eMedinewS
29th September 2014, Monday

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

Today is World Heart Day

Opening only the culprit vessel in acute heart attack no more recommended

American College of Cardiology has announced that it is "withdrawing" one of its Choosing Wisely recommendations, following the announcement of the CVLPRIT results last month at the European Society of Cardiology 2014 Scientific Sessions.

CVLPRIT showed that patients undergoing primary PCI who had complete revascularization at the time of their index admission had lower rates of major adverse cardiac events at 12 months, as compared with patients who had only their "culprit" vessel treated.

Deaths were doubled in the patients who had only their infarct–related artery treated, as were rates of recurrent MI and rates of heart failure, although none of these were statistically significant, given the low patient numbers. Importantly, no difference in procedure-related adverse events was seen between groups.

Results from the CVLPRIT trial, as well as from last year’s Preventive Angioplasty in Myocardial Infarction (PRAMI) trial, warrant a rethink of this advice.

News Around The Globe

  • A new study has found that 17% of patients who have two copies of a particular genetic marker in the HLA area of the genome are likely to go on to develop pancreatitis if they are prescribed thiopurine drugs. The study is published in Nature Genetics.
  • Patients with chronic kidney disease (CKD) treated with intravenous thrombolytic therapy during ischemic stroke exhibited a higher risk for intracranial hemorrhage and serious systemic hemorrhage; however, the risk did not appear to be related to their renal disease, suggested a new study published in Circulation.
  • The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency has recommended marketing authorization for the combination ledipasvir/sofosbuvir for the treatment of chronic hepatitis C virus infection in adults.
  • A new study published online September 25 in Lancet Diabetes & Endocrinology has shown a remarkably clear pattern between socioeconomic status and diabetes. Working long hours, at least 55 hours per week, in a job with low socioeconomic status heightens the risk for type 2 diabetes by nearly 30%. However, no effect on diabetes risk was seen in those employed in high socioeconomic status positions, regardless of the hours put in.
  • A large, prospective study has shown that people who manage to overcome their addiction to one substance do not become addicted to another substance. The study was published online in JAMA Psychiatry.

Dr KK Spiritual Blog

On 5th Navratri Learn Detached Attachment and to Control One’s Ego

Skanda Mata is worshipped on the fifth Day of Navratri. SHE is holding her son ‘Skandaa or Kartikaya’ on her lap.

SHE has three eyes and four hands. Two hands hold lotuses while the other two hands respectively display defending and granting gestures.

She is the ocean of knowledge. She rides on a lion.

In Yoga Shastra, she represents the Vishuddha chakra and HAM bija mantra. She also dignifies motherhood, fertility and mother child relationship.

Skandaa means the one with six heads corresponding to the five senses and the mind or the one who has a control over the six demonic vices: kaama (sex), krodha (anger), lobha (greed), moha (passion), mada (ego) and matsarya (jealousy).

Kartikeya carries a spear in one hand and his other hand is always blessing devotees. His vehicle is a peacock, a pious bird that grips with its feet a serpent, which symbolizes the ego and desires of people. The peacock represents the destroyer of harmful habits and the conqueror of sensual desires.

Spiritual mantra on the 5th Navratri One should learn detached attachment as the main principle of spirituality.

Inspirational Story

Give Your Best to Relationships

A boy and a girl were playing together. The boy had a collection of marbles. The girl had some sweets with her.

The boy told the girl that he will give her all his marbles in exchange for her sweets. The girl agreed. The boy kept the biggest and the most beautiful marble aside and gave the rest to the girl. The girl gave him all her sweets as she had promised.

That night, the girl slept peacefully. But the boy couldn’t sleep as he kept wondering if the girl had hidden some sweets from him the way he had hidden his best marble.

Moral of the story: If you don’t give your hundred percent in a relationship, you’ll always keep doubting if the other person has given his/her hundred percent.

This is applicable for any relationship like love, employer-employee relationship etc. Give your hundred percent to everything you do and sleep peacefully.

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 eMedinewS

  • Serum copeptin, a surrogate biomarker for vasopressin, is higher in pregnant women who go on to develop preeclampsia, suggests a new study. However, levels of copeptin were not elevated in women with other pregnancy complications, including gestational diabetes mellitus (GDM), gestational hypertension, and preterm birth. The study was published online in Hypertension.
  • The American Heart Association and American College of Cardiology released an update of their guidelines for unstable angina and non-ST segment elevation myocardial infarction (NSTEMI). The guidelines have replaced initial conservative management with "ischemia-guided strategy" in order to more clearly convey the physiologic rationale of this approach. The guideline is being published online in both the Journal of the American College of Cardiology and in Circulation: Journal of the American Heart Association.

Pediatrics eMedinewS

  • Adolescents who suffer from sleep disturbance or habitual short sleep duration are less likely to succeed academically compared to those who enjoy a good night's sleep, suggests a new study published in the journal Sleep Medicine.
  • Among patients with juvenile idiopathic arthritis (JIA) who achieved clinically inactive disease on combination therapy and attempted to withdraw from treatment, the order in which the different agents were stopped significantly affected subsequent flare, suggested a retrospective study. Researchers noted that 84% and 81% of patients who tapered their methotrexate and continued taking a tumor necrosis factor (TNF) inhibitor remained flare-free at 6 and 12 months. The study was published online in Arthritis Care and Research.

Quote of the Day

  • Try to know everything of something and something of everything. Henry Brougham
  • HATRED weakens the liver; GRIEF weakens the lungs; WORRYING weakens the stomach; STRESS weakens both the heart and the brain and FEAR fails the kidneys…so stay HAPPY! LOOK GOOD, FEEL GOOD and DO GOOD!
  • This is the great fact: strength is life, weakness is death. Strength is felicity, life eternal, immortal; weakness is constant strain and misery: weakness is death. Swami Vivekanand

IMA News

There is a misuse of antibiotics leading to multi-drug resistant strains. Situation has become all the more serious as bugs have become resistant to most of the prevalent antibiotics including carbapenems. IMA has started a multi pronged strategy involving health professionals, pharmaceuticals Govt, private and international agencies to eradicate this menace. To educate our doctors and medical students, in association with Indian Pediatric Association, IMA has constituted an Advisory Committee with experts from WHO, USAID, Public and Pvt Sectors to prepare a module on “Rational Antibiotic Practices". TOT workshops and CMEs will be arranged throughout the country. During the Advisory Committee Meeting, it was also decided to observe September 28 to October 5 as Antibiotic Awareness Week.

  • DMA Advisory Against Corruption: Following recent media coverage and MCI rulings on various issues, DMA has formulated an advisory what constitutes misconduct with examples particularly   with regards to accepting gifts; accepting sponsorship of conferences; accepting  overseas faculty trip; visit to production facilities; various business promotion activities of  labs; various business promotion activities of hospitals; what is ethical and legal and how to streamline these activities. DMA has decided to experts group as follows-  Dr. Anil Aggarwal (Chairman); Dr. KK Aggarwal (Advisor); Dr. Chandra Prakash, Dr. Harish Grover, Dr. Vijay Aggrawal and Dr. Harish Gupta  as members.
     
  • India Pharma Forum was founded on 17th September. During the IPF meeting of 16th Sept. 2014, the following was adopted as the AIM of the India Pharma Forum: To bring all constituents of the Pharmaceutical Sector on one Platform and participate as the leader in the reforms of the National Healthcare System, by enrolling the support of Pharma companies to Increase the Access, Improve the Quality and, Lower the Cost of Medicines that reach the consumer, while ensuring the Viability of the Industry stakeholders." Dr K K Aggarwal, Padmashri Awardee has been included as the Governing Council Member of the Forum.

MCI NEWS

The Central Bureau of Investigation on Wednesday carried out searches at the office of the Medical Council of India here and at a medical college in Thiruvananthapuram in connection with alleged corruption in the granting of recognition to the institute in Kerala. CBI sources said that searches were conducted at the residential and official premises of MCI Additional Secretary Prasanna Raj, Deputy Secretary Anshu Sethi Bajaj, ex–consultant Madhu Handa and Principal of Somervell Medical College, Samson Nessaih. It is alleged that the pending application of the college seeking post–graduate seats was processed in an unauthorised manner by MCI, the sources said. They said that the letter of permission to the college was also issued after the due date.

Wellness Blog

B12 deficiency can present with recent memory loss

If you are forgetting things instead of worrying that you are going towards dementia, get your vitamin B 12 levels done.

Animal products (meat and dairy products) provide the only dietary source of B12 (Cbl) for humans. Strict vegans avoid all animal products, and are at risk of developing nutritional Cbl deficiency. The usual western diet contains 5 to 7 micrograms of cobalamin per day, while the minimum daily requirement is 6 to 9 micrograms per day. Total body stores of Cbl are 2 to 5 milligrams and one-half of this is in the liver. It takes years to develop vitamin B12 deficiency after absorption of dietary B12 ceases.

There is a link between infection with Helicobacter pylori (as seen in peptic ulcer) and low serum B12 levels. Mild and usually subclinical cobalamin deficiency can also occur in 24% of the elderly. About 10 to 30 percent of patients taking metform inj (diabetics, obesity, and polycystic ovarian disease) have impaired Cbl absorption and lower B12 levels, which can be reversed with supplemental oral calcium. Prolonged use of omeprazole (given for acidity) can result in Cbl deficiency. Women who are only moderate vegetarians may become Cbl deficient during pregnancy and lactation; their infants may also be Cbl deficient.

We give up leisure in order that we may have leisure, just as we go to war in order that we may have peace. Aristotle

ePress Release

Singhara flour – a favorite Navratre diet

During Navratra fasts, wheat flour should be omitted from diet and be substituted with water chestnut (Singhara) or buckwheat (kuttu) flour, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

Singhara is not a cereal but a fruit and hence a good substitute for a Navratra fast where cereals are not to be eaten.

  • Singhara flour is prepared from Singhara or Water Chestnut.
  • Singharas are floating aquatic plants, growing in slow-moving water up to 5 meters deep. The plant bears ornately shaped fruits containing a single very large starchy seed.
  • The seeds or nuts are boiled and sold as snacks or eaten raw.
  • The flour is made from dried, ground water chestnuts. The nuts are boiled, peeled, dried then ground into flour. The flour is bright white fine powder; it is actually a starch rather than flour.
  • The flour is primarily used as a thickener.
  • The flour is used as food in Navratra and consumed as phalahar (fruit) diet.
  • It is an excellent source of energy and provides 115 kcals per 100g.
  • The glycemic index for chestnut is 60. Low GI foods have a GI value less than 55; medium GI foods have a GI value between 55 and 69 and high GI foods have GI value greater than 70.
  • Chestnuts are relatively low in net carbs (total carbohydrate minus dietary fiber) and so are included in many low carb diets.
  • Being a gluten-free product, chestnut flour is a cooking option for people with celiac disease or other gluten intolerances or allergies.
  • Chestnuts do not contain the fat that regular nuts have.
  • It contains less carbohydrate than white flour.
  • People with tree nut allergies should avoid chestnut flour as it may cause an allergic reaction.
  • Flour made from chestnuts is typically more difficult to locate in many areas as well as more expensive than white flour.
  • Avoid eating deep fried chestnut flour pooris or paranthas.
  • Do not use trans fats containing vegetables oils to cook bread from chestnut flour.
  • Buy only branded flour as flour left over from the previous year can lead to food poisoning.
  • As per Ayurveda, chestnut flour has cooling and buckwheat flour has heat producing properties.
  • Both chestnut flour and buckwheat flours can be combined.
  • One should eat phalahar once a week and at least 80 days in a year.

eMedi Quiz

Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionization of the drug in the stomach. Which of the following statements is not a correct example?

1. Absorption of digoxin is delayed by the presence of food.
2. Concurrent food intake may severely reduce the rate of absorption of phenytoin.
3. Presence of food enhances the absorption of hydrochlorothiazide.
4. Anitimalarial drug halofantrine is more extensively absorbed if taken with food.

Yesterday’s Mind Teaser: All of the following statements regarding bioavailability of a drug are true except:

1. It is the proportion (fraction) of unchanged drug that reaches the systemic circulation.
2. Bioavailability of an orally administered drug can be calculated by comparing the Area under Curve after oral and intravenous (IV) administration.
3. Low oral bioavailability always and necessarily means poor absorption.
4. Bioavailability can be determined from plasma concentration or urinary excretion data.

Answer for yesterday’s Mind Teaser: 3.Low oral bioavailability always and necessarily mean poor absorption.

Correct answers received from: DR JAINENDRA UPADHYAY, Dr Pankaj Agarwal, Dr Avtar Krishan, Daivadheenam Jella, Dr Poonam Chablani, Dr. P. C. Das,

Answer for 26th Sept Mind Teaser: 2. Griseofulvin

Correct answers received from: Dr.K.V.Sarma

Send your answer to ijcp12@gmail.com

eMedinewS Humor

Masterpiece

One day a girl came home crying to her mom. The mom asked what was wrong. The girl responded, "I’m not a creation, God made men first! I’m nothing!" Then the mom said, "Oh baby that’s not true, God may have made men first, but there’s always a rough draft before the masterpiece."

Double–pane

Last year I replaced all the windows in my house with those expensive, double–pane, energy–efficient kind.

Today, I got a call from Home Depot who installed them. He complained that the work had been completed a year ago and I still hadn’t paid for them.

Helloooo… just because I’m blonde doesn’t mean that I am automatically stupid.

So, I told him just what his fast–talking sales guy told me last year… that these windows would pay for themselves in a year. Helloooo…? It’s been a year, so they’re paid for, I told him.

There was only silence at the other end of the line, so I finally hung up. He never called back. I bet he felt like an idiot.

emedipicstoday emedipics

Spiritual Guru and renowned International author, Dr Deepak Chopra launches Heart Care Foundation of India’s new initiative – the Sameer Malik Heart Care Foundation Fund

mela_brochure
Self-Assessment-Quiz

 

expert_choice
Zee News – Health Wealth Shows

Alcohol

press release

Treating vitamin D deficiency in the country

video of day video of day

Video Library

MTNL Perfect Health Mela

Heart Care Foundation of India, a leading national non–profit organization committed to making India a healthier and disease-free nation announced the upcoming activities of the 21st MTNL Perfect Health Mela scheduled to be held from 15th – 19th October 2014 at the Talkatora Indoor Stadium in New Delhi.

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 +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG https://www.youtube.com/
watch?v=Mc3kKDXKWvs

Kishan, SM Heart Care Foundation Fund, Post CHD Repair https://www.youtube.com/
watch?v=OTEG7toVkAQ

Deepak, SM Heart Care Foundation Fund, CHD TOF https://www.youtube.com/
watch?v=rjOel0aaqt0

 

Total CPR since 1st November 2012 – 96458 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)


 

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 :

 

Dr Good and Dr Bad

Situation: A patient with stable angina was on beta blockers
Dr Good: It will relieve angina but not survival
Dr Bad: It will increase survival also
Lesson: In patients with stable coronary heart disease who have not had a recent acute MI, beta blockers are indicated to treat angina but not to improve survival (J Am Coll Cardiol 2014; 64(3):247-52).

 

Make Sure

Situation: Situation: An 18–year–old girl complained of purulent nasal discharge, nasal congestion, pain in the cheek and upper teeth for last 10 days. CT scan showed maxillary sinusitis.
Reaction: Remember to give macrolides.
Lesson: Make sure to remember that clarithromycin (macrolide) 500 mg twice–daily for 7 days is not only effective in maxillary sinusitis but also in other sinusitis.

Twitter of the Day

Dr KK Aggarwal: Anger recall is as bad as Anger itself http://Blogz.org/A/885894
Dr Deepak Chopra: True faith is the certainty of what we do not see, the unseen awareness that makes seeing possible #CosmicConsciousness

medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Editor eMedinewS and President Heart Care Foundation of India)

Giving wrong advice on email is liable for negligence

If the doctor has charged his/her full fees for the email consultation from the patient or a referring physician regarding a patient, he/she will be liable as if he or she has seen the patient. When giving a written opinion through email one can take the following precautions and write:

  • "Expert opinion provided as a professional courtesy only"
  • "Nominal fee charged is only to cover the secretarial/incidental expenses involved and does not count towards a consideration or contract"
  • "This is only an opinion based on the information provided to me. It is not a final opinion which cannot be given without seeing the patient physically.
  • "This is not a final opinion and you may use this opinion at your own responsibility and discretion"
  • "As it is an opinion given without seeing the patient, I take no legal responsibility for the opinion given".
medicolegal update
  1. Dear Sir, Thanks for the information. Regards: Dr Parik
 
cardiology news

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