The Hon’ble Supreme Court has on 16.07.2018 flatly denied a 20-year-old woman permission to terminate her 25-week-old pregnancy, observing that aborting a healthy foetus that is unlikely to affect the mother’s physical health amounted to murder.

In her petition before the Hon’ble Supreme Court, the Mumbai-based woman pleaded that she would suffer from mental trauma if she went ahead with the “unwanted pregnancy”. Before the Hon’ble Apex Court, the petitioner said she was suffering from epilepsy and was about to separate from her husband, whom she accused of domestic violence.

According to the Indian laws on Abortion, a foetus older than 20 weeks can be aborted if its birth is likely to culminate in serious physical or mental abnormalities or if the pregnancy poses a threat to the mother’s life.

 “She is not likely to suffer any physical harm,” Hon’ble Supreme Court told the petitioner woman’s counsel.

The lawyer of the petitioner, however, argued that the mental injury her client would suffer if she isn’t allowed to abort the “unwanted pregnancy” should also be considered. (Source: HT)

No service tax on membership fee of any medical association

In a significant decision the double bench of Tribunal (CESTAT) of service tax set aside the demand of service tax applicable to IMA on 4 June 2018. Earlier aggrieved of order of commissioner adjudication dated 04.02.2014 for the demand along with the interest and consequent penalty appeal was filed with the CESTAT in 2014. According to the department, Service tax was not paid on Membership fee paid by members to IMA.

After multiple hearings a stay was granted against this demand and penalty earlier and the final judgment came on 4 June. The judgment has implications on all the medical professional societies.

Stent off price cap?

Meril Life Sciences is likely to get an exemption from government-set price caps. Meril, has developed MeRes100, which is the country’s first locally made bioresorbable vascular scaffold, or naturally dissolving stent for clearing blockages in arteries. It was approved by DCGI last year. The exemption, if given, will be valid for five years.

Meril Life has sought exemption under Para 32 of the Drug Price Control Order (DPCO) 2013, which is applicable when a new drug developed through a unique, indigenous process, is patented under the Indian Patent Act, 1970, and is not produced elsewhere. (livemint)

Medical breakthrough: World’s first blood test for melanoma

Australian scientists from Edith Cowan University have developed the world’s first blood test to detect melanoma in its early stages. Early trials in 105 melanoma patients and 104 healthy people showed that the test could accurately detect early stage melanoma in 81.5% of cases. The blood test detects 10 combinations of protein autoantibodies produced by the body in response to melanoma.

Professor Mel Ziman from Edith Cowan University said, “We were able to detect melanomas that were less than 1 mm in depth, which was fantastic. The next step is to improve the sensitivity of the test, carry out extensive clinical trials and test results against biopsies of suspected melanoma.” (The Guardian/abc.net.au)

Around the globe

1. Acting Chief Justice Gita Mittal Delhi High Court observed that “Pendency of Litigation is like having Cancer!”
2. A recent study carried out by The Lancet Planetary has shown that air pollution causes an estimated 14% of all diabetes cases worldwide in 2016. To prove their study, the researchers say that particulate matter (PM2.5) when inhaled, reduces the bodys ability to respond to insulin.
3. In a proof-of-concept trial published in the New England Journal of Medicine, researchers have found that fecal microbiota transplantation (FMT) is a feasible treatment alternative to antibiotic therapy in patients with a primary Clostridium difficile infection, with no differences between the two strategies regarding  overall treatment response or treatment-related adverse events
4. Over 60 students have fallen sick apparently due to food poisoning at a hostel of Popular Academy School situated at Madina Market in Baisi, around 360km northeast of Patna Sunday late evening.
5. Scientists supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have discovered a set of powerful, broadly neutralizing antibodies (bNAbs) in the blood of EVD survivors. In animal studies, two of these antibodies provided substantial protection against disease caused by Zaire Ebola virus, Bundibugyo Ebola virus and Sudan Ebola virus, the three species known to cause fatal human illness.
6. Medical institutions in Ireland paid out more than 99 million Euros last year for negligence, according to the Courts Service. The Courts Service Annual Report reveals there were 50 cases of medical negligence in 2017. The lowest amount awarded was 17,500 euro, while the highest payout totalled 15 million euro, an increase of six million euro from 2016.
7. Higher late-life systolic blood pressure has been tied to more brain infarcts and more markers of Alzheimers disease, specifically neurofibrillary tangles, results of a novel autopsy study July 11 in Neurology
8. Double trouble: Concomitant use of nonsteroidal anti-inflammatory drugs and oral anticoagulants in patients with atrial fibrillation increases the risk for major bleeding and stroke, according to RE-LY trial.
9. The US Food and Drug Administration has ordered label changes for fluoroquinolones to strengthen warnings about the antibiotics risks for mental health side effects and serious blood sugar disturbances
10. Johnny Clyde Benjamin, MD, an orthopedic surgeon in Florida, was sentenced to life in prison on July 6 in a federal district court in Fort Lauderdale for his role in the overdose death of a 34-year-old woman, as per the US Department of Justice. In April, a jury found that Benjamin, 52, used his Vero Beach office to make counterfeit oxycodone. The pills, which were laced with furanyl fentanyl, were linked in an investigation to the overdose death of Margaret "Maggie" Crowley, of Wellington, Florida, in Palm Beach County. Fentanyl is much stronger than heroin or oxycodone.   

American Academy of Pediatrics (AAP)/American Society of Pediatric Nephrology (ASPN)’s Choosing Wisely list of appropriate nephrology tests for children

1. Do not order routine screening urine analyses in healthy, asymptomatic pediatric patients as part of routine well child care.
2. Do not initiate a work up for hematuria or proteinuria before repeating an abnormal urine dipstick analysis.
3. Avoid ordering follow-up urine cultures after treatment for an uncomplicated urinary tract infection in patients that show evidence of clinical resolution of infection.
4. Do not initiate an outpatient hypertension work-up in asymptomatic pediatric patients prior to repeating the blood pressure measurement.
5. Do not place central lines or peripherally inserted central lines in pediatric patients with advanced (Stage 3-5) chronic kidney disease (CKD)/end-stage renal disease (ESRD) without consultation with pediatric nephrology due to goals to avoid adverse events, preserve long-term vascular access, and avoid unnecessary and costly procedures.

Explorations of inequality: Childhood immunization

“Explorations of inequality: Childhood immunization”, a WHO report released in July 2018 describes how socioeconomic, demographic and geographic factors affect the chances of a child being vaccinated. The report is based on international household health surveys conducted from 2012-2016 in 10 countries (Afghanistan, Chad, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Kenya, Nigeria, Pakistan and Uganda). These countries face the most severe immunization challenges and together make up more than 70% of children who do not get a full course of basic vaccines.

Errors common in notes produced by speech recognition software

The accuracy of speech recognition software has been questioned in a study reported in JAMA Network Open, which shows an error rate of more than seven words per 100 in unedited SR-generated clinical documents, including clinically significant errors in one of every 250 words that could affect care.

Frequent social media users more likely to have subsequent ADHD symptoms

In a longitudinal cohort survey study of 2587 adolescents aged 15-16 years in Los Angeles county with no Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms at baseline, 10.5% of those who engaged in 14 digital media activities at a high frequency such as playing video games, video chatting, online shopping, checking social media self-reported ADHD symptoms vs 4.6% for those who engaged in these activities less regularly (5.9%) (JAMA, July 17, 2018).

How to deliver difficult news: 8 tips to make it easier

1. Give yourself plenty of time
2. Put yourself in your patient’s shoes
3. Offer a few words of warning first, like “I have some difficult news for you.”
4. Be completely honest
5. Don’t completely destroy your patient’s hope
6. Pause and let them react
7. Help your patient plan for what comes next
8. Follow up

(Source: Health eCareers)

Participate in survey on inflammatory bowel disease:

https://docs.google.com/forms/d/e/1FAIpQLSedaDx2iXiwU1vBpYdU6ebfCap-7PYAPSqXRJTeg8ULvNOcLg/viewform

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAOPresident HCFI