Internet addiction a red flag for mental health problems

Internet addiction a red flag for mental health problems Over-reliance on the Internet, social media and instant messaging in particular, might be linked to depression, anxiety and impulsivity, according to a study presented at the recent 29th European College of Neuropsychopharmacology Annual Meeting in Vienna, Austria. In the study from Canada, researchers evaluated the internet use of 254 freshmen at McMaster University in Ontario. The researchers used a tool called the Internet Addiction Test (IAT), developed in 1998, as well as their own scale based on more recent criteria. 33 students met criteria for internet addiction, and 107 for problematic internet use. The researchers also assessed the students' mental health, including signs of impulsiveness, depression, anxiety and stress. Most of those addicted to the internet had trouble controlling their use of video streaming and social networking sites as well as instant messaging tools. They had more trouble handling their daily routines and higher rates of depression, anxiety, impulsiveness and inattention. They also had problems with planning and time management. Excessive use of the internet may have a strong association with compulsive behavior and addiction.

A Heart Healthy Prescription

A Heart Healthy Prescription Cardiovascular disease (CVD) is one of the leading Global causes of morbidity and premature mortality contributing to over 17.5 million deaths every year New Delhi, 25 September 2016: The increasing incidence of cardiac diseases is causing serious concern amongst the medical fraternity of India. The primary reasons for this include the lifestyle irregularities of the 21st century Indian. In addition to this, early signs of heart disease are often ignored or not taken seriously causing grave problems in the future. According to Padma Shri Awardee, Dr. KK Aggarwal, President HCFI & President Elect IMA, “The number of heart patients in India can be drastically reduced if every individual lives a healthy and balanced lifestyle and immediately makes necessary lifestyle modifications whenever heart disease symptoms are reported. People often get fooled by misconceptions about heart diseases and hence, it becomes really important to understand the facts associated with your heart. For instance women often continue to believe that they can never suffer from heart disease. However, this is a myth. Similarly, it is often believed that heart disease only happens in those above the age of 55. The reality is that in the present day and age, heart disease is increasingly common in people in the age group of 30-40 years.” “Heart disease prevention and education must from the very onset because the seeds of heart disease are sown in teenagers and young adults. Over the years, the plaque in the wall of the arteries continues to clog them causing heart attacks and episodes of sudden cardiac arrest. Hypertension, diabetes, and obesity must be kept under check since they all can lead to heart attacks", he added. According to reports, more women have died from heart attacks than men in past 30 years. Doctors recommend that everyone regardless of their gender get regular cholesterol level and blood pressure checked as in the case of women, they rarely experience conventional symptoms such as heartache or pain in the chest. Lifestyle modifications are key for the reversal of CAD. If you have to consume alcohol, drink in moderation. Drinking excessive amounts of alcohol causes raised blood pressure, which is one of the most important risk factors for having a heart attack or a stroke. Increases in your blood pressure can also be caused by weight gain from excessive drinking. Obesity too leads to cardiovascular ailments. Additionally, the difference between good and bad cholesterol must be understood. While some fat is good for the body, consuming a high-trans-fat diet can cause plaque deposit over the long run A healthy and balanced diet is key for a healthy heart. An over-dependence on junk food, consumption of saturated and trans fats, food containing high salt and sugar levels cause obesity, high cholesterol, hypertension and diabetes, all key risk factors for heart disease. A healthy diet must consist of items, which have low levels of saturated fats, fresh fruits and vegetables. You should immediately break away from the thinking that ‘exercising is too risky if you have a heart disease’ as doctors recommend regular exercises to people with heart issues. Also, Regular exercise is important to strengthen one's, heart, lower blood pressure, keep obesity under control, burn off stress, boost your self-esteem and help you sleep better. By regularly exercising for at least 30 minutes three to four times a week, one can keep their heart healthy. Aerobic exercise particularly is beneficial for patients with a tendency to get heart disease. Heart’s care continues for as long as you live. In addition to this, heart disease can develop again after you have got yourself treated. Many individuals suffer heart attacks twice or thrice in their lives. But the best remedy to totally undo all the damage is by start following a healthy regime that will make you less prone to all the heart casualties. Formula of 80 to live a healthy life till the age of 80 years 1. Keep your abdominal circumference less than 80cm 2. High blood pressure and its risks, keep the lower reading at 80 3. Keep your blood sugar below 80mg 4. Bad cholesterol levels should be lesser than 80mg 5. Keep the pulse lower than 80 beats per minute 6. Eat a balanced diet and avoid cereals for 80 days in a year 7. Get at least 80 minutes of exercise in a week 8. Consume alcohol in moderation, not more than 80 grams in a week for men and two weeks for women

Heart Disease is the most common cause of death and disability in urban women

Heart Disease is the most common cause of death and disability in urban women New Delhi, September 24, 2016: In India, urban women are more at risk of heart disease today than they were three years ago. The reasons for this include an unhealthy lifestyle characterized by a predominantly high trans fat, sugar and salt diet, inadequate physical exercise, increased stress levels, dependence on addictive and extremely harmful substances like alcohol and cigarettes amongst others. The largest group of women at risk of CVD are aged 35-44. CVD risk is as high amongst housewives as it is amongst working professionals. As far as risk factors for CVD are concerned, low HDL and high BMI are the two most common contributors to CVD risk setting in as early as 35 years for women. “Important differences between women and men in the presentation of heart disease make it more difficult to establish a diagnosis in women. For instance heart disease in women generally presents 10 years later than men and with greater risk factor burden. Women are also less likely than men to have typical angina and have a higher false positive rate in the tredmill test. The symptops women face are also different than those faced by men”, said Padma Shri Awardee, Dr. KK Aggarwal, President HCFI & President Elect IMA. It is a fact that women are more likely to present initially with chest pain than a more clearly defined event such as heart attack. Many cases of heart attack in women also go unrecognized. In addition to this small vessel disease is more common in women than in men. The established risk factors of heart disease in women include the presence of history of heart blockages; age over 55 years; high LDL (bad cholestol) or low HDL (good cholestrol) , diabetes, smoking, high blood pressure, peripheral artery disease or family history of heart disease. Risk factors, which are more potent in women than in men include regular consumption of tabocco which causes 50% of all coronary events in women; obesity and diabetes. Following are the ways in which women can prevent future heart disease Moderate intensity physical activity for at least 30 minutes and for 60 to 90 minutes for weight management on most days of the week Avoidance and cessation of cigarette smoking and passive smoking Keep waist circumference less than 35 inches Consume a heart-friendly diet Presence of high triglyceride levels. One should add Omega 3 fatty acids to diet. Control cholesterol level, high blood pressure and diabetes Women who smoke should avoid oral contraceptive pills. Aspirin 80 mg in more than 65 years of age should be added Treat underlying depression.

Virtual Clinics: IMA Viewpoint

Virtual Clinics: IMA Viewpoint • In one of its judgment, Martin F. D’Souza vs Mohd. Ishfaq, 3541 of 2002, dated 17.02.2009, the Supreme Court has said that medicines should not be prescribed in a telephonic consult, unless it is an emergency. But this does not apply to counselling and advice. The Govt. of India runs helplines on mental health, tobacco cessation, child sexual abuse etc. • ‘Virtual visit’ is a new trend today. It is available via video conferencing apps that can be downloaded to a smartphone, tablet or home computer. • Patients can experience a ‘virtual’ visit with a qualified physician at any time, day or night. It’s not just a fad. The benefits go beyond triage. It’s a step towards remote, affordable, convenient primary health care. • In the west, the cost can be half of in-person visit, and most insurance companies are now covering them. In the United States, Blue Cross policies, offer the services of their own virtual doctor free of charge. Medicare does not cover virtual visits. The cost of a virtual visit can be even less than the out-of-pocket co-payment that Medicare requires for an in-person doctor visit. • In US, the consulting doctors are licensed, vetted and are assigned to the patient based on where he or she lives. They carry malpractice insurance and are authorized to order tests and prescriptions. However, without actually seeing the patient in person, they may not be able to evaluate the patient completely. • There are limitations in such consults. A physician can look at your rash, but he or she cannot examine the back of your throat or listen to your lungs. While this may not make a difference in patients with depression, a physical examination is essential in patients with abdominal pain. • The care may be no different. People who go to a virtual visit are just as likely to have a follow-up appointment in the next few weeks, have similar antibiotic prescribing rate. However, one is most likely to end up with a broad-spectrum antibiotic and less specific drugs and specific tests like in strep throat. • In US, two of the most widely used are Teladoc (www.teladoc.com) and Doctor On Demand (www.doctorondemand.com). • Virtual visits are not meant to replace doctor’s office visits but may be a good option for minor, temporary problems (cold, flu, sinusitis, a non strep sore throat, rash, diarrhea, vomiting, or conjunctivitis, especially in odd hours or for follow up visits. • It’s best to see your regular doctor as soon as possible.

Heart Care Foundation of India’s (HCFI) annual flagship event – the MTNL Perfect Health Mela to focus on controlling vector-borne diseases like Chikungunya, Dengue & Zika

Heart Care Foundation of India’s (HCFI) annual flagship event – the MTNL Perfect Health Mela to focus on controlling vector-borne diseases like Chikungunya, Dengue & Zika Commemorating 25 years of its inception, the theme for this year's Perfect Health Mela will be ‘One Health.' New Delhi, 23rd September 2016: HCFI, a leading national non-profit organisation, committed to making India a healthier and disease-free nation, today announced the theme and details of its flagship event, the MTNL Perfect Health Mela 2016. The Mela will be organised from October 25-29, 2016 at the Talkatora Indoor Stadium, New Delhi jointly with Health & F.W. Dept. NCT Delhi, MTNL, NDMC & other Central & Delhi state Government department. The Indian Medical Association will be the knowledge partner for the event. An annual event curated to spread mass health awareness using entertainment as a medium; the theme for this year’s event is “One Health” and will focus on the current vector-borne disease menace in the country with special reference to chikungunya, dengue, malaria and Zika. Speaking about the Mela Padma Shri Awardee Dr KK Aggarwal, President HCFI & President Elect IMA said, “The Perfect Health Mela will lay an increased focus on the importance of ‘One health’, a Global movement pressing the need for a collaborative effort of multiple disciplines — working locally, nationally, and globally — to attain optimal health for people, animals and the environment. We will also aim to raise mass awareness about the prevention of mosquito-borne diseases and the dangers of unnecessary platelet transfusion.” Started in 1993, the Perfect Health Mela caters to people from all age groups and all walks of life. It showcases activities across categories such as health education seminars, check-ups, entertainment programs, lifestyle exhibitions, lectures, workshops, and competitions. The Mela is attended by over 200 organisations each year including those from the State and Central government, PSUs, and leading corporates. The various events being organised this year include the Harmony & Ecofest National inter-school competitions, IMA Baby Shower program Healthy baby show, Anmol- inter-school competitions of children with special needs, Heritage National School Classical Dance Competitions, Divya Jyoti Medico Masti National Youth Competitions and a spiritual gurus conference on “All Faith Consensus on One Health”. Free medical check-ups will be provided to all visitors. Dr N V Kamat advisor IMA and former director health services Delhi Government and Dr R N Tandon, Honorary Finance Secretary IMA in a joint statement said that less than 50% people at any given time are aware of the national and state health programs and the Perfect Health Mela will give an opportunity for the people to know and take advantage of health programs. Dr P K Sharma, Medical Health Officer, NDMC & the civic partner of the year’s Perfect Health Mela in a statement said, ‘We congratulate Heart Care Foundation of India on this initiative and will extend our complete support towards making the event a success". For more information about the event, please visit www.perfecthealthmela.com./ http://www.heartcarefoundation.org/ Entry to the Mela is free for all.

Never tell patients to reduce their stress… tell them how to reduce the stress instead

IMA Detox President Secretaries Meet

Never tell patients to reduce their stress… tell them how to reduce the stress instead

Doctors very commonly advise patients to reduce their stress. But, what we don’t tell them is how they can do so.

A Detox Leadership Meet was recently organized by IMA HQs at Om Shanti Retreat Centre at Manesar in Gurgaon (Haryana). At the meet, when asked to define stress, every doctor had a different answer to the question.

Under the IMA 1 Voice Program, all IMA members should be clear and speak in one language.

The correct definition of stress is “the reaction (evident or silent) of the body and/or the mind to the interpretation of a known situation”.

The components of stress therefore include:

·         A known situation, which may or may not be alterable

·         An interpretation, which may be natural, positive or negative

·         A reaction, often modifiable, which can be at the level of mind and/or the body and this reaction can be evident or silent. 

Stress management, therefore involves changing or modifying the situation, modifying the interpretation of a given situation or living a lifestyle, which prepares the body and the mind in such a way that the stress alerts or modifies the reaction or does not allow the body to react. This can be done by proper diet, regular physical exercise, pranayama, meditation and relaxation techniques.

Patients should be educated that while a certain amount of stress does motivate us to perform better by putting in extra efforts and do a good job, too much stress or long-standing stress can be detrimental to health.

People overeat (comfort foods), start smoking, drinking or use drugs etc. as means to deal with their stress. These factors, by themselves, increase the risk of many lifestyle diseases such as heart disease, diabetes, obesity, hypertension. Anger or emotional stress, has been known to precipitate a heart attack or trigger arrhythmias. 

Health Ministry Notification on Japanese Encephalitis All confirmed Japanese encephalitis cases to be notified The Ministry of Health & Family Welfare has issued a notification on Japanese Encephalitis on Wednesday to the concerned health authorities of all the states and has requested the states of Assam, Bihar, Tamil Nadu, Uttar Pradesh and West Bengal where the number of JE cases has been reported to be high, to issue necessary notification under the Clinical Establishment (Registration & Regulation) Act, 2010 or relevant Act/Rules as applicable, to ensure necessary monitoring, prevention and control of the disease. 1. “Japanese Encephalitis (JE) is an important public health concern in the country accounting for substantial morbidity, mortality and disability. Early reporting of JE cases is necessary for effective implementation of preventive measures and case management. 2. In order to ensure early diagnosis & case management, reduce transmission, address the problems of emergency and spread of disease in newer geographical areas, it is essential to have complete information of all JE cases. Therefore, the healthcare providers shall notify every JE case to local authorities i.e. District Health Officer/Chief Medical Officer of the district concerned and Municipal Health Officer of the Municipal Corporation/Municipality concerned every week (daily during transmission period). 3. Accordingly, all laboratory-confirmed cases of Japanese Encephalitis should be notified as detailed below. (A) Definition of laboratory-confirmed JE case: Patient having any one of the following: • Presence of lgM antibodies specific to JE virus in a single sample of cerebrospinal fluid (CSF) or serum, as detected by an lgM-capture ELISA specifically for JE virus. • Detection of a fourfold or greater rise in antibodies specific to JE virus as measured by haemagglutination inhibition (Hl) or plaque reduction neutralization assay (PRNT) in serum collected during the acute and convalescent phase of illness. The two specimens for lgG should be collected at least 14 days apart. The lgG test should be done in parallel with other confirmatory tests to eliminate the possibility of cross-reactivity. • Isolation of JE virus in serum, plasma, blood, CSF or tissue. Detection of JE-virus antigens in tissue by immunohistochemistry; • Detection of JE-virus genome in serum, plasma, blood, CSF or tissue by reverse transcriptase polymerase chain reaction (PCR) or an equally sensitive and specific nucleic acid amplification test. (B) A suspected case is defined as: A person of any age, at any time of year, with the acute onset of fever, not more than 5-7 days duration and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk) AND/OR new onset of seizures (excluding simple febrile seizures). Other early clinical findings can include an increase in irritability, somnolence or abnormal behaviour greater than that seen with usual febrile illness. 4. For the purpose of this notification, healthcare providers will include clinical establishment run- or managed by the Government (including local authorities), private or NGO sectors and/or individual practitioners under Clinical Establishment (Registration & Regulation) Act, 2010. 5. The doctors in Government Health Institutions and the registered medical private practitioners of the private hospitals/clinics are required to immediately inform the office of the District Health Authority of concerned district, if a suspected case of JE is reported at their health institution. 6. The blood samples of the all JE suspected cases have to be sent to the JE Sentinel surveillance Hospital (SSH), to be tested by ELISA technique. The information of the positive case should be sent to the office of the District Health Authority immediately after the diagnosis. 7. The management of the JE cases need to be done as per the guidelines issued by the Government of the India from time to time and available on the website of Directorate of National Vector Borne Disease Control programme (NVBDCP), Government of India.” (Source: Press Information Bureau, Ministry of Health and Family Welfare, 21st September, 2016)