eMedinewS1st June 2014, Sunday

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

New form of heart failure on the rise

Heart failure is routinely described as the progressive loss of ability of the heart to pump blood. But, there is another form of heart failure where the blood–pumping ability of the heart remains near normal. This second form of heart failure is too often overlooked and is just as lethal.

In this condition the heart muscle becomes thickened. The chamber inside gets smaller and the heart is unable to relax to accommodate the blood it needs to pump out. As there is no room for the heart to relax, the blood backs up into the lungs. This kind of anomaly is not picked up by standard measurements of "ejection fraction" – the percentage of blood in the heart that goes out with every beat.

This form of the disease is called "diastolic heart failure" because the problem occurs during the diastole portion of heart activity, as the heart relaxes after a beat. Nearly one–third of these patients have an ejection fraction greater than 50 percent, which is very near normal. However, the death rate for this kind of heart failure matches that of patients with the more common form of heart failure, with more than 20% of all the patients dying within a year. There is a steady increase over 15 years of heart failure with normal or near–normal ejection fraction.

For patients, the symptoms of both types of heart failure are the same: Shortness of breath, difficulty exercising and fluid retention in the body. Physicians cannot make a diagnosis on the basis of symptoms or routine examinations. One has to have an echocardiogram and see the heart pumping and see if the ejection fraction is normal or reduced. Until now, relatively little attention has been paid to diastolic heart failure. Advances have been made against systolic heart failure, in which the ejection fraction falls below normal but not much has been done about diastolic heart failure.

Pacing for heart failure

For patients with advanced heart failure waiting for cardiac transplant, biventricular pacing not only improves the quality of life but also prolongs life. If the ejection fraction is low the combo device also gives an electric shock when the heart stops. It is said that all patients with low ejection fraction should ask their doctors for possible implantation of these devices.

Signals of heart failure

One of the commonest presentations is breathlessness on exertion, which is often confused as a part of aging or being obese. Not being able to climb stairs may be the earliest sign of hypertensive diastolic heart failure. Other signals are:

  1. Feeling extra tired even after a good night’s sleep. People with heart failure may limit activities they like to do or take naps to avoid feeling tired.
  2. Weight gain: Call your doctor if you gain weight for more than 2 days in a row or if you gain 2 or more pounds.
  3. Shortness of breath: Heart failure makes breathing harder, especially during exercise. The lying down position may make it worse.
  4. Swollen ankles, legs, belly, and/or lower back, the swelling is often worse at the end of the day.
  5. Going to the bathroom more at night.

News Around The Globe

  • The US Food and Drug Administration (FDA) has approved the first generic versions of the anti–inflammatory drug celecoxib for rheumatoid arthritis, osteoarthritis, and acute pain.
  • Impaired kidney function, as measured by depressed glomerular filtration rates (GFR), is associated with a significantly higher risk of renal and urothelial cancers, reports a retrospective cohort study published online May 29 in the Journal of the American Society of Nephrology.
  • Two new studies presented at the 2014 European Congress on Obesity have pointed that eating nuts, particularly pistachios and almonds, could protect against the development of type 2 diabetes in individuals who are already at high risk for the disease.
  • The consumption of more caffeine might help sedentary people become more physically active; however, differences in genes possibly determine who will get a boost from the substance, report 2 studies presented recently at the American College of Sports Medicine 61st Annual Meeting.
  • A novel study, published in the May 27 issue of Neurology, has noted a strong correlation between restless legs syndrome symptoms and peripheral hypoxia. Hypoxia was reversed with the initiation of dopaminergic treatment, which also relieved symptoms.

Rabies News (Dr A K Gupta)

How to approach a case of irregularities in treatment schedule, e.g., if patients missed the doses as per the due dates, i.e. dose schedule is broken?

The first three doses of modern rabies vaccine must be very timely and for the fourth and fifth, one or two days of variation is permissible.

Cardiology eMedinewS

  • A study published online May 28 in the Journal of the American Heart Association has stated that patients who are discharged from the hospital after PCI need to fill their prescription for the antiplatelet agent clopidogrel as soon as possible in order to lower their risk of stent thrombosis.
  • The US Food and Drug Administration (FDA) has approved the first wireless implantable hemodynamic monitoring system for patients with heart failure, on account of reasonable assurance that the device is safe and effective for heart–failure management and reducing the rate of heart–failure–related hospitalizations.

Pediatrics eMedinewS

  • In children, the correlation between body mass index (BMI) and activity level is weak, reports a new study presented at the American College of Sports Medicine 61st Annual Meeting. When stratified by BMI, subjects in the lowest and highest quintiles corresponded to the lowest amount of activity; however, the correlation was not very strong.
  • Cerebral blood flow levels differ significantly during puberty between boys and girls; levels increase in females and decrease in males, reports a new study. This could have implications in sex–specific susceptibilities to certain psychiatric disorders, such as depression, anxiety and schizophrenia. The findings are published in the Proceedings of the National Academy of Science.

Dr K K Spiritual Blog

Who is a Good Teacher?

A good teacher is the one who follows the principles of listening first, teaching in detail till confusion arises and then teaching with reasoning while going into the minutest details and finally summarizing the ‘take–home’ messages.

This is what Lord Krishna taught to Arjuna in Bhagavad Gita. In the first chapter, he only listens, in the second, he gives detailed counseling, from 2 to 17 chapters, he gives reasoning and in 18th chapter, he revises.

Wellness Blog

Have Leg Artery Blockages? Walk on a Treadmill

A planned program of walking is good for people with blockage of leg blood vessels called peripheral arterial disease (PAD).

Normally when there is pain in the calf muscles in the leg on walking, the usual tendency is to rest and not walk. A study of 156 people with PAD published in JAMA showed that regular six–minute walks on a treadmill improved their endurance and quality of life. The study examined patients with symptoms and without symptoms. Over the six months of the study, the participants who did their regular six–minute treadmill walks increased their walking distance by about 69 feet, while those who did not walk regularly saw a decrease of 49 feet.

There is the potential for greater oxygen extraction from the blood under maximum exercise conditions. The muscles can make better use of blood flow and the oxygen release that comes from it.

Such exercise leads to improvement in "collateral circulation" –– growth in the number of blood vessels supplying the legs. Clinicians should urge all PAD patients, whether or not they have symptoms, to engage in a regular, supervised exercise program.

Walking is a standard recommendation for people with PAD. A recommended regimen is a 40–minute walk three times a week for at least six months.

Persistent leg pain is an indication that help is needed. In the absence of that symptom, physicians can test for PAD by measuring the difference in blood pressure between an ankle and an arm.

Inspirational Story

The Father and His Sons

A father had a family of sons who were perpetually quarreling among themselves. When he failed to heal their disputes by his exhortations, he determined to give them a practical illustration of the evils of disunion; and for this purpose he one day told them to bring him a bundle of sticks.

When they had done so, he placed the faggot into the hands of each of them in succession, and ordered them to break it in pieces. They tried with all their strength, and were not able to do it. He next opened the faggot, took the sticks separately, one by one, and again put them into his sons’ hands, upon which they broke them easily.

He then addressed them in these words: "My sons, if you are of one mind, and unite to assist each other, you will be as this faggot, uninjured by all the attempts of your enemies; but if you are divided among yourselves, you will be broken as easily as these sticks."

ePress Release

Eating fast food can cause liver damage

Quoting a Swedish study by Dr. Fredrik H. Nystrom of University Hospital of Linkoping, published in the medical journal ‘Gut’, Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and Sr. National Vice President Indian Medical association said that eating at least two fast foods meals every day and restricting levels of physical activity to no more than 5,000 steps a day can lead to signs of liver damage or weight gain.

At the end of the 4 weeks, the fast food eaters had put on an average of 6.5 kgs (14.3 pounds). After just one week on the fast food diet, blood tests showed sharp increases in a liver enzyme called SGPT. SGPT levels were more than quadrupled over the 4–week study period. Increased SGPT levels are used to diagnose liver disease before symptoms develop. In 11 fast food dieters, SGPT rose to levels suggestive of liver damage. The SGPT increases were linked to weight gain and higher sugar and carbohydrate intake.

Sutra: Eating 2 fast food meals a day, walking < 5000 steps a day can cause liver damage or gain weight as per a Swedish study.

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 88972 people since 1stNovember 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 10x10 i.e. 100 per minute."

eMedi Quiz

Bedsore is an example of:

1.Tropical ulcer.
2.Trophic ulcer.
3.Venous ulcer.
4.Post thrombotic ulcer.

Yesterday’s Mind Teaser: An early systolic murmur may be caused by all of the following except:

1. Small ventricular septal defect.
2. Papillary muscle dysfunction.
3. Tricuspid regurgitation.
4. Aortic stenosis.

Answer for Yesterday’s Mind Teaser: 4. Aortic stenosis.

Correct Answers received from: Dr Swati Surana, Dr Poonam Chablani,
Dr Jainendra Upadhyay, Dr Ajay Gandhi, Dr Avtar Krishan, Dr Jayant Gaikwad, Dr palani velrajan, Dr K Raju, Dr Arpan Gandhi, Dr K V Sarma, Dr Chandresh Jardosh, Deepali Chatterjee, Dr Prabodh K Gupta, Dr Bitaan Sen &
Dr Jayashree Sen, Dr Prakash Khalap, Prabha Sanghi, Gajveer Singh.

Answer for 29th May Mind Teaser: a. Most of the children present with clinical symptoms during the neonatal period.

Correct Answers received from: Dr Avtar Krishan, Deepali Chatterjee, Raju Kuppusamy, Jayant Gaikwad, Dr Vijayalakshmi Seshadri, Tukaram Pagad,
Dr Prabodh K Gupta, Dr Bitaan Sen & Dr Jayashree Sen.

Send your answer to ijcp12@gmail.com

Make Sure

Situation: An elderly patient with unstable angina presented with URTI and was found to be positive for C. pneumoniae infection.
Reaction: Remember to start macrolides immediately.
Lesson: Make sure to remember that erythromycin 2 g/day for 10–14 days reverses the increased risk of atherosclerosis. Seroepidemiological studies have shown a strong association between C. pneumoniae infection and atherosclerosis in patients with cardiovascular disease.

eMedinewS Humor

As an English professor

As an English professor, my father would often write little notes on student essays. Often he worked late, and as the hours passed, his handwriting deteriorated. One day a student came to him after class with an essay that had been returned.

"Mr. McDonald," he said, "I can’t make out this comment you wrote on my paper."

My father took the paper and, after studying it, sheepishly replied, "It says that you should write more legibly."

Zee News – Health Wealth Shows

Alcohol
Cancer Prevention
Depression
Paralysis
Pneumonia
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Vitiligo
Fluid Intake

 

Total CPR since 1st November 2012 – 88972 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

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

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

emedipicstoday emedipics

Health Check Up Camp at Modern Era Public School, 16th May 2014

press release

Intensive medical treatment prevents second stroke not intracranial stenting

video of day video of day

 

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 :

 

Quote of the Day

Just for today don’t be angry. Just for today don’t worry. Just for today be grateful and humble. Just for today be honest. Just for today be kind to others.

 

Twitter of the Day

Dr KK Aggarwal: Weight gain precedes the onset of diabetes Weight gain after age of 18 years in women and 20 years in men (cont) http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: We can affect change every day. Through our thoughts, our words, and our actions. Join me at http://tinyurl.com/nfbwx98

Forthcoming events

Announcement

Call for Free Registration

4th annual conference Zoonosis 2014
Sunday 6th July 10am–2 pm followed by Lunch

Venue; Indian Medical Association HQs, IMA House, ITO New Delhi

Objective: To discuss about prevention of diseases communicable
from animals to human.

Who can take part: Medical Practitioners,Veterinary Practitioners, Animal Owners/Breeders, NGOworking with animal care etc.

Experts will be from Veterinary/Medical sectors

All participants will be given certificate of participation.

Organizers: Heart Care Foundation
of India, Millennium India Education
Foundation,CAR (Ministry of Agriculture Govt.of India,

Register at :
rawat.vandana89@gmail.com/
drkakroo@gmail.com
or Call: Vandana 9891673085/Dr Kakroo 9810301261

 

medicolegal update

Click on the image to enlarge

medical querymedical query

medicolegal update

Click on the image to enlarge

medicolegal updatemedicolegal update

medicolegal update
  1. Dear Sir, Very informative newspaper. Regards: Dr Kunal
cardiology news

Media advocacy through Web Media

web mediawebmediawebmedia

eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)