eMedinewS7th March 2014, Friday

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

Just to share my happiness again

Today the LIMCA Book of Records 2014 edition has been released and my name appears as record holder in CPR 10.

Records

Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal, President, Heart Care Foundation of India, Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Molchand Hospital Delhi has following records

  1. Most People Trained on CPR: Dr Aggarwal trained 10,392 people on hands–only Cardio Pulmonary Resuscitation (CPR) using multiple rescuer mode as well as the single rescuer mode at nine different venues in Delhi as part of the 19th MTNL Perfect Health Mela held from Nov 1–16, 2012.

    The breakdown of the sessions was as follows
    • 1,050 children and teachers trained in one session in multiple rescuer hands–only CPR using 200 human mannequins at Birla Vidhya Niketan School on November 1st 2012
    • 201 nurses trained in one session in single rescuer hands only CPR using 201 mannequins at Constitution Club of India, Rafi Marg on Nov 9, 2012
    • 96 Physically and mentally challenged students trained in one session in single rescuer hands only CPR at Constitution Club of India using 96 human mannequins on Nov 9, 2012
    • 1430 school boys trained at MCCP School, Barpola, Tuglakabad on Dec 3, 2012
    • 2,402 school girls trained at SKVC1, Yamuna Nagar in single rescuer CPR on Dec 13, 2012
    • 2217 members of the general public trained in single rescuer hands–only CPR at Constitution Club of India on Nov 8, 2012.
  2. Dr Aggarwal continued his training sessions after the health mela and trained 10, 200 more people, taking the total number of people trained in hands–only CPR–10 in 43 days from Nov 1–Dec 13, 2012 to 20, 592.
  3. Most People trained on CPR in least time: Dr Aggarwal trained 11,543 students (8,913 female and 2,630 male) in 8 Hrs (8.00 Am – 4 PM) on hands–only CPR–10 using mannequins at Dr Sampurnanad Sarvodaya Janya Vidyalaya, Delhi on April 6, 2013.

    Formula of 10 (CPR 10) also gets mentioned in the record book as under

    To revive after sudden cardiac arrest, within 10 minutes of cardiac arrest (earlier the better), for the next ‘at least’ 10 minutes, compress the centre of the chest, continuously and effectively, with a speed of 10 × 10 (100) per minutes.

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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."

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Ringtone – CPR 10 Mantra Hindi
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Definition of Health

sprritual blog

Health is not mere absence of disease; it is a state of physical, mental, social, spiritual, environmental and financial well–being. All aspects of health are not defined in Allopathy.

During MBBS, medical students are taught more about physical health. Social and mental healthcare is covered only in few lectures. Community health is a separate subject but is never given its due importance. Spiritual health is not defined at all and financial health is hardly covered.

Yet, in day–to–day practice, it is the social, financial, spiritual and community health, which is the most important during patient–doctor communication. It is incorporated in the four basic purposes: dharma, artha, kama and moksha.

Dharma and artha together form the basis of karma, which is righteous earning. You are what your deep rooted desires are. Most of the diseases today can be traced to a particular emotion, positive or negative. Anger and jealously are related with heart attack, fear with blood pressure, greed and possessiveness with heart failure.

Unless the mind is healthy, one cannot be free of diseases.

The best description of health comes from Ayurveda. In Sanskrit, health means swasthya, which means establishment in the self. One is established in the self when there is a union of mind, body and soul. Most symbols of health are established around a shaft with two snakes and two wings. The shaft represents the body, two snakes represent the duality of mind and the two wings represent the freedom of soul.

Sushrut Samhita in Chapter 15 shloka 10 defines the Ayurvedic person as under:

Samadosha, samagnischa,
Samadhatumalkriyah,
Prasannatmendriyamanah,
Swastha iti abhidhiyate.

From Ayurvedic point of view, for a person to be healthy, he/she must have balanced doshas, balanced agni, balanced dhatus, normal functioning of malkriyas and mind, body, spirit and indriyas full of bliss and happiness.

Human body is made up of structures (Kapha), which have two basic functions to perform; firstly, metabolism (pitta) and movement (vata). Vata, pitta and kapha are called doshas in Ayurveda. Samana dosha means balance of structures, metabolism and movement functions in the body. Agni in Ayurveda is said to be in balance when a person has normal tejas and a good appetite.

Ayurveda describes seven dhatus: rasa, rakta, mamsa, medha, asthi, majja, shukra and they are required to be in balance. They are equivalent to various tissues in the human body.

Ayurveda necessitates proper functioning of natural urges like urination, stool, sweating and breathing and that is what balance in malakriya means.

Ayurveda says for a person to be healthy he/she has to be mentally and spiritually healthy, which will only be possible when his or her indriyas are cheerful, full of bliss and devoid of any negativities. For indriyas to be in balance, one has to learn to control over lust and desires, greed and ego. This can be done by learning regular pranayama, learning the dos and don’ts in life, living in a disciplined atmosphere and learn to live in the present.

Regular pranayama shifts one from sympathetic to parasympathetic mode, balances the mind and thoughts and helps in removing negative thoughts from the mind. For living a disabled life one can follow the yama and niyama of yoga sutras of Patanjali or dos and don’ts taught by various religious gurus, leaders and principles of naturopathy.

Living in the present means conscious or meditative living. This involves either learning meditation 20 minutes twice–daily or learning subtle mental exercises like mind-body relaxation, yogic shavasana, self-hypnotic exercises, etc.

According to Yoga Sutras of Patanjali, a person who eats thrice a day is a rogi, twice a day is a bhogi and once a day is yogi. The take home message is: to live more one has to eat less.

Swar yoga defines the importance of respiration and longevity. According to this yoga shastra, everybody has a fixed number of breaths to be taken during the life span. Lesser the number a person takes in a minute more is the life. It also forms the basis of pranayama, which is nothing but longer and deeper breathing with reduced respiratory rate.

To be healthy one should follow the principle of moderation and variety in diet and exercise, regular pranayama and meditation and positive thinking.

cardiology news

A Simple Prayer

My son Gilbert was eight years old and had been in Cub Scouts only a short time. During one of his meetings he was handed a sheet of paper, a block of wood and four tires and told to return home and give all to "dad." That was not an easy task for Gilbert to do. Dad was not receptive to doing things with his son. But Gilbert tried.

Dad read the paper and scoffed at the idea of making a pine wood derby car with his young, eager son. The block of wood remained untouched as the weeks passed. Finally, mom stepped in to see if I could figure this all out. The project began.

Having no carpentry skills, I decided it would be best if I simply read the directions and let Gilbert do the work. And he did. I read aloud the measurements, the rules of what we could do and what we couldn’t do. Within days his block of wood was turning into a pinewood derby car… a little lopsided, but looking great (at least through the eyes of mom). Gilbert had not seen any of the other kid’s cars and was feeling pretty proud of his "Blue Lightning," the pride that comes with knowing you did something on your own.

Then the big night came. With his blue pinewood derby in his hand and pride in his heart we headed to the big race. Once there my little one’s pride turned to humility. Gilbert’s car was obviously the only car made entirely on his own. All the other cars were a father–son partnership, with cool paint jobs and sleek body styles made for speed.

A few of the boys giggled as they looked at Gilbert’s, lopsided, wobbly, unattractive vehicle. To add to the humility Gilbert was the only boy without a man at his side. A couple of the boys who were from single parent homes at least had an uncle or grandfather by their side, Gilbert had "mom."

As the race began it was done in elimination fashion. You kept racing as long as you were the winner. One by one the cars raced down the finely sanded ramp. Finally it was between Gilbert and the sleekest, fastest looking car there. As the last race was about to begin, my wide eyed, shy eight year old ask if they could stop the race for a minute, because he wanted to pray. The race stopped.

Gilbert hit his knees clutching his funny looking block of wood between his hands. With a wrinkled brow he set to converse with his Father. He prayed in earnest for a very long minute and a half. Then he stood, smile on his face and announced, "Okay, I am ready."

As the crowd cheered, a boy named Tommy stood with his father as their car sped down the ramp. Gilbert stood with his Father within his heart and watched his block of wood wobble down the ramp with surprisingly great speed and rushed over the finish line a fraction of a second before Tommy’s car.

Gilbert leaped into the air with a loud "Thank you" as the crowd roared in approval. The Scout Master came up to Gilbert with microphone in hand and asked the obvious question, "So you prayed to win, huh, Gilbert?"

To which my young son answered, "Oh, no sir. That wouldn’t be fair to ask God to help you beat someone else.
I just asked Him to make it so I don’t cry when I lose."

Children seem to have wisdom far beyond us. Gilbert didn’t ask God to win the race, he didn't ask God to fix the outcome, and Gilbert asked God to give him strength in the outcome. When Gilbert first saw the other cars he didn’t cry out to God, "No fair, they had a father’s help. "No, he went to his Father for strength.

Perhaps we spend too much of our prayer time asking God to rig the race, to make us number one, or too much time asking God to remove us from the struggle, when we should be seeking God's strength to get through the struggle.

Gilbert’s simple prayer spoke volumes to those present that night. He never doubted that God would indeed answer his request. He didn’t pray to win, thus hurt someone else; he prayed that God supply the grace to lose with dignity.

Gilbert, by his stopping the race to speak to his Father also showed the crowd that he wasn’t there without a "dad," but his Father was most definitely there with him. Yes, Gilbert walked away a winner that night, with his Father at his side.

News Around The Globe

  • In a phase II Trial, Eczema Area Severity Index scores dropped by a mean 74% by 12 weeks on weekly injections of a novel monoclonal antibody dupilumab compared with a 23% reduction on placebo (P<0.0001) in patients with moderate–to–severe adult atopic dermatitis. The anti–IL–4 and IL–13 drug halved severity for 86% of patients and cleared it up almost entirely for 40% (versus 35% and 7% on placebo, respectively, both P<0.0001). The study findings were presented at the American Academy of Allergy, Asthma, and Immunology meeting.
  • According to a new study presented at the American Academy of Allergy, Asthma & Immunology 2014, people who get immunotherapy injections for their allergies are less likely to develop infectious diseases such as chronic pharyngitis, nasopharyngitis, sinusitis, diseases of the tonsils and adenoids, and the flu.
  • Maternal "traditional" or "prudent" diets rich in vegetables, fruit, whole grains, and fish were linked to lower risk for preterm delivery, supporting advice to eat a balanced diet, according to findings from a large prospective cohort study published online March 4 in BMJ.
  • A 1–year prospective study presented at the 22nd European Congress of Psychiatry that included several psychotropic drugs showed that weight gain of 5% or more at 1 month predicted further weight gain at 3 and 12 months. Early weight gain following initiation of atypical antipsychotics or other psychotropic medications may provide a simple, clinically relevant marker of risk for long–term gain and underscores the importance of early weight monitoring.
  • The accuracy of modern ultrasonography precludes the need for routine measurement of amniotic fluid alpha–fetoprotein (AFP) and anticholinesterase (AChE), according to a retrospective study in the American Journal of Obstetrics and Gynecology. Among 81 women with elevated amniotic fluid AFP, 13 cases (0.2% overall) had neural tube defects and five (<0.1% overall) had ventral wall defects.
  • The Hindu dated March 3, 2014 reports that since March 1, administration of oral polio vaccine (OPV) six weeks before departure has become mandatory for all India–bound travellers from seven countries where polio cases are still being reported: Afghanistan, Ethiopia, Syria, Kenya, Somalia, Nigeria and Pakistan. Indians headed for these countries will also be administered the vaccine. This new preventive measure has been initiated as per the recommendations of the national and international expert bodies and the guidelines of the World Health Organisation” said Anuradha Gupta, Additional Secretary, Health Ministry.

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

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Rabies News (Dr. A K Gupta)

How is RIG life saving?

Administration of anti–rabies vaccine stimulates production of neutralizing antibodies by the patient’s immune system. Protective levels of antibodies (more than 0.5 IU/ml of serum) are seen 7 to 14 days after the initial dose of vaccine (window period). Moreover when the bites are on the head, neck, face & hands, the incubation period will be shorter.

Thus the patients are vulnerable to develop rabies during this window period of 7 to 14 days. RIGs are readymade anti–rabies antibodies and provide passive immunity to rabies.

cardiology news

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinewS)

  • A study published online February 22, 2014 in Circulation: Cardiovascular Genetics has reported that after a yearlong, intensive diet, exercise, and stress–management program to reduce cardiovascular risk factors, participants who successfully followed the program and lost weight also had positive changes at the molecular level. However, just as people who don’t stick to a diet and exercise program may start gaining weight again, these molecular–level changes were transient, which emphasizes the importance of making lifelong healthy choices.
  • Older adults with multiple chronic health conditions –– including hypertension –– appear to be at greater risk for sustaining serious fall injuries when treated for high blood pressure. During 3 years of follow–up, 9% of adults with an average age of 80 had a serious fall injury, including hip and other major fractures, traumatic head injuries, and joint dislocations, as reported by Mary Tinetti, MD, of Yale University, and colleagues in JAMA Internal Medicine.
cardiology news

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinewS)

  • The Mississippi infant born with HIV who made headlines worldwide last year when physicians announced she was functionally cured 10 months after stopping a combination antiretroviral therapy still has no detectable amounts of the virus at age 3.Deborah Persaud, MD, from Johns Hopkins University School of Medicine in Baltimore, Maryland reported at the 2014 Conference for Retroviruses and Opportunistic Infections that the baby had undetectable plasma viremia (< 20 copies/mL) and normal CD4+ and CD8+ T–cell counts at 39 months of age — 21 months after stopping antiretroviral therapy. Dr. Persaud introduced the case of a second baby who started receiving therapy 4 hours after birth in Los Angeles County, California. At 8 months, that baby — whose gender has not been disclosed — no longer has detectable levels of the virus.
  • Researchers report in JAMA Pediatrics that the risk for post-vaccination fever was significantly higher in children who received trivalent inactivated influenza and pneumococcal (PCV13) vaccines together compared with children who were given either vaccine alone. Children, aged 6-23 months, who were given a combined vaccination of the flu shot and PCV13 had adjusted relative risks (aRR) of 2.69 and 2.67 for developing a temperature of 100.4° or higher compared with children who received either the flu shot alone or the PCV13 shot alone.
cardiology news

Smell check, scratch and sniff, a new test for Parkinson’s disease

Olfactory dysfunction presenting as odor detection, discrimination, and identification is a common finding in patients with early non vascular Parkinson’s disease.

As per a study of 2,267 men published in the Annals of Neurology, an impaired sense of smell could be an early indicator of Parkinson’s disease, occurring up to four years before motor skill problems appear.

In the study decreased odor identification was associated with older age, smoking, more coffee consumption, less frequent bowel movements, lower cognitive function and excessive daytime sleepiness, but even after adjusting for these factors, those with the lowest odor identification scores had a five time greater risk of developing Parkinson’s disease than those with the highest scores.

Nerve loss and the formation of Lewy bodies –– abnormal clumps of proteins inside nerve cells that are thought to be a marker of the disease –– are known to take place in the olfactory structures of patients with the disease.

An impaired sense of smell could also be caused by impaired sniffing, which may be another motor symptom of Parkinson’s.

Early indicators of Parkinson’s disease are olfactory abnormality, constipation and sleep disturbances.

Besides Parkinson’s disease, obesity, diabetes, hypertension, malnutrition, Alzheimer’s disease, multiple sclerosis and Korsakoff’s psychosis are all accompanied or signaled by smell disorders.

cardiology news

Total CPR since 1st November 2012 – 86664 trained

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Sitting over 3 hours a day may reduce life expectancy

One should not sit for more than 2 hours in a day, 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.

Quoting a study published in BMJ Dr Aggarwal said that sitting for three hours per day or longer may reduce an individual’s life expectancy. The study calculated that limiting the time people spend sitting to 3 hours or fewer each day would increase the life expectancy of the population by two years. Cutting down TV watching to fewer than two hours each day would bump life expectancy up by another 1.4 years.

When you are sitting, your leg muscles (the largest in the body) are completely inactive, which causes problems with how you handle your blood sugar and how you handle cholesterol.

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

White rice linked to diabetes in Asians

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 lesion of ventrolateral part of spinal cord will lead to loss (below the level of lesion) of:

1. Pain sensation on the ipsilateral side.
2. Proprioception on the contralateral side.
3. Pain sensation on the contralateral side.
4. Proprioception on the ispilateral side.

Yesterday’s Mind Teaser: 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. Myocardial infarction.

Answer for yesterday’s Mind Teaser: 2.Hypovolemia.

Correct answers received from: Dr AK Gajjar, Dr Palanivelrajan, Dr K Raju, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr Poonam Chablani, Dr Avtar Krishan, Daivadheenam Jella.

Answer for 5th March Mind Teaser: 3.Atracurium.

Correct answers received from: Daivadheenam Jella.

Send your answer to ijcp12@gmail.com

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medicolegal update

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medicolegal update

Successful Marriage

A couple had been married for 45 years and had raised a brood of 11 children and were blessed with 22 grandchildren. When asked the secret for staying together all that time, the wife replies, "Many years ago we made a promise to each other: the first one to pack up and leave has to take all the kids."

medicolegal update

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medicolegal update

Situation: A patient of pulmonary Koch’s on ATT complained of numbness in fingers and toes.
Reaction: Oh my God! I forgot to prescribe vitamin B complex.
Lesson: Make sure that in patients talking ATT (including INH) B–complex vitamins (especially vitamin B6) are prescribed to prevent neuropathy. Addition of antioxidants and multivitamins also boost the immune system.

medicolegal update

There are no secrets to success. It is the result of preparation, hard work learning from failure. General Colin Powell

medicolegal update

Dr KK Aggarwal: Stress may increase smoking habits http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: We are communicating right now in mind space. Mental and physical reality exist in mind space which is not in time 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 News. Regards: Dr Pushpa

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