eMedinewS6th May 2014,Tuesday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee

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

Much–hyped new tuberculosis test gives inaccurate results

(TOI Report D N Jha) In a major setback to improving tuberculosis (TB) diagnosis and treatment in the country, researchers have found that the new gene Xpert gene test being promoted by government and top health agencies of the world does not give accurate results. In fact, one out of every three sputum sample put to test using this technology gave false sensitivity to TB drug (Rifampicin) in study carried at the All India Institute of Medical Sciences (AIIMS) when they were originally drug–resistant.

Dr Sarman Singh, professor and head of the clinical microbiology and molecular medicine division at AIIMS, said GeneXpert has been a revolutionary diagnostic method in Africa but in India it can miss as many as one–third of Rifampicin–resistance cases. "The Indian strains have a peculiar gene sequence which is not recognized by the probes GeneXpert has. Hence, if such systems are used routinely, this would give a false impression that India has very low rifampicin resistance thus making the programme mangers complacent," Dr Singh added.

There are four tests approved by WHO: LED Microscope, Liquid Culture and two molecular tests – Gene Xpert and Line Probe Assay. Gene Xpert, one of the advanced tests for TB diagnosis, is available at AIIMS for a patient suffering from drug resistant TB but it is not available in all hospitals due to its high cost. But central TB division of Ministry of Health, Government of India is installing GeneExpert in all the referral TB laboratories.

Dr Singh said the national TB control program managers must evaluate the performance of Xpert MTB/RIF test before rolling it out in the Drug resistant–TB control program in view of the findings, which has been published in latest issue of the Journal of Clinical Microbiology. The AIIMS study, researchers said, was done in a double-blinded manner. "After getting the RIF mono-resistance Line Probe Assay (LPA) results, one of us asked the persons in charge for Xpert MTB/RIF to run these samples in Xpert using the newer version of cartridges as per manufacturer instruction. Comparative analysis showed only 64.4% RIF mono–resistant TB cases were correctly diagnosed by Xpert. The remaining 35.6% were detected falsely RIF susceptible," said an AIIMS researcher.

In an earlier report published in PLOS Medicine journal, researchers pointed out that Xpert MTB/RIF has a number of limitations including limited shelf–life of the diagnostic cartridges, operating temperature and humidity restrictions, requirement for electricity supply, the need for annual servicing and calibration of each machine.

News Around The Globe

  • A study presented at the Digestive Disease Week (DDW) 2014 has revealed that bariatric surgery may improve nonalcoholic fatty liver disease (NAFLD) besides leading to weight loss and better metabolic profiles. The surgery has been noted to reduce fat deposits in the liver, resolve liver inflammation and reverse early–stage liver fibrosis and scarring.
  • Repetitive transcranial magnetic stimulation (rTMS) could be a promising treatment for generalized anxiety disorder (GAD), reports a study presented at the American Psychiatric Association’s 2014 Annual Meeting. Study authors noted that the efficacy of rTMS was superior to sham and about 70% of patients who completed treatment had a significant clinical response to rTMS vs. 25% in the sham condition.
  • Salivary gland ultrasonography (SGUS) improves American College of Rheumatology (ACR) classification of patients with Sjögren’s syndrome (SS) and should be included in evaluations, reports a new study conducted in France.
  • Healthy People 2020, a health initiative by the U.S. Department of Health & Human Services, is failing to achieve the targets, reported a study presented at the National Kidney Foundation’s 2014 Spring Clinical Meeting. Less than 8% of patients with kidney disease are aware of their condition. Additionally, percentage of those with CKD and hypercholesterolemia has risen, while the goal is to move in the other direction.
  • Patients with leukemic cutaneous T–cell lymphoma (CTCL) with diffuse erythema are more likely to experience complete response to alemtuzumab therapy, reports a new study published online in JAMA Dermatology. The study reported that none of the patients with discrete patches, plaques, or tumors with or without background diffuse erythema experienced full remission after alemtuzumab.

Rabies News (Dr A K Gupta)

Are pregnancy and lactation contraindications for IDRV?

Pregnancy and lactation are not contraindications for IDRV.

Cardiology eMedinewS

  • According to two studies presented at the American Association for Thoracic Surgery 2014 Annual Meeting, using the right internal mammary artery (RIMA) rather than the radial artery (RA) as the second conduit improves survival when performing CABG for multivessel disease; and that total arterial revascularization provides better long–term survival than a single arterial graft.
  • According to the 25×25 World Health Assembly (WHA) roadmap, adopting a comprehensive plan aimed at reducing tobacco use, alcohol use, salt intake, limiting physical inactivity, and reducing elevated blood pressure and glucose levels, can remarkably reduce the risk of premature mortality from noncommunicable diseases (NCDs), including CVD. The article is published May 3 in the Lancet.

Pediatrics eMedinewS

  • A new study presented at the American Psychiatric Association’s 2014 Annual Meeting has suggested that high school students who frequent the tanning salon (40 times or more in 12 months) may have 2–fold increased odds of depressive symptoms and suicidal thoughts and a greater than 4–fold likelihood of suicide attempt.
  • The Committee on the Fetus and Newborn (COFN) has changed their guidelines on the basis of new findings, and has recommended that antibiotic therapy for neonates with abnormal laboratory findings and those born to mothers with chorioamnionitis (CAM) should not be extended for longer than 72 hours. The previous guidelines led to prolonged antibiotic therapy, longer length of stay, and more interventions.

Dr K K Spiritual Blog

Positive Attitudes

All those out there who feel you are at your wits’ end wondering how things don’t ever work out for you can now relax and dwell on all those failures that life has taken you through and turn failure into success.

Positive Attitudes

  1. Failure doesn’t mean you are a failure. But it does mean you haven’t succeeded yet.
  2. Failure doesn’t mean you have accomplished nothing. It does mean you have learned something.
  3. Failure doesn’t mean you have been a foolish. It does mean you had a lot of faith.
  4. Failure doesn’t mean you’ve been discouraged. It does mean you were willing to try.
  5. Failure doesn’t mean you don’t know what to do. It does mean you have to do it in a different way.
  6. Failure doesn’t mean you are inferior. It does mean you are not perfect.
  7. Failure doesn’t mean you have wasted your life. It does mean you have a reason to start afresh.
  8. Failure doesn’t mean you should give up. It does mean you must try harder.
  9. Failure doesn’t mean you'll never make it. It does mean it will take a little longer.
  10. Failure doesn’t mean God has abandoned you. It does mean God has a better idea.

Wellness Blog

All about depression

  1. Depression is a major public health problem as a leading predictor of functional disability and mortality.
  2. Optimal depression treatment improves outcome for most patients.
  3. Most adults with clinical significant depression never see a mental health professional but they often see a primary care physician.
  4. A non–psychiatric physician 50% of times misses the diagnosis of the depression.
  5. All depressed patients must be enquired specifically about suicidal ideations.
  6. Suicidal ideation is a medical emergency
  7. Risk factors for suicide are either psychiatric known disorder, medical illness, prior history of suicidal attempts, family history of attempted suicide.
  8. The demographic reasons include older age, male gender, marital status (widowed or separated) and living alone.
  9. World over 1 million people commit suicide every year.
  10. 79% of patients who commit suicide contact their primary care provider in the last one year before their death and only 1/3 contacts their mental health service provider.
  11. Twice as many suicidal victims had contacted with their primary care provider as against the mental health provider in the last month before suicide.
  12. Suicide is the 10th leading cause of death worldwide and account for 1.2% of all deaths.
  13. In US suicidal rate is 10.5 per 100,000 people.
  14. In America suicide is increasing in middle aged adults.
  15. There are 10–40 non–fatal suicide attempts for every one completed suicide. The majority of suicides completed in US are accomplished with fire arm (57%), the second leading method of suicide in US is hanging for men and poisoning in women.
  16. Patients with prior history of attempted suicide are 5–6 times more likely to make another attempt.
  17. 50% of successful victims have made prior attempts.
  18. One of every 100 suicidal attempt survivors will die by suicide within one year of the first attempt.
  19. The risk of suicide increases with increase in age, however, younger and adolescents attempt suicide more than the older.
  20. Females attempt suicide more frequently than males but males are successful three times more often.
  21. The highest suicidal rate is amongst those individuals who are unmarried followed by widowed, separated, divorced, married without children and married with children in descending order.
  22. Living alone increases the risk of suicide.
  23. Unemployed and unskilled patients are at higher risk of suicide than those who are employed.
  24. A recent sense of failure may lead to higher risk.
  25. Clinicians are at higher risk of suicide.
  26. The suicidal rate in male clinicians is 1.41 and in female clinicians it is 2.27.
  27. Adverse childhood abuse and adverse childhood experiences increase the risk of suicidal attempts.
  28. The first step in evaluating suicidal risk is to determine presence of suicidal thoughts including their concerns and duration.
  29. Management of suicidal individual includes reducing mortality risk, underlying factors and monitoring and follow up.
  30. Major risk for suicidal attempts is in psychiatric disorder, hopelessness and prior suicidal attempts or threats.
  31. High impulsivity or alcohol or other substance abuse increase the risk.

Inspirational Story

3 Attitudes

Three people were laying bricks. A passerby asked them what they were doing.

The first one replied, "Don’t you see I am making a living?"

The second one said, "Don’t you see I am lying bricks?"

The third one said, "I am building a beautiful monument."

Here were three people doing the same thing who had totally different perspective on what they were doing.

They had three very different attitudes about their work. And would their attitude affect their performance? The answer is clearly yes.


Excellence comes when the performer takes pride in doing his best. Every job is a self–portrait of the person who does it, regardless of what the job is, whether washing cars, sweeping the floor or painting a house.

Michelangelo had been working on a statue for many days. He was taking a long time to retouch every small detail. A bystander thought these improvements were insignificant and asked Michelangelo why he bothered with them. Michelangelo replied, "Trifles make perfection and perfection is no trifle."

Most people forget how fast you did a job, but they remember how well it was done.

Pride of performance does not represent ego. It represents pleasure with humility.

"The quality of the work and the quality of the worker are inseparable."

Half–hearted effort does not produce half results; it produces no results!

ePress Release

21st MTNL Perfect Health Mela dates announced

This year’s MTNL Perfect Health Mela will be held from October 15 to 19, 2014 at Talkatora Indoor Stadium, New Delhi.

The event will be organized by Heart Care Foundation of India and New Delhi Municipal Corporation.

Announcing the dates, Padma Shri, Dr B C Roy National Awardee & DST National Science Communication Awardee, Dr K K Aggarwal, President of the Foundation said that this year the Mela would be dedicated to the rising incidence of heart disease in the country. In addition, various heart hospitals would be invited to run their OPD and provide hospital services within the Mela premises.

The Sameer Malik Heart Care Foundation Fund will provide free heart surgery along with free cardiac interventions to those heart patients who are needy or are under privileged.

Other events in the Mela would include inter–school, inter–college, inter–nursing school, inter–dancing school health festivals.

Giving further details Dr Aggarwal said under the Heart Care Fund, financial assistance is given to the needy and underprivileged people who cannot afford heart care interventions.

About HCFI : The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on" Hands only CPR" of 88972 people since 1stNovember 2012.

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 10x10 i.e. 100 per minute."

Zee News – Health Wealth Shows

Cancer Prevention
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Fluid Intake


Total CPR since 1st November 2012 – 88972 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)

emedipicstoday emedipics

World Earth Day Celebration at DAV Public School, RK Puram, New Delhi.

press release

AHA – ACS update

video of day video of day


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 :


Make Sure

Situation: A patient was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA?
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2 suggest that this intervention is much better than thrombolytic therapy in such patients.

eMedinewS Humor

Misbehaving Phone Call

Seven year old Johnny had finished his summer vacation and gone back to school.

Two days later his teacher phoned his mother to tell her that John was misbehaving.

"Wait a minute," she said. "I had Johnny here for two months and I never called you once when he misbehaved."

Quote of the Day

If you are depressed you are living in the past. If you are anxious you are living in the future. If you are at peace you are living in the present. Lao Tzu


Twitter of the Day

Dr KK Aggarwal: High BP in Pregnancy Increases Risk for Future Atherosclerosis http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: No matter what happened in the past, we all have the right and the capacity to be happy and loved http://bit.ly/DC_Ananda #ananda


eMedi Quiz

What percentage of your diet should fat make up?

A. About 10 percent of your daily calories.
B. About 20 percent of your daily calories.
C. About 30 percent of your daily calories.
D. About 40 percent of your daily calories.
E. There is no recommended amount of fat; you should strive to eat as little of it as possible.

Yesterday’s Mind Teaser: An early systolic murmur may be caused by all of the following except:

1.Small ventricular septal defect.
2.Papillary muscle dysfunction.
3.Tricuspid regurgitation.
4.Aortic stenosis.

Answer for yesterday’s Mind Teaser: 4.Aortic stenosis.

Correct answers received from: Dr A K Gajjar, Dr K V Sarma, Dr P C Das,
Dr Jainendra Upadhyay, Daivadheenam Jella, Dr pankaj Agarwal, Dr Chandresh Jardosh.

Answer for 4th May Mind Teaser: c. Indinavir

Correct answers received from: Dr Chandresh Jardosh.

Send your answer to ijcp12@gmail.com

medicolegal update

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medicolegal update
  1. Dear Sir, Very informative news. Regards: Dr Kunal
cardiology news

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