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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 …

17th August 2012, Friday

Sex Life May Offer Clues to CVD Risk

Assessment of sexual function should be incorporated into the initial cardiovascular evaluation for all men, regardless of the presence or absence of known CVD.
Erectile dysfunction has better predictive value for cardiovascular events than do traditional cardiovascular risk factors and often occurs within the context of silent coronary artery disease. The time window is 2 to 5 years between onset of ED and a CAD event. ED has predictive value for peripheral arterial disease and stroke.
"ED and cardiovascular disease (CVD) share risk factors, and ED is an independent predictor of CVD," as per Ajay Nehra, MD, of the Mayo Clinic in Rochester, Minn. in August issue of Mayo Clinic Proceedings.


  1. Stratification of patients with existing CVD by the level of cardiac risk associated with sexual activity (Am J Cardiol 2000;86:175-181).
  2. Include all men with ED and incorporated information on use of phosphodiesterase type 5 (PDE5) inhibitors in the management of ED (Am J Cardiol 2005;96:313-321).
  3. Evaluation and management of cardiovascular risk in men with ED but not CVD; updating the recommendations for evaluating cardiac risk associated with sexual activity in men with known CVD and the role of testosterone replacement therapy (TRT) in managing ED and CVD.

Assessment and risk clarification have two guiding principles: A man with organic ED should be considered at increased risk of CVD until proven otherwise. ED increases CVD risk even in the absence of CVD symptoms or history.

Recommendations for assessments: Medical history, physical exam, ED severity assessed by a validated scale, resting ECG, fasting sugar, serum creatinine level and albumin:creatinine ratio, lipid profile and testosterone levels in all men who have organic ED, particularly those who have not responded to treatment with a PDE5 inhibitor.

Sexual inquiry of all men is recommended, and those with ED should have an assessment of their exercise capacity. Exercise tolerance should help clinicians categorize patients as high, intermediate, or low risk, in keeping with accepted criteria (such as New York Heart Association functional classes).

Most low-risk patients can initiate or resume sexual activity and begin ED treatment without further testing or evaluation. High-risk patients should be referred to a cardiologist before initiating PDE5 therapy.

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

Depression made easy

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

Higgs – Boson, Consciousness and Health

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

Dr K K Aggarwal
    National News

Haryana bans gutkha, Gujarat to impose ban from Sept 11

The Haryana government has prohibited manufacture, storage, sale and distribution of gutkha and paan masala containing tobacco or nicotine as ingredients. The ban came into effect from Wednesday. The order has been issued in public health interest for one year, Commissioner of Food Safety, Haryana, Rakesh Gupta said here. The Food Safety and Standards Act, 2006, enacted by the Centre, prohibits the sale and manufacture of products which are injurious to health, Gupta said. He said under the Act, any person who manufactures for sale, stores, sells, distributes or imports any food which is unsafe, shall be punished. Meanwhile, speaking at Junagadh in Gujarat, Chief Minister Narendra Modi said gutkha will be banned in the state from September 11. “I have to save the youths of Gujarat from the dreaded evil of cancer and that’s why a decision to impose a complete ban on gutkha has been taken,” Modi said in his Independence Day speech. The comprehensive ban on sale, stocking, production and distribution of the product shall come into effect from September 11, he said. (Source: Indian Express, Aug 16 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)

Gut bacteria tied to metabolic syndrome

Certain bacteria in the gut may be associated with various components of the metabolic syndrome, a study in an Old Order Amish community showed. Although none of the three bacterial communities were associated with body mass index or any of the metabolic syndrome components, 26 of the individual bacterial species were associated either positively or negatively with BMI, serum triglycerides, HDL cholesterol, total cholesterol, fasting glucose levels, and C-reactive protein, the researchers reported online in PLoS One. (Source: Medpage Today)

PSA screening not all it's cracked up to be

Quality-of-life benefits from prostate cancer screening fell short of estimates among men who participated in a large European study of PSA-based prostate cancer screening, investigators reported. (Source: Medpage Today)

CDC cautions against relying on rapid tests to spot H3N2v

Negative results from rapid influenza diagnostic tests (RIDTs) for influenza A (H3N2v) should not be considered reliable evidence of lack of infection, according to an update published in the August 10 issue of the Morbidity and Mortality Weekly Report. (Source: Medscape)

Pain and other symptoms common in patients with diabetes

In a large study of adults with type 2 diabetes, pain and nonpain symptoms were common among all patients, not just among those near the end of life, according to a new study. Rebecca L. Sudore, MD, from the San Francisco VA Medical Center and the Division of Geriatrics, University of California, San Francisco, and colleagues published their findings online August 2 in the Journal of General Internal Medicine. (Source: Medscape)

Inflammation lower in active adults

Middle-age individuals who are physically active have lower levels of inflammatory markers sustained over time, researchers found. (Source: Medpage Today)

   Twitter of the Day

@DrKKAggarwal: Do Not Ignore Early Morning Chest Painhttp://blog.kkaggarwal.com/2012/08/do-not-ignore-early-morning-chest-pain-2/

@DeepakChopra: The Meditator travels to a snowy mountainside this

    Spiritual Update

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

Why don’t we eat curd in the month of Bhadon?

It is a traditional Ayurvedic saying that one should not eat green leafy vegetables in the month of Shravan, curd (yogurt, dahi) in the month of Bhadon, milk in the month of Ashwin and butter milk (mahi, matha) and pulses in the month of Kartik. To answer these questions, we need to understand the concept of Vata, Pitta and Kapha from Ayurveda. In terms of modern medicine, Vata represents movement, Pitta metabolism and Kapha structure and water.

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)

How is infertility diagnosed?

Ovulation testing: Ovulation occurs when your ovary releases an egg (oocyte) from a follicle (fluid filled cyst) in the ovary. After that, the egg will be picked up by the fimbria (fingers of the fallopian tubes), then travel through the tube to your uterus (womb). When you ovulate, your body goes through changes. These changes include:

  • Your body temperature rises after ovulation
  • Your body makes more of an important hormone called progesterone after you ovulate. An over the counter urine test kit or a blood test can measure LH (luteinizing hormone) levels, which is the trigger for ovulation.
  • Your follicles increase in size prior to ovulation. This change in follicle growth can be measured by an ultrasound and help predict the time of ovulation.
  • How frequently you get your period and how long it last.

    Fallopian tube testing: After you ovulate, an egg travels from the ovary to the uterus through one of your fallopian tubes. For the egg to make the trip, the tubes need to be clear of any blockages. To make sure that one or both tubes are not blocked, your doctor can perform one of two different procedures:

Hysterosalpingogram (HSG): During this x-ray procedure, a speculum is used to open the vagina then a catheter or device is used to place (inject) liquid into your cervix (opening into the uterus) so that it flows into the uterus. If the liquid comes out the ends of one or both of your tubes, then you can determine if one or both of the tubes are open. If the liquid does not enter or does not flow completely through one or both of your tubes, then the affected tube or tubes should be considered blocked.

For comments and archives

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

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

Generating request for transfusion

Each demand of blood/blood component should be raised through Blood Requisition Form (BRF). Along with the BRF, prescribed blood sample(s) should be sent. Blood Component can not be supplied without prescription of a registered medical practitioner. So every request form should be signed by a registered medical practitioner with proper identification of his/her.

Blood Requisition Form (BRF): The BRF should be dully filled and signed by the duty doctor and should be sent to the blood bank along with the blood samples. The BRF should contain the following details:

  • Complete name of patient
  • Age and sex of patient
  • Diagnosis of patient.
  • Hospital's Identification Number
  • Ward/Bed number.
  • Name of blood/blood component required
  • Quantity (units/volume) of blood/blood component required
  • Date and time of requirement
  • Category of requirement (Planned/Urgent/Life saving emergency).
  • H/o previous transfusion if any
  • Signature of the doctor


  1. For infants of less than 6 months of age, sample of mother is also required.
  2. Blood component requisition should be sent to blood bank during daytime in planned cases.
  3. After 48 hours of blood transfusion, a fresh blood sample should be sent for cross matching.
  4. If blood/blood component is not required at the time of sending demand, a “Demand Note” (having details of patient and blood/blood component required) should be sent at the time of collecting blood/blood component from the blood bank.

For comments and archives

   An Inspirational Story (Ms Rita Sinha)

Improving Self confidence

Author: Steve Goodier

Are you the type of person who easily gets influenced by negative advices? Follow this short self confidence lesson…

When Henry Ward Beecher was a young boy in school, he learned a lesson in self confidence which he never forgot. He was called upon to recite in front of the class. He had hardly begun when the teacher interrupted with an emphatic, “No!” He started over and again the teacher thundered, “No!” Humiliated, Henry sat down.

The next boy rose to recite and had just begun when the teacher shouted, “No!” This student, however, kept on with the recitation until he completed it. As he sat down, the teacher replied, “Very good!”

Henry was irritated. ”I recited just as he did,” he complained to the teacher. But the instructor replied, “It is not enough to know your lesson, you must be sure. When you allowed me to stop you, it meant that you were uncertain. If the world says, ‘No!’ it is your business to say, ‘Yes!’ and prove it.

The world will say, ‘No!’ in a thousand ways.

‘No! You can’t do that.’
‘No! You are wrong.’
‘No! You are too old.’
‘No! You are too young.’
‘No! You are too weak.’
‘No! It will never work.’
‘No! You don’t have the education.’
‘No! You don’t have the background.’
‘No! You don’t have the money.’
‘No! It can’t be done.’

And each ‘No!’ you hear has the potential to erode your confidence bit by bit until you quit all together. Though the world says, ‘No!’ to you today, you should be determined to say, ‘Yes!’ and prove it!”

For comments and archives

   Cardiology eMedinewS

Better outcomes in obese heart failure patients Read More

Nut consumption associated with good cholesterol and healthy weight
Read More

   Pediatric eMedinewS

Lipoxin A4 analog cream effective for infantile eczema in early trial
Read More

Warm, humid CO2 no help in laparoscopic appendectomy for kids
Read More

Stem Cell Update (Dr S K Verma, Consultant Ophthalmologist, New Delhi)

We all know that all organisms have a unique genetic code carried in DNA This genetic code should be termed as first or original genetic code because the scientists have deciphered a second genetic code responsible for the final assembly of protein inside living cells and it works with original genetic code.

  • Are you aware that astronauts may have weakened immune system in space than on earth because immune cells like T cells do not proliferate properly on space.
  • Researchers have identified that blood stem cells keep acquiring mutation with age and the mutational history of the cell is captured, as the clones expand, after which only two or three additional genetic changes are required to transform such a normal blood cell into the deadly acute myeloid leukemic cell.
  • Placenta derived progenitor cells have more blood vessel-forming capability than umbilical cord blood derived cells. These placental endothelial progenitors may be of help in treating neonatal cerebral ischemia and cardiovascular disease in future.
  • Cardiac stem cells from aged patients with heart disease were isolated and modified using a protein which promotes cell survival and growth. These modified stem cells when injected into immunocompromised mice showed better efficacy and enhanced cardiac repair.
  • A team led by Dr. Anna Bigas at the IMIM has identified a critical protein needed for development of blood stem cells from embryonic stem cells and this research will help in future to generate blood stem cells from the embryonic stem cells in the lab. (Courtesy: Journal of Stem cells and regenerative medicine 2012 July 25:3(12))
    IJCP Special

Dr Good Dr Bad

Situation: A patient with severe migraine wanted to know if xylocaine drops would be of help.
Dr. Bad: They have no role.
Dr. Good: You can try them.
Lesson: As an intranasal spray, 2% xylocaine drops can help migraine patients.

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 the rate of 4 liters per minute?
Lesson: Make sure that oxygen via nasal catheter, is not given at a rate of >3 liters per minute.

For comments and archives

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

Photos of Doctor’s Day Celebration

eMedinewS Apps
  Quote of the Day (Mr Vivek Kumar)

To be a leader, you have got to lead human beings with affection. JRD Tata

    Legal Question of the Day (Dr M C Gupta)

Q. I worked in a private medical college for two and half years as assistant professor. There was no written contract. I was selected for a government job. I resigned from the previous job with a request to relieve me immediately and to give me relieving certificate. No such certificate was given. I joined the government job. What should I do to get the experience certificate?


  • Written contract is not a must. An oral contract is legally valid.
  • You should send them a written request, under your signature but drafted by a lawyer, to give you the experience certificate. A properly drafted request would have high chances of being successful. If the previous employer ignores your request, you will be sure to get the required relief through court.
  • If you are forced to go to the court, it may be advisable to make the State government; the University; and, the MCI as co–respondents. A good lawyer would take care of this when drafting the request/representation for you.
    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Uric acid

  • To rule out gout
  • To monitor uric acid levels when undergoing chemotherapy or radiation treatment.
    Mind Teaser

Read this…………………

The client has a good understanding of the means to reduce the chances of colon cancer when he states:

A. “I will exercise daily.”
B. “I will include more red meat in my diet.”
C. “I will have an annual chest x-ray.”
D. “I will include more fresh fruits and vegetables in my diet.”

Yesterday’s Mind Teaser: 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

Answer for yesterday’s Mind Teaser: A. Give laxative the night before and a cleansing enema in the morning before the test

Correct answers received from: YJ Vasavada, Dr Kanta Jain, Dr KV Sarma, Dr Chandresh jardosh,
Dr Pankaj Agarwal, Muthumperumal Thirumalpillai, Dr Thakor Hitendrsinh G, Dr Jainendra Upadhyay,
Dr Valluri Ramarao, Dr Avtar Krishan, Dr LC Dhoka, Nprabakar, Dr Mohit Sharma, Chanchal Das.

Answer for 15th August Mind Teaser: B. Ulcerative colitis
Correct answers received from: Dr Mohit Sharma, Chanchal Das.

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

A quite boozy dentist sits in his practice on a Christmas Eve. There rushes an older woman into his cabinet, moaning: "O! My tooth hurts like hell! Pull it out, son!" "I am a bit boozy," the dentist argues. "I might get a wrong tooth. You better come after the Christmas." "Take it off, now! I'll pay you! I cannot stand it anymore!"

So the doctor gets down to it. Puts the old woman into his chair, tells her to open her mouth, puts the pincers into her mouth and... The old lady screams, leaps up and rushes out of the cabinet. After a couple of days a well-suited businessman walks into the same dentist's practice and asks: "Doctor, did you pull out a tooth of and old lady on the Christmas Eve?" "Yes, I did," the dentist says, wondering if he's in trouble now... "Well, here is 50 000 dollars and the keys of a SUV," the businessman says. "For what is that?" the doctor asks. "That woman was my mother-in-law. And you pulled out not the tooth but her tongue."

    Medicolegal Update

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

What is World Medical Association Declaration – Principle V–Clinical Education?

The clinical component of medical education must be centered on the supervised study of patients and must involve direct experiences in the diagnosis and treatment of disease. The clinical component should include personal diagnostic and therapeutically experience with gradual access to responsibilities. An adequate relation of the numbers of students admitted for training and teaching at the bedside of the individual patient must be observed.

  • Before beginning independent practice, every physician should complete a formal program of clinical education. This program, usually of at least one year’s duration, should be characterized by a supervised increase of responsibility for the management of clinical problems.
  • The faculty is responsible for determining that students who receive the first professional degree, have acquired a basic understanding of clinical medicine the basic skills needed to be evaluated.
  • Addressing clinical problems and to take appropriate action independently, and have the attitude and character to be an ethical physician.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Safe limit of alcohol varies with the countries

One to two drinks a day in women, and two to four drinks a day in men, are inversely related to mortality. This was stated by Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

The definition of a "standard drink" varies in different countries. A standard drink in the US is approximately 0.5 to 0.6 fl oz, or 12 to 14 g alcohol, equivalent to 12 oz beer, 5 oz wine, and 1.5 oz of 80 proof liquor. In Great Britain, a standard drink is 8 g alcohol. In Japan, it is 19.75 g and in India, it is 10 grams of alcohol.

The serum blood tests: AST (SGOT), ALT (SGPT), and gamma-glutamyl transferase (GGT) are often abnormal in alcoholic liver disease. The most common pattern of abnormalities is a disproportionate elevation of serum AST (SGOT) compared to ALT (SGPT). This ratio is usually greater than 2.0, a value that is rarely seen in other forms of liver disease.

The absolute values of serum AST and ALT are almost always less than 500 IU/L (and typically less than 300 IU/L). Higher levels should raise the suspicion of concurrent liver injury due to viral or ischemic hepatitis or acetaminophen use, even at therapeutic doses. Alcoholic liver damage can range from asymptomatic fatty liver to alcoholic hepatitis to end–stage liver failure with jaundice, coagulopathy and encephalopathy. Many alcoholics first become symptomatic only when severe, life–threatening liver disease is already present. Even at this stage, abstinence can result in significant reversal in some patients.

Alcohol can lead to a variety of histopathologic changes in the liver ranging from steatosis to cirrhosis. Steatosis, alcoholic hepatitis and possibly cirrhosis are reversible. A high prevalence (25 to 65 percent) of hepatitis C virus infection has been recognized in alcoholics, which can greatly accelerate fibrosis and associated morbidity. These patients tend to have more severe disease, decreased survival, and an increased risk of hepatocellular carcinoma. Fatty liver, or alcoholic steatosis, can occur within hours after a large alcohol binge.

    Readers Response
  1. Realy its good, to explain the indian flag tri colours co related with indian mythology Subhash jain
    Forthcoming Events
Dr K K Aggarwal

Dr K K Aggarwal

Dr K K Aggarwal

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

    eMedinewS Special

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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Dr Usha K Baveja