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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 & 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 & Hony. Visiting Professor (Clinical Research) DIPSAR


For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1–7
DD Take Care Holistically Video 1–4 Chat with Dr KK On life Style Disorders
Health Update Video 1–15 Science and Spirituality
Obesity–Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

16th August 2012, Thursday

Bleeding risk tools compared in atrial fibrillation patients

When assessing bleeding risk in patients with atrial fibrillation (AF) taking anticoagulants, a relatively new and simple tool seems to have an edge over the others. In a comparison study, the HAS-BLED score came out on top in terms of predicting clinically relevant bleeding when compared with 2 other bleeding risk scores, HEMORR2HAGES (Hepatic or renal disease, Ethanol abuse, Malignancy, Older age, Reduced platelet count or function, Re-bleeding, Hypertension, Anemia, Genetic factors, Excessive fall risk and Stroke) and ATRIA (AnTicoagulation and Risk factors In AF).

HAS-BLED score

  • Hypertension
  • Abnormal renal/liver function
  • Stroke–
  • Bleeding history or predisposition
  • Labile international normalized ratio (INR)
  • Elderly
  • Drugs/alcohol

It is important to note that the HAS-BLED tool was the only one to demonstrate a significant predictive performance for intracranial hemorrhage.

The study is published online August 1 in Journal of the American College of Cardiology.

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

Crime Against Women - Dr Rashmi Singh

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Higgs – Boson, Consciousness and Health

Heart Care Foundation of India in association with International Centre for Spirituality and eMedinewS organized seminar, Physics scholars, religious experts and doctors participated in the seminar.

Dr K K Aggarwal
    National News

Mosquitoes prefer youth when they bite

MUMBAI: Mosquitoes may have lost their sting in Mumbai but the deadly vector prefers youth when it bites. In the last three years, malaria and dengue have most attacked people in the age-group of 15-30 years, according to a survey. The study by Metropolis, a chain of diagnostic centres, said cases of malaria and dengue have gone down in three years. The survey reveals that the positivity rate of malaria decreased from 17.48% in 2009 to 6.25% 2011 in Mumbai. Similarly, that of dengue decreased from 37.19% in 2009 to 21.36% in 2011. Though overall the diseases have seen a downward trend, the survey revealed that the age-group of 15-30 years has been affected the most. "People in this group have shown the highest incidence of malaria and dengue in 2011. While 42.84% people who tested positive for malaria were from this age group, 64.40% of those who tested positive for dengue fell in this age-group," said Dr Jatinder Bhatia, chief of lab services at Metropolis Healthcare Ltd. "Effective prevention strategies such as research on vaccines, environmentally-safe insecticides, alternative approaches to disease control and training programs for health-care workers can reverse this growing trend," she added. While these figures are only that of the private diagnostic centre, the official figures from BMC are higher as they cater to a bigger group. BMC statistics show that more than 76,000 Mumbaikars had tested positive for malaria, while dengue positive cases were more than 1,000 last year. (Source: TOI, Aug 14, 2012)

My Profession My Concern

Professor Suchitra N. Pandit, Kokilaben Dhirubhai Ambani Hospital & Research Centre, Mumbai, Vice President, FOGSI (2008 -2009) on the profession

For comments and archives

Medical mistakes in Indian movies

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 rebuild the image of the medical profession.

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)

Latest flu vaccine again guards against pandemic virus

The influenza vaccine for the 2012-2013 season will once again guard against the pandemic A(H1N1) virus from 2009, the US Food and Drug Administration (FDA) announced. Except for that repeat, the new formulation of the trivalent seasonal flu vaccine, just approved by the FDA, differs slightly from last season's formulation. The agency selected 2 new virus strains that replace cousins of theirs in the previous mix. The 3 viral strains that comprise the vaccine for the upcoming influenza season are: (Source: Medscape)

  • A/California/7/2009 (H1N1)-like virus (the pandemic virus that surfaced in 2009)
  • A/Victoria/361/2011 (H3N2)-like virus
  • B/Wisconsin/1/2010-like virus

Contact lens promising in glaucoma

Continuous intraocular pressure measurement with a contact lens sensor was safe and tolerable with repeated use, although mild adverse effects were common and the measurements were variable, researchers said. (Source: Medpage Today)

2 fluoroquinolone antibiotics linked to risk for liver injury

Moxifloxacin and levofloxacin may increase the risk for acute liver injury for older outpatients, according to results from a case-control study by J. Michael Paterson, MSC, from the Institute for Clinical Evaluative Sciences, in Toronto; the Department of Health Policy, Management, and Evaluation of the University of Toronto, Ontario; and the Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada; and colleagues. The researchers report their findings in a study published online August 13 in the Canadian Medical Association Journal. (Source: Medscape)

Initial HIV therapy varies, results don't

Despite marked variation in initial treatments, most HIV patients suppress viral replication within a year, Swiss researchers reported. (Source: Medpage Today)

Discharge-day tests carry high risk for missed follow-up

Although tests ordered on the day of discharge from a hospital account for just 6.8% of all tests ordered during a hospital stay, they account for almost half of the tests not reviewed or followed up, according to a research letter published online August 13 in the Archives of Internal Medicine. (Source: Medscape)

    Twitter of the Day

@DrKKAggarwal: Heart risks detected by age 7 in overweight kids Children at risk of future obesity should be examined for bod) http://tl.gd/inq4lk

@DeepakChopra: Is my existential crisis a reaction to my awareness or just my ego struggling for survival? http://tinyurl.com/cjwbsya

    Spiritual Update

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

Science behind Indian National Flag

The Indian National flag represents the rich Vedic heritage of India. Different colors with a chakra in the center are the gist of Vedas. The flag consist of three colors; the top saffron (orange), middle white and the lower green. In the center of the white color, there is a chakra with 24 lines

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
  • 4th Asia pacific vascular intervention course paper clippings Read More
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What do you understand by unexplained infertility?

According to western Figures 5% to 10% of couples trying to conceive, all of the above tests are normal and there is no apparent cause for infertility. In a much higher percentage of couples, only minor abnormalities are found that are not severe enough to result in infertility. In these cases, the infertility is referred to as unexplained. Couples with unexplained infertility may have problems with egg quality, tubal function, or sperm function that are difficult to diagnose and/or treat. Fertility drugs and IUI have been used in couples with unexplained infertility with some success.

For comments and archives

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

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

Clinical Transfusion Practice

Decision for transfusion: The following steps should be followed, before the transfusion, when deciding for blood/blood component transfusion.

  • Decide need of blood/blood component transfusion to the patient
  • Weigh the benefits of transfusion against risk involved
  • Explore possibilities of alternatives for blood/blood component
  • If no alternative is possible and it is necessary to give transfusion then counsel the patient and provide information about transfusion.
  • Take informed consent of patient. It is mandatory to take informed consent of patient. It is the clinician’s responsibility to explain the benefits, risks, and alternative therapies of blood transfusion in the language that is understood by the patient.
  • Patient and family education regarding blood donation
  • Patient should be given opportunity to ask questions.
  • Ensure availability of blood/blood component with the blood bank.
  • Decide for the category of requirement, means whether the requirement is planned, urgent or life-saving emergency. Coordinate with the blood bank regarding normally time taken in different categories of requirement (Planned/Urgent/Life-saving emergency).

Note: Clinician should be aware of time taken for supply by blood bank for routine components, Pediatric units, Frozen components and specialized components like saline-washed red cells, apheresis components etc. Coordinate with blood bank for detailed information about these components.

For comments and archives

    An Inspirational Story (Dr Prabha Sanghi)

Friends.......They love you,
But they're not your lover.

They care for you,
But they're not from your family.

They're ready to share your pain,
But they're not your blood relation.

They are........FRIENDS! !!!!

A True friend......
Scolds like a DAD …
Cares like a MOM …
Teases like a SISTER …
Irritates like a BROTHER …
And finally loves you for YOU …

The nicest place to be is in someone's THOUGHTS!
The safest place to be is in someone's PRAYERS!

And the best place to be is in ........... GOD'S HANDS!

For comments and archives

    Cardiology eMedinewS

Sex Life May Offer Clues to CVD Risk Read More

Statin Benefits Offset Diabetes Risk Read More

    Pediatric eMedinewS

Pediatric VAD Data Inform Use Of Device In US Read More

Advice On Mom's Diet Reduces Obesity In Her Infant Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with diabetes wanted to know if he could do aerobic exercise.
Dr. Bad: You cannot do it.
Dr. Good: You can do it.
Lesson: People with type 2 diabetes should get 150 minutes of aerobics exercise every week.

For comments and archives

Make Sure

Situation: A patient on binasal oxygen developed nasal mucosal damage.
Reaction: Oh my God! why was the oxygen given at 4 liter per minute?
Lesson: Make Sure that oxygen via nasal catheter, is not given at a rate more than 3 liter per minute.

For comments and archives

  Quote of the Day (Mr Vivek Kumar)

Never start with diffidence, Always start with confidence. JRD Tata

  Fitness Update (Rajat Bhatnagar, MonaVie www.mymonavie.com/sonraj)

Food addiction, obesity and the lasting health benefits of modest weight loss

Overweight and obese individuals can achieve a decade's worth of important health benefits by losing just 20 pounds, even if they regain the weight later that decade, according to research presented at the American Psychological Association's 120th Annual Convention. With a focus on psychology's role in overcoming the national obesity epidemic, the session also examined research that indicates foods high in sugar and fat could have addictive properties.

Rena Wing, PhD, professor of psychiatry and human behavior at Brown University's Alpert Medical School and director of the Weight Control and Diabetes Research Center at The Miriam Hospital in Providence, R.I., presented the latest in behavioral treatments for obesity in an address. Kelly Brownell, PhD, director of Yale University's Rudd Center for Food Policy and Obesity, cited some of the latest findings about food addiction in his talk. Brownell and Wing were keynote speakers for the convention's opening session.

"Obesity is the No. 1 health challenge facing our country today," APA President Suzanne Bennett Johnson said in introducing Wing and Brownell. "These psychologists have each contributed greatly in combating the obesity epidemic in different ways, one on the individual patient level and the other on the public policy level."

"Helping people find ways to change their eating and activity behaviors and developing interventions other than medication to reinforce a healthy lifestyle have made a huge difference in preventing one of the major health problems in this country," Wing said in an interview. "Weight losses of just 10 percent of a person's body weight (or about 20 pounds in those who weigh 200 pounds) have also been shown to have a long-term impact on sleep apnea, hypertension and quality of life, and to slow the decline in mobility that occurs as people age."

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

Photos of Doctor’s Day Celebration

eMedinewS Apps
    Legal Question of the Day (Dr MC Gupta)

Q. A hospital treated a patient for injury. Later, an FIR was lodged in relation to the injury. The police ask the hospital to provide a copy of the medical records. Treatment records of a patient are confidential.

a. Should the patient’s consent be a pre–requirement before the hospital gives the records to the police?

b. If the accused manages to get the records from the police and sues the hospital for giving his medical record to others without his consent, how will the hospital defend itself?


  • If the police asks a party, including a hospital or anybody else, for information necessary for investigation of crime, the party concerned is bound in law to provide the information, including medical records.
  • The suit/complaint filed by the patient will fail because the hospital gave the medical records to the police in compliance of legal requirements.
    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)


Hypophosphatemia can be seen in a variety of biochemical derangements, including acute alcohol intoxication, sepsis, hypokalemia, malabsorption syndromes, hyperinsulinism, hyperparathyroidism, and as result of drugs, e.g., acetazolamide, aluminum–containing antacids, anesthetic agents, anticonvulsants, and estrogens (incl. oral contraceptives). Citrates, mannitol, oxalate, tartrate and phenothiazines may produce spuriously low phosphorous by interference with the assay.

    Mind Teaser

Read this…………………

A client is being evaluated for cancer of the colon. In preparing the client for barium enema, the nurse should:

A. Give laxative the night before and a cleansing enema in the morning before the test
B. Render an oil retention enema and give laxative the night before
C. Instruct the client to swallow 6 radiopaque tablets the evening before the study
D. Place the client on CBR a day before the study

Yesterday’s Mind Teaser: The client presents with severe rectal bleeding, 16 diarrheal stools a day, severe abdominal pain, tenesmus and dehydration. Because of these symptoms the nurse should be alert for other problems associated with what disease?

A. Crohn’s disease
B. Ulcerative colitis
C. Diverticulitis
D. Peritonitis

Answer for Yesterday’s Mind Teaser: B. Ulcerative colitis

Correct answers received from: Dr. P. C. Das, y. j. vasavada, Dr.K.Raju, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr.Chandresh Jardosh, Dr Avtar Krishan, Dr Valluri Ramarao, DR V,K,BADHWAR, Dr. L. C. Dhoka, Muthumperumal Thirumalpillai

Answer for 14th August Mind Teaser: A. Deflate the esophageal balloon

Correct answers received from:
Niraj Gupta, chanchal Das, Dr.Mohit Sharma

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Why is India still a Developing Country

An Old Story

The Ant works hard in the withering heat all summer building its house and laying up supplies for the winter. The Grasshopper thinks the Ant is a fool and laughs & dances & plays the summer away. Come winter, the Ant is warm and well fed. The Grasshopper has no food or shelter so he dies out in the cold.

Indian Version

The Ant works hard in the withering heat all summer building its house and laying up supplies for the winter. The Grasshopper thinks the Ant's a fool and laughs & dances & plays the summer away. Come winter, the shivering Grasshopper calls a press conference and demands to know why the Ant should be allowed to be warm and well fed while others are cold and starving.

NDTV, BBC, CNN show up to provide pictures of the shivering Grasshopper next to a video of the Ant in his comfortable home with a table filled with food. The World is stunned by the sharp contrast. How can this be that this poor Grasshopper is allowed to suffer so?

Arundhati Roy stages a demonstration in front of the Ant's house.

Medha Patkar goes on a fast along with other Grasshoppers demanding that Grasshoppers be relocated to warmer climates during winter.

Mayawati states this as `injustice' done on Minorities.

Amnesty International and Kofi Annan criticize the Indian Government for not upholding the fundamental rights of the Grasshopper.

The Internet is flooded with online petitions seeking support to the Grasshopper (many promising Heaven and Everlasting Peace for prompt support as against the wrath of God for non-compliance).

Opposition MPs stage a walkout. Left parties call for 'Bengal Bandh' in West Bengal and Kerala demanding a Judicial Enquiry.

CPM in Kerala immediately passes a law preventing Ants from working hard in the heat so as to bring about equality of poverty among Ants and Grasshoppers.

Lalu Prasad allocates one free coach to Grasshoppers on all Indian Railway Trains, aptly named as the 'Grasshopper Rath'.

Finally, the Judicial Committee drafts the 'Prevention of Terrorism Against Grasshoppers Act' (POTAGA), with effect from the beginning of the winter.

Arjun Singh makes 'Special Reservation 'for Grasshoppers in Educational Institutions & in Government Services.

The Ant is fined for failing to comply with POTAGA and having nothing left to pay his retroactive taxes, it's home is confiscated by the Government and handed over to the Grasshopper in a ceremony covered by NDTV.

Arundhati Roy calls it 'A Triumph of Justice'.

Lalu calls it 'Socialistic Justice'.

CPM calls it the 'Revolutionary Resurgence of the Downtrodden'

Koffi Annan invites the Grasshopper to address the UN General Assembly.

Many years later...

The Ant has since migrated to the US set up a multi-billion dollar company in Silicon Valley. Hundreds of Grasshoppers still die of starvation despite reservation somewhere in India AND as a result of loosing lot of hard working Ants and feeding the grasshoppers ….

India is still a developing country !!!

    Medicolegal Update

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

What is Sec 314 of the IPC?

Death caused by act done with intent to cause miscarriage

Sec. 314 IPC provides that whoever, with intent to cause the miscarriage of the woman with child, does any act that causes the death of such woman, shall be punished with imprisonment of either description of a term which may extend to ten years or shall also be liable to fine. If the act is done without the consent of the woman, shall be punished with imprisonment for life or with punishment above mentioned.

  • The explanation to this section says that it is not essential to this offence that the offender should know that the act is likely to cause death.
  • A person who attempted to cause miscarriage of a pregnant woman but was unsuccessful in the process and when pregnant girl died several weeks later having developed septicemia without it having been established that the person was responsible for septicemia, the person cannot be held guilty under Sec 314 of IPC.

(Ref: Vatchalabai Maruti Kgar v. State of Maharashtra, 1993 Cri LJ 702 (Bom)

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Diet is linked to the diabetes epidemic

A study published in the journal Diabetes Care, highlights the importance of the whole diet rather than focusing on certain foods or food groups that might be beneficial, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India in a statement.

A diet rich in whole grains, fruits and vegetables (leafy green), nuts and low–fat dairy may help people lower their risk of type 2 diabetes by 15% over 5 years than those who ate the lowest amounts of these foods.

In contrast, adults whose diets were high in red meat, high–fat dairy, refined grains like white bread plus beans and tomatoes, saw their diabetes risk go up by 18 percent as a group.

Type 2 diabetes is closely linked to obesity and it is well–known that maintaining a healthy weight through diet and exercise reduces the risk of developing the disease. Diet affects diabetes risk independent of a person’s weight.

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  1. Dear sir, emedinews is full of educative material. thanks: Dr Shreya
    Forthcoming Events
Dr K K Aggarwal

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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 public. Event will be promoted through hoardings, our publications and the press. Public health discussions

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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