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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

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

  Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 7 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

23rd October 2012, Tuesday

PCI Often Done at Low-Volume Centers

Twenty-five percent of all percutaneous coronary interventions in the US are performed at low-volume centers that do 200 or fewer procedures per year. Forty-nine percent are done at centers that do no more than 400 such procedures annually, Gregory Dehmer, MD, of Scott & White Healthcare in Temple, Texas, and colleagues reported in the Journal of the American College of Cardiology. They also found that on-site cardiac surgery was not available at 83% of centers that did 200 or fewer PCIs annually.

The 2011 PCI guidelines stated that facilities doing 200 or fewer PCIs per year need to take a closer look at whether they should continue doing such procedures.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

There is now mounting evidence that exercise might benefit gastrointestinal symptoms in general, and constipation symptoms, more specifically.

For Comments and archives…

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Monitoring LFT in a patient on statins

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

MCD South Zone to Train is Teachers on Health & Hygiene at Perfect Health Mela

Addressing a press conference, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Mr. Satish Upadhyay, Chairman Education Committee, MCD South Zone said that MCD South Zone in association with Heart Care Foundation of India will be organizing a training program for its teachers on 7th November, 2012, Wednesday, at Constitution Club of India.

Dr K K Aggarwal
    National News

Govt to liberalise norms for setting up new medical college

Government is in the process of liberalising norms and doing away with archaic rules for establishment of new medical colleges across the country to meet the ever growing demand of doctors. According to sources, the Ministry of Health has asked the Medical Council of India (MCI), apex medical education regulator, to rationalise and redefine its norms for setting up medical colleges and do away with rules that add little value to education but lead to higher cost of education for students. “The norms governing medical college establishment need to be reworked. We have asked the MCI to redefine and rationalise them to enable new medical colleges to come up. We plan to add at least 6,000 new MBBS seats in the next year. New norms need to reflect today’s needs,” a top Health Ministry official told PTI. Among norms under scanner are the requirement of vast spreads of land for colleges and compulsory auditoria, playgrounds, classrooms, libraries and labs of vast dimensions. Also proposed is easing of norms for hiring of faculty by allowing adjunct faculty so as to reduce the high cost of medical education. It is proposed to allow colleges to come up as multi-storey buildings comprising compact facilities of labs and libraries under new dimensions which the MCI will specify in place of old impractical ones. The government is keen to add at least 6,000 to 7,000 new MBBS seats in the coming year to help reduce the doctor-patient ratio which is a poor 1:2,000 currently. “We are planning to ease norms for land requirement by allowing managements to set up medical colleges in multi-storeyed buildings instead of as huge unwieldy complexes spread over acres as is the current norm. “Keeping in view the shortage of land, multi storeyed buildings can especially be allowed around cities where health facilities are much required and land availability minimal,” MCI officials said. There is also a plan to ease conditions on auditoria and playgrounds. (Source: The Economic Times, 21 Oct, 2012)

For comments and archives

My Profession My Concern

Recommendations of the Expert Advisory Group Meeting on the 14th Oct, 2004

Administration of Inj. Magnesium sulphate for prevention and management of eclampsia: Inj. Magsulf is the drug of choice for controlling eclamptic fits. The first does should be given by the ANM/staff nurse/Medical Officer at the PHC. The woman should immediately be referred to a CHC/FRU and not a PHC. This is because in these cases termination of pregnancy will be required, and a PHC may not be equipped for the same.

  • This first dose should be given as a 50% solution (this preparation is available in the market). 8cc need to be given to make a total dose of 4 gms.
  • It should be given deep intramuscular in the gluteal region. If this precaution is not taken, it will lead to the development of abscess at the injection site.
  • Before and during transportation for referral, certain supportive treatment needs to be included in the protocol for management of case of eclampsia.
  • Ensure that the woman does not fall down or injures herself in any manner.
  • Ensure that her air passages are clear.
  • If transportation is going to take a long time, catheterization of the woman may be considered.
  • A soft mouth gag should be put to prevent tongue bite.
  • It should be ensured that the woman reaches the referral center within 2 hours. This is because a second dose of magnesium sulphate may be required after 2 hours. Hence early and immediate referral is essential.
  • 22G needles and 10cc syringes also needed to be included in the ANM kit.

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

    Valvular Heart Disease Update

Aortic regurgitation in the elderly

Although aortic valve replacement is usually the treatment of choice for acute or chronic severe aortic regurgitation, aortic valve repair is sometimes possible in aortic regurgitation due to endocarditis and valve-sparing operations are a major consideration in patients with aortic dissection

(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)

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Ketamine reduces risk for hypoventilation in patients under deep sedation

When used as an adjunct to propofol during deep sedation, ketamine reduces hypoventilation and the need for rescued airway maneuvers, researchers from Northwestern University Feinberg School of Medicine, in Chicago, Illinois, have found. Gildasio S. De Oliveira Jr, MD, presented the findings at Anesthesiology 2012: American Society of Anesthesiologists (ASA) 2012 Annual Meeting. (Source: Medscape)

For Comments and archives…

Combination therapy beats monotherapy for bone density

A combination of the recently approved antiresorptive drug denosumab with the anabolic agent teriparatide is more effective in increasing bone mineral density (BMD) than either drug on its own, researchers reported here at the American Society for Bone and Mineral Research (ASBMR) 2012 Annual Meeting. (Source: Medscape)

For Comments and archives…

Cataract surgery may be safer with antibiotic injections

Intracameral antibiotic injections decreased the risk for postoperative endophthalmitis after cataract surgery by 22-fold when compared with standard topical antibiotic drops in a new ecological time-trend study. The findings were published online October 4 in the Journal of Cataract and Refractive Surgery. (Source: Medscape)

For Comments and archives…

Multivitamins reduce cancer risk

(Dr S K Verma, Consultant Ophthalmologist, New Delhi)

A research published in Journal of American Medical Association has shown that that daily intake of multivitamin pills may cut cancer risk. A large clinical trial of nearly 15 thousand male older doctors followed for more than a decade found that those taking a daily multivitamin experienced 8 percent fewer cancer than those subjects taking dummy pills. It was one of the largest, longest randomized, double blinded and most rigorous type of clinical trial to address questions about vitamin use. According to J Michael Gaziano et al of Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, while the main reason to take multivitamin pills is to prevent nutritional deficiency, it certain appears there is modest reduction in cancer. It would, however be mistake for people to go out and pop a multivitamin pill instead of quitting smoking, eating a good diet and exercise. (Courtesy: Indian Express, Ahmedabad, digital edition 20 October 2012 and JAMA 2012;(online edition):1-10. doi:10.1001/jama.2012.14641)

For Comments and archives…

    Twitter of the Day

@DrKKAggarwal: Who Should Not Donate Blood? http://blog.kkaggarwal.com/2012/10/who-should-not-donate-blood/ …

@DeepakChopra: How do I stop worrying about the future and thinking of the past all of time? My #askdeepak reply http://tinyurl.com/8w5ss6a

    Spiritual Update

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

On the 6th Navratri, chant AUM

Mata Katyayani is worshipped on the sixth day of Navratri. SHE has three eyes and four hands and rides on a Lion.

For Comments and archives…

    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the side effects of gonadotrophins?

Despite intensive monitoring, up to 30% of gonadotropin-stimulated pregnancies are multiple. Of the multiple pregnancies, about two-thirds are twins and one-third are triplets or more. Premature delivery is a known risk for multiple pregnancies. The greater the number of fetuses in the uterus, the greater the risk of premature deliveries. Premature delivery can subject the newborn to complications such as severe respiratory distress, intracranial hemorrhage, infection, cerebral palsy, and death. Some patients pregnant with triplets or more choose to undergo a procedure known as multifetal pregnancy reduction in an effort to decrease these risks. The most serious side effect of gonadotropin therapy is ovarian hyperstimulation syndrome (OHSS), in which the ovaries become swollen and painful. Careful monitoring of ovulation induction cycles with the use of ultrasound and/or measurement of serum estradiol levels, in conjunction with daily adjustment of gonadotropin dosage, will enable the physician to identify risk factors and prevent most cases of severe OHSS.

For Comments and archives…

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

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

Blood transfusion

Blood transfusion is a broadly based discipline that overlaps and intersects many other medical, scientific and managerial fields, including hematology, immunology, genetics, histocompatibility, cellular function and metabolism protein structure and function, cryobiology, disposable equipment, bioengineering, statistics, data-processing, public relations, logistics and standardization.

For Comments and archives…

    An Inspirational Story

Your heart's desire

One night, a young woman dreamed she was walking in the mall and noticed a shop on the second floor she hadn't seen before. The name over the door said, "Your Heart's Desire". She crossed the store's threshold and was enveloped in a charming fragrance. The store had a homey feeling, with shelves full of fascinating items.

A short, smiling dumpling of a lady was behind the counter. "What is it your shop sells?" asked the young lady. "Just as the name implies, everything your heart desires!" came the purring answer.

"Oh! I know what I want!" exclaimed the girl, "Peace, happiness, love for everyone, and..." "Wait a minute," giggled the cashier. "You don't quite understand. We sell whatever your heart desires. But we don't sell the finished product, we sell the seeds -- and you have to choose the ones you want to plant."

For comments and archives

   Cardiology eMedinewS

Type 2 diabetes screening guidelines updated Read More

Fracture risk increases after antihypertensive initiation Read More

   Pediatric eMedinewS

In utero metformin exposure tied to more weight gain in infancy
Read More

Study spotlights benefits of school-based flu shots Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with diabetes was found to have aortic stiffness.
Dr. Bad: It is normal in diabetes.
Dr. Good: It is associated with albuminuria in the urine.
Lesson: Aortic stiffness is associated with incident albuminuria and the rate of decline in glomerular filtration rate in type 2 diabetic patients (Diabetes Care 2011 Dec;34(12):2570-5).

For comments and archives

Make Sure

Situation: A patient with LDL cholesterol 100 mg% and hsCRP 3 developed MI.
Reaction: Oh my God! Why was a statin not started earlier?
Lesson: Make sure that all patients with even normal cholesterol are considered for statins if the hsCRP is high.

For comments and archives

  Legal Question of the Day (Dr MC Gupta)

Q. Can a non-specialist MO report on MLC x-rays, when a radiologist is available in the hospital?


  • When a doctor is employed in a hospital, he should do the work allotted to him within law if he can do it.
  • If the employer hospital asks a medical officer, not being a radiologist, to report on an x-ray belonging to an MLC patient, he can do any of the following at his discretion:
    • He can say—“I cannot report on this x-ray because I don’t feel competent to do so”.
    • He can report on it.
    • He can report on it and add a remark—“Recommended that the opinion of a radiologist should be taken”.
  Lab Update (Dr Arpan Gandhi and Dr Navin Dang)


This test is used to evaluate thromboembolic disorders, including ligneous conjunctivitis (a type of mucous membrane abnormality). This test is normally prescribed when investigating for the following diseases:

  • Disorders involving the fibrinolytic system
  • Ligneous conjunctivitis

High levels of plasminogen can be seen in:

  • Pregnancy (peak of 165% of normal in third trimester)
  • Increased triglyceride and/or cholesterol levels

Low levels of plasminogen can be seen in:

  • Liver disease
  • Consumptive coagulopathies
  • Fibrinolytic therapy
  • DIC
  • Advanced age
  Quote of the Day (Dr GM Singh)

Toughness is in the soul and spirit, not in muscles.

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Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Doctor’s Day Celebration

eMedinewS Apps
    Mind Teaser

Read this…………………

A glass of water with a single ice cube sits on a table. When the ice has completely melted, will the level of the water have increased, decreased or remain unchanged?

Yesterday’s Mind Teaser: A man is looking at a picture of a man on the wall and states: Brothers and sisters I have none, but this man's father is my father's son. Who is the man in the picture in relation to the man looking at the picture?

Answer for Yesterday’s Mind Teaser: Father of the

Correct answers received from: Dr Anurag Julka, Dr KV Sarma, Dr BB Aggarwal, Dr Rajiv Dhir,
Dr Thakor Hitendrsinh G Archna parwani, Dr K Raju, Dr Pankaj Agarwal, Dr Jainendra Upadhyay,
Dr Chandresh Jardosh, Dr Dinesh Yadav, Dr Vijay Kansal, Avtar Krishan, Dr Thakur Om Prakash Singh,
Dr Amol Hartalkar, Dr Archna Parwani.

Answer for 21st October Mind Teaser: Mailbox
Correct answers received from: Dr Chandresh Jardosh, Dr Dinesh Yadav.

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Academic Talk

The following list of phrases and their definitions might help you understand the mysterious language of science and medicine. These special phrases are also applicable to anyone working on a Ph.D. dissertation or academic paper anywhere!

"It has long been known" = I didn't look up the original reference.

"A definite trend is evident" = These data are practically meaningless.

"While it has not been possible to provide definite answers to the questions" = An unsuccessful experiment, but I still hope to get it published.

"Three of the samples were chosen for detailed study" = The other results didn't make any sense.

"Typical results are shown" = This is the prettiest graph.

"These results will be in a subsequent report" = I might get around to this sometime, if pushed/funded.

"In my experience" = once.

"In case after case" = twice.

"In a series of cases" = thrice.

"It is believed that" = I think.

  Medicolegal Update

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

Medicolegal cases & injury, assault and hurt in Indian law

The words injury, assault and hurt are invariably used by doctor in hospital practice and are used as synonymous. But all three have a different meaning as per law. It is defined by the Indian Penal Code as below:

  • Injury: Section 44 of IPC defines injury as any harm whatever illegally caused to any person in body, mind, reputation or property.
  • Assault: Section 351 of IPC defines assault as an offer or threat or attempt to apply force on body of another in a hostile manner. It may be a common/simple assault or an intention to murder.
  • Hurt: Section 319 of IPC defines hurt as whoever causes bodily pain, disease or infirmity to any person is said to cause hurt.

When we as doctors deal with cases of Hurt/body injury, it means bodily pain, wound, disease or infirmity voluntarily caused to any person in medicolegal cases. These would include abrasions, contusions, lacerations, stab wounds, electric shock, firearm or ligatures etc resulting in human body injury. The doctor who is certifying an injury report should keep in mind the Penal provisions required by police to book the case i.e.

  • Simple injury: IPC Section 323
  • Simple injury caused by dangerous weapons: IPC Section 324
  • Grievous injury: IPC Section 325
  • Grievous injury caused by dangerous weapons: IPC Section 326
  • Dangerous injury: IPC Section 307
  • Injury likely to cause death: IPC Section 304
  • Injury sufficient to cause death: IPC Section 302
  • Causing hurt by means of poison: IPC Section 328

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Harmony – Interschool competition at Perfect Health Mela

Over 2000 school children from various schools will participate in Harmony – the interschool health festival being organized by Heart Care Foundation of India in the forthcoming MTNL Perfect Health Mela being held at Constitution Club of India from 7th to 11th November, 2012.

The event will mark the opening of the main Mela on 7th November, Wednesday at the Mela premises. The event is supported by Rashtriya Vigyan Evem Prodyogiki Sansthan, Department of Science and Technology Govt of India.
The event will be coordinated by Birla Vidya Niketan.

Giving the details, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that the competitions will include poster-cum-slogan making, quiz, folk dance etc. The competitions will be open for primary, middle and senior schools.
On-the-spot prizes and certificates would be issued.

The teachers accompanying the school children will also participate in a two-hour workshop on health and hygiene. Entry to the Mela will be free.

Dr. Aggarwal said that school age is the right age for health education as most lifestyle disorders start at that age. Blockages of arteries supplying blood to heart and brain start in adolescence.
Correct lifestyle, therefore, in adolescence is very important.

Heart Care Foundation of India recommends that artificial junk food should be banned altogether in the vicinity of schools.

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    Forthcoming Events

19th MTNL Perfect Health Mela 2012 Programme

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    eMedinewS Special

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    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