eMedinewS27th July 2014,Sunday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee

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

Prescribe insurance to all patients in your prescription

When we do not take our car on the roads without insurance then why do we take our body out without insurance?

  1. Everybody should be insured and for those who cannot, the government must pay for their insurance. Insurance should be added in the prescription of a doctor.
  2. Even if a patient has a disease, he or she needs insurance so that he is covered for other illnesses. Remember one is entitled for 1% of the cover as room rent or 2% for the ICU bed.
  3. The coverage amount is for one full year. Do not exhaust it in one admission.
  4. The patients should choose their insurance so that even OPD treatment is added to the coverage.
  5. A person can have more than one insurance policy.
  6. Health is not mere absence of disease but a state of physical, mental, social, environmental, spiritual and financial well being.
  7. The purpose of life should be to desire for inner happiness and for that to earn righteously.
  8. One must plan for the old age; remember that today one can live above the age of 80 and old age treatments can be very costly.
  9. Most disputes are due to property and one must write his or her will in time. Property dispute is number one cause of heart attack in the country.
  10. All doctors should be insured against malpractice. To err is human and malpractice is not a criminal negligence.
  11. The banks should come out with schemes so that patients can get loans for treatments on the spot.

News Around The Globe

  • The US Food and Drug Administration (FDA) has approved over-the-counter (OTC) fluticasone propionate 50 mcg nasal spray for treatment of hay fever or upper respiratory allergies. According to a company news release, this is the first and only OTC nasal spray indicated for relief of all nasal and eye-related allergy symptoms including runny nose, sneezing, itchy nose, nasal congestion, and itchy and watery eyes.
  • An article published online July 24 in JAMA Otolaryngology has stated that diabetes might increase the odds of developing head and neck cancer with higher risk in those aged 40–65 years. The study by researchers in Taiwan reported that the risk for head and neck cancer was almost 50% higher in patients with diabetes as compared to those without diabetes.
  • A novel study has, for the first time, described a pathologic role for a third protein in the Alzheimer’s disease process, in addition to β–amyloid and tau proteins. The new protein, TDP–43, correlated strongly with cognitive impairment, as well as hippocampal and cortical atrophy, independent of amyloid deposition. The findings were presented at the Alzheimer's Association International Conference (AAIC) 2014.
  • A review published in the July issue of the Lancet Oncology has pointed that with the rapid uptake of tyrosine kinase inhibitors (TKIs) in oncology, serious drug-drug interactions are an increasing risk. The review provides an overview of known and suspected interactions between all 15 TKIs approved by the US FDA till date and conventional prescribed drugs, over–the–counter drugs, and herbal medicines.
  • A multinational randomized trial, Thrombophilia in Pregnancy Prophylaxis Study (TIPPS), has suggested that daily injections of low–molecular weight heparin (LMWH) do not improve outcomes for mother or child in thrombophilia of pregnancy. The findings are published online July 24 in the Lancet.

Rabies News (Dr A K Gupta)

What does humanizing your dog means?

  • Talking to your dog like he/she is a person.
  • Treating your dog like he/she is a person.
  • Allowing dogs to do what they want because it will hurt their "feelings."
  • Dressing them up in little doggie clothes.

Remember, humanizing your dog is fulfilling your own human needs, not your dogs. Humanizing dogs does more harm than good.

Cardiology eMedinewS

  • Simple measurement of the peripheral pulse (MPP) at the radial artery appears to be an effective screening tool for diagnosis of atrial fibrillation (AF) in patients who have had a stroke, suggests a new pilot study published online in Neurology on July 23.
  • A prospective Japanese cohort study reported that high levels of dietary sodium in people with type 2 diabetes were independently associated with elevated risk for cardiovascular events over 8 years. The correlation was particularly strong among those with the most poorly controlled levels of glycosylated hemoglobin. The study was published online in the Journal of Clinical Endocrinology & Metabolism.

Pediatrics eMedinewS

  • European Union (EU) regulators have recommended extending the indication for entecavir, a drug for treating chronic hepatitis B virus (HBV) infection, to children. The new indication recommended by the European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) applies to nucleoside-naive children aged 2 to 17 years with compensated liver disease and the same qualifications listed for adults.
  • The European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) has recommended a new indication for the tumor necrosis factor inhibitor adalimumab on July 24. The new indication is for treatment of active enthesitis–related arthritis in patients aged 6 years and older, either who have had an inadequate response to, or who are intolerant of conventional therapy.

Dr K K Spiritual Blog

Forgetfulness and Age

By the time we cross 40, most of us suffer from minimal cognitive impairment and have a memory loss of very recent events or objects. This is age related and should not be confused with dementia.

This can also happen in patients who are vegetarians and vitamin B12 deficient. People often have difficulty in naming objects and name of the people.

Just as a computer hangs up while doing multiple tasks, so does the human mind. When you handle multiple projects at the same time, you may experience thought blocks, which is natural and not a sign of a disease.

When we introduce ourselves to a new person, we often tell our name first. It is possible that by the time you finish your conversation, the person may forget your name. Therefore, one should either introduce themselves last after the conversation is over or introduce oneself at the start and also at the end of the conversation.

Some people introduce themselves before the conversation and hand over their visiting card at the end of a conversation. This is also taught in how to market yourself.

As medical doctors, we face these difficulties quite often. People send SMSs without their names or call without telling their names. For example, I once got a call "Malhotra Bol Raha Hoon Pehchana Kya?" As a doctor, we may have had hundreds of Malhotras as our patients and it is not expected from us, especially, after the age of 40 to recall a person just by his surname. Unless we are given complete information by the patient on phone, mistakes can be made, especially, if it is a phone consultation. In any way, phone consultation needs to be avoided. Even Supreme Court in one of its judgments said that giving phone consultation may amount to professional misconduct on the part of the doctor.

Wellness Blog

Food poisoning with rice dishes

Staph and Bacillus cereus can cause acute food poisoning within 6 hours of ingestion of food. B. cereus is likely when rice is the culprit.

  • B. cereus is able to persist in food processing environments due to its ability to survive at extreme temperatures as well as its ability to form biofilms and spores.
  • B. cereus has been recovered from a wide range of foods, including rice, dairy products, spices, bean sprouts and other vegetables.
  • Fried rice is an important cause of emetic–type food poisoning associated with B. cereus.
  • The organism is frequently present in uncooked rice, and heat–resistant spores may survive cooking.
  • Cooked rice subsequently at room temperature can allow vegetative forms to multiply, and the heat-stable toxin that is produced can survive brief heating such as stir frying
  • Two distinct types of toxin-mediated food poisoning are caused by B. cereus, characterized by either diarrhea or vomiting, depending on which toxin is involved. The diarrheal toxin is produced by vegetative cells in the small intestine after ingestion of either bacilli or spores. The emetic toxin is ingested directly from contaminated food. Both toxins cause disease within 24 hours of ingestion.
  • The emetic syndrome is caused by direct ingestion of the toxin.
  • The number of viable spores and vegetative bacteria that produce diarrheal toxin is reduced by heating, although spores associated with emetic toxin are capable of surviving heat processing.
  • Cereulide is heat stable and resistant to gastric conditions.
  • The ingested toxin itself may therefore cause disease despite sufficient heating to kill B. cereus.
  • The emetic syndrome is characterized by abdominal cramps, nausea, and vomiting. Diarrhea also occurs in about one–third of individuals. Symptom onset is usually within 1 to 5 hours of ingestion, but it can also occur within half an hour and up to six hours after ingestion of contaminated food.
  • Symptoms usually resolve in 6 to 24 hours.
  • Rice–based dishes in particular have been implicated in emetic toxin mediated disease, usually as a result of cooling fried rice dishes overnight at room temperature followed by reheating the next day.
  • The infective dose of cereulide required to cause symptoms is 8 to 10 micrograms per kilogram of body weight.

Inspirational Story

Hospital window

Two men, both seriously ill, occupied the same hospital room. One man was allowed to sit up in his bed for an hour each afternoon to help drain the fluid from his lungs. His bed was next to the room’s only window. The other man had to spend all his time flat on his back. The men talked for hours on end. They spoke of their wives and families, their homes, their jobs, their involvement in the military service, where they had been on vacation.

Every afternoon when the man in the bed by the window could sit up, he would pass the time by describing to his roommate all the things he could see outside the window. The man in the other bed began to live for those one hour periods where his world would be broadened and enlivened by all the activity and color of the world outside. The window overlooked a park with a lovely lake. Ducks and swans played on the water while children sailed their model boats. Young lovers walked arm in arm amidst flowers of every color and a fine view of the city skyline could be seen in the distance. As the man by the window described all this in exquisite detail, the man on the other side of the room would close his eyes and imagine the picturesque scene.

One warm afternoon the man by the window described a parade passing by. Although the other man couldn’t hear the band – he could see it. In his mind’s eye as the gentleman by the window portrayed it with descriptive words. Days and weeks passed.

One morning, the day nurse arrived to bring water for their baths only to find the lifeless body of the man by the window, who had died peacefully in his sleep. She was saddened and called the hospital attendants to take the body away. As soon as it seemed appropriate, the other man asked if he could be moved next to the window. The nurse was happy to make the switch, and after making sure he was comfortable, she left him alone.

Slowly, painfully, he propped himself up on one elbow to take his first look at the real world outside. He strained to slowly turn to look out the window beside the bed. It faced a blank wall. The man asked the nurse what could have compelled his deceased roommate who had described such wonderful things outside this window. The nurse responded that the man was blind and could not even see the wall.

She said, "Perhaps he just wanted to encourage you."

ePress Release

Chickenpox: anti viral drugs can prevent complications

March is the season for chicken pox. Primary infection with varicella virus causes chickenpox in susceptible hosts. It can cause significant complications, such as soft tissue infection, pneumonia, hepatitis and encephalitis in adults, pregnant women and immunosuppressed hosts. All adults and older children should receive antiviral drugs 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.

Treatment Guidelines

  • Anti allergic drugs can be given for pruritus.
  • Fingernails should be closely cropped to avoid significant excoriation and secondary bacterial infection.
  • Paracetamol should be used to treat fever, particularly in children, since the administration of aspirin has been associated with the onset of Reye syndrome.
  • Acyclovir, an antiviral drug (not a trade name) is an effective therapy for primary varicella in both healthy and immunosuppressed hosts.
  • Acyclovir is safe and effective for varicella if given during the first 24 hours of rash.
  • Acyclovir should be given to all older children and adults (older than 12 years of age), secondary household cases, history of chronic cutaneous or cardiopulmonary disorders, on steroids, on chronic salicylates.


  • Varicella vaccination is recommended for all children between 12 and 15 months of age without evidence of immunity.
  • Routine second dose of varicella vaccine at age 4 to 6 years.
  • All susceptible children aged 19 months to 13 years should be fully vaccinated (with two doses) by their 13th birthday.
  • Routine vaccination for all healthy persons aged >13 years is recommended for those without evidence of immunity.
  • Two doses of single-antigen varicella vaccine should be given four to eights weeks apart.
  • Varicella vaccine is highly recommended in VZV–seronegative adults with ongoing risk of exposure (e.g., day care employees), those who are household contacts of immunosuppressed hosts and in women of child-bearing age.
  • A second dose of varicella vaccine is recommended for adolescents and adults who had previously received only one dose.


Zee News – Health Wealth Shows

Cancer Prevention
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Fluid Intake


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)

emedipicstoday emedipics

Health Check Up and CPR 10 Camp at NP Primary School, Rama Krishna Marg–16th July 2014

press release

FDA panel recommends first drug for HIV prevention

video of day video of day


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 :


Make Sure

Situation: A patient with dengue fever developed shock.
Reaction: Oh my God! Why was the blood pressure 90/80 ignored?
Lesson: Make sure that a pulse pressure of less than 20 is not ignored, it is an impending sign that the patient is going into shock.

eMedinewS Humor

Never be rude to anyone

An American tourist asked a boat guy in Zanzibar, "Do you know Biology, Psychology, Geography, Geology or Criminology?"

The boat guy said, "No. I don’t know any of these."

The tourist then said, "What the hell do you know on the face of this Earth? You will die of illiteracy!"

The boat guy said nothing. After a while the boat developed a fault and started sinking. The boatman then asked the tourist, "Do you know Swimology and Escapology from Crocodiology?"
The tourist said, "No!"

The boat guy replied, "Well, today you will Drownology and Crocodiology will eat you. I will not Helpology and you will Dieology because of your Badmouthology."

Quote of the Day

The best thing about dreams is that fleeting moment, when you are between asleep and awake, when you don’t know the difference between reality and fantasy, when for just that one moment you feel with your entire soul that the dream is reality, and it really happened. Johann Wolfgang von Goethe

Twitter of the Day

Dr KK Aggarwal:Diabetes is a progressive diseasehttp://bit.ly/HTZaj4 #Health
Dr Deepak Chopra:You were created to be completely loved and completely lovable, for your whole life

eMedi Quiz

Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionization of the drug in the stomach. Which of the following statements is not a correct example?

1. Absorption of digoxin is delayed by the presence of food.
2. Concurrent food intake may severely reduce the rate of absorption of phenytoin.
3. Presence of food enhances the absorption of hydrochlorothiazide.
4. Anitimalarial drug halofantrine is more extensively absorbed if taken with food.

Yesterday’s Mind Teaser: The parameters of sensitivity and specificity are used for assessing:

1. Criterion validity.
2. Construct validity.
3. Discriminant validity.
4. Content validity.

Answer for yesterday’s Mind Teaser: 1. Criterion validity

Correct answers received from: Dr Gopal Shinde, Dr P C Das, Dr Jainendra Upadhyay, Dr K V Sarma, Dr Chandresh Jardosh, Dr Avtar Krishan

Answer for 25th July Mind Teaser: 4. X–ray diffraction.

Correct answers received from: Dr Bitaan Sen & Dr Jayashree Sen

Send your answer to ijcp12@gmail.com

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  1. Dear Sir, Very Informative Newspaper. Regards: Dr Kavish
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