eMedinewS1st October 2013, Tueday

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

Yoga in Menopause May Help Insomnia –– But Not Hot Flashes

Taking a 12–week yoga class and practicing at home was linked to less insomnia –– but not to fewer or less bothersome hot flashes or night sweats. The link between yoga and better sleep was the only statistically significant finding in this MsFLASH (Menopause Strategies: Finding Lasting Answers for Symptoms and Health) Network randomized controlled trial, as per Katherine Newton, PhD, a senior investigator at Group Health Research Institute. Hormone therapy is the only Food and Drug Administration-approved treatment for hot flashes and night sweats.

No Pancreatic Risk Seen in DPP–4 Trials

Data from two large randomized controlled trials of the cardiovascular safety of DPP–4 inhibitors have turned up no signals of pancreatic disease. In both the SAVOR and EXAMINE trials, which investigated saxagliptin and alogliptin, there were no significantly increased risks of pancreatitis or pancreatic cancer with these drugs compared with placebo, according to findings presented here at the European Association for the Study of Diabetes meeting.

The SAVOR and EXAMINE studies were cardiovascular safety studies done to comply with FDA requirements following problems with cardiac safety of other classes of diabetes medications. SAVOR was the larger trial, enrolling 16,492 patients who were followed for about 2 years, while EXAMINE was done in fewer patients (total 5,380) who were also sicker –– all of them had to have had a recent acute coronary syndrome.

The main findings were previously reported at the European Society of Cardiology meeting in Amsterdam last month and published in the New England Journal of Medicine. Both studies found that these drugs neither reduced or increased the risk of cardiovascular events –– although there was a significant 27% higher risk of hospitalizations for heart failure in patients on saxagliptin in the SAVOR study.

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

What are Satvik offerings in Vedic literature?

sprritual blog

1. Food Offerings: Panchashasha (grains of five types – brown rice, mung or whole green gram, til or sesame, mashkalai (white urad dal) or any variety of whole black leguminous seed, jowar or millet)

2. Panchagobbo (Five items obtained from cow: milk, ghee or clarified butter, curd, cow dung and gomutra), curd, honey, brown sugar, three big noibiddos, one small noibiddo, three bowls of madhupakka (a mixture of honey, curd, ghee and brown sugar for oblation), bhoger drobbadi (items for the feast), aaratir drobbadi mahasnan oil, dantokashtho, sugar cane juice, an earthen bowl of atop (a type of rice), til oil (sesame oil).

3. Water offerings: Ushnodok (lukewarm water), coconut water, sarbooushodhi, mahaoushodhi, water from oceans, rain water, spring water, water containing lotus pollen.

4. Three aashonanguriuk (finger ring made of kusha).

5. Puja Items: Sindur (vermillion), panchabarner guri (powders of five different colours – turmeric, rice, kusum flowers or red abir, rice chaff or coconut fiber burnt for the dark color, bel patra or powdered wood apple leaves), pancha pallab (leaves of five trees – mango, pakur or a species of fig, banyan, betal and Joggodumur or fig), pancharatna (five types of gems – gold, diamond, sapphire, ruby and pearl), panchakoshay (bark of five trees – jaam, shimul, berela, kool, bokul powdered in equal portions and mixed with water), green coconut with stalk, three aashonanguriuk (finger ring made of kusha).

6. Panchamrit: A mixture of Honey, Milk, Curd, Ghee and Brown Sugar.

cardiology news

A psychiatrist was consulted by a man whose marriage and career were both in serious trouble. His problem was his constant irritability and bad temper. He was concerned about this himself, but if any one tried to discuss it with him, he exploded in anger. He constantly told himself that everyone was picking on him and that he had to defend himself against them.

To counter the negative auto suggestion, he advised him to use positive auto suggestion. Several times a day in the morning, noon, and at night prior to sleep he was to repeat to himself.

From now on, I shall grow more; humor, joy, happiness and cheerfulness are now becoming my natural states of mind.

Every day I am becoming more and more lovable and understanding.

I will be center of cheer and goodwill to all those around me, infecting them with my good spirits.

This happy, joyous, and cheerful mood is now becoming my normal, natural state of mind. I am grateful.

After a month, his wife and his coworkers remarked on how much easier he was to get along with.

The things that drive you crazy are actually giant opportunities. The people who press your buttons are actually your greatest teachers. The issues that make you angry are actually your biggest gifts. Be grateful to them. Love them.

The people or circumstances that take you out of your power have extraordinary value: they reveal your limiting beliefs, fears and false assumptions. The celebrated psychologist Carl Jung once said: "Everything that irritates us about others can lead us to an understanding of ourselves." Powerful point. The things that irritate, annoy and anger you are entry points into your evolution and elevation as a human being. They are signposts for what you need to work on and the fears you need to face. They are gifts of growth. You can blame the people who trigger you and make it all about them. Or you can do the wise thing and look deeply into yourself to discover the reason for your negative reaction. Use the challenges to grow self–awareness. Because how can you overcome a fear you are not even aware of? And how can you transcend an insecurity you don’t even know you have?

As you begin to shed light on your personal weaknesses and take responsibility for them, you actually begin the very process of shedding them. You become stronger. More powerful. You begin to see the world through a different set of eyes.

Khalil Gibran, one of the greatest thinkers, once wrote: "I have learned silence from the talkative, tolerance from the intolerant, and kindness from the unkind; yet, strange, I am grateful to those teachers"

News Around The Globe

20th MTNL Perfect Health Mela Programme Brouchure

The Immune System of the Soul, October 17, 2013, Siri Fort Auditorium

Organised by Brahma Kumaris

In this fast paced world, where we all are running in the rat race to acquire all sorts of gadgets, luxuries and comforts of life, and have actually forgotten about our ‘being’, our ‘soul’ per se. None of us have the time to sit back and ponder on the very basic questions which arise even in a small child’s mind, as in who we are? Where we have come from? What is the purpose of our being? How our soul dwells in our daily activities? How can we charge up our soul or what makes it low? Do we actually listen to our inner/soul’s voice? If yes, there is still some hope, and if not, then what happens to our inner voice in return? All of us are bothered about materialistic possessions and all we care about is that we should be free from physical ailments. Does that suffice our existence? The answer is NO, as emotional ailments take its toll when we stop caring about our soul or the inner voice. To answers these questions and to help people get enlightened, Mike George, an author, spiritual leader and management consultant, has organized a workshop titled ‘The Immune System of the Soul’ which will take you to a journey from awareness to realization and finally to transformation. The workshop is scheduled on October 17, 2013, 6–8 PM at Siri Fort Auditorium, Delhi. Come and be a part of this divine experience.

  • Data from two large randomized controlled trials of the cardiovascular safety of DPP–4 inhibitors reported at the European Association for the Study of Diabetes have turned up no signals of pancreatic disease. In both the SAVOR and EXAMINE trials, which investigated saxagliptin (Onglyza) and alogliptin (Nesina), there were no significantly increased risks of pancreatitis or pancreatic cancer with these drugs compared with placebo.
  • The American Academy of Family Physicians (AAFP) has released its third list of commonly prescribed tests and procedures that may not be necessary. The evidence–based recommendations, part of the American Board of Internal Medicine Foundation Choosing Wisely campaign, were released on September 24 and are: (Source: Medscape)
    • "Do not prescribe antibiotics for otitis media in children aged 2–12 years with non–severe symptoms where the observation option is reasonable." The "observation option" is the ability to defer antibacterial treatment of selected children for 48 to 72 hours, limiting management to symptomatic relief.
    • "Do not perform voiding cystourethrogram…routinely in first febrile urinary tract infection…in children aged 2–24 months." Risks associated with radiation (plus the discomfort and expense of the procedure) outweigh the risk of delay.
    • "Do not routinely screen for prostate cancer using a prostate–specific antigen (PSA) test or digital rectal exam." Evidence suggests that PSA–based screening leads to substantial overdiagnosis of prostate tumors.
    • "Do not screen adolescents for scoliosis." Potential harms include unnecessary follow–up visits and evaluations resulting from false–positive test results and psychological adverse effects.
    • "Do not require a pelvic exam or other physical exam to prescribe oral contraceptive medications. Hormonal contraceptives are safe, effective, and well tolerated for most women."
  • The US Food and Drug Administration (FDA) has added a boxed warning about the increased risk for death to the label of tigecycline (Tygacil, Pfizer) that essentially classifies the intravenous antibiotic as a drug of last resort. The boxed warning, the strongest kind issued by the FDA, states that tigecycline "should be reserved for use in situations when alternative treatments are not suitable." Tigecycline is approved for complicated intra–abdominal infections and complicated skin and skin–structure infections, as well as for community–acquired pneumonia.
  • Acupuncture appears to be equal to counseling and may offer an additional nonpharmacologic treatment option for patients with moderate to severe depression. A randomized controlled trial of acupuncture and counseling published September 24 in PLoS Medicine showed that both treatments garnered a statistically significant symptom reduction when provided alongside usual care in patients with recurring bouts of depression at 3 months.
  • A proportion of patients with epilepsy whose disease is resistant to antiepileptic drugs (AEDs) have autoantibodies against neural components. Immune–directed therapy in these patients substantially reduces seizure frequency for many. Lead author Raffaele Iorio, MD, from the Institute of Neurology in the Department of Geriatrics, Neurosciences, and Orthopedics at the Catholic University in Rome, Italy said that patients with antibodies targeting synaptic antigens — cell surface antigens — showed a dramatic response to antibody–depleting therapy like plasmapheresis or immunoglobulins, while patients with antibodies targeting intracellular antigens respond less frequently to immunotherapy.

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Rabies News (Dr. A K Gupta)

A person has handled or eaten the raw meat of a rabid animal. What should be done?

If a person has handled or eaten the raw meat of a rabid animal, he should receive full course of rabies vaccine. If the person has eaten raw meat of a rabid animal and has oral ulcers/lesions, he may be given RIGs intramuscularly in thigh on Day 0 along with the first dose of vaccine.

cardiology news
  • The size of the left atrium may predict adverse events in type 2 diabetes patients with no history of cardiovascular disease. Of the 105 patients in the study, those whose left atrial volume index was 32 mL/m2 or greater had a significantly higher cardiac event rate (P<0.01) and death rate (P=0.002) at a median follow–up of 5.6 years than those whose volume was lower, according to Mikael Kjær Poulsen, MD, from Odense University Hospital in Odense, Denmark, and colleagues. Several characteristics were predictive of cardiac events and death in the univariate analysis including age, hypertension, left ventricular diastolic function, and left atrial volume index (LAVI) of 32 mL/m2 or greater, they reported in the study published online in the Journal of the American College of Cardiology. (Source: Medpage Today)
  • The FDA has approved new labeling for the Sapien heart valve for inoperable patients with severe aortic valve stenosis that omits references to specific access points. Patients who cannot have the Sapien Transcatheter Heart Valve inserted through transfemoral or transapical routes may now have it implanted via alternative approaches. The Sapien valve was first approved in 2011.

Valvular Heart Disease News

Patient with large vegetations are at high risk complications.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

cardiology news
  • Pediatric traumatic brain injury (TBI) can cause significant deficits in working memory, as demonstrated in a study published in Journal of Neurotrauma. Working memory is the ability to collect, retain and use information needed to perform tasks and respond to immediate demands. Amery Treble and coauthors from University of Houston, Texas and University of Texas Health Science Center at Houston used brain imaging studies to measure verbal and visuospatial working memory in a group of children who sustained TBI and a control group who did not. The comparison showed poorer visuospatial working memory in the pediatric TBI group, which was associated with disruptions in brain connectivity between neural networks that underlie working memory. According to authors, identification of neuroanatomical biomarkers indicative of these changes in brain microstructure might allow for early identification of children at increased risk for impaired working memory and for earlier intervention.
  • Young children readily learn words from their parents, grandparents, and child care providers in live conversations, but learning from video has proven more difficult. A new study questioned why and found that it’s the responsiveness of the interactions that’s key: When we respond to children in timely and meaningful ways, they learn – even when that response comes from a screen. The study, by researchers at the University of Washington, Temple University, and the University of Delaware, is published in the journal Child Development.
cardiology news

Turmeric can prevent heart failure

Traditional Indian turmeric prevents heart failure, lowers cholesterol, prevents cancers and gall stones and augments scar formation in a wound.

Studies from the University of Toronto’s Cardiology Division and published in The Journal of Clinical Investigation have shown that Curcumin, an ingredient in the curry spice turmeric, when given orally to a variety of mouse models with enlarged hearts (hypertrophy), could prevent and reverse hypertrophy, prevent heart failure, restore heart function and reduce scar formation.

In the studies, curcumin was given to rats, who then underwent surgery or received drugs designed to put them at risk of heart failure. The rats that received curcumin showed more resistance to heart failure and inflammation than comparison groups of rats that did not get curcumin.

Curcumin treatment also reversed heart enlargement. Curcumin short–circuited the heart enlargement process, though it's not clear how it did that.

The healing properties of turmeric have been well–known. The herb has been used in traditional Indian medicine to reduce scar formation. For example, when there is a cut or a bruise, the home remedy is to reach for turmeric powder because it can help to heal without leaving a bad scar.

Curcumin has come under the scientific spotlight in recent years, with studies investigating its potential benefits for reducing cholesterol levels, improving cardiovascular health and fighting cancer.

As an herb, turmeric should to be taken 300 mg thrice once daily with meals. It has useful actions like antioxidant, anti–inflammatory, anti rheumatic; lowering cholesterol, anti cancer and prevention of gall stones. It is also found to be useful in situations like dysmenorrhea, dyspepsia, HIV, muscle soreness, peptic ulcer disease, scabies and uveitis.

Curcuminoids, act as free radical scavengers. They also inhibit leukotrienes and synthesis of prostaglandins. The anti–inflammatory activity has been claimed to be comparable to NSAIDs (such as indomethacin).

Curcuminoids lower blood lipid peroxides, decrease total cholesterol and LDL cholesterol, and increase HDL cholesterol. Turmeric has also been claimed to inhibit platelet aggregation.

cardiology news

Total CPR since 1st November 2012 – 63400 trained

CPR Classes 63400

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When Constipation May be a Serious Problem 30th August


TB more dangerous than FLU 29th August


Give your child deworming now

During monsoon, humidity levels are high; houseflies, mosquitoes and other disease–carrying organisms flourish under these conditions. All fruits and vegetables should be washed with clean water; potassium permanganate can be added if available. Leafy vegetables and cauliflower often contain worms, cautioned Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

Roundworms or Ascaris are abundant in soil. Good sanitation to prevent fecal contamination of soil is required which may not be possible in the monsoon season.

A Sri Lankan study has shown that even in the setting of poor sanitary facilities, washing hands before meals and drinking boiled water significantly reduces the risks of Ascaris infection. However, this alone may not be sufficient. This is the time to give your child a tablet of de–worming if it has not been given and then to repeat three to four times a year said Dr Aggarwal.

Mass treatment for all school-age children with single dose mebendazole or albendazole every three 3 to 4 months has been advocated in most countries. This serves the dual function of treating the children and also reducing the overall worm burden in the community.

To support this he cited that in a large randomized trial of school–based deworming performed in Zanzibar, where single dose mebendazole, given three times a year, decreased intensity of Ascaris lumbricoides infection by 97 percent, compared to those children who received no mebendazole.

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 63400 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

Inaugurating the day–long ‘Dil Ka Darbar’ organized by Heart Care Foundation of India in association with Department of AYUSH, Government of India, Health Department, Government of Delhi, MTNL, Central Bank of India and LIC.

press release

Exercise impact on the knee

today video of the dayDr KK Aggarwal Birthday 5th September

Cultural Evening at IMA

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

A recent large database study of bivalirudin and vascular closure devices for interventional procedures has shown reduced bleeding with………

a. Bivalirudin use
b. Vascular closure device use
c. Both used together
d. All of the above

Yesterday’s Mind Teaser: What is a healthy blood-pressure level?

A. 110/70
B. 125/85
C. 135/90
D. 140/95
E. 150/95

Answer for yesterday’s Mind Teaser: A. 110/70

Correct answers received from: Dr ajay Gandhi, Dr.A.K.GAJJAR, pushpa otiv, Dr. SUSHMA Chawla, DR MCGUPTA, Ajit Nirvan, Prabha Sanghi,, Dr.Kaushal Kumar, Dr. V.P. Thakral, yogesh soni, DR ARPAN GANDHI, Dr Jainendra Upadhyay, DR AYYAVOO ERODE, Dr Pankaj Agarwal, soni brijesh, DR.BITAAN SEN & DR. JAYASHREE SEN, Dr chandresh Jardosh, Muthumperumal Thirumalpillai, Dr. Pawan Mehta, Dr. P. C. Das, Dr Kanta jain, DR AVTAR KRISHAN, Dr B K Agarwal, Pooja

Answer for 29th September Mind Teaser: A. Hypertension and aging.

Correct answers received from: Praveen Jain, Dr. ALOK RAI, Dr. V.P. Thakral

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

Married Couple and Fairy

A married couple in their early 60s was celebrating their 40th wedding anniversary in a quiet, romantic little restaurant.

Suddenly, a tiny yet beautiful fairy appeared on their table. She said, ‘For being such an exemplary married couple and for being loving to each other for all this time, I will grant you each a wish.

The wife answered, ‘Oh, I want to travel around the world with my darling husband.’

The fairy waved her magic wand and – poof! – Two tickets for the Queen Mary II appeared in her hands.

The husband thought for a moment: ‘Well, this is all very romantic, but an opportunity like this will never come again.

I’m sorry my love, but my wish is to have a wife 30 years younger than me.’

The wife and the fairy were deeply disappointed, but a wish is a wish.

So the fairy waved her magic wand and poof! The husband became 92 years old.

The moral of this story: Men who are ungrateful should remember… fairies are female too!

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with diabetes shows deteriorating kidney function.
Reaction: Oh my God! His HbA1c is very high!!
Lesson: Make sure that strict glycemic control is maintained in patients with type 2 diabetes in order to delay vascular complications.

medicolegal update

If the loser keeps his smile, the winner will lose the thrill of victory.

medicolegal update

Dr KK Aggarwal: Sudden Cardiac Death By Dr k k Aggarwal http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: Mainstream science is dismissive, when faced with the notion of mind outside the brain. Could science be wrong? http://tinyurl.com/l6x3eo4

medicolegal update

Dear Sir, E-medinews is very informative and useful e-bulletin/ newspaper. Regards Dr H. Rahman

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