Morning Medtalks with Dr KK

1. Cardiogenic shock survival rates jumped after FDA approval of the Impella percutaneous heart pump, Abiomeds quality assurance database showed. (Diagnostic and Interventional Cardiology)
2. Low adherence to oral anticoagulation in atrial fibrillation was highlighted along with growing evidence on the risk-benefit ratio of left atrial appendage occlusion in a review article in Mayo Clinic Proceedings.
3. Five risk factors in diabetes: elevated hemoglobin A1C, elevated LDL cholesterol, albuminuria, smoking, and elevated blood pressure.

When you should suspect C. auris?

• If the patient is from ICU or high-dependency area
• Transferred from another hospital after a long stay
• Multiple intervention & prior antifungal exposure in any patient
• If one identifies in a commercial system -Candida haemulonii, C. famata,C. guilliermondii, C. lusitaniae, C. parapsilosis, Rhodotorulaglutinis, Candida sake, Saccharomyces cerevisiae
• If the Candida appears to be resistant to fluconazole & high MIC to voriconazole Notification

Whenever there is a suspected or confirmed case of C. auris infection or C. auriscolonization in the hospital, the details should be notified toProf.ArunalokeChakrabarti, Professor and Head, Mycology Reference Laboratory, Department of Medical Microbiology, PGIMER, Chandigarh.

Toilet Training

The child should sit on the toilet shortly after a meal, for 5 to 10 minutes, two to three times per day.

Toilet sitting episodes should occur at the same time each day and be timed with a timer or stopwatch

The routine should be followed every day, particularly during times of transition (eg, holidays, vacations, or weekends

The childs adherence to the program should be encouraged with positive reinforcers rather than negative reinforcers (criticism or punishment).

For children whose feet do not touch the floor sitting on a regular toilet seat, it is helpful to use a stool for foot support.

A foot support that raises the knees above the level of the hips can help relax the pelvic floor, and is particularly helpful for a child who tends to withhold stool.