Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 31 th March, 2019

Morning Medtalks With Dr KK

New terms in aortic stenosis

1. Aortic valve replacement (AVR)

2. Transcatheter aortic valve implantation (TAVI)

3. Transcatheter AVR or TAVR

5. Mortality: Periprocedural mortality for TAVI 1.1 to 4.2 percent.

6. Conversion to open heart surgery due to TAVI complications is 1.4 percent

7. Mortality for cases that undergo emergency surgery due to cardiovascular complications carry a very poor prognosis: 45.8 percent mortality at 30 days

8. 30-day risk of stroke following TAVI in observational studies and clinical trials is 2 to 5 percent

9. Aortic valve sclerosis is defined as aortic valve thickening and calcification without a significant pressure gradient (defined as an aortic jet velocity <2 m/sec). AS is present when the antegrade velocity across an abnormal valve is at least 2 m/sec.

10. The average rate of increase in the mean systolic pressure gradient is 3 to 7 mmHg per year, but some patients showed an increase of as much as 15 to 19 mmHg per year.

11. Valve area decline at an average rate of 0.1 cm2 per year, but some patients have little or no progression and others progressed more rapidly.

12. Aortic jet velocity increases by an average of 0.3 m/sec per year, but this is also variable.

13. Patients with mild disease (aortic jet velocity less than 3.0 m/sec) are unlikely to develop symptoms due to AS over the ensuing five years.

14. A substantial number of patients with severe AS are not yet symptomatic, but most such patients have low event-free survival rates (56 to 63 percent at two years and 25 to 33 percent at four to five years)

15. Given the expected rate of AS progression, we suggest valve replacement for patients with moderate AS (stage B – moderate) who are undergoing other cardiac surgery.

Today's question

In my morning class today my colleague Charu asked me a question “how to make others happy”?

I will divide this answer into two aspects one is ‘happiness’ and second is ‘needs.

As far as happiness is concerned 45% of your happiness is based on your past experiences and 40% on our new experiences.

When we choose any action based on our past experiences, we cannot be unhappy. Similarly, when we choose a new adventure, we choose it with clear-cut understanding that it can end up with happiness or happiness. Then why worry.

Only 10% of our happiness is based on circumstances and situations which we cannot change and here comes the role of changing our interpretation and understanding stress management.

When it comes to making others happy, we need to understand the hierarchy of needs of the unhappy person.

At that moment he may be in deed of physical happiness, mental happiness, intellectual happiness, egoistic happiness or spiritual happiness.

You need to fulfil that person’s needs to make him or her happy but remember the principles of Dharma Artha Kama Moksha when acting.

Whatever we do to fulfil happiness of others we follow the principle of righteousness and inner happiness.

Childhood asthma can be prevented by keeping homes free of dust mites

The condition can even develop in children below 3 years

A new study has found that consuming a diet rich in omega-3 fatty acids is linked to fewer childhood asthma symptoms which are triggered by indoor air pollution. The study lays out that families and health care providers may be able to protect children from harmful effects of indoor air pollution by serving a diet rich in omega-3 fatty acids while reducing foods rich in omega-6 fatty acids such as soya bean oil and corn oil.

Omega-3 fatty acids, which are found abundantly in fish and certain nuts and seeds, are considered healthy as they are known to reduce inflammation. Omega-6 fatty acids, primarily found in vegetable oils (including corn, soybean, safflower, and sunflower), as came out in other studies, have mixed effects on health, but have the potential to promote inflammation.

Asthma is a disorder caused by inflammation in the airways (called bronchi) that lead to the lungs. This inflammation causes airways to tighten and narrow, which blocks air from flowing freely into the lungs, making it hard to breathe. There is no specific reason for the development of asthma in children. However, there are several triggers such as dust, air pollution, and exposure to secondhand smoke. Pediatric asthma is one of the major reasons for absenteeism from school. In most children, asthma develops before 5 years of age, and in more than half, asthma develops before 3 years of age.

Some symptoms of asthma in children include wheezing (whistling sound) when breathing, coughing, rapid and labored breathing, complaints of chest hurting, reduced energy, and feeling weak or tired.

Diagnosing asthma in children can be difficult and time-consuming. This is because of the pattern of symptoms. It is possible to prevent flare ups by making changes to the child’s diet as also avoiding exposure to environmental pollutants as far as possible. The goals of asthma therapy are to prevent children from having chronic and troublesome symptoms and reduce the need for emergency hospitalization.

Some tips from HCFI

•Prevent exposure to dust mites. These are tiny insects and one of the most common asthma triggers. They tend to live in beds, carpeting, upholstered furniture and soft toys. It is important to keep all these things dust free.

•Restrict the child’s contact with pets especially if he/she is allergic.

•Maintain a healthy weight and encourage good eating habits. Include plenty of fruits, vegetables and whole grains in their diet.

•Avoid exposure to smoke. Expectant mothers should quit smoking altogether as this is one of the major risk factors for development of asthma in children.

•Breastfeed your infant. This will increase immunity and help ward off potential complications.

Dated: 31 st March, 2019

Current Temperature Status and Warning for next 24 hours

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 30 March to 0830 hrs IST of 31 March, 2019)

Heat Wave:

Yesterday, heat wave conditions were observed at many places over Madhya Pradesh; some places over Vidarbha and in isolated pockets over south Haryana, Rajasthan, Madhya Maharashtra and Saurashtra. (Annexure 1 & 2).

Maximum Temperatures

Maximum Temperature more than 40.0°C was recorded at most places over Madhya Pradesh Marathwada, Vidarbha; at many places over Chhattisgarh, Telangana; at a few places over West Rajasthan, Saurashtra & Kutch, Gujarat region, Madhya Maharashtra, Rayalaseema and at isolated places over South Haryana, East Rajasthan, Uttar Pradesh, Odisha, North Interior Karnataka and Tamilnadu.

Maximum temperature departures as on 30-03-2019: Maximum temperatures were markedly above normal (5.1°C or more) at many places over Himachal Pradesh and Uttarakhand; at a few places over Jammu & Kashmir, Haryana, Chandigarh & Delhi, Rajasthan, Madhya Pradesh and Assam & Meghalaya; at isolated places over Vidarbha; appreciably above normal (3.1°C to 5.0°C) at most places over Marathwada; at many places over West Uttar Pradesh, Chhattisgarh Rayalaseema; at a few places over Nagaland, Manipur, Mizoram & Tripura, East Uttar Pradesh, Odisha, Gujarat, Madhya Maharashtra and Telangana; at isolated places over Jharkhand and North Interior Karnataka; above normal (1.6°C to 3.0°C) at a few places over Coastal & South Interior Karnataka, Kerala and Tamilnadu & Puducherry; at isolated places over Konkan & Goa. They were below normal (-1.6°C to -3.0°C) at a few places over Sub-Himalayan West Bengal & Sikkim and Andaman & Nicobar Islands and near normal over rest parts of the country.

The highest maximum temperature of 44.5°C was recorded at Khargone (West Madhya Pradesh) over the country. (Annexure 1).

Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 31 st to 0830 hrs IST of 01st April 2019):-

Heat wave conditions very likely at isolated pockets over Rajasthan, West Madhya Pradesh and Vidarbha. (Annexure 3)

Consent of both husband and wife is needed in an operation which may result in sterility

In the Allahabad High Court: Dr Neetu Rastogi vs Union of India and 4 Others; WP 4369 of 2017, dated 31/01/2017

Petition: The petitioner Dr Neetu Rastogi has filed this writ petition challenging the order dated 16.01.2017 passed by MCI holding the petitioner to be guilty of professional misconduct, and her name has been directed to be removed from the State Medical Register and Indian Medical Register for a period of one year....read more

"Any and all movements" improve heart health in older women

Even light physical activity such as gardening, strolling through a park, and folding clothes might be enough to significantly lower the risk of cardiovascular disease among women 63 and older. While the risk of stroke or heart failure is reduced by up to 22%, the risk of heart attack or coronary death, is reduced by as much as 42%.

In the five-year prospective study published March 15, 2019 in JAMA Network Open, researchers followed a racially and ethnically diverse group of 5,861 women aged 63 to 97 years to find out if higher amounts....read more


Do we get a human birth each time we die?