eMedinewS19th January 2014, Sunday

Dr K K AggarwalPadma 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

Finasteride chemoprevention

Inhibition of 5–alpha reductase blocks production of androgens involved in prostate cancer pathogenesis and provides the rationale for the use of Finasteride as a chemopreventive agent against prostate cancer.

Results from the Prostate Cancer Prevention Trial have shown that prophylactic use of finasteride for seven years significantly decreased the incidence of prostate cancer compared with placebo. Additional long–term follow–up of the PCPT trial confirmed the significant decrease in the overall incidence of prostate cancer, which was limited to a reduction in the incidence of low risk disease. Although an increase in the incidence of high–grade (Gleason score ≥7) prostate cancer remained, there was no difference between the finasteride and placebo groups in overall survival at 15 years.

The 5th eMedinewS revisiting scheduled for 19th January has been postponed. The new date along with other details would be published in eMedinewS.

Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV

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

Leverage your strengths

sprritual blog

• Know your strengths
• According to a British study, only about one-third of people have a useful understanding of their strengths.
• If something comes easily, you may take it for granted and not identify it as a strength.
• If you are not sure, ask someone you respect who knows you well, by noticing what people compliment you on, and by thinking about what comes most easily to you.
• Strengths most closely linked to happiness are gratitude, hope, vitality, curiosity, and love.
• Strengths are so important that they're worth cultivating and applying in your daily life, even if they don't come naturally to you.

cardiology news

The Power of Good Words

A group of frogs were traveling through the woods, and two of them fell into a deep pit.

All the other frogs gathered around the pit. When they saw how deep the pit was, they told the unfortunate frogs they would never get out. The two frogs ignored the comments and tried to jump up out of the pit.

The other frogs kept telling them to stop, that they were as good as dead. Finally, one of the frogs took heed to what the other frogs were saying and simply gave up. He fell down and died.

The other frog continued to jump as hard as he could. Once again, the crowd of frogs yelled at him to stop the pain and suffering and just die. He jumped even harder and finally made it out. When he got out, the other frogs asked him, "Why did you continue jumping? Didn’t you hear us?"

The frog explained to them that he was deaf. He thought they were encouraging him the entire time.

This story holds two lessons:

  1. There is power of life and death in the tongue. An encouraging word to someone who is down can lift them up and help them make it through the day.
  2. A destructive word to someone who is down can be what it takes to kill them. Be careful of what you say. Speak life to those who cross your path.

The power of words… it is sometimes hard to understand that an encouraging word can go such a long way. Anyone can speak words that tend to rob another of the spirit to continue in difficult times.

Special is the individual who will take the time to encourage another.

News Around The Globe


  • Body Packers Autopsy in AIIMS New, Delhi: Two dead bodies of unexplained death of foreign nationals were recently brought for the post–mortem examination by the police. During the autopsy, around one kilogram of cocaine in small capsules were recovered from stomach and the death was due to leakage of drug. People smuggle cocaine by swallowing containers filled with the drugs, whilst body pushers conceal the containers in the rectum or vagina. The process of swallowing or inserting illegal packets of drugs for the purpose of evading law enforcement officers carries risks other than criminal charges. It can be fatal. Individuals engaged in such activities are called "Body Packers". The most frequent cause of the death among body packers is acute drug intoxication due to rupture of the package(s) within the gastrointestinal tract. (Dr Sudhir K. Gupta, Professor & Head, Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences)
  • A new study shows that critically ill patients who receive stress ulcer prophylaxis suffer more adverse events with proton pump inhibitors (PPI) than with histamine 2 (H2) receptor antagonists. The results of the study were presented at the Society of Critical Care Medicine 43rd Critical Care Congress.
  • Researchers reported at the Society of Critical Care Medicine 43rd Critical Care Congress that removing mechanical ventilation could pose a risk to patients with renal failure or a high score on a new risk assessment tool.
  • The US Food and Drug Administration (FDA) has approved diclofenac sodium topical solution 2% w/w (Pennsaid 2%) for knee pain caused by osteoarthritis (OA). Pennsaid 2% is supplied in a metered dose pump bottle and has been approved for twice–daily dosing. It is contraindicated in patients with a known hypersensitivity to diclofenac sodium or any other component of Pennsaid and in patients who have experienced asthma, urticaria, or allergic–type reactions after taking aspirin or other NSAIDs.
  • Helicase–primase inhibitor pritelivir, also known as AIC316, reduced the rates of genital herpes simplex virus (HSV–2) in a dose–dependent manner in a proof–of–concept trial involving otherwise healthy men and women infected by HSV–2. The study was published in the January 16 issue of the New England Journal of Medicine.
  • Procalcitonin testing can predict whether sepsis patients will have positive blood cultures, according to a new pilot study in the American Journal of Emergency Medicine.

CPR 10 success stories

1. Hands–only CPR 10 English

2. Hands–only CPR 10 (Hindi)

3. Ms Geetanjali, SD Public School Successful Story

4. Success story Ms Sudha Malik

5. BVN School girl Harshita does successful hands–only CPR 10

6. Elderly man saved by Anuja

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  emedinewsdownload.

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Rabies News (Dr. A K Gupta)

What is pre—exposure vaccination?

Pre–exposure (Prebite) vaccination means immunization before the bite.

cardiology news

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

  • Findings from a substudy of the COURAGE trial reveal that anatomic burden, but not ischemic burden, is a good predictor of outcomes in patients with stable coronary artery disease treated with optimal medical therapy with or without revascularization. But neither risk stratification measure, used alone or in combination, helped identify patients who would benefit from percutaneous coronary intervention (PCI) in addition to medical therapy, according to the analysis, published online in the journal JACC: Cardiovascular Interventions.
  • The FDA has approved Medtronic’s CoreValve prosthesis for transcatheter aortic valve implantation (TAVI) in patients with symptomatic severe aortic stenosis who are not candidates for surgical valve replacement. CoreValve now becomes the second TAVI device available for use in the U.S., along with the Edwards Sapien valve.
cardiology news

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

  • A new study suggests that excessive gum chewing may be an important but under–recognized trigger for headaches in older children. The authors suggest that excessive gum chewing causes headache not through the ingestion of aspartame from the gum, as has been previously suggested, but by putting undue exertion on the temporomandibular joint (TMJ). Doctors should make a point of enquiring about the gum chewing habits of adolescents reporting daily or recurrent headaches. Their findings are published in the January issue of Pediatric Neurology.
  • Children with an annual myopia progression of at least 0.50 dioptres (D) may benefit from bifocal spectacles, according to the results of a randomized controlled trial in JAMA Ophthalmology. While traditional bifocals slowed myopia progression significantly, prismatic bifocals appeared to be even more effective for children with myopia and low lags of accommodation.
cardiology news

Severe hypoglycemia may lead to fatal arrhythmia

In a study of patients with diabetes and severe hypoglycemia, hypertension, QT prolongation, and hypokalemia were fairly common, and this might explain why hypoglycemia can lead to fatal arrhythmia and death.

Severe hypoglycemia was defined as requiring an emergency trip to the hospital by ambulance. Half of the patients with severe hypoglycemia and type 1 diabetes and more than half of those with type 2 diabetes had QT prolongation on their ECG readings, which might predict potential cardiac arrest. Compared with patients with type 2 diabetes, those with type 1 diabetes were less likely to have severe hypertension, but they were just as likely to have the risk factors of hypokalemia and QT prolongation.

The study was published online August 12, 2013 in Diabetes Care.

Death and or disability associated with hypoglycemia is now added to the list of never events and is a definite criteria for compensation in law suits.

cardiology news

Total CPR since 1st November 2012 – 84500 trained

Media advocacy through Web Media

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press release

Do not ignore day time sleepiness

Obstructive sleep apnea (OSA) with snoring is related to several cardiovascular diseases. It is a cause of systemic hypertension, said Padma Shri & Dr. B C Roy National Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr. National Vice President IMA.

Mild lung hypertension is also associated with OSA. Heart blockages are associated with severe OSA but not mild OSA. Night cardiac arrhythmias are known with OSA and therefore all patients with nocturnal cardiac arrhythmias should be evaluated for possible OSA.

Treatment of OSA may reduce systemic blood pressure, lung pressure, cardiovascular events and eliminate nocturnal ventricular bradycardia and asystole in many patients with OSA.

Explaining how sleep apnea occurs, Dr Aggarwal said that the throat is surrounded by muscles that control the airway for speaking, swallowing, and breathing. During sleep, these muscles are less active, and this causes the throat to narrow. In most people, this narrowing does not affect breathing. In others, it can cause snoring, sometimes with reduced or completely blocked airflow.

A completely blocked airway without airflow is called an obstructive apnea. Partial obstruction with diminished airflow is called a hypopnea. A person may have apnea and hypopnea during sleep.

Insufficient breathing due to apnea or hypopnea causes oxygen levels to fall and carbon dioxide to rise. Because the airway is blocked, breathing faster or harder does not help to improve oxygen levels until the airway is reopened. Typically, this requires the person to awaken to activate the upper airway muscles. Once the airway is opened, the person then takes several deep breaths to catch up on breathing. As the person awakens, he or she may move briefly, snort or snore, and take a deep breath. Less frequently, a person may awaken completely with a sensation of gasping, smothering, or choking.

Many people with sleep apnea are unaware of their abnormal breathing in sleep, and all patients underestimate how often their sleep is interrupted. Awakening from sleep causes sleep to be unrefreshing and causes fatigue and daytime sleepiness.

Certain factors increase the risk of sleep apnea.

  • Increasing age: Sleep apnea occurs at all ages, but it is more common in middle and older age adults.
  • Male sex: Sleep apnea is two times more common in men, especially in middle age.
  • Obesity: The more obese a person is, the more likely they are to have sleep apnea.
  • Sedation from medication or alcohol interferes with the ability to awaken from sleep and can lengthen periods of apnea (no breathing), with potentially dangerous consequences.
  • Abnormality of the airway

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 84500 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."

emedipicstoday emedipics

CPR 10 training at NDMC Premises

press release

Treatment for constipation in the elderly

vedio of day

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

A 40–year–old male had undergone splenectomy 20 years ago. Peripheral blood smear examination would show the presence of:

1. Dohle bodies
2. Hypersegmented neutrophils.
3. Spherocytes.
4. Howell–Jolly bodies.

Yesterday’s Mind Teaser: A 7 year old girl from Bihar presented with three episodes of massive hematemesis and melena. There is no history of jaundice. On examination, she had a large spleen, non–palpable liver and mild ascites. Portal vein was not visualized on ultrasonography. Liver function tests were normal and endoscopy revealed esophageal varices. The most likely diagnosis is:

1. Kala azar with portal hypertension.
2. Portal hypertension of unknown etiology.
3. Chronic liver disease with portal hypertension.
4. Portal hypertension due to extrahepatic obstruction.

Answer for yesterday’s Mind Teaser: 4. Portal hypertension due to extrahepatic obstruction.

Correct answers received from: Niraj K. Gupta, Dr Sushma Chawla, Dr A K Gajjar, Daivadheenam, Dr VP Thakral, Anil Laddha, Dr KV Sarma, Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Dr Avtar Krishan, Muthumperumal Thirumalpillai, Dr K Raju, Dr Bipin Vyas,
Dr Bitaan Sen & Dr Jayashree Sen.

Answer for 17th January Mind Teaser: 4. Clostridium perfringens infection.

Correct answers received from: Dr Bipin Vyas, Dr Bitaan Sen & Dr Jayashree Sen.

Send your answer to ijcp12@gmail.com

medicolegal update

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medical querymedical query

medicolegal update
medicolegal update

Funny Ads

These are advertisements that have appeared in papers across the country (or so we are led to believe)

– We do not tear your clothing with machinery. We do it carefully by hand.

– For Sale –– Eight puppies from a German shepherd and an Alaskan Hussy.

– Great Dames for sale.

– Have several very old dresses from grandmother in beautiful condition.

– Tired of cleaning yourself? Let me do it.

– Dog for sale: Eats anything and is fond of children.

– Vacation Special: Have your home exterminated.

– If you think you’ve seen everything in Paris, visit the Pere Lachasis Cemetery. It boasts such immortals as Moliere, Jean de la Fontain, and Chopin.

medicolegal update

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medicolegal updatemedicolegal update

medicolegal update

Situation: A patient with fever and cough develops complications after he was given antibiotics.
Reaction: Oh my God! What was the need of giving the antibiotics?
Lesson: Make sure that a patient with fever and cough is not given antibiotics as presence of cough mostly signifies viral infection.

medicolegal update

You may be deceived if you trust too much, but you will live in torment if you don’t trust enough. Frank Crane

medicolegal update

Dr KK Aggarwal: Some Alcohol Terms 1. Do not start if you do not drink Limit if you take and can not stop 3. (cont) http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Dealing with stress in a better way is the key to breaking the cycle of stress eating. http://bit.ly/15QdVeB #Health

medicolegal update
  1. Dear Sir, Thanks for the useful information. Regards: Dr Kapil

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