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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 (March 10-13); 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 …

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

13th May 2013, Monday

Top 10 Ways to Keep the Kidneys Healthy

We all want our kidneys to last for a lifetime. We all should show our love for kidneys by adopting 10-step program for protecting kidney health.

One should begin with monitoring blood pressure and controlling weight and then move on to the rest of the kidney-healthy tips.

  1. Monitor blood pressure and cholesterol.
  2. Control weight.
  3. Don't overuse over-the-counter painkillers.
  4. Monitor blood glucose.
  5. Get an annual physical exam.
  6. Know if chronic kidney disease (CKD), diabetes or heart disease runs in your family. If so, you may be at risk.
  7. Don't smoke.
  8. Exercise regularly.
  9. Follow a healthy diet.
  10. Get tested for chronic kidney disease if you're at risk.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal on

Obesity reduces life expectancy

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day 2013

Heart Care Foundation of India and World Fellowship of Religions in association with Ministry of Earth Sciences Govt. of India and Delhi Public School Mathura Road observed World Earth Day 2013.

Dr K K Aggarwal
    National News

Soon, central body on organ transplants

NEW DELHI: The Union health ministry is setting up a central coordinating agency on organ transplants. It will maintain the database of organ donors and recipients apart from training doctors on transplant procedures. The agency, National Organ and Tissue Transplant Organization (NOTTO), will be set up at Safdarjung Hospital, director general of health services Jagdish Prasad said on Friday. "The building is ready. The National Information Centre has been asked to prepare an online network to maintain the database," said Prasad. He said regular meetings are being held to monitor the progress. Under NOTTO, the government will give funds to private and public hospitals to appoint a coordinator for organ transplants. Free software would be given to all centres for uploading transplant-related data. Prasad said apart from NOTTO, four regional centres would be set up in Chennai, Kolkata, Mumbai and Delhi. Sir Ganga Ram Hospital and the Post Graduate Institute of Medical Education and Research, Ram Manohar Lohia Hospital are organizing a workshop on transplant surgery. "While Spain has 40 organ donors per million people, Britain has 27 donors, US 26, Canada 14 and Australia 11. India's count stands at 0.08 donors per million population," said Dr Harsha Jauhari, chairman transplant surgery, Sir Ganga Ram hospital. (Source: TOI, May 11, 2013)

For comments and archives

DD Programme “Take Care Holistically”, Anchoring Dr KK Aggarwal, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Anchoring Dr KK Aggarwal, every Thursday 4:30 PM in DD India

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


Types of child neglect

  • Physical neglect is failure to provide adequate food, cloth, shelter, hygiene, protection and safety.
  • Emotional neglect is failure to provide love, affection, security and emotional support.
  • Educational neglect is failure to enroll the child in school.
  • Medical neglect is refusal to seek or delay in seeking medical care when required.

For comments and archives

    Valvular Heart Disease Update

What is transcatheter aortic valve replacement?

Transcatheter aortic valve replacement is a potential option for patients with severe symptomatic aortic stenosis who are considered inoperable for surgical aortic 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)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Does ROSE test by endocrinologists aid thyroid diagnosis?

The use of a rapid on-site evaluation technique of thyroid fine-needle aspiration, known as ROSE, enables trained endocrinologists to evaluate the adequacy of samples without the assistance of a cytologist, new research shows. (Source: Medscape)

For comments and archives

'Clean' vessels seen in some young MI patients

Although young patients with acute coronary syndromes typically carry traditional cardiovascular risk factors, some of them show no evidence of underlying coronary artery disease, researchers found. (Source: Medpage Today)

For comments and archives

Racial, ethnic variation seen in BP control

Compared with blacks and whites, awareness, treatment, and control of high blood pressure are lowest among Mexican-Americans, according to the CDC. (Source: Medpage Today)

For comments and archives

Copper IUDs not associated with increased menstrual pain

Copper intrauterine contraceptive devices (Cu-IUDs) did not increase pain during menstruation, and a levonorgestrel-releasing intrauterine system (LNG-IUS) reduced dysmenorrhea, according to results from a long-term study of 2102 women published online April 11 in Human Reproduction. (Source: Medscape)

For comments and archives

Tailored hydration works in Cath Lab

Using a routinely measured hemodynamic variable to guide hydration in patients undergoing coronary angiography or percutaneous coronary intervention (PCI) improves clinical outcomes for up to 6 months, the randomized POSEIDON trial showed. (Source: Medpage Today)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: How to recognize cardiac arrest Dr K K Aggarwal Rapid recognition of cardiac arrest is the essential first (cont) http://tl.gd/n_1rk3vbq

@DrKKAggarwal: A mind hardened by judgement can neither love nor create.

    Spiritual Update

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

Identify seven types of mothers and give them mother’s day gift

As per Vedic literature “ atma-mata guroh patni, brahmani raja-patnika, dhenur dhatri tatha prthvi, saptaita matarah smrtah” theree are seven types of mothers.

1. Atama mata: the mother who gave me birth
2. Guroh patni: the wife of my teachers, guru or master

For comments and archives

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

What are the economical issues related to multiple pregnancies?

  • The healthcare costs for delivery and newborn care for twins are 4–times higher when compared to a singleton birth.
  • Companies are not as willing to donate formula, diapers, etc., to parents of multiples as in the past.
  • The cost of caring for children with lifelong disabilities may be high. Some of your children may have a disability.
  • The total cost of raising multiples is likely higher than the cost of raising the same number of singletons. Cribs, car seats, high chairs, and other items have to be bought all at once, which can be financially difficult.
    An Inspirational Story

Slow down

About ten years ago, a young and very successful executive named Josh was traveling down a Chicago neighborhood street. He was going a bit too fast in his sleek, black, 12 cylinders Jaguar XKE, which was only two months old. He was watching for kids darting out from between parked cars and slowed down when he thought he saw something.

As his car passed, no child darted out, but a brick sailed out and –– WHUMP! –– it smashed into the Jag’s shiny black side door! SCREECH…!!!! Brakes slammed! Gears ground into reverse, and tires madly spun the Jaguar back to the spot from where the brick had been thrown. Josh jumped out of the car, grabbed the kid and pushed him up against a parked car.

He shouted at the kid, "What was that all about and who are you? Just what the heck are you doing?!" Building up a head of steam, he went on. "That’s my new Jag, that brick you threw is going to cost you a lot of money. Why did you throw it?"

"Please, mister, please…I'm sorry! I didn’t know what else to do!" pleaded the youngster. "I threw the brick because no one else would stop!" Tears were dripping down the boy’s chin as he pointed around the parked car. "It’s my brother, mister," he said. "He rolled off the curb and fell out of his wheelchair and I can’t lift him up." Sobbing, the boy asked the executive, "Would you please help me get him back into his wheelchair? He's hurt and he's too heavy for me."

Moved beyond words, the young executive tried desperately to swallow the rapidly swelling lump in his throat. Straining, he lifted the young man back into the wheelchair and took out his handkerchief and wiped the scrapes and cuts, checking to see that everything was going to be OK. He then watched the younger brother push him down the sidewalk toward their home.

It was a long walk back to the sleek, black, shining, 12 cylinder Jaguar XKE –– a long and slow walk. Now, Josh never did fix the side door of his Jaguar.

He kept the dent to remind him not to go through life so fast that someone has to throw a brick at him to get his attention.

For comments and archives

  Cardiology eMedinewS

Ambrisentan fails in lung fibrosis Read More

  Pediatric eMedinewS

Govt launches drive to create awareness on immunization Read More

    Rabies Update

(Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

Can IDRV be given in private hospital?

The ID route has been permitted to be used in selected anti-rabies clinics (ARCs) having an adequate number of patients (at least 5/day) seeking post-exposure prophylaxis against rabies every day to make IDRV viable and cost-effective.

    IJCP Special

Dr Good Dr Bad

Situation: A 32–year–old man with sustained fever of 102°F for 2 weeks in whom the diagnosis was not apparent after 3 days of diagnostic evaluation was hospitalized.
Dr Bad: Manage him as a case of PUO.
Dr Good: Investigate further. Don’t diagnose PUO yet.
Lesson: Pyrexia of unknown origin (PUO) is said to occur in patients with sustained fever of =101°F for 3 weeks in whom the diagnosis is not apparent after one week of diagnostic studies.

Make Sure

Situation: A patient on amlodipine developed severe gum hypertrophy.
Reaction: Oh my God! Why was amlodipine not stopped?
Lesson: Make sure that all patients on amlodipine are watched for gum hypertrophy as its side effect.

  Quote of the Day (Dr GM Singh)

Never look back…if Cinderella had gone back to pick up her shoe, she wouldn't have become a princess.

    Mind Teaser

Read this…………………

Which is the most effective method for teaching strengthening exercises to patients with chronic pain?

1. Distributing a local listing of strengthening exercise classes
2. Providing demonstration and return demonstration
3. Providing handouts with pictures
4. Viewing a self-instruction video

Yesterday’s Mind Teaser: A female client requires hemodialysis. Which of the following drugs should be withheld before this procedure?

a. Phosphate binders
b. Insulin
c. Antibiotics
d. Cardiac glycosides

Answer for yesterday’s Mind Teaser: d. Cardiac glycosides

Correct answers received from: Dr Kala sharma, Dr kanta jain, Dr Ayyavoo, Dr Santha Kumari, Dr Pradeep Das, Dr Gajveerruhal, Dr Jayshree Sen, Dr BB Gupta, Dr Avtar Krishan, Dr Pankaj Agarwal, Dr Jainendra, Dr Muthumperumal, Dr Chandresh Jardosh, Dr Hitendra Sinha Thakur, Raju Kuppusamy, Dr Arpan Gandh

Answer for 11th May Mind Teaser: b. A new cast is needed every 1 to 2 weeks

Correct answers received from: Dr Pankaj Agarwal, Dr Jainendra, Dr Muthumperumal

Send your answer to ijcp12@gmail.com

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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

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    Laugh a While (Dr GM Singh)

History of Telecommunication

After having dug to a depth of 10 feet last year, Italian scientists found traces of copper wire dating back 100 years and came to the conclusion, that their ancestors already had a telephone network more than 100 years ago.

Not to be outdone by the Italians, in the weeks that followed, a Chinese archaeologist dug to a depth of 20 feet, and shortly after, a story in the China Daily read: ‘Chinese archaeologists, finding traces of 200 year old copper wire, have concluded their ancestors already had an advanced high–tech communications network a hundred years earlier than the Italian’s.

One week later, the Punjab Times, a local newspaper in India, reported the following: After digging as deep as 30 feet in his pasture near Amritsar, in the Indian state of Punjab, Dugdeep Singh, a self–taught archaeologist, reported that he found absolutely nothing. Dugdeep has therefore concluded that 300 years ago, India had already gone wireless.

    Medicolegal Update

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

Medical negligence

  • Any doctor who is qualified by medical council and renders emergency care or treatment to a person suffering or appearing to suffer from cardiac arrest, which may include the use of an automated external defibrillator, in good faith and without compensation, shall be immune from civil liability for any personal injury as a result of care or treatment or as a result of any act or failure to act in providing or arranging further medical treatment where the person acts as an ordinary prudent person would have acted under the same or similar circumstances, except damages that may result for the gross negligence of the person rendering emergency care. This immunity shall extend to the licensed physician.
  • If a doctor passes the scene of an accident in which some person has been injured and is in need of urgent medical attention he would not be held to have been negligent if he does not render assistance, as no doctor/patient relationship has been established and in consequences the doctor owes the patient no legal duty.
  • If, however, the doctor goes to the assistance of a person who is injured in an accident, a doctor /patient relationship is at once established. When any physician gratuitously advises medical personnel at the scene of an emergency episode by direct voice contact, to render medical assistance based upon information received by voice or biotelemetry equipment, the actions ordered taken by the physician to sustain life or reduce disability shall not be considered liable when the actions are within the established medical procedures.
  • A doctor has a duty to exercise reasonable skill and care regardless of whether or not his services are being given gratuitously. A national health policy is required to be formulated to render emergency treatment to a person.
  • If such a practitioner fails to attend an emergency call and a complaint is made against him it may well be that some disciplinary action will be taken against him by the health authority/medical council.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Mother’s Day to be Celebrated Today

Incontinence in women a neglected but treatable problem

Incontinence in women is a neglected but a treatable problem, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

He released a few tips for women to overcome this problem.

  1. Urinary incontinence in women is a neglected problem, but doctors can play a crucial role in treatment.
  2. Incontinence is extremely common, affecting about 20-25% of women before menopause and more than twice that after menopause.
  3. Age itself does not cause incontinence. Urinary tract changes that accompany age, such as increased involuntary contractions and decreased bladder sensation and contractility, make incontinence more likely.
  4. Workup for incontinence is a multistep process.
  5. At the first visit, when a patient mentions incontinence, the doctor should set her up with a voiding diary and schedule a follow-up visit in a few weeks. At that next visit, in addition to reviewing the diary, the doctor should do a history and physical, perform a stress test and measure postvoid residual.
  6. The doctor should first address possible transient, reversible causes, illustrated by the DIAPERS mnemonic: Delirium, Infection, Atrophic urethritis or vaginitis, Pharmaceuticals, Excess excretion, Restricted mobility and Stool impaction. Treating these can cure incontinence completely in one-third of patients and alleviate it in the remainder.
  7. Established urinary incontinence is caused by either storage problems, such as overactive detrusor and stress incontinence, or emptying problems, such as underactive detrusor and urethral obstruction.
  8. In women of any age, 90% of incontinence is in the storage group.
  9. Woman who has overflow urinary incontinence, indicated by a postvoid residual of 100 mL or greater, should be referred to a subspecialist. In those with a positive stress test and a low postvoid residual, the presumed diagnosis is stress incontinence. Those with a negative stress test and a low postvoid residual are presumed to have detrusor overactivity.
  10. If the transient causes have been addressed but the urinary incontinence persists, internists should treat appropriately according to type. For urge incontinence caused by detrusor overactivity, the cornerstone of treatment is behavioral. Physicians should consult the voiding diary and start with bladder retraining, prompted voiding regimens, and urgency suppression methods. Anticholinergic bladder relaxants should be used only as a last resort. The only place for drugs is at the very, very, very end, after you’ve done the rest. Desamino d-arginine vasopressin (DDVAP) has no role in treating urinary incontinence.
  11. For stress incontinence, conservative treatment works.
  12. Overweight women need to lose only 5-10% of their weight to achieve a 50% decrease in urinary leakage, according to a recent New England Journal of Medicine article.
  13. Tampons and pessaries can be effective, especially for exercise-induced incontinence. Crossing the legs and tightening the pelvic floor before coughing or sneezing can also help, as can Kegels, although women need to do 30 to 50 a day for several months to see results.
  14. Surgery can be an effective option, but patients need to understand that “it’s not going to be 100% and it’s not going to last forever”. Drugs should not be used to treat stress incontinence.
  15. The bottom line is that although incontinence is common, it’s never normal. The causes are multifactorial. With a positive, persistent approach, one can cure or help the vast majority of the patients.

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 50118 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, 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.”

    Readers Response
  1. Dear Sir, emedinews is providing very informative News. Regards: Dr Priya
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