eMedinewS15th January 2014, Wednesday

Dr K K AggarwalPadma 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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Cough

  1. Acute cough means a cough less than 3 weeks duration
  2. Chronic cough means a cough of more than 8 weeks.
  3. Sub–acute cough means cough of 3–8 weeks duration.
  4. Most common causes of chronic cough are nasal drip, asthma and gastroesophageal acid reflex.
  5. In 50% cases, sub–acute cough is post infectious in nature.
  6. ACE inhibitors (drug) can cause cough.
  7. Post nasal drip may be silent.
  8. Symptoms of post nasal drip may include frequent nasal discharge, sensation of liquid dripping into the back of throat and frequent throat clearing.
  9. Asthma is the second leading cause of chronic cough in adults. Cough can be the sole presentation of asthma (cough–variant asthma)
  10. Heartburn with acid reflex is the third most common cause of chronic cough. Heartburn may be absent in 40% of such cases.
  11. Chronic cough requires an x–ray chest.
  12. Always look for signs of post nasal drip in patients with chronic cough.
  13. In India, any cough of more than two weeks needs, TB should be ruled out.
  14. In sore throat, cough means a viral flu.
Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV

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."

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

The Five Interior Powers

sprritual blog

To be in a state of happiness, bliss and ananda is what the ultimate goal of life is. Everybody is born with certain inherent powers, which if cultivated in the right direction will lead to inner happiness.

The ancient Shiva Sutra text talks about the concept of Shiva and Shakti. Shiva is silence, Shakti is power; Shiva is creativity, Shakti is creation; Shiva is love, Shakti is loving.

In computer terminology, Shiva is the knowledge or the information and Shakti is the operational software. Shiva and Shakti both together form consciousness, in other words, the soul.

Shiva sutra – teaching about Shiva – describes five inherent powers of Shakti which everybody is born with. These are "Chitta Shakti", "Ananda Shakti", "Gyan (Gnana) Shakti", "Ichha Shakti" and "Kriya Shakti".

Kriya Shakti is the one which is most visible. Kriya is not same as karma. Karma is action born of cause and effect. Kriya Shakti is at the level of body and mind.

Ichha Shakti is the inherent desires which control the mind. Gyan Shakti is the inherent desire to learn and is at the level of intellect. Both Ananda and Chitta Shakti are at the level of consciousness and represent the desires or aim to be blissful.

These five powers also decide the needs of a person, which can be at the level of physical body, mind, intellect, ego or the soul. The needs activate the Shakti which in turn leads to action. The purpose of life should be to direct the needs and the Shaktis towards the soul and not towards the ego. The power of Kriya Shakti should have all the actions directed towards the soul; Gyan Shakti should be directed towards the knowledge of the true self; Ichha Shakti towards the desire or intention to unite with the self; Anand Shakti and Chitta Shakti towards the awareness of God and to experience the bliss of God.

All thoughts, speech or actions in life should be directed on two basic goals providing happiness to others and ending up with self–happiness. Every action and relationship in life should involve these five powers to attain inner happiness.

Most computers in the body require a key to get activated and the key in the case of Shakti is "intention or intent". Intentions are something, which are under the control of a person, or one can practice control over them.

"Intention" always requires the association of its buddy "attention" with it. Attention is the focus of action on that particular intention. The combination of intention and attention can change perceptions of life and ultimately change the reality. It has been an old Upanishad saying that you are what your thoughts are. Right intention leads to the right thought; the right thought to right action; the right action to the right habit; the right habit to the right character and the right character leads you to what you are. The punch–line, therefore, is to have right intention which should be directed towards one of the five Shakti to acquire spiritual well-being.

Health is not mere absence of disease but a state of physical, mental, social, environmental and spiritual well–being. Spiritual well–being now has been added as the fifth dimension of the health. It has been said that the body is the largest pharmaceutical armamentarium in the world and has the capacity to produce each and every drug available in the universe. This is based on the fact that no drug can go into the body without a receptor. The very fact the body has a receptor for every drug means it has the capacity to produce that drug.

All yogic paths to liberation are also directed towards these Shakti. One adopts karma Marg by activating Kriya Shakti, Gyan Marg by activating Gyan Shakti and Bhakti Marg by activating Ichha Shakti.

Faulty lifestyle also involves distractions of three of these powers: Ichha, Gyan or Kriya Shakti. Correct lifestyle involves the correct use of Kriya Shakti in doing actions, correct use of Gyan Shakti by acquiring knowledge about self and healthy behavior and correct use of Ichha Shakti by learning the dos and don’ts of life and controlling the mind towards various addictions of life, which can be addition of food, sex, drugs, alcohol, smoking, sleeping, not walking and or eating faulty Rajsik cum Tamsik high refined carbohydrate diet.

cardiology news

A Meeting of Minds

Martin was returning to work in his London office after spending two weeks with his brother over in New York. He was coming back with a heavy heart. It was not just that it was the end of a wonderful holiday; it was not just that he invariably suffered badly from jet lag; it was that Monday mornings always began with a team meeting and, over the months, he had grown to hate them.

Martin was aware that colleagues approached these meetings with hidden agendas; they indulged in game–playing; and he knew that people were not being honest and open. The meetings themselves were bad enough - but then there was all the moaning afterwards. The usual people saying the usual things – "I could have improved on that idea, but I wasn’t going to say". "I was thinking of making a suggestion – but I couldn’t be bothered".

As this morning’s meeting began, Martin braced himself for the usual moroseness and monotony. But, as the meeting progressed, he became aware of a strange background noise. At first, he thought that he was still hearing the engine noise from the aircraft that had brought him back to London – he had had to sit over the wing and the droning was terrible. But, as he concentrated on the noise, it became a little clearer.

He realized – to his amazement – that he could hear what his colleagues were thinking as well as what they were saying. As he concentrated still harder, he found that he could actually hear what they were thinking at the same time as they were speaking. What surprised him, even more than the acquisition of this strange power, was that he discovered that what people were saying was not really what they were thinking. They were not making clear their reservations. They were not supporting views which they thought might be unpopular. They were not contributing their new insights. They were not volunteering their new ideas.

Martin found it impossible not to respond to his new knowledge. So he started to make gentle interventions, based more on what he could hear his colleagues thinking than on what he could hear them saying. "So, John are you really saying …" "Susan, Do you really think that …" "Tom, Have you got an idea on how we could take this forward?" He was aware that his colleagues were unsettled by how insightful were these interventions. They looked at him mystified. In truth, he felt rather proud of his newly–acquired talent.

Emboldened now, Martin forgot his usual misery at participating in such meetings and began making comments of his own. However, he became aware that some of his colleagues were looking at him quizzically. One or two even had a gentle smile playing on their lips. Only gradually did it dawn on him – they could hear his thoughts and he was not really saying what he was thinking.

As the meeting progressed, Martin became aware of changes to the tone and style of the event. It was clear to him now that, one by one, each member of the meeting was learning how to hear the thoughts of all the others and this was subtly changing how they inter–acted with one another. The game–playing started to fall away; people started to speak more directly; views became better understood; the atmosphere became more open and trusting.

The meeting ended. As people left the room, Martin found that he could still hear what they were thinking. "That was the best meeting we’ve ever had." "All meetings should be like that." "In future, I’m going to say what I think".

News Around The Globe

News

  • Human immunodeficiency virus (HIV) sequence variants resembling early postinfection sequences‏ were found in CD4 T memory stem cells long after treatment, according to a study published online January 12 in Nature Medicine. The findings suggest a long–term viral reservoir and potential targets for future treatment.
  • All women should be screened for gestational diabetes at 24 weeks of pregnancy, even if they have no symptoms, according to new federal recommendations from the U.S. Preventive Services Task Force (USPSTF), published in the Annals of Internal Medicine.
  • Patients on maintenance treatment for lupus nephritis should do equally well on mycophenolate mofetil and azathioprine, according to a new review and meta–analysis. In the study published December 24 in Rheumatology, no significant differences between MMF and AZA in rates of sustained remission, relapse, renal failure, creatinine increase, or death were found.
  • Dr. Eun Young Lee of Seoul National University College of Medicine in Korea and colleagues report in the journal Rheumatology that udenafil and amlodipine are comparable in improving the rate of Raynaud’s phenomenon (RP) attacks, but udenafil also significantly improves the blood flow in digital arteries.
  • The rate of new cases of lung cancer decreased from 2005 to 2009 in the United States, according to the Centers for Disease Control and Prevention (CDC). Specifically, lung cancer incidence rates went down from 87 to 78 cases per 100,000 men, a decrease of 2.6% per year, and from 57 to 54 cases per 100,000 women, a decrease of 1.1% per year. The new data were published in the January 10 issue of the Morbidity and Mortality Weekly Report.

CPR 10 success stories

1. Hands–only CPR 10 English

2. Hands–only CPR 10 (Hindi)

3. Ms Geetanjali, SD Public School Successful Story

4. Success story Ms Sudha Malik

5. BVN School girl Harshita does successful hands–only CPR 10

6. Elderly man saved by Anuja

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Rabies News (Dr. A K Gupta)

What are the precautions to be taken while administering RIGs?

  • Patient should not be on an empty stomach.
  • The RIGs vial taken out from the refrigerator should be kept outside for a few minutes to warm it to room/body temperature.
  • While infiltrating RIGs into the bite wound, care must be taken to avoid injecting into blood vessels and nerves.
  • While injecting into finger tips, care must be taken to avoid compartment syndrome.
  • All emergency drugs and facilities for managing any adverse reactions must be available.
  • For ERIG, keep the patient under observation for at least one hour after ERIG administration and then send home.
  • RIGs can be infiltrated even to already sutured wounds without disturbing the sutures.
cardiology news

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

  • A preliminary study reports that drinking green tea reduced the plasma concentration and the systolic–BP–lowering effect of the beta–blocker nadolol in 10 healthy young volunteers. The researchers showed that the blood–pressure–lowering effect of a single dose of nadolol was weaker after the volunteers had been drinking about 2 cups a day of green tea for 2 weeks than after they had been drinking this amount of water for 2 weeks. Further, they showed that in cell–culture experiments, green tea appears to inhibit an organic anion–transporting polypeptide (OATP)—specifically OATP1A2—which is present in the intestinal epithelium and at least partly responsible for transporting nadolol into cells. The study is published January 13, 2014 in Clinical Pharmacology & Therapeutics.
cardiology news

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

  • Men exposed to low–dose methotrexate don’t have to worry about fathering babies with birth defects, according to a new study from Germany in a paper online December 24 in Rheumatology. According to Dr Weber–Schoendorfer of Charite Universitatsmedizin Berlin and colleagues, the data from this study do not provide evidence for an increased risk of adverse pregnancy outcome after paternal low–dose methotrexate.
  • A preservative used in some popular wet wipes may be leading to significant eczematous dermatitis in children, according to a case report published online January 13 in Pediatrics. Physicians may be misdiagnosing these cases as other skin disorders. In the study, 6 children have presented with "chronic, recalcitrant perianal and/or facial dermatitis" after the use of 2 brands of wet wipes. The problems resolved quickly and completely after use of the wipes stopped.
cardiology news

Pneumonia more risky to heart patients

People who are hospitalized with bacterial pneumonia are eight times more likely to suffer heart attack or other "acute coronary syndrome" within 15 days of admission than are their peers hospitalized for other conditions.

Even the patients with bacterial pneumonia are at greater risk for acute heart–related "events" in the days following admission than they are one year before or after hospitalization.

As per a research at Baylor College of Medicine in Houston, from a study which focused on 206 patients with pneumonia and 395 non–pneumonia patients, compared to control patients, pneumonia patients had 7.75–fold higher risk of suffering an acute heart–related event within 15 days of being admitted to the hospital. Overall, 10.7 percent of pneumonia patients suffered an acute coronary heart event within 15 days of hospital admission, compared with only 1.5 percent of control patients. Further analysis showed that pneumonia patients were roughly 45–times more likely to experience an acute coronary heart syndrome in the days following their admission than either one year before or after their hospital stay.

cardiology news

Total CPR since 1st November 2012 – 84073 trained

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Low cholesterol linked to anxiety, depression, suicide, hemorrhagic stroke and cancers

People with very low cholesterol levels are at increased risk of developing stomach cancer, according to a study published in the International Journal of Cancer, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and Sr. National Vice President Indian Medical association.

The study involved 2,600 residents of Hisayama, Japan, who were followed for 14 years. Gastric cancers developed in 97 subjects. After accounting for age and gender, stomach cancer rates rose significantly with descending cholesterol level. For example, among subjects with the highest cholesterol levels, the gastric cancer rate was the equivalent of 2.1 cases per 1000 persons per year; among those with the lowest cholesterol, the rate was 3.9 per 1000 persons per year.

Patients with low serum cholesterol should consider periodic gastrointestinal examination for the prevention of stomach cancer, said Dr Aggarwal.

Low cholesterol has been earlier linked to depression, anxiety and suicide in both men and women. Another earlier report has also shown that people with cholesterol level below 180 had twice the risk of brain hemorrhage as compared to those with cholesterol levels of 230.

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 84073 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."

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CPR 10 Training Camp at NDMC Premises

press release

Strain echo imaging for cancer chemotherapy toxicity

vedio of day

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

A 5–year–old boy passed 18 loose stools in last 24 hour and vomited twice in last 4 hour. He is irritable but drinking fluids. The optimal therapy for this child is:

1. Intravenous fluids.
2. Oral rehydration therapy.
3. Intravenous fluid initially for 4 hours followed by oral fluids.
4. Plain water ad libitum.

Yesterday’s Mind Teaser: A couple, with a family history of beta thalassemia major in a distant relative has come for counseling. The husband had HbA2 of 4.8% and the wife has HbA2 of 2.3%. The risk of having a child with beta thalassemia major is.

1. 50%
2. 25%
3. 5%
4. 0%

Answer for yesterday’s Mind Teaser: 4. 0%

Correct answers received from: Alekhya bandari, daivadheenam, Dr Avtar Krishan, Tukaram Pagad, Dr Chandresh Jardosh, Vasdev Bhagia

Answer for 13th January Mind Teaser: 3.Gelfiltration chromatography

Correct answers received from: Vasdev Bhagia, daivadheenam

Send your answer to ijcp12@gmail.com

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medicolegal update

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medical querymedical query

medicolegal update
medicolegal update

Requesting a three day pass

An Israeli soldier who just enlisted asked the Commanding Officer for a 3–day pass.

The CO says "Are you crazy? You just join the Israeli army, and you already want a 3–day pass? You must do something spectacular for that recognition!"

So the soldier comes back a day later in an Arab tank!

The CO was so impressed, he asked "How did you do it?"

"Well, I jumped in a tank, and went toward the border with the Arabs. I approached the border, and saw an Arab tank. I put my white flag up, the Arab tank put his white flag up. I said to the Arab soldier, "Do you want to get a three–day pass? So we exchanged tanks!"

medicolegal update

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medicolegal update

Situation: A patient on amlodipine developed severe gum hypertrophy.
Reaction: Oh my God! Why was amlodipine not stopped?
Lesson: Make sure that all patients on amlodipine are watched for gum hypertrophy. Gingival hyperplasia is a known side effect of amlodipine.

medicolegal update

Loneliness is the poverty of self; solitude is the richness of self. May Sarton

medicolegal update

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: No regrets and no anticipation, just this moment fresh and as is.

medicolegal update
  1. Dear Sir, Thanks for the nice information. Regards: Dr Karan

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