eMedinewS 9th August 2013, Friday

Dr K K 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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; 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

One year rural posting repercussions

  • One lac doctors are waiting for PG to be done.
  • Only 12000 clinical PG seats.
  • If rural posting is made compulsory how will government find one lac jobs?
  • Only 2500 vacancies at present in the government jobs.
  • Won’t it start a capitation fee for getting a job?
  • Alternative: make rural posting optional and give 5 marks for rural posting in the merit.
  • Make rural posting a part of PG program. 
  • Open rural medical colleges.
  • Run DNB programs only in rural areas.
  • Start one year post graduate diploma in family medicine and make it open to people who did not get the PG.
  • Shift MD family Medicine and DNB Family Medicine to rural centers.
  • Post all doctors who want to go outside India to serve rural areas for one year compulsorily
  • Post all foreign graduates who wants to reenter India to serve first one year in rural area before they are permanently registered with MCI

Pioglitazone back

As expected, the Indian government has revoked its suspension of the type 2 diabetes drug pioglitazone. However, it has stipulated that the agent should not be used as first-line treatment for diabetes and that it should carry a boxed warning relating to bladder cancer.

The decision to suspend the manufacture, sale, and distribution of pioglitazone in India, citing concerns over adverse effects, particularly bladder cancer, came out of the blue in June and was widely criticized by doctors and others there. In mid–July, however, a meeting of the drug technical advisory board (DTAB) recommended that pioglitazone be put back on the market.

Now, the Ministry of Health and Family Welfare has announced that all formulations containing pioglitazone for human use are allowed to be manufactured, sold, and distributed once again, albeit with warnings on the package insert.

The new warnings, which must be listed on pioglitazone formulations in India, will state that patients with active bladder cancer or with a history of bladder cancer and those with uninvestigated hematuria should not receive pioglitazone.

And before starting the drug, individuals should be assessed for known risk factors for bladder cancer, including age, smoking history, exposure to occupational or chemotherapy agents, or previous irradiation of the pelvic region.

Prescribers should also review the use of the agent after 3 to 6 months to ensure that only patients who are deriving benefit from it continue to be treated.

Pioglitazone should be stopped in patients who do not respond adequately to treatment.

There is also special advice for the use of pioglitazone in elderly patients, which "should be considered carefully before and during treatment because the risk of bladder cancer increases with age." Elderly patients should start on the lowest possible dose "and be regularly monitored because of the risks of bladder cancer and heart failure associated with pioglitazone." (Medscape) …Read More

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 10x10 i.e. 100 per minute."

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

Ringtone – CPR 10 Mantra English

sprritual blog Why do Hindu and Muslims fight with each other?

I find no reason why Hindu and Muslims fight with each other while Hindus worship ‘Ali’ in Diwali and Muslims worship ‘Rama’ in Ramadan.

It is time for Sevian Eid (Eid Ul Fittar) which marks the end of Ramadan, the Islamic holy month of fasting.

‘Eid’ is an Arabic word which means festivity and ‘Fittar’ means the fast. Ramadan is 30 days of dawn to sunset fasting.

30 days of Ramadan in Islam, 9 days of Navratras in Hindu and 40 days of Easter in Christianity are spiritual days observed by respective religions.

These are the days which are observed for mind, body and soul detoxification.

Broadly, they involve restraining 10 senses during the fast period. One also restrains from negative thought or action and indulges in positive thoughts and action.

Prophet Mohammad said that if you fast in the month of Ramadan, its reward shall overcome all the past sins.

Sins can be equated to hidden guilt and by spiritual detoxification one acquires positive thoughts and removes the guilt.

It is the power of fast that all ten senses in the body takes one near one’s consciousness or God. Being in touch with consciousness or God is like reformatting one’s computer which removes all the temporary files can bad sectors (sins).

One should learn lessons from the way Muslims observe Ramadan. If you abuse a Muslim during Ramadan, he will never revert back to you with an abuse but will say that he will talk to you after the Ramadan is over. ….Read More

cardiology news

The Two Hospital Patients

Two men, both seriously ill, occupied the same hospital room. One man was allowed to sit up in his bed for an hour each afternoon to help drain the fluid from his lungs. His bed was next to the room's only window. The other man had to spend all his time flat on his back. The men talked for hours on end. They spoke of their wives and families, their homes, their jobs, their involvement in the military service, where they had been on holiday.

And every afternoon when the man in the bed by the window could sit up, he would pass the time by describing to his roommate all the things he could see outside the window. The man in the other bed began to live for those one–hour periods where his world would be broadened and enlivened by all the activity and color of the world outside.

The window overlooked a park with a lovely lake. Ducks and swans played on the water while children sailed their model boats. Young lovers walked arm in arm amidst flowers of every color of the rainbow. Grand old trees graced the landscape and a fine view of the city skyline could be seen in the distance.

As the man by the window described all this in exquisite detail, the man on the other side of the room would close his eyes and imagine the picturesque scene.

One warm afternoon the man by the window described a parade passing by. Although the other man couldn’t hear the band – he could see it in his mind’s eye as the gentleman by the window portrayed it with descriptive words. Days and weeks passed.

One morning, the day nurse arrived to bring water for their baths only to find the lifeless body of the man by the window, who had died peacefully in his sleep. She was saddened and called the hospital attendants to take the body away. As soon as it seemed appropriate, the other man asked if he could be moved next to the window. The nurse was happy to make the switch and, after making sure he was comfortable, she left him alone. Slowly, painfully, he propped himself up on one elbow to take his first look at the world outside. Finally, he would have the joy of seeing it for himself. He strained to slowly turn to look out the window beside the bed.

It faced a blank wall. The man asked the nurse what could have compelled his deceased roommate who had described such wonderful things outside this window. The nurse responded that the man was blind and could not even see the wall. She said, "Perhaps he just wanted to encourage you." ….Read More

News Around The Globe

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  • Probiotics failed to protect elderly patients against diarrhea related to antibiotics and Clostridium difficile infections. In a multicenter trial with more than 2,000 inpatients ages 65 and up, antibiotic–associated diarrhea (AAD) and C. difficile–associated diarrhea (CDD) sickened 10.8% of those who took probiotics compared with 10.4% of those in the placebo group (relative risk 1.04, 95% CI 0.84–1.28), reported Stephen J Allen, MD, of the Swansea University College of Medicine in Wales, and colleagues.
  • Treatment of HIV may be based on viral load (VL) or CD4 count. A new randomized controlled trial demonstrates that both approaches are equivalent when it comes to 3-year rates of clinical failure and loss of treatment options. These results are reassuring for treatment programs that cannot afford VL measurement. (Source: Medscape)
  • An advisory committee to the US Food and Drug Administration (FDA) voted 9 to 6 not to recommend tolvaptan (Otsuka Pharmaceutical Company, Ltd) for the indication of slowing kidney disease in adults at risk for rapidly progressing autosomal dominant polycystic kidney disease (ADPKD). (Source: Medscape)
  • As per a study, published online in the Annals of Neurology, the immunosuppressant/anticancer agent everolimus was associated with a dramatic reduction in seizures in patients with tuberous sclerosis complex in whom treatment with many other antiepileptic drugs had failed. (Source: Medscape)
  • According to a new study, neurologic worsening during transport to the hospital is associated with poorer outcome of head injury. The findings suggest that early pre–hospital neurological deterioration independently predicts higher in–hospital mortality and resource use by these patients. (Source: Medscape)
  • IMA had filed a Writ petition in the Delhi High Court challenging the Letter/ Notification issued by the Joint Secretary, MoHFW, Govt. of India, whereby the said letter/ notification asked the State Government to amend law in order to give enrolment/ registration to doctors practicing Indian System of Medicine (ISM) in the State Medical Register. However, the Hon’ble Court was of the opinion that the matter is pre-mature as on date the State has not acted on the said letter and merely on assumption that States would act on said notification/ letter gives no cause of action to IMA. The Hon’ble Court was also of the opinion that IMA may have a very good case when the law is amended by a State Legislature in terms of the impugned letter. Further, the Hon’ble Court stated that it is the States’ prerogative to act or not on any letter/ notification, and till date, the fact of the matter is that the State have not acted. Therefore, the Hon’ble Court asked IMA to withdraw the above writ and challenge the law if and when amended by any of the States, in accordance with law. Accordingly, IMA had withdrawn the writ petition. IMA has asked all State and Local Branches of IMA to kindly keep a strict vigil on any such move in your State / area by your State Government/State Medical Council in accordance with the above Notification of the MoHFW and take necessary steps to prevent its implementation.
  • Preschoolers who consumed sugary drinks were more likely to gain excess weight and run the risk of being obese compared with non-drinkers. Among 4- and 5-year-olds, a higher rate of sugar-sweetened beverage consumption was associated with higher body mass index (BMI, P<0.05 and P<0.001, respectively) while a higher odds ratio for obesity was seen at age 5 (1.43, 95% CI 1.10-1.85, P<0.01) , according to Mark DeBoer, MD, of the University of Virginia's Department of Pediatrics in Charlottesville.

Rabies News (Dr. A K Gupta)

When should RIG be administered? What should be the time gap between RIG and vaccination?

Rabies immunoglobulins (RIG) are more effective if infiltrated immediately or within 24 hours of animal bite along with first dose of vaccine. If vaccine alone was started, then RIG can be given up to 7 days after starting first dose of vaccine. Ideally, rabies vaccine should precede RIG. However, in exceptional situations, approximately within 1 hour after administering RIG, the vaccine must be given.

cardiology news
  • A study from the UK published in the American Journal of Preventive Medicine states that active modes of traveling to work, such as walking or biking, were associated with a lower likelihood of obesity and diabetes. Compared with using driving a car or taking a taxi, walking to work was associated with a 20% reduced risk of being obese and a 40% reduced risk of diabetes, according to Anthony Laverty, MSc, of the Imperial College London, and colleagues. Those who cycled to work had a 37% lower risk of obesity and a 50% lower risk of diabetes. Only walking to work was associated with a decreased risk of hypertension compared with driving. (Source: Medpage Today)
  • Higher glucose levels had a significant association with an increased risk of dementia in older, nondiabetic individuals. In a study reported in the New England Journal of Medicine, nondiabetic patients who developed dementia had a mean blood glucose level of 115 mg/dL in the preceding 5 years compared with 100 mg/dL in similar patients who did not have dementia. The higher levels were associated with almost a 20% increase in the hazard for dementia. Adding to the established association between diabetes and dementia, diabetic patients who subsequently developed dementia also had significantly higher average glucose levels as compared with diabetic patients who did not develop dementia. (Source: Medpage Today)

Valvular Heart Disease News

Mitral stenosis remains a valvular disease of predominantly young people, and rheumatic fever remains the leading cause of mitral stenosis in all age groups.

(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)

cardiology news

A newly–discovered type of bacteria was identified as a possible perpetrator in colitis that develops after cord–blood stem cell transplantation. Matthew Meyerson, MD, PhD, of the Dana–Farber Cancer Institute in Boston, and colleagues found that genetic sequencing of colon biopsies from patients with cord colitis syndrome turned up a novel genome most closely related to that of a symbiotic, nitrogen–fixing bacteria used extensively in commercial agriculture. The new bacterium –– provisionally named Bradyrhizobium enterica –– was confirmed as present in all three additional cord colitis cases at a single center, but in no healthy controls or patients with colon cancer or graft–versus– host disease. (Source: Medpage Today)

cardiology news

Sugar should be regulated like alcohol, tobacco

Like alcohol and tobacco, sugar is a toxic, addictive substance that should be highly regulated with taxes, laws on where and to whom it can be advertised, and even age–restricted sales, says a team of UCSF scientists in Nature.

For both alcohol and tobacco, there is robust evidence that gentle ‘supply side’ control strategies which stop far short of all–out prohibition – taxation, distribution controls, age limits – lower both consumption of the product and the accompanying health harms. The experts have proposed adding taxes to processed foods that contain any form of added sugars.

Over the past 50 years, sugar consumption has tripled worldwide. That’s also helped contribute to the obesity epidemic – so much so that there are 30 percent more obese people in this world than there are malnourished people.

Sugar is ‘toxic,’ particularly in excessive amounts, noting that it poses dangers similar to those of alcohol. Fructose, specifically, can harm the liver and overconsumption has been linked with all the diseases involved with metabolic syndrome: hypertension, high triglycerides, insulin resistance, and diabetes. (Source AMA News) …Read More

cardiology news

Childhood television viewing is associated with increased risk of subsequent violence by demonstrating a temporal relationship; consistency, strength, and specificity of the association; and a coherent explanation for the association.

cardiology news

8th August: DMA Dharna against one year mendatory Rural Posting at Jantar Mantar


CPR 10 Camp – E Book Balwant Rai Mehta School, G K – 2, New Delhi

Total CPR since 1st November 2012 – 59389 trained

CPR Classes: Persons trained (3193)

5th August: CPR 10 at Universal Public School (1078)

6th August: CPR 10 at Moolchand (30)

7th August: CPR 10 at Moolchand (27)

CPR VIP Sensitization

CPR Classes 59389

Video Chats and uploads

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News JULY

Media advocacy through Print Media

2nd August: Hari Bhumi

3rd August: Vir Arjun

4th August: Amarujala

4th August: Dainik Jagran

4th August: Deshbandhu

4th August: Hindustan

4th August: Hindustan Times

4th August: Loksatya

4th August: Rashtriya Sahara

4th August: Rastriya Sahara

4th August: Shah Times

4th August: Veer Arjun

4th August: Virat Vaibhav

6th August: Saha Times

6th August: Veer Arjun

7th August: Loksatya

7th August: Just Zindagi–Sunday Navbharat Times

8th August: Amar Ujala

8th August: Punjaab Kesri

Media advocacy through Web Media

Low BP may be normal 7th August


Eating refined sugar can cause diabetes 6th August


Diabetic drug metformin may have anti cancer effects

As per a study published in Journal of Clinical Oncology, diabetic men with prostate cancer live significantly longer and are significantly less likely to die of prostate cancer when treated with metformin, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Six months of cumulative metformin treatment is associated with a 24% reduction in the hazard of prostate cancer mortality. The mortality benefits are unaffected by type of cancer therapy.

Metformin, therefore, should be considered as first line therapy among patients with prostate cancer and diabetes.

Metformin may also be ideal for secondary prevention because it is inexpensive, safe and well–tolerated.

One of the mechanisms may be that metformin reduces insulin resistance and insulin resistance may be linked to cancer progression.

Also there is some evidence that metformin has anti-cancer properties. More studies are required to find its role in other cancers.

A similar research is also on for its role in breast cancer.

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 59389 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."

today emedipics

Delhi Medical Association Dharna against one year mandatory Rural Posting at Jantar Mantar on 8th August 2013

press release

Sugar should be regulated like alcohol, tobacco

today video of the dayDr KK Aggarwal on Doctors Day SAHARA SAMAY News

Dr KK Aggarwal on How to Stay Fit

Smart Phones Benefits and Hazards

eMedi Quiz

Read this…………………

A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), Dr. Smith orders diagnostic tests of the vaginal discharge. Which STD must be reported to the public health department?

a. Chlamydia
b. Gonorrhea
c. Genital herpes
d. Human papillomavirus infection

Yesterday’s Mind Teaser: For a male client in the oliguric phase of acute renal failure (ARF), which nursing intervention is most important?

a. Encouraging coughing and deep breathing
b. Promoting carbohydrate intake
c. Limiting fluid intake
d. Providing pain–relief measures

Answer for yesterday’s Mind Teaser: c. Limiting fluid intake

Correct answers received from: Dr. V.P. Thakral, Tukaram Pagad, jammulab, kumarPrafull Chandra, DR ARPAN GANDHI, Dr. P. C. Das, Dr.(Maj. Gen.) Anil Bairaria, Dr Kanta jain, daivadheenam, Dr Chandresh Jardosh, Dr Pankaj Agarwal, DR.PROSUN GOSWAMI

Answer for 7th August Mind Teaser: a. Water and sodium retention secondary to a severe decrease in the glomerular filtration rate.

Correct answers received from: Dr Chandresh Jardosh, Dr Pankaj Agarwal DR.PROSUN GOSWAMI

Send your answer to ijcp12@gmail.com

eMedi Apps

medicolegal update

Click on the image to enlarge

medicolegal update

When the robbers got back, the younger robber (MBA trained) told the older robber (who is only primary school educated), "Big bro, let’s count how much we got", the older robber rebutted and said, "You very stupid, so much money, how to count?? Tonight TV will tell us how much we robbed from the bank!"

This is called "Experience ––> nowadays experience is more important than paper qualifications!"

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with rheumatoid arthritis developed deformity.
Reaction: Oh my God! Why was treatment not started early?
Lesson: Make sure all patients with rheumatoid arthritis are started with specific treatments within 3 months of diagnosis.

medicolegal update

Men for the sake of getting a living forget to live. Margaret Fuller

medicolegal update

Dr KK Aggarwal: Low BP may be normal By Dr K K Aggarwal http://bit.ly/16wknsh #Health

Dr Deepak Chopra: Non–judgment quiets the internal dialogue, and this opens once again the doorway to creativity.

medicolegal update

Dear Sir, Very Gud Work. Regards: Dr Shipra

Forthcoming Events

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medicolegal update

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