eMedinewS22nd September 2014, Monday

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 & Honorary Secretary General Elect IMA; Member Ethics Committee MCI; Chairman Ethical Committee DMC; Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) IMSA (March 10–13); Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMAAMS (06–07); President DMA (05–06); President IMA New Delhi Branch (94–95, 02–04).
For updates follow at :  www.twitter.com/DrKKAggarwal, www.facebook.com/Dr KKAggarwal

5 Ways to Use less Salt

  1. Use spices and other flavor enhancers such as spices, dried and fresh herbs, garlic and ginger, citrus, vinegars and wine. Flavors can be black pepper, cinnamon and turmeric to fresh basil, chili peppers, and lemon juice.
  2. Use the right healthy fats from roasted nuts and avocados to olive, canola, soybean and other oils.
  3. Searing and sautéing foods in a pan builds flavor. Roasting brings out the natural sweetness of many vegetables and the taste of fish and chicken. If you do steam or microwave food, perk up these dishes with a finishing drizzle of flavorful oil and a squeeze of citrus.
  4. Get your whole grains from sources other than bread. White bread contains salt, not just for flavor but to ensure that the dough rises properly.
  5. Shop for raw ingredients with maximum natural flavor, thereby avoiding the need to add as much (if any) sodium. (Harvard)
  1. IMA and Association of hospital providers of India are coming out with code of ethics for medical establishments. We need suggestions. Yesterday we caries some of the suggestions from [Hospital Code of Ethics, included in "Law and the Practice of Medicine", Published in 2010 by JayPee Brothers Med Publishers by Dr S K Joshi]. We will be carrying suggestions daily. (We regrets as his reference name got omitted in Sundays eMedinewS)
  2. We are organizing Dr Deepak Chopra's lecture cum webcast on coming Friday. Kindly bless the occasion of inauguration of a social issue "Sameer Malik Heart Care Foundation Fund".
  3. It's a matter of proud for the Indian Medical association that one of its past president Dr Ketan Desai is taking over as the President of World Medical Association.
  4. IMA is planning for many National initiatives; kindly send your suggestions and commitments.
  5. The installation of the new President Dr Marthanda Pillai and his team on 28th December 2014 will have a live webcast for the first time in the history of IMA. It's a coincidence and yet an honor for us, both the incoming President of IMA and incoming Honorary Secretary General of IMA will be National Awardee" Padma Shri"
  6. It's a matter of pride that eminent rheumatologist Dr. (Lt Gen) Ved Chaturvedi takes over as DG Medical Services (Army). We salute him.
  7. I recently attended three functions of IAP and NNF along with of MOH Government of India. Initially was disappointed as found IMA nowhere in National Programs of MOH/ MCH programs. But instantly thought every adversity is an opportunity. Never late than never. It's a challenge for me to take IMA at that level "That no national program is complete without IMA".

News Around The Globe

21st MTNL Perfect Health Mela Programme Brouchure

  • Invasive pneumococcal disease in patients with no known risk factors may be associated with genetic susceptibility, suggests a new study presented recently at the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC).
  • In patients with chronic graft-vs-host disease (cGvHD), having a female stem cell donor or a female-donor-to-male-recipient sex mismatch may be associated with an increased risk of vitiligo and alopecia areata, suggested a study published online in JAMA Dermatology.
  • The investigational antisclerostin antibody romosozumab may promote substantial increases in bone mineral density (BMD) following 2 years of treatment, suggests a new phase 2 clinical-trial. Moreover, the improvements are sustained for a third year when patients are transitioned to the antiresorptive drug denosumab. The data were presented recently at the American Society for Bone and Mineral Research (ASBMR) 2014 Annual Meeting.
  • A new study published in JAMA Psychiatry links post-traumatic stress disorder (PTSD) to increased food addiction, potentially explaining why past research has associated the disorder with increased risk of obesity. Women with no symptoms of PTSD had food addiction prevalence of 6%, compared with almost 18% prevalence among women who had 6-7 symptoms of PTSD.
  • The U.S. Food and Drug Administration has approved naloxegol, an oral treatment for opioid-induced constipation, in adults with chronic non-cancer pain. The drug’s safety and effectiveness were established in two clinical trials of 1,352 participants who had taken opioids for at least four weeks for non-cancer related pain and had opioid-induced constipation.
  • Patients with vitiligo appear to have faster and better repigmentation after a combination therapy of the implantable drug afamelanotide and narrowband UV-B (NB-UV-B) phototherapy, suggested a new study published in JAMA Dermatology.

IMA News

Ketan Desai made president of World Medical Association
(Rema Nagarajan,TNN | Sep 21, 2014, 12.39 AM IST)

Dr Ketan Desai, a former president of the Medical Council of India (MCI), has been confirmed as the president of the World Medical Association (WMA) for 2016, four years after the MCI had suspended his licence for alleged corruption. His confirmation as WMA president comes after the Indian Medical Association (IMA) told the world body that all charges against Dr Desai had been withdrawn.

In December last year, the MCI ethics committee is learnt to have revoked the suspension of Dr Desai's licence on similar grounds. However, details of the status of cases filed by the CBI against Dr Desai, provided by Dr K K Aggarwal, secretary general elect of the IMA, show that while several of the cases initiated by CBI had either been closed or did not have Dr Desai as an accused, there are two which remain pending. In one of these cases, the CBI has filed a charge sheet against several accused including Dr Desai, but further proceedings have been stayed by the Supreme Court. In another case, no court has yet framed charges.

Dr Desai was president of the MCI in 2010 when the government disbanded the regulatory body on the grounds that there was widespread corruption in its functioning. He is now a member of the MCI following the revocation of the suspension of his licence.

Details of the process by which the WMA decided to confirm him as its president for 2016 have been published in the official journal of the WMA, the World Medical Journal. These reveal that one Dr. Ajay Kumar appeared before WMA Assembly and submitted an application on behalf of IMA demanding that Dr Desai be reinstated as WMA president-elect since all charges against him had already been dropped. Interestingly, Dr Ajay Kumar happens to be a member of the MCI's ethics committee.

National News

NBMJ Award winners

The BMJ Awards India: the 10 categories

Winners

Excellence in Medical Education

Dr. Ravi Kumar Chittoria,
JIPMER, Pondicherry

Excellence in Preventive Health

KNOW Diabetes Project
from Kerala

Health Advocacy

Dr. Pankaj Chaturvedi
for his campaign on the
Voice of Tobacco Victims

Innovation in Healthcare Technology

Dr. Sarman Singh for a
rapid Diagnostic Kit
for Leishmaniasis
&
Dr. Sandeep Singh for
A novel intraosseous device
for emergency vascular access

Junior Doctor of the Year

Dr Parthik Patel
from the Karnavati College
of Dentistry, Gandhinagar

Medical Team of the Year

The infectious diseases team at Fortis Mumbai for the Antibiotic Stewardship program.

Primary Healthcare in Challenging Circumstances

The Jawadhi Hills program of community health department, CMC Vellore

Quality Improvement in Healthcare

Pediatric Cardiac Unit, Amrita Institute of Medical Sciences, Kochi

Research Paper of the Year

Dr. Anurag Bhargava, for his research on under nutrition and tuberculosis.

Surgical Team of the Year

ROBOTIC SPINE SURGERY TEAM from Apollo Hospitals, Delhi

Legal News

  • Punjab & Haryana High Court has finally admitted our WP and issued notices to Punjab, Haryana and UT police in our case against arrest of doctors under section 304 A. (Dr Neeraj Nagpal)
  • The Empowered Committee on Road Safety which was created as a result of the Public Interest Litigation has started functioning in full strength. The members are: 1) Honourable Justice K.S. Radhakrishnan, Judge, Supreme Court of India; 2) Mr S Sundar (Former Transport Secretary) and 3) Dr (Mrs) Nishi Mittal (HOD, Traffic Engineering and Safety). Central Government has agreed for establishment of a Motor Vehicle Regulation and Road Safety Authority of India.(Prof S Rajasekaran, Ph.D.]

Rabies News (Dr A K Gupta)

What are the limitations of polyclonal serum (RIG)?

Difficulties associated with the use of Polyclonal Serum (RIG) samples might consist of:

  • Batch–to–batch variation
  • Risk related to the use of human blood products. Because HRIG preparations are of human origin, they need to be treated to minimize the risk of transmission of infectious agents.
  • Difficulties in finding immune donors during sudden mass exposures might lead to a low availability of RIG.
  • Because of discontinued ERIG production by international manufacturers, supply of ERIG relies on regional production.
  • The use of ERIG has raised ethical issues and has been condemned by animal protection groups.

Cardiology eMedinewS

  • The need for cholesterol treatment among people aged more than 80 years must always be assessed individually taking into account the patient's overall situation and health, recommend Finnish researchers in an article published September 17 in JAMA.
  • hospitalization for heart failure, suggested a pooled analysis of 10 clinical trials presented at TCT 2014.

Pediatrics eMedinewS

  • A study published ahead of print in the Journal of Pediatrics has pointed that delays in the onset of walking (which should occur between 9 and 16 months of age) are common among boys with Duchenne muscular dystrophy (DMD) and often happen alongside cognitive delays. This combination can give pediatricians a critical early diagnostic clue and tip them off to the presence of DMD.
  • A new research has revealed that the overall outcomes for children with asthma are affected by socioeconomic inequalities. Researchers noted a significant socioeconomic difference in outcomes, with the poor consequences of asthma concentrated among children from economically disadvantaged backgrounds. The study was published in the journal Social Science and Medicine.

Dr K K Spiritual Blog

Never Hurt Ego of a Person

It is a well known Vedic fact that if you hurt ego of a person, he will never forgive you, especially, if you have insulted or implicated him in character assassination, cast implications, financial embezzlement or in public, you call a woman as old or a man as impotent.

For example, if I hurt ego of a chowkidaar, next time if a patient comes to the hospital gate and asks where Dr. KK Aggarwal is, he only has to whisper, "Which Aggarwal, whose cases never survive?"

Also never hurt the ego of a person who is drunk. Under the influence of alcohol, a person loses his capacity to judge persons and situations. If you provoke him, he can be destructive and aggressive.

Wellness Blog

Don’t ignore women’ health

Women are not diagnosed or treated as aggressively as men. Even though more women than men die of heart disease each year, women receive only 33% of all angioplasties, stents and bypass surgeries; 28% of implantable defibrillators and 36% of open-heart surgeries, according to the National Coalition for Women with Heart Disease in the US.

Although the traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — have a detrimental impact in men and women, certain factors play a bigger role in the development of heart disease in women.

  • Metabolic syndrome — a combination of increased blood pressure, elevated blood glucose and triglycerides has a greater impact on women than men.
  • Mental stress and depression affect women’s hearts more than they do men’s.
  • Smoking is much worse for women than men.
  • Low estrogen level before menopause is a significant risk factor for developing microvascular disease.
  • Though women will often have some chest pain or discomfort, it may not be the most prominent symptom. Diffuse plaques build–up and diseased smaller arteries are two reasons why symptoms can be different in women.
  • In addition to chest pain, pressure or discomfort, signs and symptoms of heart attack in women include: Neck, shoulder, upper back or abdominal discomfort, shortness of breath, nausea or vomiting, sweating, light-headedness or dizziness and unusual fatigue.
  • Endothelial dysfunction is more common in women. This means that the lining of the artery does not expand (dilate) properly to boost blood flow during activity, which increases the risk of coronary artery spasm and sudden death.
  • WISE study results suggest that the commonly used treatments for coronary artery disease angioplasty and stenting are not the best options for women with more diffuse plaques.
  • Typical tests for coronary artery disease — angiogram, treadmill testing and others are not reliable in women.
  • The Women’s Ischemia Syndrome Evaluation (WISE) study showed that in some women, plaques accumulate as an evenly spread layer along artery walls, which is not visible using traditional testing methods.
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Total CPR since 1st November 2012 – 98440 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."

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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 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.

eMedinewS Humor

Teacher: Billy, stop making ugly faces at other students!

Billy: Why, ma’am!

Teacher: Because when I was a child, my parents told me that if I kept making ugly faces my face would stay that way!

Billy: Well, I can see you didn’t listen then!

Quote of the Day

If we wait until our lives are free from sorrow or difficulty, then we wait forever. And miss the entire point. Dirk Benedict.

Twitter of the Day

Dr KK Aggarwal: Equipment–related failures common in Operation Theater http://Blogz.org/A/885894
Dr Deepak Chopra: While collective consciousness resides in the physical world, pure consciousness, exists in the gap between thoughts. http://tinyurl.com/mwjtqc

Inspirational Story

Blue Hummingbird

Once, long ago, there was a young boy who lived in a distant land called Tandow. He was a cheerful lad with not a care in the world. A special friend had he, the little blue hummingbird. Now this little boy didn’t have a lot of great friends, but the little bird and the boy were inseparable friends. The boy loved the little humming bird, so he built him a home. The bird also loved the boy and would follow him wherever he would go. As time went by their love grew and grew.

Then one day the young lad met a pretty young girl in school. The girl had long blonde hair, blue eyes, and a cute little smile. This was about the time of the biggest dance of the year. All the boy could think about was how he would love to take the girl to the dance. He gathered his courage all day and at the end of school confronted the girl and asked her to go with him to the dance.

Now this young girl was very popular and felt she did not want to be seen with the boy who cared for her so, but she did not want to hurt his feelings and so figured out a way to avoid saying no or yes. She told the boy if he brought her a red rose she would allow him to escort her to the dance.

This hurt the little boy because he knew that in the land of Tandow there had never been a red rose. In fact, the only roses in the land Tandow were white. On the way home the boy kept mumbling to himself why couldn’t she have asked for a white rose. There were hundreds of them in his front yard.

Feeling sorry for himself the boy didn't even notice his friend the hummingbird fluttering above him. Now the bird loved him so, that it could tell instantly the boy was troubled. The bird hovered closer as the boy mumbled on home. Now the bird knew why the boy was so troubled. The bird could not rest all the night long, it pondered all night, a solution to the boy’s problem.

Finally as the sun began to rise the answer to how the bird could help his best friend entered his mind. The little blue hummingbird flew to a rose bush and searched for a large rose with a stem bearing thorns directly above it. Now the bird chose a thorn and with all the power in his wings cast his small body against the sharp thorn. It entered with great pain, as the tear drops of blood fell upon the white petals of the rose.

Now as the boy was ready for school, as he left the house he saw a red rose, he could hardly believe it, he ran to the bush and plucked the red rose. In his excitement he failed to notice the lifeless little body that lay below the bush in a puddle of blood. Happy as could be, he began with his red rose on his way to school. Before he got there some other boys playing football in a field called to him and asked him to come and play.

His first thought was, no, he had something more important to do. But they begged him and said they really needed him to even the teams. He looked at the rose, then them, then back at the rose. He said to himself. Ah!!! She didn’t really want to go with me anyway. Then, throwing the rose down, the boy went and played football.

You’ve probably already figured out the allegory…

  1. The boy is each of us.
  2. The humming bird is Jesus Christ.
  3. The girl is eternal life.
  4. The rose is the atonement.
  5. The football game is the worldly things we sometimes feel are so important.

ePress Release

Diabetics should not smoke

The health hazards of cigarette smoking in the general population are well known. In patients with diabetes mellitus, smoking considerably increases the risk for both macrovascular (cholesterol deposition) and microvascular (eye, kidney involvement) disease, 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.

Smoking is an independent risk factor for all–cause mortality, largely due to cardiovascular disease.
There is a dose–response relationship between current smoking status and risk of coronary disease in women with diabetes. The risk is 1.7 and 2.68 for 1 to 14 and >15 cigarettes per day, respectively. The risk returns to baseline in those who had stopped smoking for more than 10 years.

The risk of mortality in diabetic women also increases with the number of cigarettes smoked per day. The risk is 1.4 and 2.1 for 1–14 and >35 cigarettes/day, respectively. The risk decreases substantially 10 years after quitting smoking.

Smoking is associated with increases in the serum concentrations of total cholesterol and very–low–density lipoprotein cholesterol, a decrease in serum high–density–lipoprotein cholesterol levels, and a greater degree of insulin resistance. Smokers, via an uncertain mechanism, have poorer glycemic control.
In patients with type 1 diabetes, smoking is independently associated with an increase in urinary albumin excretion and nonproliferative retinopathy. The degree of albuminuria falls to the level of nonsmokers if smoking is discontinued.

Smokers with either type 1 or type 2 diabetes are at increased risk for neuropathy, an effect that persists even after adjusting for glycemic control.

Smoking is associated with an increased risk of end–stage renal disease and with decreased survival once dialysis is commenced.

eMedi Quiz

Granulocytopenia, gingival hyperplasia and facial hirsutism are all possible side effects of one of the following anticonvulsant drugs:

1. Phenytoin.
2. Valproate.
3. Carbamazepine.
4. Phenobarbitone.

Yesterday’s Mind Teaser: All of the following drugs act on cell membrane, except:

1. Nystatin.
2. Griseofulvin.
3. Amphotericin B
4. Polymixin B.

Answer for yesterday’s Mind Teaser: 2. Griseofulvin.

Correct answers received from: Dr BB Aggarwal, Dr Shravan, Dr Hanif, Dr Saroj

Answer for 20th September Mind Teaser: 1. Vineet recorded an increase in MBP but Kamlesh recorded a decrease in MBP

Correct answers received from: Dr Avtar Krishan

Send your answer to ijcp12@gmail.com

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  1. Good points on relaxation therapy. Regards: Dr Shreyesh

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