eMedinewS26th December 2013, Thursday

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
www.twitter.com/DrKKAggarwal
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AF – the new epidemic of the society

The prevalence and incidence of atrial fibrillation (AF) is increasing globally. In total, 0.5% of the world’s population has AF and it has become the new global epidemic.

In a study, published online December 17, 2013 in the journal Circulation, Dr Sumeet Chugh at Cedars Sinai Medical Center, Los Angeles analyzed the numbers from the Global Burden of Disease database. The AF review included 184 studies, one–third of which were conducted in North America and another one-third in Western Europe.

  • In 1990, the estimated AF prevalence rate per 100 000 individuals was 569.5 in males and 359.9 in females; this increased to 596.2 in males and 373.1 in females in 2010.
  • In 1990, the overall incidence of AF per 100 000 individuals was 60.7 in males and 43.8 in females; by 2010, this incidence of AF increased to 77.5 in males and 59.5 in females.
  • Over the 20–year period, the age-adjusted mortality rate for AF increased twofold in men and women. By 2010, the age–adjusted mortality rate per 100 000 individuals was 1.6 and 1.7 for men and women, respectively.
  • Disability associated with AF also increased significantly from 1990 to 2010, with investigators observing an 18% increase in disability–adjusted life–years (DALYs) per 100 000 individuals.
  • In 1990, the estimated AF prevalence rate per 100 000 individuals was 569.5 in males and 359.9 in females; this increased to 596.2 in males and 373.1 in females in 2010.
  • In 1990, the overall incidence of AF per 100 000 individuals was 60.7 in males and 43.8 in females; by 2010, this incidence of AF increased to 77.5 in males and 59.5 in females.
  • Over the 20–year period, the age–adjusted mortality rate for AF increased twofold in men and women. By 2010, the age–adjusted mortality rate per 100 000 individuals was 1.6 and 1.7 for men and women, respectively.
  • Disability associated with AF also increased significantly from 1990 to 2010, with investigators observing an 18% increase in disability–adjusted life–years (DALYs) per 100 000 individuals.

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."

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

The very purpose of life is to face sufferings

sprritual blog

According to Hinduism, the very fact we are born means that in our last life, we did not get liberation or Moksha. It also means that some sufferings in our last birth still remained. Therefore, the purpose of this birth is to face those sufferings.

When the purpose of our life is to face sufferings, why suffer from them?

This should be considered as ‘sukh’ and not ‘dukh’. As per Vedic literature, every diversity is an opportunity to learn or to do something different. The four notable principles of Buddha also talk about the same. The first is that suffering exists, second that there is a reason for every suffering and third that it is possible to neutralize the suffering by understanding the 8 paths of cessation of suffering.

Also remember that in every ‘dukh’ you think of ‘sukh’ and in every ‘sukh’ you think of a ‘dukh’. Next time you have a problem, think differently and learn to enjoy them.

One of my industrialist friends was once ordered to go to Tihar Jail on Friday night. He tried his level best and wanted to get admitted in the hospital for the weekend so that he could get bail on Monday morning. I told him that whether he was in jail or in hospital, it would make no difference as far as his status was concerned. In both the situations, he would be listed as being in the jail on paper. So I told him to go to the jail and enjoy those 48 hours as a holiday. When he came back from the jail, he was a different person and learnt the principle of life which he otherwise could not have learnt.

cardiology news

Change yourself according to the environment

If you try to change the environment single–handedly, the chances are you will fail. Instead, change yourself to suit your environment. As you do this, even the environment, which has been unfriendly to you, will mysteriously change and seem congenial and harmonious.

News Around The Globe

News

  • The antitumor necrosis factor alpha (TNF–α) biological agents infliximab and adalimumab are effective treatments for severe ocular inflammatory diseases, according to recommendations from the American Uveitis Society published online December 18 in Ophthalmology.
  • The American College of Obstetricians and Gynecologists has updated its Practice Bulletin for treating vasomotor symptoms of menopause ("hot flushes") and vaginal atrophy. The 2014 Practice Bulletin published in the January 2014 issue of Obstetrics & Gynecology introduces new drug information, but there are no new risks or dangers.
  • The U.S. Preventive Services Task Force (USPSTF) recommends testing for mutations in the BRCA cancer susceptibility genes for women with a positive family history of breast or ovarian cancer.
  • Patients with diverticulitis had significantly elevated risks for irritable bowel syndrome (IBS) and mood disorders over time, potentially suggesting a new disease class ‘post–diverticulitis IBS’ as reported in the December issue of Clinical Gastroenterology and Hepatology.
  • Analysis of data from the Women’s Health Initiative reported online in Arthritis & Rheumatism has shown that postmenopausal women with rheumatoid arthritis (RA) who had highly RA-specific antibodies had twice the mortality rate of healthy women.

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Rabies News (Dr. A K Gupta)

Can a vaccinated dog transmit rabies? How effective is dog vaccine?

If a potent veterinary vaccine is given correctly as per pre–exposure schedule, it will mostly prevent rabies in the vaccinated dog, unless the exposure is severe. Ideally, its sera should be tested for protective antibody titre level but this is rarely practicable due to scare facilities in our country. Consequently, PEP vaccination is recommended following bites even by vaccinated dogs. It has been noted that:

(1) 6% of dogs found rabid have a reliable pre–exposure rabies vaccine history
(2) 40% of dogs’ vaccinated only one time lost most of their immunity 4–6 months later.
(3) Post Exposure Prophylaxis (PEP) vaccination is not very successful in dogs.

cardiology news

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

  • The American College of Cardiology (ACC) and American Heart Association (AHA), in collaboration with the Society for Cardiovascular Angiography and Interventions (SCAI), Physician Consortium for Performance Improvement, and National Committee for Quality Assurance (NCQA) have released 11 performance and quality metrics that should be recorded for patients undergoing PCI and are published December 23, 2013 in the Journal of the American College of Cardiology and Circulation. These include:
    • Documentation of the reasons for PCI.
    • Appropriate reason for elective PCI (safety vs benefit trade–offs).
    • Prior to PCI, evaluation of the patient’s ability to take dual antiplatelet therapy.
    • Use of embolic protection devices in the treatment of saphenous vein graft disease.
    • Renal function assessment prior to PCI and documentation of the amount of contrast used.
    • Documentation of the amount radiation used during the procedure.
    • Prescription of optimal medical therapy post–PCI.
    • Referral to an outpatient cardiac rehabilitation clinic.
    • Participation in a regional or national PCI registry.
    • Average annual volume of PCIs performed by physician in the last two years.
    • Average annual number of PCIs performed at the hospital in the last calendar year.
cardiology news

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

  • Data from a retrospective cohort study at four children’s hospitals and reported in the journal Pediatrics suggest that narrow–spectrum antibiotics are effective as empiric therapy for children hospitalized with community–acquired pneumonia (CAP), according to. The rate of narrow–spectrum use ranged from 18.6% to 88.3% among the 4 hospitals in the study, the researchers report Pediatrics December 9.
  • Vitamin B12 deficiency in adolescents may cause sympathetic nervous system baroreceptor dysfunction, leading to postural orthostatic tachycardia syndrome (POTS), according to a clinical study published online December 23 in Pediatrics.
cardiology news

Among patients with stable CAD and type 2 diabetes, measures of autonomic function––such as heart–rate recovery after exercise––may help predict the risk of short–term adverse cardiovascular events as per a study.

A second study reports that autonomic dysfunction is strongly linked with a greater risk of severe hypoglycemia in patients with type 2 diabetes.

The best way to avoid it is to have intensive glucose control with hemoglobin A1cs that are definitely below 7.5 and ideally below 7. On the other hand, if you have (HbA1c) levels above 8, certainly above 9, you have a very high likelihood of having the problem (within) 10 or more years.

The two studies were published online August 19, 2013 in Diabetes Care.
Test

  • The patients performed a test on an exercise bicycle, which allowed the researchers to determine their heart–rate recovery, defined as the drop in heart rate from the rate at maximal exercise to the rate one minute after stopping the exercise.
  • Blunted heart–rate recovery after exercise: defined as a drop in heart rate of less than 21 beats per minute––had a 1.69–fold greater risk having a cardiovascular event than their peers.
  • Holter: Blunted heart–rate turbulence (<3.4 ms/R–R interval) had a 2.08–fold increased risk of an event
  • Low heart–rate variability (<110 ms) had a 1.96–fold greater risk of having a cardiovascular event.
  • Heart–rate variability at three times: during a Valsalva maneuver, deep breathing, and going from lying down to standing.
cardiology news

Total CPR since 1st November 2012 – 83037 trained

Media advocacy through Web Media

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press release

Winter smoking may be dangerous

Winter smoking can precipitate heart attack, paralysis and acute rise in blood pressure, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President, Heart Care Foundation of India.

Smoking in winter can also increase the risk of erectile dysfunction in men. Men who smoke 20 cigarettes a day are 40% more likely to struggle with erectile dysfunction than men who do not smoke. Nicotine present in smoke can constrict the blood supply to the male organ.

As per a study published in the journal Tobacco Control in men aged 16–59 years, the risk of erectile dysfunction is almost double in smokers than in non smokers.

In winter blood pressure and diabetes may also be uncontrolled adding to the problem of erectile dysfunction.

Obese people and people who consume more alcohol are more at risk.

Depression is also common in winter adding to the agony.

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 83037 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

CPR 10 Utsav 15th December 2013

press release

Monitoring LFT in a patient on statins

vedio of day

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

An enzyme involved in the catabolism of fructose to pyruvate in the liver is:

1.Glyceraldehyde–3–phosphate dehydrogenase
2.Phosphoglucomutase
3.Lactate–dehydrogenase
4.Glucokinase

Yesterday’s Mind Teaser: Haemorrhage secondary to heparin administration can be best corrected by administration of:

1. Vitamin K.
2. Whole blood.
3. Protamine.
4. Ascorbic acid.

Answer for yesterday’s Mind Teaser: 2. Whole blood.

Correct answers received from: DR.A.K.GAJJAR, Dr.K.Raju, daivadheenam, Deepali Chatterjee, Dr Pankaj Agarwal

Answer for 23rd December Mind Teaser: 3. No surgery for gallbladder stones.

Correct answers received from: Dr Alok

Send your answer to ijcp12@gmail.com

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medicolegal update

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medical querymedical query

medicolegal update
medicolegal update

A woman customer called the Canon help desk with a problem with her printer.
Tech support: Are you running it under windows?
Customer: "No, my desk is next to the door, but that is a good point. The man sitting in the cubicle next to me is under a window, and his printer is working fine."

medicolegal update

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medicolegal updatemedicolegal update

medicolegal update

Situation: Doctor, this patient has developed acute renal failure (ARF).
Reaction: Oh my God, I forgot that he was on furosemide. I gave him full dose of amikacin.
Lesson: Make sure, before calculating the dose of aminoglycoside (amikacin) that furosemide and other loop diuretics, which enhance its nephrotoxicity are not being given.

medicolegal update

Many people love in themselves what they hate in others. E. F. Schumacher

medicolegal update

Dr KK Aggarwal: High BP in Pregnancy Increases Risk for Future Atherosclerosis http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Awareness exists at the core of all material objects from atoms to galaxies #CosmicConsciousness

medicolegal update
  • Dear KK, congratulations. A very good and informative launch. Suneela Garg.
  • Dr Sahib, we all, the group members of Archana Yogayatan, Naturopathy Centre, welcome and appreciate your great efforts to take such initiatives in public interest. Regards: Dr S N Yadav, Archana Yogayatan.
  • Dear Dr. KK Aggarwal, I wish to congratulate you for presenting a very informative programme on Stroke in the channel Zee News. Please arrange such programmes for public and family physicians in future also. Dr. A K Srivastava, Krishna Puram, Kanpur – 208007.

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