Morning MEDtalks with Dr KK Aggarwal

September 5, 2018

New Delhi, September 05, 2018

The Plasma brain natriuretic peptide (BNP) is a biomarker for screening ischemic cerebral small vessel disease in hypertensive patients. Plasma BNP level has been suggested to be a useful marker for identifying ischemic cerebral small vessel disease (CSVD) in high risk patients with hypertension. A study published in the August 2018 issue of the journal Medicine (Baltimore) involving 346 hypertensive patients, white matter lesions [β = 0.722; 95% confidence interval (95% CI), 0.624-0.819] and lacunar infarcts (β = 0.635; 95% CI, 0.508-0.762) had an independent association with BNL level, even after controlling for vascular risk factors and clinically manifesting cardiac diseases. Compared with each subtype taken alone, combined white matter lesions and lacunar infarcts were more strongly associated with BNP level. With the cutoff value of 106.4 pg/mL, BNP level had a sensitivity, a specificity, and an area under the curve of 95.2%, 64.9%, and 0.799, respectively, for white matter lesions, whereas the values were 143.0 pg/mL, 81.6%, 73.5%, and 0.848, respectively, for lacunar infarcts.

The Twelve people have died of leptospirosis disease in Kerala between August 1 and September 3, while 372 confirmed leptospirosis cases have been reported from the flood-hit state since August 1. Following a review meeting at Kozhikode, the district from where the most number of leptospirosis cases have been reported, Kerala Health Minister KK Shailaja announced three weeks of high alert and said, “Kerala would be on high alert for next three weeks but there is nothing to panic. All hospitals are equipped with enough stocks of medicine. Even though there were wide advisories after the flood, people were reluctant to consume precautionary tablets. As more cases have been reported from Kozhikode district, an isolated war-room will be set up in Kozhikode medical college.”

The US regulators have rejected Sunovion’s application to market dasotraline for the treatment of attention-deficit hyperactivity disorder.

The Taking suo moto cognizance of the death of a 23-year-old engineering student at Sion hospital, the Maharashtra State Human Rights Commission has directed the JJ hospital to set up a panel to probe what led to his death. The commission also pulled up doctors for not providing the family his post-mortem examination report for the last three months, while stating that it is “violation of human rights”.

The Delhi State Consumer Disputes Redressal Commission fined a Delhi eye centre of Rs 15 lakh for turning a 43-year-old housewife blind in the left who had come to get cataract operation done. It was alleged that no receipt was issued for the charges paid meant for examination prior to operation, fees for nursing home, medicine and post operation care. Also, no mandatory tests were conducted prior to the operation. The hospital in its submission said that Khanna did not disclose about her having stone and urinary infection and could have been sent to a specialist. The commission relied on the observation of the Delhi Medical Council that held the hospital and the doctor guilty of not keeping the records of cataract surgery and working in a non-registered clinic.

The US FDA has approved two new oral treatments for adults with HIV-1 infection in adults with no prior antiretroviral treatment historyPifeltro contains doravirine (100 mg), a new non-nucleoside reverse transcriptase inhibitor to be given in combination with other antiretroviral medicines.  Delstrigo is a once-daily fixed-dose combination of doravirine (100 mg), lamivudine (3TC; 300 mg) and tenofovir disoproxil fumarate (TDF; 300 mg). Both drugs are to be taken once daily with or without food

Nineteen second year medical college students from Madurai Medical College have been suspended for six months after a complaint of ragging against them were proven to be true.

The Cracking the whip on errant colleges for admitting students more than the prescribed seats in MBBS courses, the Medical Council India (MCI) has decided to debar all such medical colleges from admitting students for a year. The decision in this regard has been taken by the MCI on the suggestions of the Ministry of Health and Family Welfare, which has been initiated to bring transparency in the admission process in medical colleges.

The“India has fast-tracked many initiatives aimed at achieving all the core tenets of Universal Health Coverage i.e, strengthening health systems, improving access to free medicines & diagnostics and reducing catastrophic healthcare spending” said Shri J P Nadda, Union Minister of Health and Family Welfare at the inauguration of the ‘71st Session of the WHO Regional Committee for South-East Asia,’ in New Delhi on Sept. 3, 2018. He further stated that India on its part firmly believes in the objective of attainment of the highest possible level of health, where health is a state of complete physical, mental, spiritual and social well-being and not merely the absence of disease or infirmity.

The Patient satisfaction after plastic surgery is influenced by surgeon-related factors such as taking the time to answer questions and including patients in decision-making, while practice-related issues like waiting time and office staff have a much weaker effect on patient satisfaction (Plastic and Reconstructive Surgery, September 2018 issue).

Urging that colorectal cancer screening should begin at 45 years of age, a coalition of 22 public health and patient advocacy groups including American Cancer Society (ACS) has submitted a letter to the US Preventive Services Task Force (USPSTF) asking that the task force reconsider its 2016 guidance, in which it recommends that CRC screening begin at age 50 years and continue until age 75 years. This recommendation is scheduled for review in 2021, but the coalition is asking for earlier action (Medscape).

The Dietary supplements also can cause side effects and unwanted interactions with other substances, especially in the older adults. Ronan Factora, MD, of Cleveland Clinic’s Center for Geriatric Medicine says, “Too much of some dietary supplements can be harmful,” says Dr. Factora. “Some can interact with prescription drugs or change how the body metabolizes them.” He lists these examples:

  • Excess vitamin A may increase risk of osteoporosis.
  • Excess vitamin B6 can produce neurological problems, such as imbalance and peripheral neuropathy.
  • Garlic, ginger, ginkgo and ginseng can increase the risk of bleeding in people taking blood thinners.
  • John’s Wort, which some take for depression, can cause serotonin syndrome if combined with an antidepressant.
  • Echinacea, kava, cinnamon and melaleuca may inhibit or accelerate metabolism in the liver, causing statins, anti-seizure medications or others to either be less effective or potentially produce more side effects.

The Dr KK Aggarwal: Modern day doctor-patient relationship

https://www.youtube.com/watch?v=i9ml1vKK2DQ

Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI

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