TIME FOR ACTION
TIME TO USE rTPA IN STROKE
SAVE LIFE AND SAVE DISABILITY
JOIN HANDS TO FORM FRONT FOR USING rTPA
TIME TO USE rTPA IN STROKE
SAVE LIFE AND SAVE DISABILITY
JOIN HANDS TO FORM FRONT FOR USING rTPA
Sunday, November 22, 2009
BRAIN THE FINAL FRONTIER
Brain is final frontier of our body and understanding its anatomy and functioning is by no means complete.Ischaemic Stroke is a serious disease which kills and leaves residual paralysis.Recent advances of using the IV rTPA in stroke has revolutionised its treatment but its small window of 2 hrs makes it essential to use it at periphry and at all towns as there is no time to send patient to higher centers.
Friday, November 20, 2009
NUISANCE VALUE
IDENTIFYING NUSAINCE VALUE
Long time ago there was a village Doctor or Vaid who wanted that he could cure 100% of patients as he was also afraid of failure especially in influential people of kingdom. So he started to pray GOD and kept on praying for days. GOD became happy with him and appeared in front of him and asked him what he wants. He reaveled his desire of curing 100% of patients. GOD said that it was against law of nature as people have to die but since you have made me happy I will grant you this vision. When you go to see a patient look at his bedhead and if you see me standing there it means his day of death has come and he is going to die .Refuse that patient and say you cant treat him for any reason. And when I am not there near patient bed than treat the patient and he will be OK . That way you will have 100% cure rate. If there is some problem and you cant refuse because of any reason like patient is your near and dear , I will grant you three chances and even if you see me near bed of patient and you take that case and treat him ,patient will be alright .I will grant him life ,but only for 3 chances and even than you take such case fourth time I will take your life instead of patients as I have granted you this power to cure 100% of patients.
We are all like this village Doctor of this story and we know most of the time which patients we can treat and which we cant. We still keep on taking risks and sometime succeed also. But when we fail it can create nuisance and can take away lot of our things including peace.
To end the story that vaid became very famous and slowely became egoistic. Over period of time he forgot the limitation of three and when he took fourth patient where Death was standing at pt bedside , GOD spared pt life and took away Doctors life. So when we keep on working beyond our capabilities we are bound to have serious repercussionsWednesday, November 4, 2009
UNIVERSAL PRECAUTION
MAKING PATIENT FEEL COMFERTABLE-CONCEPTS
When a patient of AC MI or UNSTABLE ANGINA or IHD detected recently comes to you ,he is stressed about his future , about disease and wants many answers.
Doctors answers can put him at ease or can increase his tensions.Avoiding the truth and not telling him the real problem is no solution as that will lead to poor copration of patient and will harm his cause .
He has to be put at ease and motivated fairly to seek his copration for fighting the disease.
I usually start with that all of us here are heart patients including me . Any person above the age of 25 years, his arteries start getting narrowed depending on his weight,his blood sugar levels,his blood pressure, his smoking habits ,his cholesterol levels , his tension levels and his genetic makeup. My arteries may be 25% blocked, his may be 50% blocked (pointing toward his relatives) and yours are 80% blocked (100% in case of Ac MI) and when this artery gets 100% blocked ,you get Heart attack.
So what we need is universal precaution. Everybody need to take care of his diet, his blood pressure, his blood sugar, his weight, his cholesterol, do regular exercise and stop smoking or chewing tobacco. It is not alone you (pointing to patient) but everyone of us including me are fighting this meance which has increased to epidemic proportions in our country and has become first cause of mortality and morbidity
Sunday, November 1, 2009
NEW YEAR
NEW YEAR 2009
Its 31st Dec 2008 , 6 in evening , we are looking forward to rocking party in evening at Dr Diwedi,s place . At Dr Dwiwedi everything is cool and calm . Preparation for party at his house which is above NH, are in full swing . China is being polished, table is being laid ,flowers are being arranged and the mood is upbeat. Kitchen is full of activity with snacks being prepared , salads being cut , dishes being prepared. aroma is filling all your senses. Dr Dwivedi has not done any routine surgery today so as to be free of any tensions in evening. Here I would like to introduce U to Dr D formally . Dr D is a renound surgeon of city and his wife is Gynaecologist .They have a flourishing practice and run a NH in heart of city.
Dr D has just finished the rounds and is settling to see OPD. He has taken early round today . Everything seems normal , even Vimla is OK.
Vimla a 22 year girl was married last year to Shyam a clerk in Bank posted in Meerut. She became pregnant early in marriage. She was very happy , Shyam was looking after her wll . In late pregnancy she came back to his father,s house in city and when labour pains started on 31st dec 2008 early in morning she was shifted to Dr D NH for delivery. When Dr Mrs D saw her in morning and did routine Ultrasound she found fetus in distress. As it was precious baby it was decided to bring out the fetus by surgery without wasting time. It was time of stress for family as every thing was going on well but her mother shyamo had great faith in her godess Shakumbhari devi and she tied a sacred thread to her daughter Vimla. Dr D is expert surgeon and surgery went like clockwork . The fetus was delivered in 10 minutes and it was over in 20 minutes . Neelam was out of OT in half hour with baby boy and whole family was full of joy and happiness, perfect to welcome 2009. It,s 6.30Pm in evening and Dr D had allowed to take orally few minutes back when he came to take rounds ,so she is sipping tea that she suddenly feels sudden heaviness in lower chest and slightly out of breath.
Dr D is called .He arrives in few minutes and finds the patient dyspnic and out of breath. He has a gut feeling that something is very wrong .He immediately calls up physician Dr P his trusted friend and anaesthetist Dr Chandra . Both arrives in 10 minutes .By that time patients have been put on Oxygen and emergency drugs. ECG is done and Dr P rules out any heart problem. Chest is clear and the possibility of bronchial asthma is ruled out. There is no history of asthma. Her BP starts falling and she now is gasping for breath. A panic sets in relatives of patients .As Dr D try to calm everybody he himself is worried.
Immediately cardiologist is called and he excludes cardiac causes. Anaesthetist reaches and pt is shifted to ICU. Emergency tests done and it is decided to check for bleeding again. It is now 9Pm .Pt is being shifted to OT and calls are being made to cancel the party. The cook is ordered to stop the preparation .The atmosphere gets gloomy suddenly. Pt is put under anaesthesia and surgery is under way. Atmosphere in pt room filled with relatives is tense. All faces who were smiling and laughing are worried at events. Lights are turned off and there is tension everywhere.Even after surgery the patients condition worsens and it is decided to shift the patient to higher centre.Ambulance is called and Dr D accompanies the patient to higher centre.
It is 12 night on new year day and Dr D is in ambulance with serious patients. The house is in dark and everyone is tense.
Welcome 2009.
Its 31st Dec 2008 , 6 in evening , we are looking forward to rocking party in evening at Dr Diwedi,s place . At Dr Dwiwedi everything is cool and calm . Preparation for party at his house which is above NH, are in full swing . China is being polished, table is being laid ,flowers are being arranged and the mood is upbeat. Kitchen is full of activity with snacks being prepared , salads being cut , dishes being prepared. aroma is filling all your senses. Dr Dwivedi has not done any routine surgery today so as to be free of any tensions in evening. Here I would like to introduce U to Dr D formally . Dr D is a renound surgeon of city and his wife is Gynaecologist .They have a flourishing practice and run a NH in heart of city.
Dr D has just finished the rounds and is settling to see OPD. He has taken early round today . Everything seems normal , even Vimla is OK.
Vimla a 22 year girl was married last year to Shyam a clerk in Bank posted in Meerut. She became pregnant early in marriage. She was very happy , Shyam was looking after her wll . In late pregnancy she came back to his father,s house in city and when labour pains started on 31st dec 2008 early in morning she was shifted to Dr D NH for delivery. When Dr Mrs D saw her in morning and did routine Ultrasound she found fetus in distress. As it was precious baby it was decided to bring out the fetus by surgery without wasting time. It was time of stress for family as every thing was going on well but her mother shyamo had great faith in her godess Shakumbhari devi and she tied a sacred thread to her daughter Vimla. Dr D is expert surgeon and surgery went like clockwork . The fetus was delivered in 10 minutes and it was over in 20 minutes . Neelam was out of OT in half hour with baby boy and whole family was full of joy and happiness, perfect to welcome 2009. It,s 6.30Pm in evening and Dr D had allowed to take orally few minutes back when he came to take rounds ,so she is sipping tea that she suddenly feels sudden heaviness in lower chest and slightly out of breath.
Dr D is called .He arrives in few minutes and finds the patient dyspnic and out of breath. He has a gut feeling that something is very wrong .He immediately calls up physician Dr P his trusted friend and anaesthetist Dr Chandra . Both arrives in 10 minutes .By that time patients have been put on Oxygen and emergency drugs. ECG is done and Dr P rules out any heart problem. Chest is clear and the possibility of bronchial asthma is ruled out. There is no history of asthma. Her BP starts falling and she now is gasping for breath. A panic sets in relatives of patients .As Dr D try to calm everybody he himself is worried.
Immediately cardiologist is called and he excludes cardiac causes. Anaesthetist reaches and pt is shifted to ICU. Emergency tests done and it is decided to check for bleeding again. It is now 9Pm .Pt is being shifted to OT and calls are being made to cancel the party. The cook is ordered to stop the preparation .The atmosphere gets gloomy suddenly. Pt is put under anaesthesia and surgery is under way. Atmosphere in pt room filled with relatives is tense. All faces who were smiling and laughing are worried at events. Lights are turned off and there is tension everywhere.Even after surgery the patients condition worsens and it is decided to shift the patient to higher centre.Ambulance is called and Dr D accompanies the patient to higher centre.
It is 12 night on new year day and Dr D is in ambulance with serious patients. The house is in dark and everyone is tense.
Welcome 2009.
Thursday, October 29, 2009
VIEW POINT
PUT ALL OF YOU IN WHAT EVER YOU DO
Time is a very precious commodity. There are 365
days in a year( bonus of 1 day in leap year) and 24 hours in a day
and 60 minutes to an hour and that is fixed. So time is often a limitation
to lot of activity. When you are doing a job like teaching your son
or writing something or cleaning a instrument,just do the best you
can . Put all your physical and mental strength behind the job. In exams
everyone try to give 100% performance but one can train oneself
to give best performance in all things you do.
Time is a very precious commodity. There are 365
days in a year( bonus of 1 day in leap year) and 24 hours in a day
and 60 minutes to an hour and that is fixed. So time is often a limitation
to lot of activity. When you are doing a job like teaching your son
or writing something or cleaning a instrument,just do the best you
can . Put all your physical and mental strength behind the job. In exams
everyone try to give 100% performance but one can train oneself
to give best performance in all things you do.
Wednesday, October 28, 2009
EXPLANING IBS OR FUNCTIONAL GUT DISEASE OR GAS
Every Doctot has many patients of Functional gut disease including gas formation, hiccoughs ,feeling of bloating ,constipation or diarroea esp. motion after every meal.
It becomes difficult to explain to these people the real disease and most of Doctors end up saying wrong things to patient.
I start –Our nervous system has 2 parts .one is voulantry nervous system which is in our direct control like u can move your hand at will or walk at will
Other part of nervous system is called involuntary or autonomic nervous system which control the functions of body which are not in our direct control like beating of heart, intestines, stomach, formation of juices ,sweating and so on. This autonomic nervous system is run by two opposite systems-sympathetic nervous system, the accelerator and the parasympathetic nervous system , the brakes . By checks and balances of these two opposing forces the body is run all the times .If there is disturbance in this system one can have various problems like-palpitation, tightness of chest, diarrhea or constipation, trembling, sweating, sleep disturbances and so on.
Our gut is 36 feet long tube with different parts where food stays for different length of time and different juices are mixed with food for digestion and whole process is run by ANS. If there is some disturbance in ANS whole process goes haywire and different symptoms surface.
So if U want your GI tract to function normaly U have to keep UR ANS at ease and U should be at ease with ur self.
Every Doctot has many patients of Functional gut disease including gas formation, hiccoughs ,feeling of bloating ,constipation or diarroea esp. motion after every meal.
It becomes difficult to explain to these people the real disease and most of Doctors end up saying wrong things to patient.
I start –Our nervous system has 2 parts .one is voulantry nervous system which is in our direct control like u can move your hand at will or walk at will
Other part of nervous system is called involuntary or autonomic nervous system which control the functions of body which are not in our direct control like beating of heart, intestines, stomach, formation of juices ,sweating and so on. This autonomic nervous system is run by two opposite systems-sympathetic nervous system, the accelerator and the parasympathetic nervous system , the brakes . By checks and balances of these two opposing forces the body is run all the times .If there is disturbance in this system one can have various problems like-palpitation, tightness of chest, diarrhea or constipation, trembling, sweating, sleep disturbances and so on.
Our gut is 36 feet long tube with different parts where food stays for different length of time and different juices are mixed with food for digestion and whole process is run by ANS. If there is some disturbance in ANS whole process goes haywire and different symptoms surface.
So if U want your GI tract to function normaly U have to keep UR ANS at ease and U should be at ease with ur self.
Sunday, October 25, 2009
EXPLAINING ALTERNATIVE MEDICINE
EXPLAINING ALTERNATIVE MEDICINE
When you don’t know a field or area it is better to extrapolate findings to another field or area where you have some working knowledge .For example you have little knowledge about medicines it is better to compare it with other area for example with transportation.
We have various means of transportation like you can walk, cycle, bicycle. scooter ,motorcycle, car ,jeep, bus ,truck ,train ,ships ,aero planes etc. All have its usage and importance. For example you walk in your house or you walk short distances .For short distances you can use bicycle , rickshaw ,tonga etc. For still longer distances you use scooter or mobikes . For traveling long distances like going to Delhi one uses Bus or Train. Nobody walks or cycle to Delhi.
For traveling overseas you either take a plane or go by ship .You cant reach USA on cycle. Similarly one has various types of Medicines like Homeopathy ,Aurvedic , Tibbiya ,Chinese medicines, Acupuncture, Yoga ,Meditation.
One has to learn the art of using each system of medicines wisely and get best results. For example acupuncture are for chronic pain only .It cannot heal a ulcer or treat cancer for you. Meditation is good for anxiety and boosting your morale.
Homeopathy is good for psychological problems and for chronic diseases which are not going to heal or treated in short times .A patient of terminal cancer is better be taking homeopathy than no medicines . It is of course not going to cure him but will keep his hope alive and make his life less miserable till end. Then there are distances you can walk or cycle or go in car or mobike , similarly there are diseases where one can use any system of medicine or take no medicines but will become alright. So think before you use.
When you don’t know a field or area it is better to extrapolate findings to another field or area where you have some working knowledge .For example you have little knowledge about medicines it is better to compare it with other area for example with transportation.
We have various means of transportation like you can walk, cycle, bicycle. scooter ,motorcycle, car ,jeep, bus ,truck ,train ,ships ,aero planes etc. All have its usage and importance. For example you walk in your house or you walk short distances .For short distances you can use bicycle , rickshaw ,tonga etc. For still longer distances you use scooter or mobikes . For traveling long distances like going to Delhi one uses Bus or Train. Nobody walks or cycle to Delhi.
For traveling overseas you either take a plane or go by ship .You cant reach USA on cycle. Similarly one has various types of Medicines like Homeopathy ,Aurvedic , Tibbiya ,Chinese medicines, Acupuncture, Yoga ,Meditation.
One has to learn the art of using each system of medicines wisely and get best results. For example acupuncture are for chronic pain only .It cannot heal a ulcer or treat cancer for you. Meditation is good for anxiety and boosting your morale.
Homeopathy is good for psychological problems and for chronic diseases which are not going to heal or treated in short times .A patient of terminal cancer is better be taking homeopathy than no medicines . It is of course not going to cure him but will keep his hope alive and make his life less miserable till end. Then there are distances you can walk or cycle or go in car or mobike , similarly there are diseases where one can use any system of medicine or take no medicines but will become alright. So think before you use.
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