eMedinewS27th October 2013, Sunday

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
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Artificial sweeteners?

Artificial sweeteners like acesulfame, aspartame, saccharin, sucralose gives the sweetness of sugar with virtually none of the calories. Most people who use artificial sweeteners or choose foods or beverages made with them do so because they want to lose weight. And for a lot of people, they do help. But some research suggests that the use of artificial sweeteners may actually promote weight gain.

Artificial sweeteners are hundreds to thousands of times sweeter than table sugar. People who use these sweeteners often may desensitize themselves to sweetness. If that happens, they may find healthful but not-so-sweet foods such as fruits and vegetables unappetizing by comparison.

Calories removed from the diet by swapping sugar for sweeteners may re-enter in the form of refined carbohydrates (like those found in crackers, chips, pastries, and the like) and unhealthy saturated and trans fats. (Excerpts from HealthBeat)

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
eMedinewS
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

Science behind regrets

sprritual blog

In a US-based study, dying people were asked about their regrets, if any. The top five regrets were:

1. I wish I had the courage to live a life I wanted to live and not what others expected me to live.
2. I wish I had worked harder
3. I wish I had the courage to express my feelings.
4. I wish I had stayed in touch with my friends.
5. I wish I had let myself to be happier. Regrets are always based on suppression of emotions or non-fulfillment of desires and needs. These need-based desires can be at the level of physical body, mind, intellect, ego or the soul. Therefore, regrets can be at any of these levels.

I did a survey of 15 of my patients and asked them a simple question that if they come to know that they are going to die in next 24 hours, what would be their biggest regret.
Only one of them who was a doctor said that she would have no regrets.
The physical regret was only one and that was from a Yoga expert who said that her regret was not getting married till that day.
Mental regrets were two.

  1. A state trading businessman said, "I wish I could have taken care of my parents".
  2. A homeopathic doctor said, "I wish I could have given more time to my family."

Intellectual regrets were three.

  1. A lawyer said, "I wish I could have become something in life."
  2. A businessman said, "I wish I could have helped more people."
  3. A retired revenue inspector said, "I wish had married my younger child."

Egoistic regrets were two.

  1. One fashion designer said, "I wish I could have become a singer."
  2. A housewife said, "I wish I could have become a dietician."
  3. Spiritual regrets were six.
  1. A Consultant Government Liaison officer said, "I wish I could have made my family members happy."
  2. A businessman said, "I wish I could have meditated more."
  3. A Homeopathic doctor said, "I wish I could have spent more time with my family."
  4. A reception executive said, "I wish I could have spent more time with my parents."
  5. An entertainment CEO said, "I wish I could have taken my parents for a pilgrimage."
  6. A fashion designer said, "I wish I could have worked more for the animals."

In a very popular and successful movie, Kal Ho Na Ho, the hero was to die in the next 40 days. When asked to remember the days of his life, he could not remember 20 ecstatic instances in life. This is what happens in life of each one of us where we waste all our days and cannot remember more than 50 or 20 of such instances. If we are given 40 days to live and if we live every day ecstatically, we can get inner happiness. Therefore, we should learn to live in the present instead of having a habit of postponing everything we do.

We should learn to prioritize the work and do difficult work first otherwise we will be worrying all the time till that work is over.

I teach my patients that they should practice confession exercise and one of the confessions is to talk about your regrets and take them as challenge and finish before the next Tuesday. When working, there are three things which are to be remembered – passion, profession and fashion. Profession is at the level of mind, ego and spirit.

We should convert our profession in such a manner that it is fashionable and passionate. Passion means working from the heart and profession means working from mind and intellect and fashion means working the same at the level of ego which is based on show-off.

cardiology news

Each Person Shines His Own Way

A samurai who was known for his nobility and honesty, went to visit a Zen monk to ask him for his advice. When the monk had finished his prayers, the Samurai asked, "Why do I feel so inferior? I have faced death many times, have defended those who are weak. Nevertheless, upon seeing you meditating, I felt that my life had absolutely no importance whatsoever." "Wait. Once I have attended to all those who come to see me today, I shall answer you." replied the monk. The samurai spent the whole day sitting in the temple gardens, watching the people go in and out in search of advice. He saw how the monk received them all with the same patience and the same illuminated smile on his face. At nightfall, when everyone had gone, he demanded: "Now can you teach me?"

The master invited him in and led him to his room. The full moon shone in the sky, and the atmosphere was one of profound tranquility. "Do you see the moon, how beautiful it is? It will cross the entire firmament, and tomorrow the sun will shine once again."

"But sunlight is much brighter, and can show the details of the landscape around us: trees, mountains, clouds." "I have contemplated the two for years, and have never heard the moon say: why do I not shine like the sun? Is it because I am inferior?"

"Of course not." answered the samurai. "The moon and the sun are different things, each has its own beauty. You cannot compare the two." "So you know the answer. We are two different people, each fighting in his own way for that which he believes, and making it possible to make the world a better place; the rest are mere appearances."

News Around The Globe

20th MTNL Perfect Health Mela Programme Brouchure

20th MTNL Perfect Health Mela 2013 Hangout on Air with Google

Interview of Dr. Manoj Sharma, Professor of Radiotherapy, Maulana Azad Medical College and Advisor to Government of Delhi, Cancer Control

Dr. Manoj Sharma attended the ongoing 20th MTNL Perfect Health Mela as one of the judges for Divya Jyoti Inter School-cum-College Nursing Festival. He answered certain issues relating to the field of cancer.


Q.1 Which is the number one cancer in males and females in India?

Ans. Number one cancer in females in general is gynecological cancers of which cervical cancer (cancer of uterine cervix) is the commonest cancer in Indian population but in metropolitan towns, breast cancer has become the commonest female cancer. There is a shadow of endometrial cancer and ovarian cancers are also increasing. In males they are basically tobacco-related cancers which are universally found in India and in metropolitan towns there are mainly oral cancer, cancer of the sound box and cancer of gullet (esophagus).

Q.2 Is there a common lifestyle, which can prevent the cancer?

Ans. There is a common lifestyle, which is basically a tobacco-free, balanced diet and balanced physical activity lifestyle, which will help to get rid of at least 80% cancers. Tobacco alone is the cause of several cancers both in male and female and threat to the future general of children.

Q.3 Does that lifestyle also prevent heart attack, paralysis, diabetes, high blood pressure, osteoporosis and other lifestyle disorders?

Ans. It goes without saying that a tobacco-free, well balanced diet and exercise saves you from all the heart diseases, diabetes, obesity which in itself is a cause of diabetes, heart problems and cancer. In addition to that intake of antioxidants, yellow, green and red vegetables; roughage like barley, gram, jowar and bajra that are less popular these days also help a great deal.

Q.4 If like the movie Nayak you are made the Chief Minister of Delhi for one day, what changes would you bring to control the cancer menace in the country?

Ans. I will put a total ban on tobacco like many countries have done and promote anti-cancer agro forestry and agriculture in tobacco growing fields. In addition, I would make school health education, school cancer education and annual school health checkup compulsory. I would also insist upon a daily page on health-related information in newspapers and magazines and make health-related programs compulsory for all the media channels.

Q.5 If I want you to give five cancer control messages for the public which needs active promotion, what would be those messages?
Ans.

  1. Get rid of all addictions like chewable or smokable tobacco, alcohol, drugs and addiction to overeating.
  2. Learn methods of relaxation, stress release, entertainment through physical exercise, games, gardening and environmental maneuvers, etc.
  3. Learn about your own body - self-examination of breast, private parts, nodal areas, oral cavity, etc. to recognize early arrival of diseases by acquiring freely available educational material like books and CDs that give information on early signs and symptoms causes and prevention of cancer.
  4. Declare cancer as a notifiable disease and given full cooperation in this procedure, create hospital-based cancer registries that must be linked to National Cancer Registry Project of Indian Council of Medical Registry and follow up of the directives given in favor of public health by the Government.
  5. Make annual school health checkups compulsory with inclusion of health education in school level curriculum and promotion of package of health check up especially meant for women of all ages, which include a complete clinical examination by a gynecologist, annual pap smear colposcopy, ultrasound of pelvis and breast, hematological profile, x-ray of chest and mammogram wherever indicated.

Q.6 What is the common cancer control program in which doctors of all pathies can work together and implement?
Ans. There is a National Cancer Control Programme which has its directives with regard to cancer awareness, early detection, diagnosis and referral tertiary cancer in proper three tiered system.

Q.7 What necessary changes are required at the level of medical education in order to tackle the cancer problem more appropriately?
Ans. What is required is teaching of oncological science with its comprehensive approach that will involve multi-specialty decision, strengthening of follow-up system as per the guidelines of WHO, UICC and evidence of Tumor Board Culture in all the Specialties dealing with cancer cases. Creation of more post-doctoral courses and their seats in medical oncology, surgical oncology, radiation oncology, onco-psychiatry, monocular oncology, oncopathology and medical physics.

News

  • Red and processed meat consumption was significantly associated with colorectal cancer risk in patients who had a common gene mutation.
  • Death rates are as high in individuals who develop autoimmune diabetes as adults as they are in those with type 2 diabetes, despite a more favorable baseline metabolic risk profile among the former, according to a new population-based study published online October 15 in Diabetes Care from Norway.
  • An FDA panel has unanimously recommended simeprevir (Janssen) for the treatment of chronic hepatitis C virus (HCV) genotype 1 (GT1) infection, combined with peginterferon alfa and ribavirin in adults with compensated liver disease (including cirrhosis) who are treatment naïve or who have failed previous interferon therapy with or without ribavirin.
  • The US FDA has approved the expanded use of the mu-opioid receptor antagonist alvimopan (Entereg, Cubist Pharmaceuticals). The supplemental new drug application (sNDA) expands the indication to accelerate the time to upper and lower GI recovery following surgeries that include partial bowel resection with primary anastomosis. The FDA originally approved alvimopan in 2008 to accelerate the time to upper and lower gastrointestinal (GI) recovery following partial large- or small-bowel resection with primary anastomosis.
  • A novel inhaled drug appeared safe as a dual bronchodilator and anti-inflammatory in asthma and chronic obstructive pulmonary disease (COPD), a series of proof-of-concept studies showed. In COPD patients, nebulized RPL554 boosted forced expiratory volume in 1 second (FEV1) by 17% versus placebo, with peak effects comparable to inhaled beta-2 agonists.
  • The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) in a joint opinion published in the November issue of Obstetrics & Gynecology have discouraged the use of the general label "term pregnancy" and replacing it with these categories:
    • early term: 37 weeks to 38 weeks, 6 days;
    • full term: 39 weeks to 40 weeks, 6 days;
    • late term: 41 weeks to 41 weeks, 6 days; and
    • post-term: 42 weeks and beyond.
  • Of the nine million cases of tuberculosis (TB) across the world annually, children below 15 years of age account for about one million as reported in The Hindu, October 24, 2013. As per India’s Revised National TB Control Programme (RNTCP), paediatric cases account for about 12 per cent of the total TB caseload in the country. According to a March 2013 paper in the Indian Pediatrics journal, the number of paediatric (below 14 years) cases in India has been on the rise — nearly 60,000 (5.6 per cent) in 2005 and about 84,000 (7 per cent) in 2011. Many studies have pointed out that paediatric TB case detection is way down in the priority list of RNTCP and hence many cases go undetected.

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Rabies News (Dr. A K Gupta)

What are the rules every dog owner should follow?

  • The number one way to communicate to a dog that you are his pack leader is to take him or her for a Pack walk daily, where the dog is made to heel beside or behind the human who is holding the lead. This is most important for all dogs, as in a dog's mind, the leader always leads the way.
  • A dog must not be allowed to sniff or eliminate anywhere he wishes, but only where you allow him.
  • The dog should be concentrating on following the human.
  • All humans must eat before the dogs.
  • No table scraps should be fed to the dogs during a meal.
  • Feedings must be at a scheduled time.
cardiology news

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

  • The Society for Cardiovascular Angiography and Interventions has issued a consensus statement detailing best practices for the use of transradial access in the cardiac catheterization lab in response to growing use of the approach in the U.S. The statement -- published online in Catheterization and Cardiovascular Interventions -- focuses on three areas: avoidance of radial artery occlusion, minimization of radiation exposure for the operator and the patient, and transitioning to the use of the transradial approach for patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention.
  • Carotid endarterectomy and carotid stenting to treat carotid disease worked equally well in younger patients, but in elderly patients endarterectomy was associated with a lower risk of stroke, as per a meta-analysis published in October 23 in JAMA Surgery. Carotid stenting was associated with an increased risk of stroke in elderly patients compared with younger patients, according to George A. Antoniou, MD, PhD, of the Hellenic Red Cross Hospital in Athens, Greece, and his co-authors. Patients who'd undergone endarterectomy, on the other hand, had equivalent cerebrovascular outcomes whether they were old or young. Endarterectomy did carry a heightened mortality risk in elderly patients.
cardiology news

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

  • Using a larger sample size than previously reported, a new study validates the association between the presence of strabismus and significant refractive errors and the risk for unilateral amblyopia in preschoolers. The study, published online October 21 in Ophthalmology, also identifies thresholds of refractive error associated with the highest risk for amblyopia. Strabismus (P < .0001) and greater magnitude of refractive errors such as myopia, hyperopia, astigmatism, and anisometropia were independently associated with an increased risk for unilateral amblyopia. Researchers also found that astigmatism and bilateral hyperopia were independently associated with an increased risk for bilateral amblyopia.
  • Chloral hydrate (CH) may be a good alternative to general anesthesia in children who can't cooperate with detailed eye exams, according to a new study reported online September 17 in the British Journal of Ophthalmology.
cardiology news

PCI Often Done at Low-Volume Centers

Twenty-five percent of all percutaneous coronary interventions in the U.S. are performed at low-volume centers that do 200 or fewer procedures per year; 49% are done at centers that do no more than 400 such procedures annually, Gregory Dehmer, MD, of Scott & White Healthcare in Temple, Texas, and colleagues reported in the Journal of the American College of Cardiology. They also found that on-site cardiac surgery wasn't available at 83% of centers that did 200 or fewer PCIs annually. The 2011 PCI guidelines stated that facilities doing 200 or fewer PCIs per year need to take a closer look at whether they should continue doing such procedures.

cardiology news

Total CPR since 1st November 2012 – 67390 trained

Media advocacy through Print Media

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Media advocacy through Web Media

Heart disease starts in young age

Inaugurating Medico Masti, an inter youth festival, held in the ongoing Perfect Health Mela being organized by Heart Care Foundation of India at Constitution Club of India from 23rd to 27th October, 2013, noted Kathak dancer and Padma Bhushan Awardee Mrs. Uma Sharma said that to prevent heart disease in late 30s and early 40s, prevention has to start right at the adolescent age. It takes 10-20 years for heart disorders to manifest.

Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that heart attack cannot be given or accepted as gift as one has to work against the laws of the nature for 20 years to get heart diseases. Eating white rice, white maida and white sugar along with trans fats are the main culprits for development of heart diseases in future.

Dr. Aggarwal said that one should not gain weight after the age of 18 in males and 20 in females. A weight gain of 5kg is permissible in males but any weight beyond that is fat accumulation, which ultimately is dangerous to heart.
One should not consume more than 15 ml of oil, butter or ghee in a day.
Over 1000 youth participated in various events, which included fashion show, choreography, rock band competition etc.
Ryan School organized inter school competitions Over 500 children participated in various inter school competitions. Festival for children with special needs organized Anmol, festival for children with special needs was organized at the Mela. Over 200 children participated in various competitions like singing and diya decoration. Following messages were released

  1. If BP & diabetes are kept under control, 75% dialysis and transplants can be prevented.
  2. Thirty percent of heart disease can be prevented by 2.5 hours of walking per week.
  3. If salt intake is reduced to less than 2.3 grams a day, there would be 1.1 crore fewer patients of high BP.
  4. If you want to commit suicide, then start smoking early and continue. You have 50% chance of success.
  5. More deaths if patients of heart attack and/or paralysis are admitted on weekends, holidays, early morning, night time or winter.
  6. Smoking, high blood pressure and high cholesterol together reduce lifespan by 10 years for 50-year-old men.
  7. Balance diet is a mix of all 6 tastes and 7 colors.
  8. Keep Hemoglobin > 12 in females and > 14 in males.
  9. When going for a fasting blood test, fasting means no food, water allowed for 8 hours.
  10. For rabies prevention in a case of dog bite, now only four injections are required and not five. (0, 3, 7 and 14th day)
  11. More women die of heart attack than breast cancer.
  12. For every additional drink regularly consumed per day, the incidence of breast cancer increased by 11 per 1000.
  13. Most heart attacks occur in the early hours of the day.
  14. If the heart pumping ejection fraction is less than 30%, one needs more investigations.
  15. All asthmatics do not wheeze and all wheeze is not asthma.
  16. Most CAD patients do not die of kidney disease but by heart disease.
  17. Obesity is a bigger risk factor than high blood pressure for the enlargement of left atrium and atrial fibrillation risk.
  18. Do not give aspirin and other NSAID in dengue fever.
  19. Chloroquine has anti-viral properties.
  20. Rectal temperature is more reliable for hypo- and hyperthermia.
  21. Pulse will rise by 1 for every one degree rise of temperature.
  22. Sense danger if there is high fever with no sweating.
  23. Sense danger if a patient has hypothermia and no sweating.
  24. If ESR more than 100, look for TB, pus collection, cancer or thyroiditis.
  25. Fever responding to indomethacin, look for Hodgkin’s disease.
  26. Nasal discharge and cough rules out rheumatic sore throat.
  27. No fever, no flu.
  28. No cough, no flu.
  29. Fever with rash with lymph nodes behind ear unless proved otherwise is rubella
  30. Fever less than 100.4 means no infection.

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 67390 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 10x10 i.e. 100 per minute.”

today emedipics

Festival for children with special needs organized

press release

Do not give citalopram more than 40mg

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

Marco who was diagnosed with brain tumor was scheduled for craniotomy. In preventing the development of cerebral edema after surgery, the nurse should expect the use of:

a. Diuretics
b. Antihypertensive
c. Steroids
d. Anticonvulsants

Yesterday’s Mind Teaser:How many cups of fruit and vegetables should you eat daily?

A. At least one cup of fruit or vegetables.
B. One cup of fruit and one cup of vegetables.
C. One cup of fruit and 1 1/2 cups of vegetables, for a total of 2 1/2 cups.
D. Two cups of fruit and two cups of vegetables.
E. Four to five cups of fruit and vegetables.

Answer for yesterday’s Mind Teaser: E. Four to five cups of fruit and vegetables.

Correct answers received from: DR P K SAHU, Archna Parwani, Aruna Mehta, Dr Prakash Khalap, Dr. V.P. Thakral, Dr.K.V.Sarma, Dr Pankaj Agarwal, Dr Chandresh Jardosh, daivadheenam, Muthumperumal Thirumalpillai, Dr Arpan Gandhi, Dr B K Agarwal, DR PRABHA LUHADIA, Amarnath Arora, Dr Prakash Khalap

Answer for 25th October Mind Teaser: A. 110/70.

Correct answers received from: Prabha Sanghi, DR.A.K.GAJJAR, Dr. P. C. Das, Dr Prakash Khalap, Dr Arpan Gandhi

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 stool.

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/15QdVeB #Health

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

medicolegal update

Dear Editor, THE EXCELLENT INVISIBLE AID TO VISION, The charitable trust Eye Care India (ECS) recently conducted a short-term two-day Contact Lens Education Program (CLEP) for Diploma Optometrists at Meero Devi Para Medical College, October 17-18, 2013, at the instance of Eye Care Society, Saharanpur. Contact Lenses are an excellent invisible aid to vision, that work wonders in the hands of those qualified, but can surely be disastrous as well when not handled properly. ECS feels that all GPs must undergo a talk on "Introduction to Contact Lenses in order to get familiarised with this modality of refractive error correction...and to be able to guide their patients properly. And will be pleased to make a presentation before a group. Sincerely, Dr. Narendra Kumar

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