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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


Live Web Cast of 3rd eMedinewS – Revisiting 2011, on January 22, 2012

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eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

  Editorial …

3rd January 2012, Tuesday

Most sudden cardiac deaths occur on Monday mornings of
December and January

  1. Maximum sudden cardiac deaths occur in the morning.
  2. Primary arrhythmic event is more likely to occur in the morning because increased adrenergic activity at this time may increase electrical instability or induce myocardial ischemia without heart attack.
  3. Mortality reports of the Massachusetts Department of Public Health, of 2203 individuals who in 1983 died an out–of–hospital death from ischemic heart disease one hour or less after the onset of symptoms, showed peak frequency of sudden death between 9 and 11 AM. (Circulation 1987;75:131.)
  4. Framingham Heart Study: The hourly risk of sudden cardiac death was at least 70% greater between 7 and 9 AM than the average risk during the remaining 22 hours of the day. (Am J Cardiol 1987;60:801).
  5. Data from the Berlin emergency care system found a peak frequency of ventricular fibrillation between 6 AM and noon; in contrast, asystolic episodes were more evenly distributed throughout the day (Circulation 1993;88:2284.).
  6. The morning peak in sudden death is particularly related to the first three hours after awakening and onset of activity (Am J Cardiol 1992;70:65.)
  7. Data from the Seattle Fire Department, based upon 6603 cases of out–of–hospital cardiac arrest, of which 3690 were witnessed, also exhibited a diurnal variation, with a low incidence at night and two peaks of approximately the same size (Circulation 1998; 98:31.). An evening peak at 4 to 7 PM was attributed primary to patients found in ventricular fibrillation, while arrests that showed other rhythms exhibited mainly a morning peak from 8 to 11 AM.
  8. Cardiac arrests also show a weekly and seasonal variation; the daily incidence peaks on Monday and the seasonal incidence is greatest in the winter (Eur Heart J 2000;21:315, Am Heart J 1999;137:512.
  9. One 12 year analysis of 222,265 cases of death from coronary heart disease found that there were approximately 33% more deaths in December and January than in June through September. [Circulation 1999;100:1630).

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Most sudden cardiac deaths occur on Monday
mornings of December and January

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011

Dandia Mania was celebrated as a part of 18th MTNL Perfect Health Mela. Health Message was also given during the event "Save the Girl Child"

Dr K K Aggarwal
    National News

Noise pollution brings down bird count at Okhla sanctuary

NOIDA: Traffic snarls on the Kalindi Kunj road and bridge have led to a rapid decline in the bird population at Okhla Bird Sanctuary. Vehicular noise pollution has increased to such an extent that the winged creatures have abandoned a portion of the sanctuary. Officials say urban noise interferes with birds’ communication through sounds. "The side of the park which is closest to Kalindi Kunj is almost devoid of bird population now," said an official. Construction of the barrage had created a haven for water birds on the river by forming a large lake, but now, ironically, the barrage itself has become a source of noise pollution. The bridge constructed in 1986 was initially designed for traffic of 10,000 vehicles per day. But due to increased vehicular pressure, it now sees massive jams. The Kalindi Kunj road which links Noida with Delhi and Ghaziabad is also a bottleneck. (Source: TOI, Jan 1, 2012)

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

Updated GPA better predicts survival with brain mets

The prognosis for cancer patients with brain metastases varies by the type of initial tumor, but the Graded Prognostic Assessment (GPA) tool –– recently updated based on additional patient data –– can help assess survival, researchers reported. (Source: Medpage Today)

For comments and archives

Don’t rely on IgE test for pediatric allergies

The mere detection of sensitization to an allergen on allergen-specific immunoglobulin E (IgE) tests is not always equivalent to a clinical diagnosis, cautioned a clinical report from the American Academy of Pediatrics (AAP). (Source: Medpage Today)

For comments and archives

Unravelled: How HIV hits body’s defences

WASHINGTON: Scientists in the US claim to have unravelled how HIV hijacks the body’s own defences to promote infection, a finding which may pave the way for curbing the spread of AIDS. A team at University of California, led by Nevan Krogan, has described how HIV commandeers restriction factors – a class of human proteins that evolved to block viruses – to weaken the body’s defences and enhance the virulence of HIV infection, the 'Nature' journal reported. (Source: TOI, Jan 2, 2011)

For comments and archives

   Cardiology eMedinewS

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

Role of EP in Ventricular Tachycardia Management

Read More

ICDs: Management of Patients with Frequent Shocks

Read More

Newer risk factors for CAD

Read More

    Twitter of the Day

@DrKKAggarwal: Padma Shri Awardee Dr KK Aggarwal on Heart Greet your friends with the t… http://www.youtube.com/watch?v=3PlGMZaaqks&feature=share via @youtube

@DeepakChopra: Happy New Year ! May we all live our truth, share our joy, expand our awareness.

    Spiritual Update

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

How to Face Defeat?

In the current Anna campaign every one lost. Anna lost the final campaign, Government lost in providing constitutional status to the bill and BJP lost its commitment of voting in favor of providing it a constitutional status.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What are assisted reproductive technologies?

With unexplained infertility, or when traditional treatments have failed, advanced infertility therapies such as superovulation with timed intrauterine insemination (SO/IUI) or in vitro fertilization (IVF) may be suggested. In an SO/IUI cycle, you receive fertility medications to initiate the growth of multiple eggs in your ovaries. When these eggs are ready to ovulate, your physician places your partner’s sperm directly into your uterus. IVF involves removing your eggs and fertilizing them with your partner’s sperm in the lab, and then transferring the resulting embryos to your uterus.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

"Wait" and you shall have no more opportunity

Today, our house is getting bigger and bigger, but our family, smaller and smaller. Life is easier, but time, less and less. Our education level is higher and higher, but common sense, less and less. Knowledge is getting more and more, but judgement becomes worse and worse. We have more professionals, but there are more and more problems. Medicine has improved greatly, but health is becoming worse and worse.
We expend a lot, but enjoy life very little. We drive cars very fast, but temper bursts out faster.

We sleep very late, read very little, view too much TV and pray very little. Our fortune is doubled, but value reduced. We talk a lot, but love very little and lies abound. We learn how to lead a life, but we care less creating life. We extend our life span, but never increase life in our days. We have taller and taller buildings, but less and less EQ. We have wider high speed motorways, but have narrower viewpoints. We spend a great deal, but own very little. We buy more, but enjoy less.

We travel to the moon and back, but never visit our neighbors. We conquer the outer space, but have no clue as to how to control our prejudice. We can dissect atoms, but are unable to remove our biased thinking.

We write more, but learn little. More schemes, but little success. We learn how to busy ourselves, but never learn how to wait. Our income has risen, but morality, declined. We produce more and more computers, but control information flow. Multiply more and more copies, but our communications with others very lacking.

We produce more, but quality deteriorates. This is the year when fast food is aplenty and digestion failing.

Huge physique with lowly temperament coexisting era. Lots of holidays, but little enjoyment. More food, less nutrition. More family income, more divorce cases. Many more millionaires, but more broken families.

I propose……

In such an era, you do not keep what you want to do till a specific time to do, Because the day you are alive and kicking is the specific occasion you should do. Read more and obtain more knowledge. Sit in your front veranda and enjoy the beauty of nature. Do not have to worry about life’s essential needs.
Spend more time with your friends and families. Enjoy your fond food. Travel to places you like to visit.
Life does not depend on maintaining one’s existence. It consists of many happy occasions chained together.
Bring out your crystal champagne glass. Never keep your best perfume on the shelf. Any time you want to use it, do so. Remove "one day" "some day in the future" from your dictionary.

Go now to write that letter The letter you want to write one day. Let us now tell our family that we love them very much. Do not postpone telling them your happiness and love till one day. Everyday, every hour and every minute is all very special.

For comments and archives

    Fitness Update

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

Too many athletes warming up wrong says Australian sports scientist

Do you know the difference between static stretching and dynamic warm–ups? Did you know that doing the wrong one of those two can decrease subsequent athletic performance while doing the right one can increase it? If your answer is yes then perhaps you are not one of the athletes that James Zois from the School of Sport & Exercise Science at Victoria University in Melbourne, Australia is referring to when he says athletes are warming up wrong. He found that static stretching decreased jumping performance by nearly 8%, while dynamic warm–ups increased athletes’ vertical jump by 3%.

Static stretching includes things like calf, quad and hip flex stretches. Dynamic warm–ups are range of motion activities such as high knee raises, leg swings and run–throughs, or physical tasks that involve change of direction. Zois said too many athletes are overusing static stretches as pre–competition warm–ups, and this can be counterproductive. Overusing them just reduces your performance power. "If you do anything passive, like static stretching, you actually reverse those processes and so are actually doing the opposite of a warm up," Zois explained. He said his research shows there is an almost 11% difference in performance between doing static and dynamic stretching before physical performance, and athletes can’t really afford to ignore this.

For comments and archives

  Legal Question of the Day

(Dr MC Gupta, Advocate & Medico–legal Consultant)

Can an intern use the prefix "Dr." before his name?

Q. Can an intern, who has passed the final MBBS examination but has not completed internship, use the prefix "Dr." before his name?


  1. In a free society, anybody can do anything that is not prohibited by law. India is a free society.
  2. One can argue that since internship has not been completed and the degree has not been conferred by the university, the person is not entitled to use the prefix "Dr." before his name. The flaw in this argument is that the degree concerned has nothing to do with the term "Dr.". It is a bachelor’s degree (rather, twin bachelor degrees) and, obviously, a degree holder cannot prefix "Dr." before his name if the degree is a bachelor’s degree.
  3. One can also argue that one cannot legally treat patients unless he is registered with the medical council. This is the whole rationale of anti–quackery laws.
  4. Registration with a medical council means registration as a physician. Thus an intern is a physician.
  5. A physician, in common parlance and as per convention, is known in society as a doctor. Since the society validly calls him so, he is entitled to call himself so.

    In view of the above, it is clear that an intern, who has passed the final MBBS examination but has not completed internship, is entitled to use the prefix "Dr." before his name.

For comments and archives

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emedinews revisiting 2011
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    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Driving and epilepsy

Guidelines for commercial truck, taxi and bus licenses are stricter than those for private licenses. In most cases, patients with seizures (apart from some childhood seizures) will not be permitted to drive commercial vehicles.

    Medicine Update

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

What are the causes of vitamin A deficiency?

The risk of vitamin A deficiency is increased in patients suffering from fat malabsorption, cystic fibrosis, sprue, pancreatic insufficiency, IBD, or cholestasis, as well as in persons who have undergone small–bowel bypass surgery. The risk is also increased in vegans, refugees, recent immigrants, persons with alcoholism, and toddlers and preschool children living below the poverty line. These patients should be advised to consume vitamin A.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient with Mediclaim of 2 lakhs of seven years duration needed a claim of Rs. 2.2 lakhs.
Dr. Bad: You will have to pay Rs. 20,000 from your pocket.
Dr. Good: You can claim cumulative bonus.
Lesson: Sum insured under the policy shall be progressively increased by 5% for each claim–free year of insured subject to maximum accumulation of 10 claim–free years of insurance.

For comments and archives

Make Sure

Situation: A patient with fever and cough developed complications after he was given antibiotics.
Reaction: Oh my God! What was the need of giving the antibiotics?
Lesson: Make sure that a patient with fever and cough is not given antibiotics as presence of cough mostly signifies viral infection.

For comments and archives

  Quote of the Day

(Dr GM Singh)

Love is the only way to grasp another human being in the innermost core of his personality. Viktor E. Frankl

  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Electrolytes (Sodium, Potassium, Chloride and Carbon dioxide)

To help detect and evaluate the severity of an existing electrolyte imbalance and to monitor the effectiveness of treatment. Electrolytes may be affected by many conditions. In Addison’s disease, the sodium, chloride, and carbon dioxide levels are often low, while the potassium level may be very high.

    Mind Teaser

Read this…………………

Which one of the following is the investigation of choice for evaluation of suspected Perthe’s disease?

1. Plain X–ray
2. Ultrasonography (US)
3. Computed tomography (CT)
4. Magnetic resonance imaging (MRI)

Yesterday’s Mind Teaser: getting
                                       it all

Answer for Yesterday’s Mind Teaser: getting it all under

Correct answers received from: Dr Prabha Sanghi, Dr PC Das, Dr Thakor Hitendrasinh G, Satyanarayana Akupatni, Muthumperumal Thirumalpillai, yogindra vasavada, Dr Chandresh Jardosh,
Dr Neelam Nath.

Answer for 1st January Mind Teaser: The good, the bad, and the ugly
Correct answers received from: Dr Jyotsna Verma, Dr Anupama Sethi Malhotra, Dr Keshav,
Dr Priyanshu, Dr Krishna, yogindra vasavada.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Tie Discipline

A school teacher injured his back and had to wear a plaster cast around the upper part of his body. It fit under his shirt and was not noticeable at all. On the first day of the term, still with the cast under his shirt, he found himself assigned to the toughest students in school.

Walking confidently into the rowdy classroom, he opened the window as wide as possible and then busied himself with desk work. The classroom became a bit unruly and he admonished them. This happened several times.

When he could do work at his desk, the strong breeze from the window made his tie flap annoyingly. He kept rearranging and rearranging the tie as the class raised it's level of unruliness.

Finally, becoming disgusted with the wayward tie, he stood up and took a big stapler off his desk and stapled the tie to his chest in several places.

Discipline was not a problem from that day forth.

  Medicolegal Update

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

Autopsy Artifacts must be ruled out by doctor conducting postmortem examination

When an autopsy is conducted on a body, surgical intervention are made for internal examination which results in damage to blood vessels, skull bone fracture, damage to organs, etc. these are artifacts of post–mortem examination and absolutely unrelated with the natural state of the dead body. These may be grossly mistaken, especially when a re autopsy is done at a different center.

  • Using chisel and hammer to loosen the skull cap may produce additional fractures or may cause extension of an already present ante– mortem fracture. Rough handling of the brain during removal may produce tears of midbrain. If the neck structures are pulled too hard during autopsy they may be torn.
  • Pulling of the dura in the sagittal line will cause the air to enter the blood vessels at the top of the brain. Due to the reflection of the skin, air may enter the veins of the neck. This may lead to erroneous diagnosis of air embolism.
  • In case of a suspected cranial injury, the body should be opened and the cardiovascular system decompressed by opening heart before the head is opened.
  • Large blood vessels may be cut while opening the thoracic and abdominal cavities, and considerable amount of blood escapes to the pleural and peritoneal cavities.
  • Air may be drawn back into the circulation and enter coronary vessels and give false impression of air embolism.
  • During autopsy, the handling of organs and incision of vessels may result in extravasations of blood into the tissues.
  • In older persons, the hyoid bones and thyroid cartilage may be fractured while removing the neck organs. Surrounding the fracture regions, hemorrhages are not visible.
  • Osseous union between the segments of hyoid may be unilateral. Such unilateral mobility or artifact by dissection may lead to erroneous impression of antemortem fracture.
  • While dissecting the neck structures, if toothed dissecting forceps are used, it may damage the intima of the carotid artery which resembles a tear, as seen in case of strangulation.
  • The toxicological artifacts may be introduced due to the contamination of viscera with stomach contents due to autopsy, or by putting all the organs in one container or by using faulty techniques in collecting or storage of samples.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

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

Winter blood pressure 5 mm Hg higher than summer blood pressure

The systolic (top number) and diastolic (bottom number) blood pressures rise and fall with the change of seasons, said Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India.

In a study by the Institute National de la Sante et de la Recherche Medicale of Paris and published in the Archives of Internal Medicine, of 8801 people aged 65 or older, average systolic blood pressure, is five points higher in winter than in summer.

Instances of high blood pressure (systolic blood pressure higher than 159, or diastolic higher than 94 millimeters of mercury or higher) in the study were found in 33.4 percent of participants during winter but just 23.8 percent during summer.

The reason could be related to the baroreflex, a mechanism of blood pressure regulation that is modified in elderly subjects or a function of the sympathetic nervous system, which helps control involuntary actions such as stress response. 5 mm change in blood pressure can explain why there are more deaths of heart patients in winter.

For comments and archives

    Readers Response
  1. Congrats for such a useful wonderful work and thanks for mailing it to me. Thanks. Rajendra Chhabra
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. All delegates to get registration kit, Attractive gifts, Conference Newsletter, certificates, Morning Snacks, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in/ rekhapapola@gmail.com/drpawangupta2006@yahoo.com

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews "Doctor of the Year Award" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you know of any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.com

3rd eMedinewS Revisiting 2011

Dr K K Aggarwal – Revisiting the Year 2011, M K Doogar – Health Insurance, What’s New, Central Bank of India – Financial Health Update, LIC – Schemes, Dr N K Bhatia – What ís New in Transfusion Medicine, Dr Praveen Chandra – Antiplatelets in Cardiology, Dr Ambrish Mithal – Obesity as a Precursor for Diabetes, Dr Ajay Kriplani – Surgery in Diabetes, Dr Kaberi Banerjee – Infertility Update, Dr Kailash Singla – Gastro Update, Dr Surjit Jha – Diabetes Update, Dr Sheh Rawat – What’s New in Radiation Oncology, Dr Amit Bhargava – Cancer Update, Dr Sanjay Chaudhary – Automation in Cataract Surgery with Femto–second laser, Dr Neelam Mohan – Liver Transplant Update, Dr Vikram Sanghi – Imaging Update, Dr Surender Kumar – Diabetes in 2012, Dr S K Khanna – Cardiac Surgery in 2012

For Complete Details Click


The Annual conference of Indian Menopause Society is to be held from 17 to 19th Feb 2012 in Hotel The Claridges, Surajkund Faridabad. It is multidisciplinary approach to the problems of midlife onwards in women. This conference has participation of British Menopause Society and South Asian Federation Of Menopause Societies and opportunity to hear from international faculties.

For information Contact Dr. Maninder Ahuja (Organizing Chairperson) 9810881048 down load forms from web sit http://indianwoman35plus.com/ or Indianmenopausesociety.org or http://fogsi.org/

Contact at ahuja.maninder@gmail.com
Call for free papers and posters on theme topics of conference.

Early Registration till 30th Dec 2011

    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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  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

    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