10th October 2014, Friday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and National Science Communication Awardee. Limca Book of Record Holder (CPR). Gold Medalist

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); 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);
For updates follow at :  www.twitter.com/DrKKAggarwal, www.facebook.com/Dr KKAggarwal

Swachch Bharat - Swasth Bharat

Swachch Bharat - Campaign launched by Delhi BJP

Dr KK Aggarwal selected as one of the nine icons

today emedipics

News Around The Globe

  • About half of all U.S. hospital patients receive antibiotics, and these drugs are commonly the ones more likely to promote the growth of antibiotic-resistant bacteria, a new study found. "This is where the bad bugs spread, in the hospitals, because so many people are receiving antibiotics, and one of the only things that can spread are the antibiotic-resistant bugs," said Dr. Eli Perencevich, an infectious disease epidemiologist at the University of Iowa Carver College of Medicine.
  • Tobacco users are more likely than others to test positive for oral human papillomavirus type 16 (HPV-16), suggests a report published online October 7 in JAMA.
  • The US Multi-Society Task Force on Colorectal Cancer has published new consensus guidelines aimed at raising the preparation compliance goal to at least 85%. The new task force guidelines, published in the October issue of Gastroenterology, have been approved by the American College of Gastroenterology, American Gastroenterological Society, and American Society of Gastrointestinal Endoscopy governing boards.
  • Physician scientists at 22 consortia will collaborate with representatives of 98 patient advocacy groups to advance clinical research and investigate new treatments for patients with rare diseases. The collaborations are made possible through awards by the National Institutes of Health — totaling about $29 million in fiscal year 2014 funding — to expand the Rare Diseases Clinical Research Network (RDCRN), which is led by NIH’s National Center for Advancing Translational Sciences (NCATS).
  • Theramine, a "medical food" containing an amino acid blend significantly improves chronic low back pain and reduces inflammation compared with low-dose ibuprofen, a nonsteroidal anti-inflammatory drug, or a combination of these 2 treatments, results of a new study show published online September 18 in the American Journal of Therapeutics. An earlier study in Am J Ther. 2012;19:108-114 also compared this medical food with another NSAID, naproxen."Now we have done 2 multicenter, double-blind trials showing the effectiveness of theramine, not only on pain but also inflammation, and we are not seeing significant side effects," commented study author David S. Silver, MD, president and chief operating officer, Targeted Medical Pharma Inc, Los Angeles, California.(Medscape)

Dr KK Spiritual Blog

Dealing with Stress

Stress may be broadly defined as comprising of 3 components, namely a “known situation, interpretation of a situation and the physical and mental reaction to that interpretation of the situation.”

  • Stress is a situation. There cannot be a stress without a situation. One cannot be stressed about some event occurring in USA without knowing the person or the situation. The situation requires familiarity with the particular sensory object (known situation).
  • Stress is an interpretation of a situation. Without interpretation, stress is not possible. The same situation can be interpreted differently by different people. A stimulus may be stressful to one but not to another.
  • Stress is a physical and mental response to the interpretation of the situation. Stress manifests because of a chemical imbalance resulting due to sympathetic overactivity, which manifests as mental and or physical symptoms.

Stress, therefore, is the body’s physical and mental response to the interpretation of a situation. Management of stress, therefore, involves either changing the situation, changing the interpretation of the situation or making the body resistant to physical and mental changes in the situation.

Practicing Patanjali’s eight limbs of yoga via living a yogic lifestyle, adhering to the various Dos and Don’ts in life as taught in various religious teachings, and learning to meditate helps our body to resist these sympathetic-activating changes and handle the stressful situation. These involve proper diet, exercise, meditation and relaxation exercises.

Changing the interpretation of a situation involves counseling. Cognitive behavior therapy used in counseling is one such example. Change in interpretation requires deeper understanding of the problem and removal of the obstacles. This can be done by using Ganesha’s principles of stress management, Rosenburg’s Principle of Non-Violent Communication, or the principles of counseling from Bhagwad Gita.

Change of the situation is the final resort for solving the problem, even though this may not be always possible. For example, in a dispute between husband and wife, divorce should be the last choice, after all counseling efforts have failed to resolve the issue.

Inspirational Story

It’s Never Too Late

It was an unusually busy day for the hospital staff on the sixth floor. Ten new patients were admitted and Nurse Susan spent the morning and afternoon checking them in. Her friend Sharron, an aide, prepared ten rooms for the patients and made sure they were comfortable. After they were finished she grabbed Sharron and said, “We deserve a break. Let’s go eat.”

Sitting across from each other in the noisy cafeteria, Susan noticed Sharron absently wiping the moisture off the outside of her glass with her thumbs. Her face reflected a weariness that came from more than just a busy day. “You’re pretty quiet. Are you tired, or is something wrong?” – Susan asked.

Sharron hesitated. However, seeing the sincere concern in her friend’s face, she confessed, “I can’t do this the rest of my life, Susan. I have to find a higher-paying job to provide for my family. We barely get by. If it weren’t for my parents keeping my kids, well, we wouldn’t make it.”

Susan noticed the bruises on Sharron’s wrists peeking out from under her jacket. “What about your husband?” “We can’t count on him. He can’t seem to hold a job. He’s got . . . problems.” “Sharron, you’re so good with patients, and you love working here. Why don’t you go to school and become a nurse? There’s financial help available, and I’m sure your parents would agree to keep the kids while you are in class.”

“It’s too late for me, Susan; I’m too old for school. I’ve always wanted to be a nurse, that’s why I took this job as an aide; at least I get to care for patients.” “How old are you?” – Susan asked. “Let’s just say I’m thirty-something.”

Susan pointed at the bruises on Sharron’s wrists. “I’m familiar with ‘problems’ like these. Honey, it’s never too late to become what you’ve dreamed of. Let me tell you how I know.” Susan began sharing a part of her life few knew about. It was something she normally didn’t talk about, only when it helped someone else.

“I first married when I was thirteen years old and in the eighth grade.” Sharron gasped. “My husband was twenty-two. I had no idea he was violently abusive. We were married six years and I had three sons. One night my husband beat me so savagely he knocked out all my front teeth. I grabbed the boys and left. “At the divorce settlement, the judge gave our sons to my husband because I was only nineteen and he felt I couldn’t provide for them. The shock of him taking my babies left me gasping for air. To make things worse, my ex took the boys and moved, cutting all contact I had with them.

“Just like the judge predicted, I struggled to make ends meet. I found work as a waitress, working for tips only. Many days my meals consisted of milk and crackers. The most difficult thing was the emptiness in my soul. I lived in a tiny one-room apartment and the loneliness would overwhelm me. I longed to play with my babies and hear them laugh.”

She paused. Even after four decades, the memory was still painful. Sharron’s eyes filled with tears as she reached out to comfort Susan. Now it didn’t matter if the bruises showed. Susan continued, “I soon discovered that waitresses with grim faces didn’t get tips, so I hid behind a smiling mask and pressed on. I remarried and had a daughter. She became my reason for living, until she went to college.

“Then I was back where I started, not knowing what to do with myself – until the day my mother had surgery. I watched the nurses care for her and thought: I can do that. The problem was, I only had an eighth-grade education. Going back to high school seemed like a huge mountain to conquer. I decided to take small steps toward my goal. The first step was to get my GED. My daughter used to laugh at how our roles reversed. Now I was burning the midnight oil and asking her questions.”

Susan paused and looked directly in Sharron’s eyes. “I received my diploma when I was forty-six years old.” Tears streamed down Sharron’s cheeks. Here was someone offering the key that might unlock the door in her dark life.

“The next step was to enroll in nursing school. For two long years I studied, cried and tried to quit. But my family wouldn’t let me. I remember calling my daughter and yelling, ‘Do you realize how many bones are in the human body, and I have to know them all! I can’t do this, I’m forty-six years old!’ But I did. Sharron, I can’t tell you how wonderful it felt when I received my cap and pin.”

Sharron’s lunch was cold, and the ice had melted in her tea by the time Susan finished talking. Reaching across the table and taking Sharron’s hands, Susan said, “You don’t have to put up with abuse. Don’t be a victim – take charge. You will be an excellent nurse. We will climb this mountain together.” Sharron wiped her mascara-stained face with her napkin. “I had no idea you suffered so much pain. You seem like someone who has always had it together.”

“I guess I’ve developed an appreciation for the hardships of my life,” Susan answered. “If I use them to help others, then I really haven’t lost a thing. Sharron, promise me that you will go to school and become a nurse. Then help others by sharing your experiences.” Sharron promised. In a few years she became a registered nurse and worked alongside her friend until Susan retired. Sharron never forgot her colleague or the rest of her promise.

Now Sharron sits across the table taking the hands of those who are bruised in body and soul, telling them, “It’s never too late. We will climb this mountain together.”

Rabies News (Dr A K Gupta)

A pregnant woman develops rabies. What should be done?

The rabies virus is not known to cross placental barrier, and so if the mother develops rabies, the fetus is safe. Hence, the pregnant woman with rabies should be clinically managed and if induction of pregnancy or cesarean section is possible, the obstetrician should do it with some "personal precautions" and immunoprophylaxis (usually three doses of modern vaccine or if there is any accidental exposure, then full course of post–exposure vaccination either by IM or ID route should be given to the obstetrician). Later the newborn may be given a full course of rabies PEP vaccination.

Cardiology eMedinewS

  • A counterpulsation device that can be implanted using minimally invasive surgical techniques and does not touch the blood it is pumping could be beneficial in outpatients with advanced heart failure, suggests a very small feasibility study. The C-pulse extra-aortic pump is envisioned as a substitute, in some cases, for left-ventricular-assist devices (LVADs), and appears to be more beneficial. The study is published in JACC: Heart Failure.
  • An analysis from the multicenter CORONOR registry has cautioned against aspirin use in the secondary prevention of cardiovascular events among stable CAD patients also taking oral anticoagulation. The analysis suggested that the bleeding risk related to aspirin, in this specific setting, exceeds any benefits related to prevention of ischemic events. The findings were published October 7 in the Journal of the American College of Cardiology.
  • Among participants in the Bogalusa Heart Study, higher body mass index (BMI) and systolic and diastolic blood pressure in childhood and adulthood, as well as total area under the curve (AUC) and incremental AUC, were all significantly associated with higher left ventricular mass and left ventricular hypertrophy, reported Gerald S. Berenson, MD, of Tulane University School of Public Health and Tropical Medicine in New Orleans, and colleagues.

Pediatrics eMedinewS

  • Pediatric HIV patients who receive early, effective treatment tend to have smaller reservoirs of infected cells than those treated later, suggest new findings published October 6 in JAMA Pediatrics.
  • Changes in cardiac geometry and function resulting from obesity are observed as early as childhood, suggests a new study. The study authors noted thicker left ventricular (LV) walls and an increased LV mass, as well as impaired measures of systolic function, among the obese kids when compared with nonobese children. The study is published October 8 in the Journal of the American College of Cardiology.

Quote of the Day

  • If your actions inspire others to dream more, learn more, do more and become more, you are a leader. John Q. Adams


IMA at work in Kashmir

Indian Medical Association has sent following members to Srinagar.

  1. 17 to 18 September: Dr. Narendra Saini and Dr Chetan N. Patel
  2. 18-9-2014 to 21-9-2014: Dr. Deepak Jain, Dr Shalini Agarwal, Dr. Sudhir Tyagi, Dr. D.B.Nair, Dr. Shivkumar and Mr. Sunith (Ghaziabad, U.P.)
  3. 18-9-2014 to 23-9-2014: Dr. Mansukh Kanani , Dr. Girish Patel, Dr. Shailesh Jepiwala, Dr. Dinesh Patel, Dr. Bhaumik Hyrani, Mr. Bharat Gharenia and Mr. Chandu Dodia (Bhavnagar, Gujarat)
  4. 22-9-2014 to 27-9-2014: Dr. Pragnesh Shah, Dr. Kamlesh Bhadreshwara and Dr. Prashant Tanna (Gujarat)
  5. 25-9-2014 to 29-9-2014: Dr. Suresh Sablok (Himachal Pradesh)
  6. 29-9-2014 to 4-10-2014: Dr. Anirudh Lochan (Delhi) and Dr. Nav Sankalp Kalsi (Punjab)
  7. 30-9-2014 to 2-10-2014: Dr. Jayun Joshi (Gujarat)
  8. 30-9-2014 to 4-10-2014: Dr. B.M. Patel (Gujarat)
  9. The next team of 4 doctors and one paramedic is ready to go on 9-10-2014

The details of camps: 18-9-2014: Idgah: 160; 19-9-2014 - Idgah - 800; Natipura - 700; Saura - 730; 20-9-2014- Idgah -350; Nalbag -1200 ; Saura - 300, Charare Shariff - 350; 21-9-2014- Nalbaug - 525; 22-9-2014 -450; 23-9-2014 Palanpura - 425; 24-9-2014 Chanpura -225; Nalabal -142; 25-9-2014- Budgam - 312; 26-9-2014 -Batpura - 404; Srinagar- 356; 27-9-2014 -Dallake- 485; 28-9-2014- Anantnag - 714; 29-9-2014 - Sorting of medicines; 30-9-2014 - 565; 1-10-2014-Badran- 784 and 2-10-2014 -Sadpura 1200

Total Camps 19 and total no. of Patients seen: 11177. Total contribution has been received for J&K Flood relief as on 30-09-2014 is Rs.3,24,612/-

Global Hand Washing Day on October 15th

Hand washing is like a “do it yourself vaccine” which can definitely reduce the spread of diarrheal and respiratory diseases. Regular hand washing, particularly before eating and after using toilets is one of the best ways to remove germs, avoid getting infected and also prevent the spread to others. Hand washing involves five simple and inexpensive but effective steps of:- 1) Wet 2) Lather 3) Scrub 4) Rinse and 5) Dry

If inculcated as a habit among our school children, this exercise has been scientifically proven to reduce the mortality and morbidity among them by at least 50%.

Wellness Blog

Seven behaviors cut heart deaths

Seven heart-healthy behaviors can reduce the risk of death from cardiovascular disease. In a prospective study, by Enrique Artero, PhD, of the University of South Carolina, and colleagues and published in the journal Mayo Clinic Proceedings, those who met 3-4 of the American Heart Association's 'Simple Seven' heart-health criteria had a 55% lower risk of cardiovascular mortality than those who met no more than two of those practices over 11 years.

Four core behaviors

1. No smoking
2. Normal body mass index
3. Engaging in physical activity
4. Eating healthfully

Three parameters

1. Cholesterol lower than 200 mg/dL
2. Blood pressure lower than 120/80 mm Hg
3. Not having diabetes

emedipicstoday emedipics

Health Check Up and CPR 10 Camp at N P CO-ED Sr Sec School, Laxmi Bai Nagar on 28th August 2014



Zee News – Health Wealth Shows


press release

Indian spices may be a cure for metabolic syndrome

video of day video of day

Other Blogs

Video Library

MTNL Perfect Health Mela

Heart Care Foundation of India, a leading national non–profit organization committed to making India a healthier and disease-free nation announced the upcoming activities of the 21st MTNL Perfect Health Mela scheduled to be held from 15th – 19th October 2014 at the Talkatora Indoor Stadium in New Delhi.

Sameer Malik Heart Care Foundation Fund

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF

Total CPR since 1st November 2012 – 96458 trained

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)


IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :


Dr Good and Dr Bad

Situation: Is the dose of T4 thyroid drug same for children and adults?
Dr. Bad: Yes, the dose is the same.
Dr. Good: No, the dose differs.
Lesson: The necessary dose per kg body weight is higher in infants and in children.

Make Sure

Situation: Doctor, this patient has developed acute renal failure (ARF).
Reaction: Oh my God, I forgot that he was on furosemide. I gave him full dose of amikacin.
Lesson: Make sure, before calculating the dose of aminoglycoside (amikacin) that furosemide and other loop diuretics, which enhance its nephrotoxicity are not being given.

eMedinewS Humor

A Texas millionaire

A Texas millionaire had fallen ill. The doctors consulted did not seem to understand what ailed him. The millionaire let it be known that any doctor who could heal him could have whatever he desired.

A country doctor was finally able to cure him, and as the doctor was leaving after a week’s stay, the Texan said, "Doc! I am a man of my word. You name it, and if it is humanly possible I’ll get it for you."

"Well," said the doctor, "I love to play golf, so if I could have a matching set of golf clubs, that would be fine." With that the physician left.

The doctor didn’t hear from the Texan millionaire for some months. Then, one day, he got a phone call from the millionaire.

"Doc, I bet you thought that I had gone back on my word. I have your matching set of golf clubs. The reason it took so long is that two of them didn’t have swimming pools, and I didn’t think they were good enough for ya. So I had pools installed and they're all ready for you now!"

Twitter of the Day

Dr KK Aggarwal: Longer the waist line shorter the brain size
Dr Deepak Chopra: What is the actual purpose of the ego?

ePress Release

Older people should exercise to build muscle even into their 80s

Older people should exercise to build their muscles even into their eighties, according to a review which suggests it will help them with everyday tasks, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

Climbing the stairs, housework, walking and even washing was made easier if elderly people worked out 2 to 3 times a week, said Chiung-ju Liu of the Department of Occupational Therapy at Indiana University.

People lose muscle as they age, which can make daily chores more difficult. Working out by using small weights or elastic bands can help to rebuild these muscles.

By "walking well", however, you power yourself around all day using muscles in your bottom, midriff and the backs of your thighs. This brings dramatic, sustainable results.

eMedi Quiz

Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionization of the drug in the stomach. Which of the following statements is not a correct example?

1. Absorption of digoxin is delayed by the presence of food.
2. Concurrent food intake may severely reduce the rate of absorption of phenytoin.
3. Presence of food enhances the absorption of hydrochlorothiazide.
4. Anitimalarial drug halofantrine is more extensively absorbed if taken with food.

Yesterday’s Mind Teaser: Which of the following is not true about papular pruritic eruption in HIV infection?

a. It is one of the earliest manifestations of HIV infection.
b. It is an HIV-specific cutaneous manifestation.
c. Arthopod bites have been postulated to be one of the causative factors.
d. It does not serve as a cutaneous marker of underlying immune status.

Answer for yesterday’s Mind Teaser: d. It does not serve as a cutaneous marker of underlying immune status.

Correct answers received from: Dr K V Sarma, Dr Jainendra Upadhyay, Dr Avtar Krishan, Dr Shanta Haridas, Dr Poonam Chablani, Dr Prakash Khalap, Dr Jainendra Upadhyay, Dr KV Sarma, Dr AK Gajjar.

Answer for 9th Oct Mind Teaser: Most of the children present with clinical symptoms during the neonatal period.

Correct answers received from: Dr AK Gajjar.

Send your answer to email

medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Editor eMedinewS and President Heart Care Foundation of India)

Not disclosing the names of doctors in the surgical team may be deficiency of service

Recently, the Kerala State Consumer Disputes Redressal Commission presiding members M.K. Abdulla Sona and A. Radha directed the Travancore-Cochin Medical Councils-Kerala (TCMC-K) to instruct all doctors to display their medical council registration numbers on their signboards and quote the register numbers in all prescriptions and all case sheets. The commission said that using the registration number in the doctors’ prescriptions, case-sheets and signboards would help patients to get all information about the doctor including their competency and possessed the required qualifications.

The commission said that the patient/consumer has the right to know the details of each doctor who accompanied the leader of the surgical team, including the anaesthesiologist. Any denial of this would be considered a deficiency of service and an unfair trade practice under the provisions of the Consumer Protection Act.

medicolegal update
  1. Dear Dr. K.K Aggarwal, Read the WHO letter written by J&K Doctors. I strongly feel that sharing false allegations of some people will only malign the reputation of India and would wash away the ever giving character of Indian Army. To glorify IMA at any cost is not a justified thing… feeling very sorry to read all this in eMedinewS. I strongly condemn these types of articles openly. Jai Hind, Dr. Ashutosh Aggarwal.

eMedinewS Special

1. IJCP’s ejournals (This may take a few minues to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)