eMedinewS17th December 2013, Tuesday

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
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Do not start if you do not drink; if you cannot stop, limit your intake

  • The definition of a standard drink differs in countries: US = 14–15 gm alcohol equivalent to 12 oz beer, 5 oz wine and 1.5 oz 80 proof liquor; UK 8 gm alcohol, Japan 19.75 gm alcohol and India 10 gm alcohol
  • A standard drink usually means a US drink.
  • Alcohol contents: Beer 5%; Malt liquor 7%; Table wine 12%; Fortified wine (sherry, port) 17%; Cordial liquor (aperitif) 24%; Brandy (single jigger) 40% and 80 proof gin, Vodka, whisky 40%
  • 10 ml of alcohol (hard liquor) = 0.8 gm of alcohol
  • 1oz = 30 ml
  • 12 oz of beer = 360 ml of beer (360×5% = 18 ml of alcohol = 14.4 gm of alcohol)
  • 18oz of beer = 8 to 9 oz of malt liquor = 5 oz of table wine = 3–4 oz of 45 wine = 2–3 oz of cordial liquor=1.5 oz of brandy=1.5 oz hard liquor
  • Binge drinking means 4 or more drinks at one time (women) or 5 or more at one time (men)
  • Heavy drinking means more than 7 drinks per week or 3 drinks per occasion (women) or more than 14 drinks per week or 4 drinks per occasion (men).
  • Moderate drinking means less than 2 drinks per day (women) and less than 3 drinks per day (men) and for people aged more than 65, less than two drinks per day
  • Safe limits: No level of alcohol compensation can be 100% safe for some people.
  • Contraindications: Pregnancy, present or strong family history of alcoholism, previous paralysis because of brain hemorrhage, liver disease, pancreas disease, running potentially dangerous equipment or machinery
  • Limit alcohol in acute gastritis, esophagitis, strong family history of breast cancer and pre cancerous GI lesions.
  • Ideal dose of alcohol = 6 gm per day
  • 10–15gm of ethanol is found in one glass of wine, one can or bottle of beer or one mixed drink.
  • One should not take more than two drinks (men), one drink daily (women).
  • Men under the age of 45 may experience more harm than benefit from alcohol consumption.
  • Alcohol benefits for the heart are only in 45+ people.

Finasteride chemoprevention

Inhibition of 5–alpha reductase blocks production of androgens involved in prostate cancer pathogenesis and provides the rationale for the use of finasteride as a chemopreventive agent against prostate cancer.

Results from the Prostate Cancer Prevention Trial have shown that prophylactic use of finasteride for seven years significantly decreased the incidence of prostate cancer compared with placebo.

Additional long–term follow–up of the PCPT trial confirmed the significant decrease in the overall incidence of prostate cancer, which was limited to a reduction in the incidence of low risk disease.

Although an increase in the incidence of high–grade (Gleason score ≥7) prostate cancer remained, there was no difference between the finasteride and placebo groups in overall survival at 15 years.

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."

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

Science behind regrets

sprritual blog

In a US–based study, dying people were asked about their regrets, if any. The top five regrets were:

1. I wish I had the courage to live a life I wanted to live and not what others expected me to live.
2. I wish I had worked harder.
3. I wish I had the courage to express my feelings.
4. I wish I had stayed in touch with my friends.
5. I wish I had let myself to be happier.

Regrets are always based on suppression of emotions or non-fulfillment of desires and needs. These need–based desires can be at the level of physical body, mind, intellect, ego or the soul. Therefore, regrets can be at any of these levels.

I did a survey of 15 of my patients and asked them a simple question that if they come to know that they are going to die in next 24 hours, what would be their biggest regret.

Only one of them, a doctor said that she would have no regrets.

Only one person expressed a physical regret and that was from a Yoga expert who said that her regret was not getting married till that day.

Mental regrets were two.

1. A state trading businessman said, "I wish I could have taken care of my parents."
2. A homeopathic doctor said, "I wish I could have given more time to my family."

Intellectual regrets were three.

1. A lawyer said, "I wish I could have become something in life."
2. A businessman said, "I wish I could have helped more people."
3. A retired revenue inspector said, "I wish had married my younger child."

Egoistic regrets were two.

1. One fashion designer said, "I wish I could have become a singer."
2. A housewife said, "I wish I could have become a dietician."

Spiritual regrets were six.

1. A Consultant Government Liaison officer said, "I wish I could have made my family members happy."
2. A businessman said, "I wish I could have meditated more."
3. A Homeopathic doctor said, "I wish I could have spent more time with my family."
4. A reception executive said, "I wish I could have spent more time with my parents."
5. An entertainment CEO said, "I wish I could have taken my parents for a pilgrimage."
6. A fashion designer said, "I wish I could have worked more for the animals."

In a very popular and successful movie, Kal Ho Na Ho, the hero was to die in the next 40 days. When asked to remember the days of his life, he could not remember 20 ecstatic instances in life. This is what happens with each one of us where we waste all our days and cannot remember more than 50 or 20 of such instances. If we are given 40 days to live and if we live every day ecstatically, we can get inner happiness. Therefore, we should learn to live in the present instead of having a habit of postponing everything we do.

We should learn to prioritize our work and do difficult work first otherwise we will be worrying all the time till that work is over.

I teach my patients that they should practice confession exercise and one of the confessions is to talk about your regrets and take them as challenge and finish before the next Tuesday. When working, there are three things which are to be remembered – passion, profession and fashion. Profession is at the level of mind, ego and spirit.

We should convert our profession in such a manner that it is fashionable and passionate. Passion means working from the heart and profession means working from mind and intellect and fashion means working the same at the level of ego which is based on show–off.

cardiology news

Never leave the mind vacant

An empty mind is the devil’s workshop. All evil actions start in the vacant mind. Keep your mind occupied in something positive, something worthwhile. Actively follow a hobby. Do something that holds your interest. You must decide what you value more: money or peace of mind. Your hobby, like social work or religious work, may not always earn you more money, but you will have a sense of fulfillment and achievement. Even when you are resting physically, occupy yourself in healthy reading or chanting of God’s name.

News Around The Globe

News

  • Indian–origin gynaecologist suspended for misconduct in UK: An Indian origin gynaecologist, accused of groping a patient’s breasts three years ago, has been found guilty of misconduct by a British panel and suspended from practicing medicine for a year. Angamathu Arunkalaivanan was also found guilty of failing to offer a chaperone or make a record of the breast check in the patient’s notes. "The panel accepted that this is an isolated case and that the breast examination was clinically indicated. However, the manner in which you conducted the breast examination on Patient A was clearly sexually motivated," Sandra Sturdy, chair of the Medical Practitioners Tribunal Service panel in Manchester, said this week.

    "Your conduct in undertaking a breast examination…was a serious breach of trust between patient and doctor and amounted to serious misconduct… The panel has found that your actions have brought the medical profession into disrepute, and that you have breached fundamental tenets of the profession." Sturdy said the panel had determined that "the need to uphold proper professional standards and public confidence in the profession would be undermined if a finding of impairment was not made".

    Arunkalaivanan, who qualified as a doctor from the University of Madras in 1988, runs a private practice at BMI Priory Hospital in Birmingham and is employed as an NHS consultant obstetrician and gynaecologist in Birmingham City Hospital. The consultation involving Patient A took place at BMI Edgbaston Hospital in Birmingham in October 2010. "I left the room that day and I just, it just felt so wrong. I could just not get the examination out of my head," Patient A, who cannot be named for legal reasons, told the panel. According to ‘Court News UK’, when she complained to the hospital, the doctor had offered to apologise but she was also told that Indian doctors were trained to carry out breast exams in that way. She made efforts to find out if the way he conducted the examination was how Indian doctors are trained, but was told otherwise by a nurse, the panel heard. The tribunal decided not to strike off Arunkalaivanan from the UK medical register in view of the medical services he can offer to the public (Times of India)
  • The European Food Safety Authority says that the artificial sweetener aspartame is safe at the levels currently used in food and drinks. Aspartame, sold as NutraSweet and Equal, has been used in soft drinks and other low–calorie or sugar–free foods for more than 25 years. The study ruled out a potential risk of aspartame causing damage to genes and causing cancer. It says there is no evidence that the sweetener harms the brain, the nervous system, or affects behavior or mental skills in children or adults.
  • Researchers who studied 256 individuals with CKD for an average of 3.7 years found that physical activity was inversely related to kidney function decline in a graded fashion and to a degree that was stronger than previously reported in the general population. Each 60–minute increment in weekly physical activity was linked with a 0.5% slower decline per year in kidney function in the JASN study.
  • In a cohort study of 1030 adult elective cardiac surgical patients without severe chronic kidney disease and/or previous heart or renal transplant surgery, 5–year risk of death was 26.5% among patients who developed acute kidney injury (AKI) within 5 days of surgery and 12.1% among patients who did not develop AKI. After adjustment, patients with AKI had a 60% increased risk of dying within 5 years. AKI was associated with a statistically insignificant increased risk of myocardial infarction. The findings are published in Critical Care.
  • The US FDA has permitted marketing of the Cerena Transcranial Magnetic Stimulator (TMS; eNeura Therapeutics), the first device approved to relieve pain caused by migraine headache with aura. The device is used by prescription after onset of pain associated with migraine with aura. Using both hands, the patient holds the device to the back of the head and, pressing a button, releases a pulse of magnetic energy that stimulates the occipital cortex, stopping or reducing the pain associated with this type of migraine.
  • In a study in Hepatology, patients with hepatitis C and diabetes when treated with pegylated interferon plus ribavirin had significantly lower cumulative 8–year incidence of end-stage renal disease (1.1% for treated, infected patients versus 9.3% for untreated patients and 3.3% for uninfected patients) and stroke (3.1% versus 5.3% and 6.1%, respectively). There was also a trend toward less acute coronary syndrome (4.1% versus 6.6% and 7.4%, respectively.

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Rabies News (Dr. A K Gupta)

Should modern rabies vaccines meant for use in man be given to animals?

It is advisable to use human vaccines for human use and use the veterinary vaccines for animals.

cardiology news

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

  • In an analysis of over 2700 participants in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study, Dr Michael Miedema (Minneapolis Heart Institute, MN) and colleagues found that the tallest subjects in the study had the least amount of coronary artery calcium (CAC). Their study is published online December 11, 2013 in Circulation: Cardiovascular Imaging.
  • Statins can be used in the elderly, even in those aged above 75 years. Reassurance regarding the cardiovascular benefits of statin therapy in this population group was provided by a new meta–analysis by the international Cholesterol Treatment Trialists’ Collaboration. The meta–analysis included 174,099 participants in 27 major, published, randomized controlled trials with a median follow–up of 4.9 years.
cardiology news

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

  • Vitamin D supplements for pregnant women and their newborns increased the proportion of infants with serum vitamin D levels recommended by the Institute of Medicine (IOM), according to a double-blind, placebo-controlled trial published online December 16 in Pediatrics.
  • Pregnant women, children, and infants should consume only pasteurized milk and milk products, and the sale of raw milk should be banned in the United States, according to a new policy statement from the American Academy of Pediatrics (AAP). The statement was published online December 16 in Pediatrics.
cardiology news

Eating out Tips

  • Curb portions: Always order for one if you are two people and if you are alone set aside some of what is on your plate to bring home.
  • Resist refined carbohydrates.
  • Load your plate with colorful choices at the salad bar with vegetables, fruits and small amounts of lean protein. Skip the creamy and ranch dressings.
  • Choose dishes that are grilled, roasted, steamed, or sautéed.
  • Don’t be afraid to request a salad, vegetables, or fruit instead of starchy side dishes.
  • In non–veg, order only fish or seafood.
  • If you decide to have dessert, share it with your dining companion(s).

(Source Harvard Newsletter)

cardiology news

Total CPR since 1st November 2012 – 80787 trained

Media advocacy through Web Media

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press release

Winter health check–up camp at Tagore Park

A Free Health Check–up Camp was organized by Heart Care Foundation of India in association with Varishth Nagrik Kesari Club. The camp was inaugurated by Mrs. Kiran Chopra, Founder of the club and was conducted by a team lead by Padma Shri and Dr. B C Roy National Awardee Dr. K K Aggarwal, President Heart Care Foundation of India.

Hundreds of patients were provided free consultation and heart check–ups. Interacting with the patients, Dr. K K Aggarwal said that heart attacks and sudden deaths are more common in winters. Therefore, during winters, patients should consult their cardiologist to adjust the dose of drugs they are taking. The Blood Pressure is also 5 mm Hg higher during winters than in the summer.

People also tend to smoke more and consume more alcohol in the winter, which can further aggravate the heart problems.

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 80787 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

A Free Health Check–up Camp was organized by Heart Care Foundation of India in association with Varishth Nagrik Kesari Club on 16th December 2013.

press release

Vegetable and fruits lower chances of getting some cancers

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

Serum total lactate dehydrogenase level will NOT be raised in:

1. Muscle crush injury.
2. Stroke.
3. Myocardial infarction.
4. Hemolysis.

Yesterday’s Mind Teaser: Prevalence of HIV infection in India is:

a.1.8 millon
b.2.3 million
c.4.5 million
d.6.7 million

Answer for yesterday’s Mind Teaser: b.2.3 million

Correct answers received from: Dr. PC Das, Dr. DN Saksena, Dr. VP Thakral,
Dr. Jainendra Upadhyay, Tukaram Pagad, Dr. Bitaan Sen & Dr. Jayashree Sen,
Dr. Chandresh Jardosh, Dr. K Raju, Soni Brijesh, Dr. AK Gajjar, Dr. Thakor Hitendrsinh G.

Answer for 15th December Mind Teaser: 2. Presence of U waves.

Correct answers received from: Dr. Valluri Ramarao, Dr PC Das, Dr. Jainendra Upadhyay, Dr K Raju, Dr Dinesh Narain Saksena.

Send your answer to ijcp12@gmail.com

indianoil
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centralbank
medicolegal update

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medical querymedical query

medicolegal update
medicolegal update

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medicolegal updatemedicolegal update

medicolegal update

Situation: A foreigner with a single loose stool developed sepsis.
Reaction: Oh my God! Why were antibiotics not started in time?
Lesson: Make sure that all foreigners are diagnosed to be suffering from Traveler’s diarrhea even if there is one single loose motion.

medicolegal update

"Science" means simply the aggregate of all the recipes that are always successful. All the rest is literature Paul Valery

medicolegal update

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: No regrets and no anticipation, just this moment fresh and as is.

Forthcoming events

5th eMedinews Revisiting 2013

(a day long single hall medical conference on 2013 happenings, followed by doctors of the year 2013 awards)

Sunday 19th January 2014, Maulana Azad Medical College Auditorium

Dilli Gate Delhi, 10 am-6 pm


Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee President
Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman
Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

5th eMedinewS Revisiting 2013
The 5th eMedinewS–revisiting 2013 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 19th 2014.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2013. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. Lunch will be provided.

Register at: rawat.vandana89@gmail.com/drpawangupta2006@yahoo.com

5th eMedinewS Doctor of the Year Awards
Nominations invited for 5th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2013.

pls send his/her Biodata at: emedinews@gmail.com

medicolegal update
  1. Dear Sir, Thanks a lot for prvoiding the useful information. Regards: Dr Tarun

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