eMedinewS29th June 2014, Sunday

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

Role of folate or folic acid in cancer prevention

The role of folic acid in cancer prevention is uncertain. Large observational studies have suggested a decrease in risk of colorectal and other cancers with dietary folate but others randomized trials have raised the possibility of harm.

In the largest meta–analysis of individual patient data from randomized trials of folic acid for the prevention of cardiovascular disease and colorectal adenoma during an average of 5.2 years of treatment, there was no significant difference in overall cancer incidence for patients assigned to folic acid or placebo.

Vollset SE, Clarke R, Lewington S, et al. Effects of folic acid supplementation on overall and site–specific cancer incidence during the randomised trials: meta–analyses of data on 50,000 individuals. Lancet 2013.

News Around The Globe

  • The US Food and Drug Administration (FDA) has approved the inhaled human insulin product Afrezza to improve glycemic control in adults with type 1 and type 2 diabetes. Afrezza is a rapid–acting inhaled insulin to be administered before meals or within 20 minutes of starting a meal. It must be used in combination with long-acting insulin in patients with type 1 diabetes.
  • A new study from New York has pointed that many gay, bisexual and queer men who are potential candidates for pre–exposure prophylaxis (PrEP) of HIV do not believe their risk of infection is high enough to warrant using it. According to the U.S. Centers for Disease Control and Prevention, the risk of contracting HIV is up to 92% lower among people who take PrEP consistently, compared to those who do not use it. The findings have been published online in the journal LGBT Health.
  • The European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) has recommended that marketing authorization be granted for a new diagnostic radiopharmaceutical, flutemetamol (18F) (Vizamyl, 400 MBq/mL, GE Healthcare Ltd), for the visual detection of amyloid–β neuritic plaques in the brain of patients with cognitive impairment who are suspected of having Alzheimer’s disease, in association with clinical evaluation.
  • A population–based cohort study from California has suggested that obese women who become pregnant are more likely to deliver before 28 weeks of pregnancy; and the association between prepregnancy body mass index (BMI) and risk for preterm birth is affected by race/ethnicity, gestational age, and parity. The findings are published in the July issue of Paediatric and Perinatal Epidemiology.
  • The European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) has recommended marketing of a once–daily combination of the antivirals dolutegravir, abacavir, and lamivudine for the treatment of HIV infection in adults and adolescents older than 12 years of age with a weight of at least 40 kg.

Rabies News (Dr A K Gupta)

If HRIG is not available, can human normal immunoglobulin (polyvalent) be given?

Human normal immunoglobulin cannot be a substitute for HRIG.

Cardiology eMedinewS

  • The EMA’s Committee for Medicinal Products for Human Use (CHMP) is recommending the approval of a combination tablet that includes clopidogrel and aspirin for individuals at risk for atherothrombotic events who are already taking the two antiplatelet agents.
  • An analysis based on three major cardiac resynchronization therapy (CRT) trials of predominantly NYHA class 2 patients has revealed that women, compared with men, showed improved survival from CRT across a wider range of prolonged QRS durations, a pivotal factor in guidelines–based CRT indications. The findings were published in JAMA Internal Medicine.

Pediatrics eMedinewS

  • A pilot study, presented at the American Society of Clinical Psychopharmacology (ASCP) 2014 Annual Meeting, has suggested that the combination of high EPA (eicosapentaenoic acid) omega–3 fatty acids and inositol may be effective in the treatment of prepubertal children with bipolar spectrum disorders.
  • Infrared thermography (IRT) appears to be a reliable and effective strategy for assessing and monitoring the growth of infantile hemangiomas, reports a new research published online in JAMA Dermatology.

Dr K K Spiritual Blog

All about depression

  • Depression is a major public health problem as a leading predictor of functional disability and mortality.
  • Optimal depression treatment improves outcome for most patients.
  • Most adults with clinical significant depression never see a mental health professional but they often see a primary care physician.
  • A non–psychiatrist physician misses the diagnosis of the depression 50% of times.
  • All depressed patients must be enquired specifically about suicidal ideations.
  • Suicidal ideation is a medical emergency
  • Risk factors for suicide are psychiatric known disorders, medical illness, prior history of suicidal attempts, or family history of attempted suicide.
  • Demographic reasons include older age, male gender, marital status (widowed or separated) and living alone.
  • World over about 1 million people commit suicide every year.
  • Seventy–nine percent of patients who commit suicide contact their primary care provider in the last one year before their death and only one–third contact their mental health service provider.
  • Twice as many suicidal victims had contacted with their primary care provider as against the mental health provider in the last month before suicide.
  • Suicide is the 10th leading cause of death worldwide and account for 1.2% of all deaths.
  • In US suicidal rate is 10.5 per 100,000 people.
  • In America suicide is increasing in middle aged adults.
  • There are 10–40 non–fatal suicide attempts for every one completed suicide.
  • The majority of suicides completed in US are accomplished with fire arm (57%); the second leading method of suicide in US is hanging for men and poisoning in women.
  • Patients with prior history of attempted suicide are 5–6 times more likely to make another attempt.
  • Fifty percent of successful victims have made prior attempts.
  • One of every 100 suicidal attempt survivors will die by committing suicide within one year of the first attempt.
  • The risk of suicide increases with increase in age; however, younger and adolescents attempt suicide more than the older.
  • Females attempt suicide more frequently than males but males are successful three times more often.
  • The highest suicidal rate is amongst those individuals who are unmarried followed by widowed, separated, divorced, married without children and married with children in descending order.
  • Living alone increases the risk of suicide.
  • Unemployed and unskilled patients are at higher risk of suicide than those who are employed.
  • A recent sense of failure may lead to higher risk.
  • Clinicians are at higher risk of suicide.
  • The suicidal rate in male clinicians is 1.41 and in female clinicians it is 2.27.
  • Adverse childhood abuse and adverse childhood experiences increase the risk of suicidal attempts.
  • The first step in evaluating suicidal risk is to determine presence of suicidal thoughts including their concerns and duration.
  • Management of suicidal individual includes reducing mortality risk, underlying factors and monitoring and follow up.
  • Major risk for suicidal attempts is in psychiatric disorders, hopelessness and prior suicidal attempts or threats.
  • High impulsivity or alcohol or other substance abuse increase the risk.

Wellness Blog

Fever

Fever does not mean presence of infection. There are many situations where there is fever without infection and hence needs no antibiotics.

  • Sepsis is a clinical syndrome, which results from the dysregulation of inflammatory response to an infection. The temperature is between 36°C to 38.30°C. Heart rate is often more than 90 per minute.
  • Symptomatic inflammatory response syndrome means a clinical syndrome, which results from dysregulated inflammatory response to any infections such as inflammation of the pancreas, inflammation of the vessels, clot formations in the veins.
  • Many antibiotics can cause fever; unless they are discontinued, fever will not subside.
  • Hyperthermia is a condition with elevated body temperature but it is not called fever. Examples are exposure to heat or heat stroke and in response to anesthetic drugs and anti–psychotic drugs.
  • Hyperthermia may not respond to anti–fever drugs.
  • When fever is more than 41.5°C, it is acute hyperpyrexia.
  • Hyperpyrexia is usually seen in patients with severe infections but it may also occur in brain hemorrhage. It responds to anti–fever drugs.
  • High temperature without infection is found in condition of hyperfunctioning of the thyroid gland.
  • Recreational drugs such as Ecstasy can also cause fever without any infection.
  • Mild fever can also occur after exertion.

Inspirational Story

The Talking Bird

There is an old story about a fellow who lived alone and went to a pet store to buy a parrot. He thought the bird might fill some of his lonely hours. The very next day, however, he came back to complain, "That bird doesn’t talk."

The store owner asked if he had a mirror in its cage, and the man said he didn’t. "Oh, parrots love mirrors," he explained. "When he sees his reflection in the mirror, he'll just start talking away." So he sold him a birdcage mirror.

The bird owner was back the next day to gripe that his parrot still hadn’t said a word. "That’s very peculiar," allowed the pet expert. "How about a swing? Birds really love these little swings, and a happy parrot is a talkative parrot." So the man bought a swing, took it home, and installed it in the cage.

But he was back the next day with the same story. "Does he have a ladder to climb?" the salesman asked. "That just has to be the problem. Once he has a ladder, he'll probably talk your ear off!" So the fellow bought a ladder.

The man was back at the pet store when it opened the next day. From the look on his face, the owner knew something was wrong. "Didn’t your parrot like the ladder?" he asked. His repeat customer looked up and said, "The parrot died."

"I’m so sorry," the stunned businessman said. "Did he ever say anything?"

"Well, yes. He finally talked just before he died. In a weak little voice, he asked me, "Don’t they sell any bird seed at that pet store?’"

Some of us have mistakenly thought that happiness consists of lining our cages with toys, gadgets, and other stuff. Excessive consumption has become the hallmark of our life. "Whoever has the most toys wins" seems to be the likely candidate to be the bumper sticker for an entire culture. But is it so?

There is a spiritual hunger in the human heart that can’t be satisfied by seeing one’s own image reflected back in vanity mirrors, playing with our grown–up toys, or climbing the corporate ladder. Our hearts need real nourishment. The love of family and friends, relationships over the pursuit of more things, personal integrity, a secure connection to God –– these are the things that feed the soul.

Have you chosen a life course that leads to a destination that matters?

ePress Release

Dengue patients don’t die of platelet deficiency

According to international guidelines, unless the platelet count is below 10,000 per microliter or there is spontaneous active bleeding, no platelet transfusion is required, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

The cause of death in dengue is capillary leakage, which causes blood deficiency in the intravascular compartment, leading to multiorgan failure, he added. At the first instance of plasma leakage from intravascular compartment to extravascular compartment, 20 ml per kg body weight per hour of fluid replacement should be administered to the patient till the difference between upper and lower blood pressure is more than 40 mmHg or the patient passes adequate urine. Giving unnecessary platelet transfusion to the patient can harm the individual.

Dr. Aggarwal has created a ‘Formula of 20’ for family doctors to understand the severity of dengue.

  • Rise in pulse by 20
  • Fall in upper blood pressure by 20 mmHg
  • Pulse pressure is lower than 20
  • Hematocrit increased by 20%
  • Platelet count is less than 20,000
  • More than 20 petechiae in the tourniquet test

eMedi Quiz

High resolution computed tomography of the chest is the ideal modality for evaluating:

1. Pleural effusion.
2. Interstitial lung disease.
3. Lung mass.
4. Mediastinal adenopathy.

Yesterday’s Mind Teaser: Isotopic response is seen in scars of which condition

a. Orolabial herpes
b. Herpes genitalis
c. Pyoderma gangrenosum
d. Eosinophilic pustular folliculitis

Answer for yesterday’s Mind Teaser: c. Pyoderma gangrenosum

Correct answers received from: Dr Avtar Krishan, Dr Bitaan Sen, Dr Jayashree Sen, Dr Avtar Krishan, Dr KV Sarma.

Answer for 27th June Mind Teaser: b.2–12 weeks

Correct answers received from: Dr Sushma Chawla, Dr Jainendra Upadhyay Daivadheenam Jella.

Send your answer to ijcp12@gmail.com

Make Sure

Situation: A female patient C/O lower abdominal pain, fever and had uterine tenderness on bimanual palpation.
Reaction: You should do cervical swabs and consider starting antibiotics.
Lesson: Make Sure to remember that a woman with such symptoms may have endometritis, which requires prompt diagnosis and may respond to doxycycline and metronidazole.

eMedinewS Humor

Tech support

Tech support: "Okay Colin, let’s press the control and escape keys at the same time. That brings up a task list in the middle of the screen. Now type the letter "P" to bring up the Program Manager."

Customer: I don’t have a P.

Tech support: On your keyboard, Colin.

Customer: What do you mean?

Tech support: "P" on your keyboard, Colin.

Customer: I’M NOT GOING TO DO THAT!!

Zee News – Health Wealth Shows

Alcohol
Cancer Prevention
Depression
Paralysis
Pneumonia
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Vitiligo
Fluid Intake

 

Total CPR since 1st November 2012 – 94595 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

Heart Care Foundation of India announces the dates and program of the 21st MTNL Perfect Health Mela.

press release

FDA panel recommends first drug for HIV prevention

video of day video of day

 

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 :

 

Quote of the Day

Laughter is the closest distance between two people. Victor Borge

Twitter of the Day

Dr KK Aggarwal: Monsoon and Dengue on the Door http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: If life is a dream and nothing is real then what is the purpose of living? http://tinyurl.com/lkz8hq4

 

Forth Comming Event

Announcement

Call for Free Registration

4th annual conference Zoonosis 2014
Sunday 6th July 10am–2 pm followed by Lunch

Venue; Indian Medical Association HQs, IMA House, ITO New Delhi

Objective: To discuss about prevention of diseases communicable
from animals to human.

Who can take part: Medical Practitioners,Veterinary Practitioners, Animal Owners/Breeders, NGOworking with animal care etc.

Experts will be from Veterinary/Medical sectors

All participants will be given certificate of participation.

Organizers: Heart Care Foundation
of India, Millennium India Education
Foundation,CAR (Ministry of Agriculture Govt.of India,

Register at :
rawat.vandana89@gmail.com/
drkakroo@gmail.com
or Call: Vandana 9891673085/Dr Kakroo 9810301261

Zoonosis 2014 9-1 PM


6 July 2014 Zoonosis 2014

Speakers Zoonotic disease in India
Dr Jyoti Misri Pr Scientist ICAR Govt of India

Inaugural address
Dr M L Madan Fmr DDG ICAR

Dr KK Aggarwal (To Moderate)

Bovine Tuberculosis and Brucellosis
Dr R Somvanshi HOD Vety Pathology IVRI Bareilly UP

Dr Rishendra Verma Jt Dir.Centre for Animal Disease Research and Diagnosis IVRI Bareilly UP

Equine Encepahalitis
Dr. Baldev Gulati Pr.Scientist National Centre for Research in Equines,Hissar Haryana

Cysticarcosis, Neurocysticercosis
Dr R Somvanshi HOD Vety Pathology IVRI Bareilly UP

Rabies, Cat Scratch Disease
Dr. Ashok Bhardwaj Asstt.Prof. SKAUST Jammu

Swine Flu, Japanese Encepahlitis
Dr.P K Uppal Fmr FAO Expert on Flu
Dr. Baldev Gulati Pr.Scientist National Centre for Research in Equines, Hissar Haryana

Bird Flu
Dr.P K Uppal Fmr FAO Expert on Flu

Mycotic Diseases

Dr.P P Gupta Fmr Dir.Research Punjab Agri Univ.

Food Borne Diseases Salmonellosis, tapeworms, teniasis

Dr.Lal Krishna
Fmr Animal Husbandry Commissioner Govt.of India.

Anthrax, Rota Virus, Carona Virus

Dr. A K Bhatia Professor & Head, Biotechnology Dept.GLA Univ. Mathura

Dr.M P Yadav Fmr Director IVRI Bareilly UP

Dr.C Bhattacharya Vety Public Health Spl. Delhi

Emerging Threats : JD,Crone's Disease,Nepha Virus,etc.

Dr.Shoorvir Singh Pr Scientist National centre for Res in Goats Makhdoom Agra

 

medicolegal update

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medical querymedical query

medicolegal update

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medicolegal updatemedicolegal update

medicolegal update
  1. Dear Sir, Thanks for the updated news. Regards: Dr Shravan
cardiology news

Media advocacy through Web Media

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eMedinewS Special

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