eMedinewS15th October 2013, Tuesday

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; 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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Harvard’s 5 ways to dodge incontinence

  1. Watch your weight. Excess weight and incontinence can go hand in hand, particularly for women. One theory is that extra abdominal fat can weaken the pelvic floor muscles and lead to stress incontinence (leaking urine when coughing, laughing, sneezing, etc). In some cases, simply losing weight can improve incontinence.
  2. Don’t smoke. Smoking doubles the likelihood that a woman will develop stress incontinence. Nicotine has also been linked to urge incontinence.
  3. Stay active. In the Nurses’ Health Study, middle–aged women who were most physically active were least likely to develop incontinence.
  4. Minimize bladder irritants. Caffeine and alcohol have been linked to urge incontinence (the feeling you need to urinate even when the bladder isn’t full). Carbonated drinks, the artificial sweetener aspartame, spicy foods, and citrus fruits and juices cause urge incontinence in some people.
  5. Don’t strain with bowel movements. This can weaken the pelvic floor muscles. If your stools are frequently hard or take considerable effort to pass, talk with your doctor. In a study involving people ages 65 and older, treating constipation improved a variety of urinary symptoms, including frequency, urgency, and burning. Increasing the fiber in your diet and drinking enough fluid can help prevent constipation.

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."


VIP’s on CPR 10 Mantra Video
eMedinewS
Ringtone – CPR 10 Mantra Hindi

Ringtone – CPR 10 Mantra English

The Vedic meaning of Mahamritunjaya Mantra and the Gayatri Mantra

sprritual blog

Any activity should always engage the 3 H model of Heart, the Head, and the Hand. The same has been advocated by the western scholars of today. The concept involves that while doing any work one should ask the head for choices and then refer these choices to the heart to chose one and finally to order the hands to do the action.

Deepak Chopra in his blood seven spiritual laws of success also talks about them in great details. He writes that conscious based decisions are the best decisions. Before taking any decision he recommends asking the body for the signals of comfort or discomfort and if the signals of discomforts comes one should not indulge into that action.

All the above concepts come from our ancient Vedic knowledge. The two main mantras of our times are the Mahamritunjaya mantra and the Gayatri Mantra.

The Mahamritunjaya mantra from the Rig–Veda and needs initiation for attaining any Siddhi. This is the greatest reliever from all evils and reads as under: Aum Trayambakam Yajamahe, Sugandhim Pushtivardhanam; Urva Rukamiva Bandhanan, Mrityor Mokshiye Mamritat. It means we worship Shiva – The Three-Eyed Lord; who is fragrant and nourishes all beings; May he protect us (bandhanana) from all big (urva) diseases (aarookam). May he liberate us (mokshiye) from death (mrityor), For the sake of immortality (mamritat, amrit); as the cucumber is automatically liberated, from its bondage from the creeper when it fully ripens.

The meaning of the manta is the importance of the third eye and the benefits of its opening. The two eyes are at the level of the physical body. The third eye means the eyes of the mind and the eyes of the soul. It also indicates that in difficulty one should look inward from the eyes of the mind and ask for the choices. Like the cucumber, one should chose the good ones and drop the bad choices. (jo acha lage use upna lo jo bura lage use jane do).

The manta for the conscious based decision comes from Gyatri mantra. The same reads as Om Bhur Buvaha Suvaha Thath Savithur Varenyam Bhargo Devasya Dheemahi Dhiyo Yonaha Prachodayath. It means we meditate on the glory of the Creator; who has created the Universe; who is worthy of Worship; who is the embodiment of Knowledge and Light; who is the remover of all Sin and Ignorance; may He enlighten our Intellect.

It talks about the importance of conscious based decisions and its directions to the intellect to choose the right and not the convenient actions.

The Gayatri is the Vedic prayer to illuminate the intellect. Gayatri is considered as Vedasara –– "the essence of the Vedas." Veda means knowledge, and this prayer fosters and sharpens the knowledge-yielding faculty. As a matter of fact, the four mahavakyas or ‘core"declarations’ enshrined in the four Vedas are implied in this Gayatri mantra.

Choosing the right decision from the consciousness was later defined by Buddha. He taught that before any action ask yourself the following four questions and if the answer to any of the question is no, not to indulge in that actions. These four questions are: is it the truth, is it necessary, will the actions bring happiness to you and to the others.

cardiology news

Poisoning Mother–In–Law

A long time ago in China, a girl named Li–Li got married and went to live with her husband and mother–in–law.

In a very short time, Li–Li found that she couldn’t get along with her mother–in–law at all. Their personalities were very different, and Li–Li was angered by many of her mother–in–law’s habits. In addition, she criticized Li–Li constantly.

Days passed days, and weeks passed weeks. Li-Li and her mother-in-law never stopped arguing and fighting. But what made the situation even worse was that, according to ancient Chinese tradition, Li–Li had to bow to her mother–in–law and obey her every wish. All the anger and unhappiness in the house was causing the poor husband great distress.

Finally, Li–Li could not stand her mother–in–law’s bad temper and dictatorship any longer, and she decided to do something about it.

Li–Li went to see her father’s good friend, Mr. Huang, who sold herbs. She told him the situation and asked if he would give her some poison so that she could solve the problem once and for all. Mr. Huang thought for a while, and finally said, "Li–Li, I will help you solve your problem, but you must listen to me and obey what I tell you." Li–Li said, "Yes, Mr. Huang, I will do whatever you tell me to do." Mr. Huang went into the back room, and returned in a few minutes with a package of herbs.

He told Li–Li, "You can’t use a quick–acting poison to get rid of your mother–in–law, because that would cause people to become suspicious. Therefore, I have given you a number of herbs that will slowly build up poison in her body. Every other day prepare some delicious meal and put a little of these herbs in her serving. Now, in order to make sure that nobody suspects you when she dies, you must be very careful to act very friendly towards her. Don’t argue with her, obey her every wish, and treat her like a queen."

Li–Li was so happy. She thanked Mr. Huang and hurried home to start her plot of murdering her mother–in–law.

Weeks went by, months went by, and every other day, Li–Li served the specially treated food to her mother–in–law. She remembered what Mr. Huang had said about avoiding suspicion, so she controlled her temper, obeyed her mother–in–law, and treated her like her own mother. After six months had passed, the whole household had changed.

Li–Li had practiced controlling her temper so much that she found that she almost never got mad or upset. She hadn’t had an argument in six months with her mother–in–law, who now seemed much kinder and easier to get along with.

The mother–in–law’s attitude toward Li–Li changed, and she began to love Li–Li like her own daughter. She kept telling friends and relatives that Li–Li was the best daughter–in–law one could ever find. Li–Li and her mother–in–law were now treating each other like a real mother and daughter. Li–Li’s husband was very happy to see what was happening.

One day, Li–Li came to see Mr. Huang and asked for his help again. She said, "Mr. Huang, please help me to stop the poison from killing my mother–in–law! She’s changed into such a nice woman, and I love her like my own mother. I do not want her to die because of the poison I gave her."

Mr. Huang smiled and nodded his head. "Li–Li, there’s nothing to worry about. I never gave you any poison. The herbs I gave you were vitamins to improve her health. The only poison was in your mind and your attitude toward her, but that has been all washed away by the love which you gave to her."

News Around The Globe

20th MTNL Perfect Health Mela Programme Brouchure

20th MTNL Perfect Health Mela 2013 Hangout on Air with Google

The Immune System of the Soul

October 17, 2013, Siri Fort Auditorium

Organised by Brahma Kumaris


In this fast paced world, where we all are running in the rat race to acquire all sorts of gadgets, luxuries and comforts of life, and have actually forgotten about our ‘being’, our ‘soul’ per se. None of us have the time to sit back and ponder on the very basic questions which arise even in a small child’s mind, as in who we are? Where we have come from? What is the purpose of our being? How our soul dwells in our daily activities? How can we charge up our soul or what makes it low? Do we actually listen to our inner/soul’s voice? If yes, there is still some hope, and if not, then what happens to our inner voice in return? All of us are bothered about materialistic possessions and all we care about is that we should be free from physical ailments. Does that suffice our existence? The answer is NO, as emotional ailments take its toll when we stop caring about our soul or the inner voice. To answers these questions and to help people get enlightened, Mike George, an author, spiritual leader and management consultant, has organized a workshop titled ‘The Immune System of the Soul’ which will take you to a journey from awareness to realization and finally to transformation. The workshop is scheduled on October 17, 2013, 6–8 PM at Siri Fort Auditorium, Delhi. Come and be a part of this divine experience.

News

  • Better record keeping, education, and vigilance by infectious disease clinicians and pharmacists can reduce the rate of prescription errors for HIV–infected patients hospitalized for other reasons. Presenting the research at IDWeek 2013, Elizabeth Neuner, PharmD, an infectious diseases clinical pharmacist said, "Such reforms significantly reduced the rate of prescribing errors from 50% to 34% at the Cleveland Clinic. They allow more effective prescribing." When HIV–infected patients are hospitalized for non–HIV conditions, hospital providers who are unfamiliar with the complexities of HIV therapy can make errors leading to adverse effects, a loss of viral protection, and drug interactions
  • The US Food and Drug Administration (FDA) is investigating a rise in reports of life–threatening blood clots and blood–vessel narrowing in patients taking ponatinib (Iclusig, ARIAD Pharmaceuticals, Inc.) to treat leukemia. Ponatinib is indicated for adults with chronic phase, accelerated phase, or blast phase chronic myeloid leukemia (CML) or Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL) who do not tolerate or no longer benefit from other therapies such as imatinib (Gleevec, Novartis Pharmaceuticals Corporation).
  • The results of a new study published online October 8 in JAMA do not support the use of moderate hypothermia to improve outcomes in patients with severe bacterial meningitis and might even be harmful.
  • Contrary to conventional wisdom, most patients with even longstanding type 1 diabetes still have beta cells that secrete small amounts of insulin after a meal, according to a new study published online October 9 in Diabetologia. Richard A. Oram, MD, from the University of Exeter in the United Kingdom reported that by using a new, very sensitive assay for C–peptide, a marker of insulin secretion, 73% of people with type 1 diabetes, even with a long duration were found to have detectable insulin production.
  • People whose mothers showed depressive symptoms during pregnancy had an increased risk for depression themselves at age 18, as per a long-running British cohort study reported online in JAMA Psychiatry. Prenatal depressive symptoms were an independent risk factor for depression in adult offspring with an odds ratio of 1.23 (95% CI 1.03–1.44) for each standard deviation of increase in prenatal depression scores on a self–reported instrument, after adjusting for a variety of potential confounding variables, according to Rebecca M. Pearson, PhD, of the University of Bristol in England, and colleagues.

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Rabies News (Dr. A K Gupta)

What is important for the success of Animal Birth Control (ABC) program?

The success of this program hinges on the sterilization of 70% of the strays in a given geographic area within 6 months, before the next reproductive cycle begins; otherwise the entire effort is negated.

cardiology news
  • A new research published in the Canadian Journal of Cardiology says that marathon running is bad for the heart. Running a marathon can prompt heart muscle changes that cause the heart to swell, and this is particularly the case in runners with lower fitness levels.
  • Researchers at UC San Francisco concluded that whites were more prone to atrial fibrillation than other ethnic groups. The study "We found that consistently, every other race had a statistically significant lower risk of atrial fibrillation compared to whites," said senior author Gregory Marcus, MD, MAS, FHRS, an associate professor of medicine who specializes in electrophysiology in the UCSF Division of Cardiology included 14 million patients and is to be published online and in the November 12 issue of Circulation.

Valvular Heart Disease News

Transesophageal echocardiography is unlikely to become a first–line diagnostic technique in aortic stenosis or regurgitation, but should be considered as an adjunct to transthoracic echocardiography when there are conflicting data from invasive and non–invasive studies as to the hemodynamic severity of aortic regurgitation or stenosis.

(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
  • Researchers from Sweden report that the level of cortisol in hair may be a marker of prolonged stress in children, which could be a useful "complement" to other ways of studying how stress influences the health of children. In the study, high levels of cortisol were related to indicators of psychosocial stress in the child. According to the authors, it may be especially useful in stress research among children with the obvious advantage of easy sample collection, being noninvasive, and being independent of stress levels at sample collection.
  • The introduction of a vaccine targeting some of the most virulent pneumococcal serotypes has reduced the proportion of children infected with invasive pneumococcal disease caused by those serotypes. Lead author John McLaughlin, PhD, an epidemiologist at Pfizer, the manufacturer of the pneumococcal conjugate vaccine known as PCV13, presented the results at IDWeek 2013. The US Centers for Disease Control and Prevention recommends PCV13 for all children younger than 5 years of age and for adults with certain risk factors.
cardiology news

Diabetes Update

  • Morbidity from diabetes involves both macrovascular (atherosclerosis) and microvascular disease (retinopathy, nephropathy and neuropathy).
  • Smoking cessation is essential for patients who smoke.
  • Cardiovascular morbidity can also be significantly reduced with aggressive management of hypertension, cholesterol (goal LDL less than 80 mg/dL and use of aspirin (8o mg/day) in patients with or at high risk for cardiovascular disease.
  • Glycemic control can minimize risks for retinopathy, nephropathy and neuropathy in both type 1 and type 2 diabetes and has been shown to decrease the risk for cardiovascular disease for type 1 diabetes.
  • A1c goal is <7% for most patients.
  • More stringent control (A1c <6%) may be indicated for individual patients with type 1 diabetes and during pregnancy.
  • A higher target A1c (i.e., <8%) may be preferable for some type 2 patients with comorbidities or with an anticipated lifespan, owing to advanced age or other factors, that is too brief to benefit from the effects of intensive therapy on long–term complications.
  • The appropriate target for A1c in fit elderly patients who have a life expectancy of over 10 years should be similar to those developed for younger adults (<7.0%).
  • The risk of hypoglycemia, which may lead to impaired cognition and function is substantially increased in the elderly. Thus, avoidance of hypoglycemia is an important consideration in establishing goals and choosing therapeutic agents in elderly adults.
  • In the absence of specific contraindications, start with metformin as initial therapy for all patients with diabetes including the elderly. Start with metformin at the time of diabetes diagnosis, along with consultation for lifestyle intervention. Titrate metformin to its maximally effective dose (usually 2000–2500 mg/day in divided doses) over 1 to 2 months, as tolerated. Metformin should not be administered when conditions predisposing to lactic acidosis are present.
  • In patients with contraindications and/or intolerance to metformin, a short–acting sulfonylurea (e.g., glipizide) is an alternative option.
  • In patients who are intolerant of or are not candidates for metformin or sulfonylureas, repaglinide is a reasonable alternative, particularly in a patient with chronic kidney disease (CKD) at risk for hypoglycemia.
  • Start lifestyle intervention first, at the time of diagnosis. The weight gain that accompanies a sulfonylurea will presumably be less if lifestyle efforts are underway. However, if lifestyle intervention has not produced a significant reduction in symptoms of hyperglycemia or in glucose values after one or two weeks, then the sulfonylurea should be added.
  • DPP4–inhibitors can be given as monotherapy in elderly patients who are intolerant of or have contraindications to metformin, sulfonylureas, or repaglinide. They are weak agents and only lower A1c by 0.6%. They are given when the A1c level is relatively close to the goal level. DPP–4 inhibitors have no risk of hypoglycemia and are weight–neutral, when used as monotherapy. Sitagliptin or saxagliptin are the choices but more expensive and less potent in lowering glycemia than repaglinide.
  • Insulin can also be considered a first–line therapy for all patients with type 2 diabetes, particularly patients presenting with A1c >10%, fasting plasma glucose >250 mg/dL, random glucose consistently >300 mg/dL, or ketonuria.
  • Another alternative is a thiazolidinedione, which may be considered in patients with lower initial A1c values or if there are specific contraindications to sulfonylureas.
  • Patients who are initially thought to have type 2 diabetes may actually have type 1 diabetes, and therefore require insulin as initial therapy. In patients in whom it is difficult to distinguish type 1 from type 2 diabetes, initial treatment with insulin is required.
  • Further adjustments of therapy, which should usually be made no less frequently than every three months, are based upon the A1c result (and the results of home glucose monitoring).
  • If inadequate control is achieved (A1c remains > 7.0%), another medication should be added within 2 to 3 months of initiation of the lifestyle intervention and metformin.
cardiology news

Total CPR since 1st November 2012 – 63425 trained

CPR Classes 63425

Media advocacy through Print Media

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Media advocacy through Web Media

Shorter the waist line, longer the life line 2nd PR

FREEPRESSINDEX LINK, FREEPRESS RELEASE, AFRICANEWSWIRE, PRLOG, BLOGZ

Medico Masti at MTNL Perfect Health Mela

An intercollege and youth festival will be organized on Saturday, 26th October, 2013 at 20th MTNL Perfect Health Mela to be held at Constitution Club of India, New Delhi.

Padma Shri and Dr. B C Roy National Awardee, Dr K K Aggarwal, President Heart Care Foundation of India said that over 50 colleges from NCR including medical colleges will participate in the event.

The festival will be organized by the Foundation in association with various Departments of Central and Delhi Government, NDMC, MCD and Maulana Azad Medical College.

Giving the details Dr Aggarwal said that on the spot competitions like fashion show, choreography, rock band, etc would be organized as part of the festival. Other competitions will include western and classical dance, quiz, singing competition, etc.

Dr Aggarwal said that infotainment is new concept of creating health education and in this module education is interlinked with entertainment. The principles of infotainment modules are:

  1. Have competitions based on health-based theme.
  2. Display social advertisements and messages in between the competitions in the form of health practice.
  3. Have talks by eminent personalities in between the two competitions and finally
  4. Pass on social messages to the public in the award ceremony in between two awards.

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 63425 people since 1st November 2012.

The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10minutes, 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."

today emedipics

A Press Conference was being organised by Heart Care Foundation of India to announces the dates of 20th MTNL Perfect Health Mela 2013

press release

Diabetes Update

today video of the dayDr KK Aggarwal Birthday 5th September

Cultural Evening at IMA

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

Interscalene approach to brachial plexus block does not provide optimal surgical anaesthesia in the area of distribution of which of the following nerve:

1.Musculocutaneous.
2.Ulnar
3.Radial
4.Median.

Yesterday’s Mind Teaser: What percentage of your diet should fat make up?

A. About 10 percent of your daily calories.
B. About 20 percent of your daily calories.
C. About 30 percent of your daily calories.
D. About 40 percent of your daily calories.
E. There is no recommended amount of fat; you should strive to eat as little of it as possible.

Answer for yesterday’s Mind Teaser: C. About 30 percent of your daily calories.

Correct answers received from: DR ABBAS VAKIL, DR. PRAVEEN JAIN, Dr shashi saini, Dr.A.K.Gajjar, Dr.K.V.Sarma, DR AYYAVOO ERODE, Dr. V.P. Thakral, Dr.K.Raju, Dr valluri ramarao, Muthumperumal Thirumalpillai, Khurshid Alam, Dr.B.R.Bhatnagar, daivadheenam, Dr Chandresh Jardosh, Dr pawan Mehta, Dr Arpan Gandhi, drsodhani navneet, Dr Kanta jain, Dr B K Agarwal

Answer for 13th October Mind Teaser: 1.Mapleson A.

Correct answers received from: Dr Chandresh Jardosh, Dr pawan Mehta, Dr Arpan Gandhi, drsodhani navneet, DR AVTAR KRISHAN, Dr Kanta jain

Send your answer to ijcp12@gmail.com




medicolegal update

Click on the image to enlarge

medicolegal update

An elderly husband and wife visit their doctor when they begin forgetting little things. Their doctor tells them that many people find it useful to write themselves little notes.

When they get home, the wife says, "Dear, will you please go to the kitchen and get me a dish of ice cream? And maybe write that down so you won’t forget?"

"Nonsense," says the husband, "I can remember a dish of ice cream."

"Well," says the wife, "I’d also like some strawberries and whipped cream on it."

"My memory’s not all that bad," says the husband. "No problem – a dish of ice cream with strawberries and whipped cream. I don’t need to write it down."

He goes into the kitchen; his wife hears pots and pans banging around. The husband finally emerges from the kitchen and presents his wife with a plate of bacon and eggs.

She looks at the plate and asks, "Hey, where’s the toast I asked for?"

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

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

medicolegal update

Sunbeams out of the clouds. Faith out of all my doubt. Terri Guillemets

medicolegal update

Dr KK Aggarwal: Eating refined sugar can cause diabetes http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: Why do you stay in prison When the door is so wide open–Rumi

medicolegal update

Hello Mr. Musa, read your problem; start taking more of seitz bath at least 3times a day for 5-10 minutes each time. Also add tab Voveran (salt diclofenac 100mgm twice daily), syp Lactulose20–30ml at bed time and do take additional seitz bath after defecation; tab.nitrazepam15mg h.s. and more of high fiber diet. Take care and wish u best of health: Dr. Gautam Jain.

Forthcoming Events

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20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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medicolegal update



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