eMedinewS23rd September 2013, Monday

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.twitter.com/DrKKAggarwal
www.facebook.com/Dr KKAggarwal

MCI ordinance today or tomorrow

The new MCI ordinance being passed by the President of India today or tomorrow will not seek extension of the present board of governors. The present tenure will last till 10th November. But will have some more amendments to the present proposed amendments.


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Why only surgical consent

I believe all patients should sign a medical consent also. It can solve most of the medicolegal problems. I have designed one. Kindly send your inputs before I ask the association or the council to approve it.

Dr KK Aggarwal

MEDICAL CONSENT FORM

Date:
Name: Age: Sex:
Email: Mobile No: Address:
I, hereby give medical (general/specific) consent for my treatment under Dr _________________________ I have read and understood the enlisted information and the same also has been conveyed to me in my own language and I have cleared all my doubts.
  1. I understand that my treating doctors _________ are honorary consultants and not hospital employees.
  2. Being honorary consultants, they provide consultancy to their patients morning and evening at pre-defined times and they are on call for SOS consults.
  3. During their absence, the hospital provides cover through resident/floor doctors who are under the payroll of the hospital.
  4. In emergencies, the hospital provides resident/Intensivist cover. They are qualified doctors specialized only in this job. They may shift the patient if need arises to the intensive care unit. They are authorized to act independently as per the need of the situation.
  5. The night coverage is provided by the hospital residents/floor doctors. The treating consultants are available on phone in the night but for any emergency it is the hospital which provides the intensive care coverage to tackle any unforeseen event. The hospital will charge separately for these facilities.
  6. I understand that there may be situations when there is an emergency and the treating consultants may not be available for hours. In that case the hospital intensive care unit will provide necessary cover and take appropriate need based decisions.
  7. I understand that nursing care is provided by the hospital and is not under the direct charge of honorary treating consultants.
  8. If there is any problem with the nursing care, I/my relations need to contact the floor nursing manager for the same.
  9. I understand that Diet services are provided by the hospital through a hospital dietitian who can be approached through the nursing staff. Treating doctors directly do not control the dietary services.
  10. I have been told that doctors do not guarantee cure. They only provide treatment and do investigations to the best of their skills, acumen and knowledge.
  11. I understand that there may be a situation may arise where even after days of admission, the diagnosis may not be made by my treating consultants and in that situation I hereby authorize by primary treating doctor/s to call upon other specialist to give a second opinion. The fee for these specialists will be charged separately.
  12. I understand that my treating doctors have no objection to discuss my case with my primary referral doctor or a family physician.
  13. I hereby authorize my treating doctor/s to investigate me to the best of their skill and knowledge and which should be in my best interest.
  14. I understand that there is theoretical risk of sudden cardiac arrest in patients with uncontrolled blood pressure, uncontrolled diabetes, unstable heart blockages, morbid obesity, abnormal lipids, acute febrile illness (dengue, pneumonia,) etc. Sometimes while the patient is in the ward he or she may develop cardiac arrest due to lung clots ( pulmonary embolism) which may be life threatening. This usually happens when the person is lying on the bed for some time.
  15. I understand that it is my responsibility to tell the doctors on a daily basis if I do not pass motion/flatus after 24 hours of stay in the hospital or if I do not pass urine in less than 8 hours on any day.
  16. I understand that in spite of the best care by the hospital there may be an accident of fall from the bed. To prevent that except in the intensive care areas, I am supposed to provide and keep an attendant with me.
  17. I hereby give permission and authority to my treating doctors for certain invasive procedures like fluid aspiration, dressing, internal cavity fluid aspirations, etc. Each one of them may have some inherent complication rate including a rare mortality.
  18. I understand that even giving intravenous fluids is not without any risk. There are chances of developing inflammation, infection, drip reaction (fever and chills), oozing of blood, and swelling from the IV site.
  19. I hereby also give consent for any radiological investigation/s which may include ultrasound, CT scan, MRI, etc. I understand that any x–ray or CT imaging involves radiation risk.
  20. I hereby authorize my treating doctor/s to go ahead with necessary investigations irrespective of the cost in the in the best interest of my condition.
  21. I have been explained about the hospital charges including the policy of advance payment and will abide by the same.
  22. I understand that a situation may arise where I may need a blood transfusion. I authorize hereby my treating doctors to arrange necessary blood from voluntary donors for transfusion. The hospital may ask for replace of the donor.
  23. I understand that the blood bank is a hospital department and the blood is issued by them and transfused by the nurses under the supervision of the hospital resident/floor doctor/s. The treating consultant/s’ role is only to decide whether a transfusion is required or not. If any blood transfusion reaction occurs it is the responsibility of the hospital and not the treating doctors.
  24. I understand that it is my duty to disclose on oath all my previous illnesses at the time of admission. Any false information added to Mediclaim may amount to a fraud.
  25. I have declared my history of any drug allergy, history of pass illnesses and personal history including my habits and addition at the time of admission and same cannot be changed unless provided by proofs.
  26. I have checked the spelling of my name, age and address at the time of admission as it may be difficult to change these parameters at the time of discharge or after the discharge.
  27. There are certain medical procedures which are sometimes necessary in the medical treatment that may include putting in a ryles tube, urinary catheter, etc. I hereby give consent for the same.
  28. I understand that nothing comes free in a corporate hospital. I have to pay for all consumables which may include gloves, hand sanitizer, tissue paper, soaps, thermometer, etc. I have the right to carry back these disposables which have been issued/billed to me.
  29. Many of the consumables may not be covered by the Mediclaim policy/Public sector undertaking/Government units. For these I may be billed separately and may have to pay cash. It is my duty at the time of admission to clarify with the admission office as to which are the items which are not reimbursable.
  30. I understand that hospital does not accept cheques and I have to pay either in cash or by demand drafts.
  31. I understand that if I pay by credit card, the charges may be extra.
  32. I understand that being a corporate intuitions, there are no provisions for concessions. The treating doctor/s should not be embarrassed for the same as they may have no role.
  33. I understand that hospital charges more money for inpatients for certain investigations/procedures compared to outpatients.
  34. I understand that hospital does not allow bringing any food from outside or buy medicine or devices from outside.
  35. I understand that the hospital policy does not allow children to visit the hospital as relations.
  36. I understand that there are strict visiting hours which my relations might have to abide.
  37. I understand that hospital does not allow flowers to be brought within the hospital premises.
  38. I understand that hospital is a smoking-free zone.
  39. I understand that hospital will provide vegetarian healthy diet.
  40. I understand that hospital will not permit me to buy medicines or procure devices from outside hospital pharmacy.
  41. I understand there is a separate counter in the hospital to assist for Mediclaim or PSU formalities. It is my/my relations’ duty to get Mediclaim farm issued from the counter and get it signed by the treating consultant and get it faxed to the TPA. It will be my duty (not my treating consultants) to follow it up with the TPA through the TPA desk. The TPA form needs to be submitted within 24 hours of admission. If there is a delay, the primary doctors will not be responsible or the same.
  42. I understand that on the day of discharge it may take 6–8 hours by the Mediclaim counter or the TPA to process my queries and finally sanction the claim.
  43. I understand that if I leave the hospital in the night, I may end up in cancellation of my Mediclaim policy.
  44. For any ward leave, I need to contact the treating doctor/floor doctor/floor manager/floor nursing staff and need to provide the reasons for the same.
  45. I understand that the Mediclaim insurance will cover only 1% of my insured amount as the room rent (2/% for intensive care). If I upgrade any room, my charges will increase for other services also and insurance company may reimburse me for my room/other services as per original entitlement.
  46. I understand that the hospital charges may be different for different categories of patients. It is not like a hotel where the difference is only in the room rent. The charges of surgery, anesthesia, doctors fee, etc. may vary as per the bed category chosen.
  47. I understand that at the time of admission, the doctor/s may admit you with a provisional diagnosis (disorder A) and may end up in getting a diagnosis (disorder B) for which investigations and treatment facilities may not be available in the hospital and hospital may ask for a transfer to other hospital.
  48. I understand that the hospital may not have 100% facilities available in the world.
  49. In case of sudden cardiac arrest in the hospital premises, the hospital policy is to Alarm Blue Code in which hospital intensive care team reaches the spot and provides resuscitative measures. The resuscitation may be done in the room or the patient may be shifted to the ICU. During this emergency, the treating primary doctor/s may or may not be there. Certain life threatening emergency procedures may be done at that moment.
  50. I understand that there are certain unforeseen accidents which may occur in the hospital premises in spite of the precautions. These may include burn while taking steam, ECG electrode burn, electric monitor burn, fall from the bed, etc. etc.
  51. I understand that it is my responsibility to disclose about any drug allergy at the time of admission. I also understand that there may still be some drugs to whom I may be allergic and that may end up with drug reaction. Every unforeseen drug reaction carries a theoretical risk of mortality and morbidity.
  52. I am/am not suffering from HIV, Hepatitis B and C positive.
  53. I am/am not suffering from open Tuberculosis.
  54. I understand that I need to declare if I have been treated by a quake in the recent past.
  55. I understand I need to disclose if I am on Ayurvedic, Homeopathic, Unani or drugs from other traditional healers.
  56. I have disclosed my smoking status (smoker/non-smoker)
  57. I have disclosed my alcohol intake (yes/no)
  58. I do understand that smokers may carry high mortality and morbidity when treated and their response to treatment may be poor.
  59. It is my duty to disclose my past vaccination status and I have understood about my future vaccination suggestions.
  60. I understand that the hospital has a policy to examine any female patient in the presence of a female attendant or in the presence of the husband/father.
  61. While doing an ECG, X–ray or Echocardiogram, it may be possible that a male technician or the male doctor does the same in the presence of a female attendant. I hereby permit for the same.
  62. I understand that when I come for a checkup, there is an applied consent for physical and clinical examination which may involve examination of all parts of the body if clinically indicated
  63. I understand that there are 5% chances of acquiring new infection in the hospital premises by me or my relations/friends visiting me. Getting hospital acquired infection/s in spite of precautions may not mean a medical negligence on the part of the treating doctors.
  64. Even after taking all the care, it is still possible to develop bed sore during the hospital stay depending upon my nutritional status and immunity of the patent.
  65. I understand that ward boys and safai karamcharis may not be available in the ward all the time. These services are provided by the hospital and not by treating consultant/s. In case there is any delay in any such services, I may need to contact the floor manager to sort out the same.
  66. I understand that primary treating consultant/s will see me twice a day. They are allowed to see me once more if the situation arises for which my treating doctor/s will be entitled for one more consultation. My treating doctors therefore are allowed two routine and one extra emergency consultation in a day. On the day of admission and on the day of discharge two consultations may be charged. Even a telephonic emergency consultation at odd hours is counted as a valid emergency visit as it involves change in medical treatment.
  67. I understand that there is no Do Not Resuscitate Policy in India. It is my duty to follow the legal obligations regarding end of life issues.
  68. I understand that it is my right to get a refund of unused medicine and disposables at the time of discharge.
  69. I understand that difference of opinion and error of judgment is not negligence.
  70. I understand that deviation from normal practice is not negligence.
  71. I understand that medical accidents are known to occur and does not amount to negligence..
  72. I understand that to error is human. I understand that I have the right to choose my consultants.
  73. I understand that at the time of discharge I will be given a copy of detailed discharge summary for my future records.
  74. At the time of discharge I will be given radiological films, ECGs etc. However, in medico-legal cases, this may be the property of the hospital for legal purposes.
  75. In an unforeseen situation like death I give/do not give permission to the hospital to initiate the process of an autopsy.
  76. I understand that the honorary treating doctors bill their professional fee from the doctors through the hospital and the same reflects clearly in the bill. The fee includes hospital service charges for providing infra– structure for admitting the patients. All other charges are billed by the hospital and belong to them. There is no system in which primary treating consultant get any cut or commission for admitting their patients in the hospital. The billing is transparent and fee charged by the doctors is transparently reflected in the bill.
  77. For certain facilities not available in the hospital, hospital may get these investigations done form empanelled diagnostic centres. the billing for the same is done by the hospital. For these services hospital charges may include some extra service charges.
  78. For drugs and devices not available in the hospital, for procuring them from outside the hospital may include some extra service charges.
  79. It may be possible that the hospital may provide devices/implants at a higher costs than their purchase price as the Indian Government does not have an MRP on these items. The hospital may charge more to cover the cost of expiry, inventory, accidental fall, etc. The treating consultant does not get any money out of these.
  80. I have been made to understand that medi–claim does not mean 100% cashless facility. They may deny 10% of the cases and ask to pay the bill and then get it reimbursed later.
  81. I understand that Delhi medical Council does not allow doctors to provide a medical certificate for more than 15 days without a medical reason. The hospital may charge money for issuing a certificate and the certificate is not valid without counter sign of the medical administrator and the patient.
  82. I understand that at the time of death the hospital has provisions for cold mortuary on chargeable basis.
  83. I have been made to understand about the following;
    1. Provisional diagnosis
    2. Expected duration of stay
    3. Expected approximate hospital bill (the bill may increase if the hospital diagnose changes)
    4. Possible complications.
    5. Waiting time for my reports
  84. In an unforeseen situation like death the hospital may ask to clear the bill before the death certificate is released.
  85. At any stage, if I am dissatisfied with services of the hospital I need to inform the treating doctors/administration the same and not at the time of settling the bill.
  86. I understand the hospital bill does not cover the follow up visits for which I may be billed separately
  87. Hospital bills are computerized and may have computer errors. Its my duty to cross check the bill and get it sorted out with the billing department.
  88. Its my duty to sign the bill and the discharge tickets at the time of discharge.
  89. I may be asked to separately sign specific consents forms in addition for example for any surgical procedure
  90. I understand that with permission I am allowed to call my family doctor to discuss the case with the treating doctors.
  91. That If I need a private nurse I need to tale from the hospital route.
  92. That if I need an ambulance I need to tale from the hospital route.
  93. I understand the split ACs are more source if infections than window ACs
  94. I understand that cross infections may occur in intensive care units
  95. I understand that I may be billed for disposable sheets, disposable gowns, disposable working gloves etc.
  96. I understand that the hospital follows privacy policy and any information given by me is not disclosed to any other person without my permission.
  97. In an unforeseen situation if I end up unconscious, paralyzed or I am not in a position to give a consent or specific consent or statement I hereby authorize __________________________ to give consent and take all decisions on my behalf.
  98. I hereby authorize __________ to be briefed about me in routine/emergency situation.
  99. I have declared my past history: diabetes (___ years), hypertension (___ years), asthma (___ years), abnormal lipid (___ years), COPD (___ years), cancer (___ years), heart blockages (___ years), paralysis (___ years), depression (___ years), acidity (___ years), and

Signature of Patient:

Signature of Spouse:

Signature of Others:

Signature of Consultant(s):

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
eMedinewS
Ringtone – CPR 10 Mantra Hindi

Ringtone – CPR 10 Mantra English

sprritual blog Why do we Place our hands over the flame?

Flame is the "flame" of true knowledge. At the end of any aarti, we place our hands over the flame and then touch our eyes and the top of the head. It means – "May the light that illuminated the Lord light up my vision; May my vision be divine and my thoughts noble and beautiful."

The metaphysical implication of aarti extends further. The sun, moon, stars, lightning and fire are the natural sources of light. The Lord is the source of these wondrous phenomena of the universe. It is due to Him alone that everything exists.

As we light up the Lord with the flame of the aarti, we turn our attention to the very source of all light which symbolizes knowledge and life. Also, the Sun is the presiding deity of the intellect, the moon, that of the mind, and fire, that of speech. The Lord is the supreme consciousness that illuminates all of them. Without Him, the intellect cannot think, the mind cannot feel and the tongue cannot speak. The Lord is beyond the mind, intellect and speech.

How can these finite entities illuminate the Lord? Therefore, as we perform the aarti we chant:

Na tatra suryo bhaati na chandra taarakam, Nemaa vidyuto bhaanti kutoyamagnib

Tameva bhaantam anubhaati sarvam, Tasya bhasa sarvam idam vibhaati

"He is there where the sun does not shine, nor the moon, stars and lightning. Then what to talk of this small flame (in my hand), Everything (in the universe) shines only after the Lord, and by His light alone are we all illumined"

In our spiritual journey, even as we serve the guru and society, we should willingly sacrifice ourselves and all we have, to spread the "perfume" of love to all.

We often wait a long while to see the illuminated Lord but when the aarti is actually performed, our eyes close automatically as if to look within.This is to signify that each of us is a temple of the Lord.

cardiology news

The Greatest Gift is LOVE

A woman came out of her house and saw 3 old men with long white beards sitting in her front yard. She did not recognize them.

She said, "I don’t think I know you, but you must be hungry. Please come in and have something to eat." "Is the man of the house home?", they asked. "No", she said. "He’s out." "Then we cannot come in", they replied. In the evening when her husband came home, she told him what had happened. "Go tell them I am home and invite them in!" The woman went out and invited the men in. "We do not go into a House together," they replied.

"Why is that?" she wanted to know. One of the old men explained: "His name is Wealth," he said pointing to one of his friends, and said pointing to another one, "He is Success, and I am Love." Then he added, "Now go in and discuss with your husband which one of us you want in your home."

The woman went in and told her husband what was said. Her husband was overjoyed. "How nice!!", he said. "Since that is the case, let us invite Wealth. Let him come and fill our home with wealth!” His wife disagreed. "My dear, why don’t we invite Success?"

Their daughter–in–law was listening from the other corner of the house. She jumped in with her own suggestion: "Would it not be better to invite Love? Our home will then be filled with love!" "Let us heed our daughter-in-law’s advice," said the husband to his wife. "Go out and invite Love to be our guest."

The woman went out and asked the 3 old men, "Which one of you is Love? Please come in and be our guest." Love got up and started walking toward the house. The other 2 also got up and followed him. Surprised, the lady asked Wealth and Success: "I only invited Love, Why are you coming in?"

The old men replied together: "If you had invited Wealth or Success, the other two of us would’ve stayed out, but since you invited Love, wherever He goes, we go with him. Wherever there is Love, there is also Wealth and Success!"

News Around The Globe

5th Dil Ka Darbar

Date: Sunday, 29th September 2013, Venue: Constitution club of India, Rafi Marg, Time: 8 AM to 6 PM

Programme: A non stop question answer–session between all top cardiologists of the NCR region and the public.

The focus of the discussions will be prevention of heart diseases in women and young men. Special discussion will be held on Sex and Heart Diseases. Practical training will also be given to people on Hands–only Cardiopulmonary Resuscitation. Another focus of the discussion will be the launch of the Project Dhadkan (Palpitations) and Project Murmur (Congenital and valvular heart diseases in children).

Entry free…

  • A shrapnel–like injury caused by lightning provided a reminder for emergency physicians not to overlook the unexpected when examining patients. A lightning strike to an alternating current transformer caused penetrating injuries to twin 8–year–old boys who were camping in a tent near their home. Emergency personnel dispatched to the scene found that both boys had normal vital signs, including a normal pediatric score on the Glasgow Coma Scale. After the patients arrived at the hospital, physicians discovered two copper wires protruding from the scapular area of one boy, who also had a second–degree facial burn, Oscar J. F. van Waes, MD, of Erasmus University Medical Center in Rotterdam, The Netherlands, and coauthors said in a case report published online in Annals of Emergency Medicine.
  • Post–traumatic stress disorder (PTSD) is associated with lowered levels of a neurotransmitter in a brain region that plays a role in panic and stress. In a cohort study by Alexander Neumeister of NYU School of Medicine in New York City, and colleagues, positron emission tomography also linked the availability of the molecule, norepinephrine transporter or NET, to one of the five facets of the syndrome. NET is part of the family of sodium chloride neurotransmitter transporters, the researchers noted, and weakens neuronal signaling by promoting rapid clearance of norepinephrine, which plays a central role in the fight–or–flight response
  • The American Psychiatric Association (APA) has released a list of specific uses of common antipsychotic medications that are potentially unnecessary and sometimes harmful as part of an initiative from the American Board of Internal Medicine (ABIM) Foundation called Choosing Wisely The APA’s list includes 5 recommendations:
    • Don’t prescribe antipsychotic medications to patients for any indication without appropriate initial evaluation and appropriate ongoing monitoring
    • Don’t routinely prescribe 2 or more antipsychotic medications concurrently
    • Don’t use antipsychotics as first choice to treat behavioral and psychological symptoms of dementia
    • Don’t routinely prescribe antipsychotic medications as a first–line intervention for insomnia in adults
    • Don’t routinely prescribe antipsychotic medications as a first–line intervention for children and adolescents for any diagnosis other than psychotic disorders
  • The European Medicines Agency (EMA) has endorsed canagliflozin (Invokana, Janssen Pharmaceuticals), a sodium–glucose cotransporter 2 (SGLT2) inhibitor for the treatment of type 2 diabetes. The indication recommended by the CHMP for canagliflozin is for use as monotherapy in adults with type 2 diabetes when diet and exercise do not provide adequate glycemic control and patients can’t tolerate metformin or the latter is contraindicated. Canagliflozin is also recommended for add–on therapy with other glucose-lowering mediations, including insulin, when these, together with diet/exercise, do not provide adequate glycemic control.
  • The US Food and Drug Administration (FDA) has granted ofatumumab (Arzerra) breakthrough therapy designation for the treatment of chronic lymphocytic leukemia (CLL). The indication is for use in combination with chlorambucil for treatment–naďve patients who are not candidates for fludarabine–based therapy. Currently, ofatumumab, which is being codeveloped by Genmab and GlaxoSmithKline, is not approved or licensed anywhere in the world other than the United States.

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Rabies News (Dr. A K Gupta)

What is the role of monoclonal antibodies in Rabies?

Monoclonal antibodies against rabies virus have been widely used in the diagnosis and immunological analysis of rabies. Human monoclonal antibodies to rabies virus G protein are also expected to be used as a replacement for rabies immunoglobulin (RIG) in the post–exposure treatment of rabies. In 1978, Wiktor reported the preparation of rabies virus monoclonal antibodies. Since then, rabies virus monoclonal antibody (mAb) technology has been more and more widely used in basic research and diagnosis of rabies.

cardiology news

A prediction model based on Framingham Heart Study criteria was found to be better than prehypertension in identifying young adults who developed new hypertension over the next 25 years, in an analysis published in the journal Hypertension. The Framingham model relied on a composite of age, sex, body–mass index, smoking, systolic blood pressure (BP), and parental history of hypertension in predicting incident hypertension. It underestimated hypertension risk in the analysis until the model was recalibrated using data from the population studied, 4388 participants in the prospective Coronary Artery Risk Development in Young Adults (CARDIA) study.

Valvular Heart Disease News

By echocardiography, although a bicuspid aortic valve with a raphe may appear similar to a tricuspid valve during diastole, the systolic opening shape of a bicuspid valve is elliptical rather than the triangular pattern of a tricuspid valve.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

cardiology news
  • As per a case report published online September 13 in the International Journal of Surgery Case Reports, Mohammed Al Mohaidly, MD, from the Department of Pediatric Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia, and colleagues performed laparoscopic sleeve gastrectomy on the boy who had a body mass index (BMI) of 41.1 kg/m2 and who did not have a genetic explanation for the morbid obesity. Bariatric surgery led to dramatic weight loss in a 2.5–year–old boy
  • A new test for detecting sleep-disordered breathing in children could put an end to cumbersome and expensive overnight sleep studies as per findings presented at the European Respiratory Society 2013 Annual Congress. Marcin Kawalski, from the sleep-disordered breathing laboratory at Moscicki Hospital in Chorzów, Poland and coresearchers evaluated pulse transit time (time it takes the pulse pressure waveform to propagate through a length of the arterial tree) as a surrogate measure of night events in children. This method was compared with nocturnal oximetry, heart rate variability, and evaluation of the cortical arousals. Aberrant times are proposed as a surrogate marker of breathing dysfunction.
cardiology news

Diagnosis of hypertension in childhood requires repeated BP measurements

One needs to confirm presence of hypertension based on three blood pressure measurements at separate clinical visits.

Normative BP percentiles are based upon data on gender, age, height, and blood pressure measurements from the National Health and Nutrition Examination Survey and other population–based studies.

In a study initial BP measurement was normal (below the 90th percentile), pre–hypertensive (systolic or diastolic BP between the 90th or 95th percentile) and hypertensive (systolic or diastolic BP ≥95th percentile) in 82, 13, and 5 percent of children.

At follow–up, subsequent hypertensive measurements were observed in only 4 percent of the 10,848 children who had initial hypertensive values. In the cohort, the overall prevalence of hypertension was 0.3 percent.

Source: Lo JC, Sinaiko A, Chandra M, et al. Prehypertension and hypertension in community–based pediatric practice. Pediatrics 2013; 131:e415.

cardiology news

Total CPR since 1st November 2012 – 63400 trained

CPR Classes 63400

Media advocacy through Print Media

sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping
sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping

29th August: Veer Arjun

Media advocacy through Web Media

When Constipation May be a Serious Problem 30th August

NETLOG, FREEPRESS RELEASE, PRLOG, FREEPRESSINDEX , AFRICANNEWSWIRE

TB more dangerous than FLU 29th August

NETLOG, FREEPRESS RELEASE, PRLOG, AFRICANNEWSWIRE

Kidney stone of less than 5mm size needs no treatment

A stone in the kidney passage of less than 5mm should not be treated as it will invariably pass in the next four weeks, as per the new kidney stone international guidelines, said Dr. K K Aggarwal, President, Heart Care Foundation of India, and Editor eMedinewS.

A stone between 5 to 10 mm has only 20% chances of passing spontaneously. A stone of more than 10mm invariably require a non–medical intervention.

Dr. Aggarwal said that new avenues in stone management include a trial by drugs, which help in expulsion of the stone by relaxing the smooth muscle. The drugs used are Nifedipine (calcium channel blocker), alpha-blockers and steroids.

Uptil now it was thought that the best investigation for renal stone is intravenous pyelography. But now it has been prove beyond doubt that when a patient presents with kidney pain and a renal stone is suspected the undisputed investigation of choice is unenhanced CT scan of the abdomen. As per the guidelines, open removal of stones is no more recommended. Lithotripsy, PCNL and ureteroscopy have practically taken over from the open surgical procedures.

North India is considered a stone belt, with maximum cases of kidney stones in India.

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 63400 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

A press conference was organized by Heart Care Foundation of India to announce the date of Dil Ka Darbar to earmark the World Heart Day on Sunday, 29th September, 2013 at the Constitution Club of India Auditorium.

press release

Liver Transplant

today video of the dayDr KK Aggarwal Birthday 5th September

Cultural Evening at IMA

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

Which medication is the best choice to treat breakthrough pain for a patient who is currently receiving methadone (Dolophine), 10 mg, every 8 hours?

1. Methadone (Dolophine)
2. Immediate release morphine (MS IR)
3. Sustained release morphine (MS Contin)
4. Transdermal fentanyl (Duragesic)

Yesterday’s Mind Teaser: Which nonpharmacologic intervention is difficult to use with older adults who are cognitively impaired?

1. Aromatherapy
2. Distraction
3. Guided imagery
4. Heat application

Answer for yesterday’s Mind Teaser: Guided imagery

Correct answers received from: Dr.K.V.Sarma, Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Dr.Chandresh Jardosh, jayashree sen, Arpan Gandhi, Muthumperumal Thirumalpi, Kanta Jain, Arvind Gajjar, Pradip Das

Answer for 21st September Mind Teaser: "I will take my medication at breakfast."

Correct answers received from:santhi thiyagarajan, Narahari Kandakatla, gajveer singh

Send your answer to ijcp12@gmail.com




medicolegal update

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medicolegal update

Gynecologist: A man who works and operates in another man’s field

medicolegal update
medicolegal update

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medicolegal update

Situation: Doctor, this patient has developed acute renal failure (ARF).
Reaction: Oh my God, I forgot that he was on furosemide. I gave him full dose of amikacin.
Lesson: Make sure, before calculating the dose of aminoglycoside (amikacin) that furosemide and other loop diuretics, which enhance its nephrotoxicity are not being given.

medicolegal update

A crust eaten in peace is better than a banquet partaken in anxiety. Aesop

medicolegal update

Dr KK Aggarwal: Dr K K Aggarwal: Relaxation during work http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: Are we alone in the universe? Take a quick trip through the cosmos as I explore this eternal question. #CosmicConsciousness

medicolegal update

Dear Sir, Thanks for the nice Updates. Regards: Dr Sahil

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medicolegal update


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