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Morning Medtalks with Dr KK Aggarwal

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Dr K K Aggarwal    17 April 2018

Malaria eradication by 2030. Will it happen? Is a million-dollar question. We need to see this with out of box thinking. Malaria is eradicable as Sri Lanka and China have done it. All eradicable diseases should be strictly notifiable with accountability, have one National treatment protocol, one prize for the drugs available in private sector and capping of investigations. All admissions should be free or paid by the government in the private sector on a fixed national prize. Three should be no different treatments in different systems of medicine. Under section 23 of the schedule K the government can make a uniform protocol for treatment.

Can auto-immune diseases be due to Epstein-Barr virus. The virus has been associated with subsequent development of systemic lupus erythematosus and other chronic autoimmune illnesses. A novel computational method shows that a viral protein found in EBV-infected human cells may activate genes associated with increased risk for autoimmunity. Scientists supported by the National Institute of Allergy and Infectious Diseases report their findings in Nature Genetics.

Following head injury, the meninges may get a little help from immune cells that spring into action to assist with repairs. In a new study, scientists from the NIH watched in real-time as different immune cells took on carefully timed jobs to fix the damaged lining of meninges, in mice. These results may help provide clues to the discovery that the meninges in humans may heal following mild traumatic brain injury (mTBI) and why additional hits to the head can be so devastating.

Genetically modified broadly neutralizing antibodies (bNAbs) protected rhesus macaques from an HIV-like virus as per NIH. After introducing genetic mutations into two potent HIV bNAbs, researchers prepared intravenous infusions of two bNAbs known as 3BNC117-LS and 10-1074-LS. Single infusions of each modified bNAb protected two groups of six monkeys each against weekly exposures to simian-human immunodeficiency virus (SHIV) for up to 37 weeks, compared with a median of three weeks in 12 monkeys receiving no antibody. SHIV is a manmade virus commonly used in HIV nonhuman primate studies.

Trade margins charged by drug stockists and chemists must be capped as per NITI Aayog. At its meeting on 11 April in the Prime Minster’s Office, the think tank is said to have recommended a maximum trade margin of 24% on first point of sale (stockist, wholesaler, distributor or hospital) for scheduled drugs and 30% for non-scheduled drugs. Niti Aayog has also called for expanding the price control basket by adding more medicines, medical devices, consumables and vaccines, among others. It also proposed forming two panels—one for deciding essential medicines and the other one on affordable medicines and health products as reported in livemint.

A new ayurvedic drug for dengue is under development for two years under a joint initiative of the Ayush Ministry and ICMR and is likely to hit the market next year. If successful it will fall in whose domain Ayurveda or Modern Medicine or both.

Among the typhoidal organisms, S. typhi is the most common etiological agent followed by S. Paratyphi A. The ciprofloxacin susceptibility percentage was 15-18% only. Resistance in S. Paratyphi A is higher as compared to S. typhi. Fluoroquinolone resistance was associated with DNA gyrase mutations. So, it is no longer empirical choice. Third generation cephalosporin’s are most commonly used for the treatment. But MIC50 and MIC 90 showed increasing trend. [ICMR surveillance data from January 2017 to December 2017]

Delhi has more pollution due to PM1, which is directly linked to heart disease and polluting vehicles.

Maximum temperatures are likely to rise by 2-3°C over parts of northwest, West, Central & East India during next 3-4 days.

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

President HCFI

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