adminMorning Round with Dr KK Aggarwal Representational Image
New Delhi,17 February,2018 :
1. Single fathers may be at more than double the risk of early death than single mothers and partnered parents, finds a new study IN the Lancet Public Health
2. In India, 1,300 crore antibiotic pills are swallowed by patients annually compared to 1,000 crore pills used in China and 700 crore pills in the USA, according to Public Health Research Organization Centre for Disease Dynamics, Economics and Policies Report on Antibiotics 2015.
3. Medical studies, such as those published in the American Medical Association and American Journal of Epidemiology, indicate that donating blood can be good for the donor. Researchers in one study found that participants had fewer heart attacks and strokes when they donated blood every six months. In another study, participants who donated a minimum of once a year had an 88 percent lower risk of heart attacks that those who did not.
4. A prespecified analysis of the Heart Outcomes Prevention Evaluation-3 (HOPE-3) trial provides reassurance that long-term primary prevention therapy with a statin and/or the combination of candesartan and low-dose thiazide does not increase the risk for erectile dysfunction (ED) in middle-aged men at intermediate cardiovascular risk.
5. Pulmonary embolism: The PERC rule comprises eight clinical criteria: arterial oxygen saturation of 94% or lower, pulse rate of 100/minute or higher, patient age of at least 50 years, unilateral leg swelling, hemoptysis, recent trauma or surgery, prior PE or deep venous thrombosis, and exogenous estrogen use.
6. Globally it is projected that by 2050, the health consequences and economic costs of AMR are estimated at 10 million annual human fatalities and a 2 to 3.5 per cent decrease (equivalent to USD 100 trillion) in global Gross Domestic Product (GDP).
7. A study following outcomes of 28 patients with drug-resistant tuberculosis in three countries with high burdens of the disease found what the researchers cite as strong evidence that a combination of the two newest TB drugs could be part of a safe and effective treatment regimen. The drugs, bedaquiline — which was approved by the U.S. Food and Drug Administration and the European Medicines Agency in 2012 — and delamanid — approved by the EMA and the Japanese pharmaceutical regulatory body in 2014, represent the only two innovative medicines to treat TB developed in the last half century
8. In light of the above judgement, its better to give antibiotics, of course a full course . This is a practical approach. you must be aware of the case i Australia , couple of years back when a child died because administration of antibiotics was delayed due to non availability of culture report due to week end closure of reporting lab. if a person dies due to non administration of antibiotics doctor will be held guilty, but if microbes develop resistance due to antimicrobial misuse no one will be held guilty, so choice is obvious, when we are living in an era where cases of medical negligence are decided on the basis of theory that doctor is guilty unless conclusively proved otherwise, it is better to err on the side of safety first, rather than be scientifically correct. Sad but true. Dr Rajender Sharma. IMM.PAST President , IMA Punjab State
9. The information about the case of Dr Bawa-Garba is useful since there is a general deep sense of dissatisfaction about the GMC and even the NHS across all the practitioners’ groups in the United Kingdom. If you had an opportunity to read my recent article (attached) you would note that Chief Executive of the GMC is calling for the review of the legislation that gives powers to the GMC- the regulatory body. Maybe worth keeping an eye on the development. In my other work, I used to lead a ‘Capacity Building Programme’ funded by the Home Office and drawing on its experience, may suggest in the context of India, that this an opportune time for the IMA to develop a national project towards ‘Capacity Building’ of the service providing clinics, mainly relating to the public service. I am sure you would be able to convince your national and state governments to support (in-kind and cash) it for having a highly trained team of clinicians and administrators who could visit and provide an assessment of redressing weaknesses and good management practise practices with recommendations improvements in the standards. It could be then provided with a joint ‘certification’ by the State Health Body and IMA for contributing to a ‘Compact’ (between – Management Board Clinicians and other staff and the users of services) for improving services. This may provide a huge mapping opportunity for IMA, though the outreach work -hand on support- may win the organisation a reputation! The main aspect would be to help enhance the level of awareness and commitment across smaller and medium clinicians and associated personnel in many ways. I hope this is helpful and please do let me know your thoughts. Buddhdev
10. Do you know: Testing Streptococcus pyogenes for susceptibility to penicillin is not routinely performed because isolates that are not susceptible to penicillin have not been reported.
11. susceptibility testing of first and second generation cephalosporins against Salmonella and Shigella spp is not recommended due to the poor correlation between in vitro susceptibility testing results and clinical outcomes
12. Do you know that Laryngeal TB can occur in the absence of pulmonary disease.
13. Shares of Fortis HealthcareBSE -4.31 % tumbled over 4 per cent on Friday following the Supreme Court ruling which allowed lenders to the company to sell shares pledged by promoters Malvinder and Shivinder Singh with them.
14. “The publication of CHERISH study results in The New England Journal of Medicine emphasises nusinersen’s meaningful motor function and upper limb improvements [from baseline] in individuals with later-onset SMA rarely seen in the natural course of the disease, which is typically a continued decline in motor function over time,” said Eugenio Mercuri, MD, lead study investigator, U.O.C. Neuropsichiatria Infantile – Policlinico Universitario “A. Gemelli”, Rome, Italy. “During the study, some individuals treated with nusinersen achieved motor milestones including crawling or standing with assistance, or saw a stabilisation or slowing of disease progression. We also saw an improvement [from baseline] in upper limb function, including raising objects.”
15. Researchers publishing in a recent edition of the New England Journal of Medicine describe a new approach to treating severe scleroderma: stem-cell transplantation. With this treatment, stem cells (which can develop into many different types of cells) are removed and the body’s immune system is essentially wiped out with chemotherapy and radiation. The stem cells are then returned to the body where they rebuild the immune system — a sort of “rebooting” of the immune system.
16. Aasif Khan, a 22-year-old engineer from Aligarh, spent nearly an hour dead before medics were able to miraculously re-start his heart. The youth, who had complained of acute chest pain, suffered a massive cardiac arrest inside the Apollo hospital while doctors were examining him. But, Aasif suffered another cardiac arrest as he was being wheeled into the cath lab for an angiogram to locate the blood vessel clot that had caused the condition. The doctors had to conduct the angiogram, remove the clot and place a stent in the vessel while administering CPR. The report added that the youth walked out healthy from the hospital on Friday. TOI
17. USA: It’s been a very bad year for the flu. For the week ending February 3, 2018, the Centers for Disease Control and Prevention estimates that almost 8% of people saw their healthcare providers for an influenza-like illness (ILI), the highest rate of ILI since the 2009 pandemic
18. 60%-80% of ILI is caused by influenza, and the rest by other acute respiratory viruses masquerading as the flu.
19. The US Food and Drug Administration has cleared the Glooko Mobile Insulin Dosing System for the titration of long-acting (basal) insulin for people with type 2 diabetes. The system, housed within a mobile app, allows clinicians to create customized treatment plans including insulin titration rules that they then “push” to the patient. The Glooko platform integrates with 95% of the blood glucose meters on the US market, so the verified data can be directly uploaded, rather than manually entered.
20. Flu season is still raging in the United States, yet already it ranks among the most difficult in recent years. One reason: This year’s vaccine has been just 36 percent effective against both A and B virus strains, the U.S. Centers for Disease Control and Prevention estimated in Thursday’s Morbidity and Mortality Weekly Report.
