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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; 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 …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1–7
DD Take Care Holistically Video 1–4 Chat with Dr KK On life Style Disorders
Health Update Video 1–15 Science and Spirituality
Obesity–Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

27th August 2012, Monday

Add PCI to Drugs in Stable CAD: for symptomatic relief with no reduction in
MI rates

Adding PCI to optimal medical therapy (OMT) in patients with stable coronary artery disease may give patients a slight edge by alleviating more angina, but it doesn't protecting any better against death or MI.

The latest meta-analysis to grapple with the issue following the 2007 release of the seminal COURAGE trial is published in Circulation: Cardiovascular Interventions.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal on

Women is safe everywhere

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Doctor’s Day 2012

Doctor’s Day celebrations organised by Heart Care Foundation of India and eMedinewS

Dr K K Aggarwal
    National News

Infertility on the rise among Indian men

NEW DELHI: Indian men are facing a queer problem of both reduced sperm count and sub-optimal sperm quality. Union health minister Ghulam Nabi Azad said on Friday that studies are showing that not only is infertility increasing among Indian men, their sperm count and sperm quality too is taking a beating due to "xenobiotics emanating from chemical industries". Doctors from the All India Institute of Medical Sciences (AIIMS) had earlier found that while the sperm count of a normal Indian adult male used to be 60 million per ml around three decades ago, it now stands at around 20 million per ml. The study found that majority of men who were exposed to high temperature at their workplace — welders, dyers, blast furnace workers and those employed in cement and steel factories — were more prone to infertility. This is because the additional environmental heat increases the temperature of the scrotum, causing a negative effect on sperm production. Over 12-18 million couples in India are diagnosed with infertility every year. AIIMS doctors say a one degree elevation in testicular temperature leads to 14% depression of spermatogenesis. Azad said, "The government has taken steps to curb environmental pollution to check this problem." Experts say the normal temperature of the testes is three degrees lesser than the core body temperature (37 degrees Celsius or 98.6 degrees Fahrenheit).

"Not only has quantity of sperm production declined in males across the world, there has been a decrease in motility (Sperm movement) and morphology (shape and structure) of the sperms. There has been a 2% decrease in quality of male sperm annually. Also, 40% men in reproductive age group are presently recording a quantitative and qualitative decline in sperm quality. Stress also decreases the hormones that stimulate spermatogenesis," said Dr Rima Dada from AIIMS. IVF expert Dr Sonia Malik recently conducted a 10-year comparison study on sperm quality and quantity (2000-2001 to 2010-2011) in Southend Fertility and IVF Centre. According to her study, the percentage of semen ejaculation, which is considered less than normal (below 4 ml), increased from 34% to 65% and most suitable ejaculation volume (more than 4ml) went down from 15% to 3%. As far as morphology of sperm was concerned, in 2000-2001, 26% of the sperms showed above 60% normality, whereas in 2000-2011 this was reduced to 7%. Malik said, "Over the past 50 years, expansion of the chemicals has resulted in the release of a plethora of xenobiotics (molecules foreign to biological systems) into the environment leading to male infertility." (Source: TOI, Aug 25, 2012)

For comments and archives

Ahmedabad district wins Electoral Photo Identity Cards battle

AHMEDABAD: The assembly elections, scheduled later this year, will be special for Ahmedabad district in a certain way. All the 45.14 lakh registered voters in the district have been issued Electoral Photo Identity Cards (EPIC). Ahmedabad is the first district in the country which has provided photo ID cards to all its voters. Talking to reporters, district collector Vijay Nehra said on Thursday that there are 45,14,607 registered voters in the district and all of them have been issued EPIC. The electoral roll of each booth also has photographs of the voters. The revised roll of Ahmedabad district will be published on August 31 with the photographs. "Not a single entry in the electoral roll will be without photo identity," said Nehra. "The purpose behind EPIC is to ensure free and fair elections. We can expect higher voting and less chance of impersonation and bogus voting during the next Assembly elections," he added. (Source: TOI, Aug 24, 2012)

For comments and archives

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

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Chromosomes predict oral cancer risk

A pattern of chromosomal changes can predict which patients with premalignant oral lesions will go on to cancer, researchers reported. (Source: Medpage Today)

For comments and archives

Experts urge caution on use of bexarotene in Alzheimer's

Experts are calling for caution in the wake of promising research showing that a drug already approved for treating cutaneous T-cell lymphoma (CTCL) significantly and swiftly reduces the amount of beta amyloid (Aß) in mouse models of Alzheimer's disease (AD). (Source: Medscape)

For comments and archives

More strokes after CABG Vs stenting

The risk of stroke is higher after coronary artery bypass grafting (CABG) than after coronary artery stenting, a new meta-analysis shows. (Source: Medscape)

For comments and archives

Risky drugs widely used by seniors

Inappropriate drug prescribing for the elderly is still common, with possible risks in about one in five prescriptions, a Dutch systematic review found. (Source: Medpage Today)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: Monsoon Fever Can Be Deceptivehttp://blog.kkaggarwal.com/2012/08/monsoon-fever-can-be-deceptive/…

@DrKKAggarwal: Be kind to yourself and others. Come from love every moment you can.

    Spiritual Update

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

Reiki And Therapeutic Touch

  1. The National Institutes of Health Center for Complementary and Alternative Medicine (NCCAM) classifies Reiki as a biofield modality “that involves touch or placement of the hands in or through a biofield, the existence of which has not been scientifically proven”

For comments and archives

    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

Why is SHG performed?

The usual indications for sonohysterography (SHG) are abnormal uterine bleeding; infertility; recurrent spontaneous miscarriage; congenital abnormalities of the uterus; preoperative and postoperative evaluation of the uterine cavity; suspected intrauterine adhesions (synechiae or scar tissue); and further evaluation of uterine abnormalities suspected during routine ultrasonography. SHG should not be performed in women who are pregnant or who are suspected to be pregnant.

For comments and archives

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

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

Transfusion practices in obstetrics and gynecology

  • Anemia in pregnancy is defined as Hb level of <11.0 gm% in first trimester, third trimester and puerperium and <10.5 gm% in second trimester due to physiological hemodilution.
  • The diagnosis and effective treatment of chronic anemia in pregnancy is an important way of reducing the need for future transfusions and decreasing maternal morbidity and mortality.
  • Obstetric bleeding may be unpredictable and massive.
  • If disseminated intravascular coagulation is suspected, do not delay treatment while waiting for the results of coagulation tests.

For comments and archives

    An Inspirational Story (Dr GM Singh)

Akbar’s Gold Coins

The wisdom of Birbal was unparalleled during the reign of Emperor Akbar. But Akbar’s brother in law was extremely jealous of him. He asked the Emperor to dispense with Birbal’s services and appoint him in his place. He gave ample assurance that he would prove to be more efficient and capable than Birbal. Before Akbar could take a decision on this matter, this news reached Birbal. Birbal resigned and left. Akbar’s brother–in–law was made the minister in place of Birbal. Akbar decided to test the new minister. He gave three hundred gold coins to him and said, "Spend these gold coins such that, I get a hundred gold coins here in this life; a hundred gold coins in the other world and another hundred gold coins neither here nor there."

The minister found the entire situation to be a maze of confusion and hopelessness. He spent sleepless nights worrying over how he would get himself out of this mess. Thinking in circles was making him go crazy. Eventually, on the advice of his wife he sought Birbal’s help. Birbal said, just give me the gold coins. I shall handle the rest. Birbal walked the streets of the city holding the bag of gold coins in his hand. He noticed a rich merchant celebrating his son’s wedding. Birbal gave a hundred gold coins to him and bowed courteously saying, "The Emperor Akbar sends you his good wishes and blessings for the wedding of your son. Please accept the gift he has sent. The merchant felt honored that the king had sent a special messenger with such a precious gift. He honored Birbal and gave him a large number of expensive gifts and a bag of gold coins as a return gift for the king.

Next, Birbal went to the area of the city were the poor people lived. There he bought food and clothing in exchange for a hundred gold coins and distributed them in the name of the Emperor. When he came back to town he organized a concert of music and dance. He spent a hundred gold coins on it. The next day Birbal entered Akbar’s darbar and announced that he had done all that the king had asked his brother–in–law to do. The Emperor waited to know how he had done it. Birbal repeated the sequences of all the events and then said, The money I gave to the merchant for the wedding of his son – you have got back while on this earth. The money I spent on buying food and clothing for the poor "you will get it in the other world". The money I spent on the musical concert" you will get neither here nor there."

This is true even today. The money you spend on friends is returned or reciprocated in some form or the other. Money spent on charity gets converted into blessings from God which becomes your eternal property. Money spent on pleasures is just frittered away!

For comments and archives

  Cardiology eMedinewS

Too Much Red Meat Ups Stroke Risk Read More

Carotid Test Not Helpful For CV Risk Prediction Read More

  Pediatric eMedinewS

Heavy Kids at Risk for Gallstones Read More

Ads May Spur Unhappy Kids to Embrace Materialism Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient was diagnosed with HIV–AIDS.
Dr Bad: You will die within ten years.
Dr Good: You can live a fairly normal life span.
Lesson: In the 1980s, a young adult diagnosed with AIDS typically survived less than one year. Today, a similar person can expect to live to age 70 or beyond if he or she is diagnosed with HIV infection early, has access to and receives appropriate therapy, and can tolerate the drugs and their side effects.

For comments and archives

Make Sure

Situation: A patient on 10 units of insulin developed hypoglycemia after taking a light breakfast.
Reaction: Oh my God! Why was the insulin dose not reduced?
Lesson: Make sure that insulin dose is correct. The formula is 500/total daily dose. The value will be the amount of sugar fluctuation with 10 gms of carbohydrates.

For comments and archives

  Quote of the Day (Dr Prabha Sanghi)

Children find everything in nothing; men find nothing in everything. Giacomo Leopardi

    Legal Question of the Day (Dr MC Gupta)

Q. The casualty medical officer working in a corporate hospital issued a wound certificate to a patient and signed it as “Dr. ABC, CMO, for DEF, orthopedic surgeon”. Four years later, the orthopedic surgeon was summoned to the court as expert witness. My questions are:

i) Can anybody issue certificate on the behalf of someone without prior intimation to the concerned doctor.
ii) What is the legal value of such a certificate?
iii) What legal action can be taken against such a CMO?


  • The case here is that a qualified medical practitioner examined a patient and issued a wound certificate under his signature, adding that he was issuing the same on behalf of a senior doctor. In the eyes of law, this should be a valid certificate. The evidence/witness would be adduced by the person who examined the patient and issued the certificate.
  • However, if the CMO has left the hospital and is not traceable, nothing prevents the court from summoning the orthopedic surgeon concerned for his expert opinion.
  • This raises an important issue about the non-availability of the medical practitioner who issued a certificate. Such non-availability is a frequent and serious problem that delays/hampers the course of justice.
  • The responsibility for taking remedial steps for such non-availability lies squarely on the medical profession as follows:
    • All physicians need to indicate their registration no. in their prescriptions etc. as per Regulation 1.4.1, reproduced below:

      “1.4.1 Every physician shall display the registration number accorded to him by the State Medical Council/Medical Council of India in his clinic and in all his prescriptions, certificates, money receipts given to his patients.”
    • The hospital administrators need to enforce Regulation 1.4.1, in the hospital records.
    • All physicians need to inform the SMC and the MCI any change in address etc. in terms of Section 28 of the IMC Act, 1956, reproduced below:


      28. Every person registered in the Indian Medical Register shall notify any transfer of the place of his residence or practice to the Council and to the State Medical Council concerned, within thirty days of such transfer failing which his right to participate in the election of members to the Council or a State Medical Council shall be liable to be forfeited by order of the Central Government either permanently or for such period as may be specified therein.”

      If the above steps are ensured, it will not be difficult at all to trace any doctor’s whereabouts.
  • Nobody can issue a certificate on behalf of someone else. However, it is possible that there were standing instructions/convention in the hospital concerned that the CMO may issue a certificate on behalf of a consultant. If it is so, then the CMO has done nothing wrong.
  • The question of taking legal action can be taken against such a CMO arises only in the lack of standing instructions/convention etc. as mentioned above. In such a situation, the hospital can initiate disciplinary/penal proceedings against the doctor concerned as per rules in force.

For comments and archives

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Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Doctor’s Day Celebration

eMedinewS Apps
    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Uric acid

Increase in serum uric acid: Idiopathic, renal failure, disseminated neoplasms, toxemia of pregnancy, psoriasis, liver disease, sarcoidosis, ethanol consumption, drugs (most diuretics, catecholamines, ethambutol, pyrazinamide, salicylates and large doses of nicotinic acid).

Decreased serum uric acid level: Wilson’s disease, Fanconi’s syndrome, xanthinuria, and (paradoxically) in some neoplasms, including Hodgkin’s disease, myeloma, and bronchogenic carcinoma. It may not be of clinical significance

    Mind Teaser

Read this…………………

Roxy is admitted to the hospital with a possible diagnosis of appendicitis. On physical examination, the nurse should be looking for tenderness on palpation at McBurney’s point, which is located in the

A. left lower quadrant
B. left upper quadrant
C. right lower quadrant
D. right upper quadrant

Yesterday’s Mind Teaser: Romeo Diaz, age 78, is admitted to the hospital with the diagnosis of benign prostatic hyperplasia (BPH). He is scheduled for a transurethral resection of the prostate (TURP). It would be inappropriate to include which of the following points in the preoperative teaching?

A. TURP is the most common operation for BPH.
B. Explain the purpose and function of a two-way irrigation system.
C. Expect bloody urine, which will clear as healing takes place.
D. He will be pain free.

Answer for Yesterday’s  Mind Teaser: D. He will be pain free.

Correct answers received from: Dr Pankaj Agarwal, y. j. vasavada, Dr.K.Raju, Dr. Thakor Hitendrsinh G, Dr. P. C. Das, Muthumperumal Thirumalpillai, Dr Avtar Krishan, Dr. P. C. Das

Answer for 25th August Mind Teaser: B. Decreased serum calcium, blood pH 7.2, potassium 6.5 mEq/L
Correct answers received from:  Dr. P. C. Das

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

There were these two friends, Bill and Bob, and they both loved baseball. So, they made a promise to each other, the first one to die, will come back and let the other know if there's baseball in heaven. Well, the day comes and Bob passes. Weeks turn to months while Bill is still waiting to hear from his friend.

Then one day, Bill is walking down the street, and Bob appears. Bill all excited, says: "I’ve been waiting forever! So tell me, is there or isn’t there Baseball in heaven?" Bob kinda perks up and says: "I’ve got good news and bad news." "1st, there is Baseball in heaven! The bad news is you’re pitching Friday!"

    Medicolegal Update

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

Places where pregnancy may be terminated

No termination of pregnancy shall be made in accordance with this act at any place other than:

  • a hospital established or maintained by the Government, or
  • a place for the time being approved for the purpose of this Act by Government or a District Level Committee constituted by that government with the Chief Medical Officer or District Health Officer as the Chairperson of the said Committee:
  • The District Level Committee shall consist of not less than three and not more than five members including the Chairperson, as the Government shall specify from time to time.
  • Under section4, before its substitution by the present section by the Medical Termination of Pregnancy (Amendment) Act, 2002, no termination of pregnancy could be made in accordance with the act at any place other than a hospital established or maintained by the government, or
  • a place for being approved for the purpose of the Act by the government.

(Ref: MTP Act 1971)

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Eating jaggery and gram (Gur–Chana) in a week in a fasting state

To prevent the current epidemic of anemia in the society, one should resume the traditional weekly eating of Gur and Chana in a fasting state, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India.

In the past, it was a ritual for a woman of childbearing age to observe Santoshi Mata Vrata on every Friday where it was compulsory to eat Gur and Chana in a fasting state.
Gur and Chana are rich in iron and folic acid. It is a well known phenomenon that iron is absorbed better in a fasting state. If eaten with food, iron absorption is not proper.

By eating Gur and Chana once in a week in a fasting state, it is possible to fight anemia in the society.

Recently, the WHO has also suggested that one should take weekly tablets of iron and folic acid in a fasting state. Traditional eating of gur and chana once in a week in a fasting state is better than consuming iron and folic acid tablets.

    Readers Response
  1. Dear Editor, "Laugh a while" by Dr. G. M. Singh, though good, has been taken from Optometry Today, March 2012 issue. And although the source should have have been acknowledged, we appreciate the effort to highlight `optometrist', the primary eye care professional. Dr. Narendra Kumar
    Forthcoming Events
Dr K K Aggarwal

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Dr K K Aggarwal

Dr K K Aggarwal

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
A non stop question answer-session between all the top cardiologists of the NCR region and the public. Event will be promoted through hoardings, our publications and the press. Public health discussions



Weekend Retreat for Doctors on
Mind – Body – Medicine

8 (Sat) – 9 (Sun) September 2012 At Brahma Kumaris Om Shanti Retreat Centre NH–8, Bhorakalan, Pataudi Road, Bilaspur Chowk, Distt.-Gurgaon

Visit us at: www.togetherwecan.in
Contact: BK Sister Sapna – M – 9650692204
E–mail: bksapna108@gmail.com

    eMedinewS Special

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

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  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

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  Dil Ki Batein

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  Pesticides Safely

    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Dr Usha K Baveja