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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; National Vice President Elect Elect, Indian Medical Association; 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 to 7
DD Take Care Holistically Video 1 to 7 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

8th October 2012, Monday

Largest Study Links Low Vitamin D to Heart Disease Risk

There is a strong link between low levels of vitamin D and higher rates of ischemic heart disease, heat attack and early death, according to the largest epidemiological study to date led by Dr Peter Brøndum-Jacobsen at Copenhagen University Hospital, Denmark and published in their paper in Arteriosclerosis, Thrombosis Vascular, Biology.

As per the meta analysis, people with low levels of vitamin D have an increased risk of heart attack, of dying early on from cardiovascular disease.

The study compared the 5% lowest levels of vitamin D (<5 nmol/L) with the 50% highest levels (>50 nmol/L) and observed a stepwise increase in risk: those with the lowest levels of vitamin D had a 40% increased risk of ischemic heart disease, a 64% higher chance of a heart attack, a 57% increased risk of early death and an 81% higher likelihood of fatal ischemic heart disease/heart attack.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Levocarnitine Update

Carnitine in Cardiomyopathy


  • Deficiencies in thiamine, selenium and L-carnitine have been reported to produce HF and replacement therapy results in improvement in cardiac function.
  • Carnitine deficiency impairs the oxidation of fatty acids, resulting in lipid accumulation in the myocyte cytoplasm. This problem is reversed with L-carnitine replacement.

What is idiopathic cardiomyopathy?

When primary and secondary causes of heart disease (myocarditis and coronary artery disease) are excluded by evaluation including history and physical examination, laboratory testing, coronary angiography (to exclude >50 percent obstruction of one or more coronary arteries), echocardiography, and endomyocardial biopsy when indicated, it is then called idiopathic cardiomyopathy.

For Comments and archives…

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Why BP should be kept < 120:80 mm Hg

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th Perfect Health Mela to be held in November (1st to 11th)

Addressing a press conference to announce the dates for the forthcoming 19th MTNL perfect Health Mela, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India, said that focus of the Mela this year will be “Prevention of Non-Communicable Diseases”.

Dr K K Aggarwal
    National News

India loses 39 rhinos, 69 tigers in just a year

India's National Wildlife Week celebrations have been dampened by shocking deaths of endangered animals - 69 tigers and 39 rhinos in the first nine months of the year. Tiger deaths in 2012 are more than five times higher than last year’s 13 casualities and the highest since 2001, when 72 big cats died. Of the 69 tigers, 41 fell prey to poachers. "Many poaching cases were from the fringe areas of tiger reserves, where protection isn't adequate," said Kishore Rithe, member, National Board for Wildlife.

In 2010, the National Tiger Conservation Authority recorded 1,706 tigers, an increase of over 20% in four years. Maharashtra and Uttarakhand, which saw the highest increase, reported 12 tiger deaths each. The National Wildlife Crime Bureau is alarmed that poaching has spread from the north to Karnataka and Tamil Nadu in the south. Rhinos in Assam's Kaziranga National Park (KNP) faced a greater threat from floods than poachers this year. While 28 were drowned in floods in the Brahmaputra in June and September, 11 were wiped off by poachers. The most recent poaching cases were on September 27 and claimed two rhinos. Environment ministry officials said the protocol issued after the floods was ignored. (Source: Hindustan Times, October 05, 2012)

For comments and archives

My Profession My Concern

Include this in your practice

Antithrombotic therapy for patients with atrial fibrillation: In patients with atrial fibrillation for whom anticoagulant therapy is chosen start an oral direct thrombin inhibitor or a factor Xa inhibitor rather than warfarin. Dabigatran 150 mg twice daily is more effective for stroke prevention. Apixaban and rivaroxaban are two newer oral anticoagulants that also do not require laboratory monitoring.


  1. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361:1139.
  2. Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365:981.
  3. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011; 365:883.

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

    Valvular Heart Disease Update

Bicuspid aortic valve is a genetic condition with autosomal dominant inheritance. Echocardiographic screening of first degree relatives of patients with bicuspid aortic valve and a positive family history and in those with a dilated aorta is recommended.

(Experts: Dr Ganesh K Mani, Dr. Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Antidepressant cuts menopause symptoms

A low dose of the antidepressant paroxetine (Paxil, Pexeva) may modestly cut down on hot flashes and their severity, two short-term trials found. (Source: Medpage Today)

For comments and archives

BMI no issue for Vytorin in diabetes

Whether a diabetic patient is obese or non-obese, treatment with the combination of ezetimibe/simvastatin (Vytorin) works consistently to reduce cholesterol levels, researchers said. (Source: Medpage Today)

For comments and archives

Diabetes screening fails to reduce mortality

Screening and intervention for type 2 diabetes in a British population had no effect on all-cause mortality during a 10-year period, according to a study published online October 4 in The Lancet and presented during the annual meeting of the European Association for the Study of Diabetes (EASD) in Berlin, Germany. (Source: Medscape)

For comments and archives

Aspirin may curb cognitive decline in women at high CVD risk

Taking low-dose aspirin may reduce the risk for cognitive decline in older women at high risk for cardiovascular events, a new study has found. (Source: Medscape)

For comments and archives

  Twitter of the Day

@DrKKAggarwal: MTNL Perfect Health Mela 2012: http://youtu.be/wlbJBMeJuq0 via@youtube

@DrKKAggarwal: Life is fragile & tenacious, a dewdrop on a trembling leaf. Setting the record straight by @gothamchopra with love http://huff.to/RG2W0W

    Spiritual Update

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

Music as a drug

Our body is the largest pharmaceutical group in the world and has the capacity to heal each and every disease. The very fact that there is a receptor for every drug in the body, the body has the capacity to produce that drug. Music is one such modality which can heal by initiating various chains of chemical…

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)

What hormonal changes occur during the menopause transition?

One of the first hormonal changes that occur as a woman gets older is a decrease in levels of an ovarian hormone called inhibin, which causes a decrease in the production of FSH. As inhibin levels fall, FSH levels rise higher and higher during the menopause transition. FSH levels cause estrogen (female hormone produced by the ovaries) levels to rise. Just as FSH levels fluctuate, so do estrogen levels. In fact, estrogen levels may be temporarily high at times during the menopause transition. This shows that there is higher stimulation by FSH.

For comments and archives

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

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

Blood Donation - Gift Of Liquid Love

Blood donors

An important factor is the awareness that the blood of professional donors is under-hemoglobinized and, therefore, does not serve the real purpose. The trend for Autologous Transfusion has opened a much better arena as regards safety including transmission of blood-borne diseases.

For comments and archives

    Liver Abscess Update

(Dr. Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation Medanta – The Medicity Hospital)

What are the indications of percutaneous drainage?

  • Volume of abscess is large and there is risk of spontaneous rupture (especially left lobe abscesses)
  • When actual rupture has occurred, then along with abscess cavity, drainage of extraneous collection
  • When after 48-72 hours of medical therapy clinical signs of persistent sepsis or enlarging abscesses, or persistent symptoms are there
  • When there is evidence of liver failure

For comments and archives

    An Inspirational Story

Puppies for sale

A store owner was tacking a sign above his door that read “Puppies For Sale.” Signs like that have a way of attracting small children and sure enough, a little boy appeared by the store owner’s sign. “How much are you going to sell the puppies for?” he asked. The store owner replied, “Anywhere from $30-$50.”

The little boy reached in his pocket and pulled out some change. “I have $2.37,” he said. “May I please look at them?” The store owner smiled and whistled, out of the kennel came Lady, who ran down the aisle of his store followed by five teeny, tiny balls of fur. One puppy was lagging considerably behind.

Immediately the little boy singled out the lagging, limping puppy and said, “What’s wrong with that little dog?” The store owner explained that the veterinarian had examined the little puppy and had discovered it didn’t have a hip socket. It would always limp. It would always be lame. The little boy became excited. “That is the little puppy that I want to buy.” The store owner said, “No, you don’t want to buy that little dog. If you really want him, I’ll just give him to you.”

The little boy got quite upset. He looked into the store owner’s eyes, pointing his finger, and said, “I don’t want you to give him to me. That dog is worth every bit as much as all the other dogs and I’ll pay full price. In fact, I’ll give you $2.37 now, and 50 cents a month until I have him paid for.”

The store owner countered, “You really don’t want to buy this little dog. He is never going to be able to run and jump and play with you like the other puppies.”

To this, the little boy reached down and rolled up his pant leg to reveal a badly twisted, crippled left leg supported by a big metal brace. He looked up at the store owner and softly replied, “Well, I don’t run so good myself, and the little puppy will need someone who understands!”

- Author Unknown

For comments and archives

  Cardiology eMedinewS

Screen All Adults for Alcohol Misuse: USPSTF Read More

Cardiovascular Effects of Flavanol Rich Chocolate in Patients with Heart Failure Read More

  Pediatric eMedinewS

Too Much TV Linked To Aggression, Inattention In Kids Read More

New Pneumococcal Vaccine Effective In Kids, But For How Long?
Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with heart failure had a total lymphocyte count of 1000.
Dr. Bad: Lymphocyte count does not matter.
Dr. Good: You have a bad prognosis.
Lesson: In heart failure, a lymphocyte count of less than 1600 is associated with greater risk of death and hospital admission. The cut–off value of lymphocyte count is 1800 and low ejection fraction is defined as lower than 35% (Charach G, et al. Usefulness of total lymphocyte count as predictor of outcome in patients with chronic heart failure. Am J Cardiol 2011;107(9):1353-6).

For comments and archives

Make Sure

Situation: A patient with LBBB in ECG developed acute pulmonary edema.
Reaction: Oh my God! Why was the underlying low cardiac functions not suspected?
Lesson: Make sure all patients with LBBB undergo echo to rule out ejection fraction. This may not be true for RBBB.

For comments and archives

    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Hemoglobin A1c

Glycohemoglobin A1c (HbA1c) test checks the long–term control of blood glucose levels in people with diabetes. Glucose binds to hemoglobin in red blood cells at steady rate. Since red blood cells last 3 to 4 months, A1c test shows how much glucose is in the plasma part of blood. Some medical conditions can increase A1c levels, but the results may still be within normal level. These conditions include Cushing’s syndrome, pheochromocytoma and polycystic ovary syndrome (PCOS).

  Quote of the Day (Dr GM Singh)

If I have the belief that I can do it, I shall surely acquire the capacity to do it even if I may not have it at the beginning. Gandhi

    Mind Teaser

Read this…………………

ch poorri

Yesterday’s Mind Teaser: siinformationde

Answer for Yesterday’s  Mind Teaser: Inside information

Correct answers received from: y. j. vasavada, Dr. P. C. Das, Dr U Gaur, Dr.K.Raju, Dr Pankaj Agarwal, Dr Chandresh  Jardosh, Dr. Rohini Vaswani, Dr. Thakor Hitendrsinh G , Dr Avtar Krishan,Dr Jainendra Upadhyay

Answer for 29th September Mind Teaser: c. Hoarseness
Correct answers received from: Dr Kanta jain, Dr  K P Chandra, Dr Vijay Kansal,

Send your answer to ijcp12@gmail.com

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

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    Laugh a While (Dr GM Singh)

A man was in the kitchen making a lot of noise! His wife comes in and asks why he was making so much noise? The man replies: "I am killing flies." A short time later his wife came back and he was still making lots of noise! She asks: "Well, Mr. Big Shot, how many flies have you killed?" He says: "I have killed seven flies! 4 males and 3 females." She says: "Right, how can you tell the gender of flies?" He says: "Very easy: the 4 flies in my right hand are males. When I killed them, they were all on beer cans!" Then she asks: "If you are so smart, how can you tell the gender of the females?" He says: "The three in my left hand, they were all on the phone!!!"

    Medicolegal Update

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

What is impulse and its medicolegal importance?

Impulse is a sudden and irresistible desire or force in a person that compels him to the conscious performance of some act for which there is no motive; for example, kleptomania means an irresistible desire to steal articles which may be of small value and even, may be of no use to the person stealing the article. A sane person who has self–control and judgment capacity may not finally give shape to his impulsive or compulsive desire. But an insane person, who lacks in self–control and judgment capacity, cannot resist the impulse and may commit any offence. Thus, in connection with commission of an unlawful act, impulse is a good defense for an insane person which is not so for a sane person. Some types of impulses are:

  • Dipsomania: This is found in alcoholics who have an irresistible desire to take alcoholic drinks.
  • Pyromania: Here, there is an irresistible desire to set fire to things, which may be important and valuable. The person is not conscious or careful, at least temporarily, to the possible dangers of his act.
  • Mutilomania: This is an irresistible desire to injure and mutilate animals, commonly the domestic pets.
  • Sexual impulse: The person may feel compulsive urge to perform sexual intercourse, often in a perverted way. There may be some psychic problem concerning the sexual behavior; or the person may be a victim of mental sub normality.
    Public Forum

(Press Release for use by the newspapers)

Women beware of heart disease

More women die of cardiovascular disease than from the next four causes of death combined, including all forms of cancer, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela. More than 80 percent of cardiac events in women can be prevented by modifying diet, exercise and abstinence from smoking. Dr Aggarwal said that the following may be the warning signals of heart attack:

  1. Uncomfortable pressure, squeezing, fullness or pain in the center of the chest. It lasts more than a few minutes, or goes away and comes back.
  2. Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  3. Shortness of breath with or without chest discomfort.
  4. Breaking out in a cold sweat, nausea or lightheadedness.

As with men, the most common heart attack symptom in women too is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

In presence of any of the above one should not wait for more than five minutes and get to a hospital right away.

    Readers Response
  1. Respected Sir, Emedinews is very much informative & very good for practioner  Dr kamala jain
    Forthcoming Events
Dr K K Aggarwal

19th MTNL Perfect Health Mela

Heart Care Foundation of India and Depts. of Health & Family Welfare, Govt. of Delhi in association with World Fellowship of Religions, NDMC, MCD are organizing 19th MTNL Perfect Health Mela at Constitution Club of India Rafi Marg, New Delhi from 7th-11th November 2012 (8am-8pm). The focus this year will be Prevention of Non Communicable Diseases.

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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, Dr Usha K Baveja