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Morning Medtalks with Dr KK Aggarwal 15th May 2018

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Dr KK Aggarwal    15 May 2018

Public Health

 

Ebola Update: Ebola can spread rapidly, through contact with even small amount of bodily fluid of those infected. Its early flu-like symptoms are not always obvious. There are five identified strains of the Ebola virus, the deadliest to date being the Zaire strain. This is the strain involved in the latest outbreak, for which there is now a vaccine available.

Tortilla Chips warning: On May 2, the USFDA released an announcement issuing a voluntary recall of certain Utz and Weis brand tortilla chips. The recall is the result of a potential contamination of undeclared milk allergen. The recall affects Golden Flake, Good Health, Utz, and Weis brand Tortilla Chips that were distributed in 32 regions, including Alabama, Washington DC, Florida, New Hampshire, and Texas.

Pollution

Criteria pollutants: are six common outdoor air pollutants that the EPA in the United States is required to regulate based on the Clean Air Act: Particle pollution (or particulate matter); Ozone; Carbon monoxide; Nitrogen oxides; Sulphur oxides and Lead.

Healthcare allergies: Health care workers are exposed to numerous allergens and irritants. Allergy to natural rubber latex is the most common. Other allergens in the health care environment are psyllium, antibiotics, chemotherapeutics, aerosolized medications, disinfectants and sterilant (glutaraldehyde, formaldehyde), and cleaning products. Many of the disinfectants, sterilant, and cleaning products are also strong irritants.

Clinical

Ferric carboxymaltose (FCM) can be given as a dose of up to 20 mL (1000 mg of elemental iron); product labelling specifies a maximum dose of 20 mg per kg of body weight. Doses of FCM may be given over a 15-minute infusion. As with all formulations, start slowly, observe for signs of allergy or infusion reaction, and if not seen, administer the balance over 15 minutes. If appropriate, a second dose of 750 mg can be given on a different day. Several trials have shown efficacy and safety in iron-deficient patients in several different settings including heavy uterine bleeding, postpartum women, nondialysis-dependent chronic renal failure, inflammatory bowel disease, heart failure, chemotherapy-associated anaemia without concomitant use of an ESA, and nonresponse to oral iron. Several series have reported use of FCM during pregnancy without serious adverse events.

Its properties permit the administration of large doses (15 mg/kg; maximum of 1000 mg/infusion) in a single and rapid session (15-minute infusion) without the requirement of a test dose.

Treatment with intravenous iron administered at least 1 week before surgery increases haemoglobin levels and, consequently, should reduce the need for transfusion of RBC units during the perioperative period.

FCM can increase 2 gm by 1 week, 3 grams by 3 weeks and > 12 by one month.

Dabur India has developed, Glycodab, a product in partnership with the Central Council for Research in Ayurvedic Sciences of the Union Ministry of Ayush for management of diabetes.

Legal

1 M Pounds compensation from Nokia: A salesman who suffered a brain tumor is suing Nokia for ­ “significant” compensation which could hit £1million – in a case that could cost mobile phone firms a fortune. Father-of-six Neil Whitfield, 60, claims heavy mobile phones use in the late 1990s caused a deadly growth.

Delhi Medical Council has cancelled the licences of two doctors for a period of 30 days. Rajbir Kaur, an AIIMS nursing staffer was admitted on January 16, 2017, and was classified as a low-risk pregnancy. The hospital admitted lapses in Kaurs treatment where a junior resident gave general anaesthesia instead of spinal anaesthesia for C-section. The disciplinary committee also found that the consultant-on-call gynaecologist and obstetrician did not come despite several calls.

Policy

MOH propose to merge FMG with NEXT so the Indian and foreign graduates are tested against the same yardstick and a uniform standard of quality of practicing doctors is ensured.

MCI has made it mandatory for all medical colleges to start PG courses.

Chennai: Non-teaching district hospitals have started enrolling students for post graduate courses, with DNB degree awarded by the National Board of Examinations.

5th April: 5% seats of annual sanctioned intake capacity shall be filled up by persons with benchmark disabilities in accordance with the provisions of the Rights of Persons with Disabilities Act, 2016, based on the merit list of National Eligibility-Cum-Entrance Test for admission to Postgraduate Medical Courses. To be eligible for admission to Postgraduate Course for an academic year, it shall be necessary for a candidate to obtain minimum of marks at 50th percentile in the ‘National Eligibility-Cum-Entrance Test for Postgraduate courses’ held for the said academic year. However, in respect of candidates belonging to Scheduled Castes, Scheduled Tribes, and Other Backward Classes, the minimum marks shall be at 40th percentile. In respect of candidates with benchmark disabilities specified under the Rights of Persons with Disabilities Act, 2016, the minimum marks shall be at 45th percentile for General Category and 40th percentile for SC/ST/OBC.

50% of the seats in Postgraduate Diploma Courses shall be reserved for Medical Officers in the Government service, who have served for at least three years in remote and /or difficult areas and / or Rural areas. After acquiring the Postgraduate Diploma, the Medical Officers shall serve for two more years in remote and /or difficult areas and / or Rural areas as defined by State Government/Competent authority from time to time.

Ragging: In Clause 3 under the heading “Definitions:- for the purpose of these Regulations”, the following shall be added after first para of sub-clause 3.3:- “Any act of physical or mental abuse (including bullying and exclusion) targeted at another student (fresher or otherwise) on the ground of colour, race, religion, caste, ethnicity, gender (including transgender), sexual orientation, appearance, nationality, regional origins, linguistic identity, place of birth, place of residence or economic background.”

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

President HCFI

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