eMedinewS15th September 2014, Monday

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

Relaxation Therapy

  1. Relaxation techniques share two components: the repetitive focus (on a word, sound, prayer, phrase, body sensation, or muscular activity) and adoption of a passive attitude (towards intrusive thoughts.)
  2. They induce relaxation response characterized by decreased arousal and diminished sympathetic activity (decreased heart rate and lower blood pressure).
  3. There occurs increased EEG slow wave activity.
  4. Relaxation techniques may be subdivided into two methods, deep and brief, or by the specific strategy used to induce the relaxed state, including progressive muscle relaxation, autogenic training, and breath training.
  5. Adverse reactions are intrusive thoughts, fear of losing control, upsetting sensory experiences, muscle cramps, sexual arousal, and psychotic symptoms
  6. Adverse reactions are relaxation–induced anxiety or relaxation-induced panic.
  7. Relaxation–induced anxiety is a gradual increase in behavioral, physiologic, and psychological anxiety, whereas relaxation–induced panic is severe anxiety of rapid onset
  8. Patients with a history of generalized anxiety disorder or panic disorder and those with a history of hyperventilation are more likely to experience these adverse effects.
  9. Patients should also be introduced to deep breathing techniques that often accompany relaxation in a gradual manner and not more than couple of minutes at a time.
  10. Relaxation techniques can recue pain in cancer

News Around The Globe

  • Smokers who also have a high sodium intake may be at double the risk of developing rheumatoid arthritis, suggests a new study published in the journal Rheumatology.
  • A small, randomized study of patients with clozapine–resistant schizophrenia has shown that adjunctive electroconvulsive therapy (ECT) is a safe and effective treatment option for drug–resistant schizophrenia. The study was published in the American Journal of Psychiatry.
  • Hydroxyurea and long–term, periodic blood transfusions should be used more often to treat patients with sickle cell disease, suggested an expert panel in an article published in the September 10 issue of JAMA.
  • A new study has reported that depressed employees who took sickness absence experienced no improved health or quality of life; however, those who continued to work experienced health benefits. The study suggested that staying at work helps them better manage their illness. The study is published in the journal Plos One.
  • A study published in the journal Appetite has found that elderly people with fair or poor appetites may have higher risks of mortality than those with good appetites.

Rabies News (Dr A K Gupta)

Is sera testing of IDRV patients for antirabies antibodies necessary as a measure of knowing its efficacy?

Routine sera testing for rabies antibodies to know its efficacy is not required.

Cardiology eMedinewS

  • Gaining even just 5 pounds is enough to increase blood pressure in otherwise healthy adults, suggests a research presented at the AHA’s High Blood Pressure Research Scientific Sessions 2014. Researchers noted that the participants who gained weight during the study had an average systolic blood pressure increase from 114 mm Hg to 118 mm Hg.
  • A guideline–mandated one–year delay before elective noncardiac surgery after drug–eluting stent (DES) placement may be helpful in reduction of major adverse cardiac events (MACE) after such surgery, suggest researchers in an online paper published in JAMA Surgery.

Pediatrics eMedinewS

  • A child born with a severe heart defect is 30 times more likely to die before the age of one than the rest of the population, suggests a new research published in the journal Plos One.
  • A new study has found that children who are bullied between the ages of 8 and 10 are more likely to experience sleepwalking, night terrors or nightmares at the age of 12. The study has been published in the journal Pediatrics.

Dr K K Spiritual Blog

Why do we Offer Food to God in Every Pooja?

We follow a ritual of offering ‘bhog’ to the deity we worship. The ritual also involves sprinkling water all around the place where we sit down to eat food. Many people have advocated that the sprinkling of water is related to preventing ants and insects from approaching the food. But in spiritual language there is a deeper meaning of these rituals.

Bhagwad Gita and Yoga Shastras categorize food into three types corresponding to their properties termed as gunas. Depending upon satoguna, rajoguna and tamoguna, the food items are categorized as satwik, rajsik or tamsik.

Satwik food provides calmness, purity and promotes longevity, intelligence, strength, health, happiness and delight. The examples of satwik food items are fruits, vegetables, leaves, grains, cereals, milk, honey, etc. These items can be consumed as they are. One can also live on satwik food for life.

Rajsik food items possess attributes of negativity, passion and restlessness. Hot, spicy and salty food items with pungent, sour and salt taste promote rajas qualities.

Tamsik food has attributes of inducing sleep, ignorance, dullness and inertia. The examples of tamsik food are meat, onions, garlic, left-over food, etc.

Only satwik food is offered to God. Rajsik and tamsik food is never offered as Bhog. The only persons who were offered tamsik and rajsik food in Ramayana are Ahi Ravana and Kumbhkaran. Both of them were of an evil nature. Kumbhkaran signified tamas and Ahi Ravana, rajas or aggression. Tamsik and rajsik food can be converted into satwik by slow heating, sprouting or keeping them in water overnight. The examples are sprouted wheat and chana (chickpeas), etc.

A mixture of honey, milk, ghee, curd and sugar is called panchamrut and is a routine offering to the God. All the five components have satwik properties and their consumption promotes health.

In Ayurveda, there is a saying that any food item, which grows under the ground, is tamsik in nature and one, which comes from the top of the tree or plant like leaves, flower and fruits are satwik in nature. Satwik food is usually fresh, seasonal and locally grown.

Human beings are made up of body, mind and soul and soul is equated to consciousness or God. Whatever offered to external God if offered to the internal God or consciousness leads to inner happiness. The ritual, therefore, of offering food to God before eating forces us to either eat only satwik food or to include a substantial portion of satwik food in our meals. It helps a person convert his meal into a pure satwik one or at least adding satwik items.

Sprinkling water around the plate is considered an act of purification.

Many people confuse bhog with chadhava or offerings to the deity. While bhog is shared with God, chadhava is the offering of your illness or negative thoughts to the God and you go back with prasada of inner happiness. Many people counter the above argument by saying that alcohol is offered to Bhairon, viewed as a demon God, which means alcohol, is good for health. I personally feel that alcohol is offered to Bhairon not as a bhog but as an offering, which means that people who are addicted to alcohol go to Bhairon and give their share of alcohol to him so they can de-addict themselves.

Wellness Blog

About Thyroid gland

  • Low functioning thyroid is a new epidemic of the society affecting more than 3% of people. If thyroid function is low, it causes weight gain, loss of energy, cold intolerance and menstrual irregularities in women.
  • All people who are aged 50 and above should have their thyroid profile (TSH test) done to look for thyroid deficiency.
  • In younger people, or in the cases of infertility, menstrual irregularity, pregnancy, weight gain, one should check for thyroid deficiency.
  • Iodized salt should be used to prevent thyroid deficiency.
  • Non–iodized salt is only used in two conditions: firstly in patient with thyroid inflammation and secondly, while doing Jalneti in naturopathy, a yoga–related nasal wash technique.
  • In pregnancy, even mild thyroid deficiency can affect the growth of fetus hence dose requirement of thyroid medicine is much higher in pregnancy than in non–pregnancy.
  • In the elderly, the dose of thyroid medicine to be started is always low as compared to one in the adults.
  • If thyroid deficiency is untreated, osteoporosis (thickening of bone) and/or atrial fibrillation (irregular and fast heart rate) may result. Osteoporosis can cause recurrent fractures and atrial fibrillation may cause brain paralysis.
  • In Allopathic medicine, thyroid deficiency is treated by synthetic T4 hormone replacement.
  • In Ayurveda, thyroid stimulant drugs are available but they are effective only if some amount of thyroid gland is available.
  • As per Ayurveda, eating soya and drinking water from copper vessel is good for thyroid.

Inspirational Story

Most Popular Vs the Right Decision

A group of children were playing near two railway tracks, one still in use while the other disused. Only one child played on the disused track, the rest on the operational track.

The train is coming, and you are just beside the track interchange. You can make the train change its course to the disused track and save most of the kids. However, that would also mean the lone child playing by the disused track would be sacrificed. Or would you rather let the train go its way?

Let’s take a pause to think what kind of decision we could make………

Most people might choose to divert the course of the train, and sacrifice only one child. You might think the same way, I guess. Exactly, I thought the same way initially because to save most of the children at the expense of only one child was rational decision most people would make, morally and emotionally. But, have you ever thought that the child choosing to play on the disused track had in fact made the right decision to play at a safe place?

Nevertheless, he had to be sacrificed because of his ignorant friends who chose to play where the danger was. This kind of dilemma happens around us every day. In the office, community, in politics and especially in a democratic society, the minority is often sacrificed for the interest of the majority, no matter how foolish or ignorant the majority are, and how farsighted and knowledgeable the minority are. The child who chose not to play with the rest on the operational track was sidelined. And in the case he was sacrificed, no one would shed a tear for him.

The great critic Leo Velski Julian who told the story said he would not try to change the course of the train because he believed that the kids playing on the operational track should have known very well that track was still in use, and that they should have run away if they heard the train's sirens.

If the train was diverted, that lone child would definitely die because he never thought the train could come over to that track! Moreover, that track was not in use probably because it was not safe. If the train was diverted to the track, we could put the lives of all passengers on board at stake! And in your attempt to save a few kids by sacrificing one child, you might end up sacrificing hundreds of people to save these few kids.

While we are all aware that life is full of tough decisions that need to be made, we may not realize that hasty decisions may not always be the right one.

"Remember that what’s right isn’t always popular… and what’s popular isn’t always right." Everybody makes mistakes; that’s why they put erasers on pencils.

ePress Release

Do not ignore early morning chest pain

Do not ignore early morning chest pain as most fatal heart attacks occur early in the morning. In a message, 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 said that most heart attacks occur in the first three hours of getting up, more during full moon period and during winter.

A heart attack can present with chest pain, discomfort, heaviness or burning in the center of the chest, which is diffuse in nature and never localized and lasts for more than 30 minutes.

A discomfort, which lasts less than 30 seconds and which can be pinpointed with a finger, can be ignored as a non-cardiac chest pain. A burning in the chest occurring at 2 O’clock in the night may be due to acidity but any acidity occurring for the first time in life after the age of 40 years, should be considered cardiac in origin unless proved otherwise. Similarly, any breathlessness appearing for the first time in life after the age of 40 years is cardiac in origin unless proved otherwise.

Chewing a tablet of aspirin at the onset of cardiac chest pain can reduce chances of cardiac death by 22%.

All patients with chest pain should be promptly taken to the nearest cardiac hospital as timely clot dissolving therapy or clot removing angioplasty can practically cure a patient. The life saving window is to reach hospital within three hours.

Elaborating further he said that the three investigations required for evaluation of a chest pain should be available in the set up of every doctor who handles such patients and these include ViScope, an audio-visual auscultation device, ECG machine to diagnose an acute heart attack and echocardiography machine for early detection of heart attack.

ECG can often detect abnormal sounds in first six hours of heart attack but with a ViScope it is always possible to detect abnormal sounds during chest pain. Angiography is the gold–standard investigation if a patient with chest pain comes within three hours as it can help removing the clot by primary angioplasty.

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Padma Shri, Dr. BC Roy and DST National Science Communication National Awardee, Dr. KK Aggarwal delivers an oration on Medical ethics during the GPCON– 2014 – Indian Medical Association’s National CGP Conference & 44th Annual Conference of the IMA Mumbai Branch

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Exercise impact on the knee

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IJCP Book of Medical Records

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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 after sublingual nitrate developed fainting attack.
Reaction: Oh my God! Why was the systolic murmur missed on auscultation?
Lesson: Make sure that patient with left ventricular outflow tract (LVOT) obstruction are not given sublingual nitrates.

eMedinewS Humor

A group of expectant fathers sat nervously in the hall. A nurse beckoned to one of them and said, "Congratulations, you have a son!" Another man dropped his magazine, jumped up and said, "Hey, what’s the idea? I got here two hours before he did!"

Quote of the Day

Money is not the most important thing in the world. Love is. Fortunately, I love money. Jackie Mason

Twitter of the Day

Dr KK Aggarwal: Even the dead body needs respect
http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Everything in the universe is within you. Ask all from yourself. ~Rumi @DeepakChopra #CosmicConsciousness

   

eMedi Quiz

Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionization of the drug in the stomach. Which of the following statements is not a 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 hydrochlorothiazide.
4. Anitimalarial drug halofantrine is more extensively absorbed if taken with food.

Yesterday’s Mind Teaser: Beel’s phenomenon can be seen in the following conditions except:

a. Hemiplegia
b. Ramsay hunt syndrome
c. Bell’s palsy
d. Leprosy

Answer for yesterday’s Mind Teaser: a. Hemiplegia

Correct answers received from: Najib Khatee, dr poonam chablani, Tukaram Pagad, Dr.Bitaan Sen & DrJayashree Sen, Raju Kuppusamy, Dr. Jagdish Ghosh, Dr Avtar Krishan

Answer for 13th September Mind Teaser: d. A combination of store and forward, online discussion group, and author based second opinion teledermatology

Correct answers received from: Dr.K.V.Sarma, Dr.Chandresh Jardosh, Dr Rishi pal Singh, Dr Avtar Krishan, Muthumperumal Thirumalpillai

Send your answer to ijcp12@gmail.com

medicolegal update

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  1. Congratulations sir Padma Shri Dr K K Aggarwal on being elected unopposed as Secretary General of national IMA for the year 2014-2016: Dr. Bharath Prakash Avula, CWC Member, Past President, IMA Hyderabad city.

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