eMedinewS20th September 2013, Friday

Dr K K 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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); 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);
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Medical Council of India in Constitutional Crisis

The Indian Medical Council Amendment Ordinance 2013, notified on 21st May, which was introduced as Bill in the Rajya Sabha by the Central Government could not be passed in the monsoon session of the Parliament.

As per Article 123 of the Constitution of India, if an ordinance is not passed by the Parliament, it will lapse after six weeks of the commencement of the first parliament session after the ordinance is notified. As the Ordinance has not been ratified by the Parliament, it lapsed on 16/09/2013.

This is a very peculiar situation as technically the Board of Governors and thereby MCI has ceased to exist. What will the Government do now?

Mr. Sube Singh, Director MOH Govt. of India on 17th September has written to Chairman BOG that the existing Indian Medical Council (Amendment) ordinance has ceased to operate on 16.09.13. That the government is proposing to promulgate a fresh ordinance so that the work already done by the board of governors of the council as per provisions of the earlier ordinance gets validated and may continue and until the fresh Ordinance is promulgated, the BOG is requested not to convene any meeting from 16.09.13 and not take any major decision.

Therefore the health ministry is proposing to promulgate a fresh ordinance but it may not be easy as the present President may not like to enter into a controversy especially at a time when the elections are near, as there is not a single instance since 1950 till today, wherein the President of India has re-promulgated any Ordinance after its expiry.

The current ordinance gave the new Board of Governors a period of six months and was to lapse on 12th November, 2013 subject to approval of both the Houses of Parliament.

If the President of India does not re–promulgate this ordinance, the present constitutional crisis presents limited options for the government, which includes letting it lapse and come out with other modified fresh ordinance or re–install the MCI, which preceded by the first ordinance in 2010.

The term of the present Board of Governors, which ends on 12th November, can also be extended for another six months by a fresh ordinance to be passed in winter session (again the president of India may not like to do that)

The lapsed Ordinance was passed on 21st May 2013 effective retrospectively from 15th May 2013 and carried nearly 40 amendments in the Indian Medical Council Act, 1956.

It is not so that other Bills were not passed by the Parliament. It appears that most of the political parties other than the ruling one were not in favor of passing the amendment in its present state.

The present constitutional crisis has limited options for the Government, either to re promulgate the ordinance (which has not happened in the history since 1950 and the president may not like to enter in this controversy); come out with other modified fresh ordinance or re–install the MCI which was superseded by the first ordinance in 2010. The present Board of Governors term which ends on 12th November, can also be extended for another six months by a fresh ordinance to be passed in winter session.

The present Government any way has been able to carry what they wanted for over three years by carrying forward the ordinances (four till now and fifth if a new one is introduced), an action which may be considered somewhat unconstitutional. In the history of India, such a situation did arise when Supreme Court had to intervene to stop the Bihar Government from the practice of re-promulgating ordinances every six months.

The present amendment Ordinance /Bill, which is being opposed by the most of the political parties, takes away the entire autonomy of the council. If the present amendment bill is passed, the Central Government will be the final authority on each and every issue of MCI whether it relates to policy or not.

Sequence of events in MCI

  1. 15th May, 2010: MCI was superseded in exercise of the powers conferred by sub–section (1) of section 3A of the Indian Medical Council Act, 1956 (102 of 1956) and the President, Vice–President and all other Members of the said Council vacated their offices.
  2. 15th May, 2010: On supersession of the Council, the Central Government constituted the Board of Governors vide notification S.O.1123 (E) to perform the functions of the Council during the interregnum.
  3. 15th May, 2010: The health minister assured that within one year the MCI would be reconstituted but it did not happen and the term of the Board of Governors was extended to two years by the Indian Medical Council (Amendment) Act, 2011 (13 of 2011) and it was further extended up to three years by the Indian Medical Council (Amendment) Act, 2012 (20 of 2012), with effect from 15th May, 2010. It is significant to note that the Central Government had done nothing and had not initiated any measure to reconstitute MCI during this entire period of 3 years in spite of repeated assurances and promises.
  4. 14th May, 2013: The three year term of the Board of Governors expired.
  5. 19th March, 2013: The Indian Medical Council (amendment) Bill was introduced in the Rajya Sabha and is pending in that house.
  6. 21st May, 2013: To circumvent the above, the government brought Indian Medical Council (amendment) Ordinance 2013.
  7. 21st May, 2013: The board was reconstituted in accordance with the provisions of the Indian Medical Council (Amendment) Ordinance, 2013 (4 of 2013), which was promulgated by the President on the 21st May, 2013, which came into force with effect from the 15th day of May 2013.
  8. Section 3AA of the said Act, as inserted by the said Ordinance, requires the Central Government to reconstitute the Council under sub–section (1) of section 3 within a period of one hundred and eighty days with effect from the 15th day of May, 2013.
  9. The proviso to section 3AA provides that the Board of Governors constituted under sub–section (4) of section 3A shall continue to exercise the powers and perform the functions of the Council till the new Council is reconstituted or for a period not exceeding one hundred and eighty days with effect from the 15th day of May, 2013, whichever is earlier.
  10. The Indian Medical Council (Amendment) Ordinance, 2013 (4 of 2013) was to be passed in the monsoon session by both the houses of the parliament and but the same did not happen.
  11. 16th September, 2013: The present Ordinance lapsed thereby forcing a constitutional crisis as the Board of Governors and thereby the MCI has ceased to exist.
  12. 16th September, 2013: Sube Singh, Director MOH Govt. of India wrote to Chairman BOG, MCI (F No V 11011/1/2013-MEP–1(pt) dated 17th September) "with reference to the above cited subject that the existing Indian Medical council (Amendment) ordinance, 2013 would cease to operate on 16.09.
  13. The government is proposing to promulgate a fresh ordinance so that the work already done by the board of governors of the council as per provisions of the earlier ordinance gets validate and may continue. In view of the forgoing, until the fresh Ordinance is promulgated the BOG is requested not to convene any meeting from 16.09.13 not take any major decision. This issues with the approval of joint secretary (VM).

The root cause of MCI illness

Going back to the history, the first amendment in 2010 came when the then president of MCI Dr. Ketan Desai was taken into custody by CBI on 22nd April 2010 on the allegation of taking a bribe for recommending permission to Gian Sagar Medical College Patiala to admit 100 students of 4th Batch, in spite of having deficiencies. On the very next day of the arrest of Dr. Desai, CBI had conducted spot verification with the team of expert doctors and videographers at Gian Sagar Medical College Patiala and interrogated number of officers and Doctors. Now, CBI has filed its report in the competent court along with the copy of videography and stated that college had all requisite facilities except deficiency of auditorium.

Three days after Dr. Desai was taken into custody, on the direction of Union Health Minister Mr. Ghulam Nabi Azad, a high level committee of 3 members under the Chairmanship of present Health Secretary Mr. Keshav Desiraju along with Dr. Rani Kumar, Dean of AIIMS, New Delhi and Dr. A K Agarwal, Dean, Maulana Azad Medical College, New Delhi, was constituted to examine the validity/correctness of the recommendation and report made by MCI of this college. This committee had conducted the Inspection on 29th April and submitted its report on 3rdMay 2010 to the Health Ministry. This committee in its report had stated that the permission recommend by MCI was justified and also observed that the existing facilities and faculty in the College appear more than adequate for Undergraduate teaching. The committee had also observed the nonexistence of auditorium in its reports. This report was sent to Director, CBI by the Health Secretary on 11th of May 2010. The question which arises is that when the Inspection Report of the above hospital was found to be correct by both the CBI and Health Ministry and there were no other complaints against MCI or against any of its members than what was the need for the Central Government to supersede the Council at that juncture? However, the Government went ahead superseding the MCI and constituted a Board of Governors of six members under the chairmanship of Dr. Shiv K. Sareen.

Thereafter, the Health Ministry had also requested the Board of Governors of MCI to review the report of MCI and take final decision. Board of Governors had also conducted inspection and had also observed that college does not have auditorium and granted the permission for 4th Batch on 12th July 2010. The officials of MCI had clarified that the utility of auditorium was for cultural programs and convocation ceremony held once or twice in a year and as per the rules it is required at the time of permission for 5th Batch whereas this college was recommended for 4th Batch. However Supreme Court had stayed all further proceedings in this matter on 3rd January 2013.

Further, CBI on the same day when Dr. Desai was taken into custody had conducted raids at various premises, Residence, Bank lockers, office etc., of Dr. Desai at Delhi and Ahmedabad. Very wide publicity in all media and TV channels was given for several days that Dr. Desai was caught red handed while accepting bribe and huge assets like 1800 Cr. or 1.5 Tonnes of Gold were found from Dr. Desai. However, as per CBI report the fact is that Dr was not at all caught red handed for accepting bribe and during these searches, as per CBI seizure memo, only total 53,600 rupees were found from all his premises and gold jewelry of about 3.5kg was found. Significantly, even CBI in its report after detailed investigations of over 2 years had stated that this 3.5 kg Gold was already declared to the Income tax department in the year 1997.

Immediately thereafter in May 2010, CBI registered a case of Disproportionate Assets for a period from 1997 to April 2010 (13 years) against Dr. Desai and his family members. Dr. Desai’s wife is also a Doctor and running her own Maternity hospital since last 22 years and his late father was in real estate business. While filing the FIR in the disproportionate assets case, CBI had projected assets of about 233% more than the income during this period of 13 years. After detail investigation for almost 2 years, CBI in the month of May 2012 had filed the closure report with all documents and seizure memos in the competent CBI court in New Delhi. Seizure memos of all premises revealed that no unaccounted cash money or bribe money was found either from Dr. Desai or from his office as well as from his residence at Delhi and Ahmedabad. CBI in its report had stated that they have investigated all the income and assets of Dr. Desai and his family members for the period from 1/1/1997 to April 2010 (about 13 years) and came to the conclusion that Dr. Desai and his family are not in possession of any assets or financial resources disproportionate to their known and legal sources of income. CBI in its report had also stated that while filing the FIR they had inadvertently made certain incorrect calculations and added the amount of shares worth of crores, which did not actually exist. CBI in its report had further stated that they had inadvertently not included the income from the known and legal sources including loan from Banks. With these findings CBI had requested the competent court to accept the closure report. After number of hearings in December 2012, the CBI court had accepted report of CBI and ordered for release of all documents, Bank accounts and material seized. However, very little publicity was given to this fact and today there would be many people who would still have the old impression in their mind about earlier news of huge cache of gold and cash which was very widely publicized.

Subsequently, FIRs were filed by CBI against Dr. Ketan Desai linked to various medical colleges at Kolkata, Hyderabad, Chennai and at Lucknow. Preliminary inquiries were also started by CBI in many other medical colleges. After detailed investigations, CBI had filed closure repot in all preliminary inquiries as no irregularities were found. CBI had also filed a closure report giving clean cheat to Dr. Desai in cases of FIR's filed at Kolkata, Hyderabad and in both cases at Chennai.

MCI later suspended the license of Dr. Ketan Desai on the ground of pending criminal charges including DA case which is now closed. Another question which comes is, in the Gian Sagar Medical College case, why did the MCI take action only against Dr. Ketan Desai and not against Dr. Sukhvinder Singh and Dr. Suresh Shah against whom the charges were same and were co-accused in the same FIR?

Gujarat Medical Council did not agree to the decision of the MCI and did not suspend the license of Dr. Desai and this decision of GMC was conveyed to MCI on 21st December 2010 and till now has not been challenged/disputed by the MCI.

Questions which the Government must answer

The entire above narration clearly suggests that the Government is solely responsible for this sordid saga. Several questions come to my mind. It is high time that some forthright answers should come from the Government to these questions.

  1. When Dr. Desai was arrested and his home and office were searched, wide publicity was given to apparently false figures of huge collection of cash and Gold. However, when nothing could be found and CBI had to file closure report which was accepted by the Court, almost none or very little publicity was given. Why such a discriminatory attitude?
  2. MCI was superseded on the pretext of arrest of its President on the allegation of showing undue favors to a private college in Punjab – i.e. Gian Sagar Medical College, Patiala. However, three inspections were later conducted independently by teams of CBI, of Central Government headed by present Health Secretary Mr. Keshav Desiraju and of Board of Governors nominated by the Central Government within time frame of 3 months. All these 3 inspection teams of CBI, Central Government and the Board of Governors came to identical conclusion that the teaching facilities and infrastructure at this institute were adequate except for the auditorium, which was not required at this stage. The Board of Governors also granted renewal of permission for admission of new batch of students. This implies that the earlier findings of MCI inspection team were correct and no irregularity was committed. In this view of facts, why was the MCI superseded in the first instance? What was the necessity of superseding MCI when there were no allegations against any other member of MCI or when there was not even an iota of evidence against any other member of MCI?
  3. Even after the MCI was superseded, the Health Minister had repeatedly promised that it would be reconstituted soon. Such assurances were also given on the floor of Parliament. However, nothing was done by Central Government for 3 years to reconstitute the MCI. If this is not flagrant violation of promises made to public and of assurances given on the floor of parliament, what else is it?
  4. If the present amendment bill or the ordinance is passed, the Central Government will be the final authority on each and every issue of MCI whether it relates to policy or not. Why is the Government hell bent on destroying the autonomy of MCI?

Some Important Issues

Q: Under which powers can the President of India bring an ordinance?

A: Article 123 of the Constitution enables the President of India to promulgate an ordinance if neither House of Parliament is in session and “circumstances exist, which render it necessary for him to take immediate action”. Every ordinance has to be laid before Parliament, and ceases to exist six weeks from the end of the next sitting of Parliament.

Since the Constitution mandates that Parliament be called into session at least once every six months, ordinances have a de facto expiration period of approximately seven and a half months. Article 213 gives the same power to the Governor of a State.

Q: When were these powers instituted?

Ordinance-making power is not a new feature added to the Indian Constitution. Articles 42 and 43 of the Government of India Act, 1935, gave the same power to the Governor General.

Q: Can these powers be misused?

Hriday Nath Kunzru and Professor K.T. Shah called for restricting the executive’s power to promulgate ordinances through greater oversight by legislatures. They were, however, overruled by Dr B.R. Ambedkar, who stated that ordinance–making powers were necessary since existing law might be deficient to deal with a situation "which may suddenly and immediately arise". According to him, the only solution was to "…confer upon the President the power to promulgate a law which will enable the executive to deal with that particular situation because it cannot resort to the ordinary process of law…" when the legislature was not in session.

Q.: What is article 123?

Central Government Act: Article 123 in the Constitution of India 1949

123. Power of President to promulgate Ordinances during recess of Parliament

  1. If at any time, except when both Houses of Parliament are in session, the President is satisfied that circumstances exist which render it necessary for him to take immediate action, he may promulgate such Ordinance as the circumstances appear to him to require
  2. An Ordinance promulgated under this article shall have the same force and effect as an Act of Parliament, but every such Ordinance
    1. shall be laid before both House of Parliament and shall cease to operate at the expiration of six weeks from the reassemble of Parliament, or, if before the expiration of that period resolutions disapproving it are passed by both Houses, upon the passing of the second of those resolutions; and
    2. may be withdrawn at any time by the President Explanation Where the Houses of Parliament are summoned to reassemble on different dates, the period of six weeks shall be reckoned from the later of those dates for the purposes of this clause
  3. If and so far as an Ordinance under this article makes any provision which Parliament would not under this Constitution be competent to enact, it shall be void CHAPTER IV THE UNION JUDICIARY

Q: Can one misuse ordinances and bring them again and again?

D.C. Wadhwa v/s State of Bihar relates to the State of Bihar promulgating and re–promulgating ordinances on a "massive scale". Between 1967 and 1981, as many as 256 ordinances were promulgated and re–promulgated, and some of them continued to exist this way for up to 14 years.

Q.: Can the court strike down an ordinance?

The power of review over ordinances was implicitly taken one step further in 1998 in the case of Krishna Kumar Singh v/s State of Bihar, where the court struck down a number of ordinances, stating that no basis for the exercise of ordinance–making power had been shown. It stated explicitly: "There is also no explanation offered for promulgating one ordinance after another."

Q.: What can happen to an ordinance?

After the ordinance is notified it is to be laid before Parliament within 6 weeks of its first sitting. Parliament could either choose to pass the ordinance, disapprove it or it may lapse within the 6-week time frame. In addition, the President may chose to withdraw the ordinance.

Q.: What happens to an ordinance in ordinary course?

Once an ordinance is framed, it is to be laid before Parliament within six weeks of its first sitting. Parliament is empowered to either choose to pass the ordinance as law or disapprove it or let it lapse. Once the ordinance is laid in Parliament, the Government introduces a bill addressing the same issue. This is typically accompanied by a memorandum tabled by the government, explaining the emergent circumstances that required the issue of an ordinance. Thereafter, the bill follows the regular law-making process. If Parliament does not approve the ordinance, it ceases to exist.

Q.: Is there a Supreme Court Judgment on the matter of Government repeatedly re-promulgating the Ordinances?

In the 1980s, the Supreme Court was confronted with a case where a state government repeatedly re–promulgated ordinances that had lapsed in previous assembly sessions. This led the Supreme Court to examine the ordinance–making power of Government. The Supreme Court reasserted the constitutional principle that the primary law–making power rests with the legislature and not the executive. The executive is only given the legislative power to issue an ordinance to meet an "emergent situation".

Q.: Are there examples when the ordinances have lapsed as they were not passed by the government?

In 2004, a week after the winter session ended, the government issued an ordinance to give the Pension Fund Regulatory and Development Authority statutory powers as a regulator. Due to political opposition, the ordinance lapsed and, subsequently, the bill lapsed at the end of the 14th Lok Sabha.

Supreme Court of India; Dr. D.C. Wadhwa & Ors v/s State Of Bihar &Ors on 20 December, 1986 (Equivalent citations: 1987 AIR 579, 1987 SCR (1) 798), Bhagwati, P.N, J

  1. The State of Bihar adopted a practice of re–promulgating the ordinances on a massive scale from time to time without their provisions being enacted into acts of the legislature.
  2. The practice was that, after the session of the State Legislature was prorogued, the same ordinances which had ceased to operate were re–promulgated containing substantially the same provisions almost in a routine manner.
  3. The petitioners challenged the validity of this practice and in particular they challenged the constitutional validity of three different ordinances issued by the Governor of Bihar.
  4. These Ordinances suffered the same process of re-promulgation from time to time.

HELD

  1. The Bihar Intermediate Education Council Ordinance 1983 which is still in operation is struck down as unconstitutional and void.
  2. The Governor cannot assume legislative function in excess of the strictly defined limits set out in the Constitution because otherwise he would be usurping a function which does not belong to him. (818F–G)
  3. In the instant case, the executive in Bihar has almost taken over the role of the Legislature in making laws not for a limited period but for years together in disregard of the constitutional limitations. This is clearly contrary to the constitutional scheme and it must be held to be improper and invalid. It is hoped and trusted that such practice shall not be continued in the future and that whenever an Ordinance is made and the Government wishes to continue the provisions of the Ordinance in force after the assembling of the Legislature, a Bill will be brought before the Legislature for enacting those provisions into an Act. There must not be Ordinance––Raj in the country.
  4. The power conferred on the Governor to issue Ordinances is in the nature of an emergency power which is vested in the Governor for taking immediate action where such action may become necessary at a time when the Legislature is not in session.
  5. The primary law making authority under the Constitution is the Legislature and not the Executive but it is possible that when the Legislature is not in session, circumstances may arise which render it necessary to take immediate action and in such a case in order that public interest may not suffer by reason of the inability of the Legislature to make law to deal with the emergent situation, the Governor is vested with the power to promulgate ordinances. But every ordinance promulgated by the Governor must be placed before the Legislature and it would cease to operate at the expiration of six weeks from the reassembly of the Legislature or if before the expiration of that period a resolution disapproving it is passed by the Legislative Assembly and agreed to by the legislative Council, if any. The object of this provision is that since the power conferred on the Governor to issue Ordinances is an emergent power exercisable when the Legislature is not in session, an Ordinance promulgated by the Governor to deal with situation which requires immediate action and which cannot wait until the legislature reassembles, must necessarily have a limited life.
  6. The power to promulgate an Ordinance is essentially a power to be used to meet an extraordinary situation and it cannot be allowed to be "perverted to serve political ends". It is contrary to all democratic norms that the Executive should have the power to make a law, but in order to meet an emergent situation, this power is conferred on the Governor and an Ordinance issued by the Governor in exercise of this power must, therefore, of necessity be limited in point of time.
  7. That is why it is provided that the Ordinance shall cease to operate on the expiration of six weeks from the date of assembling of the Legislature. The Constitution makers expected that if the provisions of the Ordinance are to be continued in force, six weeks time should be sufficient for the Legislature to pass the necessary Act. But if within this time the Legislature does not pass such an Act, the Ordinance must come to an end.
  8. The Executive cannot by taking resort to an emergency power exercisable by it only when the Legislature is not in session, take over the law–making function of the Legislature. That would be clearly subverting the democratic process which lies at the core of our constitutional scheme, for then the people would be governed not by the laws made by the legislature as provided in the Constitution but by laws made by the Executive.
  9. The Government cannot by–pass the Legislature and without enacting the provisions of the Ordinance in an Act of the Legislature, re–promulgate the ordinance as soon as the Legislature is prorogued.
  10. A constitutional authority cannot do indirectly what it is not permitted to do directly.
  11. If there is a constitutional provision inhibiting the constitutional authority from doing an act, such provision cannot be allowed to be defeated by adoption of any subterfuge. That would be clearly a fraud on the constitutional provision.
  12. When the constitutional provision stipulates that an Ordinance promulgated by the Governor to meet an emergent situation shall cease to be in operation at the expiration of six weeks from the reassembly of the Legislature and the Government if it wishes the provisions of the Ordinance to be continued in force beyond the period of six weeks has to go before the Legislature which is the constitutional authority entrusted with the law making function, it would most certainly be a colourable exercise of power for the Government to ignore the Legislature and to re–promulgate the Ordinance and thus to continue to regulate the life and liberty of the citizens through Ordinance made by the Executive. Such a stratagem would be repugnant to the constitutional scheme, as it would enable the Executive to transgress its constitutional limitation in the matter of law making in an emergent situation and to covertly and indirectly arrogate to itself the law making function of the Legislation.
  13. The question is not of satisfaction of the Governor in issuing an Ordinance. The only question is whether the Governor has power to re–promulgate the same Ordinance successively without bringing it before the Legislature. That clearly the Governor cannot do. (818B–C) Bharat Singh v. Empire, AIR 1931 PC 111; Rajaram Bahadur Kamlesh Narain Singh v. Commissioner of Income Tax, AIR 1943 PC 153; Laxmidhar Misra v. Rangalal & Ors., AIR 1950 PC 59 and R.C. Cooper v. Union of India, (1970) 3 SCR 530.
  14. It is significant to note that so far as the President of India is concerned, though he has the same power of issuing an Ordinance under Article 123 as the Governor has under Article 213, there is not a single instance in which the President has, since 1950 till today, re–promulgated any Ordinance after its expiry.
  15. There must not be Ordinance––Raj in the country.

….Read More

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."


VIP’s on CPR 10 Mantra Video
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Ringtone – CPR 10 Mantra Hindi

Ringtone – CPR 10 Mantra English

sprritual blog Shradhs in Hindu Mythology

Shradhs are observed by every family in Indian Hindu culture to seek forgiveness from the deceased person and ancestors for their unfulfilled known or unknown desires.

Traditionally, people observe shradh either on the day of Amavasya every month or on the day of death anniversary of the deceased person or persons or during Shradh days observed in Chaturmas coinciding with the Hindi Tithi or the date on which the deceased died. Shradhs are observed till Mahashradh is observed, which is usually at a place near Ganga in Gaya, Pushkar, Haridwar etc.

In mythology, mind is linked with ocean, river or water. Most Mahashradhs are held near sacred water as it requires the process of purification of the mind away from home so that one can relax and not only take one holy bath but also take an internal bath of meditation and self–confession. Medically, Shradh is a type of an attachment disorder or guilt disorder where either you are attached to the thoughts of the diseased person which keep on disturbing in the day to day life and during dreams or you have a guilt that you have not been able to fulfill some of the desires of the diseased persons and that guilt keeps reminding you all the time in your day to day activity or in the dreams.

Shradh is a way or a reminder to you or your consciousness to fulfill and complete the incomplete jobs and finish up all the pending works. Sometimes doing this job may take time and that is the reason why Mahashradhs are done once or twice in a lifetime for a particular diseased person.

Whenever an auspicious ritual or ceremony is held, we also seek blessings from our ancestors. For example, before marriage, it is a ritual to do pooja of ancestors and take their blessings, which only means that we want to get rid of in our mind the self confession and seek forgiveness from our ancestors that please don’t disturb our mind or in emotions at this juncture of our function and we are aware of the pending work which you asked us to do in future.

Typically, a Shradh ceremony involves self confession and pooja of black sesame seeds or consuming black sesame seeds. Black sesame seeds in Ayurveda are known for their quality of absorbing negative energies both external and internal. Once the pending job is over and in the mind of the family or the person all the assigned works are finished, then they usually go to one of the pilgrimages for Mahashradh, which is like a Mahapind Daan. Remember people usually say – Ab to mera pind chhod do, which means please stop coming in my dreams and reminding me of my pending works.

Shradhs are also for unknown unfulfilled desires of our ancestors. When I say unknown desires, it means the desires which are unknown to the present family but maybe were known to the past family. This can only be understood by computer module where my soul is my internet server and spirit has the God as cloud internet. Both my internal server and cloud servers will have a social networking page of mine and will also have my page even if my physical body dies. Similarly, all the social pages of my ancestors will be present in the cloud internet. So, unfulfilled desires will always be posted there. People of my family or those who know me can get connected to that page and know that there were some unfulfilled desires which are yet to be fulfilled by my family and that keeps coming to us in the form of message from our friends that you are suffering due to unfulfilled desires which they might have read from that particular page and that is the reason why there is always a forgiveness seeking exercise during Shradh for those known and unknown unfulfilled desires of our ancestors. ….Read More

cardiology news

Words of Wisdom

Words of great wisdom, The Native American Code of Ethics:

  1. Rise with the sun to pray. Pray alone. Pray often. The Great Spirit will listen, if you only speak.
  2. Be tolerant of those who are lost on their path. Ignorance, conceit, anger, jealousy and greed stem from a lost soul. Pray that they will find guidance.
  3. Search for yourself, by yourself. Do not allow others to make your path for you. It is your road, and yours alone. Others may walk it with you, but no one can walk it for you.
  4. Treat the guests in your home with much consideration. Serve them the best food, give them the best bed and treat them with respect and honor.
  5. Do not take what is not yours whether from a person, a community, the wilderness or from a culture. If it was not earned or given, it is not yours.
  6. Respect all things that are placed upon this earth – whether it be people or plant.
  7. Honor other people’s thoughts, wishes and words. Never interrupt another or mock or rudely mimic them. Allow each person the right to personal expression.
  8. Never speak of others in a bad way. The negative energy that you put out into the universe will multiply when it returns to you.
  9. All persons make mistakes. And all mistakes can be forgiven.
  10. Bad thoughts cause illness of the mind, body and spirit. Practice optimism.
  11. Nature is not FOR us, it is a PART of us. They are part of your worldly family.
  12. Children are the seeds of our future. Plant love in their hearts and water them with wisdom and life’s lessons. When they are grown, give them space to grow.
  13. Avoid hurting the hearts of others. The poison of your pain will return to you.
  14. Be truthful at all times. Honesty is the test of ones will within this universe.
  15. Keep yourself balanced. Your Mental self, Spiritual self, Emotional self, and Physical self – all need to be strong, pure and healthy. Work out the body to strengthen the mind. Grow rich in spirit to cure emotional ails.
  16. Make conscious decisions as to who you will be and how you will react. Be responsible for your own actions.
  17. Respect the privacy and personal space of others. Do not touch the personal property of others – especially sacred and religious objects. This is forbidden.
  18. Be true to yourself first. You cannot nurture and help others if you cannot nurture and help yourself first.
  19. Respect others religious beliefs. Do not force your belief on others.
  20. Share your good fortune with others. Participate in charity.

….Read More

News Around The Globe

5th Dil Ka Darbar

Date: Sunday, 29th September 2013, Venue: Constitution club of India, Rafi Marg, Time: 8 AM to 6 PM

Programme: A non stop question answer–session between all top cardiologists of the NCR region and the public.

The focus of the discussions will be prevention of heart diseases in women and young men. Special discussion will be held on Sex and Heart Diseases. Practical training will also be given to people on Hands–only Cardiopulmonary Resuscitation. Another focus of the discussion will be the launch of the Project Dhadkan (Palpitations) and Project Murmur (Congenital and valvular heart diseases in children).

Entry free…

  • Exposure to a compound found in fish oil may protect against the development of dementia in heavy drinkers. A study presented at the recent Congress of the European Society for Biomedical Research on Alcohol in Warsaw, Poland, examined rat brain cells exposed to alcohol levels equivalent to 4 times the legal driving limit. Results showed that the cell cultures that were also exposed to omega–3 docosahexaenoic acid (DHA) showed approximately 90% less neuroinflammation and 90% less neuronal brain cell death compared with the cells that were not exposed to the fish oil compound.
  • A study from the University of California Berkeley–University of San Francisco Joint Medical Program in San Francisco found that social isolation is a risk factor for premature death for both sexes that rivals more traditional mortality risk factors of smoking and high blood pressure. The study was published online September 12 in the American Journal of Public Health. Lead investigator Matthew Pantell, MD, and colleagues state that the power of isolation as a marker of poor health cannot be ignored.
  • A small molecule, 2–aminoadipic acid or 2–AAA detected by a novel technique appears to be a marker for an increased risk of developing type 2 diabetes. Raised levels of 2-AAA were associated with about a four–fold risk of developing diabetes, Robert Gerszten, MD, of Massachusetts General Hospital in Boston and colleagues reported online in the Journal of Clinical Investigation. Also the elevated levels were detectable more than a decade before the onset of diabetes, suggesting its role as a biomarker.
  • Extended, moderate exercise produced better blood sugar control than several short walks, but the latter may still have a role in diabetes treatment. Luc J. C. van Loon, PhD, of Maastricht University Medical Center in The Netherlands, and colleagues report online in Diabetes Care that men with type 2 diabetes who performed a single 45-minute moderate exercise routine each day spent less time in hyperglycemia over a 24–hour period than sedentary controls (4 hours and 47 minutes versus 6 hours and 51 minutes. Bursts of activities of daily living (ADL) defined as three 15–minute walks meant to reflect light activities such as walking the dog, household tasks, and light gardening were also associated with less time spent in hyperglycemia (6 hours and 2 minutes), but not to a significant extent.
  • A new test that analyzes patients’ immune responses, rather than the pathogens themselves, can rapidly distinguish viral infections from bacterial infections. According to an article published in the September 18 issue of Science Translational Medicine, if carried into clinical use after further evaluation, the assay could help physicians better decide which patients need antibiotics and avoid inappropriate prescribing of antibiotics to patients who will not benefit.

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Rabies News (Dr. A K Gupta)

If HRIG is not available, can human normal immunoglobulin (polyvalent) be given?

Human normal immunoglobulin cannot be a substitute for HRIG.

cardiology news
  • Results of a new study have yet again found a link between positivity plus exercise to lower CVD mortality. The association between a positive emotional state of mind and lower mortality in patients with ischemic heart disease is mediated by exercise, according to the study. Patients with higher levels of positive affect, which reflects a pleasurable response to the environment and typically includes feelings of happiness, joy, excitement, contentment, and enthusiasm, had a 42% lower risk of all–cause mortality at five years and were 50% more likely to participate in an exercise program than those with lower levels of positive affect. Heart–disease patients often have higher rates of depression, anxiety, and other negative affective states, and these negative emotions have all been associated with adverse cardiac events, including hospitalizations and mortality. The study is published online September 10, 2013 in Circulation.
  • A meta–analysis reported online in the journal Neurology that vitamin B supplementation may modestly help reduce stroke risk, though largely for patients who don't fit the typical U.S. stroke prevention profile. The risk of stroke was 7% lower overall with B vitamin supplements due to reduction in homocysteine levels. The effect appeared of borderline significance in the absence of folate (vitamin B9) fortification of grain products but wasn’t significant for populations already getting the vitamin in their food supply

Valvular Heart Disease News

The commonest source of infection in endocarditis is infected vascular catheter, dental abscesses or infected skin legion.

(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)

cardiology news
  • Pooled data from six longitudinal studies involving 3,911 children concluded that victims of schoolyard bullying faced an approximately doubled risk of physical health problems compared with nonbullied children followed for up to 11 years. The odds ratio was 2.39 for complaints such as headache, disordered sleep, and abdominal pain in those who reported being bullied at school compared with those not reporting bullying. Findings from another 24 cross–sectional studies were similar, with an odds ratio for physical symptoms of 2.17 in pooled data on a total of more than 200,000 children.
  • Routine genetic testing for maturity–onset diabetes of the young (MODY) could be cost–effective or even save money, depending on the price of the test and the prevalence of MODY in the population screened. Rochelle N. Naylor, MD, from the University of Chicago and colleagues, who reported their findings online September 11 in Diabetes Care said that genetic screening is not typically covered even for the 50% of patients who meet classic MODY criteria and is therefore not typically practiced. The various MODY genetic types together account for about 1% to 2% of all diabetes cases but are often misdiagnosed as either type 1 or type 2 diabetes, resulting in overtreatment or unnecessary therapy.
cardiology news

ABO blood type is a risk factor for coronary heart disease

Two prospective cohort studies have identified the ABO blood group as a risk factor for the development of heart disease. People with blood groups A, B, or AB were 5–23% more likely to develop coronary heart disease compared with those with O blood type. The study by Dr Meian He from Harvard School of Public Health, Boston, MA included 62 073 women from the Nurses’ Health Study (NHS) and 27 428 men from the Health Professionals Follow–up Study (HPFS) and is published in the September 2012 issue of Arteriosclerosis, Thrombosis, and Vascular Biology.

In the NHS and HPFS, the incident rates of coronary heart disease per 100 000 person-years were 125, 128, 142, and 161 for women with type O, A, B, and AB, respectively, and 373, 382, 387, and 524 for men with type O, A, B, and AB, respectively. Compared with individuals with O blood type, individuals with blood group A, B, or AB had a respective 5%, 11%, and 23% increased risk of developing coronary heart disease in an age-adjusted model.

In non–O individuals, plasma levels of factor VIII–von Willebrand factor (vWF) are approximately 25% higher than in individuals with type O blood type. Elevated levels of factor VIII–vWF have been previously identified as a risk factor for coronary heart disease. The vWF has an important role in hemostasis and thrombosis by mediating platelet adhesion to the vascular wall, especially under high shear stress conditions.

cardiology news

Total CPR since 1st November 2012 – 63400 trained

CPR Classes 63400

Media advocacy through Print Media

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29th August: Veer Arjun

Media advocacy through Web Media

When Constipation May be a Serious Problem 30th August

NETLOG, FREEPRESS RELEASE, PRLOG, FREEPRESSINDEX , AFRICANNEWSWIRE

TB more dangerous than FLU 29th August

NETLOG, FREEPRESS RELEASE, PRLOG, AFRICANNEWSWIRE

High BP in pregnancy increases risk for future atherosclerosis

Women who have hypertension during pregnancy are at increased risk of developing atherosclerosis when they are older said Dr. K K Aggarwal, President, Heart Care Foundation of India and MTNL Perfect Health Mela.

Quoting a study from The Netherlands, and a report published in Hypertension, Dr Aggarwal said that hypertension in pregnancy acts as a kind of "nature’s cardiovascular stress test" showing vulnerability to future disease.

Gestational hypertension leads to 57% increased risk of calcification

Gestational hypertension normally resolves following the birth, and blood pressure returns to normal. But women with elevated blood pressure during pregnancy are at higher risk of hypertension, diabetes, and cardiovascular disease later in life.

491 healthy postmenopausal women selected from participants enrolled in the PROSPECT (Predictors of Response to Cardiac Resynchronization Therapy) study from 1993–1997 were evaluated.

Women with a history of gestational hypertension had an almost 60% increased risk of having coronary calcification several decades later compared with women who had normal blood pressure during pregnancy.

The relationship held for women who had mild elevations in blood pressure during pregnancy as well as for those who developed preeclampsia — a more serious complication of pregnancy characterized by very high blood pressure, edema, and risk of organ damage.

Hypertension during pregnancy should be an alert for women.

Until now it has been assumed that high blood pressure subsides after pregnancy, and there was no structured follow–up of the women who experienced it.

Hypertensive disorders are common in pregnancy, affecting 2% to 35% of all pregnancies, and ranking among the leading causes of maternal and perinatal morbidity and mortality worldwide. Preeclampsia or gestational hypertension associated with proteinuria is particularly linked with an increased risk for adverse pregnancy outcomes for both the mother and the fetus.

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 63400 people since 1st November 2012.

The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

today emedipics

A press conference was organized by Heart Care Foundation of India to announce the date of Dil Ka Darbar to earmark the World Heart Day on Sunday, 29th September, 2013 at the Constitution Club of India Auditorium.

press release

Cigarettes Hurt women’s Hearts More than Men’s

today video of the dayDr KK Aggarwal Birthday 5th September

Cultural Evening at IMA

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

A 35–year–old male patient with testicular cancer is joking and playing cards with his roommate. When assessed by the pain management nurse, the patient rates his pain as a 7 on a numeric pain rating scale of 0 to 10. The nurse concludes that the patient’s behavior:

1. Is an emotional reaction to the anticipated pain.
2. Is in anticipation of future pain.
3. Is more indicative of the need for pain medication than the pain rating.
4. May be in conflict with the pain rating, and accepts the report of pain.

Yesterday’s Mind Teaser: A 45–year–old male patient reports pain in his foot that moves up along his calf. The patient states, "My right foot feels like it is on fire." The patient further describes that he has no previous history of injuries or falls, and that his pain started yesterday. Which components of pain assessment has the patient reported?

a) Aggravating and alleviating factors
b) Exacerbation, and associated signs and symptoms
c) Intensity, temporal characteristics, and functional impact
d) Location, quality, and onset

Answer for yesterday’s Mind Teaser: d) Location, quality, and onset

Correct answers received from: Prabha Sanghi, Dr Valluri Ramarao. Dr Prakash Khalap,
Dr Sushma Chawla, Narahari Kandakatla, Dr Bitan Sen & Dr Jayashree Sen, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Gurpreet Rekhi, Dr Avtar Krishan, Daivadheenam Jella, Dr Kanta Jain, Dr PC Das, Dr AK Gajjar.

Answer for 18th September Mind Teaser: a) Alcohol

Correct answers received from: Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Gurpreet Rekhi.

Send your answer to ijcp12@gmail.com




medicolegal update

Click on the image to enlarge

medicolegal update

Seen on a famous beauty parlour in Bombay:

Don’t whistle at the girl going out from here. She may be your grandmother!

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A 62–year–old diabetic with coronary artery disease, on treatment for the same, came for follow up.
Reaction: Oh My God! Why didn’t you put him on antioxidants?
Lesson: Make Sure to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects.

medicolegal update

Sunbeams out of the clouds. Faith out of all my doubt. Terri Guillemets

medicolegal update

Dr KK Aggarwal: Eating refined sugar can cause diabetes http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: Why do you stay in prison When the door is so wide open –Rumi

medicolegal update
  1. Dear Editor, Among post graduate specialists, the number of oculo–plastic surgeons is even less in India, so much so that in Delhi these can be counted on fingers. An oculo–plastic surgeon, specializing in orbit and lid surgery can perhaps be called an ocular plastic surgeon, the example being Dr. Maneesh Kumar, consultant at Shroff’ Eye Centre. Regards. Dr. Narendra Kumar, Ophthacare Eye Centre, ophthacare@gmail.com
  2. Dear sir, I am so thankful to Dr Aggarwal and his team that I am regularly being sent this newsletter "Daily eMedinews". Let me confess that I am now so used to that I cannot take breakfast (similar to my newspaper) until I have read some portions of it. You are not only touching the medical complicated stories but also giving stories that change the mind of the readers. I have observed that if mind is at peace, life is beautiful and better in comparison to the big cars, big house or lavish style of living. I do not remember how did I started getting the newsletter (earlier it was in different format) but I am lucky to have it. It is one of those to be subscribed by every one. Congratulations and keep doing this job. All the best. Surinder Lijhara, House No.50, Sector 29, Faridabad 121008

Forthcoming Events

29thSeptember–Dil Ka Darbar at Constitution Club of India,New Delhi

20th Perfect Health Mela from 18th Oct to 22nd Oct at different locations

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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medicolegal update


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