4th December 2014, Thursday

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

Fast For 12 Hours If Going For a Cholesterol Test

  1. Getting a cholesterol test is easy.
  2. Food and drinks affect cholesterol profile. Fast for 12 hours to get accurate readings of LDL ("bad" cholesterol), HDL ("good" cholesterol), and triglyceride levels.
  3. Avoid drinking alcohol for at least 24 hours before the test.

Tell your doctor

  1. Flu or another illness shortly before the blood test can have a dramatic effect on your cholesterol levels.
  2. A change in diet in the last one week can make a difference. High levels of alcohol or carbohydrates can raise triglycerides.
  3. Did you forget to fast or sneak something to eat or drink before the test? It can affect the cholesterol levels.
  4. An underactive or overactive thyroid can affect cholesterol levels.
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66th Annual Conference of Cardiological Society of India (CSI) -2014

Dr D Solanki

Dr Dharmesh Solanki, Interventional Cardiologist, Rajkot.

What are the major advantages of ferric carboxymaltose (available as Ferinject) over other IV iron preparations?
Firstly, ferric carboxymaltose is a clinically proven IV iron for the management of iron deficiency in CHF backed by two landmark trials (FAIR HF and CONFIRM HF). The major advantages of over other IV iron preparations are:

What are the major advantages of ferric carboxymaltose (available as Ferinject) over other IV iron preparations?
Firstly, ferric carboxymaltose is a clinically proven IV iron for the management of iron deficiency in CHF backed by two landmark trials (FAIR HF and CONFIRM HF). The major advantages of over other IV iron preparations are:
• Can administer up to 1000 mg of iron in just 15 min, • Can be given as IV injection and IV drip infusion as well • Offers easy dose calculation for correction and maintenance dose • 99% utilization at targeted tissues • Rare incidences of anaphylaxis and fewer adverse events compared to other formulations
How is the dose calculated in ID patients?
The dose of ferric carboxymaltose can be calculated based on the body weight and hemoglobin
How soon we can see the benefit in CHF patients?
As mentioned in many clinical trials, the visible benefit with ferric carboxymaltose in terms of improvement in QOL was observed within 4 weeks from the initiation of the therapy. However improvement in Hb level may vary from patients to patients based on the baseline Hb value and disease status.
What are the major adverse effects that one can expect?
As with all medicines, ferric carboxymaltose can cause few undesirable effects. The most common undesirable effects that one might experience include nausea, headache, dizziness, injection site reactions, and elevated blood pressure. Usually these effects are mild and generally gets subside within couple of hours /day.
What was the method of ferric carboxymaltose administration in CONFIRM HF?
In Ferric CarboxymaltOse evaluatioN on perFormance in patients with IRon deficiency in coMbination with chronic Heart Failure (CONFIRM-HF) trial, ferric carboxymaltose was given as undiluted bolus IV injections of 10 or 20 mL (equivalent to 500 or 1000 mg of iron, respectively) administered over at least 1 min. Normal saline was administered as placebo similar to active therapy. The dose was calculated on body weight and Hb value at screening with an initial dose of 1000 mg at Week 1 followed by the rest of amount needed to correct the iron status. A maintenance dose of 500mg of iron was administered on each visit at week 12, 24 & 36 only if iron deficiency persisted. In Confirm HF, a median total dose of 1,500mg iron was administered during the one year study period (with a dosing range of 500 to 3,500mg iron) to correct iron deficiency and maintain the iron parameters within the normal range.
FAIR HF and the CONFIRM HF are landmark trials in CHF patients with iron deficiency. Are there any future trials on iron deficiency and HF?
There are many ongoing studies that are expected to provide more evidences for better outcome with IV iron in coming years. To my knowledge EFfect of Ferric carboxymaltose on Exercise Capacity in PaTients with iron deficiency and chronic Heart Failure (EFFECT-HF), iron in Congestive Heart Failure (iCHF) and the Ferric Carboxymaltose Assessment in Patients With IRon Deficiency and Chronic Heart Failure with preserved ejection fraction (FAIR-HFpEF) are the major studies. Apart from the above few meta-analyses are also expected that may further strengthen the findings of ferric carboxymaltose in CHF patients.

News Around The Globe

  • The use of iodinated contrast material in computed tomography (CT) did not increase patient risk for acute kidney injury (AKI), dialysis, or death, even among patients with poor renal function or predisposing comorbidities, suggested a study published in the December issue of Radiology.
  • Despite the increased risk for bone loss and fracture among men who receive androgen-deprivation therapy for prostate cancer, very few of these individuals are being given bisphosphonates to prevent these side effects, suggests a new study published in the December 3 issue of the Journal of the American Medical Association.
  • Rapid evolution of the human immunodeficiency virus (HIV) is decreasing its ability to cause AIDS, suggests a study of more than 2,000 women in Africa. The study was published online December 1 in the journal Proceedings of the National Academy of Sciences (PNAS).
  • A combination of dextromethorphan and quinidine significantly reduced symptoms of pseudobulbar affect (PBA) among patients with dementia, suggested a 12-week study presented at the 7th Clinical Trials Conference on Alzheimer's Disease (CTAD).
  • The first trial of the immunomodulator ipilimumab conducted in patients with malignant uveal melanoma has shown efficacy in some patients, with almost 25% patients showing long-lasting responses. The results from the study, known as GEM1, were presented at the recent Society of Melanoma Research (SMR) 2014 International Congress.

Dr KK Spiritual Blog

What is the difference between smile, hug and laugh.

Smile is a sign of joy while hug is a sign of love. Laughter on the other hand is a sign of inner happiness. None of them are at the level of mind or intellect. All comes from within the heart.

They are only the gradations of your expressions of your happiness.

It is said you are incomplete in your dress if you are not wearing smile on your phase.
Hug comes next. And laughter the last. Laughter is like an internal jogging and has benefits like that of doing meditation.

But be careful we must know when not to laugh. The most difficult is to laugh on oneself.

Inspirational Story

Beginning Today

Beginning today I will no longer worry about yesterday. It is in the past and the past will never change. Only I can change by choosing to do so.

Beginning today I will no longer worry about tomorrow. Tomorrow will always be there, waiting for me to make the most of it. But I cannot make the most of tomorrow without first making the most of today.

Beginning today I will look in the mirror and I will see a person worthy of my respect and admiration. This capable person looking back at me is someone I enjoy spending time with and someone I would like to get to know better.

Beginning today I will cherish each moment of my life. I value this gift bestowed upon me in this world and I will unselfishly share this gift with others. I will use this gift to enhance the lives of others.

Beginning today I will take a moment to step off the beaten path and to revel in the mysteries I encounter. I will face challenges with courage and determination. I will overcome what barriers there may be which hinder my quest for growth and self-improvement.

Beginning today I will take life one day at a time, one step at a time. Discouragement will not be allowed to taint my positive self-image, my desire to succeed or my capacity to love.

Beginning today I walk with renewed faith in human kindness. Regardless of what has gone before, I believe there is hope for a brighter and better future.

Beginning today I will open my mind and my heart. I will welcome new experiences. I will meet new people. I will not expect perfection from myself nor anyone else: perfection does not exist in an imperfect world. But I will applaud the attempt to overcome human foibles.

Beginning today I am responsible for my own happiness and I will do things that make me happy . . . admire the beautiful wonders of nature, listen to my favorite music, pet a kitten or a puppy, soak in a bubble bath . . . pleasure can be found in the most simple of gestures.

Beginning today I will learn something new; I will try something different; I will savor all the various flavors life has to offer. I will change what I can and the rest I will let go. I will strive to become the best me I can possibly be.

Beginning today and every day. Just a thought, but as I often think of you and realize how much God loves you, sometimes I think we need to also love ourselves through His eyes. God Bless.

Rabies News (Dr A K Gupta)

Is there a seasonal variation in dog bite cases?

Maximum dog bites are observed in the autumn months. It is observed that there is an increase during warm-weather months (May through August) and a corresponding decrease during colder months (November through March).

Cardiology eMedinewS

  • Dietary nitrate in the form of daily beetroot juice significantly reduces elevated blood pressure compared with placebo in hypertensive patients over 4 weeks, suggests a randomized phase 2 trial published online in Hypertension.
  • A large cohort study has found an association between giving epinephrine during out-of-hospital cardiac arrest and poor neurological outcomes, with the risk increasing with the dosage and the interval between the arrest itself and epinephrine administration. The study is to be published in the December 9 issue of the Journal of the American College of Cardiology.

Pediatrics eMedinewS

  • Children with Crohn's disease (CD) should begin methotrexate treatment subcutaneously, and those in complete remission can switch to oral methotrexate while being closely followed for inflammatory markers and growth, suggests new research published online in Gut.
  • Careful assessment and selection is important in determining whether infants with ankyloglossia (tongue-tie) need to undergo frenotomy, concludes a new review published online in the Archives of Disease in Childhood.

Quote of the Day

  • A successful man is one who can lay a firm foundation with the bricks others have thrown at him. ~ David Brinkley

Wellness Blog

Exercise: a prescription

Stating why one should do exercises 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 laid down a few facts:

  1. Reduces the chances of getting heart disease. For those who already have heart disease, exercise reduces the chances of dying from it.
  2. Lower the risk of developing hypertension and diabetes.
  3. Reduce the risk for colon cancer and some other forms of cancer.
  4. Improve mood and mental functioning.
  5. Keeps the bones strong and joints healthy.
  6. Helps you to maintain a healthy weight.
  7. Help maintain independence into later years
  8. Age is no bar; there is abundant evidence that exercise can enhance health and well-being. But today for most watching TV, surfing the Internet, or playing computer and video games is replacing the helpful exercises.
  9. The minimum threshold for good health is to burn at least 700 to 1,000 calories a week through physical pursuits.
  10. Exercise improves health and can extend life. Adding as little as half an hour of moderately intense daily physical activity can help one avoid a host of serious ailments, including heart disease, diabetes, depression, and several types of cancer, particularly breast and colon cancers.
  11. Regular exercise can also help one sleep better, reduce stress, control weight, brighten mood, sharpen mental functioning, and improve sex life.

As per Harvard researchers a well-rounded exercise program must have all the four components-

  1. Aerobic activity
  2. Strength training
  3. Flexibility training, and
  4. Balance exercises

Aerobic activity: is the centrepiece of any fitness program. Most benefits of exercise revolve around aerobic cardiovascular activity, which includes walking, jogging, swimming, and cycling. One should work out at moderate intensity when performing aerobic exercise—brisk walking that quickens the breathing is one example. This level of activity is safe.

Strength training protects bone: Strength or resistance training, such as elastic-band workouts and the use of weight machines or free weights, are important for building muscle and protecting bone. Bones lose calcium and weaken with age, but strength training can help slow or sometimes even reverse this trend.

Flexibility exercises ease back pains

Muscles tend to shorten and weaken with age. Shorter, stiffer muscle fibers make one vulnerable to injuries, back pain, and stress. But regularly performing exercises that isolate and stretch the elastic fibers surrounding the muscles and tendons can counteract this process. And stretching improves posture and balance.

Balancing exercises prevents fall

Balance erode over time, and regularly performing balance exercises is one of the best ways to protect against falls that lead to temporary or permanent disability. Balance exercises take only a few minutes and often fit easily into the warm-up portion of a workout. Many strength-training exercises also serve as balance exercises. Or balance-enhancing movements may simply be woven into other forms of exercise, such as tai chi, yoga, and Pilates.

emedipicstoday emedipics

Health Check Up and CPR 10 Camp at Navjeevan Sarvodaya Kanya Vidyalaya 3rd November 2014



video of day
press release

Rhinitis medicamentosa

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 40-year-old male developed dyspnea for the first time in life.
Dr. Bad: It is an attack of asthma.
Dr. Good: Get an ECG done.
Lesson: First onset of breathlessness after the age of 40, unless proved otherwise, is cardiac in nature.

Make Sure

Situation: A patient with acute heart attack died on the way to the hospital.
Reaction: Oh my God! Why was the patient not accompanied by the doctor?
Lesson: Make sure that all heart attack patients are accompanied by the doctor to the hospital so that chest compression (CPR) can be given if the heart stops on the way.

eMedinewS Humor

When she went before the judge he asked her, "What did you steal?"

She replied, "Can of peaches."

The judge asked her why she had stolen the can of peaches and she replied that she was hungry. Then the judge asked her how many peaches were in the can. She replied 6.

The judge said, "Then I will give you 6 days in jail."

Before the judge could actually pronounce the punishment, the woman's husband spoke up and asked, the judge if he could say something on his wife's behalf. The judge said, "What is it?"

The husband said, "She also stole a can of peas."

Twitter of the Day

Dr KK Aggarwal: Cause and cold does not require antibiotics
Dr Deepak Chopra: Happiness for a reason is a form of misery . Happiness for no reason is bliss

ePress Release

Women die more than men in hospital from severe heart attack

Winter months are heart attack months, 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.

Men and women have about the same adjusted in-hospital death rate for heart attack — but women are more likely to die if hospitalized for a more severe type of heart attack.

According to a report in Circulation: Journal of the American Heart Association:

  1. Women are twice as likely as men to die if hospitalized for a type of heart attack known as ST-elevation myocardial infarction (STEMI).
  2. Women are also less likely to receive appropriate and timely treatment for heart attack.
  3. Women with STEMI have a 12 percent higher relative risk for in-hospital death compared to men.
  4. Compared to men, women are 14 percent less likely to receive early aspirin; 10 percent less likely to receive beta blockers; 25 percent less likely to receive reperfusion therapy (to restore blood flow); 22 percent less likely to receive reperfusion therapy within 30 minutes of hospital arrival; and 13 percent less likely to receive angioplasty within 90 minutes of hospital arrival.

Women admitted with a STEMI are about twice as likely to die in the first 24 hours of hospitalization as men.

eMedi Quiz

A 60 year old male presented to the emergency with breathlessness, facial swelling and dilated veins on the chest wall. The most common cause is:

1. Thymoma
2. Lung Cancer.
3. Hodgkin's lymphoma.
4. Superior vena caval obstruction.

Yesterday’s Mind Teaser: Which one of the following is a recognized X-Ray feature of rheumatoid arthritis?

1. Juxta-articular osteosclerosis.
2. Sacroilitis.
3. Bone erosions.
4. Peri-articular calcification.

Answer for yesterday’s Mind Teaser: 3. Bone erosions.

Correct answers received from: Dr Rakesh Sharma, Dr Avtar Krishan, Dr ABDUL GAFAR Dabawala.

Answer for 2nd December Mind Teaser: 2. Interstitial lung disease.

Correct answers received from: Dr Jainendra Upadhyay, Dr K V Sarma, Dr Avtar Krishan, Dr Rakesh Sharma, Dr Poonam Chablani, Dr Bitaan Sen & Dr Jayashree Sen.

Send your answer to email

medicolegal update
  1. Its very nice to punish the guilty, but why the poor doctor is been punished for being the faculty, he is doing his job & getting the money whatever is been fixed between two parties , he is not doing any illegal work (doing only the medicine work for which he is qualified). In my opinion its the Medical college who should be punished & licence to admit the students should be cancelled for 10 years. Dr V K Goyal

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)