Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
  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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos…
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 9 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

5th December 2012, Wednesday

ICD + CRT No Benefit for HF with Afib

Heart failure patients with permanent atrial fibrillation who are candidates for implantable cardioverter defibrillators (ICDs) gain little benefit from addition of cardiac resynchronization therapy (CRT), according to a prespecified analysis of the RAFT Trial.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Chronic idiopathic

constipation Chronic idiopathic constipation or functional constipation is a common condition affecting the GI tract with an estimated prevalence between 4 and 20 percent. It is defined as the infrequent, persistently difficult passage of stools or seemingly incomplete defecation, which does not meet IBS criteria. These patients usually do not have any physiological abnormality.

For comments and archives

Dr K K Aggarwal
    eMedinewS Audio PostCard

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

FDA OKs first drug-eluting stents for use in MI

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela 2012

National Workshop on Pre Hospital Care in Heart attack a seminar was organized in the MTNL Perfect Health Mela

Dr K K Aggarwal
    National News

HIV lab at PGI becomes first in region to be granted national accreditation

In a first, on the occasion of World AIDS Day on Saturday, the HIV Testing and Disease Monitoring laboratory in the Department of Immunopathology, PGIMER has been accorded Accreditation by the National Accreditation Board for Calibration and Testing Laboratories (NABL). NABL is a central agency which has laid down certain guidelines (known as NABL 15189:2007) based on international standards of laboratory set-up and functioning and grants accreditation (certification) following a very stringent criteria of assessment made by independent NABL certified assessors. The PGI HIV laboratory is not only the first in Chandigarh but also in the whole of north India beyond New Delhi in a government setup to get NABL accreditation. The laboratory boasts of giving HIV diagnostic and disease monitoring (CD4 count and viral load) services as per international standards and the report generated from this laboratory will be acceptable in any country around the world following such standards. Since the services are fully sponsored by NACO (Ministry of Health and Family Welfare, Govt of India), the HIV testing and CD4 count are offered free of cost in this laboratory to the patients inflicted with this disease. Dr Sunil Arora, Professor and In charge of this laboratory insists that anybody desiring to know his/her HIV status should avail these services in ICTC, PGI, Chandigarh. The NABL assessment involves the functioning of the index laboratory related to all aspects including competency and training of authorized signatory and technical staff, functional status and calibration of all instruments, up-to-date documentation of all activities including maintenance of a quality manual, bio-safety manual, standard operating procedures (SOPs) and management review committee meetings. This kind of systematic work culture is not normally seen in government hospital/institute laboratories in India. (Source: Indian Express, Dec 02 2012)

Dear Colleague, Let’s celebrate New Year by learning CPR-10 and saving the life of a person

Watch English or Hindi Video @http://emedinews.in/videos/cpr/index.html

Dr K K Aggarwal

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    Valvular Heart Disease Update

Echocardiography with Doppler flow analysis is an invaluable diagnostic screening tool for the presence of valvular heart disease in patients with CKD.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

DSM-5 gets APA's official stamp of approval

The final diagnostic criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has been approved by the leadership of the American Psychiatric Association (APA). According to the APA, the latest edition of the manual will include "approximately the same number of disorders as the DSM-IV." In its release the APA announced that the latest edition of the manual will include a restructuring of its 20 chapters "based on disorders' apparent relatedness to one another, as reflected by similarities in disorders' underlying vulnerabilities and symptom characteristics." The new manual will remove the current mutiaxial system in favor of nonaxial documentation of diagnosis, which will combine the former Axes I, II, and III with separate notations for psychosocial and contextual factors (formerly Axis IV) and disability (formerly Axis V). (Source: Medscape)

Diabetes drug may boost ovarian Ca survival

The first-line diabetes drug metformin may have a role in ovarian cancer treatment, researchers found. (Source: Medpage Today)

Wide treatment of HIV cuts risk of transmission

A large Chinese study suggests that treating HIV has a real-world benefit in preventing transmission of the virus, even in developing countries. Evidence has been mounting – most notably in the pivotal, randomized, controlled HPTN 052 trial – that treating the HIV-positive partner in a couple where the other partner does not have the disease dramatically cuts the chance of passing on the virus. (Source: Medpage Today)

FDA approves iPhone ECG monitor

AliveCor's iPhone-compatible single-channel ECG monitor will soon be available in the US and Europe now that the Food and Drug Administration has cleared the 510(k) for the device and the EU has granted it a CE mark, the company announced. The AliveCor monitor is in a thin case with two electrodes that snaps onto the back of an iPhone 4 or 5. To obtain an ECG recording, the patient just holds the device while pressing fingers from each hand onto the electrodes. The device can also obtain an ECG from the patient's chest. The AliveCor ECG iPhone app can record rhythm strips of any duration to be stored on the phone and uploaded securely to the cloud for later analysis, sharing, or printing through AliveCor's website. It will operate for about 100 hours on a 3.0V coin cell battery, the company says. (Source: Medscape)

Visceral obesity may increase risk for osteoporosis in men

Visceral or deep belly fat might be a risk factor for bone loss and decreased bone strength in men, according to a study presented here at the Radiological Society of North America 98th Scientific Assembly and Annual Meeting. (Source: Medscape)

    Twitter of the Day

@DrKKAggarwal: Statins and risk of infection Earlier studies had suggested that prior treatment with statins might reduce the... http://fb.me/1Lg8neIqz

@DeepakChopra: Ghosts, spirits, and the paranormal - are they real? Please watch the latest episode of THE RABBIT HOLE http://tinyurl.com/aeej8cx

    Spiritual Update

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

Thinking differently

There are three ways to manage stress. One is to think opposite, second is to think different and the third is to think positive.

Thinking opposite was advocated by Patanjali, thinking differently by Adi Shankaracharya and thinking positive by Gautam Buddha. Out of three approaches, the Indian Vedic philosophy focuses on thinking differently. Thinking positive and thinking opposite may not be feasible at the time of any adversity.

For comments and archives

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What symptoms am I most likely to experience during the menopausal transition?

  • Change in uterine bleeding patterns: Many different types of bleeding patterns can occur. Some women will have irregular periods that are closer together at first and then farther apart, some bleeding on and off. While some will have heavier, irregular bleeding because of a lack of ovulation. Others may have small amounts of bleeding because of a thinner lining of the uterus. Contraception should be used for women not wishing to conceive until at least age 52 or until there are no periods for one year.
  • Hot flashes and vaginal symptoms: These symptoms are usually caused by lower estrogen levels, and may occur in some women before the menopause transition. Vaginal dryness can occur over time and may be particularly noticeable during sexual intercourse.
  • Mood symptoms/sleep disturbances: During the menopause transition, many women will experience depressed mood, decreased sex drive (libido), forgetfulness and difficulty sleeping.
    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)


  • Saline replacement
  • Antibody screen at different temp
  • Reaction with Anti-H lectin
    An Inspirational Story (Dr GM Singh)

What is life?

Life is like an unsolved puzzle. No one can define what life is because it is a very complex thing. Life is something that makes you happy and proud at times and makes you feel so low at times that you say to yourself, "Why was I born?" But whatever it is, it is real fun.

In Life, in every moment, something new happens; something that you never expected, something that you were waiting from a long while to happen and something you were expecting to happen.

It is a combination of happiness, sorrow, joy, love, anger, enjoyment, loneliness, fear, excitement and many other emotions. The definition of the word life cannot be completed without using the word emotions. Some people work in emotions whereas others work with emotions. So it's very important to understand how people are using their emotions. If they are letting emotions get control over them, then they'll be dragged by others and situations all the time.

But, if he is controlling his emotions in a proper way, then no one will ever have control over him. The way a person uses his emotions is what we call attitude. Someone has correctly said, "Your attitude determines your altitude in life". Attitude, as I already defined, is the way an individual uses his emotions and directly related to the psyche of a person.

Some people use their emotions in a positive way and some people do it in a negative sense. When people use emotions in a positive way, we call it positive attitude and when they use it in a negative way, we call it negative attitude.

It's up to an individual to decide how he uses his emotions. Which way will you decide?

Life is like an unsolved puzzle. No one can define what life is because it is a very complex thing.

For comments and archives

    Cardiology eMedinewS

Diabetes remission after gastric bypass: One third relapse Read More

Glucosamine, chondroitin, fish oil may reduce inflammation Read More

    Pediatric eMedinewS

Kids subjected to more imaging studies Read More

Car emissions may hike autism risk Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with acute MI came with a fasting sugar of 120 mg/dL.
Dr Bad: This sugar level is okay.
Dr Good: Get your A1c done.
Lesson: Long-term glucose control is poor in most acute myocardial infarction (AMI) patients with DM, but only a minority of patients undergo glucose therapy intensification at discharge. Inpatient A1c assessment is strongly associated with intensification of glucose-lowering therapy. Diabetes Care 2012 May;35(5):991-3.

Make Sure

Situation: An adult undergoing bronchoscopic biopsy developed infective endocarditis.
Reaction: Oh my God! Why was IE prophylaxis not given?
Lesson: Make sure, that all procedures of the respiratory tract that involve incision or biopsy of the respiratory mucosa include IE prophylaxis.

  Quote of the Day (Dr GM Singh)

Sow a thought, reap an act; sow an act, reap a habit; sow a habit, reap a character; sow a character, reap a destiny.

    Mind Teaser

Read this…………………

Mr. Ong, a client with CHF, has been receiving a cardiac glycoside, a diuretic, and a vasodilator drug. His apical pulse rate is 44 and he is on bed rest. The nurse concludes that his pulse rate is most likely the result of the:

A. Diuretic
B. Vasodilator
C. Bed-rest regimen
D. Cardiac glycoside

Yesterday’s Mind Teaser: The physician orders on a client with CHF a cardiac glycoside, a vasodilator, and furosemide (Lasix). The nurse understands Lasix exerts is effects in the:

A. Distal tubule
B. Collecting duct
C. Glomerulus of the nephron
D. Ascending limb of the loop of Henle

Answer for yesterday’s Mind Teaser: D. Ascending limb of the loop of Henle

Correct answers received from: Dr Arpan Gandhi, Prabha Sanghi, Dr PC Das, Dr BB Aggarwal, Dr (Maj. Gen.) Anil Bairaria, Dr Thakor Hitendrsinh G,
Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Dr kanta jain, Dr Chandresh Jardosh.

Answer for 3rd December Mind Teaser: d. Potential alteration in renal perfusion

Correct answers received from: Dr (Maj. Gen.) Anil Bairaria, Dr Thakor Hitendrsinh G, Dr Jainendra Upadhyay Dr Pankaj Agarwal, Dr kanta jain,
Dr Chandresh Jardosh, Dr KV Sarma, Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Son: Easy
Father: Then why look so unhappy?
Son: The questions didn't give me any trouble, just the answers!

Where was the Magna Carta signed?
At the bottom!

    Medicolegal Update

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

Inevitable medical accident in healthcare delivery

An inevitable medical accident or "unavoidable medical occurrence" in health care delivery is one which could not be possibly prevented by the exercise of ordinary medical/surgical/paramedics and nursing care, caution and skill.

In medical profession, it means any medical/surgical accident that results in damage/injury/disability or death that was not avoidable by any such precautions as a reasonable qualified medical professional or hospital doing such an act then, "could be expected to take." A general/reasonable medical professional is not credited by the law with exact perfection of judgment. As observed by Greene M.R., an accident is “one out of the ordinary course of things, something so unusual as not to be looked for by a person of ordinary prudence.

During the course of treatment, an accident occurs which could not be avoided by any ordinary skill or care on the part of the doctor administering the treatment, the accident is said to be inevitable accident. The term ‘inevitable accident ‘has been defined as an accident not avoidable by any such precautions as a reasonable man can be expected to take’. In the case of (Gerber V.pines 21) the plaintiff claimed damages against the defendant alleging that during the administration of a hypodermic injection the defendant left part of a broken needle in her buttock. The defendant denied liability and said that the breakage of the needle was due to a sudden muscular spasm and that no skill or care on his part could have prevented the fracture of the needle or the retention of the broken part in the plaintiff‘s body. The judge found that there had been no negligence on the part of the defendant in so far as the fracture of the needle was concerned, he found however, that had been a breach of duty on the part of defendant in not informing the plaintiff or her husband that the needle had fractured and that a piece of it was still in her body. For this the judge awarded the plaintiff a small sum by way of damages.

In cases of inevitable medical accident, a very positive/sympathetic/grief sharing approach should be taken by the doctor towards his/her patient and all logistic medical/surgical services must be extended/provided to the patient without cost by the doctor/hospital to restore/enhance faith and trust of this profession since the service which medical professionals render to the people/society and nation is the noblest one. The patient must also be told that inevitable medical accident was due to the elementary forces of nature unconnected with the hospital/doctor and they are there to share with the patient's suffering.

For comments and archives

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Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

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    Public Forum

(Press Release for use by the newspapers)

First cigarette of the day most harmful

Heart patients should avoid smoking and drinking coffee early in the morning during winter, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Both smoking and caffeine can acutely raise the blood pressure by as much as 10 mmHg. The rise in blood pressure can be greater in susceptible individuals. The effect is most prominent with the first cigarette of the day in habitual smokers.

In patients with mild high blood pressure, habit of smoking and drinking coffee, elevation of day time upper systolic blood pressure can be up to 6 mmHg during winters.

Heart patients, therefore, should avoid taking coffee, or tea, with or without a cigarette early in the morning.

It was proved that smoking a cigarette in the first 30 minutes after waking up in the morning increases the risk of getting lung cancer by 79%. According to a recent US study, the morning cigarette considerably increases the risk of getting lung cancer.

The cause of this phenomenon has not been precisely determined, but it seems that if we smoke as soon as we wake up in the morning, the smoke and all its harmful components penetrate the lungs. Still, we must remember the fact that those who feel the need to smoke right after they wake up in the morning are hardcore smokers and they smoke more during the day.

The results of this new study are what the doctors advise, who tell their patients who cannot manage to quit smoking to delay the first cigarette of the day for as much as possible.

    Readers Responses
  1. Dear Sir, Your emedinews is full of educative material. Regards: Dr Trishna
    Forthcoming Events

4th eMedinews Revisiting 2012

(a day long single hall medical conference on 2012 happenings, followed by doctors of the year 2012 awards)

Sunday 20th January 2013, Maulana Azad Medical College Auditorium

Dilli Gate Delhi


Dr KK Aggarwal
Padmashri and Dr B C ROY National Awardee President

Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman

Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

4th eMedinewS Revisiting 2012

The 4th eMedinewS–revisiting 2012 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 20th 2013.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2012. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. All delegates will get Registration Kit, Attractive gifts, Certificates. Morning snacks and lunch will be provided.

Register at: www.emedinews.in/


4th eMedinewS Doctor of the Year Awards

Nominations invited for 4th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2012.

pls send his/her Biodata at: emedinews@gmail.com

    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes 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)

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    Our Contributors

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