Morning MEDtalks with Dr KK Aggarwal 4th July 2018

Nipah free India

KOZHIKODE:  Kozhikodeand Malappuram districts were declared Nipah-free at a function organized by state health department to mark Doctor’s Day. The whole credit goes to the health cate providers.

US CDC: end of E Coli outbreak

The CDC on June 28 confirmed an end to the nationwide E. coli outbreak linked to romaine lettuce. The outbreak sickened 210 people across 36 states. Ninety-six people were hospitalized, including 27 individuals who developed kidney failure. Five deaths were reported in Arkansas, California, Minnesota and New York. Health officials believe contaminated water from irrigation canals in Yuma Valley, Ariz., may be the cause of the outbreak, although the FDA is still investigating how E. coli entered the water.

Attraction rates for Aedes aegypti

DEET works, but lemon eucalyptus insect repellentis almost as good and is much more effective than DEET four hours after application. Interestingly, those mosquito 8k

Guidelines on neuro-endocrine tumors

To assist the oncologists in making major clinical decisions encountered while managing their patients, the ICMR has issued draft consensus document on management of neuroendocrine cancers. Gastroenteropancreatic neuroendocrine tumours (GEP-NETs) are tumours resulting from the malignant transformation of cells in the diffuse neuroendocrine system that regulates secretion and motility in the gastrointestinal tract. The term GEP-NETs is currently the adopted nomenclature for all the NETs of the GI tract and pancreas.CDC retracts the study: It happens in US also

A widely cited study of suicide rates for different occupations in the US has been retracted as it may contain fatally flawed data. The Centers of Disease Control and Prevention produced the 2016 study that showed the "farming, fishing and forestry" occupational group suffered a higher rate of suicide than any other occupation. But this week, the CDC retracted the study, issuing a notice about errors it said were found in the initial data. Among the errors was mis-classifying farmers into the wrong occupation group, which resulted in the suicide rate for "farming, fishing and forestry" being overstated and the rate for other occupations being understated. 

‘Ayushman Bharat’ to be launched on 15th August

A total of 1350 medical procedure package have been made available by the Government of India. These procedures have been divided into 4 categories i.e. secondary procedures, secondary complex, tertiary procedures and super specialty. The secondary procedures for district hospital level whereas secondary complex procedures have been made reserved for medical colleges. All the remaining procedures will remain open for private and government hospitals.

Dr Reddys Laboratories launched Repatha

The first and only PCSK9 inhibitor, approved by the Drug Controller General India. Repatha (evolocumab) is a patented product of Amgen global, indicated for the treatment of adult patients with primary hypercholesterolaemia or mixed dyslipidaemia. The product would be manufactured by Amgen and distributed by the Hyderabad-based firm in the country.

Repatha is used as an adjunct to diet in combination with a statin or statin with other lipid lowering therapies in patients who are unable to reach LDL-C goals with the maximum tolerated dose of a statin.

COMPLETE AUTISTIC CHILD’S PASSPORT PROCEDURE & INTERVIEW AT HIS HOME: BOMBAY HC TO AUTHORITIES

In the matter titled as “Children of the World India Trust And Debbie Jean Childs, bearing Foreign Adoption Petition No. 22 of 2018 with Judge’s order No. 128 of 2018, the Hon’ble Bombay High Court vide judgment dated 27.06.2018 has allowed the unusual foreign adoption petition and has directed the Regional Passport Office to take necessary interviews or complete the necessary procedure at the residence of the autistic child where he is more comfortable,

Fact of the case:

1. This is an unusual Foreign Adoption Petition. The minor Joshua Vishvas Childs was born on 27th February 2006. From an early age he was diagnosed with a moderate to severe level of autism. He is a non-verbal, low-functioning autistic.
2. The adoptive mother, Debbie Jean Childs, is an American national aged about 59 years old. She has been working in India with autistic children for the last 15 years.
3. Joshua was found abandoned in the Out Patient Department of Duncan Hospital in East Champaran, Bihar on 18th September 2010. The hospital authorities contacted the police two days later and published details of the child in a newspaper. No one claimed his custody. The hospital gave Joshua in temporary custody to Debbie Jean Childs and took from her an Affidavit dated 26thFebruary 2011. Joshua has been in the sole care and custody of Debbie Jean Childs thus, for the last seven years.
4. The Child Welfare Committee, East Champaran, Bihar has declared Joshua legally free for adoption by an order dated 10thJanuary 2018 after following the necessary procedure. Ms Childs registered with CARA as a foreigner living in India. Her home study report was done by a specialised agency, The Children of the World India Trust, Navi Mumbai and CARA has approved the case for adoption. The necessary orders are on record. The required undertakings or affidavits are also available. The No Objection Certificate from CARA and a subsequent Corrigendum dated 6th June 2018 and 12th June 2018 are also on record.
5. Ms Childs is a single woman, divorced, and resides in Thane. She has no children of her own. Her marriage certificate and the certificate of dissolution of that marriage are also annexed.
6. Her health report is positive and her HIV reports has written a negative result. She works as a teacher trainer. She was in India initially on a one-year sabbatical from Action International Ministries, Washington, USA. She has taken subsequent extensions. In 2017 her aggregate wages were over US $ 35,000. She is currently a volunteer without remuneration in a project in Mumbai from 30th April 2018 to 30th October 2018.

Judgment

“8. I have seen the home study report and social worker’s assessment report. This report is entirely positive and recommends the adoption of Joshua by Ms Childs. It specifically notes that she alone has cared for Joshua for the last seven years. There is no question of her being unaware of his autism. It is she who has seen him through the last several years with that condition. There also on record an approval letter from the United State Embassy in New Delhi. In addition, I have seen the child security undertaking by Ms Childs’ niece to take care of the minor should that need arise.

12. I must note that Joshua is before me even as this order is passed. It seems to me that it will be exceedingly difficult for Joshua to wait in any waiting area while his passport application is being processed. His condition will not permit this. The Regional Passport Office is directed to take the necessary interviews or complete the necessary procedure at the residence where Joshua is more comfortable. Given that this is a special case, the Protocol Department of the High Court will assist Ms Childs in coordinating with the Regional Passport Office so that the process is smooth. The Prothonotary & Senior Master is requested to instruct the Protocol Staff to coordinate with Ms Childs, the Petitioner institution and the Passport Office.” (Ira Gupta)

Arrhythmia-induced cardiomyopathy

Is a relatively rare cause of a dilated cardiomyopathy resulting from prolonged periods of rapid ventricular heart rates.

It often improve or resolves following treatment and is associated with a good prognosis in most patients.

Chronic tachycardia ultimately produces significant structural changes in the heart, with impressive left ventricular dilatation

Virtually all tachyarrhythmias have been reported to cause arrhythmia-induced cardiomyopathy, and frequent ectopic beats have also been associated with this condition. In most cases, the myocardial dysfunction improves or normalizes following therapy to control the ventricular heart rate or to restore normal sinus rhythm.

Arrhythmia-induced cardiomyopathy is defined by the presence of a sustained tachycardia (or frequent episodes of tachycardia or very frequent ectopy) that results in with left ventricular (LV) systolic dysfunction.

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