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Medical Voice 31st July 2019

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Dr KK Aggarwal    31 July 2019

Antihistamines may benefit patients with idiopathic postprandial diarrhea

Some patients with idiopathic postprandial diarrhea may respond to treatment with antihistamines, suggests a recent case series published online July 3, 2019 in Annals of Allergy, Asthma & Immunology.

The case series describes five cases of idiopathic postprandial diarrhea associated with concurrent dermatographia and chronic urticaria in patients aged 26 to 63 years with a diarrhea duration of 8 weeks to 13 years. The diarrhea occurred consistently and exclusively after meals, absent identifiable specific food allergens or food intolerances, and was relieved by daily pre-treatment with H1 and H2 antagonists.

No improvement was seen with a lactose-free diet. Anti-tissue transglutaminase IgA (in four patients) for celiac disease, serum tryptase (in four patients), 24-hour urinary prostaglandin F2a (in three patients), and 24-hour urinary N-methylhistamine (in two patients) for mast cell activation syndrome (MCAS) were normal. After excluding underlying food allergy or intolerance, GI disease, or MCAS as the cause of postprandial diarrhea, all five patients received daily pretreatment with H1 and H2-antihistamines.

The researchers say, "The beneficial responses in these patients to H1 and H2 receptor blockers suggest that histamine released by GI mast cells is a key mediator of postprandial diarrhea. This syndrome should also be considered in the differential diagnosis of patients presenting with food intolerance after excluding food allergy and other gastrointestinal (GI) disorders."

(Source: Medscape)

Can a child be born with hypothyroidism ?

Congenital hypothyroidism occurs in approximately 1:2000 to 1:4000 newborns and is one of the most common preventable causes of intellectual disability (mental retardation).

Approximately 85 percent of permanent cases of congenital hypothyroidism are sporadic, and most of these are caused by thyroid dysgenesis. The remaining 15 percent are caused by one of the hereditary inborn errors of thyroid hormone synthesis or secretion, and may present during or after the neonatal period

Healthcare News Monitor

Lok Sabha passes Medical Commission Bill, Harsh Vardhan calls it major reform

ET Healthworld-ANI

New Delhi: The Lok Sabha on Monday passed a Bill that seeks to create National Medical Commission in place of Medical Council of India (MCI) with Health Minister Harsh Vardhan terming it as an "anti-vested interests Bill" which will be remembered as one of the greatest reforms brought by the Modi government. The National Medical Commission Bill, 2019, was passed following a division even as the minister had appealed for its unanimous passage. The Bill was passed with 260 members voting in its favour and 48 against it. The amendments moved by the Opposition were negatived. Congress members staged a walkout before the passage of the Bill. In his reply to points raised by Opposition members, Vardhan termed the Bill as "pro-public" and said it will help "move away from inspector raj". He said the Bill will help improve standards of medical education in the country and bring down costs. The minister referred to his own experience as a medical practitioner.

Dr Harsh Vardhan inaugurates advanced facilities at Safdarjung Hospital

Express Healthcare

Union Minister for Health and Family Welfare, Dr Harsh Vardhan recently inaugurated several advanced medical facilities for patients at the Safdarjung Hospital in New Delhi. The facilities include an advanced 3T MRI system - GE Healthcares 750W in the Radiology Department, a Geriatric OPD, a Cath Lab and a Lithotripsy Machine in the Urology department. This second MRI system comes with a host of advanced features like wide-bore system for helping patients who are claustrophobic, especially aiding in greater convenience for children and heavily-built people. A second feature is that it allows free-breathing body imaging which ensures high-quality images, especially for non-cooperative and pediatric patients. Thirdly, its advanced clinical applications, table ergonomics, flexible coils and feet-first imaging will improve patient comfort and drive positive clinical outcomes. The MRI system will be used for treating people with health conditions related to neurology, whole-body scans, cardiology, paediatric, musculoskeletal scans among others. This was a turnkey MRI project where GE Healthcare, in addition to the installation of the MRI, also undertook the complete interiors of the facility and enhanced user experience. The geriatrics OPD will be available every Sunday from 9:30 am to 12:30 pm. It will have specialities of medicine, general surgery, ENT, ophthalmology and orthopaedics.

Coronary artery disease on a rise in young Indians

The Statesman

There has been a rise in the incidence of coronary artery disease (CAD) in young Indians, according to recent statistics. Over 50% of cardiovascular disease mortality is seen to occur in individuals below 50 years of age, say experts. According to the ICMR State Level Disease Burden Report, among all age groups, the prevalence of heart disease has increased by over 50% from 1990 to 2016 in India, with an increase observed in every state. Heart disease contributed 17·8% of total deaths of total deaths. Thanks to a sedentary lifestyle and unhealthy habits, heart diseases are affecting young Indians 10 years ahead of their Western counterparts. A survey indicates that about 7% of patients between 25 and 40 years of age are found to be suffering from CAD - a condition that impacts the flow of blood to the heart. If the heart doesnt get adequate oxygen-rich blood then its condition starts deteriorating, putting a person at enhanced risk of heart attack.

Doctors, engineers develop novel medical devices in 30-hour operation

ET Healthworld- Sarfaraz Ahmed

NAGPUR: In a 36-hour non-stop hackathon, doctors and engineers from citys VNIT, IIT-Bombay and AIIMS Nagpur developed medical devices to solve a host of problems encountered by patients and professionals alike. The experts worked in teams with each having one doctor, one engineer, one electronics or electrical expert, and one mentor from VNIT/IIT Bombay/AIIMS, Nagpur. They proposed innovative solutions based on conceptual understanding, fabricated prototypes by working overnight during a two-day Medical Device Hackathon MEDHA-2019 held by GH Raisoni College of Engineering (GHRCE) at Hingna. The novel proof-of-concepts included pre-bed wetting indicator, computer-assisted VP shunt, dental cavity detection, damaged screw removal from bone, broken intramedullary nail removal, broken file retrieval system in root canal treatment, smartphone-based intra oral scanner, portable sonic scalar for tooth cleaning, mouth mirror with illumination and camera, early caries detection, digital calliper for intra oral bone width assessment, wearable low cost cardiac rhythm monitoring, T-scan bite force measurement, solution to heating effects in bone drilling, protection of doctors from x-ray beams in OT, customizable splints for trauma patients, internal compression packing and self-retaining catheter, and joint motion measurement.

Drug license holders urge health ministry to investigate illegal supply of malaria RDTs samples to manufacturers

Pharmabiz India - Shardul Nautiyal

The All Food And Drug Licence Holders Foundation (AFDLH), a pan-India body of distributors of Food and Drugs, has urged the Union Health Ministry to conduct investigation on illegal supply of malaria rapid diagnostic tests (RDT) samples to the manufacturers in the country. This is in view of the fact that National Institute of Biologicals (NIB) is the only sole authorised body in the country to supply the same in the interest of patient safety. The Foundation has questioned the quality and performance of malaria RDTs in view of the fact that data from NIB clearly reveals that samples are not sourced from NIB and hence is detrimental to patient safety. According to AFDLH, NIB list of buyers of the last three years of malaria positive samples clearly proves that companies that manufacture 90 per cent of malaria antigen kits are not the positive samples from NIB. "Submission have been made to the medical devices and diagnostics division of Central Drugs Standard Control Organization (CDSCO) and the same have been acknowledged. We have urged CDSCO to scrutinise claims made by manufacturers of malaria RDTs for accuracy in test results," according to Abhay Pandey, national president, AFDLHF. While malaria RDT is a user friendly screening test done by any individual in rural and urban settings to facilitate malaria control programmes and health services, microscope based test is a confirmatory test followed by the screening test recommended for actual treatment.

DPA asks govt to incorporate Pharm D professionals in NMC Bill to recognise them as community health providers

Pharmabiz India - A Raju

The members of the Doctor of Pharmacy Association (DPA) have demanded to the Central government to incorporate Doctor of Pharmacy (Pharm.D) professionals in the new National Medical Commission (NMC) Bill 2019, recognising them as community health providers. To this affect, Dr. Katam Sai Kumar, national president of DPA, has written a letter to the Union health minister Dr Harsh Vardhan seeking his intervention to amend the NMC Bill 2019 and urged him to incorporate Pharm D professionals in the new NMC bill recognising them as community health providers. Dr Kumar pointed to a reference in the NMC bill 2019, that NMC may grant a limited license to certain mid-level practitioners connected with the modern medical profession to practice medicine. These mid-level practitioners may prescribe specified medicines in primary and preventive healthcare. In other cases, these practitioners may only prescribe medicines under the supervision of a registered medical practitioner. Keeping this view, the DPA president said that Pharm.D profession is also in relation with modern system of medicine course, wherein the students undergo clinical pharmacy practice. "As part of the modern medical education, Doctor of Pharmacy professionals undergo clinical pharmacy practise and the course is a 6-year duration orientation programme after 10+2, which includes 5 years of Academic study and one year of Residency or Internship. The main intention of introducing this course by the Pharmacy Council of India was to produce clinically competent pharmacists to improve the patient care.

Medanta plans 1,000-bed hospitals in Gorakhpur, Varanasi, Allahabad

ET Healthworld-PTI

Lucknow: The Medanta group is planning to open 1,000-bed hospitals in Gorakhpur, Varanasi and Allahabad on the lines of the one being constructed in Lucknow. Speaking at the second ground breaking ceremony here, Medanta Group Chairman Naresh Trehan said, "The 1,000-bed hospital in Lucknow will be inaugurated on October 15. The group will also open similar hospitals in Gorakhpur, Varanasi and Allahabad." Referring to the hospital which is being constructed in Lucknow, Trehan said that treatment cost has been kept affordable so that more people could avail benefit. This hospital is likely to generate 6,000 direct jobs, and overall more than 13,000 jobs will be generated by the opening of this facility, he said. Trehan also said that the foundation of a 700-bed hospital in Noida has been laid on Sunday.

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