eMedinewS22nd September 2013, Sunday

Dr K K Aggarwal Padma 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);
For updates follow at
www.facebook.com/Dr KKAggarwal

Cabinet nod for fresh ordinance on MCI

The Union Cabinet has given nod for issuance of a fresh ordinance for granting legality to the Board of Governors of Medical Council of India. The cabinet gave its approval to the Health Ministry note for the draft ordinance in this regard which is likely to be issued by the President on Monday or Tuesday.

The need for a fresh ordinance came after the earlier ordinance issued on May 21 by the President, granting legality to its board of governors, lapsed and government failed to get it replaced with an Act.

In the wake of the earlier ordinance lapsing, the Centre had directed the apex medical regulator not to take any policy decisions or hold important meetings.

Under the rules, the ordinance lapses if Parliament does not pass the bill replacing it within six weeks of the first sitting since it was promulgated. The first sitting in the case of MCI ordinance was August 5 which was the first day of the Monsoon Session.

The need for issuance of an ordinance came as the Indian Medical Council (Amendment) Bill, 2013, which allows for an elected apex medical regulator, is yet to be passed by Parliament.

Though the MCI is functional till November 10 as per the previous Ordinance, it technically had no legal authority in the absence of an effective ordinance to take any decisions. (Business Standard)

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."

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

Ringtone – CPR 10 Mantra English

sprritual blog What is the significance of a Tilak?

The Tilak is not merely a beauty–enhancing mark, or a sign of religosity. Hindu cultural traditions have given a significant place to wisdom in life. Life’s journey is guided by wisdom, which leads us through evolution of life towards salvation. If a man loses everything in his life but has his wisdom, he can recreate everything he has lost.

In Gayatri Mantra we chant, "May my Wisdom be enlightened and purified". The worship that has been revered in the Vedas is symbolized in the Tilak. The seat of wisdom is the head and since the forehead is its front part, we worship wisdom by placing the Tilak on the forehead.

A Tilak is the ‘third eye’ in a manner of speaking. It is a divine eye which when ‘opened’ by divine knowledge shows the way to self–realization. Lord Shiva destroyed Kamadeva with his third eye, so too, we may destroy our desires and evil elements by striving for knowledge.

The Tilak is also the symbol of good fortune and lasting bonds of wedlock for a married couple.

cardiology news

The Greatest Gift is LOVE

A woman came out of her house and saw 3 old men with long white beards sitting in her front yard. She did not recognize them.

She said, "I don’t think I know you, but you must be hungry. Please come in and have something to eat." "Is the man of the house home?", they asked. "No", she said. "He’s out." "Then we cannot come in", they replied. In the evening when her husband came home, she told him what had happened. "Go tell them I am home and invite them in!" The woman went out and invited the men in. "We do not go into a House together," they replied.

"Why is that?" she wanted to know. One of the old men explained: "His name is Wealth," he said pointing to one of his friends, and said pointing to another one, "He is Success, and I am Love." Then he added, "Now go in and discuss with your husband which one of us you want in your home."

The woman went in and told her husband what was said. Her husband was overjoyed. "How nice!!", he said. "Since that is the case, let us invite Wealth. Let him come and fill our home with wealth!” His wife disagreed. "My dear, why don’t we invite Success?"

Their daughter–in–law was listening from the other corner of the house. She jumped in with her own suggestion: "Would it not be better to invite Love? Our home will then be filled with love!" "Let us heed our daughter-in-law’s advice," said the husband to his wife. "Go out and invite Love to be our guest."

The woman went out and asked the 3 old men, "Which one of you is Love? Please come in and be our guest." Love got up and started walking toward the house. The other 2 also got up and followed him. Surprised, the lady asked Wealth and Success: "I only invited Love, Why are you coming in?"

The old men replied together: "If you had invited Wealth or Success, the other two of us would’ve stayed out, but since you invited Love, wherever He goes, we go with him. Wherever there is Love, there is also Wealth and Success!"

News Around The Globe

5th Dil Ka Darbar

Date: Sunday, 29th September 2013, Venue: Constitution club of India, Rafi Marg, Time: 8 AM to 6 PM

Programme: A non stop question answer–session between all top cardiologists of the NCR region and the public.

The focus of the discussions will be prevention of heart diseases in women and young men. Special discussion will be held on Sex and Heart Diseases. Practical training will also be given to people on Hands–only Cardiopulmonary Resuscitation. Another focus of the discussion will be the launch of the Project Dhadkan (Palpitations) and Project Murmur (Congenital and valvular heart diseases in children).

Entry free…

  • Treatment of overweight and obese individuals with orlistat (Xenical, Alli) was associated with decreased waist circumference to a greater extent than either placebo or standard care, a meta–analysis found. In 18 studies, change in waist circumference at 6 months with orlistat was – 2.15 cm greater than for placebo and –6.96 cm more than with standard care. Also, in 20 studies, orlistat was associated with a – 2.32–cm greater decrease in waist circumference at 1 year compared with placebo, and with a –2.63–cm (95% CI –5 to–minus 0.26) greater decrease at that time point compared with standard care, the researchers reported online in Diabetes, Obesity and Metabolism.
  • After 40 years of living with type 1 diabetes, nearly all patients have small–fiber sensory neuropathy and a majority also has large–fiber nerve dysfunction. The results of a small prospective study were published online September 11 in Diabetes Care by Kari Anne Sveen, MD, from Oslo University Hospital, Norway, and colleagues. A relationship between HbA1c and nerve damage was also documented supporting the significance of intensive insulin treatment, particularly early in the course of type 1 diabetes, to preserve both large– and small–fiber nerve function.
  • A subgroup analysis from the SPIRIT trial presented at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy states that switching from an antiretroviral regimen containing a boosted protease inhibitor to a once–daily, single–tablet regimen is safe and effective in black patients with HIV. Simplified antiretroviral regimens reportedly improve adherence and reduce the likelihood of virologic failure. They also lessen the risk for long-term drug toxicity. One single–tablet regimen containing rilpivirine, emtricitabine and tenofovir disoproxil fumarate has been shown to be well tolerated and effective.
  • Bronchial thermoplasty is effective for severe persistent asthma, according to long-term results from the Asthma Intervention Research 2 (AIR2) trial. It involves use of mild heat to destroy smooth muscle tissue in the airways, reducing constriction during attacks. BT is an important option for patients with severe asthma who remain symptomatic despite taking current standard of care medications. The study was published online September 3 in the Journal of Allergy and Clinical Immunology.
  • Most patients with celiac disease would like to have medication for their condition, according to results of a survey, which analyzed responses from 365 patients with biopsy–confirmed celiac disease. Two thirds of the patients (222/339 who answered the question on medication use) were interested in medication to treat celiac disease. The survey findings are published in September issue of Therapeutic Advances in Gastroenterology

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Rabies News (Dr. A K Gupta)

If for some reason, IDRV cannot be given in deltoid region, what are the alternative sites?

IDRV can be given in deltoid region, suprascapular, anterior abdominal wall and the upper part of thigh.

cardiology news
  • Data from the AFNET (German Competence Network on Atrial Fibrillation) registry provide further evidence to confirm that that the CHA2DS2–VASc score is preferable to the CHADS2 score in identifying patients with atrial fibrillation (AF) at very low risk for stroke who do not need anticoagulation. In the study, 8847 patients with nonvalvular AF, more than one third of the strokes or other thromboembolic events that occurred in the mean follow–up period of 5 years were in patients assigned a CHADS2 score of 0 or 1, indicating that oral anticoagulation is not definitively recommended. In contrast, using the CHA2DS2–VASc score, which adds age 65 to 74 years, vascular disease, and female sex as stroke risk factors to the CHADS2 score, led to the reclassification of more than half of the patients with CHADS2 scores 0 or 1 to a CHA2DS2–VASc score of 2 and higher, in whom oral anticoagulation is the recommended treatment. Only 8 strokes and other thromboembolic events were observed in patients classified as CHA2DS2–VASc 0 at baseline (excluding strokes occurring in association with cardioversion or ablation). The findings were presented at the European Society of Cardiology (ESC) Congress.

Valvular Heart Disease News

Patient with large vegetation are at high risk complications.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

cardiology news
  • The intrapartum period plays a key role in the development of neonatal hypoxic-ischemic encephalopathy (HIE). Dr. Frances M. Cowan of Hammersmith Hospital at Imperial College, London, and her colleagues report in the journal Pediatrics online September 9 that just one antepartum factor, gestation of 41 weeks or longer, was independently associated with HIE in the study once researchers took intrapartum factors into account. Acute ischemic–hypoxic insult is by far the most common cause of encephalopathy in newborns.
  • Hyponatremia is more common with hypotonic fluids in hospitalized children as per a new study by Dr. Francis Carandang and colleagues from Stanford University School of Medicine and Lucile Packard Children’s Hospital. But it’s unclear whether isotonic maintenance fluids would fully address the problem of iatrogenic hyponatremia, given that in their study more than 25% of children give isotonic fluids still became hyponatremic.
cardiology news

Ten foods provide half of sodium eaten in US

Nine out of 10 adults in the US consume more sodium than is recommended as per CDC Morbidity and Mortality Weekly Report on February 7, 2012.

44% of sodium consumed came from 10 food categories: bread, cold cuts and cured meats, pizza, poultry, soups, sandwiches, cheese, pasta mixed dishes, meat mixed dishes and savory snacks. More than 70% of the sodium eaten came from goods obtained at a store.

Reducing the sodium content of the 10 leading sources by one–quarter would reduce total dietary sodium by more than 10%, preventing an estimated 28 000 deaths and $7 billion in healthcare expenditures annually.

cardiology news

Total CPR since 1st November 2012 – 63400 trained

CPR Classes 63400

Media advocacy through Print Media

sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping
sprritual blog Media Press Clipping Media Press Clipping Media Press Clipping

29th August: Veer Arjun

Media advocacy through Web Media

When Constipation May be a Serious Problem 30th August


TB more dangerous than FLU 29th August


Do not ignore transient brain dysfunction

TIA or transient ischemic attack or mini paralysis is "a brief episode of neurologic dysfunction caused by lack of blood supply in the focal brain or eye, with clinical symptoms typically lasting less than one hour, and without evidence of acute infarction or brain attack", said Dr KK Aggarwal president Heart Care Foundation of India.

It is a neurologic emergency, its early recognition can identify patients who may benefit from preventive therapy or from surgery of large vessels such as the carotid artery.

The initial evaluation of suspected TIA and minor non disabling ischemic paralysis includes brain imaging, neurovascular imaging, and a cardiac evaluation. Laboratory testing is helpful in ruling out metabolic and hematologic causes of neurologic symptoms.

TIA or minor non disabling ischemic paralysis are associated with a high early risk of recurrent paralysis. The paralysis risk in the first two days after TIA is approximately 4 to 10 percent. Immediate evaluation and intervention after a TIA or minor ischemic reduces the risk of recurrent stroke.

Risk factor management is appropriate for all patients. Currently viable strategies include blood pressure reduction, statins, anti platelet therapy, and lifestyle modification, including smoking cessation.

For patients with TIA or ischemic stroke of atherothrombotic, lacunar (small vessel occlusive), or cryptogenic type, one should give antiplatelet agents. For patients with atrial fibrillation and a recent ischemic stroke or TIA, the treatment is blood thinners. For patients with carotid blockages surgery is needed.

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 63400 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 10×10 i.e. 100 per minute."

today emedipics

Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal Live on Headlines Today

press release

ACE inhibitors better ARBs in new meta–analysis in hypertensives

today video of the dayDr KK Aggarwal Birthday 5th September

Cultural Evening at IMA

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

Which nonpharmacologic intervention is difficult to use with older adults who are cognitively impaired?

1. Aromatherapy
2. Distraction
3. Guided imagery
4. Heat application

Yesterday’s Mind Teaser: An older adult patient is discharged from the hospital with nortriptyline for neuropathic pain. Which statement indicates the patient's need for additional education?

1. "I will chew sugarless gum and mints."
2. "I will drink carbonated beverages."
3. "I will take my medication at breakfast."
4. "I will use a humidifier at bedtime."

Answer for yesterday’s Mind Teaser: "I will chew sugarless gum and mints."

Correct answers received from: DR MONICA GANDHI NEE MENOCHA, DR ARPAN GANDHI, Dr. V.P. Thakral, Dr.K.V.Sarma, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Dr.K.Raju, Dr.Bitaan Sen & Dr.Jayashree Sen, DR AVTAR KRISHAN, Dr Kanta jain, Dr. P. C. Das, Dr.A.K.GAJJAR,

Answer for 20th September Mind Teaser: (4) May be in conflict with the pain rating, and accepts the report of pain.

Correct answers received from: Dr.Bitaan Sen & Dr.Jayashree Sen, DR AVTAR KRISHAN, Dr Kanta jain, Dr. P. C. Das, Dr.A.K.GAJJAR,

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

While he was talking to me, his nurse came in and said,
"Doctor, there is a man here who thinks he’s invisible."
The doctor said, "Tell him I can't see him."

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A 36–year–old truck driver had severe allergic rhinitis and came for treatment.
Reaction: Oh my God, why was he not prescribed azelastine nasal spray?
Lesson: Make sure to avoid oral antihistamines in persons who perform tasks like driving as they may cause sedation and drowsiness; instead prescribe azelastine nasal spray which is effective and non–sedating.

medicolegal update

First we make our habits then our habits make us. John Dryde

medicolegal update

Dr KK Aggarwal: Equipment–related failures common in Operation Theater http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: I maintain that the cosmic religious feeling is the strongest noblest motive for scientific research–Einstein #CosmicConsciousness

medicolegal update

Namaskar Editor ji, Gratitude for awakening medical community. – Durgesh

Forthcoming Events

29thSeptember–Dil Ka Darbar at Constitution Club of India,New Delhi

20th Perfect Health Mela from 18th Oct to 22nd Oct at different locations

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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medicolegal update

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