Healthcare

130 is the new high!

Now almost half of the US adult population has high blood pressure, according to updated hypertension guidelines developed by the American Heart Association (AHA) and the American College of Cardiology which were presented at the AHA’s 2017 Scientific Sessions on 14th November. The guidelines, which are the first comprehensive new high blood pressure guidelines in over a decade, lower the threshold for high blood pressure to 130/80 mm Hg, rather than 140/90 mm Hg.

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With the previous definition, 1 in 3 US adults were defined as having high blood pressure (32%). The new guidelines will result in 46% of the US adult population having high blood pressure or hypertension. However, there will only be a small increase in the number of US adults who will require anti-hypertensive medication, according to the authors. These guidelines are designed to help individuals identify and address the potentially deadly condition much earlier.

In addition to the newly-updated threshold, the guidelines emphasise the importance of using proper technique to measure blood pressure. Blood pressure levels should be based on an average of 2-3 readings on at least 2 different occasions.

The new guidelines eliminate the category of prehypertension, which was used for blood pressures with a top number (systolic) between 120-139 mm Hg or a bottom number (diastolic) between 80-89 mm Hg. Patients with those readings now will be categorized as having either Elevated (120-129 and less than 80) or Stage I hypertension (130-139 or 80-89).

Previous guidelines classified 140/90 mm Hg as Stage 1 hypertension. This level is classified as Stage 2 hypertension under the new guidelines.

The impact of the new guidelines is expected to be greatest among younger people. The prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45 according to the report.

The new guidelines were developed by the American Heart Association, American College of Cardiology and 9 other health professional organisations. They were written by a panel of 21 scientists and health experts who reviewed more than 900 published studies.

Other changes in the new guideline include:

  • Only prescribing medication for Stage I hypertension if a patient has already had a cardiovascular event such as a heart attack or stroke, or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used in evaluating high cholesterol).
  • Recognizing that many people will need 2 or more types of medications to control their blood pressure, and that people may take their pills more consistently if multiple medications are combined into a single pill.
  • Identifying socioeconomic status and psycho-social stress as risk factors for high blood pressure that should be considered in a patient’s plan of care.

    Source

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Scientific theory of falling in love

First of all underlying all the emotion, thoughts, beliefs and hopes about love is our basic biochemistry. Humans are hard-wired to love so that they can breed.
Attraction is based on brain chemistry that included a group of neurotransmitters in our brain called monoamines, they are:
Dopamine
Norepinephrine
Serotonin
These create the feeling we experience as an attraction.

  • Dopamine is one of your brain’s “I feel good” chemicals (it’s where the term “dope” came from). It’s also involved in your brain’s motivation and reward systems. When you meet someone you’re attracted to, dopamine starts sending… I feel good chemical “rewards” to your system.
  • Norepinephrine (noradrenaline), delivers messages to your central nervous system. Norepinephrine is responsible for your ability to “block out” information that isn’t as interesting as the smart partner in front of you.
  • Serotonin regulates a lot of functions in your body, including sexual behavior and body temperature. When you are very attracted to someone, serotonin decreases your body temperature, which makes your skin slightly more able to conduct electricity. This is the reason that love can literally make your skin tingle and you say I am getting butterflies in my stomach.

Other than monoamines another neurotransmitter like oxytocin proved to help, it’s also called love hormone:
As in 2012, researchers reported that people in the first stages of romantic attachment had higher levels of oxytocin, compared with non-attached single people. Sexual activity has been found to stimulate the release of oxytocin, and it appears to have a role in erection and orgasm. It may be that the increased uterine motility may help sperm to reach their destination or correlation between the concentration of oxytocin and the intensity of orgasm.

In fact, experts say that attraction stimulates the same chemicals in the brain that addiction does, such as dopamine and oxytocin. If a boy/girl isn’t attracted to you, it’s nothing to do with you: it’s all down to the chemicals in each person’s brain.

A researcher at Rutgers University suggests that it takes less than one second for the brain to decide whether it considers someone to be attractive or not, hence this is how swipe right on tinder works.

  • You may be able to overcome or cope with this split-second first impression, or you may not.
  • If not, don’t take it personally people are not able to manage spontaneous impulses and what is judged may not have anything to do negatively with you.
    e.g. For instance, some women are drawn to men which are high risk-takers, some are more attracted to those who seem more cautious. There is nothing wrong with being either.

Understanding how attraction works may seem to take some of the mystery and magic from this human emotion. However, what it does make clear is that love and attraction is a fundamental part of how we are hard-wired. And it is on a level that is not heavily rational. And sometimes the chemistry literally is right or wrong.

Funny Quote: Here are some words of wisdom from Grandpa rick to his grandson Morty from the adult cartoon Rick and Morty:

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HOW TO PREPARE FOR THE NEET PG ENTRANCE EXAM? 

Although the study strategy should be individualized and varies from person to person. The general points that should be considered are:

1. The syllabus should be finished at least once (with crisp study material for final revision, mostly notes) around one month before the exams.

2. Keep last one month for revision only.

3. An average of 6 to 8 hours (focused) per day is sufficient for studies. There should be no use of facebook, WhatsApp like social network or any other distraction during these hours. Take small breaks after every 1.5 to 2 hours of study.

4. Keep ONE DAY OFF EVERY WEEK. It increases the productivity of remaining 6 days.

5. Most importantly give around HALF AN HOUR FOR REVISION DAILY for the topics you have studied in that particular day. Revising same day help in incorporating that topic in long term memory.

6. Try to practice around 100 MCQs daily WITHOUT SEEING THE ANSWERS. You should match the answers after solving these. Seeing the answer side by side is likely to miss many concepts which are unlikely if you answer using your memory and concepts.

7. The most important part of the preparation is to remember so many facts and concepts. One of the very effective methods for this is DISCUSSION. Keep on asking (the fact or concept which you feel is difficult) to everyone you meet. If you ask 5 people the same question, you are sure to remember this as you have revised it 5 times.

8. Another common mistake students tend to do is to target all the questions asked in previous years. You must be knowing, that even toppers never get 100 percent of marks in any competitive exams. So just keep in mind that if you know 80 to 90 percent of the questions in any competitive examination, it is good enough. The reason I am specifically focusing on this is that I have seen many students wasting time on many topics which are useless but have been asked once in some examination.
E.g. once a question was asked about speed of some mosquito, it is totally illogical to remember the speed of all the mosquitos because once it was asked on Anopheles, so it can be asked on Culex next time. In every exam, around 20 percent questions are asked which are unlikely to be repeated again ever. So, concentrate more on those topics which are frequently repeated and know them thoroughly and such type of questions should be just crammed.

9. One more area where most of the students waste a lot of time without any gain is regarding CONTROVERSIAL QUESTIONS. For some questions, different books mention different answers. Please don’t waste time on these questions and just remember any one which seems logical to you. Students keep on searching n number of books for these questions and still are confused. Even if you are able to find out some source, you still
won’t be sure that whether the examiner has made a question from that book or not. Remember, that’s why these questions are controversial. So, I will suggest not to waste time on these questions.

10. In any competitive examination, even if there is negative marking, attempt all the questions in which you have zeroed down to 2 options.

11. Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time. Certainly GIVING UP IS NOT AN OPTION one must have.

12. BOOKS AND NOTES recommended are:

First Professional: 
Anatomy: PhyBians by Dr Vivek Jain and class plus class notes
of Dr Rajesh Kaushal
Physiology: PhyBians
Biochemistry: Phybians or Biochemistry by Dr Rebecca James

Second Professional:
Pathology: Review of Pathology and Genetics by Dr Gobind Rai
Garg and Dr Sparsh Gupta
Pharmacology: Review of Pharmacology by Dr Gobind Rai Garg and Sparsh Gupta and classes of Dr Gobind Rai
Microbiology: Microbiology made easy by Dr Akhilesh or Book by Dr Apurba shastry
Forensic Medicine: Sumit seth book plus Dr Akhilesh Jhamad classes

Third Professional:
PSM: Dr Vivek Jain book + Class + Class notes
ENT: Dr Manisha Budhiraja or Dr Sakshi Arora
Opthalmology: SARP series ophthalmology by Dr Gobind Rai Garg and Dr Sparsh Gupta CBS Publishers

Final Professional:
Medicine: Dr Thameem class notes plus selected topics of Mudit
Khanna
Surgery: Class notes of Dr Deepak Guliani plus minus Dr Pritesh
surgery book
Obs and Gynae: Dr Puneet Bhojani
Orthopaedics: Dr Apurv Mehra Plus Ortho dhoom dhadaka
Radiology: Dr Sumer seth
Psychiatry, Anaesthesia, Dermatology: PROAFS by Dr Vivek Jain

Suggestions by: Dr. Gobind Rai Garg

A Complete Guide to take transfer in MBBS Internship

Taking transfer in internship of MBBS may very confusing and difficult for passed out medical student. I have concluded the easiest steps to get internship abroad of your college. For which I wasted so much of time as nobody was to help me in this guidance. So I thought why should I not write an article to help my fellow juniors to get transfer under 10 days.

Note: Always remember wherever someone require documents it should be good photo copy and not the original one, they may ask to see the original but it should be returned to you.

Step 1: Get to know where you want to take transfer, for this it is very important to verify that the college or hospital where you’re taking transfer is permitted by Medical Council of India (MCI). You can go through their website and see this list LINK:

Step 2: From your college first work you need to do is to get your provisional registration as soon as you get your passing certificate from your college. It depends on state to state to verify and finalize the provisional registration, in my state (MP) was online, while in UP it is to be written and done in physical form.

Step 3: Go to your state Directorate of Medical Education (DME) office and write an application, which is to be submitted in the counter and its photocopy that will be stamped to show your proof you giving with date. In this application you need to request an Non Objection Certificate (NOC) from DME regarding from X college to Y college and the date of joining. Attaching your passing certificate and provisional registration.

Step 4: After few days you will get letters from DME to respected:
There are two cases you want to change your internship in the same state (case A) or in some other state (case B).
You will be provided with request letters to provide NOC from:
a) MCI, New Delhi (only in case B)
b) Parent college
c) Parent university
d) College/Hospital where you want transfer

Step 5: College and University NOC
It depends on college to college, some give this NOC easily, other will charge you some fees for leaving your college. It is essential to see your bond while you joined your medical college.
For college NOC you have to give application with attached photocopy documents required by the officer. It will be signed by the Dean of the college and then provided to you in physical form as provisional NOC of college.
Again this has to be forwarded to your university with same application and copies work by you as soon as you get NOC from college.

Step 6: MCI NOC (For case B only)
Since you’re applying transfer to other state it is necessary to get permission from MCI, Dwarka, New Delhi. They need the following documents:
a) Request letter with communication address
b) Copy of NOC from parent college (Annexure 1)
c) Copy of NOC from parent university (Annexure 2)
d) Copy of MCI permitted transferee college/hospital (Annexure 3)
e) Copy of provisional registration of your state
f) Copy of your passport (only in case of applying internship abroad)
g) A demand draft of Rs. 1000/- in favour of Secretary, Medical Council of India payable at New Delhi (any nationalized bank).

Step 6: Transferee College/Hospital NOC
Here the game begins of the other side. Like I am telling you for the case B as they will ask you to get formalities as per the rule of their states.
Like in the case state UP where I took transfer, the hospital wrote a letter to DME to allow us to give admission from other state.
When you give an application with attached notary and other photo copy documents, including NOCs and passing certificate. They will provide you two letters with different mentioning. One for Department of Medical Health (DMH) of State and other to keep for yourself and that it will be used later.

Step 6: DMH NOC Letter
After getting letter from DME to request to DMH. You need to write an application again to DMH just like DME. They also need documents photo copy of NOCs similar to DME. They will provide you 3 letters.
One is supposed to give at State Medical Council for the provisional registration.
Second to the transferee college or hospital.
Third to be given to you for yourself.

Step 7: State Medical Council Registration
After all these work, it is must to get a provisional registration done to the state where you’re doing for. You need to download the form from the state council website and then submit to their office in the capital city.
In case of interstate it may take a lot of days as the verification takes to much time to get from other state. So it is advised to go or send someone at parent state medical council for quick verification.
Here again photo copy of documents required:
a) Provisional Registration copy of Parent medical college state.
b) Hometown CMO Registration Attested
c) Original letter of DME (mentioned in Step 5)
d) Original letter of DMH (mentioned in Step 6)
e) All MBBS prof marksheets
f) Highschool marksheet
g) Your Adhar Card

When you give all these attested with your form, they will ask you to pay fees (Rs. 1000 in state of UP) and provide you a receipt and on site letter that is required to give at tranferee medical college or hospital for taking complete admission.
On other side you need to apply an NOC/verification of documents in parent council to be sent on transferee state council. It may take 15 days or more.
In MP state it takes NOC to apply online and need 3 documents:
a) Provisional Registration
b) Copy of Internship Transfer Order
c) Completion of Rural Bond Certificate or a certificate of non bonded candidate

Step 8: Joining of Transferee College/Hospital
After all this work you will go to your office of transferee medical college or hospital from where you get request letter for DME in the step 6.
You need to give a joining request letter attached with letter of DME, DMH and state council permission letter.
They will finally give you joining to their hospital departments and you can officially continue your internship there.

Thanks for reading. Please read and share to everyone who is interested to take transfer from their medical college to do internship. 

 

How Yoshinori Ohsumi work on Autophagy will change Medical Science?


On 3rd October 2016, a Japanese scientist Professor Yoshinori Ohsumi, Ph.D has been awarded Nobel Prize for Medicine for his study in mechanism of autophagy.

Autophagy, the word itself means self-eating. It is an essential conserved lysosomal degradation pathway that controls the quality of the cytoplasm by eliminating protein aggregates and damaged organelles. It begins when double membraned autophagosomes engulf portions of the cytoplasm, which is followed by fusion of these vesicles with lysosomes and degradation of the autophagic contents.

autophagy

In simple words, It is the process that cells use to destroy and recycle cellular components.
A recycling program – junk cell components are stored and the useful parts comes out to generate the energy or build new cells.

By the acknowledgement of this mechanism of autophagy, many gates will open for the approaches of treating diseases by further research works.

1. Cancerous cell growths can be prevented, that is the major life threatening disease of developed nations, as the survival rate is very low and unreasonable most of the times.

2. Fight against infections of  pathogenic microorganisms, will be great as most of the biology underpinning infectious diseases can be controlled.

3. Maintenance of a healthy metabolism,  It allows cells to degrade large molecules into basic building blocks, which are used as energy sources.

4. Neurodegenerative illnesses, Dementia (caused by tau), Parkinson’s disease (alpha-synuclein), Huntington’s disease (mutant huntingtin) and other age- related disorders.

5. Diabetes Mellitus Type 2, an endocrine disease due to genetical or sedentary lifestyle getting more common in our India will be prevented by autophagy.

6. Development of Drugs, Intense research is underway to develop drugs that can target autophagy to treat various other diseases.

7. Regenerate Protein Inside Body: Because of this machinery now we’re able to rely on some of our own proteins, maybe the damaged proteins or the long-lived proteins, and they are recycled with this sophisticated machinery so that we can sustain and we survive.

Point of care testing (POCT)

Point of care testing (POCT) can be defined as the provision of a test when the result will be used to make a decision and to take appropriate action, which will lead to an improved health outcome. The basic objective of POCT is to produce a result swiftly yet reliably.

According to Accreditation Canada POCT refers to “any testing conducted outside a lab, in a hospital, in a clinic or by a health care organization providing ambulatory care. This includes testing performed at sites outside the traditional lab dedicated to medical biology, near where care is delivered to the client. POCT results may lead to a change in the care of the client. It ranges between three levels of complexity, from simple procedures such as glucose testing, moderate‐complexity procedures including provider performed microscopy procedures like used in TB or high‐complexity procedures such as influenza testing.”

The healthcare system is changing so quickly. Everyone has to run at that high speed just to keep up. Having a good health is just like happiness, can’t remain constant and whomsoever looking to maintain the status quo should not be in or go into healthcare as a profession. The change process shows no sign of slowing down.

In fact, all aspects of this field are moving equally fast like automobile industries, various new technologies like robotics and information technologies (IT). IT boosted so much in recent decade. Economics is also improving as well etc. It is no wonder that POCT is moving quickly ahead as one of the major approaches to solving what seems to be the major challenge that is how to do more with less.

What is the purpose of POC and why it is important?

1. The result of POCT is so quick that it can be done within seconds, to minutes to a few hours while the patient waits. At least result should be given on the same day depended on the complexity range of the diseases.

2. It provides rapid turn-around results that affects the clinical management of referral system, follow up of patient, treatment decisions and decision to discharge the patient.

3.The results of POCT are very useful in clinical decision making for any doctor. As the final diagnosis helps doctor to take appropriate action for the treatment without any further delay.

4. It is convenient for the patients and care providers as well. It mainly derives from the fact that the diagnostic process is achieved with in the same clinical encounter. And the patients do not have to come back for testing or go far away for some testing in medical laboratory.

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Common POCTs are:
Blood-glucose testing,
Electrolytes analysis,
Rapid coagulation testing (PT/INR, Alere, Microvisk Ltd),
Rapid cardiac markers diagnostics (TRIAGE, Alere)
Drugs of abuse screening,
Urine strips testing,
Pregnancy testing,
Faecal occult blood analysis,
Food pathogens screening,
hemoglobin diagnostics (HemoCue),
Infectious disease testing
Cholesterol screening (cholesterol, VLDL, LDL)

SUPPLEMENTARY FOOD FOR INFANTS

At no other time of life food is so important as in the first year of life (infancy). The kind, amount and sanitation of this food as well as the manner of feeding require particular attention which plays dividends in the form of a healthy, happy to baby. The nutrient requirements are high per unit of body weight because of rapid growth. In fact, in no other period of life growth is so rapid as in infancy.

Every mother is aware of that food prepared for adults are not always suitable for infants. But most of mothers do not realise that foods suitable for them can be easily prepared. They go for expensive baby foods which are sometimes beyond their reach.
Satisfactory foods can be planned and prepared for infants and children at home without using much expensive food stuffs.

We all know that breast milk is best food for the baby. But after 6 months, breast milk alone is not sufficient to meet the growing needs of the infants. Certain other food need to be provided  along with breast milk so as to supplement the short fall in the nutrients. The right time to start with supplements is after six months as per the guidelines. If we start too early, the child always at an increased risk of diarrhoea and if too late there is a constant fear of malnutrition.
Please note: Breast feeding has to be continued with supplementary foods.

The texture of consistency of the supplements can be modified according to the age of the infants, thus providing them with liquid supplements between 8-12 months. Liquid supplements include fruit juice, vegetable soups, soupy dal and cattle milk. In early stafes awe can start  with half ounce and gradually this amount can be increased upto 3 ounces per feed.

As the child grows, from liquid supplements there is a gradual transition to semisolid foods. The semisolid foods are mostly porridges made out of the stable food of the community (wheat, rice, maize, jowar, etc) These cereals are generally cooked with milk and sugar.  Some commonly used porridges are ‘Dalia’, ‘Rice Kheer’, ‘Suji Kheer’, ‘Ragi Kanjee’, ‘Sabudana Kheer’ etc. The porridge should be such that the child can swallow it easily. To ensure that the porridge is not thick and to reduce its build ARF (Amylase Rich Food) is added to porridge.

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The ARF is nothing but flour obtained from germinated grain like wheat, bajra, jowar, maize etc. Germinated grain flour contains a lot of amylase which makes the porridge soft , thin and easy to eat. Grains can be germinated, drained in Sun, powdered and the stored in air tight containers. Quarter to half tea-spoon of ARF powder can be added to the cooked porridge  when it is still hot (around 70*C). Other than porridge, boiled and mashed and given as such where as had fruits like apple, pineapple, peaches, banana etc. need to be first stewed and mashed before being served. Boiled dals, egg yolk, boiled fish and meat can also be given along with a little salt and butter.

When the baby starts teething around 8 months, it is the right time to introduce thick solid foods. The foods which were boiled and mashed earlier should now be just boiled and cut into small pieces. Boiled rice and small pieces of chapaties may also be given. Hard and crunchy foods are liked by the infants during the time of teething biscuits, toast, rusk, raw carrot, apple, cucumber are ideal food items for the child to chew.

Various food mixtures prepared from cereals, pulses, fruits,  nuts, animals foods, vegetables, milk and its products during this period. It has been noticed that children who are brought up on a variety of foods lives healthier and have much healthier tastes than those of brought up just milk and biscuits, fruits juice and vitamins. A mixed diet will not only upgrade the protein quality but will also prevent the development of vitamin and mineral deficiencies. By the age of one year the baby can take all solid foods. In fact the child can eat all the foods prepared for family meals.

Most of the problems of food acceptability in children being around one year of age. The problem in fact starts with the mother, who thinks the child should be well fed and tried to feed the child more food that its  needs. The mother should have patience and should help the child in developing good food habits gradually. Learning is a slow process and here the child learning to eat new foods one after the another.
So, have patience, be supportive and the result will be happy, healthy baby.

 

 

India, the country of road accidents

Do you know? India has the highest number of road accidents in the world.

Every hour, 40 people under the age of 25 die in road accidents around the globe.

India stands out miserably in the latest World Health Organisation’s (WHO) “Global Road Safety Report-2015” with an estimated 2,07,551 deaths on roads and around 4.5 lacs crashes. That is actually much more than the number of people killed in all our wars put together.
In 2015, one person dies every 4 minutes in roads accidents in India, according to NGO ‘Indians for Road Safety’.
People left injured were also the highest levels since the recording in India with 4.8 lacs injured people, some of them even faced permanent disability.
According to the WHO, this is the second most important cause of death for 5 to 29 year old ones after is road accident. A 16-year-old has 3 times the crash risk of an 18-year-old and 7 times the crash risk of a 25-year-old.

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“In New Delhi, the capital of India, frequency of traffic collisions is 40 times higher than the rate of London, the capital of the United Kingdom.”

Among 53 mega cities of India, capital city Delhi itself registered the highest number of fatalities Delhi with 2,199. That is like 6 lives end on Delhi’s roads everyday!
Chennai second recorded 1,046 such deaths
Bhopal ranked third with 1,015
Jaipur fourth with 844 lost lives

fatboyke (Luc)Photo URL    : http://www.flickr.com/photos/fatboyke/2668411239/

1. Safety Education & Good Roads:
One should know and follow traffic rules obediently. Uneducated people don’t know about the rules and the educated people ignores them. Preference to pedestrians and children should be first. As per Indian standards, left side should be chosen.
Caution signs should be placed. Government should provide good fund and management for the maintenance of road. Generous luminescence in the dark, street lights in working condition. Cross roads and speed breakers should be made in risky areas.

2. Safety Measurements:
Cars should be driven with seat belts as they protect body parts including brain and spinal cord. It is estimated 15,000 lives are saved each year in USA with the help of wearing seat belts.
Bikes should be only allowed on the roads if the person is wearing a well certified helmet. Youngsters avoid wearing to look cool and adventurous. End up buried under the grave. Helmet saves up to about 50% of cranial injuries.
Government should favor compulsory cars with airbags, ABS (anti-breaking system), fog lamps and rear defogger glasses.
There should be rule of not allowing kids to the age of 15 to be allowed to sit even in co-passenger seat with driver. It is followed in some countries but not in India.

3. Enforcement of Laws:
License should be strictly given after a road test under an official and it should be retested after a period of 5 years at least for renewal. Speed limit, medical fitness tests, compulsory seat belt and helmet rule should be applied. 
There should be strict laws against
a) bad driving,
b) taking and texting on mobile phones,
c) crossing the speed limit,
d) roadside alcohol and drugs intake checkup,
e) illegal street racing, and
f) under-age driving (below 18)

4. Preventive Care with Medical & Rehabilitation Facilities
The person who faced minor or major accident should be provided with ambulance to the nearest hospital for the management of any trauma. Hospital should provide fully specialized Intensive Care Unit (ICU) and Intensive Critical Care Unit (ICCU) facilities can save the life of the person.
Other than that if the person get impairment or disability, he or she should be rehabilitated to avoid being a handicap person. This include medical, social, psychological and occupational rehabilitation.

5. Psychological factors should be avoided
One should not drive in any of these following conditions:
a) Lack of experience with driving a vehicle.
b) Trying to be adventurous and taking raking risks.
c) Impulsive behavior or mood.
d) Defective judgmental behavior.
e) Delay in decision taking.
f) Ability of poor perception.
g) Driving with family dysfunction.
h) Alcohol or any other drug addiction.

Dedicated to my cousin Ankit who lost his life last month on road accident. May the lord rest his soul in peace.

References: TOI, NDTV, Hindu, K.Park’s Preventive & Social Medicine

OMG! This is the condition of health facilities in India

‘India spends less of its GDP on health than some of the world’s poorest countries.’

A single government hospital serves an estimated 61,000 people in India, with one bed for every 1833 people, new official data shows. In undivided Andhra Pradesh, every government hospital serves over 3 lakh patients while in Bihar, there is only one bed for every 8800 people.

Union Minister for Health J.P. Nadda released the National Health Profile 2015 prepared by the Central Bureau for Health Intelligence (CBHI) in September 2015 along with officials of the Ministry, the Directorate General of Health Services and the CBHI.

Every government allopathic doctor serves a population of over 11,000 people, with Bihar and Maharashtra having the worst ratios. The number of qualified allopathic doctors registered with medical councils fell in 2014 to 16,000, or less than half the previous year’s number; the data was however provisional, CBHI officials said.

India now has cumulatively 9.4 lakh allopathic doctors, 1.54 lakh dental surgeons, and 7.37 lakh AYUSH (Ayurvedic, Yoga, Unani, Siddha, Homeopathy) doctors of whom more than half are Ayurvedic doctors.
India’s 400 medical colleges admit an estimated 47,000 students annually.

According to World Health Organization, doctor patient ratio should be minimum one doctor for 1000 people. But in India there is only one doctor per 1,700 citizens which is increasing rapidly.
The Union Health Ministry figures claim that there are about 6-6.5 lakh doctors available, India would need about four lakh more by 2020—50,000 for PHCs; 0.8 lakh for community health centres (CHC); 1.1 lakh for 5,642 sub-centres and another 0.5 lakh for medical college hospitals.

Health expenditure per capita (in USD) of India is only $61 (around 4,000 INR) that is even less than poor countries like Haiti, Cambodia and Zambia.
World Health Organization statement that countries should spend 5 percent of national income on health care services. As per 2012 GDP India is only spending 1.3 per cent while developed countries like US and the UK spending 15 per cent and 8.5 per cent, respectively. Though as per the latest 12th Five-Year Plan India aims for 3 per cent till 2017.

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The Centre’s share of total public expenditure on health has fallen over the last two years, and India spends less of its GDP on health than some of the world’s poorest countries. Among all States, undivided Andhra Pradesh had the highest public expenditure on health in 2012-13. Goa and the north-eastern States spent the most on health per capita while Bihar and Jharkhand spent the least.

Out-of-pocket private expenditure on health has risen steadily over the years, with the cost of medicines, followed by that of hospitalisation accounting for the largest share of the household expenditure. Absolute spending, as well as its share in total non-food expenditure, rises with income levels. Kerala spends the most privately on health.

India is having Human Development Index (HDI) of only 0.609 that is even worse than poor African countries like Guyana & Namibia. Best countries are Norway and Australia that having HDI of 0.944 and 0.935 respectively.

Source: The Hindu & Wikipedia

Can you pass the salt please?

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Evidence shows that people of South Asian descent are at higher risk of high blood pressure and coronary heart disease (CHD). It has been predicted that people of South Asian descent are 30-40% more likely to die prematurely from CHD compared to the average UK population.(2,3) People of South Asian origin are also six times more likely to have diabetes than the average UK population, which doubles the risk of stroke (4) and are 3 -5 times more likely to suffer from end stage renal failure which can be exacerbated by high blood pressure – See more at: Salt and people of South Asian descent.
Indians consume about 3.7 grams of sodium, corresponding to about 9.3 grams of salt per day. This is nearly twice the amount recommended by the WHO. The positive side is that salt consumption has declined slightly in India between 1990 and 2010. There are major regional variations around this average.

Poor people use more of salt to make  their small amount of food tasty. Rich get more salt through fast food and packaged food.

It is estimated that hypertension in India will rise from 140 million people in 2008 to nearly 215 million by 2030 with increased risk of premature heart attacks, strokes and kidney disease. A national salt reduction  programme in India is set to target reductions in blood pressure, heart disease and stroke.

Evidence has shown that a number of health conditions are caused by, or exacerbated by, a high salt diet. Although the strongest evidence is for the effect that a high salt diet has on blood pressure, stroke and heart disease, there is also a wide body of evidence indicating a link between salt consumption and other conditions.
Salt has been linked to:
High Blood Pressure
Cardiovascular Disease (stroke, heart disease and heart failure)
Kidney Disease & Kidney Stones
Obesity
Osteoporosis
Stomach Cancer
Water retention/bloating
Salt is also thought to exacerbate the symptoms of:
Diabetes
Meniere’s Disease
Asthma
Alzheimer’s.

Indian Cuisine and Salt:

Indian cuisine in general, has excess salt. The reason being, Indian cuisine has a heavy load of spices, the spice levels in our food masks the effect of salt. Hence we keep adding salt about 40% more in excess than needed for a particular dish, when cooked sans those spices. This is the reason why in Indian cuisine we tend to add excess salt. Sometimes, people start adding salt even without tasting their food.

The next reason why Indians have excess salt in our food is that, our taste buds are tuned that way. If you gradually add less salt, your taste buds will adjust (it takes about 3 weeks) and you will not notice the difference.

Few food items in particular, that we consume on an everyday basis which has high salt content are:
Pickles, chutneys, sauces and ketchups, papads, chips and salted biscuits, savoury items, cheese and salted butter, canned foods (vegetables, dals & meats), bakery products, ready made soup powders, dried salted fish, Chinese food, salted nuts etc. Butter and ghee are both high in salt and fat. Cut these out of your cooking by replacing them with olive or rapseed oil, or use unsalted versions.

A reduction in salt consumption even by 1g in diet daily may help decrease the incidences of death, say University of California-San Francisco researchers at the American Heart Association’s 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention. The researchers say that a 3g a day reduction in salt intake could result in 6% fewer cases of new heart disease, 8% fewer heart attacks, and 3% fewer deaths.

How to reduce salt in your food?

Check nutritional information on food labels before you buy a product. Look for the amount of salt (sodium, Na), monosodium glutamate (MSG), baking soda or soda (sodium bicarbonate), baking powder, sodium benzoate, sodium sulfite, sodium nitrite, etc. present in the product. Understand the meaning of the label:

Low sodium/salt: Less than 120mg sodium/100g of food or not more than half the sodium content of the regular food (whichever is less).
Reduced sodium/salt: Up to 75% of the sodium content of the regular food.
Lightly salted: At least 90mg sodium/100g of food less than regular food and less than 600mg of sodium/100g.
Do not keep salt shaker on the dining table.
Choose fruits and vegetables as snacks, rather than salty snack foods.
Choose fresh, frozen or canned food items without added salts or of reduced salt variety. There are many products available with reduced levels of salt or with no added salt.
Select unsalted nuts or seeds.
Eat less salty foods like chips, pretzels, crisps, salted nuts, salty cheeses, soy sauce, pickles, Bikaneri bhujia, chicken broth, processed meat and fish.
Buy fresh, (plain) frozen or canned vegetables without added salt. Rinse canned vegetables to eliminate some of the added salt.
Select unsalted, fat-free broths, bouillons or soups.
Select fat-free or low-fat milk, yogurt and cheese with low sodium.
Add spices, herb, garlic and lemon juice in cooking instead of salt to enhance the taste and flavor of your food. Use only half the amount of salt recommended in a recipe.
Reduce eating pickles, they are high in salt.
Buy ready to eat meals with reduced salt. Do not buy packaged foods that contain more than 120mg of sodium per serving.
Avoid using sauces, such as mayonnaise and ketchup, as these are often high in salt.
Choose fresh or frozen fish, shellfish, poultry and meat most often. They are lower in salt than most canned and processed options.
Some drugs contain high amounts of sodium. Look for it.
Source: Quora