Morning Medtalks With Dr KK

1. Photons can behave like magnetic dipoles at absolute zero temperatures. This is the new result from a quantum simulator put forward by physicists at the EPFL in Switzerland and Paris Diderot University in France. The theoretical study proves that simple photonics devices can be used to mimic the behaviour of complex materials under extreme conditions – experiments that are difficult to actually do in the laboratory.
2. HC refuses to hear plea on generic drugs: The Hindu: the Delhi High Court on Monday declined to entertain a petition seeking directions to the Centre and the Medical Council of India (MCI) to ensure that doctors prescribe generic medicines.
3. The Bombay High Court announced a judgement and ordered an institution to issue a diploma certificate to a woman without her husbands name. The woman divorced her husband and wanted to remove his name.
4. New evidence suggests that oxidative stress and DNA damage in sperm may contribute to repeated miscarriages in female partners, according to a small study presented here at ENDO 2019: The Endocrine Society Annual Meeting.

How long does a joint replacement last?

How long will my joint replacement last?

10 to 15 years on an average but in an individual rare complications requiring re-operation can occur soon after surgery; for others, a replaced joint can last two decades or more.

The subject is important to the person who is uncertain about whether joint replacement is worth pursuing. But in addition to whether to have surgery, these numbers can help people decide when to have it done. For example, a person in their 30s might be looking at two or more revisions. Some younger joint replacement surgery candidates have been advised to wait until symptoms are more severe in the hopes of reducing the need for multiple revisions in the future.

In February 2019, two large analyses were published in the medical journal Lancet regarding the longevity of replaced hips and knees, that included nearly 300,000 total knee replacements and more than 200,000 total hip replacements.

Nearly 60% of hip replacements lasted 25 years, 70% lasted 20 years, and almost 90% lasted 15 years.

Total knee replacements lasted even longer: 82% lasted 25 years, 90% lasted 20 years, and 93% lasted 15 years.

These estimates are quite a bit higher than prior ones and may reflect improvements in surgical technique and materials, general medical care around the time of surgery, or more aggressive mobilization and physical therapy that starts right after surgery.

These surgeries were performed in New Zealand, Australia, Denmark, Finland, Norway, and Sweden. The results might be different in the US or other countries.

Surgery is usually the last (and sometimes best) option

Tele nighshift ICUs

Hospitals can turn to telemedicine to fill physician gaps in nightshifts in intensive care units when a lack of subspecialists could mean the transfer of a patient to another hospital.

This model has efficiency benefits as per a study presented by Dr Mac McCormick President and chief executive officer of Eagle Telemedicine at the Society of Hospital Medicine 2019 Annual Meeting.

Remote physicians can provide backup for onsite nurse practitioners and physician assistants, saving money.

And specialists physicians can work for three or four places at the same time.

Tele-hospitalists can work from home offices and can be hired for a few hours or a whole shift. They have access to the electronic health record, admit patients, and order labs and tests.

When a doctor working remotely needs to see the patient, a telemedicine cart is wheeled into the room.

More than half of all hospitals in the United States use some form of telemedicine, according to the American Telemedicine Association.

Types of smokers

1. Light: < 10 cigarettes per day
2. Heavy: > 25 cigarettes a day
3. Intermittent or not daily smokers
4. Chippers: Very light smokers (< 5 cigarettes a day) who regularly use tobacco without developing dependence
5. Light and Intermittent Smokers: 1-39 cigarettes per week, or an average of 10 cigarettes per day or 1-4 grams of tobacco per day and have never smoked daily.
6. Low-level Smokers: < 20 cigarettes per day and < 1 pack per week
7. Low-rate smokers: < 5 cigarettes per day and never more than 10 cigarettes per day
8. Non-daily smokers: smoke < 7 days per week and may smoke < 3 packs per week
9. Occasional smokers: < 5 cigarettes per day and smoke < 3 times per week, usually dependent on circumstances such as partying or drinking or after meals
10. Social smokers” smoke < 5 cigarettes per day and < 7 days per week in last two years and have never exceeded that limit.17,19,20

Dated: 1st April, 2019

Seasonal Outlook for the Temperatures during April to June, 2019

• The April to June (AMJ) season average maximum temperatures are likely to be warmer than normal by 0.50C over most of the meteorological subdivisions from central India and some subdivisions from northwest India. Near normal maximum temperatures are likely in the remaining subdivisions.
• The seasonal average minimum & mean temperatures over West Rajasthan are likely to be above normal by more than 1.00C.
• Above normal heat wave conditions are likely in the core heat wave (HW) zone during the season (April to June).

Current Temperature Status and Warning for next five days

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 31 March to 0830 hrs IST 01 April, 2019)

Heat Wave:

Yesterday, heat wave conditions were observed at many places over East Madhya Pradesh and at isolated pockets over West Madhya Pradesh, Gujarat, Marathwada and Vidarbha (Annexure 1 & 2).

Maximum Temperature

Maximum temperatures were markedly above normal (5.1°C or more) at a few places over Himachal Pradesh, East Madhya Pradesh and at isolated places over Uttarakhand, Vidarbha, Marathwada and Chhattisgarh; appreciably above normal (3.1°C to 5.0°C) at many places over West Madhya Pradesh; at a few places over Jammu & Kashmir, Gujarat, Telangana, Rayalseema, South Andhra Pradesh, Tamil Nadu, Jharkhand and Bihar; at isolated places over East Uttar Pradesh, Madhya Maharashtra, Rajasthan and Kerala. They were above normal (1.6°C to 3.0°C) over some pockets of the rest of the country outside Northeastern states and adjoining east India. Yesterday, the highest maximum temperature of 43.5°C was recorded at Bir (Marathawada) over the country (Annexure 1 & 2).

Temperatures Recorded at 1430 Hours IST of Today, the 01st April, 2019

• Chandrapur (Vidarbha) recorded a maximum temperature of 42.6°C (Annexure 3).
• Temperatures recorded at 1430 hours IST of today have risen by 1-3°C at many places over Jammu & Kashmir and Assam & Meghalaya and one or two pockets of Punjab, West Rajasthan, Saurashtra & Kutch, Coastal Andhra Pradesh, Konkan & Goa and Gangetic West Bengal( Annexure 4).