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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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eMedinewS Presents Audio News of the Day

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

Photos of Workshop on Stress Management and How to be Happy and Healthy

    Dr KK Aggarwal with Aamir Khan …

ASAR–Aamir Khan & Dr KK Aggarwal on Satyamev Jayate Watch Video
Docs vs Aamir Khan Headlines today 9th June 2012 7.30pm Watch Video
Aamir Khan Workshop with kids on dangerous areas Watch Video
DR KK Aggarwal on Doctor Bhagwan Hai ya Shaitan Watch Video

  Editorial …

22nd June 2012, Friday

TB, a notifiable disease since May 7, 2012

TB continues to be a major public health problem accounting for substantial morbidity and mortality in the country. Early diagnosis and complete treatment of TB is the cornerstone of TB prevention and control strategy. Inappropriate diagnosis and irregular/incomplete treatment with anti–TB drugs may contribute to complications, disease spread and emergence of Drug Resistant TB.

In order to ensure proper TB diagnosis and case management, reduce TB transmission and address the problems of emergence and spread of drug resistant–TB, it is essential to have complete information of all TB cases. Therefore, the healthcare providers shall notify every TB case to local authorities i.e. District Health Officer/Chief Medical Officer of a district and Municipal health Officer of a Municipal Corporation/Municipality every month in a given format (attached).

For the purpose of case notification, a TB case is defined as follows:

  • A patient diagnosed with at least one sputum specimen positive for acid fast bacilli, or Culture–positive for Mycobacterium tuberculosis, or RNTCP endorsed Rapid Diagnostic molecular test positive for tuberculosis, or
  • A patient diagnosed clinically as a case of TB, without microbiologic confirmation and initiated on anti–TB drugs.

For the purpose of this notification, healthcare providers will include clinical establishments run or managed by the Government (including local authorities), private or NGO sectors and/or individual practitioners.

(Source: Ministry of Health and Family Welfare)

TB Notification

All doctors/establishments dealing with TB cases are required to notify the authority (Municipal/DHO) about TB cases as per the following proforma

Period of reporting: From……………………………………………………/………………/………………To………………/……………………/…………………… Name of the health facility/ practitioner/ Laboratory:……………………………………………………
Registration Number:………………………………………………………… Telephone (with STD):………………………………
Complete Address:……………………………………………………………………………………………………………………………………
Mobile number:……………………………

Sr No

Name of TB Patient/ID of patient

Age (yrs)

Sex (M/F/O)

Gol issued identification number (Aadhaar, etc), if available

Complete residential address

Patient Phone number

Date of TB Diagnosis

Date of TB treatment initiation







For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

TB, a notifiable disease since May 7, 2012

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

Eat less to live more

On world Health Day Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal interacts with students of Mount Abu Public School

Dr K K Aggarwal
    National News

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 re build the image of the medical profession.

Govt sounds alert on dengue

NEW DELHI: The dengue threat looming large over the city is now showing up. As many as 12,000 house and office premises in the city have been reported to have heavy mosquito breeding till date, the state health department confirmed on Wednesday. Last year, mosquito breeding was found at 7,653 premises during the corresponding period. Three cases of dengue have already been reported. A senior official said the report is based on field checks done by the directorate of national vector borne disease control programme from February to June. "Dengue cases reported so far are the same as reported last year yet there is strong need to be cautious keeping % in view of the growing incidence of mosquito breeding," said A K Walia, Delhi health minister. (Source: TOI, Jun 21, 2012)

For comments and archives

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

(Contributed by Dr Monica and Brahm Vasudev)

Pancreatic Ca surgery doable with drug combo

Four patients with unresectable pancreatic cancer had margin–negative surgery following treatment with a three–drug chemoradiation regimen, results of a small clinical trial showed. A fifth patient with uncertain resectability status also had negative surgical margins. The five patients were among 17 with unresectable, nonmetastatic, locally advanced pancreatic cancer treated with capecitabine (Xeloda), bevacizumab (Avastin), and erlotinib (Tarceva), along with concurrent radiation therapy. (Source: Medpage Today)

For comments and archives

Adding markers adds little to CV prediction

Only slight improvements in cardiovascular risk prediction were gained by adding more blood lipid–related markers to conventional factors, researchers said. Fewer than 5% of individuals would have their risk classifications changed by including such markers as apolipoprotein A–I, apolipoprotein B, lipoprotein(a), or lipoprotein–associated phospholipase A2 (LpA–PLA2) in gauging the likelihood of major cardiovascular events, reported John Danesh, FRCP, of the University of Cambridge in England, and colleagues belonging to the Emerging Risk Factors Collaboration. At best, adding more lipid markers to the risk prediction equation brought "slight improvement," the researchers wrote in the June 20 issue of the Journal of the American Medical Association. (Source: Medpage Today)

For comments and archives

Medical group makes recommendations for thyroid protection

Responding to a rapid global increase in the incidence of thyroid cancer, the American Thyroid Association (ATA) has released a policy statement with recommendations for minimizing radiation exposure of the thyroid whenever possible. "In the United States in particular, (thyroid cancer) is increasing faster than any other cancer, with more than 56,000 people likely to be diagnosed" in 2012 alone, the authors warn in the statement published online June 13 on the association’s Web site. (Source: Medscape)

For comments and archives

AMA bucks USPSTF on mammography

The American Medical Association’s House of Delegates has come out in support of screening mammography for women starting at age 40. The new policy is in conflict with the controversial 2009 recommendation of the United States Preventive Services Task Force (USPSTF) that routine screening mammography for breast cancer was unnecessary in women younger than 50. The House of Delegates stopped short of recommending that "every woman should get routine screening mammograms every year starting at age 40." Strongly debated in Tuesday morning’s session, that language was rejected by the delegates in favor of a lighter "should be eligible" phrasing. (Source: Medpage Today)

For comments and archives

   Twitter of the Day

@DrKKAggarwal: Dire diabetes outlook among US kids and adolescents: Type 1 and type 2 on the rise.

@DeepakChopra: Emotional intelligence grows through perception. Look around at your present situation and observe it through the level of feeling.

    Spiritual Update

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

Power: The new medicine on the block

What keeps the politicians alive? Undoubtedly, it’s the luck that saves him from the militant’s bullet and the wonder of POWER.

It’s the power that makes the heart of these aged politicians beat. The love for limelight and not VIAGRA, gives them that extra horsepower.

For comments and archives

    4th Asia Pacific Vascular Intervention Course (APVIC)

4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More

The 4th Asia Pacific Vascular Interventional Course begins Read More

Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More

4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More

Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty
Read More

4th Asia pacific vascular intervention course Read More

4th Asia pacific vascular intervention course paper clippings Read More

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What is expectant management?

A "watchful waiting" approach, also called expectant management, may be an option for younger women after surgery for endometriosis. Up to 40% of women may conceive during the first 8 to 9 months after laparoscopic management of minimal or mild endometriosis. Fertility–enhancing treatments may be offered as an alternative to expectant management, or if pregnancy fails to occur within a reasonable period. Women aged 35 and older have lower fertility potential and higher chances of miscarriage. The decrease in fertility due to endometriosis and age may be additive.

For comments and archives

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

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

Electromechanical infusion devices

Mechanical pumps that deliver infusions at a controlled rate are useful especially for very slow rate of transfusion used for pediatric, neonatal, and selected adult patients. Some pumps use a mechanical screw drive to advance that plunger of a syringe filled with blood; others use roller pumps or other forms of pressure applied to the infusion tubing. Although some can be used with standard blood administration sets, many require special plastic disposable or tubing supplied by the manufacturer.

The manufacturer should be consulted before blood administered with an infusion pump designed for crystalloid or colloid solutions. Many induce hemolytic but of a magnitude that does not adversely affect the patient. Red cell components with high hematocrit and high viscosity are more likely to be hemolysed when infused under pressure than whole blood or red cells prepared in a manner that reduces viscosity. Platelets and granulocytes appear to sustain no adverse effects when infused with a pumping device. Proper training of personnel and appropriate policies for maintenance and quality control should reduce the chances of damage to transfused components.

For comments and archives

   An Inspirational Story

(Ms Ritu Sinha)

Things Change

Alex W Miller

For most people, graduation is an exciting day – the culmination of years of hard work. My graduation day… was not.

I remember that weekend two years ago. Family and friends had flown in from across the country to watch our class walk across that stage. But like everyone else in my graduating class, I had watched the economy turn from bad to worse my senior year. We graduates had degrees, but very limited prospects. Numerous applications had not panned out and I knew that the next day, when my lease ended, I would no longer have a place to call home.

The weeks ahead weren’t easy. I gathered up everything I couldn’t carry and put it into storage. Then, because I knew my small university town couldn’t offer me any opportunities, I packed up my car and drove to Southern California to find work. But what I thought would take a week dragged into two, and then four, and 100 job applications later, I found myself in the exact same spot as I was before. And the due date to begin paying back my student loans was creeping ever closer.

You know that feeling when you wake up and you are just consumed with dread? Dread about something you can’t control – that sense of impending failure that lingers over you as you hope that everything that happened to you thus far was just a bad dream? That feeling became a constant in my life. Days felt like weeks, weeks like months, and those many months felt like an unending eternity of destitution. And the most frustrating part was no matter how much I tried, I just couldn't seem to make any progress.

So what did I do to maintain my sanity? I wrote. Something about putting words on a page made everything seem a little clearer – a little brighter. Something about writing gave me hope. And if you want something badly enough… sometimes a little hope is all you need!

I channeled my frustration into a children’s book. ‘Beyond the River’ was the story of an unlikely hero featuring a little fish who simply refused to give up on his dream.

And then one day, without any sort of writing degree or contacts in the writing world – just a lot of hard work and perseverance – I was offered a publishing contract for my first book! After that, things slowly began to fall into place. I was offered a second book deal. Then, a few months later, I got an interview with The Walt Disney Company and was hired shortly after.

The moral of this story is… Don’t give up. Even if things look bleak now, don’t give up. Two years ago I was huddled in my car drinking cold soup right out of the can. Things change.

If you work hard, give it time, and don’t give up, things will always get better. Oftentimes our dreams lie in wait just a little further upstream… all we need is the courage to push beyond the river

For comments and archives

   Cardiology eMedinewS

Bonus Info: CHADS2 helps predict post–CABG AF risk Read More

Citicoline provides no benefit in acute ischemic stroke Read More

   Pediatric eMedinewS

Umbilical cord milking aids VLBW infants Read More

Sleep linked to CRP levels in teens Read More

Elective delivery of twins at week 37 may be safer Read More

    IJCP Special

Dr Good Dr Bad

Situation: A 30–year–old male with suspected migraine came with runny nose.
Dr. Bad: It cannot be migraine.
Dr. Good: It can be migraine.
Lesson: Migraine can also cause nasal stuffiness and runny nose, or teary eyes in 10–20% of individuals.

Make Sure

Situation: A patient with rheumatoid arthritis developed deformity.
Reaction: Oh my God! Why was treatment not started early?
Lesson: Make sure all patients with Rheumatoid Arthritis are started with specific treatments within 3 months of diagnosis.

For comments and archives

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    Health News Bulletin

Lonely children prone to obesity

The Times of India, Jhimli Mukherjee Pandey

Kolkata: Weight is an issue that is bothering city schools even more than studies these days. With at least 20% children in middle and high schools suffering from weight–related disorders, schools have started holding ‘health audits’ and getting parents involved in the back–to–health process. According to findings by most schools, a majority of students with unacceptable body mass indices are children of working parents. Such kids spend a lot of time with retainers who are unable to take proper care of their diet. The children miss their parents and try to make up for their loneliness with junk food, which leads to obesity and other lifestyle diseases. "Obesity in most cases is a contracted lifestyle disease. There are, of course, incidences of thyroid imbalances or genetic disorders, but they account for no more than 5–6% cases," says dietician Kalpana Chowdhury a specialist on child obesity "It’s an eating disorder and mostly happens when lonely children take to junk food to counter depression."

Psychiatrist Amarnath Mullick tries to quantify this. "At least 50% of the kids with mind disorders that I know of is also obese. There is a natural link. In most such cases I have prescribed a therapy of diet and company of grandparents or some other relatives or peers for three months. This has worked wonders," Mullick said.

  Quote of the Day

(Dr GM Singh)

On the shore of life friends are like waves they come and go but they touch in such a way that a feeling of closeness always remains forever.

    Lab Update

(Dr Navin Dang and Dr Arpan Gandhi)

Mean corpuscular hemoglobin concentration

MCHC (g/dL) = Hemoglobin (g/dL)/HCT (%) × 100

Reference values: 32–34 g/dL


  • Low MCHC suggests iron deficiency anemia
  • High MCHC suggests spherocytosis, dehydration, sickle cell anemia or unstable hemoglobin
    Microbial World: The Good and the Bad They Do

(Dr Usha K Baveja, Prof. and Senior Consultant Microbiology, Medanta – The Medicity, Gurgaon)

Polio vaccine

Currently in India, oral polio vaccine, which is a live attenuated bivalent vaccine is given as drops on "National Polio Immunization Days" to children up to 5 years of age. This is in addition to the primary polio vaccine given to the infant as per EPI schedule. Let us consider the pros and cons of both the live and killed polio vaccines.

Oral polio vaccine (OPV)

Many parents have apprehensions regarding use of live attenuated vaccine that it may lead to poliomyelitis. There is a remote possibility that the vaccine virus may revert to the wild form and may cause disease. It is reported that about one in 2.4 million people who receive OPV may contract polio. So the risk is negligible. However, OPV is not safe in immunodeficient and immunosuppressed subjects. In subjects having other viral infections at the time of immunization the immunity induced may be compromised, due to interference. OPV is easy to administer, efficient, induces herd immunity as the attenuated virus is excreted in feces and transmitted in the community. The attenuated vaccine virus causes infection but not the disease. OPV induces humoral as well as local intestinal mucosal immunity, which is long lasting.

    Mind Teaser

Read this…………………

An 83–year–old woman has several ecchymotic areas on her right arm. The bruises are probably caused by:

a. Increased capillary fragility and permeability
b. Increased blood supply to the skin
c. Self inflicted injury
d. Elder abuse

Yesterday’s Mind Teaser: Nurse Faith should recognize that fluid shift in an client with burn injury results from increase in the:

a. Total volume of circulating whole blood
b. Total volume of intravascular plasma
c. Permeability of capillary walls
d. Permeability of kidney tubules

Answer for yesterday’s Mind Teaser: c. Permeability of capillary walls

Correct answers received from: Dr Sushma Chawla, Prabha Sanghi, Dr Shashi Saini, Dr PC Das, Anil Bairaria, Dr Chandresh Jardosh, Raju Kuppusamy, Dr Thakor Hitendrsinh G, Jainendra Upadhyay,
Dr Avtar Krishan, Dr Valluriramarao, Muthumperumal Thirumalpillai.

Answer for 20th June Mind Teaser: d. Damage to laryngeal nerves
Correct answers received from: Dr kanta Jain, Mannalal Bhansali, Dr PC Das.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Having right vision in any endeavor always leads to a glorious conclusion…

    Medicolegal Update

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


The name Morphine originates from the Morpheus, the Greek God of dreams

  • Morphine is an alkaloid of opium a white, shining crystals, having a bitter taste and alkaline reaction.
  • It is very sparingly soluble in cold water, but is soluble in boiling water.
  • Morphine hydrochloride and morphine sulfate are medicinal preparations and morphine acetate is a non–official preparation, the dose of each being 8 to 20 mg. These salts are bitter in taste, neutral in reaction and are five to eight times more powerful than opium.
  • Morphine has a depressant action on the cortex, the respiratory and cough centers in the medulla are depressed but the vagus and vomiting centers are stimulated.
  • The spinal cord is also stimulated. Its most outstanding effect is relief of pain, partly due to depression of the cerebral area of pain perception and partly due to its euphoric effect.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Patients with acidity should avoid chocolates and peppermint

Persistent acidity is usually due to reflux of acid from the stomach into the food pipe. Mild cases of acidity reflux can usually be managed with lifestyle and dietary modifications along with antacids, H2 blockers and proton pump inhibitors.

However, patients in whom lifestyle management together with empirical treatment is unsuccessful or those who have symptoms suggestive of complicated diseases should undergo endoscopy to rule out cancer of the food pipe, a condition linked with persistent acidity. This was stated by Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

He said that symptoms that may suggest complicated disease include loss of appetite, loss of weight, and difficulty in swallowing food, bleeding and signs of systemic illness.

Lifestyle changes for reflux involve elevation of head and of the body, avoidance of food before sleep and avoidance of food which makes the food pipe valve lax. Examples of such foods include fatty food, chocolates, peppermint and excessive intake of alcohol.

    Readers Response
  1. This is kudos to the honest doctor who has exposed the myth of Mr. Aamir Khan. I too was his admirer after seeing his movies ‘3 Idiots’ and ‘Lagaan’. But, now that admiration is no more. Dr. Tara Saxena, Rewari, Haryana.
    Forthcoming Events
Dr K K Aggarwal

Dr K K Aggarwal

Dr K K Aggarwal


All are cordially invited for the 2nd National Conference of IYCF Chapter of IAP. This conference is organized by: IYCF Chapter, MOH&FW GOI, MOWCD GOI, WHO, UNICEF, IMLEA, SDHE Trust.
The theme of the conference is: "Proper Nutrition: Defeat Malnutrition – Investing in the Future"
Venue: India Habitat Centre, Lodhi Road, New Delhi – 110 003.
Date: 5th Aug 2012
For further details contact:
Conference Secretariat: Dr. Balraj Yadav, E–Mail: drbalraj@ymail.com, drvisheshkumar@gmail.com,
Ph: +91.124.2223836, Mobile: +91.9811108230

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

    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)

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  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, Dr Usha K Baveja