eMedinewS15th April 2014,Tuesday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, 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

Avoid Drunk or Drugged Driving

The dangers of drinking alcohol and driving are well known to all. But, it is also important to recognize that taking drugs and driving too can be as dangerous, Drugged driving or driving under the influence of any drug that acts on the brain can adversely affect your, vision, reaction time and judgment and driving skills. This not only endangers your life but also of your co–passengers as well as others on the road.

Tips for safe driving

  • All through the year, especially during the holiday season, take steps to make sure that you and everyone you celebrate with avoids driving under the influence of alcohol or other drugs.
  • Always designate a non–drinking driver before any holiday party or celebration begins.
  • Arrange for someone to pick you up
  • Do not let a friend drive if you think that they are impaired. Take the car keys.
  • Stay overnight at your friend’s place, if possible and drive back home in the morning.

News Around The Globe

  • Adding the endothelin receptor antagonist atrasentan to renin-angiotensin (RAS) blockade may reduce albuminuria without major side effects in patients with diabetic nephropathy, reports a recent study published online in the Journal of the American Society of Nephrology. The 0.75 mg and 1.25 mg doses significantly reduced residual albuminuria by 36% and 39%, respectively, compared with placebo. The higher dose, however, induced more fluid retention.
  • The diagnosis of eating disorders (EDs) is often missed in young men, since EDs are perceived to affect primarily teenage girls, reports a recent qualitative study in BMJ Open. The study authors noted that besides the young men and the families in this study, the primary care physicians who saw them also failed to recognize signs of EDs promptly because of this cultural gender bias.
  • An investigational inhibitor of cyclin–dependent kinases (CDK) 4 and 6 has shown early activity and potential as a monotherapy for patients with metastatic breast cancer in a recent phase I trial. The compound, known as LY2835219 (Eli Lilly), was particularly effective in hormone receptor (HR)–positive disease. The findings were presented at the American Association for Cancer Research (AACR) 2014 meeting. An investigational drug with the same CDK inhibitor action, palbociclib was also highlighted at this meeting, with promising data from a phase II trial. Researchers stated that the clinical benefit rate with LY2835219 was 61% in HR–positive patients.
  • Results from 3 trials presented at the European Association for the Study of the Liver (EASL) International Liver Congress 2014 have revealed that a single daily pill could be a potential cure for patients infected with hepatitis C genotype 1 in as early as 8 weeks. Gilead's fixed–dose combination of the directly acting antiviral drugs sofosbuvir and ledipasvir has shown these results in 3 large, phase 3 clinical trials. Sustained viral response at 12 weeks (SVR12) was attained in 94% of those who received 8 weeks of the combination alone, 93% for those who received 8 weeks of ledipasvir–sofosbuvir plus ribavirin, and 95% for those who continued ledipasvir–sofosbuvir up to 12 weeks, reported the ION–3 study (one of the 3 trials). The results were simultaneously published in the New England Journal of Medicine.
  • An interferon–free triple combination antiviral regimen has been found effective in treating hepatitis C genotype 1–infected patients in 2 new phase 3 trials (SAPPHIRE I and SAPPHIRE II). The combination of the protease inhibitor ABT–450 with ritonavir (ABT–450/r), the NS5A inhibitor ombitasvir, and the nonnucleoside polymerase inhibitor dasabuvir and ribavirin brought on 96% sustained viral response rates at 12 weeks among both previously treated and treatment–naive hepatitis C genotype 1–infected patients. The combination, termed the "3D" regimen, was quite well tolerated in both trials. The results have been published online in the New England Journal of Medicine.

Rabies News (Dr A K Gupta)

Can a rabies vaccine be given to a pregnant woman?

Following animal bite, rabies vaccine can be given to a pregnant woman. Medical termination of pregnancy should not be done as a routine clinical practice.

Cardiology eMedinewS

  • A new research has found that indicators of periodontal disease are common in patients with established coronary heart disease and are also associated with elevated cardiovascular risk. Researchers noted in the European Journal of Preventive Cardiology that gum bleeding was also associated with elevations in some cardiovascular risk factors, though the findings were less consistent. Interestingly, patients who retained more of their teeth had significantly lower levels of fasting glucose, LDL cholesterol, systolic blood pressure, waist circumference, white blood cell count, and high–sensitivity C–reactive protein, and better kidney function.
  • The European Medicines Agency (EMA) has recently issued a warning that no two drug classes that act separately on the renin–angiotensin system (RAS) should be used in combination, i.e., angiotensin–receptor blockers (ARBs), ACE inhibitors, and direct renin inhibitors should not be routinely used in combination.

Pediatrics eMedinewS

  • Sibling of a child with bicuspid aortic valve (BAV) has a one–in–ten chance of also having the anomaly, reports a recent study published online April 7 in Pediatrics. The study authors stated that BAV occurs in 1–2% of the general population and noted that 10.1% of the siblings of children with BAV also had BAV, for a mean cost of $2,109 per new case found.
  • A recent case–control study published in JAMA Psychiatry has revealed that proactive aggression in youth with callous–unemotional traits is associated with amygdala hypofunction in response to fearful facial expressions. The research stated that accounting for callous-unemotional traits helped distinguish among those kids whose conduct problems reflected increased amygdala responsiveness and those whose symptoms reflected reduced amygdala responsiveness.

Dr K K Spiritual Blog

The vast power of the Spirit

Om Poornamadah
Om Poornamadah Poornamidam
Poornaat Poornamudachyate
Poornasya Poornamaadaaya
Poornameva Avasihyate"


‘The whole is whole; if you take away the whole away from the whole the whole will still remain.’ (That is infinite, this is infinite, from the infinite, the infinite has come. Having taken the infinite out of the infinite, the infinite alone remains). (In Vedanta, "That" represents superconsciousness, God or the Brahman and "This" the visible universe)

Atman, which makes up our body, is 99.99 per cent space or void and if we look at the rest, it is also nothing but space or void. This void or ‘akasha’ is what is called Brahman, God or consciousness and is a web of energized information.

This web of information of inner space called inner consciousness is the Atman or the Soul. This is connected with the outer space in the universe having a similar web of energized information called the Spirit or Brahmand.

The Spirit has been given many names by different religions: Allah, Buddha, Brahman, Christ or Wahe Guru. They all signify the same. This spirit, the energized field of information, is a powerful expression of live energy which can move faster than the speed of light. Soul is nothing but an individualized expression of the spirit.

This energy containing information in the spirit cannot be seen, felt, touched, tasted or smelt. It is beyond the perception of the five senses. One cannot destroy it with a weapon, fire, water or air. This consciousness is embedded in the space of each and every cell of the body. It is like sugar added to the milk. Once added, you cannot find it as it gets embedded with each and every drop of the milk.

Soul originates from the spirit. Each soul differs from the other by way of the subtle layer of consciousness called the ‘Sukshma Sharir’, which is controlled by the triad of actions, memories and desires.

Spirit is like the light, which is always positive and removes darkness. The basic nature of consciousness is "truth and bliss". The soul and the spirit are devoid of hatred, anger or jealousy and are full of unconditional love. They are nothing but a treasury of information about everything. This infinite information is capable of doing anything, including miracles.

It is like the flame of a candle, which can light an infinite number of candles, while still retaining its illumination to the same degree.

Deepak Chopra once said that the soul is like the voice of Lata Mangeshkar coming through a radio, and if you break the radio, you will not find Lata Mangeshkar in it. Similarly, if you cut the body into pieces, you cannot find the physical presence of the spirit. Spirit is omnipresent and any amount of Spirit taken out from it will not make any difference to it.

In religious terms, the infinite or the vastness is equated and described by the blue color, and that is one reason why most gods are represented in blue color, or are shown in the background of blue sky. This only represents the vastness and infinite character of the consciousness.

A guru explained the Spirit to his disciples by the following equation: 1 × 1 = 1, 1/1=1 or, in other words everything is One. One can also explain it by the equation that infinity when added, subtracted, multiplied or divided by infinity will result only in infinity.

This infinite potential in our minds is present in between the thoughts and can be experienced by enabling oneself to go in between the thoughts by a process called meditation. One can experience the silent gap between the thoughts either with the use of primordial sound mantra as a vehicle or by way of yoga. People who have learnt meditation and have achieved the ability to go into the silent gaps can accomplish everything in their life using the principles of intention and attention. After any intention is introduced in the silent gap, a new reality can be created.

"That which is born of the flash is a flash; that which is born of the spirit is spirit" (John)

Wellness Blog

Elderly Beware of Commonly Prescribed Group of Drugs

Anticholinergics, a commonly prescribed group of drugs, may cause elderly people to "slow down" in their daily physical activities.

Two reports from Wake Forest University School of Medicine support findings that anticholinergic drugs – used to treat acid reflux, Parkinson’s disease and urinary incontinence –– may cause older people to lose their thinking skills more quickly than those who do not take the medicines.

Anti-cholinergic drugs work by stopping acetylcholine, a chemical that enhances communication between nerve cells in the brain, from binding to its receptors in nerve cells.

Older adults taking anticholinergics become more likely to walk more slowly and to need help in other daily activities. These results are true even in older adults who have normal memory and thinking abilities.

For older adults taking a moderately acting anticholinergic medication, or two or more mildly acting anticholinergic medications, their function is similar to that of someone 3 to 4 years older.

Common anticholinergic medicines include blood pressure medication, nifedipine; the stomach antacid, ranitidine, and the incontinence medication, tolterodine.

Cholinesterase inhibitors, a family of drugs used to treat dementia by increasing levels of acetylcholine include donepezil, galantamine, rivastigmine and tacrine. About 10 percent of patients may be taking tolterodine and dozepezil together. The two drugs are pharmacological opposites, which led to the hypothesis that the simultaneous treatment of dementia and incontinence could lead to reduced effectiveness of one or both drug.

Inspirational Story

Begin with a Blank Page

If you could start your life all over what would be different? What would you change now if you were able to wave a magic wand and start from scratch? Just imagine you have no ties, no burdens, no limits, no memories, and no past.

What would your life look like? If the answer that comes to your mind is different than what you are doing, why is that? Is it because of someone else's opinion? A spouse, a parent or maybe your children?

The ultimate test of your life is to close your eyes and think of yourself on your deathbed. Lying there, preparing yourself to leave, look back at your life as you are currently living it.

How do you feel? Are you satisfied you lived completely? Or do you wish you had done differently? Very few of our senior citizens look back on their life and say, "I sure wish I had spent more time at the office!" Nobody says, "I wish I had watched more TV!"

This is what they say. "I wish I had been bolder. I wish I had given more. I wish I had tried harder to see more, do more and feel more." People wish that they had lived more. I, for one, have to admit to a certain amount of holding back on dreams and goals because of our two boys. As my life progresses I realize there is no reason to hold back.

We have not been exactly standing still either. We have done our best to live our dreams. We built a sailboat and sailed for 7 years traveling on the open ocean. We lived in the snow in Aspen Colorado, and on the beach in South Carolina. An old brick mill was our home in Long Island, versus a boat dock in Palm Beach Florida. We are writers of books and music, actors in the theater, and we home– school the boys. We have built a horse farm, and businesses! Yet, there is so much more we want to do! It is a balancing act. We all must have sufficient finances to support a comfortable lifestyle, (although most of us tend to spend way too much on that!) Part of this balancing act is to understand what we are passionate about doing so that work becomes a joy instead of a job.

Is this not a major reason of lost dreams and goals? Many people find work, call it a job and make a living at it. But they begrudge every minute of it, going as far as using the job as a reason for playing the martyr. Find something else!

There are many, many teachers of the attraction philosophies of "making a life". With as many opportunities today in every field imaginable, somewhere, something is calling to you.

Another part of the balancing act is to include those around you in frank and open discussions in what it is you want. I find some of my coaching clients have kept their wants and needs bottled up inside them forever! They had already decided for the other person in their lives there was no interest in whatever it was they themselves wanted to do! How absurd! How can we possibly know what someone else wants!

Would it not be tragic to spend your life in a big city for 40 years, working at a job you despise because you thought your spouse liked it, even though you wanted to live in the country and be a farmer? Then one day you overhear your spouse tell her best friend all she ever wanted to do was live in the country? 40 years! Sure this is a bit far fetched – but you would be amazed at what I hear!

Make an attempt today to start with a brand new page of your life. Create your life story how you want it. If there are others in your life to be involved, have them do the same exercise. Then compare what your notes. If this matches your current life, congratulations! You are one of the few. Now make it better.

However, if your written life stories sound like someone completely different, then you are living a life of conflict. Here is the good news. Your life is your life. No one can take that away from you. You are not indentured. You are not a slave. You are free to go, do, and be whomever you wish.

It might not be easy, but it sure might be worth it. I coach people daily who are changing their lives. There are so many things to be grateful for, and so many things open to us. We owe it to all the ones before us who gave us this opportunity to take advantage of it.

ePress Release

Smoking women can increase the risk of colorectal cancer

Women who smoke are at twice the risk of developing cancer of the rectum and the risk goes up with the increase in number of cigarettes smoked per day, smoke duration and older age at smoking cessation, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

Quoting a study published in the Journal of National Cancer Institute, Dr. KK Aggarwal said that women should never smoke. Current smokers are 95% more likely to develop rectal cancer. Younger adults can develop colorectal cancer, but the chances increase markedly after age 50: More than 9 out of 10 people diagnosed with colorectal cancer are older than 50.

History of adenomatous polyps (adenomas), especially if they are large, increase the risk of cancer.

If you have had colorectal cancer, even though it has been completely removed, you are more likely to develop new cancers in other areas of the colon and rectum. The chances of this happening are greater if you had your first colorectal cancer when you were younger.

Though the no. 1 cancer in women in urban areas is breast cancer and in rural areas is cancer of the cervix, the cancer of the rectum is on the rise.

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 88972 people since 1stNovember 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 10x10 i.e. 100 per minute."

Zee News – Health Wealth Shows

Alcohol
Cancer Prevention
Depression
Paralysis
Pneumonia
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Vitiligo
Fluid Intake

 

Total CPR since 1st November 2012 – 88972 trained

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."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

emedipicstoday emedipics

A free health checkup camp was organized by Heart Care Foundation of India at Bal Bharti Public School

press release

AHA – ACS update

video of day video of day

 

IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :

 

Make Sure

Situation: A patient was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA?
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2 suggest that this intervention is much better than thrombolytic therapy in such patients.

eMedinewS Humor

Two cab drivers met. "Hey," asked one, "why did you paint one side of your cab red and the other side blue?"

"Well," the other responded, "when I get into an accident, you should see how all the witnesses contradict each other.

Quote of the Day

Only those who dare to fail greatly can ever achieve greatly. Robert F. Kennedy

 

Twitter of the Day

Dr KK Aggarwal: High BP in Pregnancy Increases Risk for Future Atherosclerosis http://youtu.be/NMIK16PyBrY?a via @YouTube
Dr Deepak Chopra: No matter what happened in the past, we all have the right and the capacity to be happy and lovedhttp://bit.ly/DC_Ananda #ananda

 

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 – reg mno, rawat.vandana89@gmail.com
SMS – BK Sapna reg mno1, bksapna@hotmail.com

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

 

Our Contributors

Dr Veena Aggarwal, Dr Chanchal Pal, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Monica Vasudev, Dr Navin Dang, Dr Pawan Gupta, Dr Parveen Bhatia, Dr Prachi Garg, Rajat Bhatnagar, Dr Sudhir Gupta, Prof.(Dr).C V Raghuveer

eMedi Quiz

Acantholysis is characteristic of:

1. Pemphigus vulgaris.
2. Pemphigoid.
3. Erythema multiforme.
4. Dermatitis hepetiformis.

Yesterday’s Mind Teaser: The Protein Efficiency Ratio (PER) is defined as:

1. The gain in weight of young animals per unit weight of protein-consumed.
2. The product of digestibility coefficient and biological value.
3. The percentage of protein absorbed into the blood.
4. The percentage of nitrogen absorbed from the protein absorbed from the diet.

Answer for yesterday’s Mind Teaser: 1. The gain in weight of young animals per unit weight of protein–consumed.

Correct answers received from: Dr Ajay Gandhi, Dr Bitaan Sen &
Dr Jayashree Sen, Dr P C Das, Daivadheenam Jella, Dr Jainendra Upadhyay,
Dr K VSarma, Prabha Luhadia, Dr Avtar Krishan, Niraj K. Gupta.

Answer for 12th April Mind Teaser: 1. The source of infection is mainly clinical cases.

Correct answers received from: Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

medicolegal update

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medical querymedical query

medicolegal update

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medicolegal updatemedicolegal update

medicolegal update
  1. Dear Sir, Thanks for the update. Regards: Dr Kartik
cardiology news

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eMedinewS Special

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