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  From the Desk of Editor–in–Chief
Dr KK 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; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy (March 10-13); National Vice President Elect Elect, Indian Medical Association; 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 & Hony. Visiting Professor (Clinical Research) DIPSAR

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10th May 2013, Friday

Alternative Therapies Lower BP

A group of experts has reviewed all the existing studies and concluded that indeed there are alternative treatments for lowering blood pressure – with aerobic exercise leading the pack as far as strong evidence goes.

Other alternative treatments – namely isometric handgrip and dynamic resistance exercises and guided breathing -- also got high grades when it came to reducing high blood pressure in some patients, according to a scientific statement from the American Heart Association published online in the journal Hypertension.

"The evidence is not as strong for transcendental meditation and acupuncture, but they may help as well," said co-senior author Sanjay Rajagopalan, MD, professor of cardiovascular medicine at Ohio State University School of Medicine in Columbus.

For the report, an expert panel headed by the University of Michigan's Robert D. Brook, MD, reviewed 1,000 studies published from 2006 to 2011. They divided the studies into three major classes of alternative treatments: behavioral therapies, noninvasive procedures and devices, and exercise. The panel did not review dietary and herbal treatments.

Based on the level of evidence, they gave each an "A," "B," or "C" recommendation -- with "A" being the highest -- for implementation into clinical practice.

The panel found:

  1. Exercise-based regimens did the best overall, with dynamic aerobic exercises getting an "A" class of recommendation, with a level of evidence of I, the highest possible.
  2. Dynamic resistance exercises got a "B" and isometric handgrip exercises got a "C" grade, with levels of evidence of IIA and IIB, respectively.
  3. Still, 4 weeks of isometric hand grip exercises resulted in some of the most impressive improvements in several studies -- a 10% drop in systolic and diastolic blood pressure. However, isometric exercise should be avoided among people with severely uncontrolled hypertension (180/110 mm Hg or higher).
  4. As for noninvasive procedures or devices, device-guided breathing got a "B" with a level of evidence of II. Device-guided slow breathing proved most effective in lowering blood pressure when performed for 15-minute sessions three to four times a week.
  5. Acupuncture also got a "B," but its level of evidence was III, meaning no benefit.
  6. Among behavioral techniques, transcendental meditation and biofeedback both received "B" grades, with IIBs for levels of evidence. Yoga got a C, with level of evidence of III, or no benefit, as did other meditation techniques.
  7. The alternative approaches that work reduce systolic blood pressure by only 2 to 10 mm Hg; whereas standard doses of a blood pressure-lowering drug reduce systolic blood pressure by about 10 to 15 mm Hg.
  8. Alternative approaches are best for patients with blood pressure levels over 120/80 mm Hg who can't tolerate or don't respond well to standard medications.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Weight loss may improve sexual health of obese diabetes

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

In cardiac arrest, CPR 10 should be started within 10 minutes

Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India trained 2236 students at a CPR 10 camp at Bahadur Garh

Dr K K Aggarwal
    National News

Facilities of organ transplant


(Private Sector 80%)

For comments and archives

Sikkim moves to 'catch' health problems

Preventive health checks! The exclusive preserve of the affluent in most parts of India but not in the hill state of Sikkim where the government-backed Comprehensive Annual and Total Check-up for Healthy (CATCH) programme aims to reach out to people even in the remotest areas.

The state's unique initiative, a slow yet sure way towards a healthier Sikkim, promises to "catch" any health problems even before they occur. The flagship programme is aimed at providing a universal and comprehensive check-up on an annual and periodical basis. A head-to-foot health check-up of all citizens is done and a database maintained, say officials. Once the check is done, a conscious attempt is made to provide comprehensive care based on the history of the patient.

Launched in August 2010, CATCH covered 50 percent of the state's estimated 607,000 population by the end of 2012. Scattered health security-based programmes are being converged at all levels and being executed by building partnerships in the health sector. At present, one state referral hospital, four district hospitals, 25 primary healthcare (PHC) centres, 147 sub centres (PHSCs) are functioning in the state. There is also a medical college, based on the private-public partnership module. All are working together to implement CATCH in various capacities. "Our aim is to provide community-based comprehensive annual health check-ups and care, free of charge. We will bring healthcare to the doorsteps of the people and make Sikkim the healthiest state in India," Chief Minister Pawan Chamling told The Journal.

The first step is to collect detailed medical history of a citizen and maintain it in a universal database. This database can be updated on each annual health check-up. This is followed by a thorough physical check-up during which a screening of major health problems is done. In case any disease is detected, the patient is sent for free consultation to the appropriate doctor. After that, a laboratory investigation is done. Counselling on a healthy lifestyle and preventing further problems follow.

The citizens are graded according to their health status and a real-time database can be obtained to find out the overall health status of Sikkim. This database also helps the state government allocate resources within the health sector as and when required. Efficient planning of the health sector is possible because of the maintenance of an annual patient health record. Based on available records, the major causes of deaths in Sikkim have been found to be heart and blood vessel diseases, alcohol-related complications, respiratory diseases, cancer and tuberculosis. Eighty-three percent of urban households and 94 percent of rural households depend on the public medical sector for healthcare. Sikkim ranks highest among all Indian states in the proportion of households that use the public medical sector as their main source of healthcare. (Source: TOI, May 7, 2013)

For comments and archives

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, Telecast every Wednesday 9 AM in DD National

DD Programme “Take Care Holistically”, Dr KK Aggarwal as an Anchor, every Thursday 4:30 PM in DD India

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    Be Human Stop Child Abuse (Team IMA for CMAAO)


A total of 63 infanticide case were reported in India in the year 2011

The incidence decreased in the year 2011 (63 cases) from 100 cases in the year 2010. A total of 132 cases of feticide were reported in the country in the year 2011 as compared total 111 cases in the year 2010. 0.222% children presenting in emergency care are victims of child abuse. In United States alone, upto 2500 children die of inflicted injuries annually with children under one year of age affected disproportionately. Higher rates of child abuse are reported from minority children.

For comments and archives

    Valvular Heart Disease Update

Bicuspid aortic valve can be associated with dilation of the ascending aorta and aortic aneurysm or aortic dissection.

(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)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

Half of back pain sufferers could be cured by antibiotics

Research conducted at the University of Southern Denmark has found that nearly half of sufferers of chronic lower back pain could be cured by antibiotics. The research found bacteria present in 46 per cent of cases of chronic lower back pain caused by a slipped disc. Of those, most were cured or greatly improved by a £114, three-month course of antibiotics. (By: Presswatch)

For comments and archives

Metabolic focus helps with critically ill

Metabolic profiling may improve care for patients with chronic critical illness, researchers suggested at the American Association of Clinical Endocrinologists meeting. (Source: Medpage Today)

For comments and archives

Hands-on exam finds more cases of thyroid Ca

Physical exam found a much a higher rate of thyroid cancer compared with incidental detection on imaging studies, researchers said at the annual meeting of the American Association of Clinical Endocrinologists. (Source: Medpage Today)

For comments and archives

More clinic time leads to better glycemic control

A protocol that provides extra office visits for type 2 diabetes patients starting on insulin appears to reduce glycated hemoglobin A1c (HbA1c) more effectively than standard treatment, researchers said here. (Source: Medpage Today)

For comments and archives

Diabetic teens show early eye changes

Retinopathy had already developed within 5 years of the onset of type 2 diabetes in a substantial number of teens with the disease, a researcher reported at the annual meeting of the Pediatric Endocrine Society. (Source: Medpage Today)

For comments and archives

   Twitter of the Day

@DrKKAggarwal: Deadly scrub typhus on the rise in Chennai, do not ignore fever with black patch on the skin Dr K K Aggarwal (cont) http://tl.gd/n_1rk55v8

@DeepakChopra: Is the mind what the brain does or is the brain what the mind does? Pls watch this video for my reply http://www.youtube.com/watch?v=wQr6oTYsq7w …

    Spiritual Update

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

How long can one fast?

As per allopathy, one cannot live without air or oxygen for more than 3 minutes, without water for more than three days and without food for more than 3 weeks.

For comments and archives

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What causes hyperprolactinemia?

Prolactin levels increase as a result of:

  • Certain medications, including commonly prescribed antidepressants, anti–psychotics and blood pressure medications
  • Herbs, including fenugreek, fennel seeds and red clover
  • Chest wall irritation (from surgical scars, shingles
  • Stress
  • Certain foods
  • Exercise
  • Sleep (prolactin levels are highest at night)
  • Nipple stimulation
  • Hypothyroidism, or underactive thyroid, pituitary tumors. These are usually very tiny, but account for about 30% of all cases of hyperprolactinemia
   An Inspirational Story

The Seed of Honesty

A successful business man was growing old and knew it was time to choose a successor to take over the business. Instead of choosing one of his Directors or his children, he decided to do something different. He called all the young executives in his company together.

He said, “It is time for me to step down and choose the next CEO. I have decided to choose one of you.”

The young executives were shocked, but the boss continued. “I am going to give each one of you a SEED today – one very special SEED. I want you to plant the seed, water it, and come back here one year from today with what you have grown from the seed I have given you. I will then judge the plants that you bring, and the one I choose will be the next CEO.”

One man, named Jim, was there that day and he, like the others, received a seed. He went home and excitedly, told his wife the story. She helped him get a pot, soil and compost and he planted the seed. Every day, he would water it and watch to see if it had grown. After about three weeks, some of the other executives began to talk about their seeds and the plants that were beginning to grow.

Jim kept checking his seed, but nothing ever grew. Three weeks, four weeks, five weeks went by, still nothing. By now, others were talking about their plants, but Jim didn’t have a plant and he felt like a failure.

Six months went by — still nothing in Jim’s pot. He just knew he had killed his seed. Everyone else had trees and tall plants, but he had nothing. Jim didn’t say anything to his colleagues, however… He just kept watering and fertilizing the soil – He so wanted the seed to grow.

A year finally went by and all the young executives of the company brought their plants to the CEO for inspection. Jim told his wife that he wasn’t going to take an empty pot. But she asked him to be honest about what happened. Jim felt sick to his stomach, it was going to be the most embarrassing moment of his life, but he knew his wife was right.

He took his empty pot to the board room. When Jim arrived, he was amazed at the variety of plants grown by the other executives. They were beautiful — in all shapes and sizes. Jim put his empty pot on the floor and many of his colleagues laughed, a few felt sorry for him! When the CEO arrived, he surveyed the room and greeted his young executives.

Jim just tried to hide in the back. “My, what great plants, trees, and flowers you have grown,” said the CEO. “Today one of you will be appointed the next CEO!” All of a sudden, the CEO spotted Jim at the back of the room with his empty pot. He ordered the Financial Director to bring him to the front.

Jim was terrified. He thought, “The CEO knows I’m a failure! Maybe he will have me fired!” When Jim got to the front, the CEO asked him what had happened to his seed – Jim told him the story.

The CEO asked everyone to sit down except Jim. He looked at Jim, and then announced to the young executives, “Behold your next Chief Executive Officer! His name is Jim!” Jim couldn’t believe it. Jim couldn’t even grow his seed. “How could he be the new CEO?” the others said.

Then the CEO said, “One year ago today, I gave everyone in this room a seed. I told you to take the seed, plant it, water it, and bring it back to me today. But I gave you all boiled seeds; they were dead – it was not possible for them to grow. All of you, except Jim, have brought me trees and plants and flowers. When you found that the seed would not grow, you substituted another seed for the one I gave you. Jim was the only one with the courage and honesty to bring me a pot with my seed in it. Therefore, he is the one who will be the new Chief Executive Officer!”

  • If you plant honesty, you will reap trust.
  • If you plant goodness, you will reap friends.
  • If you plant humility, you will reap greatness.
  • If you plant perseverance, you will reap contentment.
  • If you plant consideration, you will reap perspective.
  • If you plant hard work, you will reap success.
  • If you plant forgiveness, you will reap reconciliation.
  • If you plant faith in God , you will reap a harvest.

So, be careful what you plant now; it will determine what you will reap later.“Whatever You Give To Life, Life Gives You Back”

For comments and archives

   Cardiology eMedinewS

Glucose variance tied to hypoglycemia risk Read More

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Video game helps retrain the brain in amblyopia Read More

    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

What is IM pre-exposure vaccination schedule?

The regimen is three IM injections on days 0, 7 and 28.

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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

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    IJCP Special

Dr Good Dr Bad

Situation: A patient with heart failure came for cardiac evaluation.
Dr. Bad: Get Echo done.
Dr. Good: Go for Tissue Doppler Echo
Lesson: A patient with heart failure must go for Tissue Doppler Echo for evaluation of diastolic functions.

Make Sure

Situation: A patient on ACE inhibitor developed angioedema.
Reaction: Oh my God! Why was ACE inhibitor continued?
Lesson: Make sure that patients on ACE inhibitors are advised to watch for symptoms of urticaria and stop the drug immediately in case swelling of lip, face or tongue develops (Br J Clin Pharmacol 1999;48(6):861–5).

  Quote of the Day (Dr GM Singh)

It is wise to direct your anger towards problems – not people; to focus your energies on answers – not excuses. William Ward

    Mind Teaser

Read this…………………

The pain management nurse notices a male patient grimacing as he moves from the bed to a chair. The patient tells the nurse that he is not experiencing any pain. The nurse's response is to:

1. Clarify the patient's report by reviewing the patient's nonverbal behavior.
2. Confronting the patient's denial of pain.
3. Obtaining an order for pain medication.
4. Supporting the patient's stoic behavior.

Yesterday’s Mind Teaser: Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a female client’s uremia. Which finding signals a significant problem during this procedure?

a. Potassium level of 3.5 mEq/L
b. Hematocrit (HCT) of 35%
c. Blood glucose level of 200 mg/dL
d. White blood cell (WBC) count of 20,000/mm3

Answer for yesterday’s Mind Teaser: d. White blood cell (WBC) count of 20,000/mm3

Correct answers received from: Dr K Raju, Dr T A Sudhahar, Dr PC Das & Dr Mrs. S Das, Dr BB Gupta, Dr K V Sarma,, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Dr Avtar Krishan, Dr Jayashree Sen & Dr Bitaan Sen, Dr P K Sahu.

Answer for 8th May Mind Teaser: c. Limiting fluid intake

Correct answers received from: Dr Avtar Krishan, Dr P K Sahu, Dr Kanta Jain, Dr U Gaur.

Send your answer to ijcp12@gmail.com

    Lab Test (DR ARPAN GANDHI, Senior Consultant Lab Medicine)

NAT (nucleic acid amplification test) screening reduces window period as follows:

HIV> 11 days post infections
HBV> 20 days post infections
HCV> 15 days post infections

    Laugh a While (Dr GM Singh)

First day at School

A school teacher injured his back and had to wear a plaster cast around the upper part of his body.

It fit under his shirt and was not noticeable at all. On the first day of the term, still with the cast under his shirt, he found himself assigned to the toughest students in school.

Walking confidently into the rowdy classroom, he opened the window as wide as possible and then busied himself with desk work.

When a strong breeze made his tie flap, he took the desk stapler and stapled the tie to his chest.

He had no trouble with discipline that term.

    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

What is the medical treatment of chemical contamination and burn?

  • In case of chemical contamination or burn injury of eye, put fluorescein drops in the eye. Burns will stain yellow.
  • If there are yellow stains with fluorescein, put chloramphenicol 1% eye ointment in the eye. Put more ointment into the eye every 2 hours. Continue until the eye is no longer red and the sclera is white, and then for another 24 hours.
  • If the pain is severe, the patient may need an intramuscular injection of morphine.
  • If there is no water nearby, dab or gently wipe the skin and hair with cloth or paper.
  • Immediately wash the affected part of the body under cold or lukewarm running water, using soap if you have some. If there is no running water use buckets of water. Do it quickly and use a lot of water. Wear gloves and an apron if needed, to protect you from splashes of chemical. Some chemicals give off vapors: be careful not to breathe in vapors.
  • Quickly remove any of the patient’s clothes contaminated with chemical or vomit, as well as shoes and wrist watch if necessary. Speed is important. Cut the clothes off if the chemicals are very poisonous or corrosive.
  • If large areas of the body are contaminated with chemical, wash the patient under a shower or a hose. Remember to clean the hair and under the fingernails, in the groin and behind the ears, if necessary.
  • Continue to pour water over the patient for 10 minutes or longer if you can still see chemicals on the skin. If the skin feels sticky or soapy, wash it until the feeling disappears. This may take an hour or more.
  • Make sure the water drains away freely and safely as it will have chemical in it.
  • Do not rub or scrub the skin.
  • Dry the skin gently with a clean, soft towel. If clothing stays stuck to the skin even after water has been poured over it, do not remove it.
  • Remember that many chemicals can pass through the skin very quickly. Look for signs of poisoning.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Death is reversible up to 48 minutes?

In cardiac arrest CPR 10 should be started within 10 minutes of death, earlier the better, and should be continued for more than 10 minutes, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India, Dr. Aggarwal was conducting CPR 10 camps at Shri Rama Bharti Public School and Bal Bharti Public School at Bahadur Garh.

As per modern science and also ancient Vedic literature, life can be brought back within 48 minutes after the heart has stopped functioning.

The message for public is to start compressing the chest of the deceased victim with a speed of 100 per minute till medical help arrives. Effective and prolonged resuscitation is the key.

Over 2000 school children were trained in CPR Camp.

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 50118 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

    Readers Response
  1. Dear Sir, emedinews is very useful. Regards:Dr Shirpa
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