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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 7 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 …

10th October 2012, Wednesday

Cherries May Prevent Gout Flares

Gout Patients are less likely to report acute attacks after 2 days of eating cherries or imbibing cherry extract than during periods after no cherry intake, according to data reported in the journal Arthritis & Rheumatism by Yuqing Zhang, DSci, and colleagues from Boston University School of Medicine in Massachusetts.

Cherry intake during a 2-day period is associated with a 35% lower risk for gout attacks and that cherry extract intake with a 45% lower risk.

Risk for gout attacks was reduced by 75% when cherry intake was combined with allopurinol use.

In the study if subjects took allopurinol alone, it reduced the risk of gout attack by 53%; if subjects took cherry alone, it reduced the risk by 32%; if they took both, the risk of gout attack was reduced by 75%, reports Medscape.

A cherry serving was defined as one-half cup or 10 to 12 cherries.

Cherries may decrease serum uric acid levels by increasing glomerular filtration or reducing tubular reabsorption.

Cherries and cherry extract contain high levels of anthocyanins, which possess anti-inflammatory properties.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Carnitine Update

Carnitine in Cardiomyopathy

Facts

  • Deficiencies in thiamine, selenium, and L-carnitine have been reported to produce heart failure and replacement therapy results in improvement in cardiac function.
  • Carnitine deficiency impairs the oxidation of fatty acids, resulting in lipid accumulation in the myocyte cytoplasm. This problem is reversed with L-carnitine replacement.

What are the symptoms of dilated cardiomyopathy?

Affected patients can present with symptoms of heart failure - progressive dyspnea with exertion, impaired exercise capacity, orthopnea, paroxysmal nocturnal dyspnea and peripheral edema. Other presentations may be incidental detection of asymptomatic cardiomegaly and symptoms related to coexisting arrhythmia, conduction disturbance, thromboembolic complications or sudden death.

For Comments and archives…

 
Dr K K Aggarwal
    eMedinewS Audio PostCard

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

Weight loss may improve sexual health of obese diabetes

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela to train 10,000 people in compression only CPR

Addressing a press conference, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Mr Sandeep Marwah, Director of Asian Academy of Film & Television, said that focus of the Mela this year will be “Prevention of Non-Communicable Diseases” and “Revival of Heart After Death.”

 
Dr K K Aggarwal
    National News

Now, mother’s educational qualification linked to infant mortality rate

NEW DELHI: Now, a woman's education has now been found to be a vital factor behind the country's shamefully high infant mortality rate (IMR). For instance, a child born to an illiterate mother in India has a 65% chance of dying in the first month of birth as against just 20% to a woman with 12+ years of education. Post-neonatal mortality rate (deaths after 28 days of life but before one year) is as high as 49% in case of a child born to an illiterate mother as against just 8% to a mother with 12 years of formal education. The IMR is 110% in case of an illiterate mother against 28% in case of those with education. A child born to a mother with 11 years of formal education has been found to be 60% less likely to die in the first month of birth. However, this goes down to 20% in case of a child born to a mother with eight years of education.

A first-of-its-kind government study called "Infant and Child Mortality in India - Levels Trends and Determinants" prepared by the National Institute of Medical Statistics, which is part of the Indian Council of Medical Research ICMR), says that between 1981 and 2005, IMR among children born to illiterate mothers has been consistently higher than those born to mothers with any education. The report — to be released jointly by ICMR and UNICEF next week — says, "Numerous arguments support a causal relationship between mother's education and under-five mortality. Education generally acts to reduce under-five mortality levels. A mother's education is important because it facilitates her integration into a society impacted by traditional customs, exposes her to information about better nutrition, use of contraceptives to space births and knowledge about childhood illnesses and treatment." The report adds, "Education heightens a mother's ability to make use of government and private health care resources and it may increase the autonomy necessary to advocate for her child in the household and to the outside world."

ICMR director-general Dr V M Katoch says in the report, "Strong persistent and significant impact of maternal education on child survival is one of the most striking results of the study that points to the urgency of investing in girls' education for accelerating declines in child mortality especially among the poor and the underserved." According to the study, for the successive five-year periods between 1981 and 2005, IMR among children born to illiterate mothers was 1.7, 1.5, 1.4 and 1.3 times higher than those born to mothers with less than eight years of education. The effects of education on post-neonatal mortality are even higher at 30%, 52%, 63% and 74%. (Source: TOI, Oct 9, 2012)

For comments and archives

My Profession My Concern

Quality Control

What is pan-resistance?

Pandrug resistant means ‘resistant to all antimicrobial agents’. Examples of current definitions are: ‘resistant to almost all commercially available antimicrobials’, ‘resistant to all antimicrobials routinely tested’ and ‘resistant to all antibiotic classes available for empirical treatment’

(Ref: Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012;18(3):268–281)

For comments and archives

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

 
    Valvular Heart Disease Update

Preventing valvular endocarditis

The 2007 AHA guideline for the prevention of infective endocarditis has narrowed the indications for bacterial endocarditis prophylaxis, compared with prior versions, in recognition of the absence of strong supportive evidence.

(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)

For comments and archives

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Drug may limit brain damage after stroke

An investigational agent may provide neuroprotection to patients undergoing endovascular repair of an intracranial aneurysm, a phase II trial showed. (Source: Medpage Today)

For comments and archives

Lucentis safe in diabetic eye disease

As-needed injections of ranibizumab (Lucentis) for diabetic macular edema (DME) appear to be safe in the long run, researchers said at the European Association for the Study of Diabetes meeting. The findings come from a 2-year, open-label, extension study that followed the year-long, randomized, controlled RESTORE trial. (Source: Medpage Today)

For comments and archives

Free contraception slashes abortion rates

When adolescent and adult women were offered no-cost contraception for 3 years, abortion rates fell 62% to 78% below national levels, according to a prospective cohort study of 9256 adolescent and adult women desiring reversible contraception. Teen birth rates also fell far below national rates. (Source: Medscape)

For comments and archives

Glucose control can blunt aspirin resistance

Aspirin resistance – a concern among patients with type 2 diabetes who may be at high risk of heart disease – may be attenuated by aggressive glucose-lowering therapy, researchers said at the annual meeting of the European Association for the Study of Diabetes. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Hydrotherapy http://blog.kkaggarwal.com/2012/10/hydrotherapy/

@DeepakChopra: I no longer believe in myself. What can I do to learn to really love myself? My #askdeepak reply: http://tinyurl.com/8gsxfzg

 
    Spiritual Update

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

Gambling in Indian Mythology

  1. Gambling has been mentioned on Diwali celebrations in the story of Mahabharata. It teaches us about taking calculated risks in life.
  2. Mahabharata teaches us that excess of everything is bad. If Yudhishtira had not risked Draupadi on that day while plying dice, Mahabharata would not have been fought. The same divine dice game became a vice for that moment.

For comments and archives

 
    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

Does obesity affect the chances of getting pregnant with treatment and having a healthy baby?

In obese women, there is an increasing amount of evidence that many complications of pregnancy for the mother (gestational diabetes, preeclampsia,) and her baby (birth defects) are increased. In addition, obese women have an increased chance of a cesarean section for delivery.

For comments and archives

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

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

Blood Donation - Gift of Liquid Love

The infections that may be transmitted through transfusion are Hepatitis B, Hepatitis non-A and non-B, Human immunodeficiency virus (HIV), Cytomegalovirus (CMV), Syphilis, Malaria, Epstein-Barr virus and Human T-lymphotropic virus (HTLV).

For comments and archives

 
    Liver Abscess Update

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

When should we do open surgical drainage?

  • Ruptured abscess on presentation
  • Multiloculated abscess, abscess with thick pus, multiple abscesses not drained with percutaneous
  • Left lobe abscess (difficult to approach)
  • Other intraabdominal pathology
  • Failure of per cutaneous drainage

For comments and archives

 
    An Inspirational Story (Dr GM Singh)

Today's lesson

One day a farmer's donkey fell down into a well. The animal cried piteously for hours as the farmer tried to figure out what to do. Finally, he decided the animal was old, and the well needed to be covered up anyway; it just wasn't worth it to retrieve the donkey. He invited all his neighbors to come over and help him. They all grabbed a shovel and began to shovel dirt into the well.

At first, the donkey realized what was happening and cried horribly. Then, to everyone's amazement he quieted down. A few shovel loads later, the farmer finally looked down the well. He was astonished at what he saw. With each shovel of dirt that hit his back, the donkey was doing something amazing. He would shake it off and take a step up. As the farmer's neighbors continued to shovel dirt on top of the animal, he would shake it off and take a step up. Pretty soon, everyone was amazed as the donkey stepped up over the edge of the well and happily trotted off!

Life is going to shovel dirt on you, all kinds of dirt. The trick to getting out of the well is to shake it off and take a step up. Each of our troubles is a stepping stone. We can get out of the deepest wells just by not stopping, never giving up!

Shake it off and take a step up.

Remember the five simple rules to be happy:

  1. Free your heart from hatred - Forgive.
  2. Free your mind from worries - Most never happen.
  3. Live simply and appreciate what you have.
  4. Give more.
  5. Expect less

NOW.................................

Enough of that rubbish . . . The donkey later came back, and bit the farmer who had tried to bury him.

The gash from the bite got infected and the farmer eventually died in agony from septic shock.

When you do something wrong, and try to cover it up, it always comes back to bite you.

For comments and archives

 
    Cardiology eMedinewS

Heart disease probed for links to new diabetes Read More

Search for silent ischemia in diabetes questioned Read More

 
    Pediatric eMedinewS

New autism criteria will not exclude affected kids but concerns linger among autism groups Read More

More encouraging news for eteplirsen in DMD Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A heart patient wanted to know if he could meditate under a pyramid.
Dr Bad: You cannot do it.
Dr Good: Go ahead.
Lesson: The effect of meditation under a pyramid as twice as strong as meditating outside the pyramid.

For comments and archives

Make Sure

Situation: A diabetic patient with BP of 130/90 developed acute chest pain.
Reaction: Oh my God! Why was his BP not kept below 120/80?
Lesson: Make sure that all patients with diabetes should have a goal BP of less than 120/80.

For comments and archives

 
  Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Hyperphosphatemia

Hyperphosphatemia or high phosphate levels may occur in myeloma, Paget’s disease of bone, osseous metastases, Addison’s disease, leukemia, sarcoidosis, milk–alkali syndrome, vitamin D excess, healing fractures, renal failure, hypoparathyroidism, diabetic ketoacidosis, acromegaly, and malignant hyperpyrexia. Drugs causing serum phosphorous elevation include androgens, furosemide, growth hormone, hydrochlorothiazide, oral contraceptives, parathormone, and phosphates.

 
  Quote of the Day (Dr GM Singh)

All hard work brings a profit, but mere talk leads only to poverty.

 
    Mind Teaser

Read this…………………

Which nursing diagnosis is of the highest priority when caring for a client with myasthenia gravis?

A. Pain
B. High risk for injury related to muscle weakness
C. Ineffective coping related to illness
D. Ineffective airway clearance related to muscle weakness

Yesterday’s Mind Teaser: What would be the MOST therapeutic nursing action when a client’s expressive aphasia is severe?

A. Anticipate the client wishes so she will not need to talk
B. Communicate by means of questions that can be answered by the client shaking the head
C. Keep us a steady flow rank to minimize silence
D. Encourage the client to speak at every possible opportunity.

Answer for yesterday’s Mind Teaser: D. Encourage the client to speak at every possible opportunity.

Correct answers received from: Prabha Sanghi, Dr PC Das, Dr (Maj. Gen.) Anil Bairaria, Dr Pankaj Agarwal, Dr KP Chandra, Dr K Raju, Dr Thakor Hitendrsinh G, Dr Kanta Jain, YJ Vasavada, Dr Jainendra Upadhyay.

Answer for 8th October Mind Teaser: Take from the rich, give to the poor Correct answers received from:

Correct answers received from: Dr Thakor Hitendrsinh G, Dr Kanta Jain, YJ Vasavada, Dr Jainendra Upadhyay

Send your answer to ijcp12@gmail.com

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    Laugh a While (Dr GM Singh)

Murphy's Laws for Humor

If at first you don't succeed, destroy all evidence that you ever tried.

 
    Medicolegal Update

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

Instruments for shooting, stabbing, cutting are dangerous weapons

  • The doctor is not required to make speculation about weapon of offence in a MLC case.
  • According to the Section 324 of IPC, any instrument for shooting, stabbing, cutting or any instrument used as a weapon of offence likely to cause death or by means of fire or any heated substance or by means of poison or any corrosive substance or by means of any explosive or by means of any substance which is deleterious to the human body to inhale, to swallow, or to receive into the blood or by means of any animal - are all considered as dangerous weapons.

The duty of the attending doctor is to record all the injuries, their dimensions as far as possible, and the body parts where the injuries are located, the nature of injury, whether simple or grievous, caused by sharp/blunt object, age or duration of injury along with the vital parameters like blood pressure, pulse, respiration and the mental status of the patient. When an investigating officer comes to the hospital, he needs some specific answers for his legal investigation and to book a case under law of the land.

  • Are the injuries present self–inflicted or fabricated? If yes, please mention the forensic justification.
  • Is there any sign, symptom or smell of alcohol or any drug intoxication? If yes, please opine about his mental status due the influence of intoxication; also preserve a blood sample.
  • Please opine if the injured or intoxicated patient is fit to record his statement? If no, please give due reasons and an approximate time interval for medical evaluation for his/her fitness for statement.
  • Is the condition of patient is critical, severe or serious? If so, the dying declaration must be recorded by the attending doctor in the presence of one or two witnesses.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Be cautious in prescribing painkillers to patients with high cholesterol

Long-term non-steroidal anti-inflammatory painkiller drugs such as naproxen should not be prescribed to patients with high cholesterol, said Padma Shri and Dr B C Roy national Awardee Dr K K Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

In a swine model study published in the journal Surgery, Dr Frank Sellke, chief of cardiothoracic surgery and research at Rhode Island Hospital found that a high-cholesterol diet reduced blood flow to the heart muscle in animal models with chronic heart disease when given daily naproxen. They also found reduced levels of prostacyclin, a compound that dilates blood vessels and prevents blood clots.

These findings suggest that there may be a stronger risk of negative effects on the heart in patients who have high cholesterol levels and are taking NSAIDs as a form of pain or inflammation relief

 
    Readers Responses
  1. Dear Sir, Really well said. I always like your comments on Mythology and Nastik concepts… Please keep posting comments.
 
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