eMedinewS1st December 2013, 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
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Some HIV prevention messages for World AIDS Day to be displayed in your clinic

  • AIDS is caused by the human immunodeficiency virus (HIV), which damages the body’s defence system.
  • AIDS is the late stage (stage 4) of HIV infection.
  • AIDS virus destroys certain kind of cells that normally help the body to fight disease. With the destruction of these cells, the body cannot defend itself against infections.
  • People who have AIDS grow weaker because their bodies lose the ability to fight off illnesses and became ill.
  • Progression from HIV infection to AIDS, if untreated, may take 8-10 years. In young children, it usually develops much faster.
  • People with silent HIV–positive state may live for years without any signs of the disease but they can still pass on the virus to others.
  • AIDS is a chronic manageable disease, but it is better to prevent it. One can live a near normal life.
  • HIV is not caused by witchcraft and it cannot be cured by having sex with a virgin.
  • HIV spreads through unprotected sex with an HIV–positive person.
  • HIV spreads through transfusions of unscreened (HIV–positive) blood.
  • HIV can spread from an infected woman to her child during pregnancy and childbirth.
  • HIV infection can be passed from a mother to her child through breastfeeding.
  • HIV spreads by unsterilized infected needles or syringes, especially those used for injecting drugs.
  • Used infected razor blades, knives or tools that cut or pierce the skin also carry some risk of spreading HIV.
  • It is not possible to get HIV/AIDS from touching those who are infected.
  • Hugging, shaking hands, coughing and sneezing will not spread the disease.
  • HIV/AIDS cannot be transmitted through toilet seats, telephones, plates, glasses, eating utensils, towels, bed linen, swimming pools or public baths.
  • HIV does not spread by mosquitoes or other insects.
  • The risk of getting HIV through sex can be reduced if people reduce the number of sex partners, if uninfected partners have sex only with each other, or if people practice safe sex - sex without penetration or while using a condom.
  • Correct and consistent use of condoms can save lives by preventing the spread of HIV.
  • All pregnant mothers should get HIV test done
  • Blood banks now test all donated blood and discard all units that test positive.
  • All people, including children, are at risk for HIV/AIDS.
  • People who have a sexually transmitted infection (STI) are at greater risk of getting HIV and of spreading HIV to others.
  • People with STIs should seek prompt treatment and avoid sexual intercourse or practice safe sex (non–penetrative sex or sex using a condom.
  • The more sex partners people have, the greater the risk that one of them will have HIV/AIDS and pass it on.
  • Internal secretions, which can harbor HIV virus, are blood (including menstrual blood, semen, vaginal secretions, breast milk, peritoneal fluid, brain fluid, pleural lung fluid, pericardial heart fluid etc. These secretions, when mixed with secretions of another person infected with HIV transmit HIV.
  • External secretions, which do not harbor the HIV virus are saliva, tear, sweat, urine and feces. The mixing of these secretions with secretions of an HIV +ve person does not transmit HIV.
  • High–risk behaviors are: Anal intercourse without condom, vaginal intercourse without condom, sexual activity that causes bleeding or injury and oral sex on a man without condom.
  • No risk or low risk sexual behaviors are: Hugging and rubbing bodies together; wet kissing with your open lips; masturbating yourself; using sex toys or talking sex no risk; vaginal intercourse using condom; anal intercourse using condom.
  • A blood test is the most accurate way to tell if someone is infected with HIV.
  • Most tests for HIV/AIDS check for the presence of antibodies to the virus.
  • If the result of an HIV/AIDS test is negative, this means the person tested is not infected or it is too early to detect the virus.
  • The HIV blood test may not detect infection up to the first few weeks to few months.
  • Even if the first test is negative, the test should be repeated 6 months after any possible exposure to HIV infection to confirm the status.
  • The time period when an infected person does not come as HIV positive in the blood test is referred to as window period.
  • Since an infected person can transmit the virus at any time, it is important to use a condom during sex or to avoid penetration.
  • HIV counseling and testing can help in the early detection of HIV infection, to get the support services for those who are infected.
  • Counseling helps to manage other infectious diseases they might have, and learn about living with HIV/AIDS and how to avoid infecting others.
  • Counseling and testing can also help those not infected to remain uninfected through education about safer sex.
  • A condom should always be used during all penetrative sex, unless it is absolutely certain that both partners are free of HIV infection.
  • A person can become infected through even one occasion of unprotected penetrative sex (sex without a condom).
  • Condoms with lubrication (slippery liquid or gel) already on them are less likely to tear during handling or use.
  • If the condom is not lubricated enough, a ‘water-based’ lubricant, such as silicone or glycerin, should be added.
  • If such lubricants are not available, saliva can be used.
  • Drinking alcohol or taking drugs interferes with judgment. Even those who understand the risks of AIDS and the importance of safer sex may become careless after drinking or using drugs.
  • Young people need to be informed that there is no vaccination and no cure for HIV/AIDS.
  • Prevention is the only protection against HIV/AIDS.
  • Persons suffering from sexually transmitted infection have a 5–10 times higher risk of becoming infected with HIV if they have unprotected sexual intercourse with an HIV–infected person.
  • If both partners are not treated for a sexually transmitted infection, they will continue infecting each other with the sexually transmitted infection.
  • Most sexually transmitted infections are curable.
  • Be faithful to your partner for safe sex.
  • Do not have sex without condom whether it is a one–time sex or long–time relationship.
  • ABC for safe sex: Abstain, Be faithful to your partner and if you cannot, use Condoms.
  • Girls and women have the right to refuse unwanted and unprotected sex.

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."

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

Mindfulness meditation

sprritual blog

Sit on a straight–backed chair or cross–legged on the floor.

Focus on an aspect of your breathing, such as the sensation of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale.

Once you've narrowed your concentration in this way, begin to widen your focus. Become aware of sounds, sensations, and ideas.

Embrace and consider each thought or sensation without judging it good or bad. If your mind starts to race, return your focus to your breathing. Then expand your awareness again.

cardiology news

Live and Work

Father was a hardworking man who delivered bread as a living to support his wife and three children. He spent all his evenings after work attending classes, hoping to improve himself so that he could one day find a better paying job. Except for Sundays, Father hardly ate a meal together with his family. He worked and studied very hard because he wanted to provide his family with the best money could buy.

Whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family.

The day came when the examination results were announced. To his joy, Father passed, and with distinctions too! Soon after, he was offered a good job as a senior supervisor which paid handsomely.

Like a dream come true, Father could now afford to provide his family with life’s little luxuries like nice clothing, fine food and vacation abroad.

However, the family still did not get to see father for most of the week. He continued to work very hard, hoping to be promoted to the position of manager. In fact, to make himself a worthily candidate for the promotion, he enrolled for another course in the Open University.

Again, whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family.

Father’s hard work paid off and he was promoted. Jubilantly, he decided to hire a maid to relieve his wife from her domestic tasks. He also felt that their three–room flat was no longer big enough; it would be nice for his family to be able to enjoy the facilities and comfort of a condominium. Having experienced the rewards of his hard work many times before, Father resolved to further his studies and work at being promoted again. The family still did not get to see much of him. In fact, sometimes Father had to work on Sundays entertaining clients. Again, whenever the family complained that he was not spending enough time with them, he reasoned that he was doing all this for them. But he often yearned to spend more time with his family.

As expected, Father’s hard work paid off again and he bought a beautiful condominium overlooking the coast of Singapore. On the first Sunday evening at their new home, Father declared to his family that he decided not to take anymore courses or pursue any more promotions. From then on he was going to devote more time to his family.

Father did not wake up the next day.

News Around The Globe

News

  • Kids today cannot run as fast or as far as their parents did, which may indicate their health will worsen as adults, according to new research from the University of South Australia’s School of Health Sciences. To determine children’s cardiovascular fitness over the years, researchers analyzed 50 studies about running fitness conducted between 1964 and 2010. The studies involved more than 25 million children between the ages of 9 and 17 in 28 countries. Most of the studies gauged cardiovascular endurance by measuring how far participants could run in a set time or how long it took them to run a set distance. Declines in cardiovascular endurance performance could be caused by a variety of factors, but 30 percent to 60 percent of the declines in running performance can be explained by increases in fat mass, Grant Tomkinson, lead author of the study, said in a statement. To improve their cardiovascular fitness and prevent health issues, children should participate in physical activities that use the body’s big muscles, such as running or swimming, he added. "If a young person is generally unfit now, then they are more likely to develop conditions like heart disease later in life," Tomkinson said. "We need to help to inspire children and youth to develop fitness habits that will keep them healthy now and into the future. They need to choose a range of physical activities they like or think they might like to try, and they need to get moving." Tomkinson presented his research earlier this week at the American Heart Association’s Scientific Sessions in Dallas, but it has not yet been published in a peer–reviewed journal. (Contributed by Rajat Bhatnagar)
  • For World AIDS Day 2013, the World Health Organization (WHO) is calling attention to the special needs of adolescents. In advance of World AIDS Day, held December 1, the WHO is issuing the first–ever guidelines that specifically address prevention and treatment for adolescents with HIV. In 2012, an estimated 2.1 million adolescents worldwide were living with HIV. Although the global number of HIV–related deaths in the general population fell by 30% worldwide between 2005 and 2012, among adolescents, that number rose by 50%.
  • For patients with age–related macular degeneration, home monitoring for disease activity leads to early identification of choroidal neovascularization, which can help preserve visual acuity at the time of progression. Results from the trial, known as the Age-Related Eye Disease Study 2: Home Monitoring of the Eye, were presented here at the American Academy of Ophthalmology (AAO) 2013 Annual Meeting.
  • Patients can overcome dental phobia through a therapy in which they recall traumatic events while rapidly moving their eyes. Researchers have reported in an article published online September 23 and in the December issue of the European Journal of Oral Sciences that after undergoing eye movement desensitization and reprocessing (EMDR) therapy, some patients are able to attend dental appointments for the first time in years.
  • Some 131,000 people were newly infected with HIV in Europe and nearby countries in 2012, an 8% rise from a year earlier and a worrying reversal of a recent downward trend in AIDS cases in the West. A report published by the World Health Organization’s (WHO) European office and the European Centre for Disease Prevention and Control (ECDC) showed a steady increase in new HIV cases over the last year, but by far the majority of cases were in Eastern Europe and Central Asia. As per the report, the high and increasing number of AIDS cases in the East is indicative of late HIV diagnosis, low treatment coverage and delayed initiation of life–saving HIV treatment.
  • A study has identified, for the first time, a gene mutation that appears to be implicated in patients with Cushing’s syndrome, and a second study has shed light on abnormal receptors in the adrenal gland in patients with this disease. This early research suggests that in the future, family members of patients with Cushing’s syndrome could be offered genetic screening to look for "silent carriers," and novel drugs could be developed to target abnormal receptors and possibly halt the progression of this disease.

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Rabies News (Dr. A K Gupta)

A pregnant woman develops rabies. What should be done?

The rabies virus is not known to cross placental barrier, and so if the mother develops rabies, the fetus is safe. Hence, the pregnant woman with rabies should be clinically managed and if induction of pregnancy or cesarean section is possible, the obstetrician should do it with some "personal precautions" and immunoprophylaxis (usually three doses of modern vaccine or if there is any accidental exposure, then full course of post–exposure vaccination either by IM or ID route should be given to the obstetrician.) Later the newborn may be given a full course of rabies PEP vaccination.

cardiology news

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

  • Adding renal–artery stenting to comprehensive medical therapy did not confer significant benefit with respect to the prevention of clinical events in patients with atherosclerotic renal–artery stenosis and hypertension or chronic kidney disease in the randomized controlled CORAL trial.
  • A new study published online November 25 in the British Journal of Sports Medicine suggests it is never too late to improve your health with exercise. In the study, English elders who became newly active were more than 3 times more likely to enjoy good health at follow–up than those who stayed sedentary.
cardiology news

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

  • Pediatric responses after corneal collagen crosslinking are similar to those in adults, and the technique appears to be safe in this younger age group, report researchers. Responses, however, might not be as long lasting in children and adolescents, and longer follow–up is needed to verify this trend. The study showed that progression of keratoconus occurred in 88% of the pediatric population, suggesting that immediate treatment is needed once the diagnosis is made (American Academy of Ophthalmology 2013 Annual Meeting).
  • There has been a recent upswing in injuries in older teens, probably because they are paying more attention to their cell phones than to where they are going. That is the contention of investigators from Safe Kids Worldwide, a global nongovernmental organization dedicated to preventing injuries, the leading cause of death in children in the United States. A Safe Kids recent study showed that distracted walking is as serious a public safety issue as distracted driving, Kristin Rosenthal, program manager for pedestrian and bike safety at that organization (American Public Health Association 141st Annual Meeting).
cardiology news

Passive smoking can cause dementia

People exposed to secondhand smoke may face as much as a 44 percent increased risk of developing dementia.

Smoking is already known to increase the risk for dementia and Alzheimer’s disease.

A study from Peninsula Medical School in Exeter, England published in the journal BMJ has shown that there is an association between cognitive function and exposure to passive smoking. The risk increases with the amount of exposure to secondhand smoke. For people at the highest levels of exposure, the risk is probably higher.

The study collected data on more than 4,800 nonsmokers who were over 50 years old and tested saliva samples from these people for levels of cotinine, a product of nicotine that can be found in saliva for about 25 hours after exposure to smoke. The researchers found that people with the highest cotinine levels had a 44 percent increased risk of cognitive impairment, compared with people with the lowest cotinine levels. And, while the risk of impairment was lower in people with lower cotinine levels, the risk was still significant.

Passive smoking is also associated with an increased risk of stroke and heart disease

cardiology news

Total CPR since 1st November 2012 – 75187 trained

Media advocacy through Web Media

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Blood sugar goals

Correction and prevention of low blood sugar is beneficial to hospitalized patients, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India.

For most non–critically ill hospitalized patients with diabetes, one should have a target blood sugar of <180 mg/dL. In non–critically ill hospitalized patients, lower blood glucose levels may decrease the risk of poor clinical outcomes, but also increase the risk of hypoglycemia. A reasonable sugar goal to avoid low blood sugar is to achieve fasting blood glucose concentrations not less than 90 to 100 mg/dL.

Preventing a Peptic Ulcer

An ulcer is a breakdown in the lining of the stomach or the first part of the small intestine. A type of bacterial infection is the most frequent cause, but lifestyle factors may also raise the risk, said Dr Aggarwal.

One may follow these preventive steps that may ward off a peptic ulcer:

  1. Limit alcohol to no more than two drinks daily.
  2. Stop smoking or chewing tobacco.
  3. If you need to take painkillers, avoid anti–inflammatory drugs (NSAIDs) such as naproxen, ibuprofen or aspirin.
  4. Consider, with your doctor’s approval, paracetamol instead.

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 75187 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."

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CPR10 Training at IITF

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Monitoring LFT in a patient on statins

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

The buffering capacity of a buffer is maximum at pH equal to:

1. 0.5pKa.
2. pKa
3. pKa+1
4. 2pKa

Yesterday’s Mind Teaser:A married middle aged female gives history of repeated abortions for the past 5 years. The given below is conceptions pre–natal karyogram. This karyogram suggests the following:

1. Klinefelter’s syndrome.
2. Turner’s syndrome.
3. Down’s syndrome.
4. Patau’s syndrome.

Answer for yesterday’s Mind Teaser: 3. Down’s syndrome.

Correct answers received from: Dr.J.T.Basavaraj. Davangere, Dr. P. C. Das, DR ARPAN GANDHI, DR.A.K.GAJJAR, Dr. V.P. Thakral, Dr.K.Raju, Dr Chandresh Jardosh, BRBhatnagar, Muthumperumal Thirumalpillai, daivadheenam, DR AVTAR KRISHAN, Dr Ashok Barat, Dr Prakash Khalap.

Answer for 28th November Mind Teaser: 2. Corticosteroid.

Correct answers received from: DR.A.K.GAJJAR.

Send your answer to ijcp12@gmail.com

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medicolegal update

Click on the image to enlarge

medical querymedical query

medicolegal update

While the doctor was talking to me, his nurse came in and said,
"Doctor, there is a man here who thinks he’s invisible."
The doctor said, "Tell him I can’t see him."

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal updatemedicolegal update

medicolegal update

Situation: A 36–year–old truck driver had severe allergic rhinitis and came for treatment.
Reaction: Oh my God, why was he not prescribed azelastine nasal spray?
Lesson: Make sure to avoid oral antihistamines in persons who perform tasks like driving as they may cause sedation and drowsiness; instead prescribe azelastine nasal spray which is effective and non–sedating.

medicolegal update

First we make our habits then our habits make us. John Dryde

medicolegal update

Dr KK Aggarwal: Equipment–related failures common in Operation Theater http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: I maintain that the cosmic religious feeling is the strongest noblest motive for scientific research–Einstein #CosmicConsciousness

Forthcoming events

5th eMedinews Revisiting 2013

(a day long single hall medical conference on 2013 happenings, followed by doctors of the year 2013 awards)

Sunday 19th January 2014, Maulana Azad Medical College Auditorium

Dilli Gate Delhi, 10 am-6 pm


Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee President
Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman
Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

5th eMedinewS Revisiting 2013
The 5th eMedinewS–revisiting 2013 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 19th 2014.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2013. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. Lunch will be provided.

Register at: rawat.vandana89@gmail.com/drpawangupta2006@yahoo.com

5th eMedinewS Doctor of the Year Awards
Nominations invited for 5th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2013.

pls send his/her Biodata at: emedinews@gmail.com

medicolegal update
  1. Dear Sir, very informative news. Regards: Dr Pankaj

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Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Prof.(Dr).C V Raghuveer

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