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13th October, 2017
Explaining cardiac interventions: Using analogies to improve communication
Dr KK Aggarwal
 The doctor-patient relationship is the foundation of practice of medicine. And, communication is the key factor that decides the interaction between the doctor and his/her patient and influences outcomes.
 
Doctors are bound, both ethically and legally, to provide adequate information to the patient so that the patient can participate in the decision making process and are in a position to take an 'informed' decision.
 
Any information given to the patient should be in a language, using words or using terms he/she can understand.
 
But do patients really comprehend the information that is given to them during the process of informed consent? The science of medicine is abound with complex concepts. Medical terminology uses technical words and jargon that are unfamiliar to the patient and difficult to understand. This may hinder the effectiveness of communication. 
 
One way to improve communication and enhance understanding of medical information is by using analogies. The dictionary meaning of an analogy is a 'resemblance between two situations, people or objects that are otherwise unlike, especially when used as a basis for explanation'.
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Top News
AHA/ASA release new music video to raise awareness of stroke warning signs
 
The American Heart Association/American Stroke Association (AHA/ASA) have released a new parody music video (https://www.youtube.com/watch?v=lTykAih-USY&feature=youtu.be) to teach people how to recognize the most common stroke warning signs. The song features a person having a stroke in a diner and the patrons and staff singing about the acronym FAST, an easy way to teach people the most common stroke warning signs and to call 9-1-1 during a stroke emergency. The acronym F.A.S.T. stands for:
  • Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?
  • Arm Weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • Speech Difficulty: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat any simple sentence.
  • Time to Call 9-1-1: If someone shows any of these symptoms, even if the symptoms go away, call 911 and get to a hospital immediately. (Tip: Check the time so you'll know when the first symptoms appeared.)
(AHA, October 10, 2017)
Practice Updates
Physical activity reduces mortality risk in patients with stable CHD
 
In patients with stable coronary heart disease (CHD), more physical activity was associated with lower mortality. The largest benefits occurred between sedentary patient groups and between those with the highest mortality risk. These conclusions of a global observational study were published October 3, 2017 issue of the Journal of the American College of Cardiology.

Risk factors on rise among people with stroke
 
There has been a significant increase over a 10-year period in the percentage of people with stroke who have high blood pressure, diabetes, smoking and other risk factors for stroke, suggests a study published in the October 11, 2017, online issue of the journal Neurology. Of the 922,451 stroke cases, 93% of people had one or more risk factors, which increased from 88% in 2004 to 95% in 2014.

New UK guidelines for diagnosis and treatment of lupus
 
The first UK guideline on the management of adults with systemic lupus erythematosus (lupus) formulated by the British Society of Rheumatology have been published October 6, 2017 in the journal Rheumatology. These guidelines cover diagnosis, assessment, monitoring and treatment of patients with mild, moderate and severe lupus.

Study links vegetarian diet to depression
 
Vegetarian men were found to have more depressive symptoms after adjustment for socio-demographic factors compared to non-vegetarians in a study of more than 9600 men published in the Journal of Affective Disorders. Nutritional deficiencies such as deficiency of cobalamin or iron have been suggested as a probable cause of depression.

Stair-related injuries are common in all age groups
 
According to a study published online September 20, 2017 in the American Journal of Emergency Medicine, individuals of all age groups visit the emergency departments for sprains, stair-related injuries, though older adults, younger children and women reported more injuries. The most common types of injury were sprains and strains (32.3%), soft tissue injuries (23.8%) and fractures (19.3%). The lower extremities (42.1%) and head/neck (21.6%) were the most frequently injured body regions. 
 
eMedi Humor
Can’t find printer

Customer: Hi, good afternoon, this is Martha, I can't print. Every time I try, it says 'Can't find printer'.
I've even lifted the printer and placed it in front of the monitor, but the computer still says he can't find it...
Medicolegal Corner
Can the patient ask for his/her medical records?
Yes. A patient has the right to get a copy of his/her medical records if he/she asks for it. The Medical Council of India (MCI) Code of Ethics Regulations 2002 states as follows: "If any request is made for medical records either by the patients/authorised attendant or legal authorities involved, the same may be duly acknowledged and documents shall be issued within the period of 72 hours. (1.3.2.)"
eMedi Quiz
What percentage of your diet should fat make up?
A. About 10 percent of your daily calories.
B. About 20 percent of your daily calories.
C. About 30 percent of your daily calories.
D. About 40 percent of your daily calories.
E. There is no recommended amount of fat; you should strive to eat as little of it as possible.
Lifestyle Updates
 
eWellness: Eating refined sugar can cause diabetes

Eating too much refined white sugar can cause insulin resistance and future diabetes.

Diabetes does not mean that one cannot have desserts forever. While eating too many sugary foods should be avoided, one can have an occasional dessert, especially if one exercises and otherwise eats healthy. It's better to substitute brown sugar or Jaggery in that case. Artificial sweeteners including stevia are the other options.

Fruits are healthy for diabetics but cannot be consumed in huge amounts, as they contain carbohydrates.

As per Ayurveda, diabetes is a Kapha disorder and diabetics should limit the intake of sweet, salt and sour taste in the diet. Any fruit or vegetable, which is bitter and dark green has anti-diabetic properties.

One should combine a bitter taste with a sweet taste when choosing a vegetable of a fruit. For example one should not combine peas with potatoes but one can combine potatoes with methi or palak.

Diabetics are not more susceptible to colds and other illnesses but may have more complications of flu.

Taking insulin does not cause hardening of the arteries or high blood pressure.

Diabetes is not contagious and one cannot catch diabetes from someone else.

ESpiritual: Why do we not touch papers, books and people with our feet?

In every traditional Gurukul, no studies start without chanting the following
?
Saraswati namasthubhyam, Varade kaama roopini
Vidyaarambham karishyaami, Sidhirbhavatu me sadaa

"O Goddess Saraswati, the giver of Boons and fulfiller of wishes, I prostrate to You before starting my studies. May you always fulfil me"
 
Indian Vedas consider knowledge about self as the supreme knowledge and all tools for the same are considered sacred and divine and must be given respect. The traditional custom is not to step any sacred educational tool.
 
(Disclaimer: The views expressed in this write up are my own).
Inspirational: The Law of the Garbage Truck

One day I hopped in a taxi and we took off for the airport. We were driving in the right lane when suddenly a car jumped out of a parking space right in front of us. My taxi driver slammed on his brakes, skidded, and missed the other car by just inches! The driver of the other car whipped his head around and started yelling at us. My taxi driver just smiled and waved at the guy. And I mean he was really friendly. So I asked, 'Why did you just do that? This guy almost ruined your car and sent us to the hospital!"
 
This is when my taxi driver taught me what I now call 'The Law of the Garbage Truck.'
 
He explained that many people are like garbage trucks. They run around full of garbage, full of frustration, full of anger, and full of disappointment. As their garbage piles up, they need a place to dump it and sometimes they'll dump it on you. Don't take it personally. Just smile, wave, wish them well, and move on. Don't take their garbage and spread it to other people at work, at home, or on the streets.
 
The bottom line is that successful people do not let garbage trucks take over their day. Life's too short to wake up in the morning with regrets, so....'Love the people who treat you right. Forgive the ones who don't.'
 
Life is ten percent what you make it and ninety percent how you take it.
Every arthritis is different with different treatment methods
A combination of diet, medication, and exercise can help in reducing inflammation and pain
 
New Delhi, 12th October 2017: As per statistics, arthritis affects about 15% of the Indian population, which is over 180 million people in the country.(1) Women are more prone to develop arthritis than men as evident in a recent survey, which showed high erythrocyte sedimentation rate (52.07%) and Rheumatoid Factor (13.08%) in women as compared to men.(2)
 
Arthritis is an inflammation of the joint and can affect one or multiple joints. While arthritis is most commonly seen in adults over the age of 65, it can also develop in children, teens, and younger adults. There are several different types of arthritis, each with different causes and treatment methods. Osteoarthritis (OA) and rheumatoid arthritis (RA) are the two most common types of arthritis.
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