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17th October, 2017
AHA guidance on improving employee health and engagement
Dr KK Aggarwal
The American Heart Association (AHA) has released an evidence review report titled "Resilience in the Workplace: An Evidence Review and Implications for Practice", with practical actionable guidance for employers looking to implement resilience training programs. According to the report, resilience is an emerging, innovative strategy to improve employee health and productivity, and organizational performance.
The CEO Roundtable is the AHA's leadership collaborative with 30-plus member CEOs who represent some of the nation's largest employers who are committed to applying evidence-based approaches to improve their employees' overall health.
Studies suggest resilience training may be a useful primary prevention strategy for employers to improve employee health and engagement. Although there is no consensus on how to define resilience, the report says that "resilience can be considered, in general, the ability to withstand, recover and grow in the face of stressors and changing demands".
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Top News
Today is World Trauma Day
World Trauma Day is observed every year on October 17 to highlight the increasing rate of accidents and injuries causing death and disability across the world and the need to prevent them. Road Traffic Accident is the leading cause of trauma globally, in addition to other causes such as fires, falls, burns, etc. (National Health Portal).

Tenfold increase in childhood and adolescent obesity in four decades
The number of obese children and adolescents (aged five to 19 years) worldwide has risen tenfold in the past four decades. If current trends continue, more children and adolescents will be obese than moderately or severely underweight by 2022, according to a new study led by Imperial College London and WHO published in The Lancet... (WHO, October 11, 2017).
Practice Updates
Menopause is associated with lumbar disc degeneration
Menopause is associated with lumbar disc degeneration, says an MRI study of 1,566 women and 1,382 men published in the October 2017 issue of the journal Menopause. Postmenopausal women in the study had a significant tendency to develop more severe disc degeneration vs their age-matched men including premenopausal and perimenopausal women.

Antithrombotic drugs increase risk of hematuria
According to a study published October 3, 2017 in JAMA, compared with nonuse, the use of antithrombotic medications was associated with a significant increase in rates of hematuria-related complications that required urologic procedures, hospitalization or a visit to the emergency department.

Patients with A1c prediabetes have subclinical LV diastolic dysfunction
According to a study published October 1, 2017 in the Journal of Clinical Endocrinology & Metabolism HbA1c identifies subjects with prediabetes and subclinical left ventricular diastolic dysfunction. Patients with HbA1c prediabetes had lower peak mitral inflow in early diastole (E wave) to late diastolic atrial filling velocity (A wave) ratio (E/A ratio), higher left atrium volume and sphericity index.

Intracameral bevacizumab safe in patients with neovascular glaucoma
A study evaluating long-term efficacy and safety of intracameral bevacizumab in patients with neovascular glaucoma found it to be safe in for corneal endothelium during one year of follow-up. Intracameral bevacizumab produced rapid but transient reduction in intraocular pressure and iris neovascularization.

Dexamethasone+povidone-iodine ophthalmic suspension resolves viral conjunctivitis
In a study presented October 11, 2017 at Academy 2017, the American Academy of Optometry (AAOpt) Annual Conference in Chicago, an ophthalmic suspension (SHP640) containing dexamethasone (0.1%) and povidone-iodine (0.6%) was effective in treating viral conjunctivitis with clinical resolution as evident by absence of bulbar redness and conjunctival discharge. It also eradicated the virus.
eMedi Humor
A traffic slogan: Don't let your kids drive if they are not old enough - or else they never will be
Medicolegal Corner
What are the duties of the physician towards the paramedics?
According to Regulation 5.3, "Physicians should recognise and promote the practice of different paramedical services such as, pharmacy and nursing as professions and should seek their cooperation wherever required."
eMedi Quiz
Isotopic response is seen in scars of which condition?
a. Orolabial herpes 
b. Herpes genitalis
c. Pyoderma gangrenosum 
d. Eosinophilic pustular folliculitis
Lifestyle Updates
eWellness: How to keep your memory sharp?
  • Manage your stress, especially deadline pressure and petty arguments.
  • The biggest stress is an ongoing sense of extreme anxiety. This can be managed by deep breathing, meditation, yoga and by mindful approach to living. 
  • Get a goodnight's sleep. The most common reason for poor sleep is difficulty in falling asleep and staying asleep. Many drugs used to treat insomnia can also impair memory. 
  • If you need a sleeping medicine, it should be used in the lowest dose and for the shortest period of time.
  • Get up at the same time in the morning. 
  • If you smoke, quit. 
  • If you do not drink, do not start. 
  • Alcohol makes it difficult to perform short term memory tasks such as memorizing list. It also induces vitamin B1 deficiency, which can cause dementia. 
  • Protect your brain from injury as repeated minor head trauma can cause brain damage. 
  • Wear seat belt when riding in motor vehicle. 
  • Wear helmet while driving or riding motorcycle.

ESpiritual: Debts in Mythology
It is said that there are three debts, which everybody has to pay in his or her lifetime. In Vedic language, they are called Dev Rin, Pitra Rin and Rishi Rin. 
In medical language, the body consists of soul, physical body, mind, intellect and ego. The soul is given to us by God or Devtas (Dev Rin), the physical body by our parents (Pitra Rin) and the mind, intellect and ego by our Gurus (Rishi Rin).
In terms of computer language, if I see my body as a computer, then my body as a computer is made by my parents; operating software and my inner internet represent the soul or consciousness given by the Devtas and the application softwares i.e. Word, Excel and Power point, which we learn over a period of time are given to us by our Gurus. Therefore, we have to pay all these three debts while we are still alive.
(Disclaimer: The views expressed in this write up are my own).
Inspirational: Power of Thought: Hitting Unseen Target
Yogi Raman was a true master of the art of archery. One morning, he invited his favorite disciple to watch a display of his skill. The disciple had seen this more than a hundred times before, but he nevertheless obeyed his teacher. They went into the wood beside the monastery and when they reached a magnificent oak tree, Raman took a flower, which he had tucked in his collar and placed it on one of the branches. He then opened his bag and took out three objects: his splendid bow made of precious wood, an arrow and a white handkerchief embroidered with lilacs. The yogi positioned himself one hundred paces from the spot where he had placed the flower. Facing his target, he asked his disciple to blindfold him with the embroidered handkerchief.
The disciple did as his teacher requested. "How often have you seen me practice the noble and ancient sport of archery?" Raman asked him. "Every day," replied his disciple. "And you have always managed to hit the rose from three hundred paces away." With his eyes covered by the handkerchief, Yogi Raman placed his feet firmly on the ground, drew back the bowstring with all his might - aiming at the rose placed on one of the branches of the oak tree - and then released the arrow. The arrow whistled through the air, but it did not even hit the tree, missing the target by an embarrassingly wide margin. "Did I hit it?" said Raman, removing the handkerchief from his eyes. "No, you missed completely," replied the disciple. "I thought you were going to demonstrate to me the power of thought and your ability to perform magic."
"I have just taught you the most important lesson about the power of thought," replied Raman. "When you want something, concentrate only on that: no one will ever hit a target they cannot see."
IMA stands in solidarity with junior doctors on strike in Poland
New Delhi 16 October 2017: Junior doctors in Poland are on hunger strike protesting the poor pay and conditions including poor healthcare funding. Supporting their protest, the World Medical Association (WMA) delegates passed an emergency resolution on October 13, 2017 expressing serious concern about the dispute at the annual assembly of the Association in Chicago. The resolution also urged the Prime Minister of Poland to intervene and negotiate an acceptable solution and further said, 'It is essential that a resolution is found before these physicians suffer irreversible harm, or die, as they seek to improve working conditions for their colleagues and a better financial basis for health care provision for the population'.
According to the Polish Chamber of Physicians and Dentists, they made several appeals, unsuccessfully, to the Government to take action on all the above issues; hence, the hunger strike. The current level of expenditure did not cover the justified needs of the population and was insufficient to ensure proper working conditions for health care professionals.
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