Morning MEDtalks with Dr KK Aggarwal 29th October 2018

Wearable technology - fitness trackers, smart watches among others is the number one fitness trend for 2019, according to an annual survey of health and fitness professionals published in the November 2018 issue of Health & Fitness, an official journal of the American College of Sports Medicine (ACSM).

Countries of the Americas must take immediate action to increase polio vaccination coverage to 95%,advises the Pan American Health Organization/World Health Organization (PAHO/WHO).This call follows recent reports that countries are not maintaining the 95% vaccination coverage rate required at all levels to prevent polio transmission. This means that some communities are at risk of being unable to prevent an outbreak should an imported case occur or if there is an emergence of vaccine-derived poliovirus (VDPV).

Harm Reduction: 10 things to know about air pollution (WHO)

1. Nine out of 10 people breathe polluted air.

2. Air pollution kills 7 million people every year, 4 million of whom die from indoor air pollution.

3. 91% of those premature deaths occurred in low- and middle-income countries, and the greatest number in the WHO South-East Asia and Western Pacific regions.

4. The key pollutants include particulate matter, a mix of solid and liquid droplets arising mainly from fuel combustion; nitrogen dioxide from road traffic; ozone at ground level, caused by the reaction of sunlight with pollutants from industrial facilities and vehicle emissions; and sulfur dioxide, an invisible gas from burning fossil fuels like coal

5. A microscopic pollutant – PM2.5 – is so tiny that it can pass through many of our body’s protective armors such as mucous membranes and other barriers, to damage our lungs, heart and brain.

6. Children are highly affected by air pollution. Exposure to air pollution is linked to respiratory disease, cancers and cognitive impairment in infants, children and adolescents.

7. Household air pollution is a significant challenge and 3 billion don’t have access to clean fuels and technologies for cooking (women and children tend to be the most affected, since they spend longer indoors in areas where people use polluting stoves and lamps indoors).

8. Air pollution is also damaging the health of our planet by driving climate change

9. Countries should implement better urban planning policies, regulate dirty emissions, and ban highly polluting vehicles.

10. Individuals, when they have the option, use cleaner burning technologies and fuels for household activities like cooking, heating, or lighting; avoid burning waste and recycle as much as possible, and walk or cycle instead of driving cars.

Updated clinical report on health care transitions for youth and young adults released jointly by American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP) and American College of Physicians (ACP) published online Oct. 22 in the journal Pediatrics provides new practice-based quality improvement guidance on key elements of transition from adolescence to adulthood: planning, transfer, and integration into adultcare.

The 2018 report describes an evidence-informed, structuredhealthcaretransition process called the Six Core Elements of Health Care Transitionthat guides clinicians in the development of transition services.For pediatric practices, the Six Core Elements consist of a transition policy, tracking and monitoring, readiness assessment, transition planning (including patient education to fill the gaps in knowledge identified by the readiness assessment), transfer of care, and transfer completion.

Addition of satralizumab (anti-interleukin-6 receptor monoclonal antibody) to standard treatment for neuromyelitis optica spectrum disorder reduced the relapse rate by 62% (34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2018 in Berlin).

New drug for asthma: Dupilumab (Dupixent, Sanofi/Regeneron) has been FDA approved as “add-on maintenance therapy in patients with moderate-to-severe asthma aged 12 years and older with an eosinophilic phenotype or with oral corticosteroid-dependent asthma”. It will be available as an injectable solution in prefilled syringes with 200-mg and 300-mg doses administered every other week.

8 vital traits every healthcare provider should have(Health eCareers)

1. Communication

2. Empathetic

3. Passionate

4. Forthright

5. Professional

6. Respectful

7. Knowledgeable

8. Thorough

Non-stroke conditions may present in ways suggestive of ischemic stroke“stroke mimics”.Or, the clinical presentation of ischemic stroke can vary considerably and may appear similar to another condition“stroke chameleons”.To improve diagnostic accuracy, the clinical distinction of cerebral ischemia and triaging of patients in the emergency department is discussed in an article in the Nov. 2018 issue ofNeuroimaging Clinics of North America.

Nobel Prizes that changed medicine forever: Francis Crick, James Watson & Maurice Wilkins (1962)“For their discoveries concerning the molecular structure of nucleic acids and its significance for information transfer in living material” Building on Oswald Avery’s research which identified DNA as the bearer of the genetic code, Francis Crick and James Watson famously determined the molecular structure of DNA. The contributions of Maurice Wilkins and Rosalind Franklin (who died 4 years before the Nobel Prize was awarded) were fundamental to the identification of the molecular structure, the long double helix (Medscape).

Homosexuals in a live-in relationship is not a crime, rules Kerala High Court (Advocate Ira Gupta & Dr KK Aggarwal): In a string of progressive judgments being passed by the Indian Judiciary, the High Court of Kerala in this recent case has allowed lesbian couple to lead a live-in relationship noting that the same is not a crime or contrary to any Indian law.

In the case titled as “Sreeja S. versus The Commissioner of Police”, the seminal and intriguing issue that fell for consideration before the High Court of Kerala was“whether persons of same gender are entitled to lead a ‘live-in relationship’?

The petitioner, a lady, alleged that her ‘lesbian partner’, ‘A’, years is under illegal of her parents, against her free will. Accordingly, the Petitioner in the case prayed production of the corpus of the alleged detenue and to set her at liberty.

The High Court in view of the facts of the case noted that the larger issue in the case was whether detenu can be permitted to go along with the petitioner to lead a ‘live-in relationship’, because both of them belong to the same gender, and could not solemnize a valid marriage between them?

While arriving at its decision in favour of the Petitioner, the High Court made reference to recent string of cases highlighting the freedom of choice of an individual and the validity of adults to have a live-in relationship.

With respect to permitting of ‘live-in relationship’ the High Court made reference to the recent case of Nandakumar and another V. State of Kerala and others, where by the Supreme Court noted that, even if the parties are not competent to enter into the wedlock, they have the right to live together even outside the wedlock. The Court also observed that ‘live-in relationship’ was now recognized by the Legislature itself which has found its place under the provisions of the Protection of Women from Domestic Violence Act, 2005.

Reference was also made to the famous case of Shafin Jahan V. Asokan, wherein it was held by the Apex Court that the social values and morals have their space, but they are not above the constitutionally guaranteed freedom. Reference was also made to the landmark verdict in case of Navtej Singh Johar V. Union of India.

Finally, the High Court in the present case observed that the ‘live-in relationship’ between the petitioner and the alleged detenue will in no manner offend any provisions of law or it will become a crime in any manner and the Court directed to set the alleged detenue at liberty to go along with the petitioner, as desired by her.(Source: Vakilno1)

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

Dr KK Aggarwal

Padma Shri Awardee

President Elect CMAAO

President Heart Care Foundation of India