eMedinewS24th September 2013, Tuesday

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
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Life sentence to 29–yr–old doctor who raped patient in ICU

The Bombay High Court has confirmed the life sentence awarded to a 29–year–old doctor who was convicted for raping a patient in an Intensive Care Unit of a private hospital in Thane.

A bench of justices P V Hardas and P N Deshmukh accepted the argument of prosecutor Usha Kejriwal that though the medical evidence did not fully support the victim’s version, the act of the doctor amounted to rape and fell within the definition of 376(d) of IPC.

The victim was admitted to general ward of Lotus hospital on January 28, 2013 after she complained of giddiness. The accused was the RMO on night duty. He administered an injection which made her drowsy. In the ICU, there were three beds which were segregated and covered separately by curtains. He drew the curtains and slept on the victim's bed. He then raped her.

However, the prosecutor cited judgments to show that even slightest penetration would be termed as "rape" and that this act fell within the definition of 376(d) IPC which was punishable with life imprisonment.

The defence of the accused was that the medical evidence indicated that there were no injuries of rape found on the victim. However, the prosecutor argued that act amounted to rape, which was accepted by the court. (PTI)

Under MCI ethics regulations he can be tried under section 7.3 where adultery and improper conduct is professional misconduct and under regulation 7.5 where after conviction by a court involving moral turpitude the council can take action and suspend the license for the duration of the sentence.

The council can take su moto action under regulation clause 8.2 MCI.

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 Merits And Demerits Of Focused Living

In the epic Mahabharata, Yudhishthir symbolizes a person who has learnt the art of being in balance in loss and gain and the one who practices righteous living. Arjuna symbolizes the quality to focus and the quality to see only the eyes of a fish when focusing on the fish.

Bheema symbolizes the power to fight the evil. Sahdev stands for the quality of helping others and Nakul symbolizes how to remain neutral in any circumstances.

The weakness of Yudhishthir was lust (gambling); of Arjuna was losing focus due to any doubt and of Bheem (Bal), to get instigated on small things.

A person who is too focused can easily get diverted by any doubt. This is what happened to Arjuna when the Kurukshetra war started. He was focused completely before and after the Bhagvad Gita.

Bhagvad Gita is a dialogue between Arjuna and Lord Krishna, which was delivered when Arjuna was overpowered by doubts in his mind whether he should fight or not? Was he justified in fighting with his own people?

Once the doubts were removed by Lord Krishna using the principles of cognitive behavior therapy (as called today) he regained his focus.

In Hindu mythology, Lord Krishna represents consciousness, therefore in any doubt one should redirect them to the heart/consciousness to take the right decision.

cardiology news

Who you are speaks louder to me than anything you can say

At the beginning of my 8:00 a.m. class one Monday at University of Nevada, Las Vegas (UNLV), I cheerfully asked my students how their weekend had been. One young man said that his weekend had not been very good. He’d had his wisdom teeth extracted. The young man then proceeded to ask me why I always seemed to be so cheerful. His question reminded me of something I’d read somewhere before: "Every morning when you get up, you have a choice about how you want to approach life that day", I said to the young man. "I choose to be cheerful". "Let me give you an example", I continued.

The other 60 students in the class ceased their chatter and began to listen to our conversation. As soon as I got there, I called AAA and asked them to send a tow truck. The secretary in the Provost’s office asked me what had happened. "This is my lucky day", I replied, smiling. "Your car breaks down and today is your lucky day??" She was puzzled. "What do you mean?"

"I live 17 miles from here", I replied. "My car could have broken down anywhere along the freeway. It didn’t. Instead, it broke down in the perfect place: off the freeway, within walking distance of here. I’m still able to teach my class, and I’ve been able to arrange for the tow truck to meet me after class. If my car was meant to break down today, it couldn’t have been arranged in a more convenient fashion." The secretary’s eyes opened wide, and then she smiled. I smiled back and headed for class.’ So ended my story to the students in my economics class at UNLV.

I scanned the 60 faces in the lecture hall. Despite the early hour, no one seemed to be asleep. Somehow, my story had touched them. Or maybe it wasn’t the story at all. In fact, it had all started with a student’s observation that I was cheerful.

A wise man once said: "Who you are speaks louder to me than anything you can say". I suppose it must be so.

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…

  • Zonisamide (Zonegran) was effective as a long-term monotherapy for treatment of adult partial epileptic seizures and demonstrated non–inferiority compared with carbamazepine, as per a study presented at the World Congress of Neurology meeting. At 2 or more years, there was no significant difference in the number of patients who were seizure free with zonisamide vs carbamazepine therapy (32.3% vs 35.2%). Treatment in both drug therapy groups was associated with similar retention rates up to 27 months, similar termination rates due to lack of efficacy (8.5% vs 8%), and the same rate of termination due to adverse events (11.7% for both).
  • Findings of a new study suggest that valganciclovir is inferior to established combination therapy in patients undergoing high–risk orthotopic liver transplantation. In the pivotal clinical trials on which US Food and Drug Administration approval was based, valganciclovir, a prodrug that is converted to ganciclovir in the liver, appeared to be inferior to ganciclovir in the prevention of cytomegalovirus in liver transplant patients with mismatched donors. The study results were presented at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy by Natalie Nierenberg, MD, clinical instructor at Tufts University Medical Center in Boston.
  • According to a study from Israel, Bartholin gland abscesses are commonly culture–positive, and these microbiological findings should drive empirical antimicrobial treatment. Dr. Kessous and colleagues examined Bartholin gland abscesses in 219 women admitted to Soroka University Medical Center, including 132 with primary infections and 87 with recurrent events. Bartholin gland abscess drainage yielded positive cultures in 61.8% cases, and Escherichia coli was the most frequent pathogen found (43.6%). Only 7.9% of cases were polymicrobial. Infection with E. coli was significantly more common with recurrent infection (56.8%) than with primary infection (37%).
  • Patients with chronic pain being treated with opioids can commonly be expected to develop tolerances to the drug with longer–term treatment, but the emergence of certain, uniquely sensitive pain characteristics can be red flags for a potential differential diagnosis of hyperalgesia. According to pain specialist Sanford M. Silverman, patients with opioid–induced hyperalgesia will develop an increased sensitization to pain that may be unlike their original pain. This is a diffuse, spreading kind of pain. Patients develop an acute insensitivity to pain even though they may be stable and functioning on their opiates.
  • The European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) recommended authorization for the hemophilia A drug turoctocog alpha (NovoEight, NovoNordisk) yesterday for the treatment and prophylaxis of bleeding in patients with hemophilia A, a hereditary disorder caused by a lack of the blood clotting factor VIII protein. It is a recombinant coagulation factor VIII, which works by replacing the missing factor VIII protein through intravenous injection.

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Rabies News (Dr. A K Gupta)

What are the initial (prodromal) symptoms of rabies?

  • Pain or paresthesiae at the site of the bite is well–known as a diagnostically useful prodromal symptom occurring in one–third to two–thirds of cases.
  • In Thailand, however, a specific type of paresthesiae–itching–was the earliest symptom in >40% of cases. Itching occurred at the site of the healed bite wound or involved the whole bitten limb and was sometimes so intense as to provoke frenzied scratching and excoriation of the skin. The explanation for local paresthesiae may be the multiplication of virus in the dorsal root ganglion of the sensory nerve supplying the area of the bite.
  • Pain behind the grafted eye was an early symptom in three of the four patients who developed rabies following corneal transplants.
  • Priapism with frequent spontaneous orgasms was the first symptom in one Thai patient.
  • Fever, malaise, nausea and vomiting.
  • The skin becomes sensitive to changes of temperature, especially air currents.
cardiology news

A regional network of nine referral hospitals and a center with percutaneous coronary intervention (PCI) capabilities substantially reduced first door–to–balloon times for transferred patients with ST–segment elevation myocardial infarction (STEMI), researchers found. By implementing five main system–wide initiatives, the network reduced the median time from a patient’s arrival at the first hospital to PCI at the second hospital from 109.5 to 88 minutes (P<0.0001), according to B. Hadley Wilson, MD, of Carolinas Medical Center in Charlotte, N.C., and colleagues. The percentage of patients with a first door–to–balloon time under 90 minutes increased from 22.8% before the initiatives to 55.9% after (P<0.0001), they reported online in JACC: Cardiovascular Interventions.

Valvular Heart Disease News

After successful medical treatment of infection endocardita on echo may level persistent vegetation for months or years.

(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
  • Invasive methicillin–resistant Staphylococcus aureus (MRSA) infections have not declined among children as in adults, and community–acquired pediatric cases are actually on the rise, according to CDC data. The age– and race-adjusted incidence of invasive MRSA contracted outside the healthcare setting increased 10.2% year over year, going from 1.1 to 1.7 per 100,000 children from 2005 to 2010, Martha Iwamoto, MD, MPH, of the CDC in Atlanta, and colleagues found. Healthcare-associated and hospital–onset cases remained unchanged over that period among children overall, the researchers reported online ahead of print in the October issue of the journal Pediatrics. By contrast, recent studies in predominantly adult populations had shown both healthcare–associated and community–onset invasive MRSA infections to be on the decline.
  • Bracing in high–risk patients with adolescent idiopathic scoliosis (AIS) is associated with a significantly greater likelihood of reaching skeletal maturity with a curve of less than 50 degrees, the degree at which surgery is normally indicated. In a new study called the Bracing in Adolescent Idiopathic Scoliosis Trial (BRAIST), the researchers found that the longer children wore the brace, the better the outcome. Those who had it on at least 13 hours a day had upwards of a 90% chance of avoiding surgery. The study was halted early, in January of this year, because of the overwhelming evidence of the superiority of the brace, said lead author Stuart L. Weinstein, Ignacio V. Ponseti Chair and professor, orthopedic surgery and professor, pediatrics, University of Iowa, Iowa City. The study is published online September 19 in the New England Journal of Medicine
cardiology news

Diet and Aging: Gaining A Nutritional Edge

Choose fruits and vegetables wisely

  • Get at least five servings of fruits and vegetables a day.
  • When filling your plate with fruits and vegetables, choose from a full color palette.
  • For even more health benefits, aim for nine servings a day. To get there, choose vegetable soups and vegetable or fruit salads. Sprinkle fruit on breakfast cereal, and select it for snacks or as a sweet end note after meals.

Choose fats wisely

  • Whenever possible, use monounsaturated and polyunsaturated oils. Avoid trans fats entirely. Limit saturated fats to less than 7% of daily calories and total fat to 20% to 30% of daily calories.
  • If you don’t have coronary artery disease, the American Heart Association recommends eating foods rich in omega–3 fatty acids, such as salmon, trout, or mackerel, twice weekly. If you have documented coronary artery disease, consume roughly 1 gram a day of EPA or DHA from oily fish and supplements if your doctor advises this.

Choose carbohydrates wisely

  • Choose whole–grain foods over those made with refined grains, such as white bread. Look beyond popular choices like whole oats and brown rice to lesser–known whole grains like barley, bulgur, kasha and quinoa. Limit your intake of white potatoes.

Choosing protein wisely

  • Emphasize plant sources of protein, such as beans, nuts, and grains, to help you bypass unhealthy fats predominant in animal sources. Enjoying a wide variety of vegetables and eating beans and grains helps you get a full complement of amino acids over the course of a week. Shy away from protein sources high in saturated fat. Favor fish and well–trimmed poultry. If you do eat beef, pick lean cuts.
  • Don’t char or overcook meat, poultry, or fish — it causes a buildup of carcinogens. Cutting off fat, which causes flames to flare on the grill, can help avoid charring; try gently sautéing, steaming, or braising these foods in liquid instead. Grilling vegetables is safe, however.
cardiology news

Total CPR since 1st November 2012 – 63400 trained

CPR Classes 63400

Media advocacy through Print Media

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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

Cleaning your home may worsen asthma

Scrubbing the kitchen floor or doing other cleaning chores around the home may trigger asthma, said Padma Shri and Dr BC Roy National Awardee Dr. K K Aggarwal, President, Heart Care Foundation of India and MTNL Perfect Health Mela.

Both cleaning and cleaning agent exposures are major risks for asthma and asthma exacerbations. In a 12–week study, Bernstein and colleagues from the University Of Cincinnati College of Medicine compared the health effects of household cleaning among 25 asthmatic and 19 non–asthmatic women who reported that they are the primary cleaners in their homes.

After cleaning, they observed a statistically significant increase in the number of respiratory symptoms in asthmatic women compared with non–asthmatic women. Doctors should caution women with asthma about the potential respiratory health effects of cleaning activities and exposure to cleaning agents.

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 as applied in Indian situation

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…………………

A focused examination for fibromyalgia includes assessment for:

a) Autonomic changes, peripheral neuropathy, and skin fold tenderness.
b) Morning fatigue, widespread body pain, and focal tenderness.
c) Skin rashes, edema, and constipation.
d) Unilateral weakness, hyperesthesia, and allodynia.

Yesterday’s Mind Teaser: Which medication is the best choice to treat breakthrough pain for a patient who is currently receiving methadone, 10 mg, every 8 hours?

a) Methadone
b) Immediate release morphine
c) Sustained release morphine
d) Transdermal fentanyl

Answer for yesterday’s Mind Teaser: Immediate–release morphine (MS IR)

Correct answers received from: Narahari Kandakatla, dr.deepalichatterjee, Dr. V.P. Thakral, Dr. P. C. Das, DR AVTAR KRISHAN, DR ARPAN GANDHI, Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr.BITAAN SEN & DR.JAYASHREE SEN, Dr Kanta Jain, Dr. P. C. Das

Answer for 22nd September Mind Teaser: Guided imagery

Correct answers received from: Dr.A.K.Gajjar, Dr.K.Raju, Dr Avtar Krishan

Send your answer to ijcp12@gmail.com



medicolegal update

Click on the image to enlarge

medicolegal update

A man was complaining to a railroad engineer. What’s the use of having a train schedule if the trains are always late?

The railroad engineer replied, "How would we know they were late, if we didn’t have a schedule?"

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with renal failure came to a doctor.
Reaction: Oh, my God! Why was he given painkillers?
Lesson: Make sure to remember that most painkillers (barring nimesulide) are not kidney–friendly drugs.

medicolegal update

Do not spoil what you have by desiring what you have not; remember that what you now have was once among the things you only hoped for. Epicurus

medicolegal update

Dr KK Aggarwal: Sudden Cardiac Death By Dr k k Aggarwal http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: How to Handle Difficult People | LinkedIn #CosmicConsciousness

medicolegal update

Dear Sir, Nice Updates. Regards: Dr Sanjana

Forthcoming Events

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20th Perfect Health Mela from 18th Oct to 22nd Oct at different locations

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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