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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


eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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  Editorial …

10th November 2011, Thursday

It’s November: Time to get flu shot

All heart patients should take flu vaccine as death from flu is more common among people with heart diseases and diabetics than any other chronic condition.

The American Heart Association, American College of Cardiology and Heart Care Foundation of India all recommend that all heart patients and diabetics get flu shots.

Influenza or flu is a highly contagious viral infection of the respiratory tract, which occurs from November to April, with most cases occurring between late December and early March. Annual vaccination against seasonal influenza prevents cardiovascular morbidity and all–cause mortality in patients with cardiovascular conditions.

Heart patients should only receive the injectable flu vaccine (inactivated influenza vaccine) and not the live, attenuated vaccine given as a nasal spray. The live vaccine has not been approved for use in heart patients.

Flu complications include bacterial pneumonia, dehydration and worsening of chronic medical conditions, such as congestive heart failure, asthma or diabetes.

October or November is the best time to get a flu shot, but getting a shot in January or even later can still be beneficial. Flu season can start as early as October and last as late as May. It takes 1 to 2 weeks for the flu shot to take effect. Each September, a new flu vaccine is introduced. The vaccine is approximately 70 to 90 percent effective for healthy adults.

The FLUVACS study has shown that influenza vaccination reduces the risk of death and ischemic events in patients suffering from heart attack and post balloon angioplasty during flu season.

Influenza vaccination is now recommended with the same enthusiasm as cholesterol and blood pressure control and other modifiable risk factors for cardiovascular disease.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

It’s November: Time to get flu shot

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011– Anmol – A Health Festival for Children with Special Needs

Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal giving Awards to the winners at Anmol – A Health Festival for Children with Special Needs, an event by MTNL Perfect Health Mela 2011

Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


121 mn internet users in India by December–end: Report

NEW DELHI: With increasing affordability of PCs and internet penetration, India is all set to have 121 million internet users by December 2011, a study by Internet and Mobile Association of India (IAMAI) and IMRB has said. According to the annual I–Cube Report jointly published by IAMAI and IMRB, India’s internet population is expected to grow to 121 million users by December 2011 from 100 million in September this year. Out of 121 million, 97 million are expected to be active Internet users, who access Internet at least once in a month. "A 100 million internet users is considered a critical landmark for the country. With this internet use in India is expected to enter a critical period of growth with the possibility of becoming the largest internet using country in the world in this decade," the study said. (Source: The Economic Times, 7 Nov, 2011)

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   For More Detail

    International News

New CABG, PCI Guidelines stress collaboration

A multidisciplinary heart team –– including an interventional cardiologist and a cardiac surgeon –– should work together to develop a care plan for each patient with coronary artery disease (CAD), according to updated guidelines from the American College of Cardiology Foundation and the American Heart Association. (Source: Medpage Today)

For comments and archives

Greater stroke risk tied to cognitive problems

An increased risk of stroke, as measured by the Framingham scale, parallels a greater chance of developing cognitive impairment even in the absence of an actual stroke, researchers affirmed. (Source: Medpage Today)

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Autism linked to excess neurons

Children with autism appear to have bigger brains with more neurons than normal for their age, a small preliminary study affirmed. (Source: Medpage Today)

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Surgery no help in preventing strokes

Adding extracranial–intracranial bypass surgery to optimal medical therapy did not prevent strokes in patients with symptomatic atherosclerotic internal carotid artery occlusion and hemodynamic cerebral ischemia, researchers found. (Source: Medpage Today)

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    Twitter of the Day

@DrKKAggarwal: Watch Padma Shri Awardee Dr KK Aggarwal on Concentrate with Concentration http://www.youtube.com/watch?v=bEYL6Pw_9ec&feature=share via @youtube

@DeepakChopra: Love changes with the passage of time, but it never diminishes. It is always present in its fullness.

    Spiritual Update

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

Why most people desire that their death takes place at home

I recently came across one instance when the head of the family desired that if his mother had no chances to survive he would like to take her home and would like that she leave her ‘prana’ the last breath at home during day time.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

Promise Yourself

To be so strong that nothing can disturb your peace of mind;
To talk health, happiness, and prosperity to every person you meet;
To make all your friends feel that there is something in them;
To look at the sunny side of everything and make your optimism come true;
To think only the best, to work only for the best, and to expect only the best;
To be just as enthusiastic about the success of others as you are about your own;
To forget the mistakes of the past and press on to the greater achievements of the future;
To wear a cheerful countenance at all times and give every living creature you meet a smile;
To give so much time to the improvement of yourself that you have no time to criticize others;
To be too large for worry, too noble for anger, too strong for fear; and too happy to permit the presence of trouble;
To think well of yourself and to proclaim this fact to the world, not in loud words, but in great deeds;
To live in the faith that the whole world is on your side so long as you are true to the best that is in you.

    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

Why do people work out?

The answer is different for everyone. Some people exercise for the numerous health benefits that it brings, such as reduced risk of chronic disease or cancer. For others, exercise is a way to relieve stress. There are certain people who work out for esthetic reasons – because they want to lose weight or look toned.

A group of researchers from the University of Michigan conducted a study to learn more about personal values and how they relate to the motivation to exercise. The study, published in the International Journal of Behavioral Nutrition and Physical Activity, offers surprising insight into why women choose to break a sweat.

They selected a random sample of 226 healthy middle–aged women (40–60 years of age) to participate in the study, which lasted one year. They assessed each woman’s exercise habits as well as her personal values and reasons for working out. The primary reasons that women exercised, according to the study results, were health benefits (healthy aging as well as current health), quality of life, and weight loss or appearance. However, the results showed one significant result: women who exercised for quality of life reasons, or because they enjoyed the act of exercising or the feeling that it causes, exercised more frequently than women who listed the other reasons.

No matter what your personal goals and values are, there’s no question that exercise is beneficial for your health, your body, your mind, and much more. So whatever your reason is for working out, keep it up!

For comments and archives

    Healthy Driving

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

If you do need to use a cellular phone urgently, take the following precautions:

Use speaker phone/hands–free device.

For comments and archives

    Medicine 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, 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.

For comments and archives

    Legal Question of the Day

(Dr M C Gupta, Advocate)

What is the Hippocratic oath?

  1. To answer this question, I am referring to the Supreme Court judgment in State of Punjab versus Shiv Ram & Ors., SC, 25–8–2005, decided by CJI R.C. LAHOTI,C.K. THAKKER & P.K. BALASUBRAMANYAN
  2. The above judgment states as follows:
    • Medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. The oldest expression of this basic principle comes from Hippocrates, an early Greek Physician, born in 460 B.C. who came to be known as the "Father of Medicine" and had devoted his entire life to the advancement of medical science. He formulated a code of conduct in the form of the Hippocratic Oath, as he realized that knowledge and skill were not enough for a physician without a code of standards and ideals. He coined an oath of integrity for physicians, a code of standards and ideals to which they must swear to adhere in the practice of their profession.
    • The oath is as follows:
      "I swear by Apollo the physician, by Aesculapius, Hygeia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgement, the following Oath.
      To consider dear to me as my parents him who taught me this art; to live in common with him and if necessary to share my goods with him; to look upon his children as my own brothers, to teach them this art if they so desire without fee or written promise; to impart to my sons and the sons of the master who taught me and the disciples who have enrolled themselves and have agreed to the rules of the profession, but to these alone the precepts and the instruction. I will prescribe regimens for the good of my patients according to my ability and my judgement and never do harm to anyone. To please no one will I prescribe a deadly drug nor give advice which may cause his death.

      Nor will I give a woman a pessary to procure abortion. But I will preserve the purity of my life and my art. I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art. In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves. All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal. If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot."
    • Many versions of Hippocratic Oath are prevalent. "Light From Many Lamps" a book edited by Lilian Eichler Watson contains a little different phraseology of that oath but certainly a beautiful commentary on the significance of the Hippocratic Oath. We would like to reproduce the oath and the commentary hereunder: (pages 181–182);

      The Oath ––

      "I do solemnly swear by that which I hold most sacred:
      That I will be loyal to the profession of medicine and just and generous to its members;
      That I will lead my life and practice my art in uprightness and honor;
      That into whatsoever house I shall enter, it shall be for the good of the sick to the utmost of my power, I holding myself aloof from wrong, from corruption, and from the temptation of others to vice;
      That I will exercise my art solely for the cure of my patients, and will give no drug, perform no operation for a criminal purpose, even if solicited, far less suggest it;
      That whatsoever I shall see or hear of the lives of men which is not fitting to be spoken, I will keep inviolably secret.
      These things I do promise, and in proportion as I am faithful to this my oath may happiness and good repute be ever mine __ the opposite if I shall be forsworn."

      The Commentary ––

      The Hippocratic Collection, containing the best of the ancient Greek medical writings, was put together by Aristotle and has survived through the centuries. The "Hippocratic Oath" is one of the last and most inspiring passages in this Collection. There are a number of versions of the famous Oath; but the form given here is the one commonly used today; and is an adaptation of a translation from the original Greek.
    • Many people argue that the original Hippocratic Oath is inappropriate in a society that has seen drastic socioeconomic, political and moral changes, since the time of Hippocrates. Certain parts of the original oath such as teaching the master’s sons the secrets of medicine without fees and the promise not to bring a knife to another’s body but to leave it to ‘practitioners of the craft’ have been rendered obsolete as the modernization of education has led to the teaching of medical science in institutions of higher learning, and specialization in medicine has led to physicians who specialize in a variety of fields including surgery. Similarly, the legalization of abortion and physician–assisted suicide in certain parts of the world, has made it awkward for some medical practitioners there to carry on in the tradition of the original oath.
    • This has led to the modification of the oath to something better suited for our times. One of the most widely used versions is The Declaration of Geneva, which was adopted by the General Assembly of the World Medical Association at Geneva in 1948. Written with the medical crimes committed in Nazi Germany in view, it is a ‘declaration of physicians’ dedication to the humanitarian goals of medicine.’ It is also perhaps the only one to mention treating people equally, without regard as to race, religion, social standing and political affiliations:

      "I solemnly pledge myself to the service of humanity. I will give to my teachers the respect and gratitude which is their due. I will practice my profession with conscience and dignity. The health of my patient will be my first consideration. I will respect the secrets which are confided in me. I will maintain by all means in my power the honour and noble traditions of the medical profession. My colleagues will be my brothers and sisters. I will not permit consideration of religion, nationality, race or social standing to intervene between my duty and my patient. I will maintain the utmost respect for human life even under threat. I will not use my medical knowledge contrary to the laws of humanity. I make these promises solemnly, freely and upon my honour."
  3. As per Indian law and conventions and practice, no oath is administered to doctors now–a–days. However, oath or no oath, all doctors have to abide by the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002, which are part of law. An oath is not a part of law. An oath voluntarily taken by a person cannot be enforced by law.

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    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

For comments and archives

    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.

For comments and archives

Make Sure

Situation: A patient of pulmonary Koch’s taking ATT complained of numbness in fingers and toes.
Reaction: Oh my God! I forgot to prescribe vitamin B complex.
Lesson: 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.

  Quote of the Day

(Dr GM Singh)

In matters of style, swim with the current; in matters of principle, stand like a rock. Thomas Jefferson

    Mind Teaser

Read this…………………

Which of the following statements is true about ulcerative colitis with malignancy?

a) It has a better prognosis.
b) Is related to disease activity.
c) Is related to duration of ulcerative colitis.
d) Malignancy is more in anorectal ulcerative colitis.

Yesterday’s Mind Teaser: pPPod

Answer for Yesterday’s Mind Teaser: Two peas in a pod

Correct answers received from: Bina Sawhney, Muthumperumal Thirumalpillai, Raju Kuppusamy,
Dr Chandresh Jardosh, Dr Neelamnath, Dr ValluriRamarao.

Answer for 8th November Mind Teaser
: a) ERCP should be the initial investigation in all cases of injuries to the bile duct to define the extent of injury
Correct answers received from: Dr Neelamnath, Dr ValluriRamarao, bina sawhney.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

The Lawyer’s Dog

A butcher was minding his store one day, when a dog ran in and stole a cut of meat off his counter. The butcher recognized the dog as belonging to his neighbor who was a lawyer. He called up his neighbor and said, "Your dog stole meat from my store. I believe you owe me for the meat." The lawyer said "You are correct. How much was the meat?"

The butcher told him that it cost $4.50, the lawyer replied that the butcher should receive a check for that amount in the mail the next day. The next day, the check arrived in the mail for $4.50, with a bill attached for $150 "for legal consultation."

    Medicolegal Update

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

Left ventricular hypertrophy is the second leading cause of sudden cardiac death in the adult in autopsy

  • The longstanding raised high blood pressure causes secondary damage to the wall of the main pumping chamber of the heart, the left ventricle. Hypertrophy is associated with cardiac arrhythmias.
  • The mechanism of death in a majority of patients dying of sudden cardiac death is ventricular fibrillation and as a consequence there may be no prodromal symptoms associated with the death.
  • These patients may be going about their daily business and suddenly collapse without the typical features of myocardial infarction such as chest pain and shortness of breath. There are a number of cases in which patients feel the effect of myocardial ischemia. Myocardial ischemia is associated with referred pain, classically to the front of the chest, the left arm and the jaw. Patients may feel generally unwell, with nausea, dizziness and vomiting.
  • These symptoms may precede the death for any length of time between a few minutes and several hours.
  • I have conducted the postmortem examination of four cases of left ventricular hypertrophy causing sudden death. These cases were found dead in toilet during their daily pursuits.
    Public Forum

(Press Release for use by the newspapers)

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

More than one egg per week raises the risk of diabetes

The advertisement on Indian TV "Sunday ho ya Monday, Roj Khao Ande" needs a revision as it is not based on scientific facts, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

A new study has shown that people who eat eggs every day may substantially increase their risk of type 2 diabetes. India is already the diabetic capital of the world and continuing promotion of eating eggs every day will add to the burden.

In the study, men with the highest level of egg consumption, seven or more per week, were 58% more likely to develop type 2 diabetes than those who did not eat eggs, and women were 77% more likely to become diabetic if they ate at least an egg a day. The study done by Dr Luc Djoussé of Brigham and Women’s Hospital and Harvard is published in the Journal Diabetes Care.

Other salient features

  • Levels of egg intake above one a week incrementally increased diabetes risk in both men and women.
  • Eggs are a major source of dietary cholesterol (about 200 mg per egg).
  • Eggs add about 1.5 g of saturated fat each to the diet.
  • Eggs may influence glucose metabolism primarily through their effect on cholesterol.
  • Each egg also contributes about 0.7 g of polyunsaturated fat, which neutralize the risk to some extent only.
  • The average one–egg–a–week consumption was not associated with increased diabetes risk.

The study included 20,703 male doctors without baseline diabetes from the Physicians’ Health Study I (1982–2007) and 36,295 similarly diabetes–free female health professionals from the Women’s Health Study (1992–2007). Over a mean follow–up of 20.0 years in men and 11.7 years in women, 1,921 men and 2,112 women developed type 2 diabetes. Diabetes was more common in men and women who reported eating more than the average one egg a week.

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    Readers Responses
  1. Respected Sir, I enjoy reading this daily newsletter.Congratulations. pooja chaudhry
    Forthcoming Events

CSI 2011

63rd Annual Conference of the Cardiological Society of India

Date: December 8–11, 2011.
Venue: NCPA Complex, Nariman Point, Mumbai 400021

Organizing Committee

B. K. Goyal – Patron
Samuel Mathew – President CSI
Ashok Seth – President Elect & Chairman Scientific Committee
Lekha Adik Pathak – Chairperson
Satish Vaidya & C. V. Vanjani – Vice Chairman
N. O. Bansal – Organizing Secretary
B. R. Bansode – Treasurer
Ajit Desai , Ajay Mahajan , G. P. Ratnaparkhi – Jt. Org. Secretaries
Shantanu Deshpande , Sushil Kumbhat , Haresh Mehta – Asst. Org. Secretaries
D. B. Pahlajani, A. B. Mehta , M. J. Gandhi , G. S. Sainani, Sushil Munsi, GB Parulkar, KR Shetty – Advisory Committee

Contact: Dr. Lekha Adik Pathak, Chairperson, CSI 2011; Dr. Narender O. Bansal, Org. Secretary, CSI 2011 Tel: 91 – 22 – 2649 0261/2649 4946, Fax: 91 – 22 – 2640 5920/2649 4946.
Email: csi2011@ymail.com, csimumbai2011@gmail.com Website: www.csi2011mumbai.com

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews "Doctor of the Year Award" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.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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  Perfect Health Mela

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  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

    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