eMedinewS15th July 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

Researchers find reason why many vein grafts fail

NIH intramural–led study uncovers biology behind improper graft remodeling

National Institutes of Health researchers have identified a biological pathway that contributes to the high rate of vein graft failure following bypass surgery. Using mouse models of bypass surgery, they showed that excess signaling via the Transforming Growth Factor Beta (TGF–Beta) family causes the inner walls of the vein to become too thick, slowing down or sometimes even blocking the blood flow that the graft was intended to restore. Inhibition of the TGF–B signaling pathway reduced overgrowth in the grafted veins.

The team, led by Manfred Boehm, M.D., chief of the Laboratory of Cardiovascular Regenerative Medicine at NIH’s National Heart, Lung, and Blood Institute, identified similar properties in samples of clogged human vein grafts, suggesting that select drugs might be used in reducing vein graft failure in humans.

Endothelial cells not only form the inner lining of a blood vessel, but also contribute to blood vessel narrowing as shown in this mouse vein graft model. Endothelial cells lose their typical morphology and become more like smooth muscle cells. This change in cellular properties indicates that endothelial-to-mesenchymal transition (EndMT) is operative in vein graft stenosis.

News Around The Globe

  • New research published online July 13 in Nature Medicine has shown that new microchip technology could be effective in diagnosing type 1 diabetes at the point of care with just a finger–prick sample of blood, thus extending a potentially valuable improvement over time-consuming conventional testing.
  • A study published online July 10 in JAMA Facial Plastic Surgery has revealed that perioperative use of the anti–inflammatory drug celecoxib could potentially reduce pain after face–lifts and reduce the use of opioids that are associated with significant adverse effects.
  • Bedaquiline is the first new drug to have been approved for the treatment of tuberculosis (TB) by the Food and Drug Administration in 40 years. The drug is particularly effective against multi–drug resistant tuberculosis (MDR-TB), reducing the average time to a negative TB culture by a third and increasing the overall proportion of negative TB culture participants after 6 months from 58% to 79%. However, further research needs to proceed cautiously due to potentially serious adverse effects.
  • Using an innovative tool, scientists at Rockefeller University have identified a protein that makes breast cancer cells more likely to metastasize. The protein appears to trigger cancer’s spread in part by blocking two other proteins that are normally linked to neurodegeneration. The study is published in the journal Nature.
  • Depressive symptoms in particular, along with chronic stress, increase the risk of stroke or transient ischemic attack in older people. Researchers also found feelings of hostility, but not anger, to be a risk factor for cerebrovascular disease. The findings are published in the American Heart Association’s journal Stroke.

Rabies News (Dr A K Gupta)

Can RIG be given locally to a healed wound?

Yes. If anti–rabies vaccination has not been started, then RIG can be given locally without disturbing the scab.

Cardiology eMedinewS

  • Quadrivalent human papillomavirus (HPV) vaccination may not be associated with a greater risk of venous thromboembolism (VTE), reported a study conducted in Danish females. In a self–controlled case series, the rate of VTE was 0.126 per person–year in the 42 days after receipt of a vaccine dose compared with 0.159 per person–year during control periods. The findings are published in the Journal of the American Medical Association.
  • Researchers at the University of Pennsylvania, Boston University and Harvard University have uncovered the existence of a threshold above which fluid flowing through blood vessel walls causes new capillaries to sprout. This discovery could assist in the development of cancer–fighting drugs, treatments for the hardened blood vessels found in the cardiovascular disease arthrosclerosis or growing synthetic organs in the lab. The study was published in the Proceedings of the National Academy of Sciences.

Pediatrics eMedinewS

  • Researchers studying critically ill children with traumatic injuries have identified an immune marker that can possibly predict which patients will likely develop a hospital–acquired infection. The study is published online in the journal Shock. Researchers noted that children who went on to develop an infection exhibited a much more severe and persistent drop in immune function following injury.
  • A new research presented at the American Academy of Neurology’s Sports Concussion Conference suggests that, following a concussion, some teenagers are more susceptible to emotional symptoms than others. Teenagers who are sensitive to light or noise after a concussion appear more likely to also experience emotional symptoms, such as anxiety.

Dr K K Spiritual Blog

Can A Mantra Or Sound Be Used As A Medicine?

The answer is yes. The difference between a Mantra and a sound is that Mantra sound is an energized sound with medicinal values. There are many aspects of Mantra as a sound:

  1. The type of sound matters. It is a well known that chanting of vowel sounds produces interleukin 2 in the body which has the same action as that of aspirin and works like a natural pain killer. Chanting of nasal consonants produces delta activity in the EEG and has similar action like tranquilizers. Chanting of other consonants has different actions in the body for example chanting of LUM reduces fear, VUM reduces attachments, RUM reduces doubt, YUM increases love, HUM increases truthfulness and AUM non–judgmental activities.
  2. Mantra sounds can be vibratory or non–vibratory. Vibratory sounds use nasal consonants and vibrate bones starting from mandible, spine, and the automatic plexus lying along the spine. Chanting of nasal consonants leads to parasympathetic state.
  3. Any Mantra chanting associated with reduced respiratory rate leads to parasympathetic state of the body. Ideal is to reduce the respiratory rate to 4 per minute and then continue it for next 20 minutes that means 80 breathes in 20 minutes. This can be done by chanting for exam–le the whole Gayatri mantra in on respiratory cycle.
  4. How does one chant also matters? The yogic way of chanting is when the mind is in mantra or the chanting. This leads to deeper relaxation.
  5. Whether you chant with the understanding the meaning of the Mantra or not also matters? If you do that the chanting benefits will be more. Foreigners do not understand the meaning of Indian Mantras but yet they get benefits. But if they chant with understanding the meaning of the Mantra, the health benefits will be more.
  6. Chanting a mantra with its meaning in the mind invokes the power of intention. It’s like getting connected to any search engine on the internet and typing your query. Your consciousness in our body is the internet and the intention the search button.
  7. Chanting a mantra with its meaning in the mind also results in emotions and expressions which have an added advantage.
  8. Overtone chanting has additional benefits. The new sound heals not only those who are chanting but also those who are listening and bystanders.
  9. Group chanting is more powerful. If 1% population chants together, rest 99% also gets the benefits.
  10. One can also do distance healing by chanting at a far distance. The only way one can explain this is by understanding consciousness as an internet cum social site model. In this understanding each one of us has our page in the internet (soul) as well as a page in the cloud internet (spirit). All our pages are connected with every person in this earth through the cloud internet. People can chant at a distance and their audio file with intent automatically gets posted on their soul internet and the cloud internet. The person for whom we are prayer chanting gets the benefit whenever he is connected to the cloud internet.
  11. During chanting the mind diverts. Continuously chanting of Mantra for 12 seconds means concentration, 12×12 seconds is contemplation and 144×144 seconds is meditation. So by concentrating on the object of concentration, the mantra, one can avoid diversion of the mind.
  12. The intensity or the loudness of the chanting sound also matter Higher the loudness less will be the effects. Japa meditation involves two hours of Mantra chanting to get the benefit. In a non Japa meditation, these benefits can be acquired in 20 minutes. Thoughtless chanting is more powerful than verbal Mantra chanting. Vipasana is chanting without Mantra where you are just aware of the breath and one has to do this type of meditation for hours together to get the benefit.
  13. In Chautha or Teravi (mourning period), we have one hour of sangeet, or chanting of Mantra or prayers. This helps relax the mind, shifts one from sympathetic to parasympathetic mode. In the initial 15 minutes, there is sympathetic over activity and the person is restless. As the time passes, parasympathetic state takes over and by the time one hour is over, parasympathetic state is at its full blown activity and at that time getting connected to cloud internet is easier.

    Full attending for one hour of Chautha ceremony is only for those who are connected to the dead person and want to get distressed. These people have empathy for the diseased person. Those who have sympathy mostly show up before or after the Chautha ceremony to complete their formality.

    In Chautha, we say that Bhagwan Uski Aatma Ko Shanti De. God will forgive him only if the soul is under distress which can only happen if there are some non–fulfilled desires and these desires will always


    be linked to a particular person. Therefore, only those who have guilt will feel that the diseased person’s soul is not at rest.

    In a Chautha ceremony one can only remove this guilt in the parasympathetic phase towards the end of the Chautha ritual and seeks forgive and forgiveness.
  14. In different religions, this has different implications. In Hinduism, we only attend Chautha of whom we know but in Islam people attend the mourning ceremony of people whom they not even know. They believe in mass prayers and pray for the soul of the diseased person. In Islam this mass prayer message gets written on the cloud internet and has mass effect in the community.

    In Islam, a person usually says Mein khuda se tumhare liye dua mangunga. It is possible for them as they do Namaz prayer five times in a day and when they ask for Dua for someone they put the intent in the cloud internet which can be retrieved by others.

    In Christians, it is different. The dying patients or the relations ask the doctors and others to pray with them and not only for them.

Wellness Blog

Fever

Fever does not mean presence of infection. There are many situations where there may be fever without infection and hence needs no antibiotics.

  • Sepsis is a clinical syndrome, which results from the dysregulation of inflammatory response to an infection. The temperature is between 36°C to 38.30°C. Heart rate is often more than 90 per minute.
  • Symptomatic inflammatory response syndrome means a clinical syndrome, which results from dysregulated inflammatory response to any infections such as inflammation of the pancreas, inflammation of the vessels, clot formations in the veins.
  • Many antibiotics can cause fever; unless they are discontinued, fever will not subside.
  • Hyperthermia is a condition with elevated body temperature but it is not called fever. Examples are exposure to heat or heat stroke and in response to anesthetic drugs and anti–psychotic drugs.
  • Hyperthermia may not respond to anti–fever drugs.
  • When fever is more than 41.5°C, it is acute hyperpyrexia.
  • Hyperpyrexia is usually seen in patients with severe infections but it may also occur in brain hemorrhage. It responds to anti–fever drugs.
  • High temperature without infection is found in condition of hyperfunctioning of the thyroid gland.
  • Recreational drugs such as Ecstasy can also cause fever without any infection.
  • Mild fever can also occur after exertion.

Inspirational Story

Doctor’s service!

A doctor quickly entered the hospital after being called in for an urgent surgery. He changed his clothes and went directly to the surgery block. He saw the boy’s father walking back and forth in the hall waiting for the doctor.

Once seeing the doctor, the dad yelled: "Why did you take all this time to come? Don’t you know that my son’s life is in danger? Don’t you have the sense of responsibility?" The doctor smiled and said: "I am sorry, I wasn’t in the hospital and I came the fastest I could… now, I wish you’d calm down so that I can do my work." "Calm down?! What if your son was in this room right now, would you calm down? If your own son dies now what will you do?" said the father angrily.

The doctor smiled again and replied: "I will say what is said in the Holy Bible ‘From dust we came and to dust we return, blessed be the name of God.’ Doctors cannot prolong lives. Go and intercede for your son, we will do our best by God’s grace."

"Giving advice when we’re not concerned is so easy" murmured the father. The surgery took some hours after which the doctor went out happy, "Thank God! Your son is saved!" And without waiting for the father’s reply he carried on his way running. "If you have any question, ask the nurse."

"Why is he so arrogant? He couldn’t wait some minutes so that I ask about my son’s state?" commented the father when seeing the nurse minutes after the doctor left. The nurse answered: "His son died yesterday in a road accident, he was in the burial when we called him for your son’s surgery."

Self-Assessment-Quiz

 

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 – 94595 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

Health Check Up and CPR 10 Camp at NP Primary School, Kamraj Marg–11th July 2014

press release

Rapid flu test more accurate when positive

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: Doctor, this patient has developed acute renal failure.
Reaction: Oh my God, I forgot that he was on furosemide. I gave him a 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.

eMedinewS Humor

Under the wagon

A farm boy accidentally overturned his wagonload of wheat on the road. The farmer that lived nearby came to investigate.

"Hey, Willis," he called out, "forget your troubles for a while and come and have dinner with us. Then I’ll help you overturn the wagon."

"That’s very nice of you," Willis answered, "but I don’t think Dad would like me to."

"Aw, come on, son!" the farmer insisted.

"Well, OK," the boy finally agreed, "but Dad won’t like it."

After a hearty dinner, Willis thanked the host. "I feel a lot better now, but I know Dad's going to be real upset."

"Don’t be silly!" said the neighbor. "By the way, where is he?"

"Under the wagon," replied Willis.

Quote of the Day

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

Twitter of the Day

Dr KK Aggarwal: Weight gain precedes the onset of diabetes Weight gain after age of 18 years in women and 20 years in men (cont) http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Who is the most powerful person in your life? What are the characteristics of a powerful person? #CosmicConsciousness

 

ePress Release

Do not use 2 pin electrical appliances: they can be dangerous

With the onset of monsoon and the continuing use of electrical equipments deaths due to electrocution are quite common. 3–5 persons die due to electric shock everyday in any major city during the monsoon months. Most deaths due to electric shock could be attributed to lack of awareness regarding the basic principles of electrical systems and callousness while handling electrical equipment, 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.

The public not only needs to be aware of the safety principles but also the inherent dangers of handling electrical equipment, along with preventive measures to reduce mishaps and methods to revive a person who has suffered an electric shock. Like fire, electricity is a good servant but a bad master. If used properly it is a boon in every day’s life and if manhandled can cause death.

The most important education required is regarding the proper use of earthing. Earthing can be procured either from the city source or made indigenously at home by digging a big hole. Earthing is a thick wire attached to the top hole of a 3–pin electrical socket. Earthing leads are, by international convention, kept green so that there should be no difficulty in identifying it and pointing it out.

People need to be familiarized with the colours used on the insulation; green is for earthing, black for neutral and red for live wire. Normal electricity is generated when the live wire is connected to the neutral wire. Earth wire is a safety mechanism to remove leakage of the electrical current. Live with earth wire will also give the electrical current but not when the earth wire is connected to the neutral wire.

Earthing is a safety outlet, which allows leaking electricity to be conducted away harmlessly and not through the body. Earthing needs to be checked every 6 months because it deteriorates with time and weather, particularly during the rainy season. A check can be carried out using an ordinary tester on the body of the appliance.

A tester or a test lamp can easily check that earthing is proper. One can light bulb with live and earth wire. If the bulb fails to light while connecting live and earth socket it means a defective earthing. People tend to take earthing lightly and often misuse it. Live and earth wires are sometimes untied together for temporary connection, which can be dangerous to life.

Following are the general precautions, Dos and Don’ts which people should take to prevent electrical hazards:

  • Make sure that you have proper earthing connection in the house.
  • Always remember the green wire, without it, do not use any electrical appliances especially if it is touching any water surface. Water enhances conductivity; extra precautions therefore should be taken, while handling appliances, under wet conditions.
  • 2–pin plugs with no earthing arrangements should not be used and in fact should be banned.
  • While using 3–pin plugs, make sure all 3 wires are connected and the pins are not defective.
  • Do not use matchsticks to hold wires in the socket.
  • Do not touch any wire without ensuring that power supply is switched off.
  • Do not use the earth wire to replace the neutral wire.
  • All joint wires should be properly insulated with proper insulated tapes and not with cello tape or Band–Aids.
  • Before using geyser water, it should be switched off.
  • Do not use heater plates with exposed wire for cooking purpose.
  • Use dry rubber slipper at home.
  • Use mini circuit breaker (MCB) and earth leak circuit breaker (ELCB) facilities at home.
  • Metallic electrical appliance should not be kept near a water tap.
  • Using rubber mats and desert coolers by using rubber leggings in the stand can insulate electrical appliance.
  • Use only recommended resistance wires and fuses.
  • Earthing should be checked every 6 months.
  • Any ordinary tester can check the presence of leaking electricity.
  • Wrap cloth around the handle of the refrigerator
  • Read the set of instructions attached with every electrical appliance.

Accidental electric deaths occur more often in India due to the use of 220 V than in the US, where 110V is used. AC current is more dangerous than DC. An AC current of more than 10 MA causes tetanic muscular contractions making it impossible for a hand grasping an energized object, to free itself.

In case of electrocution, proper resuscitation is necessary. The mains should be switched off or wires disconnected using a wooden material and cardiopulmonary resuscitation should be started immediately. In a clinically dead patient, a thump in the center of the chest from a distance of one foot may alone revive a person.

In severe electrocution, clinical deaths occur within 4–5 min., therefore time to act is limited. Do not wait for the victim to be taken to the hospital. Act there and then.

eMedi Quiz

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: Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionisation of the drug in the stomach. Which of the following statements is not correct example:

1. Absorption of digoxin is delayed by the presence of food.
2. Concurrent food intake may severely reduce the rate of absorption of phenytoin.
3. Presence of food enhances the absorption of hydrochlorthiazide.
4. Anitimalarial drug halofantrine is more extensively absorbed if taken with food.

Answer for yesterday’s Mind Teaser: 3. Presence of food enhances the absorption of hydrochlorthiazide.

Correct answers received from: Dr Jayant Gaikwad, Dr Sushma Chawla, Dr P C Das, Dr Jainendra Upadhyay, Raju Kuppusamy, Dr K V Sarma, Dr Chandresh Jardosh, Daivadheenam Jella.

Answer for 13th July Mind Teaser: 2. Bilateral cordectomy.

Correct answers received from: Dr Supriya C Chandra.

Send your answer to ijcp12@gmail.com

medicolegal update

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medicolegal update

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medicolegal update
  1. Dear Sir, thanks for the information. Regards: Dr Kartik
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