Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
  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 7 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

19th October 2012, Friday

Psoriasis Can Lead to Diabetes

Psoriasis patients may be at an increased risk for type 2 diabetes, and the risk appears to be greatest among patients with severe psoriasis.

Compared with the general population, patients with mild psoriasis had a 49% increased risk of developing diabetes, and individuals with severe psoriasis had a 2.13-fold increased relative risk when compared with the general population, said Dr Ole Ahlehoff, post-doctoral fellow in cardiology at Copenhagen University Hospital Gentofte at the European Society of Cardiology meeting.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Carnitine Update


  • Deficiencies in thiamine, selenium and L-carnitine have been reported to produce heart failure and replacement therapy results in improvement in cardiac function.
  • Carnitine deficiency impairs the oxidation of fatty acids, resulting in lipid accumulation in the myocyte cytoplasm. This problem is reversed with L-carnitine replacement.

What is toxic cardiomyopathy?

Dilated cardiomyopathy can be a direct result of toxic exposure from a variety of agents, most notably alcohol, cocaine, medications, particularly chemotherapeutic drugs and radiation.

For Comments and archives…

Dr K K Aggarwal
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

FDA warning - Test kidney function before prescribing zoledronic acid

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

19th MTNL Perfect Health Mela to train 10,000 people in compression only CPR

Addressing a press conference, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that more than 10,000 members of the public would be certified in compression only CPR during the Mela.

Dr K K Aggarwal
    National News

Delhi, Mumbai far from being world class cities, says UN

NEW DELHI: India's two top metros, Mumbai and Delhi, still lack what it takes to be world class cities. In a United Nations report on world's cities, India's financial capital ranked 52 among 95 cities while the political capital came in 58th. The State of World's Cities report released by UN Habitat on Wednesday, ranked cities on five parameters of "prosperity". While Shanghai, Beijing and Bangkok were all ranked higher than the two Indian cities, Kathmandu and Dhaka came in below Delhi. The five parameters were productivity, infrastructure, quality of life, environmental sustainability and equity. The report says while conceptually, prosperity is usually related to economic growth, but it has to do with more than just "economic well-being and material progress". The two Indian cities were "half-way to prosperity" and "political and technical" interventions were needed to improve conditions, said Eduardo Lopez Moreno, head of the city monitoring branch of UN Human Settlement Programme, while launching the global report on Wednesday. For the first time, UN Habitat has ranked all the cities on five common parameters. "Delhi and Mumbai are doing moderately. They are comparatively better (but) there is ample scope for improvement," Moreno said. He said both Indian cities had an overall low ranking because of their poor record in environment index - primarily due to high air pollution. Mumbai, which scored 0.645 on a scale of one in the productivity index, left cities like Cape Town, Jakarta and Casablanca far behind. He added that while public transport in Mumbai is better and more accessible than in Delhi, there is enough scope for improvement. (Source: TOI, Oct 18, 2012)

For comments and archives

My Profession My Concern

Quality measures related to pneumonia

  • Initial antibiotic timing: The percentage of pneumonia inpatients who receive antibiotics within six hours after arrival at the hospital. National average performance is 95 percent.
  • Pneumococcal vaccination: The percentage of pneumonia inpatients age 65 and older who were screened for pneumococcal vaccine status and who were administered the vaccine prior to discharge, if indicated. US National average performance is 93 percent.
  • Influenza vaccination: The percentage of pneumonia inpatients age 50 years and older, hospitalized between October and the end of February who were screened for influenza vaccine status and were vaccinated prior to discharge, if indicated. US National average performance is 91 percent.
  • Blood culture prior to initial antibiotic received in hospital: The percentage of pneumonia patients whose initial emergency room blood culture specimen was collected prior to first hospital dose of antibiotics. US National average performance is 96 percent.
  • Appropriate initial antibiotic selection: The percentage of immunocompetent patients with pneumonia who receive an initial antibiotic regimen within the first 24 hours that is consistent with current guidelines. US National average performance is 92 percent.
  • Smoking cessation advice/counseling: The percentage of pneumonia patients with a history of smoking cigarettes who are given smoking cessation advice or counseling during hospital stay. US National average performance is 97 percent.

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

    Valvular Heart Disease Update

Overestimation of aortic valve gradient

Overestimation of the gradient may result from:

  • Mistaken identification of a jet from mitral regurgitation
  • Failure to consider increased subvalvular velocities (e.g., in hypertrophic obstructive cardiomyopathy)
  • Non representative jet selection (e.g., a postextrasystolic beat)

(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)

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Bleeding may be missed without imaging even in mild TBI

Patients with the mildest form of traumatic brain injury (TBI), defined as a Glasgow Coma Scale (GCS) score of 15, may still be at risk for bleeding in the brain or having a skull fracture. Failing to provide these patients with neuroimaging on the basis of their good GCS performance may miss a significant proportion of these injuries, a report by Latha Stead, MD, MS, MBA, Toral Family Foundation Endowed Professor of Traumatic Brain Injury, professor of emergency medicine and neurological surgery, and chief of clinical research at the University of Florida in Gainesville, and colleagues concludes. (Source: Medscape)

For comments and archives

Drug may help in hard-to-treat TB

Among patients with extensively drug-resistant (XDR) tuberculosis, adding linezolid (Zyvox) to standard therapies appears to improve treatment response, but with a high rate of adverse events, a phase IIb trial showed. (Source: Medpage Today)

For comments and archives

Sepsis deaths increasing in delivery room

Sepsis among women giving birth appears to be growing deadlier, researchers said. The incidence of sepsis remained stable over an 11-year period in the U.S., but the risk of death from the condition rose from 0.7 to 1.6 per 100,000 deliveries between 1998 and 2008 (P<0.001), Melissa Bauer, DO, of the University of Michigan at Ann Arbor, and colleagues reported at the American Society of Anesthesiologists meeting. Patients at risk of worse outcomes with sepsis were those with comorbid conditions such as congestive heart failure, liver disease, and lupus. (Source: Medpage Today)

For comments and archives

Low first-trimester vitamin D predicts gestational diabetes

Women with lower serum levels of vitamin D during the first trimester of pregnancy are at greater risk for developing gestational diabetes mellitus (GDM) later in pregnancy, according to Marilyn Lacroix, a master's degree candidate from the Faculty of Medicine and Health Sciences at the University of Sherbrooke in Quebec, Canada. She reported the results at the European Association for the Study of Diabetes (EASD) 48th Annual Meeting. (Source: Medscape)

For comments and archives

   Twitter of the Day

@DrKKAggarwal: DIVYA JYOTI at MTNL Perfect Health Mela 2012:http://youtu.be/bTH3FHfwWqc via @youtube

@DeepakChopra: Food is consciousness--my take http://bonapp.it/WAwa3m

    Spiritual Update

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

On 2nd day of Navratri, Let Go Your Impure Thoughts

Brahmacharini (Uma or Tapacharini) is worshipped on the 2nd day of Navratri as the goddess who performed ‘Tapa’ (penance or continuous efforts) (Brahma – Tapa, Charini – Performer).

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)

What is gamete donation?

When a couple is unable to get pregnant on their own, sometimes they use a donor's egg or sperm. This is called "gamete donation". When a child is conceived this way, parents must decide whether to tell their child or keep this information private.

For comments and archives

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

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

Blood transfusion

Immunoglobulin structure and the role of complement in red blood cell sensitization are now understood with considerable insight, and this knowledge has led to increase appreciation of the mechanisms of antibody-mediated red blood cell destruction.

For comments and archives

    Liver Abscess Update

(Dr Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation Medanta – The Medicity Hospital)

Liver abscess in children is very common in developing countries.

For comments and archives

   An Inspirational Story

It is the little things that make a big difference

There was a man taking a morning walk at or the beach. He saw that along with the morning tide came hundreds of starfish and when the tide receded, they were left behind and with the morning sun rays, they would die. The tide was fresh and the starfish were alive. The man took a few steps, picked one and threw it into the water. He did that repeatedly. Right behind him there was another person who couldn't understand what this man was doing. He caught up with him and asked, "What are you doing? There are hundreds of starfish. How many can you help? What difference does it make?" This man did not reply, took two more steps, picked up another one, threw it into the water, and said, "It makes a difference to this one."

What difference are we making? Big or small, it does not matter. If everyone made a small difference, we'd end up with a big difference, wouldn't we?

Source: http://great-motivational-stories.blogspot.in/

For comments and archives

   Cardiology eMedinewS

Simple tool pegs prognosis after ischemic stroke Read More

Foot ulceration ups mortality risk beyond diabetes itself Read More

   Pediatric eMedinewS

Eczema in infancy predicts hay fever in childhood Read More

Probiotics for preemies provide no infection protection Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with diabetes wanted to know whether he should go for ambulatory blood pressure checkup.
Dr. Bad: It is not required.
Dr. Good: Get it done.
Lesson: Sleep-time BP is the most significant independent prognostic marker of cardiovascular events in diabetes. Most important, decreasing sleep-time BP, a novel therapeutic target requiring proper patient evaluation by ambulatory monitoring, was the most significant independent predictor of event-free survival in diabetes. In the study, analyses of changes in BP during follow-up revealed a 20% cardiovascular risk reduction for each 5 mm Hg decrease in asleep systolic BP mean, independently of changes in clinic or any other ambulatory BP (Am J Hypertens 2011 Dec 8 Epub ahead of print).

For comments and archives

Make Sure

Situation: A child with sore throat and enlarged lymph nodes developed fever.
Reaction: Oh my God! Why were antibiotics not given in time?
Lesson: Make Sure that all children with sore throat and enlarged lymph nodes are given antibiotics as such sore throats are streptococcal unless proved otherwise.

For comments and archives

    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)


  • To help evaluate the body's water and electrolyte balance
  • To investigate hyponatremia and increased or decreased urine production
  • To detect the ingestion of toxins such as methanol
  • To monitor the effectiveness of treatment for conditions affecting osmolality
  • To help determine the cause of chronic diarrhea
  Quote of the Day (Dr GM Singh)

Best friends are the siblings God forgot to give us.

    Mind Teaser

Read this…………………

The day after her surgery Joy asks the nurse how she might lose weight. Before answering her question, the nurse should bear in mind that long-term weight loss best occurs when:

A. Fats are controlled in the diet
B. Eating habits are altered
C. Carbohydrates are regulated
D. Exercise is part of the program

Yesterday’s Mind Teaser: Joy, an obese 32 year old, is admitted to the hospital after an automobile accident. She has a fractured hip and is brought to the OR for surgery.

After surgery Joy is to receive a piggy-back of Clindamycin phosphate (Cleocin) 300 mg in 50 ml of D5W. The piggyback is to infuse in 20 minutes. The drop factor of the IV set is 10 gtt/ml. The nurse should set the piggyback to flow at:

A. 25 gtt/min
B. 30 gtt/min
C. 35 gtt/min
D. 45 gtt/min

Answer for yesterday’s Mind Teaser: A. 25 gtt/min

Correct answers received from: Dr AK Jalewa, Dhananjani Senevirathna,
Dr KP Chandra, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Dr K Raju, Dr Thakor Hitendrsinh G, Abhay Singh Deora.

Answer for 17th October Mind Teaser: B. Protecting the client from infection
Correct answers received from: Dr BB Aggarwal, Muthumperumal Thirumalpillai, Dr Avtar Krishan, Dr Kanta Jain, Dr B K Agarwal.

Send your answer to ijcp12@gmail.com

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

Photos of Doctor’s Day Celebration

eMedinewS Apps
    Laugh a While (Dr. GM Singh)

Murphy’s Laws for Humor

When in a queue, the other line always moves faster and the person in front of you will always have the most complex of transactions.

    Medicolegal Update

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

How was death defined by scientist in past?

In the fatal automobile accident of Smith v/s Smith both husband and wife sustained injury. Husband died on the spot and the wife was taken to the hospital where she remained unconscious for 17 days and then died. The petitioner argued that the deaths were simultaneous, since there was no evidence of brain activity after accident. The inference was that resuscitative efforts were maintaining the body in a state of animation although it could not be shown that life existed. The court did not accept the contention. They quoted Black’s definition of death and stated that "one who is breathing, though unconsciousness is not dead." The living body depends upon the integrity of three principal interdependent systems circulation, respiration and enervation. Failure of one of them will cause failure of the other two. This leads to the death of the individual. There are two phases of death: (i) Extinction of the personality is immediate sign of vital process: This is somatic death. (ii) Progressive disintegration of the body tissue: This is molecular death or cellular death that occurs sometimes later.

Calne in 1970, gave a more practical definition that states when destruction of the brain has been established, the individual has died no matter what the state of the rest of his body, giving four signs for such a diagnosis: (i) Deep, irreversible coma with fixed, dilated pupils and absent cranial nerve reflexes (ii) No spontaneous respiration (iii) absence of electrical brain activity (iv) Cessation of circulation in the retinal vessels.

Rantoul and Smith in 1973 defined death as complete and persistent cessation of respiration and circulation.

(Ref: Dr. PC Dikshit Head (MAMC) MD LLB, Textbook of forensic medicine, Peepe Publisher)

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Who should not donate blood?

All cannot donate blood said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela. Here is an updated list as to who cannot donate blood.

  • People with coronary artery disease, valvular heart disease, arrhythmia, significant cerebrovascular disease, or heart failure.
  • People with any active lung disease impairing gas exchange.
  • Persons who have undergone recent surgery in the absence of blood transfusion until healing is complete and full activity has been resumed.
  • Pregnant women are deferred during pregnancy and for six weeks after delivery.
  • Persons with seizure disorders are acceptable provided that they have had no seizures within the past 12 months with or without medications.
  • The minimal age for donation is generally 16 to 18. Most blood centers do not impose an upper age limit for donor eligibility.
  • Blood is not collected from persons who are febrile at the time of donation, who state that they do not feel well, or who are taking systemic antibiotics.
  • A donor with a history of a solid organ tumor should be deferred and will be eligible to donate only if he/she has been symptom-free and considered to be clinically cured for a defined time period.
  • Persons with a history of blood cancer are permanently deferred.
  • Some drugs may pose a risk due to their demonstrated cancer producing potential at low plasma concentrations. One should not donate blood for one month after taking isotretinoin and finasteride, six months for dutasteride, three years for acitretin and permanent for etretinate.
  • Persons should not donate if they have taken bovine insulin (risk of variant CJD transmission) or human growth hormone derived from pituitary glands (risk of iatrogenic CJD).
  • Persons who have received Hepatitis B immunoglobulin (HBIG) or an unlicensed vaccine are not allowed to donate for one year.
  • Most donors are also temporarily deferred if they are taking warfarin, heparin, or another anticoagulant.
  • Collections of platelets for pheresis should not occur from donors who ingested aspirin, aspirin-containing drugs, or feldene in the previous 48 hours or from donors who ingested clopidogrel or ticlopidine in the previous 14 days.
  • One should not donate blood if suffering from HIV, AIDS, for men having sex with men, IV drug users, commercial sex exchangers, receiving clotting factor concentrates for hemophilia or other clotting disorders.
  • One should not donate blood for one year if he/she has had sex in the past one year with a person who has HIV infection or AIDS; a prostitute; a person who currently or previously used intravenous drugs; for women: a man who has had sex with another man; a person receiving clotting factor concentrates.
  • Persons with a history of viral hepatitis after age 10 are permanently deferred.
  • Persons currently or previously testing positive for HBsAg are permanently deferred.
  • Persons with a history of close contact with someone who has viral hepatitis are deferred for 12 months following their last potential exposure.
  • Persons who have received a blood transfusion are deferred for 12 months.
  • Deferral is not required when the donor's history is based solely on a positive serologic test result (i.e., anti-HBc or anti-HBs) that indicates past exposure to HBV.
  • Receiving a tattoo or body piercing within the last 12 months has also been included on the donor questionnaire, due to concerns about hepatitis transmission. Some blood centers will accept donors with body piercing, provided that the procedure was performed with sterile, single use equipment. Donors with tattoos or permanent makeup are deferred for 12 months after the exposure.
  • Donors with a history of malaria are deferred for three years after becoming asymptomatic.
  • Travelers to a malaria endemic area are deferred for one year (provided they have not had malarial symptoms).
  • Immigrants from or residents of malarial endemic countries, defined as living in that country for more than five years, are deferred for three years after their departure from the endemic country based upon the premise that such individuals may have partial tolerance to malarial parasites, thereby resulting in the delay of malarial symptoms beyond one year.
    Readers Response
  1. Dear Sir, emedinews is really very informative. Regards:Dr Darshna
    Forthcoming Events

19th MTNL Perfect Health Mela 2012 Programme

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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