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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org

 

  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 (March 10-13); 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 …

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

2nd May 2013, Thursday

Do not ignore breakfast

Taking a good breakfast made up of carbohydrates and lean protein, can help lessen cravings and hunger during the rest of the day, which can lead to significant weight loss

A research by Dr. Daniela Jakubowicz, a clinical professor at Virginia Commonwealth University and an endocrinologist at the Hospital de Clinicas Caracas in Venezuela has shown that sedentary, obese women lost almost five times as much weight on the "big breakfast" diet as did women following a traditional, restrictive low-carbohydrate diet.

While treating obese people we need to treat carb cravings and hunger. On waking up in the morning, the body is primed to look for food. The metabolism is revived up, and levels of cortisol and adrenaline are at their highest. The brain needs energy right away, and if one doesn’t eat or eats too little, the brain needs to find another fuel source. To do this, it activates an emergency system that pulls energy from muscle, destroying muscle tissue in the process. Then when you eat later, the body and brain are still in high-alert mode, so the body saves energy from the food as fat.

The levels of the brain chemical serotonin are highest in the morning and the craving levels are at the lowest and you may not feel like eating. As the day wears on, serotonin levels dip, and you get cravings for chocolate or cookies, and such similar foods. If you eat these foods, your serotonin levels rise, and your body begins to associate good feelings with them, creating an addictive cycle. The high protein, carbohydrate mix in breakfast gives the body the initial energy boost it needs in the morning. Throughout the rest of the day, the meals are made up of protein and complex carbohydrates, like vegetables. Because protein is digested slowly, you won't feel hungry. If you have to eat chocolate, eat it in the morning as having a small piece of chocolate or candy when serotonin levels are high, won't taste as good, and the brain won't feel the same serotonin boost, which will eventually help cut down on cravings.

Eating breakfast with high glycemic foods may be harmful. After eating cereals or a doughnut, the blood sugar and insulin levels spike. Once that blood sugar is used up, you'll still have excess insulin circulating, which makes you hungry and makes you crave carbohydrates.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

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

AHA – ACS update new–2

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Over 1000 students trained in CPR 10 at
Bal Bharati Public School

 
Dr K K Aggarwal
    National News

Govt launches drive to create awareness on immunization

New Delhi: To create awareness about vaccinating every eligible child and intensify efforts to improve routine immunisation coverage, government launched Special Immunisation Week. Under the plan, four weeks -- one week each of the months of April, June, July and August -- will be used to hold special immunisation sessions in high-risk areas across the country, that will help improve immunisation. Every year, full immunisation prevents about four lakh under-five deaths from vaccine preventable diseases in India, but close to 75 lakh children every year miss the benefits of such childhood vaccinations. Globally every fifth child is immunised, while a majority of those missing the opportunity in India are from among the marginalised populations and being unvaccinated keeps them at highest risk of catching life-threatening diseases. "The Special Immunisation Week is an opportunity to reinforce India's Call to Action for child survival and development," Additional Secretary, Ministry of Health and Family Welfare and Mission Director, National Rural Health Mission, said while launching a new communication campaign at the India Habitat Centre here today. The new communication campaign comprises a new routine immunisation logo, TV spot, radio spot and posters and was organised in collaboration with UNICEF, which was part of the first Special Immunisation Week (April 24-30) awareness initiative. (Source: Business Standard, April 30, 2013)

For comments and archives

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, every Thursday 4:30 PM in DD India

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

    Be Human Stop Child Abuse (Team IMA for CMAAO)

(http://behumanstopchildabuse.emedinews.in/)

Child neglect is an act of omission or commission leading to the denial of a child's basic needs. Neglect can be physical, educational, emotional or psychological.

  • Physical neglect entails denial of food, clothing, appropriate medical care or supervision. It may include abandonment.
  • Educational neglect includes failure to provide appropriate schooling or special educational needs.
  • Psychological neglect includes lack of emotional support and love.
 
    Valvular Heart Disease Update

Bicuspid aortic valve

Congenital left ventricular outflow lesions can occur at valvular, subvalvular and supravalvular levels. The most common lesion is bicuspid aortic valve. A congenitally bicuspid aortic valve is present in about 1-2% of the population.

(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)

More proof soft drinks tied to diabetes

One can -- or one more can -- of soda daily significantly increased the risk of diabetes in a European population, researchers found. (Source: Medpage Today)

For comments and archives

Sjogren's carries heavy disease burden

Patients with primary Sjögren's syndrome are prone to develop serious complications over the long term, despite the presumption that this is a relatively benign autoimmune disease, a 25-year review found. (Source: Medscape)

For comments and archives

OR design helps in some CAD procedures

A one-stop "hybrid" operating room that allows surgeons and cardiologists to repair blocked arteries in the same setting improves outcomes in certain patients, a large, single-center study found. (Source: Medpage Today)

For comments and archives

New guidelines: Screen all patients aged 15-65 years for HIV

The US Preventive Services Task Force (USPSTF) recommends screening all adults and adolescents aged 15 to 65 years for HIV, according to updated guidelines published online April 29 in the Annals of Internal Medicine. The new recommendation also applies to all pregnant women who have not yet been screened, including those in labor. (Source: Medscape)

For comments and archives

FDA lowers age for OTC Plan B

The FDA has approved over-the-counter sale of the emergency contraceptive Plan B One-Step (levonorgestrel) to women and girls as young as 15. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Satish upadhayay becoming chairman education smcd pic.twitter.com/cJMipQ0ynS

@Dr Deepak Chopra: The Conscious Lifestyle: Awareness Skills | LinkedIn http://www.linkedin.com/today/post/article/20130429190435-75054000-the-conscious-lifestyle-awareness-skills …

 
    Spiritual Update

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

Why are most temples located in far away places?

Most temples represent God or the spirit or the deity located in the temple or mandir situated in an area at the outskirts of the city. A spiritual atmosphere is devoid of pollution and anything which promotes rajasik or tamasik behavior. The silence of the spiritual atmosphere reduces the internal noise and helps us onward in our inner journey. The inner journey of being in touch with one’s consciousness requires detachment from worldly pleasures and the withdrawal of the five senses of the body.

For comments and archives

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

Why is SHG performed?

The usual indications for sonohysterography (SHG) are abnormal uterine bleeding, infertility, recurrent spontaneous miscarriage, congenital abnormalities of the uterus, preoperative and postoperative evaluation of the uterine cavity, suspected intrauterine adhesions (synechiae or scar tissue) and further evaluation of uterine abnormalities suspected during routine ultrasonography. SHG should not be performed in women who are pregnant or who are suspected to be pregnant.

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

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

Transfusion practices in obstetrics and gynecology

  • Anemia in pregnancy is defined as Hb level of <11.0 gm% in first trimester, third trimester and puerperium and <10.5 gm% in second trimester due to physiological hemodilution.
  • The diagnosis and effective treatment of chronic anemia in pregnancy is an important way of reducing the need for future transfusions and decreasing maternal morbidity and mortality.
  • Obstetric bleeding may be unpredictable and massive.
  • If disseminated intravascular coagulation is suspected, do not delay treatment while waiting for the results of coagulation tests.

For comments and archives

 
    An Inspirational Story

The Whale Rescuing Experience

A 50-foot female humpback whale became entangled in a spider web of crab traps and lines. The whale was weighted down by hundreds of pounds of traps that caused her to struggle to stay afloat. She also had hundreds of yards of line rope wrapped around her tail, her torso and a line tugging in her mouth. A fisherman spotted her just east of the Farallone Islands (outside the Golden Gate) and radioed an environmental group for help. Within a few hours, the rescue team arrived and determined that she was so bad off, the only way to save her was to dive in and untangle her – a very dangerous proposition. One slap of the tail could kill a rescuer.

They worked for hours with curved knives and eventually freed her. When she was free, the divers say she swam in what seemed like joyous circles. She then came back to each and every diver, one at a time, and nudged them, pushed them gently around – she thanked them. Some said it was the most incredibly beautiful experience of their lives.

The guy who cut the rope out of her mouth says her eye was following him the whole time, and he will never be the same.

May you, and all those you love, be so blessed and fortunate… to be surrounded by people who will help you get untangled from the things that are binding you. And, may you always know the joy of giving and receiving gratitude.

For comments and archives

 
    Cardiology eMedinewS

ECG worthwhile for pre-sports check-up Read More

 
    Pediatric eMedinewS

Mandatory gloving decreases pediatric infection risk Read More

 
    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

What precautions should be taken while vaccinating by the ID route?

  • The ID injections must be administered by staff trained in this technique.
  • The Vaccine vials must be stored at +2°C to + 8°C after reconstitution.
  • The total content should be used as soon as possible, but at least within 8 hours.
  • The 0.1 ml. ID administration of cell-culture vaccine should create a wheal of at least 5 mm diameter with “peau de orange” appearance.
  • If ID dose is given subcutaneously then there is a possibility of poor immune response due to low antigen load. This may be life-threatening.
 
    IJCP Special

Dr Good Dr Bad

Situation: A patient was diagnosed with HIV–AIDS.
Dr Bad: You will die within 10 years.
Dr Good: You can live a fairly normal life span.
Lesson: In the 1980s, a young adult diagnosed with AIDS typically survived less than one year. Today, a similar person can expect to live to age 70 or beyond if he or she is diagnosed with HIV infection early, has access to and receives appropriate therapy, and can tolerate the drugs and their side effects.

Make Sure

Situation: A patient on 10 units of insulin developed hypoglycemia after taking a light breakfast.
Reaction: Oh my God! Why was the insulin dose not reduced?
Lesson: Make sure that insulin dose is correct. The formula is 500/total daily dose. The value will be the amount of sugar fluctuation with 10 gms of carbohydrates.

 
  Quote of the Day (Dr GM Singh)

Children find everything in nothing; men find nothing in everything. Giacomo Leopardi

 
    Mind Teaser

Read this…………………

A female client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis, nurse Sarah knows that the client is most likely to experience:

a. Hematuria
b. Weight loss
c. Increased urine output
d. Increased blood pressure

Yesterday’s Mind Teaser: The nurse is aware that the following laboratory values support a diagnosis of pyelonephritis?

a. Myoglobinuria
b. Ketonuria
c. Pyuria
d. Low white blood cell (WBC) count

Answer for Yesterday’s Mind Teaser: c. Pyuria

Correct answers: Dr Arpan Gandhi, Prabha Sanghi, Dr PC Das & Dr Mrs. S Das, Dr Gajveer, Dr (Maj. Gen.) Anil Bairaria, Dr BB Gupta, Dr Jella, Vineeta,
Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr K Raju, Dr Chandresh Jardosh, Arundhati, Muthumperumal Thirumalpillai, Dr Ayyavoo ERODE, Dr PK Sahu,
Dr Avtar Krishan, Dr Kanta Jain, Deepali Chatterjee, Dr Sanjeev, R N Singh.

Answer for 30th April Mind Teaser: Contact sports

Correct answers received from: Prabha Sanghi, Dr Kanta Jain, Deepali Chatterjee, Dr Sanjeev, Dr Jayashree Sen & Dr Bitaan Sen.

Send your answer to ijcp12@gmail.com

 
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    Laugh a While (Dr GM Singh)

There were these two friends, Bill and Bob, and they both loved baseball. So, they made a promise to each other, the first one to die, will come back and let the other know if there's baseball in heaven. Well, the day comes and Bob passes. Weeks turn to months while Bill is still waiting to hear from his friend.

Then one day, Bill is walking down the street, and Bob appears. Bill all excited says: "I’ve been waiting forever! So tell me, is there or isn’t there Baseball in heaven?" Bob kinda perks up and says: "I’ve got good news and bad news." "1st, there is Baseball in heaven! The bad news is you’re pitching Friday!"

 
    Medicolegal Update

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

Places where pregnancy may be terminated

No termination of pregnancy shall be made in accordance with this act* at any place other than:

  • a hospital established or maintained by the Government, or
  • a place for the time being approved for the purpose of this Act by Government or a District Level Committee constituted by that government with the Chief Medical Officer or District Health Officer as the Chairperson of the said Committee:
  • The District Level Committee shall consist of not less than three and not more than five members including the Chairperson, as the Government shall specify from time to time.
  • Under section4, before its substitution by the present section by the Medical Termination of Pregnancy (Amendment) Act, 2002, no termination of pregnancy could be made in accordance with the act at any place other than a hospital established or maintained by the government, or
  • a place for being approved for the purpose of the Act by the government.

(*Ref: MTP Act 1971)

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Before sports, children need to be screened for the heart

Sudden cardiac death amongst athletes is a rare but a devastating event. Most victims are usually young and, apparently, healthy but many have underlying undiagnosed heart disease said Padma Shri and Dr B C Roy Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

As per American Heart Association Guidelines, children and adolescents undergoing athletic training need medical clearance. Majority of sudden deaths amongst athletes are due to malignant irregularities in the heart rhythm such as ventricular tachycardia and ventricular fibrillation. The precipitating factors can be prolonged physical training or unaccustomed athletic activities.

In athletes under the age of 35, the most common cause of death is underlying congenital heart disease and for those above the age of 35, it is the presence of blockages of the coronary arteries.

As per Heart Care Foundation of India, in every school/college, the attached doctor should evaluate all students with a 12 step history and examination to rule out high risk cases that need further evaluation.

The Foundation, along the lines of European Society of Cardiology, also recommends an additional standard 12-lead ECG before a medical clearance is given for both competitive as well as recreational athletic activities.

For those master athletes who are above the age of 35, they will need an additional exercise testing before they can be given a clearance for athletic activity.

Diagnostic echocardiography is indicated with clinical, historical and physical findings suggest possibility of structural heart diseases. Athletes on pacemaker should not engage in sports as bodily collision may damage the pacemaker system.

The 12-element AHA recommendations for pre participation cardiovascular screening of competitive athletes are as follows:

  1. Exertional chest pain/discomfort
  2. Unexplained syncope/near-syncope
  3. Excessive exertional and unexplained dyspnea/fatigue, associated with exercise
  4. Prior recognition of a heart murmur
  5. Elevated systemic blood pressure
  6. Premature death (sudden and unexpected, or otherwise) before age 50 years due to heart disease, in one relative
  7. Disability from heart disease in a close relative <50 years of age
  8. Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy, long-QT syndrome or other ion channelopathies, Marfan syndrome, or clinically important arrhythmias
  9. Heart murmur
  10. Femoral pulses examination to exclude aortic coarctation
  11. Physical features of Marfan syndrome
  12. Brachial artery blood pressure (sitting position, both arms)
 
    Readers Responses
  1. Dr. K. K. Aggarwal, Your relentless work towards heart-care is commendable! Regards: Dr. Narendra Kumar
 
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