eMedinewS
4th January 2015, Sunday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and National Science Communication Awardee. Limca Book of Record Holder (CPR). Gold Medalist

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, 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.twitter.com/DrKKAggarwal, www.facebook.com/Dr KKAggarwal

How to keep your memory sharp?

  • Manage your stress, especially deadline pressure and petty arguments.
  • The biggest stress is an ongoing sense of extreme anxiety. This can be managed by deep breathing, meditation, yoga and by mindful approach to living.
  • Get a goodnight sleep. The most common reason for poor sleep is difficulty in falling asleep and staying asleep. Many drugs used to treat insomnia can also impair memory.
  • If you need a sleeping medicine, it should be used in the lowest dose for the shortest period of time.
  • Get up at the same time in the morning.
  • If you smoke, quit.
  • If you do not drink, do not start.
  • Alcohol makes it difficult to perform short term memory tasks such as memorizing list.
  • Alcohol induces vitamin B1 deficiency, which can cause dementia.
  • Protect your brain from injury as repeated minor head trauma can cause brain damage.
  • Wear seat belt when riding in motor vehicle.
  • Wear helmet while driving or riding motorcycle.

IMA NEWS

IMA in the news

  • 2 fresh cases of swine flu in Delhi; IMA issues guidelines: Business Standard
  • 2 fresh cases of swine flu in Delhi; Indian Medical Association issues guidelines: Deccan Chronicle

IMA warns docs against hiring ayurveda, homoeopathy practitioners

By Jyoti Shelar, Mumbai Mirror | Jan 3, 2015, 12.00 AM IST

The Indian Medical Association (IMA) has issued directions to the 10,000 healthcare facilities and 2.5 lakh doctors it represents that it will initiate action against those physicians and establishments found hiring homoeopaths and ayurveda practitioners to fulfill allopathic functions.

According to a senior IMA functionary, the system of employing those qualified to prescribe traditional cures in hospitals and clinics that specialise in allopathic healthcare has resulted in hundreds of medical negligence cases being filed against IMA members.

The decision to call for a ban was taken by IMA's central council last week and has been communicated to all its members. The notification stated, "Directions are being given to hospitals and doctors not to appoint Ayush (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy) Doctors as Resident Medical Officers (RMO)/Assistant. Strong action will be taken against those violating the directions". IMA could revoke the membership of a doctor or institution found flouting this directive - outcasts will lose the support of IMA in battling medico-legal and malpractice cases.

"It is a simple and clear message to our doctors. No ayurveda or homeopathy practitioner should be hired as an assistant or as an RMO in any allopathic medical set-up," Dr KK Aggarwal, senior national vice-president of IMA told Mumbai Mirror. "Such cases have only increased across the country in the past few years which forced us to call for the blanket ban," said Aggarwal.

Such hiring practices are prevalent primarily in government hospitals in rural areas, which retain the services of Ayush doctors owing to lack of qualified allopathic practitioners.

Incidentally, the state government recently passed a bill which allows those practicing ayurveda and homoeopathy to prescribe allopathic cures upon completing a year-long bridge course called 'Certificate Course in Modern Pharmacology', which will be designed by Maharashtra University of Health Sciences (MUHS).

"If a homoeopath or an ayurveda practitioner stops practicing his own stream, he is obviously degrading it. Even if they do that course, our stand will remain the same. As far as the issue of shortage of doctors is concerned, the government should increase the number of medical seats instead of allowing this," said Aggarwal, adding that doctors flouting these norms will lose their IMA registration.

Many Indian courts have excoriated homeopaths and ayurveda practitioners for prescribing allopathic medicines. In a 1996 case of medical negligence, in which a homoeopath's prescription of allopathic treatment to a man afflicted with typhoid resulted in the patient's death, the Supreme Court, which adjudicated, said: "A doctor must not only be qualified but he must also be registered with the appropriate Medical Council in order to practice as a doctor. A homeopath would not have knowledge about allopathic medicines and its drug reactions. So the mere administration of allopathic treatment by a homeopath would be enough proof to establish negligence."

Senior eye surgeon Dr T P Lahane, a medical professional of 32-years' experience, and head of the state-run JJ Hospital, was of the opinion that allowing homeopaths or ayurveda practitioners to administer modern medicine is extremely unjust. "If they have not learnt the science thoroughly and extensively, they cannot be allowed to practice it so easily," he said.

However, those Ayush doctors that are the target of the IMA's ire point out that they fulfill a vital need. "These modern medicine practitioners who are making so much noise should survey the hospitals and see who is treating the poor in Primary Health Centres in rural areas," said Dr Bahubali Shah, administrator, Maharashtra Council of Homeopathy, adding there are over 60,000 homeopaths, 81,000 ayurveda practitioners in Maharashtra, as against 1.21 lakh allopathic doctors. "We are not simply asking for permission to practice allopathy. We want to do it legitimately by doing the course."

Minor fever with breathlessness can be swine flu: IMA

IANS | New Delhi , January 2, 2015 Last Updated at 18:22 IST, Business Standard

The Indian Medical Association (IMA) Friday issued a set of guidelines to tackle swine flu and urged citizens not to neglect minor cases of fever with breathlessness. It said in its guidelines that the matter is important as the current seasonal influenza vaccines are not expected to provide protection against human infection with avian or swine flu viruses. "However, reducing seasonal influenza risk through vaccination might reduce the theoretical risk for recombination of influenza viruses of animal origin," it said in a statement.

The guidelines were launched by IMA president Marthanda Pillai and secretary general K.K. Aggarwal here Thursday. According to the IMA, a total of 10 deaths in Hyderabad and one death in Delhi have occurred due to swine flu so far. Delhi has reported 39 cases of Swine flu since last year. According to the IMA, swine flu can have symptoms like fever, coryza, cough, sore throat and body aches. It may last for one-two weeks. However, occasionally, nausea, vomiting, diarrhoea and rash may also occur.

The government has designated both government and private labs to test the presence of virus, it said. "The government has also set a control room - 23061469. People, for any kind of information on swine flu, can contact it," it said. It said that swine flu can be prevented by adhering to cough and respiratory hygiene. One should avoid coughing over hands or handkerchief and use a disposable paper instead. "Frequently hand wash should be done if hands get contaminated with any secretions," it said.

"People should avoid touching face, mouth and nose with dirty hands, avoid touching or having close proximity with any person who is coughing or has cold, and avoid shaking hands. Patients, who have symptoms should stay indoors and avoid crowded places," it said.

2 fresh cases of swine flu in Delhi; Indian Medical Association issues guidelines: Deccan Chronicle

PTI | January 02, 2015, 19.01 pm IST

New Delhi: Two fresh cases of swine flu were reported in the national capital today, taking the figure to 41 since last year. Two women, aged 35 and 53, residents of C R Park and Chattarpur, have tested positive for H1N1 (swine flu) virus, according to the officials from the health department of Delhi government. "The 35-year old woman is admitted to a private hospital in Kalkaji while the 53-year old is admitted to Fortis in Vasant Kunj," said Charan Singh, Additional Director (Public Health). One case of swine flu was reported on Thursday also. Delhi Health Secretary S C L Das today reviewed the situation and held a stock taking meeting with all the designated hospitals. The Indian Medical Association (IMA) meanwhile has issued a set of guidelines to tackle swine flu and urged citizens not to neglect minor cases of fever with breathlessness. "The matter is important as the current seasonal influenza vaccines are not expected to provide protection against human infection with avian or swine flu viruses. However, reducing seasonal influenza risk through vaccination might reduce the theoretical risk for recombination of influenza viruses of animal origin," IMA said in a statement.

According to the IMA, a total of 10 deaths in Hyderabad and one death in Delhi have occurred due to swine flu so far. Swine flu can have symptoms like fever, coryza, cough, sore throat and body aches. It may last for one-two weeks, said IMA. However, occasionally, nausea, vomiting, diarrhoea and rash may also occur. The government has designated both government and private labs to test the presence of virus, it said. The government has also set a control room - 23061469 - for any kind of information on swine flu, it said.

News around the Globe

  • The American College of Obstetricians and Gynecologists' Committee on Gynecologic Practice and have published updated recommendations in the January 2015 issue of Obstetrics & Gynecology.
    • In women at population risk for ovarian cancer, surgeons should discuss the potential benefits of salpingectomy.
    • In women considering laparoscopic sterilization, physicians can discuss the fact that bilateral salpingectomy provides effective contraception, while pointing out that this procedure eliminates the option of tubal reversal.
    • Prophylactic salpingectomy may prevent ovarian cancer in some patients.
    • More randomized controlled trials are needed to support the use of salpingectomy in reducing ovarian cancer.
  • The US FDA has approved a combination of a cephalosporin (ceftolozane) and a beta-lactamase inhibitor (tazobactam) in an intravenous formulation has been approved for treating complicated intra-abdominal infections and complicated urinary tract infections in adults. This is the fourth antibacterial drug product approved by the FDA in 2014 and was designated as a Qualified Infectious Disease Product (QIDP) and was given priority review.
  • With proper monitoring, kidney donation may be safe for individuals with high blood pressure, according to a study published early online ahead of the print edition of the Journal of the American Society of Nephrology.
  • The US Food and Drug Administration (FDA) has approved liraglutide (rDNA origin (Saxenda)) injection as a treatment option for chronic weight management in addition to a reduced-calorie diet and physical activity.

Dr KK Spiritual Blog

Debts in Mythology

It is said that there are three debts which everybody has to pay in his or her lifetime. In Vedic language, they are called Dev Rin, Pitra Rin and Rishi Rin.

In medical language, the body consists of soul, physical body, mind, intellect and ego. The soul is given to us by God or Devtas (Dev Rin), the physical body by our parents (Pitra Rin) and the mind, intellect and ego by our Gurus (Rishi Rin).

In terms of computer language, if I see my body as a computer, then my body as a computer is made by my parents; operating software and my inner internet represent the soul or consciousness given by the Devtas and the application softwares i.e. Word, Excel and Power point, which we learn over a period of time are given to us by our Gurus. Therefore, we have to pay all these three debts while we are still alive.

emedipicstoday emedipics

Health Check Up and CPR 10 Camp at G B S.S.School, Varun Marg, Defence Colony, New Delhi on 22nd December 2014

video of day
press release

Five Things Physicians and Patients should question

Sameer Malik Heart Care Foundation Fund

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF

Total CPR since 1st November 2012 – 101090 trained

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."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

 

IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :

 

Make Sure

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

eMedinewS Humor

A traffic slogan: Don’t let your kids drive if they are not old enough – or else they never will be

Twitter of the Day

Dr KK Aggarwal: TB more dangerous than flu By Dr k k Aggarwal
Dr Deepak Chopra: Letting go is the only option when you realize there is nothing to hold onto

10 Innovations That Could Change Medicine

Calling All (Healthy) Stool

The increasing popularity of fecal microbiota transplant has brought with it a demand for stool. However, screening fecal donors and processing stool can be arduous. Enter stool banks, such as OpenBiome. Colleen R. Kelly, MD, assistant professor of medicine at Brown University's Warren Alpert Medical School in Providence, Rhode Island, said, "OpenBiome has shown that they can provide material to a large number of clinicians and researchers at a reasonable cost ($250 per dose). This is very advantageous for patients, who may not be able to identify a suitable donor, and for physicians, who may spend hours on the donor identification/screening process." It's arguably safer as well. "They monitor donors carefully at and between donations, quarantine all material for 30 days until donors can be rescreened, and preserve safety aliquots on all material," she said. Institutions are also setting up their own stool banks. (Source: Medscape)

Inspirational Story

Power of Thought: Hitting Unseen Target

Yogi Raman was a true master of the art of archery. One morning, he invited his favorite disciple to watch a display of his skill. The disciple had seen this more than a hundred times before, but he nevertheless obeyed his teacher. They went into the wood beside the monastery and when they reached a magnificent oak tree, Raman took a flower, which he had tucked in his collar and placed it on one of the branches. He then opened his bag and took out three objects: his splendid bow made of precious wood, an arrow and a white handkerchief embroidered with lilacs. The yogi positioned himself one hundred paces from the spot where he had placed the flower. Facing his target, he asked his disciple to blindfold him with the embroidered handkerchief.

The disciple did as his teacher requested. “How often have you seen me practice the noble and ancient sport of archery?” Raman asked him. “Every day,” replied his disciple. “And you have always managed to hit the rose from three hundred paces away.” With his eyes covered by the handkerchief, Yogi Raman placed his feet firmly on the ground, drew back the bowstring with all his might – aiming at the rose placed on one of the branches of the oak tree – and then released the arrow. The arrow whistled through the air, but it did not even hit the tree, missing the target by an embarrassingly wide margin. “Did I hit it?” said Raman, removing the handkerchief from his eyes. “No, you missed completely,” replied the disciple. “I thought you were going to demonstrate to me the power of thought and your ability to perform magic.”

“I have just taught you the most important lesson about the power of thought,” replied Raman. “When you want something, concentrate only on that: no one will ever hit a target they cannot see.”

Rabies News (Dr A K Gupta)

What precautions should be taken while vaccinating by the ID route?

  • The ID injections must be administered by staff trained in this technique.
  • The vaccine vials must be stored at+2°C to + 8°C after reconstitution.
  • The total content should be used as soon as possible, but at least within 8 hours.
  • The 0.1 ml. ID administration of cell–culture vaccine should create a wheal of at least 5 mm diameter with "peau de orange" appearance.
  • If ID dose is given subcutaneously then there is a possibility of poor immune response due to low antigen load. This may be life–threatening.

Cardiology eMedinewS

  • A third-generation transcatheter heart valve, Sapien 3 transcatheter valve, addresses issues with earlier valves and was associated with improved ease of use, accuracy of positioning and paravalvular sealing (J Am Coll Cardiol. 2014;64:2235-2243). The rates of mortality and stroke with transfemoral access are among the lowest reported and support further evaluation as an alternative to open surgery in intermediate-risk patients.
  • Patients who were obese before developing heart failure lived longer than normal weight patients with the same condition according to a new study in the Journal of the American College of Cardiology that examined the "obesity paradox" by following obese and non-obese heart failure patients for more than a decade.

Pediatrics eMedinewS

  • Artemisinin-naphthoquine drug-combo should be considered for the treatment of children with uncomplicated malaria in settings where multiple parasite species cause malaria, according to Tim Davis from the University of Western Australia.
  • Parents whose children were part of a school-centered, community-based obesity prevention program reported losing a modest amount of weight over the course of the 2-year intervention, according to a study published online December 18 in the American Journal of Public Health.

Quote of the Day

Most people have no idea of the giant capacity we can immediately command when we focus all of our resources on mastering a single area of our lives. Anthony Robbins

Wellness Blog

Is caffeine good for health?

Caffeine is the most consumed stimulant in the world. It is consumed in the form of coffee and tea.
At present there is no scientific data for promoting or discouraging coffee and/or tea consumption in the daily diet. Short term benefits include mental alertness and improved athletic performance. Long-term benefits are dose-dependent. Caffeine is associated with a reduced risk of Parkinson disease, Alzheimer disease, alcoholic cirrhosis, and gout. Coffee, both caffeinated and decaffeinated, is associated with a lower risk of type 2 diabetes.

Short term adverse effects are headache, anxiety, tremors, and insomnia. Long term adverse affects include generalized anxiety disorder and substance abuse disorders. Heavy coffee intake may trigger coronary and arrhythmic events in susceptible individuals, although coffee intake is not considered a long-term risk factor for myocardial disease. Most studies show a modest inverse relationship between coffee consumption and all-cause mortality. Caffeine withdrawal is a well-documented clinical syndrome with headache being the most common symptom. (Source: Uptodate)

ePress Release

Over 50 focus only on upper blood pressure

For patients over 50, doctors only need to monitor the upper systolic blood pressure, and can ignore the lower diastolic blood pressure reading, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Honorary Secretary General Indian Medical Association.

Systolic blood pressure – the top number in a blood pressure reading – is the pressure exerted at the beginning of the heart's pumping cycle, while diastolic pressure records the lowest pressure during the resting cycle of the heart. Both pressures are routinely measured when recording the blood pressure.

As per a report published in the journal The Lancet, there is such an emphasis on diastolic pressure that the patients are not getting their systolic blood pressures adequately controlled. The fact is that people over the age of 50 probably do not even need to measure diastolic pressure, it is only the systolic blood pressure that should be the focus.

Generally, systolic blood pressure continues to increase with age, while diastolic pressure starts to drop after age 50, which is the same time when cardiovascular risk begins to rise. Therefore, there is an increased prevalence of systolic hypertension past age 50, whereas diastolic hypertension is practically nonexistent. Rising systolic pressure is the most significant factor in causing stroke and heart disease.

For people under 50, the scenario may be different. About 40 percent of adults under 40 years of age have diastolic hypertension, and about a third of those between 40 and 50 have the problem. For these patients, a continued emphasis on both systolic and diastolic blood pressures is needed. However, controlling systolic blood pressure, even among these younger patients, almost always results in adequate control of diastolic blood pressure, too.

For people 50 or older, systolic pressure is high if it is 140 mmHg or above.

eMedi Quiz

Isotopic response is seen in scars of which condition?

a. Orolabial herpes
b. Herpes genitalis
c. Pyoderma gangrenosum
d. Eosinophilic pustular folliculitis

Yesterday’s Mind Teaser: Formation of antibody against acetylcholine receptor in pemphigus can be explained by

a. Desmoglein compensation theory
b. Antibody excess prozone phenomenon
c. Anti idiotypic d. Epitope spreading phenomenon

Answer for yesterday’s Mind Teaser: d. Epitope spreading phenomenon

Correct answers received from: Dr Rakesh Sharma

Answer for 2nd January Mind Teaser: b. Medina-Ramirez reaction

Correct answers received from: Dr Avtar Krishan, Daivadheenam Jella, Dr Poonam Chablani

Send your answer to email

medicolegal update

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medical query

medicolegal update

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medicolegal update

medicolegal update
  1. Dear Dr KK Aggarwal, Greetings, I wish you and your family a very happy prosperous New Year 2015. From: Dr JS Bhargava, Ex Prof of Surgery, PGIMS, Rohtak and Family.

eMedinewS Special

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

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)