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Dr KK Aggarwal

From the Desk of Editor in Chief
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 October 2010, Sunday

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

The one–month spiritual yagna

One day some one asked me why Muslims and Hindus fight with each other when they worship each other’s Gods. Hindu worship ALI in DIWALI and Muslims worship RAMA in RAMAZAN. Diwali and Ramazan (Ramadan) both have one thing in common and that is one month of spiritual yagna.

In Hindu spiritual Yagna, the process starts from first day of Navratras on Amavasya and ends on Diwali, again on Amavasya. The first 10 days involve intense spiritual practice and the rest 20 days entail receiving its benefits.

The first nine days, called navratras are devoted to a process of purification and detoxification of mind, body and soul. During this period a person is required to lead a satvik spiritual life devoting first three days into activities, which reduce negativity in the mind and the body; indulge in positive behavior in the next three days and read and learn about spiritual positive things in life during the last three days.

These three phases of purification are symbolic of worshipping the Goddesses Kali, Laxmi and Saraswati respectively. The spiritual purification process involves eating only satvik food, one which is offered to God, and following the principles of satvik lifestyle which are satvik ahaar, satvik vichar, satvik vyavahaar and satvik achaar. There is a custom of worshiping wheat and barley grass during this period. They are detoxifying grasses when consumed in the form of juices. The satvik fast observed during this period helps in cleansing the internal body.

Once the nine–day purification process is complete, on 10th day one gets the first benefits symbolized by Vijayadashmi as one conquers over Tamas (Kumbhakaran), Rajas (Meghnad) and Ego (Ravana). The victory over the ego entails the rule of satya (Vibhishan) and reunion of Mind (Lakshamana), Body (Sita) and Soul (Rama).

As per the Yoga Sutras of Patanjali, when one attains an ego–free mind, one is likely to get benefits over a period of time. The first benefit is seen on the fourth day after Vijayadashmi, on Sharad Purnima (full moon day), a day known for health benefits. People on this day gather in the night and eat kheer, rice flakes with cool milk, on this night. Four days later, on the day of ‘Karva Chauth’ one gets benefit of the longevity of the spouse which gives safety to the family. On this day all married women fast and pray for their husbands. Four days later on ‘Hoi Ashtami’ one prays for the longevity of their children. This ensures old age protection for the family. ‘Dhanteras’, which falls four days later, one gets the benefit of wealth. On this day, people worship silver items; no dealings are done and people spend only to invest in silver and gold items for future needs of the family.

By this time the person, who has indulged in the process of purification, learns the true purpose of his or her existence. The inner ignorance and darkness goes away and one acquires the true meaning of wealth and that is inner happiness. The day it happens is called Diwali, when on the day of amavasya (darkness) one gets internal light (Diwali).

Diwali, therefore, is a one–month long spiritual yagna with nine days of purification and 21 days of acquiring spiritual benefits from it.

Ramazan (Ramadan) similarly involves a deep intense purification process of mind, body and soul. In Christians, the similar spiritual purification process is celebrated as Easter.

Dr KK Aggarwal
Editor in Chief
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  Dengue Update

No prophylactic platelets are needed

Thrombocytopenia in dengue infection raises concerns about bleeding risk. In one study at Dept. of Infectious Disease, Tan Tock Seng Hospital, National Healthcare Group, Singapore of 256 patients with dengue infection who developed thrombocytopenia (platelet count, < 20 × 103 platelets/microL) without prior bleeding, 188 were given platelet transfusion. Subsequent bleeding, platelet increment, and platelet recovery were similar between patients given transfusion and patients not given transfusion. Prophylactic platelet transfusion was ineffective in preventing bleeding in adult patients with dengue infection. The same is our experience.

(Reference: Lye DC, Lee VJ, Sun Y, Leo YS. Clin Infect Dis 2009 May 1;48(9):1262–5)

  Photo Feature (from the HCFI Photo Gallery)

Mohd. Rafi Award for Excellence
Rafi Foundation Memorial Society (Delhi Chapter of Rafi Foundation) organized a program Yaad Na Jaye, The Rafi Magic on 30th July 2008 at Rajendra Bhawan, New Delhi on the occasion of 28th death anniversary of Mohammed Rafi. The society initiated the Mohd. Rafi Award for Excellence to be awarded each year to a person who has been doing excellent work in spreading social awareness in any field like environment, health, music, art, etc. In the Photo: Padma Shri and Dr BC Roy National Awardee Dr. KK Aggrawal, President HCFI being greeted by Shri Zorawar Chhugani, Gen. Secy., Rafi Foundation Memorial Society


Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Prevention of recurrences of low–back pain

A systematic review showed that post–treatment exercises are more effective than no intervention for reducing the rate of low back pain recurrence at one year.

(Reference: Choi BK, et al. Exercises for prevention of recurrences of low–back pain. Cochrane Database Syst Rev 2010;CD006555).

  National News

IMA Election (for a CHANGE)

Emedinews requests all its readers to support our editor Dr. K.K. Aggarwal, Padma Shri and Dr. B C Roy National Awardee who is contesting for the post of Vice President of the National Indian Medical Association (IMA). Members of Central Council of IMA, Working Committee Members, Presidents and Secretaries of IMA in addition to all office bearers are the voters in this election. Dr. Aggarwal is well–known for his work in the field of academics.

Dengue: 13 medical teams formed

With dengue and viral fever cases flooding the hospitals in Lucknow for over two weeks, Chief Medical Officer Dr A K Shukla, on Thursday, formed 13 teams of doctors under the Malaria Control Unit. According to an official press release, the teams are required to undertake surveys in various areas of the city on a weekly basis and ensure fogging to control mosquito breeding. It will also create awareness among the residents of the area about dengue and viral fevers and protective measures. On Thursday, the doctors, teams started the survey work in the slums of Dalibagh and nearby areas. Fogging will start from Friday, said the CMO. (Source: The Indian Express)

79 new dengue cases reported in Delhi

As many as 79 new cases of dengue were reported in Delhi on Friday, taking the total number of people affected by the mosquito-borne disease to 3,938, an official said. Civil Lines zone in the capital is the worst affected area with 508 cases, said an official of the Municipal Corporation of Delhi (MCD). Seven people have died of the disease this year. There have been 20 chikungunya patients in the city, one of them had the history of travelling to Kerala, the MCD official said. There were no chikungunya cases reported last year. (Source: The Times of India)

  International News

World Mental Health Day 2010

Today is World Mental Health Day.

The concept of World Mental Health Day to spread awareness about greater public awareness and understanding of mental health and mental illness was developed by the World Federation for Mental Health, a global mental health organization with members and contacts in more than 100 countries. It was first celebrated in the year 1992 and is observed on October 10 every year. Since 2009, the Day has been jointly sponsored by the World Health Organization and the World Federation for Mental Health.

In 2009, the focus was on integration of mental health treatment and services with primary care to improve the capabilities of the primary care system to detect and treat mental illnesses. The theme for 2010 is a continuation of the one on integration of physical and mental health from last year, with a specific focus on the relationship of mental health with chronic physical illnesses.

(Dr Monica and Brahm Vasudev)

How HRT and the pill can lead to breast cancer: new research suggests possible treatment

Large population studies such as the Women's Health Initiative and the Million Women Study have shown that synthetic sex hormones called progestins used in hormone replacement therapy, HRT, and in contraceptives can increase the risk of breast cancers.

Women who get dental care have lower risk of heart disease, says study

A new study led by a University of California, Berkeley suggests that women who get dental care reduce their risk of heart attacks, stroke and other cardiovascular problems by at least one–third.

Garlic oil shows protective effect against heart disease in diabetes

A report in Science proves that Garlic can prevent cardiomyopathy, in people with diabetes. The report, which also explains why people with diabetes are at high risk for diabetic cardiomyopathy, appears in ACS’ bi–weekly Journal of Agricultural and Food Chemistry. Wei–Wen Kuo and colleagues note that people with diabetes have at least twice the risk of death from heart disease as others, with heart disease accounting for 80 percent of all diabetes–related deaths. They are especially vulnerable to diabetic cardiomyopathy. The scientists fed either garlic oil or corn oil to laboratory rats with diabetes. Animals given garlic oil experienced beneficial changes associated with protection against heart damage. The changes appeared to be associated with the potent antioxidant properties of garlic oil. They identified more than 20 substances in garlic oil that may contribute to the effect.

Rises in BP Tied to Too Little Sleep in Pregnancy

Pregnant women who get too little sleep are at risk for preeclampsia. Compared with women sleeping seven to nine hours a night early in their pregnancies, those getting less than five hours a night were nearly 10 times as likely to develop preeclampsia (Williams, ScD, of the University of Washington School of Public Health in Seattle)

  Hepatology Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta Medicity

Management of neonatal cholestasis

  • Energy: Patient should receive 150 – 200% RDA for calories (200 Kcal/kg/day)
  • Protein:1–2 gm/kg/day in infants (0.5gm/kg/day in hepatic encephalopathy (Branched chain amino acids – BCAA should be 32%))
  • MCT diet: It is more readily absorbed in presence of low concentration of bile acids (>80% of MCT in diet leads to EFA deficiency). 2–3% calories should be from essential fatty acids.
  • Vitamins: Fat–soluble vitamins (A– 5000–25000 IU/d, D–3–5mg/kg/d, 25–Hydroxy vitamin D, E–15–25 IU/kg/d TGPS, K– 2.5mg twice a week.)
  • Water–soluble vitamins and trace elements: 2–5 times RDA
  • Anorexic babies should be offered nasogastric feeding.
  Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

When is the insemination done?

Insemination is usually done around the time of ovulation. The timing is assessed by serial ultrasound and time is fixed after the injection for follicular rupture.

Do we need anesthesia for IUI?

IUI is an OPD procedure done without anesthesia. Some times abdominal cramps are noted after the procedure. These are due to uterine contractions and usually subside in short time.

  ENT Update: Question of the Day

Is ASO titer important in diagnosing an acute streptococcal sore throat?

The ASO titer is positive in patients two to four weeks after the patient has been exposed to streptococcus. Thus the ASO titer may be negative when the patient has a strep sore throat and is not of any value in diagnosing this condition.


Sawhney S. Acute Rheumatic Fever. In: Pediatric Rheumatology Surjit Singh (ed).

  Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

Grievous Hurt as per IPC (Part I)

It is very difficult to draw a line between those bodily hurts which are serious and those which are slight. To make out the offence of voluntarily causing grievous hurt, there must be some specific hurt, voluntarily inflicted and coming within the scope of following as per law.

As per Section 320 Indian Penal Code (IPC), the following kinds of hurt are designated as "grievous";
  • Emasculation: It means depriving a male of masculine power.
  • Permanent privation of sight of either eye: The gravity lies in the permanency because it deprives a person the use of the organ of sight.
  • Permanent privation of the hearing of either ear: It deprives a man of his sense of hearing. Injury to the tympanum or auditory nerve or by thrusting something into the ear which causes deafness.
  • Privation of any member or joint: The term ‘member’ means an organ or a limb being part of man capable of performing a distinct function. It includes, nose, mouth, hands, feet, phalanges etc.
  • Destruction or permanent impairing of the powers of any member or joint: the use of limbs and joints of body are essential to the discharge of the normal functions of the body. Their deprivation causes lifelong crippling and makes the person defenseless and miserable.
  Medi Finance Update

Index Funds

Over time, index fund performance will slightly lag that of the actual index as a result of cash flows and transaction costs. Since index fund investments are not actively researched, the management fees on index funds are generally very low.

Drug Update

List of drugs prohibited for manufacture and sale through gazette notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

Drugs prohibited from the date of notification

Fixed dose combinations of any other Tetracycline with Vitamin C

Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

The patient should be instructed to be fasting for 10 to 12 hours and the dinner one evening before should be a non fatty, non greasy, non alcoholic dinner for Lipid Profile estimation.

  IJCP Special

Dr Good Dr Bad

Situation: A patient with previous TG 300 mg% came for lipid profile.
Dr Bad: Get full lipid profile done.
Dr Good: Just get total and HDLC done.
Lesson: ATP III identifies non–HDL–C concentration as a secondary target of therapy in people who have high triglycerides (≥200 mg/dL). The goal for non–HDL–C is a concentration that is 30 mg/dL higher than that for LDL–C.

Make Sure

Situation: A patient on 10 units of insulin developed hypoglycemia with 11 units of insulin.
Reaction: Oh my God! Why was additional insulin given?
Lesson: Make sure that insulin dose is correct. The formula is 1500/total daily dose. The value will be the amount of sugar fluctuation with one unit of insulin.

SMS of the Day (Dr Chandresh Jardosh)

"When I quote others I do so in order to express my own ideas more clearly." Michel de Montaigne

Ethics and Misconduct

Can a medical practitioner advertise?

As per Section 6.1.1 of MCI Act, a medical practitioner is permitted to make a formal announcement in press regarding the following:

  1. On starting practice.
  2. On change of type of practice.
  3. On changing address.
  4. On temporary absence from duty.
  5. On resumption of another practice.
  6. On succeeding to another practice.
  7. Public declaration of charges.

Read this…………………

Which of the following patients presenting to the emergency room with signs and symptoms consistent with pneumonia should be admitted for inpatient treatment?

A. A 21–year–old male with history of asthma whose respiratory rate is 28/minute, is wheezing and his blood pressure in the office is 110/62 mmHg. White cell count is normal; BUN is 18 mg/dl.
B. A 45–year–old brittle diabetic with temperature of 102F, heart rate of 110/minute, blood pressure of 130/68 mmHg.
C. A 70–year–old female with history of hypertension and diabetes who is confused, heart rate is 86/minute, blood pressure of 88/52 mmHg, WBC count of 13000, BUN of 25mg/dl and a normal serum Creatinine.
D. A 61–year–old female with history of COPD, CAD and DM who has a temperature of 104F, tachycardic to 104/minute and has a BP of 100/62 mmHg. White cell count is 16,000 and BUN is 18mg/dl and creatinine is 0.8mg/dl.
E. A 52–year–old male with fever of 103F, heart rate of 110/minute, respiratory rate of 32/minute, BP 120/70. He has leucocytosis, BUN (urea) is 25mg/dl and creatinine is 1mg/dl.

(Contributed by Ashish Verma MD)

Answer for yesterday’s Mind Teaser: "Dark under the eyes"

Correct answers received from: Dr Chandresh Jardosh, Dr.Susheela Gupta, Dr Virender Prakash Gautam, Dr Umesh Mehta, Dr Meera Rekhari, Dr K Raju.

Answer for 8th October Mind Teaser is: "change of plans"
Correct answers received from: Dr. Satish Gunawant, Dr. Rajiv Dhir, Dr Rashmi Chhibber, Dr Aruna Tyagi, Dr Anurag jain

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr Chandresh Jardosh)
Test your chemistry knowledge
Which weapon can be made with tungsten iodine and iron?
It’s the deadliest weapon in the universe.
( W+ I + Fe )

You are an Indian if (Anuj Goel)
You load up the family car with as many people as possible.

  An Inspirational Story

Love and Time
Once upon a time, there was an island where all the feelings lived: Happiness, Sadness, Knowledge, and all of the others, including Love. One day it was announced to the feelings that the island would sink, so all constructed boats and left except for Love.

Love was the only one who stayed. Love wanted to hold out until the last possible moment.
When the island had almost sunk, Love decided to ask for help.

Richness was passing by Love in a grand boat. Love said, "Richness, can you take me with you?" Richness answered, " No, I can’t. There is a lot of gold and silver in my boat. There is no place here for you." Love decided to ask Vanity who was also passing by in a beautiful vessel. "Vanity, please help me!" "I can’t help you, Love. You are all wet and might damage my boat," Vanity answered.

Sadness was close by so Love asked, "Sadness, let me go with you." "Oh … Love, I am so sad that I need to be by myself!" Happiness passed by Love, too, but she was so happy that she did not even hear when Love called her.

Suddenly, there was a voice, "Come, Love, I will take you." It was an elder. So blessed and overjoyed, Love even forgot to ask the elder where they were going. When they arrived at dry land, the elder went her own way. Realizing how much was owed the elder, Love asked Knowledge, another elder, "Who helped me?" "It was Time," Knowledge answered. "Time?" asked Love. "But why did Time help me?"

Knowledge smiled with deep wisdom and answered, "Because only Time is capable of understanding how valuable Love is."

  Readers Responses
  1. Dear Dr. Aggarwal, I have always commented that you are doing a praiseworthy job with E medinews. It was nice that in your latest edition you have tried to highlight important aspects of Dengue, the very important and relevant topic these days. Regards: Dr Prachi
  Public Forum

(Press Release for use by the newspapers)

7th A P Dewan Memorial Lecture

The 7th A P Dewan Memorial Lecture, organised by Dewan Foundation, London, was delivered by Padma Shri and Dr B C Roy National Awardee Dr. K K. Aggarwal, at India International Centre in the city here today.

Drawing upon his medical experience as well as his knowledge of the Vedas and the Hindu spiritual texts, Dr. Aggarwal started by discussing the scientific meaning of AUM and the physical benefits of the chant. He said that science has recognized that chanting of vowels leads to physical relaxation and that chanting of nasal consonants provides mental relaxation to the human body. Aum combines vowels and nasal consonants and therefore is of immense medical value. He laid great emphasis on the links between science and Indian rituals, and established the scientific reasons behind various Hindu festivals and religions.

Talking about the Hindu tradition of observing shok sabhas (funeral gatherings) after a loved one’s death, he explained how it is a form of narration exposure therapy common in neuroscience and psychological treatments, wherein an individual is encouraged to share his or her grief with others to attain mental detoxification.

He also dwelt upon the science behind the epic texts Ramayana and Mahabharata, and the science behind important prayers such as the Gayatri Mantra, Maha Mrityunjay Mantra, Hanuman Chalisa and Ik Onkar. Dr. Aggarwal talked about the correct respiration and correct breathing procedures. Asserting that most humans utilize only 60 per cent of their lungs for regular breathing, he stressed that the right way to respire is to practice abdominal thoracic breathing, which involves both the stomach region as well as the chest cavity in the process of inhaling and exhaling. From this arose the concept of Pranayam and its relevance as a spiritualistic gesture.

He made the spellbound audience participate in a deep breathing and meditation exercise for 5 minutes, at the end of which most present confessed to feeling both mentally and physically relaxed.

He demonstrated autosuggestion and visualization exercises which produce a relaxed state of body and mind. The next important revelation made by him was about progressive muscular relaxation, which is espoused in yogic asanas and is also a tried–and–tested treatment.

  Forthcoming Events

CPLD 2010:Dept. of Gastroenterology & Human Nutrition, AIIMS and Dept. of Gastroenterology, PGIMER, Chandigarh are jointly organizing a conference on Current Perspective in Liver Diseases (CPLD) on 15th and 16th October at AIIMS, New Delhi.

eMedinewS Events: Register at emedinews@gmail.com

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to 10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

Dr. Sood Nasal Research Foundation Announces

Rhinology Update 11th to 15th November
22nd National Endoscopic Sinus Surgery Course on 11th & 12th November, 2010 2010 at Dr. Shroff’s Eye & ENT Hospital, New Delhi
Cadaveric Sessions on 13th November, 2010 at Lady Hardinge Medical College.
33rd All India Rhinoplasty Course, on 14th & 15th November, 2010, at Metro Hospital, Preet Vihar, Vikas Marg, New Delhi.

For information contact: Dr. V P Sood, Course Chairman, Ear, Nose & Throat Center, 212, Aditya Arcade, 30, Community Center, Preet Vihar, Vikas Marg, Delhi–110092 (India). Tel: 011–22440011, 42420429. E–mail:drvpsood@gmail.com,vpsood@drsoodnasalfoundation.com
Website: www.drsoodnasalfoundation.com

eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

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