eMedinewS6th April 2014, Sunday

Dr K K AggarwalPadma Shri, Dr B C Roy National Awardee and DST National Science Communication Awardee

Dr KK Aggarwal

President, Heart Care Foundation of India; Senior Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Editor in Chief IJCP Group, Senior National Vice President, Indian Medical Association; Member Ethics Committee Medical Council of India, Chairman Ethical Committee Delhi Medical Council, Hony. Visiting Professor (Clinical Research) DIPSAR; Limca Book of Record Holder in CPR, 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

CVD Lowest in Married Couples, Highest in Widowed, Divorced

Data from surveys of 3.5 million Americans suggest that married couples are 5% less likely to have CVD in various forms than single men and women. According to lead investigator Dr Carlos Alviar (NYU Langone Medical Center, New York), 69% of those surveyed were married, 13 % were widowed, 8% were single, and 9% were divorced. Overall, married subjects had lower rates of cerebrovascular disease, coronary artery disease (CAD), abdominal aortic aneurysm (AAA), and peripheral artery disease (PAD).

Percentage of People with CVD

Disease Unmarried Married
Cerebrovascular disease 10.82 8.8
CAD 7.55 6.3
AAA 2.0 1.9
PAD 8.12 5.7

Digging deeper into marital status, investigators report that being married was associated with lower rates of all forms of the disease, as compared with being unmarried. But being divorced or widowed was associated with an increased risk of any form of vascular disease, compared with never being married—something seen in both men and women.

Investigators also looked at different types of cardiovascular disease and found that risks of AAA, cerebrovascular disease, and PAD were all reduced in married subjects. CAD rates were not much different for married vs single subjects. The biggest difference was seen for PAD, which was reduced by almost 20% in married subjects.

One of the theories is that maybe if you have a spouse you may be more willing to follow up medical appointments, be compliant with medications, and be compliant with a healthy diet and exercise.

News Around The Globe

  • A study published in the April issue of Rheumatology has reported that foot pain in psoriatic arthritis (PsA) is predicted by synovitis, erosion, subluxation of the metatarsophalangeal (MTP) joints, obesity, and female sex; however, unlike foot pain in rheumatoid arthritis, it may not be predicted by elevated plantar pressure. The study authors compared 34 patients with confirmed PsA with 22 control patients to identify the independent predictors of forefoot pain at the MTP joints.
  • Effect of treatment with hyperimmune globulin for the management of primary cytomegalovirus (CMV) infection during pregnancy is equivalent to that of placebo, reports a new study published in the April 3 issue of the New England Journal of Medicine. The phase II CHIP study was a randomized, placebo–controlled, double–blind trial conducted at 11 centers in Italy from June 2009 to November 2011. About 124 pregnant women who acquired primary CMV infection between 5 and 26 weeks' gestation were randomized within 6 weeks of acquiring the infection to receive either hyperimmune globulin or placebo (0.9% saline solution) intravenously. Overall transmission rate was 30% in the treatment group vs. 44% in the placebo group. Additionally, the treatment group had a higher percentage of obstetrical adverse events than placebo group.
  • Limiting dietary sodium intake increases renin–angiotensin–aldosterone system (RAAS) blockade efficacy in diabetics with chronic kidney disease, reports a novel research published in The Lancet Diabetes and Endocrinology. Researchers at University Medical Center Groningen in the Netherlands conducted a double–blind, placebo–controlled, crossover randomized trial in 45 patients with type 2 diabetic nephropathy. Sodium restriction and hydrochlorothiazide were noted to considerably reduce albuminuria; residual geometric mean albuminuria with baseline treatment was 711 mg/day, with sodium restriction it was 393 mg/day, with hydrochlorothiazide it was 434 mg/day, and with the combination, it dropped to 306 mg/day.
  • Comprehensive analyses of observational and randomized clinical trials have suggested that vitamin D given alone has no effect on increase in bone–mineral density or reduction of risk for fractures or falls in older people. Vitamin D was however, found to be beneficial in pregnant women, for tooth decay in children, and in patients with chronic renal disease.
  • Results from the early–phase Stand Up to Cancer study have reported that buparlisib, a reversible pan–PI3K inhibitor, combined with letrozole, an aromatase inhibitor, may be effective in treating estrogen receptor (ER)–positive, HER2–negative metastatic breast cancer. Researchers evaluated the safety and tolerability of oral letrozole in combination with buparlisib in a phase Ib trial of 51 patients with ER–positive metastatic breast cancer that did not respond to endocrine therapies. The combination was well–tolerated and 2 of 20 patients in the continuous arm achieved a complete and a partial remission, while 11 patients (55%) had stable disease (lasting at least six months in six patients, or 30%). No patient in the intermittent arm showed a response, yet 14 (45%) had stable disease (lasting at least six months in 10 patients, or 32%).

Rabies News (Dr A K Gupta)

What is "furious form" of rabies in animals?

The excitative phase follows the prodromal phase in some animals. The animal becomes irrational and may aggressively use its teeth, claws, horns, or hooves. The expression is one of anxiety with dilated pupils. Noise invites attack. The rabid animal roams extensively and attacks other animals, including humans and any moving object. Cats usually manifest furious type of rabies.

Cardiology eMedinewS

  • A study presented at the American College of Cardiology 2014 Scientific Sessions states that metformin is of no help when given to patients without diabetes who had just suffered an ST–segment acute MI (STEMI). The drug does not preserve left ventricular ejection fraction [LVEF] after STEMI compared with placebo in those without diabetes. The study results revealed no significant difference in the primary end point, LVEF on MRI, between metformin–treated and placebo-treated subjects (53.1% vs 54.8%). NT–proBNP concentration did not differ between the 2 arms; it was 167 ng/L in both groups. The incidence of major adverse cardiac events (MACE) was 3.1% in the metformin group and 1.1% in the placebo group.
  • Another study presented at ACC 2014 reports that most athletes with heart problems requiring an implantable cardioverter defibrillator (ICD) can eventually be allowed to participate in sports. Dr David Cannom from the University of California, Los Angeles and Dr Rachel Lampert from the Yale University School of Medicine established a prospective registry to establish the safety of sports for athletes with ICDs. About 372 athletes participating in organized or high–risk sports (mean age 33 years) were identified. They noted that over 31 months of follow–up, none of the patients died or had a cardiac arrest requiring resuscitation during sports activities. There were no arrhythmia– or shock–related injuries during the activity either.

Pediatrics eMedinewS

  • A novel study published online April 2 in JAMA Dermatology has reported that children with symptoms of atopic dermatitis (AD) might have persistence of symptoms into their teens, and beyond. The long-term longitudinal study included 7157 children, aged 2–17 years. At every age, from 2 to 26 years, more than 80% of participants exhibited continued symptoms of AD and reported using topical medications to control the symptoms. By 20 years of age, about 50% of the patients had experienced at least a single 6–month symptom–free period.
  • Two new studies have suggested that estimating children’s weight without scales could be more accurate using new low–tech, inexpensive, portable methods. Researchers in the United States and United Kingdom have devised a novel method that includes both humeral length and mid–upper arm circumference (MUAC). It is called The Mercy TAPE ("TAking the guesswork out of Pediatric weight Estimation") method. In terms of prediction accuracy, the Mercy TAPE has outperformed many of the existing weight prediction methods, reported Gregory L Kearns, senior study author. Additionally, in the CORKSCREW study from Ireland, researchers noted that by switching from the widely used Advanced Pediatric Life Support (APLS) formula (age plus four, multiplied by two) to the Luscombe and Owens (LO) formula, they could more precisely estimate the weights of Irish children in life-threatening situations.

Dr K K Spiritual Blog

On the 7th Navratri, Enjoy a mind devoid of inner darkness

Kalaratri is worshipped on the Seventh Day of Navratri. She is dark and black like night. Her hairs are unlocked. SHE has three eyes and four hands.

She holds a sharp Sword in her right hand and blesses her devotees with her lower hand. HER vahana is a donkey, destroyer of darkness and ignorance (or shava). She spills out fire from her nostrils. She wears necklaces shining like lightening. In Yoga Shastra she represents the Sasahara Chakra

Spiritual mantra on the 7th Navratri

By the time chanting of Bija mantras LAM, VAM, RAM, YAM, HAM and AUM is over, the inner darkness goes over.

Wellness Blog

Beware of Synthetic Milk

  1. It is not milk
  2. It is made up of urea, caustic soda, refined oil (cheap cooking oil) and common detergents.
  3. Detergents are used as they emulsify and dissolve the oil in water giving the frothy solution, the characteristic white color of milk. Refined oil is used as a substitute for milk fat. Caustic soda is added to the blended milk to neutralize the acidity and preventing it from turning sour during transport. Urea/ sugar are added for solid–not–fat (SNF), to provide whiteness in milk and natural milk taste.
  4. It looks like natural milk, except in taste and nutritional qualities.
  5. It is normally mixed with milk and then sold in the market
  6. It is carcinogenic in humans
  7. Urea and caustic soda can harm liver and kidneys.
  8. Caustic soda with high sodium content is harmful for patients with high blood pressure.
  9. Caustic soda also deprives the body from utilizing lysine, an essential amino acid in milk, which is required by growing babies.

Inspirational Story

Four Burning Candles

In a room there were four candles burning. The ambiance was so soft you could hear them talking. The first one said, "I am PEACE, however nobody can keep me lit. I believe I will go out."

It’s flame rapidly diminishes and goes out completely. The second one says, "I am FAITH. Most of all I am no longer indispensable, so it does not make any sense that I stay lit any longer." When it finished talking a breeze softly blew on it putting it out.

Sadly, the third candle spoke in its turn. "I am LOVE. I have not gotten the strength to stay lit. People put me aside and don’t understand my importance. They even forget to love those who are nearest to them.” And waiting no longer it goes out.

Suddenly a child entered the room and saw three candles not burning. “Why are you not burning you are supposed to stay lit till the end." Saying this, the child began to cry. Then the fourth candle said, "Don’t be afraid, while I am still burning we can re–light the other candles, I am HOPE."

With shining eyes, the child took the candle of Hope and lit the other candles.

The flame of Hope should never go out from our life and that each of us can maintain HOPE, FAITH, PEACE and LOVE.

Hope never abandons you. You abandon hope. Consult not your fears but your hopes and your dreams. Think not about your frustrations, but about your unfulfilled potential. Concern yourself not with what you tried and failed in, but with what it is still possible for you to do.

ePress Release

Negative stress may lead to heart disease

Marital disharmony and job dissatisfaction are the two main mental risk factors for the causation of heart attack. Many studies in the past have found a strong correlation between a nagging wife and early heart attacks in men. Similarly, literature has shown that work–related stress is related to early onset of high blood pressure, diabetes, stroke and heart attacks, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India and Sr National Vice President Indian Medical Association.

A study from University College, London has shown that chronically stressed workers have a 68% of higher risk of developing heart disease especially in people under the age of 50.

Whether it is stress–related chemical changes or stress related behavior linked to heart disease, is yet to be answered. Stress–related lifestyle involves eating unhealthy food, smoking, drinking and skipping exercises.

Chemical changes related to chronic stress are increased levels of cortisol, epinephrine and norepinephrine.

Amongst stress, negative stress is more dangerous than positive stress and amongst negative stress it is jealousy, anger and cynicism, which are associated with heart attack.

The answer lies in managing stress by acting on a personal situation and not reacting to it. In children the same type of stress, especially during exam days, can end up with anxiety, insomnia and suicidal attempts.

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 88972 people since 1stNovember 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."

Zee News – Health Wealth Shows

Cancer Prevention
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D


Total CPR since 1st November 2012 – 88972 trained

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."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

cpr 10 mantra
VIP’s on CPR 10 Mantra Video

Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

emedipicstoday emedipics

A free heart checkup camp was organised by Heart Care Foundation of India at Mandi House, Doordarshan Kendra where over 500 people were examined.

press release

Monitoring LFT on a Patient

video of day video of day


IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.

If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :


Make Sure

Situation: An elderly patient with unstable angina presented with URTI and was found to be positive for Chlamydia pneumoniae infection.
Reaction: Start macrolides immediately.
Lesson: Make sure to remember that erythromycin 2 g/day for 10–14 days reverses the increased risk of atherosclerosis.

eMedinewS Humor

High Blood Pressure

When a physician remarked on a new patient’s extraordinarily ruddy complexion, he said, "High blood pressure, Doc. It comes from my family."

"Your mother’s side or your father’s?" I asked.

"Neither," he replied. "It’s from my wife’s family."

"Oh, come now," I said. "How could your wife’s family give you high blood pressure?"

He sighed. "You oughta meet ’em sometime, Doc!

Quote of the Day

The hardest battle you are ever going to fight is the battle to be just you. Dr. Felice Leonardo Buscaglia


Twitter of the Day

Dr KK Aggarwal: Air pollution can raise blood pressure http://youtu.be/NMIK16PyBrY?a via @YouTube
Dr Deepak Chopra: Accept what comes to you totally & completely, so that you can appreciate it, learn from it & then let it gohttp://tinyurl.com/mboexab


Forthcoming events

Date: Saturday 2PM–Sunday 3PM, 26–27 April 2014
Venue: Om Shanti Retreat Centre, Bhora Kalan, Pataudi Road, Manesar
Course Directors: Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal and BK Sapna
Organisers: Heart Care Foundation of India. Prajapati Brahma Kumari Ishwariye Vidyalaya and eMedinews
Facilities: Lodging and boarding provided (one room per family or one room for two persons). Limited rooms for first three hundred registrants.
Course: Meditation, Lectures, Practical workshops
Atmosphere: Silence, Nature, Pyramid Meditation, Night Walk
Registration: SMS– Vandana Rawat – reg mno, rawat.vandana89@gmail.com
SMS – BK Sapna reg mno1, bksapna@hotmail.com

Note: Donation in Favor of Om Shanti Retreat Centre will be welcomed


Our Contributors

Dr Veena Aggarwal, Dr Chanchal Pal, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Monica Vasudev, Dr Navin Dang, Dr Pawan Gupta, Dr Parveen Bhatia, Dr Prachi Garg, Rajat Bhatnagar, Dr Sudhir Gupta, Prof.(Dr).C V Raghuveer

eMedi Quiz

All of the following are TRUE regarding HIV infection in children except:

a. Most of the children present with clinical symptoms during the neonatal period.
b. They usually present with non specific symptoms of immunodeficiency
c. Skin is one of the most commonly involved organs with HIV infections
d. Children may remain asymptomatic upto the age of 8–10 years

Yesterday’s Mind Teaser: B-oxidation of odd–chain fatty acids produces:

1.Succinyl CoA.
2.Propionyl CoA.
3.Acetyl CoA.
4.Malonyl CoA.

Answer for yesterday’s Mind Teaser: 2.Propionyl CoA.

Correct answers received from: Dr.Bitaan Sen & Dr.Jayashree Sen, Dr. P. C. Das, Dr Poonam Chablani, Dr Jainendra Upadhyay, Dr.K.V.Sarma, Daivadheenam Jella, Dr Avtar Krishan, Deepali Chatterjee, Dr. SUSHMA CHAWLA.

Answer for 4th April Mind Teaser: 3. Leaves extension at elbow joint intact.

Correct answers received from: Dr. P. C. Das, Dr Jainendra Upadhyay

Send your answer to ijcp12@gmail.com

medicolegal update

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  1. Dear Sir, Very informative newspaper. Regards: Dr Kartik
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