eMedinewS6th March 2014, Thursday

Dr K K AggarwalPadma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, National Vice President Elect, Indian Medical Association; Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10–13); Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04);
For updates follow at
www.twitter.com/DrKKAggarwal
www.facebook.com/Dr KKAggarwal

Victory for the medical profession

The Lucknow Bench of the Allahabad High Court has taken suo moto cognizance of the ongoing strike of doctors in UP and has ordered a judicial inquiry into the Kanpur incident that led to doctors' strike. The probe will be carried out by a former judge.

This comes as the doctors' strike entered Day 5 on Wednesday. The strike has crippled the state of Uttar Pradesh as it spread to other parts too. The protest broke out after 24 junior doctors at Kanpur medical college were held for getting into a scuffle with Samajwadi Party workers.

Doctors met UP Chief Minister Akhilesh Yadav on Tuesday evening after which he gave assurances that all charges against the 24 arrested doctors will be dropped. However, he did not give any assurance to the doctors on strike of any action taken against the accused SSP and MLA.

The protests began after the supporters of SP MLA Irfan Solanki allegedly clashed with doctors at a Kanpur hospital over the reported mistreatment of a patient. The doctors claim that they were mercilessly beaten up by the police, whereas the police claim that the doctors pelted stones at them.

The Court also ordered transfer of top Kanpur cop for police crackdown on doctors after clashes last week

American Geriatrics Society (AGS) released their second "Top 5" list of low–value practices in the care of older adults.

Recommendation 1: Don’t prescribe cholinesterase inhibitors for dementia without periodic assessment for perceived cognitive benefits and adverse gastrointestinal effects.

The rationale: Although some patients with mild–to–moderate and moderate–to–severe Alzheimer disease (AD) achieve modest benefits with use of cholinesterase inhibitors, including delayed cognitive and functional decline and decreased neuropsychiatric symptoms, the impact of these drugs on institutionalization, quality of life, and caregiver burden are less well established. Treatment plans must also include advanced care planning, patient and family education, diet and exercise, and other non–pharmacologic approaches.

Recommendation 2: Don’t recommend screening for breast or colorectal cancer, or prostate cancer (with the prostate–specific antigen (PSA) test), without considering life expectancy and the risks of testing, over diagnosis, and overtreatment.

The rationale: Cancer screening is associated with a number of risks, including the risk for overdiagnosis and unnecessary treatment. The number needed to screen and treat in order to prevent a single death is over 1000 for both breast and prostate cancer in elderly adults.

Recommendation 3: Avoid using prescription appetite stimulants or high–calorie supplements for treatment of anorexia or cachexia in older adults. Instead, optimize social supports, provide feeding assistance, and clarify patient goals and expectations.

The rationale: Although high–calorie supplements increase weight in older people, there is no evidence that they affect other important clinical outcomes, such as quality of life, mood, functional status, or survival. Stimulants such as megestrol acetate and cyproheptadine should be avoided in older adults, as noted in the 2012 AGS Beers criteria. Studies of cannabinoids, dietary polyunsaturated fatty acids (DHA and EPA), thalidomide, and anabolic steroids have not demonstrated the efficacy or safety of these agents for weight gain in elderly adults.

Recommendation 4: Don’t prescribe a medication without conducting a drug regimen review.

The rationale: Older patients use more prescription and nonprescription drugs than other populations. This increase in medication burden –– particularly concerning when high–risk and potentially additive medications are used –– may lead to diminished adherence; adverse drug reactions; and increased risk for cognitive impairment, falls, and functional decline. Medication review identifies high–risk medications, drug interactions, and those continued beyond their indication.

Recommendation 5: Avoid physical restraints to manage behavioral symptoms of hospitalized older adults with delirium.

The rationale: Physical restraints can lead to serious injury or death and may worsen agitation and delirium. Effective alternatives include strategies to prevent and treat delirium, identification and management of conditions causing patient discomfort, environmental modifications to promote orientation and effective sleep/wake cycles, frequent family contact, and supportive interaction with staff. Physical restraints should only be used as a very last resort and should be discontinued at the earliest possible time.

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Zee News – Health Wealth Show

today emedipics

Cancer Prevention-Health Wealth Zee News Show2
Potbelly Obesity–Health Wealth Zee News Show
Cancer Prevention–Health Wealth Zee News Show1
Vitamin D Health Wealth
Pneumonia–Health Wealth Zee News Show
Sudden Cardiac Death
Depression
Can Alcohol be Prescribed as Medicine
Health Wealth: All about Paralysis

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

Facts about Soul and the Spirit

sprritual blog

1. Energy is the raw material of the universe.

2. Information is the organization of energy into reproducible patterns.

3. Consciousness is living information and energy (living energized information)

4. Consciousness is, therefore, intelligence.

5. Intelligence is information and energy that has self–referral or the ability to learn through experiences and the ability to reinterpret and influence one’s own information and energy states.

6. Consciousness is live, advanced, software–driven energized information.

Nearest example: Advanced computer software which can type, correct, interpret, edit and store spoken or read information.

cardiology news

A Most Important Lesson

During my second month of nursing school, our professor gave us a pop quiz. I was a conscientious student and had breezed through the questions, until I read the last one: "What is the first name of the woman who cleans the school?"

Surely, this was some kind of joke. I had seen the cleaning woman several times. She was tall, dark–haired and in her 50s, but how would I know her name? I handed in my paper, leaving the last question blank. Just before class ended, one student asked if the last question would count toward our quiz grade.

"Absolutely," said the professor. "In your careers, you will meet many people. All are significant. They deserve your attention and care, even if all you do is smile and say ‘hello’." "I’ve never forgotten that lesson. I also learned her name was Dorothy.

Moral: Every person no matter who it is should be considered equal... something that we all forget so easily. To value a person regardless of their status is the highest noble work.

News Around The Globe

Anger can be a trigger for Heart Attack or Stroke

A flash of anger may precipitate heart attack or stroke in susceptible individuals within two hours of anger episode as per a systematic review showed by Murray Mittleman, DrPH, of the Harvard School of Public Health, and colleagues in the European Heart Journal.

The relative risks estimated in this meta–analysis indicate that there is a higher risk of cardiovascular events after outbursts of anger among individuals at risk of a cardiovascular event, but because each episode may be infrequent and the effect period is transient, the net absolute impact on disease burden is extremely low. However, with increasing frequency of anger episodes, these transient effects may accumulate, leading to a larger clinical impact.

In pooled results of four of the studies, the risk of MI or acute coronary syndrome was 4.74–fold higher in the hours after an outburst. One study evaluated intracranial hemorrhage and showed that the risk was higher in the hour after a bout of anger.

Mediated through increases in circulating catecholamines, increased myocardial oxygen demand, coronary vasospasm, and increased platelet aggregability, anger can cause transient ischemia, disruption of vulnerable plaques, and increased thrombotic potential.

New guide lines for doctors to examine and treat the Sexually assaulted victims

These guide lines were drawn by MOH with the help of The Department of Health Research (DHR) along with Indian Council of Medical Research (ICMR) to formulate the set of national guidelines for dealing with criminal assault cases.

  1. That every hospital must have a designated room to deal with Medico Legal Cases of sexual assault to provide privacy to the victim and must have essential equipments listed in the guidelines.
  2. While carrying out medical tests no third person must be present in the room other than the doctor. If the doctor is male, a female attendant must be there.
  3. Provide comprehensive care which must address issues like physical injuries, STDs, HIV, Hepatitis B, etc. Also the psychological effects must be recognised and the patient shall be provided counselling, social support and appropriate referrals.
  4. The maligned two–finger test that was used by doctors to opine whether the girl is habituated to sexual intercourse or not, has been outlawed.
  5. Doctors are asked not to use word rape in their opinion, as it is a legal definition and not a medical diagnosis.
  6. Names of samples, its preservative and purpose of analysis for forensic lab has to be printed itself on the form before sending it to FSL (forensic science lab).
  7. A provision for DNA analysis has also been done. A separate form for medical management as a check list has been provided too.
  8. The doctors should examine rape cases without an FIR if the survivor reports to the hospital first.
  9. Obtaining "informed consent" of the victim( explained in the manner and language which the patient can understand) is mandatory before starting treatment and so is informing the police.

DMC partners with BMJ to provide an Online CME Programme for doctors

In an endeavour to provide highest evidence based, editorially independent peer reviewed medical information to its doctors Delhi Medical Council signed a MoU with BMJ to provide an Online CME Programme. This online programme has been based on learning needs of healthcare professionals independent of pharmaceutical industry for better patient care.

With this announcement a three month free BMJ Learning platform will be available for DMC members. The portal will be customized as learning.bmj.com/dmc and will be populated with the message from the President of DMC and regularly updated with recommended BMJ Learning modules for the DMC members. All the BMJ Learning online CME (continuous medical education) modules are accredited by Delhi Medical Council for one credit hour/CME point and doctors completing the online modules will be awarded with a joint completion certificate.

BMJ Learning editorial team would also work with DMC CME committee and create Indian modules which will be as per the needs and objectives of the state council.

Talking about the association, Dr. Arun Kumar Agarwal, President, Delhi Medical Council said; "We have been constantly striving towards taking initiative around the better education programme for our members. With this association we aim to develop a custom designed online learning website for our members and jointly contribute towards the clinical as well as academic needs of the DMC doctors."

CPR 10 success stories

1. Hands–only CPR 10 English

2. Hands–only CPR 10 (Hindi)

3. Ms Geetanjali, SD Public School Successful Story

4. Success story Ms Sudha Malik

5. BVN School girl Harshita does successful hands–only CPR 10

6. Elderly man saved by Anuja

eMedinewS e–gifts to our readers

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Rabies News (Dr. A K Gupta)

Is there any dietary restriction during PEP?

It is advisable to abstain from alcoholic drinks during the course of rabies vaccination as it may affect the immune response.

cardiology news

5 Ways to Use less Salt

  1. Use spices and other flavor enhancers such as spices, dried and fresh herbs, garlic and ginger, citrus, vinegars and wine. Flavors can be black pepper, cinnamon and turmeric to fresh basil, chili peppers, and lemon juice.
  2. Use the right healthy fats — from roasted nuts and avocados to olive, canola, soybean and other oils.
  3. Searing and sautéing foods in a pan builds flavor. Roasting brings out the natural sweetness of many vegetables and the taste of fish and chicken. If you do steam or microwave food, perk up these dishes with a finishing drizzle of flavorful oil and a squeeze of citrus.
  4. Get your whole grains from sources other than bread. White bread contains salt, not just for flavor but to ensure that the dough rises properly.
  5. Shop for raw ingredients with maximum natural flavor, thereby avoiding the need to add as much (if any) sodium. (Harvard)
cardiology news

Total CPR since 1st November 2012 – 86664 trained

Media advocacy through Web Media

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press release

Women should quit smoking to lower their risk of heart disease

Smoking is still the leading preventable cause of death. Not only does tobacco smoke cause lung cancer, it is also implicated in heart disease, other cancers and respiratory diseases. As per WHO, an estimated 3 million people in industrialized countries will have died as a result of tobacco use by 2030, and an additional 7 million people in developing countries face the same fate.

The harms of smoking are reversible and can decline to the level of nonsmokers, as per a report in Journal of the American Medical Association, 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 Sr National Vice President Indian Medical Association

Women who quit smoking have a 21 percent lower risk of dying from coronary heart disease within five years of quitting their last cigarette. The risks of dying from other conditions also decline after quitting, although the time frame varies depending on the disease. For chronic obstructive pulmonary disease, it may take up to 20 years. It’s never too early to stop, and it’s never too late to stop.

Women who are current smokers have almost triple their risk of overall death compared with non smoker women. Current smokers also have a 63 percent increased risk for colon cancer compared with never–smokers, while former smokers have a 23 percent increased risk. There was no significant association between smoking and ovarian cancer.

Women who started smoking earlier in life are at a higher risk for overall mortality, of dying from respiratory disease and from any smoking–related disease. However, a smoker’s overall risk of dying returns to the level of a never–smoker 20 years after quitting. The overall risk decline by 13 percent within the first five years of abstaining. Most of the excess risk of dying from coronary heart disease vanishes within five years of quitting.

For chronic obstructive pulmonary disease, the return to normal takes 20 years, although there is an 18 percent reduction in the risk of death seen within five to 10 years after quitting.

And the risk for lung cancer does not return to normal for 30 years after quitting, although there is a 21 percent reduction in risk within the first five years.

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 86664 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."

emedipicstoday emedipics

Mega heart checkup camp by Heart Care Foundation of India at Sagar,Madhya Pradesh February 20–23,2014

press release

Weight loss may improve sexual health of obese diabetes

vedio of day

today video of the dayPadma Shri & Dr B C Roy National Awardee,Dr KK Aggarwal on Tackling tension headaches

Hands only CPR 10 Utsav, 15th December 2013

Dr KK Aggarwal receives Harpal S Buttar Oration Award from Nobel Laureate Dr Ferid Murad

eMedi Quiz

A 64 Year old hypertensive obese female was undergoing surgery for fracture femur under general anaesthesia. Intra operatively her end–tidal carbon–dioxide decreased to 20 from 40mm of Hg. followed by hypotension and oxygen saturation of 85%. What could be the most probable cause?

1.Fat embolism.
2.Hypovolemia.
3.Bronchospasm.
4.Myocradial infarction.

Yesterday’s Mind Teaser: At the end of a balanced anaesthesia technique with non–depolarizing muscle relaxant, a patient recovered spontaneously from the effect of muscle relaxant without any reversal. Which is the most probable relaxant the patient had received?

1.Pancuronium.
2.Gallamine.
3.Atracurium.
4.Vecuronium.

Answer for yesterday’s Mind Teaser: 3.Atracurium.

Correct answers received from: Dr PC Das, Dr Jayashree Sen & Dr Bitaan Sen,
Dr Raghavendra Jayesh, Dr Arpan Gandhi, Dr Gelivi Sahadevudu, Dr Jainendra Upadhyay,
Dr Chandresh Jardosh, Dr S Tipu, Dr Avtar Krishan, Arvind Diwaker.

Answer for 4th March Mind Teaser: 4. Oxygen affinity of haemoglob

Correct answers received from: Dr Gelivi Sahadevudu.

Send your answer to ijcp12@gmail.com

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medicolegal update

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medical querymedical query

medicolegal update
medicolegal update

Absent–minded professor

One of the world’s greatest scientists was also recognized as the original absent–minded professor. One day, on board a train, he was unable to find his ticket. The conductor said, "Take it easy. You'll find it."

When the conductor returned, the professor still couldn’t find the ticket. The conductor, recognizing the famous scientist, said, "I’m sure you bought a ticket. Forget about it."

"You’re very kind," the professor said, "but I must find it, otherwise I won’t know where to get off."

medicolegal update

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medicolegal updatemedicolegal update

medicolegal update

Situation: An adult undergoing bronchoscopic biopsy developed infective endocarditis.
Reaction: Oh my God! Why was IE prophylaxis not given?
Lesson: Make sure, that all procedures of the respiratory tract that involve incision or biopsy of the respiratory mucosa include IE prophylaxis.

medicolegal update

It is strange that those we miss the most Are those we take for granted. Sir John Betjeman

medicolegal update

Dr KK Aggarwal: Weight gain precedes the onset of diabetes Weight gain after age of 18 years in women and 20 years in men (cont) http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Fluidity & flow in every moment as it unfolds in an eternal now is lightness of being http://bit.ly/WAHF_Am #WAYHF

Forthcoming events

Date: Saturday 2PM–Sunday 3PM, 26–27 April 2014
Venue: Om Shanti Retreat Centre, Bhora Kalan, Pataudi Road, Manesar
Course Directors: Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal and BK Sapna
Organisers: Heart Care Foundation of India. Prajapati Brahma Kumari Ishwariye Vidyalaya and eMedinews
Facilities: Lodging and boarding provided (one room per family or one room for two persons). Limited rooms for first three hundred registrants.
Course: Meditation, Lectures, Practical workshops
Atmosphere: Silence, Nature, Pyramid Meditation, Night Walk
Registration: SMS– Vandana Rawat – 9958771177, rawat.vandana89@gmail.com
SMS – BK Sapna 9650692204, bksapna@hotmail.com

Note: Donation in Favor of Om Shanti Retreat Centre will be welcomed

medicolegal update
  1. Dear Sir, Very Informative Newspaper. Regards: Dr Karan

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