eMedinewS16th September 2013, Monday

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

Text messaging cuts new diabetes cases by almost 40%

A new study conducted in southeast India has shown that sending mobile text messages is an effective way of preventing the development of type 2 diabetes in at–risk men. Those who received the SMS, 2 to 3 messages sent twice a week for around 2 years, were 36% less likely to develop diabetes. The findings were reported online in Lancet Diabetes and Endocrinology by Ambady Ramachandran, MD, of India Diabetes Research Foundation, Chennai, India, and colleagues.

Senior author Desmond Johnston, FMedSci, from Imperial College London, United Kingdom, said: "We’ve known for years that you can prevent type 2 diabetes by modifying your lifestyle, but the problem is how to support people to do that. Frequent personal contact with a doctor is effective, but it’s very costly to provide. We’ve shown that you can achieve similar results using mobile phone messaging, which is a very low–7cost solution."

The research team screened around 8000 men aged 25 to 55 years working at 10 industrial organizations in southeast India between August 2009 and November 2012. They had to have a body mass index (BMI) of at least 23 and positive family history of diabetes, own a mobile phone, and be able to read and understand text messages in English.

537 participants with impaired glucose tolerance as determined by an oral glucose tolerance test were selected for inclusion in the study. They were randomly assigned to a mobile phone messaging intervention (n = 271) or to standard care (n = 266). At baseline, all of the men received personalized education and motivation regarding healthy lifestyle principles and written information about diet and physical activity; the prescribed lifestyle changes were similar to those used in the IDPP.

Texts were designed to prompt physical activity — stating, for example, "Use stairs instead of a lift (elevator)," — and to encourage healthy eating — "Avoid snacks while watching TV, you may overeat."

60 to 80 different messages were created and sent cyclically, so that participants would not be likely to receive the same message in a 6–month period. Participants were assessed every 6 months, and the 2–year follow–up for the study. Just 11 People Need to Receive Texts to Prevent 1 Case …

Longer Chest Pain Equals Bigger MI Risk

Patients with acute myocardial infarction have longer duration of chest pain than those without a myocardial infarction. Patients with chest pain of short duration, less than 5 minutes, are unlikely to have an acute infarction and have a good prognosis at 30 days.

A single–center study showed that only 8.9% of the patients received a final diagnosis of acute MI, and these patients had a significantly longer duration of chest pain compared with the rest of the cohort (120 versus 40 minutes) according to Carlos Calle–Muller, MD, of Henry Ford Hospital in Detroit, and colleagues.

Those who had chest pain lasting less than 5 minutes always had a good outcome, with no acute MIs or deaths within 30 days, the researchers reported in the September issue of Critical Pathways in Cardiology.

If the clinical assessment and ECG are benign, such patients might be able to be discharged directly from the emergency department without stress testing for outpatient follow-up.

The median chest pain duration was 180 minutes among the 10 patients who died and only 40 minutes for the others.

Among the patients with acute MI, longer chest pain duration was not associated with higher 30–day mortality, but it was associated with a higher initial level of cardiac troponin-I. …

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 Express gratitude

• Gratitude is a thankful appreciation for what you have.
• Appreciate from a roof over your head to good health to people who care about you.
• Set aside a few minutes every day and think about five large or small things you’re grateful for. Write them down if you like.
• Be specific and remember what each thing means to you. ….

cardiology news

The Black Dot

A small town chamber of commerce invited a speaker to address its annual dinner. The community’s economy was bad, people were discouraged, and they wanted this motivational speaker to give them a boost.

During her presentation, the speaker took a large piece of white paper and made a small black dot at the center with a marking pen. Then she held the paper up before the group and asked them what they saw.

One person quickly replied, "I see a black dot." "Okay, what else do you see?" Others joined in agreement: "A black dot." "Don’t you see anything besides the dot?" – she asked. A resounding "No" came from the audience.

"What about the sheet of paper?" – asked the speaker. "I am sure you have all seen it", she said, "But you have chosen to overlook it."

"In life, we also tend to overlook and take for granted many wonderful things that we have or happen around us and focus our attention and energy on small, dot like failures and disappointments. The so called ‘problems’ that we have are usually like the black dot on the paper. They are small and insignificant if we can widen our horizon and look at the whole picture."

Are you one of those who focus their attention and energy on dot–like problems?

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…

  • Researchers in Pennsylvania have developed a tool, known as the DiaRem score, comprising 4 preoperative clinical variables that surgeons and patients can use to predict the likelihood of type 2 diabetes remission after Roux–en–Y gastric bypass surgery. DiaRem scores range from 0 to 22, with low scores consistently predicting higher remission rates and high scores predicting lower remission rates. Their findings are published online September 13 in the Lancet Diabetes and Endocrinology.
  • For acute bacterial and structural skin infections that require intravenous therapy, a single dose of oritavancin is as effective as a 7– to 10–day dose of vancomycin as per a study presented at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy. It is also effective against methicillin–resistant Staphylococcus aureus (MRSA). Oritavancin is an investigational lipoglycopeptide being developed by The Medicines Company. It has a long half-life and rapid bactericidal activity against Gram–positive bacteria, including MRSA. These properties make it a candidate for single–dose administration.
  • Whooping cough among adults 50 or older is much more common than generally thought, and the incidence appears to be rising. A mathematical model based on medical practice and laboratory databases presented at the annual Interscience Conference on Anti–Microbial Agents and Chemotherapy suggested that pertussis among adults ages 50 through 64 more than doubled over a 5–year period.
  • High consumption of sugar–sweetened beverages is a risk factor for gout, even among individuals who carry a gout–protective variant of a gene involved in renal excretion of uric acid. According to Tony R. Merriman, PhD, of the University of Otago in Dunedin, New Zealand, and colleagues, compared with controls who never drank sugar–sweetened beverages, New Zealanders of European Caucasian ancestry who consumed four of these drinks daily had an almost seven times greater adjusted risk for gout.
  • The FDA has approved, the UroLift system, an implanted suture–based system to help men with enlarged prostates urinate more freely. The system is the first permanent implant to relieve low or blocked urine flow in men age 50 and older with an enlarged prostate. By pulling back prostate tissue that presses on the urethra, the system allows more natural urine flow. An inserter is pushed through the urethra into the prostate gland to deploy flexible sutures.
  • Health ministers from WHO’s South–East Asia region adopted the "New Delhi Declaration on High Blood Pressure" on Friday as reported in TOI, Sep 14, 2013. The health ministers committed to according high priority to the prevention and control of high blood pressure and to strive towards measurable reduction in the prevalence of hypertension in the region by 2025. India hosted the thirty–first meeting of ministers of health of the WHO South–East Asia Region. The New Delhi Declaration on High Blood Pressure was adopted by the health ministers in recognition of the fact that while noncommunicable diseases account for 55% of the 14.5 million total deaths in the region; cardiovascular diseases alone account for 25% of all deaths (3.6 million).

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Rabies News (Dr. A K Gupta)

What does humanizing your dog means?

  • Talking to your dog like he/she is a person.
  • Treating your dog like he/she is a person.
  • Allowing dogs to do what they want because it will hurt their "feelings."
  • Dressing them up in little doggie clothes.

Remember, humanizing your dog is fulfilling your own human needs, not your dogs. Humanizing dogs does more harm than good.

cardiology news
  • Preliminary findings of the STROKESTOP study show that systematic screening of more than 25,000 individuals aged 75 to 76 years identified untreated atrial fibrillation (AF) in 5%, putting them at increased stroke risk. Presenting the preliminary data at last week's European Society of Cardiology (ESC) Congress 2013 in Amsterdam, the Netherlands, Emma Svennberg, MD, Danderyd University Hospital, Sweden, noted that AF is estimated to affect about 1.5% to 2% of the general population, and its prevalence is expected to double in the next 50 years as the population ages.
  • Results of the randomized CADUCEUS trial at one year suggest that autologous stem cells shrank cardiac scar tissue and increased viable heart tissue, but did little to improve functional outcomes. The 17 patients treated with stem cells saw an absolute decrease of 11% in LV scar tissue compared with a 2.2% decrease in eight controls not treated with stem cells. Cardiac MRI also showed a significant mean increase in viable LV mass of 22.6 g vs 1.8 g in controls. According to the researchers, the observed reductions in scar mass correlated with the increments in viable myocardium, consistent with a therapeutic response in which scar is replaced by viable myocardium. The study was published online in the Sept. 17 edition of Journal of the American College of Cardiology.

Valvular Heart Disease News

Patient with large vegetation are at high risk complications.

(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
  • Children with low levels of vitamin D and recurrent ear infections had a reduced risk for acute otitis media with vitamin D supplementation. Compared with children randomized to placebo, patients with recurrent acute otitis media (AOM) who received 1,000 IU daily had significantly lower risk of experiencing one or more episodes of AOM (26 incidents vs 38 incidents) and the risk of uncomplicated acute otitis media was markedly smaller in the vitamin D group. According to Susanna Esposito, MD, of the Universita degli Studi di Milano in Italy, and colleagues, this means that in children with recurrent otitis media, vitamin D levels can be checked and for those with low serum levels of it consider supplement use as a treatment for their condition.
  • Children who suffer through a bout of bronchiolitis can end up with lungs early in adulthood that look like those of patients with chronic obstructive pulmonary disease (COPD). In a new study, 30 years after being hospitalized for bronchiolitis when they were younger than 2 years of age, 11% of the patients exhibited lung function that fell below the 0.7 FEV (forced expiratory volume in one second)/FCV (forced vital capacity) ratio that is threshold for the definition of COPD.
cardiology news

Soft Drinks May Change Metabolism Permanently

Dr. Hans–Peter Kubis, the director of the Health Exercise and Rehabilitation group at Bangor University in England, has shown that regularly drinking soda drinks can not only cause weight gain, but can actually change the metabolism in the human body, potentially triggering a whole host of other medical problems.

The findings published in the European Journal of Nutrition in June, looked at the effects of increased soda intake on a group of 11 men and women described as ‘lightly active, healthy, lean subjects with sporadic soft drink consumption.

The study found that even in that short time, the extra soda led their bodies to process calories differently, switching to ‘an inefficient metabolism.

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


Should all patients getting admitted to ICU be given antibiotics?

Giving people antibiotics before they are admitted to an ICU leads to a drop in patient deaths, as per a Dutch study, said Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal President, Heart Care Foundation of India and MTNL Perfect Health Mela.

The study, published in the journal New England Journal of Medicine, included nearly 6,000 patients treated at 13 hospitals in The Netherlands between 2004 and 2006. In the study, all the patients were expected to be on a ventilator for at least two days and/or to be admitted to the ICU for at least three days. The patients were grouped into three. The first group was given an oral antibiotic paste four times a day. The second group was given antibiotics through a gastric tube in the intestinal tract and by intravenous drip, plus the antibiotic paste. The third group was given the standard ICU care.

After four weeks, the preventive use of antibiotics reduced the number of deaths by 3.5 percent in the second group, and by 2.9 percent in the first group. The difference between the two groups treated with antibiotics was not significant.

The number of antibiotic–resistant bacteria did not increase in patients receiving antibiotic treatment.

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

Embolization shows success in benign prostatic hyperplasia

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…………………

An infant, 6 weeks old, is brought to the clinic for a well–baby visit. To assess the fontanels, how should nurse Oliver position the infant?

a. Supine
b. Prone
c. In the left lateral position
d. Seated upright

Yesterday’s Mind Teaser: 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.

Answer for yesterday’s Mind Teaser: b. 7 to 10 days

Correct answers received from: Chandulal parmar, Dr Jainendra Upadhyay, Prabha Luhadia, Dr.K.V.Sarma, daivadheenam, Dr Kanta Jain, Dr Pankaj Agarwal, Dr.Bitaan Sen & Dr.Jayashree Sen, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai

Answer for 14th September Mind Teaser: a. Confusion, headache, and seizures.

Correct answers received from: DR AVTAR KRISHAN, Dr Prakash Khalap, DR AYYAVOO ERODE

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

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!"

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

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.

medicolegal update

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

medicolegal update

Dr KK Aggarwal: Poor hygiene habits may lead to Typhoid fever http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: Empirical facts are not descriptions of fundamental reality but descriptions of modes of human observation using a human nervous system

medicolegal update

Dear Sir, Nice Updates. Regards:Dr tapan

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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