Sunday, 19 November 2017

WMA European Region Meeting on End-of-Life Questions

WMA European Region Meeting on End-of-Life Questions
On Thursday and Friday, 16-17 November 2017, medical professionals, legal authorities, experts in palliative care and medical ethics, theological scholars and philosophers from over 30 countries gathered in the Aula Vecchia del Sinodo in the Vatican for the World Medical Association European Region Meeting on End-of-Life Questions.

Hosted by the World Medical Association (WMA), the German Medical Association (GMA) and the Pontifical Academy for Life (PAV), this two-day event provided a platform for debating the different policies and perspectives on end-of-life issues in Europe, for exploring patient rights, treatment limitations, and palliative care, and for better understanding public opinion on these complex topics.

On the first day, the Congress was introduced by a meaningful and rich message from His Holiness Pope Francis, read by Cardinal Turkson, Prefect of the Dicastery for promoting integral human development. In his words, Pope Francis developed a deep reflection about the frailty of life and the need to support it with good practices. 
Opening remarks were also delivered by WMA President Dr Yoshitake Yokokura, GMA President Prof. Dr. Frank Ulrich Montgomery and PAV President Archbishop Msgr. Vincenzo Paglia. The program continued with a look at three different perspectives on end-of-life questions by Professor Montgomery, Dr René Héman, Chairman of the Royal Dutch Medical Association, and Dr. Yvonne Gilli, Board Member of the Swiss Medical Association.

The subsequent session highlighted insights on end-of-life questions from different religious and theological backgrounds.

Rounding out the first day of programming was a session focused on examining legal aspects of euthanasia and physician-assisted suicide, which included a contribution from Prof. Dr. Volker Lipp, Professor of Civil Law, Civil Procedure, Medical Law and Comparative Law at Georg-August-Universität. This was followed by an overview of the Council of Europe’s Guide on the decision-making process regarding medical treatment in end-of-life situations as illustrated by Dr. Laurence Lwoff, Head of the Bioethics Unit of the Council of Europe’s Human Rights Directorate, and a series of presentations, including a talk by Prof. Dr. Leonid Eidelman, President of the Israeli Medical Association, exploring various aspects of compassionate use and conscientious objection.

Day two of the conference opened with an ethical debate surrounding the question of whether there is a right to determine one’s own death, after which Dr. Anne de la Tour, President of the French Society of Palliative Care, shared her expertise on treatment limitations and end-stage decisions about sedation.

Representing the patient’s perspective was Dr. Marco Greco, President of the European Patients’ Forum, who delivered a presentation on public opinions of key end-of-life issues.

The final day closed with a plenary panel discussion featuring six speakers from Switzerland, Italy, Germany and the Netherlands, representing an extensive range of opinions and policy viewpoints. 

The in-depth discussions held over the course of the two-day conference were intended to contribute to an overarching debate on end-of-life issues recently initiated by the WMA’s Medical Ethics Committee. To capture the global scale of this debate, the WMA set out to co-organize a series of regional meetings on nearly every continent. Previous meetings have been held in Tokyo and Rio de Janeiro. The WMA African Region Meeting on this subject will take place in early 2018 in Nigeria.

(Source: WMA, November 17, 2017)

About 60 million people around the world have Computer Vision Syndrome

About 60 million people around the world have Computer Vision Syndrome
Increasing amount of screen time has led to this condition exacerbating further, even in toddlers

New Delhi, 18 November 2017: As per recent statistics, the incidence of Computer Vision Syndrome ranges from 64% to 90% among computer users. About 60 million people globally suffer from this condition, with another million new cases occurring every year. According to research, our blinking frequency, which is supposed to be 15 to 20 times per minute, goes down by approximately 60% while using a computer.
Computer Vision Syndrome refers to a group of eye and vision-related problems that result from the prolonged usage of computers, tablets, e-readers and cell phones. The level of discomfort apparently increases with the amount of digital screen use.
Using a computer or staring at a screen for prolonged periods can cause symptoms such as dryness, watering, and itching in the eyes, blurred vision, headaches, neck and back pain.
Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "Screen usage has increased everywhere today, be it among students or adults. Even toddlers are given mobile phones to watch videos and cartoons, etc. When we gaze at any screen, the eyes converge to focus on a point and this position is maintained for longer periods of time. On an average, a person spends about 4.4 hours of leisure time in front of screens. Add to this, the 8 to 10 hours spent on laptops and desktops in offices. That is how pervasive this phenomenon is. When a person is focusing on the screen, the eyes move back and forth. In an office setting, one may need to also look down at papers and then back up to type. The eyes react to changing images on the screen to create so the brain can process what is seen. All this puts a lot of strain on the eye muscles. To make things worse, unlike a book or piece of paper, the screen adds contrast, flicker, and glare.”
Uncorrected vision problems like farsightedness and astigmatism, inadequate eye focusing or eye coordination abilities, and aging changes of the eyes, such as presbyopia, can all contribute to the development of visual symptoms when using a computer or digital screen device.
Adding further, Dr Aggarwal, said, “Another issue is that people often use their mobiles before they go to sleep. This can disturb sleep and also put a lot of stress on the eyes and the brain. It is better to listen to good music or even meditate an hour before hitting the bed. The first step to prevention is an awareness of the problem. There is a need to consciously wean ourselves away from screens.”
The following tips can help prevent computer vision syndrome.

  • It is good to take a full one-week social media holiday if you are addicted to various social media.
  • Everybody should have 30 minutes of electronic curfew before they sleep. This means not using mobile phones and other mobile devices for 30 minutes before sleep.
  • Use mobile only when mobile.
  • Limit mobile talk time to less than 2 hours a day.
  • Once the battery is discharged, call it a day for mobile use.
  • Follow the formula of “20-20-20 to prevent dry eyes: every 20 mins, focus the eyes on an object 20-feet (6 meters) away for 20 seconds or close the eyes for 20 seconds, at least every half hour.
  • Spend less than 3 hours on a computer at a stretch.

Saturday, 18 November 2017

Treatment gap and social stigma, the biggest barriers for those with epilepsy

Treatment gap and social stigma, the biggest barriers for those with epilepsy 
Need to remove misconceptions and myths associated with the condition

New Delhi, 17th November 2017: About 80% of those with epilepsy live in low and middle-income countries, as per reports by a global health body(WHO). Over 50 million people around the world suffer from this condition and about three-fourth of these live in low- and middle-income countries. The ‘treatment gap’ and the social stigma associated with the disorder in India further exacerbate conditions for people with epilepsy.

Epilepsy is a chronic disorder of brain characterized by recurrent ‘seizures’ or ‘fits’. The seizures are caused due to sudden, excessive electrical discharges in the neurons (brain cells). The condition can affect people at any age and each age group has unique concerns and problems.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "The International League Against Epilepsy (ILAE) has expanded the definition of epilepsy to incorporate a single unprovoked seizure with a probability of future seizures. The new definition also specifies that epilepsy can be considered ‘resolved’ if a patient has been seizure-free for 10 years, with no seizure medicines for the last 5 years. The previous definition stipulated that a patient needs to have 2 unprovoked seizures more than 24 hours apart. Epilepsy is mostly treatable with medications. The critical thing about epilepsy is that treatment should not be delayed. Start the treatment as soon as it is diagnosed. This prevents further deterioration of the condition.”

Some causative factors for epilepsy include brain damage from prenatal and perinatal injury, congenital abnormalities, brain infections, stroke and brain tumors, head injury/accidents, and prolonged high fever during childhood.

Adding further, Dr Aggarwal, said, “A lot of progress has been made in the country for treating epilepsy and controlling the onset of seizures. Many effective new anti-epileptic drugs are available in the market today. India also many centres that offer treatment facility for this condition. Only mass awareness can dispel the associated myths with epilepsy. It is important to create awareness that those with epilepsy can lead a normal life, get married, have children, and even work. This is not a contagious condition and does not spread through contact.”

One of the major reasons for incomplete control of seizures is non-compliance. Some tips to prevent onset of seizures and the condition from getting worse are as follows:

  • Adhere to the prescribed medication
  • Following a regular sleep cycle to remain stress-free
  • Keep yourself hydrated
  • Eat a balanced diet
  • Get regular medical checkups done

Exposure to air pollution in early pregnancy linked to miscarriage

Exposure to air pollution in early pregnancy linked to miscarriage

The adverse effects of air pollution on the lungs and heart are well-known and often spoken about.
Exposure to the toxic pollutants in the air can affect even the reproduction system.

A study conducted by the National Institutes of Health (NIH) has suggested that exposure to common air pollutants, such as ozone and fine particles, may increase the risk of early pregnancy loss.

The study published online November 16, 2017 in the journal Fertility and Sterility examined the effect of the exposure to ozone in 501 couples based on pollution levels in their residential communities. Ozone is a highly reactive form of oxygen that is a primary constituent of urban smog.

  • Ninety-seven (28%) of the 343 couples who achieved pregnancy experienced an early pregnancy loss before 18 weeks.
  • Couples with higher exposure to ozone had a 12% greater risk of suffering an early pregnancy loss.
  • Couples exposed to particulate matter were 13% more likely to experience a loss.

Although the cause of pregnancy loss is not well understood, impaired fetal development due to increased inflammation of the placenta and oxidative stress has been suggested as a possible factor. Based on the findings of the study, pregnant women are advised to curtail outdoors activity when pollution levels are high and the air quality is of hazardous level.

(Source: NIH, November 16, 2017)

Friday, 17 November 2017

Eating nuts is good for the heart

Eating nuts is good for the heart

People who regularly eat nuts, including peanuts, walnuts and tree nuts, lower their risk of developing cardiovascular disease or coronary heart disease compared to people who never or almost never eat nuts.

The study group comprised more than 210,000 people, including women from the Nurses’ Health Study and Nurses’ Health Study II and men from the Health Professionals Follow-up Study. The study participants were followed up for up to 32 years. In addition to the association between consumption of nuts as a whole with heart disease, researchers in this study also examined the association between specific types of nuts such as peanuts, walnuts and tree nuts with major cardiovascular events. The study included peanuts as they have a similar fatty acid and nutrient profile as other nuts. Peanuts are not nuts; they are actually legumes.

Researchers documented 14,136 cardiovascular disease cases, including 8,390 coronary heart disease cases and 5,910 stroke cases.

A consistent inverse association between total nut consumption and total cardiovascular disease and coronary heart disease was found. Compared to those who never consumed nuts.

·         Eating walnuts one or more times per week was associated with a 19% lower risk of cardiovascular disease and 21% lower risk of coronary heart disease.
·         Eating peanuts two or more times per week lowered the risk of cardiovascular disease by 13% and coronary heart disease by 15%.
·         Eating tree nuts two or more times per week lowered the risk of cardiovascular disease by 15% and coronary heart disease by 23%.

Prior studies suggest health benefits like a lower risk of heart disease and type 2 diabetes and lower cholesterol, among other health outcomes. Nuts are nutrient–dense foods. They contain unsaturated fatty acids, fiber, vitamins, minerals and antioxidants.

Nuts have no cholesterol; they are rich in polyunsaturated fats (PUFAs). They also contain fiber, vitamins, minerals and antioxidants. Nuts therefore help to reduce cholesterol levels and lower risk of heart disease and type 2 diabetes. Eating nuts is good for the heart.

The study has been published November 13, 2017 in the Journal of the American College of Cardiology.

(Source: ACC News, November 13, 2017)

Energy drinks do more harm than good to the body

Energy drinks do more harm than good to the body
The caffeine and other ingredients in these drinks can lead to various health issues in the long term

New Delhi, 16 November 2017: Consumption of energy drinks can cause serious health risks including risk-seeking behavior, mental health problems, increased blood pressure, obesity, and kidney damage, warns a recent study. Another worrying phenomenon is that of mixing energy drinks with alcohol. The ingredients in most energy drinks include water, sugar, caffeine, certain vitamins, minerals and non-nutritive stimulants such as guarana, taurine, and ginseng.

Certain energy drinks have about 100mg caffeine per fluid ounce which is eight times more than regular coffee, which has 12mg per fluid ounce of caffeine. While the daily recommended caffeine intake for adults is 400mg, there is not enough research on the tolerable levels for children and adolescents. All the above-mentioned health risks are due to the high sugar and caffeine levels in these energy drinks.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Energy drinks can cause more harm than good. The large amounts of caffeine in them can lead to serious heart rhythm, blood flow, and blood pressure problems in the young and old alike. Taurine, one of the ingredients in these drinks, is a caffeine adjuvant, meaning that it aids the effects of caffeine. Apart from this, those who mix energy drinks with alcohol end up consuming more alcohol than if they were drinking alcohol alone. Energy drinks are thought to mask the signs of alcohol inebriation, thus making a person consume more and increasing the likelihood of dehydration and alcohol poisoning.”

Energy drinks can be potentially dangerous for certain groups including those under 18 years of age, pregnant women, those with caffeine sensitivity, and people on certain medications such as Adder all, which is prescribed for ADHD.

Adding further, Dr Aggarwal, said, “It is also often seen that energy drinks are marketed and sold in stores under the same category as sports drinks. However, as per studies, they do not help in enhancing or promoting athletic ability in any way. It is important to remember that our body can obtain energy from other sources as well and that we do not need to depend on these energy drinks or caffeine for the same. Understanding this can help avert many complications in the longer term.”

Here are few food items that can help you keep alert and energized through the day, albeit naturally.

  • Green tea It contains vitamins A, B, C and E, and improves circulation and metabolism. It also contains L-theanine which is an antioxidant found only in tea.
  • Wheatgrass It is rich in vitamins A, C, E, beta-carotene, amino acids, and calcium. The B vitamins, especially B12, iron and magnesium in wheatgrass do wonders in increasing energy levels.
  • Banana They can help in fighting fatigue due to the electrolytes present in them including potassium, magnesium, sodium, calcium, and phosphorus.
  • Water A person experiences decrease in energy levels when the water content in their body goes down. Make sure to consume enough water to fight away fatigue.
  • Nuts These are rich in protein, which stabilizes blood sugar levels. Nuts like walnuts and almonds are high in magnesium and omega-3 fatty acids, which help in boosting energy levels. 

Thursday, 16 November 2017

Eating too fast may increase obesity

Eating too fast may increase obesity

People who eat slowly are less likely to become obese or develop metabolic syndrome, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2017.

The study participants were grouped according to their speed of eating food into slow, normal or fast. After five years, it was found:

·         Fast eaters were more likely (11.6%) to have developed metabolic syndrome than normal eaters (6.5%) or slow eaters (2.3%).
·         Faster eating speed was associated with more weight gain, higher blood glucose and larger waistline.

Metabolic syndrome occurs when someone has any of three risk factors that include abdominal obesity, high fasting blood sugar, high blood pressure, high triglycerides and/or low HDL cholesterol.

According to the researchers, eating fast causes bigger glucose fluctuations, which can lead to insulin resistance. People who eat too fast without chewing their food tend to overeat as they tend not to feel full.

Our shastras including Yoga Sutras of Patanjali, Bhagwad Gita and the various Upanishads also tell us “You are what you eat”. Mealtime practices influence health.

It is important to be aware of the food we are eating. This is called mindful eating, which 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.

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."

With mindful eating, you are more aware of hunger and satiety cues, so you eat less.
Chewing food well improves digestion and more nutrients are absorbed as well.

Chewing food well also helps to eat less. You will enjoy every bite and relish the flavors of food.

(Source: AHA News Release, November 13, 2017)