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  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group & Hony. Visiting Professor (Clinical Research) DIPSAR

 

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos…
Nobility of medical profession Video 1 to 9 Health and Religion Video 1–7
DD Take Care Holistically Video 1–4 Chat with Dr KK On life Style Disorders
Health Update Video 1–15 Science and Spirituality
Obesity–Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

22nd August 2012, Wednesday

Rumors over mehendi create panic in Chennai

Hundreds of Muslim women and children flocked to hospitals late on Eid eve after rumors spread that two women had died after applying mehendi on their hands and a girl had lost her limbs. It was a text message that went viral on Monday night

Rumors are based on the 100th Monkey Phenomenon. The success of a vital message is based on the principle of collective consciousness. It is nothing but the critical mass above which the generated message spreads like fire. It has been scientifically observed and proved that rumors spread like wild fire once the critical mass of 1% in the general population is achieved. Advertisements in newsprints and in electronic media also work on the same principle. In campaigning, if 1% of your voters feel that you should win, the chances are that you will win.

What is the 100th monkey phenomenon? “Long time back there was a monkey called EMO in a far off village in Japan. Monkeys at that time used to eat apples lying in the gardens full of dust. One day EMO by mistake washed the apple in the pond before eating. Why from next time onwards he washed every apple he ate. From one monkey the message went to the second monkey and then to the third and so on. Many monkeys started washing apples before eating. After sometime some neighboring monkeys from other villages also started washing apples before eating. The day 100th monkey washed the apple and ate, a strange phenomenon was observed all over the country. Monkeys all over the country started washing apples before eating. The critical mass in that area therefore was 100. Once the critical mass was achieved, the information spread like wild fire to each and every monkey and everybody started washing apples before eating.”

Politicians also make use of this principle while campaigning and make sure that the critical mass is achieved to start with. In local political meetings too, the same principle of 1% critical mass is used. For a gathering of 1000 people, politicians make sure that they have minimum 10 of their own people are sitting in the audience to initiate clapping. When 10 people clap, the rest 990 will also follow and clap. Similarly, for a gathering of 2000 they will need 20 people and for 10,000 they will need 100 people.

Rumors are also used as one of the main weapons in political campaigning. They also work on the same principle of 1% or critical mass. You can plant your people in other’s political meetings and start spreading rumors or to hoot. The only precaution that you should take is to cross 1% of the number.

When you want to pass on a message to the audience, it has to be flashed for at least 10 seconds. The mind cannot remember what it had seen or heard for less than 10 seconds. The politicians will highlight what they want to say and pass on hurriedly what they do not want the people to remember.

The other aspect of campaigning is what happens if you lose or win an election.

If you lose, you are likely to go into depression for 3 months but invariably you cover up as politicians never fight only to win and even a lost candidate has a lot to gain in the long run.

On the other hand, a lot of physical and biochemical changes are seen in the person who wins. The power of chair is tremendous. It boosts the serotonin levels in the blood. The person starts performing better, sleeps less during the night and produces results, which he may have never produced in the past.

The classical example is our former Prime Minister, Sh. Narasimha Rao who on medical grounds was unfit to even fight an election but once he became the Prime Minister, his medical condition took a U-turn.

There are many more such examples in our political scenario. The scientific principle behind this is that the feeling of being powerful alters the chemistry in the brain and the blood and keeps the serotonin levels higher than in the normal. Normally there is a balance between serotonin and melatonin levels. Serotonin increases in the daytime and melatonin at the nighttime. While serotonin causes aggression and produces vigor, melatonin is responsible for the sleep and resting state of the body.

It is a well-known observation that when politicians give a speech in the TV studio the response is not as aggressive as when they give a speech in front of a gathering of 20,000 people. With the public’s cheers, their speech becomes aggressive and often impressive.

Another example is seen in Indian cricket. In front of the home crowd, the performance of players is different compared to that when they play in other countries with very few spectators that too from that country.

The campaign in politics also may vary from positive to negative one. In positive approach, you project what you want to do while in the negative approach you project about the deficiencies of your competitor only. In the long run a person with positive approach will always win. People who have a negative approach may ultimately develop high blood pressure, diabetes, acidity or suffer from heart attack, paralysis and cancer. Negative emotions produce negative chemistry, responsible for deposition of fat in various arteries and causation of cancer.

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 on

7types of normal memory problems

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

Seminar on Health and Happiness

A seminar was organized jointly by Heart Care Foundation of India and Bharatiya Vidya Bhavan.

 
Dr K K Aggarwal
 
    National News

Lifestyle change prime reason for hernia, says doc

Change in lifestyle and dietary habits are the major reasons for hernia, which is on the rise in the country, according to Dr. Rajesh C. Shah, president of Indian Hernia Society. Less intake of dietary fibres coupled with overeating of fatty meats, deep fried foods, high fat cookies and alcohol will lead to herniation. “Number of hernia cases is definitely on the rise; however, we lack proper data on the number of hernia surgeries being done annually. In the US, eight lakh surgeries are being performed every year,” Dr. Rajesh told DC on the sidelines of a two-day national conference on hernia conducted by Indian Hernia Society at Sunrise Hospital.

With less fibre intake, there is high chance of constipation and the abdominal pressure gets increased leading to herniation. It is essential to go for medical consultation in the right time as treatment will be very difficult once there is an intestinal obstruction, which also increases the chances of further complications, he said. Laparoscopy is the latest method to treat hernia. It will help patients return to normal life very fast. “Researches are going on to develop non-invasive methods to cure hernia. A time will come soon when the disease can be cured through non-surgical method,” he said. More than 200 surgeons from across the country are participating in the conference. (Source: Deccan Chronicle, August 19, 2012)

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

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

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Antibiotic may be Tx option in lung disorder

The antibiotic azithromycin (Zithromax) may help prevent exacerbations in patients with non-cystic fibrosis bronchiectasis, researchers found. (Source: Medpage Today)

Study gauges renal failure risk in middle age

About one in 40 men and one in 60 women in middle age have a high risk of developing end-stage renal disease (ESRD) in their lifetimes, researchers reported. (Source: Medpage Today)

Cervical disease treatment does not raise preterm birth risk

Women who have been treated for cervical intraepithelial neoplasia are not at increased risk for preterm birth, according to a retrospective-prospective cohort study using record linkage, published online August 17 in the British Medical Journal. (Source: Medscape)

Inhaled combination therapy for COPD: A once-a-day alternative?

A combination of fluticasone furoate and vilanterol (FF/VI) inhaled once daily improves pulmonary function and has a duration of action of longer than 24 hours, according to the findings of a new study published in the August issue of Clinical Therapeutics. (Source: Mescape)

Reduction in depression treatment linked to EMR Use

Patients with multiple chronic conditions are significantly less likely to receive treatment for depression at primary care practices that use electronic medical records (EMRs) compared with practices that do not use EMRs, new research shows.

 
    Twitter of the Day

@DrKKAggarwal: Shedding Weight Improves the Relaxation Functions of the Heart

@DeepakChopra: Thoughts are probability waves from the conditioned mind that shape everyday reality. True creativity comes from pure consciousness.

 
    Spiritual Update

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

Spiritual Significance of Adhik Maas (Purshottam Maas, Mal maas)

  1. One solar calendar comprises of 365 days and 6 hours. One lunar calendar comprises of 354 days and 9 hours (difference of 11 days)
  2. Adhikmas (Vishnu pooja Month) is created in order to synchronize the solar calendar with the lunar calendar.
  3. The duration between one Adhikmas to another Adhikmas is from 28 to 36 months (32.5 months). So Adhikmas arrives every 3 years. The months every year are different. It does not happen between Kartik and Magh.

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)

Who are egg donors?

There are several ways of obtaining donor oocytes (eggs).

  • Anonymous donors: women who are not known to the recipient. Donors maybe recruited through established egg donation programs, or may be identified through agencies.
  • Known or directed donors: women who are known to the recipient. The donor is generally a close relative or friend. In some instances, recipients advertise directly for donors in newspapers or on the Internet. In these circumstances, the recipient couple and the donor are known to each in a limited way, having met without an intermediary program or agency.
  • IVF programs: women undergoing IVF may agree to donate their excess egg to infertile patients. This source of donors is limited, probably because of the perceived coercive nature of the donation if the women are offered a financial discount on their own IVF cycle.

For comments and archives

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

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

Patient care during and after transfusion

  • The transfusionist should remain with the patient for the first few minutes of the transfusion, which should be started slowly.
  • Catastrophic reactions from acute hemolysis, anaphylaxis, or bacterial contamination can become apparent after a very small volume enters the patient’s circulation.
  • After first 15 minutes, the patient should be observed and the vital signs recorded; if the patient’s condition is satisfactory, the rate of infusion can be increased as desired.
  • Clinical personnel should continue to observe the patient periodically throughout the transfusion and up to an hour after completion.

Rate of Infusion

  • The desirable rate of infusion depends upon the patient’s blood volume, cardiac status, and hemodynamic condition.
  • However, the references gives 4 hours as the maximum duration for an infusion, but maximum time should not be confused with recommended time, as most transfusions are completed within 2 hours.
  • If rapid transfusion is needed, blood can be infused as rapidly as the patient’s circulatory system will tolerate, within a few minutes, if the rate does not cause the red cells to hemolyse.
  • Except during urgent restoration of blood volume, the first 25-50 ml should be given slowly and patient should be closely monitored.
  • If blood flows more slowly than desired, the cause may be obstruction of the filter or needle or excessive viscosity of the component.
  • Steps to investigate and correct the problem include the following:
    • Elevate the blood container to increase hydrostatic pressure.
    • Check the patency of needle.
    • Examine the filter of the administration set for excessive debris.
    • Consider the addition of 50-100 ml of sterile 0.9% normal saline to a preparation of red cells, if there is an order permitting such addition.

For comments and archives

 
    An Inspirational Story (Ms Ritu Sinha)

Value and Invest in Yourself

Author: Warren Buffet

If you are into financial investment, you’re probably very familiar with Mr. Warren Buffet (1951–present). He is the most successful investor in the world. His investment strategies are legendary and many people seek to learn from him.

Even more respectable, he pledged to give away 99% of his wealth (more than $30 billion at the time of the pledge in 2006) to non-profit foundations, mostly to Bill Gates’ Foundation.

Mr. Buffet often travels to universities to give speeches to educate and motivate students. Here is one of his speeches to teach us the value of our body, to invest in ourselves, in education for a great future.

Imagine that a Genie offers you any car in the world. The catch is that it is the only car you will ever own. What would you do?

You would read the manual 10 times, change the oil twice as often as required, and you would take fastidious care so that that car remained the car of your dreams forever.

Think about what this tells you about your body. You get only one mind and one body–the same ones you will have at 20, 40, 60, etc.

Take care of them and maximize their potential. It will be too late to take care of your body and mind (and car) later on. You can maintain them, but it is hard or impossible to undo big mistakes or negligence later on. You do not want to end up with a wreck on your hands.

Your main asset in life is yourself.

Treat yourself as a valuable asset. I often explain to students that I would be willing to pay today for a percentage of the future earnings of good students. If you value yourself, and invest in yourself, you will be worth a great deal throughout your lifetime, both to yourself and to your community.

For comments and archives

 
    Cardiology eMedinewS

Despite edema, ambrisentan effective in PAH Read More

An apple a day keeps high cholesterol at bay? Read More

 
    Pediatric eMedinewS

Weight gain slower where school-food laws are strong Read More

High sedentary levels lessen motor coordination in children Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with fever and joint pain came with rash.
Dr Bad: It’s a drug allergy.
Dr Good: It looks like Chikungunya.
Lesson: Rash is present in 30% of cases with Chikungunya.

For comments and archives

Make Sure

Situation: A patient with dengue died.
Reaction: Oh my God, why was he not given adequate fluids?
Lesson: Make Sure that all patients with dengue are given fluids to correct intravascular dehydration.

For comments and archives

 
  Quote of the Day (Dr GM Singh)

As the yellow gold is tried in fire, so the faith of friendship must be seen in adversity. Ovid

 
    Legal Question of the Day (Dr MC Gupta)

Q. Can an MD Microbiology set up his own lab?

Ans.

  1. As per the existing law, a microbiological report related to a patient is treated as a pathology report. A pathological report has to be issued by a pathologist.
  2. The above position can be supported according to the principles of medicine that a laboratory report related to body pathology is a pathological report. It cannot be doubted, for example, that a report related to presence or absence of tubercle bacilli in the body is related to a pathological process in the body.
  3. In view of the above, it is clear that, as per law, there is no bar that a microbiologist having the degree of MD (Microbiology) or MSc (Microbiology) cannot establish his own lab. However, the reports must be signed by a pathologist. The owner of the lab has an option to employ a part time pathologist.

For comments and archives

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

Photos of Doctor’s Day Celebration

 
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    Ophthal Update (Dr S K Verma, Consultant Ophthalmologist, New Delhi)

Journey of Cataract Surgery - From Couching to Femtolaser (Part 2)

INTRAOCULAR LENS IMPLANT - ( IOL) - In 1940's Harold Ridley of England introduced the IOL which is implanted after the removal of the opaque lens and which made the comfortable visual rehabilitation possible with normal vision after cataract surgery. Now a days the IOLs are available in different designs, materials (silicon or acrylic), multifocal, toric, accommodative, foldable, injectable, etc. with so many implantation techniques.

ANAESTHESIA IN CATARACT SURGERY - It was not until the late 1840s that general anesthesia was introduced for surgical procedures. By 1884, anesthesia in the form eye drop (cocaine) developed. Before that services of strong assistants were required to hold the patient's head still during surgery.

PHACOEMULSIFICATION - (PHACO) - In late 1960's Charles Kelman of New York developed a technique for emulsifying the lens content using ultrasonic vibration and aspirating the emulsified cataract by a common probe through tiny incision at limbus or in peripheral clear cornea. The incision is so small that it does not require a suture. Phaco is a Greek word for the lens of the eye.

FEMTOLASERS - In this technique ultra short laser pulse, near infrared range of wave length, of few femto seconds (1femto second is equal to 10 to the power minus fifteen seconds) with very low energy of few nano joules (1 nJ is equal to 10 to the power minus nine joules per laser pulse) is used. This causes the disruption material limited to focal point. The process is known as photodisruption. This femtolaser is used in cataract surgery for incision making at limbus or cornea, for reproducible capsulorrhexis (circular opening in the anterior capsule of lens) and easier fragmentation and emulsification of lens material and then aspiration of lens material by simple suction probe. There is no thermal damage of the tissue.
So there is tremendous advancement in the field of cataract surgery. No one knows what lies for cataract surgery in the bag of future.

 
  Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Electrolytes (Sodium, Potassium, Chloride and Carbon dioxide)

  • To help detect and evaluate the severity of an existing electrolyte imbalance
  • To monitor the effectiveness of treatment

Electrolytes may be affected by many conditions; with Addison’s disease the sodium, chloride, and carbon dioxide levels are often low, while the potassium level may be very high.

 
    Mind Teaser

Read this…………………

A female client is admitted with a diagnosis of acute renal failure. She is awake, alert, oriented, and complaining of severe back pain, nausea and vomiting and abdominal cramps. Her vital signs are blood pressure 100/70 mm Hg, pulse 110, respirations 30, and oral temperature 100.4°F (38°C). Her electrolytes are sodium 120 mEq/L, potassium 5.2 mEq/L; her urinary output for the first 8 hours is 50 ml. The client is displaying signs of which electrolyte imbalance?

A. Hyponatremia
B. Hyperkalemia
C. Hyperphosphatemia
D. Hypercalcemia

Yesterday’s Mind Teaser: Immediately after cholecystectomy, the nursing action that should assume the highest priority is:

A. Encouraging the client to take adequate deep breaths by mouth
B. Encouraging the client to cough and deep breathe
C. Changing the dressing at least BID
D. Irrigate the T-tube frequently

Answer for yesterday’s Mind Teaser: B. Encouraging the client to cough and deep breathe

Correct answers received from: Raju Kuppusamy, Dr Jainendra Upadhyay, Dr Thakor Hitendrsinh G,
Dr Thakur Om Prakash Singh.

Answer for 20th August Mind Teaser: White. Only at the North Pole can all four walls be facing South.

Correct answers received from: Dr Vinay Nambiar.

Send your answer to ijcp12@gmail.com

 
    Laugh a While (Dr GM Singh)

A doctor worked at a mental hospital. He wanted to take some patients to a ballgame, worked months to get them to follow simple commands, and finally decided they were ready.

When the star spangled banner played he said: "Stand up nuts" and they stood. When it was over he said: "Sit down nuts" and they sat. When a player got a hit he said: "Cheer nuts" and they cheered. When the umpire made a bad call he said: "Boo nuts" and they booed. He decided it was safe to leave them with his assistant and left to get a hot dog. He came back to a near riot. He asked his assistant what in the world happened. He said: "Everything was fine 'til some vendor came be and yelled 'peanuts'."

 
    Medicolegal Update

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

What is the August 5, 2005 Supreme Court judgment on medical negligence?

Cases of doctors being subjected to criminal prosecution are on an increase. Sometimes such prosecutions are filed by private complainants and sometimes by police on an FIR being lodged and cognizance taken.

  • The investigating officer and the private complainant cannot always be supposed to have knowledge of medical science so as to determine whether the act of the accused medical professional amounts to rash or negligent act within the domain of criminal law under Section 304–A of IPC.
  • The criminal process once initiated subjects the medical professional to serious embarrassment and sometimes harassment.
  • He has to seek bail to escape arrest, which may or may not be granted to him.
  • At the end he may be exonerated by acquittal or discharge but the loss which he has suffered in his reputation cannot be compensated by any standards.
  • We may not be understood as holding that doctors can never be prosecuted for an offence of which rashness or negligence is an essential ingredient.
  • All that we are doing is emphasizing the need for care and caution in the interest of society; for, the service which the medical profession renders to human beings is probably the noblest of all, and hence there is a need for protecting doctors from frivolous or unjust prosecutions.
  • Many a complainant prefer recourse to criminal process as a tool for pressurizing the medical professional for extracting uncalled for or unjust compensation. Such malicious proceedings have to be guarded against.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Monsoon fever can be deceptive

In the current season any episode of fever should not be taken lightly as many diseases can cause fever, the commonest being viral, malaria, dengue or Chikungunya. However, fever can also be due to viral jaundice or typhoid. This was stated by Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

Following tips were released for the benefit of the public:

  • Unless you suspect typhoid, no antibiotics are required.
  • Viral fever will have cough, redness of the eyes or nasal discharge.
  • Dengue will have fever with rash and pain in eye movement.
  • Chikungunya is a triad of fever, rash and joint pain. Typically the joint pain will increase on compression of the wrist joint.
  • Typically, the fever in malaria comes with chills and rigors and will have normal phase in between two episodes of fever.
  • Fever in jaundice disappears once the jaundice starts.
  • Typhoid fever is often continuous with relatively low pulse rate and with toxic feeling.

Precautions

  • No antibiotics are required unless there is a feeling of toxemia.
  • Antibiotics in sore throat are only required if associated with pain in the throat while swallowing food or red angry-looking tonsils.
  • Except for paracetamol or nimesulide, other anti fever medicines should not be used indiscriminately as they can reduce platelet count.
  • Most diseases are self-limiting and take 4 to 7 days to resolve.
  • The basic precaution involves proper hydration, especially on the days when fever is subsiding.

Warning signals

Any fever with associated comorbid conditions should not be ignored and consultation should be taken from the doctors.

 
    Readers Responses
  1. Dear Dr KK, I fully agree with the news about incest. This is a sexual perversion and purely personal and cannot be punished under any law but the mental trauma undergone by the child is something very difficult to treat by mental health professionals. we get almost 1 case of incest every day in our deaddiction centre. Invariably the mother of the child do not want us to discuss with the offender that is father who is an alcoholic. Dr.r.mani Chennai
 
    Forthcoming Events
Dr K K Aggarwal


Dr K K Aggarwal
Dr K K Aggarwal


Dr K K Aggarwal

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 public. Event will be promoted through hoardings, our publications and the press. Public health discussions
http://www.heartcarefoundation.org

 
    eMedinewS Special

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    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