Morning MEDtalks with Dr KK Aggarwal 6th September 2018

Heart rate may be a useful biomarker to identify patient at risk of accelerated decline in kidney function. Analysis of glomerular filtration rate (GFR) (measured as iohexol clearance) and heart rate data (measured by an ambulatory BP monitor) from the RENIS-FU (RENIS Follow-Up Study), which calculated the calculated the rate of GFR decline in 81% of the participants after a median follow-up of 5.6 year show that heart rate was an independent predictor of decline in GFR decline in middle-aged persons without diabetes mellitus, cardiovascular disease, or kidney disease. Compared with the mean population GFR decline of 0.96 mL/min per year, a steeper decline of 0.21 mL/min/year per 10 bpm higher 24-hour ambulatory heart rate is a clinically important effect. Office HR was also an independent predictor of a steeper rate of GFR decline (Hypertension, September 2018).

More than one in four adults globally (28% or 1.4 billion people) are physically inactive. Analysis of data from 358 surveys across 168 countries, including 1·9 million participants shows that women were less active than men, with an over 8% difference at the global level (32% men vs 23%, women). High income countries are more inactive (37%) compared with middle income (26%) and low income countries (16%). The new Global Action Plan on Physical Activity sets the target to reduce physical inactivity by 10% by 2025 and 15% by 2030. But, if current trends continue, the 2025 global physical activity target (a 10% relative reduction in insufficient physical activity) will not be met (The Lancet Global Health, online September 4, 2018).

Do you know that hypoglycemia occurred in 10% of travelers with diabetes either during travel or in the first 24 hours of arrival to their destination? Of these, 31% report severe hypoglycemia needing assistance. Intercurrent infections with fever or diarrhea may lead to dehydration and other complications, such as diabetic ketoacidosis.

Oncologists uniformly cooperate with patients requests for second opinions according to a small study from the Netherlands published online August 23 in JAMA Oncology. However, two scenarios appear to invariably upset oncologists. With each scenario, the trouble came from patient relations, not the oncologist who provided the second opinion.

Dr Poonam Khetrapal Singh unanimously nominated for second term as Regional Director WHO South-East Asia. Her candidature was unopposed, as the 11 Member countries of WHO South-East Asia Region met at the ongoing Regional Committee session to elect the next Regional Director (SEAR/PR/1698, Sept. 5, 2018)

It does not happen only in India. The US FDA is warning consumers about a voluntary recall of Montelukast tablets by Camber Pharmaceuticals due to an incorrect drug in the bottles. Sealed bottles labeled as montelukast sodium tablets, 10 mg, 30-count bottle from Camber instead contained 90 tablets of Losartan Potassium Tablets, 50 mg. The FDA said that the tablet mix up can pose a safety risk as taking Losartan when not prescribed can cause renal dysfunction, elevated potassium levels and low blood pressure. The risk can be especially high for woman who are pregnant as the medication could harm or kill the fetus. Montelukast is used to prevent wheezing, difficulty breathing, chest tightness and coughing caused by asthma.

Ayushman Bharat is set for a September 25 launch and as the Union Health Ministry ramps up the scheme for the launch, it is projecting the new flagship scheme’s total annual requirement at Rs 120 billion, which will make it the largest health scheme ever in India in terms of yearly expenditure. This will be from 2019-20, the first full year for the scheme. For this fiscal year, the health ministry has projected a total expenditure of Rs 60 billion, from which 60 per cent will come from the Centre and 40 per cent from the states. This compares to Rs 20 billion allocated in the budget by the Centre. (PTI)

The Confederation of All India Traders (CAIT) has written to the Finance Minister Arun Jaitley seeking investigation to assess the potential of health hazards allegedly posed by currency notes and urged him to take preventive measures to protect people from diseases due to their contamination.

A diet quality score based on the PURE study, which advocates eating more of seven key foods — fruits, vegetables, nuts, legumes, fish, dairy, and non-processed red meat are linked to lower mortality and cardiovascular events in three independent data sets (Andrew Mente, MD, Population Health Research Institute at McMaster University, Hamilton, Ontario, Canada)

After dengue, now scrub typhus is haunting the citizens of Nagpur and has claimed more than 12 lives so far.

September 2018 is the National Nutrition Month under the Poshan Abhiyan. National Nutrition Month has eight focused themes: Antenatal care; optimal breastfeeding; complementary feeding; anemia; growth monitoring; education; diet and right age of marriage for girls; hygiene and sanitation, and food fortification. 

Video to watch: TEDx Talks

Dr KK Aggarwal: Modern day doctor-patient relationship

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

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

President HCFI