Morning Medtalks with Dr KK

1. An echocardiographic substudy of the COAPT trial failed to identify any baseline echo characteristics to differentiate patients with heart failure (HF) and secondary mitral regurgitation (MR) that would or would not benefit from the MitraClip (Abbott).
2. The US Food and Drug Administration (FDA) has issued a safety alertregarding cybersecurity vulnerabilities in telemetry systems in certain Medtronic lines of CareLink programmers and monitors used with many of its defibrillator implant systems.
3. Amid an ongoing series of tainted sartan drug recalls, the US Food and Drug Administration (FDA) announced Wednesday that it will not object to temporary distribution of losartan that contains the impurity N-Nitroso-N-methyl-4-aminobutyric acid (NMBA) above the interim acceptable intake limit of 0.96 parts per million (ppm) and below 9.82 ppm until it can be eliminated.
4. Immediate coronary angiography may offer no survival advantage over a delayed-angiography approach in adults resuscitated but unconscious after out-of-hospital cardiac arrest with no sign of ST-segment elevation myocardial infarction (STEMI), suggests a randomized trial with more than 500 patients. Survival at 90 days, the Coronary Angiography After Cardiac Arrest Trial (COACT) primary end point, was similar at about 66% in both the immediate- and delayed-cath groups.
5. Longer-term follow-up of stabilized patients with infective endocarditis in the left side of the heart shows no delayed treatment failure with a change from intravenous to early oral antibiotic treatment, sparing them weeks of in-hospital treatment. The results, a post hoc exploratory analysis of the POET trial, were presented here at the ACC 2019 Scientific Session (ACC.19), and published online March 17 as Correspondence in the New England Journal of Medicine.
6. Tramadol (multiple brands) was associated with significantly higher all-cause mortality compared with nonsteroidal anti-inflammatory drugs among older patients with osteoarthritis in an observational study of more than 88,000 patients. The mortality risk with tramadol was similar to that associated with codeine. [Chao Zeng, MD, PhD, from the Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China in JAMA].

Dated: 25th March, 2019

Current Temperature Status and Warning for next 24 hours

Heat Wave and Temperatures Observed Yesterday (Past 24 hours from 0830 hrs IST of 24th March to 0830 hrs IST of 25th March, 2019)

Heat Wave:

.Yesterday, No heat wave conditions were observed.

Maximum Temperatures Recorded at 1730 Hours IST of 24th March, 2019:

• Maximum Temperature more than 40.0°C was recorded at a few places over Rayalaseema and at isolated pockets over East Madhya Pradesh, Vidarbha, Madhya Maharashtra, Marathwada, North Interior Karnataka, Tamilnadu and Kerala. (Annexure-1).
• Maximum temperature departures as on 24-03-2019: Maximum temperatures were markedly above normal (5.1°C or more) at isolated places over Saurashtra & Kutch; appreciably above normal (3.1°C to 5.0°C) at many places over Uttarakhand and at isolated places over Himachal Pradesh & Konkan & Goa; above normal (1.6°C to 3.0°C) at most places over Madhya Maharashtra, Marathwada, Interior Karnataka, Rayalaseema and Kerala; at many places over East Rajasthan, West Madhya Pradesh and Tamilnadu & Puducherry; at a few places over Gujarat Region & Vidarbha; at isolated places over Jammu & Kashmir, Haryana, Chandigarh & Delhi, Telangana, Odisha, Gangetic West Bengal and Andaman & Nicobar Islands. They were below normal (-1.6°C to - 3.0°C) at isolated places over Punjab, East Madhya Pradesh and Assam & Meghalaya and near normal over rest parts of the country (Annexure-2).

Yesterday, the highest maximum temperature of 41.5°C was recorded at Gulbarga (North Interior Karnataka) over the country.

Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 25th to 0830 hrs IST of 26th March 2019):-

NIL