eMedinewS
12th October 2014, Sunday

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

Intermittent dosing of proton pump inhibitors for GI bleeding

The current recommendation is IV pantoprazole, esomeprazole, or omeprazole at a dose of 40 mg twice daily rather than a high-dose continuous infusion.

Evidence Treatment with proton pump inhibitors (PPIs) leads to elevation of gastric pH levels, which stabilizes blood clots and improves clinical outcomes.

PPIs are recommended for all patients with peptic ulcer bleeding. High-dose continuous IV PPI has traditionally been recommended for patients presenting with upper gastrointestinal bleeding.

Several meta-analyses of randomized trials have failed to show superior outcomes with high–dose continuous IV proton pump administration compared with intermittent dosing (e.g., 40 mg IV twice daily).

Intermittent dosing could lead to decreased resource utilization and cost.

In the most recent meta-analysis, published in JAMA Intern Med 2014, intermittent dosing was not inferior to high–dose continuous infusions with regard to rebleeding, mortality, need for surgery or repeat intervention, or the need for urgent intervention in patients with peptic ulcers with high-risk stigmata (active bleeding, adherent clot, or a visible vessel). There was also a trend toward a decreased risk of rebleeding with intermittent dosing (Source Up to date).

News Around The Globe

  • A single, brief session of resistance exercise done immediately after a visual learning task improves episodic memory by about 10%, suggests new research published in the October issue of Acta Psychologica.
  • The US Food and Drug Administration (FDA) has approved a new antiviral drug to treat chronic hepatitis C virus (HCV) genotype 1 infections. Ledipasvir/sofosbuvir (Harvoni, Gilead Sciences) is the first combination drug for HCV as well as the first treatment that does not require administration with interferon and ribavirin.
  • A combination of low–risk lifestyle factors substantially reduces the risk for stroke, particularly cerebral infarction, in women, according to a new study published online October 8 in Neurology.
  • More than two decades of evidence suggests that bariatric surgery produces greater weight loss and more type 2 diabetes remissions than nonsurgical treatments for the obese, reported a review published online in JAMA Surgery.
  • At least a dozen dietary supplements available in the US contain a potentially-dangerous synthetic stimulant that has never been tested on humans, pointed a new study. The inclusion of the stimulant known as DMBA in dietary supplements has researchers and an industry group calling on the US FDA to take action. The report is published online October 8 in Drug Testing and Analysis

Dr KK Spiritual Blog

How Yoga Works

  1. Yoga reduces allostatic load in stress response systems so that optimal homeostasis is restored.
  2.   
  3. Stress causes
    i. Imbalance of the autonomic nervous system (ANS) with decreased parasympathetic nervous system (PNS) and increased sympathetic nervous system (SNS) activity
    ii. Underactivity of the gamma amino-butyric acid (GABA) system, the primary inhibitory neurotransmitter system
    iii.Increased allostatic load.
  4. Yoga-based practices
    i. Correct underactivity of the PNS and GABA systems in part through stimulation of the vagus nerves, the main peripheral pathway of the PNS
    ii. Reduce allostatic load.
  5. Depression, epilepsy, post traumatic stress disorder (PTSD) and chronic pain exemplify medical conditions that are exacerbated by stress, have low heart rate variability and low GABAergic activity, respond to pharmacologic agents that increase activity of the GABA system, and show symptom improvement in response to yoga–based interventions.
  6. The observation that treatment resistant cases of epilepsy and depression respond to vagal nerve stimulation corroborates the need to correct PNS underactivity as part of a successful treatment plan in some cases.
  7. Decreased PNS and GABAergic activity that underlies stress-related disorders can be corrected by yoga practices resulting in amelioration of disease symptoms.  (Med Hypotheses 2012 May;78(5):571–9)

Inspirational Story

Most Popular Vs the Right Decision

"You are never given a wish without also having been given the power to make it come true." Richard Bach.

A group of children was playing near two railway tracks, one still in use while the other disused. Only one child played on the disused track, the rest on the operational track.

The train is coming, and you are just beside the track interchange. You can make the train change its course to the disused track and save most of the kids. However, that would also mean the lone child playing by the disused track would be sacrificed. Or would you rather let the train go its way?

Let's take a pause to think what kind of decision we could make........

Most people might choose to divert the course of the train, and sacrifice only one child. You might think the same way, I guess. Exactly, I thought the same way initially because to save most of the children at the expense of only one child was rational decision most people would make, morally and emotionally. But, have you ever thought that the child choosing to play on the disused track had in fact made the right decision to play at a safe place?
 Nevertheless, he had to be sacrificed because of his ignorant friends who chose to play where the danger was. This kind of dilemma happens around us every day. In the office, community, in politics and especially in a democratic society, the minority is often sacrificed for the interest of the majority, no matter how foolish or ignorant the majority are, and how farsighted and knowledgeable the minority are. The child who chose not to play with the rest on the operational track was sidelined. And in the case he was sacrificed, no one would shed a tear for him.

The great critic Leo Velski Julian who told the story said he would not try to change the course of the train because he believed that the kids playing on the operational track should have known very well that track was still in use, and that they should have run away if they heard the train's sirens.
If the train was diverted, that lone child would definitely die because he never thought the train could come over to that track!

Moreover, that track was not in use probably because it was not safe. If the train was diverted to the track, we could put the lives of all passengers on board at stake! And in your attempt to save a few kids by sacrificing one child, you might end up sacrificing hundreds of people to save these few kids.
While we are all aware that life is full of tough decisions that need to be made, we may not realize that hasty decisions may not always be the right one.

"Remember that what's right isn't always popular... and what's popular isn't always right." Everybody makes mistakes; that's why they put erasers on pencils.

Rabies News (Dr A K Gupta)

Is sera testing of IDRV patients for antirabies antibodies necessary as a measure of knowing its efficacy?

Routine sera testing for rabies antibodies to know its efficacy is not required.

Cardiology eMedinewS

  • The US FDA has approved the first drug-coated balloon (DCB) for the treatment of vascular disease. The FDA approval of the Lutonix 035 paclitaxel-coated balloon (Bard) follows a unanimous vote by the agency's Circulatory System Devices panel members, all of whom voted yes to questions of safety, efficacy, and risk vs. benefit.
  • Cardiovascular scientists at NYU Langone Medical Center have identified a protein known as Pcp4 as a regulator of the heart's rhythm. Researchers noted that when the Pcp4 gene is disrupted, it can cause ventricular arrhythmias. The findings are published online in the Journal of Clinical Investigation

Pediatrics eMedinewS

  • A first-of-its-kind study suggests that reduced attention to the human face soon after birth may increase the likelihood of being less responsive to others' distress later. Study authors noted that infant facial preference and early sensitive parenting may predict development of callous, unemotional traits, which in turn might suggest a tendency toward antisocial behavior. The study was published online October 6 in Biological Psychiatry.
  • The pneumococcal vaccine recommended for young children not only prevents illness and death, but also dramatically reduces severe antibiotic-resistant infections by 62%, suggests nationwide research presented at IDWeek 2014.

Quote of the Day

  • Money is not the most important thing in the world. Love is. Fortunately, I love money. Jackie Mason

IMA NEWS

  • (TOI News) Delhi BJP president Satish Upadhyay on Thursday nominated nine prominent people, including former AAP leader Shazia Ilmi, from the capital for Prime Minister Narendra Modi's Swachh Bharat mission. The move is aimed at turning Modi's cleanliness drive into a "jan andolan (mass movement)", BJP workers say. Upadhyay has nominated wrestler Sushil Kumar, Delhi University vice-chancellor Dinesh Singh, Indian Medical Association Secretary (Elect) Dr K K Aggarwal, Kathak dancer Uma Shankar, Sirazuddin Qureshi who is president of Indian Islamic Centre, Praveen Khandelwal, general secretary of Confederation of All India Traders, DUSU president Mohit Nagar, DCM group managing director Vijay Bharat Ram and former AAP leader and social activist Shazia Ilmi for the campaign....." Introducing the people nominated by him, Upadhyay said, "We want more and more people to join the mission. I want these people to nominate nine people each and take the cause forward. We all have to work hard to make the PM's initiative a success." Apart from the nine nominees, there are several organizations and people who have assured support. Among them are chairman of Sulabh International Bindeshwar Pathak, singer and composer Shivani Kashyap, member of FI Ladies Organization Harjinder Kaur, United Residents of Delhi, PHD Chamber of Commerce, and artiste Ravindra who directed the video released by Delhi BJP.
  • Indian Express: “I was asked to be one of the nine nominees for the cleanliness campaign. When I asked them about what will be required of me and who were the other nominees, I was told that the likes of Uma Sharma and Padmashree K K Aggarwal and DU Vice-Chancellor Dinesh Singh will be a part of the event. Without any hesitation, I agreed,” Ilmi told Newsline
  • Tribune: Shazia Ilmi, who has resigned from the AAP, today shared the BJP platform for the Swachh Bharat Abhiyan. She is one of the nine prominent citizens of Delhi who have promised to participate in the campaign. Other participants are Sushil Kumar, Olympian; Prof  Dinesh Singh, Vice-Chancellor of Delhi University; Dr K. K. Aggarwal, Secretary IMA; Dr Vinay Bharat Ram MD of DCM group; Uma Sharma, Kathak artist; Sirajuddin Qureshi, president, Indian Islamic Centre; Praveen Khandelwal, general secretary of CAIT; and Mohit Nagar, president, DUSU.
  • ISMA Times: On this occasion Pradesh President Satish Upadhyay introduced 9 prominent persons of Delhi to the media who have assured full participation in the Prime Minister’s Swachh Bharat Abhiyan at his request. Except Dr. Vinay Bharat Ram all the 8 prominent citizens were present in the press conference. Dr. Vinay Bharat Ram could not attend due to his prefixed engagements but his representative was present. These prominent persons are Sushil Kumar, Olympian, Prof. Dinesh Singh, Vice Chancellor, Delhi University, Dr. K.K. Aggarwal, Padmshree, Secretary IMA, Ms. Shazia Ilmi, Social Activist & Journalist, Dr. Vinay Bharat Ram, MD, DCM Group, Ms. Uma Sharma, Padma Bhushan, Kathak Artist, Sirazuddin Qureshi, President Indian Islamic Centre, Praveen Khandelwal, Gen. Sec., CAIT, Traders Leader, Mohit Nagar, President, DUSU. Upadhyay expressed his confidence that all the 9 nominated prominent citizens and other institutions that have supported us today shall create awareness in the society for this campaign honestly. Upadhyay told that the following persons and associations who have assured full cooperation in Swacch Bharat Abhiyan were also present in the press conference – Bindeshwar Pathak, Sulabh International, Ms. Shivani Kashyap, Famous Singer, Smt. Harjinder Kaur, Member FICCI (lady wing), United Residents of Delhi, a forum of 1248 RWAs. President– Jitendra Tyagi, Secretary– Saurav Gandhi, PHD Chamber of Commerce, Ravindra, Video Director.
  • DNA News: Ex-journalist and Aam Aadmi Party (AAP) member Shazia Ilmi, Indian Wrestling champion Sushil Kumar, Padma Bhushan Kathak Dancer Uma Sharma, Delhi Vice Chancellor, Dinesh Singh, Padmashri Dr K K Aggarwal are few of the eminent personalities from various walks of life who were present at an event organised by state Bhartiya Janata Party in Delhi to pledge their contribution to carry forward the mantle of Clean India Campaign.
  • Business Standard: RJD MP Rajesh Ranjan alias Pappu Yadav today announced to launch a "people's agitation" against doctors charging "exorbitant" fees and other charges from Monday to solve problems of common man.  The agitation is fixed on October 13 at Saharsa, Yadav said addressing a dharna here. 

Wellness Blog

Obesity reduces life expectancy

Obesity in adulthood is associated with a striking reduction in life expectancy for both men and women. Among 3457 subjects in the Framingham Study, done in the United States, those who were obese (Body Mass Index or BMI =30 kg/m2) at age 40 years lived 6 to 7 years less than those who were not (BMI =24.9 kg/m2).

Those who were overweight (BMI 25 to 29.9 km/m2) at age 40 years lived about three years less, and those who were both obese and smoked lived 13 to 14 years less than normal–weight nonsmokers.

The steady rise in life expectancy during the past two centuries may come to an end because of the increasing prevalence of obesity.

Being overweight during adolescence also increase the risk of premature death as an adult. The analysis of Nurses’ Health Study has shown the risk of premature death increases with higher BMIs at age 18 years. For a BMI at age 18 of 18.5 to 21.9, 22 to 24.9, 25 to 29.9, and =30 kg/m2, the hazard ratio for premature death were 0.98, 1.18, 1.66, and 2.79, respectively.

A prospective study from the United States, at National Cancer Institute, National Institutes of Health, Bethesda, valuated the relationship between BMI and risk of death over a maximum follow–up period of 10 years among over 500,000 men and women aged 50 to 71 years.

Among the subset of individuals 50 years of age (when prevalence of chronic disease is low) who had never smoked, an increased risk of death was associated with being either overweight (20 to 50 percent increase in those between 26.5 to 29.9 kg/m2) or obese (two–to over threefold increase in those =30 kg/m2).

Overweight and obesity, when analyzed together, is associated with increased mortality from diabetes and kidney disease.

Obesity, when analyzed alone, is associated with increased cardiac mortality and cancers considered to be obesity–related (colon, breast, esophageal, uterine, ovarian, kidney, and pancreatic cancer), but not with mortality from other cancers or non–cardiac mortality.

There are some recent studies which showed that obese people live longer. Overweight was shown to be associated with reduced mortality from non cancer, non–cardiovascular causes, but not with cancer or cardiovascular mortality. In them being underweight was associated with increased mortality from non cancer and non–cardiac causes, but not cancer and cardiac causes.

Obesity and increased central fat are associated with increased morbidity in addition to mortality. Overweight and obese individuals have a higher relative risk of hypertension, hypercholesterolemia, and diabetes mellitus compared with normal weight individuals. The risk of hypertension and diabetes increases with increasing BMI.

In the Nurses’ Health and the Health Professionals studies, the risk of developing a chronic disease (gallstones, hypertension, heart disease, colon cancer and stroke (in men only)) increased with increasing BMI, even in those in the upper half of the healthy weight range (BMI 22.0 to 24.9 kg/m2).

Obesity is measured by using a measurement called BMI, which is calculated by dividing a person’s weight in kilograms by the square of their height in metres.

A BMI of 18.5 to 23 is considered normal (Asians). One below 18.5 is considered underweight and 25 or above is considered obese.

emedipicstoday emedipics

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

mela_brochure
Self-Assessment-Quiz

 

expert_choice
Zee News – Health Wealth Shows

Alcohol

press release

Exercise impact on the knee

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: A mitral stenosis patient from a remote village came for surgery.
Dr. Bad: A mechanical valve will suffice.
Dr. Good: You need a bioprosthetic valve.
Lesson: Bioprosthetic valves are recommended for any patient who cannot or will not take oral anticlotting drugs or when there is a clear contraindication to them.

Make Sure

Situation: A patient with Chikungunya had persistent joint pain.
Reaction: Oh my God! Why was hydroxychloroquine not given?
Lesson: Make sure that all patients with post Chikungunya arthritis are treated with hydroxychloroquine to reduce chances of death.

eMedinewS Humor

A group of expectant fathers sat nervously in the hall. A nurse beckoned to one of them and said, "Congratulations, you have a son!" Another man dropped his magazine, jumped up and said, "Hey, what's the idea? I got here two hours before he did!"

Twitter of the Day

Dr KK Aggarwal: ECG not reliable marker for predicting heart disease
Dr Deepak Chopra: Harness the power of intention

ePress Release

Health and Spirituality is the mantra to overall happiness

Padma Shri, Dr. BC Roy and DST National Science Communication National Awardee, Dr KK Aggarwal delivers a lecture on Spiritual Prescriptions at the Shanmukhananda Auditorium, Sion East, Mumbai A spiritual prescription involves treating a patient’s physical, emotional, social, and spiritual elements as an integrated whole and not just freeing a person’s physical body from disease. Speaking about the new age concept of Spiritual Prescription and the correlation between spirituality and healthcare, renowned cardiologist, spiritual writer, inspirational speaker and President of the Heart Care Foundation of India, Dr KK Aggarwal today left over 2500 insurance agents enthralled while delivering an Inaugural Guest Lecture on Spiritual Prescriptions at Shanmukhananda Auditorium, Mumbai.

A medico-spiritual expert and social worker par excellence, Dr. KK Aggarwal is the only doctor in the country to have received three prestigious National awards namely the Padma Shri, Dr. BC Roy and the DST National Science and Communication Award. He is also a Limca Book of World Record holder for the maximum number of people trained in the lifesaving technique of hands-only CPR in one go.

Speaking on the occasion Dr. KK Aggarwal, Sr. National Vice President and Honorary General Secretary Elect, Indian Medical Association and President of the Heart Care Foundation of India said, “It is possible to reduce the dose of an allopathic medicine thereby reducing their side effects and enhancing their efficacy. The Vedic sciences originating from the Vedas can provide answers to many unsolved questions in allopathic medicine. For example, in the early Vedic era, no one suffered from heart attack despite Indians being prone to getting a heart attack. The spiritual prescription during the early Vedic era was to not eat carbohydrates every day. People of that time observed traditional spiritual fasts where they did not eat carbohydrates once a week, once a month and for nine days twice a year during the Navratras.”

“The spiritual prescription of eating Gur Chana during the fast observed by women on every Friday was to correct anemia in them. The ritual of Shahi Snan was made during that era so that people could have sun bath early in the morning to prevent vitamin D deficiency.”

Dr Aggarwal also taught the formula of CPR-10 to the audience at the lecture. The mantra is as below: Within 10 minutes of death (earlier the better), at least for at least 10 minutes, longer the better (adults 25 minutes and children 35 minutes), compress the centre of the chest of the deceased person continuously (uninterrupted) and effectively (1½ inch) with a speed of 10×10 = 100 per minute.

Dr. KK Aggarwal has been recently selected as one of the 9 icons of Swachh Delhi Abhiyan.

A pioneer of leading health initiatives, Dr. KK Aggarwal has been instrumental in bringing treatments such as clot dissolving therapy for acute heart attacks and Colour Doppler Echocardiography to the country. In addition to this, he has also conceptualized and organized unique consumer driven health awareness platforms such as The Perfect Health Mela and the Run for your Heart as a part of his role as the President of Heart Care Foundation of India. His most recent project within the NGO, called the Sameer Malik Heart Care Foundation Fund is playing an instrumental role in providing heart care for all patients in need of treatment but who do not have the financial or technical means to fund it. Dr. Aggarwal is also a member of the Ethics Committee of the Medical Council of India, and is well versed with topics such as ethical guidelines every medical practitioner must follow, medical negligence, article 21 of the constitution and a person’s right to universal healthcare.

eMedi Quiz

A hybrid teledermatology is

a. Combination of store and forward and mobile teledermatology
b. Combination of store and forward and video conference
c. Combination of online discussion group and author based second opinion teledermatology
d. Combination of online discussion group and video conference

Yesterday’s Mind Teaser: Which of the following is a basic teledermatology tool?

a. Videoconference
b. Hybrid teledermatology
c. Store-and-forward teledermatology
d. Mobile teledermatology

Answer for yesterday’s Mind Teaser: c. Store–and–forward teledermatology

Correct answers received from: Dr.K.V.Sarma, Dr. P. C. Das , Dr Avtar Krishan, dr Poonam Chablani,

Answer for 9th Oct Mind Teaser:3. Presence of food enhances the absorption of hydrochlorothiazide.

Correct answers received from: Dr Avtar Krishan,

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 Sir, Very informative news. Regards: Dr Kanchan

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