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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

  Editorial …

11th April, 2011, Monday                                eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

Sachin Tendulkar and Bharat Ratna

Sachin Tendulkar received the Padma Shri in the year 1999 and Padma Vibhushan, the second highest civilian award, in 2008. Ever since, there has been an ongoing debate about whether he should be conferred with Bharat Ratna. The very fact that there is a debate means that there are views in favor as well as against it.

Usually, there is a gap of five years in between two awards. And so, the Bharat Ratna, if conferred to him, should come at least after two more years. But the government has the power to decide otherwise.

One of the points of debate is that Sachin Tendulkar is too young to receive Bharat Ratna. All the recipients of Bharat Ratna received the honor at a very old age. To name a few – Lata Mangeshkar received it at the age of 72, Bhimsen Joshi at the age of 86 years, Amartya Sen at 66 years, Ravi Shankar at 79 years and M S Subbalakshmi in 1998 at the age of 82 years. Indira Gandhi got it when she was 54 and Rajiv Gandhi when he was 47.

Lata Mangeshkar during her lifetime, has never been seen in a TV commercial or promoting any commercial products. At the most she could be seen promoting the cause of the nation in terms of singing for the country. After receiving Bharat Ratna, will Sachin stop endorsing products or start charging more endorsement fee for the products will be another controversy and capture headlines if this happens.

No doubt, Sachin enjoys a special place in the heart of every Indian but he has also used his position for the commercial market without going into the merits of the product he is endorsing. At the same time, it is equally true that he has never appeared in a cigarette or alcohol commercial but endorsing commercial products also amounts to promoting something only for money.

Will he become the youngest to receive the Bharat Ratna? Only time will tell.

Awarded Awarded at the Age
Chakravarti Rajagopalachari
C. V. Raman
Sarvepalli Radhakrishnan
Bhagwan Das
Mokshagundam Visvesvarayya
Jawaharlal Nehru
Govind Ballabh Pant
Dhondo Keshav Karve
Bidhan Chandra Roy
Purushottam Das Tandon
Rajendra Prasad
Zakir Hussain
Pandurang Vaman Kane
Lal Bahadur Shastri
Indira Gandhi
V. V. Giri
K. Kamaraj
Mother Teresa
Vinoba Bhave
Khan Abdul Ghaffar Khan
M. G. Ramachandran
B. R. Ambedkar
Nelson Mandela
Rajiv Gandhi
Vallabhbhai Patel
Morarji Desai
Abul Kalam Azad
J R D Tata
Satyajit Ray
A P J Abdul Kalam
Gulzarilal Nanda
Aruna Asaf Ali
M S Subbulakshmi
Chidambaram Subramaniam
Jayaprakash Narayan
Ravi Shankar
Amartya Sen
Gopinath Bordoloi
Lata Mangeshkar
Bismillah Khan
Bhimsen Joshi

Dr KK Aggarwal
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  eMedinewS Audio PostCard

Pediatric Echo

Dr Savitri Srivastava speaks on
‘Pulmonary arterial hypertension - Causes’

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

8th Vishwa Dharam Sammelan

A lively religious vandana was performed in the recently concluded 8th Vishwa Dharma Sammelan on 3rd April 2011 at Maulana Azad Medical College.

Dr K K Aggarwal
    National News

Colour–coded antibiotics soon to stop misuse

Life–saving antibiotic medicines will soon be colour–coded to avoid overuse and misuse, which has led to proliferation of drug–resistant bugs that cannot be treated with the current medicines. The colour coding will be on the basis of the efficacy, rarity, habit–forming nature etc of the antibiotics under the much awaited newly–drafted Antibiotic Policy, which is likely to be unveiled in next few months. Framed by the Health Ministry, the policy which calls for the creation of a new schedule under the Drugs and Cosmetics Act aims to address issues such as over–the–counter sale of prescription antibiotics, faulty dosages, no standard treatment protocol for antibiotics prescription, lack of awareness among stakeholders, truncated treatment and counterfeit medicines. As per policy, doctors will have to give two copies of prescriptions to every patient. One copy will have to be kept for two years by the chemists while the other one will be audited by the DCGI. Those violating norms would face penal action. Dr Nata Menabde, World Health Organisation (WHO) representative to India noted that the problem of antimicrobial resistance in some pathogens poses grave challenges for some of the national disease control programmes. "The new policy will help plug various loopholes as presently the drugs which are available over–the–counter are being over–used or misused, resulting in long–term side–effects and drug–resistant organisms," she said on the eve of the World Health Day on Wednesday in Delhi. (Source: The Pioneer April 07, 2011)

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

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

Your age can affect your strength training routine

It’s known that general strength, muscle mass, and metabolism tend to decrease as people age. However, people are encouraged to stay active and continue to exercise and perform appropriate strength training exercise as they grow older, regardless of physical limitations. A new research published in the Journal of Strength and Conditioning Research suggests that this general decrease in muscle mass could be caused by specific hormonal and molecular responses to resistance training that occur as a result of aging. The study evaluated two separate groups of subjects: a group of younger men (the average age was 21 years) and a group of older men (the average age was 68). The researchers found that the muscle tissue reacted differently in the different age groups, suggesting that muscle tissue growth is affected by hormones and other specific physiological changes that occur as people age. Eventually, this data will help fitness professionals design more effective exercise and strength training programs targeted towards older populations.

(Dr Monica and Brahm Vasudev)

Diabetes patients treated with sulfonylureas may be at increased risk for hospitalization with MI

According to a study published in the journal Pharmacoepidemiology and Drug Safety, diabetic patients treated with sulfonylureas may be at increased risk for hospitalization with myocardial infarction compared with patients treated with other medications.

Safflower oil may improve glycemia, inflammation, blood lipids in certain women with type 2 diabetes

According to a study published online March 21 in the journal Clinical Nutrition, supplementation with 8 g safflower oil daily improved glycemia, inflammation, and blood lipids in obese, postmenopausal women with type 2 diabetes.

Recent heart attack may increase complication risk after major surgery

A recent heart attack remains a significant risk factor for complications and death after major surgery, despite advances in clinical management, according to a study published in the Annals of Surgery.

    IJCP Special

Dr Good Dr Bad

Situation: A patient with dengue had itchy rash.
Dr Bad: It’s an allergy.
Dr Good: This is dengue.
Lesson: Itchy rash can be present in Dengue or Chikungunya.

Make Sure

Situation: A 62–year–old diabetic with coronary artery disease, on treatment for the same, comes for follow up.
Reaction: Oh my God! Why did not you put him on antioxidants?
Lesson: Make Sure to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects.

    An Inspirational Story

(Dr GM Singh)

The Short of a Story!

This is a story about four people named Everybody, Somebody, Anybody, and Nobody.

There was an important job to be done and Everybody was sure Somebody would do it. Anybody could have done it, but Nobody did it. Somebody got angry about that, because it was Everybody's job. Everybody thought Anybody could do it, but Nobody realized that Everybody wouldn’t do it. It ended up that Everybody blamed Somebody when Nobody did what Anybody could have.

    Infertility Update

(Dr. Kaberi Banerjee, Director Precious Baby Foundation)

Who can be a sperm donor?

A young healthy male can be a sperm donor. He has to be screened and given clearance for certain medical illnesses and sexually transmitted diseases. The ICMR guidelines encourage anonymous donation through sperm bank. International anonymity is not a major criterion.

    Gastro Update

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

Q. What is the role of EUS in diagnosis of chronic pancreatitis?

A. Endoscopic ultrasonography (EUS) is likely to play an important role in diagnosis and management of patients with chronic pancreatitis. High resolution (<1mm) images of pancreatic parenchyma and duct structure can be generated without the use of ionizing radiation. Presently EUS is very popular in adult population. But, pediatric EUS is available only in limited centres and will gradually gain popularity; with the development of smaller probes and experience in children.

    Medicolegal Update

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

Is the management of patient on hunger strike an ethical dilemma?

The doctor attending a person on hunger strike faces a conflict between their loyalty to the government and loyalty to the patient. Primary obligation is the patient autonomy followed by health.

During the first 1 to 3 days of food fast the body uses energy from available glucose. After that, the liver starts processing body fat, in a process called ketosis. After a week the body enters the "starvation mode." At this point the body "mines" the muscles and vital organs for energy, and loss of bone marrow becomes life–threatening.

Doctor should assess the individual’s mental capacity i.e. verify that an individual intending to fast does not have a mental impairment that would seriously undermine the person’s ability to make health care decisions. Individuals with seriously impaired mental capacity cannot be considered to be hunger strikers and they need to be given treatment for their mental as well as physical health problems rather than allowed to fast in a manner that risks their health and life.

  • Complete patient understanding of the medical consequences of fasting is critical. Consistent with best practices for informed consent in health care, the physician should ensure that the patient understands the information conveyed by asking the patient to repeat back what they understand.
  • A thorough examination of the hunger striker should be made at the start of the fast. Management of future symptoms, including those unconnected to the fast, should be discussed with hunger strikers. Also, the person's values and wishes regarding medical treatment in the event of a prolonged fast should be noted.
  • The World Medical Association and Declaration of Malta on Hunger Strikers, in its Article 21, unambiguously state that force feeding is a form of inhuman and degrading treatment.
  • It is the responsibility of the state to monitor the health and welfare of individual, and to ensure that procedures are pursued to preserve life."
  • The therapeutic necessity from the point of view of established principles of medicine cannot in principle be regarded as inhuman and degrading and this includes force–feeding aimed at saving the life of a person
  • However the "medical necessity" must be determined by a physician seconded by another based on accepted medical standards, and force–feeding cannot be aimed at "humiliation and punishment" or inflict "physical mental and social suffering.
    Legal Question of the Day

(Dr. M C Gupta)

Q. I served a hospital for 30 years. Am I entitled for the benefit of free medical care from the hospital for myself and my wife? If yes, what should I do to get this benefit?


  • You are not entitled unless your terms and conditions of service so provided.
  • You would have been entitled for free air travel, train travel or phone services if you had joined the Indian Airlines, Indian Railways or Indian Telephones. Health services are meant for the health staff to suffer for the sake of the suffering.
    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

What are the risk factors for metabolic syndrome?

The dominant underlying risk factors for this syndrome appear to be abdominal obesity and insulin resistance. Insulin resistance is a generalized metabolic disorder, in which the body cannot use insulin efficiently. This is why the metabolic syndrome is also called the ‘insulin resistance syndrome’.

Other conditions associated with the syndrome include physical inactivity, aging, hormonal imbalance and genetic predisposition.

Some people are genetically predisposed to insulin resistance. Acquired factors, such as excess body fat and physical inactivity, can elicit insulin resistance and the metabolic syndrome in these people. Most people with insulin resistance have abdominal obesity. The biologic mechanisms at the molecular level between insulin resistance and metabolic risk factors aren’t fully understood and appear to be complex.

    Head Injury Update

Dr Shameem Ahmed, Dr Atanu Borthakur, Dr Sajida Sultana, Dr Shabbir Khan. Dept. of Trauma and Neurosurgery, Hayat Hospital, Guwahati, Assam.

Use of safety measures is important. Everyone must follow traffic rules and law must be enforced religiously. The incidence of head injury may come down in the next decade with everyone’s cooperation.

    Mind Teaser

Read this…………………
(Dr GM Singh)

Varieties of HIV that are resistant to the drug 3TC.
A. Developed in response to the use of 3TC.
B. Already existed in the population before 3TC was developed.
C. Always have an advantage in every environment.
D. Were strongly selected for as 3TC became widely used to treat HIV.
E. Drug resistance spreads through a population because it already existed in the population before 3TC was developed AND because it was strongly selected for as 3TC became widely used to treat HIV.

Yesterday’s Mind Teaser: (ice) 3

Answer for Yesterday’s Mind Teaser: 3 cubes

Correct answers received from: Dr Tilak Gupta, Dr  Manjesha, Dr Meera Rekhari, Dr Sandeep Thadani, Dr Sudipto Samaddar, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr K Raju, Dr N C Prajapati, Dr S K Bansal, Dr U Gaur, Dr Neelam Nath, Dr Anil Bairaria

Answer for 9th April eQuiz: Land before time
Correct answers received from: Dr Vijay Kansal, Dr Kushal J Manjesh, Dr K Raju, Dr Rakesh Bhasin

Send your answer to ijcp12@gmail.com

   Laugh a While

(Dr.Veena Aggarwal)

A candidate’s job application: "This has reference to your advertisement calling for a ‘Typist and an Accountant – Male or Female’… As I am both (!!) for the past several years and I can handle both with good experience, I am applying for the post.

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

A/G ratio

  • Globulin is increased disproportionately to albumin (decreasing the albumin/globulin ratio) in states characterized by chronic inflammation and in B–lymphocyte neoplasms, like myeloma and Waldenström’s macroglobulinemia. More relevant information concerning increased globulin may be obtained by serum protein electrophoresis.
  • Decreased globulin may be seen in congenital or acquired hypogammaglobulinemic states. Serum and urine protein electrophoresis may help to better define the clinical problem.
    Medi Finance Update

(Dr GM Singh)

Myth 1: I don’t want to invest in Mutual Funds… I prefer investing only in stocks

Who wants to invest in financial instrument like a mutual fund that probably grows half as fast as some ‘exciting’ stocks during a bull run? The poser is relevant. Underperformance almost always gets a thumbs down, no matter what the reason. After all, every investor wants his money to work for him and if a stock does that better, why invest in a mutual fund?

Mutual funds may lack the excitement of a stock, but it’s the kind of excitement that investors can often do without. Mutual funds may not scorch the investor’s portfolio in a bull run like some ‘exciting’ stocks, but you can be sure they won’t burn a huge crater in the investor’s portfolio either, when individual stocks are crashing by 40%, for instance. For the record, there are more than 5000 (actually around 7000) stocks listed on the stock exchanges. And most good stocks find their place in the better managed mutual funds. You as a retail investor have the liberty of investing in stocks, debt funds and Gold.

The Reality: Mutual Funds give you the privilege of diversifying your Portfolio by allowing you to hold several stocks in one place and access to other’s expertise..

    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
DCI Approval Date
Montelukast Sodium Tablet 10mg; Montelukast Sodium 4/5mg Chewable Tablet; Montelukast Sodium Oral granule(Additional Indication)
For the relief of symptoms of seasonal allergic rhinitis in adults and pediatric patients 2 years of age and older.
    IMSA Update

International Medical Science Academy (IMSA) Update

Influenza vaccine

In December 2009, the US Food and Drug Administration approved a high–dose inactivated influenza vaccine for individuals 65 years and older.

(Reference:Licensure of a high–dose inactivated influenza vaccine for persons aged ≥65 years (Fluzone High–Dose) and guidance for use – United States, 2010. MMWR Morb Mortal Wkly Rep 2010;59:485).

(Dr Vinay Sakhuja)

Latin Quotes

Deo Adjuvantes labor proficit.

With God’s help our labours will be successful.

    Quote of the Day

(Dr GM Singh)

Unless we think of others and do something for them, we miss one of the greatest sources of happiness. Ray L. Wilbur

    Readers Responses

I enjoy reading emedinews every morning, and applaud your initiative. As an humble contribution to your praiseworthy effort. Dr Jitendra Maheshwari

    Public Forum

(Press Release for use by the newspapers)

Vegetables & fruits lower chances of getting some cancers

Vegetables and fruits help lower your chances of getting head, neck, breast, ovarian and pancreatic cancers. Even one additional serving of vegetables or fruits could help lower the risk of head and neck cancer. The more fruits and vegetables you can consume, the better.

Quoting an International Study from National Cancer Institute, Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal and President, Heart Care Foundation of India, said that those who eat six servings of fruits and vegetables per 1,000 calories have a 29% decreased risk relative to those who have 1.5 servings. In the study, after adjusting the data to account for smoking and alcohol use – known head and neck cancer risk factors –the researchers found that those who consumed the most fruits and vegetables had the lowest risk for head and neck cancers. Vegetables appeared to offer more cancer prevention than fruits alone did. Adding just one serving of fruit or vegetables per each 1000 calories consumed daily resulted in a 6% reduction of risk.

In another study, broccoli and soy protein were found to protect against the more aggressive breast and ovarian cancers. When consumed together, digesting broccoli and soy forms a compound called di–indolylmethane (DIM). In lab experiments, the researchers found that DIM could affect the motility of breast and ovarian cancer cells, which could help keep cancers from spreading. Soy, acts like estrogen and is a nutritious, healthy food, and should be eaten in moderation.

Yet another study compared intake of flavonols to their risk of pancreatic cancer. Flavonols are protective compounds found in fruits and vegetables, such as onions, apples, berries, kale and broccoli. Those who had the highest consumption of flavonols reduced their risk of pancreatic cancer by 23%. The benefit was even greater for people who smoked. Smokers with high levels of flavonols reduced their risk of pancreatic cancer by 59%.

Alcohol bad for breast cancer

Drinking alcohol, even moderate amounts, is a well–established risk factor for breast cancer in women. A study found that 60 percent of breast cancer cases in women worldwide were attributable to alcohol consumption. But the mechanism(s) of alcohol–induced breast cancer are poorly understood, said Dr Aggarwal. A study in mice showed that moderate alcohol consumption stimulates the growth and progression of breast cancer by fueling the development of new blood vessels, a process called "angiogenesis." It does this by boosting expression of a key growth factor known as vascular endothelial growth factor or VEGF.

Dr. Jian–Wei Gu and colleagues from the University of Mississippi Medical Center in Jackson examined the effects of alcohol on tumor growth and progression of breast cancer in mice. For 4 weeks, 6–week old female mice consumed regular drinking water or water containing 1 percent alcohol, which is equivalent to about 2 to 4 drinks in humans. In week 2, the animals were inoculated with mouse breast cancer cells.

After about 4 weeks that breast tumor size almost doubled in mice that drank alcohol compared to control mice given plain water. Moderate alcohol intake also caused a noteworthy increase in tumor blood vessels compared with no alcohol intake.


  1. Quit smoking.
  2. Reduce alcohol.
  3. Increase consumption of fruits.
  4. Increase consumption of vegetables.
    eMedinewS Special

1. eMedinewS audio lectures (This may take a few minutes to open)

2. eMedinewS ebooks (This may take a few minutes to open)

Activities eBooks


  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
    Situation Vacant

Vacancy for a post of Consultant in Pediatric ICU at Medanta – The Medicity Hospital, Sector –38, Gurgaon.
Interested candidates may please contact: drneelam@yahoo.com/9811043475.
*Eligibility: Post MD/DNB/DCH

    Forthcoming Events

April 16–17, 2011, National Conference on Gynae–Endocrinology–2011 under aegis of FOGSI, ICOG and AOGD, Focus on newer advances in management of endocrinal problems in gynaecology with emphasis on PCOS, hyperprolactinemia, amenorrhoea, hormonal contraception. Gyne– endocrinology is a topic of high importance especially for practitioner. Detailed programme http://www.aiims.edu and http://www.aiims.ac.in
For details please contact: Prof Alka Kriplani, Organizing Chairperson, 9810828717 kriplanialka@gmail.com/Dr Nutan Agarwal, organizing Secretary, 9810107464/9868397310 nutan.agarwal1@gmail.com


May 7–8, 2011, National Seminar On Stress Prevention
A Stress Prevention Residential Seminar cum spiritual retreat with Dr KK Aggarwal and Experts from Brahma Kumaris.
Co–organizers: eMedinews, Brahma Kumaris, Heart Care Foundation of India, IMA New Delhi Branch and IMA Janak Puri Branch, IMSA (Delhi Chapter)
Venue: Om Shanti Retreat Centre, National Highway 8, Bilaspur Chowk, Pataudi Road, Near Manesar.
Timings: Saturday 7th May (2 pm onwards) and Sunday 8th May (7 am–4 pm). There will be no registration charges, limited rooms, kindly book in advance; stay and food (satvik) will be provided. Voluntary contributions welcome. For booking e–mail and SMS to Dr KK Aggarwal: 9899974439, emedinews@gmail.com, rekhapapola@gmail.com; BK Sapna: 9811796962, bksapna@hotmail.com


September 30 – October 02, 2011; XVIth World Congress on Cardiology, Echocardiography & Allied Imaging Techniques Venue: The Leela Kempinski, Delhi (NCR), September 29, 2011: A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
Highlights of Pre – Conference CME: Case based learning experience & audience interaction, Maximum 250 delegates for CME will be accepted, who will be divided in 5 batches and will rotate to different halls every 90 minutes. The topics are:(A) Right heart pressures & functions (From basics to newer methods (RV anatomy, echo views, echo assessment of RV function, prognostic impact of RV function) (B) Carotid Doppler: How do i assess and interpret in my daily practice.: Technical tips (Anatomy of the vessel, views of ultrasound scanning, Normal & abnormal Doppler hemodynamics, how to measure IMT) (C) Valvular stenosis: Assessment, limitations and their solution: (Anatomy of the valves, 2–D findings of stenotic lesions, quantitation of lesion, limitations) (D) How do I assess and report ventricular dyssynchrony in my lab. (What is ventricular dyssynchrony, what are the types of dyssynchrony, in whom, when & why do we assess it, various echo methods to assess it ) (E) Live 3–D Echo: Protocol for acquisition. How to slice and get full information. Aim is that by end of the day, every participant is well conversant with all the topics
Dr (Col) S.K. Parashar, President, e–mail: drparashar@yahoo.com, Mob:09810146231/Dr Rakesh Gupta, Secretary General, email:jrop2001@yahoo.com, Mob:09811013246
worldcon2011@in.kyoni.com, www.worldcon2011.org


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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 Naveen Dang, Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta