eMedinewS1st November 2013, Friday

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.twitter.com/DrKKAggarwal
www.facebook.com/Dr KKAggarwal

Dr. Ketan Desai Update

A debate is going on in the Internet whether it is justifiable for Dr. Ketan Desai to come back as a member of Medical Council of India.

I personally feel he was a victim of circumstances. He was charged under a DA case, which was closed by the agency as well as the CBI court.

A large number of preliminary investigations (PI) were filed against him and all ended up with a closure.

In other cases, FIRs filed were also closed due to lack of any evidence against him. Only one case is pending and the case has been stayed by the Supreme Court.

To the best of eMedinews knowledge neither has he been convicted so far nor is there any active chargesheet pending against him.

It has been said that he was caught red handed which is not based on facts as no money was recovered from him at the time of arrest.

Whenever there are charges of corruption CBI court has to prove that the person has acquired assets disproportionate to his assets. In his case, as there is no proof that he has acquired income disproportionate to his assets, there is no question of any corruption charges against him.

If he was corrupt, the CBI had no reason to close his DA case and there was no reason for the CBI court to have accepted the same.

Let us not defame a person without evidence. If someone has any evidence, kindly forward the same and we will publish the same in our newspaper.

In fact, his taking over as President of WMA, should be taken in a positive manner as it is an honour for the whole medical fraternity and the nation.

A meeting with Dr. Harsh Vardhan

A few days back, I was invited by Delhi Medical Association, which hosted a meeting with Dr. Harsh Vardhan at Nitin Gadkari’s house and was attended by over 250 doctors.

I found that except for 4–5 people, everyone who came was a hardcore BJP supporter.

The meeting looked that it was to charge its supporters. Ideally the meeting should have been of a thousand people with every BJP supporting doctor bringing five neutral doctors with them to sensitize them about Dr Harshvardhan.

Recently, Narender Modi held a rally in Rohini. As per media reports, there was a 1.5 to 2 lakh staunch BJP workers’ force in Delhi. Collecting these 1.5 – 2 lakh people as a part of public meeting does not make sense.

In fact, these two lakh staunch BJP supporters should have collected another 4 lakh non–BJP non–Congress supporters in the rally. The two lakh BJP workers instead of being in the rally should have been on the streets of the Delhi to make their presence felt in front of the public.

I always feel that one should concentrate on non–staunch supporters and work on the neutral people. That is the reason why Arvind Kejriwal has been able to make an impact on non-Congress and non–BJP staunch supporters.

I have been given to understand that another Congress Group in Delhi Medical fraternity has already become active under Dr. V K Monga. Everybody knows that in DMA there are two groups and it is likely that the other group may go along the congress lines.

Sooner or later it had to happen and our future DMA elections, I will not be surprised if in future they are backed by BJP and Congress in the background.

Up till now, Dr. Harsh Vardhan and Dr. A K Walia have been in politics. Both have been Health Ministers and yet Congress Versus BJP had never happened.

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
eMedinewS
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

The Churning of the Ocean on Dhanteras: Samudra Manthan

sprritual blog

Many of us know the story of ‘Sagar Manthan’ or the churning of the ocean. The story goes like this.

Once Indra lost his kingdom due to the disrespect he showed to sage Durvasa. He approached Lord Vishnu, who advised him to seek the help of the demons to churn the ocean of milk (Ksheer Sagar), so that he and other Devas could take the Amrita (ambrosia) that would make them immortal and help them regain their lost kingdom.

As per his advice, Devas approached the demons, and they all agreed in the end to churn the ocean of milk. They sought the help of mount ‘Mandhara’ and the great snake ‘Vasuki’ for this purpose. Vasuki, the snake God, was used as the rope and Mandhara, the mountain, as the churning stick to churn the ocean. While they were churning the great ocean, Lord Vishnu assumed the form of a tortoise and held the Mandhara from sinking. While the churning was going on, several wonderful objects came out of the ocean.

The first to come out was ‘Halahal’, the deadly poison, which threatened to engulf the world and destroy it. When no one was willing to accept the poison, Lord Shiva came forward to accept it. He swallowed it and Parvati who was standing beside him, pressed his neck as he swallowed it and thus, prevented it from going into his stomach. Thus the poison remained struck there forever in his neck, neither going up into his mind nor going down into his stomach. Then came Kamadhenu (the wish–fulfilling cow), the Ucchaisrava (the white horse), Airavata (the white elephant), Kaustubhamani (a rare diamond), Kalpavriksha (the wish–fulfilling tree), Lakshmi (the goddess of wealth), Sura or Varuni (the goddess of wine) and finally Dhanvantari (the divine physician) with the vessel of Amrita in his skilful hands. These objects, except the last one, were divided between Devas and the demons.

The nectar of immortality was, of course, finally denied to the demons and was distributed among Devas only, through a fine piece of trickery enacted by Lord Vishnu. He assumed the form of Mohini to delude the demons and make them temporarily forget all about the ‘Amrit’, while he went on distributing it among the gods who took it. Because of the effects of ‘Amrit’, they not only became immortal but also defeated the demons summarily. But two of the Daityas (demons) managed to partake of the Amrit. And they both became immortal. Therefore, the strife between good and evil continues to this day.

Spiritual Symbolism

The story represents the spiritual endeavor of man for achieving immortality and inner happiness through concentration of mind, withdrawal of senses, control of desires and practice of austerities and asceticism.

1 The Devas represent the pleasure principle in us. They also represent the senses.
2. The Demons represent the pain principle and the negative thoughts and impulses.
3. Indra represents the Intellect, which can become egoistic.
4. Ksheer Sagar or the ocean of milk is the mind or the human consciousness. The mind is always compared to an ocean (mano sagaram) while the thoughts and emotions to the waves.
5. Mandhara, the mountain stands for concentration. The word "mandhara" contains two words "man" (mind) and "dhara" (a single line), which means ‘holding the mind in one line’. This is possible only during mental concentration. The mountain Mandhara was upheld by Lord Vishnu as a tortoise.
6. The tortoise stands for the withdrawal of the senses into oneself as one practices mental concentration and meditation or contemplation. It also suggests that the mind should rest upon itself or freely surrender itself to the divine will.
7. The participation of both Devas and the demons signify the fact that when one is seeking immortality through the spiritual practice, one has to integrate and harmonize both the positive and negative aspects of one’s personality and put both the energies for the common goal.
8. The great serpent Vasuki stands for desire. The desire is always compared to a thousand hooded serpents.
9. Halahal represents the turmoil of mind one suffers in the initial phase of meditation
10. The celestial gems represent the spiritual powers or the Siddhis one can attain during meditation
11. ‘Amrit’ or nectar represents the inner happiness
12. Immortality represents Moksha.

The story represents the need for doing meditation (churning of the mind in the ocean) to gain control over ego, which takes over when the mind and intellect (Indra) lose their track.

The process involves intention to do the meditation (Devas approach the Vishnu or the consciousness who in turn advises to do the manthan) and attention (focus, concentration) on the object of concentration (God or consciousness and here the tortoise).

The process involves concentrating on a mantra or the breath continuously and giving preferences to the object of concentration over the thoughts. Meditation is incomplete without withdrawing the senses (tortoise). By yoga sutras of Patanjali, it is called ‘pratihara’ by creating a spiritual atmosphere. The contemplation or the continuing concentration is a must (mandhara).

Meditation is the process of slipping in the silent gaps between the thoughts. Negative thoughts are the Asuras, the devils or the demons. Meditation involves bypassing the thought and needs both the positive and the negative thoughts to cooperate with each other like in a rope.

While meditating, one is bound to be affected by a chain or rope of desires (Vasuki). The same needs to be tightened up caught firmly by the thoughts, and ignored by giving preference to the object of concentration, the self (the tortoise). When in difficulty, every one has to take the help of God (in the form of Mohini).

To summarize, the Vasuki used in the churning of the ocean denotes that Devas and the demons held desire (to seek immortality) as a rope and churned the mind with the help of concentration and withdrawal of the senses. You can hold the desire in your hands and manipulate it only when you have control over your desires.

In the initial phase of meditation or intense churning by opposite forces, one is affected by turmoil of the mind. Most people who start meditation leave it in this phase only, as they cannot bear this turmoil and get agitated or disturbed. That is one reason it is said that one should learn meditation under the guidance of a teacher, doctor or a guru.

The Halahal represents this suffering and pain one undergoes at the beginning of spiritual Sadhna. The problems get intensified because of inner conflicts, when one part yearns to pursue the spiritual path (Devas) while the other opposes it (demons). In short, ‘Halahal’ is the instability of the body and the mind that arises as a counter–reaction against one’s spiritual practice.

One can compare this to the release of the mental toxins comparable to the physical toxins which gets released when we rest and after a daylong rest complain of leg pains.

The mental turmoil representing all kinds of reactions, negative thoughts, desires and impulses associated with some degree of physical turmoil (body movements, flickering and tingling) need to be tackled here to complete the process of meditation.

One cannot take out these negative thoughts in the open nor can one keep it in (you cannot throw the Halahal out or swallow it). It needs to be managed or ignored by keeping it in the throat which is what was done by Shiva. Shiva here represents the ascetic principle (leading a life of self–discipline and self-denial).

It also means that another mode of controlling the turmoil is by controlling the breath. Shiva is the controller of breath and is called a ‘prananath, or praneshwar’ – The Lord of Breath. In meditation, it is essential that one gains complete mastery over one’s breathing pattern. Most sages hold their breath in their throat, near the palate, as they meditate to control this turmoil of mind.

The various objects that came out of the ocean during the churning stand for the psychic or spiritual powers (siddhis), which one gains as one progresses spiritually from stage to stage.

These siddhis are spiritual powers, which come to a seeker as he progresses on the spiritual path. We are told that a seeker should be careful about these powers as they can hamper his progress unless he uses them judiciously – not for his selfish gains but for others’ welfare. This is the reason why the gods and demons distributed these powers among others without keeping anything for themselves as they did not want to lose sight of their original aim, which was to gain immortality (inner happiness).

Dhanvantari stands for health. The vessel containing the Amrit was brought before the gods and the demons by Dhanvantari, the divine physician. This signifies that immortality can be achieved only when the body and the mind are in a perfect state of health.

Lord Dhanvantari is worshipped on Dhanteras, 2 days before Diwali as the lord of Ayurveda. He has four hands with herbal medicines, Ayurveda book, Amrit kalash and a Shankh in each arm. It defines the principles of treatments (herbal drugs for the physical body, pranayama and mantras represented by Shankha for the mind, rasayanas for spiritual health represented by the kalash and prevention by understating the knowledge of true self by reading the Ayurveda.

These spiritual powers are the ones, which one can attain while doing basic and advanced meditation and includes the capacity to fulfill desires, to give boons to others, to acquire health, wealth etc. Meditation is not possible in case of a person who is mentally or physically sick or whose gross body is not fit for receiving meditation benefits.

Lord Vishnu in the form of Mohini stands for ‘delusion of the mind’ in the form of pride. It is the pride of achievement to which the Asuras or the demons succumbed and thus, lost their right to enter into the world of immortality. Pride and egoism are the final hurdles one has to overcome in spiritual life before being able to experience self–realization.

cardiology news

One night, at 11:30 PM, an older African American woman was standing on the side of an Alabama highway trying to endure a lashing rain storm. Her car had broken down and she desperately needed a ride. Soaking wet, she decided to flag down the next car. A young white man stopped to help her – generally unheard of in those conflict–filled 1960s. The man took her to safety, helped her get assistance and put her into a taxi cab. She seemed to be in a big hurry! She wrote down his address, thanked him and drove away.

Seven days went by and a knock came on the man’s door. To his surprise, a giant gift was delivered to his home. A special note was attached. It read: "Thank you so much for assisting me on the highway the other night. The rain drenched not only my clothes but my spirits. Then you came along. Because of you, I was able to make it to my dying husband’s bedside just before he passed away. God bless you for helping me and unselfishly serving others."

Offer help to anyone who needs it

Thank others for helping you.

If you help someone…someone will help you.

Treat people the way you want them to treat you

News Around The Globe

News

  • Increasing vitamin D levels had no effect on calcium absorption in young women, according to a study reported in the Journal of Bone and Mineral Research. In the study, supplementation had no effect on calcium absorption at any dose
  • Physicians and nurses on an acute pain service increased compliance rates with their hospital’s hand–disinfection policy by nearly 30% by wearing a personal container of antibacterial hand rub. Wearing the individual hand–decontamination product improved overall application of the hand gel from a mean of 34% before the intervention to 63% after the intervention. Findings were presented at the American Society of Anesthesiologists (ASA) 2013 Annual Meeting.
  • In a detailed new report, the US FDA has outlined its approach for regulating new personalized therapies and devices. The report, Paving the Way for Personalized Medicine: FDA’s Role in a New Era of Medical Product Development, outlines the fundamental ways in which the FDA has modified its traditional approaches to drug and device regulation in the new era of products that are tailored toward specific patient subtypes, rather than broad diagnostic groups.
  • Patients with systemic sclerosis (SS) had four times the risk of myocardial infarction as matched healthy controls. In a multivariate analysis that adjusted for comorbidities and risk factors, the relative risk for MI among patients with SS was 4.1 compared with risk in the general population. The risk was highest in the first year after diagnosis, when it was eight times greater than in healthy controls. The study was presented at the annual meeting of the American College of Rheumatology.
  • Olodaterol (proposed trade name Striverdi Respimat), the novel once–daily inhaled bronchodilator improved lung function and exercise capacity in chronic obstructive pulmonary disease (COPD). The long-acting beta2 agonist (LABA) came out significantly better than placebo for forced expiratory volume over 1 second (FEV1) by all measures over the course of a day in two identical trials reported at the CHEST meeting.

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Rabies News (Dr. A K Gupta)

Can a rabies vaccine be given to a pregnant woman?

Following animal bite, rabies vaccine can be given to a pregnant woman. Medical termination of pregnancy should not be done as a routine clinical practice.

cardiology news

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

  • Continued follow–up of preliminary studies of renal denervation for patients with resistant hypertension continue to show relatively consistent and sustained reductions in blood pressure. In the EnligHTN–1 trial –– the first–in–human study of the EnligHTN renal denervation system by St. Jude Medical –– 18-month follow–up showed an average office blood pressure reduction of 24/10 mm Hg (P<0.0001), consistent with the previously reported 6–month results (26/10 mm Hg), according to Stephen Worthley, MBBS, PhD, of Royal Adelaide Hospital in Australia. In combined results from the REDUCE–HTN first–in–human and postmarketing studies of the Vessix renal denervation system, the average reduction in office blood pressure was 25/10 mm Hg at 6 months (P<0.0001), consistent with the 1–month results reported last year (30/11 mm Hg), Horst Sievert, MD, of the CardioVascular Center Frankfurt in Germany, reported. Both studies were presented at the Transcatheter Cardiovascular Therapeutics meeting.
  • Comorbidities, polypharmacy, socioeconomic stresses, and cognitive limitations frequently confound secondary prevention of cardiovascular disease in older adults, according to a scientific statement by the American Heart Association. The statement, therefore, has two intended purposes: to clarify the risks and benefits of secondary prevention and to "stimulate" the increased use of proven therapies in older adults. The study is published in Circulation: Journal of the American Heart Association.
cardiology news

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

  • Pediatric patients who received maintenance doses of hypotonic fluids intravenously were at increased risk for iatrogenic hyponatremia compared with those who received isotonic fluids. In a systematic review of 10 randomized controlled trials, the overall risk of low plasma sodium among pediatric patients who received hypotonic fluids intravenously while hospitalized was greater than two–fold. Hypotonic fluid receipt was associated with a 6.1–fold risk of moderate hyponatremia versus receipt of isotonic fluids. The findings were presented at the meeting of the American Academy of Pediatrics.
  • A computer–aided screening system for infants flags developmental delays significantly sooner than if screening is based on conversations between pediatricians and parents, according to a new study presented at the annual meeting of the American Academy of Pediatrics 2013. Rates of detection did not differ, however. The researchers developed a clinical decision support system called Child Health Improvement Through Computer Automation (CHICA). The electronic health records–based system was developed to address multiple facets of well–child care.
cardiology news

Flaxseed for lowering blood pressure

Eating flaxseed can reduce the upper blood pressure (systolic) by 10 mmHg and lower BP (diastolic) by 7 mmHg after six months, according to an international double–blind, placebo–controlled study presented at the American Heart Association 2012 Scientific Sessions.

This reduction of SBP and DBP after administration of dietary flaxseed is the largest decrease in BP ever shown by any dietary intervention.

Such reductions would be expected to result in around a 50% fall in the incidence of stroke and a 30% reduction in heart attacks.

Animal studies have shown that flaxseed has antiatherogenic, anti–inflammatory and antiarrhythmic effects and may reduce circulating cholesterol and trans–fatty acid levels.

cardiology news

Total CPR since 1st November 2012 – 71933 trained

Media advocacy through Web Media

Winter Asthma

Any breathlessness after the age of 40, appearing for the first time in winter, is cardiac asthma unless proved otherwise. Such patients should immediately have their blood pressure check-up done and if it is found to be high, then this needs immediate medical attention. First-onset breathlessness can also be an indication of angina or heart attack. This was stated by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India. However, winter asthma or acute exacerbation of winter COPD (chronic bronchitis) is more common.

Asthma is reversible airway obstruction and COPD is irreversible airway obstruction. Sudden exposure to cold, humidity, pollution at lower levels in atmosphere can precipitate asthma in susceptible individuals. Winter is the time to increase the dose of asthma medicines.

If a person can speak a full sentence, the asthma attack is mild; if a person speaks broken sentences the asthma attack is moderate and if the person is able to speak only words then the asthma attack is severe. Severe attack of asthma needs immediate hospitalization.

An attack of asthma is due to inflammation, narrowing and collection of fluid in the wind pipe and needs medicines to widen the wind pipe and reduce the inflammation.

The need of asthma medicines can be intermittent and/or permanent. The ‘Formula of ‘2’ becomes handy in such situations. A person who consumes more than two canisters of inhalers in a year or consumes asthma medicines more than twice in the night time in a month or more than twice in a day in a week, then he or she needs continuous asthma and anti inflammatory medicines. Inhalers are the best choices.

today emedipics

Students conveyed the Health messages in the recently concluded Perfect Health Mela 13

press release

AHA – ACS update new–2

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 muscles are grouped together as muscles of mastication except:

1.Buccinator.
2.Masseter.
3.Temporalis.
4.Pterygoids.

Yesterday’s Mind Teaser: How often should you have a Pap smear?

A. Once a year after puberty.
B. Once a year after either turning 21 or having sexual intercourse for the first time.
C. Once a year after age 21 and every two years after 30.
D. Once a year if you’re not in a monogamous relationship.
E. Once a year unless you’ve been vaccinated against the human papillomavirus (HPV). Then the screening is not necessary.

Answer for yesterday’s Mind Teaser: C. Once a year after age 21 and every two years after 30.

Correct answers received from: Dr. P. C. Das, Anil Bairaria, Dr Pankaj Agarwal, daivadheenam, DR AVTAR KRISHAN, Dr Kanta Jain, Dr Abbas Vakil, DR P K SAHU, Dr Prakash Khalap

Answer for 30th October Mind Teaser: B. At age 20.

Correct answers received from: Muthumperumal Thirumalpillai, DR AVTAR KRISHAN, Dr Kanta Jain, Dr Abbas Vakil

Send your answer to ijcp12@gmail.com



medicolegal update

Click on the image to enlarge

medicolegal update

A Dishonest Honest Man

One evening a man walked into a fast–food chicken place and bought a nine–piece bucket of chicken. He took his chicken to the park for a romantic dinner under the moonlight with his lady.

Upon reaching into the bucket, however, he received a surprise. Instead of chicken he discovered what was apparently the restaurant’s night deposit – some nine thousand bucks. The young man brought the bucket back to the store and asked for his chicken in exchange for the money.

The manager, in awe of the young man’s honesty, asked for his name and told him he wanted to call the newspaper and the local news station to do a story on him. He would become a local hero, an example of honesty and morality that would inspire others!

The hungry man shrugged it off, "My date’s waiting. I just want my chicken."

The manager’s renewed amazement over the young man's humility almost overwhelmed him. He begged to be allowed to tell the story on the news. At this the honest man became angry with the manager and demanded his chicken.

"I don’t get it," the manager responded. "You are an honest man in a dishonest world! This is a perfect opportunity to show the world that there are honest people still willing to take a stand for what is right. Please, give me your name and also the woman's name. Is that your wife?"

"That’s the ****** problem," said the young man. "My wife is at home. The woman in the car is my girlfriend. Now let me have my chicken so I can get out of here.

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with prosthetic heart valves (bioprosthetic) developed infective endocarditis.
Reaction: Oh my God! Why was he not given infective endocarditis prophylaxis?
Lesson: Make sure that all patients with prosthetic heart valves (bioprosthetic or homograft) are given infective endocarditis prophylaxis.

medicolegal update

With ordinary talent and extraordinary perseverance, all things are attainable. Thomas Foxwell Buxton

medicolegal update

Dr KK Aggarwal: Bed netting is of little help to prevent dengue http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Consciousness is the subjective ground of all experience. If there is reality outside of consciousness it is unknowable #CosmicConsciousness

medicolegal update
  1. Dear Sir, emedinews is very informative. Regards: Dr Saroj

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