Morning MEDtalks with Dr KK Aggarwal 18th October 2018

One drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor. And it means having one drink each day of the week, not having seven drinks on Saturday night, sleeping it off Sunday, and begging off until next Saturday night

Is there a safe limit for alcohol in a day? More than 100 studies show that a woman who has one drink per day, compared with a woman who does not drink, has a reduced risk of having a heart attack and the most common kind of stroke. Yet, many of these same studies also show that even a drink a day increases a womans risk of breast cancer.

People with diabetes appear to benefit from aspirin, but the risk of bleeding offsets some of that benefit. For people who dont have diabetes as well as anyone who is age 70 or older — aspirin provides no heart benefit and seems to increase your odds of bleeding.

One of the biggest exercise errors is using improper technique. You risk back injury if you arch your back while doing planks or push-ups, and knee injury if you bend too deeply in a lunge or squat. Another mistake is doing the wrong exercise. For instance, running when you have severe back or knee arthritis puts too much pressure on the joint. Lifting too much weight, especially lifting too much too soon, if youre just starting to get back into a routine can lead to muscle tears.

Toronto-based Myant has announced the launch of a partnership with Mayo Clinic to bring Mayo Clinic’s patented algorithms for heart monitoring and arrhythmia detection to Myant’s SKIIN textile computing platform. The agreement gives Myant exclusive license to Mayo Clinic’s technology for use in its textile computing or smart clothing projects, including its first generation of SKIIN smart underwear. The collaboration aims to help people at risk of developing Atrial Fibrillation (AFib), and give patients and doctors the ability to proactively monitor heart activity using clothing that detects normal or abnormal heart rhythm.

Nocturia may be a risk factor for higher nocturnal BP. Poor sleep quality, particularly from frequent nocturnal urination is strongly associated with nighttime blood pressure (BP) abnormalities, as per results from the Nagahama study published in the Journal of Hypertension (J Hypertens. 2018 Nov;36(11):2185-92). Systolic BP decreased 8.5% on average. The frequency of urination showed strong and independent association, with smaller nocturnal BP drop in patients with frequent nocturnal urination. Other associations with BP became nonsignificant after adjustment, including the sleep fragmentation index and 3% oxygen desaturation index. Abnormalities in circadian BP variation, particularly increase in nocturnal BP, have been reported to be risk factors for cardiovascular disease.

Guidelines recommend against routine imaging in patients with early-stage breast cancer who are at low risk for metastasis, two new studies have found that these guidelines are not being consistently followed. In the first study, the authors report that 30% of patients with early-stage breast cancer underwent staging imaging, despite guidelines recommending against it. The prevalence of inappropriate imaging varied from 26% to 68% among oncologists. The second study found that unnecessary scanning occurred in up to 19% of patients with stage I to II breast cancer. Both papers were presented at the ASCO Quality Care Symposium.

Preoperative ultrasound imaging of thyroid nodules of concern for malignancy at diagnostic imaging centers rarely includes lateral neck imaging, according to research presented here at the 2018 Annual Meeting of the American Thyroid Association (ATA). Accepted gold standard of the comprehensive evaluation of suspicious nodules is to include the lateral neck, as well as the thyroid, as critical components of any such ultrasound. This is leading to incomplete surgeries, incomplete evaluation, persistent disease, and patient morbidity. It used to be that 20 years ago you would just get a thyroid ultrasound, but then it became clear that a lot of people with papillary thyroid cancer had lymph node involvement and we now know that about a third of patients who have a biopsy-proven thyroid nodule also wind up having lymph node involvement in one or more areas of the neck

NITI Aayog to launch guidelines for PPP in treatment of non-communicable diseases. The NITI Aayog and MoHFW has worked with State Govts. and representatives from the healthcare industry to develop the Model Concessionaire Agreements (MCA) to supplement efforts for the provision of prevention and treatment services for non-communicable diseases (Cardiac Sciences, Oncology, and Pulmonary Sciences) at the district hospital particularly especially in tier 2 & 3 cities. 

The Guidelines and the MCA will be announced by Dr VK Paul, Member, NITI Aayog, Shri Amitabh Kant, CEO, NITI Aayog and Smt Preeti Sudan, Secretary, Ministry of Health and Family Welfare… (PIB, NITI Aayog, Oct. 16, 2018).

 UN “stands in solidarity with cyclone-hit India and is ready to support the response”, said United Nations Secretary-General António Guterres. He expressed sadness at the loss of lives and devastation caused by Cyclone Titli in India and said that the Organization is ready to provide assistance. According to media reports, at least 25 people have been killed, many more injured, and over 300,000 people evacuated to safer places.

Modicare to create 10 lakh jobs, says Ayushman Bharat CEO. The scheme is going to improve the quality of healthcare in public services and also in the private sector, Indu Bhushan, the CEO of Pradhan Mantri Jan Arogya Yojana said while addressing an event organised by industry body Assocham. "The scheme will create considerable employment opportunities ... It will create 10 lakh jobs in health and insurance sector," Bhushan said.

Dr KK Aggarwal

Padma Shri Awardee

President Elect CMAAO

President Heart Care Foundation of India