Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10-13); 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 …

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

5th May 2013, Sunday

How to recognize cardiac arrest

Rapid recognition of cardiac arrest is the essential first step of successful CPR 10.

As per Guidelines, the lay rescuer who witnesses a person collapse or comes across an apparently unresponsive person should confirm unresponsiveness by tapping the person on the shoulder and shouting: “are you all right?”

If the person does not respond, the rescuer calls for help or ambulance and initiates excellent chest compressions.

Lay rescuers should not attempt to assess the victim’s pulse and, unless the patient has what appear to be normal respirations, should assume the patient is apneic or without respiration.

Remember even well-trained professionals can have difficulty determining if breathing is adequate or pulses are present in unresponsive adults.

After assessing responsiveness, health care providers should quickly check the patient’s pulse. While doing so, it is reasonable to visually assess the patient’s respirations.

It is appropriate to assume the patient is in cardiac arrest if there is no breathing or abnormal breathing (gasping) or if a pulse cannot be readily palpated within 10 seconds.

The key point is to not delay CPR.

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

FDA OKs first drug-eluting stents for use in MI

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

World Earth Day 2013

Heart Care Foundation of India and World Fellowship of Religions in association with Ministry of Earth Sciences Govt. of India and Delhi Public School Mathura Road observed World Earth Day 2013.

Dr K K Aggarwal
    National News

DD Programme “Take Care Holistically”, Anchoring Dr KK Aggarwal, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Anchoring Dr KK Aggarwal, every Thursday 4:30 PM in DD India

Nearly one percent children diabetic: Health minister

New Delhi: A sample survey by the government, conducted in schools in three cities, has shown that more than one percent of children suffer from diabetes, Health Minister Ghulam Nabi Azad informed the Lok Sabha Monday. Azad, in a written reply in the Lok Sabha, said that under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke, a study was conducted on 92,047 school children in Nainital (Uttarakhand), Ratlam (Madhya Pradesh), and Bhilwara (Rajasthan). "According to the study, 1,351 (1.467 percent) of the students were suspected to be diabetic," Azad said. The minister also said that a report of the International Diabetes Federation for South-East Region of WHO, comprising 11 countries of which one is India, estimates the prevalence of type-1 diabetes in children to be 1,11,500. "An estimated 18,000 children under the age of 15 were newly diagnosed for type-1 diabetes in the year 2011 in the said region," The minister said. He added that the government in 2010 launched a National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) to prevent lifestyle diseases. Asked if there was any study on growing sleep disorders, the minister said no such study had yet been conducted. (Source: The Pioneer, 29 April 2013)

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)



  1. 4 lakh child CSWs in India
  2. 200 females enter prostitution daily
  3. About 15000 children are reported missing every year
  4. Minimum age for persons trafficked in India has fallen below 10 years.
  5. Trafficking trade is worth US $ 7 billion annually, next only to the trade of arms and drug trafficking.

For comments and archives

    Valvular Heart Disease Update

Congenital left ventricular outflow obstructive lesions can occur at valvular, subvalvular and supravalvular levels. The most common lesion is bicuspid aortic valve.

(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)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Platelet-rich plasma boosts hair growth in alopecia areata

Alopecia areata, inflammation-induced hair loss, improved more with platelet-rich plasma (PRP) than with triamcinolone acetonide in a recent trial. (Source: Medscape)

For comments and archives

FDA OKs Liptruzet for high LDL

The FDA approved Liptruzet, a combination of ezetimibe and atorvastatin, for the treatment of hyperlipidemia, drug maker Merck announced today. Liptruzet is approved to treat elevated low-density lipoprotein (LDL) cholesterol in those with either primary or mixed hyperlipidemia and whose diet and lifestyle changes have not lowered their cholesterol to recommended levels. (Source: Medpage Today)

For comments and archives

FDA limits use of Samsca (Tolvaptan) due to liver injury risk

The US Food and Drug Administration (FDA) has placed restrictions on the use of tolvaptan (Samsca, Otsuka American Pharmaceutical, Inc) because of the risk for serious and potentially fatal liver injury. (Source: Medscape)

For comments and archives

Case study links 'Pot' to pituitary damage

Chronic, daily pot smoking over 15 years may be draining on pituitary hormones, and may explain the "pot-head" image popularized in movies and TV, according to a case report presented at the meeting of the American Association of Clinical Endocrinologists. (Source: Medpage Today)

For comments and archives

Urologists ease PSA testing advice

Prostate-specific antigen (PSA) testing for prostate cancer screening should proceed only after careful discussion of risks and harms with patients, and should target men ages 55 to 69, according to the American Urological Association's first-ever clinical guideline on the topic. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Low cholesterol linked to anxiety, depression, suicide, hemorrhagic stroke and cancers People with very low... http://fb.me/25oniXXkN

@DeepakChopra: Is God a mathematician? Find out in the latest episode of #AskDeepak http://tinyurl.com/cw6ewr4

    Spiritual Update

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

Why are coconut and the kalash used in all poojas?

I f nature wanted you to drink coconut water in non-coastal areas it would not have grown coconuts in the coastal areas is a common naturopathic saying. Coconut water is the treatment for most humidity-related illness in costal areas. It is sterile water and has been used in surgical practice as a sterile fluid. It is also used as a replacement for oral rehydration solution. Hence, because of its many uses it is regarded as the ‘Tree of Life’.

For comments and archives

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What is cryopreservation?

Extra embryos remaining after the embryo transfer may be cryopreserved (frozen) for future transfer. Cryopreservation makes future ART cycles simpler, less expensive and less invasive than the initial IVF cycle, since the woman does not require ovarian stimulation or egg retrieval. There are two methods used to cryopreserve embryos: conventional (slow) freezing and “vitrification” or fast freezing.

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

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


Immunogenicity is the ability of an antigen to stimulate the production of its corresponding antibody in a person that lacks the antigen.

  • Immunogen = Antigen
    • D antigen, strong immunogen
    • Fya antigen, weak immunogen
  • Immune response depends on:
    • Chemical structure of the antigen
    • Number of red cells and amount of antigen they carry

For comments and archives

    An Inspirational Story

The tattooed homeless man

He was scary. He sat on the grass with… his cardboard sign, his dog (actually his dog was adorable) and tattoos running up and down both arms and even on his neck. His sign proclaimed him to be “stuck and hungry” and to please help.

I’m a sucker for anyone needing help. My husband both loves and hates this quality in me. It often makes him nervous, and I knew if he saw me right now, he’d be nervous. But he wasn’t with me right now.

I pulled the van over and in my rear-view mirror, contemplated this man, tattoos and all. He was youngish, maybe forty. He wore one of those bandannas tied over his head, biker/pirate style. Anyone could see he was dirty and had a scraggly beard. But if you looked closer, you could see that he had neatly tucked in the black T-shirt, and his things were in a small, tidy bundle. Nobody was stopping for him. I could see the other drivers take one look and immediately focus on something else – anything else.

It was so hot out. I could see in the man’s very blue eyes how dejected and tired and worn-out he felt. The sweat was trickling down his face. As I sat with the air-conditioning blowing, the scripture suddenly popped into my head. “Inasmuch as ye have done it unto one of the least of these, my brethren, so ye have done it unto me.”

I reached down into my purse and extracted a ten-dollar bill. My twelve-year old son, Nick knew right away what I was doing. “Can I take it to him, Mom?”

“Be careful, honey.” I warned and handed him the money. I watched in the mirror as he rushed over to the man, and with a shy smile, handed it to him. I saw the man, startled, stand up and take the money, putting it into his back pocket. “Good,” I thought to myself, “now he will at least have a hot meal tonight.” I felt satisfied, proud of myself. I had made a sacrifice and now I could go on with my errands.

When Nick got back into the car, he looked at me with sad, pleading eyes. “Mom, his dog looks so hot and the man is really nice.” I knew I had to do more.

“Go back and tell him to stay there, that we will be back in fifteen minutes,” I told Nick. He bounded out of the car and ran to tell the tattooed stranger. I could see the man was surprised, but nodded his agreement. From my car, my heart did a little flip-flop of excitement.

We then ran to the nearest store and bought our gifts carefully. “It can’t be too heavy,” I explained to the children. “He has to be able to carry it around with him.” We finally settled on our purchases. A bag of “Ol’ Roy” (I hoped it was good – it looked good enough for me to eat! How do they make dog food look that way?); a flavored chew-toy shaped like a bone; a water dish, bacon flavored snacks (for the dog); two bottles of water (one for the dog, one for Mr. Tattoos); and some people snacks for the man.

We rushed back to the spot where we had left him, and there he was, still waiting. And still nobody else was stopping for him. With hands shaking, I grabbed our bags and climbed out of the car, all four of my children following me, each carrying gifts. As we walked up to him, I had a fleeting moment of fear, hoping he wasn’t a serial killer.

I looked into his eyes and saw something that startled me and made me ashamed of my judgment. I saw tears. He was fighting like a little boy to hold back his tears.

How long had it been since someone showed this man kindness? I told him I hoped it wasn’t too heavy for him to carry and showed him what we had brought. He stood there, like a child at Christmas, and I felt like my small contributions were so inadequate. When I took out the water dish, he snatched it out of my hands as if it were solid gold and told me he had had no way to give his dog water. He gingerly set it down, filled it with the bottled water we brought, and stood up to look directly into my eyes. His were so blue, so intense and my own filled with tears as he said “Ma’am, I don’t know what to say.” He then put both hands on his bandanna-clad head and just started to cry. This man, this “scary” man, was so gentle, so sweet, so humble.

I smiled through my tears and said “Don’t say anything.” Then I noticed the tattoo on his neck. It said “Mama tried.” As we all piled into the van and drove away, he was on his knees, arms around his dog, kissing his nose and smiling. I waved cheerfully and then fully broke down in tears.

I have so much. My worries seem so trivial and petty now. I have a home, a loving husband, four beautiful children. I have a bed. I wondered where he would sleep tonight. My step-daughter, Brandie turned to me and said in the sweetest little-girl voice, “I feel so good.”

Although it seemed as if we had helped him, the man with the tattoos gave us a gift that I will never forget. He taught that no matter what the outside looks like, inside each of us is a human being deserving of kindness, of compassion, of acceptance. He opened my heart.

For comments and archives

    Cardiology eMedinewS

ECG alarm alerts docs to silent killer Read More

    Pediatric eMedinewS

One of every five Indian kids acutely malnourished: Krishna Tirath
Read More

Our Social
Network sites
… Stay Connected

  > Dr K K Aggarwal
  > eMedinewS
  > Hcfi NGO
  > IJCP Group

  > Dr K K Aggarwal
  > eMedinewS
  > HCFIindia
  > IJCP Group

  > Dr K K Aggarwal
  > eMedinewS
  > IJCP Group

        You Tube
  > Dr K K Aggarwal
  > eMedinewS

central bank
lic bank

Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

Photos of Doctor’s Day Celebration

eMedinewS Apps
    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

A patient received two doses of modern vaccine (on days 0 and 3) and the dog was well on days 5 and 7 (third injection due, but not given). However, the dog dies on any day between 8 and 15. What should be done?

In case, day 0 and 3 injections were given and the dose due on day 7 was postponed because the dog was kept under observation but the dog dies between 8 and 15 days, three doses of vaccine must be given as close to the original dates of the schedule and all five injections must be completed by day 28.

    Legal Question of the Day (Dr MC Gupta)

Q. I am a practicing gynecologist running a maternity home by myself and, hence, am very busy and short of time. I have been summoned by a far-away court as a witness in a case where I performed an obstetric ultrasound on a 32 weeks pregnant woman who, as alleged in the court case, was pregnant before marriage. I want to avoid appearing as a witness because I have no time. I will have to forego my professional practice for a full day for a mere Rs. 350/- that I will get as a witness. I am being harassed because I was not informed beforehand that I might have to appear as a witness. The husband is acting smart and says that if I don’t attend court, I will have to face legal consequences. How can a doctor practice in peace if patients behave like this? Please advice.


  1. Every citizen, including a physician, has a duty to appear in court when summoned. You are legally bound to do so. You can be punished for non-appearance.
  2. You are not doing anybody a favour by appearing in the court as an expert witness. It is your duty to assist the court as an expert when requested. If experts do not assist the court, there may be miscarriage of justice.
  3. You will, in fact, be learning a bit by appearing in the court. Besides learning some legal aspects, you will probably also learn something about record keeping and answering questions regarding medical facts posed by a non-physician. Such questions can sometimes be rather searching and sharp and you will benefit by looking up the medical books and facts as relevant.
  4. You should reach the court before the court proceedings start and should ask the PP (Public prosecutor) to arrange for an early disposal of your case because, being a doctor, you need to reach back soon to treat your patients. If the PP is not there or is not inclined to help, you can directly mention to the court in a similar manner. (mentioning is the procedure in a court whereby some urgent matters can be brought to the notice of the court before the regular work listed for the day starts).
  5. You are not being harassed by anybody. There is no system or even possibility that a physician should be informed by anybody that he would be called as a witness.
  6. The husband/complainant are not acting smart here. He is correct that you are liable to face legal consequences in case of default.
  7. Besides any other punishment for non-appearance that the court may impose on you, please take note that the court can also report your name to the medical council for professional misconduct (for non-appearance as expert witness) and the council is sure to take action against you. A few weeks’ suspension of licence will deprive your dear patients of your services much more than a day’s visit to the court.
  8. You are strongly advised against non-appearance.
    IJCP Special

Dr Good Dr Bad

Situation: A diabetic with A1c 6% had a BP of 130/88 mmHg.
Dr Bad: This is very good control of diabetes.
Dr Good: This is very good control but we also need to control BP.
Lesson: Cardiovascular morbidity can only be reduced with aggressive management of hypertension, cholesterol (LDL <100 mg/dL) and aspirin (75–150 mg/day) in patients with or at high risk for cardiovascular disease.

Make Sure

Situation: A female patient complained of lower abdominal pain, fever and had uterine tenderness on bimanual palpation.
Reaction: Oh my God! You should do cervical swabs and consider starting antibiotics.
Lesson: Make sure to remember that women with such symptoms may have endometritis, which requires prompt diagnosis. It may respond to doxycycline and metronidazole.

    Quote of the Day (Dr GM Singh)

This is my simple religion. There is no need for temples; no need for complicated philosophy. Our own brain, our own heart is our temple; the philosophy is kindness. Dalai Lama

   Mind Teaser

Read this…………………

A male client is scheduled for a renal clearance test. Nurse Maureen should explain that this test is done to assess the kidneys’ ability to remove a substance from the plasma in:

a. 1 minute
b. 30 minutes
c. 1 hour
d. 24 hours

Yesterday’s Mind Teaser: Nurse Agnes is reviewing the report of a client’s routine urinalysis. Which value should the nurse consider abnormal?

a. Specific gravity of 1.03
b. Urine pH of 3.0
c. Absence of protein
d. Absence of glucose

Answer for Yesterday’s  Mind Teaser: b. Urine pH of 3.0

Correct answers received from: Tukaram Pagad, Dr Santha Kumari, Dr Ayyavoo, Dr Arpan Gandhi, Arundhati Malviya, Dr Jayashree Sen & Dr Bitaan Sen, Dr BR Bhatnagar, Dr Pawan Mehta,
Dr Raghavendra Jayesh, Dr KV Sarma, Dr (Maj. Gen.) Anil Bairaria, Dr BB Gupta, Dr K Raju, Dr Pankaj Agarwal, Dr Jella, Dr Jainendra Upadhyay, Dr Nageswara Rao Patnala, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Avtar Krishan, Dr Kanta Jain, Dr Deepali Chatterjee, Dr BK Agarwal,
Dr BR Bhatnagar.

Answer for 3rd May Mind Teaser: Muthumperumal Thirumalpillai, Dr Avtar Krishan, Dr Kanta Jain,
Dr Deepali Chatterjee, Dr BK Agarwal, Dr BR Bhatnagar.

Correct answers received from: .........

Send your answer to ijcp12@gmail.com

   Laugh a While (Dr GM Singh)

I've sure gotten old. I've had two bypass surgeries. A hip replacement, new knees. Fought prostate cancer, and diabetes. I'm half blind, can't hear anything quieter than a jet engine, take 40 different medications that make me dizzy, I'm winded, and subject to blackouts.

I have bouts with dementia. Have poor circulation, hardly feel my hands and feet anymore. Can't remember if I'm 85 or 92. Have lost all my friends.

But... Thank God, I still have my Florida driver's license.

    Medicolegal Update

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

Preparation of MLC in injury cases by the attending doctor

  • Injuries produced by a blunt weapon on tense skin covering the bones, as on scalp, eyebrow, iliac crest, shin, perineum, knee or elbow look like incised wounds. During the preparation of MLC report the doctors should keep in mind that he has to provide a clue about the weapon used, whether sharp–edged one or otherwise, the direction of the force, the duration of injury and the location of the wound, which may suggest mode of production i.e. suicide, accident, homicides along with whether the injury is fabricated or otherwise.
  • Wounds produced by a blunt weapon or by a fall on the hard surface, object, on tense structures/skin covering the bones, such as the scalp, eyebrow, iliac crest, shin, perineum, knee or elbow when the limb is flexed look like incised wounds; but, they are lacerated wounds, also called split lacerations. These wounds may mislead the doctor and the investigating authorities about a sharp weapon.
  • When incised–looking wounds are examined by doctor under magnifying lens, the edges of such wounds are found to be irregular with bruising and wounds are produced by blunt weapon.
  • An incised wound, cut, slash and slice is a clean cut through the skin, it may or may not involve underlying tissues and structures. It is caused by a sharp–edged instrument, which is longer than the depth of wound. It is produced by infliction of an object having a sharp–cutting edge such as knife, razor, blade, scalpel, sword over the body.

For comments and archives

    Public Forum

Public Forum (Press Release for use by the newspapers)

Elderly Beware

Anticholinergics, a commonly prescribed group of drugs, may cause elderly people to "slow down" in their daily physical activities, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

It has been reported that anti-cholinergic drugs – used to treat acid reflux, Parkinson's disease and urinary incontinence -- may cause older people to lose their thinking skills more quickly than those who do not take the medicines.

Anti-cholinergic drugs act by blocking acetylcholine, a chemical that enhances communication between nerve cells in the brain, from binding to its receptors in nerve cells.

Older adults taking anticholinergics become more likely to walk more slowly and to need help in other daily activities. These results are true even in older adults who have normal memory and thinking abilities.

For older adults taking a moderately anticholinergic medication, or two or more mildly anticholinergic medications, their function is similar to that of someone three to four years older.

Common anticholinergic medicines include blood pressure medication, nifedipine; the stomach antacid, ranitidine and the incontinence medication, tolterodine.

Cholinesterase inhibitors, a family of drugs used to treat dementia by increasing levels of acetylcholine include donepezil, galantamine, rivastigmine and tacrine. About 10 percent of patients may be taking tolterodine and donepezil together. The two drugs are pharmacological opposites, which led to the hypothesis that the simultaneous treatment of dementia and incontinence could lead to reduced effectiveness of one or both drug.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 47982 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

    Readers Responses
  1. Dear Sir, emedinews is very informative newsletter. Regards:Dr Som
    Forthcoming Events
Dr K K Aggarwal
Dr K K Aggarwal
    eMedinewS Special

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

Activities eBooks



  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  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, Dr Usha K Baveja