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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 …

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

7th April 2013, Sunday

Male baldness indicates heart disease risk

Male pattern baldness is linked to an increased risk of coronary heart disease, but only if it’s on the top/crown of the head. A receding hairline is not linked to an increased risk. The researchers from University of Tokyo trawled the Medline and the Cochrane Library databases for research published on male pattern baldness and coronary heart disease, and came up with 850 possible studies, published between 1950 and 2012. Analysis of the findings from these showed that men who had lost most of their hair were a third more likely (32 percent) to develop coronary artery disease than their peers who retained a full head of hair. It showed that balding men were 70 percent more likely to have heart disease and those in younger age groups were 84 percent more likely to do so.

Extensive vertex baldness boosted the risk by 48 percent, moderate vertex baldness by 36 percent and mild vertex baldness by 18 percent. By contrast, a receding hairline made very little difference to risk. The study is published in the online journal BMJ Open.

Male pattern baldness is characterized by hair receding from the lateral sides of the forehead (known as a "receding hairline") and/or a thinning crown (balding to the area known as the ‘vertex’). Both become more pronounced until they eventually meet, leaving a horseshoe-shaped ring of hair around the back of the head.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

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

FDA OKs first drug-eluting stents for use in MI

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

WHO Day Celebrated: Over 10000 people (11459) trained in Hands Only Cardiopulmonary Resuscitation (CPR 10) in one day

The event was organised by Heart Care Foundation of India in association with Dept. of Education, Delhi Government with Dr. Sampoornanand Sarvodaya Kanya Vidyalaya, C-1 Yamuna Vihar as the host school to earmark World Health Day.

Dr K K Aggarwal
    National News

Govt aims at saving 50,000 infants annually, dying of diarrhea

New Delhi: The government is working with international agencies to increase the percentage of children treated for diarrhea with Oral Rehydration Salts (ORS) and zinc 15 times over in the next five years. Diarrhea, one of the most preventable causes of infant death, kills 2, 25, 000 children under the age of five in India every year, which accounts for 30% children deaths. Currently, less than 2% of children with diarrhea are treated with both ORS and Zinc, and the aim is to bring it up to 30 per cent. “We have chosen three high-burden states- Madhya Pradesh, Odisha and Uttar Pradesh, to begin with and aim at saving approximately 150,000 children’s lives between 2013-2017 that translates to roughly 50,000 children annually,” said Louis-Georges Arsenault, representative, UNICEF, India Country office. The government of India in collaboration with UNCEF Canada and Teck Resources Limited (“Teck”) officially launched a $5 million program on Wednesday under the Zinc Alliance for Child Health (ZACH). “The contribution is part of our global citizenship programme that supports NGOs and development agencies to strengthen the healthcare delivery system. Being the largest producers of zinc, it makes sense to help save lives by preventing diarrhea,” said Dough H. Horswill, senior vice president, Teck Resources Limited. The cost of delivering ORS-Zinc combo is about Rs. 20 per child. The agencies will be making use of the existing frontline government healthcare workers to distribute the doses. “There is need to increase awareness and knowledge among healthcare workers, including paediatricians who are our point of contact with the target group. We also plan to have a monitoring mechanism in place because just having the product is not enough, it needs to reach the needy,” said David Morley, president and CEO, UNICEF Canada. (Source: Hindustan Times, April 03, 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)


Categories of emotional or psychological abuse

  • Corrupting– Stimulating destructive, antisocial, or sexually exploitative behavior, reinforcing deviant behavior
  • Verbal assault or spurning– Name-calling; sarcasm that erodes the child's self-esteem and reinforces negative self-image; singling out a child to criticize or punish; humiliating the child in public.
  • Over pressuring– Overly advanced expectation of the child's behavior and accomplishments; criticism of age-appropriate behavior as inadequate; comparing the child's behavior to other children as "poor by comparison," resulting in a negative self-image and behavior disturbance. (Source: Uptodate)

For comments and archives

    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)

Framingham risk scores best predictors of cognitive decline?

Two Framingham vascular risk scores are more strongly associated with cognitive decline than is a dementia risk score, and they could be a better fit for use in primary prevention to target modifiable risk factors, a new study suggests. (Source: Medscape)

Better 5-year results with cervical arthroplasty than fusion

Patients who underwent cervical disc arthroplasty had improved clinical outcomes and segmental vertebral motion at 5 years, according to new research. In addition, neck disability was better after arthroplasty than after anterior cervical discectomy and fusion. (Source: Medscape)

AMD remains leading cause of vision loss

Age-related macular degeneration (AMD) remained the most common cause of severe visual impairment over a 20-year period, researchers found. (Source: Medpage Today)

Test all adenocarcinomas, new lung cancer guidelines say

New guidelines stipulate that all lung cancer patients with adenocarcinoma should be tested for the genetic abnormalities that indicate suitability for treatment with targeted agents, specifically EGRF and ALK tyrosine kinase inhibitors. (Source: Medscape)

Procedure seals up corneal perforation

The combination of an autologous fibrin membrane and platelet-rich plasma clot appears to be safe and effective for treating perforated corneal ulcers, a pilot study showed. (Source: Medpage Today)

    Twitter of the Day

@DrKKAggarwal: Never tell a patient that you are suspecting a diagnosis of cancer Informed consent and a premature... http://fb.me/2q8lGkN7A

@DeepakChopra: Are you a human being or being human? I discuss in the new episode of The Rabbit Hole http://youtu.be/Cj3GaxEM_pw

    Spiritual Update

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

The very purpose of a birthday

The purpose of birthday according to our mythology can be interpreted as follows:

  • A birthday is a reminder of our true purpose in life, towards which our actions should be directed. These are Dharma, Artha, Kama and Moksha. Dharma is righteousness – doing our duty; artha is righteous earning of the means to do our duty; kama and moksha represent fulfilling of desires and achieving inner happiness and liberation, respectively.

For comments and archives

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

What causes hyperprolactinemia?

Prolactin levels increase as a result of:

  • Certain medications, including commonly prescribed antidepressants, antipsychotics, and blood pressure medications
  • Herbs, including fenugreek, fennel seeds and red clover
  • Chest wall irritation (from surgical scars, shingles, or even a too–tight bra)
  • Stress
  • Certain foods
  • Exercise
  • Sleep (prolactin levels are highest at night)
  • Nipple stimulation
  • Hypothyroidism, or underactive thyroid
  • Pituitary tumors. These are usually very tiny, but account for about 30% of all cases of hyperprolactinemia.
    Tat Tvam Asi………and the Life Continues……

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

Natural antibodies

  • Antibodies are formed against most of the major group antigens and are present in almost all individuals when the antigen is absent.
  • In most other minor systems, natural antibodies to the antigens are found occasionally but as their antigenicity is low, the immune antibodies are also rare (except – Kell & Duffy)
  • Most of them are IgM type
  • React poorly at body temperature (except anti–A & anti–B), but agglutinate RBCs at 5–20°C
  • Usually do not cross placenta.

For comments and archives

    An Inspirational Story

The fence

There once was a little boy who had a bad temper. His father gave him a bag of nails and told him that every time he lost his temper, he must hammer a nail into the fence. The first day the boy had driven 37 nails into the fence. Over the next few weeks as he learned to control his anger, the number of nails hammered daily, gradually dwindled down. He discovered it was easier to hold his temper than to drive those nails into the fence.

Finally the day came when the boy didn’t lose his temper at all. He told his father about it and the father suggested that the boy now pull out one nail for each day that he was able to hold his temper. The days passed and the young boy was finally able to tell his father that all the nails were gone.

The father took his son by the hand and led him to the fence. He said “you have done well, my son, but look at the holes in the fence. The fence will never be the same. When you say things in anger, they leave a scar just like this one.” You can put a knife in a man and draw it out. It won’t matter how many times you say I’m sorry, the wound is still there. Make sure you control your temper the next time you are tempted to say something you will regret later.

For comments and archives

    Cardiology eMedinewS

WHO: Banning trans fats is good health policy Read More

    Pediatric eMedinewS

FDA OKs carbinoxamine ER for allergic rhinitis in children 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 modern rabies vaccines be stored at room temperature?

Vaccines must be stored at +20 C to + 80 C. They should not be stored at room temperature. Besides, the vaccine should not be exposed to sunlight and heat.

    IJCP Special

Dr Good Dr Bad

Situation: A patient wanted to know if the cost of the spectacles would be covered by Mediclaim after cataract surgery.
Dr. Bad: It will be covered.
Dr. Good: It will not be covered.
Lesson: Mediclaim does not cover the cost of spectacles, contact lenses, hearing aids.

Make Sure

Situation: A known epileptic child died of a seizure while swimming.
Reaction: Oh my God! Why was he allowed to swim?
Lesson: Make sure that patients with uncontrolled epilepsy are not allowed to swim.

    Quote of the Day (Dr GM Singh)

True dignity is never gained by place, and never lost when honors are withdrawn. Philip Massinger

    Legal Question of the Day

(Dr MC Gupta, Advocate & Medico-legal Consultant)

Q. A consumer court gave an award of Rs. 5 lakh against a DMLT pathlab? What are your comments?

Ans. My comments are as follows:

  • You are obviously referring to the following news:
    “Court tells lab to pay Rs 5l for a 'killer' report, TOI, 25-3-2013”.
  • The news is briefly as follows.

    “In this case, three-year-old Jaynil Rawal fell ill on February 26 last year in Surendranagar. His father admitted the boy in a paediatrician's hospital. The doctor asked for blood investigation report and the report was obtained from Rushabh Laboratory, which showed that little Jaynil was suffering from falciparum malaria. Treatment began on this line, but the child's condition deteriorated further.

    Jaynil was shifted to C U Shah Medical College, where another blood report was obtained. It reflected that the child did not have falciparum malaria. But it was too late by then as the child's haemoglobin count had come from 10.02 to just 3.03. He died on February 29 morning.

    The child's father, Virenkumar approached the consumer court demanding Rs 5 lakh from the laboratory owner for providing flawed blood report, which led to the death of his son. After the hearing, the consumer court held Shah guilty of giving wrong blood investigation report.

    Besides, the forum restricted Shah from signing any investigation report, practically closing down the laboratory. The consumer court observed that since Shah did not have any degree in pathology, which is a must to run a laboratory as per the high court's directions. The consumer forum can restrain people from providing harmful services under section 14 (1)(HA) of the Consumer Protection Act.”
  • This judgment has 2 components:
    • Compensation for death caused by negligence (wrong falciparum positive report).
    • An order, under section 14(ha) restraining the running of the pathlab by a non-pathologist.
  • This was an ordinary consumer case claiming compensation for negligence in services. What is needed is that a complaint(s), as defined in section 2(b), should be filed with reference to sections 2(c ) (i) and 2(c ) (vi) for adopting an unfair trade practice as defined in section 2(r) against DMLT pathlabs. Such a complaint is bound to succeed. There is no way it can fail. The complaint can be filed by any individual or group, including doctors’ groups such as IMA or by any government department (such as the health department or medical council).
  • It is a pity that the medical profession has done nothing in this direction. The law is there, the courts are there, a free legal process (without court fee) is there---but the spirit to fight and clean is not there in the medical profession.
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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

Photos of Doctor’s Day Celebration

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   Mind Teaser

Read this…………………

When assessing a patient for possible side effects related to acetaminophen, the pain management nurse asks the patient about the use of:

1. Alcohol
2. Marijuana
3. Opioids
4. Tobacco

Yesterday’s Mind Teaser: An infant, age 8 months, has a tentative diagnosis of congenital heart disease. During physical assessment, nurse Jasmine measures a heart rate of 170 beats/minute and a respiratory rate of 70 breaths/minute. How should the nurse position the infant?

a. Lying on the back
b. Lying on the abdomen
c. Sitting in an infant seat
d. Sitting in high Fowler’s position

Answer for Yesterday’s  Mind Teaser: c. Sitting in an infant seat

Correct answers received from: Tukaram Pagad, Dr. Bharat Bhushan Aggarwal, Dr Gajveer, drjella, Dr Pankaj Agarwal, DR ARPAN GANDHI, Dr Jainendra Upadhyay, Dr Chandresh jardosh, Muthumperumal Thirumalpillai, Dr Avtar Krishan, Rajiv Kohli, Dr.K.V.Sarma, Dr. Deepali Chatterjee , Dr. shashi saini, Dr.Jayashree Sen & Dr.Bitaan Sen

Answer for 5th April Mind Teaser: c. Place the infant’s arms in soft elbow restraints

Correct answers received from: Tukaram Pagad, Dr.K.V.Sarma,, DrGajveer, Dr Kanta Jain, dr. deepali chatterjee, Dr. shashi saini, Dr.Jayashree Sen & Dr.Bitaan Sen

Send your answer to ijcp12@gmail.com

   Laugh a While (Dr GM Singh)

Help is on its way

A woman was at work when she received a phone call that her daughter was very sick with a fever. She left her work and stopped by the pharmacy to get some medication.

She got back to her car and found that she had locked her keys in the car. She didn’t know what to do, so she called home and told the baby sitter what had happened, the baby sitter told her that the fever was getting worse. She said, "You might find a coat hanger and use that to open the door." The woman looked around and found an old rusty coat hanger that had been thrown down on the ground, possibly by someone else who at some time or other had locked their keys in their car.

Then she looked at the hanger and said, "I don’t know how to use this." So she bowed her head and asked God to send her some help. Within five minutes an old rusty car pulled up, with a dirty, greasy, bearded man who was wearing an old biker skull rag on his head. The woman thought, "This is what you sent to help me?" But, she was desperate, so she was also very thankful.

The man got out of his car and asked her if he could help. She said, "Yes, my daughter is very sick. I stopped to get her some medication and I locked my keys in my car. I must get home to her, please, can you use this hanger to unlock my car?" He said, "Sure". He walked over to the car, and in less than a minute the car was opened.

She hugged the man and through her tears she said, "Thank you so much! You are a very nice man." The man replied, "Lady, I am not a nice man. I just got out of prison today, I was in prison for car theft and have only been out for about an hour."

The woman hugged the man again and with sobbing tears cried out loud, "Oh, Thank you God! You even sent me a Professional!"

    Medicolegal Update

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

World Medical Association Declaration on Principle-Undergraduate Medical Education & Faculty

The goal of medical education is to educate physicians who are entitled and consistent with their training to practice the profession without limitation. Medical Education leading to the first professional degree must be conducted by an organized faculty and the faculty must possess the appropriate academic qualifications that can only be achieved through formal training and experience

  • The first professional degree should represent completion of a curriculum that qualifies the student for a spectrum of career choices, including patient care, public health, clinical or basic research or medical education. Each career choice will require additional education beyond that required for the first professional degree.
  • The research to advance medical knowledge and the provision of the highest quality of care must occur in academic settings to demonstrate the highest medical standards.
  • The content, format and evaluation of the educational experience provided are the responsibility of the faculty with participation of National Medical Associations.
  • The faculty is responsible for providing its own obligatory basic curriculum in an academic environment of freedom in which learning and inquiry can thrive in a maximal way.
  • Frequent reviews of the curriculum, allowing for the needs of the community and for input from practicing physicians should be conducted by the faculty,
  • The proper administrative structure and academic records must be maintained. When the necessary elements are available the clinical education of practitioner and specialist can be sponsored by either a university or a hospital.

(Adopted by the 39th World Medical Assembly Madrid Spain, October 1987)

For comments and archives

    Public Forum

Public Forum (Press Release for use by the newspapers)

WHO Day Celebrated: 11459 people trained in Hands Only Cardiopulmonary Resuscitation (CPR 10) in one day

On behalf of Heart Care Foundation of India, Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India created a world record by training 11459 people in Hands Only CPR 10 in one day.

The event was organized at Dr. Sampoornanand Sarvodaya Kanya Vidyalaya, C-1 Yamuna Vihar to earmark World Health Day. East Delhi Mayor Dr Annapoorna Mishra was the special guest along with Dr KK Aggarwal.

CPR 10 is based on the mantra – “Within ten minutes of death (earlier the better) for the next at least ten minutes (longer the better), compress the centre of the chest of the victim with a speed of 10x10=100 per minute”. Prior to this event, Dr. Aggarwal on behalf of the foundation has trained more than 35000 people so far. The foundation was the first one to train 11459 people in one sitting.

Over 5 people have been revived after death using CPR 10 including one attempted by a 16 year old school girl and another by a 30 year old school teacher.

Shri J.P. Aggarwal, Member of Parliament in his message said that CPR 10 should be learnt by everybody.

In the closing ceremony star celebrity Mr Sandeep Marwah released a comic on CPR 10 and said CPR 10 should be done in any patient with no response and no respiration.

Ms Rajeshwari Kapri Principal of SKV School said that teachers are role model to the society and must pass on the message of CPR 10 to all their students and parents. Every school should use the teachers, parents meeting to pass on the message.

Dr Aggarwal said that all school children must post the CPR Mantra on their face book and twitter accounts and must pass on the mantra to their friends.

Dr D R Rai Sr National Vice President IMA, Dr Anil Goel President Elect, Dr Harish Gupta Immediate Past President DMA and Dr Ajay Lekhi, Dr V K Goel from IMA, East Delhi Branch in a joint statement said that over 24 lac people die in the country every year with sudden deaths and 18 lac of them die before reaching the hospital. 12 lac of them can be saved if CPR 10 can be taught to one percent of the society.

Ms Nalini Kamalini the duo Kathak exponents said that all stars and celebrities should pass on the CPR mantra to the society at their stage functions.

Facts about CPR 10

  1. Gasping is a sign of cardiac arrest and CPR should be started in them
  2. Never learn CPR on live people
  3. During CPR if the ribs break do not worry
  4. After successful CPR take the victim to the hospital for further testing
  5. CPR should always be done on the floor or a hard bed
  6. The chest should be compressed about 1 ½ inch
  7. If the body temperature is below 35 degree continue CPR for longer periods (up to 25 minutes after the body temperature had been brought back to normal)
  8. CPR means cardio pulmonary resuscitation (revival of the heart and lungs)
  9. In electrical deaths first disconnect the electric wire before starting CPR
  10. You can alternate cardiac massage on the chest after every two minutes (two rescuers CPR 10)
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