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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
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Dr KK Aggarwal

From the Desk of Editor in Chief
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

  Editorial ...

2nd September, 2010, Thursday

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

The Birth of Krishna

Krishna represents ‘Brahman’ or ‘God consciousness’. Krishna avatar is synonymous with self–realization. Normally desires and negative thoughts core our consciousness with ignorance. The journey to self–realization involves removal or shedding of this ignorance which can only be done by the 8 spiritual principles as described by the Yoga Sutras of Patanjali. These are Yama (self control); Niyama (self–discipline), Asanas (bodily postures), Pranayama (control of breath), Pratyahara (one pointed), Dhyana (contemplation) and Samadhi (self–realization).

Ignorance is symbolized by a Prison, which represents darkness, and narrow–minded approach (small entry gate); limitedness to everything (small room) attached to your body and mind is what binds you towards this prison. The chains in the prison symbolize the bondages to lust, greed, desires and ego.

Birth of Lord Krishna in the prison means ‘self–realization out of ignorance’. It can only be acquired by adhering to the 8 principles of Ashtang Yoga with Tapas (Abhyasa) or hard work. Sri Krishna, born as the eighth child of Devaki, represents tapas of 8 limbs of yoga. The self–realization can only occur after the seven strips are successfully negotiated and the mind is purified in the process.

In the state of Samadhi, there is spontaneous birth of the self. In this state (sama = equal; dhi = intelligence), one controls equality and thus balances himself between the good and the bad.

The symbolization is that, as Krishna was born, the chains that bound his father fell off, the doors that had been bolted flew open and the prison guards immediately fell asleep. And the father, Vasudeva, put the child in a basket and went to Gokul, by walking across the Yamuna river, where at the same time Yashoda, consort of Nanda, had given birth to a female child.

The ‘chains’ here mean the bondage to the external world and the five senses. A self realized person is free of these bondages. The opening of gates symbolize, control over lust, desire, greed and attachments and sleeping of the guard signify that in a self-realized state, you are totally cut off from the world. For you, everything else perishes or you get detached.

The thunderstorm, the rain, and the fire, all represent the internal turmoil of the uncontrolled desires and hatredness. The moment Krishna’s feet touch the turbulent water, everything settles. The spiritual lesson in this is that by turning inwards and towards one's pure consciousness, any turbulent state of mind can be controlled.

Of course, while acquiring all these, one must control the ego and keep the desires inwards and not have egocentric desires. Controlling the ego is depicted as a snake sitting over the basket and guarding Lord Krishna.

The baby girl born at Gokul represents Mayashakti, which was killed by Kansa (the ego of the body).

Controlling your desires and ‘vasanas’ is easy but controlling your Ego is the most difficult thing. That is what is represented by the fact that at the time of birth of Lord Krishna, Kansa still remained alive. It took many years for Krishna (self realized state) to kill the ego (Kansa).

Thus, acquiring a state of self–realization is not the ultimate goal in life. After self–realization, if your ego controls you, you can misuse your spiritual power. The ultimate aim in life should then be to kill the ego, which is what Krishna ultimately did.

Dr KK Aggarwal
Editor in Chief
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  Photo Feature (from the net)

Weird X–rays

X–Ray is one of the most useful medical advancements in history. But they can also reveal some of the most gruesome and bizarre results. Here, an X–ray shows. A coloured X–ray of a key (outlined in red, top right) swallowed by a 7–year–old boy

 
Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

Choice of drug–eluting stent

For patients without diabetes or complex lesions in whom a drug–eluting stent (DES) is chosen, choose an everolimus, zotarolimus, or a sirolimus–eluting stent in preference to a paclitaxel–eluting stent. (N Engl J Med 2010;362:1663; Lancet 2010;375:201; J Am Coll Cardiol 2010;55:543; Lancet 2010;375:1090.)

  National News

Union Health Minister calls for a specialized public health cadre

While inaugurating the 11th Conference of Central Council of Health and Public Welfare, Union Health Minister Ghulam Nabi Azad called for the creation of a specialized public health cadre for disease prevention and management and to deal with both communicable and non-communicable diseases. He also proposed establishment of a 'directorate of public health' in states with people well trained in laboratory practices, surveillance and outreach investigations.

  International News

Meconium can reveal mother’s smoking

Meconium, the dark and tarry stools passed by a baby during the first few days after birth, can be used to determine how much the mother smoked, or if she was exposed to tobacco smoke during pregnancy. Researchers measured tobacco smoke metabolites in meconium samples from 337 babies and found that they correlated well with reported smoke exposure and other markers of tobacco smoke exposure.

FDA Panel Set To Review Stroke–Preventing Drug For Patients With Irregular Heart Rhythms

FDA panel will review dabigatran, a blood thinning agent, used to prevent strokes in patients with irregular heart rhythms, or atrial fibrillation. If approved, the drug could replace warfarin.

FDA accepts application to expand meningococcal vaccine use

FDA is reviewing meningococcal vaccine to be used in infants and toddlers. It was already approved for people aged 2 to 55.

FDA okays Phase II trials for Chelsea arthritis drug

FDA has given the go ahead to Phase II trials for CH–4051, treatment for rheumatoid arthritis.

  Dengue Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta Medicity

What are the criteria for admission in a patient with suspected dengue?

Warning signs

  • Signs and symptoms related to hypotension: Dehydrated patient, unable to tolerate oral fluids (possible plasma leakage), giddiness or postural hypotension, profuse perspiration, fainting, prostration during defervescence
  • Hypotension or cold extremities
  • Bleeding: Spontaneous bleeding, independent of the platelet count
  • Organ impairment (Renal, hepatic, neurological or cardiac)
    • Enlarged, tender liver, although not yet in shock
    • Chest pain or respiratory distress, cyanosis
  Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

Q: If I conceive, will my baby be normal?
A. Studies have shown that there is no significant increase risk of abnormality in IVF conceived babies compared to those conceived naturally.

  Question of the day

Q. What is the schedule for Td (Tetanus and diphtheria) vacine? (Dr Harish Pemde)

In previously unimmunized older children and adults, Td is satisfactory for primary immunization when administered as a three–dose series, 0–4–8 weeks – 6–12 months

  • It should be given every 10 years at least in later life.
  • TT has been recommended at 10 and 16 years of age, and Td can be used in place of TT to maintain population immunity against diphtheria. There is no contraindication to use Td whenever TT is needed.
  Medicolegal Update

Forensic Column (Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS)

What is burning, blackening and tattooing in fire arm wound?

When a weapon is fired, the primer is detonated by the firing pin and the explosion ignites the powder in the cartridge case. The powder burns rapidly, resulting in the evolution of a relatively large volume of gas within the confined space of the cartridge case, and the pressure of this gas forces the bullet or shot out of the cartridge and through the bore of the weapon. The release of the projectile is accompanied by the discharge of flame, of hot compressed gases and of unburned or partially burned powder particles.

  • The flame, discharged gases and powder grains produce effects on the skin in the region of the entrance wound if the weapon is fired at close range.
  • The flame may burn the skin or singe the hair, while the deposit from the gases may blacken the skin surface, it may also cause skin abrasions in relation to the entrance wound. The deposit of unburned powder particles on the skin gives rise to the condition known as tattooing.
  • Tattooing by black powder is readily recognized on naked–eye medical examination but a hand–lens may be necessary to demonstrate the tattooing of smokeless powder. The degree and extent of tattooing diminishes as the range of fire increase.
Low–power rim fire cartridges may not contain propellant gun powder, but only a primer compound. These cartridges, therefore, cannot produce the tattooing which is found after the discharge of cartridges containing propellant powder.
  Medi Finance Update

What are Balanced Funds?

Balanced funds invest in a mix of stocks, bonds, and cash investments. The mix will change as market conditions change, but it usually stays within predetermined ranges. (For example, stocks 40–60%, bonds 30–50%, cash 0–30%).

  Drug Update

List of Approved drugs from 01.01.2010 TO 30.4.2010

Drug Name

Indication

DCI Approval Date

Miglitol 25 mg + Metformin 500mg tablets

Additional Strength

16/3/2010

  Lab Calculator

Transferrin saturation or index

Saturation index = SI/TIBC × 100

In iron deficiency anemia (IDA), low serum iron and high transferrin/TIBC result in a low transferrin saturation or index often to levels < 10 % , compared with the normal values of 25–45 %.

  IJCP Special

Dr Good Dr Bad

Situation: A patient with 8 hour fasting came for lipid test.
Dr.Bad:
Go ahead.
Dr.Good: No, you need to be fasting for 12 hours.
Lesson: Triglycerides should be assessed after fasting for 12–14 hours.

Make Sure

Situation: An asthmatic with respiratory rate of 37 developed respiratory arrest.
Reaction: Oh my God Why was the ventilator not put early?
Lesson: Make sure to remember that a respiratory rate of  > 35 is a warning signal to start ventilation therapy.

Quote of the Day

Cherokee Saying …"Man is always more than he can know of himself; consequently, his accomplishments, time and again, will come as a surprise to him."

Hypertension Alert

Blood Pressure is a silent killer. It can damage the eyes, kidney, heart, brain, and liver.

Normal BP should be kept lower than 120/80 at any age.

  • Normal BP: Systolic <120 mmHg and diastolic <80 mmHg
  • Pre hypertension: Systolic 120 – 139 mmHg or diastolic 80 – 89 mmHg
  • Hypertension: Systolic > 140 mmHg OR diastolic > 90 mmHg
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  eQuiz

Case Scenario: Test your skills

A 25 year-old woman with no significant past medical history and on no medications has a family history of kidney stones due to high urinary calcium. Physical examination is unremarkable and her vital signs are normal. BMI is 28. Lab results: Complete blood count: Normal. Complete metabolic panel: Normal. Urinalysis: pH 5.0; no protein, blood or crystals.

Apart from increasing fluid intake, which of the following is the most appropriate advise to reduce risk of formation or renal calculi?

A. Add a calcium supplement
B. Increase dietary sucrose intake
C. Decrease dietary animal protein intake
D. Increase dietary calcium intake

(Contributed by Ashish Verma MD)

The answer for yesterday’s Mind Teaser: "I Understand"

Correct answers received from: Dr Raju Kuppusamy; Dr. R. S.Bajaj; Dr Simran Singh; Dr Kalpana Mohan; Dr Chandresh Jardosh; Dr Jayashree B Keshav, In Charge – Scientific Publications,The Himalaya Drug Company; Dr.B.Karunanand; Dr. KV Sarma; Dr Muthumperumal Thirumalpillai; Dr Shashi Saini; Meera Rekhari; Dr. Prashant Bharadwaj; Dr Mohit Joshi; Dr Vijay Kansal; Dr. RK Goel, Dr Virender Prakash Gautam, Dr. Nagendra Gupta, Dr Mukesh Bhandari, Dr Pankaj Garg, Dr Geeta Yadav,Dr.Prabha Sanghi, Dr. Alok Deb, Dr Aditya Rattan, Dr. Susheela Gupta, Dr Ajmer Singh, Aruna Tyagi,Dr Archana Jain, Dr.Lakshmi Iyer, Dr.A.K.Saxena, Dr. Anjani, Dr Suparna Khera

The answer for 31st August 2010 Mind Teaser: "Making up for Lost Time"

Correct answers received for 31st August Puzzle from: Dr.Asim Kumar Sen, Dr Meera Rekhari, Dr. Satish Gunawant, Aruna Tyagi, Dr. Akshat Bhargava, Dr Anupam Sethi Malhotra, Dr Raju Kuppusamy, Dr Virender Prakash Gautam

Send your answer to ijcp12@gmail.com

  Humor Section

Jokes
A man walks into a drug store and asks the pharmacist, "Do you have any acetylsalicylic acid?" "You mean aspirin?" asked the pharmacist. "That’s it, I can never remember that word."

Funny One Liner
Tears: The hydraulic force by which masculine willpower is defeated by feminine waterpower.

  An Inspirational Story

This should probably be taped to your bathroom mirror where you can read it every day. You may not realize it, but it’s 100% true.

  1. There are at least two people in this world that you would die for.
  2. At least 15 people in this world love you in some way.
  3. The only reason anyone would ever hate you is because they want to be just like you.
  4. A smile from you can bring happiness to anyone, even if they don’t like you.
  5. Every night, SOMEONE thinks about you before they go to sleep.
  6. You mean the world to someone.
  7. You are special and unique.
  8. Someone that you don’t even know exists loves you.
  9. When you make the biggest mistake ever, something good comes from it.
  10. When you think the world has turned its back on you take another look.
  11. Always remember the compliments you received. Forget about the rude remarks.
  12. Good friends are like stars. You don’t always see them, but you know they are always there.
  13. Whenever God closes one door he always opens another, even though sometimes it’s Hell in the hallway.
  14. I would rather have one rose and a kind word from a friend while I’m here, than a whole truckload when I’m gone.
  Readers Responses
  1. Respected Sir, I am so intrigued by your explicit description of krishna’s janam. It adds such a deep significance to the festival of janamashtami. The celebration can begin with the "realization" and hope to triumph victory of darkness within and in external world. Wishing You Happy Janmashtami. Thanking You, Yours Sincerely, Astha Gupta
  Public Forum

(Press Release for use by the newspapers)

Health Tip: Bloated and Gassy?

Cut down on foods that worsen symptoms of gas in the abdomen said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India, BSNL Dil Ka Darbar & MTNL Perfect Health Mela.

The need to burp and pass gas is normal. But some people may feel that they’re frequently bloated and gassy.

General principles

  • Foods that split equally into two produce gas e.g. pulses, rajma, Chickpeas etc.
  • Cook them after soaking them in water for 8–12 hours or cook them with ‘heeng’ (asafetida).
  • Foods grown over the surface if eaten raw produce gas-like feeling e.g. cauliflower, brocolli, cabbage etc.
  • Foods grown under the ground produce gas, if eaten raw or without soaking them in the water e.g onions, radish, carrots etc.

Heart Care Foundation of India offers the following suggestions to help reduce uncomfortable gas:

  • Cut down on foods known to cause gas, such as beans, dairy products, bran and whole wheat foods.
  • Limit gas–causing vegetables such as onions, broccoli, cabbage and brussel sprouts, and fruits such as peaches, apples and pears.
  • Avoid sugary fruit drinks and carbonated soft drinks. Instead, drink water.
  • Avoid swallowing excessive air by eating slowly and chewing thoroughly.
  • Keep a diary of foods that cause gas for you, and try to avoid them.
  Conference Calendar

1st Asia Pacific Congress on Controversies to Consensus in Diabetes, Obesity and Hypertension (CODHy)

Venue: Shanghai, China,

Date: June 2–5, 2011

http://www.comtecmed.com/codhy/china/

  Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

26th September: Sunday– BSNL Dil ka Darbar A daylong interaction with top cardiologists of the city. 8 AM  5 PM at MAMC Auditorium, Delhi Gate.

17th MTNL Perfect Health Mela 2010 Events: Venue: NDMC Ground Laxmi Bai Nagar, New Delhi

24th October, Sunday: Perfect Health Darbar, Interaction with top Medical experts of the city from 8 AM to 5 PM
30th October, Saturday: eMedinewS Update from 8 AM to 5 PM
29th October, Friday: Divya Jyoti Inter Nursing College/ School Competitions/ Culture Hungama
30th October, Saturday: Medico Masti Inter Medical College Cultural festival from 4 PM to
10 PM
31st October, 2010, Sunday: Perfect Health Darbar, An interaction with top Cardiologists

eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

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