eMedinewS
18th October 2014, Saturday

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

Pediatrics Update

Taper desmopressin rather than abrupt discontinuation

In a multicenter trial involving patients diagnosed with nocturnal enuresis and responding to desmopressin, structured withdrawal of desmopressin (giving one–half the usual dose each day or by giving the usual dose every other day) for two weeks before discontinuation) reduced relapse rates as compared to abrupt withdrawal of the drug. Structured withdrawal was also an independent factor associated with lower initial effective dose and number of wet nights per week.1

Public smoking ban also benefits perinatal and child health

A systematic review and meta-analysis of 11 quasi–experimental observational studies published between 2008-13, involving more than 2·5 million births and 247,168 asthma exacerbations found that smoke–free legislation is associated with considerable decrease in preterm births and hospital admissions for asthma.2

Avoid helmets for infants with positional skull flattening

A randomised controlled trial (HEADS, HElmet therapy Assessment in Deformed Skulls) which randomly assigned infants aged 5–6 months with moderate to severe skull deformation to helmet therapy vs observation found both to be comparable in terms of effectiveness. Because of high prevalence of side effects, and high costs associated with helmet therapy, the authors discourage the use of a helmet as a standard treatment for healthy infants with moderate to severe skull deformation.

References

1.Gökçe MI, Hajiyev P, Süer E, et al. Does structured withdrawal of desmopressin improve relapse rates in patients with monosymptomatic enuresis? J Urol 2014;192(2):530–4.
2.Been JV, Nurmatov UB, Cox B, et al. Effect of smoke–free legislation on perinatal and child health: a systematic review and meta–analysis. Lancet 2014;383(9928):1549–60.
3.van Wijk RM, van Vlimmeren LA, Groothuis–Oudshoorn CG, et al. Helmet therapy in infants with positional skull deformation: randomised controlled trial. BMJ 2014;348:g2741.

7th Asia-Pacific Heart Rhythm Scientific Session New Delhi, India

Digoxin associated with increased all-cause mortality in patients with atrial fibrillation

from the TREAT–AF (The Retrospective Evaluation and Assessment of Therapies in AF) trial, which evaluated mortality in over 120,000 patients show that digoxin was associated with increased risk of death in patients with newly diagnosed AF, independent of drug adherence, kidney function, cardiovascular comorbidities, and concomitant therapies. The findings from the TREAT–AF Study are published in J Am Coll Cardiol 2014;64(7):660-8.

Dr. Mohan Nair

Chairman, Organizing Committee of the 7th Asia Pacific Heart Rhythm Society's  (APHRS) Scientific Sessions, being organized simultaneously at the Taj Palace Hotel and ITC Maurya in New Delhi from October 29th to November 1st, 2014.

Be a part of the discussions regarding Arrhythmia Management with global experts at the 7thAsia Pacific Heart Rhythm Society Meeting from October 29th – November 1st at New Delhi.

As a special offer for all eMedinews readers, we have decided to waive off the registration fees for the conference. To register yourself, please click on the following link

https://podio.com/webforms/9727986/708939


News Around The Globe

  • The Dallas hospital that treated the first Ebola patient diagnosed in the U.S. "made mistakes," a hospital official told a congressional hearing. In its initial care of Thomas Eric Duncan, "we did not correctly diagnose his symptoms as those of Ebola," said Daniel Varga, MD, chief clinical officer of Texas Health Resources, which runs the Dallas facility, Texas Health Presbyterian Hospital.
  • Myelofibrosis (MF), a rare condition, affects approximately 1 in 100,000 people in the US each year.  Oncology nurses, hematology nurses, and other nursing professionals involved in the treatment and long-term management of patients with MF need a thorough understanding of key pathogenic, clinical, and patient features, as well as of current and emerging therapeutic strategies to combat the disease.
  • 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.
  • Alcohol intake is linked to lower sperm quality, according to a cross-sectional study of young Danish men published online October 2 in BMJ Open. Adverse effects on semen can be seen at levels as low as five drinks per week, although the trend is more pronounced among men who drink more than 25 units per week
  • Sulforaphane, a compound found in broccoli sprouts, may improve core symptoms of autism spectrum disorder (ASD), preliminary research suggests from the Dept. of Pediatrics (Neurology) at the University of Massachusetts Medical School in Worcester.
  • Eating a Mediterranean diet supplemented with either nuts or extra-virgin olive oil as opposed to eating a low–fat diet was more likely to reverse metabolic syndrome 5 years later, in a new study published October 14, 2014 in CMAJ.



Dr KK Spiritual Blog

Relieve stress by changing the interpretation

Stress is the reaction of the body or the mind to the interpretation of a known situation. Stress management, therefore, involves either changing the situation, changing the interpretation or taming the body the yogic way in such a way that stress does not affect the body.

Every situation has two sides. Changing the interpretation means looking at the other side of the situation. It is something like half glass of water, which can be interpreted either as half empty or half full.

Studies have shown that anger, hostility and aggression are the new risk factors for heart disease. It has been shown that even recall of anger can precipitate a heart attack.

Many studies have shown that when doctors talk positive in front of unconscious patients in ICU, their outcome is better than those if doctors talk negative.

The best way to practice spiritual medicine is to experience silence in the thoughts, speech and action.

Simply walking in the nature with silence in the mind and experiencing the sounds of nature can be as effective as 20 minutes of meditation. Twenty minutes of meditation provides the same physiological parameters as that of 7 hours of deep sleep.
 


Inspirational Story

The Mango Tree


Once upon a time, there lived a big mango tree. A little boy loved to come and play around it every day. He climbed to the tree top, ate the mangoes, took a nap under the shadow… He loved the tree and the tree loved to play with him.

Time went by… The little boy grew, and he no longer played around the tree. One day, the boy came back to the tree with a sad look on his face. “Come and play with me,” the tree asked the boy.

 “I am no longer a kid, I don’t play around trees anymore.” The boy replied, “I want toys. I need money to buy them.” “Sorry, I don’t have money… but you can pick all my mangoes and sell them so you will have money.” The boy was so excited. He picked all the mangoes on the tree and left happily. The boy didn’t come back. The tree was sad.

One day, the boy grown into a man returned. The tree was so excited. “Come and play with me,” the tree said. “I don’t have time to play. I have to work for my family. We need a house for shelter. Can you help me?” “Sorry, I don’t have a house, but you can chop off my branches to build your house.”
So the man cut all the branches off the tree and left happily. The tree was glad to see him happy but the boy didn’t come back afterward. The tree was again lonely and sad. One hot summer day, the man returned and the tree was delighted. “Come and play with me!” The tree said.

 “I am sad and getting old. I want to go sailing to relax myself. Can you give me a boat?” “Use my trunk to build your boat. You can sail far away and be happy.” So the man cut the tree trunk to make a boat. He went sailing and didn’t come back for a long time. Finally, the man returned after he had been gone for so many years.

 “Sorry, my boy, but I don’t have anything for you anymore. No more mangoes to give you.” The tree said. “I don’t have teeth to bite,” the man replied. “No more trunk for you to climb on.” “I am too old for that now,” the man said.

 “I really can’t give you anything… the only thing left is my dying roots,” the tree said with sadness. “I don’t need much now, just a place to rest. I am tired after all these years,” the man replied. “Good! Old tree roots are the best place to lean on and rest. Come sit down with me and rest.”
The boy sat down and the tree was glad and smiled.

The tree in the story represents our parents. When we are young, we love to play with them. When we grow up, we leave them and only come back when we need help. Parents sacrifice their lives for us.


Rabies News (Dr A K Gupta)

What are the limitations of polyclonal serum?

Difficulties associated with the use of polyclonal serum (RIG) samples include:

  • Batch–to–batch variation
  • Risks related to the use of human blood products. Because HRIG preparations are of human origin, they need to be treated to minimize the risk of transmission of infectious agents.
  • Difficulties in finding immune donors during sudden mass exposures might lead to a low availability of RIG.
  • Because of discontinued ERIG production by international manufacturers, supply of ERIG relies on regional production.
  • The use of ERIG has raised ethical issues and has been condemned by animal protection groups.
     


Cardiology eMedinewS

  • Women with hypertension develop an elevated pulse pressure (PP) at a younger age, and a larger percentage of women also have an elevated PP in each decade of life compared with men, researchers reported at the 2014 Annual Meeting of the American Society of Anesthesiologists.
  • Scientists at The Scripps Research Institute (TSRI) have created a synthetic molecule that mimics "good" cholesterol and has the potential to reduce plaque build–up in the arteries. The molecule, taken orally, improved cholesterol in just two weeks. The research is published in the October issue of Journal of Lipid Research.
  • What an individual eats in the process of gaining weight seems to affect the plasma lipoprotein profile, suggest the results of a new study. Individuals who gained weight eating polyunsaturated fatty acids (PUFAs) had a reduction in atherogenic lipoproteins, while those who consumed a diet with more saturated fatty acids (SFA) had a worsening of these same lipids. The study is published October 15 in the Journal of the American Heart Association.


Pediatrics eMedinewS

  • The Brodsky scale for evaluating the size of children's tonsils may give the most consistent results compared to two other tools – the Friedman scale and a new modified three-grade scale, reports a new study published online in JAMA Otolaryngology-Head & Neck Surgery.
  • Most young children with wheeze will not benefit from intermittent montelukast, suggests a new trial. However, those with 5/5 ALOX5 promoter genotype might respond to this approach. The findings are published online in The Lancet Respiratory Medicine.


Quote of the Day

  • Two things that define SUCCESS in LIFE: The way you manage when you have nothing & way you behave when you have everything!
     

IMA NEWS

  • Doctors of the Delhi Medical Association (DMA) on Wednesday staged a protest demanding that the Delhi Government take action against quacks in the national capital. According to Indian Medical Association (IMA), the number of quacks in Delhi, who are practising medicine, is estimated to be around 40,000. "The DMA will not let quacks play with the health of common citizens of the city. DMA has always been critical of the illegal practice of quackery," DMA president Anil Goyal told reporters. "The DMA suggests that quacks should be trained to work as healthcare workers. They should not be allowed to prescribe any medicine to anybody," he added. Update: 16–October–2014
  • A leading body of Indian-American physicians plans to hold its 9th annual Global Healthcare Summit aimed at bringing accessible, affordable and quality world-class healthcare to India in Mumbai from Jan 2–4. The Association of American Physicians of Indian Origin (AAPI), one of the largest ethnic professional bodies, is organizing the summit at Trident Oberoi Hotel in collaboration with the Indian Ministries of Health and Family Welfare and Overseas Indian Affairs.
  • Union Health Minister Dr Harsh Vardhan assured members of the newly constituted Parliamentary Consultative Committee of the Ministry of Health and Family Welfare that broad expansion of the number of undergraduate and postgraduate seats are being considered without compromising on the quality of medical education.

 

Wellness Blog

Duration of CPR may be a factor in kids' survival

Some children with in-hospital cardiac arrest can benefit from longer duration of cardiopulmonary resuscitation (CPR), a study has found. In the study among survivors, neurological outcome was favorable for the majority of patients.

Of the 3,419 children included in the study, 28% survived to hospital discharge, and 16.6% of these survivors had CPR longer than 35 minutes, according to Renée Matos, MD, MPH, of the University of Pittsburgh School of Medicine, and colleagues. A total of 60% of these survivors with longer-duration CPR achieved a favorable neurologic outcome, they reported in the study published in Circulation, journal of the American Heart Association.

In the mid–1990s, authorities considered pediatric CPR futile beyond 20 minutes' duration or when more than two doses of epinephrine were provided.

Even though longer–duration CPR can benefit some children, the reality is that after the first 15 minutes of CPR, survival rate declines rapidly. Survival decreased by 2.1% for every minute of chest compressions over 15 minutes.

When CPR was longer than 35 minutes, those in the Surgical Cardiac category had the best survival to hospital discharge rate (25%), followed by, Medical Cardiac –21%; General Surgical– 13%; General Medical – 10% and Trauma– 8%.  ([Medpage today)


ePress Release

Power Packed Performances by Nurses and Children with Special Needs at the– 21st MTNL Perfect Health Mela

Exciting activities such as debate, painting, skit, diya making and dance were the special attraction.

New Delhi 17th October 2014– Heart Care Foundation of India, a leading national non–profit organization committed to making India a healthier and disease free nation organized  on its 3rd day of the  annual flagship event, The 21st MTNL Perfect Health Mela ,Divya Jyoti  an Inter college Nursing  competition .It was held at the Talkatora Indoor Stadium, New Delhi. The main philosophy behind the program was to create health awareness amongst the nurses during their long hours of duty and stress.

Research points out that there are multiple pressures associated with the profession which is leading to increase of stress levels amongst nurses. This is due to various reasons like long working hours which lead to insomnia, insufficient resource, interpersonal conflicts and poor reward systems.

Heart Care Foundation of India organized inter college nursing competitions where more than 2000 nurses participated. The various activities that took place in the mela were  Debate, Painting, skit and dance.

Anmol, a festival for children with special needs was organized the same day at the Perfect Health Mela. Over 200 children with special needs participated in folk dance, yoga, painting, singing and diya decoration competitions.

Addressing the Event Padma Shri, DST National Science and Communication and Dr. BC Roy National Awardee and the President of the Heart Care Foundation of India, Dr. KK Aggarwal said “Nurses form the backbone of society and are an integral part of the medical profession. They help the medical fraternity to communicate better with patients. Nurses should not follow doctors blindly. If they feel that a doctor has given a piece of wrong advice, they should immediately intervene and suggest the doctor to review and revise his decision”.

Dr.Ravi Kasliwal Sr. Cardiologist Medanta Medicity and Mr. Yogesh Shukla Sr. BJP leader in a joint statement added “Classical dancing is a good form of exercise compared to western dance. Any form of classical dance is not only a mode of exercise but a way to meditate.”

The star attraction of the day was the Shopping Centre created by Department of Handloom & Handicrafts with 60 stalls. The Mela is providing free blood test, 3D echocardiography and consultation to all people visiting.

The Perfect Health Mela is an annual mass health awareness module started in 1993, catering to people from all age groups and walks of life; the Mela incorporates activities across categories such as health check up camps, entertainment programs, lifestyle exhibitions, workshops and competitions. This year’s Mela will feature a first of its kind SAIL Heart and Health Pavilion to provide a complete solution to  overall healthcare needs. People will now not only be able to learn about preventive health measures through interactive entertainment modules but will also be able to seek treatment and consultation under one roof. This year’s Mela is being organized in association with NDMC, MCD, SAIL and MTNL and its theme is “Swach Baharat, Swasth Bharat”. The main philosophy behind this theme is that by improving the cleanliness of the country, several leading diseases such as dengue, typhoid, malaria, cholera can be prevented.

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Power Packed Performances by Nurses and Children with Special Needs at the 21st MTNL Perfect Health Mela

mela_brochure
SAIL


21st MTNL Perfect Health Mela 2014
Self-Assessment-Quiz

 

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Zee News – Health Wealth Shows

Alcohol

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Confederation of Associations of Medical Specialties of India

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Video Library

MTNL Perfect Health Mela

Heart Care Foundation of India, a leading national non–profit organization committed to making India a healthier and disease-free nation announced the upcoming activities of the 21st MTNL Perfect Health Mela scheduled to be held from 15th – 19th October 2014 at the Talkatora Indoor Stadium in New Delhi.

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 – 96458 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 patient with diabetic ketoacidosis (DKA) was admitted in ICU.
Dr Bad: Start low–dose insulin.
Dr Good: Start low–dose insulin and fast IV saline.
Lesson: Because patients with DKA are invariably dehydrated, priority should be given to fluid administration and the correction of electrolyte deficiencies.

Make Sure

Situation:A patient with suspected pneumonia and normal x–ray died 12 hours after admission.
Reaction: Oh my God! Why were antibiotics not started?
Lesson: Make sure that all patients with suspected pneumonia are given antibiotics at the first suspicion as x–ray can be normal in the first 24 hours.

eMedinewS Humor

After the robbers left, the bank manager told the bank supervisor to call the police quickly. The supervisor says "Wait, wait, wait, let's put the 5 million we embezzled into the amount the robbers robbed".

This is called "Swim with the tide” – converting an unfavorable situation to your advantage!

Twitter of the Day

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer
Dr Deepak Chopra:No regrets and no anticipation, just this moment fresh and as is

eMedi Quiz

Prevalence of skin infections in HIV infection is approximately

a.50-60%
b.70-80%
c.90-100%
d.Extremely rare

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

a.1.8 million
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:Tukaram Pagad, Dr.K.V.Sarma, Dr Jainendra Upadhyay, Raju Kuppusamy, Najib Khatee, Dr Avtar Krishan, dr shanta haridas, Dr. P. C. Das, Dr.K.Raju

Answer for 16th Oct Mind Teaser:4. Rule of nine

Correct answers received from:: Raju Kuppusamy, Najib Khatee, Dr. P. C. Das, Dr.K.V.Sarma,

Send your answer to email

medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Editor eMedinewS and President Heart Care Foundation of India)

Choosing the best option in the judgment of the doctor is not medical negligence

In the case of Charan Singh vs Healing Touch Hospital And Ors on 24 April, 2003 (III(2003) CPJ 62 (NC)), the National Consumer Disputes Redressal Commission observed “it is a settled law when two choices are available, exercise of one, which is the best in the judgment of the doctor and anything else is available to contradict this, doctor in such circumstances cannot be held negligent.

medicolegal update
  1. Dear Sir, Very informative newspaper. Regards: Dr Swapna

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