eMedinewS10th December 2013,Tuesday

Dr K K AggarwalPadma 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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; 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.facebook.com/Dr KKAggarwal

Healthy obesity does not exist

New research published online in the Annals of Internal Medicine suggests that individuals cannot be simultaneously overweight and physically fit.

As BMI rose, so rose blood pressure, waist circumference and insulin resistance. As BMI increased, levels of HDL cholesterol, thought to protect against heart attack and stroke, decreased.

While participants who were either overweight or obese "may not yet have reached the points that define metabolic illness, they appeared to be on that road as their weight" increased.

Acute kidney injury in AMI more deadly

Patients with acute kidney injury and myocardial infarction later experienced more major heart and kidney problems than those with MI alone. In a CJASN study, deaths occurred most often in patients who experienced both AKI and MI (57.5%), and least often in patients with uncomplicated admissions for MI (32.3%).

High HgbA1c linked to hypoglycemia in diabetics with kidney failure

There is a link between high baseline HbA1c and an increased risk for hypoglycemia hospitalization in a retrospective study of patients with diabetes enrolled in a large hemodialysis program. Higher baseline HbA1c was also associated with greater variability in HbA1c levels.

The investigators suspect that the greater risk of severe hypoglycemia associated with high HbA1c may derive from glucose variability during treatment for hyperglycemia. The study is published in Hemodialysis International.

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 mantra
VIP’s on CPR 10 Mantra Video
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

Rome was not built in a day

sprritual blog

With ‘Abhyas’ or constant practice, one can conquer all the obstacles in life. The sutra "Rome was not built in a day" has a deep spiritual meaning. In the path for self–realization, regular practice is the principle behind all paths: Bhakti, Karma or the Gnana marg. Persistence is the key in any spiritual attainment.

Regular hard work can also change one’s past bad karmic actions. All karmas irrespective of their nature should be converted into good karmas. This can be better understood by the following example. While painting a red colored wall with green paint with the intention to make it green, it first gets converted into yellow color. But repeated painting with green will ultimately make it green.

The red color here can be compared to bad past karmas and green color to good present karmas. By doing positive activities time and again, one can dissolve the impressions of the bad actions done in the past. To start with, there may be a reaction from the others (which is equivalent to the yellow color in the above example) but if the person does not lose his confidence at that moment and continues with his good present karmas, he will ultimately end up in changing his bad past converting it into a good present and a better future. This requires continuous and repeated practice.

Self–realization and meditation are difficult processes. They involve attaining a thoughtless state, in other words, a state of experiencing the silence. All the paths for self realization are difficult, but with regular practice, one can achieve it without any problem. The path of Bhakti is often considered the path of choice for the majority of people as it is the easiest path to follow. The path of Bhakti involves a triad of "duty, devotion and discipline". But any duty, devotion or discipline done only for a short time will not end in success, unless it is practiced over a longer period of time.

A classical example can be seen in Islam. Ramadan is a classical example of hard work leading to an atmosphere of brotherhood, love, compassion and truthfulness with significant reduction in negativity amongst the community. For one month, all the Muslims participate in a self-training programme to reduce negativity and build positivity in their lives. During this month they are prohibited from indulging in sexual activities, entering into marriage ceremonies, and are encouraged to make endeavors towards self realization. The classical discipline to be maintained is fasting. Fasting here does not mean only fasting food or water alone. It also means controlling negative thinking, negative speech, and indulging in any negative action.

The Bhagavad Gita has described the five gateways to hell as attachment, desire, anger, greed and ego. Controlling them requires practice. A month of observance of controlling one’s five senses and not indulging in the five gateways of hell trains one enough to make these parameters a part of one’s life. The positive attitude practiced over one month tends to stitch it in one’s consciousness, and ultimately in a majority, becomes a part of one’s life.

The same practice is also there in Hindu religion during "Navratras", but unfortunately, not all people observe this as dedicatedly as the Muslims. Any Muslim not observing Ramadan is not considered a true Muslim but such is not the case in Hinduism.

Apart from the internal journey to self–realization, hard work plays a role even in day–to–day outer journeys be it married life, family life, social life or office life.

Hard work is the key to success, provided one controls the above five gateways to hell and practices the triad of non–expectation, detachment and being non–judgmental. Attaching oneself with actions but detaching from the results is the key to both internal as well as external success.

cardiology news

A Fresh Look at Marriage

He met her at someone’s wedding. He requested her to have coffee with him, she was surprised but being polite, she promised. They sat in a nice coffee shop, he was too nervous to say anything, she felt uncomfortable, and she thought to herself, "Please, let me go home…"

Suddenly he asked the waiter, "Would you please give me some salt? I’d like to put it in my coffee." Everybody stared at him, so strange! His face turned red but still, he put the salt in his coffee and drank it. She asked him curiously, "Why you have this hobby?" He replied, "When I was a little boy, I lived near the sea, I liked playing in the sea, I could feel the taste of the sea, just like the taste of the salty coffee. Now every time I have the salty coffee, I always think of my childhood, think of my hometown, I miss my hometown so much, I miss my parents who are still living there." While saying that tears filled his eyes. She was deeply touched. That was his true feeling, from the bottom of his heart. A man who can speak out his homesickness, he must be a man who loves home, cares about home, has responsibility of home… Then she also started to speak, spoke about her faraway hometown, her childhood, her family.

That was a really nice talk, also a beautiful beginning of their story. They continued to date. She found that actually he was a man who met all her demands; he had tolerance, was kind hearted, warm, careful. He was such a good person but she almost missed him! Thanks to his salty coffee! Then the story was just like every beautiful love story, the princess married to the prince, and then they were living the happy life… And, every time she made coffee for him, she put some salt in the coffee, as she knew that's the way he liked it.

After 40 years, he passed away, left her a letter which said, "My dearest, please forgive me, forgive my whole life’s lie. This was the only lie I said to you…the salty coffee. Remember the first time we dated? I was so nervous at that time, actually I wanted some sugar, but I said salt. It was hard for me to change so I just went ahead. I never thought that could be the start of our communication! I tried to tell you the truth many times in my life, but I was too afraid to do that, as I have promised not to lie to you for anything… Now I’m dying, I afraid of nothing so I tell you the truth, I don’t like the salty coffee, what a strange bad taste… But I have had the salty coffee for my whole life! Since I knew you, I never feel sorry for anything I do for you. Having you with me is my biggest happiness for my whole life. If I can live for the second time, still want to know you and have you for my whole life, even though I have to drink the salty coffee again."

Her tears made the letter totally wet. Someday, someone asked her, "What’s the taste of salty coffee?" She replied, "It’s sweet."

This is a little bit unrealistic story but the moral and the message of the story is wonderful…

News Around The Globe


  • Most epilepsy patients who became seizure–free after surgical therapy remained so when they stopped taking anti–epileptic drugs (AEDs), usually after a year or two, according to a retrospective study reported at the American Epilepsy Society annual meeting. In the minority of patients who experienced seizure recurrence after stopping AEDs, resumption of drug therapy restored seizure freedom in most cases
  • According to a study reported at the Radiological Society of North America meeting, ablating tumors with sound waves may eventually be one way to treat breast cancer. In the study, 10 out of 12 patients had successful tumor ablation with magnetic resonance (MR)–guided focused ultrasound. But two of those patients had residual tumor left after the procedure, due to a transducer malfunction.
  • Findings from a retrospective case series presented at the American Society of Hematology meeting show that those older patients with advanced or poor–risk hematologic malignancies, including multiple myeloma, seemed to have survival outcomes similar to that of younger patients following nonmyeloablative haploidentical bone marrow transplantation. The estimated 2–year progression–free survival (PFS) ranged from 36% to 39% in patients aged 50 to 59, 60 to 69, and 70 to 75, and estimated overall survival (OS) in the three age groups was 44% to 56%.
  • As reported November 21 online in Annals of the Rheumatic Diseases, Gout clusters within families, and shared environmental factors play a part. In the study, the relative risk of gout was significantly higher in those with first–degree relatives with the disease (1.91 for men and 1.97 for women). For second–degree relatives these relative risks were 1.27 and 1.40.
  • Patients with RA who use biological disease–modifying anti–rheumatic drugs (bDMARDs) are more likely to have clinically relevant improvement in physical function compared with patients taking nonbiologic DMARDs (nbDMARDs), according to a meta–analysis reported in an article published online August 14 and in the December issue of Rheumatology.

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Rabies News (Dr. A K Gupta)

Can a vaccinated dog transmit rabies? How effective is dog vaccine?

If a potent veterinary vaccine is given correctly as per pre–exposure schedule, it will mostly prevent rabies in the vaccinated dog, unless the exposure is severe. Ideally, its sera should be tested for protective antibody titre level but this is rarely practicable due to scare facilities in our country. Consequently, PEP vaccination is recommended following bites even by vaccinated dogs. It has been noted that:

(1) 6% of dogs found rabid have a reliable pre–exposure rabies vaccine history
(2) 40% of dogs vaccinated only one time lost most of their immunity 4–6 months later.
(3) Post Exposure Prophylaxis (PEP) vaccination is not very successful in dogs.

cardiology news

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

  • Although some studies indicate that women may have a greater risk of a myocardial infarction or death because of atypical symptoms, a study using coronary computed tomography angiography indicates that bad outcomes are not determined by sex. Major adverse cardiovascular events – heart attacks or death – occurred in 0.3% of women who were found to be free of coronary artery disease and in 1.2% of women who had mild, but nonobstructive coronary artery disease, compared with 0.3% of men with no heart disease observed with the imaging technology and 1.1% of men with some nonobstructive heart disease. The findings were presented at the annual meeting of the Radiological Society of North America.
  • Enhanced pacemaker technology sharply reduced progression of nonpermanent atrial fibrillation to permanent AF in patients with bradycardia and sinus node disease in the large international, randomized MINERVA trial. In the MINERVA (Minimize Right Ventricular Pacing to Prevent Atrial Fibrillation and Heart Failure) study, the use of dual–chamber pacemakers containing features for atrial preventive pacing and atrial antitachycardia pacing, called DDDRPs, plus managed ventricular pacing (MVP) resulted in a 61% reduction in the incidence of permanent AF during 2 years of prospective follow-up, compared with conventional dual–chamber pacing, Dr. Giuseppe Boriani reported at the American Heart Association scientific sessions.
cardiology news

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

  • Adding gemtuzumab ozogamicin to the treatment regimen can improve event–free survival in children, adolescents, and young adults with acute myeloid leukemia (AML). The addition of this drug appears to lower the risk for relapse among those who have achieved remission, according to new data presented here at the American Society of Hematology (ASH) 55th Annual Meeting. Gemtuzumab ozogamicin is not currently available; it was marketed as Mylotarg (Pfizer) but was voluntarily withdrawn in 2010. However, it is still being investigated in clinical trials, and positive results from several trials during the last few years have led to calls for the drug to be returned to the market.
  • According to findings from a new study, implementation of bronchiolitis guidelines for infants is associated with significant reductions in the use of emergency department resources. The findings are reported online December 9 in Pediatrics.
cardiology news

Working hard when tired is not good for the health

Doing mental or physical work while exhausted may harm your health, according to a study from University of Alabama at Birmingham and published in International Journal of Psychophysiology. Fatigued people have bigger spikes in blood pressure than well–rested people while doing a memorization test.

When fatigued people regard a task as worthwhile and achievable, they increase their effort to compensate for their diminished capability. As a result, the blood pressure of a tired person increases and remains elevated until the task is completed or the person gives up.

In this study, Wright and colleagues told 80 volunteers they could win a modest prize by memorizing two or six nonsense trigrams (meaningless, three–letter sequences) within 2 minutes. Compared to volunteers with low levels of fatigue, those with moderate fatigue had stronger blood pressure while doing the two–trigram memorization task.

cardiology news

Total CPR since 1st November 2012 – 77787 trained

Media advocacy through Web Media

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press release

6% of young Indians suffer from heart disease Mean age of first heart attack in Indians: 53 years 5–10% of heart attacks occur in Indian men and women younger than 40 years

According to the Global Burden of Disease Study, the developing countries contributed 3.5 million of the 6.2 million global deaths from CAD in 1990. The prevalence of CAD in India has more than doubled in the past two decades, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India. Coronary artery disease (CAD) occurs when the arteries that supply blood to the heart muscle harden and narrow.

India topped the world with 1,531,534 cardiovascular disease–related deaths in 2002, and based on WHO report, 2009, CAD currently occupies the first place in cause of death.

It is estimated that 9.2 million productive years of life were lost in India in 2000, with an expected increase to 17.9 million years in 2030.

Salient features of the CAD epidemic in India

  • Incidence of CAD in young Indians is about 12–16%, which is higher than any other ethnic group
  • Age–standardized estimates for Disability–adjusted life lost due to CAD per 1,000 population in India are three times higher than in developed countries
  • About 5–10% of heart attacks occur in Indian men and women younger than 40 years
  • Median age of first heart attack in Indians is 53 years
  • 1,55,88,000 DALYs (WHO, 2009).

About HCFI : The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National Commemorative stamps and one cancellation stamp, and who has conducted one to one training on" Hands only CPR" of 77787 people since 1st November 2012.

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."

emedipicstoday emedipics

CPR 10 Training Camp at Bal Bharti Public School, Dwarka

press release

White rice linked to diabetes in Asians

vedio of day

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

At the end of a balanced anaesthesia technique with non–depolarizing muscle relaxant, a patient recovered spontaneously from the effect of muscle relaxant without any reversal. Which is the most probable relaxant the patient had received?


Yesterday’s Mind Teaser: An increase in which of the following parameters will shift the O2 dissociation curve to the left.

1. Temperature.
2. Partial pressure of CO2
3. 2,3 DPG concentration.
4. Oxygen affinity of haemoglobin.

Answer for yesterday’s Mind Teaser: 4. Oxygen affinity of haemoglobin.

Correct answers received from: Dr Ajay Gandhi, DR.A.K.GAJJAR, Dr.Bitaan Sen & Dr.Jayashree Sen, DR ARPAN GANDHI, Dr Chandresh Jardosh, daivadheenam, DR AVTAR KRISHAN, DR.A.K.GAJJAR, Dr. P. C. Das, Dr.Bitaan Sen & Dr.Jayashree Sen, Dr. SUSHMA CHAWLA

Answer for 8th December Mind Teaser: 3.Atracurium.

Correct answers received from: Daivadheenam, DR AVTAR KRISHAN, Dr.K.V.Sarma

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medical querymedical query

medicolegal update

Customer: I have a huge problem. A friend has placed a screen saver on my computer, but every time I move the mouse, it disappears.

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal updatemedicolegal update

medicolegal update

Situation: A foreigner with a single loose stool developed sepsis.
Reaction: Oh my God! Why were antibiotics not started in time?
Lesson: Make sure that all foreigners are diagnosed to be suffering from Traveler’s diarrhea even if there is one single loose motion.

medicolegal update

Happy is the man who can do only one thing; in doing it, he fulfills his destiny. Joseph Joubert

medicolegal update

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: No regrets and no anticipation, just this moment fresh and as is.

Forthcoming events

5th eMedinews Revisiting 2013

(a day long single hall medical conference on 2013 happenings, followed by doctors of the year 2013 awards)

Sunday 19th January 2014, Maulana Azad Medical College Auditorium

Dilli Gate Delhi, 10 am-6 pm

Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee President
Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman
Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

5th eMedinewS Revisiting 2013
The 5th eMedinewS–revisiting 2013 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 19th 2014.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2013. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. Lunch will be provided.

Register at: rawat.vandana89@gmail.com/drpawangupta2006@yahoo.com

5th eMedinewS Doctor of the Year Awards
Nominations invited for 5th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2013.

pls send his/her Biodata at: emedinews@gmail.com

medicolegal update
  1. Australia also claimed similar thing few years back. But measles is back. Reason there are many parents who do not get their children vaccinated because of their faith. Same may happen in USA. Let us wait for some time.

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Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Prof.(Dr).C V Raghuveer

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