eMedinewS13th June 2014,Friday

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

Declines in eGFR Good Predictor of CKD Progression

In chronic kidney disease (CKD), decline in estimated glomerular filtration rate (eGFR) is a predictor of progression to end–stage renal disease (ESRD) and mortality.

Until now doubling of serum creatinine was used to define progression of CKD; however, in this meta–analysis, smaller decreases in eGFR "strongly" and "consistently" identified a greater proportion of people at risk for ESRD and mortality.

Optimal level of eGFR decline is approximately 30% over 2 years. At this level, you have the best information about who is going to progress to end–stage renal disease. But the doubling of serum creatinine turned out to be a 57% decreasein eGFR, which is a very strict and a very rare end point.

The study results were presented here at the European Renal Association–European Dialysis and Transplant Association (ERA–EDTA) 51st Congress, and were published online simultaneously in JAMA.

News Around The Globe

  • The American Cancer Society has issued new guidelines to help primary care physicians (PCPs) better manage prostate cancer survivors. The new guidelines are both evidence– and expert–based and advice oncologists to provide PCPs with treatment summaries and post treatment follow–up recommendations for patients. The guidance has been published online in CA: A Cancer Journal for Physicians.
  • A re examination of data from the National Institute of Child Health and Human Development microarray trial published in 2012 has revealed that anomalies detected with ultrasound in fetuses with normal karyotypes could be associated with unusual copy number variants (CNVs). The findings have been published online in Obstetrics & Gynecology.
  • A review article by investigators from the National Institute on Drug Abuse (NIDA) has suggested that marijuana use is associated with substantial adverse events, including addiction and long–term cognitive dysfunction. The review article was published in the June 5 issue of the New England Journal of Medicine.
  • The combination of late life depression and increased cerebral beta–amyloid deposits in patients with mild cognitive impairment appears to be a risk factor for quick progression to Alzheimer’s disease, reports a longitudinal analysis from the Alzheimer’s Disease Neuroimaging Initiative database. The findings were presented at the Society of Nuclear Medicine and Molecular Imaging (SNMMI) 2014 Annual Meeting.
  • A new research has suggested that the routine use of alcohol–impregnated disinfection devices on all central–line access ports has the potential to reduce central–line–associated bloodstream infections (CLABSIs). The study was presented at the Association for Professionals in Infection Control and Epidemiology (APIC) 2014 Annual Meeting.

Rabies News (Dr A K Gupta)

Is there a need to alter the dose or schedule of any concomitant medication during IDRV?

There is no need to alter the dose or schedule of any concomitant medication during IDRV.

Cardiology eMedinewS

  • New data from a study including 1.25 million patients has put forward some new observations on how blood pressure affects 12 different manifestations of cardiovascular disease, including various forms of stroke. Researchers noted that a 30–year–old patient with hypertension has a substantial increase in lifetime risk for a cardiovascular event compared with a normotensive individual (63% vs. 46%) and is likely to develop cardiovascular disease an average of 5 years earlier. The study has been published in The Lancet.
  • A new study found that physical activity levels were modestly lower among statin users compared with nonusers independently of other cardiac medications and of medical history. Researchers noted that new statin use was associated with a more rapid reduction in physical activity than nonuse. The prospective community–based cohort study of men aged >65 years was published June 9 in JAMA Internal Medicine.

Pediatrics eMedinewS

  • A large international study has shown that infants at risk for type 1 diabetes who were fed hydrolyzed formula still produced antibodies against the insulin–producing cells of the pancreas, contrary to previous reports stating that this baby formula lacking complex cow milk proteins might prevent the development of auto–antibodies. The findings were published in the JAMA.
  • New findings from the University of Illinois suggest that more parental sleep is related to more child sleep, which is in turn related to decreased childhood obesity. The study authors noted that the number of hours a parent sleeps was related to how much sleep children got, and that parents’ sleep has an effect on the likelihood that their children will be overweight or obese. The study was published in Frontiers in Psychology.

Dr K K Spiritual Blog

The spiritual prescription: "I am sorry"

The two hardest words for a doctor to say: "I’m sorry."

Most defense lawyers counsels doctors not to apologize to patients. Their view is that if you say you’re sorry for something, you are implicitly taking some degree of responsibility for whatever has happened or in other words you are pleading guilty. The complainant’s lawyers may use a doctor’s apology to the maximum extent possible to show the doctor knew what they did was wrong. The usual approach is to deny and defend. But:

  • Apologizing after a medical error is the humane thing to do.
  • Patients often sue simply because it’s the only way to find out what went wrong.
  • Erecting a wall of silence is enough to make someone very angry. And it’s awfully easy for an angry person to find a lawyer who will listen to them. At that point, it’s too late for sorry.
  • Over 35 states in the USA have passed laws prohibiting doctors’ apologies from being used against them in court. (apology laws)
  • By promptly disclosing medical errors and offering earnest apologies and fair compensation one can hope to restore integrity to dealings with patients, make it easier to learn from mistakes and dilute anger that often fuels lawsuits.

Apology the spiritual answer

  • The word ‘sorry’ is synonymous with apology.
  • To err is human, to admit one’s error is superhuman.
  • Sorry should be heartfelt and not ego felt. You should not only say sorry but it should also look like that you are sorry.
  • Tremendous courage is entailed to face the victim of our wrong doing and apologise.
  • It is generally seen that those who are in harmony with their life and consequently with themselves, find it easier to say ‘I’m sorry’. They are the positive, conscientious ones who are at peace only after making amends for their misdeeds.
  • The word ‘sorry’ in itself is imbued with so much potential and power. Within a fraction of a second, grave mistakes are diluted, tepid and estranged relations are brought alive, animosity and rancour are dissolved, misunderstandings resolved and tense situations ease out resulting in harmony and rapprochement.
  • To forgive and forget is a common spiritual saying
  • Remember we all do mistakes and seek forgiveness form GOD every day.

Wellness Blog

Drinking coffee prevents Parkinson’s disease

Nicotine present in the tobacco has been used for its medicinal value for quite some time for diseases like Parkinson’s disease and ulcerative colitis. A study from University of Miami School of Medicine, USA, now has shown that people from families prone to Parkinson’s disease are less likely to develop the disease if they drink coffee on a regular basis.

Both coffee and nicotine have a link with dopamine in the brain. Dopamine is a chemical that decreases in patients with Parkinson’s disease.

It is possible that people who are going to have Parkinson’s disease have lower levels of dopamine. Those with low levels of dopamine may be more likely to enjoy caffeine.

Parkinson’s disease is caused when brain cells that produce dopamine die. The disease is progressive, affecting about one percent of people older than 65.

Symptoms start out with shaking and can progress to paralysis. There is no cure, although a number of drugs can make symptoms better for a time.

Inspirational Story

Laughter is the Best Medicine

Many years ago, Norman Cousins was diagnosed as "terminally ill". He was given six months to live. His chance for recovery was 1 in 500.

He could see the worry, depression and anger in his life contributed to, and perhaps helped cause, his disease. He wondered, "If illness can be caused by negativity, can wellness be created by positivity?"

He decided to make an experiment of himself. Laughter was one of the most positive activities he knew. He rented all the funny movies he could find – Keaton, Chaplin, Fields, the Marx Brothers. (This was before VCRs, so he had to rent the actual films) He read funny stories. He asked his friends to call him whenever they said, heard or did something funny.

His pain was so great he could not sleep. Laughing for 10 solid minutes, he found, relieved the pain for several hours so he could sleep. He fully recovered from his illness and lived another 20 happy, healthy and productive years. (His journey is detailed in his book, Anatomy of an Illness) He credits visualization, the love of his family and friends, and laughter for his recovery.

Some people think laughter is a waste of time. It is a luxury, they say, a frivolity, something to indulge in only every so often. Nothing could be further from the truth. Laughter is essential to our equilibrium, to our well–being, to our aliveness. If we’re not well, laughter helps us get well; if we are well, laughter helps us stay that way.

Since Cousins’ ground–breaking subjective work, scientific studies have shown that laughter has a curative effect on the body, the mind and the emotions. So, if you like laughter, consider it sound medical advice to indulge in it as often as you can. If you don’t like laughter, then take your medicine – laugh anyway.

Use whatever makes you laugh – movies, sitcoms, Monty Python, records, books, New Yorker cartoons, jokes, and friends. Give yourself permission to laugh – long and loud and out loud – whenever anything strikes you as funny. The people around you may think you’re strange, but sooner or later they’ll join in even if they don’t know what you’re laughing about.

Some diseases may be contagious, but none is as contagious as the cure… laughter.

ePress Release

Elderly Beware

Anticholinergics, a commonly prescribed group of drugs, may cause elderly people to "slow down" in their daily physical activities, 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.

Two reports from Wake Forest University School of Medicine support findings that anticholinergic drugs that are used to treat acid reflux, Parkinson’s disease and urinary incontinence may cause older people to lose their thinking skills more quickly than those who do not take the medicines.

Anticholinergic drugs work by stopping acetylcholine, a chemical that enhances communication between nerve cells in the brain, from binding to its receptors in nerve cells.

Older adults taking anticholinergics become more likely to walk more slowly and to need help in other daily activities. These results are true even in older adults who have normal memory and thinking abilities.

For older adults taking a moderately anticholinergic medication, or two or more mildly anticholinergic medications, their function is similar to that of someone 3 to 4 years older.

Common anticholinergic medicines include blood pressure medication, nifedipine; the stomach antacid, ranitidine and the incontinence medication, tolterodine.

Cholinesterase inhibitors, a family of drugs used to treat dementia by increasing levels of acetylcholine include donepezil, galantamine, rivastigmine and tacrine. About 10 percent of patients may be taking tolterodine and dozepezil together. The two drugs are pharmacological opposites, which led to the hypothesis that the simultaneous treatment of dementia and incontinence could lead to reduced effectiveness of one or both drug.

eMedi Quiz

An increased incidence of cholangiocarcinoma is seen in all of the following except:

1. Hydatid cyst of liver
2. Polycystic disease of liver
3. Sclerosing cholangitis
4. Liver flukes

Yesterday’s Mind Teaser: Central nervous system manifestations in chronic renal failure are a result of all of the following, except:

1. Hyperosmolarity
2. Hypocalcemia
3. Acidosis
4. Hyponatremia

Answer for yesterday’s Mind Teaser: 1. Hyperosmolarity

Correct answers received from: Dr Manas Ranjan Sahoo, Dr. Sushma Chawla, Dr.K.Raju, Dr K V Sarma, Dr Jainendra Upadhyay, Arvind Diwaker, Daivadheenam Jella, Dr Avtar Krishan, Anil Pawah, Dr.Bitaan Sen & Dr Jayashree Sen, Dr Prakash Khalap.

Answer for 9th June Mind Teaser: 2. Tricuspid valve.

Correct answers received from: Dr Prakash Khalap.

Send your answer to ijcp12@gmail.com

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

Health Check Up Camp at Gitarattan Jindal Public School Sect–7 Rohini, 12th May 2014

press release

FDA panel recommends first drug for HIV prevention

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 with dengue fever developed shock.
Reaction: Oh my God! Why was the blood pressure 90/80 ignored?
Lesson: Make sure that a pulse pressure of less than 20 is not ignored, it is an impending sign that the patient is going into shock.

eMedinewS Humor

Never be rude to anyone

An American tourist asked a boat guy in Zanzibar, "Do you know Biology, Psychology, Geography, Geology or Criminology?"

The boat guy said, "No. I don’t know any of these."

The tourist then said, "What the hell do you know on the face of this Earth? You will die of illiteracy!"

The boat guy said nothing. After a while the boat developed a fault and started sinking. The boatman then asked the tourist, "Do you know Swimology and Escapology from Crocodiology?"

The tourist said, "No!"

The boat guy replied, "Well, today you will Drownology and Crocodiology will eat you. I will not Helpology and you will Dieology because of your Badmouthology."

Quote of the Day

The best thing about dreams is that fleeting moment, when you are between asleep and awake, when you don’t know the difference between reality and fantasy, when for just that one moment you feel with your entire soul that the dream is reality, and it really happened. Johann Wolfgang von Goethe

 

Twitter of the Day

Dr KK Aggarwal: Diabetes is a progressive disease http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra:You were created to be completely loved and completely lovable, for your whole life http://bit.ly/DC_Ananda #ananda

 

Forth Comming Event

Announcement

Call for Free Registration

4th annual conference Zoonosis 2014
Sunday 6th July 10am–2 pm followed by Lunch

Venue; Indian Medical Association HQs, IMA House, ITO New Delhi

Objective: To discuss about prevention of diseases communicable
from animals to human.

Who can take part: Medical Practitioners,Veterinary Practitioners, Animal Owners/Breeders, NGOworking with animal care etc.

Experts will be from Veterinary/Medical sectors

All participants will be given certificate of participation.

Organizers: Heart Care Foundation
of India, Millennium India Education
Foundation,CAR (Ministry of Agriculture Govt.of India,

Register at :
rawat.vandana89@gmail.com/
drkakroo@gmail.com
or Call: Vandana 9891673085/Dr Kakroo 9810301261

 

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 Shyam
cardiology news

Media advocacy through Web Media

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