July 29  2015, Wednesday
Lowering BP no help in acute stroke
Dr KK AggarwalUse of antihypertensive drugs to lower systolic blood pressure by close to 13% as part of acute treatment of ischemic stroke did not reduce early mortality or disability compared with patients who did not receive antihypertensive therapy.

At 14 days after randomization, there were 683 events among patients who received early aggressive antihypertensive therapy versus 681 events in the control group and at 3 months, there were 500 additional events in the treatment arm versus 502 among controls, said Jiang He, MD, PhD, of Tulane University School of Public Health in New Orleans.

The findings from China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) are published in the Journal of the American Medical Association (JAMA. 2014 Feb 5;311(5):479-89).
IMA pays homage to Late Dr APJ Abdul Kalam
Individuals with a neurotic personality type may have reduced brain plasticity during the performance of working memory tasks that may affect their ability to store memories, while conscientiousness is linked to stronger connectivity in healthy adults, suggests new research published online in Human Brain Mapping.

General surgery
For running closure of midline abdominal incisions, small bites are better than big bites for preventing incisional hernia, suggests new research published in the Lancet.

Infectious diseases
Antiretroviral therapy initiated on the day of an HIV diagnosis is well liked by patients and providers and leads to more rapid suppression of viral loads than standard approaches, suggest researchers involved in the RAPID program. The findings were presented at the 8th International AIDS Society Conference.

Obstetrics and Gynecology
Ex-smokers may have fewer and less severe hot flashes during menopause than women who continue to smoke, suggests a small study published in the journal Maturitas.

Ophthalmic artery chemosurgery for advanced-stage retinoblastoma appears at least as safe as enucleation, suggested a study published online in JAMA Ophthalmology.
Cardiology eMedinewS
  • Low- to intermediate-risk patients who arrived at a hospital emergency department with chest pain and had a coronary CT angiography (CCTA) scan were discharged in about 8 hours if the scan failed to detect significant CAD; otherwise they were discharged after about 3 days, reported a single-center study presented at the Society of Cardiovascular Computed Tomography (SCCT) 2015 Annual Scientific Meeting.
  • In patients who presented to the emergency room with chest pain and were found to have ACS, the culprit lesions had significant stenosis (>50%) and high-risk plaque features, but little calcification, suggested a new study presented at the Society of Cardiovascular Computed Tomography (SCCT) 2015 Annual Scientific Meeting.
Pediatrics eMedinewS

Children with otitis media with effusion were effectively treated with nasal balloons, a simple, nonsurgical treatment option, suggested a pragmatic trial published online July 27 in CMAJ.

Emergency Medicine
The Predicting Abusive Head Trauma (PredAHT) tool was effective in a validation study, suggesting it can help clinicians distinguish between abusive head trauma (AHT) and accidental head trauma. The six clinical features included in PredAHT are rib fracture, long bone fracture, apnea, seizures, retinal hemorrhage, and head or neck bruising. The predictive analysis of the PredAHT tool was published online July 27 in Pediatrics.
Dr KK Spiritual Blog
The spiritual meaning of the word ‘Artha’

Dharma, Artha, Kama and Moksha are the four fundamental principles of our very existence, which means earning righteously with a desire to fulfill the inner happiness.

Righteous earning is called ‘Artha’ and mistakenly it is linked to materialistic money. In mythology, Artha is synonymous with Lakshmi, Saraswati and Kali, where Lakshmi represents righteously earned materialistic wealth, Saraswati represents wealth of knowledge and Kali represents wealth of wisdom to fight the bad in you and in the society.

In any country, it is the wealth of knowledge, which is more important. India was ruled initially by warriors (Kali), later by money (Lakshmi) and in future will be ruled by knowledge (Saraswati).

It is the human resources, which today decide the growth of a company and the amount of money invested. If you have good human resources, your company is going to succeed.
Wellness Blog
Pollution and Diabetes

India may soon become the diabetes capital of the world. The number of diabetics diagnosed every year is increasing.

If we go back to the era of Ramayana and Mahabharata, we find none of the Devtas or Asurs suffering from diabetes. Though diabetes does get a mention in Ayurveda, its incidence and prevalence in Indian society was very low.

Today diabetes is considered to be a lifestyle disease and is linked to potbelly obesity. Lord Ganesha and Kuber both had potbelly obesity yet did not suffer from diabetes. Lord Ganesha had an uncontrolled appetite to eat sweets and yet he had no diabetes and same comes from one of his prayers, which talks about why people in that era did not suffer from diabetes. Following is a gist of one of my write–ups on the same: "Gajananam Bhoota Ganadi Sevitam; Kapittha Jambu phalasara bhakshitam; Umasutam Shoka Vinasha karanam; Namami Vighneswara pada pankajam". The Mantra means
  • "Oh Elephant–faced, worshipped by the existing beings, of all living beings, tasting the elephant apple (kaith) and jambolana (jamun), the Son of Uma, destroyer of grief, I bow to the lotus feet of Ganesha who is lord of all" or
  • Gajananam (the big tummy one worshipped by all) Bhoota (Durva grass and Bilva patra used for worshipping Ganesha) Ganadi (in equal quantity) Sevitam (if consumed); Kapittha (Kaith ) Jambu (Jamun) phalasara (fruits) bhakshitam (to be consumed); Umasutam (son of Uma) Shoka (diseases) Vinasha karanam (get rid of); Namami (I bow to) Vighneswara (destroyer of grief) pada pankajam (feet of lord)"
The mantra talks about four medicinal herbs: Durva grass and Bilva patra (Bel leaves) used for Ganesha worship; fruit of elephant apple (Kaith) and fruit of Jambolona (Jamun). All four have antidiabetic properties and can be mixed in equal quantity and prepared as a medicinal juice.

Medically, Durva grass (Cynodon dactylon) has been shown to possess antidiabetic, cholesterol–lowering, immunomodulatory, DNA protective, aphrodisiac, male fertility, anti cancer and anti inflammatory activities. Similarly, Bilva Patra has both antidiabetic and fertility-promoting properties.

Elephant apple (Limonia acidissima), also called Wood Apple, Elephant Apple, Monkey Fruit, Curd Fruit, Koth Bel, Kaitha and Kath Bel, has been shown to possess strong anti diabetic properties.

Jamun (Syzygium cumini) also has DNA protective, antioxidant and antidiabetic properties and is an essential ingredient of most antidiabetic Ayurveda preparations.

Apart from the above, two things have also happened in the current Kaliyuga era, which deviate from the Vedic era. Firstly, environmental pollution and secondly people have chosen to eat carbohydrates on a daily basis and there is also a shift of complex carbohydrates to refined carbohydrates.

Environmental pollution, especially with high particulate matter PM 2.5 exposure, is linked with diabetes. Any particulate matter of less than 2.5 micrometers in size can get absorbed from respiratory system, enter into the blood and release pro–inflammatory products leading to endothelial dysfunction and resultant diabetes and heart disease.

As per WHO, the air content of PM2.5 should be less than 10 µg/m3 but in India the levels are always more than 60 µg/m3 as 60 µg/m3 concentration has been accepted as normal in India. This means that an Indian is already six times more exposed to PM 2.5 particulate.

In India, we see values as high as 300–400 µg/m3 in selected areas on a daily basis. Constant exposure to PM 2.5 particulate matter leads to endothelial dysfunction, one of the major factors that increase the prevalence of diabetes.

As per Chandok Upanishad, food is Brahman. Food contains the same consciousness as that of human body. Fruits remain alive for up to 40 minutes after they are plucked from the tree unless they are refrigerated or frozen at the same time.

A fruit without consciousness is dead food and does not have protective nutritional value. PM2.5 particulates can also gets absorbed in the fruits, reducing its nutritional value.

If the same food is also devoid of consciousness, it will not be able to prevent and protect human being from various diseases.

To prevent oneself from diabetes, therefore, one should avoid eating refined carbohydrates, omit carbohydrates 80 days in a year from diet and avoid exposure to high PM2.5 pollution matter, exercise more and try to eat a diet full of fruits and vegetables which are live, locally grown and seasonal.
Make Sure
Situation: A chronic smoker developed cancer of lung.
Reaction: Oh my God!! Why was he not screened earlier for cancer of the lung?
Lesson: Make sure that all chronic smokers are given an option for lung cancer screening with low dose spiral CT.
Dr Good Dr Bad
Situation: A young female with tinnitus came for marriage counseling advice.
Dr Bad: It is familial.
Dr Good: It is not familial.
Lesson: According to a study in the Archives of Otolaryngology-Head & Neck Surgery, tinnitus does not appear to be a highly heritable condition (Source: Arch Otolaryngol Head Neck Surg 2010;136:178–82).

(Copyright IJCP)
eMedi Quiz
Granulocytopenia, gingival hyperplasia and facial hirsutism are all possible side effects of one of the following anticonvulsant drugs.

1. Phenytoin.
2. Valproate.
3. Carbamazepine.
4. Phenobarbitone.

Yesterday’s Mind Teaser: Medullary carcinoma of the thyroid is associated with which of the following syndrome:

1. MEN I.
2. MEN II.
3. Fraumeni syndrome.
4. Hashimoto's thyroiditis

Answer for yesterday’s Mind Teaser: 2. MEN II.
Correct Answers received from: Dr Sharavana, Dr Jainendra Upadhyay, Dr Poonam Chablani, Dr K V Sarma, Daivadheenam Jella, Dr K Raju, Dr Avtar Krishan.
Answer for 27th July Mind Teaser: 2. Familial polyposis coli.
Correct Answers received: Dr Poonam Chablani, Dr K V Sarma, Dr Shangarpawar, Dr Bitaan Sen & Dr Jayashree Sen, Dr K Raju.
Inspirational Story
The Burnt Biscuits

When I was a kid…my mom liked to make food for breakfast and for dinner every now and then. And I remember one night in particular when she had made dinner after a long, hard day at work. On that evening so long ago, my mom placed a plate of eggs, sausage and extremely burned biscuits in front of my dad. I remember waiting to see if anyone noticed! Yet all my dad did was reach for his biscuit, smile at my mom and ask me how my day was at school. I don’t remember what I told him that night, but I do remember watching him smear butter and jelly on that biscuit and eat every bite! When I got up from the table that evening, I remember hearing my mom apologize to my dad for burning the biscuits. And I’ll never forget what he said: "Honey, I love burned biscuits."

Later that night...I went to kiss Daddy good night and I asked him if he really liked his biscuits burned. He wrapped me in his arms and said, “Your Mom put in a hard day at work today and she’s real tired...And besides - a little burnt biscuit never hurt anyone!”

You know…life is full of imperfect things……and imperfect people. I’m not the best at hardly anything and I forget birthdays and anniversaries just like everyone else. What I’ve learned over the years is that learning to accept each other’s faults – and choosing to celebrate each other’s differences – is one of the most important keys to creating a healthy, growing and lasting relationship. Learn to take the good, the bad and the difficult parts of your life and take them for what they are worth. Because in the end, a burnt biscuit isn’t a deal–breaker! We could extend this to any relationship. In fact, understanding is the base of any relationship, be it a husband–wife or parent–child or friendship!

"Don’t put the key to your happiness in someone else’s pocket…keep it in your own." So please pass me a biscuit and yes…the burnt one will do just fine. Life is too short to wake up with regrets.
Rabies News (Dr A K Gupta)
If for some reason, IDRV cannot be given in deltoid region, what are the alternative sites?

IDRV can be given in deltoid region, suprascapular region, anterior abdominal wall and the upper part of thigh.
IJCP Book of Medical Records
IJCP’s ejournals
CPR 10
Total CPR since 1st November 2012 – 110490 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
eIMA News
Dear Doctors,

With the demise of Dr APJ Abdul Kalam, Past President of India, we have lost an educationalist, visionary and a true Indian, who dreamt about a modern India. IMA expresses its heartfelt condolences and salute the great son of India.

Dr Abdul Kalam has Z plus security, as it is available to serving President and Prime Minister. Medical team is part of the arrangements done by the state governments, which was available during his present visit as well. Immediately when he collapsed, a doctor reached him and tried reviving him while he was being rushed to a hospital. He was in the nearest hospital within five minutes, where his death was declared. Therefore there is no need to discuss the issue of non-availability of emergency medical aid in this situation

However, IMA feels that it is time to impart Basic Life Support Training (BLS) to all Policemen and security personals in this country, they being the closest persons always available in such situations. Also, necessary emergency facilities including ambu-bags should be made available in police vehicles. More AEDs should be installed in public places and widespread training should be given to public in using the same

Prof Dr A Marthanda Pillai      Dr KK Aggarwal
National President                    Honorary Secretary General
Indian Medical Association        Indian Medical Association
For the awareness of the members I am adding a note on BLS, based on the latest international guidelines below
If a person gets a cardiac arrest

Ø Immediate recognition of sudden cardiac arrest (SCA) is needed
      o Based on assessing unresponsiveness and absence of normal breathing (ie, the victim is not breathing or only gasping)

Ø If not responding, be prepared to use automated external defibrillator if available
      o Bystanders (lay responders) should immediately call their local emergency number (like 108/102) to initiate a response anytime they find an unresponsive victim

Ø If there is no breathing of gasping, check the central pulse for ONLY 5 seconds
      oThe lay rescuer should not check for a pulse and should assume that cardiac arrest is present if an adult suddenly collapses or an unresponsive victim is not breathing normally.
      oThe healthcare provider should take no more than 10 seconds to check for a pulse and, if the rescuer does not definitely feel a pulse within that time period, the rescuer should start chest compressions

Ø If central pulse absent, start chest compression immediately
      oChest compressions consist of forceful rhythmic applications of pressure over the lower half of the sternum. To provide effective chest compressions, push hard and push fast.
      oIt is reasonable for laypersons and healthcare providers to compress the adult chest at a rate of at least 100 compressions per minute with a compression depth of at least 2 inches/5 cm
      o Rescuers should allow complete recoil of the chest after each compression, to allow the heart to fill completely before the next compression
      o Rescuers should attempt to minimize the frequency and duration of interruptions in compressions to maximize the number of compressions delivered per minute

Ø Once chest compressions have been started, a trained rescuer should deliver rescue breaths by mouth-to-mouth or bag-mask to provide oxygenation and ventilation
      o Deliver each rescue breath over 1 second
      o Give a sufficient tidal volume to produce visible chest rise
      oUse compression to ventilation ratio of 30 chest compressions to 2 ventilations.

Ø Use automated external defibrillator if available
      o Turn the AED on.
      o Follow the AED prompts.
     o Resume chest compressions immediately after the shock (minimize interruptions).


Ø Untrained Lay Rescuer: Should provide Hands-Only (chest compression only) CPR, with an emphasis on “push hard and fast,” until an AED arrives and is ready for use or healthcare providers take over care of the victim

Ø Trained Lay Rescuer: All lay rescuers should, at a minimum, provide chest compressions and in addition, if the trained lay rescuer is able to perform rescue breaths, he or she should add rescue breaths in a ratio of 30 compressions to 2 breaths, until an AED arrives and is ready for use or healthcare providers take over care of the victim

Ø Healthcare Provider: Optimally all healthcare providers should be trained in BLS and should provide chest compressions and rescue breathes for cardiac arrest victims. This should be performed in cycles of 30 compressions to 2 ventilations until an advanced airway is placed; then continuous chest compressions with ventilations at a rate of 1 breath every 6 to 8 seconds

Prof.Dr.A.Marthanda Pillai
National President,
Indian Medical Association.
  1. Violence against medical profession is on the rise.
    There is no Central Law protesting the doctors. In 17 States there are State Ordinance And Acts regarding this Violence against Medical Practitioners and their Medical Establishments. The time has come for Govt. of India to enact a Central Law.

    Public servants have immunity at work under 193" Whoever voluntarily obstructs any public servant in the discharge of his public functions, shall be punished with imprisonment of either description for a term which may extend to three months, or with fine which may extend to five hundred rupees, or with both" and under IPC 189 "Whoever holds out any threat of injury to any public servant, or to any person in whom he believes that public servant to be interested, for the purpose of inducing that public servant to do any act, or to forbear or delay to do any act, connected with the exercise of the public functions of such public servant, shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or with both."

    Under CrPc 41: Police may arrest without warrant (e) who obstructs a police officer while in the execution of his duty...
    Member of Parliaments, Air Pilots and Air Hostess also have protection under the law.
    While on duty doctors should be protected against any violence.'
  2. Poor must get free treatment under Article 14/21 of the Constitution. All citizens of India need to be treated equally. Under Article 21 of the Constitution nobody should die just because he or she can not afford the treatment.
    There should be enough Govt. services to provide free emergency treatment to every citizen. To implement this the Govt. must involve the Private Sector in its loop and reimburse them at CGHS rate for any services rendered.
    The way out is when a patient approaches an emergency department of a Govt. hospital if he/she is denied a bed after giving First AID. He should be given the liberty to get treated at the nearest private hospital and the expenses reimbursed as per the CGHS rates.
    Similarly, in all OPDs any extra load must be off loaded to the nearest doctors and OPD consultation reimbursed at CGHS rates. The same should be true for investigations.
    There should be no waiting list for emergency procedures and for routine procedure, waiting list should not be more than 7 days. All citizens of the country should be at liberty to get the investigations done from a Private Sector with reimbursement from the Govt. at the CGHS rates. All such cases can be routed through any Govt. hospital.
  3. All citizens of India must get free emergency case and free basic investigations and drugs. The same should be applicable to all RTA cases. Police should be able to take them to the nearest hospital or medical centre and centre should be able to get reimbursement at CGHS rates.
  4. Single window registration for establishments : All medical establishments should come under a single window registration. If any registration is required it should be under the same umbrella. As on today over 50 clearances are required to open a medical establishment.
  5. To provide affordable, safe quality and accessible health care, doctors owned small medical establishments should be promoted. Subsidy should be given to doctors so as to provide affordable health. All these medical establishments and doctors should be linked with CGHS schemes.
  6. The Medi-claim Policy should be changed. Citizens of India should be able to claim for OPD treatment and all past diseases should be covered.
  7. The salary of interns, residents, Govt. service doctors and doctors posted in rural areas should be uniform in the country. Those who are working in rural areas should have Income Tax exemption. The pay given to PG student should be the same as that of the residents.
  8. Medical profession should be declared as a service industry and not a commercial industry.
  9. On the lines of CATS tribunal a medical tribunal be formed and medical services should be taken out of the purview of the Consumer Protection Act.
  10. To improve the doctor patient ratio number of medical colleges should be increased in the country. Every district hospital may be converted into a 50 seated medical colleges with 25% of the seats reserved for people from within the district.
  11. There should be introduction of NEET Exam with a common examination at national level to tackle the problem of capitation fee.
  12. The common entrance for PG should be within a month of passing MBBS and not after completing internship.
  13. Ayush doctors can not write drugs of the modern medicine of India.
  14. PC-PNDT Act needs amendments with clause of graded punishment. PC-PNDT Act should not be applicable to doctors who are not doing pelvic ultrasound.
  15. On the lines of IAS Indian Medical Service should be introduced.
  16. The registration of doctors to practice should be in a single State Medical Council and a doctor should be free to practice anywhere in the country.
  17. Whether in the Govt. or in Private Sector no targets should be given to doctors for treatment.
  18. On the lines of Govt. three tier system of health care should be in the private sector also. The concept of family practice should be revived.
  19. Doordarshan should bring out a private health channel.
  20. Clinical Establishment Act should exclude single doctor clinics and the act needs amendment so that it does not promote inspector Raj.
  21. Under Consumer Protection Act there should be a capping on compensating. At present, under the Ministry of Health guidelines there is a capping on sterilization failure of Rs.33,000/-. Similarly, there is a capping upto 2 lacs for death by unnatural calamity, train accident or plane accident. A Compensation should not be more than 50 times the fee received by the treating doctor.
IMA IPMO Initiative
Kindly go to http://module.ima-india.org/ipmo/
and pledge your organs
unless we do it public will not listen to us

Team IMA
World Head & Neck Cancer Day on 27th July 2015
International Federation of Head & Neck Oncology Societies & UICC observe 27th July as “World Head & Neck Cancer Day”

Head & Neck Cancer is an emerging public health problem, which is also lifestyle related. Head & neck cancers include those of tongue, oral cavity, larynx & pharynx.

There were 14.1 million new cancer cases, 8.2 million cancer deaths and 32.6 million people living with cancer (within 5 years of diagnosis) in 2012 worldwide. About 57% (8 million) of new cancer cases, 65% (5.3 million) of the cancer deaths and 48% (15.6 million) of the 5-year prevalent cancer cases occurred in the less developed regions.

The overall age standardized cancer incidence rate is almost 25% higher in men than in women.

It accounts for 3% of all cancers in the developed countries like USA whereas in developing countries like India it accounts for 30% of all cancers.

In India nearly 2 lakh cases of head & neck cancers occur, out of which 80000 are of oral cavity and two-thirds of them are in buccogingival sulcus, therefore they are sometimes named as “The Indian Oral Cancer”. In one of the studies-Bhopal has the India’s highest age standardized incidence of both tongue and mouth cancers in men (Nandkumar et al., 2005).

Tobacco in any form is the leading cause of head and neck cancer. The addition of alcohol with tobacco causes an 11-fold increase in the incidence of oral cancer.

Risk factors are smoking, alcohol, smokeless tobacco, pre-malignant lesions or none.

(Dr Dilip Kumar Acharya)
  • Eliminating the bacterium Helicobacter pylori can reduce the risk for gastric cancer in healthy individuals, according to a systematic review of six trials published online July 22 in the Cochrane Database of Systematic Reviews.
  • The prevalence of smoking among people with psychosis is notoriously high, and smoking is often regarded as a form of self-medication, but a new analysis suggests smoking itself may play a causative role in the development of psychotic illness, new research shows. (The Lancet)
  • The diabetes drug pioglitazone is unlikely to modify progression in early Parkinson's disease, new results from a phase 2 study suggest. Lancet
  • The first punishment in the Vyavsayik Pariksha Mandal or Vyapam scam has come, with a court in this Madhya Pradesh town sentencing two accused of fraud to five-year jail terms, an official said on Saturday. Khandwa's Superintendent of Police M.S. Sikarwar told IANS that the district court sentenced the two - Arun Kumar and Devendra Kaushal - in a case relating to the state Pre-Medical Test in 2004. See more at: http://m.deccanherald.com/content/491535/first-sentence-vyapam-scam-case.html/#sthash.6TRfYlti.dpuf
Quote of the Day
Always bear in mind that your own resolution to succeed is more important than any other. Abraham Lincoln
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IMA Humor
Upset is Unhealthy

The mother of a problem child was advised by a psychiatrist, "You are far too upset and worried about your son. I suggest you take tranquilizers regularly."

On her next visit the psychiatrist asked, "Have the tranquilizers calmed you down?"

"Yes," the boy’s mother answered.

"And how is your son now?" the psychiatrist asked.

"Who cares?" the mother replied.
Reader Response
Dear Sir, very informative news. Regards: Dr Kaveri
IMA Videos
News on Maps
Press Release
IMA Doctors observed 1 minute silence on the sudden demise of Dr APJ Kalam

All IMA members observed a minute of silence at 12 noon today on the sudden demise of Former President of India and Bharat Ratna Awardee, Dr APJ Abdul Kalam.

In their condolence message, Padma Shri Awardee Dr A Marthanda Pillai, National President, Indian Medical Association (IMA) and Padma Shri Awardee Dr K K Aggarwal, Hony Secretary General, IMA in a joint statement said that the best tribute that can be paid to Late Dr Abdul Kalam is to make it mandatory for all public places and public functions to be equipped with Automated External Defibrillators (AED).

Currently, Heart Care Foundation of India (HCFI) jointly with IMA and Delhi Red Cross Society is engaged in training the staff of PCR vans in basic hands-on CPR 10, with the aim of training 100% staff of PCR vans in this lifesaving technique.

Dr Aggarwal said that in all public places and public functions all the staff deployed must know the techniques of basic CPR.

A witnessed cardiac arrest is different from unwitnessed cardiac arrest. Chances of survival are much higher in a witnessed cardiac arrest, if basic hands-only CPR is done by the bystanders immediately at the very onset of cardiac arrest. Chances of survival further increase, if electric shock is also given by using AED machines.

In India, deaths from sudden cardiac arrest are more in number than combined deaths from diabetes, road traffic accidents and dementia.

HCFI and IMA have jointly written to the Hon’ble President of India and Hon’ble Prime Minister with a copy to the Hon’ble Health Minister and Hon’ble Law Minister to enact a law in India on the lines of laws in the United States making it mandatory to train people in “Hands-only CPR” and installing AEDs in public places and public functions.

Dr. Aggarwal also said that India needs Good Samaritan laws, which allow lay persons to learn and perform hands-only CPR and use AED machines to prevent sudden deaths due to cardiac arrest like what happened in Shillong. All over the world, under Good Samaritan law, limited immunity is provided to lay persons while resuscitating any case of witnessed or unwitnessed cardiac arrest. In US, the law is called “Community Access to Emergency Devices Act”.

In addition to making AEDs handy in public places, IMA also recommends conventional defibrillators in every healthcare setting.

In the US, it is compulsory to deploy an AED device in all commercial malls, airports, railway stations, casinos, religious places, cinema halls etc. in addition to all medical settings.