eMedinewS20th May 2014, Tuesday

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

How to recognize cardiac arrest

  • Rapid recognition of cardiac arrest is the essential first step of successful CPR 10.
  • As per guidelines, the lay rescuer who witnesses a person collapse or comes across an apparently unresponsive person should confirm unresponsiveness by tapping the person on the shoulder and shouting: "are you all right?"
  • If the person does not respond, the rescuer calls for help or ambulance and initiates excellent chest compressions.
  • Lay rescuers should not attempt to assess the victim’s pulse and, unless the patient has what appear to be normal respirations, should assume the patient is apneic or without respiration.
  • Remember even well–trained professionals can have difficulty determining if breathing is adequate or pulses are present in unresponsive adults.
  • After assessing responsiveness, health care providers should quickly check the patient’s pulse.
  • While doing so, it is reasonable to visually assess the patient’s respirations.
  • It is appropriate to assume the patient is in cardiac arrest if there is no breathing or abnormal breathing (gasping) or if a pulse cannot be readily palpated within 10 seconds.
  • The key point is not to delay CPR.

News Around The Globe

  • A retrospective study has recently revealed that worse outcomes for women with bladder cancer than for men could be, in part, due to the underrecognition by general practice clinicians that hematuria is a likely sign of cancer. The findings of the study were presented at the American Urological Association (AUA) 2014 Annual Scientific Meeting.
  • A study presented at the American Association of Clinical Endocrinologists (AACE) 23rd Annual Scientific and Clinical Congress has put forward data stating that testosterone therapy in men is not associated with an increased risk for myocardial infarction (MI) or stroke and may even be cardioprotective. This novel data is contrary to recent findings regarding risks of testosterone therapy.
  • The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) have proposed a new definition of obesity that takes complications into account, along with body mass index (BMI). The 2014 Advanced Framework for a New Diagnosis of Obesity as a Chronic Disease was presented at the American Association of Clinical Endocrinologists (AACE) 23rd Annual Scientific and Clinical Congress.
  • A novel study presented at the American Urological Association (AUA) 2014 Annual Scientific Meeting has pointed that ultrasound may be comparable to CT in its ability to discriminate between renal calculi and other causes of flank pain.
  • Another study presented at the AUA 2014 Annual Scientific Meeting has revealed that better control of glycemia in type 2 diabetes could possibly reduce the risk of developing kidney stones. Insulin therapy was significantly protective against low urine pH, whereas HbA1c levels were associated with more acidic urine.

Rabies News (Dr A K Gupta)

Can the type of vaccine be interchanged during the course of IDRV?

As far as possible, the same vaccine should be used throughout a course of IDRV. However, in exigencies, the permitted vaccines are interchangeable.

Cardiology eMedinewS

  • A study presented at the Heart Failure Congress 2014 has revealed that hospitalization for heart failure increases more than two–fold during inflammatory bowel disease (IBD) flares. Study authors noted that patients with new–onset IBD had a 37% increased risk of hospitalization for heart failure during a mean follow–up of 6.4 years compared to the healthy population.
  • A recent review has suggested that taking sleeping pills increases the risk of cardiovascular events in patients with diastolic heart failure. In the study, heart failure patients with a preserved ejection fraction (HFpEF) who were prescribed sleeping pills were eight times more likely to experience hospital readmission for heart failure or suffer cardiovascular–related death, compared with HFpEF patients who were not prescribed these medications.

Pediatrics eMedinewS

  • A study published online May 19 in Pediatrics has shown that administering the RotaTeq rotavirus vaccine to infants in the neonatal intensive care unit (NICU) appears to be safe, with no evidence of infection transmission to neighboring infants.
  • An article published online May 19 in Pediatrics reports that delaying the first measles–mumps–rubella vaccine (MMR) or the first measles–mumps–rubella–varicella vaccine (MMRV) beyond the age of 15 months may increase a 2–year–old’s risk for postvaccination seizures more than two–fold.

Dr K K Spiritual Blog

Doctors are God later and human beings first

Doctors are regarded as God because their primary job is to save the life of a patient. In fact, they are the messengers of God to look after the health of the sick person. But, Doctors are God later and human beings first.

To err is human and every doctor is likely to make mistakes. The very fact that a doctor is getting himself insured under Indemnity insurance means that medical errors are recognized as a part and parcel of Government policies.

For any error, the Court has decided a financial compensation to the patient and that compensation is paid by the insurance company as the doctor is covered under the Indemnity insurance. Medical negligence on the other hand, if proved, is not covered under the insurance. Therefore, medical negligence has to be differentiated from medical errors.

The error of judgment and difference of opinion are accepted in the law as not negligence and there are ample Supreme Court judgments to support that. Medical accidents are also exempted from being termed negligence by various Supreme Court clarifications/judgments. For a doctor to be punished under medical negligence, there has to be a proof that he willfully did some omission or commission, which led to the death or caused harm to a person.

A doctor is also not required to possess the maximum degree of skill and knowledge but is required to possess only an average degree of skill and knowledge. Therefore, when an expert is called for an opinion, he should never give an opinion from his level of perception and knowledge but should take into consideration the knowledge of an average doctor of that specialty.

Recently, one of my friends forwarded a report to me, which showed that in US when the doctors went on a strike, the number of deaths in the city during the strike period reduced. I totally agree with this observation and I am of the firm opinion that if allopathic medical profession ceases to exit, the number of deaths per day will be reduced. But at what cost? It will invariably be at the cost of increased morbidity, impaired quality of life and more sufferings. In that scenario people with sexual dysfunction will live without enjoying sexual life; people with heart failure will live on the bed all the time, patients with TB will be back in sanatoriums, patients with fractures will be bedridden for months together and patients requiring orthopedic surgeries will remain with life–long deformities. To have a better quality of life, one has to pay the price as any intervention or surgery done to improve the quality of life invariably will carry some risk and mortality. Even a simple bypass surgery of the heart carries a mortality of up to 0.5–1%. But for the family whose patient dies that 1% mortality is 100%.

In a follow up program on Aaj Tak, the film actor, Aamir Khan, said that every household in India has a negative story to tell about medical doctors. Aamir probably misunderstood or could not differentiate medical errors, medical accidents from medical negligence. People equate money with medical success. Most of the medical disputes occur in private sector when the patient’s relations have to pay money for an unsuccessful surgery or treatment. Attempts have been made to compare the results of medical treatment in India from that of abroad. They are totally incomparable as the amount of fee charged by doctors in India is practically a fraction of the fee that is charged in the west. The patient load in India per doctor is also responsible for potential medical errors.

One should also remember that the Drug Controller Government of India does not inform doctors about banned drugs, introduction of new drugs or introduction of new equipment. Most doctors depend on technology to be learnt through the manufacturers of respective machines. The manufacturers either bring the training persons from abroad or support the training of Indian doctors abroad. Their interest is ultimately covered as the doctors once trained ultimately end up in purchasing their technology.

When a new drug is launched, as there is no information from Drug Controller of India to individual doctors, they are forced to attend symposia by drug companies, which now come under the purview of unethical doctor–pharma relationship.

Most doctors will write pharmaceutical drugs of a company, which people think is in lieu of a commission they are getting. The reality is that a doctor will invariably write a drug of a company who is constantly spending in efforts in educating doctors about new technologies and innovations as both Medical Council of India and the Government of India Health Ministry have no such provisions for the doctors. On the other hand, not attending medical educational programs is considered a professional misconduct by MCI and many state councils.

Wellness Blog

Flu in children

  • The classical features of uncomplicated flu in children include abrupt onset of fever, headache, muscle pain and malaise affected by manifestation of respiratory tract illness – sore throat, sough and nasal discharge.
  • All the above features may not be present in children.
  • Flu sometimes may last for more than a week in children.
  • Ear discharge, development into asthma and pneumonia are common complications in children.
  • Complicated pneumonia may be severe and rapidly fatal, especially if the bacterium is Staph.
  • During winter, flu should be considered in all children with fever; children with fever and acute onset of respiratory illness; children with fever and exhilaration of underlying chest condition; children with pneumonia and children with fever of more than 100, with severe cough or sore throat.
  • Fever is present in over 95% of cases, often more than 39°C.
  • Cough is present in over 77% patients.
  • Nasal discharge is present in more than 78% patients.
  • Headache is present in more than 26% patients.
  • Muscle pain is present in more than 71 % patients.
  • Incubation period is 1–4 days with high transmissibility.
  • The treatment is often symptomatic.
  • Cough hygiene should be practiced.

Inspirational Story

Cure for Sorrow

There is an old Chinese tale about a woman whose only son died. In her grief, she went to the holy man and said, "What prayers, what magical incantations do you have to bring my son back to life?"

Instead of sending her away or reasoning with her, he said to her, "Fetch me a mustard seed from a home that has never known sorrow. We will use it to drive the sorrow out of your life." The woman went off at once in search of that magical mustard seed. She came first to a splendid mansion, knocked at the door, and said, "I am looking for a home that has never known sorrow. Is this a place? It is very important to me."

They told her, "You’ve certainly come to the wrong place," and began to describe all the tragic things that recently had befallen them.

The woman said to herself, "Who is better able to help these poor, unfortunate people that I, who have had misfortune of my own?" She stayed to comfort them, and then went on in search of a home that had never known sorrow. But wherever she turned, in hovels and in other places, she found one tale after another of sadness and misfortune. She became so involved in ministering to other people’s grief that ultimately she forgot about her quest for the magical mustard seed, never realizing that it had, in fact, driven the sorrow out of her life.

ePress Release

Two or more drugs may interact with each other

Two or more prescription or over–the–counter drugs interact negatively with each other and cause adverse drug reactions, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

To reduce the risk of drug reactions, one must follow the following guidelines:

  1. Read labels carefully.
  2. Understand the ingredients in each drug.
  3. Understand any possible side effects they can cause.
  4. Before taking a drug speak with the doctor or pharmacist, if you don’t understand the drug label.
  5. Make sure the doctor is aware of all the drugs you are taking.
  6. Don’t mix pills.
  7. Don’t break capsules into any food or drink.
  8. Don’t take any medication with alcohol.
  9. Don’t take medication at the same time as vitamins or mineral supplements.

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."

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

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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

Weight loss may improve sexual health of obese diabetes

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 :

 

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 motion.

eMedinewS Humor

Polishing Apples!

A young man asked a rich old man how he made his money.

The old guy said: Son, it was 1932, the depth of the Great Depression I was down to my last nickel. I invested that in an apple and spent the entire day polishing it. At the end of the day, I sold the apple for 10 cents!

The next day, I invested those 10 cents in 2 apples. I spent the entire day polishing them and sold them for 20 cents.

I continued this for a month by the end of which I had accumulated a fortune of $.1.37. Then my wife’s father died and left us 2 million dollars…!

Quote of the Day

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

 

Twitter of the Day

Dr KK Aggarwal: You can reverse heart disease Every cell in the body eventually dies and is replaced by a new cell. Every (cont) http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Is it normal for an enlightened and aware person to seek quiet alone time? http://bit.ly/WAYHF_DC #WAYHF

 

eMedi Quiz

What is not true for HNPCC (hereditary nonpolyposis colorectal cancer)?

a) It is the most common hereditary colorectal cancer syndrome in USA.
b) It is associated with MMR gene mutation.
c) It is associated with APC mutation.
d) It is associated with carcinoma colon and extraintestinal cancers.

Yesterday’s Mind Teaser: A recent fitness walk left you breathless, and you’ve been having trouble sleeping. You’ve also been dealing with an upset stomach and occasional dizziness. These could be symptoms of:

A. Depression.
B. Heart disease.
C. Diabetes.
D. High blood pressure.
E. All of the above.

Answer for yesterday’s Mind Teaser: B. Heart disease.

Correct Answers received from: Dr K Raju, Prabha Sanghi, Dr Prakash Khalap, Dr Chandresh Jardosh, Dr Avtar Krishan, Dr Jainendra Upadhyay, Daivadheenam Jella.

Answer for 18th May Mind Teaser: B. No, skin–cancer rates and deaths from the disease are on the upswing.

Correct Answers received from: Dr Bitaan Sen & Dr Jyashree Sen, Dr Chandresh Jardosh.

Send your answer to ijcp12@gmail.com

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  1. Dear Sir, Thanks for the information. Regards: Dr Kartik
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