emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
FIRST NATIONAL eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

 

Live Web Cast of 3rd eMedinewS – Revisiting 2011, on January 22, 2012

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

For regular eMesinewS updates on facebook at www.facebook.com/DrKKAggarwal

eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

 
  Editorial …

17th January 2012, Tuesday

Avoid smoking in winter

Smoking can not only precipitate heart attack, paralysis and increase blood pressure but can also increase the risk of erectile dysfunction in men. Men who smoke 20 cigarettes a day are 40% more likely to struggle with erectile dysfunction than men who do not smoke.

Nicotine present in smoke can constrict the blood supply to various organs. As per a study published in the journal Tobacco Control in men aged 16–59 the risk of erectile dysfunction is almost double in smokers than in non smokers. Apart from smoking, obesity, heavy alcohol consumption and misuse of Viagra like drugs can also disturb men’s sexual health.

Apart, uncontrolled diabetes, blood pressure, which is common in winter season also add to the same.

Depression is also common in winter adding to the agony. For those who want to quit smoking winter is the best time to do so.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

Avoid smoking in winter

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal interacting with BAMS Students on 15th January, 2012 at Punjabi Bagh. Dr Aggarwal delivers a lecture on Chikitsa Jagat Mai Ved aur Aaj Ka Vizgyan

 
Dr K K Aggarwal
 
    National News

13 lakh kids in India die before 1st birthday

NEW DELHI: Over 55,000 women die due to child birth in India every year. Of the total children born in one year, a mind boggling 13 lakh die before they reach their first birthdays, most of them within a few weeks of entering this world. Another indicator that the world watches is how many children cannot survive beyond five years of age. In India every year, over 16 lakh under–5 years children die. These are hair–raising numbers, the highest in the world, mainly because India has the highest number of births in the world–over 2.62 crore per year. But how can one compare this with other countries with lower population or lower birth rates? That is done by expressing mother’s deaths in terms of how many per 1 lakh live births. For India this maternal mortality rate works out to 212. And for infant deaths the ratio is written as so many per 1000 live births. For India this works out to 50. Under–5 mortality in India is 63. (Source: TOI, Jan 16, 2012)

For comments and archives

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

 
    International News

For the overweight, some carbs better than others

A diet with a low–glycemic load may have benefits for overweight and obese individuals who are otherwise healthy, a randomized, crossover study showed. (Source: Medscape Medical News)

For comments and archives

FDA recalls non–circulating ventilator

The FDA has issued a class I recall––the agency’s strictest––of a ventilator that may stop circulating air, possibly causing injury or death. The Respironics Trilogy 100 ventilator’s blower––a part that circulates air and other gases in the device––may move out of position. If it does, an alarm will sound, but if the alarm is ignored or attention to it is delayed, the patient may be seriously injured or die, the agency said in a statement. The recall affects 52 serial numbers, the full list of which is available on the FDA website. (Source: Medpage Today)

For comments and archives

Pharmacies can help keep diabetes patients on track

Having pharmacies blow the whistle when patients’ diabetes medication adherence sagged was helpful in keeping them on the right track, according to a study published in the diabetes–themed January issue of Health Affairs. (Source: Medscape Medical News)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Weight gain precedes the onset of diabetes Weight gain after age 18 years in women and after age 20 years in men.

@DeepakChopra: #CosmicConsciousness From the atom to the universe there is only motion. Don’t try to fix the flux. Flow.

 
    Spiritual Update

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

Winter is the Month of Depression and Uttarayana Start of Positive State of Mind

In Indian mythology, the word "Sankranti" relates to any transformation or change. Makar Sankranti which falls on 14th of January, one day after the Lohri, indicates change in the direction of the sun, as it starts moving north resulting into longer days and shorter nights. In Hindu mythology, it is called Uttarayana. This was the period during Mahabharata which Bhishma Pitamaha waited for his death.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What percentage IVF cycles gets cancelled prior to egg retrieval and why?

According to western figures 20% of cycles may be cancelled prior to egg retrieval. IVF cycles may be cancelled for a variety of reasons, usually due to an inadequate number of follicles developing. Cancellation rates due to low response to the ovulation drugs increase with a woman’s age, especially after age 35. a cycle may be cancelled to reduce the risk of ovarian hyperstimulation syndrome (OHSS). Treatment with a GnRH agonist or antagonist reduces the possibility of premature LH surges from the pituitary gland, and thereby reduces the risk of premature ovulation.

For comments and archives

 
    An Inspirational Story

(Dr Anupam Sethi Malhotra)

Mr. Doctor "Why are You Irresponsible?"

"The doctor was called one evening for an urgent surgery. He answered the call, changed his clothes, reached hospital in minutes and went directly to the surgery block. He found the boy’s father waiting, in the hall for the doctor. On seeing him, the dad yelled: "Why did U take all this time to come?

Don’t you know that my son’s life is in danger? Don’t you have any sense of responsibility?" The doctor smiled and said: "I am sorry, I wasn't in the hospital and I came as fast as I could after receiving the call…… And now, I wish you’d calm down so that I can do my work"

"Calm down?! What if your son was in this room right now, would you calm down? If your own son dies now what will you do?" said the father angrily

The doctor smiled again and replied: "I will say what "Job" said in the Holy Bible: "From dust we came and to dust we return, blessed be the name of God". Doctors cannot prolong lives. Go and intercede for your son, we will do our best by God’s grace" "Giving advises when we're not concerned is so easy" Murmured the father.

The surgery took some hours after which the doctor went out happy, "Thank goodness!, your son is saved!" And without waiting for the father’s reply he carried on his way running. "If you have any question, ask the nurse!!"

"Why is he so arrogant? He couldn’t wait some minutes so that I ask about my son’s state," commented the father when seeing the nurse minutes after the doctor left. The nurse answered, tears coming down her face:

"His son died yesterday in a road accident, he was in the burial when we called him for your son’s surgery. And now that he saved your son’s life, he left running to finish his son’s burial.

Never judge anyone…… because U never know how their life is and what they’re going through.

For comments and archives

 
   Cardiology eMedinewS

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

Bereavement triggers heart attack

Read More

Combination therapy for high BP

Read More

Pulmonary artery systolic pressure is a strong predictor of death in heart failure patients. it also provides prognostic information

Read More

 
   Pediatric eMedinewS

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

Revisiting 2011: Identification of developmental-behavioral problems in primary care

Read More

Revisiting 2011: Minor head trauma

Read More

Revisiting 2011: Rapid response teams

Read More

Revisiting 2011: Mechanisms of puberty

Read More

 
    Healthy Driving

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

Diabetes and driving

Regularly check your blood sugar. If you feel that your blood sugar is low, stop driving and immediately treat with a quick–acting sugar e.g. three glucose tablets. Wait until the sugar has started to work before driving on.

 
  Legal Question of the Day

(Dr MC Gupta, Advocate & Medico–legal Consultant)

Q. I have received a summon from the magistrate’s court to appear as a witness. It contains no details. The police man informed that it concerns a case filed by the wife against the husband and I had allegedly treated the wife as an OPD patient in 2003 and that the summon is meant to confirm my outpatient prescription. Should I appear?

Ans.

  1. There is no question of your not appearing. If a court summons you, you must appear. Not doing so is a punishable offence.
  2. The police man is possibly right. When the woman produces your prescription to substantiate her allegation, the prescription itself must be "proved", which means it must be authenticated as genuine by the one who wrote it. The prosecution lawyer (Public prosecutor) might ask you questions like the following:

Was this prescription written by you?

Is it in your handwriting and bears your signature?

You may answer to these in the affirmative. No other questions may be asked from you. If they are asked, you may apply truthfully without any fear or anxiety.

For comments and archives

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    Rabies Update

(Dr A K Gupta, R.P. Bagh, Delhi, Author of "RABIES – the worst death")

What is the best known clinical feature of rabies?

Hydrophobia is the best known clinical feature of rabies and is typically unique to human beings. Hydrophobia is due to a violent jerky contraction of the diaphragm and the accessory muscles of inspiration that is triggered by the patient’s attempt to swallow liquid.

What is the incubation period of rabies virus?

The incubation period of rabies virus, that is the time interval between the bite and the onset of symptoms, is usually from 03 weeks to 03 months (rarely 04 days to 02 years). Children are at an increased risk of a shorter incubation period because of their short stature. Bites are often closer to CNS.

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient came with an eGFR value of 15.
Dr. Bad: You need immediate dialysis.
Dr. Good: Hold on till proper investigations are done.
Lesson: A study published on December 6th in Canadian Medical Association Journal shows that starting dialysis too soon can be associated with high mortality.

For comments and archives

Make Sure

Situation: A rape victim developed HIV infection.
Reaction: Oh my God! Why was she not given post exposure ART prophylaxis?
Lesson: Make sure all rape victims are counseled for HIV post exposure ART prophylaxis.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

The secret of getting ahead is getting started. Sally Berger

 
  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Polycythemia

Polycythemia is defined as an increase in total body erythrocyte mass. As opposed to the situation with anemias, the physician may directly measure RBC mass using radiolabeling by 51chromium, so as to differentiate polycythemia (absolute erythrocytosis, as seen in polycythemia vera, chronic hypoxia, smoker’s polycythemia, Ectopic erythropoietin production, methemoglobinemia, and high oxygen affinity hemoglobins) from relative erythrocytosis (as seen in stress polycythemia and dehydration)

 
    Mind Teaser

Read this…………………

HO
HO

+HO

Yesterday’s Mind Teaser: A recent upper respiratory viral illness can be a provoking factor in:

a. Herpes zoster oticus
b. Acute vestibular neuronitis
c. Perilymphatic fistula
d. BPPV

Answer for Yesterday’s Mind Teaser: d. BPPV

Correct answers received from: Raju Kuppusamy, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Neelam Nath, Dr BB Aggarwal, Dr Avtar Krishan.

Answer for 15th January Mind Teaser: d. All of the above
Correct answers received from: Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Neelam Nath, Dr BB Aggarwal, Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Doctor, doctor, I keep thinking I’m a spoon.
Sit there and don’t stir.

 
  Medicolegal Update

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

Hanging is almost always suicidal

  • Apart from the now rare ‘lynching’, hanging is almost always suicidal or accidental, the former being by far the most common.
  • Hanging has many features in common with ligature strangulation. Death is, however, more often caused by reflex cardiac arrest from pressure on the carotid structures.
  • Many more victims of hanging are found to have pale faces, rather than the congested, hemorrhagic appearance of the slower asphyxial type of death.
  • The rapid onset of heart stoppage may antedate any evidence of congestive or ‘asphyxia’ signs, causing death immediately or within seconds, or at any time thereafter.
  • Overstimulation of nerve endings in the carotid sinus or adjacent arterial sheath may be brought about by direct pressure from fingers or from a ligature during strangulation or hanging–or from a blow directed at the side of the neck.
  • Severe pain, such as a blow on the larynx or genitals, may also trigger a ‘vagal response’. absence of congestion, cyanosis and petechial, the pale faces indicating that cardiac arrest had taken place before the congestive signs had time to appear. Electrostimulation has an excellent chance of revival.

Reference………………James and Silocks (1992), In a 15–year survey of hanging in Cardiff, found congestive–petechial features in 27 percent, being related to the completeness of suspensions

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

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

Exercise: a prescription

There are enough medical reasons to exercises said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India. The following are the benefits of exercising.

  • Reduces the chances of getting heart disease. For those who already have heart disease, exercise reduces the chances of dying from it.
  • Lowers the risk of developing hypertension and diabetes.
  • Reduces the risk for colon cancer and some other forms of cancer.
  • Improves mood and mental functioning.
  • Keeps the bones strong and joints healthy.
  • Helps maintain a healthy weight.
  • Helps maintain independence into later years.
  • Age is no bar
  • Exercise can enhance health and well–being.
  • The minimum threshold for good health is to burn at least 700 to 1,000 calories a week through physical pursuits.
  • Adding as little as half an hour of moderately intense daily physical activity can help
  • One avoids a host of serious ailments, including heart disease, diabetes, depression, and several types of cancer, particularly breast and colon cancers.
  • Regular exercise can also help one sleep better, reduce stress, control weight, brighten mood, sharpen mental functioning, and improve sex life.

As per Harvard researchers a well-rounded exercise program must have all the four components:

  1. Aerobic activity
  2. Strength training
  3. Flexibility training, and
  4. Balance exercises

Aerobic activity: is the centerpiece of any fitness program. Most benefits of exercise revolve around aerobic cardiovascular activity, which includes walking, jogging, swimming, and cycling. One should work out at moderate intensity when performing aerobic exercise—brisk walking that quickens the breathing is one example. This level of activity is safe.

Strength training protects bone: Strength or resistance training, such as elastic–band workouts and the use of weight machines or free weights, are important for building muscle and protecting bone. Bones lose calcium and weaken with age, but strength training can help slow or sometimes even reverse this trend.

Flexibility exercises ease back pains: Muscles tend to shorten and weaken with age. Shorter, stiffer muscle fibers make one vulnerable to injuries, back pain, and stress. But regularly performing exercises that isolate and stretch the elastic fibers surrounding the muscles and tendons can counteract this process. And stretching improves posture and balance.

Balancing exercises prevents fall: Balance erode over time, and regularly performing balance exercises is one of the best ways to protect against falls that lead to temporary or permanent disability. Balance exercises take only a few minutes and often fit easily into the warm–up portion of a workout. Many strength–training exercises also serve as balance exercises. Or balance–enhancing movements may simply be woven into other forms of exercise, such as tai chi, yoga, and Pilates.

 
    Readers Response
  1. Dr. K. K. Aggarwal, Apropos the news–item "Glasses, patching work for rogue form of lazy eye" (eMedinews, January 14), this is to say that correction of the error of refraction with glasses and occlusion of the better eye in order to force the weaker eye to see is the standard procedure for the management of amblyopia or lazy eye. But the correction of refractive error early in life wards off the development of amblyopia. And, GPs need to advise parents to take their kids to an eye care professional for detailed eye examination as son as possible preferably before sending them to a pre–nursery school.Dr. Narendra Kumar
 
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

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

The one–day conference will revisit and discuss all the major advances in medicine in the year 2011. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

See programme below.

There is no registration fee. All delegates will get Registration Kit, Attractive gifts, Certificates. Morning snacks and lunch will be provided.

Register at: www.emedinews.in/rekhapapola@gmail.com/drpawangupta2006@yahoo.com

3rd eMedinewS Doctor of the Year Awards

Dear Colleague, the 3rd eMedinewS "Doctor of the Year Awards" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 3 pm. If you know of any medical doctor who you feel has made significant achievement/contribution in medicine in the year 2011, send his/her Biodata at: emedinews@gmail.com

More than 900 people have registered for the conference.

View Live Webcast of 3rd eMedinewS–Revisiting 2011 at: www.emedinews.org

Viewer Requirements

  • Windows Media Player 9.0 or above for live webcast version
  • PC: P4 (Pentium 4), 1GB RAM, good quality multimedia kit, good Internet connectivity–ideally broadband connectivity–512 kbps or 1 mbps and above dedicated bandwidth
  • Firewall etc. should allow streaming content
  • Ports 80 and 8080 should be opened to allow streaming content.

Moderator by Dr K K Aggarwal

TIME

Speaker

Topic

Penalist

8.00–8.10 AM

Dr KK Aggarwal

Revisiting the Year 2011

 

8.10–8.25 AM

Dr G K Mani

Cardiac surgery in 2012

Dr Sandeep Mukherjee, Dr P K Dave

8.25–8.35 AM

Mr M K Doogar

Health Insurance

Mr Arun Kishore

8.35–8.50 AM

Mr B N S Ratnakar

Financial Health

Mr Anil Wadhwa

8.50–9.05 AM

Dr Dinesh Bhurani

Hemato Oncology Update

Dr Amit Bhargava

9.05–9.20 AM

Dr Kailash Singla

Gastro Update

Dr Ajay Kumar

9.20–9.35 AM

Dr Pramod Kumar

Beyond Coronaries

Dr Rakesh Arora

9.35–10.00 AM

Dr N K Bhatia

What’s new in transfusion medicine

Dr B B Rewari, Dr Bharat Singh

10.00–10.25 AM

Dr Praveen Chandra

Dual Anti Platelet Therapy in ACS

Dr H K Chopra

10.25–10.50 AM

Dr Ambrish Mithal

Obesity as a precursor for diabetes

Dr P D Gulati, Dr H S Luthra

10.50–11.15AM

Dr Ajay Kriplani

Diabetes: A Curable Surgical Disease

Dr K N Srivastava, Dr K Jagadeesan

11.15–11.40 AM

Dr Kaberi Banerjee

Infertility Update

Dr Veena Aggarwal

11.40–11.50 AM

Dr I M Chugh

Chest Medicine Update

Dr Pavan Mangla

11.50–12.05 PM

Dr Rajneesh Kapoor

Understanding stents (a journey from bare metal to biodegradable stents)

Dr Harsh wardhan

12.05–12.20 PM

U Kaul

DES for the future–Is India ready to take the challenge

Dr Sanjay Tyagi

12.20–12.45 PM

Dr Sujit Jha

High risk diabetes

Dr G M Singh

12.45–1.10 PM

Dr Sudhir Kumar Rawal

Robotic Surgery in India

Dr P K Julka

1.10–1. 35 PM

Dr Amit Bhargava

Oncology

Dr P K Julka

1.35–1.50 PM

Dr Sanjay Chaudhary

Automation in Cataract Surgery with Femto–second

Dr Satish Mehta

1.50–2.05 PM

Dr Surender Kumar

Diabetes in 2012

Dr Pawan Gupta

2.05–2.20 PM

Dr S N Khanna

Valve Surgery Update

Dr O P Yadav

2.20–2.35 PM

Dr Ravi Kasliwal

Markers for cardiovascular prevention

Dr Sameer Srivastava

2.35–2.50 PM

Dr Neelam Mohan

Liver Transplantation

Dr A S Soin

PEDICON 2012

Date: 18th–22nd Januray, 2011
Venue: Leisure Valley Ground, Sector 29, Gurgaon, Haryana
Website: http://pedicon2012.com/
For Latest happenings pls visit: http://pedianews.emedinews.in/

IMSOCN2012

The Annual conference of Indian Menopause Society is to be held from 17 to 19th Feb 2012 in Hotel The Claridges, Surajkund Faridabad. It is multidisciplinary approach to the problems of midlife onwards in women. This conference has participation of British Menopause Society and South Asian Federation Of Menopause Societies and opportunity to hear from international faculties.

For information Contact Dr. Maninder Ahuja (Organizing Chairperson) 9810881048 down load forms from web sit http://indianwoman35plus.com/ or Indianmenopausesociety.org or http://fogsi.org/

Contact at ahuja.maninder@gmail.com
Call for free papers and posters on theme topics of conference.

Early Registration till 30th Dec 2011

National Intervention Council Update

National Intervention Council is pleased to announce a National Interventional Fellow Competition in its forthcoming Mid–term NIC Meeting to be held in Kochi, 27–29 April 2012.

As you might know there is paucity of good interventional post–DM Fellowship programmes in the country. As such there is no consistent, dedicated teaching to the aspiring interventionists. These budding interventional cardiologists mostly learn by watching their teachers and senior colleagues. As such these students particularly lack in knowledge of basics of this sub–speciality. Therefore, NIC is focusing on alleviating this felt need by doing a "Back to Basics" session at the mid–term NIC Meeting. At the end of this session we propose to hold a National Competition.

The "Competition" will include an MCQ type written exam on basics of coronary intervention followed by a quiz. The students will be examined by judges who will award "National Interventional Fellow Award". Students enrolled in Cardiology and Intervention Cardiology teaching programme and those who have already completed within 3 years will be eligible for the competition.

Those who wish to participate for this competition can register by sending their full particulars (Name, Institution, Year of Residency, Guide/co–Guides, email address and mobile number) either on email or the following address.

Dr Sundeep Mishra

425 Mount Kailash Tower No 2, East of Kailash,
New Delhi, India 110065

drsundeepmishra@hotmail.com, Mobile 9871421390

Fellows can also register at website http://www.nickochi2012.org/ NIC will offer an all paid 3 month hands–on Interventional fellowship at an international center to winner of this award. We hope this will stimulate a desire to systemically learn the basics of coronary hardware and the techniques and will then apply this learned knowledge to clinical practice thus raising the overall standard in our country.

Please let us know what you feel about the program. Particularly, we request you encourage your students and junior colleagues to participate in this event.

 
    eMedinewS Special

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

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

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

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

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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

 
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