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10th October, 2017
High-sugar diet increases risk of heart disease in healthy people
Dr KK Aggarwal
A study from the UK has shown that healthy people who eat high amounts of sugar are at an increased risk of developing heart disease due to alteration in their fat metabolism.
The study reported October 4, 2017 in the journal Clinical Science examined two groups of men with either high or low levels of liver fat, and fed them a high (650 calories daily) or low sugar (=140 calories daily) diet to find out if the amount of liver fat influences the impact of sugar on their cardiovascular health. 
Men who had high levels of liver fat (non-alcoholic fatty liver disease [NAFLD]) had changes in their fat metabolism that are associated with an increased risk of cardiovascular disease, heart attacks and strokes after 12 weeks on the high sugar diet.
What is important to note in this study is that when the group of healthy men with a low level of liver fat consumed high amounts of sugar, their liver fat increased and their fat metabolism became similar to that of men with NAFLD putting them at risk of heart disease.
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Top News
Today is World Mental Health Day 2017: "Mental health in the workplace"
World Mental Health Day is observed on October 10 every year. The objective being to raise awareness of mental health issues around the world and mobilizing efforts in support of mental health. It is also an opportunity for all stakeholders working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people worldwide. The theme of World Mental Health Day this year is "Mental health in the workplace".
Practice Updates
Global sensory impairment impairs physical and cognitive abilities in older adults 
A 5-year long study of more than 3,000 nationally-representative older US adults has found that a natural decline of the five classical senses (vision, hearing, taste, smell and touch) can be a warning sign of poor health outcomes, including death. Adults with worse global sensory impairment moved slower and had greater difficulty performing daily activities. These findings are published online October 5, 2017 in the Journal of the American Geriatrics Society.

A news implantable device to treat moderate to severe central sleep apnea
The US Food and Drug Administration (FDA) has approved a new treatment option for patients who have been diagnosed with moderate to severe central sleep apnea. The Remede System is an implantable device that stimulates a nerve located in the chest that is responsible for sending signals to the diaphragm to stimulate breathing.

Monoclonal antibody provides sustained viral suppression in HIV patients
Results of a phase III trial presented at the annual IDWeek conference, which concluded yesterday in San Diego show that ibalizumab had long-lasting protection in the 24-week extension phase in HIV patients who have developed severe drug resistance. Viral suppression remained steady from week 24 to week 48 in the study.

First extended-release corticosteroid injection for knee OA gets FDA approval
The US Food and Drug Administration (FDA) has approved triamcinolone acetonide extended-release injectable suspension (Zilretta) to relieve pain of knee osteoarthritis. The drug is to be administered as an intra-articular injection.

Study identified loneliness as a risk factor for suicidal thoughts
New research published in the October 2017 issue of the journal World Psychiatry shows loneliness as an important risk factor for development of suicidal ideation among older US veterans. While, greater social support was associated with decreased risk of incident suicidal ideation.
eMedi Humor
Teacher: George, go to the map and find North America.
George: Here it is!
Teacher: Correct. Now, class, who discovered America? 
Class: George!
Medicolegal Corner
When should a treating doctor seek a consultation?

Unnecessary consultations should be avoided as per section 3.1. However in case of serious illness and in doubtful or difficult conditions, the physician should request consultation, but under any circumstances such consultation should be justifiable and in the interest of the patient only and not for any other consideration (Section 3.1.1). Consulting pathologists /radiologists or asking for any other diagnostic Lab investigation should be done judiciously and not in a routine manner (Section 3.1.2).
In every consultation, the benefit to the patient is of foremost importance. All physicians engaged in the case should be frank with the patient and his attendants (Section 3.2).
eMedi Quiz
A female client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis, the nurse knows that the client is most likely to experience: 
a. Hematuria 
b. Weight loss 
c. Increased urine output
d. Increased blood pressure
Lifestyle Updates
eWellness: 8 tips for buying shoes that are good to your feet
  1. Wait until the afternoon to shop for shoes - your feet naturally expand with use during the day and may swell in hot weather.
  2. Wear the same type of socks that you intend to wear with the shoes. 
  3. Have the salesperson measure both of your feet. If one foot is larger or wider than the other, buy a size that fits the larger foot. 
  4. Stand in the shoes. Make sure you have at least a quarter- to a half-inch of space between your longest toe and the end of the shoe.
  5. Walk around in the shoes to determine how they feel. Is there enough room at the balls of the feet? Do the heels fit snugly, or do they pinch or slip off? Don't rationalize that the shoes just need to be "broken in" or that they'll stretch with time. Find shoes that fit from the start. 
  6. Trust your own comfort level rather than a shoe's size or description. Sizes vary from one manufacturer to another. You're the real judge. 
  7. Feel the inside of the shoes to see if they have any tags, seams, or other material that might irritate your feet or cause blisters. 
  8. Turn the shoes over and examine the soles. Are they sturdy enough to provide protection from sharp objects? Do they provide any cushioning? Also, take the sole test as you walk around the shoe store: do the soles cushion against impact? Try to walk on hard surfaces as well as carpet to see how the shoes feel.
(Source: Harvard Healthbeat)
ESpiritual: Why do we apply holy ash?

Bhasma is the holy ash produced from the Homa, the sacrificial fire, wherein special wood along with ghee and other herbs are offered as a part of pooja. By the time a Bhasma is formed, no trace of original matter remains in the ash. Ash obtained from any burnt object is not bhasma.

The ritual involves worshipping the deity by pouring ash as abhishek and then distributing it as Bhasma, which is then applied on the forehead (usually), upper arms, chest, or rubbed all over the body. Some consume a pinch of Bhasma when they receive it.

The word Bhasma is derived from bha or "bhartsanam" ("to destroy") and "sma" or "smaranam" ("to remember"). It denotes "that by which our sins are destroyed and the Lord is remembered".  Bhasma is also called vibhuti, which means glory. Bhasma is associated with Lord Shiva who applies it all over His body.

Spiritually, the Homa is the offering of oblations into the fire with sacred chants and signifies offering or surrender of the ego and egocentric desires into the fire of knowledge. The resultant ash signifies the purity of the mind. The fire of knowledge burns the oblation and wood signifying ignorance and inertia respectively.

The application of ash implies that one should burn false identification with the body.

Bhasma has medicinal values in Ayurveda. It is supposed to be the strongest of all Ayurveda preparations. Ayurveda defines a Bhasma, when the matter is converted into non matter by the process of homa. The non matter is the spirit or the energy of the matter being processed with strong healing powers. It has the same significance as any 'potentised' medicine in homeopathy.
It absorbs excess moisture from the body and prevents colds and headaches.

When applied with a red spot at the centre, the mark symbolizes Shiva-Shakti (the unity of energy and matter that creates the entire seen and unseen universe).

The Upanishads say that the famous Mrityunjaya Mantra should be chanted whilst applying ash on the forehead.

(Disclaimer: The views expressed in this write up are my own).

Inspirational: The Trouble Tree

The carpenter I hired to help me restore an old farmhouse had just finished a rough first day on the job. A flat tire made him lose an hour of work, his electric saw quit, and now his ancient pickup truck refused to start.
While I drove him home, he sat in stony silence. On arriving, he invited me in to meet the family. As we walked toward the front door, he paused briefly at a small tree, touching the tips of the branches with both hands.
After opening the door, he underwent an amazing transformation. His face was wreathed in smiles, and he hugged his two small children and then gave his wife a kiss. 
Afterward, he walked me to my car. We passed the tree, and my curiosity got the better of me. I asked him about what I had seen him do earlier.
"Oh, that's my trouble tree," he replied. "I know I can't help having troubles on the job, but one thing for sure, troubles don't belong in the house with my wife and children. So I just hang them up on the tree every night when I come home. Then in the morning, I pick them up again."
"Funny thing is," he smiled, "when I come out in the morning to pick them up, there aren't nearly as many as I remember hanging up the night before." 
What do you think about the way the carpenter chose to deal with his problems? What do you think he accomplished by leaving his troubles outside of his home?
Vitamin D supplements can help cut the risk of asthma attacks
  • Over 20 million people in India suffer from asthma
  • Airway sensitivity both rural and urban areas has gone up due to many factors
New Delhi, 09 October 2017: As per a recent study, taking oral vitamin D supplements in addition to standard asthma medication causes a 30% reduction in asthma attacks requiring treatment with steroid tablets or injections, in those with mild-to-moderate asthma. As per the findings, there was a 50% reduction in the risk of people experiencing at least one asthma attack requiring hospitalization or visit to emergency Dept with vitamin D supplementation. Vitamin D is thought to protect against attacks triggered by viral upper respiratory infections by boosting immune responses and dampening down harmful airway inflammation.

A chronic lung disease that inflames and narrows the airways, asthma causes recurring episodes of wheezing, chest tightness, shortness of breath and coughing. The coughing often occurs at night or early in the morning. About 15 to 20 million people in India have asthma, and some studies even put this number at 30 million.
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