eMedinewS25th September 2014, Thursday

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 & Honorary Secretary General Elect IMA; Member Ethics Committee MCI; Chairman Ethical Committee DMC; Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) IMSA (March 10–13); Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMAAMS (06–07); President DMA (05–06); President IMA New Delhi Branch (94–95, 02–04).
For updates follow at :  www.twitter.com/DrKKAggarwal, www.facebook.com/Dr KKAggarwal

press release

Brain death diagnosis criteria are different

  • Diagnosis of adult brain death requires just one complete examination, with optional confirmation by another physician.
  • Standards for determining pediatric brain death were established more than 25 years ago and have been adopted and revisited by the Society of Critical Care Medicine, the American Academy of Pediatrics, and the Child Neurology Society. The diagnosis, in a guideline released in 2011, requires 2 examinations, 12 hours apart, by two different attending physicians in children 1 year or older.
emedipicstoday emedipics

Health Check Up and CPR 10 Camp at N P CO-DE Sr. Sec School, Naroji Nagar, New Delhi 15th September 2014



National News

Drugs banned in the last five years

  1. Rosiglitazone. Dated 12.11.2010
  2. Nimesulide formulations for human use in children below 12 years of age. Dated 10.02.2011
  3. Cisapride and its formulations for human use. Dated 10.02.2011
  4. Phenypropanolamine and its formulations for human use.* 10.02.2011 (*Presently stayed by the Hon’ble High Court of Madras.)
  5. Human Placental Extract and its formulations for human use except its 1. Topical application for wound healing, and 2. Injection for pelvic inflammatory disease. Dated 30.05.2011
  6. Sibutramine and its formulations for human use. Dated 10.02.2011
  7. R-Sibutramine and its formulations for human use. Dated 10.02.2011
  8. Gatifloxacin formulation for systemic use in human by any route including oral and injectable. Dated 16.03.2011
  9. Tegaserod and its formulations. Dated 16.03.2011
  10. Letrozole for induction of ovulation in anovulatory infertility. Dated 12.10.2011
  11. Serodiagnostic test kits for diagnosis of tuberculosis dated 07.06.2012 & dated 07.06.2012


  • New guidelines released by the US Preventive Services Task Force (USPSTF) recommend that sexually active young adults and adults at increased risk for sexually transmitted infections (STIs) should undergo intensive behavioral counseling to decrease their risk of becoming infected. The USPSTF also recommends screening all sexually active women aged 24 years or younger, as well as older women at increased risk for chlamydia and gonorrhea. The evidence-based recommendations were published online September 23 in the Annals of Internal Medicine.
  • The American Academy of Orthopedic Surgeons (AAOS) has released a new evidence-based practice guideline for treating anterior cruciate ligament (ACL) tears. The guideline recommends performing reconstructive surgery within 5 months of an ACL injury to protect the knee joint.
  • An array of spirometric and other measures shows that elderly asthmatics have a lower atopic status than younger people, but significantly worse pulmonary function, reported a new study published online in the Annals of Allergy, Asthma, and Immunology.
  • The US Food and Drug Administration (FDA) has cleared for marketing the first direct blood test that can rapidly detect 5 Candida species that cause bloodstream infections often leading to sepsis. The T2Candida Panel and T2Dx Instrument detect Candida albicans, Candida tropicalis, Candida parapsilosis, Candida glabrata, and/or Candida krusei.
  • Metformin appears to further decrease the levels of thyroid-stimulating hormone (TSH) in diabetic patients already being treated for hypothyroidism, reports a new study published online in CMAJ. Study authors noted that diabetic hypothyroid patients had a 55% increased risk of having low TSH levels compared with hypothyroid patients with diabetes who were taking a sulfonylurea instead. But, this association was not seen in diabetic patients who had normal thyroid function when they started getting diabetes treatment.
press release

Weight loss may improve sexual health of obese diabetes

video of day

Other Blogs

On 1st Navratri Let Go Your Desires

Navratri is the detoxification of body, mind and soul. Body detoxification means:

  1. Eating less.
  2. No cereals. You can take wheat grass juice.
  3. Eating once if possible.
  4. Satvik lifestyle.

In Navratri diet

  1. Wheat flour is replaced with Kuttu or Singhara flour.
  2. Pulses are replaced with amaranth or Rajgiri.
  3. Rice with Samak rice.

Mental and soul detoxification can be done by practicing Yoga Sadhna as described in nine forms of Durga. As per mythology, Mata Shailputri is daughter of the mountain king, Himalaya. She is the first among nine avatars of Durga and worshipped on the 1st day of Navratri. In Yogashastra, she represents the lowest Muladhara chakra. The bija sound to chant is LAM in the sacral root area. In Allopathy, she represents activation of sacral autonomic plexus.

The Goddess has a half moon on her forehead and is depicted holding a trident (trishul) in her right hand and a lotus flower in her left hand. She rides on Nandi, a bull. Shailputri represents the shakti or power of the root chakra, who, upon awakening, begins Her journey upwards in search for the last crown chakra (Shiva). Bull in mythology represents ‘desires’. On the first day we must let go our desires. Trishul represents balancing Tamas, Rajas and Satwa. Lotus represents practicing detached attachment. We are required to donate all Rajsik and Tamsik foods and items so that we are not attracted during Navratra. Moon symbolizes thinking with a cool mind.

In Navratri pooja on the first day, yogis keep their mind concentrated on Muladhara chakra as the starting point of spiritual discipline or Yoga Sadhna.

What to do on first day

  1. Let go your desires
  2. Keep the mind cool
  3. Practice detached attachment
  4. Balance Tamas and Rajas guna with Satwa or to stay in balance.
  5. Concentrate on Muladhara chakra (sacral root)
  6. Chant LAM reducing the respiratory rate to 2-4 per minute.
  7. In Ayurveda, muladhara chakra represents the earth element (attachments).


On the first day control (riding), your desires (bull) by balancing (Trishul) the mind with cool thoughts (moon) and practicing detachment (lotus). This can be assisted by chanting LAM focusing on sacral chakra."

Quote of the Day
  • True dignity is never gained by place, and never lost when honors are withdrawn. Philip Massinger
  • Friendship consists in forgetting what one gives and remembering what one receives. Alexander Dumas
  • The secret of a good sermon is to have a good beginning and a good ending; and to have the two as close together as possible. George Burns
Inspirational Story

The fence

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.

CPR 10

Total CPR since 1st November 2012 – 99898 trained

CPR 10 Camp at SKV, C Block, Defence Colony, New Delhi 17th September 2014, Trained 132 Persons
CPR 10 Camp at NP CO-ED Sr Sec School, Nauroji Nagar New Delhi 15th September 2014, Trained 277 Persons


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.

MTNL Perfect Health Mela

Heart Care Foundation of India, a leading national non–profit organization committed to making India a healthier and disease free nation announced the upcoming activities of the 21st MTNL Perfect Health Mela scheduled to be held from 15th – 19th October 2014 at the Talkatora Indoor Stadium in New Delhi.


IMA News
  • IMA has constituted a committee of five members to draft a Bill within one month in which they are requested to incorporate the punishment to be given to the owners of health institutions and diagnostic centers. The names of the committee members are: Dr. Narendra Saini, Dr. Vijay Agarwal, Dr. K K Aggarwal, Dr. Alex Thomas, Dr. Y P Munjal and Dr. Devi Shettty. Dr Vijay Aggarwal will be the convener of this committee.

  • Code of conduct for hospitals, nursing homes soon
    Monday, September 22, 2014: by Vidhi Rathee

    New Delhi: Soon hospitals and nursing homes discriminating against patients on the basis of their socioeconomic status, overcharging them, taking cuts from pharmaceutical companies or denying treatment to poor patients will be under scanner of the Indian Medical Association (IMA). The largest voluntary organization of allopathic doctors is framing a self-regulated code of conduct for hospitals and nursing homes in order to curb the increasing corruption and bribes in the sector.

    The codes, which were deliberated at the 44th national conference of the IMA held recently in Mumbai, will be broadly based on four principles – Safety Norms, Quality, Affordability and Accessibility.

    Dr K K Aggarwal, senior national vice-president, IMA, told India Medical Times, "As of now, there are no codes of conduct for hospitals and nursing homes. They function freely and indulge in such practices that lower the confidence of a patient in the sector. Keeping that in mind, we decided to clearly notify what is "ethical” and what is "unethical” for a hospital or a nursing home to do, leaving a little room for confusion. We are doing this with the help of Association of Healthcare Providers (India)."

    “The codes will be self-regulatory, any hospital or nursing home found working against the codes or indulging in unscrupulous practices will be barred from the (IMA) membership," he said.

    Dr Niteen V Dhepe, medical director, Skin City Postgraduate Institute of Dermatology, Pune, told India Medical Times, “As far as implementing code of conduct to curb unethical practices is concerned, it is a right step but if these codes of conduct are meant to direct financial functioning of a hospital, they will be imposed rather than self-regulated.”

    “Treating the underprivileged and providing health services to the poor should be the supreme responsibility of the state. Putting that as a moral obligation on private hospitals is like shrugging off its responsibility onto someone else. The rules should be in good spirit and not contradictory to the system. Overarching codes will diminish a level playing field,” he added. According to reports, the codes will also include suggestions like including patient friendly exercises and special programmes and facilities for elderly in a hospital. Preference for generic drugs, preparation of a list of NGOs and philanthropists whom patients can approach for help, will also find a mention in the codes. Dr Kamal Mahawar, senior consultant in bariatric and metabolic surgery, Indraprastha Apollo Hospitals, New Delhi, told India Medical Times, “This is a step in the right direction. These codes will help guide hospitals to tread their way ethically. Overcharging patients is totally wrong and taking huge commissions and a cut from pharmaceutical companies is a matter of disgrace.”

    “Also, doctors advertising about their private practice is not fair. Let’s hope these codes bring some uniformity across hospitals and nursing homes in India,” he said.

Make Sure

Situation: A known epileptic child died of a seizure while swimming.
Reaction: Oh my God! Why was he allowed to swim?
Lesson: Make sure that patients with uncontrolled epilepsy are not allowed to swim.

Dr Good & Dr Bad

Situation: A patient on aspirin was to go for non vascular surgery
Dr Good: Stop aspirin for seven days
Dr Bad: Stop aspirin for two days
Lesson: On the basis of the findings of POISE-2 trial, it is recommended to discontinue aspirin about seven days before noncardiovascular surgery.

Video Library
eMedi Quiz

Medullary carcinoma of the thyroid is associated with which of the following syndrome:

1. MEN I.
2. MEN II.
3. Fraumeni syndrome.
4. Hashimoto's thyroiditis

Yesterday’s Mind Teaser:
Strong correlation with colorectal cancer is seen in:
1. Peutz-Jegher's polyp.
2. Familial polyposis coli.
3. Juvenile polyposis.
4. Hyperplastic polyp.

Answer for yesterday’s Mind Teaser: 2. Familial polyposis coli.
Correct answers received from:
Dr RH Gobbur,Tukaram Pagad, Dr.K.V.Sarma, Dr Poonam Chablani, Dr Jainendra Upadhyay, Dr Avtar Krishan, Dr Deepali Chatterjee,
Answer for 23rd Sept Mind Teaser: 2. MEN II.
Correct answers received from:
Najib Khatee, Dr.Bitaan Sen & Dr.Jayashree Sen, Dr.Raghavendra Jayesh, Dr. P. C. Das
Send your answer to:

eMedinewS Humor

A mathematician and a physicist agree to a psychological experiment.

The (hungry) mathematician is put in a chair in a large empty room and his favorite meal, perfectly prepared, is placed at the other end of the room. The psychologist explains, "You are to remain in your chair. Every minute, I will move your chair to a position halfway between its current location and the meal."

The mathematician looks at the psychologist in disgust. "What? I'm not going to go through this. You know I'll never reach the food!" And he gets up and storms out.

The psychologist ushers the physicist in. He explains the situation, and the physicist's eyes light up and he starts drooling.

The psychologist is a bit confused. "Don't you realize that you'll never reach the food?"

The physicist smiles and replies: "Of course! But I'll get close enough for all practical purposes!"

IJCP Book of Medical Records

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

The records are in the form of claims as authenticated by the sender as on the day of approval. The records can be used as part of a personal bio data or institution's achievements.

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 at:

Press Release of the Day

Kidney patients can become pregnant

New Delhi: 24 September 2014: Pregnancy is not contraindicated in most women with diabetic nephropathy (kidney disease) said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

Maternal and peri-birth outcomes are generally good with tight control of sugar and blood pressure. Although mortality is low, maternal and neonatal morbidity are increased compared to non-diabetics and diabetic women without nephropathy. The major obstetrical complications are preeclampsia, fetal growth restriction and preterm birth.

Pre-conceptional treatment with drugs like angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists in women with microalbuminuria may have benefits that extend through the pregnancy. These agents should not be used during pregnancy as they are teratogenic.

Pregnancy does not appear to accelerate the progression of diabetic nephropathy in women with a mild to moderate decline in renal function.

Women with moderate to severe renal impairment (serum creatinine level >1.5 mg/dL, proteinuria >3g in 24 hours) may benefit from renal transplantation or dialysis therapy before initiating pregnancy.

Wellness Blog

Navratra: Time to eat buckwheat flour

Navratra is the time when wheat flour is omitted from the diet and substituted it with buckwheat flour or kuttu ka aata. Buckwheat is not a cereal grain; it is a fruit and hence is a good substitute for Navratra fasts where cereals are prohibited.

  1. The flour is extremely high in protein and is a wonderful substitute for those who are allergic to gluten (found in wheat).
  2. It is good for patients with celiac disease as it is gluten-free.
  3. It contains phytonutrient rutin, which lowers cholesterol and blood pressure.
  4. It is rich in magnesium, vitamin B, iron, calcium, folate, zinc, copper, manganese and phosphorus.
  5. As the buckwheat hulls are hard to chew, traditionally they are soaked for about six hours and then cooked to make them softer and easily digestible.
  6. It also contains alpha linolenic acid, which increases HDL cholesterol ("good" cholesterol) and controls LDL cholesterol ("bad" cholesterol).
  7. It is a good source of insoluble fiber and prevents occurrences of gallbladder stones. According to the American Journal of Gastroenterology, a 5 % increase in the insoluble fiber intake results in a 10% reduced risk of gall-bladder stones.
  8. Kuttu is 75% of complex carbohydrates and 25% of high quality protein, which makes it an ideal food for weight loss.
  9. As the flour is gluten-free, a potato is used to bind the flour together.
  10. The flour tastes different.
  11. Pooris made from kuttu flour are crunchier than the normal wheat flour pooris.
  12. One should not make pooris with hydrogenated oils or vanaspati as it will take away all the medical benefits of buckwheat flour.
  13. Buckwheat flour however is subjected to adulteration.
  14. Mixtures of rye flour, Indian corn flour, wheat flour, and other ground cereals are often used as a substitute for buckwheat.
  15. Being high in fiber and low glycemic index it is good substitute for diabetic patients. The glycemic index for buck wheat is 47 (Low GI foods have a GI value less than 55; medium GI foods have a GI value between 55 and 69 and high GI foods have GI value greater than 70).
  16. The chiro-inositol present in buckwheat has been identified as the diabetes preventing component.
  17. Asthma symptoms can occur in sensitized children when food allergens such as buckwheat are cooked in a confined area. Both acute and late-phase respiratory symptoms are seen.
  18. Eat kuttu ki roti instead of poori or pakodas (fried items) made from kuttu atta (buckwheat flour).
  19. One can also prepare idlis from kuttu atta (buckwheat flour) and dosa from the samak rice (non grain seed)
  20. Food poisoning may occur if flour left over from the previous year is reused.
Pediatrics eMedinewS
  • A new study published in the American Journal of Epidemiology highlights the association between maternal iron intake and offspring autism risk. According to the study, mothers of children with autism are less likely to have taken iron supplements before and during their pregnancies than mothers of children with normal development.
  • Contrary to previous hypotheses, newborn immune T cells may have the potential to trigger an inflammatory response to bacteria, according to a new study published in the journal Nature Medicine. Researchers noted that newborns’ T cells manufacture a potent anti-bacterial molecule known as IL8 that activates neutrophils to attack the body's foreign invaders.
Cardiology eMedinewS
  • Treating mild hypertension with drugs has no clear benefit and adds huge sums to national healthcare expenditures, points an article published online in BMJ. Researchers highlight that thresholds for management must be re-examined, and priorities should shift to lifestyle modification.
  • New, longer-term data on the Watchman left atrial appendage occluder from Boston Scientific studied in the PREVAIL trial suggests an increased risk of ischemic stroke in atrial fibrillation patients treated with this novel device. The findings were published in the Journal of the American College of Cardiology.
Rabies News (Dr A K Gupta)

Is washing of animal bite wound (s) essential?

The risk of rabies reduces by about 50% by just washing of wounds and application of antiseptics. The maximum benefit of the wound washing is obtained when the fresh wound is cleaned immediately. It is important to remove saliva containing rabies virus at the site of bite by physical or chemical means. This can be done by prompt and gentle thorough washing with ordinary soap or detergent and flushing the wound with running tap water for at least 15 minutes.

Washing of the wound must be done as long as the wound is raw irrespective of the time elapsed since the exposure. Care must be taken not to disturb the scab, if formed. After washing with water and soap, disinfectants like Povidone Iodine must be applied. In extraneous circumstances, other alcoholic (>40%) preparations like Rum, Whisky or aftershave lotion may be applied on the wound. If soap or antiviral agent is not available, the wound should be thoroughly washed with water.

medicolegal update

Hi Dr. KK, very informative news. Dr Ashok Ahuja

Twitter of the Day

Dr KK Aggarwal: Monsoon reduces the immunity of the body
http://bit.ly/17wSWz3  #Health

Dr Deepak Chopra: In every perceived failure or setback is the seed of success. http://bit.ly/DC_Ananda  #ananda

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