Morning MEDtalks with Dr KK Aggarwal 19^th August 2018

First biomarker evidence autism is linked to insecticide DDT

A study published online August 16 in the American Journal of Psychiatry has implicated elevated levels of a dichlorodiphenyltrichloroethane (DDT) metabolite in pregnant women with autism in children.

Previous studies have shown on proximity to sites that were contaminated with these pollutants as per Dr Alan S. Brown, MD, MPH, professor of epidemiology at Columbia Universitys Mailman School of Public Health and of psychiatry at Columbia University Medical Center in New York City.

DDT has been banned in many countries decades ago, but it persists in the food chain. DDT transfers across the placenta, resulting in potential prenatal exposure.

The researchers identified 778 children with autism born between 1987 and 2005 and a matched control group. Maternal serum specimens from early pregnancy were assayed for levels DDE (p,p-dichlorodiphenyl dichloroethylene), a metabolite of DDT. The odds of autism were nearly one third higher among offspring of mothers with DDE levels that were in the highest 75th percentile. The odds of autism with intellectual disability were increased by greater than twofold with maternal DDE levels higher than this threshold. There was no association between total maternal levels of polychlorinated biphenyls (PCBs) and autism.

Even light drinking may make fatty liver disease worse

People non-alcoholic fatty liver disease (NAFLD) should avoid alcohol if they want to prevent their liver damage from getting worse, a Korean study suggests in July 17 in Hepatology. The study examined data on 58,927 Korean young and middle aged adults with NAFLD who had low levels of fibrosis. After following half of these patients for at least 8.3 years, 5,630 people had progressed from low to more advanced levels of fibrosis.

Moderate drinkers (2 drinks per day in men and 1.5 in woman) were 29% more likely to have worse fibrosis by the end of the study than people who didnt drink at all.

Light drinkers (<10 grams of alcohol per day) were also 6% more likely to have their fibrosis become more advanced than people who avoided alcohol altogether.

There is no safe limit of alcohol intake in relation to fibrosis progression.

Researchers did not use a liver biopsy to diagnose worsening fibrosis. The study also did not distinguish between different types of alcohol.

SGLT2 inhibitors may be associated with an increased risk for below-the-knee amputations

A retrospective cohort study published in JAMA Internal Medicine shows the concern about amputations with SGLT2 inhibitors.

In May 2016 also, the canagliflozin CANVAS study revealed a significant increase in amputation rates with the drug compared with placebo. Most were toe amputations. The US FDA then issued a drug safety communication warning about the risk of foot and lower leg amputations with canagliflozin. In contrast, the label warning in Europe covers all drugs in the class.

Cleveland Clinic surgeons perform face transplant on youngest US recipient

Katie Stubblefield became the youngest person to receive a face transplant in the U.S. when she underwent the procedure at Cleveland Clinic in 2017. Ms. Stubblefield lost a large portion of her face and suffered a traumatic brain injury after she shot herself in the head during a 2014 suicide attempt. Ms. Stubblefields face transplant was the third performed at Cleveland Clinic and the 40th in the world.

The full procedure included transplantation of the scalp, forehead, upper and lower eyelids, eye sockets, nose, upper cheeks, upper jaw, half of the lower jaw, teeth, partial facial nerves, facial muscles and skin.

Loopholes in the system: "Neil Armstrong" and other persons gets online permission to slaughter goats in courtroom of Honble Bombay High Court (Ira Gupta)

In the matter titled as “Jiv Maitri Trust versus Union of India & Others, Writ Petition No. 2714 of 2018, the Hon’ble Division Bench of Bombay High Court was shocked to know that the municipal corporations have given online permission to various persons for slaughter of goat at their office address. Further, the Hon’ble Court was surprised to know that one person named Neil Armstrong has been given permission to slaughter goat in the courtroom of Hon’ble Bombay High Court.

Facts of the case

Petitioner pointed out the instances wherein some members ofthe Bar applied for grant of permission for slaughter of goats at their office addresses and they have been granted permissions. One such permission granted on 14th August 2018 is in respect of the office premises at 805, Arcadia Building, Nariman Point, Mumbai.

A similar permission granted to one member of the Bar for slaughter of five goats in the office at Raja Bahadur Mansion, Fort.

One permission is granted today to one Neil Armstrong permitting him to slaughter five goats in Room No. 13 of this Court.

One more permission has been granted to one Shaun Vaz to slaughter five goats in Room No. 13 of this Court.

One more permission to slaughter four goats even in Room No. 52 of this Court.

Thus, the documents show that without any verification and without any application of   mind, these permissions have been granted by the Municipal Corporation on the basis of the online applications.

Order

Rule 3 of the Prevention of Cruelty to Animals (Slaughter House) Rules, 2001 lays down   that   no   person shall slaughter any animal within a municipal area except in a slaughter house recognized or licenced by the concerned authority.

Faced with the copies of the permissions placed on record, the learned Counsel appearing for the   Mumbai Municipal Corporation on instructions states that the process of granting online permissions will be immediately stopped. We accept the said statement.

We are of the view that considering the manner in which online permissions have been granted, the scrutiny thereof will be necessary. 

Video to watch: Modern day doctor-patient relationship: TEDx Talk by Dr KK Aggarwal

https://www.youtube.com/watch?v=i9ml1vKK2DQ

Dr KK Aggarwal

Padma Shri Awardee

President HCFI

Vice President CMAAO