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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 December 2012, Thursday

Biggest Cardiology Stories of 2012 from Heart Wire

Atrial fibrillation

  1. Guidelines are finally recognizing that aspirin is of very little use to prevent stroke in AF patients.
  2. The European and Japanese guidelines have now taken out aspirin completely, and the Canadian and American College of Chest Physicians guidelines have virtually done the same. The ACC/AHA/HRS guidelines will follow.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Even when large volumes are ingested, PEG induced diarrhea is associated with minimal electrolyte losses or gains. PEG 3350 electrolyte solutions are thus safer than osmotic salts such as magnesium and sodium sulfate or phosphate, especially in patients with impaired renal or cardiac function. Attar A, Lémann M, Ferguson A, et al. Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation. Gut 1999;44(2):226

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Weight loss may improve sexual health of obese diabetes

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela 2012

Children from various schools participated with great enthusiasm in Perfect Health Mela

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

70% deaths due to non-communicable diseases by 2020

BHOPAL: By 2020, about 70 per cent of all deaths would be due to non-communicable diseases in the country, according to the experts attending a research methodology workshop at All India institute of medical sciences (AIIMS) Bhopal here on Monday. Those with heart ailments, diabetes, blood pressure and stroke would be vulnerable. "Non-communicable diseases are increasing at an alarming rate. Mere treatment is not the cure. Community intervention through research is needed," said retired AIIMS (Delhi) professor S K Kapoor. "Focus on prevention of non-communicable diseases has been lacking in planning by government," he added. Speaking in favour of clinical drug trials, the veteran community medicine specialist said, "Indian Council for Medical Research (ICMR) has set clear the ethical guidelines for drug trials which needs to be regulated and enforced for betterment of medical research," he added. According to organizers, some 80 doctors are participating in the five-day conference on research methodology. Professor of epidemiology in the department of community medicine at Mahatma Gandhi Institute of Medical Sciences (Wardha) Pradeep Deshmukh said research finding are often not implemented in treatment. "Research is a continuous process and funding has increased over the years. However, implementation of research is still an area where we lack focus." "The effect of non-communicable diseases on urban population is significantly higher as compared to the rural population. As a result, the exorbitant expenditure in urban areas is growing and private sector has to be involved in research," he added. (Source: TOI, Dec 18, 2012)

For comments and archives

65 % of the air pollution deaths occur in Asia and close to quarter of this in India

INDORE: According to Global Burden of Disease (GBD) count, a global initiative involving the World Health Organisation, in South Asia, air pollution is ranked as the sixth most dangerous killer. Around 65 per cent of the air pollution deaths occur in Asia and close to quarter of this in India. Reacting to the findings Centre for Science and Environment (CSE) says air pollution has become one of the top 10 killers in the world. Anumita Roychowdhury, CSE's executive director-research and advocacy and head of its air pollution unit said, "This GBD count on air pollution and its health risks must trigger urgent, aggressive and most stringent action in India to curb air pollution to protect public health. India cannot afford to enhance health risk at a time when much of its economic growth and motorization are yet to happen." The latest GBD results have been produced by a rigorous scientific process involving over 450 global experts and partner institutions including the Institute of Health Metrics and Evaluation, the World Health Organization, the University of Queensland, Australia, Johns Hopkins University, Harvard University and the Health Effects Institute. (Source: TOI, Dec 17, 2012)

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

Concurrent tricuspid valve surgery with chronic MR surgery

Concurrent tricuspid annuloplasty in patients undergoing mitral repair without mitral valve prolapse who have mild to moderate TR and tricuspid annular dilatation or pulmonary hypertension

(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)

Syncope-related risk of death linked to age

Compared with those younger and older, people between 25 and 75 have the greatest risk of death and adverse cardiovascular events in the short- and long-term following a first-time syncope episode, a population-based study found. (Source: Medpage Today)

For comments and archives

Novel 'Pet Scan' quickly scents C. difficile

A dog trained to recognize the odor associated with Clostridium difficile infection successfully identified the presence of the pathogen in stool samples and also in infected hospitalized patients, Dutch researchers reported. (Source: Medpage Today)

For comments and archives

Ponatinib wins early FDA nod

The FDA has approved ponatinib (Iclusig), a third-generation tyrosine kinase inhibitor, to treat two forms of drug-resistant leukemia. The approved indications include chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL) in adults. (Source: Medpage Today)

For comments and archives

No need for skin preps to be sterile, FDA told

Requiring that antiseptic skin preparation products be sterile -- a standard not currently mandated by the FDA -- is unnecessary and wouldn't produce a dramatic drop in infections, manufacturers, clinicians, and policy analysts told the FDA Wednesday. The requirement would instead cause undue burden for companies, manufacturers said at a public hearing on the issue hosted by the FDA. Topical antiseptic products are used before surgery, before an injection, or to reduce the risk of skin infection, but some have been recalled recently because of microbial contamination. There have been roughly 40 reports of contaminated antiseptic products submitted to the FDA, noted Joyce Ryan, DNP, director of clinical affairs at Sage Products in Cary, Ill., which makes antiseptic products. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: I uploaded a @YouTube video http://youtu.be/62i1GkGZJWU?a Savita Gupta at MTNL Perfect Health Mela 2012 on Hands only CPR 10

@DeepakChopra: This episode of THE RABBIT HOLE covers the topic of perceptual reality. Please take a look: http://tinyurl.com/9gpw2p

    Spiritual Update

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

Understanding right speech

The Upanishads, Yogasutra of Patanjali and Gautam Buddha teachings all talk about “the right speech”. As per Gautam Buddha, it has three components:

i. It should be based on truthfulness.
ii. It should be necessary.
iii. It should be kind

For comments and archives

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

What causes hyperprolactinemia?

Prolactin levels increase as a result of:

  • Certain medications, including commonly prescribed antidepressants, antipsychotics, antihypertensives
  • Herbs, including fenugreek, fennel seeds and red clover
  • Chest wall irritation (from surgical scars, shingles)
  • Stress
  • Certain foods
  • Exercise
  • Sleep (prolactin levels are highest at night)
  • Nipple stimulation
  • Hypothyroidism, or underactive thyroid
  • Pituitary tumors. These are usually very tiny, but account for about 30% of all cases of hyperprolactinemia.
    Tat Tvam Asi………and the Life Continues……

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

Blood Grouping systems & Principles, Blood Group Discrepancies & their possible solutions

Natural antibodies

  • Antibodies are formed against most of the major group antigens and are present in almost all individuals when the antigen is absent.
  • In most other minor systems, natural antibodies to the antigens are found occasionally but as their antigenicity is low, the immune antibodies are also rare (except Kell & Duffy).
  • Most of them are IgM type.
  • They react poorly at body temperature (except anti–A & anti–B), but agglutinate RBCs at 5–20°C
  • Usually do not cross placenta.

For comments and archives

    An Inspirational Story

The goose story – teamwork lesson

When you see geese flying along in “V” formation, you might consider what science has discovered as to why they fly that way. As each bird flaps its wings, it creates an uplift for the bird immediately following. By flying in “V” formation, the whole flock adds at least 71 percent greater flying range than if each bird flew on its own. People who share a common direction and sense of community can get where they are going more quickly and easily because they are traveling on the thrust of one another.

When a goose falls out of formation, it suddenly feels the drag and resistance of trying to go it alone — and quickly gets back into formation to take advantage of the lifting power of the bird in front. If we have as much sense as a goose, we will stay in formation with those people who are headed the same way we are.

When the head goose gets tired, it rotates back in the wing and another goose flies point. It is sensible to take turns doing demanding jobs, whether with people or with geese flying south. Geese honk from behind to encourage those up front to keep up their speed.

What messages do we give when we honk from behind?

Finally — and this is important — when a goose gets sick or is wounded by gunshot, and falls out of formation, two other geese fall out with that goose and follow it down to lend help and protection. They stay with the fallen goose until it is able to fly or until it dies, and only then do they launch out on their own, or with another formation to catch up with their group.

If we have the sense of a goose, we will stand by each other like that.

For comments and archives

    Cardiology eMedinewS

Rivaroxaban stands up to standard anticoagulation for VTE treatment
Read More

Weight loss achieved by 2 lifestyle interventions Read More

    Pediatric eMedinewS

Healthy snacks help kids feel full faster Read More

Pediatricians: Keep thimerosal in vaccines Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient came with an eGFR value of 15.
Dr. Bad: You need immediate dialysis.
Dr. Good: Hold on till proper investigations are done.
Lesson: A study published in the Canadian Medical Association Journal shows that starting dialysis too soon can be associated with high mortality.

Make Sure

Situation: A rape victim developed HIV infection.
Reaction: Oh my God! Why was she not given post exposure ART prophylaxis?
Lesson: Make sure all rape victims are counseled for HIV post exposure ART prophylaxis.

    Legal Question of the Day (Dr MC Gupta)

Q. I am a senior FMT specialist. About 4 months ago, an ASI conveyed the verbal request from his boss to get an autopsy performed by a board of doctors and to certify the cause of death as heart attack. My interpretation is as follows:

a. The police have doubted the honesty and integrity of the autopsy surgeon without knowing his identity.
b. The action of the police in making the request amounts to defamation and I can file a case alleging defamation.
c. Many people do not know in which cases other than section 304B, IPC, should autopsy be done by a board of doctors?

What are your comments?


  1. A request for examination by a board of doctors does not mean casting a doubt on somebody’s honesty or integrity or defaming somebody.
  2. There cannot be defamation against a person whose identity is not known.
  3. Section 304B, IPC, has nothing in it regarding a medical board.
  4. There are no clear guidelines regarding when a medical board should be formed. For example, the recent Kerala Medico-Legal Code is silent about it. The fact is that the formation of a board for performing autopsy has to be under written instructions from a court or other competent authority.
  5. An FMT specialist should not take any verbal instructions from anybody.
  6. No professional expert, including an FMT specialist, should ever give up his professional independence as an expert. You would be within your rights to inform the Commissioner Police/SSP about the illegal request made by the ASI, including his “instructions” to report the cause of death as heart attack.
  7. I don’t know what legal objection can the FMT department have if the police make an official request, sustainable in law, that two doctors may perform the post-mortem?
  8. It is true that a trial court has only one judge. However, there is a categorisation of courts as regards jurisdiction to try various offences. Grave offences are tried by a higher court. The parallel to this as regards FMT departments in a medical college will be as follows. If only a single doctor is to perform the autopsy, then the police would make a request in certain cases, such as 304(B)IPC cases, that the autopsy should be performed by the professor and HOD. If this happens, everybody will be happy, including the police, the courts, the residents and junior faculty, the relatives of the deceased etc…………EXCEPT the professors themselves. A senior FMT professor once told me that he knew of several professors who had never performed an autopsy in their life. He also told me that many professors in private medical colleges join (highly paid) jobs on the specific condition that they would not perform autopsies.
  Quote of the Day (Dr GM Singh)

Do not spoil what you have by desiring what you have not; remember that what you now have was once among the things you only hoped for. Epicurus

    Mind Teaser

Read this…………………

Contractures are among the most serious long-term complications of severe burns. If a burn is located on the upper torso, which nursing measure would be least effective to help prevent contractures?

A. Changing the location of the bed or the TV set, or both, daily
B. Encouraging the client to chew gum and blow up balloons
C. Avoiding the use of a pillow for sleep, or placing the head in a position of hyperextension
D. Helping the client to rest in the position of maximal comfort

Yesterday’s Mind Teaser: An intravenous pyelogram reveals that Paulo, age 35, has a renal calculus. He is believed to have a small stone that will pass spontaneously. To increase the chance of the stone passing, the nurse would instruct the client to force fluids and to

A. Strain all urine.
B. Ambulate.
C. Remain on bed rest.
D. Ask for medications to relax him.

Answer for Yesterday’s Mind Teaser: B. Ambulate.

Correct answers received from: Dr Bharat Bhushan Aggarwal, Dr C Mohan, Dr PC Das, Dr Arpan Gandhi, Dr Pankaj Agarwal, Dr Thakor Hitendrsinh G,
Dr Jainendra Upadhyay, Dr Kanta Jain, Dr Avtar Krishan, Prabha Sanghi.

Answer for 17th December Mind Teaser: D. performing active-assistive leg exercises

Correct answers received from: Dr Avtar Krishan, Dr Kanta Jain, Dr Jella.

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)

The paintings

A man was standing in a gallery, studying two near-identical pictures by the same artist. Both showed a glass of wine, a basket of bread rolls, a bowl of salad and a plate of smoked salmon.

Yet one painting was priced $150, the other at $125.

So, he asked the gallery owner to explain why one was more expensive than the other.

"It's simple," said the gallery owner, indicating the more expensive painting.

"You get two extra slices of smoked salmon in that one."

    Medicolegal Update

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

What is the vegetative state?

Complete absence of behavioral evidence for self or environmental awareness

  • There is preserved capacity for spontaneous or stimulus–induced arousal, evidenced by sleep–wake cycles i.e. patients are awake, but have no awareness. This means that the patients appear awake. They have normal heart beat and breathing, and do not require advanced life support to preserve life and cannot produce a purposeful, co–coordinated, voluntary response in a sustained manner, although they may have primitive reflexive responses to light, sound, touch or pain.
  • Patients cannot understand, communicate, speak, or have emotions and unaware of self and environment and have no interaction with voluntarily control passing of urine or stools. They sleep and awaken. As the centers in the brain controlling the heart and breathing are intact, there is no threat to life, and patients can survive for many years with expert nursing care.
  • The following behaviors may be seen in the vegetative state:
    • Sleep–wake cycles with eyes closed, then opened. Patient breathes on her own; Spontaneous blinking and roving eye movements; Produce sounds but no words; Visual pursuit following an object with her eyes; Grimacing to pain; changing facial expression; Yawning; chewing jaw movements; swallowing of own spit; no purposeful limb movements; arching of back; reflex withdrawal from painful stimuli; brief movements of head or eyes toward sound or movement without apparent localization or fixation; startled reaction on a loud sound.

Almost all of these features consistent with the diagnosis of permanent vegetative state were present during the medical examination of Aruna Shaunbag; behavior suggestive of a minimally conscious not vegetative state observed during the examination.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Are food additives bad?

Of thousands of food additives currently in use, only a small number are implicated in allergic or allergic-like reactions. Symptoms include urticaria and/or angioedema, asthmatic reactions and anaphylaxis, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India. Allergy to a nutritive food is far more likely than allergy to an additive, so this must be considered first in the differential diagnosis.

Clues that a patient may be reacting to a food additive

  • Reactions that occur within minutes to a few hours of eating
  • A convincing history of similar reactions to several apparently unrelated foods
  • Reactions to commercially prepared forms of foods that are tolerated when prepared at home.

Symptoms are not caused by food additives but aggravated by them.

  • Sulfites can cause potentially serious asthmatic reactions in as many as 5 percent of patients with asthma, whereas individuals without asthma are rarely affected. Sulfite-sensitive patients more often have severe and/or steroid dependent asthma.
  • Tartrazine avoidance is not necessary in patients with asthma.
  • The preservative sodium benzoate (E211) and the flavorings spearmint, peppermint, and menthol, have each been implicated in causing asthmatic symptoms
  • Anaphylaxis has been reported to annatto (E160b), carmine (E120), saffron, erythritol, guar gum (E412), psyllium, carrageenan, lupine flour, gelatin and pectin. These "natural" additives are derived from plants, insects, or animals and the reactions are believed to be IgE-mediated.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 20815 people since 1st November 2012.

Hands only CPR Training is based on the following CPR Mantra: Quote” Within 10 minutes of death, earlier the better, at least for the next 10 minutes, longer the better, compress the center of the chest of the dead person effectively and continuously with a speed of 10x10 (100 per minutes).” Unquote

    Readers Responses
  1. Dear Sir, Hats off to you and your team of eMedinewS. Regards: Dr Kanta
    Forthcoming Events
Dr K K Aggarwal

4th eMedinews Revisiting 2012

(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

4th eMedinewS Revisiting 2012

The 4th eMedinewS–revisiting 2012 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 20th 2013.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2012. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. All delegates will get Registration Kit, Attractive gifts, Certificates. Morning snacks and lunch will be provided.

Register at: www.emedinews.in/


4th eMedinewS Doctor of the Year Awards

Nominations invited for 4th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2012.

pls send his/her Biodata at: emedinews@gmail.com

    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

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

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

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

Activities eBooks



  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr 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