eMedinewS
10th December 2014, Wednesday

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

Blood Sugar Goals

Correction and prevention of low blood sugar is beneficial to hospitalized patients.

For most non-critically ill hospitalized patients with diabetes, one should have a target blood sugar of <180 mg/dL. In non-critically ill hospitalized patients, lower blood glucose levels may decrease the risk of poor clinical outcomes, but also increase the risk of hypoglycemia. A reasonable sugar goal to avoid low blood sugar is to achieve fasting blood glucose concentrations no lower than 90 to 100 mg/dL.

Preventing a Peptic Ulcer

An ulcer is a breakdown in the lining of the stomach or the first part of the small intestine. A type of bacterial infection is the most frequent cause, but lifestyle factors may also raise the risk.

One may follow these preventive steps that may ward off a peptic ulcer:

  1. Limit alcohol to no more than two drinks daily.
  2. Stop smoking or chewing tobacco.
  3. If you need to take painkillers, avoid anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen or aspirin.
  4. Consider, with your doctor's approval, paracetamol instead.

NATIONAL NEWS

Proceedings of 66th Annual Conference of Cardiological Society of India (4-7th December, Hyderabad)

Harvey Feigenbaum, USA

Future of Echocardiography as I visualize it in 2025

  • Primary echocardiography will change from 2D to 3D as the 3D frame rate increases and storage and retrieval of large 3D data sets improve. 2D views will be derived from the 3D data sets
  • Stand alone 2D examinations will be used when higher temporal resolution is required
  • Speckle tracking, strain measurements of the left ventricle, left atrium and right ventricle will be a routine part of all echo examinations
  • There will be a major effort toward automated echo interpretations and maintain quality control of echo
  • Contrast echocardiography will finally be approved and used worldwide for myocardial perfusion
  • Echocardiographic holography will be available for visualizing and manipulating the heart as if it is in your hand
  • Echocardiographic hand held devices will have a digital output which can be seen on smart phones.

Echocardiography will continue to be the imaging backbone of cardiology

Central Aortic Pressure: Clinical Impact 2014 (Dr C Venkata S Ram, USA)

  • The mortality risk in hypertensives is still higher than in normotensives.
  • ASCOT BPLA: The amlodipine-based regimen prevented more major cardiovascular events and induced less diabetes than the atenolol-based regimen (Lancet. 2005 Sep 10-16;366(9489):895-906)
  • Measurement of brachial blood pressure (BBP) may not offer accurate representation of degenerative changes associated with CVD.
  • Studies have advocated that medications with similar effects on BBP may show different effects on central aortic pressure (CAP).This change in drug effect may result in overestimation or underestimation of drug effectiveness.
  • Brachial pressure does not predict central pressure
  • Measures of central hemodynamics have been shown to be independently associated with target organ damage and incident CVD.
  • Data suggest that aortic PP predicts CV events better than brachial PP. Therefore, central pressure may improve identification and management of patients with elevated cardiovascular risk.

Value of imaging in HF patients (Dr Fausto J Pinto, Portugal)

  • Various imaging modalities in HF: Echo, radionuclide imaging, CMR, CT, PET. These various modalities should be viewed as complementary and not comparative.
  • Imaging helps to assess LV function and, define prognosis as well as to establish, monitor and follow up a therapeutic strategy. We can look at parameters of myocardial deformation and function.
  • CMR is being increasingly used and within the next 5-10 years, we may see CMR as we see echo today.

News Around The Globe

  • For women who are shown to have dense breasts on mammography screening, the addition of ultrasound screening has little impact on outcome, increases harms, and dramatically increases costs, suggests a report published online December 8 in the Annals of Internal Medicine.
  • Vitamin D-3 absorption from a dietary supplement can be significantly improved by taking it with a meal that contains fat, suggests new research published online in the Journal of the Academy of Nutrition And Dietetics.
  • Both single- and dual-hormone artificial pancreas systems provide better glycemic control than the conventional insulin pump, suggests a report published online in The Lancet Diabetes & Endocrinology.
  • One-quarter of pregnant women with chronic hepatitis B virus (HBV) infection go on to develop increased liver inflammation after giving birth, although these flare-ups are typically asymptomatic and resolve within a year, suggests a new prospective study published online in Gut.
  • Patients with wet age-related macular degeneration (AMD) that becomes refractory to intravitreal ranibizumab therapy have improved outcomes with a dexamethasone intravitreal implant, points a new study published online in the British Journal of Ophthalmology.

IMA News

The IMA CWC news, 7-12-2014,Tirupati,Fortune Kances Hotel.

  1. Govt's proposed amendment bill to MTP act that could allow quacks to do abortions, was unanimously and strongly opposed in the house.
  2. House recommended to Constitute the protocols for all free medical &Surgical camps to be followed by medical fraternity.
  3. IMA CWC house vociferously opposed the cross-pathy practices and decided to fight tooth and nail against govt's erroneous proposals of encouraging AYUSH doctors to do modern medicine & and the proposed bill to recognize new systems in medicine.
  4. IMA in Seva: Promoting "antibiotic awareness", "cleanliness in hospitals-Swachh Medical center" and "Reformed code of medical ethics".
  5. Annually only 15,000 doctors are enrolling as its members, where as the country's output of modern doctors is 50000/anum.
  6. IMA CGP has 20000 members and IMA AMS having 11000member strength. The house appealed every modern doctor to enroll in CGP (for MBBS)and AMS(for specialists) to empower their skills and to improve the CME credit-hour score..
  7. IMA NSSS(IMA national social security scheme) with the strength of about 14000members is running on good steam and providing relief to grieved families.
  8. IMA Disaster management doing wonderful job. it financed about Rs.23 lacs to construct medical facility at govind ghat in flood effected uttaraanchal.
  9. IMA professional protection scheme has only 600 members in its rolls.
  10. IMA Student's wing is gaining strength year by year with more number of medical colleges coming under its fold.
  11. Due to untiring and committed sensitization programs organized by IMA with GFATM RNTCP project, almost 70000 T.B. cases were notified in previous year. this is a major achievement in our service projects.

    DR. C. SRINIVASA RAJU

Dr KK Spiritual Blog

Five Types of People from Nastik to Astik

Following are the five types of people

  1. Nastik – the one who believes in God.
  2. Astik – for whom God exists.
  3. For them the God also exists in them (I and the God are the same)
  4. Tatvamase (God not only exists in me but also in you)
  5. God is in everybody

People who believe that God exists are fearful people and they always fear God. People who see God in themselves, live a disciplined Satvik life and do not indulge in activities which are not God-friendly.

People who believe that God is not only in me but you also, treat every person the same way as they treat themselves.

People for whom God is everywhere always work for the welfare of the society.

Inspirational Story

Laughter is the Best Medicine

Many years ago, Norman Cousins was diagnosed as “terminally ill”. He was given six months to live. His chance for recovery was 1 in 500.

He could see the worry, depression and anger in his life contributed to, and perhaps helped cause, his disease. He wondered, “If illness can be caused by negativity, can wellness be created by positivity?”

He decided to make an experiment of himself. Laughter was one of the most positive activities he knew. He rented all the funny movies he could find – Keaton, Chaplin, Fields, the Marx Brothers. (This was before VCRs, so he had to rent the actual films.) He read funny stories. He asked his friends to call him whenever they said, heard or did something funny.

His pain was so great he could not sleep. Laughing for 10 solid minutes, he found, relieved the pain for several hours so he could sleep. He fully recovered from his illness and lived another 20 happy, healthy and productive years. (His journey is detailed in his book, Anatomy of an Illness.) He credits visualization, the love of his family and friends, and laughter for his recovery.

Some people think laughter is a waste of time. It is a luxury, they say, a frivolity, something to indulge in only every so often. Nothing could be further from the truth. Laughter is essential to our equilibrium, to our well-being, to our aliveness. If we’re not well, laughter helps us get well; if we are well, laughter helps us stay that way.

Since Cousins’ ground-breaking subjective work, scientific studies have shown that laughter has a curative effect on the body, the mind and the emotions. So, if you like laughter, consider it sound medical advice to indulge in it as often as you can. If you don’t like laughter, then take your medicine – laugh anyway.

Use whatever makes you laugh – movies, sitcoms, Monty Python, records, books, New Yorker cartoons, jokes, friends. Give yourself permission to laugh – long and loud and out loud – whenever anything strikes you as funny. The people around you may think you’re strange, but sooner or later they’ll join in even if they don’t know what you’re laughing about.

Some diseases may be contagious, but none is as contagious as the cure… laughter.

Rabies News (Dr A K Gupta)

What are most dangerous sites of bites/exposure in man?

Theoretically, the richly innervated areas like head, neck, face, hands and genitals are the most dangerous sites of bite in man. But practically, it is often the wounds on legs, which are ignored/neglected, that cause rabies.

emedipicstoday emedipics

Heart Care Foundation of India announces the Mrs Abheeta Khanna Oration On Excellence In Sports And Health Journalism

video of day
press release

Treating vitamin D deficiency in the country

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 – 101090 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: A patient with erectile dysfunction came with chest pain.
Dr Bad: Its non cardiac.
Dr Good: This pain can be cardiac in origin.
Lesson: Men who present with erectile dysfunction may be at higher risk for subsequent development of cardiovascular events.

Make Sure

Situation: A patient with pygenic meningitis developed complications.
Reaction: Oh My God! Why were antibiotics not given when the meningitis was suspected?
Lesson: Make sure that first dose of antibiotics is given at the time meningitis is suspected.

eMedinewS Humor

The world’s thinnest book has only one word written in it: "Everything"; and the book is titled: "What Women Want!"

Twitter of the Day

Dr KK Aggarwal: Poly Diet and Poly Drugs by Dr k k Aggarwal
Dr Deepak Chopra: To see God without illusions, we’ve had to overturn conventional religion

Cardiology eMedinewS

  • Results from the AUGMENT HF trial, presented at the American Heart Association (AHA) 2014 Scientific Sessions, have stated that an injection of the novel hydrogel Algisyl-LVR hydrogel into the left ventricular myocardium of patients with advanced heart failure was safe and improved functional and clinical end points over 6 months.
  • Emerging research is shedding new light on the possible involvement of cardiac factors in sudden unexpected death in epilepsy (SUDEP). Increasing evidence suggests that cardiac arrhythmia precedes SUDEP. The findings were presented at the American Epilepsy Society (AES) 68th Annual Meeting.

Pediatrics eMedinewS

  • Infants with life-threatening or complex, chronic conditions are the most vulnerable to RSV-associated death, suggests a new study published online December 8 in Pediatrics.
  • A new study published online in BMJ has stated that prenatal and early-life exposure to antibiotics does not seem to cause asthma in children. Instead, genetic predisposition to respiratory infections and asthma, consultation patterns or other home and environmental factors, together with confounding by respiratory infections, seem to have biased previous results.

Quote of the Day

  • He who closes his ears to the views of others shows little confidence in the integrity of his own views. William Congreve

Wellness Blog

5 Ways to Stop A–Salting Your Kidney

Eating white salt is like a slow poison. If the amount of salt is reduced to less than 1 teaspoon per day, a large percentage of people with high blood pressure will become normal blood pressure patients. High salt intake via increase in blood pressure leads to kidney damage over a period of time and kidney failure. Consume less–anything which is artificially white in feature–white sugar, white maida and white rice.

Most people who have presence of high salt in their body will have characteristic feature of liking to both ice cold as well as boiling beverages.

5 tips to reduce salt in your diet

  1. Make reading food labels a habit. Sodium content is always listed on food labels. Sodium content can vary from brand to brand, so compare and choose the lowest sodium product. Certain foods don’t taste particularly salty but are actually high in sodium, such as cottage cheese, so it’s critical to check labels.
  2. Stick to fresh meats, fruits and vegetables rather than their packaged counterparts, which tend to be higher in sodium.
  3. Avoid spices and seasonings that contain added sodium, for example garlic salt. Choose garlic powder instead.
  4. Many restaurants list the sodium content of their products on their websites, so do your homework before dining out. Also, you can request that your food be prepared without any added salt.
  5. Try to spread your sodium intake out throughout the day; it’s easier on your kidneys than eating lots of salt all at once.

ePress Release

Heart Care Foundation of India announces the Mrs Abheeta Khanna Oration On Excellence In Sports And Health Journalism

Heart Care Foundation of India, a leading National not for profit organization aimed at creating health awareness amongst the masses today announced an oration on excellence in sports and health journalism. The annual oration has been created in fond memory of the NGO’s former Communications Director, Mrs. Abheeta Khanna.

The memorial began with a short address by Padma Shree awardee Dr. KK Aggarwal, President Heart Care Foundation of India and Mr. Surinder Khanna, former player of the Indian Cricket team and husband of late Mrs. Abheeta Khanna. All the employees of Heart Care Foundation of India also remembered her lively spirit and enthusiasm for her work.

The details of the oration were then announced including the eligibility criteria, award amount and the details of the jury.

  • Any journalist who has contributed to the field of health and sports in the year December 2014 – 2015 will be eligible for the award.
  • The winner will be chosen by an expert panel comprising of four eminent personalities, two each from the field of sports and medicine.
  • The names of the jury members include Dr KK Aggarwal, Dr Yash Gulati, Dr. Veena Aggarwal, Mr. Surinder Khanna, Mr. Vijay Lokapalli and Mr ChanderShekhar Luthra.
  • The applications will be open from July 1 to 31st August 2014
  • The name of the awardee will be announced on Mrs. Khanna’s first death anniversary, November 26th 2015.

All the details of the award, application form and other details will be available on the NGO’s website heartcarefondation.org starting January 2014.
The award winner will be facilitated with Rs. 11,000 in cash along with a citation and memento.

Speaking on the occasion, Padma Shri Awardee and the President of Heart Care Foundation of India, Dr KK Aggarwal said, ”Mrs. Abheeta Khanna was associated with Heart Care Foundation of India since over 20 years. She played an instrumental role in helping build the NGO to the level it is at today and her enthusiasm, dedication and will to always make a difference in everyone’s lives will greatly be missed. We hope that through this oration, we can help honor the field she worked with most closely and thereby keep her alive amongst all of us.”

Adding to this Mr. Surinder Khanna, renowned former cricket player of the Indian Cricket team and Mrs. Khanna’s husband said, “Abheeta was a warm, loving and large hearted person who brought a smile on the face of everybody she interacted with. She worked relentlessly to promote the causes she believed in and her association with Heart Care Foundation of India helped her do this. This award is the best way to commemorate the work that she had done with the organization.'

eMedi Quiz

The following separation technique depends on the molecular size of the protein:

1.Chromatography on a carboxymethyl (CM) cellulose column.
2.Iso-electric focusing.
3.Gelfiltration chromatography.
4.Chromatography on a diethylaminoethly (DEAE) cellulose column.

Yesterday’s Mind Teaser: An enzyme involved in the catabolism of fructose to pyruvate in the liver is:

1.Glyceraldehyde-3-phosphate Dehydrogenase.
2.Phosphoglucomutase.
3.Lactate-dehydrogenase.
4.Glucokinase.

Answer for yesterday’s Mind Teaser: 1.Glyceraldehyde-3-phosphate Dehydrogenase.

Correct answers received from: Dr Rakesh Sharma Nohar, Dr Avtar Krishan, Dr K V Sarma.

Answer for 8th December Mind Teaser: 4. Progesterone therapy.

Correct answers received from: Dr Rakesh Sharma Nohar, Dr Jainendra Upadhyay, Tukaram Pagad, Dr K V Sarma.

Send your answer to email

medicolegal update

(Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS)

Is an approval of clinic for MTP required?


Vide Regulation 7, no entry shall be made in any case–sheet, operation theatre register, follow–up card or any other document or register (except the admission register) maintained at any hospital or approved place indicating there in the names of the pregnant woman and reference to that woman shall be made therein by the serial number assigned to such woman in the admission register.

No place shall be approved under clause (b) of section 4,

  • unless the government is satisfied that the termination of pregnancies may be done therein under safe and hygienic conditions; and
  • unless the following facilities are provided therein, viz., an operation table and instruments for performing abdominal and gyanecological surgery; anaesthetic equipment, resuscitation equipment and sterilization equipment; Drugs and parenteral fluid for emergency use.

The Chief Medical Officer of the district may, if he is satisfied after such verification, enquiry or inspection, as may be considered necessary that termination of pregnancy may be done under safe and hygienic conditions, at a place, recommend the approval of such place to the government.

medicolegal update
  1. Dear Sir, Very Informative. Regards: Dr Karan

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)