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7th October, 2017
Eat slowly for good health and well-being
Dr KK Aggarwal
Most of us lead very busy lives today; we are either working, driving, looking into our smart phone, ipad/tablet etc. In a nutshell, we are too busy to pay attention to what we are eating because we are thinking of the work ahead of us and planning for it and not concentrating on the food.
 
Eating without awareness or eating while distracted by various activities can be harmful to health. It may cause weight gain, a forerunner to lifestyle diseases such as obesity, type 2 diabetes, heart disease, hypertension etc. Hence, it is important to be aware of the food we are eating. This is called mindful eating.
 
Mindful eating means being aware of the hunger and satiety signals. It also means using all the five senses while eating: colors (eye), smells (nose), flavors (taste), textures (touch) and sound while chewing (ear) of the food. Mindful eating also relieves stress
 
In Chapter 6 Shloka 17 of the Bhagwad Gita Krishna says to Arjuna "Yukaharaviharasya yuktachestasya karmasu. Yuktasvapnavabodhasya yoga bhavati duhkhaha". It means "the one, whose diet and movements are balanced, whose actions are proper, whose hours of sleeping and waking up are regular, and who follows the path of meditation, is the destroyer of pain or unhappiness."
 
The Bhagwad Gita also says, "While eating, one should concentrate only on eating as the food is served to one's consciousness".
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Top News
New WHO guidelines for childhood obesity
 
Launching new guidelines to tackle what they call a global epidemic, United Nations health experts have warned that an estimated 41 million children under five years old are obese or overweight,.
 
Faced with evidence indicating that the problem affects rich and poor countries alike, the World Health Organization (WHO) has released details on how trained professionals can better identify youngsters in need of help. The guidelines titled "Assessing and managing children at primary health-care facilities to prevent overweight and obesity in the context of the double burden of malnutrition Updates for the integrated management of childhood illness (IMCI)" include counselling and dieting, an assessment of eating habits along with the more usual weight and height measurements.
 
 WHO says the prevalence of obesity in children reflects changing patterns towards unhealthy diets and physical inactivity. Urbanization, increased incomes, availability of fast foods, educational demands, television viewing and gaming have led to a rise in the consumption of foods high in fats, sugar and salt and lower levels of physical activity. While there have been major public health interventions to promote improved diet and patterns of physical activity in adults, the contribution of antenatal and young-child interventions to reducing the risk of obesity in later life have not been significantly reviewed... (UN, October 4, 2017).
Practice Updates
AAP 7 tips for Allergies and asthma in children
 
The American Academy of Pediatrics (AAP) has published tips on treatment of allergies and asthma for parents on its website.
 
1.     Ask your pediatrician about medications to manage allergies. Common treatments include oral antihistamines, nasal corticosteroids.
2.     Knowing what your child is allergic to can be an important step in finding the right treatment. Allergy testing should be performed to determine whether your child is allergic to any environmental allergens including indoor allergens such as dust mites, pets, and pests as well as outdoor allergens such as pollens. Molds, both indoors and outdoors, can also trigger nasal allergy symptoms.  
3.     Avoid allergens that trigger the symptoms.   
4.     If your child is allergic to pests in the home, professional extermination, sealing holes and cracks that serve as entry points for pests, storing foods in plastic containers with lids and meticulous cleanup of food remains can help to eliminate pests and reduce allergen levels.
5.     Wash linens weekly and other bedding, such as blankets, every 1 to 2 weeks in hot water to prevent dust mites.
6.     If your child is allergic to outdoor allergens, it can be helpful to use air conditioners when possible. Showering or bathing at the end of the day to remove allergens from body surfaces and hair can also be helpful. For patients with grass pollen allergy, remaining indoors when grass is mowed and avoiding playing in fields of tall grass may be helpful during grass pollen season.
7.     Ask your pediatrician about allergy immunotherapy. Immunotherapy, or allergy shots, may be recommended for patients with confirmed allergy to reduce allergy symptoms.
 
(Source: Allergies and Asthma: What Every Parent Needs to Know, by the American Academy of Pediatrics)
US FDA approves second-generation rapid test to diagnose influenza
 
The US Food and Drug Administration (FDA) has cleared for marketing the second-generation rapid molecular assay 'Alere i Influenza A & B 2' diagnostic test for use in children and adults. Results from this test can be obtained as early as within 5 minutes.
Vitamin D supplementation reduces asthma exacerbations
 
According to a systematic review and meta-analysis published online October 3, 2017 in The Lancet Respiratory Medicine, supplementation of vitamin D supplementation reduced the risk asthma exacerbations by 50% in patients with low baseline vitamin D levels below 25 nmol/L that necessitated systemic corticosteroids as compared with placebo (0.30 events/person/year vs 0.43 events/person/year). It also reduced emergency visit or hospitalization for the acute episode.
Concurrent use of other drugs may increase risk of bleeding with NOACs
 
A study published October 3, 2017 in JAMA has cautioned that physicians prescribing non-vitamin K oral anticoagulants (NOACs) should consider the potential risks associated with concomitant use of other drugs. In the study of more than 90,000 individuals with nonvalvular atrial fibrillation, the risk of major bleeding was significantly increased with concurrent use of amiodarone, fluconazole, rifampin, or phenytoin compared with NOAC use alone.

Discontinuing low-dose aspiring increases risk of cardiovascular events
 
As per findings of a study reported online September 2017 in the journal Circulation, if patients on long-term low-dose aspirin therapy discontinued the drug in the absence of major surgery or bleeding, their risk of cardiovascular events (MI, stroke, or cardiovascular death) increased by 37%. Such patients should be encouraged to adhere to aspirin therapy if there is no major surgery or bleeding.
 
eMedi Humor
Interesting 911 Calls
Dispatcher: Nine-one-one... What is the nature of your emergency?
Caller: I'm trying to reach nine eleven but my phone doesn't have an eleven on it.
Medicolegal Corner
Can a doctor pay another doctor whose services he/she has engaged?
 
The AMA code of medical ethics talks about this in Opinion 6.10 - Services Provided by Multiple
Physicians:
"........It is ethically permissible in certain circumstances, however, for a surgeon to engage other physicians to assist in the performance of a surgical procedure and to pay a reasonable amount for such assistance, provided the nature of the financial arrangement is made known to the patient. This principle applies whether regardless of the assisting physician is the referring physician. (II)........"
eMedi Quiz
Which of the following is not a post transcriptional modification of RNA?

1. Splicing
2. 5' Capping
3. 3' polyadenylation
4. Glycosylation
Lifestyle Updates
 
eWellness: Top 10 Ways to Keep the Kidneys Healthy
  1. Monitor blood pressure and cholesterol.
  2. Control weight.
  3. Don't overuse over-the-counter painkillers.
  4. Monitor blood glucose.
  5. Get an annual physical exam.
  6. Know if chronic kidney disease (CKD), diabetes or heart disease runs in your family. If so, you may be at risk.
  7. Don't smoke.
  8. Exercise regularly.
  9. Follow a healthy diet.
  10. Get tested for chronic kidney disease if you're at risk.

ESpiritual: Aastik Vs Nastik
 
Traditionally, people believe that Nastik are the persons who do not go to temples or related places of worship. They also do not believe in God.

To differentiate between Astik and Nastik, we need to first understand the concept of Sanatan Dharma and Arya Samaj Dharma. People who believe in Sanatan Dharma consider God as separate from the self and worship him in the form of an idol. They believe in Dualism theory.

Arya Samaj followers do not do idol worship and believe in non-dualism and treat God and self as one.

Arya Samajis, therefore, will not go to a temple where the idols of Gods are placed. Being an Arya Samaji does not mean that the person is Nastik.

The word Nastik means someone who does not believe in God at all, therefore, he or she also does not believe in self as God is nothing but self. In medical sciences, these are the people who have no insight and will usually be suffering from depression and loss of self-esteem.
 
(Disclaimer: The views expressed in this write up are my own).
Inspirational: The Falcon & the Branch
 
Once there was a king who received a gift of two magnificent falcons. They were peregrine falcons, the most beautiful birds he had ever seen. He gave the precious birds to his head falconer to be trained. Months passed, and one day the head falconer informed the king that though one of the falcons was flying majestically, soaring high in the sky, the other bird had not moved from its branch since the day it had arrived.

The king summoned healers and sorcerers from all the land to tend to the falcon, but no one could make the bird fly. He presented the task to the member of his court, but the next day, the king saw through the palace window that the bird had still not moved from its perch.

Having tried everything else, the king thought to himself, "May be I need someone more familiar with the countryside to understand the nature of this problem." So he cried out to his court, "Go and get a farmer." In the morning, the king was thrilled to see the falcon soaring high above the palace gardens. He said to his court, "Bring me the doer of this miracle."

The court quickly located the farmer, who came and stood before the king. The king asked him, "How did you make the falcon fly?" With his head bowed, the farmer said to the king, "It was very easy, your highness. I simply cut the branch where the bird was sitting."

Moral: We are all made to fly - to realize our incredible potential as human beings. But at times we sit on our branches, clinging to the things that are familiar to us. The possibilities are endless, but for most of us, they remain undiscovered. We conform to the familiar, the comfortable, and the mundane. So for the most part, our lives are mediocre instead of exciting, thrilling and fulfilling. Let us learn to destroy the branch of fear we cling to and free ourselves to the glory of flight.
Music, dance, and language as a means to good health at the 24th MTNL Perfect Health Mela
Ancient wisdom on health should be revisited and the 3rd day of the Mela focused on this and more
 
New Delhi, 06 October 2017: The 3rd day of the MTNL Perfect Health Mela (PHM) saw continuation of various events and competitions for schools and colleges. The participation did not seem to lessen with enthusiastic youth pouring in for the event. The PHM is a flagship event organized by the Heart Care Foundation of India (HCFI), a leading national non-profit organization committed to making India a healthier and disease-free nation. The Mela is on till 8th of October at the Talkatora Stadium in New Delhi. Apart from these activities, there is something for everyone such as health checkup camps, live webcasts and consultations with eminent doctors, and even Diwali shopping.
 
The National Harmony and Eco-Festival, Divya Jyoti and Medico Masti Youth Competitions, and Heritage - a series of National Classical Dance Competitions continued today, although the themes changed. Themes today included language and health, dance as a way to fitness and health, combating water pollution, and leveraging the right to freedom of speech. 
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