eMedinewS5th September 2013, Thursday

Dr K K Aggarwal Padma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; 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

eMedinewS, IJCP & Heart Care Foundation of India extend their best wishes to Dr K K Aggarwal, Group Editor–in–Chief on his 55th birthday

God give me Strength to serve you for another 45 years

Dr K K Aggarwal
Dr K K Aggarwal

A dialogue between Krishan Kumar and Dr KK Aggarwal

Today I would like to share with you a little anecdote about how I came to be called Dr KK.

My name was Krishan Kumar till I came to Moolchand Hospital. All my school days and through college I was called Krishan. I joined Moolchand Hospital in the year 1983 and began my professional career with Dr (Col) KL Chopra. His wife said that she could not address me by my name Krishan as that was the name I shared with her husband, Dr KL Chopra. So, she gave me a new name, KK.

And that name has now stuck and it is by this name that I am now known as. To my colleagues I am Dr KK and to my friends, I am simply KK. Krishan Kumar was my name in my pre–Moolchand days and after 1983, I got the name KK.

Below is a conversation between Dr K K, the present me and Krishan, my school and college past and how grateful Dr KK is to Krishan for having lived his life the way he did.

Dr KK: Krishan, why did you not take up smoking?

Krishan: My family values were such that they did not allow me to smoke. Also, I came from a very humble background. We were not financially well off and so also I could not afford to develop such habits. I went to Wardha for my MBBS and MD and there I was greatly influenced by Gandhian ideology.

Dr KK: What about alcohol. Why do you not take alcohol?

Krishan: I never thought of taking alcohol for the same reasons I never started smoking. My family values, financial status and the teachings of Gandhi during my college days were my motivation in not drinking alcohol. They helped me to be strong and resist any peer pressure or such other influences.

Dr KK: Krishan how did you become interested in spirituality?

Krishan: My parents were very religious. So, I think my inclination towards spirituality began right from by childhood. I went to Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sevagram. This was the place where Mahatma Gandhi set up his ashram. We stayed in Bapu’s ashram for 10 days. We also had prayers every Fridaywhile in college. This further fuelled my interest in spirituality. When I began working with Dr (Col) KL Chopra, I was exposed to spiritual teachings. All these contributed to my moral make up. Later on, I was greatly influenced by his son, Dr Deepak Chopra.

Dr KK: You had to go far away from home to Wardha to study medicine. Krishan, were you disheartened that you could not secure admission in a medical college in Delhi?

Krishan: No, in fact, this proved to be a blessing in disguise. I topped Nagpur University in the aggregate of all MBBS marks and received two University gold medals. I was declared the Best Graduate of the College in 1979. I returned to Delhi a person of good character and the capability to be a good doctor.

Dr KK: Krishan, I am very thankful to you that through your hard work and perseverance, I became a much better person and so became a good doctor. It is because of the person that you were that I received the prestigious Dr BC Roy National Award and subsequently the Padma Shri, the fourth highest civilian award of our country. ….Read More

sprritual blog Was Lord Ganesha born of a induced pluripotent stem cell transplant?

Today West claims that they can make human bladder tissue from the human skin cells. But was not lord Ganesha created by Parvati from the dirt of her body? The dirt, from allopathic point of view would equate to the cells of her skin. In today’s terms Ganesha birth can be explained as the origin of a stem cell baby birth in the literature.

First identified in the hematopoietic blood system, stem cells are present in many other tissues. All stem cells are capable of self–renewal and they can differentiate.

Self–renewal is the ability to proliferate without the loss of differentiation potential and without undergoing biologic aging. Stem cells can divide symmetrically (in which both daughter cells are either stem cells or differentiated cells) or asymmetrically (yielding both a stem cell and a more differentiated cell)

Stem cells can be either totipotent, pluripotent, multipotent, or unipotent. Totipotent cells can produce all cell types (embryonic and extra embryonic placenta). Pluripotent cells can only make cells of the embryo proper. Multipotent cells can only make cells within a given germ layer. Unipotent cells make cells of a single cell type.

In 2006 Shinya Yamanaka and colleagues introduced genes expressed in pluripotent cells into mature cells by a process, called reprogramming and induced a pluripotent state in a previously differentiated cell type. These cells are now called induced pluripotent cells (iPS).

iPS technology has revolutionized science today. A keratinocyte derived from the skin can be induced to become a pluripotent stem cell.

Also a cell taken from an individual can be induced to become a cell type capable of forming any other cell type. A skin obtained from a patient with a degenerative brain disorder is now used as a drug after getting converted into a pluripotent cell.

Today the recognition that a cell taken from an individual can be induced to become pluripotent (a cell type capable of forming any other cell type in that individualís body) has provided unprecedented opportunities for regenerative medicine.

Today most easily accessible patient cell types, such as skin fibroblasts or blood cells are being reprogrammed to iPS.

Theoretically therefore it is possible to make any tissue from iPS. That means the skin cells can make liver, brain, heart or in fact the whole baby.

It looks that this technology claimed by the Western scientists of converting skin cell into iPS cell was available in our Vedic era and the birth of Ganesha by Parvati might have been an example of the first human baby made from the skin iPS. ….Read More

cardiology news

Helping Hands

A mother, wishing to encourage her son's progress at the piano, bought tickets to a performance by the great Polish pianist Ignace Paderewski. When the evening arrived, they found their seats near the front of the concert hall and eyed the majestic Steinway waiting on the stage. Soon the mother found a friend to talk to, and the boy slipped away.

At eight o’clock, the lights in the auditorium began to dim, the spotlights came on, and only then did they notice the boy – up on the piano bench, innocently picking out "Twinkle, Twinkle Little Star." His mother gasped in shock and embarrassment but, before she could retrieve her son, the master himself appeared on the stage and quickly moved to the keyboard.

He whispered gently to the boy, "Don’t quit. Keep playing." Leaning over, Paderewski reached down with his left hand and began filling in the bass part. Soon his right arm reached around the other side and improvised a delightful obligato. Together, the old master and the young novice held the crowd mesmerized with their blended and beautiful music.

In all our lives, we receive helping hands – some we notice, some we don’t. Equally we ourselves have countless opportunities to provide helping hands – sometimes we would like our assistance to be noticed, sometimes we don’t. Little of what we all achieve is without learning from others and without support from others and what we receive we should hand out.

News Around The Globe

  • More than half of all patients with hypertension globally remain unaware of their condition, as reported by Salim Yusuf, MD, DPhil, of Hamilton General Hospital in Hamilton, Ontario, and colleagues in the Journal of the American Medical Association. Among a population of patients from 17 countries with hypertension, only 46.5% were aware of their diagnosis. The majority of those who were did know they had high blood pressure received drug treatment for hypertension (87.5%), but only about a third of those had their hypertension under control (32.5% of those receiving drug treatment).
  • According to the CDC, preventable deaths from cardiovascular disease are on the decline but are still too high, particularly in younger adults and blacks. The overall rate of avoidable deaths from heart disease, stroke, and hypertensive disease before age 75 declined 29% from 2001 to 2010. But 56% of these deaths were in people younger than 65, a group for whom less improvement occurred.
  • Despite widespread implementation of quality improvement initiatives, an estimated $9.8 billion are spent each year treating hospital–acquired infections (HAIs), according to a study published online September 2 in JAMA Internal Medicine. Of the top 5 HAIs, surgical site infections contributed the most to overall costs (33.7%), followed by ventilator-associated pneumonia (31.6%), central line–associated bloodstream infections (CLABSIs; 18.9%), Clostridium difficile infections (15.4%), and catheter–associated urinary tract infections (CAUTIs; <1%).
  • A new subcutaneous formulation of trastuzumab (Herceptin, Genentech/Roche) has been approved by the European Commission. The targeted therapy, considered a breakthrough when it was developed for the treatment of HER2–positive breast cancer, is usually administered intravenously. The subcutaneous formulation is administered as a 600 mg/5 mL fixed dose every 3 weeks. For the usual intravenous administration, patients attend a hospital or clinic, and each infusion takes 30 to 90 minutes to administer. In contrast, the new subcutaneous formulation takes only 2 to 5 minutes to administer.
  • According to a prospective study published in Cancer Causes and Control, drinking 4 or more cups of coffee a day is associated with a lower risk for prostate cancer recurrence and progression. Men who drank that much coffee daily had a 59% reduced risk for prostate cancer recurrence and/or progression, compared with those who drank 1 or fewer cups per week.

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Rabies News (Dr. A K Gupta)

What are the common adverse reactions to HRIG?

In rare cases, the following adverse reactions to HRIG may occur:

  • Allergic reactions including fall in blood pressure, dyspnea, cutaneous reactions and, in isolated cases reaching as far as anaphylactic shock, even when the patient has shown no hypersensitivity to previous administration of immunoglobulins.
  • Generalized reactions such as chills, fever, headache, malaise, nausea, vomiting, arthralgia and moderate back pain
  • Cardiovascular reactions, particularly if HRIG is inadvertently injected intravenously.
  • Local reactions such as local pain, tenderness or swelling at the injection site can be observed in rare cases.
cardiology news
  • Saxagliptin and alogliptin, two oral antihyperglycemic agents, did not increase the risk of cardiovascular events in patients with type 2 diabetes mellitus in two major trials presented at the European Society of Cardiology (ESC) 2013 Congress. These trials were Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus (SAVOR–TIMI 53) study and the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care in Patients with Type 2 Diabetes Mellitus and Acute Coronary Syndrome (EXAMINE) study.
  • Suspected acute coronary syndrome (ACS) patients with a negative troponin test and a negative copeptin test (Brahms, Thermo Scientific) can be safely discharged from the hospital without further testing, according to the results of a new study, the Biomarkers in Cardiology 8 (BIC-8) trial, presented at the ongoing European Society of Cardiology (ESC) 2013 Congress. Copeptin is a marker of severe hemodynamic stress and is detectable immediately in patients with acute MI.

Valvular Heart Disease News

The clinical presentation of pediatric infective endocarditis is variable and is generally classified as either a subacute or acute process.

(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
  • An economic analysis of the Hydroxyurea to Prevent Organ Damage in Children With Sickle Cell Anemia (BABY HUG) trial data published September 2 in Pediatrics, hydroxyurea treatment of young children with sickle cell anemia results in a significantly lower overall medical care cost when compared with placebo. The total estimated annual cost for the hydroxyurea group was $11,072 per patient vs $13,962 per patient in the placebo group (P = .038). This savings is likely to increase as the children age, further justifying widespread use of hydroxyurea in this patient population.
  • Four immunization schedules with 13–valent pneumococcal vaccine (PCV13) in healthy term infants produced no significant differences in antibody levels after a booster dose for almost all serotypes. In secondary analyses, researchers found differences in protection levels between schedules during the primary dosing period, but all children reached equally high IgG levels after the booster dose. The findings are reported online September 3 in JAMA.
cardiology news

Treatment for constipation in the elderly

Patients older than 70 years being treated with enemas for constipation, water enemas should be used rather than sodium phosphate enemas

The commonly used treatment for constipation is sodium phosphate enemas. There is evidence that the use of sodium phosphate enemas may be associated with serious adverse events.

In a retrospective series, the use of sodium phosphate enemas in older adults for constipation was associated with complications including hypotension and volume depletion, hyperphosphatemia, hypo–or hyperkalemia, metabolic acidosis, severe hypocalcemia, renal failure and EKG changes (prolonged QT interval).

Preparation for flexible sigmoidoscopy also involves sodium phosphate enemas. Here, also one should use polyethylene glycol lavage or magnesium citrate) for each individual patient before deciding upon an appropriate preparation. (Arch Intern Med 2012;172:263)

cardiology news

CMAAO India Conference will be held from September 12 to 14, 2013 at Hotel Shangri La, New Delhi

CMAAO represents Confederation of Medical Associations in Asian and Oceania. The theme for the conference on 12th and 13th will be "Be Human Stop Child Abuse" and on 14th will be "Lifestyle disorders".

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


Anger recall is as bad as Anger itself

Even recall of anger is dangerous, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Anger recall causes sympathetic overactivity. The resulting increased adrenaline and noradrenaline levels lead to plaque rupture and consequently a heart attack or myocardial infarction (MI).

Anger recall is as bad as anger itself, which can be expressive or suppressive. Both are dangerous.

Expressive anger causes plaque to rupture leading to heart attack or MI, while suppressive anger causes chronic sympathetic overactivity that helps plaque formation.

The answer is anger management and not expression nor suppression of anger.

Those people who get angry and are heart patients should not miss their aspirin dose as aspirin takes away the bad effects of anger.

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

A CPR 10 Training Camp was organized by Heart Care Foundation of India to train the students of Modern School Noida on 14th August

press release

Treatment for constipation in the elderly

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…………………

Nurse Agnes is reviewing the report of a clientís routine urinalysis. Which value should the nurse consider abnormal?

a. Specific gravity of 1.03
b. Urine pH of 3.0
c. Absence of protein
d. Absence of glucose

Yesterday’s Mind Teaser: A female client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis, Nurse Sarah knows that the client is most likely to experience:

a. Hematuria.
b. Weight loss.
c. Increased urine output.
d. Increased blood pressure.

Answer for yesterday’s Mind Teaser: b. Weight loss.

Correct answers received from: Dr. V.P. Thakral, Dr Prakash Khalap, Narahari Kandakatla, Dr.K.V.Sarma, DR AJAY GANDHI, Dr Kanta Jain, Dr.K.Raju, Dr.(Maj. Gen.) Anil Bairaria, Dr Pankaj Agarwal, DR AYYAVOO ERODE, Dr Jainendra Upadhyay, Dr Chandresh Jardosh, DR.BITAAN SEN & DR.JAYASHREE SEN, daivadheenam, DR AVTAR KRISHAN

Answer for 3rd September Mind Teaser: b. The client keeps the drainage bag below the bladder at all times.

Correct answers received from: Dr Kanta Jain.

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

The Cardiologist and the Motorcycle repairman

A motorcycle mechanic was removing cylinder–head from the motor of a Harley–Davidson when he spotted a well–known cardiologist in his shop. The cardiologist was there waiting for the service manager to come and take a look at his bike when the mechanic shouted across the garage, ‘Hey Doc, want to take a look at this?’ The cardiologist, a bit surprised, walked over to where the mechanic was working on the motorcycle.

The mechanic straightened up, wiped his hands on a rag and asked, ‘So Doc, look at this engine. I opened its heart, take the valves out, repair any damage, and then put them back in, and when I finish, it works just like new. So how come I make $39,675 a year and you make $1,695,000 when you and I are doing basically the same work?’

The cardiologist paused, leaned over, and then whispered to the mechanic. ‘Try doing it with the engine running’.

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient intolerant to penicillin was denied rheumatic prophylaxis.
Reaction: Oh my God! Why was he not put on a sulfa drug?
Lesson: Make sure that patients who cannot tolerate penicillin are put on sulfadiazine or sulfisoxazole. This antibiotic class is effective for preventing group A streptococcal (GAS) infection although it cannot be used to achieve eradication.

medicolegal update

Any man’s life will be filled with constant and unexpected encouragement, if he makes up his mind to do his level best each day. Booker T. Washington

medicolegal update

Dr KK Aggarwal: Heart risks detected by age 7 in overweight kids http://bit.ly/14VajLC #Health

Dr Deepak Chopra: Love in action can create miracles. http://tinyurl.com/l6x3eo4

medicolegal update

Dear Sir, Thanks for the updates. Regards: Dr Sushma

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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