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  From the Desk of Editor–in–Chief
Dr KK 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; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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); Editor in Chief IJCP Group & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos…
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 15 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal

25th January 2013, Friday

Is cricket a horse race?

I never had interest in horse race. Recently, I got a chance of going to a horse racecourse. I have a habit of observing and analyzing things. I saw people betting on horses. Every horse had a horse rider.

Each horse rider and horse was trained and capable of winning any race. Obviously, in any race, only one would win. In horse race gambling, you put money on one horse and the rider. When I was watching the excitement and people putting money on the horses, it reminded me of Indian Cricket XI.

I started imagining each of the players as a potential horse participating in the horse race. In cricket too, betting is done on every player and only one player performs the best and is declared Man of the Match.

Both horse races as well as cricket are addictive examples. For people who bet money, it is like an irresistible addiction. If it is true then counseling should be done of these people to help them come out of addiction.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

Start bulk laxatives (e.g., psyllium) or osmotic laxatives as the first line of therapy in older patients with chronic constipation who do not respond to dietary and lifestyle modification.

Dr K K Aggarwal
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Vegetable and fruits lower chances of getting some cancers

Audio PostCard
    Photo Feature (From HCFI Photo Gallery)

CPR 10 Training Camp

CPR 10 learning camp was held at St. Matthew Public School, Paschim Vihar, on 23rd January 2013. In the Pic: A mentally challenged girl learning cpr 10.

Dr K K Aggarwal
    National News

“Be Human Stop Child Abuse” (http://behumanstopchildabuse.emedinews.in/)

(Team IMA for CMAAO)

Child neglect may present with dysfunctional personal relationship, speech and language disorders, learning difficulties and emotional and behavior problems, substance abuse, criminal behavior and failure to thrive.

Indian scientists devise 16 disaster management drugs

Preparing to deal with any future chemical, biological, radiological and nuclear (CBRN) incidents, Indian scientists have devised 16 drugs that can be used for disaster management. These include an anti-cyanide drug, an anti-nerve gas drug and an anti-toxic gas drug. Several radioactive decorporation agents and drugs for anti-cyanide, anti-nerve gas and toxic gas injuries have been approved by the Drug Controller General of India as trial drugs. Developed by scientists at the Defence Research and Development Organisation (DRDO) Institute of Nuclear Medicine and Allied Sciences (INMAS) here, the drugs have passed the efficacy test and will be cheaper than those currently available in the market. “Sixteen new drugs have been approved by the Drug Controller General of India (DGCI) as trial drugs for disaster management. These include an anti-cyanide drug, an anti-nerve gas drug, an anti-toxic gas drug and several radioactive decorporation agents,” Aseem Bhatnagar, in charge of the project at INMAS, told IANS. These will be used as samples for the users, including the armed forces, the paramilitary, the National Disaster Management Authority (NDMA), the Department of Atomic Energy (DAE) and the Ministry of Health.

“Batch production of these drugs is being undertaken in collaboration with the pharmaceuticals industry through contract manufacturing. About 50,000-200,000 doses (licensed for human use) are expected to be manufactured by March 2013,” Bhatnagar said. The DGCI approvals cover all-India use for 15 years for any number of victims. Since there cannot be proper phase two trials of drugs useful in disasters, their use in any future incident has been approved as trial drugs due to a legality. “These shall also be used for continuing clinical trials and for stockpiling. This is necessary to effectively plan stockpiling cost and perpetually (it is envisaged to provide the drug at cost price to the users). The average cost price is expected to be less than 15 percent of market price in all cases,” Bhatnagar said. Several of these drugs have been patented by the defence ministry. “The contract has been given to pharmaceutical companies to ensure that quality checks and pricing remains the prerogative of the defence ministry. Besides, adequate stocks can be retained in a cost-effective way and companies can initiate mass production in case of a disaster without any time wastage,” Bhatnagar said. (Source: The Hindu, January 13, 2013)

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    Valvular Heart Disease Update

Symptoms of bicuspid aortic valve stenosis include dizziness or syncope, chest pain that may be typical angina, and dyspnea due to heart failure.

(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)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

New position statement on sport-related concussion

An athlete with concussion should not return to practice or competitive play until all symptoms have resolved, in order to avoid the risk for further injury during the vulnerable period before the brain has recovered, the American Medical Society for Sports Medicine (AMSSM) advises in a position statement on concussions in sport. The position statement, published in the January issue of the Clinical Journal of Sport Medicine, "provides an evidence-based, best practices summary to assist physicians with the evaluation and management of sports concussion," the authors say. (Source: Medscape)

CDC urges Tamiflu Rx to curb flu death rate

The 2012-2013 influenza season is shaping up to be worse than average, and particularly so for seniors, who represent roughly half of the hospitalizations and 90% of the deaths so far, the Centers for Disease Control and Prevention (CDC) said today. A sharp increase in both hospitalization and death rates as of January 12 underlines the need to administer the antiviral drugs oseltamivir (Tamiflu, Genentech) or zanamivir (Relenza, GlaxoSmithKline) within 48 hours of influenza symptoms surfacing, said CDC Director Thomas Frieden, MD, at a press briefing today. This immediate treatment is especially important for high-risk patients such as the elderly, young children, and those with serious underlying conditions such asthma and heart disease. (Source: Medscape)

Marked jump in ADHD diagnoses

Rates of childhood diagnoses of attention-deficit/hyperactivity disorder (ADHD) increased markedly in the United States during the last decade, new research shows. (Source: Medscape)

Botox approved to treat overactive bladder

The US Food and Drug Administration (FDA) today approved the multipurpose drug onabotulinum toxin A (Botox, Allergan) for yet another indication — the treatment of overactive bladder to reduce urinary incontinence. (Source: Medscape)

Advanced age, COPD risk factors for colectomy mortality

Older patients and those with chronic obstructive pulmonary disease (COPD) are at the greatest risk for death, according to the largest series of colectomies performed for Clostridium difficile. The results were presented at the Society of Critical Care Medicine 42nd Critical Care Congress. (Source: Medscape)

   Twitter of the Day

@DrKKAggarwal: Duration of CPR Minimal duration is 10 minutes in adults and 15 minutes in children. One can prolong the CPR (cont) http://tl.gd/kq5djc

@DeepakChopra: Its a course on Just Capitalism and cause driven marketing @Sharmisthak @ColumbiaMBA @columbia_biz

    Spiritual Update

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

Think positive and think different

The Mantra to acquire spiritual health is to think positive and differently. When you think positive, it creates positive hormones and takes you from sympathetic mode to parasympathetic mode. When you think different, it gives you opportunities and from multiple options available, you can ask your heart to choose one of them.

For comments and archives

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What is pelvic adhesion?

Adhesions in and around the pelvic cavity may form if you have endometriosis, a pelvic infection, surgery on your pelvis, a cyst on an ovary, or have had surgery on your pelvis. Scar tissue causes organs that normally are separate from each other to become attached.

    Tat Tvam Asi………and the Life Continues……

(Dr. Neelam Mohan, Director, Dept. of Pediatric Gastroenterology, Hepatology & Liver Transplantation, Medanta – The Medicity, Gurgaon)

What’s reduced graft?

In a small baby, even the left lateral segment may be too large for the small size vessels that the patient has. Therefore after removing a part of the liver (usually left lateral) a bench surgery, i.e. surgery on the table is performed to reduce the weight and size and make it appropriate to the weight and needs of the child.

For comments and archives

   An Inspirational Story

Blessings not packaged as we expected

A young man was getting ready to graduate college. For many months he had admired a beautiful sports car in a dealer's showroom, and knowing his father could well afford it, he told him that was all he wanted.

As Graduation Day approached, the young man awaited signs that his father had purchased the car. Finally, on the morning of his graduation his father called him into his private study. His father told him how proud he was to have such a fine son, and told him how much he loved him. He handed his son a beautiful wrapped gift box.

Curious, but somewhat disappointed the young man opened the box and found a lovely, leather-bound Bible. Angrily, he raised his voice at his father and said, "With all your money you give me a Bible?" and stormed out of the house, leaving the holy book.

Many years passed and the young man was very successful in business. He had a beautiful home and wonderful family, but realized his father was very old, and thought perhaps he should go to him. He had not seen him since that graduation day. Before he could make arrangements, he received a telegram telling him his father had passed away, and willed all of his possessions to his son. He needed to come home immediately and take care of things. When he arrived at his father's house, sudden sadness and regret filled his heart. He began to search his father's important papers and saw the still new Bible, just as he had left it years ago. With tears, he opened the Bible and began to turn the pages. As he read those words, a car key dropped from an envelope taped behind the Bible. It had a tag with the dealer's name, the same dealer who had the sports car he had desired. On the tag was the date of his graduation, and the words...PAID IN FULL.

How many times do we miss God's blessings because they are not packaged as we expected?

For comments and archives

   Cardiology eMedinewS

Beware paracetamol can be harmful

Read More

Fatal heart attacks decline when workplaces go smoke-free Read More

   Pediatric eMedinewS

ADHD diagnoses up sharply Read More

AP neonatal care program reduces death in India, Tanzania Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with diastolic dysfunction of the heart was advised omega–3 supplements.
Dr. Bad: Take them for six months.
Dr. Good: There is no data to suggest that they improve diastolic function. Lesson: A study presented at the Experimental Biology 2012 Meeting has shown that omega 3 supplements do not reverse diastolic dysfunction.

Make Sure

Situation: A patient with suspected pneumonia and normal x–ray died 12 hours after admission.
Reaction: Oh my God! Why were antibiotics not started?
Lesson: Make sure that all patients with suspected pneumonia are given antibiotic at the first suspicion as x–ray can be normal in the first 24 hours.

  Quote of the Day (Dr Anil Kumar Jain)

The most painful thing in life is losing yourself in the process of valuing someone too much and forgetting that you are special too……… !!!

  Legal Question of the Day (Vivek Chhabra)

Daily Telegraph By: Presswatch Chemists 'ideally placed' to refer people for cancer tests: Chemists should be able to refer customers directly to hospital for cancer tests if they suspect they have a developing tumour, according to the Royal Society of Public Health. Prof Richard Parish, the chief executive of the society, said yesterday that such a move could help save lives by catching people who are reluctant to visit their GP and by reducing the time to get test results.

    Mind Teaser

Read this…………………

A patient received spinal anesthesia 4 hours ago during surgery. The patient has been on the unit for ½ hours and now reports severe incisional pain. The patient's blood pressure is 170/90 mm Hg, pulse is 108 beats/min, temperature is 99oF (37.2oC), and respirations are 30 breaths/min. The patient's skin is pale and the dressing is dry and intact. The most appropriate nursing intervention is to:

a) Call the physician and report the findings.
b) Medicate the patient for pain.
c) Place the patient in a high Fowler position and administer oxygen.
d) Place the patient in a reverse Trendelenburg position and open the IV line.

Yesterday’s Mind Teaser: Which action will best help reduce anxiety in a 64-year-old patient who has been hospitalized for suspected peptic ulcer disease?

a) Ask all members of the team to reassure the patient about the quality of care provided in the hospital.
b) Assign the patient to a room with a talkative, optimistic roommate.
c) Explain to the patient what will happen during the hospitalization.
d) Visit the patient frequently and get the patient to talk about pleasant future plans.

Answer for yesterday’s Mind Teaser: Explain to the patient what will happen during the hospitalization

Correct answers received from: DR SHAGUFTA MOIN, Dr. RAGHAVENDRA JAYESH, DR ARPAN GANDHI, Dr. P. C. Das, drjella, Dr. Thakor Hitendrsinh G, Dr.K.V.Sarma, dr deepali chatterjee, Dr Pankaj Agarwal, Muthumperumal Thirumalpillai, Dr K P Chandra, Dr Avtar Krishan, Dr Kanta Jain, Dr. Bharat Bhushan Aggarwal

Answer for 23rd January Mind Teaser: Explain to the patient what will happen during the hospitalization.

Correct answers received from: Dr Kanta Jain, Dr.Chandresh Jardosh, Dr. Bharat Bhushan Aggarwal

Send your answer to ijcp12@gmail.com

    Laugh a While (Dr GM Singh)

A walking economy

This guy is walking with his friend, who happens to be a psychologist. He says to this friend, "I’m a walking economy."

The friend asks, "How so?"

"My hairline is in recession, my stomach is a victim of inflation, and both of these together are putting me into a deep depression!"

    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

Immediate first aid may stop serious poisoning and may save life

If breathing and the heart stop, the person will die within a few minutes unless first aid is administered at once. Here is an action list. Start with the first step and follow each step in the order given. Act as quickly as you can, but stay calm.

  • Check if the patient is conscious. Try to keep the patient awake. Shout "Are you all right?" and gently shake the shoulders, but take care not to make any injuries worse. Pinch the skin on the neck and watch the face. A patient who is just sleeping will wake up, but an unconscious patient will not.
  • Open the airway. The airway is the tube through which air passes from the mouth and nose to the lungs. If it is blocked the patient cannot breathe and air cannot get into or out of the lungs. A patient who cannot breathe will die within 4 minutes. In an unconscious patient, the tongue may block the throat and the airway.
  • Make sure the airway is open and air can get down the throat. Place the patient on his/her back. Tilt the head back and lift the chin up with the finger and thumb of one hand on the bony part of the chin, while pressing the forehead back with the other hand. This will open the airway and stop the tongue blocking the throat.
  • Check whether the patient is breathing after opening the airway; quickly check whether the patient is breathing. Look for the belly or the chest moving up and down. Feel the chest moving up and down. Feel the patient’s breathe on your cheek. Listen for breath sounds. Put your ear close to the patient’s mouth. Use all four checks. Remember that the chest may move up and down even when the throat is completely blocked and air cannot get to the lungs.

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    Public Forum

(Press Release for use by the newspapers)

CPR Training Camp at St Mathew Public School, Paschim Vihar

At St Mathew Public School, Paschim Vihar, New Delhi, Conducting a CPR Camp Padma Shri and Dr BC Roy National Awardee Dr. K K Aggarwal, President, Heart Care Foundation of India and National Vice President Elect IMA said that even physically and mentally challenged students can learn CPR.

Dr Aggarwal said that every chowkidaar, Security Guard, Ward Boy and helpers in Healthcare setting should be trained in CPR so that hospital can provide resuscitation right at the gate.

Mrs Anita Sethi Principal of the school said that over 400 students were trained today. She said that the Guru Dakshina which students can give is to make 10 other people learn the CPR10 mantra –

“within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

Combo drugs best for lowering blood pressure

A low-dose four-drug combination is more effective for reducing high blood pressure than treatment with a high dose of a single drug, said Dr. K K Aggarwal, President, Heart Care Foundation of India and National Vice President Elect IMA.

Quoting an irish study published in the journal Hypertension, Dr. Aggarwal said that most people with high blood pressure need two to three antihypertensive drugs.

Combining low doses of established antihypertensive medicines in one or two drugs can produce better blood pressure control than full doses of individual drugs.

In the study doctors from Dublin, investigated this approach by studying 108 untreated, hypertensive patients. The subjects were randomly allocated to take one of four agents -- a calcium channel blocker, a beta-blocker, a diuretic, or an ACE inhibitor -- or a capsule containing all four drugs at one quarter of the dose used for single-drug therapy.

After 4 weeks, the reduction in pressure with the combination treatment was 19 points, significantly greater than the 6 to 11 points seen with the various individual agents.

In the study 60% of combination-drug patients achieved a normal blood pressure reading compared with 15 –45% of patients taking individual drugs.

The combination approach has the potential to reduce costs, with possibly fewer side effects, and the number of medicines to be taken each day.

    Readers Response
  1. Dear Sir, emedinews is very interesting. Regards: Dr Priti
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Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta