eMedinewS15th September 2013, Sunday

Dr K K Aggarwal Padma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04);
For updates follow at
www.facebook.com/Dr KKAggarwal

Internists Choosing Wisely: No Checkups for Asymptomatic Healthy Adults

The Society of General Internal Medicine has recommended that internists avoid 5 common, but not always necessary, tests or procedures. The evidence–based recommendations, which are part of the Choosing Wisely campaign, are:

  1. "Don’t recommend daily home finger glucose testing in patients with type 2 diabetes mellitus not using insulin.
  2. Don’t perform routine general health checks for asymptomatic adults.
  3. Don’t perform routine pre–operative testing before low–risk surgical procedures.
  4. Don’t recommend cancer screening in adults with life expectancy of less than 10 years.
  5. Don’t place, or leave in place, peripherally inserted central catheters for patient or provider convenience."

….Read More

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

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

Ringtone – CPR 10 Mantra English

sprritual blog How to get rid of negative thoughts

Darkness is absence of light and similarly negative thoughts are absence of positive thoughts. The answer to negative thoughts is to bring back positive thoughts. An idle mind is the devil’s workshop and so will always think negative.

Here are the ways by which you can get rid your negative thoughts.

• Think differently as taught by Adi Shankaracharya. Once Menaka approached Arjuna with lust and said that she wanted to have a son like him with him. Arjuna said that why wait for 25 years consider me as you son from today.

• Think opposite as taught by Patanjali. For example if you are having a thought to steal, silently start thinking of charity.

• Think positive as taught by Buddha. Make a list of positive actions to be done today as the first thing in the morning and concentrate on that list. Divert your mind to the pending works. It’s a type of behavioral therapy. ….Read More

cardiology news

Growing Deep and Strong!

One day, my mother and I were working together in the garden where we were transplanting plants for the third time.

Grown from seed in a small container, the plants had been transferred to a larger container; then transplanted into the garden. Now, because I was moving, we were transplanting them once again.

Inexperienced as a gardener, I turned to my green–thumbed mother. "Isn’t this bad for them?" I asked, as we dug them up and shook the dirt from the roots. "Won’t it hurt these plants, being uprooted and transplanted so many times?"

"Oh" my mother replied. "Transplanting doesn’t hurt them. In fact, it’s good for the ones that survive. That’s how their roots grow strong. Their roots will grow deep, and they will make strong plants".

Often, I’ve felt like those small plants – uprooted and turned upside. Sometimes I’ve endured the change willingly, sometimes reluctantly, but usually my reaction has been a combination. Won’t this be hard on me? I ask. Wouldn’t things be better if things remained the same? That’s when I remember my mother’s words: That’s how the roots grow deep and strong.

News Around The Globe

5th Dil Ka Darbar

Date: Sunday, 29th September 2013, Venue: Constitution club of India, Rafi Marg, Time: 8 AM to 6 PM

Programme: A non stop question answer–session between all top cardiologists of the NCR region and the public.

The focus of the discussions will be prevention of heart diseases in women and young men. Special discussion will be held on Sex and Heart Diseases. Practical training will also be given to people on Hands–only Cardiopulmonary Resuscitation. Another focus of the discussion will be the launch of the Project Dhadkan (Palpitations) and Project Murmur (Congenital and valvular heart diseases in children).

Entry free…

Child Abuse & Neglect in India: Time to Act

28th Congress of Confederation of Medical Associations in Asia and Oceania (CMAAO), New Delhi India (2013)

The 28th CMAAO Congress & 49TH Council Meet was held from September 12–14 at Hotel Shangri–La, Ashoka Road, New Delhi. The theme of the conference was "Be Human Stop Child Abuse". The event was organized by Indian Medical Association (IMA). Honorable Chief Minister of Delhi, Smt. Sheila Dikshit inaugurated the event. More than 1,000 distinguished national and international delegates participated in the conference. Experts discussed how to protect a child from sexual abuse and cope with it.

Recently some extreme forms of violence against children, including sexual exploitation and trafficking and child labor are rising in the society and have provoked nationally and international outcry. Many children are routinely exposed to neglect and violence, physical, sexual and psychological, in their homes and schools, in care and justice systems, in places of work and in their communities. These have devastating consequences for their health and well–being now and in the future as well. This scenario underscores the need for parents and guardians to take a few elementary precautions and safeguard children from becoming victims. It is always better to spot the abuse symptoms at the earliest and put the child at ease.

Dr Vinay Aggarwal, the first Indian president of CMAAO after 20 years, said that it is important to focus attention on this crime against humanity. We may still be touching only the tip of an ice berg. Nevertheless our efforts in this area should be relentless. He also called upon doctors to adhere to the ethics and etiquette of medical profession. Dr. Narender Saini, Gen. Sect, IMA said that the term "protection" relates to protection from all forms of violence, abuse, and exploitation. This underlines the importance of anticipating and averting what might happen to damage and demean a child and not just response to hurt inflicted. In addition, the Indian Child Abuse, Neglect & Child Labour (ICANCL) group and IMA have propagated that "protection" must also include protection from disease, poor nutrition and lack of knowledge, he added.
Speaking on the occasion Dr Vinay Kumar said that child abuse knows no class or livelihood barriers, or age buffers. It threatens and afflicts children up and down the economic ladder, and up and the 0-18 age spectrum. The IMA recognizes the need for diagnostic detection of children at risk and the importance of finding ways to act to help children who appear to be at risk.

  • Albuminuria is a risk factor for cognitive decline in relatively young adults with diabetes and normal renal function. In a new study published online and to appear in the November issue of the Clinical Journal of the American Society of Nephrology, diabetic patients with persistent albuminuria over 4 to 5 years had greater declines in cognitive function than those without albuminuria.
  • A study from Taiwan says that preexisting diabetes increases the likelihood of dying within 30 days of a noncardiac operation and raises the risk for other acute complications, such as myocardial infarction and renal failure after the surgery. Uncontrolled diabetes, diabetes–related comorbidities, and other coexisting medical conditions are factors that further increase this risk. The study from Taipei Medical University and colleagues in Diabetes Care.
  • According to a research presented at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy, corticosteroids might reduce the risk for Clostridium difficile–associated diarrhea, report researchers studying patients with chronic obstructive pulmonary disease (COPD) treated with antibiotics. This finding contradicts previous research suggesting no apparent benefit of steroids.
  • Patients critically ill with H1N1 influenza who received a triple dose of oseltamivir (Tamiflu, Tamivir) had a significantly more rapid viral clearance than those who received normal doses. Anand Kumar, MD, of the University of Manitoba in Winnipeg, Canada, and colleagues presented their study at the Interscience Conference on Antimicrobial Agents and Chemotherapy. Among patients with confirmed H1N1 who were critically ill, treatment with a triple dose of the flu drug was associated with a significantly larger proportion of patients achieving 5–day viral clearance than those who received a standard dose (78% versus 11%).
  • People who live in areas with more green and open space have lower rates of type 2 diabetes. In a cross–sectional study, reported online in Diabetes Care people who lived in neighborhoods that were 41% to 60% green space had significantly lower rates of type 2 diabetes than those with less open space.

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Rabies News (Dr. A K Gupta)

If for some reason, IDRV cannot be given in deltoid region, what are the alternative sites?

IDRV can be given in deltoid region, suprascapular, anterior abdominal wall and the upper part of thigh.

cardiology news
  • An analysis of four phase–2 studies testing the effectiveness of AMG145 (Amgen), a human monoclonal antibody that inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9), showed the drug reduces LDL cholesterol by 43% to 64%, depending on the dose used. The analysis combines data from studies testing AMG145 as part of different regimens, including as monotherapy and combining it with statin therapy, and different patient groups, including those with heterozygous familial hypercholesterolemia (FH) and statin–intolerant patients. PCSK9 plays a key role in the metabolism of LDL cholesterol. The results were presented at the European Society of Cardiology (ESC) 2013 Congress.
  • A new meta–analysis has found coronary artery bypass graft (CABG) surgery to be superior to PCI for reducing the risk of all–cause mortality in diabetic patients with multivessel disease. Treating diabetic patients with surgery significantly reduced the risk of death by one–third at five years compared with PCI, and there was no difference in benefit if PCI was performed with a bare–metal stent (BMS) or drug-eluting stent (DES). The results of the study were published September 12, 2013 in the Lancet.

Valvular Heart Disease News

In infective endocarditis, in patients where no localized infection is seen, the source may be from minor trauma, oral cavity or genital or urinary infection.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

cardiology news
  • According to a study presented at the at the annual meeting of the European Respiratory Society, third–hand smoke –– residue that remains on the skin, clothes, and furniture of smokers, even if they do their smoking out of the house –– still impacts children’s breathing. The risk of respiratory tract infections in children from infancy to 13 years of age more than doubled in households in which parents smoked cigarettes but claimed to smoke only outside. There was also a more than doubling of the incidence of recent wheezing in homes where third–hand smoke was reported.
  • Two studies that were presented at the American Heart Association’s High Blood Pressure Research meeting in New Orleans have shown that even occasional high blood pressure (BP) readings –– as well as overweight and obesity –– in childhood predicted an increased likelihood of being diagnosed with hypertension in adulthood.
cardiology news

5 steps to lower Alzheimer’s risk (HealthBeat)

  • Maintain a healthy weight.
  • Check your waistline.
  • Eat mindfully. Emphasize colorful, vitamin-packed vegetables and fruits; whole grains; fish, lean poultry, tofu, and beans and other legumes as protein sources; plus healthy fats. Cut down on unnecessary calories from sweets, sodas, refined grains like white bread or white rice, unhealthy fats, fried and fast foods, and mindless snacking. Keep a close eye on portion sizes, too.
  • Exercise regularly. Aim for 2½ to 5 hours weekly of brisk walking (at 4 mph). Or try a vigorous exercise like jogging (at 6 mph) for half that time.
  • Keep an eye on important health numbers. In addition to watching your weight and waistline, keep a watch on your cholesterol, triglycerides, blood pressure and blood sugar numbers.
cardiology news

Total CPR since 1st November 2012 – 63400 trained

CPR Classes 63400

Media advocacy through Print Media

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29th August: Veer Arjun

Media advocacy through Web Media

When Constipation May be a Serious Problem 30th August


TB more dangerous than FLU 29th August


Bed netting is of little help to prevent dengue

Bed netting is of little use in dengue since the dengue mosquitoes are most active during the daytime, said Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal President, Heart Care Foundation of India and MTNL Perfect Health Mela.

Remaining in well–screened or air–conditioned buildings during the day can reduce the risk of exposure. When outside during the day, one should wear clothing that reduces the amount of exposed skin and should use an effective mosquito repellent, such as N, N–diethyl–metatoluamide (DEET).

Because dramatic plasma leakage can develop suddenly, substantial attention has been placed upon the early identification of patients at higher risk for shock and other complications. The following clinical features are of help in this regard.

  • Duration of illness: The period of maximum risk for shock is between the third and seventh day of illness. This tends to coincide with resolution of fever. Plasma leakage generally first becomes evident between 24 hours before and 24 hours after fever is over.
  • Alarm signs: Severe abdominal pain, persistent vomiting, abrupt change from fever to hypothermia, or abnormal mental status, such as disorientation, are noted in a minority of patients.
  • Hematocrit: An elevation of the hematocrit is an indication that plasma leakage has already occurred and that fluid repletion is urgently required.
  • Platelet count: Severe thrombocytopenia (<100,000/mm3) is one of the clinical criteria for dengue hemorrhagic fever and usually precedes overt plasma leakage.
  • Serum aspartate transaminase (SGOT): Mild elevations in serum transaminases are common in both dengue fever and dengue hemorrhagic fever. However, levels are significantly higher in patients with dengue hemorrhagic fever and elevated SGOT levels are noted earlier in illness.

Patients with suspected dengue who do not have any of the above indicators can be safely managed as outpatients as long as close clinical observation is assured. Daily outpatient visits may be needed to permit serial assessment of blood pressure, hematocrit, and platelet count.

A patient should be hospitalized when:

  • Blood pressure <90/60 mmHg
  • Hematocrit >50 percent
  • Platelet count <50,000/mm3
  • Evidence of bleeding other than petechiae

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 63400 people since 1st November 2012.

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

today emedipics

CMAAO meet on child abuse

press release

Carotid neck ultrasound the only way to check regression of heart blockages

today video of the dayDr KK Aggarwal Birthday 5th September

Cultural Evening at IMA

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

Dr. Marquez prescribes norfloxacin 400 mg P.O. twice daily, for a client with a urinary tract infection (UTI). The client asks the nurse how long to continue taking the drug. For an uncomplicated UTI, the usual duration of norfloxacin therapy is:

a. 3 to 5 days
b. 7 to 10 days
c. 12 to 14 days
d. 10 to 21 days

Yesterday’s Mind Teaser: A female client with acute renal failure is undergoing dialysis for the first time. The nurse in charge monitors the client closely for dialysis equilibrium syndrome, a complication that is most common during the first few dialysis sessions. Typically, dialysis equilibrium syndrome causes:

a. Confusion, headache, and seizures.
b. Acute bone pain and confusion.
c. Weakness, tingling, and cardiac arrhythmias.
d. Hypotension, tachycardia, and tachypnea.

Answer for yesterday’s Mind Teaser: a. Confusion, headache, and seizures.

Correct answers received from: Dr PC Das, Dr Kanta Jain, Chandulal Parmar, Dr VP Thakral, Dr Arpan Gandhi, Dr K Raju, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Dr Bitaan Sen & Dr Jayashree Sen, Muthumperumal Thirumalpillai, Dr Avtar Krishan.

Answer for 13th September Mind Teaser: c. Mumps

Correct answers received from: Dr Pooja Khullar.

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

The surgeon told the patient that woke up after having been operated, "I’m afraid we’re going to have to operate you again because you see, I forgot my rubber gloves inside you."
The patient said, "Well, if it’s just because of this, I’d rather pay for them if you just leave me alone."

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with hiatus hernia developed severe symptoms after eating a ‘Paan’.
Reaction: Oh my God! Why was he given a peppermint?
Lesson: Make sure patients with reflex esophagitis are not given any food which can relax GI sphincter.

medicolegal update

"The only way not to think about money… is to have a great deal of it." (Edith Wharton)

medicolegal update

Dr KK Aggarwal: A mix of exercise protocol is better http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: What is the psychological meaning of Cosmic Consciousness? http://bit.ly/DpkBook #ScienceSetFree

medicolegal update

Dear Sir, Emedinews is providing information. Regards: Dr Sunil

Forthcoming Events

29thSeptember–Dil Ka Darbar at Constitution Club of India,New Delhi

20th Perfect Health Mela from 18th Oct to 22nd Oct at different locations

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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medicolegal update

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