eMedinewS 13th July 2013, Saturday

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; Chairman Ethical Committee Delhi Medical Council; 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.facebook.com/Dr KKAggarwal

Two third cases come to OT without consent forms

As per a report published in JAMA surgery by Elliott Haut, MD, of Johns Hopkins Hospital, consent forms are missing from the charts for two-thirds of patients who arrived in preop (66%), resulting in delayed operation start times in 14% of cases.

If a missing consent is subsequently obtained by a resident, 40% of hospital faculty they are not usually satisfied with that consent. And 69% said residents should not obtain consent from patients having elective surgery.

Most hospital faculty (70%) also said that they believed that patients preferred to be asked for consent by their surgeon rather than a resident.

Informed consent is the most important conversation that patients have with their surgeons, allowing for autonomy and informed decision making.

The researchers administered a web-based survey to 30 pre-op nurses, 39 surgical residents, and 53 faculty members at a single academic hospital. In addition to collecting 1 week of data on absent surgical consent forms in patients' medical records, they asked about actions following discovery of the missing consent form, and case delays.

1. When a missing consent form was discovered, 72% of nurses said they paged the attending physician.

2. Some 43.2% of residents said they were paged to acquire consent forms at least weekly, while 16.2% were called more than once a week. This resulted in 65.8% of residents being pulled from their rounds or a conference weekly; 13% were pulled away from other work daily.

3. Although most residents said they were comfortable obtaining consent forms for minor procedures (97.4%), less than half (47.4%) said they were comfortable getting consent for major procedures. (MedPage Today) ...Read More

Where is the concept of mass prayer gone?

One someone dies in the family we mourn for thirteen days. We follow a mass prayer on the 4th or the 13th day. The head of the family leads the prayer.

In Uttarakhand disaster the immediate head of the family is CM and the final head is the PM or the President.

National Disaster Management Authority vice-chairman Marri Shashidhar Reddy has stated that the number of missing persons could be over 11, 600.

Where is the mass chautha, terevi or even the mass prayer by the head of the family.

What can be done?

1. Mass prayer by the CM and the PM

2. President to address the nation starting with an appeal for one minute silence to be observed by every citizen of India.

3. All spiritual GURUS to gather in one platform and observe silence and do a peace prayer/yagna. ...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
Ringtone - CPR 10 Mantra Hindi

Ringtone - CPR 10 Mantra English

sprritual blog Spiritual Prescriptions - Controlling The Inner Noise

Yoga Sutras of Patanjali defines yoga as restraint of the mental states (Chapter 1.2). According to it in the state of total restrain the mind is devoid of any external object and is in its true self or the consciousness. To control the mind many Vedic scholars have given their own formulas.

Being in touch with ones own consciousness require restrain of mind, intellect and ego on one hand and the triad of rajas, tamas and satwa on the other hand. Every action leads to a memory, which in turn leads to a desire and with this a vicious cycle starts.

The mental turmoil of thoughts can be equated to the internal noise and the external desires and objects to an external noise.

The process of withdrawing from the external noise with an aim to start a journey inwards the silent field of awareness bypassing the internal noise is called pratihaara by Yoga Sutras of Patanjali. It involves living in a satwik atmosphere based on the do’s and don’ts learnt over a period of time or told by the scriptures.

To control inner noise based thoughts either we need to neutralize negative thoughts by cultivating opposite thoughts or kill the origin of negative thoughts. Not allowing thoughts to occur has been one of the strategies mentioned by the scholars. One of them has been neti-neti by Yagnayakya. The other way is to pass through these inner thoughts and not get disturbed by it and that is what the process of meditation is.

This can be equated to a situation where two people are talking in an atmosphere of loud external noise. For proper communication one will have to concentrate on each others voice for long till the external noise ceases to disturb. In meditation one concentrates on the object of concentration to such an extent that the noisy thoughts cease to bother or exist. One of the ways mentioned by Aadi Shankaracharya in Bhaja Govindam and by Yoga Sutras of Patanjali (Chapter 2.35) is that whenever one is surrounded by evil or negative thoughts one should meditate open the contrary thoughts.

For example, if one is getting evil desires after seeing bare breasts of a young lady, one can think that these very breasts gave me an opportunity to drink milk when I was born. Similarly when one is feeling greedy one can have a desire of donating something to somebody.

Deepak Chopra in his book Seven Laws of Spiritual Success talks in detail about the importance of giving and sharing. He says one should never visit his friends or relations empty handed.

One should always carry some gift of nature which if nothing is available can be a simple smile, compliment or a flower. By repeatedly indulging into positive behavior and thoughts one reduces the internal noise which helps in making the process of meditation or conscious living a simpler one. Washing out negative thoughts is another way mentioned by many vedic scholars. Three minutes writing is one such exercise which anybody can do. Just before sleep anybody can do free three minutes writing where one writes all his or her emotions and throw the paper away. Another exercise is to reward or punish one self at bed time for the activities done during the day by either patting or slapping yourself. ...Read More  

cardiology news


To answer a question, once Krishn and Bhishm designed a ‘test.

They called in Duryodhan one early morning and asked him to go around a kingdom for the whole day and return when he finds a ‘good person’ or by sunset, whichever is earlier.

A few minutes later they called in Yudhishthir and asked him to go around the entire kingdom for the whole day and return when he finds ‘an evil person’ or by sunset, whichever is earlier.

In the evening, Duryodhan returned empty handed and said that he could not find a single good person in the entire kingdom.

Yudhishthir also returned empty handed and said that he could not find a single evil person in the entire kingdom.

Moral: The outside is the reflection of my inside. ............Read More

News Around The Globe

Dr. KK’s CME Group

Dr. KK’s CME Group is organizing a CME with Dr. KK Aggarwal on Sunday, 14th July, 2013 at Moolchand Medcity from 8-10 am. The topic for the CME will be “How to handle common poisonings in India” and Joint Disease.

You are requested to kindly attend the CME.

With kind regards, Dr. Pawan Gupta, CME Co-ordinator

India's population to be 1.40 billion by 2026: Ghulam Nabi Azad, Union Minister for Health & Family Welfare, Govt. of India

Union Minister for Health & Welfare, Government of India Mr. Ghulam Nabhi Azad emphasised the need for curbing the population growth rate. He was speaking in the ‘National Dialogue on Population Stabilization for a Better Tomorrow,’ here organized by the Ministry of Health and Family Welfare, Government of India & Janasankya Sthirata Kosh (National Population Stabilization Fund), on the occasion of World Population Day. Addressing the gathering he said that, "As per 2011 census, India's total population was 1.21 billion. As per population projection, India's population would be 1.40 billion by 2026. With only 2.4 per cent of the entire world's landmass to support 17 per cent of the world population, the need for population stabilisation can hardly be overemphasized.” He also emphasized the need for employing extensive media advocacy to create awareness about issues relating to population control.

Addressing the panel, Dr. Hema Divakar, President, The Federation of Obstetric & Gynaecological Societies of India (FOGSI), the apex body of obstetricians and gynaecologists in the country, outlined the programs initiated by FOGSI to control the burgeoning population growth rate at the meeting on Thursday. “At FOGSI, we have several result-oriented programs aimed at arresting the growth of the population. We have tied up with government agencies and NGOs in states with poor human development indices to tackle the issue both at the macro and micro levels,” she added.


eMedinewS mourns the untimely death of Dr. Jageet Singh of Patiala and Padma Shree Awardee Dr. Dhanwant Singh Doyen of Patiala.

Two unrelated studies have shown an increased risk of heart attack ranging 38 to 70% dabigatran. The studies are published in Journal of the American College of Cardiology.

Seminar at Hamdard Institute

A seminar on transfusion medicine was organised at Department of Pathology and Blood Bank, Hamdard Institution of Medical Science and Research as an ongoing activity of the Blood Doner Day. The persons who spoke on the occasion were Prof. Sujata Jaetly, Prof. N.S. Verma, Prof. A.K. Khetrapal, Prof. S. Dwivedi.

The speakers emphasised on the role of safe blood transfer and said that voluntary donation is the only answer.

High blood concentration of EPA, DPA and DHA

A study published in July edition of Journal of National Cancer Institute indicate that high blood concentration of EPA, DPA and DHA – the three anti-inflamatory related fatty acids derived from fatty fish and fish oil supplements are associated with 71% increased risk of high grade prostate cancer.

Development of alcohlism

New study has shown that brain’s response to sweets increase risk for development of alcohlism. The study will be published in December 2013 issue of Alcoholism: Clinical and Experimental Research.

Vitamin D deficiency

A study published in Journal Science Transnational Medicine has shown that Vitamin D deficiency also reduces bone quality and makes it prone for fractures.

Prolonged exposure to air pollution

According to the results of new metanolysis published in Lancet prolonged exposure to air pollution is significantly associated with increased risk of lung cancer.

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

Which surgery is recommended for infertility?

Laparoscopic treatment of minimal and mild endometriosis has been associated with a small but significant improvement in pregnancy rates. In a study, 29% of women who had their endometriosis treated conceived over nine months, in contrast to only 17% of women whose endometriosis was diagnosed, but not treated during laparoscopy. Treatment of moderate and severe endometriosis by laparoscopy and/or laparotomy increases pregnancy rates for women in whom no other causes of infertility have been found.

Rabies News (Dr. A K Gupta)

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.

cardiology news

Sleep May Play Important Role in Heart Health

A good night's sleep boosts the benefits of a healthy lifestyle on the heart, according to a new large study from the Netherlands published in theEuropean Journal of Preventive Cardiology on Wednesday.

The researchers found that not smoking, regular exercise, a healthy diet, and moderate alcohol consumption protects against cardiovascular disease (CVD).

Chest Pain Patients Could Get Quick DNA Test for Heart Problems

Testing fragments of DNA in the blood may be a fast way to find out if a patient's chest pain is due to coronary artery disease according to a new US-led study published online this week in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.

When patients complain of chest pain, they have to undergo a time-consuming and expensive set of tests to find out if the cause is something to do with the heart or some other problem, such as in the muscles, lungs or esophagus.

Valvular Heart Disease News

Patients with mild carditis (mild mitral regurgitation or healed carditis) should receive secondary prophylaxis for rheumatic fever for 10 years after the last attack, or at least until 25 years of age (whichever is longer). Patients with more severe valvular damage (causing heart failure) or after valve surgery should receive lifelong secondary prophylaxis.

(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

Nearly half of parents know CT raises lifetime cancer risk

Nearly half of parents who visited the emergency department with a child who had suffered a head injury knew that computed tomography (CT) imaging was associated with an increased lifetime cancer risk, and 90.7% of parents wanted to know about such risk potential before CT use, according to a prospective cross-sectional study. (Source: Medscape)

Nearly half of babies have flat skull spot

Close to half of two-month-olds have "positional plagiocephaly" -- a flat spot on the back of their heads - and changes in parents' habits may be a cause. Although not thought to be medically dangerous, the flattened head shape can become permanent, which can have psychological implications for kids as they grow up, , Canadian authors suggest. (Source: Medscape)

cardiology news

Is caffeine good for the health?

  1. Caffeine is the most consumed stimulant in the world,
  2. It is consumed in the form of coffee and tea.
  3. At present there is no scientific data for promoting or discouraging coffee and/or tea consumption in the daily diet.
  4. Short term benefits include mental alertness and improved athletic performance.
  5. Short term adverse effects including headache, anxiety, tremors, and insomnia.
  6. Long term adverse affects include generalized anxiety disorder and substance abuse disorders.
  7. Long-term benefits are dose-dependent. Caffeine is associated with a reduced risk of Parkinson disease, Alzheimer disease, alcoholic cirrhosis, and gout. Both caffeinated and decaffeinated coffee are also associated with a lower risk of type 2 diabetes.
  8. Heavy coffee intake may trigger coronary and arrhythmic events in susceptible individuals, although coffee intake is not considered a long-term risk factor for myocardial disease.
  9. Most studies show a modest inverse relationship between coffee consumption and all-cause mortality.
  10. Caffeine withdrawal is a well-documented clinical syndrome with headache being the most common symptom. (Source uptodate) ...Read More
cardiology news

Alcohol and rape facts  

Rape myths  

Situation: A depressed female with recent sexual assault was brought to the hospital  

Situation: A sexually assaulted girl was found to have a vaginal tear on examination.  

Situation: A student asked his senior whether rape was mentioned in the Holy Bible  

cardiology news


CPR 10 Training Camp, EPFO, 30th May 2013

CPR 10 Camp - Police Training Center Najafgarh

CPR Classes: Persons trained (52)

Total CPR since 1st November 2012 – 54572 trained

6th July: Zoonosis Conference: 52

Video Chats and uploads

Symposium on Prayer, Faith, Meditation and healing Part 9

Symposium on Prayer, Faith, Meditation and healing Part 8

Symposium on Prayer, Faith, Meditation and healing Part 7

Symposium on Prayer, Faith, Meditation and healing Part 6

Symposium on Prayer, Faith, Meditation and healing Part 5

Symposium on Prayer, Faith, Meditation and healing Part 3

Symposium on Prayer, Faith, Meditation and healing Part 2

Symposium on Prayer, Faith, Meditation and healing Part 1

CPR 10 training was given to 1001 students learnt CPR at Bal Bharti Public School, Dwarka

Seven Steps to Patient Safety

What patient expect on doctor – A survey

MTNL Perfect Health Mela to focus on Disaster Management & Doctor patient relationship

Dr AK Aggarwal Speaks on Workshop on Patient Safety

Dr RN Makroo on Blood Safety

Prof (Dr) Usha Gupta on Medication Safety

Dr N V Kamath DHS on Patient Care

High fat diet prostate cancer prone

Diets high in saturated fat increases the risk of prostate cancer said Padma Shri & Dr. B C Roy National Awardee Dr. KK Aggarwal, President, Heart Care Foundation of India and Perfect Health Mela and National Vice President-Elect IMA.

As per a report from University of Texas M. D. Anderson Cancer Center in Houston published in the International Journal of Cancer.

  1. Men who consume high saturated animal fat diet are two times more likely to experience disease progression after prostate cancer surgery than men with lower saturated fat intake.
  2. There is also shorter "disease-free" survival time among obese men who eat high saturated fat diet compared with non-obese men consuming diets low in saturated fat.
  3. Men with a high saturated fat intake had the shortest survival time free of prostate cancer (19 months)
  4. Non-obese men with low fat intake survived the longest time free of the disease (46 months).
  5. Non-obese men with high intake and obese men with low intake had "disease-free" survival of 29 and 42 months, respectively.

Take home messages

  1. High saturated fat diet has been linked to cancer of the prostate
  2. Reducing saturated fat in the diet after prostate cancer surgery can help reduce the cancer progression.
  3. Cancer prostate has the same risk factors as that of heart blockages and both are linked to high saturated fat intake.
  4. With the increase of heart patients a corresponding increase in prostate cancer patients is also seen in the society.

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 54572 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 10x10 i.e. 100 per minute.” ...Read More

today emedipics

Doctor Day Celebration

On the occasion of Doctors Day, a CME was organized by IMANDB, eMedinewS and Heart Care Foundation of India on 29th June 2013 at IIC, New Delhi

press release

Death risks higher for heart attack survivors living near major roadways

today video of the day

Dr KK Aggarwal on 4 REALNEWS JUNE 26 2013 On Uttrakhand Disaster

Symposium on Prayer, Faith, Meditation and healing Part 9

Symposium on Prayer, Faith, Meditation and healing Part 8

eMedi Quiz

Read this…………………

A 2-month-old baby hasn’t received any immunizations. Which immunizations should nurse Jess prepare to administer?

a. Measles, mumps, rubella (MMR); diphtheria, tetanus, pertussis (DTP); and Hepatitis B (HepB)
b. Polio (IPV), DTP, MMR
c. Varicella, Haemophilus influenzae type b (HIB), IPV, and DTP
d. HIB, DTP, HepB; and IPV

Yesterday’s Mind Teaser: Nurse Dave is conducting an examination of a 6-month-old baby. During the examination, the nurse should be able to elicit which reflex?

a. Babinski’s
b. Startle
c. Moro’s
d. Dance

Answer for yesterday’s Mind Teaser: a. Babinski’s

Correct answers received from: DR ABBAS VAKIL. Dr. P. C. Das, Dr. Thakor Hitendrsinh G, Dr. Sushma Chawla, Narahari Kandakatla, Dr. V.P. Thakral, Dr.K.V.Sarma, Dr.K.Raju, DR Pankaj Agarwal, Dr Jainendra Upadhyay, Tukaram Pagad, DR Chandresh Jardosh, daivadheenam.jella, Dr Brijesh Soni, DR.BITAAN SEN & DR.JAYASHREE SEN, Dr. P. C. Das.

Answer for 11th July Mind Teaser: a. Hepatomegaly

Correct answers received from: Tukaram Pagad, Dr kanta jain, DR Chandresh Jardosh, DR.BITAAN SEN & DR.JAYASHREE SEN, Dr. P. C. Das.

Send your answer to ijcp12@gmail.com

eMedi Apps

medicolegal update

Quest 1: Should doctors plead guilty during an inquiry? (Dr. K K Aggarwal)

Awarding of Sentence


A plea is simply an answer made by someone in a civil or criminal case under common Law. In response to a criminal charge (professional
misconduct in the case of a doctor). The person may plead guilty, not guilty, no contest or afford plea. Under the common Law a plea of guilty by the defendant waives trial of the charge, offences and the defendants may be sentenced immediately.
Plea pleaded guilty with an idea to get less punishment, may be pardoned or get away with a warning.
This also avoids the mental harassment of a long trial.
Under the MCI Code of Ethics 8.2, it is written that the appropriate Medical Council MAY award such punishment as deem necessary or may
direct the removal altogether or for a specified period, from the register of the name of delinquent registered medical practitioner.
The world “MAY” here signifies that the Council has a provision to even pardon or leave him with warning. Read More

Quest 2: Can medical interventions be stopped? (Dr. M C Gupta, Advocate & Medico-legal Consultant)

Every medical intervention, including artificial nutrition and hydration, may be terminated at the patient’s request. Specific legal cases have sanctioned the withholding or withdrawal of respirators, chemotherapy, blood transfusions, hemodialysis and major surgical operations. In Cruzan, the United States Supreme Court definitively stated that artificial nutrition and hydration are medical interventions that can be withheld or withdrawn under the guidelines that apply to other medical treatments (Cruzan v. Director of Missouri Department of Health, 110 S. Ct. 2841 (1990)) Read More

medicolegal update

Gastrointestinal: "The alimentary canal is located in the northern part of Alabama."

medicolegal update
medicolegal update

Situation: Doctor screens me for thyroid deficiency.
Dr. Bad: Get TSH, FT4 and FT3 test done.
Dr. Good:
Get serum TSH done.
Lesson: The current recommendation is to do only serum TSH as the initial screening test.

medicolegal update

Situation: A patient with 3 hour of developing chest pain went into acute cardiac arrest.
Reaction: Oh my God! Why was water–soluble aspirin not given at the time of chest pain?
Lesson: Make sure that all patients with suspected MI are given water–soluble aspirin to reduce chances of death.

medicolegal update

Sow a thought, reap an act; Sow an act, reap a habit; Sow a habit, reap a character; Sow a character, reap adestiny. ~

medicolegal update

Dr KK Aggarwal: If you are at risk of heart attack ask your doctor for a statin
http://bit.ly/14JxRjo #Health

Dr Deepak Chopra: Expanded Awareness and Success
http://bit.ly/14JxRjo #Health

medicolegal update

Dear KK, this format is better and user friendly god bless u. Dr.R.Mani Chennai

Forthcoming Events

2nd annual Ped Neuro Conclave

Sunday, 25th August 2013.
This is an annual event hosted jointly by Fortis Escorts Hospital and IAP Jaipur. This conference is held every year and is attended by more than 200 delegates, which include Neurologists, Pediatricians, GPs and resident doctors from all over Rajasthan. Senior faculty from different institutes all over India and abroad participates and shares their knowledge and experience with the audience.

The eminent faculty includes
Dr. Pratibha Singhi, Head Pediatric Neurology, PGI – Chandigarh
Dr R K Sabharwal, Head Pediatric Neurology, Sir Ganga Ram Hospital, New Delhi
Dr. Vineet Bhushan Gupta, Sr Consultant Pediatric Neurologist, Apollo Hospital, New Delhi;
Dr Deepak Gupta, Sr Consultant Paediatric Psychiatrist, Sir Ganga Ram Hospital, New Delhi.
Venue: Jaipur Marriott Hotel
Date: Sunday, 25 August 2013 (0900-1700)
Organizing Secretary: Dr Sharad Sharma, MD (PGI), MRCPCH (UK), Fellow Pediatric Neurology (London)
Senior Consultant Pediatric Neurology, Fortis Hospital, Jaipur, Rajasthan

eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

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

Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Prof.(Dr).C V Raghuveer

medicolegal update

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