eMedinewS2nd September 2014, Tuesday

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

Wonder drug for heart failure: Angiotensin–Neprilysin inhibitor

In a study of more than 8,400 heart failure patients, treatment with a novel drug known as LCZ696, an angiotensin–neprilysin inhibitor, reduced the risk of cardiovascular death by about 20% compared with treatment with enalapril (711 versus 835, P <0.001), researchers reported at European Society of Cardiology meeting and were simultaneously published online by the New England Journal of Medicine.

Earlier data safety monitoring board for PARADIGM–HF recommended shutting down the trial based an interim analysis that revealed a cardiovascular mortality benefit for LCZ696, which combines the neprilysin inhibitor sacubitril with valsartan, an angiotensin receptor blocker.

The drug, which was tested at a dose of 200 mg twice daily versus enalapril 10 mg twice daily, was also superior in reducing death from any cause, 914 patients versus 1117 (P <0.001). The study randomized 4,187 patients to LCZ696 and 4,212 to enalapril.

Moreover, patients in the LCZ696 were 21% less likely to be hospitalized for heart failure (P<0.001) and were less likely to report heart failure–related symptoms or disability (P <0.001).

Innovations in Cardiology (IIC) Summit 2014

Dr Rajneesh Kapoor

Beneficial effect of pistachio consumption on prediabetes

Regular consumption of pistachio consumption is beneficial and is emerging as a useful nutritional strategy for the prediabetic state. Results of a randomized crossover trial published online in Diabetes Care. 2014 Aug 14 suggest that pistachios have a glucose- and insulin-lowering effect, promote a healthier metabolic profile and reverse certain metabolic deleterious consequences of prediabetes. In the study, participants were randomly assigned to start with either a diet including 57 gm per day of roasted pistachios or a calorie–matched control diet in which other fatty foods (mostly olive oil) compensated for the pistachio calories. There was a significant decline in fasting glucose, insulin, and HOMA of insulin resistance with pistachio diet, including other cardiometabolic risk markers such as fibrinogen, oxidized LDL, and platelet factor 4. Pistachios contain more lutein, β–carotene, and ?–tocopherol than do other nuts, and they also appear to hold particular anti–inflammatory properties.

News Around The Globe

  • A new study suggests that eating 10 or more portions of tomatoes a week significantly lowers the risk of developing prostate cancer. The study is published in the journal Cancer Epidemiology, Biomarkers and Prevention.
  • Extremely low levels of the compound in marijuana known as delta–9–tetrahydrocannabinol, or THC, may slow down or stop the progression of Alzheimer’s disease, suggests a recent study published online in the Journal of Alzheimer’s Disease.
  • An experimental drug designed to help regulate the blood’'s iron supply shows promise as a viable first treatment for anemia of inflammation. Lexaptepid, a hepcidin inhibitor, helped maintain appropriate levels of iron in the bloodstream of healthy volunteers without compromising the immune response. Results from the first human study are published online in the journal Blood.
  • A protein named p66ShcA shows promise as a biomarker to identify breast cancers with poor prognoses, suggests new research published in the journal Molecular and Cellular Biology.
  • Photodynamic therapy (PDT, which uses topical agents and light to kill tissue) appears to be a better option for actinic keratoses at three months after treatment than cryotherapy (which uses liquid nitrogen to freeze lesions). The findings are published online August 27 in JAMA Dermatology.

Rabies News (Dr A K Gupta)

What does humanizing your dog means?

  • Talking to your dog like he/she is a person.
  • Treating your dog like he/she is a person.
  • Allowing dogs to do what they want because it will hurt their "feelings."
  • Dressing them up in little doggie clothes.

Remember, humanizing your dog is fulfilling your own human needs, not your dogs. Humanizing dogs does more harm than good.

Cardiology eMedinewS

  • New research finds mixed results from oral use of colchicine for reducing complications involved in cardiac surgery. The study revealed that perioperative administration of colchicine significantly reduced the incidence of postpericardiotomy syndrome after cardiac surgery but did not reduce the risk of postoperative atrial fibrillation and postoperative pericardial/pleural effusions by intention–to–treat analysis. The findings are published in JAMA.
  • A new study has noted that taking vitamin D supplements will not prevent heart attack or stroke, although it could protect against heart failure in older individuals. Researchers noted a lower risk of dying from cardiac failure among seniors who took a daily supplement. The findings are published in The American Journal of Clinical Nutrition.

Pediatrics eMedinewS

  • A new study published in the American Journal of Preventive Medicine has evaluated what the impact over 20 years would be for a tax or advertising ban on sugar–sweetened drinks, compared with other strategies to reduce obesity in adolescents, and the simulations revealed that after–school activity programs would reduce obesity the most among children aged 6–12 (by 1.8%), advertising ban would reduce obesity the least (by 0.9%), and tax on sugary drinks would reduce obesity the most in adolescents aged 13–28 (by 2.4%).
  • A new study conducted by researchers at the University of Colorado Denver has shown that the reasons why children may not be fully vaccinated depends on the class privilege of their mothers. Researchers noted that under–vaccinated children from higher income backgrounds have parents who intentionally choose to refuse or delay vaccinations believing that they are protecting their children; children from families with lower incomes and with less educated parents are under–vaccinated because they lack access to resources. The findings are published in Gender & Society.

Dr K K Spiritual Blog

Why can the body be revived even after hours of death in hypothermia?

  • It is a well–known phenomenon that cardiopulmonary resuscitation (CPR) is not successful if the body temperature is less than 35°C.
  • In hypothermic deaths, a person can be revived even after hours of cardiac arrest. Only when the body temperature is brought back to normal, will CPR be effective. This would mean that consciousness gets frozen and does not leave the body when the temperature is below 35°C. This forms the basis for induced hypothermia after death to revive the brain.
  • Modern science is silent about this mechanism but ancient Indian literature talks about it in great detail. As per Chandogya Upanishad (6.15.1), the process of death takes time and is a sequential process.
  • First, the motor indriyas organs (Karma Indriyas) stop functioning followed by sensory indriya organs (Gnanaindriyas) followed by cessation of prana or respiration.
  • Once this happens, the frozen sensory organs, motor organs, manas (mind, body, memory and ego) and prana have to get dissolved in Tej and then leave the body, which means presence of Tej is the most important factor for consciousness to leave the body.
  • In modern science, Tej would be governed by the body temperature. That means if the body temperature is low, the motor and sensory indriyas and manas product (Vritti) will find no heat or Tej to dissolve and come out of the body.
  • Therefore, till the body temperature (Tej) is brought back to normal, the indriyas will cease to function but still be revivable.
  • This process may take up to 48 minutes in presence of Tej and there is no time limit if Tej is absent.
  • A clinically dead person with cardiac arrest therefore will have absent functioning of Manas organs, Sensory organs, mind, intellect, memory and ego with no respiration but yet revivable back to life.

Wellness Blog

Can diabetes be prevented?

Adhering to a Mediterranean diet, rich in fruits and vegetables and low in animal products may protect from developing type 2 diabetes. The diet emphasizes olive oil, vegetables, fruits, nuts, cereals, legumes and fish, and deemphasizes meat and dairy products. It is a healthy eating plan that seems to help in the prevention of heart disease.

In a study published in the British Medical Journal, researchers tracked the diets of 13,380 Spanish university graduates with no history of diabetes. Participants filled out a 136–item food questionnaire, which measured their entire diet (including their intake of fats), their cooking methods and their use of dietary supplements. During an average of 4.4 years of follow–up, the team found that people who adhered to a Mediterranean diet had a lower risk of developing type 2 diabetes. In fact, those who stuck very closely to the diet reduced their risk by 83 percent.

Moreover, the people who tended to stick closest to the diet were those with factors that put them at the highest risk for developing diabetes, such as being older, having a family history of diabetes and being an ex–smoker. These people were expected to have a higher rate of diabetes, but when they adhered to the Mediterranean diet this was not the case.

Type 2 diabetes is typically brought on by poor eating habits, too much weight and too little exercise.

One key factor that might be responsible for the protective effect of the Mediterranean diet is its emphasis on olive oil for cooking, frying, putting on bread and mixing in salad dressings.

Tips to prevent diabetes

  1. Eat less
  2. Omit refined carbohydrates (white sugar, white rice and white maida)
  3. Use olive oil, vegetables, fruits, nuts, cereals, legumes and fish, and reduce meat and dairy products.

Inspirational Story

Every Woman is Beautiful

A little boy asked his mother, "Why are you crying?" "Because I’m a woman", she told him. "I don’t understand", he said. His mum just hugged him and said, "And you never will"…

Later the little boy asked his father, "Why does mother seem to cry for no reason?" "All women cry for no reason" was all his dad could say. The little boy grew up and became a man, still wondering why women cry.

Finally he put in a call to God; when God got on the phone, the man said, "God, why women cry so easily?" God said, "When I made women she had to be special. I made her shoulders strong enough to carry the weight of the world; yet, gentle enough to give comfort. I gave her an inner strength to endure childbirth and the rejection that many times come from her children.

I gave her a hardness that allows her to keep going when everyone else gives up and take care of her family through sickness and fatigue without complaining. I gave her the sensitivity to love her children under any and all circumstances, even when her child has hurt them very badly.

This same sensitivity helps her make a child’s boo hoo feel better and shares in their teenagers’ anxieties and fears. I gave her strength to carry her husband through his faults and fashioned her from his rib to protect his heart.

I gave her wisdom to know that a good husband never hurts his wife, but sometimes tests her strengths and her resolve to stand beside him unfalteringly.

And finally I gave her a tear to shed. This is hers exclusively to use whenever it is needed. The beauty of a woman is not in the clothes she wears, the figure that she carries, or the way she combs her hair. The beauty of a woman must be seen in her eyes, because that is the doorway to her heart, the place where love resides."

Every woman is beautiful.

ePress Release

Snorers at risk of sudden death

The interrupted night time breathing of sleep apnea increases the risk of dying, 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.

Sleep apnea is a common problem in which one has pauses in breathing or shallow breaths during sleep.

Studies have linked sleep apnea during snoring to increased risk for death. Most studies were done in sleep centers rather than in the general community. An Australian study, published in the journal Sleep, suggests that the risk is present among all people with obstructive sleep apnea.

The study researcher Nathaniel Marshall, from Woolcock Institute of Medical Research in Sydney, said that the size of the increased mortality risk is surprisingly large. The study showed a six–fold increase, which means that having significant sleep apnea at age 40 gives you about the same mortality risk as somebody aged 57 who does not have sleep apnea.

For the study, Marshall’s team collected data on 380 men and women, 40 to 65 years old, who participated in the Busselton Health Study. Among these people, three had severe obstructive sleep apnea, 18 had moderate sleep apnea, and 77 had mild sleep apnea. The remaining 285 people did not suffer from the condition. During 14 years of follow–up, about 33 percent of those with moderate to severe sleep apnea died, compared with 6.5 percent of those with mild sleep apnea and 7.7 percent of those without the condition. For patients with mild sleep apnea, the risk of death was not significant and could not be directly tied to the condition.

People who have, or suspect that they have, sleep apnea should consult their physicians about diagnosis and treatment options.

Another study by researchers from the University of Wisconsin has also shown that severe sleep apnea was associated with a three-fold increased risk of dying. In addition, for those with moderate to mild sleep apnea, the risk of death was increased 50 percent compared with people without sleep apnea. Sleep apnea is also linked to future heart attacks and with thickened wall thickness of the neck artery.

eMedi Quiz

The cells belonging to the following type of epithelium are provided with extra reserve of cell membrane:

1. Transitional
2. Stratified squamous
3. Stratified cuboidal.
4. Stratified columnar.

Yesterday’s Mind Teaser: A 30–year–old man came to the outpatient department because he had suddenly developed double vision. On examination it was found that his right eye, when at rest, was turned medially. The most likely anatomical structures involved are:

1.Medial rectus and superior division of oculomotor nerve.
2.Inferior oblique and inferior division of oculomotor nerve.
3.Lateral rectus and abducent nerve.
4.Superior rectus and trochlear nerve.

Answer for yesterday’s Mind Teaser: 3.Lateral rectus and abducent nerve.

Correct answers received from: Pradip Das, Dr Jainendra Upadhyay, Dr K V Sarma, Dr Pankaj Agarwal, Daivadheenam Jella, Raju Kuppusamy, Dr Avtar Krishan, Bal Kishan Agarwal, Dr Prakash Khalap.

Answer for 31st August Mind Teaser: 3.Pain sensation on the contralateral side.

Correct answers received from: Dr PC Das, Dr KV Sarma, Dr Jainendra Upadhyay, Dr Avtar Krishan, Dr.Bitaan Sen, Dr Jayashree Sen, Dr Poonam Chablani.

Send your answer to ijcp12@gmail.com

Self-Assessment-Quiz

 

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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."

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Health Check Up and CPR 10 Camp at NP Model Primary School East Kidvai Nagar 20th August 2014

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Weight loss may improve sexual health of obese diabetes

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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 :

 

Make Sure

Situation: Sir, he collapsed after sublingual nifedipine was given.
Reaction: Oh, my God! I forgot to check for LVOT obstruction.
Lesson: Make sure that the patient does not have LVOT obstruction (left ventricular outflow tract) before giving sublingual nifedipine.

eMedinewS Humor

Double Decker Bus

There’s a double decker bus driving down the street full of passengers. On the lower level of the bus, everyone’s having a good time, talking, laughing, and singing along to the music playing.

On the upper part of the bus, Maynard is in a panic. He’s screaming, terrified, and holding onto others as the bus moves along the street.

Finally, someone gets up and walks to the top of the bus to ask what’s wrong. Maynard replies, "What’s wrong? Well, you’d be screaming too if you didn’t have a driver!"

Quote of the Day

Love looks through a telescope; envy, through a microscope. Josh Billings

Twitter of the Day

Dr KK Aggarwal: Eating refined sugar can cause diabetes http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Why do you stay in prison When the door is so wide open –Rumi

   
medicolegal update

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  1. Dear Sir, Thanks for the useful information: Regards Dr Kanika

Forthcoming Events

Dear Colleague

Kindly attend ‘Innovations in Cardiology (IIC) Summit 2014’ on 6th September, 11 am – 6 pm at Hotel Oberoi, Gurgaon.

The Organizing Secretary is Dr Rajneesh Kapoor

Highlights of the conference

  • Separate hall for Clinical Cardiology
  • One session on Medicolegal aspects will be taken by me.
  • No registration fee, limited seats

Kindly send your confirmation to rawat.vandana89@gmail.com or sms 9891673085

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