Morning Medtalks with Dr KK Aggarwal 17th May 2018


Dr KK Aggarwal    17 May 2018


  1. Drug holidays after several years of bisphosphonate use are recommended to reduce the risk for the rare but potentially serious adverse events of atypical femoral fractures and osteonecrosis of the jaw that have been associated with this class of drugs.
  2. The most recent guidelines on bisphosphonate drug holidays from the American Association of Clinical Endocrinologists and American College of Endocrinology suggest that patients with a moderate fracture risk take a drug holiday after 5 years of oral and 3 years of intravenous bisphosphonate treatment.
  3. Those with a higher fracture risk are meanwhile recommended to take the holiday after 10 years of oral and 6 years of intravenous bisphosphonate treatment.
  4. A multidisciplinary task force of the American Society for Bone and Mineral Research, as reported by Medscape Medical News, meanwhile, has recommended that patients who are not considered to be at high fracture risk after 3 to 5 years of bisphosphonate treatment can be considered for a 2- to 3-year drug holiday, with continued re-evaluation.
  5. Artificial intelligence can identify congenital Long QT Syndrome on a single lead ECG, even in patients with a normal electrocardiogram, said researchers from AliveCor -- whose Kardia Band add-on for the Apple Watch is such a device -- at the Heart Rhythm Society meeting in Boston.
  6. For elderly patients, 24-hour ambulatory blood pressure monitoring of hypertension can also pick up atrial fibrillation. (Hypertension)
  7. A novel type of catheter ablation for atrial fibrillation using pulsed electric fields rather than thermal energy appeared promising in a 22-patient study. (JACC: Clinical Electrophysiology)
  8. Analysis of the CASTLE-AF trial showed that reducing the burden of atrial fibrillation by delaying time to first recurrence with ablation in patients with heart failure was associated with better outcomes.
  9. For cardiogenic shock patients on the TandemHeart ventricular assist device, about 24% survived in bridge to recovery and 51% in bridge to left ventricular assist device or surgery, according to a single-center study reported in Catheterization and Cardiovascular Interventions.
  10. Angina drug ranolazine was associated with significantly lower A1C in veterans with type 2 diabetes in an observational study published in Federal Practitioner.
  11. Kentucky cardiologist Charles Fred Gott was sentenced to 8 years in prison over healthcare fraud and unlawful opioid distribution, Cardiovascular Business reports.
  12. European regulators expanded the indication for the Trevo Retriever thrombectomy device to use as a first-line treatment in acute ischemic stroke up to a day after symptom onset. (MassDevice)
  13. The HeartLight Excalibur balloon was cleared by the FDA for use in treating paroxysmal atrial fibrillation. (MassDevice)
  14. Most cannabis dispensaries in Colorado recommended cannabis products for relief of severe nausea during the first trimester of pregnancy, a new study has found, published online May 7 in Obstetrics & Gynecology.
  15. A search of WHO global Individual Case Safety Reports on the VigiBase database yielded 13,636 adverse drug reactions tied to ticagrelor, which included cases of dyspnea (n=2,665) and sleep apnea (n=28) (JACC) 

Mental Health

Here are Bollywood songs that can give you strength, hope, courage to fight the Depression. If you have any suggestions add to our compilation. ( First four by Vishal)


  1. https://www.youtube.com/watch?time_continue=43&v=3qgbp8z0cnc Jeet Jayenge Hum, Tu Agar Sang Hai.
  1. https://www.youtube.com/watch?time_continue=2&v=owe_1QZhmfQ Don’t worry be happy
  1. http://www.glamsham.com/en/5-bollywood-songs-that-gives-you-strength-to-fight-the-mighty-monday-blues Dil Jo Tere Baat Baat Pe Ghabraaye, Dil Idiot Hai Pyaar Se Usako Samajha Le, Hont Ghuma Siti Baja, Siti Bajaake Bol Bhaiya Aal Izz Well, Are Bhaiya Aal Izz Well.
  1. https://www.youtube.com/watch?time_continue=37&v=9-kkTYXqmrw Ae Pyarre. Chehre pe baarah mat bajaa re, Satrangi lamhon ke gubbare, Khuli hawaaon mein uda re 
  1. https://www.youtube.com/watch?time_continue=28&v=dO7OKASr8lc Rook Jana nahi tu kabhi har ke

Public Health

  1. An average 8-ounce cup of coffee contains around 100 milligrams of caffeine. EUs Food Safety Authority has noted that caffeine intake up to 400 milligrams per day is safe for most people when consumed throughout the day. FDA estimates toxic effects, like seizures, are observed around 1,200 milligrams, or 0.15 tablespoons of pure caffeine.
  2. Highly concentrated caffeine in a clear liquid form can be confused with water or distilled vinegar, and pure powdered caffeine with flour or powdered sugar. This could be toxic or even lethal.


US Health agencies are investigating an outbreak of bloodstream infections in children that may be linked to heparin and saline syringes made by BD. CDC has confirmed 14 cases of bloodstream infections in children caused by the same strain of the Serratia marcescens bacterium. All infections occurred in seriously ill children receiving intravenous medications through a catheter or central line.


Maximum Temperature

Temperatures more than 40.0°C is recorded at most parts of Rajasthan, Madhya Pradesh, Vidharbha and Marathwada; at some parts of Telangana, Madhya Maharashtra, Gujarat region and Saurashtra & Kutch.

The highest maximum temperature of 45.0°C recorded at Bramhapuri (Vidarbha)

Maximum temperature departures as on 14-05-2018:  Maximum temperatures were appreciable above normal (3.1°C to 5.0°C) at isolated places over Konkan & Goa and Tamilnadu & Puducherry; above normal (1.6°C to 3.0°C) at a few places over Assam & Meghalaya, West Rajasthan, Saurashtra & Kutch and Vidarbha; at isolated places over Madhya Pradesh, Marathwada and Madhya Maharashtra.

Heat Wave Warnings for Next 24 hours

Heat wave conditions at some places over West Madhya Pradesh and at one or two pockets over East Madhya Pradesh and Vidarbha.

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