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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 …

4th August 2011, Thursday

Nag Panchami and Health

Nag Panchami is celebrated in the month of July. On this day, snakes are worshipped. People observe a fast the day before and also on the day of the festival. The tradition is not to eat till evening on that day.

In Hindu mythology a snake represents ‘ego’. A realized man is the one who has concurred or mastered ego unlike hostile people who are constantly victimized by the demands of the ego. Practicing humility is the way to concur one’s ego. On this day, therefore, everybody practices humility so that it becomes a part and parcel of their consciousness. Ahankar, vanity or ego is one of the five obstacles to internal realization.

Ahankar or ego is normally a part and parcel of subtle mental layer. The subtle body consists of mind, intellect and ego. Without ego, there is no life but the abnormal exaggeration of ego is what is called vanity or egotism. Ego is therefore nothing but a mistake of the intellect and behaves like a cancer.

The chief action of ego is to block the path of truthfulness. It works like the bosom friend of an error. It prevents people from accepting new things. Ego works on the assumption that; "I am the only one who is right and anybody who opposes me, I have the right to destroy him".

Egoistic persons only want to defend their own rights. Ego works hand in hand with anger. Classically a man under the influence of ego can be described as a person who is advertising his virtues by pointing the faults of others. He basically advertises his own shortcomings. Such people can be seen to attract the attention of others by making a noise or imposing their opinion on the others during meetings. He frequently interprets others while they are talking. He likes to make speeches. He wants his name to appear in the print. He makes it a point to be known to everybody for every bit of charity done.

Humility is the virtue to be practiced to control ego. Humility can be acquired by spreading the message of love, and practicing "giving". Calling everybody with respect, wishing everybody early in the morning, respecting seniors, bowing and taking blessings from the teachers and the elderly, asking for forgiveness, showing appreciation and concern and having the same thought in the mind, speech and action etc are a few of the examples of acquiring humility.

"Love your enemies, bless them that curse you, do good to them that hate you and pray for them that despitefully use and persecute you". Matthew 5.4

Nag Panchami is celebrated in the monsoon season as snakes come out in rain. Most of them are non poisonous and one should not unnecessarily kill them.

Also Nag Panchami falls during the period of Chaturmas, a period of negative state of the mind. As getting egoistic is common in these months one must learn to practice humility in this part of the season.

Snake in mythology is also depicted by Sheshnag protecting Krishna at birth, Lord Shiva wearing a snake around his neck and Lord Vishnu sleeping, with the snake with mouth inward to protect him. All these festivals also fall in the Chaturmas month and mean learning to control the duality of mind and taming the ego.

Taming Kalia in Krishna Leela as described in Srimad Bhagwad also indicated taming the duality of mind and not killing it.

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Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

Severity of chest pain not related to
severity of heart attack

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

National Conference on Insight on
Medico Legal Issue

Dr HS Risam, Board of Director, MCI giving his view in the National Conference on Insight on Medicoleagl Issues held on 10th July, 2011.

 
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

http://blogs.kkaggarwal.com/?p=1134
http://twitter.com/#!/search/medicolegal
https://www.facebook.com/pages/Insight–on–Medicolegal–Issues/247091668637671

Leptospirosis vaccine ready for trials: ICMR Director–General

The leptospirosis vaccine model, designed in the Indian Council for Medical Research (ICMR) Regional Centre, Andamans, is ready for trials this year, Indian Council for Medical Research Director–General V.M. Katoch said. Speaking on the sidelines after participating in the 55th foundation day of the Tuberculosis Research Centre, Dr. Katoch said the vaccine model designed by scientists in the Andamans is ready and will now under go animal and clinical trials. He also added that these trials would begin during the current year. He stressed on the need to develop indigenous vaccines, as only these could bring the costs down and thereby, would be beneficial to more people. Some of the areas that the country could specialise in include the rotavirus, chikungunya, dengue, and even the Human Papilloma Virus. The pilot project to evolve diagnostic criteria more suited to the Indian population will kick off in a few months, Dr. Katoch said. It would be launched in 12 districts initially, across the country, involving in certain instances, private institutions with a good reputation and that have done some good research work. (Source: http://www.thehindu.com/news/states/tamil-nadu/article2314255.ece, August 2, 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)

Sweetened drinks boost heart disease risk

Beverages sweetened with fructose or high-fructose corn syrup can worsen cardiovascular risk factors, even in the young and healthy, researchers have found. When these types of drinks accounted for at least a quarter of a person’s daily calories over two weeks, there were significant increases in triglycerides, LDL cholesterol, and apolipoprotein B (apoB) concentrations that weren’t seen with glucose, Kimber Stanhope, PhD, of the University of California Davis, and colleagues reported online in the Journal of Clinical Endocrinology and Metabolism..

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Fish oil in expectant moms stifles infant sniffles

A woman who consumes fish oil–type supplements during pregnancy may decrease the number of colds early in her baby’s life, according to a randomized, controlled trial. Cold symptoms occurred 24% less often among babies whose mothers took docosahexaenoic acid (DHA) pills during pregnancy (odds ratio 0.76, 95% confidence interval 0.58 to 1.00), Usha Ramakrishnan, PhD, of Emory University in Atlanta, and colleagues found. (Source: Medpage Today)

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Muscle mass knocks out insulin resistance

Having more muscle mass may protect against insulin resistance and prediabetes, no matter overall body size, researchers said. In a cross-sectional study, every 10% increase in the ratio of skeletal muscle mass to total body weight was associated with an 11% reduction in risk of insulin resistance and a 12% drop in risk of transitional, prediabetes, or overt diabetes, Preethi Srikanthan, MD, of the University of California Los Angeles, and colleagues reported online in the Journal of Clinical Endocrinology and Metabolism. (Source: Medpage Today)

For comments and archives

 
    Fitness Update

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

What’s the best exercise for heart health?

A combination of weight training and aerobic exercise might be the best prescription for overweight people at risk for diabetes and heart disease, a new study suggests. People doing only aerobic exercise dropped weight and inches off their waistlines –– so an aerobic–only program is also a good (and less time–consuming) option, researchers said. Those in the study who just lifted weights saw very little benefit in terms of heart health, although they did gain strength. "Aerobic plus resistance is clearly the optimal program," said Dr. Timothy Church, who studies exercise and disease at Louisiana State University’s Pennington Biomedical Research Center in Baton Rouge.

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    Twitter of the Day

@DrKKAggarwal: #AskDrKK: What is normal pulse rate? #DrKKAnswers: 60–80 per minute.

@DeepakChopra: #CosmicConsciousness Our real identity is that we are luminous stardust beings

 
    Dr KK Answers

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

How long does it take for X–ray radiations to harm health?

At doses used in diagnostic and interventional procedures, ionizing radiations release free radicals that may cause DNA damage. This radiation–induced cancer may develop decades after exposure, and includes myeloma, blood cancers, lung cancer, thyroid cancer, breast cancer, bone cancer and skin cancer.

For comments and archives

 
    Spiritual Update

Anger, hostility, aggression: Risk factors for heart attack

Anger, hostility and aggression are three risk factors for heart attack with the fulcrum at the level of anger. A thought arises from the thoughtless state of mind called consciousness, which is then analyzed by the intellect and converted into an action, which is either egocentric or ego–fugal. All actions lead to memory and memory leads to desire. If the desire can be fulfilled, it will end up into action again and the cycle of action, memory and desire continues leading to habit or an addiction…

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

A Pillow and a Blanket

A long time ago, a young, wealthy girl was getting ready for bed. She was saying her prayers when she heard a muffled crying coming through her window. A little frightened, she went over to the window and leaned out. Another girl, who seemed to be about her age and homeless, was standing in the alley by the rich girl’s house. Her heart went out to the homeless girl, for it was the dead of winter, and the girl had no blanket, only old newspapers someone had thrown out.

The rich girl was suddenly struck with a brilliant idea. She called to the other girl and said, "You there, come to my front door, please." The homeless girl was so startled she could only manage to nod. As quick as her legs could take her, the young girl ran down the hall to her mother’s closet, and picked out an old quilt and a beat up pillow. She had to walk slower down to the front door as to not trip over the quilt which was hanging down, but she made it eventually. Dropping both the articles, she opened the door. Standing there was the homeless girl, looking quite scared. The rich girl smiled warmly and handed both articles to the other girl. Her smile grew wider as she watched the true amazement and happiness alight upon the other girl's face. She went to bed incredibly satisfied.

In mid–morning the next day a knock came to the door. The rich girl flew to the door hoping that it was the other little girl there. She opened the large door and looked outside. It was the other little girl. Her face looked happy, and she smiled. "I suppose you want these back." The rich little girl opened her mouth to say that she could keep them when another idea popped into her head. "No, I want them back." The homeless girl’s face fell. This was obviously not the answer she had hoped for. She reluctantly laid down the beat up things, and turned to leave when the rich girl yelled, "Wait! Stay right there."

She turned in time to see the rich girl running up the stairs and down a long corridor. Deciding whatever the rich little girl was doing wasn’t worth waiting for she started to turn around and walk away. As her foot hit the first step, she felt someone tap her on the shoulder, turning she saw the rich little girl, thrusting a new blanket and pillow at her. "Have these." she said quietly.

These were her own personal belongings made of silk and down feathers. As the two grew older they didn’t see each other much, but they were never far from each other’s minds. One day, the Rich girl, who was now a Rich woman, got a telephone call from someone. A lawyer, saying that she was requested to see him. When she arrived at the office, he told her what had happened.

Forty years ago, when she was nine years old, she had helped a little girl in need. That grew into a middle–class woman with a husband and two children. She had recently died and left something for her in her will. "Though," the lawyer said, "it’s the most peculiar thing. She left you a pillow and a blanket."

For comments and archives

 
    Idioms

(By Ritu Sinha)

All in the same boat: When everyone is facing the same challenges.

 
    Pediatric Update

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

How do you treat Hepatitis C in children?

Accumulating evidence supports the use of combination therapy with pegylated interferon and ribavirin to treat chronic hepatitis C infection in children. In a multicenter trial, this combination yielded 93% sustained viral response in patients with genotype 2 or 3, and 53 percent in those with genotype 1. The decision of whether to treat chronic hepatitis C depends on the child’s age, genotype, and liver histopathology.

(Ref: Wirth S, Ribes–Koninckx, C Calzado MA, et al. High sustained virologic response rates in children with chronic hepatitis C receiving peginterferon alfa–2b plus ribavirin. J Hepatol 2010;52:501)

For comments and archives

 
    Infertility Update

(Dr. Kaberi Banerjee, Infertility and IVF Specialist)

What is the importance of Pneumococcus vaccine?

Pneumococcus vaccine is recommended for any person at increased risk for pneumococcal infection. Individuals at high risk include those with asplenia, chronic cardiovascular/pulmonary disease, diabetes, or immunocompromise as may result from human immunodeficiency virus (HIV) infection or systemic malignancy. Ideally, high–risk women should be immunized before pregnancy.

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    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Metabolic Panel (14), Comprehensive

Test Includes: Alanine aminotransferase (ALT/SGPT); albumin:globulin (A:G) ratio; albumin, serum; alkaline phosphatase, serum; aspartate aminotransferase (AST/SGOT); bilirubin, total; BUN; BUN:creatinine ratio; calcium, serum; carbon dioxide, total; chloride, serum; creatinine, serum; globulin, total; glucose, serum; potassium, serum; protein, total, serum; sodium, serum

The Comprehensive Metabolic Panel (CMP) is a frequently ordered panel of tests that gives your doctor important information about the current status of your kidneys, liver, and electrolyte and acid/base balance as well as of your blood sugar and blood proteins. Abnormal results, and especially combinations of abnormal results, can indicate a problem that needs to be addressed.

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    IJCP Special

Dr Good Dr Bad

Situation: A patient on HCQS developed high fever.
Dr Bad: Its classical malaria.
Dr Good: Rule out other causes.
Lesson: HCQS is hydroxychloroquine and effective against malaria.

For comments and archives

Make Sure

Situation: A patient with asymptomatic sinus bradycardia after PPI developed lead infection.
Reaction: Oh my God! Why was PPI (Permanent pace maker implantation) done?
Lesson: Make sure that PPI is not implanted in patients with sinus bradycardia without significant symptoms, sinoatrial block or sinus arrest without significant symptoms, asymptomatic prolonged RR intervals with atrial fibrillation or other causes of transient ventricular pause and asymptomatic bradycardia during sleep.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

In the sweetness of friendship let there be laughter, and sharing of pleasures. For in the dew of little things the heart finds its morning and is refreshed. Kahlil Gibran

 
    Medicolegal Update

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

Silver may also cause toxicity

Silver nitrate, also known as lunar caustic or lapis infernalis, may cause toxicity when administered internally.

  • Silver nitrate is colorless rhombic crystal. Its solution has a styptic metallic taste with acidic reaction. Silver nitrate is used externally by doctors as styptic and to destroy exuberant granulations and warts.
  • It is also used in photography, silver plating and is a chief ingredient of indelible ink and hair dyes. Silver proteinate are colloidal silver compounds, which are used in ophthalmic practice.
  • When administered orally it causes severe pain in throat as well as stomach and induces severe vomiting. The vomited matter is flaky white but turns black on exposure to light. Two grams of silver nitrate may cause death in few hours.
  • If toxicity occurs, the stomach should be washed with milk mixed with sodium chloride in a proportion of 15 gram in 500 ml of milk. Water works as antidote and should be given because it forms insoluble silver salt. The demulcent and purgative should be given to the patient after recovery along with treatment for shock.

For comments and archives

 
    Mind Teaser

Read this…………………

Which of the following is true about Langer’s lines of the skin?

a) These are in the direction of muscle fibres.
b) These are perpendicular to the long axis of underlying muscle fibres
c) Most favorable incision is circular over an exposed area
d) Most favorable incision is a rhomboid shaped one over an exposed area

Yesterday’s Mind Teaser: A blood stained discharge from the nipple indicates one of the following:

1. Breast abscess
2. Fibroadenoma
3. Duct papilloma
4. Fat necrosis of breast

Answer for Yesterday’s Mind Teaser: 3. Duct papilloma

Correct answers received from: Dr Anurag Julka, Dr K Raju, Dr Vineet Banga, Dr Sukanta Sen,
Dr R Dhillon, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr G Padmanabhan, Dr Bijan Kumar Dey, Dr Prabha Luhadia, Dr Deepali Chatterjee, Dr Jainendra Upadhyay, Dr Surendra Bahadur Mathur,
Dr Neelam Nath, Dr Nikunj Garia.

Answer for 1st August Mind Teaser
: 2. Distal ischemia affecting the skin of the toes
Correct answers received from: Dr Rajshree Aggarwal.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Building Rome

Marilyn, the teacher, asked her 5th grade history class, "When was Rome built?" and called on Timothy to answer first. "Rome was built at night." was his answer. "At night?" asked Mrs. Taylor, holding her ruler firmly in her boney–knuckled hands. "How ever did you get such an idea?"

"Well," gulped the student, hoping his answer would satisfy her, "everyone knows Rome wasn’t built in a day.

For comments and archives

 
    Drug Update

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

Drug Name
Indication
DCI Approval Date
Meropenem IP 1000mg + Sulbactam sodium USP 500mg injection
For the treatment of lower respiratory tract infection caused by gram negative bacteria in adults only

15.03.11

 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

20 minutes of sunlight and a glass of milk can keep osteoporosis at bay

Osteoporosis and vitamin D deficiencies are the two new epidemics of the society said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Drinking less milk, quitting sunlight exposure and omitting the traditional aerobic indoor games are few reasons for these new epidemics. Younger professionals also stay indoors with practically no sunlight exposure. This is especially true for medical residents.

Here are few tips to prevent osteoporosis and strengthen the bones:

  1. Stop smoking: One should stop smoking as it increases bone loss.
  2. Eat a calcium–rich diet: The aim should be to get 1,500 milligrams of calcium a day in postmenopausal woman or a man over age 65. Good dietary sources of calcium include dairy products, tofu and other soy products; orange juice fortified with calcium, canned salmon with the bones, and cooked spinach. The alternative is to take calcium supplements.
  3. Get enough vitamin D: Vitamin D levels are influenced by how much sunlight one gets. Levels tend to decrease in older adults, especially in winter and in people who are unable to leave their home. One should consider taking a supplement to make sure one gets the recommended daily amount.
  4. Get exposure to sunlight of at least 20 minutes per day. The exposure should at least be of 20 minutes every day for a month in a year.
  5. Get enough protein in diet: An adequate intake of protein in diet, combined with an adequate intake of calcium helps to increase bone density. One should aim for about 12% of calories to come from proteins such as legumes, poultry, seafood, meat, dairy products, nuts and seeds. However, too much protein with too little calcium can be harmful.
  6. Weight–bearing exercises: These are activities such as walking, jogging and stair climbing that one should do on the feet, with your bones supporting your weight. They work directly on the bones of the legs, hips and lower spine to slow mineral loss.
  7. Weightlifting exercises: These exercises are also called resistance training or strength training. They strengthen muscles and bones in the arms, chest and upper spine. They can work directly on the bones to slow mineral loss.
  8. Get adequate vitamin K: This vitamin may be helpful in enhancing bone strength. Green leafy vegetables are the best sources of vitamin K. If one is taking a blood thinner he or she should check with the doctor.
  9. Avoid excessive alcohol: Women should limit alcohol consumption to less than one ounce a day and men should limit it to less than two ounces.
  10. Limit cola drinks: People who have high cola intake often have lower bone density.

For comments and archives

 
    Readers Responses
  1. Dear Sir, emedinews is very informative. Regards Dr Prachi
 
    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.

...more

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