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Morning Medtalks with Dr KK Aggarwal 1st June 2018

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Dr KK Aggarwal    01 June 2018

Clinical

  1. The US FDA has approved the first stand-alone prosthetic iris in the United States, a surgically implanted device to treat adults and children whose iris (the colored part of the eye around the pupil) is completely missing or damaged due to a congenital condition called aniridia or other damage to the eye.
  2. Paul Marik, MD, chief of pulomonary and criitical care medicine at Eastern Virginia Medical School, reported in 2017 that he gave a mix of vitamin C, vitamin B1, and a steroid to nearly four dozen patients who had sepsis in his Norfolk intensive care unit. In the 7 months before he started using the treatment, 19 of 47 sepsis patients died. Of the 47 who got the treatment, all but four survived. Now, researchers are gearing up to test the therapy with large-scale trials using patients selected at random, with some given the cocktail and others given a placebo.
  3. A medical emergency occurs once every 604 flights and 7.3 per cent led to diversions, according to a 2013 New England Journal of Medicine study. It also found that 0.3 per cent of emergencies on planes end in deaths.
  4. The regression of LVH is associated with a reduction in cardiovascular risk and improved cardiac function. The use of antihypertensive agents, weight loss, or dietary sodium restriction decreases cardiac mass in patients with LVH. Regression of LVH is associated with use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), the direct renin inhibitor, aliskiren, some calcium channel blockers (particularly diltiazem, verapamil, and amlodipine), and some sympatholytic agents (including methyldopa and alpha-blockers). Regression of LVH is less with diuretics and beta blockers and is largely absent with direct vasodilators (such as hydralazine or minoxidil).
  5. Obstructive sleep apnoea is associated with higher risk for stroke, hypertension, diabetes, congestive heart failure, arrhythmias, and the metabolic syndrome and also with fatal and nonfatal cardiovascular events (Dr Miklos Zsolt Molnar, Semmelweis University in Budapest, Hungary)

Future epidemics

  1. Francisella tularensisis the bacterium that causes tularemia, a life-threatening disease spread to humans via contact with an infected animal or through mosquito, tick or deer fly bites.  As few as 10 viable bacteria can cause the disease, which has a death rate of up to 60 percent. Scientists from the National Institute of Allergy and Infectious Diseases — part of the National Institutes of Health — have unraveled the process by which the bacteria cause disease. They found that F. tularensis tricks host cell mitochondria, which produce energy for the cell, in two different phases of infection. In the first eight hours of infection, the bacteria increase mitochondria function, which inhibits cell death and prevents the cell from mounting an inflammatory response to avoid an immune system attack. In the 24 hours after, the bacteria impair mitochondrial function, undergo explosive replication and spread. These basic science findings could play a role in developing effective treatment strategies, according to the researchers.
  2. WHO Priority Diseases: Marburg virus disease: Marburg virus disease (MVD), earlier known as Marburg hemorrhagic fever, is a highly fatal illness caused by the Marburg virus, which belongs to the Filoviridae family. It was first identified in 1967 following simultaneous outbreaks of severe febrile illness associated with hemorrhage and shock in Marburg and Frankfurt am Main in Germany and in Belgrade, Yugoslavia.

Lassa fever

  • Lassa fever is an acute viral hemorrhagic illness caused by Lassa virus, a member of the Arenavirus family of viruses.
  • Lassa virus is endemic in Benin, Ghana, Guinea, Liberia, Mali, Sierra Leone, and Nigeria and other countries in West Africa.
  • It is a zoonotic disease. Rodents (multimammate rats) are the animal reservoirs and shed the virus in their urine and feces.
  • Humans acquire the infection from contact with infected rodents through rodent urine or feces, inhalation of aerosolized rodent excretions, or consumption of infected rodents as a food source.

Public Health

  1. In Brazil, NGO Habitat for Humanity is using advertising to fight against mosquito-borne diseases, with a poster that dissolves during rain to emit an insecticide that kills mosquito larvae. It uses an environmentally-friendly larvicide applied on soluble rice-paper sheets with an organic glue. The poster informs the community about the dangers of mosquitoes with educational messages but on rainy days it performed another function, with water releasing the larvicide. Standing water therefore becomes a mosquito-killing trap, with one poster capable of treating 200 litres of water and lasting up to 60 days.
  2. The current scenario in terms of the number of infants that die due to Critical Congenital Heart Disease is grim. It further necessitates the need to implement a policy at the national level at the earliest. A pulse oximetry screening is not only inexpensive but takes less than 2 to 3 minutes per baby, with the benefits far outweighing the costs. The screening can even be carried out by an ASHA health worker with basic training. We are sure that this high-level meeting and discussion among relevant stakeholders will help us reach a consensus and get positive results," said Dr BD Bhatia, President, The National Neonatology Forum. 
  3. India, the world’s second most populous nation at 1.3 billion people after China (1.4 billion) may outstrip China’s as early as 2022
  4. The 2017 Revisionreport estimates that the fertility rate of Indians (measured as the number of children born to a woman), has plummeted from 4.97 during the 1975-80 period to 2.3 for the current period of 2015-20. By 2025-30, the report projects, the rate will be 2.1, touching 1.86 from 2045-50 and 1.78 from 2095-2100. A fertility rate of about 2.2 is generally considered the replacement level, the rate at which the population would hold steady. When the fertility rate dips below this number, the population is expected to decline. (thediplomatdotcom)

Legal

  1. IPC 92 Section allows bystanders to do CPR.“Act done in good faith for benefit of a person without con­sent.—Nothing is an offence by reason of any harm which it may cause to a person for whose benefit it is done in good faith, even without that person’s consent, if the circumstances are such that it is impossible for that person to signify consent, or if that person is incapable of giving consent, and has no guardian or other person in lawful charge of him from whom it is possible to obtain consent in time for the thing to be done with benefit:……………………

Policy

  1. The MAC Maharashtra Acupuncture Council-- on the lines of MCI was announced last week by the Maharashatra State Medical Education Department. The committee includes one ayurvedic doctor and two sujok practitioners, besides Beramji who is an allopathic and physiotherapist, with a part-time acupuncture practice.

Financial Health

  1. The following Expenditures are allowed, if incurred, for furtherance of Business without any limit:(a) Entertainment,(b) Compliments,(c) Traveling,(d) Advertisement,(e) Maintenance of Guest House

Ayurveda

सर्वदा  सर्वभावानां सामान्यं वृद्धिकारणम्|

ह्रासहेतुर्विशेषश्च, प्रवृत्तिरुभयस्य तु||४४||

(charak samhita 1/44)

The food which are like in properties (of dosha, dhatu or mala) will increase that particular dosha , dhatu or mala. Similarly, the food opposite in properties will decreases that particular dosha, dhatu or mala. For example, eating mamsa will increase the mamsa dhatu. Eating bitter foods will reduce sugar in the blood. 

Heat Wave Warnings for Next 24 hours : Heat wave conditions are very likely to occur at one or two pockets over West Rajasthan, Madhya Pradesh, and Vidarbha.

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