Morning Medtalks with Dr KK Aggarwal


Dr KK Aggarwal    13 April 2018

As per WHO suspected Syria chemical attack has affected over 500 people: Over 500 people may have been affected by a suspected chemical attack last week on Syrias rebel-held town of Douma. The symptoms included respiratory failure, severe irritation of mucous membranes and disruption to the central nervous system. WHO said more than 70 people taking shelter in basements reportedly died in the attack, with 43 of those deaths related to exposure to toxic chemicals. Two health facilities were also affected. WHO demanded "immediate unhindered access to the area" and said it was on standby to provide assistance to those affected, as soon as access was granted.

Helicopters dropped barrel bombs filled with toxic gas on the last rebel-held town in Eastern Ghouta.

Chemical Weapons: Traditional chemical agents can be pulmonary agents (chlorine or phosgene), “blood” agents [CYANIDE COMPOUNDS], vesicants [BLISTER AGENTS], nerve agents, and the anticholinergic agent BZ). Chlorine is a yellow-green gas with a characteristic chlorine odour and Phosgene is a colourless gas or white cloud with odor of newly mown or musty hay, grass, or corn.

Signs of upper airway (central compartment) irritation are consistent with type I (hydrogen chloride or hydrogen fluoride) or combination (chlorine) pulmonary agent exposure. On the other-hand signs of pulmonary oedema (peripheral compartment) suggest type II pulmonary agent exposure (phosgene).

Post Bawa Garba case all doctors are conscious of early diagnosis of sepsis. Every hour delay in antibiotic therapy is associated with a 7% to 8% increase in mortality for those with septic shock.

Heart failure being linked to metabolic syndrome should have been associated with highj cancer risk. But a new analysis of long-term follow-up data from two physician cohorts found no association between heart failure and incident cancer [University of Pennsylvania, Philadelphia]

It is not necessary to call experts in every case of alleged negligence. When information is deemed sufficiently simple that a lay jury can understand the facts, there is a so-called "common knowledge" exception to the need for an expert. Particularly egregious errors, such as retained sponges and wrong-side surgery, are common knowledge cases. As a result, the plaintiffs case may be heard without an expert.

Why give blood when Hb is > 7 gm%. Ferric carboxymaltose can be given as 1000 mg of elemental iron over a 15-minute infusion. A second dose of 1000 mg can be given on a different day.

Never keep pre signed prescriptions. In US one physician lost his license and served time in jail for pre-signing prescriptions so that nurse practitioners at his clinic could refill medications on his days off. A physician assistant was sentenced to prison for filling in prescriptions that were pre-signed by his supervising physician.

Do you know that as a part of informed consent a doctor must answer truthfully, if asked, about the number of similar procedures or cases performed, and disclose success rates. He or she must disclose, even without inquiry, any financial conflict(s) of interest. He must advise patients of all personnel involved in their care and their respective roles, including residents, students, and equipment representatives.

A 34-year-old man competing in a chili pepper–eating contest experienced a sudden thunderclap headache after ingesting a single "Carolina Reaper," which is widely considered the worlds hottest chili pepper and is grown in North eastern states in India. CT angiography showed multifocal luminal narrowing in his left supraclinoid internal carotid artery, M1 segment of bilateral middle cerebral arteries, and P1 segments of bilateral posterior cerebral arteries — a finding consistent with vasospasm.

Here come the doctors who shames the medical profession. On Tuesday, Hyderabad High court rapped police authorities for failing to take action against a private nursing home in the city that has allegedly been performing illegal abortions. A video was shot by someone in a secretive manner and submitted to the Hyderabad High Court. The video so horrific that it shocked the court.

The US CDC says that fake marijuana likely contaminated with rat poison has killed three people in Illinois and caused severe bleeding in more than 100 others, including a few in four other states. The CDC has alerted doctors nationwide that patients with severe, unexplained bleeding may be additional cases. Symptoms include coughing up blood, blood in the urine, severe bloody noses, bleeding gums and internal bleeding. Fake marijuana, also called synthetic cannabinoids, contains man-made chemicals that produce a high similar to marijuana.

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

President HCFI

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