eMedinewS23rd September 2014, Tuesday

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

press release
press release

Statins may worsen asthma

Fluctuating blood pressure more harmful

In the elderly persons with high blood pressure, further fluctuations and spikes in blood pressure readings can affect their ability to think clearly and other cognitive function.

As per a North Carolina State University study, in people whose systolic blood pressure is 130 mm Hg or higher, the cognitive functions get impaired on days when their blood pressure spikes and fluctuates. On the other hand, in people with normal blood pressure, the cognitive functions do not get impaired if their blood pressure spikes or fluctuates.

Several studies in the past have found a link between high blood pressure and dementia, which is marked by a loss of memory and other cognitive abilities, including the ability to speak, identify objects or think abstractly. In another study it was found that treating high blood pressure in the very elderly may help reduce their risk of developing dementia.

The carry home message is that if you have blood pressure that wildly fluctuates and you also have underlying high blood pressure, you might be in double trouble for poorer cognitive functioning.

News Around The Globe

  • Patients who already have hypertension and then develop diabetes are no more likely to die than those who don’t have diabetes, as per a new study by Stephanie Lip, a resident at the Institute of Cardiovascular and Medical Sciences at the University of Glasgow Scotland shows.
  • It has taken more than 11 years since Sir Nicholas Wald and Dr Malcolm Law (University of London, UK) first introduced the concept of a polypill, a fixed–dose combination tablet that would likely feature aspirin, a statin, and one or two antihypertensive agents, but the "paradigm–shifting" treatment strategy gained a small foothold on the climb toward approval when a Food and Drug Administration (FDA) advisory committee cautiously supported its availability and use among select patients.
  • A new study demonstrated that transoral incisionless fundoplication provides significant symptom resolution, similar to that achieved after laparoscopic Nissen or Toupet fundoplication. The study is published in the American Surgeon.
  • MRI to detect bone marrow edema of the wrist and finger joints may help doctors in successfully diagnosing early rheumatoid arthritis when added to the 2010 RA classification criteria, suggest researchers from Japan in a study published online in Annals of the Rheumatic Diseases.
  • A phase 1 clinical trial has shown that 2 experimental vaccines, 1 against Ebola and 1 against the related Marburg virus, are well–tolerated and confer immunity after a course of 3 shots and a later booster. The results were published online in the Journal of Infectious Diseases.
  • Among older adults with chronic obstructive pulmonary disease (COPD), especially those with asthma, newly prescribed long–acting beta–agonists (LABAs) and inhaled corticosteroid combination therapy, compared with newly prescribed LABAs alone was associated with a lower risk of death or COPD hospitalization, suggested a study published in JAMA.

National news

Autonomous Bodies in Health

  • Department of Health and Family Welfare
  • All India Institute of Medical Sciences, New Delhi
  • Jawahar Lal Institute of Post Graduate Medical Education & Research, Puducherry
  • Post Graduate Institute of Medical Education & Research, Chandigarh
  • All India Institute of Speech and Hearing, Mysore
  • National Institute of Mental Health & Neuro Sciences, Bangalore
  • Pasteur Institute of India, Coonoor
  • Lala Ram Swarup Institute of TB and Allied Sciences, New Delhi
  • Chittaranjan National Cancer Research Institute, Kolkata
  • North Eastern Indira Gandhi Institute of Health & Medical Sciences, Shillong
  • Indian Nursing Council, New Delhi
  • Pharmacy Council of India, New Delhi
  • Dental Council of India, New Delhi
  • Medical Council of India, New Delhi
  • National Academy of Medical Sciences, New Delhi
  • National Board of Examination, New Delhi
  • National Institute of Health & Family Welfare, New Delhi
  • International Institute of Population Sciences, Mumbai
  • New Delhi T.B. Center
  • Kasturba Health Society
  • Regional Institute of Medical Sciences, Imphal
  • LGB Regional Institute of Mental Health, Tezpur
  • Regional Institute of Paramedical & Nursing Sciences, Aizwal
  • National Institute of Biologicals, Noida
  • FSSAI
  • Indian Pharmacopoeia Commission (IPC), Ghaziabad
  • St. Johns Ambulance
  • Indian Red Cross Society
  • IHBAS, Shahdara

Department of Ayush

  • Central Council of Homoeopathy, New Delhi
  • Central Council for Research in Homeopathy, New Delhi
  • Central Council for Research in Ayurveda and Siddha, New Delhi
  • Central Council for Research in Unani Medicine, New Delhi
  • Central Council for Research in Yoga and Naturopathy, New Delhi
  • Central Council of Indian Medicine, New Delhi
  • Morarji Desai National Institute of Yoga, New Delhi
  • National Institute of Ayurveda, Jaipur
  • National Institute of Homoeopathy, Kolkata
  • National Institute of Naturopathy, Pune
  • National Institute of Siddha, Chennai
  • National Institute of Unani Medicine, Bengaluru
  • Rashtriya Ayurveda Vidyapeeth, New Delhi
  • Institute of Post Graduate Teaching and Research in Ayurveda, Jamnagar
  • Homoeopathy, Shillong
  • North Eastern Institute of Folk Medicine, Pasighat
  • All India Institute of Ayurveda, New Delhi

Department of Health Research

  • Indian Council of Medical Research, New Delhi

IMA News

  1. A shocked community of Indian doctors here and elsewhere has sought Union Health Minister Harsh Vardhan’s intervention to stop the appointment of the "disgraced" former Medical Council of India (MCI) chief Ketan Desai as president of the World Medical Association for 2016. News of his appointment was published in the latest issue of the WMA journal, says Kunal Saha, President, People for Better Treatment, Ohio.
    "It is unacceptable that a doctor who is awaiting trial for serious criminal charges of bribery and (other cases of) corruption and whose medical registration still remains suspended by the MCI would head the world medical body," he noted in a letter. He sent a memorandum to the Minister urging him to step in immediately to prevent Dr. Desai from becoming WMA president.

    Dr. Saha said Ajay Kumar, now a member of the MCI ethics committee and chairman of the grievance committee, went before the WMA Assembly last year with a letter from the Indian Medical Association claiming that the Indian authority (CBI) had dropped all charges against Dr. Desai, who should be reinstated as WMA president (as he was chosen as president–elect in 2009 prior to his arrest by the CBI in 2010).
    "What Dr. Kumar and other leaders of the IMA claimed before the WMA was utterly false as has been confirmed by the CBI," Dr. Saha said. IMA office–bearer Narendra Saini said: "It is up to the WMA to decide." IMA secretary–general (elect) K.K. Agarwal said: "Dr. Desai is a member of the IMA and is registered with the MCI, there is no reason why he cannot be the president of WMA." (A story by Bindu Shajan Perappadan in The Hindu)
     
  2. Anti–corruption activists have approached the health ministry to stop the elevation of scam–tainted former Medical Council of India (MCI) president Ketan Desai as head of the World Medical Association (WMA).

    Simultaneously, a petition has been filed in the Supreme Court with the objective of preventing Desai from wielding influence at the MCI, currently being run by doctors believed to be close to Desai.

    Desai will become the president–elect of WMA in October, 2015 and president in 2016. His name was recommended to the WMA by the Indian Medical Association – India’s largest body of doctors – which Desai used to head between 2001 and 2003.

    Activists argued the IMA misled the global body by claiming Desai was given a clean chit by the Central Bureau of Investigation (CBI) that arrested him in 2010 allegedly for accepting a bribe from a private medical college.

    Four years down the line, there are only two cases pending against Desai – the original case, which has now been stayed by the Supreme Court and a trial in the Lucknow bench of Allahabad High Court in connection to the MCI inspection of a private medical college during Desai’s tenure as MCI president. In the second case, charge sheet has not yet been filed.

    "In the original case, the CBI filed a closure report on the corresponding case on disproportionate assets in 2012, which was accepted by the CBI Court. Without a DA case, where is the proof of corruption? His registration which was suspended following his arrest was revoked by the MCI Board of Governors in December, 2013," K K Agarwal, the incumbent secretary general (elect) of IMA told Deccan Herald.

    The MCI did not revoke the suspension for Desai alone. It did for four other doctors including former health minister Anbumani Ramadoss and former director general of Indian Council of Medical Research N K Ganguly, who too are facing court cases.

    The revocation was done following a specific section in the MCI Act, which says a doctor’s registration cannot be cancelled unless the person is convicted. "As on date, Ketan Desai is a valid member of both IMA and MCI. His registration has also not been cancelled by the Gujarat Medical Council," said Agarwal.

    "A baleful attempt has been made by senior IMA leaders, some of whom are also occupying top positions in the newly formed MCI, to restore the public image of disgraced ex–MCI president Ketan Desai, and to obstruct the course of justice by making him president–elect of WMA through blatant lies and misleading information," said Kunal Saha, a US–based doctor who heads a NGO named People for Better Treatment (PBT).

    PBT also approached the Supreme Court claiming that the election process through which some of the doctors close to Desai became MCI office bearers, was rigged from the very beginning. (Kalyan Ray, New Delhi, Sep 21, 2014, DHNS)

eMedinewS Comments: Monoclonal The factual statement in Deccan Herald story is: His registration which was suspended following his arrest was revoked by the MCI in December, 2013 based on earlier four decisions by the then Board of Governors. Dr K K Aggarwal, Editor.

Rabies News (Dr. A K Gupta)

What are monoclonal antibodies?

Monoclonal antibodies (mAb) are important reagents used in biomedical research, in diagnosis of diseases, and in treatment of such diseases as infections and cancer. These antibodies are produced by cell lines or clones obtained from animals that have been immunized with the substance that is the subject of study. The cell lines are produced by fusing B cells from the immunized animal with myeloma cells.

Cardiology eMedinewS

  • An FDA advisory panel has recommended by a six–to–four vote that a dual–agent medication combining a beta–blocker and an angiotensin–receptor blocker (ARB) not be approved for the treatment of hypertension.
  • Six months of dual antiplatelet therapy (DAPT) is "noninferior" to the 12 months or more recommended in US guidelines for the treatment of low–risk patients with stable or unstable angina and documented ischemia undergoing PCI, at least when newer–generation drug–eluting stents are used, results of the SECURITY trial suggest.

Pediatrics eMedinewS

  • Researchers have noted in a new study that babies sleeping on animal fur for their first 3 months of life could have a reduced risk of developing asthma later in childhood. The findings were presented at the European Respiratory Society (ERS) International Congress.
  • Birth–weight and birth–length can partially predict the odds of being diagnosed with mental health disorders such as autism and schizophrenia later in life, suggests a new study published in the Proceedings of the Royal Society, London B.

Dr K K Spiritual Blog

Five Types of People

Following are the five types of people:

  1. Nastik – the one who does not believe in God.
  2. Astik – for whom God exists.
  3. For them the God also exists in them (I and the God are the same)
  4. Tat Tvam Asi (God not only exists in me but also in you)
  5. God is in everybody

People who believe that God exists are fearful people and they always fear God. People who see God in themselves, live a disciplined Satvik life and do not indulge in activities which are not God–friendly.

People who believe that God is not only in me but also in you, treat every person the same way as they treat themselves.

People for whom God is everywhere always work for the welfare of the society.

Self-Assessment-Quiz Self-Assessment-Quiz

 

expert_choice

 

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 – 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."

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

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VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

emedipicstoday emedipics

Health Check Up and CPR 10 Camp at St. Mathews Public School, 9th April 2014

press release

Statins may worsen asthma

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 diabetic patient died of flu pneumonia.
Reaction: Oh my God! Why was flu vaccine not given?
Lesson: Make sure that all diabetics are given flu vaccine every year.

eMedinewS Humor

ATTORNEY: Doctor, before you performed the autopsy, did you check for a pulse?
WITNESS: No.

ATTORNEY: Did you check for blood pressure?
WITNESS: No.

ATTORNEY: Did you check for breathing?
WITNESS: No.

ATTORNEY: So, then it is possible that the patient was alive when you began the autopsy?
WITNESS: No.

ATTORNEY: How can you be so sure, Doctor?
WITNESS: Because his brain was sitting on my desk in a jar.

ATTORNEY: But could the patient have still been alive, nevertheless?
WITNESS: Yes, it is possible that he could have been alive and practicing law.

Quote of the Day

"Time is more valuable than money. You can get more money, but you cannot get more time." Jim Rohn

Twitter of the Day

Dr KK Aggarwal: Anger recall is as bad as Anger itself http://Blogz.org/A/885894
Dr Deepak Chopra: The real you is nameless, formless, inconceivable & gives birth to all names, forms & concepts http://tinyurl.com/mwjtqc

Wellness Blog

Four of the best exercises you can ever do

  • Swimming. It is a perfect exercise. Swimming is good for individuals with arthritis because it’s less weight–bearing.
  • Strength training. Lifting light weights won’t bulk up your muscles, but it will keep them strong. If you don’t use muscles, they will lose their strength over time.
  • Walking. Walking is simple yet powerful. It can help you stay trim, improve cholesterol levels, strengthen bones, keep blood pressure in check, lift your mood, and lower your risk for a number of diseases (diabetes and heart disease, for example).
  • Kegel exercises. These exercises won’t help you look better, but they do something just as important — strengthen the pelvic floor muscles that support the bladder. Strong pelvic floor muscles can go a long way toward preventing incontinence. While many women are familiar with Kegels, these exercises can benefit men too.

To do a Kegel exercise correctly, squeeze and release the muscles you would use to stop urination or prevent you from passing gas. Alternate quick squeezes and releases with longer contractions that you hold for 10 seconds, and then release for 10 seconds. Work up to three sets of 10–15 Kegel exercises each day.

Inspirational Story

Come as You Are

I shook my head in disbelief. This couldn’t be the right place. After all, I couldn’t possibly be welcome here. I had been given an invitation several times, by several different people, and had finally decided to see what this place was all about. But, this just couldn’t be the right place. Quickly, I glanced down at the invitation that clutched in my hand. I scanned past the words, "Come as you are. No jacket required," and found the location.

Yes, I was at the right place. I peered through the window again and saw a room of people whose faces seemed to glow with joy. All were neatly dressed, adorned in fine garments and appeared strangely clean as they dined at this exquisite restaurant. Ashamed, I looked down at my own tattered and torn clothing, covered in stains. I was dirty, in fact, filthy.

A foul smell seemed to consume me and I couldn’t shake the grime that clung to my body. As I turned around to leave, the words from the invitation seemed to leap out at me, "Come as you are. No jacket required."

I decided to give it a shot. Mustering up every bit of courage I could find, I opened the door to this restaurant and walked up to a man standing behind a podium. "Your name, sir?" he asked me with a smile. "Daniel F. Renken," I mumbled without looking up. I thrust my hands deep into my pockets, hoping to conceal their stains.

He didn’t seem to notice the filth that I was covered in and he continued, "Very good, sir. A table is reserved in your name. Would you like to be seated?" I couldn’t believe what I heard! A grin broke out on my face and I said, "Yes, of course!" He led me to a table and, sure enough, there was a placard with my name written on it in a deep, dark red.

As I browsed over a menu, I saw many delightful items listed. There were things like, "peace," "joy," "blessings," "confidence," "assurance," "hope," "love," "faith," and "mercy." I realized that this was no ordinary restaurant! I flipped the menu back to the front in order to see where I was at. "God’s Grace," was the name of this place!

The man returned and said, "I recommend the ‘Special of the Day’." With it, you are entitled to heaping portions of everything on this menu." You’ve got to be kidding! I thought to myself. You mean, I can have ALL of this!

"What is the ‘Special of the Day,’ I asked with excitement ringing in my voice." Salvation," was his reply.

"I’ll take it," I practically cried out. Then, as quickly as I made that statement, the joy left my body. A sick, painful ache jerked through my stomach and tears filled my eyes. Between my sobs I said, "Mister, look at me. I’m dirty and nasty. I’m unclean and unworthy of such things. I'd love to have all of this, but, I Just can’t afford it."

Undaunted, the man smiled again. "Sir, your check has already been taken care of by that Gentleman over there," he said pointing to the front of the room. "His Name is Jesus."

Turning, I saw a man whose very presence seemed to light the room. He was almost too much to look at. I found myself walking towards Him and in shaking voice I whispered, "Sir, I’ll wash the dishes or sweep the floors or take out the trash. I’ll do anything I can do to repay you for all of this."

He opened His arms and said with a smile, "Son, all of this is yours if you just come unto Me. Ask Me to clean you up and I will. Ask me to take away the stains and it is done. Ask me to allow you to feast at my table and you will eat. Remember, the table is reserved in your name. All you must do is accepting this gift that I offer you."

Astonished, I fell at His feet and said, "Please, Jesus. Please clean up my life. Please change me and seat me at your table and give me this new life." Immediately, I heard the words, "It is finished." I looked down and white robes adorned my squeaky clean body. Something strange and wonderful had happened. I felt new, like a weight had been lifted, and I found myself seated at His table.

"The ‘Special of the Day’ has been served," the Lord said to me. "Salvation is yours." We sat and talked for a great while and I so enjoyed the time that I spent with Him. He told me, me of all people, that He would like me to come back as often as I liked for another helping from God’s Grace. He made it clear that He wanted me to spend as much time with Him as possible.

As it drew near time for me to go back outside into the "real world," He whispered to me softly, "And Daniel, I am with you always." And then, He said something to me that I will never forget. He said, "My child, Do you see these empty tables throughout this room?" "Yes, Lord. I see them. What do they mean?" I replied.

"These are reserved tables, but the individuals whose names are on each placards have not accepted their invitations to dine. Would you be so kind as to hand out these invitations to those who have not joined us yet?" Jesus asked. "Of course," I said with excitement as I picked up the invitations. "Go ye therefore into all nations," He said as I turned to leave.

I walked into God's Grace dirty and hungry. Stained in sin. My righteousness as filthy rags. And Jesus cleaned me up. I walked out a brand new man… robed in white, His righteousness. And so, I’ll keep my promise to my Lord. I'll go. I'll spread the Word. I’ll share the Gospel… I’ll hand out the invitations. And I'll start with you. Have you been to God’s Grace? There’s a table reserved in your name, and here’s your invitation… "Come as you are. No jacket required."

ePress Release

When constipation may be a serious problem

While most instances of constipation may not be serious, some cases of infrequent or difficult bowel movements need evaluation by a doctor 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.

Heart Care Foundation of India offers this list of warning signs:

  • You’re constipated for the first time
  • Constipation occurs for you very infrequently.
  • You’ve been treating constipation at home with more fiber, fluids and exercise for at least three weeks, with no improvement.
  • You have abdominal pain.
  • You have bloody stools.
  • You have unexplained weight loss.

eMedi Quiz

Medullary carcinoma of the thyroid is associated with which of the following syndrome:

1. MEN I.
2. MEN II.
3. Fraumeni syndrome.
4. Hashimoto’s thyroiditis

Yesterday’s Mind Teaser: 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.

Answer for yesterday’s Mind Teaser: 1. Phenytoin.

Correct answers received from: Dr Manoj Vithalani, Dr Pankaj Agarwal, Dr Sushma Chawla, Tukaram Pagad, Dr Jainendra Upadhyay, Dr KV Sarma, Dr Raghavendra Jayesh.

Answer for 20th September Mind Teaser: 2. Griseofulvin.

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

Send your answer to ijcp12@gmail.com

medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Editor eMedinewS and President Heart Care Foundation of India)

Choosing the best option in the judgment of the doctor is not medical negligence?

In the case of Charan Singh vs Healing Touch Hospital And Ors on 24 April, 2003 (III(2003) CPJ 62 (NC)), the National Consumer Disputes Redressal Commission observed "it is a settled law when two choices are available, exercise of one, which is the best in the judgment of the doctor and anything else is available to contradict this, doctor in such circumstances cannot be held negligent.

medicolegal update

Situation: An elderly patient after IV ondansetron 16 mg developed irregular heart rhythm.

Dr Bad: It cannot be due to the drug.

Dr Good: It is due to the drug.

Lesson: ECG interval changes, including prolongation of the QTc interval, are a class effect of the first–generation serotonin antagonists, including ondansetron; potentially fatal cardiac arrhythmias may result. QTc prolongation occurs in a dose–dependent manner, and is expected to be greater with faster rate of infusion and larger doses for IV administration. The current recommendation is to limit single IV doses to no more than 16 mg.

Canadian guidelines place additional dosing restrictions on IV ondansetron to mitigate the risk of QT prolongation, particularly in older adults, in whom the initial dose should not exceed 8 mg (healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2014/39943a-eng.php (Accessed on June 16, 2014).

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

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