Morning MEDtalks with Dr KK Aggarwal 7^th July 2018

Oral administration of honey or sucralfate after button battery ingestion in children

For asymptomatic children with acute button battery ingestions (witnessed or likely to have occurred within one to two hours) who are older than one year of age give one oral dose of pure honey (eg, 5 to 10 mL) as soon as possible after ingestion.

Guidelines previously recommended no oral intake before timely radiographic localization and emergency endoscopic removal of esophageal button batteries. A recent study using in vitro and in vivo animal models of esophageal battery impaction suggests that early and repeated oral administration of either honey or sucralfate until the battery is removed may reduce the severity of esophageal burns.

Once in the emergency department, the child may receive another dose of honey or a single dose of sucralfate 500 mg prior to confirmation of esophageal impaction and emergency battery removal.  ( Laryngoscope 2018.)

Can government give incentives for organ transplant?

Policy Document and Guidelines on National Organ and Tissue Transplant Programme (NOTP) Ministry of Health & Family Welfare, Govt. of India

(v) Utilization of corpus fund: The funds may be utilized for miscellaneous expenditure and upto 50% of the funds may be utilized for giving incentives to the retrieval and Transplant teams and also giving any other benefits to the family of donors. District level committee may be formed under the chairmanship of District Magistrate to device further guidelines, in this regard.

14. Guidelines for benefits to Families of deceased donors:

Benefits to the cadaver organ donation toward medical treatment and/or education of dependent family members of the donors with a ceiling of Rs. 1(one) lalch per year for a period of fiver years or till the scheme is in operation whichever is earlier. Voluntary donations will also be encouraged from the recipients, part of which will also be used to give additional benefits to the family of organ donor.

1. Financial benefits to the donors will be distributed through SOTTO or State Government where SOTTO is not set up.
2. Eligibility Criteria for benefits to be given to the family members of deceased donors: Should be a citizen of India.
3. Family Members eligible for benefit: or minor children or major unmarried children etc
4. 10% of the benefit is to be given upon retrieval and 90% on transplant

The corpus funds may be created at the level of SOTTO/State Government which will receive funds from following three sources: Government grants Donation from recipients Philanthropic organizations and any other source.

"Leprosy is curable", Supreme Court passes slew of directions for benefit of patients

With the object of ending discrimination against Leprosy patients, the Supreme Court passed a slew of directions aimed at their rehabilitation and integration into society. The directions came to be passed by a Bench of Chief Justice Dipak Misraand Justices AM Khanwilkar and DY Chandrachud in a petition filed by Vidhi Centre for Legal Policy and Pankaj Sinha.

Vidhi had, among other things, prayed for striking down statutes that allegedly discriminate against patients suffering from the disease. Senior Advocate Raju Ramachandran, appearing for Vidhi, had earlier submitted that at least one hundred and nineteen statutes (both Central and State) discriminate against leprosy patients and that the same violate of Articles 14, 19 and 21 of the Constitution. The Court had issued notice in the matter in December last year.

 “There has to be social awareness to the factum that with the advancement of science in the past forty years, the disease is curable.”

The Bench then passed the following directions:

1. Union of India shall carry out awareness campaigns at various levels so that people come to know that Leprosy is curable.
2. There should be specific programmes telecast on All India Radio and Doordarshan on National and regional channels for educating people about the fact that Leprosy is not a communicable disease. The programme should be telecast during primetime.
3. Hospitals should not decline to treat persons suffering from Leprosy.
4. Union of India and States shall take steps to rehabilitate Leprosy patients and to bring them to the mainstream.
5. It is the duty of the Centre and States to ensure that Leprosy patients do not suffer from any stigma.

The Court also directed the Centre and the States to apprise it of the steps taken by filing compliance reports. The matter will now be heard on August 8.

INDIAN-ORIGIN LAWYER NAMED AS ACTING HEAD OF DRUG ENFORCEMENT ADMINISTRATION (DEA) BY US PREZ TRUMP’S ADMINISTRATION

US Attorney General Jeff Sessions stated that, “With one American dying of a drug overdose every nine minutes, there can be no doubt that we are facing the deadliest drug epidemic in our history”. He further added that, “The work of the drug enforcement administration is critical to fighting this crisis, and President (Donald) Trump and I are committed to continuing to give it the strong leadership it deserves. That is why I am pleased to appoint Uttam Dhillon as acting administrator.”

Exposure to air pollution is associated with greater risk of elevated blood pressure (BP) in adults and children. Now a new study has shown that exposure to ambient PM2.5 during the third trimester of pregnancy is associated with elevated BP in children, ages 3 to 9 years. (Hypertension. 2018; 72:194-201. DOI: 10.1161/HYPERTENSIONAHA.117.10944.)

Study showed a sharp increase in offspring SBP percentile and risk for elevated BP when third-trimester PM2.5 concentration was ≥13 μg/m3. The highest versus lowest tertile of third-trimester PM2.5 exposure was associated with a 4.85 percentile increase in child SBP or a 1.61 times higher risk of child elevated BP. A 5-μg/m3 increment in PM2.5 during the third trimester was associated with a 3.49 percentile increase in child SBP or a 1.47 times higher risk of elevated BP.

 Binge alcohol and hypertension

Elevated blood pressure and total cholesterol in men aged 18 to 45 may be a sign of repeated binge drinking, according to results of a new study published in the Journal of the American Heart Association. Binge-drinking men had higher systolic blood pressure and total cholesterol levels than did their non–binge-drinking counterparts and women, irrespective of whether the women were binge drinkers or not.

 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