eMedinewS19th August 2014, Tuesday

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

PCI often done at low–volume centers

About 25% of all percutaneous coronary interventions (PCI) in the US are performed at low–volume centers that do 200 or fewer procedures per year; 49% are done at centers that do no more than 400 such procedures annually, Gregory Dehmer, MD, of Scott & White Healthcare in Temple, Texas, and colleagues reported in the Journal of the American College of Cardiology.

They also found that on–site cardiac surgery was not available at 83% of centers that did 200 or fewer PCIs annually. The 2011 PCI guidelines stated that facilities doing 200 or fewer PCIs per year need to take a closer look at whether they should continue doing such procedures.

News Around The Globe

  • According to a study published online August 14 in JAMA Ophthalmology, one in 25 US adults with diabetes aged 40 or older has diabetic macular edema (DME). Researchers noted that DME was almost 3 times as common in African Americans as in non–Hispanic whites, with Hispanics in between.
  • The first human trial of a new vaccine, published in The Lancet, appears to provide protection against chikungunya virus. The new vaccine uses non-infectious virus-like particles composed of the structural proteins from the West African strain 37997. In the majority of recipients, an immune response via neutralizing antibodies was noted after the first vaccination, and even the lowest doses of the vaccine were effective.
  • A new study, presented at the American Sociological Association’s 109th Annual Meeting, suggests that when it comes to risky situations in the workplace, women are more likely to experience higher levels of anxiety than men, which can negatively impact their performance.
  • Injections of autologous stromal vascular fraction (SVF) possibly improve hand function and decrease pain among patients with systemic sclerosis (SSc), suggests a new study published online in the Annals of the Rheumatic Diseases.
  • Patients who have had breast cancer and start tumor necrosis factor inhibitor (TNFi) treatment for rheumatoid arthritis (RA) more than 5 years after the cancer diagnosis, are not more likely to have breast cancer recurrence as compared to patients who do not start TNFi treatment, suggests an article published online in the Annals of Rheumatic Disease.

Rabies News (Dr A K Gupta)

What is the cause of death in a rabid animal?

Death in rabid animal is due to progressive paralysis.

Cardiology eMedinewS

  • Antihypertensive therapy is effective in most patients with high blood pressure; however, those with the greatest risk factors for cardiovascular disease may show the greatest absolute benefit, suggests a new study published online in The Lancet.
  • A new study has found a link between a skin condition that causes hardened lesions on the palms and soles, and an inherited heart condition known as arrhythmogenic right ventricular cardiomyopathy (ARVC). ARVC is linked with faulty genes that alter a protein that regulates the cell called the desmosome. Problems in the desmosome can cause heart and skin cells to pull apart or not communicate properly with each other.

Pediatrics eMedinewS

  • Refusal of neonatal vitamin K is uncommon and is linked to midwife delivery at home or in a birth center and refusal of immunization, suggests a retrospective, population–based cohort study published in the September issue of Pediatrics.
  • A new study has found that in just four years, the HPV vaccine resulted in a significant decrease in genital warts in young Australians from a range of backgrounds. There was a 90% fall in genital warts for girls aged between 12 and 17 years. The study has been published in the Journal of Infectious Diseases.

Dr K K Spiritual Blog

Prayer for Inner Happiness

Stress is defined as the physical and mental reaction to the interpretation of a known situation. In absence of a known situation there cannot be a stress. One cannot be stressful for a person who has just died in New York in an accident unless he or she is a known person.

There has to be a right, conscious–based interpretation of the situation as the same situation can bring happiness to one and stress to the other.

The most important consequence physical or mental of stress, therefore, depends on the right interpretation of the situation.

The interpretation or judgment in the body is governed by chemical reactions and is controlled by the balance of autonomic balance system, which in turn is governed by the interaction of parasympathetic and sympathetic nervous system.

During the phase of acute stress when the sympathetic system is predominant, heart rate and blood pressure rises and a person cannot take correct and decisive decision.

He or she is likely to make mistakes, which can often be detrimental to living. Sympathetic mode is basically the mode of flight or fight reactions of the body.

Right conscious–based decisions can only be taken in a state of relaxed mind when the intention is inserted in the field of consciousness. The relaxed mind state of the body is the parasympathetic mode, which is healing and is evident by reduction in heart rate, blood pressure and increase in the skin resistance. Most conscious-based decisions will be based on truthfulness, will be necessary and will bring happiness to both the persons and the surroundings.

The yogic lifestyle by which a person learns the dos and don’ts of living, does regular practice of correct postures, daily pranayama and practices regular withdrawal from the outer atmosphere, helps in preparing a state of physical and mental body state, which is more receptive for conscious-based decisions. Yoga Sutras of Patanajali included them in his ashtanga yoga as the processes of Yama, Niyama, Asanas, Pranayama and Pratihyar.

Prayers have no value when the mind is not at rest. All of us have participated in hundreds of mourning prayers with two minutes of silence. This prayer has no value if the two minutes of silence is not observed. If prayer is done without it the mind will remain restless and we will keep on thinking these two minutes are not over yet.

The process of silence does shift our awareness towards test and parasympathetic state and temporarily we get to be in contact with the memories of the departed soul and we pay homage to him or her. Today a large number of organizations are teaching the process of meditation but the same cannot be taught unless a person practices procedures by which the mind gets relaxed.

The eight limbs of Patanjali focus in detail about premeditation preparations and once that is learned one can go to the other three limbs which are Dharna, Dhyana and Samadhi.

Yoga asanas are different from exercises. They stimulate and stretch all or one of the seven charkas, autonomic plexuses, and ganglion and there located ductless endocrine glands. Also during a yogasana the mind is in the exercise and not wandering here and there.

While yogic exercises at rest are termed yoga asanas and the same yogic meditative exercises with activity are called traditional Indian dances. Western exercises and dances do not follow the principles of yoga. Many international studies have shown that over one–third of the people during their lifetime pray either for their own illness or for somebody else.

All hospitals should have spirituals areas. The prayer and meditation rooms in a hospital setting invariably will provide an arena which will improve patient-doctor relationship and will reduce the rising disputes amongst them in the country.

Wellness Blog

Patients with acidity should avoid chocolates and peppermint

Persistent acidity is usually due to reflux of acid from the stomach into the food pipe. Mild cases of acidity reflux can usually be managed with lifestyle and dietary modifications along with antacids, H2 blockers and proton pump inhibitors.

However, patients in whom lifestyle management along with empirical treatment is unsuccessful or who have symptoms suggestive of complicated diseases should undergo endoscopy to rule out cancer of the food pipe, a condition linked with persistent acidity.

Symptoms that may suggest complicated disease include loss of appetite, loss of weight and difficulty in swallowing food, bleeding and signs of systemic illness.

Lifestyle changes for reflux involve elevation of head and of the body, avoidance of food before sleep and avoidance of food which makes the food pipe valve lax. The examples of such foods include fatty food, chocolates, peppermint and excessive intake of alcohol.

Hurry, worry and curry are the three main factors for causing acidity apart from alcohol and smoking. People with acidity should consume less of fermented, sour, salty and pungent foods.

Inspirational Story

A Million Dollar Lesson

A cab driver taught me a million dollar lesson in customer satisfaction and expectation. Motivational speakers charge thousands of dollars to impart his kind of training to corporate executives and staff. It cost me a $12 taxi ride.

I had flown into Dallas for the sole purpose of calling on a client. Time was of the essence and my plan included a quick turnaround trip from and back to the airport. A spotless cab pulled up. The driver rushed to open the passenger door for me and made sure I was comfortably seated before he closed the door. As he got in the driver’s seat, he mentioned that the neatly folded Wall Street Journal next to me was for my use. He then showed me several tapes and asked me what type of music I would enjoy. Well! I looked around for a "Candid Camera!" Wouldn’t you? I could not believe the service I was receiving! I took the opportunity to say, "Obviously you take great pride in your work. You must have a story to tell."

"You bet," he replied, "I used to be in Corporate America. But I got tired of thinking my best would never be good enough. I decided to find my niche in life where I could feel proud of being the best I could be. I knew I would never be a rocket scientist, but I love driving cars, being of service and feeling like I have done a full day’s work and done it well. I evaluate my personal assets and… wham! I became a cab driver. One thing I know for sure, to be good in my business I could simply just meet the expectations of my passengers. But, to be GREAT in my business, I have to EXCEED the customer’s expectations! I like both the sound and the return of being ‘great’ better than just getting by on ‘average’"

ePress Release

Diabetes is a progressive disease

Diabetes is a progressive disease, 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.

Dr Aggarwal said that an analysis from the United Kingdom Prospective Diabetes Study (UKPDS) found that 50 percent of patients originally controlled with a single drug required the addition of a second drug after three years; by nine years 75 percent of patients need multiple therapies to achieve the target hemoglobin A1C (HbA1c) value which is the average blood sugar of the last three months.

After a successful initial response to oral therapy, patients fail to maintain target A1C levels (<7 percent) at a rate of 5 to 10 percent per year.

This means that all diabetic patients will start with one drug and will invariably end up with three drugs, with or without the addition of insulin within 10 years. A1c should be done every three months until it is <7 percent and then at least every 6 months and should be preferred over the fasting sugar levels. A1c represents the average blood sugar of the last three months and the value should be kept lower than 7%.

Regardless of the initial response to therapy, the natural history of most patients with type 2 diabetes is for blood glucose concentrations to rise gradually with time.

Initial treatment of patients with type 2 diabetes mellitus includes education, with emphasis on lifestyle changes including diet, exercise and weight reduction when appropriate. Monotherapy with metformin is indicated for most patients and insulin may be indicated for initial treatment for some.

In the absence of contraindications, metformin is usually the initial therapy for most patients with type 2 diabetes.

Self-Assessment-Quiz

 

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Zee News – Health Wealth Shows

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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

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VIP’s on CPR 10 Mantra Video

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

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Health Check Up and CPR 10 Camp at NP CO–ED Sr Sec School, Tilak Marg on 8th August 2014

press release

White rice linked to diabetes in Asians

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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 was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA?
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of National Registry of Myocardial Infarction 2 (NRMI–2) trial suggest that this intervention is much better than thrombolytic therapy in such patients.

eMedinewS Humor

Can’t find printer

Customer: Hi, good afternoon, this is Martha, I can’t print. Every time I try, it says ‘Can’t find printer’.
I’ve even lifted the printer and placed it in front of the monitor, but the computer still says he can’t find it…

Quote of the Day

If we would see the color of our future, we must look for it in our present; if we would gaze on the star of our destiny, we must look for it in our hearts. Canon Farrar

Twitter of the Day

Dr KK Aggarwal: High fat diet prostate cancer prone http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Negative emotions are like unwelcome guests. Just because they show up on our doorsteps doesn’t mean they have a right to stay.

eMedi Quiz

Chi–square test is used to measure the degree of:

1. Causal relationship between exposure and effect.
2. Association between two variables.
3. Correlation between two variables.
4. Agreement between two observations.

Yesterday’s Mind Teaser: Serum total lactate dehydrogenase level will NOT be raised in:

1. Muscle crush injury.
2. Stroke.
3. Myocardial infarction.
4. Hemolysis.

Answer for yesterday’s Mind Teaser: 2. Stroke.

Correct answers received from: Raju Kuppusamy, Dr P C Das.

Answer for 19th August Mind Teaser: b.2.3 million

Correct answers received from: Dr Ashok Gupta, Dr Jainendra Upadhyay, Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

medicolegal update

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  1. Dear Sir, Thanks for the information: Regards, Dr Kanishk
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