24th December 2014, Wednesday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and National Science Communication Awardee. Limca Book of Record Holder (CPR). Gold Medalist

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, 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.twitter.com/DrKKAggarwal, www.facebook.com/Dr KKAggarwal

From Jan 1, pharma companies can no longer gift freebies to doctors

Excerpts from a report by Rupali Mukherjee in TOI news dated Dec 23.

  1. Doling out freebies, cruise tickets, paid vacations and sponsorships to educational conferences and seminars for doctors by pharmaceutical companies has been banned from January.
  2. The government has woken up belatedly to curb unethical marketing practices of pharma companies by spelling out a uniform code of conduct for the industry. The code will be voluntary to start with, and kicks in from January 1. It will be reviewed after six months; if not implemented "effectively", the government will "consider” making it mandatory, sources told TOI.
  3. At present, the pharma industry follows a "self-regulatory'' code that curbs unethical sales promotion and marketing expenses, bans personal gifts, and all-expenses paid junkets for doctors and their families, but there have been several instances where companies have violated the code, industry experts say. They say the code exists only on paper as companies try to influence prescriptions through several ways.
  4. This is the first time in years that the code has been finalized by the government, as earlier attempts to do so got mired in bureaucratic red tape.
  5. Industry experts say that the government's Uniform Code of Pharmaceutical Marketing Practices has been modeled on the Medical Council of India (MCI) guidelines for doctors and healthcare professionals, which were further tightened in 2012.
  6. The code clarifies the relationship with healthcare professionals. Regarding gifts, it says "no gifts, pecuniary advantages, or benefits in kind may be supplied, offered or promised to persons qualified to prescribe or supply drugs, by a pharma company, or any of it agents including retailers, distributors or wholesalers".
  7. It says "in any seminar, conference or meeting organized by a pharma company for promoting a drug or disseminating information, if a medical practitioner participates as a delegate, it will be on his/her own cost."
  8. It further says that gifts for the personal benefit of healthcare professionals and family members (both immediate and extended) such as tickets to entertainment events are also not to be offered or provided by pharma companies, nor cash or monetary grants for individual purposes. Hospitality should also not be extended to any doctor or their family members.
  9. The industry associations have to upload the Uniform Code on their websites and will be responsible for informing its members, and the government in case of violations.
  10. The code also adds that "where there is any item missing, the code of MCI as per the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulation, 2002 as amended from time to time, will prevail''.

eMedinewS Comments

  • There is an MCI code of ethics s for doctors. Any violation of the same can only be challenged in High Court.
  • Pharma companies until now were affected for any violation in the Act Now pharma companies will also be governed by a similar (like MCI) code of conduct.
  • Unless both pharma and doctors group are covered in their respective codes of conduct, the problem will not end. Until now, the MCI code did not cover pharma companies violating MCI regulations.
  • It is same like, if doctors violate any MCI code they are punished under violation of MCI ethics regulations but the same violations, if done by medical establishments are not punished. The need of the hour is to have a uniform code of conduct for medical establishments also.
  • Another answer is to bring medical establishments as well as pharma companies under the preview of MCI ethics regulations.
Govt. of India

News Around The Globe

  • If older patients are suddenly craving sweets, gaining weight and developing swallowing difficulties, consider a diagnosis of frontotemporal dementia (FTD), suggests a new study published in the December issue of JAMA Neurology.
  • The US Food and Drug Administration (FDA) has approved a new neuraminidase inhibitor for acute uncomplicated influenza called peramivir, which offers clinicians another way to administer this class of antiviral medicine. The drug, given intravenously in a single dose, can be given to adults with influenza who have been symptomatic for no more than 2 days.
  • Bisphosphonates, known to prevent bone loss, may also help reduce women's risk of developing endometrial cancer, suggested a new study published online December 22 in Cancer. Researchers noted that women who had taken bisphosphonates in the past were about half as likely as women who had not taken the drugs to develop endometrial cancer.
  • Adrenal crisis continues to occur at a surprising rate among patients with chronic adrenal insufficiency who have been educated about their condition, suggests a research from Germany published online in The Journal of Clinical Endocrinology & Metabolism.
  • In draft diagnostics guidance issued in December, the National Institute for Health and Care Excellence (NICE) recommends that the Progensa prostate cancer antigen 3 (PCA3) assay and the Prostate Health Index (PHI) should not be used in the National Health Service in England. The tests do not improve enough the diagnosis of prostate cancer in patients with negative or inconclusive results on prostate biopsy to be recommended for clinical practice.

Dr KK Spiritual Blog

What is charity?

Some time back after returning from a free health check-up camp, I met a processor of Cardiology from Lucknow and started boasting that I had seen 100 patients free today. He said do not get excited. Charity is a positive, but still not the absolute positive, unless it is done without any motive or done secretly. He said that you were honored on the stage; you got blessings from the patients and people talked about you in positive sense. It was an investment in the long run and not an absolute charity. When you serve, never be honored on the stage by the people to whom you are serving. If you get that then it is like give and take. The purpose of life should be to help others without any expectations.

Understanding helping others

When you help others, it should not harm somebody else even though your help is unconditional. If you promote somebody by superseding another deserving senior person, this is not a help as the person to whom you are helping will give you one blessing but the person to whom you have harmed will give you 10 curses. Ultimately you end up with minus 8 points. Helping other means that it should give happiness to you, to the persons you have helped and also to others to whom you have not helped.

Helping always pays

The difference between American and Indian models is that Indians always think of now and do not invest in future. Americans always plans for the future. When we help somebody, we want that the same person should expect you by helping you when you are in need in a shorter run. But charity does not believe in that. Your job is to help others and negate your negative past karmas. You never know, may be decades later you might receive help from a person who you had helped decades earlier. Help should never be linked to returns.

Inspirational Story

Start For Yourself

Start for yourself, Face your greatest fears, and take the new step of faith, because only who can see the invisible, Can do the impossible.

God opens a door before your eyes, it’s up to you to find out Help yourself and explore the things outside. If only you could see the genuine smile through the eyes of an innocent child that gives you different insight

Sometimes it's better to be like a child They take the challenge of life No matter what comes out You will see them playing around. If you want to cope-up with your grief, you must help and start for yourself Minimize your self-centeredness, Maximize your faith and strength for living Because, God, you are still alive!

There are more things to explore outside. Even the air you breathed, the voice you've heard, the things you've seen are enough to analyze, you are still fortunate to be alive! You are blessed to take another day to feel the sun's ray. Hey, didn't you know that you are nature's greatest miracle?

Rabies News (Dr A K Gupta)

What is pre—exposure vaccination?

Pre–exposure (Prebite) vaccination means immunization before the bite.

Cardiology eMedinewS

  • Patients with mild hypertension (140 to 159 mm Hg/90 to 99 mm Hg) who received antihypertensive therapy had decreased their blood pressure by about 3.6/2.4 mm Hg and had a reduced short-term risk of dying from stroke or cardiovascular disease, suggested a large meta-analysis published online December 22 in the Annals of Internal Medicine.
  • A new study published online in Diabetes Care has pointed out that insulin-treated diabetes patients who experience hypoglycemia are at an increased and ongoing risk for cardiovascular events and all-cause mortality, irrespective of whether they have type 1 or type 2 diabetes.

Pediatrics eMedinewS

  • In overweight children, exercise can put pressure on their developing feet, suggests new research thus pointing that overweight children are at risk for foot pain and discomfort as they tend to have fatter and flatter feet, resulting in increased pressure on the arched portion of the sole. The report is published in the Journal of Science and Medicine in Sport.
  • Elevated fasting insulin levels in children aged 3 to 6 years may predict which children will develop type 2 diabetes as adults, suggests a study published online December 22 in Pediatrics.

Quote of the Day

Action makes more fortune than caution. Charlotte Whitton

Wellness Blog

Buy your shoes in the evening

Harvard 8 tips for buying shoes that are good to your feet

Start with your own feet, and look at what’s already in your closet. Stand barefoot on a piece of paper or cardboard, and trace the shape of each foot. Now take your shoes, one by one, and place them on top of the drawing. If you’re like most people, your "comfortable" shoes will closely match the outline of your own feet.

Identify the shoes that cause pain. If you’re a woman, most of these will be shoes with narrow toes or high heels. Check to see if the toe of the shoe is narrower or shorter than your own toes.

  1. Wait until the afternoon to shop for shoes — your feet naturally expand with use during the day and may swell in hot weather.
  2. Wear the same type of socks that you intend to wear with the shoes.
  3. Have the salesperson measure both of your feet. If one foot is larger or wider than the other, buy a size that fits the larger foot.
  4. Stand in the shoes. Make sure you have at least a quarter– to a half–inch of space between your longest toe and the end of the shoe.
  5. Walk around in the shoes to determine how they feel. Is there enough room at the balls of the feet? Do the heels fit snugly, or do they pinch or slip off? Don’t rationalize that the shoes just need to be "broken in" or that they’ll stretch with time. Find shoes that fit from the start.
  6. Trust your own comfort level rather than a shoe’s size or description. Sizes vary from one manufacturer to another. You’re the real judge.
  7. Feel the inside of the shoes to see if they have any tags, seams, or other material that might irritate your feet or cause blisters.
  8. Turn the shoes over and examine the soles. Are they sturdy enough to provide protection from sharp objects? Do they provide any cushioning? Also, take the sole test as you walk around the shoe store: do the soles cushion against impact? Try to walk on hard surfaces as well as carpet to see how the shoes feel.

ePress Release

The day after Christmas Is hazardous to your heart

December 26th is historically one of the most dangerous days of the year for people vulnerable to cardiac problems, including heart attacks, arrhythmias, sudden cardiac death and heart failure, said Dr K K Aggarwal, President Heart Care Foundation of India, Secretary General-Elect and Senior National Vice President of the Indian Medical Association.

A study conducted at University of California, San Diego and Tufts University in 2004 has shown that heart-related deaths increase by nearly 5% during holidays, perhaps because patients delay seeking treatment for heart attacks and also because hospital staffing patterns change. The study found quiet ER on Christmas Day with a sudden surge on December 26. A 2008 also study found that daily visits to hospitals for heart failure increased by 33% during the four days after Christmas.

Winter is anyway known to be notorious for heart attacks, heart failures, and arrhythmias. Cold weather is hard on the heart. Blood vessels constrict, which raises blood pressure. Blood also clots more readily. Frigid temperatures increase strain on the heart, and too much physical exertion can worsen the burden and trigger a heart attack. Wine and whisky if taken in excessive amount during Christmas can trigger atrial fibrillation, a form of irregular heartbeat. If it persists, atrial fibrillation can end up with stroke.

But cold weather isn't the only culprit. After Christmas Day, many people confuse the signs of a heart attack -- like shortness of breath or chest pains -- with indigestion from a big dinner. If you're having a heart attack, studies show that you can't wait longer than 12 hours to be treated.

emedipicstoday emedipics

Health Check Up and CPR 10 Camp at GB S School, Khan Pur, New Delhi, on 27th November 2014

video of day
press release

Treatment for constipation in the elderly

Sameer Malik Heart Care Foundation Fund

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF

Total CPR since 1st November 2012 – 101090 trained

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."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)


IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :


Dr Good and Dr Bad

Situation: A patient with Mediclaim of 2 lakhs of seven years duration needed a claim of Rs. 2.2 lakhs.
Dr. Bad: You will have to pay Rs. 20,000/- from your pocket.
Dr. Good: You can claim cumulative bonus.
Lesson: Sum insured under the policy shall be progressively increased by 5% for each claim–free year of insured subject to maximum accumulation of 10 claim–free years of insurance.

Make Sure

Situation: A patient with fever and cough developed complications after he was given antibiotics.
Reaction: Oh my God! What was the need of giving the antibiotics?
Lesson: Make sure that a patient with fever and cough is not given antibiotics as presence of cough mostly signifies viral infection.

eMedinewS Humor

An old lady went to her doctor to see what could be done about her constipation. "It’s terrible," she said. "I haven't moved my bowels a week." "I see have you done anything about it?" asked the doctor" Naturally", she replied. " I sit in the bathroom for a half hour in the morning and again at night"."No," the doctor said," I mean do you take anything?" "Naturally" she answered, "I take a book."

Twitter of the Day

Dr KK Aggarwal: Equipment-related failures common in Operation Theater
Dr Deepak Chopra: When reverence for life is lost the world becomes violent and the path is set for destruction and extinction

eMedi Quiz

Which of the following is not a post transcriptional modification of RNA?

1. Splicing
2. 5' capping
3. 3' polyadenylation
4. Glycosylation

Yesterday’s Mind Teaser: Which of the following is present intracellularly in muscle cells?

1. Insulin.
2. Corticosteroid.
3. Epinephrine.
4. Glucagon.

Answer for yesterday’s Mind Teaser: 2. Corticosteroid.

Correct answers received from: Raju Kuppusamy, Dr Avtar Krishan, Dr Jainendra Upadhyay.

Answer for 22nd December Mind Teaser: 2. pKa

Correct answers received from: Dr KV Sarma, Dr Avtar Krishan, Dr Rakesh Sharma Nohar.

Send your answer to email

medicolegal update
  1. Thanks for such informative & beautiful mail. With Regards, Dr Bharat Gadhvi.

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