21st November 2014, Friday

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

Can blood pressure be higher in one arm?

A small difference in blood pressure readings between arms is normal. However, a difference of more than 20 mm Hg for systolic pressure (top number) or more than 10 mm Hg for diastolic pressure (bottom number) can be a sign of an underlying narrowing of the main arteries to that arm.

A difference of 10 to 15 mm Hg for upper systolic pressure that shows up repeatedly is a risk marker for vascular disease and future heart attacks.

Always have your doctor check both arms for blood pressure; whichever is higher, use that arm for future blood pressure readings.

News Around The Globe

  • To raise awareness on WORLD TOILET DAY (19 November), the UN Information Centre for India and Bhutan has issued a poster (both in Hindi and English) that calls for the cultural integration of TOILET as a national aspiration in India. According to latest statistics, of the 825 million people practicing open defecation in the world, India tops the list with 597 million (about 47% of its population). With the voluntary participation of renowned contemporary painter PARESH MAITY and the well-known classical dancer GEETA CHANDRAN, UNIC’s campaign in India reflects the UN’s global END OPEN DEFACATION campaign. www.unic.org.in
  • A new statistical model may help ophthalmologists identify patients with age-related macular degeneration (AMD) who may progress from early or intermediate to more serious disease, suggests an article published in Investigative Ophthalmology & Visual Science. The model may also roughly predict when such patients will progress to wet AMD, which causes 80% to 90% of blindness associated with the disease.
  • Downstaging patients with hepatocellular carcinoma before liver transplantation leads to excellent 5-year recurrence-free and overall survival rates, reports a multicenter study presented at The Liver Meeting 2014.
  • Women with rheumatoid arthritis have a greater risk of dying from any cause, especially cardiovascular and respiratory disease, than women without the inflammatory disease, suggests a new study presented at the American College of Rheumatology (ACR) 2014 Annual Meeting.
  • A new research suggests that high trans fat intake is associated with deficits in word memory among working-age men. Researchers found that each gram of dietary trans fatty acids intake per day was associated with an estimated 0.76 fewer words recalled, or 11 fewer words with the highest intake vs. none from a mean of 86 words. The findings were presented at the American Heart Association (AHA) 2014 Scientific Sessions.
  • A new study by Elisabeth Kernbauer, PhD, from the New York University School of Medicine in New York City, and colleagues reveals that eukaryotic viruses are able to both shape mucosal immunity and support intestinal homeostasis in mice. Specifically, infection with murine norovirus (MNV) appears able to replace the beneficial function of bacterial colonization in the gut. The results of their murine study are published online November 19 in Nature.

66th Annual Conference of Cardiological Society of India (CSI) -2014


Dr KK Spiritual Blog

Prayer for Inner Happiness

Stress is defined as the physical and mental reaction to the interpretation of a known situation. In absence of a known situation there cannot be a stress. One cannot be stressful for a person who has just died in New York in an accident unless he or she is a known person.

There has to be a right, conscious based interpretation of the situation as the same situation can bring happiness to one and stress to the other.

The most important consequence physical or mental of stress, therefore, depends on the right interpretation of the situation.

The interpretation or judgment in the body is governed by chemical reactions and is controlled by the balance of autonomic balance system, which in turn is governed by the interaction of parasympathetic and sympathetic nervous system.

During the phase of acute stress when the sympathetic system is predominant, heart rate and blood pressure rises and a person cannot take correct and decisive decision. He or she is likely to make mistakes, which can often be detrimental to living. Sympathetic mode is basically the mode of flight or fight reactions of the body.

Right conscious-based decisions can only be taken in a state of relaxed mind when the intention is inserted in the field of consciousness. The relaxed mind state of the body is the parasympathetic mode which is healing and is evident by reduction in heart rate, blood pressure and increase in the skin resistance. Most conscious based decisions will be based on truthfulness, will be necessary and will bring happiness to both the persons and the surroundings.

The yogic lifestyle by which a person learns the dos and don’ts of living, does regular practice of correct postures, daily pranayama and practices regular withdrawal from the outer atmosphere, helps in preparing a state of physical and mental body state, which is more receptive for conscious-based decisions. Yoga Sutras of Patanajali included them in his ashtanga yoga as the processes of Yama, Niyama, Asanas, Pranayama and Pratihyar.

Prayers have no value when the mind is not at rest. All of us have participated in hundreds of mourning prayers with two minutes of silence. This prayer has no value if the two minutes of silence is not observed. If prayer is done without it the mind will remain restless and we will keep on thinking these two minutes are not over yet. The process of silence does shift our awareness towards test and parasympathetic state and temporarily we get to be in contact with the memories of the departed soul and we pay homage to him or her.

Today a large number of organizations are teaching the process of meditation but the same cannot be taught unless a person practices procedures by which the mind gets relaxed.

The eight limbs of Patanjali focus in detail about premeditation preparations and once that is learned one can go to the other three limbs which are Dharna, Dhyana and Samadhi.

Yoga asanas are different from exercises. They stimulate and stretch all or one of the seven charkas, autonomic plexuses, and ganglion and there located ductless endocrine glands. Also during a yogasana the mind is in the exercise and not wondering here and there.

While yogic exercises at rest are termed yoga asanas and the same yogic meditative exercises with activity are called traditional Indian dances. Western exercises and dances do not follow the principles of yoga. Many international studies have shown that over one-third of the people during their lifetime pray either for their own illness or for somebody else.

All hospitals should have spirituals areas. The prayer and meditation rooms in a hospital setting invariably will provide an arena which will improve patient-doctor relationship and will reduce the rising disputes amongst them in the country.

Inspirational Story

Self Motivation

My profession is running a dance school for the past 17 years. In doing so, I have learned many things about children; one being that self motivation is really not an inherited character. It is a learned behavior.

In the corporate world that we live in now where it's a race to keep up, some of our children are losing their battle before it ever begins. At times, I feel like my job requires more than just a dance instructor. I encounter children who cannot even fathom the thought of self motivation.

Why? Because their parents are probably too busy in their own corporate climb up the ladder that they've forgotten to notice their own offspring. They've forgotten that it's just as necessary to teach their own children how to be successful and to succeed -- how to be creative and to create.

In my own effort to be successful at what I do, there is one point I push every day that I walk into my studio: "You only get what you give". It may not look like much right off the bat, but if you look at the words really careful and read between the lines, it really says a lot. I have one other quote that I use in teaching expression: "You are like a paint brush on canvas. You "the dancer" are the paint brush and your canvas is the stage."

Rabies News (Dr A K Gupta)

Why do some people fear the vaccine?

In the past, rabies vaccine was a sheep brain derived nerve tissue vaccine (NTV) and was associated with considerable side effects. Large volumes and a number of injections were required. So, rabies vaccine acquired the dubious reputation of a dangerous vaccination. However, these fears are no longer justified with modern rabies vaccines that are very safe.

Cardiology eMedinewS

  • Particular attention should be given to kidney function in patients taking warfarin for atrial fibrillation, suggests a study on major bleeding at various levels of kidney function. Bleeding rates were consistently higher in the first 30 days of warfarin therapy across all estimated glomerular filtration rate categories, reported the study presented at Kidney Week 2014.
  • Cholesterol-efflux capacity, a marker of HDL function that measures reverse cholesterol transport, is inversely associated with incident atherosclerotic cardiovascular disease in a large population of patients healthy at baseline, reports a new study presented at the American Heart Association (AHA) 2014 Scientific Sessions.

Pediatrics eMedinewS

  • Mothers with rheumatoid arthritis (RA) and those with preclinical disease have increased odds of giving birth prematurely and to infants who weigh slightly less than their nonexposed counterparts, suggested a large Danish population study published online in Arthritis & Rheumatology.
  • Screening for congenital heart defects with pulse oximetry identified newborn babies with previously unsuspected critical congenital heart defects (CCHD), suggested a research presented at the American Heart Association's Scientific Sessions 2014.

Quote of the Day

  • Happiness is the meaning and the purpose of life, the whole aim and end of human existence. Aristotle

Wellness Blog

Why follow the post mortem report

In a Consultant-cum-management Joint Meeting held at Moolchand Hospital, the Medical Director of the hospital issued a statement that as per the requirement of National Accreditation of Boards of Hospitals, it is the duty of the hospital to follow the autopsy report, if done, from the Police.

The duty of the hospital does not end just by handing over the file to the Police, if the patient was treated in their hospital.

I can only explain it under two reasons, firstly, by following up of autopsy report, the hospital can correlate their findings, learn from their mistakes and improve in their future protocols.

I can narrate the second reason in the form of an example. Long time back, there was a murder of the wife of a senior resident in Anesthesia in our hospital. On the complaint of the parents of the murdered girl, the hospital Anesthetist was arrested under the Dowry Death Act. He remained in Tihar Jail for over a year when on humanitarian ground, one of our consultants visited Tihar Jail and looked at the file of the case of the doctor who in the past one year had not appeared in the court even once as every time there was a date and the court used to say ‘adjourned’.

When he looked at the file, the post mortem report had shown that the girl was raped before death as sperms were detected in her female sex organs and the DNA of those sperms did not match with that of the Anesthetist doctor.

The very next hearing the doctor was released for not being found guilty in the case. Had the hospital, followed the post mortem report, the case would have been solved within the initial few dates.

In more than 30 years of my career, I have not seen any hospital following this but being a requirement of NABH recognition, I think it will not only update the medical profession but also save situations as state above.

ePress Release

More women than men die from severe heart attack in hospitals

Winter months are heart attack months, 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.

Men and women have about the same adjusted in-hospital death rate for heart attack — but women are more likely to die if hospitalized for a more severe type of heart attack.

According to a report in Circulation, a journal of the American Heart Association:

  • Women are twice as likely as men to die if hospitalized for a type of heart attack known as ST-elevation myocardial infarction (STEMI).
  • Women are also less likely to receive appropriate and timely treatment for heart attack.
  • Women with STEMI have a 12 percent higher relative risk for in-hospital death compared to men.
  • Compared to men, women are 14 percent less likely to receive early aspirin; 10 percent less likely to receive beta-blockers; 25 percent less likely to receive reperfusion therapy (to restore blood flow); 22 percent less likely to receive reperfusion therapy within 30minutes of hospital arrival; and 13 percent less likely to receive angioplasty within 90 minutes of hospital arrival.
  • Women hospitalized with a STEMI are about twice as likely to die in the first 24 hours of hospitalization as men.
emedipicstoday emedipics

To raise awareness on WORLD TOILET DAY (19 November), the UN Information Centre for India and Bhutan has issued a poster



press release

Obesity reduces life expectancy

video of day

Other Blogs

Video Library

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 – 101090 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)


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 on aspirin was to go for non vascular surgery.
Dr Bad: Stop aspirin for two days.
Dr Good: Stop aspirin for seven days.
Lesson: The POISE-2 findings suggest discontinuing aspirin about seven days before noncardiovascular surgery.

Make Sure

Situation: A diabetic patient died of flu pneumonia.
Reaction: Oh my God! Why was flu vaccine not given?
Lesson: Make sure that all diabetics are given flu vaccine every year.

eMedinewS Humor

Salesman to Policeman

A salesman, tired of his job, gave it up to become a policeman.

Several months later, a friend asked him how he liked his new role.

"Well," he replied, "the pay is good and the hours aren't bad, but what I like best is that the customer is always wrong."

Twitter of the Day

Dr KK Aggarwal: Avoid noise pollution of more than 80dp
Dr Deepak Chopra: A God worthy of faith must actually matter. He needs to start performing instead of disappointing

eMedi Quiz

The Protein Efficiency Ratio (PER) is defined as:

1. The gain in weight of young animals per unit weight of protein-consumed.
2. The product of digestibility coefficient and biological value.
3. The percentage of protein absorbed into the blood.
4. The percentage of nitrogen absorbed from the protein absorbed from the diet.

Yesterday’s Mind Teaser: The following statements about meningococcal meningitis are true, except:

1. The source of infection is mainly clinical cases.
2. The disease is more common in dry and cold months of the year.
3. Chemoprophylaxis of close contacts of cases is recommended.
4. The vaccine is not effective in children below 2 years of age.

Answer for yesterday’s Mind Teaser: 1. The source of infection is mainly clinical cases.

Correct answers received from: Dr Jainendra Upadhyay, Priyanka, Dr Rakesh Sharma, Dr. Hitendrasinh Thakor, Raju Kuppusamy.

Answer for 19th November Mind Teaser: 3. Third quartile.

Correct answers received from: Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Dr K V Sarma, Dr Avtar Krishan, Dr Poonam Chablani, Dr Avtar Krishan.

Send your answer to email

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, Thanks for the useful spiritual blog. Regards: Dr KP Sharma

eMedinewS Special

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