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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
  Editorial …

3rd February 2013, Sunday

The time has come for the youngsters to lead

Most of the political parties today are fighting negative and not positive. They want to win by citing the poor performance of the other party.

The parties should project their positive things done in the past or the future plans. They should not only show their future plans but also their intentions for following up with those plans.

A few days back, Rahul Gandhi was elevated as Vice President of Congress Party. It was not an unexpected move as everybody knew that in Congress, dynasty rule prevails. Many Southern States and some states in the North follow the same dynasty rule.

Even in the Hindi film industry, we have the example of Prithviraj Kapoor, where we have generations of actors coming from this family with all of them giving good performances and no actor from that family achieved success only because he/she belonged to that family.

If you are educated, devoted to the family business or profession and perform well, the dynasty rule is acceptable.
On the other hand, if you are not educated or a non-performer you will any way be rejected by the people.
It will be a challenge for Rahul, who has to show that like his father, he too can perform in the interest of the nation whether as Prime Minister or Leader of Opposition, if Congress fails to form the government at the Centre. In both the situations, he will be an important person to watch out for.

We need younger people to lead the country. Most of the multinational companies in India are led and ruled by younger professionals.

In mythology, four phases of life have been described, Brahmacharya, Grahastha Jeevan, Vanaprasthan and Sanyas.
Brahmcharya (0-25 years) is the period of learning; Grahastha Jeevan (25-50 years) is the age for performance both in terms of earning money as well as looking after the family. Vanaprasthan (50-75 years) is the age when you start retiring and divert your mind towards social welfare and Sanyasa (75 years plus) is the age when your time should be 100% for community service.

As per our mythology, the right time to lead the country is between 25-50 years of age.

Barack Obama is a successful example, who became the president of US at the age of 46 years. Even Narendra Modi became the CM of Gujarat at the age of 50.

Both Rahul and Modi will have a good fight as one is 50 minus and the other became a leader when he was 50 minus.,
50+ people should become advisors to the youngsters to lead the country. Imagine an Indian cricket captain at the age of 50. You will reject him on day one. In fact in cricket after the age of 35, most players start their retirement plans. In politics also this trend is seen for example in UP. We are seeing younger leaders in both Mayawati and Akhilesh Yadav.

In Bollywood too most stars are less than 50 years of age. Post 50 they no more play the role of romantic heroes.

We should let go of the belief in our minds that a politician has to be old. If that happens we may end up seeing many of them repeating the same sentence multiple times in a speech, sleeping during important meetings or speaking irrelevantly without any meaning.

The retirement age in India is also at 60 years which means that as per the government policy the retiring Judge, police commissioner or a bureaucrat cannot give his or her 100% after retirement and the same, post retirement are appointed as an advisor.

A politician’s job involves a mix of top industrialist and the Chief Justice of a State or India. He/she can only perform better if their age is below the official retirement age.

About the author: Dr K K Aggarwal is Padma Shri and Dr B C Roy National Awardee, President Heart Care Foundation of India and National Vice President Elect IMA (blog.kkaggarwal.com)

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

How do stimulant laxatives help in constipation?

Stimulant laxatives affect electrolyte transport across the intestinal mucosa and stimulate intestinal fluid accumulation and colonic motor activity. The currently available stimulant laxatives include senna and bisacodyl. Stimulant laxatives should not be used in patients with suspected intestinal obstruction. In a trial of 77 elderly nursing home residents, the senna-fiber combination was significantly more effective than lactulose in improving stool frequency and consistency at a lower cost (Passmore AP, Wilson–Davies K, Stoker C, et al. Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna–fibre combination. BMJ 1993;307:769–71).

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

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

FDA panel recommends first drug for
HIV prevention

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

4th eMedinewS Revisiting 2012

A daylong conference, eMedinewS Revisiting 2012, organized by eMedinewS, Heart Care Foundation of India and World Fellowship of Religions.

 
Dr K K Aggarwal
    National News

AIIMS service from June

BHUBANESWAR: The much-awaited hospital service of the All India Institute of Medical Sciences (AIIMS) here will start from June. "The progress of construction work is good," said Union minister of health and family welfare Ghulam Nabi Azad after visiting the campus at Sijua, on the outskirts of the city, on Wednesday. Taking stock of the ongoing construction work, Azad said, "Two-and-a-half year's time is probably the fastest for completing a medical college and hospital of this magnitude. In case of AIIMS-Delhi the hospital started nine years after beginning of the medical college."The hospital at Sijua will have 1,000 beds and 39 super-specialty branches. The academic session of AIIMS-Bhubaneswar started in 2012. (Source: TOI, Jan 31, 2013)

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/)

Father and other relatives are responsible for 21% and 19% of sexual abuse victims respectively.

    Valvular Heart Disease Update

In young adults Bicuspid valve presents with aortic regurgitation more than aortic stenosis.

(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)

Functional issues similar with surgery, RT for prostate cancer

Men with localized prostate cancer have declines in sexual, urinary, and bowel function over time, whether they choose surgery or radiation therapy, data from a large cohort study showed. (Source: Medpage Today)

Pooled-donor platelet risk revisited

The increase in risk of bloodborne infection associated with platelet transfusions sourced from multiple donors as opposed to single-donor apheresis may not be as great as commonly thought, researchers said. (Source: Medpage Today)

FDA panel turns down CF drug

An FDA advisory committee voted unanimously, 14-0, on Wednesday against approval of inhaled mannitol (Bronchitol) for cystic fibrosis (CF), citing safety and efficacy concerns, particularly in pediatric patients. (Source: Medpage Today)

MI, mortality lower with CABG than PCI

In multivessel disease, coronary artery bypass graft surgery cut the risk of death, heart attack, or stroke 19% better than percutaneous cardiac interventions, 4-year results of the ASCERT trial showed. (Source: Medpage Today)

ACE inhibitors linked to hallucinations

Elderly patients with memory problems who suddenly have visual hallucinations may need to stop taking ACE inhibitors, researchers suggested. (Source: Medpage Today)

 
    Twitter of the Day

@DrKKAggarwal: Today's health question How many anti rabies injections should I take after a dog bite? Yesterday's health (cont) http://tl.gd/ktb210

@DeepakChopra: What is the point of continuing to feel the pain of the past? Please read my #askdeepak reply http://tinyurl.com/au7b8fq

 
    Spiritual Update

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

Relieve stress by changing the interpretation

Stress is the reaction of the body or the mind to the interpretation of a known situation. Stress management, therefore, involves either changing the situation, changing the interpretation or taming the body the yogic way in such a way that stress does not affect the body.

For comments and archives

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

Which are the most common reasons to have genetic screening performed?

One of the most common reasons to have genetic screening performed is the mother’s age, since the risk of having a child with a chromosomal abnormality increases as a woman ages. Additionally, if both parents are carriers for a genetic condition, prenatal testing can determine if the unborn child is affected with the disease.

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

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

Frozen Pooled Plasma

Description: Plasma from many donors pooled before freeze–drying

Infection risk: No virus inactivation step so the risk of transmitting infection is therefore multiplied many times. This is an obsolete product that should not be used.

For comments and archives

 
    An Inspirational Story

The stone soup story

Many years ago three soldiers, hungry and weary of battle, came upon a small village. The villagers, suffering a meager harvest and the many years of war, quickly hid what little they had to eat and met the three at the village square, wringing their hands and bemoaning the lack of anything to eat.

The soldiers spoke quietly among themselves and the first soldier then turned to the village elders. "Your tired fields have left you nothing to share, so we will share what little we have: the secret of how to make soup from stones."

Naturally the villagers were intrigued and soon a fire was put to the town’s greatest kettle as the soldiers dropped in three smooth stones. "Now this will be a fine soup", said the second soldier; "but a pinch of salt and some parsley would make it wonderful!" Up jumped a villager, crying "What luck! I’ve just remembered where some been left!" And off she ran, returning with an apron full of parsley and a turnip. As the kettle boiled on, the memory of the village improved: soon barley, carrots, beef and cream had found their way into the great pot, and a cask of wine was rolled into the square as all sat down to feast.

They ate and danced and sang well into the night, refreshed by the feast and their new–found friends. In the morning the three soldiers awoke to find the entire village standing before them. At their feet lay a satchel of the village’s best breads and cheese. "You have given us the greatest of gifts: the secret of how to make soup from stones", said an elder, "and we shall never forget." The third soldier turned to the crowd, and said: "There is no secret, but this is certain: it is only by sharing that we may make a feast". And off the soldiers wandered, down the road.

For comments and archives

 
    Cardiology eMedinewS

To prevent heart diseases gets married or get remarried Read More

Next-generation CT scanner provides better images with minimal radiation Read More

 
    Pediatric eMedinewS

FDA gives nod to Gleevec for pediatric ALL Read More

Egg-allergic children shown to safely receive flu vaccine Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient had LDL–C of 100 mg/dL and HDL–C 61 mg/dL.
Dr Bad: Start statins.
Dr Good: No treatment is required yet.
Lesson: HDL–C =60 mg/dL counts as a "negative" risk factor; its presence removes one risk factor from the total count.

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 10gm of carbohydrates.

 
    Quote of the Day (Dr GM Singh)

Teaching is the greatest act of optimism. Colleen Wilcox

 
    Mind Teaser

Read this…………………

Discharge instructions for a patient with a newly-placed pacemaker include avoiding:

• Cellular phones
• Contact sports
• Cordless phones
• Microwave ovens

Yesterday’s Mind Teaser: According to the American Hospital Association's Patient's Bill of Rights, patients are responsible for:

o Accepting the treatment decisions of the medical and nursing team.
o Allowing HIV testing when a staff member experiences a body fluid exposure.
o Participating in the hospital's research studies.
o Providing information about past illnesses, hospitalizations, and medications.

Answer for Yesterday’s Mind Teaser: Providing information about past illnesses, hospitalizations, and medications.

Correct answers received from: Dr Jella, Dr Thakor Hitendrsinh G,
Dr Jainendra Upadhyay, Dr PC Das, Dr Suresh Arora, Dr Arpan Gandhi,
Dr Pankaj Agarwal, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai,
Dr Avtar Krishan, Dr Kanta Jain, Dr Jayashree Sen & Dr Bitaan Sen, Dr K Raju.

Answer for 31st January Mind Teaser: Leg cramps

Correct answers received from: Dr K Raju, Muthumperumal Thirumalpillai,
Dr Arpan Gandhi.

Send your answer to ijcp12@gmail.com

 
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   Laugh a While (Dr GM Singh)

Proportions

One semester when my brother, Peter, attended the University of Minnesota in Minneapolis, an art-student friend of his asked if he could paint Peter's portrait for a class assignment. Peter agreed, and the art student painted and submitted the portrait, only to receive a C minus.

The art student approached the professor to ask why the grade was so poor. The teacher told him that the proportions in the painting were incorrect.

"The head is too big," the professor explained. "The shoulders are too wide, and the feet are enormous."

The next day, the art student brought Peter to see the professor. He took one look at my brother and said, "Okay, A minus."

 
    Medicolegal Update

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

Grievous Hurt as per IPC

As per Section 320 Indian Penal Code (IPC), the following kinds of hurt are designated as "grievous";

  • Permanent disfiguration of the head or face: The word ‘disfigure’ means to cause some external injuries which detracts from his personal appearance but does not weaken him.
  • Fracture or dislocation of a bone or tooth: It is not necessary that a bone should be cut through and through, the cut should be up to the medulla. If there is a break by cutting or splintering of the bone or there is a rupture or fissure in it, it would amount to a fracture but the doctor must document the dimension of fracture and duration/age correlation with age of injury. Dislocation means displacement. Mere looseness of teeth will not amount to dislocation. It has to be proven that the tooth was originally not loose and that there was fracture or dislocation by the injury.
  • Any hurt which endangers life or which causes the victim to be in severe bodily pain or unable to follow his ordinary pursuits for a period of 20 days: A wound may cause intense pain, prolonged disease or long lasting body injury but does not fall under any of the seven clauses. A body injury/beating may not mutilate the sufferer or fracture his bones but may be so harsh and painful may cause even death. The eighth clause provides for such hurts. Under this, three different clauses of hurt are included. These are:
  • Any hurt which endangers life
  • Any hurt which causes the victim to be in severe bodily pain for a period of 20 days
  • Any hurt which prevents the victim from following his ordinary pursuits for a period of 20 days

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Rise in blood pressure during mental stress is a strong predictor of plaque progression.

Rise in blood pressure during mental stress is a strong predictor of plaque (early blockages in the heart) progression said, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President-Elect IMA.

Therefore, mental stress test should be done in every patient with neck artery plaques and if positive, these patients should be put on plaque-stabilizing drugs. If the plaque is stabilized, one can reduce the chances of heart attack and paralysis.

Presence of plaque in the neck artery in an asymptomatic person is highly indicative of a future heart attack or paralysis. Plaque can be measured by using high resolution ultrasound in any echocardiography laboratory. Plaques progress along the neck artery 2.4 times more than its thickness.

 
    Readers Responses
  1. Sir two comments.
    Regarding the use of generics. The MCI in conjunction with the Govt. authorities should ask the drug companies to produce only generics. So many manufacturers should not be permitted to put up new units. Stringent control of the generic drug quality should be ensured. In Iran where I had worked we got only generics. One or two drug companies would some times request us to add company's name, which was never done. This will prevent many prevailing practices in pharma companies which the MCI has been trying to stop. Who has the courage to bell this cat I wonder! Will the authorities help?
  2. Regarding Hindi, it is still the language of the largest number of people in India. Why can’t we learn Hindi? I welcome the suggestion that the Hindi belt people should learn another language in school. In fact there should be teachers of other languages in school and children should learn one other language compulsorily and if possible, other languages voluntarily, if time permits. In fact the more the languages we know the better it is. I find that only few are able to speak Hindi in Southern side. For the sake of a common thread Hindi should be taught in those areas too. In fact English too should be taught in all areas at least for an elementary knowledge.

    Regards, Dr. AV Pathak, Consultant Gen Surgery & Urology.
 
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