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

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


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  Editorial …

23rd December 2011, Friday

Delhi Health Statistics

  1. There are 8 government tertiary care hospitals with strength of 6111 beds and 26 private tertiary care hospitals with 6004 beds.
  2. There are 625 private diagnostic centers.
  3. March 2009: 34 Allopathic, 2 Ayurveda, 2 Homeopathic hospitals run by Delhi Govt
  4. 427 dispensaries in Delhi govt (all pathies).
  5. 807 registered medical institutions (676 Private and 131 Govt/Public sectors)
  6. Total beds 40342 (23120 Govt/Public sector + 17222 private sector)
  7. Bed-population ratio in Delhi is 2.45 beds/1000 population.
  8. In 2004, there were 2.53 lac admissions in a year. The rate of hospitalization per lac population was 1559 for rural and 1683 for urban population. (India: 2599 for rural and 3482 for urban population). 46% admissions from rural and 59% from urban areas were treated in govt hospitals (India: the figures are 42% rural and 38% urban respectively). Only 2.61% get free treatments in private hospitals. Admission break ups are 12.4% heart ailments, 9.7% accidents, 9.5% FUO, 8.3% diarrhea. 90% children covered with immunization. Per person spent in hospital treatment is 8851 in urban and 5695 in rural area.
  9. Elderly 60 + people: 8.3 lac comprising 5.49% of total population in 2004, with 53% males and 47% females, 80% residing in urban and 20% in rural areas. 66% are in the age group 60–69 years. 12% are self employed, 3.28 are salaried/wage earners and 22.38 are pensioners. 3% are in BPL category.
  10. Crude birth rate (2008) 18.4 (India 22.8)
  11. Crude death rate (2008) 4.8 (India 7.4)
  12. Infant mortality rate (2009) 33 (India 50)
  13. Sex ratio 2001 821/933;2011 866/940
  14. Neonatal mortality rate (2008) 20 (National 35)
  15. Antenatal care (2008) 3.38 lacs (National 232.48 lacs)
  16. Immunization cover (2008) 83.2% (National 43.5%)
  17. Institutional deliveries (2008) in Delhi 75.6% as against a national figure of 28.3%

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

Delhi Health statistics

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011
Eco Fest–An Inter School Eco Club’s Health Festival

Purpose of this competition is not only to have a competition but to learn preventive strategies so that the children in future can become healthy adults.

Dr K K Aggarwal
    National News

Kids with rheumatic heart: Alarm bells ring

NEW DELHI: Rheumatic heart disease (RHD) among Indian children could be 20 times more than what is believed. A study conducted by the All India Institute of Medical Sciences (AIIMS) in and around Delhi to see prevalence of RHD among children in northern India found prevalence of 20.4/1000 school children as against 1 per 1000 children earlier believed. The study carried out echocardiographic screening of 6,270 randomly selected school children aged 5–15 years. RHD was twice as prevalent among children aged 11–15 years (prevalence of 26.5 per 1000 children) compared to children aged 5–10 years (12.6 per 1000 children). Girls had a higher prevalence of RHD (27.9/1000 girls) compared to boys (13.3/1000 boys). The study said though RHD was thought to be on the decline in India because of improving standards of living, the estimated prevalence of echocardiograpically detected RHD in India was comparable to those measured in Mozambique (21.5 cases per 1000). The study was published in the British journal ‘Heart’. (Source: TOI, Dec 22, 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

Blood signature may predict Alzheimer’s disease

A molecular signature found in serum samples may predict future development of Alzheimer’s disease (AD), even before the first symptoms of the disease occur in patients, new research suggests. (Source: Medscape Medical News)

For comments and archives

FDA okays raltegravir for kids, teens with HIV

The integrase inhibitor raltegravir (Isentress) can be used to treat HIV in children and adolescents ages two through 18, the FDA announced. The decision expands the indication for the drug, which was approved for adults in 2007. As in the case of other anti–HIV drugs, raltegravir is used with two other medications in a triple–drug cocktail. The drug, in pill form, is taken orally twice a day. (Source: Medpage Today)

For comments and archives

Salt cravings may start in the playpen

If you crave salty snacks, the preference might have started in infancy, researchers reported. A prospective cohort of babies was either indifferent to or actively disliked a salty water solution at 2 months, compared with plain water, according to Leslie Stein, PhD, and colleagues at the Monell Chemical Senses Center, a nonprofit research institute in Philadelphia. But four months later, babies who had in the meantime been exposed to starchy table foods, such as ready–to–eat cereals or mashed potatoes with milk and margarine, tended to prefer the salted solutions, Stein and colleagues reported online in the American Journal of Clinical Nutrition. (Source: Medpage Today)

For comments and archives

   Cardiology eMedinewS

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

Statins and The Risk Of Diabetes

Read More

One out of every six patients after PCI is readmitted within 30 days

Read More

Post TVI most strokes in the first 24 hours

Read More

Low Iron Levels in Blood Raises DVT Risk

Read More

   Twitter of the Day

@DrKKAggarwal: Watch Padma Shri Awardee Dr KK Aggarwal on Heart patients should stay more cau… http://www.youtube.com/watch?v=WbSnBumHJb4&feature=share via @youtube

@DeepakChopra: No matter what the situation, remind yourself "I have a choice."

    Spiritual Update

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

Are We All Related To Each Other?

Vasudaiva Kutumbakam is the Vedic saying, which means "the world is my home" and it is one of the most ancient Vedic teachings coming from Rig Veda. Today, in the era of rapid industrialization and globalization, people have started understanding and talking about this concept.

For comments and archives

   An Inspirational Story

(Ms Ritu Sinha)

The Scorpion and the Old Man

There was this old man who saw a scorpion floundering around in the water. He decided to save it by stretching out his finger, but the scorpion stung him. The man still tried to get the scorpion out of the water, but the scorpion stung him again.

A man nearby told him to stop saving the scorpion that kept stinging him.

But the man said: "It is the nature of the scorpion to sting. It is my nature to love. Why should I give up my nature to love just because it is the nature of the scorpion to sting?"

Don’t give up loving. Don’t give up your goodness. Even if people around you sting.

For comments and archives

    Fitness Update

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

Sick? Stay Home

If your child does have a fever, bad cough or is vomiting or has diarrhea, make sure to keep them at home. Not only will the prolonged rest help them recover faster, it will prevent other children from coming down with the same symptoms and stop the spread of disease.

For comments and archives

    Legal Question of the Day

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

Q. Dentists use a lot of materials like cements etc. If a complication arises due to faulty material, will the dentist be responsible?


  1. Yes. It is the responsibility of the dentist to purchase materials of good quality. The patient is likely to win if he files a complaint.
  2. If the material, after having been purchased, turns out to be of bad quality, it is open to the dentist to file a complaint against the manufacturer/supplier for supply of deficient goods.

For comments and archives

    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

The elderly and driving

Pentagon test

In this portion of the MMSE, the clinician draws two intersecting pentagon or hexagon figures, each side about 1 inch, and then asks the older patient to copy the figures exactly. The test is scored as a ‘pass’ if all the sides and angles of the figures are preserved and if the sides intersect. Any tremor or rotation of the figures is ignored.

    Medicine Update

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

Prevention of Rickets and Vitamin D Deficiency in Infants and Children, and Adolescents

The American Academy of Pediatrics recommends a daily intake of at least 400 IU vitamin D in infants, children and adolescents to prevent rickets and vitamin D deficiency.

  • Vitamin D (400 IU/day) should be supplemented in all breastfed and partially breastfed infants beginning in the first few days of life. Continue this unless the infant is weaned to at least 1 L/day or 1 quart/day of vitamin D–fortified formula or whole milk. Avoid whole milk till the child is one year of age.
  • Use reduced–fat milk in children aged 1–2 years who are overweight or obese or have a family history of obesity, dyslipidemia, or cardiovascular disease.
  • All older children who take <1000 mL/day of vitamin D–fortified formula or milk plus all infants who have not been breastfed should be supplemented with vitamin D 400 IU/day. Include other dietary sources of vitamin D, such as fortified foods, in the daily intake of each child.
  • Vitamin D supplementation (400 IU/day) should be given to adolescents who take less than this amount from vitamin D–fortified milk (100 IU per 8–oz serving) and vitamin D–fortified foods (such as fortified cereals and eggs (yolks)).
  • Based on the available data, serum levels of 25–OH–D in infants and children should be 50 nmol/L (20 ng/mL).
  • Higher doses of vitamin D supplementation may be needed to achieve normal vitamin D status despite an intake of 400 IU/day in children with chronic fat malabsorption and those on antiseizure drugs. The vitamin D status should be monitored with lab tests including serum 25–OH–D and PTH concentrations and measures of bone–mineral status. Repeat 25–OH–D levels at 3–month intervals till normal levels have been obtained. Monitor bone mineral status every 6 months until they have become normal.
  • It is important that pediatricians and other health care professionals should make vitamin D supplements readily available to all children within their community, in particular for those who are most vulnerable.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A pregnant lady was on PPI.
Dr Bad: Stop it.
Dr Good: Continue it.
Lesson: Proton pump inhibitors are not a major cause of birth defects when used early in pregnancy (Pasternak B, Hviid A. Use of proton–pump inhibitors in early pregnancy and the risk of birth defects. N Engl J Med 2010;363:2114–23)

For comments and archives

Make Sure

Situation: A patient developed high altitude cerebral edema while traveling to Leh.
Reaction: Oh my God! Why was acetazolamide not started before the journey?
Lesson: Make sure all high risk patients are given acetazolamide before they travel to mountains.

For comments and archives

  Quote of the Day

(Dr GM Singh)

Motivation is what gets you started. Habit is what keeps you going. Jim Ryun

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Anion gap

Increased serum anion gap reflects the presence of unmeasured anions, as in uremia (phosphate, sulfate), diabetic ketoacidosis (acetoacetate, beta–hydroxybutyrate), shock, exercise–induced physiologic anaerobic glycolysis, fructose and phenformin administration (lactate), and poisoning by methanol (formate), ethylene glycol (oxalate), paraldehyde and salicylates. Therapy with diuretics, penicillin, and carbenicillin may also elevate the anion gap.

Decreased serum anion gap is seen in dilutional states and hyperviscosity syndromes associated with paraproteinemias. Because bromide is not distinguished from chloride in some methodologies, bromide intoxication may appear to produce a decreased anion gap.

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emedinews revisiting 2011
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    Mind Teaser

Read this…………………


Yesterday’s Mind Teaser: STEP PETS PETS

Answer for yesterday’s Mind Teaser: One step forward, two steps back

Correct answers received from: Muthumperumal Thirumalpillai, Dr Mrs S Das, Prabha Sanghi, Dr PC Das, Dr Suneet Kumar, Dr Anupam Sethi Malhotra, Dr Jainendra Upadhyay, Dr KV Sarma, Christopher Mathew, Sudipto Samaddar, Dr NeelamNath.

Answer for 21st December Mind Teaser: an after thought
Correct answers received from: Dr Anupam Sethi Malhotra, yogindra vasavada, Anil Bairaria,
Dr KV Sarma, Dr John C Mathew.

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr Anupam Sethi Malhotra)

A guy goes to a phychiatrist. He says: "I don't know why Doc -- but no one listens to me or pays any attention to me". The psychiatrist stares at the guy for a second and says: "NEXT."

    Medicolegal Update

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

The extent and severity of violence used is determined from the size and swelling of bruise

  • The doctor must document in medicolegal report the dimension /shape/size of the bruise because it may connect the victim and the object or weapon used in the specific case, e.g., chain, cane stick, rifle butt, boots, ligature, vehicle etc.
  • The age of injury can be detected by the status of color of bruise, the extent and severity of violence or force used may be determined from the size and swelling of bruise, character and manner of the injury may be known from its distribution over the body.
  • Bruising of the arm may indicate restraining the person. Bruising of the shoulder blades indicates firm pressure on the body against the ground or other resisting surface. In manual strangulation, the position and number of bruises nail marks may give an indication on the method of attack and the position of the assailant.
  • The pattern bruises on chest/neck and mouth is also very important in diagnosing resuscitative injury in medicolegal cases which are invariably confused by doctor as manual strangulation/smothering.
  • Pattern bruise is an important tool for diagnosing torture injury and very commonly appreciated in sole/flexor aspect of hands/buttock and back of thighs by doctors.

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)

One can get Asthma at any age

One can get asthma at any age said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India. Asthma disturbs the regular life of asthmatic patients due to difficulty in breathing.

Asthma for a person might be due to many factors. Some of the risk factors of asthma can be controlled and some cannot. To prevent asthma one should control the trigger factors or limit the controllable risk factors such as exposure to tobacco smoke, mold spores, dust mites, perfume, feather buds, pet dander, pollen, cockroaches etc. The occupational triggers include chemicals, environmental irritants such as fumes, cold air etc. Non–controllable risk factors are family history, low birth weight, obesity and gastroesophageal reflux disease (GERD).

For comments and archives

    Readers Responses
  1. Dear Sir, It is very Nice reading eMedinews: Dr Anupama
    Forthcoming Events

Lecture on Buddism and Astronomy

By Prof. Trinh X. Thuan

UNESCO Kalinga Awardee, 2009; Prof. of Astronomy, University of Virginia, USA; UNESCO Kalinga Awardee for Popularisation of Science by UNESCO, Kalinga Chair awardee by Department of Science & Technology, Government of India.

Organised by Heart Care Foundation of India in association with Nehru Planetarium on behalf of RVPSP, Dept. of Science & Technology Govt.of India

At Nehru Planetarium Chankyapuri New Delhi on 27th Dec 2011 at 10.30 am

No fee, to register email to drkakroo@gmail.com, 9810301261

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3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews "Doctor of the Year Award" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: emedinews@gmail.com

3rd eMedinewS Revisiting 2011

Dr Ajay Kriplani (Surgical management of diabetes); Dr N K Bhatia ( What’s new in transfusion medicine); Dr Kaberi Banerjee (Fertility update); Dr Amit Bahrgava (Cancer update 2011), Onco Radiation update (Rajiv Gandhi Cancer Institute); Dr Ambrish Mithal (Vitamin D update), Dr Praveen Chandra (Interventional Cardiology update); Revisting 2011 (Dr K K Aggarwal), Portfolio management (Central Bank of India); Insurance update (LIC India); General Insurance (Doogar Associates)


The Annual conference of Indian Menopause Society is to be held from 17 to 19th Feb 2012 in Hotel The Claridges, Surajkund Faridabad. It is multidisciplinary approach to the problems of midlife onwards in women. This conference has participation of British Menopause Society and South Asian Federation Of Menopause Societies and opportunity to hear from international faculties.

For information Contact Dr. Maninder Ahuja (Organizing Chairperson) 9810881048 down load forms from web sit http://indianwoman35plus.com/ or Indianmenopausesociety.org or http://fogsi.org/

Contact at ahuja.maninder@gmail.com
Call for free papers and posters on theme topics of conference.

Early Registration till 30th Dec 2011

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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