eMedinewS13th April 2014,Sunday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee

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

5 Steps to Lower Alzheimer’s Risk

  • Maintain a healthy weight.
  • Check your waistline.
  • Eat mindfully. Emphasize colorful, vitamin–packed vegetables and fruits; whole grains; fish, lean poultry, tofu, and beans and other legumes as protein sources plus healthy fats. Cut down on unnecessary calories from sweets, sodas, refined grains like white bread or white rice, unhealthy fats, fried and fast foods, and mindless snacking. Keep a close eye on portion sizes, too.
  • Exercise regularly. Aim for 2½ to 5 hours weekly of brisk walking (at 4 mph). Or try a vigorous exercise like jogging (at 6 mph) for half that time.
  • Keep an eye on important health numbers. In addition to watching your weight and waistline, keep a watch on your cholesterol, triglycerides, blood pressure, and blood sugar numbers.

News Around The Globe

  • A new study published online in the Clinical Journal of the American Society of Nephrology has stated that the risk of developing end–stage renal disease (ESRD) may be increased two-fold in individuals with diabetes and major depression. The study included 3886 participants; 448 (11.5%) of these had major depressive symptoms and 327 (8.4%) had minor depressive symptoms. During a median follow–up of 8.8 years, approximately 2.2% of these developed ESRD. Those with major depression were noted to have a higher risk for ESRD (hazard ratio, 1.85; 95% confidence interval, 1.02–3.33).
  • A meta-analysis of published studies has revealed that screening for hepatocellular carcinoma (HCC) in patients with cirrhosis might have some benefits. The results from the meta–analysis stated that patients with cirrhosis who undergo evaluation with liver ultrasound with or without serum α–fetoprotein have cancers detected at an earlier stage, receive curative instead of palliative treatment, and live longer than their counterparts who do not undergo regular surveillance. The meta-analysis was published online April 1 in PLoS Medicine.
  • A study published recently in Otolaryngology–Head and Neck Surgery has pointed that adults have a high rate of complications after tonsillectomy, with one in five adults also having serious complications within two weeks of surgery. The study authors evaluated the records of 36,000 adult outpatient tonsillectomies in a nationwide insurance database and noted that after one week of surgery, 15% of patients had at least one possible complication, which further increased to 20% by the two– and four–week points.
  • According to a novel research, higher thyroxine levels are associated with poorer cognitive function later in childhood among babies born very prematurely. The study authors monitored free thyroxine levels at two and six weeks of life in 83 babies born at <30 weeks’ gestation. On multivariable analysis controlling for gestational age, sex, illness after birth and brain abnormalities, higher levels of thyroxine during infancy were correlated with poorer verbal learning, verbal memory and reaction time scores at a mean age of 7.5 years.
  • Elderly women with mild cognitive impairment (MCI) who undergo a 6–month aerobic training program report increased hippocampal volume compared with women doing balance and toning exercises during that period, reports a new study published online April 7 in the British Journal of Sports Medicine. However, the change in left hippocampal volume was not associated with improved performance on a verbal memory test; instead, the increased volume was associated with poorer performance.

Rabies News (Dr A K Gupta)

How is RIG life saving?

Administration of anti–rabies vaccine stimulates production of neutralizing antibodies by the patient’s immune system. Protective levels of antibodies (more than 0.5 IU/ml of serum) are seen 7 to 14 days after the initial dose of vaccine (window period). Moreover when the bites are on the head, neck, face & hands, the incubation period will be shorter.

Thus the patients are vulnerable to develop rabies during this window period of 7 to 14 days. RIGs are readymade anti–rabies antibodies and provide passive immunity to rabies.

Cardiology eMedinewS

  • Two studies presented at the European Association for the Study of the Liver International Liver Congress 2014 have revealed that nonalcoholic fatty liver disease (NAFLD) is a significant independent predictor of cardiometabolic risk that is above and beyond that conferred by traditional risk factors. In the Japanese study, NAFLD was associated with an increased risk for type 2 diabetes, and improvement in the disease over a 10–year follow–up period appeared to reduce the risk. In the French study, NAFLD appeared to predict carotid atherosclerosis, independent of the classic cardiovascular risk factors. Additionally, in patients with NAFLD, carotid intima–media thickness (C–IMT), carotid plaques, and Framingham scores were greater.
  • A novel meta–analysis presented at the World Congress on Osteoporosis, Osteoarthritis, and Musculoskeletal Disease has revealed that calcium supplementation with and without vitamin D has no role in increasing the risk of coronary heart disease or all–cause mortality in elderly women. Data from more than 63,500 elderly women revealed no possible relationship between calcium supplementation with and without vitamin D and coronary heart disease risk in these patients.

Pediatrics eMedinewS

  • Ocular complications, especially cataract and dry eye syndrome, are commonly seen in survivors of childhood bone marrow transplantation, and such patients should be carefully monitored for ocular changes, reports a recent study presented at the American Association for Pediatric Ophthalmology and Strabismus 2014. Children older than 7 years and adolescents who underwent bone marrow transplantation at St. Jude Children’s Research Hospital in Memphis from 1995 to 2009 were analyzed in the study. At a mean follow–up of 3.8 years, 27.5% of the children developed cataracts and 10% needed cataract surgery.
  • Noninvasive tests available for screening pediatric patients with type 1 diabetes for peripheral diabetic neuropathy (DN) are plagued with low sensitivity, reports a systematic review published online April 7 in Pediatrics. The American Diabetes Association has noted that neither the 10–g monofilament test nor screening with a tuning fork is particularly useful in detecting DN in children with type 1 diabetes.

Dr K K Spiritual Blog

Top Characters of Mahabharata

To be in harmony with the body (five elements represented by Draupadi) one must acquire five qualities or in other terms live a focused life, full of strength and not being disturbed with loss or gain and finally working for the welfare of the society without having any partiality towards anyone.

  • Balanced mind: Yudhishtir ("sthir" or balanced in "yudh" or disturbed state of mind)
  • Focused vision (Arjuna)
  • Using internal power or strength (Bhima)
  • Not being partial or remaining neutral (Nakul)
  • Working for the welfare of the society (Sahdev)

With this, one can kill 100 negative qualities that a person can have (the 100 Kauravs). The hundred negative qualities are acquired because of cunningness (Shakuni), not working with the eyes of the soul (Dhritarashtra) and keeping a blind eye to any wrong happening (Gandhari).

The main negative qualities are taking decisions in day–to–day life situations (Duryodhana: dusht in yudha or war) and choosing wrong choices as a ruler (dusshasana: dusht and shasan).

The positive qualities once acquired will also win over other negative qualities like blind faith or undue attachments (Bhishma pitamaha); unrighteous loyalty (Dronacharya) and unrighteous ego (Karna).

Wellness Blog

Do not ignore transient brain dysfunction

Transient ischemic attack or TIA or mini paralysis is a brief episode of neurologic dysfunction caused by lack of blood supply in the focal brain or eye, with clinical symptoms typically lasting less than one hour, and without evidence of acute infarction or brain attack

It is a neurological emergency and early recognition can identify patients who may benefit from preventive therapy or from surgery of large vessels such as the carotid artery.

The initial evaluation of suspected TIA and minor non disabling ischemic paralysis includes brain imaging, neurovascular imaging, and a cardiac evaluation. Laboratory testing is helpful in ruling out metabolic and hematologic causes of neurologic symptoms.

TIA or minor non disabling ischemic paralysis is associated with a high early risk of recurrent paralysis. The risk of paralysis in the first two days after TIA is approximately 4 to 10 percent.

Immediate evaluation and intervention after a TIA or minor ischemic reduces the risk of recurrent stroke. Risk factor management is appropriate for all patients. Currently viable strategies include blood pressure reduction, statins, antiplatelet therapy and lifestyle modification, including smoking cessation.

For patients with TIA or ischemic stroke of atherothrombotic, lacunar (small vessel occlusive), or cryptogenic type, antiplatelet agents should be given. For patients with atrial fibrillation and a recent ischemic stroke or TIA, the treatment is blood thinners. For patients with carotid blockages, surgery is needed.

Inspirational Story

It’s Never Too Late

It was an unusually busy day for the hospital staff on the sixth floor. Ten new patients were admitted and Nurse Susan spent the morning and afternoon checking them in. Her friend Sharron, an aide, prepared ten rooms for the patients and made sure they were comfortable. After they were finished she grabbed Sharron and said, "We deserve a break. Let’s go eat."

Sitting across from each other in the noisy cafeteria, Susan noticed Sharron absently wiping the moisture off the outside of her glass with her thumbs. Her face reflected a weariness that came from more than just a busy day. “You’re pretty quiet. Are you tired, or is something wrong?” Susan asked.

Sharron hesitated. However, seeing the sincere concern in her friend’s face, she confessed, "I can’t do this the rest of my life, Susan. I have to find a higher–paying job to provide for my family. We barely get by. If it weren’t for my parents keeping my kids, well, we wouldn’t make it."

Susan noticed the bruises on Sharron’s wrists peeking out from under her jacket. "What about your husband?" "We can’t count on him. He can’t seem to hold a job. He’s got… problems." "Sharron, you’re so good with patients, and you love working here. Why don’t you go to school and become a nurse? There’s financial help available, and I’m sure your parents would agree to keep the kids while you are in class."

"It’s too late for me, Susan; I’m too old for school. I’ve always wanted to be a nurse, that’s why I took this job as an aide; at least I get to care for patients."

"How old are you?" Susan asked. "Let’s just say I’m thirty–something."

Susan pointed at the bruises on Sharron’s wrists. "I’m familiar with ‘problems’ like these. Honey, it’s never too late to become what you’ve dreamed of. Let me tell you how I know."

Susan began sharing a part of her life few knew about. It was something she normally didn’t talk about, only when it helped someone else.

"I first married when I was thirteen years old and in the eighth grade." Sharron gasped. "My husband was twenty–two. I had no idea he was violently abusive. We were married six years and I had three sons. One night my husband beat me so savagely he knocked out all my front teeth. I grabbed the boys and left. "At the divorce settlement, the judge gave our sons to my husband because I was only nineteen and he felt I couldn’t provide for them. The shock of him taking my babies left me gasping for air. To make things worse, my ex took the boys and moved, cutting all contact I had with them.

"Just like the judge predicted, I struggled to make ends meet. I found work as a waitress, working for tips only. Many days my meals consisted of milk and crackers. The most difficult thing was the emptiness in my soul. I lived in a tiny one–room apartment and the loneliness would overwhelm me. I longed to play with my babies and hear them laugh."

She paused. Even after four decades, the memory was still painful. Sharron’s eyes filled with tears as she reached out to comfort Susan. Now it didn’t matter if the bruises showed. Susan continued, "I soon discovered that waitresses with grim faces didn’t get tips, so I hid behind a smiling mask and pressed on. I remarried and had a daughter. She became my reason for living, until she went to college.

"Then I was back where I started, not knowing what to do with myself – until the day my mother had surgery. I watched the nurses care for her and thought: I can do that. The problem was, I only had an eighth–grade education. Going back to high school seemed like a huge mountain to conquer. I decided to take small steps toward my goal. The first step was to get my GED. My daughter used to laugh at how our roles reversed. Now I was burning the midnight oil and asking her questions."

Susan paused and looked directly in Sharron’s eyes. "I received my diploma when I was forty–six years old." Tears streamed down Sharron’s cheeks. Here was someone offering the key that might unlock the door in her dark life.

"The next step was to enroll in nursing school. For two long years I studied, cried and tried to quit. But my family wouldn’t let me. I remember calling my daughter and yelling, ‘Do you realize how many bones are in the human body, and I have to know them all! I can’t do this, I’m forty–six years old!’ But I did. Sharron, I can’t tell you how wonderful it felt when I received my cap and pin."

Sharron’s lunch was cold, and the ice had melted in her tea by the time Susan finished talking. Reaching across the table and taking Sharron’s hands, Susan said, "You don’t have to put up with abuse. Don’t be a victim – take charge. You will be an excellent nurse. We will climb this mountain together." Sharron wiped her mascara-stained face with her napkin. "I had no idea you suffered so much pain. You seem like someone who has always had it together."

"I guess I’ve developed an appreciation for the hardships of my life," Susan answered. "If I use them to help others, then I really haven’t lost a thing. Sharron, promise me that you will go to school and become a nurse. Then help others by sharing your experiences." Sharron promised. In a few years she became a registered nurse and worked alongside her friend until Susan retired. Sharron never forgot her colleague or the rest of her promise.

Now Sharron sits across the table taking the hands of those who are bruised in body and soul, telling them, "It’s never too late. We will climb this mountain together."

ePress Release

Inhaling diesel exhaust fumes causes heart attack or stroke

Inhaling diesel exhaust fumes causes changes in the body that may make people more prone to heart attack or stroke, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

In a study, European scientists have shown that blood clots are more likely to form in otherwise healthy people exposed to relatively high amounts of diesel engine exhaust fumes for a short time. This could cause a blocked vessel, heart attack or stroke.

Diesel engines spew many times more fine pollutant particles than gasoline engines. People with heart and artery disease should stay away from traffic congestion to avoid the effects of this pollution.

The study involved 20 healthy men, aged 21 to 44 years. They breathed filtered air and also diluted diesel exhaust at a level approximating curbside exposure on a busy road. Compared to breathing filtered air, breathing air with the diesel exhaust fumes increased clot formation by roughly 20 – 25 percent in the hours after exposure. The researchers also found an increase in platelet activation in the blood. Platelets play a major role in clotting.

The same group reported in the New England Journal of Medicine that heart attack victims showed clear differences when breathing diesel fumes. They found that the hearts of those who had survived a heart attack were far more likely to be starved of oxygen when exercising while breathing in such fumes than when exercising in clear air.

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 88972 people since 1stNovember 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 10x10 i.e. 100 per minute."

Zee News – Health Wealth Shows

Alcohol
Cancer Prevention
Depression
Paralysis
Pneumonia
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Vitiligo
Fluid Intake

 

Total CPR since 1st November 2012 – 88972 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)

emedipicstoday emedipics

A free health checkup camp was organized by Heart Care Foundation of India at Bal Bharti Public School

press release

TPA safe in pediatric stroke

video of day video of day

 

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 :

 

Make Sure

Situation: A patient after sublingual nitrate developed fainting attack.
Reaction: Oh my God! Why was the systolic murmur missed on auscultation?
Lesson: Make sure that patient with left ventricular outflow tract (LVOT) obstruction are not given sublingual nitrates.

eMedinewS Humor

Stop Following Me!

A man was walking home alone one night when he heard a "BUMP…BUMP…BUMP…" behind him. Walking faster, he looked back, making out an image of an upright coffin banging its way down the middle of the street towards him…"BUMP…BUMP…BUMP…"

The man began to run toward his home, and the coffin bounced after him faster…faster…BUMP BUMP BUMP!

He ran up to his door, fumbled with his keys, opened the door, rushed in, and locked it behind him. The coffin crashed through his door, with the lid of the coffin clapping BUMP…BUMP…BUMP… on the heels of the terrified man. The man rushed upstairs to the bathroom and locked himself in, heart pounding.

With a CRASH, the coffin broke down the door, coming slowly toward him. The man while screaming, reached for something, anything…all he can find was a box of cough drops which he hurled at the coffin.

… and suddenly "the coffin stops!"

Quote of the Day

Coming together is a beginning. Keeping together is progress. Working together is success. Henry Ford

 

Twitter of the Day

Dr KK Aggarwal: The very purpose of life is to face sufferings…According to Hinduism, the very fact …http://youtu.be/NMIK16PyBrY?a via @YouTube
Dr Deepak Chopra: Your true self is nameless & formless 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 – reg mno, rawat.vandana89@gmail.com
SMS – BK Sapna reg mno1, bksapna@hotmail.com

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

 

Our Contributors

Dr Veena Aggarwal, Dr Chanchal Pal, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Monica Vasudev, Dr Navin Dang, Dr Pawan Gupta, Dr Parveen Bhatia, Dr Prachi Garg, Rajat Bhatnagar, Dr Sudhir Gupta, Prof.(Dr).C V Raghuveer

eMedi Quiz

The following statements about meningococcal meningitis are true, except:

1. The source of infection is mainly clinical cases.
2. The disease is more common in dry and cold months of the year.
3. Chemoprophylaxis of close contacts of cases is recommended.
4. The vaccine is not effective in children below 2 years of age.

Yesterday’s Mind Teaser: A measure of location which divides the distribution in the ratio of 3:1 is:

1. Median.
2. First quartile.
3. Third quartile.
4. Mode.

Answer for yesterday’s Mind Teaser: 3. Third quartile.

Correct answers received from: Dr Poonam Chablani, Dr.K.Raju, Dr Jainendra Upadhyay, Dr.K.V.Sarma, Dr Chandresh Jardosh, Daivadheenam Jella, Dr Avtar Krishan, Arvind Diwaker.

Answer for 11th April Mind Teaser: 3. Sound referral system.

Correct answers received from: Daivadheenam Jella, Arvind Diwaker.

Send your answer to ijcp12@gmail.com

medicolegal update

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medical querymedical query

medicolegal update

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medicolegal update
  1. Dear Sir, Thanks for the updation. Regards: Dr Kartik
cardiology news

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eMedinewS Special

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