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  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group & Hony. Visiting Professor (Clinical Research) DIPSAR

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22nd March 2013, Friday

Use of electronic gadgets

  1. Use mobile phones when you are mobile and use stationary phone (landline) when you are not mobile i.e. when you are at home or in office.
  2. Avoid using mobile phones for more than 8 hours a day.
  3. If your phone battery discharges, never recharge the battery the same day. This means that you have used up your quota of talk time for that day.
  4. Use hands-free when possible.
  5. Do not use mobile phone while driving even with hands-free.
  6. If you are using mobile phone, avoid other radiations such as x-rays, or from other electrical gadgets.
  7. Avoid noise pollution of more than 80 decibels. Never keep the volumes of your electronic devices more than 80% (keep it around 50%).
  8. Never put the batteries on charge in a closed room at night to prevent carbon monoxide formation.
  9. Avoid living in an area adjacent to mobile towers.
  10. If you have a family history of brain cancer, avoid mobile phones.
  11. Using Bluetooth devices along with phone gives you double radiation.
  12. Ask your doctor about radiations if you are on a pacemaker or implantable cardioverter defibrillator (ICD).

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

Texting and checking email in OT while working can be dangerous

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

Delhi Cardiologists promoting
CPR 10 on 17th March

Dr K K Aggarwal
    National News

Stressed 24-year-old suffers heart attack

MUMBAI: Anirudh Singh (24) had no idea when he woke up feeling uneasy one morning that it could be something more serious than an oncoming bout of fever. By evening, not only did the discomfort continue, but the event management executive also began feeling breathless and had a severe pain in the chest. By the time his friends rushed him to a nearby nursing home, Anirudh was on the verge of collapse. Diagnosis by doctors revealed that he had suffered an acute heart attack. Anirudh's lifestyle shifted gears about two years ago when he moved to Mumbai to make a career in event management. More than three days a week during busy periods, he would go without proper sleep, surviving on cups of coffee and energy drinks. "I even skipped meals many a time while trying to achieve my goals. And since my job is very demanding, I would hardly get any time for anything else. It was a case of running around continuously, until the day I felt the chest pain," Anirudh, a Santa Cruz resident, said.

After the diagnosis, the doctors in the nursing home administered a clot bursting injection, but it did not make much difference to his condition. That was when the nursing home referred him to Seven Hills Hospital in Andheri. "When he was admitted, we realized that he was suffering from acute myocardial infarction," said Dr Saurin Patel, cardiologist at the hospital. "His blood pressure and oxygen levels were low and he was critical. We admitted him in the ICU and gave him intravenous medication. When his condition improved a little, we conducted an angiography on him, which revealed a 90% blockage in the main artery which supplies blood to the front wall of the heart," Dr Patel said.

The doctors then performed a procedure to remove his clot. "With the help of a thrombuster device, the clot was sucked out. We then conducted an angioplasty and put a stent," Dr Patel added.

A young person suffers a more dangerous attack than an older person and there is greater damage to the heart. In an old person, calcium settles on cholesterol over a period of time and the heart gets used to the condition. In younger people, even if the vessel has little cholesterol, it bleeds. As a result, arteries expand and the heart suddenly suffers an attack.

Dr N O Bansal, head of cardiology at J J Hospital, says sedentary lifestyle, high blood pressure and arterial blockages are major factors leading to a cardiac arrest. "We have all been seeing incidence of heart diseases going up in younger people. But though men were considered to be more susceptible earlier, an increasing number of women, too, suffer from cardiac problems these days. The high stress levels and sedentary lifestyle ensures that nobody is left out," he said.

After spending more than a week in the hospital, Anirudh was discharged on Friday. The doctors have advised him to take it easy for a few days. "I will be taking rest for a few days. After the next check-up, I will come to know the activities I can start again. But I am planning not to go to work for the next few months. This incident has shaken me up and I plan to give priority to health over work from now," Anirudh said. (Source: TOI, Mar 21, 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)


Trafficking violation of children rights

They can roughly be divided in four categories:

  1. The right to life (art.6.1 CRC);
  2. The right to survival and development (art 6.2 CRC);
  3. The right to protection (from discrimination and punishment, (art. 2.2 CRC); from physical or mental violence, (art.19.1 CRC);from economic exploitation (art.32; from sexual exploitation (art. 34): 4)
  4. The right to participation (art.12)

For comments and archives

    Valvular Heart Disease Update

Valvular heart disease is common in patients undergoing maintenance dialysis. Predisposing factors include secondary hyperparathyroidism, an elevated calcium-phosphorus product, vascular calcification, hypercalcemia, uremic milieu and hyperphosphatemia.

(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)

Phlebotomy might help in fatty liver disease

Iron depletion by phlebotomy might help patients with non-alcoholic fatty liver disease (NAFLD) and high serum ferritin levels, a phase II study suggests. (Source: Medscape)

Midlife stroke a harbinger of early death

A stroke or transient ischemic attack by age 50 at least triples mortality risk over the subsequent decades, a Dutch study showed. (Source: Medpage Today)

BP control may help slow Alzheimer's

Genetics and high blood pressure appear to interact to increase deposits in the brain of a protein involved in the pathology of Alzheimer's disease, researchers reported. (Source: Medpage Today)

AAN: Short-course IVIG slows early Alzheimer's

Patients with early Alzheimer's disease receiving five doses of intravenous immunoglobulin (IVIG) showed significantly less brain atrophy after 1 year than a placebo group, researchers found. (Source: Medpage Today)

AAN: Treat concussed athletes individually

Although athletes with suspected concussions should be benched immediately, their return to play may be handled flexibly according to symptoms and risk of further injury, according to new guidelines from the American Academy of Neurology. (Source: Medpage Today)

   Twitter of the Day

@DrKKAggarwal: When your doctors is at fault while prescribing antibiotic 1. Prescribe (cont) http://tl.gd/lbq826

@DeepakChopra: Is it unreasonable to expect someone to love me in the same way that I love? Pls read my #askdeepak reply http://tinyurl.com/cq8q48j

    Spiritual Update

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

Treat Holi as Holy

The general population should be cautioned to refrain from taking alcoholic drinks while celebrating Holi as excess use of alcoholic drinks can lead to fatal vehicular accidents and also end up into fatal quarrels sometime.

For comments and archives

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

What happens after the egg retrieval procedure?

Two days after the egg retrieval, the fertilized egg divides to become a 2– to 4–cell embryo. By the third day, a normally developing embryo will contain approximately 6 to 10 cells. By the fifth day, a fluid cavity forms in the embryo, and the placenta and fetal tissues begin to separate. An embryo at this stage is called a blastocyst. Embryos may be transferred to the uterus at any time between 1 and 6 days after the egg retrieval. If successful development continues in the uterus, the embryo hatches from the surrounding zona pellucida and implants into the lining of the uterus approximately 6 to 10 days after the egg retrieval.

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

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

Virus ‘Inactivated’ Plasma

  • Plasma treated with methylene blue/ ultraviolet light inactivation to reduce the risk of HIV, hepatitis B and hepatitis C.
  • The cost of this product is considerably higher than conventional fresh frozen plasma.
  • Infection risk
  • The ‘inactivation’ of other viruses, such as hepatitis A and human parvovirus B19 is less effective

For comments and archives

   An Inspirational Story

The strength of group work

Once a US president went out to see the situation of the city. Somewhere a group of soldiers was trying to lift a large branch of a tree from their way.

The Corporal was standing by their side instructing them to work harder, but they were unable to move it.

A stranger was riding on his horse and he observed what was going on. He said to the Corporal – “if you help them they will be able to move it. Why don’t you help them?”

The Corporal replied – “That is not my job, I am the Corporal. It is their work, they should do it.”

The stranger did not hesitate a moment, immediately he dismounted from his horse, and helped the group of the soldiers to move that log.

This additional strength helped them to move the log. After moving it, the stranger mounted his horse and said to the Corporal – “Next time you need to move some heavy thing and you need a help, call for the Commander-in Chief” and went away his way.

It was then that the men realized that the stranger was none other than George Washington – the first President of the United States, the Commander-in-Chief of the army.

For comments and archives

   Cardiology eMedinewS

ACC: Clot buster tackles fatal PE events Read More

Peer coaching improves glucose control in diabetes Read More

   Pediatric eMedinewS

Chlorhexidine cleansing of umbilical cord increases cord separation time
Read More

Fluid resuscitation ups mortality risk in children Read More

    Rabies Update

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

Can the wound be deepened for cleaning purpose?

We should never try to deepen the bite wound. Deepening of wound for cleaning depends on area of injury, extent of injury and the aim should be to preserve as much tissue as possible and to excise only the dead tissue.

    IJCP Special

Dr Good Dr Bad

Situation: A patient with pneumonia not responding to antibiotics came to the hospital.
Dr Bad: Change the antibiotic.
Dr Good: You need hospitalization.
Lesson: Any patient not responding appropriately to oral antibiotic therapy requires inpatient management.

Make Sure

Situation: A hypertensive with obstructive sleep apnea (OSA) was not responding to CPAP?
Reaction: Oh my God! Why was an antihypertensive drug not started?
Lesson: Make sure that all hypertensives with OSA are given anti-HT drugs in addition to CPAP (Continuous positive airway pressure therapy). In a randomized crossover trial of 23 patients with OSA and systemic hypertension, an anti–hypertensive medication (valsartan 160 mg per day) lowered the mean 24–hour blood pressure significantly more than CPAP therapy alone (Am J Respir Crit Care Med 2010;182:954).

  Quote of the Day (Dr GM Singh)

Just don't give up trying to do what you really want to do. Where there is love and inspiration, I don't think you can go wrong. Ella Fitzgerald

    Legal Question of the Day

(Dr MC Gupta, Advocate & Medico-legal Consultant)

Q. I am a layman and wish to have answers to the following queries about an MLC:

a) Is there a specified format of MLC approved by Medical Judiciary or any governing body?
b) What is the address of the Medical Judiciary?
c) Can an MLC be prepared on simple A4 size paper which has no MLC no./Police daily Diary no. or FIR?
d) Can an MLC be prepared without informing the police before or after the treatment? e) Can the above types of an MLC be treated as authentic?


  1. There is no legally binding format for an MLC (medico-legal case report). Guidelines may be available in Police Codes published by certain states. Most large hospitals have a printed MLC register which need not be exactly similar within a state or across states. Small hospitals may have a register of their own, even un-printed, with a self-specified format which would be expected to be on the lines of the large hospitals as regards essential ingredients. Government PHCs would follow the state govt./health department guidelines as issued to them. Some basic principles are as follows:
    1. The register must have numbered pages with a certificate in the beginning that—“This register has ……..pages from page no. ….to page number……which are serially numbered”.
    2. The register must be kept under lock and key under charge of a specified officer.
    3. Reports should be made in duplicate. When the MLC is given to the police, it is given under signature and the duplicate is preserved in the hospital.
  2. There is nothing like a Medical Judiciary.
  3. There is no paper size prescribed for an MLC. Each MLC is supposed to have an MLC no. If the MLC has been made on request by police, such request should mention the DD no. or FIR no. and, if so mentioned, such number should be mentioned by the doctor concerned in the MLC itself.
  4. An MLC can be prepared without informing the police but it is desirable, at the discretion of the medical officer, to inform the police. Such information to police should preferably be sent before treatment but in no case should treatment be withheld pending police information/action?
  5. An MLC cannot be thrown away simply because it was not recorded in fulfillment of all the requirements etc. mentioned above. The courts would use their own discretion. However, the defendant would be justified in questioning the validity of the MLC if it violates important guidelines.
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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

Photos of Doctor’s Day Celebration

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    Mind Teaser

Read this…………………

For a male client in the oliguric phase of acute renal failure (ARF), which nursing intervention is most important?

a. Encouraging coughing and deep breathing
b. Promoting carbohydrate intake
c. Limiting fluid intake
d. Providing pain-relief measures

Yesterday’s Mind Teaser: A female client is admitted for treatment of chronic renal failure (CRF). Nurse Juliet knows that this disorder increases the client’s risk of:

a. Water and sodium retention secondary to a severe decrease in the glomerular filtration rate.
b. A decreased serum phosphate level secondary to kidney failure.
c. An increased serum calcium level secondary to kidney failure.
d. Metabolic alkalosis secondary to retention of hydrogen ions.

Answer for yesterday’s Mind Teaser: a. Water and sodium retention secondary to a severe decrease in the glomerular filtration rate.

Correct answers received from: Dr Thakor Hitendrsinh G, Dr Sushma Chawla, Prabha Sanghi, Dr BB Gupta, Dr Gracy Thomas, Kochi, Dr KP Chandra, Dr Arpan Gandhi, Dr Avtar Krishan, Dr PC Das,
Dr KV Sarma, Dr (Maj. Gen.) Anil Bairaria, Dr K Raju, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr LC Dhoka, Dr Thakor Hitendrsinh G, Drvalluri Ramarao.

Answer for 20th March Mind Teaser: d. White blood cell (WBC) count of 20,000/mm3

Correct answers received from: Dr Bharat Bhushan Aggarwal, Dr (Maj. Gen.) Anil Bairaria, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr Kanta Jain.

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Excited About Marriage

Jacob, age 92, and Rebecca, age 89, are all excited about their decision to get married. They go for a stroll to discuss the wedding and on the way they pass a drugstore. Jacob suggests they go in. Jacob addresses the man behind the counter:

'Are you the owner?' The pharmacist answers yes.

Says Jacob: 'We're about to get married. Do you sell heart medication?'

Pharmacist: 'Of course we do.' Jacob: 'How about medicine for circulation?'

Pharmacist: 'All kinds.' Jacob: 'Medicine for rheumatism, scoliosis? '

Pharmacist: 'Definitely.'

Jacob: 'How about Viagra?'

Pharmacist: 'Of course.'

Jacob: 'Medicine for memory problems, arthritis, jaundice?'

Pharmacist: 'Yes, a large variety. The works.'

Jacob: 'What about vitamins, sleeping pills, Geritol, antidotes for Parkinson's disease?'

Pharmacist: 'Absolutely.'

Jacob: 'You sell wheelchairs and walkers?'

Pharmacist: 'All speeds and sizes.'

Jacob says to the pharmacist: 'We'd like to register here for our wedding gifts, please.'

    Medicolegal Update

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

The forensic analyst/doctor has a legal responsibility to retain untested biological specimen in legal cases so that another person can test it for an independent conclusion

When crimes like injury, sexual offences and murder are reported to a police station, the investigating officers are assigned to examine and investigate the case and collect the related evidences. The observation of scenes of crime, collection of human body fluids, weapons of the offence and medical examination of victim, accused, or both are required in any investigation of crime against human body.

The medical examination is carried out in emergency ward of hospitals and the doctor’s main attention should be the treatment of injured and dying patient. However, in cases of crime against human body, medical examination and collection of biological sample, its recognition, documentation, packaging and analysis has an important role and are required to be done by doctor very meticulously with the high standards of science and the law in mind.

The biological materials which are frequently required to be collected/recovered by doctor during medical examination as evidence in crime against human body are blood, seminal stains, vaginal smears/slides, gastric lavage, chemical substances, poison, hair, fiber, broken glasses, knives, blunt instruments/objects, fire arms, bullet, live and empty cartridge cases, wads, clothing etc..

This scientific biological evidence becomes legal evidence in prosecution/acquittal of a case, if collected properly by maintaining the scientific sanctity and analyzed by a competent expert.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Avoid bhang at Holi, if you are a heart patient

Heart patients should avoid taking bhang (cannabis) as it can increase the heart rate and also cause a sudden rise in blood pressure. But, those who are socially committed should first consult their doctor, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and National Vice President Elect IMA

Bhang, marijuana, charas are all derived from the cannabis plant.

Bhang is prepared from the leaves and flowers of the cannabis plant. For ages, it has been a social tradition especially during Holi. Bhang is a mild preparation.

Charas is made from the resin of the cannabis plant. It is more potent than either Bhang or Ganja. It is nearly as potent as the concentrated cannabis resin preparations called hashish.

Marijuana (ganja) induces the typical state called ‘high’ and usually includes feelings of relaxation, mild paranoia and anxiety, alteration of visual, auditory, and olfactory senses, fatigue, and stimulation of the appetite. But these may vary in different people. Its effects on the body are marked increases in heart rate, blood pressure and conjunctival infection.

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 31159 people since 1stNovember 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 Response
  1. Dear Sir, Very good information: Regards: Dr Sharad
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