July 18  2015, Saturday
eMedinewS
editorial
Diabetes Update
Dr KK Aggarwal
  • Morbidity from diabetes involves both macrovascular (atherosclerosis) and microvascular disease (retinopathy, nephropathy and neuropathy).
  • Smoking cessation is essential for patients who smoke.
  • Cardiovascular morbidity can also be significantly reduced with aggressive management of hypertension, cholesterol (goal LDL less than 80 mg/dL and use of aspirin (8o mg/day) in patients with or at high risk for cardiovascular disease.
  • Glycemic control can minimize risks for retinopathy, nephropathy and neuropathy in both type 1 and type 2 diabetes, and has been shown to decrease the risk for cardiovascular disease for type 1 diabetes.
  • A1c goal is <7% for most patients.
  • More stringent control (A1c <6%) may be indicated for individual patients with type 1 diabetes and during pregnancy.
  • A higher target A1c (i.e., <8%) may be preferable for some type 2 patients with comorbidities or with an anticipated lifespan, owing to advanced age or other factors, that is too brief to benefit from the effects of intensive therapy on long–term complications.
  • The appropriate target for A1c in fit elderly patients who have a life expectancy of over 10 years should be similar to those developed for younger adults (<7.0%).
  • The risk of hypoglycemia, which may lead to impaired cognition and function, is substantially increased in the elderly. Thus, avoidance of hypoglycemia is an important consideration in establishing goals and choosing therapeutic agents in elderly adults.
  • In the absence of specific contraindications, start with metformin as initial therapy for all patients with diabetes including the elderly. Start with metformin at the time of diabetes diagnosis, along with consultation for lifestyle intervention. Titrate metformin to its maximally effective dose (usually 2000–2500 mg/day in divided doses) over 1 to 2 months, as tolerated. Metformin should not be administered when conditions predisposing to lactic acidosis are present.
  • In patients with contraindications and/or intolerance to metformin, a short–acting sulfonylurea (e.g., glipizide) is an alternative option.
  • In patients who are intolerant of or are not candidates for metformin or sulfonylureas, repaglinide is a reasonable alternative, particularly in a patient with chronic kidney disease (CKD) at risk for hypoglycemia.
  • Start lifestyle intervention first, at the time of diagnosis. The weight gain that accompanies a sulfonylurea will presumably be less if lifestyle efforts are underway. However, if lifestyle intervention has not produced a significant reduction in symptoms of hyperglycemia or in glucose values after one or two weeks, then the sulfonylurea should be added.
  • DPP4–inhibitors can be given as monotherapy in elderly patients who are intolerant of or have contraindications to metformin, sulfonylureas, or repaglinide. They are weak agents and only lower A1c by 0.6%. They are given when the A1c level is relatively close to the goal level. DPP–4 inhibitors have no risk of hypoglycemia and are weight-neutral, when used as monotherapy. Sitagliptin or saxagliptin are the choices but more expensive and less potent in lowering glycemia than repaglinide.
  • Insulin can also be considered a first–line therapy for all patients with type 2 diabetes, particularly patients presenting with A1c >10%, fasting plasma glucose >250 mg/dL, random glucose consistently >300 mg/dL, or ketonuria.
  • Another alternative is a thiazolidinedione, which may be considered in patients with lower initial A1c values or if there are specific contraindications to sulfonylureas.
  • Patients who are initially thought to have type 2 diabetes may actually have type 1 diabetes, and therefore require insulin as initial therapy. Initial treatment with insulin is required in patients in whom it is difficult to distinguish type 1 from type 2 diabetes.
  • Further adjustments of therapy, which should usually be made no less frequently than every three months, are based upon the A1c result (and the results of home glucose monitoring).
  • If inadequate control is achieved (A1c remains >7.0%), another medication should be added within 2 to 3 months of initiation of the lifestyle intervention and metformin.
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Heart Care Foundation of India, IMA, Delhi Police and Delhi Red Cross society have taken up the initiative to train 100% of the Delhi Police PCR van staff in the life-saving technique of Hands Only CPR 10
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News
  • The US Food and Drug Administration (FDA) approved the first prosthesis, called Osseoanchored Prostheses for the Rehabilitation of Amputees (OPRA), for above-the-knee amputations that does not rely on a conventional, cup-like socket fitting over the stump of a patient's leg. With the new device, an external prosthetic limb attaches to a fixture implanted in the patient's remaining thigh bone.
  • A meta-analysis on aspirin, cardiovascular disease, and age-related macular degeneration, presented at the American Society of Retina Specialists (ASRS) 2015 Annual Meeting, suggested that patients could continue to take aspirin as recommended by their primary care physicians without fear of worsening their macular degeneration.
  • Low-level laser therapy ameliorated radiation dermatitis in a pilot trial conducted in patients with breast cancer, known as the DERMIS trial, presented at the Multinational Association of Supportive Care in Cancer (MASCC) Annual Meeting.
  • Taking micronutrient supplements can help minimize psychological stress following a natural disaster, suggests a new study published online in Psychiatry Research.
  • Prolonged standing at work can result in fatigue, leg cramps and back ache and in the longer term, this type of sustained muscle fatigue can lead to more serious joint problems and back pain, suggests a new study published in Human Factors, the journal of the Human Factors and Ergonomics Society.
Top News from ADA 2015
In Sickness and in Health: Spouses Have Double Diabetes Risk

Spouses or live-in partners of people newly diagnosed with diabetes are twice as likely to develop diabetes themselves, compared with people in the general population, in the year following the initial diagnosis of their loved one, hint new data from a large Kaiser Permanente study. The findings are "quite striking," said study presenter Mohammed K Ali, MBChB, from Emory University, Atlanta, Georgia. "Not only are they provocative, but the implications are huge. It might be important to think about talking to the spouses or partners (of newly diagnosed patients) about their own risks. Even if you are not genetically related, if you are a residing spouse or domestic partner, just that shared environment is associated with an increased risk, that's what we saw." (Source: Medscape)
Cardiology eMedinewS
  • A new analysis of participants in a population-based cohort study suggests that at least two ECGs might be useful to stratify individuals at risk for sudden cardiac death (SCD) because of a prolongation in the heart-rate–corrected QT (QTc) interval. The findings are published in Heart Rhythm.
  • Researchers have determined that on average, the first-generation subcutaneous implantable cardioverter defibrillator S-ICD (Boston Scientific and formerly Cameron Health) needs to be replaced after 5 years, exactly what the manufacturer estimated and slightly less than the life-span of single-chamber or dual-chamber transvenous ICD systems (5.5 years and 5.8 years, respectively). These findings published July 6, 2015 in Circulation: Arrhythmia and Electrophysiology are based on an analysis of the 55 patients in the European Registry Trial.
Pediatrics eMedinewS
  • The US Food and Drug Administration (FDA) announced that clinicians should watch for signs of pulmonary hypertension in infants treated with the antihypoglycemia drug diazoxide and discontinue it if they appear.
  • Adding peanuts to the list of complementary foods introduced early in infancy can prevent peanut allergy in most high-risk infants, suggests a consensus statement published online in the Journal of Allergy and Clinical Immunology.
Dr KK Spiritual Blog
You are temple of the God and the Spirit of the God dwells in you

This sutra from the Bible reflects the union between the spirit and the soul. The ‘Spirit’ represents the Parmatama or the Brahman and ‘You’ represents the individualized spirit or the Soul (Jivatama).

A temple is a place of worship and also the place where God resides. Every human being represents a temple (place of worship) where God exists (one’s soul) and this soul is nothing but the essence of God (the spirit).

One should treat every individual in the same manner as the same spirit dwells in every human being. The soul is also the reflection of individual’s past and present karmic expressions. Most people are in the habit of looking and searching for God in artificial temples, gurudwaras and churches, not realizing that the same God is present within us, provided we undertake the internal journey to look for Him.

He is present in between the thoughts in the silent zone and can be approached by adopting any of the three pathways: Karma Yoga, Bhakti Yoga and Gyana (Gnana) Yoga.

Doing selfless work with detachment to its results; working with the principles of duty, devotion and discipline; and/or regularly doing Primordial Sound Meditation or other types of meditations can help one reach the stage of self-realization or meeting one’s true self. Once there, one can have all the happiness in life.
Make Sure
Situation: A patient developed rifampicin toxicity.
Reaction: Oh my God! Why was a history of Ayurvedic drugs not taken?
Lesson: Make sure to enquire if a patient is also on Ayurvedic drugs. Trikatu can enhance the action of anti TB drugs.
Events
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Dr Good Dr Bad
Situation: An obese patient failed to achieve weight loss goal through diet and exercise.

Dr Bad: Go for surgery.

Dr Good: Start drug therapy.

Lesson: Patients who fail to achieve weight loss goals through diet and exercise alone need a trial of drug therapy.

(Copyright IJCP)
Inspirational Story
How we affect others

My second year attending college....

I moved 300 miles away from my home of six years and entered a private Christian college. I was thrilled that I was going to attend my first pick school. My favorite class was English I with Professor Wilcox. He encouraged creativity and open thought which was right up my alley.

Throughout high school I had been pretty much told what to write and what to think. I enjoyed the challenge of his vague writing assignments; it made me have to really think about what I put down on paper.

As the school year progressed I became very ill and missed several of my classes. I apologized over and over to my professors for missing their classes, and I did the assignments out of hospital rooms or between trips to specialists and weekly doctors’ visits. At the end of the term my medical condition had improved some and I was able to start doing some of the extra credit to make up for my daily grades. I worked double time to bring my grades up.

The day of my English final, Professor Wilcox approached me and handed me a single sheet of rose pink paper. He told me to read on my way home to Texas. I decided that I couldn't wait and the second I stepped into my dorm room I opened the paper and read aloud. He had wanted to thank me for encouraging him throughout the school year.

In his letter he described the plight of a young woman, the youngest in her class, struggling with sickness and a full class schedule that somehow managed to pull herself up by her bootstraps and muttle through the year.

The last line of his letter read as follows: "I have watched you thoroughly enjoy yourself in my class, and I have read of your struggle against all odds to stay in school. You truly personify my favorite verse in the book of Psalms. Thank you for showing the world how to be brave and how to rely completely on God." He then went on to quote the following verse: "I have set the Lord always before me; because He is at my right hand; I will NOT be shaken." –Psalm 16:8

I hadn’t realized it at the time but everything we do and say affects other people.

My being sick had helped a professor I barely knew to get through a very trying time in his life. I just want everyone to know that even though things may seem rough, there will always be better days ahead.
Wellness Blog
Natural Fast Food is good for Health

Natural fast food is good for health.

Natural fast food consists of eating fruits, vegetables, milk products, sprouts and sattu. On the contrary, unnatural fast food, also called as junk food, is bad for the health of the heart as it is made up of refined ‘bad’ carbohydrates and either animal ‘bad’ fat or trans fats.

Sattu is grounded roasted powder of soaked pulses and cereals. It is consumed along with fruit slices, gur or milk. Green chili, lemon juice and salt can be added to add flavor.

The commonest form of sattu is grounded roasted black gram or chana. Other common variety is grounded roasted black gram with barley.

Originally, sattu was made of seven Anaja (7 cereals, millets and pulses). The seven ingredients are maize and barley (cereals), black gram, pigeon gram or Arhar, green pea, kesari dal and kulath dal (pulses).

Sattu is a high fiber diet with low sugar producing properties. It is a cooling and refreshing fast food with antidiabetic and anti-obesity properties.

It is a full breakfast, mid day or lunch meal and has minerals and vitamins.

Sattu drink can be sweetened by adding gur or honey, sour by adding lemon and salted by adding black or rock salt. Roasting is one of the best forms of cooking. Sattu is both a fast food and a soft drink for the summer but healthy.

The so–called energy drinks available in the market are harmful as they contain three times the caffeine content of coffee or tea.
eMedinewS Humor
Q: How can I calculate my body/fat ratio?

A: Well, if you have a body and you have fat, your ratio is one to one. If you have two bodies, your ratio is two to one, etc.

Q: What are some of the advantages of participating in a regular exercise program?

A: Can't think of a single one, sorry. My philosophy is: No Pain. Good!
eMedi Quiz
A 10-year old girl presents with swelling of one knee joint. All of the following conditions can be considered in the differential diagnosis, except:

1. Tuberculosis.
2. Juvenile rheumatoid arthritis.
3. Hemophilia.
4. Villonodular synovitis

Yesterday’s Mind Teaser: In actinomycosis of the spine, the abscess usually erodes:

1. Into the intervertebral disc.
2. Into the pleural cavity.
3. Into the retroperitoneal space.
4. Towards the skin.

Answer for yesterday’s Mind Teaser: 3. Into the retroperitoneal space.

Correct Answers received from: Dr Avtar Krishan, Daivadheenam Jella, Arvind Diwaker, Dr Jainendra Upadhyay.

Answer for 15th July Mind Teaser: 4. Early menopause.

Correct Answers received: Dr Jainendra Upadhyay.
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IJCP Book of Medical Records
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CPR 10
Total CPR since 1st November 2012 – 101090 trained
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Video of the Day
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 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
eIMA News
IMA to give recommendations and comments
No.N.24026/06/2015-PNDT
Government of India
Ministry of Health & Family Welfare
(PNDT Division)
Nirman Bhawan, New Delhi
Dated the 09th June, 2015

To,
The Members
Central Supervisory Board
(As per list enclosed)
Subject: Proposed Amendments to the Pre-Conception & Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 – reg.

Sir/Madam,

I am directed to refer to discussion held in 23rd meeting of the Central Supervisory Board, constituted under the Pre Conception & Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994, held on 24th June, 2015 under the Chairmanship of Union Minister for Health and Family Welfare.
  1. The list of draft amendments to the Act proposed by the Amendment Expert Committee was placed before 22nd CSB held on 13th October, 2014 and it was decided that the comments will be sought from all the members. In this regard, this Ministry has received comments only for the Ministry of Law and Justice, UNFPA, IRIA and from Dr. Rajnikatn Contractor and the same were placed before the CSB for deliberations in its 23rd Meeting.
  2. As per discussion held in 23rd meeting of the CSB, Secretary (H&FW) had urged other CSB members also to give their inputs and comments in writing on the proposed amendments to the Act so that it can be examined in detail by this Ministry.
  3. In view of above, you are requested to furnish your valuable comments on the proposed amendments at the earliest so that necessary action may be taken in this regard.
Yours faithfully
(D.K.Sahu)
Under Secretary to the government of India
Tel/Fax: 011-23062666

Annexure - I

AMENDEMENTS PROPOSED BY THE EXPERT COMMITTEE CONSTITUTED TO RE-EXAMIN THE PROVISIONS OF THE ACT
Existing provision of PC & PNDT ACT
Proposed amendments
PREAMBLE
1
Statement of Objects and Reason:
Point No (i) prohibition of the misuse of pre natal diagnostic techniques for determination of sex of the foetus leading to female foeticide
Point No (i) May read as
(i)prohibition of the misuse of pre natal diagnostic techniques for determination of sex of feotus, leading to decline sex ratio at birth (Number of females born/thousand boys)
2
Statement of Objects and Reason:
Point No.
(iii) permission and regulation of the use of Pre Natal Diagnostic Techniques for the purpose of detection of specific genetic abnormalities or disorders
Point No (iii) May read as

(iii) prohibition and prevention of the misue of Pre Natal Diagnostic Techniques for detection of determination of sex
3
Use of appropriate terms for “leading to female foeticide” and “Abortion”
Terms to be replaced as

1. “decline in female child sex ration at birth”

2. “Sex selective termination of pregnancy” respectively
CHAPTER I
4
Section 2(g)

“medical geneticist” includes a person who possesses a degree of diploma in genetic science in the fields of sex selection and pre-natal diagnostic techniques or has experience of not less than two years in any of theses fields after obtaining –

(i) Any one of the medical qualifications recognize under the India medical council Act 1956; or

(ii) A post-graduate degree in biological sciences;
“medical geneticist” is defined as a person who has DM/MD in Medical Genetic recognized by MCI or has worked/done research for not less than five years in a recognized university or institute or has obtained a doctorate degree in the area of clinical or medical or human genetics after obtaining;

(i) Medical qualifications recognized under the Indian medical Council Act 1956 (102 of 1956); or

(ii) A recognized post graduate degree in subjects like zoology/Molecular Biology/Human Genetics/Bio-chemistry/Bio Technology. Biomedical sciences and biosciences/Life Science
CHAPTER II
5
Section 3B:

Prohibition on sale of ultrasound machines etc. to persons, laboratories, clinics etc.

not registered un Act – No person shall sell any ultrasound machine or imaging machine or scanner or any other equipment capable of detecting sex of foetus to any Genetic Counseling Centre, Genetic Laboratory, Genetic Clinic or any other person not registered under the Act
Prohibition on sale or otherwise transfer of ultrasound machines etc to persons, laboratories, clinics, etc. not registered under the Act. No person shall sell or in any other manner transfer any ultrasound machine or imaging machine or scanner or any other equipment capable of detecting sex of foetus to any Genetic Counseling Centre, Genetic laboratory, Genetic Clinic or any other person not registered under the Act.
CHAPTER III
6
Section 6: Determination of sex prohibited
Insertion of section 6 (1) as:
Prevention of misuse of prenatal diagnostic techniques:

(a) Every Appropriate Authority shall prevent and may interpose for the purpose of preventing and shall to the best of his ability, prevent the misuse of pre-natal diagnostic techniques and commission of any offence under the Act.

(b) Appropriate Authority my, if it thinks fit for purpose of preventing any offence under the Act, obtain a bond from the concerned person giving undertaking that he will not indulge into misuse of pre-natal diagnostic techniques.
CHAPTER VI
7.
Section 23: Offence and Penalties Section 23 (I) Any medical geneticist, gynecologist registered medical practitioner or any person who owns a genetic counseling centre, a genetic laboratory, or a genetic clinic or is employed in such a centre, laboratory or clinic or render his professional or technical services to our at such a centre, laboratory or clinic. Whether on an honorary basis or otherwise, and who contravenes any of the provisions of this Act or Rule made thereunder shall be punishable with imprisonment for a term which may extend to three years and with fine which may extend to ten thousand rupees and on any subsequent conviction, with imprisonment which may extend to give years and with find which may extend to fifty thousand rupees
Section 23 (i):- may read as
“Any medical geneticist, gynecologist, registered medical practitioners or any person who owns a genetic counseling centre a genetic laboratory or a genetic clinic or is employed in such a centre, laboratory or clinic or render his professional or technical services to or at such a centre, laboratory or clinic, whether on an honorary basis or otherwise and who contravenes any of the provisionals of this Act or Rule made thereunder shall be punishable with imprisonment for a term which shall no be less than three years and with fine which may extend to fifty thousand rupees and on any subsequent conviction, with imprisonment which shall not be less than five years and with fine which may extend to one lakh rupees

Insertion of Section 23 )1) (a) as:-

Any person who shall not abide by the following prescribed norms including

(a) Wearing apron with proper name plate while performing diagnostic procedure

(b) Putting up-sign board disclaiming sex selection at a prominent place in the clinic

(c) Copy of PNDT Act always present in the clinic

Shall be punishable with a fine of not less than one thousand rupees and in case of continuing contravention with an additional fine of not less than five hundred rupees for every day.
8
Section 25:

Penalty for contravention of the provisions of the Act or Rules for which no specific punishment is provided;

Whoever contravenes any of the provisions of this Act or any rules made thereunder, for which no penalty has been elsewhere provided in this Act shall be punishable with imprisonment for a term which may extend to three months or with fine which may extend to one thousand rupees or with both and in the case of continuing contraventions with and additional find which may extend to five hundred rupees for every day during which such contraventions continues after conviction of the first such contravention.
Section 25: May read as
Penalty for contravention of the provisions of the Act or Rues for which no specific punishment is provided:

Under Section 25, fine may extend to Rs.10,000/- and in the case of continuous contravention. With an additional find which may extend to Rs.1,000/- for every day during which such contravention continues. Confiscation of sonography machine and other equipment used for commission of offence may be provided as per provision of Section 55 of the Indian Forest Act 1927 *
9.
Section 26: Offences by the companies
Insertion of Section 26 (3) as
When any offence punishable under this Act has been committed by a company it should be liable to a punishment of act less than 3 years and a fine not less than 25 lakhs.
10.
Section 31:

Protection of action taken in good faith –No suit, prosecution or other legal proceedings shall lie against the Central or the Appropriate Authority or any office authorized by the Central or State Government or by the Authority for anything which is in good faith done or intended to be done in pursuance of the provisions of this Act.
Section 31: May read as

Protection of action taken in good faith – No suit, prosecution or other legal proceedings shall be against the Central or the State Government or the Appropriate Authority or any officer authorized by the Ventral or State Government or by Authority or by any person including social organization which has made complaint to the Court under Section 28 (I)(b) of the Act for anything which is in good faith done or intended to be done in pursuance of the provisions of this Act.
*Section 55 in The Indian Forest Act 1927: Forest procedure tools, etc. when liable to confiscation

(1) All timber or forest – produce which is not the property of Government and in respect of which a forest – offence has been committed and all tools, boats, carts and cattle use in committing any forest – offence shall be liable to confiscation

(2) Such confiscation may be in addition to any other punishment prescribed for such offence

The meeting concluded with the vote of thanks to the chair.
NEWS
  • The Guru Gobind Singh I.P. University (GGSIP) team has awarded Army College of Medical Sciences (ACMS), Delhi Cantt Category "A" and it stands at "A+" category as per the MCI. Based on an All India survey published in the Times of India on 16th June, 2015, ACMS was ranked 37th out of a total 398 Medical Colleges and 10th amongst all the 257 Private Medical Colleges.
  • Exposure to fine particulate matter air pollution during wildfires may increase risk for cardiac arrest and other acute heart problems, particularly in the elderly, according to Australian researchers. The time-strati?ed case-crossover study, which looked at cardiovascular and respiratory health effects of wildfire smoke (PM2.5; aerodynamic diameter <2.5 lm) from the 2006-2007 bushfires in Victoria, Australia, showed a 6.98% increase in cardiac arrest when ambient air is contaminated by smoke from wildfires, reported Anjali Haikerwal, MBBS, MPH, of Monash University in Melbourne, and colleagues. Associations were observed for out-of-hospital cardiac arrests, hospital admissions, and emergency department (ED) visits for ischemic heart disease (IHD) after two days of exposure to wild?re smoke in Victoria at PM2.5 concentrations, they wrote in the Journal of the American Heart Association. (MEDPAGE TODAY)
  • Premature ventricular contractions (PVCs) may be a modifiable risk factor for congestive heart failure (CHF) and death, according to a study published in the July 14 issue of the Journal of the American College of Cardiology (JACC). DG News.
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Letter to Editor
Dear Sir, Greetings, this is to request you to launch a nationwide agitation against the biggest scam of the country of fraudulent MBBS admissions. This will help us to restore the credibility and improve the systems of medical education in this part of the world. Lot of doctors in the country are agitated and are looking towards IMA to respond befittingly. Hope to hear from you soon. With best regards: Dr Dharmesh Lal.
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News on Maps
Rabies News (Dr A K Gupta)
If for some reason, IDRV cannot be given in deltoid region, what are the alternative sites?

IDRV can be given in deltoid region, suprascapular, anterior abdominal wall and the upper part of thigh.
Press Release
Come Independence Day, and the Delhi Police PCR van staff will be able to assist sudden cardiac arrest patients in an emergency situation

Heart Care Foundation of India, IMA, Delhi Police and Delhi Red Cross society have taken up the initiative to train 100% of the PCR van staff in the life-saving technique of Hands-only CPR 10

Heart Care Foundation of India, jointly with the Indian Medical Association, Delhi Red Cross Society and Delhi Police, has taken up the challenge of training 100% of the Delhi Police PCR van staff on the life-saving technique of hands only CPR 10 by Independence Day 2015. With over 250 police personnel being trained on a daily basis and over 2500 having being trained so far, the task of training each and every of the 8000 Delhi Police PCR van staff by August 15, 2015 seems realistic and success will be met.

Addressing the gathering of over 250 police men at the IMA on 17th July Padma Shri Awardee Dr K K Aggarwal - President of Heart Care Foundation of India and Honorary Secretary General of IMA said that, “In an emergency situation, hands-only CPR 10 can be used effectively through a few easy to remember steps. First and foremost one must call an ambulance or nearest medical help. Then you can also dial 100 to request the nearest Delhi Police PCR van to reach you and assist with hands-only CPR. And most importantly without wasting any time, you must start compressing the center of the chest of the victim at a speed of 10 x 10 i.e. 100 per minute. You must continue the chest compressions till medical help arrives or the person gets revived. Each person must remember that CPR must only be performed on a person whose heart has stopped working and is not breathing.”

Adding to this, Padma Shri Awardee, Dr A Marthanda Pillai, National President, IMA said, “The Government must make it mandatory for all public places to have automatic electric shock machines to save maximum lives of people who suffer from a sudden cardiac arrest. Death for such patients is reversible if awareness is raised and the right life-saving technique is used.”

Urging people to learn hands-only CPR 10, renowned wrestling coach and former wrestler Padma Bhushan Awardee Guru Satpal Singh said, “Hands-only CPR 10 is an extremely simple to learn but an essential and extremely important technique, which can help save the lives of near and dear ones. I urge everyone to learn it and spread awareness about this new initiative where the Delhi Police can be contacted not just in case of a theft or robbery but even a medical emergency such as a cardiac arrest. They are the closest to your homes and will be the fastest to reach.”

Adding to this, Mr Ranvir Singh IPS Addl Commissioner of Police Operations said "In a situation when someone suffers a sudden cardiac arrest, you must call an ambulance, the nearest medical center or dial 100 for assistance. Without wasting even a minute, you should start compressing the center of the chest of the victim at a speed of 100 per minute. By doing this, you may help save a life.”

A sudden cardiac arrest occurs when the electrical conducting system of the heart fails and the heart beats irregularly and very fast (more than 1000 times, technically called as ventricular fibrillation). Soon after, the heart suddenly stops beating and the blood flow to the brain stops. As a result, the person becomes unconscious and stops normal breathing. A cardiac arrest is not the same as a heart attack, but it may be caused by a heart attack. In most cases, sudden cardiac arrest may be reversible in the first 10 minutes. This is possible because the brain remains alive during this period when the heart and respiration have stopped, a situation called clinical death.

It is important to act quickly for every minute lost reduces the chances of revival by 10%. So, if you wait 5 minutes, the chances of surviving are 50% less. The earlier you give CPR to a person in cardiac arrest, the greater the chance of a successful resuscitation. To know more or to organize a training camp in your locality, please call the NGO’s helpline number 9958771177.