27th October 2014, Monday

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

Prevention strategy relies on lifestyle

Stenting may not always be the answer to treating heart disease with stable.

A German study has shown that patients with stable coronary artery disease who were put on an exercise regimen had significantly higher rates of event-free survival than those who had undergone percutaneous coronary intervention (PCI). In the study, 70% of patients in the exercise program had event-free survival -- no stroke, heart attack, or death -- compared with 50% of stented patients after four years.

Exercise is an important part of any type of prevention, and it should be instituted for "anyone with stable coronary heart disease."

The study on stenting versus exercise come was a continuation of a pilot study first reported in 2004 in the journal Circulation. That study of 101 male patients found that after one year, 88% of patients who exercised had event-free survival compared with 70% of stented patients.

The updated data reflect an additional 100 patients, who performed moderate intensity exercise for two weeks under hospital supervision, and then were given an exercise bike to continue their regimen at home.

Patients with stable angina exercised at 80% of their threshold, and that after four weeks of exercising, their angina threshold increased.

The clear message for patients is to get 30 to 60 minutes of moderate-intensity aerobic activity every day, noting that 30% of heart disease could be prevented by 2.5 hours of walking per week.

7th Asia-Pacific Heart Rhythm Scientific Session New Delhi, India

A one-year study evaluating the efficacy of efficacy of pulmonary vein isolation (PVI) as index procedure for persistent atrial fibrillation (AF) ablation using the novel CB-Adv observed that at 1-year follow-up, freedom from atrial tachyarrhythmias following persistent AF ablation with the novel CB-Adv (second-generation Cryoballoon) was found to be 60%. The most common complication was phrenic nerve palsy. Duration of persistent AF and relapses during the blanking period were significant predictors of arrhythmic recurrences. The study findings are reported in Heart Rhythm.2014 Oct 1 Epub ahead of print.

Dr. Mohan Nair
Chairman, Organizing Committee of the 7th Asia Pacific Heart Rhythm Society's  (APHRS) Scientific Sessions, being organized simultaneously at the Taj Palace Hotel and ITC Maurya in New Delhi from October 29th to November 1st, 2014.

Be a part of the discussions regarding Arrhythmia Management with global experts at the 7thAsia Pacific Heart Rhythm Society Meeting from October 29th – November 1st at New Delhi.

As a special offer for all eMedinews readers, we have decided to waive off the registration fees for the conference. To register yourself, please click on the following link


News Around The Globe

  • Frozen or lyophilized specimens may offer an effective and convenient alternative to fresh stool samples for fecal transplant in patients with recurrent episodes of Clostridium difficile infection. Among 13 patients with multiple episodes of C. difficile who were treated with fresh fecal samples, 92% were considered responders at 3 months, as were 93% of 15 patients who received frozen transplants, reported Zhi-Dong Jiang, MD, DPh, of the University of Texas in Houston, at the annual meeting of the American College of Gastroenterology.
  • Shorter regimens for the treatment of tuberculosis (TB) may not be as good as standard 6-month therapy, point the results of three phase 3 trials published in the October 23 issue of the New England Journal of Medicine.
  • A corneal implant targeted to people in their mid-40s who see well at a distance could soon replace the reading glasses they rely on to read texts and menus. Researchers noted that Kamra polyvinylidene fluoride ring implanted in presbyopic patients allowed them to see up close with 20/40 vision or better. The findings were presented at the American Academy of Ophthalmology 2014 Annual Meeting.
  • An investigational solubilized estradiol capsule could serve as an option for treating vulvovaginal atrophy with even less systemic absorption than the currently available tablet, suggest early data from phase 2 and pharmacokinetic studies presented at the North American Menopause Society (NAMS) 2014 Annual Meeting.
  • High-dose resveratrol, a polyphenolic compound, stimulates the formation or mineralization of new bone in obese men with metabolic syndrome, suggests a new study published online in the Journal of Clinical Endocrinology and Metabolism.

Dr KK Spiritual Blog

Reflexology for Cancer Symptoms

A study led by a Michigan State University researcher offers the strongest evidence yet that reflexology can help cancer patients manage their symptoms and perform daily tasks.

Funded by the National Cancer Institute and published in Oncology Nursing Forum, it is the first large-scale, randomized study of reflexology as a complement to standard cancer treatment, according to lead author Gwen Wyatt, a professor in the College of Nursing.

Reflexology is based on the idea that stimulating specific points on the feet can improve the functioning of corresponding organs, glands and other parts of the body.

The study involved 385 women undergoing chemotherapy or hormonal therapy for advanced-stage breast cancer that had spread beyond the breast. The women were assigned randomly to three groups: Some received treatment by a certified reflexologist, others got a foot massage meant to act like a placebo, and the rest had only standard medical treatment and no foot manipulation.

They found that those in the reflexology group experienced significantly less shortness of breath, a common symptom in breast cancer patients. Perhaps as a result of their improved breathing, they also were better able to perform daily tasks such as climbing a flight of stairs, getting dressed or going grocery shopping.

Also unexpected was the reduced fatigue reported by those who received the "placebo" foot massage, particularly since the reflexology group did not show similarly significant improvement. Wyatt is now researching whether massage similar to reflexology performed by cancer patients' friends and family, as opposed to certified reflexologists, might be a simple and inexpensive treatment option.

Inspirational Story

Live and Work

Father was a hardworking man who delivered bread as a living to support his wife and three children. He spent all his evenings after work attending classes, hoping to improve himself so that he could one day find a better paying job. Except for Sundays, Father hardly ate a meal together with his family. He worked and studied very hard because he wanted to provide his family with the best money could buy.

Whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family. The day came when the examination results were announced. To his joy, Father passed, and with distinctions too! Soon after, he was offered a good job as a senior supervisor which paid handsomely.

Like a dream come true, Father could now afford to provide his family with life’s little luxuries like nice clothing, fine food and vacation abroad. However, the family still did not get to see father for most of the week. He continued to work very hard, hoping to be promoted to the position of manager. In fact, to make himself a worthily candidate for the promotion, he enrolled for another course in the Open University.

Again, whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family.

Father’s hard work paid off and he was promoted. Jubilantly, he decided to hire a maid to relieve his wife from her domestic tasks. He also felt that their three-room flat was no longer big enough, it would be nice for his family to be able to enjoy the facilities and comfort of a condominium. Having experienced the rewards of his hard work many times before, Father resolved to further his studies and work at being promoted again. The family still did not get to see much of him. In fact, sometimes Father had to work on Sundays entertaining clients. Again, whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family.

As expected, Father’s hard work paid off again and he bought a beautiful condominium overlooking the coast of Singapore. On the first Sunday evening at their new home, Father declared to his family that he decided not to take anymore courses or pursue any more promotions. From then on he was going to devote more time to his family.

Father did not wake up the next day.

Rabies News (Dr A K Gupta)

Why do some people fear the vaccine?

In the past, rabies vaccine was a sheep brain derived Nerve Tissue Vaccine (NTV) and was associated with considerable side effects. Large volumes and a number of injections were required. So, rabies vaccine acquired the dubious reputation of a dangerous vaccination. However, these fears are no longer justified with modern rabies vaccines that are very safe.

Cardiology eMedinewS

  • A new study by researchers at the Intermountain Medical Center Heart Institute in Salt Lake City has found that heart attacks are not as connected to family history and genetics as may have been previously believed. The research stresses that the patients’ lifestyle choices and environment, not just their genetics, may make the difference in whether or not they have a heart attack. The study was presented at the 2014 conference of the American Society of Human Genetics.
  • Survival and neurological outcomes for patients in cardiac arrest can be improved by adding extracorporeal membrane oxygenation (ECMO) when performing cardiopulmonary resuscitation (CPR), suggests a study scheduled to be presented at CHEST 2014, the annual meeting of the American College of Chest Physicians.

Pediatrics eMedinewS

  • Medication errors occurred in 696,937 nonhospitalized children 6 years of age and younger between 2002 and 2012, and more than a quarter of the episodes were documented in children younger than 1 year, according to a study published online October 20 in Pediatrics.
  • Babies born to mothers with type 1 diabetes may have alarming rates of hypotonia and congenital malformations, including various types of neural tube defects, suggests a new pilot study presented at the Child Neurology Society 2014 Annual Meeting.

Quote of the Day

  • A successful man is one who can lay a firm foundation with the bricks others have thrown at him. David Brinkley


  • Karnataka: Even as government doctors announced their plans to resign en masse on October 27 over wage disparity and irregular payment of salaries, Health Minister U.T. Khader and Principal Secretary, Health and Family Welfare, N. Sivasailam said on Thursday the department would not succumb to the “blackmail” tactics of the doctors and “resignations would be accepted if they were submitted”.
  • AIIMS head to DU VC, top law officer to Medanta boss, all meet RSS chief -
    Indian Express: RSS chief Mohan Bhagwat met nearly 60 luminaries from the fields of education, health care, law, culture and bureaucracy over lunch earlier this month, seeking their views on RSS and Hindutva and telling them that society and government need to work together to effect change in the country.

    The rare interaction with the RSS sarsanghchalak took place on October 12 at the PHD Chamber of Commerce and Industry in New Delhi. Invitation cards were issued by RSS Delhi Prant Sanghchalak Kulbhushan Ahuja.

    Those present included AIIMS director Dr M C Misra, UGC chairman Ved Prakash, Delhi University vice-chancellor Dinesh Singh, Guru Gobind Singh Indraprastha University vice-chancellor Anil K Tyagi, additional solicitor general Tushar Mehta, cardiac surgeons Dr Naresh Trehan and Dr K K Aggarwal, mountaineer Santosh Yadav, dancer Sonal Mansingh, former AIIMS director P Venugopal, National Council for Teacher Education chairman Santosh Panda, former Uttar Pradesh DGP Prakash Singh and other retired bureaucrats.

    Copies of Bhagwat’s Vijay Dashmi speech were distributed at the meeting and people present were asked to give their views. While most listened to what Bhagwat said, around a dozen engaged the RSS chief and gave their own suggestions on what the government needed to do.

    Sources privy to the meeting said Bhagwat did not promise anything and said “Sarkar sangh ki nahin hai. Hamare swayamsevak sarkar mein hain. Aapki baat un tak ham pahuncha denge (It is not a RSS government. Our swayamsevaks are in the government. Your suggestions will be conveyed).”

    “Koi bhi badlao sirf sarkar se nahin aa sakta. Sarkar aur samaj ke sahyog se hi badlao aa sakta hai (No change can be effected by a government alone. Change is possible only if the government and society cooperate,” he was quoted as having said.

    When The Indian Express contacted Dr Aggarwal, he said he suggested health sector reform measures like maximising the use of the health budget, elimination of diseases and reduction in time taken for hospitalisation. “We also discussed how health care can be improved by strengthening our ancient values,” he said.

    Dr Trehan said he put forth his ideas of reforms in the health sector to “provide health care to each and every citizen… there was no politics, no religion. It was just an exchange of views”.

    Sonal Mansingh said “RSS is one-of-its-kind organisation, totally dedicated to India” and suggested that “cultural inputs should become part of education”. “Until the HRD Ministry was created, separating culture from education, it was an inclusive, holistic system. Young generations were not deprived of important aspects and dimensions of Indian ethos,” Mansingh said.

    Sources said the AIIMS director suggested that the private sector should be encouraged to work in the field of health care to reduce the burden on the public sector. UGC chairman Ved Prakash, the sources said, called for implementation of reports of various commissions.

Wellness Blog

Harvard’s Medical School’s 4 Exercising Tips for People with Diabetes

  1. Get a “preflight” check
    • Talk with your doctor before you start or change a fitness routine.
    • Especially if you are overweight or have a history of heart disease, peripheral vascular disease, or diabetic neuropathy.
    • Go for a complete physical exam and an exercise stress test if you are 35 or older and have had diabetes for more than 10 years. The results can help determine the safest way for you to increase physical activity.
  2. Spread your activity throughout the week
    • Adults should aim for a weekly total of at least 160 minutes of moderate aerobic activity, or 80 minutes of vigorous activity, or an equivalent mix of the two.
    • Be active at least 3 to 5 days a week.
  3. Time your exercise wisely
    • The best time to exercise is 1 to 3 hours after eating, when your blood sugar level is likely to be higher.
    • If you use insulin, it’s important to test your blood sugar before exercising. If it is below 100 mg/dL, eat a piece of fruit or have a small snack to boost it and help you avoid hypoglycemia. Test again 30 minutes later to see if your blood sugar level is stable.
    • Check your blood sugar after any particularly grueling workout or activity.
    • If you use insulin, your risk of developing hypoglycemia may be highest 6 to 12 hours after exercising.
    • Do not exercise if your blood sugar is too high (over 250).
emedipicstoday emedipics

21st Perfect Health Mela 15th October 2014

21st MTNL Perfect Health Mela 2014


press release

Obesity reduces life expectancy

video of day 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 – 96458 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 on aspirin was to go for non vascular surgery
Dr Bad: Stop aspirin for two days
Dr Good: Stop aspirin for seven days
Lesson: The POISE-2 findings suggest discontinuing aspirin about seven days before noncardiovascular surgery.

Make Sure

Situation: A diabetic patient died of flu pneumonia.
Reaction: Oh my God! Why was flu vaccine not given?
Lesson: Make sure that all diabetics are given flu vaccine every year.

eMedinewS Humor

Salesman to Policeman

A salesman, tired of his job, gave it up to become a policeman.

Several months later, a friend asked him how he liked his new role.

"Well," he replied, "the pay is good and the hours aren't bad, but what I like best is that the customer is always wrong."

Twitter of the Day

Dr KK Aggarwal: Relieve Stress by Changing the Interpretation
Dr Deepak Chopra: Enemies of religion tend to conflate blind faith with faith itself, quiet unfairly

ePress Release

Carbohydrates as substitute to saturated fats not the answer

More than 20 prospective studies have addressed components of diet and the risk of heart disease, started by 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.

The type of fat consumed appears to be more important than the amount of total fat.

Saturated fats and the trans fatty acids increase the risk of heart disease, while polyunsaturated and monounsaturated fats decrease risk.

There is controversy about whether it is optimal to substitute saturated fat with carbohydrate. An increase in carbohydrate tends to reduce the level of good high density lipoprotein (HDL) cholesterol in addition to total and low density lipoprotein (LDL) cholesterol. Thus, the reduction in heart disease risk may be less than predicted by the reduction of saturated fat alone.

Observational studies have consistently shown that individuals consuming diets high in vegetables and fruits (rich in antioxidant vitamins) had a reduced risk of heart disease.

Results of a number of randomized trials are now available and show largely no significant clinical benefits of antioxidant vitamins on heart disease.

Supplemental vitamins C, E, and beta carotene cannot be recommended in the primary prevention of coronary heart disease. Taking supplements without clinical benefits could, in theory, increase the risk if individuals mistakenly avoid therapeutic lifestyle changes or drug therapies with proven benefits.

eMedi Quiz

Two students, X and Y, were asked to demonstrate in dogs the role of sinus nerve in hypovolemic shock. X severed the sinus nerve when the mean blood pressure (MBP) was 85mm Hg and Y cut the sinus nerve when the mean blood pressure was 60mm Hg. On cutting the sinus nerve:

1. X recorded an increase in MBP but Y recorded a decrease in MBP.
2. X recorded a decrease in MBP but Y recorded an increase in MBP.
3. Both recorded an increase in MBP.
4. Both recorded in decrease in MBP.

Yesterday’s Mind Teaser: All of the following are features of hallucinations, except:

1.It is independent of the will of the observer.
2.Sensory organs are not involved.
3.It is a vivid as that in a true sense perception.
4. It occurs in the absence of perceptual stimulus.

Answer for yesterday’s Mind Teaser: 2.Sensory organs are not involved.

Correct answers received from: Dr.K.V.Sarma, Tukaram Pagad, Bharat Bhushan Aggarwal, Dr Jainendra Upadhyay, dr poonam chablani, Dr Pankaj Agarwal, Dr Avtar Krishan

Answer for 25th Oct Mind Teaser: 3.Low oral bioavailability always and necessarily mean poor absorption.

Correct answers received from: Dr. B. B. Aggarwal, Daivadheenam Jella

Send your answer to email

medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Editor eMedinewS and President Heart Care Foundation of India)

Giving wrong advice on email is liable for negligence

If the doctor has charged his/her full fees for the email consultation from the patient or a referring physician regarding a patient, he/she will be liable as if he or she has seen the patient. When giving a written opinion through email one can take the following precautions and write:

  • “Expert opinion provided as a professional courtesy only”
  • “Nominal fee charged is only to cover the secretarial / incidental expenses involved and does not count towards a consideration or contract”
  • “This is only an opinion based on the information provided to me. It is not a final opinion which cannot be given without seeing the patient physically.
  • “This is not a final opinion and you may use this opinion at your own responsibility and discretion”
  • “As it is an opinion given without seeing the patient I take no legal responsibility for the opinion given”.
medicolegal update
  1. Dear Sir, very informative news. Regards: Dr KP Saha

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