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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 & 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 7 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 …

11th October 2012, Thursday

Pharma gift ban

What gifts can doctors accept from drug companies--and what drug companies should be allowed to offer is a matter of recent debate all across the globe.


  1. Congress uncovered big payments to academic researchers.
  2. Medical students lobbied against pharma giveaways.
  3. Drug makers started disclosing their gifts to doctors and financial relationships with them (often because government settlements required them to).
  4. Government settlements often covered allegations of kickbacks, junkets, and other inducements to sway physicians toward off-label prescribing.

Massachusetts gift ban

  1. Citing fears that pharma was unduly influencing doctors, the state's legislature outlawed drug company gifts completely and imposed fines of up to $5,000.
  2. Restaurants that had hosted pharma dinners lamented lost sales.
  3. Hotels and visitors' bureaus said the ban would keep conventions away.
  4. And at pharma confabs everywhere, drug company booths displayed signs warning Massachusetts doctors away from free coffee and ballpoint pens.

What may be allowed?

  1. Allowing drug makers to pay for "modest" meals as part of product-information sessions would be a "narrow change" to the law--and necessary for companies to educate docs about new drugs.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Carnitine Update

Carnitine in Cardiomyopathy


  • Deficiencies in thiamine, selenium and L-carnitine have been reported to produce heart failure and replacement therapy results in improvement in cardiac function.
  • Carnitine deficiency impairs the oxidation of fatty acids, resulting in lipid accumulation in the myocyte cytoplasm. This problem is reversed with L-carnitine replacement.

What is the clinical course of dilated cardiomyopathy?

The clinical course of dilated cardiomyopathy is largely unpredictable. The disease-independent predictors of survival are New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF) and maximal oxygen consumption (peak VO2). These prognostic determinants assume that the cause of the myocardial dysfunction cannot be treated.

For Comments and archives…

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

FDA warning - Test kidney function before prescribing zoledronic acid

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela to train 10,000 people in compression only CPR

Addressing a press conference, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that focus of the Mela this year will be “Prevention of Non-Communicable Diseases” and “Revival of Heart After Death.”

Dr K K Aggarwal
    National News

Pvt hospitals to be issued guidelines for reporting dengue cases

A day after his meeting with Union Health Minister Ghulam Nabi Azad, to review the situation of monsoon diseases, Delhi Health Minister Dr A K Walia said advisories will be issued to private hospitals to ensure a more accurate system for reporting dengue cases. Dr Walia said, “We find that private hospitals are not following the Government of India guidelines properly since they are still reporting suspected cases, which gives us an inflated picture of the spread of the disease. We have issued them an advisory stipulating the exact tests which need to be performed before reporting cases.” Dr Walia said proper reporting from the 300-odd private hospitals and diagnostic centres in the city will also give a correct picture about zonal variations of the disease. “We cannot have a complete idea about where the viral disease is concentrated without participation from the private sector, since they get a huge volume of patients,” a senior health department official said. Currently, there are only 34-odd government centres, which provide the testing facility. The possibility of increasing the number of government testing units was also discussed in Monday’s meeting with the Union Health Minister, but sources said since all central and state government hospitals and civic hospitals were providing the free testing facility, there was little possibility of increasing this number further. On Tuesday, an advisory was also issued to the Department of Education, to spread awareness among schoolchildren. It highlighted steps to be taken to prevent them from contracting monsoon diseases. Thirty people tested positive for dengue on Tuesday, taking the total dengue count to 263. The North Municipal Corporation with 109 cases leads the corporations, followed by the South Corporation with 98 cases. The East Corporation has reported 38 cases, while five patients have tested positive from the NDMC area. (Source: The Indian Express, Oct 10 2012)

For comments and archives

My Profession My Concern

Quality Control

What are the types of pneumonia?

  • Hospital-acquired (or nosocomial) pneumonia (HAP) is pneumonia that occurs 48 hours or more after admission and did not appear to be incubating at the time of admission.
  • Ventilator-associated pneumonia (VAP) is a type of HAP that develops more than 48 to 72 hours after endotracheal intubation.
  • Healthcare-associated pneumonia (HCAP) is defined as pneumonia that occurs in a non-hospitalized patient with extensive healthcare contact, as defined by one or more of the following:
    • Intravenous therapy, wound care, or intravenous chemotherapy within the prior 30 days
    • Residence in a nursing home or other long-term care facility
    • Hospitalization in an acute care hospital for two or more days within the prior 90 days
    • Attendance at a hospital or hemodialysis clinic within the prior 30 days

For comments and archives

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

Preventing valvular endocarditis

It is reasonable to prescribe antimicrobial prophylaxis for patients with the highest risk medical conditions undergoing procedures likely to result in bacteremia with a microorganism that has the potential ability to cause bacterial endocarditis

(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)

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

2012 Nobel Prize for physics

The 2012 Nobel Prize for Physics has been awarded to French scientist Serge Haroche and American David Wineland for their work in quantum physics. According to the Royal Swedish Academy of Sciences, the work of these scientists has opened the door to a new era of experimentation with quantum physics by demonstrating the direct observation of individual quantum particles without destroying them.

For comments and archives

Gabapentin improves menopausal hot flashes, insomnia

Extended-release (ER) gabapentin (Serada, Depomed), an investigational nonhormonal drug, improves sleep and reduces hot flashes in menopausal women, according to a phase 3 clinical trial known as BREEZE 3. The results were presented here at the North American Menopause Society (NAMS) 23rd Annual Meeting. (Source: Medscape)

For comments and archives

COPD: Exposure to school-aged children may up cold severity

Exposure to school-age children doubles the odds that an individual with chronic obstructive pulmonary disease (COPD) who catches a cold will have symptoms such as runny nose, sore throat, and cough, according to a new study. The results of the study were published online September 21 in the Journal of Clinical Virology. The analysis of 1000 sputum and nasal samples from patients with chronic obstructive pulmonary disease also revealed that lung disease severity and virologic factors had no bearing on symptomatic rhinovirus illness. (Source: Medscape)

For comments and archives

Safety issues seen with fast-track drugs

About a quarter of new drugs introduced to the Canadian market over a 15-year period developed serious safety issues, a researcher said. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: How To Prevent Arthritis From Slowing You

@DeepakChopra: Is there a balance between self-care & self-centeredness? Watch the latest episode of #SpiritualSolutions http://tinyurl.com/8fp33mp

    Spiritual Update

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

Collective Consciousness

Consciousness is an energized field of information with powers to do everything in the universe. Collective consciousness is the internet of the collective souls of many people in a group.

Collective consciousness is the strongest superpower ever available in the universe. As per the Vedic texts whatever is the intent of collective consciousness will become a reality. Scientifically, collective consciousness is based on the principle of critical mass. Vedic literature has shown it to be one percent of the defined population under study.

For comments and archives

    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What is the outcome of an ectopic pregnancy?

There is an increased chance of being infertile after an ectopic pregnancy. In addition, the chance of having another ectopic pregnancy is increased. Since an ectopic pregnancy is often due to pre-existing tubal disease, and these patients are at an increased risk for infertility, many physicians may consider further evaluation in those women who want a future pregnancy. Physicians may recommend that women who have had multiple recurrent ectopic pregnancies undergo in vitro fertilization (IVF).

For comments and archives

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

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

Blood Donation - Gift of Liquid Love

The discovery of post transfusion Hepatitis in 1968 led to the mandatory testing of blood for Hepatitis B antigen (HbsAg).

For comments and archives

    Liver Abscess Update

(Dr Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation Medanta – The Medicity Hospital)

What investigations should be done for the aspirated material?

  • Gram stain, culture
  • E. histolytica trophozites (especially from the wall scrapings)
  • KOH smear, AFB (if suspected)

For comments and archives

    An Inspirational Story (Ms Ritu Sinha)

How big is one?

As a man walked a desolate beach one cold, gray morning he began to see another figure, far in the distance. Slowly the two approached each other, and he could make out a local native who kept leaning down, picking something up and throwing it out into the water. Time and again he hurled things into the ocean.

As the distance between them continued to narrow, the man could see that the native was picking up starfish that had been washed upon the beach and, one at a time, was throwing them back into the water. Puzzled, the man approached the native and asked what he was doing. “I’m throwing these starfish back into the ocean. You see its low tide right now and all of these starfish have been washed up onto the shore. If I don’t throw them back into the sea, they’ll die up here from lack of oxygen.”

“But there must be thousands of starfish on this beach,” the man replied. “You can’t possibly get to all of them. There are just too many. And this same thing is probably happening on hundreds of beaches all up and down this coast. Can’t you see that you can’t possibly make a difference?”

The local native smiled, bent down and picked up another starfish, and as he threw it back into the sea he replied, “Made a difference to that one!”

Each of us is but one person: limited, burdened with our own cares and responsibilities. We may feel there is so much to be done, and we have so little to give. We’re usually short of everything, especially time and money.

When we leave this shore, there will still be millions of starfish stranded on the beach. Maybe we can’t change the whole world, but there isn’t one of us who can’t help change one person’s whole world. One at a time. We can make a difference

For comments and archives

    Cardiology eMedinewS

Interval walking improves glycemic control in type 2 diabetes Read More

Tomatoes for stroke prevention? Read More

    Pediatric eMedinewS

Exercise boosts obese teens' mental health Read More

Best friend's mom is key to teen behavior Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with fever and low TSH had ESR > 100.
Dr Bad: It’s TB.
Dr Good: This is thyroiditis.
Lesson: Thyroiditis typically has very high ESR and low TSH.

For comments and archives

Make Sure

Situation: A patient was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA?
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2, an ongoing trial suggest that this intervention is much better than thrombolytic therapy in such patients.

For comments and archives

    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Creatinine clearance test

This test evaluates the rate and efficiency of kidney filtration. It is used to detect and diagnose kidney dysfunction and/or the presence of decreased blood flow to the kidneys.

In patients with known chronic kidney disease or congestive heart failure (which decreases the rate of blood flow), this test may be ordered to help monitor the progress of the disease and evaluate its severity.

  Quote of the Day (Dr GM Singh)

If we wait until our lives are free from sorrow or difficulty, then we wait forever. And miss the entire point. Dirk Benedict.

    Mind Teaser

Read this…………………

The nurse includes the important measures for stump care in the teaching plan for a client with an amputation. Which measure would be excluded from the teaching plan?

A. Wash, dry and inspect the stump daily.
B. Treat superficial abrasions and blisters promptly.
C. Apply a "shrinker" bandage with tighter arms around the proximal end of the affected limb.
D. Toughen the stump by pushing it against a progressively harder substance (e.g., pillow on a foot-stool).

Yesterday’s Mind Teaser: Which nursing diagnosis is of the highest priority when caring for a client with myasthenia gravis?

A. Pain
B. High risk for injury related to muscle weakness
C. Ineffective coping related to illness
D. Ineffective airway clearance related to muscle weakness

Answer for Yesterday’s Mind Teaser: D. Ineffective airway clearance related to muscle weakness

Correct answers received from: Prabha Sanghi, Dr Jainendra Upadhyay,
Dr PC Das, Dr (Maj. Gen.) Anil Bairaria, Raju Kuppusamy, Muthumperumal Thirumalpillai, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr Thakor Hitendrsinh G, YJ Vasavada, Drjella, Dr Avtar Krishan.

Answer for 9th October Mind Teaser: D. Encourage the client to speak at every possible opportunity.

Correct answers received from:
Dr Thakor Hitendrsinh G, Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

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central bank

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

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    Laugh a While (Dr GM Singh)

Benefits of exercise

  • If walking/cycling is good for your health, the postman would be immortal.
  • A whale swims all day, only eats fish, drinks water and is fat.
  • A rabbit runs and hops and only lives 15 years.
  • A tortoise doesn’t run, does nothing … yet lives for 450 years.
    Medicolegal Update

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

Medical Testimony of Doctor in the Court of law

A doctor should not be dogmatic about his opinion, and lawyers also should not expect him to be so. He should be reasonable in his opinions and should not overstate the likelihood of a relationship between cause and effect. The doctor should be ready to defend every finding and conclusion on the report on clinical and scientific grounds in the court of law. He should be aware of professional and scientific viewpoints which might differ from his, and should be familiar with the latest scientific literature in relation to the subject involved. For the purpose of illustrating and clarifying his testimony in the court of law, the medical expert may employ photographs, maps, diagrams, charts, X–rays, skeletons, models, slides, films, tapes, etc., when they are properly verified. The doctor should avoid talking too much, talking too soon, and talking to the wrong persons. Prejudicial and sensational statements should not be made prior to trial. Courts of law are open to the public and the junior doctors should attend the Courts, where they can follow the proceedings, hear the evidence given by their senior medical colleague as a witness, to familiarize themselves with the procedures of the court of law.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Depression linked to paralysis

Patients with depression are more likely to have paralysis (stroke) than mentally healthy people and their strokes are more likely to be fatal, according to a study published in the Journal of the American Medical Association, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

The researchers looked at data from 28 studies of more than 300,000 people. Over a follow-up period that ranged for two to 29 years, there were 8,478 strokes. Depression was associated with a 45 percent increased risk for stroke and a 55 percent raised risk for fatal stroke. Depression was linked to a 25 percent higher risk for ischemic stroke.

About 3.9% of stroke cases in the US could be attributable to depression.

    Readers Responses
  1. Hydrotherapy gives cooling effect on your skin You keep us healthy groin area .its help us keep heathy if you sit under water tub daily after bathing for 5 min only. it helps us healthy pelvic, genital, anus & urethra also.you prevent recurrent U.T.I, also. so I can say only your 5 mints likes tooth brush time you should give your body.its needs for your healthy future.you know better health is wealth. Dr neeraj gupta
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