Editor in Chief Dr KK Aggarwal, Padma Shri Awardee


Dated: 14 th April, 2019

Morning Medtalks with Dr KK

1.According to the latest guidelines from the American College of Cardiology and the American Heart Association, a person's levels of low-density lipoprotein (LDL) cholesterol should remain under 100 milligrams per deciliter (mg/dl) to maintain health. However, new research from the Brigham and Women's Hospital and Harvard Medical School in Boston, MA, has found that women with LDL levels below 100 mg/dl may actually be more at risk of hemorrhagic (bleeding) stroke. This type of stroke, though less common than an ischemic stroke, is harder to treat and thus more dangerous to the person experiencing it.

2.British Medical Journal reports that the World Health Organization (WHO), the arm of the United Nations charged with monitoring global health, has dropped its endorsement of the EAT-Lancet Commission’s planetary health diet—a much-ballyhooed, well-publicized attempt at saving the planet through the food we eat.

3.In patients with baseline anemia, disruption of DAPT in the first 2 years after PCI due to bleeding or non-compliance was tied to MI and other major adverse cardiac events. Risk wasn't greater, however, if they discontinued DAPT by physician recommendation or had a interruption of therapy of less than 2 weeks. (Circulation: Cardiovascular Interventions)


Urinary tract infections may exacerbate with irrational antibiotic use

Any soreness or irritation while passing urine should be checked

Only one-third of patients who go to the emergency department with suspected urinary tract infection (UTI) actually have evidence of this infection. However, almost all patients were treated with antibiotics, without no use, contributing to the development of antimicrobial resistance (AMR). Although a non-infectious cause is established for many of these cases, antibiotics are often continued unnecessarily, which drives the emergence of AMR.

UTI is an infection in any part of your urinary system - kidneys, ureters, bladders and urethra. Most infections attack the lower urinary tract, which is the bladder and urethra. UTIs are caused due to microbes such as bacteria which take over the body’s defences in the urinary tract.

Antibiotic misuse is turning several bacterial infections such as UTI fatal. In addition, about 636 million households in India lack toilets, which is another major contributor to UTI and renal ailments especially among women. There are two kinds of UTIs: cystitis and urethritis. Cystitis is an infection of the bladder. Urethritis is an infection of the urethra. If left untreated, either of these can spread and cause a kidney infection. Bacteria that live in the vagina, genital, and anal areas may enter the urethra, travel to the bladder, and cause an infection.

Symptoms of UTI include pain or burning; bad-smelling or cloudy urine; blood or pus in your urine; and soreness, pressure, or cramps in your lower belly, back, or sides. If the infection spreads to the kidneys, the symptoms include pain in the mid-back; fever; chills; nausea; vomiting; and tiredness.

Antibiotics usually are the first line treatment for urinary tract infections. Which drugs are prescribed and for how long depend on your health condition and the type of bacteria found in your urine. However, antibiotics must be prescribed rationally and only when required.

Some tips from HCFI

  • Drink plenty of liquids, especially water. Drinking water helps dilute your urine and ensures that you'll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin.
  • Drink cranberry juice. Although studies are not conclusive that cranberry juice prevents UTIs, it is likely not harmful.
  • Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
  • Empty your bladder soon after intercourse. Also, drink a full glass of water to help flush bacteria.
  • Avoid potentially irritating feminine products. Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.
  • Change your birth control method. Diaphragms, or unlubricated or spermicide-treated condoms, can all contribute to bacterial growth.


Breastfeeding is the highest form of immunity for a child

The first milk or colostrum is liquid gold and boosts health

Breastfeeding mothers can be vaccinated according to the routine and recommended schedules, reports a new study. The findings of the study are published in the journal Breastfeeding Medicine. There are no risks associated with giving breastfeeding mothers routine and most other standard vaccinations, including measles, and, in fact, there are benefits for both the mothers and infants.

Breastfeeding has also earlier been suggested to cut the risk of asthma and benefit the mother’s wellbeing. There are ongoing efforts worldwide to improve the rates of breastfeeding, and the WHO has the goal of having more than half of infants worldwide being breastfed exclusively for at least six months by 2025.

Breastfeeding is an essential requirement for infants at least up to the first 6 months. Exclusive breastfeeding can reduce chances of infections and diseases by building their immunity. However, there could be several factors that discourages women from breastfeeding: lack of designated places for women to feed the child, minimal understanding of the concept and family pressure. In addition, there are many infant feed formulations available in the market. This is sometimes projected as a healthy alternative and can be a deterrent to breastfeeding.

Breast milk is rich in antibodies and enzymes that offer a child protection against several diseases. “Studies have found that children who are exclusively breastfed also gain weight better, have higher IQ, better immunity and are less prone to allergies and infection.

Colostrum is like ‘liquid gold’ for the baby. It is rich in fat and antibodies and coats the baby’s gastro-intestinal system. When the baby is out of the mother’s womb, it is attacked from outside by several factors. It is the colostrum that offers protection.

The following points are a must to remember after childbirth.

  • Wash your hands with soap or use a hand sanitizer before handling the baby.
  • Be careful to support the baby’s head and neck.
  • Start breastfeeding within an hour of birth.
  • Ensure that the baby is exclusively breastfed for the first 6 months.
  • Child should be fed on demand or at least 8 times in 24 hours.
  • Avoid feeding honey, water or things other than breast milk in lieu of a ritual as it can be a source of infection to a baby.
  • Give the baby a sponge bath until the umbilical cord falls off and the navel heals completely (1-4 weeks).
  • Kangaroo Mother Care especially for low birth weight infants, wherein the baby is held in a special way stuck with the chest to provide skin to skin contact with the mother along with exclusive and frequent breastfeeding.


Air pollution now linked to development delays in children

Young children who live near a major roadway are at greater risk of developmental delays because of traffic-related pollutants, concluded a new study published in the journal Environmental Research. They were twice as likely to score lower on tests of communications skills, compared to those who live farther away from a major roadway.

An additional finding from the study was that the offspring of women who were exposed to high levels of ultra-fine airborne particles and ozone (traffic-related pollutants) during pregnancy were also at risk of developmental delays during infancy and early childhood.....read more


The first 2-drug complete regimen for HIV-infected adults who have never received ART

Dolutegravir and lamivudine have been approved by the US FDA as the first fixed-dose, complete regimen for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults with no antiretroviral treatment history and with no known or suspected substitutions associated with resistance to the individual components of the drug.

Currently, the standard of care for patients who have never been treated is a 3-drug regimen.

With this approval, patients who have never been treated have the option of taking a two-drug regimen in a single tablet while eliminating additional toxicity and potential drug interactions from a third drug.....read more


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