eMedinewS13th February 2014,Thursday

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
www.facebook.com/Dr KKAggarwal

Flu in children

  1. The classical features of uncomplicated flu in children include abrupt onset of fever, headache, muscle pain and malaise affected by manifestation of respiratory tract illness – sore throat, sough and nasal discharge.
  2. All the above features may not be present in children.
  3. Flu sometimes may last for more than a week in children.
  4. Ear discharge, development into asthma and pneumonia are common complications in children.
  5. Complicated pneumonia may be severe and rapidly fatal, especially if the bacterium is Staph.
  6. During winter,flu should be considered in all children with fever; children with fever and acute onset of respiratory illness; children with fever and exhilaration of underlying chest condition; children with pneumonia and children with fever of more than 100, with severe cough or sore throat.
  7. Fever is present in over 95% of cases, often more than 39oC.
  8. Cough is present in over 77% patients.
  9. Nasal discharge is present in more than 78% patients.
  10. Headache is present in more than 26% patients.
  11. Muscle pain is present in more than 71 % patients.
  12. Incubation period is 1–4 days with high transmissibility.
  13. The treatment is often symptomatic.
  14. Cough hygiene should be practiced.
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."

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

Is time and place of death pre–defined?

sprritual blog

Some gurus teach that the time and place of death is predefined and some do not. I personally feel that life and respiration are predefined and not day and time of death.

It is something like – water in a sponge will become empty when every drop of water comes out but it does not matter how much time it takes to come out. It is therefore possible to postpone or prolong the fulfillment of Prarabhdha Karma and postpone death.

As per the Karma theory, unless our Prarabdha Karmas (decided at the time of death and birth) are enjoyed and fulfilled, one cannot die. But once the Prarabhdha Karmas are fulfilled, death is inevitable.

Another unanswered question is ‘can Prarabdha karma be modified’? Fate or destiny may not change, which means one may not be able to prolong the quantity of life but can definitely change the quality of life. The quality of life can be changed by modifying Agami (present Karmas).

Sanchit Karmas can be burnt with the file of knowledge about self. Prarabdha Karmas have to be experienced and Agami Karma can be neutralized by positive and negative Karmas to Zero in the present life.

The last few Prarabdha Karma experienced can thus be slowed down by the net positive result of their Agami karmas.

cardiology news

A Touch of Heaven

It had been a very disheartening day. The doctors had given us the worst of news. Our daughter, who had just completed her first brain surgery to remove a tumor and was going through radiation treatments, was now officially given a two percent chance of survival as this type of cancer had no cure.

My wife and I decided to take our daughter to lunch before continuing our afternoon conversations. We went to a local restaurant where we sat in silence waiting for the waitress. Our daughter Molly wouldn’t hear of such sadness or silence so she played happily with crayons and paper while we sat and stared at the floor.

I noticed a very elderly couple sitting a few booths away, they too in silence never speaking a word. I couldn’t help but wonder what challenges they had faced in their life and if they ever faced such terrible news about a child of theirs.

We eventually ordered our lunch and still sitting in silence we ate what we could. At some point I became intrigued by the old couple and I watched them more intently with each passing minute. I thought to myself that they hadn’t yet spoken to each other and I wondered if it was the peace they were enjoying or the food or maybe both. However, at some point I lost interest and put my focus back on my lunch.

Molly was still talking away and enjoying her meal and her mom and I both listened and tried to be happy in her presence but it wasn’t going very well. All of a sudden I saw this hand come out of nowhere. It was huge and I could tell that it had been afflicted with arthritis. The knuckles were swollen and the fingers were crooked and off center. I couldn’t take my eyes of that hand. The hand drifted down and landed on my daughter's tiny six year old hand and as it did I looked up; it was the old woman who had been sitting with the old man in silence eating their lunch.

I looked into her eyes and she spoke, but not to me. She looked at my daughter and simply whispered, "If I could do more for you I would." And then she smiled and moved away to join her husband who had moved towards the door.

I heard a "Hey look, a whole dollar." Molly spoke with excitement as she discovered that the old lady had placed a crumpled one dollar bill on the back of her hand. I looked down and saw the dollar bill and quickly realized that it had been left behind by the old lady. I looked up to thank her, but she was gone. I sat stunned, not sure what had just happened and then I looked over at my wife. In almost unison, we broke out into a smile. The sadness of the day had been wiped out by the crippled hand and generous touch of an old lady.

The dollar, although exciting to Molly, was not what made us smile or begin to feel differently, it was the offer from an old lady who felt our hurt and our suffering. The crippled hand symbolized a healing touch and made us realize that we did not have to fight this battle alone; that others cared and wanted to help. We felt uplifted and soon our day filled with more happy thoughts as we spent the rest of our lunch planning the next day at home with fun filled activities for everyone.

I will never forget that crippled arthritic hand that taught us such an important lesson. One does not have to go through life facing hardships all alone; the world is full of compassionate and understanding people. Even those that are suffering from their own afflictions have much to give to each other.

The hand that covered Molly’s on that day still covers it. And although Molly is no longer with me, I can see her holding hands with that old lady now, both hands perfect and both faces filled with smiles and laughter. And though Heaven has these two perfect angels now, the lessons that they both taught me will remain forever in my heart.

News Around The Globe

  • Distinguished Services Award in Pharmaceutical Sciences: On 31st January, 2014, Professor S.S. Agrawal, Gp. Dy. Pro Vice Chancellor, AMITY UNIVERSITY UTTAR PRADESH was bestowed with "Distinguished Services Award in Pharmaceutical Sciences" during the 6th International Conference on "Recent Advances in Cardiovascular Sciences" organized by International Society of Cardiovascular Sciences. The award was given away by Dr. Ferrid Murad, Noble Laureate – 1998 (discoverer of nitric oxide release during vasodilatations).
  • According to a new position paper by the International Osteoporosis Foundation (IOF) Epidemiology and Quality of Life Working Group, despite its ability to significantly improve risk assessment for osteoporosis, the World Health Organization’s Fracture Risk Assessment Tool (FRAX) has widely varying usage around the world.
  • Pregnant women with nonsevere hypertensive disorders between 34–37 weeks should be monitored closely rather than delivered immediately to avoid neonatal respiratory distress. In a study presented at the annual meeting of the Society for Maternal–Fetal Medicine, in a delivery group of 352 women, 0.9% of the mothers experienced adverse outcomes, but 5.7% of the neonates developed respiratory distress syndrome (RDS), while in the expectant monitoring group, 2.8% of moms had adverse outcomes, while RDS occurred in only 1.7% of the neonates.
  • Once or twice weekly prophylactic dosing of recombinant factor IX nonacog alfa significantly reduced annualized bleeding rates in patients with hemophilia B as reported in a randomized controlled trial published online January 13 in Haemophilia.
  • A new saliva test and earlier use of the HbA 1c blood test could pick up type 2 diabetes in high–risk patients earlier than methods in current use, show data from 2 studies. According to researchers, both tests could both provide an effective and timelier means of disease detection, precipitating earlier intervention, say the respective researchers.
  • A double–blind, randomized, placebo–controlled trial conducted by investigators at the University of Canterbury, Christchurch, New Zealand, showed that a micronutrient formula consisting of vitamins and minerals was significantly better than placebo in reducing symptoms of attention–deficit/hyperactivity disorder (ADHD) in adults and improved mood in a subset with moderate depression. The study was published online January 30 in the British Journal of Psychiatry.

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)

What are the factors responsible for rabies transmission in man from rabid animals?

  • Rabies is most commonly transmitted to humans via the bite of a rabies–infected animal.
  • Humans usually contract rabies through bite wounds from rabid animals (bite exposure) because the rabies virus is highly concentrated in the saliva of infected animals.
  • The amount of virus reaching the lesion is also a factor in transmission; for example, when a bite has to penetrate clothing, the saliva may be retained in the fabric and be prevented from entering the wound.
  • It can also be transmitted through non-bite exposure, although this rarely occurs. Airborne infections, such as inhaling an aerosol of infected animal brain tissue in virus laboratories, or of contaminated air in bat–inhabited caves, have been reported.
  • Iatrogenic rabies cases have occurred in patients who received cornea, kidney, liver, or blood vessel graft transplantation from donors who had undiagnosed rabies.
  • To date, the only medically verified cases of human–to–human rabies transmission are the cases infected through organ transplantation from undiagnosed rabies patients

Potential non–bite modes of transmission include contamination of a pre–existing wound, contact of mucous membrane or respiratory tract with the saliva of an infected animal, exposure to aerosolized rabies virus in the laboratory (or from bats), or via organ transplantation from an infected donor.

cardiology news

How to recognize cardiac arrest

  • Rapid recognition of cardiac arrest is the essential first step of successful CPR 10.
  • As per Guidelines, the lay rescuer who witnesses a person collapse or comes across an apparently unresponsive person should confirm unresponsiveness by tapping the person on the shoulder and shouting: "are you all right?"
  • If the person does not respond, the rescuer calls for help or ambulance and initiates excellent chest compressions.
  • Lay rescuers should not attempt to assess the victim’s pulse and, unless the patient has what appear to be normal respirations, should assume the patient is apneic or without respiration.
  • Remember even well–trained professionals can have difficulty determining if breathing is adequate or pulses are present in unresponsive adults.
  • After assessing responsiveness, health care providers should quickly check the patient’s pulse.
  • While doing so, it is reasonable to visually assess the patient’s respirations.
  • It is appropriate to assume the patient is in cardiac arrest if there is no breathing or abnormal breathing (gasping) or if a pulse cannot be readily palpated within 10 seconds.
  • The key point is not to delay CPR.
cardiology news

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

  • The American Heart Association/American Stroke Association (AHA/ASA) has issued a new statement on the management of cerebral and cerebellar infarction with brain swelling. The statement, "Recommendations for the Management of Cerebral and Cerebellar Infarction with Swelling," was published online in Stroke on January 30. The authors said that swollen cerebral and cerebellar infarcts are critical conditions that warrant immediate, specialized neurointensive care and often neurosurgical intervention. Decompressive craniectomy is a necessary option in many patients. Selected patients may benefit greatly from such an approach, and although disabled, they may be functionally independent.
  • A new study published online February 5, 2014 in the Journal of the American College of Cardiology has shed light on which low–risk patients who have inconclusive exercise ECG tests might safely avoid additional downstream imaging tests to detect potential CAD. Senior author Dr Ron Blankstein (Brigham and Women’s Hospital, Boston, MA said that patients who were most likely to have a positive finding in subsequent imaging tests were those who had typical angina symptoms despite having a normal ECG during exercise. On the other hand, patients who have positive ECG changes with rapid recovery—i.e., ECG changes that resolve in less than a minute—almost all of those patients, when they underwent further testing, had negative results as well as an excellent prognosis, which suggests that they do not require further testing.
cardiology news

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

  • When it comes to operating room time and hospital stay, excising a tracheocutaneous fistula (TCF) and letting the area heal may be better than closing it, a retrospective study suggests. The mean procedure duration was much longer for the closure group than for the excision group (37.4 vs 9.7 min), but the closure success rates did not differ significantly between the groups (30/30 versus 20/22). Nor did complication rates differ between excision (0/22) and closure (2/30). The study is reported in JAMA Otolaryngology - Head and Neck Surgery.
  • Giving children with acute asthma flare-ups 1 or 2 doses of dexamethasone in the emergency department (ED) provides equivalent relief to a 5-day course of prednisone while reducing the chance of triggering vomiting, according to a meta-analysis published online February 10 in Pediatrics.
cardiology news

Total CPR since 1st November 2012 – 86664 trained

Media advocacy through Web Media

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press release

Vegetables & fruits lower chances of getting some cancers

Vegetables and fruits help lower your chances of getting head, neck, breast, ovarian and pancreatic cancers. Even one additional serving of vegetables or fruits could help lower the risk of head and neck cancer. The more fruits and vegetables you can consume, the better.

Quoting an International Study from National Cancer Institute, Padma Shri, Dr B C Roy National & DST National Science Communication Awardee Dr K K Aggarwal, President Heart Care Foundation of India and Senior National Vice President, Indian Medical Association said that those who eat six servings of fruits and vegetables per 1,000 calories have a 29% decreased risk relative to those who have 1.5 servings. In the study, after adjusting the data to account for smoking and alcohol use – known head and neck cancer risk factors – the researchers found that those who consumed the most fruits and vegetables had the lowest risk for head and neck cancers. Vegetables appeared to offer more cancer prevention than fruits alone did. Adding just one serving of fruit or vegetables per each 1000 calories consumed daily resulted in a 6% reduction of risk.

In another study, broccoli and soy protein were found to protect against the more aggressive breast and ovarian cancers. When consumed together, digesting broccoli and soy forms a compound called di–indolylmethane (DIM). In lab experiments, the researchers found that DIM could affect the motility of breast and ovarian cancer cells, which could help keep cancers from spreading. Soy, acts like estrogen and is a nutritious, healthy food, and should be eaten in moderation.

Yet another study compared intake of flavonols to their risk of pancreatic cancer. Flavonols are protective compounds found in fruits and vegetables, such as onions, apples, berries, kale and broccoli. Those who had the highest consumption of flavonols reduced their risk of pancreatic cancer by 23%. The benefit was even greater for people who smoked. Smokers with high levels of flavonols reduced their risk of pancreatic cancer by 59%.

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 86664 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."

emedipicstoday emedipics

Distinguish Services Award in Pharmaceutical Sciences

press release

Vitamin D intake associated with reduced risk for Crohn’s disease

vedio of day

today video of the dayHeart disease starts in youth

Cholesterol tips released

Padma Shri & Dr B C Roy National Awardee, Dr KK Aggarwal on Tackling tension headaches

eMedi Quiz

An enzyme involved in the catabolism of fructose to pyruvate in the liver is:

1.Glyceraldehyde–3–phosphate dehydrogenase.

Yesterday’s Mind Teaser: A vitreous aspirate has been collected in an emergency at 9 pm. What advice would you like to give to the staff on duty regarding the overnight storage of the sample?

1. The sample should be kept at 4°C.
2. The sample should be incubated at 37°C.
3. The sample should be refrigerated deep freezer.
4. The sample should be refrigerated for the initial 3 hours and then incubated at 37°C.

Answer for yesterday’s Mind Teaser: 1. The sample should be kept at 4°C.

Correct answers received from: Arvind Gajjar, Prabha Sanghi, Dr.K.Raju, Dr Jainendra Upadhyay, Sangeetha Raja, Dr.Chandresh Jardosh, drjella, Dr Avtar Krishan, Muthumperumal Thirumalpillai

Answer for 11th February Mind Teaser: 4. Superior vena caval obstruction.

Correct answers received from: DR AYYAVOO ERODE, Dr. P. C. Das, Tukaram Pagad

Send your answer to ijcp12@gmail.com

medicolegal update

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medical querymedical query

medicolegal update
medicolegal update

To be in news in Kalyuga

Certain people learn the art of being in the news. There was a person who was nominated for a Noble Prize, so he remained in news for a month.

Next month he got the prize and again remained in news for a month. A month later, he said the he is going to return the Noble Prize, thus, again remained in news for another month.

Next month he said that he was going to retain his Noble Prize but he was going to donate the prize money in charity. It made him remain in news for another month. Next month, he donated the money to the charity and a month later people came to know that he donated the money to the charity, where he was the lone surviving trustee.

This is an imaginary humor–based fact. Remember publicity is earned and publicity like above in longer run will only harm.

medicolegal update

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medicolegal updatemedicolegal update

medicolegal update

Situation: An asthmatic with respiratory rate of 37 developed respiratory arrest.
Reaction: Oh my God!! Why was the patient not put on the ventilator in time?
Lesson: Make sure to remember that a respiratory rate of > 35 is a warning signal to start ventilation therapy.

medicolegal update

Men talk of killing time, while time quietly kills them. Dion Boucicault

medicolegal update

Dr KK Aggarwal: X ray can be normal in Pneumonia http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Detachment is freedom http://bit.ly/DC_Ananda #ananda

Forthcoming events

Date: Saturday 2PM-Sunday 3PM, 26–27 April 2014
Venue: Om Shanti Retreat Centre, Bhora Kalan, Pataudi Road, Manesar
Course Directors: Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal and BK Sapna
Organisers: Heart Care Foundation of India. Prajapati Brahma Kumari Ishwariye Vidyalaya and eMedinews
Facilities: Lodging and boarding provided (one room per family or one room for two persons). Limited rooms for first three hundred registrants.
Course: Meditation, Lectures, Practical workshops
Atmosphere: Silence, Nature, Pyramid Meditation, Night Walk
Registration: SMS– Vandana Rawat – 9958771177, rawat.vandana89@gmail.com
SMS – BK Sapna 9650692204, bksapna@hotmail.com

Note: Donation in Favor of Om Shanti Retreat Centre will be welcomed

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

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