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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


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  Editorial …

13th August 2011, Saturday

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The Indian Health Sector: Where are we after 64 years of independence?

This year we will be completing 64 years of independence. These years have witnessed several ups and downs in the field of health. Smallpox and guinea warm disease were eradicated from India. The last case of guinea worm disease (Dracunculiasis) was reported in July 1996 from Jodhpur, Rajasthan.

But, post independence a lot of new diseases have come up in India. These are: HIV/AIDS, SARS, Bird Flu, Dengue, Chikungunya and H1N1 Flu (Swine Flu). There was also a resurgence of many diseases like plague and dropsy. There has been a resurgence of malaria. India is almost free from polio. We are on the path of eradicating Polio. Will this occur in the coming 2 to 3 years or will it take longer? Only the time will tell.

In terms of lifestyle diseases, India has taken the top spot. Coronary artery disease, hypertension and diabetes have almost tripled in the last three decades. The new epidemics of the society are potbelly obesity, diastolic failure, left arterial failure, atrial fibrillation, metabolic syndrome, polycystic ovarian disease, non–alcoholic static hepatitis, diabetes, hypertension, coronary artery disease etc.

Since independence, the life expectancy has risen from 33 to 64% (2009); infant mortality has declined from 146 to 50/1000 live births (2009); under–5 year mortality rate has also declined from 236 to 69/1000 life births (2009). Crude death rate has reduced from 27 to 9 and maternal mortality rate has reduced from 1321 to 252 per 100,000 life births.

The hospital strength has increased from 2694 in 1947 to 13692 in 1993. Hospitals’ beds have increased from 117000 to 692030 (1993) and from 6600 dispensaries to 279403 (1993). The prevalence of leprosy has also declined from 57 per 1000 in 1981 to 3.74 per 10,000 in 2001. It is expected to have this prevalent less than 0.5/1000 in the next five year plan. The number of elderly people is also increasing. The number for the age of 60 was 19.61 million (5.5% of the population) and the same number in 2001 was 75.93 million (7.43% of the population). 17% of the population was residing in urban areas in the year 1947, and the same has increased to 28% in 2001.

Another problem that has surfaced in a big way is the rising trend of multi drug resistance. Multi drug resistance is common in diseases like Typhoid, Malaria, TB, HIV/AIDS, and hospital–acquired infections. NDM1 bacteria are the newest entrant to the kitty of drug resistant bugs, the so called super bugs.

Unfortunately, the country has not been able to eradicate or reduce the incidence of rheumatic heart disease or most of the communicable diseases. They still remain the number one cause of mortality in the country.

In the urban areas, there has been a change in the trend of cancers. Once, cancer of cervix was the leading cause; it has now been surpassed by breast cancer in the urban areas. And in men, cancer of lung has overtaken as the number one cancer in urban areas with cancer of oral cavity taking the second spot.

With large number of tertiary hospitals and reverse brain drain from the West, medical tourism is booming in India. Medical tourism is attracting a large number of patients from Pakistan, Afghanistan, Nigeria and other Asian and African countries. The time is not far when even patients from the West will prefer India as the medical destination.

In 1947, there was hardly any medical technology available in India, but today any technology launched in the US is available in India within next three months. The same is true as regards devices and the medicines.

But there is still a long way to go before health care is available to all Indians.

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Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

The Indian Health Sector: Where are we after 64 years of independence?

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

National Conference on Insight on
Medico Legal Issue

Dr O P Kalra was felicitated in the National Conference on Insight on Medicolegal Issues held on 10th July, 2011.

Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


Now available, India’s first safety IV cannula to end needle stick injuries

Forty–year–old M.K. Maan of Mecmaan Healthcare has come up with a safety intravenous cannula, a device that prevents needle stick injuries among healthcare workers. It eliminates the chances of needle stick injuries and blood borne infections among the healthcare providers during the needle withdrawal and disposal. The cannula consists of seven detachable segments including a safety chamber that makes it different from other intravenous cannulae available in the market. It is a hollow device attached to the back of the cannula, where the infected needle once withdrawn from the patient’s body gets automatically locked in thus preventing any kind of human touch.

(Source: http://www.thehindu.com/health/policy–and–issues/article2336366.ece, August 8, 2011)

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

    International News

(Dr Monica and Brahm Vasudev)

We turn to God under stress

Many more people turn to god in stressed societies and also seem happier. However, when peace and plenty reign, people are happier independently of their religious affiliations, says a new study. This is the first study to analyse religion and happiness on a global scale, said University of Illinois psychology professor Ed Diener, who led the research and is a senior Gallup scientist, the Journal of Personality and Social Psychology reports. "Difficult circumstances lead more strongly to people being religious. And in religious societies and in difficult circumstances, religious people are happier than non–religious people," Diener said, according to an Illinois statement. "But in non–religious societies or more benign societies where many people’s needs are met, religious people aren’t happier – everyone’s happier," added Diener.
(Source: TOI, Aug 9, 2011)

For comments and archives

Sleep–disordered breathing linked to cognitive impairment

Sleep–disordered breathing is associated with a significantly increased risk for mild cognitive impairment (MCI) and dementia in elderly women, results of a prospective study indicate. The relationship seems to be related primarily to measures of hypoxia rather than sleep fragmentation or sleep duration, Kristine Yaffe, MD, of University of California, San Francisco and colleagues note in the August 10 issue of the Journal of the American Medical Association. (Source: Medscape Medical News)

For comments and archives

What is Cyberbullying?

Cyberbullying involves harassing, threatening or embarrassing young people through the use of technology, such as computers (especially Facebook) or cell phones.

As per Nemours Foundation, the warning signs for a net saving child:

  • A child acting distressed after being on the Internet.
  • Showing changes in mood, appetite or sleep patterns.
  • Withdrawing from social gatherings and not wanting to go to school.
  • Seeing grades fall in education.
  • Having behavior problems at home or school.

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  Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

Increasing muscle mass may lower type 2 diabetes risk

Other research has shown that having less body fat reduces diabetes risk and that exercise can help too, but a new study by UCLA scientists suggests a link between higher muscle mass and a lower risk of diabetes. "Our findings suggest that beyond focusing on losing weight to improve metabolic health, there may be a role for maintaining fitness and building muscle mass," says Preethi Srikanthan, an assistant professor of medicine in the division of endocrinology at UCLA’s David Geffen School of Medicine.

For comments and archives

  Twitter of the Day

@DrKKAggarwal: #AJD Eating fat when sad really does lift mood There may be more to the term comfort eating than we realize… http://fb.me

@DeepakChopra: War of the Worldviews: Science Vs. Spirituality by Deepak Chopra http://t.co/r8EiJ9B via @amazon

    Dr KK Answers

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

What happens after cessation of a drug in cases of drug fever?

In most, resolution of drug fever will occur within 72 to 96 hours of discontinuing the offending drug.

For comments and archives

    Spiritual Update

Bhagwad Gita and Diet

A famous couplet (doha) from Kabir says "Jaisa Bhojan Kijiye, Vaisa Hi Mana Hoye, Jaisa Paani Pijiye, Taisi Vani Hoye." "You are what your food is" is an old saying. This is based on a teaching from our shastras including yoga sutras of Patanjali, Bhagwad Gita and Upanishads. Even Chanakaya in Chanakay

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    An Inspirational Story

(Ms Ritu Sinha)

Happiness is a Voyage

We convince ourselves that life will be better once we are married, have a baby, then another. Then we get frustrated because our children are not old enough and that all will be well when they are older. Then we are frustrated because they reach adolescence and we must deal with them. Surely we’ll be happier when they grow out of the teen years. We tell ourselves our life will be better when our spouse gets his/her act together, when we have a nicer car, when we can take a vacation, when we finally retire.

The truth is that there is no better time to be happy than right now. If not, then when? Your life will always be full of challenges. It is better to admit as much and to decide to be happy in spite of it all. For the longest time, it seemed that life was about to start. Real life.

But there was always some obstacle along the way, an ordeal to get through, some work to be finished, some time to be given, a bill to be paid. Then life would start. I finally came to understand that those obstacles were life. That point of view helped me see that there isn’t any road to happiness. Happiness IS the road.

So, enjoy every moment. Stop waiting for school to end, for a return to school, to lose ten pounds, to gain ten pounds, for work to begin, to get married, for Friday evening, for Sunday morning, waiting for a new car, for your mortgage to be paid off, for spring, for summer, for fall, for winter, for the first or the fifteenth of the month, for your song to be played on the radio, to die, to be reborn… before deciding to be happy. Happiness is a voyage, not a destination.

There is no better time to be happy than… NOW!

Live and enjoy the moment.

For comments and archives

    Pediatric Update

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

How does the cytomegalovirus (CMV) spread?

  • Transplacental transmission: Primary infection in a mother who does not have protective antibodies (congenital CMV).
  • Neonatal transmission can occur through cervical or vaginal secretions at birth or, later, through breast milk from a mother who has active infection (perinatal CMV).
  • However, when a pregnant woman develops primary CMV infection in the first half of pregnancy, the risk of transplacental infection is approximately 40%. Of these babies, 5 to 15% are acutely symptomatic at birth.
  • Transmission can occur through saliva during preschool years
  • Venereal route is the dominant mode after about 15 years of age
  • Iatrogenic transmission can occur at any age through organ transplants or blood transfusions.

For comments and archives

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


Decreased albumin levels are seen in: Cystic fibrosis, chronic glomerulonephritis, alcoholic cirrhosis, Hodgkin’s disease, malnutrition, nephrotic syndrome, multiple myeloma, inflammatory bowel disease, leukemia, collagen–vascular diseases

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient with inflammation was being regularly followed up.
Dr. Bad: Do sequential ESR.
Dr Good: Do sequential CRP.
Lesson: As patient’s condition worsens or improves, the ESR changes relatively slowly but the CRP concentrations changes rapidly.

For comments and archives

Make Sure

Situation: A patient’s blood pressure was not responding on Arkamin.
Reaction: Oh my God! Why was the patient given Artamin?
Lesson: Make sure that prescription is written with the drug name spelled clearly.

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  Quote of the Day

(Dr GM Singh)

The key is not to prioritize what’s on your schedule, but to schedule your priorities. Stephen Covey


(Ms Ritu Sinha)

Dropping like flies: A large number of people either falling ill or dying.

  Rabies Update

(Dr A K Gupta, Author of "RABIES – the worst death")

What is the cause of death in a rabid animal?

Death in rabid animal is due to progressive paralysis.

Is hydrophobia a sign of rabies in dogs?

Hydrophobia is not a sign of rabies in dogs. Rabid dogs can drink water and even swim in water. If a rabid dog is not able to drink water, it is because of paralysis of jaw muscles and not due to hydrophobia.

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    Medicolegal Update

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

What is a poison?

The WHO describes a poison as any substance that causes harm if it gets into the body. Harm can be mild, e.g. headache or nausea or severe e.g. fits or very high fever. Individuals who suffer severe poisoning may die. The amount of a chemical substance that gets into the body at one time is called the dose. A dose that causes poisoning is a poisonous dose or toxic dose. The smallest amount that causes harm is the threshold dose. If the amount of a chemical substance that gets into the body is less than the threshold dose, the chemical will not cause poisoning and may even have beneficial effects. For example, medicines have good effects if people take the right doses, but some can be poisonous if taken in over dosages. In India, a National Poisons Control Programme is in place to improve the treatment and prevention of poisoning.

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    Mind Teaser

Read this…………………

Q. The most common complication seen in hiatus hernia is:

1 Oesophagitis.
2 Aspiration pneumonitis.
3 Volvulus.
4 Esophageal stricture.

Yesterday’s Mind Teaser: habirdnd = bu2sh

Answer for Yesterday’s Mind Teaser: A bird in the hand is worth two in the bush

Correct answers received from: Dr Riyazul Qamar Khan, Dr Vineet Banga, Dr Chandresh Jardosh,
Dr Muthumperumal Thirumalpillai, Dr K Raju, Dr Neelam Nath, Dr Jainendra Upadhyay, Dr Anil Bairaria,
Dr Dilip Kumar Jha, Dr S Upadhyaya, Dr Sudipto Samaddar, Dr Anupam Sethi Malhotra, Dr Theogaraj Samraj.

Answer for 11th August Mind Teaser: Dark under the eyes
Correct answers received from: Dr Sudipto Samaddar, Dr Anupam Sethi Malhotra, Dr Theogaraj Samraj.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr Chandresh Jardosh)

Dukh hamesha saath rehta hai magar khushi aati jati rehti hai.

Santa explains this in English: My wife is with me but her sister comes and goes.

For Comments and Archives

    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name


DCI Approval Date

Gatifloxacin 0.3% + Loteprednol Etabonate 0.5% + Benzalkonium Chloride 0.01% w/v Ophthalmic suspension

For post–operative steroid–repulsive inflammatory ocular conditions when ocular bacterial infections or a risk of bacterial infection exists


    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

The British are out, now get Azadi from lifestyle disorders

Forget the past as a history and live in the present. Celebrate 15th August every year as the day of independence from eradicable diseases said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India & MTNL Perfect Health Mela.

Every year on 15th August, the Prime Minister should announce a ‘Quit India' Movement for a particular disease.

The International Task Force for Disease Eradication in 1992 identified six "eradicable" or "potentially eradicable" infectious diseases. These are dracunculiasis, poliomyelitis, mumps, rubella, lymphatic filariasis, and cysticercosis. In 2002, measles was added to this list. Of these six diseases, only guinea worm disease or dracunculiasis has already been eradicated from India so far. Polio is on the verge or eradication.

Malaria, yellow fever, and yaws eradication programmes of earlier years were unsuccessful but they contributed greatly to a better understanding of the biological, social, political, and economic complexities of achieving the ultimate goal in disease control. In early 1997, WHO listed leprosy, onchocerciasis (River blindness), and Chaga’s disease as being candidates for elimination "as public health problems within 10 years".

Lifestyle disorders are other eradicable diseases as they are man-made. No wild animal suffers from a heart attack but a lion in the zoo, rabbit in the lab and a dog at home may develop these diseases. A heart attack can be prevented by observing the laws of nature.

A study of 641 patients in Aug. 8 issue of the Archives of Internal Medicine, has shown that the risk of developing diabetes over next three years can go down by 50 percent by simple lifestyle interventions. The risk can further drop in the subgroup that also has impaired glucose tolerance at baseline. The interventions involve a healthy diet and regular exercise. A classical diet is low calories, high fiber, zero trans fat and low in refined carbohydrates. Even in full blown diabetics, the requirement of drugs can be reduced by 50% over three months by lifestyle interventions. The same is true in hypertension and heart blockages.

For comments and archives

    Readers Response
  1. Health Check Up on this Raksha Bandhan i think this is the best gift. Rakhi is a sacred thread embellished with sister’s love and affection for her brother. On the day of Raksha Bandhan, sisters tie rakhi on the wrists of their brothers and express their love to them. After receiving the rakhi from a sister, a brother sincerely takes the responsibility of protecting her sister. In Indian tradition, the fragile thread rakhi is considered even stronger than an iron chain as it strongly binds a brother and a sister in the circumference of mutual love and trust. Regards Kumar Bhatt
    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & National Icons in the field of Cardiology & Echocardiography will form the teaching faculty.



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