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 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

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  Editorial …

8th January 2012, Sunday

Sometimes a needle or screw will break leaving a fragment behind. Is this a reviewable sentinel event?

As per JCI, in some cases, a broken needle or screw fragment is recognized at the time of surgery and a clinical judgment is made to leave the fragment in the patient. That decision is based on an assessment of the relative risks of leaving it in versus removing it.

It would therefore not be considered an unintentionally retained foreign object. Intentional retained foreign object is not a negligence.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Sometimes a needle or screw will break leaving
a fragment behind. Is this a reviewable sentinel

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela
Medico Masti–An Inter College Health Festival at Perfect Health Mela

Infotainment is a new concept of creating health education where education is inter linked with entertainment.

Dr K K Aggarwal
    National News

New, deadlier form of TB hits India

MUMBAI:Tuberculosis, which kills around 1,000 people a day in India, has acquired a deadlier edge. A new entity–ominously called Totally Drug–Resistant TB (TDR–TB)–has been isolated in the fluid samples of 12 TB patients in the past three months alone at Hinduja Hospital at Mahim. The hospital’s laboratory has been certified by the World Health Organization (WHO) to test TB patients for drug resistance. While Iran first reported TDRTB cases three years ago, India seems to be only the second country to report this deadly form of the disease. TDR–TB is the result of the latest mutation of the bacilli after Multi–Drug–Resistant TB (MDR–TB) and Extremely Drug–Resistant TB (XDR–TB) were diagnosed earlier. Even more worryingly for Mumbai, 10 of the 12 TDR–TB cases are from the city, while the other two are patients from Ratnagiri and UP. One of the 12 patients has since died. India sees around 3–4 lakh deaths for all forms of TB each year, while the world saw 1.7 million deaths in 2009. As the full form of TDR–TB suggests, none of the known TB combination drugs work on the patient. All 12 showed resistance to 12 drugs. "The TB bacilli have obviously mutated. The emergence of TDR–TB has grave implications for public health," said Hinduja Hospital’s Dr Zarir Udwadia, whose observations have been published in the latest issue of the US-based Clinical Infectious Diseases (CID) peer review journal. His team started isolating TDR–TB cases among patients with pulmonary TB in October 2011. (Source: TOI, Jan 7, 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

Guideline urges care in mixing HIV, seizure drugs

Although the evidence is weak, doctors should be aware that combining anti–HIV and anti–epileptic medications may lead to drug–on–drug interactions, according to a new guideline. (Source: Medpage Today)

For comments and archives

Cognitive decline begins in mid–life

The cognitive decline associated with aging begins earlier than has been appreciated, with changes already evident in the fifth decade of life, a prospective study showed. (Source: Medpage Today)

For comments and archives

Now, writing exercise shrinks waistline

Writing down something most important to you for just 15–minutes may help shed your extra kilos in few months, if a new study is to be believed. The new study has found that women who wrote about their most important values, like close relationships, music, or religion, lost more weight over the next few months than women who did not have that experience. "We have this need to feel self–integrity," said Christine Logel of Renison University College at the University of Waterloo, who co–author the new study with Geoffrey L. Cohen of Stanford University. When something threatens your sense that you're a good person, like failing a test or having a fight with a friend, "We can buffer that self–integrity by reminding ourselves how much we love our children, for example," she explained. (Source: TOI, Jan 5, 2012)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Watch Padma Shri Awardee Dr KK Aggarwal on Smoking in pregnancy can harm the t… http://www.youtube.com/watch?v=NlImBDKx_A4&feature=share via @youtube

@DeepakChopra: Resist the temptation to amplify destructive gossip, rumors, and paranoid theories. Make positive, detailed contributions.

    Spiritual Update

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

Understanding the Mental States of a Person

The mental state of a person in Vedic language is described in terms of gunas. The present state of mind of any person is a result of mixing of three gunas of nature called Tamoguna, Rajoguna and Satoguna. In terms of states of mind they are called Tamas, Rajas and Satva and the nature of a person is called Tamsic, Rajsic and Satvic.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What does an embryo do in order to implant into the uterus for real pregnancy?

In a normal cycle, the egg and sperm join together in the tube that connects the ovaries to the uterus (the fallopian tube) to form an embryo. The embryo travels through the tube and sticks (implants) to the lining of the uterus (womb). But, in order for the embryo to implant into the uterus, it has to "hatch" out of its outer shell (zona pellucida).

For comments and archives

    An Inspirational Story

(Dr GM Singh)

Truths to Live By

Maybe God wants us to meet a few wrong people before meeting the right one so that when we finally meet the right person, we will know how to be grateful for that gift. When the door of happiness closes, another opens, but often times we look so long at the closed door that we don’t see the one which has been opened for us.

The best kind of friend is the kind you can sit on a porch and swing with, never say a word, and then walk away feeling like it was the best conversation you’ve ever had. It’s true that we don’t know what we’ve got until we lose it, but it’s also true that we don’t know what we've been missing until it arrives.

Giving someone all your love is never an assurance that they’ll love you back! Don’t expect love in return; just wait for it to grow in their heart but if it doesn’t, be content it grew in yours. It takes only a minute to get a crush on someone, an hour to like someone, and a day to love someone, but it takes a lifetime to forget someone.

Don’t go for looks; they can deceive. Don’t go for wealth; even that fades away. Go for someone who makes you smile because it takes only a smile to make a dark day seem bright. Find the one that makes your heart smile.

There are moments in life when you miss someone so much that you just want to pick them from your dreams and hug them for real! Dream what you want to dream; go where you want to go; be what you want to be, because you have only one life and one chance to do all the things you want to do.

May you have enough happiness to make you sweet, enough trials to make you strong, enough sorrow to keep you human, enough hope to make you happy. Always put yourself in others’ shoes. If you feel that it hurts you, it probably hurts the other person, too.

The happiest of people don’t necessarily have the best of everything; they just make the most of everything that comes along their way. Happiness lies for those who cry those who hurt, those who have searched, and those who have tried, for only they can appreciate the importance of people who have touched their lives.

Love begins with a smile, grows with a kiss and ends with a tear. The brightest future will always be based on a forgotten past. You can’t go on well in life until you let go of your past failures and heartaches. When you were born, you were crying and everyone around you was smiling. Live your life so that when you die, you're the one who is smiling and everyone around you is crying.

For comments and archives

    Cardiology eMedinewS

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

High risk severe MR do better with MitraClip

Read More

Rivaroxaban filed for ACS in US and EU

Read More

How to reduce stress

Read More

Should a Cardiologist Hire An Advocate While Defending His Case In The Court Or In The Council Enquiry?

Read More

    Pediatric eMedinewS

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

Egg Allergy

Read More

Colored Lenses or Overlays for Reading Difficulty

Read More

    Fitness Update

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

Heart failure patients benefit from warming up before exercise

Many chronic heart failure patients complain of discomfort and pain during exercise, which prevents them from being active, even from walking. The condition causes breathlessness and fatigue that severely limits normal daily activities and mild exercise. Now, a major study conducted at the University of Leeds in London, England is the first study to show that chronic heart failure can seriously impair the leg muscles. The study offers insight on how muscles strength can be regained.

The researchers, who published their work in a recent issue of the Journal of Applied Physiology, measured responses of the heart, lungs and leg muscles following a warm–up and a moderate exercise session in chronic heart failure patients. When they used laser technology to measure the oxygenation of the leg muscles, they demonstrated that heart failure had a negative impact on the normal functioning of the leg muscles, particularly in patients with severe symptoms. However, they also found that the mild warm–up exercises increased the activity of skeletal muscle. The study concludes that warming up properly can alleviate much of the discomfort experienced during exercise, and researchers encourage this population to participate in mild exercise – with approval from their doctor.

For comments and archives

    Legal Question of the Day

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

Q. I am a resident doctor in forensic medicine. I want to know:
1. What is the real future of FMT in India?
2. As per MCI website, only one assistant professor per 100/150 admissions is needed in a medical college. Does it not suggest that there will not be many jobs?
3. What are the job opportunities abroad?
4. What guidance you would like to give me?


  • While you are a resident, work hard, perform as many autopsies and MLRs as possible and publish research papers.
  • Try to get an LLB degree or, at least, a degree in academic law.
  • Stop worrying about future openings. They will open up aplenty for deserving candidates.
  • Have a pro–active outlook and organise demands on the lines suggested above.
  1. FMT should have a bright future. As a matter of fact, future is always bright for those who work hard. The future of FMT as a specialty depends upon the FMT Association(s). They should demand the following from the government, followed by a PIL if necessary:
    • That all autopsies in India should be performed by FMT specialists for proper investigation of crime.
    • That each police station in the country should, through a suitable mechanism, have available to it the expertise of an FMT specialist for investigation of crime.
    • That each district in the country should have the post of a District FMT specialist.
    • That each hospital having more than 100 beds, whether in the private or public sector, should have the post of an FMT specialist. The logic is as follows:
      • In terms of the Clinical Establishment Act, 2010, a clinical establishment is legally bound to provide emergency treatment to all patients coming to the hospital in a condition of emergency and to keep them in the hospital till their condition is stabilised.
      • In terms of the Supreme Court’s Parmanand Katara judgment, patients needing an MLC should not be shuttled from one hospital to another on the ground that they are MLC/police cases.
      • Even otherwise, the preparation of an MLC report should be viewed as a part of treatment of a patient. Just as various documents are prepared for a hospital patient, an MLC report should be deemed as one more necessary document in appropriate cases.
      • Smaller hospitals and nursing homes should be linked to a nearby larger hospital for the purpose of preparing an MLC report.
    • The MCI should make it mandatory that before recognition is granted, each medical college should ensure:
  2. If the above proposed steps are taken (they will have to be ordered by the government/HC/SC because I cannot see any logical/legal objection to them), the dependence on faculty jobs as the only available avenues for FMT specialists would cease the number of jobs/vacancies in FMT will shoot up markedly. I am surprised why such a demand is not being made (or pursued to its logical conclusion in the courts) by FMT associations themselves. The above are genuine demands and I don’t know why these are not being pursued by the leaders in the discipline. If you are concerned about the future of the specialty, it is encouraging. You and other like–minded young doctors should work actively in this direction.
  3. I think there are enough job opportunities abroad for FMT specialists. Such opportunities will be more easily available if the FMT specialist also has a good understanding of general principles of law and preferably, in addition, the law of the foreign country.
  4. The guidance I would like to give you is as follows (NOTE—I am not a forensic medicine specialist):

For comments and archives

    Healthy Driving

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

Men with five or more apneas (stopped breathing) and hypopneas (less breathing) per hour of sleep are 3–4 times more likely to have automobile accidents.

    Medicine Update

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

Gastroesophageal Reflux Disease in Children

Warning signals or the ‘red flag’ signs that require investigation for GERD in infants are:

  • Regurgitation or vomiting
  • Bilious vomiting
  • Consistently forceful vomiting
  • Gastrointestinal bleeding (Hematemesis, hematochezia)
  • Onset of vomiting after 6 months of life
  • Failure to thrive
  • Diarrhea
  • Constipation
  • Fever
  • Lethargy
  • Hepatosplenomegaly
  • Bulging fontanelle
  • Macro/microcephaly
  • Seizures
  • Abdominal tenderness or distension
  • Documented or suspected genetic/metabolic syndrome
  • Cough and anorexia or feeding refusal are common in 1 to 5 years of age than in older children.

For comments and archives

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emedinews revisiting 2011
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    IJCP Special

Dr Good Dr Bad

Situation: A patient came with very high triglycerides.
Dr Bad: Restrict fat.
Dr Good: Restrict carbohydrates.
Lesson: High triglycerides are due to excess of refined carbohydrates in diet.

For comments and archives

Make Sure

Situation: A patient with prosthetic heart valves (bioprosthetic) developed infective endocarditis.
Reaction: Oh my God! Why was he not given infective endocarditis prophylaxis?
Lesson: Make sure that all patients with prosthetic heart valves (bioprosthetic or homograft) are given infective endocarditis prophylaxis.

For comments and archives

    Quote of the Day

(Dr GM Singh)

Dream is not what you see in sleep, dream is which does not let you sleep. APJ Abdul Kalam

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Celiac Disease tests

The best initial laboratory test for diagnosis of celiac disease is anti–tissue transglutaminase antibody (anti–tTG), IgA. If this test is positive, it is likely that the patient has celiac disease. If the anti–tTG is negative but the physician still suspects celiac disease, an intestinal biopsy may be done to determine whether there is damage to the intestinal villi.

Other tests to evaluate the severity of the disease and the extent of a patient’s malnutrition, malabsorption, and organ involvement include: CBC (complete blood count) to look for anemia, ESR (erythrocyte sedimentation rate) to evaluate inflammation, CRP (C–Reactive protein) to evaluate inflammation and Vitamin D, E, and B12 to measure vitamin deficiencies.

    Mind Teaser

Read this…………………


Yesterday’s Mind Teaser: Nevirapine causes fatal hepatic necrosis when given to pregnant women with:

a. CD4+cell count >100/mm3
b. CD4+ cell count <250/mm3
c. CD4+cell count >250/mm3
d. CD4+cell count >400/mm3

Answer for Yesterday’s Mind Teaser: c. CD4+cell count >250/mm3

Correct answers received from: Dr KV Sarma, Yogindra Vasavada, Dr Ragavan Sivaramakrishnan Moudgalya, Dr Chander, Raju Kuppusamy, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Valluri Ramarao, Dr Jainendra Upadhyay, Anil Bairaria, Dr Neelam Nath, Dr Valluri Ramarao.

Answer for 6th January Mind Teaser: Neural tube defects
Correct answers received from: Anil Bairaria, Dr Neelam Nath, Dr Valluri Ramarao.

Send your answer to ijcp12@gmail.com

   Laugh a While

(Dr GM Singh)


  1. All men are extremely busy.
  2. Although they are so busy, they still have time for women.
  3. Although they have time for women, they don’t really care for them.
  4. Although they don’t really care for them, they always have one around.
  5. Although they always have one around them, they always try their luck with others.
  6. Although they try their luck with others, they get really pissed off if the women leaves them.
  7. Although the women leaves them they still don't learn from their mistakes and still try their luck with others.
    Medicolegal Update

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

What are the viscera samples taken for chemical analysis by autopsy doctor?

The majority of poisons are taken orally and the poison, due to water content/liquids, is likely to be present in the stomach and intestinal contents and their walls. After absorption all poison pass through the liver which is the major detoxifying organ in the body and has the power of concentrating many poisons and making them identifiable when the blood and urine concentrations may have declined to very low levels. The kidney being the organ of excretion contains large amounts of poison, which is excreted into the urine. The following viscera are preserved in case of any suspected or evident case of death due to poisoning.

  • Stomach and its contents. If the stomach is empty the wall should be preserved.
  • The upper part of small intestine about 30cm long with its contents.
  • Liver (about 500 gms)
  • One kidney or half of each kidney.
  • Brain in case of alcohol death
  • Blood 100ml/minimum 10ml
  • Urine 100ml

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)

Blood pressure measurement may detect proneness to heart attack

The ankle–brachial index (ABI), a simple, non–invasive 10–minute test should be incorporated into a routine physical exam for diagnosing peripheral arterial disease in the middle aged and the elderly, especially those with heart attack risk factors like smokers, diabetics and the ones with high BP or cholesterol levels, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

With the patient in a supine position, the doctor takes blood pressure readings from both arms; he then takes blood pressure readings from both ankles with a sphygmomanometer and Doppler device. ABI value is calculated by dividing the higher systolic pressure in each leg by the higher systolic brachial pressure.

ABI scores should be interpreted as follows:

  • Greater than 0.90: Normal
  • 0.71 – 0.90: Mild obstruction
  • 0.41 – 0.70: Moderate obstruction
  • Less than 0.40: Severe obstruction
  • More than 1.30: Calcification of the vessels

Presence of peripheral arterial disease may indicate associated blockages in the heart and proneness to heart attack or paralysis.

For comments and archives

    Readers Responses
  1. Dear Dr. K. K. Aggarwal, You have done well to include the feature on "January is Glaucoma Awareness Month" in yesterday’s eMedinews. Since glaucoma has been termed as a "sneak thief of vision" and vision once lost due to glaucoma cannot be regained by any means. GPs can play an important role in referring 40+ older adults to an eye care professional for dilated eye examination. Sincerely: Dr. Narendra Kumar.
    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




8.00 - 8.30 AM

Dr K K Aggarwal

Revisiting the year 2011

8.30 - 9.00 AM

LIC India

Life Insurance Schemes

9.00-9.20 AM

Dr G K Mani

Cardiac surgery in 2012

9.20 - 9.30 AM

Mr M K Doogar

Health Insurance – What’s New

9.30 - 9.45 AM

Central Bank of India

Wealth Management

9.45 - 10.00 AM

Dr Dinesh Bhurani

Hemato Oncology Update

10.00 - 10.15 AM

I M Chugh

Chest Medicine Update

10.15-10.30 AM

Dr Pramod Kumar

Beyond Coronaries

10.30 - 11.00 AM

Dr N K Bhatia

Whats New in Transfusion Medicine

11.00 - 11.30 AM

Dr Praveen Chandra

Dual Anti Platelet Therapy in ACS

11.30 - 12.00 PM

Dr Ambrish Mithal

obesity as a precursor for diabetes

12.00 - 12.30 PM

Dr Ajay Kriplani

Surgery in diabetes

12.30 - 1.00 PM

Dr Kaberi Banerjee

Infertility Update

1.00-1.10 PM

Dr Kailash Singla

Gastro Update

1.00 - 1.30 PM

Zero Hour Session


1.30 - 2.00 PM

Dr Surjit Jha

High Risk Diabetes

2.00 - 2.30 PM

Dr Sudhir Kumar Rawal

Robotic Surgery in India

2.30 - 3.00 PM

Dr Amit Bhargava


3.00 - 3.15 PM

Dr Sanjay Chaudhary

Automation in Cataract Surgery with Femto-second

3.15 - 3.30 PM

Dr Neelam Mohan

100 Cases of Liver Transplantation in Children

4.00 - 4.15 PM

Dr Surender Kumar

Diabetes in 2012

4.15 - 4.30 PM

Dr S K Khanna

Valve Surgery Update

4.30 - 4.45 PM

Dr Ravi Kasliwal

Markers for Cardiovascular Prevention

5.00 - 8.00 PM


Doctor of the Year Award, Cultural Hungama

For Complete Details Click


Date: 18th -22nd Januray, 2011
Venue: Leisure Valley Ground, Sector 29, Gurgaon, Haryana
Website: http://pedicon2012.com/
For Latest happenings pls visit: http://pedianews.emedinews.in/


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

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2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (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