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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

  Editorial …

23rd May 2011, Monday                                eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

PNDT Update

  1. Soon, sex selection may cost a doctor his licence to practice. As per new directions, Union Health Ministry through Medical Council of India is likely to direct all State Medical Councils to identify the doctors convicted till date under the PNDT Act and ensure that their licence to practice is cancelled permanently. So far about 800 court cases against doctors in 17 states have resulted in 55 convictions.
  2. A city court of Gurgaon in March convicted five Gurgaon doctors under PNDT Act and ordered rigorous imprisonment of three years with a fine of Rs. 1000 each. The doctors were Dr. J.L.M, Dr. M.S.T, Dr. D.B.L, Dr. P.B.L, and Dr. KSS. They have all been convicted for committing offence under section 23 of PNDT Act. The doctors were caught red-handed on the spot by a decoy team.
  3. A high level meeting convened by the Prime Minister’s Office looked into the possibility of making abortion a subject to checks like mandatory counseling and medical advice.

eMedinewS comments: When parents do not want a child, they have options of emergency contraception in the first 72 hours, medical pill abortion upto 8 weeks and surgical abortion upto 12 weeks. In all probabilities, if a decision to terminate the pregnancy is taken after 12 weeks, the parents somehow know the sex of the fetus. Will the Government consider banning an abortion after 12 weeks or making abortion after 12 week more stringent and more monitored? Will the law also consider taking action against the parents. Till now, many doctors have been convicted but not even a single parent has been punished for getting an abortion done.

Dr KK Aggarwal
Editor in Chief
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Blogs.kkaggarwal.com Dr K K Aggarwal on blogs
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    Changing Practice – Evidence which has changed practice in last one year

Optimal rate for patients in atrial fibrillation

Have a lenient rate control goal of <110 beats/min, compared to a stricter rate control goal of <80 beats/min, for patients in atrial fibrillation in whom a rate control strategy has been chosen.

  eMedinewS Audio PostCard

HIV Update

Dr Nalin Nag Speaks on
‘Treatment of opportunistic infections’

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery) 

World No Tobacco Day

Posters depicting messages about dangers of smoking at display at the Cremation Ground on 31st May 2004 on the occasion of World No Tobacco day.

Dr K K Aggarwal
    National News

Remote sensing technology to check water–borne diseases

Soon satellite remote sensing technology will be utilised for mapping breeding sites of water–borne vector diseases such as Dengue, Chikungunya and Malaria across the country to help the authorities take requisite preventive steps. The Indian Council of Medical Research (ICMR), a research wing of the Health Ministry, has now invited proposals from the country’s researchers for detailed strategies including district–wise risk–maps of the breeding sites as well as prediction sites of epidemics of various vector–borne diseases (VBD). All the proposals will be referred to the Vector Science Forum (VSF) which has been constituted recently by the Council with an aim to bring all vector biologists, entomologists, programme people and experts on a common platform. Besides Dengue, Chikungunya, Malaria, the ICMR has invited studies for the vector-borne diseases such as Japanese encephalitis, Chandipura virus, Nipah viruses, Filariasis, and Visceral leishmaniasis — intensities of which are increasing at an alarming level particularly due to climate change. Also, mapping water bodies, animal reservoir areas using satellite remote sensing images would help in estimating/predicting risk of disease transmission of diseases like Japanese encephalitis, the official added. (Source: The Pioneer, May 20, 2011)

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

    International News

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

Obese Americans are in denial about their own health

Business Wire recently reported that most Americans who are overweight or obese –– even those who are well–educated –– see themselves as being in good health even though they appear to be well aware of the dangers of obesity, according to a new study." The survey results suggest to us that many Americans may not connect their own weight or exercise level with perceptions of their overall fitness," said Dan Prince, president of Catalyst Healthcare Research. Their level of concern about the danger their weight poses to their health is reflected in their exercise patterns, according to the study. More than half either don’t exercise at all or merely engage in naturally occurring exercise, such as walking up the stairs in their own home. The study, conducted by Catalyst Healthcare Research, a nationally recognized leader in healthcare research, found that 60 percent of Americans say obesity is the number one threat to public health, far outdistancing cancer, in second place with 16 percent.

(Dr Monica and Brahm Vasudev)

FDA advisers punt on Trilipix

In a unanimous vote, an FDA panel said more study is needed to determine if fenofibric acid (Trilipix) treatment can reduce cardiovascular events, but advisers stopped short of ordering a label change for the drug.
(Source: http://www.medpagetoday.com/Cardiology/Dyslipidemia/26591?utm_source=breaking–

Surgery with less prostate cancer mortality than surveillance

Radical prostatectomy was associated with fewer deaths from prostate cancer compared to watchful waiting, a Scandinavian study found. But the results may not apply in the U.S., where more prostate–specific antigen (PSA) testing occurs. Researchers in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG–4) randomized 695 men with early prostate cancer to watchful waiting or radical prostatectomy from October 1989 to February 1999. Follow–up occurred through December 2009. Researchers presented results in the May 5 New England Journal of Medicine. The study follows up on the group’s 2008 report with an additional three years of data to present 15–year results.

Illicit market for organ transplants

A growing and illicit market for organ transplants…spans the globe. Every year, about 5,000 gravely ill people from countries including the US, Israel, and Saudi Arabia pay others to donate an organ, says Francis Delmonico, a Harvard Medical School professor and surgeon, a practice against the law everywhere except in Iran. More than 75 percent of the recipients of kidney transplants in the US live for more than 10 years, according to the National Institutes of Health.

People with diabetes may have 10% risk for developing cancer

Individuals with diabetes are at higher risk for certain cancers than those without the metabolic disease, according to a study published in Diabetes Care. In a poll of roughly 400,000 adults, 16 out of every 100 diabetic men and 17 out of every 100 diabetic women said they had cancer. In contrast, only seven per 100 men and 10 per 100 women had cancer without concurrent diabetes. After taking into account factors such as age, race, and smoking and drinking habits, the study team estimated that people with diabetes had a 10 percent greater likelihood for a cancer diagnosis of any type.

    Twitter of the Day

@DrKKAggarwal:To beat the summer heat do not forget to give water to the birds today.

@DeepakChopra:Accept people for who they are. And at all times, be ready to forgive.

    Spiritual Update

Hanuman Chalisa

Ram Duware Tum Rakhavare
Hot Na Aagya Binu Paisare

Meaning: You always guard the door of Sri Rama, and without your permission no one can enter.

Spiritual Significance: Without the help of Breathing Pranayama, acquiring a state of stillness in the consciousness is not possible.

    An Inspirational Story

(Dr. Anupam Sethi Malhotra)

One reason Hitler lost World War II was that he did not fully understand the situation. Bearers of bad news were punished. Soon no one dared tell him the truth. Not knowing the truth, he could not act appropriately.

Many of us are individually guilty of the same error. We do not like to admit to ourselves our mistakes, errors, shortcomings, or ever admit we have been in the wrong. And because we will not see the truth, we cannot act appropriately. Someone has said that it is a good exercise to daily admit one painful fact about ourselves to ourselves. Look for and seek out true information concerning yourself, your problems, other people, or situation, whether it is good news or bad news.

Adopt the motto – "It doesn’t matter who’s right, but what’s right."

Admit your mistakes and errors but don’t cry over them. Correct them and go forward. In dealing with other people try to see the situation from their point of view as well as your own.

    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What is embryo donation?

For embryos derived from gametes obtained from an anonymous donor or donors, they must have met all. FDA screening and testing requirements and must be eligible for anonymous donation. Embryo donors should be screened for relevant risk factors for HIV, other transmissible infections, and transmissible spongiform encephalopathy (TSE). The embryo donors must sign an informed–consent document indicating their permission to use their embryos for embryo donation.

    Pediatric Update

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

What are the indicators for hospital admission in bronchiolitis?

The indications for hospitalization include pulse oximetry saturation (SpO2) from 92% to 94%, poor feeding, dehydration, history of apnea, presence of moderate respiratory distress (chest recession, respiratory rate >70/min).

    IJCP Special

Dr Good Dr Bad

Situation: A patient came with an ESR of 90.
Dr. Bad: This means an infection.
Dr. Good: It can also occur in absence of infection or malignancy.
Lesson: Measurement of ESR has its greatest use in establishing a serious underlying cause of FUO. Although they are usually suggestive of an infection, thrombophlebitis and renal diseases like nephritic syndrome may be accompanied by a very high ESR.

Make Sure

Situation: A patient with first-onset LBBB in ECG died six hours later.
Reaction: Oh my God! Why was acute MI not suspected?
Lesson: Make sure that in all patients with LBBB of first–onset, acute MI is ruled out.

    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

What do I need to do to be successful after surgery?

The basic rules are simple and easy to follow:

  • Immediately after surgery, the dietitian will provide you with special dietary guidelines. You will need to follow these guidelines closely. Begin with liquid diets, moving to semi–solid foods and later, sometimes weeks or months later, solid foods can be tolerated without risk to the surgical procedure performed. Allowing time for proper healing of your new stomach pouch is necessary and important.
  • When able to eat solids, eat 2–3 meals per day, no more. Protein in the form of lean meats (chicken, turkey, fish) and other low–fat sources should be eaten first. These should comprise at least half the volume of the meal eaten. Foods should be cooked without fat and seasoned to taste. Avoid sauces, gravies, butter, margarine, mayonnaise and junk foods.
  • Protein snacks are encouraged between meals. Do not drink flavored beverages, even diet soda, between meals.
  • Drink 2–3 quarts or more of water each day. Water must be consumed slowly, 1-2 sips at a time, due to the restrictive effect of the operation.
  • Exercise aerobically every day for at least 20 minutes (one–mile brisk walk, bike riding, stair climbing, etc.). Weight/resistance exercise can be added 3–4 days per week, as instructed by your doctor.
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    SMS of the Day

(Dr GM Singh)

Imagination is everything. It is the preview of life’s coming attractions. Albert Einstein

    Medicolegal Update

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

What is the Therapeutic Privilege? Is it necessary for treating doctor/hospital to disclose all the information to patient?

The patient has a legitimate right to determine what medical/surgical, diagnostic or therapeutic intervention has to be done with his/her own body and the doctor has to obtain a valid consent after giving full information of medical procedure to be done to the patient.

  • When two or more persons agree upon the same thing in the same sense, it is a valid consent as per the definition of the consent given in Section 13 of the Indian Contract Act. The doctor who performs an intervention without the patient’s consent commits an offence for which he is liable as per law. Consent may be express or implied. Express consent in an oral or written authority by the patient to render the proposed medical/surgical treatment. Consent may be implied to conduct medical examination from the conduct of the patient who voluntarily submits to treatment under circumstances which would indicate awareness of the planned treatment impliedly authorizes the treatment, even without express consent. A patient who presents himself or herself at the doctor’s clinic/hospital after appointment/purchasing OPD Card/paying doctors fee for consultation/routine medical procedure/examination by way of palpation/auscultation implies his/her consent to treatment by the doctor/hospital.
  • It is now recognized that the patient has the right to full information in patient as consumer terms, concerning his diagnosis, treatment and prognosis. He/she should also be informed about the alternative treatments/methods and its possible complications. Informed means the consent of a patient to the performance of the health care services provided by a registered medical practitioner, that prior to be the consent having be given, the doctor/team of/hospital authority has informed the patient of the nature of the purposed procedure or treatment of those risks and alternative treatment or diagnosis that a reasonable patient would consider material to the decision whether or not to undergo treatment or diagnosis.
  • In standard ethical/prudent practice of medicine, the doctor’s duty to disclose the information/complete information is subject to the following two exceptions: No disclosure is required, if the patient indicates a preference not to be informed; or if the physician or surgeon believes in the exercise of sound medical judgment, that the patient personality is so anxiety prone or disturbed that the information would not be processed rationally or that it would probably cause significant psychological harm/not in the interest of his/her mental and physical health or it will cause adverse effect on good prognosis of patient health of the patient.
  • This exception to the legal duty of full disclosure to patient as informed consent in medical care delivery is called the ‘therapeutic privilege’ of a doctor. The consultation/share the information with legal heirs, another physician familiar with the patient/family doctor, with a close relative or friend of patient, or all is advisable for a treating doctor in good faith and must be documented as an extended informed consent under heading of therapeutic privilege
    Vitamins—Open Secrets revealed

(Dr Jitendra Ingole, MD Internal Medicine)

Diabetes drug linked to vitamin B12 deficiency

A case report has been documented wherein a 63–year–old man who developed a severe vitamin–B12 deficiency after having taken metformin (Glucophage) for five years. Replacing the metformin with sulfonylurea and taking 1000 mg of cyanocobalamin (vitamin B12) for two months reversed the deficiency. Dr. Mary Ann Gilligan estimates that 10 to 30 per cent of patients on metformin develop a vitamin B12 deficiency and points out there is some evidence that calcium supplementation will prevent it. (Ref: Gilligan MA. Metformin and vitamin B12 deficiency. Arch Int Med 2002;162:484–5)

    Mind Teaser

Read this…………………

The maker doesn’t need it, the owner doesn’t want it, the user doesn’t know he’s using it. What is it?

Yesterday’s Mind Teaser: All endothelial cells produce thrombomodulin except those found in:
1. Hepatic circulation
2. Cutaneous circulation
3. Cerebral microcirculation
4. Renal circulation

Answer for Yesterday’s Mind Teaser:  3. Cerebral microcirculation.

Correct answers received from: Dr Jainendra Upadhyay, Dr Neelam Nath, Dr Anil Bairaria, Dr Jeti, Dr Feiaz, Dr Anupama, Dr Alok, Dr Praveen, Dr Gagan, Dr Anuj, Dr Chandaraprakash, Dr Dilip, Dr Mantosh, Dr Naveen, Dr Kanak, Dr Kanchan, Dr Lalit, Dr.D.Chatterjee

Answer for 21st May Mind Teaser: 1. 20 mg iron & 100 micrograms folic acid.
Correct answers received from: Dr.Sumit Mehndiratta, Dr Shirish Singhal, Dr. Manjesha, Dr. Sushma Nangia, Dr Sangeeta, Dr Suman, Dr Varun, Dr Vyom, Dr Bhushan, Dr Charu, Dr Aaditya

Send your answer to ijcp12@gmail.com

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Lactate Dehydrogenase Serum

Also known as: LD, Lactate dehydrogenase, Lactic dehydrogenase, Total LDH, and LDH isoenzymes.

This test helps to identify the cause and location of tissue damage in the body and to monitor its progress. Increased levels of LDH and changes in the ratio of the LDH isoenzymes usually indicate some type of tissue damage. Raised levels of LDH may be seen with:

  • Cerebrovascular accident (CVA, stroke)
  • Drugs: Anesthetics, aspirin, narcotics, procainamides, alcohol
  • Hemolytic anemias
  • Pernicious anemias (megaloblastic anemias)
  • Infectious mononucleosis (Mono)
  • Intestinal and pulmonary infarction
  • Kidney disease
  • Liver disease
  • Muscular dystrophy
  • Pancreatitis
  • Lymphoma or other cancers

Low and normal levels of LDH do not usually indicate a problem. Low levels can be seen when a patient ingests large amounts of vitamin C.

    Medi Finance Update


  • No investment in equity shares is safe.
  • A real estate investment is always viable. However, it is tough and one should be able to judge the right locality and the cash involved.
  • One should not have an Abhimanyu approach in investing, i.e. know how to enter, but don’t know how to get out of it.
   Laugh a While

(Dr. Prabha Sanghi)

One spelling mistake can destroy your life!

A husband wrote a message to his wife on his official trip to New York and forgot to add ‘e’ at the end of a word.

"I’m having such a wonderful time in the hotel! Wish u were her…!"

    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
DCI Approval Date
Memantine HCl ER Tablet 28mg
In the treatment of moderate to severe Alzheimer’s disease.
    IMSA Update

International Medical Science Academy (IMSA) Update

Exercise blood pressure and cardiovascular outcome

A study of over 4800 asymptomatic normotensive individuals found that a hypertensive response to treadmill testing was associated with an increased risk for cardiovascular death.

    Public Forum

(Press Release for use by the newspapers)

Do not ignore minor paralytic strokes

Whispering paralysis or stroke is defined as stroke with symptoms that are so mild that they may often go unnoticed, but can nevertheless cause physical and mental harm, said Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal and President, Heart Care Foundation of India.

Quoting a report published in the international journal Stroke, Dr. Aggarwal said that 18% of over 22000 older adults in the study reported having such symptoms.

Dr. Aggarwal said that one should not ignore the following:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
  • Sudden confusion, trouble speaking or understanding.
  • Sudden trouble seeing in one or both eyes.
  • Sudden severe headache with no known cause.
  • Sudden trouble walking, dizziness or loss of balance or coordination.

Patients with above symptoms should immediately contact their doctor and they should be investigated for presence of plaques in the carotid arteries and other risk factors identified. Timely treatment and diagnosis not only can prevent future attacks but also recover minor damage due to the present attack.

    Readers Responses
  1. Hi, I am surprised to read the views on the constitution of MCI. Let us have a broader vision and not see the things in a tubular and narrowed vision. The fact behind dissolution of the Council is known to every one. The Govt wanted to bring changes in the "constitution" of the Council itself– mainly under section 3 of the IMC Act, 1956. It entails certain procedures and that is what probably is taking time. The so called IMA activists are taking little extra interest in the affairs of council and this is not a healthy trend. Let us ask ourselves - are we united on all the fronts? We are not. We have varied and varying views/opinions, but are afraid to express. Let us stop being hypcrites and work for the betterment of profession at large. Let the Govt do its job. Once the changed "constitution" comes to the fore, we should be concerned about that. It is too premature to react on the Govt’s choice on the (new) Board of Governors. Who doesn’t know calibre of Dr K K Talwar? What is in the offing, we don’t know and it is the same situation when the team led by Dr SK Sarin had taken over. Let us wait and not jump to avoidable conclusions. Dr K K Arora, Ex–MCI.
  2. Please check the following links to clear your misconception about Physiotherapist  http://www.physiotherapyindia.org/  - an official website of indian association of physiotherapists (check out the public notice) http://bit.ly/iarFPk  (Gujarat forms a independent state council, give right to a physiotherapist about diagnosis and treatment). we physio can prefix the Dr. as per rule, no MCI or IMA can interfere in this acc to the public notice, and according to guj council we can diagnose and treat the patients. From: paras joshi
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  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

    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
• Provisional Scientific Program at http://worldcon2011.org/day1.html
• Provisional program for Pre Congress CME at http://worldcon2011.org/Pre_Conference_CME.html
• Abstract submission at http://worldcon2011.org/scientificprogram.html
• Important dates at http://worldcon2011.org/importantDates.html
• Congress website at http://www.worldcon2011.org
• Entertainment – Kingdom of Dreams at http://worldcon2011.org/Pre_Post_Tours.html

Key Contacts
Dr. (Col.) Satish Parashar, President Organizing Committee, + 91 9810146231
Dr. Rakesh Gupta, Secretary General, + 91 9811013246

Congress Secretariat: Rajat Khurana, C–1 / 16, Ashok Vihar – Phase II, Delhi 110 052, INDIA., Phone: + 91–11–2741–9505, Fax: + 91–11–2741–5646, Mobile: + 91 9560188488, 9811911800,
Email: worldcon2011@gmail.com, jrop2001@yahoo.com, worldcon2011@in.kuoni.com


Medifilmfest (1st International Health Film Festival in Delhi)

October 14–23, 2011, As part of 18th MTNL Perfect Health Mela 2011(Screening of films October 14–17, Jury Screening at Jamia Hamdarad University Auditorium October 18–19, award winning films at TalKatora Stadium October 19–23, 2011)
Organized by: Heart Care Foundation of India, World Fellowships of Religions, FACES, Bahudha Utkarsh Foundation and Dept of Health and Family Welfare Govt of NCT of Delhi.
Entries Invited: from feature films, Ad Films, Serials, Documentary Films, Cartoon Films, Animation Films, Educational films; films on Yoga, Siddha, Ayurveda, Unani, Homeopathy; Indigenous Healing, Films promoting the Bio–cultural Diversity, Medical Tourism, Visual and Medical Anthropology, Gender sensitization, awareness drive on socio–medical issues and health journalism. The films can be of variable durations (0–1 minute, upto 3 minutes, upto ten minutes, upto 45 minutes and upto an hour and beyond).
Separate entries are also invited for "factual mistakes in feature films concerning health". This can be in the form of 1–5 minutes footages.

Categories:Competitive category/ Non Competitive category/ Special screening
Sub Categories:

1. General: Documentaries, animation films, corporate films, Ad films, TV health programs/reports, health chat shows.

2. Special: Short instances of "depiction of wrong health messages" through the films.

Subjects: Health, disease, sanitation, yoga, spiritual health, environment, social issues, food, better living, Indigenous healing, medical tourism, visual & medical anthropology, gender sensitization, health journalism. Duration: 0–10 seconds; <30 minutes, 30–60 minutes, 1–3 hours. Language: English or Hindi, or sub tilled in English/Hindi. Fee: No fees from participants. Entry to the film show free. Format: Any format duly converted into DVD (compatible to the latest players/systems) Boarding, Lodging and Travel Expenses: Own, the participants may raise their own sponsorships

For details contact: Dr KK Aggarwal/Dr Kailash Kumar Mishra/Mr M Malik at


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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 Naveen Dang, Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta