eMedinewS 31st July 2013, Wednesday

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; 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

Calcium carbide update

  1. The fast ripening of fruits means that they may contain various harmful properties. A commonly used agent in the ripening process is calcium carbide, a material most commonly used for welding purposes. Calcium carbide treatment of food is extremely hazardous because it contains traces of arsenic and phosphorous. Once dissolved in water, the carbide produces acetylene gas. Acetylene gas may affect the neurological system by inducing prolonged hypoxia. The findings are headache, dizziness, mood disturbances, sleepiness, mental confusion, memory loss, cerebral edema and seizures.

    A previously healthy 5 year-old girl with no chronic disease history came to ER with an 8-h history of coma and delirium. A careful history from her father revealed that the patient had eaten unripe dates treated with calcium carbide. (Per H, Kurtoglu S, Yagmur F, et al. Calcium carbide poisoning via food in childhood. J Emerg Med 2007 Feb;32(2):179-80).
  2. Bharani A, Walia R, Ramteke G, et al. Electrocardiographic abnormalities mimicking acute myocardial infarction in calcium carbide poisoning. Indian Heart J 2006 May-Jun;58(3):288.
  3. Bello F, Seeger A, Bruna CG, et al. Acute arsenic poisoning as contamination of commercial calcium carbide. Rev Med Chil 1987 Apr; 115(4):357-8.
  4. Acetylene is a commonly found industrial agent that, when mixed with oxygen, is used for welding. A case of a 40-year-old male who died of acetylene gas poisoning has been reported. (Williams NR, Whittington RM. Death due to inhalation of industrial acetylene. J Toxicol Clin Toxicol 2001;39(1):69-71).
  5. The primary target organs for arsenic toxicity are the gastrointestinal tract, heart, skin, bone marrow, kidneys, and peripheral nervous system.
  6. Acute toxicity typically starts in the gastrointestinal system and includes nausea, vomiting, abdominal pain, and diarrhea. These symptoms are soon followed by dehydration, hypotension and QTc prolongation. In severe cases, patients may experience cardiac arrhythmias, shock, acute respiratory distress syndrome, and sometimes death.
  7. In chronic poisoning, the peripheral neurologic complaints and skin manifestations are usually more prominent than the gastrointestinal symptoms. Chronic arsenic exposure is associated with increased all-cause mortality.
  8. Arsenic is rapidly cleared from the blood, so measurement of urinary arsenic either in a 24-hour urine collection or spot urine (along with a creatinine to correct for the concentration of the spot urine) is generally preferable. A concentration greater than or equal to 50 mcg/L or 100 mcg of arsenic per gram creatinine in the absence of recent fish, seaweed or shellfish intake strongly suggests arsenic poisoning. For more accurate assessment, both total and inorganic arsenic species should be measured in the urine.
  9. To reduce the risk of cancer and other chronic effects, the US Environmental Protection Agency (EPA) lowered the arsenic standard for drinking water from 50 parts per billion (ppb) to 10 ppb, and the US Food and Drug Administration (FDA) has set 10 ppb for bottled water.

    In the US, drinking water generally contains an average of 2 mcg/L of arsenic, although 12 percent of water supplies from surface water sources in the North Central region of the country and 12 percent of supplies from ground water sources in the Western region have levels exceeding 20 mcg/L
  10. People also eat small amounts of inorganic arsenic in their diet. US dietary intake of inorganic arsenic has been estimated to range from 1 to 20 mcg/day. There have also been concerns about elevated arsenic levels detected in some samples of apple and grape juice. Toddler milk formulas containing organic brown rice syrup as a sweetener also have been blamed to be high in arsenic.

.... Read More

Jayalalithaa to oppose NEET Review

As per newspaper reports, Tamil Nadu Chief Minister Jayalalithaa has written to Prime Minister and is opposing the Union Government filing a review in NEET case in the Supreme Court of India. She says that Government should not oppose Supreme Court India decision as it will take away the independence of State regarding medical education. The split judgment was recently given by the Supreme Court of India where one of the judges on record said that there was no discussion amongst the judges and he had to give his dissent in hurry. There are many States which are opposing NEET and it is likely that many more Chief Ministers will send letters to Prime Minister but in the interest of the medical education in the country, the Government should go ahead with filing a review petition and if they file, they should fight it from the heart and not as a formality.

.... Read More

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 10x10 i.e. 100 per minute.”

VIP's on CPR 10 Mantra Video
Ringtone - CPR 10 Mantra Hindi

Ringtone - CPR 10 Mantra English

sprritual blog What are three types of Vedanta thoughts?

There are three main schools of thoughts in Vedanta

Dualistic or Dvaita
Qualified Monism or vishistha Advaita
Advaita Vedanta or Absolute monism

All these perceptions are true. All expound the relationship between the individual Jiva (soul), this world or nature (Jagat) and the Ruler of the universe or God (Spirit or Brahman).

Dualism, mainly propounded by Madhvacharya (1199-1278) maintains that the individual soul and the Spirit (supreme soul) are different and there cannot be unity between the two. Spirit is the Ruler of this universe and is creator, sustainer, and the destroyer. Mostly, the path of dualism is path of Bhakti Yoga.

Qualified monism of Ramanujacharya (1040-1137) differs from dualistic thought on the ground that whatever we see or perceive is, in fact, God and nothing else. The universe includes the nature and us. Thus Soul, Jagat and Spirit are one. Just as an individual being has a body and a soul, so also God has universe as the body and He is the soul of all souls. We are on of the cell of the universe.

Advaita Vedanta: Advaita literally means not two . This is the highest concept as realized by Adi Shankaracharya (788-820). Advaita Vedanta maintains that the Highest Reality or Existence or Truth cannot be two, but must be one. It has to be all pervading, only One, and Infinite.

Many scholars have talked about this philosophy

  • That the soul exists is the main gist of Upanishads. According to Sri Shankaracharya one can sum up the entire message of Vedanta in three crisp aphorisms. Brahma Satyam, Jagat Mithya (there is only one truth and that is Brahman or the spirit) Jivo Brahmaiva naparah means that every jiva - the apparent limited and finite entity is actually the infinite and limitless Brahman, and nothing else. Every Jiva is basically God himself with his limited identity.
  • One of the two Hindu principles that symbolize the outcome of freedom of thought was conceptualized four thousand years back by some unnamed rishis in Rig-Veda as, The Universal Reality is the same, but different people can call it by different names (Ekam Sat Viprah Bahuda Vadanti). The other one is "This world is one family (Vasudaiva Kutumbakam)"
  • Om Poornamadah Poornamidam
    Poornaat Poornamudachyate
    Poornasya Poornamaadaaya
    Poornameva Avasihyate

    The whole is whole; if you take away the whole away from the whole the whole still remain. (That is infinite, This is infinite. From the infinite, the infinite has come out. Having taken the infinite out of the infinite, the infinite alone remains. In Vedanta ˜That represents super consciousness, the God or the Brahman and THIS the visible universe).
  • One may ask that if the Whole is divided into parts, how can the individual part be taken as the Whole. Advaita Vedanta maintains that there is only one Reality as Absolute Consciousness. Out of ignorance we perceive this One Reality as multifarious. This cosmic ignorance is called Maya.
  • There are 3 stages of spiritual life. Dwaita (dualism); Vishishtadwaita (Qualified Non dualism) and Adwaita (Non-dualism). Man passes through all of these. In the first stage, God and man are separate, and then man realizes he is God but still 2 exist. For if he says, I am God (that means there are 2, he and God). Only in the advanced stage of realization does man say, There is no ˜I" and only God. Here he claims God and I are one and all traces of ego (self identity) are lost.

....Read More

cardiology news

The Blind Men and the Elephant

A long time ago in the valley of the Brahmaputra River in India there lived six men who were much inclined to boast of their wit and lore. Though they were no longer young and had all been blind since birth, they would compete with each other to see who could tell the tallest story.

One day, however, they fell to arguing. The object of their dispute was the elephant. Now, since each was blind, none had ever seen that mighty beast of whom so many tales are told. So, to satisfy their minds and settle the dispute, they decided to go and seek out an elephant.

Having hired a young guide, they set out early one morning in single file along the forest track, each placing his hands on the back of the man in front. It was not long before they came to a forest clearing where a huge bull elephant, quite tame, was standing contemplating his menu for the day.

The six blind men became quite excited; at last they would satisfy their minds. Thus it was that the men took turns to investigate the elephant shape and form. As all six men were blind, neither of them could see the whole elephant and approached the elephant from different directions. After encountering the elephant, each man proclaimed in turn:

O my brothers, the first man at once cried out, it is as sure as I am wise that this elephant is like a great mud wall baked hard in the sun. Now, my brothers, the second man exclaimed with a cry of dawning recognition, I can tell you what shape this elephant is he is exactly like a spear.

The others smiled in disbelief. Why, dear brothers, do you not see, said the third man, this elephant is very much like a rope,he shouted. Ha, I thought as much, the fourth man declared excitedly, this elephant much resembles a serpent.

The others snorted their contempt. Good gracious, brothers, the fifth man called out, even a blind man can see what shape the elephant resembles most. Why he is mightily like a fan.

At last, it was the turn of the sixth old fellow and he proclaimed, This sturdy pillar, brothers, mine, feels exactly like the trunk of a great areca palm tree. Of course, no one believed him.

Their curiosity satisfied, they all linked hands and followed the guide back to the village. Once there, seated beneath a waving palm, the six blind men began disputing loud and long. Each now had his own opinion, firmly based on his own experience, of what an elephant is really like. For after all, each had felt the elephant for himself and knew that he was right!

And so indeed he was. For depending on how the elephant is seen, each blind man was partly right, though all were in the wrong. ...Read More

News Around The Globe

sprritual blog

The Haitian girl who had a 16-pound tumor removed and an entire face reconstruction

Marlie Casseus is a girl from Haiti, whose life was normal until the age of 14, when her face went completely unrecognizable and frighteningly disfigured because of a strange disease. As a result, not only did she suffer physical pain but emotional anguish for being rejected by her friends and neighbors. The reason is a rare form of polyostotic fibrous dysplasia, a genetic disease that causes the sufferer's bones to become swollen and as soft as jelly. She suffered deformation of her face and she was about to go blind due to the pressure of the tumor on her eye sockets. Fortunately, the Haitian nonprofit Good Samaritan organization helped bring Marlie to the United States. And doctors at Jackson Memorial Medical Center in Miami could evaluate her condition. The hospital's International Kids Fund began collecting money for her operation. Donations came from all over the world and even doctors donated their time to perform the surgery on the girl.

It took 17 hours to remove the growth of both parts of her face. Afterwards she was breathing on her own in stable condition at Holtz Children's Hospital. The surgery involved first, removing the mass of bone and jelly; then inserting metal plates to reconstruct Marlie's lower eye sockets; and finally reconstructing the interior of her nose. The photographs above show the miraculous result.

  • As reported in The Hindu dated July 27, 2013, the Union Health Ministry is considering a new National Antibiotics Policy for the country to handle increasing antibiotics resistance in the country. As per the Union Health secretary Keshav Desiraju, the government was considering a new policy in the light of an older policy drawn up in 2011, soon after the NDM-1 controversy broke out. That policy was later withheld ostensibly because of widespread protests against certain key recommendations: It had recommended a complete ban of across the counter antibiotics; and specified that high end antibiotics could be used only in tertiary care centres.

  • The Hindu dated July 29, 2013 has reported a 9-month-old boy from Navi Mumbai has tested positive for Vaccine- Derived Poliovirus (VDPV) type 2 and is now on ventilator at BJ Wadia Hospital in Parel. This is the fourth such case recorded in the country this year. A Polio Surveillance Team visited the Ilthanpada area in Navi Mumbai where the child lives. The area has 95% cent polio vaccination coverage, according to municipal records. The team has taken stool samples of all the family members, including the patient ™s older brother. When he arrived, he didn ™t have any power in all the four limbs. Now, he is showing signs of improvement. There is flickering and muscle contraction in his legs, said the director of the Directorate of Health Services, Dr. Satish Pawar.

  • New recommendations from the American College of Obstetricians and Gynecologists (ACOG) Committee on Health Care for Underserved Women aim at mobilizing clinicians, hospitals, and other providers to help increase the rate of breast-feeding in underserved women. These recommendations are published in the August issue of Obstetrics & Gynecology. (Source: Medscape)

  • A prospective cohort study, the Finnish Diabetic Nephropathy (FinnDiane) study, from Finland has suggested that non aneurysmal subarachnoid hemorrhage (SAH) may be a new microvascular complication of type 1 diabetes. (Source: Medscape)

  • The US Preventive Services Task Force (USPSTF) has recommended annual low-dose CT lung cancer screening for adults ages 55 through 79 who have a 30 pack-year history of smoking or who have quit in the past 15 years. Other screening modalities, such as chest x-ray and sputum cytology, were not recommended. The draft recommendation is based on a review of the evidence published online July 30 in the Annals of Internal Medicine. (Source: Medpage Today)

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Rabies News (Dr. A K Gupta)

Can a rabies vaccine be given to a pregnant woman?

Following animal bite, rabies vaccine can be given to a pregnant woman. Medical termination of pregnancy should not be done as a routine clinical practice.

cardiology news

Common blood pressure drugs may slow dementia decline

A class of drug used to lower blood pressure could potentially slow the rate of cognitive decline in dementia and even boost brain power, according to a study published by BMJ Open.

Researchers from Ireland analyzed the cognitive decline and brain power of 361 patients with an average age of 77. All had been diagnosed with either Alzheimer's disease, vascular dementia, or a mixture of both.

More people learning how to restart a heart could save 100,000 lives per year across Europe, says the European Resuscitation Council

The very first 'European Restart a Heart Day'-to teach members of the public how to help restart the heart of someone who has suffered a cardiac arrest-will be held this autumn, organised by the European Resuscitation Council (ERC). The initiative, which takes place on October 16, is aimed particularly at Europe's younger people, aims to improve the very low numbers of people surviving out-of-hospital cardiac arrests. On the day, Members of European Parliament will be taught how to resuscitate a victim and use an automated external defibrillator (AED). A poster campaign and flyers will be distributed in different languages, and events will be held across multiple European countries with the support of their national resuscitation organisation.

Valvular Heart Disease News

Clinical examination remains the first step in diagnosis of mitral valve prolapse. The non-ejection click is mobile, meaning that the timing varies with maneuvers that alter left ventricular volume. The mitral regurgitant murmur can be late systolic (early in the disease) or holosystolic (severe prolapse or flail).

(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)

cardiology news
  1. Breastfeeding may increase IQ for toddlers and grade schoolers, as per a new study published online July 29 in JAMA Pediatrics. Infants who had been breast-fed to age 12 months had higher vocabulary scores at 3 years of age and registered higher verbal and nonverbal intelligence scores at 7 years of age compared with nonbreast-fed infants. (Source: Medscape)
  2. A topically preapplied analgesic may provide children who have lacerations with a less painful experience when physicians use tissue adhesive, or skin glue, to repair the wound, according to an article published online July 29 in the Canadian Medical Association Journal. (Source: Medscape)
cardiology news

Maintain good health by sleeping 7 to 9 hours

Health is not mere absence of disease but a state of physical, mental, social, spiritual, environmental and financial well “being. Children should be given exposure to all aspects of health including financial health and spiritual health.

Internationally it has now been shown that 7 to 9 hours of sleep is necessary to achieve optimal health. This is particularly important for students, who often enjoy late night parties. Remember the formula: 8 hours for oneself (sleep and hygiene), 8 hours of studies and 8 hours for the social life and family.

Childhood obesity is the new epidemic of the society and can only be controlled by right education in school children. They should refrain from fast food that is served at parties as it is not good for health. These fast foods, also called junk food, are a combination of refined flour and cheese, with or without sugar, which are harmful.

cardiology news

Paternal age and fertility

Older men can be reassured that any excess risk of disease in their offspring related to paternal age is very small, but not zero. Advanced paternal age is associated with an increase in new autosomal dominant mutations. The best estimate of risk of autosomal dominant disease in progeny is =0.5 percent.

cardiology news


CPR 10 Camp - E Book Sahodaya Sr Sec School, SDA, New Delhi


CPR Classes: Persons trained (1336)

30th July: CPR Moolchand (25)

Total CPR since 1st November 2012 – 56831 trained

TV and Radio Coverage

24th July: Interview in Sahara TV on iron tablets

Video Chats and uploads

Dr KK Aggarwal on Say No Tobacco

Dr KK Aggarwal on NEWS 24

Advocacy through Print Media

30th July: Veer Arjun

Media advocacy through Web Media

You are at risk for osteoporosis if ¦ 30th July


Poor hygiene habits may lead to Typhoid fever

Typhoid fever is caused by a bacterium called Salmonella typhi and is transmitted through the ingestion of food or drink that has been contaminated by the feces or urine of infected people, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India. Flying insects feeding on feces may occasionally transfer the bacteria through poor hygiene habits and public sanitation conditions.

Though the cases occur round the year, more cases are seen during the summer and rainy seasons.

Symptoms usually develop 1 “3 weeks after exposure, and may be mild or severe. They include high fever, malaise, headache, constipation or diarrhea and enlarged spleen and liver. A healthy carrier state may follow acute illness.

It can be treated with antibiotics. However, resistance to common antimicrobials is widespread. Healthy carriers should be excluded from handling food.

Sanitation and hygiene are the critical measures that can be taken to prevent typhoid.

Few salient facts about Typhoid fever

  • Typhoid does not affect animals and therefore transmission is only from human to human.
  • Typhoid can only spread in environments where human feces or urine are able to come into contact with food or drinking water.
  • Careful food preparation and washing of hands are crucial to preventing typhoid.
  • Typhoid fever in most cases is not fatal.
  • Prompt treatment of the disease with antibiotics reduces the case-fatality rate to approximately 1%.
  • When untreated, typhoid fever persists for three weeks to a month.
  • Resistance to common antibiotics is now common
  • Typhoid that is resistant to common antibiotics is known as multidrug-resistant typhoid (MDR typhoid).
  • Ciprofloxacin resistance is an increasing problem, especially in the Indian subcontinent and Southeast Asia.
  • Azithromycin is a new drug for drug-resistant typhoid.
  • Typhoid vaccine taken every three years is the best preventive approach.

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 56831 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 10x10 i.e. 100 per minute.

today emedipics

Heart Care Foundation of India Organizes a CPR 10 Training camp at Sahodaya Sr Sec. School, SDA, New Delhi on 25th July 2013.

press release

Why BP should be kept

today video of the dayDr KK Aggawral on Say No to Tobacco

Dr KK Aggarwal on How to Take Care of yourself during the Monsoons

Smart Phones Benefits and Hazards

eMedi Quiz

Read this…………………

Nurse Lei is aware that one of the following is an early sign of heart failure in an infant with a congenital heart defect?

a. Tachypnea
b. Tachycardia
c. Poor weight gain
d. Pulmonary edema

Yesterday’s Mind Teaser: An infant is hospitalized for treatment of inorganic failure to thrive. Nurse Faith is aware that the nursing action is most appropriate for this child?

a. Encouraging the infant to hold a bottle
b. Keeping the infant on bed rest to conserve energy
c. Rotating caregivers to provide more stimulation
d. Maintaining a consistent, structured environment

Answer for yesterday’s Mind Teaser: d. Maintaining a consistent, structured environment

Correct answers received from: Daivadheenam, Dr Abbas Vakil, Dr PC Das, Dr Chandresh Jardosh, Dr K Raju, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Dr kanta Jain,
Dr Avtar Krishan, Dr Santhakumari, Dr Ayyavoo Erode.

Answer for 29th July Mind Teaser: b. 1 week to 1 year, peaking at 2 to 4 months

Correct answers received from: Dr kanta Jain.

Send your answer to ijcp12@gmail.com

eMedi Apps

medicolegal update

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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/12vFIfq #Health

Dr Deepak Chopra: Your only identity is I AM undefined and infinite. Any label you give yourself limits yourself.

medicolegal update

Dear Sir, you are providing great service via emedinews. Regards: Dr Kapil Sharma

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