Morning Medtalks with Dr KK Aggarwal 19th June 2018


Dr KK Aggarwal    19 June 2018

Mistakes occur around the globe

Dozens of patients have suffered harm because of major medical blunders by the Welsh NHS in the last three years. The Welsh Government publishes a list annually on the number of “serious, largely preventable patient safety incidents” that should not occur if the available preventative measures are in place. They are known as “never events” and are reported by senior hospital staff.

Since 2015-16, there have been 65 reported never events, with 21 occurring in 2017-18, 23 in 2016-17 and 21 in 2015-16. Almost a third – 20 out of 65 – involved foreign objects being left in patients after surgical procedures. And there were 16 incidences of surgery having been carried out on the wrong part of the body – including an incorrect hip replacement and surgery on the wrong eye. (walesonline)

Retained foreign object post-procedure - 5

Wrong implant/prosthesis - 5

Wrong site surgery - 7

Overdose of methotrexate for non-cancer treatment - 1

Wrong route administration of medication - 2

Transfusion or transplantation of ABO-incompatible blood components or organs - 1

Use of the World Health Organisations surgical checklist should also be mandatory and can prevent never events from occurring.

Children with a gaming addiction will now be able to get free NHS treatment: Will Mediclaim follow

WHO has listed gaming disorder in its International Classification of Diseases (ICD). As a result, on Monday it will notify governments around the world that they will be expected to incorporate “gaming disorder” into their health systems. This means that the condition will be now treated on the NHS .

Gaming disorder is defined by the WHO as a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.

For gaming disorder to be diagnosed, the behaviour pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months.

The International Classification of Diseases (ICD) is the basis for identification of health trends and statistics globally and the international standard for reporting diseases and health conditions. It is used by medical practitioners around the world to diagnose conditions and by researchers to categorize conditions.

The inclusion will result in the increased attention of health professionals to the risks of development of this disorder and, accordingly, to relevant prevention and treatment measures.

Pain does not mean painkiller

In patients with osteoarthritis, NSAIDs increase the risk for cardiovascular disease to more than twice the rate of the general population. (European League Against Rheumatism Congress 2018.). Osteoarthritis has no cure and one can-not give pain killer life-long.

Osteoarthritis alone also has already been shown to be an independent risk factor for cardiovascular disease (Sci Rep. 2016;6:39672)

What to do: Non pain killer drugs from modern medicine ( chondrin sulphate, Knee replacement, knee wash with arthoscopy), take help of physiotherapy, Haldi ( it has TNF blocker like properties), hot and cold compressions (Nature Cure), Guggul (Ayurveda), Acupressure, Acupuncture 


In the Public Interest Litigation titled as “Senior Citizen Welfare Organisation & another versus State of Uttarakhand & another” bearing Writ Petition (PIL) No. 52 of 2013, the Hon’ble Division Bench of the High Court of Uttarakhand, Nanital Bench while dealing with the petition which was filed for protecting the rights of the senior citizen as per the provisions of the Maintenance and Welfare of the Parents and Senior Citizens Act, 2007, the Hon’ble High Court has vide judgment dated 12.06.2018 held that the senior citizens in case of emergency shall be taken to the nearest hospital for treatment and the cost of conveyance shall be borne by the State Government including the medical expenditure as well as of ambulance.

The Hon’ble High Court vide judgment has issued various directions for protecting the rights of the senior citizens which are reproduced hereunder:

“13.  Accordingly, in view of the observations/ discussions made above, the present petition is disposed of with the following mandatory directions:

  1. The State Government is directed to establish old age home in each district of the State of Uttarakhand within a period of six months. It is made clear that it shall be open to the State Government to hire private accommodation, as a temporary measure.
  2. The State Government is directed to make a scheme for management of old age homes within a period of eight weeks from today as per Section 19(2) of the Act.
  3. The State Government is directed to ensure to provide sufficient number of beds for senior citizens in each Government hospital or hospitals funded by the State Government.
  4. The State Government is further directed to ensure that all the senior citizens in the State of Uttarakhand are provided free treatment including blood test, CT scan, MRI and other tests at Govt. hospitals.
  5. The respondent-State shall upgrade the facilities to be provided in old age homes from time to time including the strength of the inhabitants.
  6. The State Government is also directed to give due publicity to the Maintenance and Welfare of Parents and Senior Citizens Act, 2007 in print media, electronic media including through Panchayati Raj institutions for the awareness of the enactment as per Section 21 of the Act, 2007.
  7. The State Government shall provide the facilities to the senior citizens as per the Rules.
  8. The State Government shall provide separate accommodation for men and women including sufficient potable water, electric fans, coolers/ AC, separate kitchen, dining room, separate bathroom for disabled senior citizens.
  9. The State Government is also directed to provide wheel chair, television, newspaper and books in old age homes.
  10. The State Government is also directed to provide ramp railing to the senior citizens including telephone service.
  11. The State Government is also directed to provide balanced nutritious food, two sets of clothes for summer and winters, linen, sufficient number of sweepers for maintaining hygiene and cleanliness in old age homes.
  12. The senior citizens in case of emergency shall be taken to the nearest hospital for treatment. The cost of conveyance shall be borne by the State Government including the medical expenditure as well as of ambulance.
  13. The Circle Officers of the respective area are directed to maintain vigil in and around the old age homes.
  14. The State Government is directed to protect the life and property of the senior citizens as provided under Rule 20.

14.  The Secretary, Welfare to the State of Uttarakhand shall be personally responsible to implement the orders and monitor the directions issued hereinabove.”

Type 1 diabetes: Cell therapy

Cell therapy is one of the biggest hopes towards developing a cure for diabetes, especially for type 1 diabetes. Replacing the missing insulin-producing cells has the potential to recover normal insulin production and cure patients. However, early attempts at the transplantation of pancreatic cells have largely failed, mostly due to immune reactions against donor cells that cause complications and eventually destroy the implanted cells. The lack of donors is also a limitation.

One of the most advanced alternatives comes from the Diabetes Research Institute (DRI) in the US, which is developing a bioengineered mini-organ where insulin-producing cells are encapsulated within a protective barrier. Two years ago, the DRI announced that the first patient treated in an ongoing Phase I/II trial no longer requires insulin therapy.

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