eMedinewS27th September 2013, Friday

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; Chairman Ethical Committee Delhi Medical Council, 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

Hand, foot and mouth disease

We have been seeing a rise in the number of cases of hand, foot and mouth disease in Delhi among school children. These may be mistaken for chicken pox.

Hand, foot and mouth disease: Salient facts

  • Hand, foot and mouth disease is a viral illness most commonly caused by the Coxsackie virus A6.
  • Enteroviruses 71 (EV71) can also cause hand, foot and mouth disease.
  • Both adults and children can develop this infection. But young children below 5 years old are more susceptible.
  • It is a moderately contagious illness.
  • The incubation period is 5 days.
  • The illness begins with fever, which lasts for 24–48 hours.
  • Fever is followed by appearance of painful sores in mouth. They begin as small red spots that blister and then often become ulcers. Tongue is involved.
  • There are peripherally distributed small tender non itchy rash with blisters on palms of the hands, and soles of feet and buttocks.
  • The sores hurt on touch and swallowing is difficult.
  • There is proximal separation of nail from the nail bed.
  • The virus is present in mucus from nose, saliva, fluid from sores and traces of bowel movements.
  • The virus spreads in the first week of infection.
  • The infection spreads from person to person by direct contact with nasal discharge, saliva or blister fluid or from stool of infected persons.
  • The virus can persist in the stool for weeks.
  • The illness is not transmitted to or from pets or other animals
  • The illness stays for 2–3 days. It is usually mild and self limited.
  • Entero 71 virus is associated with brain involvement (meningitis and encephalitis), lungs and the heart.
  • The patient remains infectious after the symptoms have gone.
  • Test is not necessary.
  • There is no specific treatment.
  • Paracetamol tablet can be taken to relieve pain and fever.
  • Aspirin is to be avoided in children.
  • Dehydration should be avoided.
  • Eat ice cream to numb the pain.
  • Using mouthwashes or sprays that numb mouth
  • Regularly wash your hands with soap and water.
  • Avoid exposure to infected person.
  • Maintain touch hygiene to reduce your risk of acquiring the infection.
  • During first week of illness, the child should be kept in isolation.
  • Schools should be closed.
  • There is no vaccine currently available

….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 10×10 i.e. 100 per minute."

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

Ringtone – CPR 10 Mantra English

Spiritual prescriptions – Formulas to Improve the Soul Profile

sprritual blog

Sattchittaananda: The soul characteristics, (Absolute Existence – Absolute Knowledge) Satt means ‘truth or knowingness’
Chitta means ‘conscious based’
Ananda means ‘bliss or inner happiness’

The soul in Vedic description is described as Sattchittaananda. People in touch with their soul speak the truth, take consciousness–based decisions and experience inner happiness.

The great rishis of India have described a formula of how to be in touch with your soul and get inner happiness. The formula is based on three questions to be asked to yourself before performing any action

1. Is it the truth?
2. Is it consciousness based?
3. Will it give happiness?

If the answer to all three is ‘yes’, go ahead. In other words, if the answer to any of the three is "no", do not perform that action.

Later on, many dharma groups modified this formula for their own use

1. Buddha’s Law of Action summarizes these questions as:

• Is it the truth?
• Is it necessary?
• Will it bring happiness to me?
• Will it bring happiness to others?

If the answer to any of the questions is, no, then do not do that action.

2. Buddha’s Law of Speech summarizes the questions as:

• Is it the truth?
• Is it necessary?
• Is it kind?

If the answer to any of the question is ‘no’, then do not speak.

3. The Rotary four–way test comprises of:

• Is it the truth?
• Is it fair to all concerned?
• Will it build goodwill and better friendship?
• Will it be beneficial to all concerned?

If the answer to any of the answer is ‘no’, then do not perform that deed.

4. Formula of three H: Head, Heart and Hand: Before doing any action ask your head for the choices. Then listen to the heart to give you the best consciousness–based advice and finally order the hand to do the action.

5. The formula Satyam Shivam Sundaram is based again on three questions: Is it the truth; is it God (consciousness-based); and is it going to build my inner beauty (happiness).

6. ‘May I help you?’ is another formula given in Srimad Bhagwat where once you agree to help, you end up with truth, tapa of hard work, purity of mind and daan or charity. ….Read More

cardiology news

Everyone is Important

During Mark’s first month of college, the professor gave his students a pop quiz. He was a conscientious student and had breezed through the questions, until he read the last one: "What is the first name of the woman who cleans the school?" Surely this was some kind of joke. He had seen the cleaning woman several times. She was tall, dark–haired and in her 50s, but how would he know her name? He handed in his paper, leaving the last question blank.

Just before class ended, one student asked if the last question would count toward the quiz grade. "Absolutely," said the professor. "In your careers, you will meet many people. All are significant. They each deserve your attention and care, even if all you do is smile and say ‘hello’". Mark never forgot that lesson. He also learned her name was Dorothy.

News Around The Globe

5th Dil Ka Darbar

Date: Sunday, 29th September 2013, Venue: Constitution club of India, Rafi Marg, Time: 8 AM to 6 PM

Programme: A non stop question answer–session between all top cardiologists of the NCR region and the public.

The focus of the discussions will be prevention of heart diseases in women and young men. Special discussion will be held on Sex and Heart Diseases. Practical training will also be given to people on Hands–only Cardiopulmonary Resuscitation. Another focus of the discussion will be the launch of the Project Dhadkan (Palpitations) and Project Murmur (Congenital and valvular heart diseases in children).

Entry free…

20th MTNL Perfect Health Mela Programme Brouchure


  • Dear Dr KK Aggarwal, i am writing the sequence of events of army college of medical sciences acms is situated on a 30 yrs leased land of defence ministry, attached with base hospital, governed by army wives welfare society, an NGO as per university (IP) act & constitution article 15, reservation policy is clear, not more than 50% seats can be reserved for any group. Now since it also comes under Delhi professional institutions act 2007; which said before 13 September 2013 amendment that 10% seats can be reserved for management quota & rest of seats to filled by open merit. The college bypassed this rule & admitted 100% army wards in yr 2009 &2010. Supreme court stopped these arbitrary admissions in 2010. college didn’t admit any student in yr 2011 & 2012 in 2013 the acms advertised on 13 September for MBBS admissions with total reservations of 100% for army wards with few unspecified seats for SC/ST. we approached high court on 22 September, hearing was on 23 September, then on 25 September i.e. today acms came out with Delhi Govt amendment in professional college act 2007, article 12a.of 13 September & 23 sept. LG order by passing 12 b of said act and allowing acms 100% reservation for army wards & some for SC/ST. The case is for chief justice bench tomorrow. Now this is arbitrary, illegal, malafide to change rules in this brazen manner. also it is contempt of supreme court order 2010/2011& against IP University act to have 100% reservation for army wards only with some unspecified reservation for SC/ST.WE ALL NEED TO STOP THIS INJUSTICE TO MERITORIOUS DELHI STUDENTS.WE OWE OUR CHILDREN THIS MUCH. Regards: Dr Anil Goyal
  • A highly sensitive clinical decision rule –– dubbed the Ottawa Subarachnoid Hemorrhage, Ottawa SAH, rule –– has been developed to help clinicians diagnose subarachnoid hemorrhage. The rule, which specifies that patients with any one of six clinical features should undergo diagnostic testing beginning with a CT scan of the head and, if necessary, a lumbar puncture, had a sensitivity of 100% (95% CI 97.2–100) and a specificity of 15.3% (95% CI 13.8–16.9), according to Jeffrey J. Perry, MD, of Ottawa Hospital in Ontario, and colleagues. The features included in the rule were age 40 or higher, thunderclap headache, pain or stiffness in the neck, limited neck flexion, a witnessed loss of consciousness, and onset during exertion, Perry and colleagues reported in the Sept. 25 issue of JAMA.
  • Low testosterone levels predicted a greater risk of acute myocardial infarction (MI) in Swedish men with type 2 diabetes, according to a study presented at the European Association for the Study of Diabetes meeting. After adjustment for potential confounders, higher total testosterone levels were associated with a 25% reduced risk of acute MI in that group (HR 0.75, P=0.006), according to Bledar Daka, MD, of the University of Gothenburg in Sweden. But no such relationship was seen in men without diabetes or in women regardless of diabetes status.
  • Researchers appear to be homing in on clinically useful blood–based biomarkers indicating risk of Alzheimer’s disease in mildly impaired or asymptomatic individuals. Serum or plasma levels of apolipoprotein E (apoE), complexes of albumin and beta–amyloid protein, and a mystery substance described only as "protein Z" showed significant correlations with Alzheimer’s disease pathology and/or progression of cognitive impairment to overt dementia in separate studies reported at the World Congress of Neurology. Another study presented here confirmed that levels of beta–amyloid and tau proteins in cerebrospinal fluid (CSF) can be used with high sensitivity and specificity to predict conversion of mild cognitive impairment to clinically definite Alzheimer's disease.
  • The combination of diet and exercise worked best for knee osteoarthritis than either alone for overweight and obese patients. Joint inflammation, pain, function, and quality of life all significantly favored the combined approach compared with exercise alone over 18 months, Stephen P. Messier, PhD, of Wake Forest University in Winston–Salem, N.C., and colleagues found. Comparing single strategies, diet came out better than exercise for reducing knee joint loading and cutting inflammation, the group reported in the Sept. 25 issue of JAMA.

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Rabies News (Dr. A K Gupta)

Can the wound be deepened for cleaning purpose?

We should never try to deepen the bite wound. Deepening of wound for cleaning depends on area of injury, extent of injury and the aim should be to preserve as much tissue as possible and to excise only the dead tissue.

cardiology news
  • A "smart" self–adjusting cardiac resynchronization therapy with defibrillator (CRT–D) device that automatically adjusts pacing to the patient’s needs cut incidence of atrial fibrillation in half in heart failure patients, a post hoc analysis found. Incidence of Afib (defined as greater than 48 consecutive hours in duration) was similar between those with the "adaptive" CRT–D technology and those with conventional CRT–D devices until around 13 months, when the lines diverged, revealing a significant 46% reduced incidence of Afib in the treatment arm versus controls out to 2 years (8.7% vs 16.2%, P=0.03), according to David O. Martin, MD, MPH, an electrophysiologist at the Cleveland Clinic, and colleagues. An analysis of subgroups in the Adaptive CRT trial such as age, sex, race, heart failure etiology, ejection fraction, and QRS duration found that in the intervention arm the incidence of atrial fibrillation remained lower than in controls. The findings were reported at the Heart Failure Society of America meeting.
  • High levels of serum probrain natriuretic peptide (proBNP) are associated with an increased risk of macrovascular events, independent of baseline coronary artery disease (CAD) status, in patients with and without type 2 diabetes, according to a study presented at the European Association for the Study of Diabetes (EASD) 2013 Meeting by Dr Alexander Vonbank (Private University of Liechtenstein, Triesen). Overall, Vonbank said that patients with type 2 diabetes and low levels of serum proBNP were at a moderate risk of future events, whereas those patients with type 2 diabetes and high levels of proBNP, defined as >314 pg/mL, were "at an extremely high risk for cardiovascular events." In both groups, those with diabetes and those without, proBNP was a strong predictor of cardiovascular events. "ProBNP in patients with diabetes, as well in those without diabetes, is useful for cardiovascular–risk stratification and provides prognostic information over and above the angiographically determined CAD status," said Vonbank.

Valvular Heart Disease News

Aortic vegetation is always located on the ventricular surfaces.

(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
  • The European Medicines Agency’s (EMA’s) Committee for Medicinal Products for Human Use (CHMP) has recommended granting marketing authorization for Fluenz Tetra (MedImmune LLC), a nasal quadrivalent live attenuated seasonal influenza vaccine (J07BB03), for influenza prevention in children and adolescents aged from 24 months to less than 18 years, according to an EMA statement published September 19.Fluenz Tetra contains influenza strains A/H3N2, A/H1N1, and B strains of the Victoria and Yamagata lineages. The influenza strains used in the vaccine will be consistent with the official recommendation from the World Health Organization each season.
  • Dextrose gel is a cheap, easy way to correct neonatal hypoglycemia, according to a report published online September 25 in the Lancet. Two small observational studies of babies between 28 and 42 weeks’ gestational age reported improvement after dextrose gel treatment, but a study of 75 babies found no effect on blood glucose level and that bottle–fed infants consumed less after administration of the gel. Current practice for neonatal hypoglycemia is extra feedings and frequent blood glucose checks, but some newborns require intravenous glucose administered in an intensive care setting, which interferes with parent–child bonding and the establishment of breast–feeding. Buccal administration of dextrose gel is one mechanism that people with diabetes use to rapidly counteract a blood glucose plunge.
cardiology news

Non cardiac chest pain may not be benign

Patients discharged with non cardiac chest pain may not always be at low risk as a new study shows a worrying one–year mortality rate of around 4% in this group, which is higher in patients with a previous psychiatric hospitalization. Around one–third of the deaths were cardiovascular, suggesting that a fairly substantial number of patients with heart disease are being missed when presenting to hospitals with chest pain. The study is published in European Heart Journal on December 1, 2011 by Dr Michelle Gillies from University of Glasgow, Scotland.

One should do a thorough review of the diagnostic parameters that lead to a diagnosis of non cardiac chest pain. In patients with negative high–sensitivity troponin and stress tests and in whom a specific non cardiac cause of the chest pain has not been identified, the use of N–terminal pro–brain natriuretic peptide (NT–pro BNP) or the measurement of unbound free fatty acids may be considered, which have shown high negative predictive abilities.

Given the known link between psychiatric and cardiovascular diseases, the best time for intensive cardiac evaluation would be at the initial psychiatric hospitalization or diagnosis of psychiatric illness, rather than at hospitalization for chest pain.

cardiology news

Total CPR since 1st November 2012 – 63400 trained

CPR Classes 63400

Media advocacy through Print Media

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29th August: Veer Arjun

Media advocacy through Web Media

When Constipation May be a Serious Problem 30th August


TB more dangerous than FLU 29th August


Obesity is a disease

Any weight gain after the age of 18 years in females and 20 years in males is obesity unless proved otherwise. Also any weight gain after the age of 35 years and after the age of 50 years is considered obesity.

"Obesity is a disease and should be tackled under the supervision of doctors", Padma Shri and Dr B C Roy National Awardee Dr. K K Aggarwal, President, Heart Care Foundation of India and MTNL Perfect Health Mela, Dr. Aggarwal said that obesity can be managed either by eating low refined carbohydrates, low fat and or low calories diet. Exercise alone without dietary modification usually fails.

The need for surgery in obesity arises only if the lifestyle and medical management fails.

Anti obesity drugs often need to be added to facilitate weight reduction in individuals with co–morbid conditions.

A 10% weight reduction can reduce the need of anti–BP medicines by 50% and anti diabetes drugs by upto 40%.

It is possible to get rid of such diseases in some cases merely by weight reduction. Weight reduction can also reduce the severity of snoring. Obese people have more blood pressure, snoring, osteoarthritis and cancer.

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 63400 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 10×10 i.e. 100 per minute."

today emedipics

Padma Shri and Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India addressing a press conference as a curtain raiser to the 5th Dil Ka Darbar to be held on Sunday, 29th September. The event is being organized by the Heart Care Foundation of India at Constitution Club of India.

press release

3 D echo and pocket echo machines.

today video of the dayDr KK Aggarwal Birthday 5th September

Cultural Evening at IMA

Dr KK Aggarwal on Doctors Day SAHARA SAMAY News

eMedi Quiz

Read this…………………

What percentage of your diet should fat make up?

A. About 10 percent of your daily calories.
B. About 20 percent of your daily calories.
C. About 30 percent of your daily calories.
D. About 40 percent of your daily calories.
E. There is no recommended amount of fat; you should strive to eat as little of it as possible.

Yesterday’s Mind Teaser: The pain management nurse assesses a 67–year–old patient for reports of episodic, sudden–onset, and right–sided facial pain. The patient describes the pain as fleeting, electric–like, and triggered by light touch and brushing of the teeth. The pain management nurse suspects:

a) Facet syndrome.
b) Myofascial pain syndrome.
c) Temporomandibular disorder.
d) Trigeminal neuralgia.

Answer for yesterday’s Mind Teaser: d) Trigeminal neuralgia.

Correct answers received from: Dr Ajay Gandhi, Dr. V.P. Thakral, Dr . Raghavendra Singh, Dr Rawat Purushottam Singh, DR. RAJESH B. ASTIK, Dr. P. C. Das, Dr. Sushma Chawla, Raju Kuppusamy, Dr Pankaj Agarwal, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Dr K V Rammohan Rao, DR Chandresh Jardosh, DR AYYAVOO ERODE, Daivadheenam.Jella, Dr B K Agarwal, Dr Kanta jain, DR AVTAR KRISHAN, Dr pooja khullar

Answer for 23rd September Mind Teaser: Develop psycho–physiologic self-regulation.

Correct answers received from: DR Chandresh Jardosh, DR AYYAVOO ERODE, Daivadheenam.Jella, Dr B K Agarwal, Dr Kanta jain, DR AVTAR KRISHAN, Dr Supriya C Chandra, Dr. Sushma Chawla, Dr shashi saini

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

A doctor worked at a mental hospital. He wanted to take some patients to a ballgame, worked months to get them to follow simple commands, and finally decided they were ready.

When the star spangled banner played he said: "Stand up nuts" and they stood. When it was over he said: "Sit down nuts" and they sat. When a player got a hit he said: "Cheer nuts" and they cheered. When the umpire made a bad call he said: "Boo nuts" and they booed. He decided it was safe to leave them with his assistant and left to get a hot dog. He came back to a near riot. He asked his assistant what in the world happened. He said: "Everything was fine 'til some vendor came be and yelled ‘peanuts’."

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: A patient with dengue died.
Reaction: Oh my God, why was he not given adequate fluids?
Lesson: Make Sure that all patients with dengue are given fluids to correct intravascular dehydration.

medicolegal update

A blind person asked Swami Vivekanand: "Can there be anything worse than losing eyesight?" He replied: "Yes, losing your vision!"

medicolegal update

Dr KK Aggarwal: Dr K K Aggarwal: Relaxation during work http://bit.ly/15Lvpwx #Health

Dr Deepak Chopra: Why compare yourself with others? No one in the entire world can do a better job of being you than you.

medicolegal update

Dear Sir, emedinews is very useful. Regards: Dr Tarun

Forthcoming Events

29thSeptember–Dil Ka Darbar at Constitution Club of India,New Delhi

20th Perfect Health Mela from 18th Oct to 22nd Oct at different locations

20th Perfect Health Mela from 23rd Oct to 27th Oct at Constitution Club of India

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medicolegal update

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