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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 9 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

28th December 2012, Friday

73 rd IMA Central Council Meeting Proceedings

  1. 161 members of IMA died in the last one year
  2. The NCHRH bill has been rejected by Parliamentary Committee in Health and Family Welfare. It will be redrafted with help of all stakeholders. Unfortunately nothing was discussed about restoration of MCI.
  3. IMA is the largest NGO with 213918 members.
  4. The IMA is hosting next CMAAO meeting at Delhi in September 2013 at Hotel Maurya.
  5. IMA wants that the BSc (Community Health) course started by government should not be recognized by MCI and State Councils.
  6. On 1st March, 2012, the CEA act was notified by GOI.
  7. GOI has asked IMA and MCI to conduct survey of various kinds of health facilities in the four states and seven union territories of the country with regard to CEA.
  8. IMA will be part to CEA rules to be framed by GOI. Each state has to oppose its implementation in the state. Twelve points have been framed by IMA for all state branches of IMA to negotiate with state health ministry.

Keep the law in abeyance. Sensitize the MLAs if not. Negotiate amendments.

  • Single doctor clinic should be out. Simple registration is ok.
  • Secure adequate representation for IMA in the state councils of the act.
  • District appropriate authority should be out, if not, ensure IMA in district council, remove NGO and police members from DRA
  • Remove inspectors. Independent accreditation body.
  • Get five years to achieve standards and not one year.
  • Stabilization clause should be deleted. First aid is ok.
  • The complaint cell should be deleted
  • Try and bring reasonable registration fee and penalty structure.
  • Try and delete the provision barring civil courts from adjucating.
  • Public hearing on provisions or inviting public objections on registration of individual hospitals should not be allowed.
  • Provision for fixing the fee and charges for procedures should be deleted. Public display of rates need not be objected.
  • Provision for government issuing treatment protocols should be deleted.
  • Compliance cell to be deleted. Reasonable registration fee. Barr courts from adjudication. Govt. can not issue treatments protocols. Non congress states IMA should lobby so hat CEA is not implemented.
  • It was on the efforts of IMA that GOI made TB a notifiable disease since 7th May 2012.
  • WHO banned serological tests in TB on July 20, 2012 and allowed only accurate microbiological tests and molecular tests.

    (To be contd. tomorrow)

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

Register for 4th eMedinewS–revisiting 2012 conference

    Constipation Update

Irritable bowel syndrome with predominant constipation (IBS-C) is characterized by abdominal pain with altered bowel habits. These patients may or may not have slow colonic transit or dyssynergia, and many have visceral hypersensitivity. Abdominal pain in IBS can vary but should not be associated with weight loss, rectal bleeding, anemia, and should not be nocturnal or progressive. Patients may note diarrhea, constipation, or both.

Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Proton–pump inhibitors to carry
warning about C

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

New IMA President Dr K Vijayakumar takes over

Dr K K Aggarwal
    National News

Dear Colleague, Let’s celebrate New Year by learning CPR-10 and saving the life of a person

Watch English or Hindi Video @http://emedinews.in/videos/cpr/index.html

Dr K K Aggarwal

Primary Health Centres in 17 States short of doctors

CHENNAI, The health of many living in our rural areas rests precariously in the hands of doctors who do not exist. If the dearth of health human resources is a major issue in the country, its severest impact is probably in rural areas. The facts tell their own story of neglect: Over 17 States have an excess of 10 per cent vacancy in doctor posts in Primary Health Centres. Rural areas in the country are served through primary health centres. One PHC is provided for every 30,000 population, and in hilly areas, for every 20,000 population. Going by the figures sourced from the National Rural Health Mission by PRS Legislative Research, the human resources crunch is probably hampering the implementation of the progressive National Rural Health Mission programme in States, and thereby, the access to health care in rural areas. In the list of vacancies of doctor posts in Primary Health Centres, Chhattisgarh is at the top, with 71 per cent vacancy. As many as 1,058 posts of doctors out of 1,482 sanctioned posts are vacant. PHCs are required to have one medical officer and 14 other staff. West Bengal (44 per cent), Maharashtra (37 per cent), Uttar Pradesh (36 per cent) and Mizoram (35 per cent) are also on top of the list with high vacancies. According to the document, only nine States, including Bihar, Jharkhand, Jammu and Kashmir and Punjab have no doctor vacancies at the PHC level. Among the better performers are Rajasthan (0.4 per cent vacancies), Andhra Pradesh (3 per cent), Kerala (7 per cent), and Karnataka (10 per cent). Human resources availability in rural areas is a major issue across the country, says A.Padmanabhan, Advisor, Public Health Administration, National Health, National Health Systems Resource Centre (NHSRC), under the NRHM. “This is not for doctors alone, but nurses and other paramedical staff too,” Dr. Padmanabhan says. A number of State governments want to fill these vacancies, they call for applications, even propose some incentives for these posts, he adds. “However, the vacancies remain. Professionals are not willing to work in rural areas, clearly.” Dr. T. Sundararaman, executive director, NHSRC, says, “Where you have a vacancy it definitely affects the programme in a major way. A whole lot of work is done by the team to provide public health. Some of the key tasks are in prevention and there is not a very big barrier between that and curative work. Say, for instance in tuberculosis prevention. If you do not have the staff, none of your programmes get off the ground.” (Source: The Hindu, December 20, 2012)

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

Severity of aortic stenosis

Based upon a variety of hemodynamic and natural history data, clinicians generally grade the severity of stenosis as mild, moderate, severe, or critical

  • Mild: Valve area exceeds 1.5 cm2
  • Moderate: Valve area of 1.0 to 1.5 cm2
  • Severe: Valve area less than 1.0 cm2

(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)

Transfusion after MI boosts mortality risk

Transfusion after a myocardial infarction (MI) doubled the mortality risk and significantly increased the odds of subsequent MI in survivors, results of a meta-analysis showed. (Source: Medpage Today)

Doubling down on RAAS blockade in HF? Aldosterone antagonists, not ARBs, says meta-analysis

An aldosterone antagonist (AA) should be the drug of choice when adding a second renin-angiotensin-aldosterone system (RAAS) blocker to ACE inhibitors in patients with symptomatic systolic HF despite standard drug therapy, say the researchers behind a 16-trial meta-analysis. (Source: Medscape)

HIV and smoking may be a deadly combination

Patients with HIV who smoke shave a dozen years from their life expectancy and may have a 4-fold risk for death compared with nonsmoking patients with HIV, even when they receive well-organized care that includes free antiretroviral therapy, according to an article published online December 19 in Clinical Infectious Diseases. (Source: Medscape)

Ventilator products recalled

The FDA has issued two Class I recalls involving ventilator-related products. The Ventlab manual resuscitator for adults and children has been recalled because of a defective valve that may leak, resulting in little or no air or oxygen being delivered to the patient. The second Cass I recall is for Bunnell's Life Pulse High-Frequency Ventilator Patient Circuits. The heater wire insulation on the product can melt, resulting in sparking and smoke in close proximity to the humidifier cartridge, the FDA said. These devices are "used for ventilating critically ill infants with pulmonary interstitial emphysema and infants with respiratory distress syndrome complicated by pulmonary air leaks, who are, in the opinion of their physicians, failing on conventional ventilation," according to the FDA. (Source: Medpage Today)

Lomitapide approved for homozygous familial hypercholesterolemia

The FDA has approved lomitapide (Aegerion Pharmaceuticals, Cambridge, MA) as an adjunct to a low-fat diet and other lipid-lowering drugs, with or without LDL apheresis, to reduce LDL-C, total cholesterol (TC), apolipoprotein B (apoB), and non-HDL-C in patients with homozygous familial hypercholesterolemia (FH) [1]. It will be known by the brand name Juxtapid. (Source: Medscape)

   Twitter of the Day

@DrKKAggarwal: Blunt injury on the chest leading to cardiac arrest is called commotio cordis

@DeepakChopra: Gun Control Is About the Silent Majority. Please read my article written for SF Gate http://tinyurl.com/bt2psco

    Spiritual Update

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

Why are Hindu marriages held at night?

Originally, Hindu marriages were always held in daytime. As per Vedic knowledge and Bhagavad Gita, the auspicious time is in Uttarayana, before full moon, in daytime and near agni and light. Medically, you are more mentally positive during

For comments and archives

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

What are the risks of hysteroscopy?

Only 1% of women have complications from an office hysteroscopy. Complications with operative hysteroscopy include absorption of fluid, infection, bleeding and uterine perforation. If a perforation occurs during an operative hysteroscopy, you may need another procedure to ensure there is no damage to nearby organs such as your intestines, bladder, or blood vessels.

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

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


Anemia is one among various common health problems, especially amongst the women, in the developing countries. An anemic person has the following features:

  • Tiredness
  • Easy fatigability
  • Generalized muscular weakness
  • Lethargy
  • Headache
  • Looks pale
  • Attacks of faintness
  • Menstrual disturbances
  • Loss of weight and appetite
  • Palpitations
  • Breathlessness
  • Severe anemia leads to heart problems
  • Depression
  • Irritability
  • Listlessness–lassitude & weakness

Iron deficiency is the commonest cause of anemia world–over. The other main cause is the deficiency of vitamin B12 and folic acid. Iron obtained from diet replaces the loss of iron from the body. Requirement of iron is 1mg daily in a normal adult. It increases to 1.5 mg daily in females. Average daily requirement of folic acid or folate is 100–200 micrograms. A minor amount of trace elements like zinc, cobalt, copper & vitamin C etc. is required for proper maturation of RBCs.

Dietary Recommendations in Anemia

  • Improve food choices to increase amount of total dietary iron
  • Include a source of vitamin C at every meal
  • Include (meat, fish, poultry) at every meal if possible
  • Avoid drinking large amounts of tea or coffee with meals (both contain tannin)

NOTE: A high protein diet (1.5g/kg body weight) is desirable both for liver function and blood regeneration.

For comments and archives

   An Inspirational Story

A harsh word

A woman bought eggs and butter from a farmer who had a fine reputation not only for the quality of his products, but also for his promptness of delivery. Then one day, when she was expecting guests, he failed to come. On the next delivery, she spoke harshly to him. At the end of her tirade he said quietly, "I'm sorry if I caused you any inconvenience, but I had the misfortune of burying my mother yesterday."

Ashamed, the woman determined never to speak harshly to anyone again until she fully understood the cause of the delay.

Often we never care for other travails and traumas. Like a frog in the well, our feelings remain confined to our milieu. Even a farmer has his own priorities. Sometimes, we do not empathize with others. What if we had been stricken with some tragedy, and someone callously chastises us.

For comments and archives

   Cardiology eMedinewS

Wrist access to the heart better than femoral Read More

Nitinol stent superior to balloon angioplasty in PVD Read More

   Pediatric eMedinewS

Fragile X newborn screening feasible, but caveats exist Read More

Overweight kids more likely to be deficient in vitamin D Read More

    IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was on aerobic exercise protocol.
Dr Bad: Continue it.
Dr Good: Add resistance training also.
Lesson: According to a study published in the Journal of the American Medical Association, people with diabetes should mix aerobics with weight training to get the best results in lowering blood sugar.

Make Sure

Situation: A patient with renal failure came to a doctor.
Reaction: Oh, my God! Why was he given painkillers?
Lesson: Make sure to remember that most painkillers (barring nimesulide) are not kidney–friendly drugs.

    Legal Question of the Day (M C Gupta)

Q. Doctors in government service sometimes get less salary than nurses. For example, a BSc. in Jharkhand is appointed as a tutor nurse. In Jharkhand if a nurse joins on the post of tutor after getting BSc. nursing degree then they are placed in PB3 pay scale, which is higher than the PB2 pay scale on which a doctor with an MD degree is appointed as a tutor in a medical college. What should the doctors do?


  1. One way of looking at it is that persons are being appointed to various posts in a transparent manner and no illegality is being performed and no law is being violated.
  2. The other aspect is that it is against the universal convention (reflected in the reports of Central Pay Commissions) that in view of several factors, including the higher number of years of study and the nature of work, doctors are paid higher salary than nurses.
  3. Doctors in Jharkhand need to obtain legal opinion about how to redress this anomaly. IMA Jharkhand should apply its mind to the problem.

For comments and archives

  Quote of the Day (Dr GM Singh)

Do not spoil what you have by desiring what you have not; remember that what you now have was once among the things you only hoped for. Epicurus

    Mind Teaser

Read this…………………

During the first 24 hours after thyroid surgery, the nurse should include in her care:

A. Checking the back and sides of the operative dressing
B. Supporting the head during mild range of motion exercise
C. Encouraging the client to ventilate her feelings about the surgery
D. Advising the client that she can resume her normal activities immediately

Yesterday’s Mind Teaser: Before a post- thyroidectomy client returns to her room from the OR, the nurse plans to set up emergency equipment, which should include:

A. A crash cart with bed board
B. A tracheostomy set and oxygen
C. An airway and rebreathing mask
D. Two ampoules of sodium bicarbonate

Answer for yesterday’s Mind Teaser: B. A tracheostomy set and oxygen

Correct answers received from: Dr Sunil Bansal, Dr Bharat Bhushan Aggarwal, Dr Shagufta Moin, Dr C Mohan, Dr Kanta Jain, Prabha Sanghi,
Dr KV Sarma, Dr Arpan Gandhi, Dr KP Chandra, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Dr Thakor Hitendrsinh G, Dr Avtar Krishan,
Dr BK Agarwal.

Answer for 26th December Mind Teaser: C. Asking her to state her name out loud

Correct answers received from: Dr Bharat Bhushan Aggarwal, Dr KP Chandra, Dr Pankaj Agarwal, Dr Thakor Hitendrsinh G, Dr Avtar Krishan, Dr BK Agarwal, Dr VM Kartha.

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

Funny meanings...

MARRIAGE: An agreement wherein a man loses his bachelor's degree and a woman gains her master's.

    Medicolegal Update

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

Lacerated wound

The direction of the shelving of margins of a lacerated wound indicates the direction of the blow applied to cause the wound as seen in MLC cases.

  • Lacerations are tears or splits of skin, mucous membranes, muscle or internal organs produced by application of blunt force to a broad area of the body, which crushes or stretches the tissues beyond the limits of their elasticity.
  • Crush injury from a direct blow may produce an irregular or stellate laceration with a variable degree of devitalized tissue, abrasion and visible contamination.
  • Do not close a laceration if there is visible contamination, debris, non–viable tissue or signs of infection. Wounds may involve vascular areas of the face and scalp where the risk of infection is low or extremities where infection becomes a greater risk, along with the possibility of tendon and nerve damage. The elderly and patients on chronic steroid therapy may present with "wet tissue paper" skin tears following relatively minor trauma.
  • When produced by a blunt weapon, such as club, crowbar, stone, brick etc., a lacerated wound is usually accompanied by a considerable amount of bruising of the surrounding and underlying tissues, and has inverted and irregular edges. The direction of the shelving of margins of a lacerated wound indicates the direction of the blow applied to cause the wound.
  • When a heavy weight such as the wheel of a heavy cart or a truck passes over an extremity, by its shearing and grinding force, it tears the skin from the underlying tissue and crushes the muscles and soft part lying beneath it realizing considerable blood and fat in them.
  • Crush injury syndrome or fat emboli may follow a lacerated wound. The tear, avulsion, split are types of laceration.

For comments and archives

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    Public Forum

(Press Release for use by the newspapers)

Can one drive after one peg of alcohol?

Several studies have confirmed that consuming one or two drinks increases the risk of injury. No safe level of alcohol use exists for the use of potentially dangerous equipment, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Exposure to alcohol is measured in blood alcohol concentration (BAC) rather than drinks per day or week. BACs of 0.02 to 0.05 percent impair the ability to operate motor vehicles; this level of blood alcohol can occur with even a single drink. The legal BAC limit for driving is 0.03 percent.

This corresponds to approximately four drinks for a 200 pound man, but only 2.5 drinks for a 150 pound woman.

  • The risk of involvement in a collision while driving doubles at a BAC of only 0.05 percent.
  • Simulated driving ability is impaired with BACs as low as 0.02 percent.
  • The risk of driving accidents is greatest in the first two years of exposure to alcohol.
  • For pilots the BAC offense level is 0.04 percent.
  • Alcohol is involved in one-half to two-thirds of all homicides, at least one-half of serious assaults, and more than one-quarter of all rapes.
    Readers Response
  1. .dear Sir, reading emedinews is very informative. Regards: Dr Tapan
    Forthcoming Events

4th eMedinews Revisiting 2012

(a day long single hall medical conference on 2012 happenings, followed by doctors of the year 2012 awards)

Sunday 20th January 2013, Maulana Azad Medical College Auditorium

Dilli Gate Delhi


Dr KK Aggarwal
Padmashri and Dr B C ROY National Awardee President

Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman

Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

4th eMedinewS Revisiting 2012

The 4th eMedinewS–revisiting 2012 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 20th 2013.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2012. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. All delegates will get Registration Kit, Attractive gifts, Certificates. Morning snacks and lunch will be provided.

Register at: www.emedinews.in/


4th eMedinewS Doctor of the Year Awards

Nominations invited for 4th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2012.

pls send his/her Biodata at: emedinews@gmail.com

    eMedinewS Special

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

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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, Dr Usha K Baveja