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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

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eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

18th February 2013, Monday

Profession, passion and fashion

I have written about this topic earlier too, but this is an update. Profession is at the level of physical body and mind, fashion is at the level of ego and passion is at the level of the soul. If your passion, profession and fashion are in synchrony with each other, you are a perfect leader.

If you are not passionate about your profession, you can never be successful. To be passionate about your profession is only not important, it is also equally important to let others know about your passion for your profession.

When you do so, it becomes a fashion. Our aim in life should be to let people know that you are passionate about your profession.

When the passion is too much, it becomes an obsession.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

What are the secondary causes of constipation?

Secondary causes for constipation include endocrine or metabolic disorders, neurologic disorders, myogenic disorders and medications.

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Vowel chanting produces aspirin in my body

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

CPR in a multi-specialty camp in East Delhi

Dr Harshvardhan doing CPR with Dr KK in a multispecialty camp organized by Heart Care Foundation of India in association with East Delhi Walkers’ Association.

Dr K K Aggarwal
    National News

Delhi 5th most polluted city in India

Due to the alarming rise in pollution levels in the Capital Delhiites are forced to breathe poisonous air. This winter has seen pollution rising to alarming proportions as the levels of particulate matter have gone up by five to nine times the usual standards in Delhi. This was revealed by a joint study conducted by the Centre of Science and Environment (CSE) and Health Effects Institute that was released on Wednesday.
Attributing this explosive increase in pollution levels to the significant rise in the number of vehicles in the Capital, the study also said Delhi is among the top five cities worst hit by air pollution in India.
The report clearly indicates that Delhiites are breathing an increasing number of harmful toxics with the three times higher particulate matter levels exceeding PM10 standards. The finding said toxic fine particle (PM2.5) pollution and nitrogen dioxide were found in greater quantity in Delhi. Calling it a major concern that needs to be addressed by the Government, various scientists and doctors have said the increase in the number of heart and lung diseases, which also include cancer, were majorly caused by air pollution.
“The study that reveals such a magnitude of pollutants in our environment is worrisome. It is a challenge that we have to do something about it or we would be accountable for the harm caused to future generations. You go to Gurgaon or Delhi, you are breathing dirty air. We come to the cities to earn our livelihood but we don’t realize that this is harming our health. We go on living carelessly without even thinking about what is surrounding us all the time,” said Kalpana Balakrishnan, Director ICMR Centre for Advanced Research on Environmental Health, Sri Ramachandra University, Chennai, who was present during the release of the report. The study said there are 100,000 deaths annually in Delhi and this increase in pollution can translate into 3,000 additional premature deaths annually due to air pollution related diseases. “We have congested hospitals, railway stations, colleges, roads, vehicles and a huge number of sources that spew toxic pollutants into the air. As a result we have more deaths due to respiratory diseases in India. India had low asthma occurrences comparatively but now the numbers are rising. (Source: Daily Pioneer, 14 February 2013)

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


There are four categories of child maltreatment:

  1. Physical abuse
  2. Sexual abuse
  3. Emotional abuse
  4. Child neglect

For comments and archives

    Valvular Heart Disease Update

How common is MS in the elderly?

Mitral stenosis is relatively uncommon in elderly adults. Mitral annular calcification occasionally causes mitral obstruction. For patients with symptomatic mitral stenosis, percutaneous balloon valvotomy is the procedure of choice if valvular morphology is favorable but it is not indicated in patients with mitral obstruction due to mitral annular calcification.

(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)

Hematoma attack cuts edema in brain bleed

In findings that offer new insights into the elusive physiopathology of hemorrhagic stroke, researchers in a phase II trial found that hematoma evacuation was associated with a significant reduction in perihematomal edema. (Source: Medpage Today)

Fish oil could protect hemodialysis patients

Patients receiving hemodialysis are significantly more likely to die of sudden cardiac death in their first year of treatment if they have lower serum levels of omega 3 fatty acids compared with those who have higher levels, according to a study published online February 6 in Kidney International. (Source: Medscape)

Silent Afib may be behind unexplained stroke

Long-term cardiac monitoring of patients with stroke of unknown origin can better identify subclinical atrial fibrillation compared with standard testing, the EMBRACE randomized trial found. (Source: Medpage Today)

STIs undetected in pregnant women in ED

Many pregnant women are not being treated for 2 prevalent bacterial sexually transmitted infections (STIs) in emergency departments (EDs), even though the US Preventive Services Task Force of the Centers for Disease Control and Prevention recommends screening for all sexually active women. (Source: Medscape)

'Time is brain' also applies to endovascular Tx

A substudy of the IMS-III trial has quantitatively shown for the first time that delays in endovascular therapy for ischemic stroke are linearly correlated with worse outcomes. (Source: Medpage Today)

  Twitter of the Day

@DrKKAggarwal: Today's health question If the blood lipid profile is normal when to repeat the second test Yesterday's health (cont) http://tl.gd/l28fst

@DrKKAggarwal: Every person is #CosmicConsciousness with a unique story

    Spiritual Update

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

Saraswati Vandana

Saraswati = one who gives the essence (sara) of the true self (swa)

Sanskrit Mantra

Yaa Kundendu tushaara haaradhavalaa, Yaa shubhravastraavritha|

Yaa veenavara dandamanditakara, Yaa shwetha padmaasana||

For comments and archives

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

What are the side effects of using gonadotropins?

  1. Ovarian hyperstimulation syndrome (OHSS). OHSS is characterized by enlarged ovaries and fluid accumulation in the abdomen after ovulation or egg retrieval. It can be either mild or severe. The mild form occurs in 10-20% of cycles and results in some discomfort but almost always resolves without complications. When severe, it can result in blood clots, kidney dysfunction, twisting of an ovary (torsion), fluid collections in the chest and abdomen, and rarely even death. Most patients who are at high risk for severe OHSS are identified by closely monitoring ovulation induction cycles with the daily use of ultrasounds and/or serum estradiol levels. When serum estradiol levels are rising rapidly and/or are too high, or excessive numbers of ovarian follicles develop, one strategy for prevention of severe OHSS is to withhold further gonadotropin stimulation and delay hCG administration until estradiol levels plateau or decline.
  2. Multiple gestation. Up to 30% of pregnancies which result from cycles involving gonadotropin stimulation are multiple, in contrast to a rate of 1-2% without fertility medications. The risk of multiple gestations is dependent upon the number of mature eggs released in an ovulation induction cycle and the number of embryos transferred in an IVF cycle. While most of these pregnancies are twins, a significant percentage (up to 5%) are triplets or higher. Twins and high order (>2) multiple gestation pregnancy are associated with an increased risk of pregnancy loss, premature delivery, infant abnormalities, handicap due to the consequences of very premature delivery, pregnancy-induced hypertension, hemorrhage, and other significant maternal complications.
    Tat Tvam Asi………and the Life Continues……

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

Who is a healthy donor?

A healthy donor is any person within the age group of 18 - 60 years with minimum body weight of 45 kgs, and hemoglobin level of 12.5 gm/dL (minimum).

How frequently can a donor donate blood?

It takes about 6-8 weeks for the hemoglobin to be synthesized in the body. Three months is a very safe interval.

For comments and archives

    An Inspirational Story

The three fishes

There were three big fishes living in a lake who were very close friends. All three of them were very different from one another. The first one believed in fate. He thought things cannot be changed and what had to happen will happen no matter what. The second one was intelligent. He thought he knew how to solve a problem if he had one, with his intelligence. The third one was the wise one. It thought long and hard before acting.

So one day, the wise fish was happily playing around in the water, when it over heard a fishermen talking to another. "Look at that one, what a big fish... This lake is full of big fishes like this one. Let us come tomorrow and catch them."

It hurriedly swam to its friends to tell the news. "Let us get out of this lake before those fishermen come back. A canal I know can take us to another lake," the wise one said.

The intelligent fish said, “I know what to do if the fishermen come and catch me."

The fish which believed in fate said, "Whatever to happen will happen, I was born in this lake and I am not going to leave it."

The wise fish didn't want to risk its life, so he took the canal and went to another lake.

The fishermen came back the next morning and cast their net. The rest of the two friends were caught in it along with many other fishes.

The intelligent fish thought of a way to escape, it acted as if it were dead. The fishermen threw him along with other dead fish back into the lake. But the other fish which believed in fate was still jumping in the net and the fishermen struck him dead.

Story moral: Intelligence wins over might.

A Panchatantra story

For comments and archives

  Cardiology eMedinewS

Rapid BP lowering safe in ICH Read More

Harvard doctors give Kumbh health facilities thumbs up Read More

  Pediatric eMedinewS

TB screening is highly cost-effective in young children Read More

Fetal monitoring often tips scales toward cesarean Read More

    Rabies Update

(Dr. A. K. Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

Are there any survivors of human rabies?

Till date only seven survivors have been recorded. These patients survived not due to any specific anti-rabies therapy but following intensive life support and excellent nursing care. These patients survived for variable periods with residual neurological deficits. All the survivors had paralytic form of rabies and majority had history of some anti-rabies vaccination in the past.

    IJCP Special

Dr Good Dr Bad

Situation: An obese patient with metabolic syndrome wanted a prescription for liposuction.
Dr Bad: Go ahead.
Dr Good: It won’t be beneficial.
Lesson: Liposuction can reduce weight and fat but does not improve insulin sensitivity.

Make Sure

Situation: A patient with acute heart attack died on the way to the hospital.
Reaction: Oh my God! Why was the patient not accompanied by the doctor?
Lesson: Make sure that all heart attack patients are accompanied by a doctor to the hospital so that chest compression CPR can be given, if the heart stops, on the way.

  Quote of the Day (Dr GM Singh)

Keep your face always toward the sunshine – and shadows will fall behind you. Walt Whitman

    Mind Teaser

Read this…………………

How often should you have a Pap smear?

A. Once a year after puberty.
B. Once a year after either turning 21 or having sexual intercourse for the first time.
C. Once a year after age 21 and every two years after 30.
D. Once a year if you’re not in a monogamous relationship.
E. Once a year unless you’ve been vaccinated against the human papillomavirus (HPV). Then the screening is not necessary.

Yesterday’s Mind Teaser: A distinguishing feature of a cluster headache is that it occurs:

1. Bilaterally
2. Globally
3. Occipitally
4. Unilaterally

Answer for Yesterday’s  Mind Teaser: Unilaterally

Correct answers received from: Dr Jainendra Upadhyay , Dr. Thakor Hitendrsinh G, Dr Chandresh   Jardosh, Anil Bairaria, Dr.Jayashree Sen & Dr.Bitaan Sen

Answer for 16th February Mind Teaser: Location, quality, and onset

Correct answers received from: Dr Valluri Ramarao, drjella, Dr Avtar Krishan, Tukaram Pagad, Dr.A.K.Kela, Dr.Jayashree Sen & Dr.Bitaan Sen

Send your answer to ijcp12@gmail.com

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    Laugh a While (Dr GM Singh)

Law of Cat Composition

A cat is composed of Matter + Anti–Matter + It Doesn’t Matter.

    Medicolegal Update

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

First aid for poisonous bites and stings

People often panic if they have been bitten or stung. You should tell the patient that many snakes, spiders, insects and sea creatures are harmless and that even the bites and stings of dangerous animals often do not cause poisoning.

Keep the patient calm and still. Moving the bitten or stung limb speeds up the spread of venom to the rest of the body. Fear and excitement also make the patient worse. The patient should be told not to use the limb and to keep it still and below the level of the heart. The limb may swell after a while, so take off the patient’s rings, watch, bracelets, anklets and shoes as soon as possible. A splint and a sling may help to keep the limb still.

Avoid doing the following:

  • Do not cut into the wound or cut it out.
  • Do not suck venom out of the wound.
  • Do not use a tourniquet or tight bandage.
  • Do not put chemicals or medicines on the wound or inject them into the wound (for e.g., potassium permanganate crystals).
  • Do not put ice packs on the wound.
  • Do not use proprietary snake bite kits.
  • The patient should lie on one side in the recovery position so that the airway is clear, in case or vomiting or fainting.
  • Do not give the patient anything by mouth – no food, alcohol, medicines or drinks. However, if it is likely to be a long time before the patient gets medical care, give the patient water to drink to stop dehydration.
  • Try to identify the animal, but do not try to catch it or keep it if this will put you, the patient or others at risk. If the animal is dead take it to hospital with the patient, but handle it very carefully, because even dead animals can sometimes inject venom.
  • As soon as possible, take the patient to a hospital, medical dispensary, or clinic where medical care can be given. The patient should not walk but should keep as still as possible. If there is no ambulance or car, carry the patient on a stretcher or trestle, or on the crossbar of a bicycle.
  • Antivenom should only be given in a hospital or medical Centre where resuscitation can be given, because the patient may have an allergic reaction. If available, antivenom should be used if there is evidence of severe poisoning. It should not be used when there are no signs of poisoning.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Over 2,000 people learnt CPR in a multi-specialty camp in East Delhi

In a multispecialty camp organised by Heart Care Foundation of India in association with East Delhi Walkers’ Association, over 2000 people were examined by a team of medical experts led by Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and National Vice President (Elect), India Medical Association.

Addressing a gathering of over 2000 people, Dr. Aggarwal said that everybody should walk at least 80 minutes a day and brisk walk 80 minutes in a week. Brisk walking means walking 80 steps per minute.

Dr. Aggarwal also interacted with senior heart surgeons: Dr. Sujay Shad, Dr. Rajesh Kaushar, Dr. Mubeen Mohammad, Dr. Sandeep Singh and Dr. Baldev Sekhon.

In the discussion, the experts said that sore throat in children should not be neglected, especially if it is without cough and nasal discharge. Streptococcal sore throat can bite the heart permanently. Timely antibiotic in these patients can prevent permanent heart damage.

Interacting with other experts, Dr. Chanchal Pal, Dr. Shashi Bala, Dr. Prachi Garg, Dr. Pooja Garg, Dr. Varun Arya, Dr. Mini Mathur and Dr. NK Bhatia, Dr. Aggarwal said that it is better to get a swine flu as seasonal flu as mortality and morbidity is low. He said that prevention of flu involves respiratory hygiene, cough hygiene and hand hygiene. Respiratory hygiene means staying 3 feet away from the person who is coughing or sneezing. Cough etiquettes means not to cough in hands or handkerchief but on the side sleeves of the shirt. Hand hygiene means washing hands thoroughly with a soap and water after touching nasal secretion.

Dr. Sanjay Gupta, Sr. Orthopedic, Moolchand Medcity said that people who have joint knee problems should not use Indian latrines.

Dr. Sweta Gupta, infertility expert, said that today with advance techniques, it is possible to deliver a child in every family.

Dr. NK Bhatia, Sr. Transfusion Specialist, said that everybody can donate blood from the age of 16 to 65.

Dr Mini Mehta, Dr Nischal Gupta, Dr Saloni Tomar, Dr Rashmi Bhaskar, Dr Chetali Jain, Dr Rohit, Dr Gyanendra, Dr Shelja and Dr Neeraj Gupta Homeopathic Cardiologists of India said that time has come for homeopathic doctors to specialize in cardiology and practice as homeopathic cardiologists.

Over 2000 people were trained on how to revive a dead person using the technique Hands Only Cardiopulmonary Resuscitation. The Foundation has trained over 30000 people in the last four months.

    Readers Response
  1. Thanks a lot for this information on pain Mgt.Dr. Gajria
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