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Dr KK Aggarwal

From the Desk of Editor in Chief
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

31st August, 2010, Tuesday

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

The Message of Love and Happiness as Understood from Krishna

Reading about Krishna, one understands the way of acquiring inner happiness. It can be understood by the four cycles of Krishna described in the vedic literature: Krishna the Child; Krishna the Husband and Friend; Krishna the Preacher and Krishna the Sanyasi.

The childhood of Krishna describes the methodology and components of a child education. Krishna, pure consciousness, was born as the eight child of Devki representing that during pregnancy one needs to follow the eight limbs of yoga to get a child with no disease.

A newborn and during initial childhood, the child is full of pure consciousness that spreads love to everyone without any discrimination. The only thing the child does during this period is to steal and spread love and that is what Krishna as Makhan Chor depicts.

With time, the child’s mental faculties start developing that distract the child’s mind. During this phase of life, the child needs to be taught to control the thoughts and mind by learning viveka (discrimination between good and bad) and doing abhyas. The episode of Krishna entering into the pond (thoughts) fighting with Kaliya (mind) and controlling it represents the same. This also coincides with the time a child should be sent to the school.

The next phase of childhood is activation of intellect which in Krishna’s life is depicted as the questions in his mind such as "Radha kyun gori, main kyun kala?" This starts when the child is exposed to the worldly atmosphere and starts getting attached to it. This is the time when the child should be taught control of mind and intellect by one point concentration on the object of concentration. This is also the time when the child should be taught the purpose of life, and the aim for which he has to live in future.

In Krishna Leela, Krishna controls the intellect by winning over Indra and raising Govardhan Parvat on one finger. One finger here indicates one point concentration on the object of concentration. Once the child is taught control of intellect, he/she completes his/her spiritual education and learns about the true self. In Krishna Leela, it coincides with Ras Leela where Krishna is seen dancing with Radha and every Gopi. This also reflects the time for the internal ego to be destroyed and one acquires the qualities of humility. Killing of Kansa depicts destroying the ego. Once the ego is killed and humility is acquired, Radha and flute are no more required and Krishna is now a perfect man and enters into the Grahasth ashram.

Krishna is always depicted in blue color with yellow clothes and a flute in his hands. Blue color indicates everything is possible and yellow clothes indicate that one can acquire it, provided one has the flute which is a hollow wood representing egoless nature.

Whenever Krishna is shown with a flute, the lady alongside is Radha with blue sari whose skin is golden in color, along with Gopis dancing around them indicating that the thoughts of the mind are in symphony with each other and there is a union of mind, body and soul. Here the soul is represented by Krishna, egoless mind by the flute and body with the Radha.

The subsequent phase of Krishna’s life is shown as a perfect achiever and friend, which is evident from the story of Sudama.

The third phase of Krishna’s life represent Krishna as an advisor, which shows his role in Mahabharata and his preaching in Bhagwad Gita.

The last role of Krishna as a sanyasi is the end of Krishna’s life. The four cycles also coincide with the four ashrams of life.

The message from Krishna’s life is to learn to make efforts to control the mind, to win over the intellect by one point concentration and to acquire qualities of humility and killing internal ego to achieve inner happiness. Only then can one acquire the personality of a perfect man like Krishna.

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
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Photo Feature (from HCFI gallory)

In the photo: Mr Rajat Kapoor, TV Anchor and News Reader; Mr Prithviraj Chauhan, Minister of Science and Technology and Padma Shri and Dr BC Roy National awardee Dr K K Aggarwal, President HCFI at a party organized to celebrate Dr Aggarwal's Award function. 


K K Aggarwal


International Medical Science Academy (IMSA) Update

There is a strong evidence association of prothrombotic conditions with pediatric stroke. In a meta–analysis of 22 observational studies, conditions associated with an increased risk of arterial ischemic stroke in children (neonates to 18 years old) included protein C deficiency, antiphospholipid antibodies/lupus anticoagulant, elevated lipoprotein(a), factor V Leiden mutation, antithrombin III deficiency, prothrombin gene mutation, MTHFR TT genotype, and protein S deficiency. The association was statistically significant for all of these traits except antithrombin III deficiency and protein S deficiency.

1. Kenet G, Lütkhoff LK, Albisetti M, et al. Impact of thrombophilia on risk of arterial ischemic stroke or cerebral sinovenous thrombosis in neonates and children: a systematic review and meta–analysis of observational studies. Circulation 2010;121:1838–47.


News and Views

International News ( Dr Brahm and Dr Monica Vasudev)

Viral Videos or Cigarette Ads?

Faced with restrictions on tobacco advertising, cigarette makers are using YouTube to reach the youth market, according to a sampling of cigarette–themed videos. Almost three–quarters of 163 videos spotlighting brand-name cigarettes had pro-tobacco content, compared with < 4% with anti–tobacco messages. (Online in Tobacco Control)

Lifestyle changes curb overnight bathroom trips

The usual treatments for frequent nighttime urination include medical therapy as well as lifestyle changes.

  1. Limit the fluid intake to about 2 % of body weight during the day
  2. Avoiding too much water in the evening. This translates to about one and a half quarts of water for a 165–pound person.
  3. Limit any excess hours in bed
  4. Moderate daily exercise
  5. Keep warm while sleeping

Quitting smoking helps after serious heart attack damage

Smokers who quit the habit after suffering a heart attack have a lower rate of repeat heart attacks. They also live longer than their counterparts who continue to smoke. According to a new study, survivors of heart attack with LV dysfunction may benefit as much from smoking cessation as other heart attack patients do. The researchers headed by Dr. Amil M. Shah, cardiologist at Brigham and Women’s Hospital in Boston found that among 2,231 patients with LV dysfunction, those who quit smoking within six months of their heart attack were less likely to die within five years or suffer a repeat attack than smokers who continued the habit. They also had 30 % less chances of suffering a repeat heart attack or be hospitalized for heart failure or death.

Pancreatic cancer cells appear to feed easily on fructose

UCLA researchers have stated that pancreatic cancers use fructose to increase their growth, and that, contrary to conventional wisdom, cancers processed fructose differently than glucose.


Dengue Update:  Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta Medicity

What are the criteria / warning signs for Dengue?

Warning signs*

• Abdominal pain or tenderness
• Persistent vomiting
• Clinical fluid accumulation
• Mucosal bleed
• Lethargy, restlessness
• Liver enlargement >2 cm
• Laboratory: increase in HCT concurrent with rapid decrease in platelet count

*require strict observation and medical intervention

Probable dengue
• Resident of /travel to dengue endemic area
• Fever and 2 of the following criteria:

◊ Nausea, vomiting
◊ Rash
◊ Aches and pains
◊ Tourniquet test positive
◊ Leukopenia
◊ Any warning sign

Laboratory–confirmed dengue – important when no sign of plasma leakage

Infertility Update: Dr. Kaberi Banerjee, Infertility and IVF Specialist, Max Hospital; Director, Precious Baby Foundation

Q. What are the causes of infertility?

A. In about one–third of the couples, infertility is because of male factor; in one–third, it is because of female factor and in one–third, it is unexplained. The reasons of infertility could be male, female or unexplained. In males, the causes can be defective sexual function or absent low sperm count or poor sperm quality. In women, it could be blocked tubes, ovarian factors like polycystic ovarian disease and endometriosis or uterine factors like thin endometrium. In the rest one-third cases, there is no identified problem and so they are labeled as unexplained.

Pediatrics Update: Question of the day
Why are soft drinks ( More than one per day) bad for health?

  • Sweetened drinks have a lot of added sugar that add non–nutritious extra calories in the daily diet of children. Each 12–ounce serving of a carbonated, sweetened soft drink contains the equivalent of 10 teaspoons of sugar. Sugared soft drinks increase risk of overweight and obesity. These empty calories not only add weigh but by keeping the stomach full reduces appetite and prevent consumption of healthy meals.
  • Caffeine containing soft drinks give a kick and lead to addiction and symptoms of caffeine withdrawal with further consumption of the cola drinks leading to a vicious cycle.
  • Some children get hyperacidity and gastritis due to cola drinks.
  • Milk consumption decreases as soft drink consumption increases. Milk is the principal source of calcium.

Children should instead be given nutritious alternatives such as water, real fruit juices and low–fat milks.

Eating fresh fruits is far better than fresh fruit juice
even it no sugar is added as juice contains concentrated fructose as compared to eating a fresh fruit which gives good exercise to the teeth and gums and also provides the fiber needed for good bowel movements and the additional health problems associated with high intake of sweetened drinks are dental cavities and potential enamel erosion.

The American Academy of Pediatrics (AAP) recommends that pediatricians work to eliminate sweetened soft drinks in schools. This entails educating school authorities, patients and parents about the health ramifications of soft drink consumption. As part of the effort to reduce consumption of soft drinks in schools, the policy recommends that vending machines not be placed within the cafeteria space where lunch is sold, and that soft drinks not be sold as part of, or in competition with, the school lunch program.


Legal Update: Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

How can exit and entry wounds be identified?

  • Entry wound are small and neat in most cases. But, with ultra–high velocity small bullets or bomb splinters, the entrance wound may be of the ‘blowout’ type.
  • Exit wound are generally big. The size of the exit wound depends upon the shape of the local track, the temporary cavitation effect at the site of the exit, the impact velocity and type of bullet. If the missile has remained stable in the tissues, or alternatively has expended most of its energy, a relatively small exit wound results.

Handgun wounds such as revolver and semi–automatic pistol bullet wounds are very important in medicolegal practice. As the wounds caused by pistol and revolver bullets are similar, and the caliber of bullets used in the weapons are roughly the same, it should be noted that the muzzle velocities of magnum revolvers are higher than those of modern pistols.


Medi Finance Update

Q. What is PAN and how it is issued?

Ans. Every person whose income exceeds Rs. 50,000 per annum is required to apply for allotment of PAN or permanent account number, on a prescribed form to the assessing officer. In response to the application, the assessing officer allots PAN. Those who have already received the PAN are not required to file the application form again.


Drug Update

List of Approved drugs from 01.01.2010 TO 30.4.2010

Drug Name


DCI Approval Date

Pramipexole dihydrochloride monohydrate ER Tablet 0.375/0.75/1.5/3/4.5 mg

For the treatment of the sign and symptoms of idiopathic Parkinson's disease



Lab Calculator 

Serum osmolality

Serum osmolality (US) = (2*(Na) + (BUN/2.8) + (glucose/18)
SI units are all molar, so no need to divide by 2.8 or 18

Normal serum osmolality = 285–295 mOsm/kg


IJCP Special

Dr Good Dr Bad

Situation: A patient came with acute gout.
Dr. Bad: Take high–dose colchicine.
Dr. Good: Start low–dose regimen of colchicine.
Lesson: As per a randomized, placebo–controlled trial, a lower dose regimen of colchicine has similar efficacy and fewer side effects than a traditional, higher dose regimen in acute gouty arthritis. The trial compared 1.2 mg colchicine followed by one additional dose of 0.6 mg an hour later (total dose 1.8 mg), versus 1.2 mg followed by 0.6 mg every hour for up to six hours (total dose 4.8 mg). (Arthritis Rheum 2010;62:1060)

Make Sure

Situation: A patient died after receiving 30 ml IV potassium chloride (KCl) bolus.
Reaction: Oh my God! Why was KCL given as bolus?
Lesson: Make sure that IV KCL is not given @ > 10 mEq per hour.

Quote of the Day

Jim Rohn … "Life is a unique combination of "want to" and "how to" and we need to give equal attention to both."

Asthma Alert

Common Triggers for asthma exacerbations

• Respiratory tract infections
• Airborne allergens (for patients with allergic asthma)
• Inhaled irritants (e.g, tobacco smoke)
• Extremes of temperature and humidity (eg, very cold, dry air)
• Physical exercise


Mind Teaser (Vivek Kumar)

Read this………………

K 4 lost Time

The answer for yesterday’s Mind Teasure : "West Indies"

Correct answers received from: Dr Chandresh Jardosh, Dr Jayashree B Keshav In Charge – Scientific Publications, The Himalaya Drug Company,  Dr.Susheela Gupta, Dr Ashok Kumar,

Correct answers received for 29th August Puzzle from: Dr. G. Padmanabhan, Dr. Ashok Kumar, Dr Anjani Kumar

Send your answer to ijcp12@gmail.com


Humor Section

Jokes: (Contributed by Dr Chandresh Jardosh)

Question: When do you CONGRATULATE someone for their MISTAKE?
Answer: On their MARRIAGE.

Funny One Liner

Lecture: An art of transferring information from the notes of the Lecturer to the notes of the students without passing through "the minds of either"


An Inspirational Story

Virtually no competition

While professional soccer is still struggling to find a firm foothold in the United States, in the 1970s the North American Soccer League marked the brave first attempt to introduce the game to American sports fans. While most teams had only limited success at best, one did manage to break through to genuine mainstream popularity – the New York Cosmos.

It was the brainchild of Steve Ross, a passionate soccer fan who was also a major executive at Warner Communications.

Max Ross told his son Steve: "In life there are those who work all day, those who dream all day, and those who spend an hour dreaming before setting to work to fulfill those dreams. Go into the third category because there’s virtually no competition."


Readers Responses

  1. Dear Dr.Aggarwal, Ref emedinews dated 28th August pertaining to Grapefruit & Diabetes. It is well known that certain enzymes – furanocoumarin in grapefruit juice, by virtue of their intestinal action decrease the metabolism of a number of drugs like few calcium channel blockers, statins, diazepam, sildenefil and many others which can lead to significant side effects. This should be kept in mind before taking regular intake of the grapefruit juice, especially about one glass daily: Dr.Parashar
  2. Try LYRICA( Pregabalin) – Pfizer. It works in Neuropathic Pain: Fazl ur Rahman MS FRCS FACS FICS
  3. Congratulations emedinews. I liked the succinct answers which Dr K K Agrawal has offered to us from the story of Lord Shree Krishna. I was thrilled to read it. Our scriptures have so much to teach us. Kudos Dr Agrawal.
  4. It may not be surprising, but a new study offers some proof that patients who are worried about their medications are more likely to have side effects from them. The study involved patients with a particular kind of arthritis. While more research has to be done in patients with other illnesses to know for sure. While most medication side effects are not life threatening or seriously harmful, researchers note in the journal Arthritis Care & Research, they can still be "frightening and distressing" to patients, and can also lead to patients not taking drugs as recommended. People with a variety of illnesses who don’t feel their medications are necessary and are concerned about their side effects are known to be less likely to take these drugs as directed, the researchers add. Dr.G.M. Singh

Public Forum (Press Release for use by the newspapers)

Swine flu deaths can never surpass deaths due to heart diseases

As per the US CDC statistics only 2% of the flu patients require admissions said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India, BSNL Dil Ka Darbar & MTNL Perfect Health Mela. The mortality is also lower than that of normal human flu–pneumonia.

In Delhi in the year 2008, as per economic survey, total deaths were 100974. Out of which heart diseases (including diabetes) caused 19362 deaths, TB 2516 deaths, cancer 2597 deaths, human flu– pneumonia 879 deaths, accidents 1088 deaths, anemia 662 deaths, measles 52 deaths, burns 824 deaths, meningitis 476 deaths, cholera 54 deaths and others 72474 deaths.

Flu deaths can be reduced by postponing getting flu infection by adapting to respiratory fly hygiene measure incorporating 3 feet distance measures, frequent hand hygiene, and learning cough etiquettes.

One must also remember that not all are at risk of flu deaths. The ones at risk are people with co–morbid conditions like heart patients not including high blood pressure, uncontrolled diabetes, chronic patients with liver, kidney or lung diseases, patients with cancers, the elderly patients etc.


Conference Calendar

33rd All India Rhinoplasty Course
Date: November 14–15, 2010

Venue: Metro Hospital, Preet Vihar, Vikas Marg, New Delhi.

Course Chairman
Dr. V. P. Sood
Ear, Nose & Throat Center
212, Aditya Arcade, 30, Community Center, Preet Vihar, Vikas Marg, Delhi.
Web site : www.drsoodnasalfoundation.com


Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

26 th September: Sunday- BSNL Dil ka Darbar A day-long interaction with top cardiologists of the city. 8 AM - 5 PM at MAMC Auditorium, Delhi Gate.

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to
10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

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