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22nd October, 2017
Justice delayed is justice done
Dr KK Aggarwal
We are all familiar with saying "Justice delayed is justice denied". But this by no means is a rule.
 
Most recently, the parents of the murdered 14-year-old Aarushi Talwar, both dentists, were acquitted of the murder of their daughter after 4 years of imprisonment since 2008 by the Allahabad High Court.
 
Earlier, Dera Chief Ram Rahim was convicted after 15 long years and sentenced to 20 years imprisonment.
 
Wrong has been done in both circumstances. While, the parents of Aarushi Talwar suffered imprisonment despite being innocent, in the other case, the Dera Chief was free for last so many years and enjoyed a free life in spite of doing wrong and probably kept on doing wrong.
 
The irony of the situation is that had these been cases of medical negligence, there would have been a public outrage against the doctor concerned. He/she might well have been arrested without the allegations being substantiated.
 
Both the above stories with two extreme judgements, became national headlines, exemplify justice delayed but justice done.
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Top News
Shri Ashwini Kumar Choubey releases FSSAI report on Food Fortification 
 
A comprehensive report on "Large Scale Food Fortification in India - The Journey So Far and Road Ahead" was released by Shri Ashwini Kumar Choubey, Minister of State for Health and Family Welfare. Delivering the keynote address at the national 'Conclave on Nutrition Security: Partnership & Convergence' organized by the Food Safety and Standards Authority of India (FSSAI) on the occasion of World Food Day, Shri Choubey stated that it is not enough that the food is available but the food should be nutritious as well. He emphasized on the need to raise awareness about nutrition rich food and cautioned people against food adulteration... (Ministry of Health and Family Welfare, October 16, 2017).
Practice Updates
Eating better throughout adult years improves physical fitness in old age
 
People who have a healthier diet throughout their adult lives are more likely to be stronger and fitter in older age than those who don't, according to a new study published October 18, 2017 in The Journals of Gerontology: Series A. those who ate more fruit, vegetables and wholegrain cereals, and fewer highly processed foods, across adulthood performed better in the three tests of physical function in older age.

Oral antibiotics + mechanical bowel preparation reduces SSIs post-colorectal cancer surgery
 
A study published in JAMA Surgery online October 18, 2017 has shown that the rate of surgical site infections (SSIs) was 27% with mechanical bowel preparation only and 8% with oral antibiotics combined with mechanical bowel preparation after elective left-sided colorectal cancer surgery for left colon and rectal cancer.

ADA/AADE new recommendations on language for diabetes care and education 
 
The American Diabetes Association (Association) and the American Association of Diabetes Educators (AADE) have published a Consensus Report to help guide the language used by healthcare providers to be positive, respectful, inclusive, person-centered and strengths-based, acknowledging the paradigm shift in diabetes care toward a collaborative approach that includes people with diabetes as the primary member of their care team. Published online October 17, 2017 in Diabetes Care, the five key recommendations for discussing diabetes are:
 
1. Use language that is neutral, nonjudgmental, and based on facts, actions, or physiology/biology;
2. Use language that is free from stigma;
3. Use language that is strengths-based, respectful, inclusive and imparts hope; 
4. Use language that fosters collaboration between patients and providers; and
5. Use language that is person-centered.

Yoga and aerobic exercise together improve heart health
 
According to research presented at the 8th Emirates Cardiac Society Congress being held in Dubai from October 19-21, 2017, heart disease patients who practiced both yoga and aerobic exercise had 2-fold greater reduction in risk factors of blood pressure, total cholesterol, triglycerides, LDL-cholesterol, weight and waist circumference compared to those who practiced either yoga or aerobic exercise alone.

Acid reflux can increase BP in patients with hypertension
 
According to a new study published online October 4, 2017 in the Journal of Clinical Gastroenterology, gastroesophageal reflux provokes high blood pressure (BP) episodes in patients with hypertension suggesting that antacids can restore normal esophageal pH and help maintain normal BP. The pathologic reflux was significantly more common at nighttime, especially when supine.
 
eMedi Humor
While the doctor was talking to me, his nurse came in and said, "Doctor, there is a man here who thinks he's invisible." 
The doctor said, "Tell him I can't see him."​
Medicolegal Corner
 What information can a doctor put on his sign board?
 
Regulation 7.13 has issued directions in this regard. "It is improper for a physician to use an unusually large sign board and write on it anything other than his name, qualifications obtained from a University or a statutory body, titles and name of his speciality, registration number including the name of the State Medical Council under which registered. The same should be the contents of his prescription papers. It is improper to affix a sign board on a chemist’s shop or in places where he does not reside or work."
eMedi Quiz
The substances present in the gallbladder stones or the kidney stones can be best identified by the following technique:
 
1. Fluorescence spectroscopy. 
2. Electron microscopy. 
3. Nuclear magnetic resonance. 
4. X-ray diffraction
Lifestyle Updates
 
eWellness: Avoid food poisoning by thorough washing and proper cooking
 
Thorough washing and proper cooking of fruits and vegetables can eliminate most bacteria that cause food poisoning. 
 
Food-borne illnesses or food poisoning usually occurs due to eating food that is contaminated with bacteria or their toxins.
Virus and parasites can also be cause food poisoning. People have known for long that raw meat, poultry and eggs can also harbor diseases causing microbes. But in recent years most outbreaks of food borne illnesses have been due to fresh fruits and vegetables. 
 
Food poisoning can cause abdominal pain, nausea, headache, fatigue, vomiting, diarrhea and dehydration. Symptoms may appear several hours to several days after eating tainted food. For example, Salmonella bacteria will cause illness 12 hours to 3 days after ingestion lasting about 4-7 days. 
 
The most common way to treat food poisoning is to drink plenty of fluids. The sickness usually subsides within a few days.

eSpiritual: Mindfulness meditation
  • Sit on a straight-backed chair or cross-legged on the floor.
  • Focus on an aspect of your breathing, such as the sensation of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale. 
  • Once you've narrowed your concentration in this way, begin to widen your focus. Become aware of sounds, sensations, and ideas. 
  • Embrace and consider each thought or sensation without judging it good or bad. If your mind starts to race, return your focus to your breathing. Then expand your awareness again. 
(Disclaimer: The views expressed in this write up are my own).

Inspirational: The hedgehogs
 
It was the coldest winter ever. Many animals died because of the cold. 
 
The hedgehogs, realizing the situation, decided to group together to keep warm. This way they covered and protected themselves; but the quills of each one wounded their closest companions.
 
After a while, they decided to distance themselves one from the other and they began to die, alone and frozen. So they had to make a choice: either accept the quills of their companions or disappear from the Earth. 
 
Wisely, they decided to go back to being together. They learned to live with the little wounds caused by the close relationship with their companions in order to receive the heat that came from the others. This way they were able to survive. 
 
The best relationship is not the one that brings together perfect people, but when each individual learns to live with the imperfections of others and can admire the other person's good qualities.
Fungal infections rebound with reckless use of topical steroid creams
People trust quacks and end up buying the medication they prescribe
Over-the-counter sale of such medicines exacerbates the situation

New Delhi, 21 October 2017: As per the most recent data available, India consumes about Rs1,400 crore worth of topical steroid creams. This is a segment with an annual growth of 16%. This figure, however, excludes the over-the-counter sales.(1) Sale of topical steroids accounts for 82% topical dermatology market. What is alarming is that the top-selling combinations in these topical creams do not have any scientific rationale or logic behind them.
 
Even the strongest antifungal creams are unable to treat many fungal infections today. This is majorly due to topical steroid creams, which have turned these infections resilient. Topical steroid creams sell fast and are available anywhere over-the-counter. However, whether they are effective or not is still a question that remains unanswered.
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