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Morning Medtalks with Dr KK Aggarwal 30th May 2018

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Dr KK Aggarwal    30 May 2018

  1. Invite 2-5 PM IIC 1st  June 2018 Friday: Mrs M Shreesha, Member  National Consumer Disputes Redressal Commission (NCDRC)

Legal

  1. Justice R K Agrawal, who retired as Supreme Court judge earlier this month, was appointed the president of the National Consumer Disputes Redressal Commission (NCDRC) today. He will succeed Justice D K Jain, who completes his term on May 31.

Clinical

Eating bitter pumpkins can lead hair loss in women, as two women have been poisoned and lost hairs after their dinners including pumpkins and squashes that might have contained potent toxins. (JAMA Dermatology)

Public Health

  1. France has seen a sharp fall in the number of people smoking daily, with one million fewer lighting up from 2016-2017, a survey by Public Health France. The study pointed to the slew of anti-smoking measures introduced to France as a likely reason for the decline. Recent years have seen neutral packaging, reimbursements for people using tobacco substitutes, higher cigarette pricing and campaigns like the national tobacco-free month.
  2. Today relevant stakeholders from the medical fraternity- Heart Care Foundation India (HDFI), National Neonatology Forum (NNF) and other institutions discussed the why and how of screening newborns for heart defects at the launch of the campaign for formulating a national policy on making Critical Congenital Heart Diseases (CCHD) on making screening mandatory in all healthcare establishments in India.

Dr Anne de-Wahl Granelli, a specialized biomedical scientist who visited India to raise awareness about CCHD screening was also part of the discussion.

At the Government level, Kerala is already working towards making CCHD screening mandatory in all their state-run hospitals.

There is an urgent need to formulate a national policy on the compulsory screening of Critical Congenital Heart Diseases (CCHD) in India.

  1. Limiting global warming to 1.5°C could avoid around 3.3 million cases of dengue fever per year in Latin America and the Caribbean alone—according to new research from the University of East Anglia (UEA). A new report published today in the Proceedings of the National Academy of Sciences (PNAS) reveals that limiting warming to the goal of the UN Paris Agreement would also stop dengue spreading to areas where incidence is currently low. A global warming trajectory of 3.7°C could lead to an increase of up to 7.5 million additional cases per year by the middle of this century.
  2. Read more at: https://phys.org/news/2018-05-limiting-global-millions-dengue-fever.html

Dr Radhakrishnan Siddharth

  1. All critical CHD should ideally be diagnosed in utero. This will ensure that the parents are appropriately counselled on the expectation for their babies and also if they wish to continue with the pregnancy then appropriate steps can be taken for delivery of the baby where immediate neonatal care can be provided.  For this to happen a) The gynaecologist should identify the "high risk" pregnancies for CHD and refer them to the Ultrasonologist at the appropriate time (16 to 20 week) gestation.
  2. Our own study found out that a high percentage of referrals continue to happen much beyond 20 weeks when proper counselling may be too late. This can have devastating psychological impact for parents especially when we deal with complex CHD.
  3. All Ultrasonologist should train themselves in looking at the heart in order not to miss critical CHD and them immediately refer to an appropriate centre (with Foetal Cardiology unit). This is very important because when as Paediatric Cardiologist we counsel parents with critical CHD the most frequently asked question is " Why were we not told about this during our multiple ultrasound examination ". Many parents are of course also very agitated and devastated when this news is broken to them
  4.  Pulse oximetry remains a very simple, inexpensive tool to screen babies who are born with some critical CHD associated with low oxygen levels. Meticulous attention should be paid during recordings of oxygen level by the instrument. Clear guidelines are available for this. However, there are many critical CHD which may be associated with normal pulse oximetry results and this should not be a substitute for a thorough clinical examination at discharge from nursery.
  5. The screening should continue beyond discharge of a new born baby especially during the first visit to the Paediatrician. This will further ensure that some critical CHD which are associated with normal Oximetry at discharge are picked up early and diagnosed after referral to a unit with Paediatric Cardiology services

Financial Health

  1. Certain common expenses incurred for the purpose business or profession and allowed as deduction, as decided by case laws, are:
  1. Replacement of Machinery:
    1. Expenditure on replacement of old machines is in the nature of accumulated repairs and not current repairs. Therefore, the High court allowed such deduction under section 37 in place of section 31. Refer CIT v Gitanjali Mills Limited  265 ITR 681 (2004).
    2. Further, where parts of larger machines are purchased by the assessee, expenditure on such parts is allowable as revenue expenditure. Refer CIT Mod Industries Limited 197 Taxmann76.
    3. Again, replacement of moulds did not result in creation of new capital asset or benefit of enduring nature, mere fact that moulds were used in production process could not be conclusive as to the nature of expenditure, hence, expenditure on replacement of moulds was revenue expenditure. Refer CIT vs. Malerkotla Steels & Alloys (P.) Ltd 237 CTR 201 / 49 DTR 1.

Weather

  1. Heat Wave: Yesterday, heat wave conditions observed at most parts over West Rajasthan; many parts over East Rajasthan & Madhya Pradesh and at one or two pockets over Haryana, Chandigarh & Delhi, Vidarbha and south Uttar Pradesh
  2. Maximum Temperature Maximum temperatures were markedly above normal (5.1°C or More) at one or two pockets of East Rajasthan, West Madhya Pradesh, Saurashtra & Kutch and Vidarbha; appreciably above normal (3.1°C to 5.0°C) at most parts of West Rajasthan & Punjab; at many parts of Himachal Pradesh & East Madhya Pradesh; at some parts of Gujarat region and at one or two pockets of Madhya Maharashtra & Marathwada. Yesterday, the highest maximum temperature of 48.6°C was recorded at Khajuraho (East Madhya Pradesh) over plains of the country
  3. Temperatures Recorded at 1430 Hours IST of Today, the 29 th May, 2018 o Temperatures more than 40.0°C is observed at most parts of Punjab, Haryana, Chandigarh & Delhi, Rajasthan, Madhya Pradesh, Telengana and Vidarbha; at many parts of interior Odisha and Rayalaseema and at one or two pockets of Jammu division, Himachal Pradesh, Gujarat region, Saurashtra & Kutch, East Uttar Pradesh, Jharkhand, Chhattisgarh, North Interior Karnataka, Andhra Pradesh and Tamilnadu & Puducherry
  4. Temperatures recorded at 1430 hours of today have risen by 3-5°C at some parts of Tamilnadu and at one or two pockets of Andhra Pradesh by 1-3°C at most parts of rest Tamilnadu; at some parts of Haryana and Rayalaseema and at one or two pockets of Jammu & Kashmir, Himachal Pradesh, Punjab, West Rajasthan, Uttarakhand, Vidarbha, Chhattisgarh, Konkan & Goa, Kerala, Odisha and Gangetic West Bengal

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