eMedinewS24th October 2013, Thursday

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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, 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

Cough and Cold

  • Cough and cold are common in winter and should not be ignored.
  • Throat pain without cough is usually bacterial in origin and needs medical attention.
  • Soar throat with cough is viral in origin and requires no antibiotics.
  • A red-angry looking throat is a dangerous sign and needs urgent medical attention.
  • Do not give aspirin for fever in children.
  • Warm saline gargles can be effective in soar throat.
  • Cough not responding to treatment can be due to acidity.
  • Cough can be the only sign of asthma.
  • One should not cough in handkerchief or in the fist or in hand.
  • One should always cough on the side sleeves of the shirt.
  • A person who is coughing should stay 3-6 feet away from other persons.
  • People who are coughing should not be allowed to go in crowded places.
  • Cough syrups, whether Ayurvedic, allopathic or homoeopathic, may be effective.
  • Cough lasting for more than two weeks should not ignored.
  • No vitamin or herbal products have been shown conclusively to reduce the incidence of common cold.
  • Saline nasal wash is good for common cold.
  • In the absence of secondary bacterial infection, no antibiotics are required in common cold.
  • Vitamin E prophylaxis does not help in prevention of common cold.

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

VIP’s on CPR 10 Mantra Video
Ringtone – CPR 10 Mantra Hindi

Ringtone – CPR 10 Mantra English

Changing Spectrum of the Society

sprritual blog

If we study the Vedic philosophy, time is the only constant which changes every time. The Yugas have changed from Satya, to Treta to Dwapara to finally to Kali yuga. The ashrams have to change from brahmacharya to grahastha to vanaprasthan and finally to sanyasa. Satwa has to change to rajas and then to tamas and rulers of the society have to change from Brahmins to Kshatriyas to Vaishnavas and finally to Shudras.

During rama rajya, an ideal man was the ruler. He was called Maryada purusha as his words, thoughts and speech commanded the same effect. The villains of those times were intelligent but death sentence was the only answer because of their bad deeds. Killing of Ravana from the hand of Rama was not considered a murder.

Then came the era of Lord Krishna, who killed Kansa and which was considered a right decision by the society. Later in his life he counseled the Pandavas during Mahabharata and told them the tricks of the battle and even conveyed when and how to speak a lie when it comes to war. The world has seen a change in the rulers of the society from Brahmins (Rama, Krishna), Kshatriyas (Sikandar, Muslims rulers), Vaishnavas (British rule, industrialists are almost ruling the world today) and Shudras have still to rule the world.

If you look at the mentality of the people, this too is changing from satwa to rajas with some degree of tamas. Satwa indicates purity of mind, rajas aggression, tamas inertia and destructive mind. Movies reflect the collective mentality of the people living in the society. There was a time when people could not accept their hero doing any wrong thing. The end of the movie had to be the hero either killing or winning over the villain. Slowly one saw the change in the pattern of the movies where the hero started playing the role of a villain but at the end was killed. The examples are the negative characters played by Shah Rukh Khan in Darr and Baazigar. Still people accepted heroes as villains but never accepted their survival at the end.

The time changed and the hero started playing the role of villains. There were two versions of the movie Aankhen. One was for typical “bharatiya people” where Amitabh Bachchan at the end was caught by the police and the second for “Indian people” (people who treat themselves as western) where Amitabh Bachchan was shown bribing the police inspector and going free. The time is not far when in place of James Bond series, the public would like to have a series of “Mr. Natwar Lal”, where the hero would play only a negative role and would never die. In Don 2, Shah Rukh Khan is shown surviving at the end.

If we watch various serials the change is visible there also. There was a time when Ramayana and Mahabharata were the most accepted serials in the society but today’s serials have shifted to predominant rajas full of extra marital affairs, divorce, separations and conflicts. Some degree of tamas reflects in them in conspiracies and murders. Perception to sex and violence has also changed over time.

Today, kissing in movies has become an acceptable feature by the society. With time the duration and number of kissing scenes are increasing. Time is not far when India will be on the lines of the west and will have no shame in showing open sex to the society through the movies or serials. Only stray movies like Gadar will keep reminding us that we are true nationals of our Bharat and not India. We are proud of being bharatiya for its teachings of desh bhakti, truthfulness, satwa, forgiveness, love, affection and welfare for all. We may not be able to change the society but we can change ourselves and be proud of being a bharatiya and take out from within us the pseudo Indian culture.

cardiology news

The last cab ride

Twenty years ago, I drove a cab for a living. One time I arrived in the middle of the night for a pick up at a building that was dark except for a single light in a ground floor window.
Under these circumstances, many drivers would just honk once or twice, wait a minute, and then drive away. But I had seen too many impoverished people who depended on taxis as their only means of transportation. Unless a situation smelled of danger, I always went to the door. This passenger might be someone who needs my assistance, I reasoned to myself. So I walked to the door and knocked.
“Just a minute,” answered a frail, elderly voice. I could hear something being dragged across the floor. After a long pause, the door opened. A small woman in her 80s stood before me. She was wearing a print dress and a pillbox hat with a veil pinned on it, like somebody out of a 1940s movie. By her side was a small nylon suitcase.
The apartment looked as if no one had lived in it for years. All the furniture was covered with sheets. There were no clocks on the walls, no knick knacks or utensils on the counters. In the corner was a cardboard box filled with photos and glassware.
“Would you carry my bag out to the car?” she said. I took the suitcase to the cab, and then returned to assist the woman. She took my arm and we walked slowly toward the curb. She kept thanking me for my kindness. “It’s nothing,” I told her. “I just try to treat my passengers the way I would want my mother treated.”
 “Oh, you’re such a good boy,” she said. When we got in the cab, she gave me an address, and then asked, “Could you drive through downtown?” “It’s not the shortest way,” I answered quickly.
“Oh, I don’t mind,” she said. “I’m in no hurry. I’m on my way to a hospice.” I looked in the rear view mirror. Her eyes were glistening.
“I don’t have any family left,” she continued. “The doctor says I don’t have very long.” I quietly reached over and shut off the meter. “What route would you like me to take?” I asked.
For the next two hours, we drove through the city. She showed me the building where she had once worked as an elevator operator. We drove through the neighborhood where she and her husband had lived when they were newlyweds. She had me pull up in front of a furniture warehouse that had once been a ballroom where she had gone dancing as a girl.
Sometimes she’d ask me to slow in front of a particular building or corner and would sit staring into the darkness, saying nothing. As the first hint of sun was creasing the horizon, she suddenly said, “I’m tired. Let’s go now.” We drove in silence to the address she had given me.
It was a low building, like a small convalescent home, with a driveway that passed under a portico. Two orderlies came out to the cab as soon as we pulled up. They were solicitous and intent, watching her every move. They must have been expecting her. I opened the trunk and took the small suitcase to the door. The woman was already seated in a wheelchair.
“How much do I owe you?” she asked, reaching into her purse. “Nothing,” I said. “You have to make a living,” she answered. “There are other passengers.” Almost without thinking, I bent and gave her a hug. She held onto me tightly. “You gave an old woman a little moment of joy,” she said. “Thank you.”
I squeezed her hand, then walked into the dim morning light. Behind me, a door shut. It was the sound of the closing of a life.
I didn’t pick up any more passengers that shift. I drove aimlessly, lost in thought. For the rest of that day, I could hardly talk. What if that woman had gotten an angry driver, or one who was impatient to end his shift? What if I had refused to take the run, or had honked once, then driven away? On a quick review, I don’t think that I have done anything more important in my life. We’re conditioned to think that our lives revolve around great moments. But great moments often catch us unaware—beautifully wrapped in what others may consider a small one.

News Around The Globe

20th MTNL Perfect Health Mela Programme Brouchure

20th MTNL Perfect Health Mela 2013 Hangout on Air with Google


  • Breast cancer patients who have chemotherapy-induced menopause have climacteric symptoms at rates similar to those of women who go through spontaneous menopause before their breast cancer diagnosis, according to a new study presented at the North American Menopause Society 2013 Annual Meeting.
  • HIV-negative partners in heterosexual serodiscordant couples who were taking oral, tenofovir-based prophylaxis against HIV transmission did not report increased high-risk sexual behavior after they knew the drugs were effective, according to a longitudinal analysis of data from the Pre-Exposure Prophylaxis to Prevent HIV-1 Acquisition Within HIV-1 Discordant Couples (PartnersPrEP) study. The analysis was published online October 17 in the Lancet Infectious Diseases.
  • Screening tests for cognitive impairment can successfully identify patients with early-stage dementia, but the benefits of doing so remain unproven, according to a review for the U.S. Preventive Services Task Force (USPSTF) published online in Annals of Internal Medicine. The USPSTF last addressed the question of cognitive screening in 2003, finding then that there was insufficient evidence for or against it and this new study seems unlikely to change that recommendation.
  • Hypothyroidism is commonly associated with weight gain, but contrary to popular belief, treatment of the condition does not result in weight loss in the majority of patients, according to new research presented at the 2013 Annual Meeting of the American Thyroid Association. Elizabeth Pearce, MD, from endocrinology, diabetes, and nutrition section of Boston University School of Medicine, Massachusetts said, "We found that modest weight loss following initiation of levothyroxine treatment for hypothyroidism occurs in only about half of patients."
  • The Nobel Laureates 2013
    • Physics: François Englert and Peter W. Higgs "for the theoretical discovery of a mechanism that contributes to our understanding of the origin of mass of subatomic particles, and which recently was confirmed through the discovery of the predicted fundamental particle, by the ATLAS and CMS experiments at CERN's Large Hadron Collider"
    • Chemistry: Martin Karplus, Michael Levitt and Arieh Warshel "for the development of multiscale models for complex chemical systems".
    • Physiology or Medicine: James E. Rothman, Randy W. Schekman and Thomas C. Südhof "for their discoveries of machinery regulating vesicle traffic, a major transport system in our cells".
    • Literature: Alice Munro "master of the contemporary short story".
    • Peace: Organization for the Prohibition of Chemical Weapons (OPCW) "for its extensive efforts to eliminate chemical weapons".
    • Economics: Eugene F. Fama, Lars Peter Hansen and Robert J. Shiller "for their empirical analysis of asset prices".

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Rabies News (Dr. A K Gupta)

What is the incubation period of rabies in humans?

The incubation period of rabies i.e. the time interval between the exposure to virus and the onset of symptoms, is usually from 03 weeks to 03 months (rarely 04 days to 02 years). An incubation period as long as 19 years has been reported. Children are at an increased risk of a shorter incubation period because of their short stature and bites are often closer to CNS. Multiple bites to the head and neck are associated with very short incubation periods less than 1 month.

The incubation period varies with the amount of virus transmitted, virus strain, site of inoculation (bites closer to the head have a shorter incubation period), host immunity and nature of the wound.

During most of the long incubation period of rabies, the virus likely remains close to the site of viral entry. Centripetal spread to the central nervous system and spread within the central nervous system occur by fast axonal transport.

People who are immunocompromised will most likely be more susceptible to rabies. Rabies is usually undetectable during the incubation period, and infections can also be difficult to diagnose when the clinical signs first appear.

cardiology news

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

  • Findings of a single-center study reported in the October issue of JACC: Cardiovascular Interventions suggest that the blood pressure-lowering effects of renal denervation may not be as great when accessory renal arteries are present. The average office blood pressure reduction after 6 months was 16.6/6.7 mm Hg in patients with single renal arteries feeding each kidney -- considered the optimal anatomy for the procedure -- and only 6.2/0.2 mm Hg in those with additional arteries. In the latter group, there was no significant effect of the procedure even if all of the accessory arteries were denervated, although the difference in blood pressure reduction between patients with single renal arteries and those with denervation of all accessory arteries was not statistically significant.
  • The US FDA has alerted providers and patients that the catheter-delivered Amplatzer atrial septal occluder (ASO) from St Jude Medical poses a small risk of potentially life-threatening complications. Over time, the device can erode the surrounding tissue and may cause cardiac tamponade or other problems that require immediate surgery, according to the agency. It estimates the risk of such emergencies at one to three per 1000 implanted patients and notes that >230 000 Amplatzer ASO devices have been sold around the world. The agency "does not recommend device removal" for patients implanted with the Amplatzer ASO, unless physicians determine on a case-by-case basis that removal is appropriate.
cardiology news

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

  • The risk for high cholesterol in adults may be partly explained by intrauterine exposure to high cholesterol, according to researchers who presented their findings at the Canadian Cardiovascular Congress (CCC) 2013 say. Using multigenerational data from the Framingham Heart Study , they found that if mothers had high prepregnancy LDL levels (a surrogate for intrauterine exposure), their offspring had a 5-fold higher risk of having dyslipidemia themselves, as young adults—independent of obesity, smoking and genetic risk factors for high LDL cholesterol. This study hints that epigenetics—where genes are switched on or off by environmental factors such as exposure to high cholesterol in the womb—may have a lasting effect on regulating cholesterol levels decades later.
  • A first measles vaccine given at 12 or 13 months of age is less likely to provide lasting protection than a shot at 15 months or later. In a case-control study conducted in the wake of a large measles outbreak and reported in the October issue of JACC: Cardiovascular Interventions, people who received the shot earlier were about six times as likely to become ill as those whose vaccination was later, according to Gaston De Serres, MD, PhD, of the Quebec National Institute for Public Health in Quebec City.
cardiology news

Smoking leads to cardiovascular ageing

Consuming tobacco can increase the cardiovascular age of a person which can be much higher than the biological age.
He said that the cardiovascular ageing in chronic smokers can be 10 years more than the biological age and that cardiovascular age can be calculated by measuring the wall thickness of the carotid neck artery supplying blood to the brain.

Apart from that, one can also measure the endothelial functions of the brachial artery supplying blood to the hand. Cardiac age of a person is calculated by measuring the relaxation functions of the heart. With age, the heart fails to relax properly.

This relaxation abnormality usually comes after the age of 60. If the same is seen at the age of 40, one knows what the biological age and cardiac age is.

The good news is that cardiovascular age of a person can be regressed by quitting smoking and tobacco along with a proper lifestyle that includes diet and exercise. Graying of the hair may not be sufficient to know the age of a person. Today, it is the cardiovascular age which is important.

cardiology news

Total CPR since 1st November 2012 – 65021 trained

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20th MTNL Perfect Health Mela Inaugurated

Inaugurating the 20th MTNL Perfect Health Mela, Mr. AK Garg Chairman & Managing Director, Mahanagar Telephone Nigam Ltd., said that proper communication is the key between a patient-doctor relationship. Right communication by the right people at the right time can save many lives. Today, with the help of Social Media, Apps, it is possible to treat emergencies and take final opinions from people even if they are remotely located.

Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that it is possible to revive a person even after death within 10 minutes. As doctors may not be able to reach the patient within 10 minutes, it is the duty of the public to learn CPR 10. In Delhi alone, 30 lives can be saved every day if CPR 10 is learnt by everybody.

Mr. Anil Kumar Ganeriwala, Joint Secretary, AYUSH, Government of India and Dr BP Singh, Head NCSTC DST said that Perfect Health Mela is the perfect place where all pathies can sit together and answer queries of the people. He said that all systems of medicines have their own ‘plus’ points and should be respected.

Mr. Jalaj Srivastava, Chairman NDMC said that every child and woman should learn how to identify adulteration in food at home so that they do not eat adulterated food, which can be harmful to the health in long run.

In a joint statement, Mr. B Mondol, GM, North Central Bank of India and Mr. AK Singh, ZM (North) LIC said that financial health is an essential component of health. Everybody should plan for his or her old age. Today it is possible to get yourself insured and yet get insured for diseases and also cover your old age treatment under the reverse mortgage scheme.

The Mela is organized by Heart Care Foundation of India with the help of many government and non-government departments.

The attraction of the Mela today was Harmony, the inter-school Health Festival, which was attended by over 2000 children from various schools.

In a joint statement, Shri Ashok Chakradhar, noted Kavi and Nalini Kamalini, Kathak dancers said that pranayam, relaxation or meditation are good for health. They further said that classical dance is better than western dance in attaining good health.

In a joint statement, Mrs Rashmi Singh, Executive Director, Rashtriya Mahila Kosh, Women and Child Development, Govt. of India; Mr Rajiv Kale, Director, Department of Women and Child Development, Government of Delhi; Mr. SC Vats Department of Prohibition and Dr. Anil Kumar, Department of Environment said that excess of alcohol is bad for health. Consuming more than six pegs in one day and more than five pegs in one hour can cause sudden death.  
Ms. Uma Sharma, Padma Bhushan and noted Kathak dancer in her message said that doing 20 minutes of classical dance a day can keep one’s heart healthy. Mr. Deepak Jolly, Vice President, Coca Cola India Ltd. said that fluid resuscitation is the answer in dengue and not platelet resuscitation.

In a joint statement, Ms Meenakshi Dutt, noted makeup artist and Ms Roshni Thakur, noted Poetess said that singing as well as listening to songs can be health-friendly.

Following health messages were released during the inauguration:


  1. While treating dengue fever, PCV (packed cell volume) is more important than platelet count and it should not be allowed to rise above 50.
  2. Pot belly obesity is more dangerous than general obesity and is linked to heart attack, paralysis and diabetes.
  3. Noise pollution of more than 80 db can be harmful not only to the ears but also to the heart.
  4. Drinking more than 5 pegs of whiskey in an hour and 6 pegs in a day can be fatal.
  5. Black tea and black coffee are good for health provided no milk or sugar is added.
  6. One should not ignore first attack of acidity after the age of 40 as it may be a sign of heart attack.
  7. One should not ignore first attack of asthma after the age of 40 as it may be a sign of heart attack.
  8. Never ignore a symptom which is unusual, unexplained or occurring for the first time in life.
  9. For food hygiene, follow the principle of heat it, boil it, cook it, peel it or forget it.
  10. Keep your blood pressure lower than 120/80.

All-pathy Consensus on cardiology organized

At the Mela venue, an All-pathy consensus on cardiology was organized and the experts included Dr KK Aggarwal (Allopathy), Dr BN Sinha (Ayurveda), Dr Uzma Bano (Unani), Dr Neeraj Gupta (Homoeopathy) and Dr SN Yadav (Naturopathy).

The experts resolved that lifestyle consensus cannot be a domain of any particular pathy. All pathies should talk about a common lifestyle so that the patients do not get confused. The experts also resolved that lifestyle modifications should be such that they not only prevent heart diseases but also diabetes, blood pressure, depression and cancer.

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 65021 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.”

today emedipics

20th MTNL Perfect Health Mela Inaugurated

press release

tPA safe in pediatric stroke

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

Read this…………………

Which of the following is not a good approach to managing stress?
A. Talking directly to the person who is causing the stress.
B. Giving yourself a treat, like comfort food or a cocktail.
C. Accepting that there are things beyond your control.
D. Trying cognitive-behavioral therapy to learn new coping skills.
E. Working out regularly.

Yesterday’s Mind Teaser: Do women have more headaches than men?

A. No, they get equal numbers.
B. Yes, but not that many more.
C.Yes, and the headaches are more severe.
D.Condyles of tibia.
E.Yes, but men tend to get more painful kinds that last longer.

Answer for yesterday’s Mind Teaser: C. Yes, and the headaches are more severe.

Correct answers received from: Dr Prakash Khalap, DR. PRAVEEN JAIN, Dr. P. C. Das, DR MONICA GANDHI, Dr Arpan Gandhi, Arvind Gajjar, DR P K SAHU, Prabha Sanghi, daivadheenam, Dr. V.P. Thakral, Dr.K.Raju, Dr.Raghavendra Jayesh, Dr valluri ramarao. , Dr.K.V.Sarma, Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Muthumperumal Thirumalpillai, Dr Chandresh Jardosh, DR AVTAR KRISHAN, Dr B K Agarwal

Answer for 22nd October Mind Teaser: C. About 30 percent of your daily calories.

Correct answers received from: Dr B K Agarwal

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

A man was complaining to a railroad engineer. What’s the use of having a train schedule if the trains are always late? The railroad engineer replied, "How would we know they were late, if we didn’t have a schedule?"

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with renal failure came to a doctor.

Reaction: Oh, my God! Why was he given painkillers?

Lesson: Make sure to remember that most painkillers (barring nimesulide) are not kidney–friendly drugs.

medicolegal update

Do not spoil what you have by desiring what you have not; remember that what you now have was once among the things you only hoped for. Epicurus

medicolegal update

Dr KK Aggarwal: Sudden Cardiac Death By Dr k k Aggarwal http://bit.ly/14NZvJf #Health

Dr Deepak Chopra: How to Handle Difficult People | LinkedIn http://www.linkedin.com/today/post/article/20130822022815-75054000-how-to-handle-difficult-

medicolegal update

Dear Sir, Very infoamtive Mela. Regards: Dr Tripti

Forthcoming Events

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India
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medicolegal update

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