And now a Sonic War

Morning MEDtalks with Dr K K Aggarwal 13^th July 2018

Hon’ble Supreme Court Directs Private Hospital Of Delhi To Provide Free Treatment To Poor Patients

In the matter titled as “Union of India versus Mool Chand Khairati Ram Trust”, Civil Appeal Bearing No. 3155 of 2017, the Hon’ble Supreme Court of India vide judgment dated 09.07.2018 while dealing with the issue of validity of the Circular issued   by   the   Government   of   NCT   of   Delhi(GNCTD) on 2.2.2012 whereby it intimated the hospitals to implement the judgment of Delhi High Court with regard to free treatment to the weaker   sections   of   the   society   in   terms   of   the   judgment dated 22.3.2007 in the case of Social Jurists v. Government of NCT of Delhi & Ors. has held that the hospitals in question i.e. Moolchand Hospital, St. Stephens Hospital, Sitaram Bharti Hospital, Foundation of Cancer Research and other similarly situated hospitals shall scrupulously observe the conditions framed in the order / circular dated 02.02.2012 and in case violation is reported the same shall be viewed sternly and the lease shall be cancelled.

Facts of the case

The question   involved in   the appeals is with respect to the validity   of   Circular   issued   by   the   Government   of   NCT   of   Delhi (GNCTD) on 2.2.2012 whereby it intimated the hospitals to implement the judgment of Delhi High Court with regard to free treatment to the weaker   sections   of   the   society   in   terms   of   the   judgment   dated22.3.2007 in the case of Social Jurists v. Government of NCT of Delhi& Ors. Thereafter, the Land & Development Officer (in short, ‘L&D) passed   an   order   dated   2.2.2012   wherein   it   was   stated   that   the Government of India had taken a policy decision that all the hospitals which have been provided land by L&DO have to strictly follow the policy of providing free treatment as provided in it. That the said conditions were applicable to Moolchand Hospital and St. Stephens Hospital as they were allotted land by L&DO. Communication on similar lines was issued by Government of NCT of Delhi to Sitaram Bhartia and the Foundation of Cancer Research imposing condition of providing free treatment to 10% indoor patients and 25% to outdoor patients of poor strata of the society. The decision was taken in the light of the decision of Delhi High Court in Social Jurists case (supra)which was referred by this Court in Special Leave Petition [Civil]No.18599 of 2007 vide order dated 1.9.2011 in which this Court observed that 25% OPD and 10% IPD have to be given treatment free of cost. Said patients should not be charged with anything. However, the concerned hospital could make the arrangements of the cost either by meeting the treatment/medicines cost from its funds or resources or by way of sponsorships or endowments or donations. As the respondent’s hospitals were not a party, they have questioned imposition of said conditions in the impugned order by filing writ applications.     The   High   Court   has   quashed   the   imposition   of conditions hence, the appeals have been preferred.

Judgment

109. However, we make it clear that the hospitals in question and other   similarly   situated   hospitals, shall   scrupulously   observe   the conditions   framed   in   the   order   dated   2.2.2012   and   in   case   any violation is reported, the same shall be viewed sternly and the lease shall be cancelled.  We are constrained to pass this order as there had   been   resistance   to   wholesome   policy   violation   of   the   above conditions contained in order dated 2.2.2012.  Such violation cannot be      permitted to prevail.  We hereby direct the Government of NCT of Delhi to file a periodical report to this Court within a period of one year   from today   with   respect   to   compliance   of   conditions   by the respondents hospitals and other similar hospitals in Delhi, not only governed   by   the   decision of Social Jurists case (supra), but   also governed by this judgment. “

Sonic attacks

Sonic and ultrasonic weapons are weapons of various types that use sound to injure, incapacitate, or kill an opponent.

Some sonic weapons are currently in limited use or in research and development by military and police forces.

Some of these weapons have been described as sonic bullets, sonic grenades, sonic mines, or sonic cannons. Some make a focused beam of sound or ultrasound; some make an area field of sound.

Diplomats in at least seven cities in four different countries have sought testing for strange symptoms. The victims’ symptoms include “hearing loss, dizziness, tinnitus, balance problems, visual difficulties, headaches, fatigue, cognitive issues and sleeping problems.”

The bizarre “sonic attacks” against diplomats began in Cuba, but have now spread to other countries with over 200 illnesses reported. It all started in the fall of 2016 when diplomats at the United States Embassy in Cuba reported some hearing loss and mild brain damage after hearing unusual and puzzling sounds.

A similar phenomenon was reported earlier this year by an employee working at a U.S. diplomatic facility in China, although that incident also remains unexplained.

Now the US CDC has joined a government investigation into sonic attacks that have left more than 25 U.S. personnel with mysterious ailments.

The U.S. government has issued an alert warning Americans traveling to China to seek medical attention if they experience “auditory or sensory phenomena” similar to what was reported in Havana. Additionally, the State Department recommended anyone traveling to Cuba should “reconsider” their plans.

You can hear the sound here https://www.youtube.com/watch?time_continue=7&v=rgbnZG85IRo

Transcutol-P in Injectable diclofenac the cause of kidney damage

DCGI has ordered the withdrawal of diclofenac painkiller injection marketed by Novartis India Ltd and made by Themis Medicare Ltd, following safety concerns. As per reports the DCGI on 4 July directed the state drug controller in Dehradun, Uttarakhand, and the drug licensing authority of Daman and Diu to cancel the manufacturing licence granted to Themis Medicare for diclofenac sodium injection 75 mg/ml using Transcutol-P which causes kidney damage.

The efficacy and safety of the additive Transcutol-P came under the scanner after Troikaa, another company, claimed that it was not used anywhere in the world, and was not permitted for use in parenteral preparations, meaning that it cannot be used in intravenous or intramuscular injections.

DIETHYLENE GLYCOL MONOETHYL ETHER is a colorless, slightly viscous liquid with a mild pleasant odor. Flash point near 190°F. Used to make soaps, dyes, and other chemicals.  It is a high purity solvent and solubilizer for poorly water soluble active pharmaceutical ingredients. Associated with improved drug penetration, permeation and a drug depot effect.

Australian Scientists Cuts Dengue Mosquito Population by 80% in 8 months

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Australian scientists from Commonwealth Scientific and Industrial Research Organization (CSIRO) and James Cook University (JCU) successfully eliminated 80% of Aedes aegypti mosquito species during trials that were conducted across locations in north Queensland.

For the experiment, scientists bred about 20 million mosquitoes and infected the males with the Wolbachia bacteria that made them sterile before releasing some three million across three specific towns.

The sterile male mosquitoes did not bite or spread disease. Additionally, when the control subjects mated with wild female mosquitoes the eggs did not hatch, resulting in diminished population.

The project was funded by Googles parent company Alphabet.

No Scientific Proof That Multivitamins Promote Heart Health

According to a study published in Circulation: Cardiovascular Quality and Outcomes (a comprehensive meta-analytic review of relevant research) taking multivitamin/mineral (MVM) supplements does not prevent myocardial infarction, stroke, or death from a cardiovascular cause.

Indian Psychiatric Association says homosexuality not a medical condition

Indian Psychiatric Association: “In the opinion of the Indian Psychiatric Association, homosexuality is not a psychiatric disorder. This is in line with the position of the American Psychiatric Association and the International Classification of Diseases of the World Health Organization which removed homosexuality from the list of psychiatric disorders in 1973 and 1992 respectively.

The IPS recognises same sexuality as a normal variant of human sexuality much like heterosexuality and bisexuality. There is no scientific evidence that sexual orientation can be altered by any treatment and that any such attempts may, in fact, lead to low self-esteem and stigmatisation of the person.”

This research may find an answer for the malaria

The vacuole, a compartment inside human red blood cells in which malaria parasites reproduce and develop, takes on a distinct spherical shape just minutes before its membrane ruptures, leading to the release of parasites into the blood stream, according to researchers at the National Institutes of Health and other institutions. Their study appears in Cellular Microbiology.

The researchers, working with red blood cells from healthy donors, were able to chemically block the sequence of events leading to this rounding of the vacuole. Targeting this sequence could inform new treatment strategies against Plasmodium falciparum.

Researchers dyed the membrane of the vacuole with a substance that gives off green light. About 10 minutes before the membrane ruptured, the vacuole morphed from a lumpy, uneven shape to a sphere.

Can I start anti coagulation in CKD and AF?

eGFR <60 and AF

eGFR < 15 and AF: Think before you start warfarin

eGFR > 30 and AF: Give warfarin

For nonvalvular AF and eGFR 30 to 59 with CHADS2 score of 1 or higher: Give warfarin. CHADS2 score of 0: chronic anticoagulant or aspirin

In patients for whom anticoagulant therapy is chosen give an oral direct thrombin inhibitor or a factor Xa inhibitor, rather than warfarin

For AF patients with an eGFR between 15 and 29 and a CHADS2 of 1 or greater: give anticoagulant therapy

CHADS2 of 0 (who are rare): decide on case to case basis

eGFR < 15 but not on dialysis: same as eGFR between 15 and 29 mL/min/1.73 m²

For most nonvalvular AF patients who are on dialysis: No anticoagulant therapy or case to case basis

Cancer Diagnosis After Doc Spots Neck Lump on TV

ENT specialist DR Erich Voigt noticed a womans lump while casually watching the HGTV program Beachfront Bargain Hunt.

Voigt, who is director of General and Sleep Otolaryngology at NYU Langone Health in New York City felt obliged to reach out to her in some way.

He took to Facebook, shared the video of the TV show, and voicing his concern: "I am watching a TV show and notice this woman has a left thyroid mass," he posted on his site. "She needs a sonogram and fine needle biopsy. I wonder if she knows and hope its benign."

In 2 weeks the posting reached her. A follow-up biopsy, received in response to Voigts advice, resulted in a diagnosis of thyroid cancer and got treated. (Medscape)

Pharma News

Washington: Pfizer announced that it has temporarily rolled back the recent hike in the prices of its drugs after the American companys chief executive officer had talks with President Trump.

Regulate electronic medical records

Medical Superintendent of Safdarjung Hospital Rajendra Sharma today stressed the need for a regulatory framework that mandates and regulates the use of electronic medical records (EMRs) to store health data of patients, according to a statement by the industry body ASSOCHAM today. 

Do you know that

Cocoa helps control diabetes and also assists with the treatment. Cocoa based products are advised to be included in the daily diet to improve the insulin resistance and level of glucose in the body. 

According to data from the Centers for Disease Control and Prevention (CDC), someone in the United States has a heart attack every 40 seconds.

Almost 800,000 people in the U.S. have a heart attack every year, with 1 in 5 people not even being aware that they had one.

MEDtalk Video of the day:

CT MRI or Ultrasound: https://www.facebook.com/drkkaggarwal/videos/1905678159453478/

Does CT scan dose matters?

 https://www.facebook.com/drkkaggarwal/videos/1900824353272192/

Participate in survey on Inflammatory bowel disease: https://docs.google.com/forms/d/e/1FAIpQLSedaDx2iXiwU1vBpYdU6ebfCap-7PYAPSqXRJTeg8ULvNOcLg/viewform

Dr KK Aggarwal

Padma Shri Awardee

President HCFI

Vice President CMAAO

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