eMedinewS
17th November 2014, Monday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and National Science Communication Awardee. Limca Book of Record Holder (CPR). Gold Medalist

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

Viagra for LVH

For patients with left ventricular hypertrophy (LVH), long-term of use of phosphodiesterase type-5 (PDE-5) inhibitors (sildenafil) can also improve measures of cardiac performance.

As per Dr Elisa Gianetta (Sapienza University of Roma, Italy) patients with heart failure and LVH are the ideal target population to benefit from PDE-5 inhibition.

Their conclusions are based on a meta-analysis of 24 studies with 1622 individuals, of which 954 were treated with PDE-5 inhibitors and 772 with placebo. Their results are published October 19, 2014 in BMC Medicine.

The researchers suggest that PDE-5 inhibitors "could be reasonably offered to men with cardiac hypertrophy and early-stage heart failure." Given that the drugs were tested in men, there is a need for additional studies in women, as well as a long-term study focusing on cardiovascular outcomes, they add.

News Around The Globe

  • Clinicians know the recommendations regarding when and when not to prescribe antibiotics, but they do not always follow them, suggest in-depth interviews with physicians, nurse practitioners (NPs), and physician assistants (PAs). The report is published online November 13 in Emerging Infectious Diseases.
  • On World Diabetes Day, the European Society of Cardiology has stressed that type 2 diabetes can be prevented, or reversed with simple lifestyle changes. The society’s spokesperson stated that the use of a simple questionnaire can help people find out if they are at risk and whether they need to take action.
  • Cosmetic outcomes, scar size, and pain levels appear to be similar after purse-string suture and second intention healing, suggested a new clinical trial published online in JAMA Dermatology.
  • Anemia heightens the risk for acute kidney injury in hospitalized patients, suggests new research presented at Kidney Week 2014.
  • Brothers of women with polycystic ovary syndrome (PCOS) may have alterations in adrenal and gonadal steroidogenesis; however, fertility does not appear to be affected, suggests new research published online in Human Reproduction.

Dr KK Spiritual Blog

What is the importance of life force?

A physical body becomes useless once the life force is gone. The same body, which was lovable to everyone, becomes a liability after death. Everyone wants to dispose it as early as possible as keeping a dead body at home is considered a bad omen.

During the transfer of dead body from one place to another nobody wants to keep the body in a vehicle other than a hearse van, meant to transport dead bodies. No family would be willing to carry the dead body of a person in a car in which the deceased person had been traveling or driving for years.

May be for any reason, health or rituals, once you touch a dead body you are required to take a bath before you commence your daily routine.

Within a matter of hours in absence of life force, the physical body starts disintegrating and in a matter of days, it shows signs of self-destruction and putrefaction.

This vital force is nothing but the soul, aatma, brahma, spirit or consciousness described in different Vedic texts.

Adi Shankaracharya in his book Bhaja Govindam shloka 6 says:

Yávat-pavano nivasati dehe
Távat-pøcchati kuùalam gehe,
Gatavati váyau dehápáye
Bháryá bibhyati tasmin káye.(6)

“Till the life force remains in the body, people come and enquire about your welfare. But, the moment the life force goes out, even your wife is afraid of coming anywhere near your body”.

Life force can be equated to the network of information in computer, radio, television or mobile phone. All these gadgets without data are useless and are thrown away. This silent data retrievable by operational and application software represent the life force or soul of these electronic gadgets.

Just as one does not give importance to a computer without data, one should not give importance to the physical body. It is the life force within the body which is respected and cared for and that is what real “I” or “We” are. All glories of the body are only until the life force remains in it. In Bhagavad-Gita, Lord Krishna in Chapter 2 (2.23) says about this life force or ataman “fire cannot burn it, weapon cannot cut it, water cannot wet it, air cannot dry it, it is immortal”.

The most defined relationship in Vedic text is between husband and wife. The very fact even a wife after death does not want to touch the husband signifies the importance of life force.

The life force has no dimensions: height, weight, color or image. It is immortal, omnipotent, omniscient and omnipresent. The weight of a live and a dead body immediately after the death is the same.

It is the same life force, which dwells in everybody and during life is modified by the action, memory and desire cycle. If one gets attached to any of the three, then one starts getting detached from the soul or the life force. People who are in touch with their life force all the time attain peace and happiness and die young in old age.

Most Vedic mahavakyas talk about, that it is the same spirit, which dwells in everybody and hence every person in the society should be welcomed and treated with equal importance. Aham brahmasami, tatwam asi, vasudeva kutumbakam, etc. are a few of the examples.

According to Adi Shankaracharya, one can achieve non-duality only by seeing God in everyone. Athithi-devo-bhava is also based on the same principle.

Inspirational Story

Appreciate Life’s Annoying Little Things

Lessons from 9/11, the annoying little things:

  • As you might know, the head of a major company survived the tragedy of “9/11” in New York because his son started kindergarten.
  • Another fellow was alive because it was his turn to bring donuts.
  • One woman was late because her alarm clock didn’t go off in time.
  • One was late because of being stuck on the NJ Turnpike because of an auto accident.
  • One of them missed his bus.
  • One spilled food on her clothes and had to take time to change.
  • One’s car wouldn’t start.
  • One went back to answer the telephone.
  • One had a child that dawdled and didn’t get ready as soon as he should have.
  • One couldn’t get a taxi.
  • The one that struck me was the man who put on a new pair of shoes that morning, took the various means to get to work but before he got there, he developed a blister on his foot. He stopped at a drugstore to buy a Band-Aid. That is why he is alive today.

Now

  • When I am stuck in traffic…
  • Miss an elevator…
  • Turn back to answer a ringing telephone…
  • All the little things that annoy me…
  • I think to myself…

    This is exactly where God wants me to be at this very moment.

The next time your morning seems to be going wrong,

  • The children are slow getting dressed,
  • You can’t seem to find the car keys,
  • You hit every traffic light…
  • Don’t get mad or frustrated;

    God is at work watching over you.

    May God continue to bless you with all those annoying little things and may you remember and appreciate their possible purpose.

Rabies News (Dr A K Gupta)

How is rabies transmitted?

Rabies is transmitted by infected secretions. Most commonly, transmission to humans takes place through exposure to saliva following a bite by an infected animal. Rabies virus can be excreted in saliva, urine, nasal discharge and respiratory secretions.

Cardiology eMedinewS

  • Patients with atrial fibrillation (AF) treated with rhythm or rate control experience similar improvements in health-related quality of life (HRQoL) over 1 year of follow-up, with improvements being slightly greater among those treated with rhythm control, suggests an international observational study published online November 11 in Circulation: Cardiovascular Quality and Outcomes.
  • One's degree of visceral adiposity and its change over time, measured by computed tomography (CT), predict risk of developing metabolic syndrome independently of body mass index (BMI), suggests a new analysis based on a Multi-Ethnic Study of Atherosclerosis (MESA) cohort. The findings are published in the Journal of the American College of Cardiology: Cardiovascular Imaging.

Pediatrics eMedinewS

  • Most antiretroviral (ARV) drugs are not associated with an increased risk of congenital anomalies in babies born to HIV-infected women; however, infants exposed to atazanavir were about twice as likely to have congenital anomalies, especially musculoskeletal and skin-related birth defects, reported a new study published online in JAMA Pediatrics.
  • Child-rearing practices and attitudes could be contributing factors when kids have chronic constipation, suggests a new study published in the Archives of Disease in Childhood.

Quote of the Day

  • Worry does not empty tomorrow of its sorrow; it empties today of its strength. ~ Corrie Ten Boom

Wellness Blog

First aid for poisonous bites and stings

People often panic if they have been bitten or stung. You should tell the patient that many snakes, spiders, insects and sea creatures are harmless and that even the bites and stings of dangerous animals often do not cause poisoning.

Keep the patient calm and still. Moving the bitten or stung limb speeds up the spread of venom to the rest of the body. Fear and excitement also make the patient worse. The patient should be told not to use the limb and to keep it still and below the level of the heart. The limb may swell after a while, so take off the patient’s rings, watch, bracelets, anklets and shoes as soon as possible. A splint and a sling may help to keep the limb still.

Avoid doing the following:

  • Do not cut into the wound or cut it out.
  • Do not suck venom out of the wound.
  • Do not use a tourniquet or tight bandage.
  • Do not put chemicals or medicines on the wound or inject them into the wound (for e.g., potassium permanganate crystals).
  • Do not put ice packs on the wound.
  • Do not use proprietary snake bite kits.
  • The patient should lie on one side in the recovery position so that the airway is clear, in case or vomiting or fainting.
  • Do not give the patient anything by mouth – no food, alcohol, medicines or drinks. However, if it is likely to be a long time before the patient gets medical care, give the patient water to drink to stop dehydration.
  • Try to identify the animal, but do not try to catch it or keep it if this will put you, the patient or others at risk. If the animal is dead take it to hospital with the patient, but handle it very carefully, because even dead animals can sometimes inject venom.
  • As soon as possible, take the patient to a hospital, medical dispensary, or clinic where medical care can be given. The patient should not walk but should keep as still as possible. If there is no ambulance or car, carry the patient on a stretcher or trestle, or on the crossbar of a bicycle.
  • Antivenom should only be given in a hospital or medical Centre where resuscitation can be given, because the patient may have an allergic reaction. If available, antivenom should be used if there is evidence of severe poisoning. It should not be used when there are no signs of poisoning.

ePress Release

Winter health problems in women

The winter season can cause health problems, especially in women, 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. Following are some of the problems women might have to face:

  • Heart disease: Heart disease kills more women than any other disease. It takes more lives than breast cancer, cervical cancer, or any other disease. Stroke and heart disease-related hospitalizations and deaths rise by more than 50 percent during the winter months.
  • Seasonal affective depression: This condition is characterized by having episodes of depression every year, but only during the winter. What the exact cause is yet to be discovered, but it is thought that body temperature, ambient light, and hormone regulation play a role.
  • Hypothermia: Hypothermia is as an abnormally low body temperature and can occur in cold weather. In cold weather one looses heat faster than one is able to create it. If this happens gradually one may not even realize it is happening. If the body temperature drops below 95 degrees Fahrenheit, one needs to see emergency medical care immediately in order to avoid death.
  • Vitamin D deficiency: We are at an increased risk of vitamin D deficiency, especially during the winter month. Women who work in the house at times cannot take out time to give sunshine to their body. Vitamin D is essential for bone, immune system, and heart health. It may also help to prevent cancer.
  • Influenza: Flu is very common during the winter and has the potential to be deadly. One should not forget to take the flu shot.
emedipicstoday emedipics

21st Perfect Health Mela 18th October 2014

Self-Assessment-Quiz

 

expert_choice
press release

Proton–pump inhibitors to carry warning about C

video of day

Other Blogs

Video Library

Sameer Malik Heart Care Foundation Fund

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF

Total CPR since 1st November 2012 – 101090 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)

 

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 :

 

Dr Good and Dr Bad

Situation: A senior citizen with an insurance of one lakh came for admission.
Dr. Bad: You should opt for Rs. 1000/- room.
Dr. Good: Take any room you want.
Lesson: The 1% room rent clause is not applicable to senior citizens.

Make Sure

Situation: A 70–year–old male with antibiotic–associated diarrhea and TLC of 24000 died.
Reaction: Oh my God! Why was surgery not considered in this case?
Lesson: Make sure that urgent surgical evaluation is done in patients with acute gastroenteritis who are =65 years and have a white blood cell count =20,000 cells/microL and/or a plasma lactate between 2.2 and 4.9 mEq/L.

eMedinewS Humor

Widow's Future

A woman visits a fortuneteller who tells her, "Prepare yourself to be a widow. Your husband will die a violent and horrible death this year."

Visibly shaken, the woman takes a few deep breaths, steadies her voice and asks, "Will I be acquitted or will they catch me for the crime?"

Twitter of the Day

Dr KK Aggarwal: Do not ignore any diffuse chest pain, diffuse chest pain after the age of 40
Dr Deepak Chopra: Your true self cannot be squeezed into the volume of a body or the span of a lifetime

eMedi Quiz

Brocq's phenomenon is analogous to which clinical sigh in psoriasis

a. olfleck's phenomenon
b. auspitz sigh
c.salmon patch
d.candle wax scales

Yesterday’s Mind Teaser: Which of the following is not a post transcriptional modification of RNA?

1. Splicing.
2. 5' Capping.
3. 3' polyadenylation.
4. Glycosylation.

Answer for yesterday’s Mind Teaser: 4. Glycosylation.

Correct answers received from: Daivadheenam Jella, Tukaram Pagad, Dr Poonam Chablani, Dr Jainendra Upadhyay, Dr Avtar Krishan, Tukaram Pagad

Answer for 15th November Mind Teaser: 2. Corticosteroid.

Correct answers received from: Dr Jainendra Upadhyay, Dr Avtar Krishan.
Send your answer to email

medicolegal update

(Contributed by Dr MC Gupta, Advocate)

Q. Please answer the following questions:

  • Is it medicolegally correct for a pathologist to give an opinion on a laboratory report to the patient or discuss/explain the report if the patient so requests?
  • Can a pathologist, when consulted by the patient, directly advise further pathology investigations on the basis of other pathological reports so as to reduce the time for proper diagnosis/treatment in the interest of the patient (such as: Advising urine culture on finding pus cells in urine)?

A.

  • In response to the first question, we should not be unnecessarily tagged to the word "medico–legal". Your question is simply this "Is it against law for a pathologist to give opinion on a pathological report at the request of the patient?" The answer is obvious. It is not against any law.
  • In response to the second question also the same principle applies. The answer is "the pathologist can advise".
  • Please note that the patient may potentially allege later that the above opinion/advice resulted in damage to him and may claim damages from the pathologist. At that time the pathologist cannot repudiate the claim by saying that no fee was charged for rendering such opinion/advice.
  • A sound legal approach is as follows:
    • It is better for the pathologist to tell the patient that he should discuss the issue with his treating physician or should ask the treating physician to discuss the issue with the pathologist.
    • If any opinion or advice is rendered by the pathologist, he should feel free to charge fee for the same. This would decrease the tendency to seek/give free advice. The system of charging fee would, to some extent, compensate for any compensation for which the pathologist may be held liable later.
medicolegal update
  1. Dear Dr. KK, it is shocking to know that a Judge of High court can make such derogatory remarks against the medical profession in general and against the Doctors in particular. It does not gel with their status; they should refrain from making such remarks in the open court. I suggest this matter be taken up with the president of India so that such remarks are avoided in future. Regards: Ashok Ahooja Sqn.Ldr (Retd)
  2. Sir, Today it has been clear that death is caused as a result of adulterated ciprofloxacin by zinc phosphide performing surgeon is not at fault neither negligent nor commitent . bogus pharma company people have been arrested .. purchasers should also be booked . Government is persistently asking doctors to prescribe generic medicine . how the quality control will be. unfortunately our prime minister has fiven statement in this regard which will bring more persecution of doctors as well as family welfare programme. family welfare programme is still is need of our. Dr Gyan Prakash Aggarwal

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