Morning Medtalks with Dr KK Aggarwal

1. Get up: IMA Mahapanchaayat Today: Cycle Jeep relly 8-930 am from IMA head quarters
2. Over 25000 doctors to join Maha Panchayat at Indira Gandhi Stadium
3. The European Commission has approved Alofisel for the treatment of complex perianal fistulas in adult patients with nonactive-to-mild luminal Crohns disease who have shown inadequate response to at least one conventional or biologic therapy
4. Alofisel (darvadstrocel; Takeda, TiGenix) is the first allogeneic stem cell therapy to receive central marketing authorization in Europe
5. Free Press Journal: The insecticide control department of the BMC will start fumigation programme at all 2605 under-construction sites of Mumbai to control mosquito menace. BMC will appoint volunteers. 
6. Dr, Jasjeet Kaur, Deputy Director Govemment of Haryana: Haryana has conducted highest 338 decoy operations through their informer scheme that has nabbed 77 people involved in the illegal practice of sex selection. 129 informers have been incentivized. Sex ratio at birth has improved from 817 in 2014 to 9l4 in 2017. l8 districts out of total 2l districts have crossed the 900 girls/ 1000 boys mark.
7. Shri. Raghuveer Singh, State Nodal Officer -PNDT Rajasthan: Total l0l decoy operations have been conducted. State of Rajasthan has been innovative in forming a dedicated police Bureau at the state level. To make the punishments more stringent for the violators state has also used related provisions of the Code of Criminal Procedure (CrPC) to complement the provisions of the PV-PNDT Act.
8. Dr. Gaurav Dahiya Mission Director Government of Gujarat: “we are facing challenges in regulating the bordering districts where cross border illegal practice of sex selection could be happening.”
9. Muscular dystrophy, covered under the GOI Disability Act, 1995, is a progressive neuromuscular genetic disorder where the muscles gradually lose their strength, leaving the patient completely immobile and  dependent on others for every day to day activities. There is as on date no know cure/ treatment.
10. ACE inhibitor should be stopped if high potassium levels cannot be controlled or the serum kidney creatinine levels rise more than 30% above the baseline value within the first six to eight weeks.
11. Dry cough is seen upto 20% patients given ACE inhibitors. Treatment consists of lowering the dose or stopping the drug. Re-administration of the drug is associated with a high rate of recurrent cough. 
12. Angioedema is a rare but potentially fatal complication of ACE inhibitors and ARBs. 
13. INH-monoresistant TB include: Daily rifampin, ethambutol, and pyrazinamide (with or without a fluoroquinolone) for six to nine months (or four months after culture conversion). In HIV-infected patients prolong therapy for an additional three months.
14. The government has announced an allocation of Rs10,000 crore for the governments ambitious health insurance programme.
15. University of Stanford spin-out PhysioWave has just received FDA clearance for its pulse wave velocity (PWV) cardiovascular analyzer scale, which measures the stiffness of the vessels transporting blood from the heart to the body.
16. Capping on Compensation: Compensation Formula in case of Clinical Trial in Rule 122 DAB of Drugs and Cosmetics Rules:  Compensation = BX (8 lac) F x R/ 99.37

F = Factor depending on the age of the subject as per Annexure 2 (based on Workmen Compensation Act) 100-228

R = Risk Factor

0.50 terminally ill patient (expected survival not more than (NMT) 6 months)

1.0 Patient with high risk (expected survival between 6 to 24 months) 

2.0 Patient with moderate risk 

3.0 Patient with mild risk

4.0 Healthy Volunteers or subject of no risk

Compensation amount will vary from a minimum of Rs.4 lacs to a maximum of Rs.48 lacs depending on the age of the deceased and the risk factor. [assuming factor 4 will not be applicable in diseased patients]

In case of patients whose expected mortality is 90 % or more within 30 days, a fixed amount of Rs. 2 lac should be given