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Medical Voice 3rd October 2019

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Dr KK Aggarwal    03 October 2019

NutriRECS guideline says consuming red and processed meat at current levels is safe

Consuming red and processed meat at current levels is safe, according to guidelines published in the Annals of Internal Medicine. The NutriRECS (Nutritional Recommendations) guideline is based on four systematic reviews that addressed the health effects associated with red meat and processed meat consumption, and 1 systematic review, which addressed peoples health-related values and preferences regarding meat consumption. The panel suggested that adults continue current unprocessed red meat consumption(weak recommendation, low-certainty evidence). Similarly, the panel suggestsadults continue current processed meat consumption (weak recommendation, low-certainty evidence).

But critics are already up in arms. A spokesperson for the American Cancer Society (ACS) likens the new advice to saying its safe to ride a bike without a helmet, despite clear evidence of the risk. The conclusion runs counter to established US guidelines that recommend just one weekly serving of red and processed meat… (Annals of Internal Medicine, Oct. 1, 2019; Medscape)

Ranitidine Recall: Time to know that other drugs do not have NDMA

On September 13, 2019, the US FDA announced that preliminary tests found low levels of N-nitrosodimethylamine (NDMA) in ranitidine, a heartburn medication. Novartis (through its generic division, Sandoz) and Apotex announced that they were recalling all of their generic ranitidine products sold in the US. GSK has also recalled its ranitidine medication sold in global markets including in India.

Ranitidine is an H2 (or histamine-2) blocker and is commonly used to relieve and prevent heartburn or to treat and prevent more serious ulcers in the stomach and intestines.

Health Canada, a federal department within the Canadian government, has asked all companies to stop distributing ranitidine drugs there, indicating that “current evidence suggests that NDMA may be present in ranitidine, regardless of the manufacturer......read more

First-time pregnancy complications linked to increased risk of future hypertension

(Excerpts from NIH): Women who experience complications such as preterm births and preeclampsia during their first pregnancy are nearly twice more likely than women without complications to develop high blood pressure later in life — some as quickly as three years later, according to a new study of more than 4,000 women. The study was published in the Journal of the American Heart Association. It was funded largely by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health

The researchers obtained detailed medical histories of the women 2-7 years after their first pregnancy to see if outcomes in their first pregnancies were associated with their cardiovascular health; 31% of the women with at least one adverse outcome during their first pregnancy experienced chronic hypertension, while only 17% of those who did not experience complications developed this condition. The risk of developing chronic hypertension grew even higher with additional adverse outcomes.....read more

Do Your Duty with Discipline and Devotion

“Vasudhaiva kutumbakam” (the whole world is one family) and “Ekam Sat Viprah Bahudavanti” (truth is one but the wise call it by various names) are two basic statements, which come from the ancient Rig Veda and form the fundamentals of Vedic philosophy.

One should do one’s duty with devotion and discipline. This principle can be remembered as the principle of three Ds. ....read more

Healthcare News Monitor

 

Robotic surgery adoption in India linked to cost: Experts

ET Healthworld- IANS

Mumbai: Robotic-assisted surgery has much better postoperative outcomes, but its widespread adoption depends a lot on the reduction in the cost of the equipment, say experts. While the high cost of a robot, which may range between Rs 6-14 crore approximately, may prevent many hospitals from bringing these advanced technologies for the benefit of patients, training of doctors in carrying out these procedures is equally important. The US based-Vattikuti Foundation has helped prepare 300 robotic surgeons in India since 2011 by bringing in nearly 150 internationally acclaimed experts in the area to hold master classes, performing and observing live robotic surgeries in eight specialities. "India has over 300 trained robotic surgeons in eight specialities -- gastrointestinal, urology, oncology, head and neck, thoracic, gynaecology, general surgery and bariatric," Mahendra Bhandari, CEO, Vattikuti Foundation, told IANS.

Overkill of antibiotic drugs making liver cure difficult

ET Healthworld- Shimona Kanwar

Chandigarh: In a first-of-its kind global study published recently, doctors found a 34% overall prevalence of multidrug resistance (MDR) in cirrhosis (end-stage liver disease) patients, with the Indian figure being even a more alarming 73%, highlighting the abuse of strong antibiotics because of free availability over the counter. End-stage patients of liver disease developed resistance to antibiotics because of indiscriminate use. This resistance in cirrhosis patients means higher chances of new organ failure and higher hospital mortality than non-MDR bacteria cases. The study was done in 46 centres worldwide, including three in India—the Post Graduate Institute of Medical Education and Research (PGIMER) in Chandigarh, the Institute of Liver and Biliary Sciences in Delhi, and Srirama Chandra Bhanja Medical College and Hospital in Cuttack. Doctors enrolled 1,300 patients of cirrhosis in the study. Co-author Dr Virendra Singh said: “This study is important because it shows high prevalence of MDR bacteria in India. About 69% of the patients are men.” Alcohol is the most common cause of cirrhosis, followed by hepatitis-C viral infection. Doctors found MDR bacterial infections to be common in Indian centers, while quite low in North America (16% in the United States and 24% in Canada).

Jaipur: Mosquitoes breeding in your yard? Get ready to pay Rs 500

ET Healthworld - Sidhartha Dutta

JAIPUR: The health department and Jaipur Municipal Corporation have issued challans to 141 people in the city over the last one month for not taking steps to prevent breeding of mosquitoes in their homes. Following a rise in number of dengue cases in the city, the health department had decided to impose fine on people who failed to curb mosquito breeding at their homes. “We are identifying larvae breeding sites while conducing inspections in houses. We first serve them a notice. If they fail to obey the instruction, we issue challans,” said Dr Narrottam Sharma, chief medical health officer (Jaipur-I). He pointed out that the JMC has the power of issuing challans of Rs 500 against people who fail to take steps to prevent mosquito breeding. Health department officials conduct inspection of houses and they inform the JMC teams about habitual offenders. Intense surveys have been conducted in Vidhyadhar Nagar, Shastri Nagar and several areas in Walled City areas where vector-borne diseases played havoc last year. Also, the health department teams conducted inspections at Rajput hostel in Sindhi camp area which had reported cases of Zika last year.

Abbotts COAPT trial data shows MitraClip device is cost effective, increases life expectancy and improves quality of life

Pharmabiz

Abbott announced new analyses of the landmark COAPT Trial that show the companys MitraClip device is cost effective and is projected to increase both life-expectancy and quality of life compared to guideline-directed medical therapy (GDMT) alone in heart failure patients with secondary mitral regurgitation (MR), or a leaky mitral heart valve. The cost-effectiveness analysis also showed additional benefits of MitraClip, including decreased use of health resources after implantation. The data were presented during the late-breaking clinical trial session at the 31st Transcatheter Cardiovascular Therapeutics (TCT) annual scientific symposium of the Cardiovascular Research Foundation in San Francisco (September 25 - 29) and simultaneously published in the journal Circulation. In addition, a second late-breaking data presentation at TCT showed that over a longer-term follow-up period within the COAPT Trial, MitraClip continued to remain safe, with durable MR reduction, reduced hospitalization rates, and improved survival and quality of life compared to medical therapy alone. In tandem, the two late-breaking data sets provide strong evidence of MitraClips impact on treating secondary MR. Significant secondary MR has historically been difficult to manage, is associated with a poor prognosis, and can lead to reduced quality of life, recurrent hospitalizations and decreased survival.

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