eMedinewS 27th July 2013, Saturday

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

Clinical trial of untested drugs must follow mandatory standards
and be regulated – Supreme Court

Supreme Court of India today said that human clinical trials of untested drugs must follow mandatory standards and directed the Government to put in place the mechanism to monitor them. The Court said that Centre should convene a meeting of all Chief Secretaries and/or Health Secretaries of all the States to frame a law in this regard so that all clinical trials of drugs of multinational pharma companies are regulated. The Court granted four weeks’ time to the Centre to come out with the rules. The Court said that not only clinical trials should be regulated but there should also be proper compensation. There should be an oversight committee to monitor such trials. The Government is making amendments in the Drugs and Cosmetics Act by introducing penal provisions for any violation.

Aspirin for the primary prevention of cardiovascular disease and cancer

People above the age of 50 without excess bleeding risk should take low-dose daily aspirin (75 to 100 mg) as per the current recommendations.

Patients who are more concerned about the bleeding risks than the potential benefits (prevention of cardiovascular events and cancer) may reasonably choose to not take aspirin for primary prevention.

Meta-analyses of randomized trials have shown aspirin to reduce the risk of non-fatal myocardial infarction (Arch Intern Med 2012; 172:209) and long-term aspirin use reduces overall cancer risk (Lancet 2012; 379:1602).

A meta-analysis addressing this combined outcome suggests that aspirin use in 1000 average risk patients at age 60 years would be expected to result, over a 10-year period, in six fewer deaths, 19 fewer non-fatal myocardial infarctions, 14 fewer cancers, and 16 more major bleeding events. .... Read More

Rivaroxaban as addition to aspirin and clopidogrel for an acute coronary syndrome

For patients who have had an acute coronary syndrome (ACS) and who are taking dual antiplatelet therapy with low-dose aspirin and clopidogrel 75 mg daily, one should add rivaroxaban 2.5 mg twice daily if there are no risk factors for bleeding present.

The duration of treatment with rivaroxaban is approximately one year, as studied in the randomized trial. Patients may reasonably choose to not take rivaroxaban if they are particularly concerned about the bleeding risk. This recommendation does not apply to patients taking either prasugrel or ticagrelor. (ATLAS 2 ACS-TIMI 51 trial)

.... 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 Spiritual Prescription: Kayotsarga

Shavasana is a term used in Hatha Yoga, which means lying like a corpse. In mind body language, it is called mind body relaxation. In terms of psychiatry, it is called progressive muscular relaxation. Mahavira in his teachings called it as Kayotsarga.

Kayotsarga does not mean only lying like corpse but also abandonment of the body. It is a state of restful alertness where the mind is alert but the body is at rest. All meditative practices begin with Kayotsarga. It is the very foundation of spiritual sadhana.

In terms of physiology it increases alpha rays in the brain and in the language of neurology it creates a parasympathetic state of the body.

The process involves lying still and being aware of each and every part of the body getting relaxed gradually and in turn. Awareness or the concentration is on the body being relaxed and the process of relaxation. In yogic language, it is also called as yoga nidra as before completing the process most people fall asleep. This is one procedure, which is often used by counselors in patients with insomnia.

During the process of Kayotsarga one is neither in the past nor in the future as one’s awareness is in the present on the process of relaxation. Being in present, it detaches one from attachments and desires and prepares one for the next phase called meditation.

One of the mind body principles is that during a state of relaxation and restful alertness, the mind become suggestive. This principle is also used in hypnosis. In fact, the initial trans-state is based on this principle.

Kayotsarga is the state of the body required to win over any pain and this is one reason why during any painful procedure the person is often asked to relax and give way. In the process of Kayotsarga as the body is in a deep state of relaxation, all physical and mental sufferings are relieved. With relaxation of the body most pain would disappear.

There are several studies, which say that yogic shavasana or Kayotsarga can reduce blood pressure by 20/10 mmHg. The 10-day Vipasana Meditation is also based on prolonged Kayotsarga. It is supposed to be very effective.

Slower and deeper breathing is another way of achieving the same benefits as that of Kayotsarga. Both balance prana. Yoga sutras of Patanjali involve both of them before going into meditation. If one practices Kayotsarga, breathing automatically slows down. Kayotsarga is often done in the beginning of dhyana and at the point of culmination of dhyana.

Kayotsarga is a state of making body completely free of motion and tension. The fundamental principle of Kayotsarga is slower and deeper breathing. Unless the breathing is slow it is not possible to relax the body. One cannot do Kayotsarga successfully if the breathing is fast.

It is also combined with many visualization techniques. Once the full body is relaxed concentrating on a mantra or on a particular portion of the body may help in healing. Dean Ornish in his book reversal of heart disease also used this technique with focus on heart and showed that even heart diseases are regressible. Many people use this for relieving migraine.

Kayotsarga is the process which distinguishes the body from the soul. The detached feeling of the body is what the first stage of meditation is.

Afternoon nap is nothing but Kayotsarga. The best way to rest for a heart patient is to practice Kayotsarga. During the process of Kayotsarga the immunity develops and the prana becomes balanced. ....Read More

cardiology news

The Secret of Success

A young man asked Socrates the secret to success. Socrates told the young man to meet him near the river the next morning. They met. Socrates asked the young man to walk with him towards the river. When the water got up to their neck, Socrates took the young man by surprise and ducked him into the water. The boy struggled to get out but Socrates was strong and kept him there until the boy started turning blue. Socrates pulled his head out of the water and the first thing the young man did was to gasp and take a deep breath of air. Socrates asked, 'What did you want the most when you were there?" The boy replied, "Air." Socrates said, "That is the secret to success. When you want success as badly as you wanted the air, then you will get it." There is no other secret.

Moral of the Story: A burning desire is the starting point of all accomplishment. Just like a small fire cannot give much heat, a weak desire cannot produce great results. The motivation to succeed comes from the burning desire to achieve a purpose. ...Read More

News Around The Globe

It is not within the province of this court to exercise the power of judicial review to sit on appeal over the report of the expert committee and the related decision taken by the MCI on the basis of such report.’’

This was the observation of Chennai HC today.Here is the ENS report..........By Express News Service - CHENNAI

26th July 2013 07:46 AM A July 4, 2013 order of the Board of Governors of the Medical Council of India (MCI) in New Delhi refusing renewal of permission to admit students in the first year MBBS course for 2013-14 to Madha Medical College and Hospital in Thandalam near Chennai was upheld by the Madras High Court on Thursday.

The materials available on record supported the order passed by the MCI, Justice KK Sasidharan said. The judge was dismissing a writ petition from Loodhuammal Educational Trust in T Nagar, which was running the medical college, to quash the refusal order of the MCI.

When the matter came up today, senior central government standing counsel Haja Mohideen Gisthi, relying on a report of the expert team which inspected the college, submitted that the petitioner college did not possess essential institutional and infrastructural facilities to conduct a medical college. There were also a number of deficiencies, he added.

Dismissing the writ petition, the judge observed that the expert team found several deficiencies that would affect the capacity of the petitioner to impart medical education and training to the future medical officers. ``It is not within the province of this court to exercise the power of judicial review to sit on appeal over the report of the expert committee and the related decision taken by the MCI on the basis of such report.’’ The matter involved the future of a noble profession and medical professionals. Students of the petitioner college, after graduation, would start working as medical officers. They have to serve society. Medical students should be qualified to function as specialists in various disciplines and for the said purpose, they should receive proper medical education, he added.

How medications can affect your balance

  1. Some of the commonly prescribed medications that can affect balance include:
    1. Antidepressants
    2. Anti-anxiety drugs
    3. Antihistamines prescribed to relieve allergy symptoms
    4. Blood pressure and other heart medications
    5. Pain relievers, both prescription and nonprescription
    6. sleep aids (over-the-counter and prescription forms)
  2. Scientists have shown that the absence of an enzyme known as Parkin causes an early onset form of Parkinson disease.
  3. As per NIH, Xpert MTB/RIF is a new test for diagnosing tuberculosis in children which detects 2/3rd of cases but in a fraction of time.
  4. According to a study published in Journal of the American Heart Association, though most women resume sexual activity within 4 weeks of attack but with less frequency and with a fear most of them were not counseled by their doctors.
  5. In a study of young individuals seen at a military center who had chest pain but were at low to moderate risk of having an MI, the percentage of patients sent for invasive coronary angiography (ICA) dropped by 62% after cardiac computed tomography (CT) became available. By using cardiac CT to determine who would proceed to the cath lab, costs of diagnostic testing and the number of lost working days each decreased by about half. Dr Ahmad Slim (San Antonio Military Medical Center, TX) presented these findings in an oral abstract at the Society of Cardiovascular Computed Tomography (SCCT) 2013 Scientific Meeting.
  6. Good-quality coronary CT angiography (CTA) scans can be obtained in clinical practice with a dose of radiation as low as 1 mSv—and possibly lower—by using new technology and applying careful strategies, Dr Jörg Hausleiter (German Heart Center, Munich) said in a presentation at the Society of Cardiovascular Computed Tomography (SCCT) 2013 Scientific Meeting.
  7. In stress testing using regadenoson, detection rates of myocardial ischemia were similar with less invasive computed-tomography (CT) perfusion imaging compared with the reference method, single-photon-emission CT (SPECT) imaging, in a phase 2 trial. Regadenoson, a selective adenosine-receptor agonist that produces coronary vasodilation in patients unable to undergo exercise stress testing, is the most common agent used to induce pharmaceutical stress in SPECT tests in the US; it was used off-label for the CT imaging. Dr Ricardo C Cury (Baptist Hospital of Miami, FL) presented the trial results at a late-breaking clinical-trials session at the Society of Cardiovascular Computed Tomography (SCCT) 2013 Scientific Meeting.

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Infertility News (Dr Kaberi Banerjee, IVF expert, New Delhi)

When should ART treatment be stopped?

According to western studies, the chance for pregnancy in consecutive IVF cycles remains similar in up to four cycles. Many other factors should be considered when determining the appropriate endpoint in therapy, including financial and psychological reserves. Members of the IVF team can help couples decide when to stop treatment and discuss other options such as egg and/or sperm donation or adoption, if appropriate.

Rabies News (Dr. A K Gupta)

What is the best known clinical feature of rabies?

Hydrophobia and aerophobia are pathognomonic for rabies and occur in 50% of patients. Attempting to drink or having air blown in the face produces severe laryngeal or diaphragmatic spasms and a sensation of asphyxia. This may be related to a violent response of the airway irritant mechanisms. Even the suggestion of drinking may induce hydrophobic spasm. Hydrophobia is typically unique to human beings.

cardiology news
  1. Patients who take statins to lower cholesterol may also protect themselves against Parkinson's disease as per a Chinese population-based study suggested. Specifically, the lowest risks were for patients taking simvastatin or atorvastatin, the researchers reported in the July 30 issue of the journal Neurology.
  2. Diabetes increases the risk of physical disability, according to a literature search of studies conducted up to August 2012. In 15 studies, people with diabetes were 1.71 times more likely to have a disability related to mobility. In 10 studies, people with diabetes were 1.65 times as likely to have difficulties with instrumental activities of daily living. In 16 studies, people with diabetes had disabilities related to activities of daily living. The Lancet Diabetes & Endocrinology findings suggest that efforts to promote healthy aging should account for this diabetes-related risk of disability. (ASN News)

Valvular Heart Disease News

Prolapse is defined as systolic mitral leaflet displacement =2 mm above the annular plane in the parasternal or apical long axis views

(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

Children's solid tumors rarely metastasize to the brain

An analysis of a series of cases of children with solid primary tumors challenges the notion that these tumors often metastasize to the brain. But regardless of the management strategy, the prognosis remains poor once brain metastases appear, probably because of advanced disease when they are diagnosed, a study from M.D. Anderson Cancer Center shows. Data was presented at the 23rd Meeting of the European Neurological Society (ENS) (Source: Medscape)

Ecallantide helps adolescents with hereditary angioedema

The plasma kallikrein inhibitor ecallantide helps control hereditary angioedema (HAE) in 10- to 17-year-olds. Ecallantide is currently indicated for treating HAE in patients 16 and older. Children at least 12 years old can be treated with purified C1-inhibitor. (Source: Medscape)

cardiology news

Negative stress may lead to heart disease

Marital disharmony and job dissatisfaction are the two main mental risk factors for the causation of heart attack. Many studies in the past have suggested that there is a strong correlation between a nagging wife and early heart attacks in men. Similarly, literature has shown that work–related stress is related to early onset of high blood pressure, diabetes, stroke and heart attacks.

A study from University College, London has shown that chronically stressed workers have a 68% of higher risk of developing heart disease, especially in people under the age of 50.

Whether stress–related chemical changes or stress–related behavior is linked to heart disease, is yet to be answered. Stress–related lifestyle involves eating unhealthy food, smoking, drinking and skipping exercises.

Chemical changes related to chronic stress are increased levels of cortisol, epinephrine and norepinephrine.

Amongst stress, negative stress is more dangerous than positive stress and amongst negative stress it is jealousy, anger and cynicism which are associated with heart attack.

The answer lies in managing stress by acting on a personal situation and not reacting to it. In children the same type of stress, especially during exam days, can end up with anxiety, insomnia and suicidal attempts. ...Read More

cardiology news

Women under 30 years old have higher pregnancy rates at three, six and 12 months than women over 30 years old.

cardiology news
  1. 23rd July: HCFI Executive Meeting


CPR 10 Training Camp, EPFO, 30th May 2013

CPR 10 Camp - Police Training Center Najafgarh


CPR Classes: Persons trained (1336)

19th July: CPR Moolchand 29

20th July: CPR Moolchand 28

22nd July: CPR Moolchand 26

23rd July: CPR Moolchand 26

24th July: CPR Moolchand 27

25th July: CPR Sahodaya Sr. Sec. School, SDA, New Delhi (1200)

26th July: CPR Moolchand (20)

CPR VIP Sensitization

24th July: Imtiaz alam from pakistan doing CPR

Total CPR since 1st November 2012 – 56831 trained

TV and Radio Coverage

24th July: Interview in Sahara TV on iron tablets

Video Chats and uploads

Dr KK Aggarwal on NEWS 24

Dr KK Aggarwal on Monsoon Take Care

Dr KK Aggarwal on Danger of Epidemics (Uttarakhand Disaster)

1308 students learnt CPR at Abhinav Public School, Rohini

CPR Utsav 6th April 11543 men and women Trained in 1 day

Dr KK Aggarwal on 4 REALNEWS JUNE 26 2013 On Uttarakhand Disaster

Symposium on Prayer, Faith, Meditation and healing part 9

Symposium on Prayer, Faith, Meditation and healing Part 8

Advocacy through

Print Media

21st July: Saha Times

21st July: Viraat Vaibhav

22nd July: Veer Arjun

22nd July: Viraat Vaibhav

23rd July Veer Arjun

24th July: Veer Arjun

25th July: New Ad n Face-year-14, issue-7

26th July: Hindustaan

26th July: Rastriya Rakshak

Media advocacy through Web Media

Eating Disorders are contagious 24th July


Excess Weight Speeds Up Osteoarthritis

Apart from heart disease and diabetes, being overweight or obese can also cause rapid deterioration of the cartilage in the knee, leading to osteoarthritis. With every one unit increase in body mass index (BMI), the chances of rapid cartilage loss increased 11 percent, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India & MTNL Perfect Health Mela and National Vice President Elect IMA.

Osteoarthritis is the most common musculoskeletal disorder with major health and socioeconomic impact in our aging society. Osteoarthritis usually progresses slowly, but some patients experience a more rapid progression.

In a report published in the journal Radiology, researchers recruited 336 patients from a major osteoarthritis study. All were overweight and at risk of osteoarthritis, but had minimal or no loss of cartilage in their knees. During 30 months of follow–up, 20.2 percent of the patients showed a slow loss of knee cartilage and 5.8 percent had rapid cartilage loss. The main risk factors for cartilage loss were pre–existing cartilage damage, being overweight or obese, tears or other injury to the cartilage at the knee joint (meniscus), and severe lesions seen on an MRI. Other factors include inflammation of the membrane lining the joints and abnormal build up of fluid in the joint.

Weight loss is probably the most important factor to slow disease progression. Danger of developing osteoarthritis is another reason to control weight.

Do not let yourself get heavy. Keeping your weight down through diet and exercise or weight–loss surgery –– could prevent the need for knee–replacement surgery

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 56831 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.” ...Read More

today emedipics

Heart Care Foundation of India Organizes a CPR 10 Training camp at Sahodaya Sr Sec. School, SDA, New Delhi on 25th July 2013.

press release

Box warning on label as well as package insert and other promotional literature of formulations containing Nimesulide

today video of the dayDr KK Aggarwal on How to Take Care of your in Monsoon

Smart Phones Benefits and Hazards

Beware of Artificial Medicine

eMedi Quiz

Read this…………………

Nurse Jake is aware that most oral pediatric medications are administered:

a. With the nighttime formula
b. ½ hour after meals
c. On an empty stomach
d. With meals

Yesterday’s Mind Teaser: When caring for children who are sick, who have sustained traumas, or who are suffering from nutritional inadequacies, Nurse Ron should know the correct hemoglobin (Hb) values for children. Which of the following ranges would be inaccurate?

a. Neonates: 10.6 to 16.5 g/dl
b. 3 months: 10.6 to 16.5 g/dl
c. 3 years: 9.4 to 15.5 g/dl
d. 10 years: 10.7 to 15.5 g/dl

Answer for yesterday’s Mind Teaser: a. Neonates: 10.6 to 16.5 g/dl

Correct answers received from: Dr. deepali chatterjee, DR ABBAS VAKIL, Dr. P. C. Das, DR P K SAHU, Dr.K.V.Sarma, Dr. Sushma Chawla, Tukaram Pagad, Dr. V.P. Thakral, DR ARPAN GANDHI, daivadheenam, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr.K.Raju, Dr Avtar Krishan, Dr Kanta Jain, DR PRAVEENKUMAR SINDHUR,

Answer for 25th July Mind Teaser: b. Elevating the neonate’s head and giving nothing by mouth

Correct answers received from: Dr.(Maj. Gen.) Anil Bairaria, Dr. V.P. Thakral, dr p j khalap,

Send your answer to ijcp12@gmail.com

eMedi Apps

medicolegal update

Click on image to enlarge

medicolegal update

Doctors vs Guns


The number of physicians in the U.S. is 700,000

Accidental deaths caused by Physicians per year are 120,000

Accidental deaths per physician is 0.171

Statistics courtesy of U.S. Dept of Health Human Services.


The number of gun owners in the U.S. is 80,000,000

The number of accidental gun deaths per year, all age groups, is 1,500

The number of accidental deaths per gun owner is .000188.

Statistics courtesy of F.B.I. Statistically, doctors are approximately 9,000 times more dangerous than gun owners.

Remember, "Guns don't kill people, doctors do."

FACT: Not everyone has a gun, but almost everyone has at least one doctor.

Please alert your friends to this alarming threat immediately. We must ban doctors before this gets completely out of hand!

Note: Out of concern for the public at large, the statistics on lawyers have been withheld for fear the shock would cause people to panic and seek medical attention.

medicolegal update
medicolegal update

Click on image to enlarge

medicolegal update

Situation: An 18–year–old girl complained of purulent nasal discharge, nasal congestion, pain in the cheek and upper teeth for last 10 days. CT scan showed maxillary sinusitis.
Reaction: Remember to give macrolides.
Lesson: Make sure to remember that clarithromycin (macrolide) 500 mg twice–daily for 7 days is not only effective in maxillary sinusitis but also in other sinusitis.

medicolegal update

For success, attitude is equally as important as ability. Harry F. Banks

medicolegal update

Dr KK Aggarwal: Obsessively yours: Signs That You May Have OCD
http://bit.ly/12vFIfq #Health

Dr Deepak Chopra: One of the clearest definitions of the “cosmic religious feeling” involves four key characteristics
http://bit.ly/12vFIfq #Health

medicolegal update

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