Morning Medtalks with Dr KK Aggarwal


Dr KK Aggarwal    24 March 2018

  1. Your date with IMA today: Students Sansad at Indira Gandhi stadium 4PM onwards
  2. IMA Maha Panchayat tomorrow at 10 am – 2 PM Indira Gandhi stadium
  3. Antibiotics differ from almost every other class of drugs in one important and dangerous way: the more they are used, the less effective they become.
  4. The Trinamool Congress bagged four seats and the Congress got one in the Rajya Sabha polls from Bengal on Friday. Dr Santanu Sen prominent IMA leader emerged victorious in the vote count. Let us congratulate him.
  5. Dubbing the parliamentary standing committee report on the controversial National Medical Commission Bill as “worse than the bill itself”, the Indian Medical Association has threatened to go on a “warpath” if the contentious clauses are not removed from the proposed legislation. [Tyw New Indian Express]
  6. Indias largest body of doctors said on Friday it was preparing to intensify its opposition to the Narendra Modi governments bill for a new regulatory structure for medicine and its proposal to allow practitioners of alternative health-care systems to prescribe modern medicines. [Telegraph]
  7. A NIAID-led study found that a one-month antibiotic regimen to prevent active TB disease in people with latent TB infection was as safe and effective as the standard 9-month course in people living with HIV.
  8. A study carried out by the Indian Council of Medical Research (ICMR) showed that over 50% of female patients in India coming for IVF procedure have been reported to have genital tuberculosis.
  9. People with disabilities make up 15 percent of the world’s population. Half of those are over 60 years old, he said. Many of them don’t have the same opportunity as non-disabled people to socialize with their peers.
  10. In 2017, WHO classified antibiotics into three groups and issued guidance for how each class of drugs should be used to treat 21 of the most common infections. For example, the first of these groups consists of medicines that should always be available to patients, preferably by prescription. Amoxicillin, the preferred medicine for respiratory-tract infections in children, is in this group. The second tier includes carbapenems. And the third group, including colistin and other “last resort” antibiotics, are drugs that must be used sparingly and only for medical emergencies.
  11. New research published in BMJ links dipeptidyl peptidase-4 (DPP-4) inhibitors used to treat type 2 diabetes to an increased risk for inflammatory bowel disease
  12. India’s Red Line campaign –demands that prescription-only antibiotics be marked with a red line, to discourage the over-the-counter sale of antibiotics
  13. “Last resort” antibiotics should never be used as growth promoters in livestock farming,
  14. Today is world TB day: Globally, the incidence of TB has been declining at about 2% per year. But, this decline is not enough to achieve the first 2020 milestone of the End TB Strategy and the target of ending the TB epidemic by 2030 under the Sustainable Development Goals (SDG 3). TB cases have to decline by 4-5% to achieve this target.
  15. A normal chest X ray is possible even in active pulmonary TB. In one Canadian study of 518 patients with culture-proven pulmonary TB, 25 patients had normal chest X ray. CT scan is more sensitive than plain chest X ray for diagnosis, particularly for smaller lesions located in the apex of the lung. [Radiology 1993; 186:653.]
  16. Individuals who are on a gluten free diet are consuming more gluten than we actually imagined. Its not uncommon for them to be consuming on average a couple of hundred milligrams a day. Hidden gluten is ubiquitous in medications, food additives, seasonings, sauces, lipsticks and lip balms, fried foods and many other sources. [Reuters]
  17. Tooth loss in middle age is tied to a higher risk of cardiovascular disease, independent of traditional risk factors such as high blood pressure, poor diet, and diabetes. [Tulane University School of Public Health and Tropical Medicine in New Orleans]
  18. Culture First: First generation parenteral cephalosporins, including cefazolin, are active against most gram-positive cocci except for enterococci, oxacillin-resistant staphylococci, and penicillin-resistant pneumococci. They are also active against most strains of Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae.
  19. For patients who are actively dying from a terminal illness, CPR constitutes a non-beneficial or harmful and inappropriate medical treatment.
  20. The identification of individuals with a terminal illness who are actively dying (life expectancy measured in hours to days) may be straightforward at times, but also can be difficult.
  21. The clinical signs of impending death: Five of the signs that emerged mostly during the last three days of life had both high specificity ( >95 percent chance that the patient would not die within three days if the symptom was absent) were pulselessness of the radial artery, respiration with mandibular movement, decreased urine output, Cheyne-Stoke breathing and death rattle.
  22. Eight additional clinical bedside signs that were highly specific for impending death within three days were nonreactive pupils, decreased response to verbal stimuli, decreased response to visual stimuli, inability to close eyelids, drooping of the nasolabial fold, hyperextension of the neck, grunting of the vocal cords and upper gastrointestinal bleeding.
  23. In 2013 US FDA reported that olmesartan can produce a "sprue-like enteropathy" characterized by reversible severe chronic diarrhea and weight loss, occurring months to years after initiation of the drug. The corresponding number needed to harm was 12,550 treated to cause one additional case of severe enteropathy. Thus, patients starting olmesartan should be cautioned about the possibility of developing diarrhea and weight loss. The drug should be stopped if these symptoms occur and another cause is not found.
  24. Ramipril and telmisartan have similar rates of hyperkalemia, defined as a serum potassium greater than 5.5 mEq/L (3.3 and 3.4 percent), acute renal failure, defined as a doubling of the serum creatinine (1.9 and 2.0 percent), and syncope requiring drug discontinuation (0.2 percent with both drugs).
  25. Multiple studies have demonstrated that patients who are treated with both an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin II receptor blocker (ARB) are at higher risk for adverse effects.
  26. Saturday March 24th is being celebrated as “IMA NATIONAL TELEMEDICINE DAY”.

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