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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

  Editorial …

30th March, 2011, Wednesday                                 eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

The ‘Grand Finale’ before the final cricket match

The frenzy over the India–Pakistan semifinal match will be at its peak today. Fans all over India and Pakistan would be glued to their TV sets or the Internet and why not? This is a ‘Grand Finale’ before the actual final match of the ICC World Cup. It has already been so hyped that the Prime Ministers of both the countries will be watching it live.

One of the journalists called me up today and asked whether the presence of the Prime Minister would affect the morale of our cricket players and they might end up in performance anxiety. I replied, theoretically yes but practically no. It may also be interpreted in the other way round that it will be a great opportunity for players that they are being watched by none other than the Prime Minister of India and if any one performs well, he could well be the candidate for a Padma Bhushan or Padma Vibhushan next year. Sachin Tendulkar scoring his 100th century at Mohali might well put the criticism under rest as to whether he should get a Bharat Ratna. For Yurvaj Singh, if he performs, the Man of the Series trophy is his for the taking. Yuvraj may also be one of the Padma Awardees next year.

When you play in front of your home crowd, your serotonin levels are high which may help you to perform better and also perform at will. This is called ‘Chimpanzee Serotonin effect’. With the cheering population in Mohali, it is very clear that the serotonin levels of Indian players would be much higher than that of Pakistani players and this will give them an extra edge to perform.

Performance anxiety is another phenomenon which may negate the serotonin effect. But most of our players are experienced and not likely to get carried away with this effect. Performance anxiety affects the batsmen more than the bowlers because if a bowler makes a mistake, the team only loses six runs; but if a batsman makes a mistake, he is out of the match. The Indian team has players like Virender Sehwag, Sachin Tendulkar, Gautam Gambhir, Suresh Raina, Yuvraj Singh and Mahender Singh Dhoni who have played enough cricket to not be affected by performance anxiety.

Most of us will bet for an Indian victory because of patriotism but given the circumstances, I will scientifically and medically bet for India and give them the advantage because of the serotonin effect.

The Chimpanzee effect: If a chimpanzee dies, the next in command takes over and everybody notices a change in that chimpanzee. His performance doubles or triples than others. Scientifically, it has been shown that serotonin levels of the Head of the chimpanzee family are much higher than those who are just family members. This change is seen the very day the new chimpanzee takes over as the Head of the family. This increase in serotonin levels is also seen in politicians. Politicians who deliver a speech in front of an audience of say 20,000 have more serotonin levels than those who deliver the same speech in sitting in the studio.

Good luck readers, your wishes will bring home the World Cup.

Dr KK Aggarwal
Editor in Chief
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    eMedinewS Audio PostCard

 HIV Update

Dr Nalin Nag Speaks on
Natural History of HIV/AIDS’

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

17th MTNL Perfect Health Mela 2010

Students from Dancing Schools from Delhi and NCR participated in large numbers in group dance competition organized in the 17th MTNL Perfect Health Mela 2010.

Dr K K Aggarwal
    National News

At 1,706, India’s tiger count up 12 percent

India is today home to 1,706 tigers, says the latest tiger census released here Monday. The figure marks an increase of 12 percent, excluding the Sunderbans mangroves which accounts for 70 tigers. The census for 2010 was released at the March 28–30 International Tiger Conference hosted by Environment and Forests Minister Jairam Ramesh. The latest census indicates that the Shivalik–Gangetic plains have 353 tigers, central India and Eastern Ghats have 601 tigers, Western Ghats 534, the northeast hills and Brahmaputra floodplains 148, and the Sunderbans 70. The last census in 2006 had shown a sharp fall in tiger numbers, at 1,411 tigers in the wild. India was home to about 3,000 tigers around two decades ago. This time, the upper limit for the tiger numbers has been set at 1,875 and the lower limit at 1,571. The average figure comes to 1,706. If one excludes the figure for the Sunderbans, which was not counted last time, the tiger count is around 1,636, marking an increase of 12 percent of the 2006 figure of 1,411. (Source: The Pioneer, March 28, 2011)

Doctors’ role in public health brought out

CHENNAI: Doctors must be partners in improving the health of the community, act as informed facilitators and not become demigods, said K. Srinath Reddy, president of the National Board of Examination and of the Public Health Foundation of India. Speaking at the 13th convocation of Sri Ramachandra University here on Saturday, he said the practice of medicine involved the art of communication. He urged the graduates to act collectively as a society to influence the social determinants of health, to prevent disease and protect the environment. "The value framework must involve care and compassion in medical and public health. The community that the doctors serve must be respected and made a partner," Dr. Reddy said. (Source: The Hindu, Mar 28, 2011

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

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

Study highlights chlorinated water cancer risk

Research published in the Environmental Health journal has found that swimming in chlorinated water too often could increase the risk of bladder cancer. According to a study by the Centre for Research in Environmental Epidemiology (CREAL) in Spain, high levels of the chemical trihalomethanes (THM) could pose a risk. The research found a possible risk of cancer caused by THM being ingested through public drinking supplies or skin absorption in baths, showers and public swimming pools. Dr Gemma Castaño–Vinyals, who led the research, said: "Despite being apparently cleaner and taking more exercise – a result of taking more frequent and longer baths, and using swimming pools more often – they are actually increasing their risk of THM exposure." It must be said that, the risk of these contaminants causing bladder cancer is small, and findings from this research may help us to understand water use patterns in the context of cancer prevention."

(Dr GM Singh)

Validation of the2 score for predicting stroke risk after transient ischemic attack

An ABCD2 score >2 is associated with significantly increased risk for stroke within 90 days.

The ABCD2 score has been endorsed internationally as a simple method for identifying patients with transient ischemic attack (TIA) who are at high risk for early stroke and require admission, yet multiple external validation studies have demonstrated mixed results. In a multicenter case series study, investigators prospectively applied the score to 148 consecutive patients with TIA at three hospitals.

The 7–point ABCD2 score is based on the following:

  • Age 60 = 1 point
  • Blood pressure at presentation 140/90 mm Hg = 1 point
  • Clinical features: unilateral weakness = 2 points; speech disturbance without weakness = 1 point
  • Duration of symptoms: 10–59 minutes = 1 point; 60 minutes = 2 points
  • Diabetes mellitus = 1 point

Patients with higher ABCD2 scores had significantly higher incidences of stroke at 7 days and 90 days. The score accurately predicted high 7–day and 90–day stroke risk (area under the receiver operating characteristic curve, 0.72 and 0.75, respectively). Patients with scores >2 were five times more likely to suffer stroke at 90 days than those with lower scores.

(Dr Monica and Brahm Vasudev)

Multivitamins not protective against dying from heart disease or cancer

Taking multivitamins appears not to be protective against dying from either heart disease or cancer, according to a study recently published online in the American Journal of Epidemiology.

Mercury from eating fish may not increase risk of heart disease or stroke

In a study published in the New England Journal of Medicine, researchers analyzing toxin levels in tens of thousands of toenail clippings determined that mercury from eating fish does not raise the risk of heart disease or stroke.

Even mild stress is linked to long–term disability, study finds

Even relatively mild stress can lead to long term disability and an inability to work, reveals a large population based study published online in the Journal of Epidemiology and Community Health.

    IJCP Special

Dr Good Dr Bad

Situation: A pregnant lady died.
Dr Bad: Declare her dead.
Dr Good: Deliver the infant within 5 minutes.
Lesson: "Five minute rule", the best outcome with regards to neonatal neurological outcome is most likely when delivery occurs within five minutes of maternal cardiac arrest.

Make Sure

Situation: A rape victim became pregnant.
Reaction: Oh my God! Why was emergency contraceptive not given to her?
Lesson: Make sure that all victims of rape are given an emergency contraceptive.

    An Inspirational Story

(Dr Prachi Garg)

The Buzzard, the Bat, and the Bumblebee

If you put a Buzzard in a pen six or eight feet square and entirely open at the top, the bird, in spite of his ability to fly, will be an absolute prisoner. The reason is that a buzzard always begins a flight from the ground with a run of ten or twelve feet. Without space to run, as is his habit, he will not even attempt to fly, but will remain a prisoner for life in a small jail with no top.

The ordinary Bat that flies around at night, a remarkable nimble creature in the air, cannot take off from a level place. If it is placed on the floor or flat ground, all it can do is shuffle about helplessly and, no doubt, painfully, until it reaches some slight elevation from which it can throw itself into the air. Then, at once, it takes off like a flash.

A Bumblebee if dropped into an open tumbler will be there until it dies, unless it is taken out. It never sees the means of escape at the top, but persists in trying to find some way out through the sides near the bottom. It will seek a way where none exists, until it completely destroys itself.

In many ways, there are lots of people like the Buzzard, the Bat and the Bee. They are struggling about with all their problems and frustrations, not realizing that the answer is right there above them.

    Infertility Update

(Dr. Kaberi Banerjee, Director Precious Baby Foundation)

What is Intrauterine insemination

The IUI procedure consists of washing an ejaculated semen specimen to remove prostaglandins, concentrating the sperm in a small volume of culture media, and injecting the sperm suspension directly into the upper uterine cavity using a small catheter threaded through the cervix. The insemination is timed to take place just prior to ovulation, typically using home urine luteinizing hormone (LH) measurement. In couples with mild male infertility, IUI does improve pregnancy rates in couples when compared to intracervical insemination or timed natural cycles.

    Hepatology Update

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

How do we diagnose Galactosemia?

Diagnosis is made by demonstration of reduced or absent activity of the enzyme galactose–1–phosphate uridyl transferase (GAL–1–PUT) which is central to galactose metabolism. This test is invalid if the child has received a blood transfusion within previous 2 months. Parents’ samples should be sent instead for carrier testing.

    Medicolegal Update

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

What is somnambulism? Person walks during sleep

In the state of somnambulism, the person while sleeping, may get up from the bed, open the door, walk out a distance and return to his bed to sleep again to remember nothing the next day.

  • During the whole episode the subject is in a state of dissociated consciousness, and may perform automatic acts, over which he has no control and which he does not remember later on.
  • He is in a state of hallucination and his acts are not in consonance with his immediate environment.
  • His mind is apparently undisturbed and is uninfluenced by too many factors, as is usual during the busy hours of the day.
  • For this reason he can concentrate much in such acts of automatism, which he performs in the state of somnambulism. This is why it is occasionally observed that, a person can solve a difficult problem during the state of somnambulism which he could not do otherwise.
  • The same act of automatism may be repeated in different episodes of somnambulism or often, a coordinated work may be performed part by part during the phases of different attacks.
  • The act of automatism remains limited to the sleeping hours and does not influence the rest of the period of the day. The person has no mental abnormality when he is awake.
  • If in a fit of somnambulistic automatism, a person commits a criminal act, he will not be held responsible for the same.
    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

Infants of overweight mothers


Even in moderately overweight mothers (BMI 25–30 or 120–150% of ideal body weight), the incidence of perinatal death in the infants was 1.15– to 2.5–fold higher than that in normal–weight women. In obese women (BMI >30 or >150% of ideal body weight), the incidence of perinatal death in infants exceeded that in normal–weight women by 2.5 and 3.4. Maternal complications and preterm deliveries largely contribute to this excessive mortality.

    Head Injury Update

Dr Shameem Ahmed, Dr Atanu Borthakur, Dr Sajida Sultana, Dr Shabbir Khan. Dept. of Trauma and Neurosurgery, Hayat Hospital, Guwahati, Assam.

In the UK, out of 62 million people, 150000 people encounter head injury per year; 15000 have severe head injury and 4000 die/year (Mendelow, August 2008). Head injury in USA constitutes 1 accident per minute, 1 death every 5 minutes and 50,000 deaths every year. About 80,000 – 90,000 lose their jobs and 50-60% patients with minor head injury have different problems. Maintaining one head injury in a year costs US $4 million. In Germany, head injury counts to 300–500/100000 population, which leads to 30,000 deaths/year and costs around US$ 38 billion annually i.e. 12% of the entire hospital cost. In Gulf over last few years there has been a 42% rise in incidence of head injury (Oman Times, 14th April 2000).

    Mind Teaser

Read this………………… 

s u
i h
t s

Yesterday’s Mind Teaser: Right=right

Answer for yesterday’s Mind Teaser:
Equal rights

Correct answers received from: Dr Meera Rekhari, Dr Rakesh Bhasin, Dr Sudipto Samaddar, Dr H.L. Kapoor, Dr K.Raju, Dr U Gaur, Dr Rashmi Chhibber, Dr Anil Bairaria, Dr Muthumperumal Thirumalpillai, Dr Amol R. Hartalkar

Answer for 28th March Mind Teaser: Rock around the clock
Correct answers received from: Dr Shashi Chhabra, Dr Meera Rekhari, Dr Sandeep Thadani, Dr Rakesh Bhasin, Dr Amit Kochar, Dr KV Sarma, Dr T Samraj, Dr U Gaur, Dr Jainendra Upadhyay

Send your answer to ijcp12@gmail.com

    Lighter Side of Reading

Laugh a While
(Dr.Chandresh Jardosh)

Afridi: Hum sachin ka 100 bilkul nahi hone denge.
Misbah: kaise? Woh to full form main hai.
Afridi: Arey hum log khud 100 k andar all out ho jayenge

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Uric acid

  • Increase in serum uric acid is seen idiopathically and in renal failure, disseminated neoplasms, toxemia of pregnancy, liver disease, ethanol consumption, etc.
  • Decreased serum uric acid level may not be of clinical significance. It has been reported in Wilson’s disease, Fanconi’s syndrome, xanthinuria, and (paradoxically) in some neoplasms, including Hodgkin’s disease, myeloma, and bronchogenic carcinoma.
    Medi Finance Update

(Dr GM Singh)

I have let out a property for Rs.20,000 per month. The tenant is deducting tax that is more than my tax liability. What can I do under this circumstance?

The Income Tax Act specifies a fixed rate at which taxes are required to be deducted from certain payments made. As stated earlier, TDS is prepaid taxes which are ultimately adjusted against the tax liability of the recipient of income. Where the recipient (in the present case you who has let out property) determines that the tax liability is lower than the tax being deducted, under the provisions of the Income Tax Act, he may approach his assessing officer by filing Form 13 indicating that the actual tax liability is lower than the rate of tax applied by the tenant. He will issue a certificate directing the tenant to deduct taxes at a lesser rate. This form is available with the local Income tax office or can be downloaded from the website http://www.incometaxindia.gov.in/.

    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name


DCI Approval Date

Troxipide film coated Tablets 50mg/100mg

For the treatment of Gastric ulcers and for amelioration of gastric mucosal lesions (erosion, hemorrhage, redness and edema) in the diseases such as acute gastritis, acute exacerbation stage of chronic gastritis.


    IMSA Update

International Medical Science Academy (IMSA) Update

Screening for cervical cancer

Two randomized trials evaluated HPV screening, in conjunction with cytology, for cervical cancer screening. HPV testing led to earlier detection of high–grade cervical lesions but identified large numbers of women, especially at younger ages, with lesions that would regress without treatment (Lancet Oncol 2009;10:672, Lancet Oncol 2010;11:249.)

  Quote of the Day

(Dr GM Singh)

Nothing splendid has ever been achieved except by those who dared believe that something inside of them was superior to circumstances. Bruce Barton

    Readers Responses

Dear Sir, your article "Integrated versus Adulterated" is fabulous, beautifully written and so true!!! It has stimulated me to read and increase my knowledge about Homeopathy and Ayurveda concepts, maybe you can suggest some basic good books for the same. Regards: Dr Neeta Dhabhai.

    Public Forum

(Press Release for use by the newspapers )

Contestants should take aspirin or a beta–blocker

People contesting elections for the Member of Parliament (where ever the elections are being held) should take the election process with a strong heart or else the resultant stress can precipitate acute heart attack, paralysis or dangerously high blood pressure in susceptible individuals said Dr. KK Aggarwal, Padma Shri & Dr. B.C. Roy National Awardee and President, Heart Care Foundation of India

Data from the Multicenter Investigation of the Limitation of Infarct Size (MILIS) has shown that among 849 patients with acute heart attacks, 48 percent described one or more possible triggers, the most common of which was emotional upset (14 percent). Studies have identified possible triggers in up to 10 percent of patients.

Since current acute emotional stress may be unavoidable, benefit may be gained through efforts to interrupt the link between the stressor and the cardiovascular event by pharmacologic means.

Preliminary data from the Myocardial Infarction Onset study suggest that aspirin modifies the relative risk of anger producing heart attack. Beta–blockers may also be protective. The high–risk MPs should ask their cardiologists to prescribe aspirin and a beta–blocker if not contraindicated.

Adopting pranayama and other relaxation techniques also help. Most important is to identify the underlying risk. Individuals at low risk of having blockages or vulnerable plaques might not require intervention at these emotional stress crises since their absolute risk of an event attributable to the trigger is low.

    eMedinewS Special

1. eMedinewS audio lectures (This may take a few minutes to open)

2. eMedinewS ebooks (This may take a few minutes to open)

Activities eBooks


  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein
    Situation Vacant

Vacancy for a post of Consultant in Pediatric ICU at Medanta – The Medicity Hospital, Sector –38, Gurgaon.
Interested candidates may please contact: drneelam@yahoo.com/9811043475.
*Eligibility: Post M/DNB/DCH

    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

Sunday 3rd April, 2011, World Fellowships of Religions and Perfect Health Parade First ever Conference which will talk about science behind all Religions, Dharmas and Pathies under one roof on Global Warming, Ethnic Crises, How to be Healthy
Venue: Maulana Azad Medical College Auditorium, New Delhi;Time: 8 AM – 4 PM.
Parade through tableaus to be flagged off at 10 am from outside MAMC to move till 5 pm on different predefined routes in Delhi to create awareness about health matters.
Parade Route: Vikas Marg – Shahdara – Seemapuri – Guru Tegh Bhadur Hospital – Seelampur Pusta – Gandhinagar, to ISBT Kashmiri Gate – Civil Lines – Delhi University North Campus – Azadpur – Punjabi Bagh – Mayapuri – Raja Garden – Janakpuri – Tilak Nagar – Tihar Jail Road – Delhi Cantt. – R.K Puram – Munirka – IIT Gate – Panchsheel Park – Chirag Delhi Flyover – Nehru Place – Modi Mill Flyover – Ashram – Nizamuddin – Sunder Nagar – Pragati Maidan – ITO – finally culminate at Maulana Azad Medical College at 4pm. Full day conference on ethnic crisis and global warming. Pre lunch session to be addressed by religious representatives who would talk on what each religion has to say. Post lunch to be addressed by doctors from all streams of medicinal practice (allopathy, ISM)
Register: rekhapapola@gmail.com


April 16–17, 2011, National Conference on Gynae–Endocrinology–2011 under aegis of FOGSI, ICOG and AOGD , Focus on newer advances in management of endocrinal problems in gynaecology with emphasis on PCOS, hyperprolactinemia, amenorrhoea, hormonal contraception. Gyne– endocrinology is a topic of high importance especially for practitioner. Detailed programme http://www.aiims.edu and http://www.aiims.ac.in
For details please contact: Prof Alka Kriplani, Organizing Chairperson, 9810828717 kriplanialka@gmail.com/Dr Nutan Agarwal, organizing Secretary, 9810107464/9868397310 nutan.agarwal1@gmail.com


May 7–8, 2011, National Seminar On Stress Prevention
A Stress Prevention Residential Seminar cum spiritual retreat with Dr KK Aggarwal and Experts from Brahma Kumaris.
Co–organizers: eMedinewS, Brahma Kumaris, Heart Care Foundation of India, IMA New Delhi Branch and IMA Janak Puri Branch, IMSA (Delhi Chapter)
Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.
Timings: Saturday 7th May (2 pm onwards) and Sunday 8th May (7 am–4 pm). There will be no registration charges, limited rooms, kindly book in advance; stay and food (satvik) will be provided. Voluntary contributions welcome. For booking e–mail and SMS to Dr KK Aggarwal: 9899974439, emedinews@gmail.com, rekhapapola@gmail.com; BK Sapna: 9811796962, bksapna@hotmail.com


September 30 – October 02, 2011; XVIth World Congress on Cardiology, Echocardiography & Allied Imaging Techniques Venue: The Leela Kempinski, Delhi (NCR), September 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
Highlights of Pre – Conference CME: Case based learning experience & audience interaction, Maximum 250 delegates for CME will be accepted, who will be divided in 5 batches and will rotate to different halls every 90 minutes. The topics are:(A) Right heart pressures & functions (From basics to newer methods (RV anatomy, echo views, echo assessment of RV function, prognostic impact of RV function) (B) Carotid Doppler: How do I assess and interpret in my daily practice.: Technical tips (Anatomy of the vessel, views of ultrasound scanning, Normal & abnormal Doppler hemodynamics, how to measure IMT) (C) Valvular stenosis: Assessment, limitations and their solution: (Anatomy of the valves, 2–D findings of stenotic lesions, quantitation of lesion, limitations) (D) How do I assess and report ventricular dyssynchrony in my lab. (What is ventricular dyssynchrony, what are the types of dyssynchrony, in whom, when & why do we assess it, various echo methods to assess it ) (E) Live 3–D Echo: Protocol for acquisition. How to slice and get full information. Aim is that by end of the day, every participant is well conversant with all the topics.
Dr (Col) S.K. Parashar, President, e–mail: drparashar@yahoo.com, Mob:09810146231/Dr Rakesh Gupta, Secretary General, email:jrop2001@yahoo.com, Mob:09811013246
worldcon2011@in.kyoni.com, www.worldcon2011.org


ICC Cricket World Cup 2011

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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Naveen Dang, Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta