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


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  Editorial …

23rd October 2011, Sunday

October breast cancer awareness month

  1. Breast cancer can occur in women who have no identifiable risk factors.
  2. An average woman has 10 to 15 percent chance of developing breast cancer if she lives into her 90s.
  3. The risk of breast cancer in a woman with a strong family history who has inherited one of the genes (BRCA1 and BRCA20) that predispose her to breast cancer is over 50 percent.
  4. The primary risk factor for breast cancer is older age.
  5. Over 85 percent of cases occur in women 50 years of age and older.
  6. Only 5 percent of breast cancers develop in women younger than age 40.
  7. Women over age 50 should be screened for breast cancer every year.
  8. Breast cancer screening of women in their 40s and over the age of 70 is controversial.
  9. Women with family history of breast or ovarian cancer are at a higher risk.
  10. Women with strong family history (two or more first-degree relatives (a mother, daughter, or sister) with breast or ovarian cancer, particularly before menopause) have a greater than 50 percent chance of developing breast cancer.
  11. Women who have had cancer in one breast have an increased risk of developing cancer in the other breast. This is especially true if a woman has an inherited BRCA mutation.
  12. Estrogen stimulates cells of the breast's glandular tissue to divide. The longer a woman is exposed to estrogen, the greater her risk for breast cancer.
  13. Estrogen exposure is increased if a woman began menstruating at or before 11 years of age, or if she experiences menopause at age 55 years or older.
  14. Women who have never given birth are more likely to develop breast cancer after menopause than women who have given birth multiple times.
  15. Women who have their first full-term pregnancy at the age of 30 years or older have an increased risk of breast cancer.

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 on

Science Behind Hanuman Chalisa chopia 31-40

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011
Divya Jyoti Inter Nursing Festival

Divya Jyoti, the inter-nursing college/school competition, was held on 21st October 2011 at NDMC Ground, Laxmi Bai Nagar. Nurses from various colleges took part in it and spread the message of Non-Violence.

mela 2011
    National News

Record Rs 1.73 crore payout in medical negligence case ( TOI News)

The National Consumer Disputes Redressal Commission (NCDRC) on Friday ordered that a compensation amount of Rs 1.73 crore should be paid to the US-based husband of a child psychologist who died in Mumbai due to medical negligence. This is perhaps the highest compensation amount ordered by the commission for such negligence, however the three guilty doctors and a hospital, all Kolkata-based, will have to pay only Rs 1.34 crore after reductions ordered by the Supreme Court.

The complainant, Dr Kunal Saha, said he and his wife Anuradha, 36, were of Indian origin and settled in the US. Anuradha was pursuing a PhD in a university there. In April-May 1998, they were holidaying in Kolkata when Anuradha contracted Toxic Epidermal Necrolysis, which the NCDRC termed a "rare and deadly disease". A TEN patient loses the epidermis in layers and the exposed lower skin must be treated like a superficial burn wound. One out of 1.3 million people a year get TEN, the commission observed.

Anuradha showed symptoms of rashes over her body and received treatment as an outdoor patient until May 10, 1998. On May 11, 1998 she was admitted to the Advanced Medicare and Research Institute (AMRI) in Kolkata, where she was treated till May 16, 1998. As her condition didn't improve, she was then shifted to a hospital in Mumbai via an air ambulance. She died on May 28, 1998 following complications from an alleged overdose of steroid that had been administered in Kolkata.

Saha said the doctors and hospitals who treated Anuradha were grossly negligent and deficient in service, which led to her death. He issued legal notices to 26 people demanding compensation. In March 1999, he filed a petition before the NCDRC demanding Rs 77 crore from Dr Sukumar Mukherjee, Dr B Haldar, Dr Balram Prasad, AMRI, Dr Abani Roy Chowdhury (physician), a plastic surgeon and the AMRI directors. He also demanded Rs 25.3 crore from the hospital in Mumbai, but this complaint was later withdrawn. The NCDRC said the claim, totalling Rs 102 crore, was perhaps the highest ever claimed for medical negligence before any consumer forum in India.

The doctors and the hospital denied the allegations and in June 2006 the commission dismissed Saha's complaint. Kunal's brother-in-law had also filed a criminal complaint, but the Kolkata high court acquitted the doctors. Subsequently, appeals were filed in the Supreme Court in both the criminal and civil (consumer commission) cases. While the SC upheld the acquittal of the doctors in the criminal appeal, it decided in favour of Saha in the civil case and sent the matter back to the commission for determination of compensation. The SC ruled Mukherjee, Haldar, Prasad, Chowdhury and AMRI were guilty of medical negligence leading to Anuradha's death.

The commission considered various factors, like compensation for mental agony, costs incurred in litigation and medical expenses, and concluded that the amount payable to Saha was Rs 1.73 crore. However, following SC directives, the commission deducted 10% on account of Saha's interference during Anuradha's treatment. Furthermore, the Rs 25.93 lakh payable by Chowdhury was deducted after the Supreme Court gave its verdict.

While Mukherjee and AMRI, will have to pay Saha Rs 40.4 lakh each, Haldar and Prasad will each have to pay Rs 26.93 lakh. The total amount Saha will receive will be Rs 1.34 crore.

On the compensation amount originally claimed by Saha, the NCDRC said that it appeared that Saha was going by the law and practice prevalent in countries like the US, where the couple was settled. "At the outset, we must hold that this commission cannot take into account the system of award of compensation in other countries and it must necessarily confine the consideration of this question having regard to the law as has been settled by the Supreme Court through catena (series) of decisions and which is in vogue in our jurisdiction and has stood the test of time," the commission said.

For Comments and archives

Letrozole, anti cancer drug used for treatment of infertility banned

The government has banned the use of anti-cancer drug letrozole for induction of ovulation in anovulatory infertility with immediate effect. Letrozole is an approved drug for the treatment of breast cancer in India. It has been used in infertility as a non approved indication. The drug is banned because its use for induction of ovulation is likely to involve risk to human beings and safer alternatives to the said drugs are available. But it will continue to be available for treatment of cancer.

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)

FDA Okays Byetta plus Insulin Glargine

The FDA has approved a new indication for the type 2 diabetes drug exenatide (Byetta) as an add-on therapy with insulin glargine, diet, and exercise for adult patients. The indication's approval makes the drug the first GLP-1 receptor agonist available for use with insulin glargine, and with or without the use of metformin or a thiazolidinedione, to achieve glycemic control, according to a statement from co-developers Amylin Pharmaceuticals and Eli Lilly. (Source: Medpage Today)

For comments and archives

ASRM: IVF first may work better for older women

Bypassing superovulation steps and proceeding directly to in vitro fertilization (IVF) technology appears to improve pregnancy outcomes for older women who have unexplained infertility, researchers reported here (annual meeting of the American Society for Reproductive Medicine) (Source: Medpage Today)

For comments and archives

Study finds no cell phone-brain cancer link

For those who remain unconvinced, a team of Danish researchers reported that long-term data do not support a link between use of mobile phones and risk of brain cancer. During an additional five years of follow-up, there was no association between central nervous system tumors and subscription to a mobile phone service, Patrizia Frei, PhD, of the Danish Cancer Society, and colleagues reported online in BMJ. (Source: Medpage Today)

For comments and archives

AAP: Urinary stones in kids on the rise

The frequency of pediatric urolithiasis more than doubled over an 8-year period at a large children's hospital and the pediatric urologists have yet to find a reason for the increase. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Confidence comes naturally with Success But, Success comes only to those, who are Confident So, Begin your day with great confidence.

@DeepakChopra: :: #CosmicConsciousness We are the eternal possibility, the immeasurable potential of all that was, is, and will be.

    Spiritual Update

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

Three Types of Vedanta Thoughts

There are three main Vedanta schools of thoughts: Dualistic or Dvaita, Qualified Monism or vishistha Advaita, and Advaita Vedanta or Absolute monism. All these perceptions are true. All expound the relationship between the individual Jiva (soul), this world or nature (Jagat) and the Ruler of the universe or God (Spirit or Brahman).

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

Monetary Reminder

Imagine there is a bank, which credits your account each morning with £86,400, carries over no balance from day to day, allow you to keep no cash balance, and every evening cancels whatever part of the amount you had failed to use during the day. What would you do? Draw out every penny, of course!

Well, everyone has such a bank. Its name is Time.
Every morning, it credits you with 86,400 seconds. Every night it writes off, as lost, whatever of this you have failed to invest to good purpose. It carries over no balance. It allows no overdraft. Each day it opens a new account for you. Each night it burns the records of the day. If you fail to use the day's deposits, the loss is yours.

There is no going back. There is no drawing against the "tomorrow."

Therefore, there is never not enough time or too much time. Time management is decided by us alone and nobody else. It is never the case of us not having enough time to do things, but the case of whether we want to do it.

For comments and archives

    Fitness Update

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

New research evaluates the "talk test"

How can you tell when you're exercising at the right intensity? According to the American College of Sports Medicine guidelines, moderate-intensity physical activity means working hard enough to raise your heart rate and break a sweat, yet still being able to carry on a conversation. However, some experts have speculated that if you're able to speak comfortably, you're probably not working hard enough. A study was recently conducted at the University of New Hampshire to determine whether the "talk test" is a suitable way to determine exercise intensity. For the study, fifteen participants performed a series of treadmill exercises at different intensities. They were asked to recite the Pledge of Allegiance during the various exercise bouts and rate then their comfort level while speaking. They could choose either, "comfortable," "not sure," or "not able to speak comfortably." Researchers also measured various physiological markers, fatigue, and heart rate. They found that the talk test was a very accurate way to determine whether participants were engaging in moderate or intense exercise. If participants were able to speak comfortably, they were exercising at a moderate pace, which helps improve fitness levels.

For comments and archives

    Malaria Update

AC Dhariwal, Hitendrasinh G Thakor, Directorate of NVBDCP, New Delhi

What the National Drug Policy of India says

What are general recommendations for the management of uncomplicated malaria:

  • Avoid starting treatment on an empty stomach.
  • Give the first dose at the health facility and observe the patient for 15 minutes to check for vomiting.
  • Explain the follow up treatment, check that the patient has understood. Explain that the patient often feels better after a few doses, but that the treatment must be completed, otherwise the malaria may return, becoming even worse.
  • The patient should report back, if there is no improvement after 24-72 hours, if the situation gets worse or the fever comes back.
  • Explain that regular use of a bed net (preferably insecticide treated) is the best way to prevent malaria.
  • Even in confirmed cases, the patient should be examined for concomitant conditions. In young children, malaria often occurs together with other infections, especially bacterial pneumonia.

For comments and archives

    Medicine Update

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

What occupations have increased risk of hepatitis C?

The risk of acquiring hepatitis C from the workplace depends on the amount of exposure to human blood or blood products and needlestick injuries. In general, occupational groups with increased risk include workers such as dentists, nurses, and laboratory personnel who are repeatedly exposed to human blood and who are at risk of needlestick injuries.

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  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Categories of Anemia

Macrocytic/normochromic anemia (increased MCV, normal MCHC)

  • Folate deficiency (common)
  • B12 deficiency (common)
  • Myelodysplastic syndromes (not uncommon, especially in older individuals)
  • Hypothyroidism (rare)

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A 50–year–old male came with early morning onset of acidity.
Dr. Bad: Take an antacid.
Dr. Good: Get an ECG done.
Lesson: Onset of acidity after the age of 40 unless proved otherwise is acute coronary event.

For comments and archives

Make Sure

Situation: A patient of gross ascites presents with complaints of difficulty in breathing on lying down. Reaction: Oh my God! Why did you drain so much ascitic fluid?
Make sure, to evaluate the patient thoroughly and only moderately tap the ascitic fluid since overenthusiastic tapping can be life threatening.

For comments and archives

  Quote of the Day

(Dr GM Singh)


"Watch out! Be on your guard against all kinds of greed; a man's life does not consist in the abundance of his possessions.


Skid Row: The rundown area of a city where the homeless and drug users live.

    Mind Teaser

Read this…………………

What word in the English Language is always spelled incorrectly?

Yesterday’s Mind Teaser:
Which of the following is not true of Gardasil?

  1. It is an HPV-6,11,16,18 VLP vaccine.
  2. ACIP recommends it for males and females aged 9 to 26 years.
  3. Pap test result does not influence the decision to vaccinate.
  4. Three doses are given for vaccination.

Yesterday’s Mind Teaser: b. ACIP recommends it for males and females aged 9 to 26 years

Correct answers received from: Dr.Prof H.L. Kapoor, Dr Subash, Dr Ravi, Dr Arpit, Dr Bhavan, Dr Deepti, Dr Jagat, Dr Saumesh, Dr Pritam, Dr KS Bahgat, Dr Priya, Dr Yamini

Answer for 21st October Mind Teaser: c. The percentage of screening tests that are positive among patients who remain unaffected by the condition of interest after screening.

Correct answers received from: Dr.Prof H.L. Kapoor, Dr Jainendra Upadhyay, Neelam Nath, Dr.Anil Kumar Jain, Dr Anshu Sharma, Dr. P. C. Das

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr. Anil Kumar Jain)

2 naughty boys

Two little boys, aged 8 and 10, are excessively mischievous. They are always getting into trouble and their parents know all about it. If any mischief occurs in their town, the two boys are probably involved.

The boys' mother heard that a preacher in town had been successful in disciplining children, so she asked if he would speak with her boys. The preacher agreed, but he asked to see them individually. So the mother sent the 8 year old first, in the morning, with the older boy to see the preacher in the afternoon.

The preacher, a huge man with a booming voice, sat the younger boy down and asked him sternly, "Do you know where God is, son?" The boy's mouth dropped open, but he made no response, sitting there wide-eyed with his mouth hanging open. So the preacher repeated the question in an even sterner tone, "Where is God?!" Again, the boy made no attempt to answer. The preacher raised his voice even more and shook his finger in the boy's face and bellowed, "Where is God?!"
The boy screamed and bolted from the room, ran directly home and dove into his closet, slamming the door behind him.
When his older brother found him in the closet, he asked, "What happened?"
The younger brother, gasping for breath, replied, "We are in BIG trouble this time." ("I just LOVE reading next line again and again")
"GOD is missing, and they think we did it !"

    Medicolegal Update

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

How will a doctor diagnose a fabricated bruise?

Some irritant substances like juice of marking nut, used by washer men for marking the clothes is generally used to create false bruise. Juice of marking nut when applied to the skin produces injuries, which look like a bruise.

  • Fabricated bruise is self-made or false injury produced by a man or woman itself or by the help of some person with malign intention to make false allegation of being injured by someone for framing someone in false criminal offences.
  • These false contusions are produced with a malign intention to support a false allegation or charge of criminal infliction of injury and are seen in many occasions in medical practice. These juices are also used to produce false bruises in female private parts, arms pits to make a false allegation of rape.
  • These injuries are very superficial and on close examination are found to be granulated. They are always present on accessible parts of the body; but, in same cases, false bruise may be created on non-accessible part of the body, mostly with the help of somebody.
  • The false bruise is usually very small in size, may be multiple in numbers with absence of continuity in each other and can be differentiated on examination.
  • The color photographs of injuries should be taken as a part of medico legal report.
  • If the examining doctor is in a dilemma about false bruise, he must refer the case to a forensic doctor for further medicolegal opinion.

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)

Over 200,000 Visit MTNL Perfect Health Mela 77,000 have checkups

Around 200.000 people including a large number of students visited various events at the MTNL Perfect Health Mela 2011 organized by Heart Care Foundation of India in association with various government and non governmental bodies at Laxmi Bai Nagar, said Dr. K K Aggarwal, Padma Shri and Dr B C Roy National Awardee, President Heart Care Foundation of India & MTNL Perfect Health Mela.

Heritage Inter Classical Dance School Competition One of the highlights of the Mela was ‘LIC Heritage’, an inter classical dance school competition where Bharatnatyam, Odissi and Kathak competitions were organized. Mrs. Komlavardhan Padma Awardee and Bharat Natyam Dancer and one of the Judges said that classical dancing is like meditation and reduces chances of future heart attacks.

College students enjoy medicomasti at Health Mela

Over 2500 students of 22 colleges including Medical, Pharmacy, Homeopathy and Business schools participated in Medico Masti, an inter Youth Festival.

Dr. Aggarwal said that the right way to motivate and change the lifestyle of the youth is to pass on health ‘sutra’ messages to them. Events like Mehendi (Indian Culture), Poster Making (On the Spot), Choreography (Health is Wealth), Fashion Show (Gandhigiri) and Rockband (Harmony) were organised. Students from various colleges participated in these non-stop competitions where prizes were also given on the spot.

The students were advised here today by their senior colleagues to be soft spoken, punctual in appointments and attend to their patients always with a smile on their face.

It was pointed out that doctors should write the prescription and the case history legibly without reflecting even an iota of doubt.

Self use of drugs at any cost should be avoided. Even one tablet of painkiller in patients with underlying kidney problems can precipitate kidney failure. No drug is safe and hence should not be taken without medical prescription.

Basic causes of a disease apart from external factors constitute mental factors like fear of death and unanswered worries.

Doctors were appealed to tackle patients with love and not to over prescribe and prescribe unnecessary drugs which may have side effects.

Mr. Satish Goell Chairman Mujaffar Nagar Medical College said that definition of health is incomplete without mental relaxation. Relaxation helps in preventing or tackling lifestyle disorders. One should listen to music for 20 minutes every day for inner peace and happiness.

Dr A K Aggarwal, Dean MAMC and Dr SS Agrawal Prof DIPSAR in their messages said that failing the high level of stress among the practicing doctors, the budding doctors feel that fun, recreation and masti should be a part and parcel of medical education.

Events like fashion show, choreography, western dance, Indian dance, classical dance, T-shirt painting, pot painting, mehendi, etc were organised.

Free heath checkups were arranged at the Mela premises where blood pressure, ECG, echocardiography and eye examinations were held. Over 77,000 have benefited from the checkups so far. Free medical counselling and consultation were also provided by doctors to the public who have been coming from all over the city and outside.

It was observed that high blood pressure, high cholesterol and hypothyroidism are quite rampant in the city and need immediate medical attention.

Certain measures to reduce weight were also given. Any vegetable which is green in colour like Karela, Neem, Bhel is helpful in reducing the weight and any eatable which can be broken into two equal parts like pulses and Rajma if taken after boiling will be helpful in reducing gas. The visiting public was told to discourage the consumption of junk and unnatural fast foods. Uncontrolled and indiscriminate use of food additives may also pose health hazards. The basic guidelines still remain to prefer a food which is more near natural, seasonal and fresh. In fact, anything which is refined is unnatural and may be unhealthy.

Poor knowledge about vaccine: In a quiz vaccine survey at the Mela it was found that the public had poor knowledge about adult vaccination. Even adults need to be vaccinated : Typhoid – every 3 years; Tetanus injection – every 10 years; Hepatitis – 0, 1-2 months, 4-6 months; Pneumonia – every 5 years and Flu – every year. If all heart patients take flu vaccination the mortality can be reduced to a substantial degree, added the experts.

Mr. S.P. Aggarwal, Former Principal Secretary (Health), Government of Delhi, said that the seeds of heart diseases are born in the adolescence. He said that in the youth, one should not eat artificial junk food as it ultimately leads to high blood sugar, blood pressure and diabetes.

Mr. N B Sathe, Zonal Manager, LIC of India visited Perfect Health Mela and said that everybody should have their life insurance done for the safety and security of their family. The chairman of MTNL, Mr. Kuldeep Singh, visited the health mela and addressed a gathering. He said that doctor and patients should use more and more of electronic communication for better and efficient patient care.

Dr. N K Yadav MHO MCD said that lifestyle disorders are on the rise in the country in general and Delhi in particular. He showed concern about the rising lifestyle disorders amongst middle class and upper lower class people. Eating junk food and not exercising are the two main reasons which are affecting this population. MCD is also doing a general public survey and distributing iron tablets to people with anemia.

For comments and archives

    Readers Responses
  1. Great work,sir, every one in my house enjoys it daily. God bless you sir. Regard: Dr Surya
    Forthcoming Events

18th MTNL Perfect Health Mela

Date: 14th–18th October
Different locations in Delhi
19th–23rd October
Venue: NDMC Ground, Opp. Indira Nari Niketan Working Girls Hostel
Near Philanji Village, Laxmibai Nagar, New Delhi
Theme: Science Behind Rituals

For More Details


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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