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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 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

  Editorial …

18th May 2011, Wednesday                                 eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

Heart Attacks are More Serious if they Occur at Certain Times of the Day

Heart attacks that occur between 6am and noon are more likely to leave a 20% larger area of dead tissue (infarct) caused by the attack, which is more serious for the person affected, than at any other time of the day reveals research published ahead of print in the journal Heart.

It is well established that a person’s 24–hour body clock influences several cardiovascular physiological processes including the incidence of heart attacks, which tend to happen more around the time when a person is waking up from sleep. Researchers analysed data on 811 patients with a STEMI heart attack admitted to the coronary care unit of Hospital Clinico San Carlos in Madrid between 2003 and 2009. They calculated the size of infarct by looking at enzyme release in patients. The time of STEMI onset was divided into four 6–hour time periods in phase with 24–hour body clock rhythms.

Patients with the largest infarct size were found to be those who had a heart attack from 6am to noon. These patients were found to have around a 21% higher level of enzymes in this period (which indicated a larger infarct size) than patients who had their heart attack between 6pm and midnight. The greatest number of patients (269) had their heart attack in the 6am to noon period, followed by 240 patients who had their attack between noon and 6pm, 161 during the 6pm to midnight period, and 141 between midnight and 6 am.

Dr KK Aggarwal
Editor in Chief
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    Changing Practice – Resource which has changed practice in last one year

Bicarbonate therapy in very low birth weight infants with metabolic acidosis

It is recommended that sodium bicarbonate NOT be used routinely to correct acidosis in preterm infants.

    eMedinewS Audio PostCard

HIV Update

Dr Nalin Nag Speaks on
‘Treatment of Opportunistic infections: Pneumonia’

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day 2011 observed

Students of Delhi Public School, Mathura Road took a pledge to save the Mother Earth at a function organized on 21st April to mark World Earth Day.

Dr K K Aggarwal
    National News

CET, UG curriculum test for new MCI panel

TNN, May 17, 2011,NEW DELHI: The new five-member governing body (GB) of Medical Council of India (MCI) will meet for the first time on Wednesday. The earlier board’s tenure ended on May 15. The biggest challenge for the new board, headed by noted cardiologist Dr KK Talwar — a well–known figure in AIIMS’ corridors and former director of PGI Chandigarh — is to implement the Common Entrance Test (CET) for undergraduate students and the new medical curriculum. The notification had sought a single entrance test for MBBS and MD courses offered by all 271 medical colleges — 138 run by governments and 133 are under private management. The move had put the ministry under pressure from several state governments, including Tamil Nadu and Karnataka.

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 Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

Seniors exercise right to a better, more youthful life

A rash of new research is exploring how exercise late in life can be beneficial and help people age in place at home rather than be forced into care facilities, reports USAToday.com. Barbara Resnick, incoming president of the American Geriatrics Society, is conducting research to find ways to get people off walkers and see them ultimately "walk all the way to heaven." Maintaining the independence and mobility of older adults is emerging as a national health priority, Resnick says. The proportion of Americans ages 65 and older is projected to increase from 12% to 20% of the population by 2030. Exercise is more important the older we get, she says.

(Dr Monica and Brahm Vasudev)

Heartburn meds may boost fracture risk

New Korean research suggests that long–term use of popular heartburn drugs such as Prilosec, Prevacid and Nexium is linked to an increased risk of fractures.

Cardiovascular disease remains main risk for graft failure, death after kidney transplantation

Cardiovascular (CV) disease is the main risk factor for graft failure and for death after kidney transplantation. But, with progressive time after transplantation, the modifiable risk factors of hypertension, hyperlipidemia, and diabetes mellitus can become better controlled, according to study results presented at the American Transplant Congress 2011.

Research suggests landmark heart study has had little impact

The number of people getting optimal medical therapy hasn’t changed significantly since 2007, when a landmark study found that the right combination of drugs prevents heart attacks and deaths as effectively as procedures to restore cardiac blood flow. Most heart disease patients fail to get the best mix of life–saving medications before they land in the hospital needing intervention for clogged arteries, and one–third aren’t given the proper drugs after, according to a study published in the Journal of the American Medical Association.

AUA: Poor sleep may portend urinary problems

Disordered sleep preceded development of urinary symptoms by as much as five years in men and women, according to a study presented here. Short sleep duration and sleep disturbance doubled the likelihood of lower urinary tract symptoms (LUTS) in men and increased the risk in women by 66%. Disordered sleep was associated with an 80% to 90% increase in women’s odds for urinary incontinence and nocturia. (Source: Medpage Today)

Heart failure, afib linked to vertebral fractures

Many patients with heart failure may have a largely unrecognized risk of vertebral compression fracture, Canadian investigators reported. More than 10% of patients with heart failure had vertebral compression fractures documented by chest x–rays. The greatest risk was seen with the combination of heart failure and atrial fibrillation, according to an article published online in Circulation: Heart Failure. (Source: Medpage Today)

    Spiritual Update

Hanuman Chalisa

Tum Upkar Sugrivahi Keenha
Ram Milai Rajpad Deenha

Meaning: You introduced Rama to Sugriva, causing him to become the king of the Royal Thorne.

Spiritual Significance: Without effective breath control (Hanumana) even the consciousness (Rama) cannot control the intellect (Sugriva). And without controlling the intellect, the consciousness (Rama) cannot win over the ego (Ravana).

    IJCP Special

Dr Good Dr Bad

Situation: A patient recovering from fever had a variation of 1°C temperature.
Dr. Bad: This is a relapse.
Dr. Good: It may be normal.
Lesson: The normal daily temperature variation is typically 0.5°C (0.9°F). However, in some individuals recovering from a febrile illness, this daily variation can be as high as 1°C (1.8°F).

Make Sure

Situation: A patient died after receiving penicillin injection.
Reaction: Oh my God! Why was anaphylaxis not suspected?
Lesson: Make sure that each time a patient is given penicillin injection, anti anaphylaxis measures are available.

    An Inspirational Story

(Dr Prachi Garg)

Man asked a sculptor: "How do you make such beautiful idols from stone?" He replied: "Idols and images are already hidden there…I only remove the unwanted stone!"

Moral: Your happiness is hidden within you, just remove your worries!

    Pediatric Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

What are the features of Fanconi syndrome on investigations ?


  • Normal anion gap hyperchloremic metabolic acidosis (with low serum bicarbonate)
  • Normal or low amino acids
  • Normal glucose
  • Hypophosphatemia, hypokalemia, hypouricemia
  • Elevated alkaline phosphatase


  • Generalized (non–specific) hyperaminoaciduria
  • Glucosuria, phosphaturia
  • pH < 5.5 with low specific gravity (hyposthenuria)
  • Bicarbonaturia, hyperkaliuria, uricosuria, tubular proteinuria, carnitinuria, low urinary ammonia

Imaging Studies

Skeletal X–Ray: Rickets, osteopenia, or osteoporosis

    Infertility Update

(Dr. Kaberi Banerjee, Director Precious Baby Foundation)

How can we select the donor?

The main qualities a donor should have are good health status and the absence of genetic abnormalities. He should be less than 40 years of age. Psychological evaluation and counseling by a qualified mental health professional is recommended strongly for all sperm donors. Semen testing should be done after a 2– to 5–day abstinence. Genetic screening for heritable diseases should be performed in potential sperm donors. Donors with high risk diseases like HIV, STIs or other infections that might be transmissible via gamete donation must be avoided.

    Medicolegal Update

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

Exhumation and autopsy

The grave must be identified by relatives and the official in charge of the graveyard.

  • The word exhumation literally means ‘out of ground.’ The word ‘exhumation’ comes from Latin words ‘ex’ meaning ‘out of’, and 'humus', meaning ‘ground’ The dead body can only be exhumed when there is a written order from executive magistrate or Higher Court of Law of the land.
  • Exhumation is necessary, when the first post–mortem was inadequate, and it is thought that a second post–mortem may bring some more facts to light means exhumation combined with doing a second meticulous post–mortem. After exhumation, the post mortem examination (PME) must be done in a well equipped morgue only and preferably in presence of first team of doctors who have already examined the body.
  • In case of exhumation the concerned police official should approach the appropriate government hospital in writing along with the order of exhumation to constitute a medical board of at least three qualified and experienced doctors with written clarity of objectives of PME. Material found in exhumation/spot and further examination should be done as per law.
  • Resting places and the norm of many cultures is that the dead should not be disturbed. However, for a variety of reasons, they are disturbed through the process of exhumation.
    Twitter of the Day

@DrKKAggarwal: 33% hike in petrol charges in last one year. Will have an effect on medical treatment charges also.

@PritishNandy: Oil companies raise fuel price by 10%, slash jet fuel price by 3%. Amazing priorities!

    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

Diabesity A deadly new cocktail of sugar and fat


  • There are 285 million people with type 2 diabetes worldwide, and this figure will escalate to 438 million by 2030 with an additional half a billion people at risk.
  • India has the largest number of diabetics in the world and obesity is also on the rise, particularly affecting the younger population.
  • As globalization becomes more and more significant, Indians, especially young Indians, find themselves at the crossroads of environmental and behavioral changes. These lead to a new and deranged lifestyle of cola culture, junk food and physical inactivity.
  • Both the conditions, diabetes and obesity, affect the Indians in the prime of life, about a decade earlier than their western counterparts. High risk ethnicity and high propensity to central obesity predispose Indians to a higher risk of type 2 diabetes and metabolic syndrome even at lower levels of Body Mass Index (BMI).
    Mind Teaser

Read this………………… 

The parvocellular pathway from lateral geniculate nucleus to visual cortex is most sensitive for the stimulus of:

1. Color contrast
2. Luminance contrast
3. Temporal frequency
4. Saccadic eye movements

Yesterday’s Mind Teaser: ch poorri

Answer for yesterday’s Mind Teaser: Take from the rich, give to the poor.

Correct answers received from: Dr Neelam Nath, Dr Vijay Kansal, Dr Rashmi Chhibber, Dr Mahinder,
Dr Fatima, Dr Prayank, Dr Prabha, Dr Manjesha, Dr K.Raju.

Answer for 16th May Mind Teaser: a.
Correct answers received from: Dr Binit Sureka, Dr Prashant Bharadwaj, Dr Srikanth, Dr Rajiv Kohli,
Dr Amrendar, Dr Suresh, Dr Ketan.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr. GM Singh)

A skeleton walks into a bar. The bartender asks him what he wants. The skeleton says: "Give me a beer and a mop.

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Levels of total cholesterol, LDL and apolipoprotein B, increase significantly in women at the time of menopause thus increasing the risk factors for coronary heart disease.

    Medi Finance Update

(Dr GM Singh)

Payment of Claim

All claims under this policy shall be payable in Indian currency. All medical treatments for the purpose of this insurance will have to be taken in India only. For the purpose of settlement of claim a TPA (Third Party Administrator) is appointed by the insurer to scrutinize the claim documents and settle the same on cashless basis.

    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name


DCI Approval Date

Opipramol dihydrochloride Tablet 50mg/100mg.

For the treatment of generalised anxiety disorder (GAD) and somatic disturbances.


    IMSA Update

International Medical Science Academy (IMSA) Update

Blood pressure control in children with chronic kidney disease

Intensified blood pressure control with a targeted goal of a 24–hour mean arterial pressure (MAP) below the 50th percentile, compared with conventional blood pressure control, results in slower progression of chronic kidney disease in children.

  Thought of the Day

(Dr GM Singh)

The pain is not on the day of missing our dear ones. The pain is really when you live without them and be with their presence in your mind.

    Readers Responses
  1. Dear Sir, with regard to the Treatment of Pneumonia (Dr Good/Dr Bad), recommendations are to use Azithromycin also, because of its anti–inflammatory effects in lung parenchyma, in addition to the antibiotic effect. Thanks: Dr Kapil Aggarwal.
    Public Forum

(Press Release for use by the newspapers )

Fasting good for health

Fasting has been identified as a preventive measure for various physical and mental diseases. Regular weekly fast would act as a safety wall against ill health. This was stated by Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal and President, Heart Care Foundation of India.

He said that denying the system its usual food intake for a day every week would induce growth hormones and promote metabolism. But fasting should not be a casual affair to be observed only on certain religious occasions; it should rather be a weekly discipline, undertaken regularly on a particular day during every week.

Besides the spiritual benefits, the fast tends to create immunity in the system against diseases. The day’s rest to the digestive system as a result of the fast would cause certain chemicals in the body which would keep ailments away.

The fast is also prone to usher quietude of mind. Pollution of the physical and mental environment, hatred, anger, jealousy and all negative thoughts that enhance the chances of damage to health are taken care of by the resting digestive system.

People should, however, not precede and/or follow the fast with heavy meals. The fast would lose its health benefits if the stomach is loaded with heavy food before or after the fast. Doing so results in accumulation of more calories by eating such food compared to what they lose by fasting. While one chapatti contains 40 calories, most sweets have 200 to 300 calories per 40 grams. The higher caloric content of sweets and ‘puri kachori’ also raise cholesterol in the blood, increasing the chances of a heart attack.

People should count their calories on monthly basis rather than on daily basis.

    eMedinewS Special

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

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

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

Activities eBooks


  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
• Provisional Scientific Program at http://worldcon2011.org/day1.html
• Provisional program for Pre Congress CME at http://worldcon2011.org/Pre_Conference_CME.html
• Abstract submission at http://worldcon2011.org/scientificprogram.html
• Important dates at http://worldcon2011.org/importantDates.html
• Congress website at http://www.worldcon2011.org
• Entertainment – Kingdom of Dreams at http://worldcon2011.org/Pre_Post_Tours.html

Key Contacts
Dr. (Col.) Satish Parashar, President Organizing Committee, + 91 9810146231
Dr. Rakesh Gupta, Secretary General, + 91 9811013246

Congress Secretariat: Rajat Khurana, C–1 / 16, Ashok Vihar – Phase II, Delhi 110 052, INDIA., Phone: + 91–11–2741–9505, Fax: + 91–11–2741–5646, Mobile: + 91 9560188488, 9811911800,
Email: worldcon2011@gmail.com, jrop2001@yahoo.com, worldcon2011@in.kuoni.com


Medifilmfest (1st International Health Film Festival in Delhi)

October 14–23, 2011, As part of 18th MTNL Perfect Health Mela 2011(Screening of films October 14–17, Jury Screening at Jamia Hamdarad University Auditorium October 18–19, award winning films at TalKatora Stadium October 19–23, 2011)
Organized by: Heart Care Foundation of India, World Fellowships of Religions, FACES, Bahudha Utkarsh Foundation and Dept of Health and Family Welfare Govt of NCT of Delhi.
Entries Invited: from feature films, Ad Films, Serials, Documentary Films, Cartoon Films, Animation Films, Educational films; films on Yoga, Siddha, Ayurveda, Unani, Homeopathy; Indigenous Healing, Films promoting the Bio–cultural Diversity, Medical Tourism, Visual and Medical Anthropology, Gender sensitization, awareness drive on socio–medical issues and health journalism. The films can be of variable durations (0–1 minute, upto 3 minutes, upto ten minutes, upto 45 minutes and upto an hour and beyond).
Separate entries are also invited for "factual mistakes in feature films concerning health". This can be in the form of 1–5 minutes footages.

Categories:Competitive category/ Non Competitive category/ Special screening
Sub Categories:

1. General: Documentaries, animation films, corporate films, Ad films, TV health programs/reports, health chat shows.

2. Special: Short instances of "depiction of wrong health messages" through the films.

Subjects: Health, disease, sanitation, yoga, spiritual health, environment, social issues, food, better living, Indigenous healing, medical tourism, visual & medical anthropology, gender sensitization, health journalism. Duration: 0–10 seconds; <30 minutes, 30–60 minutes, 1–3 hours. Language: English or Hindi, or sub tilled in English/Hindi. Fee: No fees from participants. Entry to the film show free. Format: Any format duly converted into DVD (compatible to the latest players/systems) Boarding, Lodging and Travel Expenses: Own, the participants may raise their own sponsorships

For details contact: Dr KK Aggarwal/Dr Kailash Kumar Mishra/Mr M Malik at


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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 Naveen Dang, Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta