eMedinewS23rd April 2014,Wednesday

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

Pain Management

  • Pain is a common occurrence in day to day life and should be managed well.
  • Remember the word ‘ICE’ which means putting ice pack on the injured painful area, ‘C’ stands for compression and ‘E’ stands for elevation.
  • The mantra, therefore, is to use cold compression and elevation for any injury.
  • Alternate hot and cold packs are used for chronic pain.
  • Painkillers should not be taken without a doctor’s advice.
  • If a painkiller has to be taken, it should be one tablet of paracetamol.
  • People who take alcohol should not consume paracetamol without asking their doctor.
  • In patients with kidney disease, even one tablet of painkiller can precipitate kidney failure.
  • In patients with acid peptic disease, one tablet of painkiller can precipitate gastric bleeding.
  • Instead of taking a painkiller, look for alternative methods to relieve pain.
  • Pain relieving ointments are better than oral painkillers.
  • In hospital setting, intravenous and intramuscular injectable painkillers are available.
  • Always tell your doctor that you are taking painkillers.
  • There are effective pain management therapies available in Homeopathy and Ayurveda.
  • Always contact your doctor if the pain is uneasy, unexplainable or appears for the first time in life.

Information: Dear Colleague, the Manesar workshop has been postponed till further information. Kindly take a note of it

News Around The Globe

  • The US Food and Drug Administration (FDA) has approved a recombinant human monoclonal antibody, ramucirumab, for stomach cancer after it was seen to extend the overall median survival of cancer patients by 1.4 months in a recent clinical trial. Ramucirumab is indicated for both advanced stomach cancer and malignancies located at the junction of the stomach and esophagus that cannot be surgically removed or have metastasized after chemotherapy.
  • A novel study has reported that a 25–hydroxyvitamin D level of about 26 ng/mL is required for normal glucose metabolism in both black and white obese, postmenopausal women. Women with a blood vitamin D concentration at or above this threshold tend to have lower body fat and blood glucose, insulin, and triglyceride levels than women with lower levels of vitamin D, reported the study published in the May 2014 issue of the Journal of Nutrition.
  • An article published online in Clinical Infectious Diseases has reported that the quadrivalent human papillomavirus (HPV) vaccine may be safe and immunogenic against 4 types of HPV, types 6, 11, 16, and 18, among HIV–infected women aged 13–45 years.
  • Ranibizumab potentially maintains or slows the decline in visual acuity in a large proportion of patients with neovascular age–related macular degeneration, as per 1–year follow-up data from a "real-world" clinical study presented recently at the World Ophthalmology Congress 2014.
  • A study presented at the American Society of Addiction Medicine (ASAM) 45th Annual Medical–Scientific Conference reported that sending opioid–dependent patients, attending a primary care clinic, home after giving a 1–week prescription of buprenorphine, written instructions, followed with telephone support, appeared to be a feasible and safe approach. Patients remained in treatment for a mean of 77 weeks for a 48% retention rate at 1 year.

Rabies News (Dr A K Gupta)

What is pre—exposure vaccination?

Pre—exposure (Prebite) vaccination means immunization before the bite.

Cardiology eMedinewS

  • Results of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial have revealed that adding spironolactone to existing therapy may not significantly reduce the composite time to either death from cardiovascular causes, surviving a cardiac arrest, or hospitalization to manage heart failure in patients with heart failure and a preserved ejection fraction. However, hospitalizations, particularly for heart failure, had a significantly lower incidence of 12% for those taking spironolactone compared to 14.2% in placebo group.
  • Positive attitude reduces the risk of heart failure in individuals aged >50 years, reports a recent study published in the journal Circulation: Heart Failure. The study authors noted that the individuals who had higher levels of optimism had a 73% lower risk of heart failure in comparison with those who were pessimistic.

Pediatrics eMedinewS

  • In a study published online April 17 in JAMA Otolaryngology–Head & Neck Surgery, researchers from Stanford University School of Medicine, California have reported that smaller and younger children have increased odds of gaining weight after undergoing adenotonsillectomy; however, there is no correlation with obesity. Children <4 years of age were affected the most.
  • Children with attention–deficit/hyperactivity disorder (ADHD) are 3 times more likely than children without the disorder to have language problems, eventually leading to poorer academic functioning, reports a recent community–based study published online April 21 in Pediatrics.

Dr K K Spiritual Blog

Medical Profession Follows Krishna and Not Rama

Teachings from both the epics of our country are taught to every child during school age. The first being Ramayana and the second being Mahabharata. Ramayana depicts Lord Ram as the savior of truth and a person who lives an in atmosphere of truthfulness till the end. Ramayana probably is a reflection of the collective consciousness of Satyuga where the majority of the people believed in truthfulness.

Then came an era of Tetya or Dwapara yuga where the definition of dharma (to hold people together) changed as per the collective consciousness of the people. The teaching of Lord Krishna in Mahabharata was that you have to live with truthfulness but speaking a lie can be your dharma in special situations. He said that a lie which can save somebody’s life without affecting any other person may be spoken and a truth, which if spoken can hurt somebody or is not going to harm anybody if not spoken may not be spoken.

Today we are living in Kalyuga and Krishna of today is every medical doctor treating a patient. For the interest of the patient and the society if doctors were to follow the principles of Rama, miseries would have increased. We as medical professionals are taught the example of Krishna and not Rama. We are taught that our utmost duty is the comfort of the patient. In doing so we are taught not to tell a dying person that he is going to die or not to tell a cancer patient that he is going to die in the next two to three months.

As a part of our social commitment a job of a medical professional is to save the life of a person. Everybody knows that prostitution is a crime but both Govt. of India and National AIDS Control Organization (NACO) have a program in which they distribute free condoms to the commercial sex workers. Similarly, all addicts during de–addiction are provided drugs as a part of the prescription though the quantity has been defined as to be lower than 5 grams. All addicts are treated and not put behind the bar.

The Law today state that an attempt to commit suicide is a crime (section 309 of the Indian Penal Code 1860) and consuming a drug is also a crime. But medically a doctor would look it differently. For him attempt to suicide is linked to an underlying depression and the patient needs a treatment and not jail. Addiction is a disease and every addict on similar grounds need de–addiction program and not jail.

The country’s Law is very harsh and needs to be changed. Probably when the law was made addiction was not considered a disease.

Punishment for a person attempting to commit suicide should be to get a compulsory treatment for depression in a time bound manner and for an addict to get a complete de–addiction done in a time bound manner.

The answer is not punishment but rehabilitation. But till the Law is changed, the only way medical professionals can help patients with attempted suicide is to write that it was accidental and patients who are addicts is by showing that either it was accidental ingestion or he or she ingested an unknown substance.

Most of the doctors are taught not to do urine or blood test in such cases because if the test comes out to be positive, the police will have no other alternative than to arrest the addict and put them behind the bar.

The Law says that possession of cocaine in anybody’s house can amount to imprisonment. Will the same law apply to the Chief Minister or Lt. Governor of a state if cocaine is found in their state or Prime Minister of President of the country if cocaine is found in their country?

But if we look from the angle of law makers under section 64A in the NDPS Act, there is a provision that the court can direct drug addicts to get rehab done in a Govt. de–addiction centre. But most of the doctors are unaware about this. Doctors can easily label a patient as drug addict and save them. But how many people would like to be labeled as an addict or prefer a Govt. centre when best of the private sector de–addiction centers are available.

The bailable arrest of doctors in Rahul Mahajan case is a clear indication for the medical professionals to stop thinking that they are next to GOD and they have any social responsibility. They should follow the rule book of the law and state observations as they are.

Wellness Blog

A mix of exercise protocol is better

A combination of weight training and aerobic exercise is the best prescription for overweight patients at risk for diabetes and heart disease.

Only aerobic exercise is also good as it reduces weight and inches off the waistlines. Jut weight lifting alone has very little benefit.

According to a study published in the journal American Journal of Cardiology, people in the weight–training group gained about 1.5 pounds and those in the aerobic group lost an average of 3 pounds and half an inch from their waists.

Those who did both weight and aerobic training dropped about 4 pounds and 1 waistline inch. This group also saw a decrease in diastolic lower blood pressure and in a metabolic syndrome score.

Both the aerobic–only group and the combined–exercise group also lowered their levels of bad triglycerides.

Inspirational Story

The Good you do, comes back to you

A woman baked chapati for members of her family and an extra one for a hungry passerby. She kept the extra chapati on the window sill, for whosoever would take it away. Every day, a hunchback came and took away the chapati. Instead of expressing gratitude, he muttered the following words as he went his way: "The evil you do remains with you: The good you do, comes back to you!" This went on, day after day. Every day, the hunchback came, picked up the chapatti and uttered the words: "The evil you do, remains with you: The good you do, comes back to you!" The woman felt irritated. "Not a word of gratitude," she said to herself…

"Everyday this hunchback utters this jingle! What does he mean?" One day, exasperated, she decided to do away with him. "I shall get rid of this hunchback," she said. And what did she do? She added poison to the chapati she prepared for him! As she was about to keep it on the window sill, her hands trembled. "What is this I am doing?" she said.

Immediately, she threw the chapati into the fire, prepared another one and kept it on the window sill. As usual, the hunchback came, picked up the chapati and muttered the words: "The evil you do, remains with you: The good you do, comes back to you!" The hunchback proceeded on his way, blissfully unaware of the war raging in the mind of the woman.

Every day, as the woman placed the chapati on the window sill, she offered a prayer for her son who had gone to a distant place to seek his fortune. For many months, she had no news of him. She prayed for his safe return. That evening, there was a knock on the door. As she opened it, she was surprised to find her son standing in the doorway. He had grown thin and lean. His garments were tattered and torn. He was hungry, starved and weak. As he saw his mother, he said, "Mom, it’s a miracle I’m here. While I was but a mile away, I was so famished that I collapsed. I would have died, but just then an old hunchback passed by. I begged of him for a morsel of food, and he was kind enough to give me a whole chapati. As he gave it to me, he said, "This is what I eat everyday: today, I shall give it to you, for your need is greater than mine!"

As the mother heard those words, her face turned pale. She leaned against the door for support. She remembered the poisoned chapati that she had made that morning. Had she not burnt it in the fire, it would have been eaten by her own son, and he would have lost his life! It was then that she realized the significance of the words: "The evil you do remains with you: The good you do, comes back to you!"

Do good and don’t ever stop doing good, even if it is not appreciated at that time.

ePress Release

ECG can be normal in acute heart attack

Chest pain which can be pinpointed by a finger or lasts less than 30 seconds is not a heart pain 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.

ECG might not be a diagnostic test for acute heart attack. It can be normal in the first six hours of heart attack. If a heart attack is suspected one should do serial ECGs or serial blood tests for the next 12 hours to rule out a heart attack.

The presentation of a heart attack can be atypical. A person may present with toothache, neck pain, acidity or abdominal pain. In diabetics, the heart attack may be silent with no chest pain.

If chewable aspirin is given to a victim of heart attack at the onset of chest pain, the chances of sudden death may reduce by 22%.

Most heart attack deaths occur in the early hours of the morning usually within 3 hours of getting up. Therefore early morning chest pain should not be ignored.

ECG may be unreliable in women and in patients with abnormal electrical activity of the heart. In these situations, 3–dimensional echocardiography is of help. It detects heart attack much before an ECG can diagnose it.

Any irregular heart rate, whether low or high coming for the first time in life after the age of 40 should raise the alarm of an underlying impending heart attack. A pulse rate of less than 60 or more than 100 is abnormal.

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

World Earth Day Celebration at DAV Public School, RK Puram, New Delhi.

press release

Vitamin D intake associated with reduced risk for Crohn’s disease

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 acute chest pain died before reaching the hospital.
Reaction: Oh my God! Why was water–soluble aspirin not given?
Lesson: Make sure that at the onset of acute heart attack and chest pain, water–soluble aspirin is chewed to reduce chances of sudden death.

eMedinewS Humor

Keep Your Seat

A radical feminist is getting on a bus when, just in front of her, a man gets up from his seat.

She thinks to herself, "Here’s another man trying to keep up the customs of a patriarchal society by offering a poor, defenseless woman his seat," and she pushes him back onto the seat.

A few minutes later, the man tries to get up again. She is insulted again and refuses to let him up.

Finally, the man says,

"Look, lady, you’ve got to let me get up. I’m two miles past my stop already."

Quote of the Day

The human is immortal; therefore he must die endlessly. For life is a creative idea; it can only find itself in changing forms. Rabindranath Tagore

 

Twitter of the Day

Dr KK Aggarwal: Inhaling diesel exhaust Fumes causes heart attack or stroke http://youtu.be/NMIK16PyBrY?a via @YouTube
Dr Deepak Chopra: Love is the highest intelligence 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

Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionisation of the drug in the stomach. Which of the following statements is not a correct example?

1. Absorption of digoxin is delayed by the presence of food.
2. Concurrent food intake may severely reduce the rate of absorption of phenytoin.
3. Presence of food enhances the absorption of hydrochlorothiazide.
4. Anitimalarial drug halofantrine is more extensively absorbed if taken with food.

Yesterday’s Mind Teaser: Commonest cause of sporadic encephalitis is:

1. Japanese B virus
2. Herpes simplex virus.
3. Human immunodeficiency virus.
4. Rubeola virus.

Answer for yesterday’s Mind Teaser: 2. Herpes simplex virus.

Correct answers received from: Dr K Raju, Dr Poonam Chablani, Dr Kalpana Verma, Prabha Sanghi, Anil Tandon, Dr A K Gajjar, Samta Sharma,
Dr Raghavendra Jayesh, Dr Pankaj Agarwal, Dr K V Sarma, Dr Jainendra Upadhyay, Daivadheenam Jella, Dr P C Das, Dr Chandresh Jardosh, Dr Avtar Krishan, Abhay Naik.

Answer for 18th April Mind Teaser: 3. No surgery for gallbladder stones.

Correct answers received from: Dr Bitaan Sen & Dr Jayashree Sen,
Dr Prakash Khalap.

Send your answer to ijcp12@gmail.com

medicolegal update

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  1. Your spiritual blog on Mantra is really informative sir.

    It persuades me to restart Mantrochhaar and Meditation on regular basis that I have discontinued to practice in past 10 years.

    Dr. Dilip
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