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Medical Voice 16th April 2019

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Dr KK Aggarwal    15 April 2019

Morning Medtalks with Dr KK

1.Researchers may be closing in on a way to check athletes while theyre alive for signs of a degenerative brain disease thats been linked to frequent head blows. Experimental scans found higher levels of an abnormal protein tied to the disease in a study of former National Football League players who were having mood and thinking problems.

2.Estimates from WHO indicate that globally, the number of people with depression exceeds 300 million in 2018. Depression is ranked by WHO as the single largest contributor to global disability (7.5 per cent).

3.Mayo Clinic Health System is comparing its Molecular Breast Imaging technology with the medical fields standard 3D imagings ability to detect potential tumors. MBI allows doctors to better see through the tissue of women with denser breasts.

4.The US Food and Drug Administration (FDA) has approved the humanized monoclonal antibody romosozumab for treatment of osteoporosis in postmenopausal women with a history of osteoporotic fracture or multiple risk factors for fracture, or those who have failed or are intolerant to other osteoporosis therapies.

Sleeping Pill Use Linked to Later Increase in BP Meds

The use of sleeping tablets by older hypertensive patients is linked to a subsequent increase in use of antihypertensive medications in a new study by José Banegas, MD, Universidad Autónoma de Madrid, Spain, explained to Medscape Medical News. The prospective cohort study was published online on March 25 in Geriatrics and Gerontology International.

The study involved 752 patients aged ≥60 years (average, 69 years; 49% men) participating in a seniors cohort. The patients were undergoing treatment for hypertension and were followed from 2008-2010 through 2012-2013. Results showed that the mean sleep duration was 6.9 hours per night. Poor sleep quality was reported by 37%, and 16.5% reported that they usually took sleeping pills. The mean number of antihypertensive drugs used was 1.8.

UTI is an infection in any part of your urinary system - kidneys, ureters, bladders and urethra. Most infections attack the lower urinary tract, which is the bladder and urethra. UTIs are caused due to microbes such as bacteria which take over the body’s defences in the urinary tract.

Some hypnotic agents may induce atropine-related parasympathetic inhibition and tachycardia, as well as hypertension, and others may increase sleep-disordered breathing, which may be associated with hypertension and, in particular, with nocturnal hypertension in older patients.

The 2016 European Society of Cardiology/European Atherosclerosis Society guidelines make the following recommendations

1.For patients at very high risk, the low density lipoprotein cholesterol hould be lowered to <70 mg/dL or a reduction of at least 50 percent if the baseline is between 70 and 135 mg/dL

2.Very high risk is defined as documented CVD, diabetes with target organ damage, or severe chronic kidney disease (CKD).

3.For patients at high risk, the LDL-C should be lowered to <100 mg/dL or a reduction of at least 50 percent if the baseline is between 100 and 200 mg/dL

4.High risk is defined as most people with diabetes or moderate CKD.

CAC score

In both men and women, CAC detected by CT is highly sensitive for the presence of ≥50 percent angiographic stenosis but only moderately specific, especially in individuals over 60 years of age

However, the absence of CAC is highly predictive of the absence of significant (greater than 50 percent) coronary artery stenosis.

CAC score and coronary plaque burden

  • 0 – No identifiable disease
  • 1 to 99 – Mild disease
  • 100 to 399 – Moderate disease
  • ≥400 – Severe disease

Dated: 15th April, 2019

Current Temperature Status and Warning for next 24 hours

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 14 th April to 0830 hrs IST of 15th April, 2019)

Heat Wave:

Yesterday’s Heat Wave conditions observed at isolated pockets over Madhya Pradesh. (Annexures 1 & 2).

Maximum Temperature

Maximum temperature more than 40.0°C was recorded at most places over Madhya Pradesh, Vidarbha, Marathwada and Telangana; at many places over Bihar, East Rajasthan, East Uttar Pradesh, Gujarat Region and Telangana; at a few places over Odisha, Jharkhand, West Rajasthan, Saurashtra & Kutch, Chhattisgarh, Andhra Pradesh and at isolated places over West Uttar Pradesh, Madhya Maharashtra, Chhattisgarh and Tamilnadu.

Maximum temperature departures as on 14-04-2019: Maximum temperatures were appreciably above normal (3.1°C to 5.0°C) at most places over Madhya Pradesh and Kerala; at many places over Vidarbha, Marathwada and Uttarakhand; at a few places over West Uttar Pradesh; at isolated places over Assam & Meghalaya; above normal (1.6°C to 3.0°C) at most places over Rajasthan, Gujarat region and Konkan & Goa; at many places over Saurashtra & Kutch, Madhya Maharashtra, South Interior Karnataka and Tamil Nadu & Puducherry; at a few places over Coastal Andhra Pradesh, Odisha, Bihar and Jharkhand; at isolated places over Chhattisgarh; below normal(-1.6°C to -3.0°C) at a few places over Jammu & Kashmir; at isolated places over Assam & Meghalaya and Gangetic West Bengal and near normal over rest parts of the country.

The highest maximum temperature of 45.5°C was recorded at Khargone (West Madhya Pradesh) over the country.

Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 14 th to 0830 hrs IST of 15th April 2019):-

Heat Wave conditions very likely to prevail in isolated pockets over Madhya Pradesh and Vidarbha.

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