eMedinewS31st December 2013, Tuesday

Dr K K AggarwalPadma 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
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ACC and AHA Release New PCI Checklist

The American College of Cardiology and American Heart Association along with several other organizations have released new performance and quality measures for percutaneous coronary intervention. The report is published in December 23 issue of Journal of the American College of Cardiology and Circulation.

Written in collaboration with the Society for Cardiovascular Angiography and Interventions, Physician Consortium for Performance Improvement, and National Committee for Quality Assurance, the group highlights 11 performance and quality metrics that should be recorded for patients undergoing PCI, as follows.

  1. Documentation of the reasons for PCI.
  2. Appropriate reason for elective PCI (safety vs benefit trade–offs).
  3. Prior to PCI, evaluation of the patient’s ability to take dual antiplatelet therapy.
  4. Use of embolic protection devices in the treatment of saphenous vein graft disease.
  5. Renal function assessment prior to PCI and documentation of the amount of contrast used.
  6. Documentation of the amount radiation used during the procedure.
  7. Prescription of optimal medical therapy post–PCI.
  8. Referral to an outpatient cardiac rehabilitation clinic.
  9. Participation in a regional or national PCI registry.
  10. Average annual volume of PCIs performed by physician in the last two years.
  11. Average annual number of PCIs performed at the hospital in the last calendar year.

These measures, according to the writing committee, can help serve as vehicles to accelerate appropriate translation of scientific evidence into clinical practice.

Complex, determining procedural appropriateness with PCI requires documenting the presence and severity of angina symptoms, use of anti–anginal medications, and presence and severity of stenosis, according to the new report.

The present PCI performance measure set represents the first time in the cardiology literature that a specific performance measure has been constructed to address procedural appropriateness.

Dr K K Aggarwal on Zee TV

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."

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

Alcohol takes away your power of judgment

sprritual blog

Under the influence of alcohol, you may lose your power of judgment. I recall one of my friends who shot himself under the influence of alcohol after his wife refused to cook food for him and his friends at 11 pm. He said, "mujhe khana do nahin to mein khood ko shoot kar lunga", to which she replied, "shoot kar lo" and he shot himself.

Under the influence of alcohol, your crime becomes less severe. In the present gang rape case, all the accused persons were under the influence of alcohol but they were not caught at the same time. If they were caught with alcohol in their blood, their crime would have become less severe than what it would have been if alcohol was not found.

If alcohol is the major culprit than the person who invites people to drink alcohol should be punished as he was very well aware that he was inviting others to drink alcohol and after drinking alcohol, when they lose their judgment power and they may misbehave with others and indulge in violence.

If you invite people at home for alcohol party, it is your duty:

• Not to serve more than 80 ml of alcohol
• Not to serve alcohol to people who have come without drivers and are going to drive back, or
• Take their keys in your possession and get them dropped after the party
• Never serve alcohol to drivers and other people who are going to drive.

A drunken man is like a snake or an injured lion. Never hurt the ego of a person who is under the influence of alcohol. He may hurt you. In Ayurveda, there are three types of people Vata, Pitta and Kapha. People with Vata personality can get drunk with limited amount of alcohol and people with Kapha personality can be sober even after a large drink of alcohol.

Under the influence of alcohol a person usually does not speak a lie and hence starts speaking truth which can provoke others if it does not go well with them.

However, if a drunken man commits a crime or is confronted with a powerful muscular man or a policeman, he often comes back to his senses.

cardiology news

List of things we dislike

A man and his girlfriend were married. It was a large celebration. All of their friends and family came to see the lovely ceremony and to partake of the festivities and celebrations. A wonderful time was had by all.

The bride was gorgeous in her white wedding gown and the groom was very dashing in his black tuxedo. Everyone could tell that the love they had for each other was true. A few months later, the wife comes to the husband with a proposal: "I read in a magazine, a while ago, about how we can strengthen our marriage." she offered. "Each of us will write a list of the things that we find a bit annoying with the other person. Then, we can talk about how we can fix them together and make our lives happier together."

The husband agreed, so each of them went to a separate room in the house and thought of the things that annoyed them about the other. They thought about this question for the rest of the day and wrote down what they came up with.

The next morning, at the breakfast table, they decided that they would go over their lists. "I’ll start," offered the wife. She took out her list. It had many items on it enough to fill 3 pages, in fact. As she started reading the list of the little annoyances, she noticed that tears were starting to appear in her husbands eyes. "What’s wrong?" she asked.

"Nothing" the husband replied, "keep reading your lists." The wife continued to read until she had read all three pages to her husband. She neatly placed her list on the table and folded her hands over top of it.

"Now, you read your list and then we’ll talk about the things on both of our lists." She said happily.

Quietly the husband stated, "I don’t have anything on my list. I think that you are perfect the way that you are. I don’t want you to change anything for me. You are lovely and wonderful and I wouldn’t want to try and change anything about you."

The wife, touched by his honesty and the depth of his love for her and his acceptance of her, turned her head and wept.

In life, there are enough times when we are disappointed, depressed and annoyed. We don’t really have to go looking for them.

We have a wonderful world that is full of beauty, light and promise. Why waste time in this world looking for the bad, disappointing or annoying when we can look around us, and see the wondrous things before us?

I believe that we are happiest when we see and praise the good and try our best to forget the bad. Nobody’s perfect but we can find perfectness in them to change the way we see them

Always remember that you can never find a perfect partner to love you the way you wanted, only a person who’s willing to love you more that what you are.

Someone who’ll accept you for what can and can’t be… and that’s even better than perfect.

News Around The Globe

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

News

  • A history of acute mountain sickness may not predict future bouts of the condition, according to a study by Canadian researchers published in British Journal of Sports Medicine. Likewise, those who have never experienced such altitude sickness may not necessarily be protected against it in the future. The Wilderness Medical Society’s current consensus guidelines to prevent acute mountain sickness (AMS) are partly based on an individual’s prior history of the illness. But the new study’s results suggest that strategy may not be useful.
  • The recent shift toward starting antibiotics within 3 hours of admission to the emergency department and combination therapy for community–acquired pneumonia in the ICU has saved lives. In a new study reported online in the journal Chest, deaths related to pneumococcal severe community–acquired pneumonia (CAP) fell from 32.5% in 2000–2002 to 17.5% in the period 2008 to 2013.
  • Patients undergoing rapid weight loss and who either received ursodeoxycholic acid (Ursodiol) or ate a high–fat diet had a reduced risk of gallstones, as reported in the journal Clinical Gastroenterology and Hepatology.
  • Changing chemotherapy based on an early lack of circulating tumor cell response didn’t improve outcomes in metastatic breast cancer. The strategy was associated with no hint of a survival advantage compared with maintaining the original first–line chemotherapy regimen despite a failure of the tumor cell count to fall below 5 per 7.5 mL of peripheral blood in the Southwest Oncology Group S0500 trial.
  • Immediate surgery for severe chronic periodontitis costs more than scaling and root planing but reduces antibiotic usage. Surgery costs €700 ($957) more per patient than scaling and root planing, researchers from Belgium and Sweden report in an article published online November 21 in the Journal of Clinical Periodontology.

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Rabies News (Dr. A K Gupta)

A pet dog died of sudden unexplained death. What should be done?

If facilities are available, a postmortem of the dog for confirmation of rabies is required. If not possible, (or if the postmortem proves rabies) all those who came in contact with the saliva of the animal (directly or through its fomites) should be given PEP.

cardiology news

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

Successful left–ventricular–assist device (LVAD) therapy depends on successful management of anticoagulation, which means avoiding extremes that could lead to bleeding complications in one direction or thrombotic events in the other. A retrospective look at about five years of data from 956 patients discharged after LVAD implantation in HeartMate 2 (Thoratec) bridge–to–transplantation (BTT) and destination–therapy (DT) studies, published online December 11, 2013 in the Journal of the American College of Cardiology, helps clarify risks and predictors of some of the most serious potential out–of–hospital bleeding and thrombotic events. The current analysis, from Dr Andrew J Boyle (Cleveland Clinic Florida, Weston) and colleagues, documents clinically important bleeding, especially gastrointestinal bleeding, as a greater risk in LVAD destination therapy (DT) than in bridge–to–transplantation (BTT).

cardiology news

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

  • Pediatric patients who received maintenance doses of hypotonic fluids intravenously were at increased risk for iatrogenic hyponatremia compared with those who received isotonic fluids. A systematic review of 10 randomized controlled trials presented at the meeting of the American Academy of Pediatrics showed there was an overall greater than two–fold risk of low plasma sodium among pediatric patients who received hypotonic fluids intravenously while hospitalized. Hypotonic fluid receipt was associated with a 6.1–fold risk of moderate hyponatremia versus receipt of isotonic fluids.
  • As per a study presented at the meeting of the American Academy of Pediatrics, half size insulin dose was as effective as a standard dose in resolving diabetic ketoacidosis in children, but offered a gentler fall in blood glucose. In the study, resolution of diabetic ketoacidosis occurred faster on average –– but not significantly so –– among children with type 1 diabetes treated with 0.05 U/kg/hour of insulin versus 0.10 U/kg/hour (16.5 hours versus 17.2 hours. Low dose insulin was also associated with a faster time for blood glucose to reach 250 mg/dL or less (6 hours versus 6.2), and was also associated with a significantly slower drop in blood sugar over the first hour of treatment (39.1 mg/dL versus 63.2 mg/dL).
cardiology news

Preventing death due to hypothermia

People can die of hypothermia in this season. Imagine a situation when you come across two people lying in a JJ cluster area with no clothes early in the morning. One of them is shivering and the other one is not. The one who is shivering indicates that his body is trying to compensate with the low body co–temperature.

The other one, who is not shivering, may be dead, dying or normal.

Recall your naturopathy teaching "Sar Thanda, Pet Naram and Paon Garam". If the sole of the feet and the feet are cold and the person is not shivering, this is a medical emergency. On the contrary, if the person is not shivering and the feet are warm, it is not medical emergency.

Therefore, hypothermia with no shivering and hyperthermia with no sweating are bad signs.

cardiology news

Total CPR since 1st November 2012 – 84073 trained

Media advocacy through Web Media

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press release

Suraj Bhan D.A.V. Public School students learned CPR–10

1036 students of Suraj Bhan DAV Public School, Vasant Vihar learnt hands–only CPR 10 today, which explained how to revive a person within 10 minutes of cardiac death. The training camp was conducted by Padma Shri and Dr B C National Awardee, Dr K K Aggarwal, President Heart Care Foundation of India and Senior Vice President Indian Medical Association.

Sudden cardiac deaths are more common in dry winter than in wet winter. Ayurveda also mentions that there are more chances of acute rise in blood pressure and irregular heart disease in dry winter.

Smt. Anita Ahuja, Principal of DAV School said that one should include training of CPR 10 in every school in such a way that 100% of students and teachers get trained.

Later in the day at the annual function of Public Relations Society of India held at Eros Hotel, Dr. Aggarwal said that in today’s era nobody should die of sudden unexpected cardiac death. But people like Farooq Sheikh, cine actor do die now and then. It is possible to anticipate sudden cardiac death and to revive a person after death, he further added.

If you can climb two flights of stairs, walk 2 km or have an exercise with your partner in the bed without any symptoms, there are negligible chances that you will die of sudden cardiac death in the next 10 years. If your blood sugar, blood pressure and blood cholesterol are kept under control; you are a non–smoker and your ECG is normal, this further rules out future sudden cardiac death.

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 84073 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."

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Suraj Bhan D.A.V. Public School students learned CPR–10

press release

Women is safe everywhere

vedio of day

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

Commonest cause of sporadic encephalitis is:

1. Japanese B virus.
2. Herpes simplex virus
3. Human immunodeficiency virus
4. Rubeola virus

Yesterday’s Mind Teaser: Injury to radial nerve in lower part of spiral groove:

1. Spares nerve supply to extensor carpi radialis longus.
2. Results in paralysis of anconeus muscle.
3. Leaves extension at elbow joint intact.
4. Weakens pronation movement.

Answer for yesterday’s Mind Teaser: 3. Leaves extension at elbow joint intact.

Correct answers received from: Dr Chandresh Jardosh, Muthumperumal Thirumalpillai,
Dr Ajay Gandhi, Dr Avtar Krishan.

Answer for 29th December Mind Teaser: 1. Transitional

Correct answers received from: Dr V P Thakral, Dr P C Das, Daivadheenam, Dr K V Sarma.

Send your answer to ijcp12@gmail.com

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medicolegal update

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medicolegal update

A Texas Millionaire

A Texas millionaire had fallen ill. The doctors consulted did not seem to understand what ailed him. The millionaire let it be known that any doctor who could heal him could have whatever he desired.

A country doctor was finally able to cure him, and as the doctor was leaving after a week’s stay, the Texan said, "Doc! I am a man of my word. You name it, and if it is humanly possible I’ll get it for you."

"Well," said the doctor, "I love to play golf, so if I could have a matching set of golf clubs, that would be fine." With that the physician left.

The doctor didn’t hear from the Texan millionaire for some months. Then, one day, he got a phone call from the millionaire.

"Doc, I bet you thought that I had gone back on my word. I have your matching set of golf clubs. The reason it took so long is that two of them didn’t have swimming pools, and I didn’t think they were good enough for ya. So I had pools installed and they’re all ready for you now!"

medicolegal update

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medicolegal update

Situation: A 62–year–old diabetic with coronary artery disease, on treatment for the same, comes for follow up.
Reaction: Oh my God! Why did not you put him on antioxidants?
Lesson: Make Sure to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects.

medicolegal update

Shame occurs when you haven’t been able to get away with the ‘who’ you want people to think you are. Carl Whitake

medicolegal update

Dr KK Aggarwal: ECG not reliable marker for predicting heart disease : http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Happiness can be woven into every aspect of life once you make new choices http://bit.ly/15QdVeB #Health

medicolegal update
  1. Hearty Congratulations Dr KK Aggarwal. Another Feather in your cap. I am Proud of you. God Bless. Dr. Bhatia

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