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Morning Medtalks with Dr KK Aggarwal 7th June 2018

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Dr KK Aggarwal    07 June 2018

WMA

  1. The WMA recommends that physicians who have been convicted of serious criminal offences, in particular of genocide, war crimes or crimes against humanity, be denied a license to practice medicine elsewhere.
  2. The WMA recommends that national medical associations (or other relevant regulatory bodies) use their own authority to be informed, in so far as is possible, if serious allegations of participation in war crimes or crimes against humanity have been made against physicians, while at the same time respecting the presumption of innocence.
  3. The WMA recommends that national medical associations ensure that there is efficient communication amongst themselves and that where possible and appropriate they inform relevant national licensing authorities of physicians’ convictions of serious criminal offenses.
  4. Plastic waste: Plastic has been part of life for more than 100 years and is regularly used in some form by nearly everyone. While some biodegradable varieties are being developed, most plastics break down very slowly with the decomposition process taking hundreds of years. This means that most plastics that have ever been manufactured are still on Earth, unless burnt polluting the atmosphere with poisonous smoke.

Concerns about the use of plastic include “accumulation of waste in landfills and in natural habitats, physical problems for wildlife resulting from ingestion or entanglement in plastic, the leaching of chemicals from plastic products and the potential for plastics to transfer chemicals to wildlife and humans”. Many plastics in use today are halogenated plastics or contain other additives used in production, that have potentially harmful effects on health (e.g. carcinogenic or promoting endocrine disruption).

Our current usage of plastic is not sustainable, accumulating waste and therefore contributing to environmental degradation and potentially harmful effects on health. Specific regulation is therefore needed to counter the harmful distribution of slowly degradable plastic waste into the environment and the incineration of such waste which often creates toxic byproducts.

Clinical

  1. Babies born with diabetes can now be treated successfully with oral sulphonylurea tablets instead of insulin injections. Researchers from the University of Exeter have collaborated with groups in Norway, Italy, France and Poland to analyse findings from 81 patients from 20 different countries. The results showed they were successfully treated through sulphonylurea tablets and had excellent blood sugar control over the long-term. Neonatal diabetes is diagnosed before the age of six months and in half of all cases is caused by a mutation in their KCNJ11 gene, which is involved in keeping insulin-producing cells in the pancreas working properly. This results in life-threatening diabetes soon after birth.
  2. Lasix vs Dytor: Studies in subjects with normal renal function indicate that a diuresis begins with as little as 10 mg of furosemide, with the maximal effect being seen with 40 mg given intravenously. If furosemide is given orally, this maximum dose is usually twice the intravenous dose (80 mg) since its bioavailability is only about 50 percent. The equivalent maximal dose is 15 to 20 mg for either oral or intravenous torsemidesince this is almost completely absorbed. All of the loop diuretics produce the same response if given at equipotent doses. Going above these maximum doses will produce little or no further diuresis but may increase the risk of side effects.

Legal

  1. A 3-year-old Missouri girl has reached a $1,375,000 settlement with health-care providers whom she alleged failed to spot dehydration in the days following her birth, leading to a brain injury. Her attorney, Mike Meyer of Bartimus Frickleton Robertson Rader in Leawood, Kansas, said the parties, whose identities remain confidential as part of the settlement agreement

 Allowable expense in oncome tax

  1. The amount of any Bad Debt or part thereof which is written off as irrecoverable in the accounts of the assessee for the previous year [sec 36]

Vedic Medicine

  1. Bhagavad Gita chapter 6 shloka 17

युक्ताहारविहारस्य युक्तचेष्टस्य कर्मसु |युक्तस्वप्नावबोधस्य योगो भवति दु:खहा || 17||

"Yukaharaviharasya yuktachestasya karmasu. Yuktasvapnavabodhasya yoga bhavati duhkhaha"

It means "the one, whose diet and movements are balanced, whose actions are proper, whose hours of sleeping and waking up are regular, and who follows the path of meditation, is the destroyer of pain or unhappiness."

Moderation and variety is the mantra of the present day concept of dieticians. Moderation in diet, as well as moderation in thinking, recreation and actions is the secret to healthy living.

Lord Krishna further clarifies this (chapter 6 shloka 16) by saying that, eating too much food or starving, and sleeping too much or remaining awake all the time is not health friendly. Such people cannot concentrate or do sadhana

नात्यश्नतस्तु योगोऽस्ति चैकान्तमनश्नत: | चाति स्वप्नशीलस्य जाग्रतो नैव चार्जुन || 16||

nātyaśhnatastu yogo ’sti na chaikāntam anaśhnataḥna chāti-svapna-śhīlasya jāgrato naiva chārjuna

Three ante-natal interventions every doctor must know

  1. Late cord clamping (performed approximately 1–3 min after birth) is recommended for all births, while initiating simultaneous essential neonatal care. Early umbilical cord clamping (less than 1 min after birth) is not recommended unless the neonate is asphyxiated and needs to be moved immediately for resuscitation.
  1. ANM should ensure that a young infant with sepsis is referred to the nearest health facility for appropriate treatment after giving the first dose/prereferral doses of Injection Gentamicin and Syrup Amoxicillin.
  1. Administer antenatal corticosteroids to pregnant woman who are at 23+0 to 33+6 weeks of gestation and at increased risk of preterm delivery within the next seven days. Give betamethasone suspension 12 mg intramuscularly every 24 hours for two doses orfour doses of 6 mg dexamethasone intramuscularly 12 hours apart.

Public Health

12 Scary Diseases You Can Get from a Mosquito Bite: Dengue, Chikungunya, Zika, Japanese encephalitis, Venezuelan equine encephalitis, Eastern equine encephalitis , filaria, Malaria, Yellow fever, West Nile and St. Louis Encephalitis and La Crosse encephalitis

4 immunizations youll need before you travel: hepatitis A, yellow fever, typhoid, tetanus

3 things that attract mosquitoes: More CO2 (exercise, pregnancy, CO2 emitting traps), More lactate, More heat (abdomen of pregnant women)

9 plants that naturally repel mosquitoes: Besil, lemon balm, catnip, Pennyroyal, Citronella, Marigolds, lavender, eucalyptus, garlic

9 Mosquito repelling foods: Garlic, salt, lemon, onion, orange and lemon peels, apple cider vinegar, vanilla, olive oil

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