eMedinewS23rd June 2014, Monday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); 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);
For updates follow at :  www.twitter.com/DrKKAggarwal, www.facebook.com/Dr KKAggarwal

Energy drinks may put heart at risk for sudden death

Energy drinks may raise blood pressure and prolong QT interval increasing the risk of sudden cardiac death.

In a meta–analysis by Sachin A. Shah at University of the Pacific in Stockton, Calif, with a pooled analysis of 93 people who consumed energy drinks, the QT interval on an ECG was significantly prolonged by 10 ms. The threshold level of regulatory concern is around 5 ms.

In another pooled analysis of 132 people by the same group, researchers found a significant increase in systolic blood pressure by 3.5 mmHg that was associated with the consumption of energy drinks.

Doctors are generally concerned if patients experience an additional 30 ms in their QT interval from baseline. QT prolongation is associated with life–threatening arrhythmias.

Most energy drinks have caffeine. Drinks such as Monster, Red Bull, Rockstar, Full Throttle and AMP have three times the amount of caffeine as colas. A 16–oz. can of Monster Energy, for example, contains 160 mg of caffeine, which is almost as much as 5 cans of soda.

News Around The Globe

  • A new study published June 19 in the journal Cell suggests that regular sun tanning not only increases the risk of skin cancer but may also be addictive. The study authors noted that chronic exposure to ultraviolet radiation triggers the release of endorphins that act through the same biological pathway as highly addictive opiate drugs heroin and morphine. A meta-analysis has recently revealed that people with low vitamin D levels are at increased risk of dying from cancer, if they have already had cancer. All-cause mortality appeared to be 1.57 times higher among older adults in the lowest quintile of 25–hydroxyvitamin D (25(OH)D) level, but cancer-related deaths were higher only among persons with a history of cancer. The study was published online in BMJ.
  • A study published online June 17 in PLOS One has stated that musical training augments executive function (EF), especially in the areas of cognitive flexibility, working memory, and processing speed, and this may explain the link to academic achievement.
  • The first pivotal phase 3 study of ruxolitinib has shown that the agent brings about substantial improvements in patients with polycythemia vera (PV), a chronic and incurable blood cancer. Findings from the study were presented at the 19th Congress of the European Hematology Association.
  • A systematic review has shown that regimens that contain trastuzumab improve outcomes in women with metastatic breast cancer; however, it may be associated with an increased risk of cardiovascular adverse events.

Rabies News (Dr A K Gupta)

How is a skin sensitivity test performed?

Inject 0.1 ml ERIG diluted 1:10 in physiological saline intradermally into the flexor surface of the forearm to raise a bleb of about 3–4 mm diameter. Inject an equal amount of normal saline as a negative control on the flexor surface of the other forearm.

After 15 minutes, an increase in diameter to >10 mm of induration surrounded by flare is taken as positive skin test, provided the reaction on the saline test was negative.

An increase or abrupt fall in blood pressure, syncope, hurried breathing, palpitations and any other systemic manifestations should be taken as positive test.

Cardiology eMedinewS

  • A study conducted by clinicians in German, Swiss and Austrian hospitals has shown that low–to–intermediate risk patients with suspected acute coronary syndrome (ACS) can safely be discharged earlier from the emergency department (ED) using cardiac Troponin together with Copeptin. The study has been published in the European Heart Journal.
  • Mutations that lead to reduced function of the APOC3 gene have been noted to be associated with lower triglyceride levels and lower risks of ischemic vascular disease and coronary heart disease, reported two studies published online in the New England Journal of Medicine.

Pediatrics eMedinewS

  • A new study from the University of Michigan has pointed that participating in an educational sleep program resulted in a 30–minute average increase in sleep duration at a one–month follow–up for preschoolers. The study is published in the journal Sleep.
  • Children who spend more time in less structured activities, from playing outside to reading books to visiting the zoo, may be in a better position to set their own goals and take actions to meet those goals without stimulation from adults, according to a new study published online in the journal Frontiers in Psychology.

Dr K K Spiritual Blog

Doctors are God Later and Human Beings First

Doctors are regarded as God because their primary job is to save the life of a patient. In fact, they are the messengers of God to look after the health of the sick person. But, Doctors are God later and human beings first.

To err is human and every doctor is likely to make mistakes. The very fact that a doctor is getting himself insured under Indemnity insurance means that medical errors are recognized as a part and parcel of Government policies.

For any error, the Court has decided a financial compensation to the patient and that compensation is paid by the insurance company as the doctor is covered under the Indemnity insurance. Medical negligence on the other hand, if proved, is not covered under the insurance. Therefore, medical negligence has to be differentiated from medical errors.

The error of judgment and difference of opinion are accepted in the law as not negligence and there are ample Supreme Court judgments to support that. Medical accidents are also exempted from being termed negligence by various Supreme Court clarifications/judgments. For a doctor to be punished under medical negligence, there has to be a proof that he willfully did some omission or commission which led to the death or caused harm to a person.

A doctor is also not required to possess the maximum degree of skill and knowledge but is required to possess only an average degree of skill and knowledge. Therefore, when an expert is called for an opinion, he should never give an opinion from his level of perception and knowledge but should take into consideration the knowledge of an average doctor of that specialty.

Recently, one of my friends forwarded a report to me, which showed that in US when the doctors went on a strike, the number of deaths in the city during the strike period reduced.

I totally agree with this observation and I am of the firm opinion that if allopathic medical profession ceases to exit, the number of deaths per day will be reduced. But at what cost?

It will invariably be at the cost of increased morbidity, impaired quality of life and more sufferings. In that scenario people with sexual dysfunction will live without enjoying sexual life; people with heart failure will be bedridden, patients with TB will be back in sanitariums, patients with fractures will remain on the bed for months together and patients requiring orthopedic surgeries will remain with life–long deformations. To have a better quality of life, one has to pay the price as any intervention or surgery done to improve the quality of life invariably will carry some risk and mortality. Even a simple bypass surgery of the heart carries a mortality of up to 0.5–1%. But for the family whose patient dies that 1%, the mortality is 100%.

In a follow up program on Aaj Tak, the film actor, Aamir Khan, said that every household in India has a negative story to tell about medical doctors. Aamir probably misunderstood or could not differentiate medical errors, medical accidents from medical negligence. People equate money with medical success. Most of the medical disputes occur in private sector when the patient’s relatives have to pay money for an unsuccessful surgery or treatment. Attempts have been made to compare the results of medical treatment in India from that of abroad. They are totally incomparable as the amount of fee charged by doctors in India is practically a fraction of a price that is charged in the west. The patients load in India per doctor is also responsible for potential medical errors. One should also remember that the Drug Controller Government of India does not inform doctors about banned drugs, introduction of new drugs or introduction of new equipment. Most doctors depend on technology to be learnt through the manufacturers of respective machines. The manufacturers either bring the training persons from abroad or support the training of Indian doctors abroad. Their interest is ultimately covered as the doctors once trained ultimately end up in purchasing their technology.

When a new drug is launched, as there is no information from Drug Controller of India to individual doctors, they are forced to attend symposia by drug companies, which now come under the purview of unethical doctor–pharma relationship.

Most doctors will write pharmaceutical drugs of a company, which people think is in lieu of a commission they are getting. The reality is that a doctor will invariably write a drug of a company who is constantly spending efforts in educating doctors about new technologies and innovations as both Medical Council of India and the Government of India Health Ministry have no such provisions for the doctors. On the other hand, not attending medical educational programs is considered a professional misconduct by MCI and many state councils.

Wellness Blog

Echo for Long–Term Risk after Stroke

A simple risk prediction model may help identify ischemic stroke patients at a higher risk of future adverse outcomes. Age, chronic renal failure, and the amount of calcification around the aortic root were predictive of death at about 4 years after nonhemorrhagic stroke said Dr Avinash Murthy at Albany Medical Center in Albany, N.Y at the annual meeting of the American Society of Echocardiography (ASE).

The doctors assigned 2 points for each decade over 40 years, 11 points for renal failure, and 3 points for aortic root sclerosis. The high–risk group –– more than 11 points –– had a mean survival estimate of 39 months, compared with 49 months for the moderate–risk group (5–10 points) and 62 months for the low-risk group (0–5 points).

Most stroke patients undergo an echocardiography exam at the index admission to look for patent foramen ovale, shunt, or embolus and data about aortic root sclerosis is already available.

Inspirational Story

Hide and Seek

One summer day a mother looked out the window of her house. There in the garden she saw her little daughter rolling around the grass in laughter. Intrigued she went outside to investigate. Approaching her daughter the mother asked, "My child, what do you find so amusing?"

"I understand, I understand," replied the child among bursts of giggles. "What do you mean?" questioned the mother.

"Well," answered the child, "I was playing outside on the grass when I started thinking about God, and how I have heard people say that God is everywhere. But I looked around and couldn't see God anywhere. So I thought: of course! God must be playing a game of hide and seek. So I decided to try find God. I looked amongst the roses for I have heard that God is beautiful. But God was not there. I lay on my back and searched the skies for I have heard that God is up in the Heavens. But God was not there. I dug in the ground for I have heard that God supports us all. But God was not there. And I became very frustrated and I called out: Where are you God? Why have you left me? And then, all of a sudden, a sense of peace came over me and I realized the Truth!"

Spellbound, the mother gently inquired, "What truth?" "That," giggled the little child, "It was not God who was hiding, it was me". So much of our lives we stumble around lost trying to seek God, never realizing we are already Found. All we merely need to do is to stop hiding from God and to embrace Him fully.

ePress Release

TB more dangerous than FLU

Tuberculosis (TB), especially multidrug resistant TB is more dangerous and contagious than H1N1 (swine) flu said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

Respiratory secretions are of two sizes: Less than and more than 5 microns. The ones, which are more than 5 microns like H1N1, are heavy and cannot remain suspended in the air and immediately will settle down on the surface and are called droplet infections. They need contact precautions and 3 feet air precautions. A surgical three-layered mask is sufficient to prevent infections spreading to others.

Respiratory secretions that are smaller than 5 microns are called droplet-nuclei. These are lighter, can remain suspended in the air and move from one place to other with the air movement.

Air borne infections such as TB need the following precautions including N95 mask, air borne isolations rooms with 6 exchanges per hour, HEPA filter exhausts, closed rooms etc. Early identification and treatment of persons with TB can prevent production of droplet nuclei.

Most of the centers in the country do not have facilities to tackle TB, which alone kills over 2500 people in Delhi every year. In India if all the efforts are diverted to TB prevention, swine flu will be wiped out automatically.

eMedi Quiz

The prevalence of skin infections in HIV infection is approximately

d. Extremely rare

Yesterday’s Mind Teaser: The exaggerated lepromin test seen in cases of Lucio’s phenomenon is called as:

a. Mitsuda’s reaction
b. Medina Ramirez reaction
c. Fischer’s test
d. Fernandez reaction

Answer for yesterday’s Mind Teaser: b. Medina Ramirez reaction

Correct answers received from: Dr Jainendra Upadhyay, Dr.Chandresh Jardosh, Dr Avtar Krishan, Daivadheenam Jella

Answer for 21st June Mind Teaser: : b. 2–12 weeks

Correct answers received from: Dr. Jayant gaikwad

Send your answer to ijcp12@gmail.com

Make Sure

Situation: A patient with suspected meningitis developed brain damage.
Reaction: Oh my God! Why was the antibiotic not started when the diagnosis was suspected?
Lesson: Make sure that the first dose of antibiotic is given at the very time meningitis is suspected.

eMedinewS Humor

Niece and Nephew

A pregnant woman from Washington, D.C. gets in a car accident and falls into a deep coma. Asleep for nearly six months, when she wakes up she sees that she is no longer pregnant and frantically asks the doctor about her baby.

The doctor replies, "Ma’am you had twins! A boy and a girl. Your brother from Maryland came in and named them."

The woman thinks to herself, "No, not my brother… he’s an idiot!"

She asks the doctor, "Well, what’s the girl’s name?"


"Wow, that’s not a bad name, I like it! What’s the boy’s name?"


Zee News – Health Wealth Shows

Cancer Prevention
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Fluid Intake


Total CPR since 1st November 2012 – 94595 trained

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

emedipicstoday emedipics

Heart Care Foundation of India announces the dates and program of the 21st MTNL Perfect Health Mela.

press release

PPIs may be associated with a higher risk for clostridium difficile–associated diarrhea

video of day video of day


IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :


Quote of the Day

Talent works, genius creates. Robert A. Schumann

Twitter of the Day

Dr KK Aggarwal: Shorter the waist line, longer the life line http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Every child that is born is proof that God has not yet given up on human beings." ––Rabindranath Tagore


Forth Comming Event


Call for Free Registration

4th annual conference Zoonosis 2014
Sunday 6th July 10am–2 pm followed by Lunch

Venue; Indian Medical Association HQs, IMA House, ITO New Delhi

Objective: To discuss about prevention of diseases communicable
from animals to human.

Who can take part: Medical Practitioners,Veterinary Practitioners, Animal Owners/Breeders, NGOworking with animal care etc.

Experts will be from Veterinary/Medical sectors

All participants will be given certificate of participation.

Organizers: Heart Care Foundation
of India, Millennium India Education
Foundation,CAR (Ministry of Agriculture Govt.of India,

Register at :
or Call: Vandana 9891673085/Dr Kakroo 9810301261

Zoonosis 2014 9-1 PM

6 July 2014 Zoonosis 2014

Speakers Zoonotic disease in India
Dr Jyoti Misri Pr Scientist ICAR Govt of India

Inaugural address
Dr M L Madan Fmr DDG ICAR

Dr KK Aggarwal (To Moderate)

Bovine Tuberculosis and Brucellosis
Dr R Somvanshi HOD Vety Pathology IVRI Bareilly UP

Dr Rishendra Verma Jt Dir.Centre for Animal Disease Research and Diagnosis IVRI Bareilly UP

Equine Encepahalitis
Dr. Baldev Gulati Pr.Scientist National Centre for Research in Equines,Hissar Haryana

Cysticarcosis, Neurocysticercosis
Dr R Somvanshi HOD Vety Pathology IVRI Bareilly UP

Rabies, Cat Scratch Disease
Dr. Ashok Bhardwaj Asstt.Prof. SKAUST Jammu

Swine Flu, Japanese Encepahlitis
Dr.P K Uppal Fmr FAO Expert on Flu
Dr. Baldev Gulati Pr.Scientist National Centre for Research in Equines, Hissar Haryana

Bird Flu
Dr.P K Uppal Fmr FAO Expert on Flu

Mycotic Diseases

Dr.P P Gupta Fmr Dir.Research Punjab Agri Univ.

Food Borne Diseases Salmonellosis, tapeworms, teniasis

Dr.Lal Krishna
Fmr Animal Husbandry Commissioner Govt.of India.

Anthrax, Rota Virus, Carona Virus

Dr. A K Bhatia Professor & Head, Biotechnology Dept.GLA Univ. Mathura

Dr.M P Yadav Fmr Director IVRI Bareilly UP

Dr.C Bhattacharya Vety Public Health Spl. Delhi

Emerging Threats : JD,Crone’s Disease, Nepha Virus,etc.

Dr.Shoorvir Singh Pr Scientist National centre for Res in Goats Makhdoom Agra


medicolegal update

Click on the image to enlarge

medical querymedical query

medicolegal update

Click on the image to enlarge

medicolegal updatemedicolegal update

medicolegal update
  1. Dear Sir, Thanks for the updates. Regards: Dr Kaya
cardiology news

Media advocacy through Web Media

web mediawebmediawebmedia

eMedinewS Special

1. IJCP’s ejournals (This may take a few minues 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)