Morning Medtalks with Dr K K Aggarwal

Morning Health Talk :

New Delhi, May 06, 2018 :

Public Health

• A Phase 2 clinical trial of an investigational universal influenza vaccine intended to protect against multiple strains of the virus has begun in the United States. The trial is testing an experimental vaccine called M-001 for safety and its ability to produce potentially broad protective immune responses, both on its own and when followed by a standard, licensed seasonal influenza vaccine.

• Intensified Diarrhoea Control Fortnight 28th May to 9th June, 2018Give ORS and extra fluids to child immediately at the onset of diarrhoea (3 or more loose stools in one day) and continue till diarrhoea stops.
  Giving Zinc for 14 days for children suffering from diarrhoea , even if diarrhoea stops.
  Use of ORS and Zinc during diarrhoeal episodes among children is a safe treatment which makes the child recovers from diarrhoea faster.
  Safe and quick disposal of child’s faeces.
  Continue feeding, including breastfeeding in those children who are being breastfed & give extra feeds during and after illness.
  Use clean drinking water after safe handling.
  Mother should wash with soap before preparation of food, before feeding the child and after cleaning stool of child.

Clinical

• Over exposure to sunlight should also be avoided. One can adopt simple sunscreen application to the exposed areas and follow “teaspoon rule.” It involves the application of approximately 1 teaspoon (visually measured) of sunscreen to the face and neck area, a total of 2 teaspoons to the front and back torso, 1 teaspoon to each upper extremity, and 2 teaspoons to each lower extremity.
• Timing of application is important. Sunscreens should be applied 15 to 30 minutes before sun exposure to allow the formation of a protective film on the skin. It is recommended to wait for at least a few minutes (ideally, 10 to 20) following sunscreen application before dressing.   Reapplication at least every two hours is necessary.

• Short- and long-term mortality goes up after liberal use of supplemental oxygen, compared with a more conservative oxygen delivery approach, in patients with any of a range of acute illnesses. The analysis, based on patient-level data from 25 trials, also saw the mortality risk from liberal oxygen as dose-dependent, in that in-hospital and long-term mortality rates climbed with oxygen saturations rising above the threshold of 94% to 96%. The findings are “distinct” from “the current notion that at worst, liberal oxygen is not beneficial for acute illnesses,” said Derek K. Chu, MD, and Lisa H.-Y. Kim, MD, both from McMaster University, Hamilton, Ontario, Canada. The study shows about a 20% increase in hospital mortality when oxygen is given to nonhypoxic critically ill patients. There was one death for about every 71 patients given liberal oxygen, a number needed to harm that rose to about 100 in the studies limited to patients with acute coronary syndromes. The meta-analysis is published April 26 in the Lancet. Use SPO2 as the monitor is our view.

• All men 85 years and older should be screened for osteoporosis, and men as young as 65 years should be tested if they have certain risk factors for fracture, according to a new study by Cathleen Colon-Emeric, MD, from the Duke University School of Medicine in Durham, North Carolina.
• The US FDA has approved Andexxa to reverse the anticoagulation effects of factor Xa inhibitors when needed due to life-threatening or uncontrolled bleeding. Xa inhibitors are rivaroxaban and apixaban.

• Last month, the FDA approved idarucizumab to reverse the anticoagulant effect of dabigatran a direct thrombin inhibitor, in the event of urgent surgery or life-threatening or uncontrolled bleeding.

Policy

Delhi’s Mohalla clinics has been appreciated by think tank Niti Aayog. The think tank seems to be impressed by the Mohalla clinics model and wants it to be adopted for Centre’s ambitious plan to set up health and wellness centres across the country.  In Delhi Confidential column, The Indian Express has reported that the Niti Aayog is “pushing for Delhi’s Mohalla clinic model to be adopted for health and wellness centres.