Morning MEDtalks with Dr KK Aggarwal 8th October 2018

Dear Colleague

Here are two links for videos to watch. Share them with your colleagues and friends.

1. Vedic Health - A Dialogue with Shri Ashwini Kumar Choubey https://www.youtube.com/watch?v=wdorsM5IZTQ
2. TEDx Video: Doctor-patient relationship https://www.youtube.com/watch?v=i9ml1vKK2DQ

The National Health Agency responsible for implementing the Pradhan Mantri Jan Arogya Yojna (PMJAY), in a circular has advised states to authorise district collectors and district magistrates to identify eligible beneficiaries under the scheme.

Households having motorized two, three or four wheeler, fishing boat, mechanized three or four wheeler agricultural equipment, Kisan Credit Card with a credit limit of above Rs 50,000 and in which a member is a government employee and households with non-agricultural enterprises registered with the government are automatically excluded, as per SECC 2011.

Those having a member earning more than Rs 10,000 per month, paying income tax, professional tax, three or more rooms with pucca walls and roof, a refrigerator, a landline phone are also excluded.

Households owning more than 2.5 acres of irrigated land with one irrigation equipment, owning five acres or more of irrigated land for two or more crop season, owning at least 7.5 acres of land or more with at least one irrigation equipment are also excluded.

For urban areas, the 11 occupational criteria will determine entitlement. These categories of workers are rag pickers; beggars; domestic workers; street vendors; cobblers, hawkers and other service providers working on streets; construction workers, plumbers, masons, labourers, painters, welders, security guards, coolies and other head-load workers and sanitation workers.

The Madras High Court has ordered the Medical Council of India (MCI) to raise the minimum qualifying marks for foreign students from 50% to at least 80%.

Risk of aortic valve disease might be modifiable: A study of 5.4 million adults in the UK, published online Sept. 12, 2018 in the European Heart Journal has shown that patients with long-term hypertension are at a higher risk of aortic valve disease. A rise of every additional 20 mmHg, above a systolic BP of 115 mmHg, was associated with a 41% higher risk of aortic stenosis (AS) and a 38% higher risk of aortic regurgitation (AR) later in life, with stronger associations observed in younger groups. Compared to people who had a systolic BP of 120 mmHg or lower, those with systolic BP of 161 mmHg or higher had more than twice the risk of being diagnosed with AS and were nearly twice as likely to be diagnosed with AR during follow-up. These findings suggest that risk of aortic valve disease might be modifiable with potential implications on clinical practice guidelines for prevention of cardiovascular disease in general and valvular heart disease and hypertension in particular.

Being a leader can be lonely, but here are 5 answers for leadership loneliness (Dan Rockwell, Leadership Freak). Accept that loneliness is part of life. There’s nothing wrong with you. Nearly two-thirds of CEOs don’t receive outside input from coaches or advisors.

1. Actively connect with people.
2. Invite someone to go with you on your daily walk-abouts.

a. Have one-on-ones in a coffee shop.

b. Buy lunch for someone. Food facilitates connection.

c. Learn about your team members so you can find common interests.

3. Invite trusted colleagues and/or coaches into the conversation when you’re grappling with tough issues. There’s no need for you to face big challenges alone. Just say, “I’m grappling with an important issue and wonder if I could borrow your listening ear for a bit?”

4. Share your disappointments and press into the future.

5. Use the phone instead of email, occasionally.

European Medicines Agency (EMA)’s Pharmacovigilance Risk Assessment Committee (PRAC) has recommended restricting the use of fluoroquinolone and quinolone antibiotics (used by mouth, injection or inhalation) following a review of disabling and potentially long-lasting side effects reported with these medicines.The PRAC recommended that the remaining fluoroquinolone antibiotics should:

1. not be used

   1. to treat infections that might get better without treatment or are not severe (such as throat infections)

   2. for preventing traveler’s diarrhea or recurring lower urinary tract infections (urine infections that do not extend beyond the bladder)

   3. to treat patients who have previously had serious side effects with a fluoroquinolone or quinolone antibiotic

   4. to treat mild or moderately severe infections unless other antibacterial medicines commonly recommended for these infections cannot be used

2. be used with caution especially for the elderly, patients with kidney problems, patients who have had an organ transplantation or those who are being treated with a systemic corticosteroid. These patients are at higher risk of tendon injury caused by fluoroquinolone and quinolone antibiotics.

The FDA is placing a ban on seven synthetic food additives after a petition created by environmental groups laid a case linking the additives to cancer. The synthetic additives benzophenone, ethyl acrylate, methyl eugenol, myrcene, pulegone and pyridine were linked to causing cancer in animals.

The FDA has expanded its approval of the HPV vaccine to include men and women between 27 and 45, an effort to protect more people from several types of cancer caused by the human papillomavirus.

Will heavy metals provide the answer to antibiotic resistance? Human infections could be treated by targeting nutritional vulnerabilities of bacterial pathogens. Christopher H. Goss, MD, professor of pediatrics at the University of Washington School of Medicine in Seattle, and colleagues used the heavy metal gallium to safely combat bacterial growth in mice and humans. A single dose of systemic gallium administered 3 or 12 hours after mice were infected with Pseudomonas aeruginosa increased mouse survival (P < .001) and reduced lung and blood P aeruginosa counts (p < 0.001) (Science Translational Medicine, Sept. 26, 2018).

Psilocybin or magic mushrooms are naturally occurring and are consumed for their hallucinogenic effects. They belong to a group of drugs known as hallucinogens (also known as psychedelics). The key ingredient found in magic mushrooms is psilocybin. When psilocybin is taken, it is converted in the body to psilocin, which is the chemical with the psychoactive properties

A typhus outbreak in Los Angeles has reached epidemic levels. Twenty cases of the rare, flea-borne infectious disease– associated with poor sanitary conditions and overcrowding– have been recorded in Pasadena alone over the past two months.

For the first time, a hearing aid that can be fitted, programmed and controlled by the user instead of a healthcare provider has been approved by the US FDA. The device comes from Bose and users can make adjustments to its settings in real time through a mobile app.

Dr KK Aggarwal

Padma Shri Awardee

President Elect CMAAO

President Heart Care Foundation of India