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Morning MEDtalks with Dr KK Aggarwal
New Delhi, September 02, 2018
People who use solid fuels for cooking should switch to electricity or gas at the earliest. Long-term use of coal, wood, or charcoal for cooking is associated with an increased risk of death from heart disease. During 3.4 million person-years of follow-up, 8,304 participants died from heart disease. After adjusting for education, smoking and other cardiovascular risk factors, each decade of exposure to solid fuel was associated with a 3% higher risk of cardiovascular death.
Participants who had used solid fuels for 30 years or longer had a 12% greater risk of cardiovascular death than those who had used them for less than 10 years (ESC Congress 2018, August 26, 2018).
US FDA has announced a voluntary recall of Montelukast tablets. One lot of montelukast sodium tablets 10 mg, 30-count bottle from Camber Pharmaceuticals, Inc., Piscataway, N.J were found to instead contain 90 tablets of losartan potassium tablets, 50 mg.
This tablet mix-up may pose a safety risk as taking losartan tablets when not prescribed may cause renal dysfunction, elevated potassium levels and low blood pressure. This risk is especially high for pregnant women because losartan could harm or kill the fetus. This recall unrelated to the recent valsartan recalls that were due to an impurity, N-nitrosodimethylamine (NDMA).
NIOSH has launched a new framework to tackle opioid crisis in the workplace along with the CDC. The framework looks at different workplace conditions that can be risk factors for medically prescribed opioid use becoming opioid misuse. It also focuses on protecting first responders and includes guidance on developing methods to rapidly detect dangerously potent opioids in the workplace and how to effectively and safely decontaminate workplaces.
Key questions guiding the framework include: Identify workplace conditions, Determine risk factors, Protect workers and responders and Developmethods for detection and decontamination.
A new integrated intervention reduces mortality by 50% among people living with HIV who inject illicit drugs. At the end of the study, 15% of participants with HIV who had received the standard of care had died vs 7% of participants with HIV who had received the intervention consisting of psychosocial counseling along with guidance and support navigating the healthcare system.
People who received the intervention were nearly twice as likely to report being in treatment for HIV and substance use after one year as those who received their national standard of care. They also were about twice as likely to have suppressed their HIV to undetectable levels after one year (HPTN 074 trial, The Lancet)
Medical practices with an employee appreciation program report lower employee turnover. The Medical Group Management Association’s 2018 Practice Operations Survey found a link between employee appreciation programs and medical practice turnover. The survey examined comparative data from more than 1,000 organizations. Participants were physician-owned and hospital-owned practices, along with US organizations at small and large practices (Beckershospitalreview.com). The five major findings were:
- Medical practices with an employee appreciation program generally saw lower turnover than their counterparts without one, regardless of specialty.
- Among primary care practices with an employee appreciation program, business operations support staff turnover was 4.55 percent. That compares to 5 percent at their counterparts.
- Primary care practices with an employee appreciation program also saw lower clinical support staff turnover than their counterparts (14.84 percent versus 16.67 percent). However, front office support staff turnover was higher among primary care practices with an employee appreciation program.
- Surgical and nonsurgical practices with an employee appreciation program also saw lower clinical support staff turnover compared to their counterparts.
- Front office support staff turnover was 15.38 percent among surgical practices with an employee appreciation program. That’s lower than the 20 percent among surgical practices without one.
Patients with broken heart syndrome, also called takotsubo cardiomyopathy, and history of previous or current cancer doubled their risk of mortality or re-hospitalization due to post-discharge adverse events within three years. The study presented at the recent ESC Congress 2018 suggested that these patients need strict monitoring at follow-up. These patients may benefit from standard therapy for heart failure, especially an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB).
Dr KK Aggarwal: Modern day doctor-patient relationship
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Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI
HealthySoch
