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  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos…

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

24th April 2013, Wednesday

Role of folate or folic acid in cancer prevention

The role of folic acid in cancer prevention is uncertain.

Large observational studies have suggested a decrease in risk of colorectal and other cancers with dietary folate but others randomized trials have raised the possibility of harm.

In the largest meta-analysis of individual patient data from randomized trials of folic acid for the prevention of cardiovascular disease and colorectal adenoma during an average of 5.2 years of treatment, there was no significant difference in overall cancer incidence for patients assigned to folic acid or placebo.

Vollset SE, Clarke R, Lewington S, et al. Effects of folic acid supplementation on overall and site-specific cancer incidence during the randomised trials: meta-analyses of data on 50?000 individuals. Lancet 2013.

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

tPA safe in pediatric stroke

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day 2013

Heart Care Foundation of India and World Fellowship of Religions in association with Ministry of Earth Sciences Govt. of India and Delhi Public School Mathura Road observed World Earth Day 2013.

Dr K K Aggarwal
    National News

Medical Council of India proposes medical ethics in MBBS course

Apr 23, 2013: As reported in the TOI, the Medical Council of India (MCI) has asked the government to incorporate a two-month course in "medical ethics and professionalism" in the revised MBBS curriculum due to the doctor-patient relationship plummeting to a new low due to a sharp rise in medical negligence cases.

Officials said the apex medical body recently notified this as a part of new graduate medical regulations sent to the ministry of health and family welfare for implementation. The new course, which will increase the MBBS course from 4.5 years to 4.7 years, will address issues such as bedside manners and commercialisation of healthcare among others. "As things stand, instead of the existing 12-month first year MBBS course, students will be put through a 14-month first year course. It is a foundation course. Medical ethics and professional development will be the core focus," said Dr Purshottam Lal, member, MCI board of governors.

The revised curriculum is likely to be introduced next year after necessary legislation. The MCI board of governors, however, asked the government to implement the new rule as fast as possible.

It was during October 2012 MCI had a consultation on the proposed change in the curriculum with all the deans and principals of medical colleges. Dr A Y Chary, dean, Shadan Medical College, who attended the meeting, said students will also be taught how to improve communication skills under the new programme. Other experts said that it is not just about medical ethics but there are several important Acts like the PCPNDT Act, Medical Termination of Pregnancy Act and Transplantation of Human Organs Act, which doctors need to know.

However, Dr K Ramesh Reddy, former vice-chairman, AP Medical Council, said that the changes should be adjusted within the existing four years and five month course. "Earlier, anatomy was taught for 17 months and now it has been cut down to one year. This way, they can adjust the new course. Otherwise, it will be almost seven years by the time one clears MBBS," Reddy said.

Meanwhile, MCI between January 2011 and March 2013 found and punished as many as 75 doctors, guilty of medical negligence and misconduct, which experts said is just a tip of the iceberg. "Commercialisation of healthcare has led to doctors referring patients for financial gain instead of competence. To keep the good of the patients should be the highest priority," said Dr P Raghuram, breast cancer specialist.

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

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

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


Child Maltreatment

Child maltreatment is intentional harm or threat of harm to a child by a person who is acting in the role of caretaker. Four categories of child maltreatment

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Child neglect

For comments and archives

    Valvular Heart Disease Update

Underlying atherosclerosis

The presence of underlying coronary or aortic atherosclerosis affects the treatment and outcome of elderly patients in whom surgery is considered for valvular disease. The 2006 ACC/AHA and the 2007 European Society of Cardiology guidelines on the management of valvular heart disease included recommendations for coronary angiography in patients undergoing valve surgery, which would include all elderly patients.

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

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Very few people with established CVD follow healthy habits, says PURE

Most recent findings from the PURE (Prospective Urban Rural Epidemiology) study show that only a fraction of people who have established heart disease or a past stroke adhere to the most basic lifestyle recommendations known to reduce their risk of a future event. (Source: Medscape)

Health literacy linked to better asthma control

Researchers report that baseline health literacy about asthma in patients is associated with better quality of life and improved control of disease. (Source: Medpage Today)

Three PSA tests over lifetime adequate for many men

Just three prostate-specific antigen (PSA) tests over a lifetime may suffice for many men instead of routine PSA screening. (Source: Medscape)

Decrease in genital warts linked to HPV vaccine

The incidence of genital warts reduced by more than 90% in adolescent and teenage girls in the first 4 to 5 years after introduction of the human papillomavirus (HPV) vaccine in Australia. (Source: Medpage Today)

AMA introduces diabetes, heart disease programs

The American Medical Association (AMA) has announced that it would partner with national programs and private organizations in an effort to tackle cardiovascular disease and type 2 diabetes. The AMA's diabetes initiative is in conjunction with the CDC's National Diabetes Prevention Program, which encourages physicians to refer prediabetic patients to a lifestyle-change program. (Source: Medpage Today)

    Twitter of the Day

@DrKKAggarwal: Start of day with earth day celebrations pic.twitter.com/qcvmPpyW7u

@DrKKAggarwal: Just as a wave is a movement of the whole ocean, you are the energy of the cosmos. Don't underestimate your power.

    Spiritual Update

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

Hanuman: The Spiritual Journey to Lanka

Hanuman is the typical example of one who has control over the breath, the one who has obtained all the Siddhi powers after mastering the mind using breath control. Therefore, he was called as the ‘son of the wind’.

For comments and archives

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

What are the success rates of egg donation?

The success rates of egg donation depend on many factors but are generally independent of the age of the recipient. Success rates compiled by the CDC for the year 2000 show the average live birth rate per transfer of 43% for all egg donor programs. The major risk for donor egg programs is multiple gestations. In 2000, of the 3,436 pregnancies conceived with egg donation 2,992 resulted in a live birth. Of these, the multiple pregnancy rate was 40% with 36.6% being twins and 3.7% being triplets or greater. Because many of the pregnancies miscarry before the actual number of fetuses can be determined, the percentage of multiple pregnancies may actually be higher.

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

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Procedure for requesting uncrossmatched blood

  • In life-saving emergency requirement of blood components, it is always preferable to communicate to the blood bank In-charge/technician on duty, on phone before sending such a request.
  • Notify the Blood bank by phone that uncrossmatched blood is required. In the meantime send requisition form with all the required information. If the patient is unknown, then communicate that to blood bank.
  • Send properly labeled blood samples.
  • As soon as the emergency is over, complete all documentary formalities.

For comments and archives

    An Inspirational Story (Vasudha Seth)

The key to happiness

When I was a kid, my mom would prepare special breakfast every now and then. And I remember one night in particular, after a long, hard day at work. On that evening so long ago, my mom placed a plate of eggs, sausage and extremely burned biscuits in front of my dad. I remember waiting to see if anyone noticed! Yet all my dad did was reach for his biscuit, smile at my mom and ask me how my day was at school. I don't remember what I told him that night, but I do remember watching him smear butter and jelly on that biscuit and eat every bite!

When I got up from the table that evening, I remember hearing my mom apologize to my dad for burning the biscuits. And I'll never forget what he said: Honey, I love burned biscuits.

Later that night, I went to kiss Daddy good night and I asked him if he really liked his biscuits burned. He wrapped me in his arms and said, Your Momma put in a hard day at work today and she's real tired. And besides - a little burnt biscuit never hurt anyone! You know, life is full of imperfect things.....and imperfect people. I'm not the best at hardly anything, and I forget birthdays and anniversaries just like everyone else.

What I've learned over the years is that learning to accept each other's faults -and choosing to celebrate each other's differences - is one of the most important keys to creating a healthy, growing, and lasting relationship.

For comments and archives

    Cardiology eMedinewS

Sound waves and cells may help in CHF Read More

    Pediatric eMedinewS

Pulse-ox helps ID newborn heart defects Read More

    Rabies Update

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

Is observing the dog for 10 days without initiating treatment risky or justifiable?

Observing the dog for 10 days without initiating treatment is risky and not at all justifiable. It is mandatory to start treatment soon after exposure. The vaccination must be started immediately irrespective of the status of the biting animal. Improper treatment to animal bite victims may lead to rabies death and litigation under Consumer Protection Act (COPRA). According to Consumer Protection Act, the animal bite should be considered as “medical urgency” and treated with due care.

    IJCP Special

Dr Good Dr Bad

Situation: A 16–year–old female was diagnosed to have calcific lesions in the ventricles on a CT scan.
Dr Bad: This is a typical case of neurocysticercosis.
Dr Good: This is not neurocysticercosis.
Lesson: Calcification in neurocysticercosis is seen only in the parenchyma and not in ventricles or cisterns.

Make Sure

Situation: An 18–year–old girl complained of purulent nasal discharge, nasal congestion, pain in the cheek and upper teeth for last 10 days. CT scan showed maxillary sinusitis.
Reaction: Remember to give macrolides.
Lesson: Make sure to remember that clarithromycin 500 mg twice–daily for 7 days is not only effective in maxillary sinusitis but also in other sinusitis.

  Quote of the Day (Dr GM Singh)

Look at a day when you are supremely satisfied at the end. It's not a day when you lounge around doing nothing; it's when you've had everything to do, and you've done it. Margaret Thatcher

    Mind Teaser

Read this…………………

An infant is hospitalized for treatment of inorganic failure to thrive. Nurse Faith is aware that the nursing action is most appropriate for this child?

a. Encouraging the infant to hold a bottle
b. Keeping the infant on bed rest to conserve energy
c. Rotating caregivers to provide more stimulation
d. Maintaining a consistent, structured environment

Yesterday’s Mind Teaser: Sudden infant death syndrome (SIDS) is one of the most common causes of death in infants. At what age is the diagnosis of SIDS most likely?

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

Answer for yesterday’s Mind Teaser: b. 1 week to 1 year, peaking at 2 to 4 months

Correct answers received from: Dr Arpan Gandhi, Dr Nageswara rao patnala, Vineeta Pande, Dr Raghavendra Jayesh, Dr BB Gupta, Dr Kanta Jain, Dr Pankaj Agarwal, Dr Anusha Sudhakar, Dr Santhkumari, Dr U Gaur, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Raju Kuppusamy, Dr pawan Mehta, Dr Thakor Hitendrsinh G, Dr Avtar Krishan, Muthumperumal Thirumalpillai, Dr Jayashree Sen & Dr Bitaan Sen.

Answer for 22nd April Mind Teaser: . "We’ve found that babies can’t digest solid food properly until they’re 3 or 4 months old."

Correct answers received from: Raju Kuppusamy, Dr pawan Mehta,
Dr Thakor Hitendrsinh G, Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

Photos of Doctor’s Day Celebration

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    Laugh a While (Dr GM Singh)

Story begins

A local newspaper funeral notice telephone operator received a phone call. A woman on the other end asked, "How much do funeral notices cost?" "$5.00 per word, Ma’am," came the response. "Good, do you have a paper and pencil handy?" "Yes, Ma’am."

"OK, write this: ‘Fred dead."

"I’m sorry, Ma’am; I forgot to tell you there’s a five–word minimum."

"Humph," came the reply, "You certainly did forget to tell me that." A moment of silence. "Got your pencil and paper?"

"Yes, Ma’am." "OK, print this: ‘Fred dead, Cadillac for sale.’"

    Medicolegal Update

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

Sudden death due to cardiac origin–autopsy

Right coronary artery supplies blood to electrical area of heart

The most common cause of sudden cardiac death in adults over the age of 40 was coronary artery atheroma seen in postmortem examination in about 100 cases randomly selected by me in AIIMS mortuary.

  • The most common finding at postmortem examination is chronic high–grade stenosis of minimum one segment of a major coronary artery, the arteries which supply the heart muscle with its blood supply.
  • A significant number of cases also have an identifiable clot in a major coronary artery which causes transmural occlusion of that vessel.
  • In 75 cases out of hundreds, the clots were seen in right coronary artery supplying the electrical area of heart.
  • Death in these cases is thought to result from a period of transient or prolonged lack of blood supply in the muscle of the heart wall, which induces a ventricular arrhythmia/fibrillation and no changes in the myocardium are seen during postmortem examination.
  • The absence of the histological signs of acute necrosis and a healed infarct are a common finding.
  • Chronic high–grade stenosis causing previous episodes of ischemia and areas of focal fibrosis is seen histologically in the myocardium.
  • Ventricular arrhythmias may arise from a myocardium, which has been previously scarred by episodes of ischemia.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Protect our Mother Earth

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

The activities included a 1 km symbolic walk to sensitize the common masses on environment-related issues. More than 800 children participated in the walk led jointly by Padma Shri & Dr. BC Roy National Awardees, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President-Elect IMA; Mr D N Singh Additional Commissioner South Municipal; Shri Ashok Chandra Chairman, DPS Society, Rear Admiral M.M Chopra Vice Chairman DPS Society, Sh. M I Hussain Principal DPS Mathura Road and Mr. K Sareen social activist.

Speaking on the occasion Dr. Aggarwal said that the time has come when society has to work in close coordination with government agencies to ensure proper disposal of man-made environment pollutants.

The other activities held included skit competitions and cultural performances by pre primary students of DPS Mathura Road. All the participants in competitions were given certificate of participations and winners the prizes.

The celebrations ended with free heart checkup and hands-only CPR training using dummy manikins on how to save a life from sudden death within 10 minutes of death, to all teachers and parents.

    Readers Responses
  1. Very true, thanks for putting forward the grievances of a GP. I have experienced that in this age it is very difficult to run private medical practice or nursing home. Bhagwati Oza
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