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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

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  Editorial …

23rd April 2013, Tuesday

Fecal Microbial Transplantation for Ulcerative Colitis

Fecal microbial transplantation (FMT) via enema is shown to be effective, tolerable, and feasible for treating children with ulcerative colitis (UC), according to findings from a phase 1 pilot study published online March 29 and in the June issue of the Journal of Pediatric Gastroenterology and Nutrition.

It involves infusion of human stool from a healthy adult donor into the patient's intestine and has been proposed as an option for recurrent (Clostridium) difficile infection and possibly for ulcerative colitis as per Sachin Kunde, MD, MPH, from Spectrum Health Medical Group, Helen DeVos Children's Hospital in Grand Rapids, Michigan. The procedure may restore 'abnormal' bacteria to 'normal' in patients with (UC).

Ten children, aged 7 to 21 years, who had mild to moderate UC, received freshly prepared fecal enemas daily for 5 days.
The investigators collected data on tolerability, adverse events, and disease activity during FMT and weekly for 4 weeks thereafter. At baseline, pediatric UC activity index ranged from 15 to 65. The investigators considered a reduction in PUCAI by more than 15 to be clinical response, and PUCAI lower than 10 to be clinical remission.

There were no serious adverse events. Self-limiting adverse events were mild cramping, fullness, flatulence, bloating, diarrhea, blood in the stool, and moderate fever. Although 1 child could not retain fecal enemas, average tolerated enema volume in the other 9 children was 165 mL/day.

Clinical response within 1 week occurred in 7 (78%) of the 9 children, including 3 (33%) who had clinical remission and 6 (67%) who maintained clinical response at 1 month. Compared with baseline, median PUCAI significantly improved after FMT. (Medscape)

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Dr KK Aggarwal
Group Editor in Chief

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    Photo Feature (from the HCFI Photo Gallery)

World Earth Day 2013

Heart Care Foundation of India and World Fellowship of Religions in association with Ministry of Earth Sciences Govt. of India and Delhi Public School Mathura Road observed World Earth Day 2013 by organizing inter school competitions on the theme ‘Future Earth’

Dr K K Aggarwal
    National News

DD Programme “Take Care Holistically”, Anchoring Dr KK Aggarwal, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Anchoring Dr KK Aggarwal, every Thursday 4:30 PM in DD India

MCI gets third secy in two years

IPS officer’s selection raises questions on eligibility


RP Meena, an IPS officer of Odisha cadre, is the new secretary of the Medical Council of India (MCI), the statutory body regulating medical colleges, affiliations of new colleges and registration of doctors. He was currently director in the central vigilance office of the health ministry.

MCI additional secretary Prasanna Raj confirmed the development. Last week, Governance Now reported that MCI secretary Sanjay Srivastava was quitting due to alleged harassment from board chairman Dr KK Talwar. (Read the full story here: Another MCI secretary on way out?)

Dr Talwar had faced similar accusations from Srivastava’s predecessor, Dr Sangeeta Sharma who quit in March 2012, and deputy secretary Reena Nayyar.

"Meena will be the third secretary in two years. This reflects poorly on MCI," said a senior officer in the council on condition of anonymity.

It is unusual that an IPS officer has been picked for the post, as several officers refused to take up the job. Sube Singh, deputy secretary in the council, was one of them.

"How can an IPS officer without knowledge of the field of medical education can run the council?" asked retired additional secretary Dr Prem Kumar, who served as officer on special duty when Dr Sarin was chairman of the MCI.

Last year, Dr Sharma was removed on the ground that she did not fulfill eligibility criteria, especially that she did not have 15 years of medical teaching experience.

Dr Sharma said, "They were so not satisfied with my experience, and now they have brought an officer who does not have medical background. Will he be able to understand the requirements of post-graduation courses and super-speciality courses?"

In 2010, as also in 1990, the MCI was dissolved and the health ministry appointed its secretary.

Dr Sharma indeed has the requisite teaching experience too, but authorities do not consider her teaching stint at the Institute of Human Behaviour and Allied Science (IHBAS).

"Dr Sharma was removed on the ground of trivial issues like not counting her teaching experience at IHBAS since it is only an institute and not a medical college; but on the other hand an IPS officer with no medical background and no teaching experience is being given the top administrative post in MCI," said Amrendra Sharan, a former additional solicitor general and senior lawyer of the supreme court.

Another MCI secretary on way out?

Personnel battles could hurt medical education


Future of many students aspiring for medical education is in jeopardy the Medical Council of India (MCI), the statutory body regulating medical colleges, affiliations of new colleges and registration of doctors, is facing internal troubles again. For the last few days, it is running without an administrative head.

Dr Sanjay Srivastava, who had been serving as secretary for the last ten months, has gone on a leave for three weeks, which is unusual for his position at this time of the year, and sources say he is not likely resume the job. Top sources in the council say that he used to face a hostile atmosphere and some of the board members and even chairman Dr KK Talwar were interfering in the running of affairs of the MCI.

“He was being harassed by board members, especially the chairman of the council. So in a way he has probably given up the job. By March 31, the council had to give clearance to the post-graduation seats of different colleges, and that is why he continued till that date,” a highly placed source told Governance Now.

However, the MCI said that they were not aware of Dr Srivastava move to quit. “We can only tell you that he is on leave for three weeks. We don’t have any information that he has quit the place,” said additional secretary Prasanna Raj.

In fact, the MCI has already started looking for Dr Srivastva’s replacement but there are few takers. Since nobody with a medical background is willing to take up the difficult task, “the name of an IPS officer of Odisha cadre who is on deputation with the ministry is doing rounds," said an officer who did not wish to be named.

Dr Srivastava, who was working as additional director general of health services in the ministry, was appointed MCI secretary after the termination of Dr Sangeeta Sharma’s services as secretary on March 30 last year – leading to a situation just like this year’s.

“Previously, Dr Srivastava twice tendered his resignation but he was persuaded to continue,” said a senior officer, who also did not wish to be named.

Meanwhile, MCI chairman Dr Talwar has allegedly come under attack from its colleagues. The previous secretary, Dr Sharma and deputy secretary Reena Nayyar had accused him of harassment. Even, one of the board members, Dr Ashok Gupta, had written a letter to the chairman last year urging him treat these officers well.

API stresses importance of adult vaccines

COIMBATORE: Association of Physicians of India (API) has stressed the importance of adult immunisation in India and has also called for an update of the existing adult immunisation guidelines as reported in TOI. According to president of the association, Dr Muruganathan, immunisation must not stop at childhood but should continue into adulthood. "We hope to create awareness about diseases that can be prevented by getting vaccinated. This will be the focus of this year's World Immunisation Week between April 21 and 28," he said. Increased awareness, access and coverage of immunisation are the need of the hour. API also took note of the efforts undertaken by World Health Organization (WHO) encouraging immunisation among adults to protect people against diseases. The association also aims to provide updated information on treatment guidelines to the medical community. "Adults over 50 years need protection against flu, pneumonia and Hepatitis B among other illnesses," he said. Many adults in India die every year due to diseases such as Hepatitis B and pneumonia that can be prevented with vaccination. Senior citizens and those at high risk of catching infections, including smokers, diabetics and people suffering from chronic illnesses, are advised to opt for vaccination. Immunization is one of the most successful and cost-effective health interventions and prevents between 2 to 3 million deaths every year globally. Every year, health organizations all over the world come together to educate the public about the significance of vaccination for people of all ages against diseases during World Immunisation Week. (Source: TOI, Apr 22, 2013)

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


The Medicolegal Report should be submitted to the Investigating Officer within 48-72 hours of conducting the examination.

    Valvular Heart Disease Update

What are the most common causes of significant mitral regurgitation in the elderly?

The causes are mitral valve prolapse and ischemic heart disease. Surgery for severe chronic mitral regurgitation is recommended for young asymptomatic patients with early evidence of left ventricular dysfunction but the same is not indicated in patients over age 80 to proceed with surgery unless symptomatic.

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

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Vertebral fractures go unreported without sagittal views

According to a new study, failure to routinely evaluate sagittal reconstructions would result in most clinically important vertebral body compression fractures found on abdominal multidetector CT scans being unreported. (Source: Medscape)

Slow walking speed linked to early death in patients with renal disease

In a new research, slow speed of walking, common in patients with diabetes and those with chronic kidney disease, was strongly associated with early death. (Source: Medpage Today)

Anesthesia in breech delivery may reduce average costs

The additional expense of providing neuraxial anesthesia during external cephalic version (ECV) in breech fetal presentation may result in an overall cost savings due to the higher success rate for ECV under anesthesia and the decreased probability of cesarean delivery. (Source: Medscape)

IL-1 blocker is safe and efficacious for dry eye

Eye drops that contain anakinra, an interleukin-1 antagonist were found to be safe and reduced the signs and symptoms of dry eye disease in a recent research. (Source: Medpage Today)

Genetic link to vasovagal syndrome

An Australian study reports that vasovagal syncope can be inherited in an autosomal dominant manner, and the affected gene or genes are apparently located on chromosome 15. (Source: Medscape)

    Twitter of the Day

@DrKKAggarwal: Vegetables & fruits lower chances of getting some cancers Vegetables and fruits help lower your chances of... http://fb.me/Hd5Q68aC

@DrKKAggarwal: Like a whirlpool is a pattern in a river, we are a pattern in the universe #CosmicConsciousness

    Spiritual Update

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

Understanding Ayurveda

Nature is made up of five elements – air, space, water, fire and earth. The deviation from the nature leads to natural disasters and balancing the nature is what is called naturopathy.

For Comments and archives…

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

How is hyperprolactinemia treated?

The treatment depends on the cause. If your doctor cannot identify the cause or you have a microadenoma or a macroadenoma in the pituitary gland, the primary treatment is with medication. The most commonly used medications are bromocriptine and cabergoline. The treatment continues until you get pregnant. The most common side effects from bromocriptine include lightheadedness, nausea and headache. Other side effects include nasal congestion, dizziness, constipation, abdominal cramps, fatigue, vomiting, and, rarely, neurologic symptoms such as hallucinations. Slowly increasing the dose helps reduce side effects. You can also take bromocriptine as a vaginal suppository or tablet at bedtime.

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

(Dr Sanjay Chaudhary, Medical Director, Chaudhary Eye Centre, Dr Pallavi Sugandhi, Consultant Ophthalmologist, Cornea & Refractive surgeon, Chaudhary Eye Centre)

Q Do cataracts or the use of spectacles render the corneas unfit?

A. No. Both these conditions relate to the lens of the eye and not the cornea.

    An Inspirational Story

I’d rather be in Hell

When he died, Juan found himself in an exquisite place surrounded by all the comfort and beauty he had always dreamed of. A man dressed in white spoke to him: “You can have anything you want, any food, any pleasure, any diversion.”

Delighted, Juan did everything he had dreamed of doing while alive. Then after many years of pleasure, he again searched out the man in white. “I have done everything I wanted to do. Now I need a job, so that I can feel useful.” – he said.

“I’m sorry,” replied the man in white. “But that is the one thing I can’t give you. There is no work here.” “How awful!” said Juan angrily, “That means I’ll spend eternity bored to death! I wish I was in Hell!”

The man in white came over to him and said softly: “And where exactly do you think you are, Sir?”

For comments and archives

   Cardiology eMedinewS

Beet juice beats hypertension Read More

   Pedia News

Pulse-ox helps ID newborn heart defects Read More

    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

What is the mode of action of IDRV?

The deposition of approved modern rabies vaccine (or antigen) in the layers of dermis of skin stimulates the immunoreceptive Langerhan cells present within the dermis. Subsequently the antigen is carried by antigen presenting cells via the lymphatic drainage to the regional lymph nodes and later to the reticuloendothelial system eliciting a prompt and highly protective antibody response. Immunity is believed to depend mainly upon the CD 4+ T- cell dependent neutralizing antibody response to the G protein. In addition, cell-mediated immunity has long been reported as an important part of the defense against rabies. Cells presenting the fragments of G protein are the targets of cytotoxic T- cells and the N-protein induced T helper cells. The immune response induced by IDRV is adequate and protective against rabies.

    IJCP Special

Dr Good Dr Bad

Situation: A 75–year–old male was to go for flexible sigmoidoscopy.
Dr. Bad: Go for sodium phosphate enema.
Dr. Good: Go for PEG lavage.
Lesson: Use of sodium phosphate enema may be associated with serious adverse events including hypotension, volume depletion, rise in phosphate levels, fall in potassium levels, and fall in calcium levels, metabolic acidosis, kidney failure, QT prolongation in ECG (Archives of Internal Medicine 2012).

Make Sure

Situation: A patient of pulmonary Koch’s taking ATT complained of numbness in fingers and toes.
Reaction: Oh my God! I forgot to prescribe vitamin B complex.
Lesson: Make sure to prescribe B–complex vitamins (especially vitamin B6) in patients talking ATT to prevent neuropathy. Addition of antioxidants and multivitamins also boost the immune system.

  Quote of the Day (Dr GM Singh)

Envy is the art of counting the other fellow’s blessings instead of your own. Harold Coffin

    Mind Teaser

Read this…………………

Sudden infant death syndrome (SIDS) is one of the most common causes of death in infants. At what age is the diagnosis of SIDS most likely?

a. 1 to 2 years
b. 1 week to 1 year, peaking at 2 to 4 months
c. 6 months to 1 year, peaking at 10 months
d. 6 to 8 weeks

Yesterday’s Mind Teaser: A mother and grandmother bring a 3-month-old infant to the well-baby clinic for a routine checkup. Nurse Aimee weighs the infant, the grandmother asks, “Shouldn’t the baby start eating solid food? My kids started on cereal when they were 2 weeks old.” Which response by the nurse would be appropriate?

a. ”The baby is gaining weight and doing well. There is no need for solid food yet.”
b. ”Things have changed a lot since your children were born.”
c. ”We’ve found that babies can’t digest solid food properly until they’re 3 or 4 months old.”
d. ”We’ve learned that introducing solid food early leads to eating disorders later in life.”

Answer for Yesterday’s Mind Teaser: c. ”We’ve found that babies can’t digest solid food properly until they’re 3 or 4 months old.”

Correct answers received from: Tukaram Pagad, Dr PK Sahu, Dr PC Das &
Dr Mrs Sukla Das, Prabha Sanghi, Dr BB Gupta, Dr BB Gupta, Dr BB Gupta,
Dr (Maj. Gen.) Anil Bairaria, Dr Raghavendra Jayesh, Dr Jella, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr KV Sarma, Dr U Gaur, Dr Santha Kumari,
Dr Ayyavoo ERODE, Dr Santhakumari, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr K Raju, Dr Thakor Hitendrsinh G, Dr Avtar Krishan, Dr Kanta Jain, Deepali Chatterjee, Dr PK Sahu, Dr BB Gupta.

Answer for 21st April Mind Teaser: c. On an empty stomach

Correct answers received from: Dr BK Agarwal, Dr Dinesh Yadav, Dr PK Sahu, Dr PC Das & Dr Sukla Das, Dr Ayyavoo, Muthumperumal Thirumalpillai,
Dr Arpan Gandhi, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Raju Kuppusamy, Dr Avtar Krishan, Dr Kanta Jain.

Send your answer to ijcp12@gmail.com

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    Laugh a While (Dr GM Singh)

A mathematician and a physicist agree ...

A mathematician and a physicist agree to a psychological experiment.

The (hungry) mathematician is put in a chair in a large empty room and his favorite meal, perfectly prepared, is placed at the other end of the room. The psychologist explains, "You are to remain in your chair. Every minute, I will move your chair to a position halfway between its current location and the meal."

The mathematician looks at the psychologist in disgust. "What? I'm not going to go through this. You know I'll never reach the food!" And he gets up and storms out.

The psychologist ushers the physicist in. He explains the situation, and the physicist's eyes light up and he starts drooling.

The psychologist is a bit confused. "Don't you realize that you'll never reach the food?"

The physicist smiles and replies: "Of course! But I'll get close enough for all practical purposes!"

  Medicolegal Update

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

Science shows innocent man hanged in famous British murder case

Michigan’s Foran’s laboratory has devised methods to extract and isolate mitochondrial DNA. His laboratory specializes in ancient and forensic DNA evidence, often working with human remains that are thousands of years old. The nearly 100–year–old microscope slide, sent to Michigan State from the Royal London Hospital Archives and Museum, is the same one the pathologist Bernard Spilsbury used to help hang Crippen in 1910. At that time forensic medicine/pathology was more primitive; Spilsbury’s testimony, identifying what he claimed was an abdominal scar consistent with Cora’s medical history, convinced the jury that these were Cora’s remains. Crippen went to the gallows insisting he was innocent. The present–day challenge: getting past the pine sap that sealed the slide and the formaldehyde used to preserve the tissue in order to examine the mitochondrial DNA that could identify Cora Crippen based on the genetic history of her maternal relatives.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Earth Day celebrated

Heart Care Foundation of India and World Fellowship of Religions in association with Ministry of Earth Sciences Govt. of India and Delhi Public School Mathura Road observed World Earth Day 2013 by organizing inter school competitions on the theme ‘Future Earth’. More than 15 schools from different parts of Delhi participated in these competitions.

Speaking on the occasion, Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India said that Environmental Education among school children is an important step towards ensuring a sustainable and safer future. We need to keep on motivating them to think positively about the atmosphere they live in and have to live and how they can help in sensitizing their parents and other members of society about the same.

The activities included painting and slogan writing competitions. The best paintings and slogans would be submitted to Ministry of Earth Sciences as entries for their national competition on painting and slogan writing.

Ministry of Earth sciences organizes competitions amongst the winners of these competitions held earlier by NGOs on World Earth Day in the country. The winners are awarded Prizes and certificates.

The activities will continue on Tuesday with a walk and other competitions.

Recycle your e-waste

  • Electronic waste, or “e-waste,” is a term used to describe any electronic device that is outdated, obsolete, broken, donated, discarded, or at the end of its useful life. This includes cell phones, computers, laptops, PDAs, monitors, televisions, printers, scanners, and any other electrical device.
  • With the rapid expansion of technology, combined with the relatively short shelf life of many present day electronic devices, more and more e-waste is generated each year. Often, these discarded devices end up in landfills or are incinerated, which can cause major environmental problems in our communities.
  • Many of the materials found in electronic devices are extremely hazardous. These include lead, mercury and cadmium. When these electronics end up in landfills, many of these chemicals leach into the soil during rainfall or are released into the atmosphere when burned. These chemicals can have dangerous impacts on the health of plants and animals and when inhaled can lead to serious respiratory problems. Fortunately, the simple solution to limiting the dangerous effects of careless e-waste disposal is safe and responsible recycling.
  • Each year, the United States alone produces up to 50 million tons of e-waste. Of this, only 20-25% is recycled safely and responsibly. The other 75% ends up in landfills. As a direct consequence, hazardous materials found in this waste routinely contaminate our air and water supplies. By safely and responsibly recycling your e-waste, you can help protect your community and the ecosystem from these dangerous chemicals.
  • Everyone should collect all old electronic materials and take them to an e-waste recycling facility to make sure they are properly handled.
    Readers Response
  1. Hi Dr. KK, very informative news; the article why I am being punished describes in detail the thoughts of a young doctor. If the MCI can also understand these thoughts then publish them for information of all concerned so that young doctors are not embarrassed unnecessarily by general public at large. The mindset of people must change. Regards: Ashok Ahooja.
    Forthcoming Events
Dr K K Aggarwal


Date: 22nd and 23rd April

Programme brief:

22nd April, 2013 11 am onwards

Painting cum Slogan Writing competition

1 8.30 AM - 9.30 AM Special Assembly
2 9:40 AM - 10:10 AM A Symbolic Walk of ½ Km from the venue with all the participants carrying play-cards with one line environment protection slogans.
3 10.30 AM -11-00 AM Skit
4 11.00 AM onwards Hands only CPR TRAINING for teachers.

Dr K K Aggarwal
Dr K K Aggarwal
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