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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 …

4th February 2013, Monday

Most people unaware that CT radiation can cause cancer in future

One-third of people getting a CT scan are not aware that the test carries a radiation risk and future cancer risk.

The risk of cancer depends on how many scans a patient gets and which organs are exposed to CT radiation.

CT scans are high-powered X-rays that provide clearer images but expose patients to between 10 and 100 times more radiation than a normal head or chest X-ray.

The radiation dose from one CT scan typically ranges from a couple of millisieverts - comparable to the yearly background radiation from natural sources - to close to 20 millisieverts, the annual exposure limit for nuclear industry employees.

Although each scan only has a small impact on a person's long term risk of cancer, that risk can build over time with more scans and more radiation exposure. For examples repeated CT scans are being done in kidney stones, nasal sinuses or for dementia without reasons.

As per JAMA there would be about 29,000 future cancers related to scans done in 2007 alone. That year, Americans had about 72 million total CT scans.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

What is the follow–up approach to a patient with acute fecal impaction?

Following management of an acute impaction, it is important to identify and eliminate potential causes of constipation. This includes discontinuing medications that cause or exacerbate constipation. For the institutionalized adult, improving availability of toileting and/or providing assistance is necessary to prevent constipation.

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Healthcare worker fatigue and patient safety

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

4th eMedinewS Revisiting 2012

A daylong conference, eMedinewS Revisiting 2012, organized by eMedinewS, Heart Care Foundation of India and World Fellowship of Religions.

Dr K K Aggarwal
    National News

New cases of leprosy in district pose challenge

VARANASI: With 15 to 20 new cases of leprosy being reported every month and a huge floating population, district's performance in complete leprosy eradication is still a challenge, although on papers the prevalence rate of leprosy for Varanasi has reached 0.47. Prevalence rate of leprosy is the number of new cases detected in a population of 10,000 people. It is measured on a scale of 0 to 1. According to district leprosy officer, Dr Rahul Singh, so far in 2012-2013, as many as 95 new multi-bacillary (MB) cases and 146 new paucibacillary (PB) cases were reported, while the total cases on record as in January is 179. Shockingly, out of the 241 new cases detected, 15 are children while 76 are females. While the official statistics reveal considerable number of patients, a proportion of floating population which arrives in the city for earning money by working as labourer and daily-wagers are the worst sufferers. According to sources, such people, if suffering from the disease, are not getting effective treatment at government hospitals or health centres. According to sources, for the complete course of the MDT medicines, all the particulars about the permanent address of the patient are sought. Many patients arrive in the hospital who have no permanent address, and they often dwell in parks, along ghats and Cantonment Railway Station. The treatment of such patients does not start because of the uncertainty of the course completion of MDT. The medical officers and NMAs have made wrong interpretation of the guidelines and rules of National Leprosy Eradication Programme (NLEP). (Source: TOI, Jan 31, 2013)

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)


Perpetrators given access to the children usually through baby sitting and they attract children using bribes, games and systemically de-sensitizing them through touching, talking about sex and perpetrators.

    Valvular Heart Disease Update

Echocardiographic screening of first degree relatives of patients with bicuspid aortic valve and a positive family history and in those with a dilated aorta is recommended.

(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)

Breakthrough: First digital atlas of brain

LONDON: Understanding the most complex human organ — the brain, has now become a lot simpler. In a major breakthrough, scientists at Berkeley Lab has made it possible to get a front row view into how the brain develops and functions and pinpoint which part of the organ is playing truant during neurological disorders like autism, epilepsy and schizophrenia. The scientists have created the world's first genome-wide digital atlas of gene enhancers in the brain — the switches that tell genes when and where they need to be switched on or off. This atlas completely documents the cerebrum — the region that is of critical importance for cognition, motor functions and emotion identifies and locates thousands of gene-regulating elements which are the underlying causes of neurological disorders. (Source: TOI)

Little help from Lucentis for diabetic eyes

Patients with vitreous hemorrhage related to diabetic retinopathy derived no short-term benefits from treatment with the angiogenesis inhibitor ranibizumab (Lucentis), results of a randomized trial showed. (Source: Medpage Today)

Stroke: Time is still brain

Stroke treatment within 60 minutes, telestroke networks, and expanded eligibility for clot-buster therapy are among the topics outlined in the new stroke guidelines from the American Stroke Association published in Stroke: Journal of the American Heart Association. (Source: Medpage Today)

Study confirms heart risk of erectile dysfunction

As the severity of erectile dysfunction increases, so do the risks of cardiovascular disease and mortality among men both with and without a history of heart disease, researchers found. (Source: Medpage Today)

Beating-heart bypass adds $$

Bypass surgery actually cost more when done off-pump, driven by late conversions to heart-lung machine support, according to a cost analysis of the ROOBY trial. (Source: Medpage Today)

  Twitter of the Day

@DrKKAggarwal: New board to check hospital services The department of health research of the Union health ministry has (cont) http://tl.gd/ksvchg

@DrKKAggarwal: Everything is possible. If you want to get something, give something.

    Spiritual Update

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

How to remove negative thoughts

Darkness is absence of light and similarly negative thoughts are absence of positive thoughts. The answer to negative thoughts is to bring positive thoughts back. Ideal mind is devils workshop and will always think negative.

For comments and archives

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

What do you understand by multiple births?

Women who can get pregnant without fertility drugs or medical procedures usually have only one baby. Women who need fertility treatment are at higher risk to get pregnant with twins, and rarely with triplets or more. This is called multiple gestation.

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

(Dr Sanjay Chaudhary, Medical Director, Chaudhary Eye Centre, Dr Pallavi Sugandhi, Consultant Ophthalmologist, Cornea & Refractive surgeon, Chaudhary Eye Centre)

Myth: Eye donation interferes with, or delays customary final rites.
Fact: Eye donation does not interfere with or delay final rites, as the corneal excision procedure takes less than 20 minutes.

For comments and archives

    An Inspirational Story

Life may not give a second chance

It’s another morning………… Again I have to go to the office. Ohh!! this is me… I shouted, having a glance at my ‘photo’ in today’s news paper. But what the HELL is it doing in the death column??


One second………Let me think, last night when I was going to bed I had a severe pain in my chest, but I don’t remember anything after that, I think I had a sound sleep. It’s morning now, ohh……… It’s already 10:00 AM, where is my coffee? I will be late for office and my boss will get a chance to irritate me.. Where is everyone…??? I screamed. "I think there is a crowd outside my room, let me check." I said to myself.

So many people…… Not all of them crying…… But why are some of them crying… WHAT IS THIS??? I’m lying there on the floor…

"I AM HERE" …… I shouted!!! No one is listening. "LOOK I AM NOT DEAD" … I screamed once again!! No one is interested in me. They all were looking at me on the bed. I went back to my bed room. "Am I dead??" I asked myself…

Where is my wife, my children, my Mom, my Dad, my friends? I found them in the next room, all of them were crying…still trying to console each other. My wife was crying… she was really looking sad. My little kid was not sure what happened, but he was crying just because his Mom was sad. How can I go without saying to my kid that I really love him, I really do care for him? How can I go without saying to my wife that she is really the most beautiful and most caring wife in this world? How can I go without saying to my parents that I’m what I am… just because of you??

How can I go without telling my friends that without them perhaps I would have done most of the wrong things in my life… thanks for being there always when I need them…and sorry for not being there when they really need me…

I can see a person standing in the corner and trying to hide his tears…Oh… he was once my best friend, but a small misunderstanding made us part, and we both have a strong enough ego to keep us disconnected.

I went there…… and offered him my hand, "Dear friend… I just want to say sorry for everything, we are still best friends, please forgive me." No response from other side, what the hell?? He is still preserving his ego, I am saying sorry... even then!!! I really don’t care for such people. But one second…… It seems he is not able to see me!!!! He did not see my extended hand.

My goodness…… AM I REALLY DEAD??? I just sat down near ME; I was also feeling like crying… "OH ALMIGHTY!!!! PLEASE JUST GIVE ME FEW MORE DAYS…" I just want to make my wife, my parents; my friends realize how much I love them……

My wife entered the room, she looks beautiful. "YOU ARE BEAUTIFUL" I shouted. She didn’t hear my words, in fact she never heard these words because I never said this to her. "GOD!!!!" I screamed… a little more time plzzzzz… I cried… One more chance please… to hug my child, to make my mom smile just once, to feel my dad proud of me at least for a moment, to say sorry to my friends for everything I have not given to them, and thanks for still being in my life…

Then I looked up and cried!! I shouted……… "GOD!!!! ONE MORE CHANCE PLEASE!!!!"

"You shouted in your sleep," said my wife as she gently woke me up. "Did you have a nightmare?" I was sleeping… Ohh that was just a dream…

My wife was there… she can hear me… This is the happiest moment of my life… I hugged her and whispered…


I can’t understand the reason of the smile on her face with some tears in her eyes, still I’m happy…


SO, now it’s not late… Forget the egos, the Past… and express your love to others……Be friendly… Keep smiling…… forever…It is another chance For you… Please let us do things more sincerely… and make our life worthwhile.

For comments and archives

  Cardiology eMedinewS

Ranibizumab Fails To Beat Saline In Avoiding Vitrectomy Read More

Antisense drug gets OK for inherited high cholesterol Read More

  Pediatric eMedinewS

Heart-to-lung graft choice matters for tots Read More

Antibiotics help in malnutrition treatment in children Read More

    IJCP Special

Dr Good Dr Bad

Situation: An 80–year–old male patient with acute heart attack was posted for reperfusion therapy.
Dr Bad: Chew 300 mg aspirin.
Dr Good: Chew 300 mg aspirin and 75 mg clopidogrel.
Lesson: Start clopidogrel 75 mg as opposed to prasugrel for patients older than 75 years of age who are treated with fibrinolytic therapy.

Make Sure

Situation: Sir, he collapsed after sublingual nifedipine was given.
Reaction: Oh, my God! I forgot to check for LVOT obstruction.
Lesson: Make sure that the patient does not have LVOT obstruction (left ventricular outflow tract) before giving sublingual nifedipine.

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  Quote of the Day (Dr GM Singh)

Love looks through a telescope; envy, through a microscope. Josh Billings

    Mind Teaser

Read this…………………

After Billroth II Surgery, the client developed dumping syndrome. Which of the following should the nurse exclude in the plan of care?

A. Sit upright for at least 30 minutes after meals
B. Take only sips of H2O between bites of solid food
C. Eat small meals every 2-3 hours
D. Reduce the amount of simple carbohydrate in the diet

Yesterday’s Mind Teaser: Discharge instructions for a patient with a newly-placed pacemaker include avoiding:

Cellular phones.
Contact sports.
Cordless phones.
Microwave ovens.

Answer for Yesterday’s  Mind Teaser: Contact sports.

Correct answers received from: Dr jella, dr rejju rajan, dr jayashree sen, dr jainendra upadhyay, dr
hitendar singh makar, dr chandresh jardosh, dr muthumperumal thirumpillai, dr arpan gandhi, dr kanta jain, dr avtar krishan

Answer for 2nd February Mind Teaser: Providing information about past illnesses, hospitalizations, and medications.

Correct answers received from: Dr muthumperumal thirumpillai, dr arpan gandhi, dr kanta jain, dr avtar krishan

Send your answer to ijcp12@gmail.com

    Laugh a While

Communication technician

A communication technician drafted by the army was at a firing range. At the range, he was given some instructions, a rifle and 50 rounds. He fired several shots at the target. The report came from the target area that all attempts had completely missed the target. The technician looked at his weapon, and then at the target. He looked at the weapon again, and then at the target again. He then put his finger over the end of the rifle barrel and squeezed the trigger with his other hand. The end of his finger was blown off, whereupon he yelled toward the target area: "It’s leaving here just fine, the trouble must be at your end!"

    Medicolegal Update

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

A medicolegal autopsy means an examination of the body after death, which is conducted in cases where the circumstances of the death suggest that the death was caused by homicide, suicide or accident or is suspicious in nature where criminal investigation is instituted.

The Police/magistrate are empowered by the law in India to order a designated doctor to perform a forensic autopsy; hence no consent from the family/legal heir is required for forensic autopsy.

Autopsia cadaverum or an autopsy is the post–mortem examination of corpse by a registered doctor. It is a specialized surgical procedure that consists of a thorough examination of a corpse to determine the identity of corpse, the cause and manner of death and to evaluate any disease or injury that may be present. The autopsy must be performed by a specialized experienced medical doctor; however if possible, it should preferably be done only by a doctor qualified/experienced in forensic medicine.

The autopsy ideally includes both a thorough external examination of the body and a probing examination of the internal organs of the body. During the external examination, the doctor examines the body searching for wounds and injuries, noting deformities, absence of limbs, state of nutrition, and unusual features.

The doctor should examine the hands, fingers, fingernails, feet, teeth, scalp, tattoos, scars, hair, skeleton remains, hair fibers, jewelry and clothing.

While conducting the internal examination, the autopsy surgeon should remove the deceased’s chest plate, lungs, heart, liver, intestines, etc. and, with the use of a scalpel, examine these organs for wounds, disease, and deformities.

There should be an arrangement to videotape the autopsy and must release a detailed report, including the cause of death to the police as early as possible. It is best and most transparent if the postmortem report is handed over along with dead body.

Autopsies, as well as the reports released by the medical examiner, vary in quality. Some medical examiners take little care in their work. A small percentage is outright incompetent.

Once an autopsy is complete the body must be well reconstituted by sewing or suturing it back together with cosmetic care of deceased body. Suturing from chin to pubic prominence should be masked by resembling skin color paste.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Snorers at risk of sudden death

The interrupted night time breathing of sleep apnea increases the risk of dying said, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President-Elect IMA. Sleep apnea is a common problem in which one has pauses in breathing or shallow breaths during sleep.

Studies have linked sleep apnea during snoring to increased risk for death. Most studies were done in sleep centers rather than in the general community. A study published in the journal Sleep has suggested that the risk is present among all people with obstructive sleep apnea. The size of the increased mortality risk was found to be surprisingly large.

The study showed a six-fold increase, which means that having significant sleep apnea at age 40 gives you about the same mortality risk as somebody aged 57 who does not have sleep apnea.

For the study, the researchers collected data on 380 men and women, 40 to 65 years old, who participated in the Busselton Health Study. Among these people, three had severe obstructive sleep apnea, 18 had moderate sleep apnea, and 77 had mild sleep apnea. The remaining 285 people did not suffer from the condition. During 14 years of follow-up, about 33 percent of those with moderate to severe sleep apnea died, compared with 6.5 percent of those with mild sleep apnea and 7.7 percent of those without the condition. For patients with mild sleep apnea, the risk of death was not significant and could not be directly tied to the condition.

People who have, or suspect that they have, sleep apnea should consult their physicians about diagnosis and treatment options.

Another study by researchers from the University of Wisconsin has also shown that severe sleep apnea was associated with a three-fold increased risk of dying. In addition, for those with moderate to mild sleep apnea, the risk of death was increased 50 percent compared with people without sleep apnea. Sleep apnea is also linked to future heart attacks and with thickened wall thickness of the neck artery.

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 26331 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 of10x10 i.e. 100 per minute.”

    Readers Response
  1. Dear sir, good going emedinews. Regards:dr tapan
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