Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
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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

  Editorial …

30th March 2013, Saturday

Restricting salt in diet can lower heart disease risk

Restricting salt in the diet can lower the risk of developing heart disease by 25 percent and the risk of dying from heart disease by 20 percent.

Dietary intake of sodium among Indians is excessively high. Quoting a Harvard Medical School study published in British Medical Journal, Dr Aggarwal said that among hypertensive individuals, lowering sodium is quite well established to lower blood pressure, but now it has been shown that reducing salt also has an effect on cardiovascular disease.

When people with pre hypertension (blood pressure more than 120/80 and lower than 140/90), reduced their salt intake by about 25 to 35%, they were 25% less likely to develop cardiovascular disease 10 to 15 years after the trial ended. There was also a 20 percent lower death rate from cardiovascular disease among those who cut their salt consumption.

Salt restriction is best achieved by avoiding salted, salt cured and salt smoked foods such as lunch meat, hot dogs, ham, olives, pickles and regular salted canned foods, and other prepared foods, which often use more salt than homemade equivalents. Foods we would never think of as salty, such as breakfast cereals, cookies, and even some soft drinks, often contain copious additions of sodium.

WHO recommends limiting the salt intake to less than 5 grams per day.

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

One can predict acute lung injury

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

A Health Check up and CPR camp was organized by Heart Care Foundation of India in association with Mohan Singh Palace Market Association on 29th March 2013

Dr K K Aggarwal
    National News

South India lags national fertility rate, slows population boom

BANGALORE: India's burgeoning population appears to be both a problem and an advantage. Very soon, the southern states are likely to stare at an un-Indian situation: a shrinking populace, owing to a sharp dip in the fertility rate of women. Analyzing the 2011 Census data, the Population Research Centre of the Bangalore-based Institute for Social and Economic Change found that many southern districts, a significant number of them in Karnataka, have recorded fertility rates lower than the national average. The study says turnaround will happen soon. Half of India's 1.21 billion population comprises women, and the national average fertility rate stands at 2.5, slightly higher than the targeted 2. The theory is simple: two children replace two parents, and the population remains stagnant. Experts say women in most southern states appear to be settling for one child, pulling down the average fertility rate. Karnataka's overall fertility rate stands at 2, but there's an interesting variation in the districts. In Udupi, for instance, the fertility rate is 1.2; in Hassan, Mandya and Chikmangalur, it's 1.4; in Dakshina Kannada and Kodagu, it's 1.5. Bangalore, at 1.7, is well below the national average. Some districts, though, have high fertility rates: Bijapur stands at 3, and Bidar at 2.7. The other South Indian states of Kerala, Andhra Pradesh and Tamil Nadu are in the sub-2 category. "Women are, perhaps, postponing marriage and, subsequently, childbirth. Many are increasingly settling for one child as they are socially and biologically past their prime by the time they give birth for the first time," said K S James, professor, Population Research Centre, who led the data analysis. (Source: TOI, Mar 28, 2013)

For comments and archives

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)


Violation of human rights

  • Injustice to humanity
  • Violation of human rights
  • Perpetual victimization
  • Social stigma and social ostracism leading to constant humiliation.

For comments and archives

    Valvular Heart Disease Update

Aortic regurgitation (AR) is less common in elderly adults than aortic stenosis (AS) and mitral regurgitation (MR). In the Helsinki Aging Study, AR mostly mild was present in 29 percent of patients. In the Framingham Study, AR that was at least mild was present in 13 percent of subjects.

(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)

HPV test gets thumbs up in cervical cancer screening

The next step after an indeterminate Pap smear should usually be human papillomavirus (HPV) testing rather than a second cervical cytology swipe, a Cochrane review affirmed. (Source: Medpage Today)

MicroRNA HCV therapy has big promise

A nonpharmaceutical approach to hepatitis C (HCV) treatment demonstrated promising efficacy and safety results in an early stage trial, researchers reported. (Source: Medpage Today)

New CNS/AANS guidelines discourage steroids in spinal injury

For the first time ever, experts are recommending against the use of steroids early after an acute spinal cord injury. The new recommendation is among 112 evidence-based recommendations contained in an updated document on the management of acute cervical spine and spinal cord injuries, released by the Congress of Neurological Surgeons (CNS) and the American Association of Neurological Surgeons (AANS). (Source: Medscape)

Devices coated with paclitaxel help leg arteries

The drug paclitaxel may be the answer for device success in the tortuous femoropopliteal arteries, two studies suggested. (Source: Medpage Today)

Room for improvement in end-of-life communication

Cancer patients with advanced or incurable disease are dealing with the emotional impact of a life-limiting illness, and treatment decisions are complex; to communicate with them, clinicians require a distinct set of skills. (Source: Medscape)

  Twitter of the Day

@DrKKAggarwal: How to Eat Salt? http://blog.kkaggarwal.com/2013/03/how-to-eat-salt/ …

@DeepakChopra: How do you distinguish between what a soul wants vs. what a soul needs? Please read my #askdeepak reply http://tinyurl.com/bsdfumx

    Spiritual Update

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

What is the significance of the Swastika (Sathiyo)?

D uring a marriage ceremony, the swastika is painted on the wall or entrance of the house to wish for the well-being and happiness of the newly weds. The word swastika means auspicious in the Sanskrit language. It is regarded as a divine sign by Hindus and is usually found in temples, symbolizing the four directions, thus making it a universal symbol. It sends out pure vibrations for universal peace and prosperity.

For comments and archives

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

What is ovarian drilling?

In patients with PCOS, the ovaries typically have a thick outer surface and may produce more testosterone than women without PCOS. Ovarian drilling breaks through the thick outer surface and the drilling also reduces the amount of testosterone the ovaries make. In this laparoscopic (minimally invasive) procedure, a tiny camera attached to a thin telescope is inserted into a small incision (surgical opening) below your belly button. Special tools are inserted at other on your belly. These tools make very small holes in your ovaries, which help reduce testosterone production.

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

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

Leukocyte-reduced (Depleted) Red Cells/Platelets

Definition: Cellular blood components (RBCs and platelets) contain reduced number of leukocytes
(< 5×106) prepared by filtration through a leukocyte depleting filter.


Many of the reactions of blood component transfusion (especially in multi–transfused patients) are due to leucocytes, or cytokines produced by these leukocytes. If we remove these leukocytes, we can reduce the possibilities of these reactions. Leukocyte–depleted blood components imply more than 99.9% of leukocytes. These are the ideal blood components eliminating most of the post–transfusion reactions caused by leukocytes.


Two types of leukocyte depleted components are available:

  • Prestorage leukocyte reduction: Leukocyte reduction is done in blood bank just after collection of blood. This is the ideal method for leukoreduction.
  • Bedside leukocyte reduction: Special blood transfusion set (BT set) is available that contains special l leukocyte reduction filter. The blood is transfused through this BT set resulting in transfusion of leukocyte reduced component.

Leukoreduced blood components are used to prevent:

  • Non–hemolytic febrile transfusion reaction (NHFTR)
  • Alloimmunization
  • Platelet refractoriness
  • Transfusion–associated acute lung injury (TRALI)
  • Transmission of some viruses (CMV, HTLV – I and II, EB virus, Varicella Zoster virus etc.)
  • Immunomodulation

Note: Storage, shelf life, dosage and administration are almost same as of normal cellular components

For comments and archives

    An Inspirational Story

Teamwork Lesson

When you see geese flying along in "V" formation, you might consider what science has discovered as to why they fly that way. As each bird flaps its wings, it creates an uplift for the bird immediately following. By flying in "V" formation, the whole flock adds at least 71 percent greater flying range than if each bird flew on its own. People who share a common direction and sense of community can get where they are going more quickly and easily because they are traveling on the thrust of one another.

When a goose falls out of formation, it suddenly feels the drag and resistance of trying to go it alone – and quickly gets back into formation to take advantage of the lifting power of the bird in front. If we have as much sense as a goose, we will stay in formation with those people who are headed the same way we are.

When the head goose gets tired, it rotates back in the wing and another goose flies point. It is sensible to take turns doing demanding jobs, whether with people or with geese flying south. Geese honk from behind to encourage those up front to keep up their speed.

What messages do we give when we honk from behind? Finally – and this is important – when a goose gets sick or is wounded by gunshot, and falls out of formation, two other geese fall out with that goose and follow it down to lend help and protection. They stay with the fallen goose until it is able to fly or until it dies, and only then do they launch out on their own, or with another formation to catch up with their group.

If we have the sense of a goose, we will stand by each other like that.

Source: http://academictips.org/blogs/the–goose–story–teamwork–lesson/

For comments and archives

  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

Linear growth under age 2 may improve future health outcomes
Read More

TV not to blame if kids behave badly, study finds Read More

    Rabies Update

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

What is the post-exposure (WHO ESSEN-IM) schedule?

The post-exposure (WHO ESSEN-IM) Schedule is IM vaccination on days 0 (day of first dose of vaccine and not the day of bite), 03, 07, 14 and 28.

Vaccine should be injected deep into deltoid muscle (in adults) or anterolateral aspect of thigh (in children).

    IJCP Special

Dr Good Dr Bad

Situation: A patient with community–acquired pneumonia (CAP) required hospitalization.
Dr Bad: Start a macrolide.
Dr. Good: Start combination of macrolide and third–generation cephalosporin.
Lesson: Combination therapy with a macrolide + third-generation cephalosporin is the treatment of choice for CAP patients requiring hospitalization.

Make Sure

Situation: A dengue patient with BP 100/90 developed shock.
Reaction: Oh my God! Why was rapid fluid challenge not given?
Lesson: Make sure that in all dengue patients, pulse pressure (upper minus lower blood pressure) is maintained above 40.

  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 female client with acute renal failure is undergoing dialysis for the first time. The nurse in charge monitors the client closely for dialysis equilibrium syndrome, a complication that is most common during the first few dialysis sessions. Typically, dialysis equilibrium syndrome causes:

a. confusion, headache, and seizures.
b. acute bone pain and confusion.
c. weakness, tingling, and cardiac arrhythmias.
d. hypotension, tachycardia, and tachypnea.

Yesterday’s Mind Teaser: 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

Answer for Yesterday’s Mind Teaser: a. Kidney

Correct answers received from: Dr RN Singh, Dr Thakor Hitendrsinh G, Mukta Govil, Dr PC Das, Dr KV Sarma, Dr K Raju, Dr Kanta Jain, Dr (Maj. Gen.) Anil Bairaria, Dr Jainendra Upadhyay, Dr Arpan Gandhi, Dr Chandresh Jardosh, Dr KP Chandra, Muthumperumal Thirumalpillai, Dr Deepali Chatterjee, Dr Avtar Krishan, Dr BB Gupta, Tukaram Pagad, Dr Shashi Saini, Dr Jella, Dr Jayashree Sen & Dr Bitaan Sen.

Answer for 28th March Mind Teaser: b. Fluid intake should be approximately equal to the urine output.

Correct answers received from: Tukaram Pagad, Dr Shashi Saini, Dr Jella,
Dr Jayashree Sen & Dr Bitaan Sen.

Send your answer to ijcp12@gmail.com

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    Laugh a While (Dr GM Singh)

Women should not have children after 35!

This is one of those controversial statements but I fully stand behind it.

Women should not have children after 35!
Some say, "Of course women can have children after 35!"
They don't know what they are talking about and I can guarantee they have had very little experience in the matter.

I don't care what the doctor says.
I don't care what your friends say.
I don't even care what your pastor says.
Women should not have children after 35!
I don't advise it, I vehemently recommend against it,
and loudly and even at times rudely tell people "don't even consider it."

You can quote me on this. If you want to say that I said it. And I said it more than once.
"Women should not have children after 35!"
Some will send rude e-mails proclaiming the freedom of the womb but I still stand by what I said.
You may disagree with me, that I am your right.
I still stand firm on the issue.

With most things I keep an open mind but not on this issue.
If I find an exception to this rule, then I will be open to change
but for now, it's firmly closed because I have never seen an exception.
Women should not have children after 35!
35 children are enough!

    Medicolegal Update

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

Bolam Vs. Friern Hospital Management Committee 1957

Test for establishing medical negligence

  • The doctor is required to exercise the ordinary skill of a competent doctor in his field. He must exercise this skill in accordance with a reasonable body of medical opinion skilled in the area of medicine.
  • According to the Bolam test, negligence is the genus of which rashness is the species.
  • The latest trend of prosecution of the doctors, the term criminal negligence has come to light, which means recklessly acting without reasonable caution, hurting another person at risk of injury or death by negligence.
  • This applies to a medical practitioner when he shows gross negligence in his treatment, boding to severe injury or even death. He should not be held liable criminally for the patient’s death unless his negligence shows such regard for the life and safety of the patient as to amount to a crime.
  • The most important criterion is the degree of negligence required to prosecute them under the charge of criminal negligence, which should be gross or even high degree.
  • The jurisprudential concept of negligence differs in civil and criminal law. Negligence which is neither gross nor of a high degree may provide a ground for action in civil law but cannot form the basis for prosecution in criminal law.

For comments and archives

    Public Forum

Public Forum (Press Release for use by the newspapers)

Reduce liquids to reduce weight

When it comes to losing weight, cut down on liquid calories rather than food, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

"Weight loss from liquid calories is greater than loss of calorie intake from solid food, as per Dr. Liwei Chen, an assistant professor of epidemiology at the School of Public Health at the LSU Health Science Center in New Orleans, in the American Journal of Clinical Nutrition.

Body is able to self-regulate its intake of solid food. If you eat too much solid food at lunch, you'll tend to eat less at dinner. But the same self-regulation is not in place for what you drink. The body does not adjust to liquid calories, so over time, you gain more weight.

Cutting back on calories from sugary drinks - by only one serving per day – can account for nearly two-and-a-half pounds of lost weight over 18 months.

Beverages are categorized into eight categories

  1. Sugar-sweetened beverages (including soft drinks, fruit drinks, fruit punch, or high-calorie beverages sweetened with sugar)
  2. Diet drinks such as diet soda and other diet drinks that were artificially sweetened
  3. Milk (including whole milk, 2 percent milk, and 1 percent skim)
  4. 100 percent fruit and vegetable juice
  5. Coffee and tea with sugar
  6. Coffee and tea without sugar
  7. Alcoholic beverages
  8. Water with no calories

The best drinks are water, plain soda and tea/coffee with no sugar.

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 31280 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 Sir, Nice dr good and dr bad in eMedinewS. Good ways to explain Pls keep us updated. Regards: Dr Ganesh Kumar
    Forthcoming Events
Dr K K Aggarwal

IMA Annual Day Function

Date: 7th April 2013
Time: 8Am – 2 PM
Venue: Apollo Hospital Auditorium, Sarita Vihar, New Delhi.

IMA New Delhi branch along with Indraprastha Apollo Hospitals, New Delhi are arranging a half day CME programme on occasion of World Health Day at the Apollo Hospital Auditorium, Sarita Vihar, New Delhi. Registration is free.

It will be a multispeciality CME with lectures on Current Trends in various disciplines. It will include the Dr. J.J. Sood Oration and the Dr. K.B. Sharma Oration.

We will also be honouring our esteemed members Dr. Sudershan Aggarwal and Dr, G,K, Mani who were conferred the Padam Shri by the President of India this year.

The new team headed by Dr. Hotchandani will also be installed at the conclusion of the CME programme. This will be followed by lunch.

Hoping to see you all on this CME.

With Regards

President Hony. Secretary Patron
Dr. Sandeep Sindhu Dr. Satish K. Mehta Dr KK Aggarwal

Please send your latest contact details including Mobile No. and mail id to sandeepsindhu@hotmail.com, drsudeshratan@gmail.com, emedinews@gmail.com

    eMedinewS Special

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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 Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta