eMedinewS19th November 2013, Tuesday

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; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04);
For updates follow at
www.facebook.com/Dr KKAggarwal

Lowering BP No Help in Acute Stroke

Use of antihypertensive drugs to lower systolic blood pressure by close to 13% as part of acute treatment of ischemic stroke did not reduce early mortality or disability compared with patients who did not receive antihypertensive therapy.

At 14 days after randomization, there were 683 events among patients who received early aggressive antihypertensive therapy versus 681 events in the control group and at 3 months, there were 500 additional events in the treatment arm versus 502 among controls, said Jiang He, MD, PhD, of Tulane University School of Public Health in New Orleans.

The findings from China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) were reported at the American Heart Association scientific sessions and the results were simultaneously published online by the Journal of the American Medical Association. (MedPage)

TCT 2013 Update: Cardiology Trials

Two market–leading third–generation drug–eluting stents (DES), Promus Element (Boston Scientific) and Resolute Integrity (Medtronic), proved equally safe and effective in a rare, large–scale, randomized, investigator–initiated trial. In an "all–comers" population, no significant difference was seen between the zotarolimus– and everolimus–eluting stents for target vessel failure at 12 months.

Dr Cindy Grines at Detroit Medical Center said she finds all of the new–generation stents "very flexible and deliverable" and that these two, on the basis of this study, "seem reasonably equivalent."

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."

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

You Cannot Serve Two Masters (God and Wealth)

sprritual blog

This is true for both your internal spiritual journey as well as the external social journey in life. Wealth is an indicator of greed, which is one of the five known obstacles to the pathway of self–realization.

Greed according to the Patanjali is defined as possessing any material wealth more then your need.

Greed in turns is linked to attachment through any of the five senses and uncontrolled desires. Once desires are fulfilled more desires are created which is nothing but the greed. And when the desires are not fulfilled then greed gets converted into anger, which leads to loss of intellect and ultimately destruction of the body.

Lord Krishna in the Bhagvad Gita while explaining this to Arjuna has clearly mentioned the pathway of self destruction starting from attachment to loss of intellect and ultimately destruction of the self.

The Hindu mythology has always said that never be after money. When you are after money the knowledge or the wisdom will not follow you. The classical example given is that if you are after Saraswati (God of Knowledge), Laxmi (God of Wealth) follows you and if you are after Laxmi, Saraswati may not remain with you.

God is representative of your true self and that is your consciousness, which is nothing but "Satchitananda" or the triad of truthfulness, consciousness based decisions and internal bliss or happiness. To be in touch with your consciousness you have to control your five senses through your mind and detach yourself from the egocentric desires.

Greed and wealth are representatives of attachment to the material world through one of your five senses, therefore, if you want to be in touch with your consciousness you have to be detached from the materialistic world and wealth is one of them.

There is a classical description of this phenomenon in Mahabharata in the battle of Kurukshetra when Lord Krishna became the Sarathi of Arjuna and rode the five horses chariot. The symbolic representation of the whole thing is, Lord Krishna represents your true self or consciousness; Arjuna represents the ego and the intellect; the reins of the horses represent the unstable mind and five horses represent the ever changing five senses. Using your ego and intellect if you can tighten your mind (reins), you will be able to control the five horses (the five senses) and then you will have all the time in the world to be with Lord Krishna (your own consciousness). On the other hand, if you let the reins loose (let the mind wonder) all the horses (senses) will get uncontrolled and wander here and there (one gets attached to the materialistic world). The mind and the intellect, instead of becoming the master, then becomes the servant of the five senses and will get detached from the true self or the consciousness.

Electricity is a good servant and a bad master is a well known saying. Something is true for the five senses. They are very good to the life provided they are controlled like servants and never treated like masters. Once they overpower you, they will create an umbrella of darkness over the mind and the intellect making you forget about the presence of soul in the body. Once this happens, you lose your dharma.

Whenever given a choice, always choose your consciousness as the master and not any of the five senses, mind, intellect or ego.

cardiology news

My left foot

In a fantastic testament to the human spirit, Rajesh Laxman, who was born without arms, sat for his SSC exams and scored 77%, by writing impeccably with his left foot. This Mumbai–based orphan was rescued from the mean street by SUPPORT (Society Undertaking Poor People’s Onus for Rehabilitation), an NGO that works for rehabilitation.

The jubilant Rajesh offers this advice to others handicapped kids, himmat se padho aur aage badho…study hard and progress.

News Around The Globe


  • IMA reacts to BSc community health course: IMA has reacted to the media report that has indicated that the Union Cabinet has given its approval of B.Sc. (Community Health) course by on Wednesday, November 13, 2013. As per the report, the Bachelor of Science (Community Health) course will create a cadre of Community Health workers belonging to rural areas who will be posted at sub–centres, functioning under the Ministry of Health and Family Welfare to provide basic Allopathic health care after studying a three–year course on basic anatomy and diagnosis & treatment of basic ailment. As per the Media reports, the emphasis on training will be on conducting normal deliveries, pre–and antenatal care, handling diarrhoea, pneumonia, vaccination, providing tuberculosis treatment and treatment of fevers and skin infections. Indian Medical Council Act does not allow anyone except graduates in modern system of medicine to prescribe allopathic drugs. Earlier too, the MCI has expressed its inability to create such a course. IMA has strongly opposed this proposal as it will create two tiers of medical professionals – one for rural and other for urban population. It is pertinent to note that even the Parliament Standing Committee on Health and Family welfare has rejected this proposal.
  • A new study in JAMA Neurology confirms that many cognitively normal older adults harbor neurodegenerative changes akin to Alzheimer’s disease (AD), but without amyloid–β deposits. These changes are associated with cerebrovascular disease and cognitive performance, which suggests that neurodegenerative pathology can emerge through non–Aβ pathways within regions most affected by AD.
  • The jury is still out about whether adjustable or tied–off sutures are best to ensure that eye muscles remain aligned after strabismus surgery. In the absence of definitive evidence from randomized, controlled trials, experts say the decision rests on the preference and comfort level of the individual surgeon. The pros and cons of the approaches for ocular alignment in strabismus surgery were discussed at the American Academy of Ophthalmology (AAO) 2013 Annual Meeting.
  • A biosensor could help detect brain injury occurring during cardiac surgery, a problem particularly important in infants and children undergoing operations to correct congenital heart defects, whose brains are still developing. As reported in Chemical Science, a prototype of the device, which uses an organic thin film transistor and has a sensing area that is just 7 mm on each side was able to detect glial fibrillary acidic protein (GFAP), even in the presence of other proteins, in a preclinical study. GFAP is released during brain injury. The biosensor has not yet been tested in humans.
  • Surgeons have a poor track record when it comes to adhering to published guidelines for the use of perioperative antibiotics in gynecologic procedures, as per a new study in the December print issue of Obstetrics & Gynecology.
  • An international group of infectious disease specialists has suggested that the battle against antibiotic resistance needs to go global, with sweeping changes to the way the medications are developed, financed, and used. The time has come for worldwide, coordinated action to preserve antibiotic effectiveness (The Lancet Infectious Diseases).

eMedinewS e–gifts to our readers

This is the age of smartphones. To improve usability and readability, eMedinewS has launched a mobile app of the newsletter for its readers. You can now also view eMedinewS on your smart phones or iPads.

The eMedinewS app is now available for free download.

The various icons for downloading are provided on the top of the newsletter. Choose the icon that is compatible with your device, whether iPhone, Android, Blackberry, iPad, Desktop/Windows phone or GSM
Click on the icon ‘e’ from the mail and download to install the app to the home screen of your mobile phone, iPad or Desktop. After you finish downloading, you will see an icon ‘e’ on the home screen of your device. That’s it.

Now you don’t need to type the address of the website in your web browser or log in to your email account every day to read the newsletter. Just click on the app and begin reading.

Rabies News (Dr. A K Gupta)

Are there any variations in signs of rabies between different species of animals?

There are few variations in signs of rabies between different species of animals. Cattle with furious rabies attack man and other animals. A common clinical sign is a characteristic abnormal bellowing. Head butting is a characteristic sign in case of rabies in cattle, sheep and goats.

cardiology news

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

  • Two studies evaluating therapeutic hypothermia strategies in patients who had experienced an out–of–hospital cardiac arrest –– one looking at the timing of induction and one looking at different target temperatures –– failed to find a dominant approach.
    • In the first, cooling patients to 33°C (91°F) instead of 36°C (97°F) did not reduce the rate of death by the end of the trial (50% versus 48%) and did not improve neurologic outcomes, according to Niklas Nielsen, MD, PhD, of Helsingborg Hospital in Sweden.
    • In the second, initiating the cooling process before hospital arrival –– versus in the hospital –– did not increase rates of survival to discharge either in patients with a shockable rhythm (62.7% versus 64.3%, P=0.69) or those with a nonshockable rhythm (19.2% versus 16.3%, P=0.30), and did not affect neurologic outcomes, Francis Kim, MD, of Harborview Medical Center in Seattle, reported.
    • Both studies were presented at the American Heart Association meeting here. The results were published simultaneously in the New England Journal of Medicine (Nielsen’s study) and the Journal of the American Medical Association (Kim’s study).
  • Nitrites do not appear to protect the myocardium against reperfusion injury. A randomized trial found that a five–minute infusion of sodium nitrite given just before opening of the culprit artery in patients with ST–segment–elevation MI (STEMI) had no effect on infarct size as measured by coronary magnetic resonance (CMR) imaging 6 to 8 days later. Nor did it affect measures of myocardial remodeling after six months. The results of the Nitrites in Acute Myocardial Infarction (NIAMI) trial will be presented at the AHA 2013 Scientific Sessions by its lead author Dr Nishat Siddiqi (University of Aberdeen, Scotland).
cardiology news

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

AAP Releases New Principles for URI Antibiotics

  • Effective use of antibiotics to treat pediatric upper respiratory tract infections (URIs) rests on 3 basic principles: accurate diagnosis, consideration of risks vs benefits, and recognizing when antibiotics may be contraindicated, according to a clinical report by the Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) published in the December issue of Pediatrics. The report emphasizes "the importance of using stringent and validated clinical criteria when diagnosing acute otitis media (AOM), acute bacterial sinusitis, and pharyngitis caused by group A Streptococcus (GAS), as established through clinical guidelines.
  • Continuing breast–feeding while introducing infants to solid foods and waiting at least 17 weeks to introduce those solid foods may lead to fewer food allergies in infants, according to an article published online November 18 in Pediatrics.
cardiology news

Should I go for a knee replacement?

A: Yes if

  • I am no longer able to do my routine work without help
  • I have pain that keeps me awake at night despite the use of drugs
  • I have pain that keeps me from being able to walk or bend over
  • I have pain that is not relieved by rest
  • I have pain that is not responding to non–surgical approaches.
  • I have been told that less–complicated surgical procedures are unlikely to help.
  • The disease osteoarthritis is wearing me down physically, emotionally, and mentally.
  • I am suffering from severe side effects from the drugs
  • Advanced arthritis is demonstrated on my test
  • If significant joint damage has occurred on my tests.
cardiology news

Total CPR since 1st November 2012 – 71933 trained

Media advocacy through Web Media

The type of food you eat also matters

Everyone needs a mix of proteins, carbohydrates, and fats, plus enough vitamins and minerals for optimal health. But some of the food choices within these categories are better than others, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart care Foundation of India.

  1. Added sugar: Whether it’s white granulated sugar, brown sugar, high– fructose corn syrup, corn sugar, or honey, sugar contains almost no nutrients and is pure carbohydrate and full of empty calories, causing blood sugar to rise and fall like a roller coaster. Soft drinks and other sugar–sweetened beverages are the primary source of added sugar in the diet and a major contributor to weight gain. One extra 12–ounce can of a typical sweetened beverage a day can add on 15 pounds in a year. Those liquid calories aren’t as satisfying as solid food.
  2. Dairy fat. Ice cream, whole milk, and cheese are full of saturated fat and some naturally occurring trans fat both bad for the heart. The healthiest milk and milk products are low–fat versions, such as skim milk, milk with 1% fat and reduced–fat cheeses.
  3. Baked sweets. Cookies, snack cakes, doughnuts, pastries etc are packed with processed carbohydrates, added sugar, unhealthy fats, and often salt.
  4. White carbohydrates. Bread, pasta, potatoes, rice, cookies, cake, or pancakes are bad. One should opt for whole–grain versions. One can choose homemade cookies or bars using grains such as oatmeal, and less sugar and unhealthy fats.
  5. Processed and high–fat meats. Meats like bacon, ham, pepperoni, hot dogs, and many lunch meats are less healthy than protein from fish, skinless chicken, nuts, beans, soy, and whole grains. Fresh red meat should be eaten sparingly and the leanest cuts selected.
  6. Salt. Current dietary guidelines recommend reducing sodium to 1,500 mg per day and not exceeding 2,300 mg per day. But most of us get 1 ½ teaspoons (or 8,500 mg) of salt daily. That translates to about 3,400 mg of daily sodium.

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 71933 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 created health awareness on diabetes at India Gate Lawns on November 17, 2013

press release

Monitoring LFT in a patient on statins

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

All of the following features can be observed after the injury to axillary nerve except:

1.Loss of rounded contour of shoulder.
2.Loss of sensation along lateral side of upper arm.
3.Loss of overhead abduction.
4. Atrophy of deltoid muscle.

Yesterday’s Mind Teaser: Referred pain from ureteric colic is felt in the groin due to involvement of the following nerve:


Answer for yesterday’s Mind Teaser: 4.Genitofemoral

Correct answers received from: Prabha Sanghi, Deepali Chatterjee, Dr MONICA GANDHI, Dr Arpan Gandhi, Dr Jainendra Upadhyay, dr.sahadevudu gelivi, Anil Bairaria, Dr chandresh Jardosh, Thomas Issac, Dr B K Agarwal, DR AVTAR KRISHAN, lalithdevraj

Answer for 17th November Mind Teaser: 1.Buccinator.

Correct answers received from: Dr Jainendra Upadhyay, Dr. shashi saini

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

Teacher: Billy, stop making ugly faces at other students!

Billy: Why, ma’am!

Teacher: Because when I was a child, my parents told me that if I kept making ugly faces my face would stay that way!

Billy: Well, I can see you didn’t listen then!

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient after sublingual nitrate developed fainting attack.
Reaction: Oh my God! Why was the systolic murmur missed on auscultation?
Lesson: Make sure that patient with left ventricular outflow tract (LVOT) obstruction are not given sublingual nitrates.

medicolegal update

Don’t be pushed by your problems. Be led by your dreams. Calvin & Hobbes

medicolegal update

Dr KK Aggarwal: The world’s deadliest virus in China today http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: In my stillness I am the eternal possibility. In my movement I am the cosmos.

Forthcoming events

Pushpanjali Crosslay Hospital, a 350+ bedded NABH & NABL accredited multi super specialty hospital is organizing its 5th Annual Conference "PCCON 2013" in association with Indian Medical Association (East Delhi Branch & West Ghaziabad Branch) on November 23–24, 2013 at Hotel Country Inn, Sahibabad, Ghaziabad.

Chairperson : Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Day & Date : Sunday, 24th Nov, 2013

Topic : Quality Management in Healthcare Delivery

medicolegal update
  1. I think this news bulletin is an excellent piece of creative and informative work. Dr K K Arora

eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

Our Contributors

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, Prof.(Dr).C V Raghuveer

medicolegal update

Our Sites