eMedinewS27th December 2013, Friday

Dr K K AggarwalPadma 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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; 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.facebook.com/Dr KKAggarwal

2013 Research Highlights

Malaria vaccine found safe and protective

NIH researchers reported that a candidate malaria vaccine is safe and protected against infection in an early–stage clinical trial.

Gene variants predict response to breast cancer drugs

An international research team, with NIH support, found genetic variations that can be used to identify women who are most likely to benefit from this potentially life–saving strategy—and who should avoid it.

Urine test detects kidney transplant rejection

NIH–funded researchers found that certain molecules in urine can provide an early sign of transplant rejection. The test could allow doctors to act early to protect transplanted kidneys.

Technique directs immune cells to target leukemia

An NIH–funded team used a type of targeted immunotherapy to induce remission in 5 patients with this aggressive form of leukemia.

Medical management best to prevent second stroke

An NIH–funded clinical trial confirmed earlier findings that stenting adds no benefits over aggressive medical treatment alone for most of these patients.

Duration of obesity may affect heart disease

NIH researchers found that how long a young adult is obese may affect that person’s heart disease risk in middle age. The finding suggests that not only preventing but also delaying the onset of obesity can help reduce heart disease later in life.

Dr K K Aggarwal on Zee TV

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 mantra
VIP’s on CPR 10 Mantra Video
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

Do what you do to God

sprritual blog

• There are two types of people who believe in Dvaita or Advaita philosophy.
• People who believe in Dvaita philosophy, for them God and human being are different.
• The people who believe in Advaita philosophy believe that God is within them.
• In Hinduism, the first group believes in Sanatan Dharma and does idol worship (Moorti pooja) and the second group Arya Samaj, which does not believe in idol worship.
• In both situations, medically the message is one.
• If God is different than you, then you try to be like Him and if God is in within you, then you are Him.
• In both situations, we should deal with our body the same way as we deal with God.
• Anything which is not offered to God we should not offer to our body. The examples are cigarettes, drugs etc. and things like onion, garlic, radish etc. should be consumed in less quantity.
• We never worship God with hydrogenated oil; we always worship him either with oil or with Desi Ghee. The message is that we should not consume trans fats.
• We never feed God "Bhagwan ko bhog lagate hain". The message is we should eat less.
• Amongst all Gods, only Lord Shiva is said to consume Bhang and Alcohol that too only in Bhairon incarnation, which indicates that both alcohol and bhang can be consumed in some quantity only in special situations that means that they cannot be consumed without medical supervision.
• Anything grown under the ground is not offered to God, thus, these items should not be eaten or eaten in moderation.
• We never offer God white salt and white rice. They are bad for human beings also.
• Gur, shakkar, brown rice and puffed rice are offered to God. They can be consumed by human beings.

cardiology news

Endure what cannot be cured

This is the best way to turn a disadvantage into an advantage.

Every day we face numerous inconveniences, ailments, irritations, and accidents that are beyond our control. If we cannot control them or change them, we must learn to put up with these things. We must learn to endure them cheerfully. Believe in yourself and you will gain in terms of patience, inner strength and will power.

News Around The Globe


  • In a randomized, placebo–controlled trial published in the December 25 issue of JAMA, treatment nortriptyline treatment resulted in a mean improvement of 23% in symptoms of idiopathic gastroparesis compared with 21% for the placebo group making it not more effective than a placebo in this patient group.
  • An integrative treatment approach using meditation plus pharmaceutical and cognitive behavioral therapy may be more beneficial for treating nicotine addiction than current, standard interventions of drug–plus–talk therapy alone, according to preliminary research published online December 19 in Frontiers in Psychiatry.
  • A meta–analysis of international bariatric surgery studies from 2003 to 2012 provides reassurance that the surgery is effective for candidates for this procedure. The studies in the analysis also showed that current procedures have an acceptable risk of complications and a very low mortality rate that continues to decline. The meta–analysis was published online December 18 in JAMA Surgery.
  • A link between plasmacytoid dendritic cells and pathogenesis of systemic sclerosis (SSc) is the chemokine CXCL4, the main protein secreted by these cells, an international research group reported in an article published online December 18 in the New England Journal of Medicine. Proteome–wide analysis showed CXCL4 to be the only chemokine that predicted the risk and progression of SSc. High plasma CXCL4 levels were associated both with skin and lung fibrosis, as well as with pulmonary arterial hypertension (PAH), in patients with SSc.
  • GlaxoSmithKline’s Cervarix vaccine against human papillomavirus (HPV) is significantly more immunogenic than Merck’s Gardasil in HIV–infected women, though both are highly immunogenic, according to Danish and German researchers in J Infect Dis 2013. In men the difference was less pronounced.

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Rabies News (Dr. A K Gupta)

Are there any survivors of human rabies?

Till date only seven survivors have been recorded. These patients survived not due to any specific anti–rabies therapy but following intensive life support and excellent nursing care. These patients survived for variable periods with residual neurological deficits. All the survivors had paralytic form of rabies and majority had history of some anti–rabies vaccination in the past.

cardiology news

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

  • Screening for coronary artery calcium (CAC) as a sign of subclinical atherosclerosis might help refine risk even outside of the intermediate–risk category. Khurram Nasir, MD, MPH, of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, and colleagues report online in the European Heart Journal that in asymptomatic individuals with no risk factors and in those with at least three risk factors –– and, thus, outside of the intermediate–risk group –– the rate of coronary heart disease events increased along with CAC burden. A CAC score of 0 was associated with low event rates regardless of the number of risk factors.
  • Vitamin D deficiency is much more strongly linked to fatal than nonfatal CV events, results of a large prospective study suggest. Drs Laura Perna and Ben Schottker, German Cancer Research Center (Heidelberg) observed an approximately 27% increased total CV risk in subjects with vitamin D deficiency, but they indicate that the risk is much stronger for (and possibly even confined to) fatal CVD events. The findings were published in the December issue of the Journal of Clinical Endocrinology and Metabolism.
cardiology news

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

  • Pediatricians can confidently use a newly revised screening tool, the Modified Checklist for Autism in Toddlers, Revised with Follow–up (M–CHAT–R/F), which combines parents’ "yes" or "no" answers with a structured follow–up interview, to reliably screen low–risk toddlers and refer them for early intervention, according to findings from a validation study published online December 23 in Pediatrics.
  • A new study presented at the meeting of the American Academy of Pediatrics states that at least one concussion symptom was common in roughly two–thirds of pediatric sports medicine and orthopedic patients who had no history of the disorder. However, vestibular deficits –– common in roughly 81% of a separate sample of pediatric sports medicine clinic patients who did have concussions –– were not seen in this healthy group
cardiology news

Ethylene oxide used in baby powder by MNCs can cause allergy, cancer and blood abnormalities in long run

Multinationals should stop treating Indians as guinea pigs, the FDA told the Bombay HC on Friday, while opposing Johnson & Johnson’s plea to restart its Mulund facility as reported in TOI. A division bench of Justice S J Vazifdar and Justice M S Sonak, the court heard J&J’s plea challenging FDA’s order directing closure from June 24.

In 2007, J&J had used ethylene oxide (EtO) treatment for 15 batches of baby powder and did not check for residue. But J&J argued that it had checked three of the batches for residue in 2009, and had found none. To check for contamination, instead of the steam sterilization treatment, they sent the bottles for EtO treatment to a lab.

After the treatment, they were no checks for residue. As per FDA, the company was required to test each batch they put into the market.

About EtO

  • Hypotension, dyspnea, and chest pain may be produced by sensitivity to the ethylene oxide used as a membrane sterilant (1).
  • Chemicals that have been associated with sporadic spontaneous pregnancy loss include anesthetic gases (nitrous oxide), arsenic, aniline dyes, benzene, ethylene oxide, formaldehyde, pesticides, lead, mercury and cadmium (2).
  • A variety of other medications and agents have been implicated in anaphylaxis or reactions resembling anaphylaxis in susceptible individuals: The sterilization agents EtO and ortho–phthalaldehyde (3).
  • Type A allergic reactions during dialysis are caused by leachable substances from the dialyzer or by contamination with bacterial peptides. A classic cause of this type of reaction is ethylene oxide, which is used to sterilize hollow fiber dialyzers. Reactions to ethylene oxide, which are now uncommon, occur exclusively during the first use, usually when there has been inadequate rinsing of the dialyzer prior to use. IgE antibodies directed against ethylene oxide are present in some cases, particularly those with more severe reactions. One study, found that 16 of 106 unselected patients developed mild allergic symptoms after hemodialysis; 10 of these patients also developed eosinophilia (4). Two observations suggested an important role for ethylene oxide in this response: allergy to ethylene oxide could be demonstrated in seven of the cases; and the symptoms and eosinophilia were ameliorated in three patients by ethylene oxide–free hemodialysis.
  • Spina bifida patients have been reported to be at increased risk of anaphylactic reactions during general anesthesia. Following a reaction, latex is often incriminated as spina bifida patients are known to have an increased incidence of latex allergy. Ethylene oxide (EO) has recently been suggested to be an alternative cause. EtO is a highly reactive gas widely used to sterilize heat–sensitive medical devices, and traces of EtO can be found in many of the same products as latex (5).
  • There is a link between low dose EtO exposure and breast cancer (6).
  • For breast cancer the substances classified as "carcinogenic to humans" (Group 1) include EtO (7).
  • Chronic exposure to EtO causes elevation in the absolute mean number of monocytes and eosinophils and a decrease in the absolute mean number of lymphocytes. There is also an elevation in the percentage of hematocrit and the mean absolute number of the red blood cells, and a decrease in the mean absolute number of platelets, in the exposed group compared with the control group (8).


  1. Nicholls AJ, Platts MM. Anaphylactoid reactions due to haemodialysis, haemofiltration, or membrane plasma separation. Br Med J (Clin Res Ed) 1982;285:1607.
  2. Savitz DA, Sonnenfeld NL, Olshan AF. Review of epidemiologic studies of paternal occupational exposure and spontaneous abortion. Am J Ind Med 1994;25:361.
  3. Ebo DG, Bosmans JL, Couttenye MM, Stevens WJ. Haemodialysis-associated anaphylactic and anaphylactoid reactions. Allergy 2006;61:211.
  4. Röckel A, Klinke B, Hertel J, et al. Allergy to dialysis materials. Nephrol Dial Transplant 1989;4:646.
  5. Anaphylaxis to ethylene oxide – a rare and overlooked phenomenon: Bache S, Petersen JT, Garvey LH. Acta Anaesthesiol Scand 2011;55(10):1279–82.
  6. Mikoczy Z, Tinnerberg H, Björk J, Albin M. Cancer incidence and mortality in Swedish sterilant workers exposed to ethylene oxide: updated cohort study findings 1972–2006. Int J Environ Res Public Health 2011;8(6):2009–19.
  7. Weiderpass E, Meo M, Vainio H. Risk factors for breast cancer, including occupational exposures. Saf Health Work 2011;2(1):1–8.
  8. Shaham J, Levi Z, Gurvich R, et al. Hematological changes in hospital workers due to chronic exposure to low levels of ethylene oxide. J Occup Environ Med 2000;42(8):843–50.
cardiology news

Total CPR since 1st November 2012 – 83037 trained

Media advocacy through Web Media

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press release

CPR 10 camp at NDMC premises; 4671 persons trained

In a week–long campaign, Heart Care Foundation of India trained 1959 people in hands-only CPR 10 technique which teaches how to revive a person after sudden cardiac death.

Giving the details, Padma Shri & Dr. B C Roy National Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India, said that the camp was an extension of CPR 10 Utsav organized at Talkatora Stadium in association with NDMC where 2712 people were trained in CPR 10 technique.

The camp was held at the entrance of NDMC Building where office staff and other people walking in were sensitized and trained on how to revive a dead person within 10 minutes of sudden cardiac death.

Dr. Aggarwal said that 60% of the people after sudden cardiac arrest can be revived if a bystander performs the technique of CPR 10 within 10 minutes of cardiac arrest. Practical training is important as insufficient cardiac compression will not give results. The mantra is push hard and push fast and the correct technique involves compression of the chest by at least 1 ½ inches and to be continued with a speed of 100 per minutes at least for next ten minutes.

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 83037 people since 1st November 2012.

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."

emedipicstoday emedipics

CPR 10 Utsav 15th December 2013

press release

Ventilator–associated tracheobronchitis.

vedio of day

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

An anxious mother brought her 4–year–old daughter to the pediatrician. The girl was passing loose bulky stools for the past 20 days. This was often associated with pain in abdomen. The pediatrician ordered the stool examination which showed the following organisms. Identify the organism:

1. Entamoeba histolytica
2. Giardia lamblia
3. Cryptosporidium
4. E. coli

Yesterday’s Mind Teaser: An enzyme involved in the catabolism of fructose to pyruvate in the liver is:

1.Glyceraldehyde–3–phosphate dehydrogenase

Answer for yesterday’s Mind Teaser: 1.Glyceraldehyde–3–phosphate dehydrogenase

Correct answers received from: Dr A K Gajjar, Daivadheenam, Dr K V Sarma, Dr Vishal D Wahane, Sangeetha Raja, Dr Jainendra Upadhyay, Dr S Sashihharan, Dr Avtar Krishan,
Dr Ajay Gandhi, Dr R P Sharma.

Answer for 25th December Mind Teaser: 2. Whole blood.

Correct answers received from: Dr R P Sharma.

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medical querymedical query

medicolegal update
medicolegal update

A Dollar Per Point

A professor was giving a big test one day to his students. He handed out all of the tests and went back to his desk to wait.

Once the test was over the students all handed the tests back in. The professor noticed that one of the students had attached a $ 100 bill to his test with a note saying "A dollar per point."

The next class the professor handed the graded tests back out. This student got back his test, his test grade, and $ 64 change.

medicolegal update

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medicolegal updatemedicolegal update

medicolegal update

Situation: A 28–year–old pregnant woman was advised erythromycin estolate for her upper respiratory tract infection. A week later she developed jaundice.
Reaction: Oh my God! You should have prescribed erythromycin stearate instead of estolate.
Lesson: Make sure to remember that there is a higher incidence of hepatitis with cholestatic jaundice in pregnancy with erythromycin estolate.

medicolegal update

If I did know I was gonna live this long (100 years), I would have taken better care of myself. Euble Biake

medicolegal update

Dr KK Aggarwal: More women than men die in hospital from severe heart attack http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Do you think it's possible to encompass the full experience of spirituality without having a mentor? #CosmicConsciousness

medicolegal update
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