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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 …

6th April 2012, Friday

Avoid these foods for a healthier heart

Processed meats: Eat none or less than 2 servings (2–3 ounces) per week. Processed meats are those preserved using salts, nitrites, or other preservatives. They include hot dogs, bacon, sausage, salami, and other deli meats, including deli ham, turkey, bologna, and chicken. Long–term observational studies have found that the worst types of meats for the heart are those that are processed.

Highly refined and processed grains and carbohydrates: Eat none or at most 7 servings (one ounce) per week. Studies have linked whole grain intake — in place of starches (like potatoes) and refined carbohydrates (like white bread, white rice, and low-fiber breakfast cereals) — to a lower risk of heart disease, diabetes, and possibly stroke. Whole grains are also linked to lower weight gain over time. Whole grains lower blood pressure and cholesterol, and may improve blood vessel function and reduce hunger.

Refined or processed foods include white bread, white rice, low–fiber breakfast cereals, sweets and sugars, and other refined or processed carbohydrates.

High levels of processing remove many of the most healthful components in whole grains, such as dietary fiber, minerals, phytochemicals, and fatty acids.

High levels of processing destroy the food’s natural structure. For example, eating a food made of finely milled oats (e.g., Cheerios) or grains (e.g., typically finely milled whole–grain bread) produces much higher spikes in blood sugar than less–processed versions such as steel–cut oats or stone–ground bread.

Processing often adds many ingredients that are less healthy, particularly trans fats, sodium, and sugars. Fourth, some research shows that fructose is metabolized differently than other sugars, in a way that increases the liver’s production of new fat. Fructose represents about half of the sugar in sweeteners like high–fructose corn syrup or sucrose (found in cane sugar and beet sugar). That’s not to suggest that you never eat a slice of pie or white bread — just make them an occasional treat rather than a regular part of your diet.

Soft drinks and other sugary drinks: drink none at most seven 8-ounce servings per week (one 8–ounce serving per day). The examples are sodas, sweetened fruit drinks, and sports drinks. A 12–ounce can of soda contains the equivalent of 10 teaspoons of table sugar. Diet sodas are sugar–free or low in calories, but have no nutrients.

Sugary drinks have all the same ill effects on the heart as highly refined and processed carbohydrates. The body does not compute the calories you ingest in liquid form in the same way as it does the calories you take in from solid foods. So if you add a soda to your meal, you are likely to eat about the same amount of calories from the rest of your food as if you drank water instead. The soda calories are just "added on." In addition to the other harms of highly refined and processed carbohydrates, sugary drinks also increase your chances of weight gain. (Source: Harvard Health Beat)

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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

Avoid these foods for a healthier heart

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

First Mega Ajmer Health Camp provides spiritual awareness

Brahmkumaris gave non-stop spiritual consultations to the patients at large.

Dr K K Aggarwal
    National News

Identical quadruplets born in rarest of rare case

MANGALORE: In a rare instance of identical quadruplets, which doctors say happens once in 13 million births, four such males were born on March 11 in Kerala’s Kasargod district. Considering their delicate state – they were also premature – the quadruplets were moved to a Mangalore hospital’s ICU, where one of them died on Monday night. The rest of them are doing well. Dr Ali Kumble, chairman of Indiana Hospital, said that the case can be considered rare since the babies were identical and also had an average gestation period of 26 weeks as against 40 weeks. The average weight of the babies was 740 gm as against 1.3 kg as per medical literature and recorded cases. "Such cases are extremely rare. Quadruplets occur once in 70 lakh births and identical quadruplets are born once in 13 million births. There are only 60 such cases recorded worldwide and it is a challenge to ensure their survival," Dr Kumble said. While two babies weigh 900gm the other two are 580gm each. They were born to Aysha Tahira, 30, and Latheef of Kasargod after 10 years of marriage. (Source: TOI, Apr 4, 2012)

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

Solid four–year safety and efficacy data with biodegradable–polymer DES

New long–term data from a combined analysis of trials, including patients treated with drug–eluting stents with a biodegradable polymer, shows that the new stents reduce the risk of stent thrombosis and target lesion revascularization (TLR) compared with a first–generation drug–eluting stent (Cypher Select, Cordis). (Source: Medscape)

For comments and archives

‘Therapeutic Ultrasound’ shows bone stress injuries

So–called therapeutic ultrasound, commonly used to treat soft tissue injuries, can be an alternative to magnetic resonance imaging (MRI) for detecting bone stress injuries, according to a British research team. (Source: Medscape)

For comments and archives

HIV ups lung cancer risk, independent of smoking

HIV infection independently increases lung cancer risk by 70%, according to the largest study yet to examine the issue. (Source: Medscape)

For comments and archives

Omega–3 fat tied to less cancer–related fatigue

Breast cancer survivors who eat a healthy dose of omega–3 fats may get some extra energy from it, a new study suggests. Fatigue can linger years after cancer therapy ends. There’s evidence that good sleep habits and regular exercise can help, but there’s still a need for other options, researchers say. (Source: Medscape)

For comments and archives

   Twitter of the Day

@DrKKAggarwal: How to Tackle Insomnia http://blog.kkaggarwal.com/2012/04/03/how–to–tackle-insomnia/

@DeepakChopra: Always think infinite possibilities!

    Spiritual Update

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

Whatever you want people to do for you, do also to them

According to the law of karma (law of nature) for every action there is an opposite and equal reaction. The only difference is that the reaction may not be perceived today and may come tomorrow or even much later. Every debt has to be paid. All negative actions (in words, thoughts or in deeds) sooner or later will have to be accounted for.

For comments and archives

    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What is ovarian tissue cryopreservation?

Doctors are experimenting with a procedure to freeze the tissues from a woman’s ovary. The ovaries produce eggs. In this procedure, doctors cut the tissue from one of your ovaries into thin slices. These slices are then frozen. After your cancer treatment, the doctors can place a slice of thawed ovarian tissue back into your body. The tissue does not need to go back where it came from in order to start producing eggs. You may need to be treated with fertility hormones in order for this tissue to produce an egg. Once the tissue produces an egg, your doctor will retrieve it and fertilize it in the laboratory. After your doctor places the subsequent embryo into your uterus, you may be able to get pregnant. There are some disadvantages to this procedure. You will need to have surgery several times. It also is dangerous if you have cancer of the ovary. If the tissue has cancer and is placed back in your body, the cancer could spread.

For comments and archives

    Hepatitis A Update

(Dr Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation, Medanta – The Medicity Hospital, Gurgaon)

When should you get hepatitis A vaccine? (CDC guidelines)

  • For children, the first dose should be given at 12 through 23 months of age. Children who are not vaccinated by 2 years of age can be vaccinated at later visits.
  • For others at risk, the hepatitis A vaccine series may be started whenever a person wishes to be protected or is at risk of infection.
  • For travelers, it is best to start the vaccine series at least one month before traveling. (Some protection may still result if the vaccine is given on or closer to the travel date.)

Two doses of the vaccine are needed for lasting protection. These doses should be given at least 6 months apart. Hepatitis A vaccine may be given at the same time as other vaccines.

For comments and archives

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

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

What is the implication of Rh–positive and Rh–negative blood?

A patient with Rh–negative blood cannot be given Rh–positive blood as the antigen–antibody reactions will result in severe consequences.

Women who are Rh–negative with their husbands being Rh–positive, the first child with Rh–positive may be normal, subsequently she may not conceive or may have repeated abortions. There may be intrauterine fetal death. If the child born is alive, it will suffer from a fatal disease called "Erythroblastosis Fetalis." Now mothers can be given an injection of anti–D within 24 hours of the delivery of an Rh–positive child and thus protect the next baby from this catastrophe.

In which situations do patients need blood transfusion?

There are several situations where a patient needs blood to save his/her life. The patient can be given plasma substitutes for the time being, but it is a temporary measure till a blood transfusion is given.

A patient needs blood after a major accident where there is loss of blood. No major surgery is performed without blood as there is bound to be blood loss. On an average, for every open heart surgery about 6 units of blood is required. In Gynecology and Obstetrics, women may require large amounts of blood to be transfused to save not only their lives, but also their babies in situations like antepartum hemorrhage or APH (bleeding before birth), postpartum hemorrhage or PPH (bleeding after birth).

Patients with blood diseases like severe anemia especially aplastic anemia, leukemia (blood cancer), hemophilia (bleeding disorder), thalassemia etc. may require repeated transfusions. In many cases like poisoning, drug reactions and conditions of shock, burns and many other situations, blood transfusion is the only way to save the precious human life.

To put it in a nutshell, There is no substitute for blood and a patient who needs blood to save his life can only be saved if blood is transfused to him.

For comments and archives

    Medi Finance Update

(Tarun Kumar, Chartered Accountant)

Judicial precedents reversed by retrospective amendments

Indirect transfer of capital assets

  • Presently, deemed income includes income from transfer of a capital asset situated in India.
  • Scope of deemed income expanded to include income from transfer of share or interest in a Company/entity registered/incorporated outside India if the share or interest derives, directly or indirectly, its value substantially from the assets located in India. (Through this, the recent Supreme Court ruling in the case of Vodafone has been reversed).
  • The term "property" as used in the definition of capital asset to include any rights of management or control or any other rights whatsoever in relation to an Indian Company.
  • Enabling provisions also included in the definition of the term "transfer" – includes disposing of or parting with an assets or any interest therein notwithstanding that the same is flowing from the transfer of shares of a company registered or incorporated outside India.
  • In respect of such transactions, it is clarified that non–residents are required to withhold taxes at source for any payments made to any other non–resident if the payment represents income of the non–resident payee, chargeable to tax in India.

For comments and archives

   An Inspirational Story

(Ms Ritu Sinha)

Where does it end?

There is a story about a wealthy farmer who was once offered all the land he could walk on in a day, provided he came back by sundown to the point where he started. To get a new start, early the next morning the farmer started covering ground quickly because he wanted to get as much land as he could. Even though he was tired, he kept going all afternoon because he didn’t want to miss this once in a lifetime opportunity to gain more wealth.

Late in the afternoon he realized the condition he had to fulfill to get the land was to get back to the starting point by sundown. His greed had gotten him far enough. He started his return journey, keeping an eye on how close he was to sundown. The closer it got to sundown, the faster he ran. He was exhausted, out of breath and pushed himself beyond the point of endurance. He collapsed upon reaching the starting point and died. He did make it before sundown. He was buried and all the land he needed was a small plot.

There is a lot of truth in this story and a lesson to be learned. Whether the farmer was wealthy or not, any greedy person would have ended the same way.

For comments and archives

    Rabies Update

(Dr AK Gupta, Author of Rabies, the worst death)

Is there any role of systemic antibiotic treatment for animal bites infections?

Treatment with prophylactic antibiotics for 3 to 7 days is appropriate for dog bite wounds, unless the risk of infection is low or the wound is superficial. If frank cellulitis is evident, a 10– to 14–day course of treatment is more appropriate. Amoxicillin–clavulanate potassium is the antibiotic of choice for a dog bite. For patients who are allergic to penicillin, doxycycline is an acceptable alternative, except for children younger than eight years and pregnant women. Erythromycin can also be used, but the risk of treatment failure is greater because of antimicrobial resistance.

Other acceptable combinations include clindamycin and a fluoroquinolone in adults or clindamycin and trimethoprim–sulfamethoxazole in children. When compliance is a concern, daily intramuscular injections of ceftriaxone are appropriate.

For comments and archives

   Cardiology eMedinewS

Statins Alter Predictive Value Of LDL Read More

Array Platform Technology for Multiplexed Diagnostics Read More

Clinical Trial With Medicinal Plants: AIIMS Know–How Read More

   Pediatric eMedinewS

Prenatal Pollutant Exposure Adversely Affects Child Behavior Read More

Some Autistic Kids Make Gains As Late ‘Bloomers’ Read More

Infant Breathing Predicts Asthma Later Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with laryngopharyngeal reflux wanted to know whether he could take Seltzer water.
Dr Bad: Yes, you can take.
Dr Good: No, you must avoid it.
Lesson: Even noncaffeinated carbonated beverages such as seltzer water will cause belching and can result in stomach acid and enzymes coming up into the laryngopharynx with each burp.

For comments and archives

Make Sure

Situation: A 50–year–old patient, highly stressed at work and a hypertensive as well, complained of acid eructations and indigestion.
Reaction: Oh my God! He has hyperacidity. Put him on magaldrate.
Lesson: Make sure that patients who are suffering from stress, diabetes and/or hypertension and who have hyperacidity/GERD/peptic ulcers, are put on magaldrate which is safe and effective as an antacid.

For comments and archives

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  Quote of the Day

(Dr GM Singh)

It is the province of knowledge to speak, and it is the privilege of wisdom to listen. Oliver Wendell Holmes

    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Cardiolipin Antibodies

Tests for IgG and IgM cardiolipin antibodies are frequently ordered to help determine the cause of an unexplained thrombotic episode, recurrent miscarriage, or thrombocytopenia. They may be ordered along with lupus anticoagulant testing to help investigate the cause of a prolonged PTT (activated partial thromboplastin time), especially if clinical findings suggest that the patient may have systemic lupus erythematosus (SLE) or another autoimmune disorder.

    Mind Teaser

Read this…………………

i i

Yesterday’s Mind Teaser: Elective cesarean section at 38 weeks of pregnancy before the onset of labor or rupture of membrane decreases transmission by:

a. 50–80%
b. 80–90%
c. 10–20%
d. 5–10%

Answer for yesterday’s Mind Teaser: a. 50–80%

Correct answers received from: Yogindra Vasavada, Raju Kuppusamy, Dr Avrar Krishan, Usha, Dr.Chandresh Jardosh, Dr. Thakor Hitendrsinh G, Dr Jainendra Upadhyay, Anil Bairaria, Dr Valluri Ramarao.

Answer for 4th April Mind Teaser: d) Lesion in upper one–third of submucosa
Correct answers received from: Dr Avtar Krishan

Send your answer to ijcp12@gmail.com

    Laugh a While

(Dr GM Singh)

Salesman to Policeman

A salesman, tired of his job, gave it up to become a policeman. Several months later, a friend asked him how he liked his new role.

"Well," he replied, "the pay is good and the hours aren’t bad, but what I like best is that the customer is always wrong."

    Medicolegal Update

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

During autopsy clean, wide mouthed glass bottles fitted with glass stoppers of one liter capacity should be used for the preservation of viscera

  • Rubber inserts should preferably not be used under caps.
  • 20-30 ml of Blood taken from femoral artery or vein by per skin puncture should be collected in 60ml screw-capped bottles or in plastic capped tubes/10 mg of sodium or potassium fluoride per ml of blood should be added in blood for preserving blood.
  • 20-30 ml of Urine is obtained from direct puncture of the bladder during the postmortem examination with a syringe and needle and should be collected in 60 ml screw–capped bottles or in plastic capped tubes and preservative 20–30mg of thymol blue or boric acid or acetic acid should be added as preservative
  • Saturated sodium chloride solution (common salt.) for all the visceral samples for chemical/toxicological examination
  • If there is an associated history of death due to acid intoxication then all the samples should be preserved in rectified spirit.
    Public Forum

(Press Release for use by the newspapers)

Vedic description of insomnia

The best description of the causes and treatment of insomnia comes from Vidura Niti a dialogue between Vidura and Dhritarashtra, said Dr. K.K. Aggarwal, Padma Shri and Dr B C Roy National Awardee and President, Heart Care Foundation of India.

Vidura said: "Sleeplessness overtakes thief, a lustful person, him that has lost all his wealth, him that has failed to achieve success and him also that is weak and has been attacked by a strong person".

He therefore described five basic reasons for insomnia and even in today’s science they are true. No new cause has been added in this list of stress induced insomnia.

The situations are:

  1. A thief
  2. A lustful person
  3. A person who has lost all his wealth
  4. A person who has failed to achieve success
  5. A person who is weak and has been attacked by a strong person.

Ayurveda describes sleeplessness as an aggravation of vata and pitta dosha. The number one cause of the same is mental tension, suppressed feelings and acute bitterness. The above five situations again hold true to this effect.

Other causes of insomnia mentioned in allopathy are constipation, dyspepsia, excessive intake of tea, coffee and alcohol and environmental factors such as excessive cold, heat or change of environment. They are in most of the situations the effect and not the cause of insomnia.

The treatment of insomnia involves either suppressing the emotions with drugs or root level eradication of stress with proper counseling.

Bhagwad Gita, Chanakya Niti and Vidur Niti are all the high level counseling books of ancient era and provide texts and sutras even true today. Bhagwad Gita was a counseling when Arjuna became very anxious and was unable to decide whether or not he should fight with his near and dear ones. He said: my legs are trembling, my bows are leaving me, by body is shaking, what should I do". The principles of Gita today are incorporated as the principles of Bhagwad Gita and they are minimal 18 counseling sessions, second and last session being the longest. In the first session, only listen and reassure the person repeatedly.

Chanakya again described principles of how to manage conflicts and win over others by way of different principles. One of his main teachings was that money earned by unfair means can only last for eight years.

Here are some of the sutras of Vidura Niti

  • Do not inhabit a surrounding where you are not respected, cannot earn your livelihood, have no friends, or cannot acquire knowledge. (1.8)
  • Do not reveal what you have thought upon doing, but by wise counsel keep it secret, being determined to carry it into execution. (2.7)
  • Consider again and again the following: the right time, the right friends, the right place, the right means of income, the right ways of spending, and from whom you derive your power. (4.18)
  • A wise man should not reveal his loss of wealth, the vexation of his mind, the misconduct of his own wife, base words spoken by others, and disgrace that has befallen him. (7.1)

One of the answers to insomnia is learning meditation as described in Patanjali Yoga Sutra or Yoga Vashistha. It is based on the principle of concentrating on the present, which shifts the inner environment from sympathetic to parasympathetic mode.

About 20 minutes of meditation morning and evening provides the same biochemical benefit as obtained from 7 hours of deep sleep.

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    Forthcoming Events
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BSNL Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

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