eMedinewS31st October 2013, Thursday

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

ACP Guidelines: Do Not Screen Asymptomatic Adults for CKD

Adults without symptoms or risk factors should not be screened for chronic kidney disease, according to new guidelines from the American College of Physicians published online October 21 in the Annals of Internal Medicine.

The potential harms of all the screening tests — false positives, disease labeling and unnecessary treatment and associated adverse effects outweigh the benefits.

Ordering lab tests is not going to have any impact on clinical outcomes of asymptomatic patients with CKD without risk factors but will add unnecessary costs to the health care system due to increased medical visits and unnecessary tests.

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

If you hate somebody, this means that you have a lot of time to waste

sprritual blog

If you hate somebody, it only means that you have lot of meaningless time to spare. If you are busy and live in the present, you cannot think of the past or the future.

There is a well known saying in Vedanta that you cannot hate strangers, you can only hate somebody whom you have loved and withdrawal of love is what hatred is.

Love and hate, therefore, are the two sides of the same coin. You cannot have both. You need to make an effort to hate somebody but love is always spontaneous. It is not true that if you love somebody, it means that you have a lot of time to spare. Love comes from the heart and not from the mind or the intellect.

cardiology news

The Importance of Having Friends

Once upon a time, a lonely hawk lived on a tree by the riverside. He was young and handsome but he had no friends. One day, he saw a beautiful she–hawk sitting on a tree and wanted to marry her but the she–hawk refused to marry him, as he had no friends.

"Will you marry me if I make three friends?" he asked. She said that she definitely would. The hawk then went looking for friends. While flying on the other bank of the river, he saw a huge tortoise. The hawk flew down to him and said, "Dear tortoise, will you be my friend and help me in my hour of need?" The tortoise agreed to become his friend and said, "Call me whenever you need me and I shall come to your side."

The hawk also promised him his help at any time and then flew in search of the second friend. Soon, he came upon an osprey. The hawk went to it and asked her if she would be his friend and help him in time of his need. The osprey very gladly accepted his friendship and offered her help whenever he needed it.

The hawk was glad that he had made two friends. He went on searching for a third friend. He flew over the jungle and saw a tiger. Fearless as he was, he went near the tiger and requested him to be his friend. The tiger readily accepted his friendship and said, "From now onwards, I am your friend. Nobody will harm you. If anyone tries to harm you, call me and I will be there to help you."

The hawk was very happy. He thanked the tiger, flew back to the she–hawk and said, "I have made three friends, a tortoise, an osprey and a tiger. Will you marry me now?" The she–hawk agreed to marry him. Soon, their marriage took place. The three friends attended the hawk’s marriage. After some–months, she–hawk gave birth to two baby hawks. The parent hawks were very happy to have cute little babies. They lived happily in their nest.

One day, two hunters came and sat under that tree. They were tired and hungry. They had not been able to hunt any animal. They decided to catch some fish. But, they couldn’t catch even a single fish. It was getting dark and the hunters decided to spend the night under that tree. To keep themselves warm, they lit a fire. The fire soared high. The hawk–babies on the tree could not bear the heat and the smoke coming out of the fire. They started crying. The Hunters heard their cries. One of them said, "There are birds on this tree. Let us catch them. We shall roast them on the fire and eat them." The other one agreed.

The hawks heard them and were really worried about the safety of their babies. The she–hawk suggested that they seek help from their friends. The hawk went to the osprey and told her his problem. The osprey said, "Go home and protect your babies. I shall tackle with the hunters." The osprey dived into the river and then flew over the fire. The water from her wet feathers fell on the fire. She repeatedly dived into the river and flew over the fire. The water from her feathers put off the fire.

The hunters decided to light the fire again; however, as soon as they lit the fire, again the osprey put it off. In the meantime, the hawk went to get help from the tortoise. When the tortoise heard about the hawk’s problem, he said to him, "Do not worry dear friend, I will be there in no time and tackle the hunters in my own way. Go and protect your family."

The hawk flew to the tree and the tortoise reached the tree. He went quite close to where the hunters were sitting and trying to light the fire again. The hunters saw the tortoise and one of them said, "Look there is a huge tortoise. Let’s forget about the hawks and catch this tortoise."

The other hunter agreed and said, "Let’s tear our shirts and make a rope. We shall tie its one end to the tortoise and other to our waists. Then we will pull the tortoise with all our strength." The other hunter liked the idea. Soon, they make a rope out of their shirts. They tied one end of the rope to the tortoise’s legs.

Then, trying the other end to their waist, they could not pull the tortoise. The tortoise’s strength was much greater than the two hunters were together.

The tortoise pulled the two men into the water. Once, inside the water, it was very easy for the tortoise to drag them. With great efforts, they cut the rope that was tied to their waist and swam back to the bank. They were now feeling very cold. They had lost their shirts. They thought of making a fire again. Seeing them collecting leaves and twigs, the hawk was worried again. He flew to the forest and called his third friend, the tiger. He found the tiger at the edge of the forest. When the tiger heard the hawk’s problem, he immediately rushed towards the riverbank.

The hunter had now lighted the fire and one of them was preparing to climb the tree to get the hawk babies. Just then, the tiger reached the tree. Seeing the tiger, the hunters ran from there and never came back again.

The hawk thanked all his three friends for their kind and timely help. He also realized that it is very important to have at least a few friends. The female–hawk was very wise in advising the hawk to make friends before marrying him.

News Around The Globe


  • Patients taking the investigational drug apremilast achieved a reduction in signs and symptoms of psoriatic arthritis compared with patients on placebo. In a study, 38% of patients on apremilast (20 mg twice daily) and 34% of patients on a higher dose (30 mg twice daily) achieved an American College of Rheumatology (ACR) 20 compared with 20% of patients on placebo after 16 weeks of treatment. Also, about 53% of patients on apremilast achieved the ACR20 primary endpoint goal at week 52. The study results were presented at the ACR annual meeting.
  • Regardless of whether retirees participated in vigorous exercise, active leisure time was associated with better metabolic function and cardiovascular health in both men and women. During a 12.5–year follow–up period, seniors that participated in active leisure time had a 27% lower risk for cardiovascular events (HR 0.73, 95% CI 0.57–0.94), and a 30% lower risk for all–cause mortality (HR 0.70, 95% CI 0.53–0.98), compared with seniors that reported sedentary leisure time.
  • The risk of developing diabetes in adulthood is associated with weight in adolescence and weight gain during the teens and early 20s. In a longitudinal cohort of teens and young adults, the timing of the weight gain also appeared to play a role in diabetes risk. On the other hand, hypertension in adulthood was associated just with adult body mass index (BMI), while inflammation was linked only to increasing BMI.
  • Fewer than 1 in 3 rheumatologists report discussing hypertension with patients who have uncontrolled blood pressure, despite the fact that those with rheumatoid arthritis are at increased risk for cardiovascular disease compared with the general population and that hypertension is a modifiable risk factor. The study, presented here at the American College of Rheumatology (ACR) 2013 Annual Meeting, is based on electronic health records of patients with primary and rheumatologic care, uncontrolled hypertension, and encounters at 1 of 3 academic rheumatology clinics.
  • Women with at least two of the three cardinal features of polycystic ovary syndrome (PCOS) should be considered to have the disorder, according to clinical practice guidelines released by the Endocrine Society. The new guidelines endorse the Rotterdam criteria for diagnosing PCOS, which identifies excess androgen production, ovulatory dysfunction, and polycystic ovaries as the key diagnostic features of the disorder in adult women. The guidelines released are scheduled for publication in the December issue of the Journal of Clinical Endocrinology & Metabolism.
  • A Delhi based study funded by the Indian Council of Medical Research (ICMR), and carried out by Delhi government’s Guru Teg Bahadur (GTB) Hospital and its associated University College of Medical Sciences (UCMS), has found "significant" clinical evidence to link high stress levels to diabetes, in patients newly diagnosed with Type 2 diabetes, according to doctors, as reported in the Indian Express, Wed Oct 30 2013.The study which is currently under publication, found that individuals who had low glucose tolerance levels diagnosed through glucose tolerance tests (GTT) indicating diabetes, had correspondingly high stress levels and low coping levels for stress, on the basis of questionnaires developed to validate stress. Other scientific indicators were used to identify levels of stress in diabetics.

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Rabies News (Dr. A K Gupta)

Can rabies be transmitted through sexual intercourse?

Rabies virus is present in the semen and to some extent in vaginal secretions. Priapism, increased sexual libido and indulgence are seen both in male and female rabies cases. Hence, in the exposed person, a full course of rabies post–exposure vaccination either by Intramuscular (IM) or Intradermal (ID) route should be given. If there is any doubt of category III exposures, i.e. abrasion on penis or in vagina, then RIG must also be given by IM route.

cardiology news

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

  • According to the findings of the SYNTAX (Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery) trial reported at the Transcatheter Cardiovascular Therapeutics meeting, surgery still trumps stenting for treatment of patients with three–vessel coronary artery disease (CAD), but for patients with left-main disease stents offer "similar health outcomes as CABG at a lower long–term cost."
  • Patients in the Post–Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE) trial who were adherent to treatment with a statin, beta–blocker, or ACE inhibitor/angiotensin-receptor blocker (ARB) were significantly less likely to experience a major vascular event or undergo coronary revascularization. In contrast, individuals who did not take their medication and even those who were only partially adherent to treatment had no significant reduction in clinical outcomes. The results of the study were published online October 17, 2013 in the American Heart Journal.
cardiology news

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

  • Narrow–spectrum antibiotics have similar efficacy and cost–effectiveness as broad-spectrum antibiotics in the treatment of pediatric community-acquired pneumonia (CAP), according to the findings of a retrospective study published online October 28 in Pediatrics. The researchers used the Pediatric Health Information System database to assess the hospital length of stay (LOS) and associated healthcare costs of children aged 6 months to 18 years who were diagnosed with pneumonia between July 2005 and June 2011 and treated with either narrow–spectrum or broad–spectrum antibiotics. Narrow–spectrum therapy consisted of the exclusive use of penicillin or ampicillin, whereas broad–spectrum treatment was defined as the exclusive use of parenteral ceftriaxone or cefotaxime.
  • Children who experience brain injury or concussion may be up to 5 times more likely to be diagnosed with depression compared with children without these injuries, according to a study presented at the American Academy of Pediatrics (AAP) 2013 National Conference and Exhibition. The prevalence of brain injury was 1.9% in the National Survey of Children’s Health, which includes parental interviews for children from birth to age 17 years. The incidence of depression was 3.7% in the cohort, but was much higher for patients with brain injury or concussion.
cardiology news

Do not ignore joint pain

Joint pains need immediate diagnosis and proper treatment.

Checklist for joint pain

  • Which joint hurts, and which parts of the body are affected?
  • Has the pain just begun, and whether you've felt it before?
  • Did the pain start suddenly or slowly, and is it persistent or fluctuates?
  • Any recent injuries, fevers or illnesses?
  • What makes the pain feel better, and what makes it feel worse?
  • Any other symptoms, including numbness or stiffness?
  • Times of day when the pain is better, and times when it feels worse?

Any joint pain which improves with exercise, is more in the morning and is associated with joint deformity, should be reported to doctor immediately.

cardiology news

Total CPR since 1st November 2012 – 71933 trained

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Spiritual meaning of Diwali

Padma Shri and Dr B C Roy National Awardee, Dr K K Aggarwal said that Diwali is a month–long festival of detoxification of Mind, Body and Soul, which starts from Amavasya on first Navratri to Amavasya on Diwali. It involves nine days of purification during Navratri and followed by a purification fast every fourth day starting from Sharad Purnima, Karwa Chauth, Ahoi Ashtami, Dhanteras and finally gaining inner happiness on the day of Diwali. Diwali is also described as inner Purnima with outer Amavasya.

Dr Aggarwal was delivering a talk for the Jindal Group on the spiritual meaning of Diwali organized at Jindal India Thermal Power, Vasant Kunj, New Delhi. The talk was organized as a part of post 20th MTNL Perfect Health Mela activities.

Dr Aggarwal said that during Diwali days one should avoid eating trans fats and lot of sugary sweets, which can cause a total imbalance of blood pressure, blood sugar and blood cholesterol.

He also said that because of recycling most of the sweets distributed during Diwali may not be health–friendly as it is a common practice to keep the box of sweets in the car for days together before they get distributed and even if they get distributed they get recycled in a similar pattern.

today emedipics

Dr KK Aggarwal delivering a talk for the Jindal Group on the spiritual meaning of Diwali organized at Jindal India Thermal Power, Vasant Kunj

press release

Strenuous exercise may increase risk of cardiac disorder

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

How often should you have a Pap smear?

A. Once a year after puberty.
B. Once a year after either turning 21 or having sexual intercourse for the first time.
C. Once a year after age 21 and every two years after 30.
D. Once a year if you’re not in a monogamous relationship.
E. Once a year unless you’ve been vaccinated against the human papillomavirus (HPV). Then the screening is not necessary.

Yesterday’s Mind Teaser: 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.

Answer for yesterday’s Mind Teaser: B. At age 20.

Correct answers received from: Dr. P. C. Das, Dr.Akhila Mithun, Dr.K.Raju, Narahari Kandakatla, Dr.(Maj. Gen.) Anil Bairaria,, Dr Jainendra Upadhyay, Sangeetha Raja, Dr pawan Mehta, DR AVTAR KRISHAN, Dr Kanta Jain

Answer for 29th October Mind Teaser: a. Ineffective health maintenance

Correct answers received from: Dr B K Agarwal

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

As an English professor, my father would often write little notes on student essays. Often he worked late, and as the hours passed, his handwriting deteriorated. One day a student came to him after class with an essay that had been returned.

"Mr. McDonald," he said, "I can’t make out this comment you wrote on my paper."

My father took the paper and, after studying it, sheepishly replied, "It says that you should write more legibly."

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with dengue fever developed shock.
Reaction: Oh my God! Why was the blood pressure 90/70 ignored?
Lesson: Make sure that a pulse pressure of less than 20 is not ignored. It is an impending sign that the patient is going into shock.

medicolegal update

Good friends care for each other… close friends understand each other... and true friends stay forever beyond words, beyond time

medicolegal update

Dr KK Aggarwal: Smoking and ulcerative colitis http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Your only identity is I AM undefined and infinite. Any label you give yourself limits yourself.

medicolegal update
  1. I think correction is required in Fever related Tip No.21.It should be, 'For every rise of one degree Fahrenheit, pulse rises by 10. Arvind Gajjar.

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