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Morning Medtalks with Dr KK Aggarwal 4th June 2018

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Dr KK Aggarwal    04 June 2018

Clinical

  1. The Kerala government on Saturdaydecided to postpone the re-opening of educational institutions in Kozhikode district to 12 June, besides deferring all examinations, except those conducted by the Union Public Service Commission (UPSC).
  2. North Eastern region has been dubbed as the “cancer capital of India” on account of lifestyle, low awareness and late detection that has led to rise in number of cases of the disease. Director of Dr. Borooah Cancer Institute (BBCI) Guwahati Dr. AC Kataki lamented that the reason for the region being dubbed as “cancer capital” arose from the fact that it alone added about 39,635 cancer patients in a year.
  3. More than 1 billion people cross international borders each year, generally unaware of local infectious disease outbreaks. In the United States, 60 million people travel internationally most years, with 60 percent of those destinations having an active health alert. The Centers of Disease Control and Prevention (CDC) issues international Travel Alerts, but few people are actually aware of this vital information. 
  4. Severe asthma is defined as asthma that requires use of high-dose inhaled corticosteroids along with a second controller or systemic corticosteroids, or both. It also refers to asthma that remains uncontrolled despite this treatment. Do you know that recurrent exacerbations in adult severe asthma are more common among patients with gastroesophageal reflux?

Public Health

Newcastle disease outbreak in peacocks in Haryana

Twenty-two peacocks in Bhondsi, Haryana have died in the last fortnight reportedly due to Newcastle Disease. The Indian Veterinary Research Institute, Bareilly has established the presence of the Newcastle disease virus in the infected birds following which an outbreak of Virulent Newcastle Disease among peacocks has been confirmed by authorities, reported the TOI on Saturday.

Here are 10 salient points about Newcastle disease.

  1. Newcastle disease is a highly contagious and fatal zoonotic viral disease of domestic poultry, cage and aviary birds and wild birds.
  2. It is caused by the Newcastle virus, a paramyxovirus, which is antigenically distinct from any of the human paramyxoviruses.
  3. It was first identified in 1926 in Java, Indonesia and in 1927, in Newcastle-upon-Tyne in England, from where it derives its name.
  4. Clinically, the infection in birds presents with digestive, respiratory and/or neurological signs. The incubation period is usually 5–6 days, but can vary from 2–15 days.
  5. Humans can acquire the infection via direct physical contact with infected birds. The virus can also be transmitted through contaminated equipment, carcasses, water, food and clothing.
  6. No cases of human infection have been reported yet from eating poultry products
  7. In humans, the infection is mild and presents as unilateral or bilateral reddening, excessive lachrymation, edema of the eyelids, conjunctivitis and sub-conjunctival haemorrhage. It may also cause influenza-like symptoms, but otherwise poses no hazard to human health.
  8. Laboratory workers or those living in close vicinity of the birds are mainly at risk of acquiring the infection.
  9. Infection can be prevented by using standard personal protective equipment.
  10. Virulent Newcastle disease is a notifiable disease.
  11. The Paramyxoviridae are a large family of single-strand, enveloped RNA viruses which causes a number of human and animal diseases. The most recognized viruses in this family are measles and mumps for human diseases and newcastle disease virus, canine distemper and rinderpest (recently eradicated) viruses for animal diseases.

The only viruses of this family handled by the Viral Special Pathogens Branch belong to the genus Henipavirus which contain 2 virus species: Hendra virus and Nipah virus. These viruses have been isolated from humans, bats, horses, and pigs.

Viral Haemorrhagic Fevers

VHFs are caused by viruses of five distinct families: Arenaviridae, Bunyaviridae, Filoviridae, Flaviviridae, and Paramyxoviridae. Each of these families share a number of features:

  1. They are all RNA viruses, and are all covered, or enveloped, in a fatty (lipid) coating.
  2. Their survival is dependent on an animal or insect host, called the natural reservoir.
  3. The viruses are geographically restricted to the areas where their host species live.
  4. Humans are not the natural reservoir for any of these viruses. Humans are infected when they come into contact with infected hosts. However, with some viruses, after the accidental transmission from the host, humans can transmit the virus to one another.
  5. Human cases or outbreaks of hemorrhagic fevers caused by these viruses occur sporadically and irregularly.
  6. The occurrence of outbreaks cannot be easily predicted.
  7. With a few noteworthy exceptions, there is no cure or established drug treatment for VHFs.

In rare cases, other viral and bacterial infections can cause a hemorrhagic fever; scrub typhus is a good example.

 

Financial Health

Certain common examples of expenses incurred being disallowed as deduction, as decided by case laws, are:

Regulation fees paid to Municipal Authority: In this case High court of Karnataka decided that any regulation fees paid to municipal authority for compounding of offence is not available for deduction under section 37 as the same was in the nature of penalty.

 

Refundable Deposit:  Mumbai ITAT decided that any refundable deposit with stock exchange is not allowed as deduction for expenditure

 

Foreign Tour Expenditure of Wife:  In this case, the High court has disallowed 50% of Foreign Tour expenses as director of the company accompanied by his wife who is not an employee of the company.

 

Betterment Charges:  Supreme Court decided that payment of betterment charges for improvement of land where such payment had no direct nexus with the day to day running of the business. 

 

Bank Guarantee: Gujarat High Court decided that any payment of bank charges related towards bank guarantee required for purchase of machinery should not be allowed as revenue expenditure.

Vedic Medicine (Dr Mukta)

षष्टिकाञ्छालिमुद्गांश्च सैन्धवामलके यवान्|

आन्तरीक्षं पयः सर्पिर्जाङ्गलं मधु चाभ्यसेत्||१२||

Charak samhita 5/12

The concept of balanced diet as mentioned in Ayurveda.

These food articles should be taken regularly – shashtik, shali (variety of rice) , mudga (green gram dal ), saindhav salt (rock salt) , Amalaka (embelia), Yava (millets ), Antriksha jala (water from skies ) , milk , ghee , honey and the meat of Jangal (tropical ) animals

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