eMedinewS2nd February 2014, Sunday

Dr K K AggarwalPadma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04);
For updates follow at
www.twitter.com/DrKKAggarwal
www.facebook.com/Dr KKAggarwal

DOCTOR PHARMA RELATIONSHIP:LOOP Holes

6.8.1. In dealing with pharmaceutical and allied health sector industry, a medical

practitioner shall follow and adhere to the stipulations given below:–

a) Gifts: A medical practitioner shall not receive any gift from any pharmaceutical

or allied healthcare industry and their sales people or representatives

Loop hole: If the MR comes you can charge from him for giving your time and give him a receipt.

b) Travel Facilities: A medical practitioner shall not accept any travel facility inside the country or outside, including rail, air, ship, cruise tickets, paid vacations, etc. from any pharmaceutical or allied healthcare industry or their representatives for self and family members for vacation or for attending

conferences, seminars, workshops, CME programme, etc. as a delegate.

Loop Hole: 1. Chairman and faculty is also included in faculty

1. Sign a contract with pharma under 6.8.1.d. Under the contract show that you are assigned job to attend the conference and submit ideas for the pharma company.

c) Hospitality: A medical practitioner shall not accept individually any hospitality

like hotel accommodation for self and family members under any pretext.

loop Hole: As above

d) Cash or Monetary Grants: A medical practitioner shall not receive any cash or monetary grants from any pharmaceutical and allied healthcare industry for individual purpose in individual capacity under any pretext. Funding for medical research, study, etc. can only be received through approved institutions by modalities laid down by law⁄rules⁄guidelines adopted by such approved institutions, in a transparent manner. It shall always be fully disclosed.

Loop Hole: Allowed under a contract as above

g) Affiliation: A Medical practitioner may work for pharmaceutical and allied healthcare industries in advisory capacities, as consultants, as researchers, as treating doctors or in any other professional capacity. In doing so, a medical practitioner shall always:

i) Ensure that his professional integrity and freedom are maintained;
ii) Ensure that patients interest are not compromised in any way;
iii) Ensure that such affiliations are within the law;
iv) Ensure that such affiliation⁄employments are fully transparent and disclosed.

Loop Hole: You can work part time for pharma, as consultant or advisor and get all the above perks. Applicable to private sector doctors. You can get all perks for a conference if you sign a contract that you will be handling their stall for some time every day, speaking on their behalf, or doing a survey of the delegates.

h) Endorsement: A medical practitioner shall not endorse any drug or product of the industry publically. Any study conducted on the efficacy or otherwise of such products shall be presented to and⁄or through appropriate scientific bodies or published in appropriate scientific journals in a proper way.

Loop Hole: Talking about in a conference is allowed

Write prescription drugs in CAPITAL LETTERS only: MCI

Drugs names are changing in single letter difference, so that doctors write drug names in capital letters only – reg. Read: the matter with regard to Drugs names are changing in single letter difference, so that doctors write drug names in capital letters only. The Executive Committee held on 23 1.14, considered the matter and approved the draft notification to be sent to Ministry of Health & Family welfare, Gov. of India, New Delhi for its approval.

Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV Dr K K Aggarwal on Zee TV

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 mantra
VIP’s on CPR 10 Mantra Video
eMedinewS
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

Sacrifice a goat and clear the board exam: Its scientific

sprritual blog

"Students in tribal–dominated Jhabua district in Madhya Pradesh and adjoining villages in Gujarat believe that sacrificing got can make them pass an exam. Ranapur, 45 km from Jhabua, an idol of Baba Dongar, a tribal god is making all wishes come true. Here, photocopies of exam admit cards are tied around trees and in return for their entreaties coming true, the supplicants promise to offer the god a goat, a hen or a bottle of liquor. Some 500 animals are sacrificed here every day and there are more than a dozen such priests who do the slaughtering."

The above story is published in TOI and is correct as per mythology provided one understands the mythology.

In mythology riding means controlling and sacrificing means killings and animals are symbolized by human natures and behaviors.

For example mouse is a vahan of Ganesha and means that to overcome obstacles one need to control one’s greed. Similarly own is the vahan of Laxmi and means that for righteous earning one should be able to control one’s foolishness.

Goats and Rams represent sexuality and sexual desires and lambs represent purity and innocence.

Goat is mentioned in mythology both as a symbol and as a vehicle of Gods. In the Samkhya system Prakriti is depicted as a female goat (Mother Nature). The color of goat is red, black or white representing Sattva, Rajas, and Tamas.

The vehicle of Goddess Kali is a black goat. Agni rides Mesha – a ram. Kubera, the god of wealth, also has a ram as his vehicle. A ram is an uncastrated adult male sheep.

Sacrificing during exams means controlling your tamas or inertia and rajas or aggression, and controlling your sexual desires (un–castrated males).

Brahmacharya in mythology is a period where you are supposed to keep your sexual deviations and other desires under control. So goat sacrifice does not mean physical killing of goat but killing of goat like activities within you.

cardiology news

To Believe

To believe… is to know that every day is a new beginning. It is to trust that miracles happen, and dreams really do come true.

To believe… is to see Angels dancing among the clouds, to know the wonder of a stardust sky, and the wisdom of the man in the moon.

To believe… is to know the value of a nurturing heart, the innocence of a child’s eyes and the beauty of an aging hand, for it is through their teachings we learn to love.

To believe… is to find the strength and courage that lies within us. When it is time to pick up the pieces and begin again.

To believe… is to know we are not alone, that life is a gift and this is our time to cherish it.

To believe… is to know that wonderful surprises are just waiting to happen, and all our hopes and dreams are within reach. If only we believe.

News Around The Globe

6th International Conference "Recent Advances in Cardiovascular Sciences" 31st January &1st February, 2014

Bohusalav Ostadal, MD, PhD, DSc, Institute of Physiology, Academy of Sciences of Czech Republic, Prague

Professor Bohuslav Ostadal, MD, DSc, is a distinguished Czech cardiovascular physiologist. His university education started in 1957 at the Faculty of Pediatric Medicine of the Charles University in Prague where he graduated in 1963. Already during undergraduate studies, he took part in research and teaching at the Department of Pathological Physiology where he continued his subsequent studies towards a PhD. In 1966, he joined the Institute of Physiology, Czechoslovak Academy of Sciences (now Academy of Sciences of the Czech Republic), being appointed Chair of the Department of Developmental Cardiology two years later. Professor Ostadal remained loyal to this institution during his entire scientific carrier. Prof. Ostadal has published 216 full peer–reviewed papers, two books, more than 55 book chapters and edited another five books He has delivered many invited lectures and seminars at national and international conferences, universities and institutes He is a Fellow of the International Society for Heart Research and the International Academy of Cardiovascular Sciences and has received numerous awards and distinctions from scientific societies in recognition of his achievements and services.

Topic: Developmental Aspects of Cardiac Adaptation to Hypoxia

One of the most common insults during early stages of postnatal ontogenetic development is hypoxemia due to cyanotic congenital heart defects. The question of the presumed cardiac impact will be, therefore, of considerable importance. Experimental results have clearly shown that the immature heart is significantly more tolerant to acute oxygen deficiency than the adult myocardium. However, the mechanisms of this difference have not yet been satisfactorily clarified; they are likely the result of developmental changes in cardiac mitochondrial function and energy metabolism. Adaptation to chronic hypoxia confers long–lasting protection in both adult and immature heart. However, the already high resistance of the newborn heart cannot be further increased; the effects of protective mechanisms appear only when the ischemic tolerance starts to decrease during development. Early chronic hypoxia, although transient, may have serious sexdependent late consequences on the adult cardiovascular system. These results support the view that precise knowledge of individual developmental periods that are critical for cardiac ontogeny is crucial for better understanding of the mechanism of cardiac adaptation to oxygen deficiency.

USICON 2014:1st February Cancer Awareness Day (Uro Oncology)

Uro–oncology and cancer awareness: Dr Rajeev Sood, Organizing Secretary

Dear Friends,

Cancer is one dreaded disease and the society looks up to the medical and scientific community to get rid of it. Many a genito–urinary cancers are among the most common cancers found both in males and females and we as urologists are often the first contact of the patient with the health care system. Here it increases our responsibility to the society to be able to create awareness about early detection, treatment and prevention of these diseases. The holistic health care cannot be complete without pain and symptom palliation and a helping caring hand for the patient. The impact of urologic cancers on the population and the far-reaching advances in urologic oncology have provided the impetus for this to be included as a theme on this day of USICON 2014, which covers all aspects of urologic oncology in a concise yet focused fashion. This is also the week when 4th Feb is observed as the ‘World Cancer Day’. This year the focus of World Cancer Day is Target 5 of the World Cancer Declaration: Reduce stigma and dispel myths about cancer, under the tagline "Debunk the myths". We also intend to spread the knowledge and awareness about this, aiming to achieve deeper penetration into the society. Urologic oncology has become a multidisciplinary specialty, with integration of medical oncology and radiation oncology specialists along with urologic oncologist to provide the most comprehensive treatment options for the patient with urologic malignancy. The cancer control program of India needs to be strengthened by channelizing all individual or group efforts together towards the benefit of goals of this program.

This USICON presents much advancement in diagnosis and management of several urological cancers and includes participation from several large pharmaceutical and medical equipment firms, not to mention the large scientific community gathering that this conference has witnessed. Several newer exciting modalities are put forward for deliberations in this conference before the eminent experts in the fields before they are put to tests in clinical care. The question about cancer control should not be about want or need but about must have and for this to be achieved we call upon a continuous and thriving determination from all sections of our society.

Thanks & Regards

++++++++++++++++++

Delegates Speak

1. Dr Harvendra Gupta, Haridwar
- Very Good and informative symposium on renal plantation
- Wide information on robotic and laparoscopic surgery

2. Dr Shyam Babu Prasad, Patna

  1. National conference of USI is a biggest fare of the urologist of India and abroad
  2. Urologist of different states of India exchange their views regarding the urological problems
  3. I feel that the conference of this magnitude in which approx 2000 delegates and faculties are participating is very useful for society and people

3. Dr MK Senapati, Ranchi
It is the best way to communicate with the delegates

4. Dr Prasun Ghosh, New Delhi
- Interactive
- Good scientific content

5. Dr Ram Parel, Gujarat
Very concise and good information

6. Dr Sanjay Gupta, Lakhmipur
Excellent Scientific content

7. Dr Uday Mathur, Delhi

  • It has been a great pleasure to be a part of the USICON
  • A very good and informative platform

 

Dr Ganesh Gopalakrishnan, Coimbatore

Vascular problems in renal transplantation: Intraoperative & immediate postoperative
Check list before entering OT

  • Has crossmatch report been reconfirmed as negative?
  • Has immunosuppressant been administered?
  • Has blood been crossmatched and available?
  • Does donor have any last minute concerns?
  • For a deceased donor, have all formalities been addressed?
  • Weight of the recipient

Prior to releasing the clamp, check that flow in internal iliac is good, ensure that BP is around 130 mmHg; has mannitol/lasix been administered and check suture lines. Give 1 gm solumedrol if that is your practice.
When you release the clamp: keep in mind the following

  • Has the kidney picked up evenly?
  • Does the kidney have good turgor and is firm?
  • Ensure that the BP is maintained?
  • There is no twist or kink of renal artery.
  • The vein is full and stretched
  • Thrill over internal iliac should be palpable very soon.
  • Do not discard perfusion fluid or the set till you are happy.

Graft dysfunction postoperative

  • Sudden fall in urine output (anuria/oliguria)
  • Increase in BP
  • Breathlessness
  • Severe pain over graft
  • Graft tenderness
  • Unilateral limb edema

This situation requires urgent color Doppler to rule out vascular problem. A CT angio or CO2 angio may be needed.
Diagnosis of renal vein thrombosis

  • USG: Graft appears swollen and hypoechoic
  • Doppler: Absent venous flow
  • Renal arterial Doppler: Absent or reversal of diastolic flow
  • The diagnosis can be confirmed by MR angiography.

 Take home messages

  • When in doubt, revise the arterial anastomosis.
  • Venous anastomosis should be stretched sutured.
  • Intracellular fluid composition for renal perfusion more appropriate in LRD transplantation.
  • Try getting used to optical loupe for anastomosis

Be knowledgeable about nephrological problems 

Jaipur Oration: Dr Ashok Hemal, USA

Conceptual changes in improving perioperative, functional, oncological outcomes in Partial Nephrectomy
There is an underutilization of nephron-sparing surgery. Partial nephrectomy is just as likely to cure small kidney tumors as removal of the entire affected kidney. Despite this, four in five of such patients are being subjected to entire kidney removal. The question then arises ‘why is there an underutilization of partial nephrectomy’? This can be due to:
·         Resistance due to concerns over oncological outcomes
·         Surgeon comfort with technical complexity, particularly for laparascopic partial nephrectomy
·         Diffusion of laparascopic radical nephrectomy for renal tumors
·         Conception of kidney function outcomes following radical nephrectomy
Has the robotic platform been a game changer? To my mind, yes. The challenges of pure laparoscopy are: surgeon operates from a 2D image, rigid instruments, maneuverability, reduced dexterity, precision and control, steep learning curve, tactile sense, loss of 2 of the 6 degrees of freedom and surgeon fatigue. All these challenges may be overcome by robotic assistance.
Unchangeable factors in partial nephrectomy include patient characteristics (tumor biology, preop status & comorbidities).
Factors dependent on the surgeon and technique
·         Renal: to prevent parenchymal damage decrease WI, excise tumor with maximum parenchymal preservation
·         Oncologic: prevent + margin
·         Prevent complications
 Key steps of partial nephrectomy
 ·         Renal hilar dissection
·         Localization and tumor dissection
·         Intraoperative ultrasound
·         Image-guided scoring
·         Control of renal hilum: Clamped/unclamped & superselective clamping
·         Excision of renal mass
·         Renal parenchymal reconstruction
The current practice scenario
·         Consider WIT with <20 min
·         Unclamp technique/early unclamping
·         Intermittent clamping (Not preferred)
Tile Pro technology: Reduced warm ischemia times, more complex pathology, less difficult than lap and has the ability to use important real time intra-operative images
 Take home messages
· Number of nephrons (quantity) saves is the key determinant of renal function.
·  Great majority of nephrons make full recovery from the ischemic insult.
·  Precision of excision/reconstruction, to save as much as vascularized parenchyma as possible is of primary importance.
·   Even poorly functioning kidneys make a full recovery from ischemia after partial nephrectomy that is proportionate to the preserved nephron mass

Posterior urethral valves: Current concepts in management Douglas A Canning, USA

The bladder in children with valves must be compliant to preserve renal function and must empty frequently and completely to reduce risk of UTI.

We examined the long-term outcome of a large series of patients treated with primary valve ablation, and compared it to the outcome of high diversion and vesicostomy. We reviewed the records of 100 patients treated with primary valve ablation (74%), vesicostomy (13%) or high diversion (9%) before 1985. We found that Overall 13% had ESRD by age 15; 38 % by 20 years; Continence by age 10 in 46% and only one was incontinent at age 20. Our conclusion was that avoiding diversion preserves bladder function and reduces need for augmentation, and greatly reduced number of surgeries. There is no evidence to favor high diversion (Smith GH, et al. J Urol. 1996 May;155(5):1730-4). We learned that

  • Primary valve incision is procedure of choice
  • No benefit from high diversion
  • Rare benefit (1%) from secondary vesicostomy?
  • Primary treatment did not affect timing of continence (The only persistently incontinent patient in this series had early high diversion)
  • No difference in bladder volume amongst the 3 groups
  • No augmentations

Pseudo-Pseudo-Pseudo Residual – Post obstructive diuresis in the “full valve bladder” occurs when the urinary bladder is poorly compliant, the child is insensitive to increased bladder pressures, the renal units are compromised and the functional ability to eliminate (pump) urine is compromised (incomplete bladder emptying).

Take Home Messages

  • Most of the pulmonary, renal and bladder damage from valves is prenatal – we can do little with antenatal intervention
  • High diversion is not useful and in most cases only adds to the surgical burden for these boys
  • Our job is to minimize the effects of the “valve bladder” as the child ages
  • There is NO NEED for augmentation cystoplasty in the boy with PUV
  • In the young child, transplant to the diverted valve bladder is safe and effective
  • Clean intermittent catheterization and overnight catheter drainage can bridge the gap for many older patients while the bladder increases in volume
  • These patients will need lifelong management

Uro–Oncology has an Open Horizon:Dr Sudhir Rawal, Director, Surgical Oncology, RGCI, New Delhi

When Urological Society of India was initiated, there were 32 members but with increasing interest in Urology over the years, the number of members practicing solely Urology has increased to more than 2500 presently. During the last 40 years, Uro–oncology as a subspecialty has slowly and steadily evolved and a lot of urologists are getting interested in this superspecialty. Today, there is a wider scope for Uro-oncology provided there are adequate numbers of centres to train urologists in this subspecialty, with sufficient number of patients with urological cancers to impart the desired expertise. Each approaching year brings in new vista in field of genomics, drugs and technology. The tyrosine kinase inhibitors and angiogenesis inhibitors for renal cell carcinoma have given encouraging results New agents like cabazitaxel in docetaxel–failure group and Cytochrome P–450 inhibitor abiraterone have shown encouraging responses in treatment of Carcinoma Prostate. RANKL– ligand inhibitor Denusumab has been launched for skeletal metastasis. Also LHRH Antagonist, Digarelix for Carcinoma Prostate is the latest addition to the urologist armamentarium. Robotic Surgeries have been taken up by centres who have acquired a robot and are practising uro – oncology. Needless to say that minimally invasive surgery should be the approach of choice only if it meets all the principles of cancer surgery and more importantly, if performed by an adequately trained surgeon. All those who perform either laparoscopic or robotic surgery should have the basic foundation of performing open surgical procedures. For really focused treatment new ablative therapies are coming in this field like HIFU, Cryotherapy and TOOKAD. Another development is that reconstructive (Orthotopic Neobladder, etc) and organ preserving surgeries (NSS) are now more frequently used than in the past. Radiotherapy has also evolved for urological cancer specially prostate. From EBRT to IMRT to IGRT and now cyber knife, all have targeted prostate to give high dose of radiation and minimizing side effect. Uro–oncology has an open horizon like any other super specialty. Those trained uro-oncosurgeons who concentrate on a narrow zone with deep understanding of cancer biology, are likely to deliver optimal and high quality treatment with improved outcomes as opposed to those who are treating a wide spectrum of urological diseases

++++++++++++++++++

Dr (Prof) Anant Kumar, Deptt.of Urology, Robotics & Kidney, Transplantation, Max SuperspecialityHospital, New Delhi

The need of the hour is ‘minimally invasive procedure.’ It refers to endoscopy, laparoscopy and robotic surgery. All this comes with minimal morbidity, early recovery, better cosmesis and early return to work. They even help in preserving the vitals organs while cancer is kept under control or cured. This can come only from urologists given to this specialized treatment.’

++++++++++++++++++

Prof HS Bhat Symposium – Adolescent Urology

Dr Chandra Singh J, Vellore

Sexual issues related to proximal hypospadias correction

Penis size is the commonest reason for dissatisfaction. Other reasons for dissatisfaction are scars and glanular shape. The genital perception score is based on meatus, glans, penile skin, penile straightness and general appearances. The score ranges from 1 to10. A higher percentage of patients with proximal hypospadias are dissatisfied as compared to those with distal hypospadias (Liu et al. J Ped Surg 2006).

In adults who underwent an uncomplicated ventral repair of a severe penile hypospadias in their childhood, healthy psychosexual development was achieved despite the lack of a glanular meatus. Early identification of unsatisfied patients is important for appropriate long-term follow-up and counseling (J Sex Med 2011 May;8(5):1529-39).

Erection and sexual satisfaction

What are the advantages of using high power holmium laser in urolithiasis?

• Non correctible factors: penis size, associated endocrine disorders
• Correctible factors: persistent chordee, torsion, inadequate cosmetic outcome

In a survey, the commonest sexual complaints were short penis, increased curvature, painful erection or no erection (Liu et al. J Ped Surg 2006).

Unsatisfactory ejaculation has been documented in almost all series after hypospadias repair. The incidence is higher in two stage (53%) vs single stage (17%) repairs. Proximal repairs have higher rates of problems (49%) vs distal repairs (20%) (Miller et al. BJU 1997).

We do encounter an array of ejaculatory disorders after hypospadias repair in these patients. Ejaculation problems reported include: attenuated ejaculation, weak or dribbling ejaculation, spraying, having to milk out ejaculate after orgasm, quantity of semen passing after intercourse and anejaculation with or without orgasm (Singh JC, Gopalkrishna G. Ind J Urol 2007).

GAPIO

KOLKATA HOSTS INTERNATIONAL CONFERENCE of GLOBAL ASSOCIATION OF PHYSICIANS OF INDIAN ORIGIN (GAPIO)

The City of Joy, Kolkata, India, was humming with delegates from India and overseas particularly from USA, U.K., Australia, Russia, Africa and Middle East who came here to participate in a two day International Conference of Global Association of Physicians of Indian origin (GAPIO) that began on 11th January to discuss solutions in healthcare for improving health worldwide. Dr Prathap C Reddy, Chairman of Apollo Hospitals Group and Founder President of GAPIO, who has played a significant role as architect of modern healthcare in India, chose the theme "The Non Communicable Diseases Epidemic – Meeting the Challenges" for this conference. Shri Amit Mitra, Hon’ble Minister of Finance, Commerce & Industries, Government of West Bengal was the Chief Guest at this Conference. Renowned National and International faculty spoke at seven clinical sessions comprising of Cardiac Sciences, Neurosciences, Diabetes, Gastroenterology and Liver Transplantation, Robotics, Nephrology/Kidney Transplantation and Oncology during the conference. The session – "GAPIO making an impact" was the highlight.

GAPIO is a non–profit organization and its vision is "Improving Health Worldwide". GAPIO has embarked upon India’s First Truly Integrated Comprehensive Health Scheme called “Total Health” which was launched on 27 October 2013, at Aragonda village of Thavanampalle Mandal of Chittoor district in Andhra Pradesh.

During the conference Dr. Sanku Rao from USA took over as President of GAPIO, Dr. Ramesh Mehta from UK as Vice President, Dr. Anupam Sibal as Secretary General, Dr. Nandakumar Jairam as Joint Secretary and Dr. Sudhir Parikh from USA as Treasurer in the presence of a distinguished gathering, industry stalwarts and more than 300 delegates. Dr. Sandip Mukerjee and Dr. Sudhir Parikh were honored with GAPIO Lifetime Achievement Award. GAPIO Service Excellence Award was given to 14 GAPIO members. Some landmark and pragmatic decisions were taken in the Executive Committee meeting of GAPIO to carry forward the agenda of GAPIO. GAPIO assisted in developing a web portal known as SwaasthIndia.com in collaboration with American Association of Physicians of Indian Origin (AAPI), USA and British Association of Physicians of Indian Origin (BAPIO), UK to provide essential healthcare services at various locations in India with the help of doctors from India and overseas. This site will act as a matchmaking portal where Indian Medical Diaspora can view and apply for these opportunities put up on this portal by various State Governments.

CPR 10 success stories

1. Hands–only CPR 10 English

2. Hands–only CPR 10 (Hindi)

3. Ms Geetanjali, SD Public School Successful Story

4. Success story Ms Sudha Malik

5. BVN School girl Harshita does successful hands–only CPR 10

6. Elderly man saved by Anuja

eMedinewS e–gifts to our readers

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Rabies News (Dr. A K Gupta)

What are the myths about rabies in India?

The following myths about rabies are very prevalent in India:

  • In India, there are many myths and wrong practices concerning the management of an animal bite. People apply turmeric, salt and sometimes ghee over the wound area. Chilies, hydrogen peroxide and cow dung are some other wrong practices followed, mainly in the rural parts of India.
  • Some herbal extracts will cure rabies.
  • In rural areas, people also resort to witchcraft and religious practices.
  • Washing of wound(s) can cause hydrophobia.
  • Dietary changes can cure, i.e., shift from vegetarianism to non-vegetarianism or vice versa; stopping consumption of white things etc.
  • A single dose vaccine will prevent rabies.
  • Vaccines are more effective if taken on empty stomach.
  • One should not bathe or eat meat and eggs during vaccination.
  • Gems and stones have magical properties against rabies.
cardiology news

Every arthritis is not same

Every arthritis is not the same. While osteoarthritis, also called as green arthritis, may require only painkillers and rehabilitation exercises, the red inflammation arthritis called rheumatoid arthritis, if not treated early and aggressively can end up with serious deforming complications.

Any arthritis in young women of child-bearing age should not be ignored, especially if it is worse in the morning and improves by movement. Most of them will have high platelet count on blood examination. These patients require aggressive treatment with disease-modifying drugs within days of the onset of symptoms and diagnosis. Approximately 1–2% of population may have this type of disease.

Osteoarthritis, on the other hand, is a disease of age 50+ and is due to wear and tear of various joints in the body and break down of the cartilage cushion in the joints. It mainly affects the weight-bearing joints like the knees, hips, neck and lower back joints. Inflammation is not a major feature of osteoarthritis. The experts said that another form of joint disorder is due to gout which is never seen in people below 40 years of age and is almost never seen in young women before the onset of menopause unless there is a known underlying kidney disease and never seen in children.

The progression of osteoarthritis can be arrested with appropriate exercises, weight reduction and preventing posture and movement that worsen the disease.

Typical wear and tear of osteoarthritis is caused by sitting cross legged, doing Padmasana, squatting, other non physiological postures, sitting on low level surface like floor and low chairs, doing push ups, going up and down on stairs, etc.

Most yoga postures should be done under medical supervision and should follow with a counter yoga exercise.

Most patients of serious arthritis end up with treatment with other systems of medicines or with quacks.

cardiology news

Total CPR since 1st November 2012 – 86083 trained

Media advocacy through Web Media

web mediawebmedia webmedia
press release

Drugs as Good as Angioplasty for Stable Heart Disease

Aggressive drug therapy is just as good as angioplasty for patients with stable heart blockages, said Padma Shri & Dr. B C Roy National Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Senior National Vice President, Indian Medical Association.

There has been a belief amongst cardiologists that all patients with chronic stable heart disease need to have either an angioplasty or heart bypass surgery.

Patients with stable heart disease make up about three–quarters of all the patients who undergo angioplasty and receive stents. Quoting the results of 7 "Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial", Dr. Aggarwal said that optimal drug therapy, when combined with lifestyle changes, has equal results as that of angioplasty and optimal medical therapy combined.

The study published issue of the New England Journal of Medicine randomly assigned 2,300 patients with stable but significant heart disease to one of two treatment regimens. The first group received drug therapy alone, while the second group received the drug therapy plus angioplasty.

Follow up showed that 19% in the angioplasty group had died or had a heart attack, compared to 18.5% in the group that only received drug treatment. The only benefit of angioplasty, was that it reduced chest pain over the long&term compared with drug therapy alone. About 30% of the patients who received drug therapy alone did eventually undergo angioplasty because their symptoms couldn't be managed with drugs alone.

In addition, about 21% of the patients who received stents needed to have another procedure. Although angioplasty was better at relieving symptoms, it wasn’t better in preventing death or heart attack. Drug therapy for patients with stable heart disease should be tried as first–line treatment. Angioplasty should be reserved for patients who have continuing symptoms.

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 86083 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."

emedipicstoday emedipics

Dr KK Aggarwal receives Harpal S Buttar Oration Award from Nobel Laureate Dr Ferid Murad

press release

FDA OKs first drug-eluting stents for use in MI

vedio of day

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

A vascular necrosis can be possible sequelae of fracture of all the following bones, except:

1. Femur neck
2. Scaphoid.
3. Talus.
4. Calcaneum.

Yesterday’s Mind Teaser: Haemorrhage secondary to heparin administration can be best corrected by administration of:

1. Vitamin K.
2. Whole blood.
3. Protamine.
4. Ascorbic acid.

Answer for yesterday’s Mind Teaser: 2. Whole blood.

Correct answers received from: Dr.K.Raju, Abhay Naik, DR.A.K.GAJJAR, Muthumperumal Thirumalpillai, drjella, Sangeetha Raja, Dr Chandresh Jardosh, Dr Prabodh K Gupta

Answer for 31st January Mind Teaser:4. Ethylene oxide gas.

Correct answers received from:Dr Chandresh Jardosh

Send your answer to ijcp12@gmail.com

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medicolegal update

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medicolegal update

Loud and rowdy

A group of loud and rowdy drunks were making a racket in the street. It was the wee small hours of the morning and the lady of the house flung open a window and shouted at them to keep quiet.

"Is this where Frank lives?" one of the drunks asked.
"Yes, it is," the woman replied.

"Well then,"said the drunk, "Could you come and pick him out so the rest of us can go home?"

medicolegal update

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medicolegal update

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

medicolegal update

Smooth seas do not make skilful sailors African Proverb

medicolegal update

Dr KK Aggarwal:Inhaling diesel exhaust Fumes causes heart attack or stroke http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Intention is the active partner of attention; it is the way we convert our automatic processes into conscious ones

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  1. Respected Sir, Congratulations for getting DST award. Vishnu

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