Morning Medtalks with Dr KK Aggarwal 5th June 2018


Dr KK Aggarwal    05 June 2018

World Environment Day

  1. Endocrine disruptors are chemicals that mimic or disrupt the action of naturally occurring hormones. Some of these substances have estrogenic effects or anti-androgenic effects, and may have effects on reproductive and developmental outcomes in human and wildlife populations. Studies are in progress looking at the effects of contaminants that leach from plastics such as bisphenol A and phthalates, commonly found in many consumer products.
  2. Use glass, stainless steel, ceramic, or wood to hold and store foods instead of plastics.
  3. Do not microwave food/beveragesin plastic or use hard polycarbonate plastics (some water bottles/baby bottles/sippy cups) for hot liquids.
  4. Particularly avoid plastics marked 3 (PVC or vinyl), 6 (polystyrene foam), or 7 (other, can contain BPA) on the bottom, which are most likely to contain as bisphenol A and phthalates
  5. Phthalates, man-made chemicals, are used in soft, flexible plastics, polyvinyl chloride (PVC) products, and are found in medical devices, many consumer products, flooring, and a variety of personal care products (such as some shampoos and lotions). Phthalates also may be added to drugs and dietary supplements as an excipient (inactive ingredient that serves a function related to preparation, stability, delivery, etc
  6. There is "some concern" for neural and behavioral effects in fetuses, infants, and children at current human BPA exposures
  7. There is "negligible concern" that exposure of pregnant women to BPA would result in fetal or neonatal mortality, birth defects, or reduced birth weight; "negligible concern" for reproductive effects in non-occupational exposed adults; and "minimal concern" for workers exposed to higher levels in occupational settings.
  8. BPA is a monomer used to make hard, polycarbonate plastics, and some epoxy resins. Polycarbonate plastics are used in many hard sport water bottles, infant bottles, and some medical tubing and devices
  9. The primary route of exposure is through the diet, since BPA can migrate into food from food
  10. Accumulating data suggest that there is a relationship between environmental toxicants, such as endocrine disrupting compounds (EDCs) and phthalates, and allergy/asthma. These products have the potential to affect the development of the immune and respiratory systems, although the exact mechanisms are not well defined. d beverage containers


  1. The drug pricing mechanism in the country is likely to be overhauled before the end of this month. Among the changes proposed by the government is the move to introduce a new price index for pharmaceutical products that will become the benchmark to determine prices of all medicines sold in the country — even those that are currently outside the drug price control order.
  2. Prices of around 850 essential drugsare capped by the government. 
  3. There is a gradual revival in the number of clinical trials being done in India. From an all time low of 17 clinical trials approved by the Drug Controller General of India (DCGI) in 2013, the number has slowly increased to 97 in 2017, a more than 400% jump in five years. (Jyoti The Hindu)

Public Health

  1. The Flaviviridae are a family of positive, single-stranded, enveloped RNA viruses. They are found in arthropods, (primarily ticks and mosquitoes), and can occasionally infect humans.
  2. Members of this family belong to a single genus, Flavivirus, and cause widespread morbidity and mortality throughout the world. Some of the mosquitoes-transmitted viruses include: Yellow Fever, Dengue Fever, Japanese encephalitis, West Nile viruses, and Zika virus. Other Flaviviruses are transmitted by ticks and are responsible of encephalitis and hemorrhagic diseases: Tick-borne Encephalitis (TBE), Kyasanur Forest Disease (KFD) and Alkhurma disease, and Omsk hemorrhagic fever.
  3. More than 150 people have been hospitalised and four have died in the US after ingesting synthetic cannabinoids laced with rat poison, the US Centres for Disease Control and Prevention (CDC) report. Synthetic cannabinoids are in some communities a popular alternative to marijuana. In 2017, the US government classified 26 of them as controlled substances, but they remain widely available through a burgeoning black market.
  4. AEFI Sharing of experiences of MR campaign: The State EPI Officers of Odisha, Uttarakhand and Karnataka shared their experiences regarding AEFIs reported during MR campaign. A national level analysis of allergic reactions/anaphylaxis showed that no deaths were reported following MR due to anaphylaxis. It was informed that the Ministry had approved the use of a single dose of adrenaline for initial management of anaphylaxis.


  1. It is feasible to find early-stage cancer in the blood by way of free cell DNA said lead investigator Geoffrey R. Oxnard, MD, associate professor of medicine at Dana-Farber Cancer Institute and Harvard Medical School in Boston, Massachusetts.

According to ERS/ATS guidelines, any of the following qualifies a patient as having severe asthma:

Poor symptom control: ACQ score consistently > 1.5 or ACT score < 20

Frequent severe exacerbations: Two or more bursts of systemic corticosteroids (> 3 d each) in the previous year

Serious exacerbations: At least one mechanical ventilation episode, hospitalization, or intensive care unit stay in the previous year

Airflow limitation: FEV1 < 80% predicted after withholding bronchodilators


Financial Health

Legal charges incurred for defending criminal proceedings which has got nothing to do with Assessee profession is definitely of personal nature and such expenditure cannot be allowed against income from business and Profession. Refer DCIT v Salman Khan 9 Taxmann.com 74.


Vedic Medicine (Dr Mukta)

न च नापेक्षते द्रव्यं; द्रव्यापेक्षया च त्रिभागसौहित्यमर्धसौहित्यं वा गुरूणामुपदिश्यते, लघूनामपि च नातिसौहित्यमग्नेर्युक्त्यर्थम्||७||

Charak Sutra 5/7

The heavy food articles should be taken up to ½ or 1/3rd satiety

The light food articles should not be taken up to the level of satiety

IMANDB Resolutions

  1. The government policy of not allowing reuse of plastic costly cardiac disposables needs to be redressed on environmental pollution grounds also. They should be allowed to be recycled.
  2. Every doctors must council his patients about medical insurance.
  3. No cell phone should be allowed in operation theatre.
  4. Light soothing music in OT rooms should be allowed.
  5. Air purifiers can not be recommended at this stage in every room in a hospital.
  6. Ignorance of law is not a defence in medical practice.
  7. 11 crore people are covered in ESI medical insurance and 18 crore unorganised people are likely to get covered in it
  8. Affordable healthcare means transparent, safe, quality and value for money health care
  9. Filtered cigarettes does not reduce the risk of lung cancer
  10. Air should be exhausted to the outdoors (where the droplet nuclei are diluted in the outdoor air), far removed from any intake vents, people, or animals (in accordance with applicable federal, state, and local regulations on environmental discharges). If recirculation to general ventilation is unavoidable, air must be passed through a high-efficiency particulate air (HEPA) filter installed in the exhaust ducts to remove infectious droplets from the air before it is returned to the general circulation

Environment health

A Whale dies in Thailand after swallowing more than 80 Plastic Bags

In southern Thailand a whale has died after swallowing more than 80 plastic bags. Thailand’s veterinary team tried “to help stabilise its illness but finally the whale died” yesterday afternoon. Autopsy of the corpse revealed 80 plastic bags weighing up to eight kilograms (18 pounds) in the creature’s stomach.

A marine biologist said the bags had made it impossible for the whale to eat any nutritional food. “If you have 80 plastic bags in your stomach, you die (LatestLaws.com)


  1. UK Jails Indian origin man for claiming inflated Medical Compensation: Sandip Singh Atwal, a Disc Jockey (DJ) who exaggerated the effect of his relatively minor injuries in a bid to defraud National Health Service (NHS) of £800,000 (₹7.15 crore) has been jailed for three months. Atwal has been also asked to pay £75,000 (₹67 lakh) in the legal costs. (Source LatestLaws.com) (Ira Gupta)
  2. A 29-day old baby died in Kerala last week a day after he was circumcised, reportedly due to heavy bleeding. The baby’s parents filed a complaint with a human rights group, alleging that their child passed away due to the doctor’s negligence.

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