eMedinewS25th September 2013, Wednesday

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.facebook.com/Dr KKAggarwal

Statins clear cholesterol at the risk of cataract

In the primary analysis of 6,972 matched pairs of statin users and nonusers, those taking the cholesterol–lowering medication had a 9% increased risk of developing cataracts said Dr Ishak Mansi, of the VA North Texas Health System at the University of Texas Southwestern in Dallas, and colleagues in JAMA Ophthalmology. In a secondary subgroup analysis of 33,513 patients (6,113 on statins) who had no comorbidity, based on the Charlson comorbidity index, the use of statins remained significantly associated with cataracts. ….Read More

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
Ringtone – CPR 10 Mantra Hindi

Ringtone – CPR 10 Mantra English

sprritual blog Group Singing is good for the heart

Melody Synchronizes Choir Members’ Heart Rate

When people sing in a choir their heart beats are synchronized and the pulse of choir members tends to increase and decrease in unison.

A study published in Frontiers in Neuroscience from Sahlgrenska Academy at University of Gothenburg has shown that music in biological terms, affects our body and our health and can be used for medical purposes, primarily within rehabilitation and preventive care.

In December 2012, Björn Vickhoff and group brought together fifteen 18–year–olds at Hvitfeltska High School in Gothenburg and arranged for them to perform three different choral exercises: monotone humming, singing the well–known Swedish hymn "Härlig är Jorden" (Lovely is the Earth) as well as the chanting of a slow mantra. The heart rhythm of the choir members was registered as they performed in each case.

The results showed that the music’s melody had a direct link to the cardiac activity of the individual choir member. To sing in unison had a synchronizing effect so that the heart rate of the singers increased and decreased at the same time.

Singing regulates activity of vagus nerve, which is involved in our emotional life and our communication with others and affects our vocal timbre.

Songs with long or short phrases achieve the same effect as if breathing slow or fast in yoga. In other words, through song we can exercise a certain control over mental states.

Singing leads to a calm and regular breathing pattern, which has a dramatic effect on heart rate variability.

During normal breathing, both the heart rate and pulse decreases when breathing out and increases when breathing in.

Breathing out activates the vagus nerve that lowers the heart rate.

The vagus breathing connection is more pronounced with young people in good physical condition and not subject to stress.

For example singing a song with long phrases will reduce respiratory rate and in turn the heart rate and vice versa with singing small phrases.

In Vedic knowledge it is well described that people who chant together influence even the people who are not chanting and the health effects in people who chant together are higher than when they chant alone. If one percent of the society meditates together the health effects ate on the whole society.

cardiology news

The Three Races

In old times, a fable retells the story of the young athletic boy hungry for success, for whom winning was everything and success was measured by such a result.

One day, the boy was preparing for a running competition in his small native village, himself and two other young boys to compete. A large crowd had congregated to witness the sporting spectacle and a wise old man, upon hearing of the little boy, had travelled far to bear witness also.

The race commenced, looking like a level heat at the finishing line, but sure enough the boy dug deep and called on his determination, strength and power.. he took the winning line and was first. The crowd was ecstatic and cheered and waved at the boy. The wise man remained still and calm, expressing no sentiment. The little boy however felt proud and important.

A second race was called, and two new young, fit, challengers came forward, to run with the little boy. The race was started and sure enough the little boy came through and finished first once again. The crowd was ecstatic again and cheered and waved at the boy. The wise man remained still and calm, again expressing no sentiment. The little boy, however, felt proud and important.

"Another race, another race!" pleaded the little boy. The wise old man stepped forward and presented the little boy with two new challengers, an elderly frail lady and a blind man. "What is this?", quizzed the little boy. "This is no race" he exclaimed. "Race!", said the wise man. The race was started and the boy was the only finisher, the other two challengers left standing at the starting line. The little boy was ecstatic; he raised his arms in delight. The crowd, however, was silent showing no sentiment toward the little boy."What has happened? Why not do the people join in my success?" he asked the wise old man. "Race again", replied the wise man, "…this time, finish together, all three of you, finish together" continued the wise man. The little boy thought a little, stood in the middle of the blind man and the frail old lady, and then took the two challengers by the hand. The race began and the little boy walked slowly, ever so slowly, to the finishing line and crossed it. The crowd was ecstatic and cheered and waved at the boy. The wise man smiled, gently nodding his head. The little boy felt proud and important.

"Old man, I understand not! Who is the crowd cheering for? Which one of us three?", asked the little boy. The wise old man looked into the little boy’s eyes, placing his hands on the boy’s shoulders, and replied softly.. "Little boy, for this race you have won much more than in any race you have ever ran before, and for this race the crowd cheer not for any winner!"

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 new set of criteria to classify idiopathic inflammatory myopathies was more specific and sensitive than current diagnostic methods according to a study presented at the World Congress of Neurology by Marianne de Visser, MD, of the Academic Medical Center in Amsterdam, the Netherlands, and colleagues. The new criteria were able to correctly classify 87% of idiopathic inflammatory myopathies without muscle biopsy data with a sensitivity of 87% and a specificity of 88%, and correctly classify 88% of cases with muscle biopsy data with a sensitivity of 88% and a specificity of 89. However, the criteria had worse prognostic probability when used to diagnose inclusion body myositis without muscle biopsy data (78%) and when used to diagnose polymyositis with (74%) or without (73%) muscle biopsy data.
  • New guidelines from the American College of Physicians state that the first line of defense against obstructive sleep apnea should be weight loss. If more treatment is needed, the first choice should be continuous positive airway pressure (CPAP), but so-called mandibular advancement devices can be used as an alternative therapy. But the guidelines do not recommend surgery as initial treatment. The guidelines are published in the Oct. 1 issue of Annals of Internal Medicine.
  • The U.S. Preventive Services Task Force has again recommended the use of tamoxifen and raloxifene, breast cancer primary prevention drugs, for higher–risk women at low risk of side effects. These drugs scored a grade B endorsement for such women, ages 35 and older, with no prior breast cancer, ductal carcinoma in situ (DCIS), or lobular carcinoma in situ (LCIS). That group would include many with a 5–year breast cancer risk of 3% or greater as estimated by the Gail model, although the balance depends on age, race/ethnicity, the medication used, and whether or not the patient has a uterus. But chemoprophylaxis got a grade D recommendation against use in low or average breast cancer risk among asymptomatic women.
  • The FDA has approved changes to fentanyl (Duragesic) patches, requiring clearly visible marking on each patch with the drug name and strength in long lasting ink, to help reduce the risk of accidental exposure to the opioid. The fentanyl transdermal system, brand name and generic, releases the drug slowly over 3 days. After the patch is removed, however, more than half of the opioid remains in the patch, and if a child ingests it, overdosage and respiratory depression can ensue.
  • The HIV/AIDS pandemic has been halted and is beginning to reverse, at least by some measures, according to a report from the Joint United Nations Programme on HIV/AIDS (UNAIDS). New HIV infections in 2012 were down slightly from 2011 and by 33% since 2001, while AIDS–related deaths continued to fall from their peak in 2005.And about 9.7 million people in low and middle–income countries are now on antiretroviral medication, up by about 20% since 2011. Tuberculosis–related deaths in people living with HIV have fallen by 36% since 2004, although it is still the major cause of mortality in people with HIV. The 2015 UN development goals call for 50% reductions in both sexual and drug–related HIV transmission, eliminating new HIV infections among children, reaching 15 million people with HIV treatment, and mobilizing $22 billion to $24 billion a year for HIV programs.

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Rabies News (Dr. A K Gupta)

Are pregnancy and lactation contraindications for IDRV?

Pregnancy and lactation are not contraindications for IDRV.

cardiology news
  • Heart failure patients with diabetes who received a left ventricular assist device (LVAD) had an improvement in glycemic control. In a retrospective study, the 23 patients on insulin decreased their use of the drug, from a median of 53 units pre–LVAD to 35 units at around 5 months post–LVAD. Overall, fasting blood glucose improved from 136 to 108 mg/dL post–LVAD implantation meaning that they were taking less insulin but their blood sugar was better. Hemoglobin A1c levels also improved after LVAD placement. The study findings were presented by Naila Choudhary, MD, and colleagues from the University of Rochester Medical Center in Rochester, N.Y at the annual meeting of the Heart Failure Society of America.
  • Chronic exposure to arsenic, even at low levels, is associated with an increased risk of cardiovascular disease and death. In a prospective cohort study, over almost 20 years of follow–up, low levels of arsenic in drinking water and food were associated with increases in incident cardiovascular disease, coronary heart disease, and stroke, according to Ana Navas–Acien, MD, PhD, of Johns Hopkins Bloomberg School of Public Health, and colleagues. The same was true for death owing to cardiovascular disease, coronary heart disease, and stroke.

Valvular Heart Disease News

In many patients with endocarditis, there may be history of localized infection.

(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
  • Glucose control remained inadequate in a cohort of teens with type 1 diabetes, and many of these young patients already had microvascular complications, according to the findings of a British observational study. Among a group of 96 adolescents treated at multidisciplinary young adult clinics, the mean glycosylated hemoglobin (HbA1c) level was 10%, and only 9.4% had levels below the recommended 7.5%, according to Christine Eiser, PhD, of the University of Sheffield, and colleagues. In a subgroup who had been diagnosed with type 1 diabetes more than 7 years earlier, 46.9% showed signs of nonproliferative retinopathy. The study was reported online in the journal Diabetic Medicine.
  • Newly identified baseline predictors of placebo response in children and teens with autism spectrum disorders could help researchers recognize the drugs that work best for treating symptoms, as reported in the journal JAMA Pediatrics. In a secondary analysis of data from the STAART citalopram (Celexa) trial, higher scores on tests measuring severity of disruptive behaviors (primarily hyperactivity), mood and symptom burden, and caregiver strain were associated with lower placebo responses. Specifically, participants in the placebo group were less likely to respond if they entered the study with scores exceeding the median for disruptive behavior, mood or autism symptoms, or caregiver strain. The STAART (Studies to Advance Autism Research and Treatment) trial compared citalopram hydrobromide, a selective serotonin reuptake inhibitor (SSRI), versus placebo for the treatment of repetitive behavior in children with autism spectrum disorders.
cardiology news


Fever does not mean presence of infection. There are many situations where there is fever without infection and hence needs no antibiotics.

  • Sepsis is a clinical syndrome, which results from the dysregulation of inflammatory response to an infection. The temperature is between 36oC to 38.3oC. Heart rate is often more than 90 per minute.
  • Symptomatic inflammatory response syndrome means a clinical syndrome, which results from dysregulated inflammatory response to any infections such as inflammation of the pancreas, inflammation of the vessels, clot formations in the veins.
  • Many antibiotics can cause fever; unless they are discontinued, fever will not subside.
  • Hyperthermia is a condition with elevated body temperature but it is not called fever. Examples are exposure to heat or heat stroke and in response to anesthetic drugs and anti–psychotic drugs.
  • Hyperthermia may not respond to anti–fever drugs.
  • When fever is more than 41.5oC, it is acute hyperpyrexia.
  • Hyperpyrexia is usually seen in patients with severe infections but it may also occur in brain hemorrhage. It responds to anti–fever drugs.
  • High temperature without infection is found in condition of hyperfunctioning of the thyroid gland.
  • Recreational drugs such as Ecstasy can also cause fever without any infection.
  • Mild fever can also occur after exertion.
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


TB more dangerous than FLU 29th August


Avoid chocolate for heartburn

People with heartburn should avoid chocolate as it can worsen the heartburn, said Padma Shri and Dr B C Roy National Awardee Dr. K K Aggarwal, President, Heart Care Foundation of India and MTNL Perfect Health Mela.

One should also avoid other reflux–inducing foods (fatty foods, peppermint and excessive alcohol, which may reduce lower esophageal sphincter pressure).

A number of beverages have a very acidic pH and can exacerbate symptoms. These include colas, red wine and orange juice (pH 2.5 to 3.9).

Promotion of salivation by either chewing gum or use of oral lozenges may also be helpful in mild heartburn. Salivation neutralizes refluxed acid, thereby increasing the rate of esophageal acid clearance.

Restriction of alcohol use and elimination of smoking; smoking is deleterious in part because it diminishes salivation.

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

Dr KK Aggarwal Live on channel one

press release

Obesity reduces life expectancy

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…………………

Biofeedback is a therapy used to:

a) Develop psycho–physiologic self–regulation.
b) Enhance drug delivery.
c) Increase release of serotonin.
d) Promote neuronal regeneration.

Yesterday’s Mind Teaser: 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.

Answer for yesterday’s Mind Teaser: Morning fatigue, widespread body pain, and focal tenderness.

Correct answers received from: DR ARPAN GANDHI, Dr Santhi Thiyagarajan, Dr. V.P. Thakral, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr.K.Raju, Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay, DR.BITAAN SEN & DR.JAYASHREE SEN, DR AVTAR KRISHAN, Deepali Chatterjee, Dr.K.V.Sarma, Dr Prakash Khalap,

Answer for 23rd September Mind Teaser: Immediate–release morphine (MS IR)

Correct answers received from: DR AVTAR KRISHAN, Deepali Chatterjee

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

Customer: I have a huge problem. A friend has placed a screen saver on my computer, but every time I move the mouse, it disappears.

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A foreigner with a single loose stool developed sepsis.
Reaction: Oh my God! Why were antibiotics not started in time?
Lesson: Make sure that all foreigners are diagnosed to be suffering from Traveler’s diarrhea even if there is one single loose motion.

medicolegal update

Happy is the man who can do only one thing; in doing it, he fulfills his destiny. Joseph Joubert

medicolegal update

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: No regrets and no anticipation, just this moment fresh and as is.

medicolegal update

Respected Sir

1. I recommend hanging to the said doctor for having raped a patient admitted to ICU. There is something wrong with our judicial system. The punishments are very mild. All such persons should be hanged.

2. You are wrong about lust of Yudhishthira for gambling. Even his wife and brothers never criticized or commented on his gambling. Please read Mahabharata again. There was a big thunderstorm and bad omens after Rajasuya yagna, suggesting a holocaust. Sage Narada told Yudhishthira that Yudhishthira is going to be responsible for this expected holocaust, due to his acts with Kauravas which will take place very soon. He had loudly declared that he would not refuse whatever Duryodhana or any of his brothers requested of him. Therefore, it was he who accepted the invitation of Duryodhana for gambling.

Yours Sincerely: Dr. KS Ananda Kumar

Forthcoming Events

29thSeptember–Dil Ka Darbar at Constitution Club of India,New Delhi

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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