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Dr KK Aggarwal 02 August 2018
Morning MEDtalks with Dr KK Aggarwal 2nd August 2018
DAMA vs LAMA after Stenting
A new study of more than 2 million PCI procedures shows that patients who discharged against medical advice (DAMA) are uncommon but are twice as likely to be readmitted with an acute myocardial infarction (MI) as those discharged home. If DAMA patients are readmitted with MI, the mortality rate is double that of non-DAMA patients readmitted with MI.
Data from the Paris registry show that mortality risk is "stratospheric in the first 7 days" after PCI if dual antiplatelet therapy (DAPT) is discontinued.
So it may be that patients are just simply not surviving to be readmitted with a myocardial infarction. We see only those patients that survive to discharge. What we do not see are the patients who discharge themselves against medical advice that die in the community.
DAMA represents up to 2% or so of all hospital discharges and is associated with a higher likelihood of worse outcomes.
The present study is published in July 23 in JACC Cardiovascular Interventions. Predicting DAMA.
Breastfeeding
An estimated 78 million babies – or three in five – are not breastfed within the first hour of life, putting them at higher risk of death and disease and making them less likely to continue breastfeeding, say UNICEF and WHO. Most of these babies are born in low- and middle-income countries.
High cost on medical expenditure
As per a recently published research paper based on cross-sectional analysis of National Sample Survey Office (NSSO) data, 55 million Indians were pushed into poverty in a single year because of having to fund their own healthcare, and out of this, 38 million fell below the poverty line due to spending on medicines alone. As per the 71st Round (January-June 2014) of the National Sample Survey Office(NSSO) on Health in India, purchase of medicine accounted for around 72% in rural sector, and 68% in urban sector, of the total expenditure on non-hospitalized treatment of ailments (Source: PIB).
Statins and myositis
Exposure to statin medications is associated with the development of idiopathic inflammatory myositis (IMM), new research suggests. In a population-based case-controlled study of adults age 40 years and older in South Australia, there was an almost twofold increased likelihood of statin exposure in patients with IIM compared with controls. The finding is published online July 30, 2018 in JAMA Internal Medicine.
Surgical errors
Every year an estimated 4,000 people who undergo surgery are injured by surgical errors. These preventable mistakes are called “never events” because they never should have happened.
Common surgical errors include: Leaving surgical equipment (e.g., sponges or instruments) inside a patient; using unsterile surgical instruments; performing surgery on the wrong body part; performing the wrong procedure; performing surgery on the wrong patient; damaging nerves during procedure; cutting or puncturing organs that were not involved in the procedure; failing to administer an appropriate dose of anesthesia.
There are a number of reasons why surgical errors occur. They include:
Hand, foot and mouth disease outbreak in Malaysia
Hand, foot and mouth disease can damage the brain, lungs or heart, though such complications are rare. Last week, five schools in Malaysia were ordered to close for 10 days following an increase in the number of HFMD cases across the country. Since January, 39,174 cases of HFMD have been recorded throughout the country.
New AI softwares
The US Food and Drug Administration (FDA) has approved three artificial intelligence (AI)-based tools this year for use in clinics.
Northern plain in China set to become deadliest heat wave zone
The northern plain in China, one of the most densely populated regions on Earth, is on its way to becoming the worlds deadliest heatwave zone by the end of the century, scientists say. New scientific research suggests that unless there are heavy cuts in carbon emissions, climate change will lead to humid heatwaves that could push the area "against the boundaries of habitability" by 2070. Heat and high humidity can create conditions that kill even healthy people within 6 hours of being outside.
"This spot is going to be the hottest spot for deadly heatwaves in the future," said Professor Elfatih Eltahir, at the Massachusetts Institute of Technology (MIT), who led the new study reported July 31, 2018 in Nature Communications (Source: CNN).
Outbreak and Current Disease Status Information
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Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI
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