Morning MEDtalks with Dr KK Aggarwal 11^th November 2018

Improving diets by reducing food loss and waste: A new policy brief “Preventing nutrient loss and waste across the food system: Policy actions for high-quality diets” urges policymakers to prioritize the reduction of food loss and waste as a way of improving peoples access to nutritious and healthy food. The brief prepared by the Global Panel on Agriculture and Food Systems for Nutrition in partnership with the Food and Agriculture Organization of the United Nations (FAO) also points out that poor-quality diets are now a greater public health threat than malaria, tuberculosis or measles. Meanwhile, approximately one third of all the food produced for human consumption never reaches the consumers plate or bowl… (FAO, Nov. 7, 2018).

One of the biggest exercise errors is using improper technique. Exercising is one of the best things you can do for your health. But if youre performing your exercises the wrong way, you could be hurting, not helping your body. 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.

A massive Class I recall is underway for Roche Diagnostics CoaguCheck XS PT test strips used with point-of-care and home devices to adjust warfarin dosing. The test strips may overstate patients actual International Normalized Ratio (INR), leading to underdosing or interruption in warfarin use.

Inhaled inorganic nitrite did not enhance functional capacity for patients with heart failure with preserved ejection fraction. The nebulized agent didnt significantly improve exercise capacity compared with placebo after 4 weeks (13.5 versus 13.7 mL/kg/min, P=0.27), reported Barry Borlaug, MD, of Mayo Clinic in Rochester, Minnesota, and colleagues in JAMA.

Liver Meet: Results from phase 2 studies of drugs for nonalcoholic steatohepatitis — Mgl-3196 (Madrigal Pharmaceuticals), obeticholic acid (Ocaliva/Intercept Pharmaceuticals), GS-9674 (Gilead Sciences), NGM282 (NGM Bio), arachidyl amido cholanoic acid (Aramchol, Galmed Pharmaceuticals), and tropifexor (Novartis) — will be presented. The Liver Meeting 2018: American Association for the Study of Liver Diseases (AASLD).

For inpatients with heart failure, there was no evidence of a significant clinical benefit in patients on a sodium-restricted diet. In chronic ambulatory heart failure, a modest and inconsistent trend toward symptom improvement was noted (JAMA Internal Medicine, Nov. 5, 2018).

US FDA has authorized emergency use of first rapid, single-use fingerstick test with portable reader for the detection of Ebola virus (Zaire ebolavirus). “DPP Ebola Antigen System” is the second Ebola rapid antigen fingerstick test available under EUA, but the first that uses a portable battery-operated reader, which can help provide clear diagnostic results outside of laboratories and in areas where patients are likely to be treated.

Revefenacin FDA-approved for COPD for the maintenance treatment of chronic obstructive pulmonary disease. A long-acting muscarinic antagonist (LAMA), revefenacin is administered once daily 175 mcg vial (3 mL) via a standard jet nebulizer as an inhalation solution.

Causes of physician burnout (beckershospitalreview.com)

1. An inherently stressful job
2. Being not prepared for the additional non-clinical burdens i.e., documentation, billing, insurance, changing politics, malpractice, etc.
3. Inefficient work environment resulting from Electronic Health Records (EHRs) and lack of other support
4. Work-life balance is difficult to maintain
5. Loss of autonomy, flexibility and control which is very stressful. If the physicians have no control over how many patients they see, how many hours they work, how to comply with government and insurance regulations, they will no longer feel that they are providing good care.
6. Loss of meaning in our work exemplified by the deterioration of the physician-patient relationship

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