eMedinewS19th July 2014, Saturday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee

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

The Science of Hygiene

All of us are taught about hygienic living and this subject should be included as a chapter in the curriculum of every school. There are many different kinds of hygiene.

Respiratory hygiene: To prevent cross infection, specifically, from flu and related respiratory illness. One should be at a distance of minimum 3 ft, from a person who is coughing, sneezing or singing. Most respiratory particles are more than 5 microns in size and do not travel a distance of more than 3 ft. This may be one reason why in the ancient times, sneezing was considered a bad omen and people were asked to stay away for few seconds from someone who sneezes in front of them. This respiratory hygiene, however, will not prevent transmission of tuberculosis whose bacteria are less than 5 microns which keeps circulating in the area.

Hand hygiene: This is the fundamental principle for any disease prevention and the catch phrase is "before and after", which means – one should wash hands before and after eating food, touching any infected material, seeing a patient or after normal evacuation of stool in the morning.

Food hygiene: This basically means maintaining hygiene at home while cutting, serving and eating food. While cutting a vegetable, it involves clean hygienic surface, knife, hands, water, utensils etc. If that hygiene is not possible, follow the formula of boil it, heat it, peel it, cook it or forget it. That means, any food which has been boiled, heated or peeled is safe for eating. Peeling means removing the skin of a fruit such as banana or oranges.

Water hygiene: involves drinking safe water, safe drinking glass, proper washing of glass, not washing multiple glasses in the same utensil and proper picking of glasses. It is often seen that many caretakers pick up four glasses of water at a time with four fingers one in each glass.

Sexual hygiene: This involves washing local areas before and after sexual contact.

Body hygiene: This involves 16 upchars, as mentioned in mythology. Out of these 16 basic steps, some are related to body hygiene and they involve washing feet first and then hands followed by mouth and finally the body. Washing of the feet is the most important as they are the ones which carry infections into one’s house.

Cleaning of mouth is cleaning the teeth with one finger, gums with two fingers, tongue with three fingers and palate with thumb.

Abhishekam or the snana of the body involves multiple steps. Ancient steps have been washing the body with milk water (rose water etc.) followed by rubbing with curd (soap), honey (moisturizers), ghee (oil), sugar (the drying agent) and finally with milk water again. This facilitates natural bathing and not dependent on soap.

Servant hygiene: The most important hygiene to be observed at our homes is that of the servants or the help. They are often provided soap at the start of the month and they are supposed to continue using that soap for a month. If by any chance, they lose that soap in 2–3 weeks’ time, they are apprehensive in asking the owners for soap. As a result, they may wash their hands without soap for the next 2–3 weeks, which includes washing of hands in morning.

Nails hygiene: This is also one of the most important hygiene because they are responsible for causation of water and food disease. Therefore, this hygiene is very important for food handlers. It is important that they be give typhoid vaccines and de–worming tablets every three months.

News Around The Globe

  • A study published July 17 in Preventing Chronic Disease stated that the odds of developing gestational diabetes mellitus (GDM) were 40% higher among women with a history of hormonal contraceptive use than in women who never used contraception.
  • Any level of physical activity in midlife may reduce the chances of developing cognitive decline and dementia in late life, suggests a new research. The findings were presented at the Alzheimer’s Association International Conference (AAIC) 2014.
  • Three European societies have jointly issued clinical practice guidelines for the diagnosis, treatment, and follow–up of anal cancer. The guidelines were published online in the Annals of Oncology.
  • An article published online July 17 in Clinical Infectious Diseases has stated that antiviral medications may have been underprescribed for patients presenting to outpatient clinics with influenza during the 2012–2013 influenza season. However, despite repeated calls for more appropriate use, antibiotic medications were overprescribed.
  • The US Food and Drug Administration (FDA) has approved the first and only plasma–free recombinant C1–esterase inhibitor for the treatment of acute attacks of hereditary angioedema (HAE) in adolescents and adults.

Rabies News (Dr A K Gupta)

What is "furious form" of rabies in animals?

The excitative phase follows the prodromal phase in some animals. The animal becomes irrational and may aggressively use its teeth, claws, horns, or hooves. The expression is one of anxiety with dilated pupils. Noise invites attack. Rabid animals roam extensively and attack other animals, including humans and any moving object. Cats usually manifest furious type of rabies.

Cardiology eMedinewS

  • Coronary computed tomography angiography (CCTA) for those aged 50 years to screen for CAD is not warranted, suggested discussions at the Society of Cardiovascular Computed Tomography 2014 Annual Scientific Meeting. It was agreed that clinicians should not perform CCTA on everybody but insisted that there are a lot of patients in whom it may be required.
  • A large population–based study has shown that the risk of new–onset type 2 diabetes increases with adherence to statin therapy. However, the benefits of statins still clearly outweigh the risks. The report is published online in Diabetes Care.

Pediatrics eMedinewS

  • A new study published online July 14 in Pediatrics has shown that when just–born babies don't need resuscitation, clamping the umbilical cord well after spontaneous breathing is established improves first–day neonatal outcomes. There was a 20% decline in death or neonatal admission for every extra 10 seconds up to two minutes between cord clamping and spontaneous breathing, provided the cord was clamped after babies started breathing.
  • Researchers at the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the North American Society for Pediatric Gastroenterology have stated that inorganic arsenic in rice and rice–based foods poses health concerns in infants and young children. The commentary is published in the Journal of Pediatric Gastroenterology and Nutrition that recommends rice drinks should not be used in infants and young children.

Dr K K Spiritual Blog

More about Debts

Hindu scriptures have talked about three types of Hrin (debts) – Dev Hrin, Pitra Hrin and Rishi Hrin.

God or the devtas gave us the consciousness, parents gave us our body and teachers gave us the knowledge or intellect.

In Vedic language, our body is a mix of mind, body and soul which can be equated to three Hrins of mind (teachers), body (parents) and soul (Rishi & Gods). In computer language, this can be equated to operational software (God), application software (teachers) and computer hardware (parents).

Wellness Blog

Weight gain after quitting smoking does not increase the risk of heart disease

In a study published in Journal of American Association, researchers from Switzerland have shown that in non–diabetics, weight gain after quitting smoking does not take away the cardiovascular benefits of quitting smoking.

There is a net cardiovascular benefit of smoking cessation despite subsequent weight gain. Smoking cessation is always beneficial for smokers.

People gain 6–8 pounds of weight after quitting smoking. In the study, quitting smoking was also linked with a decreased risk of heart attack or cardiac death compared to smokers.

Inspirational Story

If and When Planted

How is "if and when" planted? The short stories below are examples of planting "if and when":

Karen, one of my coworkers was stressed about where she was living. She hated the apartment she was in and complained every day about it. One day over coffee, I asked her why she didn’t look for another apartment – it seemed like an easy solution to me. Karen’s reply to this was, "I will look for another apartment when I come back from vacation."

Sam hated his job. He dreaded getting up in the morning. He hated the work he was doing and it started to take a toll on him. He had a love for photography and was currently taking a two–year course to obtain his certificate. Every night he complained about his work. After listening to his complaints for a month, I asked him why he didn’t finish his course and start a small business doing photography on the weekends. His reply, "if only I had more time to finish my course. When I finish my course I will start a business."

Sarah had saved all her life and now was retired and living comfortably. The house she bought had a dishwasher in it; however, the dishwasher was old and didn’t work. She hated doing dishes, and every time we visited with her she complained about doing the dishes. One night, I asked her, "Why don’t you buy a new dishwasher Sarah."

Her reply, "I have been thinking about it, if they would only come on sale I would."

Larry worked for a company that allowed early retirement. Larry had both the years of service and his age, which allowed him to retire, but at a reduced pension. He was having difficulty coping with all the changes that were being made in his work. He had a couple of mild attacks, not a heart attack but similar to one. He called me and we talked for hours. I was worried about the stress of his job and the effects it was having on his health. "Why don’t you retire Harry? Do something that you have always wanted to do," I asked. Harry’s reply to my question was, "If only I was older then I would get my full pension." I got bolder in my conversation with him, "But Harry, you have your house paid off, you have no bills, the kids are grown up. You could sell your house and downsize, it really is not worth your health is it? Harry then said, "When the summer comes maybe I will."

All of these stories have the same theme running through them. There is a proverb that says it all: If and when were planted, and nothing grew." Now a year later, Karen is still living in the apartment she hates! Sam is still complaining about his job and still has not finished his course! Sarah is still washing dishes! Larry is still working and his health is not what it used to be!

The sad part of all of these stories is that all of these people had a lot of stress in their lives that they could have taken action to reduce. But, all of them defeated themselves by thinking "if" or "when". Life is too short for "if’s and when's".

The next time you are in a stressful situation and you find yourself saying or thinking – "if or when" – remember the saying, "If and when were planted and nothing grew!" Change your thinking and take action, so that you can reduce your stress right now.

ePress Release

Poor hygiene habits may lead to Typhoid fever

Typhoid fever is caused by a bacterium called Salmonella typhi and is transmitted via ingestion of food or drink that has been contaminated by the feces or urine of infected people, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association. Flying insects feeding on feces may occasionally transfer the bacteria through poor public sanitation conditions.

Though the cases occur round the year, more cases are seen during the summer and rainy seasons.

Symptoms usually develop 1–3 weeks after exposure, and may be mild or severe. They include high fever, malaise, headache, constipation or diarrhea and enlarged spleen and liver. A healthy carrier state may follow acute illness.

It can be treated with antibiotics. However, resistance to common antimicrobials is widespread. Healthy carriers should be excluded from handling food.

Sanitation and hygiene are the critical measures that can be taken to prevent typhoid.

Few salient facts about Typhoid fever

  • Typhoid does not affect animals and therefore transmission is only from human to human.
  • Typhoid can only spread in environments where human feces or urine are able to come into contact with food or drinking water.
  • Careful food preparation and washing of hands are crucial to preventing typhoid.
  • Typhoid fever in most cases is not fatal.
  • Prompt treatment of the disease with antibiotics reduces the case–fatality rate to approximately 1%.
  • When untreated, typhoid fever persists for three weeks to a month.
  • Resistance to common antibiotics is now common
  • Typhoid that is resistant to common antibiotics is known as multidrug–resistant typhoid (MDR typhoid).
  • Ciprofloxacin resistance is an increasing problem, especially in the Indian subcontinent and Southeast Asia.
  • Azithromycin is a new drug for drug–resistant typhoid.
  • Typhoid vaccine taken every three years is the best preventive approach.

eMedi Quiz

Which of the following statement is true regarding the author–based second opinion teledermatology?

a. Evidence based medicine is practiced as a collective opinion of the author who worked on an instant case
b. Applied for difficult to manage cases
c. Expert opinion and literature is obtained
d. All of the above

Yesterday’s Mind Teaser: The cells belonging to the following type of epithelium are provided with extra reserve of cell membrane:

1. Transitional
2. Stratified squamous
3. Stratified cuboidal
4. Stratified columnar

Answer for yesterday’s Mind Teaser: 1. Transitional

Correct answers received from: Dr Rohini Dhillon, Dr P C Das, Tukaram Pagad, Dr Poonam Chablani, Dr K Raju, Dr K V Sarma, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Daivadheenam Jella, Dr Avtar Krishan.

Answer for 17th July Mind Teaser: 3. Lateral rectus and abducent nerve.

Correct answers received from: Deepak Ambli, Dr Bitaan Sen & Jayashree Sen, Dr Prakash Khalap, Dr Sahadevudu Gelivi.

Send your answer to ijcp12@gmail.com



Zee News – Health Wealth Shows

Cancer Prevention
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Fluid Intake


Total CPR since 1st November 2012 – 94595 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

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VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

emedipicstoday emedipics

Health Check Up and CPR 10 Camp at NP Primary School, Rama Krishna Marg–16th July 2014

press release

Light from laptops, TVs, electronics, and energy–efficient light bulbs may harm health

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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 :


Make Sure

Situation: A patient on dialysis and on oral antacid developed aluminum toxicity.
Reaction: Oh my God! You should have put him on magaldrate preparations?
Lesson: Make sure to remember that magaldrate preparations do not cause aluminum toxicity in patients undergoing dialysis

eMedinewS Humor

More Words

A husband looking through the paper came upon a study that said women use more words than men. It read, "Men use about 15,000 words per day, but women use 30,000."

Excited to prove to his wife that he had been right all along when he accused her of talking too much, he showed her the study results.

The wife thought for a while, then finally she said to her husband, "It’s because we have to repeat everything we say."

The husband said "What?"

Quote of the Day

If you have controlled your mind you are the conqueror of the whole world. Swami Sivananda

Twitter of the Day

Dr KK Aggarwal: Blood Pressure: A silent killer http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Pay attention to the richness of your inner life. Daydream, imagine, and reflect. It’s the source of infinite creativity.


medicolegal update

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medicolegal update

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medicolegal update
  1. Dear Sir, Very Informative Newspaper. Regards: Dr Karan

Forthcoming Events

Ethical & Legal Issues of Medical Profession
Sunday, 20th July, 2014, 9.30am to 2.00pm, Hotel Radisson Blu, Kaushambi
Organized by: Delhi Medical Association, IMA UP State &
Crosslay Society for Promotion of Medical Education & Research
Programme Schedule



10.00 –10.30am

Inauguration by Chief Guest
Sh. Vimal Kumar Sharma, IAS
District Magistrate, Ghaziabad


How to Improve Image of Medical Profession?
Dr. Ajay Kumar, Member, Ethics Committee, World
Medical Association, Chairman Administration and
Grievance Committee, MCI


Common Ethical Violations in Medical Practice
Dr. Muzaffar Ahmad
Chairman, Ethics Committee, MCI


‘Pharma Industry–Medical Profession’ Relationship
Dr. K.P. Kushwaha, Member, Ethics Committee, MCI


Death on Table
Dr. Sharda Jain, Pushpanjali Crosslay Hospital


My Lord–I am not guilty.
Dr. K. K. Aggarwal, Member, Ethics Committee, MCI
Vice President, Indian Medical Association


Avoiding Criminal Litigations
Mr. Siddharth Aggarwal Criminal Lawyer Supreme Court

12.40 onwards

Professional Misconduct–Case Discussions
Dr. Arun Aggarwal, President, Delhi Medical Council Dr. O.P. Kalra, Chairman, Disciplinary Committee, DMC Dr. Anil Goyal, President, Delhi Medical Association Dr. Girish Tyagi, Secretary, Delhi Medical Council



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Media advocacy through Web Media

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eMedinewS Special

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