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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 …

22nd August 2011, Monday

Krishna Janmashtami the message from Lord Krishna

Reading about Lord Krishna one understands the way of acquiring inner happiness. It can be understood by the four cycles of Krishna described in the Vedic literature: Krishna the Child, Krishna the Husband and Friend, Krishna the Preacher and Krishna the Sanyasi.

The childhood of Krishna describes the methodology and components of a child education. Krishna, pure consciousness, was born as the eight child of Devki representing that during pregnancy one needs to follow the eight limbs of yoga to get a child with no disease.

A new born and during initial childhood, the child is full of pure consciousness that spreads love to everyone without any discrimination. The only thing the child during this period does is to steal and spread love and that is what Krishna as Makhan Chor depicts.

With time the child’s mental faculty starts developing distracting the child’s mind. During this phase of life the child needs to be taught to control the thoughts and mind by learning viveka (discrimination between good and bad) and doing abhyas or hard work. The episode of Krishna entering into the pond (thoughts) fighting with Kaliya (duality of mind) and controlling it represents the same. This also coincides with the time a child should be sent to the school.

The next phase of childhood is activation of intellect which in Krishna’s life is depicted as the questions in his mind "Radha kyun gori, main kyun kala?" The incident is during Krishna playing Holi with Gopis and Radha. This happens when the child gets an exposure to the worldly atmosphere and starts getting attached to it. This is the time for the child to be taught control of mind and intellect by one point concentration on the object of concentration. This is also the time when the child should be taught the purpose of life, and the aim for which he has to live in future (usually adolescent by this time).

Krishna controls the intellect by winning over Indra (intellect) and raising Govardhan Parvat (turmoil of the mind) by one finger and saves the public from the rainy storm (wavering thoughts). One finger here indicates one point concentration on the object of concentration. Once the child is taught how to control the intellect, he or she complete spiritual education and learns about the true self. Control of mind (Kalia) and intellect (Indra) leads the chilod to the next phase of life. In Krishna’s life it coincides with Ras Leela where Krishna is seen dancing with Radha and every Gopi. This also reflects the time for the internal ego to get killed and one acquires the qualities of humility. Killing of Kansa depicts the killing of ego. Once the ego is killed and humility is acquired Radha and flute are no more required and Krishna is now a perfect man and is ready to enter the next ashram of life called Grahasthashram. Radha (body) gets merged with consciousness and flute (humility) is a part of the nature. One now acquires a sudershan chakra or a weapon to take decisions and adopt the good and kill the evil.

Krishna is always depicted with a blue colour God with yellow clothes and a flute in his hands. Blue colour indicates everything is possible and yellow clothes indicate that one can acquire it provided one has the flute which is a hollow wood representing egoless nature.

Whenever Krishna is shown with a flute, the lady with him is Radha with blue sari and yellow colour, along with gopis (thoughts) dancing around them indicating that the thoughts of the mind are in symphony with each other and there is a union of mind, body and soul. Here the soul is represented by Krishna, mind by the flute, thoughts with the gopis and body with the Radha.

The second phase of Krishna’s life is shown as a perfect achiever and friend, which is evident from the story of Sudhama.

The third phase of Krishna’s life represent Krishna as an advisor, which shows his role in Mahabharata and his preaching in Bhagavad Gita. He teaches the message of Karma Yoga, Bhakti Yoga, Gnana Yoga and Raja Yoga for acquiring excellence in life and inner happiness.

The last role of Krishna as a sanyasi is the end of Krishna’s life. The four cycles also coincide with the four ashrams of life.

To achieve inner happiness the message from Krishna’s life is to learn to make efforts to control the mind, to win over the intellect by one point concentration and to acquire qualities of humility and killing internal ego. With this only one can become a perfect man like Krishna.

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Krishna Janmashtami the message from
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Invited Guest of Honour on the dias in the recenty concluded National Conference on Insight on Medicolegal Issues.

Dr K K Aggarwal
    National News

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


Common exam for undergraduates likely by 2013

The Government intends to have a common examination for under–graduate programmes across the country from 2013 and prepare a common merit list as part of efforts to improve quality of education. The candidates would qualify for prestigious technical institutes, as per the position in the merit list, HRD Minister Kapil Sibal informed the Lok Sabha on Friday. He said that an expert committee was examining the matter and that this was part of his efforts to provide equal opportunities to both rural and urban students. Sibal also said that the government would crack down on fake universities, the practice of taking capitation fee, misleading advertisements and other malpractices regarding which a bill is also being brought. (Source: The Pioneer, Aug 19 2011)

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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)

Obesity complicates asthma diagnosis

More than a third of obese asthmatic patients had no evidence of bronchial hyper–responsiveness, suggesting frequent misdiagnosis of breathlessness, British investigators reported. (Source: Medpage Today)

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Criteria improve transesophageal Echo rate

Prescreening patients who are set to have transesophageal echocardiography (TEE) reduces inappropriate scans, researchers said. In a single–center study, 16% of scans were cancelled after prescreening with appropriate use criteria, James Kirkpatrick, MD, of the University of Pennsylvania, and colleagues reported in the journal Echocardiography. The cancellation rate was just 2% when patients were not prescreened. (Source: Medpage Today)

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Men and women behave differently in illness

A new study has discovered that differences between men and women can be found even among mental illnesses, with certain disorders being more common to specific genders. The researchers at the University of Minnesota found that women are more likely to be diagnosed with anxiety or depression, whereas men are more likely to battle substance abuse and antisocial disorders. The researchers also found that women with anxiety disorders are more likely to internalize emotions, which typically results in withdrawal, loneliness and depression. Men, on the other hand, are more likely to externalize emotions, which leads to aggressive, impulsive, coercive and noncompliant behaviour. The study has been published online in APA’s journal of Abnormal Psychology. (Source: TOI, Aug 19, 2011)

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    Fitness Update

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

Aerobic exercise reduces heart disease risk, study says

Weight training alone is not an effective way to reduce the risk of heart disease or diabetes if you are overweight, but aerobic training might be, according to a new study from the Duke University Medical Center.

Participants in the study were divided into three groups for eight months. One group did only resistance training, working out on eight different weight machines three times per week. The second group did two hours of aerobic training per week, and the third group did both programs. People in the weight training group gained an average of 1.5 pounds, added to their waistline and failed to reduce their risk for heart disease or diabetes. The aerobic training group lost three pounds and a half–inch from their waists, and participants who did both cardio and weights in the study lost four pounds and an inch from their waists. Both groups also decreased their risk of illness. "When weighing the time commitment versus health benefit, the data suggest that AT (aerobic training) alone was the most efficient mode of exercise for improving cardiometabolic health," says the study, titled "Comparison of Aerobic Versus Resistance Exercise Training Effects on Metabolic Syndrome."

Exercise also plays a prominent role in reducing the risk of sudden cardiac death, which is the result of a sudden loss of heart function due to problems with the heart’s electrical impulses, according to another study published earlier this month in the Journal of the American Medical Association. By analyzing data on lifestyle factors of more than 80,000 women over the span of 25 years, researchers found that those who worked out regularly and also had a healthy body mass index (under 25), did not smoke and ate a well–balanced diet significantly reduced their chances of sudden cardiac death.

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@DrKKAggarwal: what makes a wave; support of critical mass of one percent of the society.

@DeepakChopra: #CosmicConsciousnes In its original state matter is not material

    Dr KK Answers

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

What are the five types of drug fevers?

  • Hypersensitivity reactions
  • Altered thermoregulatory mechanisms
  • Reactions that are directly related to administration of the drug
  • Reactions that are direct extensions of the pharmacologic action of the drug
  • Idiosyncratic reactions

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    Spiritual Update

Science Behind the Anti Corruption Movement

As stated by Advaita (Non–dualism) philosophy, God is within us and therefore we all need to acquire the qualities of the 10 incarnations of Lord Vishnu to become a perfect person. These 10 incarnations also tell us about the 10 levels of awareness a person can have. Lord Vishnu is known as preserv

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    An Inspirational Story

(Dr. Anupam Sethi Malhotra)

A German once visited a temple under construction where he saw a sculptor making an idol of God. Suddenly he noticed a similar idol lying nearby. Surprised, he asked the sculptor, "Do you need two statues of the same idol?" "No," said the sculptor without looking up, "We need only one, but the first one got damaged at the last stage." The gentleman examined the idol and found no apparent damage. "Where is the damage?" he asked. "There is a scratch on the nose of the idol." said the sculptor, still busy with his work. "Where are you going to install the idol?"

The sculptor replied that it would be installed on a pillar twenty feet high. "If the idol is that far, who is going to know that there is a scratch on the nose?" the gentleman asked. The sculptor stopped his work, looked up at the gentleman, smiled and said, "I will know it."

The desire to excel is exclusive of the fact whether someone else appreciates it or not. "Excellence" is a drive from inside, not outside.

Excellence is not for someone else to notice but for your own satisfaction and efficiency.

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    Gastro Update

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

Can influenza vaccine be given in patients with egg allergy?

Influenza vaccination now is recommended for all individuals six months of age and older. In addition, the actual ovalbumin content of several brands and lots of the 2009–2010 seasonal and H1N1 influenza vaccines was one or two orders of magnitude lower than the manufacturers’ claimed maximum levels in two independent assessments.1,2 Furthermore, the rate of serious adverse reactions to the vaccine was the same whether or not vaccine skin testing was performed prior to a two–step administration protocol (5 versus 3%, respectively).3 In light of the recent data, the clinical recommendations have changed for the influenza vaccine administration protocols in patients with egg allergy:

  • For the patient who is six months of age or older and has known egg allergy of any severity, except severe anaphylaxis, administration is suggested under observation of a vaccine that contains ≤1 mcg ovalbumin per 0.5 mL as a single dose without prior vaccine skin testing.
  • If a vaccine that contains =1 mcg ovalbumin per 0.5 mL dose is not available, or if the history of anaphylaxis was severe, we suggest administration of the vaccine under observation by a two–step protocol without prior vaccine skin testing.


  1. Waibel KH, Gomez R. Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines. J Allergy Clin Immunol 2010;125:749.
  2. Li JT, Rank MA, Squillace DL, et al. Ovalbumin content of influenza vaccines. J Allergy Clin Immunol 2010;125:1412.
  3. Chung EY, Huang L, Schneider L. Safety of influenza vaccine administration in egg–allergic patients. Pediatrics 2010;125:e1024.

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    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Decreased ferritin level is the earliest sign of iron deficiency anemia.

    IJCP Special

Dr Good Dr Bad

Situation: An obese patient with metabolic syndrome wanted a prescription for liposuction.
Dr Bad: Go ahead.
Dr Good: It won’t be beneficial.
Lesson: Liposuction can reduce weight and fat but does not improve insulin sensitivity.

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Make Sure

Situation: A patient with acute heart attack died on the way to the hospital.
Reaction: Oh my God! Why was the patient not accompanied by the doctor?
Lesson: Make sure that all heart attack patients are accompanied by the doctor to the hospital so that chest compression CPR can be given, if the heart stops, on the way.

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Inhaled steroids with nasal steroids can give better control. One can use inhaled steroids also instead of nasal steroids.

    Medicolegal Update

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

Clinical and forensic autopsies have an overlapping role towards each other

  • Post mortem examination of a dead body is carried out to gain insight of anatomy and pathology of corpse and close examination of the injuries, marks of weapon or disease process and it is important for forensic application of medical knowledge.
  • Whether it is a clinical/pathological or forensic, autopsy is nothing but medical study of a dead body and is carried out for enhancing clinical findings and its correlation with patient clinical manifestation during the treatment or understanding some unrevealed aspect of disease/diagnose the disease which has caused the mortality when ante–mortem efforts have failed or the autopsy/disease process in situ, thus enriching medical knowledge findings may be simultaneously used for medico–legal purpose.
  • The procedure of both the autopsies is same; the autopsy conducted by a forensic expert in cases of sudden/unexpected/unexplained death is nothing but a pure clinical autopsy.
  • The opinion expressed on the basis of a clinical autopsy is examined or cross examined in departmental/institutional peer review as the findings and opinion after a forensic autopsy has to withstand the acid test of cross examination by the defense lawyer/prosecutor and judges on circumstantial evidences available before honorable court.

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    Mind Teaser

Read this…………………

The HIV type most commonly associated with cancers of the head and neck are:

a. 6,11
c. 30,35
d. 54,55

Yesterday’s Mind Teaser: The main site of bicarbonate reabsorption is:

1. Proximal convoluted tubule
2. Distal convoluted tubule
3. Cortical collecting duct
4. Medullary collecting duct

Answer for Yesterday’s Mind Teaser: 1. Proximal convoluted tubule.

Correct answers received from: Dr Y. J. Vasavada, Dr.Anurag julka, Dr Valluri Ramarao, Dr.K.Raju, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Dr Anil Bairaria,

Answer for 20th August Mind Teaser: 2.Silicone
Correct answers received from: Dr Muthumperumal Thirumalpillai, Dr.K.Raju, Dr.A.K.KELA,  Dr Anupama, Dr Shreya, Dr Prachi, Dr Piyush, Dr Ketan, Dr Nishant

Send your answer to ijcp12@gmail.com

   Laugh a While

(Dr. GM Singh)

Memory Test

Three elderly men visited the doctor for a memory test. The doctor asked the first one, "What’s three times three?" "285!" the man replied. Worried, the doctor turned to the second man. "How about you? What’s three times three?" "Uh, Monday!" the second man shouted.

Even more concerned, the doctor motioned to the third man. "Well, what do you say? What’s three times three?" "Nine!" the third man replied. "Excellent!" the doctor exclaimed. "How did you get that?"

"Oh, it’s pretty simple," the man explained. "You just subtract the 285 from Monday!"

    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name
DCI Approval Date

Each sachet (1g) contains:

Total Probiotic… Not less than 1.25 Billion CFU (Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium longum, Saccharomyces boulardii)


Each sachet (1g) contains:

Probio (CMP 5) Total Probiotic…Not less than 1.25 Billion CFU (Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium longum, Saccharomyces boulardii)
Fructo Oligo Saccharides… 100mg


Each sachet (1.3g) contains:

Probio (CMP 5) Total probiotic
… not less than 1.25 billion CFU (Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium longum, Saccharomyces boulardii)
Fructo Oligo Saccharides…1000mg
For the treatment of rotavirus diarrhoea.
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(Press Release for use by the newspapers)

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Precautions while fasting on Janmashtami

Fasting is generally good for health, but if you are a patient, consult your doctor before you fast on Janmashtami, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

A Fast or Vrata purifies the mind, body and soul. It facilitates restraining of the senses. It advocates a satvik lifestyle. The three wise monkeys of Mahatma Gandhi symbolize inner purification by the three principles of See no evil, Hear no evil, Speak no evil. Similarly, fasting also means fasting from negative thoughts and not simply abstaining from food and water.

The Heart Care Foundation of India released guidelines for taking food while fasting.

Fast without water: The ardent followers of Lord Krishna celebrate Janmashtami by observing Nirjal fasts, which literally means starvation with no food and water intake. The fast is broken only at midnight, when aarti is performed and prasad are offered to the deity. Patients with kidney disease should not do this type of fast. Those who take medicinal drugs should take it with minimal water.

Phalahar Fast: This is another type of fast observed on Krishna Janmashtami. It is relatively lenient than the nirjal fast, because the person can consume milk and fruits. No cereals are taken. The fast is broken at midnight, after Janmashtami Puja. This fast if done once a week is good for patients with diabetes and heart disease and those who are obese. But, on the day of fast diabetics will need to reduce their intake of insulin and other anti diabetic drugs.

Food for Janmashtami Fast: A variety of dishes using milk, milk products are made like Peda, Shrikhand, Kalakand, Vella Seedai, Neyyappam, kheer are made. Some prepare 56 dishes (Chappan Bhog) on this day. People should be cautious as refined carbohydrates (white sugar, white flour and white rice), chocolates and food cooked in trans fats rich in hydrogenated vanaspati oils are harmful for the health. Instead, singhara, kuttu (buckwheat) flour, cholai laddo and samak rice are made from fruits and not cereals and can be eaten.

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    Readers Responses
  1. Dear Sir, Your editorial What makes a wave is really awesome, specially 100th–monkey phenomenon. Regards: Dr Suruchi.
    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & National Icons in the field of Cardiology & Echocardiography will form the teaching faculty.



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