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
  Editorial …

20th October 2012, Saturday

SSRIs Linked to Stroke

Use of SSRI conferred a small, but statistically significant risk of brain hemorrhage, according to an analysis of multiple epidemiologic studies. SSRI users had a 40% to 50% increase in the relative risk of intracranial and intracerebral hemorrhage compared with people who had never taken one of the drugs, according to Daniel G. Hackam, MD, PhD, and Marko Mrkobrada, MD, of the University of Western Ontario in Hamilton.

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.

How is alcohol linked to cardiomyopathy?

Excessive alcohol consumption can lead to myocardial dysfunction, although the pathogenesis and factors that determine patient susceptibility are still poorly understood. Alcohol is believed to be toxic to cardiac myocytes via oxygen free radical damage and defects in cardiac protein synthesis. The risk of developing alcoholic DCM is related to both mean daily alcohol intake and the duration of drinking. However, individual susceptibility remains important. The typical findings in patients with alcoholic DCM are left ventricular dilatation with reduced ejection fraction. More advanced cases have biventricular failure. Abstinence can lead to a dramatic improvement in cardiac function if the disease is diagnosed early.

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

Cabergoline can restore normal orgasm new

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

MCD South to train its teachers on Health and Hygiene at Perfect Health Mela

Addressing a press conference here, Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Mr. Satish Upadhyay, Chairman Education Committee, MCD South said that a series of health educational activities are being organized for MCD school teachers.

Dr K K Aggarwal
    National News

Another vector species adds to dengue threat

CHENNAI: Another mosquito species that carries the dengue virus has been spotted in urban areas in the state, raising serious public health concerns amid a sudden spike in cases of the debilitating disease. Entomologists have reported the presence of equal numbers of Aedes albopictus in cities, a species usually found in forests, in addition to the Aedes aegypti that spreads dengue. There are approximately 3,500 species of mosquitoes. Most of these are vectors, or carriers, of pathogens that cause a variety of diseases including malaria, dengue, chikungunya, Japanese encephalitis and filariasis. Researchers at Centre of Disease in Medical Entomology (CDME) in Madurai, an ICMR institute, say they have spotted an equally high number of Aedes albopictus in cities across Tamil Nadu. "Aedes albopictus was not uncommon, but today we see as many albopictus as aegypti," said CDME director B K Tyagi. Albopictus, also known as the Asian Tiger Mosquito, was till recently found only in forests, in bamboo stumps and tree holes. But the species has now moved into human habitat, earlier primarily the domain of aegypti. Scientists say albopictus is now competing with aegypti in urban areas and poses a major challenge to public health because of its adaptability. Containing albopictus is much more difficult because it grows both in natural and man-made containers. These two mosquitoes have made dengue, or break bone fever, an endemic disease in most southern states. "There are cases of dengue in almost all districts in the southern states throughout the year," Tyagi said. "It is no more a seasonal disease. And it's because we give mosquitoes a chance to breed during all seasons." The incidence of dengue has almost doubled in Tamil Nadu and increased four-fold in south India this year. (Source: TOI, Oct 19, 2012)

For comments and archives

My Profession My Concern

Quality Measures related to surgical care

  • Prophylactic antibiotic received within one hour prior to surgical incision: The percentage of surgical patients who received prophylactic antibiotics within one hour prior to surgical incision. US National average performance is 93 percent.
  • Prophylactic antibiotics discontinued within 24 hours after surgery end time: The percentage of surgical patients whose prophylactic antibiotics were discontinued within 24 hours after surgery end time. US National average performance is 95 percent.
  • Prophylactic antibiotic selection: The percentage of surgical patients who received prophylactic antibiotics consistent with current guidelines for their particular type of surgery. US National average performance is 97 percent.
  • Venous thromboembolism prophylaxis a. The percentage of surgical patients with recommended venous thromboembolism (VTE) prophylaxis ordered anytime from hospital arrival to 24 hours after anesthesia end time. US National average performance is 94 percent. b. The percentage of surgical patients who received appropriate venous thromboembolism (VTE) prophylaxis within 24 hours prior to anesthesia start time to 24 hours after anesthesia end time. US National average performance is 93 percent.
  • Perioperative blood glucose in cardiac surgery patients: The percentage of cardiac surgery patients with controlled 6 A.M. blood glucose (= 200 mg/dL) on postoperative day one and postoperative day two. US National average performance is 94 percent.
  • Appropriate hair removal: The percentage of surgical patients with no hair removal or hair removal with clippers or depilatory (and no shaving, which is considered inappropriate). US National average performance is 100 percent.
  • Beta blocker therapy: The percentage of surgical patients who were taking a beta blocker prior to hospital arrival who received a beta blocker during the perioperative period (24 hours prior to surgical incision through discharge from post-anesthesia care/recovery area). US National average performance is 93 percent.
  • Removal of urinary catheter: The percentage of surgical patients whose urinary catheters were removed on postoperative day one or postoperative day two, to reduce the risk of infection. US National average performance is 91 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

Aortic regurgitation in the elderly

Aortic regurgitation (AR) is less common in elderly adults than aortic stenosis and mitral regurgitation. In the Helsinki Aging Study, AR mostly mild was present in 29 percent of patients. In the Framingham Study, AR that was at least mild was present in 13 percent of subjects.

(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)

FDA panel recommends GI drug

An FDA panel voted unanimously on Tuesday to recommend approval of a drug to help patients who have lost the ability to absorb nutrients, despite the agency's concerns over the manufacturer's risk-management plan. (Source: Medpage Today)

For comments and archives

Urinary tract infections not prevented by cranberry juice

Because the benefit for prevention is small, cranberry juice cannot currently be recommended to prevent urinary tract infections (UTIs), according to a systematic review published online October 16 in the Cochrane Review. This is the third update of a previous Cochrane review on the same topic first published in 1998 and then updated in 2004 and 2008. (Source: Medscape)

For comments and archives

Healthy mind builds healthy bones

Various measures of psychological well-being are positively associated with adult bone mineral density (BMD), particularly in the femoral neck, a researcher reported in a poster session at the annual meeting of the American Society for Bone and Mineral Research. (Source: Medpage Today)

For comments and archives

TCT: PFO closure back in spotlight

After disappointing results with closure of patent foramen ovale for cryptogenic stroke prevention in recent years, the procedure will be making headlines again at the Transcatheter Therapeutics meeting. Two PFO closure trials slated for presentation at the meeting next Thursday -- RESPECT done in the U.S. and the PC Trial from Europe -- promise to be blockbusters. (Source: Medpage Today)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: MEDICO MASTI at MTNL Perfect Health Mela 2012:http://youtu.be/I2o5CuqizzE via @youtube

@DeepakChopra: There are as many perceptual realities as there are living entities with their qualia repertoire. http://tinyurl.com/9onyfgt

    Spiritual Update

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

On the 3rd Navratri , control your fire and negative energies

Chandraghanta is worshipped on the third day of Navratri. SHE is shown with golden skin and riding a tiger. She is depicted with 10 hands and 3 eyes with a crescent moon on the head.

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 do you understand by the egg retrieval process?

During egg retrieval, a vaginal ultrasound is used to guide the insertion of a long, thin needle through the vagina into the ovary and then into each follicle to retrieve the egg. Specific possible risks include:

  • Mild to moderate discomfort (during or after the procedure).
  • Injury to organs near the ovaries, such as the bladder, bowel, or blood vessels.
  • Bleeding from the ovary or pelvic vessels. Any bleeding is usually mild, rarely requiring transfusion or surgery.
  • Pelvic infection (mild to severe).

For comments and archives

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

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

Blood transfusion

Increased understanding of the mechanisms of blood coagulation and clot Iysis has resulted in major changes in the approach to the patient with a bleeding disorder.

For comments and archives

    Liver Abscess Update

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

Pyogenic liver abscess is more common than amebic, fungal, or other etiologies.

    An Inspirational Story

Many years ago, when I worked as a volunteer at a hospital, I got to know a little girl named Liz who was suffering from a rare and serious disease. Her only chance of recovery appeared to be a blood transfusion from her 5-year-old brother, who had miraculously survived the same disease and had developed the antibodies needed to combat the illness. The doctor explained the situation to her little brother, and asked the little boy if he would be willing to give his blood to his sister. I saw him hesitate for only a moment before taking a deep breath and saying, “Yes, I’ll do it if it will save her.”

As the transfusion progressed, he lay in bed next to his sister and smiled, as we all did, seeing the color returning to her cheeks. Then his face grew pale and his smile faded. He looked up at the doctor and asked with a trembling voice, “Will I start to die right away?”

Being young, the little boy had misunderstood the doctor; he thought he was going to have to give his sister all of his blood in order to save her.
Source: http://great-motivational-stories.blogspot.in/

For comments and archives

  Cardiology eMedinewS

Low-chloride IV fluid linked to lower risk in ICU patients Read More

SSRIs linked to risk of stroke Read More

  Pediatric eMedinewS

Longer baby's on formula, higher the leukemia risk Read More

Is celiac disease related to timing of gluten exposure in infants? Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with diabetes was found to have altered arterial stiffness.
Dr. Bad: Stop doing exercise.
Dr. Good: Do regular exercise.
Lesson: Physical activity is significantly and independently associated with multiple measures of arterial stiffness in adolescents and young adults. After adjusting for other cardiovascular disease risk factors such as age, sex, body size, mean arterial pressure and the presence of obesity or T2DM, physical activity was an independent predictor of augmentation index and brachial distensibility. A greater effect of physical activity on pulse wave velocity was found in participants with T2DM compared with participants in the lean or obese groups. Metabolism 2011 Dec 6 Epub ahead of print.

For comments and archives

Make Sure

Situation: A patient with LBBB in ECG developed acute pulmonary edema. Reaction: Oh my God! Why was underlying low cardiac functions not suspected?
Lesson: Make sure all patients with LBB undergo echo to rule out ejection fraction. This may not be true for RBBB.

For comments and archives

    Legal Question of the Day (Dr M C Gupta)

Q. Can nurses prescribe drugs?

Ans. This issue has many aspects.

  1. If the question posed is—“Can a nurse prescribe like a physician?”, the answer has to be –No
  2. If the question posed is--—“Can a nurse prescribe medicines in the absence of a physician in accordance with an SOP (Standard Operating Protocol” or comprehensive written guidelines prepared, with legal backing, by the hospital where the nurse is employed?”, the answer has to be –Yes.
  3. If the question posed is--—“Can a nurse prescribe emergency life saving drugs to an indoor hospital patient in order to save his life in the absence of a doctor on the basis of her knowledge and experience?”, the answer has to be –Yes.
  4. If the question posed is--—“Can a nurse prescribe OTC drugs to a patient in first aid or emergency situations?”, the answer may, within law, be –Yes.
  5. If the question posed is--—“Can a nurse / ANM / LHV / AWW / VHG / MPW, being a government servant or a government sponsored health functionary, prescribe, provide or supply drugs to a patient as per guidelines and training provided to her?”, the answer has to be –Yes.
  6. Attention is drawn to a recent report in Times of India, 4 October 2012, which can be viewed at: http://timesofindia.indiatimes.com//articleshow/16661737.cms?intenttarget=no

    The summary of the report is as follows:

    “The president, Rajasthan Nurses Association (United) has demanded rights for nurses to prescribe medicines to patients in the absence of doctors in emergency situations. If this is not done, it would be illegal for us to "prescribe medicines at sub-centres and other health centers”. He said there are not even half as much doctors against total number of health centres, including sub centres. At most of these centres, nurses are taking care of the patients. The state government had sought the opinion of the MCI on authorizing nurses to independently handle primary treatment of patients and even prescribe medicines in emergency situation in the absence of doctors. The state
    government, however, claimed it is yet to receive the MCI's opinion.

    The Rajasthan Nurses Association (United) said it would go ahead with its decision to protest against the MCI move outside the Vidhan Sabha on October 10. It said the Nursing Council of India approved our demand. In the letter sent to MCI, the medical health and family welfare department had cited shortage of doctors in the state due to which the nursing staff has to provide medical assistance to patients in rural areas. It said that nurses are the backbone of healthcare services in the state.”
  7. The above demand of the nurses has merit. It is open to the government not to agree to it. In that case, it would be open to the nurses to stop prescribing any drug to any patient.

For comments and archives

    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Hemoglobin A1c

Glycohemoglobin A1c (HbA1c) test checks the long–term control of blood glucose levels in people with diabetes. Glucose binds to hemoglobin in red blood cells at steady rate. Since red blood cells last 3 to 4 months, the A1c test shows how much glucose is in the plasma part of blood. Some medical conditions can increase A1c levels, but the results may still be within normal level. These conditions include Cushing’s syndrome, pheochromocytoma and polycystic ovary syndrome (PCOS).

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

Photos of Doctor’s Day Celebration

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  Quote of the Day (Dr GM Singh)

A man lost everything in fire, next day he placed a sign board. "Shop burnt, goods burnt, but faith and confidence not burnt. Business will start tomorrow."

    Mind Teaser

Read this…………………


Yesterday’s Mind Teaser: 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

Answer for Yesterday’s Mind Teaser: B. Eating habits are altered

Correct answers received from: Dr. Archna Parwani, Dr. B. B. Aggarwal, Dr.K.V.Sarma, Dr.K.Raju, Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Dr K P Chandra Muthumperumal Thirumalpillai, Dr. Thakor Hitendrsinh G, Dr Kanta Jain

Answer for 19th October Mind Teaser: A. 25 gtt/min
Correct answers received from: Dr Avtar Krishan Dr. Thakor Hitendrsinh G

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

What is the chemical formula for water?

Little Johnny's teacher asks, "What is the chemical formula for water?" Little Johnny replies, "HIJKLMNO"!! The teacher, puzzled, asks, "What on earth are you talking about? Little Johnny replies, "Yesterday you said it was H to O!"

    Medicolegal Update

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

Doctors should avoid special efforts to “cover up” any medical fact

The media and general public are vastly becoming informed and law conscious. There is awareness of modern diagnostic/therapeutic methods. The standard of doctors/hospital, its opinion and method of medical/surgical interventions are being scrutinized from time to time in public as well as Court of law and media. The doctor should not avoid talking to the media but definitely not too much and too soon. Prejudicial and sensational statements should not be made by doctor prior to trial. It is incumbent upon doctors to have good knowledge of the law governing their profession, in order not to transgress the law.

  • Doctors should totally avoid special efforts to “cover up” alleged medical negligence or unintentional wrong doing or inevitable medical accident.
  • It is a standard accepted universal fact that “Medicine is not mathematics but is a science of uncertainty and an art of probability. One thing that makes medicine so difficult is that there is no such thing as the average man can understand the intricacies. We can only say the reading is ‘within the range of normal’. Medicine is a biological science with the variability inherent in body physiology with the variability inherent in biological matters.
  • Forensic medicine is not an exact science as a mathematical calculation hence while making a forensic opinion it is required to deliberate that unexpected results are produced due to biological variations in case to case, there is an element of uncertainty and absolute proof is a rarity in any medical care delivery.
  • Doctors should bear in mind the essential difference between probability and proof. They should be reasonable in their opinions and should not overstate the likelihood of a relationship between cause and effect.
  • The doctor should be ready to defend every finding and conclusion on the report on clinical and scientific grounds in the court of law. He should be aware of professional and scientific viewpoints which might differ from his, and should be familiar with the latest scientific literature in relation to the subject involved.
  • The doctor in the Court of law may clarifying his testimony by means of photographs, maps, diagrams, charts, X-rays, skeletons, models, slides, films, tapes, etc., when they are properly verified.

For comments and archives

    Public Forum

Public Forum (Press Release for use by the newspapers)

MCD South to train its teachers on Health and Hygiene at Perfect Health Mela

Friday 19th November 2012: New Delhi: MCD South in association with Heart Care Foundation of India will be organizing a training program for its teachers on 7th November, 2012, Wednesday, at Constitution Club of India, the venue for the 19thMTNL Perfect Health Mela being organized from 7th to 11th November, 2012.

Addressing a press conference here, Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Mr. Satish Upadhyay, Chairman Education Committee, MCD South said that a series of health educational activities are being organized for MCD school teachers.

In September this year in Dil Ka Darbar, 300 school teachers were trained in cardiac first aid and now in the forthcoming MTNL Perfect Health Mela, there will be a training of 300 school teachers on Health and Hygiene. These 300 teachers will be certified as trainers who in turn will train other school teachers and students. The training will be coordinated by Ryan Global School.

Hygiene is the most important part to be taught right at the primary school level. The components of hygiene include hand hygiene, personal hygiene, sleep hygiene, respiratory hygiene, food and water hygiene and sexual hygiene.

Hand washing done in proper way can prevent 80% of food and water borne diseases including diarrhea, typhoid and jaundice.

Respiratory hygiene involves correct way of coughing into the sleeves and not in the hands can prevent spread of rheumatic fever and flu. Water hygiene involves safe drinking water techniques. Unsafe water is responsible for most of the water borne diseases. Food hygiene involves following the principle of heat it, boil it, cook it, peal it or forget it.

MCD South will also post its teachers and students in the mela on daily basis for acquiring knowledge about health. MCD Health Department will also be putting up dengue, malaria exhibitions and conduct health checkups.

Following recommendations by heart care foundation of India were also released in the press conference:

  1. All school children should be given deworming tablet albandazole once in three-six months.
  2. All school children should be given iron folic acid tablets once in a week.
  3. Hand wash technique involving six steps should be taught to every school child.
  4. Revival of heart technique learning should be compulsory for school teachers.
  5. Availability of safe water should be mandatory in school premises.
  6. Toilets in every school should be made hygienic.

The entry to the mela will be free. The mela will be a mix of exhibitions, checkups, competitions and infotainment.

Vandana Sharma, Headmistress Ryan Global School said that the training program after the event would be posted in YouTube.

    Readers Response
  1. Dear Sir, emedinews is very inspirative. Regards: Dr Sujata
    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