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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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  Editorial …

26th February 2013, Tuesday

Time for the medical profession to act: The proposed Indian Medical Council (Amendment) Bill, 2013

The Government now proposes to empower itself to remove the President or other office-bearers of Medical Council of India if found indulging in serious offences of "moral turpitude", as reported in the Indian Express. To this effect, the Ministry of Health and Family Welfare is considering changes in the law governing the MCI through the Indian Medical Council (Amendment) Bill, 2013. 

The changes suggested by the Ministry of Health and Family Welfare include restricting the tenure of the President of the elected-body of MCI to a maximum period of four years for two continuous terms instead of 5 years and an unlimited number of terms as was earlier. These changes are called for as the government has no control over the elected body under the present law governing it.  

The MCI had been dissolved by the Govt. and a Board of Governors was appointed to run the apex body. The current Board of Governors is in its second term, which will end in May 2013, after which a new board of governors would need to be appointed.  

The new bill also proposes to make mandatory renewal of enrollment of doctors every 10 years in the registers maintained by the body or state councils. 

The proposed Bill, under review of the Ministry of Law & Justice, will go to the Union Cabinet for its approval before it is passed in Parliament. Once it becomes an Act, doctors enrolled with Indian Medical Register or the State Medical Register for 10 years will have to apply for renewal within a year.  

The grounds for removal of the office-bearers include being declared insolvent, being physically and mentally incapable, being declared by a court of having an 'unsound' mind or conviction in an offence which, according to the central government, comes under "moral turpitude". Financial or other interests, that could prejudice function, will also lead to removal. 

If the Govt. thinks that the president, the vice-president or an office-bearer of the MCI have abused their position and which renders their continuance in office "detrimental to overall public interest", he/she can be removed from office. The bill also proposes removal on the grounds of being found guilty of "proved misbehavior". However, the person would be given "reasonable opportunity" of being heard in the matter before being removed from office. 

 Issues: Why we must unite and oppose many of the amendments 

1. Why only four years and two terms?  Whys not this clause for member of parliaments, chief ministers and prime ministers? 

2. Why re-registration every ten years. Why all this against allopathic profession. Re-registration will mean compulsory CME and that would mean start of paid costly CME’s in long run like in United States. Why other medical profession pathies are spared?  

3. Medical profession is already included under CPA.   

4. On one hand we say doctors should not advertise, commercialize, indulge in marketing but they will be under CPA. Why double edged sword against doctors. 

5. Govt. is coming with BSc community health courses as parallel to allopathic system. They could have strengthened MBBS courses or start MD courses in every rural district or they could have started compulsory two years MD rural health after MBBS in a rural area. 

6. Why Govt. has not declared Dr B C Roy National awards for the past many years after 2008. 

7. Why the powers of removal of the president with the government?.  Can the President of India remove the Prime Minister. Its the court or the parliament which decides the course of action. Such powers with the government will make MCI elected body ineffective. In democracy its the elected body who elects the president or the vice president. They only have powers to remove them. Removal of office should be the jurisdiction of the Courts and not the government. If such clause is not removed the office bearers will never work under freedom but will always be under the pressure of the government.

Dr KK Aggarwal
Group Editor in Chief

   Constipation Update

Can constipation be a sign of underlying systemic disease?

Infrequently, constipation is the first manifestation of metabolic diseases like diabetes mellitus, hypothyroidism, hypercalcemia, heavy metal intoxication, neurologic or obstructive intestinal disease.

For comments and archives

Dr K K Aggarwal
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tPA safe in pediatric stroke

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    Photo Feature (from the HCFI Photo Gallery)

Dr KK Aggarwal with Swami Hari Chaitanya Mahaprabhu Ji learning CPR 10

Dr K K Aggarwal
    National News

Kerala doctor invents syringe that is not reusable

Thiruvananthapuram, Feb 24 (PTI): A Kerala based doctor today claimed he has developed a "cheap, effective and eco-friendly" medical syringe that can never be reused. Dr Baby Manoj, who works as a radiologist in Kozhikode, has invented the syringe - Peanut Safe Syringe - which has been recognised by National Research Development Corporation, an undertaking of the Union Ministry of Science & Technology, as the Best Invention Award for the Year 2011.

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


Isolated examination or laboratory findings combined with a disclosure of sexual abuse, specific behavioral changes usually confirm sexual abuse.

    Valvular Heart Disease Update

What is transcatheter aortic valve replacement?

Transcatheter aortic valve replacement is a potential option for patients with severe symptomatic aortic stenosis who are considered inoperable for surgical aortic valve replacement.

(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)

    From the Desk of Vice President (Elect) IMA (Dr KK Aggarwal)

Prosthetic valve obstruction

  • When, in a newly symptomatic patient, there is an unexpected rise in transprosthetic gradient from a baseline determination or from established normal values for valves of that type and size, the possibility of critical obstruction should be considered.
  • Causes of obstruction include thrombus, pannus and vegetation. The clinical manifestations include dyspnea, heart failure, and, with thrombus formation, systemic embolization.

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

'Risk' varies in HPV-positive oropharyngeal cancer: Study

Deintensification of chemotherapy might not be the best option for all patients with oropharyngeal cancer whose disease is associated with human papillomavirus (HPV). (Source: Medscape)

HIV linked to sudden loss of hearing

Having HIV appears to increase the risk of sudden sensorineural hearing loss, at least among younger patients, researchers reported. (Source: Medpage Today)

White matter hyperintensities linked to Alzheimer's disease

A new study adds to a growing body of evidence pointing to small-vessel cerebrovascular disease as an important contributor to Alzheimer's disease (AD). (Source: Medscape)

USPSTF wants routine HIV screening

Routine HIV screening – a proposed recommendation by the U.S. Preventive Services Task Force -- is likely to remove important barriers that leave about 25% of HIV-positive people unaware they have the virus. But it would be only the first step in getting all HIV-positive people in the U.S. into care. (Source: Medpage Today)

New lung screen criteria may be more sensitive

Using different selection criteria for lung cancer screening may catch more disease than the currently recommended criteria, researchers found. A modified model from the Prostate, Lung, Colorectal, and Ovarian (PLCO) trial had a significantly better positive predictive value than criteria from the National Lung Screening Trial (NLST) -- 4% versus 3.4%, P=0.01 -- without a loss of specificity, Martin Tammemagi, PhD, of Brock University in St. Catharines in Ontario, and colleagues reported. (Source: Medpage Today)

    Twitter of the Day

@DrKKAggarwal: Guidelines about Eating Malnutrition and wrong dietary habits have been identified as major risk factors for ill... http://fb.me/1UzlKZM8B

@DrKKAggarwal: What are the three qualities of a charismatic leader? Please watch my #askdeepak video reply http://tinyurl.com/ax3yowd

    Spiritual Update

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

Why is Gayatri Mantra one of the main mantras in any pooja?

A ny activity should always engage the 3H model - of heart, the head, and the hand. The same has been advocated by the western scholars. The concept means that while doing any work one should ask the head for choices, then refer these choices to the heart to choose one and finally order the hands to do the action.

For Comments and archives…

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the benefits of minimally invasive surgery?

An obvious benefit of minimally invasive surgery is that any scars are much smaller than in traditional "open" surgery. A laparoscopy requires one incision below the belly button, then one to three other incisions along the hairline of your lower belly. These incisions are usually 1/4–1/2 inch in length. Hysteroscopy leaves no scar because the instrument goes through the natural opening in the cervix (neck of the womb) from the vagina into the uterus.

After your minimally invasive surgery, you probably will be able to go home within 24 hours. If you have open surgery, you may have to stay in the hospital for 2 to 5 days. With minimally invasive surgery, you can recover at home, and you are less likely to have problems after surgery, such as infection or blood clots in your legs. Because your incisions are smaller, minimally invasive surgery is less painful than open surgery.

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

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



  • Prepared from fresh frozen plasma by collecting the cold insoluble precipitate formed during controlled thawing at +4°C and re-suspending it in 10–20 ml plasma.
  • Contains about half of the factor VIII and fibrinogen in the donated whole blood: e.g. factor VIII; 80–100 IU/pack; fibrinogen: 150–300 mg/pack

For Comments and archives…

    An Inspirational Story

Moment of truth

There was a young student-archer who reached such proficiency in his art that he could shoot an arrow into a tree and then cleave that arrow into two with the next shot. He began to boast that he was a greater archer than his guru.

One day his guru, a venerable old man in his 70s, asked the youth to accompany him on a trip across the hills. The journey was uneventful until they came to a deep chasm.

A single log spanned the chasm. The guru walked down to the centre of the log, unshouldered his bow and taking an arrow shot it into a tree on the other side. His next shot cleaved the first arrow into two.

"Now it's your turn," he said, walking back to where his student was standing.

The youth stepped gingerly on the log and very slowly and carefully made his way to the middle. But his heart was in his mouth. He knew that if he lost his footing, he would plunge to his death. His hands trembled as he strung an arrow into his bow. Preoccupied with the danger he was in, he found it hard to focus on the target. Consequently when he let go of the arrow, it missed the tree altogether.
Whimpering, he turned around.
"Help me!" he shouted to his guru. "I'll fall!"

The old man walked up to him, took his hand and stepping backwards led him to safety. Neither of them said a word on the return journey but the boy had much to think about.

He had realized that to be a master of his art it was not enough to know how to control the bow; he had to learn how to control his mind too.

For comments and archives

   Cardiology eMedinewS

Stem cell 'homing' signal may help treat heart failure patients Read More

Microbubbles improve myocardial remodelling after infarction Read More

   Pedia News

Kids with ADHD at increased risk for substance abuse Read More

Bullying scars the adult mind Read More

    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

What are most dangerous sites of bites/exposure in man?

Theoretically, the richly innervated areas like head, neck, face, hands and genitals are the most dangerous sites of bite in man. But practically, it is often the wounds on legs, which are ignored/neglected, that cause rabies.

    IJCP Special

Dr Good Dr Bad

Situation: An elderly male had reduced sleep efficiency.
Dr Bad: Take a sleeping pill.
Dr Good: Get diabetes ruled out.
Lesson: Sleep duration is a risk factor for the development of diabetes in middle–aged and elderly men. Both short (< 5–6 hours of sleep per night) and long (>8 hours of sleep per night) sleep durations were associated with an increased incidence of diabetes (Diabetes Care 2006;29:657–61).

Make Sure

Situation: A patient with platelet counts of 72000 after coronary stent developed stent thrombosis.
Reaction: Oh my God! Why was clopidogrel not given?
Lesson: Make sure all patients with platelet counts of more than 30000 are not denied clopidogrel.

  Quote of the Day (Dr GM Singh)

We are what we think. All that we are arises with our thoughts. With our thoughts, we make the world. Buddha

    Mind Teaser

Read this…………………

Which medication is the best choice to treat breakthrough pain for a patient who is currently receiving methadone (Dolophine), 10 mg, every 8 hours?

A. Methadone (Dolophine)
B. Immediate release morphine (MS IR)
C. Sustained release morphine (MS Contin)
D. Transdermal fentanyl (Duragesic)

Yesterday’s Mind Teaser: A 73-year-old male patient with cancer is in the hospital for pain control and rates his pain as a 12 on a numeric pain rating scale of 0 to10. Thirty minutes after administering IV pain medication, the patient reports no pain relief. The pain management nurse calls the physician for additional orders for pain medication. The nurse's actions demonstrate:

A. analgesic titration
B. empathy
C. independence
D. patient advocacy

Answer for Yesterday’s Mind Teaser: d. patient advocacy

Correct answers received from: Dr KV Sarma, Dr K Raju, Dr Thakor Hitendrsinh G, Dr PC Das, Dr Arpan Gandhi, Dr Bharat Bhushan Aggarwal,
Dr (Maj. Gen.) Anil Bairaria, Dr Jainendra Upadhyay, Dr Pankaj Agarwal,
Dr Avtar Krishan, Dr Gracy Thomas, Dr Chandresh Jardosh, Dr Kanta Jain.

Answer for 24th February Mind Teaser: c. Guided imagery

Correct answers received from: Dr Kanta Jain.

Send your answer to ijcp12@gmail.com

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    Laugh a While (Dr GM Singh)

New hearing aid

Seems an elderly gentleman had serious hearing problems for a number of years.

He went to the doctor and the doctor was able to have him fitted for a set of hearing aids that allowed the gentleman to hear 100%.

The elderly gentleman went back in a month to the doctor and the doctor said, "Your hearing is perfect. Your family must be really pleased that you can hear again."

To which the gentleman said, "Oh, I haven't told my family yet. I just sit around and listen to the conversations. I've changed my will three times!"

  Medicolegal Update

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

What is the Native American Graves Protection and Repatriation Act 1990?

Doctors and scientists have long sought to understand life in early civilizations through the excavation of burial grounds and exhumation of human remains. In the United States, the attempt to understand early cultures led to the exhumation of the remains of Native Americans, many of which ended up in the nation’s museums and archaeology labs. In an attempt to prevent the desecration of Native American graves, the Native American Graves Protection and Repatriation Act was introduced in Congress in July 1990 and subsequently passed into law.

  • The bill states that any human remains and objects found on federal or tribal lands after the date of enactment are to be considered owned or controlled by lineal descendants, the tribe on whose land it was found, the tribe having the closest cultural affiliation, or the tribe which aboriginals occupied the area. Anyone who discovers items covered by the bill must cease his or her activity, notify the federal land manager responsible and the appropriate tribe, and make a reasonable effort to protect the items.
  • Anyone who violates the provisions of the bill may be fined, imprisoned not more than one year, or both. The penalty may increase to five years for a second violation.
  • The act further states that all federal agencies and museums receiving federal funds that have control over any of the items covered in the bill are to, within five years, inventory and identify the items, notify the affected tribes, and make arrangements to return such items if the appropriate tribe made a request. If an item was acquired with the consent of the tribe or if the item was part of a scientific study which was expected to be of major benefit to the country, the request for repatriation (i.e., return) could be denied.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Growing young is feasible

We all want our kidneys to last for a lifetime. We all should show our love for kidneys by adopting a 10-step program for protecting kidney health, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

One should begin with monitoring blood pressure and controlling weight and then move on to the rest of the kidney-healthy tips.

  1. Monitor blood pressure and cholesterol.
  2. Control weight.
  3. Don't overuse over-the-counter painkillers.
  4. Monitor blood glucose.
  5. Get an annual physical exam.
  6. Know if chronic kidney disease (CKD), diabetes or heart disease runs in your family. If so, you may be at risk.
  7. Don't smoke.
  8. Exercise regularly.
  9. Follow a healthy diet.
  10. Get tested for chronic kidney disease if you're at risk.
    Readers Response
  1. Dear Sir reading emedinews is very useful. Regards: Dr Jyoti
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