eMedinewS27th June 2014, Friday

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

High fat diet, prostate cancer prone

Diets high in saturated fat increase the risk of prostate cancer. As per a report from University of Texas M. D. Anderson Cancer Center in Houston published in the International Journal of Cancer:

  • Men who consume high saturated animal fat diet are two times more likely to experience disease progression after prostate cancer surgery than men with lower saturated fat intake.
  • There is also shorter "disease–free" survival time among obese men who eat high saturated fat diet compared with non–obese men consuming diets low in saturated fat.
  • Men with a high saturated fat intake had the shortest survival time free of prostate cancer (19 months)
  • Non–obese men with low fat intake survived the longest time free of the disease (46 months).
  • Non–obese men with high intake and obese men with low intake had "disease–free" survival of 29 and 42 months, respectively.

Take home messages

  • High saturated fat diet has been linked to cancer of the prostate
  • Reducing saturated fat in the diet after prostate cancer surgery can help reduce the cancer progression.
  • Cancer prostate has the same risk factors as that of heart blockages and both are linked to high saturated fat intake.
  • With an increase in number of heart patients, a corresponding increase in prostate cancer patients is also seen in the society.

News Around The Globe

  • Autologous hematopoietic stem cell transplantation (HSCT) leads to event–free survival for patients with diffuse cutaneous systemic sclerosis (SSc) who are able to survive the procedure; however, the type of pretransplant cardiac workup used with HSCT in oncology appears to be insufficient to identify those who are unlikely to survive HSCT long enough to benefit, reports a new study published online June 24 in JAMA. Erythropoietin (EPO) may be an effective therapeutic option for cognitive and neural dysfunction in patients with severe affective disorders, reports a study presented at the American Society of Clinical Psychopharmacology (ASCP) 2014 Annual Meeting. Researchers noted that patients with treatment–resistant depression or bipolar disorder, in partial or complete remission, exhibited increased growth in the left hippocampus as well as enhanced verbal memory with EPO infusions.
  • A new study supports the evidence suggesting a link between traumatic brain injury (TBI) and later dementia. The study revealed that older veterans who had a severe past TBI had a 60% increased risk of developing dementia compared with those without a history of such a head injury. The findings are published online June 25 in Neurology.
  • Hydroxynorketamine, a byproduct of the psychoactive drug ketamine, has the potential to treat symptoms of depression without any unwanted side effects, reports a new study. The agent also has potential for treating neurodegenerative disorders such as Alzheimer’s disease (AD) and Parkinson’s disease (PD). The study is published in the July issue of Anesthesiology.
  • A novel growth–hormone derivative injected once a week for treatment of adult growth–hormone deficiency (AGHD) exhibits a comparable dose response and tolerability profile to daily–use injectable somatropin (rDNA origin), suggest the results from a recent research presented at the ICE/ENDO 2014.

Rabies News (Dr A K Gupta)

Can RIG be given locally to a healed wound?

Yes. If anti–rabies vaccination has not been started, then RIG can be given locally without disturbing the scab.

Cardiology eMedinewS

  • Two new studies have shown a high detection of atrial fibrillation (AF) with prolonged electrocardiography (ECG) monitoring in patients who have had a cryptogenic stroke. The 30-Day Cardiac Event Monitor Belt for Recording Atrial Fibrillation after a Cerebral Ischemic Event (EMBRACE) trial tested an external device for 30 days, and found an AF incidence of 16% in this time period, while the CRYSTAL–AF trial showed an AF detection rate of 8.9% at 6 months (vs. 1.4% of patients in the control group), 12.4% at 12 months, and 30% at 3 years. Both trials are published June 26 in the New England Journal of Medicine.
  • A small usability study that tested a miniaturized implanted cardiac monitoring system – Reveal LINQ, Medtronic – in European patients has shown that the device successfully resulted in the wireless transmission of data in nearly 70% of patients who received the implant. After a systems upgrade to the firmware, the transmission success rate improved to 79.2%. The data were presented recently at CardioStim 2014.

Pediatrics eMedinewS

  • Children with autism spectrum disorder (ASD) could have more rapidly growing brains and bodies at the beginning of the second trimester than children without the disorder, reports a new research presented at the International Congress of the Royal College of Psychiatrists (RCPsych) 2014. The study assessing fetal anomaly ultrasound scans revealed that the children who developed ASD had significantly greater head and abdominal circumference and cerebellar diameter at around 20 weeks’ gestation as compared to their healthy peers.
  • The quadrivalent meningococcal conjugate vaccine MenACWY–CRM has joined 2 other meningococcal vaccines recommended for use in children. The Advisory Committee on Immunization Practices recommends that only children who are at increased risk for meningococcal disease receive a meningococcal vaccine and routine vaccination is not recommended for children aged 2 months through 10 years. The report appears in the June 20 issue of the Morbidity and Mortality Weekly Report. MenACWY–CRM is recommended for children aged 2 to 23 months who are at increased risk for meningococcal disease.

Dr K K Spiritual Blog

Understanding the concept of Shiva and Shakti

After the life force leaves the body even the wife does not like to come near the body (Bhaja Govindam). This life force has no weight, water cannot wet it, air cannot dry it, and weapons cannot cut it (Bhagwad Gita Chapter 2).

The scientific description of this life force comes from the first Maha Vakya, from Aitareya Upanishad in Rig Veda, which describes that "Consciousness or Intelligence is the Brahman (Pragnanam Brahma).

This life force or the intelligence represents the conscious energy, energized consciousness or energized information.

In computer language this intelligence is both the data that has been fed and the software to operate this data. The software is driven by the power of intention and by the process of attention.

In Vedic language the data is the "Purusha or Shiva" and the software the "Shakti" (Sakti). While the data or the Shiva is inactive and idle, without Shakti or energy, the data has no value and it makes" Shiva" a "SAVA". When Shakti moves toward Shiva it becomes awareness or consciousness. In Vedanta language, it is called as soul or Brahman.

For comparison, what relationship Matter and Energy have in Physics; Purusha and Prakruti in Samkya Philosophy; Infinite and Zero in Mathematics; Potential and Kinetic Energy in Energetics; Meaning and Word in Linguistics; Father and Mother in sociology; the same is with Shiva and Sakti in understanding the mystery of Vedanta.

Shiva and Sakti are thus two inseparable entities in Indian mysticism. Just as moonlight cannot be separated from the moon, Shakti cannot be separated from Shiva. Kashmir Shaivism says that "Shiva without Shakti is lifeless (Sava) because wisdom cannot move without power".

Shiva and Shakti are different from the masculine and feminine aspects of the human body. In tantric spiritual path, one seeks to develop a perfect harmony and balance between masculine aspects (example mental focus, will, intellect) and feminine aspects (example sensitivity, emotion).

Shiva or the data is classified in the body in three subgroups: creation, protection and destruction. These in Hindu mythology are called "Brahma, Vishnu and Mahesh". Some add another two more dimensions in them making them five and these are "revelation and concealment". One can find these qualities in anything that’s alive.

The Shakti or the forces (power) are also sub classified in five sub types.

  1. Chitta Shakti: Pure consciousness or the awareness of God.
  2. Ananda Shakti or pure bliss.
  3. Gnana Shakti or the ‘knowledge of God’. It is pure knowledge, which organizes and orchestrates the infinite correlative activity of the universe.
  4. Kriya Shakti or ‘pure action’ which is the actions directed toward God (action which does not have the bondage of karma. Action which has the bondage of karma comes from the ego. It’s based on beliefs and expectations and interpretations and fears and judgments and past memories, whereas non–binding action, which is non–Karmic, is called Kriya—action rooted in pure awareness and creativity)
  5. Desire (Ichcha Shakti: the desire or intention to unite with God)

Deepak Chopra in his Book, Path of Love Describes Shakti as under:

If the voice of God spoke to you, Her powers would be conveyed in simple, universal phrases:

  • Chitta Shakti: "I am."
  • Ananda Shakti: "I am blissful."
  • Gnana (Gyana) Shakti: "I know."
  • Kriya Shakti: "I act."
  • Icha Shakti: "I will" or "I intend."

These powers, if used towards acquiring spiritual wellbeing, any action (pure kriya) directed by the desire (pure ischa) leads to pure knowledge (pure gnana) and ends with internal bliss (ananda).

On the other hand, in routine life if these powers are governed by the ego, then the Action (Kriya) leads to Memory (Gnana) and the memory leads to desire (Icha) and then action again.

According to Tantra, Satchidananda is called Shiva–Sakti, the hyphenated word suggesting that Shiva or the Absolute and Sakti or its creative power, are eternally conjoined like a word and its meaning; the one cannot be thought of without the other.

Wellness Blog

Defining Acute MI

  • In 1979: The diagnosis of acute MI was based on WHO criteria based on epidemiology
  • In 2000: A Joint committee of European Society of Cardiology (ESC) and American College of Cardiology (ACC) proposed a clinically based definition of an acute, evolving, or recent MI.
  • In 2007: Joint Task Force of the European Society of Cardiology, American College of Cardiology Foundation, the American Heart Association, and the World Health Federation (ESC/ACCF/AHA/WHF) refined the 2000 criteria and defined acute MI as a clinical event consequent to the death of cardiac myocytes (myocardial necrosis) that is caused by ischemia (as opposed to other etiologies such as myocarditis or trauma)
  • 2012: This definition was not fundamentally changed in the third universal definition of MI released in 2012 by the ESC/ACCF/AHA/WHF.

Third universal definition

Any one of the following criteria meets the diagnosis of MI:

  1. Detection of a rise and/or fall of cardiac biomarker values (cTn with at least one value above the 99th percentile upper reference limit (URL)) and with at least one of the following:
    • Symptoms of ischemia
    • Development of pathologic Q waves in the ECG
    • New or presumed new significant ST–segment–T wave (ST–T) changes
    • New LBBB
    • Identification of an intracoronary thrombus by angiography or autopsy
    • Imaging evidence of new loss of viable myocardium or a new regional wall motion abnormality.
  2. Cardiac death with symptoms suggestive of myocardial ischemia and presumed new ischemia ECG changes or new LBBB, but death occurred before cardiac biomarkers were obtained, or before cardiac biomarker values would be increased.
  3. PCI- related MI: elevation of cTn >5 × 99th percentile upper reference limit in patients with normal baseline values or a rise of values >20 percent if the baseline values are elevated and are stable or falling. In addition, either (i) symptoms suggestive of myocardial ischemia, or (ii) new ischemic ECG changes or new LBBB, or (iii) angiographic loss of patency of a major coronary artery or a side branch or persistent slow– or no–flow or embolization, or (iv) imaging demonstration of new loss of viable myocardium or new regional wall motion abnormality are required.
  4. Stent thrombosis associated with MI: Detected by coronary angiography or autopsy in the setting of myocardial ischemia and with a rise and/or fall of cardiac biomarkers with at least one value above the 99th percentile
  5. CABG–associated MI: Elevation of cardiac biomarker values >10 × 99th percentile URL in patients with normal baseline cTn values. In addition, either (i) new pathologic Q waves or new LBBB, or (ii) angiographic documented new graft of native coronary artery occlusion, or (iii) imaging evidence of new loss of viable myocardium or new regional wall motion abnormality.

The joint task force further refined the definition of MI

  • Type 1 (spontaneous MI): MI consequent to a pathologic process in the wall of the coronary artery (e.g., plaque erosion/rupture, fissuring, or dissection), resulting in intra luminal thrombus
  • Type 2 (MI secondary to an ischemic imbalance): MI consequent to increased oxygen demand or decreased supply (e.g., coronary endothelial dysfunction, coronary artery spasm, coronary artery embolus, anemia, tachy–/bradyarrhythmias, anemia, respiratory failure, hypertension or hypotension)
  • Type 3 (MI resulting in death when biomarker values are unavailable): Sudden unexpected cardiac death before blood samples for biomarkers could be drawn or before their appearance in the blood
  • Type 4a (MI related to PCI)
  • Type 4b (MI related to stent thrombosis)
  • Type 5 (MI related to CABG)

Thygesen K, Alpert JS, Jaffe AS, et al. Third universal definition of myocardial infarction. Circulation 2012;126(16):2020–35.

Inspirational Story

Power of Thought: Hitting Unseen Target

Yogi Raman was a true master of the art of archery. One morning, he invited his favorite disciple to watch a display of his skill. The disciple had seen this more than a hundred times before, but he nevertheless obeyed his teacher.

They went into the wood beside the monastery and when they reached a magnificent oak tree, Raman took a flower, which he had tucked in his collar and placed it on one of the branches.

He then opened his bag and took out three objects: his splendid bow made of precious wood, an arrow and a white handkerchief embroidered with lilacs.

The yogi positioned himself one hundred paces from the spot where he had placed the flower. Facing his target, he asked his disciple to blindfold him with the embroidered handkerchief.

The disciple did as his teacher requested.

‘How often have you seen me practice the noble and ancient sport of archery?’ Raman asked him.

‘Every day,’ replied his disciple. ‘And you have always managed to hit the rose from three hundred paces away.’

With his eyes covered by the handkerchief, Yogi Raman placed his feet firmly on the ground, drew back the bowstring with all his might – aiming at the rose placed on one of the branches of the oak tree – and then released the arrow.

The arrow whistled through the air, but it did not even hit the tree, missing the target by an embarrassingly wide margin.

‘Did I hit it?’ said Raman, removing the handkerchief from his eyes.

‘No, you missed completely,’ replied the disciple. ‘I thought you were going to demonstrate to me the power of thought and your ability to perform magic.’

‘I have just taught you the most important lesson about the power of thought,’ replied Raman. ‘When you want something, concentrate only on that: no one will ever hit a target they cannot see.’

ePress Release

Monsoon and Dengue on the Door

Bed netting is of little use since the dengue mosquitoes are most active during the daytime said 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.

Remaining in well–screened or air–conditioned buildings during the day can reduce the risk of exposure. When outside during the day, one should wear clothing that reduces the amount of exposed skin and use an effective mosquito repellent, such as N, N–diethyl–metatoluamide (DEET).

Because dramatic plasma leakage can develop suddenly, substantial attention has been placed upon the early identification of patients at higher risk for shock and other complications. The following clinical features are of help in this regard.

Duration of illness: The period of maximum risk for shock is between the third and seventh day of illness. This tends to coincide with resolution of fever. Plasma leakage generally first becomes evident between 24 hours before and 24 hours after fever is over.

Alarm signs: Severe abdominal pain, persistent vomiting, abrupt change from fever to hypothermia, or abnormal mental status, such as disorientation, are noted in a minority of patients.

Hematocrit: An elevation of the hematocrit is an indication that plasma leakage has already occurred and that fluid repletion is urgently required.

Platelet count: Severe thrombocytopenia (<100,000/mm3) is one of the clinical criteria for dengue hemorrhagic fever and usually precedes overt plasma leakage.

Serum aspartate transaminase (SGOT): Mild elevations in serum transaminases are common in both dengue fever and dengue hemorrhagic fever. However, levels are significantly higher in patients with dengue hemorrhagic fever, and elevated SGOT levels are noted earlier in illness.

Patients with suspected dengue who do not have any of the above indicators can be safely managed as outpatients as long as close clinical observation is assured. Daily outpatient visits may be needed to permit serial assessment of blood pressure, hematocrit and platelet count.

A patient should be hospitalized when:

  • Blood pressure <90/60 mmHg
  • Hematocrit >50 percent
  • Platelet count <50,000/mm3
  • Evidence of bleeding other than petechiae

Zee News – Health Wealth Shows

Alcohol
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Total CPR since 1st November 2012 – 94595 trained

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."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

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VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

emedipicstoday emedipics

Heart Care Foundation of India announces the dates and program of the 21st MTNL Perfect Health Mela.

press release

Obesity reduces life expectancy

video of day video of day

 

IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

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 on ACE inhibitor developed angioneurotic edema.
Reaction: Oh my God! Why was ACE inhibitor continued?
Lesson: Make sure that patients on ACE inhibitors are advised to watch for symptoms of urticaria and stop the drug immediately in case swelling of lip, face or tongue develops (Br J Clin Pharmacol 1999;48(6):861–5).

eMedinewS Humor

Where’s the toast I asked for?

An elderly husband and wife visit their doctor when they begin forgetting little things. Their doctor tells them that many people find it useful to write themselves little notes.

When they get home, the wife says, "Dear, will you please go to the kitchen and get me a dish of ice cream? And maybe write that down so you won’t forget?"

"Nonsense," says the husband, "I can remember a dish of ice cream."

"Well," says the wife, "I’d also like some strawberries and whipped cream on it."

"My memory’s not all that bad," says the husband. "No problem – a dish of ice cream with strawberries and whipped cream. I don’t need to write it down."

He goes into the kitchen; his wife hears pots and pans banging around. The husband finally emerges from the kitchen and presents his wife with a plate of bacon and eggs.

She looks at the plate and asks, "Hey, where’s the toast I asked for?"

Quote of the Day

It is wise to direct your anger towards problems – not people; to focus your energies on answers – not excuses. William Ward

Twitter of the Day

Dr KK Aggarwal: Stable CAD and type 2 diabetes………………………Among patients with stable CAD and type 2 diabetes…… http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Understanding Your Power: Mind, Brain, and Genome featuring http://tinyurl.com/lkz8hq4

 

Forth Comming Event

Announcement

Call for Free Registration

4th annual conference Zoonosis 2014
Sunday 6th July 10am–2 pm followed by Lunch

Venue; Indian Medical Association HQs, IMA House, ITO New Delhi

Objective: To discuss about prevention of diseases communicable
from animals to human.

Who can take part: Medical Practitioners,Veterinary Practitioners, Animal Owners/Breeders, NGOworking with animal care etc.

Experts will be from Veterinary/Medical sectors

All participants will be given certificate of participation.

Organizers: Heart Care Foundation
of India, Millennium India Education
Foundation,CAR (Ministry of Agriculture Govt.of India,

Register at :
rawat.vandana89@gmail.com/
drkakroo@gmail.com
or Call: Vandana 9891673085/Dr Kakroo 9810301261

Zoonosis 2014 9-1 PM


6 July 2014 Zoonosis 2014

Speakers Zoonotic disease in India
Dr Jyoti Misri Pr Scientist ICAR Govt of India

Inaugural address
Dr M L Madan Fmr DDG ICAR

Dr KK Aggarwal (To Moderate)

Bovine Tuberculosis and Brucellosis
Dr R Somvanshi HOD Vety Pathology IVRI Bareilly UP

Dr Rishendra Verma Jt Dir.Centre for Animal Disease Research and Diagnosis IVRI Bareilly UP

Equine Encepahalitis
Dr. Baldev Gulati Pr.Scientist National Centre for Research in Equines,Hissar Haryana

Cysticarcosis, Neurocysticercosis
Dr R Somvanshi HOD Vety Pathology IVRI Bareilly UP

Rabies, Cat Scratch Disease
Dr. Ashok Bhardwaj Asstt.Prof. SKAUST Jammu

Swine Flu, Japanese Encepahlitis
Dr.P K Uppal Fmr FAO Expert on Flu
Dr. Baldev Gulati Pr.Scientist National Centre for Research in Equines, Hissar Haryana

Bird Flu
Dr.P K Uppal Fmr FAO Expert on Flu

Mycotic Diseases

Dr.P P Gupta Fmr Dir.Research Punjab Agri Univ.

Food Borne Diseases Salmonellosis, tapeworms, teniasis

Dr.Lal Krishna
Fmr Animal Husbandry Commissioner Govt.of India.

Anthrax, Rota Virus, Carona Virus

Dr. A K Bhatia Professor & Head, Biotechnology Dept.GLA Univ. Mathura

Dr.M P Yadav Fmr Director IVRI Bareilly UP

Dr.C Bhattacharya Vety Public Health Spl. Delhi

Emerging Threats : JD,Crone's Disease,Nepha Virus,etc.

Dr.Shoorvir Singh Pr Scientist National centre for Res in Goats Makhdoom Agra

 

eMedi Quiz

IRIS commonly occurs after how many weeks of ART initiation

a.1–4 week
b.2–12 weeks
c.12–24 weeks
d.after 6 months

Yesterday’s Mind Teaser: Which of the following is a basic teledermatology tool?

a. Videoconference
b. Hybrid teledermatology
c. Store–and–forward teledermatology
d. Mobile teledermatology

Answer for yesterday’s Mind Teaser: c. Store–and–forward teledermatology

Correct answers received from: Dr Jainendra Upadhyay, Daivadheenam Jella, Dr Avtar Krishan, Dr K V Sarma, Prabha Sanghi, Dr Sushma Chawla, Dr Chandresh Jardosh.

Answer for 25th June Mind Teaser: b. Combination of store and forward and video conference

Correct answers received from: Kala Sarma, Dr Jainendra Upadhyay, Prabha Sanghi.

Send your answer to ijcp12@gmail.com

medicolegal update

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medicolegal update
  1. Dear Sir, Your emedinews is like a refreshing cup of Tea. Regards: Dr Kanan
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