eMedinewS
21st December 2014, Sunday

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

Indian Medical Tourism Incomplete without Yoga Department in every Hospital

Recently in one of the interaction the Indian Tourism Minister Dr Mahesh Sharma said that India is going to be the hub of medical tourism because of its hospitality and culture.

It is correct but for that a slight paradigm shift is required in the way we practice medicine in the country.

Most western patients come to India to take advantage of Yoga and Ayurveda in addition to the western medicine.

Only for a lower cost we cannot attract medical tourists for long as sooner or later the China will over power us in future for medical treatments. Our Prime Minister has convinced the world to have an international Yoga day. But unfortunately we do not have a yoga department in every government or a private medical institution.

Let India be the first country to have a yoga and an Ayurveda department in every hospital in addition to the western medicine.

The time is to promote traditional Yoga and Ayurveda. Unfortunately as they are not getting an uplifment they are ending up in cross pathy which is not on the interest of both their profession as well as the community.

Recently a review of studies examining the benefits of yoga suggests that Yoga practice provides significant benefits on cardiovascular risk factors, including LDL cholesterol and systolic blood pressure.

Those who practiced asana-based yoga reduced their LDL-cholesterol levels by 12.1 mg/dL and systolic blood pressure by 5.2 mm Hg and increased their HDL-cholesterol levels by 3.2 mg/dL.

In addition, the yoga practitioners also saw significant reductions in body-mass index, diastolic blood pressure, total cholesterol, triglycerides, and heart rate. Overall, the yogis lost 2.35 kg compared with non exercisers.

Individuals who cannot or prefer not to perform traditional aerobic exercise might still achieve similar benefits in cardiovascular-disease risk reduction by Yoga.

The review, which is published December 15, 2014 in the European Journal of Preventive Cardiology, included 32 randomized, controlled trials involving 2768 participants.

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45th Indian Society of Nephrology Conference, Kolkata, 18th to 21st December 2014

Dr Tiny Nair

An Interview with: Dr C.R.Kar, Cuttack

Q. 1. As per various reports, statins are underused in CKD patients, what’s your view on the same?

Ans 1. As CKD increases the risk of heart disease, patients with CKD are advised to carefully manage their lipid levels. Now, as clinicians we are reviewing two sets of guidelines for cholesterol management have stated that nearly all people with pre-dialysis kidney disease should receive statins.

According to a study published in the Journal of the American Society of Nephrology, reports that 50% of CKD patients are not taking the lipid-lowering medication. High levels of cholesterol is a serious concern in CKD patients and increases the risk of heart disease; therefore, should be used in CKD patients.

Q. 2. The KDIGO guideline recommends statin therapy for all individuals 50-79 years of age with CKD. Which statin as a monotherapy should be your choice?

Ans 2. Individuals with CKD are in general more likely to develop heart disease than individuals without CKD and the prevalence of traditional risk factors, particularly diabetes and hypertension is high in all stages of kidney disease, and dyslipidemia is extremely common. Treating with the most effective statin would be the key to curb the burden CKD at very early stage. Rosuvastatin is one of the most promising choice.

Q. 3. Does the results of Listen trial, presented in ESC 2014 held at Barcelona contribute to decision-making in the choice of stain in diabetic patients in your clinical settings?

Ans 3. The results of the trial, suggest rosuvastatin may have an initially more favorable effect on glucose levels compared to atorvastatin, making it a wiser choice especially in diabetes patients who struggle to keep glucose levels down. In fact, more patients on atorvastatin were given an increase in their diabetic therapy to control their initial abrupt rise in glucose. Therefore, a statin’s impact on glucose metabolism should also be considered along with its cholesterol-lowering potency when making treatment choices for diabetic patients with high cholesterol. As the results suggest that rosuvastatin might be more preferable to atorvastatin due to its influence on glucose levels. So yes, Listen trial does contribute in decision-making on the choice of statin in such patient group.

Q. 4. Most guidelines recommend statin usage in diabetics irrespective of lipid levels. What’s your opinion on the same?

Ans 4. Statin therapy is efficacious in reducing the risk of cardiovascular events and stroke in patients of T2DM with dyslipidemia. No justification is available for having a threshold level of cholesterol as a sole arbiter of which patients with T2DM should receive statin. The focus of debate should be whether any patient are at sufficiently low-risk for not to initiate statin therapy.

News Around The Globe

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) may protect against skin cancer, suggests a study published online December 18 in the Journal of Investigative Dermatology.
  • The US Food and Drug Administration (FDA) has approved a combination oral drug called Viekira Pak for chronic hepatitis C virus (HCV) genotype 1 that could give physicians and patients a less expensive alternative to sofosbuvir and ledipasvir/sofosbuvir.
  • Frail, elderly residents of long-term-care facilities (LTCFs) who received the high-dose inactivated influenza vaccine (HD IVV) during the 2011 to 2012 and 2012 to 2013 influenza seasons produced stronger immune responses to all strains of influenza as compared to residents who received standard-dose IVV, reported a single-blinded, randomized, controlled trial published online in the Journal of Infectious Diseases.
  • The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has recommended the approval of the first new weight-loss agent for many years, prolonged-release naltrexone/bupropion. The drug will be available for weight management in adults with a body mass index (BMI) of 30 kg/m2 or more (obese) or a BMI of 27 kg/m2 to <30 kg/m2 (overweight) in the presence of one or more complications, such as type 2 diabetes, hypercholesterolemia, or hypertension.
  • Autologous serum (AS) 50% eye drops appear to be safe and effective for dry eye disease in the long-term, especially in patients with severe disease refractory to conventional treatment, suggests a retrospective cohort study published in the December issue of Cornea.

Dr KK Spiritual Blog

An empty mind is the devil’s house

It is an old saying that “Khali dimag shaitan ka ghar”.
Empty mind means when you are doing nothing and Shaitan means negative thoughts. In terms of Vedic Sciences, negative thoughts mean absence of positive thoughts and they are often equated to darkness which is absence of light.

Positive thoughts always need efforts and exertions while negative thoughts are spontaneous and without exertion.
It is recommended that one should think differently and positive otherwise there will be spontaneous appearance of negative thoughts.

Darkness is spontaneous and naturally present and to bring light one has to make efforts by switching on the light or the nature has to ask the Sun to come and give the light.

Inspirational Story

The Comfort Zone

I used to have a comfort zone where I knew I wouldn't fail. The same four walls and busy work were really more like jail. I longed so much to do the things I'd never done before, but stayed inside my comfort zone and paced the same old floor

I said it didn't matter that I wasn't doing much. I said I didn't care for things like commission checks and such. I claimed to be so busy with things inside my zone, but deep inside I longed for something special of my own.

I couldn't let my life go by just watching others win. I held my breath; I stepped outside and let the change begin. I took a step and with new strength I'd never felt before, I kissed my comfort zone goodbye and closed and locked the door.

If you're in a comfort zone, afraid to venture out, Remember that all winners were at one time filled with doubt. A step or two and words of praise can make your dreams come true. Reach for your future with a smile; Success is there for you!

Rabies News (Dr A K Gupta)

Is there carrier state of rabies in dogs?

A carrier state of rabies in dogs/cats has not yet been conclusively proven and established.

Cardiology eMedinewS

  • Healthy, middle-aged outpatients who were physically active for at least 2.5 hours a week had better blood pressure and blood glucose levels than their sedentary peers, reported a large cross-sectional study. The differences were more marked in women. The study was published online December 18 in Preventing Chronic Disease.
  • A new study has found distinct differences in heart-disease and stroke mortality in the six largest Asian ethnicities—Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese—compared with non-Hispanic whites. The research was published in the Journal of the American College of Cardiology.

Pediatrics eMedinewS

  • Children with attention-deficit hyperactivity disorder (ADHD) who take methylphenidate are less likely to present for emergency treatment of trauma, reported a new study published online in Pediatrics.
  • Children whose mothers were exposed to high levels of fine particulate pollution in late pregnancy have nearly two-fold increased risk of developing autism as compared to children of mothers breathing cleaner air, suggests a new study published online in Environmental Health Perspectives.

Quote of the Day

Luck is what happens when preparation meets opportunity. ~ Seneca

Wellness Blog

Food poisoning with rice dishes

Staph and Bacillus cereus can cause acute food poisoning within 6 hours of ingestion of food. B. cereus is likely when rice is the culprit

  • B. cereus is able to persist in food processing environments due to its ability to survive at extreme temperatures as well as its ability to form biofilms and spores.
  • B. cereus has been recovered from a wide range of foods, including rice, dairy products, spices, bean sprouts and other vegetables.
  • Fried rice is an important cause of emetic-type food poisoning associated with B. cereus
  • The organism is frequently present in uncooked rice, and heat-resistant spores may survive cooking.
  • Cooked rice subsequently at room temperature can allow vegetative forms to multiply, and the heat-stable toxin that is produced can survive brief heating such as stir frying
  • Two distinct types of toxin-mediated food poisoning are caused by B. cereus, characterized by either diarrhea or vomiting, depending on which toxin is involved. The diarrheal toxin is produced by vegetative cells in the small intestine after ingestion of either bacilli or spores. The emetic toxin is ingested directly from contaminated food. Both toxins cause disease within 24 hours of ingestion.
  • The emetic syndrome is caused by direct ingestion of the toxin.
  • The number of viable spores and vegetative bacteria that produce diarrheal toxin is reduced by heating, although spores associated with emetic toxin are capable of surviving heat processing.
  • Cereulide is heat stable and resistant to gastric conditions.
  • The ingested toxin itself may therefore cause disease despite sufficient heating to kill B cereus.
  • The emetic syndrome is characterized by abdominal cramps, nausea, and vomiting. Diarrhea also occurs in about one-third of individuals. Symptom onset is usually within one to five hours of ingestion, but it can also occur within half an hour and up to six hours after ingestion of contaminated food.
  • Symptoms usually resolve in 6 to 24 hours.
  • Rice-based dishes in particular have been implicated in emetic toxin mediated disease, usually as a result of cooling fried rice dishes overnight at room temperature followed by reheating the next day.
  • The infective dose of cereulide required to cause symptoms is 8 to 10 micrograms per kilogram of body weight.
emedipicstoday emedipics

Health Check Up and CPR 10 Camp at GB S School, Khan Pur, New Delhi, on 27th November 2014

nova nova video of day
press release

Weight loss may improve sexual health of obese diabetes

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

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 wanted to know if the cost of the spectacles would be covered by Mediclaim after cataract surgery.
Dr. Bad: It will be covered.
Dr. Good: It will not be covered.
Lesson: Mediclaim does not cover the cost of spectacles, contact lenses, hearing aids.

Make Sure

Situation: A known epileptic child died of a seizure while swimming.
Reaction: Oh my God! Why was he allowed to swim?
Lesson: Make sure that patients with uncontrolled epilepsy are not allowed to swim.

eMedinewS Humor

There are 49 blondes and one redhead, they are hanging from a rope on a flying plane, one of them has to get off or the rope will break. The redhead said she’ll let go. Then all the blondes clap. Can you guess what happend?

Twitter of the Day

Dr KK Aggarwal: Longer the waist line shorter the brain size
Dr Deepak Chopra: Each one of us is a radiant, spiritual being - beautiful and perfect as we were created, exactly as we are

ePress Release

Economy-class syndrome

All doctors should diagnose and treat venous thromboembolisms, which include deep-vein thrombosis and pulmonary embolism, 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.
These are potentially fatal conditions that occur when a blood clot that's formed at one point of the venous circulatory system detaches and travels to the lungs.

A pulmonary embolism occurs when this kind of clot, which usually forms in the veins of the leg, obstructs the pulmonary artery in the lungs or one of its branches. This can cause acute right heart failure or sudden death.

The problem of deep-vein thrombosis gained notoriety when passengers on long-haul flights develop deep vein thrombosis and lung embolism now called as "economy-class syndrome." It results from long hours of minimal movement for example airline passengers sitting in their seats for hours and not being able to move. Treating the condition at an early stage can help save lives and prevent complications such as pulmonary embolism or recurrent deep vein thrombosis. Deep vein thrombosis claims the life of at least one airline passenger a month at Heathrow.

Precautions

  • Get up and walk about at least once an hour.
  • While seated, flex your ankles and move your feet around to stimulate blood circulation.
  • Remain hydrated.
  • Consider wearing support stockings or elastic wraps to keep blood from settling in the veins in your legs.
  • A simple aspirin tablet taken a few hours before take-off thins the blood during long periods of inactivity. The number of victims would fall significantly if more passengers followed this advice.
  • Severe risk for thrombosis should be given injections with low molecular weight heparin (LMWH), a form of prophylaxis already in common use in hospital patient.
  • One should abstain from alcoholic beverages and caffeine.

eMedi Quiz

In a patient with a tumor in Superior medistinum compressing the superior vena cava, all the following venis would serve as alternate pathways forthe blood to return to the right atrium, except:

1.Lateral thoracic vein.
2.Internal thoracic vein.
3.Hemiazygos vein.
4.Vertebral venous plexus.

Yesterday’s Mind Teaser: B-oxidation of odd-chain fatty acids produces:

1.Succinyl CoA.
2.Propionyl CoA.
3.Acetyl CoA.
4.Malonyl CoA.

Answer for yesterday’s Mind Teaser: 2.Propionyl CoA.

Correct answers received from: Dr Rakesh Sharma Nohar, Dr Avtar Krishan.

Answer for 19th December Mind Teaser: 3. Leaves extension at elbow joint intact.

Correct answers received from: Raju Kuppusamy, Dr K V Sarma, Dr Avtar Krishan, Dr Jainendra Upadhyay.

Send your answer to email

medicolegal update
  1. Dear Sir, Very informative news. Regards: Dr Kapil

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