eMedinewS 14th July 2013, Sunday

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

New treatment for advanced cervical cancer

Chemotherapy plus bevacizumab for recurrent, advanced, or metastatic cervical cancer For women with recurrent cervical cancer, those with advanced cancer who are not surgical candidates, and those who present with metastatic disease the new first-line treatment is chemotherapy plus bevacizumab rather than chemotherapy alone.

Women with recurrent, metastatic, or advanced cervical cancer should receive treatment consisting of platinum-based combination chemotherapy plus the angiogenesis inhibitor bevacizumab.

Results of the GOG 240 study, in which over 450 women were randomly assigned to chemotherapy with or without bevacizumab and presented at the 2013 American Society of Clinical Oncology meeting has shown that chemotherapy plus bevacizumab resulted in a significant improvement in overall survival compared to chemotherapy alone. The new treatment also improved the overall response rate and progression free survival without a detriment in quality of life.

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: NAMASKAR and Namaste

We are virtually nobodies while the Cosmos is the Ultimate Being

While greeting any one in Hindu culture one takes the name of GOD, the supreme Brahma. It reminds us that we are nothing, Every thing is GOD.

This traditional greeting of India has a deep spiritual meaning. It signifies non-arrogance or negation of ego.

NAMASKAR is made of three words: NAMAH + OM + KAR

NAMAH means NOT ME. It is a negation of one's identity and hence of one's ego or arrogance. It signifies that I am nothing.

OM is the sound of life, the primordial sound of nature. In Vedic language it signifies soul, the spirit or the GOD.

KAR means shape/form of or manifestation of.

OMKAR therefore signifies manifestation of OM, the UNIVERSE, the cosmos, BRAHMA, SHIVA or GOD. OMKAR is omnipresent and omnipotent.

NAMASKAR therefore indicates that I am nothing while the OMKAR is every thing. IT also gives respect to the one you say Namaskar. That I am nothing and you are GOD. In vedantic text we are taught to give respect to atihiti (atithi devo bhava)

When you bow to say namaskar and try to get angry. You can not. As the body posture does not allow you to do so. For an angry posture you must have expansion of the chest wall and not the flexion of the chest wall.

Other schools of thought:


NAM is the root form of NAMAH and has the same meaning as NAMAH - NOT ME. (I am nothing).

AS means "To Be" or "To Exist". A word derived from Astitva which means existence.

KAR means doer or one who makes or creates. For example, KAR can be seen in the words Kalakar, Chitrakar, Karmkar, Charmkar. In the above words, the suffix kar leads to the meaning of one who creates work.

ASKAR therefore means the creator of all that exists, the GOD.

Namaskar therefore has the same meaning: I am nothing every thing is the GOD

Other meanings

  1. Some people interpret NAMAH as “I Bow to”. Ultimately the deeper meaning remains the same. I bow to GOD. Here you are considering the other person as GOD. Which is one of Mahavakyas from Chandogya Upanishad in Sam Veda, “Tat Tyam Asi” (you are that).
  2. "I salute the Almighty within you." The true Namaste gesture is is accompanied by bowing the head and shoulders slightly. This is a gesture that lessens our sense of ego and self-centredness, requiring some humility to do it well — whereas shaking hands can be quite an arrogant event.
  3. Its a sign of respect and peace
  4. I bow to God in you; I love you and I respect you, as there is no one like you."
  5. The word 'Namo' can be split into 'Na' + 'Mama' - meaning 'Not mine'.
  6. In AHIRBUDNYA SAMHITA, Siva explains the meaning of Namah in three ways:
    1. STULA ARTHA: Gross etymological derivation referring to the inherent nature of the Jeeva as Sesha. Bowing the body is acceptance of the greatness of the one bowed to; when done with the eight angas ( limbs), it is 'Sashtanga' and is the perfect Namas.
    2. SUKSHMA ARTHA: Subtle meaning as seen in 'Nirukta' when it refers to bowing in thought , word and deed with an understanding of the bowing to be a Sadhyopaya ( means).
    3. PARA ARTHA: Supreme meaning derived from the Sastras thus: NA indicating the Upaya; MA indicating its importance and S indicating Bhagavan, the Siddhopaya.( goal )


Namaste = NAMAH + TE

Namah means Not Me

Te means “they”.

The literal meaning of NAMASTE hence is "Not me, they". The word they refer to “GOD”.

NAMASTE = that the doer of everything is not me but the Gods.

Other means of greetings

  1. RAM-RAM
  6. Sikhs say SAT SHRI AKAL, which means that Truth is the God and is timeless.
  7. Sikhs also say WAHE GURUJI KA KHALSA, WAHE GURUJI KI FATEH. This is a declaration that the ultimate victory will be of the Guru and his followers.
  8. Muslims say KHUDA HAFIZ, which means Khuda is the Protector. ...Read More
cardiology news

The Tiger's Whisker

Once upon a time, a young wife named Yun Ok was at her wit's end. Her husband had always been a tender and loving soul mate before he had left for the wars but, ever since he returned home, he was cross, angry, and unpredictable. She was almost afraid to live with her own husband. Only in glancing moments did she catch a shadow of the husband she used to know and love.

When one ailment or another bothered people in her village, they would often rush for a cure to a hermit who lived deep in the mountains. Not Yun Ok. She always prided herself that she could heal her own troubles. But this time was different. She was desperate.

As Yun Ok approached the hermit's hut, she saw the door was open. The old man said without turning around: "I hear you. What's your problem?" She explained the situation. His back still to her, he said, "Ah yes, it's often that way when soldiers return from the war. What do you expect me to do about it?"

"Make me a potion!" cried the young wife. "Or an amulet, a drink, whatever it takes to get my husband back the way he used to be." The old man turned around. "Young woman, your request doesn't exactly fall into the same category as a broken bone or ear infection." "I know", said she. "It will take three days before I can even look into it. Come back then."

Three days later, Yun Ok returned to the hermit's hut. "Yun Ok", he greeted her with a smile, "I have good news. There is a potion that will restore your husband to the way he used to be, but you should know that it requires an unusual ingredient. You must bring me a whisker from a live tiger." "What?" she gasped. "Such a thing is impossible!" "I cannot make the potion without it!" he shouted, startling her. He turned his back. "There is nothing more to say. As you can see, I'm very busy." That night Yun Ok tossed and turned. How could she get a whisker from a live tiger?

The next day before dawn, she crept out of the house with a bowl of rice covered with meat sauce. She went to a cave on the mountainside where a tiger was known to live. She clicked her tongue very softly as she crept up, her heart pounding, and carefully set the bowl on the grass. Then, trying to make as little noise as she could, she backed away.

The next day before dawn, she took another bowl of rice covered with meat sauce to the cave. She approached the same spot, clicking softly with her tongue. She saw that the bowl was empty, replaced the empty one with a fresh one, and again left, clicking softly and trying not to break twigs or rustle leaves, or do anything else to startle and unsettle the wild beast.

So it went, day after day, for several months. She never saw the tiger (thank goodness for that! she thought) though she knew from footprints on the ground that the tiger - and not a smaller mountain creature - had been eating her food. Then one day as she approached, she noticed the tiger's head poking out of its cave. Glancing downward, she stepped very carefully to the same spot and with as little noise as she could, set down the fresh bowl and, her heart pounding, picked up the one that was empty. ............Read More

News Around The Globe

Kids' pneumonia shots helping young and old

Vaccinating children against pneumococcal pneumonia cut hospitalizations for the infection over the past decade in nearly all age groups, particularly the youngest and oldest, a nationwide study showed. (Source: Medpage today)

'Caution' warranted if consuming artificial sweeteners

Consumption of noncaloric, artificially sweetened beverages (ASBs) is associated with an increased risk for disease variety of chronic diseases, according to an opinion article by Susan E. Swithers, PhD, a professor of behavioral neuroscience at Purdue University in West Lafayette, Indiana, published onlineJuly 10 in Trends in Endocrinology & Metabolism. (Source: Medscape)

Tuberculosis rates spike in HIV patients on antiretrovirals

The incidence of active tuberculosis (TB) infection increased as much as 5 times for HIV-infected patients who received highly active antiretroviral therapy (HAART) therapy in rural South Africa, according to a new study. Dr. Naidoo presented the findings here at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. (Source: Medscape)

Hepatitis C reinfection rising among HIV patients

Nearly 25% of HIV patients infected with and subsequently cured of the hepatitis C virus went on to acquire a second or even third infection within 24 months at one hospital in the United Kingdom. These results suggest that much better educational initiatives related to coinfection with HIV and hepatitis C are needed, he noted. Dr. Martin presented the results here at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. (Source: Medscape)

Growth, not size, of brain aneurysms biggest risk for rupture

Brain aneurysms — even small ones — are more likely to rupture if they are growing, a new study has shown. The discovery counters current guidelines and emphasizes the need for regular monitoring and earlier treatment. The study was published online in Radiology on July 2. (Source: Medscape)

Stress fractures may be preventable

Lower-extremity stress fractures often occurred in association with potentially modifiable muscular and biomechanical factors, according to a study of 1,800 military cadets. (Source: Medpage Today)

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

What happens in an egg donation cycle?

In an egg donation cycle, the donor receives fertility medications to stimulate the production of multiple eggs in her ovaries. At the same time, you are given hormone therapy to prepare your uterus to receive the fertilized eggs (embryos). After the eggs are obtained from the donor, they are fertilized in the laboratory with your partner’s sperm. Several days after fertilization, the embryos are transferred to your uterus. Any embryos which are not transferred may be frozen (cryopreserved) for a future cycle.

Rabies News (Dr. A K Gupta)

  • Study of passive immunity in the prevention of rabies discusses the advances in passive immunoprophylaxis, most notably the shift from the recommended polyclonal human or equine immunoglobulin to monoclonal antibody therapies. The first rabies-specific monoclonal antibodies are undergoing clinical trials, so passive immunization might finally become an accessible, affordable, and routinely used part of global health practices for rabies.
  • A report on use of a reduced (4-dose) vaccine schedule for post exposure prophylaxis to prevent human rabies summarized new recommendation and updates previous recommendations of the Advisory Committee on Immunization Practices (ACIP) for post exposure prophylaxis (PEP) to prevent human rabies.
  • Human rabies can be very effectively prevented, and animal control is an important component in reducing the public health risk to humans. Dog rabies can be eliminated by well established control methods and routine dog rabies vaccination programs.
cardiology news

Large Study Affirms Safety of Statins

An analysis of trials including nearly a quarter of a million people confirmed that statins as a class are well tolerated, although safety profiles vary from agent to agent, researchers found.

Statin therapy was associated with increased odds of diabetes and elevations of liver enzymes compared with placebo, but there were no differences in development of myalgia or cancer, elevations in creatine kinase, or discontinuations because of adverse events, according to Huseyin Naci, MHS, of the London School of Economics and Political Science, and colleagues.

Diabetes Tied to Timing of Baby's First Solid Food

Among children already at higher risk for type 1 diabetes, missing the sweet spot for introduction of solid foods may increase the risk even further, researchers found.

Compared with exposing children to solid food for the first time at ages 4 or 5 months, introducing solid food both earlier and later was associated with greater risks of developing the disease (hazard ratio 1.91 for early and HR 3.02 for later), according to Jill Norris, PhD, MPH, of the Colorado School of Public Health in Aurora, and colleagues.

Valvular Heart Disease News

When should one intervene in patients with chronic MR with symptoms?

Patients with chronic MR who become symptomatic are candidates for corrective mitral surgery, even if symptoms improve with medical therapy or the left ventricle appears to be compensated. If there is uncertainty about the presence or absence of symptoms, exercise testing may provide objective information that may not be available from the medical history alone.

(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

More patch time repairs amblyopia faster, full study report

Residual amblyopia improves more with 6 hours of daily eye patching than it does if a 2-hour patching regimen is continued, researchers report in an article published online June 5 in Ophthalmology. (Source: Medscape)

HPV: Less than a third of patients vaccinated

Recent guidelines to prevent cervical cancer via human papilloma virus (HPV) screening and Papanicolaou (Pap) smears have not led to widespread HPV vaccination, according to a study published in the July 9 issue of the American Journal of Preventive Medicine (Source: Medscape)

cardiology news

Clot dissolving therapy or angioplasty in early acute heart attacks

Outcomes are comparable between primary removal of clot in heart artery with stent angioplasty and clot dissolving drugs in patients with ST-elevation heart attacks who present early.

Results of STREAM study

  1. Best is stent angioplasty if it can be done within one hour of presentation to the hospital
  2. Those who present within three hours of chest pain and stent angiopslaty cannot be done in one hour there was no difference between the two treatments (stent angioplasty of clot dissolving drugs) in the primary composite end point of major adverse cardiovascular events at 30 days.

    Comments: In most non busy cardiac center stent angioplasty labs needs to be informed and angiographer called for doing the procedure and that take time. In such cases give clot dissolving drugs. ...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

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

Poor hygiene habits may lead to Typhoid fever

Typhoid fever is caused by a bacteria Salmonella typhi and is transmitted through the ingestion of food or drink contaminated by the faeces or urine of infected people, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India. Flying insects feeding on feces may occasionally transfer the bacteria through poor hygiene habits and public sanitation conditions.

Though the cases occur round the year more cases are seen in summer and rainy season.

Symptoms usually develop 1–3 weeks after exposure, and may be mild or severe. They include high fever, malaise, headache, constipation or diarrhea and enlarged spleen and liver. Healthy carrier state may follow acute illness.

It can be treated with antibiotics. However, resistance to common antimicrobials is widespread. Healthy carriers should be excluded from handling food.

Sanitation and hygiene are the critical measures that can be taken to prevent typhoid.

  1. Typhoid does not affect animals and therefore transmission is only from human to human.
  2. Typhoid can only spread in environments where human feces or urine are able to come into contact with food or drinking water.
  3. Careful food preparation and washing of hands are crucial to preventing typhoid.
  4. Typhoid fever in most cases is not fatal.
  5. Prompt treatment of the disease with antibiotics reduces the case-fatality rate to approximately 1%.
  6. When untreated, typhoid fever persists for three weeks to a month.
  7. Resistance to common antibiotics is now common
  8. Typhoid that is resistant to common antibiotics is known as multidrug-resistant typhoid (MDR typhoid).
  9. Ciprofloxacin resistance is an increasing problem, especially in the Indian subcontinent and Southeast Asia.
  10. Azithromycin is a new drug for drug resistant typhoid.
  11. Typhoid vaccine taken every three years is the best preventive approach. ...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

Initial dosing of warfarin

today video of the day1308 students learnt CPR at Abhinav Public School, Rohini

Symposium on Prayer, Faith, Meditation and healing Part 9

CPR Utsav 6th April 11543 Male Female Trained in 1 day

eMedi Quiz

Read this…………………

When caring for children who are sick, who have sustained traumas, or who are suffering from nutritional inadequacies, nurse Ron should know the correct hemoglobin (Hb) values for children. Which of the following ranges would be inaccurate?

a. Neonates: 10.6 to 16.5 g/dl
b. 3 months: 10.6 to 16.5 g/dl
c. 3 years: 9.4 to 15.5 g/dl
d. 10 years: 10.7 to 15.5 g/dl

Yesterday’s Mind Teaser: Dr. Smith suspects tracheoesophageal fistula in a 1-day-old neonate. Which nursing intervention is most appropriate for this child?

a. Avoiding suctioning unless cyanosis occurs
b. Elevating the neonate’s head and giving nothing by mouth
c. Elevating the neonate’s head for 1 hour after feedings
d. Giving the neonate only glucose water for the first 24 hours

Answer for yesterday’s Mind Teaser: b. Elevating the neonate’s head and giving nothing by mouth

Correct answers received from: Dr.K.V.Sarma, Dr Prabha Luhadia, Mahesh Tandale, Dr Ayyavoo Erode, Dr Santha kumara, soni brijesh, Dr. B.B. Gupta, Dr Pankaj Agarwal, Tukaram Pagad, Dr.Chandresh Jardosh, Dr Jainendra Upadhyay, RAVI BINDRA, Dr Kanta Jain, nprabakar, Dr. P. C. Das,

Answer for 13th July Mind Teaser: d. HIB, DTP, HepB; and IPV

Correct answers received from: Dr B.B. Gupta, Dr Pankaj Agarwal, Tukaram Pagad, Dr.Chandresh Jardosh,

Send your answer to ijcp12@gmail.com

eMedi Apps

medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Chairman Legal Cell Indian Academy of Echocardiography; Chairman Ethical Committee Delhi Medical Council; Editor eMedinewS and President Heart Care Foundation of India)

Is it ethical for a physician I have never seen to refuse to see me?

AMA Code of Ethics: Opinion 10.05, "Potential Patients" defines circumstances in which a physician may ethically decline to accept specific patients before a patient-physician relationship has been established.

Opinion 10.05 - Potential Patients

  1. Physicians must keep their professional obligations to provide care to patients in accord with their prerogative to choose whether to enter into a patient-physician relationship.
  2. The following instances identify the limits on physicians’ prerogative:
    1. Physicians should respond to the best of their ability in cases of medical emergency (Opinion 8.11, "Neglect of Patient").
    2. Physicians cannot refuse to care for patients based on race, gender, sexual orientation, or any other criteria that would constitute invidious discrimination (Opinion 9.12, "Patient-Physician Relationship: Respect for Law and Human Rights"), nor can they discriminate against patients with infectious diseases (Opinion 2.23, "HIV Testing").

Read More

medicolegal update

A woman went shopping, at cash counter she opened her purse to pay.

The cashier noticed a TV remote in her purse. He couldn't control his curiosity and asked, "Do you always carry your TV remote with you?"

She replied, "No, not always, but my husband refused to accompany me for shopping today, so...

The shopkeeper smiles and takes back all the items that the lady had purchased.

Shocked at this act, she asks the shopkeeper, What are you doing?"

He said, "Your husband has blocked your credit card."

MORAL: Respect the hobbies of your husband. Read More

medicolegal update
medicolegal update

Situation: A patient of atrial fibrillation on amiadorone developed hypothyroid state.
Dr. Bad: Continue thyroid drugs
Dr. Good: TSH will become normal once the offending drug is stop.
Lesson: A amiadorone can cause reversible hypothyroidism. Read More

medicolegal update

Situation: A patient of gross ascites presents with complaints of difficulty in breathing on lying down.
Reaction: Oh my God! Why did you drain so much ascitic fluid?
Lesson: Make sure to evaluate the patient thoroughly and only moderately tap the ascitic fluid since overenthusiastic tapping can be life–threatening.

medicolegal update

If CARE is a WAVE, I give u SEA. If RESPECT is a LEAF, I give u TREE. If TRUST is a PLANET, I give u GALAXY, if FRIENDSHIP is LIFE, I give u MINE 4 FREE… Keep smiling.

medicolegal update

Dr KK Aggarwal: Add ECG when screening school children
http://bit.ly/132xLOW #Health

Dr Deepak Chopra: All thoughts & perceptions arise & subside in awareness. Observer & observed are one
http://bit.ly/14JxRjo #Health

medicolegal update

Dear Sir, Nice information in emedinews. Regards: Dr Sandeep

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

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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, Prof.(Dr).C V Raghuveer

medicolegal update

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