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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 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 …

12th November 2012, Monday

Rhinitis medicamentosa

Topical vasoconstrictor decongestants include phenylephrine, oxymetazoline, xylometazoline, and naphazoline.

Nasal decongestant sprays are NOT recommended as monotherapy in chronic allergic rhinitis. Downregulation of the alpha-adrenergic receptor develops after 3-7 days and rebound nasal congestion results, ultimately resulting in a cycle of nasal congestion both caused by and temporarily relieved by the medication, leading to increasing use and eventual dependency.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Do not ignore chronic constipation

A study presented at the American College of Gastroenterology's (ACG) 77th Annual Scientific meeting in Las Vegas in October has observed that patients with chronic constipation may be at increased risk of developing colorectal cancer and benign neoplasms. The risk of developing colorectal cancer was found to be 1.78 times higher for patients with chronic constipation and the risk of developing benign neoplasms was 2.70 times higher.

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

Rhinitis medicamentosa

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Concluding day of MTNL Perfect Health Mela

On the concluding day of MTNL Perfect Health Mela being organised by Heart Care Foundation of India, India’s Home Minister Sh Sushil Shinde released the CPR 10 Mantra . Mr Shinde to the Mela Delegation led by Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, and President Heart Care Foundation of India said that CPR should be learned by everybody.

Dr K K Aggarwal
    National News

CPR 10

click for video

Special e-registry of diabetes patients from next year

MUMBAI: The BMC has decided to prepare a special online registry of diabetic patients in the city. Diabetes-related ailments claim about 1 million lives in the country every year, and experts say a better understanding of the prevalence would help design policies to curb it. The online registry will have all details of the patient like his history, diagnosis, name, age and the doctor who treated him. Additional municipal commissioner Manisha Mhaiskar said, "There is a need to keep track of diabetic patients in the city to facilitate their treatment. The online registry will have a database, including every detail of patient's disease history as well as medication. This will help both the patient and doctors for further treatment." The diabetes online registry will start from 2013. Special software will be developed for this, she added. The BMC, in co-ordination with the NGO Heal Foundation, will also make a film on the preventive aspects of diabetes. On Friday, the International Diabetes Federation announced that India will be its focus on prevention of diabetes. More importantly, childhood and adolescent obesity caused by Type-II diabetes will remain the focus this year. The Diabetic Association of India has started working with 10 city schools to sensitise them about better eating habits. (Source: TOI, Nov 10, 2012)

For comments and archives

My Profession My Concern

Include this in your practice

Pre-exposure prophylaxis against HIV

In addition to counseling about consistent condom use in all HIV-uninfected adults at high risk, and who are committed to drug adherence and close follow-up advise pre-exposure prophylaxis with tenofovir-emtricitabine. In July 2012, the US FDA approved the same. The risk reduction is 48 to 75 percent with daily use of tenofovir-emtricitabine compared with placebo.

For comments and archives

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

    Valvular Heart Disease Update

Echocardiographic screening of first degree relatives of patients with bicuspid aortic valve and a positive family history and in those with a dilated aorta is recommended.

(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)

Mitral valve fix during CABG may help

In patients with moderate ischemic mitral regurgitation who were scheduled to undergo bypass surgery, repairing the mitral valve during coronary artery bypass grafting (CABG) had some benefits, the randomized RIME trial showed. Preliminary results in March and final results were reported this week at the American Heart Association meeting in Los Angeles. (Source: Medpage Today)

For comments and archives

Steroid during heart surgery has no CV benefit

Giving high-dose dexamethasone as a prophylactic during heart surgery didn't reduce cardiovascular events, but it may diminish respiratory failure and infections, researchers found. (Source: Medpage Today)

For comments and archives

Long-acting insulins win FDA panel support

An FDA advisory committee voted 8-4 Thursday in favor of approval of a new ultra-long-acting insulin for type 1 and type 2 diabetes. But the Endocrinologic and Metabolic Drugs Advisory Committee also voted unanimously (12-0) in support of a cardiovascular outcomes trial for the product's two formulations, insulin degludec (Tresiba) and insulin degludec/aspart, (Ryzodeg), due to a potential signal in a meta-analysis of major trials conducted thus far. (Source: Medpage Today)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: PCI Often Done at Low-Volume Centers 25% of all percutaneous coronary intervention in the U.S. is performed at... http://fb.me/27eZAir3V

@DeepakChopra: You are capable of making a quantum leap in how you use your brain. http://tinyurl.com/adwt7hy

    Spiritual Update

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

Samudra Manthan: The Churning of the Ocean on Dhanteras

Many of us know the story of ‘Sagar Manthan’ or the churning of the ocean. The story goes like this.

Once Indra lost his kingdom due to the disrespect he showed to sage Durvasa. He approached Lord Vishnu who advised him to seek the help of the demons to churn the ocean of milk (Ksheer Sagar), so that he and Devas could partake the Amrita (ambrosia) which would make them immortal and help them regain their lost kingdom.

For comments and archives

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

What percentage IVF cycles gets cancelled prior to egg retrieval and why?

According to western figures 20% of cycles may be cancelled prior to egg retrieval. IVF cycles may be cancelled for a variety of reasons, usually due to an inadequate number of follicles developing. Cancellation rates due to low response to the ovulation drugs increase with a woman’s age, especially after age 35. a cycle may be cancelled to reduce the risk of ovarian hyperstimulation syndrome (OHSS). Treatment with a GnRH agonist or antagonist reduces the possibility of premature LH surges from the pituitary gland, and thereby reduces the risk of premature ovulation.

For comments and archives

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

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

Blood group antibodies

These are plasma proteins which are produced by the body as defense mechanism in response to exposure to a foreign antigen.

  • Primary response
    o the first time a person is exposed to a red cell antigen
    o slow response which takes 2 - 6 month
  • Secondary response
    o the second time a person is exposed to a red cell antigen
    o rapid response with large amount of antibody
    o binds to the corresponding antigens on red blood cells, which may cause destruction of the RBCs.
    o can only be recognized by their interaction with antigens
    o appear “naturally” e.g. anti-A and anti-B.
    o appear after exposure to incompatible blood e.g. anti-D and anti-K

For comments and archives

    An Inspirational Story (Ms Ritu Sinha)

The Pearls

The cheerful girl with bouncy golden curls was almost five. Waiting with her mother at the checkout stand, she saw them: a circle of glistening white pearls in a pink foil box. "Oh please, Mommy. Can I have them? Please, Mommy, please!"

Quickly the mother checked the back of the little foil box and then looked back into the pleading blue eyes of her little girl's upturned face. "A dollar ninety-five. That's almost $2.00. If you really want them, I'll think of some extra chores for you and in no time you can save enough money to buy them for yourself. Your birthday's only a week away and you might get another crisp dollar bill from Grandma."

As soon as Jenny got home, she emptied her penny bank and counted out 17 pennies. After dinner, she did more than her share of chores and she went to the neighbor and asked Mrs. McJames if she could pick dandelions for ten cents. On her birthday, Grandma did give her another new dollar bill and at last she had enough money to buy the necklace.

Jenny loved her pearls. They made her feel dressed up and grown up. She wore them everywhere-Sunday school, kindergarten, even to bed. The only time she took them off was when she went swimming or had a bubble bath. Mother said if they got wet, they might turn her neck green.

Jenny had a very loving daddy and every night when she was ready for bed, he would stop whatever he was doing and come upstairs to read her a story. One night when he finished the story, he asked Jenny, "Do you love me?"

"Oh yes, Daddy. You know that I love you."

"Then give me your pearls."

"Oh, Daddy, not my pearls. But you can have Princess - the white horse from my collection. The one with the pink tail. Remember, Daddy? The one you gave me. She's my favorite."

"That's okay, Honey. Daddy loves you. Good night." And he brushed her cheek with a kiss.

About a week later, after the story time, Jenny's daddy asked again, "Do you love me?"

"Daddy, you know I love you."

"Then give me your pearls."

"Oh Daddy, not my pearls. But you can have my baby doll. The brand new one I got for my birthday. She is so beautiful and you can have the yellow blanket that matches her sleeper."

"That's okay. Sleep well. God bless you, little one. Daddy loves you." And as always, he brushed her cheek with a gentle kiss. A few nights later when her daddy came in, Jenny was sitting on her bed with her legs crossed Indian-style.

As he came close, He noticed her chin was trembling and one silent tear rolled down her cheek. "What is it, Jenny? What's the matter?"

Jenny didn't say anything but lifted her little hand up to her daddy. And when she opened it, there was her little pearl necklace. With a little quiver, she finally said, "Here, Daddy. It's for you." With tears gathering in his own eyes, Jenny's kind daddy reached out with one hand to take the dime-store necklace, and with the other hand he reached into his pocket and pulled out a blue velvet case with a strand of genuine pearls and gave them to Jenny. He had had them all the time. He was just waiting for her to give up the dime-store stuff so he could give her genuine treasure.

So like our Heavenly Father. Wonder what we're hanging on to...

For comments and archives

  Cardiology eMedinewS

Cinacalcet Fails To Reduce Death Or Cardiovascular Events Read More

BLOCK-HF: Replace RV Pacing With Biv In AV-Block Heart Failure Read More

  Pediatric eMedinewS

Kids Allergic To Hen's Egg Tolerate Baked Egg Read More

Head-Shaking May Be Clue To Cerebellar Malformation Read More

    IJCP Special

Dr Good Dr Bad

Situation: An adolescent came with pre pubertal gynecomastia of more than six months duration.
Dr Bad: It’s normal.
Dr Good: This is persistent prepubertal gynecomastia.
Lesson: If the patient is an adolescent and has a normal general physical and genital examination, then it is quite likely that he has pubertal gynecomastia (seen in 25% cases). Re–evaluation at 6–monthly intervals will show whether the condition is persistent or not; improvement supports the initial impression of a pubertal cause.

For comments and archives

Make Sure

Situation: An adult undergoing bronchoscopic biopsy developed infective endocarditis.
Reaction: Oh my God! Why was IE prophylaxis not given?
Lesson: Make sure, that all procedures of the respiratory tract that involve incision or biopsy of the respiratory mucosa include IE prophylaxis.

For comments and archives

    Legal Question of the Day (Dr M C Gupta)

Q. What are your comments about the news that the Maharashtra govt. plans to slap murder charges for sex selection? I am against it because according to the MTP Act, abortion is a woman’s right. I fear that applying section 302 (IPC) would curtail women’s access to safe abortion services.


  1. It is true that the Maharashtra Health Minister, Mr Suresh Shetty, has stated that the Central Government should make applicable section 302, IPC, (murder charges) against woman, husband, relatives and the doctors for cases of “sex selection”.
  2. It is equally true that he does not know what he is talking. No offence under the PCPNDT Act can amount to murder.
  3. It is also true that no abortion in conformity with the MTP Act can amount to murder. MTP Act allows abortion only till 20 weeks pregnancy. The foetus is not a human being under the law at 20 weeks. Hence there is no question of murder.
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  Quote of the Day (Dr GM Singh)

It is wise to direct your anger towards problems – not people; to focus your energies on answers – not excuses. William Ward

    Mind Teaser

Read this…………………

What number comes next?
2, 2, 4, 12, 48, ___

Yesterday’s Mind Teaser: You have four chains. Each chain has three links in it. Although it is difficult to cut the links, you wish to make a single loop with all 12 links. What is the fewest number of cuts you must make to accomplish this task?

Answer for Yesterday’s Mind Teaser: 3 cuts. Cut each link in one chain. Separate them, and use the links to join the ends of the 3 intact chains.

Correct answers received from: Dr Kanta Jain,Dr. P. C. Das,BARBARA GUNTHER, Dr Chandresh  Jardosh, Dr Avtar Krishan, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai

Answer for 10th November Mind Teaser: C. Hangs the bag on a clothes hook on the bathroom door during fluid insertion
Correct answers received from: Dr Avtar Krishan, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

The reluctant spender

After being away on business, Tim thought it would be nice to bring his wife a little gift. "How about some perfume?" he asked the cosmetics clerk. She showed him a Rs 50.00 bottle. "That’s a bit much," said Tim, so she returned with a smaller bottle for Rs 30.00.

"That’s still quite a bit," Tim complained. Growing annoyed, the clerk brought out a tiny Rs 15.00 bottle.

"What I mean," said Tim, "is I’d like to see something really cheap."

So the clerk handed him a mirror.

    Medicolegal Update

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

Doctor is neither a detective nor a curtain between injured/sick alleged criminal and police or judiciary.

  • The primary and absolutely transparent duty of a doctor/hospital is to provide medical services to sick and injured patient may be an alleged criminal to save his health/limb and life without any discrimination.
  • When the medical care records is required for judicial/police investigation the records becomes medico–legal in nature and the same may be required to testify under oath in the court of law by treating doctor.
  • The doctor should acquire the habit of making a careful note of all the facts observed by him with exact time and date.
  • The doctor should examine the facts which come to his knowledge in his special medical man capacity, draw his conclusions logically and correctly after a detailed consideration of the pros and cons of the case, and elaborate in the Court that interpretation, along with the medical grounds on which it is based.
  • Presumption is not proof, and conjecture is not evidence. The Court has no special medical knowledge. It relies on medical witness for an opinion and expects him to assist it with his special knowledge and experience in perusal of truth.
  • Presumption, assumption hypothesis, and mere conclusion on self defined interpretation is not a proof, and conjecture is not evidence

For comments and archives

    Public Forum

Public Forum (Press Release for use by the newspapers)

Learn CPR- Sushil Shinde The popular Perfect Health Mela ends

New Delhi: Sunday, 11 November 2012: On the concluding day of MTNL Perfect Health Mela being organised by Heart Care Foundation of India, India’s Home Minister Sh Sushil Shinde released the CPR 10 Mantra “Within 10 Miniutes of Cardiac arrest( earlier the better) for the next atleast 10 miniutes compress the centreof the chest with a speed of 100/min (10x10)”

Mr Shinde to the Mela Delegation led by Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that CPR should be learned by everybody. He wished the CPR-10 initiative all the success.
The 19th Perfect Health Mela was formally closed on Sunday evening. Thousands of people participated and visited the Mela.
Chief Guest of the function Dr. (Prof.) Kiran Walia, Women & Child Department, Social Welfare Department and Languages said that youngsters should not indulge into alcoholism. She said that the drug addiction is becoming a major problem in adolescents. Patient who indulges in substance abuse should be tackled gently and with care. She also said that menstruating women should take a weekly dose of folic acid.
Dr. KK Aggarwal said that the Mela has ended with a good note for the public as dengue is at its decline.
CPR 10 a draw at the Mela
Following records were made  

  • 1050 students were trained in one session of multiple-rescuer CPR.
  • 201 people were trained in one session of single-rescuer CPR.
  • Maximum people trained in one day were 2168.
  • 96 children with special needs were trained in one session.
  • Total number of people trained more than 8500 people in CPR 10  

Heritage Inter Dancing School Competition
Various classical dances like Bharatnatyam, Odissi and Kathak were organized as part of Heritage, the Inter Dance School Festival. The competitions were coordinated by Indian Oil Corporation.     

  • Classical dance has effects like meditation.
  • Classical dancing should be part and parcel of school education.
  • People who indulge into classical dance have less lifestyle disorders.  

Conference on Zoonoses 2012
Over 100 people participated in a conference on Zoonoses. The messages were:  

  • Zoonoses is an animal disease, which can be transmitted to humans.
  • Humans are accidental hosts who acquire disease through close contact with an infected animal who may or may not be having a Zoonosis.
  • Children are at higher risk.
  • Pets can transmit bacterial, fungal and parasitic zoonoses.
  • The different routes of transmission may be saliva, respiratory secretions or through direct contact.
  • Saliva transmission can be through bites or contaminated scratches.
  • The risk of transmission can be reduced by simple precautions.
  • Owners should wash their hands following contact with their pets or cleaning of their cages.
  • Younger pets present a greater risk of diseases than older pets.
  • Pets should not be fed raw meat or eggs.
  • Pets should not be allowed to eat garbage.
  • Pets should not be allowed to drink surface water or toilet water.
  • Pets should be treated timely for diarrhea and dermatoses.
  • All dogs should be vaccinated for rabies.  

  National Workshop on pre-hospital care in heart attack
A national workshop on pre-hospital care in heart attack was organized in association with National Heart Institute. The faculty included Dr Vinod Sharma, Dr K K Aggarwal, Dr. Tushar Roy, Dr. Lokesh C Gupta, Dr. SK Modi, Dr. KC Goswami and Dr. Sameer Srivastava.
Facts released
In heart attack, at the onset of chest pain, one should chew a tablet of 300 gm of water soluble aspirin. This will reduce chances of death by 22%.

  • Any pain which can pinpointed by a finger is not a heart pain.
  • Any pain of less than 30 seconds duration is not a heart pain.
  • One should reach hospital within 90 minutes of heart attack to receive clot dissolving or clot removing therapy.
  • At the onset of heart attack, one should also be given stat dose of anti cholesterol medicine.
  • Burning in chest for the first time in life after the age of 40 should raise the suspicion of a heart attack.
  • Breathlessness after the age of 40 for the first time in life should not be ignored.

 Live discussion on diabetes
 A live discussion was held on Dilli Aajtak on diabetes. The faculty included Dr K K Aggarwal and Dr A K Jinghan. The star attraction was cricketer Mr Vijay Dahiya.
 Facts about diabetes:  

  • Fasting sugar of more than 90 can have cardiovascular involvement.
  • A1c of more than 6.5 is diagnostic of diabetes.
  • A1c testing should be done every three years.
  • Blood sugar along with blood pressure should be kept under control in all patients with diabetes.
  • If uncontrolled, diabetes can damage the heart, eyes, kidney and brain.  

Sindhi Academy organized cultural evening
 A cultural evening was organized where Sindhi singer Uma Lallo performed.
 Symposium on Prayer, Health & Religion
 A symposium was organized on prayer, health and religion in association with Bharatiya Vidya Bhavan.
 The panelists included Prof. Sunil Kumar (Hinduism), Imam Umar Ahmed Iliyasi (Islam), Padri Kanasih G (Christianity), Bhikshu Purnima (Buddhism), Dr. AK Merchant (Bahai Faith), Dr. E A Malekar (Yahudi) and Acharya Dr. Sadhvi Sadhna Ji Maharaj (Jainism). The session was moderated by Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President of the Mela. Mr. J. Veeraraghavan delivered the keynote address.
 Facts about prayer:

  • Even silent prayers can be effective
  • Prayer has been known to help heal patients.
  • Every hospital should have a prayer room with facilities for prayer for every religion.
  • Patients of some religions may request the doctor to pray with them. Their sentiments should be preserved.
  • In Islam doctors may pray for patients and they are encouraged to do so.
  • Prayer is one of the five pillars in Islam.
  • Prayer is a staple of Jewish spiritual life.
    Readers Response
  1. Dear Sir…excellent experience in MTNL Perfect Health Mela 2012. Regards: Dr Prishna
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