eMedinewS
20th October 2014, Monday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and National Science Communication Awardee. Limca Book of Record Holder (CPR). Gold Medalist

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

Cough Hygiene

  1. When you cough or sneeze, you tend to expel out respiratory waste, which can be droplets (larger than 5 microns) or airborne droplet less than 5 microns; both have different implications.
  2. Droplets remain suspended in the air only for a limited period and exposure of less than 3 feet is usually required for human to human transmission of droplet–borne respiratory organisms. In flu this can be upto 6 feet. The examples of droplet infections are patients with meningitis, influenza, rubella (German measles) etc.
  3. No precautions need to be taken by a person, who is 6–10 feet away from the patient but if a person is sitting or working even at a distance of 3–6 feet, the non-coughing person should wear simple mask.
  4. In contrast, airborne droplet nuclei, which carry respiratory secretions smaller than 5 microns can remain suspended in the air for extended period and can cause infections to people who are standing even more than 10 feet away. The example of airborne droplet nuclei infections are TB, measles, chickenpox and SARS.
  5. Patients with these diseases require to be placed in an isolation room and all those people who are looking after these patients must use a safe N95 mask.
  6. In normal house with open windows, there is a constant exchange of air, which prevents spread of infections but in rooms with air conditioners (ACs) with no air exchange, the infections can spread from one person to another.
  7. When sitting in an air conditioned atmosphere, the setting of the AC should be such that the same air is not circulated and fresh air is allowed to exchange.  Split ACs, therefore, are more dangerous than the window ACs.
  8. In an office with split AC, if one of the employees is suffering from any of the droplet nuclei disease, he/she can transmit infection to others. Therefore, patients with confirmed TB, measles, chickenpox and SARS should not be allowed to work in offices with split ACs

7th Asia-Pacific Heart Rhythm Scientific Session New Delhi, India

Cardiac resynchronization in mild heart failure

In patients with mild heart–failure symptoms, left ventricular dysfunction, and left bundle–branch block, early intervention with cardiac resynchronization therapy with a defibrillator (CRT–D) was associated with a significant long-term survival benefit as reported in N Engl J Med. 2014 May 1;370(18):1694–701. At 7 years of follow–up after initial enrollment, among patients with left bundle branch block (LBBB), the mortality rate was reduced with CRT–D (18%) vs that observed with ICD alone (29%). In contrast, among patients without LBBB, CRT–D was not associated with any clinical benefit and possibly with harm in patients.

Dr. Mohan Nair

Chairman, Organizing Committee of the 7th Asia Pacific Heart Rhythm Society's  (APHRS) Scientific Sessions, being organized simultaneously at the Taj Palace Hotel and ITC Maurya in New Delhi from October 29th to November 1st, 2014.

Be a part of the discussions regarding Arrhythmia Management with global experts at the 7thAsia Pacific Heart Rhythm Society Meeting from October 29th – November 1st at New Delhi.

As a special offer for all eMedinews readers, we have decided to waive off the registration fees for the conference. To register yourself, please click on the following link

https://podio.com/webforms/9727986/708939

News Around The Globe

  • The American Academy of Neurology and the American Association of Neuromuscular & Electrodiagnostic Medicine have issued a new guideline for the diagnosis and management of patients with limb-girdle or distal muscular dystrophies. The guideline, published in the October 14 issue of Neurology, highlights the importance of genetic testing to identify specific types of dystrophy.
  • The genotype of primary gastrointestinal stromal tumors (GIST) of gastric origin may help predict the risk of relapse and, thereby, identify patients for adjuvant therapy with imatinib, suggests a new analysis published online in Clinical Cancer Research.
  • Dr. Ashley C. Mays from Wake Forest Baptist Health in Winston-Salem, North Carolina has come up with a new model that accurately predicts the need for gastrostomy tube placement in patients undergoing surgery of the upper aerodigestive tract. The data are published online in JAMA Otolaryngology Head and Neck Surgery.
  • Obese patients who have plastic surgery to remove excess skin after bariatric surgery may be more apt to keep the weight off than those who don't, suggests a new study presented at the annual conference of the American Society of Plastic Surgeons in Chicago.
  • Injecting melanoma lesions with specific common cold or herpes simplex viruses destroys tumor cells and induces systemic immune responses, suggested a research presented at the European Society for Medical Oncology Congress 2014.

Dr KK Spiritual Blog

Spiritual Prescriptions: Satsang

Satsang is a common household word and is often held in many residential colonies. Traditionally, Satsang meant the regular meeting of a group of elderly or women of an area with a common intention of attaining inner happiness or peace through Bhajans or devotional songs for a particular God or Gods.  In Satsang, people realize that it is the Self, communing with Self.

The Sanskrit word ‘Satsang’ literally means gathering together for guidance, mutual support or in search of truth. It may involve talking together, eating together, working together, listening together or praying together.

Most scriptures describe sat and asat. They discriminate that this world is maya (asat) and God is Divine. Furthermore, they state that maya is not yours; Divine is yours.

Sang means to join, not just coming close, but to join. And how do you join? Only with love, which acts as the glue. So Satsang is:  Sat—Divine. Sang—loving association.

In non-traditional Satsang, people verbally express themselves to others in an uninhibited way. Here, each participant talks free of judgment of others, and self. In this way, each person is able to see many viewpoints, which may serve to diminish the rigidity of their own.

Satsang is one way of acquiring spiritual well-being. Many scientific studies have shown that when mediation or chanting is done in groups it has more benefits than when done individually. Maharishi Mahesh Yogi once said that if 1% of the population meditates or chants together it will have a positive influence on the entire society.

Satsang also helps in creating a network of people with different unique talents. Satsangi groups are often considered in a very deep-rooted friendship.

Adi Shankaracharya in his book Bhaja Govindam also talks about satsang in combination with sewa and simran and says that together the three can make one acquire spiritual well– being. Nirankaris and Sikhs also give importance to satsang and in fact every true Sikh is supposed to participate in the Gurudwara on a regular basis.

Chanting of mantra or listening to discourses in a satsang helps to understand spirituality through gyan marga. Group chanting continued on a regular basis is one of the ways of meditation mentioned in the shastras. It shifts consciousness from sympathetic to the parasympathetic mode.

The medical educational programs of doctors of today can be called medical satsangs as whatever is discussed is for the welfare of the society.

Satsang also inculcates in us, one of the laws of Ganesha, the law of big ears, which teaches everyone to have the patience to listen to the others.
In satsang, nobody is small or big, everybody has a right to discuss or give his or her views. Over a period of time, most people who regularly attend satsang, start working from the level of their spirit and not the ego.

Inspirational Story

Hiding their weaknesses and highlighting their strength

There was a King who had only one eye and one leg. He asked all the painters to draw a beautiful portrait of him. But none of them could because how could they paint him beautifully with the defects in 1 eye and 1 leg.
Eventually one of them agreed and drew a classic picture of the King. It was a fantastic picture and surprised everyone.

He painted the King aiming for a hunt. Targeting with one eye closed and one leg bent

Moral: Why can’t we all paint pictures like this for others.

Hiding their weaknesses and highlighting their strength....!!!!

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 eMedinewS

  • Hypertensive patients who also have psoriasis, and particularly those with extensive skin involvement, are at risk for having poorly controlled blood pressure, suggests a cross–sectional study published online in JAMA Dermatology.
  • Findings of a study published in the journal Nature suggest that fibroblasts, which normally give rise to scar tissue after a heart attack, can be turned into endothelial cells, which generate blood vessels to supply oxygen and nutrients to the injured regions of the heart, thus greatly reducing the damage done following heart attack. This switch is driven by p53, the well-documented tumor–suppressing protein. Increasing the level of p53 in scar-forming cells significantly reduced scarring and improved heart function after heart attack.

Pediatrics eMedinewS

  • A standardized slow enteral feeding (SSEF) protocol significantly reduces the incidence of necrotizing enterocoltis (NEC), or death of intestinal tissue, and death in infants with extremely low birth weight, suggests a new study published in the OnlineFirst version of the Journal of Parenteral and Enteral Nutrition (JPEN).
  • New research reports that children from lower-income families are more likely to have complications following tonsillectomy. The study is published in the online edition of Otolaryngology – Head and Neck Surgery.

Quote of the Day

  • Happy is the man who can do only one thing; in doing it, he fulfills his destiny. Joseph Joubert

IMA NEWS

Indian express: The Indian Medical Association (IMA) on Saturday set a 24-hour deadline for Bihar Chief Minister Jeetan Ram Manjhi to express “regret” over his remarks regarding doctors, failing which the association would either approach the court or go on strike. The CM had landed in a soup after he said on Friday that he would “chop off the hands (of doctors) if there was any negligence in the treatment of the poor”. Manjhi had also said that he would not tolerate “any slackening in matter of health”.

His statement further strained the relationship between the government and the IMA. The CM had earlier suspended the medical superintendent of Patna Medical College and Hospital without serving a showcause notice in the wake of the stampede at Gandhi Maidan.

Manjhi, meanwhile, defended himself saying, “I cannot do anything about people who do not understand the meaning of a Hindi proverb I used. I used ‘chopping hands’ in the context of curtailing powers of negligent doctors. I am disappointed at people taking it literally.”

IMA Bihar vice-president Dr Sahjanand said, “It is a shocking statement coming from the CM. We met today but were divided over whether to go on strike or to court. We have given the CM a 24-hour deadline to express regret or we will meet tomorrow (Sunday) to decide our course of action.”

Wellness Blog

Diagnosis of hypertension in childhood requires repeated BP measurements

The presence of hypertension should be confirmed on the basis of three blood pressure measurements at separate clinical visits.

Normative BP percentiles are based upon data on gender, age, height, and blood pressure measurements from the National Health and Nutrition Examination Survey and other population–based studies.

In a study, initial BP measurement was normal (below the 90th percentile), pre–hypertensive (systolic or diastolic BP between the 90th or 95th percentile) and hypertensive (systolic or diastolic BP ≥95th percentile) in 82, 13, and 5 percent of children.

At follow–up, subsequent hypertensive measurements were observed in only 4 percent of the 10,848 children who had initial hypertensive values. In the cohort, the overall prevalence of hypertension was 0.3 percent.

Source: Lo JC, Sinaiko A, Chandra M, et al. Prehypertension and hypertension in community–based pediatric practice. Pediatrics 2013;131:e415.

ePress Release

Dr KK Aggarwal nominates nine renowned doctors to join the Swachch Bharat Campaign Pledge to make India a healthy and clean nation at the valedictory ceremony of Heart Care Foundation of India’s annual Flagship event – MTNL 21st Perfect Health Mela & SAIL Heart Pavilion New Delhi, October 19, 2014: Just by keeping the city’s environment clean, over 50% of the diseases can be eliminated. Reinforcing this message, Padma Shri awardee, President of Heart Care Foundation of India, and one of the nine Nav Ratans of Delhi chosen to carry forward the Swachh Bharat Swastha Bharat Abhiyan started by Prime Minister Shri Narender Modi; Dr KK Aggarwal today further nominated nine leading doctors in the city. The names were announced as a part of the valedictory ceremony of the Perfect Health Mela, Heart Care Foundation of India’s annual flagship event.

The 9 Medical Icons nominated by Dr KK Aggarwal included:

· Dr Naresh Trehan – MD & Chairman Medanta Medicity
· Dr Anupam Sibbal – Group Medical Director, Apollo Hospital
· Dr Naveen Dang – Director Dr Dangs Path Lab
· Dr D K Deewan – Director Dept of family welfare, GOI
· Dr P K Sharma – MOH, NDMC
· Dr O P Yadava – Chairman National Heart Institute
· Dr Anil Goel – Chair Delhi Medical Council
· Dr Girish Tyagi – Secretary Delhi Medical Council
· Dr Vinay Aggarwal - Former President IMA

The team of some of the leading doctors in the city led by Delhi BPJ President, Mr Satish Upadhyay and Heart Care Foundation of India’s President Dr KK Aggarwal together pledged– “Hum Shapath lete hain ki hum Bharat to Swachh or Samridh Banayenge”. In addition to this they also took brooms in their hands and participated in a symbolic cleanliness drive at the Talkatora Indoor Stadium. Commenting on the campaign, Dr Naresh Trehan, Chairman & MD of Medanta - The Medcity said that I am privileged to be nominated to be a part of the 9 Medical Navratnas of the Swachch Bharat campaign and I am convinced that by keeping our surroundings clean, we can make India a healthier and disease free nation.

Speaking at the valedictory ceremony, Padma Shri Awardee, Sr. National VP and Secretary General Elect - IMA and President - Heart Care Foundation of India, Dr KK Aggarwal said,“ Improper sanitation, unhygienic habits, un kept surroundings, improper disposal of waste and open defecation all drastically increase the prevalence of disease in our country. It has been Heart Care Foundation of India’s constant endeavor over the past 21 years through the Perfect Health Mela to raise awareness about preventive health and this year we decided to add cleanliness to it given their indispensible relationship. I would like to thank all the doctors present here today, participants, sponsors and supporters for the wholehearted efforts and contribution in making Mela a success” Started in 1991, Perfect Health Mela is a mass health awareness module, which attracts over 2-3 lakh people each year. In its 21st edition, the Mela was organized in association the NDMC, MCD, SAIL, UN Information Center for Bhutan and Nepal and MTNL and the theme was “Swach Baharat, Swasth Bharat”. The main philosophy behind this theme being that by improving the cleanliness of the country several leading diseases such as dengue, typhoid, malaria, cholera can be eliminated. Some of the key one of its kind features of this year’s event included a live telemedicine facility set up by Medanta – the Medicity, the SAIL Heart and Health Pavilion and subsidized heart surgeries provided by the Sameer Malik Heart Care Foundation Fund.

Commenting on his nomination, the Group Medical Director of Apollo Hospitals, Dr Anupam Sibbal, added, “A country can only truly progress if its citizens are healthy and environment is clean. I thank Dr KK Aggarwal for nominating me and hope I can help carry forward this message. I congratulate him and his team at Heart Care Foundation of India for their constant efforts towards raising health awareness and providing effective health solutions for the marginalized sections of the society.” Over 1000 people attended the valedictory function of the 21st MTNL Perfect Health Mela & SAIL Health Pavilion.

eMedi Quiz

Injury to radial nerve in lower part of spiral groove:

1. Spares nerve supply to extensor carpi radialis longus.
2. Results in paralysis of anconeus muscle.
3. Leaves extension at elbow joint intact.
4. Weakens pronation movement.

Yesterday’s Mind Teaser:A 30 year old man came to the outpatient department because he had suddenly developed double vision. On examination it was found that his right eye, when at rest, was turned medially. The most likely anatomical structures involved are:

1. Medial rectus and superior division of oculomotor nerve.
2. Inferior oblique and inferior division of oculomotor nerve.
3. Lateral rectus and abducent nerve.
4. Superior rectus and trochlear nerve.

Answer for yesterday’s Mind Teaser:3.Lateral rectus and abducent nerve.

Correct answers received from:Dr.K.V.Sarma, Dr. B. B. Aggarwal, Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Dr Avtar Krishan, anu rekha

Answer for 18th Oct Mind Teaser:c.90–100%

Correct answers received from: Daivadheenam Jella


Send your answer to email

emedipicstoday emedipics

Pledge to make India a healthy and clean nation at the valedictory ceremony of Heart Care Foundation of India’s annual Flagship event – MTNL 21st Perfect Health Mela & SAIL Heart Pavilion

SAIL

21st MTNL Perfect Health Mela 2014
Self-Assessment-Quiz

 

expert_choice
Zee News – Health Wealth Shows

Alcohol

press release

Longer CPR efforts may improve survival chances

video of day video of day

Other Blogs

Video Library

MTNL Perfect Health Mela

Heart Care Foundation of India, a leading national non–profit organization committed to making India a healthier and disease-free nation announced the upcoming activities of the 21st MTNL Perfect Health Mela scheduled to be held from 15th – 19th October 2014 at the Talkatora Indoor Stadium in New Delhi.

Sameer Malik Heart Care Foundation Fund

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF

Total CPR since 1st November 2012 – 96458 trained

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

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

 

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 :

 

Dr Good and Dr Bad

Situation:A patient with diastolic heart failure was advised BNP test
Dr Bad: The test is not needed
Dr Good: Get it done
Lesson: In the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, patients with symptomatic heart failure, left ventricular ejection fraction of ≥45 percent with elevated natriuretic peptide levels benefit from spironolactone therapy.

Make Sure

Situation:A foreigner with a single loose stool developed sepsis.
Reaction: Oh my God! Why were antibiotics not started in time?
Lesson: Make sure that all foreigners are diagnosed to be suffering from Traveler’s diarrhea even if there is one single loose stool.

eMedinewS Humor

What It Means

Five year old Becky answered the door when the Census taker came by. 

She told the Census taker that her daddy was a doctor and wasn't home, because he was performing an appendectomy. 

"My," said the census taker, "that sure is a big word for such a little girl. Do you know what it means?" 

"Sure! Fifteen hundred bucks, and that doesn't even include the anesthesiologist!"

Twitter of the Day

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer
Dr Deepak Chopra:No regrets and no anticipation, just this moment fresh and as is

medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Editor eMedinewS and President Heart Care Foundation of India)

Giving wrong advice on email is liable for negligence
If the doctor has charged his/her full fees for the email consultation from the patient or a referring physician regarding a patient, he/she will be liable as if he or she has seen the patient. When giving a written opinion through email one can take the following precautions and write:

  • “Expert opinion provided as a professional courtesy only”
  • “Nominal fee charged is only to cover the secretarial / incidental expenses involved and does not count towards a consideration or contract”
  • “This is only an opinion based on the information provided to me. It is not a final opinion which cannot be given without seeing the patient physically.
  • “This is not a final opinion and you may use this opinion at your own responsibility and discretion”
  • “As it is an opinion given without seeing the patient I take no legal responsibility for the opinion given”.
medicolegal update
  1. Dear Sir, Very informative newspaper. Regards:” Dr KP Sharma

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