eMedinewS21st April 2014,Monday

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

Shoe Hygiene

  1. Avoid poorly fitting shoes.
  2. Diabetic patients should avoid walking bare feet.
  3. Shoes that are too tight can cause pressure ulcers.
  4. High heels are okay for occasions but if you wear them all the time, significant foot pain and other problems can develop. These problems can range from bunions, corns and calluses to more complex problems like misshapen hammer toes or worsening excruciating pain in the ball of the foot.
  5. Whenever you wear shoes that are tight, they will cause foot pain.
  6. Whenever you wear shoes that constrict the natural shape of the foot, it is bound to cause foot pain.
  7. Women, who regularly wear high heels, walk with shorter, more forceful strides and require more muscles to walk.
  8. Shoes can be classified under following three categories:
    1. Good shoes or low risk shoes: athletic and casual sneakers.
    2. Average mid risk shoes: hard or rubber–soled shoes – special shoes and work boots.
    3. Poor or high risk shoes are the ones that do not have support or structure such as high heels, sandals, sleepers.
  9. Pointed toed shoes are equally bad as they disrupt the natural shape of the feet.
  10. If you love to wear heels, then choose heels that are not higher than 2" and are wide.
  11. It is always better to buy shoes in the evening as the foot swells up by evening. If you buy them in the morning, the shoes may feel tight in evening hours.
  12. Always try both shoes as one foot may be smaller or larger than the other one in some people.
  13. Always wear the shoes that are wider than your foot.
  14. The actual size of the shoe may vary between different manufactures.
  15. The selected shoe should be wider than broadest part of the foot.
  16. Your foot tends to become longer and wider as you age, always check the size of your shoes every two years.
  17. Narrow shoes with heels should only be used for a function, dinner or a formal party, specially a party where you do no have to stand for a longer time.

News Around The Globe

  • According to a new study, fecal calprotectin represents a non–invasive test that may help clinicians distinguish between organic inflammatory bowel disease (IBD) and functional disorder (irritable bowel syndrome, or IBS). The test has 87% negative predictive value to exclude IBD, and cutoffs <250 μ/g have 90% sensitivity to determine remission in IBD.
  • In 2012, a task force of the American Association of Clinical Endocrinologists (AACE) and the American Thyroid Association (ATA) had recommended that in pregnant women, total T4 must be used in place of free T4 to test thyroid function. However, a new research has now suggested that total T4 is no better than free T4 for identifying pregnant women with subclinical hypothyroidism. Thus, either of the assays is suitable for clinical use during pregnancy.
  • The US Food and Drug Administration (FDA) has granted full approval to ofatumumab for chronic lymphocytic leukemia (CLL). The drug is indicated to be used in combination with chlorambucil for previously untreated patients who are not candidates for fludarabine-based therapy. Ofatumumab is a cytolytic monoclonal antibody that binds to the CD20 molecule expressed on the surface of normal and malignant B-lymphocytes.
  • A novel research presented at the 16th International Congress on Infectious Diseases has put forward the ESBL Nordmann/Dortet/Poirel (NDP) test as a potential new biochemical test that can rapidly identify extended–spectrum beta–lactamase (ESBL)–producing Enterobacteriaceae in a blood culture. It is an easy, 20 minutes test with the sensitivity, specificity, negative predictive value, and positive predictive value all at 100%.
  • A new study presented at the American Association of Neurological Surgeons (AANS) 82nd Annual Meeting has revealed that stimulating both the occipital and supraorbital nerves leads to better relief of chronic migraine than stimulating only the occipital nerve. Fourteen of the 20 enrolled patients reported >50% improvement, including 9 patients who reported >80% improvement at follow–up.

Rabies News (Dr A K Gupta)

Is there a one–shot ARV? Is there any ARV that offers lifelong protection?

There is no single dose vaccine or a vaccine that gives lifelong immunity.

Cardiology eMedinewS

  • Doctors at the Henry Ford Hospital reached a medical milestone on April 3, when they performed the 25th successful transcatheter valve replacement using a novel way to access the heart. Henry Ford is the only hospital in the United States performing the unique procedure called transcaval valve replacement, which accesses the heart by temporarily connecting major blood vessels.
  • A new research from the Centers for Disease Control and Prevention has shown that five major complications related to diabetes have declined in the US during the last 20 years. These include rates of heart attack, stroke, end–stage kidney failure, lower-limb amputation and deaths from hyperglycemia. Cardiovascular complications and deaths from high blood sugar each decreased by over 60%, rates of strokes and lower extremity amputations decreased by around 50%, and rates for end-stage kidney failure decreased by 30%.

Pediatrics eMedinewS

  • According to a study published online April 14 in Pediatrics, most high–risk medical devices that have been cleared by the US Food and Drug Administration (FDA) for pediatric use have not yet been tested in patients younger than 18 years. The study authors noted that of the 25 devices approved for pediatric use between 2008 and 2011, 88% were approved for use only in patients aged 18 years or older, and 84% were not studied in any patients less than 18 years of age.
  • A study published online in the Journal of the American College of Surgeons is the first prospective study on non–operative management of acute appendicitis in pediatric patients in the United States and states that antibiotic therapy alone to treat children with uncomplicated acute appendicitis is a potential alternative to surgery that leads to less pain and fewer missed school days.

Dr K K Spiritual Blog

How to remove negative thoughts

Darkness is absence of light and similarly negative thoughts are absence of positive thoughts. The answer to negative thoughts is to bring positive thoughts back. Ideal mind is devils workshop and will always think negative.

Here are the ways

  • Think differently as taught by Adi Shankaracharya. Once Menaka approached Arjuna with lust and said that she wanted to have a son like him with him. Arjuna said that why wait for 25 years consider me as you son from today.
  • Think opposite as taught by Patanjali. For example if you are thinking of stealing, then silently start thinking of charity.
  • Think positive as taught by Buddha. Make a list of positive action to be done today as the first thing in the morning and concentrate on that list. Divert your mind to the pending works. It’s a type of behavioral therapy.

Wellness Blog

Duration of CPR May Be a Factor in Kids’ Survival

Some children with in–hospital cardiac arrest can benefit from longer duration of cardiopulmonary resuscitation (CPR), a study has found. In the study among survivors, neurological outcome was favorable for the majority of patients. Of the 3,419 children included in the study, 28% survived to hospital dischar

ge, and 16.6% of these survivors had CPR longer than 35 minutes, according to Renée Matos, MD, MPH, of the University of Pittsburgh School of Medicine, and colleagues. A total of 60% of these survivors with longer–duration CPR achieved a favorable neurologic outcome, they reported in the study published Jan. 21 in Circulation: Journal of the American Heart Association.

In the mid–1990s, authorities considered pediatric CPR futile beyond 20 minutes’ duration or when more than two doses of epinephrine were provided.

Even though longer–duration CPR can benefit some children, the reality is that after the first 15 minutes of CPR, survival rate declines rapidly. Survival decreased by 2.1% for every minute of chest compressions over 15 minutes.

When CPR was longer than 35 minutes, those in the Surgical Cardiac category had the best survival to hospital discharge rate (25%), followed by, Medical Cardiac –– 21%; General Surgical –– 13%; General Medical –– 10% and Trauma –– 8%. ([Medpage today)

Inspirational Story

Begin with a Blank Page

If you could start your life all over what would be different? What would you change now if you were able to wave a magic wand and start from scratch? Just imagine you have no ties, no burdens, no limits, no memories, and no past.

What would your life look like? If the answer that comes to your mind is different than what you are doing, why is that? Is it because of someone else’s opinion? A spouse, a parent or maybe your children?

The ultimate test of your life is to close your eyes and think of yourself on your deathbed. Lying there, preparing yourself to leave, look back at your life as you are currently living it.

How do you feel? Are you satisfied you lived completely? Or do you wish you had done differently? Very few of our senior citizens look back on their life and say, "I sure wish I had spent more time at the office!" Nobody says, "I wish I had watched more TV!"

This is what they say. "I wish I had been bolder. I wish I had given more. I wish I had tried harder to see more, do more and feel more." People wish that they had lived more. I, for one, have to admit to a certain amount of holding back on dreams and goals because of our two boys. As my life progresses I realize there is no reason to hold back.

We have not been exactly standing still either. We have done our best to live our dreams. We built a sailboat and sailed for 7 years traveling on the open ocean. We lived in the snow in Aspen Colorado, and on the beach in South Carolina. An old brick mill was our home in Long Island, versus a boat dock in Palm Beach Florida. We are writers of books and music, actors in the theater, and we home– school the boys. We have built a horse farm, and businesses! Yet, there is so much more we want to do! It is a balancing act. We all must have sufficient finances to support a comfortable lifestyle, (although most of us tend to spend way too much on that!) Part of this balancing act is understanding what we are passionate about doing so that work becomes a joy instead of a job.

Is this not a major reason of lost dreams and goals? Many people find work, call it a job and make a living at it. But they begrudge every minute of it, going as far as using the job as a reason for playing the martyr. Find something else!

There are many, many teachers of the attraction philosophies of "making a life". With as many opportunities today in every field imaginable, somewhere, something is calling to you.

Another part of the balancing act is to include those around you in frank and open discussions in what it is you want. I find some of my coaching clients have kept their wants and needs bottled up inside them forever! They had already decided for the other person in their lives there was no interest in whatever it was they themselves wanted to do! How absurd! How can we possibly know what someone else wants!

Would it not be tragic to spend your life in a big city for 40 years, working at a job you despise because you thought your spouse liked it, even though you wanted to live in the country and be a farmer? Then one day you overhear your spouse tell her best friend all she ever wanted to do was live in the country? 40 years! Sure this is a bit far fetched – but you would be amazed at what I hear!

Make an attempt today to start with a brand new page of your life. Create your life story how you want it. If there are others in your life to be involved, have them do the same exercise. Then compare what your notes. If this matches your current life, congratulations! You are one of the few. Now make it better.

However, if your written life stories sound like someone completely different, then you are living a life of conflict. Here is the good news. Your life is your life. No one can take that away from you. You are not indentured. You are not a slave. You are free to go, do, and be whomever you wish.

It might not be easy, but it sure might be worth it. I coach people daily who are changing their lives. There are so many things to be grateful for, and so many things open to us. We owe it to all the ones before us who gave us this opportunity to take advantage of it.

ePress Release

Exercise reduces Depression

Quoting a British study published in the American Journal of Epidemiology 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 said that those who get regular vigorous exercise are less likely to develop depression or an anxiety disorder over time.

In general, men who reported regular vigorous exercise –– such as running or playing soccer –– were about one-quarter less likely than their less active peers to develop depression or anxiety over the next 5 years.

Even Small Amounts of Exercise Are Beneficial

In a study, published in the Journal of the American Medical Association, by Dr Timothy Church of Louisiana State University System it has been shown that even small amounts of physical activity––approximately 75 minutes a week––can improve cardio respiratory fitness levels of sedentary overweight individuals.

Commenting on the study Dr K K Aggarwal said that while this level of exercise is lower than that currently recommended to produce weight loss, the current findings may be used to encourage those people who don’t exercise at present to start some form of physical activity.

Improvements in fitness are associated with a reduction in the risk of cardiovascular disease and death.

The National Institutes of Health Consensus Development Panel recommends at least 30 minutes of moderate–intensity physical activity on most days of the week, the reports suggest that 60 minutes of exercise each day may be necessary to prevent weight gain.

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

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

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

emedipicstoday emedipics

A free health checkup camp was organized by Heart Care Foundation of India at St. Forebal Public School on 16th April 2014

press release

Monitoring LFT in a patient on statins

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 patient with acid peptic disease was denied any painkiller for his distressing illness.
Reaction: Oh, my God! Why did you not give him nimesulide?
Lesson: Make Sure to prescribe nimesulide as it is safe in acid peptic disease.

eMedinewS Humor

Preacher’s Wish from God

A preacher went into his church and he was praying to God. While he was praying, he asked God, "How long is 10 million years to you?" God replied, "One second." The next day the preacher asked God, "God, how much is 10 million dollars to you?"

And God replied, "A penny." Then finally the next day the preacher asked God, "God, can I have one of your pennies?" And God replied, "Just wait a sec."

Quote of the Day

Only those who dare to fail greatly can ever achieve greatly. Robert F. Kennedy

 

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://youtu.be/NMIK16PyBrY?a via @YouTube
Dr Deepak Chopra: We dream of a universe where leaders work tirelessly and selflessly to fulfill the highest aspirations of the human soul. http://bit.ly/DC_Ananda #ananda

 

Forthcoming events

Date: Saturday 2PM–Sunday 3PM, 26–27 April 2014
Venue: Om Shanti Retreat Centre, Bhora Kalan, Pataudi Road, Manesar
Course Directors: Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal and BK Sapna
Organisers: Heart Care Foundation of India. Prajapati Brahma Kumari Ishwariye Vidyalaya and eMedinews
Facilities: Lodging and boarding provided (one room per family or one room for two persons). Limited rooms for first three hundred registrants.
Course: Meditation, Lectures, Practical workshops
Atmosphere: Silence, Nature, Pyramid Meditation, Night Walk
Registration: SMS– Vandana Rawat – reg mno, rawat.vandana89@gmail.com
SMS – BK Sapna reg mno1, bksapna@hotmail.com

Note: Donation in Favor of Om Shanti Retreat Centre will be welcomed

 

Our Contributors

Dr Veena Aggarwal, Dr Chanchal Pal, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Monica Vasudev, Dr Navin Dang, Dr Pawan Gupta, Dr Parveen Bhatia, Dr Prachi Garg, Rajat Bhatnagar, Dr Sudhir Gupta, Prof.(Dr).C V Raghuveer

eMedi Quiz

A 70–year–old male patient presented with history of chest pain and was diagnosed to have coronary artery disease. During routine evaluation, an ultrasound of the abdomen showed presence of gallbladder stones. There was no past history of biliary colic or jaundice. What is the best treatment advice for such a patient for his gallbladder stones?

1. Open cholecystectomy.
2. Laparoscopic cholecystectomy.
3. No surgery for gallbladder stones.
4. ERCP and removal of gallbladder stones.

Yesterday’s Mind Teaser: The correct sequence of cell cycle is:

1. G0-G1–S–G2–M.
2 .G0–G1–G2–S–M.
3 .G0–M–G2–S–G1.
4 .G0–G1–S–M–G2.

Answer for yesterday’s Mind Teaser: 1. G0–G1–S–G2–M.

Correct answers received from: Abhay Naik, Trupti Pagad, Daivadheenam Jella, Dr Ajay Gandhi, Dr Jainendra Upadhyay, Tukaram Pagad, Dr Jainendra Upadhyay, Dr.Chandresh Jardosh, Dr Avtar Krishan,

Answer for 19th April Mind Teaser: 2. Presence of U waves.

Correct answers received from: Narahari Kandakatla, jayashree sen, Sahasranam, Dr Prakash Khalap

Send your answer to ijcp12@gmail.com

medicolegal update

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medicolegal update

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medicolegal update
  1. Dear Dr. K. K. Aggarwal, Hats off to your work towards educating people about CPR 10. Regards: Dr BC Roy
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eMedinewS Special

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