has further declined to 914 (2011 data)—

When the 2011 data became available showing that the child sex ratio in 2011 was the lowest since independence, the government, instead of looking at the problem in a logical and rational manner and appointing a committee of scientists, including social scientists, to find the causes of continuous decline in sex ratio, became panicky and wanted to look aggressive in its apparent efforts to control the falling sex ratio. The aggression has become manifest in the past few years in the form of a spate of cases booked under the PNDT Act.

It needs to be remembered that ultrasound machine has become available only over last 25 years or so while the decline in child sex ratio has continued since 1947 onward. It has continued even after 1994 when the Act became operative. Common sense would tell a common man the following two things:

--That the cause of low sex ratio is not the ultrasound machine.
--That the PNDT Act, operationalized in 1994, has been ineffective over 18 years.

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  Quote of the Day (Dr GM Singh)

A Teacher can give knowledge, but the Master brings a heightened awareness. A Teacher can give information but the Master awakens intelligence. Sri Sri Ravi Shankar

    Mind Teaser

Read this…………………

Twenty four hours after admission for an acute MI, Jose’s temperature is noted at 39.3 C. The nurse monitors him for other adaptations related to the pyrexia, including:

A. Shortness of breath
B. Chest pain
C. Elevated blood pressure
D. Increased pulse rate

Yesterday’s Mind Teaser: What is special about the following number sequence?
8, 5, 4, 9, 1, 7, 6, 10, 3, 2, 0

Answer for Yesterday’s Mind Teaser: The numbers are in alphabetical order.

Correct answers received from: Dr K Raju, Dr Avtar Krishan, Dr Girish Dani, Dr Jainendra Upadhyay,
Dr Chandresh Jardosh, Dr Kanta Jain, Dr PC Das.

Answer for 1st November Mind Teaser: Four canaries and three cages.
Correct answers received from: Dr Chandresh Jardosh, Dr PC Das, Dr BB Gupta, Dr Suresh Arora.

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Work Load

Salesman: This computer will cut your workload by 50%.
Office Manager: That's great, I'll take two of them.

    Medicolegal Update

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

The right to refuse medical interventions - The Nancy Vehicle Accident Case

The US Supreme Court declared that artificial hydration or nutrition is no different from medicines

Nancy Cruzan, a 31–year–old woman suffered severe brain damage in a vehicular accident that placed her in a persistent vegetative state, dependent upon a feeding tube.

  • After four years without improvement in her cognitive function, her family asked to have her artificial feeding and hydration stopped.
  • In its decision, the United States Supreme Court recognized that competent patients have a constitutional right to refuse medical care.
  • Using the Fifth Amendment’s guarantee that no person shall "be deprived of life, liberty, or property, without due process of law" the Supreme Court affirmed patients’ rights to refuse medical treatments. The Court declared that artificial hydration or nutrition is no different from other medical interventions. Although mentally incapacitated patients have the same right, the Supreme Court allowed states to impose restrictions on how explicit and specific the patient’s prior wishes had to be.
  • After this court ruling, some of Cruzan’s friends provided evidence that she had previously expressed wishes that she would want artificial feedings discontinued in such a scenario. As a result of this testimony, her feedings were terminated.
  • Mentally competent patients need not be terminally ill to exercise this right to refuse interventions they have the right regardless of health status.
  • The right applies equally to withholding proposed treatments and to discontinuing initiated treatments.
  • The right to refuse medical care does not imply a correlative right to demand treatment.

For comments and archives

    Public Forum

Public Forum (Press Release for use by the newspapers)

Lifestyle changes should start in childhood

The seeds of heart blockages are born while a person is in his adolescence or childhood. Prevention, therefore, must start right at that age, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India, Padma Shri Dr. S.C. Manchanda and Dr. A.K. Jhingan, Diabetes Specialist, in a joint statement. They were participating in an open house group discussion organized at Ryan International School, Vasant Kunj as a part of the 19th MTNL Perfect Health Mela being organized by the Heart Care Foundation of India in association with Department of Health, Government of Delhi.

The doctors said that heart attack cannot be given or accepted as a Gift. It takes minimum 15 years to live a lifestyle against the laws of nature to develop early blockages. Heart disease, therefore, is reversible and gives you enough time to reverse. They also said that in diet one should adopt the principle of moderations and variety and include all seven colours and six tastes in their diet.

Noted Kathak Dancers, Nalini and Kamalini, who were celebrity guests said that aerobic dance in any form should be part and parcel of school health programme. Traditional dances are better than western dance as classical traditional dance is a mix of yoga, meditation, relaxation and exercise.

The main Perfect Health Mela will start on 7th November, 2012 at Constitution Club of India and will have a mix of exhibitions, competitions, workshops, seminars, entertainment incorporating all pathies under one roof. The entry to the Mela will be free. The programme will also be aired on 7th November, 2012 6pm on Fit Delhi Dilli Aaj Tak.

    Readers Response
  1. Dear Sir, emedinews is very informative. Regards:Dr Rachna
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