eMedinewS
1st October 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

Quitting smoking is not easy

Smoking is an addiction and quitting is a process which cannot be done in one sitting.

A new large population–based Danish case–control study has shown that those who are able to quit smoking easily on the first try are significantly more likely to develop Parkinson’s disease (PD) than their counterparts who struggle to quit.

Patients with PD are able to quit smoking more easily because they have fewer nicotinic receptors in their brain said Beate Ritz, MD, PhD, from the University of California, Los Angeles.

Parkinson's is no more a motor disease that starts when you get rigidity, slowness of movement, the falls and tremors. It starts 10, 20, or 30 years prior to the motor symptoms.

PD has a lot of nonmotor features, such as constipation, sexual dysfunction, heart and blood pressure issues, depression, cognitive impairment, sleep disorders, and loss of the sense of smell. Ease of stopping smoking is another premotor symptom of Parkinson’s. Their findings were published online September 12 in Neurology. (Source Medscape}

News Around The Globe

  • Doctors have found that higher levels of branched chain amino acids were present in people who went on to develop pancreatic cancer, compared to those who did not develop the disease," study co-senior author Dr. Brian Wolpin, of the Dana-Farber Cancer Institute in Boston, said in an institute news release. Further research showed that mice with newly formed pancreatic tumors had elevated blood levels of branched chain amino acids, according to the study published online Sept. 28 in the journal Nature Medicine.
  • The number of Americans with atrial fibrillation may double by 2050 said Nihar Desai, MD, MPH, a cardiologist and faculty member at the Yale School of Medicine
  • For mild to moderate pain conditions, including headache, fibromyalgia, and chronic low back pain, the risks for overdose, addiction, or serious adverse effects associated with long-term use of opioids likely outweigh the benefits, reports a new position paper from the American Academy of Neurology (AAN).
  • The Food and Drug Administration has approved eye implant Iluvien, from Alimera Sciences and pSivida Corp, for the treatment of diabetic macular edema (DME) in patients who have been previously treated with a course of corticosteroids and did not have a clinically significant elevation in intraocular pressure (IOP).
  • Thoracic radiotherapy improves long-term survival and progression-free survival in patients with extensive stage small-cell lung cancer (SCLC), suggest results from a phase 3 trial published online in The Lancet.
  • A new clinical guideline published in the journal Neurosurgery recommends bilateral deep brain stimulation for cases of obsessive-compulsive disorder that do not respond to medication. Researchers sponsored by the American Society of Stereotactic and Functional Neurosurgery and the Congress of Neurological Surgeons conducted a systematic review of research to develop the guidelines.
  • A new study has noted that people who spend more time preparing and cooking meals are more likely to have healthier diets, while those who spend the least time on food preparation appear to spend the most money on food away from home and are more likely to eat at fast food restaurants. The study is published online in the American Journal of Preventive Medicine.

National News

  • AMRI Hospital and IMA filed separate Review petitions challenging the compensation awarded in Anuradha Saha death case and seeking a “cap” in all cases involving medical negligence.
  • Supreme Court has dismissed AMRI’s Review petition and rejected IMA’s plea " “Permission to file review petition(s) is rejected (for IMA). We have considered the averments in the review petitions. Having regard to the facts and issues involved, in our opinion, no case for review is made out. There is no error in the impugned order. Hence, the Review Petitions are dismissed. "

Dr KK Spiritual Blog

On 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 has put on 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.

Inspirational Story

My Sunshine

It was May 2003. I knew something was wrong. I felt my body weakening as the days progressed. Finally it gave out and I collapsed. I was posted to my bed for months. The pain my body felt was indescribable. I could barely stand and gasped for every breath. One would think in the sick body I was in, depression would take over. But I was blessed. Truly blessed. My illness became a blessing.

Due to my illness I was not able to attend my religious meetings. I would listen to them over the phone on the days the medication didn't consume my body leaving me numb. This particular day there was a problem with the sound system. One of the members of the congregation was trying zealously to connect me, but was unsuccessful. That same day he decided to pay me a visit.

His visit was God sent. His words of encouragement and comfort were what I needed. Those visits progressed and helped with my recovery. As we grew to know each other, we realized how much we had in common, that our lives were parallel. Our friendship blossomed at full speed, creating a powerful bond. We became a source of comfort for each other.

As my body healed, our outings became frequent. We spent most of the time together, going places and talking on the phone for hours. He became the sunshine in my day. My mornings were filled with his early phone calls. My evenings were filled with his warmth. Not a day went by when he wasn't a part of it.

One Sunday evening we were watching a movie on my couch. He put his arms around me and I knew there was more he was feeling. That night we experienced our first kiss. He was confused on what he felt. In his eyes I was beautiful in every way. However, our lives were headed in different directions. Love between us was impossible.

I begged him to not end our friendship. I just couldn't imagine not having him in my life. Weeks went by and he distanced himself from me. He didn't know how to handle what had happened. We spoke about it but there was no solution. Throughout the months we tried to mend the friendship, but the attraction would take over bringing us back to moments of passion; beautiful moments where I expressed my deepest love for him. Our bodies would intertwine leaving me breathless. Sadly those moments would only remind us of our impossible love.

We decided to accept reality. It took all the strength in me to end it. I was heartbroken. The void of his loss consumed me. I tried lying to myself saying I didn't need him or miss him and that life will be OK without him. But I had to give in to what I truly felt. My heart was aching. But I had to do the right thing and stay away.

Two months later I received a phone call from one of my close friend. She didn't want to tell me over the phone what had happened and drove me to the hospital. I found my dear Chris being prepared for surgery. He fell and smashed his foot. My heart was in pieces. I visited him in the hospital every day and our feelings were awakened. We spent those days in the hospital holding each other. I couldn't stop telling him how much I had missed him. It was a sigh of relief being together again.

Then it was time for him to go home and begin his recovery. I helped care for him as much as I could. The love I felt for him only deepened. But again reality struck. We couldn't continue seeing each other. It was only making the departure harder to bear. Again we ended it leaving me devastated. He was sick and I couldn't be there for him as he was for me. I had to walk away with my heart shredded to pieces…again.

Occasionally I called to see if he was OK. But things were never the same again. I lost my best friend and my soul mate. Even though I knew it was for the best, the pain was unbearable at times. Seeing him at church didn't help either. It only reminded me of the loss. Throughout the months that followed there were moments in which we spoke. We spoke of our desire for one another, which only help build it even stronger. There were moments of deeper passion that followed those conversations but they lead nowhere. What we had was what he called a "dead end."

I was tired of the roller coaster. I needed my inner peace. This time we ended it for good. Now he is a memory; someone who will always hold a special place in my heart. I live remembering the loss every day. He never leaves my mind and heart.

I don't know what turns our lives will take, but I wish him happiness. He taught me to always remember the good - a lesson I will carry with me to my grave. I live each day grateful for our encounter even though it was brief. He will always be the sunshine in my day. All I have to do is remember.

Rabies News (Dr A K Gupta)

Management if anaphylactic reaction occurs:

ð€¢ Adrenaline: The dose is 0.5 ml of 0.1% solution (1 in 1000, 1mg/ml) for adults and 0.01ml/kg body weight for children, injected intramuscularly (IM).

ð€¢ Inj Hydrocortisone: 100 mg stat and 6 hourly I/V.
ð€¢ Inj Chlorphinaramine I/V.
ð€¢ Inj Ranitidine I/V.

If patient is sensitive to ERIG, HRIG should be used. Patient who has had prior exposure of anti–sera (e.g. Anti–tetanus serum, anti–diphtheria serum) should receive subcutaneous dose of Inj adrenaline (the requirement will be half dose of that required for treatment for anaphylaxis).

Cardiology eMedinewS

  • Patients with stable coronary artery disease (CAD) appear to face an increased risk for bleeding when given anti-platelet therapy in addition to a vitamin K antagonist, suggested a French study published in the Journal of the American College of Cardiology
  • A new study has found that more than half of the patients who have suffered a stroke with no well-defined etiology appear to have an enlarged left atrial appendage of the heart. The results thus point that the enlargement of the left atrial appendage may be an independent risk factor of strokes with cardiac origin. The study is published in PLOS ONE.

Pediatrics eMedinewS

  • Infants aged 0 to 23 months who had repeated exposure to broad-spectrum antibiotics may be more likely to be obese at age 5 years than children who did not receive antibiotics, suggests a new study published online September 29 in JAMA Pediatrics.
  • Toddlers whose mothers had gestational diabetes mellitus that required medication had increased odds of being diagnosed with autism spectrum disorder compared with other children, suggested a new study conducted among Californian women. The study was presented at the European Association for the Study of Diabetes 2014 Meeting.

Quote of the Day

  • The weak can never forgive. Forgiveness is the attribute of the strong. – Mahatma Gandhi
  • When you are content to be simply yourself and don’t compare or compete, everybody will respect you- Lao Tzu

IMA/MCI NEWS

Over 500 junior doctors from nine teaching hospitals affiliated to Osmania Medical College boycotted non-emergency duties on Monday in protest against mandatory rural service. Government is holding counselling for doctors for the rural stint on Oct 1. Led by Dr G Srinivasa, president of Telangana Junior Doctors' Association (TJUDA), the PG students sat on a dharna outside Osmania General Hospital superintendent Dr C G Raghuram's chamber for a couple of hours before laying siege to the office of the director of medical education (DME). As a result of the protest, many patients slated to undergo surgeries on Monday were left high and dry.

Instead of a one-year compulsory rural stint, the TJUDA wants the government to replace it with a voluntary system. They also demanded introduction of residential system for students and faculty members and provision of special protection force inside the premises of teaching hospitals.

"Why are only PG medicos in Telangana and AP being singled out for compulsory rural service when other states have no such system? Even IIT and IIM graduates are never asked to undertake compulsory rural service though the Centre heavily subsidizes their education," said M Kiran, a TJUDA member.

While the stir did not impact emergency services in the teaching hospitals on Monday, the TJUDA members said they would boycott even emergency services if talks with the government failed. "When we gave a representation to DME Dr Putta Srinivas, seeking to withdraw the compulsory rural service, the latter promised to respond in a couple of days with the state government's answer," said Srinivasa.

Interestingly, Kiran, a PG second year student at Osmania Medical College, said that they would consider compulsory rural service if the government is ready to pay them salaries on par with assistant professors and civil assistant surgeons.

Junior doctors, who are mostly PG students of Gandhi Medical College and Kakatiya Medical College, also took out symbolic protests but did not boycott duties. (Times of India)

eMedinewS Comments: The government must see to it that it does not end up in total strike. The best solution is rural posting as a part of three years PG training and not after or before that.

Wellness Blog

Cherries May Prevent Gout Flares

Gout Patients are less likely to report acute attacks after 2 days of eating cherries or imbibing cherry extract than during periods after no cherry intake, according to data reported in Arthritis & Rheumatism by Yuqing Zhang, DSci, and colleagues from Boston University School of Medicine in Massachusetts.

Cherry intake during a 2-day period is associated with a 35% lower risk for gout attacks and that cherry extract intake with a 45% lower risk.

Risk for gout attacks was reduced by 75% when cherry intake was combined with allopurinol use.

In the study if subjects took allopurinol alone, it reduced the risk of gout attack by 53%; if subjects took cherry alone, it reduced the risk by 32%; if they took both, the risk of gout attack was reduced by 75%, reporst Medscape.

A cherry serving was defined as one-half cup or 10 to 12 cherries.

Cherries may decrease serum uric acid levels by increasing glomerular filtration or reducing tubular reabsorption.

Cherries and cherry extract contain high levels of anthocyanins, which possess anti-inflammatory properties.

ePress Release

Heart Care Foundation of India successfully trains over 1 lakh people in the life–saving technique of Hands Only CPR for revival after sudden cardiac arrest

Creates new milestone on the occasion of World Heart Day

Reinforcing its commitment to making India a healthier and disease free nation, leading National non–profit organization Heart Care Foundation of India achieved a new milestone on the occasion of World Heart Day today. It crossed the 1–lakh mark of the number of people successfully trained in the lifesaving technique of Hands Only CPR 10 for revival after sudden cardiac arrest.

In a country, where over 24 lakh individuals die due to a heart disease each year, 50% of which die just because they cannot reach the hospital on time; it is extremely crucial for all citizens to know the technique of hands only CPR for revival after sudden cardiac arrest. Keeping this in mind, HCFI started a national training campaign for this cause and has developed a special Hands only CPR 10 mantra to educate people about how a person who dies due to a sudden cardiac arrest can be brought back to life within ten minutes of his death. The NGO also holds three Book of World records for the maximum number of people trained in a day and certain time.

Commenting on the occasion of World Heart Day, Padma Shri, DST National Science and Communication and Dr. BC Roy National Awardee and the President of the Heart Care Foundation of India, Dr. KK Aggarwal said" Indian’s are more prone to heart attacks than their western counterparts due to common factors such as their sedentary lifestyle, unhealthy eating habits and everyday stress. Given this scenario, there exists an urgent need raise awareness about preventive factors and provide practical solutions to the already widespread problem. One of the biggest problems that India faces is the absence of a National CPR training program which if implemented can help save a large number of lives. We at Heart Care Foundation of India have in the past one-year tried to train as many people as we can in this lifesaving technique and are proud to have crossed the 1–lakh mark today".

"We have devised a simple and easy to remember formula of Hands Only CPR 10 to educate the public – To revive someone after a sudden cardiac death, within 10 minutes of the cardiac arrest (earlier the better) for ‘at least’ 10 minutes (longer the better) compress the center of the chest of the victim, continuously and effectively, with a speed of at least 10 × 10 (i.e.100) per minute" He added.

Hands only CPR 10 is an extremely easy to learn technique which can help save the life of 2–3 in 5 people who suffer from sudden cardiac arrest. Over the past one year Heart Care Foundation of India has seen over 16 success stories of lives saved due to their efforts. What people are not aware of is that it takes only 5 minutes to learn the technique of Hands Only CPR, it can be performed anywhere by anyone and that through this method, a person can be revived till after 10 minutes of their death.

To know more about the NGO or to enroll in for a CPR training camp please visit: www.heartcarefoundation.org or call its helpline number 99587711777

– ENDS –

About Heart Care Foundation of India

Initiated in 1986, the Heart Care Foundation of India is a leading National NGO working in the field of creating mass health awareness among people from all walks of life and providing solutions for India’s everyday healthcare needs. The NGO uses consumer based entertainment modules to impart health education and increase awareness amongst people. A leading example of this is the Perfect Health Mela, an annual event started in 1993 that is attended by over 2–3 lakh people each year. The Mela showcases activities across categories such as health education seminars and check ups, entertainment programs, lifestyle exhibitions, lectures, workshops and competitions. In addition to this, the NGO conducts programs and camps to train people on the technique of hands only CPR through its CPR 10 mantra for revival after a sudden cardiac arrest. They currently hold three Limca book of world records for the maximum number of people trained in hands only CPR in one go. Keeping article 21 of the Indian constitution in mind, which guarantees a person Right to Life, Heart Care Foundation of India has also recently initiated a project called the Sameer Malik Heart Care Foundation Fund to ensure that no one dies of a heart disease just because they cannot afford treatment.

emedipicstoday emedipics

Health Check Up and CPR 10 Camp at A.S.V.J Sr Sec School, New Delhi on 24th September 2014

mela_brochure
Self-Assessment-Quiz

 

expert_choice
Zee News – Health Wealth Shows

Alcohol

press release

Do not give citalopram more than 40mg

video of day video of day

Video Library

MTNL Perfect Health Mela

Heart Care Foundation of India, a leading national non–profit organization committed to making India a healthier and disease-free nation announced the upcoming activities of the 21st MTNL Perfect Health Mela scheduled to be held from 15th – 19th October 2014 at the Talkatora Indoor Stadium in New Delhi.

Sameer Malik Heart Care Foundation Fund

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG https://www.youtube.com/
watch?v=Mc3kKDXKWvs

Kishan, SM Heart Care Foundation Fund, Post CHD Repair https://www.youtube.com/
watch?v=OTEG7toVkAQ

Deepak, SM Heart Care Foundation Fund, CHD TOF https://www.youtube.com/
watch?v=rjOel0aaqt0

 

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)


 

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 :

 

Dr Good and Dr Bad

Situation: An elderly patient after IV ondansetron 16 mg dose developed irregular heart rhythm
Dr Good: Its due to the drug
Dr Bad: It can not be due to the drug
Lesson: ECG interval changes, including prolongation of the QTc interval, are a class effect of the first-generation serotonin antagonists, including ondansetron; potentially fatal cardiac arrhythmias may result. QTc prolongation occurs in a dose-dependent manner, and is expected to be greater with faster rate of infusion and larger doses for IV administration.

The current recommendation is to limit single IV doses to no more than 16 mg.

Canadian guidelines place additional dosing restrictions on IV ondansetron to mitigate the risk of QT prolongation, particularly in older adults, in whom the initial dose should not exceed 8 mg (healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2014/39943a-eng.php (Accessed on June 16, 2014). {Is available as emeset)

 

Make Sure

Situation: A patient after sublingual nitrate developed fainting attack.
Reaction: Oh my God! Why was the systolic murmur missed on auscultation?
Lesson: Make sure that patient with left ventricular outflow tract (LVOT) obstruction are not given sublingual nitrates.

eMedinewS Humor

A guy is walking up to a doctor’s office when a nun comes running out screaming and crying.

The guy walks in and says, "Doc, what’s with the nun?"

The doctor says, "Oh, I just told her she’s pregnant."

The guy says, "The nun’s pregnant?"

The doctor says, "No. But it certainly cured her hiccups!"

Twitter of the Day

Dr KK Aggarwal: Relieve Stress by Changing the Interpretation http://bit.ly/15ArAmM #Health
Dr Deepak Chopra: "The Three Biggest Career Mistakes — And How to Avoid Them" by #CosmicConsciousness

eMedi Quiz

A lesion of ventrolateral part of spinal cord will lead to loss (below the level of lesion) of:

1.Pain sensation on the ipsilateral side.
2.Proprioception on the contralateral side.
3.Pain sensation on the contralateral side.
4.Propriception on the ispilateral side.

Yesterday’s Mind Teaser: A 30 year old man came to the outpatient department because he had suddenly developed double vision. On examination it was found that his right eye, when at rest, was turned medially. The most likely anatomical structures involved are:

1.Medial rectus and superior division of oculmotor nerve.
2.Inferior oblique and inferior division of oculomotor nerve.
3.Lateral rectuas and abducent nerve.
4.Superior rectus and trochlear nerve.

Answer for yesterday’s Mind Teaser: 3.Lateral rectuas and abducent nerve.

Correct answers received from: Tripti Parmar, Dr Pankaj Agarwal, Dr.K.V.Sarma, Dr Jainendra Upadhyay, Najib Khatee, Dr Poonam Chablani.

Answer for 28th Sept Mind Teaser: 3. Presence of food enhances the absorption of hydrochlorothiazide.

Correct answers received from: Dr. Jainendra Upadhyay, Dr Pankaj Agarwal, Dr Avtar Krishan, Dr.K.V.Sarma, Dr Poonam Chablani, Dr.Bitaan Sen & Dr.Jayashree Sen.

Send your answer to ijcp12@gmail.com

medicolegal update

(Dr. K K Aggarwal, Padma Shri and Dr. B C Roy National Awardee; Editor eMedinewS and President Heart Care Foundation of India)

Dr P Kamalasanan, a private medical practitioner from Kollam in Kerala was punished last month for dispensing drugs without a license. Additional Sessions Judge, Kollam on August 7 sentenced Dr Kamalasanan of one-day “imprisonment” and also fined him Rs 1.20 lakh on the charges of running a pharmacy without a license from his clinic. Appearing before the court, Dr Kamalasanan reportedly served the sentence by remaining there till the rising of the court.

View1: Under the rules, only a single-doctor clinic is exempted from the process of obtaining a license before dispensing drugs and any clinic run with the help of more than one doctor falls under the category of hospital, for which it is mandatory to obtain a license to dispense medicines.

View 2: The Drugs & Cosmetics Act, 1940 & Rules, is very clear that private clinics, the place where professional activities of registered medical practitioners take place, are exempted from the drug licence. Private clinics are fully protected from harassment of drug controllers.

Clause–5 of Schedule-K of the Drugs and Cosmetics Rules allows a single doctor to stock, prescribe or dispense medicines without having a license, it does mandate a clinic run by more than one doctor to obtain a license.

A doctor cannot dispense medicines on the prescription given by another doctor, neither can a visiting doctor dispense medicines from that clinic.

Item 5. Drugs supplied by a registered medical practitioner to his own patient or any drug specified in Schedule C supplied by a registered medical practitioner at the request of another such practitioner if it is specially prepared with reference to the condition and for the use of an individual patient provided the registered medical practitioner is not (a) keeping an open shop or (b) selling across the counter or (c) engaged in the importation, manufacture, distribution or sale of drugs in India to a degree which render him liable to the provisions of Chapter IV of the Act and the rules there under.” (Excerpts from a news in IMT)

medicolegal update
  1. Dear Sir, Thanks for the information. Regards: Dr Sneha
 
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