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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Noise pollution

1. Excessive noise can ultimately affect hearing.
2. Constant exposure to loud noise can cause frequent sensory neural hearing loss.
3. A person who is exposed to > 80 dB noise must observe hearing conservation and hearing precaution guidelines.
4. It is safe to be exposed to a noise of 90 dB for 8 hours.
5. An exposure of more than 4 hour with 95 dB sound can be hazardous to health.
6. At 100 dB more than 2 hours of exposure can be harmful.
7. A loud noise can cause severe to profound sensory neural hearing loss or pains. This exposure involves exposure to noise of more than 150 dB.
8. Muffs can be used for hearing precaution.
9. Earplugs are highly recommended any time when a person is exposed to a loud noise.
10. One should not use TV volume of more than 50%.
11. One should not use MP3 volume of more than 50% when plugged in the years.
12. Those who have some hearing problem should always use ear plugs or muffs if they are expecting an atmosphere of loud noise.
13. The rough way test that the noise is loud is when you find it difficult to talk in a noisy atmosphere.
14. Acute noise pollution can increase the blood pressure acutely.
15. Chronic persistent noise pollution can be the cause of high blood pressure.

Sword, Dragger and Discus in Mythology

Out of nine forms of Goddess Durga, Chandraghanta, Katyayani and Kalratri are shown to carry a sword. Kushmunda, Siddadatri holding discuss and Kalratri holding additional Dragger (Bhala). All have mythological significance.

Durga powers represent feminine powers in all of us. The mythological weapons represent our inherent mental powers to fight to live in this world.

Sword power (non moving astra power) s indicate sharp intelligence and relates to straight forward resistance. For example, if you are not happy with somebody’s answer, you stub him on the spot and prove him wrong, is like using your sword power.

On the contrary, Discuss power ( moving shastra power) is your indirect power to make the other person realize his mistake and come back and withdraw.

Dragger or Bhala is in between the two. It is both atsra and shastra (moving and non-moving weapon). It is much more sharper and powerful than the sword.

All three of them are three human qualities used by a person in three different situations. For example, there is a theft in your house and you are suspecting your servant. You can use the sword power and confront him directly till he says yes or you can keep mum for the time being, look for evidence and, if found, now you confront him with much more force using your Dragger power and, lastly, you can create circumstances by using your discuss power and make the servant realize his mistake and come back to you to admit his mistake and seek pardon.

But your approach is destructive if the same thing happens with your wife or husband. Husband will not tolerate their wife having an affair with some one else.

Lesson from the Hedgehogs – Teamwork

It was the coldest winter ever. Many animals died because of the cold. The hedgehogs, realizing the situation, decided to group together to keep warm. This way they covered and protected themselves; but the quills of each one wounded their closest companions.

After awhile, they decided to distance themselves one from the other and they began to die, alone and frozen. So they had to make a choice: either accept the quills of their companions or disappear from the Earth.

Wisely, they decided to go back to being together. They learned to live with the little wounds caused by the close relationship with their companions in order to receive the heat that came from the others. This way they were able to survive.

The best relationship is not the one that brings together perfect people, but when each individual learns to live with the imperfections of others and can admire the other person’s good qualities.

News Around The Globe

Ketan Desai nominated as GU man in MCI

Ahmedabad: At a special meeting held on Sunday, the  Gujarat University senate nominated Dr Ketan Desai, former president of the Medical Council of India (MCI) and head of urology department, BJ Medical College, as the university’s representative member to the MCI. Dr S P Balodiya, former dean of medical faculty at GU, proposed the name of Dr Ketan Desai and Dr Bharat Shah, dean of B J Medical College seconded it. In a meeting that lasted less than 10 minutes, all members of the senate unanimously approved of Dr Desai’s name for representative. According to MCI norms, GU has to nominate one member to the council. GU had earlier called the meeting for selection of a representative 30 days back but the meeting was declared void due to lack of required number of members in attendance.

Some BJP members of the university held a meeting on Saturday night to field a candidate against Dr Ketan Desai but after a long discussion, they decided against it. According to some GU members, Dr Ketan Desai is perceived as close to the Congress. In another development, Dr Desai was elected unopposed president of World Medical Association (WMA) at the body’s meeting held recently in Brazil. (Source: THE TIMES OF INDIA, AHMEDABAD MONDAY, OCTOBER 28, 2013)

"I will get Indian docs exposure to global healthcare"

He was accused of turning the Medical Council of India (MCI) into a den of corruption; he even spent some time in jail on bribery charges. But Ahmadabad-based Dr Ketan Desai has bounced back as the president of the world Medical Association, reports Bharat Yagnik

Q. In what circumstances did you take over as the World Medical Association (WMA) president?
A. I was elected for the first time in 2009 and was to take charge in Canada in October 2010. A court had granted me permission to do so. Various vested interests prevented me from leaving India. However, members of the WMA realized that injustice had been done to me. The general body of the WMA, which met in Brazil recently unanimously resolved to give me another chance.

Q. What is the significance of the WMA?
A. The WMA comprises members of the national associations of about 109 countries. The WMA represents the community of physicians and ensures uniformity in practice. It lays down ethical standards and takes up issues like environment, disaster management, and the care of the elderly. I will act as the WMA ambassador in different for a like the WHO and UNICEF. These experiences will help me advise our government on health policies. My WMA stint will help Indian doctors get better exposure to global healthcare.

Q. You have been controversial since 1996 when you became the MCI president. A. I had taken very tough decisions that angered some influential quarters. Thousands of doctors who had secured medical degrees from dubious institutions in countries like Russia and China were barred. Ultimately a screening test was introduced in the MCI Act which affected a very powerful bobby. A large number of private medical colleges, run by influential people, had failed to obtain favorable orders from the MCI. They gunned for me. Regulations were introduced to check cheating try medical colleges. Eight private medical colleges were debarred in 2010 but after the supersession of the MCI. The ne2w board of governors reversed the decisions. Then tough laws were notified to prevent pharma companies from learning doctors. Show-cause notices were issued to two big pharma companies which had taken more than 200 doctors each abroad for a conference. Sadly nothing happened after I was dethroned. In 2000. Income Tax authorities carried out searches at all my premises. Each penny vas thorough verified. On determining that there was not even a rupee which was not accounted for the PT authorities gave me a clean chit. The CBI registered a case in 2001 and gave me a clean chit in 2003, which was accepted by a competent court in 2005, subsequently, the health ministry had forwarded letters to the CBI against me but a thorough investigation did not find any substance in any of these cases.

Q. in 2010, the CBI had detained you for allegedly accepting a bribe of Rs 2 crore.
A. Not even a penny was found or seized by the CBI. An inquiry proved that permissions were granted to colleges by the MCI in accordance with rules. The propaganda against me was malicious. In May 2010, the CBI registered case of is proportionate assets spanning 13 years (1997 to April 2010) against me and my family. After investigations over two years, the CBI in May 2012 gave me a clean chit.

Q. The Supreme Court recently issued a notice on NEET to the central government and the MCI. What is your opining?
A. NEET was recommended by the MCI for the first time in 2009 when I was the president. I had constituted a committee for working out a practical scheme to bring about transparency in the admission process. Almost 89 entrance examinations were being conducted by different entities. The committee had recommended a single entrance test for the entire country by incorporating an appropriate amendment to the MCI Act. The report was sent to the Government of India. Had these been accepted, the present messy situation would not have arisen.
Source: THE TIMES OF INDIA, AHMEDABAD

News

• Obesity might be a risk factor for community-acquired Clostridium difficile infection (CDI), as per results of a small retrospective study reported in the November issue of Emerging Infectious Diseases. Patients who developed CDI in the community were more likely to be obese than the general population, 34% compared with 23%.
•  Less than 10% of patients with hematuria are referred for bladder cancer screening, even though this is recommended in American Urological Association guidelines. A new retrospective study suggests that clinical factors and practice site play a role in this lack of adherence. Presence of certain clinically relevant risk factors, such as age and gender, predicted whether or not an individual subsequently got evaluated, according to David Friedlander, MD, now a first-year urology resident at Brigham and Women's Hospital in Boston.
• A European Union (EU) regulatory body has banned the use of high-dose oral and suppository forms of short-acting beta-agonists (SABAs) for the suppression of premature labor and other obstetric indications because they pose serious cardiovascular risks. However, clinicians can continue to use injectable versions of the drugs for obstetrical purposes on a restricted, short-term basis, the EU's Coordination Group for Mutual Recognition and Decentralised Procedures–Human (CMDh) announced.

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Rabies News (Dr. A K Gupta)

What are the precautions to be taken while administering RIGs?

• Patient should not be on an empty stomach.
• The RIGs vial taken out from the refrigerator should be kept outside for a few minutes to warm it to room/body temperature.
• While infiltrating RIGs into the bite wound, care must be taken to avoid injecting into blood vessels and nerves.
• While injecting into finger tips, care must be taken to avoid compartment syndrome.
• All emergency drugs and facilities for managing any adverse reactions must be available.
• For ERIG, keep the patient under observation for at least one hour after ERIG administration and then send home.
• RIGs can be infiltrated even to already sutured wounds without disturbing the sutures.

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinewS)

• Intracranial ultrasound treatment using an operator-independent device together with tissue plasminogen activator (tPA) in stroke patients, especially those who have clots that are not likely to lyse completely with tPA appears to be safe and produced promising recanalization rates, a new study has shown. According to lead author, Andrew D. Barreto, MD, University of Texas Health Science Center at Houston, ultrasound therapy causes the meshwork of fibrin strands within the clot to disperse, thereby allowing better access of tPA to the clot. The study was published online in Stroke on October 24.
• Screening high-risk heart patients for subclinical atherosclerosis using coronary artery calcium (CAC) testing can help identify those who would benefit most from treatment with the polypill as well as those for whom the risks of treatment may outweigh the benefits. A new study published in the Journal of the American College of Cardiology found that for participants with no evidence of atherosclerosis (CAC score=0), the 5-year number needed to treat (NNT) to prevent one cardiovascular event ranged from 84 to 134, while the NNT among those with CAC scores greater than 100 was 19 to 21. The vast majority of cardiovascular events over a median follow-up of 7.6 years occurred in participants with CAC scores greater than 100.

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinewS)

• Portable vision screening devices can simply and accurately identify vision problems in young children, according to a study that evaluated the sensitivity and specificity of 4 such devices. The study was presented at the American Academy of Pediatrics (AAP) 2013 National Conference and Exhibition.
• Children with chronic autoimmune uveitis showed favorable responses to treatment with either adalimumab (Humira) or infliximab (Remicade), although not with etanercept (Enbrel), according to a meta-analysis of observational studies reported online in Arthritis Care & Research. Among more than 200 children included in eligible studies in the literature, 87% of those treated with adalimumab and 72% of those given infliximab were considered responders. In contrast, only 33% of those treated with etanercept responded.

5 steps to lower Alzheimer's risk (HealthBeat)

• Maintain a healthy weight.
• Check your waistline.
• Eat mindfully. Emphasize colorful, vitamin-packed vegetables and fruits; whole grains; fish, lean poultry, tofu, and beans and other legumes as protein sources; plus healthy fats. Cut down on unnecessary calories from sweets, sodas, refined grains like white bread or white rice, unhealthy fats, fried and fast foods, and mindless snacking. Keep a close eye on portion sizes, too.
• Exercise regularly. Aim for 2½ to 5 hours weekly of brisk walking (at 4 mph). Or try a vigorous exercise like jogging (at 6 mph) for half that time.
• Keep an eye on important health numbers. In addition to watching your weight and waistline, keep a watch on your cholesterol, triglycerides, blood pressure, and blood sugar numbers.

Total CPR since 1st November 2012 – 69833 trained

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Credible Health Sutras Can Be Ideal Answers to Lifestyle Diseases

20th MTNL Perfect Health Mela, organized by Heart care foundation of India, ended at Constitution Club of India on Sunday. The five day health mela, a unique one of its kind focused on the issues like life style disorders and disaster management. The key speakers included Padma Shri & Dr. BC Roy National Awardee, Dr. K K Aggarwal, President, Heart Care Foundation of India; Dr.  Rajneesh Malhotra, Dr Aparna Jaswal, Dr. Viveka Kumar, Dr. Vipul Gupta, Dr. Praveen Chandra, Dr Ambrish Mithal and  Dr Sameer Srivastava. Besides experts from other systems of medicine and dharma gurus from various religions also participated making the event interesting, educative and easily approachable for the common man.

The foundation announced starting of its prestigious Think tank of eminent people who will meet once in three months to come out with policies on how to deal with lifestyle disease burden and other social, medical issues. The members of the Think tank include: Dr. S Y Quraishi Former Chief Election Commissioner of India; Dr. Mathew Cherian Chief Executive Helpage India; 
Dr. Dindeshwar Pathak Founder Sulabh International; Dr. S P Agarwal,  Secretary General Indian Red cross Society, Lt Gen D Raghunath  and Raja Saboo Former President Rotary International.  All of them received first National Health Care Promotion awards.

It was researched and discussed at the mela that the incidence of lifestyle diseases is rising at an alarming rate in India and there is an urgent need to create awareness among the general public about these diseases and their prevention.  Credible ‘Health Sutras’, using low cost awareness modules can be the answer to lifestyle diseases, said Padma Shri & Dr. BC Roy National Awardee, Dr. K K Aggarwal, President, Heart Care Foundation of India. The best low cost awareness module is to display and communicate credible ‘Health Sutras’ in places where there is a public gathering such as a circus, zoo, movie hall, Mela etc. Various infotainment modules can also be used to disseminate health messages.

The Heart Care Foundation of India has been field testing such modules effectively and successfully and the recently concluded Health Mela is one such example. Other modules that have been successfully tested by the Foundation include: Road shows in established public places e.g. Zoo, India Gate, Pragati Maidan; Interval of movie shows; Health Darbars; Using cremation ground to create awareness about a disease – Tobacco; Playing cards with health messages; Games: Ludo, Chess, Snakes & Ladders with health messages; Kites with health messages; Folk dances with health messages; Jhoolas with health messages; Walkathons using Tongas, Cycles, Auto rickshaws; Walk/Run for a health-related cause; Cabaret shows with HIV awareness messages especially for the lower socioeconomic masses; Karwa Chauth with a theme ‘Be faithful to your partner’; Inter School, Inter Nursing school, Inter College competitions with health-based themes with Health Breaks in between two performances.

Some interesting facts about health sutras include one liner health messages or thumb rules or formulas on factual health which are evidence based, filed tested and released from the mouth of credible people at a time when they are needed. The following are examples of a few vital Health Sutras:

• Any food of plant in origin does not contain cholesterol.
• Any fat that is liquid at room temperature is saturated fat.
• Any fat that is solid at room temperature is unsaturated fat.
• One percent increases in cholesterol increases the chances of heart attack by 2%.
• One percent increase in good HDL cholesterol decreases the chances of heart attack by 3%.
• High BP, blood sugar and blood cholesterol can remain silent for up to a decade.
• Longer the waist line, shorter the lifeline.
• Even one whiff of cigarette is not health-friendly.
• Formula of 10: To revive a dead person after sudden cardiac arrest, within 10 minutes of cardiac arrest (earlier the better) for the next 'at least' 10 minutes compress the center of the chest, continuously and effectively, with a speed of 10 x 10 (100) per minute
• Formula of 80: To live > 80 years without lifestyle diseases, keep your abdominal circumference, lower blood pressure, LDL (bad) cholesterol, pulse rate and fasting sugar all below 80. Walk 80 minutes per day with a speed of 80 steps per minute. Do not smoke to avoid paying a hospital bill of Rs. 80 thousand. Do not drink, if you drink, do not drink more than 80 ml a day or 80 gm a week.

Click on the image to enlarge

An Irish woman An Irish woman of advanced age visited her physician to ask his advice on reviving her husband’s libido.

’What about trying Viagra?’ asked the doctor.

’Not a chance’, she said. ’He won’t even take an aspirin.’

’Not a problem,’ replied the doctor. ’Give him an "Irish Viagra". It’s when you drop the Viagra tablet into his coffee. He won’t even taste it. Give it a try and call me in a week to let me know how things went.’

It wasn’t a week later when she called the doctor, who directly inquired as to her progress. The poor dear exclaimed, ‘Oh, faith, bejaysus and begorrah! T’was horrid! Just terrible, doctor!’

‘Really? What happened?’ asked the doctor.

’Well, I did as you advised and slipped it in his coffee and the effect was almost immediate. He jumped straight up, with a twinkle in his eye! With one swoop of his arm, he sent me cups and tablecloth flying, ripped me clothes to tatters and ...! It was a nightmare, I tell you, an absolute nightmare!’

‘ ’Why so terrible? ’ asked the doctor. ’Freakin ’ ’twas wonderful! But sure as I ’m sittin ’ here, I ’ll never be able to show me face in Starbucks again.

• First person and NGO to trained Maximum Number of Police People trained in Hands only CPR10 in one day
• "First NGO and doctor to provide "hands on training" to 11543 people in "Hands Only CPR 10" in one day.
• First individual doctor and NGO to provide "hands on training" to 8913 females in "Hands Only CPR 10" in one day.

Click on the image to enlarge

Situation: A foreigner with a single loose stool developed sepsis.

Reaction:Oh my God! Why were antibiotics not started in time?

Lesson: Make sure that all foreigners are diagnosed to be suffering from Traveler’s diarrhea even if there is one single loose motion.

Happy is the man who can do only one thing; in doing it, he fulfills his destiny. Joseph Joubert

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: No regrets and no anticipation, just this moment fresh and as is.

1. Respected Sir, May be I am not having sufficient wisdom and knowledge. But does this mean that we are helpless?
   Why should not somebody approach Supreme Court and let them how much the judgment hurts the society in general? I am very much pained. Yours Sincerely, Dr.K.S.Ananda .Kumar
2. Sorry or not sorry depends upon one’s attitude, honesty of purpose, sincerity towards his/her profession and personal outlook as professional and concern. There is no point in keeping the matter linger indefinitely and make excuses- one must be honest to oneself at least. I remember one case where aggrieved father of deceased young 23? years old son ran from pillar to post seeking justice, and in the meanwhile the treating physician - an orthopedic surgeon in this case- died. And probably the father lost hope and I don't know if the case is still pending. We should not avoid troubles, there are many who are underprivileged and troubled because of other waggeries of life. Let us pledge to be a approachable and helping hand to all those rather than being extra defensive. I can tell that if one is sincere and honest, no one on earth can do any harm except giving sarcastic pleasures to a few.Dr K K Arora

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