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  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; 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); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

 

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eMedinewS Presents Audio News of the Day

Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Workshop on Stress Management and How to be Happy and Healthy

 
  Editorial …

18th May 2012, Friday

Even 3–4 mm BP reduction matters

Every year, May 17 is dedicated to World Hypertension Day (WHD). The theme for 2012 is Healthy Lifestyle – Healthy Blood Pressure.

If you change the oil in the car regularly, and don’t wait until it’s performing poorly to change it, then why treat the body any differently.

Cardiovascular disease (CVD) is the leading cause of death and hypertension is the most common, reversible risk factor for CVD. High blood pressure goes hand–in–hand with, heart disease, stroke, kidney disease, overweight/obesity and diabetes.

In the United States alone, 7.2 crore people age 20 and older have high blood pressure. Of those with high blood pressure, nearly 30% don’t know they have it, and 65% don’t have it under control. In India, the number is over 10 crore. Worldwide, an estimated 97.2 crore people had hypertension in the year 2000. By 2025, an estimated 156 crore people will have it.

High blood pressure is easily detected and usually controllable.

  • Normal blood pressure is systolic pressure below 120 and diastolic below 80.
  • Hypertension is systolic blood pressure at or above 140 mm Hg and/or diastolic blood pressure at 90 mm Hg or higher.
  • "Pre–hypertension" is systolic pressure of 120–139 mm Hg, and/or diastolic pressure of 80–89 mm Hg. This is the point at which lifestyle changes are recommended to reduce blood pressure.

There are dramatic benefits from small decreases in blood pressure, even in people without hypertension by current definitions.

  • A 3–4 mmHg systolic increase in blood pressure would translate into a 20% higher stroke death rate and a 12% higher death rate from ischemic heart disease.
  • In patients with obesity, diabetes and hyperlipidemia, the impact of these small changes in blood pressure on CVD is even greater.
  • Hypertension does not typically cause a symptom; that’s why it’s called the ‘silent killer. There is a long lag period from the beginning of the problem to the time when patients are aware of the damage it’s caused.
  • One should have their blood pressure checked routinely.
  • One should live a healthy lifestyle to prevent hypertension.
  • One should keep weight in a good range.
  • One should be physically active.
  • One should eat a diet high in fresh fruits and vegetables and low in saturated fat and sodium.
  • One should avoid tobacco at any cost.
  • Those who choose to drink;should do so in moderate amounts (no more than an average of one drink a day for women or two for men).
  • Those who already have high blood pressure, should keep it controlled under a physician’s care.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Even 3–4 mm BP reduction matters

Audio PostCard
 
    Photo Feature (From HCFI Photo Gallery)

World Earth Day organized at DPS Mathura Road

Students of Delhi Public School, Mathura Road presented a beautiful skit, on the occasion of World Earth Day. The event was organized by Heart Care Foundation of India, DPS Mathura Road and Ministry of Earth and Sciences.

 
Dr K K Aggarwal
 
    National News

24% of men above 25 hypertensive

NEW DELHI: As many as 24% men and 22.6% women in India – aged 25 years and above – are suffering from high blood pressure (BP). Over one in 10 men and women aged 25 years and above have high blood sugar. More women in India (2.5% of adults aged 20 years and above) are obese compared to Indian men (1.3%). Almost one in five (19%) boys, aged 13–15 years (adolescents), and 8% girls smoke tobacco. Among those aged 15 years and above, the prevalence of tobacco consumption is 26% among males and 4% among women. Only 23% men (aged between 15 and 49 years) used condoms during high risk sex between 2005 and 2010, while only 36% men aged 15–24 and 20% women have a comprehensive correct knowledge about HIV. The World Health Statistics 2012 released on Wednesday by the World Health Organization (WHO) point out to worrying trends for Indians. For the first time, the report includes information from 194 countries on the percentage of men and women with raised blood pressure and blood glucose levels. One in three adults worldwide, according to the report, has raised blood pressure – a condition that causes around half of all deaths from stroke and heart disease. One in 10 adults has diabetes. Left untreated, diabetes can lead to cardiovascular disease, blindness and kidney failure, it said. "This report is further evidence of the dramatic increase in the conditions that trigger heart disease and other chronic illnesses, particularly in low and middle–income countries," said Dr Margaret Chan, director–general of WHO. (Source: TOI, May 17, 2012)

For comments and archives

Oral cancer big killer in Central India: Study

NAGPUR: The five biggest killers in Central India are cancers of mouth, breast, cervix, lungs and stomach, in that order, according to the observations of city–based RST Regional Cancer Hospital. One would imagine better facilities would bring down the incidence as well as the mortality associated with cancer. Numbers, however, tell a sad story. 2011 has seen a steep rise in deaths caused by the disease. According to the registries of the patients in the region, 25% of the patients suffered from oral cancer, while a little more than 12% had breast or cervical cancer. The number of people suffering from lung cancer has seen a rise with around 7% cancer patients suffering from it, followed by stomach cancer that affected more than 6% of the patients. According to the ICMR report, based on data collected from 27 cancer registries including RST Regional Cancer Hospital, there were 9.8 lakh new cancer cases in the country in 2011. (Source: TOI, May 14, 2012)

For comments and archives

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology: Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Guidance for young people with Wolff–Parkinson–White syndrome

A "first–of–its–kind" consensus statement on the management of asymptomatic patients with Wolff–Parkinson-White (WPW) syndrome should help clarify which young people should undergo catheter ablation, authors of the document say. "While it is a small chance that an asymptomatic young person could end up having a life–threatening heart event, the number is not zero," lead author on the statement, Dr Mitchell I Cohen (Phoenix Children’s Hospital, AZ), said in a press statement. "Yet, catheter ablation for every child who has ever had a WPW pattern is also not the answer." Cohen and colleagues released the statement last Friday at the Heart Rhythm Society (HRS) 2012 Scientific Sessions. The guidance is explicitly directed at physicians treating young patients with WPW and defines young people as between eight and 21. At the crux of the document is the question of just when physicians should intervene — and when they shouldn’t — in young people found, on ECGs, to have the signature electrocardiographic WPW pattern. These are increasingly important questions, given increased emphasis on preparticipation screening for sports in young people. (Source: Medscape)

For comments and archives

Aspirin response in PAD predicts long–term risk

Patients with peripheral artery disease (PAD) who are resistant to aspirin therapy have a higher long–term risk of cardiovascular events than those who respond to aspirin, researchers reported at the Society for Cardiovascular Angiography and Interventions (SCAI) meeting. (Source: Medpage Today)

For comments and archives

Low back pain eases but doesn't vanish

Symptoms of acute and persistent low back pain improved significantly in the first 6 weeks after treatment, but even at 1 year there was lingering chronic pain and disability, a major meta–analysis by Australian and Brazilian researchers found. (Source: Medpage Today)

For comments and archives

FAME II: FFR pinpoints stable CAD patients who fare worse with OMT

Patients with stable coronary artery disease (CAD) in whom fractional flow reserve (FFR) identifies at least one "hemodynamically significant" stenosis face more than a 10–times–higher risk of urgent revascularization if they are initially treated with optimal medical therapy (OMT) rather than PCI. That difference in urgent revascularizations was what led to the premature halting of FAME II last fall. (Source: Medscape)

For comments and archives

Irritable bowel syndrome: new dietary guidelines

The British Dietetic Association (BDA) has issued evidence–based guidelines for the dietary management of irritable bowel syndrome (IBS) in adults. The new recommendations were published online April 10 and in the June print issue of the Journal of Human Nutrition and Dietetics. On the basis of their comprehensive literature search and critical appraisal of 30 studies, the group developed evidence statements, clinical recommendations, good practice points, and research recommendations. The resulting dietetic care pathway followed a logical sequence of treatment, including 3 lines of dietary management: (Source: Medscape)

  • First–line dietary management: clinical and dietary evaluation and healthy eating and lifestyle management, with some general advice on lactose and NSP.
  • Second–line dietary management: Advanced dietary interventions to alleviate symptoms resulting from NSP and fermentable carbohydrates, and use of probiotics.
  • Third–line dietary management: Elimination and empirical diets.

For comments and archives

 
   Twitter of the Day

@DrKKAggarwal: I uploaded a @YouTube video http://youtu.be/ZS6_l8kpjWk?a anand mohan

@DeepakChopra: Experiences in consciousness recycle themselves as persons

 
    Spiritual Update

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

Lotus – Detached Attachment

When Swami Chinmayananda was alive, he used to be a patient of my guru Late Dr. (Col.) K.L. Chopra and I happened to do all his echocardiograms in the last few years of his life.

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the benefits of minimally invasive surgery?

An obvious benefit of minimally invasive surgery is that any scars are much smaller than in traditional "open" surgery. A laparoscopy requires one incision below the belly button, then one to three other incisions along the hairline of your lower belly. These incisions are usually 1/4–1/2 inch in length. Hysteroscopy leaves no scar because the instrument goes through the natural opening in the cervix (neck of the womb) from the vagina into the uterus.

After your minimally invasive surgery, you probably will be able to go home within 24 hours. If you have open surgery, you may have to stay in the hospital for 2 to 5 days. With minimally invasive surgery, you can recover at home, and you are less likely to have problems after surgery, such as infection or blood clots in your legs. Because your incisions are smaller, minimally invasive surgery is less painful than open surgery.

For comments and archives

 
    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Cryoprecipitate

Description

  • Prepared from fresh frozen plasma by collecting the cold insoluble precipitate formed during controlled thawing at +4°C and resuspending it in 10–20 ml plasma.
  • Contains about half of the factor VIII and fibrinogen in the donated whole blood: e.g. factor VIII; 80–100 IU/pack; fibrinogen: 150–300 mg/pack

Unit of issue: Usually supplied as a single donor pack or a pack of 6 or more single donor units that have been pooled

Infection risk: As for plasma, but a normal adult dose involves at least 6 donor exposure

Storage: At –25°C or colder for up to 1 year Indications

  • As an alternative to factor (von willebrand’s disease)
  • Factor VIII (hemophilia A)
  • Factor XII
  • As a source of fibrinogen in acquired coagulopathies; e.g. disseminated intravascular coagulation (DIC)

Administration

  • If possible, use ABO–compatible product
  • No compatibility testing required
  • After thawing, infuse as soon as possible through a standard blood administration set
  • Must be infused within 6 hours of thawing

For comments and archives

 
   An Inspirational Story

(Ms Ritu Sinha)

Just a little smile

Mark was walking home from school one day when he noticed the boy ahead of him had tripped and dropped all of the books he was carrying, along with two sweaters, a baseball bat, a glove and a small tape recorder. Mark knelt down and helped the boy pick up the scattered articles.

Since they were going the same way, he helped to carry part of the burden. As they walked Mark discovered the boy’s name was Bill, that he loved video games, baseball and history, and that he was having lots of trouble with his other subjects and that he had just broken up with his girlfriend.

They arrived at Bill's home first and Mark was invited in for a Coke and to watch some television. The afternoon passed pleasantly with a few laughs and some shared small talk, then Mark went home. They continued to see each other around school, had lunch together once or twice, and then both graduated from junior high school. They ended up in the same high school where they had brief contacts over the years.

Finally the long awaited senior year came and three weeks before graduation, Bill asked Mark if they could talk. Bill reminded him of the day years ago when they had first met.

"Did you ever wonder why I was carrying so many things home that day?" asked Bill. "You see, I cleaned out my locker because I didn’t want to leave a mess for anyone else. I had stored away some of my mother’s sleeping pills and I was going home to commit suicide. But after we spent some time together talking and laughing, I realized that if I had killed myself, I would have missed that time and so many others that might follow. So you see, Mark, when you picked up those books that day, you did a lot more. You saved my life."

For comments and archives

 
   Cardiology eMedinewS

Postorthopedic anticoagulation a double-edged sword Read More

 
   Pediatric eMedinewS

Lights on or off for pediatric red reflex exam? Read More

Oral, topical combo calms itch, rash of eczema Read More

Kids TV time tied to unhealthy food choices Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: An elderly male had reduced sleep efficiency.
Dr Bad: Take a sleeping pill.
Dr Good: Get diabetes ruled out.
Lesson: Sleep duration is a risk factor for the development of diabetes in middle–aged and elderly men. Both short i.e. < 5–6 hours of sleep per night and long i.e. >8 hours of sleep per night, sleep durations were associated with an increased incidence of diabetes (Diabetes Care 2006;29:657–61).

For comments and archives

Make Sure

Situation: A patient with platelet counts of 72000 after coronary stent developed stent thrombosis.
Reaction: Oh my God! Why was clopidogrel not given?
Lesson: Make sure all patients with platelet counts of more than 30000 are not denied clopidogrel.

For comments and archives

 
    Legal Question of the day

(Prof. M C Gupta, Advocate & Medico–legal Consultant)

Q. Can a SMC go ahead with the scheme of re–registration every 5 years even though there is no such provision in the IMC Act, 1956?

Ans.

  1. Registration of medical practitioners is the function of the SMC, not the MCI, which only maintains the IMR on the basis of information received from the SMC. Re–registration is, accordingly, done by the SMC and does not need an amendment of the IMC Act. Re–registration every 5 years is already being done by some SMCs, such as in Punjab and Delhi.
  2. Please note that re–registration need not imply that earlier registration automatically stands cancelled. Such cancellation has to be done as per the procedure prescribed in the SMC Act.

For comments and archives

 
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  Quote of the Day

(Dr GM Singh)

We are what we think. All that we are arises with our thoughts. With our thoughts, we make the world. Buddha

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum magnesium

Magnesium levels may be used to monitor pre–eclampsia patients being treated with magnesium sulfate, although in most cases monitoring clinical signs (respiratory rate and deep tendon reflexes) is adequate and blood magnesium levels may not be required.

 
    Mind Teaser

Read this…………………

Which of the following represents a significant risk immediately after surgery for repair of aortic aneurysm?

a. Potential wound infection
b. Potential ineffective coping
c. Potential electrolyte balance
d. Potential alteration in renal perfusion

Yesterday’s Mind Teaser: The following are lipid abnormalities. Which of the following is a risk factor for the development of atherosclerosis and PVD?

a. High levels of low density lipid (LDL) cholesterol
b. High levels of high density lipid (HDL) cholesterol
c. Low concentration triglycerides
d. Low levels of LDL cholesterol

Answer for yesterday’s Mind Teaser: a. High levels of low density lipid (LDL) cholesterol

Correct answers received from: Dr Thakor Hitendrsinh G, Dr P C Das, Dr. Sushma Chawla, Mannalal Bhansali, Kanta Jain, Dr Chandresh Jardosh, Dr Avtar Krishan, Muthumperumal Thirumalpillai, Raju Kuppusamy, Dr KV Sarma, Dr Jainendra Upadhyay, Dr Valluri Ramarao, Anil Bairaria, Dr L C Dhoka,

Answer for 15th May Mind Teaser: c. Headache
Correct answers received from:Yogindra Vasavada, Dr P C Das, Dr B Rajammal, Dr L C Dhoka

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Kidneys and Livers

Two old men were arguing the merits of their doctors. The first one said, "I don’t trust your fancy doctor. He treated old Jake Waxman for a kidney ailment for nearly a year, and then Jake died of a liver ailment."

"So what makes you think your doctor is any better?" asked his friend.

"Because when my doctor treats you for a kidney ailment, you can be sure you’ll die of a kidney ailment."

 
    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

What is the Native American Graves Protection and Repatriation Act 1990?

Doctors and scientists have long sought to understand life in early civilizations through the excavation of burial grounds and exhumation of human remains. In the United States, the attempt to understand early cultures led to the exhumation of the remains of Native Americans, many of which ended up in the nation’s museums and archaeology labs. In an attempt to prevent the desecration of Native American graves, the Native American Graves Protection and Repatriation Act was introduced in Congress in July 1990 and subsequently passed into law.

  • The bill states that any human remains and objects found on federal or tribal lands after the date of enactment are to be considered owned or controlled by lineal descendants, the tribe on whose land it was found, the tribe having the closest cultural affiliation, or the tribe which aboriginals occupied the area. Anyone who discovers items covered by the bill must cease his or her activity, notify the federal land manager responsible and the appropriate tribe, and make a reasonable effort to protect the items.
  • Anyone who violates the provisions of the bill may be fined, imprisoned not more than one year, or both. The penalty may increase to five years for a second violation.
  • The act further states that all federal agencies and museums receiving federal funds that have control over any of the items covered in the bill are to, within five years, inventory and identify the items, notify the affected tribes, and make arrangements to return such items if the appropriate tribe made a request. If an item was acquired with the consent of the tribe or if the item was part of a scientific study which was expected to be of major benefit to the country, the request for repatriation (i.e., return) could be denied.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Avoid curd at night

It is an old Ayurveda saying that one should not eat curd in the night. In all pathy consensus organized by Heart Care Foundation of India in association with All India Radio in a panel discussion, experts felt that one should not consume fermented foods alone after sunset. Items like Dosa, Idali, Dhokla etc. should not be eaten after the sunset.

The programme was moderated by Padmashri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal. The experts were Dr.Anupam Sethi & Dr Aditya Kaushik from Homeopathy, Dr. B N Sinha from Ayurved, Dr. Shakir Jamil from Unani and Dr S N Yadav from Naturopathy.The experts further said that even alcohol is an evening drink and evening means before sunset. Studies all over the world which shows beneficial effects of alcohol when alcohol is served between 4pm to 6 pm. The all pathy experts further said that food of plant in origin contains no cholesterol and balanced diet comprises of seven colours and six tastes.

The experts further said that anything which is bitter and green has antidiabetic and antiobesity features.

 
    Readers Response
  1. Dear Sir, emedinews consists useful informations. Regards Dr JP Singh
 
    Forthcoming Events
Dr K K Aggarwal

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM
Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001
http://www.heartcarefoundation.org

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

 
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Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Dr Usha K Baveja