Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
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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

  Editorial …

10th April, 2011, Sunday                                 eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

How to influence the government

Anna Hazare called off his 4-day old indefinite fast after the government issued a gazette notification to form a joint committee of ministers and civil society activists to draft the Lokpal Bill.

The government can be influenced in two ways. One is the method that both Mahatma Gandhi and Anna Hazare adopted. The second way is that of the BJP, which disrupted the Winter Session of the Parliament demanding a JPC to look into the 2-G scam and did not allow it to function. This led to loss of crores of rupees to the exchequer. This was wastage of public money. They won the battle but lost the public support.

So, why didn't BJP go the Anna Hazare way? Anna Hazare did not waste public money. He used no political parties to support his movement. Advani Ji should have done what Ann did this time.

The succes of any moment scientifically relates to the 100th monkey phenomenon which denotes collective consciousness of the people. Simply put, it advocates that when a ‘critical mass’ number of people adopt a new behavior or way of thinking, it is spontaneously adopted by everyone. To put in the present day’s context, if 1% of the people in a society join a movement, it spreads like wildfire.

The government agreed to Anna’s demands before this critical mass of 1% was reached. He had the support of the intellectuals, corporate leaders and others. His support base was growing every day. Though the masses had not yet joined the movement. He had the support of about 0.2% of the society.

If 1% of the society had joined Anna’s movement, this would have resulted in another movement like the Dandi Yatra, a nonviolent protest which became a watershed event in India’s struggle for independence. The result could have even been the downfall of the Government.

How smartly the Govt reacted, accepted his demands before the critical mass was achieved.

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
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    eMedinewS Audio PostCard

 CKD Update

Dr KK Aggarwal Speaks on
‘Estimated glomerular filtration rate’

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

8th Vishwa Dharam Sammelan

Dharma Guru H H Lama Lob Jang was honored at the 8th Vishwa Dharma Sammelan.

Dr K K Aggarwal
    National News

(By Dr Jitendra ingole)

CM launches Jan Aushadi stores

HYDERABAD: The state government will urge the Centre to enact a law making the sale of both generic and branded medicines in all drug stores mandatory across the country. Launching Jeevandhara and Jan Aushadi outlets at Osmania General Hospital on the occasion of World Health Day, chief minister N Kiran Kumar Reddy asked the department of medical and health to ensure that utmost care was taken in proper storage and distribution of medicines so that the poor and the disadvantaged were benefited. (Source: TOI, Apr 8, 2011)

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

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

Living Healthier, Longer with Ageless Essentials

Who wouldn’t want to feel ten years younger, live long enough to play with their great–great grandchildren, travel the world at 80, or see who wins Super Bowl 2050? Ageless Essentials Daily Pack can help you live these dreams of a future with long–term health and quality of life.

Convenient AM and PM packets make it the solution for keeping your cells healthier, keeping your bones and heart stronger, and your brain and other organs functioning at their best. The pack offers you the latest that science has to offer in terms of anti–aging nutrition.

"This is one of the best products that has come out in the last nine years," said Dennis Harper, DO, chair of the Isagenix Scientific Advisory Board, during Isagenix New Year Kick Off 2011, which took place last weekend in Phoenix, Ariz. Ageless Essentials Daily Pack offers four potent supplements designed to serve as a foundation for preserving health in the face of age–related biochemical and metabolic changes.

(Dr Monica and Brahm Vasudev)

TAVI as good as surgery

At one year there was no difference in mortality between highrisk patients who underwent transcatheter aortic valve replacement and those who had surgery, according to results of the PARTNER trial. Stroke was higher at 30 days and at one year in the TAVI (trans catheter aortic valve implantation) group.

Short daily hemodialysis may benefit patients with restless legs syndrome

Dialysis patients with restless legs syndrome (RLS) who use short daily hemodialysis (SDHD) at home show improvements in RLS severity and in sleep disturbances after a year, according to a study published online March 17 in the Clinical Journal of the American Society of Nephrology.

Renal denervation treatment may help reduce BP in patients with drug–resistant hypertension

A technique that interrupts nerve signals between the kidneys and brain dropped blood pressure to normal levels in 39 percent of patients with drug–resistant hypertension, according to a small new study presented at the Society of Interventional Radiology’s annual scientific meeting.

    IJCP Special

Dr Good Dr Bad

Situation: A patient with positive malaria came with severe thrombocytopenia.
Dr Bad: This is classical malaria.
Dr Bad: Also look for dengue.
Lesson: Malaria and dengue may co exist in the same patient.

Make Sure

Situation: A patient of pulmonary Koch’s taking ATT complains of numbness in fingers and toes.
Reaction: Oh my God! I forgot to prescribe vitamin B complex.
Lasson: Make sure that in patients talking ATT (including INH) B–complex vitamins (especially vitamin B6) are prescribed to prevent neuropathy. Addition of antioxidants and multivitamins also boost the immune system.

    An Inspirational Story

(Dr GM Singh)

Sand and Stone

A story tells that two friends were walking through the desert. During some point of the journey they had an argument, and one friend slapped the other one in the face. The one who got slapped was hurt, but without saying anything, wrote in the sand: "Today my best friend slapped me in the face."

They kept on walking until they found an oasis, where they decided to take a bath. The one, who had been slapped, got stuck in the mire and started drowning, but the friend saved him. After the friend recovered from the near drowning, he wrote on a stone: "Today my best friend saved my life."

The friend who had slapped and saved his best friend asked him, "After I hurt you, you wrote in the sand and now, you write on a stone, why?" The other friend replied: "When someone hurts us, we should write it down in sand where winds of forgiveness can erase it away. But, when someone does something good for us, we must engrave it in stone where no wind can ever erase it."

Learn to write your hurts in the sand, and to carve your benefits in stone.

    Infertility Update

(Dr. Kaberi Banerjee, Director Precious Baby Foundation)

When do I know that I am pregnant after a IVF treatment?

The earliest you can know that you are pregnant after IVF is usually 14 days after embryo transfer.

    Pediatric Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

Complimentary feeding practices between 6 and 24 months

Supporting advice for caregivers and families

  • Make sure children’s immunization schedules are complete by 1 year of age.
  • Use ORT to rehydrate children during diarrhea.
  • Give liquid iron supplements daily (12.5 mg/day) to infants 6 months to 1 year of age if daily vitamin–mineral supplements or iron–fortified foods are not being given. If the prevalence of anemia is known to be very high (=40%), continue supplementation until 24 months of age. For low birth weight infants, start supplementation at 2 months.
  • Give semi–annual, high–dose vitamin A supplements after 6 months (100,000 IU for infants and 200,000 IU for children 12 months and older) in areas where vitamin A deficiency occurs.


  1. Brown KH, Dewey KG, Allen LH. Complementary Feeding of Young Children in Developing Countries: A Review Of Current Scientific Knowledge. WHO/UNICEF, 1998.
  2. Dewey KG. Guiding principles for complementary feeding of the breastfed child. PAHO/WHO, 2003.
  3. WHO. Complementary feeding: family foods for breastfed children. Geneva: World Health Organization, 2000.
    Medicolegal Update

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

What is minimally conscious state?

Minimally conscious state is distinguished from vegetative state by the partial preservation of conscious awareness.

  • Some patients with severe alteration in consciousness have neurological findings that do not meet criteria for vegetative state (VS).
  • These patients demonstrate some behavioral evidence of conscious awareness but remain unable to reproduce this behavior consistently the condition referred here as the minimally conscious state (MCS).
  • To make the diagnosis of MCS, limited but clearly discernible evidence of self or environmental awareness must be demonstrated on a reproducible or sustained basis by one or more of behaviors like verbal yes/no responses regardless of accuracy, purposeful behavior, including movements or emotional behaviors that occur in relation to relevant environmental stimuli and are not due to reflexive activity.
  • Some examples of qualifying purposeful behavior include: appropriate smiling or crying in response to the emotional but not to neutral topics, vocalizations or gestures that occur in direct response to the linguistic content, reaching for objects.
    Legal Question of the Day

(Dr. M C Gupta)

Q. Can a private practitioner with a non-clinical MD degree face legal problem because the public might think he has a clinical postgraduate degree?

Ans. As long as the doctor practices like an MBBS doctor and holds out himself as "Dr ABC, MD", he is unlikely to face a legal problem. It is true that ideally he should hold out as MD (Physiology…etc.), but then, ideally, if a patient wants to be treated by an MD, he should find out the type of MD degree possessed by the doctor. He cannot presume that the degree of MD he has is in a clinical subject. The responsibility for such presumption cannot be fastened upon the doctor.

    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

What is the metabolic syndrome?

The metabolic syndrome is characterized by a group of metabolic risk factors in one person. They include:

  • Abdominal obesity (excessive fat tissue in and around the abdomen)
  • Atherogenic dyslipidemia (blood fat disorders — high triglycerides, low HDL cholesterol and high LDL cholesterol — that foster plaque buildups in artery walls)
  • Elevated blood pressure
  • Insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar)
  • Prothrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor–1 in the blood)
  • Proinflammatory state (e.g., elevated C-reactive protein in the blood)

People with the metabolic syndrome are at increased risk of coronary heart disease and other diseases related to plaque buildups in artery walls (e.g., stroke and peripheral vascular disease) and type 2 diabetes. The metabolic syndrome is become increasingly common.

    Knee Update

Dr. J Maheshwari, Knee & Shoulder Surgeon, Author of Essential Orthopaedics, Sitaram Bhartia Institute and Indian Spinal Injury Centre, New Delhi

Is knee replacement the only option for arthritis?

Till recent years, knee replacement was considered the only option for a knee damaged beyond a certain stage. Recently, more options such as open–wedge high–tibial osteotomy (HTO) and partial replacement have become potential options for those who wish to avoid or postpone knee replacement. These are suitable options in early stages of the disease, and help to delay or stop progress of knee osteoarthritis.

Till recent years, the potential alternatives were in primitive stage of development, but now these are good options with good track record. Of course, the last option in severely damaged knee remains knee replacement.

    Head Injury Update

Dr Shameem Ahmed, Dr Atanu Borthakur, Dr Sajida Sultana, Dr Shabbir Khan. Dept. of Trauma and Neurosurgery, Hayat Hospital, Guwahati, Assam.

Traumatic brain injury is on the rise in developing countries. In India, it is a great public health problem and since it can be prevented, prevention of head injury should be our motto. We as public have a tremendous role in such prevention.

    Mind Teaser

Read this …………………

(ice) 3

Yesterday’s Mind Teaser: Land Time

Answer for yesterday’s Mind Teaser:
Land before time

Correct answers received from: Dr Sudipto Samaddar, Dr S. Upadhyaya, Dr Anil Bairaria, Dr U Gaur, Dr Muthumperumal Thirumalpillai

Answer for 8th April eQuiz: b. According to Strasberg's classification of biliary injuries, Type B injury is the one in which there is no bile leak. It is an occlusion of the right sectoral duct.
Correct answers received from: Dr Jainendra Upadhyay

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr Veena Aggarwal)

Letter writing: "I am well here and hope you are also in the same well."

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum Lactate Dehydrogenase

Lactate dehydrogenase (LDH or LD) is an enzyme found in almost all body tissues, but only in a small amount in the blood. LDH is found in the bloodstream when cells are damaged. Because of this, LDH test can be used as a general marker of cell damage. Level of LDH may be measured either as a total LDH or as LDH isoenzymes. Elevated levels of LDH may be seen with:

  • Cerebrovascular accident (CVA, stroke)
  • Drugs: anesthetics, aspirin, narcotics, procainamides, alcohol
  • Hemolytic anemia
  • Pernicious anemia (megaloblastic anemia)
  • Infectious mononucleosis (Mono)
  • Intestinal and pulmonary infarction
  • Kidney disease
  • Liver disease
  • Muscular dystrophy
  • Pancreatitis
  • Lymphoma or other cancers
    Medi Finance Update

(Dr GM Singh)

Financial update

Remember, while everyone buys house property(s), it is important to avail the benefits available under the Income Tax Act, wisely as this would enable optimally saving your tax liability, and of course enjoy the fruits of your investment made and/or enjoy the comfort of your dream house.

    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name


DCI Approval Date

Tacrolimus PR Caps 0.5/1/5 mg

For prophylaxis of transplant rejection in adult kidney or liver allograft rejection


    IMSA Update

International Medical Science Academy (IMSA) Update

Association of CAP with antipsychotic drugs

In a case–control study, current use of atypical or typical antipsychotics was associated with a dose–dependent increased risk for community–acquired pneumonia (CAP) compared with past use.

(Dr Vinay Sakhuja)

Latin Quotes

Adhibenda est in jocando moderatio.

One should employ restraint in his/her jests. (Jokes should not exceed the bounds of good taste).

  Quote of the Day

(Dr GM Singh)

"Truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self–evident."

    Readers Responses
  1. Dear Dr. Aggarwal, I enjoy reading emedinews daily & also share it with others; it is too good to not share with others. Thank you very much. Dr.Vinodini Reddy
  2. Dear Dr. Aggarwal, This information for emedinews readers, Every eight minutes a women in India dies during child birth. Despite improvements in maternal health in recent years, the loss of more than 63,000 women every year due to pregnancy and its complications is clearly unacceptable. Ministry of Health And Family Welfare, Government of India and The White Ribbon Alliance for Safe Motherhood, India are celebrating National Safe Motherhood Day on 11th April 2011 at Auditorium, Teaching Block, National Institute of Health and Family Welfare, Munirka, New Delhi. Dr. Santosh Sahi
    Public Forum

(Press Release for use by the newspapers )

Summer diarrhea treatment

One loose motion is equal to loss of one glass of ORS. Most summer diarrheas are watery, effortless and painless with no mucous or blood. They need no antibiotics. The only treatment is oral rehydration solution, said Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal and President, Heart Care Foundation of India. Citing an example, Dr. Aggarwal said that if a patient has passed 10 loose motions he needs 10 glasses of ORS apart from normal requirement of fluids and one glass for every loose motion passed again.

A patient with up to 12 loose motions can be managed as an outpatient but if the loose motions are more than 12, he needs observation and if more than 40, he needs intensive treatment.

The main complication is renal shut down, which will happen if the blood pressure remains low for more than few hours. One should maintain that the patient passes urine every 6-8 hours. If no urine is passed for eight hours, this may indicate threatening Kidney failure.

    eMedinewS Special

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

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

Activities eBooks


  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein
    Situation Vacant

Vacancy for a post of Consultant in Pediatric ICU at Medanta – The Medicity Hospital, Sector –38, Gurgaon.
Interested candidates may please contact: drneelam@yahoo.com/9811043475.
*Eligibility: Post MD/DNB/DCH

    Forthcoming Events

April 16–17, 2011, National Conference on Gynae–Endocrinology–2011 under aegis of FOGSI, ICOG and AOGD, Focus on newer advances in management of endocrinal problems in gynaecology with emphasis on PCOS, hyperprolactinemia, amenorrhoea, hormonal contraception. Gyne– endocrinology is a topic of high importance especially for practitioner. Detailed programme http://www.aiims.edu and http://www.aiims.ac.in
For details please contact: Prof Alka Kriplani, Organizing Chairperson, 9810828717 kriplanialka@gmail.com/Dr Nutan Agarwal, organizing Secretary, 9810107464/9868397310 nutan.agarwal1@gmail.com


May 7–8, 2011, National Seminar On Stress Prevention
A Stress Prevention Residential Seminar cum spiritual retreat with Dr KK Aggarwal and Experts from Brahma Kumaris.
Co–organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, IMA New Delhi Branch and IMA Janak Puri Branch, IMSA (Delhi Chapter)
Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.
Timings: Saturday 7th May (2 pm onwards) and Sunday 8th May (7 am–4 pm). There will be no registration charges, limited rooms, kindly book in advance; stay and food (satvik) will be provided. Voluntary contributions welcome. For booking e–mail and SMS to Dr KK Aggarwal: 9899974439, emedinews@gmail.com, rekhapapola@gmail.com; BK Sapna: 9811796962, bksapna@hotmail.com


September 30 – October 02, 2011; XVIth World Congress on Cardiology, Echocardiography & Allied Imaging Techniques Venue: The Leela Kempinski, Delhi (NCR), September 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
Highlights of Pre – Conference CME: Case based learning experience & audience interaction, Maximum 250 delegates for CME will be accepted, who will be divided in 5 batches and will rotate to different halls every 90 minutes. The topics are:(A) Right heart pressures & functions (From basics to newer methods (RV anatomy, echo views, echo assessment of RV function, prognostic impact of RV function) (B) Carotid Doppler: How do i assess and interpret in my daily practice.: Technical tips (Anatomy of the vessel, views of ultrasound scanning, Normal & abnormal Doppler hemodynamics, how to measure IMT) (C) Valvular stenosis: Assessment, limitations and their solution: (Anatomy of the valves, 2–D findings of stenotic lesions, quantitation of lesion, limitations) (D) How do I assess and report ventricular dyssynchrony in my lab. (What is ventricular dyssynchrony, what are the types of dyssynchrony, in whom, when & why do we assess it, various echo methods to assess it ) (E) Live 3–D Echo: Protocol for acquisition. How to slice and get full information. Aim is that by end of the day, every participant is well conversant with all the topics
Dr (Col) S.K. Parashar, President, e–mail: drparashar@yahoo.com, Mob:09810146231/Dr Rakesh Gupta, Secretary General, email:jrop2001@yahoo.com, Mob:09811013246
worldcon2011@in.kyoni.com, www.worldcon2011.org


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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 Naveen Dang, Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta