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Mizoram Society For Medical Education & Research, Chanmari, Aizal (2026)

18/04/2015

THIAMINE DEFICIENCY (Beri Beri)

A big issue in a place like Mizoram where eating Betel nut (Areca) is customary. It is a well known fact that it cause Thiamine deficiency. Recently many morbidity/mortality including heart failure and peripheral neuropathy and even sudden infant death have been attributed to thiamine deficiency. If you are in a habit of taking betel nut please make sure you take thiamine replacement especially if ur pregnant

Betel nut (Areca)- Kuhva rah hian thiamine tlakchhamna taksa ah a siam thei a. Natna tam tak a nghawng thei a ni. Heng natna nerve thalo, thawhah, lung na thleng hian a nghawng thei a ni. Nausen pawh an bang chuang lo (NU kuhva ei ah). Chuvang chuan vitamin Thiamine awm telna hi kuhva ei tan chuan ei a tha, naupai ngat tan phei chuan

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24/08/2014

Ebola virus update

1. Ebola is a filovirus and among the most virulent human pathogens known.

2. In the present epidemic, all cases of Ebola virus have been reported in four countries: West and Central Africa, Liberia, Siberia and Nigeria.

3. As on today, no case has been reported in India. So No panic.

4. Ebola virus has five strains and the strain which is currently epidemic is Zaire and is the most virulent.

5. There is no evidence that asymptomatic persons still in the incubation period are infectious to others, however, symptomatic individuals should be assumed to have high levels of virus in the blood and other body fluids and proper safety precautions should be taken. The incubation period is 8–10 days after exposure (ranging from 2–21 days). s the disease is unlikely to transmit during incubation period, it is unlikely to spread through air travel, if the passengers who are boarding the plane are asymptomatic. Symptomatic patients should not be allowed to board a flight. It is also true that symptomatic patients will be sick enough not to board.

6. There is no role of thermal scanning at airports. Exit screening is sufficient.

7. The disease initially presents with non–specific flu or dengue like symptoms but rapidly within a week ends up to multi–organ failure and septic shock. May also have relative bradycardia, non productive cough, sensation of a lump in the throat.

8. It may have low platelet counts and SGOT may be greater than SGPT. Bleeding is not universally present. Eye hemorrhage and oral mucosa hemorrhages may be the first manifestations. Platelet count usually range between 50,000 to 1 lakh. PT and PTT are prolonged.

9. Person to person transmission requires direct contact with blood or other virus containing body fluids which mean blood, vomits, urine, f***s and, probably, sweat.

10. Direct contact can lead to infection in the ritual washing of ebola victims at funeral grounds.

11. The nature of transmission is usually mucus membrane or broken skins. The disease is not transmitted via air borne droplets.

12. Ebola virus being highly infectious is classified as biological weapon. Mortality of victims of ebola virus is 58%. Death occurs between 7 to 16 days.

13. No rapid diagnostic methods are available. The blood test may not be positive in the incubation period.

14. Barrier nursing is the answer for infected patients. No vaccine is available. No specific treatment is there.

15. Any suspected case of Ebola virus should be informed to 23061469, 23063204, 23061302.

16. In Delhi Ram Manohar Lohia hospital is the only authorized hospital to handle Ebola virus.

17. If a suspected patients enters in the country, he will be compulsorily be isolated for 30 days.

18. As per the Indian government, all passengers who show symptoms and resemble with Ebola like symptoms like muscle pain, sore throat, vomiting, diarrhea and bleeding should report to Health Officer on arrival.

19. Besides, anybody who has visited above mentioned countries and develops these symptoms, up to 30 days of arrival in India are asked to immediately visit designated hospitals.

20. As per the instructions received from National Centre for Disease Control, all airlines are asked to render an inflight message on these lines. (With input from IMA)

07/05/2014

Much–hyped new tuberculosis test gives inaccurate results

(TOI Report D N Jha) In a major setback to improving tuberculosis (TB) diagnosis and treatment in the country, researchers have found that the new gene Xpert gene test being promoted by government and top health agencies of the world does not give accurate results. In fact, one out of every three sputum sample put to test using this technology gave false sensitivity to TB drug (Rifampicin) in study carried at the All India Institute of Medical Sciences (AIIMS) when they were originally drug–resistant.

Dr Sarman Singh, professor and head of the clinical microbiology and molecular medicine division at AIIMS, said GeneXpert has been a revolutionary diagnostic method in Africa but in India it can miss as many as one–third of Rifampicin–resistance cases. "The Indian strains have a peculiar gene sequence which is not recognized by the probes GeneXpert has. Hence, if such systems are used routinely, this would give a false impression that India has very low rifampicin resistance thus making the programme mangers complacent," Dr Singh added.

There are four tests approved by WHO: LED Microscope, Liquid Culture and two molecular tests – Gene Xpert and Line Probe Assay. Gene Xpert, one of the advanced tests for TB diagnosis, is available at AIIMS for a patient suffering from drug resistant TB but it is not available in all hospitals due to its high cost. But central TB division of Ministry of Health, Government of India is installing GeneExpert in all the referral TB laboratories.

Dr Singh said the national TB control program managers must evaluate the performance of Xpert MTB/RIF test before rolling it out in the Drug resistant–TB control program in view of the findings, which has been published in latest issue of the Journal of Clinical Microbiology. The AIIMS study, researchers said, was done in a double-blinded manner. "After getting the RIF mono-resistance Line Probe Assay (LPA) results, one of us asked the persons in charge for Xpert MTB/RIF to run these samples in Xpert using the newer version of cartridges as per manufacturer instruction. Comparative analysis showed only 64.4% RIF mono–resistant TB cases were correctly diagnosed by Xpert. The remaining 35.6% were detected falsely RIF susceptible," said an AIIMS researcher.

In an earlier report published in PLOS Medicine journal, researchers pointed out that Xpert MTB/RIF has a number of limitations including limited shelf–life of the diagnostic cartridges, operating temperature and humidity restrictions, requirement for electricity supply, the need for annual servicing and calibration of each machine.

12/03/2014

Harvard’s 4 simple ways to boost your energy

1. Pace yourself. If you’re a go–getter, you probably like to keep going — but don’t risk overtaxing yourself. You can pace yourself and still get things done. For example, instead of burning through all your "battery life" in two hours, spread it out among morning tasks, afternoon tasks, and evening activities — with rest and meals in between.

2. Take a walk or a nap. There’s nothing more satisfying than a short power nap when you’re pooped out. However, if you have trouble sleeping at night, know that napping can make insomnia worse. If that’s the case for you, get moving instead. Get up and walk around the block, or just get up and move around. If you are not an insomniac, though, enjoy that 20– to 30–minute power nap.

3. Skip most supplements. You may have heard about energy–boosting or "anti–aging" supplements. There is no evidence they work.
DHEA. There is no evidence that DHEA offers any real benefits, and the side effects remain a question mark. You especially shouldn’t be buying it from ads in the back of a magazine, because you don’t know what’s in it.
Iron. Iron only improves energy if you are clearly deficient, which a doctor can check with a blood test. Unless you are low in iron, you don’t need to take it — and getting too much iron can be harmful.
B vitamins. It is true that B vitamins (B1, B2, B6, B12) help the body convert food into the form of energy that cells can burn, but taking more B vitamins doesn’t supercharge your cells. That’s a myth.

4. Fuel up wisely. A sugary roll from the bakery delivers plenty of calories, but your body tends to metabolize them faster, and then you can end up with sinking blood sugar and fatigue. You’ll maintain a steadier energy level by eating lean protein and unrefined carbohydrates. Try low–fat yogurt with a sprinkling of nuts, raisins, and honey. Your body will take in the carb–fiber–protein mix more gradually. Don’t skip meals, either. Your body needs a certain number of calories to get through the day’s work. It’s better to space your meals out so your body gets the nourishment it needs all through the day.

15/01/2014

Flu in children

1. The classical features of uncomplicated flu include abrupt onset fever, headache, muscle pain and malice accompanied by cough, sore throat or nose running. All of these features may not be present in children.

2. The symptoms may last for more than 7 days, particularly among young children.

3. Flu can complicate into pneumonia, asthma or ear discharge.

4. Viral flu may get complicated into bacterial pneumonia.

5. The fever is usually more than 100°F

6. Diagnostic tests are available but often not indicated.

7. Generally, it is an acute self–limiting disease.

8. Patients with uncomplicated flu usually improve gradually over 2–5 days.

9. Cough may persist for longer period.

10. Persistence of symptoms or weakness and easy fatigability called post flu asthenias may last for several weeks in older children.
In 10–15% of the children, flu may end up with ear discharge.

11. The ear discharge usually starts 3–4 days after onset of flu.

12. Anti–flu drugs are indicated for high–risk children.

13. Flu vaccination is recommended on annual basis in high risk

13/01/2014

India polio free from today

Ruksha’s the last recorded case of polio — on January 13, 2011 — in India, and if the nation’s polio eradication programme stays on track, it may well be India’s last. Being declared polio-free means the virus has died in the environment and new cases, if any, would be caused by infection in another country where infection persists.

Before a country can be certified polio-free, it should have at least three years of zero polio cases. Since the launch of the 1988 Global Polio Eradication Initiative to eradicate polio, 5 million people - mainly in the developing world - who would otherwise have been paralysed, will be free of polio.

27/12/2013

2013 Research Highlights

1. Malaria vaccine found safe and protective

NIH researchers reported that a candidate malaria vaccine is safe and protected against infection in an early–stage clinical trial.

2. Gene variants predict response to breast cancer drugs

An international research team, with NIH support, found genetic variations that can be used to identify women who are most likely to benefit from this potentially life–saving strategy—and who should avoid it.

3. Urine test detects kidney transplant rejection

NIH–funded researchers found that certain molecules in urine can provide an early sign of transplant rejection. The test could allow doctors to act early to protect transplanted kidneys.

4. Technique directs immune cells to target leukemia

An NIH–funded team used a type of targeted immunotherapy to induce remission in 5 patients with this aggressive form of leukemia.

5. Medical management best to prevent second stroke

An NIH–funded clinical trial confirmed earlier findings that stenting adds no benefits over aggressive medical treatment alone for most of these patients.

6. Duration of obesity may affect heart disease

NIH researchers found that how long a young adult is obese may affect that person’s heart disease risk in middle age. The finding suggests that not only preventing but also delaying the onset of obesity can help reduce heart disease later in life.

20/12/2013

JNC 8: Expert Panel Want BP Cuffs Loosened

1. The long–awaited update to guidelines for the management of hypertension, from the panel appointed to the Eighth Joint National Committee (JNC 8), raises the recommended blood pressure threshold to determine the need for drug therapy in many patients.

2. For most hypertensive individuals aged 60 or older, pharmacologic treatment should be started when the systolic pressure is 150 mm Hg or higher or the diastolic pressure is 90 mm Hg or higher, with the goal of achieving readings below those cutoffs.

3. For younger hypertensive patients and for those with chronic kidney disease or diabetes –– regardless of age –– treatment should be initiated when the systolic pressure is 140 or higher or the diastolic pressure is 90 or higher

4. In the previous JNC 7 guidelines released in 2003, the target blood pressure was less than 140/90 mm Hg for most hypertensive patients and less than 130/80 mm Hg for patients with chronic kidney disease or diabetes.

For the initial choice of agent, the authors made the following recommendations:

- For nonblack individuals, including those with diabetes, ACE inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers, and thiazide–type diuretics can all be chosen for first–line treatment

- For black individuals, including those with diabetes, calcium channel blockers and thiazide–type diuretics are recommended as first–line therapy

- For patients with chronic kidney disease, regardless of race or diabetes status, initial or add–on therapy should include an ACE inhibitor or an ARB to improve renal outcomes

30/11/2013

NIH Statement on World AIDS Day 2013 — December 1, 2013

1. Progress has turned an HIV diagnosis from an almost–certain death sentence to what is now for many, a manageable medical condition and nearly normal lifespan.

2. NIH–funded researchers—in partnership with academia and the biotechnology and pharmaceutical industries—have developed more than 30 life–saving antiretroviral drugs and drug combinations for treating HIV infection.

3. Moreover, as the landmark HPTN 052 clinical trial proved, antiretroviral treatment can also effectively prevent HIV transmission by lowering the amount of virus in infected individuals, thereby making them less able to transmit the virus to their s*xual partners.

4. NIH scientists and grantees are exploring the administration of anti–HIV antibodies as a way to treat infection. This approach was recently shown to be effective when used in monkeys infected with a genetically engineered version of simian HIV.

5. NIH researchers have begun early stage human testing of a monoclonal antibody (called VRC01), which in the laboratory, protected human cells against infection by more than 90 percent of known HIV strains.

6. The HPTN 065 study (also known as TLC–Plus), is assessing the feasibility of conducting widespread voluntary HIV testing, linking HIV–infected individuals to care and antiretroviral treatment, and providing incentives to individuals to adhere to treatment. The study is being conducted in New York City, and Washington, D.C.—both of which have communities at greater than average risk of HIV infection.

7. Internationally, the recently launched HPTN 071 study, also called PopART, is examining whether offering expanded voluntary HIV testing along with enhanced delivery of antiretroviral treatment and prevention services can substantially reduce the number of new infections in South Africa and Zambia. The study will involve 21 communities and 1.2 million people in those countries.

8. NIH–funded research has proven the effectiveness of such HIV prevention strategies as voluntary medical adult male circumcision and pre–exposure prophylaxis, or PrEP (taking a daily antiretroviral pill to prevent HIV acquisition). In order to be effective, these strategies must be used consistently under strict guidelines.

9. The NIH also continues to investigate new HIV prevention tools for those groups most at risk for HIV infection, including women and men who have s*x with men. The multinational ASPIRE clinical trial, launched in 2012, is testing whether a vaginal ring containing the experimental antiretroviral drug dapivirine can prevent HIV infection in women. The recently launched MTN 017 External Web Site Policy clinical trial is examining the safety of a rectally applied gel containing the antiretroviral drug tenofovir for men who have s*x with men.

10. A cornerstone of our HIV prevention efforts continues to be the search for a safe and effective vaccine.

11. We have reached the point when the thought of an HIV cure is not unrealistic. Several cases, including that of a toddler, have demonstrated the possibility of sustained remission, in which patients control or perhaps even eliminate HIV without the need for a lifetime of daily antiretroviral therapy.

28/11/2013

Harvard: 6 things you should know about vitamin D

The body makes vitamin D when sunlight hits the skin. You can also get the vitamin from food (mainly because it’s been added; few foods are natural sources of vitamin D) or by taking a supplement.

The process by which the body makes vitamin D is complex. It starts when the skin absorbs rays in the invisible ultraviolet B (UVB) part of the light spectrum. The liver and the kidneys also participate to make a form of the vitamin that the body can use.

A number of factors influence a person’s vitamin D levels. Here are six important ones.

1. Where you live. The further away from the Equator you live, the less vitamin D–producing UVB light reaches the earth’s surface during the winter. Residents of Boston, for example, make little if any of the vitamin from November through February. Short days and clothing that covers legs and arms also limit UVB exposure.

2. Air quality. Carbon particles in the air from the burning of fossil fuels, wood, and other materials scatter and absorb UVB rays, diminishing vitamin D production. In contrast, ozone absorbs UVB radiation, so pollution–caused holes in the ozone layer could end up enhancing vitamin D levels.

3. Use of sunscreen. Sunscreen prevents sunburn by blocking UVB light. Theoretically, that means sunscreen use lowers vitamin D levels. But as a practical matter, very few people put on enough sunscreen to block all UVB light, or they use sunscreen irregularly, so sunscreen’s effects on vitamin D might not be that important. An Australian study that’s often cited showed no difference in vitamin D between adults randomly assigned to use sunscreen one summer and those assigned a placebo cream.

4. Skin color. Melanin is the substance in skin that makes it dark. It "competes" for UVB with the substance in the skin that kick–starts the body’s vitamin D production. As a result, dark–skinned people tend to require more UVB exposure than light–skinned people to generate the same amount of vitamin D.

5. Weight. Body fat sops up vitamin D, so it’s been proposed that it might provide a vitamin D rainy–day fund: a source of the vitamin when intake is low or production is reduced. But studies have also shown that being obese is correlated with low vitamin D levels and that being overweight may affect the bioavailability of vitamin D.

6. Age. Compared with younger people, older people have lower levels of the substance in the skin that UVB light converts into the vitamin D precursor. There’s also experimental evidence that older people are less efficient vitamin D producers than younger people.

11/11/2013

Harvard six ways to ease neck pain

1. Don’t stay in one position for too long.

2. Make some ergonomic adjustments. Position your computer monitor at eye level so you can see it easily. Use the hands–free function on your phone or wear a headset. Prop your touch–screen tablet on a pillow so that it sits at a 45° angle, instead of lying flat on your lap.

3. If you wear glasses, keep your prescription up to date.

4. Don’t use too many pillows.

5. Know your limits. Before you move a big armoire across the room, consider what it might do to your neck and back, and ask for help.

6. Get a good night’s sleep.

25/10/2013

Can a doctor expose other doctor’s misconduct?

A trial court has directed the Delhi government to provide protection to three doctors of Babu Jagjivan Ram hospital who exposed two doctors for giving a false autopsy report and pressuring their juniors in an alleged murder case.

Additional sessions judge Kamini Lau directed the principal secretary health and director health services, to ensure that Dr Bhim Singh and his team, including Dr Javed and Dr Sameer, who exposed the misdoings in their department, are not harassed by authorities.

The court also asked the government to take action against Dr Suresh Seth, DMS of BJRM hospital, and autopsy surgeon Dr Sudesh, for giving false autopsy report of a woman by making it an unnatural death though it was a natural death and pressurizing juniors.

Dr. Sudesh is currently lodged in judicial custody in another corruption and cheating case.

"The conduct of Dr. Suresh who is the controlling authority and the officer who allegedly exerted pressure on committee members to save Dr. Sudesh and so also the conduct of the Dr. Sudesh is directed to be placed before the principal secretary (health & family welfare) and director, directorate of health services for information and appropriate action against them in accordance with the procedure established by law under intimation to this court, "it said.

The court asked the government to explore the possibility of videographing post- mortem procedure. (TOI 23/10/2013)

Issues

Can a doctor expose misconduct of other doctors?

MCI: 1.7 Exposure of Unethical Conduct: A Physician should expose, without fear or favour, incompetent or corrupt, dishonest or unethical conduct on the part of members of the profession.

Is it a professional misconduct?
Yes only after the person is convicted MCI: 7.5 Conviction by Court of Law: Conviction by a Court of Law for offences involving moral turpitude / Criminal acts

Mizoram Society For Medical Education & Research

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