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Morning Medtalks with Dr KK Aggarwal

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Dr KK Aggarwal    23 February 2018

  1. According to Centre’s Integrated Disease Surveillance Programme released on February 11, Rajasthan reported 871 cases of flu, the highest in the country; of them 578 from Jaipur alone.
  2. Dear Dr. Aggarwal, It is very useful and interesting to read the Morning Medtalks. In today’s Medtalk there is an error in item no.7. It reads as: Serum sickness………..Characterised by fever, rash (usually urticarial)……..The rash in serum sickness is urticarial vasculitis not urticaria. Immunologically urticaria is Type 1 hypersensitivity phenomenon whereas Urticarial vasculitis is type 3. Clinically, urticaria will disappear in 24 hours whereas urticarial vasculitis will remain and leave behind post inflammatory hyperpigmentation. Hope to see the column continues. Regards. Prof. Criton
  3. In a retrospective cohort study of over 40,000 patients, patients who had surgery for hip fracture within 24 hours of admission had lower 30-day mortality than patients who had surgery more than 24 hours after admission [ JAMA 2017; 318:1994.].
  4. New guidelines from the Society of Critical Care Medicine/European Society of ICU Medicine (SCCM/ESICM)advise that methylprednisolone may be administered to patients with early (ie, <14 days) moderate to severe acute respiratory distress syndrome (ARDS)
  5. AMR: organisms that grow in rare amounts in cultures of noninvasively collected urine specimens are likely to represent contamination and be of little clinical significance.
  6. TB: Testing for Latent TB infection is warranted in long term care facilities to identify individuals who are at risk of new infection and to identify individuals at increased risk of reactivation due to associated conditions.
  7. Infection control: Patient bathing with chlorhexidine gluconate (an antiseptic agent with broad-spectrum activity against many organisms) has been demonstrated to reduce the rate of hospital-acquired bloodstream infections and the risk of colonization with drug-resistant organisms among patients in intensive care units and bone marrow transplant units [Arch Intern Med 2007; 167:2073.].
  8. Do you know that another word for stye is "hordeolum."
  9. Falls in hospital can be a compensable deficiency but not administrative negligence. The average rate of falls in the nursing home is estimated to be 1.5 falls per nursing home bed annually (range: 0.2 to 3.5 falls per bed annually) [Ann Intern Med 1994; 121:442.].
  10. There is no evidence to support the use of physical restraints to reduce falls in the nursing home or inpatient setting [J Am Geriatr Soc 2002; 50:90.].
  11. The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines changed the definition of hypertension in adults (now defined as a systolic pressure ≥130 mmHg and/or a diastolic pressure ≥80 mmHg). This has substantially changed the prevalence of hypertension among adults in the United States. According to NHANES data from 2011 to 2014, 46 percent of adults 18 years and older had hypertension.
  12. The incidence of SCD among young athletes is actually quite low, estimated to be between 1:50,000 and 1:100,000 young athletes per year. This rate is notably higher in older adults, closer to 1:7000 healthy adult athletes per year.
  13. Notice is hereby given for the Annual General Body Meeting of Cardiological Society of India Delhi branch to be held on 25th March 2018 at 12.30 P.M. Also find attached Minutes of the AGBM held on 25th march 2017 at Hotel Lee Meridien ,New Delhi.
  14. Many IMA - DNB doctors are being thrown out of medical colleges due to additional years of teaching experience in the name of Junior residency/senior residency. Govt and private medical colleges are reluctant to take DNBs. [Ramesh Ganesan ]]
  15. Next National AEFI Committee meeting will be held on 13th March 2018 (Tuesday) at New Delhi.
  16. A real-life structured weight management intervention in patients with diabetes can reduce weight in the medium term, result in improved glycaemic control with fewer medications, and may be more effective than pharmacological alternatives. [http://onlinelibrary.wiley.com/doi/10.1111/dom.13171/full
  17. Heavy drinking biggest risk factor for dementia: This study, published in the journal The Lancet Public Health, included only the most severe cases of alcohol use disorder — ones involving hospitalisation.
  18. Measurement of waist-thigh ratio can serve as a simple and cost-effective screening tool to identify people at a high risk of type 2 diabetes. a waist-thigh ratio (WTR) or WC (cms)/TC (cms) of 2.3 as a cut-off point, was a predictor of diabetes. diabetics had significantly greater waist circumference (WC) than non-diabetics. Also, diabetics had lesser thigh circumference (TC) than non-diabetics. The study titled -- Waiste-thigh Ratio: A Surrogate Marker for Type 2 Diabetes Mellitus in Asian North Indian Patients -- was published recently in the Indian Journal of Endocrinology and Metabolism.
  19. Leaving a sponge in the abdomen during surgery can be an error but not criminal negligence. In the United States, about a dozen sponges and other surgical instruments are left inside patients bodies every day, resulting in around 4,500 to 6,000 cases per year, according to the American Society of Anesthesiologists. Approximately 70% of the items left in patients bodies are sponges, according to a 2003 study in the New England Journal of Medicine. The remaining 30% are surgical instruments such as clamps and retractors.
  20. Kenya has officially been declared free of guinea worm disease.

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