30th November 2014, Sunday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and National Science Communication Awardee. Limca Book of Record Holder (CPR). Gold Medalist

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04);
For updates follow at :  www.twitter.com/DrKKAggarwal, www.facebook.com/Dr KKAggarwal

Natural foods and not supplements prevent heart disease

One should take seasonal and locally grown natural food and vegetables grown in organic farms.

Eat less, dinner lighter then the lunch, eat natural and in moderation are few of the mantras. Taking food supplements can be harmful.

According to the American Heart Association (AHA), supplementation with beta carotene and vitamin E, either alone or in combination with each other or other antioxidant vitamins does not prevent heart disease.

High dose vitamin E supplementation (400 IU/day) may be associated with an increase in all-cause mortality.

Supplementation with vitamin C does not prevent second heart attack.

Beta carotene supplementation may be dangerous and should be discouraged.

Vitamin E supplementation may be of benefit for only secondary prevention of heart patients with chronic renal failure who are undergoing hemodialysis.

The AHA concluded that current data do not justify the use of antioxidant supplements for the prevention or treatment of cardiovascular disease risk.

The above recommendations apply to supplementation only. Diets high in natural antioxidants are associated with lower cardiovascular mortality.

News Around The Globe

  • High-dose oral resveratrol (RES) administration stabilized levels of amyloid-beta 40 (Aß40) in cerebrospinal fluid (CSF) and plasma compared with placebo in patients with mild to moderate Alzheimer's disease (AD), suggested a phase 2 study presented at the 7th Clinical Trials Conference on Alzheimer's Disease (CTAD).
  • Epidural steroid injections (ESIs) should be contraindicated under certain circumstances in the management of back pain, the US Food and Drug Administration's (FDA's) Anesthetic and Analgesic Drug Products Advisory Committee has concluded. The committee stated that injecting a particulate steroid in the cervical region, using the transforaminal approach, heightens the risk for sometimes serious and irreversible neurological adverse events, including stroke, paraplegia, spinal cord infarction, and death.
  • The durability of the responses seen with immunotherapy in advanced metastatic melanoma continues to impress with the latest data from several early trials showing that the some responses are maintained for years. The data were presented at the Society for Melanoma Research (SMR) 2014 International Congress.
  • A single infusion of an intravenous (IV) bisphosphonate zoledronate is the treatment of choice in patients with Paget's disease of the bone who are at risk of future complications, suggest the first clinical-practice guideline for the condition by the US Endocrine Society. The new guideline is published online in the Journal of Clinical Endocrinology and Metabolism.
  • The herpes zoster vaccine can be safely used in patients with rheumatoid arthritis, psoriatic arthritis, and spondyloarthropathies who are being treated with biologic agents, suggests a new study presented at the American College of Rheumatology (ACR) 2014 Annual Meeting.

66th Annual Conference of Cardiological Society of India (CSI) -2014


Dr KK Spiritual Blog

Love in Ayurveda

Euphoria, reaction, adjustment and liking are the four fundamental phases of any relationship. When a person gets engaged to a girl, both go through a phase of euphoria where they can talk to each other for hours. This phase lasts for six months to three years. The next phase is the phase of reactions and fighting on smaller issues. This phase will end with mutual adjustment after a variable duration depending upon the family counseling available.

The last phase in any relationship is the real spiritual love and liking for each other.

The first euphoric phase of love relationship is medically called infatuation. It starts when two persons are attracted to each other and is due to release of adrenaline like neurochemicals like phenylethylamine, dopamine and norepinephrine. Dopamine makes them feel good and norepinephrine stimulates the production of adrenaline which makes the heart beat faster. These chemicals also make one feel euphoric, energized and float on air.

The last chemical oxytocin is the cuddling chemical which makes women and men calmer and more sensitive to the feelings of others. It plays an important role in romantic love as a sexual arousal hormone that signals orgasm.

The final stage of a relationship usually starts after seven years and is the stage of attachment. The chemicals involve in this are endorphins. These morphine-like opiates calm and reassure with intimacy, dependability, warmth, and shared experiences.

These hormones are not as exciting as phenylethylamine but are more addictive. The longer two people have been in a relationship the more likely it is that they'll stay in that relationship as they get addicted to the endorphins. It is the absence of endorphins that make long-time partners yearn for each other when apart. Absent endorphins also play a part in grief from the death of a spouse.

Mark Goulston, at the University of California, said "Adrenaline-based love is all about ourselves, we like being in love. With endorphins, we like loving”.

The stages in between are the stages of reaction and adjustment and represent the normal reactions of men or women to stress and strains.

As per Ayurveda a person is made up of body, mind (mind, intellect and ego) and soul. Infatuation is at the level of body and the mind. Attachment is at the level of soul and the reactions and adjustments are at the level of mind, intellect and ego.

From Ayurveda point of view a person can have a Satvik mind (calm and poise), Rajsik mind (aggressive) and a Tamsik mind (inertia and destructive). The first infatuation and the last attachment phases of relationship are all Satvic states and the in between states are Rajsik or Tamsik.
This is one reason why newly wedded couples are given Satvik food for the initial few months including a cup of hot milk with sugar before going to the bed.

The relationship of a person can also be classified at the levels of physical body, mind, intellect, ego and the soul. All depends upon the need and the resultant satisfaction.

Rarely the husband and wife will be able to fulfill the role of all the relationships. They may be physically together but not mentally.
It is quite common for the partners to have separate relationships to satisfy their respective needs. They may have multiple relationships apart from the wife, which is only for the physical needs. They may have separate friend to satisfy their mental needs (with whom they can open out and share), another for intellectual needs and a guru for the spiritual needs.

Inspirational Story

Four Burning Candles

In a room there were four candles burning. The ambiance was so soft you could hear them talking. The first one said, “I am PEACE, however nobody can keep me lit. I believe I will go out.”

Its flame rapidly diminishes and goes out completely. The second one says, “I am FAITH. Most of all I am no longer indispensable, so it does not make any sense that I stay lit any longer.” When it finished talking a breeze softly blew on it putting it out.

Sadly, the third candle spoke in its turn. “I am LOVE. I have not gotten the strength to stay lit. People put me aside and don’t understand my importance. They even forget to love those who are nearest to them.” And waiting no longer it goes out.

Suddenly a child entered the room and saw three candles not burning. “Why are you not burning you are supposed to stay lit till the end.” Saying this, the child began to cry. Then the fourth candle said, “Don’t be afraid, while I am still burning we can re-light the other candles, I am HOPE.”

With shining eyes, the child took the candle of Hope and lit the other candles.

The flame of Hope should never go out from our life and that each of us can maintain HOPE, FAITH, PEACE and LOVE.

Hope never abandons you. You abandon hope. Consult not your fears but your hopes and your dreams. Think not about your frustrations, but about your unfulfilled potential. Concern yourself not with what you tried and failed in, but with what it is still possible for you to do.

Rabies News (Dr A K Gupta)

What are the initial (prodromal) symptoms of rabies?

  • Pain or paresthesiae at the site of the bite is well–known as a diagnostically useful prodromal symptom occurring in one–third to two–thirds of cases.
  • In Thailand, however, a specific type of paresthesiae–itching–was the earliest symptom in >40% of cases. Itching occurred at the site of the healed bite wound or involved the whole bitten limb and was sometimes so intense as to provoke frenzied scratching and excoriation of the skin. The explanation for local paresthesiae may be the multiplication of virus in the dorsal root ganglion of the sensory nerve supplying the area of the bite.
  • Pain behind the grafted eye was an early symptom in three of the four patients who developed rabies following corneal transplants.
  • Priapism with frequent spontaneous orgasms was the first symptom in one Thai patient.
  • Fever, malaise, nausea and vomiting.
  • The skin becomes sensitive to changes of temperature, especially air currents.

Cardiology eMedinewS

  • A diet rich in foods with antioxidants appears to provide protection against the development of atrial fibrillation (AF) following cardiac surgery, suggest the results of a new observational study published in the Journal of Thoracic and Cardiovascular Surgery.
  • In a study of nearly 2,000 adults, researchers found that a buildup of plaque in the body's major arteries was associated with mild cognitive impairment. Results of the study were presented at the annual meeting of the Radiological Society of North America (RSNA).

Pediatrics eMedinewS

  • An abnormality in the dentate gyrus area of the hippocampus has been discovered in babies who have died from sudden infant death syndrome (SIDS). This could help with understanding why this condition occurs, and could pave way for an intervention to lower the risk. The report is published online November 25 in Acta Neuropathologica.
  • A program for mothers living in poverty resulted in significant improvements in their children's IQ and other cognitive outcomes 5 years after the intervention, suggested new research presented at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

Quote of the Day

  • Luck is what happens when preparation meets opportunity. Seneca

Wellness Blog

Profession, passion and fashion

I have written about this topic earlier too, but this is an update. Profession is at the level of physical body and mind, fashion is at the level of ego and passion is at the level of the soul. If your passion, profession and fashion are in synchrony with each other, you are a perfect leader.

If you are not passionate about your profession, you can never be successful. To be passionate about your profession is only not important, it is also equally important to let others know about your passion for your profession.

When you do so, it becomes a fashion. Our aim in life should be to let people know that you are passionate about your profession. When the passion is too much, it becomes an obsession.

emedipicstoday emedipics

Health Check Up and CPR 10 Camp at G.B.S.S.School, Jangpura New Delhi-14 on 19th November 2014



press release

Healthcare worker–fatigue and patient safety

video of day

Other Blogs

Video Library

Sameer Malik Heart Care Foundation Fund

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF

Total CPR since 1st November 2012 – 101090 trained

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)


IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :


Dr Good and Dr Bad

Situation: A patient with chronic kidney disease (CKD) needed a diuretic.
Dr. Bad: Take OD dose.
Dr. Good: Take TDS dose.
Lesson: Diuretics are to be given every 6–8 hours in CKD.

Make Sure

Situation: A patient missed her last dose of hepatitis B vaccine as she was out of station at 6th month.
Reaction: Oh my God! Why was the vaccine not given between 4–6 months?
Lesson: Make sure that all patients are given the complete vaccine regimen. The correct regimen is 0, 1–2 months and 4–months.

eMedinewS Humor

A man driving home late at night in his Volkswagen beetle car was stopped by policemen on patrol. The police asked the man to produce his car documents. When they could not fault the documents, the next question to the man was: "My friend, do you realize that you committed a criminal offence by driving alone in this car at late night?"

The man became angry and responded: "How could you say that? God the father, the son and holy spirit, Prophet Elijah and Angels Micheal and Gabriel are all with me in the Car." The policeman replied: "You mean all these people are in this small car? I charge you for overloading!"

Twitter of the Day

Dr KK Aggarwal: Heart patients should take aspirin unless contraindicated
Dr Deepak Chopra: The Future of #God is our evolution from a fragmented mind to a whole mind, from thought which is in time to Awareness which is not in time

ePress Release

The holiday season is also the season for heart attack

A look at a US database of 53 million deaths occurring between 1973 and 2001 reveals that deaths from heart disease peak in December/January, with spikes on Christmas and New Year's Day.

Giving reasons for this, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association, said that:

  • People with symptoms of heart trouble tend to delay going to the doctor prior to the holidays as they do not want to spoil holiday fun.
  • They are less likely to see their physicians over this period of time in order to get the acute care they may need.
  • During the holidays, many people take a break from their diet and exercise programs.
  • The amount of time spent eating out and eating over at friends and family becomes more than usual.
  • It becomes easier to find excuses not to stay on an exercise regimen.
  • The consumption of alcohol can increase during the holidays, which can contribute to something called "holiday heart syndrome."
  • Alcohol has a toxic effect on the heart muscle. It can lead to atrial fibrillation -- an abnormal heart rhythm, which is a classic finding of the holiday heart.
  • The hectic pace of the holiday season can cause people to forget to take medications such as blood thinners and pills for high blood pressure. Such lapses can lead to acute coronary trouble.
  • Winter is any way the peak season for heart attacks. Most heart attacks and paralysis due to brain haemorrhage peak during early morning periods of winter season due to sudden rise in BP reading.

eMedi Quiz

Which of the heart valve is most likely to be involved by infective endocarditis following a septic abortion?

1. Aortic valve.
2. Tricuspid valve.
3. Pulmonary valve.
4. Mitral valve.

Yesterday’s Mind Teaser: A 2-month-old baby with acute icteric viral hepatitis-like illness slips into encephalopathy after 48 hours. The mother is a known hepatitis B carrier. Mother's hepatitis B virus serological profile is most likely to be:

1. HBsAg positive only.
2. HbsAg and HBeAg positive.
3. HBsAg and HBe antibody positive.
4. HBV DNA positive.

Answer for yesterday’s Mind Teaser: 2. HbsAg and HBeAg positive.

Correct answers received from: Dr Jainendra Upadhyay, Dr Rakesh Sharma, Dr Avtar Krishan, Dr Palanivelrajan.

Answer for 27th November Mind Teaser: 1. Cell wall

Correct answers received from: Dr Palanivelrajan.

Send your answer to email

medicolegal update

(Contributed by Dr MC Gupta, Advocate)

Q. When a patient gets treatment at a hospital, he is the consumer of the services provided by the hospital. The consumer complaint should be made against the hospital, not the treating doctor. Why do the consumer courts allow the patient to file a consumer complaint against an individual doctor?

Ans. Many reasons can be given as to why the doctor should be made a party.

  • It has been held in court judgments that a doctor cannot be held guilty behind his back. He must be given a chance to defend himself. Courts have therefore directed that the treating doctor must be made a party.
  • The treatment to an individual is directly given by the doctor, not by the aggregate body called the hospital. If the doctor is protected by professional indemnity insurance, there is no reason why the compensation awarded should be paid by the hospital and not by the insurance company providing the cover to the doctor. The insurance company would pay only when there is a court judgment against the doctor.
  • Some hospitals may preferably employ those consultants who are covered by insurance. The insurance company would pay only when there is a court judgment against the doctor.
  • There may be some confusion as to whether the hospital is the service provider or not, while there may be no controversy regarding the role of the doctor as the service provider. The patient cannot be made to suffer in the legal procedural wrangle about determining the role and status of the hospital as service provider.
  • When the complainant alleges medical negligence, it is inevitable that even if the hospital alone is made the respondent, the hospital will have to ask the concerned doctor to explain his stand. The doctor may choose not to respond to the hospital’s request and, in the interest of justice, summons may have to be issued to the doctor to testify in the court. This will entail avoidable delay and also harassment to the doctor. At present, doctors have rarely to be present themselves in the consumer court.
  • The legal nature of the hospital as an entity may be unclear. Some are corporate hospitals; some are government hospitals; some are small hospitals that may not even be registered. Only a few states have nursing home acts or Clinical Establishment Act. The ownership and management etc. of a hospital may be unclear. All this may delay the legal process at the "service stage" itself. (Service here means the act of serving the court summons upon the opposite party.)
  • The same doctor may treat a patient partly as a hospital patient and partly as his private patient in his private clinic. When he alleges negligence in treatment, the treatment cannot be artificially separated into private clinic treatment and hospital treatment.
  • The consumer courts have been established to dispense speedy justice as summary proceedings by avoiding arguments and delays related to procedure. Justice would be speedy when the doctor is a party.
  • Please also note that till today, probably no treating doctor has pleaded as to why a case has been filed against him and not against the hospital alone. Your question is, hence, merely a hypothetical/theoretical question.
medicolegal update
  1. Dear Sir, Very Informative news. Regards: Dr Shantanu

eMedinewS Special

1. IJCP’s ejournals (This may take a few minues to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

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

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