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Digital Gaming addiction defined as a mental disorder by World Health Organisation


  • WHO described the addiction as a “pattern of persistent or recurrent gaming behaviour” that becomes so extensive it “takes precedence over other life interests”
  • Gaming disorder can lead to disturbed sleep patterns, diet problems and deficiency in physical activities

 

Digital Gaming  Addiction

Although   substance addiction with  drugs or alcohol is well recognized, newer  addictive behaviors are now being realized as well. As  digital and vedio gaming has been quite popular now, compulsive gaming and  severe withdrawal symptoms in game addicts are getting commoner. A child/ adult needs more of a  game  to keep him going. If the child does not get more of the game, he becomes irritable and miserable.

If parent try to prohibit gaming, children exhibit  anger, violence, or depression. The children cry, sit in the corner and cries, refuses meals or sleep.

For  compulsive gamers, it is  the fantasy world that makes them feel better.

The lure of a fantasy world is especially pertinent to online role-playing games. These are games in which a player assumes the role of a fictional character and interacts with other players in a virtual world. As  A child can  show his dominance in the game. There fore virtual life becomes more appealing than real life.

possibility of harm: gaming addiction can ruin lives. Children who play few hours per day have  no time left for socializing, studies, or sports. Social development is poor.

In older people or adults  it can have effect on professional life and relationships.

 

Warning signs for  gaming  addiction include:  The important  issue here is  whether one is  able to control  gaming activity or not:

  • Playing for increasing amounts of time
  • Thinking about gaming during other activities
  • to choose gaming to escape from real-life problems, anxiety,  depression
  • Lying to friends and family to conceal gaming
  • Feeling irritable when trying to cut down on gaming

Gaming addicts tend to become isolated, giving up other hobbies and  withdrawn from other activities.

Parents need to be careful

Parents need to be careful and not take it as another routine phase of childhood.  Keep  track of  child’s gaming behavior, including:

  • for how long and frequently  the child plays.
  • Problems resulting from gaming
  • How the child reacts to time limits

to get rid of the game addiction, these children need to be taught about the advantages of real life excitement as opposed to online achievements.

Addiction to digital and video gaming has been classified as a mental health disorder by the World Health Organisation (WHO) in its new International Classification of Diseases (ICD).

The agency described the addiction as a “pattern of persistent or recurrent gaming behaviour” that becomes so extensive it “takes precedence over other life interests

The classification is aimed at alerting health professionals and systems to the existence of this condition and ensuring that people suffering from these conditions can get appropriate help.

Gaming disorder” has three main characteristics. One, that the gaming behaviour takes precedence over other activities to the extent that other activities are pushed to the periphery.

 

If the condition leads to significant distress and impairment in personal, familial, social, educational or occupational functioning.

Gaming disorder can lead to disturbed sleep patterns, diet problems and deficiency in physical activities.

The 11th edition of ICD covers 55,000 injuries, diseases and causes of death. Researchers across the world use it as reference for data, whereas doctors and other medical practitioners use it to diagnose disease and other conditions. The ICD is also used by health insurers in some countries to claim reimbursements based on ICD coding.

Besides, the classification is used by national health program managers; data collection specialists; and others. The new ICD-11 also reflects progress in medicine and advances in scientific understanding.

Expensive dream or a disaster self bought: Pay millions to be a doctor (#NEET)


Reluctance of candidates to wrap up  expensive medical college seats is just an indicator of aspiring medical student’s   better understanding of  the cruel reality about medical education. Becoming a doctor is not easy these days. Paying crores is like  getting into a trouble zone and getting yourself entrapped into a system of exploitation. It  may be alright for candidates who are from rich backgrounds.  But for the candidates whose families are not  strong financially, it may be self bought disaster. Steep rise in fee of medical colleges has been huge, beyond logic and is injustice to the meritorious.  One advantage of inappropriate media bashing of doctors, recent assaults against doctors has  given some wisdom to  innocent students, who  used to just enter into a system of entrapment unknowingly. Choosing medical career and then trying to place your feet into post graduation, spending crores in all these situations is akin to  falling victim to  a system of entrapment.  Some one paying for it in millions and  crores is an absurd thought  and  highly ill advised. For the candidates who are not financially strong, it may be difficult to even recover the money spent, what to say about the time and youth wasted in  getting a degree which may or may not be that worth.

Therefore it may become  dream turning into nightmare  for the people who can not afford.  Lower merits combined with not so good medical colleges   may produce thousands of degree holders but not good doctors.  Recent sporadic campaign of stray cases projected as generalization  by media has definitely diminished respect for profession. Individually most of the doctors may be working hard honestly but they are uniformly painted in the same colours due to misplaced priorities of the media. Society has already developed a prejudiced mind towards doctors.   Since these projections are created by outside agencies, doctors even with hard work and doing work honestly  may not be able to change the perception that has been created. Damage to profession has been immense and it is nearly impossible  task to reverse the mistrust generated and  undo the damage. If individually doctors are doing good and media continues the negative projection, the sad situation will persist. All efforts by doctors  in this direction are like oil  on the sand.

In  nutshell, this toil and trouble for years, buying a seat, paying millions or crores and becoming a doctor does not save you from vulnerability of court cases and wrath of public. Rather suboptimal training and capabilities makes them  more vulnerable to problems. It may be alright if some one with strong financial background  decides to be a health manager or administrator.

Real problem of mediocrity remains as such. Candidates with higher merit will be left behind as candidates who can buy and pay more will get in. This process  will be called as “lawful selection” along with diluted merit .This process makes count number of degrees distributed under various conditions attached to it other than merit.  But  just number of   degrees will not provide better doctors for future.

Quack menace: Patient killed by quack (Delhi): qualified doctors regulated strictly but not unqualified?


 

In an era, when even licensed and qualified doctors are finding it  difficult to practice medicine, it is strange that unqualified and unlicensed are having a field day. Why a strict regulation does not apply to them, is beyond any reasoning and logic. If a medical facility or clinic is functional, it is difficult for the patient, specially in emergency, to check or even doubt its credentials. How such facilities are open, functional and thriving, which does not have a qualified medical person is beyond logic. Sadly our regulation is trying to regulate, who are already regulated. It is trying to punish those who are qualified and licensed, but turns a blind eye towards unlicensed and unqualified doctors.

Such fake doctors own medical set ups, may conduct surgeries,  sometimes run with little help from qualified doctors,  and do procedures. Another problem is that they   promote fake rumours about genuinely qualified doctors and create a mist of mistrust to propagate their fake medical business.

If this is state of medical affairs prevalent in heart of capital and such facilities are functional and thriving, what will be state of affairs in peripheral or remote areas. Again it does not need an Einstein brain to guess.

The Delhi Medical Council (DMC) on Wednesday ordered criminal action against a quack whose “treatment” resulted in the death of a patient in November last year.

The hospital in which the patient was treated was also not registered with the Directorate of Health Services, Delhi. The patient was treated by an unqualified person in an unregistered hospital and did not receive proper treatment, which led to his death. The man, who had pretended to be a doctor, had been practising medicine for almost 12 years in Delhi and was a member of the Indian Medical Association (IMA), a pan-india representative organisation of doctors, and the Indian Academy of Paediatrics (IAP), a renowned association of paediatricians.

The 45 years old patient  had an undiagnosed liver disease. He went to a private hospital in Munirka ( New Delhi) around 2 pm on noticing blood in his vomit and stool. Within nine hours, the condition of the patient deteriorated and he was taken to Safdarjung hospital New Delhi , where he was declared dead on arrival at 2 am.

The patient was just put on a saline and given some antibiotics and pain medication. No diagnostic test was done to find the source of the bleeding, neither was any blood given to the patient. Any doctor can tell you the treatment was wrong. First he gave a DMC number, but the number corresponded to someone else. So, he provided  a registration number of the Goa Medical Council, again it belonged to someone else.

 

This is an  example of  how modern medicine is detrimental in unsafe hands, that are functional without proper training. How these fake doctors openly call themselves doctors, use prefix of Dr and register themselves somehow.   It is no less than fraud with lives of innocent public.

Neglect towards this sad reality  is akin to playing with health of innocent people. Medical organizations and media  has either  not taken it seriously or not able to take any constructive step  in curbing this menace by quacks.

Although genuine doctors face many problems from system of quackery. Misuse of antibiotics, local goonism and nuisance, all kinds of malpractice, misguiding the patient are few examples. But ultimately it is the society who is  the sufferer. Therefore resistance to such practices and  a wish to have good health system is  actually need of society. Unless people themselves make a true effort towards a robust health system, this menace of quackery is likely to persist, due  to prevalence  of  vested interests.

Plan to revamp the regulator for drug price regulation , National Pharmaceutical Pricing Authority (NPPA).


In an attempt to revamp drug price regulation in the country, while strengthening implementation and market monitoring, the government is set to restructure the regulator, National Pharmaceutical Pricing Authority (NPPA).

The authority, which is expected to be re-christened soon, will be replaced by a board or a council with four full-time members, including the chairman. The other three members — an economist, a costing specialist and a technology expert — will also hold a rank similar to the chairman, according to a proposal being considered at the highest level of the government.

According to another source, the new structure of the regulator, currently responsible for regulating drug prices and ensuring the availability of medicines, will be in line with the Telecom Regulatory Authority of India and Insurance Regulatory and Development Authority.

 
The role of the authority is also expected to change to become more of a regulatory body implementing and monitoring prices in the market, than fixing them.

 
At present, NPPA has the powers to cap prices of medicines according to the Drugs Price Control Order. It also gives new price approvals and looks at price revisions. Besides, the authority also enjoys powers to regulate prices of all medicines and medical devices under extraordinary circumstances in the public interest.

“NEET – NOT So NEAT” : Courtesy switch to Percentile system?


Imagine, an opportunity is available to a patient, to decide the doctor as based on his route or marks for entry into medical college. Whether patient will like to get treated by a doctor, who   secured 20% marks, 30 % marks or 60% marks or 80% marks for medical college.  Even   an illiterate person can answer that well. But strangely for selection of doctors, rules were framed so as to dilute the merit to the minimum possible. So that a candidate who scores 20 -25 % marks also becomes eligible to become a doctor. What is the need to dilute and shortlist around half a million for few thousand seats. Answer to that is simple.  To select and find only those students from millions, who can pay millions to become doctors.  

      Although the whole effort and huge expenditure to become doctors in this way may be really worthless in today’s scenario, considering the difficult times and vulnerability of medical profession. By allowing a intentional dilution of quality  can be advantageous only to  few and detrimental to others.

  • Beneficiaries are rich candidates, medical colleges who collecting fee and may be public who will get numbers of doctors. Surplus of doctors is thought to be an advantage to society. But here quality is least of the consideration.
  • Disadvantage to students, who are meritorious but can’t pay, and possibly society in long run, who is deprived of good quality doctors.

 

 

  •      A lower eligibility cut-off would mean that students with even lower percentage       of    marks will be eligible for MBBS
  • Last year, 11,114 students who scored 270 or less out of 720 got admission into medical colleges, mostly in private colleges
  • By the percentile system, last year, a student scoring 270 was within the 80th percentile

 

NEW DELHI: The results of the National Eligibility cum Entrance Test (NEET) for MBBS admissions for 2018 announced on Monday showed even lower cut-offs than last year. The cut-off for the unreserved category is down from 131 out of 720 marks last year to 119 this year, while the one for the reserved categories has dropped by a similar margin from 107 to 96. Over 7 lakh students from the 13 lakh plus who appeared for the exam have qualified to join medical college.

A lower eligibility cut-off for NEET would mean that students with even lower percentage of marks will be eligible to get admission for MBBS. In case you thought just being eligible would not allow those with poor scores to get admission, here’s what happened last year. Over 4,300 students who scored 180 or less in NEET actually got admission to MBBS. The overwhelming majority of them in private colleges, where high fees make it difficult for those with meagre means to join even if they have the marks.

A score of 180 out of 720 is the minimum mark a student would get if they got 40% of the answers right, even if they got all the rest wrong, with the negative marking scheme in place in NEET. Of course, 40% is the pass percentage in most exams. In terms of percentage, 180 out of 720 is a mere 25%. But going by the percentile system of NEET, 180 in 2017 meant the student was within the 64th percentile, well above the 50th percentile cut-off for the unreserved category.

Last year, 11,114 students who scored 270 or less out of 720 got admission into medical colleges, once again mostly in private colleges. If a student got half the answers right, he could not have got less than 270. Before NEET, the minimum eligibility criteria for MBBS admission was 50% through various entrance exams though the quality of some of the exams conducted by colleges themselves was dubious. By the percentile system, last year, a student scoring 270 was within the 80th percentile.
Incidentally, because there are no cut-offs specified for individual subjects within NEET, there were several cases last year of people who qualified and got admission into medical colleges with scores of zero or even negative marks in chemistry or physics. With the cut-offs dropping further this year in terms of percentage marks (though remaining the same in percentile terms), chances are we will see a repeat of worse this year.

If the society continues to accept such below par practices, it has to introspect, whether it actually deserves to get good doctors. Paying the irrational fee of medical colleges may be unwise idea for the candidates, who are not from strong financial backgrounds. But at the same time unfortunately, it may be a compulsion and entrapment for students, who have entered the profession and there is no way  forward.  So children have to be careful while choosing medical careers from the beginning.

A famous axiom “as you sow so shall you reap” has an application to health system in this scenario, so people should not rue scarcity of good doctors.  

New price index for pharmaceutical products likely


  • Govt plans to introduce a new price index for pharmaceutical products
  • Under the proposed mechanism, the Centre plans to link prices of all medicines with the new pharmaceutical index
  • However, it seems the government’s latest move may also not go well with drug makers

The drug pricing mechanism in the country is likely to be overhauled before the end of this month (India). Among the changes proposed by the government is the move to introduce a new price index for pharmaceutical products that will become the benchmark to determine prices of all medicines sold in the country — even those that are currently outside the drug price control order.

Even now, the government loosely regulates prices of all medicines in public interest. Prices of around 850 essential drugs are capped by the government. The drug price regulator National Pharmaceutical Pricing Authority (NPPA) revises these prices annually based on the wholesale price index (WPI). For all other medicines, companies are allowed to raise prices by no more than 10% in a year.

Under the proposed mechanism, the Centre plans to link prices of all medicines with the new pharmaceutical index. Drug makers will be allowed to revise prices annually only on the basis of movement in the index, sources said.

The proposal is in its final stages and is likely to be notified by the department of pharmaceuticals in June itself. The proposed index will not only replace the WPI for revising prices of scheduled or price-controlled drugs, it will be used to regulate prices of non-scheduled medicines.

The proposal is part of the recommendations made by the government think-tank Niti Aayog for making changes to the Drug Price Control Order, 2013.

Once in place, the new system will change the price movement of all medicines. Under the present price mechanism, only 17% of the over Rs 1 lakh crore domestic pharmaceutical market is under direct government price control. Even by volumes, the government regulates 24% of all medicines sold.

The suggestion to create a new index came in the wake of objections from the pharmaceutical industry to linking of prices with WPI. However, it seems the government’s latest move may also not go well with drug makers.
Experts who believe that linking prices to an index will be better and less discretionary than the present mechanism and may actually result in increase in prices rather than a decrease.

 

Smoking in moderation also carries significant risk: World No Tobacco Day


Tobacco and heart disease

Every year, on 31 May, WHO and partners mark World No Tobacco Day (WNTD), highlighting the health and other risks associated with tobacco use, and advocating for effective policies to reduce tobacco consumption.

The focus of World No Tobacco Day 2018 is “Tobacco and heart disease.” The campaign will increase awareness on the:

  • link between tobacco and heart and other cardiovascular diseases (CVD), including stroke, which combined are the world’s leading causes of death;
  • feasible actions and measures that key audiences, including governments and the public, can take to reduce the risks to heart health posed by tobacco.

World No Tobacco Day 2018 coincides with a range of global initiatives and opportunities aimed at addressing the tobacco epidemic and its impact of public health, particularly in causing the death and suffering of millions of people globally

 Tobacco endangers the heart health of people worldwide

Tobacco use is an important risk factor for the development of coronary heart disease, stroke, and peripheral vascular disease.

Despite the known harms of tobacco to heart health, and the availability of solutions to reduce related death and disease, knowledge among large sections of the public that tobacco is one of the leading causes of CVD is low.

Facts about tobacco, heart and other cardiovascular diseases

Cardiovascular diseases (CVD) kill more people than any other cause of death worldwide, and tobacco use and second-hand smoke exposure contribute to approximately 17% of all heart disease deaths. Tobacco use is the second leading cause of CVD, after high blood pressure.

The global tobacco epidemic kills more than 7 million people each year, of which close to 900 000 are non-smokers dying from breathing second-hand smoke. Nearly 80% of the more than 1 billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest.

  • Of the nearly 7 million who die each year due to tobacco-related causes, 6 million die from direct tobacco use
  • Another 890,000 are victims of second-hand smoke
  • Roughly half of those who lose their lives to tobacco each year succumb to cardio vascular diseases

Tobacco kills almost 7 million people across the world every year and nearly a million of them are not even smokers. It also costs the world about $1.4 trillion annually in healthcare costs related to tobacco-attributable diseases and in lost productivity due to death and illness.

Of the nearly 7 million who die each year due to tobacco related causes, 6 million die from direct tobacco use while another 890,000 are victims of second-hand smoke, according to the WHO estimates. Roughly half of those who lose their lives to tobacco each year succumb to cardio vascular diseases. In fact, tobacco is one of the major causes for heart diseases accounting for about 17% of all deaths due to them.

This is also true of non-smokers who die from exposure to tobacco smoke. Of the economic costs, around $400 billion is in direct medical care costs and nearly $1 trillion is in indirect costs, representing the value of lost productivity due to premature death and morbidity from exposure to second-hand smoke, the study estimated. The WHO material on tobacco has findings that may come as a surprise to many, particularly to those who use tobacco. For instance, it says that while there is some relationship between how much tobacco you smoke each day and the risk of heart diseases, it is not a linear one.

Thus, smoking even just one cigarette a day incurs half the risk of developing heart disease and stroke incurred by smoking a pack of 20 each day. In short, the idea of smoking in moderation is largely a myth. Similarly, the WHO concludes that there is no evidence to show that electronic nicotine delivery systems like e-cigarettes or vape pens are less harmful than smoking cigarettes in terms of the risk of heart disease.

This is despite the fact that on the whole such devices do contain fewer toxicants. The same caveats hold also for what are called heat-not-burn tobacco products. Another sobering fact is that despite tobacco being a major cause of heart attacks and stroke, a significant proportion of adults in several countries surveyed either do not know this or do not believe it. In India, for instance, 36% did not know or believe that smoking can cause heart attacks while 51% had similar disbelief or ignorance when it came to strokes. China was even worse with 61% of adults disclaiming knowledge of or belief in the connection between smoking and heart attacks and 73% in the connection with stroke. Like smoking, smokeless tobacco too is harmful and carries similar risk of cardio vascular diseases and stroke.
While smokeless tobacco is not a major issue in most parts of the globe, it is a widely prevalent form of tobacco use in parts of the sub-continent, like India and Bangladesh. Thus, while the prevalence of tobacco smoking is lower in India (particularly among women) than in many other large countries, those countries have virtually no use of smokeless tobacco. In India, in contrast, over a quarter of the adult population uses some form of smokeless tobacco.

Lawlessness strike docs: doctor attacked by mob SGM Hospital, Delhi


In reality violence against doctors is a law and order problem. But cleverly blame is put on doctors. Doctors can not treat mobs. That too with limited resources. Recent attack on doctors at  hospital is another example of lawless and uncivilized society.  Doctors have become punching bags for  all the malaise and inadequacy of prevalent health system. It is really appalling to see the impunity with which these incidents are happening.

Resident doctors of Sanjay Gandhi Memorial hospital in Mangolpuri   Delhi  are on  strike  for the second day. The doctors went on a flash strike on Monday after one of the  doctors  was attacked by a mob. They were  carrying  knives  and wanted to kill the doctor.

Government ‘s unwillingness or failure  to assure doctor’s protection will have deep ramifications on future of medical profession.  Role of organizations like Human right commission and other right’s bodies is also questionable.  Doctor bodies have also failed to take some concrete action other than showing some concern.  Role of media, celebrities, film stars in spreading the hatred against medical profession as a whole is unpardonable.

Every incident of verbal, legal, physical assault is a trust breaker.  It will hit  trust  and empathy of doctors  towards patients. Patients will get their revenge for naturally occurring disease, but society will be looser in the long run. Since the authorities, who matter have chosen to remain silent on the issue, doctors will have to find some way to save themselves.

Eating alone is Important cause of sadness?


As part of Sainsbury’s Living Well Index, developed in partnership with leading researchers Oxford Economics and the National Centre for Social Research, the retailer surveyed more than 8,000 British adults to investigate how people can live better day-to-day.

However, the data gathered inadvertently revealed that the mood of the nation has declined over the last six months with a drop of 0.5 points to an average of 60.7. While much of the drop appears to be linked to seasonal factors such as extreme weather and public transport chaos, the index discovered more surprising reasons for people’s unhappiness.

Interestingly, it found that eating meals alone is strongly associated with unhappiness  other  than having a mental illness. In this case, people who ate by themselves scored 7.9 points lower than the national average, compared with someone who always eats in company.
Mental health was found to have the strongest negative association with wellbeing, with those who reported conditions such as anxiety, depression, panic attacks or compulsive behaviour scoring 8.5 points below the average figure. Other issues associated with unhappiness included limited physical mobility where participants scored 5.4 points lower, while people with a learning disability scored 3.7 points lower.
Conversely, eating with others had one of the highest positive associations with wellbeing with a score 0.22 points higher, alongside having enough time to do enough time to things (0.36),a satisfactory sex life (0.44 higher) and sleeping well (0.93 points higher).
As such, the researchers say their findings highlight the importance of face-to-face contact with improved happiness. This is because other forms of social contact, including talking to neighbors and meeting with friends, were associated with higher happiness scores, while digital interactions such as social media, showed no association at all.

 

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