eMedinewS28th November 2013, Thursday

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.twitter.com/DrKKAggarwal
www.facebook.com/Dr KKAggarwal

Harvard: 6 things you should know about vitamin D

The body makes vitamin D when sunlight hits the skin. You can also get the vitamin from food (mainly because it’s been added; few foods are natural sources of vitamin D) or by taking a supplement.

The process by which the body makes vitamin D is complex. It starts when the skin absorbs rays in the invisible ultraviolet B (UVB) part of the light spectrum. The liver and the kidneys also participate to make a form of the vitamin that the body can use.

A number of factors influence a person’s vitamin D levels. Here are six important ones.

  1. Where you live. The further away from the Equator you live, the less vitamin D–producing UVB light reaches the earth’s surface during the winter. Residents of Boston, for example, make little if any of the vitamin from November through February. Short days and clothing that covers legs and arms also limit UVB exposure.
  2. Air quality. Carbon particles in the air from the burning of fossil fuels, wood, and other materials scatter and absorb UVB rays, diminishing vitamin D production. In contrast, ozone absorbs UVB radiation, so pollution–caused holes in the ozone layer could end up enhancing vitamin D levels.
  3. Use of sunscreen. Sunscreen prevents sunburn by blocking UVB light. Theoretically, that means sunscreen use lowers vitamin D levels. But as a practical matter, very few people put on enough sunscreen to block all UVB light, or they use sunscreen irregularly, so sunscreen’s effects on vitamin D might not be that important. An Australian study that’s often cited showed no difference in vitamin D between adults randomly assigned to use sunscreen one summer and those assigned a placebo cream.
  4. Skin color. Melanin is the substance in skin that makes it dark. It "competes" for UVB with the substance in the skin that kick–starts the body’s vitamin D production. As a result, dark–skinned people tend to require more UVB exposure than light–skinned people to generate the same amount of vitamin D.
  5. Weight. Body fat sops up vitamin D, so it’s been proposed that it might provide a vitamin D rainy–day fund: a source of the vitamin when intake is low or production is reduced. But studies have also shown that being obese is correlated with low vitamin D levels and that being overweight may affect the bioavailability of vitamin D.
  6. Age. Compared with younger people, older people have lower levels of the substance in the skin that UVB light converts into the vitamin D precursor. There’s also experimental evidence that older people are less efficient vitamin D producers than younger people.

TCT 2013 Update: Cardiology Trials

FFR-CT and iFR Accurately Identify: Two studies show the benefit of assessing the functional severity of the coronary lesion using new twists on measuring fractional flow reserve (FFR) in patients with suspected CAD. In one, researchers measured the instantaneous wave–free ratio (iFR), which is a pressure–derived, adenosine-free measurement of coronary stenosis, and reported that it successfully characterized the hemodynamic severity of more than 90% of stenoses. In the other trial, FFR–CT accurately detected 81% of coronary stenoses in patients with stable CAD compared with 64% of stenoses detected with coronary angiography and 53% with CT alone.

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
eMedinewS
Ringtone – CPR 10 Mantra Hindi
Ringtone – CPR 10 Mantra English

What is charity?

sprritual blog

Some time back after retuning from a free health check-up camp, I met a Professor of Cardiology from Lucknow and started boasting that I saw 100 patients free today. He said do not get excited. Charity is a positive, but still not the absolute positive, unless it is done without any motive or done secretly. He said that you were honored on the stage; you got blessings from the patients and people talked about you in positive sense. It was an investment in the long run and not an absolute charity. When you serve never get honour on the stage by the people to whom you are serving. If you get that then it is like give and take. The purpose of life should be to help others without any expectations.

Understanding helping others

When you help others, it should not end up in harming somebody else. If you help even if it is unconditional, if you end up in promoting no.2 by superseding another senior person who deserves is not a help as the person to whom you are helping will give you one blessing but the person to whom you have harmed will give you 10 curses. Ultimately you end up with minus 8 points. Helping other means that you should give happiness to you, to the persons you have helped and also to others to whom you have not helped.

Helping always pays

The difference between American and Indian models is that Indians always think of now and do not invest in future. Americans always plans for the future. When we help somebody, we want that the same person should expect you by helping you when you are in need in a shorter run. But charity does not believe in that. Your job is to help others and negate your negative past karmas. You never know, may be decades later you get a help from a person to whom you helped decades earlier. Help should never be linked to returns.

cardiology news

Peace of Mind

Once, Buddha was walking from one town to another town with a few of his followers. This was in the initial days. While they were traveling, they happened to pass a lake. They stopped there and Buddha told one of his disciples, "I am thirsty. Do get me some water from that lake there."

The disciple walked up to the lake. When he reached it, he noticed that some people were washing clothes in the water and, right at that moment, a bullock cart started crossing through the lake. As a result, the water became very muddy, very turbid. The disciple thought, "How can I give this muddy water to Buddha to drink!" So he came back and told Buddha, "The water in there is very muddy. I don’t think it is fit to drink."

After about half an hour, again Buddha asked the same disciple to go back to the lake and get him some water to drink. The disciple obediently went back to the lake. This time he found that the lake had absolutely clear water in it. The mud had settled down and the water above it looked fit to be had. So he collected some water in a pot and brought it to Buddha.

Buddha looked at the water, and then he looked up at the disciple and said, "See what you did to make the water clean. You let it be… and the mud settled down on its own – and you got clear water… Your mind is also like that. When it is disturbed, just let it be. Give it a little time. It will settle down on its own. You don’t have to put in any effort to calm it down. It will happen. It is effortless."

News Around The Globe

News

  • The US FDA has approved polidocanol injectable foam (Varithena, BTG) for the treatment of incompetent veins and visible varicosities of the great saphenous vein (GSV) system. Varithena (formerly known as Varisolve) is a pharmaceutical–grade, low–nitrogen, polidocanol foam dispensed from a proprietary canister device. It is a minimally invasive, non–surgical procedure that requires neither tumescent anesthesia nor sedation.
  • According to a new study (November 18 Journal of Clinical Oncology), the incidence of oropharyngeal cancer (OPC) has significantly increased during the past 2 decades, and almost exclusively in economically developed nations. This trend underscores the potential role of human papillomavirus (HPV) in this increasing incidence, particularly in men.
  • Thalidomide induced remission in children and adolescents with treatment–refractory Crohn’s disease in 8 weeks, according to the results of a small randomized trial In addition, patients continued to respond beyond a year in an open–label continuation phase of the trial, as reported in an article published in the November 27 issue of JAMA.
  • Embolization of the left gastric artery was associated with significant weight loss compared with that seen in patients who underwent a control procedure. Compared with those who underwent embolization of a different artery, patients who underwent embolization of the left gastric artery lost a mean 7.9% of their body weight 3 months after the procedure versus a mean 1.2% for other procedures.
  • A specific immune response signature associated with latent cytomegalovirus (CMV) infection may help predict response to treatment in very early rheumatoid arthritis. When peripheral blood mononuclear cells from recently diagnosed patients were cultured with various types of immune stimuli including combined lysates of CMV and Epstein–Barr virus (EBV), patients who failed to have a clinically meaningful response to disease–modifying anti–rheumatic drugs (DMARDs) had higher CMV/EBV scores at baseline than responders (65.6 versus 50.2).

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Rabies News (Dr. A K Gupta)

Can a rabies patient make a valid will?

A rabies patient can make a valid will.

According to Section 59 in the Indian Succession Act, 1925

Person capable of making will:–

  1. Every person of sound mind not being a minor may dispose of his property by will.
  2. A married woman may dispose by will of any property which she could alienate by her own act during her life.
  3. Persons who are deaf or dumb or blind are not thereby incapacitated for making a will if they are able to know what they do by it.
  4. A person who is ordinarily insane may make a will during interval in which he is of sound mind.
  5. No person can make a will while he is in such a state of mind, whether arising from intoxication or from illness or from any other cause that he does not know what he is doing.
cardiology news

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinewS)

  • About 20% of the variation in fluoroscopy times in the cardiac catheterization lab appears to be modifiable. In a study reported in the Dec. 1 issue of Catheterization and Cardiovascular Interventions, median fluoroscopy times varied widely from 2.6 minutes in patients undergoing invasive coronary angiography to 16 minutes in patients undergoing both invasive angiography and percutaneous coronary intervention (PCI) who had undergone CABG previously. After adjustment for patient characteristics and the complexity of the procedure, operator and hospital factors explained 17% of the variation in fluoroscopy times for invasive angiography and 19% of the variation for PCI.
  • Weight loss combined with close management of hypertension and other risk factors results in fewer atrial fibrillation (AF) events and less symptom burden in highly symptomatic patients with AF vs risk factor management alone, as per a study published in the November 20 Cardiology/Cardiovascular Disease–themed issue of JAMA.
cardiology news

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinewS)

  • A study published in Clinical Physiology and Functional Imaging has defined reference values for a large number of HRV parameters in a sample of children living in Kuopio, eastern Finland. Measurement of heart rate variability (HRV) is a useful method when assessing the role of the nervous system for heart function.
  • A study in the journal Child Development has identified which types of teacher–child interactions support children’s learning and development in which areas. They found that it was not just the quality of instructional interactions that mattered for children’s academic progress. What the researchers termed responsive teaching, which involved teachers’ sensitivity in responding to the children as well as their fostering of positive relationships and respect for the children’s autonomy, contributed to multiple aspects of the children’s development, including their language and literacy development but also their ability to hold information in memory and the quality of their relationships.
cardiology news

OTC drug does not mean it can be taken without a doctor’s advice

An over–the–counter antacid is often used to relieve mild cases of heartburn or acid reflux. Though they are available without a doctor’s prescription they should be taken only under a doctor’s advice.

As per American Academy of Family Physicians

  • There are different types of antacids that work in different ways.
  • One should talk to the doctor before taking an antacid.
  • To manage an ulcer, an antacid may need to be taken in conjunction with an antibiotic.
  • If one needs more calcium to help strengthen bones, one should prefer an antacid that contains calcium carbonate.
  • In some, antacids may have minor side effects such as nausea, headache, diarrhea or constipation.
  • One should read the label carefully to make sure that one is not allergic to any of the ingredients.
  • People with kidney disease may not be able to take all types of antacids.
  • An antacid may interact with other medications.
cardiology news

Total CPR since 1st November 2012 – 75187 trained

Media advocacy through Web Media

Over 50 focus only on upper blood pressure

For patients over 50 years of age, doctors only need to monitor the upper systolic blood pressure and can ignore the lower diastolic blood pressure reading, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India.

Systolic blood pressure – the top number in a blood pressure reading – is the pressure exerted at the beginning of the heart’s pumping cycle, while diastolic pressure records the lowest pressure during the resting cycle of the heart. Both pressures are routinely measured when recording the blood pressure.

As per a report published in the journal The Lancet, there is such an emphasis on diastolic pressure that the patients are not getting their systolic blood pressures adequately controlled. The fact is that people over the age of 50 probably do not even need to measure diastolic – it’s only the systolic blood pressure that should be the focus.

Generally, systolic blood pressure continues to increase with age, while diastolic pressure starts to drop after age 50, which is the same time when cardiovascular risk begins to rise. Therefore, there is an increased prevalence of systolic hypertension past age 50, whereas diastolic hypertension is practically nonexistent. Rising systolic pressure is the most significant factor in causing stroke and heart disease.

For people under 50, the scenario may be different. About 40 percent of adults under 40 years of age have diastolic hypertension, and about a third of those between 40 and 50 have the problem. For these patients, a continued emphasis on both systolic and diastolic blood pressures is needed. However, controlling systolic blood pressure, even among these younger patients, almost always results in adequate control of diastolic blood pressure, too.

For people 50 or older, systolic pressure is high if it is 140 mmHg or above.

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 75187 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

CPR10 Training at IITF

press release

Weight loss may improve sexual health of obese diabetes

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

Which of the following is not a post transcriptional modification of RNA?

1. Splicing.
2. 5’ Capping.
3. 3’ polyadenylation.
4. Glycosylation.

Yesterday’s Mind Teaser: The primary defect which leads to sickle cell anemia is:

1.An abnormality in porphyrin part of hemoglobin.
2.Replacement of glutamate by valine in B–chain of HbA.
3.A nonsense mutation in the B–chain of HbA.
4.Substitution of valine by glutamate in the a–chain of Hba.

Answer for yesterday’s Mind Teaser: 2.Replacement of glutamate by valine in B–chain of HbA.

Correct answers received from: Dr.K.Raju, Dr.sahadevudu Gelivi, Dr.Dinesh Narain Saksena, DR.A.K.GAJJAR, Dr.Raghavendra Jayesh, DR ARPAN GANDHI, Dr. V.P. Thakral, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr.Jayashree Sen & Dr.Bitaan Sen, Dr.Chandresh Jardosh, DR AVTAR KRISHAN, Dr B K Agarwal, Dr Prakash Khalap

Answer for 26th November Mind Teaser: 2.Decreased production of 2,3-bisphosphoglycerate.

Correct answers received from: Dr.Chandresh Jardosh, DR AVTAR KRISHAN, Dr B K Agarwal, Shravan Kumar, Muthumperumal Thirumalpillai

Send your answer to ijcp12@gmail.com



medicolegal update

Click on the image to enlarge

medicolegal update

Seen on a famous beauty parlor in Bombay

Don’t whistle at the girl going out from here. She may be your grandmother!

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A 62–year–old diabetic with coronary artery disease, on treatment for the same, came for follow up.
Reaction: Oh My God! Why didn’t you put him on antioxidants?
Lesson: Make Sure to add antioxidants to the prescription because of their free radical scavenging and other beneficial effects.

medicolegal update

Sunbeams out of the clouds. Faith out of all my doubt. Terri Guillemets

medicolegal update

Dr KK Aggarwal: Eating refined sugar can cause diabetes http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Why do you stay in prison When the door is so wide open–Rumi

Forthcoming events

5th eMedinews Revisiting 2013

(a day long single hall medical conference on 2013 happenings, followed by doctors of the year 2013 awards)

Sunday 19th January 2014, Maulana Azad Medical College Auditorium

Dilli Gate Delhi, 10 am-6 pm


Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee President
Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman
Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

5th eMedinewS Revisiting 2013
The 5th eMedinewS–revisiting 2013 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 19th 2014.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2013. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. Lunch will be provided.

Register at: rawat.vandana89@gmail.com/drpawangupta2006@yahoo.com

5th eMedinewS Doctor of the Year Awards
Nominations invited for 5th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2013.

pls send his/her Biodata at: emedinews@gmail.com

medicolegal update
  1. Dear Sir, very informative news. Regards: Dr Mayank

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medicolegal update

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