Heart Patients should avoid living on top floors of high-rise buildings- HCFI

Heart Patients should avoid living on top floors of high-rise buildings- HCFI

According to a recent study, heart patients residing in lower floors of high-rise buildings had a higher chance of surviving sudden cardiac arrests as opposed to those who live on higher floors. The reason being, the time it takes for a first responder arriving at the building to reach the patient having a cardiac arrest increases when the patient lives on a higher floor.  In addition to this there exists an overall lack of awareness about the importance of Hands-only CPR 10 as a life-saving technique that can help revive a sudden cardiac arrest patient within ten minutes of their death.

The study that was conducted on a sample of 5,998 patients found that on an average, it took responders about 6 minutes from the time of receiving the SOS phone to arrive at the building. But it took them an average of 3 minutes between arriving at the building and first contact with the patient for those lived on the first or second floor, compared to an average of almost 5 minutes for those who lived on or above the third floor. 4.2% of those who lived below the third floor of their buildings survived cardiac arrests as opposed to only 2.6% of those who stayed on higher floors. Thus medically, it is suggested that living on the higher floors of high-rise building can be fatal for heart patients.

Keeping this in mind, the leading National NGO Heart Care Foundation of India recommends that doctors must ensure that each and every family member and those in regular contact with the heart patient must be trained in the easy to learn and perform technique of Hands Only CPR. In addition to this, they must discourage them from residing on higher floors in society buildings. All societies must also have Automated External Defibrillators (AEDs) readily available in the lobby, on certain floors or the elevators.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal Honorary Secretary General IMA & President HCFI said, “It is the responsibility of all doctors to inform heart patients and their patients about the dangers of living on higher floors of high-rise buildings. For those who do, it is essential that each and every family member and building staff is trained in the life-saving technique of hands only CPR which can be performed by anyone and can help revive patients who have suffered a sudden cardiac arrest within ten minutes of their death. Societies must also ensure that an AED is available. Around 240,000 people die every year due to heart attacks and we believe about 50% of them can be saved if 20% of the population learns hands only CPR. What people need to remember is two things, one CPR must not be practiced on a person who is breathing, has a pulse rate and is clinically alive. It must be administered within ten minutes of someone’s death and continued till the ambulance arrives or the person is revived.”

The HCFI Hands- Only CPR 10 mantra is: Within 10 minutes of death (earlier the better), for a minimum of 10 minutes (adults 25 minutes and children 35 minutes), compress the center of the chest of the deceased person continuously and effectively with a speed of 10×10 = 100 per minute.

Continuous compression only CPR compresses the heart between the sternum and the back bone and builds up the pressure that keeps the oxygenated blood flowing to the brain and keeps the person alive until a defibrillator becomes available or expert medical help arrives. Therefore, if you see someone collapse from sudden cardiac arrest, acting promptly can save his or her life. It is important to act quickly for every minute lost reduces the chances of revival by 10%. So, if you wait 5 minutes, the chances of surviving are 50% less. The earlier you give CPR to a person in cardiac arrest, the greater the chance of a successful resuscitation. To know more or to organize a training camp in your locality, please call the NGO’s helpline number 9958771177. 

Kesari dal being reintroduced: Too early for IMA to call it 100% safe

Kesari dal being reintroduced: Too early for IMA to call it 100% safe Dr SS Agarwal and Dr KK Aggarwal Three new varieties of kesari dal, Ratan, Prateek and Mahateora, which have low p-N oxalyl- L-p-diaminopropionic acid (P-ODAP) content, have been released for general cultivation. Kesari dal or lathyrus sativus is commonly known as grass pea. The Indian Council of Agricultural Research (ICAR) has developed these three new strains in collaboration with State agriculture universities ODAP is found in the seeds of Kesari Dal at a constant concentration of 0.5%. While, the ODAP content in these varieties is in the range of 0.07-0.10%, which is safe for human consumption. It has been shown that the concentration of ODAP increases in plants grown under stressful conditions. Kesari dal, a key Rabi pulse crop, is mainly cultivated in the states of Madhya Pradesh, Chhattisgarh, Maharashtra, Bihar and West Bengal. Arhar dal is expensive and often retailers mix the cheap khesari dal because of similarity in appearance. It is learnt that the ICAR admitted that a research panel headed by India Council of Medical Research has proposed lifting the ban. In the new varieties of the dal, the toxicity is "negligible." The proposal is now being considered by the Food Safety and Standards Authority of India (FSSAI). IMA would like to know more about the studies, animal studies and long term follow ups before our members can call it 100% safe for human consumption. Lathyrism, a disorder of spastic paraparesis occurs in association with increased dietary intake of food plants with neurotoxic potential. Neurolathyrism is associated with prolonged consumption of the grass pea. Exposed persons suffer a slowly developing spastic paraparesis with cramps, paresthesias and numbness, accompanied by bladder symptoms and impotence. Some patients have tremors and other involuntary movements in their arms. Pathologic studies have demonstrated a loss of myelinated fibers in the corticospinal and spinocerebellar tracts. The toxin appears to be the neuroexcitatory amino acid, beta-N-oxalylaminoalanine. There is no treatment.

Eight points all doctors must keen in mind before treating an Elderly Patient- IMA

Eight points all doctors must keen in mind before treating an Elderly Patient- IMA

N The increase in life expectancy over the years has resulted in a drastic rise in the number of elderly residing in our country. Reports indicate that while the overall population of India will grow by 40% between 2006 and 2050, the population of those aged 60 and above will increase by 270%.

Medically, the treatment of an elderly patient is always a high-risk job since an aged body is different physiologically from the younger adult body, and during old age, the decline of various organ systems becomes manifest. Given this, special care and attention need to be given to them.

Keeping this in mind, the Indian Medical Association recommends certain guidelines that all doctors must follow while dealing with elderly patients.

Speaking about this, Dr SS Agarwal National President and Dr K K Aggarwal Honorary Secretary General IMA in a joint statement said, “Doctors need to be aware and meticulous while treating the elderly and thus we have framed proper guidelines for the doctors to look upto. It is projected that by 2030 nearly half of India’s disease burden will be borne by older adults. Thus, there would be a large number of chronic conditions that would need care and attention”.

The IMA recommends that the following points must be kept in mind while attending to elderly patients:

1.All doctors should be educated in the basics of Geriatric Care: With the explosion of the aging population, it is impossible to train the required number of geriatricians. To ensure that elderly patients receive good care there need to be 10 times as many geriatrics savvy internal medicine physicians as certified geriatricians.

2. Focus on managing the patient’s mobility than the disease: Most older adults spend majority of their days lying on the hospital in bed, even when they are able to walk independently. This is a major risk factor for functional decline. One should ambulate three times a day under nursing supervision.

3. Follow the ten Choosing Wisely Guidelines set forth by the American Geriatrics Society: Taking care when prescribing medications for the elderly, guarding against the dangers of polypharmacy, and avoiding restraints in cases of delirium

4. Follow an interdisciplinary team-based approach to cover the patient's and family's needs and individual goals for care.

5. Guard Against Delirium: Do not wake patients up multiple times in a night, it can add to delirium. Dementia patients’ especially are at a high risk for delirium and must be observed more closely.

6. Beware of polypharmacy and high-risk drugs. Polypharmacy is a major contributor to delirium. Ensure the right drug in the right dose is ordered for the right patient at the right time.

7. Follow the syndrome approach rather than independent cause based approach. For example, in a patient with post-operative delirium, incontinence, or an increased risk of falls, look for multiple contributing factors rather than a unique cause.

8. Focus care on the patient as a whole, and on individual goals for treatment. Treat the patient and not the disease. Do not treat high blood pressure aggressively if the drugs make a patient dizzy to the point of falling.

The elderly constitute 8% of the Indian population and proper disease management and treatment is the responsibility of each and every medical professional

Secrecy and privacy in MCI Code of Ethics Regulations

Secrecy and privacy in MCI Code of Ethics Regulations Dr SS Agarwal and Dr KK Aggarwal Appendix 1: Declaration: At the time of registration, each applicant shall be given a copy of the following declaration by the Registrar concerned and the applicant shall read and agree to abide by the same: g. I will respect the secrets which are confined in me. Regulation 7.14 The registered medical practitioner shall not disclose the secrets of a patient that have been learnt in the exercise of his / her profession except – 1. in a court of law under orders of the Presiding Judge; 2. in circumstances where there is a serious and identified risk to a specific person and / or community; and 3. notifiable diseases. In case of communicable / notifiable diseases, concerned public health authorities should be informed immediately. Regulation 2.2 Patience, Delicacy and Secrecy: Patience and delicacy should characterize the physician. Confidences concerning individual or domestic life entrusted by patients to a physician and defects in the disposition or character of patients observed during

IMA Polio Dates

IMA Polio Dates

·              April 1^st: tOPV would not be available after this date.

·             April 11^th: bOPV would be available in private market but it is not to be opened or used before 25^th April.

·             April 25 is IMA Polio Switch Day, when tOPV would be completely withdrawn and replaced by bOPV in both routine immunization and polio campaigns.

·             9^th May is IMA National Validation Day when India would be declared free of tOPV.       

        

      Dr S S Agarwal and Dr KK Aggarwal

The IMA Polio Vaccine Switch Awareness Campaign

The IMA Polio Vaccine Switch Awareness Campaign

Dear Colleague

A lot of progress has been made in the global efforts in achieving a polio-free world. The remaining two polio endemic countries are Afghanistan and Pakistan. But more needs to be done before polio can be eradicated from the world.

Replacing trivalent OPV with bivalent OPV is a significant step in polio eradication. The currently used OPV contains all thee polio serotypes - type 1, 2 and 3 and its use has led to the eradication of wild poliovirus type 2. The switch from tOPV to bOPV removes the type 2 component (OPV2) from the vaccine. April being the ‘low’ season for poliovirus transmission in many countries with endemic polio or recent polio cases has been chosen as the target date for the switch to bOPV in all OPV using countries. The switch from trivalent to bivalent vaccine has to be globally synchronized to minimize the risk of new cVDPV type 2 emergence.

India has been polio-free for five years and the government also plans to switch to bOPV as part of the global polio eradication initiative.

April 25, 2016 has been designated as the National Switch Day, when tOPV would be completely withdrawn and replaced by bOPV in both routine immunization and polio campaigns. And, the country would be declared free of tOPV on 9th May, 2016, National Validation Day. tOPV would not be available after 1st April 2016. bOPV would be made available two weeks before the switch date in private market. But, it is not to be opened or used before the switch date.

We request all our members to join hands with the government in its efforts for global eradication of polio and support this initiative.

Please share this information with all your colleagues so that every member of the fraternity is aware of this very important information.

Let us work together to make our world, a polio-free world…

Dr SS Agarwal                                                                                       Dr KK Aggarwal

IMA appeals for release of surgeon imprisoned in Egypt

IMA appeals for release of surgeon imprisoned in Egypt

New Delhi, January 19, 2015: Egyptians authorities have jailed and reportedly tortured an Egyptian vascular surgeon, Dr. Ahmed Said, alongside four others, claiming his involvement in protests that took place four years ago.

This has been widely criticized by the international medical community, and would set a dangerous precedent if not dealt with immediately. As a global voice of doctors, the World Medical Association (WMA) has strongly protested this and called for the immediate release of the doctor.

As reported by the WMA the only evidence against the ‘offenders’ was the report of a single National Security officer. ‘The World Medical Association would like to recall that the freedom of expression is a fundamental human right. Egypt ratified the International Covenant on Civil and Political Rights in 1982, hereby establishing its consent to be bound by the provisions of the Covenant.

Speaking about this, Dr. SS Agarwal – National President IMA and Padma Shri Awardee, Dr KK Aggarwal – Honorary Secretary General IMA and President HCFI in a joint statement said, “The Indian Medical Association (IMA), the largest organization of doctors in India, stands in solidarity with WMA in this cause and strongly condones this act by the Egyptian authorities. IMA demands the release of the Dr Ahmed Said and others on account of basic human rights.

We would like to emphasize in particular the Article 19 (2) of the Covenant providing that “Everyone shall have the right to freedom of expression; this right shall include freedom to seek, receive and impart information and ideas of all kinds, regardless of frontiers, either orally, in writing or in print, in the form of art, or through any other media of his choice,”’ said Sir Michael Marmot WMA President.