Morning MEDtalks with Dr K K Aggarwal

New Delhi, July 26, 2018 :

Modicare costing study

The central government has commissioned a costing study on 1,350 treatment packages under Ayushman Bharat – National Health Protection Mission — and said it is open to review the package rates based on the study. Niti Aayog and ICMR are tasked to do undertake a detailed study that aims to examine the cost of each procedure and arrive at a suitable package rate.

Leptospirosis in Mumbai

Is a zoonosis caused by spirochetes of the genus Leptospira. The organism infects wild and domestic mammals, especially rodents, cattle, swine, dogs, horses, sheep, and goats. Animals can be asymptomatic or develop fatal clinical infection. Reservoir animals may shed the organism in their urine resulting in contamination of water. Humans gets after exposure to environmental sources, such as animal urine, contaminated water or soil, or infected animal tissue through cuts or abraded skin, mucous membranes, or conjunctiva.

The disease may manifest as a subclinical illness, a self-limited systemic infection, or a severe, potentially fatal multiorgan failure. Patients presents with abrupt onset of fever, rigors, myalgias, and headache in 75 to 100 percent of patients. Conjunctival suffusion in a patient with a nonspecific febrile illness should raise suspicion for the diagnosis of leptospirosis.

Severe cases may develop renal failure, uveitis, hemorrhage, acute respiratory distress syndrome with pulmonary hemorrhage, myocarditis, and rhabdomyolysis.

Treatment is oral doxycycline or azithromycin. These agents are also effective for rickettsial disease, which can be difficult to distinguish from leptospirosis.

Prevention include avoiding potential sources of infection, administration of prophylaxis for individuals at high risk of exposure, and animal vaccination.

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