Morning Medtalks with Dr KK Aggarwal

Morning Health Talk :

New Delhi, May 09, 2018 :

Clinical

• A higher intake of vitamin E is thought to counteract the increased oxidative stress found in patients with NAFLD and it is commonly prescribed as a supplement in the clinical practice. Integr Med Insights. 2016; 11:19-25, Am J Gasstroenterol 2012; 107(6): 811-826.
• Restricting carbohydrates and opting for a very low-carb-diet shows promise in patients with type 1 diabetes. Led by Belinda Lennerz of Boston Children’s Hospital, the study suggest that the diet can improve blood sugar control in type 1 diabetes, with low rates of hypoglycaemia and other complications.
• Dengue fever could be passed on through sex. Scientists have found the virus in the semen of a man, more than a month after he fell ill while travelling in Thailand. The study is thought to be the first instance of the virus being recorded in the male genitals and suggests dengue fever could be transmitted during sexual intercourse. The study, published in journal Eurosurveillance, documented the case of an Italian man in his 50s diagnosed with dengue fever after returning from Thailand in January.
• DACAB trial study published in the Journal of American Medical Association showed that aspirin plus ticagrelor, an inhibitor of platelet aggregation, increased graft patency approximately 1 year following elective coronary artery bypass grafting with saphenous vein grafting to a greater degree than aspirin-only therapy.
• Results of the RADIAL meta-analysis found that using a radial artery instead of a saphenous vein was associated with better outcomes after multivessel coronary artery bypass grafting.
• A recent meta-analysis found that common painkillers such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) confer little if any risk of inflammatory bowel disease exacerbation.
• Frequent Finnish-style sauna baths were linked to a substantially reduced risk of new-onset stroke in an observational study in Europe.
• A diet high in oily fish and fresh legumes was tied to later onset of natural menopause, and a diet high in refined pasta and rice was tied to earlier onset of menopause.

Fatty Liver

NAFL versus NASH: Non-alcoholic fatty liver disease (NAFLD) is subdivided into non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). In NAFL, hepatic steatosis is present without evidence of inflammation, whereas in NASH, hepatic steatosis is associated with hepatic inflammation that histologically is indistinguishable from alcoholic steatohepatitis.

WMA

A call for Taiwan to be allowed to participate in this months’ World Health Assembly has come from the World Medical Association. The WMA, a body representing 114 national medical associations and constituent bodies around the world, has written to Dr. Tedros Adhanom Ghebreyesus, Director General of the World Health Organization, saying it is unacceptable for Taiwan to be locked out of the WHA meeting. In their letter, Dr. Yoshitake Yokokura, President of the WMA, and Dr. Ardis Hoven, Chair of the WMA Council, write: ‘After some years of granting the delegation from Taiwan observer status we experienced last year a lockout of the delegation from Taiwan and we are concerned that the participation of Taiwan in global health activities of WHO might be extremely limited. Behind these restrictions we can see only political reasons. But as physicians we reject the idea of a political instrumentalization of global health.

Diarrhoea fortnight

Diarrhoea is the one of the important cause of morbidity and mortality among under 5 Children and causes 10% of under 5 deaths. The under 5 mortality rates is 22. Almost all Deaths can be averted due to diarrhea by preventing & treating dehydration by use ORS & Zinc and nutritional support. As per RSOC 2014 survey, the prevalence of Diarrhea was 10% in Delhi and as per IDCF campaign observed in Delhi in 2016 was 4.1%.

Public Health

About ten years ago, the hospitals used to procure medicines based on procurement price and quality and now, the criteria are MRP price. The manufacturer who prints the highest MRP price wins the bid, allowing the hospitals to make higher profit margins. The fixing of MRP is completely arbitrary. It is a complete breakdown of market economics. (Rajiv Nath, forum coordinator, Association of Indian Medical Device Industry)

People search for information on a wide variety of health topics in Google and other search engines. That’s no surprise. Do you know that “apple cider vinegar weight loss diet” was among the fastest-rising health topic searches for Google in 2017? It was used to improve strength, for “detoxification,” and flor weight loss. Studies in obese rats and mice suggest that acetic acid can prevent fat deposition and improve their metabolism. The most widely quoted study of humans is a 2009 trial of 175 people who consumed a drink containing 0, 1, or 2 tablespoons of vinegar each day. After three months, those who consumed vinegar had modest weight loss (2 to 4 pounds) and lower triglyceride levels than those who drank no vinegar.

Aural toilet: Use a 50% peroxide solution in sterile water for clearing the ear canal prior to placement of topical therapies. Instil five drops of the solution into the affected ear, let it sit in the ear canal for at least 30 seconds if possible, and then have the patient tip their head to let the solution and debris drain out. Examples of antiseptic agents used in this setting include hydrogen peroxide, acetic acid (vinegar), and povidone-iodine (PVP-I).

Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI