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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


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  Editorial …

9h August 2011, Tuesday

Performance anxiety

There is release of adrenaline and noradrenalin when you want to perform better or you are being watched for your performance? The result can be an acute attack of anxiety, panic reaction or faulty judgments.

Even Sachin Tendulkar is not immune to this anxiety. His nervous 90s are well–known. Several times he has been out with his score in nineties including on 99. At present, we can see him taking time to complete his hundredth century also. The opposition has been using his weakness as their strength. Each time before a match, the captain of the opposite team declares that they would not allow Sachin to score hundred runs in this match. Not only this, it’s the expectations of the entire country and Indians all around the world which adds to the pressure.

Performance anxiety is also evident in extramarital affairs. When the age of the male partner is 20 years more than the female partners the resultant anxiety to perform better can lead to acute rise in pulse rate and blood pressure and can even precipitate heart attacks.

Performance anxiety is also seen when you face an interview, participate in a competition, face the camera or make a public speech.

The medical drug commonly used is a beta blocker and the Yogic drugs are practicing Pranayama and Meditation.

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Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Performance anxiety

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    Photo Feature (from the HCFI Photo Gallery)

National Conference on
Insight on Medico Legal Issues

Dignitaries on the dias in the National Conference on Insight on Medicoleagl Issues held on 10th July, 2011.

Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


CDFD finds new pathways that can cause colorectal cancer

HYDERABAD: The molecular oncology laboratory at the Centre for DNA Fingerprinting and Diagnostics in Hyderabad has made a significant cancer–related discovery. Scientists at the lab have discovered that there are more cellular pathways than were previously known, that lead to colorectal cancer. So far, research done in the West had revealed that there were two major cellular ‘pathways’ that result in colorectal cancer. The research at CDFD has revealed that this may not be the case, at least among Indian patients. "The research findings imply one important thing and that is that cancer treatment cannot be the same for patients in the West and patients in India. The treatment has to be based on the cause of the disease and the drugs need to be developed taking the causes into account," CDFD scientist Murali D Bashyam told TOI. (Source: TOI, Aug 5, 2011)

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

(Dr Monica and Brahm Vasudev)

Air cleaners do not thwart most effects of secondhand smoke

Air cleaners significantly reduce particulate matter (PM) levels but are not enough to reduce exposure to secondhand smoke in inner–city children with asthma residing with a smoker, a new study has found. Arlene M. Butz, ScD, MSN, CPNP, with the Division of General Pediatrics at The Johns Hopkins University School of Medicine, in Baltimore, Maryland, and colleagues reported the findings in the August issue of the Archives of Pediatrics & Adolescent Medicine. (Source: Medscape Medical News)

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Afib hospital days reduced with dronedarone

Cardiovascular hospitalization and length of stay declined significantly in patients with paroxysmal or persistent atrial fibrillation or flutter treated with dronedarone (Multaq), a post hoc analysis of a large randomized trial showed. First cardiovascular hospitalization occurred in 26% fewer patients treated with dronedarone versus placebo, and the rate of hospitalization for Afib was almost 40% lower with dronedarone. The total number of hospital days associated with Afib was reduced by about one third, including a significant reduction in the number of ICU/CCU days. (Source: Medpage Today)

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Studies support culprit–only PCI for STEMI

Treatment of culprit lesions only should remain the standard of care for patients with ST–segment elevation myocardial infarction (STEMI) and multivessel coronary disease, investigators in two studies have concluded. Deferred, or staged, treatment of nonculprit lesions was associated with significantly lower short– and long–term mortality, cardiac mortality, and a lower rate of stent thrombosis, as compared with treatment of culprit and nonculprit lesions in a single session. Authors of one study, a meta-analysis involving 40,000 patients, suggested that the best results occur when only culprit lesions are treated, as reported online in the Journal of the American College of Cardiology. (Source: Medpage Today)

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    Fitness Update

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

Obesity is baby boomers’ main health problem

A higher percentage of baby boomers are obese than in any other group in the USA, a poll carried out by LifeGoesStrong has revealed. Findings revealed that while approximately 36% of baby boomers are obese, the figure for the two generations directly above and below them is about 25%. A baby boomer is somebody born during a baby boom, which in this text refers to US citizens born between 1946 and about 1965. When WWII was over, birth rates worldwide increased significantly – this explosion of new babies became known as the baby boom. This rise in population produced a considerable increase in demand for consumer goods, which stimulated the post–war economy. Baby boomers make up almost 20% of the US population and have a significant impact on the economy. They are frequently the focus of marketing, business and health campaigns.

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    Twitter of the Day

@DrKKAggarwal: #IJMD As the tracheostomy needs transtracheal dissection and carries significant morbidity, submental intubation…http://fb.me/1dTJfgock

@DeepakChopra: The only way to reverse these hard times in America is for each one of us to live the question "How can I make a difference?" Then do it !

    Dr KK Answers

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

At what prevalence is screening for stroke beneficial?

Only at prevalence rates of over 20% significant benefits are seen with at best about 100 strokes prevented for every 10,000 screened at 20 percent prevalence. Clinical features cannot identify asymptomatic individuals likely to have carotid stenosis. The annual risk of stroke in patients with asymptomatic carotid artery stenosis is relatively low.

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    Spiritual Update

Relieve stress by changing the interpretation

Stress is the reaction of the body or the mind to the interpretation of a known situation. Stress management, therefore, involves changing the situation, changing its interpretation or preparing the body and the mind in such a way that stress does not affect them. Changing the situation is always n

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    An Inspirational Story

(Ms Ritu Sinha)

The value of sincerity of purpose.

A story is told of a man who approached three workers who were doing the same job. "What are you doing?" he asked each one of them separately and got different answers. "I am cutting the stones" replied the first. "I am earning my livelihood," replied the second. "I am building a mosque" replied the third. Each of the three workers saw himself linked to a different purpose each, one was to that extent, different from others, although all worked alike and were engaged in the same task. Our two hands with which we work are in no sense different from the hands of any other person.

The value of what we do depends upon the quality of the inner purpose in our heart with which we do our work.

For comments and archives

    Pediatric Update

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

What are the effects of CMV infection in older children/adults?

In older children and adults, cytomegalovirus (CMV) causes only a mild flu–like illness. When clinical manifestations are present, they include:

  • Malaise
  • Fever
  • Generalized lymphadenopathy
  • Hepatosplenomegaly

Patients who are immunocompromised may develop extremely serious sequelae of infection, including chorioretinitis and pneumonitis.

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    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Low platelet counts

Surgical bleeding due solely to a reduction in the number of platelets does not generally occur until the platelet count is <50,000/microL.

Clinical or spontaneous bleeding does not occur until the platelet count is <10,000 to 20,000/microL.

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    IJCP Special

Dr Good Dr Bad

Situation: A 24–year–old female suffered migraine attacks after physical exertion.
Dr. Bad: The two are not related.
Dr. Good: There is an association between the two.
Lesson: Migraines can be triggered by stress, worry, menstrual periods, birth control pills, physical exertion, fatigue, lack of sleep, hunger, head trauma, and certain foods or drinks that contain chemicals such as nitrites, glutamate, aspartate, tyramine.

For comments and archives

Make Sure

Situation: A patient developed high altitude cerebral edema while traveling to Leh.
Reaction: Oh My God: Why was acetazolamide not started before the journey?
Lesson: Make sure all high risk patients are given acetazolamide before they go to mountains.

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  Quote of the Day

(Dr GM Singh)

No man is worth your tears, but once you find one that is, he won’t make you cry.

    Medicolegal Update

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

What is arsenic poisoning and its medicolegal importance?

The organic compounds contain arsenic either in trivalent or pentavalent combination.

  • The chief toxic manifestations are anaphylactic reaction; later on, skin reactions, hepatitis, jaundice, encephalitis may occur. The less soluble compounds cause local tissue necrosis.
  • Salvarsan and its derivatives are generally administered intravenously and occasionally intramuscularly. Arsenic is found in the blood soon after an intravenous injection of one of these preparations and is rapidly eliminated by the kidneys and bowels but may be retained in the tissues for a longer time after an intramuscular injection.
  • Arsenic is used homicidally much more frequently in India than in any other country, as it is cheap, easily available and can be easily concealed in the food. A very small quantity of arsenic is sufficient to produce fatal effects, although cases have occurred where much larger quantities were given for homicidal purposes. Mass homicidal poisoning in which persons have been affected has sometimes occurred from arsenic having been administered by an individual in some article of food.
  • Arsenic may also be administered along with some other poisons like powdered glass, copper sulfate, mercury, opium, nux etc.
  • Instead of administering a single fatal dose of arsenic at once, the murderer in western countries usually administers small doses over a long period in order to produce the symptoms simulating gastroenteritis and thus to conceal the crime.
  • Arsenic is sometimes employed as an abortifacient, both as an internal administration and as a local application in the form of paste or ointment to abortion sticks.

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    Mind Teaser

Read this…………………

In which of the following locations is carcinoid tumor most common?

1. Esophagus
2. Stomach
3. Small bowel
4. Appendix

Yesterday’s Mind Teaser: Horner’s syndrome is characterized by all of the following except:

1. Miosis
2. Enophthalmos
3. Ptosis
4. Cycloplegia

Answer for Yesterday’s Mind Teaser: Cycloplegia

Correct answers received from: Dr Anil Kumar Jain, Dr Shirish Singhal, Dr.(Maj. Gen.) Anil Bairaria,
Dr R Aggarwal, Dr Priyanka Sharma, Dr sandeep Arora, Dr Chandresh Jardosh, Dr Pramod M Kulkarni,
Dr Muthumperumal Thirumalpillai, Dr Surendra Bahadur Mathur, Dr Jainendra Upadhyay, Dr Neelam Nath, Dr Sukanta Sen.

Answer for 7th August Mind Teaser: c) It increases displacement of oxygen from hemoglobin
Correct answers received from: Dr K Raju, Dr Nayan Naya, Dr Rajesh, Dr Anupam.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Internet Lingo

The language of the internet is full of shortcuts. Some, like LOL (laugh out loud) and KISS(keep It Simple Stupid) have gone mainstream. But new online lingo is always popping up.

AYPI: And Your Point Is?

AWGTHTGTTA: Are We Going to Have to Go Through This Again?

BEG: Big Evil Grin

HHO1/2 K: Ha HA, Only Half Kidding


For comments and archives

    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name
DCI Approval Date
Asenapine Maleate Sublingual Tablets 5mg/10mg
For acute treatment of schizophrenia in adults only.
    Public Forum

(Press Release for use by the newspapers)

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Beware of lead in the paints

Seventy three percent of consumer paint brands from 12 countries in one study tested positive for lead higher than the U.S. standard of 600 parts per million (ppm) said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Paints can be a source of lead poisoning. Enamel paints have higher lead concentration. Painters who scrap paints may end up with acute lead poisoning with abdominal pain.

Some paints have Volatile Organic Compounds (VOCs) that may cause asthma and cough. VOCs are organic chemical compounds that vaporize and enter the atmosphere. VOCs include aldehydes, ketones, and hydrocarbons and may be either organic compounds or mixtures of varied composition. Conventional household paints release VOCs in the air. VOCs contain many chemicals considered carcinogens.

‘Chuna’(limestone) used to whitewash their houses is safer to use than the high end paints available in the market.

Exposure to lead can lead to weakness in fingers, abnormal blood pressure, anaemia and severe damage to brain and kidneys. Dry hacking cough can occur due to exposure to toluene diisocyanate (TDI), a well–known sensitizing agent, and one of the chemical components in the car paint sprays.

Many of the toxic effects of lead are reversible if identified early.

Asthmatics should avoid entering a freshly painted room. Instead of using paints that can be harmful opt for organic paint or environmentally friendly paint such as real milk paint or other natural paint made from natural ingredients.

Long–term exposure to household paints has led to the medical diagnosis of "Painter’s’ syndrome" to describe the effects that solvents used in synthetic paints can have on those exposed to them in the medium and longer terms.

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    Readers Responses
  1. Some people always throw stones in your path. It depends on you what you make with them. Wall? or Bridge? Remember, you are the architect of your life. Dr GM Singh
    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & National Icons in the field of Cardiology & Echocardiography will form the teaching faculty.



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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