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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

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  Editorial …

10th March 2013, Sunday

We can predict malaria epidemic in North India four months sooner

The probability of a malaria epidemic is currently calculated largely by looking at monsoon-season rainfall totals to predict the likelihood of breeding sites for the malaria mosquito that carries the malaria parasite. This typically gives one-month headstart over actual outbreaks.

As per a new study published in the journal Nature Climate Change, changes in sea surface temperatures in the South Atlantic Ocean can predict malaria epidemics in north-west India well before the actual outbreaks.

According to the scientists at the University of Michigan Ann Arbor, lower July temperatures in the tropical South Atlantic are associated with malaria epidemics in Delhi, Rajasthan, Punjab and Haryana 4-months before actual outbreaks that typically occur in October or November.

This climate link can now be used as warning indicator of malaria coming after four months.

In the study, colder-than-usual July temperatures of the sea in the tropical South Atlantic, just west of Africa coincide with increases in both monsoon rainfall and in malaria incidence in northwest India in 9 out of 11 epidemic years. (Source Hindustan Times)

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Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Obesity reduces life expectancy

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

4th eMedinewS Revisiting 2012

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

Dr K K Aggarwal
    National News

25% cancer cases of breast, cervix: Experts

CHANDIGARH: Experts discussed trends in the management of breast and gynaecological cancer during a continuing medical education or CME organized by the department of radiotherapy, PGI on Friday. More than 150 delegates from the region attended the CME, which will continue for three days. Focusing on the common cancers affecting women in the country was the PGI's way of observing International Women's Day. Breast cancer is by far, the most commonly diagnosed cancer among women around the world and accounts for almost 20% of all cancers among women in developed countries. The incidence is low in developing countries and in India, it accounts for about 12% of all cancers. Cancer of the breast and cervix constitute almost 25% of all cancers among women in India. At the CME, experts deliberated on advances in the treatment of both breast and gynecological cancers. They highlighted how developments in molecular diagnosis and treatment of breast cancer have added to long term control, besides leading to personalized treatment. Five year survival of more than 80% is achieved in the early stages of carcinoma of the breast and cervix with present day treatment while 35 to 40% of stage III cancers can also be controlled for the long term. (Source: TOI, Mar 9, 2013)

For comments and archives

Medical mistakes in Indian movies

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

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

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

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


Medical neglect

Refusal to seek or delay in seeking medical care resulting in damage or risk of damage to the child's health.

For comments and archives

    Valvular Heart Disease Update

When should aortic valve replacement be done?

Aortic valve replacement should be performed in essentially all patients with symptomatic aortic stenosis. Surgery in such patients is associated with marked reductions in symptoms and subsequent mortality.

(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)

Radiation exposure negligible from airport security scans

Exposure to ionizing radiation from airport security scanners is negligible unless people travel frequently or work for the aviation industry, investigators report. (Source: Medscape)

Brain infection relapses tied to peripheral nerves

Neurologic syndrome relapses following brain infection were tied more to lesions of the peripheral nervous system than to central nervous system lesions, researchers found. (Source: Medpage Today)

Diagnosing gestational diabetes a 2-step process, says panel

Diagnosing gestational diabetes should remain a 2-step approach, a panel convened by the National Institutes of Health has decided. (Source: Medscape)

Higher dose of rifampin seems safe in TB

More than tripling the standard dose of rifampin – a key player in combating tuberculosis infection – appears to be safe, well-tolerated, and possibly more effective in fighting the disease, researchers said at the Conference on Retroviruses and Opportunistic Infections. (Source: Medpage Today)

Outdoor heat linked to respiratory disorders in the elderly

Increases in outdoor temperature may increase the risk for emergency hospitalizations resulting from respiratory disorders among the elderly in the United States, according to the findings of a large, population-based study. (Source: Medscape)

    Twitter of the Day

@DrKKAggarwal: Dr Sadhna Sadhana Ji Maharaj my mentor attained nirvana on Thursday morning. Deep sad moment for me and my family. pic.twitter.com/lRjdYDQ3MW

@DeepakChopra: Non-judgment quiets the internal dialogue, and this opens once again the doorway to creativity.

    Spiritual Update

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

Science behind Shiva, the Neelkanth

The blue necked Shiva called Neelkanth symbolizes that one should neither take out the vices or negative emotions nor suppress them. Instead one should alter or modify them. Blue neck means to hold on the negative emotions temporarily so that it can be neutralized at appropriate time. The blue color in mythology symbolizes slow poison that includes attachments, anger, greed,

For comments and archives

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

What is the procedure of selecting a gestational surrogate?

Gestational surrogates may be known to the intended parents or may be anonymous. Known surrogates are typically relatives or friends who volunteer to carry the pregnancy. Anonymous surrogates are identified thorough agencies that specialize in recruiting women to become surrogates. The surrogate should be a minimum of 21 years of age and have delivered a live born child at term. Certainly evaluation of a woman’s overall health and appropriate screening for underlying medical conditions that might complicate a pregnancy, as well as counseling regarding the obstetric risk should be preformed if considering an older surrogate.

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

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

Q: What is a unit of blood?

A: The blood is collected in plastic bags. They contain a watery fluid, which prevents the blood from getting coagulated. On an average, we draw about 350 or 450 ml. of blood from a person depending on his body weight. This blood plus the amount of anticoagulant present in the bag is known as one unit of blood.

For comments and archives

    An Inspirational Story

A message from above

I never thought I would be writing about a trip to the convenient store, but this trip was like no other. It seemed like a typical November day, two years ago, as I walked out of Walgreens. It was just a month after my grandmother had passed away and I spent my days running useless errands hoping to fill the void in my heart and distract me from the pain.

As I attempted to walk out of the store, I was frustrated by everything that was going on around me which was a very common feeling during this time. I was angry because I couldn’t even remember what I went there to buy so I ended up spending over $20 on nonsense just to waste time and money, both of which I didn’t have.

I was mad and confused at everyone, especially, the young girl walking through the store holding her grandmother’s hand. The little girl was begging her grandmother for ice cream just like I use to when I was little, before I was old enough to know that there are bigger problems than a lack of sugar. There is heartache and pain in this world. Before I was old enough to understand that one day my grandmother wouldn’t be here with me. “Here is $20 my sweetie,” the woman said, “Keep it for later and well get you some Mr. Softy.” As I carried on, I remembered all of the times my cousins and I would play outside of my grandma’s house, waiting patiently to hear the sounds of the Mr. Softy truck. The minute we heard it, no matter how far it may have been, we would run inside smothering my grandma with hugs and kisses while begging for some money. No matter how many times she would say, “Remember kids, no ice cream today,” everyday we would ask and every time she would always end up giving each of us exactly $20. Obviously, we all know that ice cream doesn’t cost this much, but that was my grandma, always giving more than she ever had to give.

Who knew that I, an 18 year old, could be jealous of a three-year-old little girl wearing pink slippers and a Dora the Explorer backpack, but I was, because at the end of the day she had something I didn’t have any more. A grandmother by her side. I had to force myself to ignore the little girl who others kept calling “cute” and “adorable” when I simply thought she was nothing but obnoxious. She was just too happy for me and that was unacceptable, at this time, in my world.

I continued to the register to pay for my things, none of which I even remembered picking until I placed them on the counter. It was than that my anger quickly shifted from the little girl who seemed to have everything to the cashier who didn’t have anything, not even my change. She had to bring my things to another register which just felt like a waste of time. Everything felt like a waste of my time. When the cashier gave me my change I didn’t say thank you. I didn’t say have a good day. I simply took my change and left.

Feeling exhausted and hopeless, I began walking to my car. Every step seemed draining, and every step was another to survive. As I looked up into the sky I thought about how my grandmother had left me, and my anger began to return. I was outraged by the loss, and my belief in God was beginning to diminish. I couldn’t understand why these things happened. So as I stood in a public parking lot a million questions formed in my mind. Why did this happen to me? Aren’t we supposed to get signs from the people that pass on? Why did I not feel her presence anymore? Is there a heaven?

Suddenly, a woman driving right by my side rolled down her window and distracted my unanswered thoughts. “Excuse me, excuse me, excuse me,” she said loudly. Thinking she was going to ask for my parking spot, I simply pointed to my car. The thought of having to verbalize where my car was seemed like too much to bear. “No, excuse me,” she said again. At this point, I felt I had no choice but to see what this annoying lady wanted. As I got closer though I was startled-was this my grandmother’s nurse, Adu, who lived with her during her final months? I soon realized that she wasn’t, although the resemblance was uncanny. Then, I realized that this Adu look alike was searching for something in her bag. Surprisingly, I was overcome by a sense a relief that lead me to be patient the entire time the lady was searching. Others would be nervous by a stranger reaching in their bag unanimously, but I wasn’t. Under a clutter of makeup, money, pens, and other belongings, she finally reached to the very bottom of her bag and handed me a three page booklet. “It looks like you need this,” she said calmly with a warm smile on her face.

I looked down at the mysterious and obviously used pamphlet and on the front cover in big bold letters read “What Hope for Dead Loved Ones?” It took me only a few seconds to comprehend the exchange with this woman, but by the time I looked up, she was gone.

I walked slowly into my car gripping the tiny little book that was given to me with fear that it would fly away in the wind. I didn’t know what it was exactly, but I knew that if my grandmother had anything to do with this that I didn’t want to let it go.

I felt a sense of relaxation as I opened the first page. It explained how people pass on, but their spirit remains with us. This was the first time since my grandma had passed that I felt her with me, just like I had wanted. I didn’t know whether to laugh or cry, but I did know that I finally felt happiness from the surprising change in events.

I couldn’t, and still can’t, believe what had happened to me on that day. I don’t remember the specific details that you usually hear about like what the person was wearing, the time of day, or even the weather, but it doesn’t matter. It was a random day in November when my life turned back around and I began to feel hope again. It was real. It was a miracle. And, I’ll remember it for the rest of my life.

For comments and archives

    Cardiology eMedinewS

Home monitoring helps lower blood pressure Read More

ESC backs transradial as the default access route in PCI Read More

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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

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    Pediatric eMedinewS

Small brain bleeds not so bad for preemies Read More

MRSA data show increased risk for children during summer 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)

Why a person does not acquire immunity against natural rabies infection, as it occurs in other viral infections?

A person does not acquire immunity against natural rabies infection, as it occurs in other viral infections because there is no viremia in rabies and the virus is not accessible to the normal immune mechanism of the body. The antibody production starts only after travelling efferently from CNS via mostly autonomic nerves to different target organs. But by this time, the neuronal cells of patient’s brain stem are affected.

    IJCP Special

Dr Good Dr Bad

Situation: A patient with visceral obesity had episodes of nighttime chest burning.
Dr Bad: Don’t worry. This is acidity.
Dr Good: Rule out CAD.
Lesson: Nighttime acute coronary syndrome occurs more often in patients with visceral fat accumulation and sleep–disordered breathing (Nakagawa Y, Kishida K, Mazaki T, et al. Impact of sleep–disordered breathing, visceral fat accumulation and adiponectin levels in patients with night–time onset of acute coronary syndrome. Am J Cardiol 2011;Aug 12. Epub ahead of print).

Make Sure

Situation: A patient with prosthetic heart valves (bioprosthetic) developed infective endocarditis.
Reaction: Oh my God! Why was he not given infective endocarditis prophylaxis?
Lesson: Make sure that all patients with prosthetic heart valves (bioprosthetic or homograft) are given infective endocarditis prophylaxis.

    Quote of the Day (Dr GM Singh)

What you get by achieving your goals is not as important as what you become by achieving your goals.

    Mind Teaser

Read this…………………

Which is an accurate statement about the administration of acetaminophen (Tylenol) to children?

a. Acetaminophen (Tylenol) affects platelet aggregation.
b. Acetaminophen (Tylenol) causes gastric irritation.
c. Acetaminophen (Tylenol) does not have an analgesic ceiling.
d. Acetaminophen (Tylenol) has an analgesic ceiling.

Yesterday’s Mind Teaser: When a female client with an indwelling urinary (Foley) catheter insists on walking to the hospital lobby to visit with family members, nurse Rose teaches how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information?

a. The client sets the drainage bag on the floor while sitting down.
b. The client keeps the drainage bag below the bladder at all times.
c. The client clamps the catheter drainage tubing while visiting with the family.
d. The client loops the drainage tubing below its point of entry into the drainage bag

Answer for Yesterday’s Mind Teaser: b. The client keeps the drainage bag below the bladder at all times.

Correct answers received from: Dr Kanta Jain, Raju Kuppusamy, Dr Avtar Krishan, Anil Bairaria,
Dr Arpan Gandhi, Dr KV Sarma, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr Jainendra Upadhyay,
Raju Kuppusamy, Dr Jayashree Sen & Dr Bitaan Sen.

Answer for 8th March Mind Teaser: a. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.

Correct answers received from: Dr valluri Ramarao, Raju Kuppusamy.

Send your answer to ijcp12@gmail.com

   Laugh a While (Dr Vasant)

Man goes into a bar, orders a beer, drinks it then looks in his shirt pocket. After doing so, he orders another beer and again looks in his shirt pocket. This went on for a while, then after drinking a few beers, the bartender asks him why he looked in his pocket each time he finished drinking a beer.

The man replied: "Well, I've got a picture of my wife in my shirt pocket and as soon as she looks good, I'm going home".

    Medicolegal Update

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

Doctor is a professional of Medical science with neutrality and impartiality

  • When a doctor appears as medical witness in the court of law, he/she must strive to achieve respect, good medical understanding and the most important thing is credibility before the honorable judge as well legal counsel of both sides.
  • Doctor must give the appearance of being independent medical witnesses of truth based on medical science with neutrality, impartiality and authentic characteristics. Vagueness and theory has no place in legal medicine.
  • Vagueness and theory have no place in legal medicine hence a medical witness, should remain a man of science; you have no victim to avenge, no guilty person to convict and no innocent person to save.
  • A doctor must bear testimony within the limits of medical/allied science". The attitude of a medical/clinician/scientific witness should be the same whether he is called by the defense or prosecution. The doctor really testifies neither for nor against the prosecution or the defense. The doctor’s expertise is in the application of science to a legal controversy and the proper interpretation of scientific findings.
  • A doctor’s sole obligation is to present the truth as he sees it, adding nothing, withholding nothing and distorting nothing mean revealing whole truth.
  • A doctor should not concern himself with the previous character of the accused or with other evidence in the case.
  • A doctor should not be influenced in any way by emotional consideration, such as sympathy or antipathy. The doctor must be honest, the honesty gives the confidence with enlightened conscience and the success in the court of law depends upon your confidence.
  • Honest perusal of medical science, confidence and medical ethics are tripods of this noble medical professional.

For comments and archives

    Public Forum

Public Forum (Press Release for use by the newspapers)

Cancer and heart disease linked

CRP, a protein that signals inflammation and heart disease may also indicate that a person has a high risk of cancer, said Padma Shri & Dr. B C Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President-Elect IMA.

CRP or C–reactive protein is associated with inflammation, an activation of the immune system.

Measurements of CRP should be part of a regular health check.

People with high levels of C–reactive protein have a 30 percent higher risk of cancer. Cancer patients with the highest CRP levels are 80 percent more likely to die early.

Dr. Kristine Allin and colleagues at the University of Copenhagen studied more than 10,000 people who had their CRP levels measured and who were then followed for 16 years. About 1,600 developed cancer over this time and if they had high CRP levels at the beginning of the study, they were 30 percent more likely to be in this group of cancer patients.

And if a person developed cancer and also had high CRP levels, they were 80 percent more likely to die, whether from the cancer or something else, regardless of whether the cancer spread in their bodies.

The study published in the Journal of Clinical Oncology concluded that five years after cancer diagnosis, 40 percent of patients with high CRP levels were alive, compared with 70 percent of patients who had low CRP levels.

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