eMedinewS14th April 2014,Monday

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

In Paralysis, Act Fast

Brain attach should be tackled like a heart attack. As time is brain, a patient with suspected paralysis/stroke or brain attack should be shifted to hospital at the earliest and given a clot dissolving therapy if the CT scan is negative for brain hemorrhage. Prevention for paralysis is the same as prevention for heart attack.

All patients with paralysis should undergo testing for underlying heart disease and all patients with heart diseases should undergo testing to detect blockages in the neck artery which can cause future paralysis.


  1. One should rule out brain hemorrhage as soon as possible.
  2. Obtain emergent brain imaging (with CT or MRI) and other important laboratory studies, including cardiac monitoring during the first 24 hours after the onset of ischemic stroke.
  3. Check glucose and correct high or low sugar. If the blood sugar is over 180 mg/dL start insulin.
  4. Maintain normothermia for at least the first several days after an acute stroke.
  5. For patients with acute ischemic stroke who are not treated with thrombolytic therapy, treat high blood pressure only if the hypertension is extreme (systolic blood pressure >220 mmHg or diastolic blood pressure >120 mmHg), or if the patient has another clear indication (active ischemic coronary disease, heart failure, aortic dissection, hypertensive encephalopathy, acute renal failure, or pre–eclampsia/eclampsia).
  6. For patients with acute ischemic stroke who will receive thrombolytic therapy, antihypertensive treatment is recommended so that systolic blood pressure is ≤185 mmHg and diastolic blood pressure is ≤110 mmHg.
  7. Antithrombotic therapy should be initiated within 48 hours of stroke onset.
  8. For patients receiving statin therapy prior to stroke onset it should be continued.

News Around The Globe

  • A study published online April 4 in the American Journal of Psychiatry reported that an experimental nasal drug, 3b–androsta–4,16–dien–3–ol (PH94B), works through pheromone pathways and has the potential to calm symptoms of social anxiety. The novel agent represents an on–demand treatment that can be used just before a stressful social situation.
  • A German research has shown that virtually all smartphones and tablet computers used by healthcare workers are contaminated with at least one organism. The findings were presented at the 16th International Congress on Infectious Diseases. The study authors assessed the surfaces of smartphones and tablets for bacterial contamination, and evaluated whether a 14–day intensified cleaning period altered the subsequent burden of microbial contamination. It was noted that 100 of the 101 smartphones and 19 of the 20 tablets tested were positive for at least one pathogen. About 55% of the touchscreens were contaminated with more than 1 species. The predominant pathogens were Staphylococcus aureus, Enterococcus, and Enterobacteriaceae.
  • A French study has reported that the presenting features of scabies may be different for patients of different ages. Researchers analyzed data on 323 consecutive patients (92 infants, 107 children, and 113 adults, with 11 missing data) from 13 French departments of dermatology and pediatric dermatology. Relapse was common particularly in patients aged <15 years of age. Presenting signs included burrows in 78% of patients, nodules in 67.6%, and vesicles in 43.5%. Infants were more likely to develop nodules than older children and adults, especially in the axillary area and back. Facial involvement and atopic dermatitis were found only in patients below 15 years of age.
  • New guidelines for hepatitis C virus infection from the World Health Organization (WHO) and the European Association for the Study of the Liver (EASL) have been released at the EASL International Liver Congress 2014. The WHO guidelines focus on risk–based screening and follow–up testing for people with hepatitis C infection, and for screening and counseling in relation to alcohol use and other behaviors that heighten transmission risk. The guidelines also focus on interferon injections and the new all–oral regimens. The EASL guidelines update the guidelines that were issued in January and focus specifically on evidence–based treatment, and incorporate the anticipated approval of 3 new direct–acting antivirals in 2014 by the European Medicines Agency (EMA).
  • A new research has found that counseling on how to manage whiplash injuries along with a list of optional exercises can reduce pain as effectively as an intensive physical therapy program. The study included 150 participants in Australia recruited from September 2009 to 2012. All patients had suffered from whiplash-related pain for at least three months but not more than five years. At baseline, patients randomized to the physical therapy group rated their pain, on average, as 5.5 out of 10 while those in the advice group rated it 4.9 out of 10. One year later, these numbers dropped to 3.7 and 4.4, respectively.

Rabies News (Dr A K Gupta)

If a person is on antimalarials or steroids or taking immunosuppressant drug, what is the schedule for rabies vaccine?

The vaccine on Day 0 (first injection) must be doubled and given at two sites (deltoids or thigh in young children). In category II exposures, it is recommended to administer even RIGs along with vaccine. Rest of the schedule is same as for any other patient.

Cardiology eMedinewS

  • A study published recently in Biological Psychology points towards an association between blood pressure and a tendency to worry. The study revealed that individuals considered less likely to worry had higher systolic and diastolic blood pressure levels than those who worried a lot. At rest, there was an approximate 10 mmHg difference in systolic blood pressure between the high worriers and low worriers, with the low–worry group having a significantly higher baseline level of systolic and diastolic blood pressure. Baroreflex sensitivity (BRS) was also significantly higher in the low–worry group than in high–worry group at rest and during the self–induced worry phase.
  • Fibrinolytic therapy for intermediate risk pulmonary embolism prevents hemodynamic decompensation but augments the risk for major hemorrhage and stroke, reports a randomized, double–blind trial published April 9 in the New England Journal of Medicine. In patients with intermediate risk, routine anticoagulation for acute pulmonary embolism was sufficient since 7–day total mortality in these patients was low (1.8%) and was not different from patients who received thrombolysis in addition to anticoagulation (tenecteplase group; 1.2%). Additionally, increased risks with tenecteplase included extracranial bleeding (6.3% vs 1.2% (placebo group)) and stroke (2.4% vs 0.2%).

Pediatrics eMedinewS

  • A novel study published in the Journal of Antimicrobial Chemotherapy has stated that twice–daily dosing of oral amoxicillin is as effective as a thrice daily approach in treating mild pediatric pneumonia. In the study, researchers randomized children aged 2 to 59 months to receive oral amoxicillin 50 mg/kg/day given twice daily or three times daily (at 16.7 mg/kg/dose). In intention–to–treat analysis, treatment failure was seen in 23.0% of the twice–daily and 22.8% of the thrice–daily group. Corresponding values in per–protocol analysis were 21.3% and 20.1%, respectively.
  • A new study conducted in two UK medical centers has revealed that prefabricated fitted foot orthoses (FOs) may reduce pain and improve quality of life of children with juvenile idiopathic arthritis (JIA). The study published in Archives of Disease in Childhood compared the outcomes with prefabricated FOs and sham control orthoses and noted that children in the fitted FOs group had significantly greater pain reduction and better clinical improvement in quality of life as compared to children in the control group.

Dr K K Spiritual Blog

Why do We Burn Camphor In Any Pooja?

No Aarti is performed without camphor. Camphor when lit burns itself out completely without leaving a trace of it.

Camphor represents our inherent tendencies or vasanas. When lit by the fire of knowledge about the self the vasanas burn themselves out completely, not leaving a trace of ego.

Ego is responsible for a sense of individuality that keeps us separate from the Lord or consciousness.

In addition, camphor when burns, emits a pleasant perfume. This signifies that as we burn our ego we can only spread love and nothing else.

Wellness Blog

Seven behaviors cut heart deaths

Seven heart–healthy behaviors can reduce the risk of death from cardiovascular disease. In a prospective study by Enrique Artero, PhD, of the University of South Carolina and colleagues and published in the October issue of the Mayo Clinic Proceedings, those who met 3–4 of the American Heart Association’s ‘Simple Seven’ heart–health criteria had a 55% lower risk of cardiovascular mortality than those who met no more than two of those practices over 11 years.

Four core behaviors

  1. No smoking
  2. Normal body mass index
  3. Engaging in physical activity
  4. Eating healthfully

Three parameters

  1. Cholesterol lower than 200 mg/dL
  2. Blood pressure lower than 120/80 mm Hg
  3. Not having diabetes

Inspirational Story

Saying Grace in a Restaurant!

Last week I took my children to a restaurant. My six–year–old son asked if he could say grace.

As we bowed our heads he said, "God is good. God is great. Thank you for the food, and I would even thank you more if Mom gets us ice cream for dessert. And Liberty and justice for all! Amen!"

Along with the laughter from the other customers nearby I heard a woman remark, "That’s what’s wrong with this country. Kids today don’t even know how to pray. Asking God for ice–cream! Why, I never!"

Hearing this, my son burst into tears and asked me, "Did I do it wrong? Is God mad at me?"

As I held him and assured him that he had done a terrific job and God was certainly not mad at him, an elderly gentleman approached the table. He winked at my son and said,

"I happen to know that God thought that was a great prayer."

"Really?" my son asked.

"Cross my heart," the man replied.

Then in a theatrical whisper he added (indicating the woman whose remark had started this whole thing), "Too bad she never asks God for ice cream. A little ice cream is good for the soul sometimes."

Naturally, I bought my kids ice cream at the end of the meal. My son stared at his for a moment and then did something I will remember the rest of my life. He picked up his sundae and without a word, walked over and placed it in front of the woman. With a big smile he told her, "Here, this is for you. Ice cream is good for the soul sometimes; and my soul is good already."

ePress Release

Air pollution can raise blood pressure

Breathing polluted air for even two hours can increase blood pressure, potentially raising the risk of cardiovascular disease in those exposed to smog, 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 susceptible patients this small increase may actually be able to trigger a heart attack or stroke. In the study, which appeared in a recent issue of the journal Hypertension, researchers tested 83 people as they breathed levels of air pollution similar to those in an urban city near a roadway. The air pollution caused diastolic pressure –– the lower number in a blood pressure reading –– to rise within two hours. Blood vessels were impaired for as long as 24 hours. Tests showed that microscopic particles in the air, rather than ozone gases, caused the rise in blood pressure and impaired blood vessel function. If air pollution levels are forecasted to be high, those with heart disease, diabetes or lung disease should avoid unnecessary outdoor activity.

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."

eMedi Quiz

The Protein Efficiency Ratio (PER) is defined as:

1. The gain in weight of young animals per unit weight of protein–consumed.
2. The product of digestibility coefficient and biological value.
3. The percentage of protein absorbed into the blood.
4. The percentage of nitrogen absorbed from the protein absorbed from the diet.

Yesterday’s Mind Teaser: 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.

Answer for yesterday’s Mind Teaser: 1. The source of infection is mainly clinical cases.

Correct answers received from: Dr. P. C. Das, DR AYYAVOO ERODE, Dr Jainendra Upadhyay, Dr Ratnesh Prakash, Dr Avtar Krishan, Dr.Chandresh Jardosh, Daivadheenam Jella, Dr B K Agarwal, dr poonam chablani

Answer for 12th April Mind Teaser: 3

Correct answers received from: Dr Ratnesh Prakash

Send your answer to ijcp12@gmail.com

Zee News – Health Wealth Shows

Cancer Prevention
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D


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

Should I be registered with MCI?

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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 62–year–old–diabetic with coronary artery disease, on treatment for the same, comes for follow up.
Reaction: Oh my God! Why did not you put him on antioxidants?
Lesson: Make Sure to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects.

eMedinewS Humor


One day, a housework–challenged husband decided to wash his sweatshirt. Seconds after he stepped into the laundry room, he shouted to his wife, "What setting do I use on the washing machine?"

"It depends," she replied. "What does it say on your shirt?"

He yelled back, "Texas A & M."

Quote of the Day

Determine what specific goal you want to achieve. Then dedicate yourself to its attainment with unswerving singleness of purpose, the trenchant zeal of a crusader.


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://youtu.be/NMIK16PyBrY?a via @YouTube
Dr Deepak Chopra: Learn the seven stages of consciousness & how they lead to enlightenment. Which stage have you reached?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

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  1. Dear Sir, emedinews is very informative. Regards: Dr Kavish
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