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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 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


eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

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

  Editorial …

18th October 2011, Tuesday

Why BP should be kept < 120/80 mm Hg

  1. Incidence of paralysis will reduce by 35-40%.
  2. Heart attacks will go down by 20-25%.
  3. Heart failure will reduce by 50%.
  4. A 5 mm reduction in diastolic BP can reduce heart disease risk by 21% (Magnus and Beaglehole, 2001).
  5. If we can eliminate pre hypertension (BP > 120/80 and less than 140/90 mm Hg) from the society, we can prevent about 47 % of all heart attacks.
  6. The Framingham Study has shown that a pre hypertensive person is more than three times more likely to have a heart attack and 1.7 times more likely to have heart disease than a person with normal blood pressure.
  7. A 3–4 mm Hg increase in systolic upper blood pressure would translate into a 20% higher paralysis death rate and a 12 % higher death rate from ischemic heart disease.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

Faculty of all pathy consensus statement at
MTNL Perfect Health Mela

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011 – ‘Anmol’ – Festival for Children with Special Needs'

Anmol – a festival was organised by Heart Care Foundation of India in association with Balwant Rai Mehta Vidhya Bhawan. In the Photo: Padma Shri Awardee Dr KK Aggarwal with the Award wining students.

Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter


Compensation package for clinical trial victims in the offing

NEW DELHI: India will soon quantify the amount of compensation to be paid by pharmaceutical companies, if a volunteer dies or gets injured during a clinical trial. On October 10, the Drug Technical Advisory Board (DTAB) gave its nod to the Central Drugs Standard Control Organization (CDSCO) to prepare a "compensation chart" or extensive guidelines that will specify the amount to be paid. Ethical committees of the company will have to decide the quantum of compensation on the basis of these guidelines. The compensation has to be paid by the trial's sponsor or its representative within 90 days of the death or injury to the victim or the next of h/his kin. In the first 30 days, the firm will have to prove to the ethics panel that the death or injury wasn't due to the drug, else it has to pay. (Source: TOI, Oct 14, 2011)

For comments and archives

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

(Dr Monica and Brahm Vasudev)

Mom, baby fare worse with polycystic ovary

Polycystic ovary syndrome is associated with adverse pregnancy and birth outcomes, whether assisted reproductive technology was used to conceive or not, a large, population-based cohort study showed. Women with the disorder were more likely to have pre-eclampsia and gestational diabetes, and their babies were more likely to be large for gestational age and to have a low Apgar score, Nathalie Roos, MD, of the Karolinska Institute in Stockholm, and colleagues reported online in BMJ. (Source: Medpage Today)

For comments and archives

FDA okays drug for iron overload disorder

A new oral chelator drug, deferiprone (Ferriprox), has received FDA approval for treating thalassemia-related iron overload that has not responded adequately to other iron-removing drugs such as deferoxamine. Patients with thalassemia, a genetic disease, require frequent blood transfusions. Over time, iron accumulates in toxic levels, requiring chelation therapy. (Source: Medpage Today)

For comments and archives

AAP: Guideline calls for Pre-K ADHD evaluation

Primary care physicians should begin evaluating children for attention deficit hyperactivity disorder (ADHD) at age 4 and continue through age 18, according to a new clinical guideline from the American Academy of Pediatrics. An accumulation of evidence in recent years has enabled diagnosis and management of ADHD in a broader pediatric population. Earlier versions of the guidelines covered children ages 6 to 12. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: #MTNL Perfect Health Mela- metabolic syndrome the most common knowing???? disease now-a-days

@DeepakChopra: #CosmicConsciousness We are ancient beings. The atoms in our body this very moment were forged in the crucible of stars.

    Spiritual Update

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

Importance of Life Force

A physical body becomes useless once the life force is gone. The same body, which was lovable to everyone, becomes a liability after death. Everyone wants to dispose it as early as possible as keeping a dead body at home is considered a bad omen.

For comments and archives

    An Inspirational Story

(Ms Ritu Sinha)

Little Brown Boy

Danielle was only four when she burst through the front door, having just gotten off the school bus, after preschool. Charging through the living room, she spotted me in the dining room and launched into a speech while she headed toward me. While it was comical to see such a little person behave so dramatically, her outrage seemed real enough that she had my full attention.” They are MEAN to him!" she raged, her little fist hammering the table top for emphasis. “Who is mean to who?" I interrupted. “Those kids on the bus! They are MEAN to the little brown boy!" She looked up at me, hands on her hips, her eyes wide, incredulous. I knew she expected me to right this injustice immediately. It was the first one she had discovered in her very new Out in the World on Her Own adventures. “They make fun of him and make fun of him and make fun of him." Her golden head nodded emphatically with each repetition. "They laugh at him. They copy the way he talks. They hurt his feelings!" I watched her while I listened. This was something very different for her, this little girl I knew so well. I had never seen her just this way before. I even saw flashes of anger in her green eyes.

"The way he talks...?" I prompted, as if she needed prompting. I sat down at the table and set her on my lap. “He doesn't talk perfect, but that's just because he's a little kid!" this four-year-old elderly person informed me loudly, inches from my face. She looked directly into my eyes, needing answers. "WHY are they so MEAN?"

My husband and I had been a little apprehensive about sending her to and from preschool ("Head start") on a bus with many of the kids so much older and bigger and tougher than she was. This was our baby of the family, our sheltered miniature princess, and it was not easy to back off and let her face the world without us for a few hours a day ... Alas, even princesses grow up. “Do you think they might be doing that just because he's new?" I asked her. She thought for a minute. "No. When I was new, they didn't make fun of me."

I took a deep breath. "Do you think maybe they tease him because his skin is black?" She thought for a minute, clearly puzzled. Then she wrinkled her nose and said, "You mean brown?" I nodded and she went on: "Because he's BROWN? You don't make fun of someone just because of that!"

I told her I hoped she was right. She was learning lessons none of us should need to learn. Man's inhumanity to man ... Kid's inhumanity to kids ... Whatever the reason, people can be so cruel.(Since we were looking into that subject, and since Danielle has a Downs' syndrome sister who rode on the same bus, I asked quietly, "Does anyone on the bus make fun of Shannon, Danielle?"

I'll never forget the look she gave me. My question threw her totally off guard. Her brow furrowed, her nose wrinkled again and she asked, "Why in the world would they make fun of Shannon?" The very idea was ludicrous. Her mother could be so silly sometimes...Relief was great...

But just in case, there really was a flash of racial prejudice or any other mean-streak residing in the preschool bus in our little rural neighborhood, it was necessary to take a bit of action. First, I telephoned the principal and informed him that my preschooler had come home upset because of the way a little boy was treated on the bus. I told him what she had told me, and he asked me to thank her for him, for alerting us to a possible problem, something that needed his attention. He assured me he would look into it and he appreciated Danielle's and my concern. She was happy. We had done something. Then, for good measure, she and I sang a song together: a song we both knew very well.

"Jesus loves the little children All the children of the world. Red and yellow Black ('AND BROWN', I threw in) and white, All are precious in His sight. Jesus loves the little children of the world. “I don't know how the principal chose to handle the problem: I don't know what he said to the kids. But rest assured Danielle kept me posted on Life on the School Bus, and there was not even one more negative incident involving the little brown boy.

A princess had seen to that.

For comments and archives

    Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

Dieters lose weight when their doctors send them to weight watchers

A new study published in the Lancet showed that overweight patients told by their doctors to go to Weight Watchers lost twice as much weight as patients who received standard weight loss care over 12 months.1 Researchers in London randomized 772 overweight or obese adults to either 12 months of standard care (weight loss advice from their practitioner based on national clinical guidelines) or 12 months of free membership to Weight Watchers (a commercial program that promotes a low-calorie, balanced diet with increased physical activity and group support). In both groups, body weight, height, fat mass, waist circumference, and blood pressure were measured at baseline and at 2, 4, 6, 9, and 12 months.

Results showed that at 12 months, participants in the Weight Watchers group lost an average of 11 pounds and participants who were only given advice from their practitioner lost just under 5 pounds, on average. Likewise, of those who completed the 12-month assessment, 32% of the participants on weight watchers lost 10% or more of their starting weight and only 13% in the doctors-care group lost 10% of their initial weight, an amount that has been shown to improve health and lower risk of disease. Study authors concluded that referral by health care professionals to commercial programs like Weight Watchers that provide key weight loss strategies like regular weighing, advice about diet and physical activity, motivation, and group support can offer a clinically useful early intervention for weight management in overweight and obese people.

Many practitioners admit that while they know their patients need counseling to lose weight, they just don't have the time, incentive (reimbursement), skills, etc. to do it. Thus, referrals to programs that are proven effective, accessible, and affordable (in this case free) are a viable solution. But, building a list of such community resources takes time and effort and commercial programs are not free and not available in many areas. Maybe commercial programs like Weight Watchers should become part of publicly funded health care?

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    Malaria Update

AC Dhariwal, Hitendrasinh G Thakor, Directorate of NVBDCP, New Delhi

What the National Drug Policy of India says

What is the advice for chemoprophylaxis under the programme?

Chemoprophylaxis should be administered only in selective groups in high P. falciparum endemic areas. Use of personal protection measures, including Insecticide Treated bed Nets (ITN)/Long Lasting Insecticidal Nets (LLIN) should be encouraged for pregnant women and other vulnerable population including travellers for longer stay. However, for longer stay of Military and Paramilitary forces in high Pf endemic areas, the practice of chemoprophylaxis should be followed wherever appropriate e.g. troops on night patrol duty and decisions of their Medical Administrative Authority should be followed.

For comments and archives

    Medicine Update

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

What is the prevalence of chronic hepatitis B in India?

In the meta–analysis of hepatitis B prevalence studies in India, the point prevalence among nontribal populations is 2.4% (corresponding to a chronic carrier rate of 1.9%) and the point prevalence among tribal populations is 15.8%. These figures may be useful in estimation of the burden of the disease in the country and for projecting the cost-benefits of immunization.

For comments and archives

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


Markedly increased triglycerides (>500 mg/dL) usually indicate a nonfasting patient (i.e., one having consumed any calories within 12–14 hour period prior to specimen collection). If patient is fasting, hypertriglyceridemia is seen in hyperlipoproteinemia types I, IIb, III, IV, and V. Exact classification theoretically requires lipoprotein electrophoresis, but this is not usually necessary to assess a patient’s risk to atherosclerosis.

Cholestyramine, corticosteroids, estrogens, ethanol, miconazole (intravenous), oral contraceptives, spironolactone, stress, and high carbohydrate intake are known to increase triglycerides. Decreased serum triglycerides are seen in abetalipoproteinemia, chronic obstructive pulmonary disease, hyperthyroidism, malnutrition, and malabsorption states.

For comments and archives

    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Please answer the following:

a--What is the legal responsibility of Ambulance driver, especially when:

i)- Driving rashly (violating speed limits/red light signals etc.
ii)- Hitting another vehicle (whether or not somebody sustains injury or dies)

b. What are the privileges of an ambulance driver?
c. Are there any special requirements for issuing a licence to drivers of ambulance vehicles?
d. Can the ambulance driver use the mobile phone while driving?


In terms of the Central Motor Vehicles Act, 1988; Central Motor Vehicles Rules, 1989; or Delhi Motor Vehicles Rules, 1993:

  1. The legal responsibility of an ambulance driver is the same as per any other driver.
  2. He has no privileges, including use of mobile phones.
  3. There are no special requirements for issuing a licence to drivers of ambulance vehicles.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient with Chikungunya was found to have high ESR.
Dr. Bad: It may not be Chikungunya.
Dr. Good: It is Chikungunya.
Lesson: High ESR is seen in Chikungunya.

For comments and archives

Make Sure

Situation: A patient died after receiving penicillin injection.
Reaction: Oh my God! Why was anaphylaxis not suspected?
Lesson: Make sure that each time a patient is given penicillin injection, anti anaphylaxis measures are available.

For comments and archives

  Quote of the Day

(Dr GM Singh)

Every new beginning comes from some other beginning's end. Seneca


Put a sock in it: To tell noisy person or a group to be quiet.

    Mind Teaser

Read this…………………

The ideal treatment of alkaline reflux gastritis after Billroth I and Billroth II gastrectomy is

a) Conversion of Billroth I to Billroth II
b) Roux en Y gastrojejunostomy
c) Total gastrectomy
d) Conservative management

Yesterday’s Mind Teaser: A 14-year-old girl is referred to the physician for primary amenorrhea. She has never had a menses but does note some cyclic abdominal pain that seems to occur each month. She has no other medical problems and has never had surgery. She takes a multivitamin every day and has no known drug allergies. A thorough evaluation of the patient, including imaging studies, reveals that the patient has Mayer-Rokitansky-Kuster-Hauser syndrome. Which of the following is this patient likely to require, given her condition?

(A) Creation of a neovagina
(B) Creation of breasts
(C) Hormone replacement therapy
(D) Intrauterine device
(E) Medroxyprogesterone acetate injections

Answer for Yesterday’s Mind Teaser: (A) Creation of a neovagina

Correct answers received from: Dr Shikha, Dr Praveen, Dr Ganga, Dr K H Mehra, Dr Rashmi, Dr Tarun, Dr Sahil, Dr Prachi, Dr Piyush, Dr Jainendra Upadhyay, Dr Neelam Nath, Prabha Sanghi, Dr (Maj. Gen.) Anil Bairaria, Dr. P. C. Das, Dr.S.D.Jambhekar.

Answer for 16th October Mind Teaser: a. Neural tube defects
Correct answers received from: Dr AK KELA, Dr Shagun Aggarwal, Rozario Menezes, DR Chandresh Jardosh, Gita Arora, Neelam Nath.

Send your answer to ijcp12@gmail.com

    Laugh a While


What is it that Ravan can do but Ram cannot?

Ans: Group discussion when he is alone.

  Medicolegal Update

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

Clinical and forensic autopsies is overlapping to each other

  • Whether clinical/pathological or forensic, autopsy is nothing but medical study of a dead body and is carried out for enhancing clinical findings and its correlation with patient clinical manifestation during the treatment or understanding some unrevealed aspect of disease/diagnose the disease which has caused the mortality when ante-mortem efforts have failed or the autopsy/disease process in situ, thus enriching medical knowledge findings may be simultaneously used for medico-legal purpose
  • Postmortem examination of a dead body is carried out to gain insight of anatomy and pathology of corpse and close examination of the injuries, marks of weapon or disease process and it’s significant for forensic application of medical knowledge.
  • The procedure of both types of autopsies is same. Autopsy conducted by a forensic expert in cases of sudden/unexpected/unexplained death is nothing but a purely clinical autopsy.
  • The opinion expressed on the basis of a clinical autopsy is examined or cross examined in departmental/institutional peer review as the findings and opinion after a forensic autopsy has to withstand the acid test of cross examination by the defense lawyer/prosecutor and judges on circumstantial evidences available before honorable court.
  • Both clinical and forensic autopsies have a complimentary role towards each other.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Breast awareness Campaign- Inaugurated

Inaugurating a breast awareness campaign as a part of ongoing MTNL Perfect Health Mela, Mr Jayadev Sarangi, Special Secretary, Department of Health & Family Welfare, Govt. of Delhi, said that after the age of 18, all women should learn self-breast examination and become breast aware and notify to the doctors if they find any abnormal lump.

Dr. Sapna Nangia and Dr. Anil Aggarwal, Cancer Specialists from International Oncology said that all breast cancer is number one cancer in the city of Delhi. Risk factor breast cancer in women, prostate cancer in men and heart attack in both are common. After the age of 40, high risk women should go for annual mammography.

Dr. Jalaj Bakshi, Dr. Manish Singhal and Dr. Gagan Saini from International Oncology, co-organiser of the event released the following message, “Be Breast Aware- Breast Cancer is Preventable and Curable if detected early”.

Over 2000 doctors, cancer patient survivors and members of the public participated in the special drum jamming show organized at Ansal Plaza by Mr Roberto Narain.

Padmashri & Dr. B.C. Roy National Awardee and President Heart Care Foundation of India Dr. KK Aggarwal said that any sign or symptom which is unusual, appearing for the first time or which cannot be explained should not be ignored.

The experts said that most cancers are preventable and curable if diagnosed early. There has been a recent change in the occurrence of cancers in India with cancer of the breast in women and cancer of the lung in the men becoming the number one cancers in the urban areas.

The Mela is being organized by Heart Care Foundation of India and World Fellowship of Religions jointly with Health Department, Government of Delhi, MCD and NDMC from October 14 to 23, 2011.

MTNL Perfect Health Mela Activity ‘Anmol’ – Festival for Children with Special Needs' at Balvant Ray Mehta Vidhya Bhawan, Greater Kailash-II

Anmol – a festival was organised for children with special needs. It was organised by Heart Care Foundation of India in association with Balwant Rai Mehta Vidhya Bhawan. More than 200 children enjoyed taking part in painting, skit and singing competition. Giving the details, Dr. Aggarwal, said that the special children are not disabled but differently abled. If they loose one of the senses invariably other senses become predominant. The event competitions included dancing, singing and painting. The children were judged by eminent judges.

For comments and archives

    Readers Response

Dear Sir, as per the data provided on AIIMS, a simple calculation shows that:

  1. OPD Patients: <4 patients are seen by a doctor per day,(1528000/1653 = approx. 1000 patients/doctor/year)
  2. Admissions: 1 admission/doctor in one week (84000/1653 doctors)
  3. Surgeries (Whether includes minor surgeries too): 78000/1653 = 50 surgeries/ doctor; Even if we say only 10% of doctors are surgeons:500 surgeries/doctor/year means 1.5 surgeries/doctor/day

    Yours: Dr. Gurdev Singh
    Forthcoming Events

18th MTNL Perfect Health Mela

Date: 14th–18th October
Different locations in Delhi
19th–23rd October
Venue: NDMC Ground, Opp. Indira Nari Niketan Working Girls Hostel
Near Philanji Village, Laxmibai Nagar, New Delhi
Theme: Science Behind Rituals

for complete programme details

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