eMedinewS9th May 2014,Friday

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

What’s new in Stroke

  1. Blood pressure management in the acute phase of ischemic stroke: Management of hypertension in the acute phase of stroke is controversial, partly because of concerns that the ischemic penumbra may be at risk if cerebral blood flow is reduced. In an open–label randomized trial, over 4000 adults with acute ischemic stroke were assigned to intensive blood pressure control or discontinuation of all antihypertensive therapies within the first 48 hours of stroke onset (1). At 14 and 90 days post–stroke, there were no differences in rates of death or major disability between the groups.
  2. NSTEMI following carotid intervention: In a retrospective study of over one million patients who underwent carotid endarterectomy or carotid artery stent placement, approximately 1 percent developed NSTEMI during hospitalization (2). NSTEMI was associated with significantly higher rates of neurologic complications (6.0 versus 1.4 percent), longer hospital stay (12.2 versus, 2.8 days), and in–hospital mortality (6.2 versus 0.4 percent).
  3. RCT of unruptured brain AV malformations: In the Randomized trial of Unruptured Brain Arteriovenous malformations (ARUBA), patients with unruptured arteriovenous malformations (AVMs) were assigned to medical versus interventional (surgery, radiotherapy, and/or endovascular therapy) treatment (3). The trial was halted early with outcome data on 223 patients followed for a mean of 33 months. Composite rates of symptomatic stroke (ischemic and hemorrhagic) and death were higher in the interventional compared to medical treatment group (31 versus 10 percent).
  4. Patent foramen ovale and cryptogenic stroke: The Risk of Paradoxical Embolism (RoPE) study analyzed individual patient data polled from 12 cryptogenic stroke cohorts (4). The prevalence of patent foramen ovale (PFO)—and the likelihood that PFO was the cause of the stroke—correlated with the absence of vascular risk factors and the presence of a cortical (as opposed to subcortical) cryptogenic infarct on imaging. Patients whose PFO was most likely to have caused the cryptogenic stroke were at the lowest risk for stroke recurrence.
  5. Secondary prevention of stroke from intracranial large artery atherosclerosis: The final results of the SAMMPRIS trial confirm that aggressive medical management is superior to angioplasty and stenting for patients with recently symptomatic high–grade intracranial large artery stenosis (5).


  1. He J, Zhang Y, Xu T, et al. Effects of immediate blood pressure reduction on death and major disability in patients with acute ischemic stroke: the CATIS randomized clinical trial. JAMA 2014; 311:479.
  2. Khan A, Adil MM, Qureshi AI. Non-ST-elevation myocardial infarction in patients undergoing carotid endarterectomy or carotid artery stent placement. Stroke 2014; 45:595.
  3. Mohr JP, Parides MK, Stapf C, et al. Medical management with or without interventional therapy for unruptured brain arteriovenous malformations (ARUBA): a multicentre, non–blinded, randomised trial. Lancet 2014; 383:614.
  4. Kent DM, Ruthazer R, Weimar C, et al. An index to identify stroke–related vs incidental patent foramen ovale in cryptogenic stroke. Neurology 2013; 81:619.
  5. Derdeyn CP, Chimowitz MI, Lynn MJ, et al. Aggressive medical treatment with or without stenting in high–risk patients with intracranial artery stenosis (SAMMPRIS): the final results of a randomised trial. Lancet 2014; 383:333.

(Source Uptodate)

News Around The Globe

  • Ondansetron and metoclopramide have similar efficacy in treating morning sickness in pregnant women, reports a recent study published online May 7 in Obstetrics & Gynecology. The women’s nausea ratings and length of stay were not significantly different with the two drugs; however, ondansetron was better tolerated for a 24–hour period.
  • A new study published online in JAMA Dermatology has reported that blue nevi that appear in elderly patients may be associated with a low risk of malignancy. Of the 204 blue nevi identified between 1991 and 2013, most with duration of 10 years or less, none was malignant, reported the study authors.
  • A study published online in Neurology has stated that people with more years of education are in a better position to recover from a traumatic brain injury. The study authors noted that individuals who received education for 12 to 15 years were almost 5 times more likely to recover without disability compared with those who had less than 12 years’ education.
  • Larazotide acetate, an oral peptide, reduced both gastrointestinal (GI) and non–GI symptoms in people inadvertently exposed to gluten, reported a recent randomized placebo–controlled trial. The drug prevents tight–junction opening and reduces gluten uptake. The study was presented at the Digestive Disease Week 2014.
  • Elevated levels of gamma–glutamyl transferase (GGT) before pregnancy lead to increased risk of developing gestational diabetes, reports a case–control study published online May 2 in Diabetes Care. The association was strongest for women in the highest tertile of insulin resistance before pregnancy.

Rabies News (Dr A K Gupta)

Are there any survivors of human rabies?

These patients survived not due to any specific antirabies therapy but following intensive life support and excellent nursing care. These patients survived for variable periods with residual neurological deficits. All the survivors had paralytic form of rabies and majority had history of some anti–rabies vaccination in the past.

Cardiology eMedinewS

  • A new study published online May 5 in Circulation has revealed that individuals in their 60s and 70s who regularly engaged in physical activity, such as walking, had the healthiest hearts. Additionally, older adults that increased their walking pace or distance had improved heart rate variability when compared with those that decreased their walking pace or distance.
  • A combined analysis of three studies involving the polypill has shown that patients taking only the single tablet had increased odds than patients taking multiple cardiovascular drugs to adhere to therapy at one year and had significantly lower LDL–cholesterol and blood–pressure levels. The findings from the Single Pill to Avert Cardiovascular Events (SPACE) study were presented at the World Congress of Cardiology 2014 Scientific Sessions.

Pediatrics eMedinewS

  • A research published in the May 7 issue of JAMA has reported that taking prenatal omega-3 fatty acid docosahexaenoic acid (DHA) supplements leads to no significant differences in measures of early childhood development at 4 years.
  • A new study from Netherlands has suggested that kids tend to eat more calories when playing a computer game that features advertisements for candy than when the game has ads for toys. Children with low self-control were especially vulnerable. The study is published online May 5 in Pediatrics.

Dr K K Spiritual Blog

Bhoot, Pret and Pishach

In mythology, ‘Bhoot’ means the memories of known people whose unfulfilled desires keep on disturbing us. ‘Pret’ means the memories of unknown people whose unfulfilled desires keep coming to our mind during sleep and disturbing us. These unfulfilled desires of unknown people are instances that we may have forgotten but still reach us through the cloud internet. When these memories start disturbing our day to day life, they are defined as Pishach.

Bhoot, Pret and Pishach are seen only by some people and not everyone. That means that their attachment will only be with those with whom their unfulfilled desires were linked to.

This attachment disorder where the unfulfilled desires of the deceased person keep on coming to our mind during day time, night and in our dreams can be understood by a computer IT model used by porn sites.

People who own porn sites develop software by which a specific program can get transferred to our computer and whenever we open these sites the program file gets embedded in our computer in a secret location in such a way that whenever we open the computer, the specific will appear on the desktop or will become the preferred sites whenever we open the internet. The specific site only will automatically open even if we do not wish to open it.

These files are difficult to delete unless the computer is reformatted or an experienced IT professional is able to delete these files.

The attachment disorders and the unfulfilled desires of the deceased persons can be compared to this technology and can be explained why those thoughts keep on coming in our mind. Not only the thoughts, even the images of people keep coming into mind and they are difficult to get deleted.

Wellness Blog

Nine Modifiable Risk Factors for Heart Attack

The majority of known risk factors for heart attack disease are modifiable by specific preventive measures.

Nine potentially modifiable factors include smoking, dyslipidemia, hypertension, diabetes, abdominal obesity, psychosocial factors, regular alcohol consumption, lack of adequate fruits and vegetables in diet and sedentary lifestyle. These account for over 90 percent of the population–attributable risk of a first heart attack.

In addition, aspirin is recommended for primary prevention of heart disease for men and women whose 10–year risk of a first heart attack event is 6 percent or greater.

Smoking cessation reduces the risk of both heart attack and stroke. The risk of heart attack and death from heart disease is reduced by one–half one year after quitting, and after several years it begins to approach that of nonsmokers.

A number of observational studies have shown a strong inverse relationship between leisure time activity and decreased risks of CVD. The Heart Care Foundation of India recommends walking 80 minutes in a day with a speed of 80 steps per minute.

Inspirational Story

Determining Your True Path

A master was strolling through a field of wheat when a disciple came up to him and asked, "I can’t tell which is the true path. What’s the secret?"

"What does that ring on your right hand mean?" asked the master. "My father gave it to me before dying." "Well, give it to me." The disciple obeyed, and the master tossed the ring into the middle of the field of wheat.

"Now what?" shouted the disciple.

"Now I have to stop doing everything I was doing to look for the ring! It’s important to me!"

"When you find it, remember this: You yourself answered the question you asked me. That is how you tell the true path: It is more important than all the rest."

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 & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association 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 – known risk factors for head and neck cancer – 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. In lab experiments, the researchers found that di–indolylmethane 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

The conversion of an optically pure isomer (enantiomer) into a mixture of equal amounts of both dextro and levo forms is called as:


Yesterday’s Mind Teaser: Which of the following factors increase your risk of having a stroke?

A. Hypertension and aging.
B. Being female and Caucasian.
C. Being female and African–American.
D. Menopause.
E. B and C.

Answer for yesterday’s Mind Teaser: A. Hypertension and aging.

Correct answers received from: Dr B R Bhatnagar, Dr Valluri Ramarao, Dr K Raju, Dr Arpan Gandhi, Dr K V Sarma, Dr Jainendra Upadhyay, Dr Pankaj Agarwal.

Answer for 5th May Mind Teaser: C. About 30 percent of your daily calories.

Correct answers received from: Dr Avtar Krishan, Daivadheenam Jella, Dr Bitaan Sen & Dr Jayashree Sen.

Send your answer to ijcp12@gmail.com

Zee News – Health Wealth Shows

Cancer Prevention
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
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

World Earth Day Celebration at DAV Public School, RK Puram, New Delhi.

press release

Vitamin D intake associated with reduced risk for Crohn’s disease

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 diabetic patient’s wound was not healing.
Reaction: Oh my God! Why is his A1c still more than 8?
Lesson: Make sure to control diabetes in such cases. Every 1% increase in hemoglobin A1c is associated with almost a 0.03 cm2 reduction in daily rate of wound resolution.

eMedinewS Humor

Embarrassing Traffic Stop

A police car pulled me over near the high school where I teach. As the officer asked for my license and registration, my students began to drive past. Some honked their horns, others hooted, and still others stopped to admonish me for speeding. Finally the officer asked me if I was a teacher at the school, and I told him I was. "I think you’ve paid your debt to society," he said with a smile, and left without giving me a ticket

Quote of the Day

Where there is determination there is success

Think of all that you wanted to achieve in the past few days. Now check if you have achieved it or are still trying for it. Check if you have left anything midway. Pick out one of the things that you wanted to achieve or create an aim for yourself and think, "I am the one who is victorious and I will achieve whatever I set out to. I will not leave any task unfinished."


Twitter of the Day

Dr KK Aggarwal: Cleaning your home may worsen asthma http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: The most positive action we can take about the past is to change our perception of it http://bit.ly/DC_Ananda #ananda


medicolegal update

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  1. Dear Sir, very informative Newspaper. Regards: Dr Kaushik
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