eMedinewS30th March 2014,Sunday

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

Dramatic Rise in Extensively Drug–Resistant Tuberculosis

Almost half (43.7%) of patients with multidrug–resistant (MDR) tuberculosis in 8 countries studied were resistant to at least 1 second–line drug, and 6.7% had extensively drug–resistant (XDR) tuberculosis, according to a study published online August 30 in The Lancet by Tracy Dalton, PhD, a senior service fellow in the Division of Tuberculosis Elimination at the Centers for Disease Control and Prevention in Atlanta, Georgia. MDR tuberculosis is caused by Mycobacterium tuberculosis that is resistant to at least isoniazid and rifampicin. XDR tuberculosis is caused by Mycobacterium tuberculosis strains that are resistant to isoniazid, rifampicin, and at least 1 drug within the fluoroquinolones and 1 antituberculosis injectable drug. Fluoroquinolones and injectable drugs are second–line antituberculosis drugs.

Most international recommendations for tuberculosis control have been developed for (MDR) tuberculosis prevalence of up to around 5%. Yet we now face prevalence up to 10 times higher in some places, where almost half of the patients with infectious disease are transmitting MDR strains of Mycobacterium tuberculosis.

According to data from the World Health Organization, 5.4% of patients with MDR tuberculosis have XDR tuberculosis.


Zee News – Health Wealth Show

Dr kk Aggarwal on Zee Show

Vitiligo–Health Wealth Zee News Show Show
Safe Holi–Health Wealth Zee News Show
Safe Drugs–Health Wealth Zee News Show
Cancer Prevention–Health Wealth Zee News Show2
Potbelly Obesity–Health Wealth Zee News Show
Cancer Prevention–Health Wealth Zee News Show1
Vitamin D Health Wealth
Pneumonia–Health Wealth Zee News Show
Sudden Cardiac Death
Can Alcohol be Prescribed as Medicine
Health Wealth: All about Paralysis

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
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

How long can one fast?

sprritual blog

As per allopathy, one cannot live without air or oxygen for more than 3 minutes, without water for more than three days and without food for more than 3 weeks.

According to the Chandogya Upanishads, food is responsible for the making of motor organs (Karmaindriyas), Sensory Organs, Manas (mind, intellect, memory and ego) and Prana.

The fiery foods are responsible for making the motor indriyas, earthy foods for sensory indriyas and manas and water for making Prana Vayu.

Therefore, it is possible for a person to live on water for up to few weeks because he will keep making Prana and keep breathing but absence of food on 14th day onward will start affecting his Gnanaindriyas and Manas. The person will start losing power of hearing, touching and sensing and will start showing impairment in mental status, memory, intellect functions and egoistic behavior.

cardiology news

Determination and Persistence

This is a real life story of engineer John Roebling building the Brooklyn Bridge in New York, USA back in 1870. The bridge was completed in 1883, after 13 years.

In 1883, a creative engineer named John Roebling was inspired by an idea to build a spectacular bridge connecting New York with the Long Island. However bridge building experts throughout the world thought that this was an impossible feat and told Roebling to forget the idea. It just could not be done. It was not practical. It had never been done before.

Roebling could not ignore the vision he had in his mind of this bridge. He thought about it all the time and he knew deep in his heart that it could be done. He just had to share the dream with someone else. After much discussion and persuasion he managed to convince his son Washington, an up and coming engineer, that the bridge in fact could be built.

Working together for the first time, the father and son developed concepts of how it could be accomplished and how the obstacles could be overcome. With great excitement and inspiration, and the headiness of a wild challenge before them, they hired their crew and began to build their dream bridge.

The project started well, but when it was only a few months underway a tragic accident on the site took the life of John Roebling. Washington was also injured and left with a certain amount of brain damage, which resulted in him not being able to talk or walk.

"We told them so." "Crazy men and their crazy dreams." "It’s foolish to chase wild visions." Everyone had a negative comment to make and felt that the project should be scrapped since the Roebling’s were the only ones who knew how the bridge could be built.

In spite of his handicap Washington was never discouraged and still had a burning desire to complete the bridge and his mind was still as sharp as ever. He tried to inspire and pass on his enthusiasm to some of his friends, but they were too daunted by the task.

As he lay on his bed in his hospital room, with the sunlight streaming through the windows, a gentle breeze blew the flimsy white curtains apart and he was able to see the sky and the tops of the trees outside for just a moment.

It seemed that there was a message for him not to give up. Suddenly an idea hit him. All he could do was move one finger and he decided to make the best use of it. By moving this, he slowly developed a code of communication with his wife.

He touched his wife’s arm with that finger, indicating to her that he wanted her to call the engineers again. Then he used the same method of tapping her arm to tell the engineers what to do. It seemed foolish but the project was under way again.

For 13 years Washington tapped out his instructions with his finger on his wife’s arm, until the bridge was finally completed. Today the spectacular Brooklyn Bridge stands in all its glory as a tribute to the triumph of one man’s indomitable spirit and his determination not to be defeated by circumstances. It is also a tribute to the engineers and their team work, and to their faith in a man who was considered mad by half the world. It stands too as a tangible monument to the love and devotion of his wife who for 13 long years patiently decoded the messages of her husband and told the engineers what to do.

Perhaps this is one of the best examples of a never–say–die attitude that overcomes a terrible physical handicap and achieves an impossible goal.

Often when we face obstacles in our day–to–day life, our hurdles seem very small in comparison to what many others have to face. The Brooklyn Bridge shows us that dreams that seem impossible can be realized with determination and persistence, no matter what the odds are.

News Around The Globe

  • The US Food and Drug Administration (FDA) has recently approved a hearing aid, made by the Danish company William Demant, that reduces tinnitus. The device is especially targeted at the U.S. Veterans Administration, a government–led program for US military veterans. There is a big market for such a hearing aid in the US since it was estimated that in 2011, 840,865 members of the VA had tinnitus.
  • The World Health Organization has declared India free of polio virus on Thursday, thereby making the country’s almost 20–year–long, multi–billion–dollar effort one of the biggest successes in the field of public health in recent times. India’s last case of the wild polio virus was detected in January 2011 in a girl in West Bengal. Three years without any new cases means a country can be certified as polio–free. Afghanistan, Pakistan and Nigeria now remain the only countries in the world where the virus is still endemic.
  • Repetitive transcranial magnetic stimulation (rTMS) has the potential to improve the quality of life in patients with fibromyalgia; however it does not affect pain, reports a new study, which appeared online March 26 in Neurology. The randomized, double–blind study was conducted by a group from Aix-Marseille Université, Marseille, France. Thirty–eight patients were randomly assigned to high–frequency rTMS (n = 19) or sham stimulation (n = 19) applied to the left primary motor cortex in 14 sessions over 10 weeks. Patients receiving rTMS therapy exhibited greater improvement in quality of life, particularly in affective (mood or feelings), emotional (joy, sadness, anger, anxiety), and social (work performance, participation in social activities, contact with friends, and engaging in hobbies and interests) areas.
  • A recent retrospective cohort study of more than 100,000 age– and sex–matched patients has revealed that those who used anxiolytics and/or hypnotics had a 3–fold increased risk of dying prematurely during the 7–year follow–up period as compared to those who did not use these drugs.
  • A study published March 27 in the New England Journal of Medicine states that brain abnormalities in children with autism may begin before birth. The findings are supported by the evidence of disorganized neurons in the prefrontal cortex, noted in the detailed postmortem study. The study revealed the presence of patches of disorganized neurons in areas that regulate functions that are disturbed in autism, including social, emotional, communication, and language function. Thus, it could be stated that autism may begin before birth.

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

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Rabies News (Dr. A K Gupta)

How is RIG injected locally? What is the mode of administration of full dose of RIG?

It is important to infiltrate all wounds with rabies immunoglobulin (RIG). Intramuscular (IM) administration of RIG is of very little value. The previous recommendation to give antirabies serum half into wounds and half IM no longer holds true and may lead to treatment failure. As much of the calculated dose of RIG as is anatomically feasible should be infiltrated into and around all the wounds. In the event that some volume of RIGs is left over after all wounds have been infiltrated, it should be administered by deep IM at a site distant from the vaccine injection site.

If the calculated dose of RIG is insufficient to infiltrate all wounds, sterile saline can be used to dilute it 2 or 3 fold to permit thorough infiltration.

cardiology news
  • The US Food and Drug Administration (FDA) has recently approved topiramate for the prevention of migraine headache in adolescents aged 12 to 17 years. This comes as the first FDA approval of a drug for migraine prevention in this age group. The study reported that the frequency of migraine decreased by about 72% in patients treated with topiramate vs. 44% in subjects receiving placebo.
  • The American College of Obstetricians and Gynecologists (ACOG) has stated in a report published in the April issue of Obstetrics & Gynecology that physicians should consider a multidimensional assessment process that evaluates all the potential contributing factors in cases of neonatal encephalopathy. Researchers recommend doing a root–cause analysis in order to identify issues that may help prevent some cases of neonatal encephalopathy.
cardiology news
  • A new guideline by the American Heart Association (AHA), American College of Cardiology (ACC), and Heart Rhythm Society (HRS), in collaboration with the Society of Thoracic Surgery, on atrial fibrillation (AF) has put forward a more precise stroke–risk calculator and described the correct time to use aspirin, novel oral anticoagulants, and catheter ablation. The guideline was published online March 28 in the Journal of the American College of Cardiology, Circulation, and Heart Rhythm, The guideline replaces the AF guideline published in 2006 as well as two updates published in 2011.
  • The American Heart Association/American Stroke Association has recently issued a scientific statement on palliative care for stroke patients published online in Stroke on March 27. The statement stresses the significance of a well–coordinated medical team to personalize care, optimize quality of life, and minimize suffering. According to the statement, palliative care for stroke patients should include: talking about patient preferences, needs, and values to guide medical decisions; discussing the aspects of recovery most important to the patient/family; having effective, sensitive discussions about the prognosis of the patient, dealing with physical or mental losses, and, if necessary, of dying; offering guidance through choices about life–sustaining treatment options, addressing pros and cons of cardiopulmonary resuscitation, ventilators, feeding tubes, surgery, do–not–resuscitate orders, do–not–intubate orders, and natural feeding; among others.
cardiology news

Treatment of Summer Diarrhea

Most summer diarrhea is watery, effortless and painless diarrhea with no mucous or blood. They need no antibiotics. The only treatment is oral rehydration solution.

One loose motion is equivalent to loss of one glass of fluid. Explaining this, Dr. Aggarwal said that if a patient has passed 10 loose motions, he needs 12 glasses of ORS apart from normal requirement of fluids and one glass for every loose motion passed again.

For up to 12 loose motions, a patient can be managed as an outpatient but if the loose motions are more than 12, he needs observation and if the numbers of loose motions are more than 40, he needs intensive treatment.

The main complication is renal shut down, which will happen if the blood pressure remains low for more than few hours. During diarrhea, urine should be passed every 6-8 hours. If no urine is passed for eight hours it may indicate an impending renal failure.

cardiology news

Total CPR since 1st November 2012 – 88972 trained

Media advocacy through Web Media

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press release

ECG not reliable marker for predicting heart disease

Doing an ECG is of little use in predicting future heart problems for people who are examined because of chest pain, 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.

Chest pain is the most common reason people seek medical attention for possible heart trouble, and an ECG is a common test for such people. ECG can be normal in the first six hours even in frank heart attacks. Missing the diagnosis of heart attack on ECG is the commonest mistake done in the emergency rooms.

The classical history and physical findings still remain the most important parameters.

  1. Chest pain, which can be pinpointed by a finger is not a heart pain.
  2. Pain lasting less than 30 seconds is not a heart pain.
  3. Heart pain is diffuse pain in the center of the chest lasting more than minutes and manifesting as heaviness, burning, discomfort, heaviness or pain often precipitated by physical or mental exertion.

Doing anWhen in doubt one should do an exercise stress test and if negative these patients should be reassessed for risk factors.

If the patient is at high risk, then even with negative treadmill he/she should undergo risk reduction management for prevention of future heart attacks.

High risk patients are smokers, presence of blood pressure, obesity, high cholesterol and diabetes.

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 88972 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

A free heart checkup camp was organised at Mandi House, Doordarshan Kendra where over 500 people were examined by a team lead by 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

press release

ACE inhibitors better ARBs in new meta–analysis in hypertensives

vedio of day

today video of the dayTackling tension headaches

Hands only CPR 10 Utsav, 15th December 2013

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

eMedi Quiz

A measure of location which divides the distribution in the ratio of 3:1 is:

1. Median
2. First quartile
3. Third quartile
4. Mode

Yesterday’s Mind Teaser: Elements of primary health care include all of the following except:

1. Adequate supply of safe water and basic sanitation.
2. Providing essential drugs.
3. Sound referral system.
4. Health Education.

Answer for yesterday’s Mind Teaser: 3. Sound referral system.

Correct answers received from: Dr Abbas Vakil, Dr Rakesh Bansal, Trupti Pagad,
Dr Sushma Chawla, Dr Jainendra Upadhyay, Dr K Raju, Daivadheenam Jella, Dr Avtar Krishan.

Answer for 29th March Mind Teaser: 3. Down’s syndrome.

Correct answers received from: Dr Sushma Chawla, Dr Jainendra Upadhyay, Dr Avtar Krishan.

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medical querymedical query

medicolegal update
medicolegal update

A man was in the kitchen making a lot of noise! His wife comes in and asks why he was making so much noise? The man replies: "I am killing flies."

A short time later his wife came back and he was still making lots of noise! She asks: "Well, Mr. Big Shot, how many flies have you killed?"

He says: "I have killed seven flies! 4 males and 3 females."

She says: "Right, how can you tell the gender of flies?"

He says: "Very easy: the 4 flies in my right hand are males. When I killed them, they were all on beer cans!" Then she asks: "If you are so smart, how can you tell the gender of the females?"

He says: "The three in my left hand, they were all on the phone!!!"

medicolegal update

Click on the image to enlarge

medicolegal updatemedicolegal update

medicolegal update

Situation: A patient with LBBB in ECG developed acute pulmonary edema.
Reaction: Oh my God! Why was the underlying low cardiac functions not suspected?
Lesson: Make sure all patients with LBBB undergo echo to rule out ejection fraction. This may not be true for RBBB.

medicolegal update

If I have the belief that I can do it, I shall surely acquire the capacity to do it even if I may not have it at the beginning. Gandhi

medicolegal update

Dr KK Aggarwal: Cinnamon in Nonalcoholic Fatty Liver Disease Cinnamon (dalchini) helps improve lipid profiles and improve (cont) http://tl.gd/n_1rvf2c6
Dr Deepak Chopra: Love is what we are in our essence. The more love we feel in our hearts, the more it will be brought to us http://bit.ly/DC_Ananda #ananda

medicolegal update
  1. Dear Sir, emedinews is like a daily morning cup of tea to me. Regards: Dr Kapil

Forthcoming events

Date: Saturday 2PM–Sunday 3PM, 26–27 April 2014
Venue: Om Shanti Retreat Centre, Bhora Kalan, Pataudi Road, Manesar
Course Directors: Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal and BK Sapna
Organisers: Heart Care Foundation of India. Prajapati Brahma Kumari Ishwariye Vidyalaya and eMedinews
Facilities: Lodging and boarding provided (one room per family or one room for two persons). Limited rooms for first three hundred registrants.
Course: Meditation, Lectures, Practical workshops
Atmosphere: Silence, Nature, Pyramid Meditation, Night Walk
Registration: SMS– Vandana Rawat – reg mno, rawat.vandana89@gmail.com
SMS – BK Sapna reg mno1, bksapna@hotmail.com

Note: Donation in Favor of Om Shanti Retreat Centre will be welcomed

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