eMedinewS28th November 2013, Thursday

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);
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Harvard: 6 things you should know about vitamin D

The body makes vitamin D when sunlight hits the skin. You can also get the vitamin from food (mainly because it’s been added; few foods are natural sources of vitamin D) or by taking a supplement.

The process by which the body makes vitamin D is complex. It starts when the skin absorbs rays in the invisible ultraviolet B (UVB) part of the light spectrum. The liver and the kidneys also participate to make a form of the vitamin that the body can use.

A number of factors influence a person’s vitamin D levels. Here are six important ones.

  1. Where you live. The further away from the Equator you live, the less vitamin D–producing UVB light reaches the earth’s surface during the winter. Residents of Boston, for example, make little if any of the vitamin from November through February. Short days and clothing that covers legs and arms also limit UVB exposure.
  2. Air quality. Carbon particles in the air from the burning of fossil fuels, wood, and other materials scatter and absorb UVB rays, diminishing vitamin D production. In contrast, ozone absorbs UVB radiation, so pollution–caused holes in the ozone layer could end up enhancing vitamin D levels.
  3. Use of sunscreen. Sunscreen prevents sunburn by blocking UVB light. Theoretically, that means sunscreen use lowers vitamin D levels. But as a practical matter, very few people put on enough sunscreen to block all UVB light, or they use sunscreen irregularly, so sunscreen’s effects on vitamin D might not be that important. An Australian study that’s often cited showed no difference in vitamin D between adults randomly assigned to use sunscreen one summer and those assigned a placebo cream.
  4. Skin color. Melanin is the substance in skin that makes it dark. It "competes" for UVB with the substance in the skin that kick–starts the body’s vitamin D production. As a result, dark–skinned people tend to require more UVB exposure than light–skinned people to generate the same amount of vitamin D.
  5. Weight. Body fat sops up vitamin D, so it’s been proposed that it might provide a vitamin D rainy–day fund: a source of the vitamin when intake is low or production is reduced. But studies have also shown that being obese is correlated with low vitamin D levels and that being overweight may affect the bioavailability of vitamin D.
  6. Age. Compared with younger people, older people have lower levels of the substance in the skin that UVB light converts into the vitamin D precursor. There’s also experimental evidence that older people are less efficient vitamin D producers than younger people.

TCT 2013 Update: Cardiology Trials

FFR-CT and iFR Accurately Identify: Two studies show the benefit of assessing the functional severity of the coronary lesion using new twists on measuring fractional flow reserve (FFR) in patients with suspected CAD. In one, researchers measured the instantaneous wave–free ratio (iFR), which is a pressure–derived, adenosine-free measurement of coronary stenosis, and reported that it successfully characterized the hemodynamic severity of more than 90% of stenoses. In the other trial, FFR–CT accurately detected 81% of coronary stenoses in patients with stable CAD compared with 64% of stenoses detected with coronary angiography and 53% with CT alone.

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

What is charity?

sprritual blog

Some time back after retuning from a free health check-up camp, I met a Professor of Cardiology from Lucknow and started boasting that I saw 100 patients free today. He said do not get excited. Charity is a positive, but still not the absolute positive, unless it is done without any motive or done secretly. He said that you were honored on the stage; you got blessings from the patients and people talked about you in positive sense. It was an investment in the long run and not an absolute charity. When you serve never get honour on the stage by the people to whom you are serving. If you get that then it is like give and take. The purpose of life should be to help others without any expectations.

Understanding helping others

When you help others, it should not end up in harming somebody else. If you help even if it is unconditional, if you end up in promoting no.2 by superseding another senior person who deserves is not a help as the person to whom you are helping will give you one blessing but the person to whom you have harmed will give you 10 curses. Ultimately you end up with minus 8 points. Helping other means that you should give happiness to you, to the persons you have helped and also to others to whom you have not helped.

Helping always pays

The difference between American and Indian models is that Indians always think of now and do not invest in future. Americans always plans for the future. When we help somebody, we want that the same person should expect you by helping you when you are in need in a shorter run. But charity does not believe in that. Your job is to help others and negate your negative past karmas. You never know, may be decades later you get a help from a person to whom you helped decades earlier. Help should never be linked to returns.

cardiology news

Peace of Mind

Once, Buddha was walking from one town to another town with a few of his followers. This was in the initial days. While they were traveling, they happened to pass a lake. They stopped there and Buddha told one of his disciples, "I am thirsty. Do get me some water from that lake there."

The disciple walked up to the lake. When he reached it, he noticed that some people were washing clothes in the water and, right at that moment, a bullock cart started crossing through the lake. As a result, the water became very muddy, very turbid. The disciple thought, "How can I give this muddy water to Buddha to drink!" So he came back and told Buddha, "The water in there is very muddy. I don’t think it is fit to drink."

After about half an hour, again Buddha asked the same disciple to go back to the lake and get him some water to drink. The disciple obediently went back to the lake. This time he found that the lake had absolutely clear water in it. The mud had settled down and the water above it looked fit to be had. So he collected some water in a pot and brought it to Buddha.

Buddha looked at the water, and then he looked up at the disciple and said, "See what you did to make the water clean. You let it be… and the mud settled down on its own – and you got clear water… Your mind is also like that. When it is disturbed, just let it be. Give it a little time. It will settle down on its own. You don’t have to put in any effort to calm it down. It will happen. It is effortless."

News Around The Globe

News

  • The US FDA has approved polidocanol injectable foam (Varithena, BTG) for the treatment of incompetent veins and visible varicosities of the great saphenous vein (GSV) system. Varithena (formerly known as Varisolve) is a pharmaceutical–grade, low–nitrogen, polidocanol foam dispensed from a proprietary canister device. It is a minimally invasive, non–surgical procedure that requires neither tumescent anesthesia nor sedation.
  • According to a new study (November 18 Journal of Clinical Oncology), the incidence of oropharyngeal cancer (OPC) has significantly increased during the past 2 decades, and almost exclusively in economically developed nations. This trend underscores the potential role of human papillomavirus (HPV) in this increasing incidence, particularly in men.
  • Thalidomide induced remission in children and adolescents with treatment–refractory Crohn’s disease in 8 weeks, according to the results of a small randomized trial In addition, patients continued to respond beyond a year in an open–label continuation phase of the trial, as reported in an article published in the November 27 issue of JAMA.
  • Embolization of the left gastric artery was associated with significant weight loss compared with that seen in patients who underwent a control procedure. Compared with those who underwent embolization of a different artery, patients who underwent embolization of the left gastric artery lost a mean 7.9% of their body weight 3 months after the procedure versus a mean 1.2% for other procedures.
  • A specific immune response signature associated with latent cytomegalovirus (CMV) infection may help predict response to treatment in very early rheumatoid arthritis. When peripheral blood mononuclear cells from recently diagnosed patients were cultured with various types of immune stimuli including combined lysates of CMV and Epstein–Barr virus (EBV), patients who failed to have a clinically meaningful response to disease–modifying anti–rheumatic drugs (DMARDs) had higher CMV/EBV scores at baseline than responders (65.6 versus 50.2).

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