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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 and 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 of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR


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  Editorial …

28st July 2011, Thursday

Today is World Hepatitis Day

Hepatitis B more deadly than HIV

Over 200 diseases can be transmitted from exposure to blood; the most serious infections are hepatitis B virus, hepatitis C virus and HIV.

HIV, Hepatitis B and Hepatitis C all can be transmitted through blood and blood products and /or by sexual route. The prevalence of HIV is only 0.3% in the general population the same of hepatitis C is up to 5%.

Hepatitis B virus is the most infectious of the three blood borne viruses. It gets transmitted by percutaneous and mucosal exposures and Human Bites.

Hepatitis B can also be transmitted by FOMITES such as FINGER STICK BLOOD SUGAR CHECK, multi dose medication vials, jet gun injectors, and endoscopes. Hepatitis B virus can SURVIVE ON COUNTER TOPS FOR UPTO SEVEN DAYS and remain capable of causing infection.

Testing of health care workers for hepatitis C virus (HCV) should be performed after needle sticks, sharp injuries, mucosal, or non intact exposure to hepatitis C virus positive blood.

The average incidence of sero conversion to hepatitis C virus after unintentional needle sticks or sharps exposures from an hepatitis C virus positive source is 1.8 percent (range, 0-7 percent).

Transmission of hepatitis C virus can occur from infected fluid splashes to the conjunctiva. Hepatitis C virus can survive on environmental surfaces for up to 16 HOURS.

The first step after being exposed to blood or bodily fluids is to wash the area well with soap and water. EXPRESSING FLUID BY SQUEEZING the wound will not reduce the risk of blood borne infection.

Give Hepatitis B Vaccine to all unvaccinated persons after exposure to blood. If the exposed blood is positive for HBV and the exposed person is unvaccinated, treatment with hepatitis B immune globulin is recommended.

New weapons of war are HIV kanya, HIV blood transfusions after kidnapping, HIV positive syringes for extraction of money and infected hepatitis C, hepatitis B and HIV combined blood (most deadly weapon ever possible).

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Dr KK Aggarwal
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  eMedinewS Audio PostCard

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

Hepatitis B more deadly than HIV

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    Photo Feature (from the HCFI Photo Gallery)

National Conference on Insight on
Medico Legal Issue

Dr Arvind Chopra, was felicitated at the National Conference on Insight on Medico legal issues.


Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


Rs99cr for Sunderbans power

KOLKATA: Two years since Cyclone Aila ravaged Sunderbans and totally damaged its power supply system, the area will finally get green power from renewable energy sources. The West Bengal Green Energy Development Corporation (WBGEDC) has received the Centre's financial sanction to develop a first-of-its-kind biomass solar hybrid system in Sunderbans that will benefit around 35,000 families who have been affected. (Source: The Times of India, Jul 26, 2011).

For comments and archives

Over 30m in India carry hepatitis virus

NEW DELHI: India is reeling under a serious burden of Hepatitis. Professor S K Acharya, HoD of gastroenterology at AIIMS, said studies reported from various parts of India estimate that about 20 million Indians are Hep B carriers and about 8 to 10 million may have silent Hep C virus infection. "These individuals do not know that they have these infections. We presume that about 300,000 cirrhosis and about 20,000 liver cancers may be occurring annually in this country," Prof Acharya said. According to him, India does not have a Hep B virus registry, or information on the disease burden. "Their treatment is expensive. Control strategies should include mass awareness, universal guideline for immunization and hygienic handling of food and water, which can reduce the liver disease burden substantially in our country," he added.

Other experts say Asia Pacific carries the highest burden of viral hepatitis, with India and China together having an estimated 123 million people chronically infected with Hepatitis B and 59 million chronically infected with Hepatitis C, accounting for almost 50% of all infections worldwide. (Source: TOI, Jul 27, 2011)

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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

(Dr Monica and Brahm Vasudev)

A1c may not accurately reflect postpartum glucose

Women with recent gestational diabetes, alignment of A1c with glucose levels is only "fair," new research shows. "A1c tests are easy to use after delivery for a diabetes screening test, but clinicians should be aware that they do not match up well with glucose in this time period when iron stores tend to be low and women's hemoglobin levels are in flux," Dr. Catherine Kim of the University of Michigan, Ann Arbor told Reuters Health by email. (Source: Medscape - Reuters Health Information)

For comments and archives

AAP issues consent for pediatric emergency medical services

New recommendations from the American Academy of Pediatrics (AAP) provide guidance when parental consent is not readily available or unnecessary, or when parental refusal of consent could harm the child. The Policy Statement, entitled "Consent for Emergency Medical Services for Children and Adolescents," was reported online July 25 and will appear in the August issue of Pediatrics.

"Parental consent generally is required for the medical evaluation and treatment of minor children," write Paul E. Sirbaugh, DO, and Douglas S. Diekema, MD, MPH, from the Committee on Pediatric Emergency Medicine and Committee on Bioethics. "However, children and adolescents might require evaluation of and treatment for emergency medical conditions in situations in which a parent or legal guardian is not available to provide consent or conditions under which an adolescent patient might possess the legal authority to provide consent. In general, a medical screening examination and any medical care necessary and likely to prevent imminent and significant harm to the pediatric patient with an emergency medical condition should not be withheld or delayed because of problems obtaining consent."
(Source: Medscape Medical News)

For comments and archives

Odds of surviving heart attacks can be predicted

Is it possible to predict whether someone is likely to survive or die suddenly from a heart attack? Yes, says a new study. Researchers found that hypertension, body mass index (BMI), heart rate and additional markers that can be identified by an electrocardiogram (ECG) can differentiate between dying suddenly versus living through a heart attack. “For some people, the first heart attack is more likely to be their last,” said Elsayed Z. Soliman, director of the Epidemiological Cardiology Research Centre (EPICARE) at Wake Forest Baptist, who led the study. “For these people especially, it is important that we find ways to prevent that first heart attack from ever happening because their chances of living through it are not as good,” Soliman added, reports the journal Heart. “Identifying specific predictors that separate the risk of sudden cardiac death from that of non-fatal or not immediately fatal heart attacks would be the first step to address this problem, which was the basis for our study,” Soliman was quoted as saying in a statement by Wake Forest. Researchers analysed data from two of the largest US cardiovascular studies -- the ARIC (Atherosclerosis Risk in Communities) and the CHS (Cardiovascular Health Study) -- containing records for more than 18,000 participants. (Source: http://www.thehindu.com/health/medicine-and-research/article2295336.ece?homepage=true, July 26, 2011

For comments and archives

    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

Physical activity levels linked to employment status

People's employment status has an impact on how physically active they are during the work week, but men and women are affected differently, new research shows. The investigators found that full-time employed men in either active or sedentary jobs were more active than healthy unemployed men during the work week. In comparison, women with sedentary jobs were less physically active Monday through Friday compared to unemployed women. These differences in activity levels between employed and unemployed people did not extend to weekends, the researchers noted.

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    Twitter of the Day

@DrKKAggarwal: Insight on Medicolegal issues - Dr M C Gupta on When to do the MLC_1-2.mp3: http://t.co/Z4OSfFs via @AddThis

@DeepakChopra: Stress & the Brain http://huff.to/r8Ly8U

    Dr KK Answers

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

Dr K K Answers: Can garlic lower cholesterol?

In Ayurveda, garlic has been advocated as a method to lower serum cholesterol concentrations. However, a large randomized trial compared three different garlic preparations (raw, powdered, and aged garlic extracts, dose one 4 gram clove) and placebo in 192 adults with LDL bad cholesterol 130-190 mg/dL. Patients were treated six days per week for 6 months, and none of the preparations of garlic had a significant effect on LDL-C or other lipid levels.
(Ref: Arch Intern Med 2007;167:346)

For comments and archives

    Spiritual Update

Understanding Your Personality: Vata, Pitta, Kapha

Ayurveda classifies human personality and body into different types scientifically. As per the concept the universe is made up of five elements: space, air, fire, water and earth. As is the macrocosm so is the microcosm is a common Vedic saying. Human body according to Ayurveda is also made up of the....
For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

A Little Mouse Story

A mouse looked through a crack in the wall to see the farmer and his wife opening a package. What food might it contain? He was aghast to discover that it was a mouse trap. Retreating to the farmyard the mouse proclaimed the warning: "There is a mouse trap in the house, a mouse trap in the house! “The chicken clucked and scratched, raised her head and said, "Excuse me, Mr. Mouse, I can tell this is a grave concern to you, but it is of no consequence to me. I cannot be bothered by it."

The mouse turned to the pig and told him, "There is a mouse trap in the house, a mouse trap in the house!" "I am so very sorry Mr. Mouse," sympathized the pig, "but there is nothing I can do about it but pray. Be assured that you are in my prayers. “The mouse turned to the cow. She said, "You say, Mr. Mouse. A mouse trap? Like I am in grave danger....NOT!"

So the mouse returned to the house, head down and dejected, to face the farmer's mouse trap alone. That very night a sound was heard throughout the house, like the sound of a mouse trap catching its prey. The farmer's wife rushed to see what was caught. In the darkness, she did not see that it was a venomous snake whose tail the trap had caught. The snake bit the farmer's wife.

The farmer rushed her to the hospital. She returned home with a fever. Now everyone knows you treat a fever with fresh chicken soup, so the farmer took his hatchet to the farmyard for the soup's main ingredient. His wife's sickness continued so that friends and neighbors came to sit with her around the clock. To feed them, the farmer butchered the pig. The farmer's wife did not get well and a few days later she passed away. So many people came for her funeral that the farmer had the cow slaughtered, to provide meat for all of them to eat. So the next time you hear that someone is facing a problem and think that it does not concern you, remember that when the least of us is threatened, we all may be at risk.

We are all one family on this planet Earth!

For comments and archives


(By Ritu Sinha)

Add fuel to the fire: When something is done to make a bad situation even worse than it is.

    Pediatric Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

What is the copper-free diet in Wilson’s disease?

Foods with very high concentrations of copper like shellfish, nuts, chocolate, mushrooms, and organ meats, coco powder generally should be avoided, at least in the first year of treatment. Well water or water brought into the household through copper pipes should be checked for copper content, but in general, municipal water supplies do not have to be checked. A water purifying system may be advisable if the copper content of the water is high. Copper containers or cookware should not be used to store or prepare foods or drinks.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, Dr. Kaberi Banerjee, Infertility and IVF Specialist, Max Hospital)

Why is vaccination important before infertility treatment and during pregnancy?

Immunizations should be completed before conception as some recommended vaccinations cannot be administered during pregnancy. Vaccinations protect women from serious illnesses and prevents intrauterine infections and passive immunity to the newborn. Maternal immunoglobulin (IgG) antibodies is transported to the fetus occurs throughout gestation.

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    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Reticulocyte count

A reticulocyte count is a blood test that measures how fast red blood cells called reticulocytes are made by the bone marrow and released into the blood. Reticulocytes remain in the blood for about 2 days before developing into mature red blood cells. Normally, about 1- 2% of the red blood cells in the blood are reticulocytes. This test is done to

  • See whether anemia is caused by fewer red blood cells being made or by a greater loss of red blood cells.
  • Check how well bone marrow is working to make red blood cells.
  • Check to see if treatment for anemia is working. For example, a higher reticulocyte count means that iron replacement treatment or other treatment to reverse the anemia is working.

The reticulocyte count increases

  • When there is a lot of blood loss
  • In certain diseases in which RBCs are destroyed prematurely, e.g. hemolytic anemia
  • At high altitudes to help you adjust to the lower oxygen levels
For comments and archives
    IJCP Special

Dr Good Dr Bad

Situation: A pre diabetic wanted to know whether he could eat fish?
Dr Bad: Do not take it.
Dr Good: You can have it.
Lesson: According to a study published online July 20 in the American Journal of Clinical Nutrition eating fish can help men reduce their risk for type 2 diabetes by 27%.
For comments and archives

Make Sure

Situation: An asymptomatic sickle cell-positive patient with gallstones developed complications after gallbladder surgery.
Reaction: Oh my God!! Why was the gallbladder removed?
Lesson: Make sure that prophylactic gallbladder removal is not done in asymptomatic patients with sickle cell disease.
For comments and archives

  Quote of the Day

(Dr GM Singh)

Be more concerned with your character than your reputation, because your character is what you really are, while your reputation is merely what others think you are.

    Medicolegal Update

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

Defeat a negligence claim by showing the absence of elements of medical negligence

If a physician can show that no physician-patient relationship exists, this “no duty” defense may suffice to defeat the plaintiff’s action. Where there is no duty owed to the patient by the physician, a negligence claim generally fails.

  • Doctors generally have no duty to treat new patients or patients of years past, with some exceptions. This may be true even where the physician is “on call”. In some cases, even though a physician treats or diagnoses a condition, a duty exists only between the physician and the patient’s employer.
  • Courts rarely hold that the “no duty” defense applies and have even held that a simple telephone consultation between a physician and emergency department personnel may be sufficient to create a professional relationship between the physician and patient, with the attendant requirement to comply with such duty. Pre-certification review of a case may also create the potential for liability.
  • Physician who wishes to withdraw from the care of certain patients, plans to relocate his or her practice, or simple retires must notify affected patients in a manner in which an ordinary and reasonably prudent physician would do so in the same circumstances. Such notice is best made in writing and mailed postage paid to the patient’s last known address.
  • All patients receiving ongoing care for potentially serious ailments should be notified by certified mail, return receipt requested, at the last known address. Such patients should be informed that their physician will continue to see them for emergencies during a certain fixed and reasonable period of time. The physician may recommend a successor physician, provide a list of suitable physicians or offer to forward records or copies of records (at reasonable or no cost) to another physician chosen by the patient.

(Ref: American College of Legal Medicine, The Medical Malpractice Survival Handbook)

For comments and archives


    Mind Teaser

Read this…………………

Under the WHO ‘Vision 2020’ programme, the ‘SAFE’ strategy is adopted for which of the following diseases?

1. Trachoma
2. Glaucoma
3. Diabetic retinopathy
4. Onchocerciasis

Yesterday’s Mind Teaser: Type I hypersensitivity is mediated by which of the following immunoglobulins?

1. Ig A
2. Ig G
3. Ig M
4. Ig E

Answer for Yesterday’s Mind Teaser: 4 Ig E.

Correct answers received from: Dr Priyanka Sharma, Dr Prabha Sanghi, Dr Shirish Singhal, Dr KV Sarma, Dr Rajendra, Dr Surendra Bahadur Mathur, Dr B B Aggarwal, Dr Neelam Nath, Dr Nikunj Garia,

Answer for 26th July June Mind Teaser
: 2. Herpes simplex keratitis
Correct answers received from: Dr Anupama, Dr Ketan, Dr Santosh, Dr Jai, Dr Piyush, Dr Anil Bairaria, Dr K V Sarma, Dr B B Aggarwal

Send your answer to ijcp12@gmail.com

    Medi Finance Update

(Dr GM Singh)

Proposed Direct Tax Amendments In Brief

Investment Linked Deduction Under Section 35AD

  • Removal of term “new” from existing definition of specified businesses (only hotel and hospital) claiming 100% deduction under section 35AD. Thus losses under section 73A for such businesses to be freely allowed to be set off. Applicable from AY 2011-2012
  • Two additional businesses – “affordable housing projects”, “production of fertilizers” eligible for investment linked deduction (100%) under section 35AD. Applicable from AY 2012-2013.
    Laugh a While

(Dr GM Singh)

Bit of political fun

Sarkari Nai (Barber) ne baal kaat-te waqt politician se poochha, "Saab, ye Swiss Bank wala kya lafda hai?" The politician shouted, "Abey, tu baal kaat raha hai ya inquiry kar raha hai?"
Nai: "Sorry Saab, aise hi poochh liya." Agle din dusre politician se bal kaat-te waqt poochha, "Saab, ye kaala dhan kya hota hai?"
Politician shouted, "Tumne humse ye sawaal kyon poochha?" Nai: "Sorry Saab, bas aise hi poochha liya." Next day, CBI interrogated the Nai, "Are you an agent of Opposition party? Nai: "Nahin, Saab Ji." CBI: "To tum baal kat-te waqt political netaon se faltu ke sawaal kyon karte ho?"
Nai: "Saab, na jaane kyon Swiss Bank aur kaale dhan ke naam par in politicians ke baal khade ho jate hain, aur mujhko baal kaatne me aasani ho jati hai is liye poochhta rehta hoon."

For comments and archives

    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name
DCI Approval Date
Pidotimod Tablet 400 mg/800 mg & Oral Solution 400 mg/800 mg per 7ml
For infections of the respiratory system in secondary and primary immunodeficiency with alteration in maturation of T cells in adults only.


    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Ideal medicinal dose of alcohol is 6 grams or 18 ml per day.

Diseases like coronary heart blockages, ischemic paralysis and diabetes, that moderate alcohol intake prevents, are the diseases of the elderly, men, and people with coronary heart disease risk factors. Its only in this group that moderate alcohol consumption is associated with a substantial mortality benefit relative to abstention or limited drinking, said Padma Shri and Dr B C Roy national Awardee Dr K K Aggarwal president Heart Care Foundation of India and MTNL Perfect Health Mela.

For young to middle-aged adults, especially women, moderate alcohol consumption can increase the risk of the most common causes of death such as trauma and breast cancer. Women drinkers should take folate supplements to reduce the risk of breast cancer.

Younger men, below 45 years of age, experience more harm than benefit from alcohol consumption. Moderate alcohol use in this group is unlikely to provide any mortality benefit. However, if there are no contraindications, consumption of less than one drink a day is safe provided they are not in a job of operation of dangerous equipment.

In patients with established contraindications to alcohol use, even this level of alcohol use is dangerous. For them no level of alcohol consumption is safe. These people include pregnant women, personal or strong family history of alcoholism, past hemorrhagic paralysis, liver or pancreatic disease and operation of potentially dangerous equipment or machinery. There are some who can take alcohol but only under a limit. These individuals include those that have active gastritis, esophagitis, premalignant gastrointestinal lesions such as Barrett's esophagus, or a strong family history of breast cancer.

Men can tolerate more alcohol than women. The ideal safe “medicinal dose” of alcohol for men is 6 grams per day (app. 18 ml 80-proof whisky) or one drink taken every other day, in those where it is not contraindicated. The dose associated with lowest mortality in woman is 4 gm/day (One drink every 4th day).

The medicinal safe dose differs from the safe dose in absence of contraindications. The safe limit is no more than two drinks (each drink is 45 ml of 80-proof whisky) daily for men and one drink daily for women.

For comments and archives

    Readers Responses
  1. Dear Sir Your Newsletter is really very informative. Regards: Dr Anupama
    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & National Icons in the field of Cardiology & Echocardiography will form the teaching faculty.



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