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Morning Medtalks with Dr KK Aggarwal 19th May 2018

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Dr KK Aggarwal    19 May 2018

Practice changing news

Delhi saw a series of storms. I noticed large number of cases with accelerated hypertension. Some within the family. Would like to know observations of others.

Answer lies in Ayurveda in two terms Vayu Vikriti and Kal Vikriti. When there happens a reverse of what is expected in that Ritu or time there will occur vitiation of doshas.

For example, in Grishm Ritu (start of summer) you do not expect rain or high winds if that happens means there is Ritu Vikriti.

One of the manifestation of this vitiation will be sudden rise in BP (such cases may not have underlying LVH).

In an "unfortunately negative trial," the factor Xa inhibitor rivaroxaban was not superior to aspirin in preventing recurrent stroke after a first embolic stroke of undetermined source but was associated with a significant increase in bleeding events, researchers report (NAVIGATE-ESUS) trial.

One extra glass of wine a day will shorten your life by 30 minutes as per a study by Angela Ward in theLancet. Irish guidelines on the maximum amount of alcohol that can be consumed per week to ensure low risk to health are 17 standard drinks per week for men and 11 for women. A standard drink contains 10 grams of alcohol and is equivalent to half a pint of beer, a single measure of spirits or a small (125 millilitres) glass of wine. The maximum low-risk intake of alcohol per week for a man is therefore 170 grams and 110 grams for a woman.

Clinical

A first-of-its kind randomised controlled trial (RCT) to examine the effectiveness of Panchakarma, an ayurvedic therapeutic process, in the rehabilitation of stroke patients will start at three elite healthcare institutions in the country cleared by ICMR. The treatment integrates modern medicine principles with ancient ayurvedic wisdom to expedite rehabilitation and bring back the motor and sensory functions of the brain following a cerebrovascular accident or stroke. The RCT, considered the gold standard for a clinical trial, will be conducted at three centres — Christian Medical College Ludhiana, Amrita Institute of Medical Sciences (AIMS) Kochi and Sree Chitra Tirunal Institute for Medical Sciences Thiruvananthapuram (Pharmabiz)

CDC researchers have developed a real-time PCR-based rabies test that is simpler and more precise than direct fluorescent antibody, or DFA, testing, which is the current gold-standard for rabies diagnosis.

The new LN34 assay is designed to identify rabies infection in animals. During a pilot study, LN34 produced no false-negative results and fewer false-positive and inconclusive results compared with DFA testing. Unlike the DFA test, which requires specialized training and equipment, LN34 can be easily used in resource-limited settings, where rabies diagnostics and treatment supplies are often stored in urban areas that may take people several days to reach, according to the CDC.

The Centers for Disease Control USA is to continue to promote early diagnosis of HIV infection by expanding the availability of rapid HIV testing services. The CDC has since last year been distributing rapid HIV self-test kits through various channels, including vending machines and online orders that can picked up from convenience stores, to reduce the rate of late HIV infection diagnosis. The CDC would also continue to increase the availability of anonymous HIV testing.

Prices of drug-eluting stents capped by NPPA has ended with increased cost of procedure and other charges. According to the NPPA minutes of this meeting, a group of hospitals claimed that capping the stent prices forced them to increase the procedure costs and other related charges. Joint director of Telangana Drug Control Administration (TDCA) T Kailasam said people could lodge complaints only in case of violation of the stent sale price and not other costs. (Newindianexpress)

It is safe for persons at high risk of [type 2 diabetes] and those with [type 2 diabetes] to include eggs, an acceptable and convenient food source, in their diet regularly (Diabetes and Egg (DIABEGG) study May 7 in the American Journal of Clinical Nutrition.

In utero exposure to high levels of particulate matter (PM) ≤2.5 μm air pollution was associated with an increased risk for elevated blood pressure during childhood in a newly reported study. (Hypertension)

Drinking more water did not slow the decline of kidney function in patients with stage 3 chronic kidney disease (CKD), according to a Canadian trial (JAMA)

Public Health

Why wears loose-fitting, light-colored clothing: Mosquitoes are less attracted to light-colored clothing.

Mosquitoes are attracted to carbon dioxide from breath, heat from our bodies and the lactic acid that humans secrete.

 

R3 Campaign: Restoring Regular Rhythm

Five questions every patient should ask on AF:  Am I at risk of stroke and what is the risk, do I need to take drugs to reduce my stroke risk, do I have a choice of drugs, do I need to change my life style on drugs and is aspirin not sufficient?

A greater burden of even intermittent atrial fibrillation was linked with a significantly higher stroke risk and could warrant anticoagulation, according to a retrospective study of continuous ambulatory heart monitoring data. ( JAMA Cardiology)

Legal

On Wednesday i.e. on 16.05.2018, the Honble Kerala High Court ruled that talking on a mobile phone while driving is not illegal. It ordered that the police cannot register a case against those who talk on the mobile phone while driving.

The Honble Division Bench of the High Court said that the police can’t register case as there are no provisions in the law to book a person for this.

The police register a case as per 118 Section, 118(e) of Kerala Police Act. This section states that any person who knowingly does any act which causes danger to public or failure in public safety shall on conviction be punishable with imprisonment for a term which may extend up to three years or with a fine not exceeding Rs 10,000 or with both.

The Honble Division Bench’s ruling was in response to a petition filed by MJ Santhosh, a native of Kakkanad in Ernakulam questioning the police for registering a case against him using the provisions of the Act.

The court said that police action is possible only if the Act of talking over phone causes danger to public. “Also, there is no provision in the police act that bans people from talking over the mobile phone while driving. Hence a person doing the act can’t be assumed as one who causes danger to the public,” the court said.

Following the court order those who have been booked by the police for using mobile phones while driving can approach the magistrate courts concerned for cancelling the case.

Honble High Court expounded that if a case should be registered, the law should be amended and should be passed in the Legislative Assembly.

The ruling is applicable in Kerala only. (Ira Gupta)

Source : Latestlaws.com

Weather

 Maximum Temperature Maximum temperatures were appreciable above normal (3.1°C to 5.0°C) at some parts of Madhya Maharashtra and Andaman & Nicobar Islands; above normal (1.6°C to 3.0°C) at many parts of Himachal Pradesh, Saurashtra & Kutch, Vidharbha and West Madhya Pradesh; at some parts of Uttarakhand, East Madhya Pradesh and Marathwada and at one or two pockets of Punjab, Haryana, Chandigarh & Delhi. Yesterday, the highest maximum temperature of 45.3°C recorded at Kandla (Saurashtra & Kutch)

Temperatures Recorded at 1430 Hours IST of Today, the 17 th May, 2018 o Temperatures more than 40.0°C are recorded at most parts of Rajasthan, Madhya Pradesh, Vidarbha, Marathwada and Gujarat region; at many parts of Haryana, Delhi, Saurashtra & Kutch and Telengana; at some parts of Madhya Maharashtra and one or two pockets of Punjab, Chandigarh, Jharkhand, East Uttar Pradesh, North Interior Karnataka, Konkan & Goa, Rayalseema, Andhra Pradesh, Chhattisgarh and interior Odisha.

Temperature recoded at 1430 hours of today have risen by 3-5°C at some parts of Gangetic West Bengal and at one or two pockets of West Madhya Pradesh; by 1-3°C at most parts of rest Madhya Pradesh and Rayalseema; at many parts of Kerala and Gujarat region; at some parts of Saurashtra & Kutch, Vidharbha and Assam & Meghalaya and at one or two pockets of Uttarakhand, Rajasthan, Haryana, Delhi, Bihar, Jharkhand, Chhattisgarh, Odisha, Andhra Pradesh, Karnataka, Konkan & Goa and Tamilnadu & Puducherry.

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