eMedinewS13th May 2014,Tuesday

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

DoJ Investigating St Jude Cardiac ‘Kickback’ Scheme

The US Department of Justice is once again investigating whether St Jude Medical provided financial kickbacks to physicians or facilities using its cardiac devices. St Jude Medical paid $16 million in 2011 to settle a civil suit, resolving allegations that the company paid kickbacks to physicians to use their implantable cardioverter defibrillators (ICDs) and pacemakers. At that time, St Jude used postmarketing studies and a registry as vehicles to reward physicians participating in those studies to implant the devices, paying each participating physician as much as $2000 per patient.

News Around The Globe

  • Phonophoresis: Therapeutic ultrasound uses sound waves to increase blood flow, relax muscle spasms, and aid healing. The doctor applies gel to your skin and moves an ultrasound wand over your skin around the painful area. In a special ultrasound technique called phonophoresis, medication (often hydrocortisone) is added to the gel. Most use ultrasound and phonophoresis to reduce soft–tissue inflammation (in tendinitis or bursitis, for example). These techniques are also used to manage pain, heal tissue, and help muscles stretch.
  • A study published online in Annals of the Rheumatic Diseases has stated that patients with very high disease activity –– ankylosing spondylitis disease activity index (ASDAS) scores of 3.5 at baseline –had disease progression of 3.1 units on spine x–ray scores over 2 years.
  • A novel study, presented at the American Association of Endocrine Surgeons (AAES) 2014 Annual Meeting, has pointed that screening all resistant–hypertensive patients for primary aldosteronism and surgically treating prospective candidates is more cost–effective as compared to lifelong medical therapy.
  • Results from the DECISION trial have revealed that sorafenib treatment can significantly improve progression–free survival in patients with radioactive iodine–refractory, locally advanced or metastatic differentiated thyroid cancer. The study has been published online in The Lancet.
  • A study published online in the American Journal of Obstetrics and Gynecology stated that various fibroid characteristics affect pregnancy outcomes in different ways. Fibroids located in the lower uterus were significantly associated with cesarean section and postpartum hemorrhage; admissions for pain were related to fibroid size, but not number, location, or type of fibroid.
  • A new phase III study has shown that monthly intravitreal injections of the vascular endothelial growth–factor (VEGF) inhibitor aflibercept is more effective strategy in treating macular edema secondary to branch retinal vein occlusion, as compared to laser therapy. The study was presented at the Association for Research in Vision and Ophthalmology 2014 Annual Meeting.

Rabies News (Dr A K Gupta)

How is RIG injected locally? What is the mode of administration of full dose of RIG?

It is important to infiltrate all wounds with rabies immunoglobulin (RIG). Intramuscular (IM) administration of RIG is of very little value. The previous recommendation to give antirabies serum half into wounds and half IM no longer holds true and may lead to treatment failure. As much of the calculated dose of RIG as is anatomically feasible should be infiltrated into and around all the wounds. In the event that some volume of RIGs is left over after all wounds have been infiltrated, the same should be administered by deep IM at a site distant from the vaccine injection site.

If the calculated dose of RIG is insufficient to infiltrate all wounds, sterile saline can be used to dilute it 2 or 3 fold to permit thorough infiltration.

Cardiology eMedinewS

  • Findings from a new pilot study have revealed that injecting botulinum toxin into the fat pads around the heart following bypass surgery might help avoid postoperative atrial fibrillation. Patients receiving botulinum toxin instead of normal saline placebo had a significantly lower rate of atrial fibrillation and atrial flutter/tachycardia in the first 30 days (30% vs. 7%).
  • An ablation method that does not rely on inducing ventricular tachycardia in patients with ischemic cardiomyopathy and ventricular tachycardia improves outcomes in terms of freedom from any recurrent ventricular tachyarrhythmias through 1 year, reports a small randomized trial. The findings were presented at the Heart Rhythm Society meeting.

Pediatrics eMedinewS

  • A novel Danish study has suggested that longer breastfeeding encourages the friendly lactic acid bacteria to flourish in the guts of children for longer. The study is published in the journal Applied and Environmental Microbiology.
  • A study presented at the Pediatric Academic Societies (PAS) annual meeting has revealed that pregnant women who watched television while eating were more likely to sit in front of the TV while feeding their infant. The study also pointed that turning the TV off during mealtimes could help prevent childhood obesity and needs to be started even before a child is born.

Dr K K Spiritual Blog

Vedic principles behind cognitive behavior therapy

1) What is counseling?

A: The mental process involves generation of a thought or idea, which is analyzed and then acted upon. Thought, analysis and action therefore are the primary three process of human mind. Counseling involves action at all three levels.

2) What are different types of counseling?

A: Counseling involves basically two principles – Cognitive counseling and behavioral counseling. Behavioral, when the concentration is only on the actions and cognitive, when the concentration is on the changes in either the thought process or in the interpretation of the thought process.

3) What is cognitive behavior therapy?

A: As against a pure behavior therapy where a person is counseled to do pre–defined things on regular intervals, cognitive behavior therapy involves changing the actions by changing observations of the interpretation of a particular situation.

4) What is the origin of counseling in India?

A: The origin of counseling goes back to Vedic era. Upanishads were basically text books on counseling based on the original knowledge of Rigveda, Yajurveda, Samveda and Atharvaveda.

5) Is there a relationship of Bhagavad Gita with Counseling?

A: Bhagavad Gita is counseling done by Krishna to resolve the conflict in Arjuna’s mind whether to fight or not. At that time there were no doctors and hence counseling was done by the elders in the family.

6) Are the principles of Bhagavad Gita followed today?

A: All the principles of cognitive behavior therapy today are basically principles that have originated from Bhagavad Gita.

7) What is the first principle?

A: The first principle is that "counseling cannot be done in 1 or 2 sessions." It requires up to 18 sessions which is what Krishna did in Bhagavad Gita. Bhagavad Gita contains 702 dialogues in the form of Shlokas therefore a proper counseling involves in–depth conversation between the counselor and the patient.

8) What is the second principle of counseling?

A: The second principle of counseling is to listen to the patient in the first session in great detail and this is what Krishna did in Bhagavad Gita. In Chapter 1, only Arjuna speaks and Krishna does not utter a word. A patient listening is half the healing done.

9) What is the third principle?

A: As per the third principle, the second (first interactive) session between counselor and the patient should be the longest one. Chapter 2 of Bhagavad Gita is the gist of Krishna’s counseling.

10) What is the fourth principle?

A: The fourth principle is that after giving a detailed counseling in the second session, it is expected that the patient will be confused. This is what happens in start of Chapter 3 where Arjuna says to Krishna "I am confused. Sometimes you are talking about one path and other time you are talking about another path. Guide me again." The third counseling session therefore, is the most important where one has to counsel slowly and in great detail.

11) What is the fifth principle?

A: The next principle is to give reasoning to the counseling. One should not take patient for granted. Krishna discusses each and every aspect of life with Arjuna in great detail giving scientific reasoning at every stage.

12) What is the sixth principle?

A: Reassure the patient again and again. During counseling Krishna assures Arjuna on multiple occasions that you did your job and do not worry. I am with you.

13) What is the seventh principle?

A: The seventh principle involves creating some fear in the patient’s mind. This is what Krishna does while showing his virat swaroop. This especially works in patients of addiction. Some degree of fear with re–assurance from the counselor always works.

14) What is the eight principle?

A: The summing up counseling session should be as long as the second session. The Chapter 18 of Bhagavad Gita is as big as Chapter 2 where the whole Bhagavad Gita is summarized again.

15 What are the ingredients of counseling?

A: Counseling basically involves indepth knowledge of dharma, artha, kama and moksha. They are greatly described in Dharmashastra, Arthashastra, Kamasutra and Upanishads through various Vedas.

16) What is stress?

A: Stress is the reaction of the body or the mind to the interpretation of any situation.

17) How can stress be managed?

A: Stress can be managed by either changing the response of the body through yogic living, or changing the interpretation by understanding the principles of counseling or change the reaction by willful actions.

18) Are different nitis of our scriptures based on counseling?

A: Yes. Vidur Niti was the counseling given by Vidur to Dhritarashtra when he was not sleeping and Chanakya Niti was based on how to rule a country. Yoga Vashishtha was the counseling given by Vashishtha to Rama to acquire higher levels of spiritual knowledge.

Wellness Blog

New Test that Rapidly Detects Blood Infections

A new simple and inexpensive test can identify bacteria in the blood in less than 20 minutes. The method combines a selective lysis step in which blood cells in the sample are destroyed, a centrifugation step to collect any bacteria or fungi in the sample, and a fluorescence step that analyzes the particular fingerprint of any pathogens present in the sample. It can correctly identify the species of bacteria or fungi in 96.5 % of positive blood culture samples.

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

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VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

emedipicstoday emedipics

World Earth Day Celebration at DAV Public School, RK Puram, New Delhi.

press release

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

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: Doctor, this patient has developed acute renal failure (ARF).

Reaction: Oh my God, I forgot that he was on furosemide. I gave him full dose of amikacin.

Lesson: Make sure, before calculating the dose of aminoglycoside (amikacin) that furosemide and other loop diuretics, which enhance its nephrotoxicity are not being given.

eMedinewS Humor

Science Lesson

Miss Jones had been giving her second–grade students a lesson on science. She had explained about magnets and showed how they would pick up nails and other bits of iron.

Now it was question time, and she asked, "My name begins with the letter ‘M’ and I pick up things. What am I?"

Little Johnny in the front row proudly said, "You’re a mother!"

Quote of the Day

I feel sorry for people who don’t drink. When they wake up in the morning, that’s as good as they’re going to feel all day. Frank Sinatra

 

Twitter of the Day

Dr KK Aggarwal: Weight gain precedes the onset of diabetes Weight gain after age of 18 years in women and 20 years in men (cont) http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Fluidity & flow in every moment as it unfolds in an eternal now is lightness of being http://bit.ly/HTZaj4 #Health

 

Inspirational Story

Colors of Rainbow

Once upon a time the colors of the world started to quarrel. All claimed that they were the best…the most important, the most useful, the most beautiful and the favorite.

Green said: "Clearly I am the most important. I am the sign of life and of hope. I was chosen for grass, trees and leaves. Without me, all animals would die. Look over the countryside and you will see that I am in the majority."

Blue interrupted: "You only think about the earth, but consider the sky and the sea. It is the water that is the basis of life and drawn up by the clouds from the deep sea. The sky gives space and peace and serenity. Without my peace, you would all be nothing."Yellow chuckled: "You are all so serious. I bring laughter, gaiety, and warmth into the world. The sun is yellow, the moon is yellow, and the stars are yellow. Every time you look at a sunflower, the whole world starts to smile. Without me there would be no fun."

Orange started next to blow her trumpet: "I am the color of health and strength. I may be scarce, but I am precious for I serve the needs of human life. I carry the most important vitamins. Think of carrots, pumpkins, oranges, mangoes, and papayas. I don’t hang around all the time, but when I fill the sky at sunrise or sunset my beauty is so striking that no one gives another thought to any of you."

Red could stand it no longer he shouted out: "I am the ruler of all of you. I am blood – life’s blood! I am the color of danger and of bravery. I am willing to fight for a cause. I bring fire into the blood. Without me, the earth would be as empty as the moon. I am the color of passion and of love, the red rose, the poinsettia and the poppy."

Purple rose up to his full height: He was very tall and spoke with great pomp: "I am the color of royalty and power. Kings, chiefs, and bishops have always chosen me for I am the sign of authority and wisdom. People do not question me! They listen and obey." Finally Indigo spoke, much more quietly than all the others. But with just as much determination: "Think of me. I am the color of silence. You hardly notice me, but without me you all become superficial. I represent thought and reflection, twilight and deep water. You need me for balance and contrast, for prayer and inner peace."

And so all the colors went on boasting to each other. Each convinced of his or her own superiority. Their quarreling became louder and louder.

Suddenly there was a startling flash of bright lightening, thunder rolled and boomed. Rain started to pour down relentlessly. The colors crouched down in fear, drawing close to one another for comfort.

In the midst of the clamor, the Rain began to speak: "You foolish colors, fighting amongst yourselves, each trying to dominate the rest. Don’t you know that you were each made for a special purpose, unique and different? Join hands with one another and come to me."

Doing as they were told, the colors united and joined hands.

The Rain continued, "From now on, when it rains, each of you will stretch across the sky. In a great bow of color as a reminder that you can all live in peace. The Rainbow is a sign of hope for tomorrow." And so, whenever a good rain–washes the world and a Rainbow appears in the sky, is to let us remember to appreciate one another.

ePress Release

Excess Fat around the Waist May Increase Death Risk for Women

There is increasing evidence that excess abdominal fat is a risk factor for long–term conditions like diabetes and heart disease. However, a recent study from Harvard and the National Institutes of Health published in the journal Circulation has linked abdominal obesity and risk of premature death in women, 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.

As per the study, women who carry excess fat around their waists are at greater risk of dying early from cancer or heart disease than women with smaller waistlines, even if they were of normal weight.

In the study researchers followed more than 44,000 nurses over the course of 16 years to track their medical history and lifestyle. At the beginning of the study the women were asked to measure their waists and hips. Every two years, the women completed questionnaires about their health, providing information about their age, activity level, smoking status, diet, blood pressure and cholesterol levels.

They examined the cause of death for all women who died over the course of the study. In total, 3,507 deaths occurred, of these, 1,748 were due to cancer and 751 were due to heart disease. They discovered that women with greater waist circumferences were more likely to die prematurely, particularly from heart disease, when compared to women with smaller waists. For example, women with waist size equal to or greater than 35 inches were approximately twice as likely to die of heart disease as were women with a waist size less than 28 inches, regardless of their body mass index.

Similarly, women with a waist size equal to or greater than 35 inches also were twice as likely to die of cancer as were women with a waist size less than 28 inches. Women who had a greater waist circumference and were also obese were at the greatest risk of premature death. Greater waist circumference is a sign of collecting excess fat around one’s midsection, called abdominal obesity. A healthy waist limit for women is 80 cm and for men is 85 cm. Waist circumference is determined by measuring around the waist at the navel line.

eMedi Quiz

Since sunscreen–awareness campaigns began, have skin–cancer rates decreased?

A. About 10 percent of your daily calories.
B. About 20 percent of your daily calories.
C. About 30 percent of your daily calories.
D. About 40 percent of your daily calories.
E. There is no recommended amount of fat;

Yesterday’s Mind Teaser: you should strive to eat as little of it as possible.

A. Yes, fewer people are getting skin cancer.
B. No, skin–cancer rates and deaths from the disease are on the upswing.
C. No, skin cancer is on the rise, but fatalities are down.
D. Skin–cancer rates have been stable over the past decade.
E. Yes, but only among older women.

Answer for yesterday’s Mind Teaser: C. About 30 percent of your daily calories.

Correct Answers received from: Dr K.Raju, Prabha Sanghi, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Dr.B.R.Bhatnagar, Dr Pawan Mehta, Dr Avtar Krishan, Dr Ajay Gandhi, Daivadheenam Jella

Answer for 11th May Mind Teaser: 3.Racemization.

Correct Answers received from:Dr. Pawan Mehta, Dr Avtar Krishan

Send your answer to ijcp12@gmail.com

medicolegal update

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  1. Dear Sir,Very informative news. Regards: Dr Kartik
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