August 7  2015, Friday
eMedinewS
editorial
Bystander CPR better when more people help
Dr KK Aggarwal
  • Patients entering cardiac arrest are more likely to receive good–quality bystander–initiated cardiopulmonary resuscitation if multiple people assist
  • Among cases of out–of–hospital cardiac arrest, CPR quality is associated with multiple rescuers initiating bystander CPR, being in a central or urban setting, and receipt of bystander–initiated CPR and longer duration of resuscitation as per Dr Hideo Inaba, at Kanazawa University Graduate School of Medicine in Japan in the journal Resuscitation.
  • Good–quality bystander CPR is less commonly performed by a family member, by older bystanders and in home environments.
  • The key to survival and positive neurological outcomes for those experiencing an out–of–hospital cardiac arrest is the initiation of bystander CPR. This CPR should be performed with chest compressions only, without mouth–to–mouth resuscitation.
  • Good quality means: Appropriate hand positions or finger positions for infants, Compression rate of at least 100 per minute, Compression depth of at least 2 inches or at least one third of the anterior–posterior diameter of the chest
  • Time to arrest or recognition of arrest to initiation of CPR is significantly shorter among those who provided good-quality CPR (median 3 minutes versus 4 minutes).
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In cardiac arrest call 102 or 100
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News
Oncology
A new study published in the Lancet Oncology suggests that birth control pill offers long-term protection against endometrial cancer.

Neurology
Military personnel who reported three or more traumatic brain injuries (TBIs) demonstrated high total tau protein concentrations in plasma, in some cases long after the injuries had occurred, reported an observational study published online in JAMA Neurology. The findings suggest that accumulations of tau in plasma may contribute to chronic neurological symptoms following TBI.

Surgery
Obesity

Gut microbiota may play a direct role in the reduction of adiposity observed after bariatric surgery, suggested a European trial published online in Cell Metabolism. The microbiome changes were independent of body mass index (BMI) and degree of weight and fat mass loss, suggesting that these gut microbiota shifts are specific to bariatric surgery.

Infectious diseases
The BIG LoVE (Utah Better Identification of Germs-Longitudinal Viral Epidemiology) study suggests that big families have viral infections for 87% of the year but only half cause illness and that each kid puts the entire household at increased risk for infection with viruses that cause colds, flu, and other respiratory illnesses. The results were published in the journal Clinical Infectious Diseases.

Diabetes
People with type 2 diabetes can lower their blood sugar and benefit from following a structured, personalized self-monitoring blood glucose (SMBG) schedule even if they don't require insulin, suggest data presented at the American Association of Diabetes Educators Annual Meeting & Exhibition 2015.
Cardiology eMedinewS
  • Women and black patients will lose more years of expected life after a heart attack compared with white men, reported a new study published in the Journal of the American College of Cardiology.
  • Two implantable left ventricular assist devices (LVADs) -- the Heart Mate II and HeartWare -- have been linked to serious adverse events, according to the FDA. The adverse events include an increased rate of pump thrombosis (blood clots inside the pump) with HeartMate II and a high rate of stroke with the HeartWare HVAD.
Pediatrics eMedinewS
Pediatrics
Endocrinology

Even before a child is conceived, the parents' exposure to environmental stressors, such as endocrine-disrupting chemicals, psychological stress and malnutrition, can alter the way genes are expressed and ultimately harm the child's health, in the form of increased risk of cognitive disorders and metabolic diseases, when those genes are passed down to the next generation, suggested a new article published in the journal Endocrinology.

Pediatrics
Psychiatry

Contrary to previous findings, a new study suggested that chronic marijuana use by teenage boys does not appear to be linked to later physical or mental health issues such as depression, psychotic symptoms or asthma. The findings are published by the American Psychological Association in the journal Psychology of Addictive Behaviors.
Dr KK Spiritual Blog
What are Satvik offerings in Vedic literature?
  • Food Offerings: Panchashasha (grains of five types – brown rice, mung or whole green gram, til or sesame, mashkalai (white urad dal) or any variety of whole black leguminous seed, jowar or millet)
  • Panchagobbo (Five items obtained from cow: milk, ghee or clarified butter, curd, cowdung and gomutra), curd, honey, brown sugar, three big noibiddos, one small noibiddo, three bowls of madhupakka (a mixture of honey, curd, ghee and brown sugar for oblation), bhoger drobbadi (items for the feast), aaratir drobbadi mahasnan oil, dantokashtho, sugar cane juice, an earthen bowl of atop (a type of rice), til oil (sesame oil).
  • Water offerings: Ushnodok (lukewarm water), coconut water, sarbooushodhi, mahaoushodhi, water from oceans, rain water, spring water, water containing lotus pollen.
  • Three aashonanguriuk (finger ring made of kusha).
  • Puja Items: Sindur (vermillion), panchabarner guri (powders of five different colours – turmeric, rice, kusum flowers or red abir, rice chaff or coconut fibre burnt for the dark colour, bel patra or powdered wood apple leaves), panchapallab (leaves of five trees – mango, pakur or a species of fig, banyan, betal and Joggodumur or fig), pancharatna (five types of gems – gold, diamond, sapphire, ruby and pearl), panchakoshay (bark of five trees – jaam, shimul, berela, kool, bokul powdered in equal portions and mixed with water), green coconut with stalk, three aashonanguriuk (finger ring made of kusha).
  • Panchamrit: A mixture of Honey, Milk, Curd, Ghee and Brown Sugar.
Make Sure
Situation: A foreigner with a single loose stool developed sepsis.
Reaction: Oh my God! Why were antibiotics not started in time?
Lesson: Make sure that all foreigners are diagnosed to be suffering from Traveler’s diarrhea even if there is one single loose motion.
Dr Good Dr Bad
Situation: A patient came for counseling for a high risk sexual behavior.
Dr. Bad: Use condoms.
Dr. Good: Use condoms and take a pre–exposure prophylaxis pill for 7 days.
Lesson: Pre exposure prophylaxis for 7 days is now a reality.

(Copyright IJCP)
eMedi Quiz
What is a healthy blood-pressure level?

A. 110/70.
B. 125/85.
C. 135/90.
D. 140/95.
E. 150/95.

Yesterday’s Mind Teaser: Which of the following is not a good approach to managing stress?

A. Talking directly to the person who is causing the stress.
B. Giving yourself a treat, like comfort food or a cocktail.
C. Accepting that there are things beyond your control.
D. Trying cognitive-behavioral therapy to learn new coping skills.
E. Working out regularly.

Answer for yesterday’s Mind Teaser: B. Giving yourself a treat, like comfort food or a cocktail.

Correct Answers received from: Dr G Madhusudhan, Pandit Hantodkar, Dr Avtar Krishan, Dr A C Dhariwal, Dr Bitaan Sen & Dr Jayashree Sen.
Answer for 4th August Mind Teaser: C. Yes, and the headaches are more severe.
Correct Answers received: Dr Avtar Krishan, Dr Jayashree Sen & Dr Bitaan Sen, Dr G Madhusudhan, Dr Jainendra Upadhyay, Dr K V Sarma, Dr Poonam Chablani, Dr G Madhusudhan, Dr K Raju.
eMedinewS Humor
Bank name
Mother decided that 10-year-old Cathy should get something 'practical' for her birthday. "Suppose we open a savings account for you?" mother suggested. Cathy was delighted. "It's your account, darling," mother said as they arrived at the bank, "so you fill out the application." Cathy was doing fine until she came to the space for 'Name of your former bank.' After a slight hesitation, she put down 'Piggy.'
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Rabies News (Dr A K Gupta)
What are the signs of rabies in dogs/cats?
  • Any change in normal behavior suggesting either undue aggression or depression
  • Running aimlessly and attacking others without provocation
  • Becomes too drowsy and withdraws to a corner
  • Change in voice/bark
  • Excessive salivation
  • Refusal to feed or eating objects like stone, paper, wood, metal pieces etc.
IJCP Book of Medical Records
IJCP’s ejournals
CPR 10
Total CPR since 1st November 2012 – 113241 trained
Video of the Day
Sameer Malik Heart Care Foundation Fund
The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.
Madan Singh, SM Heart Care Foundation Fund, Post CAG
Kishan, SM Heart Care Foundation Fund, Post CHD Repair
Deepak, SM Heart Care Foundation Fund, CHD TOF
Press Release
HCFI and IMA congratulates police PCR van who saved life of a businessman with cardiac first aid

Both HCFI and IMA congratulated the Delhi Police PCR van that saved the life of a businessman in Delhi by the timely implementation of the life-saving technique of hands-only CPR10. Heart Care Foundation of India jointly with the Indian Medical Association, Delhi Red Cross Society and Delhi Police has taken up the challenge of training 100% of the Delhi Police PCR van staff on the life-saving technique of Hands-only CPR 10 by Independence Day 2015. Until now over 7000 police PCR van staff have been trained so far.

Addressing a gathering of over 250 police persons Padma Shri Awardee Dr K K Aggarwal President Heart Care Foundation of India and Honorary Secretary General IMA, said that, “Once 100% training of Delhi Police PCR is completed, they should be able to save atleast one life a day.”

“Hands-Only CPR 10 is an easy to learn and extremely effective life-saving technique. If administered within 10 minutes of death, it can help revive a majority of the sudden cardiac arrest victims. No formal training is required to perform the technique”, added Padma Shri Awardee Dr A Marthanda Pillai, National President IMA.

Past President Medical Council of India Dr Ketan Deasi who was the chief guest for the function said, “Hands only CPR should be mandatory part of a curriculum right in the first year of medical, dental, pharmacy and nursing colleges”.

The correct posture to perform hands-only CPR 10 is to sit on ones knees, lay the victim flat on their back, lock the hands and then start pressing the center of their chest (1.5 -2inches deep) at a speed of 10x10 – 100 a minute. The compressions must not be stopped until the person gets revived or medical help arrives. In drowning victims and children mouth to mouth breathing needs to be added after 30 compressions. In all other situations, Hands only CPR 10 is the most effective.

A sudden cardiac arrest occurs when the electrical conducting system of the heart fails and the heartbeats irregularly and very fast (more than 1000 times, technically called as ventricular fibrillation). Soon after the heart suddenly stops beating and the blood flow to the brain stops. As a result, the person becomes unconscious and stops normal breathing. A cardiac arrest is not the same as a heart attack, but it may be caused by a heart attack. In most cases, sudden cardiac arrest may be reversible in the first 10 minutes. This is possible because the brain remains alive during this period when the heart and respiration have stopped, a situation called clinical death. To know more or to organize a training camp in your locality, please call the NGO’s helpline number 9958771177.

 
 
eIMA News
First life has been saved
IMA, Heart Care Foundation of India and Delhi Red Cross Society are jointly training 100% PCR staff on hands only CPR

Kindly see the coverage

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Dr Pillai and Dr KK
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File No. 10/QA/Noodle Issues/FSSAI/2015 (Part-II)
Food Safety and Standards Authority of India

(A Statutory Authority established under the Food Safety and Standards Act, 2006) (Quality Assurance Division)

FDA Bhawan, Kotla Road, New Delhi - 110002

Dated, the 28th July, 2015

To
Dr. K.K. Aggarwal Honorary Secretary General,
Indian Medical Association, IMA House,
Indraprastha Marg, New Delhi - 110002

Subject: Queries related to "Maggi" - reg.

Ref : Your letter dated 22.05.2015

Sir,

Your kind attention is invited to the subject & reference cited above. At the outset, please accept our regrets for the delayed response. It is informed that Regulation No. 2.1.1 (2) of FSS (Contaminants, toxins and residues) Regulation, 2011 prescribes the limit of lead as 2.5 ppm in Foods not specified. Incidentally, 'Noodles with Tastemaker' is a non-standardised food and hence requires Product Approval. As such, the maximum permissible of Lead in this kind of Food may be as stated by the applicant subject to an upper cap of 2.5 ppm. Further, Regulation No. 3.1.11 (1) of FSS (Food Product Standards and Food Additives) Regulation, 2011 prescribes the use of MSG at GMP (Good Manufacturing Practices) level and states the list of foods where Monosodium Glutamate is not allowed (copy of regulations enclosed).

2. An advisory was issued to all Commissioners of Food Safety vide letter No. 10/QA/ Enforcement Issues/FSSAI-2015 dated 08.06.2015 for sampling and testing of Noodles, Pasta and Macaroni (with Tastemaker) of all makes and brands present in the market. A copy of this Advisory is also available on the FSSAI website.

3. In case where samples are found to be contaminated, provisions for penal action against the offenders are provided under Section 50, 51, 54, 57 and 59 of the Food Safety and Standards Act, 2006. You would be aware about the action taken by the FSSAI in respect of the Maggi Noodles. It may be contextual to inform you that M/s Nissin Foods and M/s Hindustan Lever voluntarily recalled their Noodles Product from the market as they had launched these products without obtaining the prior Product Approvals and hence unauthorized.

                                                         Yours faithfully,
                                                         (Sandhya Kabra)
                                                         Director
                                                         (QA/PA/Legal)
                                                         Ph: 011-23237418
IMA IPMO Initiative
Kindly go to http://module.ima-india.org/ipmo/
and pledge your organs
unless we do it public will not listen to us

Team IMA
ICON 2015
Complaints about negative portrayal of doctors forwarded to council Press Trust of India | New Delhi
Press Trust of India | New Delhi

August 5, 2015 Last Updated at 16:42 IST: Business Standard

Government today said complaints received from Indian Medical Association (IMA) about negative portrayal of doctors in NCERT social science class VII text book has been forwarded to the council for "taking appropriate action".

IMA had recently objected to the negative portrayal of a section of doctors in the National Council of Education Research and Training (NCERT) and the cost of cure in private hospitals in comparison to government hospitals.

"Complaints have been received from the office bearers of IMA and some of its state branches. These complaints have been forwarded to NCERT for taking appropriate action," HRD Minister Smriti Irani said in a written reply in Lok Sabha.

The complaints were about the social science text book under the sub-heading 'healthcare and equality' published in February 2007 and in circulation since the 2007-08 academic session.

"In order to earn more money, these private services encourage practices that are incorrect. At times cheaper methods, though available are not used. For example, it is common to find doctors prescribing unnecessary medicines, injections and saline bottles when tablets or simple medicines can suffice," the book read.

IMA had also objected to the content on the 'cost of cure' on page 22 and 23 which indicated the differences in the cost of treatment in government and private hospitals.
NEWS
  • Official guidelines should set lower exercise targets for people older than 60 years than for younger adults, a meta-analysis shows. This population can reduce its risk for death by about 22% with only half the recommended 150 minutes per week of moderate-intensity exercise, according to a new report in the British Journal of Sports Medicine.
  • Death due to cardiovascular disease (CVD) in the United States has been declining since the 1970s, but the burden remains high, accounting for roughly 32% of all deaths in 2010, with many disadvantaged groups disproportionately affected, according to the statement, published online August 3 in Circulation. (Medscape)
  • A peer-reviewed, multidisciplinary journal, Transgender Health, focusing on scientific and clinical studies to advance understanding of the health issues faced by transgender people will be launched this fall. (Medscape)
Inspirational Story
The Duck and the Devil

There was a little boy visiting his grandparents on their farm. He was given a slingshot to play with out in the woods.

He practiced in the woods, but he could never hit the target. Getting a little discouraged, he headed back for dinner. As he was walking back he saw Grandma's pet duck.

Just out of impulse, he let the slingshot fly, hit the duck Square in the head, and killed it. He was shocked and grieved.

In a panic, he hid the dead duck in the wood pile, only to see his sister watching! Sally had seen it all, but she said nothing.

After lunch the next day Grandma said, " Sally, let's wash the dishes." But Sally said, "Grandma, Johnny told me he wanted to help in the kitchen." Then she whispered to him, "Remember the duck?" So Johnny did the dishes.

Later that day, Grandpa asked if the children wanted to go fishing and Grandma said, “I’m sorry but I need Sally to help make supper." Sally just smiled and said," Well that's all right because Johnny told me he wanted to help." She whispered again, "Remember the duck?" So Sally went fishing and Johnny stayed to help.

After several days of Johnny doing both his chores and Sally's, He finally couldn't stand it any longer. He came to Grandma and confessed that he had killed the duck. Grandma knelt down, gave him a hug, and said, “Sweetheart, I know. You see, I was standing at the window and I saw the whole thing, but because I love you, I forgave you. I was just wondering how long you would let Sally make a slave of you."

Thought for the day and every day thereafter?

Whatever is in your past, whatever you have done... And the devil Keeps throwing it up in your face (lying, cheating, debt, fear, bad Habits, hatred, anger, bitterness, etc.) ....whatever it is....You need to know that God was standing at the window and He saw the whole thing..... He has seen your whole life. He wants you to know that He loves you and that you are forgiven.

He's just wondering how long you will let the devil make a slave of you.

The great thing about God is that when you ask for forgiveness, He not only forgives you, but He forgets. It is by God's grace and Mercy that we are saved. Always remember: God is at the window.
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Creativity is allowing yourself to make mistakes. Art is knowing which ones to keep. Scott Adams
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Wellness Blog
Turmeric can prevent heart failure

Traditional Indian turmeric prevents heart failure, lowers cholesterol, prevents cancers and gall stones and augments scar formation in a wound.

Studies from the University of Toronto’s Cardiology Division and published in the Journal of Clinical Investigation have shown that curcumin, an ingredient in the curry spice turmeric, when given orally to a variety of mouse models with enlarged hearts (hypertrophy), could prevent and reverse hypertrophy, prevent heart failure, restore heart function and reduce scar formation.

In the studies, curcumin was given to rats, who then underwent surgery or received drugs designed to put them at risk of heart failure. The rats that received curcumin showed more resistance to heart failure and inflammation than comparison groups of rats that did not get curcumin. Curcumin treatment also reversed heart enlargement. Curcumin short–circuited the heart enlargement process, though it’s not clear how it did that.

The healing properties of turmeric have been well–known. The herb has been used in traditional Indian medicine to reduce scar formation. For example, when there is a cut or a bruise, the home remedy is to reach for turmeric powder because it can help to heal without leaving a bad scar.

Curcumin has come under the scientific spotlight in recent years, with studies investigating its potential benefits for reducing cholesterol levels, improving cardiovascular health and fighting cancer.

As an herb, turmeric should to be taken 300 mg thrice–daily with meals. It has useful actions like antioxidant, anti–inflammatory, anti rheumatic; lowering cholesterol, anti cancer and prevention of gall stones. It is also found to be useful in situations like dysmenorrhea, dyspepsia, HIV, muscle soreness, peptic ulcer disease, scabies and uveitis.

Curcuminoids, act as free radical scavengers. They also inhibit leukotrienes and synthesis of prostaglandins. The anti–inflammatory activity has been claimed to be comparable to NSAIDs (such as indomethacin).

Curcuminoids lower blood lipid peroxides, decrease total cholesterol and LDL cholesterol, and increase HDL cholesterol. Turmeric has also been claimed to inhibit platelet aggregation.
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Reader Response
IMA Desinganad Branch, Quilon district, Kerala conducted a workshop on BLS training to police personnel and volunteers. It was widely publicized by a cycle rally flagged off by National President, along with Dr Vijayakumar K Past National President and branch president Dr Sreekumar Sasidharan Pillai and Dr Uma Mohandas Vice president Kerala State. It gives good rapport between police officials and IMA. Dr Alex Franklin