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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

  Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 9 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 November 2012, Tuesday

Harvard’s Medical school’s 4 exercising tips for people with diabetes

  • Get a “preflight” check
    • Talk with your doctor before you start or change a fitness routine.
    • Especially if you are overweight or have a history of heart disease, peripheral vascular disease, or diabetic neuropathy.
    • Go for a complete physical exam and an exercise stress test for people if you are 35 or older and who have had diabetes for more than 10 years. The results can help determine the safest way for you to increase physical activity.
  • Spread your activity throughout the week
    • Adults should aim for a weekly total of at least 160 minutes of moderate aerobic activity, or 80 minutes of vigorous activity, or an equivalent mix of the two.
    • Be active at least 3 to 5 days a week.
  • Time your exercise wisely
    • The best time to exercise is 1 to 3 hours after eating, when your blood sugar level is likely to be higher.
    • If you use insulin, it’s important to test your blood sugar before exercising. If it is below 100 mg/dL, eat a piece of fruit or have a small snack to boost it and help you avoid hypoglycemia. Test again 30 minutes later to see if your blood sugar level is stable.
    • Check your blood sugar after any particularly grueling workout or activity.
    • If you use insulin, your risk of developing hypoglycemia may be highest 6 to 12 hours after exercising.
    • Do not exercise if your blood sugar is too high (over 250).

Be prepared

Should you experience a medical problem while exercising (or at any time) it is important that the people who care for you know that you have diabetes. Keep card handy or glucose tablets with you while exercising in case your blood sugar takes a sudden nosedive.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

   Constipation Update

Constipation is defined as any two of the following features: straining, lumpy hard stools, sensation of incomplete evacuation, use of digital maneuvers, sensation of anorectal obstruction or blockage with 25 percent of bowel movements, and

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 on

DVT risk starts early, stays long after
acute stroke

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela 2012

Heritage Inter Dancing School Competition Various classical dances, Bharatnatyam, Odissi and Kathak were organized in Heritage – Inter Dance School Festival.

Dr K K Aggarwal
    National News

Dear Colleague, Let’s celebrate New Year by learning CPR-10 and saving the life of a person

Watch English or Hindi Video @http://emedinews.in/videos/cpr/index.html

Dr K K Aggarwal

Vaccine against dengue to be tested in India

PARIS: The world's most effective vaccine candidate against dengue is all set for trials in India and if all goes to plan, the vaccine will be available globally by 2015. The vaccine will be tested on 120-odd adults in the beginning, the results of which should be available by 2013. Thereafter, a large scale study on children — the main target group — will be undertaken. In an exclusive interview, French pharma giant Sanofi Pasteur's CEO Christopher Viehbacher told TOI, "Sites for the vaccine's final trials will stretch from Thailand to India as this vaccine has to work on populations across countries. We will test it in India soon." Dr Jean Lang, head of the vaccine's R&D programme, added, "The drug controller general of India has asked us to conduct phase II safety trials on adults first, then on children. It will help us get licence to market the vaccine in India faster if it has been tested on the Indian population and is found safe and effective." Even the world's most effective dengue vaccine candidate, set for trials in India soon, will not be able to counter all virus strains, early tests have showed. (Source: TOI, Nov 19, 2012)

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

(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)

Prosthetic Valve update

Thromboembolic and anticoagulation-related problems are by far the most frequent complications of mechanical valves. In contrast, structural failure is relatively rare with these prostheses compared to bioprosthetic valves

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

New drug looks good in psoriatic arthritis

The investigational drug apremilast – a phosphodiesterase 4 inhibitor – appears to improve outcomes among patients with psoriatic arthritis when compared with placebo, researchers said at the annual meeting of the American College of Rheumatology (PALACE study). (Source: Medpage Today)

TB no barrier to anti-TNF treatment

Patients being treated with tumor necrosis factor (TNF) inhibitors who develop tuberculosis (TB) may safely reinstitute their biologic before completing the lengthy TB treatment regimen, a small retrospective study suggested. (Source: Medpage Today)

First meningitis B vaccine recommended for EU approval

The European version of the US Food and Drug Administration (FDA) yesterday recommended the approval of the first vaccine for meningitis caused by serogroup B Neisseria meningitides. The European Medicines Agency (EMA) will ask the European Commission, the executive branch of the European Union, to approve the vaccine, called Bexsero (Novartis), for individuals older than 2 months. The commission generally follows EMA recommendations, according to Novartis. (Source: Medscape)

Meditation may improve emotional processing

Meditation may produce lasting improvements in the area of the brain responsible for processing emotions, new research suggests. (Source: Medscape)

    Twitter of the Day

@DrKKAggarwal: Flaxseed for lowering blood pressure Eating flaxseed can
reduce the upper blood pressure (systolic) by 10 mmHg... http://fb.me/2ugmYYohp

@DeepakChopra: A breakthrough has occurred in explaining our universe that hasn’t yet become mainstream. http://tinyurl.com/bm523v3

    Spiritual Update

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

Mini-relaxation exercises: When you’ve got three minutes

While sitting, take a break from whatever you’re doing and check your body for tension. Relax your facial muscles and allow your jaw to open slightly. Let your shoulders drop. Let your arms fall to your sides. Allow your hands to loosen so

For Comments and archives…

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

Is laparoscopy a risky procedure to retrieve eggs?

Laparoscopy carries the risks of any surgery that requires anesthesia. Removing eggs through an aspirating needle entails a slight risk of bleeding, infection and damage to the bowel, bladder, or a blood vessel. This is true whether the physician uses laparoscopy or ultrasound to guide the needle. Less than one patient in 1,000 will require major surgery to repair damage from complications of the egg retrieval procedure.

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

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

ABO system is controlled by allelic genes A1, A2, B, O located on the long arm of chromosome 9.

    An Inspirational Story (Dr GM Singh)

An interesting story

There was a king who was a great admirer of art. He encouraged artists from all over his country and gave them valuable gifts.

One day an artist came and said to the king, "Oh King! Give me a blank wall in your palace and let me paint a picture on it. It will be more beautiful than anything you have ever seen before. I promise you shall not be disappointed." Now, the king happened to be constructing a big hall at the rear end of the palace. So he said, "All right you may work on one of the walls in the new hall."

So the artist was given the job and he was very pleased indeed. Just then, another young man said, "Oh King! Please allow me to work on the opposite wall. I too am an artist."

The king said, "What would you like to make?"

The man said, "My Lord, I shall make exactly what that man will make on the opposite wall. Moreover, I shall do so, without looking at his work. I would even request you to have a thick curtain put up between the two walls so that either of us cannot see the other." Now, that was a tall statement. Everyone in the king's court, including the king and the first artist were intrigued. But the king loved surprises and he decided to give the young fellow a chance. The following day a thick curtain was put into place and both the artists got to work. The first artist brought in a regular supply of paint, oil, water etc. The second one would come with a cloth and a bucket of water every day.

After a month the first artist told the king that his work was complete and he would like to show it to the king. The king sent for the second artist and asked him, "Young man, when would your work be ready? I am coming to see the first wall this evening."

The man said, "My Lord, my wall is ready too!"

The king went to see the first artist's wall. He was very, very impressed with the painting and gave a hefty sum as a reward to the artist. He then asked for the curtain to be opened up

Lo and behold! The same painting was to be seen on the opposite wall too!

Amazing! But true! Each line, each minor detail was exactly as it was on the first wall. But this man had not been seeing what was going on, on the other side of the curtain. So how had he done it? The king wanted to know the secret.

He gave a double reward to the fellow. Then he said, "Young man, I am indeed very happy with your work. But you must tell me; how did you do it?"

The lad said simply, "It's very easy! I just polished the wall every day!"

It was a wall made of white marble! The fellow polished it till it shone like a mirror. The reflection of the painting across the room, showed up in it!

That is what it means to polish yourself. For when we polish our hearts and souls, we see God's reflection within.

It is said that the world is a reflection of you. Whatever you are, the world will seem to be that too. If you are sad, jealous, dejected, angry, restless ... that is what the world will seem to be!

If you are happy, the world will seem to be paradise.

You decide how you want your world to look...

For comments and archives

   Cardiology eMedinewS

Job stress a major factor in high rates of physician suicide Read More

New drug for diastolic heart failure? Read More

   Pediatric eMedinewS

Imaging may identify epilepsy risk after febrile seizures Read More

Meningococcal conjugate vaccine appears safe in infants Read More

    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was found to have high ESR and elevated CRP.
Dr Bad: You are suffering from an inflammatory disease.
Dr Good: It may be a part of diabetes.
Lesson: In diabetes, both ESR and CRP can be high at the same time and this can be due to IL–6 secretion by adipose tissue.

Make Sure

Situation: A patient on dialysis and on oral antacid developed aluminum toxicity.
Reaction: Oh my God! You should have put him on magaldrate preparations?
Lesson: Make sure to remember that magaldrate preparations do not cause aluminum toxicity in patients undergoing dialysis.

  Legal Question of the Day (Dr MC Gupta)

Q. What are your comments about the 80-year-old cancer specialist being jailed for a day and asked to pay Rs. 15 lakh as compensation for medical negligence?


  • You are obviously referring to the case of Padma Vibhushan Awardee Dr. Prafulla Desai decided recently by the Bombay HC. Details can be seen at:



  • The brief facts appear to be as follows:
    • Former IAS officer PC Singhi’s wife Leela was ill. She had previously consulted Dr. Earnest Greenberg, a cancer specialist attached to Sloan Kettering Memorial Hospital in New York, who had advised against surgery.
    • She consulted Padma Vibhushan Awardee Dr. Prafulla Desai who charged professional fee and admitted her under his care in Bombay Hospital. He advised surgery but did not attend upon her in the operation theatre. She died after 14 months on 26-2-1989.
    • In December 1987, Sh. P C Singh filed a suit for medical negligence on the grounds that:
      • Dr. Desai tried to operate in spite of knowing that Dr. Earnest Greenberg had advised against surgery.
      • Dr. Desai refused to do anything when he found out that her stomach was inoperable.
      • He even denied that Leela was admitted as his patient.
    • On September 7, 1988, Sh. Singhi filed a complaint at Azad Maidan police station alleging medical negligence but the police did not register FIR.
    • Maharashtra Medical Council held that there was negligence on the part of Dr. Desai.
    • In 1989, Sh. Singhi filed a civil suit alleging medical negligence.
    • On May 14, 1991, an FIR was registered pursuant to the criminal (police) complaint.
    • The trial court held Dr. Desai guilty. Dr. Desai appealed.
    • Justice KU Chandiwal of the Bombay HC held that “The findings recorded by both the courts do not call for interference.” It held that Dr. Desai failed to exercise reasonable and proper care and avoided to operate the patient himself in spite of the risky decision taken by him. This involves moral delinquency,” the court said.

      “The violent indifference, deliberate omission, associated ego demonstrated by Dr Desai has put the life of the patient in a miserable situation.”

      The court had held Dr. Desai guilty of breaching a contract between a patient and doctor.
    • On September 3, 2011, deciding the civil suit, the high court directed Dr. Prafulla Desai to pay Rs15 lakh as compensation to the deceased’s husband PC Singhi for medical negligence.
    • The criminal case resulted in a day’s jail and Rs. 50,000/- as fine.
  • The above facts clearly establish negligence on the part of Dr. Desai.
  • It is unfortunate that the case took more than 2 decades to be decided. One does not know if Dr. Desai intends to approach the SC.
  • Doctors need to be careful about their legal duties. I must admire the complainant Sh. P C Singhi for his determined fight, without which the illegalities committed by even highly respected and senior doctors would have remained under wraps.
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  Quote of the Day (Dr GM Singh)

Once upon a time leadership mattered, now dealership rules the world.

    Mind Teaser

Read this…………………

A chest tube with water seal drainage is inserted to a client following a multiple chest injury. A few hours later, the client’s chest tube seems to be obstructed. The most appropriate nursing action would be to

A. Prepare for chest tube removal
B. Milk the tube toward the collection container as ordered
C. Arrange for a stat Chest x-ray film.
D. Clam the tube immediately

Yesterday’s Mind Teaser: Eddie, a plane crash victim, undergoes endotracheal intubation and positive pressure ventilation. The most immediate nursing intervention for him at this time would be to:

A. Facilitate his verbal communication
B. Maintain sterility of the ventilation system
C. Assess his response to the equipment
D. Prepare him for emergency surgery

Answer for Yesterday’s Mind Teaser: C. Assess his response to the equipment

Correct answers received from: Dr Ashok Barat, Dr.K.V.Sarma, dr ajay Gandhi, Dr. P. C. Das , Dr Pankaj Agarwal, Dr Kanta Jain, Dr Jainendra Upadhyay, Dr. Thakor Hitendrsinh G, Muthumperumal Thirumalpillai, Dr Avtar Krishan,

Answer for 18th November Mind Teaser: D. Quality of respirations and presence of pulses

Correct answers received from: Dr B K Agarwal

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

A Psychiatrist was testing the mental status of a patient.
"Do you ever hear voices without being able to tell who is speaking or where the voices are coming from?" asked the psychiatrist.
"As a matter of fact, I do," said the patient.
"And when does this happen?" asked the psychiatrist.
"Oh," said the patient, "when I answer the telephone."

  Medicolegal Update

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

No Narco test without valid informed consent, rules Supreme Court of India

The most exhausting/frustrating and laborious part of a criminal investigation for agencies like CBI or FBI is extracting information from an uncooperative alleged accused and suspects by investigators in India as well as abroad. No individual should be forcibly subjected to any of these techniques/method of interrogation in question, whether in the context of investigation in any criminal cases or otherwise. The narcoanalysis test began to be used with the presumption that it provides a simple, nonviolent method of finding out the truth. In a world where until quite recently, torture was employed in criminal cases, perhaps narcoanalysis is a simple, civilized way of conducting criminal investigation

  • The Supreme Court of India said that the so–called narcoanalysis, brain mapping and polygraph tests cannot be conducted on any person without their consent.
  • The Apex Court further said the confession of guilt during the course of the tests cannot be treated as evidence in court.
  • The results of narco test provided clues and did not have any evidentiary value. There is no scientific literature to prove that truth serum works; human rights groups have held the tests to be mental torture.
  • "The compulsory administration of any of these techniques is an unjustified intrusion into the mental privacy of an individual. It would also amount to ‘cruel, inhuman or degrading treatment’ with regard to the language of evolving international human rights norms," said a Bench comprising Chief Justice K G Balakrishnan and Justices R V Raveendran and J M Panchal. The police, instead of collecting real evidence, relied on these tests to spread rumors about the suspect, and selective leaks were made to the media that a particular suspect has made confession during the tests."

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Pre-exposure prophylaxis against HIV

In addition to counseling on consistent condom use, pre-exposure prophylaxis with tenofovir-emtricitabine should be given to HIV-uninfected adults who are at high risk for sexually-acquired HIV and are committed to medication adherence and close follow-up, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India. The drug combination is available in India. All high-risk patients should ask their doctors for the same.

In July 2012, the US FDA approved the combination for pre-exposure prophylaxis among confirmed HIV-negative individuals at high risk for sexually-acquired HIV infection.

Specific high-risk populations include the following:

  • Men who have unprotected anal sex with men and have multiple or anonymous sex partners
  • Heterosexual individuals who have multiple sex partners in areas of high HIV prevalence
  • Partners of HIV-infected individuals who have not achieved viral suppression

Several trials have demonstrated a reduction in the risk of HIV infection by 48 to 75 percent with daily use of the above combination compared with placebo.

The combination drug should be given once daily and continued for as long as the risk of infection persists. If a decision is made to prescribe the drug it should be dispensed as a 90-day supply, renewable only after HIV testing.

Prior to initiation of pre-exposure prophylaxis, all patients should have HIV antibody testing to be certain that they do not have unsuspected chronic HIV infection.

Condoms are highly effective in preventing HIV transmission without the risk of systemic side effects and are an important aspect of any HIV prevention strategy.

    Readers Response
  1. Dear Sir, Initially I used to delete eMedi newS like spam mail, but one day I went through it and now I don't miss to read it. It’s a stimulating combination of knowledge, action, legalities and finally humor and spirituality. Accept my hearty thanks for all efforts, Best wishes: Dr. Sadhana Gupta, Chairperson Safe Motherhood Committee (FOGSI 2011-2013), Senior Consultant Obstetrician & Gynecologist, Jeevan Jyoti Hospital & Medical Research Centre, Bobina Road, Gorakhpur - 273 001.
    Forthcoming Events

Seminar on "Mind and Body in Health and Harmony in Asian Systems of Medicine"

Date: December 11-13, 2012
Venue: India International Centre, New Delhi
Themes of the Workshop: Anatomy, Philosophy, Diagnostics and imbalances, Therapeutics and treatments, Understanding Mind-Body relationships and Preventive and Promotive aspects in the traditional systems of medicine

4th eMedinews Revisiting 2013

(a day long single hall medical conference on 2012 happenings, followed by doctors of the year 2012 awards)

Sunday 20th January 2013, Maulana Azad Medical College Auditorium

Dilli Gate Delhi


Dr KK Aggarwal
Padmashri and Dr B C ROY National Awardee President

Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman

Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

    eMedinewS Special

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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