Forego fake challenges and focus on real ones to avoid potential threat to life

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Awareness must be generated on the dangers of the most recent Kiki challenge

New Delhi, 02 August 2018: With 82 million views on YouTube, a track has recently gained immense popularity and prompted a potentially dangerous social media dance challenge. Called the Kiki challenge, it requires the performer to shake and shimmy beside a moving car and then jump back into it. Videos of people undertaking the challenge are already viral on various social media platforms with hashtags such as #punjabikiki, #shiggychallenge, #bhangra, #bds, #desikiki #kikidoyouloveme #dotheshiggy and #drake.

In a cheeky play on the lyrics, the UP police tweeted on Monday saying ‘Dear Parents, whether Kiki loves your child or not, we are sure you do! So please stand by your kids in all the challenges in life except #kikichallenge.’ The Chandigarh Traffic Police, in association with Radio Mirchi, has also issued a traffic advisory on the dare and so has the Mumbai police.In Spain, the US, Malaysia, and the UAE, cops have alerted people to the dangers of the challenge.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Adolescents are extremely vulnerable to such online challenges. Prior to the Kiki challenge, in 2016, two such games were popular which caused a number of road accidents. One was Pokemon Go, the world’s most popular game with over 15 million players trying to catch Pokemons. The game caused thousands of road accidents as well. According to study, more than 110,000 incidents in a 10-day period occurred thanks to drivers and pedestrians distracted by the game. The second and more fatal challenge was the Blue Whale Game in which various tasks / challenges are assigned to the player to reach a higher level. Ultimately, the player must commit suicide to complete the challenge. However, the said game has been banned now. In all these three situations, it is the teens and young adults who undertook/are undertaking the challenge and putting their life into danger.”

The #kikichallenge craze began on June 30 when comedian Shiggy posted a video on Instagram where he is dancing to the song in a busy stretch. Later Shiggy’s friend Odell Beckham Jr also recorded himself dancing outside his car. Now there are hundreds of such videos with some of them showing people crashing into poles and tripping on potholes. In one clip a woman’s handbag is stolen while attempting the challenge.

Commenting on this, Dr Aggarwal, who is also the Vice President of CMAAO & Ms Era Legal Advisor HCFI said, “Many Bollywood and TV actors have also filmed themselves dancing to this song outside a moving car. They are influencers and youngsters are most likely to take a cue and follow suit. It is imperative to be cautious and warn the public at large to make them aware of these life-threatening challenges and stop following them blindly. Parents should counsel their children and keep a watch to prevent them from risking their lives.”

Some tips from HCFI

Such situations arise out of an addiction to social media as well. It is important to recognize this and take steps to wean off.

Review your usage Understand and review the amount of time you spend on social media every day. You can take the help of a counsellor in understanding your behaviour and inclination towards this.

Acknowledge your addiction Try taking a break from using any social media apps for sometime, maybe days. The first way to overcome any addiction is to acknowledge that you have it.

Deactivate your account and delete apps This will ensure that you do not get the urge to check and post every other time.

Leaving against medical advice: DAMA vs LAMA vs DOPR

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Patients leaving against medical advice are a common worldwide problem in hospitals, both in wards and emergency departments. Such patients have been variously labeled as DAMA, LAMA, absconding or DOPR.

DAMA or discharge against medical advice is when the patient discharges himself from the hospital, but the discharge has not been authorized by the treating doctor.

LAMA or left against medical advice again means that the patient leaves the hospital against the advice of the doctor; but, a LAMA patient may also leave without informing or the patient may walk out of the ward.

A patient who leaves the hospital without informing the ward/hospital staff can also be said to be absconding.

Discharge on patient request or DOPR is when a patient asks or requests to leave the hospital. In such a situation, the patient leaves the hospital against medical advice but with the consent of the treating doctor.

Regardless of the terminology used, such circumstances have clinical, ethical and legal implications.

The treating doctor is still liable, even in DOPR. Informed consent is critical here meaning that the patient has decided to leave the hospital of his free will, without any coercion, at the same time fully understanding the risks of leaving the hospital, benefits of hospitalization, alternatives including possible consequences of refusing the doctor’s recommendations. The doctor has a duty to provide safe discharge in such cases, which also includes a follow-up advice in addition to the abovementioned.

The subsequent decision of the patient to decline the advice of the doctor is termed informed refusal, which is an integral component of informed consent.

It is not just enough to simply record that the patient has requested DOPR, it is essential to document the entire process of informed consent along with informed refusal.

Failure to obtain an informed refusal before accepting the patient’s decision to leave the hospital makes the doctor vulnerable to prosecution for medical malpractice.

Patients who leave the hospital against medical advice (DAMA/LAMA/DOPR) are at risk of adverse or poor health outcomes because of incomplete treatment, which may increase the risk of re-hospitalization or they may suffer an acute potentially life-threatening event.

A study of more than 2 million PCI procedures published in JACC Cardiovascular Interventions shows that though DAMA patients are uncommon, they are twice more likely to be re-hospitalized with an acute myocardial infarction (MI) than those discharged home or have neuropsychiatric reasons as noncardiac causes of readmission. If DAMA patients are re-hospitalized with MI, the mortality rate is double that of non-DAMA patients readmitted with MI