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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

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

  Editorial …

23rd November 2011, Wednesday

Alert: Fluoroquinolone can cause liver damage

In a prospective study conducted by the Drug–Induced Liver Injury Network, 12 of 679 patients who had received a fluoroquinolone (ciprofloxacin, moxifloxacin, levofloxacin, and gatifloxacin) had hepatotoxicity.

  • Seven had fever, rash, and eosinophilia
  • Four had hepatocellular injury, 4 cholestatic injury, and 4 both. All 4 with both had mild disease without jaundice
  • Two out of 4 patients with hepatocellular injury and jaundice died; one of acute liver failure.
  • One patient with cholestatic injury developed vanishing bile duct syndrome and required liver transplantation.

(Ref: Orman ES, Conjeevaram HS, Vuppalanchi R, et al. Clinical and histopathologic features of fluoroquinolone–induced liver injury. Clin Gastroenterol Hepatol 2011;9:517).

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    eMedinewS Audio PostCard

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

Alert: Fluoroquinolone can cause liver damage

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

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

The children are not physically disabled and handicapped but they are differently abled.

Dr K K Aggarwal
    National News

Researchers look for rare type of HIV patients in India

New Delhi: An international consortium of HIV researchers, searching the globe for a rare, specialized type of HIV patients known as "elite neutralizers", is now scouring India with the hope that it will find such people who could help in the race to find a vaccine for the formidable, highly infectious virus. Elite neutralizers are among a niche subset of HIV patients who, despite being infected with the virus, show a fraction of the levels of viruses that circulate and eventually destroy the body when infected. Though such neutralizers, too, eventually fall prey to the infection, their relative resilience comes from having immune systems that produce a class of specialized, rare antibodies called broadly neutralizing antibodies (BNABs), which in turn hold key clues to designing potential vaccines. Thus far, only 18 individuals from the US, Australia, Europe and Africa have been classified as elite neutralizers. (Source: http://www.livemint.com/2011/11/22004838/Researchers–look–for–rare–type.html?h=A1)

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

AIDS–related deaths ‘down 21% from peak’, says UNAids

AIDS–related deaths are at the lowest level since their 2005 peak, down 21%, figures from UNAids suggest. Globally, the number of new HIV infections in 2010 was 21% down on that peak, seen in 1997, according to UNAids 2011 report. The organisation says both falls have been fuelled by a major expansion in access to treatment. Its executive director, Michel Sidibe, said: "We are on the verge of a significant breakthrough." He added: "Even in a very difficult financial crisis, countries are delivering results in the Aids response. "We have seen a massive scale up in access to HIV treatment which has had a dramatic effect on the lives of people everywhere." (Source: http://www.bbc.co.uk/news/health–15816813)

For comments and archives

First supplemental Chagas disease test approved

The US Food and Drug Administration (FDA) has approved the first test licensed as a supplemental test for the detection of antibodies to Trypanosoma cruzi, the parasite that causes Chagas disease. The ESA Chagas assay (Abbot Laboratories) is the first test for use as an additional, more specific test on human serum and plasma specimens that are positive for antibodies to T cruzi, noted the FDA in a press release. (Source: Medscape Medical News)

For comments and archives

Biomarkers for Alzheimer’s linked to body mass index

Biomarkers for cerebral beta–amyloid and tau are associated with lower body mass index (BMI) in both those who are cognitively normal and those with mild cognitive impairment, researchers have found. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Padma Shri Awardee Dr KK Aggarwal on Check regression of heart blockages… http://www.youtube.com/watch?v=fAW7uopTVoY&feature=share via @youtube

@DeepakChopra: The next step in the Occupy Movement: #Occupyyourself. Be the 100%. Lets start now

    Spiritual Update

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

Why do we pray on the day of marriage?

Addressing the spiritual needs of a person facilitates recovery from any mental stress. Religious involvement and spirituality are associated with better health outcomes. In prayer we talk to God. In meditation, GOD talks to us. Prayer is like inserting intent in the field of consciousness and meditation is akin to formatting our hard disk.

For comments and archives

    An Inspirational Story

(Dr Anupam Sethi Malhotra)

Small victories

Standing in the noisy cafeteria of the old school, I was watching the students line up for lunch. Having wearied of trying to "cut" in line on each other, they were intently moving toward the food. As I continued to watch their progress, I began to remember scenes from my own grade school days. This old school building was somewhat similar to mine.

I could still remember coming into the warm building with the funny smells of furnace heat and cleaning liquids. I visualized the rooms, heated with old–fashioned steam pipe radiators and the hand–turn heat regulators. I could picture the Spartan desks in long straight rows, with scratched and scared surfaces, and the small cloak closets with wood doors folding in along the back of the room. "Teacher," a small hand tugged my wrist, "I can’t eat my lunch," complained a small Asian American boy, standing behind me. My thoughts abruptly returned to the present in the cafeteria of the old school where I was substitute teaching. "What’s wrong?" I replied as I watched the last of the lunch line disappear into the kitchen. "Why not?" I asked as I turned to face the cafeteria at large.

"Jamal and Anthony keep poking at my food. I don’t want to eat it!" Making my way to his lunch table, I took up Lee’s cause. I admonished the children, "Keep your hands to yourselves and eat properly!"

My repeated warnings went unheeded, and I began to move the children to different spots at the table. To no avail––as soon as Lee sat down, the pestering began again. As the hearty children began finishing their food, I urged Lee to go back to the kitchen to get a second lunch, promising I would speak to the cooks for him. When I went out to playground duty, he was still sitting in front of his second tray, picking at the food. I tried not to worry about the thin child because I remembered that I had not always eaten my cafeteria lunches and I survived. I substituted frequently at this school, and in a few weeks, I was back in Lee’s small class. Both the teacher and the assistant were absent. The children in this room had some learning difficulties, and each child had different instructions and activities. I soon realized that Lee had a problem with staying on task and with anger. As I moved through the room, I stopped by each child to check on progress and to help with work. Lee was working with educational coloring sheets, and I let him work on his pictures in sequence rather than finishing one at a time. Doing a part of each until all were completed seemed to suit his temperament. He began to smile as if he and I shared a huge joke. This time, I did not have lunch duty, so I lined the children up and led them to the cafeteria where another teacher took charge of their progress through the line. I went back to the room to check each child’s work again and eat a quick sandwich. In fifteen minutes, Lee was back in the room, unable to eat lunch again, having left the cafeteria without permission. I gave him some money, the cost of an alternate lunch, and walked him down to the cafeteria. At the end of lunch, Lee was back in the room with the young man assigned to the room as psychological counselor. Evidently, a cafeteria supervisor sent him to be counseled about his difficulties with eating.

Slowly, with shyness and pride, he handed me my money back and told me what he and the counselor had rehearsed. "Thank you, Mrs. Grishan (his pronunciation), but my mom and dad will not let me accept money. They provide my food." I smiled, accepted the money, and watched Lee go with the counselor for further discussion. When he returned, the counselor stayed with him to keep him sweet and on task.

Later in the year, I was back at the same school to substitute with a large fourth grade class for a week. The day I had lunch duty, I noticed as I glanced quickly around the cafeteria that Lee’s table was at peace. They were eating quietly and were not teasing each other. Lee was eating too, and as he looked at me intensely, I glanced away because I did not want to interfere with his concentration on his food. I know, though, that I was smiling, and my heart was singing. I thought of the phrase, "all the little children of the world, brown and yellow, black and white," and these precious children were all getting along just fine. I knew that major work by persistent teachers, a dedicated counselor, fine administrators, and parents willing to partner with the school had wrought a change in the life of these troubled children.

For comments and archives

    Cardiology eMedinewS

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

CSI News

What to do while dealing with typical Angina and normal coronaries?

For comments and archives

Old people too getting infective endocarditis now

For comments and archives

More Than 20% Of Individuals With Heart Problems Are Not Receiving Statins.

For comments and archives

Peri–operative myocardial infarction

For comments and archives

    Fitness Update

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

Back pain can be relieved by yoga

Much research has shown that exercise, along with stretching, can ease chronic pain. Certain studies have also suggested that yoga helps relieve back pain. However, those studies are sometimes criticized because they only included one instructor or had small a number of participants. Now, a new British study published in the journal Annals of Internal Medicine shows new, promising evidence for people who suffer from back pain. The study was larger than previous ones, and included over 20 different yoga instructors.

Researchers from England found 313 middle–aged British citizens who suffered from moderate chronic back pain. All participants were given booklets on coping with back pain, but half of the participants were also enrolled in three months worth of weekly yoga classes. Each class lasted 75 minutes, and the yoga practiced was low impact and designed for especially for beginners who had back pain. After three months, study participants answered questionnaires about their pain levels and how their back pain influenced their quality of life and daily activities. After participation in the yoga class, back pain patients were able to do 30% more activities of daily living than the control group (those who received only a booklet). In addition, they reported a decrease in back pain symptoms. Furthermore, sixty% of the people from the yoga group indicated that they were still practicing yoga on their own after the end of the study.

For comments and archives

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emedinews revisiting 2011
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    Healthy Driving

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

Should Old Patients Drive

Driving performance is usually impaired only after a considerable loss of function since most driving patterns are learned and become second nature.

    Medicine Update

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

Can celiac disease present with constipation?

Yes, celiac disease may manifest with constipation, though diarrhea is the commonest manifestation. In western data, constipation may be seen in around 5% of children.

For comments and archives

  Legal Question of the Day

(Dr M C Gupta)

A patient with an injury comes to the hospital and wants a medicolegal report. Can it be given without a court order?

  1. If he is a patient and needs treatment, the treatment cannot be denied in the absence of court order. If an injured patient is treated with history of injury that may not be natural, it is the duty of the doctor to inform the police and, after informing, to prepare an MLR. The original of the MLR is to be given to the police and the copy is kept in the MLR register/hospital records.
  2. If his clinical condition does not call for any treatment, the doctor is not bound to treat him or to entertain his request for an MLR. The proper procedure for him is to go to the police and make a police complaint about his injury. The doctor would prepare an MLR only when the person is brought by the police for a written request for MLR.
  3. There is no question of any court order. The doctor can prepare an MLR at the written request of the police.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient came with fever with chills and rigors.
Dr. Bad: It is classical malaria.
Dr. Good: It can be due to other causes also.
Lesson: Fever with chills and rigors can be seen in malaria, UTI and even viral infections.

For comments and archives

Make Sure

Situation: A patient died after consuming six pegs of alcohol.
Reaction: Oh my God! why was he allowed to consume six pegs?
Lesson: Make sure that no patient is allowed binge alcohol i.e. consuming more than six pegs in a day or five pegs at a time.

For comments and archives

  Quote of the Day

(Dr GM Singh)

May you have the hindsight to know where you’ve been, The foresight to know where you are going, And the insight to know when you have gone too far. Irish Blessings

    Mind Teaser

Read this…………………

In the classification of cholangiocarcinoma by site, Type II:

a) Is confined to the common hepatic duct.
b) Involves the bifurcation without involvement of secondary intrahepatic ducts.
c) Tumors extend into either the right or left secondary intrahepatic ducts, respectively.
d) Involves the secondary intrahepatic ducts on both sides.

Yesterday’s Mind Teaser: What is the management of choledochal cyst adherent to portal vein?

a) Excision and Roux en Y hepaticojejunostomy
b) Internal drainage into Roux en Y jejunal limb
c) Hepatic lobectomy
d) The internal lining of the cyst can be excised, leaving the external portion of the cyst wall intact.

Answer for yesterday’s Mind Teaser: d) The internal lining of the cyst can be excised, leaving the external portion of the cyst wall intact.

Correct answers received from: Ravi Shanmu, Dr Sukla Das, Dr PC Das, Dr Surendra Bahadur Mathur, Dr Jainendra Upadhyay, Dr Ragavan Modugalya, Dr Alexander Daniel Sunad, Anil Bairaria, Dr Thkor Hitendrasinh G, Raju Kuppusamy, Muthumperumal Thirumalpillai, Yogindra Vasavada, Dr Chandresh Jardosh.

Answer for 21st November Mind Teaser: What comes up must come down
Correct answers received from: Muthumperumal Thirumalpillai, Yogindra Vasavada, Dr Sukla Das,
Dr PC Das, Dr LVK Moorthy, Rameshwar prasad, Dr KV Sarma, Rajiv Kohli.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

As an English professor, my father would often write little notes on student essays. Often he worked late, and as the hours passed, his handwriting deteriorated. One day a student came to him after class with an essay that had been returned. "Mr. McDonald," he said, "I can’t make out this comment you wrote on my paper." My father took the paper and, after studying it, sheepishly replied, "It says that you should write more legibly."

    Medicolegal Update

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

Human body dies in bits and pieces–The clinical death implies the failure of the body as an integrated system.

  • After death the life continues in the separate tissues, which constitute the body. These only die after varying periods depending upon the ability of the tissue to function without blood supply.
  • This is called molecular or cellular death. The nervous tissue dies rapidly and the vital centers die in about 5 minutes. The muscle live longer and they will constrict to direct electrical stimuli up to 3 hours. The corneal reflex and papillary reflex disappear at the time of death.
  • The pupil reacts to the drugs like atropine that causes dilatation up to 1 hour. The cornea can be removed for transfused for up to 6 hours and blood can be transfused for up to 6 hours of death. Therefore, we die in bits and pieces.
  • The legal definition of death depends upon the diagnosis of somatic death. The distinction between somatic and molecular death becomes important because in order to remove essential tissues and organs for transplantation there is a relatively short time for the biological properties of living matter to persist after somatic death. With somatic death, there is complete generalized anoxia of the tissue and consequently stoppage of metabolic process carried out by the tissue cells.
  • The metabolic process of the ganglionic cells stops in minutes, which are most sensitive whereas that of connective tissue stops in hours, which are the least sensitive.

(Reference Dr. PC Dikshit Head (MAMC) MD LLB, Textbook of forensic medicine, Peepe Publisher)

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

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

HCFI Health Games at IITF

Heart Care Foundation of India has set up live health games at the Ministry of Health and Family Welfare Pavilion, India International Trade Fair at Pragati Maidan.

Games like Ludo and Worms & Ladders are on display and played virtually by visitors as pawns. Giving the details, Padma Shri & Dr. B.C. Roy National Awardee, Dr KK Aggarwal, President, Heart Care Foundation of India, said that most children enjoy playing games and if health information is added to them, they can become educational too.

The Foundation has also organized an exhibition on how to prevent lifestyle disorders through its Formula of 80. Talking to the children, he stated a Formula of 80, which could be remembered by all.

  • Keep fasting blood sugar <80 mg%.
  • Keep the lower BP <80 mmHg.
  • Keep bad LDL cholesterol <80 mg%.
  • Keep abdominal girth <80 cm.
  • Keep resting pulse <80/minute.
  • Keep HDL cholesterol >40 (half of eighty).
  • Keep triglyceride levels <160 mg% (double of eighty).
  • Walk 80 minutes a day.
  • Wherever possible walk with a speed of 80 steps per minute.
  • Eat less, preferably not more than 80 grams per meal.
  • Do not drink or restrict to less than 80 ml/day or 80 grams per week.
  • Do 80 pranayams a day.

For comments and archives

    Readers Responses
  1. Sir,The dilemma shown by Dr M C Gupta for the practice in metro city is genuine and candid expression of reality. Dr K K Aggarwal’s views and solution (my assumption) are worth debating by all those who are affected by this "metro/corporate syndrome". As a public health practitioner, I totally endorse the views of Dr Aggarwal. It would revolutionalize the health sector in India, if we medical fraternity are honest to the cause of serving to self and others who need us.
    Debate should go on… All the best.With warm regards. Dr A C Dhariwal
    Forthcoming Events

CSI 2011

63rd Annual Conference of the Cardiological Society of India

Date: December 8–11, 2011.
Venue: NCPA Complex, Nariman Point, Mumbai 400021

Organizing Committee

B. K. Goyal – Patron
Samuel Mathew – President CSI
Ashok Seth – President Elect & Chairman Scientific Committee
Lekha Adik Pathak – Chairperson
Satish Vaidya & C. V. Vanjani – Vice Chairman
N. O. Bansal – Organizing Secretary
B. R. Bansode – Treasurer
Ajit Desai , Ajay Mahajan , G. P. Ratnaparkhi – Jt. Org. Secretaries
Shantanu Deshpande , Sushil Kumbhat , Haresh Mehta – Asst. Org. Secretaries
D. B. Pahlajani, A. B. Mehta , M. J. Gandhi , G. S. Sainani, Sushil Munsi, GB Parulkar, KR Shetty – Advisory Committee

Contact: Dr. Lekha Adik Pathak, Chairperson, CSI 2011; Dr. Narender O. Bansal, Org. Secretary, CSI 2011 Tel: 91 – 22 – 2649 0261/2649 4946, Fax: 91 – 22 – 2640 5920/2649 4946.
Email: csi2011@ymail.com, csimumbai2011@gmail.com Website: www.csi2011mumbai.com

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

    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