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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; 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…
Nobility of medical profession Video 1 to 9 Health and Religion Video 1–7
DD Take Care Holistically Video 1–4 Chat with Dr KK On life Style Disorders
Health Update Video 1–15 Science and Spirituality
Obesity–Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

29th August 2012, Wednesday

Jalneti Linked to Rare Brain Disease

A rare brain disease previously seen mainly in swimmers is now turning up in some people who do Jalneti.
Jonathan S. Yoder, MSW, MPH, an epidemiologist from the National Center for Emerging and Zoonotic Infectious Diseases at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, and colleagues studied 2 cases of primary amebic meningoencephalitis (PAM) that occurred in patients who irrigated their sinuses with neti pots and contaminated tap water. The authors report their findings in an article published online August 23 in Clinical Infectious Diseases. (Medscape)

PAM is caused by Naegleria fowleri, a free-living ameba that feeds on bacteria and is often found in natural bodies of warm freshwater. It thrives in warm water (up to 45°C) and most often infects swimmers by traveling up the nose, along the olfactory nerve, through the cribriform plate, and to the brain, killing its victim within about 5 days.

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

Tattoos to warn of medical conditions

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Workshop for Teachers on Proper Hygiene in schools

Heart Care Foundation of India and DAV School, Kailash Hills organized a workshop on health and hygiene . Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India, said that school education must focus on health and hygiene.

Dr K K Aggarwal
    National News

(Dr GM Singh)

Eminent NRI heart surgeon Dr Mukesh Hariawala to unveil 'revolutionary' cardiac technologies in India

New Delhi, Aug 25 (ANI): Harvard-trained, eminent Indian-American Heart Surgeon and Research Scientist Dr Mukesh Hariawala will deliver the keynote lecture on receipt of this years prestigious “India's Most Admired Surgeon” award in Mumbai on 21st Sept, to be presented by Maharashtra Governor K Sankaranarayan.
The event will see the national launch of 3 new revolutionary cardiac technologies, Dr Hariawala's pioneering Triple Heart Therapy (Angiogenesis + Stem Cells + Laser) best done in a “Hybrid Operation Suite" , VAD (Ventricular Assist Device) and Non Invasive Shockwave Therapy in India. The FDA or CE mark approved VADs, which will be offered to patients as an alternative to Heart Transplantation, has a cumulative worldwide Implantations record which has crossed 10,000. The "Optimal VAD for India" would be one that has a good track record of reliability, minimal complications and competitive shelf price.

Elaborating on the long life lithium ion battery operated VADs which play the role of a Mechanical Artificial Heart, Dr Hariawala told ANI in an exclusive interview that VAD is only for patients who are in advanced stage heart failure and who do not qualify as patients for routine angioplasty, stent or bypass surgery. VAD patients following implantation will be able to ambulate and begin enjoying an improved quality of life with certain restrictions, he said.

Storz Medical's unique “MODULITH - SLC Shock Wave" Non - Invasive system has an excellent record with CE certification that employs the principles of “Therapeutic Angiogenesis". This easy to deliver technology is ultrasound image guided. The controlled targeted level of shock wave energy stimulates the release of cellular growth factors like VEGF helping in formation of micro blood vessels from pre existing ones. This resultant effect is provision of a large pool of oxygen rich collateral vessel network which supports circulation to the failing heart, thus giving early relief of angina related symptoms. The advantage of this technology is negligible incidences of procedural complications, and is best suited for most Indian patients who have diabetes, diffused extensive non bypass-able coronary artery disease and who are in need of repeat bypass surgery but are high risk subjects. The well established EECP (External Enhanced Counter Pulsation) technology works on the same principle using inferior extremity cuffs.

Boston, US based Dr Mukesh Hariawala is also a Visiting Honorary Cardiac Surgeon at Mumbai's Jaslok Hospital. In addition to performing open heart surgery on many worldwide celebrities, Dr Hariawala along with Dr John Wright had performed the first Bypass operation in London on Prime Minister Dr Manmohan Singh in 1990. (ANI)

For comments and archives

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

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Mixed carotid IMT results of treating diabetic patients with insulin glargine and PUFAs: GRACE

Treating patients with dysglycemia at high risk for cardiovascular disease with polyunsaturated fatty acids (PUFAs) failed to halt the progression of atherosclerosis as assessed by carotid intima-media thickness (IMT), while treatment with insulin glargine in the same patient population showed a trend toward benefit with two IMT measurements of the common carotid artery but failed to show any reduction in a 12-segment maximum carotid IMT measurement--the study's primary end point. These are the conclusions of the Glucose Reduction and Atherosclerosis Evaluation (GRACE), a substudy of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial. The study was presented here at the European Society of Cardiology 2012 Congress. (Source: Medscape)

For comments and archives

Spotlight shifts, again, to anti-inflammatories for cutting CV Risk

It's time to shift some of the attention paid to lipid-lowering drugs onto therapies that fight vascular inflammation, according to a number of experts speaking on the opening day of the European Society of Cardiology (ESC) 2012 Congress. Statin and aspirin studies tracking markers of inflammation show that "the magnitude of this disease associated with inflammation is at least as large as that of lipids or blood pressure," said Dr Paul Ridker (Brigham and Women's Hospital, Boston, MA). (Source: Medscape)

For comments and archives

Asthma worsens with step-off therapy

Discontinuation of long-acting beta-agonist therapy in patients whose asthma is well controlled is associated with a worsening of symptom control and quality of life, a systematic review suggested. (Source: Medpage Today)

For comments and archives

ESC: Aliskiren onboard no help in T2D

When added to monotherapy with either an ACE inhibitor or an angiotensin receptor blocker (ARB), aliskiren (Tekturna) did not improve outcomes in patients with type 2 diabetes who had high cardiovascular and renal risk, the prematurely halted ALTITUDE trial showed. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Relieve Stress by Changing the Interpretation

@DeepakChopra: Close your eyes, set your intent in your heart and take a few minutes to yourself with the meditator.

    Spiritual Update

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

Heat and Cold Therapy

  1. Cold application with ice packs, malleable chemical gel packs, and vapocoolant sprays may reduce muscle spasm, inflammation, and edema (1-3).
  2. It causes initial vasoconstriction, followed by vasodilation.
  3. Various superficial and deep heating methods are applied to control pain and are popular among cancer pain

For comments and archives

    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

How are the sexual dysfunction and infertility inter-related?

Sexual dysfunction may cause problems getting pregnant (infertility). The right time for sexual activity is when the egg is released from the ovary (ovulation). Determine the time of ovulation by your partner's menstrual history or by the use of a urine test that becomes positive when the hormone that triggers the egg to be released can be detected. If you cannot or do not have sex near that time, the woman is less likely to get pregnant. If you only have sex once in a while because of low sexual desire or pain during sex, you may miss that important time for pregnancy. Men who have erectile dysfunction or ejaculatory dysfunction will not be able to get their partner pregnant.

For comments and archives

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

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Multiple red blood cells transfusion

  • Multiple transfusions are repeated transfusions of red blood cells over a long period of time.
  • Patients who receive multiple transfusions are particularly at risk of acute febrile reactions. With experience these can be recognized, so that transfusions are not delayed or stopped unnecessarily.

For comments and archives

    An Inspirational Story (Ms Ritu Sinha)

Human value

Life is full of ups and downs. It is easy to lose hope and confidence. This little story helps us to realize that no matter what happens, we remain valuable as individuals.

A well known speaker started off his seminar by holding up a $20 bill. In the room of 200, he asked, “Who would like this $20 bill?” Hands started going up.

He said, “I am going to give this $20 to one of you but first, let me do this.” He proceeded to crumple the dollar bill up. He then asked, “Who still wants it?” Still the hands were up in the air.

“Well,” he replied, “What if I do this?” And he dropped it on the ground and started to grind it into the floor with his shoe. He picked it up, now all crumpled and dirty. “Now who still wants it?” Still the hands went into the air.

“My friends, no matter what I did to the money, you still wanted it because it did not decrease in value. It was still worth $20.

Many times in our lives, we are dropped, crumpled, and ground into the dirt by the decisions we make and the circumstances that come our way.

We feel as though we are worthless. But no matter what has happened or what will happen, you will never lose your value. You are special – Don’t ever forget it!”

For comments and archives

    Cardiology eMedinewS

Coronary Artery calcium bests other risk markers for CVD risk assessment Read More

Psoriasis drugs may curb heart disease risk Read More

    Pediatric eMedinewS

Circumcision a matter of parental choice Read More

ESC: Smoking may thicken young arteries Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient came with an eGFR of 15.
Dr. Bad: Go for immediate dialysis.
Dr. Good: Hold till proper investigations are done.
Lesson: A study published in December 2010 in the Canada Medical Association Journal shows that starting dialysis too soon may increase the risk of death.

For comments and archives

Make Sure

Situation: A patient with rheumatoid arthritis was not responding.
Reaction: Oh my God! Why was smoking not stopped?
Lesson: Make sure that all patients of RA stop smoking. It is a major preventable factor contributing to the development of antibody–positive rheumatoid arthritis in genetically susceptible individuals.

For comments and archives

  Quote of the Day (Dr Prabha Sanghi)

Idleness is an inlet to disorder, and makes way for licentiousness. People that have nothing to do are quickly tired of their own company. Jeremy Collier

    Legal Question of the Day (Dr MC Gupta)

Q. I am a pathologist. I think there is not much difference in the work and function of a DCP and MD in pathology. I think a DCP is competent to do histopathology also. We the pathologists unnecessarily differentiate in degree/diploma. I have seen many diploma holders of other specialities (Obs & Gyne, ENT, Eye, DMRD etc.) doing all sorts of procedures and major operations without any inhibitions and bar from anybody. It is a question of one's confidence. All DCPs can practice all the branches in Pathology if they are confident. What are your comments?


My comments are as follows:

  1. It is wrong to assume that there is no difference between a DCP and MD in pathology. An MD in pathology is a certified expert in the field of pathology as a whole. A DCP is a certified expert in only one field—Clinical pathology.
  2. Legal competence does not come from the confidence a doctor has in himself. It comes from his educational credentials. If a patient gets a histopathology report signed by a DCP and engages me as an advocate to file a case against him, I am quite hopeful that I will win in the complaints filed in the medical council and the consumer court.
  3. If you or other doctors have seen “many diploma holders of other specialities (Obs & Gyne, ENT, Eye, DMRD etc.) doing all sorts of procedures and major operations without any inhibitions and bar from anybody”, it is highly unfortunate. Persons indulging in such practice are committing an illegality for which they can be and should be punished. The MCI cancelled for 2 years the licence of an anesthesiologist who performed surgery upon a woman to conduct a caesarean delivery. He was full of confidence in himself.

For comments and archives

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Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Doctor’s Day Celebration

eMedinewS Apps
  Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Lab Tests for Infertility in men

  • Semen analysis
  • Free and total testosterone
  • Luteinizing hormone (LH)
  • Follicle–stimulating hormone (FSH)
  • Prolactin (PRL)
  • Testicular biopsy: In some cases, a biopsy of testicular tissue can identify the problem, for example, sperm production, abnormal growths, tumors, or incomplete growth or maturation of reproductive organs.
    Mind Teaser

Read this…………………

A 30-year-old homemaker fell asleep while smoking a cigarette. She sustained severe burns of the face, neck, anterior chest, and both arms and hands. Using the rule of nines, which is the best estimate of total body-surface area burned?

A. 18%
B. 22%
C. 31%
D. 40%

Yesterday’s Mind Teaser: Mr. Valdez has undergone surgical repair of his inguinal hernia. Discharge teaching should include:

A. Telling him to avoid heavy lifting for 4 to 6 weeks
B. Instructing him to have a soft bland diet for two weeks
C. Telling him to resume his previous daily activities without limitations
D. Recommending him to drink eight glasses of water daily

Answer for yesterday’s Mind Teaser: A. Telling him to avoid heavy lifting for 4 to 6 weeks

Correct answers received from: Dr Avtar Krishan, Dr Sushma Chawla, Dr Mohit Sharma, Prabha Sanghi, Dr KV Sarma, Dr Pankaj Agarwal, Anil Bairaria, YJ Vasavada, Dr BB Aggarwal, Dr Thakor Hitendrsinh G,
Dr PC Das, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Kanta Jain.

Answer for 27th August Mind Teaser: C. right lower quadrant

Correct answers received from: Dr Rakesh Goel, Dr Thakur Om Prakash Singh, Ashok Kumar Patel,
Dr PH Patel, Dr Satya Bhooshan Sood, Dr Ajay Gandhi.

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

God vs. Satan

And God populated the Earth with broccoli and cauliflower and spinach and green and yellow vegetables of all kinds, so Man and Woman would live long and healthy lives.

And Satan created McDonald's. And McDonald's brought forth the 99-cent double cheeseburger.

And Satan said to Man "You want fries with that?" And Man said, "Super size them". And Man gained pounds.

And God created the healthful yogurt, that woman might keep her figure that Man found so fair.

And Satan froze the yogurt, and he brought forth chocolate, nuts and brightly colored sprinkle candy to put on the yogurt. And woman gained pounds.

And God said "Try my crispy fresh salad."

And Satan brought forth creamy dressings, bacon bits and shredded cheese.

And there was ice cream for dessert. And Woman gained pounds.

And God said "I have sent you heart healthy vegetables and olive oil with which to cook them."

And Satan brought forth chicken-fried steak from Cracker Barrel so big it needed its own platter. And Man gained pounds, and his bad cholesterol went through the roof.

And God brought forth running shoes, and Man resolved to lose those extra pounds.

And Satan brought forth cable TV with remote control so Man would not have to toil to change channels between ESPN and ESPN2. And Man gained pounds.

And God said "You are running up the score, Devil." And God brought forth the potato, a vegetable naturally low in fat and brimming with nutrition.

And Satan peeled off the healthful skin and sliced the starchy center into chips and deep-fried them. And he created sour cream dip also. And Man clutched his remote control and ate the potato chips swaddled in cholesterol. And Satan saw and said "It is good."

And Man went into cardiac arrest. And God sighed and created quadruple by-pass surgery...

And Satan created HMOs

    Medicolegal Update

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

What is Somatic Death?

For many years it was accepted that death occurred if respiration and circulation ceased for more than 10 minutes. Now it is possible to stop the heart and respiration for an hour or longer and restart them again at will by methods such as cooling the whole body to 15°C or 59°F or less. During this period, ECG and EEG show no electrical activity and body looks like a corpse. This leads to the view that it is not the cessation of the respiration or circulation but it is their failure to return that indicates death. Thus we are driven from a positive to negative approach. Therefore, the doctor while taking decision must satisfy himself that not only respiration and circulation has stopped, but their failure has persisted to such a period that under no circumstances it is possible for the person to come to life again.

  • Death is said to have occurred when a final expiration is followed by continuous immobility of the chest, loss of pulse and alteration of the features. These changes indicate that respiration and circulation have been stopped and the brain will stop functioning if it has not been so.
  • Residual heart movement is not of practical importance as they are insufficient to maintain the circulation.
  • Somatic death can be detected by ECG that will stop within minutes.

(Ref: Dr. PC Dikshit Head (MAMC) MD LLB, Textbook of Forensic Medicine, Peepee Publishers)

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Workshop for Teachers on Proper Hygiene in schools

While conducting a workshop on health and hygiene organized by Heart Care Foundation of India and DAV School, Kailash Hills, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India, said that school education must focus on health and hygiene. This will take care of the burden of communicable diseases and provide healthy and correct lifestyle and prevent most non-communicable diseases.

He said that to start with, children should clean their teeth properly as chronic poor oral health and tooth loss is associated with modest increases in future heart blockages and paralysis. This effect persists even after adjustment for known cardiovascular risk factors.

Keeping the environment clean can prevent a large number of communicable diseases. Environment hygiene includes air hygiene, water hygiene and food hygiene. Most food-borne diseases are direct food or water-borne illnesses. Typhoid fever is caused by a bacterium, Salmonella typhi, and is transmitted through the ingestion of food or drink contaminated by the feces or urine of infected people. Houseflies or other flying insects feeding on feces may occasionally transfer the bacteria through poor hygiene habits and public sanitation conditions. Though the cases occur round the year, typhoid occurs more often during summer and rainy seasons.

Do not eat fruits and vegetables that are cut and sold open as they can cause diseases such as typhoid, diarrhea, cholera and jaundice. Cut open fruits and vegetables, especially watermelon, sold on the streets and sugarcane juice attract flies and other infective organisms. Any food stored at room temperature for over two hours gets spoiled and may grow organisms. Cut open fruits on the road often remain in this state for hours together. In summer, precautions should also be taken while eating cut salad and uncovered food in the tiffin. The best fruits to eat in such situations are bananas and oranges.

Healthcare-associated infections are also becoming common. Therefore, one should avoid visiting a hospital for a formality.

A heart attack may occur at the age of 40 but the process of heart artery blockages starts in school age and early college life. To prevent the rising burden of obesity, diabetes, heart diseases, prevention must begin in school age.

Teachers from over 50 schools participated in the event. The participants included teachers, vice-principals and principals of various schools. Speaking on the occasion, Ms Era Khanna, Principal of DAV, Kailash Hills School said that the teachers who are trained in this workshop will work like trainers for other teacher and school children. She said that every school must have a teacher who is trained to educate children on health and hygiene.

The subjects covered in the workshop were food hygiene, hand hygiene, water hygiene, respiratory hygiene and sexual parts hygiene.

    Readers Responses
  1. Dear Editor, Apropos "Acanthamoeba keratitis in contact lens wearers" in eMedinewS, this is to say that while not observing hygiene in the wearing of spectacles (since they are away from eyes) may not cause harm, observing hygiene in the wearing of contact lenses (since they are on the eye) is of utmost importance...but let's not make wearing of `contacts' a scary thing as even swimming done while wearing daily disposable contact lens with swimming goggles on and discarding the used contact lens pair is unlikely to cause harm. However, swimming with contact lenses should generally be avoided. Dr. Narendra Kumar, Member, IACLE.
    Forthcoming Events
Dr K K Aggarwal

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Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
A non stop question answer-session between all the top cardiologists of the NCR region and the public. Event will be promoted through hoardings, our publications and the press. Public health discussions



Weekend Retreat for Doctors on
Mind – Body – Medicine

8 (Sat) – 9 (Sun) September 2012 At Brahma Kumaris Om Shanti Retreat Centre NH–8, Bhorakalan, Pataudi Road, Bilaspur Chowk, Distt.-Gurgaon

Visit us at: www.togetherwecan.in
Contact: BK Sister Sapna – M – 9650692204
E–mail: bksapna108@gmail.com

    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

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  Dadi Ma ke Nuskhe

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  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

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  Pesticides Safely

    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 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