Morning MEDtalks with Dr KK Aggarwal 12^th October 2018

According to the National Institute on Drug Abuse, in response to a request for comment from the website Tonic: “A previous substance use disorder is a risk factor for future development of substance use disorder (SUD),” but “It is also possible that someone who once had an SUD but doesn’t currently have one has a balance of risk and protective genetic and environmental factors that could allow for alcohol consumption without developing an AUD [alcohol use disorder].”

One study published in JAMA in 2014 showed that, “As compared with those who do not recover from a substance use disorder, people who recover have less than half the risk of developing a new substance use disorder. Contrary to clinical lore, achieving remission does not typically lead to drug substitution, but rather is associated with a lower risk of new substance use disorder onset.”

‘Concerted effort’ must be made to help 600 million-plus adolescent girls realize full potential, says UN chief. There are “multiple barriers” including “systemic discrimination” bias and lack of training, which are keeping the largest generation of girls in human history from reaching their full potential, said UN Secretary-General Antonio Guterres in a statement on Thursday, marking International Day of the Girl Child. “Let us recommit to supporting every girl to develop her skills, enter the workforce on equal terms and reach her full potential,” he said... (UN)

The fastest treatment of heartburn is to neutralize the acid already in the stomach and lower esophagus by taking an over-the-counter antacid. While antacids work within minutes, they often dont last, so you may have to take repeated doses until symptoms subside. H2 blockers begin to act within an hour and last for another 10 to 12 hours. If you still need the occasional antacid, wait 30 to 60 minutes after taking one before adding an H2 blocker. Proton-pump inhibitors are even stronger acid blockers. If the heartburn doesnt respond to these drugs or lasts for more than 10 days, see a doctor.

The HPV vaccine is now also approved for men and women from 27 to 45-years-old, the Food and Drug Administration said. The vaccine, which prevents cervical cancer and other malignancies, had been previously approved for minors and people up to age 26.

Alternative milks are plant-based beverages made from macadamias, almonds, quinoa, peas, rice, coconut, oats, soy, walnuts or cashews.

Michael & another v Linksfield Park Clinic (Pty) Ltd & another [2002] 1 All SA 384 (A): The court is not bound to absolve a defendant from liability for allegedly negligent medical treatment or diagnosis just because evidence of expert opinion. The court must be satisfied that such opinion has a logical basis, … that the expert has considered comparative risks and benefits and has reached a “defensible conclusion”.

Man with chest pain sent to buy medicines, dies of stroke in queue. The family of former TV journalist Deepanshu Dubey filed a FIR against Delhi government’s Hedgewar Hospital for alleged medical negligence after Dubey was sent to buy his own medicines even while he was suffering from a heart attack. He died while waiting for his turn to buy his medicines in a queue at the pharmacy. 

Acute flaccid myelitis is a rare, polio-like condition that affects an individuals nervous system and can cause sudden arm and leg weakness. Six children in Minnesota have contracted AFM since mid-September, the state health department said Oct. 5. Nationwide, the CDC has confirmed 362 AFM cases between August 2014 and August 2018.

Adolescent mental health

1. As per WHO, suicide is the second leading cause of death among 15-29-year-olds.
2. Globally, depression is the ninth leading cause of illness and disability among all adolescents, whereas anxiety is the eighth leading cause
3. Adolescents with emotional disorders may also experience excessive irritability, frustration, or anger, apart from depression or anxiety.
4. Harmful use of substances (such as alcohol or drugs) is a major concern in several countries. This can lead to risky behaviours, including unsafe sex or dangerous driving.

In medical first, HIV-positive mother donates liver to her uninfected baby, in South Africa. A liver transplant from an HIV-positive woman to her uninfected baby in South Africa has the potential to widen the countrys organ donor pool, experts say. Doctors in the Wits Donald Gordon Medical Centre transplant unit in Johannesburg announced last week that they had performed a liver transplant from a living HIV-positive donor to an uninfected patient, the first in the world. The operation on the woman and her daughter with end-stage liver disease took place last year, when the girl was 13 months old.

The mother was monitored to ensure that her CD4 count was at acceptable levels. Her HIV viral load had been suppressed for six months before donation, and only part of her liver was used for the operation. The baby was given three antiretroviral drugs the night before the procedure to prevent HIV transmission. An anti-inflammatory was administered during the operation. Both mother and child are doing well and the baby remains HIV-negative, the doctors say, but they will continue to follow up with them… (CNN)

Doctors are prescribing nature to patients in the UKs Shetland Islands. Long walks, bird-watching and making daisy chains are being prescribed by doctors to patients in Scotlands Shetland Islands as part of treatment for chronic illnesses. A partnership project between National Health Service Shetland and the Royal Society for the Protection of Birds (RSPB) Scotland, which is thought to be the first of its kind in the UK, has been extended following a successful pilot, which took place at Scalloway surgery last year. From this week, all of Shetland’s GPs will be able to prescribe nature as part of their patient’s treatment. 

RSPB Scotland have produced a leaflet and a calendar of seasonal activities using local knowledge and understanding of connecting people with nature. It attempts to provide a greater variety of ways to realise the health benefits that nature can provide regardless of health condition, confidence or if you are a sociable or more solitary person. The leaflet will be handed out at each doctor’s discretion. "Through the Nature Prescriptions project GPs [doctors] and nurses can explain and promote the many benefits which being outdoors can have on physical and mental well-being," Lauren Peterson, health improvement practitioner for NHS Shetland, said in a statement... (CNN – RSPB)

Video to watch: TEDx Video: Doctor-patient relationship www.youtube(dot)com/ watch?v=i9ml1vKK2DQ

Dr KK Aggarwal

Padma Shri Awardee

President Elect CMAAO

President Heart Care Foundation of India