eMedinewS 26th August 2013, Monday

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; 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

Low–heat cooking may reduce insulin resistance

Traditional Ayurveda cooking has been recommending low heat cooking and now a western study endorses it.

Low–temperature cooking reduces insulin resistance among overweight women as per a 4–week study published online August 19 in Diabetes Care by Alicja B. Mark, PhD, from the department of nutrition, exercise and sports, faculty of science, University of Copenhagen, Denmark, and colleagues.

Cooking at high temperature — such as with baking, roasting and frying — induces formation of advanced glycation end products (AGEs), which are associated with inflammation and believed to impair glucose metabolism in patients with type 2 diabetes. Common high–AGE foods include bakery products, cooked meat, and roasted coffee.

In the study patients randomized to a high–AGE diet were instructed to fry, bake, roast, or grill their food; eat bread with the crust; and choose other high–AGE foods from a list. The low–AGE group was told to boil or steam their food, eat bread without the crust, and choose lower–AGE foods from a list. They were also randomized to supplements of either fructose or glucose.

At 4 weeks, no effect was seen from the fructose or glucose on insulin resistance, as assessed by the homeostasis model assessment of insulin resistance (HOMA–IR) and the calculated insulin sensitivity index (ISI) or on any secondary measures. But the AGE content of the diet did make a difference. Weight, BMI, and waist circumference all decreased in both the high– and low–AGE groups, but to a greater degree among those in the low–AGE group compared with the high–AGE group. Overall, the low–AGE group consumed about 15% more protein, 10% more carbohydrates, and 22% less fat than did the high–AGE group. ….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 10x10 i.e. 100 per minute."

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

Ringtone – CPR 10 Mantra English

sprritual blog Prayer for inner happiness

Stress is defined as the physical and mental reaction to the interpretation of a known situation. In absence of a known situation, there cannot be a stress. One cannot be stressed about a person who has just died in New York in an accident unless he or she is a known person.

There has to be a right, conscious–based interpretation of the situation as the same situation can bring happiness to one and stress to the other.

The most important consequences of stress, physical or mental, therefore, depend on the right interpretation of the situation.

The interpretation or judgment in the body is governed by chemical reactions and is controlled by the balance of autonomic balance system which in turn is governed by the interaction of parasympathetic and sympathetic nervous system.

During the phase of acute stress when the sympathetic system is predominant, heart rate and blood pressure rises and a person cannot take correct and decisive decision. He or she is likely to make mistakes which can often be detrimental to ones living. Sympathetic mode is basically the mode of flight or fight reactions of the body.

Correct conscious–based decisions can only be taken in a state of relaxed mind when the intention is inserted in the field of consciousness. The relaxed mind state of the body is the parasympathetic mode, which is healing and is evident by reduction in heart rate, blood pressure and increase in the skin resistance.

Most conscious–based decisions will be based on truthfulness, will be necessary and will bring happiness to both the persons and the surroundings.

The yogic lifestyle by which a person learns the dos and don’ts of living, does regular practice of correct postures, indulges in daily pranayama and practices regular withdrawal from the outer atmosphere, helps in preparing a state of physical and mental body state which is more receptive for conscious based decisions. Yoga Sutras of Patanajli included them in ashtanga yoga as the processes of Yama, Niyama, Asanas, Pranayama and Pratyahara Prayers have no value when the mind is not at rest. All of us have participated in hundreds of mourning prayers, each lasting for two minutes of silence. This prayer has no value if the two minutes of silence is not observed. If prayer is done without it the mind will remain restless and we will keep on thinking these two minutes are not over yet. The process of silence does shift our awareness towards test and parasympathetic state and temporarily we get to be in contact with the memories of the departed soul and we pay homage to him or her.

Today a large number of organizations are teaching the process of meditation but the same cannot be taught unless a person practices procedures by which the mind gets relaxed.

The eight limbs of Patanjali focus in detail about pre–meditation preparations and once that is learned one can go to the other three limbs which are dharna, dhyana and samadhi.

Yoga asanas are different from exercises. They stimulate and stretch all or one of the seven charkas, autonomic plexuses, and ganglion and there located ductless endocrine glands. Also during a yogasana the mind is in the exercise and not wondering here and there.

While yogic exercises at rest are termed yoga asanas and the same yogic meditative exercises with activity are called traditional Indian dances. Western exercises and dances do not follow the principles of yoga.

Many international studies have shown that over one-third of the people during their lifetime pray either for their own illness or for somebody else. All hospitals should have spirituals areas. The prayer and meditation rooms in a hospital setting invariably will provide an arena which will improve patient-doctor relationship and will reduce the rising disputes amongst them in the country. ….Read More

cardiology news

Don’t Be Afraid

Here we are, afraid of losing what we have all the time, holding on to it so tight that not a soul can touch it. We think by hiding it from the world, it’s hidden and it’s ours. Nothing is. Nothing ever will be. For, nothing ever was.

If you think there is anything that you have, that’s yours, be it money, a house, a job, or a girlfriend… it’s nothing but an illusion. It’ll all disappear… in one blow. One blow, my man.

Here we are, so insecure that we are afraid of re–starting our lives, so we just carry on trying to sort out the current mess. The thought that we should give it all up and just start all over – with nothing – might cross our minds some time, sure, but we get scared and we push away anything that scares us.

There is nothing I can ever achieve or gain that I cannot lose, in a matter of seconds. You have never gained enough to not be able to lose it all, in just a few minutes. What you think is yours, was never yours and will never be yours. Whatever you make here, you leave here. You came naked and you’re going to go back naked. So what are you afraid of?

Let all be lost. Let them take away everything. As long as you have your heart beating strong, as long as you have your nostrils working fine, as long as the blood flows in your veins, you will live, you will breathe and you can get it all back… again and again. For, if you can do it once, you can damn well do it again. It’s just a game we play – Life.

...Read More

News Around The Globe

  • Tobacco–related cancers constitute for 40.2% cancer in men and 11.8% in women among all cancers in 2009 in Delhi, says a report published by cancer department at the All India Institute of Medical Sciences and as reported in TOI dated August 21, 2013. Among the tobacco related cancer sites in New Delhi, cancer of lung was the most common (23.3%) followed by cancer of tongue (16.9%) and mouth (14.6%). Interestingly in females, cancer of lung accounted for 26.0% followed by mouth (17.8%) and esophagus (17.7%). As per the report, in 2008, tobacco related cancers constituted for 39.2% of all cancers in men and 11.5% of all cancers in women. The number of tobacco related cancers has gone up significantly since 2006–07 cancer registries due to excessive chewing of tobacco and ‘paan masala’
  • Markers of systemic oxidative stress correlate with the development and worsening of diabetic retinopathy among patients with longstanding, inadequately controlled type 2 diabetes. Alejandra Guillermina Miranda–Diaz, MD, PhD, of the University of Guadalajara in Mexico, and colleagues report online in the Journal of Diabetes that the mean levels of products of lipid peroxidation such as malondialdehyde and 4–hydroxyalkenals were 1.42 µmol/L in patients with mild diabetic retinopathy compared with 0.98 µmol/L in healthy controls. And in those with moderate and severe retinal involvement, levels increased to 2.49 µmol/L and 3.29 μmol/L (P<0.017), respectively, the researchers.
  • Regular exercise improved cardiac functioning in patients with chronic kidney disease in the largest CKD intervention study to date reported in the September issue of the Clinical Journal of the American Society of Nephrology. Patients who engaged in a closely supervised exercise program for 12 months had an 11% increase in their maximal aerobic capacity vs 1% decrease among patients who were not in the exercise intervention group. The exercise intervention group also lost a modest amount of weight (–1.8±4.2 kg vs 0.7±3.7 kg).
  • In a study reported by Robert J. Motzer, MD, of Memorial Sloan–Kettering Cancer Center in New York City, and co-authors in the Aug. 22 issue of the New England Journal of Medicine, patients treated with pazopanib (Votrient) had a median progression–free survival (PFS) of 8.4 months, whereas treatment with sunitinib (Sutent) led to a median PFS of 9.5 months. These results show that these two drugs are comparable as first–line therapy for metastatic renal–cell carcinoma.
  • About 20% of neurologists are not aware of major established safety risks associated with antiepileptic drugs (AEDs), such as the risk for birth defects and suicidal thoughts, despite being exposed to multiple sources of information, according to results of a new survey. The survey findings were published in the October issue of Epilepsy & Behavior.
  • The obesity epidemic can’t be successfully fought through debates about the "ideal" diet, but by helping patients choose one and stick to it, according to Sherry Pagoto, PhD, of the University of Massachusetts Medical School in Worcester, and Bradley Appelhans, PhD, of Rush University Medical Center in Chicago. They found in their study that adherence was most strongly associated with weight loss and improvement in disease–related outcomes

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Rabies News (Dr. A K Gupta)

A person started with PVRV wants to change over to HDCV or PCECV or PDEV or vice versa. What should be done?

The currently available TCVs such as HDCV, PCECV, PVRV, and PDEV, are all equally good and approved by WHO. All are interchangeable following non availability of one brand or due to allergy to one of the CCVs or PDEV. All are considered protective against different strains of rabies viruses in different parts of the world.

cardiology news
  • A review of more than a million stroke cases has found that stroke patients eligible for thrombolytic therapy have significantly better odds of receiving the therapy than they did a few years ago. More than three–fourths of patients who arrived at a hospital within 2 hours of symptom onset received intravenous tissue plasminogen activator (tPA). The study is reported in the journal Circulation Cardiovascular Quality Outcomes.
  • A study published online August 13 in the journal Diabetes Care has reported that following a Mediterranean diet (MedDiet) may not only reduce fasting glucose concentrations and lipid levels in patients who are genetically at increased risk for type 2 diabetes but may also lower their risk for stroke. Polymorphisms of the transcription factor 7–like 2 (TCF7L2) gene are strongly associated with type 2 diabetes, as well as, in some studies, plasma lipids and cardiovascular disease. In this study, being on the Mediterranean diet reduced the number of strokes in people with 2 copies of the variant

Valvular Heart Disease News

In patients with mitral annular calcification (MAC) aged ≥62, 6 percent have mitral obstruction.

(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
  • A small brain imaging study showed that children between the ages of 7 and 12 years with ASD had significantly superior numerical problem–solving abilities, including the use of more sophisticated strategies to figure out single–digit addition questions, than their age–, sex–, and IQ-matched healthy peers. Participants with ASD showed different activation patterns in the ventral temporal-occipital cortex (VTOC), the posterior parietal cortex, and the medial temporal lobe during mathematical problem solving — with activation patterns in the VTOC region actually predicting these superior abilities. According to the researchers, a unique pattern of brain organization may explain why children with autism spectrum disorder (ASD) often possess superior math skills.
  • Antipsychotic medications were linked to type 2 diabetes in children and young adults, particularly with longer use at higher doses in a study reported online in JAMA Psychiatry. Diabetes risk was elevated 3.03–fold overall after going on antipsychotic drugs, with hazard ratios rising from 2.13 to 5.43 at progressively higher cumulative doses.
cardiology news

Fluctuating blood pressure more harmful

Further fluctuations and spikes in blood pressure readings in the elderly hypertensive persons can affect their ability to think clearly and other cognitive functions.

As per a North Carolina State University study, people whose systolic blood pressure is 130 mm Hg or above, the cognitive functions get impaired on days when their blood pressure spikes and fluctuates. On the other hand, in people with normal blood pressure the cognitive functions do not get impaired if their blood pressure spikes or fluctuates.

The carry home message is that if you have blood pressure that wildly fluctuates and you also have underlying high blood pressure, you might be in double trouble for poor cognitive functioning.

Several studies in the past have found a link between high blood pressure and dementia, which is marked by a loss of memory and other cognitive abilities, including the ability to speak, identify objects or think abstractly. Another study found that treating high blood pressure in the very elderly may help reduce their risk of developing dementia.

cardiology news

Bruises ulcers do not necessarily indicate elderly neglect but may occur more rapidly if the standard of care for prevention is not adhered to in a patient at risk is willful failure to follow the standard of care is an abuse.

cardiology news

CPR Classes: Persons trained (1200)

21st August: CPR 10 at Ramjas School, R K Puram – 1200

Total CPR since 1st November 2012 – 62966 trained

14th August: CPR 10 at Modern School, Noida (2000)

CPR Classes 62966

Media advocacy through Print Media

sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping

Media advocacy through Web Media

Sudden Cardiac Death 24th August


Delivering a lecture at Shanmukhananda Hall, Sion East, near Gandhi Market, Mumbai organized by Indian Institute of Excellence and Consultancy, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India, said that stress is the reaction of the body and the mind to the interpretation of a known situation. Stress management, therefore, involves either changing the situation, changing one’s interpretation or preparing the body and the mind with a yogic lifestyle in such a way that stress does not bother you.

Dr. Aggarwal said that Indian traditional rituals were made to remain physically and mentally healthy and to acquire leadership qualities.

  • The ritual of Santoshi Mata Ka Vrat probably was made to eat Gur and Chana in a week so that women of childbearing age did not end up with iron deficiency anemia.
  • The ritual of devoting one month in a year to holy sun bath was probably intended to acquire full one–year quota of Vitamin D from early morning or late evening sunlight.
  • The ritual of fasting 80 days a year (weekly fast + one extra fast in a month + 2 Navratras of 9 days each) was probably meant to reduce the incidence of heart disease, diabetes and paralysis. These fasts prohibited intake of carbohydrates, which today have been identified as a major culprit for developing insulin resistance and ultimately heart blockages.

When we chant a vowel sound, interleukin–2 is produced in our body. It is a painkiller, which is 100 times stronger than aspirin. When we chant nasal consonants during aspiration through the nose, delta activity is produced in the EEG. It is the same delta activity seen after one takes a tranquilizer. Chanting of a vowel sound and a nasal consonant together, therefore, produce both physical and mental relaxation. Explaining further, Dr. Aggarwal said that ‘Aum’ traditionally is a Vedic chant with a combination of vowel and consonant and, therefore, produces physical and mental relaxation which no single drug in the available pharmaceutical armamentarium today can do.

To acquire leadership qualities, one needs to learn the principles of creativity, organizational capabilities and the quality of winding up with a success. Dr Aggarwal narrated the examples of Brahma, Vishnu and Mahesh as Creator, Organiser and Destroyer. He said that instead of worshipping them, we should acquire their qualities and try to become like them. Leadership qualities should be learned from the 10 incarnations (Dashavatar) of Lord Vishnu. Each avatar of Vishnu has one quality for us to adopt.

  • Be like a fish, the Matsyavatar, which means learn to be different like a fish, which can swim against the current of the ocean.
  • Acquire the quality of a tortoise, Kurma Avatar, the second incarnation of Lord Vishnu, which means learn to withdraw when required.
  • Acquire the quality of Boar (Varaha), the third avatar, which means be persistent in your action.

The first three incarnations basically can be interpreted as to think differently and if the need arises, to withdraw but to persist after you get an opportunity again.

  • Acquire qualities of Narasimha, the fourth incarnation, which means to understand that nothing is impossible.
  • Acquire the qualities of the 5th incarnation, the Vamana, which means that one needs to learn all the tactics of Saam, Daam, Dand, Bhed to make the impossible possible.
  • Acquire the quality of Parshuram, the 6th incarnation, to be honest in life and fight against corruption.
  • Acquire qualities of Rama, the 7th Avatar so that you can lead the community.
  • Learn Raajneeti to lead the community from Krishna, the 8th incarnation.
  • Learn the qualities of Buddha, the 9th incarnation, to devote oneself for the welfare of the society.
  • The 10th Avatar – Kalki is yet to come.

Death is reversible in the first 10 minutes. Quoting from the Chandok Upanishad, Dr. Aggarwal said that death is a process where motor and sense organs merge with Pran Vayu and Udaan Vayu, which merges with Tej, which ultimately leave the body to merge with the Sata in the universe. He said that consciousness does not leave the body for up to 10 minutes after the heart has stopped. During this period, if the heart can be revived, it is possible to revive the dead person.

Dr. Aggarwal said that Savitri saving Satyavan in ancient times was the origin of cardiopulmonary resuscitation or CPR. He narrated the Savitri CPR 10 Mantra which is – "within ten minutes of sudden death (earlier the better) for the next ten minutes (longer the better) compress the centre of the chest of the victim with a speed of 10x10 i.e. 100 per minute". In Hindi, it can be remembered as – "Marne ke das minute ke bheetar (jitna jaldi ho achha), agle das minute tak (jitni der tak ho utna achha), apni chhati peetne ke badle mare hue aadmi ki chhati peeto."

Dr. Aggarwal said that at normal body temperature, it is possible to revive a body within 60 minutes of death but if the body temperature is low, it is possible to revive a clinically dead patient even after hours of death due to stoppage of the heart.

He narrated the principles of non–violent communication to be followed on every Monday, finishing your pending work and knowing the unknown on Tuesday, giving non–materialistic gifts to everybody you meet on Wednesday, thinking differently on Thursday, taking care of your food and other sensory inputs on Friday and do charity on Saturday with little bit of cheating on Sunday.

Dr. Aggarwal also said that it is possible to live up to the age of 80. He narrated his ‘Assi Ka Funda’, which is "Walk 80 minutes a day with a speed of 80 steps per minute; keep your lower blood pressure, bad cholesterol, waist line all under 80; do not drink alcohol but if you drink, do not drink more than 80 ml a day or 80 gm a week; do not smoke because if you smoke you will end up in paying a hospital bill of 80000."

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 62966 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 CPR 10 Training Camp was organized by Heart Care Foundation of India to trained the students of Ramjas School, R K Puram

press release

No Blood Tests for TB

today video of the dayDr KK Aggarwal on Costly Treatment

Dr KK Aggarwal on Sleeping Disorder

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

Nurse Wayne is aware that which finding would be least suggestive of necrotizing enterocolitis (NEC) in an infant?

a. Hepatomegaly
b. Distended abdomen
c. Gastric retention
d. Blood in the stool

Yesterday’s Mind Teaser: When developing a postoperative plan of care for an infant scheduled for cleft lip repair, Nurse Elaine should assign highest priority to which intervention?

a. Comforting the child as quickly as possible
b. Maintaining the child in a prone position
c. Restraining the child’s arms at all times, using elbow restraints
d. Avoiding disturbing any crusts that form on the suture line

Answer for yesterday’s Mind Teaser: a. Comforting the child as quickly as possible

Correct answers received from: Dr. V.P. Thakral, Dr Monica Gandhi, Dr kanta jain, Dr Jainendra Upadhyay, Raju Kuppusamy, Dr. Chandresh Jardosh,DR AVTAR KRISHAN, daivadheenam, dr. deepali chatterjee, Dr. P. C. Das

Answer for 24th August Mind Teaser: a. A sunken fontanel

Correct answers received from:Dr. P. C. Das

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/16wknsh #Health

Dr Deepak Chopra: How to Handle Difficult People | LinkedIn http://tinyurl.com/kqlhghj

medicolegal update

Dear sir, Thanks for the updates. Regards: Dr Tushar

Forthcoming Events

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