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Editorial (Dr SS Agarwal, Dr K K Aggarwal)
6th July 2016
Sedentary white-collar workers should consider walking meetings for better health
 
Changing traditional seated meetings at work into a walking meeting increased the work-related physical activity levels of white-collar workers by 10 minutes, says a new study published in Preventing Chronic Disease, a journal of the Centres for Disease Control and Prevention (CDC).
The Walking Meeting (WaM) Pilot Study, Miami, 2015 examined opportunities to increase physical activity in the workplace among sedentary white-collar workers. Workers, mean age 39.8 years, who conducted weekly meetings in groups of 2 or 3 individuals from January 2015 to August 2015 were recruited for the study. The researchers developed a 7-item core component walking meeting protocol that included a safe 25- to 30-minute walking path on the university campus. 
  • Set a time and place to meet before your WaM.
  • Create an agenda for your WaM.
  • To make the walk more comfortable, bring items such as water, sunglasses, and sunscreen. Wear comfortable shoes.
  • Have the group leader assign roles to each walking meeting group member. (i.e., time checker, note taker, path leader).
  • Follow the prescribed route.
  • Walk for 30 minutes minimum.
  • After the walking meeting, sit and conclude to wrap up meeting; take care of paperwork or other tasks that could not be accomplished during WaM.
Data analysis showed that walking meetings, a simple modification of traditional seated meetings, were not only well accepted by the study population, they were also easy to implement and feasible to conduct during regular working hours. Among the 8 participating groups, 7 completed both walking meetings. All groups walked from 30 to 40 minutes. The study found that the sit-and-conclude session and creating an agenda were the least frequently completed components. 

The various health benefits of walking are well recognized. And, that a sedentary lifestyle has negative health effects is also well known. Physical activity is recommended for all ages. 

White collar workers or people who have desk jobs spend most of their working hours sitting in chairs. Interventions such as this that encourage walking and physical activity in the workplace are needed to counter the negative health effects of sedentary behavior.
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Top News
New study sheds light on how some survive Ebola
 
A first-of-its-kind Ebola study recently published online in the Clinical Infectious Disease Journal provides clues to how some people are able to survive the deadly virus and suggests possible avenues for treatments that could save more lives. Samples were taken from patients during both their illness and recovery. In the seven US patients, researchers tracked 54 different markers of immune-system activity from hospital admission until the day of discharge. Among the seven patients, five had moderate Ebola virus disease and two had severe Ebola virus disease requiring mechanical ventilation and dialysis. All of the patients with moderate illness and one patient with severe illness survived.
 
The results show patients with severe disease had high levels of virus in their blood and Biomarkers that were associated with severe EVD were proinflammatory and indicative of endothelial or coagulation cascade dysfunction associated with fatal outcomes. While, biomarkers that were associated with moderate disease were suggestive of a strong interferon response and control of both innate and adaptive responses. Genetics and comorbid illnesses or conditions have been suggested as possible contributing factors to why some people’s immune systems respond more effectively to viruses … (CDC)
Practice Updates
Latanoprostene bunod better controls the intraocular pressure in open angle glaucoma
 
According to a pooled analysis of two phase 3 studies, intraocular pressure was at least 1 mm Hg lower in patients treated with the investigational antiglaucoma agent latanoprostene bunod than in those treated with timolol in patients with open-angle glaucoma or ocular hypertension. The results of the analysis were presented July 2, 2016 at Optometry's Meeting by the American Optometric Association (AOA). Latanoprostene bunod is a nitric-oxide-donating prostaglandin F2-alpha analog that is metabolized in situ to latanoprost acid, a prostaglandin agent, which enhances uveoscleral outflow. It is also a nitric oxide donor compound (soluble guanylyl cyclase) that increases outflow through the trabecular meshwork and Schlemm's canal.

A video-assisted decision-support tool helps advanced HF patients plan advanced care
 
Findings from the VIDEO-HF study suggest that patients with heart failure who viewed a video-assisted decision-support tool were more informed, more likely to select a focus on comfort, and less likely to desire CPR/intubation vs patients who received only verbal information. In the study published online June 29, 2016 in the journal Circulation, 51% of this group chose comfort-focused care after the video-assisted intervention vs 30% of those randomized to verbal education only (control group), while only 22% of the video group vs 41% of the control group chose life-prolonging care. And, significantly more of the video group said no to future CPR attempts (68% vs 35% of the control group) and no to intubation (76% vs 48%, respectively).

Hypothyroidism in pregnancy may be a risk factor for schizophrenia in offsprings
In a large, national birth cohort, prospectively documented hypothyroxinemia during early gestation to mid-gestation was associated with increased odds of schizophrenia in offspring, says a new study published in the June 2016 issue of Biological Psychiatry. Children born to women with hypothyroxinemia during pregnancy had a 75% increased risk of developing schizophrenia, which remained significant after taking into account known risk factors for the disease.

Risk of developing delayed dementia post-ICH is also high
 
Incident dementia early after intracerebral hemorrhage (ICH) is strongly associated with the size and location of the hematoma. Delayed incident dementia is frequent among patients who have experienced ICH and is not prominently associated with acute characteristics of ICH. Larger hematoma size and lobar location of ICH were associated with early post-ICH dementia (EPID) but not with delayed post-ICH dementia (DPID). Educational level, incident mood symptoms and white matter disease as defined via computed tomography were associated with DPID but not EPID.

Mechanical stress on sole linked to melanoma formation
 
New findings published online June 16 in the New England Journal of Medicine suggest that mechanical stress such as plantar pressure and shear stress may promote melanoma formation on the plantar surface. These melanomas usually do not have the oncogenic BRAF mutation seen often in melanomas on sun-exposed skin. The authors of the study suggest that melanoma should be suspected more strongly in a case of a developing pigmented lesion located on the plantar mechanical stressful areas, including the heel.

Gastric bypass superior to lifestyle-medical management intervention but with side effects
 
Gastric bypass is more effective than lifestyle-medical management intervention in achieving diabetes treatment goals, mainly by improving glycemic control in patients with uncontrolled type 2 diabetes in mild-to-moderate obesity. But, the effect of surgery diminishes with time and is associated with more adverse events, as reported online June 16 in a study in Diabetes Care. Lifestyle-medical management patients used more medications than gastric bypass patients (3.8 vs. 1.8, respectively). Over a period of 3 years, 24 serious or clinically significant adverse events were observed in lifestyle-medical management as compared to 51 with gastric bypass.
Lybrate Question of the Day
A 20-year-old male from Chennai asked:
Recently I cleaned my teeth in dental hospital but eventhough my teeth is not so as white. How to remove yellow sadness in teeth? Using tooth polish will help or not?
 
Dr. Geeta Asrani, Dentist, replied:
Cleaning of teeth that is scaling will only clean the stains or spots that are on the outer surface of your teeth if the stains are from inside of the teeth and you want to make it... read more
Lybrate SMS of the Day
IMA-Lybrate Initiative: Ease patients' lives and forge strong relationship with convenient follow ups with an online clinic. Learn more http://lybr.at/open-online-clinic
eMedi Humor
Traffic Court 
 
A New York man was forced to take a day off from work to appear for a minor traffic summons. He grew increasingly restless as he waited hour after endless hour for his case to be heard. When his name was called late in the afternoon, he stood before the judge, only to hear that court would be adjourned for the next day and he would have to return the next day. "What for?" he snapped at the judge. 
 
His honor, equally irked by a tedious day and sharp query roared, "Twenty dollars contempt of court. That’s why!" Then, noticing the man checking his wallet, the judge relented. "That’s all right. You don’t have to pay now." The young man replied, "I’m just seeing if I have enough for two more words."
Medicolegal Corner
Where can one complain about advertising?

Dr KK Aggarwal

A complaint can be made to the:
  • State Medical Council
  • Drug Controller General of India
  • Advertising Standards Council of India
eMedi Quiz
A couple, with a family history of beta thalassemia major in a distant relative has come for counseling. The husband had HbA2 of 4.8% and the wife has HbA2 of 2.3%. The risk of having a child with beta thalassemia major is.
 
1. 50% 
2. 25% 
3. 5% 
4. 0% 
Webcasts 
Lifestyle Updates
eWellness:  Tackling obesity in children
 
More than 30% people of the society including children have potbelly abdominal obesity. India is witnessing an epidemic of metabolic syndrome, which is characterized by abdominal obesity, high triglyceride, low good cholesterol, high blood pressure and high sugar....read more
 eSpiritual: The Five Internal Powers 
 
To be in a state of happiness, bliss and ananda is what the ultimate goal of life is. Everybody is born with certain inherent powers, which if cultivated in the right direction will lead to inner happiness.The ancient Shiva Sutra text talks about the concept of Shiva and Shakti....read more
 
Inspirational: Temper Control 
 
There once was a little boy who had a bad temper. His father gave him a bag of nails and told him that every time he lost his temper, he must hammer a nail into the fence. 
 
The first day the boy had driven 37 nails into the fence. Over the next few weeks as he learned to control his anger, the number of nails hammered daily, gradually dwindled down. He discovered it was easier to hold his temper than to drive those nails into the fence...read more
Press Release
 
Monsoon and Road Safety:  Tips for driving in the rain
 
New Delhi, July 05, 2016: "During the monsoon season, many people become victims of road accidents. Thus, it is important for the public to know about road safety," says Padma Shri Awardee Dr KK Aggarwal – President Heart Care Foundation of India (HCFI) and Honorary Secretary General IMA.

The Heart Care Foundation of India has released road safety guidelines to reduce the risk of accidents while driving and also requested the transport department and the traffic police to intensify their educational campaign in this regard.
The following tips should be followed for safe driving during the monsoons.
  • Drive slowly. Driving too fast is the No. 1 cause of accidents on rainy days.
  • If an accident occurs or your vehicle stalls, pull as far off the road as possible, turn on the flashing emergency lights, and move to a safe area. If there is no safe place next to the road, stay in your car and remain buckled up.
  • Drive in the tyre prints of the car ahead of you. When a car hydroplanes, it is riding on a thin layer of water between the tyres and the road. The water in tyre prints has already been displaced, so you get better traction.
  • If your car hydroplanes, hold the steering wheel steady and lightly apply brakes. When you feel the tyres touch the pavement, slow until you regain control.
  • Do not speed through standing water.
  • Motorcyclists should bear in mind that crosswalk lines and pavement arrows are super-slick.
  • Check the tyres and wipers of your car. According to the traffic police, many drivers in accidents say their visibility was hampered as the car wipers smeared their windshields on a rainy day.
  • Keep a safe distance between you and the vehicle in front. Your braking distance is greatly increased in wet driving.
  • if possible, do not brake while at a curve. Brake before entering the curve.
  • Do not change lanes. If at all you need to do so, use turn signals for all lane changes and turn well in advance so that you do not surprise another driver and cause him to brake.