eMedinewS 23rd July 2013, Tuesday

Dr K K 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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Hony. Visiting Professor (Clinical Research) DIPSAR; 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.facebook.com/Dr KKAggarwal

Supreme Court to hear PNDT Act new notifications

Govt. of India had issued two PNDT notifications dated 7th Feb 2012 and 4th June 2012. A “Forum for Radiologists/Sonologists” challenged the notification on 29th May 2012 in Delhi High Court. The petition was dismissed there. The forum again filed review petition on 13th July 2012, which was again dismissed.

Subsequently the forum challenged both notifications Dated 7th Feb. 2012 and 4th June 2012 in Supreme Court. The Hon’ble Supreme Court issued notice to Govt. of India. On 29.01.13 the Govt. of India gave reply to the petition. Next date of hearing in Supreme Court is on 2nd Aug. 2013.

The forum is in process of submitting its counter-reply to the reply by Govt. of India. The forum has invited suggestions for the same. ....Read More

SC's NEET logic contrary to constitution bench rulings

(Excerpts from Dhananjay Mahapatra, TNN)


The Supreme Court quashed the single-window admission system for all medical colleges by faulting the Medical Council of India-prescribed National Eligibility-cum-Entrance Examination (NEET) on three grounds.

  1. The majority judgment, authored by former CJI Altamas Kabir and agreed to by Justice Vikramjit Sen, held that NEET violated Articles 19(1)(g), 25, 26 and 30 of the Constitution, which guarantees a citizen freedom to practice any profession and gives freedom to religious and linguistic minority groups to manage their religious affairs as well as educational institutions.
  2. The bench said neither the Medical Council Act, 1956 nor the regulations framed thereunder empowered the MCI to formulate and enforce a single-window admission process for medical colleges.
  3. The court also said NEET could not ensure a level playing field given the disparity in educational standards in different parts of the country.

Since the Unnikrishnan judgment (1993 (1) SCC 645), the Supreme Court has been peppered with petitions by private medical colleges whose counsel look for interim orders just before admission time every year either for grant of permission from MCI to admit students or to step around the rules.

Counter Points

The issues dealt by Justices Kabir and Sen were touched upon by larger benches which decided important questions of law.

  1. Unnikrishnan case: a constitution bench had said education could never be considered trade or commerce under Article 19(1)(g). "We are certainly of the opinion that such activity can neither be a trade or business nor can it be a profession within the meaning of Article 19 (1) (g). Trade or business normally connotes an activity carried on with a profit motive. Education has never been commerce in this country," it had said.
  2. A decade later, an 11-judge bench in T M A Pai (2002 (8) SCC 481) dealt with the subject of 'capitation fee' and whether imparting education could be a trade or business. It had said, "We, however, wish to emphasize one point, and that is that inasmuch as the occupation of education is, in a sense, regarded as charitable, the government can provide regulations that will ensure excellence in education, while forbidding the charging of capitation fee and profiteering by the institution. Since the object of setting up an educational institution is by definition 'charitable', it is clear that an educational institution cannot charge such a fee as is not required for the purpose of fulfilling that object."

    It also had hinted about regulating admissions to private colleges. "Excellence in professional education would require that greater emphasis be laid on the merit of a student seeking admission. Appropriate regulations for this purpose may be made keeping in view the other observations made in this judgment in the context of admissions to unaided institutions," it said.

  3. In the Inamdar case (2005 (6) SCC 637), a seven-judge bench had said a common entrance test (CET) for admissions to medical colleges, including minority institutions, would be ideal and should be conducted by a credible agency, preferably the state machinery. It had also said that a test of this nature, akin to the quashed NEET, would not violate Article 19(1) (g) or the religious rights conferred in the fundamental rights chapter of the Constitution.

    "CET is necessary in the interest of achieving the said objectives and also for saving the student community from harassment and exploitation. Holding of such common entrance test followed by centralized counseling or, in other words, single window system regulating admissions does not cause any dent in the right of minority unaided educational institutions to admit students of their choice. Such choice can be exercised from out of list of successful candidates prepared at the CET without altering the order of merit inter se of the students so chosen," it had said, articulating a vision for transparency sans profiteering in medical education.

    It had said that despite repeated rulings of the apex court against capitation fee, private colleges were indulging in it with impunity and felt that CET could curb this evil.

    "If capitation fee and profiteering is to be checked, the method of admission has to be regulated so that the admissions are based on merit and transparency and the students are not exploited. It is permissible to regulate admission and fee structure for achieving the purpose just stated," it had said.

  4. The majority judgment's view that MCI had no jurisdiction to devise and enforce NEET also stands on doubtful legal grounds as a five-judge constitution bench in Dr Preeti Srivastava case (1999 (7) SCC 120) had clearly held that regulations framed by the council were binding on states.


  1. Can it be said that the MCI, set up to ensure excellence in medical education, is barred from infusing transparency and merit into the process of intake of students?
  2. The majority judgment in the NEET case said, "In a single-window competition, the disparity in educational standards in different parts of the country cannot ensure a level playing field."

    Well, if that is the logic, then the court must consider scrapping the Civil Services Examination which through a single-window test chooses officers for IAS, IPS, IFS and other central services.

....Read More

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 10x10 i.e. 100 per minute.”

VIP's on CPR 10 Mantra Video
Ringtone - CPR 10 Mantra Hindi

Ringtone - CPR 10 Mantra English

sprritual blog Why do unmarried women worship Shiva on 16 Mondays in Chaturmas starting from the month of Shravan?

Shravan is the first month of Chaturmas, which forms the first four months of Dakshinayana. During Dakshinayana the days are shorter and the nights are longer, there are more levels of melatonin compared to serotonin in the body and there are tendencies for spontaneous negative thoughts in the mind. Kama or desire is the first negative thought, which gets exaggerated in this period.

Shravan is the month linked to a disturbed state of mind. There is a famous song which describe the mental status of a mind in the shravan, i.e. “Sawan Ka Mahina Pawan Kare Shor”, which means that just as in the month of Shravan the air in atmosphere is disturbed and violent so is our mind.

The answer lies in controlling our desires in the month of Shravan. Unmarried and married fertile women do it by following the ritual of Shiva Vrata on Mondays (the first day of the week) and man do it by participating in Kanwar yatra from Ganga river to the respective Shiva Linga Mandir.

Unmarried women and married women observing Monday fast indicates observing a sexual and non-sexual desire fast.

You cannot enter in a Shiva temple with your sexual desires. Therefore, you keep your Nandi (Bull sexual desire) outside the temple.

Some scholars co-relate Shiva Lingam as your internal Lingam, which you try to control by pouring milk onto it. A continuous flow of milk represents continuous flow of positive thoughts. By controlling the sexual desires for 16 consecutive weeks, the sexual energy can be converted into a more forceful spiritual energy.

Both sexual and non-sexual desires are equally common in unmarried and married man who to control their desires need to make more efforts and thereby need to devote time.

In the month of Shravan in the “Kanwar yatra” people walk for days together and reach Ganga destination and bring Gangajal to be poured over the Shiva Lingam. This again indicates continuous mental and physical efforts on the part of the person to earn positive thoughts (Ganga) and with that to pacify the sexual and non-sexual desires (Shiva Lingam).

This way one converts again sexual energy and the non-sexual desires into spiritual energy. The observance of fast apart from Shiva Lingam worship helps in controlling five sensual senses in the mind and the body. ....Read More

cardiology news

A Foot Has No Nose

Of the many interactions I had with my mother those many years ago, one stands out with clarity. I remember the occasion when mother sent me to the main road, about twenty yards away from the homestead, to invite a passing group of seasonal work-seekers home for a meal. She instructed me to take a container along and collect dry cow dung for making a fire. I was then to prepare the meal for the group of work-seekers.

The thought of making an open fire outside at midday, cooking in a large three-legged pot in that intense heat, was sufficient to upset even an angel. I did not manage to conceal my feelings from my mother and, after serving the group, she called me to the veranda where she usually sat to attend to her sewing and knitting.

Looking straight into my eyes, she said "why did you sulk when I requested you to prepare a meal for those poor destitute people?" Despite my attempt to deny her allegation, and using the heat of the fire and the sun as an excuse for my alleged behavior, mother, giving me a firm look, said ""Lonao ga lo na nko" - "A foot has no nose". It means: you cannot detect what trouble may lie ahead of you.

Had I denied this group of people a meal, it may have happened that, in my travels sometime in the future, I found myself at the mercy of those very individuals. As if that was not enough to shame me, mother continued: "Motho ke motho ka motho yo mongwe". The literal meaning: "A person is a person because of another person". ...Read More

News Around The Globe

  • Women with type 2 diabetes are at a greater risk of developing mild cognitive impairment (MCI) than men with diabetes or nondiabetic women, according to new research presented at the Alzheimer's Association International Conference. (Source: Medpage Today)
  • The US FDA has approved golimumab (Simponi Aria, Janssen Biotech, Inc), intravenous (IV) formulation in combination with methotrexate, for the treatment of moderately to severely active rheumatoid arthritis (RA). Golimumab is a tumor necrosis factor (TNF) inhibitor previously approved for subcutaneous injection in patients with moderate to severe RA. (Source: Medscape)
  • A Swedish population-based study has shown that elderly men with elevated levels of low-grade inflammation measured by high sensitivity C-reactive protein (hs-CRP) are more likely to break a bone, particularly vertebrae. (Source: Medpage Today)
  • The new type 2 diabetes treatment algorithm consensus statement from the American Association of Clinical Endocrinologists (AACE) has been published online and is available for free download. It is one of the first to incorporate obesity, prediabetes, and cardiovascular risk factor management for the care of patients with type 2 diabetes. (Source: Medscape)
  • A gene test may point to the causes of childhood fever. (Source: The Gupta Guide, Medpage Today)
  • Patients with chronic kidney disease are at risk for treatment-resistant hypertension, although certain subgroups carry a higher risk than others. (Source: Medpage Today)

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

What are the psychological effects of a multiple pregnancy on a family?

Many women with a multiple pregnancy do well; their families may experience significant stress. Even if medical problems are overcome and the infants survive without disability, the effect of multiple births on family life is profound and life–altering. The impact of a multiple birth clearly affects the parents, but also the babies, other siblings, and the extended family. Financial stresses may be overwhelming. Obvious additional costs include feeding, clothing, housing, and caring for multiple children.

Rabies News (Dr. A K Gupta)

How is rabies transmitted?

Rabies is transmitted by infected secretions. Most commonly, transmission to humans takes place through exposure to saliva following a bite by an infected animal. Rabies virus can be excreted in saliva, urine, nasal discharge and respiratory secretions.

cardiology news

Hitting in childhood tied to adult obesity and heart disease

Children who were punished physically had higher risks for cardiovascular disease, arthritis, and obesity in adulthood, researchers found. Compared with adults who were not punished physically as children, those who received harsh physical punishment in childhood were 24% more likely to be obese (95% CI 1.05-1.47) and 35% more likely to have arthritis (95% CI 1.10-1.69), according to Tracie Afifi, PhD, of the University of Manitoba in Winnipeg, and colleagues.

Activity has modest effect on stroke risk

People who consider themselves physically inactive have an increased risk of stroke, adding to previous evidence of the association, results of a large cohort study showed. Self-reported low activity was associated with a 20% increase in stroke risk, as compared with people who reported higher levels of physical activity, according to Michelle N. McDonnell, PhD, of the University of South Australia in Adelaide, and co-authors.

Valvular Heart Disease News

Clinical examination remains the first step in diagnosis of mitral valve prolapse. The non-ejection click is mobile, meaning that the timing varies with maneuvers that alter left ventricular volume. The mitral regurgitant murmur can be late systolic (early in the disease) or holosystolic (severe prolapse or flail).

(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)

cardiology news

Repair aortic coarctation early and follow for life: 60-year study

Babies born with a narrowing of the aorta should be followed for cardiac issues throughout their lives, say the authors of a six-decade review of cases at the Mayo Clinic in Rochester, Minnesota. (Source: Medscape)

Presence of eczema may affect infant food allergies

Infants with atopic dermatitis (AD), also known as atopic eczema, may be more likely than infants without AD to be sensitized to commonly allergenic foods, according to an article published online July 18 in the Journal of Investigative Dermatology. (Source: Medscape)

cardiology news

A mix of exercise protocol is better

A combination of weight training and aerobic exercise is the best prescription for overweight patients at risk for diabetes and heart disease. Only aerobic exercise is also as good as it reduces weight and takes inches off the waistlines. Just weight lifting alone has very little benefit.

According to a study published in the American Journal of Cardiology, people in the weight–training group gained about 1.5 pounds and those in the aerobic group lost an average of 3 pounds and half an inch from their waists.

Those who did both weight and aerobic training dropped about 4 pounds and 1 waistline inch. This group also saw a decrease in diastolic lower blood pressure and in a metabolic syndrome score.

Both the aerobic–only group and the combined-exercise group also lowered their levels of bad triglycerides.

...Read More

cardiology news

A prepubertal child came with sexual assault.

Dr. Bad: Give prophylactic antibiotics.
Dr. Good: There is no need for antibiotic prophylaxis.
Lesson: Prepubertal children who have no symptoms of sexual transmitted infection should not receive antibiotic prophylaxis. ...Read More

cardiology news
  1. 16th July: HCFI Executive Meeting


CPR 10 Training Camp, EPFO, 30th May 2013

CPR 10 Camp - Police Training Center Najafgarh


CPR Classes: Persons trained (83)

19th July: CPR Moolchand 29

20th July: CPR Moolchand 28

22nd July: CPR Moolchand 26

CPR VIP Sensitization

Total CPR since 1st November 2012 – 54758 trained

Video Chats and uploads

Dr KK Aggarwal on NEWS 24

Dr KK Aggarwal on Monsoon Take Care

Dr KK Aggarwal on Danger of Epidemics (Uttarakhand Disaster)

1308 students learnt CPR at Abhinav Public School, Rohini

CPR Utsav 6th April 11543 men and women Trained in 1 day

Dr KK Aggarwal on 4 REALNEWS JUNE 26 2013 On Uttarakhand Disaster

Symposium on Prayer, Faith, Meditation and healing part 9

Symposium on Prayer, Faith, Meditation and healing Part 8

Advocacy through

Print Media

21st July: Saha Times

21st July: Viraat Vaibhav

22nd July: Veer Arjun

22nd July: Viraat Vaibhav

Media advocacy through Web Media

The ideal medicinal dose of alcohol is six grams or 18 ml per day? 21st link


Osteoporosis is preventable and treatable

Osteoporosis is termed as "The Silent Thief," because it can progress for years without symptoms, robbing the strength from bones until a fracture occurs, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India & MTNL Perfect Health Mela and National Vice President Elect IMA.

Osteoporosis is not an inevitable part of menopause or of aging. Risk of osteoporosis is so high in women that developing an osteoporosis-related hip fracture is equal to combined risk of developing breast, uterine and ovarian cancer.

Four out of 10 women >50 years of age experience a hip, spine, or wrist fracture during their lifetime.

One out of every five persons who has a hip fracture will not survive more than 1 year. Men and younger women are also victims to osteoporosis.

Dr Aggarwal said that the standard x-ray cannot diagnose osteoporosis until approximately 30% of bone is already lost. A Bone Mineral Density test is the best way to detect osteoporosis before a fracture occurs.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 54758 people since 1st November 2012.

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 10x10 i.e. 100 per minute.” ...Read More

today emedipics

Heart Care Foundation of India organized a CPR 10 Camp with Delhi Transport Department (DTC) HQ, ITO on 18th July 2013

press release

Red flag arthritis

today video of the dayBeware of Artificial Medicine

Dr KK Aggarwal on Pollution in Delhi

Dr KK Aggarwal on Hazards of Smart Phones

eMedi Quiz

Read this…………………

Nurse Dave is conducting an examination of a 6-month-old baby. During the examination, the nurse should be able to elicit which reflex?

a. Babinski’s
b. Startle
c. Moro’s
d. Dance

Yesterday’s Mind Teaser: Nurse Wayne is aware that which finding would be least suggestive of necrotizing enterocolitis (NEC) in an infant?

a. Hepatomegaly
b. Distended abdomen
c. Gastric retention
d. Blood in the stool

Answer for yesterday’s Mind Teaser: a. Hepatomegaly

Correct answers received from: Dr SANTHAKUMARI, Dr.Raghavendra Jayesh, Dr. P. C. Das, Arpan Gandhi, DR P K SAHU, Dr. Sushma Chawla, Dr.K.V.Sarma, Dr Brijesh soni, Dr. V.P. Thakral, daivadheenam, Dr Pankaj Agarwal, pushpa otiv, Dr.K.Raju, DR Chandresh Jardosh, Dr. Thakor Hitendrsinh G, DR AVTAR KRISHAN, Dr kanta jain, DR SANTHAKUMARI, Dr. P. C. Das

Answer for 21st July Mind Teaser: a. Comforting the child as quickly as possible

Correct answers received from: Dr. Thakor Hitendrsinh G, DR AVTAR KRISHAN, Dr kanta jain, DR SANTHAKUMARI, Dr. P. C. Das,

Send your answer to ijcp12@gmail.com

eMedi Apps

medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Chairman Legal Cell Indian Academy of Echocardiography; Chairman Ethical Committee Delhi Medical Council; Editor eMedinewS and President Heart Care Foundation of India)

In which circumstance can a doctor disclose the HIV status of a person?

Can I complain to the council if some lab offers me commission?

Can I film my patients?

Who is responsible for the mistakes of his assistants?

medicolegal update

Whisky is a brilliant invention. One double and you start feeling single again.

medicolegal update
medicolegal update

Situation: A patient on Glimepiride 2 mg morning and evening came for a Ramadan fast advice.
Dr. Bad: Continue it.
Dr. Good: Read More

Situation: A diabetic patient on sulfonylureas came for Ramadan fast advice.
Dr. Bad:
It is safe.
Dr. Good:
Read More

Situation: A diabetic patient on acarbose came for Ramadan fast advice.
Dr. Bad:
We need to reduce the dose.
Dr. Good:
Read More

medicolegal update

Situation: A patient on dialysis and on oral antacid developed aluminum toxicity.
Reaction: Oh my God! You should have put him on magaldrate preparations?
Lesson: Make sure to remember that magaldrate preparations do not cause aluminum toxicity in patients undergoing dialysis.

medicolegal update

Striving for excellence motivates you; striving for perfection is demoralizing. Harriet Braiker

medicolegal update

Dr KK Aggarwal: What not to do in snake poisoning
http://bit.ly/12vFIfq #Health

Dr Deepak Chopra: How do you find the right path in life? How do you choose between all your options?
http://bit.ly/12vFIfq #Health

medicolegal update

Always useful and current information. Thanks Dear Dr. KK: Dr Vinod Agarwal.

Forthcoming Events

2nd annual Ped Neuro Conclave

Sunday, 25th August 2013.
This is an annual event hosted jointly by Fortis Escorts Hospital and IAP Jaipur. This conference is held every year and is attended by more than 200 delegates, which include Neurologists, Pediatricians, GPs and resident doctors from all over Rajasthan. Senior faculty from different institutes all over India and abroad participates and shares their knowledge and experience with the audience.

The eminent faculty includes
Dr. Pratibha Singhi, Head Pediatric Neurology, PGI – Chandigarh
Dr R K Sabharwal, Head Pediatric Neurology, Sir Ganga Ram Hospital, New Delhi
Dr. Vineet Bhushan Gupta, Sr Consultant Pediatric Neurologist, Apollo Hospital, New Delhi;
Dr Deepak Gupta, Sr Consultant Paediatric Psychiatrist, Sir Ganga Ram Hospital, New Delhi.
Venue: Jaipur Marriott Hotel
Date: Sunday, 25 August 2013 (0900-1700)
Organizing Secretary: Dr Sharad Sharma, MD (PGI), MRCPCH (UK), Fellow Pediatric Neurology (London)
Senior Consultant Pediatric Neurology, Fortis Hospital, Jaipur, Rajasthan

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medicolegal update

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