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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 ...

11th September, 2010, Saturday

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

Ganesha: Oh My God!

We sing His praises, we worship His deity, we believe in His powers blindfolded and yet distance Him from us by pining to see what lies deep within us.  God, to which the world bows down, has infact been reincarnated into an issue of communal dispute, a reason for violence, and an agenda to be banked for something as mere votes.  Brahma, Vishnu, Shiva or be it Allah, Waheguru or Jesus, all personify the beauty of the unpolluted soul within us which is deep-rooted and blanketed by earthly desires.

While mythological studies knit stories of the Almighty’s existence, the fact remains that human being is bestowed with the untainted potential of recognizing heavenly facets in his own self.  Ganesha, the son of Shiva and Parvati is likewise the name given to the harmonious ‘Aacharan’ or characteristic disposition of man. Remembered and ritually worshiped before starting a new venture, the entity of Ganesha has in store the facets of a complete man. The magnanimous head of the Ganesha, which is that of an elephant, represents wisdom, intelligence and a healthy mind capable of making sound decisions.  Not in vain is it said that ‘think before you speak’, which implies Ganesha’s huge head, that is identified with the need for a thoughtful and retrospective attitude.  The big ears of this elephant-deity instills among the earthly man the patient channel of lending ears to the echo produced by others’ deeds and speech. It is said that half the dispute is resolved when an ear is lend most patiently.  Ganesha or the Ganapati’s extremely small mouth characteristically represents the need for a limited dialogue and the vanity of chattering. Over-expression through words triggers unsought problems many a times which otherwise could be avoided by a tight-lip.
Ganesha also represents the guru of stress affected individuals. Shiva’s most promising son, Ganesha, by virtue of his small eyes, highlights the need of a focused outlook in life.  Such an outlook not only redefines and foresees the right goals, but also relieves one from the stress-manifested episodes from the various chapters of life.  The long trunk identifies with the power of discrimination.  The sensitivity of the Ganesha’s long nose has the strength to uproot a tree and the competency of picking up a pin from the ground.  Such should be the approach of an individual who should be capable enough to perceive the good and the bad for himself besides the undaunted strength of overcoming all odds.  The tusks and the small teeth of Ganesha should however, be recollected with the loss and gains in the life of a man. Man similarly ought to engrave his mental stature in such a manner that the ups and downs may not deter him from his honest endeavor and the balance of inevitable bliss and sorrow is maintained to add spice in the earthly existences.This stable healthy mental status is only possible if the physical, social, spiritual and environmental requirements of the body are fulfilled. To achieve this, individuals need to be bestowed upon a complete mental and physical health.

The big stomach of Ganapati Deva preaches the need for retaining information.  Acquiring knowledge, utilizing it and retaining it for years to come, becomes the crux of ‘big-belly commandment’.
The Char-Bhuja Dhari Ganesha, further represents strength by virtue of the four hands in which the Lord entraps his attachments, desires and greed.  The Two arms of Ganesha, which hold a rope, symbolize control over attachments.  The laddo or sweet in the other two show command over desires and earthly delusion.  The mouse sitting near the feet of Ganesha represents greed and gluttony upon which the Almighty rides, propagating a control over the evils.
Ganesha’s physical traits are an assembly of the characteristics most required in an individual of substance.  Disposition incarnated with the goodness of such features will result in success in life and will positively procure an ailment-free survival. Specifically for executives, Ganesha’s characteristic principles may be incorporated in a time-table format which will help in the dawn of a conformable work-atmosphere along with congenial relationship between the management and the union of workers.

Deciding the first day of the week to hear all grievance and woes of the workers, the second for thinking and planning strategies to work upon and finally setting targets to be achieved may utilize three days of the week very constructively. A day devoted to evaluating losses and gains (Ganesha’s teeth principle) additionally may help in business management. Retaining information and filing all the pending work can affirmatively call upon the fifth day of the week, which works entirely on the principle of Ganesha’s tummy, which is massive by the virtue of holding tremendous loads of information.  Contemplation, discrimination and judging the good and the bad for the entire unit may take another day, leaving Sunday for self-retrospection through meditation and yoga. One should strive and adopt Ganpati Bappa Morya’s principles of life management rather than worshiping him with vanity.  Life has much in store besides bothering about unnecessary qualms. Giving into a disciplined attitude may lead to a peaceful life.  Heaven is where you are, it’s only a matter of perception which makes life as difficult as hell.

Ganesha’s Principles of Stress Management

It’s not worshiping Ganesha but his principles which are important to acquire holistic health. For removing any obstacles in life one should adopt Ganesha’s principles.
•    Ganesha’s head represents ‘think, use your wisdom and intelligence’
•    Big ears represent ‘hear everybody, do not take a hasty decision’
•    Small eyes represent ‘focus your vision, make your targets’
•    Small mouth represent ‘speak less’
•    Broken and complete external teeth represent ‘balancing yourself between loss and gain’
•    Trunk represent ‘Viveka, and power of discrimination between the opposites’
•    Big belly represent ‘to retain all information’
•    4 hands represent ‘strength’, ladoo in hand represent ‘controlling your desires’
•    Mouse represent ‘controlling your greed’
•    Two ropes represent ‘controlling your attachments’.

Mere worshipping of the idol will not remove the obstacles in your life

Dr KK Aggarwal
Editor in Chief
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  Photo Feature (from the HCFI Photo Gallery)

Celebrities need to be involved in an event for a greater impact

Nikhil Chopra, Cricketer and Dr Naresh Trehan were the main guests at ‘Walk for Health’, a function organized by Heart Care Foundation of India (HCFI)

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Initial chemotherapy for metastatic pancreatic cancer

Use Folfirinox rather than gemcitabine for patients with metastatic disease who have a good ECOG (Eastern Cooperative Oncology Group) performance status and a serum total bilirubin level that is <1.5 times the upper limit of normal. (J Clin Oncol 2010; 28:303s)

  National News

IMA Election

Emedinews requests all its readers to support Padma Shri and Dr. B C Roy National Awardee Dr. K.K. Aggarwal, Group Editor-in-Chief, IJCP Group of Publications Chief Editor, eMedinews, first national daily emedical newspaper of India, who is contesting for the post of Vice President of the National Indian Medical Association. 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 public health and academics

Dengue cases reach 1580 in Delhi

The national capital on Thursday reported 68 new dengue cases, taking the total number of patients in the city to 1580. The city has recorded over 350 dengue cases in the last five days. There were four dengue deaths in Delhi this season. During the same period last year, the number of the vector–borne disease in the city was only 12 while it was 160 and 26 in the corresponding periods in 2008 and 2007. South Delhi continued to be worst–affected this season recording 260 cases, followed by MCD Central Zone (225) and Civil Lines (188). (Source: The Indian Express)

Bigger role envisaged for technology in healthcare

The potential of Information and Communication Technology (ICT) should be increasingly leveraged for delivering healthcare that is accessible and affordable, experts said on Wednesday. Panellists at a session on ‘Creating Health Next’ at ‘Connect 2010’ hosted by the CII pointed out that while the country was beginning to see the benefits of adoption of IT in the distribution of smart cards and expanding the reach of medical expertise through telemedicine, technology was set to play a more critical role in healthcare. (Source: The Hindu)

  International News

(Dr Monica and Brahm Vasudeva)

Acupuncture relieves pain in hemophilia patients

According to a study presented at the World Federation of Hemophilia 2010 Congress, acupuncture relieved some joint pain (hemarthrosis) that patients of hemophilia commonly suffer. According to Angela Lambing, MSN, nurse practitioner coordinator at Henry Ford Health System, Detroit, six of 9 patients included in the pilot study achieved substantial pain relief, including one patient whose visual analog pain scale score dropped from 10 to 5. Improvement in physical functioning, emotional problems, mental health, pain relief and positive changes in health were reported by the patients in the quality–of–life survey using the Short Form (SF–36) questionnaire. No bleeding was observed in any patient after any treatment session. 36–gauge needles were used.

Atherosclerotic process begins early in RA

An ongoing prospective Swedish study reports that the process of atherosclerosis starts very early in the course of rheumatoid arthritis (RA). In the study, intima–media thickness, an overall indicator of atherosclerosis, increased significantly from 0.52 mm to 0.57 mm (P<0.05) among RA patients only one and half years post diagnosis. The increase was significant despite therapy with disease–modifying anti–rheumatic drugs (DMARDs) and low levels of inflammation. The study findings are presented in Arthritis Research & Therapy.

Measurement of tumor hemoglobin as adjunct to diagnostic mammography

Measuring hemoglobin content of breast tumor by optical tomography may be an adjunct to diagnostic mammography and ultrasound for distinguishing early–stage invasive breast cancers from benign lesions. In a study involving 178 women, hemoglobin content of breast masses accurately differentiated malignant from benign lesions. Malignant lesions had significantly higher hemoglobin values, consistent with tumor angiogenesis. The sensitivity and specificity for in–situ and T1 lesions exceeded 90%, with values only marginally reduced for more advanced tumors. The study is published online in the journal Radiology.

Triglyceride content of HDL predicts statin myotoxicity

The composition of high–density lipoprotein (HDL) particles may predict a patient’s risk of developing statin–induced myotoxicity. In a study involving more than 600 patients, those having higher levels of HDL particles rich in triglycerides before starting statins were 3–21 times more at risk of myotoxicity, especially the more severe forms, after adjustment for age, sex, statin dose, and concomitant medications. The study was presented at the annual World Congress on Heart Disease sponsored by the International Academy of Cardiology.)

  Nutrition Update

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

Complimentary feeding practices between 6 and 24 months

Appropriate complementary feeding involves a combination of practices to maintain breastmilk intake and, at the same time, improve the quantity and quality of foods children consume.
The 6– 11 month period is an especially vulnerable time because infants are just learning to eat and must be fed soft foods frequently and patiently. Care must be taken to ensure that these foods complement rather than replace breastmilk. For older infants and toddlers, breastmilk continues to be an important source of energy, protein, and micronutrients.


  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.
  Infertility Update

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

Q: If I don’t get pregnant after my first attempt, when can I try again?

A. You may try again after your next spontaneous menstrual cycle. You will need to take birth control pills for at least 21 days prior to starting injectable medications. If you have frozen embryos, your physician will review the procedure and medication protocol with you.

  ENT Update

Dr. Aru Handa MS, DNB (Department Co – ordinator and Senior Consultant Deptt. Of ENT Moolchand Medcity)

Ear pain while flying: Ear blockage occurs while flying due to the pressure difference between middle ear and pressure inside aeroplane. The discomfort is more when the plane descends, due to relative negative pressure inside the ear.
The predisposing factors are: Nasal blockage; Upper respiratory tract infection or nasal allergy; Previous nasal or sinus pathology;Non pressurized planes and Anatomical nose or nasopharyngeal abnormalities.

  Medicine Update: Question of the day

How is typhoid fever diagnosed?

The lab diagnosis of typhoid fever is based on:

  • Isolation of organism
  • Detection of microbial antigen
  • Titration of antibody against causative organism

The various investigations which help in the diagnosis of typhoid include:

  • Total and differential counts show leucopenia and neutropenia in about 50% of patients.
  • Blood cultures are the standard diagnostic methods. They are positive in 60-80% of patients. The sensitivity of blood culture is higher in the first week of illness, is reduced by prior use of antibiotics and increases with the volume of blood cultured.
  • Bone marrow culture: It is the most sensitive method of isolating S.typhi. It is positive in 80-85% of patients even in patients who have taken antibiotics for several days.
  • Stool cultures are positive only in 30% of patients and the sensitivity depends upon the amount of stool cultured and the positivity rate increases with duration of illness.
  • Widal test: Widal test detects agglutinating antibodies to O and H antigens of S. typhi. A 4-fold rise in titer of paired sera is a good criterion but clinical usefulness is doubtful.
  • Vi agglutination has been used to screen for S.typhi carriers. It has a sensitivity of 70-80%, with a specificity of 80-95%.
  Medicolegal Update

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

What are the factors governing the maximum range of tattooing?

The larger the caliber the greater the distance to which the powder is discharged

In a firearm missile wound, the amount of tattooing and the maximum distance to which the powder particles can be discharged depend upon the barrel length and the nature of the cartridge, both in its caliber and in its power load. I have seen during postmortem examination of a fire arm missile victim that the larger the caliber, the greater the distance to which the powder is discharged. Tests to determine the maximum possible distance to which the powder particles can be discharged are done by ballistic experts, not doctors in all cases where it is important to ascertain the range of fire with the weapon used at the crime and with similar ammunition. The range of fire of a firearm cannot be scientifically determined in cases where the weapon is discharged beyond the range of powder grain deposit.

  Medi Finance Update

What is advance tax, when is it paid?

Ans. Advance tax is based on the concept of pay as you earn. Therefore, the entire amount of tax is to be paid in advance before the end of previous year. It is paid as per the schedule prescribed in the Act.

  Drug Update

Drugs prohibited for manufacture, sale and distribution from subsequent date

Drug Formulation

Effective date


Fixed dose combination of haemoglobin in any form (natural or synthetic).

Sep 1,2000

GSR 814(E)

  Lab Update

Variations in platelet count

Variation of the platelet count in a given individual is limited; differences in the absolute platelet count > 70 to 90,000/microL will occur by chance less than 1 percent of the time.
Even if the patient’s platelet count is within the normal range, if the count has recently fallen ≥50% from a prior value, this should immediately raise the possibility of heparin–induced thrombocytopenia in any patient begun on heparin therapy within the preceding 5 to 10 days. If confirmed, this constitutes a medical emergency, requiring appropriate urgent action.

  IJCP Special

Dr Good Dr Bad

Situation: A migraine patient was put on Valproate.
Dr.Bad: It is a anti fit medicine not required for migraine.
Dr.Good: It is used to prevent migraine.
Lesson: Two anti–seizure medications, valproate and topiramate, are sometimes used to prevent migraines.

Make Sure

Situation: A patient with dengue developed severe reaction with platelet transfusion.
Reaction: Oh my God! Why were platelets transfused?
Lesson: Make sure no platelets are transfused unless there is active bleeding or the platelets are less than 10000.

Quote of the Day

"The greed of gain has no time or limit to its capaciousness. Its one object is to produce and consume. It has pity neither for beautiful nature nor for living human beings. It is ruthlessly ready without a moment’s hesitation to crush beauty and life out of them, molding them into money." - Rabindranath Tagore
(Contributed by Dr.G.M.Singh)

Hypertension Alert

Very high BP

  1. Severe hypertension (systolic upper blood pressure ≥180 mmHg or diastolic lower blood pressure ≥120 mmHg), with no acute signs of end–organ damage, is often called hypertensive urgency.
  2. If there are signs or symptoms of acute end–organ damage, the condition is considered a hypertensive emergency and is treated more aggressively.
  Mind Teaser

Read this…………………

What is black when you buy it, red when you use it, and gray when you throw it away?
(Contributed by Dr. Jagjit Singh)

The answer for yesterday’s Mind Teaser: "The third. Lions that haven’t eaten in three years are dead."

Correct answers received from: Dr Muthumperumal Thirumalpillai, Dr.G.Padmanabhan, Dr Rawat Purushottam Singh, Dr Sandeep Singh, Dr K Mohan, Dr Chandresh Jardosh, DR  NP SINGH(Nanu), Dr. Anjani, Dr.K.V.Sarma, Dr. Susheela Gupta, Dr. Deepankar Sakhuja,Dr.A.K.Saxena, Dr.Satish Gunawant, Dr. Dinesh Kumar S, Dr Meera Malik, Dr.Harimohan Goel, Dr. Anupam Sethi Malhotra, Dr. Rohini, Dr.S.K.Bansal, Dr.G.Padmanabhan, Dr Rajiv Khosla

Answer for 9th September Puzzle is: Scrambled eggs

Correct answers received from: Dr Anurag Jain, Dr. Rohini, Dr Muthumperumal Thirumalpillai
Send your answer to ijcp12@gmail.com

  Humor Section

The Polish Divorce
A Polish man moved to the USA and married an American girl. Although his English was far from perfect, they got along very well.
One day he rushed into a lawyer’s office and asked him if he could arrange a divorce for him.
The lawyer said that getting a divorce would depend on the circumstances, and asked him the following questions:
Have you any grounds? Yes, an acre and half and nice little home.
No, I mean what is the foundation of this case? It made of concrete.
I don’t think you understand. Does either of you have a real grudge?
No, we have carport, and not need one. I mean what are your relations like?
All my relations still in Poland.
Is there any infidelity in your marriage?
We have hi-fidelity stereo and good DVD player.
Does your wife beat you up?
No, I always up before her.
Is your wife a nagger?
No, she white.
Why do you want this divorce?
She going to kill me.
What makes you think that?
I got proof.
What kind of proof?
She going to poison me.
She buy a bottle at drugstore and put on shelf in bathroom.
I can read, and it say:
~~~Polish Remover~~~
(Contributed by Dr Chandresh Jardosh)

Funny But True Fact
Committee: Individuals who can do nothing individually and sit to decide that nothing can be done together.
(Contributed by Dr Chandresh Jardosh)

  An Inspirational Story

Why Mothers Cry…

"Why are you crying?" he asked his mom. "Because I’m a mother," she told him. "I don’t understand," he said. His mom just hugged him and said, "You never will!" Later the little boy asked his father why Mother seemed to cry for no reason. "All mothers cry for no reason," was all his dad could say.

The little boy grew up and became a man, still wondering why mothers cry. So he finally put in a call to God and when God got on the phone the man said, "God, why do mothers cry so easily." God said, "You see son, when I made mothers they had to be special. I made their shoulders strong enough to carry the weight of the world, yet gentle enough to give comfort. I gave them an inner strength to endure childbirth and the rejection that many times come from their children.

"I gave them a hardiness that allows them to keep going when everyone else gives up, and to take care of their families through sickness and fatigue without complaining. "I gave them the sensitivity to love their children under all circumstances, even when their child has hurt them very badly. This same sensitivity helps them to make a child’s boo–boo feel better and helps them share a teenager’s anxieties and fears.
"I gave them a tear to shed. It’s theirs exclusively to use whenever it’s needed. It’s their only weakness.

  Readers Responses
  1. Dearest Brother KK, Thanks a ton for making my morning full of love, knowledge, committment to profession and country......We all STAND LIKE ROCKS behind you in any endeavours of life...Please count me as ONE OF YOUR MILLION SUPPORTERS for IMA.
    Krishna will once again deliver the Gita Gospel to the world.....from land of UK.......but you left your Arjuna back home......Regards Dr. N. K. Bhatia
  Public Forum

(Press Release for use by the newspapers)

Second attack of dengue is more dangerous

If you have suffered from dengue last year, you need to be more careful as the second attack of dengue may be more dangerous than the first attack. This was stated by Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India, BSNL Dil Ka Darbar & MTNL Perfect Health Mela.

Giving the details, Dr. Aggarwal said that there are four different types of dengue and one can, therefore, suffer with dengue four times in his or her lifetime. Subsequent dengue infections are always more serious and are more likely to end up with deadly combinations.

Dr. Aggarwal said that a person with dengue can also simultaneously suffer from malaria. Malaria and dengue together can lower platelet counts to a dangerous level leading to complications.

In a dengue season nobody should take aspirin for fever as it can precipitate bleeding, he added.
In dengue most complications occur within two days of subsiding of fever and most people are careless during this period. Any type of abdominal pain, giddiness or weakness after the fever has subsided should be attended to, by a doctor. Dengue complications during this period are due to shift of blood volume and patient requires rapid infusion of oral or intravenous fluids in large quantity. Dr. Aggarwal said that there is no need for giving platelets even if the count is as low as 10000 unless there is an associated bleeding.

  Conference Calendar

40th Annual Conference of the German Society of Immunologie

Date: September 16–17, 2010
Venue: Shanghai Marriott Hotel Changfeng Park, Shanghai, China

  Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

26th September: Sunday–BSNL Dil ka Darbar A daylong interaction with top cardiologists of the city. 8 AM  5 PM at MAMC Auditorium, Delhi Gate.

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

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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