eMedinewS29th August 2013, Thursday

Dr K K Aggarwal 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; 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);
For updates follow at
www.facebook.com/Dr KKAggarwal

How safe are anti obesity drugs?

Obesity is a major health problem. The long–term success rate is low of diet and physical activity. Therefore, antiobesity drugs are of great interest, especially when lifestyle modification has failed. As obesity is not an immediate life–threatening disease, these drugs are required to be safe.

Drugs developed so far have limited efficacies and considerable adverse effects affecting tolerability and safety. Therefore, most antiobesity drugs have been withdrawn.

  • Fenfluramine and dexfenfluramine were withdrawn because of the potential damage to heart valves.
  • Sibutramine was associated with an increase in major adverse cardiovascular events in the Sibutramine Cardiovascular Outcomes (SCOUT) trial and it was withdrawn from the market in 2010.
  • Rimonabant was withdrawn because of significant psychiatric adverse effects.
  • Orlistat was approved for long–term treatment of obesity, but many patients cannot tolerate its gastrointestinal side effects.
  • Phentermine and diethylpropion can only be used for less than 12 weeks because the long–term safety of these drugs is unknown.
  • Ephedrine and caffeine are natural substances but the effects on weight reduction are modest.
  • Recently lorcaserin and topiramate plus phentermine have been approved for the treatment of obesity but long–term safety data are lacking. (Ther Adv in Drug Safe 2013;4(4):171–181)

….Read More

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 10x10 i.e. 100 per minute."

VIP’s on CPR 10 Mantra Video
Ringtone – CPR 10 Mantra Hindi

Ringtone – CPR 10 Mantra English

sprritual blog Why was Meghnaad killed by Laxman and not Ram?

We need to understand Ramayana in the language of Internal Ramayana taking place in the body everyday in which Ram represents consciousness, Sita the body and Lakshman, determination or mind with an aim. Here Meghnaad means Rajas or Rajoguna which can be killed easily by controlling the mind. Rajoguna activates anger, cynicism, aggression etc. Once you control the mind, you can kill your aggressive behavior.

Lakshman killing Meghnaad means that for killing of Rajoguna you do not need the help of the consciousness or the Rama. ….Read More

cardiology news

Good alphabet given by Swami Shivananda

A………Adjust, adopt, accommodate
B………Be good, do good, be kind, be compassionate
C………Control anger by forgiveness and love
D………Do to others as you would wish them to do to you
E………Envy not others
F………Forget and forgive
G………Giving is the secret of abundance
H………Hate sin not the sinner
I………Industrious nature destroy evil tendencies
J………Jealousy is a cancer, therefore kill it
K………Keep company with the sages
L………Love the lord by seeing every one in him
M………Morality is the great way to the eternal bliss
N………Never insult or backbite
O………Obedience is a greater virtue than reverence
P………Purity leads to god realization
Q………Quench the sensual carving
R………Return good for evil
S………Share what you have with others
T………Truthfulness is a fundamental virtue
U………Unite cooperate collaborate
V………Virtues are ornaments they adorn life
W………Wander not in sensual pleasure
X………Examine your heart and remove the evil traits
Y………Yields not to temptation
Z………Zealously endeavor to be simple and ample ...Read More

News Around The Globe

  • A case–control study from Australia has proved that vaccination against flu virus reduces the risk of future heart attacks. In the study, it was shown that influenza vaccination was significantly protective against acute heart attack with infected people almost twice as likely as vaccinated to have acute heart attack. The study was published in August issue of journal Heart.
  • Bharat Biotech has launched world’s first clinically proven typhoid conjugate vaccine, Typbar – TCV, for infants above six–months as well as adults. The newly launched typhoid conjugate vaccine would help make the vaccinated immune to the disease for a longer period of time as against the existing vaccines in the market that provide protection only for two to three years.
  • Liver cancer — the third most frequent cause of cancer death in India, mostly could be prevented with simple lifestyle changes such as avoiding excess alcohol, having protected sex and getting vaccinated against the hepatitis B virus.
  • Rajya Sabha passed a bill on Monday making it mandatory for the wife to get a share of her husband’s immovable property over divorce. The Marriage Laws (Amend–ment) Bill now needs to be passed by the Lok Sabha to become law. The bill provides for a three year deadline within which marriages can be dissolved on the new ground of "irretrievable breakdown" which will allow the party to file for divorce either jointly or separately in cases where the marriage has broken down for all practical purposes.
  • A two–pronged approach to screening for ovarian cancer –– using CA–125 levels and a mathematical stratification model –– demonstrated nearly 100% specificity and also showed improved predictive power, a prospective single-center study found. Over an 11-year period, screening determined that 2.9% of women (117) were high risk, and thereby referred for a transvaginal sonography exam, according to Karen Lu, MD, chair of gynecologic oncology at the University of Texas MD Anderson Cancer Center, and colleagues. Eighty–two of these patients had a normal exam, 11 had benign ovarian findings, 14 did not have the exam, and 10 had suspicious findings, they wrote online in the journal Cancer. (Medpage)
  • Contrast–induced nephropathy (CIN) is a frequent complication of many radiological procedures involving the application of contrast media. A new study has shown that alkalinization of urine with Na/K citrate may reduce its incidence.
  • As per Darrell Hulisz, PharmD, Associate Professor, Case Western Reserve University School of Medicine; Clinical Specialist in Family Medicine, University Hospitals, Case Medical Center, Cleveland, Ohio the use of selective serotonin receptor inhibitors (SSRIs) has been associated with slightly increased risks for gastrointestinal (GI) bleeding, intraoperative and postoperative blood loss, bruising, epistaxis, hematomas, and cerebral hemorrhage in case reports and epidemiologic studies.

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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 news
  • The subcutaneous implantable cardioverter–defibrillator (ICD) was safe and effective in the full pivotal trial results finally being published, but the device still has limitations. As per findings of Martin C. Burke, DO, of the University of Chicago Heart Rhythm Center, and colleagues, the S–ICD System met both its primary trial endpoints with a 180-day complication–free rate of 99% and induced acute ventricular fibrillation conversion rate of 100% in evaluable patients. According to the researchers, the subcutaneous ICD is a viable alternative to transvenous systems among patients who do not require pacing therapy for heart failure, bradycardia, or ventricular tachycardia. The study is published in Circulation: Journal of the American Heart Association. (Source: Medpage Today)
  • Results from a readjudication of the Rosiglitazone Evaluated for Cardiovascular Outcomes and Regulation of Glycemia in Diabetes (RECORD) trial, supporting the original trial conclusion that the diabetes drug rosiglitazone does not increase the risk for adverse cardiovascular outcomes, have now been published in full in the August issue of the American Heart Journal, by Kenneth W. Mahaffey, MD, from Duke University, Durham, North Carolina, and colleagues. (Source: Medscape)

Valvular Heart Disease News

Subacute presentation is characterized by a prolonged course of low-grade fevers and nonspecific complaints, including fatigue, arthralgias, myalgias, weight loss, exercise intolerance, and diaphoresis.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

cardiology news
  • A retrospective study has found that introduction of rotavirus vaccine in 2006 for young children also lowered the risk of hospitalizations for the illness in older children and adults. Compared with the years 2000 to 2006, the incidence rate ratio for rotavirus–associated gastroenteritis hospitalization in the years 2008 to 2010 was 0.20 for children up to age 4 and 0.30 for those ages 5 to 14. And for those ages 15 to 24, the incidence rate ratio was 0.47 compared with the earlier time period. (Source: Medpage Today)
  • Pediatric clinicians apply do–not–resuscitate (DNR) orders not only in cases of cardiopulmonary arrest (which was the DNR's original intent) but also as surrogates for broader treatment directives, according to an article published online August 26 in JAMA Pediatrics. The survey results also show that most clinicians think DNR discussions take place later in the treatment course than they should. (Source: Medscape)
cardiology news

Forgetfulness — 7 types of normal memory problems

It’s normal to forget things from time to time, and it’s normal to become somewhat more forgetful as you age. But how much forgetfulness is too much? How can you tell whether your memory lapses are within the scope of normal aging or are a symptom of something more serious? Healthy people can experience memory loss or memory distortion at any age. Some of these memory flaws become more pronounced with age, but — unless they are extreme and persistent — they are not considered indicators of Alzheimer’s or other memory–impairing illnesses.

Seven normal memory problems

  1. Transience: This is the tendency to forget facts or events over time. You are most likely to forget information soon after you learn it. However, memory has a use–it–or–lose–it quality: memories that are called up and used frequently are least likely to be forgotten. Although transience might seem like a sign of memory weakness, brain scientists regard it as beneficial because it clears the brain of unused memories, making way for newer, more useful ones.
  2. Absentmindedness: This type of forgetting occurs when you don’t pay close enough attention. You forget where you just put your pen because you didn’t focus on where you put it in the first place. You were thinking of something else (or, perhaps, nothing in particular), so your brain didn’t encode the information securely. Absentmindedness also involves forgetting to do something at a prescribed time, like taking your medicine or keeping an appointment.
  3. Blocking: Someone asks you a question and the answer is right on the tip of your tongue — you know that you know it, but you just can’t think of it. This is perhaps the most familiar example of blocking, the temporary inability to retrieve a memory. In many cases, the barrier is a memory similar to the one you’re looking for, and you retrieve the wrong one. This competing memory is so intrusive that you can’t think of the memory you want. Scientists think that memory blocks become more common with age and that they account for the trouble older people have remembering other people’s names. Research shows that people are able to retrieve about half of the blocked memories within just a minute.
  4. Misattribution: Misattribution occurs when you remember something accurately in part, but misattribute some detail, like the time, place, or person involved. Another kind of misattribution occurs when you believe a thought you had was totally original when, in fact, it came from something you had previously read or heard but had forgotten about. This sort of misattribution explains cases of unintentional plagiarism, in which a writer passes off some information as original when he or she actually read it somewhere before. As with several other kinds of memory lapses, misattribution becomes more common with age. As you age, you absorb fewer details when acquiring information because you have somewhat more trouble concentrating and processing information rapidly. And as you grow older, your memories grow older as well. And old memories are especially prone to misattribution.
  5. Suggestibility: Suggestibility is the vulnerability of your memory to the power of suggestion — information that you learn about an occurrence after the fact becomes incorporated into your memory of the incident, even though you did not experience these details. Although little is known about exactly how suggestibility works in the brain, the suggestion fools your mind into thinking it’s a real memory.
  6. Bias: Even the sharpest memory isn’t a flawless snapshot of reality. In your memory, your perceptions are filtered by your personal biases — experiences, beliefs, prior knowledge, and even your mood at the moment. Your biases affect your perceptions and experiences when they’re being encoded in your brain. And when you retrieve a memory, your mood and other biases at that moment can influence what information you actually recall. Although everyone’s attitudes and preconceived notions bias their memories, there’s been virtually no research on the brain mechanisms behind memory bias or whether it becomes more common with age.
  7. Persistence: Most people worry about forgetting things. But in some cases people are tormented by memories they wish they could forget, but can’t. The persistence of memories of traumatic events, negative feelings, and ongoing fears is another form of memory problem. Some of these memories accurately reflect horrifying events, while others may be negative distortions of reality. People suffering from depression are particularly prone to having persistent, disturbing memories. So are people with post–traumatic stress disorder (PTSD). PTSD can result from many different forms of traumatic exposure — for example, sexual abuse or wartime experiences. Flashbacks, which are persistent, intrusive memories of the traumatic event, are a core feature of PTSD.

    (Source: HealthBeat)
cardiology news

The Bombay high court on Tuesday observed that a suicide note alone was not enough proof in a case of suicide and dismissed an appeal against acquittal in one case. In the absence of independent evidence to prove a case of abetment, Justice A H Joshi dismissed the appeal filed by the victim’s family.

cardiology news

CPR Classes: Persons trained (1200)

21st August: CPR 10 at Ramjas School, R K Puram – 1200

Total CPR since 1st November 2012 – 62966 trained

14th August: CPR 10 at Modern School, Noida (2000)

CPR Classes 62966

Media advocacy through Print Media

sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping

Media advocacy through Web Media

Sudden Cardiac Death 24th August


TB more dangerous than Flu

Tuberculosis, especially multidrug resistant TB is more dangerous and contagious than swine flu said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India & MTNL Perfect Health Mela and National Vice President elect IMA.

Respiratory secretions are of two sizes: Less than and more than 5 microns. The ones, which are more than 5 microns like H1N1, are heavy and cannot remain suspended in the air and immediately will settle down on the surface and are called droplet infections. They need contact precautions and 3 feet air precautions. A surgical three–layered mask is sufficient to prevent infections spreading to others.

Respiratory secretions that are smaller than 5 microns are called droplet–nuclei. These are lighter, can remain suspended in the air and move from one place to other with the air movement. Air borne infections such as TB need the following precautions including N95 mask, air borne isolations rooms with 6 exchanges per hour, HEPA filter exhausts, closed rooms etc. Early identification and treatment of persons with TB can prevent production of droplet nuclei.

Most centers in the country do not have facilities to tackle TB, which alone kills over 2500 people in Delhi every year.

In India, if all the efforts are diverted to TB prevention, swine flu will be wiped out automatically.

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 62980 people since 1st November 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 10×10 i.e. 100 per minute."

today emedipics

A CPR 10 Training Camp was organized by Heart Care Foundation of India to train the students of Ramjas School, R K Puram

press release

7 types of normal memory problems

today video of the dayDr KK Aggarwal on Costly Treatment

Dr KK Aggarwal on Sleeping Disorder

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

Dr. Smith suspects tracheoesophageal fistula in a 1–day–old neonate. Which nursing intervention is most appropriate for this child?

a. Avoiding suctioning unless cyanosis occurs
b. Elevating the neonate’s head and giving nothing by mouth
c. Elevating the neonate’s head for 1 hour after feedings
d. Giving the neonate only glucose water for the first 24 hours

Yesterday’s Mind Teaser: A 2–month–old baby hasn’t received any immunizations. Which immunizations should nurse Jess prepare to administer?

a. Measles, mumps, rubella (MMR); diphtheria, tetanus, pertussis (DTP); and Hepatitis B (HepB)
b. Polio (IPV), DTP, MMR
c. Varicella, Haemophilus influenzae type b (HIB), IPV, and DTP
d. HIB, DTP, HepB; and IPV

Answer for yesterday’s Mind Teaser: d. HIB, DTP, HepB; and IPV

Correct answers received from: Dr pooja khullar, daivadheenam, dr deepalichatterjee, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Dr.K.V.Sarma, Dr . Nageswara Rao, DR AVTAR KRISHAN, Dr. Laxman Kumar, D dr anil sarin

Answer for 26th August Mind Teaser: a. Babinski’s

Correct answers received from: Dr. P. C. Das, niraj k. Gupta

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

A doctor worked at a mental hospital. He wanted to take some patients to a ballgame, worked months to get them to follow simple commands, and finally decided they were ready.

When the star spangled banner played he said: "Stand up nuts" and they stood. When it was over he said: "Sit down nuts" and they sat. When a player got a hit he said: "Cheer nuts" and they cheered. When the umpire made a bad call he said: "Boo nuts" and they booed. He decided it was safe to leave them with his assistant and left to get a hot dog. He came back to a near riot. He asked his assistant what in the world happened. He said: "Everything was fine 'til some vendor came be and yelled ‘peanuts’."

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with dengue died.
Reaction: Oh my God, why was he not given adequate fluids?
Lesson: Make Sure that all patients with dengue are given fluids to correct intravascular dehydration.

medicolegal update

A blind person asked Swami Vivekanand: "Can there be anything worse than losing eyesight?" He replied: "Yes, losing your vision!"

medicolegal update

Dr KK Aggarwal: Dr K K Aggarwal: Relaxation during work http://bit.ly/16wknsh #Health

Dr Deepak Chopra: Why compare yourself with others? No one in the entire world can do a better job of being you than you.

medicolegal update

Excellent spiritual messages lord krishna bless u. Dr.R.Mani Chennai

Forthcoming Events

29thSeptember–Dil Ka Darbar at NDMC Convention Centre, CP New Delhi

20th Perfect Health Mela from 18th Oct to 22nd Oct at different locations

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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medicolegal update

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