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Dr KK Aggarwal

From the Desk of Editor in Chief
Padma Shri and Dr B C Roy National Awardee

Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; 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); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

  Editorial ...

1st November 2010, Monday

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

Prefer Meditation and Not Medication

Meditation and not medication should be the first-line of treatment for most lifestyle disorders.

The very fact that our body has a receptor for each and every drug means it has the capacity to produce that drug. God never made these receptors for pharmacological agents or drugs. The key lies in achieving the undisturbed state of consciousness, which can be obtained by either controlling the disturbed state of mind or bypassing it by using mantras. With meditation, diseases such as diabetes, high blood pressure, heart disease, paralysis, asthma and acid-peptic disease can be kept under control without or with minimal medicines.

Meditation is not concentration. Concentration is holding the mind to something within or outside the body. On the other hand, meditation is an unbroken flow of thoughts towards the object of concentration. It can be called prolonged concentration. Meditation is like pouring of oil from one vessel to another in a steady unbroken stream.

Samadhi or absorption is when the object of concentration and the mind of the perceiver becomes one. When concentration, meditation and Samadhi are brought to bear upon one subject it is called samyam. According to Yoga Sutras of Patanjali, (3.1–3.6), meditation needs to be learned and applied step by step. The practice starts by sitting straight with the spine erect, preferably in padmasana (one can also sit on a chair), and concentrate on the breathing or on a primordial sound given by the teacher.  

  • When the mind can be made to flow uninterruptedly towards the same object for 12 seconds, one is said to have learned the process of concentration.
  • When the mind can concentrate 12 times (12 seconds × 12 i.e., 2 minutes 24 seconds) it is meditation.
  • When the mind can concentrate 12 times (12 minutes 24 seconds × 12 i.e. 28 minutes 48 seconds), it is Samadhi.
  • And if this lower Samadhi can be maintained 12 times, i.e., for 5 hours 45 minutes and 36 seconds, it is called nirvikalpa Samadhi.

The mind becomes one–pointed when similar thought waves arise in succession without any gap between them. One should remember that during meditation, the object of concentration may change in form, time and rhythm. The whole process of meditation, therefore, varies from person-to person and from day–to–day. During meditation some just concentrate, some may actually meditate and some may go into Samadhi. Most of us wander between concentration and meditation.  

Dr KK Aggarwal
Editor in Chief
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  Photo Feature (from the HCFI Photo Gallery)

 17th MTNL Perfect Health Mela 2010 
Valedictory Function

The popular 17th MTNL Perfect Health Mela ended at NDMC Grounds Laxmi Bai Nagar. Acharya Dr Sadhna Ji Maharaj blessed the occasion by her presence and said that spiritual health is an essential component of any health. Sardar Buta Singh ji (Former Home Minister) also graced the Valedictory Function of the Mela. In the photo: Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President HCFI, Noted Kathak dance exponents, Ms Nalini and Ms Kamalini and other dignitaries.

Dr K K Aggarwal
  IMSA Update

International Medical Science Academy (IMSA) Update

BP control in type 2 diabetes

The randomized ACCORD BP trial compared systolic blood pressure targets of <120 or <140 in patients with type 2 diabetes at high risk for cardiovascular events. There was no significant difference in the primary composite cardiovascular endpoint, but there were more adverse events with the lower BP goal.

(Ref: Cushman WC, et al. Effects of intensive blood–pressure control in type 2 diabetes mellitus. N Engl J Med. 2010 Apr 29;362(17):1575–85)

  National News

Certificate courses in 2D and 3D Echocardiography/ Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

Specialised units across country to treat stroke patients

Soon, stroke patients will have specialised units across the country with technical expertise and required equipment to treat them. Dr Shirish Hastak, president of Indian Stroke Association (ISA) and consultant at Kokilaben Ambani Hospital, announced an initiative to accredit the hospitals on the basis of infrastructure and expertise to treat stroke patients. "We plan to establish five comprehensive units which will require to have top facilities. These include a 24/7 MRI, CT scan and blood bank facilities, and expertise for thrombolysis– a procedure of busting a clot in the brain by injecting a drug," said Dr Hastak. Two hundred other hospitals in various districts of the country will be accredited by ISA as primary stroke treatment centres. "Here we will insist on a CT scan and a trained neurologist," said Dr Hastak. (Source: Indian Express)

  International News

(Rajat Bhatnagar, International Sports & Fitness Distribution, LLC)

FDA shoots down another weight loss drug

The FDA has told the makers of the proposed weight–loss drug Lorcaserin that it will not at this time approve the marketing of the medication, citing concerns about its marginal effectiveness and about cancers that occurred at higher–than–usual rates during clinical trials. The FDA’s decision comes just two weeks after the makers of the prescription diet–pill Meridia pulled it from the U.S. and Canadian markets at the request of the FDA. It is the first signal of how the U.S. drug agency will deliberate on a trio of new weight–loss drugs proposed for the U.S. market, where about one in three adults are obese.

(Dr Monica and Brahm Vasudev)

Severe sepsis associated with later cognitive, physical decline

Older adults who survive hospitalization involving severe sepsis, are at higher risk for cognitive impairment and physical limitations than older adults hospitalized for other reasons. The research conducted by the University of Michigan and supported primarily by the National Institute on Aging (NIA), part of the NIH, appears in the Oct. 27, 2010, issue of the Journal of the American Medical Association.

Is it better to stop smoking abruptly or gradually?

The traditional view has been that establishing a "quit day" to stop smoking helps increase the chance that people will actually be able to kick the habit. But a review by the international Cochrane
Collaboration involving 10 randomized controlled studies and 3,760 participants concluded that a more gradual approach is just as effective and may be more appealing to smokers who want to quit.

Study links BMI to outcomes of IVF

Results from a retrospective cohort study show that women with BMI either higher or lower than the normal range fare poorly as regards outcomes of in vitro fertilization (IVF). Compared with normal–weight women, the odds ratios for IVF cycle cancellation overall and cancellation because of lower response to medication increased with increasing BMI, from 1.05 and 1.11 for overweight women to 1.92 and 2.18 for women with BMIs of 50 and higher. Similarly, underweight women had higher odds of cycle cancellation overall (OR 1.05) but lower odds of cancellation because of low response (OR 0.96). The results were presented at the American Society for Reproductive Medicine.

Use of electronic health records improves financial performance

Medical practices that have adopted an electronic health record (EHR) system report better financial performance as compared to practices that have not done the same, according to a new report by the Medical Group Management Association (MGMA). Results were presented at the MGMA 2010 Annual Conference.

Maternal herpes antiviral treatment does not prevent neonatal transmission

Swetha Pinninti, MD, fellow in pediatric infectious diseases at the University of Alabama at Birmingham notes in a retrospective multicenter chart review that maternal antiviral suppressive therapy during pregnancy does not prevent herpes disease in the newborn. Antiviral drugs acyclovir and valacyclovir taken during the last few weeks of pregnancy appear to reduce active lesions and the need for cesarean delivery, but even subclinical or asymptomatic infections are associated with cervical shedding of virus. Her study involved 7 cases of infants infected with herpes whose mothers received antiviral drugs in the final few weeks of their pregnancies. The findings were presented at the 48th Annual Meeting of the Infectious Diseases Society of America (IDSA).

  Gastro Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity

What lab tests help in the diagnosis of IBD?

  • Complete blood count (FBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and liver function tests (LFTs) (especially albumin). Reduced levels of hemoglobin, raised inflammatory markers (CRP, ESR, and platelets), and reduced serum albumin are suggestive of IBD.
  • Stool cultures should be carried out to exclude infectious diarrhea and stool tested for Clostridium difficile toxins A and B prior to invasive tests. Identification of the pathogen, however, does not necessarily exclude a diagnosis of IBD because a first episode of IBD may present after documented enteric infection.
  • In children from populations at risk for tuberculosis (TB), this should be excluded.
  • The noninvasive stool tests of fecal calprotectin and lactoferrin may become increasingly important both for screening and monitoring disease activity to avoid more invasive investigations.
  • Abdominal radiography is essential for assessment of patients with suspected severe colitis to exclude colonic dilatation and silent perforation.
  Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

How long should a woman continue to try fertility treatments before choosing another option?

This is a personal decision based on each couple’s needs and resources. Drs. Yakov Epstein and Helane Rosenberg offer some excellent advice on making this decision in their book, "Getting Pregnant When You Thought You Couldn’t." They introduce an exercise called "moving the line." At each phase of treatment, you draw a hypothetical line about how far you’ll go, and then focus on treatment to that point. But you give yourself permission to move the line should it be appropriate. This enables couples to focus on where they are right now without worrying about next steps that may never need to be taken.

  Books to read

Dr Jitendra Ingole, MD Internal Medicine, Asst Professor (Medicine), SKN Medical College, Pune

How Doctors Think (By Gerome Groopman)

Written by Harvard Hematologist, Gerome Groopman, "How Doctors Think" is an engaging book that is a must–read for every physician who cares for the patient and for every patient who wishes to get best medical care. In this book, he explains how doctors think to arrive at diagnosis; how the daily altercations affect this ability to make correct diagnosis. He further writes that majority of medical mistakes are due to predictable mental traps or cognitive errors. Only 20% errors are due to technical fault. Doctors can use the information in the book for better care of their patients.  

  Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

What is first aid for poisoning?

Immediate first aid may stop serious poisoning and may save life. If breathing and the heart stop, the person will die within a few minutes unless first aid is given immediately. Act as quickly as you can, but stay calm.

  • Check if the patient is conscious: Try to make the patient wake up. Shout "Are you all right?" and gently shake the shoulders, but take care not to make any injuries worse. Pinch the skin on the neck and watch the face. A patient who is just sleeping will wake up, but an unconscious patient will not.
  • Open the airway: If the airway is blocked the patient cannot breathe and air cannot get into or out of the lungs. A patient who cannot breathe will die within four minutes. In an unconscious patient the tongue may block the throat and the airway. Make sure the airway is open and air can get down the throat. Place the patient on his or her back. Tilt the head back and lift the chin up with the finger and thumb of one hand on the bony part of the chin, while pressing the forehead back with the other hand. This will open the airway and stop the tongue blocking the throat.
  • Check whether the patient is breathing after opening the airway: Quickly check whether the patient is breathing. Look for the belly or the chest moving up and down. Feel the chest moving up and down. Feel the patient’s breathe on your cheek. Listen for breath sounds. Put your ear close to the patient’s mouth. Use all four checks. Remember that the chest may move up and down even when the throat is completely blocked and air cannot get to the lungs.
  Medi Finance Update

Industry specific funds provide an opportunity to capitalize on the strength of a particular sector of the economy. Investing a significant portion of your portfolio in one industry can be risky, especially if that industry falls on hard times. However, the upside can be equally as good if the industry performs well. (We have seen this in the technology sector.)

  Drug Update

List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

Drugs prohibited from the date of notification

Fixed dose combination containing more than one antihistamine

  Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Dengue fever antibodies (IgG, IgM) assay

To detect both IgG and IgM class antibodies against Dengue fever virus types. Except for very early IgM responses, the immune response to Dengue fever is not type specific.

emedinews 3D echocardography
  IJCP Special

Dr Good Dr Bad

Situation: A diabetic patient was diagnosed with sarcopenia.
Dr. Bad: It is related to diabetes.
Dr. Good: It is not related to diabetes
Lesson: In the Korean Sarcopenic Obesity Study (KSOS), type 2 diabetes was associated with increased risk of sarcopenia. These characteristics may contribute to physical disability and metabolic disorders in older adults with diabetes.

Make Sure

Situation: A patient who had multiple blunt trauma on his abdomen is admitted for management.
Reaction: Oh my God! Why did you not do a peritoneal lavage?
Lesson: Make sure to perform a peritoneal lavage in patients of multiple blunt trauma to exclude peritoneal haemorrhage from ruptured abdominal organs as the peritoneal reaction is often mild and a thorough clinical examination is not possible.

Quote of the Day (Dr GM Singh)
"Everything comes to us that belongs to us if we create the capacity to receive it." Rabindranath Tagore

Mind Teaser

Read this…………………


Answer for yesterday’s Mind Teaser: "Splitting headache"

Correct answers received from: Dr Sukanta Sen, Dr Neelam Nath, Dr Kalpana Mohan, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Col (Dr) Narendra Kotwal, Dr Sudha Nayyar, Dr. Vishal Bansal

Answer for 30th October Mind Teaser: "A little misunderstanding between two friends."
Correct answers received from:  Dr Meera Rekhari, Dr Avdhesh Shukla, Dr Joshi Sachin, Dr. Satish Gunawant, Dr Vijay Kansal, Dr. Anjani Kumar, Dr. Anjani Kumar, Dr. Hiren Shah, Dr. Puneet Kathuria, Dr. Anjani Kumar, Dr Vijay Kansal

Send your answer to ijcp12@gmail.com

  Humor Section

Joke (Dr G M Singh)

The new young doctor’s first patient was a tailor who had pneumonia. The man was very sick–he wouldn’t live through the weekend. But on Monday the doctor passed the tailor’s shop and found the little man whistling happily as he worked. "This is incredible!" the medic cried. "You’re healthy." "Well," explained the tailor, "when you told me I was going to die I figured I might as well enjoy myself. So I had thirty–two potato pancakes, and now I feel fine." The doctor recorded this amazing phenomenon in his casebook.

His next patient was a shoemaker, also suffering from pneumonia. Without hesitation, the doctor prescribed thirty—two potato pancakes for him. The next day the doctor called on the patient only to find he had died the night before. "In cases of pneumonia," the doctor wrote in his case book," "Potato pancakes are good for tailors, but not for shoemakers."

An Inspirational Story

(Contributed by Anuj Goyal)

A Jury to be proud of

In a criminal justice system based on 12 individuals not smart enough to get out of jury duty, here is a jury to be proud of:

A defendant was on trial for murder. There was strong evidence indicating guilt, but there was no corpse. In the defense’s closing statement, the lawyer, knowing that his client would probably be convicted, resorted to a trick. "Ladies and gentlemen of the jury, I have a surprise for you all," the lawyer said as he looked at his watch. "Within one minute, the person presumed dead in this case will walk into this courtroom." He looked toward the courtroom door. The jurors, somewhat stunned, all looked on eagerly. A minute passed. Nothing happened.

Finally the lawyer said, "Actually, I made up the previous statement. But you all looked on with anticipation. I, therefore, put it to you that you have a reasonable doubt in this case as to whether anyone was killed, and I insist that you return a verdict of not guilty." the jury retired to deliberate. A few minutes later, the jury returned and pronounced a verdict of guilty. "But how?" inquired the lawyer. "You must have had some doubt; I saw all of you stare at the door."

The jury foreman replied: "Yes, we did look, but your client didn't.

  Readers Responses
  1. The current new practice of Tetanus Vaccination in the developed world has further evolved while we are talking of 10 years interval.
    People who had 5 vaccination shots for tetanus (i.e. 3 jabs with DPT in year one, 4th one at age 4 and 5th one at age 13-18 yrs) are considered not needing any further tetanus boosters for non-tetanus prone wounds. However, I have personally noted 2 tetanus shots being given within 3 hrs gap over 2 medical setups for a clean non tetanus prone wounds in Delhi - NCR area, not long back. Not only the community, even doctors need education regarding current status of tetanus vaccination as it is doctors who teach the community ultimately. Regards: Dr Vivek Chhabra, Specialty Emergency Physician, James Paget University Hospital, Gr Yarmouth, Norfolk, UK.
  Public Forum

(Press Release for use by the newspapers)

17th MTNL Perfect Health Mela ends

The popular 17th MTNL Perfect Health Mela ended at NDMC Grounds Laxmibai Nagar, Delhi yesterday Addressing the Valedictory Function, Dr. Yoganand Shastri, Hon’bl Speaker, Delhi Vidhan Sabha said that the time has come to spread the message of Common Health after Commonwealth Games. He further said that more and more such health awareness programmes should be organized in slum and JJ clusters.

Special guest of the day Sh A P Sethi Member of Parliament and Central Election oath AICC said that the aim of life should be to cross 100 years of age without any disease.

In his message Sh Rakesh Mehta, Chief Secretary Delhi said that all citizens should help make Delhi the healthiest city in the country.

Presiding over the function, Shri Parimal Rai, Chairman, NDMC said every citizen in the city should help the government in keeping Delhi safe, green, hygienic and free from mosquitoes.

Giving the details, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that over 40000 people got their checkups done at the Mela venue. The tests done at the Mela findings showed that high cholesterol, high blood pressure and diabetes are quite rampant in the society. Over 60% of the people visiting the Mela were unaware about their disease/s, and even if they were aware, their disease was inadequately controlled. More than 70% of the people felt that blood pressure, diabetes and high cholesterol do not require a lifelong treatment.

Acharya Dr Sadhna Ji Maharaj blessed the occasion by her presence and said that spiritual health is an essential component of any health.

Mr. Vijender Singh, President BJP Delhi and Mr. Yogender Chandelia, Chairman, Standing Committee, MCD in a joint statement said that in in the forthcoming Diwali Melas, every organizer should put up a health stall so that the public can get awareness about the health.

Mr. K. Kumar,
Chairman, Shakti Bhog said that plant oils do not cholesterol and should be preferred over vanaspati and Desi Ghee.

Noted Kathak dance exponents, Ms Nalini and Ms Kamalini, Dr D K Pandey from DST, Dr N K Yadav MHO MCD, Dr P K Sharma,  MOH NDMC and Sr. officers from  LIC and OBC, Mr Deepak Jolly, VP Coke also graced the Valedictory Function of the Mela.

The grand valedictory function had performances from various segments which included Yoga, Aerobics, Science behind miracles and Diwali myths. Demonstrations were also given to people about testing for adulteration in sweets during Diwali festival.

This year also more than 25000 people from all age groups availed the free health checkup services by allopathic, homeopathic, Ayurveda and Unani doctors during the Mela days. The free health checkup counseling and other diagnostic facilities were availed by:

Allopathy (4000    patients)

Homeopathy ( 2352  patients)

Ayurveda (2000 patients)

Unani (700 patients)

Blood pressure Checkups (5000 patients)

ECG (4942 patients)

Blood Tests (Executive health Packages 985 patients)

Eye Checkup (100 patients)

ENT (1100 patients) etc.

Dental (3000 patients)

Leprosy (42 patients)

Yoga (1200 patients)

Campaigns: Dengue, Malaria & Chikungunya Prevention Campaign: NDMC (The local civic agencies), MCD and National Vector Borne Prevention Control Dept. demonstrated live mosquitoes species responsible for the spread of these diseases. In addition, IEC material on the Dos & Don’ts for the prevention & control of these diseases was distributed free by these organizations.

Jaago Grahak Jaago: Consumer Awareness Campaign: Department of Consumer Affairs Govt. of Delhi created awareness about consumer items under their jaago grahak jaago campaign. The ministry participated through its nodal agencies viz National Test House, National Consumer Helpline, Bureau of Indian Standards etc.

Forthcoming Events

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eMedinews Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 2, 2011. The event will have a day–long CME, Doctor of the Year awards, Cultural Hungama and Live Webcast. Suggestions are invited.

Dr. Sood Nasal Research Foundation Announces

Rhinology Update 11th to 15th November
22nd National Endoscopic Sinus Surgery Course on 11th & 12th November, 2010 2010 at Dr. Shroff’s Eye & ENT Hospital, New Delhi
Cadaveric Sessions on 13th November, 2010 at Lady Hardinge Medical College.
33rd All India Rhinoplasty Course, on 14th & 15th November, 2010, at Metro Hospital, Preet Vihar, Vikas Marg, New Delhi.

For information contact: Dr. V P Sood, Course Chairman, Ear, Nose & Throat Center, 212, Aditya Arcade, 30, Community Center, Preet Vihar, Vikas Marg, Delhi–110092 (India). Tel: 011–22440011, 42420429. E–mail:drvpsood@gmail.com,vpsood@drsoodnasalfoundation.com
Website: www.drsoodnasalfoundation.com

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