emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
 
  From the Desk of Editor–in–Chief
Dr KK 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; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; 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); Editor in Chief IJCP Group & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos…
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 9 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

31st October 2012, Wednesday

Most sudden cardiac deaths occur on Monday mornings of December and January

  1. Maximum sudden cardiac deaths peak in the morning.
  2. Primary arrhythmic event is more likely to occur in the morning because increased adrenergic activity at this time may increase electrical instability or induce myocardial ischemia without heart attack.
  3. Mortality reports of the Massachusetts Department of Public Health, of 2203 individuals who in 1983 died an out-of-hospital death from ischemic heart disease one hour or less after the onset of symptoms, showed peak frequency of sudden death between 9 and 11 AM (Circulation 1987;75:131).
  4. Framingham Heart Study: The hourly risk of sudden cardiac death was at least 70 percent greater between 7 and 9 AM than the average risk during the remaining 22 hours of the day (Am J Cardiol 1987;60:801).
  5. Data from the Berlin emergency care system found a peak frequency of ventricular fibrillation between 6 AM and noon; in contrast, asystolic episodes were more evenly distributed throughout the day (Circulation 1993;88:2284).
  6. The morning peak in sudden death is particularly related to the first three hours after awakening and onset of activity (Am J Cardiol 1992;70:65)
  7. Data from the Seattle Fire Department, based upon 6603 cases of out-of-hospital cardiac arrest, of which 3690 were witnessed, also exhibited a diurnal variation, with a low incidence at night and two peaks of approximately the same size (Circulation 1998;98:31). An evening peak at 4 to 7 PM was attributed primary to patients found in ventricular fibrillation, while arrests that showed other rhythms exhibited mainly a morning peak from 8 to 11 AM.
  8. Cardiac arrests also show a weekly and seasonal variation; the daily incidence peaks on Monday and the seasonal incidence is greatest in the winter (Eur Heart J 2000;21:315, Am Heart J 1999;137:512).
  9. One 12 year analysis of 222,265 cases of death from coronary heart disease found that there were approximately 33 percent more deaths in December and January than in June through September (Circulation 1999;100:1630).

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

A trial of osmotic laxatives should be considered in patients not responding to bulking agents.

 
Dr K K Aggarwal
    eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal on

Give thiazides only to obese hypertensives

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

19th MTNL Perfect Health Mela to focus on revival after sudden death

The forthcoming 19th MTNL Perfect Health Mela being organized by Heart Care Foundation of India jointly with Health Department, Government of NCT Delhi.

 
Dr K K Aggarwal
    National News

Now, Gurgaon has a hospital mall

Gurgaon: The Fortis Memorial Research Institute (FMRI) - named the 'next-generation concept hospital'- was officially inaugurated in Gurgaon on Monday. The facility is a unique combination of a multi-specialty hospital and a multi-brand shopping-mall, with eighteen retail and food outlets set up on the premises. "This is a comprehensive institute, aimed at delivering cutting-edge medicine, in line with the best that is available in the West," said Malvinder Singh, executive chairman, Fortis Healthcare Limited (FHL). At present, the FMRI has been equipped with 25 operating rooms and 450 beds. Fortis representatives say that this institute will provide 'advanced multi-clinical treatments for complex medical problems.' In the next phase of operations here will also see an expansion both in terms of space and facilities. The number of beds, for one, will be taken up to 1,000. Besides, the place will soon have a health club and spa and a movie lounge. "The facility has been designed with great sensitivity, keeping in mind the anxiety and stress that patients and their families undergo," said Shivinder Singh, executive vice chairman, FHL. The hospital staff comprises 400 doctors and 1,000 nurses. "It is the first hospital in its category to have a full-fledged stem-cell lab. We will also offer robotic surgery and organ transplant facilities," said an FMRI representative. (Source: TOI, Oct 30, 2012)

For comments and archives

My Profession My Concern

Quality control

Administration of anti-hypertensive: There was a universal consensus that only the Medical Officer should be allowed to administer anti- hypertensives to a woman with hypertension in pregnancy.

For comments and archives

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

 
    Valvular Heart Disease Update

Underlying atherosclerosis

The presence of underlying coronary or aortic atherosclerosis affects the treatment and outcome of elderly patients in whom surgery is considered for valvular disease. The 2006 ACC/AHA and the 2007 European Society of Cardiology guidelines on the management of valvular heart disease included recommendations for coronary angiography in patients undergoing valve surgery, which would include all elderly patients.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

For comments and archives

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

Radium-223 extends survival in CRPC

Men with metastatic castration-resistant prostate cancer (CRPC) lived significantly longer when treated with a bone-targeted, alpha-emitting agent, a randomized trial showed. (Source: Medpage Today)

For comments and archives

Prepare for patient surge after hurricane sandy, says expert

Physicians in the path of Hurricane Sandy, which is expected to make landfall tonight on the New Jersey shore, should open up their office schedules later this week for a surge of patients with chronic illnesses, according to an expert on healthcare emergency preparedness. "People lose their medicine, or it gets wet," said Linda Landesman, MD, author of Public Health Management of Disasters: The Practice Guide. "They lose power, and there goes the medicine in their refrigerator. They lose their glasses. Dampness exacerbates their asthma. You can't imagine all the possibilities. (Source: Medscape)

For comments and archives

Walking ability linked to dementia risk in the very old

People older than age 90 years who are unable to walk are about 30 times more likely to have dementia than those of about the same age who can walk the fastest, according to a new cross-sectional study. Researchers found that the relationship between declines in walking speed, grip strength, and balance and the odds of dementia were dose dependent: The slower the walking or the worse the grip strength, the higher the likelihood of having dementia. The results suggest that poor physical performance is a risk factor for dementia, the authors conclude. (Source: Medscape)

For comments and archives

FDA OKs leukemia drug for adults

The FDA has approved omacetaxine mepesuccinate (Synribo) for the treatment of chronic myelogenous leukemia in adults. The drug blocks proteins that foster development of cancerous blood and bone marrow cells. It is indicated for use in patients whose disease progressed after treatment with at least two tyrosine kinase inhibitors. (Source: Medpage Today)

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: The health effects of the climate change The sudden change in climate in Delhi with stormy rains will cause more... http://fb.me/1DPny0RwT

@DeepakChopra: Take a few minutes to travel with The Meditator to a country windmill for a peaceful meditation. http://tinyurl.com/8orut3o

 
    Spiritual Update

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

Why do we burn camphor in any pooja?

No Aarti is performed without camphor. Camphor when lit burns itself out completely without leaving a trace of itself.

For comments and archives

 
    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What is endometrial ablation?

Endometrial ablation is a medical procedure that removes the lining of the uterus, called the endometrium. If your periods are very heavy or last too long, your health care provider may prescribe medications that will cause you to have a lighter period. If the medication does not work, your health care provider may recommend endometrial ablation.

 
    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Can blood of animals be transfused to human beings?

Scientists have tried a lot but so far they have not been successful. Only blood of a human being can be transfused to a human patient

For comments and archives

 
    An Inspirational Story (Ms Ritu Sinha)

The power of determination (A true story)

A true story about athlete Glenn Cunningham who was horribly burned in a schoolhouse fire at the age of 8 … Doctors predicted he would never walk again. Determined to walk, Glenn would throw himself off his wheelchair and pull his body across the yard and along a fence. Twenty-two months later, he took his first steps and through sheer determination, learned to run despite the pain…

The little country schoolhouse was heated by an old-fashioned, pot-bellied coal stove. A little boy had the job of coming to school early each day to start the fire and warm the room before his teacher and his classmates arrived.

One morning they arrived to find the schoolhouse engulfed in flames. They dragged the unconscious little boy out of the flaming building, more dead than alive. He had major burns over the lower half of his body and was taken to a nearby county hospital.

From his bed the dreadfully burned, semi-conscious little boy faintly heard the doctor talking to his mother. The doctor told his mother that her son would surely die – which was for the best, really – for the terrible fire had devastated the lower half of his body.

But the brave boy didn’t want to die. He made up his mind that he would survive. Somehow, to the amazement of the physician, he did survive. When the mortal danger was past, he again heard the doctor and his mother speaking quietly. The mother was told that since the fire had destroyed so much flesh in the lower part of his body, it would almost be better if he had died, since he was doomed to be a lifetime cripple with no use at all of his lower limbs.

Once more the brave boy made up his mind. He would not be a cripple. He would walk. But unfortunately from the waist down, he had no motor ability. His thin legs just dangled there, all but lifeless.

Ultimately he was released from the hospital. Every day his mother would massage his little legs, but there was no feeling, no control, nothing. Yet his determination that he would walk was as strong as ever.

When he wasn’t in bed, he was confined to a wheelchair. One sunny day his mother wheeled him out into the yard to get some fresh air. This day, instead of sitting there, he threw himself from the chair. He pulled himself across the grass, dragging his legs behind him.

He worked his way to the white picket fence bordering their lot. With great effort, he raised himself up on the fence. Then, stake by stake, he began dragging himself along the fence, resolved that he would walk. He started to do this every day until he wore a smooth path all around the yard beside the fence. There was nothing he wanted more than to develop life in those legs.

Ultimately through his daily massages, his iron persistence and his resolute determination, he did develop the ability to stand up, then to walk haltingly, then to walk by himself – and then – to run. He began to walk to school, then to run to school, to run for the sheer joy of running. Later in college he made the track team.

Still later in Madison Square Garden this young man who was not expected to survive, who would surely never walk, who could never hope to run – this determined young man, Dr. Glenn Cunningham, ran the world’s fastest mile*!

*On June 16, 1934, Glenn Cunningham ran the mile in 4:06.8 minutes, breaking the world’s record. His effort portrays that whatever you want to create in your life is yours for the making. As long as you desire it enough and allow your will to guide you, you can have and be whatever your heart desires. The only one that can put limits on our personal will is ourselves. Develop and encourage your will to create and all the forces of nature within and without will help you bring your desire to pass.

Source: http://academictips.org/blogs/the-power-of-determination-true-story/

For comments and archives

 
    Cardiology eMedinewS

TCT news: Stents for erectile dysfunction Read More

Sapien valve Ok’d for high-risk surgery patients Read More

 
    Pediatric eMedinewS

GAAP: Devices best to see 'lazy eye' in young kids Read More

Make the ED ouchless, says AAP Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient came with mild cognitive impairment.
Dr. Bad: No treatment is needed.
Dr. Good: You need to change your lifestyle, stop smoking and reduce alcohol consumption.
Lesson: Modifiable risk factors for mild cognitive impairment should be sought (at the very latest) in persons who already have mild cognitive impairment, as their optimal treatment may improve these patients' cognitive performance or keep the existing deficits from progressing. Epidemiological data suggest that a Mediterranean diet, physical activity, and moderate alcohol consumption protect against MCI, while cigarette smoking promotes it and should be stopped (Dtsch Arztebl Int 2011 Nov;108(44):743-50).

For comments and archives

Make Sure

Situation: A patient on ACE inhibitor developed angioneurotic edema.
Reaction: Oh my God! Why was ACE inhibitor continued?
Lesson: Make sure that patients on ACE inhibitors are advised to watch for symptoms of urticaria and stop the drug immediately in case swelling of lip, face or tongue develops (Br J Clin Pharmacol 1999;48(6):861–5).

For comments and archives

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Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

Photos of Doctor’s Day Celebration

 
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  Legal Question of the Day (Dr MC Gupta)

Q. Can the appropriate authority seal the ultrasound machine without suspension of PC&PNDT registration?

Ans. Yes.

The scheme of law is as follows:

  1. Inspection along with seizure/sealing can be done under Rule 12.
  2. This is followed by suspension of registration under section 20.
 
  Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Iron deficiency anemia

In iron deficiency anemia, the serum iron concentration is reduced, and the level of transferrin, also measured as total iron binding capacity (TIBC) is elevated; the latter finding reflects the reciprocal relationship between serum iron and transferrin gene expression in most nonerythroid cells.

 
  Quote of the Day (Dr GM Singh)

Wherever you see a successful business, someone once made a courageous decision. Peter Drucker

 
    Mind Teaser

Read this…………………

Here is a series of numbers. What is the next number in the sequence?

1
11
21
1211
111221
312211
13112221

Yesterday’s Mind Teaser: An early finding in the EKG of a client with an infarcted myocardium would be:

A. Disappearance of Q waves
B. Elevated ST segments
C. Absence of P wave
D. Flattened T waves

Answer for yesterday’s Mind Teaser: B. Elevated ST segments

Correct answers received from: Dr PC Das, Dr Thakor Hitendrsinh G, Dr KV Sarma, Dr Kanta Jain,
Dr BB Aggarwal, Dr AK Kela, Dr Parimal Shah, Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay,
Dr Chandresh Jardosh Dr K Raju, Dr Avtar Krishan Dr Mukesh K Bhandari, Dr Pankaj Agarwal.

Answer for 22nd October Mind Teaser: Four daughters and three sons. Each daughter has 3 sisters and 3 brothers, and each brother has 2 brothers and 4 sisters.
To figure it out mathematically, you could use the following two equations where G = the number of girls and B = the number of boys:
G - 1 = B
2(B - 1) = G Solving for G gives you 4 and plugging that in to G - 1 = B gives you a B of 3.

Correct answers received from: Dr BR Bhatnagar.

Send your answer to ijcp12@gmail.com

 
    Laugh a While (Dr GM Singh)

How you made your money

A young man asked an old rich man how he made his money.

The old guy fingered his worsted wool vest and said, "Well, son, it was 1932. The depth of the Great Depression. I was down to my last nickel. I invested that nickel in an apple. I spent the entire day polishing the apple and, at the end of the day, I sold the apple for ten cents.”

"The next morning, I invested those ten cents in two apples. I spent the entire day polishing them and sold them at 5:00 pm for 20 cents. I continued this system for a month, by the end of which I'd accumulated a fortune of $1.37."

"And that's how you built an empire?" the boy asked.

"Heavens, no!" the man replied. "Then my wife's father died and left us two million dollars."

 
    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

Autopsy in death due to adverse events following immunization (AEFI)

The doctor conducting the autopsy is duty bound to take samples for toxicological screening and send them to Forensic Laboratory for toxicological/chemical examination

  • The injection site and the tissues underneath up to 2–3 cms (button size) with dermis and epidermis of the sight of injection prick should be excised out. It should be preserved in a glass jar which should be filled two–thirds with saturated saline water. The specimens should be sealed, signed, labeled by the doctor/autopsy surgeon and should be handed over to police/investigating officer for further toxicological/chemical examination.
  • Viscera for toxicological/chemical examination: The following viscera specimen/biological samples should be collected for toxicological/chemical examination (80-100 gms of liver, 80-100 gms of brain with meninges, whole of the stomach with gastric contents (If no gastric contents, a section of stomach should be sent), upper part of small intestine about 30cm long with its contents, fragments from both adrenal glands, half of transverse section of kidneys, half of spleen, blood (100 ml ideal/minimum 10 ml) and urine (100 ml/minimum 10 ml).
  • All the visceral specimens should be collected in separate container a wide-mouthed bottle as prescribed and saturated saline should be added as preservatives. The quantitative of the saline should be sufficient to cover all the pieces of specimen viscera in bottle.
  • The specimens should be sealed, signed, labeled by the doctor/autopsy surgeon and should be handed over to police/investigating officer for further chemical examination in a forensic lab.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

National workshop on Yoga in cardiology

A one-day national workshop on naturopathy and yoga in cardiology will be organised on Saturday, 10th November, 2012 at Constitution Club of India as part of the forthcoming 19th MTNL Perfect Health Mela 2012 being organised by Heart Care Foundation of India jointly with Department of Health, Government of Delhi. More than 500 naturopaths and yoga experts will deliberate on various issues.

Giving the details Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that there are enough trials to suggest that with correct lifestyle involving yoga and meditation, it is possible to regress heart blockages. If a person can walk 2 kms, climb 2 flights of stairs or do exercise in bed with his or her partner without any discomfort, he or she does not require any invasive cardiac investigations. Recent recommendations and guidelines also have shown that in an asymptomatic healthy people with no family history stress tests need to be done.

Principles of yoga care involve living a satvik lifestyle and doing regular exercise and pranayama. Talking about Pranayama, Dr. Aggarwal said that it is nothing but slower and deeper breathing. If one can spend 20 minutes every day and breath with a speed of four per minute, one can acquire heart healing over a period of time.

 
    Readers Responses
  1. Dear Dr Aggarwal, apropos the item in EmedinewS on Soya milk, I doubt if it can be a substitute for milk from the nutritional angle. Its protein, being a plant protein, will be of poor quality (because of methionine deficiency) unless supplemented with cereal protein. Vegetarians depend on milk for vitamin B12, and to some extent vitamin D; soya will not provide these. Soy milk is thus an alternative drink, and can also give us an alternative to cheese, but it cannot replace milk. Hence, the real answer to adulteration of milk is to work for prevention of adulteration rather than use soya milk as a substitute for milk. Of course, adults can live without milk, as the vegans do, but that is besides the immediate question on hand. With best regards, Sincerely: Ramesh Bijlani.
 
    Forthcoming Events


19th MTNL Perfect Health Mela 2012 Programme

Dr K K Aggarwal
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    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

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  Personal Cleanliness

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  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

 
    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta