Morning MEDtalks with Dr KK Aggarwal 8^th August 2018

Suggestions on amendments in the provisions of the Pre­conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) (Six Months Training) Rules 2014 by Heart Care Foundation of India

1. In the proposed change it is clearly mentioned that the said 6 months training will prepare the MBBS doctor to conduct the prenatal diagnostics only. It should be further clearly specified that the said 6 months training is not applicable for any other diagnostic and the medical registered practitioners are not required to undergo the said 6 months training or any competency-based exam under the said rules if he or she is not undertaking prenatal diagnostics. Also, that Geneticists are exempted from undertaking the said training.
2. The registered medical practitioners who are not undertaking prenatal diagnostic test should not be required to undertake the said 6 months or competency-based exam provided they furnish an undertaking that they shall not undertake prenatal diagnostic test.
3. The said rule 9 (as mentioned in the title: Changed criteria to be made prospective) should clarify that the said rule is prospective in nature and not retrospective. The text of the clause accordingly needs to be changed and the new MBBS doctors should undertake the said 6 months training and not the existing MBBS doctors who have been undertaking prenatal diagnostic test.

Based on this prospective clause the existing registered medical practitioners who are conducting prenatal diagnostics ultrasound procedures in a Genetic Clinic or Ultrasound Clinic or Imaging Centre on the basis of one-year experience six-month training should be exempted from undertaking the said training provided they have been allowed to prenatal diagnostic test earlier. Also, the said existing medical practitioners should not be required to undertake competency-based exams.

Baguio in Philippines may become the first CPR-ready city by 2021

A proposed ordinance in Baguio City seeks to require all establishments in the city, public and private, to be equipped with life-saving support systems and have all their staff learn how to do cardiopulmonary resuscitation (CPR) to respond to emergency situations like a heart attack. The proposal is an offshoot of the Philippine Heart Association’s Baguio leg of a nationwide CPR training

The ordinance seeks to mandate government and private establishments to supply, maintain, and make available an Automated External Defibrillator (AED) device in cases of emergencies.

An AED is a portable electronic device that automatically diagnoses a life-threatening heart condition. Baguio may become the first CPR-ready city by the year 2021.

Bionic prosthetic devices

When you lose a limb, even the simplest of daily tasks can turn into a challenge. High-tech devices can help restore independence. New technologies are even making it possible to connect the mind to an artificial limb. These artificial limbs are called bionic prosthetic devices.

Lower the bad cholesterol as much as possible

The clinical benefit for every 1 mmol/L reduction in LDL ‘bad’ cholesterol was the same with statins or any of the nonstatin medications (combined relative risk reduction, 0.79; 95% CI, 0.71 - 0.87; P < .001), the researchers note in a study published online August 1, 2018 in JAMA Cardiology. 

Extra fat around your belly poses a unique health threat

A study from the UK reported in the March 6, 2018 issue of the Journal of the American Heart Association took body measurements of the participants (aged 40 to 69 years) and then kept track of who had heart attacks over the next seven years. During that period, the women who carried more weight around their middles (measured by waist circumference, waist-to-hip ratio, or waist-to-height ratio) had a 10-20% greater risk of heart attack than women who were just heavier over all (measured by body mass index, or BMI, a calculation of weight in relation to height).

A larger waist-to-hip ratio, in particular, appeared to be a bigger heart attack risk factor for women than for men. The analysis showed that compared with BMI, waist-to-hip ratio was 18% stronger as a heart attack predictor in women vs 6% stronger in men.

New drug approvals around the globe by FDA

1. Iobenguane I 131 for adults and children with iobenguane scan-positive, unresectable, locally advanced or metastatic pheochromocytoma or paraganglioma who require anticancer therapy.
2. Eli Lilly announced the submission of a new drug application to the FDA for investigational nasal glucagon for the treatment of severe hypoglycemia in adults and pediatric patients with diabetes.
3. First oral gonadotropin-releasing hormone antagonist for women with moderate to severe endometriosis pain, AbbVie and Neurocrine Biosciences announced in a press release.
4. Eli Lilly has updated the label for the once-weekly GLP-1 receptor agonist dulaglutide to reflect new safety and efficacy data reported for adults with type 2 diabetes and moderate to severe chronic kidney disease.
5. The FDA approved the FreeStyle Libre flash glucose monitoring system, which allows patients with diabetes to wear the sensor up to 14 days with high accuracy.
6. The FDA has granted 510(k) clearance for the first finger-stick capillary testing meter for critically ill patients with and without diabetes.
7. A “breakthrough” designation led to faster FDA approval for new medications in oncology, although these agents did not show improved safety, novelty or efficacy compared with nonbreakthrough agents, study data showed.

Limit screen-based recreational media at home, says AHA

Screen time from computers, phones, tablet computers, video games, TV and other screen-based devices is associated with an increased amount of sedentary behavior in children and teens leadint to overweight and obesity, according to a new scientific statement “Sedentary Behaviors in Today’s Youth: Approaches to the Prevention and Management of Childhood Obesity” released by the American Heart Association (AHA) published in the journal Circulation.

Though TV viewing by children and adolescents has declined, the recreational use of other screen-based devices, such as smart phones, tablet computers and others has resulted in a net increase in screen time overall.

The AHA recommends not more than 1-2 hours of recreational screen time daily for children and teenagers.

Video to watch: Wheat disorders

https://www.facebook.com/drkkaggarwal/videos/1945381452149815/

Dr KK Aggarwal

Padma Shri Awardee

President HCFI

Vice President CMAAO