August 11  2015, Tuesday
eMedinewS
editorial
To screen or not to screen all young athletes with ECG to discover hidden heart disease
Dr KK AggarwalGuidelines from the American Heart Association (AHA) (endorsed by the American College of Cardiology) and the European Society of Cardiology (ESC), both recommend a screening before sports participation, but the Americans favor a detailed medical history combined with a physical examination only, while the Europeans favor the addition of the 12–lead ECG.

The controversy was evident in the results of a poll conducted during a debate session at the AHA meeting last year, which were published this week in the New England Journal of Medicine by James Colbert, MD, of Harvard Medical School.

Of the audience members who voted –– an unscientific sample, to be sure –– 70% favored some type of screening for cardiac disease in young athletes. And in a scenario where screening was already a foregone conclusion, 60% said it should include an ECG. A similar online poll on the NEJM website was even more informative, showing that the differences in opinion exist on both sides of the Atlantic.

Of the 1,266 people who voted on the site –– again, not a scientific sample –– 18% didn’t want any mandatory screening, 24% wanted screening with a medical history and physical exam, and 58% favored screening that included an ECG. The percentage of voters who endorsed an ECG was higher among Europeans than among Americans (66% versus 45%), but that still indicates a substantial amount of controversy regardless of geography.
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IMA Past Presidents Meet 2015
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News
Gastroenterology

Serum biomarker assays measuring neo-epitopes can discriminate between Crohn's disease (CD) and ulcerative colitis (UC), suggests new research published in the Journal of Crohn's and Colitis. Researchers said that these neo-epitopes are increasingly released into the circulation as part of the inflammatory condition.

Oncology
Men with newly diagnosed prostate cancer are initially treated with hormonal therapy, and chemotherapy is used only when the disease is no longer responsive. However, it has now been shown that using chemotherapy early on in the treatment of prostate cancer can improve survival. The results are published online August 5 in the New England Journal of Medicine.

Psychiatry

Obstetrics and Gynecology

Treating psychiatric disorders in pregnant women with commonly used antidepressants (selective serotonin reuptake inhibitors or SSRIs) lowers the risk of several pregnancy complications including preterm birth and Cesarean section. But, use of this medication is also associated with an increased risk of neonatal problems, reported a new study published in the American Journal of Psychiatry.

Pulmonary Medicine

Patients with moderate to severe chronic obstructive pulmonary disease (COPD) experienced significant reduction in lung function for up to 5 years after discontinuing long-term inhaled corticosteroid (ICS) treatment, suggested a new study published in the journal Chest
Cardiology eMedinewS
  • A new review based on data from four large contemporary trials of patients with atrial fibrillation (AF) has shed light on the incidence, risk factors, and morbidity of extracranial systemic embolic events, a less common but often lethal outcome. The findings were published in Circulation.
  • Ignoring social factors such as education, income, and living environment could wipe out the progress achieved in curbing deaths due to heart disease and stroke, suggested the American Heart Association (AHA) in a statement published online August 3 in Circulation.
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Neurology
Kids with traumatic brain injury (TBI) have more lapses in attention and longer reaction times than children who suffer trauma to other parts of the body, suggests new research published online August 3 in Pediatrics.

Pediatrics
Psychiatry
Street youth who were abused or neglected in childhood are more likely to attempt suicide, suggested a new study published online August 3 in Pediatrics.
Dr KK Spiritual Blog
Why do we not offer Vanaspathi Ghee at the time of cremation or worship?

Vanaspati Ghee is never offered to God at the time of Aarti in the Diya or to the dead body at the time of cremation. Only pure ghee is offered.

It is considered a bad omen to offer Vanaspati ghee at the time of the last cremation ritual even though the consciousness has left the body.

What is not offered to God should not be offered to our consciousness and that was the reason for this ritual in a temple. Vanaspati ghee increases bad cholesterol and reduces level of good cholesterol in the blood. On the other hand, pure ghee only increases bad cholesterol but does not reduce the level of good cholesterol. The medical recommendation is that one should not take more than 15 ml of oil, ghee, butter or maximum ½ kg in one month.

It is a spiritual crime to offer vanaspati ghee to God.
Make Sure
Situation: A patient on dialysis and on oral antacid developed aluminum toxicity.
Reaction: Oh my God! You should have put him on magaldrate preparations?
Lesson: Make sure to remember that magaldrate preparations do not cause aluminum toxicity in patients undergoing dialysis.
Dr Good Dr Bad
Situation:A patient with lung cancer was prescribed lung nosodes.
Dr Bad: It has no role. 
Dr Good: It is prescribed in Homeopathy.
Lesson: Different pathies have different treatments.

(Copyright IJCP)
eMedi Quiz
When should most women have their first mammogram?

A. At age 30.
B. At age 35.
C. At age 40.
D. At age 45.
E. At age 50.

Yesterday’s Mind Teaser:How often should you have a Pap smear?

A. Once a year after puberty.
B. Once a year after either turning 21 or having sexual intercourse for the first time.
C. Once a year after age 21 and every two years after 30.
D. Once a year if you’re not in a monogamous relationship.
E. Once a year unless you’ve been vaccinated against the human papillomavirus (HPV). Then the screening is not necessary.

Answer for yesterday’s Mind Teaser: C. Once a year after age 21 and every two years after 30.

Correct Answers received from: Dr.K.Raju, Dr Poonam Chablani, Dr.B.R.Bhatnagar, Dr. G. Madhusudhan, Daivadheenam Jella, Dr Avtar Krishan

Answer for 9th August Mind Teaser: B. At age 20.

Correct Answers received: Daivadheenam Jella, Dr Avtar Krishan, Dr. G. Madhusudhan, Dr. G. Madhusudhan, Raju Kuppusamy, Dr.K.V.Sarma, Dr Poonam Chablani, Dr Jainendra Upadhyay
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Rabies News (Dr A K Gupta)
How is rabies transmitted?

Rabies is transmitted by infected secretions. Most commonly, transmission to humans takes place through exposure to saliva following a bite by an infected animal. Rabies virus can be excreted in saliva, urine, nasal discharge and respiratory secretions.
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CPR 10
Total CPR since 1st November 2012 – 113241 trained
Video of the Day
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 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
MA News
To day morning being Monday, Lakh of devotees (kawaria) gather at Deoghar,Baba dham. There was stamped and 11 devotees died on spot and many persons are injured. Entire team of IMA Deoghar has rendered their services to suffering people. Local people are appreciating for services done by IMA doctors.

I am in contact with Dr R N Prasad ,CWC member and ex Vice President.and Dr Rajesh Secretary IMA Deoghar branch and now everything under control.

We,Jharkhand IMA appreciate and thanks entire IMA team of Deoghar for their commendable services.

Dr A K Singh
State President
IMA.Jharkhand
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Kindly go to http://module.ima-india.org/ipmo/
and pledge your organs
unless we do it public will not listen to us

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ICON 2015
Inspirational Story
Success depends upon maturity!

Maturity is many things. It is the ability to base a judgment on the big picture, the long haul. It means being able to resist the urge for immediate gratification and opt for the course of action that will pay off later.

One of the characteristics of the young is “I want it now.” Grown-up people can wait. Maturity is perseverance–the ability to sweat out a project or a situation, in spite of heavy opposition and discouraging setbacks, and stick with it until it is finished. The adult who is constantly changing friends and changing mates is immature. He/she cannot stick it out because he/she has not grown up.

Maturity is the ability to control anger and settle differences without violence or destruction. The mature person can face unpleasantness, frustration, discomfort and defeat without collapsing or complaining. He/she knows he cannot have everything his/her own way every time. He/she is able to defer to circumstances, to other people-and to time. He/she knows when to compromise and is not too proud to do so.

Maturity is humility. It is being big enough to say, “I was wrong.” And, when he/she is right, the mature person need not experience the satisfaction of saying, “I told you so.”

Maturity is the ability to live up to your responsibilities, and this means being dependable. It means keeping your word. Dependability is the hallmark of integrity. Do you mean what you say-and do you say what you mean? Unfortunately, the world is filled with people who cannot be counted on. When you need them most, they are among the missing. They never seem to come through in the clutches. They break promises and substitute alibis for performance. They show up late or not at all. They are confused and disorganized. Their lives are a chaotic maze of broken promises, former friends, unfinished business and good intentions that somehow never materialize. They are always a day late and a dollar short.

Maturity is the ability to make a decision and stand by it. Immature people spend their lives exploring endless possibilities and then doing nothing. Action requires courage. Without courage, little is accomplished.

Maturity is the ability to harness your abilities and your energies and do more than is expected. The mature person refuses to settle for mediocrity. He/she would rather aim high and miss the mark than low-and make it.

Maturity is the art of living in peace with that which cannot be changed, the courage to change that which should be changed, no matter what it takes, and the wisdom to know the difference.
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Reader Response
Dear Sir, Very nice information. Regards: Dr Kiren
Wellness Blog
Exercise impact on the knee

Different exercises produce different impacts on the knee joints. The best and safest exercises causing minimum impact on the knee for patients post knee replacement or knee arthritis are walking, biking, hiking, riding an exercise bike, riding an elliptical trainer and walking on the treadmill. In sports one can play doubles tennis and not singles. One can also participate in downhill or cross–country skiing.

The maximum stress–producing exercises are jogging and golf swings.

Impact
  • Biking generates the least force, producing impact of about 1.3 times the person’s body weight.
  • Treadmill walking was next best, producing forces of 2.05 times the body weight.
  • Walking on level ground generated forces of 2.6 times the body weight.
  • A game of tennis produces forces of 3.1 to 3.8 times the body weight; serving produces the highest impact.
  • Jogging produced forces of 4.3 times body weight.
  • Golf swings produces forces of 4.5 times body weight on the forward knee and 3.2 times body weight in the opposite knee.
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A Horoscope for the Workplace

Middle Management/Department Management/Team Leaders: Catty, cut–throat, yet completely spineless, you are destined to remain at your current job for the rest of your life. Unable to make a single decision you tend to measure your worth by the number of meetings you can schedule for yourself. Best suited to marry other "Middle Managers," as everyone in your social circle is a "Middle Manager."
Press Release
Freedom from Sudden Cardiac Arrest Deaths

Hands only CPR is an effective and easy to learn life-saving technique and it can help revive sudden cardiac arrest patients if administered within the first ten minutes of their death

New Delhi, July 18, 2015: Sudden cardiac arrest is the number one killer in India taking an estimated 25 lakh lives annually. According to the data revealed by the Delhi Economical Survey, 150 to 250 deaths happen in the city every single day. Out of these 25 – 45 deaths occur suddenly. With 60% of the people dying before they reach the hospital and the large number of sudden cardiac arrest victims; it is essential that each one of us must know the essential life-saving technique of hands only CPR – 10. A simple and easy to learn technique, Hands only CPR 10 does not require any mouth-to-mouth resuscitation and can be performed by anyone.

Addressing the issue Padma Shri Awardee Dr. A Marthanda Pillai, National President & Padma Shri Awardee Dr. KK Aggarwal - President of Heart Care Foundation of India and Honorary Secretary General of IMA in a joint statement said that, “Sudden cardiac arrests are being found to be taking lives of people as young as 30-40 years of age. Many a times these are triggered by mild heart issues which go unnoticed. These are mostly found to be percepitated by stress and unhealthy life choices.  The hands only CPR 10 mantra is extremely simple to rememeber and can help revive a sudden cadiac arrest patient within the first ten minutes of his or her death. Given how prevalent it is in today’s generation, it is essential that each person learns the life-saving technique of hands-only  CPR 10. “

Hands only CPR 10 does not require mouth-to-mouth breathing unless the victim has died due to drowning or is a small child. What each of us need to remember is that within 10 minutes of death (earlier the better), for a minimum of 10 minutes (the longer the better), compress the center of the chest of the deceased person continuously and effectively with a speed of 10×10 = 100 per minute. Chest compression should be stopped only when the person starts breathing or the ambulance arrives.

Adding to this, Dr. KK Aggarwal said, “A first time manifestation of breathless or acidity, even if in the mildest form post the age of must not be ignored.  Similarly, any chest discomfort should also not be ignored after the age of 40. These can all be indications of heart disease and medical advice must be taken in such cases.”

Heart Care Foundation of India, a non-profit organization working towards raising health awareness in the country has been training people in this life-saving technique for over two years now. It has successfully trained over 1,20,000 people till now in Delhi NCR itself and holds three Limca Book of World Records for the maximum number of people trained at a time, at the same place and in an hour. The NGO has now joined hands with the Indian Medical Association, Delhi Red Cross Society and Delhi Police to train 100% of the Delhi Police PCR van staff on the life-saving technique of hands only CPR 10 by Independence Day 2015. Given the shortage of ambulances in the city and the Delhi Police PCR vans being the first to reach an emergency site, with this training they will now be able to try to revive a sudden cardiac arrest patient till the ambulance arrives.

A sudden cardiac arrest occurs when the electrical conducting system of the heart fails and the heartbeats irregularly and very fast (more than 1000 times, technically called as ventricular fibrillation). Soon after the heart suddenly stops beating and the blood flow to the brain stops. As a result, the person becomes unconscious and stops normal breathing. A cardiac arrest is not the same as a heart attack, but it may be caused by a heart attack. In most cases, sudden cardiac arrest may be reversible in the first 10 minutes. This is possible because the brain remains alive during this period when the heart and respiration have stopped, a situation called clinical death.

To know more or to organize a training camp in your locality, please call the NGO’s helpline number 9958771177.