eMedinewS11th May 2014,Sunday

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

Heart Diseases in children

Many different types of heart diseases can affect children, ranging from congenital heart diseases to acquired heart diseases.

About one percent of children are born with congenital heart disease, which can be classified as a blue baby or a non–blue baby. There was a time when no cure was available for congenital heart disease but today, many hospitals are performing surgeries in children with congenital heart disease with excellent outcomes.

Rheumatic heart disease means involvement of valves of the heart because of a bacterium, which causes sore throat. It usually occurs in school going children who present with sore throat with no cough and sneezing. A sore throat is a red angry–looking throat with pain on swallowing. If ignored and not treated in time, the infection can bite the heart and lick the joint (rheumatic fever). There may be sore or swollen joints and fever, which may disappear but the valves of the heart may be permanently damaged causing rheumatic heart disease. The affected children require valve replacement, which if not done in time may even result in death. A large number of children with congenital heart disease and rheumatic heart disease die because of non-availability of operative facilities in the country, especially for complex congenital heart disease. Many of them die as they cannot afford the cost of treatment including surgery.

The following options are available for children with heart diseases who cannot afford treatment:

  • Sameer Malik Heart Care Foundation Fund a initiative of Heart Care Foundation of India, Helpline no. 09958771177, which is open from Monday to Saturday and provides assistance to the needy and underprivileged children for free surgery.
  • Various Rotary Clubs in the country provide free surgery to children with heart disease.
  • ‘Being Human’, the organization run by the cine actor Salman Khan also provides financial assistance to children with congenital heart diseases.
  • Most states provide assistance of up to Rs 1 lakh for congenital heart disease to children if they possess BPL or equivalent card in the state.
  • The Delhi State Government also provides free heart treatment to children whose parents have annual income of less than Rs 3 lakhs.
  • Parents can apply through legal counsel to municipal corporations for assistance, through their local MLA or through their MP to the Prime Minister Relief Fund.
  • Children can also approach Puttaparthi Heart Centre at Bengaluru, which provides free surgeries to such children.
  • Various NGOs and associations also provide free treatment; for example, Maheshwari Club provides free treatment to Maheshwari families.
  • People can also approach their religious organizations like Gurudwaras, Mosque committees and Hindu Mahasabhas etc. for free assistance in respective category.
  • Under Article 21 of the Constitution of India, people can also approach respective High Courts for directions to respective state heart departments to avail free surgeries.
  • In every state, there are government hospitals, which provide free surgeries; for example, GB Pant Hospital provides free surgery to everyone with heart disease.
  • Safdarjung Hospital, New Delhi provides free heart surgery to all BPL patients from across the country.
  • People can also approach various PSUs for assistance under their CSR policy.
  • People can also approach various large private companies for assistance under their CSR policy.

The end result is – no children in India should die of curable heart disease just because he or she cannot afford it.

News Around The Globe

  • The Stroke Oxygen Supplementation (SO2S) Study, presented at the XXIII European Stroke Conference (ESC), has found no benefit from routine oxygen supplementation in stroke. The primary outcome, disability at 90 days on the modified Rankin scale, showed a neutral result with an odds ratio of 1.04 for a better outcome with oxygen vs. control.
  • Another study presented at the XXIII European Stroke Conference (ESC) has revealed that giving simvastatin in the first few days after subarachnoid hemorrhage (SAH) had no significant effect on functional outcome at 6 months.
  • For rheumatoid arthritis patients not responding to TNF inhibitors, swapping to other agents with a different mechanism of action brings about better outcomes than switching to a second anti–TNF drug, reports a recent study. Swapping to another biologic class was associated with 2.258–fold more treatment retention than switching to another TNF inhibitor.
  • According to a new study, ibuprofen and excedrin have the potential to relieve the pain and symptoms of severe migraine better than placebo. Excedrin users reported more pain relief than ibuprofen users from 45 minutes to four hours post medication.
  • A study published online May 4 in the New England Journal of Medicine has pointed that the combination of sofosbuvir and ribavirin produces a sustained virologic response in patients with hepatitis C virus (HCV) genotypes 2 and 3.

Rabies News (Dr A K Gupta)

What precautions should be taken while vaccinating by the ID route?

  • The ID injections must be administered by staff trained in this technique.
  • The Vaccine vials must be stored at +2°C to + 8°C after reconstitution.
  • The total content should be used as soon as possible, but at least within 8 hours.
  • The 0.1 ml. ID administration of cell–culture vaccine should create a wheal of at least 5 mm diameter with "peau d’ orange" appearance.
  • If ID dose is given subcutaneously then there is a possibility of poor immune response due to low antigen load. This may be life–threatening.

Cardiology eMedinewS

  • Physical inactivity may be responsible for more heart disease than smoking, obesity, or high blood pressure among Australian women older than 30 years. The study was published online May 8 in the British Journal of Sports Medicine.
  • Results from the Efficacy of Nitric Oxide and Stroke (ENOS) trial, presented at the XXIII European Stroke Conference (ESC), found no evidence to support the continuation of prestroke blood pressure–lowering therapy in patients in the acute phase of stroke.

Pediatrics eMedinewS

  • Antimicrobial treatment hastens the resolution of middle ear effusion associated with acute otitis media, reports a new study published online May 5 in JAMA Pediatrics. Middle ear effusion resolved about 2 weeks earlier in children who received antimicrobial therapy (mean, 18.9 days) as compared to those not treated with antibiotics (mean, 32.6 days).
  • A retrospective study published online May 5 in JAMA Pediatrics has revealed that very few children who receive new prescriptions for second–generation antipsychotics receive the recommended metabolic monitoring. Only 0.1% of the pediatric patients included in the study received all baseline and follow–up metabolic monitoring.

Dr K K Spiritual Blog

The science behind IPL matches

Is IPL injurious to the health of Indian cricket?

Many would say no but I personally feel in the long run it will be. Because, you are disclosing the weaknesses of your fellow national cricketers who are in other league teams to foreign players who are a part of your IPL team. For example, you are telling an Australian bowler who is in your IPL team how to get Shikhar Dhawan or Rohit Sharma out because they happen to be in the opposite teams.

Some may argue that foreign players may also convey similar information about their own colleagues but remember only a few of the foreign players play in IPL, while 100% Indian players are playing. A time will come when weaknesses of each and every Indian cricketer would be known to every foreign cricket team and that will be the day when it will be true that IPL is injurious to health of Indian cricket.

Another thing which is worrying about IPL is that you are also creating animosity amongst the Indian cricket players who play opposite each other.

Wellness Blog

Is caffeine good for the health?

  1. Caffeine is the most consumed stimulant in the world.
  2. It is consumed in the form of coffee and tea.
  3. At present there is no scientific data for promoting or discouraging coffee and/or tea consumption in the daily diet.
  4. Short–term benefits include mental alertness and improved athletic performance.
  5. Short–term adverse effects including headache, anxiety, tremors, and insomnia.
  6. Long–term adverse affects include generalized anxiety disorder and substance abuse disorders.
  7. Long-term benefits are dose–dependent. Caffeine is associated with a reduced risk of Parkinson disease, Alzheimer disease, alcoholic cirrhosis, and gout. Both caffeinated and decaffeinated coffee is also associated with a lower risk of type 2 diabetes.
  8. Heavy coffee intake may trigger coronary and arrhythmic events in susceptible individuals, although coffee intake is not considered a long–term risk factor for myocardial disease.
  9. Most studies show a modest inverse relationship between coffee consumption and all–cause mortality.
  10. Caffeine withdrawal is a well–documented clinical syndrome with headache being the most common symptom. (Source: Uptodate)

Inspirational Story

Footprints of God and Man

One night a man had a dream. He dreamed he was walking along the beach with the Lord. Across the sky flashed scenes from his life. For each scene, he noticed two sets of footprints in the sand; one belonging to him, and the other to the Lord.

When the last scene of his life flashed before him he looked back at the footprints in the sand. He noticed that many times along the path of his life there was only one set of footprints. He also noticed that it happened at the very lowest and saddest times in his life.

This really bothered him and he questioned the Lord about it. "Lord, you said that once I decided to follow you, you’d walk with me all the way. But I have noticed that during the most troublesome times in my life, there is only one set of footprints. I don’t understand why when I needed you most you would leave me."

The Lord replied, "My precious, precious child, I love you and I would never leave you. During your times of trial and suffering, when you see only one set of footprints, it was then that I carried you."

ePress Release

Mother’s Day to be Celebrated Tomorrow: Incontinence in women a neglected but treatable problem

Incontinence in women is a neglected but a treatable problem, said 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.

He released a few tips for the women to overcome this problem.

  1. Urinary incontinence in women is a neglected problem, but doctors can play a crucial role in treatment
  2. Incontinence is extremely common, affecting about 20% to 25% of women before menopause and more than twice that after menopause.
  3. Age itself does not cause incontinence. Urinary tract changes that accompany age, such as increased involuntary contractions and decreased bladder sensation and contractility, make incontinence more likely.
  4. Workup for incontinence is a multistep process.
  5. At the first visit, when a patient mentions incontinence, the doctor should set her up with a voiding diary and schedule a follow–up visit in a few weeks. At that next visit, in addition to reviewing the diary, the doctor should do a history and physical, perform a stress test and measure post void residual urine.
  6. The doctor should first address possible transient, reversible causes, illustrated by the DIAPERS pneumonic: delirium, infection, atrophic urethritis or vaginitis, pharmaceuticals, excess excretion, restricted mobility, and stool impaction. Treating these can cure incontinence completely in one–third of patients and alleviate it in the remainder.
  7. Established urinary incontinence is caused by either storage problems, such as overactive detrusor and stress incontinence, or emptying problems, such as underactive detrusor and urethral obstruction.
  8. In women of any age, 90% of incontinence is in the storage group.
  9. Women who have overflow urinary incontinence, as indicated by a postvoid residual of 100 mL or greater, should be referred to a subspecialist. In those with a positive stress test and a low postvoid residual, the presumed diagnosis is stress incontinence. Those with a negative stress test and a low postvoid residual are presumed to have detrusor overactivity.
  10. If the transient causes have been addressed but the urinary incontinence persists, internists should treat appropriately according to type. For urge incontinence caused by detrusor overactivity, the cornerstone of treatment is behavioral. Physicians should consult the voiding diary and start with bladder retraining, prompted voiding regimens, and urgency suppression methods. Anticholinergic bladder relaxants should be used only as a last resort. The only place for drugs is at the very, very, very end, after you’ve done the rest. Desamino d–arginine vasopressin (DDVAP) has no role in treating urinary incontinence.
  11. For stress incontinence, conservative treatment works.
  12. Overweight women need to lose only 5% to 10% of their weight to achieve a 50% decrease in urinary leakage, according to a recent New England Journal of Medicine article.
  13. Tampons and pessaries can be effective, especially for exercise-induced incontinence. Crossing the legs and tightening the pelvic floor before coughing or sneezing can also help, as can Kegels, although women need to do 30 to 50 a day for several months to see results.
  14. Surgery can be an effective option, but patients need to understand that "it’s not going to be 100% and it’s not going to last forever. Drugs should not be used to treat stress incontinence.
  15. The bottom line is that although incontinence is common, it’s never normal. The causes are multifactorial. With a positive, persistent approach, one can cure or help the vast majority of the patients.

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."

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: Doctor, this patient has developed acute renal failure (ARF).
Reaction: Oh my God, I forgot that he was on furosemide. I gave him full dose of amikacin.
Lesson: Make sure before calculating the dose of aminoglycoside (amikacin) that furosemide and other loop diuretics, which enhance its nephrotoxicity are not being given.

eMedinewS Humor

A civilized fight between husband & wife

Wife: Twinkle Twinkle little star, you should know what YOU are and once YOU know what YOU are Then the Mental hospital is’nt so far.

Husband: The rain makes all things beautiful The grass & flowers too If rain makes all things beautiful, Why doesn’t it rain on YOU?

Wife: Roses are red Violets are blue Monkeys like YOU should be kept in zoo.

Husband: Don’t feel so angry YOU will find me there too, Not in cage but laughing at YOU.

Quote of the Day

Behavior is a mirror in which every one displays his own image. Johann Wolfgang von Goethe


Twitter of the Day

Dr KK Aggarwal: Dr K K Aggarwal: Relaxation during work http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Are we alone in the universe? Take a quick trip through the cosmos as I explore this eternal question. http://bit.ly/DC_Ananda #ananda


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: The primary role of chaperones is to help in:

1.Protein synthesis.
2.Protein degradation.
3.Protein denaturation.
4. Protein folding.

Answer for yesterday’s Mind Teaser: 4. Protein folding.

Correct answers received from: Abhay Naik, Dr Ajay Gandhi, Dr Jainendra Upadhyay, Prabha Sanghi, Dr P C Das, Dr Arrpan Gandhi, Dr Vishal D Wahane, Dr Chandresh Jardosh, Dr Avtar Krishan, Daivadheenam Jella, Anil Tandon.

Answer for 9th May Mind Teaser: 3.Racemization.

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

Send your answer to ijcp12@gmail.com

medicolegal update

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  1. Dear Sir, Very informative news. Regards: Dr Joy
cardiology news

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