Clinical Practice Changing News

Avoid western diet: A research team led by Dr. Lisa Mosconi from Weill Cornell Medicine has found differences in brain imaging scans between people who reported eating a Mediterranean diet and those who ate a standard Western diet. A Mediterranean diet is high in foods such as fruits, vegetables, and lean protein. In contrast, a standard Western diet contains an excess of red meat, saturated fats, and refined sugar. The differences that the research team found may signal early Alzheimer’s disease.

Obesity is a disease:  Lee Kaplan, MD, PhD, director of the Obesity, Metabolism and Nutrition Institute at Massachusetts General Hospital in Boston “obesity is a disease". Like diabetes, obesity is also never "cured," although a patients body mass index (BMI) can be under excellent control. Patients "still have the disease of obesity, even though they no longer meet the definition of obesity by our measurements. If obesity is, in fact, a chronic disease, then physicians need to treat it as a chronic disease. And there are many good reasons to do so. Obesity carries substantial adverse health risks. Type 2 diabetes, for example, is common in the setting of obesity, as are hypertension, dyslipidemia, sleep apnea, and fatty liver disease.

Clinical

A non-invasive spinal stimulation technique called transcutaneous stimulation can help men with complete muscle paralysis in the lower body voluntarily move their legs again. The method delivers electrical current to the spinal cord via electrodes strategically placed on the skin. In the study, electrodes were placed over the lower thoracic spine. ( Journal of Neurotraumaon April 13, 2018)

US FDA has approved Retacrit (epoetin alfa-epbx) as a biosimilar to epoetin alfa for the treatment of CKD anemia, chemotherapy, or use of zidovudine in patients with HIV infection. It is also approved for use before and after surgery to reduce the chance that red blood cell transfusions will be needed because of blood loss during surgery.

Biological products are generally derived from a living organism and can come from many sources, such as humans, animals, microorganisms or yeast. A biosimilar is a biological product that is approved based on data showing that it is highly similar to a biological product already approved by the FDA (reference product) and has no clinically meaningful differences in terms of safety, purity and potency (i.e., safety and effectiveness) from the reference product, in addition to meeting other criteria specified by law.

AMR

Cepheid has received clearance from USFDA for expanded claims for Xpert^® Carba-R, an on-demand molecular test for rapid and accurate detection of carbapenemase-producing Gram-negative bacteria.

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Weather

Weather sensitive blood pressure: A fall of around 10C can led to an increase in blood pressure of between 3mm and 6mm of mercury.  A change of just 2mm is enough to significantly affect the odds of fatal heart attacks and strokes.

As per Dr Jennifer Vanos, Ph.D when the barometric pressure drops, so does your blood pressure.

As per Dr. Matthew Fink, neurologist in chief at New York-Presbyterian Hospital/Weill Cornell Medical Center, low barometric pressure can cause headaches or migraines by creating a pressure difference between the atmosphere and the air-filled sinuses.

Number of obstructive sleep apnea "events" increased on the nights when atmospheric pressure was lower. Falling atmospheric pressure is a common feature of most storms.

Apart from cold weather, blood pressure may also be affected by a sudden change in weather patterns, such as a weather front or a storm. The blood vessels may react to abrupt changes in humidity, atmospheric pressure, cloud cover or wind in much the same way it reacts to cold.

Legal

1. Letter to the editor: This PIL is very important. If this practice of hospitals is prevented, it will stop one of the biggest malpractices being committed by corporate hospitals. They buy medicines, appliances and consumables at very low prices  in bulk and force  the patients to buy these at exorbitant prices. Please let us know further development in this case. Thanks Dr. R. D. Dubey

2. Synthetic marijuana or synthetic cannabinoids are manmade. Chemicals are sprayed on dried plants and smoked.  The substance has been linked to an epidemic of deaths and psychotic breakdowns.

Dr. Tegan Boehmer from CDC says: “There is product on the market that contains rat poison and its impossible for somebody to know whether or not the product that theyre using contains that ingredient," Boehmer warned. The active ingredient in rat poison in an anticoagulant. When ingested, rats die of internal bleeding. Now, that same chemical is being sprayed on synthetic marijuana.  The drug has been linked to more than 200 cases of excessive, uncontrolled bleeding.   Nine states have reported incidents, including Florida, Illinois, Indiana, Kentucky, Maryland, Missouri, Pennsylvania, Virginia, and Wisconsin.

Policy

1. The Foreign Medical Graduates Test (FMGT) which Indian doctors who studied medicine abroad had to undergo in June has been cancelled and is being replaced by a combined exam for students of Indian medical colleges and foreign medical graduates in the first week of July.
2. Punjabhealth minister refused to sign the MOU for Ayushman Bharat, a mega scheme to provide free health treatment up to Rs 5 lakh to people living below poverty line on the ground that the Punjab government was already running similar schemes.
3. WHO has published its first essential diagnostics list, a catalogue of tests needed to diagnose the most common conditions as well as a number of global priority diseases.  The essential diagnostics list concentrates on in-vitro tests like tests of blood and urine. Apart from this, 58 tests are listed for detection and diagnosis of a wide range of common conditions, thus providing an essential package that can form the basis for screening and management of patients.
4. According to the American Heart Association, 46 percent of Americans have high blood pressure, but only about half of them have it under control.

3R Campaign: Restoring Regular Rhythm

Intraoperative injections of botulinum toxin A into epicardial fat pads may prevent future AF after CABG.