Morning MEDtalks with Dr KK Aggarwal 8th November 2018

Ebola outbreak in Congo may not be containable, says Robert Redfield, Director Centers for Disease Control and Prevention on Monday. The Ebola outbreak in conflict-ridden Congo has become so serious that international public health experts need to consider the possibility that it cannot be brought under control and instead will become entrenched. If that happened, it would be the first time since the deadly viral disease was first identified in 1976 that an Ebola outbreak led to the persistent presence of the disease. In all previous outbreaks, most of which took place in remote areas, the disease was contained before it spread widely. The current outbreak is entering its fourth month, with nearly 300 cases, including 186 deaths … (Washington Post, Nov. 5)

Eating a late dinner may contribute to cardiometabolic risk in American Hispanics and Latinos. In a population-based study, people who consumed at least 30% of their energy after 6 pm had 23% higher odds of hypertension (OR 1.23, 95% CI 1.05-1.44) and 19% higher odds of prediabetes (OR 1.19, 95% CI 1.03-1.37) compared with those who ate less in the evening (American Heart Associations Scientific Session 2018, Chicago).

How much information must you reveal to patients about your experience with specific procedures, your track record, and outcomes? More courts are now saying that its possible that lack of disclosure violates informed consent rules. In the case of Andersen v. Khanna, Supreme Court of Iowa, June 15, 2018 (read the complete judgement at https://cases.justia.com/iowa/supreme-court/2018-14-1682.pdf?ts=1529073259), a surgeon had never performed a procedure he recommended. The patient experienced severe complications and sued for both negligence and lack of informed consent. In a 5-4 decision, the Iowa Supreme Court in June 2018 ruled that the patient had the right to know about the surgeons lack of experience. Although a doctors experience generally hasnt been considered part of the informed consent process, the law is evolving. The issue is often decided on a case-by-case basis. Still, more disclosure of experience, and even outcomes, may be required... (Medscape)

Healing of ozone layer gives hope for climate action. The findings of a new UN-backed report, “Scientific Assessment of Ozone Depletion: 2018”, released on Monday, showing the ongoing healing of the ozone layer, are being hailed as a demonstration of what global agreements can achieve, and an inspiration for more ambitious climate action to halt a catastrophic rise in world temperatures. The study shows that the concentration of ozone-depleting substances continues to decrease, leading to an improvement in the layer since the previous assessment carried out in 2014.

Japans youth suicide rate highest in 30 years: More Japanese children and teenagers killed themselves between 2016 and 2017 than in any year since 1986, according to a new government report. The latest survey shows 250 elementary and high school age children took their own lives in that year for a variety of reasons including bullying, family issues and stress, the countrys Ministry of Education said Monday, according to local media. Those figures were 5 up on the previous year, and the highest since 1986, when 268 pupils died... (CNN Tokyo)

New guidelines for the evaluation and management of patients with bradycardia and cardiac conduction delay have been jointly released by the American College of Cardiology (ACC), the American Heart Association (AHA) and the Heart Rhythm Society (HRS) released a guideline for the evaluation and treatment of patients with bradycardia, or a slow heartbeat, and cardiac conduction disorders. Bradycardia has been defined as a heart rate of less than 50 beats per minute, compared to a normal heart rate of 50-100 beats per minute.

Results from a new 5-year study presented Oct. 22, 2018 at the American College of Rheumatology 2018 Annual Meeting in Chicago show that a brisk walk for just 5 minutes a day can lower the risk for total knee replacement over 5 years in people with knee osteoarthritis

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