eMedinewS7th June 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

New form of heart failure on the rise

Heart failure is routinely described as the progressive loss of ability of the heart to pump blood. But, there is another form of heart failure where the blood–pumping ability of the heart remains near normal. This second form of heart failure is too often overlooked and is just as lethal.

In this condition the heart muscle becomes thickened. The chamber inside gets smaller and the heart is unable to relax to accommodate the blood it needs to pump out. As there is no room for the heart to relax, the blood backs up into the lungs. This kind of anomaly is not picked up by standard measurements of "ejection fraction" – the percentage of blood in the heart that goes out with every beat.

This form of the disease is called "diastolic heart failure" because the problem occurs during the diastole portion of heart activity, as the heart relaxes after a beat. Nearly one–third of these patients have an ejection fraction greater than 50 percent, which is very near normal. However, the death rate for this kind of heart failure matches that of patients with the more common form of heart failure, with more than 20% of all the patients dying within a year. There is a steady increase over 15 years of heart failure with normal or near–normal ejection fraction.

For patients, the symptoms of both types of heart failure are the same: Shortness of breath, difficulty exercising and fluid retention in the body. Physicians cannot make a diagnosis on the basis of symptoms or routine examinations. One has to have an echocardiogram and see the heart pumping and see if the ejection fraction is normal or reduced. Until now, relatively little attention has been paid to diastolic heart failure. Advances have been made against systolic heart failure, in which the ejection fraction falls below normal but not much has been done about diastolic heart failure.

Pacing for heart failure

For patients with advanced heart failure waiting for cardiac transplant, biventricular pacing not only improves the quality of life but also prolongs life. If the ejection fraction is low the combo device also gives an electric shock when the heart stops. It is said that all patients with low ejection fraction should ask their doctors for possible implantation of these devices.

Signals of heart failure

One of the commonest presentations is breathlessness on exertion, which is often confused as a part of aging or being obese. Not being able to climb stairs may be the earliest sign of hypertensive diastolic heart failure. Other signals are:

  1. Feeling extra tired even after a good night’s sleep. People with heart failure may limit activities they like to do or take naps to avoid feeling tired.
  2. Weight gain: Call your doctor if you gain weight for more than 2 days in a row or if you gain 2 or more pounds.
  3. Shortness of breath: Heart failure makes breathing harder, especially during exercise. Lying position may make it worse.
  4. Swollen ankles, legs, belly, and/or lower back, the swelling is often worse at the end of the day.
  5. Going to the bathroom more at night.

News Around The Globe

  • Although often associated with the worldwide obesity epidemic, a novel group of studies has shown that video games can improve fitness. Researchers reported that markers of strength, agility, endurance, and body composition improved significantly in college students after playing Just Dance 4 Kinect for the Xbox (Microsoft) for 2 months. The findings were presented at the American College of Sports Medicine (ACSM) 61st Annual Meeting.
  • Ipilimumab has been shown to be effective in an adjuvant setting for earlier–stage melanoma, reports a study presented at the 2014 Annual Meeting of the American Society of Clinical Oncology. The drug significantly delayed recurrence, compared with placebo, in stage III patients.
  • Magnetic resonance imaging (MRI) has the potential to accurately diagnose appendicitis in pregnant women and is cost–effective, reports a study published online in JAMA Surgery.
  • The US Food and Drug Administration (FDA) has approved phenylephrine and ketorolac injection 1%/3% for use during cataract surgery or intraocular lens replacement (ILR). The drug prevents intraoperative miosis (pupil constriction) and decreases postoperative pain.
  • In patients with chronic obstructive pulmonary disease (COPD), a combination of umeclidinium and vilanterol can improve lung function to a greater extent than either drug alone or the globally approved agent tiotropium, reports a study published online in The Lancet Respiratory Medicine.

Rabies News (Dr A K Gupta)

What are monoclonal antibodies?

Monoclonal antibodies (mAb) are important reagents used in biomedical research, in diagnosis of diseases, and in treatment of such diseases as infections and cancer. These antibodies are produced by cell lines or clones obtained from animals that have been immunized with the substance that is the subject of study. The cell lines are produced by fusing B cells from the immunized animal with myeloma cells.

Cardiology eMedinewS

  • The relationship between blood pressure and brain changes consistent with cognitive impairment in late life depends on whether the individual had a history of hypertension in midlife, reports a recent study published online June 4 in Neurology.
  • An article published online June 4 in Heart has pointed that there is no clear evidence that air pollution raises the risk for heart attack and stroke. However, small–diameter particulate matter could possibly increase the risk for death from arrhythmias, atrial fibrillation, and blood clot in the lungs.

Pediatrics eMedinewS

  • A new research published in BMJ Open has stated that children whose parents divorce may be more inclined to weight gain than those with a secure parental marital status. It was noted that children of parents who divorced were 54% more likely to be generally overweight or obese and 89% more likely to be abdominally obese, compared to children of parents who were still married.
  • A study published in the journal NeuroImage: Clinical has suggested that youths between the ages of 12 and 18 years who have committed homicide, appear to have significantly different brain structures, compared with other teenage criminals who have not committed homicide.

Dr K K Spiritual Blog

Always Respect Others Viewpoints

It is an old saying that one is proud of his or her own intelligence and somebody else’s partner and wealth. Most disputes occur when there is an ego clash and that occurs when you want your point to be noticed by everybody. But remember that for every situation, invariably, there will be multiple opinions.

In one of my meetings, I asked my lifestyle students–cum–colleagues to imagine Rahul Gandhi as the Prime Minister of the country. Following were the views of various people:

  • He is too young.
  • He is immature.
  • He is childish
  • It will be failure of democracy
  • He has no political will
  • He has no strength for taking decisions
  • He has no experience
  • He is open minded
  • He will bring youth to politics
  • He has experienced team behind him
  • He will bring a new approach to politics etc. etc.

The message is very clear that everybody has their own perception and we should learn to respect that.

Wellness Blog

ACIP Issues 2014 Immunization Schedule for Adults

Updated vaccination recommendations for adults aged 19 years and older for 2014 have been released by the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization.

  1. Haemophilus influenzae type b (Hib): The vaccine is recommended for certain adults at increased risk for Hib who have not received the vaccine before, except for those with HIV because their risk for Hib infection is low. Adults who have had a successful hematopoietic stem cell transplant are recommended to receive a 3–dose series of Hib vaccine 6 to 12 months after the transplant regardless of Hib vaccination status.
  2. Influenza vaccine: The update adds information on the use of the recombinant influenza (RIV) and inactivated influenza (IIV) vaccines among egg–allergic patients was added to the footnote and indicates that RIV or IIV can be used among persons with hives–only allergy to eggs, as it contains no egg protein.
  3. Td/Tdap: The tetanus, diphtheria, acellular pertussis (Tdap) and tetanus, diphtheria (Td) vaccines footnote was edited to harmonize with the language used in the pediatric immunization schedule. A single dose of Tdap vaccine is recommended for previously unvaccinated persons aged 11 years or older, and Td booster should be administered every 10 years thereafter.
  4. Human papillomavirus: "Information was added to the human papillomavirus…vaccine footnote to clarify the timing between the second and third doses and to harmonize language between the pediatric and adult immunization schedules. No changes in recommendations were made.
  5. Zoster: "Being a healthcare worker is no longer an indication for vaccination."
  6. Pneumococcal vaccines: "PCV13 (the 13–valent pneumococcal vaccine) is recommended to be administered before PPSV23 (the 23–valent pneumococcal vaccine) among persons for whom both vaccines are recommended. The PCV13 footnote now precedes the PPSV23 footnote and includes wording to remind providers of the appropriate order of these vaccines when both are indicated."
  7. Meningococcal vaccine: The footnote "was edited to clarify which persons need either one or two doses of vaccine and to provide greater clarity regarding which patients should receive meningococcal conjugate (MeanACWY–D) versus the meningococcal polysaccharide (MenACWY–CRM)."

Ann Intern Med. 2014;160:190–197

Inspirational Story

A Simple Gesture

A little boy selling magazines for school walked up to a house that people rarely visited. The house was very old and run down and the owner hardly ever came out. When he did come out he would not say hello to neighbors or passers by but simply just glare at them.

The boy knocked on the door and waited, sweating from fear of the old man. The boy’s parents told him to stay away from the house, a lot of the other neighborhood children were told the same from their parents.

As he was ready to walk away, the door slowly opened. "What do you want?" the old man said. The little boy was very afraid but he had a quota to meet for school with selling the magazines.

"Uh, sir, I uh am selling these magazines and uh I was wondering if you would like to buy one." The old man just stared at the boy. The boy could see inside the old man’s house and saw that he had dog figurines on the fireplace mantle. "Do you collect dogs?" the little boy asked. "Yes, I have many collectibles in my house, they are my family here, they are all I have." The boy then felt sorry for the man, as it seemed that he was a very lonely soul. "Well, I do have a magazine here for collectors, it is perfect for you, I also have one about dogs since you like dogs so much." The old man was ready to close the door on the boy and said, "No boy, I don’t need any magazines of any kind, now goodbye."

The little boy was sad that he was not going to make his quota with the sale. He was also sad for the old man being so alone in the big house that he owned. The boy went home and then had an idea. He had a little dog figure that he got some years ago from an aunt. The figurine did not mean nearly as much to him since he had a real live dog and a large family. The boy headed back down to the old man’s house with the figurine. He knocked on the door again and this time the old man came right to the door. "Boy, I thought I told you no magazines."

"No, sir I know that, I wanted to bring you a gift." The boy handed him the figurine and the old man’s face lit up. "It is a Golden Retriever, I have one at home, this one is for you." The old man was simply stunned; no one had ever given him such a gift and shown him so much kindness. "Boy, you have a big heart, why are you doing this?" The boy smiled at the man and said, "Because you like dogs."

From that day on the old man started coming out of the house and acknowledging people. He and the boy became friends; the boy even brought his dog to see the man weekly.

This simple gesture changed both of their lives forever.

ePress Release

Vegetables & fruits lower chances of getting some cancers

Vegetables and fruits help lower your chances of getting head, neck, and breast, ovarian and pancreatic cancers. Even one additional serving of vegetables or fruits could help lower the risk of head and neck cancer. The more fruits and vegetables you can consume, the better.

Quoting an international Study from National Cancer Institute, Padma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President IMA said that those who eat six servings of fruits and vegetables per 1,000 calories have a 29% decreased risk relative to those who have 1.5 servings. In the study, after adjusting the data to account for smoking and alcohol use – known head and neck cancer risk factors – the researchers found that those who consumed the most fruits and vegetables had the lowest risk for head and neck cancers. Vegetables appeared to offer more cancer prevention than fruits alone did. Adding just one serving of fruit or vegetables per each 1000 calories consumed daily resulted in a 6% reduction of risk.

In another study, broccoli and soy protein were found to protect against the more aggressive breast and ovarian cancers. When consumed together, digesting broccoli and soy forms a compound called di–indolylmethane (DIM). In lab experiments, the researchers found that DIM could affect the motility of breast and ovarian cancer cells, which could help keep cancers from spreading. Soy, acts like estrogen and is a nutritious, healthy food, and should be eaten in moderation.

Yet another study compared intake of flavonols to their risk of pancreatic cancer. Flavonols are protective compounds found in fruits and vegetables, such as onions, apples, berries, kale and broccoli. Those who had the highest consumption of flavonols reduced their risk of pancreatic cancer by 23%. The benefit was even greater for people who smoked. Smokers with high levels of flavonols reduced their risk of pancreatic cancer by 59%.

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 88972 people since 1stNovember 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 10x10 i.e. 100 per minute."

eMedi Quiz

Central nervous system manifestations in chronic renal failure are a result of all of the following, except:

1. Hyperosmolarity.
2. Hypocalcemia.
3. Acidosis.
4. Hyponatremia.

Yesterday’s Mind Teaser: Which of the heart valve is most likely to be involved by infective endocarditis following a septic abortion?

1. Aortic valve.
2. Tricuspid valve.
3. Pulmonary valve.
4. Mitral valve.

Answer for yesterday’s Mind Teaser: 2. Tricuspid valve.

Correct answers received from: Daivadheenam Jella, Dr Narahari, Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Dr.Chandresh Jardosh, Arvind Diwaker, Dr Avtar Krishan.

Answer for 5th June Mind Teaser: C. Lipodystrophic areas can result, causing erratic insulin absorption rates from these

Correct answers received from: Dr Poonam Chablani.

Send your answer to ijcp12@gmail.com

Zee News – Health Wealth Shows

Alcohol
Cancer Prevention
Depression
Paralysis
Pneumonia
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Vitiligo
Fluid Intake

 

Total CPR since 1st November 2012 – 88972 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)

emedipicstoday emedipics

Health Check Up Camp at Modern Era Public School, 16th May 2014

press release

PPIs may be associated with a higher risk for clostridium difficile–associated diarrhea

video of day video of day

 

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 patient with dengue fever developed shock.
Reaction: Oh my God! Why did you ignore the blood pressure of 90/80?
Lesson: Make sure that a pulse pressure of less than 20 is not ignored, it is an impending sign that the patient is going into shock.

eMedinewS Humor

Health Professionals in Heaven

Three nurses died and went to Heaven. They were met at the Pearly Gates by St. Peter, who questioned them.

"What did you used to do back on Earth?" he asked the first nurse. "Why do you think you should be allowed into Heaven?"

She told him, "I was a nurse at an inner city hospital. I worked to bring healing and peace to many sufferers, especially poor children."

"Very noble. You may enter." And he ushered her through the gates. He asked the same questions to the next nurse.

"I was a missionary nurse in the Amazon. For many years I worked with a small group of doctors and nurses to help people in numerous tribes, healing them and telling them of God’s love." The second nurse replied.

"Excellent!" said St. Peter. And he ushered her through the gates as well. Finally he posed his questions to the third nurse. She hesitated, and then explained, "I was just a nurse at an HMO."

St. Peter considered her answer for a moment, then told her, "Well, you can enter too."

"Wow!" the nurse exclaimed in relief. "I almost thought you weren't going to let me in."

"Oh, you can certainly come in," St. Peter told her, "but you can only stay for three days."

Quote of the Day

Productive achievement is a consequence and an expression of health, self–esteem, not its cause. Nathaniel Branden

 

Twitter of the Day

Dr KK Aggarwal: Heart disease starts in youth http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: At our core we are all capable and deserving of love http://bit.ly/DC_Ananda #ananda

 

Forth Comming Event

Announcement

Call for Free Registration

4th annual conference Zoonosis 2014
Sunday 6th July 10am–2 pm followed by Lunch

Venue; Indian Medical Association HQs, IMA House, ITO New Delhi

Objective: To discuss about prevention of diseases communicable
from animals to human.

Who can take part: Medical Practitioners,Veterinary Practitioners, Animal Owners/Breeders, NGOworking with animal care etc.

Experts will be from Veterinary/Medical sectors

All participants will be given certificate of participation.

Organizers: Heart Care Foundation
of India, Millennium India Education
Foundation,CAR (Ministry of Agriculture Govt.of India,

Register at :
rawat.vandana89@gmail.com/
drkakroo@gmail.com
or Call: Vandana 9891673085/Dr Kakroo 9810301261

 

medicolegal update

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  1. Dear Sir, Very informative news. Regards: Dr Kartik
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