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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; National Vice President Elect Elect, Indian Medical Association; 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 to 7
DD Take Care Holistically Video 1 to 9 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal

16th November 2012, Friday

Meditation may reduce death, heart attack and stroke in heart patients

Twice-a-day Transcendental Meditation helped African Americans with heart disease reduce risk of death, heart attack and stroke. Meditation helped patients lower their blood pressure, stress and anger compared with patients who attended a health education class.

African Americans with heart disease who practiced Transcendental Meditation regularly were 48 percent less likely to have a heart attack and stroke or die from all causes compared with African Americans who attended a health education class over more than five years, according to new research published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

Those practicing meditation also lowered their blood pressure and reported less stress and anger. And the more regularly patients meditated, the greater their survival, said researchers who conducted the study at the Medical College of Wisconsin in Milwaukee.

The National Heart, Lung and Blood Institute funded the study. (Medline)

For Archives and Comments

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Constipation Sutra : Panel Discussion (Dr KK Aggarwal, Dr Ajay Kumar, Dr Rajiv Khosla, Dr A K Jhinghan, Dr Kailash Siungla)

Pain is a must to diagnose irritable bowel syndrome

According to the Rome III criteria, diagnosis of irritable bowel syndrome requires the presence of recurrent abdominal pain or discomfort (an uncomfortable sensation not described as pain) for at least 3 days a month in the past 3 months, associated with two or more of the following:

  • Improvement with defecation
  • Onset associated with a change in frequency of stool
  • Onset associated with a change in form (appearance) of stool

These criteria should be fulfilled for the past 3 months with symptom onset at least 6 months before diagnosis.

(Spiller R, Aziz Q, Creed F, et al. Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut 2007;56:1770–98).

For Comments and archives…

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Vitamin D intake associated with reduced risk for Crohn’s disease

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

CPR with the Hon’ble Chief Minister

Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal demonstrating the technique of CPR 10 – compression only CPR to the Hon’ble Chief Minister Smt Sheila Dikshit and Shri Haroon Yusuf, Minister, Power, Development, Food & Civil Supplies Dept. Govt. of Delhi at the Heart Care Foundation of India stall in IITF.

Dr K K Aggarwal
    National News

Dear Colleague, Let’s celebrate New Year by learning CPR-10 and saving the life of a person

Watch English or Hindi Video @http://emedinews.in/videos/cpr/index.html

Dr K K Aggarwal

Quarter of world's pneumonia child deaths in India

KANPUR: Doctors of the Academy of Paediatrics advised locals to take extra care of their kids in the prevailing weather conditions and keep pneumonia at bay. They were speaking at a press conference on Pneumonia Day here on Monday and emphasised strengthening immunity and resistance to fight the killer disease. Commenting on pneumonia deaths among young children in India, president of the academy Dr Rashmi Kapoor informed that the disease globally killed an estimated 1.4 million children below the age of five years every year-more than AIDS, malaria and tuberculosis together did. It is alarming that India accounts for almost 25 per cent of the world's pneumonia deaths of children. "Pneumonia accounts for 20 per cent deaths among children below 5 years of age becoming the leading cause of death in the age group. According to the IAP records, annually, India witnesses 45 million pneumonia cases among children below 5 years of which 0.37 million die due to pneumonia," added Dr Kapoor. The experts also stressed the government should take serious steps towards introduction of pneumococcal conjugate vaccine (PCV) which immunises children against pneumonia and other diseases caused by Streptococcus pneumoniae. They also stressed creation of a clean environment, addressing the issue of malnutrition and breast feeding for the first 6 months, timely immunisation and appropriate healthcare during delivery to reduce significantly mortality rates due to vaccine preventable diseases like pneumonia. "Try to take extra precautions for kids under the 5 years of age with the onset of winters. Consult doctor immediately in case of prolonged cough, cold or fever," said Dr Saurabh Dwivedi, another paediatrics. (Source: TOI, Nov 13, 2012)

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

    Valvular Heart Disease Update

The onset of symptoms in aortic stenosis is associated with a poor prognosis; as a result, intervention is recommended for symptomatic aortic stenosis.

(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)

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Well-worn cell phones may be allergy risk

When heavy use of cell phones wears off the plastic coatings on metallic keypads and other parts, it could be problematic for people with metal sensitivities, a researcher said at the American College of Allergy, Asthma, and Immunology annual meeting. (Source: Medpage Today)

For comments and archives

Lyme disease recurrences may be reinfections, not relapses

Repeat episodes of Lyme disease (erythema migrans) in antibiotic-treated patients result from reinfection and not relapse, according to a new study. This conclusion was made from genotyping the isolates of Borrelia burgdorferi from paired consecutive episodes of erythema migrans. Robert B. Nadelman, MD, from New York Medical College in Valhalla, and colleagues published results of their genotyping study in the November 15 issue of the New England Journal of Medicine. (Source: Medscape)

For comments and archives

Simple HCV regimen shows promise

A simplified hepatitis C (HCV) regimen with just two oral drugs had promising results in a difficult-to-treat population, a researcher reported at the annual meeting of the American Association for the Study of Liver Diseases. (Source: Medpage Today)

For comments and archives

   Twitter of the Day

@DrKKAggarwal: CPR with the Hon’ble Chief Minister at IITF 2012

@DeepakChopra: The Conscious Lifestyle: Short-Term
Desireshttp://www.linkedin.com/today/post/article/20121115013343-75054000-the-conscious-lifestyle-short-term-desires …

    Spiritual Update

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

Difference between prayer and meditation

  • Prayer is talking to God; meditation is listening to God
  • Everybody can pray but only a purified mind is really able to meditate
  • Righteous conduct, moral and ethical values, quality in work, fulfillment of duties, unselfishness, etc.
    purify the mind.

For comments and archives

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

Are there fertility problems in men with obesity?

Obesity in men may be associated with changes in testosterone levels and other hormones important for reproduction. Low sperm counts and low sperm motility have been found to occur more often in overweight and obese men.

For comments and archives

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

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

ABO system

  • Three major genes:; A, B and O
  • H gene determines the action of the L-fucosyl transferase, which produces the H substance
  • H substance results in the production of A and B antigen
  • Group O retains a large amount of H antigen
    • No A or B gene-specified transferase
  • H gene is expressed in
    • Homozygous (H/H)
    • Heterozygous (H/h)

For comments and archives

   An Inspirational Story

The seed of honesty

A successful business man was growing old and knew it was time to choose a successor to take over the business. Instead of choosing one of his Directors or his children, he decided to do something different. He called all the young executives in his company together. He said, “It is time for me to step down and choose the next CEO. I have decided to choose one of you.”

The young executives were shocked, but the boss continued. “I am going to give each one of you a SEED today – one very special SEED. I want you to plant the seed, water it, and come back here one year from today with what you have grown from the seed I have given you. I will then judge the plants that you bring, and the one I choose will be the next CEO.”

One man, named Jim, was there that day and he, like the others, received a seed. He went home and excitedly, told his wife the story. She helped him get a pot, soil and compost and he planted the seed. Every day, he would water it and watch to see if it had grown. After about three weeks, some of the other executives began to talk about their seeds and the plants that were beginning to grow.

Jim kept checking his seed, but nothing ever grew. Three weeks, four weeks, five weeks went by, still nothing. By now, others were talking about their plants, but Jim didn’t have a plant and he felt like a failure.

Six months went by — still nothing in Jim’s pot. He just knew he had killed his seed. Everyone else had trees and tall plants, but he had nothing. Jim didn’t say anything to his colleagues, however… He just kept watering and fertilizing the soil – He so wanted the seed to grow. A year finally went by and all the young executives of the company brought their plants to the CEO for inspection.

Jim told his wife that he wasn’t going to take an empty pot. But she asked him to be honest about what happened. Jim felt sick to his stomach, it was going to be the most embarrassing moment of his life, but he knew his wife was right. He took his empty pot to the board room. When Jim arrived, he was amazed at the variety of plants grown by the other executives. They were beautiful — in all shapes and sizes.

Jim put his empty pot on the floor and many of his colleagues laughed, a few felt sorry for him! When the CEO arrived, he surveyed the room and greeted his young executives. Jim just tried to hide in the back. “My, what great plants, trees, and flowers you have grown,” said the CEO. “Today one of you will be appointed the next CEO!”

All of a sudden, the CEO spotted Jim at the back of the room with his empty pot. He ordered the Financial Director to bring him to the front. Jim was terrified. He thought, “The CEO knows I’m a failure! Maybe he will have me fired!” When Jim got to the front, the CEO asked him what had happened to his seed – Jim told him the story.

The CEO asked everyone to sit down except Jim. He looked at Jim, and then announced to the young executives, “Behold your next Chief Executive Officer! His name is Jim!” Jim couldn’t believe it. Jim couldn’t even grow his seed. “How could he be the new CEO?” the others said.

Then the CEO said, “One year ago today, I gave everyone in this room a seed. I told you to take the seed, plant it, water it, and bring it back to me today. But I gave you all boiled seeds; they were dead – it was not possible for them to grow. All of you, except Jim, have brought me trees and plants and flowers. When you found that the seed would not grow, you substituted another seed for the one I gave you. Jim was the only one with the courage and honesty to bring me a pot with my seed in it. Therefore, he is the one who will be the new Chief Executive Officer!”

  • If you plant honesty, you will reap trust.
  • If you plant goodness, you will reap friends.
  • If you plant humility, you will reap greatness.
  • If you plant perseverance, you will reap contentment.
  • If you plant consideration, you will reap perspective.
  • If you plant hard work, you will reap success.
  • If you plant forgiveness, you will reap reconciliation.
  • If you plant faith in God, you will reap a harvest.

So, be careful what you plant now; it will determine what you will reap later. “Whatever You Give To Life, Life Gives You Back”

For comments and archives

   Cardiology eMedinewS

100 million deaths due to smoking in last 100 years in India Read More

Lower is better for cooling after cardiac arrest Read More

   Pediatric eMedinewS

Prolonged fever during pregnancy may increase autism risk Read More

Some kids with CF face early liver disease Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with Mediclaim was advised MRI post discharge.
Dr. Bad: It will not be covered.
Dr. Good: It will be covered.
Lesson: Post hospitalization related medical expenses incurred during period up to 60 days after hospitalization of disease/illness/injury sustained are covered as part of the claim.

For comments and archives

Make Sure

Situation: A 60–year–old male developed acute heart attack after consuming Viagra.
Reaction: Oh my God! Why was cardiac clearance not taken before?
Lesson: Make sure that all older patients get a cardiac clearance before they are given Viagra group of drugs.

For comments and archives

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    Legal Question of the Day (Dr MC Gupta)

Q. A patient comes to a private nursing home with acute MI. The relatives are not willing to pay the professional charges immediately and say they would pay later. There are two possible outcomes:

a. We perform the procedure. The patient does not benefit. They refuse to pay on some ground or the other.
b. We do not perform the procedure. The patient’s condition deteriorates. They initiate legal proceedings.

What should the hospital do?


The hospital should proceed as follows:

  • If the procedure is not essential and there are reasonable grounds for adopting a conservative approach, the latter approach can be followed after getting a signed informed consent. If they give consent but refuse to sign, let three doctors/others give a signed statement that the relatives/patient consented for conservative approach but refused to sign consent.
  • If the procedure is essential, the relatives should be advised to take the patient to a government hospital and informed consent/declaration should be taken about shifting the patient. A properly documented urgent request should be made to the local government hospital to transfer the patient itself. If the hospital refuses, the refusal should be documented.
  • If the procedure is essential and the relatives ask for deferred payment, they should be asked to produce a guarantee/guarantor for paying the hospital bill. Such guarantor is liable in law to pay.
  • If the procedure is essential and the relatives do not comply with any of the above requirements and do not shift the patient elsewhere, the essential/life saving treatment should be given and the following further actions should be taken if the patient leaves the hospital without paying:
    • A legal notice should be served upon the patient to pay up. If not paid, a civil suit for recovery should be initiated.
    • At the same time, a request should be made to the state to reimburse the cost of treatment because the treatment was done and expenses incurred for the sake of public good and ensuring health which is a fundamental right that operates against the state. It should be argued that the hospital provided services on behalf of the state because the state is supposed to help a citizen in emergency.
    • Details should be provided to the local IMA and heart specialists with a request that the patient may be black listed and not treated by other doctors. The IMA should be requested to take up the issue with the authorities concerned.
    • If all else fails, a writ petition should be filed, with the following as respondents: state; local government hospital; patient; guarantor.
  • If a WP is filed, the following may happen:
    • There is a slight possibility that if the point is argued forcefully and the court is so inclined, some amount may be granted.
    • If no amount is paid, at least the court might make directions/observations that a doctor or hospital is not bound to give costly treatment to all patients.
    • Such a WP would help in existing or future proceedings against the CEA.
    • The legal proceedings, including the WP, would send a message across the public that doctors are not sitting ducks. It will also embolden the medical profession.
  Quote of the Day (Dr GM Singh)

It might be the only sunshine he sees all day. H Jackson Brown, Jr.

    Mind Teaser

Read this…………………

When doing colostomy irrigation at home, a client with colostomy should be instructed to report to his physician:

A. Abdominal cramps during fluid inflow
B. Difficulty in inserting the irrigating tube
C. Passage of flatus during expulsion of feces
D. Inability to complete the procedure in half an hour

Yesterday’s Mind Teaser: The nurse would know that dietary teaching had been effective for a client with colostomy when he states that he will eat:

A. Food low in fiber so that there is less stool
B. Everything he ate before the operation but will avoid those foods that cause gas
C. Bland foods so that his intestines do not become irritated
D. Soft foods that are more easily digested and absorbed by the large intestines

Answer for yesterday’s Mind Teaser:B. Everything he ate before the operation but will avoid those foods that cause gas

Correct answers received from: Dr. P. C. Das, Dr.(Maj. Gen.) Anil Bairaria, Dr. Thakor Hitendrsinh G, Dr Pankaj Agarwal, Dr Jainendra Upadhyay.

Answer for 14th November Mind Teaser: next number in the sequence is 1113213211

Correct answers received from: Dr Dinesh Yadav, Archna Parwani, Dr. B. B. Aggarwal

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Gut Buster

A pharmacist comes back from his break and sees a man leaning against the wall, his face strained and nervous. He asks his assistant: "What’s wrong with that man over there?"

"He came in looking for cough medicine," she replies. "I couldn’t find any, so I gave him a whole bottle of laxatives."

    Medicolegal Update

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

Contributory medical Negligence

A pregnant woman delivered a child with spina bifida however she failed to attend regularly advised dates for antenatal ultrasounds that would have identified this problem. The patient was found to be 100% at fault.

  • In a medical malpractice case, medical negligence is the foremost ingredient to establish the liability of damage and dereliction in provided medical care. However, it is important to establish the difference between malpractice and contributory negligence when determining liability
  • Contributory negligence means the patient/legal heirs/parties are partially to blame for the maloccurrence or medical untoward incident. For e.g., a patient is admitted to the emergency room for treatment and they fail to inform the doctor about a pre–existing condition e.g. any allergy to a drug. The patient is guilty of contributing to the negative outcome/damage of the treatment
  • If the victim is found to be even one percent at fault, he/she will be unable to recover compensation for their injuries. However, comparative negligence is used to determine degree of liability of the doctor/medical care provider
  • Contributory negligence will determine who will receive compensation for their losses and how much they may be entitled to receive in compensation for their injuries. Pure comparative negligence means that in case of an aggrieved patient, damages will be calculated and then reduced to reflect his or her contribution to the injury.

In India, the doctors take the defense against malpractice cases when determining how the parties involved are responsible. In US, 4 categories applied in compensation cases in many of its states: Pure Comparative Negligence/Pure Contributory Negligence/Modified Comparative Negligence—50% Bar Rule and Modified Comparative Negligence—51% Bar Rule. Twenty–one states that recognize the 51% bar rule which means that the party who is less than 51% liable can seek compensation; only 11 US states use the 50% bar rule, which means that if the damaged party is less than 50% responsible, they can collect damages.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Do not take more than 4 grams paracetamol in a day

Supra-therapeutic amounts of paracetamol are given to at least 4% of adult inpatients said Padma Shri and Dr B C Roy national Awardee Dr KK Aggarwal President Heart Care Foundation of India quoting a review by Dr Li Zhou at Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, and published in the journal Archives of Internal Medicine.

Paracetamol is one of the most widely used medications for relieving pain and reducing fever, but it is also the most common cause of acute liver failure.

In the study

  • About 6.6% of all hospitalized adults were given in excess of 4 g/day.
  • The recommended limit of 3 g/day was exceeded by 22.3% of patients 65 years or older and 17.6% of patients with chronic liver disease.
  • Half of the occurrences of supratherapeutic dosing were at least 5 g/day.
  • Forty percent of patients were given supratherapeutic dosing for at least 3 days and 4.0% for at least 10 days.
  • Osteoarthritis was associated with an increased likelihood of supratherapeutic dosing
    Readers Response
  1. .Congratulation Dr Aggarwal. Sir. really the Mela has become fully successful due to your wide imagination and magnetic personality. Perfect health mela has become such a big canvas that one can paint of all aspects of life on it. I tell you every one was impressed n talking about ur communicating skill at a time you can do many things no doubt u have compartmental mind which you are using very effectively. Regards Manasi
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