eMedinewS14th December 2013, Saturday

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
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Dear Colleagues

As doctors, creating health awareness and providing health education should be our commitment to the society. We do provide one to one health education to our patients but the same cannot cater to the needs of the society. The answer therefore is to use mass media technique to create health awareness.

For over three decades I have been involved in conceptualizing low cost mass health awareness modules which included the annual perfect health mela.

Starting 15th Dec.’13 Sunday I have taken a new assignment with Zee News where I will be anchoring a weekly show "Health Wealth."

The show will be telecast on every Sunday at 11.00 AM with a repeat telecast on subsequent Saturday at the same time.

In 52 episodes I will try to cover 52 common diseases and will incorporate doctors from all systems of medicine.

Please join me in seeing the first episode on 15th Dec.’13 11.00 AM on Zee News.

Tobacco, drug use in pregnancy can double risk of stillbirth

Smoking tobacco or marijuana, taking prescription painkillers, or using illegal drugs during pregnancy is associated with double or even triple the risk of stillbirth, according to research funded by the National Institutes of Health.

Researchers based their findings on measurements of the chemical byproducts of nicotine in maternal blood samples; and cannabis, prescription painkillers and other drugs in umbilical cords. Taking direct measurements provided more precise information than did previous studies of stillbirth and substance use that relied only on women’s self–reporting. The study findings appear in the journal Obstetrics & Gynecology.

"Smoking is a known risk factor for stillbirth, but this analysis gives us a much clearer picture of the risks than before," said senior author Uma M. Reddy, M.D., MPH, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute that supported the study. "Additionally, results from the latest findings also showed that likely exposure to secondhand smoke can elevate the risk of stillbirth." Stillbirth occurs when a fetus dies at or after 20 weeks of gestation.

The researchers tested the women’s blood for cotinine, a derivative of nicotine, and tested fetal umbilical cords for evidence of several types of drugs. They looked for evidence of the stimulants cocaine and amphetamine; prescription painkillers, such as morphine and codeine, and marijuana. These tests reflect exposure late in pregnancy. Among the women who had experienced a stillbirth, more than 80 percent showed no traces of cotinine and 93 percent tested negative for the other drugs. In comparison, about 90 percent of women who gave birth to a live infant tested tobacco–free and 96 percent tested negative for other drugs.

Based on the blood test results and women’s own responses, the researchers calculated the increased risk of stillbirth for each of the substances they examined:

  • Tobacco use: 1.8 to 2.8 times greater risk of stillbirth, with the highest risk found among the heaviest smokers
  • Marijuana use: 2.3 times greater risk of stillbirth
  • Evidence of any stimulant, marijuana or prescription painkiller use: 2.2 times greater risk of stillbirth
  • Passive exposure to tobacco: 2.1 times greater risk of stillbirth

The researchers noted that they could not entirely separate the effects of smoking tobacco from those of smoking marijuana.

Only a small number of women tested positive for prescription painkiller use, but there was a trend towards an association of these drugs with an elevated stillbirth risk.

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."

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The success behind Arvind Kejriwal

sprritual blog

Some time back I wrote an article about leadership qualities of a person and compared different leaders about their leadership qualities.

The time has come again to talk about the 10 incarnations of Lord Vishnu and see whether Arvind Kejriwal’s success coincides with these principles.

The 10 incarnations of Lord Vishnu basically indicate 10 levels of leadership qualities in a person which can be acquired over a period of time.

The first incarnation Matsya (Fish) indicates thinking differently. A fish swims against the direction of the current. The second incarnation Tortoise means to learn to withdraw when you find that people are not with you. The third incarnation is of Warah (Wild Boar), which means being persistent in your action.

The fourth incarnation Narsimha indicates that nothing is impossible in life. The fifth incarnation Vaman indicates learning and using all the tactics to make impossible possible. The 6th incarnation Parshurama indicates quality of fighting against corruption. The seventh incarnation Rama indicates entering into politics and becoming a political leader and running the country in a righteous manner. The eighth incarnation Krishna indicates learning Rajneeti and the 9th incarnation Buddha indicates working for the welfare of the society.

Arvind Kejriwal has qualities of Fish (he is thinking differently); of tortoise (he withdrew on many occasions when things were not going his way); of wild boar (he is persisting in his goals); Narsingha (he is attempting to do what seems impossible today); Vaman (he is using all tactics for making impossible into possible; Parshurama (he is fighting against corruption).

He has now entered into politics and if he becomes the chief minister of prime minster he will be like Rama.

Will he go further and learn the Rajneeti of Krishna and welfare of Buddha only time will tell.

I wish him all the luck.

cardiology news

Forgive and Forget

This is the most powerful aid to peace of mind. We often develop ill feelings inside our heart for the person who insults us or harms us. We nurture grievances. This in turn results in loss of sleep, development of stomach ulcers, and high blood pressure. This insult or injury was done once, but nourishing of grievance goes on forever by constantly remembering it.

Get over this bad habit. Life is too short to waste in such trifles. Forgive & Forget and march on. Love flourishes in giving and forgiving.

News Around The Globe

News

  • In a cross–sectional study of 926 home–dwelling renal transplant recipients who were transplanted at one of three Swiss transplant centers, individuals who reported having daytime sleepiness were more likely to be nonadherent in the taking and timing of their immunosuppressive medications. Their study is published in Clinical Transplantation.
  • A JAMA Internal Medicine study of 72,310 adults who were at least 60 years old and had type 2 diabetes found that the duration of diabetes and advancing age independently predicted diabetes morbidity and mortality rates.
  • Nephrology trials are few and small in scale, comprising only 2.6% of interventional studies registered in ClinicalTrials.gov from 2007 to 2010, and typically enrolling 100 or fewer patients, according to a review published in the American Journal of Kidney Disease.
  • Two proteins of the retinoblastoma family, Rb1 and Rb2/p130, are key regulators of the formation and function of fat tissue in bone marrow, based on new research published in Cell Cycle.
  • In a recent Hepatology study, kidney disease, stroke, and heart attack occurrences were reduced in diabetic patients with the hepatitis C virus (HCV) who were treated with pegylated interferon and ribavirin.
  • Aspirin at bedtime instead of morning modestly improved its anti–platelet effect but didn’t lower blood pressure, a randomized trial showed BY Tobias N. Bonten, MD, of Leiden University Medical Center in the Netherlands, and colleagues.
  • There is no clear evidence that any of the three available pharmacotherapies for smoking cessation—nicotine–replacement therapy, bupropion , and varenicline increase the risk for major adverse cardiovascular events (MACE), researchers report, based on a network meta–analysis BY Dr Edward J Mills (Stanford University, Stanford, CA), write.

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Rabies News (Dr. A K Gupta)

How should the animal causing the bite be handled?

It is important to establish if the biting animal is healthy or diseased, bearing in mind that a rabid animal excretes the virus in its saliva not just throughout the illness but also several days before the appearance of the first signs. An unknown animal, which has disappeared, must be considered as rabid and a full course of PEP must be given. Cats and dogs, which can be identified, must be kept under observation. The risk of rabies can be considered as slight if the animal shows no sign of disease after 5 days, and non–existent if the animal is still healthy on the 10th day (The European Standards recommend an observation period of 15 days).

All wild animals, and those domestic animals suspected of having rabies must be put down and the rabies diagnosis must be carried out in the laboratory.

If it is proven that the animal is not rabid – and only then the anti–rabies treatment may be halted.

cardiology news

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

  • The risk of bleeding, stroke, and pump thrombosis after receipt of a continuous flow left ventricular assist device (CF–LVAD) differed by demographic group and was highest in women, a retrospective analysis reported in The Journal of the American College of Cardiology. Older age (>65) (Hazard Ratio=1.31), lower preoperative hematocrit (≤31) (HR=1.31), ischemic etiology (HR = 1.35), and female sex (HR=1.45) were statistically significant multivariable risk factors for bleeding.
  • Lyme disease was recently found in sudden cardiac death patients whose tissues were being examined for transplant use by pathologists at a Georgia tissue bank. The Centers for Disease Control and Prevention (CDC) reported details of those cases in an article published in the December 13 issue of the Morbidity and Mortality Weekly Report to alert pathologists, medical examiners, and coroners of the need to consider Lyme carditis in cases of sudden cardiac death. CDC investigators warned clinicians to check cardiac status in patients with Lyme disease and Lyme exposure in patients with acute, unexplained cardiac symptoms.
cardiology news

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

  • In a retrospective study reported online in the Journal of Pediatrics, among young hospital patients, factors like older age and the presence of multiple medical conditions were associated with higher rates of hospital–associated venous thromboembolism (VTE). Compared with children ages 2 to 9, the rate of hospital–associated VTE was about four times higher for teens ages 14 to 17 and nearly eight times higher for young adults ages 18 to 21.
  • The US FDA has given approval for studies to begin on a medicinal form of marijuana for the treatment of intractable epilepsy in children. The drug, cannabidiol (Epidiolex, GW Pharmaceuticals) is the largest nonpsychoactive component of the cannabis plant. The product has also been granted orphan drug status for the treatment of children with Dravet syndrome, a rare and severe syndrome of infantile–onset, genetic, drug–resistant epilepsy.
cardiology news

Patients with acidity should avoid chocolates and peppermint

Persistent acidity is usually due to reflux of acid from the stomach into the food pipe. Mild cases of acidity reflux can usually be managed with lifestyle and dietary modifications along with antacids, H2 blockers and proton pump inhibitors.

However, patients in whom lifestyle management along with empirical treatment is unsuccessful or who have symptoms suggestive of complicated diseases should undergo endoscopy to rule out cancer of the food pipe, a condition linked with persistent acidity..

He said that symptoms that may suggest complicated disease include loss of appetite, loss of weight and difficulty in swallowing food, bleeding and signs of systemic illness.

Lifestyle changes for reflux involve elevation of head and of the body, avoidance of food before sleep and avoidance of food which makes the food pipe valve lax. The examples of such foods include fatty food, chocolates, peppermint and excessive intake of alcohol.

Hurry, worry and curry are the three main factors for causing acidity apart from alcohol and smoking. People with acidity should consume less of fermented, sour, salty and pungent foods.

cardiology news

Total CPR since 1st November 2012 – 77787 trained

Media advocacy through Web Media

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press release

Mega CPR 10 Utsav on Sunday

Heart Care Foundation of India and New Delhi Municipal Corporation are jointly organizing a Mega CPR 10 Utsav on Sunday, 15th December, 2013 at Talkatora Stadium. Over 25000 members of the public including school children will be trained in the technique.

Mr Jalaj Shrivastava Chairman NDMC will inaugurate the event at 11 a.m. Mr Vikas Anand Secretary NDMC will be the guest of honour.

Giving the details Padma Shri & Dr. BC Roy National Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Dr. PK Sharma, MHO, NDMC said that over 24 lakh people die in the country every year because of sudden cardiac death and of these, 18 lakh die before reaching the hospital. At least 12 lakh of them can be revived if the bystander learns the technique of CPR 10 and attempts it on the cardiac arrest victim within 10 minutes of cardiac arrest.

The technique is based on the principle that consciousness does not leave the body and the brain remains alive in the first 10 minutes of cardiac arrest. During this period if the heart is revived, the person can be brought back to life.

Even school children can learn this technique. There are cases on record where an 85–year–old man was able to revive his 80–year–old wife with this technique.

The internationally accepted hands only CPR 10 technique has been modified for Indian people by framing CPR 10 mantra which is as under: "Marne ke dus minute ke andar 10x10 = 100 per minute ki raftar se apni chhati peetne ke bajay mare hue aadmi ki chhati peeto."

"Within 10 minutes of sudden cardiac death (earlier the better) for the next 10 minutes (longer the better) press the chest of the victim with a speed of 10×10=100 per minute."

The Foundation has named it the Savitri Mantra on the ground that it was Savitri who could bring back her husband Satyavan to life in mythological era for the first time, probably using this technique.

The Foundation has already trained over 80000 people in the last one year and has a record of training over 13000 people in one day.

The Foundation aims to train all the police personnel, DTC drivers and conductors, relations of health care workers, school children and teachers in the first phase and if the same is done alone in the city of Delhi, 40 lakh can be saved every day.

The entry to the public will be free for the training.

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 77787 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."

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Health Check Camp at Bal Bharti Public School, Dwarka

press release

Supreme court of India describe never events

vedio of day

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

All of the following infections are often associated with acute intravascular hemolysis except:

1. Clostridium tetani.
2. Bartonella bacilliformis.
3. Plasmodium falciparum.
4. Babesia microti.

Yesterday’s Mind Teaser: A patient has been allegedly bitten by cobra snake. The venom in such a bite would be:

1. Musculotoxic.
2. Vasculotoxic.
3. Cardiotoxic.
4. Neurotoxic.

Answer for yesterday’s Mind Teaser: 4. Neurotoxic.

Correct answers received from: Narahari Kandakatla, Dr Prakashvir Tyagi, Dr. Mihir Vora, DR.A.K.GAJJAR, Dr Ajay Gandhi, Dr. P. C. Das, Dr.K.Raju, Dr Jainendra Upadhyay, DR AVTAR KRISHAN, Dr Chandresh Jardosh, Ravi Shanmugavel, Dr Arpan Gandhi, Dr B K Agarwal, Dr. Pradip Patil, Vineet Kumar Soni

Answer for 12th December Mind Teaser: 4. Desiccation of a dead body.

Correct answers received from: Dr Chandresh Jardosh, daivadheenam

Send your answer to ijcp12@gmail.com

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medicolegal update

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medicolegal update

A Dishonest Honest Man

One evening a man walked into a fast–food chicken place and bought a nine–piece bucket of chicken. He took his chicken to the park for a romantic dinner under the moonlight with his lady.

Upon reaching into the bucket, however, he received a surprise. Instead of chicken he discovered what was apparently the restaurant’s night deposit – some nine thousand bucks. The young man brought the bucket back to the store and asked for his chicken in exchange for the money.

The manager, in awe of the young man's honesty, asked for his name and told him he wanted to call the newspaper and the local news station to do a story on him. He would become a local hero, an example of honesty and morality that would inspire others!

The hungry man shrugged it off, "My date’s waiting. I just want my chicken."

The manager’s renewed amazement over the young man’s humility almost overwhelmed him. He begged to be allowed to tell the story on the news. At this the honest man became angry with the manager and demanded his chicken.

"I don’t get it," the manager responded. "You are an honest man in a dishonest world! This is a perfect opportunity to show the world that there are honest people still willing to take a stand for what is right. Please, give me your name and also the woman’s name. Is that your wife?"

"That’s the problem," said the young man. "My wife is at home. The woman in the car is my girlfriend. Now let me have my chicken so I can get out of here.

medicolegal update
medicolegal update

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medicolegal update

Situation: A patient with prosthetic heart valves (bioprosthetic) developed infective endocarditis.
Reaction: Oh my God! Why was he not given infective endocarditis prophylaxis?
Lesson: Make sure that all patients with prosthetic heart valves (bioprosthetic or homograft) are given infective endocarditis prophylaxis.

medicolegal update

With ordinary talent and extraordinary perseverance, all things are attainable. Thomas Foxwell Buxton

medicolegal update

Dr KK Aggarwal: Bed netting is of little help to prevent dengue http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Consciousness is the subjective ground of all experience. If there is reality outside of consciousness it is unknowable #CosmicConsciousness

Forthcoming events

5th eMedinews Revisiting 2013

(a day long single hall medical conference on 2013 happenings, followed by doctors of the year 2013 awards)

Sunday 19th January 2014, Maulana Azad Medical College Auditorium

Dilli Gate Delhi, 10 am-6 pm


Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee President
Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman
Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

5th eMedinewS Revisiting 2013
The 5th eMedinewS–revisiting 2013 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 19th 2014.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2013. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

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Register at: rawat.vandana89@gmail.com/drpawangupta2006@yahoo.com

5th eMedinewS Doctor of the Year Awards
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pls send his/her Biodata at: emedinews@gmail.com

medicolegal update
  1. Dear Sir, emedinews is providing very useful informations. Regards: Dr Tarun

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