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Morning Round with Dr KK Aggarwal

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Dr KK Aggarwal    15 February 2018

The WHO says as many as 450 people may have been infected with Lassa fever in Nigeria in less than five weeks.

About Lassa Fever : the fever with deafness in Nigerians

 

Why talk in India: Large number of patient from Nigeria come for treatment in India

Lassa fever is a viral hemorrhagic fever caused by Lassa virus

In West Africa; each year, there are approximately 300,000 cases and 5000 deaths.

The primary mode of transmission to humans is via exposure to infected Mastomys rodents (direct contact with urine or feces, inhalation of aerosolized rodent excretions).

Person-to-person transmission may occur after exposure to Lassa virus in the blood, urine, feces, or other bodily secretions of an infected individual.

Lassa fever infection is not spread through casual contact

Individuals with Lassa fever infection are not believed to be contagious prior to onset of symptoms.

The incubation period is one to three weeks.

Most (80 percent) have mild symptoms (low-grade fever, malaise, and headache).

The most common complication of Lassa fever is deafness, which occurs in up to one-third of patients and may develop in the setting of mild or severe illness.

Disease progresses in 20% cases with pharyngitis, cough, nausea, vomiting, diarrhea, myalgias, retrosternal chest pain, back pain, and abdominal pain.

Most recover after 8 to 10 days of symptoms.

Death usually occurs within two weeks.

1 percent of Lassa virus infections result in death

The diagnosis is suspected in individuals with fever, malaise, headache, pharyngitis, cough, nausea, vomiting, diarrhea, myalgia, chest pain, or hearing loss in the setting of relevant epidemiologic exposure.

The diagnosis of Lassa fever is usually established via serum enzyme-linked immunosorbent serologic assay, which can detect immunoglobulin (Ig)M and IgG antibodies and Lassa antigen.

Serum IgM is detectable 10 to 21 days after symptom onset; serum IgG is detectable approximately 21 days after symptom onset.

Treatment of Lassa fever involves intravenous ribavirin or oral ribavirin.

Clue: Platelet count low but always > 1 lac; Low TLC, fever with deafness, SGOT > SGPT >10:1, high amylase ( dengue like illness with negative serology.

 

News

  1. The antipsychotic, pimavanserin,  significantly improves psychosis symptoms in people with the condition, without the devastating side-effects of currently-used antipsychotics. The drug had an even greater benefit in those with the most severe psychotic symptoms.
  2. Antibiotics are now failing to work in a fifth of patients who suffer an infection following hospital surgery, according to the first major study investigating the crisis. The global research found that one in eight patients undergoing common procedures such as appendix removal developed an infection while recovering. Some 22 per cent of cases were found to be resistant to the antibiotics which should have protected them. The study, published by the Lancet, tracked more than 13,000 patients in 66 countries, including those in the UK, who were undergoing gastrointestinal surgery.
  3. Doctors recommend that new parents get 12 weeks off work, but even the top doctors teaching their future peers at America’s best medical schools are getting leave far short of their own profession’s guidelines.

 

Delhi health officials have threatened to fine or jail the actor Pierce Brosnan if he fails to explain why he appeared in adverts for a chewing mixture that sometimes includes tobacco. Brosnan appeared nearly 18 months ago in TV and newspaper ads for a brand of pan masala.

  1. Valentine and like days precautions for diabetics and obese people
  • Valentines and similar days poses a challenge in diabetics and obese individuals.
  • Most celebrate by gifting or eating chocolate or sweets after the dinner.
  • Eating sweets can cause someone with diabetes to have their blood sugars spike, fall into a coma, and worsen their complications with the disease.
  • People with diabetes and or obesity can eat sugar free treats, but still need to be careful. Stevia is OK.
  • Read the amount of carbohydrates on the labels of the candy today and limit yourself to fifteen to twenty grams of carbohydrates if youre going to indulge in candy.
  • Chocolates with higher contents of cocoa solids and low amounts of sugar are okay in small quantities
  1. A  study found that people working irregular or rotating shifts with usual night shifts were 44 per cent more likely to have Type 2 diabetes. [Ceiine Vetter, Professor at the University of Colorado-Boulder.]
  2. A drink based on the trendy low carb diet favored by celebrities could help to control diabetes. Scientists at the University of British Columbia and Oxford University have shown for the first time that downing a keto supplement lowers blood sugar levels. The diet is high in fat and low in carbs.
  3. State lawmakers who care about the health of Washington youth need to vote to make it illegal to sell tobacco, either for smoking or vaping, to anyone under 21.
  4. The proposal of Medical Council of India (MCI) to amend the Screening Test Regulations, 2002, making it mandatory to qualify NEET to pursue foreign medical course has been approved by this Ministry
  5. Observing that "unwarranted" cesarean sections were harmful to the mother and the baby and a violation of their fundamental rights, the Delhi High Court today asked the AAP government about the steps it has taken to curb this practice by certain hospitals.
  6. The National Company Law Tribunal (NCLT) has approved the scheme of amalgamation of Dr Naresh Trehan & Associates Health Services Pvt Ltd into Global Health Pvt Ltd.
  7. Fortis Healthcare got a second downgrade of its loans within a week, this time from Care Ratings, which lowered ratings on borrowings worth Rs 853 crore.
  8. Fortis Healthcare has signed a definitive agreement to acquire the entire portfolio of assets of RHT Health Trust listed in Singapore.

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