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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
  Editorial …

17th December 2012, Monday

Concerns about Proton Pump Inhibitors

  • PPIs and Clostridium difficile: this was a concern listed by the US FDA
  • PPIs and clopidogrel: Concern continues about the interaction between clopidogrel and PPIs, and the FDA, narrowed this down to omeprazole and esomeprazole.
  • PPIs and methotrexate: FDA alert issued in December 2011, following case reports describing patients who received high-dose induction methotrexate intravenously and who had very high serum levels of methotrexate, which were potentially attributed to exposure to a PPI -- in this case, omeprazole.
  • PIs and bone density: Studies continue to suggest an increased risk for fractures with long-term use of PPIs.
  • PPIs and antidepressants: Combination of PPIs and citalopram has raised some concern, particularly with the racemic mixture. This drug has (R) and (S) enantiomers, and the (S) (the left side) is the one involved in the antidepressant effect. The same is true for escitalopram, a drug that many of you may prescribe and that can contribute to the toxicity of QRS prolongation in torsade de pointe.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Even when large volumes are ingested, PEG induced diarrhea is associated with minimal electrolyte losses or gains. PEG 3350 electrolyte solutions are thus safer than osmotic salts such as magnesium and sodium sulphate or phosphate, especially in patients with impaired renal or cardiac function (Attar A, Lémann M, Ferguson A, et al. Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation. Gut 1999;44(2):226)

Dr K K Aggarwal
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal on

Weight loss may improve sexual health of
obese diabetes

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela 2012

Children from various schools participated with great enthusiasm in learning the technique of CPR 10 - hands-only cardio pulmonary resuscitation.

Dr K K Aggarwal
    My Profession My Concern (Prof. Dr. S. Arulrhaj, MD, FRCP (Glasg))

We are relaxed that BRHC has metamorphosed to BSc & they will be paramedics. This is our illusion. MOH plans behind. Recently I was at the Parliamentary House of India & many of my intuitions proved right. Issues are:

  • MCI Act 1956 does not permit MCI to prepare & submit the Syllabus & Curriculum for a Paramedical course, but MCI is doing it. Why?
  • MOH is silent on the registration of these graduates.
  • What we want?
    • MCI must pullout from supporting through Syllabus & Curriculum.
    • MOH must form Paramedical Council & declare to register them.
    • Way out; only legal.
    • IMA is a party in Meenakshi Gautham case. TN & Kerala have filed cases on BRHC.
    • They must move a petition in these cases.
    • PIL from Medical Professionals & Branches of IMA throughout India must be filed. Urgent.
    • Political lobbying has to be intensified as the winter session of Parliament is on till 22nd Dec.
    • Kindly give your thought, evaluate the legal modus operandi & proceed. We will succeed.
    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

Govt bid to make Jaipur smoke-free by March 2013

JAIPUR: The state government is taking measures to make Jaipur smoke-free city by the end of this financial year through effective implementation of Cigarette and Other Tobacco Product Act (COTPA) 2003. Under a special campaign, the medical and health department, in collaboration with city police, have issued challans to over 3,000 people in the last one month. Narendra Singh, state consultant of National Tobacco Control Programme, WHO India Tobacco Free Initiative/MoHFW, Rajasthan, said, "We have started process for making Jaipur a smoke-free city. The health department with all stakeholders, including police, education and civil society will ensure effective enforcement of COTPA. The department will study the compliance report after the campaign comes to an end on December 18, following which the city will be declared as smoke-free. Only Bhubaneswar, Chandigarh, Shimla and Kottayam have been declared smoke-free cities in the country," he added. Jaipur was one of the two cities of Rajasthan which was selected in the National Tobacco Control Programme (NTCP) as a pilot project. In India, 42 cities of 21 states were selected for the NTCP. The second district for NTCP was Jhunjhunu, which has already been declared as a smoke-free city. The health department has inspected hotels, restaurants and various public places and issued challans to the offenders. A cigarette and tobacco product shop owner at railway station said, "The police officials came to my shop and challaned me for not displaying mandatory tobacco warning board." The health department has started issuing challans to offenders in Kota, Udaipur and Jodhpur. As per COTPA, to declare a district smoke-free, there should be boards at entrances of every government building on ban on smoking. Also, restaurants and hotels should also be smoke-free as they are public places. Also, smoking zones would be identified in the city, where people would be able to smoke. In Jaipur, there would be prohibition of smoking in a public place, prohibition of advertisement of cigarettes and other tobacco products, prohibition of sale of cigarette or ether tobacco products to a person below the age of 18 years and in particular area, restrictions on trade and commerce in, and production, supply and distribution of cigarettes and other tobacco products. (Source: TOI, Dec 15, 2012)

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

Underlying atherosclerosis

The presence of underlying coronary or aortic atherosclerosis affects the treatment and outcome of elderly patients in whom surgery is considered for valvular disease. The 2006 ACC/AHA and the 2007 European Society of Cardiology guidelines on the management of valvular heart disease included recommendations for coronary angiography in patients undergoing valve surgery, which would include all elderly patients.

(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)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

ICP alternative OK to guide care of brain injury

In patients with traumatic brain injury, monitoring intracranial pressure to help guide therapy has been the standard of care – but on the basis of limited evidence. (Source: Medpage Today)

Chantix may up heart risk, FDA warns

The smoking-cessation drug varenicline (Chantix) may increase the risk of cardiovascular events, according to an updated review from the FDA. (Source: Medpage Today)

FDA approves raxibacumab for inhalational anthrax

The US Food and Drug Administration (FDA) has approved a novel drug for the treatment of inhalational anthrax. (Source: Medscape)

Physician fatigue not a factor in PCI outcome

Potentially sleep-deprived interventional cardiologists appear to perform percutaneous coronary interventions (PCIs) just as well as their more well-rested colleagues, a single-center study suggested. (Source: Medpage Today)

Breast cancer survivors have higher diabetes incidence

Postmenopausal breast cancer survivors have a modest but meaningful increase in the incidence of diabetes, according to the findings of a population-based observational study. However, diabetes incidence varied over time in breast cancer survivors. (Source: Medscape)

Vitamin D deficiency in pregnancy linked to low birth weight

Vitamin D levels in early pregnancy are closely related to birth weight, head circumference and ponderal index, but not placental growth, in term infants, according to a study published online November 16 and in the January 2013 issue of the Journal of Clinical Endocrinology & Metabolism. (Source: Medscape)

  Twitter of the Day

@DrKKAggarwal: Heart patients should avoid stress in winter All heart patients should have their cardiac and mental stress... http://fb.me/2d0A91kfn

    Spiritual Update

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

Is it wrong not to respond to an SMS?

One of the top government officers showed unhappiness to me on account that I did not accept her face book friend request in time. Many other people also became upset with me on account that I did not respond to their face book updates and never clicked ‘Like’. The same I experienced with SMS. Everyday, expects if a SMS is seen it should be responded.

For comments and archives

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

What is endometriosis?

Endometriosis is a common condition that affects women during the reproductive years. It occurs when normal tissue from the uterine lining, the endometrium, attaches to organs in the pelvis and begins to grow. This displaced endometrial tissue causes irritation in the pelvis that may lead to pain and infertility.

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

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

What does pre transplant evaluation include?

Pre transplant immunizations: Most units including ours consider live vaccines to be contraindicated after liver transplant because of the risk of dissemination secondary to immunosuppression. It is therefore better to complete normal immunizations before transplant. These include: BCG, DPT + Hib, Hepatitis B, Measles, MMR. It’s suggested to give even optional vaccine such as Hepatitis A, Typhoid, Chickenpox, Influenza, Rotavirus and Pneumococcal vaccines. The vaccination schedule may be expedited and may differ from the normal recommendations.

Management of hepatic complications: It is important to ensure that specific hepatic complications are appropriately managed while the patient waits for transplant. These include portal hypertension, esophageal varices, ascites, hypoproteinemia etc.

Nutritional support: It has been demonstrated in several studies that nutritional status at liver transplant is an important prognostic factor in survival i.e. better outcome is seen in patients with good nutritional status. The patient needs to be on a high calorie diet (150–200% calories good protein intake) with two times the RDA of multi vitamins and in patients with cholestasis, supplementation with fat–soluble vitamins like vitamin A, D, E, and K is done. In patients with cholestasis, MCT oil as in coconut oil is used for cooking. If a child is not able to feed well orally then tube feed supplementation is done, which could be for overnight feeds or during the day as per the need.

For comments and archives

    An Inspirational Story

Words to live by…

Accept that some days you’re the pigeon, and some days you’re the statue. Always keep your words soft and sweet, just in case you have to eat them. Always read stuff that will make you look good if you die in the middle of it. Drive carefully. It’s not only cars that can be recalled by their maker. Eat a live toad in the morning and nothing worse will happen to you for the rest of the day. If you can’t be kind, at least have the decency to be vague. If you lend someone $20, and never see that person again, it was probably worth it. It may be that your sole purpose in life is simply to serve as a warning to others. Never buy a car you can't push.

Never put both feet in your mouth at the same time, because then you don’t have a leg to stand on. Nobody cares if you can’t dance well. Just get up and dance. The early worm gets eaten by the bird, so sleep late. When everything’s coming your way, you're in the wrong lane. Birthdays are good for you; the more you have, the longer you live. Ever notice that the people who are late are often much jollier than the people who have to wait for them? If ignorance is bliss, why aren't more people happy? You may be only one person in the world, but you may also be the world to one person. Some mistakes are too much fun to only make once. Don’t cry because it’s over; smile because it happened. We could learn a lot from crayons: Some are sharp, some are pretty, some are dull, some have weird names, and all are different colors but they all have to learn to live in the same box.

A truly happy person is one who can enjoy the scenery on a detour. Happiness comes through doors you didn’t even know you left open. Have an awesome day, and know that someone has thought about you today…

For comments and archives

  Cardiology eMedinewS

Insulin sensitivity improved with Mediterranean-style diet Read More

CVD Death Rate In Us Declines, But One In Three Still Dying From Cardiac Causes Read More

  Pediatric eMedinewS

MRSA Led Surge In Pediatric Staphylococcus Hospitalizations Read More

Flu Triage With Online Test For Kids Not Specific Enough Read More

    IJCP Special

Dr Good Dr Bad

Situation: A diabetic on exercise protocol came for blood sugar check up.
Dr Bad: Get fasting sugar done.
Dr Good: Get fasting and post prandial sugar done.
Lesson: The 2–hour plasma glucose level is more sensitive than fasting plasma glucose level to the beneficial effects of physical activity. These beneficial effects are apparent across the waist circumference spectrum (Diabetes Care 2006;29:2598–604).

Make Sure

Situation: A patient with diabetes shows deteriorating kidney function.
Reaction: Oh my God! His HbA1C is very high?
Lesson: Make sure that strict glycemic control is maintained in patients with type 2 diabetes in order to delay vascular complications.

  Quote of the Day (Dr GM Singh)

Six essential qualities that are the key to success: Sincerity, personal integrity, humility, courtesy, wisdom & charity. William Menninger

    Mind Teaser

Read this…………………

Which of the following would be inappropriate to include in a diabetic teaching plan?

A. Change position hourly to increase circulation
B. Inspect feet and legs daily for any changes
C. Keep legs elevated on 2 pillows while sleeping
D. Keep the insulin not in use in the refrigerator

Yesterday’s Mind Teaser: Rene, age 62, is scheduled for a TURP after being diagnosed with a Benign Prostatic Hyperplasia (BPH). As part of the preoperative teaching, the nurse should tell the client that after surgery:

A. Urinary control may be permanently lost to some degree
B. Urinary drainage will be dependent on a urethral catheter for 24 hours
C. Frequency and burning on urination will last while the cystotomy tube is in place
D. His ability to perform sexually will be permanently impaired

Answer for Yesterday’s  Mind Teaser: B. Urinary drainage will be dependent on a urethral catheter for 24 hours

Correct answers received from: Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Dr.Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr B K Agarwal, Dr Avtar Krishan, drjella

Answer for 14th December Mind Teaser: (A) 30 degrees

Correct answers received from: Muthumperumal Thirumalpillai, Dr B K Agarwal, Dr Avtar Krishan, drjella

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Railroad accident

In a terrible accident at a railroad crossing, a train smashed into a car and pushed it nearly four hundred yards down the track. Though no one was killed, the driver took the train company to court.

At the trial, the engineer insisted that he had given the driver ample warning by waving his lantern back and forth for nearly a minute. He even stood and convincingly demonstrated how he’d done it. The court believed his story, and the suit was dismissed.

“Congratulations,” the lawyer said to the engineer when it was over. "You did superbly under cross–examination."

“Thanks,” he said, "but he sure had me worried."

“How’s that?” the lawyer asked.

“I was afraid he was going to ask if the lantern was lit!”

    Medicolegal Update

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

What is Touch DNA?

Locard’s Exchange Principle states that with contact between two items, there will always be an exchange. So, when a crime is committed, if the perpetrator deposits a sufficient number of skin cells on an item at the scene, that item is collected as possible evidence.

  • It is the DNA in skin cells that is left at a crime scene and may be sampled from a variety of items including gun grips, steering wheels, eating utensils, luggage handles, and clothing.
  • Humans shed tens of thousands of skin cells each day, and these cells are transferred to every surface with which human skin comes into contact.
  • Touch DNA is not Low Copy Number DNA (LCN DNA).
  • LCN DNA profiling allows a very small amount of DNA to be analyzed, from as little as 10 to 30 cells.
  • Touch DNA samples are processed exactly the same way as blood, semen, saliva etc, and can stand up to scrutiny in court much better than LCN DNA.
  • Touch DNA analysis may be able to link the perpetrator to the crime scene, by collecting the skin cells and analyzing them.

For comments and archives

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

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    Public Forum

(Press Release for use by the newspapers)

Fast food is good for children

Distributing prizes for the baby show held at winter carnival organised by Bal Bharti School Dwarka, Padmashri and Dr B. C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India said that unlike junk food fast food is good for children.

Fast food includes fruits, raw vegetables, coconut water, lemon water, fresh juices etc.  they need no preparation. Sattu is another prepared natural at food.

Junk food on the other hand has refined carbs and animal fat with hydrogenated oils and is bad for the heart.

The foundation also trained children on hand only CPR 10.
    Readers Response
  1. Integrated medical practice can not work in our country simply because of one reason ,good number of  alternative medicine professionals forget their own science and start practicing modern medicine. vivek kumar ,Varanasi
    Forthcoming Events

Seminar on "Mind and Body in Health and Harmony in Asian Systems of Medicine"

Date: December 11-13, 2012
Venue: India International Centre, New Delhi
Themes of the Workshop: Anatomy, Philosophy, Diagnostics and imbalances, Therapeutics and treatments, Understanding Mind-Body relationships and Preventive and Promotive aspects in the traditional systems of medicine

4th eMedinews Revisiting 2012

(a day long single hall medical conference on 2012 happenings, followed by doctors of the year 2012 awards)

Sunday 20th January 2013, Maulana Azad Medical College Auditorium

Dilli Gate Delhi


Dr KK Aggarwal
Padmashri and Dr B C ROY National Awardee President

Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman

Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

4th eMedinewS Revisiting 2012

The 4th eMedinewS–revisiting 2012 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 20th 2013.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2012. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

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/


4th eMedinewS Doctor of the Year Awards

Nominations invited for 4th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2012.

pls send his/her Biodata at: emedinews@gmail.com

    eMedinewS Special

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

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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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  Dil Ki Batein

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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