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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

  Editorial …

10th May 2011, Tuesday                                eMedinewS Present Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

10 simple steps to help de–stress from Health Beat (Harvard News Letter)

  1. Frequently late? Apply time management principles. Consider your priorities (be sure to include time for yourself) and delegate or discard unnecessary tasks. Map out your day, segment by segment, setting aside time for different tasks, such as writing or phone calls. If you are overly optimistic about travel time, consistently give yourself an extra 15 minutes or more to get to your destinations. If lateness stems from dragging your heels, consider the underlying issue. Are you anxious about what will happen after you get to work or to a social event, for example? Or maybe you’re trying to jam too many tasks into too little time.
  2. Often angry or irritated? Consider the weight of cognitive distortions. Are you magnifying a problem, leaping to conclusions, or applying emotional reasoning? Take the time to stop, breathe, reflect, and choose.
  3. Unsure of your ability to do something? Don’t try to go it alone. If the problem is work, talk to a co–worker or supportive boss. Ask a knowledgeable friend or call the local library or an organization that can supply the information you need. Write down other ways that you might get the answers or skills you need. Turn to CDs, books, or classes, for example, if you need a little tutoring. This works equally well when you’re learning relaxation response techniques, too.
  4. Overextended? Clear the deck of at least one time–consuming household task by hiring help. If you can, hire a housecleaning service, shop for groceries through the Internet, convene a family meeting to consider who can take on certain jobs, or barter with or pay teens for work around the house and yard. Consider what is truly essential and important to you and what might take a backseat right now.
  5. Not enough time for stress relief? Try mini–relaxations. Or make a commitment to yourself to pare down your schedule for just one week so you can practice evoking the relaxation response every day. Slowing down to pay attention to just one task or pleasure at hand is an excellent method of stress relief.
  6. Feeling unbearably tense? Try massage, a hot bath, mini–relaxations, a body scan, or a mindful walk. Practically any exercise — a brisk walk, a quick run, a sprint up and down the stairs — will help, too. Done regularly, exercise wards off tension, as do relaxation response techniques.
  7. Frequently feel pessimistic? Remind yourself of the value of learned optimism: a more joyful life and, quite possibly, better health. Practice deflating cognitive distortions. Rent funny movies and read amusing books. Create a mental list of reasons you have to feel grateful. If the list seems too short, consider beefing up your social network and adding creative, productive, and leisure pursuits to your life.
  8. Upset by conflicts with others? State your needs or distress directly, avoiding "you always" or "you never" zingers. Say, "I feel _____ when you _____." "I would really appreciate it if you could _____." "I need some help setting priorities. What needs to be done first and what should I tackle later?" If conflicts are a significant source of distress for you, consider taking a class on assertiveness training.
  9. Worn out or burned out? Focus on self–nurturing. Carve out time to practice relaxation response techniques or at least indulge in mini–relaxations. Care for your body by eating good, healthy food and for your heart by seeking out others. Give thought to creative, productive, and leisure activities. Consider your priorities in life: is it worth feeling this way, or is another path open to you? If you want help, consider what kind would be best. Do you want a particular task at work to be taken off your hands? Do you want to do it at a later date? Do you need someone with particular expertise to assist you?
  10. Feeling lonely? Connect with others. Even little connections — a brief conversation in line at the grocery store, an exchange about local goings–on with a neighbor, a question for a colleague — can help melt the ice within you. It may embolden you, too, to seek more opportunities to connect. Be a volunteer. Attend religious or community functions. Suggest coffee with an acquaintance. Call a friend or relative you miss. Take an interesting class. If a social phobia, low self–esteem, or depression is dampening your desire to reach out, seek help. The world is a kinder, more wondrous place when you share its pleasures and burdens
Dr KK Aggarwal
Editor in Chief
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    Changing Practice – Evidence which has changed practice in last one year

Treatment for solid tumor bone metastases

Use an osteoclast inhibiting agent to reduce the risk of skeletal complications in patients with bone metastases from a wide variety of solid tumors, including breast and prostate cancer. For most patients who do not have multiple myeloma, use denosumab as the preferred agen.

  eMedinewS Audio PostCard

HIV Update

Dr Nalin Nag Speaks on
‘Treatment of opportunistic infections: TB’

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

National Seminar on Stress Prevention

The 2–day National Workshop–cum–seminar on Stress Management and Prevention of Lifestyle Disorders was held at Om Shanti Retreat Centre, near Manesar. In the Photo (Left to Right): BK Sapna, BK Asha, BK Brij Mohan, Mr. Rakesh Mehta (State Election Commissioner, Govt of Delhi) Dr N K Gupta, Dr V K Narang and Padma Shri & Dr BC Roy National awardee Dr K K Aggarwal.

Dr K K Aggarwal
    National News

Drugs with Osama

There has been curiosity about the medicine chests found in the Laden mansion in Abbottabad and American TV channel NBC has tried to find out what the medicines were. Nearly a dozen drugs, including those to treat stress, stomach ulcers, were recovered. Either Osama or those who lived with him at the Pakistan compound where he was killed apparently suffered from stomach ulcers, high blood pressure and nerve pain. In addition, the medicine cache was said to contain Avena syrup, a botanical product that has at least two uses: as an artificial sweetener often used for a sour stomach and as "natural Viagra" that could be used to increase sexual desire and potency. Here's the complete list:
1) Tablet
2) Ulcer Capsule
3) Tab/Cap Gabapentin (for nerve pains, neuropathy)
4) Penza drops (ampicillin an antibiotic)
5) Natrilix (for high blood pressure or heart failure)
6) Grucid (omeprazole for acid stomach ulcers)
7) Avena syrup (artificial sweetener plus natural Viagra. It is an extract of wild oats)
8) NIFIM (an antibiotic)
9) Syp Tixylax, children cough syrup
10) Brufen syp (painkiller)
11) Dettol (an antiseptic)

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

How to burn calories instead of storing them: turn bad fat into good fat?

By changing the expression of a gene that affects body weight regulation and turns "bad" white fat into brown "good" fat, US scientists believe they may have found a way to help the body burn calories instead of storing them, opening the door to better treatments for obesity.

Lead researcher Dr Sheng Bi, an associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine in Baltimore, Maryland, and colleagues were researching appetite regulation in rats when they made their discovery.

(Dr Monica and Brahm Vasudev)

Strict exercise regimen beats back glood sugar

A meta–analysis found that any regular regimen of physical activity –– be it aerobic exercise, resistance training, or a combination of the two –– was associated with about a 0.67% decrease in glycated hemoglobin levels compared with controls, according to Beatriz Schaan, MD, ScD, of Hospital de Clinicas de Porto Alegre in Brazil, and colleagues. They reported their findings in the May 4 issue of the Journal of the American Medical Association.

Black patients may be experiencing worse outcomes after heart transplants

According to a study published in the journal Circulation, black patients may be experiencing worse outcomes after heart transplants than patients of other racial backgrounds.

Age may be used as effectively as medical tests to predict risk of heart disease

A person’s age can be used as effectively as medical tests to predict the risk of heart disease or stroke, according to a new study published in the journal PLoS ONE.

Mild hyponatremia may increase fracture risk in elderly

Mild hyponatremia –– low sodium in the blood –– may be a risk factor for vertebral and non–vertebral fractures in elderly men and women, researchers reported at the 13th European Congress of Endocrinology in Rotterdam, The Netherlands.

    Spiritual Update

Hanuman Chalisa
Doha 8

Prabhu Charittra Sun ibe Ko Rasiya
Ram Lakhan Sita man basyia

Meaning: Your greatest pleasure is listening to His glories. Rama, Lakshman and Sita always reside in your heart.

Spiritual significance: Using Pranayama and Breathing Awareness Meditation it is easy to get connected with the soul. Once connected, one does not want to come out. One can unite mind, body and soul easily and effectively. Mind, body, soul and Pranayama are stitched to each other like four in one. Here Rama is Soul, Lakshman is the Determined mind and Sita, the body.

    IJCP Special

Dr Good Dr Bad

Situation: A patient with fever had low platelet counts.
Dr Bad: It is dengue.
Dr Good: It can be any viral infection.
Lesson: Low platelet count can occur in malaria, dengue, Chikungunya, typhoid and in other viral infections.

Make Sure

Situation: A patient after sublingual nitrate developed fainting attack.
Reaction: Oh my God! Why was the systolic murmur missed on auscultation?
Lesson: Make sure that patient with left ventricular outflow tract (LVOT) obstruction are not given sublingual nitrates.

    An Inspirational Story

(Dr Anupam Sethi Malhotra)

What’s right

A group of children were playing near two railway tracks, one still in use while the other disused. Only one child played on the disused track, the rest on the operational track.

The train is coming, and you are just beside the track interchange. You can make the train change its course to the disused track and save most of the kids. However, that would also mean the lone child playing by the disused track would be sacrificed. Or would you rather let the train go its way?

Let’s take a pause to think what kind of decision we could make................

Most people might choose to divert the course of the train, and sacrifice only one child. You might think the same way, I guess. Exactly, I thought the same way initially because to save most of the children at the expense of only one child was rational decision most people would make, morally and emotionally. But, have you ever thought that the child choosing to play on the disused track had in fact made the right decision to play at a safe place?

Nevertheless, he had to be sacrificed because of his ignorant friends who chose to play where the danger was. This kind of dilemma happens around us everyday. In the office, community, in politics and especially in a democratic society, the minority is often sacrificed for the interest of the majority, no matter how foolish or ignorant the majority are, and how farsighted and knowledgeable the minority are. The child who chose not to play with the rest on the operational track was sidelined. And in the case he was sacrificed, no one would shed a tear for him.

The great critic Leo Velski Julian who told the story said he would not try to change the course of the train because he believed that the kids playing on the operational track should have known very well that track was still in use, and that they should have run away if they heard the train’s sirens. If the train was diverted, that lone child would definitely die because he never thought the train could come over to that track! Moreover, that track was not in use probably because it was not safe. If the train was diverted to the track, we could put the lives of all passengers on board at stake! And in your attempt to save a few kids by sacrificing one child, you might end up sacrificing hundreds of people to save these few kids.

While we are all aware that life is full of tough decisions that need to be made, we may not realize that hasty decisions may not always be the right one.

"Remember that what’s right isn’t always popular… and what’s popular isn’t always right."

Everybody makes mistakes; that’s why they put erasers on pencils.

    Pediatric Update

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

How do we manage a case of chronic constipation in children?

The basic aim for treating such cases is cleaning of fecal retention, prevention of further retention and promotion of regular bowel habits. The general approach includes:

  • Disimpaction
  • Initiation of maintenance treatment with laxative
  • Dietary modification, toilet training, and close follow–up
    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What are the indications of Donor insemination?

  • When the male partner has azoospermia, severe oligospermia, or other significant sperm or seminal fluid abnormalities or has ejaculatory dysfunction.
  • The female partner is Rh–negative and severely Rh–iso–immunized and the male partner is Rh–positive.
  • If the male partner has a sexually transmissible infection that cannot be eradicated.
    Medicolegal Update

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

Plasma transfusion is beneficial in seriously injured accident cases

Whole blood refers to blood containing all its components, including red blood cells, white blood cells, platelets, and so on. "Plasma" can refer either to the yellowish fluid of blood in which the cells are suspended, or to the blood after red blood cells have been removed.

  • In the cases of mismatch between Donor and Recipient the plasma can be given to a recipient with an incompatible group much more safely than red blood cells, since the antibodies in the plasma are quickly diluted when transfused into circulatory system.
  • The plasma donations can be done much more frequently than whole blood donations even up to twice a week. This is because the red blood cells, which take so much time to replace, are separated from the plasma and injected back into the plasma donor in saline solution.
  • In case of trauma/serious injuries resulting in massive ongoing loss of blood, the plasma can be transfused to restore the volume of the recipient’s blood and to stop bleeding because of its high concentration of clotting factors. Hemophiliacs, who don’t clot well, are frequent recipients of plasma.
  • Whole blood is rarely used and medically required for transfusions. Rare exceptions are for sickle–cell disease and heart surgery, in which the blood loss can be several units.
  • The red blood cells have blood group antigens that cause illness and even death has been seen at many occasions when types are mismatched. Plasma contains antibodies for the antigens proteins in red blood cells that trigger an immune response.
    Twitter of the Day

@DrKKAggarwal: Drugs with Osama There has been curiosity about the medicine chests found in the Laden mansion in Abbottabad

@sanjayguptaCNN:Music therapy helps speech, but also motor skills, memory and balance. also emotionally uplifting..

    Obesity Update

Dr. Parveen Bhatia and Dr. Pulkit Nandwani

Obesity in Pregnancy – National Health Service Guidelines

The prevalence of obesity in the general population has increased markedly since the early 1990s. The prevalence of obesity in pregnancy has also been seen to increase, rising from 9–10% in the early 1990s to 16–19% in the 2000s.

Obesity in pregnancy is associated with an increased risk of a number of serious adverse outcomes, including miscarriage, fetal congenital anomaly, thromboembolism, gestational diabetes, pre–eclampsia, dysfunctional labour, postpartum haemorrhage, wound infections, stillbirth and neonatal death. There is a higher cesarean section rate and lower breastfeeding rate in this group of women compared to women with a healthy BMI. There is also evidence to suggest that obesity may be a risk factor for maternal death: the Confidential Enquiry into Maternal and Child Health’s report on maternal deaths in the 2003–2005 triennium showed that 28% of mothers who died were obese, whereas the prevalence of obesity in the general maternity population within the same time period was 16–19%.

    Mind Teaser

Read this…………………

Which is the site for escharotomies in extremities for deep burns?

a. Anterior aspect
b. Posterior Aspect of the limb
c. Medial or lateral aspect of limb
d. It can be anywhere

Yesterday’s Mind Teaser: LANG4UAGE

Answer for Yesterday’s Mind Teaser: Foreign language

Correct answers received from: Dr Sumit Mehndiratta, Dr Rakesh Bhasin, Dr T Samraj, Dr Amit Kochar, Dr Bharat Aggarwal, Dr YJ Vasavada, Dr Muthumperumal Thirumalpillai, Dr Rashmi Chhibber,
Dr Chandresh Jardosh.

Answer for 8th May Mind Teaser: once upon a time
Correct answers received from: Dr Chandresh Jardosh, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr Sudipto Samaddar, Dr Anupam Sethi Malhotra, Dr Raju Kuppusamy.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr. GM Singh)

Family Bible

A little boy opened the big and old family Bible with fascination, looking at the old pages as he turned them. Then something fell out, and he picked it up and looked at it closely. It was an old leaf from a tree that had been pressed in between the pages.

"Momma, look what I found," the boy called out. "What have you got there, dear?" his mother asked.

With astonishment in the his voice, he answered, "It’s Adam’s Suit!"

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum calcium

Hypercalcemia (or high serum calcium level) is seen in

  • Malignant neoplasms (with or without bone involvement)
  • Primary and tertiary hyperparathyroidism
  • Sarcoidosis
  • Vitamin D intoxication
  • Milk–alkali syndrome
  • Paget’s disease of bone (with immobilization)
  • Thyrotoxicosis
  • Acromegaly
  • Diuretic phase of renal acute tubular necrosis
  • Drugs: Alkaline antacids, DES, diuretics (chronic administration), estrogens (incl. oral contraceptives), and progesterone

For given total calcium level, acidosis increases the physiologically active ionized form of calcium. Prolonged tourniquet pressure during venipuncture may spuriously increase total calcium.

    Medi Finance Update

(Dr GM Singh)

What is financial planning?

Financial planning is a process whereby you will have a road map of your personal and financial life that will help you to meet all your life’s expenses – both the expected –– and the unexpected.

    Drug Update

List of approved drugs from 01.01.2010 to 31.8.2010

Drug Name
DCI Approval Date
Nilotinib Capsules 200mg
For the treatment of chronic and accelerated phase Philadelphia chromosome positive chronic myelogenous leukemia (CML) in adult patients resistant to or intolerant to prior therapy that included imatinib.
    IMSA Update

International Medical Science Academy (IMSA) Update

Safety guidelines for atypical antipsychotic medications in children

With exception of using risperidone (i.e., for the management of irritability associated with autism, manic and mixed episodes associated with Bipolar I Disorder, and Schizophrenia) and aripiprazole (i.e., for manic and mixed episodes associated with Bipolar I Disorder and Schizophrenia), the Food and Drug Administration (FDA) has not approved the use of AAMs in children and adolescents.

  Quote of the Day

(Dr GM Singh)

Conscience is a man’s compass. Vincent van Gogh

    Readers Responses
  1. I enjoy reading eMedinewS. Dr. LVK Moorthy
    Public Forum

(Press Release for use by the newspapers)

Normal Weight Obesity

Normal weight obesity is the new epidemic of the society, said Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal and President, Heart Care Foundation of India.

Dr. Aggarwal said that obesity is based on excessive fat accumulation in the body and yet the weight may be within normal range.

Giving an example, he said that if the normal weight range of a person is 45–65 kg and the person weighs 45 kg at baseline, with an increase of 10 kg fat he may still be in the normal range but will amount to obesity with 10 kg extra fat.

Dr. Aggarwal said that after a person’s height stops growing it is unlikely that a person can gain weight more than 10% as organs also stop growing after the height. Any weight gain of more than 10%, therefore, after the growth of height is accumulation of fat and nothing else. Similarly, he said that, after the age of 50 the weight must reduce and not increase. Any weight gain after 50 is indicative of obesity.

In normal weight obesity, a person may look perfectly normal but there will be extra accumulation of fat around the abdomen. An extra inch of abdominal girth increases the chances of heart disease and diabetes by 1.5 times.

The criteria for obesity, therefore, should rely more on abdominal circumference than the weight of a person. If both are high, it is obviously more dangerous but when it comes to weight vs. abdominal circumference, abdominal circumference is more reliable. Indian men should have their abdominal circumference lower than 35 inches and women lower than 32 inches.

    eMedinewS Special

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

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

3. 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

  Towards Well Being

    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), India

A unique & highly educative Pre–Conference CME, International & national icons in the field of cardiology & echocardiography will form the teaching faculty.
• Provisional Scientific Program at http://worldcon2011.org/day1.html
• Provisional program for Pre Congress CME at http://worldcon2011.org/Pre_Conference_CME.html
• Abstract submission at http://worldcon2011.org/scientificprogram.html
• Important dates at http://worldcon2011.org/importantDates.html
• Congress website at http://www.worldcon2011.org
• Entertainment – Kingdom of Dreams at http://worldcon2011.org/Pre_Post_Tours.html

Key Contacts
Dr. (Col.) Satish Parashar, President Organizing Committee, + 91 9810146231
Dr. Rakesh Gupta, Secretary General, + 91 9811013246

Congress Secretariat: Rajat Khurana, C–1 / 16, Ashok Vihar – Phase II, Delhi 110 052, INDIA., Phone: + 91–11–2741–9505, Fax: + 91–11–2741–5646, Mobile: + 91 9560188488, 9811911800,
Email: worldcon2011@gmail.com, jrop2001@yahoo.com, worldcon2011@in.kuoni.com


Medifilmfest (1st International Health Film Festival in Delhi)

October 14–23, 2011, As part of 18th MTNL Perfect Health Mela 2011(Screening of films October 14–17, Jury Screening at Jamia Hamdarad University Auditorium October 18–19, award winning films at TalKatora Stadium October 19–23, 2011)
Organized by: Heart Care Foundation of India, World Fellowships of Religions, FACES, Bahudha Utkarsh Foundation and Dept of Health and Family Welfare Govt of NCT of Delhi.
Entries Invited: from feature films, Ad Films, Serials, Documentary Films, Cartoon Films, Animation Films, Educational films; films on Yoga, Siddha, Ayurveda, Unani, Homeopathy; Indigenous Healing, Films promoting the Bio–cultural Diversity, Medical Tourism, Visual and Medical Anthropology, Gender sensitization, awareness drive on socio–medical issues and health journalism. The films can be of variable durations (0–1 minute, upto 3 minutes, upto ten minutes, upto 45 minutes and upto an hour and beyond).
Separate entries are also invited for "factual mistakes in feature films concerning health". This can be in the form of 1–5 minutes footages.

Categories:Competitive category/ Non Competitive category/ Special screening
Sub Categories:

1. General: Documentaries, animation films, corporate films, Ad films, TV health programs/reports, health chat shows.

2. Special: Short instances of "depiction of wrong health messages" through the films.

Subjects: Health, disease, sanitation, yoga, spiritual health, environment, social issues, food, better living, Indigenous healing, medical tourism, visual & medical anthropology, gender sensitization, health journalism. Duration: 0–10 seconds; <30 minutes, 30–60 minutes, 1–3 hours. Language: English or Hindi, or sub tilled in English/Hindi. Fee: No fees from participants. Entry to the film show free. Format: Any format duly converted into DVD (compatible to the latest players/systems) Boarding, Lodging and Travel Expenses: Own, the participants may raise their own sponsorships

For details contact: Dr KK Aggarwal/Dr Kailash Kumar Mishra/Mr M Malik at


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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr AK 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 Naveen Dang, Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr Rajiv Parakh, Dr Sudhir Gupta.