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Editor-in-Chief eMediNexus – Dr KK Aggarwal
 
14th September 2018
Think before you prescribe
Consider dual therapy in patients with atrial fibrillation undergoing PCI and stenting

Dr KK Aggarwal, Recipient of Padma Shri

Dual antiplatelet therapy (DAPT), with aspirin and clopidogrel for 6-12 months, is usual after percutaneous coronary intervention (PCI) to prevent stent thrombosis and major adverse cardiac events (MACE) (J Thorac Cardiovasc Surg. 2016;152:1243-75). Because these patients are already on warfarin, an anti-Xa inhibitor (rivaroxaban or apixaban) or a direct thrombin inhibitor (dabigatran) as they have a separate indication for atrial fibrillation (AF), they are therefore subject to triple antiplatelet therapy increasing their risk of serious bleeding complications.

Data from the WOEST (What is the Optimal AntiplatElet and Anticoagulant Therapy in Patients With Oral Anticoagulation and Coronary StenTing) trial conducted in 15 centers in Belgium and the Netherlands show that compared with triple therapy, use of clopidogrel without aspirin was associated with a significant reduction in bleeding complications and no increase in the rate of thrombotic events. Bleeding episodes were seen in 19.4% patients receiving double therapy and in 44.4% receiving triple therapy (Lancet. Mar 30; 2013;381:1107-15)...read more

Top News

Health Ministry bans 328 FDCs with immediate effect

The Ministry of Health and Family Welfare has prohibited the manufacture for sale, sale or distribution for human use of 328 Fixed Dose Combinations (FDCs) with immediate effect. It has also restricted the manufacture, sale or distribution of six FDCs subject to certain conditions. ... read more

Morning Medtalks

Morning MEDTalks with Dr KK Aggarwal 14th September 2018

TEDx Video: Doctor-patient relationship:https://www.youtube.com/watch?v=i9ml1vKK2DQ
The Ministry of Health and Family Welfare has prohibited the manufacture for sale, sale or distribution for human use of 328 Fixed Dose Combinations (FDCs) with immediate effect. It has also restricted the manufacture, sale or distribution of six FDCs subject to certain conditions. The Drugs Technical Advisory Board recommended, amongst other things, that there is no therapeutic justification for the ingredients contained in 328 FDCs and that these FDCs may involve risk to human beings. The Board recommended that it is necessary to prohibit the manufacture, sale or distribution of these FDCs under section 26 A of the Drugs and Cosmetics Act, 1940 in the larger public interest. With regard to six FDCs, the Board recommended that their manufacture, sale... read more

Practice Updates

Dairy consumption lowers heart disease and mortality rates

Dairy consumption of around three servings per day is associated with lower rates of cardiovascular disease and mortality, compared to lower levels of consumption, according to data from the Prospective Urban Rural Epidemiological (PURE) global observational study of over 130,000 people in 21 countries, published September 10, 2018 in The Lancet. Those who... read more


Amyotrophic lateral sclerosis also affects the mind

A new study published online September 12, 2018 in the journal Neurology says that amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease, also affects the mind, especially later in the course of the disease. These patients have problems with thinking skills and behavioral problems such as apathy, changes in eating behaviors and lack of inhibition even at the earliest stages and ... read more


Gestational diabetes increases maternal risk of type 2 diabetes a decade later

According to a study published September 11, 2018 in JAMA, high blood sugar during pregnancy, even if did not meet cut-off for diagnosis of gestational diabetes were significantly more likely to have developed type 2 diabetes a decade after pregnancy when compared to women who did not ... read more


Perception of quality of care lower in certain dialysis settings, says study

For-profit operation, free-standing status, and large dialysis organization designation were associated with less favorable patient-reported experiences of care, according to a cross-sectional analysis of 2939 US dialysis facilities published online September 10, 2018 in JAMA Internal Medicine... read more


USPSTF recommends ocular prophylaxis of newborns to prevent gonococcal ophthalmia neonatorum

The USPSTF recommends prophylactic ocular topical medication (with 0.5% erythromycin ophthalmic ointment) for all newborns to prevent gonococcal ophthalmia neonatorum (Grade A recommendation) in a draft recommendation statement on ocular prophylaxis for gonococcal... read more

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Lifestyle Updates
 
Inspirational Story 1: The Carpenter
Inspirational Story 2: God's Hands
Alarming rise in risk factors for non-communicable diseases in India in the last 25 years
Physical activity, healthy diet, and quitting smoking and drinking are the three pillars for prevention
 
New Delhi, 13 September 2018: A recent study has indicated that the risk factors for non-communicable diseases (NCDs) have increased in every Indian state over the past 25 years. NCDs including heart diseases, stroke, diabetes, chronic respiratory disease, cancers and injuries, are now the leading causes of death worldwide. However, their co-existence with infectious diseases is leading to a “double burden” in less developed states still battling infections like diarrhea, lower respiratory tract infections and tuberculosis, among others.

The Union health ministry is expanding its NCDs programme by promoting early screening, diagnosis and treatment under the 150,000 health and wellness centres being set up by 2022. There is a need for India to invest in improved surveillance systems to monitor changing trends in NCDs and injuries, and related risk factors, across the country.

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