1.Preliminary research suggests a possible association between consumption of sugar-sweetened beverages (SSBs) and higher disability in patients with multiple sclerosis. In a cross-sectional study, MS patients who reported drinking two cans of SSBs per day were far more likely to have severe disability than those who seldom consumed these drinks. (Elisa Meier-Gerdingh, MD, of St. Josef Hospital in Bochum, Germany)

2.Exposure to secondhand smoke is linked with the development of chronic kidney disease (CKD) among nonsmokers, according to a large cohort study published online today in the Clinical Journal of the American Society of Nephrology.

3.Crohns disease involves inflammation of the digestive tract. But new research into its causes is focusing on fungi commonly found on the skin.These microscopic fungi, called Malassezia restricta, are linked to dandruff. Theyre found in oily skin and scalp follicles, but they also end up in the gut. However, its not known how they get there or what they do.

Management of acute heart attack

1.ECG diagnosis should be done within 10 minutes of suspected heart attack

2.Activate heart attack network including cath lab

3.Single-call patient transfer protocols

4.In-field bypass of non-PCI centers

5.Minimize first contact to device time for patients who are treated with primary PCI

6.Minimise first contact to thrombolysis time for those who are treated with fibrinolysis and then transfer early to PCI enabled center

7.Written, updated heart attack management protocols

8.Audit treatment delays, reperfusion rates, and false activation rates

9.Maximum contact to device time of ≤120 minutes (ideal ≤90)

10.Consider fibrinolytic therapy if this timeline cannot be achieved.

11.Door-in–door-out time ≤30 minutes when transferring to another hospital

12.Fitts contact to needle time ≤30 minutes when fibrinolysis is considered

13.Routine rapid transfer to PCI centers after fibrinolysis, immediate PCI for patients with failed reperfusion, and routine angiography with or without PCI within 24 hours after successful fibrinolysis

14.When access to cardiac catheterization is available within 120 minutes of first contact do not go for fibrinolysis or a combination of fibrinolysis and glycoprotein inhibitor

15.In heart attacks with cardiogenic shock and multivessel disease, non-culprit lesion PCI is not recommended during primary PCI

16.Routine upfront thrombectomy is not recommended during primary PCI

17.Transradial access is better than transfemoral access in primary PCI provided it can be performed by an experienced radial operator.

18.The use of unfractionated heparin is recommended for procedural anticoagulation in primary PCI.

19.The use of bivalirudin is preferred over UFH or low molecular-weight heparin for procedural anticoagulation in primary PCI who have a history of heparin-induced thrombocytopenia or a very high risk of bleeding.

20.Fondaparinux is not recommended for procedural anticoagulation in primary PCI.

21.It is not recommended that IV or intracoronary GPI be routinely used for primary PCI.