24th October 2014, Friday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and National Science Communication Awardee. Limca Book of Record Holder (CPR). Gold Medalist

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, 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.twitter.com/DrKKAggarwal, www.facebook.com/Dr KKAggarwal

Mindfulness meditation

Sit on a straight-backed chair or cross-legged on the floor.

Focus on an aspect of your breathing, such as the sensation of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale.

Once you've narrowed your concentration in this way, begin to widen your focus. Become aware of sounds, sensations, and ideas.

Embrace and consider each thought or sensation without judging it good or bad. If your mind starts to race, return your focus to your breathing. Then expand your awareness again.

7th Asia-Pacific Heart Rhythm Scientific Session New Delhi, India

Prolonged PR interval predicts clinical recurrence of atrial fibrillation after catheter ablation. A study published in J Am Heart Assoc. 2014 Oct 7;3(5) concluded that the PR interval was closely associated with advanced left atrium remodeling due to atrial fibrillation (AF), and had a noninvasive significant predictive value of clinical recurrence of AF after radiofrequency catheter ablation (RFCA).

Dr. Mohan Nair
Chairman, Organizing Committee of the 7th Asia Pacific Heart Rhythm Society's  (APHRS) Scientific Sessions, being organized simultaneously at the Taj Palace Hotel and ITC Maurya in New Delhi from October 29th to November 1st, 2014.

Be a part of the discussions regarding Arrhythmia Management with global experts at the 7thAsia Pacific Heart Rhythm Society Meeting from October 29th – November 1st at New Delhi.

As a special offer for all eMedinews readers, we have decided to waive off the registration fees for the conference. To register yourself, please click on the following link


News Around The Globe

  • Results of a meta-analysis published online October 15 in JAMA Psychiatry show that the adjunctive use of NSAIDs, celecoxib in particular, was associated with improved antidepressant treatment response without an increased risk for adverse effects.
  • Frequent consumption of fried foods before becoming pregnant increases a woman's risk for gestational diabetes, and that risk is even higher when those fried foods are eaten away from home, according to a recent study published online October 8 in Diabetologia.
  • Alcohol intake is linked to lower sperm quality, according to a cross-sectional study of young Danish men published online October 2 in BMJ Open. Adverse effects on semen can be seen at levels as low as five drinks per week, although the trend is more pronounced among men who drink more than 25 units per week.
  • The US Food and Drug Administration (FDA) has expanded the approval of collagenase clostridium histolyticum (HCC; Xiaflex, Auxillium Pharmaceuticals) for the treatment of up to two Dupuytren's contracture (DC) joints in the same hand during a single treatment visit.
  • A new Descemet membrane endothelial keratoplasty (DMEK) technique results in low complication rates and acceptable cell density. The new technique was presented by Dr Straiko during the poster session at the American Academy of Ophthalmology 2014 Annual Meeting.
  • A US Food and Drug Administration (FDA) advisory committee has recommended approval of secukinumab (Cosentyx, Novartis Pharmaceuticals) for the treatment of moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. Secukinumab is a fully human monoclonal antibody that inhibits the proinflammatory cytokine interleukin-17A.

Dr KK Spiritual Blog

What is the importance of Govardhan Pooja?

Mistakes of the intellect are responsible for the disturbed state of mind. Even if the mind is under control, the intellect can disturb the mind. It is the discriminative faculty of the mind and can be very destructive. It is the main cause of ignorance. External desires and the uncontrolled five senses are responsible for it. Kama, Krodha, Lobha and Moha are the causative factors.

In mythology, Krishna won over the intellect- symbolized by King Indra, the one who controls the indriyas and the senses. Govardhan pooja is the example of winning over the intellect. The same can only be done by one point concentration on the object of concentration. Krishna raised the mountain (the problem) on his one finger (one point determination) to save the people from heavy rains (turmoil of thoughts).

It means taking one point decision (one finger) whenever the mind is indecisive (Mountain) with multiple possibilities (rain).

Only when the mind body and soul are purified after one month Yagna (first Navratra to Diwali) can one use the intellect to take one point decisions.

Govardhan pooja can also be understood by the following story.

Once a disciple asked his Guru about the difference between a girlfriend and wife. The Guru asked him to go to the tomato field and pick up the largest and most colored tomato but put a condition that once he had crossed one line he could not return back.

The disciple went and saw a large tomato in the first row. He went ahead and found a larger tomato in the next row. Thinking that the subsequent rows would have still larger tomatoes he went on further and further. In the seventh row he found a very large red tomato but in search of finding a still larger tomato he left it and went to next row only to find smaller and smaller tomatoes in the subsequent rows and ultimately came empty handed. The Guru said this is the example of search for a girlfriend.

Four days later the Guru asked the disciple to do the same exercise again. This time in the fifth row the disciple found a very large red tomato, got satisfied, plucked it and came back. When the guru asked why he did not search further, he said that that once he decided on that tomato his mental turmoil to search further stopped. It did not bother him anymore that a still larger tomato may have been ahead. The Guru said this is an example of the search for a wife.

Govardhan pooja means stopping your search at some point and being satisfied with what you get or learning to make a stop to all your desires at some point in your life.

Inspirational Story

The perfectionist sculptor

A gentleman once visited a temple under construction where he saw a sculptor making an idol of God. Suddenly he noticed a similar idol lying nearby. Surprised, he asked the sculptor, “Do you need two statues of the same idol?”

“No,” said the sculptor without looking up, “We need only one, but the first one got damaged at the last stage.” The gentleman examined the idol and found no apparent damage. “Where is the damage?” he asked.

“There is a scratch on the nose of the idol.” said the sculptor, still busy with his work. “Where are you going to install the idol?” The sculptor replied that it would be installed on a pillar twenty feet high.

“If the idol is that far, who is going to know that there is a scratch on the nose?” the gentleman asked. The sculptor stopped his work, looked up at the gentleman, smiled and said, “I know it and God knows it!”

Moral: The desire to excel should be exclusive of the fact whether someone appreciates it or not. Excellence is a drive from inside, not outside. Excel at a task today – not necessarily for someone else to notice but for your own satisfaction.

Rabies News (Dr A K Gupta)

What is the importance of pre-exposure vaccination?

Pre-exposure vaccination simplifies post-exposure vaccination because after bite, those who have received full pre-exposure vaccination require only two doses of vaccine at Days 0 & 3. RIG is not required (WHO 2007).

Cardiology eMedinewS

  • Two older patients with severe functional mitral regurgitation underwent successful transapical transcatheter mitral valve implantation as reported in a recent study published in the Journal of the American College of Cardiology. The two patients were a 73-year-old man and a 61-year-old woman with severe functional mitral regurgitation, NYHA class IV HF, depressed LV ejection fraction, pulmonary hypertension and additional comorbidities. Old age, comorbidities or severe left ventricular dysfunction prevent some patients with mitral regurgitation from being recommended for surgery. In this high-risk patient cohort, transapical transcatheter mitral valve implantation may be an attractive option.
  • Drug-eluting stents were associated with a 28% reduction in mortality compared with bare-metal stents (BMS) in a cohort of patients undergoing PCI for stenosis of saphenous vein grafts, according to new data published in the Journal of the American College of Cardiology. In the study, procedural complications occurred in 2.3% of patients receiving DES and 2.8% among those receiving BMS.

Pediatrics eMedinewS

  • New research shows that low maternal education increases the likelihood that a child with ADHD will receive medication, whereas immigrant status decreases the odds. The study was published in the October issue of the British Journal of Psychiatry. According to the authors, physicians should bear in mind the possible contribution of social characteristics on their practices.
  • Results of a study published online October 13 in Pediatrics suggest that families who express more warmth, group enjoyment and positive reinforcement at family meals have children with reduced risk of obesity. Lead author Jerica M. Berge of the Department of Family Medicine and Community Health at the University of Minnesota in Minneapolis said that these findings only identify associations between meal habits and childhood obesity, and do not prove that mealtime dynamics cause obesity, but there are some known healthy strategies parents can employ at the dinner table.

Quote of the Day

  • The love that is defined by a relationship is limited. Dive deep in a love that is beyond relationships. Sri Sri Ravi Shankar


  • Doctors of the Delhi Medical Association (DMA) on Wednesday staged a protest demanding that the Delhi Government take action against quacks in the national capital. According to Indian Medical Association (IMA), the number of quacks in Delhi, who are practising medicine, is estimated to be around 40,000. "The DMA will not let quacks play with the health of common citizens of the city. DMA has always been critical of the illegal practice of quackery," DMA president Anil Goyal told reporters. "The DMA suggests that quacks should be trained to work as healthcare workers. They should not be allowed to prescribe any medicine to anybody," he added. Update: 16–October–2014
  • A leading body of Indian-American physicians plans to hold its 9th annual Global Healthcare Summit aimed at bringing accessible, affordable and quality world-class healthcare to India in Mumbai from Jan 2–4. The Association of American Physicians of Indian Origin (AAPI), one of the largest ethnic professional bodies, is organizing the summit at Trident Oberoi Hotel in collaboration with the Indian Ministries of Health and Family Welfare and Overseas Indian Affairs.
  • Union Health Minister Dr Harsh Vardhan assured members of the newly constituted Parliamentary Consultative Committee of the Ministry of Health and Family Welfare that broad expansion of the number of undergraduate and postgraduate seats are being considered without compromising on the quality of medical education.

Wellness Blog

Non–alcoholic Fatty Liver Disease Independently Predicts Prediabetes

Non–alcoholic fatty liver disease has been linked to increased risk for developing type 2 diabetes. A new study in Liver International 2013;33(9):1406–1412 evaluated the independent role of NAFLD in predicting the development of pre–DM in a 7–year prospective follow–up of healthy volunteers.

A prospective cohort of a subsample of the Israeli National Health Survey was evaluated at baseline and after 7 years by identical protocols. Metabolic parameters and ultrasonographic evidence of NAFLD were evaluated in 213 subjects, without known liver disease or history of alcohol abuse. Exclusion criteria were pre–DM at the baseline survey. Steatosis was quantified by ultrasound with the hepatorenal ultrasound index (HRI).

The study included 141 volunteers (mean age 48.78 ± 9.68, 24.82% with NAFLD) without pre–DM/DM at baseline. Both NAFLD on regular US (OR=2.93, 1.02–8.41 95%CI) and HRI (OR=7.87, 1.83–33.82) were independent predictors for the development of pre–DM, adjusting for age, gender, BMI, family history of DM, baseline insulin, adiponectin and glucose. Further adjustment for physical activity and dietary intake did not weaken the association. Furthermore, NAFLD was a stronger predictor for pre–DM than the metabolic syndrome. Subjects with both NAFLD and glucose =89 had 93.3% incidence rate of pre–DM. The study concluded that non–alcoholic fatty liver disease is a strong and independent risk factor for pre–DM in the general adult population; thus, NAFLD patients should be classified as a population at risk.

ePress Release

Patients with acidity should avoid chocolates and peppermint

Persistent acidity is usually due to reflux of acid from the stomach into the food pipe. Mild cases of acidity reflux can usually be managed with lifestyle and dietary modifications along with antacids, H2 blockers and proton pump inhibitors.

However, patients in whom lifestyle management together with empirical treatment is unsuccessful or those who have symptoms suggestive of complicated diseases should undergo endoscopy to rule out cancer of the food pipe, a condition linked with persistent acidity. This was stated by Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

He said that symptoms that may suggest complicated disease include loss of appetite, loss of weight, and difficulty in swallowing food, bleeding and signs of systemic illness.

Lifestyle changes for reflux involve elevation of head and of the body, avoidance of food before sleep and avoidance of food which makes the food pipe valve lax. Examples of such foods include fatty food, chocolates, peppermint and excessive intake of alcohol.

eMedi Quiz

Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionisation of the drug in the stomach. Which of the following statements is not a correct example?

1. Absorption of digoxin is delayed by the presence of food.
2. Concurrent food intake may severely reduce the rate of absorption of phenytoin.
3. Presence of food enhances the absorption of hydrochlorothiazide.
4. Anitimalarial drug halofantrine is more extensively absorbed if taken with food.

Yesterday’s Mind Teaser: The buffering capacity of a buffer is maximum at pH equal to:

1. 0.5pKa.
2. pKa
3. pKa+1
4. 2pKa

Answer for yesterday’s Mind Teaser: 2. pKa

Correct answers received from: Dr.Bitaan Sen & Dr.Jayashree Sen, Dr Jainendra Upadhyay, Dr Avtar Krishan, Tukaram Pagad

Answer for 22nd Oct Mind Teaser: 4.Vertebral venous plexus

Correct answers received from: Tukaram Pagad

Send your answer to email

Twitter of the Day

Dr KK Aggarwal: Weight gain precedes the onset of diabetes Weight gain after age of 18 years in women and 20 years in men

Dr Deepak Chopra: Who is the most powerful person in your life? What are the characteristics of a powerful person?

emedipicstoday emedipics

21st Perfect Health Mela 15th October 2014

21st MTNL Perfect Health Mela 2014


Zee News – Health Wealth Shows


press release

Monitoring LFT in a patient on statins

video of day video of day

Other Blogs

Video Library

MTNL Perfect Health Mela

Heart Care Foundation of India, a leading national non–profit organization committed to making India a healthier and disease-free nation announced the upcoming activities of the 21st MTNL Perfect Health Mela scheduled to be held from 15th – 19th October 2014 at the Talkatora Indoor Stadium in New Delhi.

Sameer Malik Heart Care Foundation Fund

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF

Total CPR since 1st November 2012 – 96458 trained

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."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)


IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :


Dr Good and Dr Bad

Situation: A patient with COPD needed oxygen.
Dr. Bad: Use binasal cannula.
Dr. Good: Use Venturi mask.
Lesson: Venturi mask helps to wash out carbon dioxide.

Make Sure

Situation: A patient intolerant to penicillin was denied rheumatic prophylaxis.
Reaction: Oh my God! Why was he not put on sulfa?
Lesson: Make sure that patients who cannot tolerate penicillin are put on sulfadiazine or sulfisoxazole. This antibiotic class is effective for preventing group A streptococcal (GAS) infection although it cannot be used to achieve eradication.

eMedinewS Humor

A man really loved a woman, but he was just too shy to propose to her. Now he was up in his years and neither of them had ever been married. Of course, they dated about once a week for the past six years, but he was so timid he just never got around to suggesting marriage much less living together.

But one day, he became determined to ask her the question. So he calls her on the phone, "June."

"Yes, this is June."

"Will you marry me?"

"Of course I will! Who's this?"

medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Editor eMedinewS and President Heart Care Foundation of India)

Choosing the best option in the judgment of the doctor is not medical negligence

In the case of Charan Singh vs Healing Touch Hospital And Ors on 24 April, 2003 (III(2003) CPJ 62 (NC)), the National Consumer Disputes Redressal Commission observed “it is a settled law when two choices are available, exercise of one, which is the best in the judgment of the doctor and anything else is available to contradict this, doctor in such circumstances cannot be held negligent.

medicolegal update
  1. Dear Sir, Wishing you a very happy Diwali. Regards: Dr Karuna

eMedinewS Special

1. IJCP’s ejournals (This may take a few minues 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)