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Morning Medtalks with Dr KK Aggarwal 16th May 2018

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Dr KK Aggarwal    16 May 2018

Public Health

  1. US FDA is sounding the alarm on a possible EpiPen (epinephrine auto injector) shortage because of a manufacturing problem.
  2. All patients should be assessed clinically when transfusion is considered. If the patient is stable, transfusion may not be needed even when the Hb level is 7 to 8 g/dL.
  3. In most medical and surgical hospitalized hemodynamically stable ICU or non-ICU patients transfuse only to maintain Hb at >7 g/dLrather than a higher threshold.
  4. For patients with underlying cardiovascular disease, undergoing orthopedic surgery, or cardiac surgery, as well as ambulatory patients give blood transfusion to maintain the Hb at ≥7 to 8 g/dLrather than 10 g/dL.
  5. The world could eliminate industrially-produced trans fats by 2023, the World Health Organisation said unveiling a plan that it said would prevent 500,000 deaths per year from cardiovascular disease.

Clinical

  1. Blood transfusion should not be used a treatment for iron deficiency unless the individual has severe anaemia or hemodynamic instability.
  2. Administering intranasal esketamine plus an antidepressant is safe, effective, and well tolerated in adult patients with treatment-resistant depression a new phase 3 trial suggests.
  3. Patients with type 2 diabetes whose weight fluctuates appear to be at increased risk for cardiovascular (CV) events, such as stroke, myocardial infarction (MI), and death, compared with those whose weight remains stable, an analysis of previously published trial data suggests. (European Atherosclerosis Society (EAS) 2018 meeting)
  4. The annual "well-woman visit" should include an assessment of heart disease risk, according to the American Heart Association and American College of Obstetricians and Gynaecologists. Clinicians need to perform enhanced screening for cardiovascular disease and associated risk factors reported Haywood L. Brown, MD, immediate past president of ACOG, and colleagues in Circulation.

Legal

  1. The NCDRC, while dismissing an application, held that even if there exists an arbitration clause in an agreement and a complaint is made by the consumer in relation to efficiency of service, then the existence of an arbitration clause will not be a bar to the entertainment of the complaint by the redressal agency constituted under the Consumer Protection Act, since the remedy provided under the consumer act is in addition to provisions of any other law currently in force.
  2. In Scotland, health professionals suspected of killing patients as a result of negligence can be prosecuted for culpable homicide. This is equivalent to gross negligence manslaughter in England and Wales. Doctors should not be charged with culpable homicide over medical blunders if they did not intend to harm a patient. Professor David Galloway, president of the Royal College of Physicians and Surgeons Glasgow (RCPSG), said a "genuine blame free culture" in the NHS was in the best interest of both patients and medics because it would lead to a culture in which "lessons can be learned and patient safety enhanced".
  3. A PIL bearing Writ Petition (Civil) No. 337/2018 titled as "Siddharth Dalmia & Anr. versus Union of India & Others" has been filed and the same was listed for on 14.05.2018 before the Honble Supreme Court of India. 

The said PIL seeks Writ of Mandamus or any other appropriate Writ, order or direction under Article 32 of the Constitution of India, banning the Hospitals from compelling and forcing the patients and their attendants to mandatorily purchase medicines, medical devices and implants, and medical consumables from the Hospitals or hospital pharmacies only, and further declare and direct that the patients and their attendants shall be free and have the choice to purchase medicines, medical devices and implants and medical consumables from the vendor of their choice and the Hospitals cannot compel the patients their attendants to buy medicines, medical devices and implants and medical consumables from Hospitals or hospital pharmacy, and give appropriate directions to the Respondents ban the above malpractices and protect the interests of the buyers of the medicines, medical devices and implants and medical consumables.

Weather

  1. Heat Wave: Yesterday, heat Wave conditions were observed at one or two pockets over East Madhya Pradesh.
  2. Maximum Temperature Maximum temperatures were appreciable above normal (3.1°C to 5.0°C) at one or two pockets of East Madhya Pradesh; above normal (1.6°C to 3.0°C) at many parts of Uttarakhand; at some parts of Himachal Pradesh, Punjab, East Rajasthan, West Madhya Pradesh, Gujarat and Andaman & Nicobar Islands; at one or two pockets of Gangetic West Bengal, Odisha, Assam & Meghalaya, Konkan & Goa, Madhya Maharashtra and Coastal Karnataka. Yesterday, the Highest maximum temperature of 45.7°C was recorded at Nowgong (East Madhya Pradesh).
  3. Temperatures Recorded at 1430 Hours IST of Today, the 14th May, 2018 o Temperatures more than 40.0°C is observed at most parts of West Rajasthan and Vidarbha; at many parts of East Rajasthan, Madhya Pradesh and Marathwada; at some parts of Gujarat region and at one or two pockets of Punjab, Saurashtra & Kutch, Konkan & Goa, Madhya Maharashtra, Jharkhand and Telengana (Annexure 3). o Temperature recoded at 1430 hours of today have risen by 3-5°C at one or two pockets of Jammu & Kashmir, Himachal Pradesh, Chandigarh, Rayalaseema, Andhra Pradesh and Gangetic West Bengal; by 1-3°C at many parts of rest Himachal Pradesh, Telengana and Marathwada; at some parts of northeastern states and West Rajasthan and at one or two pockets of Vidarbha, Jharkhand, Konkan & Goa, Karnataka, Kerala, Chhattisgarh and Odisha.

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

President HCFI

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