eMedinewS 3rd August 2013, Saturday

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; 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

Marked rise in under-30 heart patients

The age of heart patients has been falling over the years. Heart patients in their 20s are not unheard of, they are still uncommon.  However, we do see many with heart attacks in their early 30s, reports TOI.

As per Dr Prafulla Kerkar, head of cardiology at KEM Hospital, in a study of 350 heart attack patients, 9.5% of cases were below 40 years of age and 3% below 30. In almost all the young patients, smoking was invariably a common factor.

According to the November 2009 issue of Harvard Men's Health Watch, as many as 10% of all heart attacks in men occur before the age of 45. In older adults, around 80% of these attacks stem from coronary artery disease. 

The Coronary Artery Risk Development in Young Adults (CARDIA) study in the US evaluated more than 5,000 young adults ages 18 to 30 and then monitored them for up to 15 years to find out how their risk factors influenced their heart health. The overall incidence of heart attack is 13% for the 18-25 age group and 18% for those aged between 25 and 30. 

There is no pooled data or large-scale analysis in India. But hospital record surveys have revealed a variable percentage of 9% to 15% heart attacks below the age of 40 years across the country. The statistics are only increasing by the day.

....Read More

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 10x10 i.e. 100 per minute."

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

Ringtone – CPR 10 Mantra English

sprritual blog Which are the inseparable pairs in Vedanta?

Luv-Kush, Shubha-Labha, Riddhi-Siddhi are inseparable pairs of Vedanta. They signify that you cannot get one without the help of the other.

In Luv-Kush, Kush is a symbol of purity and Luv symbolize the spiritual love. To achieve love one has to be pure in consciousness. To acquire love and inner happiness in life, one may have to use kush, a herb, in daily life. No traditional Hindu ritual is complete without the use of kush grasses. 

Kush is a benevolent satvik detoxifying grass, a symbol of progress and alertness. The word “kushal buddhi” originates from the word kush. In Bhagavad Gita (shloka 6.10) Krishna said that for meditation one should sit on a seat covered with kush grass. The Garuda Purana also described the importance of kush grass in rituals of Panchak death and in cremation of a person whose body has not been found as in natural calamities, by making an effigy of kush grass and completing the rituals. Kush grass is often held in the hands before taking a sankalp.

Kush grass is called Imperata cylindrica Beauv. It is a clean, pure, brittle grass with acrid, cooling, oleaginous, aphrodisiac and diuretic properties. Kush sharbat is a drink routinely used by traditional healers of Chattisgarh. 

In Riddhi-Siddhi, Riddhi is knowledge and Siddhi is perfection.  An obstacle-free life (represented by Ganesha) can be attained only when one masters or tames both knowledge and perfection. 

Riddhi and Siddhi are the two inseparable wives of Lord Ganesha.  

Some symbolize Siddhi as success and Riddhi as prosperity or Riddhi as material abundance and Siddhi as the intellectual and spiritual prowess or Riddhi as prosperity and Siddhi as progress. All are dependent on each other.

Ganesha is said to have two sons, Shubha-Labha. Again the two terms are inseparable from each other. Both the words are written during Diwali on each account book. Shubha is auspiciousness and Labha, profit.

Ram Lakshman are often spoken of as Ram-Lakhan, which signifies that to be in touch with consciousness (Rama) one has to control the mind with an aim (Mana with a Lakshya). 

Other pairs, which are inseparable, are the duals of Rama and Sita, Radha and Krishna, Shiva and Parvati, Brahma and Saraswati and Vishnu and Lakshmi. 

In Rama-Sita, Rama signifies soul consciousness and Sita, the body. It is true for the Krishna and Radha combination. They also signify the dual character of the nature, feminine and masculine natures.

In Brahma and Saraswati, Brahma represents creativity or innovations and Saraswati the art of acquiring pure knowledge. Again both are dependent on each other.

Lakshmi and Vishnu are again inseparable. Vishnu or Krishna is the doer and performer. They signify action in the present. Lakshmi signifies material and spiritual benefits. One can only get the benefits by action in dharma.

Shiva-Parvati is other inseparable word used in Vedic literature. The other is Shiva and Shakti. They represent the true nature of the consciousness, the male and the female energies; the purusha and the prakriti. In terms of computer language, they represent the operational and the application software. No computer can run without both of them. One is knowledge or the information and the other is energy.

Other uncommon pairs are Bharata and Shatrughana of Ramayana. Bharata represents bhakti, devotion and discipline and Shatrughana, victory over the enemy. To win over the Shatru, one has to become Bharata.

In Mahabharata, there is the pair of Nakul (being neutral) and Sahdeva (helping every one). Again they are inseparable. You cannot help unless you are neutral. 

The pairs of modern post Vedic era are Heer-Ranjha; Laila-Majnu, Sheeri-Farhad, Banti and Babli and Veer-Zara. They all symbolize human love relationship. ...Read More

cardiology news

The Tattooed Homeless Man

He was scary. He sat on the grass with… his cardboard sign, his dog (actually his dog was adorable) and tattoos running up and down both arms and even on his neck. His sign proclaimed him to be “stuck and hungry” and to please help.

I’m a sucker for anyone needing help. My husband both loves and hates this quality in me. It often makes him nervous, and I knew if he saw me right now, he’d be nervous. But he wasn’t with me right now.

I pulled the van over and in my rear-view mirror, contemplated this man, tattoos and all. He was youngish, maybe forty. He wore one of those bandannas tied over his head, biker/pirate style. Anyone could see he was dirty and had a scraggly beard. But if you looked closer, you could see that he had neatly tucked in the black T-shirt, and his things were in a small, tidy bundle. Nobody was stopping for him. I could see the other drivers take one look and immediately focus on something else – anything else.

It was so hot out. I could see in the man’s very blue eyes how dejected and tired and worn-out he felt. The sweat was trickling down his face. As I sat with the air-conditioning blowing, the scripture suddenly popped into my head. “Inasmuch as ye have done it unto one of the least of these, my brethren, so ye have done it unto me.”

I reached down into my purse and extracted a ten-dollar bill. My twelve-year old son, Nick knew right away what I was doing. “Can I take it to him, Mom?”

“Be careful, honey.” I warned and handed him the money. I watched in the mirror as he rushed over to the man, and with a shy smile, handed it to him. I saw the man, startled, stand up and take the money, putting it into his back pocket. “Good,” I thought to myself, “now he will at least have a hot meal tonight.” I felt satisfied, proud of myself. I had made a sacrifice and now I could go on with my errands.

When Nick got back into the car, he looked at me with sad, pleading eyes. “Mom, his dog looks so hot and the man is really nice.” I knew I had to do more.

“Go back and tell him to stay there, that we will be back in fifteen minutes,” I told Nick. He bounded out of the car and ran to tell the tattooed stranger. I could see the man was surprised, but nodded his agreement. From my car, my heart did a little flip-flop of excitement.

We then ran to the nearest store and bought our gifts carefully. “It can’t be too heavy,” I explained to the children. “He has to be able to carry it around with him.” We finally settled on our purchases. A bag of “Ol’ Roy” (I hoped it was good – it looked good enough for me to eat! How do they make dog food look that way?); a flavored chew-toy shaped like a bone; a water dish, bacon flavored snacks (for the dog); two bottles of water (one for the dog, one for Mr. Tattoos); and some people snacks for the man.

We rushed back to the spot where we had left him, and there he was, still waiting. And still nobody else was stopping for him. With hands shaking, I grabbed our bags and climbed out of the car, all four of my children following me, each carrying gifts. As we walked up to him, I had a fleeting moment of fear, hoping he wasn’t a serial killer.

I looked into his eyes and saw something that startled me and made me ashamed of my judgment. I saw tears. He was fighting like a little boy to hold back his tears. How long had it been since someone showed this man kindness? I told him I hoped it wasn’t too heavy for him to carry and showed him what we had brought. He stood there, like a child at Christmas, and I felt like my small contributions were so inadequate. When I took out the water dish, he snatched it out of my hands as if it were solid gold and told me he had had no way to give his dog water. He gingerly set it down, filled it with the bottled water we brought, and stood up to look directly into my eyes. His were so blue, so intense and my own filled with tears as he said “Ma’am, I don’t know what to say.” He then put both hands on his bandanna-clad head and just started to cry. This man, this “scary” man, was so gentle, so sweet, so humble.

I smiled through my tears and said “Don’t say anything.” Then I noticed the tattoo on his neck. It said “Mama tried.”
As we all piled into the van and drove away, he was on his knees, arms around his dog, kissing his nose and smiling. I waved cheerfully and then fully broke down in tears.

I have so much. My worries seem so trivial and petty now. I have a home, a loving husband, four beautiful children. I have a bed. I wondered where he would sleep tonight.

My step-daughter, Brandie turned to me and said in the sweetest little-girl voice, “I feel so good.”

Although it seemed as if we had helped him, the man with the tattoos gave us a gift that I will never forget. He taught that no matter what the outside looks like, inside each of us is a human being deserving of kindness, of compassion, of acceptance. He opened my heart.  ...Read More

News Around The Globe

  • sprritual blog
    The 'Tree man' who got six kilograms of warts removed

    This Indonesian man named Dede, first noticed the warts on his body after cutting his knee when he was a teenager. Over time, as the horn-like extensions grew to cover most of his body, he was sacked from his job, deserted by his wife and shunned by neighbors. After dealing with this problem for over two decades, the 37-year-old man, dubbed ‘The Tree Man', went under surgery and 95 percent of the warts have been removed after nine operations. ‘He cannot be 100 percent cured, but his life quality has improved. If once he depended on others to do his activities, now he can eat by himself, use his hand to write, use the cell phone', said Rachmad Dinata, one of his doctors. The warts on Dede's body were a result of severe Human Papilloma Virus infection, according to an American doctor. And they might re-grow, but at least the disease is not life-threatening anymore.

  • FDA has warned of fatal skin reactions with Paracetamol, the reaction is rare but severe and sometimes fatal at usual doses.
  • The biomarker CK-MB should be preferred over cardiac troponin (cTn) to identify coronary angioplasty-related myocardial injury that predicts later events. said Issam D. Moussa, MD, of the Mayo Clinic in Jacksonville, Fla., and colleagues.
  • Over a 10-year span, the proportion of New Yorkers diagnosed with type 2 diabetes jumped from 8% to almost 11%, and today one in nine adults living in the Big Apple has diabetes.
  • The Japanese Health, Labor, and Welfare Ministry is currently investigating a potential a link between valsartan (Novartis) and skin eruptions that result in sores and blisters, according to the Japan Times.
  • Centrally acting ACE inhibitors reduce the rate of cognitive decline in patients with dementia, regardless of blood-pressure levels at the time of their hypertension diagnosis. There's a growing body of literature now showing that these drugs slow down the deterioration that people with Alzheimer's disease experience, probably by between 20% and 30% a year compared with another antihypertensive drug or no centrally acting ACE inhibitor, said Dr D William Molloy (University College Cork, Ireland).in July 22, 2013 in BMJ Open.
  • Indian Medical Association is organizing “AADHAAR & VOTER ID CARD CAMP” with the support of Journalists Indraprastha Press Club of India and Delhi Journalists Association on 4th & 5th August, 2013 at IMA House, Indraprastha Marg, New Delhi-110 002. The camp will start at 11.00 a.m. to 05.00 p.m.
  • 2.9 Secretary, MoH&FW’s DO Letter regarding consideration of proposal to introduce single exit exam for students passing final MBBS : After detailed discussion, the Board of Governors have unanimously accepted the need to have an exit examination at the national level in order to further improve the quality of medical education . It was brought to the notice of BOGs that a comprehensive report in this matter had been prepared by a team of experts comprising Dr. Ranjit Rai Chowdhury and Dr. R.K. Srivastava (former DGHS). It was decided that a copy of the said report be obtained and placed before the BOGs for detailed discussion.
  • New York City's campaign against super-sized sugary drinks continues to fizzle, with an appellate court upholding an earlier ruling that the ban is unconstitutional.
  • Screen high-risk smokers for lung cancer CME Annual low-dose CT screening for lung cancer got the thumbs-up from the U.S. Preventive Services Task Force for adults ages 55 through 79 who have a 30 pack-year history of smoking or who have quit in the past 15 years.

Rabies News (Dr. A K Gupta)

Is there carrier state of rabies in dogs?

A carrier state of rabies in dogs/cats has not yet been conclusively proven and established.

cardiology news
  • A retrospective study in the Journal of the American College of Cardiology suggests that over the long term, the best of three operative approaches for patients with severe carotid and coronary artery disease (CAD) also happens to be the one that is least available to them. Patients who underwent carotid artery stenting followed a few weeks later by open heart surgery (a 'staged' procedure) had a lower risk of the composite primary endpoint of all-cause death, stroke, or myocardial infarction (MI) than those who underwent staged carotid endarterectomy followed by open heart surgery (CEA-OHS) or those who had CEA-OHS performed on the same day (a ''combined' procedure). The relative reduced risk over a period longer than 1 year was 67% for staged stenting compared with staged endarterectomy, and 65% for staged stenting versus the combined procedure. (Source: Medpage Today)
  • Findings from the General Reproductive Assistance and Vascular Illness Study (GRAVID) suggest that women who gave birth after receiving fertility therapy had about half the risk of CVD or death in the subsequent decade as compared with women who gave birth without this therapy. The study also confirmed that fertility therapy increased the odds of short-term pregnancy complications such as maternal metabolic syndrome (gestational diabetes and hypertension). GRAVID is the first large, population-based study to assess long-term risk of CVD following fertility therapy. (Source: Medscape)

Valvular Heart Disease News

Prolapse is defined as systolic mitral leaflet displacement =2 mm above the annular plane in the parasternal or apical long axis views.

(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
  • An FDA Panel  has voted to allow triamcinolone acetonide (TAA) nasal metered-dose spray (Nasacort, sanofi-aventis) to be switched from prescription to over-the-counter (OTC), but with the proviso that the product label must clearly reflect the risk for slowing of growth in children, among other concerns. The indication is the same it now has as a prescription product "for the treatment of seasonal and perennial allergic rhinitis for the temporary relief of hay fever and other respiratory allergies (nasal congestion, runny nose, sneezing, itchy nose)." (Source: Medscape)
  • Union Health Minister Ghulam Nabi Azad launched the National Teeka Express, an initiative to protect children from life-threatening diseases in Rajasthan's Alwar district as reported in PTI, August 1, 2013. "Vaccines of seven deadly diseases will be distributed in villages and hamlets under this scheme. This affirms our commitment to vaccinate children in remote areas," Azad said during the inauguration ceremony of the programme.
cardiology news

Osteoporosis is preventable and treatable

Osteoporosis is termed as "The Silent Thief," because it can progress for years without symptoms, robbing the strength from bones until a fracture occurs. Early diagnosis can check bone loss and reduce risk of fractures.

Though osteoporosis can occur in any one, it is more common in older women after menopause. Risk of osteoporosis is so high in women that developing an osteoporosis–related hip fracture is equal to combined risk of developing breast, uterine, and ovarian cancer.

One out of every five persons who has a hip fracture will not survive more than 1 year. Men and younger women are also victims to osteoporosis.

The standard x–ray cannot diagnose osteoporosis until approximately 30% of bone is already lost. A Bone Mineral Density test is the best way to detect osteoporosis before a fracture occurs.

Four out of 10 women above 50 years of age experience a hip, spine, or wrist fracture during their lifetime.

...Read More

cardiology news

Paternal age and fertility

Older men can be reassured that any excess risk of disease in their offspring related to paternal age is very small, but not zero. Advanced paternal age is associated with an increase in new autosomal dominant mutations. The best estimate of risk of autosomal dominant disease in progeny is ≤0.5%.

cardiology news

HCFI Activities

2nd August: Heart Care Foundation of India Organizes a CPR 10 Training camp at Balwant Rai Mehta School, Greater Kailash, Part 2, New Delhi.

IMA/DMA/DMC Meetings

30th July: IMA Delegation with Sheila Dikshit


CPR 10 Camp – E Book Sahodaya Sr Sec School, SDA, New Delhi


CPR Classes: Persons trained (20)

30th July: CPR 10 Moolachand (20)

Total CPR since 1st November 2012 – 57939 trained

TV and Radio Coverage

30th July: Dr KK Aggarwal on India News

Video Chats and uploads

Dr KK Aggarwal on Say No Tobacco

Dr KK Aggarwal on NEWS 24

Advocacy through Print Media

30th July: Veer Arjun

Media advocacy through Web Media

Poly Diet and Poly Drugs 1st Aug


Longer the waist line shorter the brain size

For every excess pound piled on the body, the brain gets a little bit smaller, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India.

A research from UCLA neuroscientist Paul Thompson, has found that elderly individuals who were obese or overweight had significantly less brain tissue than individuals of normal weight. The brains of obese people looked 16 years older than their healthy counterparts while those of overweight people looked 8 years older.

Much of the tissue lost was in the frontal and temporal lobe regions of the brain, the seat of decision–making and memory, among other things. These have serious implications for aging, overweight or obese individuals, including a heightened risk of Alzheimer’s. Obesity thus may accelerate ageing.

The researchers studied brain images of 94 people in their 70s. None of the participants had dementia or other cognitive impairments. They were followed for five years. Clinically obese people had 8 percent less brain tissue, while the overweight had 4 percent less brain tissue compared to normal–weight individuals.

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 57939 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 10x10 i.e. 100 per minute.”

today emedipics

Heart Care Foundation of India Organizes a CPR 10 Training camp at Balwant Rai Mehta School, Greater Kailash, Part 2, New Delhi on 2nd August 2013.

press release

Weight loss may improve sexual health of obese diabetes

today video of the dayDr KK Aggawral on Say No to Tobacco

Dr KK Aggarwal on How to Take Care of yourself during the Monsoons

Smart Phones Benefits and Hazards

eMedi Quiz

Read this…………………

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?

a.    This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.
b.    The most common treatment is metronidazole, which should eradicate the problem within 7 to 10 days.
c.    The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
d.    The human papillomavirus (HPV), which causes condylomata acuminata, can’t be transmitted during oral sex.

Yesterday’s Mind Teaser: When a female client with an indwelling urinary (Foley) catheter insists on walking to the hospital lobby to visit with family members, Nurse Rose teaches how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information?
a.    The client sets the drainage bag on the floor while sitting down.
b.    The client keeps the drainage bag below the bladder at all times.
c.    The client clamps the catheter drainage tubing while visiting with the family.
d.    The client loops the drainage tubing below its point of entry into the drainage bag.

Answer for yesterday’s Mind Teaser: b. The client keeps the drainage bag below the bladder at all times.

Correct answers received from: DR ABBAS VAKIL, Dr Gajveer Singh, Dr. V.P. Thakral, Dr. P. C. Das, Dr.K.V.Sarma, DR. SUSHMA CHAWLA, Dr.(Maj. Gen.) Anil Bairaria, DR SANTHAKUMARI, Dr kanta Jain, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Dr(Brig) C H Gidvani, DR Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr B K Agarwal, daivadheenam, Raju Kuppusamy, DR AVTAR KRISHAN, Dr.Bitaan Sen & Dr.Jayashree Sen, Dr P J Khalap

Answer for 1st August Mind Teaser: b. The presence of a boggy mass

Correct answers received from: Dr. V.P. Thakral, Dr.Bitaan Sen & Dr.Jayashree Sen,

Send your answer to ijcp12@gmail.com

eMedi Apps

medicolegal update

Click on the image to enlarge

medicolegal update

Wife comes home late at night and quietly opens the door to her bedroom. From under the blanket she sees four legs instead of two. She reaches for a baseball bat and starts hitting the blanket as hard as she can. Once she’s done, she goes to the kitchen to have a drink. As she enters, she sees her husband there, reading a magazine. "Hi Darling", he says, "Your parents have come to visit us, so l let them stay in our bedroom. Hope you said Hello to them."

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient of suspected MI died after receiving sublingual nitrate.
Reaction: Oh my God! Why was a history of Viagra drug intake not taken?
Lesson: Make sure to take a history of Viagra drug intake before giving nitrates, because the two drugs co–administered can cause fatal fall in blood pressure.

medicolegal update

It takes less time to do things right than to explain why you did it wrong. Henry Wadsworth Longfellow

medicolegal update

Dr KK Aggarwal: Poly Diet and Poly Drugs by Dr k k Aggarwal
http://bit.ly/19z6HQg #Health

Dr Deepak Chopra: Do you think it's possible to encompass the full experience of spirituality without having a mentor? http://tinyurl.com/nsoww5o

medicolegal update

Dear Dr. K. K. Aggarwal, Apropos "People bringing bad name to the profession..." column, this is to say that no honest professional would act the way the report depicts. It's quite likely that both MD and MRCH qualifications belong to Alternative (or Homoeopathic) Medicine...and are not from a Government recognised Board. Sincerely: Dr. Narendra Kumar.

Forthcoming Events


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medicolegal update

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