eMedinewS17th September 2013, Tuesday

Dr K K 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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; 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.facebook.com/Dr KKAggarwal

Do not compromise on your health

Last week I interviewed 25 domestic helps working in highly educated, financially affluent class of the society. When asked what they fear the most, they said "a firing from the Madam (owner of the house) for wasting oil or soap".

All of them were given one soap for their personal use to be used for 3 to 4 weeks. If by mistake, they lost the soap before then to avoid a snub from the lady of the house, they preferred not to tell her and continue working in the house without using the soap even after their morning evacuation, which may lead to a serious health hazard. For servants, it does not matter as prior to their job, they never realized the importance of soap as they have been cleaning their hands with mud or the ash in their respective villages.

It is our duty to see that our servants are taken care of and their personal hygiene is important. They should be given adequate supply of soaps, oil for their personal use, clean undergarments and outer clothes and hygienic food.

Another situation is when we book for a catering of a large function like a marriage. We often hire Maharajs to cook food, but we forget to give them a place to sleep, toilet to use, clean water to drink and adequate water to wash their hands and feet after the morning evacuation. They defecate in the nearby open area and bathe and wash hands with the same water used for cooking food.

If they are not provided with soaps, they will wash their hands with fire ash collected from cooking place.

The same people are not given gloves to wear when they are serving golgappas.

Next time when you do that make sure you treat your servants hygienically in the same way as you treat yourself or your kids. ….Read More

Do not ask for concessions when buying food

A few days back I was delivering a lecture in Friends Club organized by All India Vaish Federation. There were many people who owned a car worth over 25 lakhs. When asked how much they spend on the car, the answer was on an average 3 lakhs per annum which included 60000/– for insurance, 2 lakhs for driver and the rest on annual maintenance. It amounts to over 10% of the car value being spent to look after its maintenance.

When asked how much they spend on their body, the answer was less than 25,000/– per annum. The worth of the body from the above calculation comes out to be less than 2.5 lakhs.

I called the chief hotel chef and asked him how was the food prepared? He said the food was prepared in soybean oil and the sweet dish in vanaspati ghee. When asked why did he chose them he said that oils like olive oil and desi ghee are costly.

This means a chef whose income is less than Rs.25,000/– per month has a perception that people who own a car worth over Rs.25 lakh cannot afford food which is costly, and therefore by default he has to make food using tin based cheapest soybean oil or panghat ghee which is the trans–fat full vanaspati ghee.

When asked how he presumed that these people could not afford he said that every day he has been watching people coming and negotiating about the prices of food when they book for any evening.

These people who book do not realize that the hotel will pass on any concessions to the people by supplying cheaper oil and other ingredient of the food. They will never reduce their personal margin. So next time you go to a restaurant or a hotel and ask for concessions you will get it but at the cost of inferior material.

When you eat out you pay double or triple the amount you would have spent if the food was made at home then why compromise on the quality. ….Read More

Use copper based kitchen and toilet accessories

Copper, pure or alloy, used in door knobs or other bathroom or kitchen accessories prevent infection.

I casually asked this question to one of the builders why in a house he uses steel based accessories and not copper based. He said that copper accessories are costly. When asked how much costly he said it may amount to spending extra 50,000/–.

A person can buy a flat for Rs.2.5 crores but when it comes to renovation he wants to save Rs.50000/– and compromise on the quality.

My end answer is never negotiate or bargain when it comes to eatables and healthcare.

In healthcare never negotiate when it comes to implants. For example you need a heart stent and you end up negotiating a discount of Rs.20000/–. The hospital will never reduce its margin of profit but install in you a 20,000/– cheaper stent.

The very purpose of your getting treatment in a private hospital is to get the best and not the costliest treatment with cheapest consumables and implants. ….Read More

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."

VIP’s on CPR 10 Mantra Video
Ringtone – CPR 10 Mantra Hindi

Ringtone – CPR 10 Mantra English

sprritual blog What is the difference between smile, hug and laugh.

Smile is a sign of joy while hug is a sign of love. Laughter on the other hand is a sign of inner happiness. None of them are at the level of mind or intellect. All come from within the heart.

They are only the gradations of your expressions of your happiness.

It is said you are incomplete in your dress if you are not wearing smile on your face.

Hug comes next, and laughter the last.

Laughter is like an internal jogging and has benefits like that of doing meditation.

But be careful we must know when not to laugh. The most difficult is to laugh at ourselves. ….Read More

cardiology news

An Office Boy

A jobless man applied for the position of ‘office boy’ at a very big company. The employer interviewed him, then a test: clean the floor. "You are hired." – The employer said. "Give me your email address, and Iíll send you the application to fill, as well as when you will start."

The man replied, "I don’t have a computer, neither an email."" I’m sorry," said the employer, "if you don’t have an email that means you do not exist. And who doesnít exist, cannot have the job.Ē

The man left with no hope. He didnít know what to do, with only $10 USD in his pocket. He then decided to go to the supermarket, bought a 10kg tomato crate, then sold the tomatoes door to door. In less than two hours, he succeeded and doubled his capital.

He repeated the operation 3 times and returned home with $60 USD. The man realized that he could survive by this way, and started to go every day earlier, and returned late. Thus, his money doubled or tripled every day. Shortly later, he bought a cart, then a truck, and then he had his own fleet of delivery vehicles.

Five years later, the man’s company was one of the biggest food retailers. He started to plan his family’s future, and decided to have a life insurance. He called an insurance broker and chose a protection plan. When the conversation was concluded, the broker asked him his email. The man replied: "I don’t have an email."

The broker replied curiously, "You don’t have an email, and yet have succeeded to build an empire. Do you imagine what you could have done if you had an email?" The man paused for a while, and replied: "An office boy!"

Don’t be discouraged if something is not in your favor today. Better opportunities are waiting ahead. ….Read More

News Around The Globe

5th Dil Ka Darbar

Date: Sunday, 29th September 2013, Venue: Constitution club of India, Rafi Marg, Time: 8 AM to 6 PM

Programme: A non stop question answer–session between all top cardiologists of the NCR region and the public.

The focus of the discussions will be prevention of heart diseases in women and young men. Special discussion will be held on Sex and Heart Diseases. Practical training will also be given to people on Hands–only Cardiopulmonary Resuscitation. Another focus of the discussion will be the launch of the Project Dhadkan (Palpitations) and Project Murmur (Congenital and valvular heart diseases in children).

Entry free…

  • Veterans receiving highly active antiretroviral therapy (HAART) were more likely to adhere to treatment and less likely to be hospitalized when taking a single versus multiple tablets, as per a study presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy. Compared with veterans with a multiple–pill treatment burden, single–pill therapy was associated with a nearly two–fold odds of adherence (odds ratio 1.98, P<0.001) and a 31% lower risk of hospitalization at follow–up. Among hospitalizations, single–pill therapy was associated with "a reduced risk of hospitalizations, fewer hospitalizations, and a longer time to hospitalization.
  • A therapeutic vaccine for herpes simplex type 2 (HSV–2) virus reduced viral shedding and had an acceptable safety profile. Early results for the GEN003 investigational therapeutic vaccine presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy showed that treatment with 30 mcg and 100 mcg of vaccine with adjuvant significantly reduced viral shedding in patients with HSV–2 and reduced HSV–2 DNA copies/mL. These patients also had greater time to first recurrence at a median of 60 days and no recurrence at the time of the presentation, respectively vs 45 days (non significant).
  • A common mutation, BRAF V600E, associated with thyroid cancer did not predict an unfavorable prognosis and had no consistent association with adverse characteristics as reported online in JAMA Otolaryngology–Head and Neck Surgery by Lisa A. Orloff, MD, of the University of California San Francisco, and co–authors. The mutation was associated with male sex, total thyroidectomy, and adverse follicular variant papillary thyroid cancer (PTC) but not with any other clinicopathologic features. The mutation had significant associations with positive tumor margins and lymph node involvement in a univariate analysis but did not remain significant by multivariate analysis.
  • According to a research presented at PAINWeek 2013, a critical component in the treatment of chronic pain is teaching patients strategies for coping with the pain, and an approach focusing on 5 essential coping skills offers beneficial, cost–effective result. The teaching of coping skills is in line with the suggestion of medicine as a "3–legged stool" that was established by Massachusetts General Hospital cardiologist Herbert Benson, MD. The idea of the 3–legged stool is that 1 leg of the stool is interventions (pharmacotherapy etc.); the other leg is surgeries and procedures and the third leg is the mind/body connection, which is largely controlled by the patient him- or herself, and without that third leg, the stool can’t stand on its own; it will fall over.
  • Exercise may have a moderately beneficial effect on depressive symptoms, according to an updated literature review and meta–analysis published online September 12 in the Cochrane Database of Systematic Reviews. However, the currently available evidence is unable to tell which kinds of exercise regimes are most effective or whether the benefits continue after a patient stops their exercise program
  • India has joined 10 other countries in a south–east Asian regional initiative to eliminate measles by 2020 and also control rubella, which causes congenital abnormalities in fetuses by 2020 as reported in The Telegraph, Sept 15. However, health experts caution that the country will need to significantly improve immunization and dramatically enhance case detection to achieve that goal. These countries were participating in a meeting for WHO’s regional committee for the south–east Asian region. The 11 countries have defined measles elimination as the absence of any measles transmission in a defined geographic area for at least 12 months in the presence of a well–performing surveillance system.

eMedinewS e–gifts to our readers

This is the age of smartphones. To improve usability and readability, eMedinewS has launched a mobile app of the newsletter for its readers. You can now also view eMedinewS on your smart phones or iPads.

The eMedinewS app is now available for free download.

The various icons for downloading are provided on the top of the newsletter. Choose the icon that is compatible with your device, whether iPhone, Android, Blackberry, iPad, Desktop/Windows phone or GSM
Click on the icon ‘e’ from the mail and download to install the app to the home screen of your mobile phone, iPad or Desktop. After you finish downloading, you will see an icon ‘e’ on the home screen of your device. That’s it.

Now you don’t need to type the address of the website in your web browser or log in to your email account every day to read the newsletter. Just click on the app and begin reading.

Rabies News (Dr. A K Gupta)

If a person is on antimalarials or steroids or taking immunosuppressant drug, what is the schedule for rabies vaccine?

The vaccine on Day 0 (first injection) must be doubled and given at two sites (deltoids or thigh in young children). In category II exposures, it is recommended to administer even RIGs along with vaccine. Rest of the schedule is same as for any other patient.

cardiology news
  • A new study published in the September issue of Critical Pathways in Cardiology has concluded that the duration of chest pain can signal a heart attack. Patients with pain of a shorter duration (less than 5 minutes) are less likely to have a heart attack than those with longer–lasting chest pain. However, researchers recommend further study. Although an electrocardiogram (ECG) and cardiac markers in the blood are important in the evaluation of patients with a possible heart attack, they are not 100 percent accurate.
  • Treatment with a statin reduced the relative rate of worsening peripheral artery disease by roughly 20% in a registry with nearly 6,000 patients with peripheral artery disease. However, the registry data also showed that more than a third of patients with peripheral artery disease (PAD) failed to receive statin treatment. The study was presented at the annual Congress of the European Society of Cardiology. In PAD patients with CAD, statins were used in about 75%, while, in PAD patients without CAD, it was less than 50%.

Valvular Heart Disease News

3D echo is instrumental in describing the sadal of the mitral anallus and redefining the diagnostic correctly for mitral valvular lapse.

(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)

cardiology news
  • Surveys of kids in grades 6 to 10 done over about 10 years revealed increases in physical activity, consumption of fruits and vegetables, and having breakfast as the first meal of the day suggesting that American teenagers are adopting healthier habits, paralleling a recent leveling of obesity rates. There has also been a decline in television viewing and consumption of sweets and sugary drinks.
  • According to a report from the United Nations Children’s Fund (UNICEF), the WHO, the World Bank Group, and the United Nations Department of Economic and Social Affairs/Population Division, the global community continues to make progress reducing the number of children who die before their fifth birthday, but more needs to be done to meet Millennium Development Goal 4 (to cut the rate of mortality in those younger than 5 years (under–5 mortality) by two thirds by 2015). If current trends continue, that development goal will not be reached until 2028, If no immediate action is taken to accelerate progress, as many as 35 million more children could die, mostly from preventable causes, between 2015 and 2028. The global infant mortality rate has been roughly halved, going from 90 deaths per 1000 live births in 1990 to 48 per 1000 live births in 2012.
cardiology news

Lifestyle counseling can reduce heart disease

An intensive, effort to change the lifestyle in people at high risk of heart disease can help them reduce such risk factors as high blood pressure, cholesterol and smoking.

A trial, called the Euroaction study, published in The Lancet compared the results of added counseling on lifestyle issues such as diet, physical activity and smoking to the usual care. It included more than 3,000 people with coronary heart disease and 2,300 at high risk. Half got the counseling from a team of nurses, dietitians, physiotherapists and the treating doctors. The counseling was given to families as well as individuals.

Two groups of patients were studied. One group included patients who already had developed coronary heart disease. The second group included those who were asymptomatic but at high risk because of a combination of risk factors that gives a high chance of developing heart disease over 10 years.

Fifty–five percent of those getting the counseling reduced their intake of saturated fat, compared to 40 percent of those not getting the advice. Increased consumption of fruits and vegetables was seen in 72 percent of the counseled group, and 17 percent of them also increased their consumption of heart–friendly oily fish, compared to 35 percent and 8 percent in the other group. Similar results were seen for blood pressure, cholesterol and physical activity, but it proved difficult to have people seen in general practice quit smoking

cardiology news

Total CPR since 1st November 2012 – 63400 trained

CPR Classes 63400

Media advocacy through Print Media

sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping
sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping

29th August: Veer Arjun

Media advocacy through Web Media

When Constipation May be a Serious Problem 30th August


TB more dangerous than FLU 29th August


CMAAO IMA orations awarded to eminent doctors.

CMAAO IMA orations were given to Dr. Naresh Trehan, Chairman, Medanta–The Medicity; Dr. Viveka Kumar, Director Cardiovascular, Max Health Care; Dr. Rajneesh Malhotra, Director Cardiac Surgery, Max Health Care; Dr. D.S. Rana, Chairman, Sir Ganga Ram Hospital; Dr. K.K. Aggarwal, President Heart Care Foundation of India; Dr. Martendey Pillai, eminent Neurosurgeon and Dr. Sampath Kumar, eminent Cardiac Surgeon, Pushpanjali Crosslay Hospital. These awards were presented during the recently concluded 28th CMAAO Conference and 49th Council Meet in New Delhi.

Director General Health Services, Dr. R K Srivastava presented the awards. Speaking on the occasion, President CMAAO, Dr. Vinay Aggarwal, said that the orations are given to people of eminence for their contribution in the field of medicine and healthcare in the country.

Dr. Naresh Trehan after receiving the oration said that India is all set to lead the CMAAO countries and can provide excellent training in the field of heart care to people from neighboring countries.

Dr. Viveka Kumar and Dr. Rajneesh Malhotra in a joint statement said that India is second to none as far as health care facilities are concerned. They said that the medical tourism in India is booming as India provides not only a cheaper but also the best treatment in this part of the world. They also said that the personal healing touch in the Indian hospitals cannot be matched by others.

Padma Shri awardee Dr. K.K. Aggarwal and Dr. Martendey Pillai in a joint statement said that both heart attack and paralysis should be treated on a war footing. Unfortunately, today heart attack is treated aggressively but brain attack is not.

Others who received the oration–cum–awards were Dr. J. D. Mukerjee, Head Neurosciences, Max Health Care and Dr. Anu Kant Mittal from Mumbai.

Dr. Narender Saini, Secretary General IMA and Dr. D.R. Rai, Sr. Vice President, IMA in a joint statement said that Indian Medical Association is committed to the prevention of lifestyle disorders and said that a special program would be run by all the branches of IMA to education public about prevention of heart attack, diabetes and stroke.

The conference was inaugurated by Mrs. Sheila Dikshit Chief Minister of Delhi and the theme of the conference was "Be Human – Stop Child Abuse".

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 63400 people since 1st November 2012.

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."

today emedipics

Live in Dilli Aajtak on dengue

press release

Mammography survival benefit

today video of the dayDr KK Aggarwal Birthday 5th September

Cultural Evening at IMA

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

When assessing a patient’s cultural beliefs about pain, the pain management nurse asks about:

a) A family history of pain.
b) Home remedies used to treat pain.
c) The frequency of visits to health care facilities.
d) The patient’s dietary preferences.

Yesterday’s Mind Teaser: An infant, 6 weeks old, is brought to the clinic for a well–baby visit. To assess the fontanels, how should nurse Oliver position the infant?

a. Supine
b. Prone
c. In the left lateral position
d. Seated upright

Answer for yesterday’s Mind Teaser: d. Seated upright

Correct answers received from: Dr Prabha Luhadia, Jigishapatadia, Narahari Kandakatla, Dr Kanta Jain, Dr Pankaj Agarwal, Dr Arpan Gandhi, Dr Jayesh Sonvani, Dr Jainendra Upadhyay, Dr Avtar Krishan, Muthumperumal Thirumalpillai, Dr Chandresh Jardosh, Dr PK Sahu, Daivadheenam Jella, Dr Abbas Vakil.

Answer for 15th September Mind Teaser: b. 7 to 10 days.

Correct answers received from: Arvind Gajjar, Dr PC Das, Dr Abbas Vakil.

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

A Dishonest Honest Man

One evening a man walked into a fast–food chicken place and bought a nine–piece bucket of chicken. He took his chicken to the park for a romantic dinner under the moonlight with his lady.

Upon reaching into the bucket, however, he received a surprise. Instead of chicken he discovered what was apparently the restaurant’s night deposit – some nine thousand bucks. The young man brought the bucket back to the store and asked for his chicken in exchange for the money.

The manager, in awe of the young man’s honesty, asked for his name and told him he wanted to call the newspaper and the local news station to do a story on him. He would become a local hero, an example of honesty and morality that would inspire others!

The hungry man shrugged it off, "My date’s waiting. I just want my chicken."

The manager’s renewed amazement over the young man’s humility almost overwhelmed him. He begged to be allowed to tell the story on the news. At this the honest man became angry with the manager and demanded his chicken.

"I don’t get it," the manager responded. "You are an honest man in a dishonest world! This is a perfect opportunity to show the world that there are honest people still willing to take a stand for what is right. Please, give me your name and also the woman’s name. Is that your wife?"

"That’s the f***** problem," said the young man. "My wife is at home. The woman in the car is my girlfriend. Now let me have my chicken so I can get out of here.

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with prosthetic heart valves (bioprosthetic) developed infective endocarditis.
Reaction: Oh my God! Why was he not given infective endocarditis prophylaxis?
Lesson: Make sure that all patients with prosthetic heart valves (bioprosthetic or homograft) are given infective endocarditis prophylaxis.

medicolegal update

With ordinary talent and extraordinary perseverance, all things are attainable. Thomas Foxwell Buxton

medicolegal update

Dr KK Aggarwal: Bed netting is of little help to prevent dengue http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: Consciousness is the subjective ground of all experience. If there is reality outside of consciousness it is unknowable #CosmicConsciousness

medicolegal update

Excellent idea…a suitable Vedic Return Form (like IT forms) may be designed for standardization. Dr. Singh

Forthcoming Events

29thSeptember–Dil Ka Darbar at Constitution Club of India,New Delhi

20th Perfect Health Mela from 18th Oct to 22nd Oct at different locations

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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)

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, Prof.(Dr).C V Raghuveer

medicolegal update

Our Sites