Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
  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

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 9 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

10th December 2012, Monday

How to explain about cardiac interventions?

For any traffic management, following are the options:

  • Placing traffic signals which can be equated to do’s and don’ts of lifestyle management.
  • Posting a traffic inspector on the crossing. This can be equated with clinical cardiologist.
  • Diverting the traffic from main road to side roads. This can be equated to opening collaterals by drugs, exercise and massage.
  • Hiring the architect to make maps. This can be equated to an angiographer doing angiography.
  • Looking for the possibility of widening the roads. This can be equated to balloon angioplasty.
  • To prevent encroachment of widened roads to place rallying around the widened roads can be equated to placement of metallic stent.
  • To prevent rallying from mishandling grills are to be put on the rallying. This can be equated to drug alluting stents.
  • When the roads cannot be widened, flyovers are made which can be equated to bypass surgery.
  • Flyovers can be made by stopping the traffic. This can be equated to open bypass surgery.
  • Flyovers can be made without disturbing the traffic, this can be equated to heart bypass surgery.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Saline laxatives such as magnesium hydroxide have not been examined in older adults, and should be used with caution because of the risk of hypermagnesemia.


Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Texting and email checking in OT while work can be dangerous

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela 2012

Large number of Nursing students took active participation in the 19th MTNL Perfect Health Mela

Dr K K Aggarwal
    National News

Dear Colleague, Let’s celebrate New Year by learning CPR-10 and saving the life of a person

Watch English or Hindi Video @http://emedinews.in/videos/cpr/index.html

Dr K K Aggarwal

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

    Valvular Heart Disease Update

Valvular heart disease is common in patients undergoing maintenance dialysis. Predisposing factors include secondary hyperparathyroidism, an elevated calcium-phosphorus product, vascular calcification, hypercalcemia, uremic milieu and hyperphosphatemia.

(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

64th annual conference of CSI and SAARC Cardiac Congress 2012

STEMI and Reperfusion Therapy: Bernard Gersh

In management of STEMI time to treatment is critical. PCI is always better than thrombolytic therapy. According to ACC/AHA guidelines door to balloon time for PCI should be less than 120 minutes. However, according to data from MITI trial if the patient is seen within 70 minutes of onset of symptoms, prehospital fibrinolytic therapy is very useful and is associated with better outcomes. Even if the patient is seen within 120 minutes then fibrinolytic should be given before transferring the patient to a PCI centre. If the patient is seen later than 120 minutes then he should be loaded with clopidogrel and transferred for primary PCI.

SCD and IHD- Global and Indian Perspective:B Hygriv Rao

Sudden cardiac death and ischemic heart disease have an enigmatic relationship. IHD is the most common cause of SCD. We have data from very few countries like those in North America and Europe. The challenge in the Indian scenario is that the data are not reliable. Globally the burden of SCD is 5.6% of all deaths while in India it is 10% of all deaths, which is a sizable number. Also, while the mean age of patients of SCD is 74 years globally, in Indians most of the SCDs occur in a much younger age group(50-70 years), the mean age being 60 years. Additionally, majority of SCDs in Indians occurred in hypertensives, diabetics and smokers. To tackle the problem of SCD in India, which is facing an epidemic of diabetes and CAD, we need to screen and treat people for coronary risk factors, treat ACS timely with timely revascularization, ensure compliance with proper medication(ACEIs, statins, aspirin, etc.) and identify patients at high risk and provide them with ICDs.

Acute Coronary disease 2012 :Keith AA Fox

With better management of patients with ACS the mortality from STEMI and NSTEMI has been brought down drastically in the last 6-7 years primarily due to better reperfusion therapy with PCI which limits tissue injury.. However, there is scope for improved outcomes since the decline is less in patients less than 35 years. We need to identify the vulnerable patient by new non invasive modalities which can detect the vulnerable plaques. Genetics can help since it is now known that gene expression at Chromosome 9p21 is associated with coronary artery disease susceptibility and recurrent plaque rupture.

    Twitter of the Day

@DrKKAggarwal: With Ryan Global School Gurgaon http://coll.ag/_qqAJB0g via @PicCollage pic.twitter.com/JMjH60Bk

@DeepakChopra: The universe unfolds its potential as consciousness expands #CosmicConsciousness

    Spiritual Update

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

Understanding Buddha Nature: The Doctrine of fine Karmas

The term ‘Buddha’, ‘Krishna’, ‘Wahe Guru’ or Brahma does not pertain to a person but to the ever-pervading life force, the GOD consciousness.

For comments and archives

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

What happens after the egg retrieval?

Two days after the egg retrieval, the fertilized egg divides to become a 2– to 4–cell embryo. By the third day, a normally developing embryo will contain approximately 6 to 10 cells. By the fifth day, a fluid cavity forms in the embryo, and the placenta and fetal tissues begin to separate. An embryo at this stage is called a blastocyst. Embryos may be transferred to the uterus at any time between 1 and 6 days after the egg retrieval. If successful development continues in the uterus, the embryo hatches from the surrounding zona pellucida and implants into the lining of the uterus approximately 6 to 10 days after the egg retrieval.

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

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

Virus ‘Inactivated’ Plasma


  • Plasma treated with methylene blue/ ultraviolet light inactivation to reduce the risk of HIV, hepatitis B and hepatitis C.
  • The cost of this product is considerably higher than conventional fresh frozen plasma.

Infection risk

  • The ‘inactivation’ of other viruses, such as hepatitis A and human parvovirus B19 is less effective
    An Inspirational Story (Dr Anupam Sethi Malhotra)

God is never wrong

A king who did not believe in the goodness of God, had a slave who, in all circumstances, said: My king, do not be discouraged, because everything God does is perfect, no mistakes!

One day they went hunting and along the way a wild animal attacked the king. His slave managed to kill the animal, but could not prevent his majesty losing a finger.

Furious and without showing his gratitude for being saved, the nobleman said "Is God good? If He was good, I would not have been attacked and lost my finger."

The slave replied: "My king, despite all these things, I can only tell you that God is good, and he knows "why" of all these things. What God does is perfect. He is never wrong!" Outraged by the response, the king ordered the arrest of his slave. Later, he left for another hunt and was captured by savages who made human sacrifices.

In the altar, ready to sacrifice the nobleman, the savages found that the victim had not one of his fingers, so he was released. According to them, it was not so complete to be offered to the gods. Upon his return to the palace, he authorized the release of his slave that he received very affectionately.

"My dear, God was really good to me! I was almost killed by the wild men, but for lack of a single finger, I was let go! But I have a question: if God is so good, why did he allow me to put you in jail?"

"My King, if I had gone with you in this hunt, I would have been sacrificed for you, because I have no missing finger, therefore, remember, everything God does is perfect. He is never wrong."

Often we complain about life, and negative things that happen to us, forgetting that nothing is random and that everything has a purpose.

Every morning, offer your day to God, don’t be in a rush.

Ask God to inspire your thoughts, guide your actions, and ease your feelings. And do not be afraid. God is never wrong!

You know why this message is for you? I do not know, but God knows, because he never makes mistakes………

The path of God and his word is perfect, without impurities. He is the way of all those who trust in Him.

What you do with this message is up to you. May God put in your heart the desire to send it to someone. God knows why He choose you to receive this message. Please bless someone with it.

For comments and archives

    Cardiology eMedinewS

Fatty streak is the first visible lesion in atherosclerosis
Read More

Management of Endocarditis: An Overview Read More

    Pediatric eMedinewS

Secondhand Smoke Effects Are Lasting
Read More

FDA OKs Levemir for Tots Read More

    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was found unconscious.
Dr Bad: He has suffered a stroke.
Dr Good: First rule out hypoglycemia.
Lesson: In diabetics, sudden loss of consciousness is hypoglycemia unless proved otherwise.

Make Sure

Situation: A patient with pyogenic meningitis developed complications. Reaction: Oh My God! Why were antibiotics not given when the meningitis was suspected?
Lesson: Make sure that first dose of antibiotics is given at the time meningitis is suspected.

    Legal Question of the Day

(Ex)Prof. M C Gupta, Advocate & Medico-legal Consultant)

Are doctors supposed to answer calls round the clock? Can they delegate this task to an assistant?

QUESTION--Are doctors supposed to answer calls round the clock from their patients, or is it ok to give the assistant's number for routine queries, and the hospital number for emergencies?


  1. No human being can be on duty round the clock every day. A doctor has a right to choose his working hours commensurate with service rules and with general guidelines given in the MCI Code of Ethics Regulations,2002.
  2. It is true that once a doctor undertakes to treat a patient, the latter should not be neglected and should have access to medical information or aid at all times as long as he is under treatment. However, this does not mean he should have access to the same individual all the time. The treating doctor has a legitimate right and duty to so arrange that a competent physician / assistant is available for this purpose. Such assistant should be given clear directions as to when he should bring any important or crucial development to the notice of the senior doctor.
  3. In effect, it would be OK to give the assistant's number for routine queries, and the hospital number for emergencies. However, it would be the duty of the senior or main treating physician to ensure that the queries made to the assistant or the emergency department are attended to without delay.
  Quote of the Day (Dr GM Singh)

He who asks a question is a fool for five minutes; he who does not ask a question remains a fool forever.

    Mind Teaser

Read this…………………

Immediately after cholecystectomy, the nursing action that should assume the highest priority is:

A. Encouraging the client to take adequate deep breaths by mouth
B. Encouraging the client to cough and deep breathe
C. Changing the dressing at least BID
D. Irrigate the T-tube frequently

Yesterday’s Mind Teaser: Which description of pain would be most characteristic of a duodenal ulcer?

A. Gnawing, dull, aching, hungerlike pain in the epigastric area that is relieved by food intake
B. RUQ pain that increases after meal
C. Sharp pain in the epigastric area that radiates to the right shoulder
D. A sensation of painful pressure in the midsternal area

Answer for Yesterday’s Mind Teaser: A) Gnawing, dull, aching, hungerlike pain in the epigastric area that is relieved by food intake

Correct answers received from: Dr.K.V.Sarma, Dr. B. B. Aggarwal, Dr. Thakor Hitendrsinh G, Dr prabha, Dr. P. C. Das, Dr Pankaj Agarwal, Dr.(Maj. Gen.) Anil Bairaria, Dr K P Chandra, DR ARPAN GANDHI, Dr Jainendra Upadhyay, DR Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Avtar Krishan, Dr Kanta jain, Dr U Gaur, Dr prabha, Dr. P. C. Das

Answer for 8th December Mind Teaser: B. Assess gag reflex prior to administration of fluids

Correct answers received from: Muthumperumal Thirumalpillai, Dr Avtar Krishan, Dr Kanta jain, Dr U Gaur, Dr prabha, Dr. P. C. Das, Dr Ashok Barat, Archna parwani,

Send your answer to ijcp12@gmail.com

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

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    Laugh a While (Dr.GM Singh)

Dumb and dumber

Friend 1: Is it true that your wife talks to herself when she is alone?

Friend 2: I don’t know. I wasn’t with her when she was alone.

    Medicolegal Update

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

Forensic opinion in case of fatal hanging

  • Hanging was formerly thought to be a pure asphyxia as a result of ‘cutting off the air’ by occlusion of the airway during the fatal pressure on the neck.
  • It has been recognized by many forensic authors that the rapidity of death in many cases made it impossible for hypoxia to be the sole or even major cause. Many victims died almost immediately and exhibited none of the so–called ‘classic’ signs of asphyxia.
  • Hanging means self–suspension; the body weight is constricting force/partial/complete, which constricts the laryngeal/tracheal lumen, root of tongue/venous congestion/reflex vagal inhibition/cerebral ischemia/fracture and dislocation of cervical vertebra as in case of typical/judicial hanging.
  • The doctor who is conducting the postmortem examination, on the basis of position and type of knot/material/partial/complete hanging/length of duration of hanging/slipping of ligature/partial hanging, has to opine with clarity on the followin

    o Go Whether the death is due to strangulation by ligature and subsequent postmortem hanging? This is a point of contention and requires clarity.

    o What is the medicolegal inference of injury in neck as described ligature mark? Whether it is a case of antemortem homicidal hanging by use of force or poisoning?

    o Whether it is a case of death due to asphyxia as a result of antemortem hanging or not? If yes then whether it is a case of suicidal hanging?

    o What is the forensic importance/explanation of any other injury on body……poisoning?

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Controlling diabetes and high blood pressure can prevent kidney disease

Uncontrolled high blood pressure and diabetes are the 2 main cause of silent kidney damage said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Presence of proteins in the urine, persistently high uric acid levels in the blood and a low estimated kidney filtration rate can be the early markers of kidney damage.

The cheapest screening test is to get the urine tested for presence of proteins or a blood Creatinine levels done. One can calculate the estimated kidney filtration by the following formula: (140 minus age multiplied by weight in kg) and divided by (72 multiplied by the serum craetinine level). The value will be O.85 times in women. Normal filtration is more than 100.

Patients with kidney disease may present with different clinical presentations. Some may present with blood in the urine, flank pain and others with edema and high blood pressure.

Many patients may remain asymptomatic and are detected on routine examination to have an elevated plasma craetinine concentration or an abnormal urinalysis.

    Readers Responses
  1. Dear Sir, we like reading emedinews. Regards:Dr Tarun
    Forthcoming Events

4th eMedinews Revisiting 2012

(a day long single hall medical conference on 2012 happenings, followed by doctors of the year 2012 awards)

Sunday 20th January 2013, Maulana Azad Medical College Auditorium

Dilli Gate Delhi


Dr KK Aggarwal
Padmashri and Dr B C ROY National Awardee President

Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman

Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

4th eMedinewS Revisiting 2012

The 4th eMedinewS–revisiting 2012 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 20th 2013.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2012. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. All delegates will get Registration Kit, Attractive gifts, Certificates. Morning snacks and lunch will be provided.

Register at: www.emedinews.in/


4th eMedinewS Doctor of the Year Awards

Nominations invited for 4th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2012.

pls send his/her Biodata at: 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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  Towards Well Being

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  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