eMedinewS11th August 2014, Monday

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

Importance of Vitamin D in mythology

Today it is a known fact that 80% of the Indian society is vitamin D deficient. It was probably known to our Rishi Munis and they created rituals so that everybody gets enough Vitamin D from sunlight. Shahi snan in sunlight is mentioned in our Vedic literature.

  1. The month of Magha, Vaishakha and Kartik are considered as months for Shahi Snans where one is supposed to worship the sun early in the morning and eat calcium rich food whether it is Urad Ki Daal or sesame seeds.
  2. Chhat pooja which falls immediately after Diwali is also linked to sun worship.
  3. Sun is also worshipped in Marghshirsha month, which comes immediately after the month of Kartik.
  4. Kartik purnima and Vaishakh purnima are especially known for sun worship.

Vitamin D deficiency has been associated with metabolic syndrome, heart diseases and also with fertility. All these months when sun is worshipped are also the months of increased fertility. After chaturmas is over, Tulsi vivah starts the marriage season during which one worships both Tulsi and Amla. Both of them are known to increase the quantity of semen and increased ovulation.

Probably, the age old treatment of infertility was to acquire vitamin D, taking calcium rich food and consume both tulsi and amla on regular basis.

The current vitamin D mantra is that 40 days in a year for atleast 40 minutes, one should expose 40% of the body to the sunlight either after sunrise or just before sunset.

News Around The Globe

  • A new study has suggested that disorganization of the retinal inner layers is associated with visual acuity and its changes in patients with center–involved diabetic macular edema. The study was published online in JAMA Ophthalmology.
  • A study published online in the Archives of Disease in Childhood has revealed that patients diagnosed with sacrococcygeal teratoma in childhood face long–term morbidities, including abnormal bowel function and urinary symptoms.
  • A new study has found that women who consume more caffeine are less likely to have tinnitus. Study authors noted that rates of tinnitus were 15% lower among women who consumed 450–599 mg a day of caffeine, compared with women who drank less than 150 mg a day. The study was published in the American Journal of Medicine.
  • A new study by researchers at the Cardiff University, UK has revealed that metformin could increase the lifespan of individuals who are non–diabetics, besides being an effective therapy for type 2 diabetes. The findings have been published in Diabetes, Obesity and Metabolism.
  • The American Heart Association has published a statement in the journal Stroke unveiling an association between stroke and therapy involving neck manipulation, although they could not confirm whether neck manipulation causes stroke or not. They stress that patients should be informed of this potential risk before receiving neck manipulation therapy.

Rabies News (Dr A K Gupta)

If vaccination is required for a person bitten by a vaccinated dog, then why vaccinate the dog at all?

Vaccinating the pet dog is primarily to protect it from contracting rabies following bites by stray rabid dogs/animals. No veterinary vaccine offers 100% protection against rabies. Rabies is enzootic in our stray animal/dog population. The facility of protective antibody titer test (in vaccinated dog) is available only at a few centers in the country. The facility to quarantine the bitten vaccinated pet is limited and difficult. In view of the above facts and practical realities, rabies being 100% fatal, we take no chances and start PEP (immunization) in the bitten person and presume the vaccinated dog to be incubating rabies (and infective) and simultaneously observe the dog.

However, in extremely rare situations exception to the above thumb rule can be made at the professional discretion of the treating physician.

Cardiology eMedinewS

  • A new research has pointed that loss of sensation in the feet, a result of diabetes, may be a predictor of cardiovascular events such as heart attack and strokes. The study is published online in Heart.
  • A survey by Japanese researchers has revealed that rupture of the mitral chordae tendineae in young children is more common than previously thought. In a paper published online in Circulation, researchers note that there have been several recent reports of such rupture in children in Japan; most of them in infants, and congenital malformations of the mitral valve apparatus were absent.

Pediatrics eMedinewS

  • A study published recently in the Journal of Clinical Endocrinology & Metabolism has pointed that abnormally high levels of percholate in women may lead to adverse effects in their offspring. High levels of percholate in women were associated with below average IQ levels in their offspring when compared to other children.
  • A study published in the journal Developmental Science has improved the understanding of the role of letter position in children’s word recognition, including in dyslexia. The study found that while developing young readers and skilled adult readers had similar difficulty correctly recognizing anagrams that can form another word by switching the order of only the inside letters, both groups also found it equally easy to recognize anagrams when the outside letters also had to be switched around to form another word.

Dr K K Spiritual Blog

Why puffed rice and not rice are offered to Lord Ganesha

Lord Ganesha is shown with a big tummy and craving for eating sweets (ladoos or modakas) and puffed rice.

Both sweets and rice are addicting in nature and consuming them regularly can lead to metabolic syndrome, which presents with diabetes and high blood pressure. In Hindu mythology for this reason it is said to avoid eating carbohydrates atleast once in a week.

Ganesha is in each one of us depicting our inherent weakness for eating carbohydrates. To prevent metabolic syndrome, Ganesha is shown to consume Bilva leaves, Durva grass juice, fruits of elephant apple and Jamun, all of which have antidiabetic and insulin–sensitizing properties.

Ganesha is also shown to be eating puffed rice and not plain rice. Puffed rice is a safer carbohydrate than plain rice.

The importance of puffed rice is mentioned in many places in mythology. The main mention comes in Kubera Ganesha interaction in one of the Purana (Vedic message in the form of stories) story.

Kubera (the god of wealth) became proud of his wealth and invited child Ganesha for a meal. Ganesha increased his appetite so much that there was nothing else to eat. When Kubera made Shiva to intervene, Shiva gave Ganesha a handful of puffed rice, which he ate, and immediately his hunger was suppressed.

This teaches us two Vedic lessons. Firstly that handful of puffed rice given with love and eaten with devotion is more important and filling than all the wealth which Kubera flaunted to impress others.

Secondly, a man of perfection (Ganesha) has an endless appetite for experiences. Lord Shiva, the perfect Guru, alone can satisfy the hunger of such devotee by giving them a handful of "puffed rice", representing the "baked vasanas", burnt in the fire of knowledge’. Only when the lust is burnt up, the enthusiasm for experiencing life is quietened.

The spiritual message is that one should learn to control lust and burn it in the fire of knowledge.

In mythology the symbolic representation of rice is for lust (attachments, desires and greed) and puffed rice for baked lust. Rice is equated to lust being a carbohydrate with high glycemic index and proneness to obesity and metabolic syndrome.

Apart from carbohydrates lust can also be for sex, cigarettes, alcohol and narcotics. The answer for any lust is either to discard lust or to think before indulging in it.

Medically also puffed rice is better than plain rice. Puffed rice or murmura is to rice what popcorn is to maize. Puffed rice however lacks the essential amino acid lysine and therefore is not a complete meal by itself. It is about 10 times the volume of regular rice. A cup of plain puffed rice contains only 20–25 calories. Puffed rice is recommended healthy snack and healthy fast food for preventing diabetes. It is light, dry and gives a feeling of fullness. It is also gluten–free.

In mythology, puffed rice has been mentioned at many other places also.

  • When Sudama went to meet Krishna he carried puffed rice as a gift which Krishna relished. Puffed rice indicates a healthy gift and that only a person who has controlled his lust can meet Krishna the consciousness.
  • Ramakrishna has been mentioned having his first spiritual ecstasy at the age of six or seven while eating puffed rice. Spiritually again this means that only those who have mastered lust can achieve spiritual ecstasy.
  • In marriage rituals also both bride and groom are required to offer puffed rice into the fire. The spiritual message is again that both groom and bride need to leave their lust before they enter into a new relationship. This is again shown in another marriage ritual Laaja Homam where the bride with the assistance of her brothers makes offerings of puffed rice into the sacred fire.
  • In Buddhist mythology puffed rice also depicts the end "one who cannot be reborn" and puffed rice is used at funerals. Puffed rice represents rice that cannot be grown again.

Wellness Blog

Cycling can cause erectile dysfunction?

Age, diabetes, hypertension, obesity, high lipids, smoking, drugs, heart disease, upright cycling for more than 3 hrs a week can cause erectile dysfunction in males. For those who drive cycles for more than 3 hours a week should do so in reclining position and not upright position.

A man is considered to have erectile dysfunction when he cannot acquire or sustain an erection of sufficient rigidity for sexual intercourse. Any man may, at one time or another during his life, experience periodic or isolated sexual failures.

The term "impotent" is reserved for those men who experience erectile failure during attempted intercourse more than 75 percent of the time. Heart disease increases the risk for later erectile dysfunction. Erectile dysfunction may be an early warning sign of future heart disease. Men with erectile dysfunction without an obvious cause (e.g., pelvic trauma), and who have no symptoms of heart disease, should be screened for heart disease prior to treatment since there are potential cardiac risks associated with sexual activity in patients with heart disease.

Eight of the 12 most commonly prescribed medications list impotence as a side effect and it is estimated that 25 percent of cases of erectile dysfunction are due to drugs.

Depression, stress, or the drugs used to treat depression can result in erectile dysfunction.

Neurologic causes of erectile dysfunction include stroke, spinal cord or back injury, multiple sclerosis, or dementia. In addition, pelvic trauma, prostate. Surgery or priapism may cause erectile dysfunction.

Bicycling, less obvious, but of increasing importance, has been the possible association of erectile dysfunction with bicycling.

Anything that places prolonged pressure on the pudendal and cavernosal nerves or compromises blood flow to the penile artery can result in penile numbness and impotence.

Cycling–induced impotence is primarily a problem of serious cyclists and is reported to occur in Norwegian men competing in a 540 km bicycle race.

The penile numbness is attributed to the pressure on the perineal nerves whereas the erectile dysfunction is thought to be due to a decrease in oxygen pressure in the pudendal arteries.

Recreational cyclists, those who cycle for less than three hours per week and men who cycle in a reclining position avoid the sustained intense pressure on the penile nerve and artery and are less likely to experience sexual side effects. Continued cycling in a seated upright position can reduce the penile oxygen levels lasting 10 minutes.

Inspirational Story

Joy of Giving

A woman who was traveling alone in the mountains found a precious stone in a stream. The next day she met another traveler who was hungry; the woman opened her bag to share her food.

The hungry traveler saw the precious stone and asked the woman to give it to him. She did so without hesitation. The traveler left, rejoicing in his great fortune. He knew the stone was worth enough to give him security for a lifetime. But a few days later he came back to return the stone to the woman.

"I’ve been thinking," he said, "I know how valuable the stone is, but I give it back in the hope that you can give me something even more precious. Give me what you have within you that enabled you to give me the stone."

The woman smiled, "The joy of giving!"





Zee News – Health Wealth Shows

Cancer Prevention
Potbelly Obesity
Sudden Cardiac Death
Safe Drugs
Safe Holi
Vitamin D
Fluid Intake


Total CPR since 1st November 2012 – 96458 trained

cpr10 Mantra The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."

CPR 10 Success Stories

Ms Geetanjali, SD Public School
Success story Ms Sudha Malik
BVN School girl Harshita
Elderly man saved by Anuja

CPR 10 Videos

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Hands–only CPR 10 English
Hands–only CPR 10 (Hindi)

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Health Check Up and CPR 10 Camp at SD Public School Pitam Pura, 1st August 2014

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One can predict acute lung injury

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If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us on :


Make Sure

Situation: An elderly patient with unstable angina presented with URTI and was found to be positive for Chlamydia pneumoniae infection.
Reaction: Remember to start macrolides immediately.
Lesson: Make sure to remember that erythromycin 2 g/day for 10–14 days reverses the increased risk of atherosclerosis.

eMedinewS Humor

A Tried and Trusted Employee

A wealthy investor walked into a bank and said to the bank manager, "I would like to speak with Mr. Reginald Jones, who I understand is a tried and trusted employee of yours."

The banker said, "Yes he certainly was trusted. And he will be tried as soon as we catch him."

Quote of the Day

Good manners sometimes means simply putting up with other people’s bad manners. H. Jackson Brown, Jr.

Twitter of the Day

Dr KK Aggarwal: You are at risk for osteoporosis if… http://bit.ly/HTZaj4 #Health
Dr Deepak Chopra: Consciousness is the only proof of consciousness. Do not look outside for yourself http://bit.ly/DC_Ananda #ananda

ePress Release

Weight gain after quitting smoking does not increase the risk of heart disease

In a study published in the Journal of American Association, researchers from Switzerland have shown that in non–diabetics, weight gain after quitting smoking does not take away the cardiovascular benefits of quitting smoking.

Commenting on the study, Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and Sr. National Vice President Indian Medical association said that there is a net cardiovascular benefit of smoking cessation despite subsequent weight gain. Smoking cessation is always beneficial for smokers.

People gain 6–8 pounds of weight after quitting smoking. In the study, quitting smoking was also linked with a decreased risk of heart attack or cardiac death compared to smokers.

eMedi Quiz

Which of the following is not true about papular pruritic eruption in HIV infection?

a. It is one of the earliest manifestations of HIV infection.
b. It is an HIV–specific cutaneous manifestation.
c. Arthopod bites have been postulated to be one of the causative factors.
d. It does not serve as a cutaneous marker of underlying immune status.

Yesterday’s Mind Teaser: A hybird teledermatology is

a. Combination of store and forward and mobile teledermatology
b. Combination of store and forward and video conference
c. Combination of online discussion group and author–based second opinion teledermatology
d. Combination of online discussion group and video conference

Answer for yesterday’s Mind Teaser: b. Combination of store and forward and video conference

Correct answers received from: Dr Gopal Shinde, Dr K V Sarma, Dr Bitaan Sen & Dr Jayashree Sen, Dr poonam chablani, Dr K Raju, Dr Avtar Krishan

Answer for 10th August Mind Teaser: b. Combination of store and forward and video conference

Correct answers received from: Dr Sushma Chawla, Dr Bitaan Sen & Dr Jayashree Sen, Dr Prakash Khalap

Send your answer to ijcp12@gmail.com

medicolegal update

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  1. Dear Dr Agarwal,K.K, Wish to thank you for providing detailed information regarding Ebola virus. It is need of time to have knowledge of this deadly virus.With best wishes, Dr N.K.Bohra Consultant Psychiatrist, Director Delhi Academy of Practicing Psychiatrist, Fmr Chairman IABP, Patron DPS, New Delhi 110065.
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