Morning MEDtalks with Dr K K Aggarwal 14th July 2018

Kind attention DCGI: Drugs shortage in the country

1. SEPTRAN: Sulfamethoxazole,Trimethoprim
2. Dispirin
3. Penicillin LA Injection Penidure

Paramedic jailed in England

England: A paramedic who stole an 87-year-old patients purse during an emergency call-out has been jailed for six months. Anna Mogford, 38, took Joyce Bealeys bank card and PIN number from the purse and used them to withdraw £1,400. The judge, told her the offence was a breach of trust and one that the public would view with "distaste" and wrote "Your culpability was between high and medium, given the breach of trust and your responsibility towards a patient.

Sea food lovers read this

Raw oysters in summer or high temperature can have vibriosis. The CDC recommends not eating raw oysters, washing hands after handling raw seafood and separating cooked seafood from raw seafood.

5 simple ways to get more restful sleep

1. Cut down on caffeine: Caffeine blocks the effects of adenosine, a neurotransmitter thought to promote sleep. Caffeine can also interrupt sleep by increasing the need to urinate during the night. Caffeine withdrawal can cause headaches, irritability, and extreme fatigue, it may be easier to cut back gradually rather than to go cold turkey. Those who cant or dont want to give up caffeine should avoid it after 2 p.m., or noon if they are especially caffeine-sensitive.
2. Stop smoking or chewing tobacco: Nicotine is a central nervous system stimulant that can cause insomnia. It speeds your heart rate, raises blood pressure, and stimulates fast brainwave activity that indicates wakefulness. If you continue to use tobacco, avoid smoking or chewing it for at least one to two hours before bedtime.
3. Limit alcohol intake: Alcohol depresses the nervous system, so a nightcap may seem to help some people fall asleep. However, alcohol suppresses REM sleep, and the soporific effects disappear after a few hours. Drinkers have frequent awakenings and sometimes frightening dreams. Alcohol may be responsible for up to 10% of chronic insomnia cases. Also, alcohol can worsen snoring and other sleep breathing problems, sometimes to a dangerous extent. Even one drink can make a sleep-deprived person drowsy. In an automobile, the combination significantly increases a persons chance of having an accident.
4. Regular physical activity
5. Creating and sticking to a regular sleep schedule and routine. (Harvard NewsLetter)

Indian mental health expert heads BMA

Dr Dinesh Bhugra, Emeritus Professor of Mental Health and Cultural Diversity at the Institute of Psychiatry, Psychology & Neuroscience at the London based King’s College began his Presidency of the British Medical Association (BMA) on June 27, 2018.

Imaging technique illuminates immune status of monkeys with HIV-like virus

Findings from an animal study suggest that a non-invasive imaging technique could, with further development, become a useful tool to assess immune system recovery in people receiving treatment for HIV infection. Researchers used single-photon emission computed tomography (SPECT) and a CD4-specific imaging probe to assess immune system changes throughout the bodies of macaques infected with SIV, a simian form of HIV, following initiation and interruption of antiretroviral therapy (ART). They evaluated pools of CD4 T cells, the main cell type that HIV infects and destroys, in tissues such as lymph nodes, spleen and gut.

TIA is a neurologic emergency

Transient ischemic attack is transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction. The end point is biological (tissue injury) rather than arbitrary (24 hours) and requires use of neurodiagnostic tests to identify brain injury and its cause.

The classic old definition was sudden onset of a focal neurologic symptom and/or sign lasting less than 24 hours, caused by a transient decrease in blood supply. This classic definition is inadequate because even relatively brief ischemia can cause permanent brain injury.

Do not eat Kellogg’s Honey Smacks cereal of any size package

USA: A salmonella outbreak linked to a popular Kelloggs cereal has infected 100 people, the Centers for Disease Control and Prevention announced Thursday.

The agency is urging consumers to avoid Honey Smacks, a sugary puffed wheat cereal which has been the subject of a recall by the company since mid-June. At least 30 of the 100 have been hospitalized.

CDC said that it has found salmonella strains in unopened and leftover samples of Honey Smacks. Though the recall covers cereal with a best-by date of June 14, 2018, through June 14, 2019, the agency is recommending people avoid the cereal altogether.

Types of TIA

Embolic TIAs: discrete, usually single, more prolonged (hours) episodes of focal neurologic symptoms. The embolus may arise from a pathologic process in an artery, usually extracranial, or from the heart (AF or LV thrombus) or aorta.

Lacunar or penetrating or small vessel: induced by stenosis of one of the intracerebral penetrating vessels arising from the middle cerebral artery stem, the basilar artery, or the vertebral artery. They are caused either by atherothrombotic obstructive lesions at the origin of the penetrating vessel or by lipohyalinosis distally within the penetrating vessel.

Large artery low-flow TIAs: are often associated with a tightly stenotic atherosclerotic lesions of the internal carotid artery origin, middle cerebral artery stem, or junction of the vertebral and basilar artery. Low-flow TIAs usually are often recurrent.

Several pathologic processes can cause low-flow TIAs or embolic TIAs that can produce sudden devastating stroke if not recognized and treated

Atherothrombotic lesions of the internal carotid artery that are narrowed more than 50 percent

Intracranial atherothrombotic disease that produces low-flow or embolic TIA

Emboli to the top of the basilar artery or the middle cerebral artery stem

Arterial dissection of the internal carotid artery or the vertebral artery

Therefore, the initial evaluation of suspected TIA and minor ischemic stroke requires urgent evaluation (uptodate)

Tapeworm in the spine

A Frenchwoman whose symptoms started out as “electric shocks” in her legs got an even bigger shock when she found out that she had a tapeworm in her spine. A 35-year-old French woman reported tingling in her legs. It turns out she had a parasite called a dog tapeworm or Echinococcus granulosus. The parasite caused enough swelling in the woman’s spine to affect her ability to walk and ride a horse, French doctors reported in Thursday’s issue of the New England Journal of Medicine.

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