eMedinewS15th November 2013, Friday

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
www.facebook.com/Dr KKAggarwal

Sleep deprivation and sleep apnea both bad for the heart

Both sleep deprivation and sleep apnea have been linked to a higher risk of heart disease.

Over time, inadequate or poor quality sleep can increase the risk of heart disease. Short–term sleep deprivation is linked with high cholesterol, high triglycerides, and high blood pressure.

Sleep apnea makes people temporarily stop breathing many times during the night. Up to 83% of people with heart disease also have sleep apnea.

In sleep apnea oxygen levels dip and the brain sends an urgent "Breathe now!" signal. That signal briefly wakes the sleeper and makes him or her gasp for air. That signal also jolts the same stress hormone and nerve pathways that are stimulated when you are angry or frightened. As a result, the heart beats faster and blood pressure rises — along with other things that can threaten heart health such as inflammation and an increase in blood clotting ability. (Source Harvard)

Exercise may lower C–reactive protein

Individuals who vigorously exercise significantly reduce the odds that they will have high levels of C–reactive protein.

If a person exercised vigorously less than 500 MET per week, there was a 27% reduction in the odds of having elevated C–reactive protein levels said lead author Michael Richardson, BSH, a graduate assistant at Brooks College of Health at the University of North Florida in Jacksonville.

If a person did 500 METs or more per week, the risk reduction was 33%.

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
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

Should doctors smile while talking to their patients?

sprritual blog

Bhagavad Gita 2.10: tam uva ca  hṛṣīkeśaḥ, prahasann iva bhārata, senayor ubhayor madhye, viṣīdantam idaḿ vacaḥ

SYNONYMS: tam — unto him; uvāca — said; hṛṣīkeśaḥ — the master of the senses, Kṛṣṇa; prahasan — smiling; iva — like that; bhārata — O Dhṛtarāṣṭra, descendant of Bharata; senayoḥ — of the armies; ubhayoḥ — of both parties; madhye — between; viṣīdantam — unto the lamenting one; idam — the following; vacaḥ — words.

TRANSLATION: O descendant of Bharata, at that time Krishna, smiling, in the midst of both the armies, spoke the following words to the grief-stricken Arjuna. The answer comes in Bhagavad Gita, the first text book of counseling. When grief-ridden Arjuna approaches him, he starts his counseling in happy and smiling mood. Arjuna was grief-filled, sad and rebellious. Yet Krishna smiled.

The word in the Gita is prahasann, which means to smile before laughing (beginning to laugh). It was not a weak or full smile or a sarcastic grimace, but a very positive smile.

The grief of a patient halves if he sees his doctor smiling or the relatives see a smile on the face of the doctor coming out of the operation theater. In a situation like in Bhagavad Gita, it also gives confidence to the patient (Arjuna) that his doctor (Krishna) has understood his problem fully and has a solution to his problem. Buddha is also shown smiling and Goddess Kushmanda is also shown with a smiling face.

cardiology news

Let me put forward a story to you which I once read which should be born on mind by every parent.

A little boy was playing ball when his father hurried out calling the secretary on the phone.

"Dad, do you have a minute to play ball with me?"

"Sorry son, I’m busy" was the response.

Years later, the father, now bald–headed and reclining in a chair in the lawn saw his son coming out to his car, keys twirling on his finger.

"Son, do you have a moment to have a cup of tea with me?" he asked.

"Sorry I’m busy," came the response.

A simple story and one which I am sure is not new to many of you in essence, but one which does call for some soul searching.

Of course, we have our busy schedules but it is important to make up for the time which you could not give your child when you were busy, with some quality time later.

But make sure that it happens before it is too late.

News Around The Globe


  • The Union Cabinet on Wednesday cleared the health ministry’s proposal to institute a three–year degree programme for public health professionals. The bachelor in community health programme will act as a bridge between auxiliary nurse midwife and a doctor and overrides the objections raised by a parliamentary panel and the Medical Council of India.
  • Chronic rhinosinusitis may be the result of an overactive immune response to normal microbes, not necessarily bacterial infection. A new study found that patients and healthy controls tended to have qualitatively similar microbiomes. While control lavage samples triggered interleukin (IL)–5 production in peripheral blood leukocytes from patients, this was not the case with leukocytes from controls.
  • The US FDA has approved ibrutinib (Imbruvica, Pharmacyclics, Janssen Biotech), a "breakthrough" drug for mantle cell lymphoma (MCL) that has been hailed as a successor to traditional chemotherapy in treating hematological cancer. Ibrutinib is indicated for patients with MCL who have undergone at least one other therapy for this rare and aggressive form of blood cancer. The drug inhibits an enzyme that the cancer needs to multiply and spread.
  • According to a research from Sweden, women who have undergone bariatric surgery should be classified as at–risk during pregnancy, with a greater chance of giving birth to preterm or small–for–gestational–age babies. The study is reported online in BMJ.
  • A new analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial published in the journal Diabetes Care has shown that response to standard or intensive glucose–lowering strategies appears to differ by age in individuals with type 2 diabetes. Cardiovascular mortality increased in the trial in middle–aged adults who received intensive vs standard glucose–lowering therapy, but this was not true for older adults. However, severe hypoglycemia occurred more often in the older individuals.
  • A novel variant of avian influenza A infected a 20–year–old woman in Taiwan, as reported by Ming–Tsan Liu, PhD, of the Taiwan Centres for Disease Control in Taipei, and colleagues in The Lancet Respiratory Medicine. It is the first reported case of an H6N1 avian virus infecting and causing disease in a human, although very similar viruses are endemic in chickens in the island nation. The woman was treated in May and made a complete recovery, with no indication that she passed the novel virus to anyone else.

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Rabies News (Dr. A K Gupta)

What are the initial (prodromal) symptoms of rabies?

  • Pain or paresthesia at the site of the bite is well–known as a diagnostically useful prodromal symptom occurring in one–third to two–thirds of cases. In Thailand, however, a specific type of paresthesia–itching–was the earliest symptom in >40% of cases. Itching occurred at the site of the healed bite wound or involved the whole bitten limb and was sometimes so intense as to provoke frenzied scratching and excoriation of the skin. The explanation for local paresthesia may be the multiplication of virus in the dorsal root ganglion of the sensory nerve supplying the area of the bite.
  • Pain behind the grafted eye was an early symptom in 3 of the 4 patients who developed rabies following corneal transplants.
  • Priapism with frequent spontaneous orgasms was the first symptom in one Thai patient.
  • Fever, malaise, nausea and vomiting.
  • The skin becomes sensitive to changes of temperature, especially air currents.
cardiology news

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

  • Not all polyunsaturated fatty acids (PUFAs) are created equal, according to a new report, so simply replacing dietary saturated fats with polyunsaturated fatty acids might not be enough to lower the risk of heart disease. In an analysis published November 11, 2013 in CMAJ, two researchers argue that to obtain the "heart benefits" of polyunsaturated fatty acids, the emphasis should be on a-linolenic acid, an omega–3 fatty acid, and not on linoleic acid, which is an omega–6 fatty acid.
  • Fractional flow reserve, intravascular ultrasound, and optical coherence tomography all likely have a place in the interventional cardiologist’s armamentarium, according to a consensus statement from the Society for Cardiovascular Angiography and Interventions (SCAI). The guideline published in Catheterization and Cardiovascular Interventions states that fractional flow reserve (FFR) is used to determine the functional significance of a coronary stenosis. Intravascular ultrasound (IVUS) offers excellent visualization of intraluminal and transmural coronary anatomy. Optical coherence tomography (OCT) further improves vascular visualization.
cardiology news

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

  • For children with juvenile idiopathic arthritis, early treatment with a combination of methotrexate and etanercept leads to sustained clinically inactive disease more often than methotrexate alone. An exploratory analysis of data from the Trial of Early Aggressive Therapy in Polyarticular Juvenile Idiopathic Arthritis (TREAT) was presented at the American College of Rheumatology (ACR) 2013 Annual Meeting. TREAT was a double–blind placebo–controlled trial of 85 patients 2 to 17 years of age who had juvenile arthritis for less than a year.
  • Young adults with major depressive disorder seemed to resolve depression after a 12–week exercise program with a motivational component. In a small, pilot study of depressed 18– to 24–year–olds presented at the Society for Neurology meeting, exercise was associated with declines in depression severity of 63%, where 83% of participants were no longer considered depressed at the end of the 12–week program.
cardiology news

Children too may have acidity

Children who have continuing recurrence of cough and croup could be suffering from stomach acid reflux problems.

Croup or ‘Kali Khansi’ as it is called in local parlance is recognized by a loud cough that often sounds like the barking of a seal. It can cause rapid or difficult breathing, and sometimes wheezing. Croup is thought to be caused by a virus, but reflux acidity has been suggested as a possible trigger.

In gastroesophageal reflux disease, stomach acid causes swelling and inflammation of the larynx, which narrows the airway. It can trigger more swelling with any kind of viral or respiratory infection.

Identifying children with gastroesophageal reflux disease could help treat and improve recurring croup. It is unusual for a child to have 3 or more bouts of croup over a short period of time. These children need to be evaluated.

The same is true for adults also. Patients with non responding asthma should be investigated for underlying acidity as the cause of acute asthma.

cardiology news

Total CPR since 1st November 2012 – 71933 trained

Media advocacy through Web Media

Beware of winter sore throat in children: It can bite the heart

Viral sore throats in children are closely followed in frequency by group A Streptococcus pyogenes (GAS) sore throats, which is the most frequent bacterial cause of infectious pharyngitis, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

In the winter months as many as 30 percent of episodes of pharyngitis may be caused by S. pyogenes. If not detected and treated in time it can bite the heart valves and lick the joints (temporary joint pains).

GAS accounts for 15 to 30 percent of all cases of pharyngitis in children between the ages of 5 and 15 years. In temperate climates, the incidence peaks during the winter and early spring. GAS pharyngitis is seen most frequently in school–age children, but may occur in younger children, especially if they have contact with school–age children.’

In children older than 3 years, GAS pharyngitis typically has an abrupt onset. Fever, headache, abdominal pain, nausea, and vomiting may accompany the sore throat, which can lead to poor oral intake. Often there is absence of cough and nasal discharge, which if present often represents viral cough.

Additional features may include exudative pharyngitis, enlarged tender anterior cervical lymph nodes, palatal petechiae and an inflamed uvula.

Symptoms usually resolve spontaneously in 3 to 5 days.

Streptococcal infections usually manifest with atypical symptoms in children younger than 3 years of age. Instead of a well–defined episode of pharyngitis, they may have protracted symptoms of nasal congestion and discharge, low–grade fever, and tender anterior cervical adenopathy. This GAS symptom complex is called "streptococcosis".

Infants younger than 1 year may be fussy or present with decreased appetite and low–grade fever. They often have older siblings or daycare contacts with GAS infection.

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 71933 people since 1st November 2012.

The CPR 10 Mantra is – "Within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

today emedipics

20th MTNL Perfect Health Mela - Spiritual Guru's doing CPR 10.

press release

Monitoring LFT in a patient on statins

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

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

Cultural Evening at IMA

eMedi Quiz

The nerve commonly damaged during McBurney’s incision is:

3.11th thoracic
4.10th thoracic

Yesterday’s Mind Teaser: The blood vessel related to the paraduodenal fossa is:

1. Gonadal vein
2.Superior mesenteric artery
3.Portal vein
4.Inferior mesenteric vein

Answer for yesterday’s Mind Teaser: 4.Inferior mesenteric vein.

Correct answers received from: Dr.K.Raju, DR ARPAN GANDHI, Dr.K.V.Sarma, dr.suresh srinivasan, Dr.(Maj. Gen.) Anil Bairaria, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Sangeetha Raja, DR AVTAR KRISHAN, Dr.G.Sahadevudu Gelivi, Dr B K Agarwal

Answer for 13th November Mind Teaser: 3.Left common carotid artery arising from brachiocephalic trunk.

Correct answers received from: Dr B K Agarwal

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

Gynecologist: A man who works and operates in another man’s field

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: Doctor, this patient has developed acute renal failure (ARF).
Reaction: Oh my God, I forgot that he was on furosemide. I gave him full dose of amikacin.
Lesson: Make sure, before calculating the dose of aminoglycoside (amikacin) that furosemide and other loop diuretics, which enhance its nephrotoxicity are not being given.

medicolegal update

A crust eaten in peace is better than a banquet partaken in anxiety. Aesop

medicolegal update

Dr KK Aggarwal: Dr K K Aggarwal: Relaxation during work http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Are we alone in the universe? Take a quick trip through the cosmos as I explore this eternal question. @thechoprawell http://youtu.be/65NXtLfQMYo

Forthcoming events

The Principal, Staff and Students of Bal Bharati Public School ((An Institution of child education society (Regd.))

Sector – 12, Dwarka, New Delhi – 110078 cordially invite you to their 16th Annual Day on Sunday, November 17, 2013

5:00 pm onwards

Venue: School premises

Chief Guest: Sh Vineet Joshi, IAS, Chairman CBSE

Guest of Honor: Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India

medicolegal update
  1. Dear Sir, emedinews is very informative newspaper. Regards: Dr Varun

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