Editor in Chief Dr KK Aggarwal, Padma Shri Awardee


Dated: 8 th April, 2019

Morning Medtalks With Dr KK

1. According to a new study published in the Lancet medical journal, bad diets kill more people each year than tobacco consumption.

2. It is not the presence of junk food in the diet, but rather the absence of healthier and more nutritious food choices in the diet, which the study deems responsible for this issue. It was also found that one in five deaths could be prevented by changing dietary habits and including healthier choices in one’s diet.

3. The 12 boys who were trapped in a Thai cave last summer were given ketamineto help protect them from hypothermia during the nerve-wracking rescue. The boys were given unspecified doses of the drug by rescue divers as they were taken out of Tham Luang cave, according to details of the rescue released in a medical journal. In a joint letter to the New England Journal of Medicine, three Thai medics and an Australian anaesthetist who was involved in the rescue said the boys also wore full-face masks supplying oxygen and poorly fitting wetsuits. Rescuers wrote oxygen levels were falling and they needed to keep the boys from developing hypothermia, so they gave them “unspecified doses” of ketamine and a face mask filled with oxygen.

4. WHO chief said that all people deserve access to health services, “when and where they need them, without financial hardship.” However, half the world’s population, he said, still lacks access to essential health services, with around 100 million people pushed into extreme poverty each year because of out-of-pocket spending on health. This is why the WHO is focusing on its number one goal this year: universal health care.

5. The UN agency defines universal health care as meaning that all individuals and communities are able to access the health services they need – from health promotion to prevention, treatment, rehabilitation, and palliative care – without suffering financial hardship.When people are not protected from the financial consequences of paying for health services out of their own pockets, they may have to use up their life savings, sell assets, or borrow, destroying their futures and often those of their children.

6. Achieving universal health coverage is one of the targets the nations of the world set when adopting the Sustainable Development Goals in 2015: good health provides the basis for long-term economic development, allowing children to learn and adults to earn, and helping people escape from poverty.

7. The WHO is calling on all countries to invest in primary health care, which is the “bedrock of universal health coverage,” covering the majority of health needs throughout a person’s life, and keeping people out of hospitals and in the community.


Landmark Judgment on abortion beyond 20 weeks

Excerpts, Bombay High Court, The division bench of Justice AS Oka and Justice MS Sonak

1. Permission from either the High Court or the Supreme Court will have to be taken for terminating a pregnancy over 20 weeks where the woman feels that its continuation would involve risk to her or the fetus mental/ physical health and/or there is substantial risk that the child when born would suffer from abnormalities.

2. However, permission would not be required from the court for terminating a pregnancy that has crossed the 20-week period, if it poses a risk to the womans life.

3. The division bench of Justice AS Oka and Justice MS Sonak also directed the government of Maharashtra to constitute medical boards at district levels within three months to examine pregnant women, who wish to terminate their pregnancy beyond 20 weeks.

4. “In cases where a registered medical practitioner is of the opinion, formed in good faith, that termination of pregnancy, which has exceeded 20 weeks, is immediately necessary to save the life of the pregnant woman, there is no necessity for even seeking any permission …. Thus, if a doctor is of the opinion that if the pregnancy is not medically terminated immediately the woman may die, then it is the duty of such a doctor to undertake the termination process and the MTP Act provisions will afford immunity to such doctors.”

5. But if the child is born alive, then the doctor and the hospital concerned will have to assume full responsibility to ensure the baby is offered the best medical treatment.

6. “Under no circumstances such a child must be neglected or left to perish, particularly where the woman or her family members may not be in a position to or not willing to assume responsibility... in the unfortunate situation where, for several myriad factors, the parents are unwilling or genuinely not in a position to care for the child, then the state government will assume parental responsibility towards such a child.”


FDA Issues 'Clean' List for Sartan Drugs: Nitrosamine-free ARBs do exist, agency stresses

Among a flurry of press releases from the FDA in Scott Gottlieb's last days as its commissioner, the agency released a list of 40 angiotensin receptor blockers (ARBs) free from potentially carcinogenic nitrosamine impurities. The list included candesartan, olmesartan, telmisartan, and valsartan products -- many in fixed-dose combination pills with other antihypertensives -- by a range of manufacturers.

Also, although the FDA decided to temporarily ease the contamination standards for losartan to head off a looming drug shortage, "the agency expects many companies will be able to manufacture losartan without nitrosamine impurities and replenish the U.S. supply in approximately six months," it said.

"Despite the very low risks associated with the use of affected ARBs, we fully recognize that these medications can be made without nitrosamine impurities and are working with manufacturers to reach that goal," the statement noted. (Excerpts Medpage today)


Dated: 7th April, 2019

Current Temperature Status and Warning for next five days

Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 06 April to 0830 hrs IST of 07 April, 2019)

Heat Wave:

Yesterday, heat wave conditions observed at most places over West Rajasthan; at a few places over East Rajasthan; at isolated places over Himachal Pradesh, Haryana, Chandigarh & Delhi and West Madhya Pradesh. (Annexures 1 & 2).

Maximum Temperature

Maximum Temperature more than 40.0°C was recorded at most places over Rajasthan, Marathawada, Vidarbha and Rayalaseema; at many places over Madhya Pradesh, at a few places places over Saurashtra & Kutch, Chhattisgarh, Telangana and at isolated pockets over East Uttar Pradesh, Jharkhand, Haryana, Chandigarh & Delhi, Gujarat Region, Madhya Maharashtra, Coastal Andhra Pradesh, Tamil Nadu and North Interior Karnataka.

Maximum temperature departures as on 06-04-2019: Maximum temperatures were markedly above normal (5.1°C or more) at many places over Jammu & Kashmir and West Rajasthan; at a few places over Himachal Pradesh; at isolated places over East Rajasthan; appreciably above normal (3.1°C to 5.0°C) at most places over Punjab, at a few places over Madhya Pradesh and Vidarbha; at isolated places over Haryana, Chandigarh & Delhi, east Assam & Meghalaya and Kerala; above normal (1.6°C to 3.0°C) at most places over Marathwada; at many places over Rayalaseema, Coastal Karnataka and Tamilnadu & Puducherry; at a few places over West Uttar Pradesh, Uttarakhand, Madhya Maharashtra, Chhattisgarh and Jharkhand; at isolated places over Telangana and Konkan & Goa. They were markedly below normal (-5.1°C or less) at a few places over Sub-Himalayan West Bengal & Sikkim; at isolated places over Bihar and below normal (-1.6°C to -3.0°C) at a few place over East Uttar Pradesh, Gangetic West Bengal and Andaman & Nicobar Islands; at isolated places over west Assam & Meghalaya and near normal over rest parts of the country.

The highest maximum temperature of 43.6°C recorded at Khargone ( West Madhya Pradesh) over the country. (Annexure 1).


Bombay High Court allows abortion beyond 20 weeks to save the woman's life

The Bombay High Court has ruled that permission from either the High Court or the Supreme Court will have to be taken for terminating a pregnancy over 20 weeks where the woman feels that its continuation would involve risk to her or the fetus' mental/ physical health and/or there is substantial risk that the child when born would suffer from abnormalities. However, permission would not be required from the court for terminating a pregnancy that has crossed the 20-week period, if it poses a risk to the woman's life.....read more


Practice changing: Advise interval appendectomy to all conservatively managed patients with perforated appendicitis

Should an interval appendectomy be done in patients with perforated appendicitis and who have been managed conservatively or nonoperatively with intravenous antibiotics and percutaneous drainage of an abscess, if present? Or, can these patients be followed-up with MRI scans?
The Peri–Appendicitis Acuta randomized clinical trial examined this question and found the answer. It recommends interval appendectomy for patients with perforated appendicitis managed conservatively at the time of presentation to exclude an appendiceal neoplasm.....read more


eSpiritual

3rd Chaitra Navratri: Chandraghanta (Controlling your negative energies)