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Morning Medtalks with Dr KK Aggarwal 1st May

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Dr KK Aggarwal    01 May 2018

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Doctors are reluctant to discuss prognostic information because of concerns about a negative impact on the patient-doctor relationship, but accumulating evidence suggests that prognostic disclosure might improve patient satisfaction. ( J Clin Oncol 2018; 36:225.)

In WB dead animal’s meat is being sold mixed with fresh meat. As soon as carcasses of dead animals are thrown in the dumping ground, scavengers have been trained to skin theses dead animals and collect the meat which is sold to meat sellers. These animals may be cows, bulls, dogs, chickens, pigs or any. This meat is then put in formalin, treated with different chemicals. Twenty tons of dead meat has been found in deep fridge of one meat dealer. Police are searching other places also. Dr R D Dubey Kolkata

We can’t eat them as already dead animals will be carrying active diseases.

 

Clinical

Type 3 diabetes is a title or Alzheimers disease which results from resistance to insulin in the brain. Studies carried out by the research team at Warren Alpert Medical School at Brown University identified the possibility of a new form of diabetes after finding that insulin resistance can occur in the brain

Rat bite fever (RBF) is a rarely diagnosed, systemic illness caused by infection with Spirillum minus. S. minus is a tightly coiled spiral gram-negative rod. It can be identified by darkfield examination but cannot be cultured on artificial media. Infection can result from a bite or scratch from an infected or colonized rat, or from handling rats at home or the workplace (eg, laboratories or pet stores). The incubation period is 1-3 weeks. The management of patients with RBF includes local care of the wound in those reporting a bite and antibiotics. Penicillin is the treatment of choice, and prompt therapy can prevent severe complications. To prevent infection following a rat bite, a three-day course of oral penicillin V (adults: 500 mg four times per day; children: 25 to 50 mg/kg per day in three or four divided doses, maximum 2 grams per day) is reasonable.

Monkey bites account for 2–21% of animal bite injuries. In India for example, two studies found monkeys to be second to dogs as the most common source of animal bite injuries.

NPPA permitted Abbott Healthcare Pvt Ltd to discontinue selling its premium metallic stent Xience Alpine Premium from the Indian market. In August last year, Abbott had expressed its intent to discontinue the product. However, in September NPPA directed the drug giant’s Indian unit Abbott Healthcare Pvt. Ltd to discontinue the product after 12 months of issuing a public notice. Normally, NPPA allows products to be withdrawn after six months; however, in this case, the regulator invoked a “public interest” clause that prevented Abbott from discontinuing the life-saving device for a year to ensure adequate supplies. Abbott Laboratories had also said that it would not introduce its latest stent Xience Sierra in India.

Alpine has better results for chronic total occlusion and complex lesions.

XIENCE Sierra offers these features: Increased post dilatation maximum expansion to 5.5 mm for 3.5 and 4.0 mm diameters; 0% shortening even at maximum post dilatation maximum at 5.5 mm; Ultra-low stent profile of 0.0390" allows for easier crossing of difficult lesions and best in class deliverability while expending less force across lesions (e.g., 73% less force than Synergy)

Other stents are XIENCE V, XIENCE nano, XIENCE PRIME, XIENCE PRIME LL, XIENCE Xpedition, XIENCE Xpedition SV and XIENCE Xpedition LL Everolimus Eluting Coronary Stents

 

A device, called IDx-DR, is a software program that uses an artificial intelligence algorithm to analyze images of the eye taken with a retinal camera called the Topcon NW400. Its the first device authorized for marketing that provides a screening decision without the need for a clinician to also interpret the image or results, which makes it usable by healthcare providers who may not normally be involved in eye care. The technology was able to correctly identify the presence of more than mild diabetic retinopathy 87.4 percent of the time and was able to correctly identify those patients who did not have more than mild diabetic retinopathy 89.5 percent of the time.

 

Public Health

26 Vaccine-preventable diseases: Examples are Cervical cancer, Cholera, Diphtheria, Hepatitis B, Influenza, Japanese encephalitis, Measles, Mumps, Pertussis, Pneumonia, Polio, Rabies, Rotavirus, Rubella, Tetanus, Typhoid, Varicella, Yellow Fever

Drugs that are federally classified as substances with no medicinal benefit and high abuse potential are heroin, LSD and marijuana. The US FDA recently received a Citizen Petition for Stricter Regulation of Added Sugar "to amend the Drug Schedules to include added sugar to either Schedule I or Schedule II of the Controlled Substances Act.

Education

"Because of allotment of exam centres in other states, the candidates will have to travel a long distance and there will be financial implications on them," the bench said.

"We direct the CBSE that in respect of the candidates who have been allotted centres in Kerala, Rajasthan or other faraway places or in other states, (they) shall be allotted centres adjacent to their place of residence or at least in Tamil Nadu at the earliest," it added.

Kochi TOI: KOCHI: Medical Council of Indias decision to grant additional weightage in post-graduate medical admissions for MBBS doctors serving in government hospitals in rural areas has been challenged before the Kerala High Court.

While the additional weightage in marks was given to only for in-service candidates serving in remote or difficult areas, the amendment extended the benefit to those serving in rural areas too. For each year of service, in-service candidates are given additional weightage of 10 per cent of the marks obtained in National Eligibility cum Entrance Test (NEET), subject to a maximum of 30 per cent.

Weather

Temperature recoded at 1430 hours have risen by 3-5°C at one or two pockets of Jammu & Kashmir, West Uttar Pradesh, Jharkhand, Odisha and Telengana; by 1-3°C at many parts of Gangetic West Bengal, Rayalaseema, rest Jharkhand and Kerala; at some parts of Jammu & Kashmir, Haryana and rest Telengana and at one or two pockets of Himachal Pradesh, Punjab, East Uttar Pradesh, East Madhya Pradesh, Vidarbha, Saurashtra & Kutch, Konkan & Goa, Coastal Karnataka, South interior Karnataka, Odisha, and Tamilnadu & Puducherry.

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