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16th October, 2017
WMA approves Modern Physicians' Pledge
Dr KK Aggarwal
A modern successor to the Hippocratic Oath for physicians around the world has been approved by the World Medical Association.
Physician leaders, meeting at the WMA's annual General Assembly in Chicago approved revisions to the Declaration of Geneva, which was adopted by the Association in 1948.
The revised Declaration, to be called a pledge, refocuses the text to reflect changes over the decades in the relationship between physicians and their patients and between physicians themselves. As a result, the new pledge makes specific reference for the first time to respecting the autonomy of the patient, which is not included in the current text. It also includes a new obligation for respect between teachers, colleagues and students.
The present Declaration says students must respect their teachers, but there is no reciprocity. There is a new obligation on physicians to share medical knowledge for the benefit of their patients and the advancement of healthcare.
Also added is a requirement for physicians to attend to their own health, well-being and abilities in order to provide care of the highest standard.
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Top News
Today is World Food Day
World Food Day is celebrated every year globally on October 16. The day marks the founding of the Food and Agriculture Organization (FAO) of the United Nations in 1945. World Food Day also shows commitment to Sustainable Development Goal (SDG) 2 "to achieve Zero Hunger by 2030". 
The theme this year is "Change the future of migration. Invest in food security and rural development".
Practice Updates
High SVR with glecaprevir + pibrentasvir in patients with hepatitis C and severe kidney impairment
Treatment with glecaprevir and pibrentasvir for 12 weeks resulted in a high rate of sustained virologic response (SVR) in patients with stage 4 or 5 chronic kidney disease and hepatitis C infection, according to a study published October 12, 2017 in the New England Journal of Medicine.

Study identifies prognostic factors in neurosarcoidosis
In a study of patients with neurosarcoidosis published online October 9, 2017 in JAMA Neurology, encephalic and peripheral nervous system involvement were associated with worsening of the functional score. Immunosuppressive therapies were associated with lower relapse rates.

CMR helps risk stratification in patients with suspected myocarditis
Tissue characterization with cardiac magnetic resonance (CMR) imaging provides effective risk stratification in patients with suspected myocarditis, says a study reported in the October 2017 issue of the Journal of the American College of Cardiology. A normal CMR study corresponded to low annual major adverse cardiovascular events (MACE) rate, while a patchy distribution was associated with 3-fold increased MACE rate.

Combined treatment superior to either SSRI or CBT monotherapy
Secondary analysis of outcomes in the Child/Adolescent Anxiety Multimodal Study (CAMS) showed that children and adolescents with severe anxiety who were treated with the combination of selective serotonin reuptake inhibitor (SSRI) sertraline and cognitive-behavioral therapy (CBT) were 3-times more likely to undergo remission of their anxiety. The study is published online September 28, 2017 in the Journal of Clinical Child and Adolescent Psychology.

Dual-focus contact lens slows myopia progression in children
A dual-focus contact lens was found to slow the progression of myopia in children compared to a single-vision lens, according to findings of a study presented October 12, 2017at the American Academy of Optometry (AAOpt) 2017 in Chicago, USA. The efficacy was maintained for the study duration of three years
eMedi Humor
Customer: My keyboard is not working anymore. 
Tech support: Are you sure it's plugged into the computer? 
Customer: No. I can't get behind the computer. 
Tech support: Pick up your keyboard and walk 10 paces back. 
Customer: OK 
Tech support: Did the keyboard come with you? 
Customer: Yes 
Tech support: That means the keyboard is not plugged in. Is there another keyboard? 
Customer: Yes, there's another one here. Ah...that one does work.
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 5 years, organised by reputed professional academic bodies or any other authorised 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
Interscalene approach to brachial plexus block does not provide optimal surgical anesthesia in the area of distribution of which of the following nerve: 
1. Musculocutaneous. 
2. Ulnar 
3. Radial 
4. Median.
Lifestyle Updates
eWellness: Tips to maintain a healthy lifestyle
  • Follow a healthy eating plan. Make healthy food choices, keep your calorie needs and your family's calorie needs in mind, and focus on the balance of energy IN and energy OUT. 
  • Focus on portion size. Watch the portion sizes in fast food and other restaurants. The portions often served are enough for two or three people. Children's portion sizes should be smaller than those for adults. Cutting back on portion size will help you balance energy IN and energy OUT. 
  • Be active. Make personal and family time active. Find activities that everyone will enjoy. For example, go for a brisk walk, bike or rollerblade, or train together for a walk or run. 
  • Reduce screen time. Limit the use of TVs, computers, DVDs, and video games because they limit the time for physical activity. Health experts recommend 2 hours or less a day of screen time that does not work- or homework-related. 
  • Keep track of your weight, body mass index, and waist circumference. Also, keep track of your children's growth. 
  • Ensure that your abdominal circumference is lower than 80 cm/90cm (women and men) 
  • Keep fasting sugar lower than 80 mg% and blood pressure lower than 80 mm Hg. 
  • Keep heart rate lower than 80 per minute and bad LDL cholesterol lower than 80 mg%. 
  • Do not consume more than 80 grams of caloric solid or liquid food at once. 
  • Observe carbohydrate fast 80 days a year. 
  • Consume at least 80 fruits and vegetables servings in a week.

ESpiritual: How to remove negative thoughts
Darkness is the absence of light and similarly, negative thoughts are absence of positive thoughts. The answer to negative thoughts is to bring back positive thoughts. An idle mind is the devil's workshop and so will always think negative. Here are some ways by which you can get rid your negative thoughts.
  • Think differently as taught by Adi Shankaracharya. Once Menaka approached Arjuna with lust and said that she wanted to have a son like him with him. Arjuna said that why wait for 25 years consider me as you son from today.
  • Think opposite as taught by Patanjali. For example, if you are having a thought to steal, silently start thinking of charity.
  • Think positive as taught by Buddha. Make a list of positive actions to be done today as the first thing in the morning and concentrate on that list. Divert your mind to your list of pending jobs. This is a type of behavioral therapy.
(Disclaimer: The views expressed in this write up are my own).

Inspirational: Going the Extra Mile 
I was 20 and had just finished my first degree when I asked my father's advice on how to approach the world of work. He had a long and distinguished career in the Indian Army and rose to become commander-in-chief of a million men. He was a soldier's soldier and his men adored him. His manner was strict and firm, but he was very friendly. He appreciated and trusted people and gave then freedom. 
"Come and see me in my office if you want to talk to me about work" he said. So I made an appointment with his ADC and went to see him. He had a huge office and I felt very small. 
"You are starting out and you will be given a lot of tasks to fulfill" he said. "The first thing is always to do something to the best of your ability. Then the second time you do it, give it that little bit extra". What he was saying was: "Take the initiative; be innovative; be creative. Always go the extra mile."
India still lags behind in child nutrition with a child-wasting prevalence of 21%
A healthy diet including all food groups is key to preventing this condition
New Delhi, 15 October 2017: Twenty-one percent of children under 5 years of age in India suffer from wasting, according to a report. India has not seen any significant strides in checking the prevalence of this indicator since the last 25 years. Djibouti, Sri Lanka, and South Sudan are the only remaining countries in the Global Hunger Index (GHI) 2017 with a child-wasting prevalence over 20%. Child wasting is one of the four indicators in the GHI.
Statistics indicate that the prevalence of child wasting in India has increased from 17.1% in 1998-2002 to 21% in 2012-16. This is way above the global prevalence. Wasting or thinness in a child is the result of acute and inadequate nutrition along with frequent infections leading to rapid weight loss or failure to gain weight normally.
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