eMedinewS 17th August 2013, Saturday

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; 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

What’s new in medicine

  1. Added sugar proves toxic in mice: When mice ate a diet of 25% extra sugar, which for a healthy human diet equates to an extra three cans of soda daily
    • Females died at twice the normal rate over 32 weeks.
    • Males were a quarter less likely to hold territory.
    • Males also produced 25% fewer offspring than control males
    • Females had higher reproduction rates than controls initially but then had lower rates as the study progressed.

      The findings are published in Nature Communications.
  2. Surgeons implant lab–grown blood vessel into dialysis patient: Researchers have developed a bioengineered blood vessel and successfully implanted it into the arm of a dialysis patient, as per Duke Medicine. The procedure was part of a 20–patient phase I trial designed to test the vessel’s safety. The new vein is an off–the–shelf product with no biological properties that might cause rejection. Investigators engineered it by cultivating donated human cells on a tubular scaffold to form a vessel. They then cleansed the vessel of the qualities that might trigger an immune response. In preclinical tests, the veins have performed better than other synthetic and animal–based implants.
  3. Eating a healthy diet and drinking a moderate amount of alcohol may be associated with decreased risk or progression of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus, according to a report published by JAMA Internal Medicine
  4. Performance anxiety: A person may become so worried about sexual performance that sex is not enjoyable, or even possible. Performance anxiety becomes more common for both men and women as they move into their 50s.

….Read More

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 10x10 i.e. 100 per minute."

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

Ringtone – CPR 10 Mantra English

sprritual blog Should there be a mourning room in the hospital?

In a survey conducted by Heart Care Foundation of India of 400 people from all walks of life, 90% of the people wanted that wishes of the dying person and dead body should be respected in the hospital setting. They said that doctors should be more compassionate and emphatic at the time of declaring a patient dead.

Unless people are expecting a death, death usually comes as a shock to the family members. It is expected that the relations may be in agony, pain and even anger. Every hospital should have a mourning room where relations should be made to sit, counseled and death declared.

After the death is declared, the treating doctors, nurses and hospital staff must sit with the patient’s relations, counsel them, tell them about the sequence of what happened before death and also counsel them about how to handle dead body. People also want to know the cause of death so that similar thing may not happen to another person in the family.

They also want to know if the body is infectious or not and what rituals should not be done if the body is infectious. They also like to know about how to preserve the dead body till cremation.

They also may like to know whether a postmortem is required to know exact cause of death, which can help future family members of the family. ….Read More

cardiology news

True Treasure

My daughter saw a colorful rainbow the other day after a thunderstorm. She called to me to look out the window and see it as well. Looking at it I was amazed at how its beauty could still uplift my middle–aged heart. As I gazed upon it, I also remembered one of the very first times I ever saw a rainbow as a boy.

I had been sitting in the house for an hour waiting impatiently for the rain to stop so I could go out and play. It had been pounding on the roof incessantly and I thought it would never end. When it finally did stop I raced outside and was greeted with the glorious sight of a rainbow curving across the sky. I had just recently heard the old legend of leprechauns hiding a pot of gold at the end of a rainbow. Excited, I looked to where the rainbow seemed to be touching the ground in the far distance. I started to quickly run down the railroad tracks near our house in search of that elusive treasure. The quicker I ran, though, the more the rainbow began to fade. Finally, I found myself running as fast as I possibly could, but it was too late. By the time I got there the rainbow and its pot of gold were gone.

Sadly that wasn’t the last time I found myself chasing after false treasure. Over the years I ran after fame, success, money, and even relationships that I thought would bring me the happiness I always wanted. None of them did, however. It took me a long time to find the true treasure that doesn’t rust, break, fade, or flee. That treasure is the love of God and it is free to all. I welcomed this treasure into my heart, soul, and life and shared it with others as well. The funny thing too was that the more love I gave away, the more love I had within me.

God loves you so much. He is forever ready to light up your life with the rainbow of His love. Accept His treasure with joy, share it with everyone, and grow richer everyday. Read More

News Around The Globe

  • 9th International Convention 2013
    To celebrate the excellence of our esteemed fraternity of insurance professionals a grand ‘9th International Convention 2013’ is organized by Indian Institute of Excellence & Consultancy Pvt. Ltd. (IIOE) in Mumbai. Dr KK Aggarwal has been invited as a GUEST SPEAKER at the inaugural function.

  • Inaugurating a three days’ Advance Skill Training in Echocardiography organized by JROP Institute of Echocardiography, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that all echo cardiographers who are not doing fetal echo and who are not sharing their machines with ultrasonologists, should be spared from the PNDT Act. Quoting a Kerala High Court Judgment, Dr. Aggarwal said that echo cardiographer should submit an affidavit with the local PNDT Department that their centre is only an echocardiography centre and they do not do any obstetric ultrasounds work.
    Others who were present on the occasion were Dr. Rakesh Gupta; Dr. SK Parashar, Past President, Cardiological Society of India; Dr.HK Chopra, President (Elect) Cardiological Society of India, Dr. R. Alagesan from Chennai and Dr. RV Singh, President, IMA Delhi North Zone was the Guest of Honour.

  • Damage to the retina from high blood pressure independently points towards elevated paralysis risk even if blood pressure is controlled, as per a study published in October issue of the journal Hypertension. Moderating hypertensive retinopathy was associated with 2.37 fold elevated likelihood of paralysis over 13 years of follow up.

  • CDC’s 8 ways to deal with antibiotic resistance. Pharmaceutical companies are no longer developing new antibiotics because they cannot break even. The last new antibiotic class for gram-negative bacteria was quinolones developed four decades ago. Possible ways are: (i) collect data, (ii) stop antibiotic use in the farms (iii) use antibiotic judiciously (iv) stop inappropriate antibiotic use in outpatients (v) adopt rapid diagnostic tests (vi) develop new drugs (vii) integrated antibiotic resistance initiatives into health care reforms and (viii) create a plan for your own country.

  • 2D strain and Echo tracking appears to improve early identification of myocardial changes in patient with beta thalassemia major, according to Dr. BK Khandheria.

  • You are a specialist later, an internist or family physician first. When every investigation fails in a patient what does one do? The answer is examining the patient. Quite often with availability of increasing technology we are moving away from taking proper history and doing proper physical examination. There was a time when Indian doctors were preferred in U.S. because they were thorough in their physical examination but over the last one decade we have seen the rest are picking up the art of physical examination and we are depending more and more on the technology.
  • Venous thromboembolism (VTE) prophylaxis should be considered for rheumatoid arthritis (RA) patients who are facing additional risk factors, such as surgery or hospitalization. In a study from Taiwan published online August 7 in the Annals of the Rheumatic Diseases, RA was associated with a significantly increased risk for potentially fatal blood clots in the legs and lung.

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Rabies News (Dr. A K Gupta)

When is World Rabies Day observed?

"World Rabies Day" is on 28th September.

cardiology news
  • Inclusion of the ankle–brachial index (ABI) may better define the presence of vascular disease in patients with nonvalvular atrial fibrillation. The established CHA2DS2–VASc risk score tagged 17.3% of patients with vascular disease, a figure that increased to 33% when information on ABIs of 0.90 or lower was added. According to Francesco Violi, MD, of Sapienza University of Rome, and colleagues. "If ABI ≤0.90 was encompassed in the definition of vascular disease of CHA2DS2–VASc score (documented by a history of acute myocardial infarction (MI), symptomatic peripheral, or detection of atherosclerotic plaque in the aortic arch], the prevalence of vascular disease increased in every risk class". (JAMA)
  • Coronary obstruction does not occur frequently after transcatheter aortic valve implantation (TAVI), but it can be a deadly complication, a multicenter registry showed. Of 6,688 patients who underwent the procedure, only 44 (0.66%) developed symptoms from an obstructed coronary artery, according to Josep Rodes–Cabau, MD, of Laval University in Quebec City, and colleagues. Percutaneous coronary intervention was attempted in most of the coronary obstruction cases –– and carried an 81.8% success rate –– but outcomes remained poor, with a 30–day mortality rate of 40.9%, the researchers reported online in the Journal of the American College of Cardiology.

Valvular Heart Disease News

Mitral stenosis remains a valvular disease of predominantly young people, and rheumatic fever remains the leading cause of mitral stenosis in all age groups.

(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
  • The use of nasal intermittent positive–pressure ventilation (IPPV) shows no significant improvement over nasal continuous positive airway pressure (CPAP) as a noninvasive ventilation strategy for vulnerable preterm infants, according to research published in the August 15 issue of the New England Journal of Medicine. No significant difference between nasal IPPV and nasal CPAP in the risk of death or survival with bronchopulmonary dysplasia were observed overall, nor were there significant differences according to birth–weight stratum or prior intubation status. (Source: Medscape)
  • Childhood obesity not only increases the risk of cardiovascular disease in later life but also is linked to cardiovascular damage before adulthood, according to a review of evidence published in the Journal of the American College of Cardiology by Angela Devlin, PhD, and colleagues at the University of British Columbia in Vancouver. Clinical evidence is accumulating to suggest that the cardiovascular damage, once only observed in adults, is also occurring in obese children. (Source: Medpage Today)
cardiology news

Test blood sugar in all hospitalized patients

Hyperglycemia in hospitalized patients is associated with a greater risk for complications, as reported by Umpierrez and colleagues issue of the Journal of Clinical Endocrinology & Metabolism.

  • All patients, independent of a prior diagnosis of diabetes, should undergo blood glucose testing on admission.
  • Hyperglycemia is linked to prolonged hospital stay, increased incidence of infections and death in non–critically ill hospitalized patients.
  • Hyperglycemia affects 32–38% of patients in community hospitals and is not restricted to individuals with a history of diabetes.
  • Better blood sugar control is associated with fewer hospital complications in general medicine and surgery patients.
  • All diabetics or individuals with hyperglycemia (glucose > 140 mg/dL) should have an A1c test, if not tested in last 2 or 3 months.
  • For most hospitalized patients with noncritical illness, the pre meal glucose target is less than 140 mg/dL and the target for a random blood glucose level is less than 180 mg/dL.
  • Anti diabetic treatment should be re–evaluated when glucose levels drop below 100 mg/dL and should be modified if glucose levels are below 70 mg/dL.
  • Go for tighter control of blood sugar in patients not prone to hypoglycemia.
  • Opt for a higher target range (200 mg/dL) for patients with terminal illness or limited life expectancy, or who are at high risk for hypoglycemia.
  • Patients with diabetes who receive insulin at home should receive a scheduled regimen of subcutaneous insulin during hospitalization.
  • To prevent perioperative hyperglycemia, all patients with type 1 diabetes and most patients with type 2 diabetes who undergo surgery, should be treated with intravenous continuous insulin infusion or subcutaneous basal insulin with as–needed bolus insulin.
  • All patients with high glucose values (140 mg/dL) on admission, and all patients receiving enteral or parenteral nutrition, should be monitored with bedside capillary point–of–care glucose testing, independent of diabetes history.
  • At least 1 to 2 hours before intravenous continuous insulin infusion is discontinued, all patients with type 1 and type 2 diabetes should be transitioned to scheduled subcutaneous insulin therapy.

(Source: The Clinical Guidelines Subcommittee of The Endocrine Society, American Diabetes Association, the American Heart Association, the American Association of Diabetes Education, the European Society of Endocrinology, and the Society of Hospital Medicine, January 2012 issue of the Journal of Clinical Endocrinology & Metabolism)

cardiology news

The effect of viewing violence depends upon the amount, the context in which it is seen, and the social message that accompanies the presentation. Televised violence differs from real violence in ways that affect its impact on children and adolescents. Media violence often is perceived as socially acceptable and without consequence.

cardiology news

Total CPR since 1st November 2012 – 61668 trained

14th August: CPR 10 at Modern School, Noida (2000)

CPR Classes 61668

Video Chats and uploads

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News JULY

Media advocacy through Print Media

sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping

Media advocacy through Web Media

Birth defects linked to mother's use of cold medicines. 14 August


ACE inhibitors can reduce dementia progression 13Th Aug


Avoid food poisoning by thorough washing and proper cooking

With thorough washing and proper cooking of fruits and vegetables one can eliminate most bacteria that cause food poisoning, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Food-borne illnesses or food poisoning usually comes from eating food tainted with bacteria or their toxins. Virus and parasites can also be behind the food poisoning. People have long known that raw meat, poultry and eggs can also harbor disease–causing microbes. But in recent years most outbreaks of food–borne illnesses are due to fresh fruits and vegetables.

Food poisoning can cause abdominal pain, nausea, headache, fatigue, vomiting, diarrhea and dehydration. Symptoms may appear several hours to several days after eating tainted food. For example, Salmonella bacteria will cause illness 12 hours to 3 days after ingestion lasting about 4–7 days. The most common way to treat food poisoning is to drink plenty of fluids. The sickness usually subsides within a few days.

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 61668 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

Heart Care Foundation of India Organizes a CPR 10 Training camp at Balwant Rai Mehta School, Greater Kailash, Part 2, New Delhi on 2nd August 2013.

press release

Dr KK Aggarwal Speaks on Treatment of CKD

today video of the dayDr KK Aggarwal on Say No to Soft Drinks for Good Health

One more life saved from CPR 10

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

A study of aspirin plus clopidogrel therapy has shown an increase in death, MI and stroke in which patients?

a. Primary prevention
b. Secondary prevention
c. High risk of bleeding
d. a & c

Yesterday’s Mind Teaser: Percutaneous intervention for unprotected left main stenosis is what level of recommendation in the current ACC/AHA guidelines?

a. I
b. IIa
c. IIb
d. III

Answer for yesterday’s Mind Teaser: c. IIb

Correct answers received from: Dr Prakash Khalap, Dr Santhakumari, Dr VP Thakral,
Dr KV Sarma, Dr Chandresh Jardosh, Dr Avtra Krishan, Dr Kanta Jain.

Answer for 15th August Mind Teaser: d. All of the above

Correct answers received from: Dr Avtra Krishan, Dr Kanta Jain.

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

While he was talking to me, his nurse came in and said,
"Doctor, there is a man here who thinks he’s invisible."
The doctor said, "Tell him I can’t see him."

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A 36–year–old truck driver had severe allergic rhinitis and came for treatment.
Reaction: Oh my God, why was he not prescribed azelastine nasal spray?
Lesson: Make sure to avoid oral antihistamines in persons who perform tasks like driving as they may cause sedation and drowsiness; instead prescribe azelastine nasal spray which is effective and non–sedating.

medicolegal update

First we make our habits then our habits make us. John Dryde

medicolegal update

Dr KK Aggarwal: Equipment–related failures common in Operation Theater http://bit.ly/16wknsh #Health

Dr Deepak Chopra: I maintain that the cosmic religious feeling is the strongest noblest motive for scientific research–Einstein http://tinyurl.com/kqlhghj

medicolegal update

Suspension and reinduction of pioglitazone clearly show that policy makers and thinkers about medical sciences as a whole have no idea about medicine.It is irony that inspite of availability of best brains in world of medicine, these policy makers are either bureaucrats or politicians.
dr vivek kumar,varanasi

Forthcoming Events

press release

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medicolegal update

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