Do not ignore 2nd attack of dengue

Do not ignore 2nd attack of dengue New Delhi, August 03, 2016: If you have suffered from dengue in the past be more careful as the second attack of dengue may be more dangerous than the first attack, said Padma Shri Awardee Dr KK Aggarwal – President Heart Care Foundation of India (HCFI) and Honorary Secretary General IMA. There are four different strains of dengue and one can, suffer with dengue four times during lifetime. Subsequent dengue infections are more likely to end up with deadly complications. A person with dengue can also simultaneously suffer from malaria. Malaria and dengue together can lower platelet counts to a dangerous level leading to complications. In a dengue season nobody should take aspirin for fever as it can precipitate bleeding, he added. In dengue most complications occur within two days of subsiding of fever and most people are careless during this period. Any abdominal pain, giddiness or weakness after the fever has subsided should be attended to, by a doctor. Dengue complications during this period are due to shift of blood volume and patient requires rapid infusion of oral or intravenous fluids in large quantity. There is no need for giving platelets unless the counts have fallen lower than 2% of original platelet counts

Frequent travel can double one’s risk of blood clots

Frequent travel can double one’s risk of blood clots New Delhi, July 24, 2016: Long distance travelers periodically should move around and stretch their legs, and drink plenty of water to stay hydrated, saidPadma Shri Awardee Dr KK Aggarwal – President Heart Care Foundation of India (HCFI) and Honorary Secretary General IMA. Long–distance travel can lead to potentially fatal blood clots in some people –– showing that the risk grows with the length of the trip. Certain people are at increased risk of blood clots, including cancer patients, people who have recently had major surgery such as a joint replacement, and women on birth control pills. In general, travel is associated with a nearly three-fold increase in the risk of venous thromboembolism (blood clots that form in the veins), often in the legs. If such a clot dislodges and travels to the lungs, it can cause a potentially fatal condition called pulmonary embolism. A combination of factors including dehydration and hours of sitting in cramped conditions explains why some people develop blood clots. A review, published in the Annals of Internal Medicine, analyzed 14 studies involving more than 4,000 cases of venous thromboembolism and found that travelers had a nearly three–fold higher risk of blood clots than non–travelers. The risk climbed along with the duration of the trip –– rising 18 percent for every two hours of any type of travel, and by 26 percent for every two hours of air travel. But there is no reason for panic, because the absolute risk to any one traveler is still low. People who travel long distances should be aware of the risk of blood clots and learn to recognize the symptoms. Symptoms of a blood clot in the leg include pain, warmth, swelling and redness in the limb. If the clot travels to the lungs, it may cause sudden shortness of breath, chest pain or a cough that produces blood.

Strong evidence that alcohol causes cancer at seven sites in the body

Strong evidence that alcohol causes cancer at seven sites in the body

Dr K K Aggarwal There is strong epidemiological evidence that alcohol causes cancer at seven sites in the body and probably others, says a new study in the latest issue of the journal Addiction reported 21st July, 2016. These sites include oropharynx, larynx, esophagus, liver, colon, rectum and female breast. A "dose-response relationship" between alcohol and cancer was observed for all these cancers, where the increase in cancer risk with increased average consumption is monotonic, either linear or exponential, without evidence of threshold of effect. The beverage type did not appear to influence any variation. The strength of the association with alcohol varies by site of the cancer, being particularly strong for mouth, pharynx and esophagus (relative risk in the range of 4–7 for ≥ 50 g of alcohol per day compared with no drinking) and less so for colorectal cancer, liver and breast cancer (relative risk approximately 1.5 for ≥ 50 g/day). Alcohol-attributable cancers at these sites were estimated to make up 5.8% of all cancer deaths globally. These conclusions are based on comprehensive reviews undertaken in the last decade by the World Cancer Research Fund and American Institute for Cancer Research, the International Agency for Research on Cancer, the Global Burden of Disease Alcohol Group including a comprehensive dose–response meta-analysis published last year in the British Journal of cancer. In the study, Jennie Connor, Dept. of Preventive and Social Medicine, University of Otago, New Zealand from New Zealand attempted to clarify the strength of the evidence for alcohol as a cause of cancer, and the meaning of cause in this context. Even without complete knowledge of biological mechanisms, the authors observed, the epidemiological evidence can support the judgment that alcohol causes cancer of these seven sites.

AAP/AAPD issue updated guidelines on safe sedation for children

AAP/AAPD issue updated guidelines on safe sedation for children The American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) have released updated guidelines on the monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures. • The guidelines recommend that practitioners consult with appropriate subspecialists and/or an anesthesiologist for patients at increased risk of experiencing adverse sedation events because of their underlying medical/surgical conditions. • The child shall be accompanied by a parent, legal guardian, or other responsible person to and from the treatment facility. • Facilities, personnel, and equipment to manage emergency and rescue situations should be immediately available, including an emergency cart or kit containing the necessary age- and size-appropriate equipment (oral and nasal airways, bag-valve-mask device, LMAs or other supraglottic devices, laryngoscope blades, tracheal tubes, face masks, blood pressure cuffs, intravenous catheters, etc.) to resuscitate a nonbreathing and unconscious child. • The guidelines recommend documentation prior to sedation with regard to informed consent and instructions and information provided to the responsible person. • During the procedure, ventilation should preferably be monitored by capnography or by amplified, audible pretracheal stethoscope. • Not only the practitioner, but the support personnel should also be trained in and capable of providing advanced airway skills (e.g., PALS). A useful acronym ‘SOAPME’ is suggested as a checklist. S: Size-appropriate suction catheters and a functioning suction apparatus (eg, Yankauer-type suction) O: adequate Oxygen supply and functioning flow meters or other devices to allow its delivery A: size-appropriate Airway equipment (eg, bag-valve-mask or equivalent device [functioning]), nasopharyngeal and oropharyngeal airways, LMA, laryngoscope blades (checked and functioning), endotracheal tubes, stylets, face mask P: Pharmacy: all the basic drugs needed to support life during an emergency, including antagonists as indicated M: Monitors: functioning pulse oximeter with size-appropriate oximeter probes, end-tidal carbon dioxide monitor, and other monitors as appropriate for the procedure (eg, noninvasive blood pressure, ECG, stethoscope) E: special Equipment or drugs for a particular case (eg, defibrillator) The guidelines were published online June 27, 2016 and in the July issue of the journal Pediatrics