eMedinewS30th October 2013, Wednesday

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; 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.facebook.com/Dr KKAggarwal

World Stoke Day

  1. Both heart attack and brain attack share same risk factors.
  2. In both conditions, time is muscle or brain and early diagnosis is the clue to reduce mortality.
  3. In both conditions, patient should rushed to the nearest hospital as early as possible but definitely within 6 hours to receive clot–dissolving therapy or clot removal by invasive procedure.
  4. In both conditions, giving a water–soluble aspirin at home at the time of transferring helps.
  5. In acute stoke, urgent CT scan of the head should be done as early as possible to rule out brain hemorrhage.
  6. In both conditions, a person should be transferred preferably to a set up where cath lab is available and facilities for clot–dissolving therapy are available.
  7. One should remember the mnemonic Act FAST for identification of stroke – where "F" stands for fallen Face; "A" stands for inability to hold Arms high, "S" stands for slurred Speech and "T" stands for the importance of Time or any other words to act fast definitely within 6 hours.
  8. One should correct rapidly if the blood pressure is less than 60 in acute stoke.
  9. In acute stroke, blood sugar should not be allowed to higher than 180 mg/dL.
  10. Prevent aspiration in every patient of stroke.
  11. In acute stroke, the upper blood pressure should be kept below185 mm Hg.
  12. In acute stroke, lower blood pressure should be kept less than 110 mg Hg.
  13. All patients of stroke should be cardiac monitored for first 24 hours to look for irregular rhythm.
  14. The estimated 30 day–mortality after the first stroke ranges from 16 to 23%.
  15. After an acute stroke, there is persistent neurological deficit at 6 months in 40–50% patients.

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."

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

Meaningful Coincidences: Synchronicity

sprritual blog

If you meet someone you haven’t met for a long time, stop and talk to him or her. Remain aware of a message from the Universe that they might be carrying for you.

Follow the coincidence through, and you’ll be amazed to find where it takes you.

Time and again, we all experience coincidences that have some special meaning or significance, and that appear to defy the laws of probability. Most of us tend to ignore them as something amusing or insignificant.

cardiology news

The seed

Once upon a time, there was a seed and because it was only a seed, nobody cared to notice it. Thus, gripped by a sense of inferiority, the seed gave no importance to his existence. Then one day, a wind picked him up - randomly or otherwise he didn't know - and threw him mercilessly on an open field under the sweltering sun. He was confused. Why would anything do such a thing? But instead of any copasetic answers, he was provided with rain (in addition to sunlight); sometimes in drizzles and sometimes in torrents. Meanwhile time flew and years later he saw a traveler sitting by his side. "Thank you God for this.

I really needed some rest," he heard the traveler say. "What are you talking about?" The seed promptly asked. He thought the man was making fun of him. Sure, he had witnessed many people sitting by his side - more so in recent years - but no one ever spoke to him like that. "Who is this?" The man was startled. "This is me. The seed." "The seed?" The man looked at the giant tree. "Are you kidding me? You are no seed. You are a tree. A goliath of a tree!" "Really?" "Yes! Why else do you think people come here?" "What do they come here for anyways?" "To feel your shade! Don't tell me you didn't know you had grown over time."

A moment passed before the traveler's words struck the chord of realization within him. The seed, now a prolix tree, thought and smiled for the first time in his life. The years of relentless tortures by the sun and the rain finally made sense to him. "Oh! That means I'm not a tiny-flimsy seed anymore! I wasn't destined to die unnoticed but was actually born to strip people of their lassitude. Wow! Now that's a life worth a thousand gems!"

News Around The Globe


The Interact Club of Birla Vidya Niketan partnered with Heart Care Foundation of India and organized a number of competitions at the Perfect Health Mela to promote health awareness. The various competitions on 23rd, 24th and 26th October, 2013 included poster making cum slogan writing, health model display cum demonstration, State folk, heritage, cartoon making, creating best out of waste, yoga, aerobics and singing. The highlight of the competition was the importance given to students with special needs.

26th October was dedicated to children with special needs who participated with great zeal and fervor and turned up in large number. Mrs. Minakshi Kushwaha, Principal of BVN and Mrs. Tapati Singhi, Educational Adviser constantly encouraged and guided the Interact club volunteers to make the event a success.

Eco Fest organized at the Health Mela

Eco Fest 2013 was organized by Ryan Global School at the Health Mela. The event included Nukkad Natak, Debate and Cheerleading Competitions. Various schools from Delhi NCR participated and showcased their talent while emphasizing on the issues concerning health.

  • A type of "exposure therapy" for patients who can’t tolerate continuous positive airway pressure (CPAP) may help improve adherence to the treatment, according to results of a small pilot study. Some patients who had been unable to tolerate the treatment –– mostly because of an inability to wear the mask properly –– were able to significantly increase the number of minutes per night on CPAP after doing a program that desensitized them to it.
  • A breath test for volatile organic compounds accurately detected lung cancer in high–risk patients and characterized its subtype. As reported at the American College of Chest Physicians meeting, the test had C–statistics of 0.824 to 0.874 for various cancer subtypes compared with controls; 0.8 or better on the 1–point scale is considered strong concordance. It was even better at distinguishing adenocarcinoma from squamous cell carcinoma, with a C–statistic of 0.896.
  • Breast cancer radiotherapy doses have decreased over time, but the associated risk for long–term heart disease remains and appears to be lowest among women in good cardiac health. The overall average radiation dose to the heart for 48 women treated for early breast cancer after 2005 was 1.37 gray (Gy) compared with 4.9 Gy reported in a study of women from 1958 to 2001. David J. Brenner, PhD, DSc, of Columbia University Medical Center in New York City, and colleagues reported their findings in a research letter in JAMA Internal Medicine.
  • With its focus on breathing exercises, yoga may improve some of the symptoms of chronic pulmonary obstructive disease (COPD) along with boosting quality of life. In a small study of patients in India reported at the CHEST meeting, 12 weeks of twice weekly yoga classes improved several measurements of dyspnea and living quality.
  • According to a new study, a pair of microRNA (miRNA) biomarkers strongly predicted papillary thyroid cancer (PTC) recurrence. MicroRNA–222 and microRNA–146b were overexpressed 10.8–fold and 8.9–fold in the tissue samples of patients with recurrent PTC compared with samples from patients who did not recur.

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Rabies News (Dr. A K Gupta)

What are the signs of rabies during the prodromal phase in animals?

Prodromal phase may last for 1–3 days and the animal may show only vague CNS signs, which intensify rapidly and death is virtually certain within 10 days after the initial onset of signs.

cardiology news

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinewS)

  • The overall burden of stroke in terms of absolute numbers of people affected around the world is growing, especially in younger age groups and in low–to–middle–income countries, a global study showed. In 2010, there were 16.9 million people who had a first stroke, 33 million stroke survivors, and 5.9 million people who died from a stroke –– increases of 68%, 84%, and 26% respectively since 1990. In addition, 102 million disability–adjusted life years DALYs were lost, up 12%. The study is reported online in The Lancet.
  • Measurement of coronary artery calcium (CAC) stratified patient risk for cardiovascular disease regardless of dyslipidemia burden or definition. When measured across lipid abnormality categories, patients with CAC score of 100 or more had a 22.2 to 29.2 incidents of cardiovascular disease per 1,000 person–years vs 2.4 to 6.2 events per 1,000 person–years among those with arterial calcium scores of 0. Among patients with no lipid abnormalities, those with arterial calcium scores of 100 or more had a higher rate of cardiovascular disease than did those with three lipid abnormalities and an arterial calcium score of 0 (22.2 events versus 6.2 events per 1,000 person years). The study is reported online in the journal Circulation.
cardiology news

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinewS)

  • According to a study presented at the meeting of the American Academy of Pediatrics (AAP), children with severe spinale curving from scoliosis had three–fold risk for abnormal tricuspid regurgitant jet velocity, which is an indirect measure of pulmonary hypertension.
  • Some children bitten by snakes may not need lab testing and antivenom. Presenting their study at the meeting of the American Academy of Pediatrics, Mary Brandt, MD, of Texas Children’s Hospital, the study’s senior author said that guidelines for snakebite management are "very specific to geographical location and the type of snake. If it is possible that it is a rattlesnake bite, antivenom should be given. We are raising the question of whether that is true in an area where most of the snakes are cottonmouth or copperheads.
cardiology news

The hidden burden of high blood pressure

Hypertension generally does not cause any outward signs or symptoms. Yet it silently damages blood vessels, the heart, kidneys and other organs. It isn’t a disease. It is a sign that something is wrong in the body. In some people with hypertension, the culprit is a narrowing of the arteries supplying the kidneys (renal artery stenosis), or an overactive thyroid gland (hyperthyroidism) or adrenal glands (aldosteronism). When these are treated, blood pressure drops back to normal. More often, though, doctors find no underlying cause for high blood pressure. This condition is called essential hypertension.

High blood pressure imposes an upfront burden in people who know they have it and who are working to control it. It adds to worries about health. It alters what you eat and how active you are, since a low–sodium diet and exercise are important ways to help keep blood pressure in check. Some people need medication and may need to take one or more pills a day, which can be a costly hassle.

There are long–term consequences too. High blood pressure contributes to the development of stroke, heart attack, heart failure, and kidney disease. In the United States, it directly accounts for about 60,000 deaths a year and contributes to another 300,000.

Then there are hidden burdens. Perhaps because of all the ways hypertension interferes with health, the average life span for people with it is 5 years shorter than it is for those with normal blood pressure. A team of Spanish researchers has tallied up another hidden drain of high blood pressure — its effect on survival and rehospitalization after someone is admitted to the hospital for a heart problem.

These researchers looked at the 1,007 men and women admitted to the hospital over a 10–month period for any potentially heart–related problem. These ranged from chest pain and fainting to heart attack, heart failure, atrial fibrillation, and pericarditis. In this group, 69% had been diagnosed with high blood pressure before being admitted to the hospital. Each person was followed for one year. At the end of that time, 17% of those with high blood pressure had died, compared with 9% of those with normal blood pressure. Rehospitalization for a cardiac problem followed the same pattern: 31% of those with high blood pressure, and 18% of those without (American Journal of Cardiology, published online, Aug. 24, 2011).

There is a lot a person can to do help keep it in check, and even prevent it from occurring in the first place. The National Heart, Lung, and Blood Institute, Centers for Disease Control and Prevention and the American Heart Association offer these recommendations:

  • Achieve and maintain a healthy weight for your height.
  • Exercise regularly.
  • Eat a diet that is rich in fruits, vegetables and whole grains.
  • Limit sodium intake to under 2,300 mg a day (one teaspoon of salt), and get plenty of potassium (at least 4,700 mg per day) from fruits and vegetables.
  • Drink alcohol in moderation, if at all.
  • Reduce stress.
  • Monitor your blood pressure regularly, and work with your doctor to keep it in a healthy range.

(Source Harvard HealthBeat)

cardiology news

Total CPR since 1st November 2012 – 67390 trained

Media advocacy through Web Media

World Stroke Day

On the occasion of World Stroke Day, Padma Shri and Dr B C Roy National Awardee, Dr K K Aggarwal and Dr Vipul Gupta, Senior Interventional Neuroradiologist at Medanta - The Medicity said that both heart attack and brain attack should be tackled in the same way. Both conditions share the same predisposing factors and in both cases early diagnosis and clot removal is life-saving.

In both cases the patient should be rushed to the nearest hospital as early as possible but definitely within 6 hours and the treatment in both the conditions is either clot dissolving therapy or removal of the clot by invasive cath procedure.  In both cases preferably the patient should be shifted to the nearest hospital where cath lab facilities are available.  

They said one should remember the mnemonic Act FAST to identify stroke, where “F” stands for Fallen Face; “A” stands for inability to raise both arms high, “S” stands for slurred speech and the last “T” stands for the importance of time or in other words to act fast definitely within 6 hours if any of these signs are present.

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 67390 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 10x10 i.e. 100 per minute.”  

today emedipics

Students in Large number participated in 20th MTNL Perfect Health Mela

press release

Thin line between ethical and unethical acts

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

When should you have your first cholesterol screening?

A. At age 10.
B. At age 20.
C. At age 35.
D. At age 40.
E. It depends on your risk factors.

Yesterday’s Mind Teaser: A client has been diagnosed with hypertension. The nurse priority nursing diagnosis would be:

a. Ineffective health maintenance
b. Impaired skin integrity
c. Deficient fluid volume
d. Pain

Answer for yesterday’s Mind Teaser: a. Ineffective health maintenance

Correct answers received from: Dr.Akhila Mithun, Dr.K.Raju, Dr. V.P. Thakral, Dr Jainendra Upadhyay, Dr Arpan Gandhi, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Avtar Krishan, Dr.Shravan Kumar Chinnikatti

Answer for 28th October Mind Teaser: b. Myocardial damage

Correct answers received from: Dr Avtar Krishan, Dr.Shravan Kumar Chinnikatti

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

Doctor complaining to mechanic
A doctor is taking to a car mechanic, "your fee is several times more per hour then we get paid for medical care."
‘Yeah, but you see, doc, you have always the same model! It hasn't changed since Adam; but we have to keep up to date with new models coming every month"

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A foreigner with a single loose stool developed sepsis.
Reaction: Oh my God! Why were antibiotics not started in time?
Lesson: Make sure that all foreigners are diagnosed to be suffering from Traveler’s diarrhea even if there is one single loose motion.

medicolegal update

The will to win means nothing if you haven’t the will to prepare.

medicolegal update

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: No regrets and no anticipation, just this moment fresh and as is.

medicolegal update
  1. Beautiful & educative. 11 Sutras reminds us of the importance of clinical approach rather than depending primarily on lab reports. Dr Madanmohan

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