eMedinewS 14th July 2013, Sunday

Dr K K 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; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; 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
www.twitter.com/DrKKAggarwal
www.facebook.com/Dr KKAggarwal

Consuming Artificial Sweeteners Can Cause Heart Disease

Consumption of non-caloric, artificially sweetened beverages is associated with an increased risk for chronic life style diseases according to Susan E. Swithers, PhD, a professor of behavioral neuroscience at Purdue University in West Lafayette, Indiana, published online July 10 in Trends in Endocrinology & Metabolism.

Frequent consumers of these sugar substitutes may be at increased risk of excessive weight gain, metabolic syndrome, type 2 diabetes, hypertension and cardiovascular disease. This risk is independent of baseline body mass index.

Another earlier study found that children of normal weight who consume artificially sweetened beverages may have decreased weight gain compared with those who consume sweetened beverages.

In another study, overweight and obese adults who substituted water or artificially sweetened beverages for sweetened beverages had no greater weight loss at 6 months than an attentional control group.

Artificially sweetened beverages intake was not associated with improved fasting glucose, but water intake was. ...Read More

EDTA chelation therapy and secondary prevention of heart disease

EDTA chelation therapy has been prescribed for patients with cardiovascular disease despite an absence of evidence to support its use. The TACT trial, randomly assigned patients with prior heart attack to infusions of a chelation solution or placebo over one to two years and found a small benefit from chelation in terms of a composite of total mortality, recurrent heart attack, stroke, coronary revascularization, or hospitalization for angina. However the current recommendation is not to use this due to significant limitations of the study (multiple interim analyses, high dropout rates, potential for unmasking). (JAMA 2013; 309:1241). ...Read More

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 10x10 i.e. 100 per minute.”


VIP's on CPR 10 Mantra Video
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Ringtone - CPR 10 Mantra Hindi

Ringtone - CPR 10 Mantra English

sprritual blog Spiritual prescriptions - Formulas to Improve the Soul Profile

Sattchittaananda: The soul characteristics, (Absolute Existence -Absolute Knowledge)

Satt means ‘truth or knowingness’
Chitta means ‘conscious based’
Ananda means ‘bliss or inner happiness’

The soul in Vedic description is described as Sattchittaananda. People in touch with their soul speak the truth, take consciousness-based decisions and experience inner happiness.

The great rishis of India have described a formula of how to be in touch with your soul and get inner happiness. The formula is based on three questions to be asked of yourself before performing any action

  1. Is it the truth?
  2. Is it consciousness based?
  3. Will it give happiness?

If the answer to all three is ‘yes’, go ahead. In other words, if the answer to any of the three is ‘no’, do not perform that action.

Later on, many dharma groups modified this formula for their own use.

  1. Buddha’s Law of Action summarizes these questions as:
    1. Is it the truth?
    2. Is it necessary?
    3. Will it bring happiness to me?
    4. Will it bring happiness to others?

      If the answer to any of the questions is ‘no’, do not do that action.
  2. Buddha’s Law of Speech summarizes the questions as:
    1. Is it the truth?
    2. Is it necessary?
    3. Is it kind?

      If the answer to any of the question is ‘no’, do not speak.
  3. The Rotary four-way test comprises of:
    1. Is it the truth?
    2. Is it fair to all concerned?
    3. Will it build goodwill and better friendship?
    4. Will it be beneficial to all concerned?

      If the answer to any of the answer is ‘no’, do not perform that deed.
  4. Formula of three H: Head, Heart and Hand Before doing any action ask your head for the choices. Then listen to the heart to give you the best consciousness-based advice and finally order the hand to do the action.
  5. The formula Satyam Shivam Sundaram is based again on three questions.
    1. Is it the truth?
    2. Is it God (consciousness based)?
    3. Is it going to build my inner beauty (happiness)?
  6. ‘May I help you?’ is another formula given in Srimad Bhagwat where once you agree to help, you end up with truth, tapa of hard work, purity of mind and daan or charity. ...Read More
cardiology news

Confidence

A man had been on a long flight.

The first warning of the approaching problems came when the sign on the airplane flashed on: “Fasten your seat belts.”

Then, after a while, a calm voice said, “We shall not be serving the beverages at this time as we are expecting a little turbulence. Please be sure your seat belt is fastened.”

As he looked around the aircraft, it became obvious that many of the passengers were becoming apprehensive. Later, the voice of the announcer said, “We are so sorry that we are unable to serve the meal at this time. The turbulence is still ahead of us.”

And then the storm broke. The ominous cracks of thunder could be heard even above the roar of the engines. Lightening lit up the darkening skies and within moments that great plane was like a cork tossed around on a celestial ocean. One moment the airplane was lifted on terrific currents of air; the next, it dropped as if it were about to crash.

The man confessed that he shared the discomfort and fear of those around him. He said, “As I looked around the plane, I could see that nearly all the passengers were upset and alarmed. Some were praying.

The future seemed ominous and many were wondering if they would make it through the storm. And then, I suddenly saw a girl to whom the storm meant nothing. She had tucked her feet beneath her as she sat on her seat and was reading a book.

Everything within her small world was calm and orderly. Sometimes she closed her eyes, then she would read again; then she would straighten her legs, but worry and fear were not in her world. When the plane was being buffeted by the terrible storm, when it lurched this way and that, as it rose and fell with frightening severity, when all the adults were scared half to death, that marvelous child was completely composed and unafraid.”

The man could hardly believe his eyes. It was not surprising therefore, that when the plane finally reached its destination and all the passengers were hurrying to disembark, he lingered to speak to the girl whom he had watched for such a long time.

Having commented about the storm and behavior of the plane, he asked why she had not been afraid.

The sweet child replied, “Sir, my Dad is the pilot and he is taking me home. Nothing can go wrong......”

............Read More

News Around The Globe

Obesity may cause gallstones

Higher body mass index (BMI) appears to be a causal risk factor for gallstones, particularly for women, Danish researchers found. (Source: Medpage Today)

FDA sets standard for arsenic in apple juice

The FDA proposed on Friday an "action level" for arsenic in apple juice, with the goal of preventing exposure to unsafe levels of the inorganic form of the element. (Source: Medpage Today)

Gilotrif gets FDA OK for NSCLC

The FDA has approved afatinib (Gilotrif) as targeted first-line therapy for patients with metastatic non-small cell lung cancer (NSCLC). Afatinib is a tyrosine kinase inhibitor that targets cancer-driving mutations in the epidermal growth factor receptor (EGFR) gene. The drug is the second this year approved for first-line therapy in patients with metastatic NSCLC whose tumors have the EGFR mutations. (Source: Medpage Today)

Type A behavior related to lower mortality risk in diabetes

Patients with type 1 diabetes and type A behaviors had a significantly lower mortality risk during 22 years of follow-up, investigators reported. Type A behavior -- associated with competitiveness, aggressiveness, and achievement-oriented personality traits -- may represent a modifiable risk factor in type 1 diabetes. (Source: Medpage Today)

Updated ASCO guide on chemoprevention for breast cancer

New clinical practice guideline from the American Society of Clinical Oncology (ASCO) now more strongly recommends the use of pharmacological prevention interventions for women who are at increased risk for invasive breast cancer. The selective estrogen receptor modulators (SERMs) tamoxifen and raloxifene (Evista, Lily) "should be discussed as an option" to reduce the risk of estrogen receptor (ER)-positive breast cancer. (Source: Medscape)

News

  1. The FDA has proposed an "action level" for arsenic in apple juice, with the goal of preventing exposure to unsafe levels of the inorganic form of the element. The agency set the threshold at 10 parts per billion (ppb) of inorganic arsenic, which matches the standard for total arsenic -- both inorganic and organic -- set for drinking water by the Environmental Protection Agency (EPA). There has been no arsenic standard for fruit juices to date.
  2. It only takes one bad apple to spoil the bunch, and the same may be true of certain proteins in the brain. Studies have suggested that just one rogue protein (in this case, a protein that is misfolded or shaped the wrong way) can act as a seed, leading to the misfolding of nearby proteins. According to an NIH-funded study, various forms of these seeds — originating from the same protein — may lead to different patterns of misfolding that result in neurological disorders with unique sets of symptoms. “This study has important implications for Parkinson’s disease and other neurodegenerative disorders,” said National Institute of Neurological Disorders and Stroke (NINDS) Director Story Landis, Ph.D. “We know that among patients with Parkinson’s disease, there are variations in the way that the disorder affects the brains. This exciting new research provides a potential explanation for why those differences occur.”
  3. Research from the National Institutes of Health has identified neural circuits in mice that are involved in the ability to learn and alter behaviors. The findings help to explain the brain processes that govern choice and the ability to adapt behavior based on the end results. Researchers think this might provide insight into patterns of compulsive behavior such as alcoholism and other addictions.
  4. Analysis of three biomarkers in the urine of kidney transplant recipients can diagnose — and even predict — transplant rejection, according to results from a clinical trial sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. This test for biomarkers — molecules that indicate the effect or progress of a disease — offers an accurate, noninvasive alternative to the standard kidney biopsy, in which doctors remove a small piece of kidney tissue to look for rejection-associated damage. The findings appear in the July 4 issue of the New England Journal of Medicine.

Infertility News (Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the causes of intrauterine adhesions?

The most common cause of intrauterine adhesions is trauma to the uterine cavity. This may occur following dilation and curettage (D&C), an outpatient surgical procedure during which the cervix is dilated and the tissue contents of the uterus are emptied. Prolonged use of an intrauterine device (IUD), infections of the endometrium (endometritis), and surgical procedures involving the uterus (such as removal of fibroids) also may lead to the development of intrauterine adhesions.

Rabies News (Dr. A K Gupta)

Can vaccinated dog succumb to rabies following bite by rabid animal?

Following severe and extensive bites which mean injection of very high challenge dose of virulent virus by a rabid dog, a vaccinated dog can still succumb to rabies.

cardiology news

Competition, not need, drives Cath Lab growth

U.S. hospitals spent up to $4 billion adding angioplasty services over a 4-year period, but the new services did little to improve access to timely medical care, researchers found.

Between 2004 to 2008, some 251 hospitals added the invasive cardiac care, but the new programs were mainly built near existing ones in competitive healthcare markets, rather than where the need for the services was greatest, according to Thomas W. Concannon, PhD, an assistant professor at the Tufts University School of Medicine in Boston and a policy researcher at RAND, and colleagues. The percent of the U.S. population with timely access to angioplasty -- a drive time of under 1 hour -- improved by less than 2% during the study period. At the same time, the number of hospital-based cardiac labs and clinics increased by 16%, they wrote in the study published online before print in Circulation: Cardiovascular Quality and Outcomes.

Diabetes tied to timing of baby's first solid food

Among children already at higher risk for type 1 diabetes, missing the sweet spot for introduction of solid foods may increase the risk even further, researchers found.

Compared with exposing children to solid food for the first time at ages 4 or 5 months, introducing solid food both earlier and later was associated with greater risks of developing the disease (hazard ratio 1.91 for early and HR 3.02 for later), according to Jill Norris, PhD, MPH, of the Colorado School of Public Health in Aurora, and colleagues. The specific food category associated with the greatest risk was rice or oats when first exposure occurred at age 6 months or later (HR 2.88, 95% CI 1.36-6.11), the researchers reported online in JAMA Pediatrics.

Valvular Heart Disease News

Echocardiographic screening of first degree relatives of patients with bicuspid aortic valve and a positive family history and in those with a dilated aorta is recommended.

(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)

cardiology news

Nearly half of parents know CT raises lifetime cancer risk

Nearly half of parents who visited the emergency department with a child who had suffered a head injury knew that computed tomography (CT) imaging was associated with an increased lifetime cancer risk, and 90.7% of parents wanted to know about such risk potential before CT use, according to a prospective cross-sectional study. (Source: Medscape)

Nearly half of babies have flat skull spot

Close to half of two-month-olds have "positional plagiocephaly" -- a flat spot on the back of their heads - and changes in parents' habits may be a cause. Although not thought to be medically dangerous, the flattened head shape can become permanent, which can have psychological implications for kids as they grow up, , Canadian authors suggest. (Source: Medscape)

cardiology news

Buy your shoes in the evening

Harvard 8 tips for buying shoes that are good to your feet

Start with your own feet, and look at what’s already in your closet. Stand barefoot on a piece of paper or cardboard, and trace the shape of each foot. Now take your shoes, one by one, and place them on top of the drawing. If you’re like most people, your “comfortable” shoes will closely match the outline of your own feet.

Identify the shoes that cause pain. If you’re a woman, most of these will be shoes with narrow toes or high heels. Check to see if the toe of the shoe is narrower or shorter than your own toes.

  1. Wait until the afternoon to shop for shoes — your feet naturally expand with use during the day and may swell in hot weather.
  2. Wear the same type of socks that you intend to wear with the shoes.
  3. Have the salesperson measure both of your feet. If one foot is larger or wider than the other, buy a size that fits the larger foot.
  4. Stand in the shoes. Make sure you have at least a quarter- to a half-inch of space between your longest toe and the end of the shoe.
  5. Walk around in the shoes to determine how they feel. Is there enough room at the balls of the feet? Do the heels fit snugly, or do they pinch or slip off? Don’t rationalize that the shoes just need to be “broken in” or that they’ll stretch with time. Find shoes that fit from the start.
  6. Trust your own comfort level rather than a shoe’s size or description. Sizes vary from one manufacturer to another. You’re the real judge.
  7. Feel the inside of the shoes to see if they have any tags, seams, or other material that might irritate your feet or cause blisters.
  8. Turn the shoes over and examine the soles. Are they sturdy enough to provide protection from sharp objects? Do they provide any cushioning? Also, take the sole test as you walk around the shoe store: do the soles cushion against impact? Try to walk on hard surfaces as well as carpet to see how the shoes feel. ...Read More
cardiology news

Alcohol and rape facts  

Rape myths  

Situation: A depressed female with recent sexual assault was brought to the hospital  

Situation: A sexually assaulted girl was found to have a vaginal tear on examination.  

Situation: A student asked his senior whether rape was mentioned in the Holy Bible  

cardiology news

EBook

CPR 10 Training Camp, EPFO, 30th May 2013

CPR 10 Camp - Police Training Center Najafgarh

Total CPR since 1st November 2012 – 54572 trained

6th July: Zoonosis Conference: 52

Video Chats and uploads

Symposium on Prayer, Faith, Meditation and healing Part 9

Symposium on Prayer, Faith, Meditation and healing Part 8

Symposium on Prayer, Faith, Meditation and healing Part 7

Symposium on Prayer, Faith, Meditation and healing Part 6

Symposium on Prayer, Faith, Meditation and healing Part 5

Symposium on Prayer, Faith, Meditation and healing Part 3

Symposium on Prayer, Faith, Meditation and healing Part 2

Symposium on Prayer, Faith, Meditation and healing Part 1

CPR 10 training was given to 1001 students learnt CPR at Bal Bharti Public School, Dwarka

Seven Steps to Patient Safety

What patient expect on doctor – A survey

MTNL Perfect Health Mela to focus on Disaster Management & Doctor patient relationship

Dr AK Aggarwal Speaks on Workshop on Patient Safety

Dr RN Makroo on Blood Safety

Prof (Dr) Usha Gupta on Medication Safety

Dr N V Kamath DHS on Patient Care

Vegetarian diet and soya products help reduce BP

Ingestion of a vegetarian diet may reduce systolic blood pressure by 5 mmHg. A 5 mm reduction in blood pressure may reduce the risk of heart disease by 21%. This was stated by Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

One major feature of a vegetarian diet that may affect blood pressure is the amount of dietary fiber; with an increased amount being associated with decreased systemic pressures. Multiple meta-analyses have shown benefits with dietary fiber intake on blood pressure.

Vegetarians, in general, have lower blood pressure levels and a lower incidence of hypertension and other cardiovascular diseases. Experts postulate that a typical vegetarian's diet contains more potassium, complex carbohydrates, polyunsaturated fat, fiber, calcium, magnesium, vitamin C and vitamin A, all of which may have a favorable influence on blood pressure.

More significant reductions were observed in older (greater than 40 years) and hypertensive individuals.

Soy is good for high blood pressure because it is naturally high in potassium and low in sodium. Potassium and sodium are electrolytes and a high-potassium, low-sodium diet promotes a healthy blood pressure.

Soy can be good for high blood pressure when you eat it as an alternative protein source to unhealthy meats. Soy-based meat substitutes, such as veggie burgers, veggie bacon and meatless cold cuts, can be higher in fiber and lower in sodium than animal-based meat products. They can lower your risk for heart disease because they are lower in saturated fat. However, soy does not contain the long-chain omega-3 fatty acids that are found in fatty fish and shellfish; these may lower your blood pressure, according to the Linus Pauling Institute.

Even though soy is low in unhealthy saturated fat, some soy products are high in total fat and calories, and as a result will contribute to weight gain if you eat too much. Losing weight if you are overweight, or maintaining your current weight if you are already at a healthy weight, improves your chances of lowering your high blood pressure.

...Read More

today emedipics

Doctor Day Celebration

On the occasion of Doctors Day, a CME was organized by IMANDB, eMedinewS and Heart Care Foundation of India on 29th June 2013 at IIC, New Delhi

press release

Vitamin D intake associated with reduced risk for Crohn’s disease

today video of the day CPR Utsav 6th April 11543 Male Female Trained in 1 day

Symposium on Prayer, Faith, Meditation and healing Part 9

Dr KK Aggarwal on 4 REALNEWS JUNE 26 2013 On Uttrakhand Disaster

eMedi Quiz

Read this…………………

Dr. Smith suspects tracheoesophageal fistula in a 1-day-old neonate. Which nursing intervention is most appropriate for this child?

a. Avoiding suctioning unless cyanosis occurs
b. Elevating the neonate’s head and giving nothing by mouth
c. Elevating the neonate’s head for 1 hour after feedings
d. Giving the neonate only glucose water for the first 24 hours

Yesterday’s Mind Teaser: A 2-month-old baby hasn’t received any immunizations. Which immunizations should nurse Jess prepare to administer?

a. Measles, mumps, rubella (MMR); diphtheria, tetanus, pertussis (DTP) and Hepatitis B (HepB)
b. Polio (IPV), DTP, MMR
c. Varicella, Haemophilus influenzae type b (HIB), IPV and DTP
d. HIB, DTP, HepB and IPV

Answer for yesterday’s Mind Teaser: d. HIB, DTP, HepB and IPV

Correct answers received from: Dr Bitaan Sen & Dr Jayashree Sen, Dr Abbas Vakil,
Dr Nageswara Rao Patnala, Dr periasamy Subarayan, Dr KV Sarma, Dr Arpan Gandhi, Dr VP Thakral, Dr Jainendra Upadhyay, Dr Ayyavoo ERODE, Dr Pankaj Agarwal, Dr(Brig) C H Gidvani, Dr Santhakumari, Tukaram Pagad, Dr K Raju, Dr Chandresh Jardosh, Daivadheenam Jella, Muthumperumal Thirumalpillai, Pushpa Otiv, Mahendra Shah, Dr Kanta Jain.

Answer for 11th July Mind Teaser: a. Babinski’s

Correct answers received from: Mahendra Shah, Dr Santhakumari, Dr BB Gupta, Dr Bitaan Sen & Dr Jayashree Sen.

Send your answer to ijcp12@gmail.com




eMedi Apps



medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Chairman Legal Cell Indian Academy of Echocardiography; Chairman Ethical Committee Delhi Medical Council; Editor eMedinewS and President Heart Care Foundation of India)

Can a physician refuse to see a patient because of an unpaid bill?

Ans. AMA Code of Medical Ethics

  • The general AMA policy on billing is Opinion 6.05, "Fees for Medical Services." This Opinion does not specifically address whether a physician might refuse to see a patient due to an unpaid bill.
  • However, Opinion 8.11, "Neglect of Patient" states, "Once having undertaken a case, the physician should not neglect the patient." Refusing to see a patient might be considered neglect, unless the physician appropriately terminated the patient-physician relationship.
  • Opinion 8.115, "Termination of the Patient-Physician Relationship" states that the physician should provide "notice to the patient, the relatives, or responsible friends sufficiently long in advance of withdrawal to permit another medical attendant to be secured."

B: MCI Code of Medical Ethics: 2.4 The Patient must not be neglected: A physician is free to choose whom he will serve. He should, however, respond to any request for his assistance in an emergency. Once having undertaken a case, the physician should not neglect the patient, nor should he withdraw from the case without giving adequate notice to the patient and his family. Provisionally or fully registered medical practitioner shall not willfully commit an act of negligence that may deprive his patient or patients from necessary medical care.

medicolegal update

The prospective son-in-law was asked by his girl friend's father, "Son, can you support a family?" "Well, no, sir," he replied. "I was just planning to support your daughter. The rest of you have to fend for yourselves." Read More

medicolegal update
medicolegal update

Situation: Can thyroid medicine and omeprazole be taken together on an empty stomach?
Dr. Bad: You can take it.
Dr. Good: Don’t combine the two.
Lesson: T4 thyroid medicine should not be taken along with other drugs that interfere with its absorption such as, proton pump inhibitors (PPIs), calcium carbonate etc. Read More

medicolegal update

Situation: A patient with fever and cough developed complications after he was given antibiotics.
Reaction: Oh my God! What was the need of giving the antibiotics?
Lesson: Make sure a patient with fever and cough is not given antibiotics as presence of cough is mostly due to viral infection.

medicolegal update

If you’re not using your smile, you’re like a man with a million dollars in the bank and no checkbook. Les Giblin

medicolegal update

Dr KK Aggarwal: High fat diet prostate cancer prone
http://bit.ly/14JxRjo #Health

Dr Deepak Chopra: The strange thing about paranormal is that no matter how often you prove it, it remains unproven.
http://bit.ly/14JxRjo #Health

medicolegal update

Dear Sir, Emedinews is really very informative. Regards: Dr Tapan

Forthcoming Events

2nd annual Ped Neuro Conclave

Sunday, 25th August 2013.
This is an annual event hosted jointly by Fortis Escorts Hospital and IAP Jaipur. This conference is held every year and is attended by more than 200 delegates, which include Neurologists, Pediatricians, GPs and resident doctors from all over Rajasthan. Senior faculty from different institutes all over India and abroad participates and shares their knowledge and experience with the audience.

The eminent faculty includes
Dr. Pratibha Singhi, Head Pediatric Neurology, PGI – Chandigarh
Dr R K Sabharwal, Head Pediatric Neurology, Sir Ganga Ram Hospital, New Delhi
Dr. Vineet Bhushan Gupta, Sr Consultant Pediatric Neurologist, Apollo Hospital, New Delhi;
Dr Deepak Gupta, Sr Consultant Paediatric Psychiatrist, Sir Ganga Ram Hospital, New Delhi.
Venue: Jaipur Marriott Hotel
Date: Sunday, 25 August 2013 (0900-1700)
Organizing Secretary: Dr Sharad Sharma, MD (PGI), MRCPCH (UK), Fellow Pediatric Neurology (London)
Senior Consultant Pediatric Neurology, Fortis Hospital, Jaipur, Rajasthan

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