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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

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

25th September 2012, Tuesday

Romney takes Statin and Aspirin Daily

This is how the politicians declare their health status in US before elections.

Sixty–five year old Republican presidential nominee Mitt Romney has hyperlipidemia and takes a statin and low–dose aspirin daily, but he has no physical impairments to doing the job, according to a letter from his personal physician released Friday, reports Medpage.

He has reserves of strength, energy, and stamina that provide him with the ability to meet unexpected demands and there are no physical impairments that should interfere with his rigorous and demanding political career as the next president of the United States.

He is on 81–mg aspirin and 10–mg atorvastatin. He also has mild BPH and sinus bradycardia. He is allergic to penicillin with no history of asthma, diabetes, coronary heart disease, or hypertension. His slow, resting, regular heart rate in the 40s is most likely related to his past intensive exercise with regular running. A low resting heart rate does occur not just in athletes, but in many people who exercise regularly (daily) for 5 to 7 days a week, particularly those who work out intensely (particularly runners). In the absence of any evidence of other heart problems, low heart rates are a sign of good health and conditioning, not a warning signal.

He is a non smoker and non alcoholic. He eats a high fiber diet with abundant fruits and vegetables and minimizes intake of high–cholesterol foods and concentrated sweets.

His TG levels are 179. He has family history of cardiac arrhythmias, heart attack, and prostate cancer. He gets his PSA check up done regularly.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

How do stimulant laxatives help in constipation?

Stimulant laxatives affect electrolyte transport across the intestinal mucosa and stimulate intestinal fluid accumulation and colonic motor activity. The currently available stimulant laxatives include senna and bisacodyl. Stimulant laxatives should not be used in patients with suspected intestinal obstruction. In a trial of 77 elderly nursing home residents, the senna-fiber combination was significantly more effective than lactulose in improving stool frequency and consistency at a lower cost (Passmore AP, Wilson–Davies K, Stoker C, et al. Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna–fibre combination. BMJ. 1993;307:769–71).

For Comments and archives…

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

DD Take Care Holistically Video 1–7

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

4th Dil Ka Darbar

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.

Dr K K Aggarwal
    National News

India lags behind in nutritional terms, among 36 worst countries

New Delhi: A study has found India to be the lowest on nutrition parameters, sharing the last rank with Democratic Republic of Congo and Yemen. India performed lowest at the level of policy as well as implementation. Nutrition barometer, the study carried out by Save the Children, compared commitments and outcomes of 36 countries which together account for 90 per cent of the world’s stunted children. Components for the commitment included a snapshot of national governments’ political, legal and financial promises. Outcomes were measured by analysing progress in addressing child nutrition. India as a country came last on both the counts. Despite 12th five year plan being focused on health, according to current outlay, India will spend 1.67 per cent of its gross domestic product on health sector. In fact, countries in South Asia such as Bangladesh, Pakistan and Nepal fared better than India in dealing with malnutrition. The countries that performed best are Guatemala, Malawi and Peru. All three show strong commitment with strong nutrition outcomes. Save the Children India’s CEO Thomas Chandy said, "The report is a pointer to the need to back political commitment with adequate resources and effective mechanisms." The nutrition barometer was based on the global hunger index produced by the international food policy research institute and the hunger reduction commitment index of the Institute of development studies. The study recognised United Nations Children’s Fund’s conceptual framework, which considers national–level indicators like health and social policy as well as household factors — income and education. The outcomes for India have been measured using the national family and health survey 3 from 2005–06 in the absence of more recent data on malnutrition. "This itself is a big lacuna that the government needs to address immediately. Unless we track the efficacy of our schemes and policies on the ground there can be no course correction even if it is required," said Shireen Vakil Miller, director, advocacy and policy, Save the Children. "There is an urgent need to commission a comprehensive health and nutrition survey in the country." (Source: Deccan Herald, Sep 20, 2012)

For comments and archives

My Profession My Concern

Treatment of acute bacterial rhinosinusitis

  • Treat patients whose clinical symptoms meet criteria for acute bacterial rhinosinusitis with an antibiotic.
  • In light of increasing microbial resistance to antibiotics, start initial empiric treatment with amoxicillin–clavulanate (500 mg/125 mg orally three times daily or 875 mg/125 mg orally twice daily) for 5 to 7 days rather than clarithromycin or azithromycin, trimethoprim–sulfamethoxazole, or oral second– or third–generation cephalosporins. Doxycycline is a reasonable alternative. Doxycycline or a respiratory fluoroquinolone may be used in patients with penicillin allergy.
  • Three features suggest the diagnosis of ABRS:
    • Persistent symptoms or signs of ARS lasting 10 or more days with no clinical improvement
    • Onset with severe symptoms (fever >39°C or 102°F and purulent nasal discharge or facial pain) lasting at least three consecutive days at the beginning of illness.
    • Onset with worsening symptoms following a viral upper respiratory infection that lasted five to six days and was initially improving.
  • Symptomatic therapy for acute rhinosinusitis, whether viral or bacterial, includes mild analgesics, saline nasal irrigation, and intranasal glucocorticoids.

(Reference: Chow AW, et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis 2012;54:e72).

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

What are the types of valves used in cardiac surgery?

Among patients who undergo cardiac valve replacement, approximately 60 percent receive mechanical valves composed of carbon alloys with a tilting disk or bileaflet design. The remaining 40 percent receive bioprosthetic valves, which may be heterografts, composed of porcine or bovine tissue, homografts, which are preserved human aortic valves, or pulmonary autografts.

(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)

Catheter replacement can be limited to clinical indication

Routine peripheral intravenous catheter replacement and clinically indicated replacement carry a similar risk for phlebitis, according to the results of a randomized controlled equivalence trial. Claire M. Rickard, PhD, from the Research Centre for Clinical and Community Practice Innovation in Nathan, Australia, and colleagues reported their findings in an article published in the September 22 issue of the Lancet. (Source: Medscape)

For Comments and archives…

FDA approves Eylea for macular edema following CRVO

The US Food and Drug Administration (FDA) has approved aflibercept injection (Eylea, Regeneron Pharmaceuticals) for treating macular edema following central retinal vein occlusion (CRVO), the manufacturer announced today. The decision expands the use of aflibercept injection, which won FDA approval in November 2011 for neovascular (wet) age–related macular degeneration In August, the agency greenlighted another form of aflibercept (Zaltrap, Regeneron/Sanofi) for metastatic colorectal cancer. An angiogenesis inhibitor, aflibercept neutralizes vascular endothelial growth factor (VEGF) types A and B and placental growth factor, and therefore acts more broadly than other antiangiogenic agents such as bevacizumab (Avastin, Genentech). (Source: Medscape)

For Comments and archives…

Autism may arise from unreliable brain responses

High–functioning adults with autism exhibited variable brain responses to visual and auditory stimuli, suggesting that the condition may involve specific alterations in neural processing, investigators reported. (Source: Medpage Today)

For Comments and archives…

Perioperative deaths dramatically drop around the globe

Even as patients’ medical conditions have gotten more complex and surgeries more complicated, perioperative mortality (death from any cause within 48 hours after surgery) has significantly declined over the last 50 years, with the greatest improvement seen in developed countries vs developing countries, according to a global meta–analysis. Daniel Bainbridge, MD, from the Department of Anesthesia and Perioperative Medicine at the University of Western Ontario in London, Canada, and colleagues’ results were reported in an article published in the September 22 issue of the Lancet. (Source: Medscape)

For Comments and archives…

    Twitter of the Day

@DrKKAggarwal: Treating depression: take three steps (HealthBeat) Acute phase. The goal here is to relieve your symptoms… http://fb.me/1UXTt6Agu

@DeepakChopra: Can one realize thoughtlessness? Isn’t realizing that you are thoughtless a thought itself? My #askdeepak replyhttp://tinyurl.com/9hv3342

    Spiritual Update

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

Symposium on Diet, Health & Religion: Dr AK Merchant of the Baha’i Faith

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)

Does stress causes infertility?

Infertility is very stressful; there is no proof that stress causes infertility. In an occasional woman, having too much stress can change her hormone levels and therefore cause the time when she releases an egg to become delayed or not take place at all.

For Comments and archives…

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

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

How frequently can a donor donate blood?

Ans. It takes about 6 – 8 weeks for the hemoglobin to be synthesized in the body. Three months should be there as a very safe interval.

For Comments and archives…

    Liver Abscess Update

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

What is the commonest site of liver abscess?

Approximately two thirds of liver abscess occur in the right lobe of the liver and majority are solitary.

For Comments and archives…

    An Inspirational Story

Temper control

There once was a little boy who had a bad temper. His father gave him a bag of nails and told him that every time he lost his temper, he must hammer a nail into the fence.

The first day the boy had driven 37 nails into the fence. Over the next few weeks as he learned to control his anger, the number of nails hammered daily, gradually dwindled down. He discovered it was easier to hold his temper than to drive those nails into the fence. Finally the day came when the boy didn’t lose his temper at all. He told his father about it and the father suggested that the boy now pull out one nail for each day that he was able to hold his temper.

The days passed and the young boy was finally able to tell his father that all the nails were gone. The father took his son by the hand and led him to the fence. He said "you have done well, my son, but look at the holes in the fence. The fence will never be the same. When you say things in anger, they leave a scar just like this one."

You can put a knife in a man and draw it out. It won’t matter how many times you say I’m sorry, the wound is still there.

Make sure you control your temper the next time you are tempted to say something you will regret later.

(Source: http://academictips.org/blogs/temper–control/)

For comments and archives

   Cardiology eMedinewS

Global focus urged to cut heart disease Read More

Na intake tied to higher BP in children Read More

   Pediatric eMedinewS

Na intake tied to higher BP in children Read More

Cord blood vitamin D linked to air pollution Read More

    IJCP Special

Dr Good Dr Bad

Situation: A child presented with focal convulsions with onset of high–grade fever.
Dr Bad: These are simple febrile convulsions.
Dr Good: These are not simple febrile convulsions.
Lesson: Simple benign febrile convulsions are always generalized.

For comments and archives

Make Sure

Situation: In an STD clinic, a 23–year–old heterosexual male presenting with dysuria, and uretheral discharge was prescribed azithromycin to cover a suspected Chlamydia trachomatis infection.
Reaction: Oh my God! Why didn’t you advise the same treatment for his partner also?
Lesson: Make sure to remember that in such cases, it is essential that both the partners are treated.

For comments and archives

  Quote of the Day (Dr GM Singh)

Excellence is to do a common thing in an uncommon way. Booker T. Washington

  Lab Update (Dr Arpan Gandhi and Dr Navin Dang)

Beta–2 microglobulin

  • To help identify a mycobacterial infection
  • To diagnose tuberculosis (TB)
  • To monitor the effectiveness of treatment
  Rabies Update (Dr A. K. Gupta, Author of "RABIES – the worst death")

Can a vaccinated dog transmit rabies? How effective is dog vaccine?

If a potent veterinary vaccine is given correctly as per pre–exposure schedule, it will mostly prevent rabies in the vaccinated dog, unless the exposure is severe. Ideally, its sera should be tested for protective antibody titer level but this is rarely practicable due to scare facilities in our country. Consequently, PEP vaccination is recommended following bites even by vaccinated dogs. It has been noted that:

  • 6% of dogs found rabid have a reliable pre–exposure rabies vaccine history
  • 40% of dogs, vaccinated only one time, lost most of their immunity 4–6 months later
  • Postexposure prophylaxis (PEP) vaccination is not very successful in dogs.
    Mind Teaser

Read this…………………

John, 16 years old, is brought to the ER after a vehicular accident. He is pronounced dead on arrival. When his parents arrive at the hospital, the nurse should:

A. Ask them to stay in the waiting area until she can spend time alone with them
B. Speak to both parents together and encourage them to support each other and express their emotions freely
C. Speak to one parent at a time so that each can ventilate feelings of loss without upsetting the other
D. Ask the MD to medicate the parents so they can stay calm to deal with their son’s death.

Yesterday’s Mind Teaser: Business :)

Answer for Yesterday’s Mind Teaser: Business before pleasure

Correct answers received from: Dr K Raju, Dr Thakor Hitendrsinh G,
Dr Chandresh Jardosh, Avula Ramadevi.

Answer for 22nd September Mind Teaser: Fork in the road
Correct answers received from: Avula Ramadevi, Sudipto Samaddar, Dr Rajiv Dhir.

Send your answer to ijcp12@gmail.com

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

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    Laugh a While (Dr GM Singh)


The shipwrecked mariner had spent several years on a deserted island. Then one morning he was thrilled to see a ship offshore and a smaller vessel pulling out toward him. When the boat grounded on the beach, the officer in charge handed the marooned sailor a bundle of newspapers and told him, "The captain said to read through these and let us know if you still want to be rescued."

  Medicolegal Update

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

Investigation and medical negligence

The investigating police officer and the private/patient complainant cannot always be supposed to have knowledge of medical science so as to determine whether the act of the alleged medical professional/doctor/hospital amounts to rash or negligent act within the domain of criminal law under Section 304–A of IPC said the Supreme Court of India.

The SC says:

  • As we have noticed hereinabove that the cases of doctors being subjected to criminal prosecution are on an increase. Sometimes such prosecutions are filed by private complainants and sometimes by police on an FIR being lodged and cognizance taken.
  • The criminal process once initiated subjects the medical professional to serious embarrassment and sometimes harassment. He has to seek bail to escape arrest, which may or may not be granted to him. At the end he may be exonerated by acquittal or discharge but the loss which he has suffered in his reputation cannot be compensated by any standards.
  • We may not be understood as holding that doctors can never be prosecuted for an offence of which rashness or negligence is an essential ingredient.
  • All that we are doing is to emphasize the need for care and caution in the interest of society; for, the service which the medical profession renders to human beings is probably the noblest of all, and hence there is a need for protecting doctors from frivolous or unjust prosecutions.
  • Many a complainant prefers recourse to criminal process as a tool for pressurizing the medical professional for extracting uncalled for or unjust compensation. Such malicious proceedings have to be guarded against.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Prehypertension triples the risk of heart attack

A person with pre–hypertension, systolic blood pressure between 120–139 mmHg and diastolic pressure between 80–89 mmHg, is more than three times likely to have a heart attack and 1.7 times more likely to have heart disease than a person whose blood pressure is lower than 120/80 mmHg.

Systolic blood pressure is the pressure against the artery wall when the heart beats and diastolic blood pressure is the pressure when the heart is at rest between the heart beats. Normal blood pressure is lower than 120/80 mmHg and hypertension is a blood pressure more than 140/90 mmHg or higher.

Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela said that research has shown that if prehypertension is aggressively treated, 45% of all heart attacks can be prevented. Lifestyle modifications such as weight control, regular physical activity and changes in diet are recommended for people with pre–hypertension. The importance of prehypertension has been listed as one of the top 10 recent advances in cardiology. Dr. Aggarwal said that every effort should be made to lower the blood pressure below 120/80 mmHg.

    Readers Response
  1. Dear Dr. KK Aggarwal, eMedinews has become a cup of morning tea for me. Thoroughly enjoy reading it. My compliments and big thanks, Dr. Mithilesh Chandra, Consultant Histopathologist.
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