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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 …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1–7
DD Take Care Holistically Video 1–4 Chat with Dr KK On life Style Disorders
Health Update Video 1–15 Science and Spirituality
Obesity–Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

24th September 2012, Monday

Treating depression: take three steps (HealthBeat)

Acute phase. The goal here is to relieve your symptoms. Generally, this occurs within four to eight weeks, but it may take longer depending on your response to the first treatments you try.

Continuation phase. During this period, you work with your doctor to maximize the improvement you’ve made. Further treatment adjustments, such as modifying the dosage of a medication, can help. This period can take four to five months.

Maintenance phase. Throughout the maintenance phase, your goal is to prevent depression from reemerging. Ongoing treatment is often necessary, especially if you have already experienced several depressive episodes, have chronic low mood, or have risk factors that make a recurrence more likely.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

What are the common causes of fecal impaction?

Fecal impaction is more common in older adults, children, certain medications (especially opiate analgesics, antidepressants), immobility and patients with psychiatric conditions or medical conditions such as multiple sclerosis, diabetes mellitus and spinal cord injury.

For Comments and archives…

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

H5N1 Bird Flu Pandemic Just Three Mutations Away

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

4th Dil Ka Darbar Inaugurate

The Darbar was organized by Heart Care Foundation of India in association with Indian Oil, Central Bank of India Department of AYUSH and various Departments under Health Ministry, Government of Delhi on Sunday 23rd September 2012 at Talkatora Stadium, New Delhi. Guest of Honour was noted singer and composer Ms Shibani Kashyap.

Dr K K Aggarwal
    National News

4th Dil Ka Darbar

September 23, 2012, 9:00 AM–6:00 PM , Tal Katora Indoor Stadium, Connaught Place, New Delhi

A non stop question answer–session between all top cardiologists of the NCR region and the public.

International conference on geriology in Bangalore

BANGALORE: An international conference on geriology, geriatrics medicine and rehabilitation titled "Healthy ageing in the changing world–2012" will be held on September 29, 2012 at JN Tata Auditorium, Indian Institute of Science. H R Bharadwaj, governor, Karnataka, unveiled the brochure for it. The current and projected growth of older people over the coming decades is an issue that will have significant health, economic and policy implications at a global level. The conference will deliberate on these issues and a broad range of clinical topics including the latest information on diagnosis, management and treatment for common problems in the ageing population. The conference would help provide advice and knowledge on making ageing process as harmless as possible. It would also help to distinguish between changes directly connected with normal ageing and changes induced by diseases, including their untypical manifestation. Speaking about the conference, Dr VP Rao, convener, BioGenesis Health Cluster said: "The conference would also discuss about the contribution of biotechnology to gerontology. Biotechnology is revolutionizing the ageing experience by offering earlier diagnoses, new treatments such as regenerative and genetic interventions and ultimately disease prevention. In the years to come, it may even be possible to address the fundamental causes of the ageing process and prevent or delay the onset of its most important diseases." The conference is organised by BioGenesis Health Cluster, The Euro–Indian Health Cluster and Federation of Asian Biotech Association (FABA). (Source: TOI, Sept 20, 2012)

For comments and archives

My Profession My Concern

Initiating treatment for HIV infection

Revised guidelines from the United States Department of Health and Human Services recommend treatment of all patients with HIV infection regardless of CD4 T cell counts. Supportive arguments include the availability of more potent agents with less toxicity and recognition that untreated HIV infection has been associated with increased morbidity and mortality related to complications including cardiovascular, kidney, and liver disease and malignancy. Earlier therapy leads to immunologic recovery and suppressive ART decreases the risk of sexual transmission.

Earlier recommendations

  • Stat ART for patients with a CD4 cell count between 350 and 500 cells/mm3
  • Recent: Start ART when CD4 cell count >500/mm3


For comments and archives

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

    Valvular Heart Disease Update

When is bypass surgery indicated during valvular replacement?

The 2006 ACC/AHA guidelines reached the following conclusions about CABG at the time of aortic valve replacement.

  • CABG was recommended in patients with ≥70 percent stenosis of major coronary arteries.
  • Among patients undergoing CABG, the weight of evidence favored use of a left internal mammary artery graft for ≥50 to 70 percent stenosis left anterior descending coronary artery.
  • CABG was considered reasonable in patients with 50 to 70 percent stenosis of major coronary arteries.

(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)

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

IUDs and contraceptive implants best for teenagers

Intrauterine devices and contraceptive implants, with their very low pregnancy rates and high rates of patient satisfaction, are the best method to prevent unintended pregnancy in adolescent girls, according to new guidelines issued by the American College of Obstetricians and Gynecologists. The latest guidelines, from the Committee on Adolescent Health Care Long–Acting Reversible Contraceptive Working Group, were published in the October issue of in Obstetrics & Gynecology. (Source: Medscape)

For comments and archives

As–needed catheter change works well

Replacing venous catheters only when clinically indicated did not increase the risk of phlebitis compared with a routine replacement protocol, a randomized trial showed. (Source: Medpage Today)

For comments and archives

Sleep quality poor in patients with COPD

Patients with chronic obstructive pulmonary disease (COPD) are unlikely to get a good night’s sleep –– possibly because their blood is oxygen–starved during their waking hours, a secondary analysis found. (Source: Medpage Today)

For comments and archives

Drug shows promise in Fragile X and possibly autism

The investigational ?–aminobutyric acid type B (GABA–B) agonist STX209 (arbaclofen, Seaside Therapeutics) may improve social function and behavior in patients with fragile X syndrome (FXS). In a randomized, controlled phase 2 study of children and adults with FXS, investigators from Rush University Medical Center in Chicago found that treatment with arbaclofen was well tolerated and improved social avoidance and problem behaviors. (Source: Medscape)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: Sore Throats Mostly Viral, Not Strep Most throat infections are viral and should not be treated with… http://fb.me/21ECkOpfb

@DrKKAggarwal: Ambiguity opens the door for an entirely new interpretation of Nature:#Qualia Science http://tinyurl.com/8zb9des

    Spiritual Update

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

Symposium on Diet, Health & Religion

Prof Sunil Kumar, Member, Managing Committee, Ramakrishna Mission, spoke on how Hinduism regards food and diet.

A symposium on Diet, Health & Religion, second in a series was held at Bharatiya Vidya Bhavan on 5th September, 2012. The Chief Guest was Shri J Veeraraghavan, Chairman, Bhavan’s KM Munshi Institute of Educational Leadership and Management.

For comments and archives

    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

How does BMI affect fertility?

A BMI of 18.5 or less (underweight) may cause irregular menstrual cycles and may cause ovulation (release of an egg from the ovaries) to stop. A BMI of 17.5 or less may indicate an eating disorder. A BMI in the obesity range may also lead to irregular menstrual cycles and irregular ovulation. Women with a BMI of greater than 29 should see a doctor for an evaluation of hormonal status related to ovulation.

For comments and archives

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

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

Who is a healthy donor?

Any person within the age group of 18 – 60 years with minimum body weight 45 kg, and hemoglobin content minimum 12.5 gm%.

For comments and archives

    Liver Abscess Update

(Dr. Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation Medanta – The Medicity Hospital)

What are the commonest causative organisms of liver abscess?

Pyogenic (60 – 70%)

  • Staphylococcus – most common
  • Others – Streptococci, E. coli, Klebsiella, Enterobacter

Amoebic (21–30%)

Fungal & tubercular (Rare)

For comments and archives

    An Inspirational Story

Treasures To Be Thankful For

Author unknown

A man was exploring caves by the seashore. In one of the caves he found a canvas bag with a bunch of hardened clay balls. It was like someone had rolled clay balls and left them out in the sun to bake.

They didn’t look like much, but they intrigued the man, so he took the bag out of the cave with him. As he strolled along the beach, he would throw the clay balls one at a time out into the ocean as far as he could.

He thought little about it, until he dropped one of the clay balls and it cracked open on a rock. Inside was a beautiful, precious stone!

Excited, the man started breaking open the remaining clay balls. Each contained a similar treasure. He found thousands of dollars worth of jewels in the 20 or so clay balls he had left. Then it struck him.

He had been on the beach a long time. He had thrown maybe 50 or 60 of the clay balls with their hidden treasure into the ocean waves. Instead of thousands of dollars in treasure, he could have taken home tens of thousands, but he had just thrown it away!

It’s like that with people. We look at someone, maybe even ourselves, and we see the external clay vessel. It doesn’t look like much from the outside. It isn’t always beautiful or sparkling, so we discount it. We see that person as less important than someone more beautiful or stylish or well known or wealthy. But we have not taken the time to find the treasure hidden inside that person. There is a treasure in each and every one of us. If we take the time to get to know that person, and if we ask God to show us that person the way He sees them, then the clay begins to peel away and the brilliant gem begins to shine forth.

May we not come to the end of our lives and find out that we have thrown away a fortune in friendships because the gems were hidden in bits of clay. May we see the people in our world as God sees them.

(Source: http://www.inspire21.com/stories/generalstories)

For comments and archives

  Cardiology eMedinewS

Fructose Intake Associated With Liver Damage In Obese Patients With Diabetes. Read More

Thin Placenta May Be Linked To Increased Risk Of Sudden Cardiac Death As Adult. Read More

  Pediatric eMedinewS

BP Check in Children Overlooked Read More

Guideline On Pediatric Febrile Neutropenia Highlights Differences From Adults Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient of CAD developed dengue.
Dr Bad: Start paracetamol.
Dr Good: Start paracetamol and stop low–dose aspirin.
Lesson: In dengue, lose–dose aspirin needs to be stopped.

For comments and archives

Make Sure

Situation: A patient after receiving 40 units of insulin developed severe hypoglycemia.
Reaction: Oh my God! The order was 4 units.
Lesson: Make sure that 4 unit is not written as 4.0 units as it may be read incorrectly as 40.

For comments and archives

  Quote of the Day (Dr GM Singh)

If there is any kindness I can show, or any good thing I can do to any fellow being, let me do it now, and not deter or neglect it, as I shall not pass this way again. William Penn

    Legal Question of the Day (Dr MC Gupta)

Q. A patient came to the hospital casualty department with injury lower third of right leg which he attributed to be the result of getting hurt when his son was backing up the car. The injury was found to be a fracture of both bones. He was admitted in the hospital. He did not want an MLC to be registered. After a month, he got an FIR registered alleging that a neighbor had run his car over him and that the hospital doctor on duty should have made an MLC report. What are the legal aspects of this case?


The legal aspects are as follows:

  • Registering an MLC is at the discretion of the duty medical officer in the casualty. If the patient is not very serious and if no foul play is suspected, as in this case, he need not make an MLC. However, he should take a signed statement from the patient that he does not want an MLC.
  • Not making an MLC report does not mean that proper details should not be entered in the casualty register/records.
  • If proper medical details are entered along with the patient’s statement that he was hurt while his son was at the wheel and that he does not want an MLC, there is nothing lacking on the part of the hospital. These records can be shown/given to the police if asked. The hospital and the doctor would be safe.
  • The following is reproduced from the "Hospital Manual" published in 2002 by the Directorate General of Health Services, MOHFW, GOI, in Appendix V titled "The guidelines for medico–legal work—Pages 192–193"—
    • Cases of suspected accident, poisoning, burns, comatosed or brought dead persons should invariably be made a medico–legal case. In a case where the condition is not serious and the CMO does not suspect any foul play the fact should be recorded in the casualty register with reasons under (patient’s) signature. However, detailed findings and treatment administered should always be recorded in the casualty register."

For comments and archives

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Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

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    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)


  1. Increased: Acute pancreatitis, pancreatic duct obstruction, alcohol ingestion, mumps, parotitidis, renal disease, cholecystitis, peptic ulcers, intestinal obstruction, mesenteric thrombosis, postop abdominal surgery.
  2. Decreased: Liver damage, pancreatic destruction (pancreatitis, cystic fibrosis)
    Rabies Update

(Dr. A. K. Gupta, Author of "RABIES – the worst death")

If vaccination is required for a person bitten by a vaccinated dog, then why vaccinate the dog at all?

Vaccinating the pet dog is primarily to protect it against contracting rabies following bites by stray rabid dogs/animals. No veterinary vaccine offers 100% protection against rabies. Rabies is enzootic in our stray animal/dog population. The facility of protective antibody titer test (in vaccinated dog) is available only at a few centers in the country. Also, the facility to quarantine the bitten vaccinated pet is limited and difficult.

In view of the above facts and practical realities, rabies being 100% fatal, we take no chances and start PEP (immunization) in the bitten person and presume the vaccinated dog to be incubating rabies (and infective) and simultaneously observe the dog. However, in extremely rare situations, exception(s) to the above thumb rule can be made at the professional discretion of the treating physician.

For comments and archives

    Mind Teaser

Read this…………………

Business :)

Yesterday’s Mind Teaser: roforkad

Answer for Yesterday’s  Mind Teaser: Fork in the road

Correct answers received from: y. j. vasavada, DR KANTA JAIN, Kanta Jain, Dr.(Maj. Gen.) Anil Bairaria, Dr. Thakor Hitendrsinh G, Dr.K.Raju, Dr Chandresh Jardosh, Dr Vijay Kansal, Dr Avtar Krishan, Dr Avtar Krishan

Answer for 21st September Mind Teaser: A. Force air out of the lungs
Correct answers received from: Dr Chandresh Jardosh, Dr Vijay Kansal, Dr Avtar Krishan, Dr Avtar Krishan

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Graduation speech

I would like to thank,
The Internet, Google, Wikipedia,
Microsoft Office and
The one who invented copy paste!

    Medicolegal Update

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

What is impulse and its medicolegal importance?

Impulse is sudden and irresistible desire or force in a person, compelling him to the conscious performance of some act for which there is no motive; for example, kleptomania means an irresistible desire to steal articles which may be of small value and even, may be of no use to the person stealing the article. A sane person who has self–control and judgment capacity may not finally give shape to his impulsive or compulsive desire. But an insane person, who lacks in self–control and judgment capacity, cannot resist the impulse and may commit any offence. Thus, in connection with commission of an unlawful act, impulse is a good defense for an insane person which is not so for a sane person. Some types of impulses are:

  • Dipsomania: This is found in alcoholics who have an irresistible desire to take alcoholic drinks.
  • Pyromania: Here, there is an irresistible desire to set fire to things, which may be important and valuable. The person is not conscious or careful, at least temporarily, to the possible dangers of his act.
  • Mutilomania: This is an irresistible desire to injure and mutilate animals, commonly the domestic pets.
  • Sexual impulse: The person may feel compulsive urge to perform sexual intercourse, often in a perverted way. There may be some psychic problem concerning the sexual behavior; or the person may be a victim of mental sub normality.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Dil Ka Darbar inaugurated: Telecardiology a welcome advancement in today’s era, Dr Ashok Walia

Dr Ashok Walia, Minister of Health Government of Delhi, in his message to the 4th Dil ka Darbar said that telecardiology should now become a part of the facilities in every hospital.

The Darbar was organized by Heart Care Foundation of India in association with Department of AYUSH and various Departments under Health Ministry, Government of Delhi on Sunday at Talkatora Stadium, New Delhi.

Messages were also received from many dignitaries.

Shri M. Veerapa Moily, Union Minister of Law said that non–governmental organizations should play an important role in healthcare of poor patients who are unable to meet hospital bills and consultation fees.

Shri Beni Prasad Verma, Union Minister of Steel, expressed confidence that this endeavor of the Foundation would provide a platform to thousand of heart patients to avail facilities like free checkups, etc.

Shri Bhoopinder Singh Hooda, Chief Minister of Haryana, said that priority of the government should be to provide free medicines to those people who cannot afford them. Shri Narendra Modi, Chief Minister, Gujarat said that changing lifestyle, stressful event and competitive environment are responsible for most heart diseases. Shri Lal Thanhawla, Chief Minister of Mizoram said that the time has come for the medical fraternity to educate general masses about healthy living.

Shri Akhilesh Yadav, Chief Minister Uttar Pradesh, said that the efforts of the Foundation to provide facilities of free check–ups to the heart patients and interaction with top cardiologists during the programme are highly commendable.

The Chief Minister of Kerala, Mr. Oommen Chandy said that in our country where cases of heart ailments are on the rise, the activities of Heart Care Foundation of India are truly inspiring.

Shri Raj Kumar Chauhan, Minister of PWD, said that NGOs should come forward to organize free health checkup camps for the public. Prof. Kiran Walia, Minister of Social Welfare, Government of Delhi said that telecardiology consultations should also be used for free health checkup camps. Shri Arvinder Singh Lovely, Minister of Education, Government of Delhi, said that heart awareness should be the priority of every individual.

Inaugurating the Darbar, Shri B Mandal, General Manager, Central Bank of India said that one should follow the laws of nature to prevent cardiac diseases. He said that wild animals do not get heart attack.

Presiding over the function, Shri AK Ganeriwala, IAS, Joint Secretary, AYUSH, said that the death prevention heart care is when you combine allopathy with other systems of medicines.

Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India, who is also the Vice President–Elect of National Indian Medical Association, said that everyone after the age of 30 should get their risk of getting heart attack in the next 10 years evaluated and take precautions if the risk is more than 10%. He also demonstrated and conducted a workshop on "How to revive a dead patient." He said that within 10 minutes of death, it is possible to revive a dead person’s heart by following the formula of 10 i.e. within 10 minutes of death, for the next 10 minutes, one should compress the chest of the deceased person 100 times (10 × 10).

Guest of Honour, noted singer and composer Ms Shibani Kashyap, said that music is good for recovery of the heart patients. Chanting various sounds is similar to doing meditation.

Dr Ishwar VB Reddy, Director, Morarji Desai National Institute of Yoga, Dr Ramesh Babu Devalla, DG CHRS, Dr Surender Verma, DG, Dept. of Homeopathy in a joint statement said that blockages in the heart is lifestyle disorder and can be prevented utilizing all systems of medicines.

Dr PK Sharma, MOH NDMC and Dr NK Yadav, Director Health MCD South in a joint statement said that one should not consume trans fats in diet and reduce amount of salt intake to prevent future heart diseases.

Shri Satish Upadhyay, Chairman, Standing Committee on Education, MCD South said that prevention of heart diseases should start right in school age.

Dr NV Kamath, DHS, Shri PK Jaggi, Head of Office Drug Controller Department of Government of Delhi said that one should believe in natural pharmacy and take medicines only when they are required. Others who were present were Hakim Javed–ul–Haq Director General Central Council for Research in Unani Medicine (CCRUM), Dr RK Manchanda, Director General, CCRH, Dr Surender Verma Dy. Director Dept.of ISM & Homeopathy, Dr PK Sharma Medical Officer Health NDMC, Dr NK Yadav Director (Health) MCD South, Director ISM & H, Govt. of NCT of Delhi and Dr NV Kamat Director Health Services.

Eminent faculty on the dais included Dr RK Manchanda, Dr PK Sharma, Dr Rajesh Malhotra, Dr NK Bhatia, Dr. SV Tripathi, Dr HK Chopra, Dr Manju Gupta, Dr Anupam, Dr Praveen Chandra, Dr Subhash Manchanda, Dr Sameer Srivastava, Dr Yugal Mishra, Dr Praveen Bhatia, Dr Sujay Shad, Dr Neelam Mohan, Dr Ajit Saxena, Dr Saurabh Juneja, Dr BN Sinha, Dr RK Tuli, Dr ZS Mehrwal, Dr JC Katoch, Dr Ishwar V Basava Reddy and Dr Ramesh Babu Devalla.

Over 2000 heart patients were given consultations and checkups.

    Readers Response
  1. Dear Sir, its quite an imp info about CPR dat u shard Doc. Thanx for sharing. Gayatri Bohra
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