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8th October, 2017
HIV Self-Testing: Comments and suggestions invited
Dr KK Aggarwal
As per HIV estimation 2015, India is estimated to have 21 lakh people infected with HIV and only 15.2 lakh PLHIV know their HIV status (Press Information Bureau, August 4, 2017). This means that around 6-7 lakh are still unaware of their HIV status.
To end AIDS by 2030, the United Nations has set global targets as part of its '90-90-90' strategy - to diagnose 90% of all people living with HIV by 2020, to treating 90% of all people with diagnosed HIV infection with sustained antiretroviral therapy and to maintain viral suppression in 90% of all people receiving ART. Lack of diagnosis has been a major obstacle in achieving these targets. Hence, there is a need for ways to increase access to and use of HIV testing services.
HIV Self-Testing (HIVST) is an innovative way, which can complement the efforts put by NACO in achieving the global target of diagnosing 90% of all people living with HIV by 2020.
Also, HIVST can help in reaching first-time testers, undiagnosed PLHIV and population groups who need frequent retesting and can help countries meet the above targets.
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Top News
Global Task Force on Cholera Control commits to reduce cholera deaths by 90% by 2030
The Global Task Force on Cholera Control (GTFCC), a diverse network of more than 50 UN and international agencies, academic institutions, and NGOs has devised a new strategy to reduce deaths from cholera by 90% by 2030. The GTFCC's new plan, "Ending Cholera: A Global Roadmap to 2030" recognizes that cholera spreads in endemic "hotspots" where predictable outbreaks of the disease occur year after year. By implementing the Roadmap, up to 20 affected countries could eliminate cholera by 2030. The new plan focuses on
  • Early detection and quick response to contain outbreaks at an early stage 
  • A multisectoral approach to prevent cholera in hotspots in endemic countries (including improved water, sanitation, and hygiene (WASH) and through use of oral cholera vaccines (OCV))
  • An effective mechanism of coordination for technical support, resource mobilization and partnership at local and global level - with the GTFCC providing a strong framework to support countries in intensifying efforts to control cholera.
 (WHO, October 3, 2017).
Practice Updates
US FDA approves first test for screening Zika virus in blood donations
The US Food and Drug Administration has approved the cobas Zika test, a qualitative nucleic acid test for the detection of Zika virus RNA in individual plasma specimens obtained from volunteer donors of whole blood and blood components, and from living organ donors. It is intended for use by blood collection establishments to detect Zika virus in blood donations, not for the individual diagnosis of Zika virus infection.

Bariatric surgery lowers risk of cancer risk in severely obese patients
According to a retrospective study published online October 5, 2017 in the Annals of Surgery, severely obese patients who underwent bariatric surgery had a 33% lower risk of developing any cancer during follow-up especially, obesity-associated cancers including postmenopausal breast cancer, endometrial cancer, pancreatic cancer and colon cancer.

Adequate water intake reduces risk of frequent UTIs in women
Women at risk of urinary tract infections (UTIs) who increased their daily water intake by an additional three pints had a 48% reduction in their risk of developing UTIs compared to women who did not. The study presented October 5, 2017 at IDWeek 2017 in San Diego included 140 healthy premenopausal women who had at least three UTIs in the last year and reported low daily fluid intake.

Low serum calcium may increase risk of sudden cardiac arrest
Individuals with lower calcium levels in the blood are more likely to experience sudden cardiac arrest compared to those who had higher calcium levels, suggests a study published October 5, 2017 in Mayo Clinic Proceedings. Patients with serum calcium in the lowest quartile (<8.95 mg/dL) had twice the risk of sudden cardiac arrest vs those in the highest quartile (>9.55 mg/dL).

Sleep problems increase risk of depression in older adults
Sleep problems, short sleep and a combination of both increase the risk of depressive symptoms in older people, according to findings from a 6-year follow-up investigation from the English Longitudinal Study of Ageing published in the September 2017 issue of the journal Sleep Medicine. Waking up in the morning feeling tired followed by difficulties falling asleep were also found to predict the future risk of depression.
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
Is membership in a medical society/association mandatory for a doctor?

The MCI has issued guidelines in this regard as below.

1.2.2 Membership in Medical Society: For the advancement of his profession, a physician should affiliate with associations and societies of allopathic medical professions and involve actively in the functioning of such bodies.
1.2.3 A Physician should participate in professional meetings as part of Continuing Medical Education programmes, for at least 30 hours every five years, organized by reputed professional academic bodies or any other authorized organisations. The compliance of this requirement shall be informed regularly to Medical Council of India or the State Medical Councils as the case may be.
eMedi Quiz
You've had yeast infections before, but in the past year they haven't really gone away. This could be a sign of:
A. Diabetes.
B. Emphysema.
C. Stomach ulcers.
D. Depression.
E. Food allergies.
Lifestyle Updates
eWellness: 3 diet changes to help lower cholesterol levels
For every 10% drop in your cholesterol level, your heart attack risk falls by 20% to 30%.
  • Choose healthy fats. Avoid saturated fats, which increase unhealthy LDL levels, and steer clear of trans fats, which both raise LDL and lower protective HDL. Instead, substitute healthier unsaturated fats found in fish, nuts, and vegetable oils.
  • Go with whole grains. Whole-grain breads, pastas, and cereals help prevent a blood sugar roller coaster and make you feel full longer. Many of these foods contain fiber, which can help lower LDL levels.
  • Make other healthy choices. Eat more fruits and vegetables. Ideally, substitute these for processed foods and sweets. Choose fat-free milk instead of whole milk. Opt for low-fat yogurt and pick brands that are not loaded with sugar. (Harvard Newsletter)

ESpiritual: Why do we regard trees and plants as sacred?
The upper part of the plants, the leaves, flowers and fruits are worshipped as sacred and offered to God. As per the Bhagwad Gita, these have satvik properties. Roots of any plant are tamsik and not offered in pooja or eaten during pooja days. The same is true for the stems of plants, which have rajsik properties. Fresh and live fruits have the same spirit and life force as in the human beings and are considered sacred the same way as any human being.
Human life also depends on plants and trees. They give us the vital factors that make life possible on earth: food, oxygen, clothing, shelter, medicines etc.
Ancient scriptures suggest the planting of a minimum of ten trees. We are also urged to apologize to a plant or tree before cutting it to avoid incurring a specific sin named soona.
Many trees and plants like tulsi, peepal etc., which also have medicinal value, are worshipped.
(Disclaimer: The views expressed in this write up are my own).

Inspirational: A Young Sad Lady
The old Master instructed the unhappy young lady to put a handful of salt in a glass of water and then to drink it. "How does it taste?" the Master asked. "Very bad" said the lady.
The Master then asked the young lady to take another handful of salt and put it in the lake. The two walked in silence to the nearby lake and when the apprentice swirled his handful of salt into the lake, the old man said, "Now drink from the lake."
As the water dripped down the young lady's chin, the Master asked, "How does it taste?" "Good!" remarked the apprentice. "Do you taste the salt?" asked the Master."No," said the young lady.
The Master said, "The pain of life is pure salt; no more, no less. The amount of pain in life remains the same, exactly the same. But the amount we taste the 'pain' depends on the container we put it into. So when you are in pain, the only thing you can do is to enlarge your sense of things... Stop being a glass. Become a lake!"
Three-day workshop focusing on food for heart health at the 24th Perfect Health Mela

Events and competitions such as 100-m racing and youth court scene competition mark the 4th day of the Mela
Focus on preventive health and tips for a healthy heart
New Delhi, 07 October 2017: Amidst the plethora of events and competitions being held as part of the 24th MTNL Perfect Health Mela, there was also a three-day workshop by food expert Ms Geeta Anand on Healthy Food for a Healthy Heart. The workshop provided interesting insights into how our eating patterns can affect our heart and what a heart healthy diet is composed of. It was an eye-opener in many respects as many things that we consume as part of our daily lives may not be so good for the heart. The PHM, on till the 8th of October 2017 at Talkatora Stadium, New Delhi, is a one-of-its-kind event combining knowledge and fun.
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