News and Views
ECG by paramedics in acute heart attack (Dr G M Singh)
People with chest pain who are given an ECG by paramedics before reaching the hospital don‘t wait as long to receive treatment to open their arteries. They often were able to bypass the emergency room and go directly to the cardiac catheterization laboratory for treatment with angioplasty. They were treated 60 minutes, on average, after reaching the hospital, compared with 91 minutes for people who did not have an EKG before arriving at the hospital. (Source: Catheter Cardiovasc Interv 2007 Feb. 1;75 (2):174–8)
Complications of TORCH infection during pregnancy
(Dr G M Singh)
Small–for–gestational–age, or SGA
Congenital heart disease (heart defects the child is born with)
Cataract (clouding of the lens of the eye), blindness, or significant visual impairment
Hearing impairment, including deafness
Microcephaly (Small head size)
Mental retardation or other learning, behavioral, or emotional problems
Low blood counts (anemia)
Liver or spleen enlargement
Skin rash–usually reddish–purple or brown
Involvement of the central nervous system (encephalitis, calcium deposits in the brain tissue, and seizures)
In addition to these symptoms, each of the TORCH infections has its own characteristic differentiating symptom cluster in newborns.
Steroids for sore throat
Many patients receive antibiotics for sore throat. A systematic review and meta–analysis by Del Mar and colleagues, published in the October 2006 issue of the Cochrane Database of Systematic Reviews, found that antibiotics significantly reduced complications of sore throat such as rheumatic fever, sinusitis, and otitis media, but that there were not enough cases to demonstrate efficacy in preventing glomerulonephritis. Antibiotics also reduced throat pain and fever by approximately one–half, with the greatest effect noted on day 3 to 4 of the antibiotic prescription.
Corticosteroids could reduce the inflammation and pain of sore throat. (Dr G M Singh)
FDA warns of higher risk for weight gain with olanzapine
FDA has issued a warning to doctors that adolescents taking the drug olanzapine have an increased potential––in comparison with adults taking the new–generation antipsychotic drug––for weight gain and metabolic disturbances that could result in diabetes or elevated blood cholesterol levels.
Didanosine label to include liver damage warning
FDA has updated labels of the HIV drug didanosine to include warnings for potentially serious liver damage. The drug may cause non–cirrhotic hypertension.
Nicotine patch for extended period may increase success. According to a University of Pennsylvania study in the Annals of Internal Medicine, cigarette smokers trying to quit who wear a nicotine patch for six months, rather than the standard two, may stay away from smoking longer.
Green tea and cancer
Green tea may reduce the risk of developing lung cancer, particularly for smokers. At least a cup a day was associated with a 5.16–fold lower lung cancer risk among Taiwanese adults (P<0.001), according to I–Hsin Lin, MS, of the Chung Shan Medical University in Zhonghe City, Taiwan, and colleagues.
Cancer blood tests
A blood test for 21 inflammatory, angiogenesis, and other cancer–related biomarkers had 92% accuracy in picking out stage I lung cancer from at–risk controls, according to Gina Lee, MD, of UCLA, and colleagues.
Criticare 2010 International Critical Care Congress & 16th Annual Conference of Indian Society of Critical Care Medicine (ISCCM) February 10–14, 2010
Venue: Hyderabad, Andhra Pradesh
New Form of Heart Failure on the Rise: Experts
A form of heart failure that is too oftenoverlooked is on the rise and it‘s just as deadly as the better–known variety.
The standard description of heart failure is that the heart progressively loses its ability to pump blood. But there‘s another form of the disease where the heart‘s blood–pumping ability remains near normal, said Dr. K K Aggarwal President, Heart Care Foundation of India and Editor eMedinewS.
In this condition, the heart muscle becomes thickened making the inside chamber of the heart smaller. The heart is thus unable to relax to accommodate the blood it needs to pump out. As there is no room for the heart to relax, the blood backs up into the lungs.
This kind of aberration isn‘t picked up by standard measurements in echocardiography of "ejection fraction" ––the percentage of blood in the heart that goes out with every beat. This heart failure is called " heart failure with normal ejection fractions or with normal LV functions"
Nearly one–third of heart–failure patients will have normal ejection fraction. However, the death rate for this kind of heart failure matches that of patients with the more common form of heart failure with low ejection fraction and with more than 20% of all the patients dying within a year.
For patients, the symptoms of both types of heart failure are the same: Shortness of breath, difficulty exercising, and fluid retention in the body. Doctors cannot make a diagnosis on the basis of symptoms or routine examinations. A tissue Doppler echocardiogram is needed to see the heart pumping, its ejection fraction and diastolic relaxing functions of the heart.
Advances have been made against systolic heart failure, in which the ejection fraction falls below normal but not much has been done about diastolic heart failure.
Question of the day (Dr G M Singh)
Q: I know high heels are bad for the feet, but when I switched to flats, my feet started to hurt. Why?
A: Wearing heels for long periods can result in a shortening and tightening of the Achilles’ tendon. When you walk in a relatively flat shoe, your foot flexes up (dorsiflexes) when your heel hits the ground and then flexes down (plantarflexes) as you toe is off the ground If the Achilles’ tendon is short and tight because of high heels, the foot loses its ability to flex up and down, so switching to a flat footwear can cause heel and calf pain. Flats can also aggravate conditions like plantar fasciitis if they lack good arch and heel support.
If you‘re moving away from high heels to flats, do so gradually, wearing lower heels at first. That will give your Achilles‘ tendon time to relax and stretch out. You might also try doing some of the standard exercises for stretching the Achilles’ tendon. the basic maneuver involves keeping your heel on the ground and your leg straight as you lean forward.
Last mounth, the court dismissed lawsuit on the sale of I-PILL without doctor prescription (Dr G M Singh)
A bench of chief justice K.G. Balakrishanan & justice Deepak Raveendran dismissed the lawsuit with petitioner Krupa Prolifers contention that I-Pill leads to abortion in violation of relevant law of pregnancy. The petitioner contended that a child is conceived in the womb soon after intercourse and I-Pill leads to destruction of the foetus within 1st 72 hours after fertilisation , the serious effects of medicine are nausea, vomiting,headache, weakness, breast tenderness etc and regular intake reduces the chances of pregnancy again. But the bench did not appear convinced of these arguments and dismissed the lawsuit.