Medical Voice 18th February 2019 |
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Medical Voice 18th February 2019
Dr KK Aggarwal,  17 February 2019
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Not getting sleep, try this?

Sleep restriction

Do not spend a lot of time in bed with the hope of falling asleep.

Less time in bed helps you to sleep better

Make the bedroom a welcome sight instead of a torture chamber.


Use the bed only for sleeping or sex

go to bed only when youre sleepy.​​​​​​​

If youre unable to sleep, move to another room and do something relaxing. Stay up until you are sleepy, and then return to bed.

If sleep does not follow quickly, repeat.

Relaxation techniques

Meditation, breathing exercises, progressive muscle relaxation, and biofeedback — can help you sleep better.

Cognitive behavioral therapy

CBT for insomnia aims to change the negative thoughts and beliefs about sleep into positive ones.

People with insomnia tend to become preoccupied with sleep and apprehensive about the consequences of poor sleep.

This worry makes relaxing and falling asleep nearly impossible.

Set realistic goals and learn to let go of inaccurate thoughts that can interfere with sleep

Do 3 minutes free emotions writing exercise (Harvard)


Hon’ble SC: No loudspeaker, says children’s studies more important than rallies

On 11th Feb the Hon’ble Bench of Chief Justice Ranjan Gogoi and Hon’ble Mr. Justice Sanjiv Khanna, dismissed a petition filed by West Bengal BJP challenging order of the State Pollution Control Board banning the use of loudspeakers in the residential areas and near educational institutions.

The court while dismissing the  challenge asked “You are challenging an order of 2013?”. He also pointed out “the children are writing their exams around this time”.

The petitioner said said it violates the party’s right to garner public support and is an infringement on the right to free speech.

The petitioner said that checking noise pollution especially at the time when exams are to be held in the state appears to be within legitimate purpose however a blanket ban on the use of microphones near residential areas or educational institutions virtually results in a complete ban.




Stroke Prediabetic Patients: Give Pioglitazone

The insulin-sensitizing drug pioglitazone was found to be effective for secondary prevention in pre-diabetic stroke patients according to a post hoc analysis of the IRIS randomized clinical trial published in JAMA Neurology. Over a median of 4.8 years the drug reduced a composite outcome of stroke and myocardial infarction by 40%, stroke alone by 33%, and new-onset diabetes by 80%.

These associations were greater than the ones found in the full IRIS trial cohort and occurred despite a high proportion of men and smokers, those with high diastolic blood pressures, and low high-density lipoprotein (HDL) cholesterol levels in this subgroup.

The IRIS trial, a study of 3,876 recent stroke or transient ischemic attack (TIA) patients with insulin resistance, reported in 2016 that pioglitazone reduced recurrent stroke or myocardial infarction by about one-fourth compared with placebo but raised the risk of weight gain, edema, and fractures.

Patients were randomized to 15 mg of pioglitazone, with dose titrated to a target of 45 mg daily, or matching placebo.

Prediabetes was defined by American Diabetes Association criteria of hemoglobin A1c of 5.7% to 6.4%, or fasting plasma glucose of 100 to 125 mg/dL

Pioglitazone still carries a fear of adverse effects including bladder cancer and heart failure.

FDA confirmed a possible link between bladder cancer and pioglitazone in 2016, though a 2017 meta-analysis found no evidence of increased risk of heart failure with the drug. In IRIS, patients with heart failure or bladder cancer were excluded.

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