eMedinewS10th September 2013, Tuesday

Dr K K 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; 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

Supreme Court blow on private medical colleges

Private technical and medical colleges demanding capitation fee from students is illegal and unethical. Supreme Court has asked the Centre to make laws to put an end to such practices which deny admission to meritorious financially poor students in those institutions.

Excerpts from the order by bench of Justices K S Radhakrishnan and A K Sikri

  • Collection of large amount by way of capitation fee running into crores of rupees for MBBS and postgraduate seats, exorbitant fee, donation etc, by many of such self- financing institutions, have kept the meritorious financially poor students away from those institutions.
  • Pressure, it is also seen, is being extended by various institutions, for the additional intake of students, not always for the benefit of the student community and thereby serve the community, but for their own betterment.
  • We cannot lose sight of the fact that these things are happening in our country irrespective of the constitutional pronouncements by this court in TMA Pai Foundation case that there shall not be any profiteering or acceptance of capitation fee etc.
  • Central Government, Ministry of Health and Family Welfare, CBI, or the Intelligence Wing have to take effective steps to undo such unethical practices or else self-financing institutions will turn to be students financing institutions.

….Read More

5 foods that fight high cholesterol

  • Oats give you soluble fiber. Add a banana or some strawberries for more soluble fibers.
  • Beans are especially rich in soluble fiber. They also take a while for the body to digest, meaning you feel full for longer after a meal.
  • Nuts: Eating almonds, walnuts, peanuts and other nuts is good for the heart. Eating 2 ounces of nuts a day can slightly lower LDL by about 5%. Nuts have additional nutrients that protect the heart in other ways.
  • Foods fortified with sterols and stanols. Companies are adding them to foods ranging from margarine and granola bars to orange juice and chocolate. They’re also available as supplements. Getting 2 grams of plant sterols or stanols a day can lower LDL cholesterol by about 10%.
  • Fatty fish. Eating fish 2 to 3 times a week can lower LDL in two ways: by replacing meat, which has LDL–boosting saturated fats and by delivering LDL–lowering omega-3 fats.

Stay away from saturated and trans fats

Saturated fats are found in red meat, milk and other dairy foods and coconut and palm oils. Trans fats are a byproduct of the chemical reaction that turns liquid vegetable oil into solid margarine or shortening and that prevents liquid vegetable oils from turning rancid. Trans fats boost LDL as much as saturated fats do. They also lower protective HDL, rev up inflammation and increase the tendency for blood clots to form inside blood vessels. ….Read More

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."

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

Ringtone – CPR 10 Mantra English

sprritual blog Spiritual Prescription: The Role of Prayer in Healing

Religious beliefs may have a powerful influence on the health of our patients, and we need to know about them.

A large and growing number of studies have shown a direct relationship between religious involvement and positive health outcomes, including mortality, physical illnesses, mental illness, health–related quality of life and coping with illness.

Studies also suggest that addressing the spiritual needs of patients may facilitate recovery from illness. A majority of the nearly 350 studies of physical health and 850 studies of mental health that have used religious and spiritual variables have found that religious involvement and spirituality are associated with better health outcomes.

Although the relationship between religious involvement and spirituality with health outcomes seems valid, it is difficult to establish causality. The benefits of religious and spiritual involvement are likely conveyed through complex psychosocial, behavioral and biological processes that are incompletely understood.

All physicians should take a spiritual history of their patients, which could help discern their spiritual needs during treatment.

According to Dr. Harold Keonig of Duke University Medical Center in majority of cases, the doctor should not attempt to address complex spiritual needs of patients. When the patient is reluctant to talk with clergy and prefers to discuss spiritual matters with a trusted physician, taking a little extra time to listen and be supportive is usually all that is required.

Providing support for religious beliefs and practices that do not conflict with medical care may be appropriate, but when beliefs conflict with medical care, it is important not to criticize the belief, but rather to listen, gather information, enter into the patient’s world view and maintain open lines of communication, perhaps enlisting the help of the patient’s clergy.

Recently a study published in the journal Mayo Clinic Proceedings confirmed the importance of religion and spirituality for many patients undergoing medical treatment. The single–center, randomized, double–blind trial was conducted at the Mayo Clinic in Rochester, Minn. from July 4, 1997 to Oct. 21, 1999 and involved 799 male and female coronary care patients aged 18 years or older.

Earlier too, a number of published studies have already assessed the effects of spiritual factors on health care outcomes: 75 percent report a positive effect; 17 percent report no effect; and 7 percent report a negative effect.

In the study, the patients were randomized into the intercessory prayer group and the control group. Intercessory prayer was administered at least once a week for 26 weeks by five intercessors per patient. After 26 weeks, a medical setback (such as death, cardiac arrest, re–hospitalization, coronary revascularization or an emergency department visit for cardiovascular disease) occurred in 25.6 percent of the prayer group and 29.3 percent of the control group. Among high–risk patients, such a setback occurred in 31 percent of the prayer group and 33 percent of the control group. Among low-risk patients, the difference between the groups was 17 percent for the prayer group and 24 percent for the control group.

Though the results were in favor of prayer yet the study had some limitations, which might have influenced the low positive results. It did not measure the ‘power of God,’ nor was the prayer offered for patients by loved ones, relatives and friends. The researchers said most patients have a spiritual life and regard their spiritual health and physical health as equally important. People may have greater spiritual needs during illness and are looking to have those needs met.

Prayer works on the principle that in the relaxed state, the mind becomes suggestive. The inner healing starts when the intent reaches the inner consciousness or a state of stillness.

Prayer is different from meditation. In Prayer, one is talking to the GOD and in meditation, GOD is talking to you. Meditation is much stronger than prayer as it bypasses the mind and deals with the spirit or the consciousness. In prayer, the mind is in an active working phase. Meditation is the phase of restful alertness.

It all works at the level of autonomic nervous system. The parasympathetic state of mind is the healing state. Both prayer and the meditation take one from sympathetic to the parasympathetic state.

cardiology news

A Short Story on Self Confidence

There was a business executive who was deep in debt and could see no way out. Creditors were closing in on him. Suppliers were demanding payment. He sat on the park bench, head in hands, wondering if anything could save his company from bankruptcy.

Suddenly an old man appeared before him. "I can see that something is troubling you," he said. After listening to the executive’s woes, the old man said, "I believe I can help you."

He asked the man his name, wrote out a check, and pushed it into his hand saying, "Take this money. Meet me here exactly one year from today, and you can pay me back at that time." Then he turned and disappeared as quickly as he had come.

The business executive saw in his hand a check for $500,000, signed by John D. Rockefeller, then one of the richest men in the world!

"I can erase my money worries in an instant!" he realized. But instead, the executive decided to put the uncashed check in his safe. Just knowing it was there might give him the strength to work out a way to save his business, he thought.

With renewed optimism, he negotiated better deals and extended terms of payment. He closed several big sales. Within a few months, he was out of debt and making money once again.

Exactly one year later, he returned to the park with the uncashed check. At the agreed–upon time, the old man appeared. But just as the executive was about to hand back the check and share his success story, a nurse came running up and grabbed the old man.

"I’m so glad I caught him!" she cried. "I hope he hasn’t been bothering you. He’s always escaping from the rest home and telling people he’s John D. Rockefeller." And she led the old man away by the arm.

The astonished executive just stood there, stunned. All year long he’d been wheeling and dealing, buying and selling, convinced he had half a million dollars behind him.

Suddenly, he realized that it wasn’t the money, real or imagined, that had turned his life around. It was his newfound self–confidence that gave him the power to achieve anything he went after.

News Around The Globe

5th Dil Ka Darbar

Date: Sunday, 29th September 2013, Venue: Constitution club of India, Rafi Marg, Time: 8 AM to 6 PM

Programme: A non stop question answer–session between all top cardiologists of the NCR region and the public.

The focus of the discussions will be prevention of heart diseases in women and young men. Special discussion will be held on Sex and Heart Diseases. Practical training will also be given to people on Hands–only Cardiopulmonary Resuscitation. Another focus of the discussion will be the launch of the Project Dhadkan (Palpitations) and Project Murmur (Congenital and valvular heart diseases in children).

Entry free…

cpr10 Mantra Building Partnerships in Healthcare

Dr Vishwas Mehta, Joint Secretary, Ministry of Health and Family Welfare, Got of India visited IMA House on September 4, 2013. His visit was a part of the ‘Building Partnerships in Healthcare’ mission of IMA. Office bearers of IMA and eminent medical professionals from Delhi and NCR were present on the occasion.

  • The American College of Gastroenterology has issued updated guidelines on the diagnosis, workup, nutrition, and management for patients with acute pancreatitis. Two of the following 3 criteria should be present to diagnose acute pancreatitis: Characteristic (severe) abdominal pain, serum amylase and/or lipase exceeding 3 times the upper limit of normal, and/or characteristic abdominal imaging findings (strong recommendation, moderate quality of evidence). The guidelines further recommend a CT scan only to be done when diagnosis is not clear or if patients have not improved 48–72 hours after hospital admission. The new recommendations were published online July 30 and in the September issue of the American Journal of Gastroenterology.
  • New research published online September 4 in Neurology shows that low cardiovascular fitness in men at age 18 is strongly associated with increased risk for epilepsy later on suggesting that cardiovascular fitness may contribute to an increased brain reserve capacity or somehow raise the seizure threshold.
  • The findings, from the Ranibizumab Monotherapy or Combined with Laser vs Laser Monotherapy for Diabetic Macular Edema (RESTORE) trial reported August 22 in JAMA Ophthalmology suggest that ranibizumab alone or in conjunction with laser therapy was associated with better visual outcomes among patients with diabetic macular edema (DME) than laser monotherapy. Ranibizumab is a monoclonal antibody derived from the same mouse antibody as bevacizumab. Both work by blocking the action of vascular endothelial growth factor (VEGF).
  • The use of selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants among women in midlife does not cause a greater rate of bone loss. Among women enrolled in the longitudinal Study of Women’s Health Across the Nation, annual decrease in bone mineral density (BMD) at the lumbar spine averaged 0.63% in new users of SSRIs vs 0.68% in those not taking antidepressants. And among those taking the tricyclic antidepressants, the annual lumbar spine BMD decrease was 0.40% compared with nonusers. The study is reported in the Journal of Clinical Endocrinology and Metabolism. (Source: Medpage Today)
  • In a retrospective cohort study from Australia reported online in the journal Sexually Transmitted Infections, chlamydia infection diagnosed before or during a first pregnancy was linked with an increased risk of spontaneous preterm birth and stillbirth. According to Bette Liu, MBBS, DPhil, of the University of New South Wales in Sydney, Australia, and colleagues, gonorrhea was associated with preterm birth but not stillbirth, and neither infection was linked to having babies small for their gestational age.

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Rabies News (Dr. A K Gupta)

What does humanizing your dog mean?

  1. Talking to your dog like he/she is a person.
  2. Treating your dog like he/she is a person.
  3. Allowing dogs to do what they want because it will hurt their "feelings."
  4. Dressing them up in little doggie clothes.

Remember, humanizing your dog is fulfilling your own human needs, not your dogs. Humanizing dogs does more harm than good.

cardiology news
  • Presenting PURE SODIUM at the European Society of Cardiology (ESC) 2013 Congress, Dr Andrew Mente (McMaster University, Hamilton, ON) and colleagues found that only certain subgroups will actually experience blood–pressure benefits from restricting their sodium consumption. As such, sweeping recommendations for daily sodium limits are likely pointless in many parts of the world. They suggest that a targeted approach would be more appropriate for populations that consume a moderate amount of sodium in the 3–to–5–g/day range, because there would be very little benefit or a modest benefit of getting them down to low levels
  • Waist circumference, which measures abdominal obesity, was a better predictor of 5–year mortality among French survivors of an acute myocardial infarction (MI) than was BMI, according to analysis of data from the French FAST–MI registry by Tabassome Simon, MD, of H˘pital Saint Antoine in Paris.

Valvular Heart Disease News

Vegetations in patients with progressive valve legions are usually located in the arterial surface of incompetent AV valve area, a ventricular surface.

(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)

cardiology news
  • Parents who yell, insult, or swear in an effort to correct bad behavior may perpetuate the behavior and increase a child’s risk for depression. A new study has observed that nearly half of parents (45% to 46% of mothers and 42% to 43% of fathers) reported using harsh verbal language to discipline their 13– and 14–year–old children. Higher exposure to harsh verbal discipline at age 13 predicted increased adolescent behavior problems between the ages of 13 and 14. Also, higher exposure to parental yelling and other forms of harsh verbal discipline at age 13 predicted increased depressive symptoms between the ages of 13 and 14
  • The European Commission has approved canakinumab (Ilaris, Novartis), the first interleukin–1β (IL–1β) inhibitor for the treatment of active systemic juvenile idiopathic arthritis (SJIA) in patients aged 2 years and older who have responded inadequately to previous therapy with nonsteroidal anti–inflammatory drugs (NSAIDs) and systemic corticosteroids. Canakinumab can be used alone or in combination with methotrexate. SJIA is a rare and disabling form of childhood arthritis characterized by prolonged high, spiking fevers; rashes; and arthritis in the small joints of the hands, wrists, knees and ankles.
cardiology news

Red meat consumption linked to increased risk of early death

A study from the Harvard School of Public Health and published in the Archives of Internal Medicine has linked red meat to a higher risk of early death. Eating red meat –– any amount and any type –– appears to significantly increase the risk of premature death, according to the study.

The researchers found that those who increased consumption of unprocessed red meat by one serving each day had an 18 percent higher risk of dying from heart disease and a 10 percent greater risk of dying from cancer, while those who ate one more daily serving of processed red meat had a 21 percent higher risk of dying from heart disease and a 16 percent increased risk of dying from cancer.

The increased risks linked to processed meat, like bacon, were even greater: 20 percent over all, 21 percent for cardiovascular disease and 16 percent for cancer.

The researchers estimate that substituting one daily serving of red meat with fish, poultry, nuts, legumes, whole grains, or low–fat dairy products would reduce the risk of dying in this stage of life by 7–19%.

If people ate less than half a serving of red meat a day, deaths during the 28 years of follow–up could have been reduced by 9.3 percent for men and 7.6 percent for women.

About three years ago, a study by the National Cancer Institute found that people who ate the equivalent of a quarter–pound burger or small steak each day had about a 30% greater risk of dying over 10 years than people who only ate red meat occasionally.

cardiology news

Mrs. Sheila Dikshit, Chief Minister of Delhi to inaugurate the CMAAO India conference

The CMAAO India conference will be inaugurated by Chief Minister of Delhi Smt. Sheila Dikshit on 12th September at Hotel Shangri La, New Delhi at1.30pm. Dr. Naresh Trehan, CMD Medanta–The Medicity will be the Guest of Honour. Dr. Vinay Aggarwal, Past President, IMA will take over as CMAAO President.

cardiology news

Total CPR since 1st November 2012 – 62980 trained

CPR Classes 62980

Media advocacy through Print Media

sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping
sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping

29th August: Veer Arjun

Media advocacy through Web Media

When Constipation May be a Serious Problem 30th August


TB more dangerous than FLU 29th August


Dengue is preventable and manageable

The Dengue situation in the city has created an unnecessary panic, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India, & MTNL Perfect Health Mela.

Dengue is both preventable and manageable. The risk of complications is in less than 1% of dengue cases. If warning signals are known to the public, all deaths from dengue can be avoided.

A platelet transfusion is not needed if the platelet counts are more than 10,000. Unnecessary platelet transfusion can cause more harm.

Most complications of dengue occur after the fever is over. The two days after the last episode of fever are crucial and during this period, a patient should be encouraged to take plenty of oral fluids mixed with salt and sugar. The main complication is leakage of capillaries and collection of blood outside the blood channels leading to intravascular dehydration. Giving fluids orally or by intravenous routes, if given at a proper time, can save fatal complications.

Physicians should remember the ‘Formula of 20’ i.e. rise in pulse by more than 20; fall of BP by more than 20; difference between lower and upper BP less than 20 and presence of more than 20 hemorrhagic spots on the arm after a tourniquet test suggest a high risk situation and the person needs immediate medical attention.

The onus of preventing dengue lies with the public and not with the Government authorities. The dengue mosquitoes are found only in fresh water collected outside the house and not in dirty water in the drains or ‘nallas’, flowing all over the country.

In dengue, one should NOT use aspirin for fever as aspirin also has anti platelet effects.

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 63400 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."

today emedipics

A CPR 10 Training Camp was organized by Heart Care Foundation of India to train the students of Modern School Noida on 14th August

press release

Trimetazidine for heart failure

today video of the dayDr KK Aggarwal Birthday 5th September

Cultural Evening at IMA

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

A male client with acute pyelonephritis receives a prescription for co–trimoxazole P.O. twice daily for 10 days. Which finding best demonstrates that the client has followed the prescribed regimen?

a. Urine output increases to 2,000 ml/day.
b. Flank and abdominal discomfort decrease.
c. Bacteria are absent on urine culture.
d. The red blood cell (RBC) count is normal.

Yesterday’s Mind Teaser: A female client requires hemodialysis. Which of the following drugs should be withheld before this procedure?

a. Phosphate binders
b. Insulin
c. Antibiotics
d. Cardiac glycosides

Answer for yesterday’s Mind Teaser: d. Cardiac glycosides

Correct answers received from: Dr valluri ramarao, Dr.K.V.Sarma, Narahari Kandakatla, Dr.Bitaan Sen & Dr.Jayashree Sen, Dr. V.P. Thakral, Dr.K.Raju, DR ARPAN GANDHI, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, dr kanta jain, DR AVTAR KRISHAN.

Answer for 7th September Mind Teaser: d. White blood cell (WBC) count of 20,000/mm3

Correct answers received from: DR AVTAR KRISHAN, Dr B K Agarwal, Dr. P. C. Das

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

An army major called his wife to tell her that he would be late home because dirty magazines had been found in the barracks, and the soldiers responsible were facing serious disciplinary action.

"The punishment sounds a little harsh," she said. "After all, most of the soldiers have pictures of women on the walls of their quarters."

"No, honey," he explained patiently. "Dirty magazines means the clips from their rifles had not been cleaned properly!"

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A terminally ill patient, who developed bed sores, is prescribed only systemic antibiotics.
Reaction: Please change the position of the patient frequently and keep the skin clean and dry.
Lesson: Make sure that good nursing care and maintenance of skin hygiene is advised first to patients with bed sores, along with topical antibiotics.

medicolegal update

We give up leisure in order that we may have leisure, just as we go to war in order that we may have peace. Aristotle

medicolegal update

Dr KK Aggarwal: Dr KK Aggarwal Birthday 5th September http://bit.ly/16wknsh #Health

Dr Deepak Chopra: Based on the central doctrine of materialism consciousness shouldn't exist. You are conscious now http://tinyurl.com/l6x3eo4

medicolegal update

Dear Sir, Happy Ganesha Chaturthi.Regards: Dr Shravan

Forthcoming Events

29thSeptember–Dil Ka Darbar at Constitution Club of India,New Delhi

20th Perfect Health Mela from 18th Oct to 22nd Oct at different locations

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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medicolegal update

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