eMedinewS 12th August 2013, Monday

Dr K K 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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); 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);
For updates follow at
www.twitter.com/DrKKAggarwal
www.facebook.com/Dr KKAggarwal

Spontaneous human combustion

Rahul has been virtually in flames four times since he was born two–and–a–half months ago because of a rare condition called spontaneous human combustion reports TOI. The disease is seen only in 200 people across the world in the past 300 years.

Rahul was nine days old when he first developed spontaneous burns. The baby emitted some highly combustible gas through the pores of his skin, which made him catch fire.

There are many theories about the poorly understood condition, ranging from high acetone content in the body to the paranormal. Some doctors say everyone has certain amount of alcohol present in their blood and when its content is high, it combines with the gases in the body; resulting in burns. Though there is no special cure for the condition, it can be treated like a regular burn injury.

A plausible hypothesis for SHC is that some bacteria, such as the methanogenic micro–organism–archaebacteria, in the intestine convert the food into methane, which is a combustible substance.

A small spark, which need not be an obvious one, anywhere nearby, can trigger the fire. If the child is covered with a silk cloth which can generate static electricity, the combustible gas and the electricity can cause fire. The boy should not be near inflammable substances. …Read More

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute."


VIP’s on CPR 10 Mantra Video
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Ringtone – CPR 10 Mantra Hindi

Ringtone – CPR 10 Mantra English

sprritual blog Spiritual Prescriptions: Samudra Manthan - The Churning of the Ocean

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 the devas could partake the amrita (ambrosia) which would make them immortal and help them regain their lost kingdom.

As per his advice, the devas approached the demons, and they all agreed in the end to churn the ocean of milk. They sought the help of mount ‘Mandhara’ and the great snake ‘Vasuki’ for this purpose. Vasuki, the snake god, was used as the rope and Mandhara, the mountain, as the churning stick to churn the ocean. While they were churning the great ocean, Lord Vishnu assumed the form of a tortoise and held the Mandhara from sinking. While the churning was going on, several wonderful objects came out of the ocean.

The first to come out was ‘halahal’, the deadly poison, which threatened to engulf the world and destroy it. When no one was willing to accept the poison, Lord Shiva came forward to accept it. He swallowed it and Parvathi who was standing beside him, pressed his neck as he swallowed it and thus, prevented it from going into his stomach. Thus the poison remained struck there forever in his neck, neither going up into his mind nor going down into his stomach.

Then came Kamadhenu (the wish-fulfilling cow), the Ucchaisrava (the white horse), Airavata (the white elephant), Kaustubhamani (a rare diamond), Kalpavriksha (the wish-fulfilling tree), Lakshmi (the goddess of wealth), Sura or Varuni (the goddess of wine), and finally Dhanvantari (the divine physician) with the vessel of Amrita in his skilful hands. These objects, except the last one, were divided between the devas and the demons.

The nectar of immortality was, of course, finally denied to the demons and was distributed among the devas only, through a fine piece of trickery enacted by Lord Vishnu. He assumed the form of Mohini to delude the demons and make them temporarily forget all about the ‘amrit’, while he went on distributing it among the gods who took it. Because of the effects of ‘amrit’, they not only became immortal but also defeated the demons summarily. But two of the Daityas (demons) managed to partake of the Amrit. And they both became immortal. Therefore, the strife between good and evil continues to this day.

Spiritual Symbolism

The story represents the spiritual endeavor of man for achieving immortality and inner happiness through concentration of mind, withdrawal of senses, control of desires and practice of austerities and asceticism.

  1. The devas represent the pleasure principle in us. They also represent the senses.
  2. The demons represent the pain principle and the negative thoughts and impulses.
  3. Indra represents the Intellect, which can become egoistic.
  4. Ksheer Sagar or the ocean of milk is the mind or the human consciousness. The mind is always compared to an ocean (mano sagaram) while the thoughts and emotions to the waves.
  5. Mandhara, the mountain stands for concentration. The word “mandhara” contains two words “man” (mind) and “dhara” (a single line) which means ‘holding the mind in one line’. This is possible only during mental concentration. The mountain Mandhara was upheld by Lord Vishnu as a tortoise.
  6. The tortoise stands for the withdrawal of the senses into oneself as one practices mental concentration and meditation or contemplation. It also suggests that the mind should rest upon itself or freely surrender itself to the divine will.
  7. The participation of both the devas and the demons signify the fact that when one is seeking immortality through the spiritual practice, one has to integrate and harmonize both the positive and negative aspects of one’s personality and put both the energies for the common goal.
  8. The great serpent Vasuki stands for desire. The desire is always compared to a thousand hooded serpent.
  9. Halahal represents the turmoil of mind one suffers in the initial phase of meditation
  10. The celestial gems represent the spiritual powers or the sidhis one can attain during meditation
  11. ‘Amrit’ or nectar represents the inner happiness
  12. Immortality represents moksha

The another interpretation of the story is:

The story represents the need for doing meditation (churning of the mind in the ocean) to gain control over ego, which takes over when the mind and intellect (Indra) lose their track.

The process involves intention to do the meditation (devas approach the Vishnu (consciousness and in turn advised to do the manthan) and attention (focus, concentration) on the object of concentration (God or consciousness and here the tortoise). The process involves concentrating on a mantra or the breath continuously and giving preferences to the object of concentration over the thoughts. Meditation is incomplete without withdrawing the senses (tortoise). By yoga sutras of patanjali it is called ‘pratihara’ by creating a spiritual atmosphere. The contemplation or the continuing concentration is a must (mandhara).

Meditation is the process of slipping in the silent gaps between the thoughts. Negative thoughts are the asuras, the devils or the demons. Meditation involves bypassing the thought and needs both the positive and the negative thoughts to cooperate with each other like in a rope.

While meditating, one is bound to be affected by a chain or rope of desires (vasuki). The same needs to be tightened up, caught firmly by the thoughts, and ignored by giving preference to the object of concentration, the self (the tortoise). When in difficulty, every one has to take the help of God.

To summarize, the Vasuki used in the churning of the ocean denotes that the devas and the demons held desire (to seek immortality) as a rope and churned the mind with the help of concentration and withdrawal of the senses. You can hold the desire in your hands and manipulate it only when you have control over your desires.

In the initial phase of meditation or intense churning by opposite forces, one is affected by turmoil of the mind. Most people who start meditation leave it in this phase only, as they cannot bear this turmoil and get agitated or disturbed. That is one reason it is said that one should learn meditation under the guidance of a teacher, doctor or a guru.

The halahal represents this suffering and pain one undergoes at the beginning of spiritual sadhana. The problems get intensified because of inner conflicts, when one part yearns to pursue the spiritual path (devas) while the other opposes it (demons). In short, ‘halahal’ is the instability of the body and the mind that arises as a counter-reaction against one’s spiritual practice.

One can compare this to the release of the mental toxins comparable to the physical toxins which gets released when we rest and after a daylong rest complain of leg pains.

The mental turmoil representing all kinds of reactions, negative thoughts, desires and impulses associated with some degree of physical turmoil (body movements, flickering and tingling) need to be tackled here to complete the process of meditation.

One cannot take out these negative thoughts in the open nor can one keep it in (you can not throw the halahal out or swallow it). It needs to be managed or ignored by keeping it in the throat which is what was done by Shiva. Shiva here represents the ascetic principle (leading a life of self-discipline and self-denial).

It also means that another mode of controlling the turmoil is by controlling the breath. Shiva is the controller of breath and is called a ‘prananath, or praneshwar’ - The Lord of Breath. In meditation, it is essential that one gains complete mastery over one’s breathing pattern. Most sages hold their breath in their throat, near the palate, as they meditate to control this turmoil of mind.

The various objects that came out of the ocean during the churning stand for the psychic or spiritual powers (siddhis) which one gains as one progresses spiritually from stage to stage.

These siddhis are spiritual powers, which come to a seeker as he progresses on the spiritual path. We are told that a seeker should be careful about these powers as they can hamper his progress unless he uses them judiciously - not for his selfish gains but for others’ welfare. This is the reason why the gods and demons distributed these powers among others without keeping anything for themselves as they did not want to lose sight of their original aim, which was to gain immortality (inner happiness).

After the ‘halahal’, came Kamadhenu (the wish-fulfilling cow), the Ucchaisrava (the white horse, as white as the moon), Airavata (the white elephant), Kaustubha mani ( a rare diamond, type of ruby), Kalpavriksha or the Kalpataru (the wish-fulfilling tree, called Parijata), Rambha Apsara the (celestial dancer), Lakshmi (the goddess of wealth), Sura or Varuni, the Somarasa (the goddess of wine), Sankha (the conch), Sankra Dhanush (the weapon), and finally Dhanvantari (the divine physician) with the vessel of Amrita in his skillful hands.

Dhanvantari stands for health. The vessel containing the amrit was brought before the gods and the demons by Dhanvantari, the divine physician. This signifies that immortality can be achieved only when the body and the mind are in a perfect state of health.

These spiritual powers are the ones which one can attain while doing basic and advanced meditation and includes the capacity to fullfill desires, to give boons to others, to acquire health, wealth etc. Meditation is not possible in case of a person who is mentally or physically sick or whose gross body is not fit for receiving meditation benefits.

Lord Vishnu in the form of Mohini stands for ‘delusion of the mind’ in the form of pride. It is the pride of achievement to which the asuras or the demons succumbed and thus, lost their right to enter into the world of immortality. Pride and egoism are the final hurdles one has to overcome in spiritual life before being able to experience self-realization.

….Read More

cardiology news

Rafting

By good fortune, I was able to raft down the Motu River in New Zealand twice during the last year. The magnificent four-day journey traverses one of the last wilderness areas in the North Island.

The first expedition was led by "Buzz", an American guide with a great deal of rafting experience and many stories to tell of mighty rivers such as the Colorado. With a leader like Buzz, there was no reason to fear any of the great rapids on the Motu.

The first half day, in the gentle upper reaches, was spent developing teamwork and co–ordination. Strokes had to be mastered, and the discipline of following commands without question was essential. In the boiling fury of a rapid, there would be no room for any mistake. When Buzz bellowed above the roar of the water, an instant reaction was essential.

We mastered the Motu. In every rapid we fought against the river and we overcame it. The screamed commands of Buzz were matched only by the fury of our paddles, as we took the raft exactly where Buzz wanted it to go.

At the end of the journey, there was a great feeling of triumph. We had won. We proved that we were superior. We knew that we could do it. We felt powerful and good. The mystery and majesty of the Motu had been overcome.

The second time I went down the Motu, the experience I had gained should have been invaluable, but the guide on this journey was a very softly spoken Kiwi. It seemed that it would not even be possible to hear his voice above the noise of the rapids.

As we approached the first rapid, he never even raised his voice. He did not attempt to take command of us or the river. Gently and quietly he felt the mood of the river and watched every little whirlpool. There was no drama and no shouting. There was no contest to be won. He loved the river.

We sped through each rapid with grace and beauty and, after a day, the river had become our friend, not our enemy. The quiet Kiwi was not our leader, but only the person whose sensitivity was more developed than our own. Laughter replaced the tension of achievement.

Soon the quiet Kiwi was able to lean back and let all of us take turns as leader. A quiet nod was enough to draw attention to the things our lack of experience prevented us from seeing. If we made a mistake, then we laughed and it was the next person’s turn. We began to penetrate the mystery of the Motu. Now, like the quiet Kiwi, we listened to the river and we looked carefully for all those things we had not even noticed the first time.

At the end of the journey, we had overcome nothing except ourselves. We did not want to leave behind our friend, the river. There was no contest, and so nothing had been won. Rather we had become one with the river.

It remains difficult to believe that the external circumstances of the two journeys were similar. The difference was in an attitude and a frame of mind. At the end of the journey, it seemed that there could be no other way. Given the opportunity to choose a leader, everyone would have chosen someone like Buzz. At the end of the second journey, we had glimpsed a very different vision and we felt humble – and intensely happy. Read More

News Around The Globe

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News

  • Antioxidant supplements do not increase a woman’s chances of conceiving when compared with placebo or no treatment, according to a systematic review published online August 5 in the Cochrane Database of Systematic Reviews. The antioxidants evaluated included pentoxifylline, N–acetyl–cysteine, melatonin, L–arginine, vitamin E, myo-inositol, vitamin C, vitamin D plus calcium, and omega–3–polyunsaturated fatty acids. (Source: Medscape)
  • A study from Taiwan has reported that patients with rheumatoid arthritis (RA) are at elevated risk for the development of deep venous thrombosis (DVT) and pulmonary embolism (PE). According to the study reported online in Annals of the Rheumatic Diseases, patients with RA had more than three times the likelihood of DVT compared with healthy controls after adjustment for age, gender, and comorbidities. (Source: Medpage Today)
  • The World Health Organization (WHO) has issued new clinical protocols and guidelines for addressing the mental health consequences of trauma and loss. Care for posttraumatic stress disorder (PTSD), acute stress, and bereavement have been included in the new guidelines, published August 7 in JAMA, in a theme issue on violence and human rights. (Source: Medscape)
  • Joel M. Gelfand, MD, of the University of Pennsylvania in Philadelphia and colleagues report in JAMA Dermatology that patients with psoriasis are at an increased risk of multiple comorbid conditions affecting most major organ systems including the lungs, liver, kidneys, and cardiovascular system. The magnitude of comorbidity in their study ranged from about a 10% increase in the odds of chronic pulmonary disease to a doubling of the odds of rheumatologic diseases.(Source: The Gupta Guide, Medpage Today)
  • Probiotic supplements did not prevent antibiotic-associated diarrhea (AAD) or Clostridium difficile diarrhea (CDD) in a large randomized, double–blind, placebo-controlled trial published online August 8 in the Lancet. (Source: Medscape)

Rabies News (Dr. A K Gupta)

What are monoclonal antibodies?

Monoclonal antibodies (mAb) are important reagents used in biomedical research, in diagnosis of diseases, and in treatment of such diseases as infections and cancer. These antibodies are produced by cell lines or clones obtained from animals that have been immunized with the substance that is the subject of study. The cell lines are produced by fusing B cells from the immunized animal with myeloma cells.

cardiology news
  • According to Dr Brent M Egan from Medical University of South California, Charleston and lead author of a study of clinic patients with treated but uncontrolled hypertension, 30% of the patients had been prescribed three or more antihypertensive medications––as recommended––but they appeared to have treatment–resistant hypertension. But, it was found that half of these patients were not receiving optimal antihypertensive therapy. (Source: Medscape)
  • Coexisting diabetes and end-stage renal disease (ESRD) synergistically boosted the risk of cardiovascular events as much as five––fold compared with patients who had neither condition, according to long–term follow–up in two large cohorts reported in Diabetes Care. According to Junne–Ming Sung, MD, of the National Cheng–Kung University Hospital in Tainan, Taiwan and co–authors, the study findings emphasize the importance of screening for and control of diabetes in patients with ESRD. (Source: Medpage Today)

Valvular Heart Disease News

In elderly adults, mitral valve repair, if possible, is the surgical treatment of choice for mitral regurgitation. It preserves all of the functional components of the native valve, avoids the use of a prosthesis with its attendant complications, and overall is associated with lower rates of morbidity and mortality than mitral valve replacement.

(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)

cardiology news
  • Children and adolescents with coexisting asthma and depression tended to have high levels of the inflammatory marker C–reactive protein (CRP). The presence of both asthma and depression was associated with a 7–fold greater risk of having levels of CRP above 2 mg/L. For children with both conditions, the likelihood of having CRP levels above 3 mg/L rose 10–fold. The study is reported online in the Journal of Pediatrics. (Source: Medpage Today)
  • Hedvig E. Jakobsson, MSc, from the KTH Royal Institute of Technology and Karolinska Institutet, Stockholm, Sweden, and colleagues report online August 7 in Gut that cesarean delivery may result in lower bacterial diversity, lower abundance of the phylum Bacteroidetes, and lower circulating levels of Th1 chemokines in infants compared with vaginal delivery. Lower diversity may lead to higher exposure to health risks such as allergies later in life. (Source: Medscape)
cardiology news

Hospital noise fractures sleep

  1. Nighttime hospital noise causes poor sleep and adds up to poor healing
  2. In a lab sleep study, recorded hospital sounds of overhead paging, IV alarms, squeaky carts and the like disrupted sleep and raised heart rates as per Orfeu M. Buxton, PhD, of Harvard and Brigham and Women’s Hospital in Boston in June 19 issue of the Annals of Internal Medicine.
  3. Electronic alert sounds like ringing phones and IV alarms are the most "potent" in arousing sleepers, disrupting normal sleep brain wave patterns more than half of the time, even when set at their quietest settings.
  4. Staff conversations and voice paging at a level of 50 dB –– quieter than normal conversation –– disrupted sleep half of the time in the study.
  5. The 14 common sounds used in the study were voices, IV alarm, phone, ice machine, toilet flush, laundry cart, outside traffic and helicopter noise (played at levels increasing from 40 to 70 dB). The heart rate jumped about 10 bpm when a sound fully roused a sleeper.
  6. When sleep was disrupted, even for a few seconds, heart rates increased. Sleep disruption occurred most often during rapid eye movement (REM) sleep, the lightest sleep stage.
cardiology news

Children and adolescents in the United States spend an average of 6.5 hours per day watching television, playing video games, or using computers. Children’s television (particularly cartoons), movies, music videos, and video games are potential sources of violent content.

cardiology news

8th August: DMA Dharna against one year mendatory Rural Posting at Jantar Mantar

EBook

CPR 10 Camp – E Book Balwant Rai Mehta School, G K – 2, New Delhi

Total CPR since 1st November 2012 – 59455 trained

CPR Classes: Persons trained (3193)

5th August: CPR 10 at Universal Public School (1078)

DMA Dharna against one year mandatory Rural Posting at Jantar Mantar

6th August: CPR 10 at Moolchand (30)

7th August: CPR 10 at Moolchand (27)

CPR VIP Sensitization

CPR Classes 59455

Video Chats and uploads

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News JULY

Low BP may be normal 7th August

NETLOG, FREEPRESS RELEASE, PRLOG, FREEPRESSINDEX, AFRICANNEWSWIRE

The world’s deadliest virus in China today

Currently, the deadliest virus dominating is a new strengthened virus of Bird Flu H7N9 in China. Detected last month, the virus transmits easily from birds to human killing 4 in 5 people. This is unusually dangerous for human, said Padma Shri " Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India. It is one of the deadliest flu viruses we have ever seen.

Also the globe is facing another corona virus, a SARS–like virus that has killed more than 20 people in last one year.

The deadliest viruses by death rate

Over the past century, urbanization, changing sexual behavior, a growing world population, and increased mobility have helped viruses to spread. Here are seven deadly viruses that claim thousands—sometimes even millions—of lives each year.

  • HIV/AIDS: causes a staggering 1.61.9 million deaths every year.
  • Hepatitis: It has been estimated that hepatitis (all types) causes around a million deaths annually. Hepatitis B accounts for 600,000 deaths and is 50100 times more infectious than HIV. Additionally, every year there are 350,000 deaths related to hepatitis C and 70,000 deaths related to hepatitis E.
  • Influenza: Despite the fact that effective and safe vaccines have been available and used for more than 60 years, influenza causes 250,000500,000 deaths every year. Elderly people and those with chronic medical conditions are at particular risk of developing serious illness.
  • Human papillomavirus: Although most infections with human papillomavirus (HPV) are not symptomatic, persistent infection can cause cervical cancer. In fact, HPV is the cause of virtually all cervical cancers (99%), which is the second most common cancer in women worldwide. HPV causes 275,000 deaths every year.
  • Rabies: More than 55,000 people die of rabies every year.
  • Dengue fever: Around 50100 million people are infected every year, resulting in 12,50025,000 deaths.
  • Rotavirus: It is the most common cause of severe diarrhea in infants and children globally. Each year there are around 500,000 deaths related to rotavirus.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on" Hands only CPR" of 59455 people since 1st November 2012.

The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

today emedipics

Conducting a Second CPR 10 Training Programme for South Delhi Police Personnel, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India

press release

Hospital noise fractures sleep

today video of the dayOne more life saved from CPR 10

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

Smart Phones Benefits and Hazards

eMedi Quiz

Read this…………………

Parents bring their infant to the clinic, seeking treatment for vomiting and diarrhea that has lasted for 2 days. On assessment, Nurse Ernie detects dry mucous membranes and lethargy. What other finding suggests a fluid volume deficit?

a. A sunken fontanel
b. Decreased pulse rate
c. Increased blood pressure
d. Low urine specific gravity

Yesterday’s Mind Teaser: Nurse Rose is caring for a neonate with congenital clubfoot. The child has a cast to correct the defect. Before discharge, what should the nurse tell the parents?

a. The cast will be removed in 6 weeks
b. A new cast is needed every 1 to 2 weeks
c. A short leg cast is applied when the baby is ready to walk
d. The cast will be removed when the baby begins to crawl

Answer for yesterday’s Mind Teaser: b. A new cast is needed every 1 to 2 weeks

Correct answers received from: Daivadheenam, Dr Pankaj Agarwal, DR AVTAR KRISHAN, Dr Jainendra Upadhyay, Dr. Pawan Mehta, Dr Kanta Jain, Narahari Kandakatla, Kuldeep Gupta, Dr Jainendra Upadhyay, DR P K SAHU

Answer for 10th August Mind Teaser: c. Bacteria are absent on urine culture.

Correct answers received from: Dr. P. C. Das

Send your answer to ijcp12@gmail.com




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medicolegal update

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medicolegal update

ATTORNEY: Doctor, before you performed the autopsy, did you check for a pulse?
WITNESS: No.

ATTORNEY: Did you check for blood pressure?
WITNESS: No.

ATTORNEY Did you check for breathing?
WITNESS: No.

ATTORNEY: So, then it is possible that the patient was alive when you began the autopsy?
WITNESS: No.

ATTORNEY: How can you be so sure, Doctor?
WITNESS: Because his brain was sitting on my desk in a jar.

ATTORNEY: But could the patient have still been alive, nevertheless?
WITNESS: Yes, it is possible that he could have been alive and practicing law.

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A diabetic patient died of flu pneumonia.
Reaction: Oh my God! Why was flu vaccine not given?
Lesson: Make sure that all diabetics are given flu vaccine every year.

medicolegal update

Don’t be pushed by your problems. Be led by your dreams. Calvin & Hobbes

medicolegal update

Dr KK Aggarwal: Diabetic drug metformin may have anti cancer effects http://bit.ly/16wknsh #Health

Dr Deepak Chopra: The world is as we are. What we see we become. Choose your seeing wisely.

medicolegal update

Dear Sir, emedinews is very useful. Regards: Dr Krishna

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