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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 November 2011, Thursday

Treat GAD for one year instead of six months

If effective continue SSRI or SNRI in generalized anxiety disorder for at least 12 months rather than the 6 months.

Selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) are first–line medications for the treatment of generalized anxiety disorder (GAD).

In a randomized trial, 136 patients with GAD who experienced reduced anxiety during six months of treatment with venlafaxine were continued the drug or to placebo for another six months. Patients continuing venlafaxine had a lower rate of relapse with no additional side effects.

If the patient experiences a relapse following termination of an effective medication, the length of treatment can be extended. After two relapses when tapering off the medication, ongoing maintenance treatment should be considered.


  1. Rickels K, Etemad B, Khalid–Khan S, et al. Time to relapse after 6 and 12 months’ treatment of generalized anxiety disorder with venlafaxine extended release. Arch Gen Psychiatry 2010;67:1274.

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

Treat GAD for one year instead of six months

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011–Dandiya Masti

A Special Dandiya night was organised in Garden of Five Senses by Heart Care Foundation of India with Delhi Tourism on 16th October as a part of 18th MTNL Perfect Health Mela.

Dr K K Aggarwal
    National News

28% of Bangalore uses tobacco products

Marking the National Lung Cancer Awareness Month, the National Cancer Registry Programme came out with its findings related to Bangalore. Experts spoke about how the disease had not spared even the young population. Pollution and smoking are the prime culprits, they observed. For every 10 lakh men in the city, over 107 suffer from lung cancer, every year. And for every 10 lakh women, 39 suffer from the disease. However, the incidence of lung cancer is high in the northeast Indian states, including Aizwal, Manipur, Mizoram, and Imphal, when compared to the rest of India. For every 10 lakh men in India, 109 men suffer from the disease, and 25 out of every 10 lakh women are victims of the disease, the study revealed. (Source: http://www.dnaindia.com/bangalore/report_28pct–of–
bangalore–uses–tobacco–products_1615382, Nov 21, 2011)

For comments and archives

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

Canned soup delivers high levels of BPA

Levels of bisphenol A, a plasticizer suspected of causing a range of adverse health effects, shot up nearly 20–fold in people who ate canned soup daily for five days, researchers said. (Source: Medpage Today)

For comments and archives

FDA Okays cervical cancer treatment system

The FDA has approved the BSD–2000 Hyperthermia System for use with radiation therapy as a treatment for cervical cancer in patients who are ineligible for chemotherapy. The system delivers localized heating through radiofrequency energy to solid tumors, according to a statement from manufacturer BSD Medical. Device treatment can be adjusted for size, shape, and location of a tumor, as well as frequency, phase, and amplitude of the radiofrequency energy, the statement added. (Source: Medpage Today)

For comments and archives

Heart attacks worst between 1am and 5am: Study

NEW DELHI: Heart attacks are worst when they take place between 1 am and 5 am. Researchers say the size of the heart attack and the subsequent left–ventricular function is significantly different based on the time of the attack. A study in humans, published online in the reputed journal, Circulation Research, says ‘the greatest amount of injury to the heart occurs when individuals have a heart attack between 1 am and 5 am’. (Source: TOI, Nov 23, 2011)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Carotid neck ultrasound the only way to check regression of heart blockageshttp://blog.kkaggarwal.com/2011/11/23/carotid–neck–ultrasound–

@DeepakChopra: #CosmicConsciousness Instead of thinking outside the box, get rid of the box.

    Spiritual Update

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

Why do we do Pradakshina?

We cannot draw a circle without a centre point. The Lord is the centre, source and essence of our lives. We go about doing our daily chores, recognizing Him as the focal point in our lives. This is the significance of pradakshina, which is a Sanskrit word meaning circumambulation or walking in a circle around the deity.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

Peace of mind

Once Buddha was walking from one town to another town with a few of his followers. This was in the initial days. While they were traveling, they happened to pass a lake. They stopped there and Buddha told one of his disciples, I am thirsty. Do get me some water from that lake there.

The disciple walked up to the lake. When he reached it, he noticed that some people were washing clothes in the water and, right at that moment, a bullock cart started crossing through the lake. As a result, the water became very muddy, very turbid. The disciple thought, How can I give this muddy water to Buddha to drink! So he came back and told Buddha, The water in there is very muddy. I don’t think it is fit to drink.

After about half an hour, again Buddha asked the same disciple to go back to the lake and get him some water to drink. The disciple obediently went back to the lake. This time he found that the lake had absolutely clear water in it. The mud had settled down and the water above it looked fit to be had. So he collected some water in a pot and brought it to Buddha.

Buddha looked at the water, and then he looked up at the disciple and said, See what you did to make the water clean. You let it be… and the mud settled down on its own and you got clear water… Your mind is also like that. When it is disturbed, just let it be. Give it a little time. It will settle down on its own. You don’t have to put in any effort to calm it down. It will happen. It is effortless.

What did Buddha emphasize here? He said, It is effortless. Having ‘peace of mind’ is not a strenuous job; it is an effortless process. When there is peace inside you, that peace permeates to the outside. It spreads around you and in the environment, such that people around start feeling that peace and grace.

For comments and archives

    Cardiology eMedinewS

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

CSI News

Stress Echocardiography in Valvular Stenotic Heart Disease

For comments and archives

Ivabradine safe in acute heart failure for reducing heart rate

For comments and archives

CABG or PCI both effective in TVD and LMCA Lesion

For comments and archives

In STEMI Radial PCI better than femoral PCI

For comments and archives

    Fitness Update

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

Brain Study: How successful students overcome math anxiety?

For the highly math anxious, researchers found a strong link between math success and activity in a network of brain areas in the frontal and parietal lobes involved in controlling attention and regulating negative emotional reactions. This response kicked in at the very mention of having to solve a mathematics problem. Teachers as well as students can use the information to improve performance in mathematics, said Doctor Sian Beilock of the University of Chicago. Instead of feeling anxious about an impending math task, students who could focus their attention were able to complete difficult math problems more successfully. Perhaps counter–intuitively, their success was not just about activating areas of the brain involved in math calculation. For math–anxious individuals to succeed, they need to focus on controlling their emotions, Beilock said.

The study began by administering a questionnaire to a group of University of Chicago students to determine if they had math anxiety. Students answered questions about how anxious they felt when registering for a math course, walking to a challenging math class, being handed a math textbook and so on. Lyons and Beilock then invited a group of students who were especially anxious about these math–related tasks to have their brains scanned using functional magnetic resonance imaging (fMRI) while they performed difficult math problems and a similarly difficult spelling task. A group of non–math–anxious students was selected as a control group.
The study found that for the highly math–anxious students who performed well on the math task, the brain activity that started during the anticipation phase initiated a cascade of brain activity during completion of the math task itself. This activity did not involve areas typically associated with performing numerical calculations. Rather, it was seen in subcortical structures — especially caudate and nucleus accumbens — associated with motivation and juggling risks and rewards with the demands of the task at hand.

For comments and archives

    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Should old patients drive?

No one uses chronological age as the sole indicator of driving ability.

    Medicine Update

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

What are the precautions to prevent an asthmatic attack?

An essential component in asthma treatment is the control of factors contributing to asthma severity. Clinicians should evaluate patients with persistent asthma for allergen exposures and sensitivity to seasonal allergens. Some common precautions especially in children are:

  • Keep the house clean.
  • The child should avoid places where there is a lot of smoke and pollution.
  • Compliance of asthmatic drugs must be monitored and children must carry an inhaler on them.
  • Make sure that the school of child is asthma–friendly. Parent’s must discuss the child’s condition with their teacher and explain to them the action plan to be followed if the child has an attack.
  • Avoid active and passive cigarette smoking. Passive smoke can be one of the triggers of asthma, which is usually ignored as an advice to parents.
  • Make sure that child’s toys and other playthings are hypoallergenic.
  • Even the clothes that parents buy for the child should be hypoallergenic so that child does not get allergic to their stuffed animals or clothes.

For comments and archives

    Legal Question of the Day

(Dr M C Gupta, Advocate)

There is a practice adopted by some physicians whereby OTC drugs are advertised on the video screens in the waiting room. What are the legal and ethical issues of such practice?

  1. Such practice is prima facie repugnant to the conscience of the medical profession. As per professional morals, doctors are free to give health education messages or information their own clinic and services etc. to the persons waiting to consult him. It is wrong to display drug advertisements. It would be a safe presumption that this is being done not gratis but in lieu of favours received from the company which, in itself, is an undesirable practice.
  2. This practice can be deemed to be in violation of the regulation 6.8.1(h) of the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002, reproduced below.

    "h) Endorsement: A medical practitioner shall not endorse any drug or product of the industry publically. Any study conducted on the efficacy or otherwise of such products shall be presented to and/or through appropriate scientific bodies or published in appropriate scientific journals in a proper way.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient with suspected dengue came with severe muscular pain.
Dr. Bad: Start aspirin.
Dr. Good: Start paracetamol.
Lesson: Aspirin or other NSAID agents should general be avoided because of the risk of bleeding complications and in children because of the initial risk of Reye syndrome.

For comments and archives

Make Sure

Situation: A patient with acid peptic disease was denied any painkiller for his distressing illness.
Reaction: Oh my God! Why did you not give him nimesulide?
Lesson: Make sure to prescribe nimesulide as it is safe in acid peptic disease.

For comments and archives

  Quote of the Day

(Dr GM Singh)

Patience and silence are powerful energies. Patience makes you mentally strong and silence makes you emotionally strong.

    Mind Teaser

Read this…………………

What is not true regarding laparoscopic biliary injuries?

a) As surgeon’s experience goes beyond twenty cases, rate of bile duct injury decreases.
b) The rate of laparoscopic bile duct injury is approximately 0.8%.
c) Most of the injuries are due to errors of judgement and skill.

Yesterday’s Mind Teaser: In the classification of cholangiocarcinoma by site, Type II:

a) Is confined to the common hepatic duct.
b) Involves the bifurcation without involvement of secondary intrahepatic ducts.
c) Tumors extend into either the right or left secondary intrahepatic ducts, respectively.
d) Involves the secondary intrahepatic ducts on both sides.

Answer for Yesterday’s Mind Teaser: b) Involves the bifurcation without involvement of secondary intrahepatic ducts.

Correct answers received from: Dr PC Das, Dr KV Sarma, Dr VK Shah, yogindra vasavada, Dr Surendra Bahadur Mathur, Dr Chandresh Jardosh, Raju Kuppusamy, Muthumperumal Thirumalpillai, Dr Alexander Daniel Sunad, Dr Jainendra Upadhyay, Anil Bairaria, Dr Avtar Krishan.

Answer for 22nd November Mind Teaser
: d) The internal lining of the cyst can be excised, leaving the external portion of the cyst wall intact.
Correct answers received from: Dr SR Mittal, Dr Surendra Bahadur Mathur,
Dr Chandresh Jardosh, Raju Kuppusamy, Muthumperumal Thirumalpillai.

Send your answer to ijcp12@gmail.com

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    Laugh a While

(Dr GM Singh)

Doctor, Doctor! I keep getting pains in the eye when I drink coffee!
Doc: Have you ever tried taking the spoon out FIRST?

    Medicolegal Update

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

Post mortem discoloration does not have the same connotation as cyanosis produced during life

  • A gravitational pooling of blood in the veins and capillary beds of the dependent parts of the body occurs as the body remains lying in a position and cessation of the circulation after death. Postmortem coloration helps the doctor to estimate the time since death.
  • The skin of deceased may show dark purple discoloration due to accumulated blood. The process begins immediately after the circulation stops, and in a person dying slowly with circulatory failure, it may be pronounced very shortly after death.
  • Postmortem lividity is first apparent about 20–30 minutes after death and is seen as dull red patches or blotches, which deepen in intensity and coalesce over the succeeding hours to form extensive areas. Lividity is present in all bodies, although it may be inconspicuous in some and thus escape notice.
  • Postmortem lividity is usually well–marked in the earlobes and in the fingernail beds. In a supine corpse, there may be isolated areas of lividity over the front and sides of the neck resulting from incomplete emptying of superficial veins. If the head is slightly flexed on the neck, then lividity may have a linear distribution corresponding to the skin folds.
  • Fading of the primary pattern of lividity and development of a secondary pattern of lividity will be quicker and more complete if the body is moved.
  • Cyanide poisoning results in lividity which has been described by different authors as pink, bright scarlet, and violet

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

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

Winter sore throat can cause heart disease in children

Winter sore throat in children needs to be differentiated, because the viral sore throat needs no treatment; however, bacterial sore throat, if ignored, can end up with permanent heart or kidney damage.

Sore throat is a symptom, not a disease. Issuing a winter warning, Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India, said that during winter season if children between 5 to 15 years complain of redness in the throat with fever ranging between 101–104°F and associated enlarged tender cervical lymph nodes, they need immediate attention and antibiotics. This sore throat is devoid of any cough, nasal discharge or nasal congestion.

On the contrary, viral sore throat will present with recurrent cough and nasal discharge.

The bacteria sore throat illness may last only for 2 to 3 days and if no antibiotics are given, the child may present with joint pains and involvement of the heart/kidney weeks later.

So called strep sore throat, the illness licks the joints and bites the heart. Six out of every 1000 children suffer from this illness. The illness is more common in winter season as children tend to spend more time indoor with each other.

Schools should be especially concerned about cough in children as the disease can rapidly spread from one child to another by droplet infection.

For comments and archives

    Readers Responses
  1. Dear Sir Thanks a lot for the updating us. Regards: Dr Priya
    Forthcoming Events

CSI 2011

63rd Annual Conference of the Cardiological Society of India

Date: December 8–11, 2011.
Venue: NCPA Complex, Nariman Point, Mumbai 400021

Organizing Committee

B. K. Goyal – Patron
Samuel Mathew – President CSI
Ashok Seth – President Elect & Chairman Scientific Committee
Lekha Adik Pathak – Chairperson
Satish Vaidya & C. V. Vanjani – Vice Chairman
N. O. Bansal – Organizing Secretary
B. R. Bansode – Treasurer
Ajit Desai, Ajay Mahajan, G. P. Ratnaparkhi – Jt. Org. Secretaries
Shantanu Deshpande, Sushil Kumbhat, Haresh Mehta – Asst. Org. Secretaries
D. B. Pahlajani, A. B. Mehta, M. J. Gandhi, G. S. Sainani, Sushil Munsi, GB Parulkar, KR Shetty – Advisory Committee

Contact: Dr. Lekha Adik Pathak, Chairperson, CSI 2011; Dr. Narender O. Bansal, Org. Secretary, CSI 2011 Tel: 91 – 22 – 2649 0261/2649 4946, Fax: 91 – 22 – 2640 5920/2649 4946.
Email: csi2011@ymail.com, csimumbai2011@gmail.com Website: www.csi2011mumbai.com

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3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews "Doctor of the Year Award" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.com

    eMedinewS Special

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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