eMedinewS23rd July 2014, Wednesday

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

Warning signs of worsening heart failure

If you have heart failure, call your doctor if you notice any of these signs:

  • Sudden weight gain (2–3 pounds in one day or 5 or more pounds in one week)
  • Extra swelling in the feet or ankles
  • Swelling or pain in the abdomen
  • Shortness of breath not related to exercise
  • Discomfort or trouble breathing when lying flat
  • Waking up feeling short of breath
  • Coughing or wheezing
  • Increased fatigue
  • Mental confusion
  • Loss of appetite

News Around The Globe

  • A study published in the Journal of Neuroscience has stated that after 24 hours of sleep deprivation, healthy individuals show symptoms of psychosis similar to those observed in schizophrenia.
  • A Spanish study has revealed that anti–TNF–alpha therapy was effective and relatively safe in patients with Behcet’s disease uveitis refractory to conventional treatment, including high-dose corticosteroids and at least one immunosuppressant. The study has been published online in Rheumatology.
  • Preliminary results of a new study have shown that the multiple sclerosis drug fingolimod may be useful in treating patients with intracranial hemorrhage (ICH). Oral fingolimod, given within 72 hours of symptom onset, appeared safe and was associated with reduced perihematomal edema and neurologic deficits. The study has been published online in JAMA Neurology.
  • A study published online in Gut has pointed that patients taking entecavir for chronic hepatitis B may still be at risk for hepatocellular carcinoma (HCC). Thus, despite being a strong antiviral agent and improving the patient’s overall condition, entecavir does not prevent progression to liver cancer.
  • A meta–analysis of 15 trials has shown that early tracheostomy offers better outcomes than late or no tracheostomy for patients in the ICU. In 13 trials, early tracheostomy was associated with a 28% lower risk of all–cause mortality in the ICU. The findings are published online in Lancet Respiratory Medicine.

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 eMedinewS

  • Consumption of probiotics, found in yogurt, kefir, miso soup, etc., has the potential to decrease blood pressure to a modest degree, suggest the results of a new meta–analysis. The reductions in systolic and diastolic blood pressure were about 3.5 and 2.4 mmHg, respectively, while larger reductions were noted among individuals with elevated blood pressure at baseline and those who consumed multiple probiotic species. The findings are published July 21 in Hypertension.
  • In a retrospective study of patients referred for coronary computed tomographic angiography (CTA), clinicians were likely to strengthen lipid–lowering therapy, predominantly with statins, based on CAD at CTA irrespective of whether the disease included a >50% stenosis. This led to a significant reduction in risk of MI or cardiovascular death. The findings are published in the July 2014 issue of Circulation: Cardiovascular Imaging.

Pediatrics eMedinewS

  • A study conducted by researchers at the University of Pittsburgh in Pennsylvania and Lurie Children’s Hospital in Chicago, Illinois has revealed that obesity and increased weight gain during pregnancy could possibly increase the risk for childhood asthma or wheeze in offspring. The study is published online July 21 in Pediatrics.
  • A new study by researchers at the Women and Children’s Hospital of Buffalo, New York has stated that concurrently treating overweight and obese preschoolers and their parents with a behavioral intervention leads to greater reduction in child percentage over body mass index (%OBMI), z–BMI, and parent BMI, compared with focusing only on the child. The findings are published in the August issue of Pediatrics.

Dr K K Spiritual Blog

Leverage your strengths

  • Know your strengths
  • According to a British study, only about one–third of people have a useful understanding of their strengths.
  • If something comes easily, you may take it for granted and not identify it as a strength.
  • If you are not sure, ask someone you respect and who knows you well, by noticing what people compliment you on, and by thinking about what comes most easily to you.
  • Strengths which are most closely linked to happiness are gratitude, hope, vitality, curiosity, and love.
  • Strengths are so important that they're worth cultivating and applying in your daily life, even if they don't come naturally to you.

 

Wellness Blog

Pacing Without Leads

The first leadless pacemaker, less than one-tenth the size of a conventional pacemaker, has been approved for use in Europe. It can be delivered via a catheter into the heart.

There will be elimination of the visible lump and scar at a conventional pacemaker’s implant site. Also there is removal of patient activity restrictions that may prevent the dislodgement or damage to a conventional lead.

Initial results from the first–in–man LEADLESS study presented at the Heart Rhythm Society meeting, showed successful implantation in 32 of 33 patients and performance comparable with traditional pacemakers with leads

Inspirational Story

Story of Appreciation

One young academically excellent person went to apply for a managerial position in a big company. He passed the first interview; the director did the last interview, made the last decision. The director discovered from the CV that the youth’s academic achievements were excellent all the way, from the secondary school until the postgraduate research, never had a year when he did not score good grades. The director asked, "Did you obtain any scholarships in school?" the youth answered "None." The director asked, "Was it your father who paid for your school fees?" The youth answered, "My father passed away when I was one year old, it was my mother who paid for my school fees."
The director asked, "Where did your mother work?" The youth answered, "My mother worked as clothes cleaner." The director requested the youth to show his hands. The youth showed a pair of hands that were smooth and perfect.

The director asked, "Have you ever helped your mother wash the clothes before?" The youth answered, "Never, my mother always wanted me to study and read more books. Furthermore, my mother can wash clothes faster than me."

The director said, "I have a request. When you go back today, go and clean your mother’s hands, and then see me tomorrow morning." The youth felt that his chance of landing the job was high. When he went back, he happily requested his mother to let him clean her hands. His mother felt strange, happy but with mixed feelings, she showed her hands to the kid. The youth cleaned his mother’s hands slowly. His tear fell as he did that. It was the first time he noticed that his mother’s hands were so wrinkled, and there were so many bruises in her hands. Some bruises were so painful that his mother shivered when they were cleaned with water.

This was the first time the youth realized that it was this pair of hands that washed the clothes everyday to enable him to pay the school fee. The bruises in the mother's hands were the price that the mother had to pay for his graduation, academic excellence and his future.

After finishing the cleaning of his mother hands, the youth quietly washed all the remaining clothes for his mother. That night, mother and son talked for a very long time.

Next morning, the youth went to the director’s office. The Director noticed the tears in the youth’s eyes, asked: "Can you tell me what have you done and learned yesterday in your house?"

The youth answered, "I cleaned my mother’s hand, and also finished cleaning all the remaining clothes." The Director asked, "Please tell me your feelings."

The youth said, Number 1, I know now what appreciation is. Without my mother, there would not be the successful me today. Number 2, by working together and helping my mother, only I now realize how difficult and tough it is to get something done. Number 3, I have come to appreciate the importance and value of family relationship.

The director said, "This is what I am looking for to be my manager." I want to recruit a person who can appreciate the help of others, a person who knows the sufferings of others to get things done, and a person who would not put money as his only goal in life. You are hired. Later on, this young person worked very hard, and received the respect of his subordinates. Every employee worked diligently and as a team. The company's performance improved tremendously. Lessons to be learnt:

A child, who has been protected and habitually given whatever he wanted, would develop "entitlement mentality" and would always put himself first. He would be ignorant of his parent's efforts. When he starts work, he assumes that every person must listen to him, and when he becomes a manager, he would never know the sufferings of his employees and would always blame others. For this kind of people, who may be good academically, may be successful for a while, but eventually would not feel sense of achievement. He will grumble and be full of hatred and fight for more. If we are this kind of protective parents, are we really showing love or are we destroying the kid instead?

You can let your kid live in a big house, eat a good meal, learn piano, watch a big screen TV. But when you are cutting grass, please let them experience it. After a meal, let them wash their plates and bowls together with their brothers and sisters. It is not because you do not have money to hire a maid, but it is because you want to love them in a right way. You want them to understand, no matter how rich their parents are, one day their hair will grow gray, same as the mother of that young person. The most important thing is your kid learns how to appreciate the effort and experience the difficulty and learns the ability to work with others to get things done.

ePress Release

Monsoon and Dengue on the Door

Bed netting is of little use in dengue since the dengue mosquitoes are most active during the daytime, said Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal President, Heart Care Foundation of India and MTNL Perfect Health Mela.

Remaining in well–screened or air–conditioned buildings during the day can reduce the risk of exposure. When outside during the day, one should wear clothing that reduces the amount of exposed skin and should use an effective mosquito repellent, such as N, N–diethyl–metatoluamide (DEET).

Because dramatic plasma leakage can develop suddenly, substantial attention has been placed upon the early identification of patients at higher risk for shock and other complications. The following clinical features are of help in this regard.

  • Duration of illness: The period of maximum risk for shock is between the third and seventh day of illness. This tends to coincide with resolution of fever. Plasma leakage generally first becomes evident between 24 hours before and 24 hours after fever is over.
  • Alarm signs: Severe abdominal pain, persistent vomiting, abrupt change from fever to hypothermia, or abnormal mental status, such as disorientation, are noted in a minority of patients.
  • Hematocrit: An elevation of the hematocrit is an indication that plasma leakage has already occurred and that fluid repletion is urgently required.
  • Platelet count: Severe thrombocytopenia (<100,000/mm3) is one of the clinical criteria for dengue hemorrhagic fever and usually precedes overt plasma leakage.
  • Serum aspartate transaminase (SGOT): Mild elevations in serum transaminases are common in both dengue fever and dengue hemorrhagic fever. However, levels are significantly higher in patients with dengue hemorrhagic fever and elevated SGOT levels are noted earlier in illness.

Patients with suspected dengue who do not have any of the above indicators can be safely managed as outpatients as long as close clinical observation is assured. Daily outpatient visits may be needed to permit serial assessment of blood pressure, hematocrit, and platelet count.

A patient should be hospitalized when:

  • Blood pressure <90/60 mmHg
  • Hematocrit >50 percent
  • Platelet count <50,000/mm3
  • Evidence of bleeding other than petechiae
Self-Assessment-Quiz

 

Zee News – Health Wealth Shows

Alcohol
Cancer Prevention
Depression
Paralysis
Pneumonia
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Vitiligo
Fluid Intake

 

Total CPR since 1st November 2012 – 96458 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

Health Check Up and CPR 10 Camp at NP Primary School, Rama Krishna Marg–16th July 2014

press release

To err is human

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:  A patient was brought to the ICU in cardiogenic shock.

Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA?

Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2 trial suggest that this intervention is much better than thrombolytic therapy in such patients.

eMedinewS Humor

A girl was crying bitterly.

Mom: What happened dear?

Daughter: Mom do I look like a wicked witch?

Mom: No!

Daughter: Are my eyes big as toad?

Mom: No!

Daughter: Is my nose flat?

Mom: No baby!

Daughter: Am I fat like a bulldog?

Mom: You have a fine physique, you are a Barbie doll!

Daughter: Then why people tell me that you look like your mom?

One resolution I have made, and try always to keep, is this: To rise above the little things. John Burroughs

Quote of the Day

Discipline is the bridge between goals and accomplishment. Jim Rohn

Twitter of the Day

Dr KK Aggarwal: Shorter acting calcium channel blockers linked to breast cancer http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Those who make wise choices in life should wind up happier & more successful
http://bit.ly/HTZaj4 #Health

 

eMedi Quiz

An enzyme involved in the catabolism of fructose to pyruvate in the liver is:

1.Glyceraldehyde–3–phosphate dehydrogenase.
2.Phosphoglucomutase.
3.Lactate–dehydrogenase.
4.Glucokinase.

Yesterday’s Mind Teaser: Counseling and health and occupational screening require which of the following teledermatology tools?

a. Videoconference
b. Mobile tele dermatology

Answer for yesterday’s Mind Teaser: a. Videoconference

Correct answers received from: Dr.K.V.Sarma, Dr Avtar Krishan, Dr Chandresh Jardosh,Dr.Bitaan Sen & Dr.Jayashree Sen

Answer for 21st July Mind Teaser: a. Mobile teledermatology

Correct answers received from: Dr Prakash Khalap

Send your answer to ijcp12@gmail.com

medicolegal update

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medical querymedical query

 

medicolegal update

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medicolegal update
  1. Dear Sir, Thanks for the news. Regards: Dr Jay
cardiology news

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