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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


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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

  Editorial …

9th February 2012, Thursday

In MI, keep K between 3.5 to 4.5 mEq/L

While serum K levels of 3.5 to 5.0 mEq/L are considered normal, in acute MI the guidelines recommend potassium administration to maintain a range of 4.0 to 5.0 mEq/L so as to lower the risk of ventricular fibrillation (VF) or cardiac arrest.

The current analysis, which is published in the January 11, 2012 Journal of the American Medical Association, is based on >38 000 MI admissions at 67 hospitals in the US from 2000 to 2008, a time when most ST–elevation MI patients received beta blockers and reperfusion therapy.

Serum K levels of 4.5 to 5.0 mEq/L were associated with about twice the in–hospital mortality risk as levels of 3.5 to 4.5 mEq/L after adjustment for many comorbidities and other potential confounders. It’s reasonable for the guidelines to be amended to say that in most patients with acute myocardial infarction, maintaining a potassium (level) of 3.5 to 4.5 mEq/L may be reasonable, unless they’re having a lot of (threatening) ventricular rhythms.

Mortality was lowest for levels of 3.5 to –4.0 mEq/L and went up significantly at both higher and lower concentrations.

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Dr KK Aggarwal
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  eMedinewS Audio PostCard

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

In MI, keep K between 3.5 to 4.5 mEq/L

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

3rd eMedinewS Revisiting 2011

Dr U Kaul Presenting a lecture on DES for the future – Is India ready to take the challenges in the recently concluded 3rd Revisitng eMedinewS Revisiting 2011

Dr K K Aggarwal
    National News

SMS will now be treated as train ticket

MUMBAI: Booking an outstation train ticket is much easier now. All it requires is a few keystrokes on your cellphone. The ticket comes in the form of an SMS, which can be shown to the ticket checker instead of a paper ticket. Railway officials said there was good response to the Mobile Rail Ticket Booking Service, which has been introduced by the IRCTC. Tickets can be booked on the mobile website: www.irctc.co.in/mobile. The IRCTC mobile website is convenient and easy to use, and can be accessed from any browser enabled mobile having basic GPRS activated on the phone. After initial registration and downloading the genuine IRCTC software on the mobile handset with internet facility, passengers can book a ticket through the mobile. After booking, the passenger will receive a reservation message with complete details of the ticket including PNR, Train No, date of journey, class, etc. This virtual message will be treated at par with the print–out of the e–ticket The simple authorised SMS will have all the vital details, and when displayed through laptops/palmtops/mobile phones combined with valid photo–id in original shall be treated as a valid ticket, an official said. This will take paperless ticketing to the next level, he stated. (Source: TOI, Feb 4, 2012)

For comments and archives

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

New Guideline: Metformin best to control HbA1c

Metformin should be the first drug of choice in oral therapy for type 2 diabetics who don’t respond to diet and lifestyle changes, according to a new guideline. A second agent can be added if metformin monotherapy fails to control hyperglycemia, but there’s insufficient evidence to recommend one secondary agent over another, Amir Qaseem, MD, PhD, director of clinical policy at the American College of Physicians, and colleagues wrote in the organization’s new guideline for the management of type 2 diabetes, published in the Annals of Internal Medicine. (Source: Medpage Today)

For comments and archives

FDA okays another diabetes combo agent

The FDA has approved an extended–release version of a combination sitagliptin and metformin (Janumet XR) for adults with type 2 diabetes. (Source: Medpage Today)

For comments and archives

Solitaire clot retrieval device outperforms merci in stroke

cute cerebral ischemia was more successfully treated with a new stent retriever, the Solitaire Flow Restoration device, than with the Food and Drug Administration (FDA)–approved Merci Retrieval System, according to a head–to–head comparison study. (Source: Medscape Medical News)

For comments and archives

Stroke score may predict if clot busters will work

A tool used to predict outcomes in patients with acute ischemic strokes also may help predict the clinical response to intravenous thrombolytic therapy, researchers found. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: #AJD Clinic prevalence and risk analysis of early –onset T2DM among rural Indian Diabetic population. Nanda Kumar… fb.me/1w9JkV5uV

@DeepakChopra: Love is the ultimate truth at the heart of the universe and transcends all boundaries.

    Spiritual Update

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

Neti Neti (Not This Not This): The Main Principle of Knowing the Truth

Most of the great teachings of Hindu philosophy are base on the teachings of sage Yajnavalkya. He taught the great doctrine of "Neti – Neti", the view that truth can be found only through the negation of all thoughts about it.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the risks of tubal surgery?

The biggest risk after tubal surgery is the possible development of a tubal (ectopic) pregnancy. A tubal pregnancy is a serious health problem that is more likely to happen after tubal surgery or tubal disease. The fertilized egg does not travel to the uterus. Instead, it stays in the fallopian tube and begins to grow there. The tube is too small to hold a baby, and the tube will burst if the pregnancy continues. The mother may have internal bleeding or rarely could even die.

For comments and archives

    An Inspirational Story

(Vijay Maroo)

Why Some People Have All the Luck?

By Professor Richard Wiseman, University of Hertfordshire

Why do some people get all the luck while others never get the breaks they deserve? A psychologist says he has discovered the answer.

Ten years ago, I set out to examine luck. I wanted to know why some people are always in the right place at the right time, while others consistently experience ill fortune. I placed advertisements in national newspapers asking for people who felt consistently lucky or unlucky to contact me. Hundreds of extraordinary men and women volunteered for my research and over the years, I have interviewed them, monitored their lives and had them take part in experiments. The results reveal that although these people have almost no insight into the causes of their luck, their thoughts and behavior are responsible for much of their good and bad fortune. Take the case of seemingly chance opportunities. Lucky people consistently encounter such opportunities, whereas unlucky people do not.

I carried out a simple experiment to discover whether this was due to differences in their ability to spot such opportunities. I gave both lucky and unlucky people a newspaper, and asked them to look through it and tell me how many photographs were inside. I had secretly placed a large message halfway through the newspaper saying: "Tell the experimenter you have seen this and win $50."

This message took up half of the page and was written in type that was more than two inches high. It was staring everyone straight in the face, but the unlucky people tended to miss it and the lucky people tended to spot it.

Unlucky people are generally more tense than lucky people, and this anxiety disrupts their ability to notice the unexpected. As a result, they miss opportunities because they are too focused on looking for something else. They go to parties’ intent on finding their perfect partner and so miss opportunities to make good friends. They look through newspapers determined to find certain types of job advertisements and miss other types of jobs.

Lucky people are more relaxed and open, and therefore see what is there rather than just what they are looking for. My research eventually revealed that lucky people generate good fortune via four principles. They are skilled at creating and noticing chance opportunities, make lucky decisions by listening to their intuition, create self-fulfilling prophesies via positive expectations, and adopt a resilient attitude that transforms bad luck into good.

Towards the end of the work, I wondered whether these principles could be used to create good luck. I asked a group of volunteers to spend a month carrying out exercises designed to help them think and behave like a lucky person.

Dramatic results! These exercises helped them spot chance opportunities, listen to their intuition, expect to be lucky, and be more resilient to bad luck. One month later, the volunteers returned and described what had happened. The results were dramatic: 80% of people were now happier, more satisfied with their lives and, perhaps most important of all, luckier.

The lucky people had become even luckier and the unlucky had become lucky. Finally, I had found the elusive "luck factor".

Here are Professor Wiseman’s four top tips for becoming lucky:
1) Listen to your gut instincts – they are normally right
2) Be open to new experiences and breaking your normal routine
3) Spend a few moments each day remembering things that went well
4) Visualize yourself being lucky before an important meeting or telephone call.

Have a Lucky day and work for it. "The happiest people in the world are not those who have no problems, but those who learn to live with things that are less than perfect."

For comments and archives

    Fitness Update

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

Nervous activity is related to weight loss

A recent study performed by the Baker Heart & Diabetes Institute in Melbourne, Australia reports that certain people with a higher rate of resting nerve activity are more likely to lose weight if they are on a diet. The study was recently published in the Journal of Clinical Endocrinology & Metabolism.

In this study, researchers examined 42 overweight subjects who had volunteered to participate in dietary and lifestyle intervention study that lasted for 12 weeks. The intervention involved decreasing their caloric intake by 30% and being "more active." However, there were no distinct measures of physical activity. Researchers measured different types of nervous activity using metal microelectrodes and performing various laboratory tests, and surprisingly, they found that those who lost more weight had higher levels of nervous activity. The association was so strong that weight loss could be predicted by measuring the nervous system activity.

More research is needed before any conclusive results can be agreed upon, but it would be interesting to measure this type of nerve activity in response to exercise, and to determine whether it has an impact on weight loss as well.

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    Cardiology eMedinewS

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

Statins may benefit women as much as men

Read More

Fractional flow reserve therapy trial shows positive results

Read More

Study suggests mortality rises with higher PA pressure

Read More

    Pediatric eMedinewS

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

Junk Food In Middle Schools Not Linked To Obesity.

Read More

Lead Harms Children At Lower Levels Than Previously Believed.

Read More

E–Prescribing Cuts Medication Errors

Read More

    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Cardiac evaluation for a driver

Drivers should be able to complete three stages of the Bruce protocol or equivalent safely, without antiangina medication for 48 hours and should remain free from signs of cardiovascular dysfunction, such as angina, syncope, hypotension, ventricular tachycardia, and/or electrocardiographic ST segment shift (usually >2 mm horizontal or down-sloping) which accredited medical opinion interprets as being indicative of myocardial ischemia.

    Legal Question of the Day

(Dr MC Gupta)

Q. I am an anesthesiologist. I have seen gyn–obs specialists performing appendicectomy and even cholecystectomy along with either TLH or LAVH. Is it ethical /legal?


  1. The words ethical and legal are not synonymous. Being ethical has a sense of morality. It is well–known that what is immoral may not always be illegal and what is illegal may not always be immoral. Without going into this controversy, for the purpose of answering, let us rephrase you question as "I have seen gyn–obs specialists performing appendicectomy and even cholecystectomy along with either TLH or LAVH. Is it against the MCI Code of medical ethics, 2002?"
  2. If a complaint is made before the medical council or the consumer court against a gynecologist for performing appendicectomy or cholecystectomy along with either TLH (Total laparoscopic hysterectomy) or LAVH (Laparoscopically Assisted Vaginal Hysterectomy), and if I am the advocate for the complainant, then, depending upon the facts and circumstances of the case, I would make the following arguments against the gynecologist:
    • That the gynecologist, for ulterior motives, wrongly represented herself for doing surgeries for which she was not qualified.
    • That the gynecologist, for ulterior motives, performed surgeries that were not needed.
    • That the gynecologist performed surgeries without informed consent.
    • That, as per general principles of surgery, a laparoscopic procedure should be performed only when the performer knows how to do it the conventional way. In other words, before a surgeon performs laparoscopic surgery, he must be competent to perform the same surgery non-laparoscopically. The reason is that laparoscopic surgery may fail while the patient is under anesthesia or other unexpected complications may occur or may be found which would necessitate open surgery. A gynecologist is naturally not competent to perform open surgeries of the type mentioned. Hence it is wrong on her part to perform the said surgeries laparoscopically. Only a surgeon who knows how to do appendicectomy or cholecystectomy in a regular manner should perform these laparoscopically.
  3. The outcome of the arguments will depend upon the deciding authorities. However, I can say with about 80% surety that I would win.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A female with rheumatoid arthritis became pregnant while taking leflunomide.
Dr. Bad: Continue it.
Dr. Good: Stop it immediately.
Lesson: In women with rheumatoid arthritis who become pregnant while taking leflunomide, healthy pregnancy outcomes usually occur, if the drug is discontinued at the earliest and a cholestyramine drug elimination procedure is done. (Arthritis Rheum 2010;62:1494)

For comments and archives

Make Sure

Situation: A diabetic patient died of flu pneumonia.
Reaction: Oh my God! Why was flu vaccine not given?
Lesson: Make sure that all diabetics are given flu vaccine every year.

For comments and archives

  Quote of the Day

(Dr GM Singh)

The qualities of a great man are vision, integrity, courage, understanding, the power of articulation, and profundity of character. Dwight David Eisenhower

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

The American Diabetes Association (ADA) has recommended HbA1c as the diagnostic test for diabetes.

    Mind Teaser

Read this…………………

Which Sentence About Schizophrenia Medication Is True?

a) Medication should never be stopped abruptly, even if you feel better, or even if you’re experiencing a negative side effect.
b) The side effects of some antipsychotic medications are sometimes used to advantage in the treatment of schizophrenia.
c) Some injectable medications can be taken just once or twice a month.
d) All of the above.
e) None of the above.

Yesterday’s Mind Teaser: Which of these properties of cinnarizine make it an efficacious agent for gastric vertigo?

a. Inhibits vasoconstriction
b. Inhibits vascular spasm
c. Cerebral irrigation
d. All of the above

Answer for Yesterday’s Mind Teaser: c. Cerebral irrigation

Correct answers received from: Muthumperumal Thirumalpillai, Dr Mrs S Das, Dr PC Das, Dr KV Sarma, Anil Bairaria.

Answer for 6th February Mind Teaser
: c) People cannot live normal, productive lives while having hallucinations or delusions.
Correct answers received from: Annappa Pangi.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Ten men and one woman

Eleven people were hanging on a rope, under a helicopter: 10 men and 1 woman.

The rope was not strong enough to carry them all, so they decided that one had to leave, as otherwise they were all going to fall. They weren't able to choose that person, until the woman gave a very touching speech.

She said that she would voluntarily let go of the rope, because, as a woman, she was used to giving up everything for her husband and kids or for men in general, and was used to always making sacrifices with little in return.

As soon as she finished her speech, all the men started clapping.

    Medicolegal Update

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

DNA tests are run at least twice, both independent of each other

DNA testing is done by taking DNA extracts from biological sample putting them into a gel matrix and then using probes to help extract certain markers. Each human being has a unique signature that lives within every cell of our body. This signature is commonly known as DNA. Testing can be done on DNA to help determine parentage, ancestry, presence of genetically based diseases and to help identify someone who may have been present at a crime scene

  • Most DNA tests are run at least twice, both independent of each other. This not only builds upon the credibility of the test but also helps ensure that no wrong data or incorrect marker analysis was performed on the first test. If any discrepancies are detected between the two tests then a new sample is used and the entire test is performed again to understand where the discrepancy may lay.
  • We get our DNA from our biological mother and biological father. Each of them contributes 50% of our chromosomes that will make our up our DNA – this same DNA will stay with us for our entire lives without change. This is the very reason that makes DNA such a great choice for uniquely identifying a person.
  • Questions may arise as to how accurate DNA tests are. After all, in the past blood tests can not been as accurate as we might have hoped. They often left a bit of uncertainty or could not be conclusive in many areas. But thanks to the uniqueness of DNA almost all of these doubts can be taken away if the test is done with all the required authenticity.
  • Modern testing procedures and rules for DNA analysis mean that with rare exception DNA testing results can be guaranteed to be more than 90% accurate for most paternity, forensic and genetically–based disease analysis. However human error can come into play. A lab may mistakenly switch samples or key in data incorrectly. All of these factors are possible, but also are very rare in occurrence. If there is ever any doubt as to the authenticity or correctness of a test it can simply be performed again to confirm accuracy in another or same lab.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Stay away from stress during examination days

Exam stress can lead to depression and suicide. During exam days prescriptions for anti-depressant drugs, so called happy drugs, increase amongst teenagers of 16–18 years in full time education. This figure crosses 20% in school population in the West. This was stated by Padma Shri and Dr B C Roy Awardee Dr. KK Aggarwal, President, Heart Care Foundation of India,

The fears of failure, fear of letting down are the two most common factors leading to suicide and depression.

Also, children indulge in drugs to keep awake during exams and end up with addictions like iodex on sandwich, toothpaste, shoe polish, whitener, Vicks and anti-fit drugs, cough syrups etc. This is in addition to indulgence in smoking, tobacco, alcohol, tea, coffee, and superman drugs like LSD, etc. Some children go to the extent of even eating the tail of the lizards.

Anticipatory anxiety peaks before exams resulting in adverse affects on the body and mind and therefore, a sub optimal performance.

Stress not only causes palpitations and tense muscles but also reduces the ability to make decisions, act or express oneself including organization of thoughts. Stress during exams can makes it difficult to read and understand questions and even to recall terms and concepts.

A study has shown that 45 minutes of afternoon nap improves the declarative memory. Declarative memory is the memory of facts learnt and understood earlier during the year.

Not taking afternoon nap or the night sleep may cause the child end up with transient loss of declarative memory.

Free writing can clear mental stress: By spending 30 minutes each day for four days to write out your innermost thoughts and feelings, one can significantly boost mental and physical health. In expressive writing therapy, students are encouraged to express whatever is on their mind, letting their hopes and fears flow out in a natural, unrestrained way. It's akin to keeping a journal, but more focused on the things that might be bothering you or triggering stress.

Short walk can help de–addict: Just 5 to 10 minutes of walk can cut cravings for cigarettes among people trying to kick the habit, According to Dr. Adrian H. Taylor of the University of Exeter. Twelve out of 14 studies reviewed by him found that a bout of physical activity reduced cigarette cravings and withdrawal symptoms compared to staying inactive. Exercise cut craving as much as chewing nicotine gum. Exercise also triples the time it takes for people to reach for their next cigarette.

Effects were seen for vigorous bouts of exercise lasting for up to 40 minutes, but even a less intense 15-minute session and/or five minutes of isometrics, have a significant effect. Distraction, reducing stress and boosting mood may be the reasons.

Afternoon nap:
A study published in the journal Sleep, showed that a 45–minute midday nap can help boost the "declarative memory" which applies to standard textbook learning and knowledge. Sleep appears to help "set" these declarative memories and make them easier to recall. The other type of memory is "procedural memory," which applies to skills and is not affected by midday nap.


  1. Do not compare kids: it can lead to anger or depression in the child.
  2. One should unconditionally appreciate whatever the child has achieved.
  3. One should avoid giving false promises for example if "you come first, you will get a bike". When that happens, "You are not yet 18 – so you can’t get a license. This time, settle for a bicycle and later we’ll get that bike". Broken promises hurt the child.
  4. Avoid anger chain, for example, the father unleashes his anger on the mother (because she does not answer back), and she takes it out on the child (because of the same reason). And the child takes it out on books or studies or younger sibling or hired help at home.
  5. Do not force your expectations on the child, for example, you should only become a doctor.
  6. Avoid giving the child two conflicting messages like mother asks child to study and father says – "do not force him".
  7. Make your child exercise daily, learn pranayama and meditation,
  8. Provide your child with balanced and nutritious diet. Avoid overeating or long periods of hunger. Restrict caffeine, give more water.
  9. Ensure adequate sleep with a consistent schedule to improve concentration, memory and mood, it also reduces irritability.
    Readers Responses
  1. Absolutely superb (Inspirational Story – The Life will not give a second chance), if we are just aware of this story atleast once a day, half job is done. Please try, it works. Just be conscious of the fact. Rakesh
    Forthcoming Events

Ajmer Health Fair: Ajmer’s Largest Ever Super Specialty Health Camp

Date: February 11 and 12, 2012
Venue: Patel Stadium, Ajmer
Organizer: Heart Care Foundation of India


The Annual conference of Indian Menopause Society is to be held from 17 to 19th Feb 2012 in Hotel The Claridges, Surajkund, Faridabad. It is a multidisciplinary approach to the problems of midlife onwards in women. This conference has participation of the British Menopause Society and South Asian Federation of Menopause Societies and is an opportunity to hear international faculties.

For information contact Dr. Maninder Ahuja (Organizing Chairperson) 9810881048
Download forms at: http://indianwoman35plus.com/ or Indianmenopausesociety.org or http://fogsi.org/

Contact at ahuja.maninder@gmail.com
Call for free papers and posters on theme topics of conference.

National Summit on "Stress Management" and Workshop on "How to be happy and Healthy"

Date: Saturday 2PM–Sunday 4PM, 21–22 April 2012
Venue: Om Shanti Retreat Center, Bhora Kalan, on Pataudi Road, Manesar
Course Directors: Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal and BK sapna
Organisers: Heart Care Foundation of India, Prajapati Brahma Kumari Ishwariya Vidyalaya and eMedinewS
Fee: No fee, donations welcome in favour of Om Shanti Retreat Center
Facilities: Lodging and boarding provided ( One room per family or one room for two persons). Limited rooms for first three registrants.
Course: Meditation, Lectures, Practical workshops,
Atmosphere: Silence of Nature, Pyramid Meditation, Night Walk,
Registration: Rekha 9899974439 rekhapapola@gmail.com, BK Sapna 9350170370 bksapna@hotmail.com

    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

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

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

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

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  Dil Ki Batein

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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