Morning MEDtalks with Dr KK Aggarwal 10^th October 2018

Dear Colleague

As global temperatures rise, so will mental health issues, says a study published Oct. 8, 2018 in the journal PNAS. A rise in average monthly temperatures is tied to a small increase in mental health issues. And over five years, a 1 degree Celsius increase in average temperature results in an even greater prevalence of mental difficulties.

Health risk perceptions and reasons for use of tobacco products among clients in addictions treatment. Campbell BK, Le T, Gubner NR, Guydish J. Addict Behav. 2018 Sep 3. https://www.ncbi.nlm.nih.gov/pubmed/30206006: Treating smoking in addictions treatment should assess all tobacco products use, accuracy of health risk perceptions, and use of e-cigarettes to reduce/quit smoking, in order to promote cessation of combustible tobacco.

Flea-borne typhus spreads across Los Angeles area. A rise in typhus, a bacterial disease spread by lice or fleas, has hit the Los Angeles area, and public health officials are sounding the alarm. As of Monday, there have been 57 cases of flea-borne typhus in Los Angeles County, the county Department of Public Health said. On Thursday, the department announced that officials are investigating an outbreak of flea-borne typhus in downtown Los Angeles, and they are working with the city to implement environmental safety measures to help reduce the spread of the disease… (CNN).

A deadly epidemic may be wiping out the world’s last few Asiatic lions. In the past one month alone, at least 23 of the big cats have died in the Gir Wildlife Sanctuary and National Park in the western Indian state of Gujarat. These deaths include those of three cubs and three adult females. Tests conducted at the Indian Council of Medical Research’s National Institute of Virology, Pune, have officially confirmed the presence of the deadly canine distemper virus (CDV) in at least four of the tissue samples extracted from the carcasses. CDV is extremely infective (sic). In Serengeti (national park in Tanzania) it killed a 1,000 lions in three weeks. 

Distemper is closely linked with the measles virus in humans. The two diseases are so similar, in fact, that it is speculated by medical historians and pathologists that the measles virus may have mutated at some point and spread to dogs. Because of this close link between the two, human beings can be infected with the canine distemper virus. However, an important thing to note is that, while the virus can successfully replicate in the human system, it produces no illness and no symptoms.

While distemper is a deadly and very dangerous disease for pet dogs, it is not often a major concern for humans; humans can get the virus, but there are no effects.

Metformin has been the foundational therapy for patients with diabetes, particularly those with established cardiovascular disease. Yet while no large randomized trials have directly compared this long-established therapy against SGLT2 inhibitors and GLP-1 receptor agonists in first-line use, evidence exists to suggest improved cardiovascular benefit with these newer classes of drugs (James Januzzi, MD, of Massachusetts General Hospital in Boston).

Use of acarbose as the add-on remedy to metformin was associated with lower risks of major atherosclerotic events, ischemic stroke, and hypoglycemia, compared with sulfonylurea in patients with type 2 diabetes (Journal of Clinical Endocrinology & Metabolism)

Heart attacks without blocked arteries or MINOCA or myocardial infarction with non-obstructive coronary arterieThey also have elevated blood levels of a protein called troponin but with normal angio.

Sexual guidelines for newly-wed persons: Hold for planning a child if one of you has suffered from Zika: Updated guidelines for preventing sexual transmission of Zika virus infection were published by the United States Centers for Disease Control and Prevention (CDC) in August 2018. The new guidelines state that men with relevant history should wait at least three months after Zika virus symptom onset (if symptomatic) or last possible Zika virus exposure (if asymptomatic) before having unprotected sex. Relevant exposure is defined as residence in or travel to an area where mosquito-borne transmission of Zika virus infection has been reported, or unprotected sexual contact with a person who meets these criteria. The previous recommendation, for a wait time of at least six months, was revised based on updated data on the time frame for risk of sexual transmission following infection or exposure.

Dr KK Aggarwal

Padma Shri Awardee

President Elect CMAAO

President Heart Care Foundation of India