Morning MEDtalks with Dr KK Aggarwal 5^th July 2018

Nipah Update

ICMR has confirmed fruit bats were the primary source of the virus that killed 17 persons in Kozhikodeand Malappuram districts of the state earlier this year. The delay in identifying the zoonotic virus host occurred because the wrong bat species were trapped and tested in May. In the second round, samples from 55 fruit bats were collected and sent to National Institute of Virology in Pune.

ICMR Nutrition App

ICMR’s Hyderabad-based National Institute of Nutrition has launched a mobile App that offers comprehensive nutrition related information on a wide range of Indian food articles.  The App named ‘Nutrify India Now’ is based on authentic and well researched India-specific databases and uses guidelines prescribed by ICMR, the apex medical research body of the country.

Zika may cause more abortions than expected

According to an NIH study, published in Nature Medicine, fetal death in utero occurred in more than one-fourth of monkeys infected in the laboratory with Zika virus in early pregnancy.

Long working hours and diabetes

Women who work long hours have an increased risk of diabetes, a new study suggests. Researchers found women who work more than 45 hours a week have a significantly higher risk of developing the disease. But the same link was not found in men, according to the study published in the journal BMJ Open Diabetes Research and Care

Metformin for lung fibrosis

University of Alabama, Birmingham, have amassed evidence that Metformin can help repair the lung fibrosis. The team is particularly interested in finding effective treatments for idiopathic pulmonary fibrosis (IPF), a progressive, fatal disease. The scientists zeroed in on cells called myofibroblasts, which are responsible for depositing the damaging collagen that proliferates in lung fibrosis. They found that the activity of an enzyme called AMP-activated protein kinase (AMPK) was suppressed in fibrotic areas of tissue samples taken from IPF patients. The metabolisms of those cells went into overdrive, making them less likely to undergo apoptosis, or programmed cell death. Metformin activates AMPK. In experiments with the tissue samples and lung fibroblasts from mice, the researchers found that metformin reversed lung fibrosis.

Death Rates May Be Lower When Patients See the Same Doctor

Lower death rates occur when patients see the same doctor over time as per authors of a study in BMJ Open.

Sir Denis Pereira Gray, who led the investigation, said: "There have been huge advances in technology – and theyve had a lot of publicity – and one can argue that the human side of medicine has been a bit neglected."

Sir Denis said the advantages of personal care have been established. "Its been shown that it improves patient satisfaction, it improves the likelihood of a patient following medical advice, it improves the uptake of personal preventive medicine, and it reduces unnecessary admissions to hospital significantly."

The study, a collaboration between St Leonards Practice in Exeter and the University of Exeter Medical School, investigated whether higher levels of continuity of care, in any setting, with any patient group, was associated with changed mortality.

Vedic reference on diet

अनशनमायुषो ह्रासकराणां,

 प्रमिताशनं कर्शनीयानाम्,

अजीर्णाध्यशनं ग्रहणीदूषणानां, विरुद्धवीर्याशनं निन्दितव्याधिकराणां

Not eating or long fasting lowers the age. Eating in less amount causes emaciation. Eating when the previous meal is not digested causes diseases of duodenum and eating food articles with opposite potencies may cause diseases like obesity, diabetes, skin diseases.

IMA TNSB NHB

1. ACCOMMODATION COST: Floor areas as Per the CEA 003 (central act) and Value as per Average Rental Value per Sq rft in a semi urban area @ Rs.70 /Sq Ft for 50% bed occupancy = 1761/-
2. EMPLOYEE COST: No. of Employees as per IPH S (Indian Public health Standards) and as per Minimum Wages Act GO (2d) No. 24 Dated 02.03.2018 – Govt. of Tamil Nadu: Rs 2212/- for 50% bed occupancy
3. ADMINISTRATIVE COST: For all Statutory Licenses / Taxes etc. Rs. 796 / Bed Day at 50 % Occupancy
4. COMMONLY USED EQUIPMENT AND FURNITURE FOR WARD (OTHER THAN OT/ICU/OTHER SPECIAL EQUIPMENT) as per the CEA 003 (central act) Standards Annex 3-page 21-26 139/bed/day (107 usage cost and 32 per bed maintenance cost)
5. OT ACCOMMODATION: 191 /- per hour usage (Floor Area as per CEA 003 (Central act). Calculated on 6 hours usage per day
6. OT COMMON EQUIPMENTS: as per the CEA 003 (central act) Standards 702/- per hour (usage cost 591 and maintainance cost 111 per hour)

OT SPECIAL EQUIPMENTS: As per Case Usage cost

1. ICU ACCOMMODATION: Floor areas as the CEA 003 (central act) Standards, Value calculated per bed Day @50% usage. 2224/per bed.
2. ICU COMMON EQUIPMENTS: as per the CEA 003 (central act) Standards, per bed @50 usage 2328 per bed per day (1938 usage and 390 maintenance cost)
3. ICU SPECIAL EQUIPMENTS AS PER EQUIPMENT USED: As per Equipment Used

THE WARD BED CHARGES PER BED PER DAY ON THE BASIS OF 50 % OCCUPENCY: (ACCOMMODATION COST + EMPLOYEE COST+ ADMINISTRATIVE COST+ COMMONLY USED EQUIPMENT) = Rs. 4908 / bed day

2.ICU CHARGES PER BED PER DAY ON THE BASIS OF 50% OCCUPENCY = (ICU ACCOMMODATION + ICU COMMON EQUIPMENTS +    EMPLOYEE COST+ ADMINISTRATIVE COST+ COMMONLY USED EQUIPMENT) = Rs. 7699 + special Equipment charges.

3.O T CHARGES: Per Hour (OT ACCOMMODATION + OT COMMON EQUIPMENTS) = Rs 893 / per hour special Equipment charges / hour

Bollywood actress Sonali Bendre has been diagnosed with metastatic cancer.

Is there something like cancer of unknown primary?

CUP accounts for up to 4 to 5 percent of all cancer diagnoses.

CUPs can be classified into four categories

Adenocarcinoma

Squamous cell carcinoma

Neuroendocrine carcinoma, which may be either well differentiated or poorly differentiated

Poorly differentiated cancer

Accurate prediction of the tissue of origin using immunohistochemical staining and/or gene expression profiling is now possible in most CUP patients, and site-specific therapy based on these predictions is replacing empiric chemotherapy as the new treatment standard.

Participate in survey on Inflammatory bowel disease: https://docs.google.com/forms/d/1SAbiZpxKIqt6bWixE3J-1ZB7VPH-Z530tmAgseQLK4g/edit

Dr KK Aggarwal

Padma Shri Awardee

President HCFI

Vice President CMAAO