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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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19th April 2013, Friday

Problems faced by consultants in the city of Delhi

There was a time when smaller nursing homes were flooded with top consultants of the city but now most of them either are not opting for or have left the smaller medical establishments.

Most of them are opting for bigger private establishments to survive as the smaller nursing homes are unable to provide them with the latest infrastructure facilities. Consultants prefer to do their procedures in bigger hospitals.

Most of the nursing homes, which are running are single consultant nursing home owned and run by the specialty of the owner.

In a bigger setup, there is a great disparity in salary structure. Most of the corporate hospitals cater to only 1% of the population, which can afford treatment at these hospitals.

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

tPA safe in pediatric stroke

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

WHO Day Celebrated

Over 11459 people were trained in Hands Only Cardiopulmonary Resuscitation (CPR 10) in one day

Dr K K Aggarwal
    National News

World Haemophilia Day to be observed on April 19

MANIPAL: Manipal Haemophilia Society, Kasturba Hospital, Manipal will celebrate World Haemophilia Day differently on April 19. A series of events will be held to encourage and support persons with haemophilia (PwH). It has been the endeavour of Manipal Haemophilia Society to provide support, enlighten and empower PwH. Novo Nordisk Haemophilia Foundation (NNHF) is sponsoring the programme. As part of the celebrations, the society will organize a variety of events to address crucial areas concerning haemophiliacs. A mass exercise will be performed by hundreds of student volunteers of various colleges along with haemophiliacs. In a change, this exercise will involve terra band with music composed by Manipal Haemophilia Society. A 10-over cricket match between Manipal University XI and Haemophilia XI will be played.

Dr HS Ballal, pro-chancellor of Manipal University will lead the Manipal University XI team and former Indian stumper and chief selector Syed Kirmani will lead the latter. Malathi Holla, Paralympics medalist will motivate haemophiliacs. Team Mangalore will fly some of the kites which have earned them international acclaim. These celebrations will be a prelude to the annual event, "Asha Kiran", a camp for persons with haemophilia. There will also be live art painting by more than 30 artists in the venue from 4.30pm- 6.30pm. This live art painting is organized by the Souparnika Creative Art Center, Manipal. The paintings are available for sale for the cause of haemophiliacs. The camp organized every year is attended by a large number of haemophiliacs from in and around Manipal. The three-day camp has medical care, knowledge sharing, interaction and entertainment. There is a specialized hemostasis and thrombosis division at Kasturba Hospital, Manipal, set up with support from Manipal University, where patients from four districts of Udupi, Dakshina Kannada, Shimoga and Chikmagalore with suspected bleeding disorders like haemophilia will get facilities for free testing. Incidentally, World Haemophilia Day is celebrated on April 17 where global bleeding disorder community comes together. (Source: TOI, Apr 17, 2013)

For comments and archives

‘A’ care nurses not available in city

Dr K K Aggarwal

As per Delhi Nursing Home Act, only nurses registered with Delhi Nursing Council can be attached to a recognized medical establishment. Delhi Nursing Council only registers ‘A’ grade nurses. All other nurses coming from other cities or states are not recognized under Delhi Nursing Council Act.

ICU requires a nurse: patient ratio of 1 to 1; nursing homes require 4 to 1 nurse. There are no ‘A’ grade nurses available in medical establishments. Over, 600 nursing homes and 35000 beds are at stake. The time has come for the government to either change the Act or allow nurses from other states to work in the medical establishments or open more nursing colleges or schools.

For comments and archives

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, every Thursday 4:30 PM in DD India

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)


Isolated examination or laboratory findings combined with a disclosure of sexual abuse, specific behavioral changes usually confirm sexual abuse.

    Valvular Heart Disease Update

What is transcatheter aortic valve replacement?

Transcatheter aortic valve replacement is a potential option for patients with severe symptomatic aortic stenosis who are considered inoperable for surgical aortic valve replacement.

(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)

CT ordered for other reasons can screen for osteoporosis

Information gleaned from computed tomography (CT) scans of the abdomen can be a useful tool in screening patients for osteoporosis, according to findings from a 10-year cross-sectional study published in the April 16 issue of the Annals of Internal Medicine. (Source: Medscape)

For comments and archives

Freezing lung metastases helps, early trial shows

CT-guided cryoablation of lung metastases may provide some benefit to patients with few remaining treatment options, a phase I study suggested. (Source: Medpage Today)

For comments and archives

Beet juice beats hypertension

Drinking a cup of nitrate-rich beetroot juice significantly lowered blood pressure (BP) in hypertensive individuals, a small, proof-of-principle study showed. (Source: Medpage Today)

For comments and archives

'Art' of interpersonal medicine improves patient outcomes

Patients experience improved healthcare outcomes when care is planned around the patient's needs and circumstances, according to a new study. Although this statement may seem intuitive, the study documents an association between contextualizing patient care, also known as patient-centered decision making (PCDM), and patient care outcomes. (Source: Medscape)

For comments and archives

Workout helps with ADL in Alzheimer's

An exercise program for people with Alzheimer's disease helped them cope with activities of daily living, without increasing health and social care costs, researchers reported. (Source: Medpage Today)

For comments and archives

   Twitter of the Day

@DrKKAggarwal: Understanding Ayurveda the allopathic way Dr K K Aggarwal The universe is made up of five elements namely (cont) http://tl.gd/n_1rjqstp

@DeepakChopra: What is the most effective way to connect with God? Please read my #askdeepak reply http://tinyurl.com/bmtwnm4

    Spiritual Update

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

On 7th Navaratri enjoy a mind devoid of inner darkness

Kalaratri is worshipped on the Seventh Day of Navratri. She is dark and black like night. Her hairs are unlocked. SHE has three eyes and four hands.

For comments and archives

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

What would happen to the mother and the babies due to multiple pregnancies?

Multiple gestations are risky for the babies. Because there are too many babies in the womb, you may have a miscarriage. Or you could have a premature delivery when the babies may be born too early (but after 20 weeks of pregnancy) and have problems with lungs, stomach, or intestinal tract. They may have bleeding in the brain, which can cause problems with the baby's brain, nervous system, and hamper its development. One of the more common problems is cerebral palsy, a condition that affects movement. The mother might have health problems, too. Your blood pressure may get too high (called pre-eclampsia, pregnancy-induced hypertension or toxemia) and you may develop diabetes (high blood sugar).

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

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

Advantages of disposable plastic bags

  • Convenience in storage and transportation
  • No breakage
  • Ease to transfuse
  • Less risk of transfusion reactions
  • Facilitates various blood components separation

For comments and archives

   An Inspirational Story

The world is a wonderful place

A true story happened in 1892 at Stanford University.

An 18-year-old student was struggling to pay his fees. He was an orphan, and not knowing where to turn for money, he came up with a bright idea. He and a friend decided to host a musical concert on campus to raise money for their education.

They reached out to the great pianist Ignacy J. Paderewski. His manager demanded a guaranteed fee of $2000 for the piano recital. A deal was struck and the boys began to work to make the concert a success.

The big day arrived. But unfortunately, they had not managed to sell enough tickets. The total collection was only $1600. Disappointed, they went to Paderewski and explained their plight. They gave him the entire $1600, plus a cheque for the balance $400. They promised to honor the cheque at the soonest possible.

“No,” said Paderewski. “This is not acceptable.” He tore up the cheque, returned the $1600 and told the two boys: “Here’s the $1600. Please deduct whatever expenses you have incurred. Keep the money you need for your fees. And just give me whatever is left”. The boys were surprised, and thanked him profusely.

It was a small act of kindness. But it clearly marked out Paderewski as a great human being.

Why should he help two people he did not even know? We all come across situations like these in our lives. And most of us only think “If I help them, what would happen to me?” The truly great people think, “If I don’t help them, what will happen to them?” They don’t do it expecting something in return. They do it because they feel it’s the right thing to do.

Paderewski later went on to become the Prime Minister of Poland. He was a great leader, but unfortunately when the World War began, Poland was ravaged. There were more than 1.5 million people starving in his country, and no money to feed them. Paderewski did not know where to turn for help. He reached out to the US Food and Relief Administration for help.

The head there was a man called Herbert Hoover — who later went on to become the US President. Hoover agreed to help and quickly shipped tons of food grains to feed the starving Polish people.

A calamity was averted. Paderewski was relieved. He decided to go across to meet Hoover and personally thank him. When Paderewski began to thank Hoover for his noble gesture, Hoover quickly interjected and said, “You shouldn’t be thanking me Mr. Prime Minister. You may not remember this, but several years ago, you helped two young students go through college. I was one of them.”

The world is a wonderful place. What goes around comes around!

For comments and archives

   Cardiology eMedinewS

Polycystic ovary tied to higher diabetes, CVD Read More

Women secreting low levels of melatonin are more likely to develop type 2 diabetes Read More

   Pediatric eMedinewS

First mother's milk bank opens in Udaipur Read More

Seven ultrasound clinics sealed in Bihar 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)

What should be done with a patient who has had exposure but goes for treatment after considerable delay (weeks to months)?

An early and correct administration of modern anti-rabies vaccine is life-saving. The vaccination must be started immediately irrespective of the status of the biting animal. Patients who seek treatment after a delay of 48 hours or even months after having been bitten should be dealt in the same manner as if the exposure occurred recently.

    IJCP Special

Dr Good Dr Bad

Situation: A patient of CAD developed dengue.
Dr Bad: Start paracetamol.
Dr Good: Start paracetamol and also stop low-dose aspirin.
Lesson: In dengue, low-dose aspirin should be discontinued.

Make Sure

Situation: A patient with cough of more than 4 weeks duration came with blood in his sputum.
Reaction: Oh my God! Why was TB not suspected earlier?
Lesson: Make sure that all patients with cough of more than 3 weeks duration are investigated for TB.

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  Quote of the Day (Dr GM Singh)

No matter how much you plan, it is tenacity, unyielding desire to succeed, and the ability to cope with change that will eventually prevail. Perry Payne

    Mind Teaser

Read this…………………

Dr. Smith suspects tracheoesophageal fistula in a 1-day-old neonate. Which nursing intervention is most appropriate for this child?

a. Avoiding suctioning unless cyanosis occurs
b. Elevating the neonate’s head and giving nothing by mouth
c. Elevating the neonate’s head for 1 hour after feedings
d. Giving the neonate only glucose water for the first 24 hours

Yesterday’s Mind Teaser: A 2-month-old baby hasn’t received any immunizations. Which immunizations should Nurse Jess prepare to administer?

a. Measles, mumps, rubella (MMR); diphtheria, tetanus, pertussis (DTP); and Hepatitis B (HepB)
b. Polio (IPV), DTP, MMR
c. Varicella, Haemophilus influenzae type b (HIB), IPV, and DTP
d. HIB, DTP, HepB; and IPV

Answer for yesterday’s Mind Teaser: d. HIB, DTP, HepB and IPV

Correct answers received from: Dr Jayashree Sen & Dr Bitaan Sen, Dr Suresh Arora, Rajeev Ardey,
Dr Jella, Dr Arpan Gandhi, Dr Pankaj Agarwal, Dr U Gaur, Madhu Arora, Dr Chandresh Jardosh,
Dr Jainendra Upadhyay, Raju Kuppusamy, Dr Vijay Kansal, Dr pawan Mehta, Dr PK Sahu, Dr Avtar Krishan, Dr Santhakumari, Dr Ayyavoo, Muthumperumal Thirumalpillai.

Answer for 17th April Mind Teaser: a. Babinski’s

Correct answers received from: Muthumperumal Thirumalpillai, Raghavendra Singh

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)


I couldn't find my luggage at the airport baggage area. So I went to the lost luggage office and told the woman there that my bags never showed up.

She smiled and told me not to worry as they were trained professionals and I was in good hands. "Now," she asked me, "has your plane arrived yet?"

    Medicolegal Update

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

What is medical fasting?

  • Various blood tests require a fasting of up to 12–16 hours so that a baseline normalcy of blood can be established.
  • The patient is asked to remain in a fasting state for medical reasons: surgery or other procedures of diagnostic or therapeutic intervention that require anesthetic. The presence of food in a person's system can cause complications when they are anesthetized; medical personnel strongly suggest that their patients fast for several hours before the procedure.
  • Some animal studies show that fasting every other day while eating double the normal amount of food on non–fasting days led to better insulin control, neuronal resistance to injury and health indicators similar to mice on calorie restricted diets.
  • Patient refusal of nutrition and hydration in terminal illness: "within the contexts of adequate palliative care, the refusal of food and fluids does not contribute to suffering among the terminally ill" and might actually contribute to a comfortable passage from life: "At least for some persons, starvation does correlate with reported euphoria."
  • In homeopathic medicine, fasting is seen as a way of cleansing the body of toxins, dead or diseased tissues, and giving the gastrointestinal system a rest. During fasts, water, fruit and vegetable juices are usually taken on choice.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Best time to have a heart attack is week days

The best time to have a heart attack is a week day and 15 minutes of sun exposure is a must, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

  • Best time to have a heart attack is a week day: Your chances for surviving a cardiac arrest are 13.4 percent worse if you are admitted to the hospital on the weekend versus a week day. Even after taking into account factors such as hospital size and location and the person's age, gender and other illnesses, the lower survival rate remains the same. "A higher death rate among patients admitted on weekends may be due to lack of resources for treating cardiac arrest," as per the study author Richard M. Dubinsky, of the University of Kansas Medical Center in Kansas City. The findings come from researchers analyzing a national database containing a 20 percent sampling of all U.S. hospital admissions for cardiac arrest from 1990 to 2004. The analysis included 67,554 admissions. During cardiac arrest, the heart slows or stops working, and brain death can occur in just four to six minutes
  • 15 minutes of sun exposure must: Research by Dr. Michal Melamed, at Albert Einstein College of Medicine in New York City has discovered that people with low blood levels of vitamin D were found to have a higher incidence of peripheral arterial disease (PAD), potentially dangerous blockages in the leg arteries. The study of nearly 4,900 American adults found more than double the incidence of PAD among those with the lowest levels of vitamin D compared to those with the highest levels. Vitamin D is made when the body is exposed to sunlight. In addition to sunlight, other sources of the vitamin are salmon, sardines, cod liver oil, fortified milk and some fortified cereals. Exposure to sunlight "always calls for a balance. Overexposure raises the risk of skin cancer. The recommendation is about 10 to 15 minutes of direct exposure.
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