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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

  Editorial …

12th April, 2011, Tuesday                                eMedinewS Present Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Will Anna Hazare’s hunger strike open the door for other groups to "blackmail" the government?

No. It was Anna who was successful. If a politician had called for this type of dharna, the same could not have been successful. I found the explanation for this in a story mentioned by Dhananjay Mahapatra in TOI. He wrote:

"Why did Anna’s crusade against corruption carry so much weight? Why did it attract so much support in such a short span? In the past, we have seen much weightier politicians wearing the Gandhi cap and attired in khadi exhorting larger audiences to declare war against corruption. Why did the politicians fail to stir even those present in the rally ground? A small story could prove why Anna succeeded while the politicians failed.

With peace and prosperity reigning in a small, beautiful kingdom, the king’s very able prime minister sought six month leave to spend time with his guru. "Why six months? What do you plan to do," asked the king. The minister’s answer that he wanted to learn the Gayatri mantra left the king puzzled. The king knew it was a simple mantra. Asking the minister to meet him the next day to discuss leave, he sent for the head priest and learnt the mantra by heart. Next day, when the minister presented himself, the king recited the mantra twice over, looked triumphantly at the minister and said, "For this, you wanted to take leave for six months? Were you joking yesterday? I learnt it in just in two minutes."

Without blinking, the minister said, "You recited it alright but there is no authority, moral force or legitimacy of command in the recitation." The king was furious at being challenged. He thought old age was making the minister a little senile. A mantra is a mantra, he thought and asked the minister to prove that mantra recitation needed some kind of authority. The minister called a servant and ordered, "Tie the king up." The servant was shell–shocked and did not even move. The king was now convinced that the minister had gone mad. In rage, he ordered the servant to tie up the minister. The servant immediately tied up the minister.

The arrested minister laughed. A surprised king demanded an explanation. He said, "Both of us gave the same order. But the servant only complied with your order because there was authority and legitimacy in your command." Realisation dawned on the king who embraced the minister and sent him on leave to learn the mantra. Legitimacy is the reason why people, who ridicule the politicians’ call to fight against corruption, flocked to Anna in droves across the country."

To conclude, who leads the campaign is always important. If we ourselves smoke and tell our patients not to smoke, will they listen to us? If we ourselves give and take cuts and commissions in our profession and then talk about anti corruption measures, will anybody join our movement?

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
Krishan Kumar Aggarwal Dr k k Aggarwal on Facebook
  eMedinewS Audio PostCard

HIV Update

Dr Nalin Nag Speaks on
‘Diagnosis of HIV infection’

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

8th Vishwa Dharma Sammelan

Dr SY Quaraishi, Chief Election Commissioner of India was the Chief Guest at the recently concluded 8th Vishwa Dharma Sammelan. In the Photo: Dr Quaraishi being welcomed on the dais.

Dr K K Aggarwal
    National News

eMedinewS: Make Our Profession Corruption Free movement

From today onwards eMedinewS will have a debate on anti corruption measures and will be the voice of the people. You can share your views with each other on this subject.

Govt. acting on the Anna’s demand is not the end but a beginning? If we want a corruption free medical profession it is obligatory for us to take an oath that

  1. We will not pay and take commissions.
  2. We will not a have a nexus with pharma companies.
  3. We will not have a nexus with chemists.
  4. We will not give false certificates.
  5. We will not over bill the patients.
  6. If we do not accept gifts and commissions, the pharma companies and the corporate houses cannot be corrupt.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

Number of diabetes cases in US is growing drastically

A new statement released by the CDC declares that "nearly 26 million Americans now have type 2 diabetes," which is equal to a staggering 9% increase over the past two years. Another estimated 80 million Americans have higher than normal blood sugar, which is considered a medical condition called "pre–diabetes." If left untreated, pre–diabetes is likely to turn into diabetes. Furthermore, it is estimated that 7 million Americans already have type 2 diabetes and are unaware of their condition, thus making their disease worse by leaving it untreated and not making the necessary lifestyle adjustments, such as exercising regularly. In its statement, the CDC also explains that with the increased incidence of diabetes, its costs have risen to an all–time high of $175 billion each year. In light of these rising costs, federal officials are urging Americans to exercise regularly to prevent the onset of the disease, as exercise and a healthy diet are the two key elements needed to defend against diabetes.

(Dr Monica and Brahm Vasudev)

Patients with type 2 diabetes with NSTE–ACS appear to have antiplatelet–resistant thrombi

According to research presented at a UK diabetes conference, patients with type 2 diabetes have a greater thrombus burden after experiencing non–ST elevation acute coronary syndrome (NSTE–ACS) than nondiabetics.

hsCRP may differentiate HNF1A–MODY from type 2 diabetes

According to research presented at a UK diabetes conference, patients with maturity onset diabetes of the young, resulting from HNF1A mutations (HNF1A–MODY), have lower levels of high–sensitivity C–reactive protein (hsCRP) than patients with other forms of diabetes.

Scientists pinpoint mitochondrial mutation associated with essential hypertension

A single–letter change in DNA passed on only by women appears to be responsible for essential hypertension in a Chinese family, according to a study in Circulation Research.

    IJCP Special

Dr Good Dr Bad

Situation: A vivax malaria came with high fever.
Dr Bad: Start artesunate.
Dr Good: Start chloroquine.
Lesson: Vivax is mostly sensitive to chloroquine

Make Sure

Situation: A patient with acute chest pain died before reaching the hospital.
Reaction: Oh my God! Why was water–soluble aspirin not given?
Lesson: Make sure that at the onset of acute heart attack and chest pain, water – soluble aspirin is chewed to reduce chances of sudden death.

    An Inspirational Story

(Dr Prachi Garg)

Formula for Success

The more desire you have to improve some part of yourself, the more successful you’ll become.

After every basketball game, a high school basketball coach watches the videotape and analyzes what the team did so he can reinforce the things the team did well and suggest ways to improve the things they didn’t do well. Just as the coach reviews the team’s performance after every game so he can suggest ways to keep them in the win column, you should review your performance at work and develop a winning game plan. Actually, you can use the same strategy as the high school basketball coach. Here’s the coach’s winning formula:

Goals: First and foremost, you have to know what you’re shooting for. In the team’s case, it’s to win. What are your goals at work? To be the best in your area or department? To get a promotion? To reduce the number of errors in your department? To increase productivity?

Skills: Once you have a goal, you must have the skills to be able to reach your goal. If you don’t have them, you have to acquire them. If you want to be a computer programmer, for instance, then you must learn the language. Whatever you decide you want to do, you must learn and develop the skills necessary to put in a top performance every day.

Execution: Now, just having the skills doesn’t mean you can use them well. You must be able to perform them to perfection. That means practice, practice, practice.

Support: We all need to work together to reach our goals. No one member of the basketball team can win the game alone. Players need one another and rely on one another to get the job done. The same applies at work (and at home and school too).

Leadership: The team has a captain or co captains –– leaders –– to ensure the team executes the coach’s game plan. Companies need leaders who direct their efforts toward profitable endeavors.

Desire: Last, but by far not least, you must have the burning desire to reach your goal –– whatever that goal may be. You can possess the sharpest skills, execute them perfectly, and have the most support and the best leadership –– but if you don’t care, chances are good you’ll still fall short. You must WANT it. And that’s what it takes to win. You can have anything you want if you want it desperately enough.

    Infertility Update

(Dr. Kaberi Banerjee, Director Precious Baby Foundation)

If I conceive by IVF, will my baby be normal?

Studies have shown that there is no increased risk of abnormality in IVF conceived babies compared to those conceived naturally.

    Hepatology Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

What is the current status of Penicillamine and Trientine in the treatment of Wilson’s disease?

Penicillamine and Trientine since long have been regarded as the mainstay of treatment in Wilson’s disease and yet while the current guidelines recommend the use of chelating agents (D–penicillamine, trientine) as first–line therapy of symptomatic patients, optimal treatment regimens are yet to be established. In the data published by European Association for the Study of the Liver on March 31, 2011, a retrospective multicenter cohort study on the long–term outcomes of treatment with D–penicillamine and trientine were reviewed in 347 patients with Wilson’s disease. At an average follow–up period of 16.5 years, both treatments provided a similar and excellent survival rate and prevented disease progression with the need for liver transplantation in over 98% of patients, thereby emphasizing the role of the chelation therapy in improving the long term prognosis and also avoiding liver transplantation.

    Medicolegal Update

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

How will a doctor judge/assess the decision–making capacity of patient?

Competent patients have the exclusive right to refuse medical care.

  • The patient’s right to refuse care is determinative even in cases where the patient’s wishes may conflict with those of his/her family or legal agency.
  • Decisions become more difficult when patients have some cognitive impairment, such as moderate Alzheimer’s disease, senile dementia. In such situation, the first step is to try to determine if the patient is able to make decisions for himself or herself. If not, the next step would be to determine whether they have made any previous instructions for their care.
  • Mental competence is a legal term and must be determined by a judge and not doctor after a thorough medical examination report and relates to whether individuals have the legal right to make their own decisions and whether others should respect the decisions they make.
  • Mental capacity is the clinical cousin to the legal term competence. A patient may have the capacity to express their values and preferences and make decisions regarding treatment even if they are unable to carry out other functions of higher reasoning such as balancing their money/property or living independently.
  • On the other hand, a patient without capacity may seem intact in superficial conversation but be unable to make decisions regarding their medical care on their own preferences and values. Capacity does not require a formal legal determination or psychiatric/medical evaluation but can be done by clinicians.
    Legal Question of the Day

(Dr. M C Gupta)

Q. I am an MBBS planning to get MD (Medicine) degree from the American Institute of Medicine, University of Seychelles (www.usaim.edu). It is not recognized by the MCI. I do not want any job. I plan to have my own nursing home and treat my own patients. Am I likely to face any legal problems?

Ans. The plain answer is, YES.

  • You cannot claim to be an MD in medicine if the MD degree is not recognised by the MCI.
  • If you practice as an MD in medicine without having a valid MD degree, you will be liable under a variety of laws. You are advised not to allow yourself to fall into this trap.
    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

How is the metabolic syndrome diagnosed?

There are no well–accepted criteria for diagnosing the metabolic syndrome. The criteria proposed by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), with minor modifications, are currently recommended and widely used. The American Heart Association (AHA) and the National Heart, Lung, and Blood Institute recommend that the metabolic syndrome be identified as the presence of three or more of these components:

  • Elevated waist circumference: ≥ 40 inches (102 cm) in men, ≥35 inches (88 cm) in women.
  • Elevated triglycerides: ≥150 mg/dL
  • Elevated blood pressure: ≥ 130/85 mm Hg
  • Elevated fasting glucose: ≥ 100 mg/dL
    Mind Teaser

Read this…………………

sweet sweet
be be
gotten gotten gotten gotten

Yesterday’s eQuiz: Varieties of HIV that are resistant to the drug 3TC______.
A. Developed in response to the use of 3TC.
B. Already existed in the population before 3TC was developed.
C. Always have an advantage in every environment.
D. Were strongly selected for as 3TC became widely used to treat HIV.
E. Drug resistance spreads through a population because it already existed in the population before 3TC was developed AND because it was strongly selected for as 3TC became widely used to treat HIV.

Answer for Yesterday’s eQuiz: E

Correct answers received from: Dr Prabha Luhadia, Dr Chandresh Jardosh, Dr Anil Bairaria, Dr Muthumperumal Thirumalpillai

Answer for 10th April Mind Teaser: 3 cubes
Correct answers received from: Dr S.Upadhyaya, Dr Madhu Sinha, Dr Rakesh Malhotra, Dr Amol R Hartalkar, Dr K P Rajalakshmi, Dr KV Sarma, Dr Amit Kochar.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr. Veena Aggarwal)

A candidate’s job application: "This has reference to your advertisement calling for a ‘Typist and an Accountant – Male or Female’… As I am both for the past several years and I can handle both with good experience, I am applying for the post.&h

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Vitamin B1, Plasma

Thiamine, or thiamin, sometimes called aneurin, is a water–soluble vitamin of the B complex (vitamin B1), whose phosphate derivatives are involved in many cellular processes. The best characterized form is thiamine diphosphate (ThDP), a coenzyme in the catabolism of sugars and amino acids.

  • Thiamine deficiency can lead to myriad problems including neurodegeneration, wasting and death.
  • A lack of thiamine can be caused by malnutrition, a diet high in thiaminase–rich foods (raw freshwater fish, raw shellfish, ferns) and/or foods high in anti–thiamine factors (tea, coffee, betel nuts) and by grossly impaired nutritional status associated with chronic diseases, such as alcoholism, gastrointestinal diseases, HIV–AIDS, and persistent vomiting.
    Medi Finance Update

(Dr GM Singh)

Myth 2: Funds with highest *Star Ratings* or Rankings make better buys

Beware! While you may be tempted to invest your hard earned money in that 5–Star (*****) Fund, let us throw some light on what could be the consequences of doing the same. Before you jump to any erroneous conclusions, a clarification is in order. We are not referring here to Astrology, nor does reading horoscopes feature on our agenda. In fact the stars we are speaking about aren’t even celestial bodies. Instead, they denote rankings and ratings by various agencies/publications to Mutual Fund Schemes.

It is common place for Fund Houses to flaunt the number of *stars* /points their funds have garnered. In turn, the same is utilized by distributors and agents alike, to convince you about the merits of the fund. There is nothing wrong with the idea of granting rankings/star ratings to Mutual Funds. However, you should not completely depend on them.

    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
DCI Approval Date
Irsogladine Maleate Tablet 2mg/4mg
For gastric ulcers, improvement of gastric mucosal lesion (erosion, hemorrhage, redness and edema) caused by acute gastritis and acute exacerbation stage of chronic gastritis.
    IMSA Update

International Medical Science Academy (IMSA) Update

Clinical and prognostic subforms of new daily–persistent headache

Clinical and laboratory features used to assess neurologic prognosis after cardiac arrest may not be reliable in early evaluations in the setting of induced hypothermia therapy. (Ann Neurol 2010; 67:301, Neurology 2010;74:965).

  Quote of the Day

(Dr GM Singh)

Happiness is the meaning and the purpose of life, the whole aim and end of human existence. Aristotle

    Readers Responses
  1. Dear Editor, I enjoyed the "Set deadlines" by Dr Prachi Garg. In fact I have been exactly following these rules for the last 32 years and teaching the same to my children, students and friends. This is why I have been able to achieve a lot and continuing to achieve in my field and so are many around me who willingly accept these rules. Hats off to Dr. Garg for sharing openly with others. Regards C.Vaishnavi
  2. Dear Dr. Aggarwal, I admire you for your multiple achievements, the latest being the emedinews Daily. It is heartening to note that you are not averse to refer to Ayurvedic concepts. I was unable to understand the following statement in editorial (7th April) – "Coconut water is a treatment for humidity". I shall be grateful for elucidation. Dr M C Gupta

    eMedinewS Responds: Coconut water is given as a prescription for summer dehydration. There is a concept of heat index. Even if the outside temperature is low but humidity is high, dehydration and heat disorders can set in. In coastal areas, heat strokes can occur even at relatively low temperature as humidity is high. Drinking coconut water in these areas can prevent it. Nature probably has grown coconut in costal areas for this reason.
    Public Forum

(Press Release for use by the newspapers)

Why are the commercial and foods cooked by halwais tasty ?

Foods cooked in hydrogenated oils containing trans fatty acids are tastier than foods cooked in plant oils. Hydrogenation also increases their shelf life. Most hydrogenated oils involve hydrogenation of palm oils.

French fries, microwave popcorns and food cooked by traditional halwais are full of hydrogenated trans fatty acids and have different tastes than food cooked at home in plant oils.

The recommended intake of trans fatty acids is less than 5 gm, said Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal and President, Heart Care Foundation of India. Per serving 5 grams of trans fatty acids is present in French fries, 6 gm in breaded fish burger, 5 gm in breaded chicken nuggets, 2 gm in biscuits, 2.7 gm in margarine, 2 gm in cakes, 1.6 gm in corn chips, 1.2 gm in popcorn microwave and 1.1 gm in pizza.

Just about 2.6 gm a day of trans fats (half as much contained in a packet of French fries) can raise the risk of heart disease significantly.

Traditional Indian food of old Delhi has high trans fatty acid content; 4 gm of trans fatty acid is present in one parantha, 3.4 gm in one poori, 5.2 gm in one bhatura, 1.7 gm in one dosa, 6.1 gm in one tikki, 3 gm in one samosa, 2 gm in one serving of pakoda, 2.9 gm in one serving of vegetable pulao and 3.6 gm in one serving of halwa.

    eMedinewS Special

1. eMedinewS audio lectures (This may take a few minutes to open)

2. eMedinewS ebooks (This may take a few minutes to open)

Activities eBooks


  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein
  How to Use PesticidesSafely
  Towards Well Being
    Forthcoming Events

April 16–17, 2011, National Conference on Gynae–Endocrinology–2011 under aegis of FOGSI, ICOG and AOGD, Focus on newer advances in management of endocrinal problems in gynaecology with emphasis on PCOS, hyperprolactinemia, amenorrhoea, hormonal contraception. Gyne– endocrinology is a topic of high importance especially for practitioner. Detailed programme http://www.aiims.edu and http://www.aiims.ac.in
For details please contact: Prof Alka Kriplani, Organizing Chairperson, 9810828717 kriplanialka@gmail.com/Dr Nutan Agarwal, organizing Secretary, 9810107464/9868397310 nutan.agarwal1@gmail.com


May 7–8, 2011, National Seminar On Stress Prevention
A Stress Prevention Residential Seminar cum spiritual retreat with Dr KK Aggarwal and Experts from Brahma Kumaris.
Co–organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, IMA New Delhi Branch and IMA Janak Puri Branch, IMSA (Delhi Chapter)
Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.
Timings: Saturday 7th May (2 pm onwards) and Sunday 8th May (7 am–4 pm). There will be no registration charges, limited rooms, kindly book in advance; stay and food (satvik) will be provided. Voluntary contributions welcome. For booking e–mail and SMS to Dr KK Aggarwal: 9899974439, emedinews@gmail.com, rekhapapola@gmail.com; BK Sapna: 9811796962, bksapna@hotmail.com


September 30 – October 02, 2011; XVIth World Congress on Cardiology, Echocardiography & Allied Imaging Techniques Venue: The Leela Kempinski, Delhi (NCR), September 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
Highlights of Pre – Conference CME: Case based learning experience & audience interaction, Maximum 250 delegates for CME will be accepted, who will be divided in 5 batches and will rotate to different halls every 90 minutes. The topics are:(A) Right heart pressures & functions (From basics to newer methods (RV anatomy, echo views, echo assessment of RV function, prognostic impact of RV function) (B) Carotid Doppler: How do i assess and interpret in my daily practice.: Technical tips (Anatomy of the vessel, views of ultrasound scanning, Normal & abnormal Doppler hemodynamics, how to measure IMT) (C) Valvular stenosis: Assessment, limitations and their solution: (Anatomy of the valves, 2–D findings of stenotic lesions, quantitation of lesion, limitations) (D) How do I assess and report ventricular dyssynchrony in my lab. (What is ventricular dyssynchrony, what are the types of dyssynchrony, in whom, when & why do we assess it, various echo methods to assess it ) (E) Live 3–D Echo: Protocol for acquisition. How to slice and get full information. Aim is that by end of the day, every participant is well conversant with all the topics
Dr (Col) S.K. Parashar, President, e–mail: drparashar@yahoo.com, Mob:09810146231/Dr Rakesh Gupta, Secretary General, email:jrop2001@yahoo.com, Mob:09811013246
worldcon2011@in.kyoni.com, www.worldcon2011.org


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    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 Naveen Dang, Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta