Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 12 th April, 2019

Morning Medtalks With Dr KK

1. Acupuncture administered in the emergency department (ED) is feasible and beneficial as a non-opioid, non-pharmacologic option for treating pain, new research suggests [Department of Integrative Medicine, Aurora Health Center, Milwaukee]

2. Levels of vitamin B9 and B12 deficiency are high in children and particularly adolescents with psychiatric disorders [Department of Child and Adolescent Psychiatry, Hospital Clinic Barcelona, Spain]

3. High-dose vitamin D supplementation has shown some benefit in patients with metastatic colorectal cancer in the first randomized clinical trial (known as SUNSHINE), but another trial in patients with gastrointestinal cancers (known as AMATERASU) found no significant effect. The American study (SUNSHINE) and the Japanese study (AMATERASU) were both published online April 9 in JAMA.

4. Unity in diversity: https://www.facebook.com/drkkaggarwal/videos/595724254266156/

5. Shri Vijay Kumar Dev on World Health Day 2019 - Heart to Heart: https://www.youtube.com/watch?v=RxUOVZFRljI&feature=youtu.be

Thyroid drugs

1. Levothyroxine, is routinely used as the primary form of thyroid hormone replacement in the management of hypothyroidism [affects up to 7% of the general population].

2. Levothyroxine is absorbed in the small intestine and is 70%-80% bioavailable in the euthyroid individual.

3. Peak absorption is achieved at approximately 2 hours after oral ingestion

4. But can be delayed to 3-4 hours if it is ingested simultaneously with interfering medications, supplements, or some foods/drinks.

5. American Thyroid Association advise patients to take levothyroxine at least 60 minutes before the first meal of the day or at bedtime (at least 3 hours after the evening meal), and at least 4 hours apart from other medications or supplements, if possible.

6. Certain conditions have the potential to further reduce the absorption of oral levothyroxine.

7. If an individual has known Helicobacter pylori–related gastritis, atrophic gastritis, or celiac disease, a higher dose of levothyroxine may be needed to overcome these malabsorptive states.

8. Less is absorbed when it is taken concurrently with substances that include coffee, soy, calcium carbonate, iron, aluminum hydroxide, sucralfate, cholestyramine, colesevelam, raloxifene, orlistat, phosphate binders, or cow's milk, compared with when levothyroxine is taken alone.

9. Interference occurs as a result of physical adsorption (complexing) between the interfering substance and levothyroxine in the gastrointestinal tract.

10. Taking levothyroxine together with an interfering substance can decrease the amount of thyroid hormone that is absorbed by as much as 50%, although the degree of this interference has been variable.

Food poising

1. Foodborne illness occurs half the time because of produce.

2. At the grocery store select pre-cut fruits that are refrigerated or kept on ice.

3. Separate your fruits and veggies from other items like raw meat in your grocery bags.

4. At home, wash your hands and any utensils before handling produce, and then wash the produce itself.

5. Refrigerate the produce within two hours of cutting it.

6. People at high risk of foodborne illness include children under five, adults older than 65, pregnant women, and people with weak immune systems.

The Right Prescription?

The amendments in Clinical Establishments Second Amendment Rules, 2019 are aimed at ensuring that patients are not conned into undergoing costly tests and diagnosis that may be totally unwarranted
The Clinical Establishments (Registration and Regulation) Act, 2010, was enacted by the central government to provide for registration and regulation of all clinical establishments in the country with a view to prescribing the minimum standards of facilities and services provided by them. On March 1, 2019, the ministry of health issued another notification that lists certain rules for further amendments in the sector.....read more

Drug Regulatory System

Anil Khaitan, Immediate Former President-PHD CCI, New Delhi, 11 April 2019

In my opinion, India needs a single Drug Regulatory System under a federal set-up. This may solve all the drawbacks that plague the present drugs control administrations in both Center and States. It will also eliminate the PAN India presence of Not-of-Standard-Quality (NSQ) drugs, which pose a challenge to regulators all over India.
As a permanent solution to this technical snag, the central and state drugs control administrations (Central Drugs Standard Control Organisation [CDSCO] and state DCAs) should merge into one single entity under the federal set up of the constitution.....read more


7th Chaitra Navratri: Kalaratri