The 5th ‘Dil Ka Darbar’ inaugurated

Inaugurating the day-long ‘Dil Ka Darbar’ organized by Heart Care Foundation of India in association with Department of AYUSH, Government of India, Health Department, Government of Delhi, MTNL, Central Bank of India and LIC, Dr. Ambrish Mithal, Chairman, Division of Endocrinology and Diabetes at Medanta, the Medicity said that women suffer more from diabetes as compared to men.  Therefore, women’s health should not be ignored. He further said that 85% of Indians are Vitamin D deficient and should take Vitamin D supplement and spend more time in sunlight.  Vegetarians in India should consume Vitamin B12 as their deficiency can cause multiple symptoms, he added. 

In his message Mr. S.Y. Quraishi, Former Chief Election Commissioner of India said that the best way to prevent heart disease is to exercise.  One can start with 1000 steps a day with an aim of walking 10000 steps every day.  This increment in steps can be gradual. 

Delivery the key note address, Padma Shri and Dr BC Roy National Awardee, Dr KK Aggarwal, President, Heart Care Foundation of India said that it is possible to reverse heart disease.  He said the first blood pressure check should be done at 4 years of age and the first lipid profile test in high risk patients should be done at age 7. 

An adult without risk factor if he or she can walk two kilometers and climb two flights of stairs or enjoy a sexual life without any discomfort or heaviness in the chest needs no further investigation.  He said the earliest test to know about heart disease is the thickness of the neck (carotid) artery wall. 

In a group statement, Sr. Cardiologists of the city, Dr. H.K. Chopra, President (Elect), Cardiological Society of India, Dr. Sumita Mishra, Pediatric Cardiologist said that sore throat and joint pain in children should not be ignored, especially if the sore throat is not associated with cough or sneezing as it can bite the heart and damage the valves, a condition called rheumatic heart disease. 

Doctors from other pathies, which included Dr. B.N. Sinha, Dr. Vishal Tripathi, Dr. Shashi Bala, Dr. Mini Mehta, Dr. Poonam Chiblani, Dr. Nirmaljeet Singh, Dr. S.N. Yadav, Dr. R.K. Tuli said that prevention of heart disease comes under the domain of all the pathies and one should come out with a protocol, which is common to all pathies. 

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 63400 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."

Heart disease is the most common cause of death and disability in urban women

Important differences between women and men in the presentation of heart disease make it more difficult to establish a diagnosis in women, said Padma Shri and Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India. He was addressing a press conference as a curtain raiser to the 5th Dil Ka Darbar to be held on Sunday, 29th September. The event is being organized by the Heart Care Foundation of India at Constitution Club of India in association with Ayush, Department of Health, Government of NCT Delhi, LIC, MTNL, Central Bank of India and GAIL.

Special Guests of Honour were Padma Shri & Rajiv Gandhi Khel Ratna Awardee Yogeshwar Dutt, a Bronze Medalist at the 2012 Summer Olympics in the  60kg Freestyle wrestling, Dronacharya Awardee Yashbir Singh (Wrestling coach) and Arjuna Awardee Dharmendra Dalal, a Bronze Medalist in in 120 Kg Greco-Roman style wrestling at the 2010 Commonwealth Games.

Dr KK Aggarwal said:

1.    Women generally present 10 years later than men and with greater risk   factor burden.

2.    Women are less likely than men to have typical angina.

3.    Women in the emergency department with new onset of chest pain are approached and diagnosed less aggressively than man.

4.  Women are more likely to present initially with chest pain than a more clearly defined event such as heart attack.

5. Symptoms of heart attack in women differ from those in men.

6.  Many cases of heart attack in women are unrecognized.

7.  In women, treadmill exercise has a higher false positive rate.

8.  Small vessel disease is more common in women than in men.

9.  Established risk factors in women are: Presence of history of heart blockages; age over 55 years; high LDL (bad) or low HDL (good) cholesterol, diabetes, smoking, high blood pressure, peripheral artery disease or family history of heart disease. 

10.  Risk factors, which are more potent in women than in men are: Smoking is associated  with 50% of all coronary events in women; diabetes confers more prognostic information in women than in men.

Prevention in Women

For all Women

·        Moderate intensity physical activity for at least 30 minutes and for 60 to 90 minutes for weight management on most days of the week.

·        Avoidance and cessation of cigarette smoking and passive smoking

·        Keep waist circumference less than 35 inches.

·        Take a heart-friendly diet.

·        Presence of high triglyceride levels.  One should add Omega 3 fatty acids to diet.

·        Control cholesterol level, high blood pressure and diabetes.

·        Women who smoke should avoid oral contraceptive pills.

·        Aspirin 80 mg in more than 65 years of age should be added
·        Treat underlying depression.

 Women at high risk

·  Aspirin 75 to 150 mg, as prevention

·  Control of blood pressure.

·  No use of anti oxidant vitamin supplement.

·  No use of folic acid support.

·  No Hormone Replacement Therapy.

·  Lowering of LDL cholesterol of less than 80.

Co-addressing the Press Conference, Mr GP Sinha GM (Mktg) MTNL said that the best gift we can give to our wives, mothers and sisters is an annual heart check up.  Dr NK Yadav, MHO, South Delhi, Medical Corporation; Dr. PK Sharma, MOH, NDMC; Dr NV Kamat, Director, Health Services, Delhi; and Sr representatives from Central Bank of India in a joint statement said that our concern in women should shift from breast cancer to heart awareness as the lifestyle adopted to prevent heart disease would also prevent breast cancer.

Dil Ka Darbar to be held on 29th September

Heart Care Foundation of India will be organizing a unique Dil Ka Darbar to earmark the World Heart Day on Sunday, 29^th September, 2013 at the Constitution Club of India Auditorium from 8am to 4pm. The Darbar will be a non-stop interaction between top cardiologists and cardiac surgeons of the city and heart patients, nurses and family physicians.

Addressing a press conference here, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that the very fact that in our mythological era, there is no mention of heart attack among the kings, it corroborates that heart disease is a recent phenomenon and a preventable lifestyle disorder.

Co-addressing the press conference, Dr. Smita Mishra, Sr. Pediatric Cardiologist said that heart disease amongst children is equally preventable.

Others who spoke on the occasion were Sh Deepak Chanduka, General Manager (Mkt.), MTNL Corporate Office, Dr. N V Kamath, and Dr. K S Baghotia from DHS and Sr. representatives from Central Bank of India.

Sore throat and join pains in children should not be ignored. An angry-looking throat in patients of cough should be immediately treated with an antibiotic to prevent rheumatic heart disease. If a child is diagnosed to have red angry looking throat, he or she should be referred to a pediatric cardiologist for opinion.

She also said that school health programs should pick up murmurs so that congenital heart diseases can also be detected in time.

About the Darbar, Dr. Aggarwal said over 500 heart patients, nurses and family physicians will interact non-stop with the top cardiologists of the city on subjects related to heart care. The focus of the discussions will be prevention of heart diseases in women and young men. A special discussion will be held on Sex and Heart Diseases.

Practical training will also be given to people on Hands-only Cardiopulmonary Resuscitation.

Dengue Update

This year the city is in the grip of dengue epidemic and the epidemic this year is a serious one.

 Facts about severe dengue

·      As per the WHO, dengue can be classified as dengue and severe dengue.

·      Severe dengue needs care and prevention of death.

·      Severe dengue is characterized by severe plasma leakage, shock, fluid accumulation with respiratory distress, severe hemorrhage, SGOT and SGPT levels more than 1000, impaired consciousness, severe involvement of heart and other organs.

·      Mild dengue can be with or without warning signals. The warning signals are:

o   Abdominal pain or tenderness

o   Persistent vomiting

o   Clinical fluid accumulation

o   Mucosal bleeding

o   Lethargy

o   Restlessness

o   Increased in PCV with rapid fall in platelet count

o  Liver enlarged more than 2 cm

 Remember the Formula of 20

·      If pulse rate increases by more than 20

·      If upper blood pressure falls by more than 20

·      If the difference between upper and lower blood pressure is less than 20

·      If platelet count is less than 20,000

·      If blood thickens by more than 20% by increase in PCV

 Presence of any of these features indicates need for hospitalization.

Dengue in patients with heart disease needs special attention. These patients need to be hospitalized and treated.

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 63400 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."

MTNL Perfect Health Mela to extend for over a month on the theme Disaster Management and Practice etiquette based medicine

This year’s MTNL Perfect Health Mela will have its activities extending over a month. Announcing this in a press conference, Padma Shri and Dr B C Roy National Awardee Dr. KK Aggarwal president Heart care foundation of India said that the activities will start on 29th September World Heart day with a Dil ka Darbar and end on 31st October with CPR 10 Utsav at DPS Mathura Road. The main traditional mela will be held at Constitution Club of India from 23-26th October which will have exhibitions, competitions entertainment, checkups and workshops about all aspects of health incorporating all pathies under one roof.

Co addressing the conference  Mr Vinod Kumar, GM Marketing MTNL, Delhi; Mr Deepak Chanduka, GM Marketing MTNL Corporate; Dr. N V Kamath, and Dr. K S Baghotia from DHS; Dr. N K Yadav MHO MCD South, Dr. Ramesh Kumar, CMO NDMC and Dr Shally Kamra, CMO, PNDT said that the mela will focus on disaster management and prevention.

Celebrity guest for the event Pandit Jwala Prasad a music legend released the dates and the theme. He said that music and entertainment when combined with health can be more healing. 

1st July doctors day

Sixty percent of people do not discuss their sexual behavior and performance with the doctor when they go for consultation

A survey of 452 people was conducted by Heart Care Foundation of India and eMedinewS on the occasion of Doctors Day. The objective of the survey was to assess the perception of doctor-patient relationship among the people. 

The survey included patients, social workers, RWAs, morning walkers, college students and government employees from Delhi.  Data was collected using a questionnaire, which the survey participants were asked to answer. 

Elaborating on the observations of the survey, Padma Shri & Dr. BC Roy National Awardee,
Dr. K K Aggarwal, President Heart Care Foundation of India said that the data came up with some interesting changing trends among the people with regard to doctor-patient relationship.

Sexual preferences, choices and behaviors

a. The survey revealed that only 42% had a family physician. 

b. When suffering from an illness 52% of the people would directly opt to visit a specialist and not a family physician, which is not a good trend.

c. The traditional concept of a ‘family physician’, who looked after all the health needs of a family regardless of his/her specialization, is now changing. Everybody should have a family physician for better patient care.

d. Even today, 60% people do not discuss their sexual behavior and performance with the doctor when they go for consultation. 

e. 80% of the ties doctors also do not ask them about their sexual preferences, behaviors and problems. 

f.  This brings them to seek help from sex quacks and advise from friends and neighborhood.

g. People are sexually active even at elderly age. The proportion of man reporting no sex is 20% at age 51-60 and 87.5% at age above 75.  In women, reporting no se is 100% after the age of seventy. 16.17% of men reported that they are facing erectile dysfunction and 17.64% are having premature ejaculation during sexual act.

h. It is customary in US medical schools to be taught, when taking a sexual history, to ask whether someone is sexually active, and if so, what are his sexual preferences?

i. The questions asked in the history include as a routine:

Sexual history: "Do you feel comfortable with your sexuality?"

Sexual preference:  "Are you sexually attracted to men, women, or both?" 

Sexual high risk behavior: Do you have multiple partners

Young vs old doctors

a. 57% of people check the credentials and qualifications of a doctor before visiting them for consultation. This is a new trend in the society. 

b. But, even today 63% of people put their faith in the capabilities of their doctor and not on their dress code. 

c. Only 37% felt that their doctors should be well dressed in a suit and tie. 

d. While 65% still feel that senior doctors with white hair can provide better patient care than their younger fashionable counterparts as they have more clinical experience. 

e.  100% said that if you cannot practice “ compassion based medicine” at least practice etiquette based medicine”

Patients want privacy

40% of people did not want doctors to be their friends on Facebook. New International guidelines also warn doctors not to be connected with their patients on face book. 

Doc, no smoking please

Eighty-one percent people reported being disturbed when they saw their doctors smoking in public and would not like to be treated by a doctor who smoked in front of them.

Write legibly

67% felt that their doctors should have legible handwriting and favored an electronic prescription instead.

Please provide affordable, quality and safe medical care

78% people felt that that medical profession is becoming commercialized today and should be made more affordable for a common man. 59% felt that doctors’ charging less fee is not their concern. But, 41% were of the opinion that doctors should charge less as their profession is a noble one.

Patients want doctors to spend more time with them

a. 49% people I the survey reported being satisfied with less 15 minutes of a doctor’s time; 26% wanted their doctor to spend more than 15 minutes with them and the rest wanted time till they were satisfied. 

b. Even today 44% percent doctors do not advise their patients about adult vaccination. This needs immediate attention.

c. 55% people reported that their blood pressure had never been checked in both arms.

d.49% people preferred to take a dietary advice from their doctor and not from a dietitian.

e. Forty-seven percent persons did not have any health insurance. 49% of the patients did not know that when they are hiring a room in a private hospital, the insurance covers only 1% of the sum amount ensured for the bed.

f.  52% of the people do not know that error of judgment or difference of opinion is not an act of negligence on the part of the doctor. 

g.  48% are unaware of the fact that a doctor is supposed to possess only an average degree of skill and knowledge and not the maximum degree of skill and knowledge when treating a patient. 

h. 30% still did not know that creating violence in the hospital premises is an offence.

Patient wants second opinion from the same doctor

1. 60% would get a second opinion from their regular doctor if they are not satisfied, while 40% would like to take another opinion from another doctor

2. 72% of people do not want doctors to treat them just on clinical grounds but prefer getting investigated first. When advised investigations, 57% would ask their doctor to suggest a lab, while the rest said that they would choose their own lab.

                 .

Patient etiquette

1. 46% people said that they preferred to call their doctor directly to fix an appointment and not the secretary. 

2. When calling for an appointment, 53% would choose to call on a mobile number and not the landline, whether the call is to the doctor or the secretary.

ABC of a good doctor

Where A is availability, B is behavior and C is capability.  95% of the people said that the will be satisfied if the doctors is available and has practices etiquette based medicine.

Etiquette based medicine

Remember Mnemonic AIEDT

A: Acknowledge

I: Introduce yourself

E: Explain about your plan

D: define the time spam of your plan

T thank the patient

Dil Ka Darbar inaugurated: Telecardiology a welcome advancement in today's era, Dr Ashok Walia

Dr Ashok Walia, Minister of Health Government of Delhi, in his message to the 4th Dil ka Darbar said that telecardiology should now become a part of the facilities in every hospital.

The Darbar was organized by Heart Care Foundation of India in association with Department of AYUSH and various Departments under Health Ministry, Government of Delhi on Sunday at Talkatora Stadium, New Delhi.

Messages were also received from many dignitaries.

Shri M. Veerapa Moily, Union Minister of Law said that non-governmental organizations should play an important role in healthcare of poor patients who are unable to meet hospital bills and consultation fees.

Shri Beni Prasad Verma, Union Minister of Steel, expressed confidence that this endeavor of the Foundation would provide a platform to thousand of heart patients to avail facilities like free checkups, etc.

Shri Bhoopinder Singh Hooda, Chief Minister of Haryana, said that priority of the government should be to provide free medicines to those people who cannot afford them. Shri Narendra Modi, Chief Minister, Gujarat said that changing lifestyle, stressful event and competitive environment are responsible for most heart diseases. Shri Lal Thanhawla, Chief Minister of Mizoram said that the time has come for the medical fraternity to educate general masses about healthy living.

Shri Akhilesh Yadav, Chief Minister Uttar Pradesh, said that the efforts of the Foundation to provide facilities of free check-ups to the heart patients and interaction with top cardiologists during the programme are highly commendable. 

The Chief Minister of Kerala, Mr. Oommen Chandy said that in our country where cases of heart ailments are on the rise, the activities of Heart Care Foundation of India are truly inspiring.

Shri Raj Kumar Chauhan, Minister of PWD, said that NGOs should come forward to organize free health checkup camps for the public. Prof. Kiran Walia, Minister of Social Welfare, Government of Delhi said that telecardiology consultations should also be used for free health checkup camps.   Shri Arvinder Singh Lovely, Minister of Education, Government of Delhi, said that heart awareness should be the priority of every individual.

Inaugurating the Darbar, Shri B Mandal, General Manager, Central Bank of India said that one should follow the laws of nature to prevent cardiac diseases. He said that wild animals do not get heart attack.

Presiding over the function, Shri AK Ganeriwala, IAS, Joint Secretary, AYUSH, said that the death prevention heart care is when you combine allopathy with other systems of medicines.

Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India, who is also the Vice President-Elect of National Indian Medical Association, said that everyone after the age of 30 should get their risk of getting heart attack in the next 10 years evaluated and take precautions if the risk is more than 10%. He also demonstrated and conducted a workshop on “How to revive a dead patient.” He said that within 10 minutes of death, it is possible to revive a dead person’s heart by following the formula of 10 i.e. within 10 minutes of death, for the next 10 minutes, one should compress the chest of the deceased person 100 times (10 x 10).

Guest of Honour, noted singer and composer Ms Shibani Kashyap, said that music is good for recovery of the heart patients. Chanting various sounds is similar to doing meditation.

Dr Ishwar VB Reddy, Director, Morarji Desai National Institute of Yoga, Dr Ramesh Babu Devalla, DG CHRS, Dr Surender Verma, DG, Dept. of Homeopathy in a joint statement said that blockages in the heart is lifestyle disorder and can be prevented utilizing all systems of medicines.

Dr PK Sharma, MOH NDMC and Dr NK Yadav, Director Health MCD

South in a joint statement said that one should not consume trans fats in diet and reduce amount of salt intake to prevent future heart diseases.

Shri Satish Upadhyay, Chairman, Standing Committee on Education, MCD South said that prevention of heart diseases should start right in school age.

Dr NV Kamath, DHS, Shri PK Jaggi, Head of Office Drug Controller Department of Government of Delhi said that one should believe in natural pharmacy and take medicines only when they are required. Others who were present were Hakim Javed-ul-Haq Director General Central Council for Research in Unani Medicine (CCRUM), Dr RK Manchanda, Director General, CCRH, Dr Surender Verma Dy. Director Dept.of ISM & Homeopathy, Dr PK Sharma Medical Officer Health NDMC, Dr NK Yadav Director (Health) MCD South, Director ISM & H, Govt. of NCT of Delhi and Dr NV Kamat Director Health Services.

Eminent faculty on the dais included : Dr RK Manchanda, Dr PK Sharma, Dr Rajesh Malhotra, Dr NK Bhatia, Dr. SV Tripathi, Dr HK Chopra, Dr Manju Gupta, Dr Anupam, Dr Praveen Chandra, Dr Subhash Manchanda, Dr Sameer Srivastava, Dr Yugal Mishra, Dr Praveen Bhatia, Dr Sujay Shad, Dr Neelam Mohan, Dr Ajit Saxena, Dr Saurabh Juneja, Dr BN Sinha, Dr RK Tuli, Dr ZS Mehrwal, Dr JC Katoch, Dr Ishwar V Basava Reddy and  Dr Ramesh Babu Devalla.

Over 2000 heart patients were given consultations and checkups.

A non-stop Interaction between Patients and Cardiologists

Addressing a press conference, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India, said that Heart Care Foundation of India in association with World Fellowship of Religions is organizing the 4th Dil Ka Darbar at Talkatora Stadium on Sunday, 23^rd September, 2012.

The Darbar will provide a unique opportunity for non-stop questions and answers between nurses, doctors, patients and cardiologists. The panel of doctors will include clinical cardiologists, preventive cardiologists, interventional cardiologists, cardiac surgeon, Ayurvedic cardiologists, Homeopathic cardiologists, naturopathy cardiologists and Yoga experts trained in cardiology. These experts will give a joint opinion for medical queries. Free cardiac consultations will be available on the spot. Cardiologists from Apollo Hospital will also be available on Telemedicine. People can avail concessional cardiac investigations and procedural facilities on the spot.

 Ministry of Health and Family Welfare, AYUSH Department will provide experts from Ayurveda, Homeopathy, Naturopathy and Yoga. Apart, eminent Ayush experts from private sector will also be available. Cardiologists and experts from other specialities from various hospitals will be participating as Allopathy experts. A few of them include Dr. Z.S. Meharwal, Dr. Rajesh Malhotra, Dr. N.K. Bhatia, Dr. S.V. Tripathi, Dr. H.K. Chopra, Dr. Manju Gupta, Dr. Anupam, Dr. Praveen Chandra, Dr. Subhash  Manchanda, Dr. Sameer  Srivastava, Dr. Yugal Mishra,  Dr. Praveen Bhatia, Dr. Sujay Shad, Dr. Neelam  Mohan, Dr. Ajit Saxena, Dr. Saurabh Juneja, Dr. B.N. Sinha.

Dr N K Yadav, Director (Health) MCD South Zone, Prof. Manju Gupta, HOD Cardiac Surgery, Safdarjung Hospital and Dr. Deepak Khurana, HOD Cardiac Surgery, Max Heart & Vascular Centre, Patparganj in a joint statement said that a second opinion is also required as to when to intervene in patients with congenital and valvular heart disease. There may be situations when one needs to decide whether to go for angioplasty or bypass surgery. Replacement of aortic valve often requires a team opinion. Whether a patient needs a bare metal stent or a drug eluting stent too can be a matter of debate. The answer is - when in doubt go for a joint opinion and not for multiple opinions.

Ms Shibani Kashyap, noted singer, composer and celebrity said that when in doubt, one should go for second opinion either to the same doctor or for a joint opinion. The Darbar will be a unique opportunity to the people for the same. She further said that such concepts are unique and can provide forum for better patient-doctor understanding.