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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


eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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  Editorial …

22nd December 2011, Thursday

Ondansetron May Cause Abnormal Heart Rhythms

In September 2011, the US FDA issued a warning that ondansetron may prolong the QT interval, which can lead to abnormal and potentially fatal arrhythmias including torsade de pointes.

The FDA recommended that

  • Ondansetron be avoided in patients with congenital long QT syndrome.
  • EKG monitoring be performed in patients with hypokalemia or hypomagnesemia.
  • EKG monitoring be done in heart failure, bradyarrhythmias and in patients taking other drugs that can lead to QT prolongation.

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

Ondansetron may cause abnormal
heart rhythms

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011
Anmol-A Health Festival for Children with Special Needs

This unique event is organized every year to spread the message in the community that disabled children are differently able.

Dr K K Aggarwal
    National News

Meta–varsity by July 2012: VC

NEW DELHI: Universities are coming together to make higher education accessible to everyone. As part of an innovative set up Delhi University, Jawaharlal Nehru University (JNU), Jamia Milia Islamia and IIT–Delhi are working on creating a meta–university to allow students to pursue courses available across these institutions. "We are doing it on our own in Delhi. A student may not have to do semesters in quick succession. They can sit at any university and pursue the options they want. That’s the fun of a meta–university," said DU vice–chancellor Dinesh Singh while delivering a lecture on ‘Education in 21st Century’ at Vasant Valley School on Wednesday. (Source: TOI, Dec 15, 2011)

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

Vaginal progesterone cuts premature births

Women with a sonographically detected short cervix cut their risk for preterm birth in half with vaginal progesterone, according to a meta–analysis published online December 14 in the American Journal of Obstetrics and Gynecology. The report confirms results from several, prospective, randomized trials showing that progesterone was effective in preventing preterm births. (Source: Medscape Medical News)

For comments and archives

Diuretics yield long–term survival benefit

Older patients with isolated systolic hypertension gained an extra day of life expectancy for every month of treatment with diuretic–based stepped care, according to long–term follow–up of a randomized trial. (Source: Medpage Today)

For comments and archives

Endometriosis linked to later inflammatory bowel disease

Endometriosis is associated with an increased risk of developing inflammatory bowel disease (IBD), according to a large–scale, long–term study by Danish researchers published online December 19 in Gut. (Source: Medscape Medical News)

For comments and archives

    Cardiology eMedinewS

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

Statins May Protect Against Flu–Related Death

Read More

Heart Failure Update: Dr Sanjay Mittal

Read More

Vorapaxar Increases Bleeding in ACS

Read More

Drop in PCV after PCI a bad prognostic indicator

Read More

    Twitter of the Day

@DrKKAggarwal: Padma Shri Awardee Dr KK Aggarwal on Heart Patients Beware of Eating Cak… http://www.youtube.com/watch?v=3Aa84uAh1e4&feature=share via @youtube

@DeepakChopra: Speak of love with others. Remind each other of your spiritual purpose. Never give up hope. Know that you are loved.

    Spiritual Update

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

Mythology and The Science of Pregnancy

Most of the research claims of today by scientists in the West are re-searches and not researches as the Vedic era has examples of every possible scientific explanation of all happenings in life. During Rama and Krishna era, there were nuclear weapons, airplanes and what not.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

It is more blessed to give than to receive

A young man, a student in one of our universities, was one day taking a walk with a professor, who was commonly called the students’ friend, from his kindness to those who waited on his instructions.

As they went along, they saw lying in the path a pair of old shoes, which they supposed to belong to a poor man who was employed in a field close by, and who had nearly finished his day’s work.

The student turned to the professor, saying: "Let us play the man a trick: we will hide his shoes, and conceal ourselves behind those bushes, and wait to see his perplexity when he cannot find them." "My young friend," answered the professor, "we should never amuse ourselves at the expense someone. But you are rich, and may give yourself a much greater pleasure by means of the poor man. Put a coin into each shoe, and then we will hide ourselves and watch how the discovery affects him." The student did so, and they both placed themselves behind the bushes close by. The poor man soon finished his work, and came across the field to the path where he had left his coat and shoes.

While putting on his coat he slipped his foot into one of his shoes; but feeling something hard, he stooped down to feel what it was, and found the coin. Astonishment and wonder were seen upon his countenance. He gazed upon the coin, turned it round, and looked at it again and again. He then looked around him on all sides, but no person was to be seen.

He now put the money into his pocket, and proceeded to put on the other shoe; but his surprise was doubled on finding the other coin. His feelings overcame him; he fell upon his knees, looked up to heaven and uttered aloud a fervent thanksgiving, in which he spoke of his wife, sick and helpless, and his children without bread, whom the timely bounty, from some unknown hand, would save from perishing.

The student stood there deeply affected, and his eyes filled with tears. "Now," said the professor, "are you not much better pleased than if you had played your intended trick?"

The youth replied, "You have taught me a lesson which I will never forget. I feel now the truth of those words, which I never understood before: ‘It is more blessed to give than to receive.’"

For comments and archives

    Fitness Update

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

Get Enough Sleep

Children need about 8–10 hours of sleep a night. Those who don’t get enough sleep will have difficulty paying attention in school. Their body also won’t have as much energy to fight off infection. Keep to a strict nighttime schedule to make sure your children remain well-rested.

    Legal Question of the Day

(Dr MC Gupta, Advocate & Medico-legal Consultant)

Q. I am a physiotherapist and have the following questions:
a. In what manner do physiotherapists violate rules and regulations?
b. Is physiotherapy an independent profession? Is it an aid to other systems of medicine?
c. Can a doctor, who is not an expert in physiotherapy, prescribe a physiotherapeutic plan for his patient?


  1. First of all, we need to be clear about the words physiotherapy and physiotherapist. I am relying on the definitions given in Section 2(o) of the Paramedical and Physiotherapy Central Councils Bill, 2007, (Bill No. 96 Of 2007), "(o) physiotherapy means medically directed therapy through physical agents including heat, cold, light, water, massage, electricity or manual exercises to persons with the aim of preventing or correcting any disability and includes occupational therapy;" From the perspective of law, I am not concerned with definitions that might be given by WHO etc.
  2. Physiotherapists are known to indulge in following violations:
    1. They illegally use the prefix "Dr." to their name. The illegality is clear from the following:
      1. Section 6–A of the Indian Medical Degrees Act, 1916, reads––"no person shall add to his name any title, descriptions letters or abbreviations which imply that he holds a degree, diploma, licence or certificate as his qualification to practice any system of medicine unless, he actually holds such degree, diploma, licence or certificate;……………".
      2. On 25th August, 2008, the Executive Committee of the MCI issued a letter No.MCI–5(3)/2008–Med./ dated 25th August, 2008. This letter referred to the Indian Medical Degrees Act, 1916, and stated that "wherever any person found to be using the title of ‘Doctor’ as a prefix when such a person is holding a qualification in physiotherapy but not possessing any recognized medical qualification, he would be violating the provisions of Act of 1916 and as such he would expose himself for necessary action by filing or requiring the filing of a complaint in accordance with Section 7 of the 1916 Act for violation of Sections 6 and 6A of the extent applicable.
      3. A reading of the Delhi Council for Physiotherapy and Occupational Therapy Act, 1997, reveals that there is nothing in the Act to imply that those registered under the Act may use the prefix "Dr." http://www.lawsofindia.org/pdf/delhi/1997/1997Delhi7.pdf
      4. On 25–11–2003, the Ministry of Health and Family Welfare, Government of India issued an order No.R.14015/25/96–U&H(R)(Pt.) Government of India Ministry of Health & Family Welfare (Research Desk). This order states, inter alia, that— "the term "Doctor" should be used only by practitioners of Systems of Medicine recognized by the Government of India". The full text of the order can be seen at
      5. On 9–9–2009, the Government of Tamil Nadu Health and Family Welfare (Z1) Department issued an Annexure dated 9–9–2009 to the G.O. (Ms) No.338 Health and Family Welfare Department, dated 16.10.2008, wherein it was stated that in reference to Tamil Nadu State Council for Physiotherapy:

        "Physiotherapist means a person who possesses recognized physiotherapy education and whose name has been entered in the Register of Physiotherapy Council. He shall not use "Dr." before his name and prescribe drugs". This may be viewed at–– http://iapchennai.org/annexure.php
      6. The Madras High Court has held that physiotherapists cannot use the prefix "Dr." as per the following news report "High court warns against use of ‘Dr’ without valid medical degree TNN Feb 24, 2010, 01.44am IST CHENNAI: Putting a pause to the tug–of–war between physicians and physiotherapists over the use of the prefix ‘Dr,’ the Madras High Court has asked the authorities to take action against persons who use the prefix in their prescriptions and advertisements without a valid medical degree. Passing orders on a writ petition filed by the Indian Medical Association’s Quackery Eradication Committee, the first bench comprising Chief Justice HL Gokhale and Justice KK Sasidharan said the IMA must furnish details of people prescribing allopathic medicines and administering allopathic treatment and using the prefix ‘Dr' to the authorities. The IMA wanted the court to consider its two representations to the government, and to initiate criminal prosecution against paramedical technicians, practitioners and physiotherapists who prescribed allopathic medicine and used the prefix 'Doctor (Dr).’ The government pleader assured the court that the authorities would take necessary action in accordance with law. The state government had passed an order last year that a physiotherapist cannot use the prefix ‘Dr’ and should not prescribe drugs. However, paramedics and physiotherapists have been maintaining that the use of the prefix ‘Dr’ is more a matter of courtesy rather than adherence to law."
    2. Physiotherapists sometimes prescribe medicines though they are not supposed to do so in terms of the Patna High Court judgment in Sri Sarjoo Prasad and Ors. vs The State Of Bihar And Ors., dated 21 February, 2003, reported as 2003 (51) BLJR 686. http://www.indiankanoon.org/doc/1012912/
  3. It is undisputed that physiotherapy is not a system of medicine. It can obviously be only an aid to a system of medicine in the context of treating a patient. Physiotherapy cannot be an independent profession on the same footing as the recognised systems of medicine.
  4. The responsibility for treating a patient lies with the physician. In order to discharge this responsibility, he may have to get the aid of disciplines that are not systems of medicine in themselves but are meant to aid such systems in the interest of patient care. Examples are clinical psychology, acupuncture, physiotherapy (including occupational therapy), etc. It is obvious that a physician, who is admittedly not an expert in physiotherapy can, at his discretion, follow any one of the following approaches:
    1. Prescribe physiotherapy to the patient directly on his own without any reference to a physiotherapist.
    2. Prescribe a certain physiotherapeutic regimen and refer the patient to a physiotherapist for administering the same, subject to any modification in the regimen by the physiotherapist in view of his superior knowledge of physiotherapy.
    3. Refer the patient, after diagnosing and prescribing necessary medicines etc., to a physiotherapist for necessary assessment and planning a line of treatment as regards physiotherapy.

For comments and archives

    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Mental status testing

The Mini–Mental State Exam (MMSE), a brief test of orientation, memory and attention, can be used in the office setting to evaluate mental status. The maximum score on the MMSE is 30. Older drivers with scores of 23–25 out of 30 have more serious driving problems than normal controls. Drivers scoring 23 or less should be advised to stop driving until more formal neuropsychological testing is completed.

    Medicine Update

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

How do you take care of lactose intolerance?

There is no drug therapy available. The only treatment available is diet modification i.e. foods containing lactose need to be limited e.g. milk, cheese but not yoghurt where the bacteria have mostly metabolized the lactose. The quantity of lactose that may be ingested without developing symptoms is different for different individuals and only the affected person himself or herself along with the family members are able to determine this value. Also, milk taken along food or a cereal is better tolerated than plain milk alone. In some countries, lactase enzyme is available that is added to milk and left overnight for the enzyme to digest the lactose before it is drunk! Lactose intolerance is usually not clinically significant in acute gastroenteritis and does not demand modification of diet. Breastfeeding should almost never be discontinued for this reason.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient of recurrent miscarriage wanted to know her future risk of heart attack.
Dr. Bad: There is no risk.
Dr. Good: There is a future risk of heart attack.
Lesson: Women who suffer recurrent miscarriage have an increased risk of heart attack. Each miscarriage increases heart attack risk by 40% and having > 2 miscarriages increases the risk by >4–folds. In women who had > 3 miscarriages, the risk is 9–folds. One stillborn increases the risk of heart attack by 3.5 times (December 1, Journal Heart)

For comments and archives

Make Sure

Situation: A patient died after receiving penicillin injection.
Reaction: Oh my God! Why was anaphylaxis not suspected?
Lesson: Make sure that every time a patient is given penicillin injection, anti anaphylaxis measures are available.

For comments and archives

  Quote of the Day

(Dr GM Singh)

Do you Miss me or Hate me………………If you miss me, I‘m always in your heart. If you hate me then I’m always be in your mind

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum phosphorus

Hypophosphatemia or low serum phosphorus levels can be seen in several biochemical derangements, including acute alcohol intoxication, sepsis, hypokalemia, malabsorption syndromes, hyperinsulinism, hyperparathyroidism, and as result of drugs, e.g., acetazolamide, aluminum–containing antacids etc.

    Mind Teaser

Read this…………………


Yesterday’s Mind Teaser: thought an

Answer for Yesterday’s Mind Teaser: an after thought

Correct answers received from: Dr Anupam Sethi Malhotra, Dr Prabha Sanghi, Dr KV Sarma, Sudipto Samaddar, Dr HL Kapoor, Muthumperumal Thirumalpillai, Dr Mrs S Das, Dr PC Das, Dr Gautam Roy, Anil Bairaria.

Answer for 19th December Mind Teaser
: A step above the rest
Correct answers received from: Dr Gautam Roy, Anil Bairaria, Dr Neelam Nath, Dr A Rama Devi, Dr Vijay Kansal, Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr Anupam Sethi Malhotra)

Dedicated to all Married Couples

Question: Why do women live longer than men?
Answer: Shopping never causes heart attacks, but paying the bill does!

    Medicolegal Update

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

The duration of abrasion is roughly estimated as fresh when it is bright red

Mechanical momentum means mass with velocity discharged into the human body by a moving object or weapon or the impact of moving body against a surface produces injuries over the body. In the first case, the counter force is provided by the body and in the second case, by the rigidity of the object/weapon/surface/wall against which the victim falls itself or forced to fall by external reason. In most cases it is seen that the mechanical injuries produced over the body are due to a combination of two above forces. An abrasion is one of the most superficial injuries and means destruction of the superficial layers of the skin, caused by fall on a rough surface, by being dragged by a vehicular accident. According to the pattern of its causing force, abrasions are termed as scratches, grazes, pressure, impact or imprint abrasions. The duration of abrasion is roughly estimated as fresh when it is bright Red /½ day – 1day – Bright scab (covering) 2–3days – Reddish Brown covering and on 7th day – Almost normal.

  • Abrasions give an idea about the site of impact and direction of the force.
  • Often, they may be the only external signs of a serious internal injury.
  • Patterned abrasions are helpful in connecting the wound with the object which produced them.
  • The age of the injury can be determined, which helps to corroborate with the alleged time of assault
  • In throttling cases, crescent abrasions due to fingernails are found in the neck; however, in smothering, abrasions may be seen around the mouth or nose.
  • In open wounds, dirt, dust, grease, sand are usually present, which may connect the injuries to the scene of crime? Character and manner of the injury may be known from its distribution.
    • in throttling cases, crescent abrasions due to fingernails are found in the neck
    • In smothering, abrasions may be seen around the mouth or nose.
    • In sexual assaults, abrasions may be found on the breasts, genitals, inside of the thighs, and around the anus.
    • Abrasions around the face of the assailant indicate a struggle.
    • Abrasions on the victim may show whether the fingernails of the assailant were long, irregular or even broken.

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emedinews revisiting 2011
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    Public Forum

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Heart patients should stay more cautious during Xmas time

In the emergency room, heart attacks can be both over and under diagnosed. About 10% of heart attacks are overdiagnosed and equivalent number can be missed as the ECG can be normal in the first six hours after a heart attack, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Most heart attacks all over the world, including India, occur in winter. Missing a diagnosis of heart attack during this period in the early hours of the morning can lead to spurts in number of cases of sudden cardiac death.

Every effort should be taken to reduce the number of false positive or false negative diagnosis of heart attack.

In a study published in JAMA, Henry and coauthors studied the medical records of 1,345 people treated for suspected heart attacks in a regional system between 2003 and 2006, looking at emergency room decisions. In the study all patients had classical heart attack called STEMI heart attack characterized by a specific ECG pattern. About 14 % of heart attacks were overdiagnosed.

During Xmas most senior doctors maybe on vacation making the situation worse for the common man.

Men and women have about the same adjusted in–hospital death rate for heart attack — but women are more likely to die if hospitalized for a more severe type of heart attack

For comments and archives

    Readers Responses
  1. Excellent ! Daily update...Highly informative. Dr Ravi Jaya
    Forthcoming Events

Lecture on Buddism and Astronomy

By Prof. Trinh X. Thuan

UNESCO Kalinga Awardee, 2009; Prof. of Astronomy, University of Virginia, USA; UNESCO Kalinga Awardee for Popularisation of Science by UNESCO, Kalinga Chair awardee by Department of Science & Technology, Government of India.

Organised by Heart Care Foundation of India in association with Nehru Planetarium on behalf of RVPSP, Dept. of Science & Technology Govt.of India

At Nehru Planetarium Chankyapuri New Delhi on 27th Dec 2011 at 10.30 am

No fee, to register email to drkakroo@gmail.com, 9810301261

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews "Doctor of the Year Award" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.com

3rd eMedinewS Revisiting 2011

Dr Ajay Kriplani (Surgical management of diabetes); Dr N K Bhatia ( What’s new in transfusion medicine); Dr Kaberi Banerjee (Fertility update); Dr Amit Bahrgava (Cancer update 2011), Onco Radiation update (Rajiv Gandhi Cancer Institute); Dr Ambrish Mithal (Vitamin D update), Dr Praveen Chandra (Interventional Cardiology update); Revisting 2011 (Dr K K Aggarwal), Portfolio management (Central Bank of India); Insurance update (LIC India); General Insurance (Doogar Associates)


The Annual conference of Indian Menopause Society is to be held from 17 to 19th Feb 2012 in Hotel The Claridges, Surajkund Faridabad. It is multidisciplinary approach to the problems of midlife onwards in women. This conference has participation of British Menopause Society and South Asian Federation Of Menopause Societies and opportunity to hear from international faculties.

For information Contact Dr. Maninder Ahuja (Organizing Chairperson) 9810881048 down load forms from web sit http://indianwoman35plus.com/ or Indianmenopausesociety.org or http://fogsi.org/

Contact at ahuja.maninder@gmail.com
Call for free papers and posters on theme topics of conference.

Early Registration till 30th Dec 2011

    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