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Morning Medtalks with Dr KK Aggarwal 23rd May 2018

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Dr KK Aggarwal    23 May 2018

Public Health

  1. MBANDAKA, Democratic Republic of Congo (Reuters) - Congo began administering an experimental Ebola vaccine to medical staff in the northwestern city of Mbandaka on Monday to tackle an outbreak of the virus believed to have killed 26 people since early April.
  2. Kerala Health Minister K.K. Shailaja said things are under control and there is no need to panic. “All the periphery hospitals of the Kozhikode Medical College hospital are fully equipped to tackle the Nipah fever. All those who have fever need not rush to the medical college itself.
  3. Transmission of NiV takes place through direct contact with infected bats, pigs or from other NiV-infected people. “The health officials visited the house of Sabith and his brother, who passed away due to Nipah virus, and found there was a well in their house that was unused but had lots of bats.  The authorities have sealed the top of the well to ensure that the remaining bats do not come out.
  4. People were being educated to ensure that they do not eat any fruits that fall down from trees.
  5. Kerala nurse taking care of Nipah patients dies; death toll rises to 10. The current mortality is 70%.
  6. WHO claims that a 20% increase in the price of fizzy drinks would decrease consumption by 20% and improve health, despite there being no international evidence that sugar taxes have reduced obesity. This follows calls from campaigners for soda taxes – such as those that have been introduced in the UK, Ireland, France and Hungary – to be extended to milkshakes, coffee and food.
  7. The WHO’s definition of ‘unhealthy’ food arbitrarily categorizes food and drink deemed high in fat, sugar, salt or calories.
  8. A group of scientists speaking at the European Society of Endocrinologys annual meeting this weekend revealed that while fasting can help shed weight it can also impair the action of insulin – the sugar-regulating hormone – and lead to an increased risk of diabetes. As a result, the researchers are urging people to take care before starting a weight loss programme such as the 5:2.( 5 days normal diet and 2 days caloric restricted diet)
  9. A recent study found that dumping alcohol from your diet could decrease your risk of developing type 2 diabetes, and possibly prevent the condition. Published in BMJ Open, the research suggested that if moderate-to-heavy drinkers stopped consuming alcohol their risk of developing diabetes would dramatically decrease.
  10. People around the world are becoming more resistant to antifungal treatments, and according to researchers from Imperial College London and the University of Exeter, the end result could be increased outbreaks of disease and food shortages.
  11. A multidisciplinary team of epidemiologists from Boston Childrens Hospital and the University of Toronto have found that higher local temperatures and population densities correlate with a higher degree of antibiotic resistance in common bacterial strains. The findings were published today in Nature Climate Change.
  12. 14th June is observed globally as World Blood Donor Day. NACO/NBTC proposes to observe a month long campaign for World Blood Donor Day in June 2018, also considered to be a "dry month" for blood collection, due to weather conditions and students being on vacation. 

 

One Health

Parrot being given CPR: https://www.facebook.com/chelsea.steiner.507/videos/458802514576251/

Clinical

  1. The ratio of bone mineral density (BMD) to body mass index (BMI) may be a simple and reliable tool for assessing fracture risk in obese individuals, new research suggests. 
  2. The findings were presented May 17 here at the American Association of Clinical Endocrinologists (AACE) 2018 Annual Scientific & Clinical Congress by Mikiko Watanabe, MD, and Carla Lubrano, MD, PhD, both of Sapienza University, Rome, Italy.
  3. AACE/ACE now recommend LDL goals of < 55 mg/dL, < 70 mg/dL, < 100 mg/dL, and < 130 mg/dL for individuals at extreme, very high, high/moderate, and low risk for cardiovascular events, respectively.  

Targets for Five CVD Risk Categories

Extreme-risk goals

LDL < 55 mg/dL, non-HDL < 80 mg/dL, apolipoprotein B (apoB) < 70 mg/dL

Progressive atherosclerotic cardiovascular disease (ASCVD), including unstable angina, in patients after achieving an LDL-C <70 mg/dL.

Established clinical cardiovascular disease in patients with diabetes, chronic kidney disease (CKD) stages 3/4, or heterozygous familial hypercholesterolemia (HeFH).

History of premature ASCVD (< 55 years of age in men, < 65 in women).

Very high-risk goals

LDL < 70 mg/dL, non-HDL < 80 mg/dL, apoB < 80 mg/dL

Established or recent hospitalization for acute coronary syndrome, coronary, carotid, or peripheral vascular disease, 10-year risk > 20%.

Diabetes or CKD stages 3/4 with one or more risk factors.

HeFH.

High-risk goals

LDL < 100 mg/dL, non-HDL < 130 mg/dL, apoB < 90 mg/dL

Two or more risk factors and 10-year risk 10% to 20%.

Diabetes or CKD stages 3/4 with no other risk factors.

Moderate risk

Same goals as high risk

Two or more risk factors and 10-year risk < 10%.

Low-risk goals

LDL < 130 mg/dL, non-HDL < 160 mg/dL, apoB not relevant)

0 risk factors.

For calculating 10-year event risk levels, the AACE/ACE guidelines suggest using one of four established risk calculators:

the Framingham Risk Assessment Tool;

the Multi-Ethnic Study of Atherosclerosis (MESA) 10-year ASCVD Risk with Coronary Artery Calcification Calculator

the Reynolds Risk Score, which includes high-sensitivity CRP (hs-CRP) and family history of premature ASCVD

Type 2 diabetes, the United Kingdom Prospective Diabetes Study (UKPDS) risk engine.

  1. A major international study that involved 312 babies from Aotearoa New Zealand has led to life-saving changes in the care of premature babies. Findings from the Australian Placental Transfusion Study showed that simply waiting 60 seconds after birth to clamp a premature baby’s umbilical cord dramatically improves its chances of survival.

Weather

  1. Temperatures more than 40.0°C is observed at most parts of Punjab, Haryana, Delhi, Rajasthan, Madhya Pradesh, Vidarbha, West Uttar Pradesh and Gujarat region; at many parts of Telengana and East Uttar Pradesh; at some parts of Chhattisgarh and Saurashtra & Kutch and at one or two pockets of Jammu & Kashmir, Uttarakhand, Bihar, Jharkhand, interior Odisha, Gangetic West Bengal, Madhya Maharashtra and Andhra Pradesh
  2. Temperature recoded at 1430 hours of today have risen by 3-5°C at one or two pockets of Odisha and Andhra Pradesh; by 1-3°C at most parts of Punjab, Haryana, Chandigarh & Delhi and Chhattisgarh; at some parts of Rajasthan, Madhya Pradesh and Kerala and at one or two pockets of Jammu & Kashmir, Himachal Pradesh, Uttarakhand, Uttar Pradesh, Gujarat, Jharkhand, Andhra Pradesh, Karnataka and Tamilnadu & Puducherry

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