Morning MEDtalks with Dr KK Aggarwal

Morning Health Talk :

New Delhi, July 07, 2018 :

Oral administration of honey or sucralfate after button battery ingestion in children

For asymptomatic children with acute button battery ingestions (witnessed or likely to have occurred within one to two hours) who are older than one year of age give one oral dose of pure honey (eg, 5 to 10 mL) as soon as possible after ingestion.

Guidelines previously recommended no oral intake before timely radiographic localization and emergency endoscopic removal of esophageal button batteries. A recent study using in vitro and in vivo animal models of esophageal battery impaction suggests that early and repeated oral administration of either honey or sucralfate until the battery is removed may reduce the severity of esophageal burns.

Once in the emergency department, the child may receive another dose of honey or a single dose of sucralfate 500 mg prior to confirmation of esophageal impaction and emergency battery removal.  ( Laryngoscope 2018.)

Binge alcohol and hypertension

Elevated blood pressure and total cholesterol in men aged 18 to 45 may be a sign of repeated binge drinking, according to results of a new study published in the Journal of the American Heart Association. Binge-drinking men had higher systolic blood pressure and total cholesterol levels than did their non–binge-drinking counterparts and women, irrespective of whether the women were binge drinkers or not.

CDC Updates Recommendations of 3HP for Latent TB Infections

US Centers for Disease Control and Prevention (CDC) have issued new recommendations on treatment of LTBI with once weekly isoniazid rifapentine for 12 weeks (3HP) to include more populations. In 2011, the CDC recommended the regimen of 3HP for treatment of LTBI with limitations for children under the age of 12 and individuals with HIV.

Following the evidence from the systematic review and TB / LBTI expert recommendations which include the use of 3HP in adults, as well as:

1. Children with LTBI aged 2 to 17 years;
2. Individuals with LTBI who have HIV infection (including AIDS), and are taking antiretroviral medications with acceptable drug-drug interactions with rifapentine; and
3. By directly observed therapy or self-administered therapy in individuals over the age of 2 years.

In addition to the new guidelines, the CDC indicates that health care providers should choose the mode of administering 3HP based on individual patient’s needs. Patients should be monitored monthly to assess treatment adherence and baseline hepatic chemistry blood tests should be ordered for patients with HIV and liver disorders.

Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI