eMedinewS28th April 2014,Monday

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

Fetus is a patient

Recognizing the fetus as a patient, the American Heart Association (AHA) has released a scientific statement that addresses the diagnosis and treatment of fetal cardiac disease.

For diagnosis, the statement covers the timing of referral for evaluation, indications for referrals, and the level of experience needed to perform and interpret various diagnostic studies. That includes a detailed discussion of the fetal echocardiogram –– the main tool for evaluating fetal cardiac disease –– and reviews of other tests, including advanced ultrasound, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography.

Although the most common trigger for a referral is an obstetric ultrasound that raises the suspicion of a fetal structural heart abnormality, numerous other factors increase the chances of congenital heart disease in the fetus, such as:

  • Maternal pregestational diabetes and diabetes diagnosed in the first trimester
  • Maternal uncontrolled phenylketonuria
  • Exposure to nonsteroidal anti–inflammatory drugs in the third trimester
  • The presence of congenital heart disease in the mother or a close relative
  • The use of assisted reproductive technology to conceive

Once the diagnosis is made, it is important to manage parental stress and anxiety and discuss treatment options, according to the statement. Although there is no proven best way to do that, the authors provide guidance on counseling parents.

News Around The Globe

  • According to a new study, an investigational agent – ferric citrate – for iron–deficiency anemia significantly increased transferrin saturation (TSAT) and decreased serum phosphate levels in chronic kidney disease patients not yet on dialysis. TSAT increased from 22% to 32% in patients given ferric citrate.
  • A new randomized controlled trial has revealed that UV–A1 phototherapy improves the symptoms of vulvar lichen sclerosus (VLS), but may not be as effective as topical corticosteroids, the current "gold standard" of treatment. The total clinician’s score (TCS) was reduced by 51.4% in the clobetasol group and by 35.6% in the phototherapy group.
  • A new case series has suggested that photobiomodulation may be effective in patients with non–center–involving diabetic macular edema (NCDME). Researchers noted that two 80–second photobiomodulation (PBM) treatments a day significantly reduced macular thickening in all four treated eyes.
  • Research suggests that a new approach, "DICE", to handle agitation, aggression and other unwanted behaviors in people with dementia could potentially reduce the use of antipsychotics and other psychiatric drugs in this population. DICE stands for Describe, Investigate, Evaluate, and Create. The report is published in the April issue of Journal of the American Geriatrics Society.
  • A novel research has put forward the prognostic value of tumor regression grading (TRG) after preoperative chemoradiotherapy (CRT) for locally advanced rectal carcinoma. At 10 years, complete and intermediate tumor regression after preoperative CRT was noted to be associated with improved metastasis-free and disease–free survival, independent of clinicopathologic parameters.

Rabies News (Dr A K Gupta)

How is rabies transmitted?

Rabies is transmitted by infected secretions. Most commonly, transmission to humans takes place through exposure to saliva following a bite by an infected animal. Rabies virus can be excreted in saliva, urine, nasal discharge and respiratory secretions.

Cardiology eMedinewS

  • Among patients enrolled in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), those with an estimated glomerular filtration rate (eGFR) of 30 to 45 ml/min had 43% increased risk of all cancers compared with those who had an eGFR of at least 90. The findings were presented during a poster session at the National Kidney Foundation meeting recently.
  • A research published in Circulation Research has reported that fibroblasts could represent an alternative to heart transplants for patients with heart disease. Using cutting edge technology, the researchers noted that cardiac fibroblasts have specific genes called transcription factors and could thus be considered in replacement therapies.

Pediatrics eMedinewS

  • A study presented at the National Kidney Foundation’s 2014 Spring Clinical Meeting has pointed that nearly 18% of severely obese adolescents show signs of abnormal kidney function.
  • A study presented at the British Sociological Association’s annual conference in Leeds has reported that children as young as three years old have improved mental health if their parents are better off than other families living in their area. Being at the top of the income ranking for their area was associated with a 39% improved overall score for mental health as compared to being at the bottom of the ranking.

Dr K K Spiritual Blog

Spiritual Prescription: You are born with a quota use it judicially

Everyone is born with a passport with a defined battery life to live up to 100 years after which one has to go back to renewal or recharging of the batteries.

If the battery is overused or misused and is depleted early, one may have to go back prematurely for recharging, but this time when one comes back, he or she may come back with a different body which may not be the human one. There are 64 lakh Yonis as described in the Vedic literature.

According to the Vedic description, if one dies prematurely there are chances that the rebirth will not be in the same species.

To live up to the time period defined at the time of birth by Dharmaraja, one has to follow the principles as described in Yogashastra.

The main principle is the principle of moderation and variety. It says that everything has to be used, if not used will get rusted and if overused well undergo wear and tear. The classical example is that GOD had made uterus in the women for producing a child; if the same organ is not used at al it will produce a fibroid and if overused it may end up in a cancer.

When using the principles of moderation and variety when should remember that each one of us is born with a fix quota of everything, a quota of diet, respirations, heart rate and thoughts.

According to swara yoga one is born with predefined number of respirations to be taken during life. If one consumes them early he will depart for refueling early from the life. To reduce the respiratory rate is therefore the basis of postponing aging and prolonging life. Stimulation of the parasympathetic nervous system by learning and practicing pranayama, which is slower and deep breathing, does the same.

One breathes 15 times a minute or 21600 breaths in a day, or 7884000 (78.84 lakhs) a year or 788400000 (78.84 crores) during life (assuming it to be 100 years). Some yoga books say that a person is born with 33 crore breaths, the same if taken at the rate or 15 per minute would last for 42 years.

In fact Pranayama originated on the concept that the breaths of each one of us are numbered, that our life–span is dependent on how many times we shall breathe in a given life, and that, as a consequence of this fact, we must reduce the number of breaths so as to live longer.

In Gorakshapaddhati (I.93), it is written that "Due to fear of death even Brahma, the Lord of creation, keeps on practicing pranayama and so do many yogis and minis. It is recommended that a student of yoga must always control his breath."

Hathayoga–pradipika (II.39) also writes: ‘All the gods including Lord Brahma became devoted to the practice of pranayama because they were afraid of death. We the mortals should follow the same path and control the breath."

Similarly one is born with a quota of heartbeats, which is an average of 70 per minute. Many studies have shown that people whose resting heart rate is higher have more chances of sudden death. The aim therefore is to keep the heart rate at a lower pace. The same can be achieved either by regular exercise, meditation, AUM Pranayama, or by meditation. In people who run marathons or participate in athletic activities, the temporary increase in the heart rate during exercise is compensated by the body by adapting the cardiovascular system in such a way that the basal heart rate reduces. The marathon runners may have a heart rate of only 50 per minute.

The less one eats the more he lives is an Yogic saying, It is said that people who eats once a day are Yogi, twice a day are Bhogi and thrice a day are Rogi. There are enough studies now, which say that 25% reduction in the calories content can increase the life span. Many studies in rodents have also shown similar effect.

The moderation in exercise is to walk 10000 steps a day. No exercise will end up with obesity and over use with osteoarthritis.

Stress is the excess of thoughts in the mind. Controlling the mind forms the basis of meditation. Samadhi is the state of no thoughts. Practicing meditation 20 minutes twice daily helps in the restrain of the mind with resultant state of Turya where the mind has controlled limited positive thoughts.

Wellness Blog

Eat 20 almonds or 15 cashews or 30 peanuts every day

People who ate a 1–ounce serving of nuts each day showed a 20 percent reduced risk of dying from any cause over three decades, compared to those who didn’t eat the tasty snacks, as shown a study published in the Nov. 21 issue of the New England Journal of Medicine by Dr. Charles Fuchs, director of the Gastrointestinal Cancer Center at the Dana–Farber Cancer Institute in Boston.

Prior studies suggest health benefits like a lower risk of heart disease and type 2 diabetes and lower cholesterol, among other health outcomes. Nuts are nutrient–dense foods. They contain unsaturated fatty acids, fiber, vitamins, minerals and antioxidants.

One–ounce serving was equal to about 16 to 24 almonds, 16 to 18 cashews or 30 to 35 peanuts.

Inspirational Story

Beauty Tips

For attractive lips, Speak words of kindness!

For lovely eyes, Seek out the good in people!
For a slim figure, Share your food with the hungry!
For beautiful hair, Let a child run his or her fingers through it once a day!
For poise, Walk with the knowledge you’ll never walk alone!
People, even more than things, have to be restored, renewed, revived,
Reclaimed, and redeemed;

Never throw out anybody! Remember, If you ever need a helping hand, You'll find one at the end of your arm!

As you grow older, you will discover that you have two hands, One for helping yourself, the other for helping others! The beauty of a woman is not in the clothes she wears, The figure that she carries, or the way she combs her hair! The beauty of a woman must be seen from in her eyes, Because that is the doorway to her heart, the place where love resides! The beauty of a woman is not in a facial mole, But true beauty in a woman is reflected in her soul!

It is the caring that she lovingly gives, the passion that she knows, And the beauty of a woman with passing years–only grows! If you send this to other women, something good will happen – you will Boost another woman’s self esteem!

ePress Release

Low Vitamin D Linked to Heart Risk

Low blood levels of vitamin D are associated with an increased risk of cardiovascular problems such as heart attack and stroke, 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

The five years of research with participants in the Framingham Heart Study included 1,739 people, average age 59, living in that Massachusetts city found that those with the lowest levels of vitamin D had a 62 percent greater risk of a cardiovascular event than those with the next highest levels.

As per a report published in the issue of Circulation of sunlight on the skin each week allows the skin to produce blood levels of about 30 nanograms of vitamin D per liter of blood, more than enough to prevent a deficiency such as rickets.

Food sources of vitamin D include milk (which is fortified) and oily fishes such as salmon.

Recommendations from the U.S. Institute of Medicine call for a daily intake of vitamin D ranging from 200 International Units (IU) for young people, to 400 IU for the middle–aged, to 600 IU for older people.

But getting that amount from food and sunlight may not be easy. A glass of fortified milk contains only about 100 IU of vitamin D. The suggested recommendation is 1,000 – 2,000 IU.

The cardiovascular risk associated with low vitamin D levels was especially greater for people who also had high blood pressure. Their incidence of cardiovascular events was double that of people with higher blood levels of vitamin D.

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 88972 people since 1stNovember 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."

Zee News – Health Wealth Shows

Cancer Prevention
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Fluid Intake


Total CPR since 1st November 2012 – 88972 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)

emedipicstoday emedipics

World Earth Day Celebration at DAV Public School, RK Puram, New Delhi.

press release

School Health Education

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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 with dengue fever developed shock.
Reaction: Oh my God! Why was the blood pressure 90/70 ignored?
Lesson: Make sure that a pulse pressure of less than 20 is not ignored. It is an impending sign that the patient is going into shock.

eMedinewS Humor

As an English professor, my father would often write little notes on student essays. Often he worked late, and as the hours passed, his handwriting deteriorated. One day a student came to him after class with an essay that had been returned.

"Mr. McDonald," he said, "I can’t make out this comment you wrote on my paper."

My father took the paper and, after studying it, sheepishly replied, "It says that you should write more legibly."

Quote of the Day

Good friends care for each other… close friends understand each other… and true friends stay forever beyond words, beyond time


Twitter of the Day

Dr KK Aggarwal: Smoking and ulcerative colitis http://youtu.be/NMIK16PyBrY?a via @YouTube
Dr Deepak Chopra: Your only identity is I AM undefined and infinite. Any label you give yourself limits yourself.


eMedi Quiz

The buffering capacity of a buffer is maximum at pH equal to:

1. 0.5pKa.
2. pKa
3. pKa+1
4. 2pKa

Yesterday’s Mind Teaser: A measure of location which divides the distribution in the ratio of 3:1 is:

1. Median.
2. First quartile.
3. Third quartile.
4. Mode.

Answer for yesterday’s Mind Teaser: 2. First quartile.

Correct answers received from: Dr poonam chablani, Dr Jainendra Upadhyay, Devinder Kumar, Nirmala Agarwal, Daivadheenam Jella, Dr Avtar Krishan, Arvind Diwaker, Dr.BItaan Sen & Dr.Jayashree Sen

Answer for 26th April Mind Teaser: 4. Glycosylation

Correct answers received from: Dr Jainendra Upadhyay, Devinder Kumar,

Send your answer to ijcp12@gmail.com

medicolegal update

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medicolegal update

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medicolegal update
  1. Dear Sir, Thanks for the information: Regards: Dr Kamant
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