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Dr KK Aggarwal

From the Desk of Editor in Chief
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

16th August, 2010, Monday

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

Single entrance test for MBBS-MD from 2011: a welcome step

From 2011 there will be only one common entrance test each for over 30,000 MBBS seats and over 11,000 MD seats in all government and medical colleges in the country. This MCI decision, and accepted by the Union Ministry of Health, was conveyed to the Supreme Court. Earlier, students had to appear in at least five to six entrance tests for various colleges and worry about attendant problems like clash of exam dates as well as travel to distant places for counselling for allotment of seats.

From 2011, there will be just one entrance test each for MBBS and MD courses offered by all 271 medical colleges, 138 government–run and 133 under private management. These colleges together offer over 31,000 seats for MBBS courses and another 11,000 for PG.

During hearing of the petition before a Bench comprising Justices R V Raveendran and H L Gokhale, the decision for one common entrance test was conveyed by MCI counsel and senior advocate Amarendra Saran. Additional solicitor general P P Malhotra said the government had accepted MCI's suggestion to amend the regulation concerning admissions to medical colleges.

However, i personally feel, there are some unanswered questions.

1. What about DM and MCH courses? They should also be included.   
2. These steps should be to check the cash capitation fee only then the system will be transparent. The country needs transparency in the admission to prevnt brain drain from going out of the country.
3. The counseling also should be done by a centralized body? 
4. One can also think of a single MD/DNB exam?. Afterall both the degrees are at par.  
5. DNB has already done the exercise of a single window exam from next session with centralised merit list.  This step has already checked the probelm of capitation cash fee in DNB.

Dr KK Aggarwal
Editor in Chief
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Photo Feature

Even during early years of it’s foundation, Heart Care Foundation of India under flagship of Dr Col K L Chopra and leadership of Dr. K K Aggarwal organised several conferences and events to spread health awareness

In the photo: Ms Girja Vyas, Lt Dr Col K L Chopra during a conference. Also in the photo Padmashri and Dr B C Roy National Awardee Dr K K Aggarwal, President HCFI


k k Aggarwal


News and Views


Two separate councils in higher education and health soon: Dr Manmohan Singh {15th August Speech} 

We have been giving special attention to education and health in the last six years. Improvement in these two areas is an important component of our strategy for inclusive growth. It is also necessary for higher economic growth in the years to come. After independence, these two areas could not get the importance they deserved. We tried to change this state of affairs in the 11th Plan. Today, almost every child in our country has access to primary education. Now, we need to pay more attention to secondary and higher education. We also need to improve the quality of education at all levels. It is our endeavour that every child, irrespective of whether he is rich or poor and which section of the society he belongs to, should be given an education that enables him to realize his potential and makes him a responsible citizen of our country. We will continue to implement the new schemes that we have started in the last six years in the areas of education and health with sincerity and hard work and in partnership with the State Governments. We will soon bring a Bill to Parliament for constitution of two separate councils in higher education and health respectively so that reforms in these two areas can be accelerated.

Nutritious food and good health services are necessary but not enough for ensuring good health of our citizens. We also need cleanliness and good sanitation in our villages, towns and cities. There are many diseases which would be difficult to prevent otherwise. The truth is that our country lags behind in this area. I consider it a primary responsibility of all our citizens to maintain cleanliness and hygiene around them. I would like our children to be taught the importance of cleanliness and hygiene in schools from the very beginning under a campaign for a Clean India. I appeal to the State Governments, Panchayat Raj Institutions, civil society groups and common citizens to make this campaign successful.”

International ( Dr Brahm and Dr Monica Vasudev)

Researchers examine factors influencing long-term risk for ihd, all–cause mortality, and cv mortality in type 1 diabetes

The long–term risk for ischemic heart disease (IHD), all–cause mortality, and cardiovascular (CV) mortality are increased in patients with type 1 diabetes if they have poor glycemic control, dyslipidemia, and renal dysfunction. This was reported in a study published in the Journal of Diabetes and Its Complications.

Should belly fat prompt early colon cancer screens?

A large waistline more than doubles the risk that people in their 40s will develop precancerous cells in the colon, according to Korean researchers. The chances of finding abnormal cells during a screening test were just as good in younger men with too much belly fat as in slimmer men over 50. As a result, the researchers recommend lowering the age of colon cancer screening from 50 years to 45 in men with weight problems. (Reuters)

Allergy update

According to the Centers for Disease Control and Prevention, 2 percent of U.S. adults and 4 to 8 percent of kids have food allergies, which cause about 150 deaths each year. People with allergies vary in the severity of their reactions - some will get a mild rash or an itchy tongue if they eat something that contains the allergen; others may stop breathing and lose consciousness.

Blood vessel diameter in normotensive persons with type 1 diabetes unaffected by ACEIs, ARBs

In patients with type 1 diabetes mellitus who have normal blood pressure, neither angiotensin–converting enzyme inhibitors nor angiotensin–receptor blockers have an effect on retinal arteriole or venule diameter, according to a study in the February issue of the Archives of Ophthalmology.


Legal Column

Forensic Column: Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

WMA declaration of Malta on hunger strikers

Beneficence does not necessarily involve prolonging life at all costs

‘Benefit’ and ‘harm’: these two concepts need to be in balance. Physicians must exercise their skills and knowledge to benefit those they treat. ‘Benefit’ includes respecting individuals’ wishes as well as promoting their welfare. Avoiding ‘harm’ means not only minimizing damage to health but also not forcing treatment upon competent people nor coercing them to stop fasting. Beneficence does not necessarily involve prolonging life at all costs, irrespective of other values.


Experts’ Views

Question of the day

What are the indications of laser treatment in diabetic retinopathy? (Dr Madhivanan Natarajan)

1. Proliferative diabetic retinopathy

2. Severe nonproliferative diabetic retinopathy

When associated with other risk factors like severe renal dysfunction
Where frequent follow up is not possible
Patient noncompliance

3. Diabetic maculopathy

Clinically significant macular edema
Retinal thickening within 500 microns from center of fovea
Hard exudates within 500 microns from center of fovea with adjacent retinal thickening
Retinal thickening within 1,500 microns from center of fovea any area of which is > 1,500 microns


Public Forum (Press Release for use by the newspapers)

Depression, severe mental illness and loneliness not heart-friendly

Depression, severe mental illness and loneliness are linked to heart disease and dementia said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India, BSNL Dil ka Darbar & MTNL Perfect Health Mela. Quoting Dr. Jesse Stewart, formerly of the University of Pittsburgh School of Medicine, Dr Aggarwal said that there is correlation between depression and hardening of the arteries.

The arteries of those who are most depressed were narrowed twice as much as those who were least depressed, in the study. Hardening of the arteries is a precursor to a heart attack or stroke.

Depression may also upset the body’s regulation of glands that release chemicals governing energy level and growth, and alter the functioning of cells responsible for blood clotting.

Hardening of the arteries leads to an overreaction of the immune system and the resulting inflammation is known to release chemicals that can cause the diseases.

Quoting a British study, Dr Aggarwal said that severely mentally ill people are more than three times as likely to die from coronary heart disease and stroke than people not suffering from mental illness. Mental illness more than doubled the risk of dying from heart disease for people up to age 75.

The risk of dying from heart disease was even higher among those taking antipsychotic medications.

A persistent feeling of loneliness among the elderly doubles the risk of developing Alzheimer's-like symptoms compared to those who felt connected to others.


Conference Calendar

BASIC (Basic Assessment and Support in Intensive Care) Chinese University of Hong Kong Accredited

Date: August 21 – 22, 2010
Venue: 142, Bharathiyar Road, Papanayakanpalayam, Coimbatore, Tamil Nadu.


Dr KK Aggarwal on Net

Dengue threat looms large over Games
"The stagnant water is responsible for more mosquito breeding," said Dr KK Aggarwal, a physician at Moolchand Hospital. However, MCD officials refuse to … (http://www.mid-day.com/news/2010/aug/120810-Delhi-CWG-Dengue-Malaria-monsoon.htm)


An Inspirational Story

Appreciate all Gifts

She tried so very hard, so very many times, to walk away from him; to escape the hold that he seemed to have over her. She recognized that he chose to live such a separate life and had little room for her, but for a few stolen moments in time. She knew there would come a day when even the moments in time were no longer possible, yet she didn't have the strength to follow through. She couldn’t move away on her own.

It was like being sucked down into a whirlpool endlessly, hopelessly spinning downward. But each time, when spending time with him became a possibility, she was released from the downward spiral and lifted up onto the waves, with the clear blue sky and sunshine looming above her. She took flight, soaring above the sea, above the world, in a place where she felt such joy such freedom. It was these times she could not give up.

For those moments were unlike any other and she knew they would continue to be unlike any others that would come to her in her remaining lifetime. Sometimes she almost hated the hold he had on her. Sometimes she prayed for logic, reality and reason to take control and protect her from his reach. But these efforts were hopeless. She knew she had no chance of escaping; knew that for her, this man embodied all that was beautiful, all that was precious, all that was life.

His strength, his compassion, his beautiful soul; a single hour in his presence was equal to years of peace and serenity filled with such an enduring feeling of security and safety. He rescued her from her responsibilities. Rescued her from her life, from the draining demands by all those around her. He made her whole. He made her complete.

Though she would never fully understand why the walls he put up would not come down, why it could not be more, she was left to accept what there was, yet ultimately to appreciate that God and fate had brought to her this special gift.

The conventional is not always the course. Don’t miss out on the wonderful moments that can be captured in life by expecting more. Learn to accept that which touches you, which leads you to appreciate every aspect of life; that which brings you to appreciate all of the other special things in life; that which makes you smell the air after a spring rain, rejoice in the sounds of the birds, be moved deeply by a sunrise, a sunset, to feel all of the beauty that surrounds you.

Embrace anyone and anything that can make this happen for you. Enjoy it while you can and afterwards let your sweet memories return you to this state, over and over again.


IJCP Special

Dr Good Dr Bad

Situation: A patient with hyperthyroidism was found to have very low HDL cholesterol.
Dr Bad: It is genetic.
Dr Good: It is due to thyroid overactivity.
Lesson: Patients with hyperthyroidism tend to have low serum total and high–density lipoprotein (HDL) cholesterol concentrations and a low total cholesterol/HDL cholesterol ratio. These values increase after treatment. (Clin Endocrinol 1997;46:17.)

Make Sure

Situation: A 62–year–old diabetic with coronary artery disease, on treatment for the same, comes for follow up.
Reaction: Oh my God! Why didn’t you put him on antioxidants?
Lesson: Make Sure, to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects.

Quote of the Day

Michael Paul …

I wrote on the door of heart, "Please do not enter."

Love came smiling and said: "Sorry I am an illiterate."

Are you fit to fly?

Carry with you

  1. Detailed list of all diseases
  2. Detailed list of all medications, including dosages and allergies
  3. Any medication that may be needed during flight (eg, insulin, bronchodilator, nitroglycerin)
  4. Medical alert bracelet for severe diseases and allergies
  5. Copy of a recent ECG

International Medical Science Academy Update (IMSA)

Parapneumonic effusion and empyema

The incidence of parapneumonic effusions in children is increasing despite reductions in pneumococcal pneumonia achieved by use of the pneumococcal conjugate vaccine This may reflect a rising incidence of complicated pneumonias caused by invasive pneumococcal serotypes that are not included in the 7–valent vaccine.


  1. Obando I, Munoz–Almagro C, Arroyo LA, et al. Pediatric parapneumonic empyema, Spain. Emerg Infect Dis 2008;14:1390

Drug Update

List of Approved drugs from 01.01.2010 TO 30.4.2010

Drug Name


DCI Approval Date

Olopatadine Hcl Nasal Spray 0.6% w/w (Additional Indication)

For the relief of the symptoms of seasonal allergic rhinitis in patients 6 years of age and older.



Medi Finance

Q. What is the minimum amount on which a doctor is not assessable?

Ans. As an individual Rs. 160,000/–.


Lab Test (Dr Arpan Gandhi and Dr Navin Dang)

Laboratory Tests for Infertility for men

• Semen analysis
• Free and total testosterone
• Luteinizing hormone (LH)
• Follicle–stimulating hormone (FSH)
• Prolactin (PRL)
• Testicular biopsy: In some cases, a biopsy of testicular tissue can identify the problem, for example, sperm production, abnormal growths, tumors, or incomplete growth or maturation of reproductive organs.


Lateral thinking

Read this………………

AID <–

The answer for yesterday’s puzzle "he is beside himself"

Correct answers received from: Dr Anurag Jain, Dr Muthumperumal Thirumalpillai

Correct answer received for 14th August Puzzle from: Dr Anurag Jain, Dr. Ashok Kumar, Dr. Naorem Sharat

Correct answer received for 13th August Puzzle from: Dr Anurag Jain

Send your answer to ijcp12@gmail.com


Humor Section


Modern Funeral (ANIL JAJU)

A family in Gujarat was puzzled when the coffin of their dead mother (Ba) arrived from the US. It was sent by one of the daughters.

The dead body was very tightly squeezed inside the coffin, with no space left in it when they opened the lid; they found a letter on top addressed to her brothers and sisters:

Dear Chandrakantbhai, Arvindbhai, Smitaben and Varsha,

I am sending Ba’s body to you, since it was her wish that she should be cremated in the compound of our ancestral home in GUJARAT.

Sorry, I could not come along as all of my paid leave is consumed.

You will find inside the coffin, under Ba’s body, cans of cheese, 10 packets of Toblerone chocolates and 8 packets of Badam (peanuts) please divide these among all of you.

On Ba's feet you will find a new pair of Reebok shoes (size 10) for Mohan.

There are also 2 pairs of shoes for Radha’s and Lakshmi’s sons. Hope the sizes are correct.

Ba is wearing 6 American T–Shirts. The large size is for Mohan.

Just distribute the rest among yourselves. The 2 new Jeans that Ba is wearing are for the boys.

The Swiss watch that Reema wanted is on Ba’s left wrist. Shanta masi, Ba is wearing the necklace, earrings and ring that you asked for. Please take them off her.

Funny One Liner

Teacher: Which was the first silent film in English?
Student: If the film was silent, how could you know it was English?

(Contributed by Dr Chandresh Jardosh)


Readers Responses

  1. Dear KK, through this medium of yours, I congratulate Dr K P Singh for the ethical and concerted service. I am reminded of good old days, when every doctor whether he knew you or not, refused to charge any fee from a fellow doctor. Today, I have seen many colleagues, if they know you, may not charge, but if you are not known, their facial expression reflects that their time and expertise has not been rewarded. Why are we so materialistic? We have stopped pondering over this and that is what has given us a bad name. There are many who do not charge from fellow colleagues, even if they do not announce, yet Dr KP Singh announcing it is setting an example and is reminding our brethren to realize and for others to emulate. Good show Dr Singh, keep it up and I hope many even if they do not announce will start this kind of practice: Dr K K Arora

  2. Dear Doctor Aggarwal, I am pleased that the news published by your daily e medinews is well read and readers have started speaking and commenting on the topics. That was the forum which probably we needed to give our opinion and voice. Dr Varshney has raised a very important point – MEDICAL ETHICS AND HIPPOCRATIC OATH. The generation which passed out 20 years back knows the value of these ethics and always appreciated that. I experienced a divine feeling when as a medical student I went to a private doctor around 30 years back. The doctor not only waived of his consultation me but offered me a cup of tea and told me about the first basic ethic of medical profession – TREAT ALL DOCTORS AS YOUR PROFESSIONAL BROTHERS. We always used to have a sense of identity with doctors. The corporate set up has changed everything. I have seen many reports where even very seniors doctors have sued these hospitals and our own colleagues for unnecessary tests and inflated bills. We all know for the corporate hospitals these ethics do not matter at all. Even consultants working in these hospitals are helpless to offer any relief to their colleagues and juniors and senior friends. But all those doctors who believe in this ethics – while investigating and treating your own colleagues please always keep in mind that if you communicate more with them and avoid unnecessary tests and expensive medicines you can save a lot of money for them and keep them hospitalized for bare minimum duration. May be tomorrow some ethical doctors like yourself find a permanent solution for these ailments of corporate hospitals: Dr. R.S. Bajaj, Consultant Pediatrician, Sector 13, Rohini, Delhi–85

  3. Dear Dr. Aggarwal, Thanks a lot for publishing an Article as "Breaking News" on the basis of recently just published Article in a "LANCET" by an Indian scientist on presence of NDM–1 Bacteria, originating from New Delhi, Called New Delhi Metallo–beta–Lactamase–1, a new Super bug. It is really a new threat to World and our country too. But the way it has been published with an inference at last paragraph issuing a warning to all countries to beware of going to India as if it is the only hub for such bacteria. Adding name of our capital "NEW DELHI" to its name only on the basis of one patient who got treatment from New Delhi before detection of this Bacteria from his blood in Sudan, having no knowledge whether he was carrying it before treatment in India and then sporadically adding that it is also found in Pakistan, Bangladesh and even in UK raise serious questions regarding authenticity of such publication funded by two multi national Drug companies. If a Journal like the Lancet is also manipulated like this then our whole Humanity is under threat. But it does not mean that we shall not take precautions, we should take extra effort in sterilization of our Operation Theatre, Post up Wards and Pre op Wards and post Op care so much clean and clear that such Bacteria never infect any patient whether Indian or from outside under our treatment. Dr. D. R. Nakipuria, Ambika Multispeciality Hospital, Siliguri

  4. Sir, Ref article on Super Bug named after New Delhi. I do not understand the naming process. The current H1N1 Swine flue pandemic started from Mexico. Was it ever named Mexican bug or Mexican virus? SARS in 2003 started from Guangdong in China. Nobody then thought of naming it after the place of origin. Why the sudden need to name the bug after New Delhi? Dr. R. Dhillon

  5. Error in page setting in low carb /low fat diet with the pediatric story – FYI. Having said that sincere appreciation on the content and delivery of your e news. Shubnum
  6.  Sir, I request to start "job vacancies" column in you newsletter. Dr. Nitin Kumar Gupta
  7.   May2005 in Krishna institute of medical sciences. i am working as a senior resident since 2002.in Krishna institute Karad. Post DNB I have completed one research study and my experience as a senior resident is five and half year. but still MCI is  not considering me as a lecturer in teaching institute have given all my documentation twice to MCI please guide me sir.
  8.  Dear Dr. Aggarwal, Thank you for your best wishes regarding Independence Day. I wholeheartedly reciprocate the greetings and sentiments. You have written-probably as a result of oversight-63rd Independence Day. It is, however, 64th Independence Day. We have had sixty three years of independence it is true but as far as the day is concerned it is 64th. Dr. Satish Gunawant [Thanks for the correction)
  9. SIR, Today on Aug 15, I was honored on 64th independence day by Distt Administration, Amritsar. DR.N.S.NEKI, MD, FRCPE, FAMS, FICP; Prof. of Medicine, Govt. Medical Amritsar, INDIA, Mob. 9872413788
  10.  Respected Dr Aggarwal: Regards, Your suggestion that "Research in Allopathy be integrated with Indian System of Medicine" is the long felt need of many of us. I am convinced that combination of these two illustrious systems can be very rewarding in many difficult to treat diseases..India has a rich heritage in form of Ayurveda texts and medicines. Serious research can open new vistas. MCI & Govt should go ahead in this direction. Also please enlighten us whether we can prescribe Ayurveda medicines or not? Dr Varesh  Nagrath ( Emedinews: Thanks. Ideally we should not infiltrate into each other’s territory, We should have a joint particle with Ayurveda doctor as our partner.
  11.  Please make a correction under the caption Drug Update for the indication of Ketorolac ophthalmic solution in 15th Aug newsletter. There has been a mix-up with cytarabine. Dr. H.L. Kapoor : D-13A, SFS, Mayur Vihar, Phase - III, New Delhi - 110 096. Cancer Consultation and Counseling Services [Thanks for the correc tion, the drug name column may be read as "Ketorolac Tromethamine Ophthalmic Solution 0.45%" error is regretted)

Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

5th September: 3 PM to 5 PM – A dialogue with His Holiness Dalai Lama at C 599 Defence Colony Acharya Sushil Ashram in association with Acharya Sushil Muni Ahimsa Peace Award Trust

26 th September: Sunday- BSNL Dil ka Darbar A day-long interaction with top cardiologists of the city. 8 AM - 5 PM at MAMC Auditorium, Delhi Gate.

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to
10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

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