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Morning Medtalks with Dr KK Aggarwal 28th May 2018

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Dr KK Aggarwal    28 May 2018

In December 2015 WHO had included Nipah as a disease likely to cause serious outbreaks

Nipah Breaking News

Way back on 10 December 2015:  A panel of scientists and public health experts convened by WHO met in Geneva to prioritise the top emerging pathogens likely to cause severe outbreaks in the near future, and for which few or no medical countermeasures exist. The initial list of disease priorities needing urgent R&D attention comprises:

Crimean Congo haemorrhagic fever, Ebola virus disease and Marburg, Lassa fever, MERS, SARS coronavirus diseases, Nipah and Rift Valley fever.

Three other diseases were designated as serious, requiring action by WHO to promote R&D as soon as possible Chikungunya, Severe fever with thrombocytopaenia syndrome and Zika.Other diseases with epidemic potential - such as HIV/AIDS, Tuberculosis, Malaria, Avian influenza and Dengue - were not included in the list because there are major disease control and research networks for these infections, and an existing pipeline for improved interventions.

2018 annual review of the Blueprint list of priority diseases

The second annual review occurred 6-7 February 2018. Experts consider that given their potential to cause a public health emergency and the absence of efficacious drugs and/or vaccines, there is an urgent need for accelerated research and development for:

  1. Crimean-Congo haemorrhagic fever (CCHF)
  2. Ebola virus disease and Marburg virus disease
  3. Lassa fever
  4. Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS)
  5. Nipah and henipaviral diseases
  6. Rift Valley fever (RVF)
  7. Zika
  8. Disease X: Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease, and so the R&D Blueprint explicitly seeks to enable cross-cutting R&D preparedness that is also relevant for an unknown “Disease X” as far as possible.

A number of additional diseases were discussed and considered for inclusion in the priority list, including: Arenaviral hemorrhagic fevers other than Lassa Fever; Chikungunya; highly pathogenic coronaviral diseases other than MERS and SARS; emergent non-polio enteroviruses (including EV71, D68); and Severe Fever with Thrombocytopenia Syndrome (SFTS).

These diseases pose major public health risks and further research and development is needed, including surveillance and diagnostics.

Although not included on the list of diseases to be considered at the meeting, monkeypox and leptospirosis were discussed, and experts stressed the risks they pose to public health.

Several diseases were determined to be outside of the current scope of the Blueprint: dengue, yellow fever, HIV/AIDs, tuberculosis, malaria, influenza causing severe human disease, smallpox, cholera, leishmaniasis, West Nile Virus and plague. These diseases continue to pose major public health problems and further research and development is needed through existing major disease control initiatives, extensive R&D pipelines, existing funding streams, or established regulatory pathways for improved interventions. In particular, experts recognized the need for improved diagnostics and vaccines for pneumonic plague and additional support for more effective therapeutics against leishmaniasis.

Financial Health: Nature of expenses covered under Section 43B –

  1. Any tax, duty, cess or fee under any law;
  2. Contribution made by employer to any provident fund or superannuation fund or gratuity fund or any other fund for the welfare of employees;
  3. Bonus or commission to employees;
  4. Interest on any loan or borrowing from any public financial institution or a State financial corporation or a State Industrial Investment corporation;
  5. Interest on any loan or advances from a Scheduled bank;
  6. Sum payable by the assessee as an employer by way of leave encashment.

Wellness

High fiber sources: brown rice, bulgur (cracked wheat), barley, oats, nuts, beans and lentils, apples, blueberries and carrots

Vitamins and minerals

Iron - meat, poultry, fish, and beans

Vitamin A - carrots, sweet potatoes, spinach, kale

Vitamin B12 - meat, poultry, fish

Vitamin E - nuts, seeds, vegetable oils

Phytochemicals

Flavonoids - blueberries, raspberries, strawberries, blackberries

Carotenoids - orange vegetables such as carrots, sweet potatoes, and winter squash

Lycopene - tomatoes

Isoflavones - soy foods, such as soybeans (or edamame)

Resveratrol - red grapes

Catechins - teas

Policy

  1. A petition has been filed in the Supreme Court challenging the Delhi High Court verdict upholding the upper age limit of 25 years for General category candidates and 30 years for those belonging to SC/ST/OBC category for appearing in the NEET. The appeal questions whether the age of a candidate has any relation to competence, caliber and merit of a candidate seeking admission to medicine courses.

Legal

  1. Doctor faces multiple malpractice lawsuits for singing and dancing during surgeries: An Atlanta based plastic surgeon is now facing multiple malpractice lawsuits for negligence after she was caught on camera dancing and singing while performing surgery. CNN
  2. A campaign for dignified healthcare launched by a forum of family members of children who died due to alleged medical negligence, has appealed the Union Health Minister J P Nadda to intervene for justice to families concerned.

Clinical

  1. Prazosin for sleep disturbance in PTSD: Six randomized clinical trials support the efficacy of prazosin for reducing sleep disturbance and nightmares in posttraumatic stress disorder. But a new randomized trial failed to show benefits from prazosin. Give prazosin for PTSD-associated sleep disruption or nightmares, either as monotherapy or in conjunction with a selective serotonin reuptake inhibitor or a serotonin-norepinephrine reuptake inhibitor for other PTSD symptoms. (N Engl J Med 2018; 378:507.)
  2. Adopting a diet heavy with vegetables did not slow prostate cancer progression among men with low-risk disease who were on active surveillance, according to final, 2-year results from Mens Eating and Living (MEAL) study.
  3. Daily finasteride does not elevate the long-term risk for prostate cancer death. (Dr Ian Thompson, University of Texas Health Science Center at San Antonio)
  4. Record numbers of men with low-risk prostate cancer are opting for conservative management in the form of watchful waiting or active surveillance rather than undergoing immediate treatment, a Veterans Affairs (VA) analysis indicates.With watchful waiting, men defer treatment until symptoms worsen, whereas active surveillance relies on regular follow-up visits to monitor patients for any signs of disease progression.  (Stacy Loeb, MD, Perlmutter Cancer Center at NYU Langone Health and the Manhattan Veterans Affairs (VA) Medical Center in New York City)

Pollution

Indoor pollution: Volatile organic compounds (VOCs) are carbon-containing compounds with a high vapor pressure at room temperature. VOCs are emitted from a variety of building and consumer products and are largely responsible for the "new carpet" or "new car" smell. VOCs can emanate from many indoor materials such as paints, floor finishes, furniture, carpeting, polyurethane spray foam insulation, and other building materials. They are implicated to upper-airway and mucous membrane irritation, headaches, difficulty concentrating, irritability, nausea, and drowsiness.

Weather

Heat Wave:

Yesterday, heat wave conditions observed at most parts over West Rajasthan; many parts over north Madhya Pradesh, Haryana, Chandigarh & Delhi; at some parts over East Rajasthan and at one or two pockets over Vidarbha and Punjab. 

Maximum Temperature 

Maximum temperatures were appreciably above normal (3.1°C to 5.0°C) at most places over Punjab, Haryana, Chandigarh & Delhi, West Rajasthan and West Madhya Pradesh; at many places over Uttrakhand, East Rajasthan, Gujarat, Uttar Pradesh, Marathwada and Madhya Maharashtra; at a few places over Himachal Pradesh, East Madhya Pradesh and Bihar; at isolated places over Jammu & Kashmir and Vidarbha; above normal (1.6°C to 3.0°C) at a few places over Jharkhand; at isolated places over Kerala. They were markedly below normal (-5.1°C or less) at a few places over Assam & Meghalaya; appreciably below normal (-3.1°C to- 5.0°C) at a few places over Lakshadweep and Tamilnadu & Puducherry and below normal (-1.6°C to -3.0°C) at many places over Andaman & Nicobar Islands and Coastal Andhra Pradesh; at a few places over Odisha and Chhattisgarh and near normal over rest of the country. Yesterday, the highest maximum temperature of 47.5°C was recorded at Churu (West Rajasthan) over plains of the country.

Temperatures Recorded at 1430 Hours IST  27 th May, 2018 

Temperatures more than 40.0°C is observed at most parts of Punjab, Haryana, Chandigarh & Delhi, Rajasthan, Madhya Pradesh, East Uttar Pradesh, Gujarat region and Vidarbha; at many parts of Marathwada; at some parts of West Uttar Pradesh and at one or two pockets of Jammu division, Chhattisgarh, Gangetic West Bengal, Telengana, Jharkhand, Odisha, Saurashtra & Kutch and Madhya Maharashtra. (Annexure 3). o Temperature recoded at 1430 hours of today have risen at isolated places by 3-5°C in Jammu Division and by about 2°C in Madhya Pradesh and Gujarat region.

Heat Wave Warnings for Next 5 Days 

Day maximum temperatures very likely to continue 42-45°C over from parts of Northwest India and Central India, in the range of 41-44°C most parts of Northern parts of peninsular India and West India during next 48 hours and decrease thereafter. Heat wave conditions are very likely abate gradually from more parts of Northwest India and Central India from tomorrow onward, in view of the likely setting of easterly winds over the northern plains. 

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