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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

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos…

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

27th February 2013, Wednesday

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

Yes if

  1. Why only four years and two terms? Why is this clause not for Members of Parliament, Chief Ministers and Prime Ministers?
  2. Why re-registration every 10 years? Why all this against allopathic profession? Re-registration will mean compulsory CME and that would mean start of paid costly CMEs in long run, just as in the United States. Why are other medical profession pathies spared?
  3. Medical profession is already included under CPA.
  4. On one hand, it is said that doctors should not advertise, commercialize, or indulge in marketing but they come under the purview of the CPA. Why this double-edged sword against doctors?
  5. The Govt. is coming out with BSc community health courses as parallel to allopathic system. They could have instead strengthened the existing MBBS courses or started MD courses in every rural district or they could have started compulsory 2-year MD Rural Health after MBBS in a rural area.
  6. Why has the Govt. not declared Dr B C Roy National awards for the past many years after 2008?
  7. Why do the powers of removal of the president lie with the government? Can the President of India remove the Prime Minister? It’s the court or the parliament which decides the course of action. Such powers with the government will make the MCI elected body ineffective. In democracy, it is the elected body, which elects the president or the vice president. Only they have the powers to remove them. Removal of office should be the jurisdiction of the Courts and not the government. If such clause is not removed, then the office bearers will never work with freedom but will always be under the pressure of the government.

Dr KK Aggarwal
Group Editor in Chief

For More editorials…

Guest Editorial

(Prof. Dr. S. Arulrhaj, Chairman, Commonwealth Health Professions Alliance, UK, Founder & Chairman, ’ARULS Groups’, Chairman & Head Acute Medicine, Sundaram Arulrhaj Hospitals, Tamil Nadu, India)

Proposed Amendment to MCI Act is a step to make an Office of MOH

1. Tenure can be restricted to nominated members But not to elected members. It will be violation of Human right.
2. Rights to remove the Pres or other elected office bearers is undemocratic. Only the Forum that has elected them will have the right to remove or let the IPC prevail. This is against an Autonomous MCI.
3. Reregistration is a laudable idea being awaited by Medical Prof for a long time but must be suitably coupled with CME credit hours.
4. Transparency is the issue for which we are beating around the Bush. Increasing the number of elected members to one per 10,000 registered members & permitting representations to largest professional organizations is the sure way to have a Transparent & Autonomous MCI which is the need of the hour for India.

    Constipation Update

How does chronic constipation affect quality of life for a patient?

Chronic constipation has been associated with considerable impairment in quality of life as it can be physically and mentally troublesome for many patients, and can significantly interfere with their daily living and well-being. Individuals with constipation have higher medical care (outpatient and emergency) use, which leads to large individual healthcare costs, and represents a burden to healthcare delivery systems.

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

AHA – ACS update new–2

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Multi-specialty camp in East Delhi

A multispecialty camp organized by Heart Care Foundation of India in association with East Delhi Walkers’ Association on 17th February 2013.

Dr K K Aggarwal
    National News

BMC unveils blueprint to tackle TB cases in city

Days after Mayor Sunil Prabhu directed the BMC health department to chalk out a comprehensive strategy to tackle tuberculosis cases in the city, the civic body has come up with an action plan. Additional Municipal commissioner Manisha Mhaiskar, along with members from the World Health Organisation (WHO), National Tuberculosis Institute (NTI), Bangalore, Central TB Division (CTD), Bill and Melinda Gates Foundation and other agencies comprising NGOs and private practitioners declared an 'upscaling' of the existing TB action programme of the BMC. "The BMC started its anti-TB campaign last year after the news of the 'totally' drug resistant strain of the virus was observed. The new blueprint is a more comprehensive and ambitious plan wherein we aim to have universal access to quality TB care in Mumbai. The civic body has invited over 4,000 qualified medical practitioners to be part of its anti-TB programme," said Mhaiskar. The BMC is looking to get five more GeneXperts in the city, which will identify TB within a couple of hours. The state-run J J Hospital is also expected to have a drug susceptibility test (DST) soon after a team from the hospital completes its training at the NTI. The TB scare in Mumbai became a major issue last year when 12 persons were found to be suffering from a strain of the disease wherein the patient is resistant to both first and second lines of treatment. Six patients subsequently succumbed while six others are being treated at the Sewri TB hospital. Soon after, the Centre declared TB as a notifiable disease, which means the even private clinics and hospitals are liable to report all TB cases to government authorities. However, non-compliance from the private sector is a grey area that medical experts in the public sector have been observing. (Source: Indian Express, Feb 26 2013)

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 neglect is an act of omission or commission leading to the denial of a child's basic needs. Neglect can be physical, educational, emotional or psychological.

  • Physical neglect entails denial of food, clothing, appropriate medical care or supervision. It may include abandonment.
  • Educational neglect includes failure to provide appropriate schooling or special educational needs.
  • Psychological neglect includes lack of emotional support and love.

For comments and archives

    Valvular Heart Disease Update

Bicuspid aortic valve

Congenital left ventricular outflow lesions can occur at valvular, subvalvular and supravalvular levels. The most common lesion is bicuspid aortic valve. A congenitally bicuspid aortic valve is present in about 1-2% of the population.

(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)

FDA panel endorses epilepsy device

An implanted neurological device that is intended to reduce the frequency of epileptic seizures gained the unanimous backing of an FDA advisory panel Friday. Members of the Neurological Devices Panel of the Medical Devices Advisory Committee voted 11-0, with two members abstaining, to recommend approving the NeuroPace RNS System. (Source: Medpage Today)

National study: 30% of chemotherapy used off-label

About one third of intravenous chemotherapy is prescribed off-label to cancer patients in the United States, according to a study published online February 19 in the Journal of Clinical Oncology. (Source: Medscape)

Familial high cholesterol may be polygenic

Some cases of familial hypercholesterolemia (FH) may have a polygenic cause, rather than a monogenic one, researchers found. (Source: Medpage Today)

Computer entry for scripts may halve medication error rates

Hospitals that process prescription orders through a computerized provider order entry (CPOE) system likely reduced their medication errors by 48% in 2008¬, according to a new meta-analysis. Given the adoption rate of the new technology by American hospitals, that translates to an estimated 17.4 million medication errors averted that year. (Source: Medscape)

ACIP: Four vaccines added for the next flu season

Four newly approved influenza vaccines were added to the guidance for the 2013-2014 season following a meeting of the Advisory Committee on Immunization Practices (ACIP). At one of the committee's regular meetings at CDC headquarters in Atlanta, ACIP members unanimously approved the addition of two quadrivalent vaccines, a cell culture-based vaccine, and a recombinant hemagglutinin vaccine produced using insect cell cultures. The additions were accompanied by new abbreviations that reflected the increasing variety of vaccine types beyond trivalent inactivated vaccine (TIV) and live-attenuated influenza vaccine (LAIV). (Source: Medpage Today)

    Twitter of the Day

@DrKKAggarwal: Gursharan Singh on Diet and Exercise: http://youtu.be/tLm9GjqzxdE?a via@YouTube

@DrKKAggarwal: Be mindful of how you release your negativity so that it does not reflect back into your reality.

    Spiritual Update

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

Why do we put on Tilak on the forehead?

The Tilak is a mark of auspiciousness and invokes a feeling of respect in the wearer and others. It is recognized as a religious mark. Its form and color vary according to one’s caste, religious sect or the form of worship of the person in question.

Tilak is applied on the forehead with sandal paste, sacred ash or kumkum, a red turmeric powder. In a wedding, a Kumkum tilak is applied on the forehead of both the bride and groom.

For comments and archives

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

What is pelvic adhesion?

Adhesions in and around the pelvic cavity may form if you have endometriosis, a pelvic infection, surgery on your pelvis, a cyst on an ovary, or have had surgery on your pelvis. Scar tissue causes organs that normally are separate from each other to become attached.

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

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

Blood Donation - Gift of Liquid Love

  • The dependence of human source for the reagents will also be reduced if the hybridoma technology is applied for preparation of reagents.
    • Recent advances in medical knowledge have significantly increased the volume and complexity of the work of the hospital blood bank.

For comments and archives

    An Inspirational Story

Arms and legs for others

Bob Butler lost his legs in a 1965 land mine explosion in Vietnam. He returned home a war hero. Twenty years later, he proved once again that heroism comes from the heart.

Butler was working in his garage in a small town in Arizona, USA on a hot summer day; when he heard a woman’s screams coming from a nearby house. He began rolling his wheelchair toward the house but the dense shrubbery wouldn’t allow him access to the back door. So he got out of his chair and started to crawl through the dirt and bushes.

“I had to get there”, he says. “It didn’t matter how much it hurt”. When Butler arrived at the pool there was a three-year-old girl named Stephanie Hanes lying at the bottom. She had been born without arms and had fallen in the water and couldn’t swim. Her mother stood over her baby screaming frantically. Butler dove to the bottom of the pool and brought little Stephanie up to the deck. Her face was blue, she had no pulse and was not breathing.

Butler immediately went to work performing CPR to revive her while Stephanie’s mother telephoned the fire department. She was told the paramedics were already out on a call. Helplessly, she sobbed and hugged Butler’s shoulder.

As Butler continued with his CPR, he calmly reassured her. Don’t worry, he said. “I was her arms to get out of the pool. It’ll be okay. I am now her lungs. Together we can make it”.

Seconds later the little girl coughed, regained consciousness, and began to cry. As they hugged and rejoiced together the mother asked Butler how he knew it would be okay. The truth is, “I didn’t know”, he told her. “But when my legs were blown off in the war, I was all alone in a field. No one was there to help except a little Vietnamese girl. As she struggled to drag me into her village, she whispered in broken English, ‘It okay. You can live. I be your legs. Together we make it’.” Her kind words brought hope to my soul and I wanted to do the same for Stephanie.

There are simply those times when we cannot stand alone. There are those times when we need someone to be our legs, our arms, our friend.

Source: http://academictips.org/blogs/arms-and-legs-for-others/

For comments and archives

    Cardiology eMedinewS

Bad air may worsen post-MI outcomes Read More

Updated ACC use-criteria help, but 30% of echo tests still ordered for inappropriate reasons Read More

    Pediatric eMedinewS

Pediatricians: Watchful waiting best for ear infections Read More

Genetic testing in children: Guidelines updated 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 is the best known clinical feature of rabies?

Hydrophobia and aerophobia are pathognomonic for rabies and occur in 50% of patients. Attempting to drink or having air blown in the face produces severe laryngeal or diaphragmatic spasms and a sensation of asphyxia. This may be related to a violent response of the airway irritant mechanisms. Even the suggestion of drinking may induce hydrophobic spasm. Hydrophobia is typically unique to human beings.

    IJCP Special

Dr Good Dr Bad

Situation: A 63–year–old male with pneumonia had blood urea of 44 mg/dL.
Dr Bad: He needs ICU care.
Dr Good: This can be treated as an outpatient case.
Lesson: Patients with a CURB–65 score of 0 to 1 could probably be treated as outpatients, those with a score of 2 should be admitted to the hospital, and those with a score of 3 or more should be assessed for ICU care, particularly if the score was 4 or 5 (Thorax 2003;58:377–82).

Make Sure

Situation: A diabetic patient’s wound was not healing.
Reaction: Oh my God! Why is his A1c still more than 8?
Lesson: Make sure to control diabetes in such cases. Every 1% increase in hemoglobin A1c was associated with almost a 0.03 cm2 reduction in daily rate of wound resolution.

  Quote of the Day (Dr GM Singh)

Where there is determination there is success.

Think of all that you wanted to achieve in the past few days. Now check if you have achieved it or are still trying for it. Check if you have left anything midway. Pick out one of the things that you wanted to achieve or create an aim for yourself and think, "I am the one who is victorious and I will achieve whatever I set out to. I will not leave any task unfinished."

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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

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    Mind Teaser

Read this…………………

A focused examination for fibromyalgia includes assessment for:

A. Autonomic changes, peripheral neuropathy, and skin fold tenderness
B. Morning fatigue, widespread body pain, and focal tenderness
C. Skin rashes, edema, and constipation
D. Unilateral weakness, hyperesthesia, and allodynia

Yesterday’s Mind Teaser: 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)

Answer for yesterday’s Mind Teaser: b. Immediate release morphine (MS IR)

Correct answers received from: Dr PC Das, Dr KV Sarma, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Tukaram Pagad, Muthumperumal Thirumalpillai, Dr Thakor Hitendrsinh G, Dr Avtar Krishan,
Dr ValluriRamarao.

Answer for 25th February Mind Teaser: d. patient advocacy

Correct answers received from: Dr Chandresh Jardosh Tukaram Pagad, Dr Thakor Hitendrsinh G.

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)


As an instructor in driver education at the local area High School, I’ve learned that even the brightest students can become flustered behind the wheel. One day I had three beginners in the car, each scheduled to drive for 30 minutes. When the first student had completed his time, I asked him to change places with one of the others. Gripping the wheel tightly and staring straight ahead, he asked in a shaky voice, "Should I stop the car first?"

    Medicolegal Update

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

Should a doctor perform CPR in a patient with already injured chest?

When a person needs CPR or cardiopulmonary resuscitation, this means that he/she is unconscious, not moving and not breathing normally. If this is the case, the person is presumably in cardiac arrest or in a state that justifies cardiopulmonary resuscitation.

  • If the person is awake, is breathing normally and therefore does not appear to need CPR, it would be correct that chest compressions and CPR may complicate the already damaged chest and further complicate the victim’s injuries.
  • As soon as the victim becomes unconscious, is not breathing normally and now appears to need CPR, Emergency Services would be contacted and CPR would be initiated regardless of the injuries of the patient.
  • If the person needs CPR, this means that they are clinically dead. If the victim does not receive CPR, they will simply graduate to permanent death.
  • This is why, regardless of the chest injury, if the person is "dead" or in need of CPR, compressions are to be given per the American Heart Association (AHA) guidelines even if the complications could include those of punctured lungs, lacerated organs, or bruised/punctured heart muscle. These injuries must be recorded in clinical sheet.
  • This would be based on the theory that a person in need of CPR is already dead and will not be harmed more even if there are negative side effects from providing chest compressions. If a person remains dead, surgery is not an option but if the person is resuscitated with CPR, and alive at the hospital, we have an opportunity to fix the injuries that may have been aggravated by doing CPR.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Heart patients beware of bhang

Heart patients to avoid bhang or consult cardiologist. Indiscriminate use can increase heart rate and BP. Pretreatment with beta-blocker can help.

Heart patients should not take bhang as it can precipitate an increase in heart rate and sudden rise in blood pressure, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

Those who are socially committed should consult their doctor. Pre-treatment with propranolol a beta blocker can block the cardiovascular effects of marijuana. It can prevent the learning impairment and, to a lesser degree, the characteristic subjective experience.

Marijuana is known to induce typical subjective state ("high") with marked increases in HR, BP and conjunctival infection. It impairs performance on a learning test without significantly affecting attention.

About Bhang

  • Bhang is a traditional Indian beverage made of cannabis mixed with various herbs and spices, which has been popular in India for ages.
  • Bhang is a less powerful preparation than Ganja, which is prepared from flowering plants for smoking and eating.
  • Charas, more potent than either Bhang or Ganja, consists of cannabis flower tops harvested at full bloom.
  • Dense with sticky resin, Charas is nearly as potent as the concentrated cannabis resin preparations called hashish.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 29949 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

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  1. Dear Sir, We enjoy reading emedinews. Regards:Dr Shreya
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