eMedinewS3rd September 2013, Tuesday

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

Naprosyn safest NSAID for heart patients

In patients who require high doses of a nonselective NSAID for long–term use and who have known cardiovascular disease or are at high risk for cardiovascular events. The current recommendation is to use naproxen rather than ibuprofen or diclofenac.

One should prefer naproxen to other nonselective NSAIDs, although there are few data evaluating nonselective NSAIDs other than ibuprofen and diclofenac in patients at high cardiovascular risk.

Most NSAIDs increase the risks of major cardiovascular events.

The magnitude of risk is best illustrated by a meta–analysis of data from over 300,000 participants in over 700 trials that compared nonselective NSAIDs (used at the upper end of their dose range) or coxibs with either placebo or another nonselective NSAID or coxib.

Compared with placebo, use of high–dose diclofenac or a coxib increased major cardiovascular events (nonfatal MI, nonfatal stroke, or vascular death) by 40 percent.

High-dose ibuprofen increased the risk of major coronary events but not major vascular events.

High-dose naproxen did not increase major cardiovascular events, major coronary events, or vascular death.

The estimated excess absolute risk of a major vascular event or death with use of diclofenac, coxib, and possibly ibuprofen was two events per 1000 persons per year in patients at low baseline cardiovascular risk and seven to eight events per 1000 persons per year, including two fatal events, in patients at high baseline cardiovascular risk.

Naproxen is therefore the preferred nonselective NSAID when long–term use is needed in patients at increased risk for cardiovascular disease. (Uptodate) ….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 Why did Lord Ganesha never suffer from diabetes in spite of having pot belly obesity?

Today the developing world is facing an epidemic of potbelly obesity–related diabetes and the same has been linked to eating refined carbohydrates especially refined sugar.

Lord Ganesha is depicted with big tummy and sweet (laddoo) in one of his hands and yet he never suffered from diabetes.

There are two interpretations of this. The first is a spiritual interpretation and i.e. that in mythology Ganesha depicts principles of stress management and sweet laddoo means control of desires. The big tummy symbolizes retaining all information gathered from hearing with two big elephant ears.

The second is a medical interpretation where the big tummy represents the susceptibility of Indians to metabolic syndrome, the present epidemic related to abdominal obesity. Indians have a weakness for eating sweets as well as being vulnerable to developing pot belly obesity.

This is shown as uncontrolled desire to eat sweets (Laddoos) and the prevention of the same is shown by all the fruits or leaves, offered to Ganesha, that have anti diabetic properties.

The main Ganesha Mantra can also be interpreted as explaining anti diabetes properties of Ganesha offerings.

"Gajananam Bhoota Ganadi Sevitam; Kapittha Jambu phalasara bhakshitam; Umasutam Shoka Vinasha karanam; Namami Vighneswara pada pankajam".

The Mantra means

a. "Oh Elephant–faced, worshipped by the existing beings, of all living beings, tasting the elephant apple (kaith) and jambolana (jamun), the Son of Uma, destroyer of grief, I bow to the lotus feet of Ganesha who is lord of all."

b. Or Gajananam (the big tummy one worshipped by all) Bhoota (Durva grass and Bilva patra used for worshipping Ganesha) Ganadi (in equal quantity) Sevitam (if consumed); Kapittha (Kaith) Jambu (Jamun) phalasara (fruits) bhakshitam (to be consumed); Umasutam (son of Uma) Shoka (diseases) Vinasha karanam (get rid of); Namami (I bow to) Vighneswara (destroyer of grief) pada pankajam (feet of lord)"

The mantra talks about four medicinal herbs: Durva grass and Bilva patra (Bel leaves) used for Ganesha worship; fruit of elephant apple (Kaith) and fruit of Jambolona (or Jamun). All four have anti diabetic properties and can be mixed in equal quantity and prepared as a medicinal juice.

Medically, Durva grass (Cynodon dactylon) has been shown to possess anti diabetic, cholesterol lowering, immune-modulatory, DNA protective, aphrodisiac, male fertility, anti cancer and anti inflammatory activities. Similarly Bilva Patra has both anti diabetic and fertility promoting properties.

Elephant apple (Limonia acidissima) also named as Wood Apple, Elephant Apple, Monkey Fruit, Curd Fruit, Koth Bel, Kaitha and Kath Bel, has been shown to possess strong anti diabetic properties.

Jamun (Syzygium cumini) also has DNA protective, antioxidant and antidiabetic properties and is an essential ingredient of most antidiabetic Ayurveda preparations.

Worth trying: Regularly take equal mixed quantity of Durva grass, Kaith fruit and Jamun fruit juices to prevent diabetes and to reduce the ill effects of metabolic syndrome.

Note: This article is the author’s personal interpretation based on listening to many Ayurveda experts. ….Read More

cardiology news

Salt, Glass of Water and the Lake

Once an unhappy young man came to an old master and said that he had a very sad life and asked for a solution. The old Master instructed the unhappy young man to put a handful of salt in a glass of water and then to drink it.

"How does it taste?" the Master asked. "Terrible." spat the apprentice.

The Master chuckled and then asked the young man to take another handful of salt and put it in the lake. The two walked in silence to the nearby lake and the apprentice swirled his handful of salt into the lake.

The old man said, "Now drink from the lake." As the water dripped down the young man’s chin, the Master asked, "How does it taste?"

"Good!" remarked the apprentice. "Do you taste the salt?" asked the Master. "No." said the young man.

The Master sat beside this troubled young man, took his hands, and said, “The pain of life is pure salt; no more, no less. The amount of pain in life remains the same, exactly the same. But the amount we taste the ‘pain’ depends on the container we put it into. So when you are in pain, the only thing you can do is to enlarge your sense of things. Stop being a glass. Become a lake." ...Read More

News Around The Globe

  • In a viewpoint article published online Aug. 30 in The Lancet Diabetes & Endocrinology that included a review of the literature, Matthias Schulze, DrPH, of the German Institute of Human Nutrition Potsdam-Rehbruecke, and colleagues wrote that a clearer definition of metabolically healthy obesity could lead to better targeting of costly weight loss interventions that would focus on the most at-risk patients. (Source: Medpage Today)
  • A molecular test that detects pepsin in bronchoalveolar lavage (BAL) fluid was a more sensitive biomarker of aspiration–associated reflux disease in children with chronic pulmonary disease than the most widely used test, according to a new study by Elizabeth A. Kelly, MD, of the Medical College of Wisconsin, Milwaukee, and colleagues and reported in JAMA Otolaryngology–Head "Neck Surgery.
  • People treated for Hodgkin’s lymphoma could face an increased risk for the subsequently development of stomach cancer. New data show a dose–dependent increase in the risk for stomach cancer in patients who received subdiaphragmatic radiotherapy and a chemotherapy regimen containing high-dose procarbazine (Matulane). Results from the case–control study were published online August 26 in the Journal of Clinical Oncology.
  • An individualized approach to treatment offers the best outcomes for patients with wet age–related macular degeneration (wAMD). According to the lead author Dr. Paolo Lanzetta from the University of Udine in Italy, the theoretical advantages of tailored therapies for neovascular AMD are to avoid over- and under-treatment with a proper benefit/risk balance while maintaining the same outcomes of fixed regimens. The report, online August 8 in the British Journal of Ophthalmology, includes three head–to–head studies comparing different anti–VEGF drugs and four studies comparing alternative dosing regimens with ranibizumab.
  • Severe psychiatric illness, especially schizophrenia and major depression, are associated with an increased risk for death, but the newer agents prescribed to treat these illnesses appear to reduce this risk. The results are from an analysis of US Food and Drug Administration (FDA) Summary Basis of Approval (SBA) reports comprising more than 92,000 patients with psychiatric illness.

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Rabies News (Dr. A K Gupta)

What are the signs of rabies in dogs/cats?

  • Any change in normal behavior suggesting either undue aggression or depression.
  • Running aimlessly and attacking others without provocation.
  • Becomes too drowsy and withdraws to a corner.
  • Change in voice/bark.
  • Excessive salivation.
  • Refusal to feed or eating objects like stone, paper, wood, metal pieces etc.
cardiology news
  • Among patients with non–ST–segment elevation acute coronary syndrome (ACS), pretreatment with prasugrel (Effient) before angiography did not improve outcomes and worsened bleeding, a randomized trial showed. The rate of cardiovascular death, MI, stroke, urgent revascularization, or glycoprotein IIb/IIIa inhibitor rescue therapy through day 7 was 10% with pretreatment of all patients and 9.8% when prasugrel was given only after angiography resulted in planned use of percutaneous coronary intervention (HR 1.02, 95% CI 0.84–1.25). That lack of efficacy was accompanied by a significant increase in all TIMI major bleeding –– regardless of whether it was related to CABG –– through day 7 (2.6% versus 1.4%; HR 1.90, 95% CI 1.19-3.02). These findings were reported by Gilles Montalescot, MD, PhD, of Pitié–Salpêtrière University Hospital in Paris at the European Society of Cardiology meeting and were published simultaneously online in the New England Journal of Medicine. (Source: Medpage Today)
  • David Wald, MD, of Barts and the London School of Medicine and Dentistry reported at the at the European Society of Cardiology meeting that in patients with acute ST-segment elevation myocardial infarction (STEMI), stenting all coronary arteries with major stenoses –– not just the one causing the event –– improved outcomes. Compared with stenting only the culprit lesion, stenting all arteries with at least 50% stenosis reduced the rate of the composite of cardiac death, nonfatal MI, or refractory angina (9% versus 23%; HR 0.35, 95% CI 0.21–0.58). The finding was similar when refractory angina –– a more subjective outcome –– was left out of the composite endpoint (HR 0.36, 95% CI 0.18–0.73). The results of PRAMI trial were published simultaneously online in the New England Journal of Medicine.

Valvular Heart Disease News

The principles of treatment of infective endocarditis in children are the same as adults. The choice, dosage, and duration of antibiotic therapy are dependent upon the underlying causative microbial agent

(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
  • Vaccinate children against the flu as soon as possible rather than holding out for the new quadrivalent versions, the American Academy of Pediatrics urged in its annual influenza recommendations. Four–strain vaccine wasn't preferred over the trivalent vaccine in the recommendations published in the October issue of Pediatrics. (Medpage Today)
  • Hyperopia, or farsightedness, is the most common refractive eye error in Asian and non–Hispanic white (NHW) Southern California children overall, but myopia, or nearsightedness, is "relatively more prevalent" among Asian children than hyperopia or astigmatism, according to the findings of a population–based, cross–sectional study as part of the Multi–Ethnic Pediatric Eye Disease Study (MEPEDS) and published online August 14 in Ophthalmology.
cardiology news

How sleep loss threatens your health

Many people do not realize that lack of sufficient sleep can trigger mild to potentially life–threatening consequences, from weight gain to a heart attack. Recently I came across an article in the Harvard Health Newsletter (Health Beat) and thought of sharing the information with you all.

Viral infections: Anecdotal evidence supports the belief that when you’re tired and run–down, you’re more likely to get sick. A 2009 study in Archives of Internal Medicine provides some proof. Researchers followed the sleep habits of 153 men and women for two weeks, then quarantined them for 5 days and exposed them to cold viruses. People who slept an average of less than 7 hours per night were three times as likely to get sick as those who averaged at least eight hours.

Weight gain: Not getting enough sleep makes you more likely to gain weight, according to a 2008 review article in the journal Obesity that analyzed observations from 36 different studies of sleep duration and body weight. This association is especially strong among children. Lack of sufficient sleep tends to disrupt hormones that control hunger and appetite, and the resulting daytime fatigue often discourages you from exercising. Excess weight, in turn, increases the risk of a number of health problems.

Diabetes: A 2009 report in Diabetes Care found a sharp increase in the risk of type 2 diabetes in people with persistent insomnia. People who had insomnia for a year or longer and who slept less than 5 hours per night had a three–fold higher risk of type 2 diabetes compared with those who had no sleep complaints and who slept six or more hours every night. As with overweight and obesity (which are also closely linked to type 2 diabetes), the underlying cause is thought to involve a disruption of the normal hormonal regulation of the body due to inadequate sleep.

High blood pressure: Researchers involved in the diabetes study also evaluated risk of high blood pressure among the same group of people, which included more than 1,700 randomly chosen men and women from rural Pennsylvania. As described in a 2009 article in the journal Sleep, the researchers found the risk of high blood pressure was three–and–a–half times greater among insomniacs who routinely slept less than six hours per night compared with normal sleepers who slept six or more hours nightly.

Heart disease: A number of studies have linked short–term sleep deprivation with several well–known risk factors for heart disease, including higher cholesterol levels, higher triglyceride levels, and higher blood pressure. One such report, published in a 2009 issue of Sleep, included more than 98,000 Japanese men and women ages 40 to 79 who were followed for just over 14 years. Compared with women who snoozed for seven hours, women who got no more than four hours of shut–eye were twice as likely to die from heart disease, the researchers found.

Sleep apnea is a common cause of poor sleep, a life–threatening condition in which breathing stops or becomes shallower hundreds of times each night also increases heart disease risk. In the Wisconsin Sleep Cohort study, people with severe sleep apnea were three times more likely to die of heart disease during 18 years of follow–up than those without apnea. When researchers excluded those who used a breathing machine (a common apnea treatment), the risk jumped to more than five times higher. Apnea spells can trigger arrhythmias (irregular heartbeats), and the condition also increases the risk of stroke and heart failure.

Mental illness: A study of about 1,000 adults ages 21 to 30 found that, compared with normal sleepers, those who reported a history of insomnia during an interview were four times as likely to develop major depression by the time of a second interview three years later. Two studies in young people–one involving 300 pairs of young twins, and another including about 1,000 teenagers–found that sleep problems developed before a diagnosis of major depression and (to a lesser extent) anxiety. Sleep problems in teenagers preceded depression 69% of the time and anxiety disorders 27% of the time.

Mortality: In the Japanese heart disease study, short sleepers of both genders had a 1.3–fold increase in mortality compared with those who got sufficient sleep. According to a 2009 study of 6,400 men and women whom researchers followed for an average of eight years, severe sleep apnea raises the risk of dying early by 46%. Although only about 8% of the men in the study had severe apnea, those who did and who were between 40 and 70 years of age were twice as likely to die from any cause as healthy men in the same age group.

It is clear that getting enough sleep is just as important as other vital elements of good health, such as eating a healthy diet, getting regular exercise, and practicing good dental hygiene.

In short, sleep is not a luxury but a basic component of a healthy lifestyle.

cardiology news

Chief Minister of Delhi Smt. Sheila Dikshit to host a dinner for CMAAO India conference faculty

Smt. Sheila Dikshit, Chief Minister of Delhi will be hosting an invited limited faculty dinner at CM’s residence on 12th September at 8pm. The invitees will include the international and national faculty of CMAAO India conference.

cardiology news

Total CPR since 1st November 2012 – 62980 trained

CPR Classes 62980

Media advocacy through Print Media

sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping
sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping

29th August: Veer Arjun

Media advocacy through Web Media

When Constipation May be a Serious Problem 30th August


TB more dangerous than FLU 29th August


Caloric restriction may prevent disease & increase life span

A study published in Science has gathered a front–page response in most of the USA newspapers. The study talks about ancient Indian philosophy" the less you eat the more you live", said Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal, President, Heart Care Foundation of India and MTNL Perfect Health Mela. It’s a yogic saying that who eats once a day becomes yogi, eats twice a day becomes bhogi and eats thrice day becomes rogi.

What US papers have reported In a front–page story, the New York Times (7/10, A1, Wade) reports that, according to research published in the journal Science, "people could…fend off the usual diseases of old age and considerably extend their life span by following a special diet." The approach, "known as caloric restriction," contains "all the normal healthy ingredients, but" with "30 percent fewer calories than usual." Past research has shown that "mice kept on such a diet from birth" may "live up to 40 percent longer than comparison mice fed normally. "To investigate whether the same would "be true in people," researchers began "two studies of rhesus monkeys" over "20 years ago."

The Wall Street Journal (7/10, Winstein) reports that findings from one of those studies "appear to validate" the "technique…as a way to live longer," providing "new impetus to researchers and companies" that "are searching for a drug to mimic the beneficial effects of a meager diet in humans without the feeling of near–starvation." The study "began in 1989 with 30 rhesus monkeys and added 46 more in 1994." Researchers restricted "half the monkeys’ diets, reducing their calories by 30 percent, when the monkeys were fully grown, or about 10 years old."

The Los Angeles Times (7/10, Kaplan) reports, "Over the course of the study, the monkeys that ate the regular diet were three times more likely to die of an age–related disease than their counterparts on caloric restriction." These results were "welcomed by scientists who study the biological mechanisms of aging and longevity." Susan Robergs, of the Human Nutrition Research Center on Aging at Tufts University, noted that "it adds to the evidence piling up that caloric restriction…is a healthy way to stay alive and healthy longer."

But, Dr. David Finkelstein, of the National Institute on Aging, noted that "what we would really like is not so much that people should live longer, but that people should live healthier," the AP (7/10) reports. In fact, "the calorie–cut monkeys" in the study "had less than half the incidence of cancerous tumors or heart disease of the monkeys who ate normally." Researchers also found using brain scans that the "dieting monkeys" had "less age–related shrinkage." Furthermore, the calorie–restricted monkeys appeared "many more years younger."

The researchers noted, however, that their efforts were aimed at "studying calorie restriction, not malnutrition," CNN (7/10, Mann) reports. The monkeys "consumed very healthful diets" in both groups, including "15 percent protein and 10 percent fat." Their diets were also "enriched with vitamins." Still, "exactly how a calorie–restricted diet helps stave off age–related diseases and extend lifespan is unknown."

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 63000 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."

today emedipics

Hon'ble Governor of Karnataka releasing the book "Me Lord I am not guilty" by Dr KK Aggarwal in Mysore.

press release

Avoid these foods for a healthier heart

today video of the dayDr KK Aggarwal on Costly Treatment

Dr KK Aggarwal on Sleeping Disorder

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

When a female client with an indwelling urinary (Foley) catheter insists on walking to the hospital lobby to visit with family members, Nurse Rose teaches how to do this without compromising the catheter.
Which client action indicates an accurate understanding of this information?

a. The client sets the drainage bag on the floor while sitting down.
b. The client keeps the drainage bag below the bladder at all times.
c. The client clamps the catheter drainage tubing while visiting with the family.
d. The client loops the drainage tubing below its point of entry into the drainage bag.

Yesterday’s Mind Teaser: The nurse is aware that the following findings would be further evidence of a urethral injury in a male client during rectal examination?

a. A low–riding prostate
b. The presence of a boggy mass
c. Absent sphincter tone
d. A positive Hemoccult TEST

Answer for yesterday’s Mind Teaser: b. The presence of a boggy mass

Correct answers received from: DR AJAY GANDHI, DR.BITAAN SEN & DR.JAYASHREE SEN, dr p j khalap, Narahari Kandakatla, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr.K.Raju, Dr Chandresh Jardosh, daivadheenam, DR AVTAR KRISHAN, Dr. Laxman kumar, Dr Abbas Vakil

Answer for 1st September Mind Teaser: d. A positive Hemoccult

Correct answers received from: DR AYYAVOO ERODE

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

What about children?

Little Bobby (seven) was in love with Little Susie (same age) who lived next door. One day, Bobby went to Susie’s dad and announced (as seriously as he could), "I’m in love with Susie, and we’re getting married". Amused, Susie’s dad started asking questions (in the hopes to discourage the idea). Susie’s dad: "Where will you live?" Bobby: "Well, Susie has a playhouse in the back yard, so we're gonna live there."

Susie’s dad: "How are you going to make money to support her?"

Bobby: "Well, Susie gets 75 cents a week, and I get $1.25 a week." (pauses to think) "That should be more than enough!" Seeing that Bobby was still serious, Susie’s dad asked, "Well, what about children?" Bobby perked up and quickly answered, "Oh, we have that figured out already. Whenever Susie lays an egg, I’m gonna stomp on it!"

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with diabetes shows deteriorating kidney function.
Reaction: Oh my God! His HbA1c is very high?
Lesson: Make sure that strict glycemic control is maintained in patients with type 2 diabetes in order to delay vascular complications.

medicolegal update

At the height of laughter, the universe is flung into a kaleidoscope of new possibilities.

medicolegal update

Dr KK Aggarwal: Dr K K Aggarwal: Relaxation during work http://bit.ly/16wknsh #Health

Dr Deepak Chopra: Based on the central doctrine of materialism consciousness shouldn’t exist. You are conscious now http://tinyurl.com/l6x3eo4

medicolegal update

Dear Sir, Gud Explanation of Lord Ganesha. Regards: Dr Shruti

Forthcoming Events

29thSeptember–Dil Ka Darbar at NDMC Convention Centre, CP New Delhi

20th Perfect Health Mela from 18th Oct to 22nd Oct at different locations

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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medicolegal update

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