The study, published in JAMA Cardiology, found that people randomized to the intensive systolic BP target of <120 mm Hg had remarkably less incident LV conduction disease (including fascicular and left bundle-branch block) over a median of 3.5 years in the trial than the looser target of <140 mm Hg (HR 0.74).

LV conduction disease predicts death and heart failure, and the implantation of a permanent pacemaker is the only strategy to mitigate its effects. Currently, there are no proven preventive strategies for this common condition. Therefore, Emilie K. Frimodt-Møller, Herlev and Gentofte Hospital, Copenhagen, Denmark, and colleagues aimed to determine the association between targeting intensive BP control and the risk of developing left ventricular conduction disease.

For this purpose, the researchers conducted a post hoc analysis of the 2-arm multicenter SPRINT trial that involved participants from 102 sites in the US and Puerto Rico. The study included adults aged 50 years and above with hypertension, and at least one other cardiovascular (CV) risk factor was included. For the post-hoc analysis, participants with baseline left ventricular conduction disease, ventricular pre-excitation, or ventricular pacing were excluded.

Participants were randomly allocated to a standard treatment group in which they received a systolic blood pressure target of less than 140 mm Hg or to the intensive treatment group in which participants received less than 120 mm Hg.

The study's primary outcome was incident left ventricular conduction disease, assessed by serial electrocardiography. The incident right bundle-branch block was examined as a negative control.

The study revealed the following findings:

• Among 3918 participants randomized to standard treatment and 3956 to intensive therapy (mean age, 67.6 years; 36% female) monitored for a median of 3.5 years, 203 developed left ventricular conduction disease.
• Older age (hazard ratio per 10-year increase [HR], 1.42), cardiovascular disease (HR, 1.46), and male sex (HR, 2.31) were associated with a higher risk of left ventricular conduction disease.
• Assignment to intensive treatment was associated with a 26% lower risk of left ventricular conduction disease (HR, 0.74).
• These findings persisted when incident ventricular pacing was included in the outcome and when considering death from all causes as a competing risk.
• The authors found no association between randomization assignment and right bundle-branch block was observed (HR, 0.95).

"Targeting intensive BP control was tied to a lower risk of left ventricular conduction disease, which indicates that conduction disease may be a modifiable outcome susceptible to prevention strategies," the researchers concluded.

Reference:

Frimodt-Møller EK, Vittinghoff E, Kaur G, Biering-Sørensen T, Soliman EZ, Marcus GM. Association Between Intensive vs Standard Blood Pressure Control and Incident Left Ventricular Conduction Disease: A Post Hoc Analysis of the SPRINT Randomized Clinical Trial. JAMA Cardiol. Published online May 03, 2023. doi:10.1001/jamacardio.2023.0845

In
Jamaica, approximately 600 0f 40,000 births per year see children being diagnosed with autism spectrum disorder (ASD). This statistic has led Dr Rochelle Allison Bailey to conceptualise an early animal therapy intervention strategy — Rabbits for autistic kids — to improve the outcomes of children on the spectrum.

Dr Bailey, in an interview with the Jamaica Observer, said an early intervention can be introducing a pet to your autistic child, and noted that some children may feel intimidated by having a larger animal like a dog. Thus, a rabbit will make for an "excellent companion".

Once they are able to socialise and form a bond, she argued, pet rabbits can be a great comfort to autistic children.

"Rabbits have a particular routine. They stick to a specific schedule, and they are also quiet just like most autistic children. Hence, they make for a more relatable pet. Rabbits are safe, non-threatening, and soothing to watch and pet. It has been proven that having a rabbit and being able to pet them helps to reduce stress and anxiety thus promoting positive feelings of care, love and empathy," Dr Bailey said.

ASD is a developmental condition that affects a person's ability to socialise and communicate with others. People with ASD can also present with restricted and/or repetitive patterns of behaviour, interests or activities.

Further, the term spectrum refers to the degree in which the symptoms, behaviours and severity vary within and between individuals.

"Some people are mildly impaired by their symptoms, while others are severely disabled. Boys are four times more likely than girls to develop symptoms of ASD and children across all demographic and socioe-conomic groups experience ASD," Dr Bailey told Your Health Your Wealth.

"Children with autism can also develop mental health conditions such as anxiety disorders, attention deficit hyperactivity disorder [ADHD] or depression. According to the DSM-5-TR, to meet the diagnostic threshold of autism, someone would have to experience persistent differences in all of these areas," she added, listing social – emotional reciprocity, non-verbal communication behaviours used in social interactions and developing, maintaining, and understanding relationships.

Dr Bailey is in the process of gifting a family with an autistic child a rabbit to see if it will help to improve his social skills and how he interacts with the world at large.

She said, "Rabbits also tend to be quite shy and withdrawn until they get to know you. Once they are comfortable and a sense of trust has been built, you can see their true personality emerge. This shared experience in the autistic community helps them to connect with rabbits more deeply than other animals."

Further, Dr Bailey told Your Health Your Wealth that unlike dogs, rabbits don't require extensive care.

"They don't need to be showered as they self-groom and placing them in a body of water can lead to a panic attack or they may become hypothermic as their coats are dense. They are easy to feed. They feed on grass or hay and they can be fed pellets of any kind, rabbit pellets, chicken feed or pig pellets.

"In comparison to most small pets, they also have one of the longest life expectancies; they can live anywhere between 10-15 years once they are properly cared for, thus the period of bonding remains unbroken for over a decade."

Moreover, Dr Bailey said given that ASD is a developmental condition that begins early in life, having a cascading effect on developmental milestones, there is no known cure. But there are various effective treatments available.

"Early autism diagnosis means children can have early intervention, which can make a significant difference. Treatment options include education and development, including specialised classes and skills training, time with therapists such as speech and language and occupational therapists, and other specialists," she said.

"Behavioural treatments such as applied behaviour analysis (ABA), medication for co-occurring symptoms, combined with therapy and complementary and alternative medicine (CAM), such as supplements and changes in diet."

A second medical opinion is a terminology frequently used when a patient seeks the opinion of another health-care professional, usually a specialist or subject matter expert within a specialty, to confirm or clarify a diagnosis or treatment plan recommended by their primary care physician or another specialist. In today's column, we will discuss the importance of second medical opinions and how they can benefit patients.

Why and when are second opinions helpful?

Health care is becoming increasingly complex and personalised, with patients often facing difficult decisions regarding their medical care despite limited knowledge of advances in care and implications of varying treatment options. In such situations, expert or second medical opinions can be a valuable tool to help patients make informed decisions about their health care. Second medical opinions provide patients with assurance in their decision-making process and a greater sense of control over their health care. This can also reduce the stress and anxiety that often accompanies medical decision-making, helping patients feel more confident and empowered in their health care journey. Furthermore, second medical opinions from appropriately qualified and experienced specialists can help to prevent misdiagnosis, unnecessary or inappropriate treatments. Studies have shown that misdiagnosis is a common problem in health care, with up to 20 per cent of patients being misdiagnosed. Misdiagnosis and inappropriate treatments tend to occur with greater propensity in low resource nations where there is a dearth of specialists and limited availability and/or experience with advanced diagnostic modalities. A second opinion can help to identify any errors or oversights in the initial diagnosis, ensuring that patients receive the correct diagnosis and treatment plan. Additionally, a second opinion can help to prevent unnecessary treatments, such as surgery, interventional procedures or chemotherapy, which can be costly, risky, and have significant side effects. In cases where there are multiple treatment options available, a second opinion can help patients weigh the pros and cons of each option and make an informed decision.

There are several specific scenarios where seeking a second medical opinion can be beneficial and a few are highlighted here:

1. Serious medical conditions: For serious medical conditions such as cancer or heart disease, a second opinion can be helpful to confirm the diagnosis and treatment plan. This can give patients more confidence in their medical care and ensure that they are receiving the best possible treatment.

2. Complex medical cases: Some medical conditions can be complex and require specialised expertise. A second opinion can be beneficial in these cases, as it can provide patients with access to additional expertise and diagnostic tests that may not be available to their primary physician.

3. Surgical and Interventional procedures: Before undergoing surgery or interventional procedures, patients may want to seek a second opinion from a more qualified or more experienced specialist. This can help to confirm that the planned surgery or intervention is the best course of action and ensure that the surgical or interventional plan is appropriate for the patient's needs.

4. Chronic conditions: For chronic conditions such as arthritis, hypertension or diabetes, a second opinion may be helpful in determining the most effective treatment plan. This can help to improve quality of life and ensure that patients are receiving the best possible care for their condition based on the most current medical evidence.

5. Medication management: Patients who are taking multiple medications may benefit from a second opinion to ensure that the medications are being used appropriately and that there are no potential serious drug-drug interactions or adverse effects.

In all these scenarios, a second medical opinion can provide patients with valuable insights and help them make more informed decisions about their health care

Where should patients get second opinion?

It is critical however that second medical opinions be sought only from more qualified and experienced providers considered to be more reputable than the source of primary opinion. In general, it's a good idea to choose a provider or facility with experience, a proven track record and reputation for providing high-quality care and excellent outcomes. It is unhelpful to seek a second opinion from a less qualified or inexperienced provider or facility. When seeking a second medical opinion, it's important to choose the right facility or provider to ensure that you receive the best possible care. There are potential dangers associated with getting a second medical opinion from a less qualified physician, including:

1. Misdiagnosis: If the second opinion provider is less qualified or lacks expertise in a particular area, they may misdiagnose your condition or provide inaccurate recommendations for treatment.

2. Delayed treatment: Seeking a second opinion from a less qualified physician can lead to delays in treatment, as the provider may need to refer you to another specialist or order additional tests to confirm the diagnosis.

3. Conflicting advice: If the second opinion provider disagrees with your primary physician, it can be confusing and overwhelming to try to reconcile conflicting advice. This can create stress and uncertainty and may even lead to inappropriate or ineffective treatment.

4. Unnecessary testing and procedures: If the second opinion provider is less qualified, they may order unnecessary tests or procedures, which can be costly and potentially harmful.

5. Failure to do necessary procedures or testing; A less qualified provider of second opinion may withhold indicated procedures or testing because of limited knowledge and this could potentially lead to a false or misleading diagnosis and treatment recommendations.

6. False sense of security: If the second opinion provider is less qualified but agrees with your primary physician, you may feel a false sense of security that you are receiving the best possible care. This can lead to complacency and prevent you from seeking additional opinions if necessary or appropriate and necessary treatment.

To avoid these dangers, it's important to choose a more qualified and experienced provider for your second medical opinion. This can involve doing research, asking for unbiased recommendations from trusted sources, and checking the provider's credentials and reputation before making an appointment. By taking the time to choose the right provider, you can feel more confident in your medical care and avoid potential risks associated with seeking a second opinion from a less qualified physician.

Dr Ernest Madu, MD, FACC and Dr Paul Edwards, MD, FACC are consultant cardiologists for the Heart Institute of the Caribbean (HIC) and HIC Heart Hospital. HIC is the regional centre of excellence for cardiovascular care in the English-speaking Caribbean and has pioneered a transformation in the way cardiovascular care is delivered in the region. HIC Heart Hospital is registered by the Ministry of Health and Wellness and is the only heart hospital in Jamaica. Send correspondence to info@caribbeanheart.com or call 876-906-2107.

However, the Onamet explained that the effects of a trough to the north over the Atlantic Ocean associated with a weak frontal system will originate in the afternoon until early evening cloudy increases with isolated downpours, thunderstorms, and possible wind gusts in the northwestern portion and the Central Cordillera, with greater frequency in the provinces: Dajabón, Elías Piña, Puerto Plata, Valverde, Espaillat, Santiago Rodríguez, Santiago, among other nearby areas.

Temperatures will continue to be quite hot during the day due to the combination of the dust coming from the Sahara and the wind blowing from the southeast. Therefore, the recommendation to the entire population to drink enough liquids (water), wear light clothes (preferably light colors), and not expose themselves directly to the sun, especially from 11:00 a.m. to 4:00 p.m. without sunscreen, is maintained.

For tomorrow Sunday, in the morning hours, there will be isolated showers on the Caribbean coast and the northeast of the country. However, in the afternoon, the trough will bring more moisture and instability to our forecast area, generating cloudy conditions with locally moderate to heavy downpours, thunderstorms, and wind gusts over the northwest, northeast, Central, Central Cordillera, and the border area until the early hours of the night. Cloudy skies and scarce precipitation will continue to prevail for the rest of the country.

Delhi: NEET PG 2023 counseling to begin soon. The Medical Counselling Committee (MCC) is responsible for conducting the counseling process for seat allotment.

MCC conducts counseling for the following –

1. 50% seats of All India Quota

2. 100% seats of Deemed/Central Universities

3. 100% all India open DNB seats

For Central Universities, there will be four rounds of counseling, i.e., Round 1, Round 2, Mop-Up Round & Stray Vacancy Round, to be conducted by MCC of DGHS. All the candidates who have qualified for All India Quota seats based on their rank in NEET PG conducted by NBE will be eligible for the 50% AIQ seats of Central University.

Reservation of seats under the PWD Category is 5% in AIQ and the 21 Benchmark Disabilities as envisaged under the regulations of the Rights of Persons with Disabilities Act 2016 and as per NMC norms. Candidates who want to avail 5% PwD reservation in PG seats of Govt. /Central medical institutions should obtain a Disability certificate per 21 Benchmark Disabilities given under RPWD Act 2016 and as per NMC norms from the designated disability centers. The certificate issued by any other hospital/ board will not be accepted.

Also Read:PGIMER Invites Online Applications For House Job Dentistry July 2023 Session, details

The central university consists of the following institute –

1. Delhi University

2. Aligarh Muslim University

3. Banaras Hindu University

4. Central Institute of Psychiatry, Ranchi

5. Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur

6. Under IP University- VMMC & SJH, ABVIMS & RML, ESIC, Basaidarapur

The following reservation policy will be followed –

Delhi University –

Reservation Policy for AIQ seats and internal seats of DU –

1. S.C.- 15%

2. S.T.- 7.5%

3. O.B.C.- (Non-Creamy Layer) as per the Central OBC list- 27%

4. EWS- as per Central Government norms- 10%

5. PwD- Horizontal Reservation as per NMC norms- 5%

Aligarh Muslim University –

Reservation Policy for AIQ seats –

1. S.C. - 15%

2. S.T. - 7.5%

3. O.B.C.- (Non-Creamy Layer) as per the Central OBC list- 27%

4. EWS- as per Central Government norms- 10%

5. PwD- Horizontal Reservation as per NMC norms- 5%

There is no reservation for the Reservation Policy of 50% Internals seats of AMU.

Banaras Hindu University –

Reservation Policy for AIQ and internal seats of BHU –

1. S.C.- 15%

2. S.T. - 7.5%

3. O.B.C. - (Non-Creamy Layer) as per the Central OBC list- 27%

4. EWS- as per Central Government norms- 10%

5. PwD- Horizontal Reservation as per NMC norms- 5%

Central Institute of Psychiatry, Ranchi –

Reservation Policy –

1. S.C. - 15%

2. S.T. - 7.5%

3. O.B.C.- (Non-Creamy Layer) as per the Central OBC list- 27%

4. EWS- as per Central Government norms- 10%

5. PwD- Horizontal Reservation as per NMC norms- 5%

Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur –

Reservation Policy –

1. S.C.- 15%

2. S.T.- 7.5%

3. O.B.C.- (Non-Creamy Layer) as per the Central OBC list- 27%

4. EWS- as per Central Government norms- 10%

5. PwD- Horizontal Reservation as per NMC norms- 5%

Central Institutes Under IP University- VMMC & SJH, ABVIMS & RML, ESIC, Basaidarapur –

Reservation Policy –

1. S.C.- 15%

2. S.T.- 7.5%

3. O.B.C.- (Non-Creamy Layer) as per the Central OBC list- 27%

4. EWS- as per Central Government norms- 10%

5. PwD- Horizontal Reservation as per NMC norms- 5%

Also Read:AIIMS To Release Admit Card, Final Registration Status Today For INI CET July 2023 Session

Range Developments collaborated with the office of St David’s Constituency to make the lives of our elderly and physically challenged in Grenada a little easier

View the full post Range Developments donates wheelchairs and canes on NOW Grenada.

Santo Domingo.- The Dominican Republic has been experiencing an intense heat wave in recent weeks due to various phenomena such as El Niño and dust from the Sahara. The high temperatures have resulted in a thermal sensation of 41°C, as registered between 1-3 pm yesterday. Additionally, the convective season that began in May, characterized by marine humidity, heat, and electrical discharges, is expected to extend from May to September.

To understand the impact of the heat wave on the heart, the internist cardiologist Vizmaira Pineda was consulted by the newspaper elCaribe. People, especially those with heart disease, are advised to take several measures as excessive sweating results in the loss of electrolytes and can cause arrhythmias and fainting. The heart can experience temporary loss of consciousness and a momentary paralysis of movements due to a lack of blood supply to the brain. The formation of blood clots is also a significant risk factor during hot weather because dehydration leads to an imbalance of electrolytes and the thickening of the blood. Neglecting to take medications can exacerbate the formation of thrombi, which travel to the lung and cause pulmonary embolisms.

The most vulnerable groups are the elderly, obese individuals, and children because they have less fluid in their bodies and tend to dehydrate faster. Patients with heart failure, large hearts, and kidney failure are also at a higher risk due to their limited fluid intake. Pineda recommends that people wear fresh clothes made of cotton, consume a diet rich in refreshing fruits and vegetables, and avoid hot, salty, or copious foods, and alcohol intake. Physical activities should be performed early in the morning or late afternoon, avoiding caps and rough clothing to stay cool during this heat wave.

A new organizational structure to strengthen PAHO’s technical cooperation

Cristina Mitchell

4 May 2023