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Morning MEDtalks with Dr K K Aggarwal
New Delhi, August 18, 2018
AHA advises low-calorie sweeteners may be useful in adults
“On the basis of the available evidence, the [AMERICAN HEART ASSOCIATION] writing group concluded that, at this time, it is prudent to advise against prolonged consumption of low-calorie sweetened beverages by children,”
“For adults who are habitually high consumers of sugar-sweetened beverages, the AHA writing group concluded that low calorie sweetened beverages may be a useful replacement strategy to reduce intake of sugar-sweetened beverages.”
The report was published online July 30 in Circulation and is endorsed by American Diabetes Association (ADA).
An important exception to the recommendation for children is for those with diabetes mellitus. The advisory says that in those who follow a balanced diet and closely monitor their blood glucose, low-calorie beverages may represent a useful substitution in preventing excessive glucose excursions.
The recommendations refer to the six high-intensity sweeteners currently approved by the US Food and Drug Administration (FDA) — saccharin, aspartame, acesulfame-K, sucralose, neotame and advantage — and the two additional high-intensity sweeteners to which the FDA has issued no objection letters — steviol glycosides, obtained from the leaves of the stevia plant (Stevia rebaudiana), and extracts obtained from Siraitia grosvenorii swingle fruit, also known as luo han guo or monk fruit.
Minimal cognitive impairment
There are two kinds of minimal cognitive impairment (MCI). In both, symptoms are not severe, although they can be upsetting and disruptive.
- Amnestic MCI is memory-specific and is marked by signs like forgetting conversations and misplacing items.
- Non-amnestic MCI involves changes in other brain activities regardless of whether you have memory loss. It may show up as problems with language (you lose your train of thought during a conversation), attention (you have a hard time accomplishing tasks like bill paying), or spatial sense (you can’t find your way around a familiar place).
Globally more than 6% of people in their 60s have MCI. The number climbs to more than 37% by age 85. The guidelines published December 27, 2017 in Neurology, note that MCI cases progress to full-blown dementia about 15% of the time among people 65 or older.
Supreme Court: 85% of the principal display area of the packaging of tobacco products should have specified health warnings
The stay on the judgment of the Karnataka High court, which had quashed the Cigarettes and Other Tobacco Products (Packaging and Labelling) Amendment Rules, 2014 (2014 Rules), was made “absolute” by the Hon’ble Supreme Court on 14.08.2018 in the matter titled as Cancer Patient Aids Association versus Union of India, SLP 8786/2018. This would mean that 85% of the principal display area of the packaging of tobacco products’ should have specified health warnings till the matter is decided one way or the other.
A Bench of Chief Justice Dipak Misra and Justice AM Khanwilkar granted leave in appeal against the High Court verdict while ordering that the interim order passed by it “is made absolute”.
The 2014 Rules mandate printing of specified health warnings covering 85% of the principal display area of the products’ packaging.
The Karnataka High Court Bench of Justices BS Patil and BV Nagarathna had struck down the 2014 rules. The said judgment was then challenged in Supreme Court. On January 8 this year, the Supreme Court had stayed the Karnataka High Court verdict while observing that the health of citizens has primacy over business of tobacco companies. In its interim order of January 8, the Court had stated,
“Considering the rivalized submission advanced at the Bar and keeping in view the objects and reasons of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 and the measures taken by the State, we think it appropriate to direct stay of operation of the judgment and order passed by the High Court of Karnataka…
Though a very structural submission has been advanced by the learned counsel for the respondents that it will affect their business, we have remained unimpressed by the said proponement as we are inclined to think that health of a citizen has primacy and he or she should be aware of that which can affect or deteriorate the condition of health. We may hasten to add that deterioration may be a milder word and, therefore, in all possibility the expression “destruction of health” is apposite.” (Ira Gupta)
Hoarding to be classified as mental disorder by WHO
Hoarding has been classified as a medical disorder for the first time by WHO. It affects up to 5% of the population. Hoarding disorder is characterized by an accumulation of possessions due to excessive acquisition of or difficulty discarding possessions, regardless of their actual value. People perceive a need to save the items and typically experience distress when facing the prospect of discarding things.
The most commonly saved items include newspapers, old clothing, bags, books, and paperwork, but virtually any item can be saved. The nature of items is not limited to worthless possessions, because many individuals acquire and save valuable things too.
Patients who remain resistant to psychosocial interventions, or who lack access to them, can be provided a trial of a serotonin-reuptake inhibiting medication, particularly in patients with comorbid mood or anxiety disorders.
Video to watch: Modern day doctor-patient relationship: TEDx Talk by Dr KK Aggarwal
https://www.youtube.com/watch?
Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI
