eMedinewS
28th November 2014, Friday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and National Science Communication Awardee. Limca Book of Record Holder (CPR). Gold Medalist

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

Use painkillers with caution in the elderly

Painkillers can cause stroke via irregular heart rhythm. Non selective non–steroidal anti–inflammatory drugs (NSAIDs) and new generation selective COX–2 inhibitors commonly used to treat inflammation are now linked to an increased risk of irregular heart rhythm called atrial fibrillation (AF), as per a Danish Research of 32602 patients led by Professor Henrik Toft Sørensen at Aarhus University Hospital in Denmark.

These drugs are already linked to increased risk of heart attacks and strokes. And now through AF, the risk gets intensified for stroke and new risk added of heart failure and death.

In the study compared with non users, new users (first drug within 60 days of diagnosis) showed 40% increased risk of AF with non–selective NSAIDS and 70% increased risk with COX–2 inhibitors. This means four extra cases of AF per year per 1000 new users of non–selective NSAIDS and seven extra cases of AF per 1000 new users of COX–2 inhibitors.

The risk was highest in the elderly, patients with chronic kidney disease or rheumatoid arthritis especially on COX–2 inhibitors. NSAIDs should be used very cautiously in older patients with a history of hypertension or heart failure.

News Around The Globe

  • Six weeks of antibiotics appear to be sufficient for treating patients with diabetic foot osteomyelitis even in the absence of surgery, suggests a new randomized prospective trial published online in Diabetes Care.
  • A study published online in JAMA Internal Medicine has stated that although hyperbaric oxygen (HBO) treatment is well tolerated by patients with postconcussion syndrome, and improves their symptoms and quality of life, the results do not appear to be any better than a sham air compression treatment.
  • Bariatric surgery does not appear to have adverse effects on kidney function in the early post-operative period (i.e., 3 months) and kidney function remains stable at 1 year follow-up, suggests a new study published online in the American Journal of Kidney Diseases.
  • A new study shows that compared to people who do not have sleep apnea, those who suffer from the disorder may not be capable of burning sufficiently high levels of oxygen during strenuous aerobic exercise. The study is published in the Journal of Clinical Sleep Medicine.
  • Preconceptual folic acid supplementation significantly reduces the risk for small for gestational age (SGA) at birth, suggests a population database study and systematic review published online November 26 in BJOG.

66th Annual Conference of Cardiological Society of India (CSI) -2014

Vignettes

Dr KK Spiritual Blog

Never Hurt the Ego of a Person

It is a well known Vedic fact that if you hurt the ego of a person, he will never forgive you, especially, if you have insulted or implicated him in character assassination, or have cast implications about financial embezzlement or you call a woman as old or a man as impotent in public.

For example, if I hurt ego of a chowkidaar, next time if a patient comes to the hospital gate and asks where Dr. KK Aggarwal is, he only has to whisper, “Which Aggarwal, whose cases never survive?”

Also never hurt the ego of a person who is drunk. Under the influence of alcohol, a person loses his capacity to judge persons and situations. If you provoke him, he can be destructive and aggressive.

Inspirational Story

Sometimes You Just Have To Cry

There are a lot of things about parenthood that could make one cry... the cost of formula, sleepless nights, or diaper messes just to name a few. However, for me the absolute worst had to be - immunization shots.

At about two months into parenthood, I learned the true meaning of the word "heartbreak". There could not have be anything worse than watching helplessly as he receives his first round of immunization shots. I would have rather have been run over by a truck than have to sit there and watch him go through that. While listening to his screams, I kept thinking that surely medical science could have come up with a better way of doing this by now. As far as any solace from the doctor, all he could say was, "Ah, look at those healthy tears." As we left the office, I whispered into my son's ear, "It’s okay, Sam. Sometimes you just have to cry."

In a way I guess it was only a matter of time before Sam was introduced to pain in his life. I remembered losing my father to a sudden car accident a number of years ago. I tried to remain strong through it all. One day, when a song came on the radio that reminded me of your grandpa, I completely lost it. It was the first time since the funeral that I just let go and cried. It felt good to not hold back anymore.

The earliest memory I have of my father is one of me as a young boy holding his hand by his two last fingers as we walked together. His hands seemed so large that his fingers were all I could actually grip. He always took me with him to basketball games even at my young age. I will never forget that.

As I grew older I remember dad and I listening to high school basketball games together on an old transistor radio. I would make a list of player’s names on a piece of paper and keep track of how many points each would score as the game went on. Too small to stay awake for the whole game, I always fell asleep before the game ended. When I would wake up in the morning I would find the score sheet lying next to me. The score sheet would be filled out with the final score on it completed by my father before he carried me to bed.

I remember the times when my father would stop by the house in the early morning on those cold days when I was home from school over Christmas break. I used to ride on the floor of that bread truck as he delivered the bread to the stores. I don't know if those old trucks even had heaters but it didn't matter. The smell and warmth from the bread that had just come from the bakery ovens would make my mouth water and keep me warm both at the same time.

In high school I became very interested in athletics. My father would attend all my games. My senior year our football team qualified to play in the state championship game. It was the first time in the history of our school that any team had advanced that far. The night before the game my father came to me and sadly announced that he would not be able to attend. He had to deliver the bread to the stores and the site of the games was a three hour drive from his route. He vowed to listen to every play on the transistor radio. Consumed with the anticipation of the game, I acknowledged his comments without fully noticing his regret.

The next day as game time approached I couldn't help thinking about my dad. For some reason as I lined up for the second half kickoff I happened to look across the field into the parking lot. There I saw his blue and white bread truck pulling into the stadium. He has delivered the bread and made the long drive in time to at least see part of the game in which we won the state championship.

Years later I had become a teacher and coach. Early one morning I was awakened by the sound of the telephone ringing at 5:30 A.M. As I struggled to answer the phone I'll never forget the sound of the sheriff's voice on the other end telling me that my dad had just been killed in an automobile accident on his way to work. Cattle from a nearby farm had broken through a fence and wandered onto the highway.

Being a dark, rainy morning my father never saw them as he came over a ridge. The impact spun the car sideways in the highway before a semi-trailer collided with it. He was killed instantly. As I listened to the story I could hear my heart beat in my ears. I hung up the phone devastated.

For a long time after that things really didn't matter to me. I went about my life but I really didn't care. It felt as if my heart had been torn away and in a sense it had. I went to work. I still taught school but I was just going through the motions.

One day I was on the school playground supervising a first grade recess. A little boy walked up to me and grabbed my hand by my last two fingers. Just like I use to do to my dad. In that moment my father came back to me. In that instant I realized that even though my father was gone he had left me something behind. He had left me his smile. He had left me his compassion. He had left me his heart. When that little boy touched my hand I realized that all these wonderful gifts that I had loved so much about my father could be passed on to others. From that moment on I started. In that moment I understood the meaning of the word heritage.

Like his father, there will be times in my son's life when he will feel pain. When that happens, I hope I am there for him. If I am not, I hope he remembers the words I whispered in his ear that day as we left the doctor's office. "It's okay, Sam. Sometimes you just have to cry."

Rabies News (Dr A K Gupta)

What are the various types of modern anti–rabies vaccines?

These are:

  • Purified vero cell rabies vaccine (PVRV)
  • Purified chick embryo cell vaccine (PCECV)
  • Human diploid cell vaccine (HDCV)
  • Purified duck embryo vaccine (PDEV)

Cardiology eMedinewS

  • The US Food and Drug Administration (FDA) has approved a software program that can noninvasively identify coronary artery blockages, avoiding the need to diagnose the problem via cardiac catheterization. The software is called FFR-CT and calculates fractional flow reserve (FFR).
  • Emergency department treatment of atrial fibrillation (AF) or flutter in patients with acute underlying medical illness is associated with a six-fold increase in adverse events, suggests a new study published online in Annals of Emergency Medicine.

Pediatrics eMedinewS

  • There is insufficient evidence of a link between early life exposure to acetaminophen and asthma to warrant changing guidelines on early life paracetamol exposure, suggested a systematic review and meta-analysis published online November 25 in the Archives of Diseases of Childhood.
  • Researchers at the University of Oxford in the UK have identified a chemical marker for type 1 diabetes in the breath of children, paving the way for a breath test that allows early diagnosis before they develop severe illness. The data are published in the Journal of Breath Research.

Quote of the Day

  • Always ask God to give what you deserve and not what you desire because your desires may be few but you deserve a lot.

Wellness Blog

Don’t Ignore Women’ Health

Women are not diagnosed or treated as aggressively as men. Even though more women than men die of heart disease each year, women receive only 33% of all angioplasties, stents and bypass surgeries; 28% of implantable defibrillators and 36% of open-heart surgeries, according to the National Coalition for Women with Heart Disease.

Although the traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — have a detrimental impact in men and women, certain factors play a bigger role in the development of heart disease in women.

  • Metabolic syndrome — a combination of increased blood pressure, elevated blood glucose and triglycerides — has a greater impact on women than men.
  • Mental stress and depression affect women's hearts more than they do men's.
  • Smoking is much worse for women than men.
  • A low level of estrogen before menopause is a significant risk factor for developing microvascular disease.
  • Though women will often have some chest pain or discomfort, it may not be the most prominent symptom. Diffuse plaques build-up and diseased smaller arteries are two reasons why symptoms can be different in women.
  • In addition to chest pain, pressure or discomfort, signs and symptoms of heart attack in women include: Neck, shoulder, upper back or abdominal discomfort, shortness of breath, nausea or vomiting, sweating, light-headedness or dizziness and unusual fatigue.
  • Endothelial dysfunction is more common in women. In this the lining of the artery does not expand (dilate) properly to boost blood flow during activity, which increases the risk of coronary artery spasm and sudden death.
  • WISE study results suggest that the commonly used treatments for coronary artery disease — angioplasty and stenting — are not the best option for women with more diffuse plaques.
  • Typical tests for coronary artery disease — angiogram, treadmill testing and others — are not reliable in women.
  • The WISE study showed that in some women, plaques accumulate as an evenly spread layer along artery walls, which is not visible using traditional testing methods.
emedipicstoday emedipics

Health Check Up and CPR 10 Camp at Navjeevan Sarvodaya Kanya Vidyalaya 3rd November 2014

Self-Assessment-Quiz

 

expert_choice
press release

Ventilator–associated tracheobronchitis

video of day

Other Blogs

Video Library

Sameer Malik Heart Care Foundation Fund

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF

Total CPR since 1st November 2012 – 101090 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

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

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

 

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 :

 

Dr Good and Dr Bad

Situation: A patient with low BMD wanted to know if he could take potassium citrate.
Dr. Bad: There is no role.
Dr. Good: Take it.
Lesson: Daily supplementation with potassium citrate significantly increases BMD in the elderly. BMD increases significantly with daily supplementation of 60 mmol potassium citrate.

Make Sure

Situation: A patient with gross ascites presents with complaints of difficulty in breathing on lying down.
Reaction: Oh my God! Why did you drain so much ascitic fluid?
Lesson: Make sure, to only moderately tap ascitic fluid as overenthusiastic tapping can be life–threatening.

eMedinewS Humor

Violin Practice

Little Harold was practicing the violin in the living room while his father was trying to read in the den. The family dog was lying in the den, and as the screeching sounds of little Harold’s violin reached his ears, he began to howl loudly. The father listened to the dog and the violin as long as he could. Then he jumped up, slammed his paper to the floor and yelled above the noise, "For pity’s sake, can’t you play something the dog doesn’t know?"

Twitter of the Day

Dr KK Aggarwal: Snoring is linked with high blood pressure
Dr Deepak Chopra: When you let go of your story you return to the freedom of infinite possibilities. Do it now or only death will give you the opportunity

ePress Release

A great loss for Heart Care Foundation of India – Demise of Mrs. Abheeta Khanna, Director HCFI

With deep sorrow, we would like to inform you of the demise of Mrs. Abheeta Khanna w/o of renowned cricketer Mr. Surinder Khanna and an integral part of the Heart Care Foundation of India family.

Mrs. Abheeta Khanna was associated with the Heart Care Foundation of India since 20 years. She worked as a PR Director for the NGO where in she played a very important role in the execution of all media strategies and activities. She worked closely with all the employees of the organization and maintained a very cordial relationship with all the colleagues as well as the media persons whom she interacted on a regular basis for the NGO. Mrs. Abheeta Khanna assisted Dr. KK Aggarwal in his initiative, Perfect Health Mela and many other such social endeavors.

Abheeta bravely fought brain cancer for the past 8 years and finally reached her heavenly abode on the 26th November 2014. A warm and ever smiling person, Abheeta will be sorely missed by one and all.

May her soul rest in peace and give strength to her family to bear this loss.

eMedi Quiz

Bacitracin acts on:

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

Yesterday’s Mind Teaser: An increased incidence of cholangiocarcinoma is seen in all of the following, except:

1. Hydatid cyst of liver.
2. Polycystic disease of liver.
3. Sclerosing cholangitis.
4. Liver flukes.

Answer for yesterday’s Mind Teaser: 1. Hydatid cyst of liver.

Correct answers received from: Dr Jainendra Upadhyay, Dr Pankaj Aggarwal, Dr Rakesh Sharma, Dr Avtar Krishan.

Answer for 25th November Mind Teaser: 2. Tricuspid valve.

Correct answers received from: Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr Poonam Chablani.

Send your answer to email

medicolegal update
  1. Dear Sir, very informative newspaper. Regards: Dr Tarun
medicolegal update

(Contributed by Dr MC Gupta, Advocate)

Q. Doctors registered under the PNDT Act have to keep record of pregnant and nonpregnant women separately. If they can’t perform sonography on non pregnant then what is the idea of having a separate register for non pregnant patients?


Ans. A doctor registered under the PNDT Act is not barred from performing ultrasonography on non–pregnant women or on men if he is competent to do so by virtue of his qualifications, such as MD in Radiology/Radiodiagnosis. The PNDT authorities are concerned only with ultrasounds done on pregnant women and not with other ultrasounds. That may be the reason why doctors registered under the PNDT Act have to keep record of pregnant and nonpregnant women separately.

eMedinewS Special

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2. eMedinewS audio PPT (This may take a few minutes to download)

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