eMedinewS26th August 2014, Tuesday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, 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, www.facebook.com/Dr KKAggarwal

All about tea

When we speak of tea, it is commonly assumed to be black tea with milk and sugar. However, the word ‘Tea’ means any herb. This means even hot Tulsi water is Tulsi tea or hot mint water is Mint tea. Herbs which can be converted into tea are jasmine tea, lemon tea, lemon grass tea, masala tea, sounf tea etc.

When the decoction of the leaves and the water is reduced to 50% on boiling, it is called Kadha. Black tea without milk and sugar is much healthier than black tea with milk and sugar. Classical tea without sugar and milk has an astringent taste. But according to Ayurveda, this is good for health as it reduces Kapha imbalance. When sugar and milk is added, both of which have sweet taste, they neutralize the weight reducing and kapha–relieving properties of the black tea. Therefore, milk or sugar should not be added to tea. For the purpose of taste, one can add Gur or jaggery or artificial plant sweetener Stevia.

Black tea is also a mild diuretic and increases urination as it contains caffeine, which is also a stimulant and that is the reason why tea is used to remain awake. In this regard, coffee is stronger than tea. When taken in moderation, black tea is good for the heart and overall health. If one has to choose amongst various teas then jasmine, lemon and lemongrass teas are better than others.

In Ayurveda, there are different teas for different personalities. Therefore, you can get Vata–pacifying tea, pitta–pacifying tea and kapha–pacifying tea.

Innovations in Cardiology (IIC) Summit 2014

Aspirin and noncardiovascular surgery

(Dr Rajneesh Kapoor)

For patients taking aspirin for primary or secondary prevention of cardiovascular disease based on POISE–2, the current recommendation is to discontinue aspirin about seven days before noncardiovascular surgery. In

this trial, 10,010 patients scheduled for noncardiac surgery, with or at risk of atherosclerotic disease, were randomly assigned to either aspirin or placebo. The primary outcome of death or nonfatal heart attacks at 30 days was similar in both groups as well as between those who were taking long–term aspirin and those who were not. However, major bleeding was more common in the aspirin group.

News Around The Globe

  • Scientists from the University of Manchester have discovered that insulin can protect the cells of the pancreas from acute pancreatitis. The findings are published in the Journal of Biological Chemistry.
  • A study published in the FASEB Journal has provided evidence that juvenile–onset or type–1 diabetes and type-2 diabetes are both caused by the formation of toxic clumps of a hormone called amylin. This suggests that both major forms of diabetes are the result of the same mechanism.
  • Histone deacetylase (HDAC) inhibitors are effective in "flushing out" HIV from latently infected cells, potentially exposing the reservoirs available for elimination by cytotoxic T lymphocytes (CTL), also called killer T cells. However, a report published in PLOS Pathogens has suggested that treatment with HDAC inhibitors might suppress CTL activity and therefore compromise the "kill" part of the "flush–and–kill" HIV eradication strategy.
  • A new study published in the Journal of Parkinson’s Disease has stated that depression, despite being a common symptom of Parkinson’s disease, remains untreated for many patients.
  • A comprehensive study conducted in people aged 40 to 79 years with diabetes found no evidence supporting the common belief that patients receiving intensive blood pressure treatment are prone to falling and breaking bones. The study is published in the Journal of General Internal Medicine.

Rabies News (Dr A K Gupta)

Do rat bite cases require rabies vaccination?

In India most rodents, rats, squirrel, rabbits, birds and bats have been found to be free of rabies. However, following exposure to mongoose, PEP is recommended. Rat bite cases do not require rabies vaccination but this is a right opportunity to start pre–exposure vaccination.

Cardiology eMedinewS

  • Endothelial cells lodged in the coronary arteries may play the role of cardiac stem cells to produce new heart muscle tissue, suggest researchers from the Vanderbilt University. The findings were published recently in Cell Reports.
  • A new Finnish study has found that the low–expression variant of fatty acid-binding protein 4 (FABP4) reduces the risk of heart attack and stroke, paving way for customization of a potentially preventive drug for atherosclerosis. The study is published in Circulation: Cardiovascular Genetics.

Pediatrics eMedinewS

  • A new study conducted in pregnant teenagers reported that nearly half engaged in pica (the craving and intentional consumption of ice, cornstarch, vacuum dust, baby powder and soap) and other nonfood items. Such teens also had significantly lower iron levels as compared with teens who did not eat nonfood substances. The study is published online in the Journal of Nutrition.
  • Kids with attention deficit hyperactivity disorder (ADHD) often make poorer decisions as compared to their unaffected classmates. Researchers from the University of Zurich have now discovered that different learning and decision–making mechanisms are responsible for these behaviors, and have localized the underlying impairments in the brain. The novel research is published in JAMA Psychiatry.

Dr K K Spiritual Blog

Do not give health advice unless you are an expert

Once a foreigner visited India and when he returned back, somebody asked him to tell three things about India. He said – All time is tea time; all behave like doctors and every street wall can be used as a urinal. Out of these three, the second one is very important and must be understood by all of us. In India, every person behaves like a doctor and is ready to give an advice.

In the West, when a person is sick, nobody is supposed to visit him or her except for close relatives, but in India, not visiting a sick person is considered bad manners.

Everybody who visits, comes with an advice; an advice to change the doctor, hospital or the pathy. They start giving examples of their experiences and try to influence the patient and the family. Neem Hakeem Khatraye Jaan is an old saying. No two patients are same and no two diseases behave in the same direction.

Changing medicines or pathy can be dangerous. When you go to another doctor for a second opinion, by default he or she has to disagree with the previous doctor, even if they do not need to. If they cannot find anything wrong in the prescription of the previous doctor, they will change the brand of the drugs or do minor modifications in the medicine.

In judicial practice, when you seek a review of judgment, you always file review petition in front of the same judge. Why can’t the same thing apply to medical science? If you are not satisfied with a doctor, go back to him and ask him to review you again as a fresh case.

Also in judicial system, if you are not satisfied with the judgment, you do not go to single judge bench but a double judge bench. Same thing should happen in medical science. If you are not happy with one doctor, never go to another single doctor but ask for a joint opinion with two specialists.

Wellness Blog

Carbohydrates as substitute to saturated fats not the answer

More than 20 prospective studies have addressed components of diet and the risk of heart disease.

The type of fat consumed appears to be more important than the amount of total fat.

Trans fatty acids increase risk of heart disease while polyunsaturated and monounsaturated fats decrease risk.

There is a controversy about whether it is optimal to substitute saturated fats with carbohydrates. An increase in carbohydrate tends to reduce the level of good high density lipoprotein (HDL) cholesterol in addition to total and low density lipoprotein (LDL) cholesterol. Thus, the reduction in heart disease risk may be less than predicted by the reduction of saturated fat alone.

Observational studies have consistently shown that individuals consuming diets high in vegetables and fruits, which are rich in antioxidant vitamins, had a reduced risk of heart disease.

Results of a number of randomized trials are now available and show largely no significant clinical benefits of antioxidant vitamins on heart disease.

Supplemental vitamin C, E, and beta carotene cannot be recommended in the primary prevention of CHD.

Taking supplements without clinical benefits could, in theory, increase the risk if individuals mistakenly avoid therapeutic lifestyle changes or drug therapies with proven benefits.

Inspirational Story

Life and Love’s Unending Journey

Love should always remain hopeful and positive in the difficult journey that follows along lives "bumpy detours and highways". Love should never lead dreamers astray, left to stumble and stammer along the "narrow muddy paths" of unfulfilled love, nor leave them alone to pass the dark and shadowy graveyards on the "lonely boulevards" of broken hearts, strewn with unkept promises and shattered dreams of "what was to be".

Love should always be alert and avoid the uncompromising gray sidewalk of the "two way street" of opposite direction and conflict and seek the sunny "one way street" of like attraction, goals, aims, purposes and desires.

So always drive on the "high road" on life’s golden carpet down the "yellow brick road" to love and life’s grand "promenades" and elegant "thoroughfares," leaving together to follow and smell the sweet scents and fragrances that waif and rise to greet and linger in the air.

ePress Release

Exercise: a prescription

Enumerating the various benefits of doing exercises, 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 said that exercise:

  1. Reduces the chances of getting heart disease. For those who already have heart disease, exercise reduces the chances of dying from it.
  2. Lowers the risk of developing hypertension and diabetes.
  3. Reduces the risk for colon cancer and some other forms of cancer.
  4. Improves mood and mental functioning.
  5. Keeps the bones strong and joints healthy.
  6. Helps to maintain a healthy weight.
  7. Helps maintain independence in the later years
  8. Age is no bar; there is abundant evidence that exercise can enhance health and well–being. But today, for many people, watching TV, surfing the Internet, or playing computer and video games has taken the place of helpful exercises.
  9. The minimum threshold for good health is to burn at least 700 to 1,000 calories a week through physical pursuits.
  10. Exercise improves health and can extend life. Adding as little as half an hour of moderately intense daily physical activity can help one avoid a host of serious ailments, including heart disease, diabetes, depression, and several types of cancer, particularly breast and colon cancers.
  11. Regular exercise can also help one sleep better, reduce stress, control weight, brighten mood, sharpen mental functioning, and improve sex life.

According to researchers from Harvard, a well–rounded exercise program must have all four components:

  1. Aerobic activity
  2. Strength training
  3. Flexibility training
  4. Balance exercises

Aerobic activity: It is the center piece of any fitness program. Most benefits of exercise revolve around aerobic cardiovascular activity, which include walking, jogging, swimming, and cycling. One should work out at moderate intensity when performing aerobic exercise; brisk walking that quickens the breathing is one example. This level of activity is safe.

Strength training: These exercises protect bones. Strength or resistance training, such as elastic–band workouts and the use of weight machines or free weights, are important for building muscle and protecting bone. Bones lose calcium and weaken with age, but strength training can help slow or sometimes even reverse this trend.

Flexibility exercises ease back pains. Muscles tend to shorten and weaken with age. Shorter, stiffer muscle fibers make one vulnerable to injuries, back pain, and stress. But regularly performing exercises that isolate and stretch the elastic fibers surrounding the muscles and tendons can counteract this process. And stretching improves posture and balance.

Balancing exercises prevent fall. Balance erodes over time, and regularly performing balance exercises is one of the best ways to protect against falls that lead to temporary or permanent disability. Balancing exercises take only a few minutes and often fit easily into the warm–up portion of a workout. Many strength–training exercises also serve as balance exercises. Balance–enhancing movements may simply be woven into other forms of exercise, such as tai chi, yoga, and Pilates.

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: Bacitracin acts on

1. Cell wall
2. Cell membrane
3. Nucleic acid
4. Ribosome

Answer for yesterday’s Mind Teaser: 1. Cell wall

Correct answers received from: Prabha Sanghi, Dr PC Das, Dr Raghavendra Jayesh, Dr Jainendra Upadhyay, Daivadheenam Jella, Dr Avtar Krishan.

Answer for 23rd August Mind Teaser: 2. HbsAg and HBeAg positive.

Correct answers received from: Raju Kuppusamy, Dr PC Das, Dr Narahari, Nirmala Agarwal, Dr Gopal Shinde, Shashank Jalak.

Send your answer to ijcp12@gmail.com

Quote of the Day

Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending. Carl Bard

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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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Hands–only CPR 10 English
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Health Check Up and CPR 10 Camp at NP CO-ED Sr Sec School, Ansari Nagar on 13th August 2014

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FDA OKs first drug–eluting stents for use in MI

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IJCP Book of Medical Records

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If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :

 

Make Sure

Situation: A patient with diabetes shows deteriorating kidney function.
Reaction: Oh my God! His HbA1c is very high?
Lesson: Make sure that strict glycemic control is maintained in patients with type 2 diabetes in order to delay vascular complications.

eMedinewS Humor

Health Professionals in Heaven

Three nurses died and went to Heaven. They were met at the Pearly Gates by St. Peter, who questioned them.

"What did you do back on Earth?" he asked the first nurse. "Why do you think you should be allowed into Heaven?"

She told him, "I was a nurse at an inner city hospital. I worked to bring healing and peace to many sufferers, especially poor children."

"Very noble. You may enter." And he ushered her through the gates. He asked the same questions to the next nurse.

"I was a missionary nurse in the Amazon. For many years I worked with a small group of doctors and nurses to help people in numerous tribes, healing them and telling them of God’s love." The second nurse replied.

"Excellent!" said St. Peter. And he ushered her through the gates as well. Finally he posed his questions to the third nurse. She hesitated, then explained, "I was just a nurse at an HMO."

St. Peter considered her answer for a moment, then told her, "Well, you can enter, too."

"Wow!" the nurse exclaimed in relief. "I almost thought you weren't going to let me in."

"Oh, you can certainly come in," St. Peter told her, "but you can only stay for three days."

Twitter of the Day

Dr KK Aggarwal: If you are at risk of heart attack ask your doctor for a statin http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Each of us is a unique strand in the intricate web of life and here to make a contribution http://bit.ly/DC_Ananda

medicolegal update

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  1. Dear Sir, Thanks for the information: Regards, Dr Kanishk

Forthcoming Events

Dear Colleague

Kindly attend ‘Innovations in Cardiology (IIC) Summit 2014’ on 6th September, 11 am – 6 pm at Hotel Oberoi, Gurgaon.

The Organizing Secretary is Dr Rajneesh Kapoor

Highlights of the conference

  • Separate hall for Clinical Cardiology
  • One session on Medicolegal aspects will be taken by me.
  • No registration fee, limited seats

Kindly send your confirmation to rawat.vandana89@gmail.com or sms 9891673085

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