eMedinewS7th August 2014, Thursday

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

First aid for poisonous bites and stings

People often panic if they have been bitten or stung. You should tell the patient that many snakes, spiders, insects and sea creatures are harmless and that even the bites and stings of dangerous animals often do not cause poisoning.

Keep the patient calm and still. Moving the bitten or stung limb speeds up the spread of venom to the rest of the body. Fear and excitement also make the patient worse. The patient should be told not to use the limb and to keep it still and below the level of the heart. The limb may swell after a while, so take off the patient’s rings, watch, bracelets, anklets and shoes as soon as possible. A splint and a sling may help to keep the limb still.

Avoid doing the following:

  • Do not cut into the wound or cut it out.
  • Do not suck venom out of the wound.
  • Do not use a tourniquet or tight bandage.
  • Do not put chemicals or medicines on the wound or inject them into the wound (for e.g., potassium permanganate crystals).
  • Do not put ice packs on the wound.
  • Do not use proprietary snake bite kits.
  • The patient should lie on one side in the recovery position so that the airway is clear, in case or vomiting or fainting.
  • Do not give the patient anything by mouth – no food, alcohol, medicines or drinks. However, if it is likely to be a long time before the patient gets medical care, give the patient water to drink to stop dehydration.
  • Try to identify the animal, but do not try to catch it or keep it if this will put you, the patient or others at risk. If the animal is dead take it to hospital with the patient, but handle it very carefully, because even dead animals can sometimes inject venom.
  • As soon as possible, take the patient to a hospital, medical dispensary, or clinic where medical care can be given. The patient should not walk but should keep as still as possible. If there is no ambulance or car, carry the patient on a stretcher or trestle, or on the crossbar of a bicycle.
  • Antivenom should only be given in a hospital or medical Centre where resuscitation can be given, because the patient may have an allergic reaction. If available, antivenom should be used if there is evidence of severe poisoning. It should not be used when there are no signs of poisoning.

News Around The Globe

  • According to an article published in the August 5 issue of the Annals of Internal Medicine, the burden of hepatitis C virus (HCV) infection is expected to be greatly reduced by new all–oral direct–acting antivirals and birth–cohort screening recommendations. Experts suggest, however, that even more aggressive screening recommendations are needed to identify and treat currently infected patients.
  • Three screening tools – the Psoriasis and Arthritis Screening Questionnaire (PASQ), the Psoriasis Epidemiology Screening Tool (PEST) and the Toronto PsA Screen ToPAS) – can help identify psoriatic arthritis (PsA) so patients can receive timely treatment, suggests a new study in the Journal of the American Academy of Dermatology.
  • According to the July 23 JAMA Dermatology online report, the oral phosphodiesterase inhibitor apremilast relieves signs of inflammatory rosacea in a pilot study in patients with moderate to severe disease.
  • Psoriatic arthritis (PsA), which remains woefully underdiagnosed and misdiagnosed, could be treated earlier, lessening the disease burden, if patients and clinicians were more aware of the ailment, if effective screening tools existed, and if there were a more straightforward way to determine when referrals and treatment by rheumatologists were appropriate, according to a consensus statement in Arthritis Care & Research. About 50% of patients with psoriasis have undiagnosed PsA.

Rabies News (Dr A K Gupta)

What are the various brands of RIG available in India?

The different RIGs available in India are:

HRIG Brands

  • BERIRAB–P– manufactured by CSL Behring GmbH, Germany and marketed by Bharat Serum & Vaccines Ltd.
  • KAMRAB – manufactured by Kamada Ltd., Israel and marketed by Synergy.

ERIG Brands

  • Anti Rabies Serum – manufactured by CRI – Kasauli.
  • EQUIRAB – manufactured and marketed by Bharat Serum & Vaccines Ltd.
  • ABHAYRIG – manufactured by VINS Bioproducts and marketed by Human Biologicals Ltd.
  • VINIRIG – manufactured and marketed by VINS Bioproducts.

Cardiology eMedinewS

  • Monitoring blood levels of vascular endothelial growth factor–A (VEGF–A) in children after heart transplantation can help predict the development of post–transplant coronary disease (cardiac allograft vasculopathy, or CAV), a small study suggests. The findings were presented at the World Transplant Congress in San Francisco.
  • Cautions against engaging in PCI prematurely after angiography in patients with diabetes and more broadly as well as sharpened recommendations for CABG in diabetics feature prominently in a new focused update to the 2012 clinical–practice guidelines for patients with stable ischemic heart disease. The document from the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons was published in Circulation, the Journal of the American College of Cardiology, and Catheterization and Cardiovascular Interventions.

Pediatrics eMedinewS

  • Prenatal exposure to tobacco smoke appears to lead to alterations in the brain similar to those seen with attention–deficit/hyperactivity disorder (ADHD), as per a new study in the July issue of JAMA Psychiatry.
  • A new research in the American Psychological Association’s Journal of Personality and Social Psychology has for the first time found that teenagers who play mature–rated, risk–glorifying video games are more likely subsequently to engage in a wide range of deviant behaviors beyond aggression, including alcohol use, smoking cigarettes, delinquency and risky sex.

Dr K K Spiritual Blog

What is the importance of life force?

A physical body becomes useless once the life force is gone. The same body, which was lovable to everyone, becomes a liability after death. Everyone wants to dispose it as early as possible as keeping a dead body at home is considered a bad omen.

During the transfer of dead body from one place to another nobody wants to keep the body in a vehicle other than a harsh van whose job is only to carry dead bodies. No family will be willing to carry the dead body of a person in a car in which the deceased person has been traveling or driving for years.

May be for any reason, health or rituals, once you touch a dead body you are required to take a bath before you commence your daily routine.

Within a matter of hours in absence of life force, the physical body starts disintegrating and in a matter of days, it shows signs of self–destruction and putrification.

This vital force is nothing but the soul, aatma, brahma, spirit or consciousness described in different Vedic texts.

Aadi Shankaracharya in his book Bhaja Govindam shloka 6 says:

yávat–pavano nivasati dehe
távat–pøcchati kuùalam gehe,
gatavati váyau dehápáye
bháryá bibhyati tasmin káye.(6)

"Till the life force remains in the body, people come and enquire about your welfare. But, the moment the life force goes out, even your wife is afraid of coming anywhere near your body".

Life force can be equated to the network of information in computer, radio, television or mobile phone. All these gazettes without a data are useless and are thrown away. This silent data retrievable by operational and application software represent the life force or soul of these electronic gadgets.

Shankara says that as one does not give importance to a computer without data one should not give importance to the physical body. It is the life force within the body which is respected and cared for and that is what real "I" or "We" are. All glories of the body are only until the life force remains in it. In Bhagavad–Gita, Lord Krishna in Chapter 2 (2.23) says about this life force or ataman "fire cannot burn it, weapon cannot cut it, water cannot wet it, air cannot dry it, it is immortal".
The most defined relationship in Vedic text is between husband and wife. The very fact even a wife after the death does not want to touch the husband signifies the importance of life force.

The life force has no dimensions: height, weight, colour or image. It is immortal, omnipotent, omniscient and omnipresent. The weight of a live and a dead body immediately after the death is the same.

It is the same life force, which dwells in everybody and during life is modified by the action, memory and desire cycle. If one gets attached to any of the three one starts getting detached from the soul or the life force. People who are in touch with their life force all the time attain peace and happiness and die young in old age.

Most Vedic mahavakyas talk about, that it is the same spirit, which dwells in everybody and hence every person in the society should be welcomed and treated with equal importance. Ahambrahmasami, tatwamasi, vasudeva kutumbakam, etc. are a few of the examples.

According to Aadi Shankara one can achieve non–duality only by seeing God in everyone. Athithi–devo–bhava is also based on the same principle.

Wellness Blog

All about tea

When we speak of tea, it is commonly assumed to be black tea with milk and sugar. However, the word ‘Tea’ means any herb. This means even hot Tulsi water is Tulsi tea or hot mint water is Mint tea. Herbs which can be converted into tea are jasmine tea, lemon tea, lemon grass tea, masala tea, sounf tea etc.

When the decoction of the leaves and the water is reduced to 50% on boiling, it is called Kadha. Black tea without milk and sugar is much healthier than black tea with milk and sugar. Classical tea without sugar and milk has an astringent taste. But according to Ayurved, this is good for health as it reduces Kapha imbalance. When sugar and milk is added, both of which have sweet taste, they neutralize the weight reducing and kapha–relieving properties of the black tea. Therefore, milk or sugar should not be added to tea. For the purpose of taste, one can add Gur or jaggery or artificial plant sweetener Stevia.

Black tea is also a mild diuretic and increases urination as it contains caffeine, which is also a stimulant and that is the reason why tea is used to remain awake. In this regard, coffee is stronger than tea. When taken in moderation, black tea is good for the heart and the health. If one has to choose tea then jasmine, lemon and lemongrass teas are better than others.

In Ayurveda, there are different teas for different personalities. Therefore, you can get Vata–pacifying tea, pitta–pacifying tea and kapha–pacifying tea.

Inspirational Story

Heaven and Hells

A holy man was having a conversation with the Lord one day and said, "Lord, I would like to know what Heaven and Hell are like." The Lord led the holy man to two doors. He opened one of the doors and the holy man looked in.

In the middle of the room was a large round table. In the middle of the table was a large pot of stew which smelled delicious and made the holy man’s mouth water.

But the people sitting around the table were thin and sickly. They appeared to be famished. They were holding spoons with very long handles that were strapped to their arms and each found it possible to reach into the pot of stew and take a spoonful, but because the handle was longer than their arms, they could not get the spoons back into their mouths. The holy man shuddered at the sight of their misery and suffering. The Lord said, ‘You have seen Hell.’

They then went to the next room and opened the door. It was exactly the same as the first one. There was the large round table with the large pot of stew which made the holy man's mouth water. The people were equipped with the same long–handled spoons, but here the people were well nourished and plump, laughing and talking.

The holy man said, "I don’t understand."
"It is simple" said the Lord, "In this place the people have learned to feed one another."

ePress Release

Energy Drinks May Put Heart at Risk for Sudden Death

Energy drinks may raise blood pressure and prolong QT interval increasing the risk of sudden cardiac death said Padmashri and Dr B C Roy national Awardee Dr K K Aggarwal President Heart Care Foundation of India and National President Elect IMA.

In a meta–analysis by Sachin A. Shah at University of the Pacific in Stockton, Calif, with a pooled analysis of 93 people who consumed energy drinks, the QT interval on an ECG was significantly prolonged by 10 ms. The threshold level of regulatory concern is around 5 ms.

In another pooled analysis of 132 people by the same group, researchers found a significant increase in systolic blood pressure by 3.5 mmHg that was associated with the consumption of energy drinks.

Doctors are generally concerned if patients experience an additional 30 ms in their QT interval from baseline. QT prolongation is associated with life–threatening arrhythmias.

Most energy drinks have caffeine. Drinks such as Monster, Red Bull, Rockstar, Full Throttle, and AMP have three times the amount of caffeine as colas. A 16–oz. can of Monster Energy, for example, contains 160 mg of caffeine, which is almost as much as five cans of soda.

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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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Health Check Up Camp Sonipat, 27th July 2014

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No Blood Tests for TB

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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: An asthmatic patient became worse after receiving a painkiller.
Reaction: Oh my God! Why was he not put on a leukotriene receptor antagonist?
Lesson: Make sure that a patient with asthma is not given aspirin or he is put on a leukotriene receptor antagonist.

eMedinewS Humor

Jumping on Beds

Connie told her 4–year–old grandson, Dean, not to jump on the beds. After several warnings she punished him, explaining that should he fall, he would hurt himself badly.

Several minutes passed and he was back to jumping on the beds.

Connie said, "Dean, you weren’t jumping on the beds again, were you?"

He stood with his little head dropped low and said, "I’m trying, but it’s so hard to quit."

Quote of the Day

When you are at a loss of what to do, do nothing. Doing nothing can be very wise. When you pause doing things, you become more aware of God’s presence, and often an unexpected solution to your question will arise.

Twitter of the Day

Dr KK Aggarwal: Cleaning your home may worsen asthma http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: The key to joy is to be able to carry it with us even when life is not going exactly as we wish http://bit.ly/DC_Ananda #ananda

eMedi Quiz

Bacitracin acts on:

1. Cell Wall
2. Cell Membrane.
3. Nucleic Acid.
4. Ribosome.

Yesterday’s Mind Teaser: An increased incidence of cholangiocarcinoma is seen in all of the following except:

1. Hydatid cyst of liver.
2. Polycystic disease of liver.
3. Sclerosing cholangitis.
4. Liver flukes.

Answer for yesterday’s Mind Teaser: 1. Hydatid cyst of liver.

Correct answers received from: Dr K V Sarma, Dr Poonam Chablani, Dr Sushma Chawla, Dr P C Das, Deepak Ambli, Dr Vijayakumar R R, Dr Meenakshi, Dr K Raju, Rajanish shetty, Dr Jainendra Upadhyay, Dr Pankaj Agarwal.

Answer for 5th August Mind Teaser: 1. Hyperosmolarity.

Correct answers received from: Dr K Raju.

Send your answer to ijcp12@gmail.com

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  1. Dear Sir, Very informative newspaper. Regards: Dr Karan

Forthcoming Events

HSICON 2014

Dear Colleague,

Hypertension Society of India is organizing its "23rd Annual Conference HSICON–2014" to be held on 9th & 10th August, 2014 at Kempinski Ambience Hotel, Near Yamuna Sports Complex, New Delhi

Dr. N. P. Singh                          Dr. Neeru P. Aggarwal

Organizing Chairperson               Organizing Secretary

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