April 12  2015, Sunday
5 natural ways to overcome erectile dysfunction (Harvard)
Dr KK Aggarwal
  1. Start walking. According to one Harvard study, just 30 minutes of walking a day was linked with a 41% drop in risk for ED. Other research suggests that moderate exercise can help restore sexual performance in obese middle–aged men with ED.
  2. Eat right. In the Massachusetts Male Aging Study, eating a diet rich in fruit, vegetables, whole grains, and fish — with fewer red and processed meat and refined grains — decreased the likelihood of ED. Another tip: a chronic deficiency in vitamin B12 may contribute to erectile dysfunction. A daily multivitamin and fortified foods are the best bets for those who absorb B12 poorly, including many older adults.
  3. Pay attention to your vascular health. High blood pressure, high blood sugar, high cholesterol, and high triglycerides can all damage arteries in the heart (causing heart attack), in the brain (causing stroke), and leading to the penis (causing ED). Low levels of HDL (good) cholesterol and an expanding waistline also contribute. Check with your doctor to find out whether your vascular system — and thus your heart, brain, and penis — is in good shape or needs a tune–up through lifestyle changes and, if necessary, medications.
  4. Size matters, so get slim and stay slim. A trim waistline is one good defense — a man with a 42–inch waist is 50% more likely to have ED than one with a 32–inch waist. Getting to a healthy weight and staying there is another good strategy for avoiding or fixing ED. Obesity raises risks for vascular disease and diabetes, two major causes of ED. And excess fat interferes with several hormones that may be part of the problem as well.
  5. Move a muscle, but we’re not talking about your biceps. A strong pelvic floor enhances rigidity during erections and helps keep blood from leaving the penis by pressing on a key vein. In a British trial, three months of twice–daily sets of Kegel exercises (which strengthen these muscles), combined with biofeedback and advice on lifestyle changes — quitting smoking, losing weight, limiting alcohol — worked far better than just advice on lifestyle changes.
Indian Medical Association 213th Meeting of the Central Working Committee at Hotel Radisson Blu, New Delhi.
  • The first recommendations to help clinicians make the best use of imaging in the clinical management of both axial and peripheral spondyloarthritis (SpA) were published online by an expert task force assembled by the European League Against Rheumatism (EULAR). The task force developed 10 recommendations that addressed all currently available imaging modalities. The guidelines are published in the Annals of Rheumatic Disease.
  • The beneficial effects of subthalamic nucleus (STN) deep brain stimulation (DBS) on pain in patients with Parkinson's disease (PD) persist long-term, suggests a new study published online in JAMA Neurology.
  • Aerobic exercise reduces liver fat and visceral adipose tissue (VAT) by a small amount even in individuals who do not experience clinically significant weight loss, suggests a randomized placebo-controlled study published online April 7 in the Journal of Hepatology.
  • The American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) have issued new, more comprehensive guidelines outlining optimal care for patients with type 2 diabetes. The guidelines include an algorithm to help guide clinicians and the updated information also briefly addresses the use of insulin in type 1 diabetes. The guidelines are published in the April issue of Endocrine Practice.
Dr KK Spiritual Blog
Panchamrit body wash

Panchamrit is taken as a Prasadam and is also used to wash the deity. In Vedic language, anything which is offered to God can also be done to the human body. Panchamrit bath, therefore, is the original and traditionally full bath prescribed in Vedic literature. It consists of the following:
  • Washing the body with milk and water, where milk acts like a soothing agent.
  • Next is washing the body with curd, which is a substitute for soap and washes away the dirt from the skin.
  • The third step is washing the body with desi ghee, which is like an oil massage.
  • Fourth is washing the body with honey, which works like a moisturizer.
  • Last step is to rub the skin with sugar or khand. Sugar works as a scrubber.
Panchamrit bath is much more scientific, cheaper and health friendly.
Cardiology eMedinewS
  • Add increased risk of coronary artery disease (CAD) to the list of insults, along with Randy Newman's famously satirical song, for short people, suggests new research, pointing that the risk increases further the shorter an individual is. The study is published online April 8 in the New England Journal of Medicine.
  • Significant race- and gender-based disparities in the management of newly diagnosed atrial fibrillation (AF), especially in oral anticoagulation and the use of catheter ablation, were noted in a huge cohort of Medicare patients, reported a study published online in Heart Rhythm.
Pediatrics eMedinewS
  • Topiramate (Topamax, Janssen Pharmaceuticals) prescribed for migraine prevention may trigger or worsen eating disorder symptoms in susceptible adolescents, suggests new research published online in Pediatrics.
  • Psychologically stressful life events can heighten the risk for developing type 1 diabetes (T1D) in children, reported a new study published online April 9 in Diabetologia.
Make Sure
Situation: An adult undergoing bronchoscopic biopsy developed infective endocarditis.

Reaction: Oh my God! Why was IE prophylaxis not given?

Lesson: Make sure, that all procedures of the respiratory tract that involve incision or biopsy of the respiratory mucosa include IE prophylaxis.
Dr Good Dr Bad
Situation: A patient wanted to know if the cost of the spectacles would be covered by Mediclaim after cataract surgery.

Dr. Bad: It will be covered.

Dr. Good: It will not be covered.

Lesson: Mediclaim does not cover the cost of spectacles, contact lenses, hearing aids.

(Copyright IJCP)
Rabies News (Dr A K Gupta)
Is there any dietary restriction during PEP?

It is advisable to abstain from alcoholic drinks during the course of rabies vaccination as it may affect the immune response.
eMedinewS Humor
Car Accident

As my five year old son and I were headed to McDonald’s one day, we passed a car accident. Usually when we see something terrible like that, we say a prayer for those who might be hurt, so I pointed and said to my son, "We should pray."

From the back seat I heard his earnest request: "Please, God, don’t let those cars block the entrance to McDonald’s."
IJCP Book of Medical Records
IJCP’s ejournals
CPR 10
Total CPR since 1st November 2012 – 101090 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
IMA News
Sonal Namaste
Diarrhea Prevention

To reduce subsequent episodes of diarrhea, malnutrition, and delays in physical and mental development. Recommendations
  • Exclusive breastfeeding until age six months
  • Continued breastfeeding with complementary foods until two years of age.
  • Complementary feeding may be considered in younger infants if growth is inadequate.
  • The consumption of safe food and water.
  • Water brought to a rolling boil for at least five minutes is optimal for preparing food and drinks for young children.
  • Handwashing after defecating, disposing of a child's stool, and before preparing meals.
  • The use of latrines; these should be located more than 10 meters and downhill from drinking water sources.
Facts about Tuberculosis (TB)
What happens if a patient develops adverse reaction to the drugs?
  • Adverse reactions are uncommon and usually mild in nature like nausea, vomiting, gastritis, itching etc.
  • The DOT providers are trained to identify the adverse drug reactions and take appropriate action as per the protocol.
Give free treatment to acid attack victims: SC to private hospitals
In an order likely to have far-reaching effects, the Supreme Court ruled on Friday that private hospitals could neither “turn away” victims of acid attack nor wash their hands of after providing first aid.
The court made it mandatory for these hospitals across the country to provide full and free medical treatment to the victims. The order said the term “treatment” included reconstructive surgery, free medicines, bed, rehabilitation and aftercare.

The order came on a public interest litigation petition filed by Laxmi, an acid attack victim, following nine years of fighting for the rights of victims.

Ms. Laxmi was only 15 when three men, one of whom she had refused to marry, threw acid on her near Tughlaq Road in New Delhi. She has been fighting a lonely battle since 2006 in the Supreme Court, and in the process, succeeded in getting the Indian Penal Code amended to make acid attack a special offence. She further persuaded the court to increase the compensation for victims to Rs. 3 lakh, besides procuring a complete ban on over-the-counter sale of acid.

Friday’s order dealt with Ms. Laxmi’s final demand for getting victims proper treatment, aftercare and rehabilitation.
In its order, the Social Justice Bench of Justices Madan B. Lokur and U.U. Lalit directed that “all States should take up with private hospitals and ensure that they do not deny treatment to acid attack victims. We see there is a reluctance on the part of some private hospitals to provide free treatment.”

The court clarified that “free treatment would mean not only free medical treatment but also availability of medicines, food and reconstructive surgery.” The court directed the State governments to take action against the hospitals turning away victims.

The Bench was interpreting Section 357C of the Criminal Procedure Code, inserted in Feb. 2013, to deal with the issue of cost of treatment of acid-attack victims.
Inspirational Story
The Cookie Thief

A woman was waiting at an airport one night, with several long hours before her flight. She hunted for a book in the airport shops, bought a bag of cookies and found a place to drop. She was engrossed in her book but happened to see, that the man sitting beside her, as bold as could be. . .grabbed a cookie or two from the bag in between, which she tried to ignore to avoid a scene.

So she munched the cookies and watched the clock, as the gutsy cookie thief diminished her stock. She was getting more irritated as the minutes ticked by, thinking, “If I wasn’t so nice, I would blacken his eye.” With each cookie she took, he took one too, when only one was left; she wondered what he would do. With a smile on his face, and a nervous laugh, he took the last cookie and broke it in half.

He offered her half, as he ate the other; she snatched it from him and thought… oooh, brother. This guy has some nerve and he’s also rude, why he didn’t even show any gratitude! She had never known when she had been so galled and sighed with relief when her flight was called. She gathered her belongings and headed to the gate, refusing to look back at the thieving ingrate.

She boarded the plane, and sank in her seat, then she sought her book, which was almost complete. As she reached in her baggage, she gasped with surprise, there was her bag of cookies, in front of her eyes.

If mine are here, she moaned in despair, the others were his, and he tried to share. Too late to apologize, she realized with grief, that she was the rude one, the ingrate, the thief.
Quote of the Day
Character is the result of two things: Mental attitude and the way we spend our time. Elbert Hubbard
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Wellness Blog
All About Calcium Carbide
  • Under PFA Section 44AA, the use of calcium carbide for artificial ripening of mangoes, apple, plum, banana is prohibited and can attract both imprisonment and fine.
  • Calcium carbide powder is usually kept wrapped in paper between the fruits (unripe mangoes) in a basket or box.
  • Once the basket of mango is closed from the top, calcium carbide absorbs moisture and produces acetylene gas, which accelerates the ripening process of fruits.
  • The health hazards are related to the gastrointestinal tract, kidney, heart, liver and brain and in long run cancer.
  • Calcium carbide 1kg is available for Rs. 25/– and is sufficient to ripe 10 tons of fruit.
  • How do we know that the fruit has been artificially ripened with calcium carbide?
    • It will be less tasty.
    • The aroma will be different
    • It is uniform in color.
    • The color of the mango changes from green to dark yellow.
    • It will have a less shelf life.
    • It will be overtly soft.
    • There may be black patches on the mango skin.
    • There may be multi color patches on the skin of the mango (Red, yellow, green patches)
  • How should artificially ripened fruits be handled?
    • Never eat off–season fruits, especially before time
    • Rinse all fruits in running tap water for few minutes before use.
Reader Response
Dear Sir, thanks for the information. Regards: Dr Kanan
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eMedi Quiz
The Protein Efficiency Ratio (PER) is defined as:

1. The gain in weight of young animals per unit weight of protein-consumed.
2. The product of digestibility coefficient and biological value.
3. The percentage of protein absorbed into the blood.
4. The percentage of nitrogen absorbed from the protein absorbed from the diet.

Yesterday’s Mind Teaser: The following statements about meningococcal meningitis are true, except:

1. The source of infection is mainly clinical cases.
2. The disease is more common in dry and cold months of the year.
3. Chemoprophylaxis of close contacts of cases is recommended.
4. The vaccine is not effective in children below 2 years of age.

Answer for yesterday’s Mind Teaser: 1. The source of infection is mainly clinical cases.

Correct Answers received from: Daivadheenam Jella,

Answer for 10th April Mind Teaser: 3. Third quartile.

Correct Answers receives: Dr Jainendra Upadhyay, Dr Vasanti Thote, Dr G Madhusudhan, Daivadheenam Jella, Dr Avtar Krishan, Dr Prabodh K Gupta, Tukaram Pagad, Viswanatha Sarma, Dr Shangarpawar, Dr Poonam Chablani.
Deep frying, burning or charring foods may produce cancers
Regularly eating burned or charred red meat, similar to that cooked on a grill can increase the chances of pancreatic cancer by 60%, 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 Honorary Secretary General IMA.

Turning down the heat when grilling, frying, and barbecuing to avoid excess burning or charring of the meat may be a sensible way for some people to lower their risk for getting pancreatic cancer.

As per Dr Kristin Anderson of the University of Minnesota, charred meat contains several known cancer-causing chemicals, including heterocyclic amines.

Heterocyclic amines (HAs) are carcinogens produced by cooking meat and animal protein at high temperatures; metabolism of HA is influenced by polymorphisms in the N-acetyltransferase-2 (NAT-2) gene. Data from a variety of sources suggest that HA may play a role in human carcinogenesis and are liked to many cancers.

Anderson's team started with 62,000 healthy people and documented what they actually did eat. Over nine years, 208 were diagnosed with pancreatic cancer. When divided into five groups based on how much charred meat such as hamburgers they ate, the people diagnosed with pancreatic cancer were far more likely to be in the top two groups.

They found that those who preferred very well-done steak were almost 60 percent more likely to get pancreatic cancer as those who ate steak less well-done or did not eat steak. Those with the highest intake of very well-done meat had a 70 percent higher risk for pancreatic cancer over those with the lowest consumption.

The mutagenic activity and the mass amount of heterocyclic amines responsible for the mutagenic activity have been measured in some cooked foods. Cooked meats are the predominant source of mutagenic activity in the diet with values ranging from 0 to 10,000 revertants per gram reported in the Ames/Salmonella test with strain TA98.

Frying at higher temperatures and for longer times produces the greatest mutagenic response, and thus concomitantly, the largest amounts of heterocyclic amines.

Non-meat products such as baked breads can also form significant mutagenic activity, particularly when overcooked. Commercially prepared hamburgers made from meat substitutes such as tofu, wheat gluten or tempeh and fried at 210 degrees C have up to 10% of the mutagenic activity of a fried beef patty cooked under the same conditions.