eMedinewS21st November 2013, Thursday

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

Non–alcoholic Fatty Liver Disease Independently Predicts Prediabetes

Non–alcoholic fatty liver disease has been linked to increased risk for developing type 2 diabetes. A new study in Liver International 2013;33(9):1406–1412 evaluated the independent role of NAFLD in predicting the development of pre–DM in a 7–year prospective follow-up of healthy volunteers.

A prospective cohort of a subsample of the Israeli National Health Survey evaluated at baseline and after 7 years by identical protocols. Metabolic parameters and ultrasonographic evidence of NAFLD were evaluated in 213 subjects, without known liver disease or history of alcohol abuse. Exclusion criteria were pre–DM at the baseline survey. Steatosis was quantified by ultrasound with the hepatorenal ultrasound index (HRI).

The study included 141 volunteers (mean age 48.78 ± 9.68, 24.82% with NAFLD) without pre–DM/DM at baseline. Both NAFLD on regular US (OR=2.93, 1.02–8.41 95%CI) and HRI (OR=7.87, 1.83–33.82) were independent predictors for the development of pre–DM, adjusting for age, gender, BMI, family history of DM, baseline insulin, adiponectin and glucose. Further adjustment for physical activity and dietary intake did not weaken the association. Furthermore, NAFLD was a stronger predictor for pre–DM than the metabolic syndrome. Subjects with both NAFLD and glucose ≥89 had 93.3% incidence rate of pre–DM.

The study concluded that non–alcoholic fatty liver disease is a strong and independent risk factor for pre–DM in the general adult population; thus, NAFLD patients should be classified as a population at risk.

TOPAC trial

The TOPCAT trial evaluating spironolactone in patients with heart failure and preserved ejection fraction did not meet its primary endpoint, but there was some evidence of benefit.

Through an average follow–up of 3.3 years, the rate of cardiovascular mortality, aborted cardiac arrest, or heart failure hospitalization was 18.6% in the spironolactone group and 20.4% in the placebo group according to Marc Pfeffer, MD, PhD, of Brigham and Women’s Hospital in Boston. The rate of heart failure hospitalization was, however, significantly reduced in the spironolactone group (12% versus 14.2%) with no differences in the other components of the primary endpoint (American Heart Association meeting.)

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 – Controlling the Inner Noise

sprritual blog

Yoga Sutras of Patanjali define yoga as restraint of the mental states (Chapter 1.2) i.e. in the state of total restraint, the mind is devoid of any external object and is in its true self or the consciousness. To control the mind many Vedic scholars have given their own formulas.

Being in touch with ones own consciousness requires restraint of mind, intellect and ego on one hand and the triad of rajas, tamas and satwa on the other hand. Every action leads to a memory, which in turn leads to a desire end and with this a vicious cycle starts.

The mental turmoil of thoughts can be equated to the internal noise and the external desires and objects to an external noise.

The process of withdrawing from the external noise with an aim to start a journey inwards into the silent field of awareness bypassing the internal noise is called pratihaara by Yoga Sutras of Patanjali. It involves living in a satwik atmosphere based on the dos and don’ts learnt over a period of time or told by the scriptures.

To control inner noise–based thoughts, we either need to neutralize negative thoughts by cultivating opposite thoughts or kill the origin of negative thoughts.

Not allowing thoughts to occur has been one of the strategies mentioned by the scholars. One of them has been neti–neti by Yagnayakya.

The other way is to pass through these inner thoughts and not get disturbed by them and this is what the process of meditation is. This can be equated to a situation where two people are talking in an atmosphere of loud external noise. For proper communication, one will have to concentrate on each others’ voice for long till the external noise ceases to disturb. During meditation, one focuses on the object of concentration to such an extent that the noisy thoughts cease to bother or exist.

One of the ways mentioned by Adi Shankaracharya in Bhaja Govindam and by Yoga Sutras of Patanjali (Chapter 2.35) is that whenever one is surrounded by evil or negative thoughts, one should meditate open the contrary thoughts. For example, if one is getting evil desires after seeing bare breasts of a young lady, one can think that these very breasts gave me an opportunity to drink milk when I was born. Similarly when one is feeling greedy one can have a desire of donating something to somebody.

Deepak Chopra in his book Seven Laws of Spiritual Success talks in detail about the importance of giving and sharing. He says one should never visit his friends or relations empty handed. One should always carry some gift of nature, which if nothing is available can be a simple smile, compliment or a flower. By repeatedly indulging into positive behavior and thoughts, one reduces the internal noise, which helps in making the process of meditation or conscious living a simpler one.

Washing out negative thoughts is another way mentioned by many Vedic scholars. One such exercise which anybody can do is a 3–minute writing. Just before going off to sleep, anybody can do free 3–minute writing where one writes all his or her emotions and then throws the paper away. Another exercise is to reward or punish one self at bed time for the activities done during the day by either patting or slapping yourself.

cardiology news


Love heals, but love with unacknowledged ‘broken wings’ never gets off the ground for long. Love with a couple needs four wings to fly the highest into a freedom and bliss that remains forever. To really love, you have to ‘let go’ of things that create a love that flutters and gets lost in flight, even before love has really begun. Love isn't a trip to a Safari park, or to a caged love, but a journey out of all cages to a freedom beyond words that has no limits.

Love is free, but freedom has constraints! The biggest constraint is ‘you’ unprepared for the transcending of who you are not, but are trapped into thinking you are. An escape from all impediments begins to heal the emotional broken wings. The birth of a new dimension in experience is in you hands to choose. No choice is a choice.

Doing nothing but living out your life with no introspection is to ‘bypass’ the possibilities of evolving the spirit of life and love. Giving up freedoms is not just an outer containment, but an inner prison that shuts out the growth of the emotional and spiritual. The mind alone isn’t adequate without paying attention to emotional/spiritual barriers.

Bonding as a couple if one or both of you is an ‘emotional broken wing’ from uncleared negative childhood issues is akin to ‘walking a high wire tight rope’ without the acquired skills. Things may at first seem good, but the issues come up and splatter the good intentions. Most are conditioned to accept problems, and end up moving around them while the intended love is kept together by fears, and well, by a fragile string. People are more prepared today to be smarter, and educated so as to be a success financially, but almost nothing in schools works on the emotional, spiritual life. Why? Easy. The teachers/professors are too emotionally/spiritually handicapped themselves!

Open communication, sound agreements, and the focus on a total heart opening are especially important if one or both partners have any unresolved issues from underlying fears, be it fear of abandonment, intimacy, trust, and so forth. The fear of ‘flying, uninhibited into a total freedom of love’ evades billions, and likely no one in your lineage has been able to heal into a love that transcends all blocks. Don’t let it be in competition with other priorities as rarely it is not the case. The only problem in life is missing enough love! Trying to grow roses in a garden of weeds is futile. Weeds are personal insecurity, jealousies, self doubt, miseries, ego trips, being someone you are not, and on and on.

There are no tomorrows for love – only now! Time to have the courage to ‘untangle’ all barriers, and staying focused on the highest possibilities. No moment in history has been better for so many to fly with uninhibited love than the moment now!

News Around The Globe


  • On September 9, 2013, the Hawaii Department of Health (HDOH) was notified of seven patients with severe acute hepatitis and fulminant liver failure of unknown etiology. Patients were previously healthy and sought medical care during May–September 2013. Clinicians reported that the seven patients had all used OxyELITE Pro, a dietary supplement marketed for weight loss and muscle gain, before illness onset.
  • In a recent study, both healthy individuals and patients with diabetes who received a single 40 IU intranasal dose of insulin experienced improved verbal learning and visual–spatial learning and memory. Imaging tests revealed that these improvements were dependent on the brain’s vascular function. Intranasal insulin administration, which delivers insulin directly to the brain and bypasses the blood–brain barrier, does not affect systemic glucose control. (Diabetes Care)
  • Idiopathic pulmonary fibrosis (IPF), a fatal progressive lung disease, might be caused by a virus. Evidence of the pathogen, herpes virus saimiri, was found in all tissue samples from a cohort of patients with IPF, but in none of those from patients with fibrosis with a known cause, according to Gerard Nuovo, MD, of Ohio State University Comprehensive Cancer Center in Marion, and colleagues reported online in Modern Pathology. And interventions aimed at stopping the proliferation of herpes virus saimiri might stabilize IPF, which is typically fatal within 2 years of diagnosis.
  • Recently, local bone denervation by MR–guided focused ultrasound has been demonstrated as a promising tool for pain palliation of bone metastases. A study in BMC Musculoskelet Disord 2013;14(267) has shown the safety and efficacy of MRgFUS treatment in osteoarthritis. Significant increase of Pressure pain thresholds on treated area showed successful denervation effect on the nociceptive nerve terminals. MRgFUS is a promising and innovative procedure for noninvasive pain management of knee OA.
  • Although extremely elevated ferritin levels may be associated with rheumatologic diseases, more often they are found in patients with other conditions such as malignancy or infection. In addition, extremely high ferritin levels can be found in patients with seemingly indolent disease or levels of chronic inflammation (J Clin Rheumatol. 2013;19(6):324–328).

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Rabies News (Dr. A K Gupta)

How is RIG injected locally? What is the mode of administration of full dose of RIG?

It is important to infiltrate all wounds with rabies immunoglobulin (RIG). Intramuscular (IM) administration of RIG is of very little value. The previous recommendation to give antirabies serum half into wounds and half IM no longer holds true and may lead to treatment failure. As much of the calculated dose of RIG as is anatomically feasible should be infiltrated into and around all the wounds. In the event that some volume of RIGs is left over after all wounds have been infiltrated, the same should be administered by deep IM at a site distant from the vaccine injection site.

If the calculated dose of RIG is insufficient to infiltrate all wounds, sterile saline can be used to dilute it 2 or 3 fold to permit thorough infiltration.

cardiology news

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

Cardio news

Patients who fail to fill prescriptions or take their meds are an enduring thorn in the side of cardiologists, who see a direct correlattion between medication compliance and preventing CV events. A new randomized trial looking at a "multifaceted" intervention involving patient education, voice messaging, and a stepped–up role for the pharmacist suggests this strategy may lead to significant improvements in medication adherence. But, the study failed to show improvements in cholesterol or blood pressure as a result of the improved compliance (AHA 2013 annual meeting).

cardiology news

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

  • A gene expression signature both distinguishes infection with respiratory syncytial virus (RSV) from other viral lower respiratory tract infections (LRTI) in infants and correlates degree of immune system suppression to severity of illness, according to a report published online November 12 in PLOS Medicine.
  • Milk consumption during adolescence is not associated with decreased risk for hip fracture later in life, according to results from a new study. In fact, high consumption of milk may actually up risk by increasing height. The study was published online November 18 in JAMA Pediatrics.
cardiology news

Is caffeine good for the health?

  1. Caffeine is the most consumed stimulant in the world,
  2. It is consumed in the form of coffee and tea.
  3. At present there is no scientific data for promoting or discouraging coffee and/or tea consumption in the daily diet.
  4. Short term benefits include mental alertness and improved athletic performance.
  5. Short term adverse effects including headache, anxiety, tremors, and insomnia.
  6. Long term adverse affects include generalized anxiety disorder and substance abuse disorders.
  7. Long–term benefits are dose–dependent. Caffeine is associated with a reduced risk of Parkinson disease, Alzheimer disease, alcoholic cirrhosis, and gout. Both caffeinated and decaffeinated coffee is also associated with a lower risk of type 2 diabetes.
  8. Heavy coffee intake may trigger coronary and arrhythmic events in susceptible individuals, although coffee intake is not considered a long–term risk factor for myocardial disease.
  9. Most studies show a modest inverse relationship between coffee consumption and all–cause mortality.
  10. Caffeine withdrawal is a well–documented clinical syndrome with headache being the most common symptom. (Source Uptodate)
cardiology news

Total CPR since 1st November 2012 – 71933 trained

Media advocacy through Web Media

Expressive writing can relieve stress

By spending 30 minutes each day for four days to write out innermost thoughts and feelings, one can significantly boost mental and physical health, said Dr. K K Aggarwal, President, Heart Care Foundation of India.

This so–called expressive writing requires only pen and a paper. In expressive writing therapy, patients are encouraged to express whatever is on their mind, letting their hopes and fears flow out in a natural, unrestrained way. It is like keeping a journal, but more focused on the things that might be bothering one or triggering stress.

Talking about other updates, Dr Aggarwal said that snoring at night or sleepiness during the day may be a symptom of obstructive sleep apnea, a potentially life–threatening problem affecting one out of three diabetics. It occurs when the airway becomes blocked during sleep and is usually caused by the collapse of soft tissue in the back of the throat during sleep. Between snores, breathing stops for a period of 10 seconds or longer, and this pattern repeats itself multiples times over the course of a night.

Smoking while pregnant can damage thyroid function of both the mother and the fetus. Good thyroid function is the key to maintaining a pregnancy. This, in turn, affects metabolism and the risk of miscarriage, premature birth, low birth weight and impaired brain development.

People who develop chronic cough and phlegm (sputum production) are at 4–fold risk of developing chronic obstructive lung disease.

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 71933 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

CSR Activity by Heart Care Foundation of India on the Diabetes Day

press release

Vitamin D intake associated with reduced risk for Crohn’s disease

today video of the day20th MTNL Perfect Health Mela Press Conference with Marwadi Yuva Manch, Faridabad

20th MTNL Perfect Health Mela Press Conference at Marwah Studio, Noida

Cultural Evening at IMA

eMedi Quiz

The main enzyme responsible for activation of xenobiotics is:

1.Cytochrome P–450
2.Glutathione S–transferase.
3.NADPH cytochrome P–450–reductase.
4.Glucuronyl transferase.

Yesterday’s Mind Teaser: The right coronary artery supplies all of the following parts of the conducting system in the heart except:

1.SA Node.
2.AV Node.
3.AV Bundle.
4.Right bundle branch.

Answer for yesterday’s Mind Teaser: 3.AV Bundle.

Correct answers received from: .DR.A.K.GAJJAR, Dr. P. C. Das, Prabha Sanghi, DR ARPAN GANDHI, Dr Jainendra Upadhyay, Narahari Kandakatla, Dr.Chandresh Jardosh, Dr.Jayashree Sen & Dr.Bitaan Sen, Sangeetha Raja, DR AVTAR KRISHAN, Dr Kanta Jain, daivadheenam, Muthumperumal Thirumalpillai, Dr K P Chandra, Dr Prakash Khalap

Answer for 19th November Mind Teaser: 3.Loss of overhead abduction.

Correct answers received from: Muthumperumal Thirumalpillai, Dr K P Chandra, Dr.Jayashree Sen & Dr.Bitaan Sen, Dr Prakash Khalap

Send your answer to ijcp12@gmail.com

medicolegal update

Click on the image to enlarge

medicolegal update

Gynecologist: A man who works and operates in another man’s field

medicolegal update
medicolegal update

Click on the image to enlarge

medicolegal update

Situation: Doctor, this patient has developed acute renal failure (ARF).
Reaction: Oh my God, I forgot that he was on furosemide. I gave him full dose of amikacin.
Lesson: Make sure, before calculating the dose of aminoglycoside (amikacin) that furosemide and other loop diuretics, which enhance its nephrotoxicity are not being given.

medicolegal update

Every great and commanding movement in the annals of the world is the triumph of enthusiasm. Ralph Waldo Emerson

medicolegal update

Dr KK Aggarwal: Dr K K Aggarwal: Relaxation during work http://bit.ly/15QdVeB #Health
Dr Deepak Chopra: Are we alone in the universe? Take a quick trip through the cosmos as I explore this eternal question.http://tinyurl.com/mwjtqcs

Forthcoming events

Quality Management in Healthcare Delivery

Pushpanjali Crosslay Hospital, a 350+ bedded NABH & NABL accredited multi super specialty hospital is organizing its 5th Annual Conference "PCCON 2013" in association with Indian Medical Association (East Delhi Branch & West Ghaziabad Branch) on November 23–24, 2013 at Hotel Country Inn, Sahibabad, Ghaziabad.

Chairperson : Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal
Day & Date : Sunday, 24th Nov, 2013

5th eMedinews Revisiting 2013

(a day long single hall medical conference on 2013 happenings, followed by doctors of the year 2013 awards)

Sunday 19th January 2014, Maulana Azad Medical College Auditorium

Dilli Gate Delhi, 10 am-6 pm

Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee President

Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman

Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

5th eMedinewS Revisiting 2013
The 5th eMedinewS–revisiting 2013 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 19th 2014.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2013. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. Lunch will be provided.

Register at: rawat.vandana89@gmail.com/drpawangupta2006@yahoo.com

5th eMedinewS Doctor of the Year Awards
Nominations invited for 5th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2013.

pls send his/her Biodata at: emedinews@gmail.com

press release

medicolegal update
  1. I completely agree with you, Dr Aggarwal. Health must be prioritized in any election campaign. We as Indians have right to access to robust health system. Regards: Dr Neeraj Gupta

eMedinewS Special

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Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Prof.(Dr).C V Raghuveer

medicolegal update

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