Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Drug induced heart burn

Some prescription drugs can add to the woes of heartburn. Oral contraceptives or postmenopausal hormone preparations containing progesterone are known culprits. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can irritate the stomach lining. Other drugs—such as alendronate used to prevent and treat osteoporosis—can irritate the esophagus. And some antidepressants, bronchodilators, tranquilizers, and calcium-channel blockers can contribute to reflux by relaxing the LES.

Add-on not switch for Best HbA1c

Adding on a medication to an existing type 2 diabetes therapy that does not appear to be lowering HbA1c is the best way to achieve optimal glycemic control, as opposed to switching one drug for another, indicates a new study, reports Medscape.

Andrew McGovern, MD, clinical research fellow and study lead from the University of Exeter, UK "A limited apparent response to HbA1c testing at 6 months on a new therapy is common, but switching medication does not improve outcomes, when presenting the results of his study at the Diabetes UK Professional Conference (DUPC) 2019 last week. Only adding in a new therapy improves...HbA1c.

Diabetes is a progressive disease that normally needs a stepwise approach to keep HbA1c within the individualized targets set in discussions between the healthcare professional and the person with diabetes.

However, intensification of therapies doesn't occur in a timely manner — a situation known as 'therapeutic inertia'. This leaves patients in chronic hyperglycemia for the longer term, and having a dysglycemic legacy leads to longer-term microvascular complications.

Not having any change in HbA1c "does not mean that the patient has not had a response to treatment.

Morning Medtalks with Dr KK

1. RLS is a neurological disorder involving a powerful impulse to move body parts, usually because of uncomfortable sensations, according to the National Institute of Neurological Disorders and Stroke (NINDS). Although this condition nearly always affects the legs—they’re right there in the name, after all—it’s also possible for RLS to affect areas like the arms, chest, and head, according to the NINDS.

2. The Apple Watch was able to detect irregular heart pulse rates that could signal the need for further monitoring for a serious heart rhythm problem, according to data from a large study funded by Apple Inc (AAPL.O), demonstrating a potential future role for wearable consumer technology in healthcare. Results of the largest AF screening and detection study, involving over 400,000 Apple Watch users who were invited to participate, were presented on Saturday at the American College of Cardiology meeting in New Orleans.

3. Doctors have developed an algorithm using machine learning and smartphone-based photoplethysmography (PPG) to detect diabetes. They used contact PPG to obtain waveforms of color changes in blood vessels with heart beat — which is also used by apps to measure heart rate — to develop the screening test for diabetes.

Specifically, they input waveforms from 54,269 people older than 18 years who transmitted their data from the Azumio Instant Heart Rate smartphone app (and about 2.6 million PPG waveforms) to the Health eHeart Study into a 45-layer deep neural network computer program to "train" the program to develop a better algorithm to predict diabetes [Robert Avram, MD, a cardiology fellow at University of California, San Francisco]

4. About one in three CT scans performed for cancer also shows coronary artery calcium (CAC), but the finding makes its way into the radiology report only about half the time, suggests a retrospective study. Statins or aspirin are prescribed in very few such cases.

In these patients who are already undergoing CT scans to evaluate their cancer, this could be some valuable information that we can obtain that doesn't pose any further risk to the patient, it doesn't expose them to any more radiation [Matthew C. Hooks, MD, University of Minnesota, Minneapolis]

5. Low-carbohydrate intake appears to predict future atrial fibrillation (AF) risk, independent of traditional AF risk factors and other dietary factors, a new ARIC analysis suggests. [ Xiaodong Zhuang, MD, PhD, a cardiologist at the first affiliated hospital of Sun Yat-sen University, Guangzhou, China]

6. About 1 out of 4 diabetic adults worldwide suffers from some kind of a kidney disease, says study published in the Journal of the American Medical Association.

7. Bempedoic acid is an oral, once-daily ATP Citrate Lyase (ACL) Inhibitor that reduces cholesterol and fatty acid synthesis in the liver

Dated: 17 th March, 2019

Current Temperature Status and Warning for next 24 hours.

Heat Wave and Temperatures Observed Yesterday (Past 24 hours from 0830 hrs IST of 16 th March to 0830 hrs IST of 17 th March, 2019)

Heat Wave:

.Yesterday, No heat wave conditions were observed.

Maximum Temperatures Recorded at 1730 Hours IST of 16 th March, 2019:

Maximum Temperature more than 40.0°C was recorded at isolated places over Marathwada. (Annexure-1).

• Maximum temperature departures as on 16-03-2019: Maximum temperatures are appreciably above normal (3.1°C to 5.0°C) at a few places over Arunachal Pradesh, Assam & Meghalaya, Jammu & Kashmir, Himachal Pradesh and Saurashtra & Kutch; above normal (1.6°C to 3.0°C) at a few places over Vidarbha, Madhya Maharashtra, Telangana, Rayalaseema and Kerala; at isolated places over Konkan & Goa, South Interior Karnataka, Tamilnadu & Puducherry and Andaman & Nicobar Islands. They are appreciably below normal (-3.1°C to -5.0°C) at a few places over Haryana, Chandigarh & Delhi, Rajasthan and West Madhya Pradesh; at isolated places over East Uttar Pradesh, Chhattisgarh and Gangetic West Bengal; below normal (-1.6°C to -3.0°C) at a few places over East Madhya Pradesh and Odisha and at isolated places over Gujarat region, Coastal Andhra Pradesh, Bihar and Jharkhand and near normal over rest parts of the country. (Annexure-2).

Yesterday, the highest maximum temperature of 40.2°C was recorded at Parbhani (Marathawada) over the country.

Heat Wave Warnings for Next 24 hours(From 0830 hrs IST of 17 th to 0830 hrs IST of 18 th March 2019):-


GAPIO Midyear Conference at Antigua, 3-5 May 2019



Metabolic Syndrome Obesity / Diabetes

Nephrology / Transplant

Neurology / Stroke

Artificial Intelligence

Vedic Wisdom

Reaching the unreached

Global opportunities in healthcare


ICMR-Pfizer Collaboration: A Conflict of Interest?

Does the CSR activity of the pharma giant Pfizer which is independent of its commercial interests and where a grant of Rs 7 crore was given to ICMR to set up a disease centre compromise the collaboration?

Recently, there was a lot of furore over news that the Indian Council for Medical Research (ICMR) was collaborating with Pfizer, a drug multinational company that sells antibiotics, for its Anti-Microbial Resistance (AMR) project. There were charges of conflict of interest (CoI) in this "public-private partnership" (PPP) as Pfizer had provided an initial grant of Rs 7 crore to set up a centre in Delhi to combat anti-microbial resistance and to enhance the surveillance programme for this malaise.

As per officials of the ICMR, Pfizer offered its Corporate Social Responsibility (CSR) funds to it and there were no strings attached and no CoI....read more

Most acute liver failure are caused by drugs

Drug-induced liver injury or DILI is the leading reason for a drug that is approved by the Drug Administration to subsequently be withdrawn from the market.

DILI can result from both prescribed and over-the-counter (OTC) agents, including some herbal and dietary supplements. It is both difficult to predict and challenging to recognize....read more


Dealing with Stress