Practice changing guidelines

1. Patients who suffer TIA have a rising risk for recurrent stroke for the next 5 years after the initial event. The 5-year risk for a major vascular event is 12.9%, and half of these events occur between 1 and 4 years after the initial TIA. The results of the TIA registry were also published online in the New England Journal of Medicine. Secondary prevention must last for minimum five years.
2. Increased prevalence of atrial fibrillation (Afib) among elderly has sparked debate among cardiologists about a so-called epidemic of Afib, with some data suggesting that as many as 20% of seniors over 80 will develop the condition.
3. Lifelong endurance athletes. Studies comparing rates of atrial fibrillation among long distance athletes with age-matched control groups have found the incidence of Afib is as much as seven times higher in vigorous exercisers.
4. FERRIC-HF II study: IV iron repletion cause dramatic improvements in exercise performance (six minutes-walk test) even with low Hb response stage. The ability to exercise is based on the ability of muscles to generate adenosine triphosphate (ATP), which is the energy currency used by the cell to do muscle contraction. Because iron is incorporated in many of these mitochondrial enzymes and helps them generate ATP, IV iron repletion might be augmenting exercise performance via mechanisms unrelated to Hb and may be related to augmentation of mitochondrial enzymes.

Nipah Update

1. A team from the National Centre for Disease Control (NCDC) has termed the incidence the “third major outbreak in the country.” The State government is considering seeking the help of the World Health Organisation. A team of experts of the All-India Institute of Medical Sciences visited the district on Tuesday.

Public Health

1. Portland State University researchers who published an article three years ago in the New England Journal of Medicine about the presence of previously undiscovered forms of formaldehyde in e-cigarette vapor revisited their research and found that formaldehyde risks were even higher than they originally thought.

The US Preventive Services Task Force recommended in 2013 that all individuals aged 55 to 80 years who have a smoking history of 30 pack-years or longer and who currently smoke or have quit within the past 15 years should be screened annually for lung cancer with low-dose CT. There are an estimated 7 million such individuals in the United States. In 2016, fewer than 2% of those eligible underwent LDCT at one of the nearly 1800 screening centers across the country.

Consumer Financial Health

1. You may be able to cancel your domestic air ticket within 24 hours of booking without any cancellation charges for flights that are at least four days away from departure time. It will not matter whether you booked the ticket directly from the airline or through an agent or travel portal.And if an airline tells you 24 hours before the departure time that your flight has been delayed by over four hours, you could be entitled to a full refund. Similarly, airlines may have to offer compensation between Rs 5,000 and Rs 20,000 to passengers for missing connecting flights due to the first flight being late. However, both the domestic flights for connecting passengers should be on one PNR — meaning on the same airline ticket. (TOI)
2. The National Restaurant Association of India, an umbrella body of restaurants-cum-bars in the capital, on Tuesday said they would continue to play recorded music on their premises because there was no ban on them.
3. Cardiac resynchronization therapy seemed to improve 12-month clinical outcomes in patients with heart failure but without left bundle-branch block on their electrocardiograms (ECGs) in a small randomized trial (ENHANCE CRT)

Weather

Yesterday, Heat wave conditions observed at some parts over Vidharbha and at one or two pockets over Madhya Maharashtra & West Madhya Pradesh

Maximum Temperature Maximum temperatures were markedly above normal (5.1°C or more) at many parts of Uttrakhand; at some parts of Himachal Pradesh; appreciably above normal (3.1°C to 5.0°C) at most parts of Haryana, Chandigarh & Delhi; at many parts of Punjab; at some parts of Rajasthan; at one or two pockets of Jammu & Kashmir and Madhya Maharashtra; above normal (1.6°C to 3.0°C) at most parts of Gujarat and Madhya Pradesh; at many parts of Sub-Himalayan West Bengal & Sikkim, Konkan & Goa and Vidarbha; at some parts of Uttar Pradesh and Kerala; at one or two pockets of Assam & Meghalaya, Gangetic West Bengal and Marathwada. Yesterday, the highest maximum temperature of 46.4°C was recorded at Sheopur (West Madhya Pradesh).

Heat Wave Warnings for Next 5 Days (on next page) (For significance of colour code and criteria for Heat Wave, kindly refer to Annexure5 at end of this document) Heat wave conditions are very likely to persist over parts of Northwest India and Central India during 23rd to 27th May.