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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; National Vice President Elect Elect, Indian Medical Association; 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 to 7
DD Take Care Holistically Video 1 to 9 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

22nd December 2012, Saturday

Biggest Cardiology Stories of 2012 from Heart Wire


  • ROMICAT II and ACRIN-PA were both published in the New England Journal of Medicine this year, demonstrating that cardiac (computed tomography) CT, when used in the emergency room, saved 50% time for patients and confirmed an earlier trial (CT STAT) that showed not only that use of CT is safe and expedites discharge (but) 2 of the 3 randomized trials of cardiac CT compared with standard of care showed significant cost savings. Doctors have already starting triaging patients from our emergency room to the CT scanner, instead of using the nuclear or treadmill algorithms that have been used for many years.
  • The CONFIRM (registry) continues to establish CT (angiography) as a major tool in chest-pain diagnosis.
  • DEFACTO suggests that the "holy grail" of noninvasive (fractional flow reserve) FFR may soon be obtainable, which would dramatically shift noninvasive testing patterns and alter cath-lab referral (but this is still not ready for prime time).
  • (There were) no blockbuster trials in echo, but the revised echo appropriate-use criteria came out, which may also alter care.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

What are the causes of constipation in children?

Constipation in children usually is functional. But it can also be due to organic causes such as Hirschsprung’s disease (congenital aganglionic megacolon), pseudo-obstruction, spinal cord abnormality, hypothyroidism, diabetes insipidus, cystic fibrosis, gluten enteropathy or congenital anorectal malformation.

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Treating vitamin D deficiency in the country

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Dr. KK Aggarwal awarded ISWA Honorary Fellowship

Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India was awarded Dr. RD Sharma ISWA Honorary Fellowship in appreciation and recognition of his contributions in the field of science, writing and communication.

Dr K K Aggarwal
    National News

Dear Colleague, Let’s celebrate New Year by learning CPR-10 and saving the life of a person

Watch English or Hindi Video @http://emedinews.in/videos/cpr/index.html

Dr K K Aggarwal

Mumbai hospitals make beeline for dissolving stent

MUMBAI: Within hours of the launch of bio-absorbable stents in the city on Wednesday, at least five hospitals deployed the new option for heart treatment. These stents, which will dissolve after 18-odd months, appear to be a better option than metallic ones, said doctors. Following a successful clinical trial involving 100 patients, the Drug Controller General of India (DCGI) gave an approval to multinational firm Abbott Vascular to launch the stent. Marking the GenNext of heart treatment, major private hospitals in the city deployed these on various patients. Krishna Natrajan (71), for instance, had undergone a bypass surgery 10 years ago. However, he recently started getting pain in his stomach. Once he was taken to the hospital, the doctors realized that two of his bypass grafts were closed and only one was working. Dr V T Shah, cardiologist at Surana Hospital at Chembur, said that Natraj had four blockages. "This was a high-risk patient as he may need surgeries for joints or kidneys in days to come. He had four blockages and we put four bio-absorbable stents to restore the blood supply to his heart." On Thursday itself, doctors from Jaslok, Bombay, L H Hiranandani hospitals and Asian Heart Institute, too, used bio-absorbable stents. Dr Ganesh Kumar, of Hiranandani Hospital, Powai, said the bioabsorbable 'stent' should be called a 'scaffolding' as it dissolves. Dr A B Mehta, senior cardiologist from Jaslok Hospital, who also did a stent procedure on Thursday, said there would not be any clotting because the stent dissolves. Dr B K Goyal, cardiologist from Bombay Hospital, also conducted a bio-absorbable stent surgery on a 48-year-old man who was critical and had 90% blockage in the main artery. Dr Goyal said, "With metallic stents, restenosis can occur even after three years of deployment. Restenosis is narrowing of blood vessels leading to restricted blood flow." This apart, follow-up becomes easier. "For metallic stent patients, a CT scan is no use as the metal refracts the scan rays. But in case of absorbable stents, CT coronary angioplasty is possible to see if there are any other blockages. The restenosis rate for metallic stents is 5% initially and goes on increasing every year thereafter. But in absorbable stents, after the similar risk initially, the rate reduces to less than 2% after six months, as the stent starts dissolving," said Dr Shah. (Source: TOI, Dec 21, 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

    Valvular Heart Disease Update

When should aortic valve replacement be done?

Aortic valve replacement should be performed in essentially all patients with symptomatic aortic stenosis. Surgery in such patients is associated with marked reductions in symptoms and subsequent mortality.

(Experts: Dr Bhabha Nanda Das and Dr Ganesh K Mani, Dr. Yugal Mishra, Dr Deepak Khurana, Dr K S Dagar, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

New diabetes guidelines ease systolic blood pressure target

New clinical practice guidelines from the American Diabetes Association (ADA) include recommendations for a less stringent systolic blood pressure target and greater individualization with regard to the frequency of blood glucose self-monitoring. The ADA's Clinical Practice Recommendations 2013 is published as a supplement to the January issue of Diabetes Care. Revised on an annual basis, the document includes the association's major position statement along with additional position statements on a range of diabetes management–related topics. (Source: Medscape)

Guidelines target HIV-associated neurocognitive deficits

More attention needs to be focused on the diagnosis and treatment of neurocognitive disorders associated with HIV infection, according to a new consensus report. Early identification and treatment with combination antiretroviral therapy (cART) could minimize potential adverse effects of neurocognitive impairment, including reductions in treatment compliance, quality of life, and survival, according to an article by the 66 members of the Mind Exchange Working Group published online November 21 in Clinical infectious Diseases. (Source: Medscape)

'Major step forward' in carcinoma of unknown primary

Gene-expression profiling should become an integral part of the management of carcinoma of unknown primary, according to results from a phase 3 clinical trial. The profiling classified a very high percentage of carcinomas of unknown primary into a constituent cancer group, which, in turn, allowed for more individualized treatment, report the study authors, led by John Hainsworth, MD, from the Sarah Cannon Research Institute of Nashville, Tennessee. The study was published online December 10 in the Journal of Clinical Oncology. (Source: Medscape)

Updated CVD risks with varenicline: FDA

The US Food and Drug Administration (FDA) issued new information this week warning physicians that the smoking-cessation aid varenicline (Chantix, Pfizer) may increase the risk of cardiovascular events in adults with cardiovascular disease. In a new meta-analysis, a higher number of major adverse cardiovascular events, a combined end point that included cardiovascular mortality, nonfatal MI, and nonfatal stroke, were observed among those treated with varenicline. (Source: Medscape)

Fear may spur unneeded ovarian cancer tests

Many women who received indeterminate BRCA test results chose to have additional ovarian cancer screening and risk-reducing procedures, according to survey results. (Source: Medpage Today)

    Cardiology Alert

Dabigatran (Pradaxa) should not be used to prevent stroke or blood clots in patients with mechanical prosthetic heart valves. Healthcare professionals should promptly transition patients to another medication.

    Twitter of the Day

@DrKKAggarwal: Are Food Additives Bad? http://blog.kkaggarwal.com/2012/12/are-food-additives-bad/ …

@DeepakChopra: What is the role of listening and engagement, when it comes to civic engagement? http://tinyurl.com/bm7mu52

    Spiritual Update

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

Lotus is synonymous with Bhagavad Gita

When Swami Chinmayananda was alive, he used to be a patient of my Boss Late Dr. K.L. Chopra. I used to see him along with Dr Chopra and got the opportunity of doing his color Doppler Echocardiography every time he needed one. I had the habit of not charging from spiritual gurus. Instead, whenever Swami Chinmayananda used to come for echo, I used to ask him to give me a spiritual lesson (seekh).

For comments and archives

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What is the procedure of selecting a gestational surrogate?

Gestational surrogates may be known to the intended parents or may be anonymous. Known surrogates are typically relatives or friends who volunteer to carry the pregnancy. Anonymous surrogates are identified thorough agencies that specialize in recruiting women to become surrogates. The surrogate should be a minimum of 21 years of age and have delivered a live born child at term. Certainly evaluation of a woman’s overall health and appropriate screening for underlying medical conditions that might complicate a pregnancy, as well as counseling regarding the obstetric risk should be preformed if considering an older surrogate.

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

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

Q: What is a unit of blood?

A: The blood is collected in plastic bags, which contain an anticoagulant, which prevents the blood from getting clotting. On an average, we draw about 350 or 450 ml. of blood from a person depending on his body weight. This blood plus the amount of anticoagulant present in the bag is known as one unit of blood.

    An Inspirational Story (Dr GM Singh)

What ever happens is for Good!

Me: God, can I ask you a question?

God: Sure.

Me: Promise you won't get mad.

God: I promise.

Me: Why did you let so much stuff happen to me today?

God: What do you mean?

Me: Well, I woke up late.

God: Yes.

Me: My car took forever to start.

God: Okay.

Me: At lunch they made my sandwich wrong and I had to wait.

God: Hmmm…

Me: On the way home, my phone went dead, just as I picked up a call.

God: All right.

Me: And on top of it all, when I got home I just wanted to soak my feet in my new foot massager and relax, but it wouldn't work!!!Nothing went right today! Why did you do that?

God: Let me see, the Death Angel was at your bed this morning and I had to send one of the other angels to battle him for your life. I let you sleep through that.

Me: (humbled): OH...

GOD: I didn't let your car start because there was a drunk driver on your route that would have hit you if you were on the road.

Me: (ashamed)

God: The first person who made your sandwich today was sick and I didn't want you to catch what they have, I knew you couldn't afford to miss work.

Me: (embarrassed): Ok...

God: Your phone went dead because the person that was calling was going to give false information; I didn't even let you talk to them so you would be covered.

Me: (softly) I see God.

God: Oh and that foot massager, it had a shortage that was going to throw out all of the power in your house tonight. I didn't think you wanted to be in the dark.

Me: I'm sorry God.

God: Don't be sorry; just learn to trust me.....in all things, the good and the bad.

Me: I will trust you.

God: And don't doubt that my plan for your day is always better than your plan.

Me: I won't God. And let me just tell you God, thank you for everything today.

God: You're welcome child. It was just another day being your God, and I love looking after my children.

For comments and archives

    Cardiology eMedinewS

Syncope-related risk of death linked to age Read More

Biventricular pacing may be better than RV pacing in left ventricular dysfunction Read More

    Pediatric eMedinewS

Babies' vision improves with fatty acid formula supplements Read More

In utero oxygen deprivation linked to ADHD risk Read More

    IJCP Special

Dr Good Dr Bad

Situation: An obese patient came with BMI of more than 40.
Dr Bad: Go for surgery.
Dr Good: First try diet, exercise and drug therapy.
Lesson: Obesity surgery is indicated in patient with BMI more than 40 who have failed diet and exercise with or without drugs.

Make Sure

Situation: A patient with acute chest pain died before reaching the hospital.
Reaction: Oh my God! Why was water-soluble aspirin not given?
Lesson: Make sure that at the onset of acute heart attack and chest pain, water–soluble aspirin is chewed to reduce chances of sudden death.

    Legal Question of the Day

Q. I am greatly perturbed by the gang rape and brutal injuries to a 23-year-old physiotherapy student in Delhi on 16-12-2012. During my 8 years stay in Zanjan (Iran) not a single case of theft of any kind or adultery was seen or heard of. The law there is Tit for Tat (Hand/s amputation for theft & killing by stoning for adultery). Punishment should be given in such a way that criminals are afraid of committing the crime. I know that judiciary does not follow common sense. I am not sure I am for or against such law. But, human laws cannot be applied to those rapists who not only gangraped the helpless girl but hurt her genitals & other body parts with sharp objects. What are your comments?

Ans. My comments are as follows:

  1. Ref: I know that judiciary does not follow common sense.

    It is obvious that your knowledge is deficient. The basics are as follows: a. Law reflects the will of the people.

    b. Law is based on common sense.

    c. The judiciary is bound by law. It has to follow law. If the law makers (legislators) have made a law that appears to be against common sense, the judge does not have the freedom to substitute the express provision of law by his common sense or intelligence, however intelligent he may be.

    The judiciary does use common sense along with its legal sense, as it should be.
  2. Every judge has to follow the law of the country concerned. Iranian laws cannot be used in India.
  3. Law may frighten people but does not change them. Ask people in other countries (where Sharia law does not operate) as to whether Iranians, Arabs etc. commit less or more theft and adultery compared to local population. There answer will surprise you. As a matter of fact, every 2 years or so you read in the newspapers that some prince or princess from the Arabian Sheikhdoms is caught shop- lifting in Europe or USA. Their Sharia does not make them more virtuous or pious.
  4. As per principles of criminology, the punishment is supposed to have three main aims—Retributory; Deterrent; and, Reformative. Scholarly studies have shown that the deterrent effect of the most severe punishment (capital punishment) is minimal.
  5. Ref: human rights laws cannot be applied to those rapists. Rapists are humans and have human rights. Those rights have even been partially extended to animals, particularly apes, in some countries. In India too, there is the Prevention Of Cruelty To Animals Act, 1960. Cruelty cannot be applied to humans when denied by law to animals.
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  Quote of the Day (Dr GM Singh)

It is one of the blessings of old friends that you can afford to be stupid with them. Ralph Waldo Emerson

    Mind Teaser

Read this…………………

Lucy is admitted to the surgical unit for a subtotal thyroidectomy. She is diagnosed with Grave’s disease. When assessing Lucy, the nurse would expect to find:

A. Lethargy, weight gain, and forgetfulness
B. Weight loss, protruding eyeballs, and lethargy
C. Weight loss, exophthalmos and restlessness
D. Constipation, dry skin, and weight gain

Yesterday’s Mind Teaser: Following prostate surgery, the retention catheter is secured to the client’s leg causing slight traction of the inflatable balloon against the prostatic fossa. This is done to:

A. Limit discomfort
B. Provide hemostasis
C. Reduce bladder spasms
D. Promote urinary drainage

Answer for Yesterday’s Mind Teaser: B. Provide hemostasis

Correct answers received from: DR K P CHANDRA, DR B K AGARWAL, Dr.K.V.Sarma, dr.shagufta moin Dr.(Maj. Gen.) Anil Bairaria, Dr.(Maj. Gen.) Anil Bairaria, Dr Monica Gandhi, DR ARPAN GANDHI, Dr Pankaj Agarwal, DR Chandresh Jardosh, Dr Jainendra Upadhyay

Answer for 20th December Mind Teaser: D. Helping the client to rest in the position of maximal comfort

Correct answers received from:Dr Kanta jain, dr.shagufta moin, Dr. Thakor Hitendrsinh G, Dr Avtar Krishan

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Start at the very beginning...

When the new patient was settled comfortably on the couch, the psychiatrist began his therapy session.

"I'm not aware of your problem," the doctor said. "So perhaps, you should start at the very beginning."

"Of course." replied the patient. "In the beginning, I created the Heaven and the Earth..."

    Medicolegal Update

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

Accidental suffocation

  • There have been numerous accidental deaths as a result of children putting things into their mouths and swallowing them, which in turn block the airways. This is why it is imperative that small children are never left unattended and are not allowed to put anything in their mouths, which may result in their choking.
  • People also die of suffocation in the instance of a house fire where there is a lack of oxygen and they cannot breathe. The postmortem examination in such cases provides information whether or not the victim was conscious at the time of the fire starting or if indeed they had already been deceased. This process is measured by the amount of carbon dioxide in the deceased’s system at the autopsy stage.
  • Murder is comparatively rare however in some cases the assailant has tried to cover his or her tracks by setting fire to the location at which the deceased is finally found. This could be a house, an office, a workshop, anywhere.
  • The autopsy surgeon must look for the telltale signs: the bloodshot eyes, the high levels of carbon dioxide in the blood and bruising around the nose and mouth and may even collect trace evidence such as hairs and fibers from around the nose and mouth of the deceased.
  • As accidental suffocation or smothering is relatively common, therefore until proven otherwise by a forensic surgeon/doctor and subsequent inquest, all cases of suffocation or smothering should be treated as potentially suspicious.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Heart patients beware of eating cakes

Foods of animal in origin and saturated foods contain cholesterol. A one percent rise in cholesterol increases the chances of heart attack by 2%, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India. Heart patients should therefore avoid eating cakes during the Christmas and New Year Season. They should distribute fruits and dry fruits instead of cakes.

Beware of the term Low or High Cholesterol on food labels.

  1. “Cholesterol-free” means less than 2 mg cholesterol and 2 grams or less fat.
  2. “Low Cholesterol” means 20 mgs or less cholesterol and 2 grams or less saturated fat.
  3. “Fat Free” means less than ½ gram fat;
  4. “Low Fat” means 3 grams or less fat;
  5. “Reduced Fat” means at least 25% less fat than other brands of same food.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 20815 people since 1st November 2012.

Hands only CPR Training is based on the following CPR Mantra: Quote” Within 10 minutes of death, earlier the better, at least for the next 10 minutes, longer the better, compress the center of the chest of the dead person effectively and continuously with a speed of 10x10 (100 per minutes).” Unquote

    Readers Responses
  1. Thank you all especially, Dr K K Agarwal. Great job done for medical community and public. The idea should go down to people across country. Ajay Sinha, Patna.
    Forthcoming Events
Dr K K Aggarwal

4th eMedinews Revisiting 2012

(a day long single hall medical conference on 2012 happenings, followed by doctors of the year 2012 awards)

Sunday 20th January 2013, Maulana Azad Medical College Auditorium

Dilli Gate Delhi


Dr KK Aggarwal
Padmashri and Dr B C ROY National Awardee President

Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman

Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

4th eMedinewS Revisiting 2012

The 4th eMedinewS–revisiting 2012 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 20th 2013.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2012. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. All delegates will get Registration Kit, Attractive gifts, Certificates. Morning snacks and lunch will be provided.

Register at: www.emedinews.in/


4th eMedinewS Doctor of the Year Awards

Nominations invited for 4th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2012.

pls send his/her Biodata at: emedinews@gmail.com

    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

Activities eBooks



  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta