Morning MEDtalks with Dr KK Aggarwal 30th September 2018Dear ColleagueHere are two links for videos to watch. Share them with your colleagues and friends.Vedic Health - A Dialogue with Ashwini Kumar Choubey
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MCI Take-over: Malafide and Scheming (Team IMA 2018)
In an emergency session in Mumbai, the IMA Action Committee condemned the supersession of the Medical Council of India (MCI).
This action of the Government, at a juncture when the election to MCI has been announced, is unwarranted and malafide. The composition of the Board of Governors (BOG) itself is unacceptable. Directors of major National institutions would scarcely find time to administer more than 450 medical colleges and their UG and PG courses. Moreover, there is no representation to women and Registered Medical Practitioners.
The Indian Medical Association (IMA) is convinced that supersession of MCI is only a smoke screen and ploy to prepare the ground for NMC and sabotage the democratic process of MCI. Why the Government was in a hurry to scuttle a democratic process needs an answer.
IMA’s concerns remain. Bringing MCI directly under the government control seems to be the plan to implementation of Bridge Courses, crosspathy and registration of non medical persons.
IMA demands that the BOG should refrain from taking any major policy decisions or amendments changing the character of the IMC Act.
IMA also demands that the election process in progress in MCI should be allowed to continue.
IMA will continue its resistance to NMC Bill. Any intentions of the NMC Bill implemented through the appointed BOG will be fought with determination.
This is the fourth time that BOG is being appointed. All the previous attempts were an abject failure.
The eminent clinicians appointed have little exposure to the day-to-day administration of MCI.
The Government has not cited any reason for superseding MCI.
MCI Election process is on. It was inappropriate for the Government to supersede at this stage. This betrays a malafide intention.
BOG should conform to the basic tenets of IMC Act and refrain from tinkering with its fundamental structure.
Crosspathy, registration of non medical persons, bridge courses and mixing of syllabi are core concerns. The fidelity, identity and the privileges of the profession will be defended at any cost.
184 private medical colleges are awaiting recognition due to strict norms of the outgoing MCI team. IMA, media and the people should keep vigil in this regard.
IMA foresees a highly difficult period ahead when checks and balances have been removed.
A generation of substandard doctors will be the legacy of this action.
IMA will keep its tryst with destiny and redeem the profession from dark forces. Every single challenge thrown at the profession will be repulsed with single minded.
Fake news in cancer can be devastating. A decline in public trust in doctors and the rise of misinformation and "fake news" spread via the Internet and Whatsapp has led to an increase in the use of unproven, unconventional treatments by cancer patients. Efforts to communicate genuine medical advances need to be redoubled.
The editorial, published in the September 2018 issue of the Lancet Oncology, says that the "collision" between greater patient autonomy, falling trust, and the rise in social media has led to an increase in self-diagnosis and the use of alternative therapies by cancer patients. This may result in patients refusing conventional, proven therapies and increase their risk for death compared with patients who follow recommended treatment regimens.
Mild TBI too is associated with dementia risk. Investigators used data from two Veterans Health Administration (VHA) databases to study over 350,000 veterans with and without traumatic brain injury (TBI) and found that mild TBI, both with and without loss of consciousness, was associated with an approximately twofold increase in dementia risk, although the risk was somewhat higher in those who had experienced loss of consciousness. Moderate to severe TBI was associated with an almost fourfold higher risk (JAMA Neurology, September 2018).
Flu Update: Record flu deaths in USA. An estimated 80,000 Americans died of flu and its complications last winter, according to the US Centers for Disease Control and Prevention (CDC), as reported in CNN. The United States 2017–18 influenza season (October 1, 2017–May 19, 2018) was a high severity season with high levels of outpatient clinic and emergency department visits for influenza-like illness, high influenza-related hospitalization rates and elevated and geographically widespread influenza activity across the country for an extended period as per Morbidity and Mortality Weekly Report, June 8, 2018. Total flu fatalities during the most recent season included the deaths of 180 children, which exceeded the previous record high of 171 during a non-pandemic flu season, according to the CDC.
Some batches of oral polio vaccine have been found to be contaminated with polio type 2 virus, a strain which has been eradicated worldwide, including in India, reports TOI. While the contamination has the potential of bringing polio back to India, the health ministry and the drug regulator have initiated preventive measures to contain the impact. "We have alerted UP and Maharashtra where contaminated vaccines may have been used," a senior official.
The contamination was first suspected when surveillance reports from UP showed signs of the virus in stool samples of some children. Samples of OPV vaccines were sent for testing. At least 50,000 vials are under the scanner. The government has also ordered a probe to find out how the type 2 strain was retained by Biomed even after the central drug regulator had ordered all manufacturers in the country to take necessary measures for complete destruction of all traces of Polio Virus Type 2 by 25 April, 2016.
Patient privacy curtains in hospitals become progressively contaminated with bacteria, including MRSA and increased MRSA positivity was observed between 10 and 14 days after being hung. Test curtains showed increased microbial contamination (mean colony-forming units [CFU]/cm2 = 1.17) compared to control curtains (mean CFU/cm2 = 0.19) by the third day of the study. Test curtains became increasingly contaminated over time, with mean CFU/cm2 for days 17 and 21 of 1.86 and 5.11, respectively. By day 10, 1/8 test curtains tested positive for MRSA, and 5/8 were positive by day 14. This is the time to either change or clean the curtains, suggests the study (American Journal of Infection Control, Sept. 2018).
Public Health England has confirmed a third case of monkeypox in England. This person was involved in the care of the case in Blackpool Victoria Hospital before monkeypox was diagnosed. This third case is now isolated to minimize the risk of onward transmission to others. Earlier this month, two people were reported to have been diagnosed with monkeypox in the UK in unrelated cases, with both having contracted the disease in Nigeria before traveling to England.
Long-term maintenance strategy is needed for sustained control of BP. Reductions in BP levels obtained in a 12-month intensive antihypertensive intervention were not maintained in longer-term follow-up. The sustained effects following intensive intervention lasted for up to 24 months (12 months after the intervention ended). Evaluation of participants in a cluster-randomized trial in which patients with uncontrolled hypertension were assigned to either intensive monitoring and management or to usual care conducted over an additional 42 months showed that the benefits of intensive approach over usual care disappeared after the randomized phase had ended. These findings suggest that long-term maintenance strategies may be needed to sustain BP intervention effects over several years with resumption of the intervention if BP increases. (JAMA Network Open, September 7, 2018).
Diseased liver cells can be detected in the peripheral blood. Patients with CLD and more severe fibrosis were found to have significantly more hepatic circulating epithelial cells in their blood. So-called liquid biopsy offers the possibility of non-invasive cancer detection (Gastroenterology, September 14, 2018).