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23rd October, 2017
WMA policy statement on participation of doctors in executions should be implemented
Dr KK Aggarwal

Should doctors participate in state executions or capital punishments? This is a very controversial issue in medical ethics.
Doctors are required to monitor vital signs during the process of execution (hanging in case of India) and look for signs of life and then pronounce death. This is against medical ethics.
Opposing the participation of doctors, the World Medical Association (WMA) came out with a “Resolution on physician participation in capital punishment” in 1981 and amended in 2008. The resolution states as follows

“RESOLVED, that it is unethical for physicians to participate in capital punishment, in any way, or during any step of the execution process, including its planning and the instruction and/or training of persons to perform executions.

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Video Of The Day: Why Pray to Goddess Laxmi
Top News
Emergency funding needed to combat climate change, says WMA
 
A call for national governments to provide designated funds for the strengthening of health systems to combat climate change has come from the World Medical Association. In a policy statement adopted at its annual Assembly in Chicago, the WMA emphasises the urgency for taking action and for emergency planning on local, national and international levels.
 
WMA President Dr Yoshitake Yokokura said: ‘With the next United Nations conference on climate change less than a month away, it is important that the voice of the world’s physicians is heard about the risks posed to health by climate change’. 
 
The WMA says that human influence on the climate system is clear, with recent emissions of green-house gases the highest in history. Recent climate changes have had widespread impact on human and natural systems. Compelling evidence proves numerous health risks which threaten all countries. These include more frequent and potentially more severe heatwaves, droughts, floods, storms and bushfires. 
 
Climate change, especially warming, is already leading to changes in the environment in which disease paths flourish. There is reduced availability and quality of potable water, and worsening food insecurity leading to malnutrition and population displacement. And although climate change is universal, its effects are uneven, with many of the areas most affected the least able to manage the challenges it poses. Those with generally the poorest health and lowest life and health expectancy will be least able to adapt to the adverse effects of climate. 
 
Dr Yokokura said: ‘We are also urging national governments to provide for the health and wellbeing of people displaced by environmental causes, including those becoming refugees because of the consequences of climate change’ (WMA News Release, October 20, 2017).
Practice Updates
CDC guidelines for management of infants with congenital Zika virus infection
 
The Centers for Disease Control and Prevention (CDC) has published updated clinical guidance on caring for infants with congenitally acquired Zika infection. According to the guidelines, infants with clinical findings consistent with congenital Zika syndrome regardless of maternal testing results and infants without clinical findings consistent with congenital Zika syndrome who were born to mothers with laboratory evidence of possible Zika virus infection should be further tested and clinical evaluated for Zika.

Regular walking lowers all-cause mortality
 
According to a new study published online October 19, 2017 in the American Journal of Preventive Medicine, regular walking, even below minimum recommended levels, is associated with lower all-cause mortality compared with inactivity. Walking at or above physical activity recommendations is associated with even greater decreased risk.

New IOF Compendium documents osteoporosis, its management and global burden
 
The International Osteoporosis Foundation (IOF) issued the first edition of a comprehensive and scientifically referenced report on osteoporosis 'IOF Compendium of Osteoporosis' on the occasion of World Osteoporosis Day. This compendium will be available in five languages, is to be periodically updated, and is intended as an authoritative reference document for all key stakeholders in the field of musculoskeletal health.

First guidelines on chronic pain in people living with HIV
 
According to guidelines released by the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA), people living with HIV should be assessed for chronic pain. Those who screen positive should be offered a variety of options for managing pain, starting with non-drug treatment such as cognitive behavioral therapy, yoga and physical therapy. These recommendations are published online September 14, 2017 in the journal Clinical Infectious Diseases.

Study suggests four in one tablet as switch option for treatment of HIV-1 infection in adults
 
Findings of the EMERALD phase 3 noninferiority trial published online October 6, 2017 in The Lancet HIV have demonstrated that a new single-tablet regimen (STR) containing darunavir, cobicistat, emtricitabine and tenofovir alafenamide maintained viral suppression at 48 weeks of the study in most study participants with HIV-1.
 
eMedi Humor
And I work in the dark
 
A doctor of psychology was doing his normal morning rounds, and he entered a patient’s room to find his patient sitting on the floor, sawing at a piece of wood with the side of his hand. Meanwhile, another patient was in the room, hanging from the ceiling by his feet. The doctor asked his patient what he was doing, sitting on the floor.

The patient replied in an irritated fashion, "Can’t you see I’m sawing this piece of wood in half?" The doctor inquired, "And what is the fellow hanging from the ceiling doing?" "Oh. He’s my friend, but he’s a little crazy. He thinks he’s a light bulb."

The doctor asks, "If he’s your friend, don’t you think you should get him down from there before he hurts himself?" "What? And I work in the dark!?!"
Medicolegal Corner
Can a doctor publish photographs or report an interesting case that he has come across in his  practice?
 
Regulation 7.17 of MCI Code of Ethics clarifies this issue as follows: “A registered medical practitioner shall not   publish photographs or  case reports of his/her patients without their permission, in any medical or other journal in a manner by which their identity could be made out. If the identity is not to be disclosed, the consent is not needed.”
eMedi Quiz
 All of the following conditions may predispose to pulmonary embolism except:

1. Protein S deficiency.
2. Malignancy.
3. Obesity.
4. Progesterone therapy.
Lifestyle Updates
 
eWellness: Gaining weight & losing strength vs losing weight & gaining strength 
 
When we gain weight, we must acquire more strength and when we lose weight, we must lose the strength. This is a fundamental principle. If we gain weight and feel weak, it is a disease and when we lose weight and gain strength, we are recovering from the disease. One should not gain more than 5kg of weight after the age of 20 years. Any weight gain after that will only be due to accumulation of fat, which leads to insulin resistance. Insulin resistance does not allow food to convert into energy. In the state of insulin resistance, whatever you eat is converted into fat. As it is not converted into energy, you feel weak. When you reduce insulin resistance by drugs or walking, the metabolism becomes normal and whatever you eat gets converted into energy and you start gaining strength.

eSpiritual: The 3 C’s: Don’t Criticize, Condemn, or Complain! 
 
• Don’t Criticize, always look for positive in a person or a situation. There is always something positive in every situation. 
• Don’t Condemn a situation (and a person) howsoever small it may be. 
• Don’t Complain, unless it is a must. 
You will not do any of the 3 Cs, if you are laughing. By avoiding the 3Cs, we avoid a lot of arguments that would usually naturally occur when you criticize, condemn or complain. If we criticize, condemn, complain, show resentment, or gossip about others, it comes back to "us." If we praise, support, encourage and forgive others, this too comes back to us.
 (Disclaimer: The views expressed in this write up are my own).

Inspirational: Trust Your Relationship 
When you've seen a couple fight or having a pity argument, what is the first thing that comes in your mind? 
Probably you think that you will never allow arguments to set in your relationship (especially when you get married), or will never think to start one, but arguments seem to come naturally. You argue about the brand of coffee, or what to eat at lunch, who will do the dishes, etc. Sometimes, more than that, but regardless of your reasons for the argument (or fight), patching up a troubled relationship and having a solution is very important. 
Second to God, our partners are a believer's most valuable asset. Companions provide a listening ear for our troubles, support for our dreams, and a safety net when we fall. They give us love, even when we are unlovable. They are and must be our friends. Inevitably, though, sometimes we go through troubled periods and a solution should be sought through the following steps: 
1. Address the situation. Acknowledge to your partner that something is amiss and needs to be fixed. 
2. Determine the problem. Together, discuss where the relationship veered off course and what wrongs may have been spoken or committed. Be honest and let your honesty be in its proper place. Remember, you are talking to your partner, another half of yourself. 
3. Apologize. As believers we accept responsibility for our actions and seek forgiveness. 
4. Refuse to blame. In addition, we must avoid defending ourselves. There could be a temptation to argue over who did what; however, the goal is not proving who is right but saving the relationship. 
5. Begin repairs. Ask, "What can I do to rebuild our closeness?" The key here is to do willingly whatever is requested. 
6. Commit to rebuilding. Immediately start investing your time, energy, and love in restoring the relationship. 
In order to have the blessing of a good relationship, with a partner who accepts and loves us, we must be willing to pay the high price of patching things up. Walking away might seem easier, but in the long run, we would lose a valuable treasure.
Prolonged neck and back pain should not be ignored
Incorrect posture and sedentary lifestyle are two major causes of back problems today
 
New Delhi, 22 October 2017: Recent research indicates that about 20% of youngsters today suffer from some form of back and spine problems, with a majority of such people falling the age group of 16 to 34 years. The prevalence of these disorders has been found to be more pronounced in the cities of New Delhi, Mumbai, Bengaluru, and Pune. The IMA indicates that it is not prudent to ignore back and neck problems. With timely treatment, the pain can be resolved by understanding the root cause of the problem.
 
Stress and lack of exercise are factors that can make the spine vulnerable to injury. This is exacerbated by driving on poor and potholed roads in cities. The spine is most important for accomplishing simple, daily activities such as sitting, standing, bending, and lying down. It is therefore, important to protect it and keep it healthy. 
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