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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 …

2nd November 2011, Wednesday

Dr KKs Rules in managing chest pain

  1. Rule of 30 seconds: Chest pain, burning, discomfort, heaviness in the center of the chest lasting for over 30 seconds and not localized to a point unless proved otherwise is a heat pain. To this rule, add the rule of pin pointing finger i.e. any chest pain which can be pin pointed by a finger is not a heart pain.
  2. Rule of 5: If you suspect a heart attack, do not wait for more than five minutes and get to a hospital right away.
  3. Rule of 3: Reach hospital within 3 hours in case of heart attack to receive clot-removing angioplasty or clot-dissolving drugs.
  4. Rule of 300: Chew a tablet of water-soluble 300 mg aspirin and take 300 mg clopidogrel tablets at the onset of cardiac chest pain (heart attack) to reduce mortality.
  5. Rule of 10: Door-to-ECG time is the time within which an ECG should be done in the emergency room and it should be less than 10 minutes.
  6. Rule of 30: Door-to-needle time in acute heart attack is the time before which the clot-dissolving drug should be given after a patient reaches the hospital. In ST elevation heart attack, the door-to-needle time should be less than 30 minutes.
  7. Rule of 40: First-onset acidity or first-onset asthma after the age of 40: Rule out heart attack or heart asthma.
  8. Rule of 90: Door-to-balloon time is the ideal time for primary percutaneous coronary intervention in acute heart attack by an experienced operator and should be less than 90 minutes.

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

Dr KKs Rules in managing chest pain

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011 - Medico Masti - An Inter College Health Festival

Infotainment is a new concept of creating health education where education is inter linked with entertainment. The competitions like Fashion Show was organized on the spot.

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


New health scheme for Delhi school children

The Chacha Nehru Health Scheme, under which free medical check-up and treatment will be provided to all the school children, will be launched by the Delhi Government on Children's Day, November 14. At a meeting chaired by Chief Minister Sheila Dikshit on Friday, it was stated that to begin with the scheme will cover 100 schools. The scheme had been announced by the Delhi Government in the Budget speech for the year 2011-22 that was made by Ms. Dikshit, who also holds the Finance portfolio. The Delhi Government has since then completed the formalities pertaining to the scheme and is now prepared to implement it. (Source: http://www.thehindu.com/news/cities/Delhi/article2579438.ece, October 29, 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)

Airport metal detectors safe for pacemakers

Metal detector security screening appears safe for people with pacemakers or implantable cardioverter-defibrillators (ICDs), researchers found. (Source: Medpage Today)

For comments and archives

ACG: Clear liquids before colonoscopy not a must

Colonoscopy was as successful on patients allowed a full liquid diet -- including foods such as pudding and oatmeal -- as for those restricted to only clear liquids, researchers reported here. (Source: Medpage Today)

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Age no barrier to live kidney donation

Healthy, older seniors can act as living kidney donors, with overall survival among recipients similar to that seen with younger donors, a study suggested. (Source: Medpage Today)

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ACG: Bone loss common in IBD

Patients with inflammatory bowel disease (IBD) are often at higher risk for developing osteoporosis or osteopenia, but clinicians at one institution failed to look for it most of the time, researchers said here. (Source: Medpage Today)

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    Twitter of the Day

@DrKKAggarwal: #AJD ICMR–INDIAB study provides new figures for diabetes New figures for diabetes prevalence in India indicate... fb.me/16bpes93F

@DeepakChopra: Reversal of Aging Part 5 Maintaining Biological Rhythms

    Spiritual Update

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

Pragyapradh: The Mistake of the Intellect

Maharishi Mahesh Yogi in his teachings said “Pragyapradh or ‘mistake of the intellect’ occurs when the intellect, drawn towards and influenced by material consciousness, loses connection with the wholeness of consciousness. And this happens when we stop being centered within ourselves.”

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    An Inspirational Story

(Ms Ritu Sinha)

Nothing is Random

Nothing is random, nor will anything ever be, whether a long string of perfectly blue days that begin and end in golden dimness, the most seemingly chaotic political acts, the rise of a great city, the crystalline structure of a gem that has never seen the light, the distributions of fortune, what time the milkman gets up, the position of the electron, or the occurrence of one astonishingly frigid winter after another.

Even electrons, supposedly the paragons of unpredictability, are tame and obsequious little creatures that rush around at the speed of light, going precisely where they are supposed to go. They make faint whistling sounds that when apprehended in varying combinations are as pleasant as the wind flying through a forest, and they do exactly as they are told. Of this, one can be certain.

And yet there is a wonderful anarchy, in that the milkman chooses when to arise, the rat picks the tunnel into which he will dive when the subway comes rushing down the track from Borough Hall, and the snowflake will fall as it will. How can this be? If nothing is random, and everything is predetermined, how can there be free will? The answer to that is simple.

Nothing is predetermined; it is determined, or was determined, or will be determined. No matter, it all happened at once, in less than an instant, and time was invented because we cannot comprehend in one glance the enormous and detailed canvas that we have been given - so we track it, in linear fashion, piece by piece. Time, however, can be easily overcome; not by chasing light, but by standing back far enough to see it all at once.

The universe is still and complete. Everything that ever was, is; everything that ever will be, is - and so on, in all possible combinations. Though in perceiving it we imagine that it is in motion, and unfinished, it is quite finished and quite astonishingly beautiful.

In the end, or rather, as things really are, any event, no matter how small, is intimately and sensibly tied to all others. All rivers run full to the sea; those who are apart are brought together; the lost ones are redeemed; the dead come back to life; the perfectly blue days that have begun and ended in golden dimness continue, immobile and accessible; and, when all is perceived in such a way as to obviate time, justice becomes apparent not as something that will be, but as something that is.

For comments and archives

    Fitness Update

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

12 Indian foods that cut fat


Foods containing chillies are said to be foods that burn fat. Chillies contain capsaicin that helps in increasing the metabolism. Capsaicin is a thermogenic food, so it causes the body to burn calories for 20 minutes after you eat the chillies.

For comments and archives

    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Who is not fit to drive?

Pre-existing heart disease, vision disturbances, dementia can be the grounds to reject a license to the commercial vehicles.

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    Malaria Update

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

What the National Drug Policy of India says

What are the criteria for referral to a Referral Hospital?

  • Cerebral malaria patients not responding to initial anti-malarial treatment.
  • Severe anemia warranting blood transfusion
  • Bleeding and clotting disorder
  • Hemoglobinuria
  • Pulmonary edema
  • Cerebral malaria complicating pregnancy
  • Oliguria not responding after correction of fluid deficit and diuretics
  • Fluid, electrolyte and acid-base disturbance

For comments and archives

    Medicine Update

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

What are the routes of Hepatitis B infection in children?

  • Vertical transmission: This is the most important route of transmission in children. Most of this occurs at the time of delivery due to exposure to maternal blood and other secretions. Ninety percent of the infected neonates become chronic carriers, compared to only 6–10% if the infection is acquired after 6 years of age. The risk is greater in HBeAg-positive mothers. There is no added benefit of LSCS delivery. If adequately vaccinated, breastfeeding is considered safe.
  • Horizontal transmission: Mostly in children by exposure to blood of an infected person.

For comments and archives

    Legal Question of the Day

(Dr M C Gupta, Advocate)

I am an India citizen. I graduated in medicine from China. I have been offered a scholarship to pursue postgraduation in Orthopedics in China without paying any fees. The university is recognised by WHO but not by the MCI. Will I face any problem if I work in the private sector in India as an orthopedician? Can I get a diploma in orthopedics from India while I am working for my postgraduate degree in China? Please give me career guidance.


  1. The question of your practicing medicine in India does not arise unless you are registered with the medical council in India. If you want to work in India as a doctor, this is a must. You should get in touch with the MCI to find if there is a way to get registered.
  2. If you don’t get a licence to practice medicine in India, the only option to pursue medical career for you is to get your PG degree in China and work there or in some other country that may allow you to work there.
  3. If you get an Indian licence and, after getting it, you still want to get your PG degree from China because it is free, you may do so and, afterwards, do one of the two things:

    EITHER come back and try to get D Orth, MS or DNB in India;

    OR, go to USA, Canada, UK, Australia or New Zealand and get a degree in ortho from any of these 5 countries because it would be recognised in India if it is recognised by the medical council of the country concerned.
  4. If you are not a registered medical practitioner in India on the basis of medical graduation, it is doubtful that you would be permanently registered with the medical council in India on the basis of a PG degree from the 5 countries as mentioned above.
  5. It is possible that even if you do not get registered with the MCI and obtain a PG degree from any one of the 5 countries, and if you want to work in India as a medical teacher or researcher or a doctor working in a charitable institution, then, as per the MCI Act, 1956, you can be given temporary registration in India.

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  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


  • Markedly increased triglycerides (>500 mg/dL) usually indicate a nonfasting patient (i.e., one having consumed any calories within 12–14 hour period prior to specimen collection).
  • If patient is fasting, hypertriglyceridemia is seen in hyperlipoproteinemia types I, IIb, III, IV, and V. The exact classification theoretically requires lipoprotein electrophoresis, but this is not usually necessary to assess a patient’s risk to atherosclerosis.
  • Cholestyramine, corticosteroids, estrogens, ethanol, miconazole (intravenous), oral contraceptives, spironolactone, stress, and high carbohydrate intake are known to increase triglycerides.
  • Decreased serum triglycerides are seen in abetalipoproteinemia, chronic obstructive pulmonary disease, hyperthyroidism, malnutrition, and malabsorption states.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A 36–year–old executive used to take 5 pegs of alcohol once a week.
Dr Bad: Continue it.
Dr Good: Either stop it or just take one peg a day.
Lesson: The French habit of drinking wine almost daily is less taxing to the heart than the Irish custom of downing an equivalent amount of beer on one or two nights a week, according to a study published Nov. 23 in the British Medical Journal.

For comments and archives

Make Sure

Situation: A 40-year-old hypertensive complains of head reeling in spite of being on antihypertensive.
Reaction: Oh my God! Her blood pressure is still high. Why didn’t you advise lifestyle modification?
Lesson: Make sure to first advise lifestyle modifications like exercise, low salt diet, high fiber diet, decreasing stress etc. before advising antihypertensive medication, in essential hypertensives.

For comments and archives

  Quote of the Day

(Dr GM Singh)

One can never speak enough of the virtues, the dangers, the power of shared laughter.


The last straw: When one small burden after another creates an unbearable situation, the last straw is the last small burden that one can take.

    Mind Teaser

Read this…………………

Which malignancy does not occur in Lynch syndrome?

a) Bronchus
b) Ovary
c) Endometrium
d) Sebaceous carcinoma

Yesterday’s Mind Teaser: What is not true about the immune mechanism in the small intestine?

a) Intestine contains more than 70% of IgA-producing cells in the body.
b) IgA acts by activating the complement pathway.
c) IgA is produced by plasma cells in the lamina propria.
d) Approximately 60% of the lymphoid cells are T cells.

Answer for yesterday’s Mind Teaser: b) IgA acts by activating the complement pathway.

Correct answers received from: Dr Sukla Das, Dr PC Das, YJ Vasavada, Dr (Maj. Gen.) Anil Bairaria,
Dr Surendra Bahadur Mathur, Dr Chandresh Jardosh, Dr K Raju, Muthumperumal Thirumalpillai,
Dr Jainendra Upadhyay, Jayaraman TP, Dr Neelam Nath, Dr Krishna Kavita.

Answer for 31st October Mind Teaser
: d) Pancreatic YY
Correct answers received from: Dr Dinesh Yadav, Gita Arora, Anil Bairaria

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

A famous heart specialist doctor died and everyone was gathered at his funeral. A regular coffin was displayed in front of a huge heart.
When the minister finished with the sermon and after everyone said their good-byes, the heart was opened, the coffin rolled inside, and the heart closed.

Just at that moment one of the mourners started laughing. The guy next to him asked: "Why are you laughing?" "I was thinking about my own funeral" the man replied. "What's so funny about that?" "I'm a gynecologist."

    Medicolegal Update

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

Giving birth is one of the most precious and exciting experiences of doctor

JAMA states that 7,000 medication errors are made every year when a baby is injured because of the error of judgment of a doctor or nurse during the pregnancy, during the labor, or during delivery the consequences are usually devastating. Birth injuries often result in cerebral palsy and mental impairments, conditions that place tremendous financial and emotional burdens on the entire family. Several medical reasons can lead to birth injuries, which include:

  • Failure to diagnose and treat preeclampsia
  • Inadequate pre-natal care
  • Failure to diagnose and treat pregnancy induced diabetes
  • Failure to conduct adequate fetal wellbeing assessments
  • Failure to continuous monitor vital signs during labor
  • Failure to diagnose fetal distress during labor
  • Failure to timely perform a cesarean section
  • Failure to treat umbilical cord compression during delivery
  • Failure to adequately resuscitate a depressed baby
  • Shoulder dystocia causing Erb's Palsy
  • Improper use of forceps
  • Improper use of vacuum extractor
  • Birth injuries that prove fatal are some of the most serious and common dissatisfaction of patient.
  • Wrongful death birth injuries typically arise because a poor decision is made or a detail is missed in the chaos of delivery means lack in attention to the baby heart monitor, tangled umbilical cord, hypoxia leading to brain death, and anesthesia or surgical errors in the act of giving birth

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    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Erectile dysfunction may be the first sign of underlying heart blockages

Erectile dysfunction may be the earliest warning sign of heart blockages or other circulatory problems, said Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India.

An erection is a hydraulic event. Extra blood is delivered to the male organ, kept there for a while, then drained away. An erection may not happen if a blockage interferes with blood flow to the penis.

Atherosclerosis or blockage is the artery-clogging process and can present with chest pain on exercise or stress, heart attacks, strokes, and other cardiovascular conditions. There occurs with accumulation of cholesterol-filled plaque inside arteries.

Blockage in a coronary artery can cause angina (chest pain with exercise or stress) or a heart attack. In an artery in the brain, it can cause memory loss, dementia, or stroke. Atherosclerosis in arteries supplying the penis can prevent the increase in blood flow needed to start or sustain an erection.

Erections serve as a barometer for overall heart’s health and erectile dysfunction can be an early warning sign of trouble in the heart or elsewhere.

Simple lifestyle changes like losing weight, exercising more, or stopping smoking can help. Viagra and other erectile dysfunction drugs work for some men.

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    Readers Responses
  1. I never miss reading. Because highly informative, laugh a while... ha ha ha.. Look forward for the next mo journal.. Dr.R.Somasekar. Prof. Peds., M.M.C Chennai.
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