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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 (March 10-13); 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

7th June 2013, Friday

Why cricketers do not commit suicide

In an analysis of all 61 cine star celebrity deaths by Heart Care Foundation of India, it was found that 8 out of 61 committed suicide and another 2 survived a severe depression. Till now, the medical profession, especially the initial years, was perceived as the most suicide prone profession. Would the film industry today acknowledge that depression and suicides are very common as compared to other professions? When we compare the film industry and the current IPL cricket industry, we find that both of them deal with stress and strains of life.

Cricketers face the stresses of being left out from the final XI, losing a match or scoring a duck or getting out on a score of 99. The stress in cricket is even more as the person is playing for the country. But even with similar levels of stress, cricketers do not get depressed or commit suicide. One reason may be that cricket as a game is more disciplined, requires a constant practice, regular physical fitness and exercise, not eating refined carbohydrates as has been advocated by the cricket academy and regular presence of counselors in every academy where they are attached. Counseling sessions are often held before and after the game. On the other hand, in the film industry people are more isolated, self-centered with no food discipline or sessions of yoga, pranayama and meditation. Seniors often suppress the newcomers/juniors. The expectation from juniors by seniors is much more in the cine industry. Its not only suicides, other lifestyle disorders too are much more common in the film industry than that in cricket industry or any other profession. Three major causes of death in the cine industry are heart attacks, cancer and depression or suicide. All three are related to lifestyle disorders. The time has come for the film industry to come out with policies and guidelines on how to reduce this stress.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Can vitamin D treat pain?

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Excessive use of mobile phone can be injurious to your health

A press conference was organised by Heart Care Foundation of India on the occasion of World Environment Day.

Dr K K Aggarwal
    National News

Use of mobile phone in the Operation Theater - A Clarification

Yesterday PTI carried a story titled: 90pc of nurses use cellphones while assisting surgeries. The story further said that 50 per cent of operation theatre technicians employed in various Delhi hospitals use their mobile phones while assisting surgeries, apart from 10 per cent of doctors who check SMSes during the procedure.

This is to clarify facts of the above story.

The data in the survey did not pertain to nurses, technicians or surgeons who are scrubbed in for the surgery, but for the other staff present in the operation theater, such as unscrubbed nurses and technicians. They often switch on their electronic gadgets to kill time in case of long surgeries to avoid boredom. ‘Doctors’ means Anesthetists and not the operating surgeons. Anesthetists are not scrubbed and so often use their cell phones or smartphones.

Also, whenever there is a call for the operating surgeon on his/her cell phone, either the un scrubbed nurse or the technician or the junior anesthetist will take the call on behalf of the operating surgeon and communicate if there is any emergency.

Our purpose of conducting this study was not to create fear or talk about one profession but to awaken the medical industry to come out with guidelines for the use of smartphones in the OT complex. These are preliminary observations and need to be validated by similar surveys at other places.

Our data

In a US survey of cardiopulmonary bypass technicians published in the journal Perfusion, 50% used a smartphone during surgery, 43% in a cardiac OT, 50% talked on cell phone and 50% texted on their phones. In cardiac OT, 20% perfusionists accessed emails, 15% used internet and 3% checked or posted on social networking sites during surgery.

Heart Care Foundation of India conducted a similar survey in one of the corporate hospital in Delhi. In the survey, we found that 90% of nurses in the OT (unscrubbed) and 50% of OT technicians (unscrubbed) answered their cellphones during the surgery. Ten percent doctors (anesthetists), 20% nurses (unscrubbed) and 50% technicians (unscrubbed) would check their messages (SMSes) even during surgery. No doctor or nurse (unscrubbed) tweeted during the surgery, but 50% of the technicians (unscrubbed) who have a Twitter account, said that they do use Twitter and tweet during the surgery. None of the doctors (anesthetists), nurses (unscrubbed) or technicians (unscrubbed) used their emails or accessed their Face book accounts during surgery. Doctors (operating surgeons) do talk and attend to their mobile phones while surgery is going on but they communicate through a nurse (unscrubbed) or a junior (unscrubbed) who act as a bridge between the surgeon and the caller.

The reason given for picking up the phone was to rule out emergency calls, but the reason for use of SMS or Twitter was boredom.

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, every Thursday 4:30 PM in DD India

    Valvular Heart Disease Update

In the elderly, when aortic valve needs to be replaced, a bioprosthetic valve should be preferred. The reason is that life expectancy is shorter than the expected functional life of the bioprosthesis in these cases.

(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)

    Be Human Stop Child Abuse (Team IMA for CMAAO)


The prevalence of clear evidence of sexual assault in the U.S. ranges from 3-23%, in Italy 9.5%, in Thailand 32% and in Denmark 40%. In Israel, as elsewhere in the world, few cases of sexual assault in children will have clear evidence of a sexual nature.

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Atrasentan reduces albuminuria and cholesterol

In patients with type 2 diabetes and nephropathy, atrasentan reduces albuminuria and improves levels of low-density-lipoprotein (LDL) cholesterol and triglyceride, according to a study presented at the European Renal Association-European Dialysis and Transplant Association 50th Congress. (Source: Medscape)

Afib hastens cognitive decline

The development of atrial fibrillation was associated with a more rapid decline in cognitive function among older adults, even in the absence of clinical stroke, researchers found. (Source: Medpage Today)

ASCO: Screen for clot risk at start of chemo

Cancer patients should be formally screened for thromboembolic risk when they start chemotherapy and periodically thereafter, according to American Society of Clinical Oncology guidelines. Low-molecular-weight heparin was recommended as the agent of choice in most situations for those who need prophylaxis, whereas newer oral anticoagulants shouldn't be used in patients with malignancy. (Source: Medpage Today)

Thyroid surgery: Guidelines for improving voice outcomes

The new clinical practice guideline from the American Academy of Otolaryngology—Head and Neck Surgery Foundation includes a strong recommendation that surgeons performing thyroid surgery identify the recurrent laryngeal nerve or nerves. The guidelines are designed to highlight the importance of a patient's voice and to improve voice outcomes in patients receiving thyroid surgery. (Source: Medscape)

Retinal vessels leak at high elevations

Leakage of the retinal vessels is common at high altitudes, although it doesn't appear to be a major contributing cause of acute mountain sickness, researchers found. (Source: Medpage Today)

   Twitter of the Day

@DrKKAggarwal: Asian Indians more likely to develop heart disease Being an Indian is now considered a heart attack... http://fb.me/2Px1GhSxZ

@DeepakChopra: Just when the caterpillar thought the world was over it became a butterfly #CosmicConsciousness

    Spiritual Update

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

Preventing suicides in film industry

Zia Khan’s death has sparked a debate on “how to prevent suicides in film fraternity?

For comments and archives

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

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What are the indications for sperm donation?

Therapeutic donor insemination (DI or TDI) is appropriate when the male partner has severe abnormalities in the semen parameters. These abnormalities include both obstructive (caused by a blockage of the ejaculatory ducts) and non-obstructive (due to testicular failure) azoospermia (absence of sperm), which may be congenital or acquired. Severe oligospermia (decreased sperm count) or other significant sperm or seminal fluid abnormalities are also indications for DI.

DI is also indicated if the male has ejaculatory dysfunction or if he is a carrier or affected with a significant genetic defect and would prefer not to pass this gene on to his children. DI may be used if the female is Rh-sensitized and the male partner is Rh-positive.

   An Inspirational Story (Dr GM Singh)

This is the story of Robby.

He was a young boy who lived with his elderly Mother. His mother wanted him to learn how to play the piano because she longed to hear her son play for her. She sent her son to a piano teacher who took Robby under her guidance.

However, there was one small problem because Robby was not musically inclined and therefore was very slow in learning.

The teacher did not have much faith in the boy because of his weakness. The mother was very enthusiastic and every week she would send Robby to the teacher.

One day Robby stopped attending the piano lessons. The teacher thought that he had given up and in fact she was quite pleased since she did not give much hope to Robby. Not long after, the piano teacher was given the task to organize a piano concert in town. She sent out circulars to invite the students and public to attend the event.

Suddenly, she received a call from Robby who offered to take part in the concert. The teacher told Robby that he was not good enough and that he was no longer a student since he had stopped coming for lessons.

Robby begged her to give him a chance and promised that he would not let her down.

Finally, she gave in and she put him to play last, hoping that he would change his mind at the last minute. When the big day came, the hall was packed and the children gave their best performance. Finally, it was Robby's turn to play and as his name was announced, he walked in. He was not properly attired and his hair was not properly groomed.

The teacher was really nervous since Robby's performance could spoil the whole evening's brilliant performance.

As Robby started playing, the crowd became silent and was amazed at the skill of this little boy. In fact, he gave the best performance of the evening. At the end of his presentation the crowd and the piano teacher gave him a standing ovation. The crowd asked Robby how he managed to play so brilliantly.

With a microphone in front of him, he said, "I was not able to attend the weekly piano lessons as there was no one to send me because my mother was sick with cancer.

She just passed away this morning and I wanted her to hear me play. You see, this is the first time she is able to hear me play because when she was alive she was deaf and now I know she is listening to me. I have to play my best for her!"

This is indeed a touching story of love and excellence. When you have a passion and a reason to do something, you will surely excel.

You may not be talented or gifted but if you have a strong enough reason to do something, you will be able to tap into your inner God-given potential.

For comments and archives

   Cardiology eMedinewS

Aspirin equals heparin for VTE prophylaxis Read More

   Pediatric eMedinewS

Flaxseed no help to kids with high cholesterol 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)

What should be done to a person who has consumed milk of a rabid animal?

If a person has consumed milk of a rabid animal, counseling should be done. If counseling is not effective, then PEP by IM or ID route or as a last resort, a course of PEP (only vaccine) should be given.

If the milk is boiled or heated then only counseling or at the most a course of PEP should be given only due to compulsions in medical practice in Indian setting.

    IJCP Special

Dr Good Dr Bad

Situation: A patient was diagnosed with HIV–AIDS.
Dr Bad: You won’t live long enough.
Dr Good: You can live a fairly normal life span.
Lesson: In the 1980s, a young adult diagnosed with AIDS typically survived less than one year. Today, a similar person can expect to live to age 70 or beyond if he or she is diagnosed with HIV infection early, has access to and receives appropriate therapy, and can tolerate the drugs and their side effects.

Make Sure

Situation: A patient on 10 units of insulin developed hypoglycemia after taking a light breakfast.
Reaction: Oh my God! Why was the insulin dose not reduced?
Lesson: Make sure that insulin dose is correct. The formula is 500/total daily dose. The value will be the amount of sugar fluctuation with 10 gm of carbohydrates.

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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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  Quote of the Day (Dr GM Singh)

Children find everything in nothing; men find nothing in everything. Giacomo Leopardi

    Mind Teaser

Read this…………………

A 45-year-old male patient reports pain in his foot that moves up along his calf. The patient states, "My right foot feels like it is on fire." The patient further describes that he has no previous history of injuries or falls, and that his pain started yesterday. Which components of pain assessment has the patient reported?

1. Aggravating and alleviating factors
2. Exacerbation, and associated signs and symptoms
3. Intensity, temporal characteristics, and functional impact
4. Location, quality, and onset

Yesterday’s Mind Teaser: When assessing a patient for possible side effects related to acetaminophen (Tylenol), the pain management nurse asks the patient about the use of:

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

Answer for yesterday’s Mind Teaser: Alcohol

Correct answers received from: Tukaram Pagad, DR AYYAVOO ERODE, Dr. Bharat Bhushan Aggarwal, Dr. B.B. Gupta, DrGajveer singh, DR ARPAN GANDHI, rajeev ardey, DR Chandresh Jardosh, Dr.(Maj. Gen.) Anil Bairaria, daivadheenam, Dr Pankaj Agarwal, Dr.K.Raju, Dr Jainendra Upadhyay, Dr. Thakor Hitendrsinh G, Dr Avtar Krishan, Dr Deepali chatterjee, Arundhati, Muthumperumal Thirumalpillai, Tukaram Pagad

Answer for 5th June Mind Teaser: (b) Home remedies used to treat pain.

Correct answers received from:Dr.Bitaan Sen & Dr.Jayashree Sen, drpksahu

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

There were these two friends, Bill and Bob, and they both loved baseball. So, they made a promise to each other, the first one to die, would come back and let the other know if there was baseball in heaven. Well, the day comes and Bob passed away. Weeks turn to months while Bill is still waiting to hear from his friend.

Then one day, Bill is walking down the street, and Bob appears. Bill all excited says: "I’ve been waiting forever! So tell me, is there or isn’t there Baseball in heaven?" Bob kinda perks up and says: "I’ve got good news and bad news." "1st, there is Baseball in heaven! The bad news is you’re pitching Friday!"

    Medicolegal Update

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

Places where pregnancy may be terminated

No termination of pregnancy shall be made in accordance with this act at any place other than a hospital established or maintained by the Government, or a place for the time being approved for the purpose of this Act by Government or a District Level Committee constituted by that government with the Chief Medical Officer or District Health Officer as the Chairperson of the said Committee. The District Level Committee shall consist of not less than three and not more than five members including the Chairperson, as the Government shall specify from time to time.

Under section4, before its substitution by the present section by the Medical Termination of Pregnancy (Amendment) Act, 2002, no termination of pregnancy could be made in accordance with the act at any place other than a hospital established or maintained by the government, or a place for being approved for the purpose of the Act by the government.

(Ref: MTP Act 1971)

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Lifestyle counseling can reduce heart disease

An intensive effort to change lifestyle in people at high risk of heart disease can help them reduce such risk factors as high blood pressure, raised cholesterol levels and smoking said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President-Elect IMA.

The Euroaction study published in The Lancet compared the results of added counselling on lifestyle issues such as diet, physical activity and smoking to the usual care. It included more than 3,000 people with coronary heart disease and 2,300 high risk people. Half got the counselling from a team of nurses, dieticians, physiotherapists and the treating doctors. The counselling was given to families as well as individuals.

The trial included two groups of patients. One those who already had developed coronary heart disease, another those who were asymptomatic but were at high risk because of a combination of risk factors that increase the chance of developing heart disease over 10 years.

  • Fifty–five percent of those getting the counselling reduced their intake of saturated fat, compared to 40 percent of those not getting the advice.
  • Increased consumption of fruits and vegetables was seen in 72 percent of the counselled group, and 17 percent of them also increased their consumption of heart–friendly oily fish, compared to 35 percent and 8 percent in the other group.
  • Similar results were seen for blood pressure, cholesterol and physical activity, but it proved difficult to get people seen in general practice to quit smoking.
    Readers Response
  1. Dear Sir, very good writeup on Mobile phobia. Regards: Dr TS Sharma
    Forthcoming Events

Enrollment for workshop

Heart Care Foundation of India under the aegis of Perfect Health Mela is organizing a series of skill workshops in the month of Oct as per the following programmes

Communication Skills 23rd October, Wednesday
8 am
Constitution Club of India
4 hours
Handling Media crisis Saturday 26th October
2 pm
Constitution Club of India
1 hour
Conflict Management 24th October Thursday
10 am
Constitution Club of India
2 hours
Organizational Behavior 24th October Thursday
8 am
Constitution Club of India
2 hours
Team Building 25th October, Friday
8 am
Constitution Club of India
2 hours
Time Management 25th October, Friday
10 am
Constitution Club of India
2 hours

The workshops will have experts interacting both theoretically and with practical demonstrations and interactions. If interested, kindly confirm your registration at rekhapapola@gmail.com. You can also forward this information to your interested friends and colleagues for a registration.

Dr KK Aggarwal
Padma Shri and Dr B.C. Roy National Awardee
President of Heart Care foundation of India

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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K 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 Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta