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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; National Vice President Elect Elect, Indian Medical Association; 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…

eMediTube (videos), eMedipics, eMediSlide, eMediLaw


29th March 2013, Friday

Physical illness can trigger depression

If you have depression, a thorough physical exam and careful medical history should be evaluated to pinpoint a physical source of the problem for an appropriate treatment.

In depression not only look for what’s going on in the mind and brain but also check what’s going on in the body. Many medical problems are linked to mood disturbances.

Over fifty percent of heart attack survivors and those with cancer report feeling depressed. Depression is also linked to diabetes, Parkinson’s and other chronic conditions.

Depression too can affect the course of a physical disease. Depression is linked with slower recovery from a heart attack and an increased risk for future heart trouble.

Thyroid disorders also affect mood. Overactive thyroid can cause mania and under active thyroid can cause depression. Other medical conditions associated with mood disorders include certain neurological conditions (multiple sclerosis, Parkinson’s disease, Alzheimer’s), other hormonal imbalances, and lack of vitamin B12.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Treating vitamin D deficiency in the country

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

A symposium on prayer, faith, meditation and healing was organised by Heart Care Foundation of India jointly with Bhartiya Vidya Bhavan at Bhavan’s Auditorium.

Dr K K Aggarwal
    National News

Court tells lab to pay Rs 5L for a 'killer' report (Saeed Khan, TNN Mar 25, 2013, 02.44AM IST)

AHMEDABAD: A consumer court has ordered a laboratory technician to pay Rs 5 lakh towards compensation for preparing wrong blood report due to which a three-year-old kid died during treatment. The Consumer Dispute Redressal Forum, Surendranagar, has also prohibited the laboratory technician, Rupesh Shah, of Rushabh Pathology Laboratory from issuing blood investigation reports with his signature. This is because he is not a qualified pathologist and Gujarat high court has ordered that no laboratory technician without having a degree in pathology can run a lab in the state. In this case, three-year-old Jaynil Rawal fell ill on February 26 last year in Surendranagar. His father admitted the boy in a paediatrician's hospital. The doctor asked for blood investigation report and the report was obtained from Rushabh Laboratory, which showed that little Jaynil was suffering from falciparum malaria. Treatment began on this line, but the child's condition deteriorated further. Jaynil was shifted to C U Shah Medical College, where another blood report was obtained. It reflected that the child did not have falciparum malaria. But it was too late by then as the child's haemoglobin count had come from 10.02 to just 3.03. He died on February 29 morning. The child's father, Virenkumar approached the consumer court demanding Rs 5 lakh from the laboratory owner for providing flawed blood report, which led to the death of his son. After the hearing, the consumer court held Shah guilty of giving wrong blood investigation report. On deciding the amount of compensation, the consumer court said, "Human life cannot be valued in money, but still certain parameters are taken into consideration to decide the amount of compensation in such cases. The child was just three-year-old, and he was studying in Dayamati Mata English Medium School. His examination report shows that he got 83% marks... It cannot be said what this boy would have done in life. The forum believes that the full compensation amount demanded should be granted in this case." Besides, the forum restricted Shah from signing any investigation report, practically closing down the laboratory. The consumer court observed that since Shah did not have any degree in pathology, which is a must to run a laboratory as per the high court's directions. The consumer forum can restrain people from providing harmful services under section 14 (1) (HA) of the Consumer Protection Act.

Pushpanjali Medicine Update 2013

PUSHPANJALI CROSSLAY HOSPITAL in association with API Ghaziabad is organizing first round of Zonal CME of API “Pushpanjali Medicine Update 2013” on 21st April 2013 (Sunday). The Conference will cover a wide range of scientific topics of relevance to Physicians and Residents in their day-to-day practice. Participants/Delegates will have an opportunity of interacting with Eminent National and International Faculty at the CPC and Q&A during the sessions learning latest and updated International best practice procedure/methods. Venue: Hotel Radisson Blu, Kaushambi, Ghaziabad. 12.30pm onwards. Contact: Dr. Neelesh Goyal (09810003488) at docneelesh@yahoo.co.in

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)


Sexual abuse is when a child engages in sexual activity for which he/she cannot give consent, is unprepared for developmentally, cannot comprehend, and/or an activity that violates the law or social taboos of society.

For comments and archives

    Valvular Heart Disease Update

Prosthetic valve update

Systemic embolization (predominantly cerebrovascular events) occurs at a frequency of approximately 0.7 to 1.0 percent per patient per year in patients with mechanical valves who are treated with warfarin. In comparison, the risk is 2.2 percent per patient per year with aspirin and 4.0 percent with no anticoagulation. Patients with mitral valve prostheses are at approximately twice the risk compared to those with aortic valve prostheses.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

New guidelines for weight-loss surgery upgrade sleeve procedure

Sleeve gastrectomy is an effective form of bariatric surgery and should no longer be considered investigational, according to updated guidelines cosponsored by the American Association of Clinical Endocrinologists, The Obesity Society, and the American Society for Metabolic & Bariatric Surgery. (Source: Medpage Today)

FDA approves third oral agent for MS

The US Food and Drug Administration (FDA) has approved dimethyl fumarate (Tecfidera, Biogen Idec) for the treatment of relapsing-remitting multiple sclerosis (MS). The approval brings to 3 the number of oral agents now approved for this indication. Fingolimod (Gilenya, Novartis) was the first, in September 2010, followed by teriflunomide (Aubagio, Genzyme/Sanofi) earlier this year. (Source: Medscape)

Macrolides may help in non-CF bronchiectasis

Two macrolide antibiotics -- erythromycin and azithromycin -- reduced infectious pulmonary exacerbations in patients with non-cystic fibrosis bronchiectasis, but at the cost of increased resistance to the drugs, two year-long randomized trials showed. (Source: Medpage Today)

Predictors of failure after laser surgery for glaucoma

Laser trabeculoplasty procedures can fail in 30% to 40% of patients with glaucoma, and they will need additional treatment to control their eye disease, according to 2 new studies. (Source: Medscape)

Heart failure: Is there a breath test?

Analyzing a single puff of exhaled air, or "breathprint," aids in speedy diagnosis of heart failure, according to research from Cleveland Clinic. (Source: Medpage Today)

   Twitter of the Day

@DrKKAggarwal: Never tell a patient that you are suspecting a diagnosis of cancer Informed consent and a premature... http://fb.me/2eXGQ9Ajr

@DeepakChopra: All my life people have been repelled from me and I don’t know why. How do I change tish? http://tinyurl.com/bptenwy

    Spiritual Update

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

Should Sanjay Dutt be pardoned?

If the law is clear that under Section 25 (1 A) of the arms act that after the possession of arms without license, there is a minimum punishment of five year imprisonment, then why a long trial. As I understand the role of a judge is to look for the mitigating circumstances at the time of crime.

For comments and archives

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What is atresia?

Atresia is a degenerative process that occurs regardless of whether you are pregnant, have normal menstrual cycles, use birth control, or are undergoing infertility treatment. Smoking appears to accelerate atresia and is linked to earlier menopause.

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

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

Antibodies can be detected by

  • Saline agglutination test (SAT)
  • Tests using cells suspended in colloid media
  • Tests using enzyme-treated cells- Rh & occasional antibodies
  • Indirect antiglobulin (Coomb’s test) - wide spectrum.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A 6–year–old child with fever needed an antipyretic.
Dr Bad: Take aspirin.
Dr Good: Take paracetamol.
Lesson: Children should not be given aspirin for chickenpox and flu–like symptoms as it can cause Reye’s syndrome.

Make Sure

Situation: A patient with hypothermia with no shivering died.
Reaction: Oh my God! Why was intensive management not given?
Lesson: Make sure all patients of hypothermia with no shivering are treated aggressively. Absence of shivering is bad prognostic sign.

   An Inspirational Story

Why dogs live less than human!

Being a veterinarian, I had been called to examine a ten-year-old Irish Wolfhound named Belker.

The dog’s owners, Ron, his wife, Lisa, and their little boy, Shane, were all very attached to Belker and they were hoping for a miracle.

I examined Belker and found he was dying.

I told the family we couldn’t do anything for Belker and offered to perform the euthanasia procedure for the old dog in their home.

As we made arrangements, Ron and Lisa told me they thought it would be good for six-year-old Shane to observe the procedure.

They felt as though Shane might learn something from the experience. The next day, I felt the familiar catch in my throat as Belker’s family surrounded him.

Shane seemed so calm, petting the old dog for the last time, that I wondered if he understood what was going on.

Within a few minutes, Belker slipped peacefully away. The little boy seemed to accept Belker’s transition without any difficulty or confusion.

We sat together for a while after Belker’s death, wondering aloud about the sad fact that animal lives are shorter than human lives.

Shane, who had been listening quietly, piped up, “I know why.” Startled, we all turned to him. What came out of his mouth next stunned me. I’d never heard a more comforting explanation.

He said, “People are born so that they can learn how to live a good life — like loving everybody all the time and being nice, right?”

The six-year-old continued, “Well, dogs already know how to do that, so they don’t have to stay as long.”

Source: http://academictips.org/blogs/why-dogs-live-less-than-human/

For comments and archives

    Laugh a While (Dr GM Singh)

Financial Management

A beggar to another beggar: I had a grand dinner at Taj yesterday.

How? The other beggar asked.

First beggar: Some one gave me a Rs 100/- note yesterday.

I went to Taj and ordered dinner worth Rs 1,000/- and enjoyed the dinner. When the bill came, I said, I had no money.

The Taj manager called the policeman, and handed me over to him.

I gave the Rs 100/- note to the police fellow, and he set me free.

A wonderful example of financial management indeed.

    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

Can rabies vaccine be given to HIV or AIDS patient?

Rabies vaccine can be given to HIV or AIDS patient. It is recommended to administer RIGs even in category II exposures in such patients and double dose of anti-rabies vaccine must be given on day 0 of vaccination.

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   Cardiology eMedinewS

Less invasive coronary revascularization lowers spending, days missed from work Read More

Very obese patients do well after TKA Read More

   Pediatric eMedinewS

FDA OKs new antibiotic form for CF use Read More

  Quote of the Day (Dr GM Singh)

A dreamer is one who can only find his way by moonlight, and his punishment is that he sees the dawn before the rest of the world. Oscar Wilde

    Mind Teaser

Read this…………………

A male client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region, which radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site?

a. Kidney
b. Ureter
c. Bladder
d. Urethra

Yesterday’s Mind Teaser: Nurse Claudine is reviewing a client’s fluid intake and output record. Fluid intake and urine output should relate in which way?

a. Fluid intake should be double the urine output.
b. Fluid intake should be approximately equal to the urine output.
c. Fluid intake should be half the urine output.
d. Fluid intake should be inversely proportional to the urine output.

Answer for yesterday’s Mind Teaser: : b. Fluid intake should be approximately equal to the urine output.

Correct answers received from: Dr. Bharat Bhushan Aggarwal, dr prabha, drjella, DR P K SAHU , Dr Pankaj Agarwal, Dr.K.V.Sarma,, Dr.K.Raju, Dr. Thakor Hitendrsinh G, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr R.Sahoo, Dr Avtar Krishan, JAYARAMAN TP, Dr B K Agarwal, Pinky Naik, DR.T.H.SAHERWALA, Dr.V.M.kartha, Dr.Raghavendra Jayesh, Dr.Jayashree Sen & Dr.Bitaan Sen

Answer for 27th March Mind Teaser: c. Mumps

Correct answers received from: Dr.(Maj. Gen.) Anil Bairaria, Dr.K.V.Sarma, Dr Arpan Gandhi, Dr.Rohini Dhillon, Dr Jainendra Upadhyay, Dr.Jayashree Sen & Dr.Bitaan Sen, Dr. shashi saini, DrGajveer, Dr. Bharat Bhushan Aggarwal

Send your answer to ijcp12@gmail.com

    Medicolegal Update

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

What is contributory medical Negligence?

The pregnant woman delivered a child with spina bifida however she failed to regularly attend the advised dates for antenatal ultrasounds that would have identified this problem. The patient was found to be 100% at fault."

  • In a medical malpractice/maloccurence case, medical negligence is the foremost ingredient to establish the liability of damage and dereliction in provided medical care. However, it is important to establish the difference between malpractice and contributory negligence when determining liability.
  • Contributory negligence means the patient/legal heirs/parties are partially to blame for the maloccurrence or medical untoward incident. For e.g., a patient is admitted to the emergency room for treatment and they fail to inform the doctor about a pre–existing condition e.g. any allergy to a drug. The patient is guilty of contributing to the negative outcome/damage of the treatment.
  • If the victim is found to be even one percent at fault, they will be unable to recover compensation for their injuries. However, comparative negligence is used to determine degree of liability of the doctor/medical care provider.
  • Contributory negligence will determine who will receive compensation for their losses and how much they may be entitled to receive in compensation for their injuries. Pure comparative negligence means that in case of an aggrieved patient, damages will be calculated and then reduced to reflect his or her contribution to the injury.

In India, the doctors take the defense against malpractice cases when determining how the parties involved are responsible. In US, 4 categories apply in compensation cases in many of its states: Pure Comparative Negligence/Pure Contributory Negligence/ Modified Comparative Negligence—50% Bar Rule and Modified Comparative Negligence—51% Bar Rule. Twenty–one states that recognize the 51% Bar rule which means that the party who is less than 51% liable can seek compensation; only 11 US states use the 50% Bar rule, which means that if the damaged party is less than 50% responsible, they can collect damages.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Do not mix salt with milk

A high-salt diet may increase the risk of developing gastric and duodenal ulcers. High concentrations of salt in the stomach can induce gene activity in the ulcer-causing Helicobacter pylori bacterium that causes it to become more virulent. Bacterial cells exposed to increased salt exhibit striking morphological changes. Cells become elongated and form long chains.

Salt restriction also reduces the diastolic blood pressure by 2-8 mmHg, said Padamshri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

A WHO report, said that reducing salt intake would be a cost-effective way to reduce the risk of developing high blood pressure directly and reducing the risk of heart attack and stroke indirectly. The report recommends people to reduce consumption of sodium to less than 2 gm per day for each person. Common salt is chemically called Sodium Chloride (NaCl). About 2.5 gm of table salt contains one gm of Sodium. This would mean that about 5 gm of table salt is the current recommended level of consumption per day.

According to a report published from the All India Institute of Medical Sciences in the year 2000, the average intake of salt in India is 10 gm per day for each person. This would amount to about 4 gm of Sodium. The current recommendations suggest reducing this consumption by half.

A recent research study conducted by researchers at Harvard Medical School and published in the British Medical Journal, found that reducing salt intake by 25% reduced the risk of developing heart disease by 25% and reduced the chance of death from heart disease by 20%.

In 2002 WHO estimated that globally about 62% of strokes and about 50% of heart attacks were attributable to high blood pressure.

Adding a pinch of salt to milk will keep it fresh longer is a common Internet tip for the population but traditional Ayurveda teaching goes against it. As per charka samhita, too much of pipalli, alkali and salt are bad for the health. Ayurveda totally prohibits taking salt with the milk.

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 31266 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

    Readers Response
  1. Dear Dr Aggarwal, I have gone through the article (You Can Reverse Heart Disease published in eMedinewS dated March 25, 2013) and I salute you for your instincts and depth of knowledge. Source must be from within because no science textbook explains it this way. I really can’t take stock of the knowledge that you as an individual possess. On same account, I believe that you must be a person with not just six senses but seven senses. Dr Kiran Kapoor
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