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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 …

19th August 2011, Friday

Paper money contains traces of BPA

Paper money may contain trace levels of bisphenol A (BPA), a chemical found in some plastics and other consumer products. But only small amounts of BPA are absorbed through our skin when we handle the money.

The study is published in Environmental Science & Technology. BPA is considered an endocrine disruptor, which means it looks or acts like a hormone in the body. It may be associated with behavioral and reproductive issues. Young children may be particularly vulnerable to these effects. As a result, many manufacturers have taken steps to eliminate the BPA in baby bottles and some sippy cups. The study analyzed BPA levels in 156 forms of paper money from 21 countries. All of them contained some BPA. The highest amounts of BPA were found in paper money from Brazil, the Czech Republic, and Australia. The lowest amounts of BPA were seen in paper money from the Philippines and Thailand. Levels of BPA in U.S. dollars were about average.

(Source: WebMD)

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Dr KK Aggarwal
Group Editor in Chief

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

Paper money contains traces of BPA

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    Photo Feature (From HCFI Photo Gallery)

National Conference on Insight on
Medico Legal Issue

Mr Siddarth Luthra presented his views on Medico legal record keeping in the recently concluded National Conference on Insight on Medico Legal Issue.

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


HbA1c test highly indicative of future diabetes in Asian Indian subjects: expert

Even as the world debates whether the three–month average of blood sugar (HbA1c) can be a tool to identify people at high risk of diabetes, a study from Chennai has shown that the test is highly indicative of future diabetes in Asian Indian subjects with impaired glucose tolerance (IGT). The study by A. Ramachandran et al, published in DiabeticMedicine last week, concluded that HbA1c could show who among the pre–diabetics would go on to develop diabetes later. Ramachandran, founder, India Diabetes Research Foundation, and A. Ramachandran’s Diabetes Hospital, explains that about 55 per cent of pre–diabetics (or IGT) in the Indian population go on to develop diabetes in the next three years. "The HbA1c will tell you which of the 55 per cent will go on from pre–diabetes to diabetes."

(Source: http://www.thehindu.com/health/policy-and-issues/article2366813.ece, August 18, 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)

A baby’s first 1,000 days ‘determines their health prospects for life’

You have encouraged them to eat their greens, battled to get them into the best school and sweated with them over their homework – all to give them the best start in life. But your children’s prospects may have been determined long before all the hard work. A growing body of research suggests the first 1,000 days of a child’s life – the nine months in the womb and the first two years out of it – are vital to their long–term health. That period can permanently affect everything from a child’s chances of developing diabetes or having a heart attack in old age, to their future weight and life expectancy. The theory was developed after decades of research by Professor David Barker and his colleagues at Southampton University. They believe there are a series of critical stages in a child’s development. If conditions are not perfect at each step, problems can occur later. Many of these danger points lie when the baby is still in the womb.

(Source: http://www.dailymail.co.uk/health/article–2026482/Babys–1–000–days–determine–health–prospects-life.html)

For comments and archives

Enzyme works for hard–to–treat gout

The intravenous enzyme pegloticase (Krystexxa) is an effective therapy for many people whose gout doesn’t respond to conventional treatment, researchers reported.

(Source: Medpage Today)

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Low–level, chronic hematuria in young signals later ESRD

Persistent, trace amounts of blood in the urine in teens and young adults may serve as a marker for future end–stage renal disease (ESRD), according to a large–scale, retrospective study.

(Source: Medpage Today)

For comments and archives

Needle before door safe for STEMI patients

It’s widely recognized that shortening "door–to–needle" time improves outcomes for STEMI patients, but starting lysis before the patient reaches the hospital may give an added edge. An analysis of seven pre–hospital fibrinolysis programs confirmed a low reinfarction rate –– ranging from 2.4% (France) to 5.8% (England/Wales) –– reported Thao Huynh, MD, MSc, from McGill Health University Center in Montreal, Quebec, and colleagues. Rates of in–hospital stroke also were low –– less than 2% of pre–hospital fibrinolysis patients (≤0.6% in most programs), according to the study in the August JACC: Cardiovascular Interventions.

(Source: Medpage Today)

For comments and archives

   Fitness Update

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

Cancer patients benefit from supervised exercise

According to the American Cancer Society, over 560,000 deaths were caused by cancer in 2010. While the death toll remains high, new reports show that cancer survival rates have increased over the past several years due to better treatments, fewer side effects and better quality of life while they are receiving treatment for cancer. In a study recently conducted at the University of Waterloo in Ontario, Canada, researchers explored the effects of an exercise program on individuals receiving treatment for various forms of cancer. The five–year study included 386 cancer patients who took part in a supervised exercise program while undergoing cancer treatment. The exercise program involved two weekly sessions for a total of 12 weeks; sessions involved aerobic exercise, resistance training and stretching. Researchers conducted physical assessments before and after each session and collected survey information to assess changes in quality of life. The data clearly indicate that a physical activity program involving cardiovascular exercise, resistance training and flexibility significantly improves physical function and various measures of quality of life in people undergoing treatment for cancer as compared with people who are not active while undergoing treatment.

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   Twitter of the Day

@DrKKAggarwal: #eMedinews WHO declares end to global swine flu pandemic "The World Health Organization is declaring an end to… fb.me/ExEHEWLX

@DeepakChopra: #vmdhealthblog How does stress alter our brain? I am explaining it in my Health Tip. bitly.com/Dpak_Stress

    Dr KK Answers

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

AskDrKK: How do heart blockages in young present?

DrKKAnswers: Clinical presentation in young is different from that in older patients. Most do not experience heart pain, angina and majority come with threatening heart attack or classical full blown heart attack.

For comments and archives

    Spiritual Update

Get freedom from lifestyle disorders

British are out and now get azadi from life style disorders: Forget the past as a history and live in the present. Celebrate 15th August every year as day of independence from eradicable diseases. Every year on 15th August the Prime Minister should announce a ‘Quit’ India Movement for a particular disease.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

An essay on happiness

One essential standard for living is being able to be happy. Happiness can be found in many different forms. It can be found with the purchasing of inanimate objects that better our living styles or it can be found with someone else that you associate with. The latter is the more imperative of the designs of happiness. In order to be truly happy you need to be able to understand that everything is good within your own life and that you are able to be happy with the people that are in your life and the people that influence how you live your daily life.

Happiness is all of the good that someone experiences combined into one emotion. This emotion can, and usually does, bring out the best in people. For someone to be happy they need to know that everything that has happened in their past has happened for a reason and that it has happened in order for them to become a better person. Not only does it make them a better person but it also makes them realize how good they have it or can possibly have it.

Although things might be hard to deal with at the moment, people need to realize that they will be able to learn from their experiences and that they will learn to take the good from them all. In the end, the hard times will help people strive for happiness. Happiness isn’t free. You have to earn it and work to keep it. The price for happiness is having to suffer and having to question events that occur during one’s life. People need to be able to adapt to their surroundings so that they can get the best out of them. You can’t live your life in fear of what can go wrong. You just need to go out and live your life to the fullest and know that you’ll be happy, even if something doesn’t go the way that you had planned it to.

The best kind of happiness is when you know that you are able to care for someone and that they may care about you. They may just be your friends but you care about them enough that you want what is best for them and in return they want the same for you. This kind of happiness is of the purest form. It is an unspoken agreement between people that says that each of you will do whatever they can to make the other person happy and that in this process you, yourself, will be able to be happy and enjoy the moment.

Happiness may come and go like the seasons but in the end, every moment that you have that is filled with happiness will be well worth the sad or unnerving ones that you have had to endure.

For comments and archives

    Gastro Update

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

How and when does Alagille’s present?

Jaundice, a yellow coloring of the white of the eyes and then the skin, is usually the first sign. It mostly occurs before 6 months of age but sometimes is not noticed up to the age of 3 years.

For comments and archives

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

C02 (total)

Increased: Respiratory acidosis, compensation for metabolic acidosis, severe vomiting, primary aldosteronism, volume contraction, emphysema
Decreased: Respiratory alkalosis, starvation, diabetic ketoacidosis, lactic acidosis, alcoholic ketoacidosis, severe diarrhea, renal failure, drugs (salicylates etc), dehydration.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient on ACE inhibitors wanted to know whether he could take aspirin.
Dr. Bad: No, you cannot take aspirin.
Dr. Good: It can be given if it is a must.
Lesson: Though some evidences suggest that aspirin inhibits the acute affect of ACE inhibitors, most of the evidence do not support an inhibitive affect of aspirin on the long term outcome of ACE inhibitors.

For comments and archives

Make Sure

Situation: A patient with suspected heart attack with blood pressure of 40 mm Hg with warm peripheries died.
Reaction: Oh my God! Why was a diagnosis of anaphylaxis not considered?
Lesson: Make sure all patients with warm shock are managed on the lines of sepsis or anaphylaxis. Heart attack will have cold shock.

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  Quote of the Day

(Dr Chandresh Jardosh)

A true Quote…!!
If silence is meant to be the best for all situations…… then why do we all get so hurt when people don’t talk to us?


(Ms Ritu Sinha)

Eighty Six: A certain item is no longer available. Or this idiom can also mean, to throw away.

    G P Pearls

(Dr Pawan Gupta)

LABA should not be used with out inhaled corticosteroids.

    Medicolegal Update

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

Resuscitation injuries in postmortem report

It is essential to consider the entire history along with autopsy findings during a death investigation by the forensic doctor and legal agency.

  • Soft tissues injuries nail marks, contusions ribs fracture are common in both adults and children who have undergone cardiopulmonary resuscitation; however, potentially life–threatening injuries are very rare.
  • The doctors performing the resuscitation go through a very exhaustive cycle of CPR and generally forget to put a note after resuscitation particularly if resuscitation is followed by death. Hence a format of resuscitation details should be kept attached to clinical sheet by the doctors.
  • The pre–arrest history in a resuscitated adult often assists the doctor conducting the autopsy to interpret findings related with resuscitation.
  • In infants or children, there may not be a reliable history. In this situation, it may be difficult if not impossible to distinguish resuscitation injuries from pre–existing accidental or inflicted trauma.
  • It has been seen in some cases that there were significant autopsy–documented injuries initially attributed to abuse like contusions and nail marks produced during resuscitation. The State filed murder charges against the caretaker in each case. However, further history and review of the medical records suggested that resuscitation rather than pre–arrest trauma caused almost all of the injuries. The State dismissed the charges in the first case. A western jury returned a "not guilty" verdict in the second.
  • The Honorable Delhi high court recently has also given an acquittal on the benefit of doubt in a case of alleged murder by strangulation where CPR has been given.

For comments and archives

    Mind Teaser

Read this…………………

What is VLP

a. very large particle
b. very long peptide
c. virus like particle
d. virus like protein

Yesterday’s Mind Teaser: Patients of rectovaginal fistula should be initially treated with:

1. Colostomy
2. Primary repair
3. Colporrhaphy
4. Anterior resection

Answer for yesterday’s Mind Teaser: 2. Primary repair

Correct answers received from: Dr Chandresh Jardosh, Dr K Raju, Dr Muthumperumal Thirumalpillai, Dr Neelam Nath, Dr Jainendra Upadhyay, Dr Anil Bairaria, Dr Anupam.

Answer for 17th August Mind Teaser: Out in left field
Correct answers received from: Dr Prabhat, Dr Shreyesh, Dr Priya, Dr Gautam, Dr Gaurav, Dr Pradeep, Dr Shashank.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr Chandresh Jardosh)

Kid: Why are some of your hair white, dad?
Dad: Everytime you make me unhappy, one of my hair turns white.
Kid: Now I understand why grandpa’s hair are all white..!

For comments and archives

    Drug Update

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

Drug Name
DCI Approval Date
Dexketoprofen 50mg + Dicyclomine 20mg per 2ml Injection
For the treatment of acute colicky pain in adult patients
    Public Forum

(Press Release for use by the newspapers)

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Formula of three for hunger strike and Satyagraha

Rough formula of 3 is that one cannot live for three minutes without air, three days without water and three weeks without food said Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and President MTNL Perfect Health Mela.

But this formula is for healthy muscular and fatty people. People who are in their extremes of ages or are suffering from a chronic ailment, pregnant ladies, diabetics should not fast without a doctor’s clearance.

Dr Aggarwal said that a large number of people are joining Anna Hazare for fast. All are not fit and may lose health. Medically observed spiritual fats can be helpful for the body but prolonged unsupervised fast can be life risky. Here are some facts:

  1. Fasting is willingly abstaining from some or all food, drink, or both, for a period of time.
  2. An absolute fast is abstinence from all food and liquid for a defined period.
  3. Partially restrictive fast is limited to particular foods or substances.
  4. The fast may be intermittent in nature.
  5. Fasting medically means the metabolic status of a person who has not eaten overnight, and to the metabolic state achieved after complete digestion and absorption of a meal. A person is assumed to be fasting after 8–12 hours of eating.
  6. Metabolic changes after fasting begin after absorption of a meal (typically 3–5 hours after a meal). Medically it is called "post–absorptive state" as against "post–prandial" state of ongoing digestion.
  7. A diagnostic fast refers to prolonged fasting (from 8–72 hours depending on age)
  8. The longest known fast for a human is 132 days (without food).
  9. Glucose is the body’s primary fuel source and is essential for the brain’s functioning. When denied glucose for more than 4–8 hours, the body turns to the liver for glycogen, a storage form of glucose, to be used for fuel. A process called glycogenolysis converts glycogen into a usable form of fuel. At this point, the body also uses small amounts of protein to supplement this fuel. This fuel will last for up to 12 hours before the body needs to turn to glycogen stored in muscles, lasting for a few more days.
  10. If glucose is still denied at this point, muscle wasting is prevented by temporarily switching to fat as the fuel source, meaning fat is converted into ketone through catabolism. Ketones, while not sugars, can be used by the brain as a fuel source as long as glucose is denied. The body continues to use fat for as long as there is fat to consume.
  11. If the fast is not broken, starvation begins to occur, as the body begins to use protein for fuel.
  12. Health complications associated with fast–induced starvation include electrolyte imbalances, thinning hair, cardiac arrhythmias and renal failure. Death can occur if fasting is pursued to the point of complete starvation.
  13. Hypovolemia refers to any condition in which the extracellular fluid volume is reduced. It can be produced by dehydration.

For comments and archives

    Readers Responses
  1. Most ‘First Class’ students get technical seats, some become Doctors and some Engineers. The ‘Second Class’ pass, and then pass MBA, become Administrators and control the ‘First Class’. The ‘Third Class’ pass, enter politics and become Ministers and control both. Last, but not the least, The ‘Failures’ join the underworld and control all the above. Regards: Dr Chandresh Jardosh.
    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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