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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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26th April 2013, Friday

Diagnosis of hypertension in childhood requires repeated BP measurements

One needs to confirm presence of hypertension based on three blood pressure measurements at separate clinical visits.

Normative BP percentiles are based upon data on gender, age, height, and blood pressure measurements from the National Health and Nutrition Examination Survey and other population-based studies.

In a study initial BP measurement was normal (below the 90th percentile), pre-hypertensive (systolic or diastolic BP between the 90th or 95th percentile) and hypertensive (systolic or diastolic BP =95th percentile) in 82, 13, and 5 percent of children.

At follow-up, subsequent hypertensive measurements were observed in only 4 percent of the 10,848 children who had initial hypertensive values. In the cohort, the overall prevalence of hypertension was 0.3 percent.

Source: Lo JC, Sinaiko A, Chandra M, et al. Prehypertension and hypertension in community-based pediatric practice. Pediatrics 2013; 131:e415.

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Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Weight loss may improve sexual health of obese diabetes

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day 2013

Heart Care Foundation of India and World Fellowship of Religions in association with Ministry of Earth Sciences Govt. of India and Delhi Public School Mathura Road observed World Earth Day 2013.

Dr K K Aggarwal
    National News

2,644 died during clinical trial of drugs in 7 years: Govt to SC

As many as 2,644 people, called subjects, died during the clinical trials of 475 new drugs on human beings in last seven years and only 17 of the medicines were approved for marketing in India, the Centre has informed the Supreme Court.

Responding to allegations by NGO, Swasthya Adhikar Manch, in its PIL that Indians were used as guinea pigs by foreign pharmaceutical majors for human trial of their new drugs, the Union health and family welfare ministry said of the 57,303 enrolled subjects, 39,022 completed the clinical trials.

"Serious adverse events of deaths during the clinical trials during the said period were 2,644, out of which 80 deaths were found to be attributable to the clinical trials," health secretary Keshav Desiraju said in an affidavit on behalf of the ministry of health and family welfare.

"Around 11,972 serious adverse events (excluding death) were reported during the period from January 1, 2005 to June 30, 2012, out of which 506 events were found to be related to clinical trials," he said.

The secretary promised to the court for stringent regime on clinical trials on the recommendations of the Parliamentary Standing Committee, which faulted the Drugs and Cosmetics (Amendment) Bill, 2007.

Source: The Times of India 25th April

For comments and archives

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, every Thursday 4:30 PM in DD India

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)


Child Maltreatment

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Child neglect
  1. Child maltreatment is intentional harm or threat of harm to a child by a person who is acting in the role of caretaker.
  2. Four categories of child maltreatment

For comments and archives

    Valvular Heart Disease Update

Underlying atherosclerosis

The presence of underlying coronary or aortic atherosclerosis affects the treatment and outcome of elderly patients in whom surgery is considered for valvular disease. The 2006 ACC/AHA and the 2007 European Society of Cardiology guidelines on the management of valvular heart disease included recommendations for coronary angiography in patients undergoing valve surgery, which would include all elderly patients.

(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)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

PML Reported in Europe with Fumarate

April 24, 2013

Two cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients treated with oral dimethyl fumarate, a form of which won FDA approval last month for multiple sclerosis.

For comments and archives

"THE CRIMINAL LAW (AMENDMENT) ACT, 2013", which came into force on 3 Feb 2013

Section 376 stands modified as follows:

376. (1) Whoever, except in the cases provided for in sub-section (2), commits rape, shall be punished with rigorous imprisonment of either description for a term which shall not be less than seven years, but which may extend to imprisonment for life, and shall also be liable to fine.

For comments and archives

Lifestyle advice at school not enough for CVD prevention

School-based counseling about a healthy lifestyle improved fitness and a decrease in leptin levels according to a study presented at the European Association for Cardiovascular Prevention and Rehabilitation's EuroPRevent meeting. But there no change in adiponectin or high sensitivity C-reactive protein (hsCRP). All three cardiovascular risk markers improved in children who reduced their body weight. (Source: Medpage Today)

For comments and archives

HAART has beneficial effects on heart in children with HIV

Highly active antiretroviral therapy (HAART) was found to preserve cardiac function in children and adolescents infected with HIV in a new study. (Source: Medpage Today)

For comments and archives

   Twitter of the Day

@DrKKAggarwal: Gums bacteria can cause preterm delivery http://bit.ly/XYE3kP #Health

@DeepakChopra: Is it alright to use music to meditate or is silence more effective? Please read my #askdeepak reply http://tinyurl.com/cecgq4r

    Spiritual Update

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

Why do we Place our hands over the flame?

F lame is the “flame” of true knowledge. At the end of any aarti, we place our hands over the flame and then touch our eyes and the top of the head. It means – “May the light that illuminated the Lord light up my vision; May my vision be divine and my thoughts noble and beautiful.”

For comments and archives

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

What percentage IVF cycles gets cancelled prior to egg retrieval and why?

According to western figures 20% of cycles may be cancelled prior to egg retrieval. IVF cycles may be cancelled for a variety of reasons, usually due to an inadequate number of follicles developing. Cancellation rates due to low response to the ovulation drugs increase with a woman’s age, especially after age 35. a cycle may be cancelled to reduce the risk of ovarian hyperstimulation syndrome (OHSS). Treatment with a GnRH agonist or antagonist reduces the possibility of premature LH surges from the pituitary gland, and thereby reduces the risk of premature ovulation.

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

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

Blood group antibodies

These are plasma proteins which are produced by the body as defense mechanism in response to exposure to a foreign antigen.

  • Primary response
    • the first time a person is exposed to a red cell antigen
    • slow response which takes 2 - 6 month
  • Secondary response
    • the second time a person is exposed to a red cell antigen
    • rapid response with large amount of antibody
    • binds to the corresponding antigens on red blood cells, which may cause destruction of the RBCs.
    • can only be recognized by their interaction with antigens
    • appear “naturally” e.g. anti-A and anti-B.
    • appear after exposure to incompatible blood e.g. anti-D and anti-K

For comments and archives

   An Inspirational Story

Student Counting Apples

A teacher teaching Maths to seven-year-old Laiq asked him, “If I give you one apple and one apple and one apple, how many apples will you have?” Within a few seconds Laiq replied confidently, “Four!”

The dismayed teacher was expecting an effortless correct answer, three. She was disappointed. “Maybe the child did not listen properly.” – she thought.

She repeated, “Laiq, listen carefully. If I give you one apple and one apple and one apple, how many apples will you have?”

Laiq had seen the disappointment on his teacher’s face. He calculated again on his fingers. But within him he was also searching for the answer that will make the teacher happy. His search for the answer was not for the correct one, but the one that will make his teacher happy.

This time hesitatingly he replied, “Four.”

The disappointment stayed on the teacher’s face. She remembered that Laiq liked strawberries. She thought maybe he doesn’t like apples and that is making him loose focus.

This time with an exaggerated excitement and twinkling in her eyes she asked, “If I give you one strawberry and one strawberry and one strawberry, then how many you will have?”

Seeing the teacher happy, young Laiq calculated on his fingers again. There was no pressure on him, but a little on the teacher. She wanted her new approach to succeed. With a hesitating smile young Laiq replied, “Three?”

The teacher now had a victorious smile. Her approach had succeeded. She wanted to congratulate herself. But one last thing remained. Once again she asked him, “Now if I give you one apple and one apple and one more apple how many will you have?”

Promptly Laiq answered, “Four!”

The teacher was aghast. “How Laiq, how?” she demanded in a little stern and irritated voice. In a voice that was low and hesitating young Laiq replied, “Because I already have one apple in my bag.”

When someone gives you an answer that is different from what you expect, don’t think they are wrong. There shall be an angle that you may not have thought about yet.

For comments and archives

   Cardiology eMedinewS

AMA introduces diabetes, heart disease programs Read More

   Pediatric eMedinewS

Lifestyle advice at school not enough for CVD prevention 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)

Is there any dietary restriction during PEP?

It is advisable to abstain from alcoholic drinks during the course of rabies vaccination as it may affect the immune response.

    IJCP Special

Dr Good Dr Bad

Situation: An adolescent came with pre pubertal gynecomastia of more than six months duration.
Dr Bad: It’s normal.
Dr Good: This is persistent prepubertal gynecomastia.
Lesson: If the patient is an adolescent and has a normal general physical and genital examination, then it is quite likely that he has pubertal gynecomastia (seen in 25% cases). Re–evaluation at 6–monthly intervals will show whether the condition is persistent or not; improvement supports the initial impression of a pubertal cause.

Make Sure

Situation: An adult undergoing bronchoscopic biopsy developed infective endocarditis.
Reaction: Oh my God! Why was IE prophylaxis not given?
Lesson: Make sure, that all procedures of the respiratory tract that involve incision or biopsy of the respiratory mucosa include IE prophylaxis.

  Quote of the Day (Dr GM Singh)

It is wise to direct your anger towards problems – not people; to focus your energies on answers – not excuses. William Ward

    Mind Teaser

Read this…………………

The nurse is aware that the following findings would be further evidence of a urethral injury in a male client during rectal examination?

a. A low-riding prostate
b. The presence of a boggy mass
c. Absent sphincter tone
d. A positive Hemoccult

Yesterday’s Mind Teaser: Nurse Lei is aware that one of the following is an early sign of heart failure in an infant with a congenital heart defect?

a. Tachypnea
b. Tachycardia
c. Poor weight gain
d. Pulmonary edema

Answer for yesterday’s Mind Teaser: b. Tachycardia

Correct answers received from: Tukaram Pagad, Dr Jella, Dr Pavan Kumar, Dr Jayashree Sen & Dr Bitaan Sen, Dr Kanta Jain, Dr BB Gupta, Dr (Maj. Gen.) Anil Bairaria, Dr KV Sarma, Dr Pankaj Agarwal, Dr Valluri Ramarao,
Dr Nageswara Rao Patnala, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Dr U Gaur, Dr Santha Kumari, Dr Ayyavoo, Dr Thakor Hitendrsinh G, Dr K Raju, Muthumperumal Thirumalpillai, Dr Avtar Krishan.

Answer for 24th April Mind Teaser: d. Maintaining a consistent, structured environment

Correct answers received from: Dr U Gaur, Dr Santha KumariI, D Ayyavoo, Dr Thakor Hitendrsinh G, Dr K Raju, Muthumperumal Thirumalpillai, Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

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    Laugh a While (Dr GM Singh)

The reluctant spender

After being away on business, Tim thought it would be nice to bring his wife a little gift. "How about some perfume?" he asked the cosmetics clerk. She showed him a Rs 50.00 bottle. "That’s a bit much," said Tim, so she returned with a smaller bottle for Rs 30.00.

"That’s still quite a bit," Tim complained. Growing annoyed, the clerk brought out a tiny Rs 15.00 bottle.

"What I mean," said Tim, "is I’d like to see something really cheap."

So the clerk handed him a mirror.

    Medicolegal Update

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

Doctor is neither a detective nor a curtain between injured/sick alleged criminal and police or judiciary.

  • The primary and absolutely transparent duty of a doctor/hospital is to provide medical services to sick and injured patient may be an alleged criminal to save his health/limb and life without any discrimination.
  • When the medical care records is required for judicial/police investigation the records becomes medico–legal in nature and the same may be required to testify under oath in the court of law by treating doctor.
  • The doctor should acquire the habit of making a careful note of all the facts observed by him with exact time and date.
  • The doctor should examine the facts which come to his knowledge in his special medical man capacity, draw his conclusions logically and correctly after a detailed consideration of the pros and cons of the case, and elaborate in the Court that interpretation, along with the medical grounds on which it is based.
  • Presumption is not proof, and conjecture is not evidence. The Court has no special medical knowledge. It relies on medical witness for an opinion and expects him to assist it with his special knowledge and experience in perusal of truth.
  • Presumption, assumption hypothesis, and mere conclusion on self defined interpretation is not a proof, and conjecture is not evidence

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Curtain Raiser Two days stress management workshop at Manesar at Om Shanti Retreat centre

10th National Workshop on Stress Management is being organized by Heart Care Foundation of India jointly with Prajapati Brahmkumaris Eishwarya Vidyalaya at Om Shanti Retreat Centre on 27th and 28th April 2013. Over 200 doctors and their families will be participating in the workshop.

Giving the details, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Vice Chairman World Fellowship of Religions said that stress it he reaction of the body and the mind to the interpretation of a known situation.

The charity begins at home. Doctors should not only teach their patients stress management but also reduce their own stressed life. Doctors on an average sacrifice 10 years of their life to reduce the stress of others.

Chief Guest for the function will be Mr. Rakesh Mehta, IAS, Election Commissioner of Delhi. The workshop will be conducted by Dr. KK Aggarwal, BK Brij Mohanji, BK Asha and BK Sapna.

    Readers Response
  1. Dear Sir, Emedinews is very informative. Regards: Dr Priya
    Forthcoming Events
Dr K K Aggarwal

10th National Summit on Stress Management and
Workshop on How to be Happy and Healthy


Saturday 27th April 2013

2.00pm – 4.00pm                                      : Registration
4.00pm – 4.30pm                                      : TEA
4.30pm – 5.30pm                                      : Dr. K.K.Aggarwal
5.30pm–6.30pm                                        : Inauguration
6.30pm–8.00pm                                        : Brahma Kumaris
8.00pm – 8.30pm                                      : DINNER
8.30pm – 10.00pm                                    : Dr. K K Aggarwal Sunday

28th April 2013

7.00am–8.30am                                      : Meditation Session
8.30am–9.00am                                      : BREAKFAST
9.00am–11.00am                                    : Dr. K.K.Aggarwal
11.00am–11.30am                                   : TEA BREAK
11.30am–1.00pm                                    : Brahma Kumaris
1.00pm–1.30pm                                      : Prasad and Blessings
1.30pm–2.00pm                                      : LUNCH Farewell for a New Beginning

Dr K K Aggarwal
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