eMedinewS6th September 2014, Saturday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee

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

Happy Birthday to Me, Krishan (Dr K K Aggarwal)

On the day of my birth, I file my Vedic returns of good and bad I have done in the last one year.

We are born with both Sanchit Karma and Prarabdha Karma. Prarabdha Karma is the part of Sanchit karma, a collection of past karmas, which are ready to be experienced through the present body. We have to bear the fruits of Prarabdha Karma, while Sanchit Karma can be negated with our positive present and future Karmas.

We must also make a balance sheet of our three debts and repay them, if not paid by this time. The three debts are Dev Rin (God who gave us the birth), Pitra Rin (Parents who gave us the body) and Rishi Rin (Teachers who gave us the education)

On our birth, we must re–calculate our age as 100 minus age left or we must redefine our age by saying I am 18 years old with so many years of experience. For me 100–56 is 44. Also I am 20 years old with 36 years of experience.

On our birthday, instead of extinguishing a lamp, we should light a lamp.

Out of our Vedic earnings, we must give tax of 30% to God. This means if you have got positive earnings by 100 happiness, you must pass happiness to 30 others.

I will be filing my Vedic returns today at 6 pm today (time of my birth, coincidently it was also Friday in 1958, the year I was born). The balance so far is positive. Last year I got National Science Communication Award, international Dr Harpal S Butter Oration and now I have been elected as Honorary Secretary General of IMA.

Today is also Teachers’ Day and I received lot of wishes from my colleagues who regard me as their teacher.

Today also marks the birthday of Dr S Radha Krishnan and yesterday I received Dr Radha Krishnan Memorial Award. My name is also Krishan (as in 1958 the day I was born was Janmashtami)

When I went through the IMA constitution, I found that the term used for my post was "Honorary Secretary General" and not Secretary General. On the other hand for the President, it was National President and not Honorary National President. I wondered why and then I read the constitution again and found the answer. A Secretary General is the custodian of IMA treasure and has the authority to sanction all the financial transactions.

The custodians of IMA constitution, who at the time of making it were clear about this, and wrote the word ‘Honorary’ as a constant minute to minute reminder to the Secretary General that his work is only ‘Honorary’ and he is the custodian of IMA wealth.

On my Birthday I reaffirm that in my new assignment, I will be honest, transparent, committed, and loyal to my profession, association, senior leaders and my colleagues.

Innovations in Cardiology (IIC) Summit 2014

Dr Rajneesh Kapoor

Higher potassium intake reduces ischemic stroke

A latest analysis from the Women’s Health Initiative (WHI) study published online in Stroke September 4 has suggested that higher intake of potassium is associated with a lower risk for all stroke and ischemic stroke, especially for women without hypertension, as well as all–cause mortality in older women. WHI Higher potassium intake was also associated with a lower risk for small–vessel stroke subtype but was not linked to any reduction in hemorrhagic stroke. The WHI study is the largest prospective study and included 90,137 postmenopausal women aged 50 to 79 years at enrollment, with no history of stroke. They were followed for an average of 11 years.

News Around The Globe

  • The US Food and Drug Administration (FDA) has approved the first immunomodulator that acts as a programmed death (PD) inhibitor. Pembrolizumab, previously known as MK–3475, has been approved for use in patients with advanced or unresectable melanoma who fail to respond to other drugs.
  • A study published online in Scientific Reports has pointed that treating opioid dependence with methadone can considerably decrease testosterone levels, but only in men.
  • A new study has suggested that less time spent sitting may lengthen telomeres and protect DNA from age–related damage; however, no significant association was found in telomere length with increased exercise. The study was published online September 3 in the British Journal of Sports Medicine.
  • A study published online in JAMA Surgery has revealed that intestinal transplantation is an acceptable alternative for patients with intestinal failure after Crohn’s disease. The study also proposed a new scoring system that would help identify patients who might undergo this treatment instead of additional attempts at conventional surgery.
  • A genomic signature, in association with bilirubin and platelet tests, can help identify patients with early hepatitis C virus (HCV) cirrhosis who are at high risk for complications, suggests new research published online in the journal Gut.

Rabies News (Dr A K Gupta)

Can a person receiving/completed antirabies immunization, either pre–exposure or post–exposure, donate blood?

A person receiving/completed antirabies immunization can donate blood. However, the recipient does not benefit from the transfer of rabies-neutralizing antibodies due to hemodilution.

Cardiology eMedinewS

  • The CONFIRM HF study, presented at the European Society of Cardiology (ESC) 2014 Congress, has revealed that iron supplementation in patients with chronic heart failure and iron deficiency improves functional capacity, symptoms, and quality of life.
  • Pregnant women with mechanical valves face significantly higher risks of complications and death than pregnant cardiac patients with no prostheses, suggests a study presented at the European Society of Cardiology 2014 Congress.

Pediatrics eMedinewS

  • Nine and 10–year–olds who ate breakfast daily, particularly a high–fiber cereal, had lower fasting blood sugar and insulin levels and lesser other risk factors for type 2 diabetes, suggested a new study published online September 2 in PLOS Medicine.
  • Elevated levels of C–reactive protein in pregnant women are strongly associated with an increased risk for schizophrenia in the offspring, suggests a new study published in the September issue of the American Journal of Psychiatry.

Dr K K Spiritual Blog

How to Be Happy and Healthy

Somebody once asked Lord Buddha, "After meditating for years, I have not been able to gain anything." Then Lord Buddha asked, "Did you lose anything?" The disciple said, "Yes, I lost my anger, desires, expectations and ego." Buddha smiled and said, "That is what your gain is by meditating."

To be happy, one must learn to let go the following:

  • One should let go the desires. In Amarnath Ki Yatra, Lord Shiva firstly let go of the Bull, which represents the sexual desires. In Hanuman ki Lanka yatra, desires are represented by Samhiki, a creature who used to catch birds by their shadow. Hanuman killed the desires. So, it is possible to kill your desires.
  • Again in Ramayana, desires are linked to Rajsik mind and in mythology, Meghnath represents the Rajsik mind. Meghnath was killed by Lakshman, the determined mind. Therefore, one should let go of the desires by killing them by focused concentration of the mind on the desires.
  • Let go of your expectations. In Amarnath Ki Yatra, the second thing which Lord Shiva discarded was the moon, which in mythology is symbolized by letting go of expectations.
  • Let go of your ego. In mythology, ego represents Kansa in Krishna era and Ravana in Rama era. Both were killed by Krishna and Rama respectively, who symbolize the consciousness. Ego can never be killed by the mind and can be killed only by the consciousness (conscious–based decisions).
  • Ego is also represented by Sheshnaag and we have Lord Shiva and Lord Vishnu both having a Sheshnaag each with a mouth downwards indicating the importance of controlling one’s ego.
  • One should let go his or her ego but also remember never to hurt somebody’s ego. Hurting somebody’s ego in terms of allegations of sexual misconduct, financial corruption or abusing one’s caste is never forgotten and carries serious implications.
  • In Hanuman Ki Lanka Yatra, ego is represented by Sursa and Hanuman managed her by humility and not by counter ego. In Naag Panchami also, we worship Naag, the ego, by folded hands and by offering milk.
  • Let go of your inaction. One should learn to live in the present. In Hanuman Ki Lanka Yatra, Hanuman first meets Menak Mountain, which indicates destination to rest. One should never do that and willfully divert his or her mind towards action.
  • Let go of your attachments. Let go of your attachments to your close relatives and the worldly desires. In Amarnath Ki Yatra, Lord Shiva first leaves Bull (desires), moon (expectations), sheshnaag (ego) and then he gives up Ganesha and worldly desires (five elements). In mythology, this is practiced as detached attachment and in Bhagavad Gita is equated to Lotus. In Islam, detached attachment is practiced in the form of Bakra Eid.
  • Let go of your habit of criticizing, complaining and condemning people. One should always practice non–violent communication and speak which is truth, necessary and kind. One should not criticize, condemn or complain about people, situation and events. Wayne Dyer said, "The highest form of ignorance is when you reject something you do not know anything about."
  • Most of us often condemn people without knowing their capabilities and label them as unmatchable to us. One should also let go habit of gossiping as it is a form of violent communication.
  • Let go of your habit of blaming others: One should learn to take the responsibilities and people believe in team work. Good leader is the one who learns to be responsible in life.
  • Let go of your need to be always right: It is a form of ego. Remember, in arguments either you can win arguments or relationships. Always try to win relationship and not arguments.
  • Let go of your need to control situations, events and people: Learn to accept people as they are. The world is won by those who let this habit go.
  • Let go of your habit and the need to impress others: This is also a type of ego where we always seek appreciation.
  • Give up your belief that you cannot do it: Remember ‘IMPOSSIBLE’ is ‘I M POSSIBLE’. A belief is not an idea held by the mind but it is a mind that holds the mind. (Elli Roselle).
  • Give up your resistance to change: Remember change is the only constant which will happen and always welcome it. Joseph Campbell once said that one should follow one’s bliss and will open doors to your where there are only walls.
  • Let go of your fear and all negative thoughts: Remember, the mind is a superb instrument if used rightly. It becomes very destructive if used badly. (Eckhart Tolle).
  • Let go of your habit of giving excuses.
  • Let go of always being in the past.

Wellness Blog

Why is my nose bleeding?

Nosebleed is a common problem, occurring in up to 60 percent of the general population and is often because of a respiratory illness or dry conditions. Nasal drying is common in the hot summer months because of the extreme temperature and dry air due to use of air conditioners. Here are some typical reasons for nosebleeds:

  • Nasal allergies
  • Blowing your nose too hard or trying to remove something from inside the nose
  • A result of "popping" the ear
  • Nasal exposure to chemicals
  • Frequent sneezing or having an upper respiratory infection
  • Use of nasal spray or a blood–thinning drug, such as aspirin
  • Inhaling air that is extremely dry or cold
  • Having recent surgery on the nose or elsewhere on the face
  • Breaking the nose or a similar injury
  • Uncontrolled blood pressure

Bleeding can be controlled by direct pressure i.e. compression of the nostrils rasping the alae distally so all mucosal surfaces are opposed. Direct pressure should be applied continuously for at least five minutes, and for up to 20 minutes. The patient should be encouraged not to check for active bleeding. Patients who are properly instructed may control their bleeding while the evaluation gets underway.

Other maneuvers include bending forward at the waist while sitting up (to avoid swallowing blood), placing a plug of cotton wool or gauze into the bleeding nostril (sometimes coated with antibiotic ointment), expectorating out blood that accumulates in the pharynx and applying a cold compress to the bridge of the nose.

These maneuvers also should be taught to high–risk patients for use at home. Many ENT specialists recommend initial treatment with two puffs of oxymetazoline to hasten hemostasis.

Inspirational Story

Darts

A young lady named Sally relates an experience she had in a Seminary Class, given by her teacher, Dr. Smith. She says Dr. Smith was known for his elaborate object lessons.

One particular day, Sally walked into the seminary and knew they were in for a fun day. On the wall was a big target and on a nearby table were many darts. Dr. Smith told the students to draw a picture of someone that they disliked or someone who had made them angry, and he would allow them to throw darts at the person’s picture.

Sally's girlfriend drew a picture of a girl who had stolen her boyfriend. Another friend drew a picture of his little brother. Sally drew a picture of a former friend, putting a great deal of detail into her drawing, even drawing pimples on the face. Sally was pleased at the overall effect she had achieved.

The class lined up and began throwing darts, with much laughter and hilarity. Some of the students threw their darts with such force that their targets were ripping apart. Sally looked forward to her turn, and was filled with disappointment when Dr. Smith, because of time limits, asked the students to return to their seats. As Sally sat thinking about how angry she was because she didn't have a chance to throw any darts at her target.

Dr. Smith began removing the target from the wall. Underneath the target was a picture of Jesus……

A complete hush fell over the as each student viewed the mangled picture of Jesus; holes and jagged marks covered His face and His eyes were pierced. Dr. Smith said only these words…… "In as much as ye have done it unto the least of these my brethren, ye have done it unto me." Matthew 25:40

No other words were necessary; the tear–filled eyes of each student focused only on the picture of Christ.

ePress Release

B12 deficiency can present with recent memory loss

If you are forgetting things, get your vitamin B 12 levels done instead of worrying that you might be developing dementia, 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.

Animal products (meat and dairy products) provide the only dietary source of B12 (cobalamin) for humans. Strict vegans avoid all animal products, and are at risk of developing nutritional cobalamin deficiency.

The usual western diet contains 5 to 7 micrograms of cobalamin per day, while the minimum daily requirement is 6 to 9 micrograms per day. Total body stores of cobalamin range from 2 to 5 milligrams and one–half of which are in the liver. It takes years to develop vitamin B12 deficiency after absorption of dietary B12 ceases.

There is a link between infection with Helicobacter pylori (as seen in peptic ulcer) and low serum B12 levels. Mild and usually subclinical cobalamin deficiency can also occur in 24% of the elderly. Ten to 30 percent of patients taking metformin (diabetics, obesity and polycystic ovarian disease) have impaired cobalamin absorption and lower B12 levels, which can be reversed with supplemental oral calcium. Prolonged use of omeprazole (given for acidity) also can result in cobalamin deficiency.

Women who are only moderate vegetarians may develop cobalamin deficiency during pregnancy and lactation; their infants may also be cobalamin deficient.

eMedi Quiz

The buffering capacity of a buffer is maximum at pH equal to:

1. 0.5pKa.
2. pKa
3. pKa+1
4. 2pKa

Yesterday’s Mind Teaser: In a patient with a tumor in superior mediastinum compressing the superior vena cava, all the following veins would serve as alternate pathways for the blood to return to the right atrium, except:

1. Lateral thoracic vein.
2. Internal thoracic vein.
3. Hemiazygos vein.
4. Vertebral venous plexus.

Answer for yesterday’s Mind Teaser: 4. Vertebral venous plexus.

Correct answers received from: Dr K Raju, Dr Jainendra Upadhyay, Dr Avtar Krishan.

Answer for 4th September Mind Teaser: 2.Propionyl CoA.

Correct answers received from: Dr PC Das, Daivadheenam Jella, Dr Avtar Krishan, Dr Thakor Hitendrsinh G.

Send your answer to ijcp12@gmail.com

Self-Assessment-Quiz

 

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New treatment for acute asthma in children

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Make Sure

Situation: A patient with blood in sputum came back with massive bleeding.
Reaction: Oh my God! Why was the first bleeding ignored?
Lesson: Make sure to properly investigate even minor bleeding in sputum.

eMedinewS Humor

Wonderful confession by a girl in church and amazing reply she got.

She: I m in love with a boy who is far away from me.
I m in India and he lives in UK.

We met on marriage website.
Became friends on FB.
Had long chats on Whatsapp.
Proposed to each other on Skype.

N now 2 months of relationship through Viber.

I need ur blessings and good wish. Oh God.

Guy besides her said: Now get married on twitter.
Have fun on Tango.
Buy your kids from ebay.
Send them through Gmail.
And if u r fed up with ur husband or kids, toh unko OLX pe bech de

Quote of the Day

High achievers spot rich opportunities swiftly, make big decisions quickly and move into action immediately. Follow these principles and you can make your dreams come true. Robert H. Schuller

Twitter of the Day

Dr KK Aggarwal: Poor hygiene habits may lead to Typhoid fever http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: #God is what mind becomes when it has passed beyond the scale of our comprehension" Freeman Dyson #CosmicConsciousness

   
medicolegal update

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medicolegal update

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medicolegal update
  • Heartiest Congratulations, Dr Agarwal. God Bless. Kind Regards: Dr Yash Gulati
  • Heartiest Congratulations KK !!! Dr. Ashok Seth
  • Congrats KK, Great news ! Lots of work ahead ! May God Help you to restore the "noble" image of the Doctor, which has been eroded over the years, thanks to Healthcare becoming an Industry. If you can discourage the "kick–back" practice and let only "merit" lead to eminence. This I feel, would be a step in the right direction? As Secretary General of IMA , please invite all the Padma Awardees to India Gate at 6–30am on Sunday, 28th September to encourage "Hearty Choices" ! (World Heart Day is on Monday 29th September). DMA is encouraging ‘Morning Walk’. Thanks and all the Best for your new assignment ! Sincerely: Ganesh Mani
  • Felicitations and all good wishes: GPTalwar
  • Great news, KK. We are all very proud of you! You truly deserve this. Warm regards, Rajiv Khosla
  • Congratulations Sir! We are very proud of you and wish you all the best. With warm personal regards: Vinod Sharma.

Forthcoming Events

Dear Colleague

Kindly attend ‘Innovations in Cardiology (IIC) Summit 2014’ on 6th September, 11 am – 6 pm at Hotel Oberoi, Gurgaon.

The Organizing Secretary is Dr Rajneesh Kapoor

Highlights of the conference

  • Separate hall for Clinical Cardiology
  • One session on Medicolegal aspects will be taken by me.
  • No registration fee, limited seats

Kindly send your confirmation to rawat.vandana89@gmail.com or sms 9891673085

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