eMedinewS17th January 2014, Friday

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);
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Low Vitamin D Levels Linked to Fatal CVD

Vitamin D deficiency is much more strongly linked to fatal than nonfatal CV events (27% increased risk), results of a large prospective study by Drs Laura Perna and Ben Schottker, German Cancer Research Center (Heidelberg) suggests. The findings are published in the December issue of the Journal of Clinical Endocrinology and Metabolism.

The population–based cohort study enrolled 9949 adults aged 50 to 74 years recruited during regular health check–ups at primary–care practices in 2000 to 2002. There were more women than men (59% vs 41%); most participants (59%) had inadequate vitamin D levels (<50 nmol/L). Blood samples were collected at baseline, five, and eight years, reports Medscape Cardiology.

Mean follow–up was 9.2 years for mortality and 6.5 years for the end points of CVD, CHD, and stroke. A total of 854 patients had a nonfatal CVD event, 176 had a fatal CVD event, 460 had a nonfatal CHD event, 79 had a fatal CHD event, 313 had a nonfatal stroke, and 41 had a fatal stroke. Overall, the proportion of individuals who had no events was significantly lower among those with vitamin D deficiency.

Even after adjustment for other potential confounders, including smoking and physical activity, vitamin D deficiency still conferred a significant 27% increased risk for total CVD, and a 62% increased risk for fatal CVD.

There was no association between vitamin D deficiency and nonfatal CVD events. Individuals with low vitamin D levels also had a significant 36% increased risk of total CHD and a nonsignificant 33% increased risk of total stroke.

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."

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Ringtone – CPR 10 Mantra Hindi
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Shiksha and Sabhyata

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Suno, Samjho, Jaano and Karo is the mantra for education and involves not only hearing but listening and understanding and converting understanding into wisdom by doing it practically.

One of the components of education is etiquettes or manners which can be at every level of education. In older era, Rajkumars or princes were sent to Gurukuls for formal education including that of warriorship. They were also sent to Gharanas/Kothas to learn tehzeeb the Lucknawi way where they were taught how to talk to each other and respect others. Their language in typically Lucknawi style used to be ‘we’ oriented and not ‘I’ oriented. Today’s education is more oriented towards ‘I–ness’ or ego and not towards the soul or respect.

In our student days, we were taught that a senior is a senior and needs to be respected. Even today, when we meet our teachers, we take blessings by touching their feet but today’s students believe in shaking hands or saying ‘hi’. There is more and more commercial touch in the teacher–student relationship of today.

Ego makes one rude and arrogant with a mentality full of Rajas and Tamas. Road rage, gang rapes, murders, violence, terrorism are all examples of not learning etiquettes at the right time.

cardiology news

Positive thinking

Jerry was the kind of guy you love to hate. He was always in a good mood and always had something positive to say. When someone would ask him how he was doing, he would reply, "If I were any better, I would be twins!"

He was a unique manager because he had several waiters who had followed him around from restaurant to restaurant. The reason the waiters followed Jerry was because of his attitude. He was a natural motivator. If an employee was having a bad day, Jerry was there telling the employee how to look on the positive side of the situation.

Seeing this style really made me curious, so one day I went up to Jerry and asked him, "I don’t get it! You can’t be a positive person all of the time. How do you do it?" Jerry replied, "Each morning I wake up and say to myself, Jerry, you have two choices today. You can choose to be in a good mood or you can choose to be in a bad mood.’ I choose to be in a good mood. Each time something bad happens, I can choose to be a victim or I can choose to learn from it. I choose to learn from it. Every time someone comes to me complaining, I can choose to accept their complaining or I can point out the positive side of life. I choose the positive side of life." "Yeah, right, it’s not that easy," I protested.

"Yes it is," Jerry said. "Life is all about choices. When you cut away all the junk, every situation is a choice. You choose how you react to situations. You choose how people will affect your mood. You choose to be in a good mood or bad mood. The bottom line: It’s your choice how you live life."

I reflected on what Jerry said. Soon thereafter, I left the restaurant industry to start my own business. We lost touch, but often thought about him when I made a choice about life instead of reacting to it. Several years later, I heard that Jerry did something you are never supposed to do in a restaurant business: he left the back door open one morning and was held up at gunpoint by three armed robbers. While trying to open the safe, his hand, shaking from nervousness, slipped off the combination. The robbers panicked and shot him. Luckily, Jerry was found relatively quickly and rushed to the local trauma center. After 18 hours of surgery and weeks of intensive care, Jerry was released from the hospital with fragments of the bullets still in his body. I saw Jerry about six months after the accident. When I asked him how he was, he replied, "If I were any better, I’d be twins. Wanna see my scars?"

I declined to see his wounds, but did ask him what had gone through his mind as the robbery took place. "The first thing that went through my mind was that I should have locked the back door," Jerry replied. "Then, as I lay on the floor, I remembered that I had two choices: I could choose to live, or I could choose to die. I chose to live."

"Weren’t you scared? Did you lose consciousness?" I asked. Jerry continued, "The paramedics were great. They kept telling me I was going to be fine. But when they wheeled me into the emergency room and I saw the expressions on the faces of the doctors and nurses, I got really scared. In their eyes, I read, ‘He’s a dead man.’ I knew I needed to take action."

"What did you do?" I asked.

"Well, there was a big, burly nurse shouting questions at me," said Jerry. "She asked if I was allergic to anything. ‘Yes,’ I replied. The doctors and nurses stopped working as they waited for my reply… I took a deep breath and yelled, ‘Bullets!’ Over their laughter, I told them, ‘I am choosing to live. Operate on me as if I am alive, not dead."

Jerry lived thanks to the skill of his doctors, but also because of his amazing attitude. I learned from him that every day we have the choice to live fully. Attitude, after all, is everything.

News Around The Globe

News

  • A study by investigators from the Johns Hopkins Children’s Center and Byramjee Jeejeebhoy Government Medical College in India reveals high prevalence of tuberculosis (TB) infection among young children, troubling rates of disseminated disease and alarming patterns of drug resistance, reports TOI, Jan 15, 2014. The study’s findings, published online in the open–access journal BioMed Research International, raise important questions about the direction of current research efforts, health resource allocation and the diagnosis and treatment of infected children in India and around the world, the researchers say.
  • Middle–age men who averaged three or more drinks daily showed faster 10–year declines in cognitive function than did lighter drinkers, but the same effect was not seen in women, researchers reported online in Neurology.
  • Patients who survive traumatic brain injury (TBI), particularly those with comorbid psychiatric and substance abuse problems, have about a 3–fold higher risk of dying prematurely, particularly from injury, assault, and suicide, new research shows. TBI patients with psychiatric disorders are particularly vulnerable, report Seena Fazel, MD, of the University of Oxford, United Kingdom, and colleagues in JAMA Psychiatry.
  • The more "walkable" an area, the less likely its residents are to be overweight/obese or to have diabetes, a new study conducted in Toronto has found. Results from the research, which also sought to determine the best measures of "walkability" for public policy purposes, were published online January 14 in PLOS One by Richard H. Glazier, MD, from St. Michael’s Hospital, Toronto, Ontario, and colleagues.
  • In a January 8 online report in JAMA Dermatology, researchers from the US have cautioned Ultrapulsed, fractionated CO2 laser therapy for hypertrophic scars in a patient previously treated with silver–impregnated dressings led to worsening pigmentation and dystrophic calcification. The authors suggest that a history of argyria or silver–impregnated dressing use be considered before treatment of hypertrophic scarring with the fractionated, ultrapulsed CO2 laser.

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)

What precautions should be taken while vaccinating by the ID route?

  • The ID injections must be administered by staff trained in this technique.
  • The Vaccine vials must be stored at +2°C to + 8°C after reconstitution.
  • The total content should be used as soon as possible, but at least within 8 hours.
  • The 0.1 ml. ID administration of cell–culture vaccine should create a wheal of at least 5 mm diameter with "peau de orange" appearance.
  • If ID dose is given subcutaneously then there is a possibility of poor immune response due to low antigen load. This may be life–threatening.
cardiology news

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

  • New research suggests that longer dialysis duration may improve electrocardiographic parameters associated with sudden cardiac arrest, which is the leading cause of death in hemodialysis patients. The ASAIO Journal study found frequent nocturnal hemodialysis was associated with an improvement in Tpeak to Tend within 365 days and past 365 days of dialysis initiation as well as improvement in QRS amplitude variation within 365 days and past 365 days of dialysis initiation.
  • In a study that compared atenolol–based antihypertensive therapy with lisinopril–based therapy in 200 dialysis patients with hypertension and left ventricular hypertrophy, home blood pressure was consistently higher in the lisinopril group despite the need for more antihypertensive agents. The findings are reported in Nephrology Dialysis Transplantation.
cardiology news

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

  • Treatment with the probiotic Lactobacillus reuteri DSM 17938 during the first 3 months of life reduced the likelihood of colic, regurgitation, and functional constipation. In a clinical trial reported in JAMA Pediatrics, prophylactic treatment also reduced the public and private costs of managing these conditions.
  • Risk for intussusception, a common cause of intestinal obstruction in infants and toddlers, is slightly but significantly elevated after vaccination with currently licensed rotavirus vaccines, according to the results of 2 large surveillance studies published online January 14 in the New England Journal of Medicine.
cardiology news

Do I Need Multivitamin Tablets?

  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.
cardiology news

Total CPR since 1st November 2012 – 84073 trained

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Be Alert about Symptoms of Heart Attack

If you aren't sure whether you have heartburn or something more serious –– like a heart attack –– you should get yourself checked out, said 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.

The most common symptom of coronary heart disease is chest pain (angina) or discomfort, which can also occur in the shoulders, arms, neck, jaw or back. People may mistake this pain for indigestion, which can be dangerous. Sometimes, it's impossible to tell the difference between the symptoms of heartburn, angina and heart attack.

A heart attack occurs when the blood supply to part of the heart muscle is severely reduced or stopped. This can result in death or disability, depending on how much of the heart muscle is damaged. Unfortunately, many people may not be aware they are having a heart attack.

There are some useful pointers that might help a person know whether they're having a heart attack or not, but when in doubt, one should check it out.

Symptoms of a heart attack include the sudden onset of tightness, pressure, squeezing, burning or discomfort in the chest, throat, neck or either arm. When these symptoms are accompanied by nausea, vomiting, sweating, shortness of breath or a fainting sensation, Dr. Aggarwal says one should be especially suspicious that you might be having a heart attack. People who have any risk factors that may predispose them to a heart attack should be particularly cautious.

Some clues

  • Heart attack pain is never pinpointed.
  • Heart attack pain never lasts less than 30 seconds.
  • If you smoke, have diabetes, high cholesterol, high blood pressure, are overweight or have a strong family history of heart disease and have any symptom related to the chest or heart, you should be alert.

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."

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CPR 10 training at NDMC Premises

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Obesity reduces life expectancy

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

Thirty–eight children consumed eatables procured from a single source at a picnic party. Twenty children developed abdominal cramps followed by vomiting and watery diarrhea 6–10 hours after the party. The most likely etiology for the outbreak is:

1. Rotavirus infection.
2. Entero–toxigenic E. coli infection
3. Staphylococcal toxin.
4. Clostridium perfringens infection.

Yesterday’s Mind Teaser: 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.

Answer for yesterday’s Mind Teaser: 2. Bilateral cordectomy.

Correct answers received from: Dr Ayyavoo Erode, Dr Raghavendra Singh,
Dr A K Gajjar, Dr K V Sarma, Tukaram Pagad, Dr Monica Gandhi, Dr Arpan Gandhi,
Dr Jainendra Upadhyay, Anil Bairaria, Dr Chandresh Jardosh, Dr Pankaj Agarwal, Dr Sushma Chawla, Dr K Raju, Dr B K Agarwal, Dr Avtar Krishan, Muthumperumal Thirumalpillai, Daivadheenam.

Answer for 14th January Mind Teaser: 2. Oral rehydration therapy.

Correct answers received from: Dr Sushma Chawla, Dr K Raju, Dr B K Agarwal.

Send your answer to ijcp12@gmail.com

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medicolegal update

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Old age secret

Grandpa was celebrating his 100th birthday and everybody complimented him on how athletic and well–preserved he appeared.

"Gentlemen, I will tell you the secret of my success," he cackled. "I have been in the open air day after day for some 75 years now."

The celebrants were impressed and asked how he managed to keep up his rigorous fitness regime.

"Well, you see my wife and I were married 75 years ago. On our wedding night, we made a solemn pledge. Whenever we had a fight, the one who was proved wrong would go outside and take a walk."

medicolegal update

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medicolegal update

Situation: A neonate in an ICU being administered IV calcium exhibits signs of inflammation and necrosis at injection site.
Reaction: Oh my God! Why didn’t you observe the IV site carefully?
Lesson: Make Sure that all hypocalcemic neonates are put on a cardiac monitor while receiving calcium infusions and the IV site is closely observed, because extravasation of calcium can produce severe interstitial necrosis.

medicolegal update

Difficulties increase the nearer we get to the goal. Johann Wolfgang von Goethe

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.

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  1. Dear Sir, very informative news. Regards: Dr Kanak

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