eMedinewS24th February 2014,Monday

Dr K K AggarwalPadma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04);
For updates follow at
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Tackling obesity in children

More than 30% people of the society including children have potbelly abdominal obesity. India is witnessing an epidemic of metabolic syndrome, which is characterized by abdominal obesity, high triglyceride, low good cholesterol, high blood pressure and high sugar.

Abdominal girth of more than 90 cm in men and 80 cm in women indicates that the person is vulnerable to future heart attack.

Normal weight obesity is the new epidemic. A person could be obese even if his body weight was within the normal range. An extra inch of fat around the abdomen increases the chances of heart disease by 1.5 times.

Normally once the height stops growing, most of the organs will also stop growing. The weight of the heart, liver of kidney cannot increase after that. Only muscles can build up to some extent. The only thing, after that stage, which can increase the weight of the body, is deposition of fat. Therefore any weight gain after puberty is invariably due to fat. Though the overall weight can be in the acceptable normal range but any weight gain within that range will be abnormal for that person. One should not gain weight of more than 5 kg after the age of 20 years in males and 18 years in females. After the age of 50, the weight should reduce and not increase.

Potbelly obesity is linked to eating refined carbohydrates and not animal fats. General obesity is linked to eating animal fats.

Refined carbohydrate includes white rice, white maida and white sugar. Brown sugar is better than white sugar. Refined carbohydrates are called bad carbohydrates and animal fat is called bad fat.

Trans fat or vanaspati is bad for health. It increases the levels of bad cholesterol and reduces good cholesterol in the body.

Reduction in weight can reduce snoring, pain of arthritis, blood pressure and control uncontrolled diabetes.

Some points

  1. Skip carbohydrates once in a week.
  2. Combine a sweet food with bitter food (prefer aloo methi over aloo matar).
  3. Walk, walk and walk…
  4. Consume green bitter items in foods such as karela, methi, palak, bhindi etc.
  5. Do not eat trans fats (vanaspati).
  6. Do not consume more than 80 ml of soft drink in a day.
  7. Do not consume sweets with more than 30% sugar.
  8. Avoid maida, rice and white sugar.
Dr K K Aggarwal on Zee TV

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

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

Definition of Health

sprritual blog

Health is not mere absence of disease; it is a state of physical, mental, social, spiritual, environmental and financial well being. All aspects of health are not defined in allopathy.

During MBBS, medical students are taught more about physical health. Social and mental healthcare is covered only in few lectures. Community health is a separate subject but is never given its due importance. Spiritual health is not defined at all and financial health is hardly covered.

Yet, in day–to–day practice, it is the social, financial, spiritual and community health which is the most important during patient–doctor communication. It is incorporated in the four basic purposes: dharma, artha, kama and moksha.

Dharma and artha together form the basis of karma which is righteous earning. You are what your deep rooted desires are. Most of the diseases today can be traced to a particular emotion, positive or negative. Anger and jealously are related with heart attack, fear with blood pressure, greed and possessiveness with heart failure. Unless the mind is healthy, one cannot be free of diseases.

The best description of health comes from Ayurveda. In Sanskrit, health means swasthya, which means establishment in the self. One is established in the self when there is a union of mind, body and soul. Most symbols of health are established around a shaft with two snakes and two wings. The shaft represents the body, two snakes represent the duality of mind and the two wings represent the freedom of soul.

Sushrut Samhita in Chapter 15 shloka 10 defines the Ayurvedic person as under:

Samadosha, samagnischa,
Samadhatumalkriyah,
Prasannatmendriyamanah,
Swastha iti abhidhiyate.

From Ayurvedic point of view, for a person to be healthy, he⁄she must have balanced doshas, balanced agni, balanced dhatus, normal functioning of malkriyas and mind, body, spirit and indriyas full of bliss and happiness.

Human body is made up of structures (Kapha) which have two basic functions to perform; firstly, metabolism (pitta) and movement (vata). Vata, pitta and kapha are called doshas in Ayurveda. Samana dosha means balance of structures, metabolism and movement functions in the body. Agni in Ayurveda is said to be in balance when a person has normal tejas and a good appetite.

Ayurveda describes seven dhatus: rasa, rakta, mamsa, medha, asthi, majja, shukra and they are required to be in balance. They are equivalent to various tissues in the human body.

Ayurveda necessitates proper functioning of natural urges like urination, stool, sweating and breathing and that is what balance in malakriya means.

Ayurveda says for a person to be healthy he⁄she has to be mentally and spiritually healthy, which will only be possible when his or her indriyas are cheerful, full of bliss and devoid of any negativities. For indriyas to be in balance, one has to learn to control over lust and desires, greed and ego. This can be done by learning regular pranayama, learning the dos and don’ts in life, living in a disciplined atmosphere and learn to live in the present.

Regular pranayama shifts one from sympathetic to parasympathetic mode, balances the mind and thoughts and helps in removing negative thoughts from the mind. For living a disabled life one can follow the yama and niyama of yoga sutras of Patanjali or dos and don’ts taught by various religious gurus, leaders and principles of naturopathy.

Living in the present means conscious or meditative living. This involves either learning meditation 20 minutes twice a day or learning subtle mental exercises like mind-body relaxation, yogic shavasana, self–hypnotic exercises, etc.

According to Yoga Sutras of Patanjali, a person who eats thrice a day is a rogi, twice a day is a bhogi and once a day is yogi. The take home message is: to live more one has to eat less.

Swar yoga defines the importance of respiration and longevity. According to this yoga shastra, everybody has a fixed number of breaths to be taken during the life span. Lesser the number a person takes in a minute more is the life. It also forms the basis of pranayama, which is nothing but longer and deeper breathing with reduced respiratory rate.

To be healthy one should follow the principle of moderation and variety in diet and exercise, regular pranayama and meditation and positive thinking.

cardiology news

Attitude is Everything

Jerry was the kind of guy you love to hate. He was always in a good mood and always had something positive to say. When someone would ask him how he was doing, he would reply, "If I were any better, I would be twins!"

He was a unique manager because he had several waiters who had followed him around from restaurant to restaurant. The reason the waiters followed Jerry was because of his attitude. He was a natural motivator. If an employee was having a bad day, Jerry was there telling the employee how to look on the positive side of the situation. Seeing this style really made me curious, so one day I went up to Jerry and asked him, "I don’t get it! You can’t be a positive person all of the time.

How do you do it?" Jerry replied, "Each morning I wake up and say to myself, ‘Jerry, you have two choices today. You can choose to be in a good mood or you can choose to be in a bad mood.’ I choose to be in a good mood. Each time something bad happens, I can choose to be a victim or I can choose to learn from it. I choose to learn from it. Every time someone comes to me complaining, I can choose to accept their complaining or I can point out the positive side of life. I choose the positive side of life." "Yeah, right, it’s not that easy," I protested.

"Yes, it is," Jerry said. "Life is all about choices. When you cut away all the junk, every situation is a choice. You choose how you react to situations. You choose how people will affect your mood. You choose to be in a good mood or bad mood. The bottom line: It’s your choice how you live life."

I reflected on what Jerry said. Soon thereafter, I left the restaurant industry to start my own business. We lost touch, but I often thought about him when I made a choice about life instead of reacting to it.

Several years later, I heard that Jerry did something you are never supposed to do in a restaurant business: he left the back door open one morning and was held up at gunpoint by three armed robbers. While trying to open the safe, his hand, shaking from nervousness, slipped off the combination. The robbers panicked and shot him. Luckily, Jerry was found relatively quickly and rushed to the local trauma center. After 18 hours of surgery and weeks of intensive care, Jerry was released from the hospital with fragments of the bullets still in his body.

I saw Jerry about six months after the accident. When I asked him how he was, he replied, "If I were any better, I’d be twins. Want to see my scars?" I declined to see his wounds, but did ask him what had gone through his mind as the robbery took place. "The first thing that went through my mind was that I should have locked the back door," Jerry replied. "Then, as I lay on the floor, I remembered that I had two choices: I could choose to live, or I could choose to die. I chose to live."

"Weren’t you scared? Did you lose consciousness?" I asked. Jerry continued, "The paramedics were great. They kept telling me I was going to be fine. But when they wheeled me into the emergency room and I saw the expressions on the faces of the doctors and nurses, I got really scared. In their eyes, I read, ‘He’s a dead man.’ "I knew I needed to take action."

"What did you do?" I asked. "Well, there was a big, burly nurse shouting questions at me," said Jerry. "She asked if I was allergic to anything. ‘Yes,’ I replied. The doctors and nurses stopped working as they waited for my reply. I took a deep breath and yelled, ‘Bullets!’ Over their laughter, I told them. ‘I am choosing to live. Operate on me as if I am alive, not dead." Jerry lived thanks to the skill of his doctors, but also because of his amazing attitude. I learned from him that every day we have the choice to live fully. Attitude, after all, is everything.

News Around The Globe

  • More dramatic clinical results with engineered T–cell therapy have been reported, this time from a trial showing that 14 of 16 patients (88%) with advanced adult B–cell acute lymphoblastic leukemia (B–ALL) achieved complete remission (CR). The findings were published in the February 19 issue of Science Translational Medicine.
  • Although mesh repair had a small reduction in recurrence rates compared with suture repairs for primary ventral hernias, risks for seroma and surgical site infection (SSI) increased, according to a literature review and meta–analysis published online February 19 in JAMA Surgery.
  • A review of literature reported in Infection and Immunity suggests that recurrent genital infection with Chlamydia may sometimes derive from organisms harbored in the gastrointestinal tract. According to the authors, chlamydiae can persist indefinitely in a commensal relationship in the GI tract of naturally infected ruminants and in mouse models. They reside in the GI tract but do not elicit a pathologic response
  • Young adults who had not been vaccinated against influenza had severe cases and needed the most intensive treatment, according to a case series published online February 10 in the American Journal of Respiratory and Critical Care Medicine.
  • New findings in Rheumatology show that Tocilizumab may help prevent bone loss in patients with methotrexate–resistant rheumatoid arthritis (RA). Tocilizumab is an IL–6 receptor inhibitor and "highly effective" RA treatment, they add, and IL–6 may also be involved in promoting osteoporosis.

CPR 10 success stories

1. Hands–only CPR 10 English

2. Hands–only CPR 10 (Hindi)

3. Ms Geetanjali, SD Public School Successful Story

4. Success story Ms Sudha Malik

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

6. Elderly man saved by Anuja

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Rabies News (Dr. A K Gupta)

What should be done with a patient who has had exposure but goes for treatment after considerable delay (weeks to months)?

An early and correct administration of modern anti–rabies vaccine is life–saving. The vaccination must be started immediately irrespective of the status of the biting animal. Patients who seek treatment after a delay of 48 hours or even months after having been bitten should be dealt in the same manner as if the exposure occurred recently.

cardiology news

Smell check, scratch and sniff, a new test for Parkinson’s disease

Olfactory dysfunction presenting as odor detection, discrimination, and identification is a common finding in patients with early non vascular Parkinson’s disease.

As per a study of 2,267 men published in the Annals of Neurology, an impaired sense of smell could be an early indicator of Parkinson’s disease, occurring up to four years before motor skill problems appear.

In the study, decreased odor identification was associated with older age, smoking, more coffee consumption, less frequent bowel movements, lower cognitive function and excessive daytime sleepiness, but even after adjusting for these factors, those with the lowest odor identification scores had a five time greater risk of developing Parkinson's disease than those with the highest scores.

Nerve loss and the formation of Lewy bodies –– abnormal clumps of proteins inside nerve cells that are thought to be a marker of the disease –– are known to take place in the olfactory structures of patients with the disease.

An impaired sense of smell could also be caused by impaired sniffing, which may be another motor symptom of Parkinson’s.

Early indicators of Parkinson’s disease are olfactory abnormality, constipation and sleep disturbances.

Besides Parkinson’s disease, obesity, diabetes, hypertension, malnutrition, Alzheimer’s disease, multiple sclerosis and Korsakoff’s psychosis are all accompanied or signaled by smell disorders.

cardiology news

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

  • A European pilot study of patients with atrial fibrillation (AF) undergoing catheter ablation reveals that just over 40% of patients are free from AF at one year without the use of antiarrhythmic medications. AF patients with paroxysmal AF had higher success rates than those with persistent or long–lasting persistent AF, according to the authors of the new report. The data in the report, published January 31, 2014 in the European Heart Journal, are taken from the Euro–Observational Research Program (EORP) AF Ablation Pilot Study conducted by the European Heart Rhythm Association (EHRA).
  • The first mobile stroke unit in the US: If you have a stroke within about 3 miles of Memorial Hermann-Texas Medical Center in Houston, you might end up in the first mobile stroke unit in the U.S., which is scheduled to begin treating patients within weeks. The unit ––a standard ambulance equipped with a CT scanner and stocked with clot-busting tissue plasminogen activator (tPA) –– overcomes the limitation of having to wait until a patient arrives at the hospital to confirm that the stroke is ischemic, which can drastically delay administration of the proven treatment. The hope is that bringing the imaging and the tPA to the point of first medical contact out in the field will restore blood flow to the brain faster, save neurons, and ultimately improve patient outcomes, according to James Grotta, MD, director of stroke research for the Clinical Institute for Research & Innovation at Memorial Hermann–Texas Medical Center.
cardiology news

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

  • High family stress can lead to the child’s immune system being affected, as a research group at the School of Health Sciences at Jônkôping University and the Faculty of Health Sciences at Linkôping University in Sweden shows in a study being published in the Journal of Immunology.
  • One of the first studies to use crowd–sourced information to uncover potential predictors of obesity has suggested that children whose parents are very involved in their young lives are more likely to be slim in adulthood. Results of the study, conducted by researchers at Cornell University in New York, are published in the journal Plos One.
cardiology news

Total CPR since 1st November 2012 – 86664 trained

Media advocacy through Web Media

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press release

Heart Attack Symptoms in Women and Older are Different

Maximum heart attacks occur in winter and symptoms in women and the elderly may be different, warns 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.

Chest pain is still the most common sign of a heart attack in most women but women are more likely than men to have symptoms other than chest pain in heart attack.

These symptoms include pain in the middle or upper back, neck, or jaw; shortness of breath; nausea or vomiting; indigestion; loss of appetite; weakness or fatigue; cough; dizziness and palpitations. Between 30 and 37% of women may not have chest discomfort during a heart attack.

Women are on an average nearly a decade older than men at the time of their initial heart attack. Older people also are more likely to have heart attack without chest discomfort.

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 86664 people since 1st November 2012.

The CPR 10 Mantra is – "Within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

emedipicstoday emedipics

Mega heart checkup camp by Heart Care Foundation of India at Sagar,Madhya Pradesh 20th February 2014

press release

TPA safe in pediatric stroke

vedio of day

today video of the dayHands only CPR 10 Utsav,15th December 2013

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

Padma Shri & Dr B C Roy National Awardee,Dr KK Aggarwal on Tackling tension headaches

eMedi Quiz

The parameters of sensitivity and specificity are used for assessing:

1. Criterion validity.
2. Construct validity.
3. Discriminant validity.
4. Content validity.

Yesterday’s Mind Teaser: The following separation technique depends on the molecular size of the protein:
1.Chromatography on a carboxymethyl (CM) cellulose column.
2.Iso–electric focusing.
3.Gelfiltration chromatography.
4.Chromatography on a diethylaminoethly (DEAE) cellulose column.

Answer for yesterday’s Mind Teaser:3.Gelfiltration chromatography

Correct answers received from: Daivadheenam Jella, Dr Jainendra Upadhyay, Dr Avtar Krishan, Dr Prakash Khalap

Answer for 22nd February Mind Teaser:4.X–ray diffraction.

Correct answers received from: Daivadheenam Jella, Dr Jainendra Upadhyay, Dr Avtar Krishan, Dr Prakash Khalap

Send your answer to ijcp12@gmail.com

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medicolegal update

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medical querymedical query

medicolegal update
medicolegal update

Missing Homework

After teaching high school for nearly 20 years, I thought I’d heard every possible excuse for missing homework until one parent sent me this note: "Please excuse Lori for not having her algebra homework. The cat had kittens on it last night."

medicolegal update

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medicolegal updatemedicolegal update

medicolegal update

Situation: A patient with cough of more than 4 weeks duration came with blood in his sputum
Reaction:Oh my God! Why was TB not suspected earlier?
Lesson: that all patients with cough of more than 3 weeks duration are investigated for TB.

medicolegal update

No matter how much you plan, it is tenacity, unyielding desire to succeed, and the ability to cope with change that will eventually prevail. Perry Payne

medicolegal update

Dr KK Aggarwal: : Kidney stone of less than 5mm size needs no treatment http://bit.ly/15QdVeB #Health
Dr Deepak Chopra:You are the choice–maker who can create any change you desire http://bit.ly/WAHF_Am #WAYHF

Forthcoming events

Date: Saturday 2PM-Sunday 3PM, 26–27 April 2014
Venue: Om Shanti Retreat Centre, Bhora Kalan, Pataudi Road, Manesar
Course Directors: Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal and BK Sapna
Organisers: Heart Care Foundation of India. Prajapati Brahma Kumari Ishwariye Vidyalaya and eMedinews
Facilities: Lodging and boarding provided (one room per family or one room for two persons). Limited rooms for first three hundred registrants.
Course: Meditation, Lectures, Practical workshops
Atmosphere: Silence, Nature, Pyramid Meditation, Night Walk
Registration: SMS– Vandana Rawat – 9958771177, rawat.vandana89@gmail.com
SMS – BK Sapna 9650692204, bksapna@hotmail.com

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

medicolegal update
  1. Dear Sir, Thnaks for the updates. Regards: Dr Shikha

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