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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 September 2011, Thursday

Heart attack lowest in September but not amongst diabetics

There is a seasonal pattern of deaths from heart attacks with more fatal events (20 to 30 percent variation) occurring in the winter than the summer. But this seasonal pattern is absent in diabetics or those taking beta blockers or aspirin.

The heart attack trends are independent of gender, geographic location, age, and the type of heart attack (ST elevation or non–ST elevation). In–hospital mortality fatality rates for heart attack also follow a seasonal pattern, with a peak of 9% in winter and 8.4% in the summer. Deaths from heart attack are highest in January and lowest in September, with a relative risk difference of 18.6%.

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

Heart attack lowest in September but not
amongst diabetics

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela to be Multi-Locational

In a press conference, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Perfect Health Mela, with the team of upcoming movie Dharna Unlimited

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


India steps up polio surveillance as virus re–emerges in China

NEW DELHI: With the detection of four cases of polio in China after a gap of ten years, India has heightened surveillance in border states. The Health Ministry has put on high alert various border states in the country, asking them to put up polio booths. States like Punjab, Himachal Pradesh, Rajasthan and Gujarat, besides Uttar Pradesh and Bihar have been asked to compulsorily administer polio drops to all children entering India from any of the neighbouring countries. Rapid Response Teams, especially trained for virus threats in the country, have also been put on high alert, said Health Ministry officials. (Source: TOI, Sep 20, 2011)

For comments and archives

Transplantation of Human Organs Act to be amended

The Transplantation of Human Organs (Amendment) Bill, 2011

  1. The Bill aims to expand the definition of "near relatives" to include grandparents and grandchildren
  2. Another amendment, seeks to make it mandatory for the treating medical staff to request relatives of brain dead patients for organ donation and to provide for enucleating of corneas by a trained technician.
  3. Amendments also propose to provide for development and maintenance of a national registry of recipients of human organ transplants

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

(Dr Monica and Brahm Vasudev)

Laser therapy matches standard varicose vein Tx

A newer laser ablation treatment for varicose veins is just as effective as conventional therapy, researchers found. Over two years of follow–up, recurrence rates were similar for endovenous laser treatment (EVLT) and high ligation and stripping (HLS), Knuth Rass, MD, of Saarland University Hospital in Hamburg, Germany, and colleagues reported online in the Archives of Dermatology. (Source: Medpage Today)

For comments and archives

Yawning, a natural brain–cooling mechanism

Yawning, popularly considered a mark of boredom or fatigue, could serve as a method for regulating brain temperature, according to a new study. A study led by Andrew Gallup, a postdoctoral research associate in Princeton University’s Department of Ecology and Evolutionary Biology, is the first involving humans to show that yawning frequency varies with the season and that people are less likely to yawn when the heat outdoors exceeds body temperature. This suggests that yawning could be a natural brain–cooling mechanism, Princeton University and University of Arizona researchers reported. (Source: TOI, Sep 21, 2011)

For comments and archives

Stress can precipitate sudden death in heart patients

  • Evidence suggests a possible role for psychosocial factors in sudden cardiac death.
  • Sudden death in heart patients peaks in the morning. Increased adrenergic activity at this time may increase electrical instability or induce myocardial ischemia without heart attack.
  • Cardiac arrests also show a weekly and seasonal variation. The daily incidence peaks on Monday and the seasonal incidence is greatest in winter.
  • Depression increases the risk of sudden death
  • Emotions can precipitate irregular heart rhythm
  • The cardio protective effect of beta blockers after heart attack may work through modification of acute stressors.

For comments and archives

    Fitness Update

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

Exercise and confidence can help beat rheumatoid arthritis symptoms

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation in the joints. The disease is common; the WHO estimates that the disease affects 1 percent of the world’s population. Symptoms include pain, swelling, and tenderness in joints, and functional disability. Previous research that shows the benefit of exercising on RA has been presented in Health E–Review. Now, new research published in the journal Arthritis Care & Research shows that a healthy dose of confidence can help, too.

The study, conducted by a group of scientists in the Netherlands, surveyed a total of 106 RA patients in order to assess physical activity, motivation and self–efficacy (which is defined as one’s confidence to perform a task) for physical activity, level of arthritis pain, and quality of life. They also asked participants to set a physical activity goal that they wanted to achieve. After six months, researchers found that participants with higher confidence were more likely to reach their goal, and those who reached their goal were significantly more likely to experience decreased pain and increased quality of life.

If you know someone with RA, encourage them to speak with a health professional about safe and low impact exercise options to help their symptoms.

For comments and archives

    Twitter of the Day

@DrKKAggarwal: "Don’t get disappointed whenever U fall because only fallen leaves have the power 2 touch great heights when wind blows"

@DeepakChopra: #CosmicConsciousness Explaining the universe implies an explainer. There is no explanation of anything without a knower.

    Dr KK Answers

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

Can patient with high blood pressure take Viagra group of drugs?

Viagra group of drugs are typically well tolerated with only minor reductions in blood pressure in patients taking conventional antihypertensive drugs (ACE inhibitors, AR blockers, calcium blockers, beta blockers, and diuretics), even when used in combination.


  1. Sildenafil Study Group. Am J Hypertens 2001;14:70.
  2. Am J Hypertens 2004;17:1135.

For comments and archives

    Spiritual Update

Why don’t we eat curd in Bhadon month?

It is a traditional Ayurveda saying that one should not take green leafy vegetables in the month of Shravan, curd (yogurt, dahi) in the month of Bhadon, milk in the month of Ashwin and butter milk (mahi, matha), pulses and oil in the month of Kartik.

For comments and archives

    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Does the SDM have power to waive off the requirement for post mortem examination?


1. With whom the power to waive autopsy lies can vary from state to state because police is a state subject. It is the duty of the police to make a request for post–mortem examination. A doctor cannot perform autopsy unless there is a written request from the police. The police would make a request only as per rules applicable in the state.

2. The rules in Punjab are as follows:

"The Punjab police rule (25:38)7 state that if a body is unidentified, the officer making the investigation shall record a careful description of it, giving all marks, peculiarities, deformities, other distinctive features and shall take the finger impressions. In addition to taking all other reasonable steps to secure identification he shall, if possible, have it photographed. In cases where such action appears desirable, a description should be published in the criminal intelligence Gazette. Unidentified body should be handed over to any charitable society which is willing to accept them, and if no such society comes forward, they should then be buried or burnt. In Delhi, the police sends telegram message called "Hue and cry notice’ to various police head–quarters of the country. The "Hue and cry notice’ contained brief description of the identification features of the deceased. The body is preserved in the mortuary for 72 hours from the time telegram message is sent. If there is no one to claim the body after 72 hours the police is legally authorized to dispose of the body. But if the police think that the body maybe identified by the relatives, it should be preserved for longer time till relatives comes and claims the body. The expenditure on the disposal of body in unidentified case are born by the police department. This is applicable in medicolegal cases expired outside hospital or inside the hospital.

Again as per Punjab police rule (25:36)7 an investigating officer is empowered by law to waive off the postmortem in case he thinks that there is no foul play and death is due to natural cause."

(In: Procedure for preservation and disposal of dead bodies in hospital. T. Millo, Arun Agnihotri, Shakti Gupta, T.D. Dogra. http://cyberlectures.indmedica.com/show/125/3/

3. The rules in Delhi are as follows:

"In Delhi the Assistant commissioner of police is authorized to waive off the postmortem on the recommendation of the investigating officer. However autopsy surgeon can recommend investigating officer for waiving off the case if he think it is a case of natural death, but the final authority rests with the Assistant commissioner of police."

(Ref: Millo et al., as above)

4. The legal principles involved are as follows:

  • There may be situations when performing an autopsy may not be necessary or practical and the requirement for autopsy may have to be waived off. The role of police is to maintain law and order and to investigate crime as per rules and, after investigation, to file the charge sheet or the closure report before the appropriate judicial authority for passing appropriate judicial orders.
  • Police is bound to get a postmortem examination done as per departmental rules and has little or no discretion in the matter.
  • When death occurs and a body is likely to be disposed/cremated, the judicial authority has powers to grant a request for postmortem and to issue necessary orders to the police to get an autopsy done.
  • It stands to reason that if the judicial authority has power to order an autopsy, it should also have power to waive the requirement for autopsy when the circumstances so demand.

For comments and archives

    An Inspirational Story

(Dr Anil Kumar Jain)

Her struggle……Part three

After all of my social and official duties towards Sultan were over, I went to the ‘ICTC’. I conveyed to the doctor the fate of Sultan. I asked her that as I was pregnant and HIV–positive, were there any legal bindings on me to give birth to my baby or not. She told me that confidentiality was the primary object of ‘ICTC’. She had told me about the HIV status of Sultan only after he had consented to it. There were no legal bindings even over him to tell his wife about his HIV status. At least we the health providers keep it confidential. She told me that it was up to me to go for a baby or not. Till date HIV–positives have full right to go for a baby or not. She told me HIV–positive mothers could transmit HIV infection to their babies during pregnancy, during labor or delivery and via breast milk. There are medicines which can reduce this risk. But even after proper prophylaxis, there were chances of mother to child transmission (MTCT). If you opt for a baby to be delivered you have to take extra calories in your diet throughout your pregnancy. During childbirth also, it was not mandatory that HIV–positive mothers should disclose their status to the doctor but such disclosures might save the life of mother and child or might be good to stop MTCT. If HIV mothers gave birth to a child there are up to 20% chances of MTCT and up to 20%. A HIV–negative baby born to HIV–positive mother might get it through breastfeeding. Drugs given to the mother during pregnancy and to the baby just after birth can reduce this up to almost 2% chances. If HIV–positive mother does not opt for breastfeeding, she has to opt for AFASS criteria for feeding the baby. The AFASS criteria was to protect child from getting opportunistic infections as these infections might kill more newborn babies than the number of babies getting HIV infections through breast milk. If HIV–positive mothers opt for breast feeding it has to be total breastfeeding, no milk substitute are allowed for six months then abrupt stopping of breastfeeding is recommended. The HIV–positive mothers during pregnancy and HIV–positive new born should receive the same vaccines as if they were HIV negative.

I thanked the doctor for the information given and visited my mother’s home. She still did not know about my HIV status or my pregnancy. She formally condoled Sultan’s death and insisted that I should remarry now. Then I told her that I was HIV–positive and pregnant too. She was shocked and started weeping. I was the main cause of her sorrows. I never gave ears to her advice. I could not stay there very long. I returned home.

Then was the time when I had to take firm decisions. But every decision of me regarding my life had been a catastrophe for me. Sultan and each person known to me opposed my decision to be pregnant. But I went for pregnancy. HIV virus showed me no courtesy. It infected me and was in my blood for ever. Should I go for abortion? But why? I could adopt a child when I was HIV–negative. I insisted on having Sultan’s child regardless of me acquiring the infection. What was the difference in the situation now? What I wanted was inside me. But this virus would not spare my baby. How would my baby after birth withstand the disease and the stigmas associated with it? Then once again I collected all my courage and made a final decision that I would struggle against this cruel virus. I would give birth to my child. The last remains of Sultan had every right to flourish. I would take every necessary medicine available on the earth. My baby would see the world. Let me prove that this virus could not be bigger than human efforts. I would give birth to my baby and would also breast feed him. And only this child would tell the world that the love story of his parents was not an inch lesser than the story of Laila–Majnu.

I took every precaution and medication during the pregnancy which the doctors advised me. I had disclosed my status to the Obstetrician. Maa visited often but she was not happy with me at all. My diet was increased. I was getting 600 extra calories per day.

I gave birth to a son. Doctor gave my son a prophylactic dose of syrup Nevirapine. I fed him colostrum. I was anxious to know the HIV status of my son. But the doctor told me that it was not possible as baby had mother’s antibodies against HIV. Doctors had also counseled me about the health of my breasts and oral hygiene of baby's oral cavity. They also counseled me about AFASS criteria if I did not feed my baby.

The baby grew. He was healthier than the other babies of his age. After six months I stopped breastfeeding abruptly as advised by doctors.

At the age of about one year, my son underwent HIV test. He was HIV–negative. That day I could not prevent my tears to flow out of my eyes. After all I had defeated that dreaded virus. This was a victory of human efforts over HIV.

Today my son is five years old and I am not taking antiretroviral treatment as my CD4 count is over five hundred. Doctors of ICTC say that I can live upto 15more years and I have taken another oath that if I will be alive up to the marriage of my son I will marry him with an HIV–positive girl. Of course, only if she got it accidentally, as Sultan got it. Till than I have to remain alive whatsoever may be the circumstances. I will struggle to see that happen. Thus her struggle starts………

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    Medicine Update

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

How is lactose intolerance diagnosed?

In many countries lactose breath hydrogen test is available to confirm the presence of lactose intolerance. However, this test is not easily available in India. Here the diagnosis is made on ‘clinical grounds’ with a good history and physical examination and a trial of lactose–free diet. Relief of all symptoms on a lactose–free diet and recurrence of symptoms on lactose ingestion is a good way to make a diagnosis. However, it is imperative that if you have persistent lactose intolerance then the possibility of an underlying disease should be kept in mind.

For comments and archives

    Infertility Update

(Dr. Kaberi Banerjee, Infertility and IVF Specialist)

Infertility is still an enigma to us. The most advanced technique gives a pregnancy rate of at best 50–60% per attempt. Definitely there is lot more to be understood. We are hosting a Conference on 8th–9th of October at Le’ Meridian, New Delhi on Current Practices and Recent Advances in ART (CUPART 2011). We have invited a very respectable panel of International and National faculty whose experiences will be a wealth of knowledge to us.

Under the aegis on AOGD

Organizing Chairperson – Dr Kaberi Banerjee

Day – 1 Interesting Highlights

Session 3 – Common Gynaecological Problems and Infertility – Effective Treatment Options

This session highlights effective treatment options for women suffering from infertility and associated gynaecological disorders like endometriosis, polycystic ovaries, fibroids and tubal factor.

Speakers: Dr Neeta Singh (AIIMS), Dr Abha Majumdar (New Delhi), Dr Yakoub Khalaf (UK), Dr Sohani Verma (New Delhi)

Inauguration & Welcome Address by Chief ICMR New Delhi at 7.00pm followed by Shaan – e – Hindustan – Sufi Night with Adil Hussaini, Hyderabad & Fellowship Dinner

For Registration Please Contact: Address: E –23 Ayurvigyan Nagar New Delhi – 110049

For details contact +91 9871250235

For comments and archives

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum phosphorus

Hyperphosphatemia or high serum phosphorus levels may occur in myeloma, Paget’s disease of bone, osseous metastases, Addison’s disease, leukemia, sarcoidosis, milk–alkali syndrome, vitamin D excess, healing fractures, renal failure, hypoparathyroidism, diabetic ketoacidosis, acromegaly, and malignant hyperpyrexia. Drugs causing serum phosphorous elevation include androgens, furosemide, growth hormone, hydrochlorothiazide, oral contraceptives, parathormone, and phosphates.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient wanted to know if he could take a tablet along with a condom for a high–risk sex.
Dr Bad: There is no such drug.
Dr Good: Yes, you can have one of the antiretroviral drugs.
Lesson: Pre–exposure prophylaxis involves giving uninfected people antiretroviral drugs as a possible means of preventing HIV infection. The published results of the NIH–sponsored iPrEx study indicated that a daily dose of an oral antiretroviral drug cut the risk of HIV infection by more than 40 percent among men who have sex with men.

For comments and archives

Make Sure

Situation: An elderly died of pneumonia.
Reaction: Oh my God! Why was pneumonia not suspected?
Lesson: Make sure in all elderly, pneumonia is excluded even if the symptoms are atypical in nature.

For comments and archives

  Quote of the Day

(Dr. GM Singh)

True friendship for ever

Stars has 5 ends, Square has 4 ends, Triangle has 3 ends, Line has 2 ends but Circle of our friendship has no end.


Last but not least: An introduction phrase to let the audience know that the last person mentioned is no less important than those introduced before him/her.

  Sri Chanukah Niti-Sastra: The Political Ethics of Chanakya Pandit

(Dr Anupam Sethi Malhotra)

Therefore with an eye to the public good, I shall speak that which, when understood, will lead to an understanding of things in their proper perspective.

    Medicolegal Update

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

No two people except identical twins have the same DNA structure

  • Human being has a unique signature that lives within every cell of our body. This signature is commonly known as DNA, testing is done by taking DNA extracts from biological sample putting them into a gel matrix and then using probes to help extract certain markers.
  • We get our DNA from our biological mother and biological father. Each of them contributes 50% of our chromosomes that will make up our DNA, which will stay with us for our entire lives without change. This is the very reason that makes DNA such a great choice for uniquely identifying a person.
  • Questions may arise as to how accurate DNA tests are. After all, in the past blood tests cannot have been as accurate as we might have hoped. They often left a bit of uncertainty or could not be conclusive in many areas. But thanks to the uniqueness of DNA almost all of these doubts can now be taken away.
  • Testing can be done on DNA to help determine parentage, ancestry, presence of genetically–based diseases and to help identify someone who may have been present at a crime scene.
  • Most DNA tests are run at least twice, both independent of each other. This not only builds upon the credibility of the test but also helps ensure that no wrong data or incorrect marker analysis was performed on the first test. If any discrepancies are detected between the two tests then a new sample is used and the entire test is performed again to understand where the discrepancy may lay.
  • Modern testing procedures and rules for DNA analysis mean that with rare exception DNA testing results can be guaranteed to be more than 90% accurate for most paternity, forensic and genetically–based disease analysis.
  • However human error can come into play. A lab may mistakenly switch samples or key in data incorrectly. All of these factors are possible, but are very rare in occurrence. If there is ever any doubt as to the authenticity or correctness of a test it can simply be performed again to confirm accuracy.

For comments and archives

    Mind Teaser

Read this…………………

The most common subtype of Hodgkin’s lymphoma seen in children in India is

a. Nodular sclerosis
b. Mixed cellular
c. Nodular lymphocyte predominant Hodgkin’s lymphoma (NLPHL)
d. Lymphocyte rich classical Hodgkin’s lymphoma (LRCHL)

Yesterday’s Mind Teaser: Which of the following hormones are not released in duodenum?

a) Gastrin
b) Moiling
c) Somatostatin
d) Pancreatic YY

Answer for Yesterday’s Mind Teaser: d) Pancreatic YY

Correct answers received from: Bina Sawhney, YJ Vasavada, Dr Bharat Bhushan Aggarwal, Dr Anil Kumar Jain, Muthumperumal Thirumalpillai, Dr K Raju, Dr Chandresh Jardosh, Dr Surendra Bahadur Mathur, Dr Jainendra Upadhyay, Dr Neelam Nath, Anil Bairaria.

Answer for 20th September Mind Teaser
: What comes up must come down
Correct answers received from: Dr Surendra Bahadur Mathur, Dr Jainendra Upadhyay, Dr Neelam Nath, Anil Bairaria.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr. GM Singh)

An 86–year–old man goes for a physical. All of his test results come back normal. The doctor says, "Gary everything looks great. How are you doing mentally and emotionally? Are you at peace with God?" Gary replies, "God and I are tight. He knows I have poor eyesight, so he’s fixed it so when I get up in the middle of the night to go to the bathroom, *poof* the light goes on. When I'm done, *poof* the light goes off." "Wow, that’s incredible," the doctor says.

A little later in the day, the doctor calls Gary’s wife. "Marianne, he says, Gary is doing fine but I had to call you because I’m in awe of his relationship with God. Is it true that he gets up during the night and *poof * the light goes on in the bathroom, and when he’s done, *poof* the light goes off?" "Oh my God!" Marianne exclaims. "He’s peeing in the refrigerator again!!!!"

    Drug Update

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

Drug Name
DCI Approval Date
Aspirin (EC Tablets) 75mg/75mg/150mg + Rosuvastatin (Granules) 5mg/10mg/10mg Capsules
For the treatment of dyslipidemia associated with atherosclerotic arterial disease with risk of myocardial infarction, stroke or peripheral vascular disease.


    Public Forum

(Press Release for use by the newspapers)

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

Rat bite does not cause rabies

28th September is World Rabies Day: Rabies is transmitted through animal bites, scratches, abrasions, or contact with animal saliva via mucous membranes or a break in the skin, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President heart Care Foundation of India and MTNL Perfect Health Mela.

Dog, cat and bats can transmit rabies. Raccoons, skunks, foxes and coyotes can also transmit rabies. Rabies has been reported in large rodents (woodchucks and beavers) but small rodents, such as squirrels, chipmunks, rats, hamsters, gerbils, guinea pigs, mice, and lagomorphs (rabbits and hares) are almost never identified as infected with rabies virus; there has never been a case of transmission to a human from one of these animals. Monkey bite can also cause rabies.

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    Readers Responses
  1. Dear Sir emedinews is very informative newspaper. Regards; Dr Priya.
    Forthcoming Events

International Heart Protection Summit (IHPS–2011)

Organized by Ministry of Health & Family Welfare Govt. of India & ASSOCHAM September 28th, 2011 at Hotel Ashok, Chanakyapuri, New Delhi
President: Dr. H.K. Chopra, Intl. President: Dr. Navin C. Nanda, Scientific Chairman: Dr. S.K. Parashar, Org. Secretary: Dr. O.S. Tyagi,
For Registration & Details: Contact – Mob. 9971622546, 8010222883,
E–mail: agnideep.mukherjee@assocham.com; sandeep.kochhar@assocham.com,


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


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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