eMedinewS22nd November 2013, Friday

Dr K K Aggarwal Padma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; 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.facebook.com/Dr KKAggarwal

Signs of ‘sudden’ cardiac death come weeks before

Signs of approaching "sudden" cardiac arrest, an electrical malfunction that stops the heart, usually appear at least a month ahead of time, according to a study of middle–age men in Portland, Oregon.

Over 3.6 lakhs out–of–hospital cardiac arrests occur each year in US largely involving middle-aged men, with only 9.5 percent surviving, according to the American Heart Association.

Patients can survive if they are given CPR immediately and their hearts are jolted back into normal rhythm with a defibrillator.

Earlier clinical trials have focused only on symptoms or warnings signs within an hour of such attacks.

Among 567 men who had "sudden" arrests, researchers determined 53 percent had symptoms beforehand. Among those with symptoms, 56 had chest pain, 13 percent had shortness of breath and 4 percent had dizziness, fainting or palpitations.

About 80 percent of symptoms happened between four weeks and one hour before the cardiac arrest.

And although most men had coronary artery disease, just half had been tested for it before their attacks.

The message here is, if you have these signs or symptoms, please don’t ignore them: seek healthcare.

The new findings, from the 11–year–old "Oregon Sudden Unexpected Death Study," were presented on Tuesday at the annual scientific sessions of the American Heart Association being held in Dallas.

New Test that Rapidly Detects Blood Infections

A new simple and inexpensive test can identify bacteria in the blood in less than 20 minutes. The method combines a selective lysis step in which blood cells in the sample are destroyed, a centrifugation step to collect any bacteria or fungi in the sample, and a fluorescence step that analyzes the particular fingerprint of any pathogens present in the sample. It can correctly identify the species of bacteria or fungi in 96.5% of positive blood culture samples.

TCT 2013 Update: Cardiology Trials

FREEDOM: Insulin–treated diabetics benefit from CABG: A subanalysis of the FREEDOM trial, a study that showed a benefit of coronary artery bypass graft (CABG) surgery over PCI in diabetic patients with multivessel disease, confirmed that this benefit was maintained in insulin–treated patients. (Dr Michael Farkouh of Mount Sinai School of Medicine, New York)

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."

VIP’s on CPR 10 Mantra Video
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

What are the Vedic principles behind cognitive behavior therapy?

sprritual blog

1) What is counseling?

A: The mental process involves generation of a thought or idea, which is analyzed and then acted upon. Thought, analysis and action therefore are the primary three process of human mind. Counseling involves action at all three levels.

2) What are different types of counseling?

A: Counseling involves basically two principles – Cognitive counseling and behavioral counseling. Behavioral, when the concentration is only on the actions and cognitive, when the concentration is on the changes in either the thought process or in the interpretation of the thought process.

3) What is cognitive behavior therapy?

A: As against a pure behavior therapy where a person is counseled to do pre–defined things on regular intervals, cognitive behavior therapy involves changing the actions by changing observations of the interpretation of a particular situation.

4) What is the origin of counseling in India?

A: The origin of counseling goes back to Vedic era. Upanishads were basically text books on counseling based on the original knowledge of Rigveda, Yajurveda, Samveda and Atharvaveda.

5) Is there a relationship of Bhagavad Gita with Counseling?

A: Bhagavad Gita was the counseling done by Krishna to Arjuna to resolve the conflict in Arjuna’s mind whether to fight or not. At that time there were no doctors and hence counseling was done by the elders in the family.

6) Are the principles of Bhagavad Gita followed today?

A: All the principles of cognitive behavior therapy today are basically principles that have originated from Bhagavad Gita.

7) What is the first principle?

A: The first principle is "counseling cannot be done in 1 or 2 sessions. It requires up to 18 sessions which is what Krishna did in Bhagavad Gita. Bhagavad Gita contains 702 dialogues in the form of Shlokas therefore a proper counseling involves in–depth conversation between the counselor and the patient.

8) What is the second principle of counseling?

A: The second principle of counseling is to listen to the patient in the first session in great detail and that is what Krishna did in Bhagavad Gita. In Chapter 1, only Arjuna speaks and Krishna does not utter a word. A patient listening is half the healing done.

9) What is the third principle?

A: As per the third principle, the second (first interactive) session between counselor and the patient should be the longest one. Chapter 2 of Bhagavad Gita is the gist of Krishna’s counseling.

10) What is the fourth principle?

A: The fourth principle is that after giving a detailed counseling in the second session one should expect the patient to get confused. This is what happens in start of Chapter 3 where Arjuna says to Krishna "I am confused. Sometimes you are talking about one path and other time you are talking about another path. Guide me again." The third counseling session therefore, is the most important where one has to counsel slowly and in great detail.

11) What is the fifth principle?

A: The next principle is to give reasoning to the counseling. One should not take patient for granted. Krishna discusses each and every aspect of life with Arjuna in great detail giving scientific reasoning at every stage.

12) What is the sixth principle?

A: Re-assure the patient again and again. During counseling Krishna assures Arjuna on multiple occasions that you did your job and do not worry. I am with you.

13) What is the seventh principle?

A: The seventh principle involves creating some fear in the patient’s mind. This is what Krishna does while showing his virat swaroop. This especially works in addiction patient. Some degree of fear with re–assurance from the counselor always works.

14) What is the eight principle?

A: The sum up counseling session should be as big as the second session. Chapter 18 of Bhagavad Gita is as big as Chapter 2 where the whole Bhagavad Gita is summarized again.

15 What are the ingredients of counseling?

A: Counseling basically involves in–depth knowledge of dharma, artha, kama and moksha. They are greatly described in dharmashastra, arthashastra, kamasutra and Upanishads through various Vedas.

16) What is stress?

A: Stress is the reaction of the body or the mind to the interpretation of any situation.

17) How can stress be managed?

A: Either change the response of the body through yogic living, or change the interpretation by understanding the principles of counseling or change the reaction by willful actions.

18) Are different nitis of our scriptures based on counseling?

A: Yes. Vidur Niti was the counseling given by Vidur to Dhritarashtra when he was not sleeping and Chanakya Niti was based on how to rule a country. Yoga Vashishtha was the counseling given by Vashistha to Rama to acquire higher levels of spiritual knowledge.

cardiology news

The Thirst and the Rusty Well

There is a legend of a man who was lost in the desert, dying of thirst. He stumbled on until he came to an abandoned house. Outside the dilapidated, windowless, weather–beaten, deserted shack was a pump. He stumbled forward and began pumping furiously, but no water came from the well. Then he noticed a small jug with a cork at the top and a note written on the side: "You have to prime the pump with water, my friend. P.S. And fill the jug again before you leave." He pulled out a cork and saw that the jug was full of water.

Should he pour it down the pump? What if it didn’t work? All of the water would be gone. If he drank the water from the jug, he could be sure he would not die of thirst. But to pour it down the rusty pump on the flimsy instruction written on the outside of the jug?

Something from inside told him to follow the advice and choose the risky decision. He proceeded to pour the whole jug of water down the rusty old pump and furiously pumped up and down. Sure enough, the water gushed out! He had all he needed to drink. He filled the jug again, corked it and added his own words beneath the instructions on the jug: "Believe me, it really works. You have to give it all away before you can get anything back."

That’s why giving is important…

News Around The Globe


  • Early treatment of active axial spondyloarthritis (SpA) with naproxen plus infliximab (Remicade) led to high rates of remission, which then were sustained whether patients continued to receive naproxen or not after stopping the infliximab, an international research group reported in two studies. A total of 61.9% of patients given the combination therapy were in partial remission according to the criteria of the Assessment of Spondyloarthritis International Society at week 28 bd 35.3% of those given naproxen alone (Annals of the Rheumatic Diseases).
  • As reported in the Journal of Clinical Endocrinology and Metabolism, older men whose natural testosterone levels were in the middle range tended to live longer than those with the highest and lowest levels, suggesting that having too much of the hormone in old age may be no better for survival than having too little.
  • The World Health Organization (WHO) released an updated Malaria Vaccine Technology Roadmap on November 13 at the annual conference of the American Society of Tropical Medicine & Hygiene 62nd Annual Meeting. The updated plan includes development by 2030 of a high–efficacy second–generation vaccine that will target both Plasmodium vivax and Plasmodium falciparum. The changes include:
    • A new focus on all ages (rather than just children younger than 5 years) because the effectiveness of malaria control measures has shifted the peak age of clinical malaria and the median age of malaria–related hospitalization to older children
    • An increase in the efficacy goal from 50% efficacy against severe disease and death and lasting longer than 1 year (the 2015 goal) to 75% protective efficacy by 2030, and the addition of the requirement to include Plasmodium vivax malaria infections as well as Plasmodium falciparum infections as vaccine targets
    • The development of vaccines that reduce transmission of the malaria parasite
    • An expanded focus on all malaria–endemic areas, not just sub-Saharan Africa.
  • The chance of an indeterminate penicillin skin test is 10 times higher in patients in intensive care than in other hospitalized patients. This suggests that the test is not worth performing in this setting, according to results from a retrospective case–control study presented at the American College of Allergy, Asthma & Immunology 2013 Annual Scientific Meeting.
  • The US FDA has approved 4 next–generation gene sequencing devices for clinical use. According to the FDA, the new technology will enable physicians to "take a broader look at their patients’ genetic makeup and can help in diagnosing disease or identifying the cause of symptoms."

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Rabies News (Dr. A K Gupta)

How is rabies transmitted?

Rabies is transmitted by infected secretions. Most commonly, transmission to humans takes place through exposure to saliva following a bite by an infected animal. Rabies virus can be excreted in saliva, urine, nasal discharge and respiratory secretions.

cardiology news

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinewS)

  • The combination of endovascular revascularization and a supervised exercise program for patients with peripheral artery disease reduced claudication pain and increased walking distance by about a quarter mile. The results of the 212–patient Endovascular Revascularization And Supervised Exercise (ERASE) study were reported at the American Heart Association Scientific Sessions. The addition of supervised exercise dramatically improved outcome in these patients. Current treatment strategy for intermittent claudication is angioplasty or supervised exercise, but not both.
  • The FDA has recommended that clinicians should avoid using the imaging agents regadenoson (Lexiscan, Astellas Pharma US) and adenosine (Adenoscan, Astellas Pharma US) for cardiac nuclear stress tests of patients with signs or symptoms of unstable angina or cardiovascular instability because the drugs may increase their risk for a fatal heart attack. The recommendation will appear on updated labels for both drugs.
cardiology news

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinewS)

  • Childhood leukemia survivors sustained vascular damage measurable within a few years after treatment. A new study reported at the AHA meeting found that children showed significantly more signs of subclinical atherosclerosis roughly 5 years after cancer treatment compared with siblings who never had cancer. Other types of childhood cancer typically treated with surgery or radiation more than chemotherapy didn’t show the same vascular effects.
  • Peak scores of well–being for teenagers occurred with about 14 hours a week of sport practice, or twice the recommended 7 hours, but higher sport durations independently predicted poor well–being, according to a Swiss survey study published online November 21 in the Archives of Disease in Childhood.
cardiology news

Physical illness can trigger depression

If you have depression, a thorough physical exam and careful medical history should be evaluated to pinpoint a physical source of the problem for an appropriate treatment.

In depression not only look for what’s going on in the mind and brain but also check what’s going on in the body. Many medical problems are linked to mood disturbances.

Over fifty percent of heart attack survivors and those with cancer report feeling depressed. Depression is also linked to diabetes, Parkinson’s and other chronic conditions.

Depression too can affect the course of a physical disease. Depression is linked with slower recovery from a heart attack and an increased risk for future heart trouble.

Thyroid disorders also affect mood. Overactive thyroid can cause mania and under active thyroid can cause depression. Other medical conditions associated with mood disorders include certain neurological conditions (multiple sclerosis, Parkinson’s disease, Alzheimer’s), other hormonal imbalances and lack of vitamin B12.

cardiology news

Total CPR since 1st November 2012 – 71933 trained

Media advocacy through Web Media

Stress may increase smoking habits

Stress increases the risk of heart attack by pushing people toward bad habits, said Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal President, Heart Care Foundation of India.

A British study published in the Journal of the American College of Cardiology suggests that people with psychological stress had a 50 percent increased risk of a cardiovascular disease event over the follow–up period.

The reasons were higher smoking rates and low exercise levels of individuals who were stressed.

In the study over a seven year follow-up period, incidence of cardiovascular events –– heart attacks, stroke, bypass surgery and the like –– was 50 percent higher among the people with a high level of depression and anxiety when compared to happier people. Smoking and lack of physical activity explained about 63 percent of the increase, with smoking alone responsible for 41 percent.

Alcohol intake explained less than 2 percent of the increase, with high blood pressure assigned 13 percent of the blame.

All such patients should be treated with combined physiological approaches with intensive lifestyle changes to reduce modifiable risk

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 71933 people since 1st November 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 10×10 i.e. 100 per minute."

today emedipics

CSR Activity by Heart Care Foundation of India on the Diabetes Day

press release

Treatment for constipation in the elderly

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

Injury to radial nerve in lower part of spiral groove:

1. Spares nerve supply to ex tensor 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: The main enzyme responsible for activation of xenobiotics is:

1.Cytochrome P–450
2.Glutathione S–transferase.
3.NADPH cytochrome P–450–reductase.
4.Glucuronyl transferase.

Answer for yesterday’s Mind Teaser: 3.NADPH cytochrome P–450–reductase.

Correct answers received from: Dr. P. C. Das, Dr Jainendra Upadhyay, DR ARPAN GANDHI, Dr Chandresh Jardosh, Dr.Jayashree Sen & Dr.Bitaan Sen, DR AVTAR KRISHAN

Answer for 20th November Mind Teaser: 3.AV Bundle.

Correct answers received from: DR AVTAR KRISHAN

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

Doctor complaining to mechanic

A doctor is taking to a car mechanic, "your fee is several times more per hour then we get paid for medical care."

‘Yeah, but you see, doc, you have always the same model! It hasn’t changed since Adam. But we have to keep up to date with new models coming every month"

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA?
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2 trial suggest that this intervention is much better than thrombolytic therapy in such patients.

medicolegal update

Do not dwell in the past, do not dream of the future, concentrate the mind on the present moment Gautam Budhha

medicolegal update

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Those who make wise choices in life should wind up happier & more successful http://tinyurl.com/mwjtqcs

Forthcoming events

Quality Management in Healthcare Delivery

Pushpanjali Crosslay Hospital, a 350+ bedded NABH & NABL accredited multi super specialty hospital is organizing its 5th Annual Conference "PCCON 2013" in association with Indian Medical Association (East Delhi Branch & West Ghaziabad Branch) on November 23–24, 2013 at Hotel Country Inn, Sahibabad, Ghaziabad.

Chairperson : Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal
Day & Date : Sunday, 24th Nov, 2013

5th eMedinews Revisiting 2013

(a day long single hall medical conference on 2013 happenings, followed by doctors of the year 2013 awards)

Sunday 19th January 2014, Maulana Azad Medical College Auditorium

Dilli Gate Delhi, 10 am-6 pm

Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee President

Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman

Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

5th eMedinewS Revisiting 2013
The 5th eMedinewS–revisiting 2013 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 19th 2014.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2013. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. Lunch will be provided.

Register at: rawat.vandana89@gmail.com/drpawangupta2006@yahoo.com

5th eMedinewS Doctor of the Year Awards
Nominations invited for 5th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2013.

pls send his/her Biodata at: emedinews@gmail.com
press release

medicolegal update
  1. Dear Sir, emedinews is very useful. Regards: Dr Kavita

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Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Prof.(Dr).C V Raghuveer

medicolegal update

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