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Address: 39 Daryacha, Hauz Khas Villege, New Delhi, India. e-Mail: drkk@ijcp.com , Website: www.ijcpgroup.com

Dr K K Aggarwal

Dr KK Aggarwal
Dr BC Roy Awardee
Sr Physician and Cardiologist,
Moolchand Medcity
President, Heart Care
Foundation of India
Gp Editor-in-Chief,
IJCP Group
Delhi Medical Council
Director, IMA AKN Sinha Institute (08-09)



emedinews is now available online on www.emedinews.in

26th December Saturday

Dear Colleague,

             Should a non CGHS paneled hospital admit a referred patient from CGHS paneled hospital?

Yes only with a rider:if a recent DMC decision is taken as a verdict the hospital may not be able to charge full rates and may even be required to refund the money charged over and above the CGHS rates.  I personally feel this order will get challenged as the patient was shifted to higher non CGHS panel hospital with the consent of the relations.

The order: The DMC Disciplinary Committee recently examined a representation from Police Station DBG Road Karol Bagh, seeking medical opinion on a complaint of Smt. Santosh, alleging medical negligence on the part of doctors of Jeewan Nursing Home, Pusa Road, Sir Ganga Ram Hospital, new Delhi and Jeewan Mala Hospital, New Rohtak Road in the treatment administered to late Ganesh Lal, resulting in his death or 5.2.2009.

The patient with Chronic Cholecystitis was taken up for lap cholecystectomy, ending in open cholecystectomy due to Cholecystoduadenal Fistula. Excision of Fistula done on at Jeewan Nursing Home. After surgery, the patient went into shock for which exploratory laprotomy done. On 3rd post operative day patient was biliary leak. CT Angio done at Sir Ganga Ram Hospital was suggestive of Pseudo aneurysm in cystic artery. He was shifted to Sir Ganga Ram Hospital on request of patientís relatives where embolization was done. The condition of the patient stabilized and he was discharged on 21.1.2009. On 28.1.2009, the patient reported with unconsciousness, dypsnea, tachypnea. As there was no bed available in Sir Ganga Ram Hospital, the patient was shifted to Jeewan Mala Hospital. He was started on life support system (ventilator/Inotropic) but he continued to remain critical and in spite of possible treatment and efforts could not survive.

DMC in the order raised the problem of financial burden which the family had to incur in the treatment of a complication which has arisen as a result of medical procedure. Even though the patient, underwent cholecystectomy at a CGHS panel hospital he was constrained to seek treatment of the complication associated with the aforementioned surgical procedure, at Sir Ganga Ram Hospital (a non-CGHS panel hospital) and was thereby burdened financially.  Subsequently, He was treated at Jeewan Mala Hospital where in he was admitted under a non-CGHS category (in spite of the fact that Jeewan Mala Hospital was a CGHS panel hospital) and as such the patient was made to pay over and above all the expenses admissible under CGHS.

1. The Disciplinary Committee, DMC, directed Jeewan Mala Hospital to return all the charges taken from the complainant which went beyond the CGHS limit in respect of this patient.
2.It further directed Ganga Ram Hospital to reimburse the complainant the expenses charged for CT Angiography performed on the patient at Ganga Ram Hospital and may if like raise the claim in respect of this procedure to CGHS through Jeewan Mala Hospital which is affiliated to Ganga Ram Hospital.
3. It also recommended that all hospitals/nursing homes at CGHS panel should refrain from raising bills directly to the patient family, who is a CGHS beneficiary and instead should make their claim to CGHS.


Dr KK Aggarwal



Silicic Acid is a Mineral, found in Abundance in the Sea Bed. Sodium Meta Silicate,the Isomer of Silicic Acid is Found to have Unique Beneficial Effects on the Human Body. Sodium Meta Silicate Improves the Body Immunity and thus helps Reduce the Incidence of Allergic Disorders, It is known to Improve the Brittlness of nails, Increase the Hair Tensile Strength and Make the Skin Glow. It has been Found to be very Useful Adjunct in Acne Vulgaris. Sodium Meta Silicate also helps Improve Memory Loss in Old age, Especially in patients with Alzeimer,s Disease , by Reducing the Uptake of Aluminium into the Brain Tissue.. It provides Stronger Bones and Smoother Joints by Mobilising Calcium and Increasing the Bone Mineral Density.Recent Studies have shown Sodium Meta Silicate to help Reduce the LDL and VLDL levels and Increase the good Cholesterol,the HDL.
In the Year 2009, Sodium Meta Silicate has been rated as one of the most Popular and Effective Immunity Boosting Health Supplement available in United States of America and Europe.

Take home messages from the Medicine Update 2009, MAMC: Part 3
HIV: (Dr Koushik Dutta and Dr N P Singh)
1. CD4 count should be done in all HIV patients.
2. Suspect CD4 level appropriate opportunistic infections.
3. Use primary and secondary prophylaxis as appropriate for the CD4 level and existing opportunistic infection in the patient.
4. Tuberculosis can occur at any CD4 level.
5. HIV is also associated with an array of non communicable diseases. Suspect and treat them early.
6. As HIV treatment has evolved over the years, we can now aim for full virologic suppression. Viral load <50 copies/mL is now achievable. Combination of new agents can be used to evade resistance and minimize toxicity. AIDS is now a chronic managable disease.

 Dr Good Dr Bad
Situation: A patient came with vomiting followed with headache
Dr Bad: A classical case of migraine
Dr Good: I need o rule out SOL
Lesson: in migraine vomit follows headache. When headache follows vomiting rule out raised intra cranial pressure.

Dietary Needs of Aging Women (Dr Prachi Garg)
1. At least 1,500 milligrams daily of calcium, which may be found in dairy products and leafy green vegetables, or dietary supplements.
2. Eight milligrams of daily iron is needed to help produce red blood cells. Healthy sources of iron include fortified breakfast cereals, spinach and beans.
3. Limited intake of saturated and trans fats.
4. Limited intake of salt (sodium) and added sugars.
5. Plenty of fiber.

Funny clinical notes (Dr. Minakshi)
I saw your patient today, who is still under our car for physical therapy.

Brahm Vasudeva
Elderly patients need not be treated aggressively for high blood pressure.
Elderly patients are being treated too aggressively for high blood pressure, according to research published in the British Medical Journal. Data from 2 new trials found little evidence that aggressive treatment saves more lives.

Extended release niacin may improve HDL quality in patients with diabetes.
According to a study published online Dec. 21 in the journal Circulation, treatment with extended release niacin ( 1500 mg /day) for three months increased HDL cholesterol but also improved the   endothelial protective effects   of   HDL cholesterol in individuals with diabetes.  

Intravitreal use of corticosteroid triamcinolone may slow diabetic retinopathy progression.
According to a study published in the Dec. issue of the Archives of Ophthalmology,   intravitreal use of the corticosteroid triamcinolone may slow the progression of diabetic retinopathy, but adverse effects including cataract formation and glaucoma may prevent use of this treatment merely to reduce progression of proliferative diabetic retinopathy.

European regulators approve gastrointestinal liner meant to treat type 2 diabetes, obesity.
Lexington medical device company, GI Dynamics, has won approval in Europe for a gastrointestinal liner to treat type 2 diabetes and obesity.   The EndoBarrier, which is   implanted via the mouth in an outpatient procedure that is considered an alternative to gastric bypass surgery,   forms a   barrier between food and the wall of the small intestine, to control how food moves through the digestive system.  


What 's the difference between a nurse and a nun?
A nun only serves one God.


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emedinews: revisiting 2009
IJCP Group, Heart care Foundation of India and World Fellowships of Religions are  is organizing emedinews: revisiting 2009, day long conference on the top health happenings in the year 2009 on 10th Jan 2010 at Maulana Azad Auditorium. There is no registration fee however advanced information is required.  Top experts (Dr KK Aggarwal (revisiting 2009), Dr Naresh Trehan (whats new in cardiac surgery), Dr Ajay Kriplani (Current Trends in the Management of Morbid Obesity), Dr Praveen Chandra (The Indications of Interventional Treatment in Cardiology), Dr Kaberi Banerjee (IVF- Where We Stand Today?), Dr N K Bhatia (TTI infections), Dr V Raina ( molecular genetics), Dr Ajit Saxena (ED and male infertility), Dr S C Tewari (Nephroprotection), Dr. Ambrish Mithal (Diabetes), Dr Vanita Arora (ECG arrhythmias), Dr N Subramanium (Current concept in Male infertility ), Dr Neelam Mohan (Coeliac Disease), Dr. Sanjay Chaudhary (Eye Update), Dr Harish Parashar (aluminum toxicity), Dr Praveen Khillani (Whats new in field of critical care in past decade?), will deliver lectures.

CME will be followed by lively cultural evening guest performances by Shabani Kashyap, Vipin Aneja and perfomances by medical professional singers Dr Praveen Khillani, Dr Lalita and Dr N Subramanium, Dr Lata Tandon, Dr Arti Pathak, Dr Sudipto Pakrasi, Dr Harjeet Kaur, Dr Ramni Narsimhan, Dr Sanjay Chugh (on the drum), Dr Yash Gulati (Anchor) Dr Reshma Aggarwal (Anchor), doctors of the year award, dance and dinner. For registration mail emedinews@gmail.com. We have crossed 1200 registrations. 

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Dear Organiser,
Please convey my thanks and congratulations to Dr K K Agarwal on the very informative and useful e medinews. It is a great service he is providing. Thanks and Regards,Dr Anvita Pandiya



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