July 16  2015, Thursday
Non obstructive heart blockages not benign
Dr KK AggarwalIn a retrospective study of patients undergoing elective coronary angiography, non-obstructive coronary artery disease (heart blockages), compared with no apparent coronary artery disease (no blockages), was associated with a significantly greater 1-year risk of heart attack and all-cause mortality.

After risk adjustment, there was no significant association between 1- or 2-vessel non-obstructive coronary artery disease (blockages in one or two arteries) and mortality, but there were significant associations with mortality for 3-vessel non-obstructive coronary artery disease (blockages in all three arteries).

Veterans with evidence of non-obstructive CAD on elective coronary angiography had a 2- to 4.5-fold greater risk for heart attack compared with those with no evidence of blockages and 1-year heart attack risk was found to increase progressively by the extent of blockages, rather than increasing abruptly when blockages became obstructive. The results of this study are published in the Journal of American Medical Association.

Never tell your patients “that your coronaries are fine and they have nothing to worry about." Instead, one should say “There is evidence of atherosclerosis and while there is no need to panic, we need to address it.”

Remember there is nothing like “mild coronary artery disease." Up to 1 in 4 angiograms show minimal plaque or blockages.

Non-obstructive blockages mean presence of atherosclerotic plaques revealed during coronary angioplasty or angiography that does not appear to obstruct blood flow or result in angina symptoms.

These non-obstructive lesions occur in between 10% and 25% of patients undergoing elective angiography, and their presence has historically been characterized as "insignificant" or "no significant blockages in the medical literature even though multiple studies have shown plaque ruptures leading to heart attack commonly come from non-obstructive plaques.
A workshop conducted jointly by Heart Care Foundation of India, Indian Medical Association, Delhi Red Cross Society and Delhi Police with an aim of training 100 percent of PCR Staff by 14th August.
  • The combination of antidepressants and nonsteroidal anti-inflammatory drugs (NSAIDS) is linked to an early increased risk for intracranial hemorrhage, irrespective of the type of NSAID or antidepressant, suggests new research published online July 14 in the BMJ.
  • The American Society of Clinical Oncology (ASCO) has updated its 2006 clinical practice guideline on the use of hematopoietic colony-stimulating factors (CSFs) in patients with cancer who are undergoing chemotherapy. The update was published online July 13 in the Journal of Clinical Oncology.
  • New guidelines produced by the European Society of Endocrinology (ESE), published online in the August issue of the European Journal of Endocrinology, focus on how best to monitor and treat chronic hypoparathyroidism, with emphasis on patient well-being and long-term outcomes.
  • The Community Prevention Services Task Force updated recommendations based on a systematic review of 53 studies recommending that healthcare systems and communities provide counseling and longitudinal support to individuals who are at increased risk for type 2 diabetes. The recommendations are published July 13 in the Annals of Internal Medicine.
  • Patients with ulcerative colitis older than 50 years of age had a lower mortality risk with elective surgery than with long-term medical therapy, although there was no difference in younger patients. The results were published online July 14 in the Annals of Internal Medicine.
Top News from ADA 2015
Obstructive sleep apnea common in type 1 diabetes

Obstructive sleep apnea (OSA) is common in people with type 1 diabetes and is associated with abnormal glycemia and microvascular complications but not body mass index (BMI), reported Laurent Meyer, MD, an endocrinologist at Hôpitaux Universitaires de Strasbourg, France. The link between type 1 diabetes and OSA has been reported in three previous small trials, but this study of 90 adults with type 1 diabetes is the largest such trial to date and the first to use both continuous glucose monitoring and sleep studies. The message for clinicians is to "think of OSA" in type 1 patients with long disease duration, Dr Meyer said. "With the design of our study we can't say check at 10 or 15 years, but in my opinion if (a patient has) a duration of more than 20 years, it's important to check for OSA."
Cardiology eMedinewS
  • Two new studies, published July 14 in the Journal of the American Medical Association, conclude that the new American College of Cardiology/American Heart Association (ACC/AHA) guidelines for statin eligibility are better than previous iterations for identifying patients at increased risk for cardiovascular disease and that the risk threshold used to initiate statins in primary prevention is worth the expended financial costs of long-term therapy.
  • Nearly 60% of elderly heart failure patients have at least three major comorbidities, including functional and cognitive impairments, and these disorders can be as compromising to patient outcome as disease-related comorbidities, suggested the Cardiovascular Health Study (CHS) published in the Journal of the American College of Cardiology: Heart Failure.
Pediatrics eMedinewS
  • A multi-national research team has reported that children with a form of genetic obesity, known as Prader-Willi Syndrome (PWS), shared a similar imbalance in their gut microbiota as children with simple obesity. The paper was published online in EBioMedicine.
  • New research suggests that high levels of fatty acid ethyl esters (FAEE) found in the meconium (a newborn's first stool) from a mother's alcohol use during pregnancy can alert doctors that a child is at risk for problems with intelligence and reasoning. The findings are published in the Journal of Pediatrics.
Dr KK Spiritual Blog
Temple enhances soul to soul connectivity

A Temple, Gurudwara or a Masjid can also be understood by studying the concept of computer internet-based virtual e-communication.

The physical body can be compared to that of a computer hardware and the subtle body with three application softwares of a computer namely, Mind (Microsoft Word), Intellect (Excel) and Ego (Power Point).

These three application softwares are controlled by Chitta or the life force, which is a combination of Prana, Tejas and Ojas (or Operational Software in computer language). Without chitta or operational software, the body cannot function. A dead person (dead computer) will be devoid of chitta (operational software).

The application and operation softwares in turn are controlled by the soul, which is nothing but energized information or soul. This energized information in the body in Vedic language is called Shiva Shakti, where Shiva represents information and Shakti represents the energy or the power of the software.

This energized information or the soul can be equated to a very high speed internet connection www.god.com-drkkaggarwal for me. For another person, for example, Mr B S Sokhi, the soul communication will be www.god.com-bssokhi.

Both these souls will be communicated to a virtual internet called GOD or SPIRIT. The same can be represented as www.GOD.com and in this virtual consciousness or GOD, these pages will be similar to Facebook pages for individual members. For example, there will be a page called www.GOD.com-drkkaggarwal and another page called www.GOD.com-bssokhi.

Whatever you do is converted into a virtual memory and a copy of that is saved in both www.god.com and www.GOD.com. This way the phrase that GOD is watching each and every action can be explained.

Increasing one’s connectivity with GOD is like increasing the bandwidth of a computer internet. The same can be done in the body by controlling the mind, intellect and ego and by learning the process of Meditation, Pranayama and living a parasympathetic lifestyle.

Mobile towers or satellites are used to enhance connectivity for computers.

The natural towers in the body are called Chakras or the automatic ganglion. They behave like internal towers and intensify our communication with the soul and the spirit. In the outside world, this work is done by a Temple, Gurudwara or a Masjid.

According to the Vedic philosophy, we should practice focusing on our Chakras or ganglions regularly to increase our internal communication.

With collective consciousness of people (more than 1% of the population) focusing on a particular area or a stone, it acquires the powers of a communication tower or satellite.

A stone that becomes a focus of the collective consciousness of the people becomes a GOD ideal and the process is called Pratishthan.

A Mandir, Gurudwara or a Masjid, where the collective consciousness of the people gets focused, becomes a source of increase connectivity between the body and the soul. A person sitting in such an environment therefore, finds himself more near God, Allah or Wahe Guru.

The story of Hiranyakashyap where God comes out of the pillar on the request of the Prahlad and kills Hiranyakashyap basically proves that even the impossible is possible if you focus your concentration on the object of concentration and give preference to object of concentration over other thoughts.

This explains how in the past the collective consciousness of the people could bring rains or light candles or diyas. This also forms the basis of collective prayer.

The collective thoughts of the people get posted to the virtual Mandir, Gurudwara and Masjid and when a critical mass of 1% is reached, everyone will start working towards what is taught.
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 Travelers diarrhea even if there is one single loose motion.
Dr Good Dr Bad
Situation: A patient’s fever was not controlled with paracetamol.
Dr. Bad: Add nimesulide.
Dr. Good: No, give nimesulide in place of paracetamol.
Lesson: Nimesulide alone is more antipyretic than paracetamol, more anti-inflammatory than aspirin, and equivalent in analgesia to any of the NSAIDS alone, so efficacy gains are unlikely with added paracetamol. Br J Clin Pharmacol. 2008 May;65(5):795-6.

(Copyright IJCP)
eMedi Quiz
All of the following are known risk factors for development of endometrial carcinoma except:

1. Obesity.
2. Family history.
3. Use of hormone replacement therapy
4. Early menopause.

Yesterday’s Mind Teaser: A case of gestational trophoblastic neoplasia belongs to a high risk group if disease develop after:

1. Hydatidiform mole.
2. Full term pregnancy.
3. Spontaneous abortion.
4. Ectopic pregnancy.

Answer for yesterday’s Mind Teaser: 2. Full term pregnancy
Correct Answers received from: Dr Jainendra Upadhyay, Dr Poonam Chablani, Dr K V Sarma, Dr Nikhil Mohanty, Dr PRAVIN H PATEL, Dr Pandit Hantodkar, Dr K Raju, Dr Avtar Krishan.
Answer for 13th July Mind Teaser: 2. Cesarean section
Correct Answers received: Dr Nikhil Mohanty, Dr K Raju.
eMedinewS Humor
People born between 1925 and 1942 were called ‘The Silent Generation’

People born between 1942 and 1946 were called ‘War babies’

People born between 1946 and 1964 are called ‘The Baby Boomers’

People born between 1965 and 1979 are called ‘Generation X’

And people born between 1980 and 2010 are called ‘Generation Y’

Why do we call the last group Generation Y?

Y should I get a job? Y should I leave home and find my own place? Y should I get a car when I can borrow yours? Y should I clean my room? Y should I wash and iron my own clothes? Y should I buy any food? Y do I do this? Y should I do that?
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 but 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
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
eIMA News
Commemoration of July1st as Doctors Day- regarding
Shri JP Nadda
Honourable Union Health Minister

Dear Sir

Sub: Commemoration of July1st as Doctors Day- regarding

July 1st the birth and death anniversary of Bharat Ratna Dr BC Roy is being celebrated by the medical fraternity as Doctors Day. This day was proclaimed as Doctors Day by the Government of India in 1991.

The Medical Council of India instituted Dr. B.C. Roy National Award Fund in 1962 to perpetuate his memory. "The Fund" is registered under Societies Registration Act, 1860. "The Fund" invites nominations under the following categories (Statesmanship of the Highest Order in our country, Medical man-cum-Statesman, Eminent Medical Person, Eminent person in Philosophy and Eminent person in Arts) as provided under the Memorandum of Association of the Society. The Award is of the value of Rs.100,000 and a Silver Salver in each category. Such conferment of awards not only goes a long way in recognizing the talent of the eminent personalities in various specialties and walks of life but also acts towards a positive motivation for others to emulate and pursue with commitment and dedication the path of excellence

However, it is sad that there was no celebration of Doctors day by the government-neither the Prime Minister nor Union Health Minister gave any greeting to the medical community on that day which would have been a great moral boost to the doctors and would have motivated them to rededicate their services to the sick.

IMA requests the government at least from next year onwards a government sponsored Doctors day celebration may be conducted and we wish that the Prime Minister and Union Health Minister wish the medical community

It has also been noted with regret that the BC Roy award which is to be awarded on Doctors day is recently being done in an irregular manner. Declaring awards for 3-4 years together and in some years never declared.

IMA requests the government and medical council to uphold the dignity and solemnity of this award and declare it every year and award it to the recipients in a befitting function to be give by the Honourable President of India

Thanks and regards

Dr A Marthanda Pillai             Dr K K Aggarwal
National President                   Honorary Secretary General
Standards of TB care in India (Rough Draft)
Dr A M Pillai Dr K K Aggarwal

TB Notification
  1. TB can spread from a sputum-positive case through singing, puffing, speaking aloud or sneezing.
  2. Laryngeal TB can spread even while talking or whispering. TB spreads by any maneuver using forced expiration.
  3. One sputum-positive TB untreated case, will spread infection in upto 20 new cases in a year.
  4. About 10% of infected people will develop full blown clinical TB over time. Therefore each sputum-positive case will lead to 20 contacts and 2 TB cases; out of which, one will be infectious (pulmonary) and one will be non-infectious.
  5. It takes upto 15 days for a sputum-positive case to make non infectious case. The first 15 days before a person becomes non infectious are most dangerous to the family members as the bacilli is most infectious during this period.
  6. A sputum-positive case, if not treated, remains infective for the coming 2 to 3 years.
  7. If untreated, two-thirds of people with full blown TB will die.
  8. It is very important to trace or track every contact of TB.
  9. About 2-3% of TB cases have primary MDR TB.
  10. About 14-15% of re-treatment cases are MDR-positive.
  11. Vide letter number Z-28015/2/2012-TB, the Government of India, Ministry of Health and Family Welfare on 7th May 2012 declared TB as a notifiable disease.
  12. Not notifying TB is a violation of MCI Act, Municipal Corporation Act and Sections 269 & 270 of the Indian Penal Code.
  13. MCI Ethics Regulations: 5.2 Public and Community Health: Physicians, especially those engaged in public health work, should enlighten the public concerning quarantine regulations and measures for the prevention of epidemic and communicable diseases. At all times the physician should notify the constituted public health authorities of every case of communicable disease under his care, in accordance with the laws, rules and regulations of the health authorities. When an epidemic occurs a physician should not abandon his duty for fear of contracting the disease himself.
  14. MCI Ethics Regulations: 7.14 The registered medical practitioner shall not disclose the secrets of a patient that have been learnt in the exercise of his / her profession except – in a court of law under orders of the Presiding Judge; in circumstances where there is a serious and identified risk to a specific person and / or community; and notifiable diseases. In case of communicable / notifiable diseases, concerned public health authorities should be informed immediately.
  15. IPC 269: Negligent act likely to spread infection of disease dangerous to life. Whoever unlawfully or negligently does any act which is, and which he knows or has reason to believe to be, likely to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine, or with both.
  16. IPC 270: Malignant act likely to spread infection of disease dangerous to life. Whoever malignantly does any act which is, and which he knows or has reason to believe to be, likely to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or with both.
  17. In most of the municipal corporation acts for example DMC Act (Delhi) TB is defined as a dangerous disease under 2 (9) "dangerous disease" means— (a) Cholera, plague, chicken-pox, small-pox, tuberculosis, leprosy, enteric fever, cerebrospinal meningitis and diphtheria; and (b) any other epidemic, endemic or infectious disease which the Commissioner may, by notification in the Official Gazette, declare to be a dangerous disease for the purposes of this Act; Prevention of dangerous diseases. The DMC act also mandates reporting under section 371. “Obligation to give information of dangerous disease: Any person being in charge of, or in attendance, whether as a medical practitioner or otherwise, upon any person whom he knows or has reason to believe to be suffering from a dangerous disease, or being the owner, lessee, or occupier of any building in which he knows that any such person is so suffering shall forthwith give information respecting the existence of such disease to the Municipal Health Officer.

    TB Management
  18. Suspect TB in every case of HIV and vice versa.
  19. If an elderly develops TB, rule out diabetes and if an elderly develops diabetes, rule out TB.
  20. Rule out TB in every case of uncontrolled diabetes.
  21. All children up to 6 years age in contact with a TB case need chemoprophylaxis.
  22. Two weeks of cough can be TB. Do minimum two sputum tests.
  23. If the first sputum is positive, a second sample should also be tested; if both are positive, this indicates heavy infection load.
  24. A new case of TB should be treated with all 3 drugs (Rifampicin, Ethambutol and Isoniazid) for 6 months and one drug for 2 months (pyrazinamide), all together under supervision.
  25. Sputum examination every two months (two samples); if at two months of treatment, sputum is positive (even if one sample is positive) MDR should be suspected and patient referred to a TB Specialist.
  26. If MDR TB is suspected, sample should be sent for GeneXpert test (molecular diagnostic test for rapid diagnosis of TB and drug resistance); if not available, then for sputum culture/sensitivity (DST).
  27. In patients with cough less than 2 weeks duration, drugs like ciprofloxacin should not be given. Giving fluoroquinolones for cough of 0-2 week duration may amount to deficiency of service under the Consumer Protection Act (CPA).
  28. Sputum should always be collected early in the morning as the first sample. Rinse the mouth with water and cough out the sputum. Do not use mouthwash. Move away from people, when collecting the sputum sample.
  29. In adults starting ATT only on the basis of X-day or tuberculin test may amount to deficiency in service under CPA.
  30. If the patient stops treatment within one month, restart the treatment & complete it.
  31. If the patient stops the treatment for more than one month, he/she should be treated as re-treatment case. Such cases where the gap in treatment is more than one month should be referred to and treated by TB Specialists.
  32. Such cases required treatment for 8 months with 5 drugs for first two months, four drugs for next one month and 3 drugs for 5 months. In such cases, sputum need to be examined at 3-5-8 months.
  33. Whenever you suspect MDR TB, refer the patient to TB specialist
  34. Treatment of sputum-negative TB is similar to that of a new sputum-positive case.
  35. Treatment of extra pulmonary TB is similar to that of a new sputum-positive case.
  36. In TB meningitis, treatment duration of 9 months is required
  37. Bone TB requires treatment for 9 months.
  38. In pregnancy, the treatment protocol is same as for a new sputum-positive case.
  39. Injection streptomycin should be avoided in pregnancy.
  40. If a patient of TB develops jaundice, refer the case to a physician.
  41. All TB patients should be counseled about side effects of TB drugs.
  42. Sputum disposal should be done in disposable container.
  43. Sputum can be burnt or boiled in a bottle or added with phenyl, bleach or soda lime to disinfect it.
  44. All patient with cough should be provided with simple mask at the reception of a hospital.
  45. All patients with cough should not be made to stand in a line at registration counter in a hospital.
  46. All patients with cough should be tested on priority in the laboratory and X-ray dept.
  47. Doctors should wear N 95 mask for TB prevention.
  48. Split AC is not the right atmosphere for sputum positive cases. Natural window and fans are better alternatives.
  49. Only hair and nails cannot develop TB in the body.
  50. TB can be acquired during delivery.
  51. Compliance of treatment should be counseled. Not counseling a patient about compliance may amount to violation of Indian Penal Code under Clauses 269 and 270.
  52. Maintenance of records in TB care is very important.
  53. TB is a medicolegal emergency.
  54. TB has legal obligations.
  55. In children, anti-TB drugs are to be given as per weight for each child.
  56. If sputum is not available for examination, the child can be treated as probable pediatric TB with other signs and symptoms.
  57. Serodiagnostic tests are banned in India.
Report of visit by Dr.N.Appa Rao to Jabalpur regarding Vyapam Scam
Senior National Leader Dr N.Appa Rao went to Jabalpur to meet the aggrieved family of Late Dr. Arun Sharma, Dean, who was assisting the probe in the investigation of the Vyapam Scam on behalf of IMA HQs. and died in Delhi.

He met the aggrieved family members and garlanded the photograph of late Dr. Arun Sharma. He expressed the deepest condolences on behalf of IMA HQs. After that he attended condolence ceremony at Netaji Subhash Chandra Bose Medical College Jabalpur which was attended by the Dean, Principal and all other faculty members alongwith State and Local IMA leaders and the medical students of the college.

He paid rich tributes to the departed soul and demanded a compensation of Rs.5 crores for the aggrieved family.

(Dr.N.Appa Rao)
Eosinophilic esophagitis is something that you are seeing increasingly more of from referring gastroenterologists.
Inspirational Story
Look Fear in the Face

Look fear in the face. Be brave and bold. Don't be scared of the unknown. Accept your own wrongdoings as an opportunity to search deep within your soul. This way, you cannot blame others for your problems.

Be strong my child, admit defeat and always stand tall with dignity and pride. Allow your tribulations to become your guide for new found wisdom. Don't look back with regret; move forward with positive thoughts about the good and bad.

Be slow to speak and listen openly to what others have to say with respect. Remember you have a choice to make. Live negatively or positively; the choice is only dependent upon you.

You are sent to this world for a reason; a gift to others and remember always you have a special purpose so never give up but move straight ahead with love, peace, forgiveness, and strength!
Wellness Blog
Why is my nose bleeding?

Nosebleed is a common problem, occurring in up to 60 percent of the general population and is often because of a respiratory illness or dry conditions. Nasal drying is common in the hot summer months because of the extreme temperature and dry air due to use of air conditioners.

Here are some typical reasons for nosebleeds:
  • Nasal allergies
  • Blowing your nose too hard or trying to remove something from inside the nose
  • A result of “popping” the ear
  • Nasal exposure to chemicals
  • Frequent sneezing or having an upper respiratory infection
  • Use of nasal spray or a blood-thinning drugs, such as aspirin
  • Inhaling air that is extremely dry or cold
  • Having recent surgery on the nose or elsewhere on the face
  • Breaking the nose or a similar injury
  • Uncontrolled blood pressure
Bleeding can be controlled by direct pressure i.e. compression of the nostrils rasping the alae distally so all mucosal surfaces are opposed. Direct pressure should be applied continuously for at least 5 min and for up to 20 min. The patient should be encouraged not to check for active bleeding. Patients who are properly instructed may control their bleeding while the evaluation gets underway.

Other maneuvers include bending forward at the waist while sitting up (to avoid swallowing blood), placing a plug of cotton wool or gauze into the bleeding nostril (sometimes coated with antibiotic ointment), expectorating out blood that accumulates in the pharynx and a cold compress applied to the bridge of the nose.

These maneuvers also should be taught to high-risk patients for use at home. Many ENT specialists recommend initial treatment with two puffs of oxymetazoline to hasten hemostasis.
Quote of the Day
It does not matter how slowly you go as long as you do not stop. Confucius
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http://imahq.blogspot.com/ www.ima-ams.org




Reader Response
  • Dear Dr Aggarwal, I am really strained to find all this. Pl take up the issue with appropriate authorities. Thanks. Dr RK Maheshwari. EB Member cIAP 2007, 2015: Dr RK Maheshwari, Barmer.
  • Dear sir, rightly said and meticulously represented: Dr AK Ravikumar M.S
  • Kudos to Padma Shri Dr A Marthanda Pillai, National President IMA who is taking up national issues pertaining to Doctors of Modern medical profession in such a way that his forceful intervention and exemplary discussions make the concerned authorities to wake up and address positively the various issues raise by him and his Hony Gen Secretary Dr KK Aggarwal. Sir may God give you infinite energy and strength to pursue all our issues and redress all our grievances taking it to their logical end so that the profession and society will benefit at large: Dr V Sasidharan Pillai, IMA Desinganad Branch.
  • Dear Sir, very good morning. Today’s newsletter is very nice: Dr R Bobade.
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Press Release
2208 PCR staff of Delhi Police trained in CPR 10 so far

While training a batch of 283 PCR staff of Delhi Police, Padma Shri Awardee, Dr K K Aggarwal, President, Heart Care Foundation of India and Honorary Secretary General, IMA said “a dead heart can be revived in the first few minutes of its stoppage.”

Medically, this condition is called “Cardiac Arrest “and the technique of reviving it is called “Hands-only CPR 10”. CPR is cardiopulmonary resuscitation. No mouth to mouth breathing is given in this technique. The heart can be revived by just compressing the center of the chest with the heels of both hands by 1-2 inches for 10 minutes or longer.

Clinical situations where heart can be revived are sudden cardiac arrest due to heart attack, electrical shock, choking, sudden chest trauma or emotional shock.

CPR in children and near drowning death requires compression of chest, opening of air way and artificial breathing.

In his message, Padma Shri Awardee Dr A Marthanda Pillai, National President, IMA said “Relatives of all heart patients must also learn the technique of CPR 10.”

A series of workshops are being conducted by Heart Care Foundation of India jointly with Indian Medical Association, Delhi Red Cross Society and Delhi Police with an aim to train 100% PCR Staff by 14th August, 2015.

The Heart Care Foundation of India aims to train 1% of Delhi population in CPR 10 by the end of the current year.