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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


eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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  Editorial …

15th November 2011, Tuesday

All kids need cholesterol tests as per new AAP guidelines

As per new guidelines from the American Academy of Pediatrics (AAP) published in Pediatrics.

  1. Cholesterol checks should be part of periodic well–child visits for all children
  2. Screen cholesterol at least once between the ages of 9 and 11 and again at 17 to 21. Pediatricians previously had been directed to screen cholesterol only in children with risk factors like a family history of heart disease or high cholesterol. Routine screening need only be a non–HDL cholesterol measurement that doesn’t require fasting.
  3. Dietary management is often effective and should be the first line of attack against elevated cholesterol. Short–term use of plant sterol or stanol esters –– such as those in some margarines –– have been shown safe at doses up to 20 g per day, but longer–term use has not been tested and should be reserved for children who do not respond to diet alone.
  4. Statins should be considered for those with LDL levels at 190 mg/dL or higher for children who are at least 10 years old and have not responded after six months of lifestyle management or at an LDL of 160 to 189 mg/dL if risk factors are present.
  5. One should emphasize on breastfeeding and a diet low in saturated fat after a child’s first year.
  6. Advise parents on protecting children from tobacco exposure
  7. Start active anti–smoking advice to children at ages 5 to 9.
  8. Track weight–for–height, reviewing growth with parents and refer when above the 85th percentile without reductions for more than six months after age 4.
  9. Start routine annual blood pressure checks at age 3.
  10. Encourage physical activity and limiting time spent sedentary or in front of a screen to two hours or less per day.
  11. Start measuring fasting glucose at age 9 to 11.
  12. Detecting and intervening on these risks early should give children a healthier future.

For Comments and archives…

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

All kids need cholesterol tests as per
new AAP guidelines

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011–Valedictory Function

18th MTNL Perfect Health Mela ends up with the cultural and energetic performance. Mela is mixup of infotainment and fun.

Dr K K Aggarwal
    National News

World Diabetes Day: More women than men have diabetes in Mumbai

MUMBAI: More Mumbai women suffer from diabetes as compared to men. This was revealed in a survey ahead of World Diabetes Day on November 14. Significantly, the city has the most diabetics in the country. The survey conducted across five cities–Mumbai, Pune, Bangalore, Noida, Chennai–screened 28,79,175 people. Of the 24,34,799 people screened in Mumbai, 17.26% were found to be suffering from diabetes. But what was surprising was the fact that more women (50. 51%) were found to be suffering from diabetes than men (44.49%). Dr Hemraj Chandalia, director of Diabetes Endocrine Nutrition Management and Research Centre ( DENMARC), said: "The high numbers of diabetics is the result of a combination of genetics and environment. While Indians are genetically prone to diabetes, improving lifestyle is the key to reducing diabetes." (Source: TOI, Nov 14, 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

Study: Xarelto cuts heart attack mortality

Adding the oral anticoagulant rivaroxaban (Xarelto) to standard therapy after a myocardial infarction or unstable angina significantly reduced the risk of death, researchers reported here. (Source: Medpage Today)

For comments and archives

Asthma exacerbations can last a week or longer

Episodes of asthma worsening, when symptoms become more severe or frequent, commonly last for a week or more and can seriously affect a patient’s quality of life, according to a study presented in a poster session here at the American College of Allergy, Asthma & Immunology 2011 Annual Scientific Meeting. (Source: Medscape Medical News)

For comments and archives

AHA: Novel antiplatelet increases bleeding in ACS

Giving a novel antiplatelet, vorapaxar, to acute coronary syndrome patients did not reduce mortality or serious cardiovascular events, but it did significantly increase the risk of major bleeding, including intracranial hemorrhage, researchers said (American Heart Association meeting). (Source: Medpage Today)

For comments and archives

TCT: New pressure index is FFR minus adenosine

A new pressure–based index to measure the severity of coronary lesion stenosis without adenosine compared favorably to fractional flow reserve (FFR) with adenosine, researchers found (Transcatheter Cardiovascular Therapeutics meeting). (Source: Medpage Today)

For comments and archives

    World Diabetes Day
( Dr Shridhar Dwivedi )
Dr K K Aggarwal
    Twitter of the Day

@DrKKAggarwal: #AJD Diabetics Should Avoid Late Nights World Diabetes Day on 14th November Young adults who do not get enough… fb.me/UCveqekH

@DeepakChopra: Obesity, diabetes & high blood pressure get a lot of attention. They lead to CKD, which we need to know more about.

    Spiritual Update

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

What are the Different Types of Marriages?

As per Rig Veda, there are eight types of marriages depending on which need you are trying to fulfill.

  1. Brahman or arranged marriage: The parents choose the right spouse for their daughter and give her away in a wedding function.
  2. Praajaapathyam: Groom wants to marry to become a grihasth to do his dharma.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)


Alas. It is good to reminisce. But how come when you reminisce, you can’t help but to remember the not so good ones? How can you prevent the feeling from even entering your mind? You can never tell…

To reminisce is to understand. When you reminisce, you understand things you never understood before. To understand different thoughts and ideas, to understand the value of friendship and especially to understand the value of loyalty.

I have experienced reminiscing… Now I ask myself, WHY? Does it have to do anything about me? Maybe God wants me to change something. To change things that is wrong. Quoted from Lion King III: "You won’t change the past, so why worry?"

Again, why worry? Because it is our responsibility to change things we feel wrong. We have to make sure that everything is right in order to have a beautiful and peaceful life. But on the other side, we cannot remove the obstacles and trials in our lives. It is part of the tapestry of living and cannot be broken and scratched out by any means at all.

To reminisce is to remember good times. To remember the unforgettable days and wished you were back in time. Again, I say to myself over and over again, I cannot turn back time. I just can’t. I also say to myself that it is not good to dwell in those memories forever because you have to move on. There is a big world waiting for you out there–waiting for you to change it, waiting for you to unfold and reveal its mysteries.

But then again, it is not good to reminisce forever. You must face and take the world in your hands and with the help of our Lord; you must overcome any trials and obstacles ahead for you to be worry–free in your life.

For comments and archives

   Cardiology eMedinewS

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


Post PCI care

For comments and archives

CSI Abstracts

Now redo BMV

For comments and archives

CSI News

Access Site Drives TAVI Costs, Quality

For comments and archives

Facts and figures in cardiology

In ALLHAT, CKD (serum creatinine of >1.5 mg/dL) was a strong predictor of failure to achieve goal blood pressure.

    Fitness Update

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

Simple 5–step guide to form your habit

1. Take it Easy

One of the biggest mistakes you can make is over committing too early. This is not the time to push yourself or to embark on long gruelling workouts. These workouts are not sustainable and you ultimately end up either injured or giving up. Spend the first 4 weeks just forming a habit. Start with 5 – 10 minutes and add a little more each week. Don’t worry about the results at this stage just build up that habit of exercise.

For comments and archives

    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Drinking and Driving

Nothing but time sobers you up. Sleeping, coffee or taking a shower does not work.

For comments and archives

    Medicine Update

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

What are the features of appendicitis in a preschool age group (2–5 years)?

Appendicitis is still rare at this age, with children 5 years or younger accounting for less than 5% of all pediatric appendicitis.

  • Abdominal pain (89% to 100%), vomiting (66% to 100%), fever (80% to 87%), and anorexia (53% to 60%) predominate.
  • In contrast to infants, right lower quadrant tenderness is more common.
  • Vomiting is often the first symptom noted by parents and a history of vomiting that precedes pain is common.

For comments and archives

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    Legal Question of the Day

(Dr M C Gupta)

Can doctors having passed MBBS from India and postgraduation (such as ECFMG or PLAB or any other PG degrees) from abroad legally hold out as specialists on the basis of such PG qualifications and work as consultants in hospitals?

  1. ECFMG and PLAB are not PG degrees.
  2. PG degrees can be those recognised by the MCI or not so recognised. There is no problem when the degrees are recognised by the MCI.
  3. When a person with a PG degree not recognised by the MCI but considered as adequate and reliable by the hospital concerned is employed by a hospital, without violating some existing law, the following situations may arise:
    • A complaint may be made to the MCI that the doctor concerned is violating the following MCI Regulations, 2002:
      • "1.4.2–– Physicians shall display as suffix to their names only recognized medical degrees or such certificates/diplomas and memberships/honours which confer professional knowledge or recognizes any exemplary qualification/achievements."

        The above cannot be meant to imply that a cardiac surgeon with a PhD from Russia (not recognised by the MCI) cannot present himself in the following manner:
        "Dr. XYZ, MBBS (Calcutta), PhD in Cardiac Surgery (xyz University, Russia), Fellow, International College of Cardiac Surgery, USA. Senior Consultant, Cardiac Surgery, KKK Corporate Hospital. Reg. no. xxxxxx (WB Medical Council)"
      • "7.20––A Physician shall not claim to be specialist unless he has a special qualification in that branch." It is not stated here that the qualification must be recognised by the MCI. A cardiac surgeon with a PhD from Russia (not recognised by the MCI) cannot be said to be without a special qualification in that branch. He can certainly claim to be a cardiac surgeon.
    • A complaint may be made to a consumer court for negligence.

      Here the court would be concerned with the issue of negligence. Whether there is negligence or not is a matter of fact as determined by subject experts and peers in the profession and is not related to the fact whether he is an MCh from India or a PhD from Russia.
  4. The decision to employ such a person is taken by the hospital and the MCI cannot question this decision because hospitals are outside the purview of the MCI.

For comments and archives

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Low platelet counts and bleeding

  • In idiopathic thrombocytopenic purpura, minimal bleeding after trauma is uncommon unless the platelet count is less than 60,000/microL.
  • Self–limited bleeding, spontaneous bleeding requiring special attention (eg, nasal packing for epistaxis), and severe life threatening bleeding does not occur until platelet counts are <40,000, <12,000 and <6000/microL, respectively.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient of dengue hemorrhagic fever with minor GI bleed came for evaluation.
Dr Bad: Sister, admit him for platelet transfusion.
Dr Good: Sister, admit him for observation.
Lesson: Minor bleeds do not require platelet transfusion unless the bleeding is profuse and hematocrit is high. No blood transfusion is needed.

For comments and archives

Make Sure

Situation: A patient with asymptomatic second degree Mobitz 1 block after PPI developed lead infection.
Reaction: Oh my God! Why was PPI (Permanent pace maker implantation) done?
Lesson: Make sure that PPI is not implanted in patients with asymptomatic second–degree Mobitz I (Wenckebach) AV block.

For comments and archives

  Quote of the Day

(Dr GM Singh)

There is nothing in which people more betray their character than in what they laugh at.

    Mind Teaser

Read this…………………

Which of the following has the weakest association with hepatocellular carcinoma (HCC)?

a) Hepatitis B
b) Hepatitis C
c) Oral contraceptives
d) Smoking

Yesterday’s Mind Teaser: Which of the following structures does not form the portal triad in liver?

a) Portal vein
b) Hepatic vein
c) Hepatic artery
d) Bile duct

Answer for Yesterday’s Mind Teaser: b) Hepatic vein

Correct answers received from: Raju Kuppusamy, krithika, Dr Rajshree Aggarwal, Dr Chandresh Jardosh, Dr AK Kela, Dr Avtar Krishan, Dr Sukla Das, Dr PC Das, Dr Sukanta Sen, Selva Pandian, Uma Vasanth, Dr S Upadhyaya, Dr Surendra Bahadur Mathur, Dr Harkanwaljit Singh Saini, Dr Thakor Hitendrasinh G, Muthumperumal Thirumalpillai, Pramod Jain, Mayur Gunderia, Dr Jainendra Upadhyay, Anil Bairaria, Dr Neelam Nath.

Answer for 13th November Mind Teaser: Foreign Language
Correct answers received from: Dr KV Sarma, Sudipto Samaddar, Yogindra Vasavada.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Too drunk

A police officer pulls over this guy who had been weaving in and out of the lanes. He goes up to the guy’s window and says "Sir, I need you to blow into this breathalyzer tube."
The man says, "Sorry officer I can’t do that. I am an asthmatic. If I do that I’ll have a really bad asthma attack."

"Okay, fine. I need you to come down to the station to give a blood sample."
"I can’t do that either, I am a hemophiliac. If I do that, I’ll bleed to death."

"Well, then we need a urine sample."
"I’m sorry officer I can’t do that either. I am also a diabetic. If I do that I’ll get really low blood sugar."

"Alright then I need you to come out here and walk this white line."
"I can’t do that, officer."

"Why not?"
"Because I’m too drunk to do that.

  Medicolegal Update

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

Issuance of death Certificate by Doctor

Coma is a clinical symptom and not a cause of death

The certificate of death is always issued by doctor as an honor/respect to the deceased person without any fee. In accordance with the Registration of Births and Deaths Act 1969, the registration of deaths is now compulsory throughout India. The doctor must write his registration number in Death Certificate and a register for such information should be maintained with his clinic/hospital and a copy/information of death must/mandatorily be sent immediately to the birth and death registration office. It is essential that the cause of death must be documented/determined before lawful disposal of the deceased body by the doctor. The death certificate also provides the exact cause of death for statistical purposes. The cause of death is recorded according to international conventions; the sequence being that adopted by the World Health Organization. Thus, the international medical Certificate of the Cause of Death consists of two parts:

  • Part I: Records (a) the immediate cause, and (b) the morbid conditions, if any, giving rise to the immediate cause. Thus (a) must be due to (b). When (b) is due to other causes, it should be mentioned in (c). The basic pathological condition is that on the lower–most line and this is the one that is used for statistical purposes.
  • Part II: records any other significant condition contributing to death, but not related to the immediate cause of death. The underlying cause of death is defined as the disease, which initiated the train of morbid events leading directly to death for instance; a patient may die primarily from myocardial infraction due to coronary artery disease. These should be placed in parts (a) and (b) of part I as the myocardial infraction due to coronary artery disease (or coronary insufficiency). Similarly, it can be certified that the patient died of cerebral hemorrhage due to hypertension.

However, if the patient also suffers from diabetes, it should be entered in part II as it does not have a direct contributing role to the immediate cause of death. It is incorrect to write ‘heart failure ‘or ‘cardiac failure’ or’ cardiopulmonary arrest’ without mentioning the underlying pathological cause, which might be’ coronary artery disease’ or ‘rheumatic valve lesions’ or’ senile myocardial degeneration’. It should be remembered that everyone dies of cardiopulmonary arrest’ or’ heart failure’ or ‘cardiac failure’ which simply means cessation of circulation and respiration leading to somatic death.

The modes of death, e.g., cardiorespiratory failure, or asphyxia should not be recorded as the cause of death, unless qualified as explained here, for instance, ‘coma’ is a clinical symptom and not a cause of death. It should be used with proper cause such as crush injury of head or meningitis etc.

The terms like angina, cancer, tumor apoplexy congestion’,’ debility’, ‘asthenia,’ organic disease toxemia, sepsis and hemorrhage are sign/symptoms of the disease and not a pathological condition. It is pertinent for medical professional to note that a death certificate requires the underlying pathological cause and not clinical manifestations or modes of death.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

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

Winter Asthma Alert

All asthmatics do not wheeze and all who wheeze are not asthmatics. Chronic cough may be the only symptom of asthma, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Formula of 2 for persistent asthma

Asthma can be intermittent or persistent. The asthma is persistent if one gets > 2 asthma attacks in the night in a month; gets > 2 attacks of asthma in day in a week or uses more than 2 canisters of asthma in a year.

Persistent asthma (mild, moderate or severe) needs continuous drugs. On the contrary, intermittent asthma may be put on intermittent drugs.

Asthma attacks can occur in both intermittent and persistent asthma category and can be mild, moderate of severe attack.

  • If a person can speak a sentence, its mild asthma attack and can be managed as an OPD case.
  • If a person is breaking sentences, its moderate asthma attack and needs observation.
  • If the person is speaking in words, its severe asthma attack and needs ICU care.

For comments and archives

    Readers Response
  1. Sir, your yeoman service in enriching knowledge about the connection between spirituality and materialistic life will really put indelible imprint on the mindset of ours. bhupendra kumar
    Forthcoming Events

CSI 2011

63rd Annual Conference of the Cardiological Society of India

Date: December 8–11, 2011.
Venue: NCPA Complex, Nariman Point, Mumbai 400021

Organizing Committee

B. K. Goyal – Patron
Samuel Mathew – President CSI
Ashok Seth – President Elect & Chairman Scientific Committee
Lekha Adik Pathak – Chairperson
Satish Vaidya & C. V. Vanjani – Vice Chairman
N. O. Bansal – Organizing Secretary
B. R. Bansode – Treasurer
Ajit Desai , Ajay Mahajan , G. P. Ratnaparkhi – Jt. Org. Secretaries
Shantanu Deshpande , Sushil Kumbhat , Haresh Mehta – Asst. Org. Secretaries
D. B. Pahlajani, A. B. Mehta , M. J. Gandhi , G. S. Sainani, Sushil Munsi, GB Parulkar, KR Shetty – Advisory Committee

Contact: Dr. Lekha Adik Pathak, Chairperson, CSI 2011; Dr. Narender O. Bansal, Org. Secretary, CSI 2011 Tel: 91 – 22 – 2649 0261/2649 4946, Fax: 91 – 22 – 2640 5920/2649 4946.
Email: csi2011@ymail.com, csimumbai2011@gmail.com Website: www.csi2011mumbai.com

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews "Doctor of the Year Award" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.com

    eMedinewS Special

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

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

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

Activities eBooks


  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

    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