eMedinewS26th February 2014, Wednesday

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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Stress may increase smoking habits

Stress increases the risk of heart attack by pushing people toward bad habits.

A British study published in the Journal of the American College of Cardiology suggests that people with psychological stress had a 50 percent increased risk of a cardiovascular disease event over the follow–up period.

The reasons were higher smoking rates and low exercise levels of individuals who were stressed.

In the study over a seven year follow–up period, incidence of cardiovascular events –– heart attacks, stroke, bypass surgery and the like –– was 50 percent higher among the people with a high level of depression and anxiety when compared to happier people. Smoking and lack of physical activity explained about 63 percent of the increase, with smoking alone responsible for 41 percent.

Alcohol intake explained less than 2 percent of the increase, with high blood pressure assigned 13 percent of the blame.

All such patients should be treated with combined physiological approaches with intensive lifestyle changes to reduce modifiable risk

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."

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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

Should doctors detach themselves?

sprritual blog

In dealing with patients the traditional Patient–Doctor relationship model has been that doctor should remain cool, calm and collected at all times.

Doctor’s approach needs to be strictly scientific, logical, objective, methodical precise and dispassionate. This model has been since the era of William Osler, the father of modern medicine. The term used is imperturbability which means coolness and presence of mind under all circumstances.

Osler said a rare and precious gift to doctor is right of detachment. The right of detachment insulates the doctors and protects them from the powerful emotions that patients display in their presence like anger, frustration, grief, rage and bewilderment. It also insulates patients from the rolling emotions that doctors may at times feel towards them.

However, a detached attitude also insulates doctors from empathizing with patients. A detached doctor may talk in a language that is over patient’s head.

Detachment is not like a light switch that you can turn on and off to suit the situation. Detachment as a practice cannot be in isolation if it becomes your personal style of distracting from the world, it may not be just for the patients but also from your colleague, family friends and even yourself.

I recall when I joined by hospital the first lesson given to me by my boss was not to get unduly attached with patients. As etiquette, we were taught not to socialize with patients. Even today the new American Guidelines talk that doctors should not socialize with their patients on social media including Facebook. Even doctors are human beings and their personal life should not be known to the patients. As far as law suits are concerned, it is equally true that known close patient’s file a law suit much more than unknown people because over a period of time they know your weakness. One should learn to empathize with the patients and yet be detached from its results. Doctors who follow Bhagwat Geeta understand this concept very well.

cardiology news

Last week I took my children to a restaurant. My six–year–old son asked if he could say grace.

As we bowed our heads he said, "God is good. God is great. Thank you for the food, and I would even thank you more if Mom gets us ice cream for dessert. And Liberty and justice for all! Amen!"

Along with the laughter from the other customers nearby I heard a woman remark, "That’s what’s wrong with this country. Kids today don’t even know how to pray. Asking God for ice–cream! Why, I never!"

Hearing this, my son burst into tears and asked me, "Did I do it wrong? Is God mad at me?"

As I held him and assured him that he had done a terrific job and God was certainly not mad at him, an elderly gentleman approached the table. He winked at my son and said,
"I happen to know that God thought that was a great prayer."
"Really?" my son asked.
"Cross my heart," the man replied.

Then in a theatrical whisper he added (indicating the woman whose remark had started this whole thing), "Too bad she never asks God for ice cream. A little ice cream is good for the soul sometimes."

Naturally, I bought my kids ice cream at the end of the meal. My son stared at his for a moment and then did something I will remember the rest of my life. He picked up his sundae and without a word, walked over and placed it in front of the woman. With a big smile he told her,
"Here, this is for you. Ice cream is good for the soul sometimes; and my soul is good already."

News Around The Globe

  • Lower urinary concentrations of lignan metabolites are associated with a higher risk for type 2 diabetes, new prospective data from the Nurses’ Health Study (NHS) suggest. Lignans are plant–synthesized chemicals commonly found in fiber–containing foods. Results from the study, believed to be the first to prospectively examine urinary concentrations of lignan metabolites in relation to type 2 diabetes risk, were published online February 18 in Diabetes Care.
  • In its latest report, the US Preventive Services Task Force (USPSTF) has concluded that there is insufficient evidence to determine whether vitamins help prevent either of these diseases. However, the USPSTF does recommend against supplementing with either beta–carotene or vitamin E (grade D recommendation). The evidence shows that there is no benefit to taking vitamin E, and that beta–carotene can increase the risk for lung cancer in some populations. The report, published in the February 25 issue of the Annals of Internal Medicine, is an update of the 2003 recommendations.
  • People plagued by chronic urticaria (hives) may benefit from high–dose daily vitamin D supplements. A new study in Annals of Allergy, Asthma & Immunology suggests that add–on therapy with 4,000 International Units (IUs) of vitamin D3 per day could be considered safe and potentially beneficial in patients with chronic hives, the authors reported online February 7 in.
  • A study involving almost 6,000 women showed in the Journal of Clinical Oncology that carriers of BRCA 1/2 mutations had an 80% lower risk of ovarian cancer if they underwent bilateral oophorectomy,. Of 186 ovarian, fallopian, and peritoneal cancers diagnosed during follow-up, 108 (4.8%) occurred in women who did not undergo oophorectomy, 23 (1.1%) in women who had oophorectomy at enrollment, and 55 (4%) in women who underwent oophorectomy after enrollment. Oophorectomy also was associated with a 77% reduction in the hazard for all–cause mortality, owing primarily to the effect on ovarian and breast cancer risk.
  • Thyroid tumors that develop following an earlier malignancy are more deadly for young people than primary thyroid tumors, researchers reported. As reported in Cancer, in an analysis from a national database, adolescents and young adults (up to age 39) had nearly a seven–fold increased mortality risk with secondary thyroid cancers compared with primary tumors (OR 6.63, 95% CI 4.97 to 8.86, P<0.001).

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)

If a person is on antimalarials or steroids or taking immunosuppressant drug, what is the schedule for rabies vaccine?

The vaccine on Day 0 (first injection) must be doubled and given at two sites (deltoids or thigh in young children). In category II exposures, it is recommended to administer even RIGs along with vaccine. Rest of the schedule is same as for any other patient.

cardiology news

Honey excellent for Cough

A spoonful of honey can quieten children’s’ night time cough and help them — and their parents — sleep better.

When compared to the cough syrup ingredient dextromethorphan or no treatment, honey came out on top. As per a study from Archives of Paediatrics and Adolescent Medicine, the results are so strong that one is able to say that honey is better than no treatment and dextromethorphan was not. There is currently no proven effective treatment for cough due to an upper respiratory infection like the common cold. While dextromethorphan is widely used, there is no evidence that it works, and it carries risks.

Honey is used around the world as a home remedy for cough, and might provide a safe, effective alternative to cough medicine. To investigate, the researchers compared buckwheat honey, a honey–flavoured dextromethorphan preparation, and no treatment in 105 children who had sought treatment for night time coughs due to colds. Among the three groups, children given honey had the greatest reduction in cough frequency and severity, and the most improved sleep, as did their parents. Its sweet, syrupy quality may be soothing to the throat, while its high antioxidant content could also be a factor. Honey also has antimicrobial effects. Honey is not recommended for infants younger below one year of age because of the risk of botulism spores.

cardiology news

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

  • In a meta–analysis including about 4900 patients, programming implantable cardioverter defibrillators (ICDs) to delay the time they take to treat ventricular arrhythmias i.e. with prolonged detection times—cut mortality by 23% and inappropriate shocks by more than one–half. The included studies were prospective and multicenter and covered both primary and secondary prevention and patients with either ischemic or nonischemic cardiomyopathy. The risk of syncope didn’t go up significantly with longer detection times, despite traditional concerns that lots of patients wouldn’t tolerate prolonged arrhythmia exposure before their ICD is allowed to deliver therapy—either shocks or antitachycardia pacing. According to the authors, their results highlight the importance of setting longer default ICD detection times
  • Primary care physicians may be dropping the ball on getting young adults with hypertension the medication they need to control their blood pressure, a retrospective study in the Journal of General Internal Medicine showed. The rate of starting antihypertensive medications or achieving blood pressure control without drugs was relatively low across age groups, but it was worst in those ages 18 to 39 at just 34%. That compared with 44% of those ages 40 to 59 and 56% of those 60 and older.
cardiology news

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

  • Prenatal exposure to acetaminophen — a drug considered safe in pregnancy — may raise the risk for behavioral problems in children, including attention–deficit/hyperactivity disorder (ADHD) and hyperkinetic disorder (HKD), a severe form of ADHD. The study was published online February 24 in JAMA Pediatrics.
  • Because more than half of the medications approved for marketing by the US Food and Drug Administration (FDA) lack evidence of safe and effective use in pediatric patients, the practice of medicine will "more than likely" require that practitioners prescribe medicines off–label to appropriately treat pediatric patients, according to the American Academy of Pediatrics (AAP). The group published an updated policy statement on the topic online February 24 in Pediatrics.
cardiology news

Total CPR since 1st November 2012 – 86664 trained

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Over 50 focus only on upper blood pressure

For patients over 50, doctors only need to monitor the upper systolic blood pressure, and can ignore lower diastolic blood pressure reading 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.

Systolic blood pressure – the top number in a reading – is the pressure exerted at the beginning of the heart’s pumping cycle, while diastolic pressure records the lowest pressure during the resting cycle of the heart. Both pressures are routinely measured when taking blood pressure.

As per a report published in the journal The Lancet, there is such an emphasis on diastolic pressure, that the patients are not getting their systolic blood pressures adequately controlled. The fact is that people over the age of 50 probably do not even need to measure diastolic – it’s only the systolic blood pressure that should be the focus.

Generally, systolic blood pressure continues to increase with age, while diastolic pressure starts to drop after age 50, which is the same time when cardiovascular risk begins to rise. Therefore, there is an increased prevalence of systolic hypertension past age 50, whereas diastolic hypertension is practically nonexistent. Rising systolic pressure is the most significant factor in causing stroke and heart disease.

For people under 50, the scenario may be different. About 40 percent of adults under 40 years of age have diastolic hypertension, and about a third of those between 40 and 50 have the problem. For these patients, a continued emphasis on both systolic and diastolic blood pressures is needed. However, controlling systolic blood pressure, even among these younger patients, almost always results in adequate control of diastolic blood pressure, too.

For people 50 or older, systolic pressure is high if it is 140 mmHg or above.

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."

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Mega heart checkup camp by Heart Care Foundation of India at Sagar, Madhya Pradesh 20th–23rd February 2014

press release

FDA OKs first drug–eluting stents for use in MI

vedio of day

today video of the dayPadma Shri & Dr B C Roy National Awardee,Dr KK Aggarwal on Tackling tension headaches

Hands only CPR 10 Utsav, 15th December 2013

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

eMedi Quiz

The extent to which ionisation of a drug takes place is dependent upon pKa of the drug and the pH of the solution in which the drug is dissolved. which of the following statements is not correct.

1.pKa of a drug is the pH at which the drug is 50% ionized.
2.Small changes of pH near the pKa of a weak acidic drug will not affect its degree of ionisation.
3.Knowledge of pKa of a drug is useful in predicting its behaviour in various body fluids.
4.Phenobarbitone with a pKa of 7.2 is largely ionized at acid pH and will be about 40% non–ionised in plasma.

Yesterday’s Mind Teaser: All of the following conditions may predispose to pulmonary embolism except:

1. protein S deficiency.
2. Malignancy.
3. Obesity.
4. Progesterone therapy.

Answer for yesterday’s Mind Teaser: 4. Progesterone therapy.

Correct answers received from: Dr PC Das, Dr SUSHMA Chawla, Arvind Gajjar, Dr Vishal D Wahane, Dr KP Chandra, Dr Jainendra Upadhyay, Sangeetha Raja, Dr Chandresh Jardosh,
Dr Avtar Krishan, Dr Asha Anand, Muthumperumal Thirumalpillai, Dr BK Agarwal, Arvind Gajjar.

Answer for 24th February Mind Teaser: 1. Criterion validity.

Correct answers received from: Dr PC Das, Dr KP Chandra, Dr Asha Anand, Muthumperumal Thirumalpillai.

Send your answer to ijcp12@gmail.com

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medicolegal update

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medicolegal update

Scientists Competition!

Once there was a competition conducted with Scientists from America, France and China.

The Americans reported: "We crossed chickens with cows. And now the new breed simultaneously produces milk, meat and eggs."

On this, Scientists from France came with the report: "We crossed flies and bees. Now, the hybrid flies over the trash fields and produces honey."

Chinese gave others run for their money.

They said: "We crossed a melon with cockroaches. And now when you cut this melon, seeds run away by themselves…"

medicolegal update

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medicolegal updatemedicolegal update

medicolegal update

Situation: A rape victim became pregnant.
Reaction: Oh my God! Why was emergency contraceptive not given to her?
Lesson: Make sure that all victims of rape are given an emergency contraceptive.

medicolegal update

Do not follow where the path my lead. Go instead where there is no path and leave a trail.
George Bernard Shaw

medicolegal update

Dr KK Aggarwal: Dr K K Aggarwal: Relaxation during work http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Are we alone in the universe? Take a quick trip through the cosmos as I explore this eternal question.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

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  1. Dear Sir, Thanks for the nice updates: Regards: Dr Karan

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