Kawasaki Disease still remains largely undiagnosed in India

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Kawasaki Disease still remains largely undiagnosed in India

The goal of therapy for KD is to manage symptoms to maintain cardiovascular health

New Delhi, 21 November 2017: In what can be called a rare but rapidly spreading disease, the Kawasaki Syndrome or Disease (KD) continues to remain one of the largely undiagnosed conditions in Indian children, primarily due to lack of awareness amongst pediatricians. KD is believed to be the commonest vasculitic disorder of children. Incidence rates as high as 60 to 150 per 100,000 children below 5 years of age have been reported from several countries. The IMA indicates that untreated children are at risk for developing potentially fatal coronary artery aneurysms.

KD is a condition that causes inflammation in the walls of medium-sized arteries throughout the body, including the coronary arteries, which supply blood to the heart muscle. It is also called mucocutaneous lymph node syndrome because it also affects lymph nodes, skin, and the mucous membranes inside the mouth, nose and throat.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Although the exact cause of KD is not known, it is not thought to be a contagious disease. Some theories link KD to bacteria, viruses or other environmental factors, but none has been proved. Certain genes can increase a child’s susceptibility to KD. This disease is one of the leading causes of acquired heart disease in children. However, lasting damage can be prevented with effective treatment. Some of the heart complications that may develop as a result of KD include inflammation of blood vessels (vasculitis), usually the coronary arteries, that supply blood to the heart; inflammation of the heart muscle (myocarditis); and heart valve problems. As per the AHA, the diagnosis of incomplete or atypical KD should be considered in any infant or child with prolonged unexplained fever, fewer than 4 of the classical clinical findings, and compatible laboratory or echocardiographic findings.”

Some of the classic symptoms of KD apart from fever include redness in both eyes; a very red, swollen tongue; redness of the palms or soles; skin peeling; a rash; and swollen lymph nodes. The symptoms usually appear in three phases.

Adding further, Dr Aggarwal, said, “Treatment should begin as soon as the signs and symptoms appear, preferably while the child still has a fever. The goals of initial treatment are to lower fever and inflammation and prevent heart damage. The recommendations may include infusion of an immune protein (gamma globulin) through a vein (intravenously) to lower the risk of coronary artery problems; and high doses of aspirin to help treat inflammation.”

The goal of therapy is to prevent thrombosis and myocardial ischemia while maintaining optimal cardiovascular health. Risk-stratification of patients for effective long-term evaluation and management should be done according to the relative risk of myocardial ischemia, either related to coronary artery thrombosis or stenoses/occlusions. The guidelines also recommend development of effective and collaborative programs between pediatric and adult cardiology providers for effective long-term management of the patient.

Health Ministry defines maximum permissible limits of antibiotics in food animals

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Antibiotic resistance has become a major public health threat worldwide. Use of antibiotics in food animals is emerging as a major cause of emergence of antibiotic resistance. The WHO has also recently published guidelines recommending farmers and the food industry to stop using antibiotics routinely to promote growth and prevent disease in healthy animals. The Ministry of Health and Family Welfare has notified amendment to Food Safety Standards Contaminants Toxins Residues Regulations 2011 on 7th November 2017. Now called the Food Safety and Standards Contaminants toxins and Residues Amendment Regulations 2017 the notification contains maximum permissible limits of various antibiotics in meat and meat products including chicken. Maximum permissible limits of 37 antibiotics and 67 other veterinary drugs are prescribed for chicken. 2 No person shall use any of the following antibiotics and other pharmacologically active substances in any unit which processes sea foods including shrimps prawns or any variety of fish and fishery products namely. 1. Nitrofurans including i Furaltadone ii Furazolidone iii Nitrofurnatoin iv Nitrofurazone. 2. Chloramphenicol. 3. Sulphamethoxazole. 4. Aristolochia spp and preparations thereof. 5. Chloroform. 6. Chloropromazine. 7. Colchicine. 8. Dapsone. 9. Dimetridazole. 10. Metronidazole. 11. Ronidazole. 12. Ipronidazole and other nitromidazoles. 13. Clenbuterol. 14. Diethylstibestrol. 15. Glycopeptides. 16. Stilbenes and other steroids. 17. Crystal Violet. 18. Malachite Green. The tolerance limits of various antibiotics used in human beings and animals exclusively used in animals and other various veterinary drugs have been specified in the notification. The draft notification is available on FSSAI website. Objections and suggestions have been invited from all the stakeholders including general public within 30 days of the notification i.e. by 6th December 2017. Source Press Information Bureau Ministry of Health Family Welfare November 20 2017