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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 …

24th September 2011, Saturday

Vitamin D levels inversely associated with type 2 diabetes risk

Vitamin D levels are inversely correlated with the risk for type 2 diabetes and this association may be partially mediated by subclinical inflammation.

A study published in the journal Diabetes Care, involving 1,683 middle–aged and senior adults found an independent association between serum 25–OHD and incident type 2 diabetes.

After adjusting for soluble intercellular adhesion molecule–1, interleukin–6, interferon–?–inducible protein–10/CXCL10, and C–reactive protein the HRs were attenuated for the upper tertile of 25–OHD by 16–18%," which suggested that these four markers of inflammation were considered potential mediating factors.

India is facing an epidemic of both diabetes and vitamin D deficiency. Both may be related.

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

Vitamin D levels inversely associated with type
2 diabetes risk

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela to be Multi-Locational

In a press conference at Russian Culture Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Perfect Health Mela, Ms Rajni Abbi, Mayor, Delhi, with Team Dharna Unlimited.

Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


PGI to introduce virtual lab teaching

CHANDIGARH: In a first for any teaching institution in the country, PGI will soon introduce virtual lab teaching on neuroradiology for junior doctors to have a hands–on training in the field. In this regard, the department of radiodiagnosis is organizing the 14th annual conference of Indian Society of Neuroradiology from 22nd to 25th September. Dr N Khandelwal, head of the radiodiagnosis department, said, "We will be training doctors on dummy patients. The image will be transmitted virtually for doctors to learn the procedure." The neuroradiology procedure involves invasive diagnosis and treatment of head and neck lesions such as tumours, aneurysms or stroke. If an aneurysm, which is a bulge in the wall of an artery, grows large, it can burst and cause bleeding leading to death. (Source: TOI, Sep 21, 2011)

For comments and archives

Moolchand Heart Hospital™ organizes Heart Awareness Week

To commemorate World Heart Day, Moolchand Heart Hospital™ is organizing a Heart Awareness Week. The free offerings at this Heart Awareness Week are: Consultation by senior cardiologist, ECG, ECHO, cholesterol test, blood sugar estimation, height, weight, BMI estimation, blood pressure and second opinion on possible procedure and surgeries. The tests available at the camp with upto 50% discount are: Lipid profile, TMT, Stress ECHO, Holter, Chest x-ray, ECHO colour Doppler and Lab packages. Angiography is being offered at a price of Rs. 6,999 only.

Heart Awareness Week Details
Date: September 23, 2011
Timing: 10:00 am to 12:00 noon Venue: Indian Meteorological Department, Lodhi Road, New Delhi 110 016

Date: September 24-25, 2011
Timing: 10:00 am to 2:00 pm: Venue: Moolchand Auditorium

Date: September 26, 2011
Timing: 10:00 am to 12:00 noon, Venue: Acharya Sushil Ashram, C-599, Defence Colony, RWA, New Delhi-110 024

Date: September 29, 2011
Timing: 10:30 am to 03:00 pm, Venue: Dilli Haat, opposite INA Market, Kidwai Nagar, New Delhi 110 024

For more information, please call Program Coordinator at + 91 99589 97293

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

(Dr Monica and Brahm Vasudev)

Traffic fumes can trigger heart attacks, say researchers

Study published in the British Medical Journal identifies pollutant particles and nitrogen dioxide as main culprits. Breathing in large amounts of traffic fumes can trigger a heart attack up to six hours after exposure, according to research which reaffirms the health risks associated with pollution. The study, in the British Medical Journal, found that high levels of pollution can increase the risk of suffering a heart attack. It identifies exposure to pollutant particles and nitrogen dioxide expelled by cars, which are both markers of contaminated urban atmospheres, as the main culprits. The authors quantify the risk as small – up to 1.3% higher risk of a heart attack up to six hours after exposure to those substances. But they say that getting enough of those two substances into the lungs can bring forward by a few hours a heart attack that would have happened anyway. This is called short–term displacement or the "harvesting" effect of pollution. (Source:

For comments and archives

ICAAC: Maggots make happy meal of diabetic wounds

Diabetic patients facing lower limb amputation because of non–healing lesions may get a leg up from the insect world, a researcher said here. Biosurgery using the sterile larvae of the green blow–fly (Lucilia sericata) may be an alternative to amputation in many cases, according to Lawrence Eron, MD, of the University of Hawaii in Honolulu. In a series of 37 patients with complicated limb wounds, the approach, which used the larvae to debride the lesion, yielded a successful outcome in 27, Eron reported at the Interscience Conference on Anti-Microbial Agents and Chemotherapy. (Source: Medpage Today)

For Comments and archives

ICAAC: Superbugs escape through hospital sewers

Antibiotic–resistant pathogens born in hospitals may enter the wider environment through the facilities’ sewers, although the magnitude of the danger remains unclear, researchers said here. A team from the Federal University of Saõ Paulo in Brazil analyzed wastewater from their medical center, finding that 21 of 130 Gram–negative bacterial isolates contained the KPC (Klebsiella pneumoniae carbapenemase) gene. In a similar study, another group based at the University of Limoges, France, found a host of resistance elements in the local university hospital's sewage. Both studies were reported here at the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). (Source: Medpage Today)

For comments and archives

  Fitness Update

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

New research predicts future consequences of obesity

New research from the Columbia University Mailman School of Public Health has found staggering results about the rapid rise of obesity and its health consequences for Americans. By the year 2030, the study estimates that over three out of four American adults will be overweight or obese. That amounts to 65 million more obese adults in the United States than there were in 2010.

For comments and archives

  Twitter of the Day

@DrKKAggarwal: cardiac problems can be prevented by changing your life style

@DeepakChopra: #CosmicConsciousness Every observer is woven into what he or she observes

    Dr KK Answers

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

Can drugs lead to sexual dysfunction?

Always look for a reversible causes including drugs (thiazide diuretics, beta blockers, and lipid–lowering drugs)

For comments and archives

    Spiritual Update

The science behind Naming a Child and behind Bija Sounds

In Indian culture, the name of a person is decided by the priest on the basis of the time, day and place of birth. As per the Vedic science, there is a sound in the environment called Bija sound which correlates with the time and place of the birth. This Bija sound is usually given in Hindu culture to the parents to be the starting Akshara (word) of the name of the child. As per Hindu mythol

For comments and archives

    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Before I went to USA, I was registered with Delhi medical Council. I came back to India after Residency, Fellowship in Cardiology with specialization in Interventional Cardiology. I want to practice in Punjab. I got registered with Punjab Medical Council but they have registered my qualifications only as MBBS. That does not help me because I need permission to operate an echo machine during my intervention cardiology work and the PNDT authorities refuse to give me such permission unless I am registered as a cardiologist. The Punjab Medical Council has told me to register my foreign degrees with MCI. I have emailed MCI to ask about the relevant procedure but without a response so far. What is your comment/advice?


  1. You should not have got registered with Punjab Medical Council. Registration with a single medical council is sufficient to practice all over India. My advice is that you should keep only one registration and get the other cancelled.
  2. It appears that you have a Post Graduate medical qualification which is recognized in USA for practicing Cardiology in terms of Schedule 3 (ii) of the Indian Medical Council Act, 1956, as amended by gazette notification dated 10 march 2008 which can be viewed at http://www.pib.nic.in/release/rel_print_page1.asp?relid=36675
  3. Section 14 of the Punjab Registration Act, 1916, reads as follows: "Entry of new qualifications and titles in register 14. If any person whose name is entered in the register obtains any title or qualification other than the titles and qualification in respect of which he has been registered he shall on payment of the prescribed fee be entitled to have an entry stating such other title or qualification made against his name in the register either in substitution for or in addition to any entry previously made."
  4. In view of the above, you have a right to apply to the PMC for registration of additional medical qualification in addition to MBBS and the PMC has a duty to act as per law and register your additional qualification. It has no business to tell you to register your foreign qualifications with the MCI. If it has some doubt, it should get the doubt clarified from the MCI on its own and should not ask you to approach MCI on your own. If they ask you to do so in writing, you should file a writ petition against the PMC. I know it might be easier to approach the MCI directly but that would be accepting injustice of the PMC born out of lethargy and will not pave the smooth way for others in future.

For comments and archives

    An Inspirational Story

(Dr Anupam Sethi Malhotra)

An old man was visiting a city for the first time in his life. He had grown up in a remote mountain village, worked hard raising his children, and was then enjoying his first visit to his children's modern homes.

While being shown around the city, the old man heard a sound that stung his ears. He had never heard such an awful noise in his quiet mountain village. Following the grating sound back to its source, he came to a room in the back of a house where a small boy was practicing on a violin.

‘SCREECH! SCREECH!’ came the discordant notes form the groaning violin. When he was told that it was called a ‘violin’, he decided he never wanted to hear such a horrible thing again.

The next day, in a different part of the city, the old man heard a beautiful sound, which seemed to caress his aged ears. He had never heard such an enchanting melody in his mountain valley. Following the delightful sound back to its source, he came to a room in the front of a house where an old lady, a maestro, was performing a sonata on a violin. At once, the old man realized his mistake. The terrible sound that he had heard the previous day was not the fault of the violin, or even the boy. It was just that the young man had yet to learn his instrument well.

With a wisdom reserved for the simple folk, the old man thought it was the same with religion. When we come across a religious enthusiast causing such strife with his beliefs, it is incorrect to blame the religion. It is just that the novice has yet to learn his religion well. When we come across a saint, a maestro of her religion, it is such a sweet encounter that it inspires us for many years, whatever their beliefs.

But that was not the end of the story……

The third day, in a different part of the city, the old man heard another sound that surpassed in its beauty and purity even that of the maestro on her violin. What do you think that sound was?

It was a sound more beautiful than the cascade of the mountain stream in spring, than the autumn wind through the forest groves, or than the mountain birds singing after a heavy rain. It was even more beautiful than the silence in the mountain hollows on a still winter’s night. What was that sound that moved the old man’s heart more powerfully than anything before?

It was a large orchestra playing a symphony.

The reason that it was, for the old man, the most beautiful sound in the world was, firstly, that every member of that orchestra was a maestro of their own instrument; and secondly, that they had further learned how to play together in harmony.

‘May it be the same with religion,’ the old man thought. ‘Let each one of us learn through the lessons of life the soft heart of our beliefs. Let us each be a maestro of the love within our religion. Then, having learned our religion well, let us go further and learn how to play, like members of an orchestra, with other religions in harmony together!’ That would be the most beautiful sound!

For comments and archives

    Medicine Update

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

What is functional constipation?

Functional or idiopathic constipation is mainly caused by the painful bowel movement with resultant voluntary withholding of feces to avoid unpleasant defecation. Because of prolonged stasis of stools in the rectum, the fluid is absorbed and hard fecoliths are formed, which are very difficult for the child to bring out so resulting in more pain and the child trying to hold the stools further. Thus a vicious cycle sets in. Eventually, liquid stool from the proximal colon may percolate around hard retained stool and pass per rectum involuntarily (encopresis or fecal soiling). In fact, almost 30–50% children with functional constipation develop encopresis.

Causes of initial painful defecation: Change in routine or diet, stress, illness, child’s postponing defecation because he or she is too busy (morning school), forceful toilet training, exposure to antimotility drugs (antispasmodic, antidiarrheal, antitussive etc).

For comments and archives

    Infertility Update

(Dr. Kaberi Banerjee, Infertility and IVF Specialist)

CUPART 2011 (Current Practices and Recent Advances in ART)

Infertility is still an enigma to us. The most advanced technique gives a pregnancy rate of at best 50–60% per attempt. Definitely there is lot more to be understood. We are hosting a Conference on 8th – 9th of October at Le’ Meridian, New Delhi on Current Practices and Recent Advances in ART (CUPART 2011). We have invited a very respectable panel of International and National faculty whose experiences will be a wealth of knowledge to us.

Under the aegis on AOGD

Organizing Chairperson – Dr Kaberi Banerjee

For Registration Contact: Address:
E–23 Ayurvigyan Nagar New Delhi – 110049

For details contact +91 9871250235

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    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Platelet count: Thrombocytopenia

Thrombocytopenia (or low platelet count) is divided pathophysiologically into production defects and consumption defects based on examination of the bone marrow aspirate or biopsy for the presence of megakaryocytes.

  • Production defects are seen in Wiskott–Aldritch syndrome, May–Hegglin anomaly, Bernard–Soulier syndrome, Chediak–Higashi anomaly, Fanconi’s syndrome, aplastic anemia, marrow replacement, megaloblastic and severe iron deficiency anemias, uremia, etc.
  • Consumption defects are seen in autoimmune thrombocytopenias (including ITP and systemic lupus), DIC, TTP, congenital hemangiomas, hypersplenism, following massive hemorrhage, and in many severe infections.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient developed asthma within a year of menopause.
Dr. Bad: It is not asthma.
Dr. Good: It is associated with menopause.
Lesson: The onset of asthma within a year of menopause is a separate asthma phenotype.

For comments and archives

Make Sure

Situation: A patient with chest pain with normal ECG died half an hour later.
Reaction: Oh my God! Why was acute MI not suspected?
Lesson: Make sure all patients of chest pain are observed for 12 hours. ECG can be normal in acute heart attack for up to six hours.

For comments and archives

  Quote of the Day

(Dr GM Singh)

Some people come into our lives and quickly go. Some stay for a while, leave footprints on our hearts, and we are never, ever the same.


Level playing field: A fair competition where no side has an advantage.

  Sri Chanakya Niti-Sastra: The Political Ethics of Chanakya Pandit

(Dr Anupam Sethi Malhotra)

A wicked wife, a false friend, a saucy servant and living in a house with a serpent in it are nothing but death.

    Medicolegal Update

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

Very old, very young or in patients in poor health harmed more by poison

  • The effect of exposure depends partly on how long the contact lasts and how much poison gets into the body, and partly on how much poison the body can get rid of during this time. Exposure may happen only once or many times.
  • Acute exposure is a single contact that lasts for seconds, minutes or hours, or several exposures over about a day or less.
  • Chronic exposure is contact that lasts for many days, months or years. It may be continuous or broken by periods when there is no contact. Exposure that happens only at work, for example, is not continuous. Chronic exposure to small amounts of poison may not cause any signs or symptoms of poisoning at first.
  • It may be many days or months before there is enough chemical inside the body to cause poisoning. For example, a person may use pesticide every day.
  • Each day the person is exposed to only a small amount of pesticide, but the amount of pesticide in the body gradually builds up, until eventually, after many days, it adds up to a poisonous dose. Only then does the person begin to feel unwell.
  • WHO states that a poison is any substance that causes harm if it gets into the body. Harm can be mild for example, headache or nausea or severe for example, fits or very high fever, and severely poisoned people may die.

For comments and archives

    Mind Teaser

Read this…………………


Yesterday’s Mind Teaser: On immunohistochemistry, classical Hodgkin’s lymphoma Reed sternberg cells are likely to be:

a. CD15(–), CD 30(+), CD45(–)
b. CD15(+), CD 30(+), CD45(+)
c. CD15(+), CD 30(+), CD45(–)
d. CD15(–), CD 30(+), CD45(+)

Answer for Yesterday’s Mind Teaser: c. CD15(+), CD 30(+), CD45(–)

Correct answers received from: Dr Anu Tiwary, Priyanka Sharma, Dr K Raju, Dr Anil Kumar Jain,
Dr Jainendra Upadhyay, Anil Bairaria, Dr Kishan, Dr Fiza, Dr Sohan, Dr KP Mishra, Dr Tushar.

Answer for 22nd September Mind Teaser: b. Mixed cellular
Correct answers received from: Dr Bharat Bhushan Aggarwal, Dr Priya, Dr Sandeep, Dr Shweta,
Dr Kiran, Dr Anuraag.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

MINT CONDITION: Male, 1932, high mileage, good condition, some hair, many new parts including hip, knee, cornea, valves. Isn’t in running condition, but walks well.

    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name


DCI Approval Date

Tapentadol Hydrochloride Tablets 50mg/75mg/100mg

For relief of moderate to severe acute pain in adults 18 years of age or older.


    Public Forum

(Press Release for use by the newspapers)

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

Air Quality a Temporary Trigger for MI

Heavy air pollution can trigger acute heart attack in the hours after exposure, Said Padmashri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

Every 10 μg/m3 increase in small particulate matter and nitrogen dioxide temporarily boosts heart attack risk by 1.2% and 1.1%, respectively, as per a report in BMJ.

The increased risk is seen up to six hours after exposure to typical traffic–related pollutants. The take home message is that breathing in large amounts of traffic fumes can trigger a heart attack up to six hours after exposure.

The investigators found the chance of suffering an attack increases by 1.3% in the six hours after coming in contact with high levels of vehicle–related pollutants.

For comments and archives

    Readers Response
  1. Dear Dr. Aggarwal, Thanks for the info. I am an ardent reader of your mails/blogs. It is an eye opener even to the well read. Please do continue. Thanks & Warm regards: Dr. Sengu.
    Forthcoming Events

International Heart Protection Summit (IHPS–2011)

Organized by Ministry of Health & Family Welfare Govt. of India & ASSOCHAM September 28th, 2011 at Hotel Ashok, Chanakyapuri, New Delhi
President: Dr. H.K. Chopra, Intl. President: Dr. Navin C. Nanda, Scientific Chairman: Dr. S.K. Parashar, Org. Secretary: Dr. O.S. Tyagi,
For Registration & Details: Contact – Mob. 9971622546, 8010222883,
E–mail: agnideep.mukherjee@assocham.com; sandeep.kochhar@assocham.com,


18th MTNL Perfect Health Mela

Date: 14th–18th October
Different locations in Delhi
19th–23rd October
Venue: NDMC Ground, Opp. Indira Nari Niketan Working Girls Hostel
Near Philanji Village, Laxmibai Nagar, New Delhi
Theme: Science Behind Rituals



8th international conference on geriatric care

Under the agies of Geriatric Society of India(GSICON)
Date: Nov 5th & 6th , 2011,
Venue: Guru Nanak Dev Hospital attached to Govt. Medical College Amritsar, Punjab(India).
Many distinguished speakers from India & whole of world having expertise in the geriatric field are participating in this mega event. More than 900––delegates are expected to join GSICON 2011. For registration & any enquiry, contact PROF(DR) N.S. NEKI, President GSI & Organising Chairman at email: drnsneki_123@yahoo.com CME hours will be accredited as per Punjab Medical Council.

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    eMedinewS Special

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  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