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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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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Workshop on Stress Management and How to be Happy and Healthy

    Dr KK Aggarwal on Social Media …

DR KK Aggarwal on Doctor Bhagwan Hai ya Shaitan
ASAR–Aamir Khan And Dr KK Aggarwal on Satyamev Jayate

  Editorial …

14th June 2012, Thursday

Daily aspirin to prevent heart disease may increase risk of GI or cerebral bleeding

JAMA has raised a red flag, saying the risk of bleeding even from low dose aspirin everyday is greater than they thought.

The study included more than 186,000 people aged 30 or older being treated with low–dose aspirin and more than 186,000 who were not. During six years, more than 6,900 first episodes of major bleeding requiring hospitalization were documented, including nearly 4,500 episodes of gastrointestinal bleeding and nearly 2,500 episodes of brain hemorrhage. Daily prescribed aspirin was associated with a 55% relative increase in the risk of major bleeding –– an excess of two bleeding cases per 1,000 patients treated each year.

This bleeding rate is roughly equal to the number of major cardiovascular events avoided in primary prevention for patients with a 10–year risk in the range of 10% to 20%.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Daily aspirin to prevent heart disease may increase risk of GI or cerebral bleeding

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day 2012

Students of Delhi Public School presenting a beautiful skit on the occasion of the World Earth Day celebration at DPS Mathura school premises. The Event was jointly organized by Heart Care Foundation of India, Delhi Public School and Ministry of Earth Sciences.

Dr K K Aggarwal
    National News

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 re build the image of the medical profession.

Why should we oppose the National Commission for Human Resources in Health (NCHRH) Bill–2011

Loss of autonomy

The Commission, National Board for Health Education and the National Evaluation and Assessment Committee shall consist of only appointed persons derived from medical as well as non–medical fields (e.g. engineering, business, law etc.)

The National Medical Council will have roughly equal number of appointed and elected members; only one–third will be required to complete the Quorum.

All the four bodies shall be duty–bound to execute the orders/policies of the Central Government (Clause 105).

No matter how respectable a post one holds in any of the four bodies, one can be instantly fired at the displeasure of the minister concerned. (‘…shall hold office till the pleasure of Government.’ Explanation: The President is the Head of State while the Prime Minister is the Head of Government.)

Non–democratic treatment of doctors

Renewal of registration every ten years opens up another avenue of exploiting the doctors by raising flimsy objections in the papers submitted for renewal, delaying renewal in red–tapism and asking for bribes. (Not required in any other profession).

Schedule VII (Professional Misconduct) incorporates many arbitrary and illogical clauses not supported by the established ethical norms of medical practice the world over.

On pronouncing a Doctor guilty of Professional Misconduct, The National Medical Council can impose a monetary penalty of upto 10 Lakhs and/or force the Doctor to do a compulsory period of Professional Service for a specified time.(Cl 69)

A Doctor can not seek protection of his fundamental rights in a court of law; Cl.100 bars jurisdiction of Courts.

Exploitation of doctors

High monetary penalty (upto ? 10 Lakhs) with another provision for letting off lightly (Cl 69) with a reprimand only speaks volumes in intended extortion (Either one pays up the extortion money or risks suffering heavy fine and/or suspension/removal from the National Medical Register with no recourse open to seek legal remedy)

Arbitrary clauses in the VII schedule (Professional Misconduct) makes it impractical to follow and result in making the Doctor end up as guilty of Professional Misconduct e.g. a health practitioner shall be deemed guilty of professional misconduct, if he is found absent on inspection from the place of duty on two occasions ( Sch.VII Part II Cl 21,22) on inspection.

Fails to keep moneys of his patient in separate bank accounts and spend them for the intended purpose within a specified time. (Sch.VII, Part I cl.20).

Fails to obtain sufficient information which is necessary for expression of an opinion or its exceptions are sufficiently material to negate the expression of an opinion. (Sch.VII, Part I cl 18).

Clause 108 empowers the Central Government to amend (i.e. including newer clauses in Sch.VII defining professional misconduct, for example) any of the schedules without seeking subsequent approval from the Parliament.

Strangulation of any voices of dissent

Nobody appointed or elected to any of the four bodies (viz.Commission, Board, Committee or Council) can utter a dissenting word against the policy/ies of the Central Government (e.g. The Ill-Conceived BRHC course of 3 1/2 years). He will lose office quickly at the displeasure of the minister concerned and risk other serious aftermaths like being left without employment (cl 89). If manages to sufficiently enrage the Central Government, he may also be hunted down and made to loose his registration without any recourse open to obtain a legal remedy.

A bleak future for healthcare in India

In an atmosphere vitiated by such Draconian legislations as CEA 2010 and NCHRH Bill 2011, by an apparently vindictive Central Government, it is not surprising if we find less and less youths aspiring to become Doctors and those already MBBS, opting for other career options in business and administration.

(Dr Amitabh Shrivastava, Asst Secretary IMA UP State. Etawah)

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

(Contributed by Dr Monica and Brahm Vasudev)

ADA: Added NSAID boosts glycemic control

Salsalate, an anti–inflammatory agent similar to aspirin, may moderately boost glycemic control when added to current oral anti–diabetic regimens, researchers found. (Source: Medpage Today)

For comments and archives

HIV infection no protection from superinfection

The rate of HIV "superinfection" – acquiring different HIV strains at different times – in a widespread heterosexual epidemic can be substantial, researchers reported. (Source: Medpage Today)

For comments and archives

Most don’t need antibiotics before dental work

Recommendations restricting the use of antibiotic prophylaxis before invasive dental procedures to only a handful of patient groups did not appear to increase rates of infective endocarditis caused by viridans group streptococci, researchers found. (Source: Medpage Today)

For comments and archives

Quitting smoking decreases death risk even in older people

Smokers are at almost twice the risk of dying of any cause at older ages than people who never smoked, and contrary to popular belief, quitting smoking — even at an older age — reduces the risk for death, according to a study published in the June 11 issue of the Archives of Internal Medicine. (Source: Medscape)

For comments and archives

Sore muscles may not benefit from regular NSAIDs

Muscle pain after heavy exercise is natural and even healthy, and taking anti–inflammatory drugs for normal soreness may be a bad idea, researchers suggested at the annual meeting of the European League Against Rheumatism. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Thin line between ethical and unethical acts Giving commissions and cut is an unfair trade practice in terms… http://fb.me/14ODs51Y7

@DeepakChopra: When you give, you show your appreciation to the source of all things. We only keep what we give away.

    Spiritual Update

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

Changing spectrum of the society

If we see the Vedic philosophy time is the only constant which changes every time. The Yugas have changed from Satya, to Tretya to Dwapara to finally to Kalyuga.

The ashrams have to change from Brahmacharya to Grahastha to Vanaprasthan and finally to Sanyasa. Satwa has to change to rajas and then to tamas and rulers of the society have to change from Brahmins to Kshatriyas to Vaishnavas and finally to Shudras.

For comments and archives

    4th Asia Pacific Vascular Intervention Course (APVIC)

4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More

The 4th Asia Pacific Vascular Interventional Course begins Read More

Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More

4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More

Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty
Read More

4th Asia pacific vascular intervention course Read More

    Aamir Khan Special

ASAR–Aamir Khan & Dr KK Aggarwal on Satyamev Jayate Read More

Docs vs Aamir Khan Headlines today 9th June 2012 7.30 pm Read More

Aamir Khan workshop with kids on dangerous areas Read More

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

How does one find an infertility counselor and other support?

Ask your physician for a list of books, support resources, and trained counselors in your area who have experience dealing with infertility. Counselors may be psychiatrists, psychologists, social workers, psychiatric nurses, or marriage and family counselors.

For comments and archives

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

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

Access to peripheral Veins

Steel needles or plastic catheters are commonly used for short–term transfusion therapy. Catheters are less likely to become dislodged or puncture the vessel wall, but carry risks of infection and thrombophlebitis that increase with time. There should be an institutional policy defining the maximum time a needle or catheter may remain in a vein and providing a surveillance mechanism to confirm that access devices are maintained aseptically and changed as often as specified.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

It only takes a second

A few days ago I got a call from my old college mate whom I hadn’t seen for a very long time. The topic, which was about all the good old times that we had and about his recent graduation changed to a touching story when he started talking about his father.

His father’s declining health required him to stay at the hospital. Because of his illness, his father suffered from insomnia and often talked to himself. My friend, who had not been able to sleep for a few days as he had to keep watch of his father’s condition, became irritated and told his father to keep silence and try to get some sleep. His father said that he really wanted to sleep well because he was very tired and told my friend to leave him alone in the hospital if he did not want to keep him company.

After his father finished talking he fell unconscious and had to be rushed to the Intensive Care Unit (ICU). My friend was very sorry for he had spoken ill words towards his father.

My friend, whom I knew as a tough person, cried like a baby on the other end of the telephone. He said that from that moment on he prayed every day asking God to let his father woke up from his coma. He promised himself that whatever words came out from his father’s mouth after he regained his conscious would be gladly taken. His only hope was for God to give him a chance to rectify his past mistake, a mistake that he might not forget for the rest of his life…

Often we complain when we have to accompany or to watch over our parents for years, months, days, hours or even minutes. But do we realize that our parents keep us companied and watch over us for as long as we (or they) live? Since the day we were born to our adulthood, and even when death comes to greet us, they are always at our side. When it's time for them to return to God, their memory lingers for the rest of our life.

Imagine how broken–hearted our parents will be to a seemingly innocent word of "no" which comes out from our mouth when they try to embrace us in their tender loving care, but which we often consider as something that bind us and hold us from flying the blue sky. What other words will replace the word "crying" when there are no more tears to shed from their eyes as the tears are wasted to shower our days so that our life would grow and produce fruits and flowers to liven up the dark days of the rotating wheel of life.

We can make promises to ourselves that from now on there will be no more complaints come out from our mouths when we have to watch and accompany our parents. No more complaints come out from our mouths when we feel that our parents have treated us like little children. Have faith, out there are so many unlucky ones who have neither fathers nor mothers, who long to have the things that we most complain about, but never have them.

Actually, it takes only a second to contemplate and light the lamp that will bring us to where peace is dwelling. Now it’s all up to us whether we want to spare our short time for a great and meaningful life ahead of our lives.

For comments and archives

    Cardiology eMedinewS

Add insulin if metformin fails Read More

Eat less and your heart will thank you Read More

People with pre diabetes may be at greater stroke risk later in life
Read More

    Pediatric eMedinewS

UNICEF urges countries to treat diarrhea, pneumonia Read More

Study Shows Even Little Kids Can Be Cutters Read More

Teens with poorly controlled diabetes often depressed Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with painful diabetic neuropathy came with postural hypotension.
Dr Bad: The two are unrelated conditions.
Dr Good: It is due to autonomic dysfunction.
Lesson: Painful diabetic peripheral neuropathy (DPN) is associated with significantly greater autonomic dysfunction than painless diabetic neuropathy. The greater autonomic dysfunction seen in painful DPN may reflect more predominant small fiber involvement and also adds to the growing evidence of its role in the pathophysiology of painful DPN.

For comments and archives

Make Sure

Situation: A neonate in an ICU being administered IV calcium exhibits signs of inflammation and necrosis at injection site.
Reaction: Oh my God! Why didn’t you observe the IV site carefully?
Lesson: Make Sure that all hypocalcemic neonates are put on a cardiac monitor while receiving calcium infusions and the IV site is closely observed because extravasations of calcium can produce severe interstitial necrosis.

For comments and archives

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    Health News Bulletin

Surya Pharma scrip tanks as IFCI invokes pledged shares
The Economic Times, Vijay Gaurav

Mumbai: Surya Pharmaceutical, an Rs 1,650–crore mid–sized company, has become a victim of promoters’ indebtedness. On Monday, the stock slipped to its lowest since listing, with brokers attributing the fall to a sustained selling pressure due to the promoters’ inability to honor margin calls from IFCI, the lender. The promoters had pledged almost their entire holding – 7.7 crore shares or 38% of the equity as on March 31, 2012 – with lenders including IFCI. As disclosed to stock exchanges, IFCI has invoked a large number of pledged shares which, according to brokers, may have been offloaded in the open market to recover dues. Invocation of a pledge is triggered when a borrower, faced with a dip in share price, is unable to deposit additional margin with the lender. At Monday’s close of Rs 2.8 (face value Rs 1, Surya Pharmaceutical has lost 70% in two months, and 90% from its peak recorded in November 2010.

  Microbial World: The Good and the Bad They Do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta – The Medicity, Gurgaon)

Immunizable diseases

Immediately after birth the baby is exposed to a wide plethora of microbes, all around. The immune status of the baby may still be developing. However, the newborn has to be protected from the harmful microbes around. This is done to some extent by immunization of the newborn. The vaccines are not available for all the communicable diseases. A tentative list of currently available vaccines used to protect the newborn against these immunizable diseases is given. Different countries include vaccines depending upon priority and resources in their Universal Immunization Programme. In India, the UIP includes vaccines for seven immunizable diseases.

  • Tuberculosis (BCG)
  • Hepatitis B
  • Diphtheria
  • Tetanus
  • Pertussis (Whopping cough)
  • Polio myelitis
  • Haemophilus influenzae type B(Hib)
  • Measles
  • Mumps
  • Rubella
  • Varicella
  • Hepatitis A
  • Human papilloma virus (HPV)
  Quote of the Day

(Dr GM Singh)

The weak can never forgive. Forgiveness is the attribute of the strong. Mahatma Gandhi

    Lab Update

(Dr Navin Dang and Dr Arpan Gandhi)

Cardiolipin antibodies (IgG and IgM)

  • To help determine the cause of an unexplained thrombotic episode, recurrent miscarriage, or thrombocytopenia.
  • To help investigate the cause of a prolonged PTT (activated partial thromboplastin time), along with lupus anticoagulant testing, especially if clinical findings suggest that the patient may have SLE or another autoimmune disorder.
    Mind Teaser

Read this…………………

Atropine sulfate (Atropine) is contraindicated in all but one of the following client?

a. A client with high blood
b. A client with bowel obstruction
c. A client with glaucoma
d. A client with UTI

Yesterday’s Mind Teaser: A 65–year–old female is experiencing flare up of pruritus. Which of the client’s action could aggravate the cause of flare ups?

a. Sleeping in cool and humidified environment.
b. Daily baths with fragrant soap.
c. Using clothes made from 100% cotton.
d. Increasing fluid intake.

Answer for Yesterday’s Mind Teaser: b. Daily baths with fragrant soap.

Correct answers received from: Dr Mrs S Das, Dr PC Das, Dr shashi saini, Dr P Narayana samy,
Dr Thakor Hitendrsinh G, Raju Kuppusamy, Dr S Jha, Dr Jainendra Upadhyay, Anil Bairaria, Dr Sushma chawla.

Answer for 12th June Mind Teaser: d) Malignancy is more in anorectal ulcerative colitis.

Correct answers received from:
Dr Chandresh Jardosh, Dr Kanta Jain, Muthumperumal Thirumalpillai,
Dr Avtar Krishan, Dr LC Dhoka, Anil Bairaria.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Beggars can be choosers

A man walks past a beggar every day and gives him Rs. 10 and that continues for a year. Then suddenly the daily donation changes to Rs. 7.50. "Well," the beggar thinks, "it’s still better than nothing."

A year passes in this way until the man’s daily donation suddenly becomes Rs. 5. "What’s going on now?" the beggar asks his donor. "First you give me Rs. 10 every day, then Rs. 7,50 and now only Rs. 5. What’s the problem?"

"Well," the man says, "last year my eldest son went to university, it’s very expensive, so I had to cut costs. This year my eldest daughter also went to university, so I had to cut my expenses even further."

"And how many children do you have?" the beggar asks.

"Four," the man replies.

"Well," says the beggar, "I hope you don’t plan to educate them all at my expense".

    Medicolegal Update

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

What are ethanol and isopropanol?

Ethanol is ethyl alcohol or grain alcohol and isopropanol is isopropyl alcohol or rubbing alcohol.

  • When people talk about alcohol it usually means ethanol. Alcoholic drinks beers, wines and spirits contain ethanol. Methylated spirit and surgical spirit contain mainly ethanol, with a small amount of methanol. Ethanol is also an ingredient of some liquid medicines, mouthwashes, antiseptics, disinfectants, and cosmetics such as aftershaves, perfumes, and colognes. Alcohol abuse is common and chronic abuse can lead to dependence. People who try to poison themselves by taking large doses of medicine often take alcohol at the same time. Ethanol content of drinks and other products: Distilled spirits 40–50%; Wines 10–20%; Beers 2–10%; Mouthwashes up to 75% and Colognes 40–60%.
  • Isopropanol is used as a sterilizing agent and as rubbing alcohol, and is added to some antifreeze, car windscreen washes, window cleaners, aftershaves and disinfectants. Car windscreen washes may also contain methanol.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Do not ignore breakfast

Taking a good breakfast made up of carbohydrates and lean protein, can help lessen cravings and hunger during the rest of the day, which can lead to significant weight loss, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

A research by Dr. Daniela Jakubowicz, a clinical professor at Virginia Commonwealth University and an endocrinologist at the Hospital de Clinicas Caracas in Venezuela has shown that sedentary, obese women lost almost five times as much weight on the "big breakfast" diet as did women following a traditional, restrictive low–carbohydrate diet.

While treating obese people we need to treat carb cravings and hunger. On waking up in the morning, the body is primed to look for food. The metabolism is revived up, and levels of cortisol and adrenaline are at their highest. The brain needs energy right away, and if one doesn’t eat or eats too little, the brain needs to find another fuel source. To do this, it activates an emergency system that pulls energy from muscle, destroying muscle tissue in the process. Then when you eat later, the body and brain are still in high–alert mode, so the body saves energy from the food as fat.

The levels of the brain chemical serotonin are highest in the morning and the craving levels are at the lowest and you may not feel like eating. As the day wears on, serotonin levels dip, and you get cravings for chocolate or cookies, and such similar foods. If you eat these foods, your serotonin levels rise, and your body begins to associate good feelings with them, creating an addictive cycle. The high protein, carbohydrate mix in breakfast gives the body the initial energy boost it needs in the morning. Throughout the rest of the day, the meals are made up of protein and complex carbohydrates, like vegetables. Because protein is digested slowly, you won’t feel hungry.

If you have to eat chocolate, eat it in the morning as having a small piece of chocolate or candy when serotonin levels are high, won’t taste as good, and the brain won’t feel the same serotonin boost, which will eventually help cut down on cravings.

Eating breakfast with high glycemic foods may be harmful. After eating cereals or a doughnut, the blood sugar and insulin levels spike. Once that blood sugar is used up, you’ll still have excess insulin circulating, which makes you hungry and makes you crave carbohydrates.

    Readers Responses
  1. Dear Sir, emedinews is very informative newspaper. Regards:Trisha
    Forthcoming Events
Dr K K Aggarwal

Dr K K Aggarwal


All are cordially invited for the 2nd National Conference of IYCF Chapter of IAP. This conference is organized by: IYCF Chapter, MOH&FW GOI, MOWCD GOI, WHO, UNICEF, IMLEA, SDHE Trust.
The theme of the conference is: "Proper Nutrition: Defeat Malnutrition – Investing in the Future"
Venue: India Habitat Centre, Lodhi Road, New Delhi – 110 003.
Date: 5th Aug 2012
For further details contact:
Conference Secretariat: Dr. Balraj Yadav, E–Mail: drbalraj@ymail.com, drvisheshkumar@gmail.com,
Ph: +91.124.2223836, Mobile: +91.9811108230

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

    eMedinewS Special

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    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