Morning MEDtalks with Dr KK Aggarwal

July 8, 2018

Morning Health Talk:

New Delhi, July 8, 2018:

Bombay HC cuts short sentence for acid attacker after he marries victim and decides to get treatment of victim done by donating his skin

In the matter titled as “Anil Shivaji Patil versus The of Maharashtra”, bearing Criminal Appeal No. 312 of 2014, the Hon’ble Division Bench of High Court of Bombay vide judgment dated 27.06.2018 has reduced the sentence of the acid attacker accused as the said accused and the victim have decided to marry each other and lead a peaceful life and have also decided to get treatment of the victim done from a plastic surgeon for which the accused has undertaken to donate his skin.

Facts of the case

The incident appears to be an outcome of a love affair between the accused and the victim of the crime. It appears that both the Appellant and the victim were having love affair with each other for a long time. However, when the accused asked her to marry, she refused. On such refusal the accused became angry and used to threaten the victim. On the date of incident i.e. on 16/04/2010 when the victim was proceeding towards her college along with her friends Bhagyashri and Pranali, the accused came there and threw Acid on the face and shoulder of the victim.

Thereafter vide the Judgment and Order passed by the learned Additional Sessions Judge, Khed, dated 18/12/2013 convicted the accused for the offence punishable under Section 326 and 341 of IPC and sentenced to suffer rigorous imprisonment for life and to pay a fine of Rs.25,000/­ in default to suffer simple imprisonment for three months. Insofar as the offence punishable under Section 341 is concerned, the learned trial Judge has sentenced Appellant to suffer rigorous imprisonment for one month. Against the said judgment and order passed by the Ld. Trial Court, the accused filed the present appeal before the Hon’ble High Court of Bombay thereby submitting that the sentence of life which is imposed by the Learned Trial Court for the offence punishable u/s 326 is disproportionate to the facts of the case.

Judgment of Hon’ble High Court of Bombay

After hearing all the submissions of the accused the Hon’ble High Court of Bombay reduced the sentence of the accused to 8 years which he had already undergone and has held that:

5. It is further to be noted that after the conviction and during the pendency of the Appeal, the matter has been amicably settled between the Appellant and the victim. Both of them have been married to each other on 22/06/2017. Not only that, after the marriage the victim is required to take a treatment from a plastic surgeon and for which the Appellant has undertaken to donate his skin. The learned APP on the last date was requested to enquire from the concerned Police Station. On enquiry he has confirmed the fact with regard to the marriage of the Appellant and the victim.

6. The Appellant has already undergone the sentence of more than 8 years. We find that the said sentence is more than sufficient taking into consideration the nature of the factual background. We find that the Appellant and the victim have decided to lead a peaceful life and have also decided to get treatment of the victim done from a plastic surgeon for which the Appellant has undertaken to donate his skin. It is just and necessary that the Appellant and the victim be permitted to lead a peaceful life.

Vitamins and children

According to a study published in the June issue of the Journal of American Medical Association Pediatrics, a third of US children and adolescents would say they “had taken any vitamins, minerals, herbals or other dietary supplements in the last 30 days.” And the use of alternative or herbal supplements has almost doubled from 3.7% to 6.3% from 2003-2004 to 2013-2014.

Comments invited for creation of National Health Stack 

The National Health Stack (NHS) envisages a centralized health record for all citizens of the country in order to streamline the health information and facilitate effective management of the same. The proposed NHS is an approach to address the challenge and seeks to employ latest technology including Big Data Analytics and Machine Learning Artificial Intelligence, a state of the art Policy Mark-up Language and create a unified health identity of citizens – as they navigate across services across levels of care, i.e. Primary, Secondary and Tertiary and also across Public and Private. The innovativeness of the proposed National Health Stack design lies in its ability to leverage a shared public good – a strong digital spine built with a deep understanding of the incentive structures of the system. Once implemented, the National Health Stack will significantly bring down the costs of health protection, converge disparate systems to ensure a cashless and seamlessly integrated experience for the poorest beneficiaries, and promote wellness across the population.

In order to arrive at a well-informed conclusion, NITI Aayog invites comments from all the stake holders on the consultation paper, which has been uploaded at NITI website and can be found at www.niti.gov.in. Comments can be sent at [email protected] by 1st August 2018… (PIB, NITI Aayog, July 6, 2018)

“Delivering Quality Health Services-a Global Imperative for Universal Health Coverage”: Key findings from the WHO, OECD & World Bank joint report

  • In low and middle-income countries, 10% of hospitalized patients can expect to acquire an infection during their stay vs 7% in high income countries.
  • One in 10 patients is harmed during medical treatment in high income countries.
  • Health care workers in seven low- and middle-income African countries were only able to make accurate diagnoses one-third to three-quarters of the time, and clinical guidelines for common conditions were followed less than 45% of the time on average.
  • Research in eight high-mortality countries in the Caribbean and Africa found that effective, quality maternal and child health services are far less prevalent than suggested by just looking at access to services.
  • Around 15% of hospital expenditure in high-income countries is due to mistakes in care or patients being infected while in hospitals.

Anti-diabetes regimen

Among patients with uncontrolled type 2 diabetes with very high HbA1c, two treatment regimens led to “dramatic improvements” in glycemic control at 6 months, but one strategy stood out. Initiating a treatment regimen of basal insulin plus the glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide was more effective at lowering HbA1c than a regimen of basal plus bolus insulin in the randomized SIMPLE study.

Vegetarian diets improve HbA1c

Vegan and vegetarian diets reduce HbA1c and cholesterol levels and improve other cardiometabolic risk factors in middle-aged, overweight people controlling their type 2 diabetes with medications, says a literature review published online June 13, 2018 in Clinical Nutrition.

NIH tips to reduce risk of hyperthermia in older adults

Older people are at significant increased risk of heat-related illnesses during the summer months. Hyperthermia can include heat stroke, heat edema (swelling in your ankles and feet when you get hot), heat syncope (sudden dizziness after exercising in the heat), heat cramps, and heat exhaustion. If you suspect that someone is suffering from a heat-related illness:

  • Get the person out of the heat and into a shady, air-conditioned or other cool place. Urge them to lie down.
  • If the person can swallow safely, offer fluids such as water and fruit or vegetable juices, but not alcohol or caffeine.
  • Apply a cold, wet cloth to the wrists, neck, armpits, and groin. These are places where blood passes close to the surface of the skin, and a cold cloth can help cool the blood.
  • Encourage the person to shower, bathe, or sponge off with cool water if it is safe to do so.

Past use of oral contraceptives increases chances of insulin resistance

Past use of OCPs increases the prevalence of insulin resistance and diabetes among postmenopausal women. Sung-Woo Kim, MD, from Daegu Catholic University Hospital, South Korea, presented results of the cross-sectional study here at the American Diabetes Association (ADA) 2018 Scientific Sessions.

Platelet count in pregnancy

Pregnant women experienced declines in platelet count as early as the first trimester compared with non-pregnant women. Mean first trimester platelet count was 251,000 per cubic millimeter for women with uncomplicated pregnancies compared with a mean 273,000 per cubic millimeter for non-pregnant women. Platelet counts declined by an estimated 17% throughout pregnancy (New England Journal of Medicine, July 5, 2018).

Advanced kidney disease takes a great emotional toll on patients

Advanced kidney disease takes a great emotional toll on patients in the form of feelings of isolation, abandonment, alienation, mistrust, and even self-blame in what may come as a surprise to their treating doctors. As per a study published online June 28, 2018 in the Clinical Journal of the American Society of Nephrology, when providers seemed to lack insight into the patient’s experience of illness and treatment, this could cause a sense of mistrust, abandonment, isolation and/or alienation. Patients can also be impacted by how care was organized.

Heat disorders

A new study from the Centers For Disease Control and Prevention suggests that the current OSHA threshold of 91 degrees may be too high and that a heat index of 85 degrees could be hazardous for some workers. Outdoor workers wearing non-breathable clothing, as well as those who have not been climatized to high temperatures, are especially at risk. The researchers suggest employers develop a schedule to climatize workers to hotter temperatures and train supervisors to look for symptoms of heat stress.

Doctor sentenced in botched abortion death

Dr Robert Rho  was sentenced to jail time last week after pleading guilty to medical malpractice and negligence in the death of a woman who died as the result of a botched abortionn. He drew a sentence of 1 1/3 to four years in prison after entering a guilty plea to criminally negligent homicide before Judge Gregory Lasak of the State Supreme Court in Queens.

Six months pregnant patient was scheduled for an abortion. While performing the surgery, Rho, an obstetrician and gynecologist, caused a laceration to her cervix, a perforation of the uterine wall as well as a disruption and transection of the uterine artery. Brown said Morales was still bleeding profusely when she was in the recovery room after the surgery, which led to Rho performing a second procedure to rectify the damage but failing to realize that she was in dire, necessary need of emergency medical care.

The DA’s office said that Rho had actually encouraged Morales to leave the facility after the second operation, even though she appeared lethargic and was still experiencing excessive bleeding.

Morales left the facility, but on the way to her sister’s residence in the Bronx, she fell out of the car backseat and became unresponsive. She was treated for vaginal bleeding and given six units of blood at a Bronx hospital, but ended up dying at the hospital later that same evening.

The doctor has accepted responsibility and admitted his failure to provide adequate care following surgery, and he has been sentenced to prison as a result of his inaction.

The doctor is said to have performed 40,000 successful abortions in his 25-year career.

AHA opposes stay on taxes on beverages

California lawmakers last week approved a bill that would ban local communities from enacting taxes on groceries, including sugary beverages, for the next 12 years. Governor Jerry Brown signed the bill into law June 28. The deal was met with fierce opposition by many medical societies, including the American Heart Association (AHA), the American Diabetes Association (ADA), and the American Cancer Society, and by the California Dental Association.

MCI and Visual or hearing impairment

Ministry of Health and Family Welfare (MoHFW) has accepted the recommendations of Medical Council of India to not allow admission of students with 40 per cent visual and hearing impairments. In its recommendations submitted to the Health Ministry, the MCI has stated that students of such categories wouldn’t be allowed to get admission in medical colleges for MBBS course. Similarly, the persons with learning disabilities, autism, mental illness, etc have also been debarred from pursuing the medical education.

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Health Tips

Dr. T S Kler Padma Bhushan Awardee
MD, DM, MRCP, FRCP(U.K), FACC, D.Sc
Chairman – Fortis Heart Institute Gurugram

Precautions to avoid Corona Virus:

  1. Stay home as far as possible.
  2. Wash hands with soap and water frequently.
  3. Keep distance from people even your home members.
  4. Keep atleast 1-2 metres away from anybody coughing.
  5. Don’t touch your face, nose and mouth.

 

Dr. K.K Says

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