eMedinewS3rd January 2014, Friday

Dr K K AggarwalPadma 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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; 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.facebook.com/Dr KKAggarwal

Dear Colleague Watch my show on Zee News @ Health Wealth: Can Alcohol be Prescribed as Medicine

Tackling Vitamin B12 Deficiency

Vitamin B12 deficiency can be prevented if you are strict vegetarian. 3.2% of adults over age of 50 have a serious low B12 levels and up to 20% may have a borderline deficiency. The common causes of B12 deficiency are being on a vegetarian diet and after a weight loss surgery. Plants do not make Vitamin B12. It is only present in animal food.


  1. Strange sensations, numbness or tingling in the hands, legs or feet.
  2. Difficulty in walking (staggering, balance problem)
  3. Anemia
  4. A swollen inflamed tongue.
  5. Difficulty thinking and reasoning (cognitive difficulties) or memory loss.
  6. Yellowed skin (jaundice)
  7. Paranoia or Hallucinations
  8. Weakness
  9. Fatigue

Ask your Doctor about having your B12 level check if you:

  • Are over 50 years old
  • Take a proton–pump inhibitor or H2 blocker drugs for acidity
  • Take metformin (a diabetes drug)
  • Are a strict vegetarian
  • Had weight loss surgery or have a condition that interferes with absorption of food.

Seven Common Causes of Forgetfulness

  1. Lack of sleep is the most common cause. Two little restful sleep can also lead to mood changes and anxiety which in turn can contribute to memory impairment.
  2. Many drugs can affect memory, which includes tranquilizers, antidepressants, blood pressure drugs and anti–allergic drugs.
  3. Low functioning thyroid can affect memory.
  4. Drinking too much alcohol can interfere with short–term memory.
  5. Stress and anxiety can lead to memory impairment. Both can interfere with attention and block the formation of new memory or retrieval of old memories.
  6. Forgetfulness can be a sign of depression or a consequence of it.
  7. If you are vegetarian, vitamin B12 deficiency can loss memory impairment.

Fenofibrate in Diabetic Retinopathy

Fenofibrate to slow the progression of existing diabetic retinopathy in people with type 2 diabetes has been approved by FDA in Australia. As per the new findings fenofibrate has a major beneficial effect on eye disease and disability as per Anthony Keech, MD, professor of medicine, cardiology, and epidemiology at the University of Sydney.

He stressed the importance of treating it early, before the condition worsens to the point of needing laser surgery.

Laser surgery is very effective at preventing retinal hemorrhages but destroys the treated retina. Early treatment also helps prevent the need for intraocular injections of anti–(vascular endothelial growth factor) VEGF drugs and associated risks.

Diabetic retinopathy is the most common cause of vision loss in adults of working age with more than 50% of people with type 2 diabetes having retinopathy after 10 years of disease. Without effective treatment, 10% of patients will have severe visual impairment after 15 years of diabetes and will be unable to read or drive a car, and around 2% will be legally blind.

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 mantra
VIP’s on CPR 10 Mantra Video
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

Why most temples are located in far away places?

sprritual blog

Most temples represent God or the spirit the deity located in the temple or mandir situated in an area at the outskirts of the city. A spiritual atmosphere is devoid of pollution and anything which promotes rajsik or tamsik behavior. The silence of the spiritual atmosphere reduces the internal noise and helps us onward in our inner journey. The inner journey of being in touch with one’s consciousness requires detachment from worldly pleasures and the withdrawal of the five senses of the body.

To be in touch with one’s consciousness one needs to bypass the disturbed state of consciousness controlled by emotion, memories and desires, through mind, intellect and ego.

This bypass usually requires a prolonged period of persistence and undertaking the inward journey devoid of external stimuli. The parikrama, which means "the path surrounding something", incorporating many long walks helps to detoxify the mind and thus shifts the consciousness from a disturbed state to an undisturbed, calm state.

A long walk not only has physical benefits but one also gets the benefits of nature as one’s inner stimuli are exposed to the outer stimuli during the parikrama. The person is often required to walk bare foot on natural ground, inhale pure air and concentrate and listen to the sounds of the nature, birds and trees. This proximity of nature helps in the inward spiritual journey and shifts one from the sympathetic to parasympathetic mode described by lowering of blood pressure and pulse rate and rise in skin resistance.

The final happiness invariably comes from within us at the time of final darshan when a person invariably closes his eyes and experiences God within his heart.

Most temples today are being constructed in residential colonies and provide a holy atmosphere to people right at their doorstep. However, this does not have the same spiritual significance and benefits as a temple located at the outskirts of a city.

There is no way a person can go to a temple in the vicinity of his house and detoxify his mind as this can hardly be achieved in minutes unless you are a siddha yogi, and if you are one, you need not go to a temple as the temple is within you.

In Vedic texts, it has been clearly mentioned that to acquire powers and inner happiness, rishi, munis were also required to do tapasya for months and years together.

This tells us that spiritual well–being is acquired over an extended period of time as the process of detoxification is a long drawn process. Cars and other vehicles should not be allowed near temples as the basic motive is to have a pollution–free atmosphere and to give time and space for the mind to detoxify.

cardiology news

Do not be jealous

We all have experienced how jealousy can disturb our peace of mind. You know that you work harder than your colleagues in the office, but sometimes they get promotions; you do not. You started a business several years ago, but you are not as successful as your neighbor whose business is only one year old. There are several examples like these in everyday life.

Should you be jealous? No. Remember everybody’s life is shaped by his/her destiny, which has now become his/her reality. If you are destined to be rich, nothing in the world can stop you.

If you are not so destined, no one can help you either. Nothing will be gained by blaming others for your misfortune.

Jealousy will not get you anywhere; it will only take away your peace of mind.

News Around The Globe


  • For patients with mild to moderate Alzheimer disease, 2000 IU of vitamin E daily slows functional decline and reduces caregiver burden, according to results of a large randomized controlled trial published in the January 1, 2014, issue of JAMA.
  • Atopic disease may double the risk for herpes simplex virus ocular disease and herpes zoster ophthalmicus, according to a retrospective case-control study of more than 217,000 patients enrolled in a Hawaiian managed care organization in JAMA Ophthalmology.
  • A study from Bangladesh reports that a single dose of intravenous liposomal amphotericin (AmBisome, Gilead) can cure visceral leishmaniasis, also known as "Kala–azar" or black fever. According to Dr. Dinesh Mondal, not only is the treatment highly effective, but it’s safe, it improves compliance, and it allows patients to be treated closer to home, with only a brief hospital stay. The findings are published in The Lancet Global Health. Liposomal amphotericin B is a lipid encapsulated formulation of anti–fungal amphotericin with a better safety profile than plain amphotericin
  • Researchers from Japan report in the journal Radiology that repeated use of gadolinium–based contrast agents was associated with increased MRI signal intensity in certain brain regions that could affect the interpretation of scans.
  • All antidepressant drugs may potentially cause liver injury, even at recommended doses, and some groups are more vulnerable than others, French researchers report in the American Journal of Psychiatry. Antidepressant–induced liver injury can be irreversible. The authors suggest that an early detection and prompt drug discontinuation is critical.

CPR 10 success stories

1. Hands–only CPR 10 English

2. Handsonly CPR 10 (Hindi)

3. Ms Geetanjali, SD Public School Successful Story

4. Success story Ms Sudha Malik

5. BVN School girl Harshita does successful handsonly CPR 10

6. Elderly man saved by Anuja

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Rabies News (Dr. A K Gupta)

Is hydrophobia a sign of rabies in dogs?

Hydrophobia is not a sign of rabies in dogs. Rabid dogs can drink water and even swim in water. If a rabid dog is not able to drink water, it is because of paralysis of jaw muscles and not due to hydrophobia.

cardiology news

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

  • Heart disease in women is typically viewed as different from men’s heart disease, in part because of women’s unique presenting symptomatology. But a study reported at the annual meeting of the Radiological Society of North America suggests that they may not really be all that different when it comes to mild coronary artery disease. A prospective, multinational registry analysis found that 1.2 %of women and 1.1 % of men with mild, nonobstructive coronary artery disease on coronary CT angiography experience a major adverse cardiovascular event, either heart attack or death, each year. For those free of coronary artery disease (CAD), the event rate was 0.3 % for both sexes.
cardiology news

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

  • Continued co–trimoxazole prophylaxis after 96 weeks of antiretroviral therapy (ART) in HIV–infected children was associated with fewer hospitalizations for both malaria and infection not related to malaria, according to a randomized noninferiority trial published in the January 2 issue of the New England Journal of Medicine.
  • Hospitalized children who receive hypotonic maintenance intravenous (IV) fluids are at higher risk of developing hyponatremia than those receiving isotonic IV fluids, according to a recent meta-analysis published online December 30 in Pediatrics.
cardiology news

Hookah as bad as smoking

An hour of puffs from a hookah packs the same carbon monoxide punch as a pack–a–day cigarette habit.

Hookahs have grown in popularity in recent years and Hookah bars have appeared in cities all over the world that allow people to smoke these water pipes.

Users inhale tobacco smoke after it bubbles through water, a process that some people think filters toxins from the tobacco.

Hammond and a student, in a study published in the Journal of the American Medical Association, recruited 27 students who smoked water pipes for an hour on three different evenings in April 2006. Another five students did not smoke the hookahs but stayed in the room with those who did. The participants abstained from water pipe smoking for 84 hours before taking part in the study; the bowls of their water pipes were filled with water and 10 grams of Al Fakher mu'assal tobacco, and then heated with charcoal.

Researchers monitored carbon monoxide in the breath of the participants both before and after the experiment using a machine designed to detect if people are smokers.

The exhaled carbon monoxide in participants was an average of 42 parts per million, higher than that reported in cigarette smokers (17 parts per million). The study also found that carbon monoxide levels grew in the room where the subjects smoked hookahs and might reach environmentally unhealthy levels, as determined by the federal government, during longer sessions.

Smoking a water pipe for 45 minutes produces 36 times more tar than smoking a cigarette for five minutes.

cardiology news

Total CPR since 1st November 2012 – 84073 trained

Media advocacy through Web Media

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press release

Natural food and not supplements to prevent heart disease

One should eat seasonal and locally grown natural food and vegetables grown out of organic farms, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India & National Vice President IMA.

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

According to the American Heart Association, 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 only for secondary prevention of heart patients with chronic renal failure who are undergoing hemodialysis.

The American Heart Association 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.

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 84073 people since 1st November 2012.

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."

emedipicstoday emedipics

IMA new years celebrations, with staff, retirement of Sh V K Sharma

press release

Strenuous exercise may increase risk of cardiac disorder

vedio of day

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

A 55–year–old lady presenting to outpatient department (OPD) with postmenopausal bleeding for 3 months has a 1×1 cm nodule on the anterior lip of cervix. The most appropriate investigation to be done subsequently is:

1. Pap smear
2. Punch biopsy
3. Endocervical curettage
4. Colposcopy

Yesterday’s Mind Teaser: The earliest immunoglobulin to be synthesized by the fetus is:

1. IgA.
2. IgG.
3. IgE.
4. IgM.

Answer for yesterday’s Mind Teaser: 4. IgM.

Correct answers received from: Dr B K Agarwal, Chenalla Laxmankumar, Daivadheenam, Dr SUSHMA Chawla, Dr KV Sarma, Dr K Raju, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Dr Bitaan Sen & Dr Jayashree Sen, Sangeetha Raja, Muthumperumal Thirumalpillai, Dr Ajay Gandhi, Dr Avtar krishan.

Answer for 1st January Mind Teaser: 3. Borrelia recurrentis is the etiological agent.

Correct answers received from: Dr Jainendra Upadhyay, Dr Bitaan Sen & Dr Jayashree Sen, Muthumperumal Thirumalpillai, Dr Ajay Gandhi.

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medical querymedical query

medicolegal update
medicolegal update


A small boy was looking at the red ripe tomatoes growing in the farmer’s garden. "I’ll give you my two pennies for that tomato," said the boy pointing to a beautiful, large, ripe fruit hanging on the vine.

"No," said the farmer, "I get a dime for a tomato like that one."

The small boy pointed to a smaller green one, "Will you take two pennies for that one?"

"Yes," replied the farmer, "I’ll give you that one for two cents."

"OK," said the lad, sealing the deal by putting the coins in the farmer’s hand, "I’ll pick it up in about a week."

medicolegal update

Click on the image to enlarge

medicolegal updatemedicolegal update

medicolegal update

Situation: A patient with 3 hour of developing chest pain went into acute cardiac arrest.
Reaction: Oh my God! Why was water–soluble aspirin not given at the time of chest pain?
Lesson: Make sure that all patients with suspected MI are given water–soluble aspirin to reduce chances of death.

medicolegal update

Never Miss First Opportunity, because the Second Opportunity Will be Much More Difficult than First!

medicolegal update

Dr KK Aggarwal: Promising Medical Advances Insights into brain injury A study by NIH researchers provided insight into the (cont) http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Happiness can be woven into every aspect of life once you make new choices http://bit.ly/15QdVeB #Health

medicolegal update
  1. Dear Sir, Thanks for the nice updates. Regards: Dr Karan

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