eMedinewS30th May 2014, Friday

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

All about depression

  • Depression is a major public health problem as a leading predictor of functional disability and mortality.
  • Optimal depression treatment improves outcome for most patients.
  • Most adults with clinical significant depression never see a mental health professional but they often see a primary care physician.
  • A non–psychiatrist physician misses the diagnosis of the depression 50% of times.
  • All depressed patients must be enquired specifically about suicidal ideations.
  • Suicidal ideation is a medical emergency
  • Risk factors for suicide are psychiatric known disorders, medical illness, prior history of suicidal attempts, or family history of attempted suicide.
  • Demographic reasons include older age, male gender, marital status (widowed or separated) and living alone.
  • World over about 1 million people commit suicide every year.
  • Seventy–nine percent of patients who commit suicide contact their primary care provider in the last one year before their death and only one–third contact their mental health service provider.
  • Twice as many suicidal victims had contacted with their primary care provider as against the mental health provider in the last month before suicide.
  • Suicide is the 10th leading cause of death worldwide and account for 1.2% of all deaths.
  • In US suicidal rate is 10.5 per 100,000 people.
  • In America suicide is increasing in middle aged adults.
  • There are 10–40 non–fatal suicide attempts for every one completed suicide.
  • The majority of suicides completed in US are accomplished with fire arm (57%); the second leading method of suicide in US is hanging for men and poisoning in women.
  • Patients with prior history of attempted suicide are 5–6 times more likely to make another attempt.
  • Fifty percent of successful victims have made prior attempts.
  • One of every 100 suicidal attempt survivors will die by suicide within one year of the first attempt.
  • The risk of suicide increases with increase in age; however, younger and adolescents attempt suicide more than the older.
  • Females attempt suicide more frequently than males but males are successful three times more often.
  • The highest suicidal rate is amongst those individuals who are unmarried followed by widowed, separated, divorced, married without children and married with children in descending order.
  • Living alone increases the risk of suicide.
  • Unemployed and unskilled patients are at higher risk of suicide than those who are employed.
  • A recent sense of failure may lead to higher risk.
  • Clinicians are at higher risk of suicide.
  • The suicidal rate in male clinicians is 1.41 and in female clinicians it is 2.27.
  • Adverse childhood abuse and adverse childhood experiences increase the risk of suicidal attempts.
  • The first step in evaluating suicidal risk is to determine presence of suicidal thoughts including their concerns and duration.
  • Management of suicidal individual includes reducing mortality risk, underlying factors and monitoring and follow up.
  • Major risk for suicidal attempts is in psychiatric disorders, hopelessness and prior suicidal attempts or threats.
  • High impulsivity or alcohol or other substance abuse increase the risk.

News Around The Globe

  • A high level of cynical distrust, for instance, believing that no one cares much what happens to you and that it’s safer not to trust anybody, is associated with a higher risk for dementia, and the association may not entirely be explained by depressive symptoms, reported a new study published online May 28 in Neurology.
  • An oral drug, BCX4161, has been found effective in a mid–stage trial in reducing attacks related to hereditary angioedema (HAE), a genetic disease characterized by sudden attacks of swelling of the skin or the mucous membranes.
  • Results from a phase II trial have shown that benralizumab reduces exacerbations and improves lung function in asthma patients with elevated eosinophil counts. Results from the trial were presented at the American Thoracic Society 2014 International Conference.
  • A report published online in the journal Gut has stated that testing for salivary pepsin may spare patients with GERD from undergoing unnecessary antireflux therapy and invasive expensive tests. Researchers noted that patients with heartburn had a significantly higher prevalence of saliva samples positive for pepsin.
  • Patients coinfected with HIV and tuberculosis (TB) may benefit from raltegravir as an alternative to efavirenz, reports a new study published in The Lancet Infectious Diseases. Standard doses of raltegravir, 400 mg twice daily, had fewer treatment-related serious adverse events compared to efavirenz 600 mg once daily, reported the study.

Rabies News (Dr A K Gupta)

What are the common side effects of intra–dermal rabies vaccination?

Cell culture vaccines have proved to be remarkably safe and free of significant adverse events. However, mild symptoms of pain, erythema, irritation or swelling at the intradermal injection sites occur in 3–92% of patients. The most frequent symptom is local irritation in 7–64% of vaccines. Generalized symptoms reported by 3–14% of recipients include headache, fever and influenza–like illness. Transient macular, papular and urticarial rashes are occasionally seen. All these adverse effects are mild, transient and self limiting and rarely call for the use of antihistamines and analgesics.

Cardiology eMedinewS

  • Young adults exposed to adverse experiences as children have more signs of unhealthy blood vessel function than young people without a traumatic past, reports a new study published online in Hypertension. Early–life stress may thus increase the risk of heart disease later on by affecting blood vessel function and blood pressure.
  • New study results presented at EuroPCR 2014 suggested that the Direct Flow transcatheter valve, considered first in class owing to its unique design, is safe and associated with very low rates of mortality and stroke, and minimal aortic regurgitation.

Pediatrics eMedinewS

  • A community program of prenatal screening for chronic hepatitis B virus (HBV) and use of neonatal immunoprophylaxis for infants born to HBV–positive women is highly effective in preventing perinatal transmission, reports a study published online May 26 in the Annals of Internal Medicine.
  • A study published online in the Annals of the Rheumatic Diseases has revealed that most of the kids with juvenile idiopathic arthritis (JIA) who begin currently recommended treatment within 6 months of diagnosis have increased likelihood of attaining inactive disease within 2 years, and approximately half of them may achieve remission within 5 years.

Dr K K Spiritual Blog

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

  • 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 once the body temperature is brought back to normal CPR will be effective.
  • That 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 the 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 pana 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 seize to function but still be revivable.
  • This process may take upto 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

Cholesterol tips released

Blood lipid levels may exhibit mild seasonal variation with a drop in the summer and total cholesterol level peaking in the winter. The variation can be up to 5 mg/dL.

Serum total and HDL–cholesterol can be measured in fasting or non–fasting individuals. There are only small clinically insignificant differences in these values when measured in the fasting or non–fasting state.

The total cholesterol can vary by 4 to 11 percent within an individual due to multiple factors including stress, minor illness and posture. Values may also vary between different laboratories, with data suggesting that a single measurement of serum cholesterol can vary as much as 14 percent. Therefore in an individual with "true" serum cholesterol concentration of 200 mg/dL the range of expected values is 172 to 228 mg/dL.

More than one measurement of total cholesterol should therefore be obtained when treatment considerations demand a precise determination. Measurement of serum HDL–C and triglycerides may demonstrate even greater variability.

A standard serum lipid profile consists of total cholesterol, triglycerides, and HDL–cholesterol. Lipid profile should be performed after 12 to 14 hours of fasting to minimize the influence of postprandial hyperlipidemia. One can use either plasma or serum specimen. The serum cholesterol is approximately 3 percent lower than the plasma value.

Inspirational Story

Black or White

When I was in elementary school, I got into a major argument with a boy in my class. I have forgotten what the argument was about, but I have never forgotten the lesson I learned that day.

I was convinced that "I" was right and "he" was wrong – and he was just as convinced that "I" was wrong and "he" was right. The teacher decided to teach us a very important lesson. She brought us up to the front of the class and placed him on one side of her desk and me on the other. In the middle of her desk was a large, round object. I could clearly see that it was black. She asked the boy what color the object was. "White," he answered.

I couldn’t believe he said the object was white, when it was obviously black! Another argument started between my classmate and me, this time about the color of the object. The teacher told me to go stand where the boy was standing and told him to come stand where I had been. We changed places, and now she asked me what the color of the object was. I had to answer, "White."

It was an object with two differently colored sides, and from his viewpoint it was white. Only from my side it was black.

Sometimes we need to look at the problem from the other person’s view in order to truly understand his/her perspective.

ePress Release

Heart disease starts in youth

Autopsy studies of young people who died in accidents have shown that by the late teens, the heart blockages, the kind of lesions cause heart attacks and strokes are in the process of developing, 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.

Quoting a study published in the journal Circulation, Dr Aggarwal said that it is never too early to start protective measures against heart disease.

The best opportunity to prevent heart disease is to look at children and adolescents and start the preventive process early. More than a third of children and adolescents are overweight or obese.

The first signs that men are at higher risk of heart disease than women appear during the adolescent years despite the fact that boys lose fat and gain muscle in adolescence and girls add body fat.

Between the ages of 11 and 19, levels of triglycerides, a type of blood fat associated with cardiovascular disease, increases in the boys and drops in the girls. Levels of HDL cholesterol, the "good" kind that helps keep arteries clear, go down in boys but rise in girls.

Blood pressure increases in both, but significantly more in boys. And insulin resistance, a marker of cardiovascular risk, which is lower in boys at age 11, rises until the 19.

Any protection that the young women have for cardiovascular protection can be wiped out by obesity and hence obesity in girls at any cost should be handled on priority.

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 1stNovember 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."

eMedi Quiz

All of the following are TRUE regarding HIV infection in children except:

a. Most of the children present with clinical symptoms during the neonatal period.
b. They usually present with non specific symptoms of immunodeficiency
c. Skin is one of the most commonly involved organs with HIV infection
d. Children may remain asymptomatic upto the age of 8–10 years

Yesterday’s Mind Teaser: How much exercise do you really need?

A. 45 minutes twice a week.
B. 30 minutes three or four days a week.
C. 60 minutes at least three or four days a week.
D. 30 minutes at least four or five days a week.
E. It depends on your age and overall physical–fitness level.

Answer for Yesterday’s Mind Teaser: C. 60 minutes at least three or four days a week.

Correct Answers received from: Arvind Diwaker, Nirmala Agarwal, Dr K V Sarma, Dr Jainendra Upadhyay.

Answer for 27th May Mind Teaser: B. No, skin cancer rates and deaths from the disease are on the upswing.

Correct Answers received from: Dr Poonam Chablani, Dr Jainendra Upadhyay, Dr Smita Uday Shevade, Daivadheenam Jella, Dr Avtar Krishan, Dr KV Sarma, Prabha Sanghi, Dr Chandresh Jardosh, Dr Prakash Khalap, Tukaram Pagad, Prabha Sanghi, Dr BR Bhatnagar.

Send your answer to ijcp12@gmail.com

Zee News – Health Wealth Shows

Alcohol
Cancer Prevention
Depression
Paralysis
Pneumonia
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Vitiligo
Fluid Intake

 

Total CPR since 1st November 2012 – 88972 trained

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

emedipicstoday emedipics

Health Check Up Camp at Modern Era Public School, 16th May 2014

press release

DVT risk starts early, stays long after acute stroke

video of day video of day

 

IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :

 

Make Sure

Situation: A patient died after receiving penicillin injection.
Reaction: Oh my God! Why was anaphylaxis not suspected?
Lesson: Make sure that each time a patient is given penicillin injection, anti anaphylaxis measures are available.

eMedinewS Humor

Where’s the toast I asked for?

An elderly husband and wife visit their doctor when they begin forgetting little things. Their doctor tells them that many people find it useful to write themselves little notes.

When they get home, the wife says, "Dear, will you please go to the kitchen and get me a dish of ice cream? And maybe write that down so you won’t forget?"

"Nonsense," says the husband, "I can remember a dish of ice cream."

"Well," says the wife, "I’d also like some strawberries and whipped cream on it."

"My memory’s not all that bad," says the husband. "No problem – a dish of ice cream with strawberries and whipped cream. I don’t need to write it down."

He goes into the kitchen; his wife hears pots and pans banging around. The husband finally emerges from the kitchen and presents his wife with a plate of bacon and eggs.

She looks at the plate and asks, "Hey, where’s the toast I asked for?"

Quote of the Day

Heart tells the eyes "See less, because you see and I suffer lot".
Eyes replied, "Feel less because you feel and I cry a lot".

 

Twitter of the Day

Dr KK Aggarwal: Weight gain precedes the onset of diabetes Weight gain after age of 18 years in women and 20 years in men (cont) http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Can we spiritually evolve & come to know who we really are without meditating? http://tinyurl.com/nfbwx98

 

medicolegal update

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medicolegal update

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medicolegal update
  1. I salute you, Dr Aggarwal, Sir, for regularly sending me the wonderful E Medicine News. I am grateful to you Sir, for making illiterate people in medicine literate. I try to follow what you say in the news letters. Regards and Best Wishes: Joginder Singh IPS Retd. Former Director CBI
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