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  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma 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; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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); Editor in Chief IJCP Group & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 7 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

14th October 2012, Sunday

How to lift correctly

Follow these basic steps, as recommended by HealthBeat, whenever you need to lift something:

  • Face the object and position yourself close to it.
  • Bend at your knees, not your waist, and squat down as far as you comfortably can.
  • As you prepare to lift, tighten your stomach and keep your buttocks tucked in.
  • Lift with your legs, not your back muscles.
  • Don't try to lift the object too high — don't raise a heavy load higher than your waist; keep a light load below shoulder level.
  • Keep the object close to you as you lift it.
  • If you need to turn to set something down, don't twist your upper body. Instead, turn your entire body, moving your shoulders, hips, and feet at the same time.
  • Ask for help lifting anything that's too heavy.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Carnitine Update

Facts

  • Deficiencies in thiamine, selenium and L-carnitine have been reported to produce heart failure and replacement therapy results in improvement in cardiac function.
  • Carnitine deficiency impairs the oxidation of fatty acids, resulting in lipid accumulation in the myocyte cytoplasm. This problem is reversed with L-carnitine replacement.

Should all patients with dilated cardiomyopathy undergo angiography?

Occult disease is a not uncommon cause of DCM, accounting for as many as 7 percent of otherwise unexplained cases. This plus the potential reversibility of hibernating myocardium constitute the rationale for performing angiography in most patients with heart failure of uncertain etiology.

For Comments and archives…

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal on

Cabergoline can restore normal orgasm new

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela to train 10,000 people in compression only CPR

Addressing a press conference, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that more than 10,000 members of the public will be certified in compression only CPR during the Mela.

 
Dr K K Aggarwal
    National News

EFC nod to Rs 20,000-cr National Urban Health Mission

New Delhi: Government today gave its nod to the ambitious National Urban Health Mission, a dedicated public health delivery system to address medicare challenges in town and cities, with focus on the poor living in slums. The Rs 20,000-crore NUHM was cleared by the government's Expenditure Finance Committee (EFC) at its meeting. The plan will now go to the Union Cabinet after the Health Ministry fine-tunes its proposals. The NUHM will be on the lines of the Health Ministry's flagship National Rural Health Mission (NRHM) launched in 2005 to address the health challenges of rural India. A revised note had been sent for approval after incorporating some concerns raised by the Planning Commission. "The NUHM will be launched soon across the country. It will focus on the health needs of the urban population, with special focus on the urban poor in slums and colonies," a senior Health Ministry official told PTI. The Mission is expected to cover cities and towns with over 50,000 people which would come to around 779 cities including Mumbai, New Delhi, Kolkata, Chennai, Bengaluru, Hyderabad and Ahmadabad. The NUHM will finally be a part of the National Health Mission, which will take care of both rural and urban health needs of the people in the country. NUHM seeks to improve the health status particularly of slum dwellers and other disadvantaged sections by ensuring equitable access to quality health care through a revamped public health system. The Mission would help improve the health indicators of urban poor. The National Family Health Survey-3 revealed that under-five mortality rate was 73 for every 1000 live births among the urban poor as against 48 among other city residents. (Source: Business Standard, October 10, 2012)

For comments and archives

My Profession My Concern

Quality Control

Bed sore prevention bundle - Risk assessment (Braden tool)

  • Skin assessment 8 hourly
  • Head of bed =30° unless contraindicated or superseded by VAP bundle
  • Incontinence skin care
  • Position change
  • Bed – 2 hourly
  • Chair – hourly
  • Heel elevation
  • Nutritional assessment
  • Pressure relief mattresses (not a replacement for positional change)

For comments and archives

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    Valvular Heart Disease Update

Preventing valvular endocarditis

Which antibiotic — The choice of antibiotic is patient- and procedure-specific.

For patients undergoing a dental procedure the preferred regimen is oral amoxicillin 2 grams given 30-60 minutes before the procedure.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Abraxane OK'd for some NSCLC patients

The FDA has approved protein-bound paclitaxel (Abraxane) as first-line therapy in combination with carboplatin for patients with non-small cell lung cancer that is not amenable to surgery or radiation therapy. (Source: Medpage Today)

For comments and archives

Appropriateness revascularization criteria validated in real-world study

Coronary revascularization is both overused in patients without appropriate indications and underused in those with appropriate indications, according to the results of a new Canadian study. The study did find some positive results, though. It showed that when revascularization was performed in line with the recently created appropriateness guidelines, it was associated with reduced adverse outcomes compared with patients not undergoing revascularization. But in patients without an appropriate indication according to the criteria, no such reduction was seen with revascularization procedures. (Source: Medscape)

For comments and archives

New antibiotic shows promise for drug-resistant infections

A new potential class of antibiotics called LpxC inhibitors was recently found to block the ability of bacteria to initiate the septic cascade, saving mice from lethal infection, although agents did not kill the bacteria in vitro, as is the typical mechanism of action of antibiotics. (Source: Medscape)

For comments and archives

Dentist arm pain lessened by use of lighter, wider curette

Dental professionals experience less pain in the shoulders and numbness in the fingers when they use lighter, wider-diameter curettes for scaling and root planing, researchers report in an article published in the October issue of the Journal of the American Dental Association. (Source: Medscape)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: Apples Reduce Oxidized LDL http://blog.kkaggarwal.com/2012/10/apples-reduce-oxidized-ldl/ …

@DeepakChopra: Allow yourself to float away on a magic carpet with today's meditation!http://tinyurl.com/dxkceas

 
    Spiritual Update

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

How Yoga Works

  • Yoga practices reduce allostatic load in stress response systems such that optimal homeostasis is restored.
  • Stress induces
    • Imbalance of the autonomic nervous system (ANS) with decreased parasympathetic nervous system (PNS) and increased sympathetic nervous system (SNS) activity

For comments and archives

 
    4th Asia Pacific Vascular Intervention Course (APVIC)
  • 4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More
  • The 4th Asia Pacific Vascular Interventional Course begins Read More
  • Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More
  • 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More
  • 4th Asia pacific vascular intervention course Read More
  • 4th Asia pacific vascular intervention course paper clippings Read More
 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What do you understand by multiple births?

Women who can get pregnant without fertility drugs or medical procedures usually have only one baby. Women who need fertility treatment are at higher risk to get pregnant with twins, and rarely with triplets or more. This is called multiple gestation.

For comments and archives

 
    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Introduction of disposable plastic bags

In 1960, the changeover from glass bottles to plastic bags revolutionized the working of the blood banks. This helped in the use of the components to a much greater extent and also helped in better safety procedures. The introduction of disposables too helped in much safer transfusion procedures.

For comments and archives

 
    Liver Abscess Update

(Dr. Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation Medanta – The Medicity Hospital)

Should blood culture be send with liver abscess?

Yes, it could be positive in up to 40% of cases.

For comments and archives

 
    An Inspirational Story (Ms Ritu Sinha)

Years ago a Johns Hopkin’s professor gave a group of graduate students this assignment: Go to the slums. Take 200 boys, between the ages of 12 and 16, and investigate their background and environment. Then predict their chances for the future. The students, after consulting social statistics, talking to the boys, and compiling much data, concluded that 90 percent of the boys would spend some time in jail.

Twenty-five years later another group of graduate students was given the job of testing the prediction. They went back to the same area. Some of the boys – by then men – were still there, a few had died, some had moved away, but they got in touch with 180 of the original 200. They found that only four of the group had ever been sent to jail.

Why was it that these men, who had lived in a breeding place of crime, had such a surprisingly good record? The researchers were continually told: “Well, there was a teacher…” They pressed further, and found that in 75 percent of the cases it was the same woman.

The researchers went to this teacher, now living in a home for retired teachers. How had she exerted this remarkable influence over that group of children? Could she give them any reason why these boys should have remembered her? “No,” she said, “no I really couldn’t.” And then, thinking back over the years, she said amusingly, more to herself than to her questioners: “I loved those boys…”

- Author – Bits & Pieces

(Source: http://www.motivationalwellbeing.com/motivational-stories-9.html)

For comments and archives

 
    Cardiology eMedinewS

Study: More strokes in middle-age Read More

Satiety hormone tied to diabetes, heart disease Read More

 
    Pediatric eMedinewS

Prenatal mercury exposure linked to ADHD Read More

Severe bandemia not linked to pediatric bacterial illness Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A case of RHD came with signs of CHF and fever with generalized joint pains.
Dr Bad: Treat empirically for infective endocarditis along with CHF treatment.
Dr Good: Do blood culture, ASO, CRP to differentiate between acute rheumatic fever and infective endocarditis along with Echo before giving empiric treatment of infective endocarditis.
Lesson: Cause of fever in a case of RHD could either be infective endocarditis or acute rheumatic fever, which should be differentiated and appropriate therapy started.

For comments and archives

Make Sure

Situation: A patient with large intestinal diarrhea developed sepsis after he was given antimotility drugs.
Reaction: Oh my God, Why was an antibiotic not given?
Lesson: Make sure that if antimotility drug is given in a large intestinal diarrhea, it is always given with an antibiotic.

For comments and archives

 
    Legal Question of the Day (Dr MC Gupta)

Q. Is there any rule that a dead body cannot be transported in an ambulance, whether owned by the government or a private person?

Ans.

  • It is for the owner to make rules regarding what to transport or not in the vehicle(s) owned by him, as long as such rules do not violate law.
  • I do not know of any law that is violated by transportation of a dead body in an ambulance.
  • Such a law does not exist because it would be an absurd law. The legislature avoids making absurd laws.
  • The absurdity of such a law would be clear from the following examples:
    • A patient in the ambulance who dies on the way to the hospital will have to be taken out of the ambulance and put on the road side till some other vehicle is available.
    • An ambulance sent to bring a patient from the site of an accident will have to return empty if it is found/suspected on arrival that the patient is dead.
    • A still-born child delivered in an ambulance will have to be immediately taken out of the ambulance.
 
    Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Tests to diagnose Hashimoto’s thyroiditis

Anti–thyroid peroxidase antibody (anti–TPO) in addition to thyroid function tests (TSH, T4, T3); anti–TPO test detects autoantibodies against a protein found in thyroid cells. These antibodies are not normally present, so a high value usually indicates autoimmune damage to the thyroid due to disorders such as Hashimoto’s thyroiditis and Graves’ disease.

 
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    Quote of the Day (Dr GM Singh)

Some of us think holding on makes us strong; but sometimes it is letting go. Herman Hesse

 
    Mind Teaser

Read this…………………

A 70-year-old female comes to the clinic for a routine checkup. She is 5 feet 4 inches tall and weighs 180 pounds. Her major complaint is pain in her joints. She is retired and has had to give up her volunteer work because of her discomfort. She was told her diagnosis was osteoarthritis about 5 years ago. Which would be excluded from the clinical pathway for this client?

A. Decrease the calorie count of her daily diet.
B. Take warm baths when arising.
C. Slide items across the floor rather than lift them.
D. Place items so that it is necessary to bend or stretch to reach them.

Yesterday’s Mind Teaser: A client is admitted from the emergency department with severe-pain and edema in the right foot. His diagnosis is gouty arthritis. When developing a plan of care, which action would have the highest priority?

A. Apply hot compresses to the affected joints.
B. Stress the importance of maintaining good posture to prevent deformities.
C. Administer salicylates to minimize the inflammatory reaction.
D. Ensure an intake of at least 3000 ml of fluid per day.

Answer for Yesterday’s Mind Teaser: D. Ensure an intake of at least 3000 ml of fluid per day.

Correct answers received from: Dr PC Das, Dr Jainendra Upadhyay, Dr K Raju, Dr Pankaj Agarwal,
Dr Chandresh Jardosh, Dr Thakor Hitendrsinh G.

Answer for 12th October Mind Teaser: C. Altered cerebral tissue perfusion
Correct answers received from: Dr Priyaranjan Bhattacharjee, Dr Ajay Gandhi.

Send your answer to ijcp12@gmail.com

 
   Laugh a While (Dr GM Singh)

Visa

A businessman called and had a question about the documents he needed in order to fly to China. After a lengthy discussion about passports, I reminded him he needed a visa.

"Oh no I don't, I've been to China many times and never had to have one of those."

I double checked and sure enough, his stay required a visa.

When I told him this he said, "Look, I've been to China four times and every time they have accepted my American Express!"

 
    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

Cite the source of the evidence in medical literature

For a document to serve as legitimate evidence in a trial it must exist in the public domain and the degree to which a medical document/literature/book validates the point you are making depends upon the reliability of the document. The author of a document is a witness that you are calling upon to testify.

  • To constitute valid medical testimony, the witness must be identified.
  • Conventions for citing sources are somewhat dynamic. However, at a minimum you should identify the individual, institution, or publication that authored the document and the publication date.
  • When it is not otherwise evident, you ought to make quick reference to the qualifications of the author to lend an air of credibility to the document. Although it is not necessary to read additional information into the records, you must be prepared to provide a complete bibliographic citation if called upon to do so by the court of law or cross lawyer.

For comments and archives

 
    Public Forum

Public Forum (Press Release for use by the newspapers)

Navratra: Time to eat buckwheat flour

Navratra is the time when wheat flour is omitted from the diet and substituted it with buckwheat flour or kuttu ka aata, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart care Foundation of India and MTNL Perfect Health Mela.

Buckwheat is not a cereal grain, instead it is a fruit and hence is a good substitute for Navratra fasts where cereals are prohibited.

  1. The flour is extremely high in protein and is a wonderful substitute for those who are allergic to gluten (found in wheat).
  2. Its good for patients with celiac disease as it is gluten-free.
  3. It contains phytonutrient rutin, which lowers cholesterol and blood pressure.
  4. It is rich in magnesium, vitamin B, iron, calcium, folate, zinc, copper, manganese and phosphorus.
  5. As the buckwheat hulls are hard to chew, traditionally they are soaked for about six hours and then cooked to make them softer and easily digestible.
  6. It also contains alpha linolenic acid, which enhances HDL cholesterol ("good" cholesterol) and controls LDL cholesterol ("bad" cholesterol).
  7. It is a good source of insoluble fiber and prevents occurrences of gallbladder stones. According to the American Journal of Gastroenterology, a 5 % increase in the insoluble fiber intake results in a 10% reduced risk of gall-bladder stones.
  8. Kuttu is 75% of complex carbohydrates and 25% of high quality protein, which makes it an ideal food for weight loss.
  9. As the flour is gluten-free, a potato is used to bind the flour together.
  10. The flour tastes different.
  11. Pooris made of this flour are crunchier than the normal wheat flour pooris.
  12. One should not make pooris with hydrogenated oils or vanaspati as it will take away all the medical benefits of buckwheat flour.
  13. Buckwheat flour however is subjected to adulteration.
  14. Mixtures of rye flour, Indian corn flour, wheat flour, and other ground cereals are often used as a substitute for buckwheat.
  15. Being high in fiber and with low glycemic index it is good substitute for diabetic patients. The glycemic Index for buck wheat is 47 (Low GI foods have a GI value less than 55; medium GI foods have a GI value between 55 and 69 and high GI foods have GI value greater than 70).
  16. The chiro-inositol present in the buckwheat has been identified as the diabetes preventing component.
  17. Asthma symptoms can occur in sensitized children when food allergens such as buckwheat are cooked in a confined area. Both acute and late-phase respiratory symptoms are seen.
  18. Instead of poori or pakodas (fried items) made from kuttu atta (buckwheat flour), eat kuttu ki roti.
  19. One can also prepare idli from the kuttu atta (buckwheat flour) and dosa from the samak rice (a type of fruit)
  20. Food poisoning may occur if flour left over from the previous year is reused.
 
    Readers Responses
  1. Please keep up the good work. Regards Dr L V Kapoor
 
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