eMedinewS12th January 2014, Sunday

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
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Harvard 7 tips for smarter snacking

  1. Go for the grain. Whole–grain snacks — such as whole–grain low–salt pretzels or tortilla chips and high–fiber, whole–grain cereals — can give you some energy with staying power.
  2. Bring back breakfast. Many breakfast foods can be repurposed as a nutritious snack later in the day. How about a slice of whole–grain toast topped with low–sugar jam? Low–sugar granola also makes a quick snack.
  3. Try a "hi–low– combination. Combine a small amount of something with healthy fat, like peanut butter, with a larger amount of something very light, like apple slices or celery sticks.
  4. Go nuts. Unsalted nuts and seeds make great snacks. Almonds, walnuts, peanuts, roasted pumpkin seeds, cashews, hazelnuts, filberts, and other nuts and seeds contain many beneficial nutrients and are more likely to leave you feeling full (unlike chips or pretzels). Nuts have lots of calories, though, so keep portion sizes small.
  5. The combo snack. Try to eat more than one macronutrient (protein, fat, carbohydrate) at each snacking session. For example, have a few nuts (protein and fat) and some grapes (carbohydrates). Try some whole–grain crackers (carbohydrates) with some low–fat cheese (protein and fat). These balanced snacks tend to keep you feeling satisfied.
  6. Snack mindfully. Don’t eat your snack while doing something else like surfing the Web, watching TV, or working at your desk. Instead, stop what you’re doing for a few minutes and eat your snack like you would a small meal.
  7. You can take it with you. Carry a small bag of healthful snacks in your pocket or purse so you won’t turn in desperation to the cookies at the coffee counter or the candy bars in the office vending machine.
Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV

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."

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

What is the difference between smile, hug and laugh?

sprritual blog

Smile is a sign of joy while hug is a sign of love. Laughter on the other hand is a sign of inner happiness.
None of them are at the level of mind or intellect. All come from within the heart.

They are only the gradations of your expressions of your happiness.

It is said you are incomplete in your dress if you are not wearing a smile on your face.

Hug comes next… and laughter the last. Laughter is like an internal jogging and has benefits like that of doing meditation.

But be careful we must know when not to laugh. The most difficult is to laugh on oneself.

cardiology news

A little Monkey and Man

Once upon a time, a man was passing through a jungle. He saw a monkey and was attracted to it. He called the monkey and to his surprise, the monkey came near him.

The man told the monkey that it was his ancestor and so they should cultivate friendship. With different kinds of gestures, he was able to establish friendship with it. The man was just trying to kill time using the monkey as company while crossing the jungle.

Suddenly unexpectedly, a lion roared fiercely and pounced in front of them. They scarcely had time to escape. The monkey ran and the man followed suit. They found a very huge tree and soon climbed it. Though they were breathless, they did not stop until they climbed to a safe height.

The lion continued to prowl here and there, hoping to catch them when they climbed down. The lion was angry and hungry and awaiting his prey finally sat down under the tree. The man was clinging to one of the strong branches, while the monkey was sitting on a branch with ease, as if nothing had happened. After a prolonged wait, the lion lost patience and proposed to let one of them go scot–free if the other was offered to him as ‘food’.

The man and the monkey consulted each other. They even offered to sacrifice their lives for each other, but ultimately concluded that they would live and die together. The lion was disappointed, but not dissuaded. He continued his vigil. Nevertheless, the wait on the tree proved a testing time for both the monkey and the man.

They were feeling drowsy. They were both faced with the danger of falling down while dozing on the tree. Ultimately they decided to take turns to sleep. The monkey would sit wide–awake while the man slept and the man would keep vigil while the monkey had his share of sleep.

As decided, it was the man's turn to sleep first, while the monkey kept guard. The monkey slept in the other half of the night, while the man held forth.

When the monkey was fast asleep, the man started contemplating. He thought that if he pushed away the sleeping monkey, the lion, as promised, would allow him to go scot–free. Immediately, he translated his thoughts into action. The monkey was in deep slumber. The man pushed him down.

As the monkey was accustomed to such things, he immediately caught hold of the branches halfway and was back to his place in a moment. Without uttering a single word, he went back to sleep as if nothing had happened. In the morning, the monkey led the man to safety. The lion was still on prowl under the tree.

When they reached at the safer place, the monkey made a special request to the man. "Please do not allege that monkeys are ancestors of mankind." Man without humanity is inferior to animals.

News Around The Globe

News

  • Nearly 70% of Americans are taking a prescription drug, and more than 50% are taking two or more drugs, says a study from the Mayo Clinic. Drug sales are at least 10% of all health care dollars spent and a huge part of the U.S. economy. Americans spend more on prescription drugs than people in any other country. The following drugs each sold more than $1 billion in the third quarter of 2013, from July 1–Sept. 30:
    • Abilify, a drug for depression, bipolar disorder and schizophrenia, $1.6 billion
    • Nexium, for acid reflux, $1.5 billion
    • Humira, an anti–inflammatory used to treat arthritis, $1.4 billion
    • Cymbalta, an antidepressant, $1.4 billion
    • Crestor, a statin used to reduce serum cholesterol, $1.3 billion
    • Advair Diskus, two medications used in combination to help asthma patients and to help with other lung disorders such as chronic obstructive pulmonary disease, $1.2 billion
    • Enbrel, an anti–autoimmune drug used to treat psoriasis and arthritis, $1.2 billion
    • Remicade, used to treat arthritis, bowel diseases like Crohn’s and skin disorders like psoriasis, $1 billion. (Rajat Bhatnagar)
  • Life–long therapy with tyrosine kinase inhibitors (TKIs) is still the consensus treatment for patients with chronic myeloid leukemia (CML), but researchers are examining the feasibility of discontinuing therapy in select individuals. The latest study on this approach, known as the A–STIM (According to Stop Imatinib) trial, suggests that patients should be evaluated for loss of major molecular response (MMR). This could be used as a criterion for resuming therapy. The study was published online December 9, 2013, in the Journal of Clinical Oncology. Medscape
  • Results from a study, published in the January issue of Nutrients, show that smoking and diets rich in animal products have the strongest correlations with cancer incidence rates. The strongest correlation with animal products was seen in cancers of the female breast, corpus uteri, kidney, ovaries, pancreas, prostate, testicles, and thyroid, and in multiple myeloma. In contrast, alcohol consumption was found to be significantly correlated with only colorectal cancer.
  • Polyp and adenoma detection rates were highest when the colonoscopy withdrawal time was 9 minutes long, near the upper limit of the recommended 6 to 10 minutes withdrawal time in a study in the American Journal of Gastroenterology. For each minute of normal withdrawal time above 6 minutes, incident rate ratios for detection of adenomas or clinically significant serrated polyps increased by 50% and 77%, respectively, with a leveling benefit at 9 minutes.

CPR 10 success stories

1. Hands–only CPR 10 English

2. Hands–only CPR 10 (Hindi)

3. Ms Geetanjali, SD Public School Successful Story

4. Success story Ms Sudha Malik

5. BVN School girl Harshita does successful hands–only CPR 10

6. Elderly man saved by Anuja

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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.

cardiology news

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

  • According to a retrospective study, when considering patients with acute strokes for endovascular therapy, an MRI might help select those who will be most likely to benefit. A protocol that added MRI to the standard CT–based assessment was associated with a lower percentage of patients who underwent endovascular therapy (51.7% versus 96.6%, P<0.05), but a greater percentage who achieved a good clinical outcome at 30 days (23.6% versus 9.1%, P=0.01) compared with a CT–based approach alone. The addition of MRI also was associated with a lower rate of 30-day mortality (25% versus 48.5%, P<0.001). The findings are reported online in Stroke: Journal of the American Heart Association.
  • Older people who quit their moderate smoking habit reduced their cigarette-associated cardiovascular risks to the level seen people who had never smoked in as little as 8 years, according to a prospective population study presented at the American Heart Association’s annual scientific sessions. And this risk reversal occurred much sooner than the 15 years predicted in a 2004 report by the U.S. Surgeon General.
cardiology news

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

  • Children vaccinated with Bacille Calmette–Guérin (BCG) may have less risk of suspected acute lower respiratory infection (ALRI) than children who aren’t vaccinated, and the protection may increase in children vaccinated against diphtheria–tetanus–pertussis (DTP), as reported in the journal Pediatrics. The number of DTP doses does not appear to modify this effect, but the order in which the vaccines are received does.
  • A new study in the January 8 online issue of Neurology shows that children exposed to levetiracetam in utero had better language and motor development in comparison to children exposed to valproate in utero. The authors suggest that this information should be used collaboratively between health care professionals and women with epilepsy when deciding on women’s preferred choice of antiepileptic drug.
cardiology news

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.
cardiology news

Total CPR since 1st November 2012 – 84073 trained

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Tips on family history of high cholesterol

Premature heart disease is when heart disease occurs before 55 years in men and 65 years in women. In premature heart disease, the prevalence of dyslipidemia (high cholesterol levels without symptoms) is 75–85%, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and Sr. National Vice President Indian Medical association.

Fifty–four percent of all patients with premature heart disease and 70% of those with a lipid abnormality have a familial disorder. Screening lipid analysis therefore is recommended for first–degree relatives of patients with MI (particularly if premature). Screening should begin with a standard lipid profile and if normal, further testing should be done for Lp(a) and apolipoproteins B and A–I.

About 25% patients with premature heart disease and a normal standard lipid profile will have an abnormality in Lp(a) or apo B. Elevated apo A–1 and HDL are likewise associated with reduced CHD risk.

First–degree relatives are brothers, sisters, father, mother; second–degree relatives refer to aunts, uncles, grandparents, nieces, or nephews; and third–degree relatives refers to first cousins, siblings, or siblings of grandparents.

Familial hypercholesterolemia (FH) is a genetic disorder, characterized by high cholesterol, specifically very high LDL "bad cholesterol") levels, and premature heart disease. Patients may develop premature cardiovascular disease at the age of 30 to 40. Heterozygous FH is a common genetic disorder, occurring in 1:500 people in most countries. Homozygous FH is much rarer, occurring in 1 in a million births. Heterozygous FH is normally treated with drugs. Homozygous FH often does not respond to medical therapy and may require apheresis or liver transplant.

To detect familial high cholesterol levels one must do universal screening at age 16. The cholesterol levels in heterozygous patients are between 350 to 500 mg/dL, and in homozygous, the levels are between 700 to 1,200 mg/dL.

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 84073 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."

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CPR 10 Camp Suraj Bhan DAV School 30th December 2013

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Red flag arthritis

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

A 10–year old girl presents with swelling of one knee joint. All of the following conditions can be considered in the differential diagnosis, except:

1. Tuberculosis
2. Juvenile rheumatoid arthritis
3. Hemophilia
4. Villonodular synovitis

Yesterday’s Mind Teaser: A vascular necrosis can be possible sequelae of fracture of all the following bones, except:

1. Femur neck
2. Scaphoid
3. Talus
4. Calcaneum

Answer for yesterday’s Mind Teaser: 4. Calcaneum

Correct answers received from: Dr VP Thakral, Tukaram Pagad, Dr KV Sarma, Muthumperumal Thirumalpillai, Dr Gopal Shinde, Dr Avtar Krishan, Dr Prakash Khalap.

Answer for 10th January Mind Teaser: 3. Hemophilia.

Correct answers received from: Muthumperumal Thirumalpillai, Dr Gopal Shinde, Dr P C Das, Dr Bitaan Sen & Dr Jayashree Sen, Suresh Srinivasan.

Send your answer to ijcp12@gmail.com

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medicolegal update

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medicolegal update

Gynecologist: A man who works and operates in another man’s field

medicolegal update

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medicolegal update

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.

medicolegal update

Boredom is the feeling that everything is a waste of time; serenity, that nothing is. Thomas Szasz

medicolegal update

Dr KK Aggarwal: Stress may increase smoking habits http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: What keeps life fascinating is the constant creativity of the soul.

medicolegal update
  1. Dear Sir, very informative news. Regards: Dr Geeta

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