"Society, Stress, and Doctor's Suicides": It is not only Dr Archana Sharma; you could be the next!

The changing scenario between society's lookout toward the medical profession has taken a bad turn. The stress of education, practice starting, increasing to a peak of one's performance in the early years and later on to maintain it after the age of 50 is a great challenge. Recent tragic events have brought up the role of social elements, media, press, politicians, police, and prosecutors under the lens. We as professionals and organizations must find out the weakest link which enforces someone to indulge in self-harm. We also should try to strengthen the chain of healthcare delivery system with the motto of "A healthy physician only can impart quality healthcare. His image, interests, and intentions must be protected by our own profession, society, policymakers- government agencies."

Squamous Cell Carcinoma of Oesophagus with Tracheo- Esophageal Fistula, Pulmonary Tuberculosis and Hyperthyroidism in 16 yrs Old Female.

This case of a 16-year-old female with moderately-differentiated squamous cell carcinoma of the esophagus with tracheo-esophageal fistula, hyperthyroidism and sputum positive pulmonary tuberculosis with RNTCP Category 1 DOTS is reported because of its rarity. The patient presented with cough, vomiting, weight loss and respiratory distress.

Module for Interns in Medical Ethics: A Developmental Diegesis.

BACKGROUND: Media report is rife with incidences of doctor-patients' conflict, and this partly is due to communication gap and unethical practices being adopted by the doctors. Our regular curriculum fails to impart any training in ethical issues in patient care. Imparting training to students in these soft-skills is the need of the hour. AIM AND OBJECTIVES: To develop a module for interns in medical ethics (MIME) in patient care, validate it and pilot run the module for standardization. METHODOLOGY: After conducting faculty development workshop in curriculum designing and three rounds of Delphi with alumni, a module in medical ethics was developed and peer validated. The questionnaire for pilot run, questionnaire for future use of module delivery and pre- and post-test were also peer validated. The module was delivered to 17 interns as pilot run in the form of 4 days' workshop. After pilot run, the module was standardized to 10 broad topics and 3 days' workshop. The questionnaire for future delivery of module in regular routine was also validated during pilot run. RESULTS: Twenty-five faculty members participated in 1 day faculty development workshop and 59 alumni completed three rounds of Delphi. After peer review by five experts, a module of 11 broad areas was developed and was pilot run on 17 interns. Based on the feedback from pilot run, a standardized, validated 18 h teaching MIME in patient care was developed. CONCLUSION: Pilot study proves that curriculum innovation in the form of medical ethics training to interns; when as undergraduate students, they actively participate in patient care under supervision will go a long way in inculcating soft skills like ethics, compassion and communication in them.

Gestational diabetes: the public health relevance and approach.

The prevalence of diabetes is increasing globally and the causes attributed are the ageing population, urbanization, obesity epidemic, physical inactivity and stressful modern life. While all these factors contribute to the epidemic of DM, intra-uterine exposures and gestational programming are emerging as potential risk factors. Gestational programming is a process whereby stimuli or stresses that occur at critical or sensitive periods of foetal development, permanently change structure, physiology, and metabolism, which predispose individuals to disease in adult life. If the stimulus happens to be glucose intolerance in pregnancy, gestational diabetes mellitus (GDM) manifests. Diagnosis of GDM in a woman predisposes her and her offspring for increased risk of developing glucose intolerance and obesity in the future. GDM may play a crucial role in the increasing prevalence of diabetes and obesity and hence has become a public health priority issue. There has to be an excellent coordination and cooperation between all the stake holders of health delivery care system. A great understanding of the importance of GDM and its consequences by the Government and public will go a long way in containing the epidemic of diabetes.