Top Ten Health Stories of the Year 2010

The year 2010 saw a lot of ‘hustle and bustle’ in the medical circle. Here are the Top 10 stories as viewed by eMedinewS.

1. Overhauling of Medical Council of India: The major story of the year was the arrest of MCI President Dr. Ketan Desai, dissolution of the MCI; appointment of six out of seven Board of Governors; subsequent release of Dr. Ketan Desai on bail, common entrance exam for MBBS; reduction in forensic faculty requirement; increase in retirement age to seventy and the suspense behind 7th seat of Board of Governors etc.
2. Medical Council of India action against Indian Medical Association: MCI took action against the IMA President and Secretary for violation of MCI Ethics on the ground that IMA should not have endorsed Pepsi products. The IMA had to approach High Court to take a stay. The matter is now in the High Court. Is that a start of MCI actions against ethics violations? Will it act against the cut system?
3. Delhi Bug: A huge controversy arose when British Medical Journal broke a story about NDM1 bug being named after New Delhi. The medical circle in India said that it was unfair and was an attempt to sabotage the medical tourism in India. The new bug is a gram negative bacteria showing resistance to all present antibiotics. New Delhi metallo–beta–lactamase (NDM–1) is an enzyme that makes bacteria resistant to a broad range of beta–lactam antibiotics. These include the antibiotics of the carbapenem family, which are a mainstay for the treatment of antibiotic–resistant bacterial infections. The gene for NDM–1 is one member of a large gene family that encodes beta–lactamase enzymes called carbapenemases. Bacteria that produce carbapenemases are often referred to in the news media as “superbugs” because infections caused by them are difficult to treat. Such bacteria are usually only susceptible to polymyxins and tigecycline. NDM–1 was first detected in a Klebsiella pneumoniae isolate from a Swedish patient of Indian origin in 2008. It was later detected in bacteria in India, Pakistan, the United Kingdom, the United States, Canada, Japan and Brazil. The most common bacteria that make this enzyme are Gram negative such as Escherichia coli and K. pneumoniae, but the gene for NDM–1 can spread from one strain of bacteria to another by horizontal gene transfer.
4. H1N1 havoc: H1N1 created great havoc, but ultimately, proved to be a ‘much hyped’ virus with mortality even lower than the regular human flu virus. Most of the hospitals who had started special H1N1 virus wards, now do not have these wards.
5. Chikungunya epidemic: The latest epidemic in the North India was that of Chikungunya with patients presenting with fever, rash and joint pains. It complicated the pre–existing dengue epidemic in the society.
6. Dengue with a difference: This year dengue was different than other years, came with more GI symptoms, pancreas involvement, dengue hepatopathy and lot of skin reactions. The platelet count dropped to less than 10000 but most required no platelet transfusion.
7. Diabetes diagnosis: The year saw a new advancement where A1C is to be used for diagnosis of diabetes and not fasting sugar. An A1C >6.5% means diabetes.
8. New pill for HIV prevention: A new pill is now available for HIV prevention along with condoms. It is to be used before the act and continues for seven days. In a trial involving nearly 2,500 HIV–negative, but high risk, gay men in six countries, researchers found that a combination antiretroviral pill (tenofovir and emtricitabine) reduced the risk of HIV infection by 44%, compared with placebo. When scientists looked more carefully at the study volunteers who took the medication most faithfully, on a daily basis, they found that the risk of contracting HIV was even lower — 73% lower than the placebo group. More studies will need to confirm the benefit of antiretrovirals in the prevention of HIV, and public health experts warn that even if the results hold up, it would not replace the best method of prophylaxis: safe sex and consistent use of condoms. That’s because the way so–called pre–exposure prophylaxis, or PrEP, works is to load up high–risk people with HIV–disabling antiretroviral drugs before exposure to the virus, which allows the medication to hit HIV as early as possible. But the drugs do not work as a vaccine would, by priming the immune system to actually prevent infection.
9. National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) started in the country:At last, Govt. of India, Ministry of Health and Family Welfare has started the above program.
10. New drug for premature ejaculation: The year ended with the launch of an SOS drug for premature ejaculation. This will be breakthrough for the community. Premature ejaculation, the most common sexual problem apart from erectile dysfunction, has been often found to put marriages under strain. While the existing drugs, which are not specific to treat premature ejaculation, need to be taken regularly, the new pill can be popped just a few hours before intercourse. It works by altering levels of serotonin, a chemical in the brain. The drug, dapoxetine, comes from a family of drugs called selective serotonin reuptake inhibitors, which block the reabsorption of the neurotransmitter serotonin.

Key findings from American Heart Association (AHA) 2010 scientific sessions

The American Heart Association (AHA) 2010 Scientific Sessions took place in Chicago, Illinois, November 13-17, 2010.

Key trials presented at the sessions include:

• ADVANCE: New LVAD equivalent to HeartMate II, nonrandomized study shows
• RAFT: CRT shows survival benefit for patients with class 2 and 3 HF who have low EF and wide QRS
• EMPHASIS-HF: Eplerenone shows large benefits in milder heart failure
• ASCEND HF: Nesiritide safe but of limited dyspnea benefit in acute HF
• ROCKET AF: Rivaroxaban noninferior to warfarin, but superiority analyses at odds
• CLOSURE I: No overall benefit, no reduction in stroke or TIA with PFO closure
• GRAVITAS: No benefit of doubling dose in clopidogrel nonresponders
• P-OM3: Omega-3 PUFA caps don't suppress paroxysmal AF in randomized trial
• BASKET-PROVE: DES as safe as bare-metal stents in larger coronary arteries, with less TVR 
• DEFINE: Large effects on LDL and HDL cholesterol with CETP inhibitor anacetrapib
• SYMPLICITY HTN: Catheter-based renal denervation reduces BP in patients with resistant hypertension
• ASCOT CRP: Analysis fuels debate over JUPITER-based CRP indication for statins
• ACT: No benefit of N-acetylcysteine to reduce contrast-induced nephropathy

Some drug interactions

Questioner: Edie
Question: My 85 year old mother has been taking some form of sleeping pills for the past 50 years the last 20 years at least has been restoral she is prescribed 30 mg. (there is times she binges and takes 2 pills a night) She also takes Xanax, Tylenyol with Codeine.  Should someone her age (or any age) be taking this much medication.  She has recently started drinking again.  What are the dangers/risks of her taking this much medication?  I am working with her Dr. to take the administration of the medications out of her hands as she is getting more and more abusive.
Answer: There is risk of major interaction between Tylenol (acetaminophen) and alcohol. Consumption of alcohol may increase the risk of acetaminophen-induced hepatotoxicity. There is moderate risk of interaction between (1) alcohol with codeine, Xanax (alprazolan) and Restoril (Temazepam). CNS depressant effects of these drugs may be potentiated. (2) codeine, alprazolam and Temazepam with each other.  Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.
There is no need for her to take codeine, acetaminophen or alcohol. The are not helpful in getting to sleep. Stopping these three will dramatically reduce risk of adverse effects.