eMedinewS22nd March 2014,Saturday

Dr K K AggarwalPadma 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

Delhi High Court directs AIIMS to treat poor boy suffering from rare disease

Aggrieved by the conduct of All India Institute of Medical Science (AIIMS) for denying treatment to his seven-year-old son suffering from life–threatening Gaucher’s disease, a man has knocked the Delhi high court door seeking free treatment for his kid. The boy required enzyme replacement once in a month and the expenses come above Rs 6 lakh.

Gaucher’s disease is a rare inherited disorder that affects many organs and tissues. Fat accumulates in cells and organs and the disease is characterized by bruising, fatigue, anemia, low blood platelets and enlargement of the liver and spleen.

AIIMS denied treatment to the boy, son of a rickshaw puller, on the ground that the drug used for the treatment is very expensive.

On Thursday, the Delhi high court said, "A patient cannot be denied treatment due to financial constraint and the State is bound to find a source to generate funds for the poor patients."

Pulling up the Delhi government for expressing its inability to come forward and provide financial help, Justice Manmohan said, "You have to find a way to provide medical aid to poor patients. Funds have to be created. There cannot be a vacuum."

The court accepted the funds generated by the Delhi High Court Bar Association and directed the AIIMS director to provide treatment to the boy till the time the court settles the man’s plea.

Appearing for the lawyers’ body, former additional solicitor general A S Chandhiok, who is also ex–president of the bar, told the court that the lawyers have contributed Rs7.80 lakh and deposited it in the petitioner's account which can be transferred to AIIMS account.

Justice Manmohan directed immediate transfer of the amount to AIIMS director’s account, and asked him to continue treatment till the court decides.

The court has decided to hear the matter and pass a detailed order on the plea and fixed March 25 as the next date for hearing.

Earlier, the court had said that the cost of treatment should not be an impediment as far as the life of a child is concerned and India being a welfare state, it is the constitutional obligation of the state machinery to do whatever is necessary to preserve a human life in a time–bound manner. The court directed the Central and Delhi governments to decide if a policy can be framed to provide treatment to terminally–ill patients.

The principal secretary for health in Delhi government told the court that "there is no policy under which the government can provide financial help and there are no resources to generate funds".

To this, Justice Manmohan said, "Since there is no government, you are the sole authority. Frame a policy and get it approved by the Lieutenant Governor."

Meanwhile, the petitioner’s lawyer Ashok Agarwal referred to several apex court judgments and submitted that due to financial constraints a patient cannot be denied treatment.

According to the father of the ailing child, he has already lost four children to Gaucher’s disease and this child has survived till this age due to regular treatment.

It is difficult for him to meet the huge expenses occurred towards the treatment for life long, he said.

Advocate Shyel Trehan, who was appointed as amicus curiae by the court, told the court that Gaucher’s disease from which Ahmed suffers was a rare chronic disease known worldwide as "Orphan disease".

She said that according to research, only about 200 cases of this disease have been diagnosed in India so far and the monthly expenditure on treatment was over Rs 6 lakh.

Trehan said that in the US, there was a specific legislation, "Orphan Drug Act", which provides incentives to pharmaceutical companies to undertake research on the rare disease. She said there was no such Act or even a policy in India. (Source: dnaindia)


Zee News – Health Wealth Show

Dr kk Aggarwal on Zee Show

Safe Holi-Health Wealth Zee News Show
Safe Drugs-Health Wealth Zee News Show
Cancer Prevention–Health Wealth Zee News Show2
Potbelly Obesity–Health Wealth Zee News Show
Cancer Prevention–Health Wealth Zee News Show1
Vitamin D Health Wealth
Pneumonia–Health Wealth Zee News Show
Sudden Cardiac Death
Can Alcohol be Prescribed as Medicine
Health Wealth: All about Paralysis

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

You Are the Temple of God and the Spirit of the God Dwells in You

sprritual blog

This sutra from the Bible reflects the union between the spirit and the soul. The ‘Spirit’ represents the Parmatama or the Brahman and ‘You’ represents the individualized spirit or the Soul (Jivatama).

A temple is a place of worship and also the place where the God resides. Every human being represents a temple (place of worship) where the God exists (one’s soul) and this soul is nothing but the essence of God (the spirit).

One should treat every individual with the same manner as the same spirit dwells in every human being. The soul is also the reflection of individual’s past and present karmic expressions. Most people are in the habit of looking and searching for God in artificial temples, gurudwaras and churches, not realizing that the same God is present within us, provided we undertake the internal journey to look for Him.

He is present in between thoughts in the silent zone and can be approached by adopting any of the three pathways: Karma Yoga, Bhakti Yoga and Gyana (Gnana) Yoga.

Doing selfless work with detachment to its results; working with the principles of duty, devotion and discipline and/or regularly doing Primordial Sound Meditation or other types of meditations can help one reach the stage of self–realization or meeting one’s true self. Once there, one can have all the happiness in life.

cardiology news

It’s Never Too Late

It was an unusually busy day for the hospital staff on the sixth floor. Ten new patients were admitted and Nurse Susan spent the morning and afternoon checking them in. Her friend Sharron, an aide, prepared ten rooms for the patients and made sure they were comfortable. After they were finished she grabbed Sharron and said, "We deserve a break. Let’s go eat."

Sitting across from each other in the noisy cafeteria, Susan noticed Sharron absently wiping the moisture off the outside of her glass with her thumbs. Her face reflected a weariness that came from more than just a busy day. "You’re pretty quiet. Are you tired, or is something wrong?" – Susan asked.

Sharron hesitated. However, seeing the sincere concern in her friend’s face, she confessed, "I can’t do this the rest of my life, Susan. I have to find a higher–paying job to provide for my family. We barely get by. If it weren’t for my parents keeping my kids, well, we wouldn’t make it."

Susan noticed the bruises on Sharron’s wrists peeking out from under her jacket. "What about your husband?" "We can’t count on him. He can’t seem to hold a job. He’s got … problems." "Sharron, you’re so good with patients, and you love working here. Why don’t you go to school and become a nurse? There’s financial help available, and I’m sure your parents would agree to keep the kids while you are in class."

"It’s too late for me, Susan; I’m too old for school. I’ve always wanted to be a nurse, that’s why I took this job as an aide; at least I get to care for patients.:" "How old are you?" – Susan asked. "Let’s just say I’m thirty–something."

Susan pointed at the bruises on Sharron’s wrists. "I’m familiar with ‘problems’ like these. Honey, it’s never too late to become what you’ve dreamed of. Let me tell you how I know." Susan began sharing a part of her life few knew about. It was something she normally didn’t talk about, only when it helped someone else.

"I first married when I was thirteen years old and in the eighth grade." Sharron gasped. "My husband was twenty–two. I had no idea he was violently abusive. We were married six years and I had three sons. One night my husband beat me so savagely he knocked out all my front teeth. I grabbed the boys and left. "At the divorce settlement, the judge gave our sons to my husband because I was only nineteen and he felt I couldn’t provide for them. The shock of him taking my babies left me gasping for air. To make things worse, my ex took the boys and moved, cutting all contact I had with them.

"Just like the judge predicted, I struggled to make ends meet. I found work as a waitress, working for tips only. Many days my meals consisted of milk and crackers. The most difficult thing was the emptiness in my soul. I lived in a tiny one’room apartment and the loneliness would overwhelm me. I longed to play with my babies and hear them laugh."

She paused. Even after four decades, the memory was still painful. Sharron’s eyes filled with tears as she reached out to comfort Susan. Now it didn’t matter if the bruises showed. Susan continued, "I soon discovered that waitresses with grim faces didn’t get tips, so I hid behind a smiling mask and pressed on. I remarried and had a daughter. She became my reason for living, until she went to college.

"Then I was back where I started, not knowing what to do with myself – until the day my mother had surgery. I watched the nurses care for her and thought: I can do that. The problem was, I only had an eighth–grade education. Going back to high school seemed like a huge mountain to conquer. I decided to take small steps toward my goal. The first step was to get my GED. My daughter used to laugh at how our roles reversed. Now I was burning the midnight oil and asking her questions."

Susan paused and looked directly in Sharron’s eyes. "I received my diploma when I was forty–six years old." Tears streamed down Sharron’s cheeks. Here was someone offering the key that might unlock the door in her dark life.

"The next step was to enroll in nursing school. For two long years I studied, cried and tried to quit. But my family wouldn’t let me. I remember calling my daughter and yelling, ‘Do you realize how many bones are in the human body, and I have to know them all! I can’t do this, I’m forty–six years old!’ But I did. Sharron, I can’t tell you how wonderful it felt when I received my cap and pin."

Sharron’s lunch was cold, and the ice had melted in her tea by the time Susan finished talking. Reaching across the table and taking Sharron’s hands, Susan said, "You don’t have to put up with abuse. Don’t be a victim – take charge. You will be an excellent nurse. We will climb this mountain together." Sharron wiped her mascara-stained face with her napkin. "I had no idea you suffered so much pain. You seem like someone who has always had it together."

"I guess I’ve developed an appreciation for the hardships of my life," Susan answered. "If I use them to help others, then I really haven’t lost a thing. Sharron, promise me that you will go to school and become a nurse. Then help others by sharing your experiences." Sharron promised. In a few years she became a registered nurse and worked alongside her friend until Susan retired. Sharron never forgot her colleague or the rest of her promise.

Now Sharron sits across the table taking the hands of those who are bruised in body and soul, telling them, "It’s never too late. We will climb this mountain together."

News Around The Globe

  • The results of the MS–STAT trial are out. The results of the phase 2 trial published in The Lancet reveal that there is a significant reduction in brain atrophy in patients with secondary progressive multiple sclerosis (MS) with high–dose simvastatin. In all, 140 patients with secondary progressive MS were randomly allocated to receive simvastatin, 80 mg daily, or placebo. The study reported 0.3% shrinkage in brain size per year in patients taking simvastatin, which is otherwise 0.6% in MS patients.
  • Despite agreeing that women with dense breast tissue are at a modestly increased risk for breast cancer as well as reduced sensitivity to mammography, the ACOG Committee on Gynecologic Practice stated that there is not enough evidence to support use of alternative screening techniques, such as tomosynthesis or thermography, or adjunctive screening methods, such as ultrasound or magnetic resonance imaging, in improving breast cancer mortality in asymptomatic women with no other risk factors. The committee also stated that digital mammography may be more effective than film mammography in women with extremely dense tissue. The committee’s opinion has been published in the April issue of Obstetrics and Gynecology.
  • A study published online March 20 in JAMA Otolaryngology – Head and Neck Surgery has revealed that persistent sore throat and a neck mass constitute the most frequent initial symptoms of oropharyngeal squamous cell carcinoma. These symptoms are the initial signs of human papillomavirus (HPV)–positive throat cancer, reported Terry Day and colleagues through a retrospective study conducted in 88 patients with known HPV status. The records of these patients diagnosed with newly diagnosed oropharyngeal squamous cell carcinoma and known HPV status revealed neck mass to be the initial symptom in 44% patients and sore throat in 33% patients.
  • According to a recent meta–analysis, adults over 65 at the high end of the healthy body mass index (BMI) range were at lower risk of mortality, and those at the low end were at highest risk. Caryl A. Nowson, PhD, of Deakin University in Melbourne, Australia, and her co–authors report in the American Journal of Clinical Nutrition that the association between all–cause mortality and BMI created a U–shaped curve with a broad base (P–nonlinearity <0.001). The nadir of the curve for BMI and mortality was between 24.0 and 30.9, with the lowest risk being between 27.0 and 27.9 (HR 0.90, 95% CI 0.88–0.92).
  • DNA analysis of the tissue attained through dilation and curettage (D&C) procedures after miscarriage has the potential to determine chromosomal abnormalities responsible for the pregnancy loss, reports a study published in Reproductive Biology and Endocrinology. A retrospective study of case series using rescue karyotyping was conducted on 20 specimens from 17 women with recurrent pregnancy loss. Sixteen samples that were evaluable yielded copy number variants in 8 of them: 3 trisomies, 1 mosaic trisomy, 2 partial deletions, and 2 unclassified variants.

CPR 10 success stories

1. Hands–only CPR 10 English

2. Hands–only CPR 10 (Hindi)

3. Ms Geetanjali, SD Public School Successful Story

4. Success story Ms Sudha Malik

5. BVN School girl Harshita does successful hands–only CPR 10

6. Elderly man saved by Anuja

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Rabies News (Dr. A K Gupta)

Is sera testing of IDRV patients for antirabies antibodies necessary as a measure of knowing its efficacy?

Routine sera testing for rabies antibodies to know its efficacy is not required.

cardiology news

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

  • The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics has recently stated that childbirth in water has lesser number of proven benefits, but several risks attached, and should therefore be approached with caution. Studies of immersion childbirth have reported of cases of severe respiratory distress among infants who aspirated the water, including 1 child who died from overwhelming sepsis. The article is published online March 20 in Obstetrics and Gynecology and in Pediatrics.
  • A novel retrospective review in JAMA Otolaryngology Head and Neck Surgery states that vocal fold immobility (VFI) persists in nearly three quarters of children who develop it, despite reports of symptomatic resolution. Researchers reviewed 404 cases of pediatric VFI and follow–up records were available for 362 patients. Only 28.0% of these showed resolution by laryngoscopy. About 10% had insufficient follow–up data, and 61.6% had ongoing immobility. Of those with ongoing immobility, 28.9% were asymptomatic at their last follow–up appointment. Overall, 45.8% had symptoms related to VFI at their last follow–up appointment
cardiology news

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

  • A novel US analysis taken from the Nationwide Inpatient Sample has revealed that maternal cardiac arrest during childbirth is an extremely rare event, occurring in approximately one in 12,000 deliveries despite the perception it may be on the rise because of more and more women with congenital heart conditions now having children. The report appears in the April 2014 issue of Anesthesiology. The analysis included 56 million hospital deliveries between 1998 and 2011. Of these, there were 8.5 cardiac arrests per 100,000 hospitalizations.
  • The latest American College of Cardiology (ACC) and American Heart Association (AHA) guidelines for the treatment of cholesterol are estimated to amplify the number of individuals eligible for statin therapy by nearly 13 million people. Among those aged 60 to 75 years, 87.4% of men would now be eligible for the lipid–lowering medication. About 53.6% women in the same age group would now be eligible for statin therapy as compared to 21.2% in the old Adult Treatment Panel (ATP) III guidelines.
cardiology news

What type of a vegetarian are you?

There are 4 main types of vegetarian diets

  1. Lacto–ovo–vegetarian consumes dairy products and eggs but no meat, poultry, or seafood
  2. Lacto–vegetarian eats dairy products but not eggs, meat, poultry, or seafood
  3. Ovo–vegetarian eats eggs but no dairy products, meat, poultry, or seafood
  4. Vegan does not eat any animal products, including meat, fish, poultry, eggs, and dairy products; many vegans will also avoid honey.

Vegetarian and plant–based diets are associated with a reduced risk of obesity, diabetes, heart disease, and some types of cancer as well as increased longevity. Vegetarian diets are typically lower in fat, particularly saturated fat, and higher in dietary fiber. They are also likely to include more whole grains, legumes, nuts, and soy protein, and together with the absence of red meat, this type of eating plan may provide many benefits for the prevention and treatment of obesity and chronic health problems, including diabetes and cardiovascular disease.

cardiology news

Total CPR since 1st November 2012 – 88972 trained

Media advocacy through Web Media

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press release

Do not ignore transient brain dysfunction

TIA or transient ischemic attack or mini paralysis is a brief episode of neurologic dysfunction caused by lack of blood supply in the focal brain or eye, with clinical symptoms typically lasting less than one hour, and without evidence of acute infarction or brain attack, 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. It is a neurological emergency; its early recognition can identify patients who may benefit from preventive therapy or from surgery of large vessels such as the carotid artery.

The initial evaluation of suspected TIA and minor non disabling ischemic paralysis includes brain imaging, neurovascular imaging, and a cardiac evaluation. Laboratory testing is helpful in ruling out metabolic and hematologic causes of neurologic symptoms.

TIA or minor non disabling ischemic paralysis is associated with a high early risk of recurrent paralysis. The paralysis risk in the first two days after TIA is approximately 4 to 10 percent. Immediate evaluation and intervention after a TIA or minor ischemic reduces the risk of recurrent stroke.

Risk factor management is appropriate for all patients. Currently viable strategies include blood pressure reduction, statins, antiplatelet therapy and lifestyle modification, including smoking cessation.

For patients with TIA or ischemic stroke of atherothrombotic, lacunar (small vessel occlusive), or cryptogenic type, antiplatelet agents should be given. For patients with atrial fibrillation and a recent ischemic stroke or TIA, the treatment is blood thinners. For patients with carotid blockages surgery is needed.

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 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."

emedipicstoday emedipics

Heart Care Foundation of India, a national not–for–profit organization committed to raising awareness and providing effective solutions for impending health issues in the country, announced the opening of applications for the ‘Sameer Malik Heart Care Foundation Fund’

press release

TPA safe in pediatric stroke

vedio of day

today video of the dayPadma Shri & Dr B C Roy National Awardee,Dr KK Aggarwal on Tackling tension headaches

Hands only CPR 10 Utsav, 15th December 2013

Dr KK Aggarwal receives Harpal S Buttar Oration Award from Nobel Laureate Dr Ferid Murad

eMedi Quiz

Injury to radial nerve in lower part of spiral groove:

1. Spares nerve supply to extensor 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 cells belonging to the following type of epithelium are provided with extra reserve of cell membrane:

1. Transitional
2. Stratified squamous.
3. Stratified cuboidal.
4. Stratified columnar.

Answer for yesterday’s Mind Teaser: 1. Transitional

Correct answers received from: : Dr.K.Raju, Dr.A.K.Gajajar, Dr Prakash Khalap, Dr.Raghavendra Jayesh, Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr Aabbas Vakil, Dr.K.Raju, Arvind Gajjar, Dr. P. C. Das

Answer for 20th March Mind Teaser: 3.Lateral rectus and abducent nerve.

Correct answers received from: Dr Pankaj Agarwal, Dr Chandresh Jardosh,Dr Aabbas Vakil, Yamini Alsi, Dr B K Agarwal

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medical querymedical query

medicolegal update
medicolegal update

French Toast

The warden, addressing the three instigators of a failed prison riot, said, "I would like to know two things: First: Why did you revolt? Second: How did you get out of your cell?"

One of the three men stepped forward, "Warden, we rebelled because the food is awful."

"I see. And what did you use to break the bars?" the warden asked.

Replied the spokesman, "French Toast…"

medicolegal update

Click on the image to enlarge

medicolegal updatemedicolegal update

medicolegal update

Situation:A patient after sublingual nitrate developed fainting attack.
Reaction:Oh my God! Why was the systolic murmur missed on auscultation?
Lesson: Make surethat patient with left ventricular outflow tract (LVOT) obstruction are not given sublingual nitrates.

medicolegal update

Anxiety does not empty tomorrow of its sorrows, but only empties today of its strength. Charles Spurgeon

medicolegal update

Dr KK Aggarwal: The very purpose of life is to face sufferings…According to Hinduism, the very fact http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Your true self is nameless & formless http://bit.ly/15QdVeB #Health

medicolegal update
  1. Dear Sir, Heartiest congratulations for the Heart Care Foundation Fund. Regards: Dr Kalpana

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 – 9958771177, rawat.vandana89@gmail.com
SMS – BK Sapna 9650692204, bksapna@hotmail.com

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

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