7th January 2015, Wednesday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and National Science Communication Awardee. Limca Book of Record Holder (CPR). Gold Medalist

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); 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);
For updates follow at :  www.twitter.com/DrKKAggarwal, www.facebook.com/Dr KKAggarwal

Low cholesterol linked to anxiety, depression, suicide, hemorrhagic stroke and cancers

People with very low cholesterol levels are at increased risk of developing stomach cancer, according to a study published in the International Journal of Cancer.

The study involved 2,600 residents of Hisayama, Japan, who were followed for 14 years. Gastric cancers developed in 97 subjects. After accounting for age and gender, stomach cancer rates rose significantly with descending cholesterol level. For example, among subjects with the highest cholesterol levels, the gastric cancer rate was the equivalent of 2.1 cases per 1000 persons per year; among those with the lowest cholesterol, the rate was 3.9 per 1000 persons per year.

Patients with low serum cholesterol should consider periodic gastrointestinal examination for the prevention of stomach cancer.

Low cholesterol has been earlier linked to depression, anxiety and suicide in both men and women. Another earlier report has also shown that people with cholesterol level below 180 had twice the risk of brain hemorrhage as compared to those with cholesterol levels of 230.

IMA in the news

Swine flu test to be done at govt approved pvt labs: IMA: Express Healthcare

Death toll due to swine flu rises, government issues guidelines: Down to Earth

IMA guidelines to treat H1N1 flu: The Hindu

IMA prescribes swachchata pills for hospitals: Times of India

IMA guidelines to treat H1N1 flu

CHENNAI, January 5, 2015: The Hindu: The Indian Medical Association has issued guidelines for treating H1N1 infection (swine flu). A three-member committee has come up with protocols following death of 11 persons in the country owing to the infection. “We have devised a protocol as the climatic conditions make south India more prone to the infection and there has been rising panic,” said IMA president K.K. Aggarwal. Swine flu symptoms could last a fortnight. However, patients with severe breathlessness should undergo further investigation, the IMA has decreed. The government has designated laboratories and test results that return positive from these facilities only would be considered confirmed.

Preventive vaccines

The committee has advised preventive vaccines for flu caused by human strains for children aged over six months and adults over 50 years. Intranasal spray is recommended for those in the two to 49 years age group, except pregnant women. Live attenuated vaccine is advised for patients with pulmonary, cardiovascular, renal, hepatic, neurological, haematological disorders and diabetes, and healthcare providers.


Most swine flu patients can be managed at home based on symptoms, Dr. Aggarwal said. Avoid touching face (mouth and nose) with your hands. Though with cough, cold and sneezing should remain indoors; avoid crowded places and physical contact. Cough into disposable paper and not in to hands or handkerchief and wash hands frequently to avoid contamination. Only symptomatic patients must be given drugs. The committee recommends antiviral medications as the first-line medicines for treatment of novel H1N1, H3N2, and H3N2v flu as most cases are susceptible to Oseltamivir and Zanamivir.

Death toll due to swine flu rises, government issues guidelines

Southern states Telangana and Andhra Pradesh are worst affected

Jan 5, 2015 Swine flu fatality in India has risen to 21 per cent now as compared to 13 per cent in 2013 and 8 per cent in 2012 (file photo, Meeta Ahlawat)With fresh cases of swine flu, one each from Andhra Pradesh, Telangana and Delhi, the total cases of for this season stands at 88. Though no fresh casualties due to the flu have been confirmed yet, it is suspected that eight to 10 people, mainly in the two southern states, have died so far. However, two deaths have been reported from Delhi as well. While the one that occurred on December 24 was confirmed by the health ministry’s National Centre for Disease Control, the death of a woman in Delhi’s Sir Ganga Ram Hospital on Friday has been confirmed by private laboratory Dr Lal Pathlabs. She had died after a multiple organ failure. According to official data, Delhi has had 43 confirmed cases of swine flu this season, five of them reported since January 1. Two of them have been confirmed by National Centre for Disease Control (NCDC) while the others were confirmed by private laboratory Dr Lal Pathlabs.

Awareness can curb its spread

The Indian Medical Association (IMA) has issued guidelines for public to assess and respond to the flu conditions. It has said that swine flu has not taken epidemic proportions yet, unlike last year. In last winter season, Delhi alone reported 16 deaths. However, IMA said that rise in cases in the last three weeks calls for immediate attention.

In its public statement, prepared by a committee of experts, IMA said that symptoms of swine flu are similar to ordinary flu like fever, cough, sore throat, body ache etc. It, however, noted that patients who have fever with coryza, i.e inflammation of mucous membrane, and breathlessness should be kept in isolation and investigated for influenza. “We recommend everyone should take vaccine for ordinary influenza. It will not prevent swine flu, but will reduce its severity,” said K K Aggarwal, Honorary Secretary General, IMA, and member of the expert committee. But a doctor from pulmonary medicine at All India Institute of Medical Sciences said that as swine flu is contagious, it can spread fast. “Swine flu is air borne. Even the sneeze of a patient can infect the others. Proper arrangements should be made immediately,” he said, requesting anonymity.

Swine flu test to be done at govt approved pvt labs: IMA

By EH News Bureau on January 5, 2015

Only rRT-PCR test is reliable and should be used to diagnose H1N1 flu and this technology is available only in selected laboratories

Indian Medical Association (IMA) has recommended that all members of the association should get swine flu testing done only from government accredited government and private laboratories.

Releasing the guidelines for the diagnosis of swine flu, Dr A Marthanda Pillai, National President and Dr KK Aggarwal, Secretary General, IMA said that the card rapid test is not reliable and should not be used to diagnose H1N1 cases. Only rRT-PCR test is reliable and should be used to diagnose H1N1 flu and this technology is available only in selected laboratories.

The samples to be sent for the tests are throat and nasal swabs. No blood test is available for H1N1 diagnosis. The test report may take up to 24 hours to be available.

IMA recommends swine flu testing only for patients who have flu-like symptoms with breathlessness or in pregnant ladies with flu-like symptoms. These are the patients who may require hospital admission.

News around the Globe

  • New criminal behaviors, such as theft, sexual advances, and violence, can be the first manifestation of dementia, and the frequency and type of such behaviors may point to a specific underlying neurodegenerative disorder, suggests a new study published online January 5 in JAMA Neurology.
  • Women who have moderate to severe vasomotor symptoms (VMS) are at higher risk of hip fractures than women with less severe or no hot flashes and night sweats, suggest new findings published in the Journal of Clinical Endocrinology and Metabolism. Researchers stated that higher VMS severity may be associated with lower bone mineral density (BMD).
  • Laparoscopic lavage for perforated diverticulitis with purulent peritonitis is feasible and as safe as open surgery, suggests new research published online in the Annals of Surgery.
  • Antiviral prophylaxis with valganciclovir in living kidney donors may reduce transmission of cytomegalovirus (CMV) and Epstein-Barr virus (EBV), suggests a pilot study published online in Transplantation.
  • Pelvic floor muscle training resulted in improved self-reported symptom scores compared with watchful waiting for women with mild prolapse, though the significance of the results is unclear, suggests a new study published in BMJ.

Dr KK Spiritual Blog

Writing a Vedic Will – as I understand it

Sometimes back, I used to think that a ‘will’ simply meant how my finances would be controlled by my wife and my children after my death. As I started acquiring Vedic knowledge, my interpretation changed. Following is the gist for writing a Will, as I understand it the Vedic way. Of course, writing a will requires a sound state of mind, two witnesses, signed registered paper with accompanying, if possible audio-visual link.

  • The first step is to calculate your life earnings. Your earnings are not only your finances earned but also the respect, dignity and image that you have earned in the society.
  • Now the next step is to pay off your unpaid debts (Hrins). Apart from actual loans we have taken from banks, friends and others, there are three more debts (Hrins) which we need to pay before we die and define in our Will to be paid from our earning if we die unexpectedly. These as per mythology are Pitra Hrin, Dev Hrin and Rishi Hrin and mean that we have not been able to fulfill the committed desires of our ancestors and commitments made to our GOD and teachers respectively. All these debts, if unpaid, need to be paid out of the finances you are leaving at the time of death. A percentage of your finances, therefore, should be kept to pay these debts. These commitments are usually fulfilled by the eldest son and eldest daughter if there is no son or wife till she is alive.
  • Rest of the finances need to be divided to fulfill your Dharma, Artha, Kama and Moksha or purpose for which you were born.
    • Artha: A percentage of your finances should go and be equally divided within your immediate family. A percentage of this amount should be converted into a family trust account to be used for the minus 18 years of age children in future.
    • Dharma: Dharma in literal meaning is to hold. A percentage of your finances should be kept into a reserve account and this account interest can be used by the family only if they stick to the code of family conduct (includes rituals, religious activities etc) you have created in your life and mentioned in the will or this amount may be given for charity as defined in your will.
    • Kama and Moksha: Kama means the unfulfilled desires at the level of intellect and ego and Moksha the same at the level of our soul.

We must enlist both our desires at the level of mind and at the level of soul and a percentage of our finances should be converted into a trust or defined to fulfill these desires. The examples of desires at the level of soul are to do some charitable work without any publicity. The same at the level of ego are to open some dispensary, dharamshala etc. in our own name. You also need to fulfill and document your desired rituals at the time of death. These rituals must answer the following questions:

  • Should my death be celebrated (band, lunch) as I have completed all my purposes of life?
  • How should my death anniversary be celebrated or observed?
  • How should my last rites be done?

Final Note: If my children and wife are not willing to take care of the finances other than Artha, I nominate the following persons to manage my finance to look after my other desires……

emedipicstoday emedipics

Health Check Up and CPR 10 Camp at G B S.S.School, Varun Marg, Defence Colony, New Delhi on 22nd December 2014

video of day
press release

Five Things Physicians and Patients should question

Sameer Malik Heart Care Foundation Fund

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF

Total CPR since 1st November 2012 – 101090 trained

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)


IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :


Make Sure

Situation: A 62–year–old–diabetic with coronary artery disease, on treatment for the same, comes for follow up.
Reaction: Oh my God! Why did not you put him on antioxidants?
Lesson: Make Sure to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects.

eMedinewS Humor

A doctor of psychology was doing his normal morning rounds, and he entered a patient's room to find his patient sitting on the floor, sawing at a piece of wood with the side of his hand.

Meanwhile, another patient was in the room, hanging from the ceiling by his feet.

The doctor asked his patient what he was doing, sitting on the floor.

The patient replied in an irritated fashion, "Can't you see I'm sawing this piece of wood in half?"

The doctor inquired, "And what is the fellow hanging from the ceiling doing?"

"Oh. He's my friend, but he's a little crazy. He thinks he's a light bulb."

The doctor asks, "If he's your friend, don't you think you should get him down from there before he hurts himself?"

"What? And I work in the dark!?!"

Twitter of the Day

Dr KK Aggarwal: Blood Pressure: A silent killer
Dr Deepak Chopra: Pay attention to the richness of your inner life. Daydream, imagine, and reflect. It’s the source of infinite creativity.

Final Note: If my children and wife are not willing to take care of the finances other than Artha, I nominate the following persons to manage my finance to look after my other desires……

Inspirational Story

Take Time

Take time to laugh, it is the music of the soul. Take time to think, it is the source of power.

Take time to play, it is the source of perpetual youth. Take time to read, it is the fountain of wisdom.

Take time to pray, it is the greatest power on earth. Take time to love and be loved, it is a God-given privilege.

Take time to be friendly, it is the road to happiness Take time to give, it is too short a day to be selfish

Take time to work, it is the price of success.

Rabies News (Dr A K Gupta)

What are the most common modes of exposures of rabies virus?

Human exposures to rabies can generally be categorized as bite, open wound, mucous membrane, or other types of exposures.

  • Bite exposure: Any penetration of the skin of a person by the teeth of a rabid or potentially rabid animal.
  • Open wound exposure: Introduction of saliva or other potentially infectious material (cerebrospinal fluid, spinal cord, or brain tissue) from a rabid or potentially rabid animal into an open wound (e.g., broken skin that bled within the past 24 hours).
  • Mucous membrane exposure: Introduction of saliva or other potentially infectious material (cerebrospinal fluid, spinal cord, or brain tissue) from a rabid or potentially rabid animal onto any mucous membrane (eyes, nose, mouth).
  • Other exposure: Any interaction with a rabid or potentially rabid animal where a bite, open wound, or mucous membrane exposure cannot be definitively ruled out.

Cardiology eMedinewS

  • Adopting six healthy lifestyle behaviors could avert about 73% of coronary heart disease cases among women over 20 years, and 46% of diabetes, hypertension, and hyperlipidemia, suggests an analysis of about 69 000 participants followed for 20 years in the Nurses' Health Study II (NHS II). The findings are published in the January 6/13, 2015 issue of the Journal of the American College of Cardiology.
  • Women who work rotating night shifts for 5 years or more may be at increased risk of all-cause and cardiovascular disease mortality, while working such shifts for 15 years or more may increase the risk of lung cancer mortality, reported a new study published in the American Journal of Preventive Medicine.

Pediatrics eMedinewS

  • Patients who require urgent tonsillectomy without or with adenoidectomy (TA) tend to be younger, have increased obstructive apnea-hypopnea indices, and more persistent desaturations below 80% as compared to children who receive timely TA and after surgery, nearly half of children who receive urgent TA will no longer require supplemental oxygen because of a significant improvement in gas exchange, suggests new research published online January 2 in JAMA Otolaryngology–Head & Neck Surgery.
  • Sleeping near a small screen or TV and more screen time appear to be linked to shorter sleep time in children, and presence of a small screen may be associated with perceived insufficient rest or sleep, suggest the findings of a cross-sectional study published in the January 5 issue of Pediatrics.

Quote of the Day

However difficult life may seem, there is always something you can do and succeed at. Stephen Hawking

Wellness Blog

15 Ways to Reduce or Stop Drinking

If you are dependent on alcohol, or have other medical or mental health problems you should stop drinking completely. Reduction of heavy drinking may be a more acceptable goal for some patients who lack readiness to quit drinking.

The frequency of heavy drinking (more than 5 drinks per day for men and 4 for women) has the highest correlation with negative life consequences such as impaired driving, interpersonal problems and injuries.
You need to cut down if in the past one year you have taken one or more times, more than 5 drinks in a day (4 drinks for women). This positive response to a single question “How many times in the past year have you had x or more drinks in a day?”, where X is 5 for men and 4 for women, is recommended for use by the National Institute on Alcohol Abuse and Alcoholism. The sensitivity and specificity of this question is 81.8 and 79.3 percent, respectively.

The National Institute on Alcohol Abuse and Alcoholism suggests the following for stopping or reducing alcohol:

  1. Put it in writing why you want to reduce or stop: Write what you want to achieve, for example, will feel healthier; will sleep better, will improve my relationships.
  2. Write confessions: learn and practice various confession exercises. This will help you take care of inner guilt which may be the precipitating factor.
  3. Set a drinking limit: Those who are cutting back should set a limit as per your health. Most healthy people should limit to less than 40 ml in one hour, 80 ml in one day and less than 240 ml in a week. Women should take less than half of this amount.
  4. Keep a diary of your drinking. For initial 3-4 weeks, keep track of every drink. Note the situations you are most likely to drink. Give each situation a rating out of ten. Try avoiding those situations for the next few weeks.
  5. Don’t keep alcohol within your reach. Remove alcohol from your living place. This can help limit drinking.
  6. Eat your drink. Drinking slowly can help. Sip and do not gulp. Sip soda, water, or juice after each drink. This is called Mindful drinking. If you are aware of your drinking, you will cut back on it. Otherwise, you will drink more.
  7. Never drink on an empty stomach.
  8. Keep weekly one or two spiritual fast/s. This will allow alcohol-free days. Decide not to drink a day or two each week.
  9. Observe spiritual retreats: Observing spiritual retreats with no drinking can help or try to abstain for a week or a month to see your commitment to not drinking.
  10. Become a tortoise: Learn to withdraw yourself from all stimuli which can force you to drink.
  11. Watch for peer pressure. Learn to say no. Do not drink just because others are, and you shouldn’t feel obligated to accept every drink you’re offered. Stay away from people who encourage you to drink.
  12. Keep busy. Take a walk, play sports, go out to eat, or catch a movie. When you’re at home, pick up a new hobby or revisit an old one.
  13. Ask for support. Let friends and family members know that you need their support.
  14. Guard against triggers. Stay away from people and places that make you want to drink. In Yoga it is called Pratahyara and means staying away from the external stimuli.
  15. Be persistent. Most people who successfully cut down or stop drinking altogether do so only after several attempts.

ePress Release

Smoking in women can increase risk of colorectal cancer

Women who smoke are at twice the risk of developing cancer of the rectum and the risk goes up with the increase in number of cigarettes smoked per day, duration of smoking and older age at smoking cessation, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Honorary Secretary General Indian Medical Association.

Quoting a study published in the Journal of National Cancer Institute, Dr. KK Aggarwal said that women should never smoke. Current smokers are 95% more likely to develop rectal cancer. Younger adults can develop colorectal cancer, but the chances increase markedly after age 50. More than 9 out of 10 people diagnosed with colorectal cancer are older than 50.

A history of adenomatous polyps (adenomas) especially if they are large, increase the risk of cancer.

If you have had colorectal cancer, even though it has been completely removed, you are more likely to develop new cancers in other areas of the colon and rectum. The chances of this happening are greater if you had your first colorectal cancer when you were younger.

Though the no. 1 cancer in women in urban areas is breast cancer and in rural areas is cancer of the cervix, cancer of the rectum is on the rise.

eMedi Quiz

The following separation technique depends on the molecular size of the protein:

1.Chromatography on a carboxymethyl (CM) cellulose column.
2.Iso-electric focusing.
3.Gelfiltration chromatography.
4.Chromatography on a diethylaminoethly (DEAE) cellulose column.

Yesterday’s Mind Teaser: An enzyme involved in the catabolism of fructose to pyruvate in the liver is:

1.Glyceraldehyde-3-phosphate dehydrogenase.
3.Lactate dehydrogenase.

Answer for yesterday’s Mind Teaser: 1.Glyceraldehyde-3-phosphate dehydrogenase.

Correct answers received from: Dr Rakesh Sharma Nohar.

Answer for 5th January Mind Teaser: c. Nail psoriasis

Correct answers received from: Dr Jainendra Upadhyay, Dr Avtar Krishan, Dr B K Agarwal

Send your answer to email

medicolegal update

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medical query

medicolegal update

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medicolegal update

medicolegal update
  1. Many Many Congrats. Vinay Arora
  2. Padma Shri Dr.K.K.Aggarwal, Hony Secy Gen IMA HQs: Dear Dr. Aggarwal, Please accept my heartiest congratulations on your taking over as Hony Secy Gen of IMA HQs. I hope and am sure that IMA will progress further and attain new heights with your open and foresighted vision and hard work for which you are popular. I promise my whole hearted support in all your efforts to take IMA to new dimensions and in service of Medical Profession and mankind. Kindly forward my good wishes to the Hon'ble National President also. I also wish a very prosperous and Happy New Year to you and your family. Yours Very Sincerely, Dr.Om Parkash Singh Kande, National Vice President Elect 2015-16 IMA HQs, Patiala
  3. Sir, Happy New Year 2015. Kindly accept my Hearty Congratulation on assuming office as Hony Secy Gen of Indian Medical Association. I hope and am sure the Indian Medical Association will attain new Horizons and will have more fruitful and constructive activities during your tenure. Thanking you once again and hoping for better and brighter future of IMA under your administrative control. With Warm Regards, yours sincerely, Dr. R.K. Pathak, Hony State Secretary, IMA MP State, Branch, Jabalpur

eMedinewS Special

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

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)