emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
FIRST NATIONAL 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 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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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of 1st Mega Ajmer Health Camp 2012

 
  Editorial …

10th April 2012, Tuesday

Children and adolescents with congenital heart disease
should avoid body piercing

Children and teenagers with congenital heart disease should be strongly discouraged from getting a tattoo or piercing their ears or other body parts, because it could lead to a potentially deadly infection of the heart called endocarditis.

Infective endocarditis occurs when bacteria or fungi attach and begin to grow on the valves of the heart. If left untreated, it can lead to a fatal destruction of heart muscle.

Most people are not aware that they should talk to their doctor before tattooing or piercing their body.

Body art in the form of tattoos and piercing has become increasingly popular among children and teenagers.

Most experts today strongly discourage all forms of body art. For those who cannot be dissuaded, the recommendation is to give antibiotics prior to tattooing or piercing, “with strong advice for prompt treatment of any signs of subsequent infection”.

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

Stay Tuned

Crime Against Women - Dr Rashmi Singh part 5

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

Talking to 2000 school children at Mount Abu School, Rohini, Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal said that ‘Eat less to live more’ has its origin in Vedas.

 
Dr K K Aggarwal
 
    National News

Walkathon to mark World Health Day

A group of 500 people, including the elderly, participated in a walkathon in the capital to spread awareness about healthy and active ageing on the occasion of the World Health Day Saturday. Health and Family Welfare Secretary P.K. Pradhan and WHO representative to India Nata Menabde flagged off the walkathon at the All India Institute of Medical Sciences (AIIMS). The theme of World Health Day this year is ‘healthy and active ageing’. Recognising that ageing of the population had major implications for the health system and society as a whole, the WHO also supported a national level consultation at AIIMS to prepare strategies for ensuring active and healthy ageing. “With rising life expectancy more and more people will live longer in most of the countries and it is imperative to ensure their continued and active engagement in all spheres of life,” said Menabde. ”This cannot be achieved without investing in healthy ageing throughout life course and ensuring adequate response to their health care needs. Finding the right models of long-term care for the rapidly ageing populations also becomes more urgent,” she said. India’s population is ageing and will continue to age steadily in the next few decades. It is estimated that the population aged 60 years and above will grow from 77 million (7.4 percent of the total population) in 2001 to 300 million (17 percent) by 2050. (Source: http://health.india.com/news/walkathon-to-mark-world-health-day/ Apr 8, 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

Most fat people don’t think they are fat: Study

NEW DELHI: How many fat people think they are fat? "Hardly," said half a dozen doctors TOI spoke to. Most of them said, "Majority of our obese patients don't think they are fat enough to be in trouble." Experts now say misperception of weight is becoming a major barrier to weight loss - a serious problem in India which has seen a nearly 20% increase in overweight population rates between 1998 and 2005. Take for example a recent University of Illinois study by researchers who surveyed over 3,500 college applicants. More than a third couldn't report their weight accurately and overweight and obese men were more likely to underestimate their weight than women. In physical exams, the height, weight and body mass index (BMI) of 3,622 18- to 20-year-old applicants to the Mexican University were recorded. Around 33.6% were overweight or obese, but only 16.9% described themselves as being in those categories. Women seemed to be a better judge of their weight than men with the gap between the former's perception and reality on their weight being smaller -- 27.8% of women were actually overweight or obese, but only 21.2% believed that they were. The study findings have serious implications for India where currently, 1 in 5 men and over 1 in 6 women are overweight. In some urban areas, the rates are as high as 40%. (Source: TOI, Apr 9, 2012)

For Comments and archives…

Mitral regurgitation: early hazard, later gains following TAVI

Moderate-to-severe mitral regurgitation (MR) is relatively common in patients undergoing transcatheter aortic valve implantation and is associated with a doubling in risk of 30-day death, a new series suggests. Beyond this initial period, however, survival among MR patients is just as good as among patients with no MR, and MR itself is likely to improve over time, authors of a new analysis say. (Source: Medscape)

For Comments and archives…

Brain wired in an 'astonishingly' simple grid structure

A new brain imaging study shows that the human brain is wired in a simple and orderly 3-dimensional grid, akin to a checkerboard, with no diagonal paths. "Far from being just a tangle of wires, the brain's connections turn out to be more like ribbon cables — folding 2D sheets of parallel neuronal fibers that cross paths at right angles, like the warp and weft of a fabric," Van J. Wedeen, MD, from Massachusetts General Hospital (MGH), the Martinos Center for Biomedical Imaging, and Harvard Medical School in Boston, explained in a statement. The highly detailed images were obtained with the Connectom diffusion magnetic resonance imaging (MRI) scanner installed at MGH's Martinos Center for Biomedical Imaging last fall. The scanner can visualize the networks of crisscrossing fibers in 10-fold higher detail than can conventional scanners. (Source: Medscape)

For Comments and archives…

Acute lung injury linked to cognition issues

Long-term survivors of acute lung injury (ALI) often have chronic impairment of neuropsychologic function, follow-up of clinical trial participants showed. (Source: Medpage Today)

For Comments and archives…

 
    Twitter of the Day

@DrKKAggarwal: Lifestyle choices in controlling blood pressure Try lifestyle management for up to 6 months

@DeepakChopra: The picture of the world is not the look of it but only our way of looking at it

 
    Spiritual Update

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

Vasudeva Kutumbakam: The whole world is one family

Vasudeva Kutumbakam is the gist of Upanishads indicating Universal brotherhood and goodwill.

One of the Vedic theories is that we are all part of the universe. As described by Ramanuja, whole universe can be treated as one person. Each one of us are the individual cells of this one universe. Similarly if I am the universe than each of my cell is mini replica of mine.

As we fight each other, do creative activities, conspire and kill others the same is being done by the cells inside our body. The collective consciousness of all the cells of our body decides our future. In the same way the collective consciousness of the people decides the fate of the universe.

For Comments and archives…

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the various risks factor for multiple pregnancies?

Your race, age, heredity, or history of prior pregnancy does not increase your chances of having identical twins, but does increase your chance of having non identical twins:

Race: Twins occur in approximately 1 of every 90 pregnancies in North America. The incidence is higher in Africa, with a rate of 1 in 20 births in Nigeria. Twins are less common in Asia. In Japan, for example, twins occur only once in every 155 births.

Heredity: The mother's family history may be more significant than the father's. Non-identical twin women give birth to twins at the rate of 1 set per 60 births. However, non-identical males father twins at a rate of 1 set per 125 births.

Maternal age and prior pregnancy history: The frequency of twins increases with maternal age and number of pregnancies. Women between 35 to 40 years of age with four or more children are three times more likely to have twins than a woman under 20 without children.

Maternal height and weight: Non-identical twins are more common in large and tall women than in small women. This may be related more to nutrition than to body size alone.

Fertility Drugs and Assisted Reproductive Technology: Multiple pregnancy is more common in women who utilize fertility medications to undergo ovulation induction or superovulation. Approximately 20% of pregnancies resulting from gonadotropins are multiples. While most of these pregnancies are twins, up to 5% are triplets or greater due to the release of more eggs than expected.

For Comments and archives…

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

(Dr. Sujay Shad, Senior Consultant Cardiac Surgeon and Director of Heart-Lung Transplantation, SGRH)

Who can donate a heart for a transplant?

Part of the reason for the delay in commencing a viable Heart Transplant programme is the limited number of Brain dead cadaveric donors. However, it is only part of the reason; the other part being the lack of awareness amongst heart failure patients about the benefits of heart transplantation.

The donor must be certified brain dead, which means that the brain is so badly damaged either by trauma, bleeding or otherwise that the person suffers irreversible end of all brain activity (including involuntary activity like ventilation necessary to sustain life) due to total necrosis of the cerebral neurons following loss of brain oxygenation. It should not be confused with a persistent vegetative state. Patients classified as brain dead can have their organs surgically removed for organ donation.

Additionally they must not be suffering from sepsis (exceptions are there), malignancies (there are exceptions) and viremia (there are exceptions). Generally, donors should be less than 55 years of age (exceptions are regularly made) and not on large dose inotropes.

However, the most important criterion is: Donor family must be educated and must have a big enough heart to donate organs.

For Comments and archives…

 
  Medi Finance Update

(Tarun Kumar, Chartered Accountant)

General Anti-Avoidance Rule (GAAR)

  • GAAR introduced primarily to codify the doctrine of substance over form and to deal with aggressive tax planning.
  • GAAR provisions may override tax treaties to prevent treaty abuse and bring certain cross border transactions under taxation.
  • An arrangement entered into by an assessee may be declared to be an impermissible avoidance arrangement with attendant tax consequences.

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

The doll and white rose

I was walking around in a Target store, when I saw a Cashier hand this little boy some money back. The boy couldn’t have been more than 5 or 6 years old. The Cashier said, “I’m sorry, but you don’t have enough money to buy this doll.” Then the little boy turned to the old woman next to him:”Granny, are you sure I don’t have enough money?” The old lady replied:”You know that you don’t have enough money to buy this doll, my dear.” Then she asked him to stay there for just 5 minutes while she went to look around. She left quickly.

The little boy was still holding the doll in his hand. Finally, I walked toward him and I asked him who he wished to give this doll to. It’s the doll that my sister loved most and wanted so much for Christmas. She was sure that Santa Claus would bring it to her. I replied to him that maybe Santa Claus would bring it to her after all, and not to worry. But he replied to me sadly. “No, Santa Claus can’t bring it to her where she is now. I have to give the doll to my mommy so that she can give it to my sister when she goes there.”

His eyes were so sad while saying this. “My Sister has gone to be with God. Daddy says that Mommy is going to see God very soon too, so I thought that she could take the doll with her to give it to my sister.” My heart nearly stopped. The little boy looked up at me and said: “I told daddy to tell mommy not to go yet. I need her to wait until I come back from the mall.” Then he showed me a very nice photo of him where he was laughing. He then told me “I want mommy to take my picture with her so she won’t forget me.” “I love my mommy and I wish she doesn’t have to leave me, but daddy says that she has to go to be with my little sister.” Then he looked again at the doll with sad eyes, very quietly.

I quickly reached for my wallet and said to the boy. “Suppose we check again, just in case you do have enough money for the doll?” “OK” he said, “I hope I do have enough.” I added some of my money to his without him seeing and we started to count it. There was enough for the doll and even some spare money. The little boy said: “Thank you God for giving me enough money!” Then he looked at me and added, “I asked last night before I went to sleep for God to make sure I had enough money to buy this doll, so that mommy could give it to my sister. He heard me!” “I also wanted to have enough money to buy a white rose for my mommy, but I didn’t dare to ask God for too much. But He gave me enough to buy the doll and a white rose.” “My mommy loves white roses.”

A few minutes later, the old lady returned and I left with my basket. I finished my shopping in a totally different state from when I started. I couldn’t get the little boy out of my mind. Then I remembered a local newspaper article two days ago, which mentioned a drunk man in a truck, who hit a car occupied by a young woman and a little girl. The little girl died right away, and the mother was left in a critical state. The family had to decide whether to pull the plug on the life-sustaining machine, because the young woman would not be able to recover from the coma. Was this the family of the little boy? Two days after this encounter with the little boy, I read in the news paper that the young woman had passed away. I couldn’t stop myself as I bought a bunch of white roses and I went to the funeral home where the body of the young woman was exposed for people to see and make last wishes before her burial. She was there, in her coffin, holding a beautiful white rose in her hand with the photo of the little boy and the doll placed over her chest. I left the place, teary-eyed, feeling that my life had been changed forever. The love that the little boy had for his mother and his sister is still, to this day, hard to imagine. And in a fraction of a second, a drunk driver had taken all this away from him.

The value of a man or woman resides in what he or she gives, not in what they are capable of receiving…

(Source: http://academictips.org/blogs/the-doll-and-white-rose/).

For Comments and archives…

 
  Microbial World: The Good and the Bad They Do

(Dr Sunil Sharma, Senior Consultant Microbiology, Medanta The Medicity)

High levels of antibiotics are found in the environment, like local bodies of water, sewage etc. Antibiotics are given to healthy cattle, pigs, chickens, and fish as prophylaxis. This may be one of the reasons for the prevalence of multidrug-resistant organisms in the environment. Regulation banning the use of antibiotics in European feed, with the exception of two antibiotics in poultry feeds, became effective in 2006. In Scandinavia, there is evidence that the ban has led to a lower prevalence of antimicrobial resistance in (nonhazardous) animal bacterial populations.

The resistant bacteria in animals due to antibiotic exposure can be transmitted to humans via three pathways:

  • Through the consumption of meat
  • From close or direct contact with animals
  • Through the environment.

For comments and archives

 
   Cardiology eMedinewS

Natural History Of Rheumatic Heart Disease Read More

Molecular Mechanisms of the Beneficial Effects of Anti-Platelet Therapy in Heart Failure Read More

Evaluation of Safety Profile Of Nimesulide Along With Adjuncts Read More

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Some ADHD Behavior A Variation Of Normal? Read More

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    IJCP Special

Dr Good Dr Bad

Situation: A pregnant lady was on PPI.
Dr Bad: Stop it.
Dr Good: Continue it.
Lesson: Proton pump inhibitors (PPIs) are not a major cause of birth defects when used early in pregnancy (N Engl J Med 2010;363:2114–23).

For comments and archives

Make Sure

Situation: A patient developed high altitude cerebral edema while traveling to Leh.
Reaction: Oh My God: Why was acetazolamide not started before the journey?
Lesson: Make sure all high risk patients are given acetazolamide before they travel to mountains.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

One thought fills immensity. William Blake

 
  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Anion gap

  • Increased serum anion gap reflects the presence of unmeasured anions, as in uremia (phosphate, sulfate), diabetic ketoacidosis (acetoacetate, beta–hydroxybutyrate), shock, exercise–induced physiologic anaerobic glycolysis, fructose and phenformin administration (lactate), and poisoning by methanol (formate), ethylene glycol (oxalate), paraldehyde, and salicylates. Therapy with diuretics, penicillin, and carbenicillin may also elevate the anion gap.
  • Decreased serum anion gap is seen in dilutional states and hyperviscosity syndromes associated with paraproteinemias. Because bromide is not distinguished from chloride in some methodologies, bromide intoxication may appear to produce a decreased anion gap.
 
    Mind Teaser

Read this…………………

notic

Yesterday’s Mind Teaser: Which of these properties of cinnarizine make it an efficacious agent for gastric vertigo?

a. Inhibits vasoconstriction
b. Inhibits vascular spasm
c. Cerebral irrigation
d. All of the above

Answer for Yesterday’s Mind Teaser:c. Cerebral irrigation

Correct answers received from: Dr. P. C. Das, y. J. Vasavada, Dr. Thakor Hitendrsinh G

Answer for 8th April Mind Teaser: Gross injustice
Correct answers received from:Dr. Thakor Hitendrsinh G, Dr. P. C. Das, Sudipto Samaddar, Ritu Sinha, Dr.Chandresh Jardosh, y. j. vasavada, Neelam Nath, Dr. Anupam Sethi Malhotra/em>.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Feline Physics

Law of Cat Thermodynamics

Heat flows from a warmer to a cooler body, except in the case of a cat, in which case all heat flows to the cat.

 
  Medicolegal Update

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

How is a blood sample collected in a medicolegal case?

Collection of a blood sample is said to be a surgical process and should only be performed by a qualified doctor in a hospital setup where at least primary medical facility is available because in many occasion the patient may develop medical complication and even loss of consciousness hence it cannot be drawn in police station or court of law. 

  • The sample should be taken from the vein in the antecubital fossa.
  • Before blood collection, the subject should remove tight clothes that might constrict the upper arm.
  • The phlebotomist ties the tourniquet around the upper arm of the subject, searches the proper vein by inspecting and palpating and then sterilizes the injection site.
  • The vein can be anchored by placing the thumb about 2 cms below the vein and pulling gently to make the skin a little taut.
  • After that, the needle, beveled upward, should be pushed smoothly and quickly into the vein, to minimize the possibility of hemolysis as a result of vascular damage.
  • Immediately after the insertion, the tourniquet should be released to minimize the effect of hem concentration.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

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

Suspecting stroke and heart attack risk without tests

Carotid bruit, an unusual, harsh sound a doctor can hear when passing a stethoscope over the main artery to the brain could indicate an increased risk of heart attack and death from heart disease and stroke, said Padma Shri and Dr B C Roy Awardee Dr. K K Aggarwal, President Heart Care Foundation of India

The sound is caused by turbulent blood flow due to buildup of fatty deposits in one of the two arteries that carry blood to the front and middle part of the brain. It is usually regarded as a possible indicator of increased risk of stroke.

An analysis of 22 studies involving more than 17,000 patients and published in The Lancet found that people with carotid bruits were more than twice as likely to have heart attacks or to die of cardiovascular disease.

However patients who do not have carotid bruit may have other evidence of cardiovascular disease. Physicians should routinely listen for possible carotid bruits when doing a physical examination of people who are middle-aged or older.

Studies have shown that there is a link between the risk of stroke and of coronary heart disease.

 
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  1. Dear Sir, Reading emedinews is really a good adventure. Regards: Dr SP Malhotra
 
    Forthcoming Events
Dr K K Aggarwal


Dr K K Aggarwal

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
http://www.heartcarefoundation.org

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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