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eMedinewS eIMANewS wish their readers a very Healthy, Happy & Safe Diwali
EDITORIAL
Dr KK AggarwalDr KK Aggarwal MEDICAL ASSOCIATIONS CRITICISE GOVERNMENT ATTEMPTS TO UNDERMINE PHYSICIANS' INDEPENDENCE

Attempts by the Albanian Government to undermine the independence and self-governance of physicians in the country have been strongly criticised by the World Medical Association, the CPME (Standing Committee of European Doctors), and the German Medical Association.

In a letter to Albania's Minister of Health, WMA leaders have expressed their concern about the Ministry of Health's involvement in the election for President of the Order of Physicians of Albania by nominating its own candidate. When its candidate lost the election, the Government challenged the election result in court last month.

In their letter, WMA President Sir Michael Marmot and Council Chair Dr. Ardis Hoven write: ‘We were surprised to learn of the Ministry of Health's involvement in the election process and the legal proceedings taken against the Order of Physicians of Albania. In order for the OPA to remain effective in accordance with international standards, it must retain its independence. This is essential to the OPA's status as a constituent member of international organizations like the World Medical Association.'

They added: ‘On behalf of the World Medical Association, we reiterate our firm commitment to our colleagues in the Albanian medical profession and call upon the Ministry of Health to respect the independence of the Order of Physicians of Albania and to enable the system of physicians' self-governance to flourish in Albania.'

Dr. Katrín Fjeldsted, President of the CPME, said: ‘The Order of Physicians of Albania is a valued member of CPME. Across Europe, we see that independent and democratic representative bodies for doctors benefit society as a whole. We hope the Albanian authorities will take note and strengthen the Order of Physicians of Albania.'

Professor Frank Ulrich Montgomery, President of the German Medical Association, also called upon the Albanian government to recognise the essential role played by an independent Order of Physicians of Albania: ‘Our organisations are united in our dedication to a system of physicians' self-governance. Because it is proven to enhance professional integrity and to ensure quality care, effective self-regulation is one of the key features of the healthcare systems in our region.'

In a separate letter to Dr. Fatmir Brahima, the newly elected President Order of Physicians of Albania, the WMA leaders write: ‘On behalf of the World Medical Association, we would like to assure you of our firm and continued commitment to our colleagues in the Albanian medical profession. We fully support the independence of the Order of Physicians of Albania and have called upon the Albanian Ministry of Health to duly respect the system of physicians' self-governance in your country. We wish you strength and determination in the face of the challenges currently confronting your organization and urge you to continue advocating for that which is in the best interests of physicians and their patients.'
Breaking News
AHA: SPRINT results confirm lower is best BP strategy
Lowering systolic blood pressure to a goal of 120 mm Hg in patients at high risk of cardiovascular events reduced the risk of heart attack, stroke, or death by 25% in the randomized SPRINT trial compared with the conventional target of 140 mm Hg, a robust benefit that many believe provides a convincing "lower is better" argument. In addition, the lower-target group had 27% lower risk of all-cause mortality and 43% lower risk of CV death. However, this group also had higher adverse events such as hypotension, syncope, and acute kidney injury (AKI) or failure. Over 3.26 years there were 243 deaths, heart attacks or strokes in the intensive treatment group for an event rate of 1.65% per year versus 319 events -- 2.19% per year -- in the control group, said Jackson T. Wright, MD, PhD, of University Hospitals, Case Western Reserve University in Cleveland, in an interview. Wright was lead investigator of the study. SPRINT was funded by the National Institutes of Health (NIH) and included more than 9000 US patients who were hypertensive but not diabetic… (Medpage Today, Medscape)

Smell test offers hope of early Parkinson's diagnosis

A test based on the smell of someone's skin may allow the early diagnosis of Parkinson's disease, say United Kingdom (UK) researchers, led by Perdita Barran, PhD, professor of mass spectrometry and director of the Michael Barber Centre for Collaborative Mass Spectrometry, University of Manchester, UK, who have launched a study to investigate chemicals secreted by patients with the disease. The study was inspired by a "super smeller" who detected a distinct odor on the skin of her husband, who had Parkinson's disease that was strongest both before he was diagnosed and toward the end of his life. The smell was subsequently detected in a small pilot study, and now it is hoped that, if this is replicated in a 200-strong controlled study, it could lead to a test that could offer early diagnosis of Parkinson's disease and monitoring of disease progression… (Medscape)
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Specialty Updates
• Statins may slow the damage to white matter in the brain in individuals with mild cognitive impairment, thus slowing the cognitive decline, suggests a new study published in Alzheimer's & Dementia.

• A meat-rich diet, in association with genetic factors, may increase the risk of developing kidney cancer, through mechanisms related to particular cooking compounds, suggested a study published online in the journal Cancer.

• For infants hospitalized with acute bronchiolitis, nebulized hypertonic saline (HS) without adjunctive bronchodilators is safe but not superior to 0.9% normal saline (NS) in reducing length of stay in the hospital, suggested a randomized clinical trial published online November 9 in Pediatrics.

• Riding a bus or train to work instead of driving a car could significantly reduce the risk of high blood pressure, diabetes and being overweight, suggested a new study presented at the American Heart Association's Scientific Sessions 2015.

• A meta-analysis examining neuroimaging studies of neurologic and psychiatric disorders concludes that they are distinct illnesses. The study was published in the November issue of the British Journal of Psychiatry.

• A US Food and Drug Administration (FDA) panel voted unanimously to recommend sugammadex for reversal of moderate or deep neuromuscular blockade induced by rocuronium or vecuronium during surgery.

• Patients with suspected axial spondyloarthritis (AxSpA) on full-dose nonsteroidal anti-inflammatory drugs (NSAIDs) had a high drop-out rate, reported a 6-week Belgian study of daily practice. In those who tolerated therapy, there was no clinically relevant decrease in Spondyloarthritis Research Consortium of Canada (SPARCC) scores and low Bath Ankylosing Spondylitis Disease Activity Index 50 (BASDAI 50) response. The findings were published in Arthritis & Rheumatology.

• Obese patients with psoriasis or psoriatic arthritis reported clinical improvements following weight loss associated with bariatric surgery, suggested new research presented at the annual meeting of the American College of Rheumatology.

• A funding crunch and procurement delays in the state-run HIV/AIDS program have disrupted supplies of free condoms, thus hampering India’s fight against AIDS. Government data released recently showed about two-thirds of India's 31 state AIDS units had less than a month's supply of condoms.

• Some patients with operable pancreatic cancer and elevated levels of the CA 19-9 biomarker should receive chemotherapy first, rather than undergo the usual approach ? surgery followed by chemotherapy. That is because patients with elevated CA 19-9 levels, which are associated with worse outcomes in general, benefit from the hit of chemotherapy before surgery. The findings of this study were presented November 9 at the Western Surgical Association annual meeting, in Napa, California.
eSpiritual
Diwali the Festival of Inner Purnima on Outer Amavasya

Diwali is celebrated on the day of Amavasya but the festival is symbolized by inner happiness, lighting or Purnima. Moon in mythology is symbolized by cool positive thoughts. Normally one encounters negatives thoughts on the day of Amavasya and positive thoughts on the day of Purnima.

Diwali is the only day in a year where one experiences positive thoughts on the day of Amavasya, hence some people believe that Diwali symbolizes Diwali with inner Purnima and outer Amavasya. Diwali celebrations also coincide with the terminal phase of Chaturmas, the four months of negative state of mind. The purification process in Chaturmas starts with 1st Navratri falling on Amavasya. During these nine days, one undergoes mind, body and soul detoxification by not thinking negative, doing positive things and acquiring soul based knowledge. The mind, body detoxification during Navratri ends with killing of Tamas (Kumbhakarna), Rajas (Meghnath) and ego (Ravan) and victory of consciousness (Rama) over the evil.

These benefits do not lead to inner Moksha or happiness until 20 days, the day of Diwali. In order to continue getting benefits of Navratri one needs to fast with positive state of mind every fourth day till Diwali. On Sharad Purnima, the fast involves thinking positive with a cool mind to get health benefits. Four days later, on Karvachauth again, one fasts and worships the Moon with positive thoughts and acquires longevity benefits. Four days later on Ahoi Ashtami again, one worships the moon and the stars with positive thoughts and acquires fertility benefits. On the day of Dhanteras one acquires a win over the fear of death (Yama). On this day, the fast involves deeper meditation (Samudra manthan) to get all the benefits of Samadhi. At the end of the meditation in the state of Samadhi, one gets in touch with the consciousness or the God, the insight gets illuminated and a person experiences bliss, a state of ecstasy of inner happiness and that is what is called experiencing inner Purnima on the day of outer Amavasya and the festival is celebrated as Diwali.

Let us all worship this Diwali as a state of positive mental state. This one month of purification of thoughts helps one in combating the depression phase seen in winter.

Diwali is the only Amavasya where one does not do Shraadh pooja. On Diwali Amavasya (falling in Chaturmas) one is allowed to start any new project. Even deaths on this Amavasya are considered auspicious (unlike on other Amavasya days).
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Legal Quote
Martin F. D'Souza vs Mohd. Ishfaq SCI: 3541 of 2002, dated 17.02.2009

“An expert should be consulted in case of any doubt”
Medicofinance
Developing an Investment Portfolio

There are five basic asset categories in an investment portfolio. These are:

• Liquid Assets (Cash and Equivalents)
• Bonds
• Stocks
• Real Estate (residential and investment property)
• Gold

Before allocating funds to each of these investment categories, it is important to look first at the balance of the existing portfolio. Then, the actual percentage allocated to each category will depend on the doctor and his/her circumstances.

(Source: IJCP)
Industry News
Flipkart relaunches mobile web business: Flipkart Ltd, India’s largest e-commerce firm, relaunched its mobile web business by introducing web-based apps that will potentially make it easier and more convenient for people to shop on mobile phone browsers, as the company seeks to dominate smartphone-based shopping and avoid losing customers to rivals. Flipkart shut its mobile website in March, a move that was seen as a precursor to it becoming an app-only shopping platform. Flipkart’s Myntra unit went app-only in May… (Live Mint – Mihir Dalal)

The booming logistics industry in India: Booming ecommerce seems to have put India’s logistics business in consolidation mode. Today, Delhi-based Shadowfax, an on-demand delivery service, announced that it has acquired smaller player Pickingo for an undisclosed amount. India’s logistics industry is estimated to be worth $130 billion and may touch $300 billion by 2020. It has seen a great deal of activity, especially as ecommerce picks up pace, but is still highly fragmented. According to Indian consulting firm Technopak, India’s ecommerce start-ups spend as much as 30% of their net income on logistics… (Business Standard - Paloma Ganguly / Tech in Asia)

Startups UrbanClap, Easyfix and Easyrewardz come up with novel gift ideas for staff on this Diwali: Startups like UrbanClap, Easyfix and Easyrewardz, to name just three, have taken up offbeat routes to celebrate Diwali with employees. They are known for doing innovative and creative business and this Diwali, startups have come up with novel ideas and concepts that companies can gift to their employees. UrbanClap, which provides instant professional solutions to its customers, from interior decoration to birthday celebrations and plumbing services, is giving its employees the same facilities and options to choose from as Diwali gifts – apart from bonus… (The Financial Express- IANS)

5 questions you must ask yourself before incorporating your startup: What is the first thing we should do after opening a new business? Incorporating it into a legal entity like private limited or partnership firm, right? No, wrong. The first thing should be finding a customer for your product, even if it isn’t ready yet. That may be considered a contradictory piece of advice to a traditional lifestyle business. If you are opening a business where you will start getting revenue from the first day, then you must incorporate your business before opening your shop… (Yourstory- Guest Column)
IMA Satyagraha
IMA Satyagraha, suggested slogans

• Allow doctors to treat patients irrespective of patients’ income - If compensation is not capped, we can't do this.
• Writing prescription drugs by anyone other than with an MBBS degree is injurious to peoples’ health.
• Please allow Doctors to treat poor and rich equally.
• More patients will die if doctors are not provided protection during duty hours.
• Death does not mean negligence.
• Save single clinic and small establishments - Exclude them from Clinical Establishment Act
• PCPNDT Act needs graded punishments

View Video: https://www.youtube.com/watch?v=UV1zCH33BlU
IMA Nationwide Satyagraha on 16th November
Dear Sir, I am highlighting the A to I (9-Point agenda) to be placed for deputation to MPs as received from our national leaders.

Memorandum (9 points) in simplified way to remember (A to I)

1. A: Assault prevention. With modification of IPC and CrPC
2. B. B Sc Community Health withdrawal. This will generate quackery and will endanger life of village people.
3. C. Capping of compensation in alleged medical negligence cases.
4. D. Development and strengthening Primary health care and rural health services.
5. E. Enactment of Clinical Establishment Act and keeping small and medium health care institutions and single doctor's chamber out of the purview of the act for the sake of their viability.
6. F. Financial allocation and improved budgetary provision on health.
7. G. Good quality of drugs to be made available at an affordable cost.
8. H. Humanistic amendment of PCPNDT Act (1994, amended 2003) with simplification, concentrating on obstetric ultrasounds, clarification of offences etc.
9. I. Immediate barring crosspathy i.e. other system than allopathy to practice modern medicine indigenously or through bridge courses.

Dr Ranjan Bhattacharyya
MD, DNB (Psychiatry)
Asst Prof and Head, Dept. of Psychiatry, Murshidabad Medical College and Hospital
Hony Secretary, IMA Berhampore branch.
Representative to the zone, Indian Psychiatric Society, West Bengal State Branch
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22nd MTNL Perfect Health Mela, the annual flagship event of the Heart Care Foundation of India
What forced medicos to adopt the Satyagraha path?

Doctors across India have been feeling the heat from all sections of society may it be mob fury resulting in assault on doctors or judiciary’s wrath in terms of imposition of huge compensations in cases of alleged negligence or making doctor a scapegoat for falling sex ratio or selective targeting of allopaths for all ills in medical profession whereas non-allopaths are allowed to practice allopathy under broad day light or even government’s attempt to cover-up the failure of public healthcare sector by getting control over privately owned health institutions by imposing Clinical Establishment Act with irrational clauses. Doctors have been requesting government to look into their woes and resolve the issues. Seeing no respite from any corner, we the doctors are forced to adopt the Satyagraha path in our nationwide protest on November 16, 2015. If society expects doctors to behave as (second) Gods, then they have to treat them in that manner- it can’t be that you label doctors as demons and expect them to behave like God!

Medical professionals are daily grappling with emergencies in which there is a very thin line between “live” and “dead” status of serious patients. Slightest of error of judgment attracts wrath of relatives, society; adverse propaganda in media and huge compensations from consumer forums/ courts in the name of deficiency of service. Modern day society has an inbuilt hatred and suspicion against doctors that may even manifest as ransacking/arson of pediatrician of Mansa on one day and gunning down of Jind doctor at another day. Advancement of technology has also in a way contributed more negativity against the pious medical profession as most of the prescriptions and case records are tallied with Google to detect slightest of deviation from Dr Google’s expert line of treatment. A doctor, who builds his house after 20 years of hard work is termed as “lootera” building up his house out of public’s money, Doctor owing a car gives gossip- “logo ki jeb kaat kaat kar gaadi mein ghoom raha hai”, Doctor goes abroad even for attending a conference makes people think “zaroor kisi company ne trip sponsor kiya hoga”.

Doctors face assault, hospitals are ransacked after death of a patient and rioters have rarely been punished so far. Numerous acts, unending list of legislations, rulings etc. added to such vulnerability make medical profession less sought after in India these days. Today, doctors in India are in a frightened state of mind and usually don’t wish their wards to opt for their career. Entrepreneurship (setting own hospital) amongst doctors has taken a back seat, young doctors are left with three options- move to foreign countries for want of security and better prospects, join government service (if available) and finally joining corporate hospitals in search of better deal. Talking of public health scenario of India, even government hospitals are in a bad state with huge rush of patients, very less specialists and unimaginable number of surgeries/ deliveries/ caesareans with respect to number of gynecologists/ surgeons/ anesthetists. Episodes such as Chhatisgarh sterilization deaths where poisonous medicines of government supply killed the patients, but the doctor R K Gupta, labeled as doctor death, is still behind bars leave a permanent scar of fear and insecurity on the minds of doctors.

In order to provide state of the art healthcare facilities, one has to spend at least 450 crores for a 300 bed hospital. After spending this much amount commercialism is bound to creep in and expenses on healthcare are bound to be sky high. On the contrary small setups with modest facilities, are within the reach of most people and provide a blend of good competence with affordability. Obviously if one is going to a hospital with world class facilities, he/she shall find deficiencies in the relatively affordable small setup. But consumer law and forums in many of their orders expect even small setups to provide same world-class care. Crux of the story here is that medical profession is dogged with innumerable problems; a few of them described here below:

• On one hand medical profession is labeled as a commercial venture for all billing and tax purposes, in the name of ethics/ code of conduct doctors are not allowed to advertise the facilities in their hospitals. Clause 6.1 regarding advertisement in the Code of Medical Ethics 2002 notified under the IMC Act 1965 and followed by the State Medical Councils needs a re- look keeping in view of the present scenario of corporate health sector and rapid advances being made in the medical sciences. The individual doctors are at a distinct disadvantage vis-à-vis corporate health sector as far as public visibility. More over the rapid advances being made in the medical field necessitate that such information is disseminated quickly and effectively to the needy patients so that they can take advantage of the latest treatments. Strictly monitored and logical advertisements can help in creating awareness about the latest available treatments at nearby centers, which can benefit many patients hugely who may not be aware of such medical facilities in the neighborhood.

• It is a matter of great concern that in spite of the clear guidelines laid down by the Supreme Court in Jacob Mathews Case in Aug 2005 that a preliminary enquiry is must before entertaining a private complaint against a doctor alleging negligence, police officers keep on registering cases under section 304 A against doctors and have even arrested them. Following such event there are bound to be headlines painting the doctor as a Merchant of death, Doctor Death etc. Even if the doctor is proved innocent in the medical board’s report, the career of the doctor stands finished by the rash act on the part of police as well as such ruthless journalism. The offence under Medicare Services protection Act (in many states) is Cognizable and non-bailable and it has a provision for one year imprisonment and fine of Rs 50,000- along with penalty of double the purchase price of the medical equipment and property damaged. But the police concerned officers don’t book the culprits under the provisions of this Act in spite of the insistence by the complainant doctor and thus dilute the case. This encourages the miscreants to create trouble at hospitals and nursing homes. Rising cases of assault on doctors and ransacking of the hospitals is testimony to the fact that the desired motive of this Act has not been achieved due to its faulty implementation.

• PC & PNDT Act 1994, even after 20 years of implementation has not yielded desired results aimed to curb feticide; it has only resulted in harassment of doctors who have been made a scapegoat in the witch hunting exercise. It is time that some new idea is tried. Let there be some amendments in the PC & PNDT Act- there should be compulsory sex determination of the fetus in all pregnant ladies and those mothers having female fetus should be followed up to delivery and their babies up to one year. The vast network of ASHA workers and staff at disposal of the Civil Surgeons can easily do this monitoring. Let the parents and society with help from health department guard their female babies. “Beti Bachao, Beti Padhao” scheme announced by Ms Maneka Gandhi, which is incentive targeted rather than doctor targeted is a laudable step. Recently the Govt. of India came up with 6 months ultrasound training even for existing Sonologists with up to 25 years of experience. What this training has to do with curbing sex selection-most doctors fail to understand. In cases of alleged violations of the act, different yard sticks are used for imposing punishment.

• Most non allopaths practice allopathy in broad daylight whereas the onus of adhering to ethics is only with qualified allopaths. In the name of Biomedical waste disposal, medical profession has been given under pollution control boards, in the name of fire safety it has been given under fire department, in the name of safeguarding of ethics it has been given under state medical councils, in the name of checking sex determination/feticide it has been placed under Civil Surgeons, in the name of hazardous profession municipal corporations keep serving notices of license fees etc. No such taboos apply to quacks, tantriks who are free to do whatever they like and even give advertisements for their claims. Rules of the game have to be the same, same have to be the yardsticks. Crosspathy has to stop.

We are on agitation by compulsion, not by choice!

Doctors are a part of society, none denies the degradation of moral values of society; some medicos are also bound to sweep along the downward waves- but that is the reality in most other professions also. That does not justify genocide of doctors. Many positive steps are needed to be taken by society, judiciary as well as government to boost the sagging morale of doctors in India; otherwise the day is not far when there will be total exodus of doctors from India! God save the society!

Dr Amandeep Aggarwal
Central working Committee member, Indian Medical Association
Longowal, District Sangrur- Punjab
Met Dept predicts severe levels of pollution in Delhi during Diwali
The meteorological department has cautioned that pollution level during Diwali night is expected to be "severe" due to bursting of firecrackers and advised those persons with heart and lung diseases to stay indoors. According to System of Air Quality, Weather Forecasting and Research (SAFAR), an agency of Ministry of Earth Science responsible to track pollution levels the national capital said, November 12-13 is expected to witness dense haze formation. The Diwali this year is falling on November 11. The peak time pollution is expected at 1 AM and the duration for maximum pollution will be between 10 PM to 2 PM on the intervening night of November 11 and 12 and 7-9 am early morning… (DNA)
Indian-Americans raise $200,000 for healthcare in rural India
Washington: Indian-Americans have raised nearly USD 200,000 to reduce maternal and child mortality in impoverished rural areas of India. The fund was raised at an annual gala organised by American India Foundation here which was attended by influential guests from the US and Indian governments, corporate and entrepreneur leadership, media and philanthropy. In his keynote address, renowned film writer, lyricist, and poet Javed Akhtar, who was honoured at the event, praised the involvement and contribution of the American-Indian community in strengthening villages and small towns in India… (ET HEalthworld – Lalit K Jha)
Germany bans assisted suicide
Berlin: Germany on Friday passed a law banning professional assisted suicide services - even if practitioners say they do so purely in the interest of suffering people. Critics warned however that this meant doctors could now face prosecution for helping their terminally ill patients to die. Under the new law, passed with 360 in favour out of 602 votes, assisted suicide remains permitted in Germany, but anyone who turns it into a professional service -with or without payment - faces three years in jail. In practice, this means that a husband who helps his terminally ill wife to die would not be prosecuted. But an association or a business that repeatedly offered to help people die would face prosecution… (ET Healthworld – AFP)
GP Tip
Waiting room tools can calm kids

Placing old stethoscopes, patella hammers, and other “discarded” tools of the trade in the waiting room helps to calm kids. As young patients get acquainted with these instruments, they are less fearful when the doctor uses such tools on them during physical examinations. (Source: IJCP)
eWellness
The hazards of eating sweets during Diwali

• Mithai or Sweets are usually made in trans fats (Vanaspati) which lower the good cholesterol and increase bad cholesterol. Sweets are bad for patients with high blood pressure, diabetes, obesity or heart disease.

• Diwali sweets have very high content of white sugar and cause metabolic syndrome, insulin resistance and resultant rise in blood pressure, blood sugar and weight.

• The sweets may have non-permissible colors, which may cause allergy (skin or lung). These colors may also be carcinogenic in the long run.

• Most sweets are recycled from one family to another. The sweet packets are often left in the car for hours together and sometimes even overnight before getting distributed the next day. Any food items kept in the room temperature for more than two hours may not be good for the health.

• There may be adulteration in the ingredients used and may have harmful effects on the health depending upon the adulterant used.

• Most sweets are overeaten till they are finished. On the day Annakoot therefore it’s a tradition to neutralize the sweet taste by bitter vegetables taste but often the same is not followed.
Bioethical issues in medical practice
Rights and duties of a parent

Smita N Deshpande

Head, Dept. of Psychiatry, De-addiction Services
PGIMER-Dr. Ram Manohar Lohia Hospital
Park Street, New Delhi

A girl suffering from intellectual disability, serious enough so that she could not take care of herself became pregnant at the care home. By the time the pregnancy was discovered she was pregnant for over four months. The girl was admitted to a government hospital and assessed for MTP. The girl insisted- from the point of view of her limited understanding of the matter- that she wanted to keep the child and bring it up herself. Doctors at the hospital where she was admitted after the pregnancy was discovered were of the opinion that she was intellectually unfit to look after herself, what to say of a child. What should the doctors do?

a) Carry out MTP regardless of the girl’s wishes

b) Allow the pregnancy to continue possibly to the future detriment of the unborn baby.

c) Any other recourse such as going to court – but what if the court orders continuance of the pregnancy? Who will look after the baby?

Do write in with views and your solutions!
 
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Inspirational Story
I'm Glad I Got Sick

Twenty-seven years ago I got sick. The reason I can remember the date so well is because being sick is what caused me to choose my future wife. She was just a good friend, but because she came over to my apartment, brought me medicine, and made me breakfast, I thought for the first time "what a super wife she will make for someone."

I took her out to eat in Nashville, Tennessee for helping me get over the flu. After that we became even better friends, but still no thought of marriage. A few months later I was going to take a new job in the Atlanta area with a Community College, so Cathy helped me pack up boxes to get ready to leave. We had a great time that day and had lunch together. Near the end of that day I noticed a few tears in Cathy's eyes, so I asked what was wrong.

She said, "I don't know if I can live without you, you are my best friend." I said, "I know, I've been thinking the same thing." That day we decided to get married and we have been married ever since. We have had our tough times, as many others have had, but we are still BEST FRIENDS!

When I get to the family unit in my Health class and we talk about marriage ...I always tell this story. My students seem to love it because they learn for the first time that giving, sharing and caring about others is all that really matters in life, and that sex, looks, money and other things are secondary.

By the way, my wife is 12 years younger than me, and she is beautiful. Coaches constantly kid her about marrying me; they say she must be blind. We have two beautiful children, but we still have dates on every week-end.

Cathy is the greatest thing that has ever happened to me! She is a fantastic mother, and the best wife a coach could ever have. Thank God I got sick 27 years ago!!
eMedi Quiz
Which of the following is not a post transcriptional modification of RNA?

1. Splicing.
2. 5' Capping.
3. 3' polyadenylation.
4. Glycosylation.

Yesterday’s Mind Teaser:  Which of the following is present intracellularly in muscle cells:

1. Insulin.
2. Corticosteroid.
3. Epinephrine.
4. Glucagon.

Answer for Yesterday’s Mind Teaser: 2. Corticosteroid.

Answers received from: Dr K.Raju, Dr K V.Sarma, Daivadheenam Jella, DR ARPAN GANDHI, arvind kumar, Baradakanta Mishra, Dr.B.R.Bhatnagar, Dr.Jayashree Sen & Dr.Bitaan Sen

Answer for 9th November Mind Teaser: 2. pKa

Answers received from: Dr Avtar Krishan, Dr.Bitaan Sen & Dr.Jayashree Sen, Dr Jainendra Upadhyay
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Humor
Murphy's Laws for Humor

If at first you don't succeed? Destroy all evidence that you ever tried.
Readers column
Dear Sir, great explanation on Diwali. Regards: Dr Shruman
Press Release
Be safe and healthy this Diwali season

As one approaches the festivals of lights, they often forget the health risks that come with it. Necessary precautions are a must to enjoy the festive season to the fullest.

Speaking about this, Padma Shri Awardee – Dr KK Aggarwal – President HCFI and Honorary Secretary General IMA said, “This Diwali, we must take a pledge to take necessary precautions to prevent environmental pollution and accidental injuries. We must also eliminate evils like smoking and drinking from our lives. With the rising incidence of lifestyle diseases it is important that everyone restricts the consumption of food containing high levels of trans fat, sodium and refined sugar. We must deal with stress through a holistic approach and to do away with anger and negativity from our lives. Most lifestyle diseases are preventable and manageable, only when necessary precautionary measures are taken. We must work towards beating obesity, heart disease, hypertension and diabetes.”

Here are a few tips for a healthy and safe Diwali

Candle Pollution: One should be careful of candle pollution. Candles made from beeswax or soy, although more expensive, are safer because they do not release potentially harmful pollutants.

However an occasional paraffin candle and its emissions do not harm but lighting many paraffin candles daily or lighting them frequently in an unventilated bathroom around a tub, may cause problems. Pollutants from burning candles can also cause respiratory irritation and allergy. The candles, which are made from petroleum, are a source of known human carcinogens and indoor pollution.

Diwali Sweets: White sugar in sweets can lead to uncontrolled diabetes and weight gain in individuals. Adulterated khoya can cause GI upset. Artificial coloring in sweets can cause cancer in long run. Eating chocolates can add to calories in blood sugar. The best item for Diwali is fruits and dry fruits.

Diwali Fire Hazards: Diwali should not lead to fire with resulted burns and loss to life. In case of burning the effected part should be put in the running water till burning disappears. Blisters should not be punctured, as they work like a natural dressing.

Eye injury- Particle of crackers can cause eye burn. Continuous water should be poured into the effected eye till the burning is over.

Safe dressing- if medicated bandage is not available, one can use a piece of cloth and iron it. It will work like a medicated bandage.

Diwali Pollution: The condition of patients with COPD (Adult Asthma) may worsen in Diwali festival and they should use wet clothes whenever they are exposed to smoke.

Noise Pollution: Excessive noise pollution during Diwali day can cause hearing loss. One should wear earplugs to avoid noise related ear injury. Noise pollution can also cause high blood pressure and mental irritation.