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12th October, 2017
 Meaning of Birthday
Dr KK Aggarwal
A birthday is the day when we should file our Vedic returns of all that we have done, good and bad, in the last one year.
All of us are born with both Sanchit Karma and Prarabdha Karmas. Prarabdha Karma are the part of sanchit karma, a collection of past karmas, which are ready to be experienced through the present body in this lifetime. We have to bear the fruits of Prarabdha Karmas, while Sanchit Karmas can be negated with our positive Karmas, both present and future.
On this day, we must also make a balance sheet of our three debts and pay them if not paid by this time. There are three types of rins (debts): Dev Rin, Pitra Rin and Rishi Rin. God or the devtas gave us the consciousness, parents gave us our body and teachers gave us the knowledge or intellect.
I file my Vedic returns at 6 pm, the time of my birth, every year on my birthday.
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Top News
Today is World Arthritis Day: "It's in your hands, take action"
World Arthritis Day is celebrated every year on October 12. It is a global initiative to raise awareness about rheumatic and musculoskeletal diseases among the general public and the various issues that patients with rheumatic and musculoskeletal diseases face. The theme for World Arthritis Day this year is "It's in your hands, take action".

Today is World Sight Day: "Make Vision Count"
World Sight Day is observed every year on the second Thursday of October, which happens to be today this year. By focusing global attention on blindness and vision impairment, the day highlights various eye care issues that affect people all over the world. The theme this year is "Make Vision Count".

Prime Minister launches Intensified Mission Indradhanush (IMI) 
"Let no child suffer from any vaccine-preventable disease". This was stated by Prime Minister Shri Narendra Modi as he launched the Intensified Mission Indradhanush (IMI) at Vadnagar in Gujarat on Sunday. Through this program, Government of India aims to reach each and every child under two years of age and all those pregnant women who have been left uncovered under the routine immunization programme. The special drive will focus on improving immunization coverage in select districts and cities to ensure full immunization to more than 90% by December 2018. The achievement of full immunisation under Mission Indradhanush to at least 90% coverage was to be achieved by 2020 earlier. With the launch of IMI, achievement of the target has now been advanced...(Press Information Bureau, Ministry of Health and Family Welfare, October 8, 2017).
Practice Updates
Ovarian reserve tests fail to predict fertility
Tests that estimate ovarian reserve before menopause, do not appear to predict short-term chances of conception in older women still of reproductive age, according to a study of women with no history of infertility published October 10, 2017 in the Journal of the American Medical Association. No significant differences in results were observed between women with low levels and normal levels of anti-Mullerian hormone after six cycles of attempting to conceive; 65% vs 62%, respectively.

Aging slows perception of falls
Older adults need twice as long as young adults to realize they are falling, says a new study published October 11, 2017 in the journal Gait & Posture. This delay in perception of falls puts them at greater risk of serious injuries. While young adults required the fall to happen about 44 milliseconds before the sound in order for both cues to be perceived as occurring simultaneously, older adults required fall onset to occur about 88 milliseconds before the sound.

Cigarette smoking increases SLE risk
Smoking has been implicated in the pathogenesis of systemic lupus erythematosus (SLE) in analysis of data from the Nurses' Health Study and the Nurses' Health Study II reported online October 7 2017 in the Annals of the Rheumatic Diseases. A strong and specific association of anti-double stranded DNA-positive SLE was seen between current smoking and >10 pack-years of smoking.

Antithrombotics associated with increased risk of hematuria-related complications
Use of antithrombotic drugs was found to be significantly associated with hematuria-related complications including emergency department visits, hospitalizations and urologic procedures in older adults aged 66 years and above in a study published October 3, 2017 in JAMA.

MR enterography accurately diagnoses active inflammation in children with IBD
A systematic review and  meta-analysis published online October 9, 2017 in JAMA Pediatrics shows that the noninvasive, radiation-free technique, magnetic resonance enterography can accurately diagnose active inflammation in children with known or suspected inflammatory bowel disease (IBD).
eMedi Humor
Preacher's Wish from God

A preacher went into his church and he was praying to God. While he was praying, he asked God, "How long is 10 million years to you?" God replied, "One second." The next day the preacher asked God, "God, how much is 10 million dollars to you?"
And God replied, "A penny." Then finally the next day the preacher asked God, "God, can I have one of your pennies?" And God replied, "Just wait a sec.
Medicolegal Corner
Can a telephonic medical consult be regarded as a valid consult?

The MCI, Clinical Establishments (Registration and Regulation) Act (CEA) and National Commission for Human Rights (NCHR) Acts are silent on this issue. However, in a Supreme Court of India judgement (SCI: 3541 of 2002, Martin F. D'Souza vs Mohd. Ishfaq, dated 17.02.2009), Justice Markandey Katju and Justice GS Singhvi gave directions to all medical establishments and doctors and observed: "54 (iii b): No prescription should ordinarily be given without actual examination.
The tendency to give prescription over the telephone, except in an acute emergency, should be avoided." It is implied that a tele-consult is a full consult but should be used only in an emergent situation and not as a routine. Being a consultation, it can be billed.
eMedi Quiz
The nurse applies mafenide acetate to the patient, who has second and third degree burns on the right upper and lower extremities, as ordered by the physician. This medication will: 
A. Inhibit bacterial growth 
B. Relieve pain from the burn 
C. Prevent scar tissue formation 
D. Provide chemical debridement
Lifestyle Updates
eWellness: Have leg artery blockages? Walk on a Treadmill

A planned program of walking is good for people with blockage of leg blood vessels called peripheral arterial disease (PAD). 
There is the potential for greater oxygen extraction from the blood under maximum exercise conditions. The muscles can make better use of blood flow and the oxygen release that comes from it. 
Such exercise leads to improvement in "collateral circulation"- growth in the number of blood vessels supplying the legs. Clinicians should urge all PAD patients, whether or not they have symptoms, to engage in a regular, supervised exercise program. 
Walking is a standard recommendation for people with PAD. A recommended regimen is a 40-minute walk three times a week for at least six months. 
Persistent leg pain is an indication that help is needed. In the absence of that symptom, physicians can test for PAD by measuring the difference in blood pressure between an ankle and an arm.
ESpiritual: Do what you do to God
  • There are two types of people who believe in Dvaita or Advaita philosophy.
  • For people who believe in Dvaita philosophy, God and human being are different.
  • The people who believe in Advaita philosophy believe that God is within them.
  • In Hinduism, the first group believes in Sanatan Dharma and does idol worship (Moorti pooja) and the second group Arya Samaj, which does not believe in idol worship.
  • In both situations, medically the message is one.
  • If God is different than you, then you try to be like Him and if God is in within you, then you are Him.
  • In both situations, we should deal with our body the same way as we deal with God.
  • Anything which is not offered to God, we should not offer to our body. The examples are cigarettes, drugs etc. and things like onion, garlic, radish etc. should be consumed in less quantity.
  • We never worship God with hydrogenated oil; we always worship him either with oil or with Desi Ghee. The message is that we should not consume trans fats.
  • We never feed God "Bhagwan ko bhog lagate hain". The message is we should eat less.
  • Amongst all Gods, only Lord Shiva is said to consume Bhang and Alcohol that too only in Bhairon incarnation, which indicates that both alcohol and bhang can be consumed in some quantity only in special situations that means that they cannot be consumed without medical supervision.
  • Anything grown under the ground is not offered to God, thus, these items should not be eaten or eaten in moderation.
  • We never offer God white salt and white rice. They are bad for human beings also.
  • Gur, shakkar, brown rice and puffed rice are offered to God. They can be consumed by human beings.
(Disclaimer: The views expressed in this write up are my own).
Inspirational: Benefits of Struggling

A man found a cocoon of a butterfly. One day a small opening appeared, he sat and watched the butterfly for several hours as it struggled to force its body through that little hole.
Then it seemed to stop making any progress. It appeared as if it had gotten as far as it could and it could go no farther. Then the man decided to help the butterfly, so he took a pair of scissors and snipped off the remaining bit of the cocoon. The butterfly then emerged easily.
But it had a swollen body and small, shrivelled wings. The man continued to watch the butterfly because he expected that, at any moment, the wings would enlarge and expand to be able to support the body, which would contract in time. 
Neither happened!
In fact, the butterfly spent the rest of its life crawling around with a swollen body and shrivelled wings. 
It never was able to fly.
What the man in his kindness and haste did not understand was that the restricting cocoon and the struggle required for the butterfly to get through the tiny opening were God's way of forcing fluid from the body of the butterfly into its wings so that it would be ready for flight once it achieved its freedom from the cocoon.
Sometimes struggles are exactly what we need in our life. If God allowed us to go through our life without any obstacles, it would cripple us. We would not be as strong as what we could have been. 
And we could never fly.
Bipolar disorder symptoms can be effectively managed with certain lifestyle changes
About 10 to 20 million people in India are affected by this condition
New Delhi, 11 October 2017: As per a recently published study, patients with bipolar depression treated with adjunctive bright white light showed a significantly higher remission rate as compared with the placebo light group. This corresponds to 68.2% vs 22.2%, respectively, at weeks 4 to 6 and significantly lower depression scores at the end of the study period. In India, about 10 to 20 million people suffer from mental disorders, one of them being bipolar disorders.
Bipolar disorder is a condition associated with episodes of mood swings ranging from depressive lows to manic highs. The cycles of mood swings can often last for days, weeks, or months, with the changes being so intense that they interfere with a person's ability to function properly. The condition not only affects daily activities of life, but also the person's relationship with others.
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