May 28  2015, Thursday
Tips for safe eating
Dr KK Aggarwal
  1. Snack with raw vegetables instead of potato chips.
  2. Add fruits in breakfast.
  3. Prefer juice instead of a usual coffee, tea or soda.
  4. Wash fruits and vegetables with water and scrub with a dish brush when appropriate.
  5. Throw away the outer leaves of leafy vegetables, such as lettuce and cabbage.
  6. Peel and cook when appropriate, although some nutrients and fiber may be lost when produce is peeled.
  7. Avoid fruits and vegetables that look brownish, slimy or dried out. These are signs that the product has been held at an improper temperature.
  8. Wash cutting boards with hot water, soap and a scrub brush to remove food particles.
  9. Wash hands with warm water and soap for at least 20 seconds before and after handling food, especially fresh whole fruits and vegetables and raw meat, poultry and fish. Clean under fingernails, too.
IMA NMA Initiative: Dr A Marthanda Pillai, National President Indian Medical Association and Dr KK Aggarwal, Hony Secy Gen IMA in Kathmandu, Nepal
Dr KK Spiritual Blog
Collective Consciousness

Consciousness is an energized field of information with powers to do everything in the universe. Collective consciousness is the internet of the collective souls of many people in a group.

Collective consciousness is the strongest superpower ever available in the universe. As per the Vedic texts whatever is the intent of collective consciousness will become a reality. Scientifically collective consciousness is based on the principle of critical mass. The Vedic literature has shown it to be the 1% of the defined population under study.

The origin of the critical mass comes from 100th monkey phenomenon. The story goes as under: long ago in Japan a monkey called Emo used to eat dirty apples everyday picked up from the ground. One day by accident the apple fell down in a river, the dirt got washed off and he ate the washed apple. Obviously it tasted delicious. The monkey started washing the apple thereafter every day before eating. His fellow monkey started following the same. The process of following went on. A time came when the 100th monkey washed the apple and ate. A strange phenomenon was noticed. All monkeys in and around that state started washing the apple before eating. The number 100 was the critical mass.

Once this mass is crossed, information spreads like wild fire and the intent becomes a universal reality. Vedic literature has also shown if 1% of the public of any area meditates together the crime rate of that area goes down. It also talks about the role of critical mass in prayers in achieving miracles.

The principle of critical mass is often used in designing and organizing an event. In a movie hall of 1000 people if 10 people sitting in different areas clap, then everybody will clap. The same applies to hooting. Most politicians use this principle when they organize election rallies. For a gathering of 10000 they need 100 and for a gathering of 1000 people they only need 10 supporters who are supposed to sit in different areas and shout or clap on given directions. The Mexican way of hooting or clapping in cricket grounds also follow the same principle. Most successful leaders used this technology to lead.
Cardiology eMedinewS
  • Increasing alcohol consumption in elderly men and women appears to be associated with changes in the heart's structure and function, suggests a new analysis published online May 26 in Circulation: Cardiovascular Imaging. Women were more susceptible, with a reduction in left ventricular ejection fraction (LVEF) with increasing alcohol consumption.
  • Initiation and uptitration of the angiotensin-receptor/neprilysin inhibitor (ARNI) LCZ696 is safe and tolerable in a broad range of individuals with reduced-LVEF heart failure (HFrEF), including both in- and outpatients and those taking ACE inhibitor or ARB, suggests new research presented at the Heart Failure Congress 2015 of the European Society of Cardiology Heart Failure Association.
Pediatrics eMedinewS
  • Infants who undergo regional anesthesia are less likely to experience apnea after surgery than infants who undergo general anesthesia, suggest two multinational studies published online in Anesthesiology.
  • Obese male teenagers are more than twice as likely to develop colorectal cancer by middle age, and those with a high level of systemic inflammation are also at increased risk, suggests a large cohort study published online May 26 in Gut.
Make Sure
Situation: A patient with cough of more than 4 weeks duration came with blood in his sputum.
Reaction: Oh my God! Why was TB not suspected earlier?
Lesson: Make sure that all patients with cough of more than 3 weeks duration are investigated for TB.
Dr Good Dr Bad
Situation: A patient with Crohn's disease needed a painkiller.

Dr Bad: Take any painkiller

Dr Good: Give Nimesulide

Lesson: Nimesulide is safe in IBD. A study in Scand J Gastroenterol. 2015 Mar;50(3):255-63 reviewed evidence for NSAIDs in patients with quiescent inflammatory bowel disease. Most patients with IBD tolerated these medications, while in the sole clinical trial of NSAIDs, 20% experienced a clinical and laboratory documented relapse of disease, within 7-10 days of NSAID ingestion. Though data on COX-2-selective NSAIDs are somewhat unclear, but nimesulide, celecoxib and etoricoxib do not appear to be associated with relapse of disease. The study concluded that conventional NSAIDs may cause clinical relapse in about 20% of patients with quiescent IBD, which may be due to dual inhibition of the COX enzymes. Certain COX-2-selective NSAIDs appear to be safe.

(Copyright IJCP)
eMedinewS Humor
Smelling and Hearing

An elderly woman goes to the doctor. She says, "Doc, it’s terrible, I pass gas all the time. Fortunately, it’s odorless and silent, otherwise I’d be mortified. For example, I’ve passed gas ten times just since we’ve been talking, but it’s odorless and silent so you can’t tell." The doctor gives her some green pills and tells her to take one a day and come back in a week.

The woman comes back after taking the pills for a week. She says, "Doc, there’s been a change but not for the better. I still pass gas all the time, but while it’s still silent, now it smells terrible!"

The doctor says, "Well, I’m glad we cleared up your sinus blockage. Now we’ll have to work on your hearing."
IJCP Book of Medical Records
IJCP’s ejournals
CPR 10
Total CPR since 1st November 2012 – 101090 trained
Video of the Day
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 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
Press Release
Ten ways to ease neck pain

Neck stiffness is common and can be uncomfortable enough to hamper day to day life. Ten easy steps can prevent neck pain, said Padma Shri, Dr B C Roy & DST National Science Communication Awardee, Dr K K Aggarwal, President Heart Care Foundation of India and Honorary Secretary General Indian Medical Association.

Following are the 10 steps:
  1. Don’t stay in one position for too long
  2. Keep the computer monitor at eye level.
  3. Use the hands-free function of the phone or wear a headset.
  4. Prop your touch-screen tablet or the ipad on a pillow so that it sits at a 45° angle, instead of lying flat on your lap.
  5. Keep your prescription up to date if you wear glasses to prevent leaning your head back to see better.
  6. Don’t use too many pillows as it can stifle your neck’s range of motion.
  7. Before you move a big wardrobe across the room, consider what it might do to your neck and back, and ask for help.
  8. Sleep well.
  9. Call your doctor if neck pain is associated with radiating pain, weakness, or numbness of an arm or leg.
  10. Also call the doctor if you have fever or weight loss associated with your neck pain, or severe pain.
eIMA News
IMA Swachch Bharat Swastha Bharat
Observe IMA Hygiene Hour every Friday from 4-5 p.m. Do one hour cleanliness awareness drive.
Key Resolutions and Decisions: 68th World Health Assembly – 26th May
Item 13.4 Follow-up to 2014 UN Review NCDs: The report contained in A68/11 was noted. Member States highlighted their commitment to keeping NCDs high on the agenda and the urgent need for greater and more even progress ahead of the 3rd UN Review and Assessment on NCDs in 2018, in order to achieve the 25 by 25 targets. Both HICs and LMICs underlined WHO technical assistance was of utmost importance to speed up implementation at the national level, including through the UN NCD Task Force. Delegates welcomed the GCM/NCD work plan 2016-2017 and several Member States called for the 2017 General Meeting to be held at the technical level rather than the political, and to ensure the participation of civil society and academia.

The World Heart Federation and the NCD Alliance delivered a joint statement.

68th World Health Assembly Statement by World Heart Federation on behalf of the NCD Alliance Agenda item 13.4: Follow-up to the 2014 UN Review and Assessment on NCDs

Honourable chairperson, distinguished delegates,

Thank you for the opportunity to deliver this statement on behalf of the World Heart Federation and the NCD Alliance, a network of 2,000 civil society organisations united against non-communicable diseases.

We are all aware, and note with profound concern, that the 2014 UN NCD Review indicates that progress on NCDs has been insufficient and highly uneven. The deadline for achieving the commitments made at the 2014 UN NCD Review is only a few short months away. We therefore urge Member States and the WHO to accelerate progress at the country level to ensure that the world is on track to meet the highly ambitious, but nevertheless achievable 25 by 25 NCD targets.

To this end, we urge Member States to pursue these three recommendations:
  1. Fully implement the time-bound commitments agreed at the 2014 UN Review. In practical terms, this means, by the end of this year, all Member States to establish and operationalize national NCD targets, national multisectoral NCD plans, and national NCD commissions. Among the time-bound commitments made by Member States, we highlight the further commitment that, by 2016, Member States will prioritize reduction of NCD risk factors and strengthening of health systems to stem the tide of NCDs. We urge you to prioritise these promises and pledge to work with you to achieve them. Civil society will not sit by while commitments go unfulfilled.
  2. Monitor national progress and ensure greater accountability ahead of the third UN NCD Review scheduled for 2018. We thank Members States for the progress already made in this regard, and welcome the recent development of 10 NCD process indicators.
  3. Fully leverage the Global Coordination Mechanism on NCDs and ensure full and meaningful engagement of civil society in all GCM activities, including the 2017 General Meeting. We furthermore appeal to Member States to ensure that all GCM Working Groups and Dialogues deliver concrete, actionable recommendations.
To conclude, let us not delay, but work together so that by 2018, we can report adequate progress towards a world free from the preventable burden of NCDs.
World No Tobacco Day
  • The US Food and Drug Administration (FDA) has approved a once-daily oral inhalation spray combining tiotropium and olodaterol for chronic obstructive pulmonary disease (COPD). Tiotropium-olodaterol is indicated for the long-term treatment of airflow obstruction in patients with COPD, including chronic bronchitis and emphysema, but not as a therapy for asthma or acute deterioration of COPD.
  • A new study demonstrates the feasibility of using MRI instead of the standard computed tomography (CT) to screen stroke patients for eligibility to receive tissue plasminogen activator (tPA). There was a significant 40% reduction in median door to needle (DTN) time with MRI and a four-fold increase in the proportion of patients treated with tPA in under an hour, reported the study published online in Neurology.
  • Adrenal-sparing surgery enables half of patients with multiple endocrine neoplasia type 2 (MEN2) and bilateral pheochromocytoma to gain 10 years without adrenal insufficiency and still have a rate of tumor recurrence similar to those who undergo classical adrenalectomy, suggests a large international study presented at the European Congress of Endocrinology (ECE) 2015.
  • Cannula type, infusion accessories, and carrier lines can all influence the speed of drug delivery by infusion, with speed varying 10-fold, suggested a new simulation study published online in the Emergency Medicine Journal.
  • Anti-TNF therapy for inflammatory bowel disease (IBD) during pregnancy appears to be safe for mother and fetus, suggested a prospective study published online in Gut.
Inspirational Story
Tears of Happiness

Once there lived two brothers who lost their parents at an early age. They worked together on their family farm. Some years later, the elder married and had a family with two children, while the other was still single. They worked hard together in the day and at the end of each day they shared their produce equally.

One day while the single brother was working in the fields, he thought to himself, "It’s not right that we share equally everything. I’m alone and my needs are simple. My brother has a big family. He needs much more." With that in mind he took a sack full of grains and slowly went to his brother’s barn and placed the sack quietly. He did so every night.

Meanwhile, the married brother thought to himself, "It’s not right that we share everything equally. After all, I’m married and I have my wife and children to look after me in years to come. My brother has no family and no one can take care of his future. He really should have a bigger share." So each night he took a bag of grain and put it into his brother’s barn quietly.
This went on and both men were puzzled for months because their grain never dwindled.

Then one night, on the way to each other’s barn, the two brothers coincidentally met and they found out what was happening all these years!

They dropped their bags, cried and embraced one another with tears of happiness.
Quote of the Day
Creativity is intelligence having fun. Albert Einstein
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Reader Response
Dear Sir, Very informative newspaper. Regards: Dr Kapil
Wellness Blog
ABO Blood Type is a Risk Factor for Coronary Heart Disease

Two prospective cohort studies have identified the ABO blood group as a risk factor for the development of heart disease. People with blood groups A, B, or AB were 5–23% more likely to develop coronary heart disease compared with those with O blood type. The study by Dr Meian He from Harvard School of Public Health, Boston, MA included 62 073 women from the Nurses’ Health Study (NHS) and 27 428 men from the Health Professionals Follow–up Study (HPFS) and is published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.

In the NHS and HPFS, the incident rates of coronary heart disease per 100 000 person–years were 125, 128, 142, and 161 for women with type O, A, B, and AB, respectively, and 373, 382, 387, and 524 for men with type O, A, B, and AB, respectively. Compared with individuals with O blood type, individuals with blood group A, B, or AB had a respective 5%, 11%, and 23% increased risk of developing coronary heart disease in an age–adjusted model.

In non–O individuals, plasma levels of factor VIII–von Willebrand factor (vWF) are approximately 25% higher than in individuals with type O blood type. Elevated levels of factor VIII–vWF have been previously identified as a risk factor for coronary heart disease. The vWF has an important role in hemostasis and thrombosis by mediating platelet adhesion to the vascular wall, especially under high shear stress conditions. Along with fibrinogen, vWF also participates in platelet aggregation and plays a role in the development of atherosclerosis.
eMedi Quiz
An increase in which of the following parameters will shift the O2 dissociation curve to the left.

1. Temperature.
2. Partial pressure of CO2
3. 2,3 DPG concentration.
4. Oxygen affinity of hemoglobin.

Yesterday’s Mind Teaser: The parameters of sensitivity and specificity are used to assess:

1. Criterion validity.
2. Construct validity.
3. Discriminant validity.
4. Content validity.

Answer for yesterday’s Mind Teaser: 1. Criterion validity.

Correct Answers received from: Dr K Raju, Dr Poonam Chablani, Dr G Madhusudhan, Dr K C Sharma, Dr K V Sarma, Dr Jainendra Upadhyay, Tukaram Pagad, Dr Avtar Krishan, Dr Jainendra Upadhyay.

Answer for 26th May Mind Teaser: 4. X-ray diffraction.

Correct Answers received: Dr Jainendra Upadhyay, Dr Avtar Krishan, Dr Nikhil Mohanty, Dr K V Sarma.
Rabies News (Dr A K Gupta)
Why do dogs always keep their mouth open with tongue protruding out?

Dogs do not sweat through the skin. They exchange most of their heat through the mouth, and extend the tongue to increase the surface exposed to the air.
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