eMedinewS14th June 2014,Saturday

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

Congratulations to Mukul!

Mukul Rohtagi, senior advocate Supreme Court of India has been appointed as Attorney General of India and will be representing the Government in the Supreme Court in all matters. He will also be representing and advising the President on all legal matters. His tenure as Attorney General will be for three years.

Mukul is my brother–in–law and has been advising me on many matters related to the medical profession.

eMedinewS congratulates him for his elevation to the highest legal post in the country and hope under his attorney–ship, a lot of positive medical decisions would take place in the country.

Acute encephalitis: Are litchis to blame?

Since the last six years, we see a spurt in cases of encephalitis in the same areas of the country during this season with many children dying as a consequence of the disease. No cause for these outbreaks has been identified yet. This year too, deaths of children due to encephalitis have been reported in Bihar and West Bengal, areas where litchis are cultivated. But it’s not yet known whether these deaths are in any way connected to litchis.

So, is there a link between litchis and these acute episodes of acute encephalitis? Only one study from Vietnam published in Emerg Infect Dis 2012 Nov;18(11):1817 –24 has confirmed the suspected association between litchi plantation and acute encephalitis. The clinical, biological and immunologic characteristics of the patients in the study suggested that a virus could be the cause of these outbreaks. The same study also suggested a possible route of transmission to humans. The authors of the study have proposed that fruit–bearing litchi trees can attract bats. And, these bats could be the reservoir for the supposed virus responsible, which could be then transmitted to humans through mosquitoes who feed on the infected bats.

If only litchis were to be blamed, then the encephalitis cases could have been seen all over the country as people across the country eat litchis.

Why are so many children dying every year? Why has the government not taken any action since the last six years? We have not yet been able to determine the cause of the disease. The least the government can do is to establish treatment centers with ICU facilities, so that the affected children receive prompt treatment.

News Around The Globe

  • A new study, published online June 12 in the Journal of Clinical Endocrinology & Metabolism, has shown that African Americans with type 2 diabetes respond better to the glucose –lowering effect of metformin as compared to whites.
  • A US national survey that confirms and extends a previous study from a single Veterans Affairs (VA) center has stated that the prevalence of insomnia is extremely high in female veterans in the US. The findings were presented recently at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies.
  • A study published June 12 in the New England Journal of Medicine has stated that continuous positive airway pressure (CPAP) is effective for lowering blood pressure in patients with moderate to severe sleep apnea, even those with blood pressures in the normal range.
  • Intake of protein, especially fish, may be associated with a decreased risk for stroke, reported a new meta-analysis published online June 11 in Neurology. Researchers noted that animal protein intake decreased the risk for stroke by 29% while vegetable protein could decrease it by 12%.
  • The number of moles a woman has may be linked with her risk of developing breast cancer, suggest two new studies published online June 10 in PLOS Medicine. One study revealed that women with no moles had an 8.5% chance of developing breast cancer, compared to an 11.4% chance among women with 15 or more moles on their left arm. The second study reported that women having too many moles were 13% more likely to develop breast cancer than women who had no moles.

Rabies News (Dr A K Gupta)

What is pre–exposure vaccination?

Pre–exposure (Prebite) vaccination means immunization before the bite.

Cardiology eMedinewS

  • The risk of both incident heart failure (HF) and HF mortality has risen significantly over 12 years with increasing intake of processed red meats among participants in the Cohort of Swedish Men. The risk of new HF and of death from HF went up by 8% and 38%, respectively, for every 50 g increment in daily processed meat intake. The findings are published in Circulation: Heart Failure.
  • A new study published in the journal PLOS One has revealed that patients with cardiovascular disease (CVD) who received lycopene supplementation exhibited improved blood vessel response to acetylcholine, compared with healthy volunteers, thereby suggesting normalized endothelial function. Lycopene improved blood vessel response to acetylcholine by 53% in CVD patients.

Pediatrics eMedinewS

  • A new research has revealed that brain images of neuroinflammation in children with Tourette syndrome are different from those in children with neuropsychiatric disorders related to streptococcal infections. This has intensified the debate about whether the two conditions are part of a single spectrum. The research was presented at the Society of Nuclear Medicine and Molecular Imaging 2014 Annual Meeting.
  • A large–scale study, published June 10 in Plos One, has found significantly altered levels of salivary biomarkers – insulin, C–reactive protein (CRP), adiponectin and leptin – in obese children. This potentially non–invasive approach may help identify metabolic disease risk in children.

Dr K K Spiritual Blog

Medical Profession Follows Krishna and Not Rama

Teachings from both the epics of our country are taught to every child during school age. The first being Ramayana and the second being Mahabharata.

Ramayana depicts Lord Ram as the savior of truth and a person who lives in an atmosphere of truthfulness till the end. Ramayana probably is a reflection of the collective consciousness of Satyuga where the majority of the people believed in truthfulness.

The Tretya Yuga and Dwapara Yuga then followed, when the definition of dharma (to hold people together) changed as per the collective consciousness of the people. The teaching of Lord Krishna in Mahabharata was that you have to live with truthfulness but speaking a lie can be your dharma in special situations. He said that a lie which can save somebody’s life without affecting any other person may be spoken and a truth, which if spoken can hurt somebody or is not going to harm anybody if not spoken may not be spoken.

Today we are living in Kalyuga and the Krishna of today is every medical doctor treating a patient. For the interest of the patient and the society, if doctors were to follow the principles of Rama, miseries would have increased. We as medical professionals are taught the example of Krishna and not Rama. We are taught that our utmost duty is the comfort of the patient. In doing so we are taught not to tell a dying person that he is going to die or not to tell a cancer patient that he is going to die in the next 2 to 3 months.

As a part of our social commitment a job of a medical professional is to save the life of a person. Everybody knows that prostitution is a crime but both Govt. of India and National AIDS Control Organization (NACO) have a program in which they distribute free condoms to the commercial sex workers. Similarly, all addicts during de-addiction are provided drugs as a part of the prescription though the quantity has been defined to be lower than 5 grams. All addicts are treated and not put behind the bar.

The Law today state that an attempt to commit suicide is a crime (section 309 of the Indian Penal Code 1860) and consuming a drug is also a crime. But medically a doctor would look it differently. For him attempt to suicide is linked to an underlying depression and the patient needs a treatment and not jail. Addiction is a disease and every addict on similar grounds need de-addiction program and not jail.

The country’s Law is very harsh and needs to be changed. Probably when the law was made, addiction was not considered a disease.

Punishment for a person attempting to commit suicide should be to get a compulsory treatment for depression in a time bound manner and for an addict to get a complete de-addiction done in a time bound manner.

The answer is not punishment but rehabilitation. But till the Law is changed, the only way medical professionals can help patients who have attempted suicide is to write that it was accidental and patients who are addicts by showing that either it was accidental ingestion or he or she ingested an unknown substance.

Most doctors are taught not to do urine or blood test in such cases because if the test comes out to be positive, the police will have no other alternative than to arrest the addict and put them behind the bar.

The Law says that possession of cocaine in anybody’s house can amount to imprisonment. Will the same law apply to the Chief Minister or Lt. Governor of a state if cocaine is found in their state or Prime Minister of President of the country if cocaine is found in their country?

But if we look from the viewpoint of law makers, under section 64A in the NDPS Act, there is a provision that the court can direct drug addicts to get rehab done in a Govt. de–addiction centre. But most of the doctors are unaware about this. Doctors can easily label a patient as drug addict and save them. But how many people would like to be labeled as an addict or prefer a Govt. centre when best of the private sector de–addiction centers are available.

The bailable arrest of doctors in the Rahul Mahajan case was a clear indication for the medical professionals to stop thinking that they are next to God and they have any social responsibility. They should follow the rule book of the law and state observations as they are.

Wellness Blog

A mix of exercise protocol is better

A combination of weight training and aerobic exercise is the best prescription for overweight patients at risk for diabetes and heart disease.

Only aerobic exercise is also good as it reduces weight and inches off the waistlines. Just weight lifting alone has very little benefit.

According to a study published in the journal American Journal of Cardiology, people in the weight-training group gained about 1.5 pounds and those in the aerobic group lost an average of 3 pounds and half an inch from their waists.

Those who did both weight and aerobic training dropped about 4 pounds and 1 waistline inch. This group also saw a decrease in diastolic lower blood pressure and in a metabolic syndrome score.

Both the aerobic –only group and the combined–exercise group also lowered their levels of bad triglycerides.

Inspirational Story

The Good you do, comes back to you

A woman baked chapati for members of her family and an extra one for a hungry passerby. She kept the extra chapati on the window sill, for whosoever would take it away. Every day, a hunchback came and took away the chapati. Instead of expressing gratitude, he muttered the following words as he went his way: "The evil you do remains with you: The good you do, comes back to you!" This went on, day after day. Every day, the hunchback came, picked up the chapatti and uttered the words: "The evil you do, remains with you: The good you do, comes back to you!" The woman felt irritated. "Not a word of gratitude," she said to herself.

"Everyday this hunchback utters this jingle! What does he mean?" One day, exasperated, she decided to do away with him. "I shall get rid of this hunchback," she said. And what did she do? She added poison to the chapati she prepared for him! As she was about to keep it on the window sill, her hands trembled. "What is this I am doing?" she said.

Immediately, she threw the chapati into the fire, prepared another one and kept it on the window sill. As usual, the hunchback came, picked up the chapati and muttered the words: "The evil you do, remains with you: The good you do, comes back to you!" The hunchback proceeded on his way, blissfully unaware of the war raging in the mind of the woman.

Every day, as the woman placed the chapati on the window sill, she offered a prayer for her son who had gone to a distant place to seek his fortune. For many months, she had no news of him. She prayed for his safe return. That evening, there was a knock on the door. As she opened it, she was surprised to find her son standing in the doorway. He had grown thin and lean. His garments were tattered and torn. He was hungry, starved and weak. As he saw his mother, he said, "Mom, it’s a miracle I’m here. While I was but a mile away, I was so famished that I collapsed. I would have died, but just then an old hunchback passed by. I begged of him for a morsel of food, and he was kind enough to give me a whole chapati. As he gave it to me, he said, "This is what I eat everyday: today, I shall give it to you, for your need is greater than mine!"

As the mother heard those words, her face turned pale. She leaned against the door for support. She remembered the poisoned chapati that she had made that morning. Had she not burnt it in the fire, it would have been eaten by her own son, and he would have lost his life! It was then that she realized the significance of the words: "The evil you do remains with you: The good you do, comes back to you!"

Do good and don’t ever stop doing good, even if it is not appreciated at that time.

ePress Release

ECG can be normal in acute heart attack

Chest pain which can be pinpointed by a finger or lasts less than 30 seconds is not a heart pain 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.

ECG might not be a diagnostic test for acute heart attack. It can be normal in the first six hours of heart attack. If a heart attack is suspected one should do serial ECGs or serial blood tests for the next 12 hours to rule out a heart attack.

The presentation of a heart attack can be atypical. A person may present with toothache, neck pain, acidity or abdominal pain. In diabetics, the heart attack may be silent with no chest pain.

If chewable aspirin is given to a victim of heart attack at the onset of chest pain, the chances of sudden death may reduce by 22%.

Most heart attack deaths occur in the early hours of the morning usually within 3 hours of getting up. Therefore early morning chest pain should not be ignored.

ECG may be unreliable in women and in patients with abnormal electrical activity of the heart. In these situations, 3–dimensional echocardiography is of help. It detects heart attack much before an ECG can diagnose it.

Any irregular heart rate, whether low or high coming for the first time in life after the age of 40 should raise the alarm of an underlying impending heart attack. A pulse rate of less than 60 or more than 100 is

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

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: A patient with acute chest pain died before reaching the hospital.
Reaction: Oh my God! Why was water –soluble aspirin not given?
Lesson: Make sure that at the onset of acute heart attack and chest pain, water–soluble aspirin is chewed to reduce chances of sudden death.

eMedinewS Humor

Keep Your Seat

A radical feminist is getting on a bus when, just in front of her, a man gets up from his seat. She thinks to herself, "Here’s another man trying to keep up the customs of a patriarchal society by offering a poor, defenseless woman his seat," and she pushes him back onto the seat.

A few minutes later, the man tries to get up again. She is insulted again and refuses to let him up.

Finally, the man says, "Look, lady, you’ve got to let me get up. I’m two miles past my stop already."

Quote of the Day

A little more persistence, a little more effort, and what seemed hopeless failure may turn to glorious success. Elbert Hubbard

 

Twitter of the Day

Dr KK Aggarwal: Dr KK Aggarwal: Inhaling diesel exhaust Fumes causes heart attack or stroke http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra:Dr Deepak Chopra: Love is the highest intelligence 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

 

eMedi Quiz

Bacitracin acts on:

1. Cell wall
2. Cell membrane
3. Nucleic acid
4. Ribosome

Yesterday’s Mind Teaser: 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

Answer for yesterday’s Mind Teaser: 1. Hydatid cyst of liver

Correct answers received from: Dr Manas Ranjan Sahoo, Tukaram Pagad, Dr. P. C. Das, Dr.K.V.Sarma, Dr.Jayant Gaikwad, Dr.K.Raju, Dr Jainendra Upadhyay, Daivadheenam Jella, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr. SUSHMA Chawla, Muthumperumal Thirumalpillai, Arvind Diwaker, Dr Avtar Krishan, jayant gaikwad

Answer for 9th June Mind Teaser: : 1. Hyperosmolarity

Correct answers received from: Dr . Raghavendra Singh, Tukaram Pagad, jayant gaikwad

Send your answer to ijcp12@gmail.com

medicolegal update

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medical querymedical query

medicolegal update

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medicolegal update
  1. Dear Editor, Medical practitioners take care of general health of their patients, but what about their own ocular health? It’s a fact that even GPs overlook their yearly eye examinations…knowing pretty well that presbyopia may strike anyone around the age of 40, glaucoma (even though not so common) may attack anyone anytime suddenly after the age of 45, and cataract may set in anytime after the age of 55. Dr. Narendra Kumar, Ophthacare Eye Centre.
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