eMedinewS9th December 2013, Monday

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);
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Non–alcoholic Fatty Liver Disease Independently Predicts Prediabetes

Non–alcoholic fatty liver disease has been linked to increased risk for developing type 2 diabetes. A new study in Liver International 2013;33(9):1406–1412 evaluated the independent role of NAFLD in predicting the development of pre–DM in a 7–year prospective follow-up of healthy volunteers.

A prospective cohort of a subsample of the Israeli National Health Survey was evaluated at baseline and after 7 years by identical protocols. Metabolic parameters and ultrasonographic evidence of NAFLD were evaluated in 213 subjects, without known liver disease or history of alcohol abuse. Exclusion criteria were pre–DM at the baseline survey. Steatosis was quantified by ultrasound with the hepato–renal ultrasound index (HRI).

The study included 141 volunteers (mean age 48.78 ± 9.68, 24.82% with NAFLD) without pre–DM/DM at baseline. Both NAFLD on regular US (OR=2.93, 1.02–8.41 95%CI) and HRI (OR=7.87, 1.83–33.82) were independent predictors for the development of pre–DM, adjusting for age, gender, BMI, family history of DM, baseline insulin, adiponectin and glucose. Further adjustment for physical activity and dietary intake did not weaken the association. Furthermore, NAFLD was a stronger predictor for pre-DM than the metabolic syndrome. Subjects with both NAFLD and glucose ≥89 had 93.3% incidence rate of pre–DM. The study concluded that non–alcoholic fatty liver disease is a strong and independent risk factor for pre–DM in the general adult population; thus, NAFLD patients should be classified as a population at risk.

MR–Guided Focused Ultrasound for Knee Osteoarthritis

Recently, local bone denervation by MR–guided focused ultrasound has been demonstrated as a promising tool for pain palliation of bone metastases. A study in BMC Musculoskelet Disord 2013;14(267) has shown the safety and efficacy of MRgFUS treatment in osteoarthritis. Significant increase of Pressure pain thresholds on treated area showed successful denervation effect on the nociceptive nerve terminals. MRgFUS is a promising and innovative procedure for noninvasive pain management of knee OA.

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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VIP’s on CPR 10 Mantra Video
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Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

You cannot serve two masters (God and Wealth)

sprritual blog

This is true for both your internal spiritual journey as well as the external social journey in life. Wealth is an indicator of greed, which is one of the five known obstacles to the pathway of self–realization.

Greed, according to the Patanjali is defined as possessing any material wealth more then your need.

Greed in turns is linked to attachment through any of the five senses and uncontrolled desires. Once desires are fulfilled more desires are created, which is nothing but the greed. And when the desires are not fulfilled then greed gets converted into anger, which leads to loss of intellect and ultimately destruction of the body.

Lord Krishna in the Bhagvad Gita while explaining it to Arjuna has clearly mentioned the pathway of self destruction starting from attachment to loss of intellect and ultimately destruction of the self.

The Hindu mythology has always said that never be after money. When you are after money the knowledge or the wisdom will not follow you. The classical example given is that if you are after Saraswati (God of Knowledge), Laxmi (God of Wealth) follows you and if you are after Laxmi, Saraswati may not remain with you.

God is representative of your true self and that is your consciousness, which is nothing but "Satchitananda" or the triad of truthfulness, consciousness–based decisions and internal bliss or happiness. To be in touch with your consciousness you have to control your five senses through your mind and detach yourself from the egocentric desires.

Greed and wealth are representatives of attachment to the material world through one of your five senses, therefore, if you want to be in touch with your consciousness you have to be detached from the materialistic world and wealth is one of them.

There is a classical description of this phenomenon in Mahabharata in the battle of Kurukshetra when Lord Krishna became the Sarathi of Arjuna and rode the five horses chariot.

The symbolic representation of this is, Lord Krishna represents your true self or consciousness; Arjuna represents the ego and the intellect; the rein of the horses represents the unstable mind and five horses represent ever changing five senses. Using your ego and intellect if you can tighten your mind (rein), you will be able to control the five horses (the five senses) and then you will have all the time in the world to be with Lord Krishna (your own consciousness). On the other hand, if you let the reins loose (let the mind wonder) all the horses (senses) will be out of control and wander here and there (one gets attached to the materialistic world). Instead of becoming the master, the mind and the intellect would then become the servant of the five senses and will get detached from the true self or the consciousness.

Electricity is a good servant and a bad master is a well known saying. Something is true for the five senses. They are very good to the life provided they are controlled like servants and never treated like masters. Once they overpower you they will create an umbrella of darkness over the mind and the intellect making you forget about the presence of soul in the body. Once this happen you lose your dharma.

Whenever given a choice always choose your consciousness as the master and not any of the five senses, mind, intellect or ego.

cardiology news

Good Luck? Bad Luck? Who Knows?

There is a Chinese story of an old farmer who had an old horse for tilling his fields. One day the horse escaped into the hills and, when all the farmer’s neighbors sympathized with the old man over his bad luck, the farmer replied, ‘Bad luck? Good luck? Who knows?’

A week later the horse returned with a herd of wild horses from the hills and this time the neighbors congratulated the farmer on his good luck. His reply was, ‘Good luck? Bad luck? Who knows?’

Then, when the farmer’s son was attempted to tame one of the wild horses, he fell off its back and broke his leg. Everyone thought this very bad luck. Not the farmer, whose only reaction was, ‘Bad luck? Good luck? Who knows?’

Some weeks later the army marched into the village and conscripted every able–bodied youth they found there. When they saw the farmer’s son with his broken leg they let him off. Now was that good luck? Bad luck? Who knows?

News Around The Globe

News

  • New figures show an estimated 44 million people worldwide now have dementia, up from 35 million in 2010, and that number will reach 76 million in 2030, and 135 million by 2050.The new estimates are a "staggering" increase of 17% over figures published in 2009, Alzheimer’s Disease International (ADI) said in a Policy Brief for heads of government released this week, ahead of the first G8 Dementia Summit, which will take place in London, United Kingdom, on December 11.
  • Findings from a prospective longitudinal study reported in the December Arthritis Care & Research suggest that patients with osteoarthritis of the hip or knee are at heightened risk for cardiovascular disease. After adjustment for risk factors, men older than 65 with osteoarthritis had a 15% increased risk for hospitalization for cardiovascular disease.
  • Insulin sensitizing agents may carry a lower risk of cancer for women with type 2 diabetes than insulin secretagogues. In a retrospective review of a large data set, insulin sensitizers such as thiazolidinediones (TZDs) and metformin were associated with a 21% decreased cancer risk for women compared with insulin secretagogues such as sulfonylureas as reported online in Diabetes, Obesity, & Metabolism.
  • The US FDA has approved the first–in–kind nucleotide analog inhibitor sofosbuvir (Sovaldi, Gilead Sciences, Inc) for the treatment of adults with chronic hepatitis C virus (HCV) infection, a widely anticipated move that is expected to dramatically improve outcomes for many patients. Sofosbuvir is used for all–oral dual therapy of infections with HCV genotypes 2 and 3, as well as in triple therapy along with injected pegylated interferon (pegIFN) and RBV for treatment–naive patients with HCV genotypes 1 and 4.
  • The gut microbiome of patients with colorectal cancer (CRC) was less diverse than that of matched patients without cancer, and the presence of some taxa was associated with increased CRC risk, according to research published online December 6 in the Journal of the National Cancer Institute.

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Rabies News (Dr. A K Gupta)

Is washing of animal bite wound(s) essential?

The risk of rabies reduces by about 50% by just washing of wounds and application of antiseptics.

The maximum benefit of the wound washing is obtained when the fresh wound is cleaned immediately. It is important to remove saliva containing rabies virus at the site of bite by physical or chemical means. This can be done by prompt and gentle thorough washing with ordinary soap or detergent and flushing the wound with running tap water for at least 15 minutes.

Washing of the wound must be done as long as the wound is raw, irrespective of the time elapsed since the exposure. Care must be taken not to disturb the scab, if formed.

After washing with water and soap, disinfectants like Povidone Iodine or Surgical Spirit must be applied.

In extraneous circumstances, other alcoholic (>40%) preparations like Rum, Whisky or aftershave lotion may be applied on the wound. If soap or antiviral agent is not available, the wound should be thoroughly washed with water.

cardiology news

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

  • A higher BMI was associated with decreased mortality in certain subsets of patients with acute decompensated heart failure, according to an intercontinental study that supports the existence of a global "obesity paradox." Overall, a higher BMI was associated with decreased 30–day and 1–year mortality (11% decrease at 30 days; 9% decrease at one year per 5kg/m²; P< 0.05), after adjustment for clinical risk, wrote James L. Januzzi Jr, MD, of Massachusetts General Hospital, and his co-authors in the Journal of the American College of Cardiology.
  • Coronary CT angiography may be a sensible alternative to the cardiac stress test or angiography in patients with mild artery disease according to findings from a prospective international cohort study presented at the Radiological Society of North America Annual Meeting. The noninvasive test uses CT to image the amount of plaque in the coronary arteries.
cardiology news

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

  • Using ultrasound as the first diagnostic imaging technique to detect appendicitis in children produces comparable outcomes to computed tomography (CT) scanning with less radiation and without increasing hospital length of stay, according to a retrospective study published in the December issue of the American Journal of Roentgenology.
  • Advocates for newborn health are proposing to accelerate kangaroo mother care (KMC) as the standard of care for preterm infants."A multi–stakeholder group is now in the process of developing both global– and national–level strategies and implementation plans around the several parallel streams of work needed to ‘bend the curve’ as part of the Every Newborn Action Plan to be launched in May 2014," said Dr. Cyril Engmann from the Bill & Melinda Gates Foundation, Seattle, Washington. KMC comprises a host of care practices for preterm infants which include continuous skin–to–skin contact, breastfeeding, and close follow–up after discharge from a health facility.
cardiology news

Small weight gain a risk to kidneys

In healthy men of normal weight, relatively small increases in weight raise the risk of chronic kidney disease (CKD). Quoting a study reported in the Journal of the American Society of Nephrology, Dr Aggarwal said that CKD should be added to the list of conditions that are associated with weight gain, including diabetes and high blood pressure.

Obesity is a known risk factor for CKD, but weight gain in normal–weight individuals without high blood pressure or diabetes is now shown to be an added risk factor.

The experts followed 8792 healthy men ages 30 to 59 years with no known risk factors for CKD between 2002 and 2007. The prevalence of obesity was about 33 percent. The researchers observed a U–shaped association between changes in weight categories among normal-weight and overweight subjects and the development of CKD. Men who lost or gained a lot of weight (more than 0.75 kg, or 1.7 pounds, per year) had the highest risk of developing CKD. Increased risk was seen among men with even small weight changes. The lowest risk observed was among those who gained or lost as little as 0.25 kg, or 0.6 pounds, per year.

The findings suggest that weight gain within 'the normal' weight range is clearly one of the risk factors in developing CKD, and initial low body mass index does not counteract the deleterious effect of weight gain.

Avoidance of weight gain, even among lean individuals, is important to reduce the risk for this disease.

cardiology news

Total CPR since 1st November 2012 – 77197 trained

Media advocacy through Web Media

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press release

CPR 10 Training Camp at Bal Bharti Public School, Dwarka, New Delhi

Heart Care Foundation of India organized a Health Checkup camp and CPR 10 training camp at Bal Bharti Public School, Dwarka, New Delhi. The Foundation has conducted one to one training on” Hands only CPR 10” of 77157 people since 1st November 2012.

Administering a training to over 2500 people today on” Hands only CPR 10” , Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that even gasping is a sign of cardiac arrest. One should start chest compression hands only CPR in a gasping person.

CPR 10 is based on the concept that consciousness does not leave the body for 10 minutes after the cardiac arrest. If Hands-only CPR is done on the victim by a bystander during this period, the person can be revived.

The Foundation has created a Savitri CPR 10 mantra which states “within 10 minutes of 10 - earlier the better, for the next 10 minutes - longer the better, press the centre of the chest of the deceased victim with a speed of 10x10 i.e. 100 per minute effectively and continuously. In Hindi, it reads as “marne ke dus minute ke under dus minute tak aur 10 x 10 yani 100 minute ke speed par apni chhati peetne ke badle marne wale ki chhati peeto.”

Dr Sanjay Gupta, Dr Smita Mishra, Dr Shashi Bala and sixty nurses and technicians participated in the camp.

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 77157 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 10x10 i.e. 100 per minute.”

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CPR 10 Training Camp at Bal Bharti Public School, Dwarka, New Delhi

press release

Monitoring LFT in a patient on statins

vedio of day

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

An increase in which of the following parameters will shift the O2 dissociation curve to the left.

1. Temperature.
2. Partial pressure of CO2
3. 2,3 DPG concentration.
4. Oxygen affinity of haemoglobin.

Yesterday’s Mind Teaser: At the end of a balanced anaesthesia technique with non–depolarizing muscle relaxant, a patient recovered spontaneously from the effect of muscle relaxant without any reversal. Which is the most probable relaxant the patient had received?

1.Pancuronium.
2.Gallamine.
3.Atracurium.
4.Vecuronium.

Answer for yesterday’s Mind Teaser: 3.Atracurium.

Correct answers received from: Dr.Dinesh Narain Saksena, DR AVTAR KRISHAN, Dr Chandresh Jardosh,

Answer for 7th December Mind Teaser: 2.Hypovolemia.

Correct answers received from: Dr.Dinesh Narain Saksena, Dr. P. C. Das

Send your answer to ijcp12@gmail.com

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medicolegal update

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medicolegal update

As an English professor, my father would often write little notes on student essays. Often he worked late, and as the hours passed, his handwriting deteriorated. One day a student came to him after class with an essay that had been returned.

"Mr. McDonald," he said, "I can’t make out this comment you wrote on my paper."

My father took the paper and, after studying it, sheepishly replied, "It says that you should write more legibly."

medicolegal update
medicolegal update

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medicolegal updatemedicolegal update

medicolegal update

Situation: A patient with dengue fever developed shock.
Reaction: Oh my God! Why was the blood pressure 90/70 ignored?
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.

medicolegal update

Good friends care for each other… close friends understand each other… and true friends stay forever beyond words, beyond time

medicolegal update

Dr KK Aggarwal: Smoking and ulcerative colitis http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Your only identity is I AM undefined and infinite. Any label you give yourself limits yourself.

Forthcoming events

5th eMedinews Revisiting 2013

(a day long single hall medical conference on 2013 happenings, followed by doctors of the year 2013 awards)

Sunday 19th January 2014, Maulana Azad Medical College Auditorium

Dilli Gate Delhi, 10 am-6 pm


Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee President
Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman
Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

5th eMedinewS Revisiting 2013
The 5th eMedinewS–revisiting 2013 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 19th 2014.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2013. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. Lunch will be provided.

Register at: rawat.vandana89@gmail.com/drpawangupta2006@yahoo.com

5th eMedinewS Doctor of the Year Awards
Nominations invited for 5th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2013.

pls send his/her Biodata at: emedinews@gmail.com

medicolegal update
  1. Dear Sir, emedinews is very informative. Regards: Dr Sapna

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Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Prof.(Dr).C V Raghuveer

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