eMedinewS16th May 2014,Friday

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

Cough Hygiene

  1. When you cough or sneeze, you tend to expel out respiratory waste, which can be droplets (larger than 5 microns) or airborne droplet less than 5 microns; both have different implications.
  2. Droplets remain suspended in the air only for a limited period and exposure of less than 3 feet is usually required for human to human transmission of droplet–borne respiratory organisms. In flu this can be upto 6 feet. The examples of droplet infections are patients with meningitis, influenza, rubella (German measles) etc.
  3. No precautions need to be taken by a person, who is 6–10 feet away from the patient but if a person is sitting or working even at a distance of 3–6 feet, the non–coughing person should wear simple mask.
  4. In contrast, airborne droplet nuclei, which carry respiratory secretions smaller than 5 microns can remain suspended in the air for extended period and can cause infections to people who are standing even more than 10 feet away. The example of airborne droplet nuclei infections are TB, measles, chickenpox and SARS.
  5. Patients with these diseases require to be placed in an isolation room and all those people who are looking after these patients must use a safe N95 mask.
  6. In normal house with open windows, there is a constant exchange of air, which prevents spread of infections but in rooms with air conditioners (ACs) with no air exchange, the infections can spread from one person to another.
  7. When sitting in an air conditioned atmosphere, the setting of the AC should be such that the same air is not circulated and fresh air is allowed to exchange. Split ACs, therefore, are more dangerous than the window ACs.
  8. In an office with split AC, if one of the employees is suffering from any of the droplet nuclei disease, he/she can transmit infection to others. Therefore, patients with confirmed TB, measles, chickenpox and SARS should not be allowed to work in offices with split ACs.

News Around The Globe

  • The Centers for Disease Control and Prevention (CDC) has released new guidelines stating that the use of oral antiretroviral therapy should be advised to HIV–uninfected patients who are at high risk for HIV infection. Preexposure prophylaxis (PrEP) can reduce the risk for HIV infection by more than 90%, reported the CDC. The guidelines are published May 14 in the Morbidity and Mortality Weekly Report.
  • A study published online May 12 in CMAJ has stated that women are at increased risk of being seriously injured during a motor vehicle accident during the second trimester of pregnancy. Researchers noted that pregnant women were 42% more likely to be involved in a serious motor vehicle accident.
  • Premature surgical or natural menopause could adversely affect brain function later in life that cannot be entirely offset by hormone treatment, reports a new study published online in BJOG. It appeared that early menopause was associated with increased odds of performing poorly on tasks assessing verbal fluency (OR 1.56) and visual memory (OR 1.39) in later life.
  • A study presented at the American Academy of Neurology (AAN) 66th Annual Meeting has pointed that the novel 40 mg dosing of glatiramer acetate given 3 times a week could be more convenient than the traditional 20 mg daily regimen for patients with relapsing–remitting multiple sclerosis (RRMS), and could also avoid adverse effects linked to long–term injections.
  • A study published online in the American Journal of Medicine states that inhaled budesonide has the potential to prevent the onset of acute mountain sickness tied to hypobaric hypoxia set in by rapidly ascending to high altitudes. The drug also has fewer side effects as compared to oral dexamethasone.

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 eMedinewS

  • The LAPLACE–2 study, published in the May 14, 2014 issue of the Journal of the American Medical Association, has revealed that adding evolocumab to moderate– or high–intensity statin therapy leads to very large reductions in LDL–cholesterol levels when compared with statin therapy alone. The study was presented at the recent American College of Cardiology Scientific Sessions.
  • Drinking more than a glass of wine or one shot of whiskey per day is associated with a significantly increased risk of sudden cardiac death over that of nondrinkers, if they suffer an ST–segment–elevation MI, reports a case–control study of STEMI patients presented at the Heart Rhythm Society 2014 Scientific Sessions.

Pediatrics eMedinewS

  • According to a new report from the World Health Organization (WHO), depression appears to be the major cause of illness and disability in adolescents worldwide, and road traffic injuries are the top cause of death and the second major cause of illness and disability in this population.
  • Heavy marijuana use between the ages of 15 to 17 years could lead to an earlier age of onset of psychosis in those already destined to develop the disorder. These teenagers experienced first episode psychosis (FEP) an average of almost 4 years earlier than those with FEP who did not use cannabis. The study was presented at the American Psychiatric Association’s (APA’s) 2014 Annual Meeting.

Dr K K Spiritual Blog

Understanding Indriyas

As per ancient Indian literature, we have 10 Indriyas – 5 motor and 5 sensory. The motor Indriyas are called Karmendriyas and the sensory indriyas are called Gnanendriyas. The motor indriyas involve the functions of elimination (anus), procreation (genitals), movement (legs), grasping (hands) and speaking (speech). The five sensory indriyas in sequence are smell, taste, seeing, touching and hearing.

The first motor indriya is linked to the first sensory indriya. Therefore, elimination is linked to smelling, procreation to tasting, movement to seeing, grasping to touching and speaking to hearing.

Controlling the senses is the fundamental principle in acquiring spiritual health. Senses in Indian mythology are depicted by horses, which are chanchal and are likely to go out of control. The control over 10 senses is required to become a yogi.

The Ashwamedha Yagna of ancient era of kings basically meant doing a sacrifice so as to be able to control one’s senses.

In internal Ramayana, Lord Dashrath represents a person who has control over his 10 senses. Here ‘Dash’ means ten and ‘Rath’ means horse.

During meditation also, one is taught to sequentially control one’s senses. For example, to be able to meditate, one must first pass urine and stool as in the presence of these urges, one will not be able to meditate. The second is to control one’s sexual desires. It is well known that sexuality and spirituality cannot go hand in hand. In any Shiv Mandir, Nandi, the bull, is always worshipped outside the temple and not inside the temple.

The next step in meditation is control on movements and that is practicing stillness followed by relaxing each every muscle representing control over grasping and then going to an inner journey of inner silence of controlling over the 5th motor indriya i.e. speech. Only after one has learnt to control the mortal indriyas, can one be able to control the 5 sensory indriyas in succession as mentioned above.

Wellness Blog

Warning signs of worsening heart failure

If you have heart failure, call your doctor if you notice any of these signs:

  • Sudden weight gain (2–3 pounds in one day or 5 or more pounds in one week)
  • Extra swelling in the feet or ankles
  • Swelling or pain in the abdomen
  • Shortness of breath not related to exercise
  • Discomfort or trouble breathing when lying flat
  • Waking up feeling short of breath
  • Coughing or wheezing
  • Increased fatigue
  • Mental confusion
  • Loss of appetite

Inspirational Story

Did you know…?

That Joan of Arc was only 17 when she was riding at the head of the army that liberated France from the English? That John Calvin was 26 when he published his "Institutes"?

That John Keats died when he was 26? That Shelley was 30 when he was drowned, but not before he left English literature his classic "Odes"?

That Sir Isaac Newton had largely discovered the working of the law of gravitation when he was 23? That Henry Clay, the "great compromiser," was sent to the United States Senate at 29 and was Speaker of the House of Representatives at 34?

That Raphael painted his most important pictures between 25 and 30? That Mozart only lived 35 years?

Of course, most of us will never achieve the prominence of these extraordinary individuals. Nor should we –– we are each cut from a unique pattern. But many people feel as if they should be leaving more of a mark on the world. When I was a young man I wanted to make things happen. After a few years I realized I would have to content myself with watching most things happen. (Now I often find that I have no idea at all what is happening!)

It helps to remember that there is a time for everything – and everybody. Our time to bear good fruit may be yet to come. In fact, we may do our best work, or find our unique place, later in life.

Colorado aspen trees grow vigorously. After the devastation of a forest fire, frequent occurrences in the Rockies, aspens are sometimes the first trees to return. They re-forest an area quickly, providing shade for slower–growing spruce and pine saplings. These evergreens grow slower, but may live many years longer than the aspens. Each tree grows in its own time.

So does each person. Some people come to fruition quickly; others contribute more significantly in later years.

If you’ve not yet come into your own, don’t worry. Tend to your work and aspirations with care. Don’t give up; but rather be patient, for growth can be slow. Remember, storms and disease are devastating, but they can also prune you and make you stronger. With proper nurture, you will in time enjoy a full harvest.

There is a time for everything and everybody. And the time to begin is now.

ePress Release

ECG not a reliable marker for predicting heart disease

Doing an ECG is of little use in predicting future heart problems for people who are examined because of chest pain, 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.

Chest pain is the most common reason people seek medical attention for possible heart trouble, and an ECG, is a common test for such people. ECG can be normal in the first six hours even in frank heart attacks. Missing the diagnosis of heart attack on ECG is the commonest mistake done in the emergency rooms.

The most important parameters still remain the classical history and physical findings.

  1. A chest pain which can be pinpointed by a finger is not a heart pain.
  2. Pain lasting less than 30 seconds is not a heart pain.
  3. Heart pain is diffuse in the center of the chest lasting more than minutes and manifests as heaviness, burning, discomfort, heaviness or pain often precipitated by physical or mental exertion.

When in doubt one should do an exercise stress test and if negative these patients should be reassessed for risk factors.

If the patient is at high risk even with negative treadmill, he/she should undergo risk reduction management for prevention of future heart attacks.

High risk patients are smokers plus presence of blood pressure, obesity, high cholesterol and diabetes.

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."

eMedi Quiz

You’ve had yeast infections before, but in the past year they haven’t really gone away. This could be a sign of:

A. Diabetes.
B. Emphysema.
C. Stomach ulcers.
D. Depression.
E. Food allergies.

Yesterday’s Mind Teaser: Which of the following is not fermented by colonic bacteria?

a) Lignin
b) Pectin
c) Cellulose
d) None of above

Answer for yesterday’s Mind Teaser: a) Lignin

Correct Answers received from: Dr Jainendra Upadhyay, Dr Bitaan Sen & Dr Jayashree Sen, Dr Prakash Khalap, Dr Himanshu Trivedi.

Answer for 14th May Mind Teaser: B. Heart disease

Correct Answers received from: Dr Himanshu Trivedi.

Send your answer to ijcp12@gmail.com

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

World Earth Day Celebration at DAV Public School, RK Puram, New Delhi.

press release

To err is human

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 trial suggest that this intervention is much better than thrombolytic therapy in such patients.

eMedinewS Humor

The International Food Shortage

Recently, a worldwide survey was conducted and the only question asked was: "Would you please give your honest opinion about the solution to the food shortage in the rest of the world?"

The survey was, not surprisingly, a huge failure. Because:

In Africa they didn’t know what "food" meant.
In Eastern Europe they didn’t know what "honest" meant.
In Western Europe they didn’t know what "shortage" meant.
In China they didn’t know what "opinion" meant.
In the Middle East they didn’t know what "solution" meant.
In South America they didn’t know what "please" meant.
And, in the USA they didn’t know what "the rest of the world" meant.

Quote of the Day

If we wait until our lives are free from sorrow or difficulty, then we wait forever. And miss the entire point. Dirk Benedict.

Forthcoming events

Coffee with Dr KK

Next CME session with Dr K K will be held on Sunday 18th May, 2014 at 8 am at Moolchand Hospital.

  1. Jaundice Update
  2. Understanding what is transgender
  3. Prevalent common ailments observed in the last two weeks in general practice.

Kindly note that CME will start at 8am sharp.

You can also pass on the message to your colleagues and bring them if they would like to attend.

With regards, Dr Pawan Gupta, Convener, 09813193071

 

Twitter of the Day

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Those who make wise choices in life should wind up happier & more successful http://bit.ly/WAYHF_DC #WAYHF

 

medicolegal update

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medicolegal update

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  1. Dear Sir, Thanks for the news. Regards: Dr Jay
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