We generally think most about skin protection in summer with its extended daylight, time at the pool or beach and leisurely walks – but it’s important to keep in mind that the sun’s rays can reach us in every season.

To help prevent skin cancer, keep in mind these sun protection guidelines from the American Academy of Dermatology:

• Seek shade during peak sun hours of 10:00am to 2:00pm.
• Wear sunglasses with UV protection, a wide-brimmed hat and sun-protective clothing.
• Always use sunscreen (at least SPF 30), and don’t forget to reapply every two hours, especially when swimming or sweating. Remember to apply to your feet when barefoot or wearing sandals.

Risk factors for skin cancer include past sunburns, indoor tanning, atypical moles and having fair skin. Make sure to perform regular skin self-exams to notice if anything has changed, and see a dermatologist for screenings.

According to the American Cancer Society, “More people are diagnosed with skin cancer each year in the U.S. than all other cancers combined.” 1 in 5 Americans are diagnosed with skin cancer by age 70, so odds are you or someone you know has been affected by skin cancer.

You may also be aware that skin cancer treatments can be intense – and while necessary, may leave long-lasting scars and skin discoloration. Treatment methods range from chemical peels, cryosurgery and laser surgery for precancerous spots to traditional excisional surgery and Mohs surgery for basal and squamous cell carcinomas. Some cancers even require treatment with radiation therapy.

Should you or a loved one receive a skin cancer diagnosis, the Skin Cancer Foundation recommends seeking out medical information only from verified, trustworthy online resources. They also recommend not to rush a treatment decision and to seek a second opinion if you’re uncertain about the diagnosis.

SecondOpinions.com offers quick and affordable medical second opinions in a wide range of medical specialties, including dermatology. Contact our reliable specialists to feel confident in your diagnosis and condition.

With just 21 shows left in a 120-date lineup, Lady Gaga had to abruptly end her concert tour due to a hip injury. With her rigorous choreography and demanding schedule, the wear and tear on her hip over the years caused debilitating pain that shot through her entire body. Previously, doctors had reviewed her MRIs, diagnosed her with a labral tear –  an injury to tissue within the hip – and recommended over-the-counter painkillers and anti-inflammatories.

Upon seeing another physician after ending her tour, Lady Gaga was quickly diagnosed with a hip fracture and treated with surgery to repair it. In her own words:

“When we got all the MRIs finished before I went to surgery there were giant craters, a hole in my hip the size of a quarter, and the cartilage was just hanging out the other side of my hip. I had a tear on the inside of my joint and a huge breakage. The surgeon told me that if I had done another show I might have needed a full hip replacement.”

Had she required hip replacement surgery, Lady Gaga would have been unable to perform for at least a year. As it was, the repair surgery involved six months of recovery. She has since embarked on a multi-phase treatment plan including trigger point injections and massage. But the effects of the fracture – possibly missed by doctors for months or even years – continued to cause intense pain and body spasms for more than five years after her surgery. The ongoing pain and effects on her daily life also took a severe toll on her mental health. What might have been different had her fracture been recognized sooner?

The array of doctors and treatments available to an A-list celebrity like Lady Gaga are much less affordable and accessible for the average patient, yet she still suffered the effects of misdiagnosis. Everyone deserves to be confident in their diagnosis and provided the proper treatment. If you or someone you love are seeking another review of an MRI, reach out to our network of physicians at SecondOpinions.com.

2 International Journal of Health Information and Medical Research Vol: 1, Issue: 1, Jan 2014 Guidelines for Handling Medico Legal Cases Vinay M Raj1, Vasudeva D S2, Gagan S3 edicolegal knowledge is an es-sence for a medical professional, irrespective of their specialty. Law is common to all. Knowledge about Medico legal is-sues is not optional for a treating Doctor but a mandatory social re-sponsibility. Proper knowledge of the roles and responsibilities of a health care provider is of im-mense importance while han-dling these cases to facilitate so-cial and legal justice. A health care provider along with the medical records called to the court as an expert witness is of pivotal importance for the pro-ceedings of the trial and any in-competence by the health care provider can result in grave con-sequences for both the Institution and self.The health care provider must therefore exercise vigilance and proper documentation while treating a Medico Legal Case. It is advisable to follow the legal as-pects to avoid embarrassment in the court of law due to the lack of knowledge or awareness regard-ing MLC’s and their practices.Hence, this effort is done to compile a set of basic guidelines to be practiced in a hospital when dealing with MLCs. The follow-ing is a non-exhaustive list of guidelines compiled to effectively handle MLCs in a hospital.Role of Doctor in CasualtyRemain calm, do not panic, and treat as a regular case.Lives saving measures are always FIRST in priority.MLC workup is done SOON after it.Casualty services are 24×7 CMOs are supposed to reg-ister MLC by entering the follow-ing in the MLC register. Preliminary data:Name –Full name should be taken with ini-tials,Age Sex Address –local and permanent. Identification marks:Two reliable identifi-cation marks have to be noted preferably from the peripheral parts of the body,If not found then it could be from private parts Mole/scar/birth mark/ deformity/ any other peculiar mark can becon-sidered. Consent of the patient / relative has to be taken:Signature/ thumb impression of the patient.Signature of the rela-tive / guardian. Brief history of the inci-dent –time/ place/nature of in-cident. Examination findings:Injuries must be noted in the order of Head to toe or major to minor injuries.

Treatment given:Immediate treat-ment givenReferral to the concerned department. If referred outside –Place where it is referred should be mentioned. Information given to police –Name of the Police Station.Deciding a case as Medico-Legal or not, is based solely on the treating DoctorMLC can be registered at any time after the patient has come to the hospital –arrival/ later –based on the time of suspi-cionAny Doctor at any point of their treatment should inform the CMO regarding any suspicion about any foul play suggestive of unnatural means in the case.It is better to register as MLC and later easy to convert into non MLC than vice versa if the Doctor is in dilemma about the case.Once MLC done –either in our hospital or outside is suffi-cient –no need to repeat the same.

Dept. Of Forensic Medicine,2Principal, 3Dept. Of Community Medicine,S N Medical College &Research Centre. Address for Correspondence: Dr Vinay M Raj, Assistant Professor, Dept. Of Fo-rensic Medicine, Akash Institute of Medical Sciences &Research Centre, Deva-nahalli –
International Journal of Health Information and Medical Research Vol: 1, Issue: 1, Jan 2014 copy of the same should be at-tached to the file.If patient is referred from our hospital after registering un-der MLC, the same has to be men-tioned in the referring letter and inform the same to the police.History told by the patient or the relatives has to be entered in the same words preferably, if any doubt regarding the history has to be asked specifically. Avoid guessing, assumptions about the facts. All the information written should be legible, understandable and simple in nature. Try to avoid scientific and medical terminolo-gies as much as possible.To document, use ball point pen preferably. Avoid use of ink or gel pen. Avoid over writing, scrib-bling, etc. and any corrections made must be initialed along with the date.Saving the life of the pa-tient is a priority, irrespective of availability of attendees/ relatives for consent. However only lives saving procedures are allowed. Anything other than life saving procedures has to be with the con-sent.Life saving procedures Stabilizing the patient –Airway, Breathing, Circula-tion.oCPR. Based on knowledge/skill/experience, the treating Doctor will decide the most appropriate life sav-ing procedures needed for the patient at that specific time.Eg: Medical emer-gencies –Patient with chest pain with ECG changes suggestive of myocardial infarction should be treated with aspirin & clopidogrel Patient in Hypovo-lemic shock –need fluid re-placement.

CMO can take the ad-vice from the concerned de-partment if needed any time. Concerned specialist will decide the specific treat-ment required and the same can be done under their guid-ance during their physical ab-sence.Delay in payment should never be the reason to deny the treatment. ‘FIRST SAVE THE LIFE THEN TAKE THE PAYMENT’.MLC register & Police Inti-mation Register has to be kept in a locker and the Doctor at casualty is in charge of the key. At the time of change of duty, the concerned doctor has to handover the key to the reporting Doctor along with the instructions.If anybody found safe guarding of the patient from legal circumstances either the treating Doctor or any other person in-volved is punished asper the sec-tion IPC 201.Cases to be Regis-tered as MLCThe following is an in-exhaus-tive list of cases to be registered as MLC

Alleged history of assault

Road traffic accident –Ve-hicle collision / pedestrian injury.

Firearm injuries4.Self fallinjuries not con-sistent with the history

Poisoning / drug over dos-age6.

Alcohol intoxication & drunkenness Anaphylaxis due to thera-peutically injected drugs Victims of Animal ferocity

Snake Bite/ scorpion sting; however Bee sting or other insect sting being an exception

.Attempted Suicide –self in-flicting injuries/ poisoning / any means.

.Attempted Homicide -Hanging / strangulation / poison-ing

Burns except for minor do-mestic nonfatal accidental burn injuries

Electrocution/ Lightning.14.Any patient with uncon-sciousness/ unexplained coma.15.Death occurring within 24hrs of hospitalization without establishment of a diagnosis.16

Alleged Criminal abortion Any brought dead/ Death on arrival, without any corrobora-tive history supports death.Case of AssaultAll cases ofassault have to be registered as MLC and MUST be informed to the police without fail.Injuries have to noted down from oHead to toe or major to minor oThey have to be num-beredoDescription of the injury –size, site, shape, position from bony landmark should be noted, preferably take the measurement using measur-ing tape.oAging of the injury has to be mentioned.Fresh / dark brown/ brown/ black/scar  Type of weapon in-flicted can be assessed and cor-related with the type of injuryInjury certificate has to be issued only with the patient’s or police request.