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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 and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; 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 of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR


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  Editorial …

21st October 2011, Friday

Lifestyle choices in controlling blood pressure

  • Try lifestyle management for up to 6 months. It can alone control BP if initial BP is <160/100 mmHg.
  • Lifestyle interventions have effects similar to single drug therapy.
  • Combinations of two (or more) lifestyle modifications can achieve even better results.
  • Maintain normal body weight. One can achieve a reduction of 5-20 mmHg of BP for every 10 kg weight loss.
  • Consume a diet rich in fruits, vegetables, and low fat dairy products with a reduced content of saturated and total fat. It can reduce a blood pressure of 8-14 mmHg.
  • Reduce dietary sodium intake to no more than 100 mmol per day (2.4 g sodium or 6 g sodium chloride). It can alone reduce BP by 2-8 mmHg.
  • Engage in regular aerobic physical activity such as brisk walking (at least 30 min per day, most days of the week). This can alone reduce BP by 4-9 mmHg.
  • One should limit consumption of alcohol to no more than 2 drinks (1 oz or 30 mL ethanol; e.g., 24 oz beer, 10 oz wine, or 3 oz 80-proof whiskey) per day in most men and to no more than 1 drink per day in women and lighter weight persons. This can alone reduce BP by 2-4 mmHg.

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Dr KK Aggarwal
Group Editor in Chief

    eMedinewS Audio PostCard

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

What is Life After Death

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011
Harmony-Inter School Competitions Held

In Harmony- Inter school competitions Students from various school took active participation. The Theme was Maintaining Good health. Dancing is also a good base for maintaining good health.

mela 2011
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


Big cities have worst sex ratios in country

NEW DELHI: India's towns are worse than its villages when it comes to the child sex ratio (CSR), but its biggest cities are even worse. Against an overall ratio of 914 girls for 1,000 boys in the age group of 0–6 years, the urban ratio is 902 but the combined figure for cities with a population of a million or more is just 898. Look through the data for the relevant states, however, and you see distinctly different trends. In several northern states, the all-India pattern is repeated – the CSR quite clearly going from bad to worse as you go from overall population to urban population to the million–plus cities. The states which fall in this category are with one exception from what were once pejoratively labeled the BIMARU (Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh) belt. The only exception is Gujarat, where the CSR for the million-plus cities, which include Ahmedabad, Surat, Vadodara and Rajkot, falls to 836, a good 50 points lower than the state's average. In Karnataka and West Bengal, while the same pattern held, the decline in the ratios in the big cities was much smaller. The opposite of this trend is witnessed in states like Tamil Nadu, Maharashtra and Andhra Pradesh, where the CSR actually is better in the biggest cities than in the state as a whole or in the urban areas. In the case of Kerala, there really isn’t much of a difference between the three figures. (Source: TOI, Oct 20, 2011)

For Comments and archives

GP CON 2011

National Conference of IMA CGP
Date: October 29th-30th, 2011
Venue: Savera, Chennai
IMA CGP HQ is organizing a two day CME, Group discussion and Workshop pertaining to Family Medicine Concept, Which will be a “Reincarnation” opf the traditional Family Doctor Concept in India.
More details Contact Conference Secretariat, Dr TN Ravisankar, email:imacgp.chennai@yahoo.com; website:imacgpindia.com

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    International News

(Dr Monica and Brahm Vasudev)

AAP: 'Screen-Free' environment best for toddlers

Babies and toddlers should learn and get their entertainment from play, not from TV screens, computer displays, or video games, according to a new policy statement from the American Academy of Pediatrics. Reaffirming its longstanding support for a "screen-free" environment for children younger than 2, the AAP encourages parents to play with toddlers whenever possible and to provide opportunities for supervised independent play when direct engagement with a child is not possible. When parents do allow media exposure, they should set strict time limits, keeping in mind that the AAP discourages media use by children before age 2. (Source: Medpage Today)

For comments and archives

To stay slim, eat lots of protein

MELBOURNE: Want to stay slim? Make sure that you eat enough protein in your diet, rather than simply cutting calories, says a new study. Researchers at the University of Sydney have carried out the study and found that low protein in diets can lead to excessive energy intake and drive people to eat more snacks, the 'PLoS ONE' journal reported. On the contrary, they have found that enough protein in their diets help people in curbing appetites and preventing excessive eating of fats and carbohydrates. The results represent the first scientifically supported evidence that dietary protein plays an important role in appetite in humans, and are an important step in addressing the global obesity epidemic. (Source: TOI, Oct 20, 2011)

For comments and archives

Malaria wanes globally, not in India

About one-third of all malaria-affected countries are expected to eliminate the vector-borne disease in the next 10 years. However, for the South-East Asia region the future isn't that bright. Maldives is the only country among the 11 nations in the region that has eliminated malaria, while Sri Lanka and Korea are in the pre-elimination stage. The remaining eight countries, including India, are trying to control regular outbreaks. The latest report of the Roll Back Malaria Partnership (RBM) says the number of malaria cases reported by countries in the region has remained relatively stable between 2000 and 2010 primarily due to continuing high reported malaria burdens in India, Indonesia and Myanmar. "There were 52 lakh probable and confirmed cases of malaria reported in 2000 as against 50 lakhs in 2010," the report said. Bhutan and Thailand have large areas with no malaria transmission and have expressed their intention to proceed with elimination joining the Asia Pacific Malaria Elimination Network (APMEN). An updated WHO fact sheet shows that there were 225 million cases of malaria and an estimated 7.8 lakh deaths in 2009, a decrease from 233 million cases and 9.8 lakh deaths in 2000. (Source: TOI, Oct 19, 2011)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Watch Padma Shri Awardee Dr KK Aggarwal on Harmony Inter School Competitions http://www.youtube.com/watch?v=1i3RgoTEriQ&feature=share via @youtube

@DeepakChopra: : i'm very grateful to The Skeptic's guide to the Universehttp://bit.ly/pPMnQO for helping @lmlodinow and I make the NYT bestseller list

    Spiritual Update

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

Satyam, Shivam, Sundaram

Satyam, Shivam, Sundaram is a common phrase used in India. It signifies the absolute truth and how to achieve the same.
According to the verse ‘Satyam, Shivam, Sundaram’, life is described as having three facets which are Truth (Satyam), God (Shivam) and, Beautiful (Sundaram) or Satya (truth), Shivam (consciousness) and Sundaram (inner happiness, inner beauty)

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

Love, Wealth and Success?

A woman came out of her house and saw three old men with long white beards sitting in her front yard. She did not recognize them. She said "I don't think I know you, but you must be hungry. Please come in and have something to eat."

"Is the man of the house home?” they asked. "No", she said. "He's out." "Then we cannot come in", they replied.

In the evening when her husband came home, she told him what had happened. "Go tell them I am home and invite them in!" The woman went out and invited the men in.

"We do not go into a House together," they replied. "Why is that?" she wanted to know. One of the old men explained: "His name is Wealth," he said pointing to one of his friends, and said pointing to another one, "He is Success, and I am Love." Then he added, "Now go in and discuss with your husband which one of us you want in your home."

The woman went in and told her husband what was said. Her husband was overjoyed. "How nice!!", he said. "Since that is the case, let us invite Wealth. Let him come and fill our home with wealth!" His wife disagreed. "My dear, why don't we invite Success?" Their daughter-in-law was listening from the other corner of the house. She jumped in with her own suggestion: "Would it not be better to invite Love? Our home will then be filled with love!" "Let us agree to our daughter-in-law's advice," said the husband to his wife. "Go out and invite Love to be our guest." The woman went out and asked the 3 old men, "Which one of you is Love? Please come in and be our guest." Love got up and started walking toward the house. The other two also got up and followed him.

Surprised, the lady asked Wealth and Success: "I only invited Love, Why are you coming in?" The old men replied together: "If you had invited Wealth or Success. The other two of us would've stayed out, but since you invited Love. Wherever He goes, we go with him.

Wherever there is Love, there is also Wealth and Success!!!!!!"

For comments and archives

    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

Migraines can be treated with exercise

A recently published study conducted at the University of Gothenburg in Sweden is the first report to show evidence that exercise can be just as effective as pharmacotherapy when it comes to migraine relief. The study, published in the journal Cephalalgia, involved 91 chronic migraine suffers who were divided equally into three groups. The members of the first group were asked to exercise for 40 minutes three times a week, the second performed a series of relaxation exercises, and the final third given topiramate, a pharmaceutical drug used to treat migraines. The study lasted for three months, and researchers regularly monitored participants' migraine frequency and intensity, quality of life, and physical fitness. They found that the group receiving the medication experienced just as much relief as the members of the exercise group.

For comments and archives

    Malaria Update

AC Dhariwal, Hitendrasinh G Thakor, Directorate of NVBDCP, New Delhi

What the National Drug Policy of India says

What are the clinical features of severe and complicated malaria?

Serious complications can occur in P. falciparum infection. However, recently few serious cases have been noted in P. vivax infection also. They may develop suddenly over a span of time as short as 12-24 hours and may lead to death, if not treated promptly and adequately. Severe malaria is clinically characterized by confusion or drowsiness with extreme weakness (prostration). In addition, the following complications may develop:

  • Cerebral malaria with coma, generalized convulsions, paralysis or other symptoms of central nervous system affection
  • Renal failure, often with hemoglobinuria
  • Pulmonary edema or adult respiratory distress syndrome
  • Severe anemia
  • Hypoglycemia (especially common in pregnant women)
  • Metabolic acidosis
  • Circulatory collapse/shock
  • Spontaneous bleeding and evidence of DIC
  • Hyperthermia
  • Hyperparasitemia

For comments and archives

    Medicine Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

NEW 2010 AHA Guidelines: The ABCs of CPR are rearranged to CAB

The 2010 AHA Guidelines for CPR and ECC now recommends a CAB sequence (Chest compressions, Airway, Breathing/ventilations), which are documented in the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, published in the November 2 supplemental issue of Circulation: Journal of the American Heart Association, and represent an update to previous guidelines issued in 2005; which earlier recommended sequence of CPR, previously known by the initials "ABC": Airway, Breathing/ventilation, and Chest compressions (or Circulation). The changes are starting CPR with 30 compressions followed by 2 ventilations, which should theoretically delay ventilations by only about 18 seconds for the lone rescuer and by an even a shorter interval for 2 rescuers. The CAB sequence for infants and children is recommended in order to simplify training with the hope that more victims of sudden cardiac arrest will receive bystander CPR. It offers the advantage of consistency in teaching rescuers, whether their patients are infants, children, or adults.

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  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum uric acid

  • Increased: Idiopathic, renal failure, disseminated neoplasms, toxemia of pregnancy, psoriasis, liver disease, sarcoidosis, ethanol consumption, etc. Many drugs elevate uric acid, including most diuretics, catecholamines, ethambutol, pyrazinamide, salicylates and large doses of nicotinic acid.
  • Decreased: Wilson’s disease, Fanconi’s syndrome, xanthinuria, and (paradoxically) in some neoplasms, including Hodgkin’s disease, myeloma and bronchogenic carcinoma. It may not be of clinical significance.

For comments and archives

  Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

What are the legal aspects of a robotic surgery done upon a patient in India by a foreign surgeon sitting abroad in his chamber?


  1. Since the patient is admitted in India in a hospital under the care of a surgeon who is present in the operation theatre to carry out: pre-operative management; intraoperative management including necessary surgery and coordination and assistance in collaboration with the foreign expert; and, post-operative management, the patient will be entitled to sue the hospital and the surgeon in India for compensation etc.
  2. The consent should be obtained after giving necessary information to the patient about the name of the foreign surgeon and the nature of the surgery.
  3. Necessary permission from the MCI should be taken because this would involve surgery in India by a doctor not registered with the MCI.
  4. The hospital and the surgeon should be adequately covered by professional indemnity insurance.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient with COPD needed oxygen.
Dr. Bad: Use binasal cannula. 
Dr. Good: Use Venturi mask.
Lesson: Venturi mask helps to wash out carbon dioxide.

For comments and archives

Make Sure

Situation: A patient intolerant to penicillin was denied rheumatic prophylaxis.
Reaction: Oh my God! Why was he not put on sulfa?
Lesson: Make sure that patients who cannot tolerate penicillin are put on sulfadiazine or sulfisoxazole. This antibiotic class is effective for preventing group A streptococcal (GAS) infection although it cannot be used to achieve eradication.

For comments and archives

  Quote of the Day

(Dr GM Singh)

Communication with our children in a positive manner is an art and a talent that we should master for better parent child bonding.


Smell something fishy: Detecting that something isn't right and there might be a reason for it.

    Mind Teaser

Read this…………………

Which one of the following is an accurate definition of the sensitivity of a screening test?

  1. The percentage of screening tests that are positive.
  2. The percentage of screening tests that are negative among patients when remain unaffected by the condition of  interest after screening.
  3. The percentage of screening tests that  are positive among patients who remain unaffected by the condition of  interest after screening.
  4. The probability of a diagnosis of the condition of interest after a positive  screening test.

Yesterday’s Mind Teaser:  A 43-year-old man is evaluated in the emergency department because of dyspnea. He was one of several people exposed to an unknown gas released in a subway station. Immediately following exposure to the gas, the victims complained of headache, nausea and vomiting, diaphoresis and shortness of breath. The patient is drenched in sweat, drooling and tearing, and sitting upright, gasping for air. Vital signs are: BP 90/60 mmHg, pulse 45/min, and respiratory rate 24/minute. Pupils are 2 mm and non-reactive. Lung examination reveals diffuse wheezing; the heart sounds are slow but regular. He suddenly becomes too weak to remain sitting, falls back in bed, and appears ashen.

Which of the following interventions should be instituted first?

A. Intravenous atropine and 2-pralidoxime chloride (2-PAM)
B. Albuterol and ipratropium via nebulizer
C. Intravenous cyanide antidote kit
D. Subcutaneous scopolamine
Answer for yesterday’s Mind Teaser: : A. Intravenous atropine and 2-pralidoxime chloride (2-PAM).
Correct answers received from: : Dr. Sathiyamoorthy Veerasamy, Dr.Neelu C Guglani, Dr Surendra Bahadur Mathur, Dr.K.Raju, Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay, Neelam Nath, Anil Bairaria, Dr Avtar Krishan

Answer for 19th October Mind Teaser: a) Malignancy
Correct answers received from: Dr Valluri Ramarao, Dr Shreya, Dr Swapnil, Dr yamini, Dr udit, Dr Sumit

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr Prabha Sanghi)

Medical Records

The following are actual medical records (supposedly) taken from patients' actual medical charts...

  • I saw your patient today, who is still under our car for physical therapy.
  • The patient lives at home with his mother, father, and pet turtle, who is presently enrolled in day care three times a week.
  • She is numb from her toes down.
  • While in the emergency room, she was examined, X-rated and sent home.
  • The lab test indicated abnormal lover function.
  • Occasional, constant, infrequent headaches.
  • Patient was alert and unresponsive.
  • When she fainted, her eyes rolled around the room.
    Medicolegal Update

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

WMA guidelines for clinical research combined with professional care

The mission of medical doctor is to safeguard the health of the people. The Declaration of Geneva of the World Medical Association (WMA) binds the doctor with the words, "The health of my patient will be my first consideration." In the treatment of the sick person, the doctor must be free to use a new diagnostic and therapeutic measure, if in his/her judgment it offers hope of saving life, re–establishing health or alleviating suffering.

  • The potential benefits, hazards and discomfort of a new method should be weighed against the advantages of the best current diagnostic and therapeutic methods.
  • In any medical study, every patient including those of a control group, if any, should be assured of the best proven diagnostic and therapeutic method.
  • The refusal of the patient to participate in a study must never interfere with the doctor–patient relationship.
  • If the doctor considers it essential not to obtain informed consent, the specific reasons for this proposal should be stated in the experimental protocol for transmission to the independent committee.
  • The doctor can combine medical research with professional care, the objective being the acquisition of new medical knowledge, only to the extent that medical research is justified by its potential diagnostic or therapeutic value for the patient.
(Ref: 18th World Medical Assembly, Helsinki, Finland, 1964 and revised by the 29th World Medical Assembly, Tokyo, Japan, 1975).

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Food adulteration stall attracts Eco Fest School Children

18th Ecofest, a School Eco Club’s Festival was organized at MTNL Perfect Health Mela, NDMC Grounds Laxmibai Nagar, New Delhi. Over 3000 school children from Delhi/NCR participated in the event. Competitions which took place were Cartoon Making (Reduce Pollution), Paper Bag Painting (Pollution), Creating best out of e-waste, Street Play (Pollution Free Environment), Yoga (Spiritual Health), Aerobics (Dance Your Way).

School children were also sensitized on the subject of food adulteration. Near Diwali festival season, it is common to get adulterated sweets and fruits.

The Department of Prevention of Food Adulteration and Department of Science & Technology have put up special exhibitions on how to identify food adulteration at home.

Speaking on the occasion Padmashri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal, President Heart Care Foundation of India, said that school children should be taught how to identify food adulteration.

Certain rules were released when buying and cooking foods

1. When buying fruits and vegetables those which are cheapest in the market are usually locally grown and seasonal.

2. When buying fruits and vegetables, if all the pieces of the fruits and vegetables are of the same size and look alike, there are chances that these are grown artificially.

3. Though there are permissible colours, it is always advisable not to consume sweets which are artificially coloured as there is no clue public can differentiate permissible colours from non-permissible colours.

4. Any food item which is kept at room temperature for more than two hours may not be health friendly. Most sweets circulated near Diwali days keep on passing from one family to another and on the way may never get a fridge to get preserved.

5. Most sweets are made in transfat. It is better to distribute fruits and dry fruits during Diwali days.

6. Even eating lot of chocolates may be bad for the heart’s health.

Free blood tests at the mela
Free heath checkups are arranged at the Mela premises including free blood tests. Thousands of people have benefited from the checkups. Consultations from all pathies are available.

It was observed that high blood pressure, high cholesterol, hypothyroidism is quite rampant in the city and need immediate medical attention. It was distressing to note that over 50% of the people were either not aware about hypertension or the blood pressure was not under control.

Obesity was also found very common. People were told that the waistline should not be more than 90 cm in men and 80 cm in women. “Longer the waist line shorter the lifeline”, was the slogan of the day.

Diwali myths on display in the mela
Department of Food Adulteration, Government of Delhi and the Department of Science & Technology, Government of India taught the school teachers about food adulteration detection methods

1. Vanaspati in milk can cause of GI and liver disorders: The test is simple. Take milk in a test tube and add 5 drops of hydrochloric acid along with some sugar. If the colour of the sample turns red, it indicates presence of vanaspati inside the milk.

2. Presence of Metanil Yellow in haldi can cause cancer: The same can be detected by adding five drops of hydrochloric acid and five drops of water in the haldi powder. If the sample gets magenta colour, it indicates adulteration.

3. Argemona oil adulteration can cause health hazards: The same can be detected by taking a sample of food oil with equal amount of nitric acid and leave it for five minutes. If it develops red colour, it indicates presence of Argemona oil.

Grand Craft Bazaar Attracts Crowds at Perfect Health Mela
Thirty stalls representing emporia and participants from every state of India with handicraft items is the soul of the on-going MTNL Perfect Health Mela.

An attempt has been made by Ministry of Textiles, to incorporate a Craft Bazaar inside the Health Mela. Craft Bazaars attract crowd and they apart from shopping get an opportunity to learn something about health. The Craftsmen in the country are of poor health. It is an opportunity for the government to have them expose to healthy lifestyle.

The craftsmen in the Mela are also demonstrating live how different handicrafts and craft items are made which stimulates the younger school children visiting the Mela to experiment with their own hidden talents. The craft shopping mall similar to Dilli Haat is only a segment of the current Mela.

For comments and archives

    Readers Responses
  1. Sare problem hi khatam ho jaaye agar aiims mein jumping of appointment que or source baji stop ho jaaye. Vivek Kumar, Varanasi
  2. I enjoy your letters. They keep me updated. Dr.(Mrs) PN Singh.
    Forthcoming Events

18th MTNL Perfect Health Mela

Date: 14th–18th October
Different locations in Delhi
19th–23rd October
Venue: NDMC Ground, Opp. Indira Nari Niketan Working Girls Hostel
Near Philanji Village, Laxmibai Nagar, New Delhi
Theme: Science Behind Rituals

For More Details


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  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