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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


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  Editorial …

31st August 2011, Wednesday

Go wish your Muslim friend Eid Mubarak

Once I was listening to a scholar who was trying to find out why Hindu and Muslims fight with each other. He narrated that Muslims want their ‘Ali’ back from "Diwa–li" and Hindus want their ‘Rama’ back from "Rama–dan".

Eid is observed in Islam twice in a year, once it is observed as Sevainyan Eid (Eid ul–Fitr) and the other as Bakra Eid (Eid–al–adha).

Eid ul Fitr marks the end of Ramadan, the Islamic holy month of fasting. Eid is an Arabic word meaning "festivity," while Fitr means "breaking (the fast)". Ramadan is thirty days of dawn–to–sunset fasting.
Thirty days of Ramadan in Islam; nine days of Navratra in Hinduism and forty days of Easter in Christianity are spiritual practices observed by respective religions. These are days of mind, body and soul detoxification observed as per religion defined rituals. Broadly, they involve restraining the ten senses during the fast period. One restrains from negative thoughts cum actions and indulges in positive thoughts cum actions.

In Ramadan, one month continuous fast detoxifies the mind, body and soul and reenergizes the human being.

Eid ul Fitr is observed as general detoxification process of the mind, body and soul. Eid–al–adha on the other hand is based on observing "detached attachment" where a person leans to sacrifice (detachment) a goat after practiced attachment for few months.

On the day of Eid, people wear new clothes and also care for the poor and the needy. They also offer prayers and seek Allah help for forgiving their sins and make them pure and pious human beings.

In Ramadan, Muslims fast and increase their spiritual devotions, and recognize their spiritual powers. On Eid Muslims thank Allah for the gift of fasting, in which they avoid food and drink from dawn to dusk. The Prophet Muhammad said, "Whoever fasts the month of Ramadan out of faith, seeking its reward, shall have all their past sins forgiven."

‘Fast’ is common between Navratre, Ramadan and Easter. It’s the power of fast (of all ten senses in the body) which takes one near to one’s consciousness and the God. Being in touch with the consciousness and the God is like reformatting once computer which removes all the temporary files and bad sectors (sins).

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Dr KK Aggarwal
Group Editor in Chief

    eMedinewS Audio PostCard

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

Go wish your Muslim friend Eid Mubarak

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

National Conference on Insight on
Medico Legal Issues

Invited Guests of Honour on the dais in the recenty concluded National Conference on Insight on Medicolegal Issues.

Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


Over 3.7 lakh migratory kids administered polio immunization drops

CHANDIGARH: Around 3,73,719 migratory children below the age of 5 years were administered polio immunization drops on Sunday, the first day of the 3–day sub–national immunization campaign for Pulse Polio immunization held across Punjab. No case of polio was reported during the year 2010, while, in 2009, 4 cases were reported from the state. While2 of these were reported from Ludhiana, one case each was from Jalandhar and Mohali. Doctors say that it required at least 3 years consecutively of there being no polio case before a region can be declared in the safe zone of polio eradication. A total of 3,147 teams and 629 supervising teams have been formed by the government to achieve an overall target covering 7,86,777 migratory children in Punjab during the 3-day Pulse Polio campaign that will continue till August 30. (Source: TOI, Aug 29, 2011)

For Comments and archives

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

(Dr Monica and Brahm Vasudev)

No eczema protection from breastfeeding

Breastfeeding offered no protection against the development of childhood eczema, according to a survey of more than 51,000 schoolchildren worldwide. Lifetime risk of eczema increased by about 10% in children who had any exposure to breastfeeding and for those who were breastfed for less than six months. (Source: Medpage Today)

For comments and archives

ESC: Anger drives heart attacks but laughter may be antidote

New research suggests that patients with cardiovascular disease who have unresolved anger problems may find themselves vulnerable for recurrent heart attacks. Over a 10–year period, 78.5% of patients with cardiovascular disease who did not indicate an angry personality profile had infarction free–survival compared with 57.4% of similar patients who exhibited anger profiles (P=0.0025), said Franco Bonaguidi, DPsych, from the Institute of Clinical Physiology in Pisa, Italy, at the European Society of Cardiology meeting. On the other hand, Michael Miller, MD, from the University of Maryland in Baltimore, showed that when people laughed their major blood vessels dilated, allowing for easier blood flow, a surrogate marker for a reduced risk of cardiac events. (Source: Medpage Today)

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ESC: Novel HDL–raising drug appears safe

A novel cholesteryl ester transfer protein (CETP) inhibitor, dalcetrapib, raised HDL cholesterol without any safety concerns in phase IIb dal–VESSEL trial, but it remains to be seen whether that boost in HDL will improve clinical outcomes. (Source: Medpage Today)

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    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

Exercise decreases the risk of cancer recurrence

A new report shows that although many doctors admit to advising their cancer patients and survivors to take it easy, this may not be the best advice. The report from Macmillan Cancer Support, the largest charity foundation in Great Britain, shows that exercising after a diagnosis or treatment for cancer may be an effective way to prevent recurrence and aid recovery. As long as exercise programs are low–impact and designed with the particular needs of the individual patient, they are safe and beneficial for cancer survivors. The report reviewed 60 studies and surveyed over 400 health professionals who work closely with cancer patients and found that lack of physical activities might be putting as many as 1.6 million cancer survivors in the UK at greater risk of long term health problems with some at greater risk of cancer recurrence. The report also found that women with breast cancer who exercise for 150 minutes a week at moderate intensity are 40 percent less likely to experience disease recurrence, as compared to women who were active for less than an hour a week.

The report concludes by recommending that doctors and other health professionals prescribe exercise to all cancer survivors.

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    Twitter of the Day

@DrKKAggarwal: #IJMD Peripheral Ameloblastoma: review of literature and case presentation. Renu Yadav et al… fb.me/uaaEFvgs

@DeepakChopra: #CosmicConsciousness Everything "objective" is subjective

    Dr KK Answers

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

Should I screen each patient for presence of carotid neck artery blockages?

The guideline says no. The potential harms include risks associated with the screening procedure itself like false–positive findings leading to anxiety and the potential for unnecessary surgical procedures. Carotid angiography is associated with risk of neurological complications including stroke, with rates ranging from 0.1 to 1%.

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    Spiritual Update

Why puffed rice and not rice is offered to Lord Ganesha

Lord Ganesha is depicted with big tummy and craving for eating sweets (ladoo or modakas) and puffed rice. Both sweets and rice are addicting in nature and consuming them regularly can lead to metabolic syndrome which presents with diabetes and high blood pressure. For this reason, Hindu mythology says to avoid eating carbohydrates atleast once in a week.

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    An Inspirational Story

(Ms Ritu Sinha)

My Mom Only Had One Eye

My mom only had one eye. I hated her… She was such an embarrassment. She cooked for students and teachers to support the family. There was this one day during elementary school where my mom came to say hello to me. I was so embarrassed. How could she do this to me? I ignored her, threw her a hateful look and ran out. The next day at school one of my classmates said, ‘EEEE, your mom only has one eye!’

I wanted to bury myself. I also wanted my mom to just disappear. I confronted her that day and said, ‘If you’re only going to make me a laughing stock, why don’t you just die?’

My mom did not respond… I didn’t even stop to think for a second about what I had said, because I was full of anger. I was oblivious to her feelings. I wanted out of that house, and have nothing to do with her. So I studied real hard, got a chance to go abroad to study.

Then, I got married. I bought a house of my own. I had kids of my own. I was happy with my life, my kids and the comforts. Then one day, my Mother came to visit me. She hadn’t seen me in years and she didn’t even meet her grandchildren. When she stood by the door, my children laughed at her, and I yelled at her for coming over uninvited. I screamed at her, ‘How dare you come to my house and scare my children!’ GET OUT OF HERE! NOW!!!’

And to this, my mother quietly answered, ‘Oh, I’m so sorry. I may have gotten the wrong address,’ and she disappeared out of sight.

One day, a letter regarding a school reunion came to my house. So I lied to my wife that I was going on a business trip. After the reunion, I went to the old shack just out of curiosity.

My neighbors said that she died. I did not shed a single tear. They handed me a letter that she had wanted me to have.

My dearest son, I think of you all the time. I’m sorry that I came to your house and scared your children. I was so glad when I heard you were coming for the reunion. But I may not be able to even get out of bed to see you. I’m sorry that I was a constant embarrassment to you when you were growing up. You see………when you were very little, you got into an accident, and lost your eye. As a mother, I couldn’t stand watching you having to grow up with one eye. So I gave you mine. I was so proud of my son who was seeing a whole new world for me, in my place, with that eye. With all my love to you, Your mother.

For comments and archives

    Gastro Update

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

Chronic Pancreatitis: Imaging Studies

Endoscopic Retrograde Pancreatography (ERP)

In the absence of tissue confirmation, ERP is considered the most sensitive and specific test for diagnosis of chronic pancreatitis, with sensitivity and specificity in earlier reports approaching 90–100% respectively.

  • In mild or early disease, findings include dilations and irregularity of the smaller ducts and branches of pancreatic duct.
  • In more moderate disease, these changes are found in main pancreatic duct as well.
  • Tortuosity, stricture, calcification and cysts may also be seen as disease becomes more severe.

For comments and archives

  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Angiotensin–converting enzyme

ACE is done to help diagnose and monitor sarcoidosis. It is often ordered as part of an investigation into the cause of a group of troubling chronic symptoms that may or may not be due to sarcoidosis

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    IJCP Special

Dr Good Dr Bad

Situation: A patient was on rapid weight loss program.
Dr Bad: Go ahead.
Dr Good: Add UDCA.
Lesson: As weight loss may increase the likelihood of gallstones, UDCA is often added when the weight loss is more than 1 – 1.5 kgs per week.

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Make Sure

Situation: A patient missed his second dose of Hepatitis B vaccine and developed Hepatitis B.
Reaction: Oh my God! Why was the vaccine not given between 1–2 months?
Lesson: Make sure that all patients who missed their second dose of vaccine at one month are given the same upto second month (1–2 months).

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  Quote of the Day

(Dr Chandresh Jardosh)

"When u Truly Believe That u Deserve Success,
Your Mind Will Automatically Generate Ways To Achieve It…!!!Develop
Conviction n Passion.


Get down to Brass Tacks: To become serious about something.

  G P Pearls

(Dr Pawan Gupta)

Levofloxacilin with azithromycin and levo with chloromycetin is a suitable combination. The incidence of typhoid is unexpectedly this year very high.

    Medicolegal Update

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

What is the countercoup injury of brain?

  • Two types of impacts occur on skull and the sound wave elicited by the impact. The first at the site where the force is applied, the second where the advancing segments of the accelerated brain are brought suddenly to rest by the forces that resist its forward motion.
  • Counter coup lesions of the brain were once thought to be caused by the brain moving within the skull in a straight line with the force of the blow striking against its opposite side, but from experiments on mechanics of head injuries it has demonstrated the countercoup lesions are chiefly due to local distortions of the skull and the sudden rotation of the head as result of a blow, which arouse shear strains or slide produced by the pulling apart of the constituent particles of the brain.
  • Shear strains occur due to pulling apart of the constituent particles of the brain. They occur in all parts of the brain, but to a large extent at the base of the frontal lobe and the tip of the temporal lobe, as the skull gets a good grip on the brain in this region owing to the projecting ridge of the sphenoid bone. Hence, severe and extensive injuries occur in this region when a blow is struck on the occiput.
  • On the other hand, countercoup injuries which are caused by rotation will not occur if the head is so well fixed that it cannot rotate at all when it receives a blow. Cerebral contusions and tears have been reported in autopsy as a result of trauma.

(References Modi’s medical jurisprudence 25th edition)

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    Mind Teaser

Read this…………………

Ideal treatment of alkaline reflux gastritis after Billroth I and Billroth II gastrectomy is

a) Conversion of Billroth I to Billroth II
b) Roux en Y gastrojejunostomy
c) Total gastrectomy
d) Conservative management

Yesterday’s Mind Teaser: The most common malignant neoplasm of infancy is:

1. Malignant Teratoma
2. Neuroblastoma
3. Wilms’ tumor
4. Hepatoblastoma

Answer for yesterday’s Mind Teaser: 2. Neuroblastoma

Correct answers received from: Dr Sachin Srivastava, Dr YJ Vasavada, Dr Pallipalayam Sivaramakrishnan, Poonam Chandra, Dr Rajshree Aggarwal, Dr Pramod M Kulkarni, Dr Muthumperumal Thirumalpillai, Dr Priyanka Sharma, Dr K Raju, Dr Prabodh Kumar Gupta, Dr Jainendra Upadhyay.

Answer for 29th August Mind Teaser: 3. DTPA Renogram
Correct answers received from: Dr Sukanta Sen, Dr K Raju.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr. GM Singh)

Divorce: Future tense of marriage.

    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name


DCI Approval Date

Alpha Lipoic Acid USP 100mg + Methylcobalamin 1500mcg + Vitamin B6 IP 3mg + Folic Acid IP 1.5mg + Benfotiamine 50mg + Biotin USP 5mg + Chromium Picolinate USP Eq. to Chromuim 200mcg Capsule

For the treatment of diabetic neuropathy


    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Diabetes and Dental Screening

Periodontal or gum disease is a common complication of diabetes and itself contributes to poor glycemic control, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela. Severe periodontal disease has been shown to be an independent risk factor for mortality from ischemic heart disease and nephropathy.

Annual dental examination is recommended in both dentate and non–dentate diabetic patients.

In diabetics, control of the blood sugar is the key. If uncontrolled, one carries a higher risk of

  1. Tooth decay (cavities). The mouth naturally contains many types of bacteria. The higher the blood sugar level, the greater the supply of sugars and starches — and the more acid damages the teeth.
  2. Early gum disease (gingivitis). Diabetes reduces the ability to fight bacteria, which can cause more plaque to build up on the teeth.
  3. Advanced gum disease (periodontitis). Left untreated, gingivitis can lead to a more serious infection called periodontitis, which destroys the soft tissue and bone that support the teeth. Periodontitis tends to be more severe among people who have diabetes because diabetes lowers the ability to resist infection and slows healing.
  4. Patients with diabetes mellitus should also receive influenza flu vaccination yearly and pneumococcal vaccination. The pneumococcal vaccine should be repeated once after 65 years of age if the initial vaccination was prior to this age.
  5. Tetanus and diphtheria vaccinations should also be updated.
  6. Diabetes is considered equivalent to known coronary disease in predicting the risk of future cardiac events. Smoking cessation is essential for patients who smoke. Cardiovascular morbidity can also be significantly reduced with aggressive management of hypertension (goal blood pressure less than 120/80 mmHg), cholesterol (goal LDL less than 80 mg/dL) and use of aspirin (80 mg/day) in patients over age 40 years, and in younger patients with additional cardiovascular risk factors.
  7. Aspirin alone may not be the answer as a Japanese research has shown that low-dose aspirin does not reduce the risk of cardiovascular events in people with type 2 diabetes.

For comments and archives

    Readers Responses
  1. Dear Dr KK Agarwal, I found the article 80% Indians do not get essential drugs interesting. I think we should practice evidence based medicine in India. Simple things like aspirin, ace–inhibitors & statins can make huge difference in CVD outcomes. For Hypertension we should use Ace– Inhibitors & ARB as first line medications as per latest guidelines. They have good protective effects on CVS & kidneys. Also we do not have prevention programs like pap & Feacal occult testing for bowel cancer. I think these simple things can prevent a lot serious diseases. Most important of all is lifestyle changes – stop smoking, weight loss, regular exercise & healthy eating. We must emphasise these things. We find when a patient goes to a doctor, he is given a multiple medications without any advise on life style changes.Thank You, Dr S Ghosal
    Forthcoming Events

18th MTNL Perfect Health Mela

Date: 14th–18th October
Different locations in Delhi
19th–23rd October
Venue: NDMC Ground, Opp. Indira Nari Niketan Working Girls Hostel
Near Philanji Village, Laxmibai Nagar, New Delhi
Theme: Science Behind Rituals


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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