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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 …

29th July 2011, Friday

Gatifloxcin banned but not the eye drops

Gatifloxacin formulation for systemic use in human by any route including oral and injectable was prohibited for manufacture and distribution in the country by Ministry of Health, Government of India on 16.03.2011.

After the ban, the Drug Controller Department approved an eye formulation of gatifloxacin which caused confusion amongst the medical professionals.

Drug Controller of India issued a clarification dated 03.06.2011 that gatifloxacin ophthalmic formulations like eye drops and ointment ,which are topical formulations and are not for systemic use, are not banned.

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Dr KK Aggarwal
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  eMedinewS Audio PostCard

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

Science behind Hanuman Chalisha

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

National Conference on Insight on
Medico Legal Issue

Justice AK Sikri delivering the keynote address in the National Conference on Insight on Medico legal issues. In the Photo: eminent speakers on the dias.


Dr K K Aggarwal
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook – Twitter


Study says India most depressed country

A study based on the World Health Organization’s World Mental Health Survey Initiative has said that India has the highest rate of major depression in the world. The study, ‘Cross-national epidemiology of DSM-IV major depressive episode,’ based on interviews of nearly 90,000 subjects across 18 countries with different income levels, was published in the peer-reviewed journal BMC Medicine by Biomed Central. The average lifetime rates of depression, according to the study, were found to be 14.6 per cent in ten high income countries, and 11.1 percent in eight low- to middle-income countries. But lifetime incidents of what was identified as Major Depressive Episodes (MDE), were highest among Indians at 35.9 percent, while China was at the lowest at 12 per cent. Average percentage of MDE was, however, considerably higher in high-income countries at 28.1 percent, compared to 19.8 percent in the low- to middle-income countries. (Source: Indian Express, Jul 27 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

(Dr Monica and Brahm Vasudev)

Genes bind families via heart attacks, not stroke

Genetic connections between parents and siblings confer more of a risk for heart attack than stroke, researchers found in a population-based study. Siblings with one parent who experienced a myocardial infarction (MI) had a 48% chance of having one as well (OR 1.48, CI 1.04 to 2.10; P=0.03), while those with two affected parents had a nearly sixfold increase of having an MI themselves (OR 5.97, CI 3.23 to 11.03; P<0.0001), reported Peter M. Rothwell, MD, PhD, of the University of Oxford, England, and colleagues. (Source: Medpage Today) For comments and archives

FDA Panel gives okay to pediatric use of LVAD

An FDA advisory committee has recommended in favor of a humanitarian exemption for Berlin Heart's EXCOR ventricular assist device for use in children as a bridge to heart transplant. Panel members voted unanimously, 16-0, that the device is safe for use in patients who meet eligibility criteria, and also voted unanimously that the device's benefits outweigh its risks. The device is intended for use by pediatric patients with severe isolated left ventricular or biventricular dysfunction who are candidates for cardiac transplant and who require circulatory support. The panel compared survival on the device with treatment with extracorporeal membrane oxygenation (ECMO). (Source: Medpage Today) For comments and archives

Facebook, Google as addictive as drugs: Study

NEW YORK: Several studies have found that Facebook,Twitter and Google are as addictive as drugs. People react like twitchy addicts denied their drugs when forced to give up access to the Internet and other electronic media. And just like a boozer who leans on bourbon as a social lubricant, online addicts believe that people who aren't hooked on the information superhighway, text messaging and instant messaging are huge bores, reports the New York Post. "Giving up technology was considered by some to be as hard as quitting smoking or drinking," said the research firm Intersperience about a new study of people deprived of their online habits. According to the study, a full 53 per cent of 1,000 people surveyed reported feeling 'upset' when "deprived of Internet connection." The study also found that, 40 per cent of those people "feel lonely when not able to go online." (Source: The Economic Times, 26 Jul, 2011)
For comments and archives

FDA Alert

FDA restricts use of simvastatin 80 mg

The Food and Drug Administration is recommending that physicians restrict prescribing high-dose simvastatin (Zocor, Merck) to patients, given an increased risk of muscle damage [1]. The new FDA drug safety communication, issued today, states that physicians should limit using the 80-mg dose unless the patient has already been taking the drug for 12 months and there is no evidence of myopathy. "Simvastatin 80 mg should not be started in new patients, including patients already taking lower doses of the drug," the agency states. In addition, the FDA is requesting that additional changes be made to the drug's label. The label will be changed to include the new dosing recommendations, as well as warnings not to use the drug with various medications, including itraconazole (Sporanox, Jannsen Pharmaceutica), ketoconazole (Nizoral by Ortho-McNeil Pharmaceutical), posaconazole (Noxafil, Merck), erythromycin, clarithromycin, telithromycin (Ketek, Sanofi-Aventis), HIV protease inhibitors, nefazodone, gemfibrozil, cyclosporine, and danazol. (Source: Medscape)
For comments and archives

   Fitness Update

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

New method of forecasting could change the way life expectancy is calculated

Many reports have claimed that that the younger generation of Americans could be the first not to outlive their parents, and a study recently published in the journal Health Affairs sheds some light on those figures can be calculated, and why childhood obesity complicates the process.

While traditionally, researchers have used "two dimensional" forecasting to predict life expectancy, this study explains the need for "three dimensional" forecasting. In the past, experts always assumed that younger generations will experience better health and lower mortality than their parents, thanks to lifestyle improvements, modern healthcare and pharmaceutical treatments. However, this study explains that today's children can no longer be expected to outlive their parents, which introduces another dimension into calculating their life expectancy. Since the long-term effects of childhood obesity are still unclear, it's impossible to predict exactly how long the youngest generation will live. The study does show that applying this "three dimensional" forecasting technique to the US obesity epidemic suggests that future death rates and health care expenditures could be far higher than anticipated, and that reversal of the US life expectancy rate is a possibility for the current generation of young Americans.

For comments and archives

   Twitter of the Day

@DrKKAggarwal: #DNBIndia: Treatment- 1000mg of iv methylprednisolone for first 3 days f/b 0.5-1mg/kg PO daily; in life... http://fb.me/TMxTgQyP

@DeepakChopra: How to love your enemies http://huff.to/pNph3Q

    Dr KK Answers

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

Dr KK Answers: Which iron salt should one choose in anemia?

Iron is best absorbed as the ferrous (Fe2+) salt in a mildly acidic medium. It is better to add 250 mg vitamin C at the time of iron administration to enhance the degree of iron absorption. The cheapest salt is iron sulfate (325 mg of iron salt with 65 mg is elemental iron) For comments and archives

    Spiritual Update

Can I Take Curd in the Dinner

According to Charaka Samhita, the Bible of Ayurvedic text, one should not take curd, a predigested fermented food, in the night. This rule of Ayurveda has created a lot of controversy between doctors of Ayurveda and Modern System of medicine. In fact, both Chinese and Ayurveda medicine clearly docum.... more

For comments and archives

    An Inspirational Story

(Dr. Anupam Sethi Malhotra)

Love is what we do and what we don't!

One Sunday, a mother took her son and little daughter to watch a circus. In the middle of the circus, the little girl, Jenny, who was two years old, fell asleep in her mother's lap. The brother, Jack, who was six, stayed awake, and watched the rest of the circus with his mother. When it was over, the mother picked up Jenny in her arms and carried her to the bus station. It was very cold that night, so she took off her scarf and gently covered Jenny's head with it.

When they arrived home, the mother first carried Jenny into the bed room and put her to sleep. After Jack had changed his clothes, his mother lay down next to him to talk about the evening together. "How did you like it, Jack?" "Fine, he answered."Did you have fun?""Yes". "What did you like most?" "I don't know. The elephant dance, I guess.""That was quite a thing, wasn't it doing those tricks like that?" There wasn’t much response on his part. The mother wondered why her son wasn't opening up more. He usually did when exciting things happened. She was a little disappointed.

She sensed something was wrong: he had been so quiet on the way home and while getting ready for bed. Suddenly Jack turned over on his side, facing the wall. She wondered why and lifted him up just enough to see his eyes welling up with tears. "What's wrong, honey? What is it?" He turned back, and she could sense he was feeling some embarrassment for the tears and his shivering lips and chin. "Mom, if I were cold, would you put your scarf around me, too?" Of all the events of that special evening out together, for Jack the most important was a little act of affection - a momentary, unconscious showing of her love to his little sister.

Moral: In relationships, little things matter the most.

For comments and archives


(By Ritu Sinha)

Against the clock: Rushed and short on time.

    Pediatric Update

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

What is the role of liver transplantation in Wilson’s disease?

Liver transplantation is the only effective option for those who present with acute liver failure in Wilson’s disease. It is also indicated for all patients of WD with decompensated liver disease who are unresponsive to medical therapy. Some individuals who undergo transplantation for decompensated cirrhosis have had psychiatric or neurologic symptoms, which improved after liver transplantation but liver transplantation primarily for neurological symptoms is not indicated.
For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, Dr. Kaberi Banerjee, Infertility and IVF Specialist, Max Hospital)

Why vaccination should be completed before conceiving?

After conceiving, many doctors are reluctant to immunize pregnant women because a spontaneous abortion or incidental congenital anomaly might be attributed. The fear persists despite extensive reassuring experience with polio, influenza, and rubella vaccinations in pregnant women.

For Comments and Archives

    Rabies Update

(Dr A K Gupta, Author of "RABIES – the worst death")

How is rabies transmitted?

Rabies is transmitted by infected secretions. Most commonly, transmission to humans takes place through exposure to saliva during a bite by an infected animal. Rabies virus can be excreted in saliva, tears, urine, sweat, nasal discharge and respiratory secretions.

Man-to-man transmission of rabies is possible. Rabies can be transmitted following bite by a rabies patient. In 2004, three cases of human rabies were reported in U.S. following liver and kidney transplantation from rabies patients. Transplantation of rabies infected cornea can cause rabies in recipient. Therefore a careful neurological history of donor must be taken before cornea transplantation.

For Comments and archives

    GP Pearls

(Dr Pawan Gupta)

Detection of malarial parasite is possible not only in blood but in other body fluids by PCR methods. However with QDX malaria Rapid Test (Piramal Ltd) it is possible to detect Malarial parasite in urine. It has 100% specificity, 20% sensitivity, 35% accuracy, 100% positive and 23 % negative predictive value. Testing urine is non invasive and safe and useful in certain sub set of patients.

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    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)


  • To diagnose C-cell hyperplasia and medullary thyroid cancer
  • To evaluate the effectiveness of treatment
  • To monitor patients for recurrence
  • To screen for medullary thyroid cancer in family members of patients with multiple endocrine neoplasia type 2 (MEN 2)

If treatment for medullary thyroid cancer (thyroidectomy) has been successful, then calcitonin levels fall to very low levels.

If levels continue to be low over time, it is likely that the treatment was effective.

If levels fall but remain moderately elevated, this means that some calcitonin-tissue remains.

If calcitonin levels begin to rise, then it is likely that there is a recurrence of medullary thyroid cancer.

For comments and archives

    IJCP Special

Dr Good Dr Bad

Situation: A patient with fever had headache.
Dr. Bad: It is meningitis unless proved otherwise
Dr. Good: It can be simple malaria also.
Lesson: Fever with headache can be seen in meningitis, malaria, dengue and many viral infections
For comments and archives

Make Sure

Situation: A patient with 105 degree fever was not responding to the paracetamol
Reaction: Oh my God!! Why was IM paracetamol given.
Lesson: Make sure to remember that when the fever is more than 105 degree, fever medicines alone will not work. Answer is tap water sponging to lower the temperature. For comments and archives

  Quote of the Day

(Dr GM Singh)

Childhood is that wonderful time of life when all you need to do to lose weight is take a bath. Richard Zera

    Medicolegal Update

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

Doctor should have good grasp of the legal process

The percentage of patients injured by medical negligence who actually file a lawsuit is very small. The estimates range from one in 8 to one in 10, and of those who file lawsuits, only one in three receives any compensation - American college of legal medicine

  • Prophylactic awareness by physicians of malpractice liability, coupled with the adoption of preventive programs, should minimize allegations of malpractice.
  • Victory is achievable when preventative alertness diminishes the need for aggressive legal defense. Competently trained, experienced physicians and surgeons are mindful of legal liability. They follow a course of medical and surgical care that is commensurate and consistent with their skill, knowledge, ability, and experience. Such physicians and surgeons, when accused of medical malpractice, rarely lose in a court of law.
For comments and archives
    Mind Teaser

Read this…………………

One of the following statements regarding the investigations for UTI is true

a. Urine culture should not be routinely obtained at the first prenatal visit
b. Screening for asymptomatic bacteriuria is not recommended during pregnancy
c. Presence of secretory IgA has been found to be correlating with the UTI
d. Urine dip for nitrites and leukocytes esterase should be routinely used for diagnosis

Yesterday’s Mind Teaser: Under the WHO ‘Vision 2020’ programme, the ‘SAFE’ strategy is adopted for which of the following diseases?

1. Trachoma
2. Glaucoma
3. Diabetic retinopathy
4. Onchocerciasis

Answer for yesterday’s Mind Teaser: 1. Trachoma

Correct answers received from: Dr Bina Sawhney, Dr Ashraf M, Dr Prabha Sanghi, Dr Priyanka Sharma, Dr Surendra Bahadur Mathur, Dr Raju Kuppusamy, Dr U Gaur, Dr Muthumperumal Thirumalpillai, Dr Neelam Nath, Dr Nikunj Garia, Dr Jainendra Upadhyay, Dr Anil Bairaria, Dr yogindra vasavada

Answer for 26th July Mind Teaser: 4. Ig E
Correct answers received from: Dr Raju Kuppusamy, Dr U Gaur 

Send your answer to ijcp12@gmail.com

    Medi Finance Update

(Dr GM Singh)

What is TDS?

It is the amount withheld from payments of various kinds such as salary, contract payment, commission, professional fees, etc. This withheld amount can be adjusted against your tax due. It is primarily for better tax administration that taxes are deducted at the time of payment to the recipient of taxable income.

They are similar to prepaid taxes, credit for which can be claimed while filing Return of Income.

    Laugh a While

(Mr Sudesh Kumar)

Funny quote on a husband’s T-Shirt:

All girls are devils, but my wife is the queen -- -- -- -- . . . . .of them!!!

    Drug Update

List of Approved Drug From 01–01–2011 to 30–06–2011

Drug Name
DCI Approval Date
Ursodeoxycholic Acid Suspension 125mg/5ml and 250 mg /5ml.
For the treatment of patients with chronic cholestatic liver disease.
    Public Forum

(Press Release for use by the newspapers)

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Asthma linked to smoking

Active smoking increases the risk of developing asthma, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India and MTNL Perfect Health Mela.

Dr. Aggarwal said that adolescents who smoke more than 300 cigarettes a year are at 4 times the risk of developing asthma compared to their non-smoking peers. Active smoking is strongly associated with high incidence of asthma between ages 17 to 33.

It is also seen that those children who develop asthma by age 7, usually go in remission but relapse by age 33 if they smoke.

Secondhand smoking is also associated with developing asthma in early life, especially, if the mother is a smoker. Many studies have shown that children of smoking mothers are two times are more likely to develop asthma than children of non-smoking mothers.

For comments

    Readers Responses
  1. Respected Dr K K Aggarwal sir thanks for wonderful presentation of causes of fever. Dr Sundeep Nigam
    Forthcoming Events

September 30th to October 2nd, 2011, Worldcon 2011 – XVI World Congress of Cardiology, Echocardiography & Allied Imaging Techniques at The Leela Kempinski, Gurgaon (Delhi NCR), INDIA

from Sept 29, 2011: A unique & highly educative Pre–Conference CME, International & National Icons in the field of Cardiology & Echocardiography will form the teaching faculty.



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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 Naveen Dang, Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Pawan Gupta (drpawangupta2006@yahoo.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta