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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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

  Health Videos …

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

12th February 2013, Tuesday

To prevent HIV is to start early treatment

Treat all HIV positive cases: The HPTN 052 trial has become one of medicine's most heralded reports and the recipient of the Science award for Breakthrough of the Year in 2011, leading to substantial practice changes in 2012.

The 052 trial included 1763 couples, of which one partner had HIV infection and the other was HIV-negative. The infected partners were randomly assigned to either HIV treatment or placebo.

Results showed 39 transmissions in the placebo group and none in the treatment group.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

   Constipation Update

How is chronic idiopathic constipation defined?

Chronic idiopathic constipation, also known as functional constipation is generally defined as the persistent difficult or seemingly incomplete defecation and/or infrequent bowel movements (once every 3–4 days or less) in the absence of alarm symptoms or secondary causes. The prevalence varies widely and ranges from 4 to 20% of patients.

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Longer CPR efforts may improve
survival chances

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

CPR 10 workshop at Gita Rattan Jindal Public School at Rohini, Sector 7.

Students along with Nursury Training Teachers were trained and given one to one training in hands only CPR 10.

Dr K K Aggarwal
    National News

Dr. Anil Goyal –Delhi Medical Association President (Elect)

This Sunday, 10th February, 2013, elections of Delhi Medical Association were held. 4194 doctors voted in the elections. Dr. Anil Goyal got total 2271 votes, Dr. Ramesh Duta got 1347 votes and Dr. Sharad Lakhotia got 512 votes.

Dr. Singhal was elected as the Senior Vice President and got 2379 votes. Dr. Srivastava was elected the Vice President with 2301 votes. Dr. Manjul Mehta with 1576 votes and Dr. Anand Gupta with 1465 votes could not make it.

From South Zone, Dr. Anil Goyal got 360 votes, Dr. Ramesh Dutta got 148 votes and Dr. Sharad Lakhotia got 213 votes.

From East Zone, Dr. Anil Goyal got 1218 votes, Dr. Dutta got 119 votes and Dr. Lakhotia got 66 votes.

From North Zone, Dr. Anil Goyal got 411 votes, Dr. Dutta got 300 votes and Dr. Sharad Lakhotia got 153 votes.

From West Zone Dr. Anil Goyal got 239 votes, Dr. Dutta got 708 votes and Dr.Lakhotia got 52 votes.

From Central Zone, Dr. Anil Goyal got 43 votes, Dr. Dutta got 72 votes and Dr. Sharad Lakhotia got 28 votes.

Congratulations to Dr. Anil Goyal and his team for the victory!

Ranbaxy recalls generic Lipitor in United States

Ranbaxy Laboratories has recalled its generic version of Atorvastatin in the United States after certain batches were found to contain glass particles, reports Reuters. Ranbaxy’s U.S. subsidiary, Ranbaxy Pharmaceuticals Inc., said the recall affects certain lots of 10-, 20- and 40-milligram doses of the drug, known generically as atorvastatin calcium. The 80-miligram dosage is not affected. Ranbaxy, the first company to introduce generic Lipitor after Pfizer’s patent expired in November 2011, controls about 60 percent of the market. In 2008 the FDA banned the company from importing about 30 drugs after it found manufacturing deficiencies at two of the company’s facilities in India. In 2009, the U.S. Government accused Ranbaxy of falsifying data used in drug application.s (Dated: 27.11.2012)

Childhood cancers double in a decade

KOLKATA: Paediatric cancers are on the rise and environmental pollution may have a lot to do with it, say experts. According to the Indian Council for Medical Research (ICMR), a decade back, childhood cancers were 2.5% of the total number of cancer cases. Today, they add up to 5.5%. Tata Memorial Centre in Mumbai's Parel area alone treats 2,000 new pediatric cancer cases annually. While leukemia and lymphoma are the commonest childhood cancers, an unusually high percentage is afflicted by non-Hodgkin lymphoma (see box). "Non-Hodgkin lymphoma is caused by mutation due to external factors of which pollution is a major cause. Our studies confirm this," says Soma Mukhopadhyay, a researcher at Netaji Subhas Chandra Bose Cancer Research Institute in Kolkata. "Environmental disasters like the one that followed the Hiroshima-Nagasaki nuclear blasts and the Bhopal gas tragedy led to a spurt in the number of children affected by non-Hodgkin. The depleting ozone layer is also a contributing factor." According to Dr Gauri Kapoor, director and head, paediatric oncology at Delhi's Rajiv Gandhi Cancer Institute and Research Centre, "Globally, whenever there has been industrialization and technological advancement, an increase in cancers is seen. In India, out of eight lakh cancers diagnosed annually, about 50,000 are childhood cancers. Of these, 30-40% are leukemia and lymphomas and 20% are brain tumours. We are also increasingly seeing children with retinoblastomas (eye cancer) which form 1% of paediatric cancers." Teenagers are also coming with oral and liver cancers, hitherto seen only in the adult population. "In India, we are seeing even 13-year-olds with oral cancer," says Dr Brijesh Arora of Tata Memorial Hospital. "This is due to the tobacco and gutka habit. Children from lower-socio economic groups start working early and get exposed to this habit." (Source: TOI, Feb 9, 2013)

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    Be Human Stop Child Abuse (Team IMA for CMAAO)


Categories of emotional or psychological abuse

  1. Rejecting – Refusing to acknowledge the child’s worth and the legitimacy of his/her needs; refusing to show affection
  2. Isolating – Denying the child normal social experiences and peer/familial relationships, creating a sense in the child that he/she is “alone in the world”; some parents may lock the child in a bedroom, closet, basement, or attic away from normal familial interaction
  3. Terrorizing – Verbal assault/threatening of the child or his or her loved ones or objects; making the child feel unsafe; creating a climate of fear; convincing the child that “the world is capricious and hostile.” Weapons may be used to further terrorize the child.
  4. Ignoring – Psychological unavailability to the child, depriving him or her of essential stimulation and interaction; emotional starvation; lack of protection from danger
  5. Corrupting – Stimulating destructive, antisocial, or sexually exploitative behavior, reinforcing deviant behavior
  6. Verbal assault or spurning – Name-calling; sarcasm that erodes the child’s self-esteem and reinforces negative self-image; singling out a child to criticize or punish; humiliating the child in public.
  7. Over pressuring – Overly advanced expectation of the child’s behavior and accomplishments; criticism of age-appropriate behavior as inadequate; comparing the child’s behavior to other children as “poor by comparison,” resulting in a negative self-image and behavior disturbance. (Source: Uptodate)

For comments and archives

    Valvular Heart Disease Update

When should surgery be avoided in chronic mitral regurgitation?

Asymptomatic patients with severe chronic MR and normal LV systolic function (defined as LV ejection fraction (LVEF) =60 percent and LV end–systolic dimension <40 mm) are usually followed and managed conservatively.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Red meat raises gestational diabetes risk, nuts lower it

Red meat consumption significantly raises the risk for developing gestational diabetes mellitus (GDM), while eating nuts reduces it, new data from the Nurses' Health Study II suggest. (Source: Medscape)

Metoclopramide, ondansetron cut nausea in cesarean delivery

A new drug regimen appears to be more effective than prophylactic phenylephrine alone in mitigating the nausea and vomiting that may take place during the course of an elective cesarean delivery, according to results from a study published online February 5 in Obstetrics & Gynecology. (Source: Medscape)

High CRP levels predict risk of eye disease

High levels of the proinflammatory marker C-reactive protein (CRP) predicted an increased risk of age-related macular degeneration (AMD), including neovascular AMD, data from five large prospective cohort studies showed. (Source: Medpage Today)

Laparoscopic Gyn surgery: Fasting better than bowel prep

Surgical view slightly improved when women had a minimal-residue diet 2 days before laparoscopic gynecologic surgery, followed by mechanical bowel preparation, but the technique was accompanied by such significant preoperative adverse effects that fasting alone remains the preferred alternative for bowel handling, according to a randomized controlled trial. (Source: Medscape)

Falls: Tai Chi may be remedy

In a small, randomized study, tai chi showed promise for reducing the risk of falls among stroke survivors. (Source: Medpage Today)

    Twitter of the Day

@DrKKAggarwal: 15th Feb is International Pediatric Cancer Day. Watch Dr KK in Chat with Dr Gauri Kapoor on Cancers in Children.... http://fb.me/W1tAaygZ

@DrKKAggarwal: Can we know all there is to know? Will there be any limit of knowledge?

    Spiritual Update

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

Why the ritual of Namaskar or Namaste?

Namaskar is a customary greeting when two people meet. It signifies non-arrogance or negation of ego. Namaskar is made of three words: Namah + Om + Kar.

  • Namah means Not Me. It is a negation of one’s identity and hence of one’s ego or arrogance. It signifies that I am nothing.
  • Om is the sound of life, the primordial sound of nature. In Vedic language it signifies soul, the spirit or the God.

For Comments and archives…

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

Describe some variations of IVF?

Gamete intrafallopian transfer (GIFT): This technique is similar to IVF, but the gametes (egg and sperm) are transferred to the woman’s fallopian tubes rather than her uterus, and fertilization takes place in the tubes rather than in the lab. GIFT is an option only for women who have normal fallopian tubes. One limitation of GIFT is that fertilization cannot be confirmed as with IVF.

Zygote Intrafallopian Transfer (ZIFT): This technique differs from GIFT in that fertilization takes place in the lab rather than the fallopian tube, but is similar in that the fertilized egg is transferred to the tube rather than the uterus.

    Tat Tvam Asi………and the Life Continues……

(Dr Sanjay Chaudhary, Medical Director, Chaudhary Eye Centre, Dr Pallavi Sugandhi, Consultant Ophthalmologist, Cornea & Refractive surgeon, Chaudhary Eye Centre)

How will the donated eyes be used?

A. After the cornea is removed from the whole eye, it is evaluated and then supplied to the eye surgeon for use in a patient.

For Comments and archives…

    An Inspirational Story

Father's Gift

A young man was getting ready to graduate from college. For many months he had admired a beautiful sports car in a dealer's showroom, and knowing his father could well afford it, he told him that was all he wanted. As Graduation Day approached, the young man awaited signs that his father had purchased the car.

Finally, on the morning of his graduation his father called him into his private study. His father told him how proud he was to have such a fine son, and told him how much he loved him. He handed his son a beautiful wrapped gift box.

Curious, but somewhat disappointed the young man opened the box and found a lovely, leather-bound Bible, with the young man's name embossed in gold. Angrily, he raised his voice to his father and said, "With all your money you give me a Bible?" and stormed out of the house, leaving the Bible.

Many years passed and the young man was very successful in business. He had a beautiful home and wonderful family, but realized his father was very old, and thought perhaps he should go to him. He had not seen him since that graduation day.

Before he could make arrangements, he received a telegram telling him his father had passed away, and willed all of his possessions to his son. He needed to come home immediately and take care of things. When he arrived at his father's house, sudden sadness and regret filled his heart. He began to search his father's important papers and saw the still new Bible, just as he had left it years ago. With tears, he opened the Bible and began to turn the pages. His father had carefully underlined a verse, Matt 7:11,

"And if ye, being evil, know how to give good gifts to your children, how much more shall your Heavenly father which is in heaven, give to those who ask Him?"

As he read those words, a car key dropped from the back of the Bible. It had a tag with the dealer's name, the same dealer who had the sports car he had desired. On the tag was the date of his graduation, and the words...PAID IN FULL.

How many times do we miss God's blessings because they are not packaged as we expected?

For comments and archives

   Cardiology eMedinewS

Contraindications for tPA updated Read More

Ramipril substantially improved walking times in PAD trial Read More

   Pedia News

Seizures common in pediatric stroke Read More

New data on seizures and risk factors in pediatric ICH Read More

    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

Why is rabies an important disease?

Rabies is one of the oldest and most feared zoonotic diseases, and has been a threat to human health for more than 4000 years. Rabies is a neglected and severely under-reported disease killing each year an estimated 55,000people (24,000 to 90,000 deaths) worldwide (WHO 2007). All mammals, but mainly carnivores and bats, are susceptible and can transmit rabies virus. Human exposures are most frequently associated with bites by rabid dogs and transmission of virus from dogs’ saliva. The Association for the Prevention and Control of Rabies in India (APCRI) estimated in 2004 that in India, there were 20,565 reported human deaths every year. About half of the world’s population lives in areas in which rabies is enzootic. Rabies is practically 100% fatal even today but easily preventable.

    IJCP Special

Dr Good Dr Bad

Situation: A patient with heat stroke had fever >106°F.
Dr Bad: Give injection paracetamol.
Dr Good: Do cold sponging.
Lesson: Paracetamol is not effective in heat stroke until the fever is brought down to < 103°F.

Make Sure

Situation: A foreigner with 2 loose motions developed sepsis.
Reaction: Oh my God! Why was an antibiotic not started early?
Lesson: Make sure that all cases of diarrhea in foreigners are treated with antibiotics.

  Legal Question of the Day

(Ex)Prof. M C Gupta, MD (Medicine), MPH, LL.M., Advocate & Medicolegal Consultant)

Q. Can the wife unilaterally decide to have an abortion? Is husband’s consent necessary? What is the law regarding consent for abortion?


  • It is important to keep in mind the following facts:
    • That pregnancy can occur in an unmarried woman and in this situation, the question of husband’s consent would not arise.
    • That a married woman can get pregnant from a person other than her husband and in this situation, the question of husband’s consent would not practically arise.
    • That a pregnant married woman may not like to or may not be able to or may not be medically advised to continue pregnancy but the husband may not give consent and, in such a situation, continuation of pregnancy may cause irreparable damage to the woman.
  • When a law is made, various possibilities like the above have to be kept in mind. That is why the MTP Act, 1971, does not provide for husband’s consent.
  • If it is an illegal abortion with the knowledge, consent, instigation or coercion on the part of the husband, he would be liable for the crime. Both husband and wife are often prosecuted when prenatal sex determination is followed by abortion.
  • If a wife unilaterally or secretly decides to get an abortion, she should be prepared to face divorce proceedings on the ground of cruelty towards the husband. The husband would plead mental cruelty as ground for divorce and the court can treat it as a valid ground.
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  Quote of the Day (Dr GM Singh)

Great minds have purposes; others have wishes. Washington Irving

    Mind Teaser

Read this…………………

Which statement indicates the development of opioid tolerance?

1. Larger doses of opioids are needed to control pain compared to several weeks earlier.
2. Stimulants are needed to counteract the sedating effects of opioids.
3. The patient becomes anxious about knowing the exact time of the next dose of opioid.
4. The patient no longer experiences constipation from the usual dose of opioid.

Yesterday’s Mind Teaser: On discharge, the nurse teaches the patient to observe for signs of surgically induced hypothyroidism. The nurse would know that the patient understands the teaching when she states she should notify the MD if she develops:

A. Intolerance to heat
B. Dry skin and fatigue
C. Progressive weight gain
D. Insomnia and excitability

Answer for Yesterday’s Mind Teaser: C. Progressive weight gain

Correct answers received from: Dr Shamsher Singh, Rajiv Kohli, Prabha Sanghi, Dr Jaya, Dr Ajay Gandhi, Dr PC Das, Dr Kanta Jain, Dr Arpan Gandhi, Dr Jella, Dr Chandresh Jardosh, Dr K Raju, Dr Thakor Hitendrsinh G.

Answer for 10th February Mind Teaser: c. The pressure gradient against which the muscle ejects blood during contraction

Correct answers received from: Dr Avtar Krishan, Dr Jayashree Sen & Dr Bitaan Sen.

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Never be rude to anyone

An American tourist asked a boat guy in Zanzibar, "Do you know Biology, Psychology, Geography, Geology or Criminology?"

The boat guy said, "No. I don't know any of these."

The tourist then said, "What the hell do you know on the face of this Earth? You will die of illiteracy!"

The boat guy said nothing. After a while the boat developed a fault and started sinking. The boatman then asked the tourist, "Do you know Swimology and Escapology from Crocodiology?"

The tourist said, "No!"

The boat guy replied, "Well, today you will Drownology and Crocodiology will eat you. I will not Helpology and you will Dieology because of your Badmouthology."

  Medicolegal Update

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

Medical testimony of doctor in the Court of law

The doctor should acquire the habit of making a careful note of all the facts observed by him. Vagueness and theory have no place in legal medicine. He should examine the facts that come to his knowledge in his special capacity, draw his conclusions logically and correctly after a detailed consideration of the pros and cons of the case, and indicate to the Court that interpretation, along with the grounds on which it is based. Presumption is not proof and conjecture is not evidence. The Court has no special medical knowledge. It relies on medical witness for an opinion and expects him to assist it with his special knowledge and experience in perusal of truth.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Gasping does not mean person is dead

A gasping respiration means the brain is still alive and the stopped heart is still revivable, said Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Vice President (Elect) Indian Medical Association. He was conducting a camp at Gita Rattan Jindal Public School at Rohini, Sector 7. 1194 students along with Nursury Training Teachers were trained and given one to one training in hands only CPR 10.

Dr. Aggarwal said that often people consider gasping as the sign of life and do not start resuscitation in time. Effective and continuous cardiac resuscitation in such patients can revive the heart. CPR 10 should be started within ten minutes of the death and continued for at least ten minutes. In children it can be continued till 35 minutes and in adults for 25 minutes. Mouth to mouth breathing is not required as it has been seen that only chest compression is sufficient for reviving the heart.

The function was chaired by Dr Sonia Jindal, Director, Gita Rattan Educational Group, Jindal Public School & Principal Ms Pawinder Pal Kaur.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 29132 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

    Readers Response
  1. Dear Sir, Nice inspirational stories in emedinews. Pls keep us updated. Regards:Dr Deepti
    Forthcoming Events


Sri Aurobindo Ashram – Delhi Branch will organize the 6th Study Camp on ‘Mind-Body Medicine and Beyond’ for doctors, medical students and other health professionals at its Nainital Centre (Van Nivas) from June 8-14, 2013. The camp, consisting of lectures, practice, and participatory and experiential sessions, will help the participants get better, feel better, and bring elements of mind-body medicine into their practice. The camp will be conducted by Prof. Ramesh Bijlani, M.D., former Professor, AIIMS, founder of the Mind-Body Medicine Clinic at AIIMS, and the author of Back to Health through Yoga, Eating Wisely and Well and Essays on Yoga. For more details, send an e-mail to the Ashram (aurobindo@vsnl.com) or to Dr. Bijlani (rambij@gmail.com).

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