eMedinewS16th January 2014, Thursday

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
www.facebook.com/Dr KKAggarwal

Flu in children

  • The classical features of uncomplicated flu include abrupt onset fever, headache, muscle pain and malice accompanied by cough, sore throat or nose running. All of these features may not be present in children.
  • The symptoms may last for more than 7 days, particularly among young children.
  • Flu can complicate into pneumonia, asthma or ear discharge.
  • Viral flu may get complicated into bacterial pneumonia.
  • The fever is usually more than 100°F
  • Diagnostic tests are available but often not indicated.
  • Generally, it is an acute self–limiting disease.
  • Patients with uncomplicated flu usually improve gradually over 2–5 days.
  • Cough may persist for longer period.
  • Persistence of symptoms or weakness and easy fatigability called post flu asthenias may last for several weeks in older children.
  • In 10–15% of the children, flu may end up with ear discharge.
  • The ear discharge usually starts 3–4 days after onset of flu.
  • Anti–flu drugs are indicated for high–risk children.
  • Flu vaccination is recommended on annual basis in high risk individuals.
  • Absence of cough in sore throat means bacterial infection
Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV

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

The Right Action

sprritual blog

Dharma is the path of righteousness and living one’s life according to the codes of conduct as described by the Vedas and Upanishads. Its western equivalents might include morality, ethics, virtue, righteousness and purity. The term dharma can best be explained as the "law of being" without which things cannot exist.

The word dharma is derived from dhri, which means "to hold". It literally means "that which holds" the people of this world and the whole creation. The same is described in the Vedic Text, in Atharva Veda as: Prithivim dharmana dhritam, that is, "this world is upheld by dharma".

In Hinduism, Dharma is the very foundation of life. Tulsidas, the author of Ramcharitmanas, defined the root of dharma as compassion. Buddha has also described this principle in his book Dhammapada. According to Hindu philosophy, it’s GOD, who holds us through "Truth" and/or "Love". "Dharma prevails" or "truth prevails" is the essence of Hinduism.

In order to achieve good karma, Vedas teach that one should live according to dharma (the right action). This involves doing what is right for the individual, the family, the class or caste and also for the universe.

According to the Bhagavat Purana, righteous living or life on a dharmic path has four pillars: truthfulness (satya), austerity (tap), purity (shauch) and compassion (daya). It further adds that the adharmic or unrighteous life has three main vices: pride (ahankar), bad company (sangh), and intoxication (madya).

Manusmriti prescribes 10 essential rules for the observance of dharma: Patience (dhriti), forgiveness (kshama), piety or self control (dama), honesty (asteya), sanctity (shauch), control of senses (indriya–nigrah), reason (dhi), knowledge or learning (vidya), truthfulness (satya) and absence of anger (krodha). Manu further writes, "Non–violence, truth, non–coveting, purity of body and mind, control of senses are the essence of dharma".

In Bhagwad Gita, Lord Krishna says that in society, dharma is likely to fall from time to time, and to bring dharma back, a GOD representative is born from time to time.

The shloka "(parithraanaaya saadhoonaam vinaashaaya cha dhushkr.thaam | dharma–samsthaapanaarthaaya sambhavaami yuge yuge’ (Chapter IV – 8)" says that "For the protection of the virtuous, for the destruction of evil–doers, and for establishing the rule of righteousness (Dharma), I am born from age to age (in every age)". Another shloka "yada yada hi dharmasya glanir bhavati bharata abhyutthanam adharmasya tadatmanam srjamy aham" means that O descendant of Bharata "Whenever and wherever there is a decline in religious practice, and a predominant rise of irreligion – at that time I descend Myself".

Deepak Chopra in his book Seven Spiritual Laws of Success talks about the "Law of ‘Dharma’ or Purpose in Life". According to him, everybody should discover his or her divinity, find the unique talent and serve humanity with it. With this, one can generate all the wealth that one wants.

According to him, when your creative expressions match the needs of your fellow humans, then wealth will spontaneously flow from the un–manifest into the manifest, from the realm of spirit to the world of form. In spiritual terms this is an attempt to find out whether one’s life is progressing as per the Laws of Dharma )Dharma in Sanskrit means ‘purpose in life’) which, according to the scriptures, is said to be the sole purpose for a human being to manifest in this physical form.

For one to achieve ‘DHARMA’ he suggests the following affirmative exercises:

  • Today I will lovingly nurture the God or Goddess in embryo form that lies deep within my soul. I will pay attention to the spirit within me that animates both my body and my mind. I will awaken myself to this deep stillness within my heart. I will carry this consciousness of timeless, eternal being in the midst of time–bound experiences.
  • I will make a list of my unique talents. Then I will list all of the things I love to do while expressing my unique talents. When I express my unique talents and use them in the service of humanity, I lose track of time and create abundance in my life as well as in the lives of others.
  • I will ask myself daily, ‘How can I serve?’ and ‘How can I help?’ The answers to these questions will allow me to help and serve my fellow human beings with love.

Karma, dharma and samsara are three fundamental aspects of Hinduism. Buddhism, Jainism and Hinduism are all built on these aspects. Dharma is one’s appropriate role or attributes. Karma measures of how well one performs one’s dharma, explains why one is born where he or she is, and why there is suffering and seeming injustices. Samsara is the continuous cycle of birth, death and rebirth, and the context for all experience.

Dharma sutras from Dharma Shãstras are the basic texts which talks about the morality of individuals and the society. Most Indian laws are made from these Shãstras.

In Jainism also, the wheel of Dharma (Chakra) with 24 spokes represents the religion preached by the 24 Tirthankaras consisting of nonviolence (Ahimsa) and other virtues.

The very first word of the Gita is "Dharma". The Gita concludes with the word "Mama". The whole of Bhagavad Gita is contained in the two words ‘Mama’ and ‘Dharma’. When you join these two words it becomes mamadharma, meaning ‘your true Dharma’. This is what the Gita teaches. ‘What is your Dharma?’

How to achieve your dharma?

  • Do unto others what you do unto yourself and satisfy your conscience. That is your Dharma.
  • The word ‘Living Dharma’ signifies the right action in every moment of the life.
  • Do not follow the dictates of body, and do not indiscriminately follow the mind, for the mind is like a mad monkey. Hence, follow the conscience.
cardiology news

A bowl of noodles from a stranger

That night, Sue quarreled with her mother, and then stormed out of the house. En route, she remembered that she did not have any money in her pocket; she did not even have enough coins to make a phone call home. At the same time, she went through a noodle shop, picking up sweet fragrance, she suddenly felt very hungry. She wished for a bowl of noodles, but she had no money!

The seller saw her standing before the counter and asked: – Hey little girl, you want to eat a bowl? But … but I do not carry money … she shyly replied.

Okay, I’ll treat you – the seller said – come in; I will cook you a bowl. A few minutes later the owner brought her a steaming bowl of noodles. Sue cried as she ate some pieces

What is it? – He asked. Nothing. I am just touched by your kindness! – Sue said as she wiped her tears. Even a stranger on the street gives me a bowl of noodles, and my mother, after a quarrel, chased me out of the house. She is cruel!!

The seller sighed: Girl, why did you think so? Think again. I only gave you a bowl of noodles and you felt that way. Your mother has raised you since you were little, why were you not grateful and disobeyed your mom? Sue was really surprised after hearing that.

"Why did I not think of that? A bowl of noodles from a stranger made me feel indebted, and my mother has raised me since I was little and I have never felt so, even a little."

On the way home, Sue thought in her head what she would say to her mother when she arrives home: "Mom, I’m sorry. I know it is my fault, please forgive me …"

Once up the steps, Sue saw her mother worried and tired of looking for her everywhere. Upon seeing Sue, her mother gently said: "Sue, come inside honey. You are probably very hungry? I cooked rice and prepared the meal already, come eat while it is still hot …" Unable to control any longer, Sue cried in her mom’s hands.

In life, we sometimes easy to appreciate the small actions of some people around us, but for the relatives, especially parents, we see their sacrifices as a matter of natural …

Parental love and concern are the most precious gifts we have been given since birth. Parents do not expect us to pay back for nurturing us …… but have we ever appreciated or treasure the unconditional sacrifice of our parents?

News Around The Globe

Meditation ‘works just as well as anti–depressants’

Meditating for just half an hour a day can offer people with depression as much relief as taking pills, researchers have claimed. The report, published in JAMA Internal Medicine, found an eight–week training programme in mindfulness meditation reduced symptoms of anxiety, depression, stress and pain as well as improving the participants’ quality of life. Daily Mail By: Presswatch 07/01/2014


  • Peter Abdelmessieh, DO, from Lenox Hill Hospital in New York City, and colleagues report that bedside percutaneous tracheotomy can be done in critically ill patients with a low risk of morbidity in the community hospital setting. The findings were presented at the annual meeting of the Society of Critical Care Medicine (SCCM).
  • Contrary to common beliefs, delirium in the intensive care unit (ICU) may not be related to long–term mortality or poorer quality of life –– but instead appears to be associated with mild cognitive impairment among survivors of critical illnesses (annual meeting of the Society of Critical Care Medicine).
  • Survivors of intensive care unit (ICU) critical illnesses who show signs of malnutrition at admission –– especially protein–calorie specific malnutrition –– are at significantly higher risk of readmission within 30 days after hospital discharge and of 30–day and 90–day mortality (annual meeting of the Society of Critical Care Medicine). In patients with specific protein–calorie malnutrition, the 30–day readmission rate was 26.8% compared with 16.6% for patients in the ICU who were not malnourished.
  • An analysis of more than 1000 adult participants from the Baltimore Epidemiologic Catchment Area (ECA) study, which included interviews going back 24 years, showed that middle–aged and older adults who had reported a mental disorder in previous assessments under–reported by 2– to 12–fold this information at later recall. On the other hand, this patient population provided much more accurate recall of physical disorders, such as diabetes, hypertension, and arthritis. The study was published online January 8 in JAMA Psychiatry.
  • According to a study in January 3 Annals of the Rheumatic Diseases, none of four current algorithms – Systematic Coronary Risk Evaluation (SCORE) score, Framingham risk score (FRS), Reynolds risk score (RRS), and QRisk II risk score – accurately predict the risk of cardiovascular events in patients with early rheumatoid arthritis (RA).

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

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Rabies News (Dr. A K Gupta)

Is there carrier state of rabies in dogs?

A carrier state of rabies in dogs/cats has not yet been conclusively proven and established.

cardiology news

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

  • A new study presented at the Society of Critical Care Medicine 43rd Critical Care Congress shows that reusing cleaned electrocardiography (ECG) lead wires does not increase toxicities in intensive care units (ICUs).
  • Coronary computed tomography angiography with diagnostic image quality is feasible at an ultralow radiation dose of 0.2 millisievert using model–based iterative reconstruction. This represents roughly an 80% reduction in radiation dose compared with standard coronary CT angiography, Dr. Julia Stehli said at the annual meeting of the Radiological Society of North America.
cardiology news

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

  • A sizable share of gram–negative bacilli bacteremia cases in the neonatal intensive care unit (NICU) are now multidrug resistant (MDR), new data published online January 13 in Pediatrics show.
  • Current guidelines for detecting undiagnosed celiac disease (CD) are inadequate for widespread CD screening, according to results from a study published online January 13 in Pediatrics. Current guidelines rely on asking children about disease symptoms, but in a population–based screening study, researchers found that questionnaire data on symptoms did not differ significantly between individuals ultimately diagnosed with CD and those without the disease.
cardiology news

IBD linked to heart disease

Inflammatory bowel disease is associated with increased risks for stroke, myocardial infarction and ischemic heart disease, particularly in women.

A meta–analysis and systematic review has shown that increased odds for cerebrovascular accidents including ischemic and hemorrhagic stroke –– and for ischemic heart disease according to Siddharth Singh, MD, of the Mayo Clinic in Rochester, Minn. and colleagues.

These risks are specifically elevated in women versus men, with women having a 28% increased odds of cerebrovascular events and a 26% increased odds of ischemic heart disease.

The study was presented in a poster presentation at the American College of Gastroenterology meeting in San Diego.

cardiology news

Total CPR since 1st November 2012 – 84073 trained

Media advocacy through Web Media

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press release

Eat all seven colors in food

Delivering a keynote address at Romancing Print 2014, a Printers’ Conference organized by All India Federation of Master Printers at Hotel Ashoka, Padma Shri & Dr. B C Roy National Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr. National Vice President IMA said that one should use all seven colors in one’s diet.

Every color represents a vitamin. As per Ayurveda, a balanced diet is one which includes all seven colors and six tastes.

Dr. Aggarwal said that anything which is green and bitter in taste reduces weight, sugar and is good for the heart.

He said that one should be cautious about artificial colors because if they are not permissible, they can be dangerous to the health. Artificial colors are often put into sweets and vegetables so that they look attractive.

If fruits or vegetables appear uniform in color or size at the time of purchase, it should be taken for granted that they are either artificially colored or artificially ripened. Fruits and vegetables that ripen naturally will have varying shades of their color.

White sugar in sweets can lead to uncontrolled diabetes and weight gain in individuals; artificial coloring in sweets can cause cancer in the long run.

Some diet tips

  1. Multivitamin tablets are not needed unless there is a scarcity of a particular vitamin.
  2. If you include all seven colors and six tastes in your food, there is no need for vitamin supplementation.
  3. Wheat grass and barley grass juice contain folic acid and vitamin B12.
  4. Anything which is green contains vitamin B.
  5. Anything which is red contains lycopene.
  6. Citrus foods contain vitamin C.
  7. All dry fruits contain vitamin E.
  8. Sunlight is an excellent source of vitamin D.
  9. Carrots contain vitamin A.
  10. Folic acid is lost if the food is boiled and the water is discarded.
  11. Vitamin D is not absorbed if exposure to sunlight is through glass.
  12. Vitamin D is not absorbed through clothes if you are fully–clothed in sunlight.

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 84073 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."

emedipicstoday emedipics

CPR 10 in NDMC Premises

press release

Weight loss may improve sexual health of obese diabetes

vedio of day

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

A middle–aged male comes to the outpatient department (OPD) with the only complaint of hoarseness of voice for the past 2 years. He has been a chronic smoker for 30 years. On examination, a reddish area of mucosal irregularity overlying a portion of both cords was seen. Management would include all except:

1. Cessation of smoking.
2. Bilateral cordectomy.
3. Microlaryngeal surgery for biopsy.
4. Regular follow–up.

Yesterday’s Mind Teaser: A 5–year–old boy passed 18 loose stools in last 24 hour and vomited twice in last 4 hour. He is irritable but drinking fluids. The optimal therapy for this child is:

1. Intravenous fluids.
2. Oral rehydration therapy.
3. Intravenous fluid initially for 4 hours followed by oral fluids.
4. Plain water ad libitum.

Answer for yesterday’s Mind Teaser: 2. Oral rehydration therapy.

Correct answers received from: Dr Raghavendra Singh, Arvind Gajjar, Khurshid Alam,
Dr VP Thakral, Dr Monica Gandhi, Dr Arpan Gandhi, Dr K Raju, Dr Jainendra Upadhyay, Abhay Naik, Muthumperumal Thirumalpillai, Dr Gelivi Sahadevudu, Dr Pankaj Agarwal,
Dr Chandresh Jardosh, Dr Avtar Krishan, Dr Prakash Khalap.

Answer for 14th January Mind Teaser: 4. 0%

Correct answers received from: Dr Gelivi Sahadevudu, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr B K Agarwal.

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medical querymedical query

medicolegal update
medicolegal update

Funny quote on a husband’s T–Shirt

All girls are devils,
but my wife is the queen

of them.

medicolegal update

Click on the image to enlarge

medicolegal updatemedicolegal update

medicolegal update

Situation: A patient with cough of more than 4 weeks duration came with blood in his sputum.
Reaction: Oh my God! Why was TB not suspected earlier?
Lesson: Make sure that all patients with cough of more than 3 weeks duration are investigated for TB.

medicolegal update

Luck is what happens when preparation meets opportunity. Seneca

medicolegal update

Dr KK Aggarwal: Long term use of painkillers can cause kidney cancer http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Eat only when you feel hungry. Notice and feel your hunger. This is conscious eating http://bit.ly/15QdVeB #Health

medicolegal update
arjun ki antvarytha

S Dwivedi, Dean/Principal, Professor of Medicine/Preventive Cardiology,
Hamdard Institute of Medical Sciences and Research,
Associated Hakeem Abdul Hameed Centenary Hospital,
Jamia Hamdard (Hamdard University)
New Delhi–110062

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