26th November 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

Women above 65 to Take Extra Care Of Their Health

  • Women aged 65 and above should take low dose aspirin routinely to prevent heart attack and paralysis.
  • All women are urged to exercise a minimum of 30 minutes per day, but women who need to lose weight or maintain weight loss are now advised to engage in 60 to 90 minutes of moderate-intensity activity on most, or preferably all, days of the week.
  • A heart-healthy diet should be rich in fruits, whole grains and fiber foods with a limited intake of alcohol and sodium.
  • Saturated fat should be reduced to less than 7 percent of calories.
  • Women at very high risk for heart disease should try to lower their LDL ("bad") cholesterol to less than 70 mg/dL.
  • Women aged 65 and over should consider taking low-dose aspirin on a routine basis, regardless of their risk. Aspirin has been shown to prevent both heart attacks and stroke in this age group.
  • The upper dose of aspirin for high-risk women is 325 mg per day.
  • Hormone replacement therapy, selective estrogen receptor modulators or antioxidant supplements such as vitamins C and E should be used to prevent heart disease.
  • Folic acid should also not be used to prevent cardiovascular disease.
  • Women should eat oily fish or some other source of omega-3 fatty acids at least twice a week.
  • Women should not only quit smoking but should use counseling, nicotine replacement or other forms of smoking cessation therapy.

News Around The Globe

  • An experimental drug showed promising results and potential problems in treating a common liver disease. More research will be needed to determine the drug’s long-term safety and effectiveness. Currently, there are no specific therapies for NASH. Management typically includes losing weight, eating a healthy diet, increasing physical activity, and avoiding alcohol. NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) launched a large clinical trial to test the effectiveness of a modified bile acid called obeticholic acid (OCA) for treating NASH. Natural bile acids affect metabolism and insulin sensitivity, and are used by the body to help with digestion. The study enrolled 283 adults diagnosed with NASH at 8 medical centers across the country. Participants were randomly assigned to take 25 milligrams of OCA daily or a placebo pill. Results appeared online on November 6, 2014, in the Lancet.
  • Being overweight or obese is associated with poorer brain health in cognitively healthy adults in their 60s, according to new data from the long-running Australian PATH Through Life Study.
  • A report published online November 19 in the journal Neurology suggests that people who have complex jobs that require working with data, such as architects and engineers, or with other people, such as social workers and lawyers, may have better memory and thinking abilities in later life than their peers in less complex jobs.
  • Applying external pressure to the perineum in conjunction with standard constipation treatment can improve bowel function and quality of life for people suffering from the common digestive condition. In a randomized trial of 91 patients published online November 18 in the Journal of General Internal Medicine, the self-acupressure technique improved constipation symptoms at 4 weeks in 72% of the patients randomly assigned to the treatment.
  • According to the new recommendations from the US Preventive Services Task Force (USPSTF), there simply is no evidence on the specific pros and cons of screening for vitamin D deficiency, so routine screening cannot be advised at the current time. The USPSTF has issued its first-ever guidance on the routine screening of asymptomatic patients for vitamin D deficiency. The recommendation is now final following the issue of draft guidance in June.

IMA News

  • Indian Medical Association was shocked to see the Medical Termination of Pregnancy (Amendment) Draft Bill which allows Ayurvedacharyas, Homeopaths and Nurses to conduct MTP which is highly objectionable.

    IMA strongly opposed this proposal of the Government. We have written letters to the Hon’ble Prime Minister of India and met Union Health Minister of India to kindly withdraw this proposal in the interest of the safety of the general public.

    A meeting of IMA along with Delhi Gynaecologist Forum was held on 7th November, 2014 at IMA house, New Delhi where the amendments were unanimously opposed by one and all.

    In continuation of the same, a meeting of the IMA & FOGSI was held today at IMA House, New Delhi. The minutes of the same are being sent to you for your information:

    The following members were present:-
    1. Dr. Narendra Saini, Hony. Secretary General, IMA
    2. Dr. D.R. Rai, Past Hony. Secretary General, IMA
    3. Dr. K.K. Aggarwal, Sr. National Vice President, IMA
    4. Dr. Suchitra Pandit, President, FOGSI
    5. Dr. Nozer K. Sheriar, Secretary General, FOGSI
    6. Dr. Jaydeep Tank, Treasurer, FOGSI
    7. Dr. Anil Goyal, President, DMA
    8. Dr. Ajay Lekhi, President-Elect, DMA
    9. Dr. Sharda Jain, Convenor, MTP Issues-2014
  • Although all participants were unanimously of the view that IMA & FOGSI will work together for safety of women’s health in providing safe abortion services – the two Organizations felt to give pie importance to the safety of medical professionals as well in today’s time.

    The following points were finalized during the meeting: -
    1. MTP to be done by all registered medical practitioners only i.e. all trained qualified MBBS Doctors only as in the MTP law.
    2. MTP may be extended up to 24 weeks of gestation in vulnerable women as in the new amendment 2014.
    3. To increase the number of providers, MEDICAL ABORTION can be done by all MBBS doctors after training.
    4. All public medical services (Govt./Private/Army hospital) should also be involved for rendering safe MTP Services as per the law of the land.

      Finally, it was decided that IMA & FOGSI will prepare the proposal of their respective organizations on these lines and will submit the same for final submission to the Govt. i.e. Ministry of Health & Family Welfare
  • Marthanda Pillai, All-India President of the Indian Medical Association (IMA), has said that the practice of medicine is an art. “Communication skill is an important part of medical practice,” he said while addressing doctors attending the continuing medical education (CME) programme — Medcon-2014 — organised by N.C. Cooperative Hospital in association with the Kollam branch of the IMA.
  • The Indian Medical Association is considering writing to the Central government to collect a unit of blood from the first patient of Ebola in the country. This will help fight any case of Ebola in future, said an IMA member. The urine and saliva samples of a 26-year-old man, who is currently under observation at the Airport Health Organisation Quarantine Centre, has tested negative. The samples were tested at the National Centre for Disease Control. “We will be writing to the Centre to persuade the man to donate blood or plasma for a future patient. The World Health Organisation had issued interim guidance for the collection and administration of convalescent whole blood or plasma for treatment of the Ebola Virus Disease (EVD),” said Dr K K Aggarwal, Honorary General Secretary Elect, IMA.
  • Kerala chief minister Oommen Chandy has called a high-level meet on Tuesday after a Bhopal-based laboratory confirmed that the recent mass deaths of ducks in Alapuzha were due to avian influenza or bird flu. “No need for panic. I have called an emergency meet on Tuesday to coordinate various departments. We have also asked Union health ministry to rush enough medicines,” Chandy told HT. Last week, 17,000 ducks perished in water-logged Kuttanad and surrounding areas. The state animal husbandry department has ordered culling of poultry in one-km radius of the affected area to contain the outbreak and started distributing veterinary kits.

66th Annual Conference of Cardiological Society of India (CSI) -2014


Dr KK Spiritual Blog

Thinking Differently

There are three ways to manage stress. One is to think opposite, second is to think different and the third is to think positive.

Thinking opposite was advocated by Patanjali, thinking differently by Adi Shankaracharya and thinking positive by Gautam Buddha. Out of three approaches, the Indian Vedic philosophy focuses on thinking differently. Thinking positive and thinking opposite may not be feasible at the time of any adversity.

Thinking differently has been emphasized in mythology at multiple places. Ten heads of Ravana, five heads of Brahma, elephant head of Lord Ganesha, Fish incarnation of Lord Vishnu and third eye of Lord Shiva remind us of the principle of thinking differently.

We can see or analyze a person or a situation with the eyes of our physical body (physical eye) or eyes of the mind (thinking and analyzing) and eyes of the soul (conscious based decision).

Lord Buddha once said that a good action should be based on truth, should be necessary and bring happiness both for the person doing it and the society.

The 3H principle advocated in the West is also based on the same which means before any action think from your Head and from multiple options available, choose from the Heart and then order the Hands to do the job.

The first incarnation of Lord Vishnu Fish indicates the capacity of swimming against the stream. The third eye of Lord Shiva means thinking from the mind and choosing the right answer from the heart. The ten heads of Ravana and five heads of Brahma also indicate thinking to get multiple options.

The example of thinking differently comes from the dialogue between Urvashi and Arjuna. Once Urvashi in a mind full of Kama went to Arjuna and said “If you are not going give me a son like you today, I am going to give you a curse”. Arjuna was in a dilemma but he thought differently and said – “Why do you want to wait for 25 years to get a son like me from today I am your son: Mother.”

Inspirational Story

Small Victories

Standing in the noisy cafeteria of the old school, I was watching the students line up for lunch. Having wearied of trying to "cut" in line on each other, they were intently moving toward the food. As I continued to watch their progress, I began to remember scenes from my own grade school days. This old school building was somewhat similar to mine.

I could still remember coming into the warm building with the funny smells of furnace heat and cleaning liquids. I visualized the rooms, heated with old-fashioned steam pipe radiators and the hand-turn heat regulators. I could picture the Spartan desks in long straight rows, with scratched and scared surfaces, and the small cloak closets with wood doors folding in along the back of the room.

"Teacher," a small hand tugged my wrist, "I can't eat my lunch," complained a small Asian American boy, standing behind me. My thoughts abruptly returned to the present in the cafeteria of the old school where I was substitute teaching.

"What's wrong?" I replied as I watched the last of the lunch line disappear into the kitchen. "Why not?" I asked as I turned to face the cafeteria at large.

"Jamal and Anthony keep poking at my food. I don't want to eat it!"

Making my way to his lunch table, I took up Lee's cause. I admonished the children, "Keep your hands to yourselves and eat properly!" My repeated warnings went unheeded, and I began to move the children to different spots at the table. To no avail--as soon as Lee sat down, the pestering began again. As the hearty children began finishing their food, I urged Lee to go back to the kitchen to get a second lunch, promising I would speak to the cooks for him. When I went out to playground duty, he was still sitting in front of his second tray, picking at the food. I tried not to worry about the thin child because I remembered that I had not always eaten my cafeteria lunches and I survived.

I substituted frequently at this school, and in a few weeks, I was back in Lee's small class. Both the teacher and the assistant were absent. The children in this room had some learning difficulties, and each child had different instructions and activities. I soon realized that Lee had a problem with staying on task and with anger. As I moved through the room, I stopped by each child to check on progress and to help with work. Lee was working with educational coloring sheets, and I let him work on his pictures in sequence rather than finishing one at a time. Doing a part of each until all were completed seemed to suit his temperament. He began to smile as if he and I shared a huge joke.

This time, I did not have lunch duty, so I lined the children up and led them to the cafeteria where another teacher took charge of their progress through the line. I went back to the room to check each child's work again and eat a quick sandwich. In fifteen minutes, Lee was back in the room, unable to eat lunch again, having left the cafeteria without permission. I gave him some money, the cost of an alternate lunch, and walked him down to the cafeteria. At the end of lunch, Lee was back in the room with the young man assigned to the room as psychological counselor. Evidently, a cafeteria supervisor sent him to be counseled about his difficulties with eating.

Slowly, with shyness and pride, he handed me my money back and told me what he and the counselor had rehearsed. "Thank you, Mrs. Grishan (his pronunciation), but my mom and dad will not let me accept money. They provide my food."

I smiled, accepted the money, and watched Lee go with the counselor for further discussion. When he returned, the counselor stayed with him to keep him sweet and on task.

Later in the year, I was back at the same school to substitute with a large fourth grade class for a week. The day I had lunch duty, I noticed as I glanced quickly around the cafeteria that Lee's table was at peace. They were eating quietly and were not teasing each other. Lee was eating too, and as he looked at me intensely, I glanced away because I did not want to interfere with his concentration on his food. I know, though, that I was smiling, and my heart was singing. I thought of the phrase, "all the little children of the world, brown and yellow, black and white," and these precious children were all getting along just fine. I knew that major work by persistent teachers, a dedicated counselor, fine administrators, and parents willing to partner with the school had wrought a change in the life of these troubled children.

emedipicstoday emedipics

21st Perfect Health Mela 18th October 2014



press release

Longer CPR efforts may improve survival chances

video of day

Other Blogs

Video Library

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 acute pulmonary edema had a blood pressure of 240/140.
Dr. Bad: It is due to heart damage.
Dr. Good: It is due to diastolic heart failure.
Lesson: Patients with significant elevation of blood pressure have mostly preserved left ventricular systolic function.

Make Sure

Situation: A patient with chest pain with normal ECG died half an hour later.
Reaction: Oh my God! Why was an acute MI not suspected?
Lesson: Make sure all patients of chest pain are observed for 12 hours. ECG can be normal in acute heart attack for up to six hours.

eMedinewS Humor

Santa calls up the doc at 2 AM. "Doc, my wife is having severe abdomen pain. I think it's her appendix."

"What nonsense!" says the doc sleepily.

"I took out your wife's appendix two years ago. Go back to sleep."

Five minutes later, the phone rings and it's Santa again.

"Doc, I'm sure it's her appendix."

"Oh God!" the doctor groaned.

"Did you ever hear of anyone having a second appendix?"

"No...," says Santa. "But I'm sure you must have heard of someone having a second wife!!!!"

Twitter of the Day

Dr KK Aggarwal: Eat less to live more
Dr Deepak Chopra: 12 step programs may not always be the answer for people whose lives are being damaged by alcoholism

Rabies News (Dr A K Gupta)

Can a person receiving/completed antirabies immunization, either pre–exposure or post–exposure, donate blood?

A person receiving/completed antirabies immunization can donate blood. However, the recipient does not benefit from the transfer of rabies–neutralizing antibodies due to hemodilution.

Cardiology eMedinewS

  • Results of the investigator-initiated BASKET PROspective Validation Examination II (BASKET-PROVE II) showed that, in an intention-to-treat analysis, the biolimus-eluting stent was as effective as second-generation durable-polymer stents, and was superior to bare metal stents, said Christoph Kaiser, MD, professor of medicine at University Hospital Basel, Switzerland. When the hypertension treatment recommendations from panel members appointed to the Eight Joint National Committee (commonly but unofficially known as JNC 8) controversially shifted the blood pressure treatment goal from 140/90 mm Hg to 150/90 mm Hg for patients ages 60 and older without diabetes or chronic kidney disease, it reclassified one in seven people seen at cardiology clinics for hypertension into being "at goal." However, among those 14.6%, nearly a quarter had a prior stroke or transient ischemic attack, and 65% had coronary artery disease, found William B. Borden, MD, of George Washington University, Washington, D.C., and colleagues.
  • Results of the Air Versus Oxygen in ST-Elevation Myocardial Infarction (AVOID) trial suggest supplemental oxygen therapy in patients with ST-elevation MI (STEMI) may actually be harmful for patients who are not hypoxic. The trial compared supplemental oxygen vs no oxygen unless O2 fell below 94%. Dr Dion Stub (St Paul's Hospital, Vancouver, BC, and the Baker IDI Heart and Diabetes Institute, Melbourne, Australia, said, “The AVOID study found that in patients with ST-elevation myocardial infarction who were not hypoxic, there was this suggestion that, potentially, oxygen is increasing myocardial injury, recurrent myocardial infarction, and major cardiac arrhythmia and may be associated with greater infarct size at 6 months.”

Pediatrics eMedinewS

  • Infant exposure to peanut traces in house dust may double the risk for peanut allergy, researchers have found. In a new study, published online November 18 in the Journal of Allergy and Clinical Immunology, environmental peanut exposure increased likely peanut allergy 2.10-fold (95% confidence interval (CI), 1.20-fold to 3.67-fold; P < .01). It also increased the odds of peanut skin prick test (SPT) sensitization (1.71-fold; 95% CI, 1.13-fold to 2.59-fold; P = .01).
  • Children between the ages of 6 and 18 years with immune deficiency disorders and other high-risk conditions should receive a single dose of PCV13, according to a new recommendation from the American Association of Pediatrics (AAP) published in the December issue of Pediatrics. The AAP recommends that children in this age group with HIV, sickle-cell disease, cerebrospinal fluid leaks, or cochlear implants receive the pneumococcal conjugate vaccine PCV13 if they have not previously received it. They should receive this dose of PCV13 regardless of whether they have received PCV7 or PPSV23 in the past. In addition, if these children have not previously been vaccinated with the pneumococcal polysaccharide vaccine PPSV23, they should receive a dose of this vaccine no less than 8 weeks after their dose of PCV13.

Quote of the Day

  • Assumptions are the termites of relationships. Henry Winkler

Wellness Blog

Avoid Drunk or Drugged Driving

The dangers of drinking alcohol and driving are well known to all. But, it is also important to recognize that taking drugs and driving too can be as dangerous. Drugged driving or driving under the influence of any drug that acts on the brain can adversely affect your, vision, reaction time and judgment and driving skills. This not only endangers your life but also of your co-passengers as well as others on the road.

Tips for safe driving

  • All through the year, especially during the holiday season, take steps to make sure that you and everyone you celebrate with avoid driving under the influence of alcohol or other drugs.
  • Always designate a non-drinking driver before any holiday party or celebration begins.
  • Arrange for someone to pick you up
  • Do not let a friend drive if you think that they are impaired. Take the car keys.
  • Stay overnight at your friend’s place, if possible and drive back home in the morning.

ePress Release

Reduce weight first if facing infertility problem

Both obese men and women can face fertility problems unless they reduce their weight. Reducing weight as the first step can bring back their fertility, 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

  1. Obese men are more than three times as likely to have low sperm counts compared with their normal-weight peers. A study published in the journal Fertility and Sterility showed that the heaviest men has three times higher risk of having a low count of progressively motile sperms -- sperms that swim forward in a straight line.
  2. Increased body fat can also contribute to lower testosterone levels and higher estrogen levels.
  3. Obese men were also 1.6 times more likely than overweight or normal-weight men to have a high percentage of abnormally shaped sperm.
  4. There is a trend toward increasing likelihood of erectile dysfunction with increasing BMI.
  5. Obesity is associated with a greater risk of impotence.
  6. Obesity is also associated with metabolic syndrome and polycystic ovarian disease (PCOD) in women and associated infertility.

eMedi Quiz

Which of the heart valve is most likely to be involved by infective endocarditis following a septic abortion?

1. Aortic valve.
2. Tricuspid valve.
3. Pulmonary valve.
4. Mitral valve.

Yesterday’s Mind Teaser: A 2-month-old baby with acute icteric viral hepatitis like illness slips into encephalopathy after 48 hours. The mother is a known hepatitis B carrier. Mother's hepatitis B virus serological profile is most likely to be:

1. HBsAg positive only.
2. HbsAg and HBeAg positive.
3. HBsAg and HBe antibody positive.
4. HBV DNA positive.

Answer for yesterday’s Mind Teaser: 2. HbsAg and HBeAg positive.

Correct answers received from: Dr K V Sarma, Dr Avtar Krishan, Arvind Diwaker, Dr Rakesh Sharma.

Answer for 23rd November Mind Teaser: 3. Presence of food enhances the absorption of hydrochlorothiazide.

Correct answers received from: Dr Poonam Chablani, Dr Avtar Krishan, Dr Rakesh Sharma, Raju Kuppusamym, Dr K V Sarma.

Send your answer to email

medicolegal update
  1. Dear Sir, emedinews is very informative. Regards: Dr Suraj

eMedinewS Special

1. IJCP’s ejournals (This may take a few minues to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)