eMedinewS15th March 2014, Saturday

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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  • A new FDA statement regarding use of combination drugs containing paracetamol targets use of prescription analgesics that contain both paracetamol and another ingredient, typically opioids.
  • In January 2011, the FDA asked that by January 14, 2014, manufacturers of prescription combination drugs containing paracetamol would limit the amount of paracetamol to not more than 325 mg in each tablet or capsule.
  • According to the FDA, cases of severe hepatic injury with paracetamol occurred in patients who exceeded the prescribed dose of an paracetamol-containing product in a 24–hour period; took 2 or more paracetamol–containing products concurrently; or combined alcohol with paracetamol products.
  • Because of the risk for liver damage, the FDA is now asking clinicians not to prescribe combination prescription pain relievers containing more than 325 mg of paracetamol per tablet, capsule, or other dosage unit, and to consider the amounts of both the paracetamol and opioid components. The agency intends to begin proceedings soon to withdraw approval of prescription combination drug products containing more than 325 mg of paracetamol per dosage unit that are still available on the market.

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Zee News – Health Wealth Show

Dr kk Aggarwal on Zee Show

Safe Drugs-Health Wealth Zee News Show
Cancer Prevention–Health Wealth Zee News Show2
Potbelly Obesity–Health Wealth Zee News Show
Cancer Prevention–Health Wealth Zee News Show1
Vitamin D Health Wealth
Pneumonia–Health Wealth Zee News Show
Sudden Cardiac Death
Depression
Can Alcohol be Prescribed as Medicine
Health Wealth: All about Paralysis

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

Wahans (Vehicles) In Mythology

sprritual blog

In mythological era, the negative tendency of a man is symbolized with the animal nature. Gods in Indian mythology are symbolized by living a positive behavior. Every God has been given a vehicle or Wahan. Both God and the Wahan symbolized how to live a positive life and how to control the animal tendencies.

Following are a few examples:

1. Lord Ganesha rides a Mouse. Mouse in mythology is symbolized with greed and Ganesha with one who removes obstacles. The spiritual meaning behind both is – one should learn to control greed to tackle obstacles in life.

2. Lord Shiva riding Nandi (Bull is symbolized with uncontrolled sexual desires) and the duo signifies that for learning meditation, one needs to control sexual desires first.

3. Saraswati (the goddesses of knowledge) sitting on Swan symbolizes that to acquire knowledge one must learn to control the power of discrimination or Vivek. Swan can drink milk and leave water from a mixture of milk and water.

4. Indra (the one who has a complete control over the intellect) riding on the elephant Airavat symbolizes that intellect (Indra) for its development requires control over Masti and madness (elephant).

5. Durga (the perfect woman) riding a lion symbolizes that to become a perfect woman, one must learn to control her agitation or aggression (lion).

6. Lakshmi (wealth) riding an owl symbolizes that to earn righteously, one must learn to control Owl like properties within us, which is not to get befooled.

7. Lord Vishnu (the doer) riding eagle or Garuda (Eagles are opportunistic predators which means they eat almost anything they can find) means controlling your desires to eat the unbalanced food.

8. Krishna riding five horses means one need to control our five senses.

9. Kartikey rising on Peacock symbolizes that should learn to control one’s pride (vanity) or ego.

10. The vehicle of Goddess Kali is a black goat. Agni rides Mesha – a ram. Kubera, the god of wealth, also has a ram as his vehicle. A ram is an uncastrated adult male sheep. Goat also signifies uncontrolled sexual desires but lesser than the bull.

11. Yamraj rides a buffalo, which is known for its rampant destruction. Lord Yama or Yamraja is referred to as the God of death, twin brother, lord of justice, Dharma Raja. One can do justice only if one has a control over anger and aggressive behavior.

In mythology, apart from Wahans, animals are also shown to be sacrificed, which means to kill that animal tendency within ourselves. For example, during exams, you need to kill your goat behavior, which is known to possess excessive sexual desires. You may need to control them throughout the year but during exams you need to kill them. In Kali Pooja, a buffalo is sacrificed, which again means that in extreme situations, you may need to kill your ego or anger.

cardiology news

All Good Things

He was in the first third grade class I taught at Saint Mary’s School in Morris, Minn. All 34 of my students were dear to me, but Mark Eklund was one in a million. Very neat in appearance, but had that happy–to–be–alive attitude that made even his occasional mischievousness delightful.

Mark talked incessantly. I had to remind him again and again that talking without permission was not acceptable. What impressed me so much, though, was his sincere response every time I had to correct him for misbehaving. "Thank you for correcting me, Sister!" I didn’t know what to make of it at first, but before long I became accustomed to hearing it many times a day.

One morning my patience was growing thin when Mark talked once too often, and then I made a novice–teacher’s mistake. I looked at Mark and said, "If you say one more word, I am going to tape your mouth shut!" It wasn’t ten seconds later when Chuck blurted out; "Mark is talking again." I hadn’t asked any of the students to help me watch Mark, but since I had stated the punishment in front of the class, I had to act on it.

I remember the scene as if it had occurred this morning. I walked to my desk, very deliberately opened my drawer and took out a roll of masking tape. Without saying a word, I proceeded to Mark’s desk, tore off two pieces of tape and made a big X with them over his mouth. I then returned to the front of the room. As I glanced at Mark to see how he was doing, he winked at me. That did it!! I started laughing.

The class cheered as I walked back to Mark’s desk, removed the tape, and shrugged my shoulders. His first words were, "Thank you for correcting me, Sister." At the end of the year, I was asked to teach junior–high math.

The years flew by, and before I knew it Mark was in my classroom again. He was more handsome than ever and just as polite. Since he had to listen carefully to my instruction in the "new math," he did not talk as much in ninth grade as he had in third. One Friday, things just didn't feel right. We had worked hard on a new concept all week and I sensed that the students were frowning, frustrated with themselves – and edgy with one another.

I had to stop this crankiness before it got out of hand. So I asked them to list the names of the other students in the room on two sheets of paper, leaving a space between each name. Then I told them to think of the nicest thing they could say about each of their classmates and write it down. It took the remainder of the class period to finish their assignment, and as the students left the room, each one handed me the papers. Charlie smiled. Mark said, "Thank you for teaching me, Sister. Have a good weekend." That Saturday, I wrote down the name of each student on a separate sheet of paper, and I listed what everyone else had said about that individual.

On Monday I gave each student his or her list. Before long, the entire class was smiling. "Really?" I heard whispered. "I never knew that meant anything to anyone!" "I didn’t know others liked me so much."

No one ever mentioned those papers in class again. I never knew if they discussed them after class or with their parents, but it didn’t matter. The exercise had accomplished its purpose. The students were happy with themselves and one another again.

That group of students moved on. Several years later, after I returned vacation, my parents met me at the airport. As we were driving home, mother asked me the usual questions about the trip – the weather, my experiences in general. There was a lull in the conversation. Mother gave Dad a side–ways glance and simply says, "Dad?" My father cleared his throat as he usually did before something important.

"The Eklunds called last night," he began. "Really?" I said. "I haven’t heard from them in years. I wonder how Mark is." Dad responded quietly. "Mark was killed in Vietnam," he said. "The funeral is tomorrow, and his parents would like it if you could attend."

To this day I can still point to the exact spot on I–494 where Dad told me about Mark. I had never seen a serviceman in a military coffin before. Mark looked so handsome, so mature. All I could think at that moment was, Mark I would give all the masking tape in the world if only you would talk to me.

The church was packed with Mark’s friends. Chuck’s sister sang "The Battle Hymn of the Republic." Why did it have to rain on the day of the funeral? It was difficult enough at the graveside.

The pastor said the usual prayers, and the bugler played taps. One by one those who loved Mark took a last walk by the coffin and sprinkled it with holy water. I was the last one to bless the coffin. As I stood there, one of the soldiers who acted as pallbearer came up to me. "Were you Mark’s math teacher?" he asked. I nodded as I continued to stare at the coffin. "Mark talked about you a lot," he said.

After the funeral, most of Mark’s former classmates headed to Chuck’s farmhouse for lunch. Mark’s mother and father were there, obviously waiting for me. "We want to show you something,’ his father said, taking a wallet out of his pocket. "They found this on Mark when he was killed. We thought you might recognize it."

Opening the billfold, he carefully removed two worn pieces of notebook paper that had obviously been taped, folded and refolded many times. I knew without looking that the papers were the ones on which I had listed all the good things each of Mark’s classmates had said about him. "Thank you so much for doing that," Mark’s mother said. "As you can see, Mark treasured it."

Mark’s classmates started to gather around us. Charlie smiled rather sheepishly and said, "I still have my list. It’s in the top drawer of my desk at home." Chuck’s wife said, "Chuck asked me to put his in our wedding album." "I have mine too," Marilyn said. "It’s in my diary."

Then Vicki, another classmate, reached into her pocketbook, took out her wallet and showed her worn and frazzled list to the group. "I carry this with me at all times," Vicki said without batting an eyelash. "I think we all saved our lists."

That’s when I finally sat down and cried. I cried for Mark and for all his friends who would never see him again.

News Around The Globe

  • The US Food and Drug Administration (FDA) has recently approved an extended–release combination of oxycodone and acetaminophen, previously known as MNK–795. The combination, first of its kind, has been approved for the management of acute pain severe enough to require opioid treatment. The combination is also indicated in patients for whom alternative treatment options are either ineffective, or are inadequate and not tolerated well. The FDA based its approval on the results of a phase III trial in an acute post–surgical pain model of bunionectomy.
  • An article published online in the journal Ophthalmology states that three significant modifiable lifestyle behaviors may be associated with loss of vision over a period of 20 years. These include smoking, drinking alcohol and physical activity, with smoking having the most significant impact on vision.
  • Low–dose doxycycline has the potential to slow down the progression of diabetic retinopathy, reports a small proof-of concept, 24–month randomized, double–masked study published online in JAMA Ophthalmology. Large–scale investigations are required to confirm the findings of the study before the drug can finally be used in clinical practice.
  • It has been noted in a recent study that history of penicillin allergy, often reported inaccurately, is associated with longer hospital stay, accentuated antibiotic use and increased prevalence of Clostridium difficile, methicillin–resistant Staphylococcus aureus (MRSA), and vancomycin–resistant Enterococcus (VRE) infections. The results of this retrospective, matched cohort study were published in the March issue of the Journal of Allergy and Clinical Immunology. Patients with penicillin allergy had an average of 0.59 more total hospital days during follow–up, received significantly more fluoroquinolones, clindamycin, and vancomycin and had 23.4% more C. difficile, 14.1% more MRSA and 30.1% more VRE infections, in comparison to controls.
  • Glucosamine drink has no particular benefit for patients suffering from knee osteoarthritis. A recent randomized, placebo–controlled trial in Arthritis & Rheumatism reported that patients with mild to moderate knee osteoarthritis who consumed 1500 mg glucosamine hydrochloride dissolved in lemonade everyday for 6 months had similar degrees of pain and knee cartilage deterioration as patients who drank only lemonade.

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

eMedinewS e–gifts to our readers

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Rabies News (Dr. A K Gupta)

A patient received two doses of modern vaccine (on days 0 and 3) and the dog was well on days 5 and 7 (third injection due, but not given). However, the dog dies on any day between 8 and 15. What should be done?

In case, day 0 and 3 injections were given and the dose due on day 7 was postponed because the dog was kept under observation but the dog dies between 8 and 15 days, three doses of vaccine must be given as close to the original dates of the schedule and all five injections must be completed by day 28.

cardiology news

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

  • A recent evaluation by Kyle Van Arendonk of Johns Hopkins University School of Medicine, Baltimore and his colleagues has reported that kidney transplant outcomes have drastically improved in children over the past 25 years. Most of the improvements were limited to the first year following transplant and appeared to be independent of recipient or donor characteristics. Analyzing data from the Scientific Registry of Transplant Recipients, researchers noted that 10–year patient survival rates were 90.5% post–2001, compared to 77.6% in 1987, while 10–year graft survival rates were 60.2% post–2001 that were 46.8% in 1987.
  • A Spanish study has reported that the longer the kids watch TV, the lesser sleep they get. The study published in JAMA Pediatrics stated that a nine–year–old who watched five hours of television a day, slept on an average one hour less a night as compared to a nine–year–old who watched television for less than an hour and a half a day. A total of 1700 children were followed for up to three years to get to the results.
cardiology news

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

  • Preliminary reports from surgeons from France on a new, fully endoscopic, surgical aortic–valve replacement technique highlight that the novel method first removes the calcified native valve, which is not the case with transcatheter aortic–valve replacement (TAVR). The technique is named totally endoscopic aortic–valve replacement (TEAVR) and the results of the first two cases successfully managed with the novel technique appear in the March 2014 issue of the Journal of Thoracic and Cardiovascular Surgery.
  • Patients with hypertension and simultaneous depression are less likely to get intensive medical care like coronary revascularization, reports a study. Of the 158 hypertensives enrolled in the study, about 45% had a diagnosis of depression. The failure to augment antihypertensive treatment or to refer to a hypertension specialist was more commonly noted in case of depressed than nondepressed patients. The study was published March 10 in JAMA Internal Medicine.
cardiology news

Treatment of mild hypertension in low–risk patients

There is no convincing data to show the benefit from antihypertensive therapy in patients with mild hypertension and no preexisting cardiovascular disease. A meta–analysis combined four placebo-controlled trials totaling 8912 patients with mild hypertension and no preexisting cardiovascular disease (1). During 4 to 5 years of follow–up, antihypertensive therapy resulted in lower rates of mortality and stroke but higher rates of myocardial infarction. Low–risk patients with mild hypertension and no preexisting cardiovascular disease who fail to reduce their blood pressure with lifestyle modification should receive antihypertensive therapy.

Treatment of hypertension in frail older adults

Older adults who are frail may not benefit from antihypertensive therapy. In an observational study of 2340 adults older than 65 years, the association between blood pressure and mortality was examined according to whether or not individuals were frail (2). Frail is defined as an inability to walk 6 meters in less than 8 seconds. Among frail adults, there was no association between blood pressure and mortality. In addition, a higher blood pressure was associated with a lower risk of death among the most frail (i.e., those who could not walk the distance at all).

References

  1. Diao D, Wright JM, Cundiff DK, Gueyffier F. Pharmacotherapy for mild hypertension. Cochrane Database Syst Rev 2012;8:CD006742.
  2. Odden MC, Peralta CA, Haan MN, Covinsky KE. Rethinking the association of high blood pressure with mortality in elderly adults: the impact of frailty. Arch Intern Med 2012;172:1162.
cardiology news

Total CPR since 1st November 2012 – 88792 trained

Media advocacy through Web Media

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press release

Blue and Green Holi Colours may be Dangerous

Use only natural herbal colors this Holi as otherwise there can be serious health hazards, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association. Other way is to apply chandan ka tika. The deeper meaning behind the festival is to remove internal dirt from the body by spreading love and affection.

Chemical colours, bhang and indiscriminate use of alcohol, can all lead to health hazards.

An earlier report from AIIMS has shown that green/bluish–green colours are associated with higher incidence of ocular toxicity.

In fact most "pleasing to eye" colours available in the market are toxic and could cause serious disorders.

Malachite green is extensively used in Holi and can cause severe eye irritation with epithelial defect upon exposure, though it usually does not penetrate through the cornea.

Presence of cheap inorganic chemicals like mica, acids, alkalis, pieces of glass, not only induce skin disorders like abrasion, irritation or itching but can also impair vision, cause respiratory problems and also cancer. Th

e alkaline base of these colours can cause injuries, the severity of which depends upon the area of contact and the degree of penetration.

Broadly, there are three categories of colours available in the market: Pastes, dry powders and water colours. The hazards increase when these are mixed with oil and applied to the skin.

Most inorganic dry colours or gulals have two components — a colorant which may be toxic and a base, which could be asbestos or silica, both of which are capable of causing health hazards. While silica dries as well as chaps the skin, asbestos that is a known human carcinogen, can result in cancer.

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 88792 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 Press Club-8th March 2014

press release

FDA OKs first drug–eluting stents for use in MI

vedio of day

today video of the dayPadma Shri & Dr B C Roy National Awardee,Dr KK Aggarwal on Tackling tension headaches

Hands only CPR 10 Utsav, 15th December 2013

Dr KK Aggarwal receives Harpal S Buttar Oration Award from Nobel Laureate Dr Ferid Murad

eMedi Quiz

An enzyme involved in the catabolism of fructose to pyruvate in the liver is:

1.Glyceraldehyde–3–phosphate dehydrogenase.
2.Phosphoglucomutase.
3.Lactate–dehydrogenase.
4.Glucokinase.

Yesterday’s Mind Teaser: The following separation technique depends on the molecular size of the protein:

1.Chromatography on a carboxymethyl (CM) cellulose column.
2.Iso–electric focusing.
3.Gelfiltration chromatography.
4.Chromatography on a diethylaminoethly (DEAE) cellulose column.

Answer for yesterday’s Mind Teaser: 3.Gelfiltration chromatography.

Correct answers received from: Lalita Chugh,Dr.K.V.Sarma,DR.A.K.Gajjar, Daivadheenam Jella, Raju Kuppusamy, DR Avtar Krishan, Dr Poonam Chablani, Tukaram Pagad,Dr.P.C. Das,Dr Prakash Khalap,Dr R.Sahoo

Answer for 13th March Mind Teaser: 2. HbsAg and HBeAg positive

Correct answers received from: Dr.P.C. Das,Dr Prakash Khalap

Send your answer to ijcp12@gmail.com

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medicolegal update

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medical querymedical query

medicolegal update
medicolegal update

Computer Gender

Why computers should be considered masculine

  1. In order to get their attention, you have to turn them on.
  2. They have a lot of data but are still clueless.
  3. They are supposed to help you solve your problems, but half the time they ARE the problem.
  4. As soon as you commit to one, you realize that, if you had waited a little longer, you could have had a better model.

Why computers should be considered feminine

  1. No one but their creator understands their internal logic.
  2. The native language they use to communicate with other computers is incomprehensible to everyone else.
  3. Even your smallest mistakes are stored in long–term memory for later retrieval.
  4. As soon as you make a commitment to one, you find yourself spending half your paycheck on accessories for it.
medicolegal update

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medicolegal updatemedicolegal update

medicolegal update

Situation: A female patient complained of lower abdominal pain, fever and had uterine tenderness on bimanual palpation.
Reaction: Oh my God! You should do cervical swabs and consider starting antibiotics.
Lesson: Make sure to remember that women with such symptoms may have endometritis, which requires prompt diagnosis. It may respond to doxycycline and metronidazole.

medicolegal update

This is my simple religion. There is no need for temples; no need for complicated philosophy. Our own brain, our own heart is our temple; the philosophy is kindness. Dalai Lama

medicolegal update

Dr KK Aggarwal: Stress may increase smoking habits http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Science is a creation of the mind in order to understand reality. The mind itself is an expression of consciousnesshttp://bit.ly/15QdVeB #Health

medicolegal update
  1. Dear Sir, Thanks for the updation. Regards: Dr Tarun

Forthcoming events

Date: Saturday 2PM–Sunday 3PM, 26–27 April 2014
Venue: Om Shanti Retreat Centre, Bhora Kalan, Pataudi Road, Manesar
Course Directors: Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal and BK Sapna
Organisers: Heart Care Foundation of India. Prajapati Brahma Kumari Ishwariye Vidyalaya and eMedinews
Facilities: Lodging and boarding provided (one room per family or one room for two persons). Limited rooms for first three hundred registrants.
Course: Meditation, Lectures, Practical workshops
Atmosphere: Silence, Nature, Pyramid Meditation, Night Walk
Registration: SMS– Vandana Rawat – 9958771177, rawat.vandana89@gmail.com
SMS – BK Sapna 9650692204, bksapna@hotmail.com

Note: Donation in Favor of Om Shanti Retreat Centre will be welcomed

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Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Prof.(Dr).C V Raghuveer

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