70% of women with early breast cancer do not need chemotherapy : Morning MEDtalks with Dr KK Aggarwal

June 6, 2018
Morning Medtalks with Dr KK Aggarwal

Morning Health Talk :

New Delhi, June 06, 2018 :

Clinical

  • Women with early-stage HER2 negative, lymph node negative, breast cancer (1-5 cm) who would currently be treated with chemotherapy could skip the toxic treatment, a major international study TAILORx published in the New England Journal of Medicine suggests. This applies to cancers with a mid-range recurrence score (11 to 25) on a widely used gene marker test. Roughly 70 per cent of women who fit this patient profile could be spared chemotherapy.
  • Can a man remain conscious during CPR: A man undergoing cardiopulmonary resuscitation, or CPR, exhibited signs of conscious awareness for 90 minutes before the medical team stopped the life-sustaining procedure, according to a new case presented Monday at the annual European Anaesthesiology Congress in Copenhagen, Denmark. (Views: The answer is yes, it happens in thump resuscitation when done in CHB)

Public health

  • Mayo Clinic: “Potassium is an extremely important mineral, as supported by the recent Dietary Guidelines for Americans and the Food and Drug Administration designation that K+ is a ‘nutrient of public health’ concern because of its general underconsumption across the US population.”
  • Harvard: “High salt intakes increase blood pressure, ultimately leading to heart disease; high potassium intakes can help relax blood vessels and decrease blood pressure. Our bodies need far more potassium each day than sodium…”
  • Cleveland Clinic: “Researchers found that heavy salt consumption was linked to a 20 percent increased risk of death, while high potassium intake offered a 20 percent risk reduction.”
  • The index case: is the first documented or suspected patient in the onset of an epidemiological investigation. The index case may bring awareness of an emerging outbreak.

1.     Never ignore the first case of any new illness

2.     If you get two or more similar cases in the same family or area get concerned

3.     If you note sudden death/s of any animal or bird ring the bell

4.     Human to human transmission will occur from house hold contacts or treating healthcare workers

5.     The term primary case can only apply to infectious diseases that spread from human to human, and refers to the person who first brings a disease into a group of people.

6.     “Patient Zero” is used to refer to an individual identified as the first carrier of a communicable disease in a population (the primary case), or the first incident in the onset of a catastrophic trend.

7.     A known or suspected patient zero may be informally referred to as an index case for the purpose of a scientific study, such as the one-year-old boy who thought to be the source of the largest Ebola virus outbreak in history.

Policy

  • ‘Need to follow basic minimum standards’: Medical colleges need not be given a second chance to rectify their defects if they do not bother even to follow the “basic minimum standards of medical education,” the Supreme Court held. In a recent judgment, a Bench of Justices L. Nageswara Rao and M.M. Shantangoudar interpreted Regulation 8 (3) (1) (a) of the Establishment of Medical Colleges Regulations of 1999.
  • Regulation 8 (3) (1) provides that a medical college, which failed the Medical Council of India (MCI) inspection, should be given an opportunity to redeem itself and seek a re-inspection. But even to seek this re-inspection, the errant college should satisfy certain minimum standards. This means that the college cannot afford to have more than 30% deficiency in faculty or residents and the bed occupancy should not be less than 50%. The court held that this “prescription of standards for availing an opportunity to seek re-inspection is not ultra vires” of Regulation 8 or the Indian Medical Council Act.
  • The National Eligibility cum Entrance Test (NEET) witnessed a marked fall in the cut-off this year compared to last year. The Central Board of Secondary Examination (CBSE) announced the results.  The cut-off this year decreased from 131to 119, out of a total of 720. The decrease has been attributed to the complexity of the question paper this year.

Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI

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