Tuesday, May 22, 2012

Handling Anger During The Attack

Handling Anger During The Attack

Add Fiber To The Diet Only Slowly

Add Fiber To The Diet Only Slowly

Emedinews:Insights on Medicolegal Issues:What are the cases that should be regarded as medicolegal?

The following cases must be labeled as medicolegal by the treating doctor and medicolegal report should be prepared for further legal investigation
  • All injury/hurt cases, circumstances of which suggest commission of offence by someone
  • All traffic vehicular, railways, aeroplane, ship, boat, factory, construction site or other unnatural accidents
  • Self-inflicted injuries/ attempted suicide
  • Cases of criminal abortion
  • Accidents where there is likelihood of death or grievous hurt
  • All cases of suspected or evident poisoning
  • Suspected or evident homicide, suicide including attempted
  • All burn injuries, whatever the cause of burn
  • All suspected or evident sexual assaults
  • All suspected or evident criminal abortion
  • Unconscious cases where the cause is not natural or not clear
  • Cases referred by Courts for age estimation
  • Cases brought dead with improper medical history
  • Dead on arrival cases or patients who die shortly after being brought to the hospital before a definite diagnosis can be made
  • Patients dying suddenly after parenteral administration of a drug or medication
  • Patient falling down or any mishap in the Hospital, sustaining injury in the Hospital
  • Death on the operation table
  • Unexplained death after surgery or interventional procedure
  • Unexplained ICU death
  • Patient treated and then referred from a private hospital or other Government hospital with complications of surgery or delivery or bleeding, where the cause of death is unexplained.
  • Relatives of the patient assault the treating doctor or other staff of the hospital.
  • Any other case not falling under the above mentioned category but has legal implications like medical examination of arrested accused without consent of person.
In case of death of a medicolegal case, the treating doctor has to only handover the body to the concerned police officer with written recommendation for medicolegal (Forensic) autopsy in final death summary/discharge report and a receipt must be obtained for record. 

Emedinews:Makesure: A 19–year–old boy came to the clinic with complains of rectal pain, tenesmus and bleeding per rectum.

Situation: A 19–year–old boy came to the clinic with complains of rectal pain, tenesmus and bleeding per rectum. He gave the history of anorectal intercourse. Rectal culture was positive for Chlamydia trachomatis.
Reaction: Oh my God! Why did you not prescribe macrolides?
Lesson: Make sure to remember that treatment with single dose of 1 g azithromycin is effective in treatment of LGV proctitis.

Emedinews:Inspiration:A sincere man's promise

This is a true story about two friends. One day a young man said to his good friend, "I can see that someday you will become great and rich."
His friend scoffed, "Ridiculous! How will I become a great and rich man?" The first friend said, "Yes, I can see it. It is written on your forehead." The second one said, "All right, if I become great and rich, I will give you ten thousand rupees." "Do you really mean it?" the first friend asked. "If so, then write it down." The second one wrote down, "I will give you 10,000 rupees if ever I become rich and great," and he signed his name.
The young man kept the note that his friend had written, but he never took his friend seriously. The agreement was made as a joke. Now, it happened that in 10 or 12 years the one friend really did become rich and great, while the other unfortunately remained quite poor. By that time both friends had drifted apart and were leading their own lives. Even so, the poor friend continued to preserve the note, although he felt that since it was a joke, he would never receive the money.
Quite unexpectedly, the poor man fell seriously ill. Just before he died, he called his son, who was only seven years old, and said to him, "My son, please bring me the box that is near the window. Inside it there is something very precious that I have kept for you."
The son was so sad that his father was dying that he did not want to bring the box. He felt that nothing could be more precious than his father's life. But the father insisted, so the son went and got the box. Then the father said, "When I die . . ." and immediately the little boy and his mother started crying. But the father continued, "After I die, you go to this man and show him what he has written." The wife and son looked at the paper and were surprised to learn that the rich man had promised to give his friend ten thousand rupees. But at that moment they could think of nothing but their beloved who was about to leave them.
Soon the man died. Their friendship had faded so much that the rich man, who was once the poor man's best friend, did not even come to see him before he left this world. But after three or four weeks' time the son took the note to the rich man. The rich man had many servants. At first they didn't want to allow this little boy to bother their master. But finally, when they saw he was only an innocent child, they allowed him to come in. The boy gave the rich man the note. The rich man read it and asked, "Did I write this?"
The boy said, I do not know. Before he died, my father gave it to me to give to you." The son was near tears. The rich man summoned one of his secretaries and explained, "I promised this boy's father many years ago that I would give him 10,000 rupees if I became rich and great. I have been rich for seven years; please calculate how much interest I have to give him in addition to the 10,000 rupees." The secretary told him, "An additional 7,000 rupees, which makes it 17,000 altogether."
The rich man immediately issued a check for 17,000 rupees and gave it to the little boy, saying, "Take this directly to your mother. Don't go anywhere else first." This is how one sincere man kept his promise.

Monday, May 21, 2012

Why is My Nose Bleeding?

Why is My Nose Bleeding?

How To Be Happy And Healthy

How To Be Happy And Healthy

Bimaare Ek Ilaj Anek

First Working Group meeting to "Create Awareness about valvular heart diseases" held

Heart Care Foundation of India has announced a new initiative "Creating Awareness about valvular heart diseases". The meeting was moderated by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India.

Seminar on contrast echocardiography held

The Board of Medical Education, Moolchand Medicity, organised a Medical Education Programme for the doctors on ‘Contrast Echocardiography’.

Emedinews:Inspiration:The crime is the same

A worried woman went to her gynecologist and said, “Doctor, I have a serious problem and desperately need your help! My baby is not even 1 year old and I'm pregnant again. I don't want kids so close together." So the Doctor said, "OK and what do you want me to do?"

She replied, “I want you to end my pregnancy, and I'm counting on your help with this." The Doctor thought and after some silence he said to the lady, “I think I have a better solution for your problem. It's less dangerous for you too."

She smiled, thinking that the doctor was going to accept her request.

Then he continued, “You see, in order for you not to have to take care of 2 babies at same time, let's kill the one in your arms. This way, you could rest some before the other one is born. If we're going to kill one of them, it doesn't matter which one it is. There would be no risk for your body if you chose the one in your arms." The lady was horrified and said, “No Doctor! How terrible! It's a crime to kill a child!"

"I agree", the Doctor replied, “But you seemed to be OK with it, so I thought maybe that was the best solution."
The doctor smiled, realizing that he had made his point, He convinced the mom that there is no difference in killing a child that's already been born and one that's still in the womb.

The crime is the same!

Friday, May 4, 2012

Anger Prevention

Anger Prevention:As per Shiva Puran, anger management is described under Neelkanth role of Lord Shiva.

Wednesday, May 2, 2012

Emedinews:Insights on Medicoleagl Issues:Sudden death due to cardiac origin–autopsy

Right coronary artery supplies blood to electrical area of heart
The most common cause of sudden cardiac death in adults over the age of 40 has been  coronary artery atheroma seen in postmortem examination in about 100 cases randomly selected by me in AIIMS mortuary.
  • The most common finding at postmortem examination is chronic high–grade stenosis of minimum one segment of a major coronary artery, the arteries which supply the heart muscle with its blood supply.
  • A significant number of cases also have an identifiable clot in a major coronary artery which causes transmural occlusion of that vessel.
  • In 75 cases out of hundreds, the clots were seen in right coronary artery supplying the electrical area of heart.
  • Death in these cases is thought to result from a period of transient or prolonged lack of blood supply in the muscle of the heart wall, which induces an ventricular arrhythmia/fibrillation and no changes in the myocardium is seen during postmortem examination.
  • The absence of histological signs of acute necrosis and a healed infarct are a common finding.
  • Chronic high–grade stenosis causing previous episodes of ischemia and areas of focal fibrosis is seen histologically in the myocardium.
  • Ventricular arrhythmias may arise from a myocardium which has been previously scarred by episodes of ischemia.

Emedinews:Makesure:A patient intolerant to penicillin was denied rheumatic prophylaxis.

Situation: A patient intolerant to penicillin was denied rheumatic prophylaxis.
Reaction: Oh my God! Why was he not put on a sulfa drug?
Lesson: Make sure that patients who cannot tolerate penicillin are put on sulfadiazine or sulfisoxazole. This antibiotic class is effective for preventing group A streptococcal (GAS) infection although it cannot be used to achieve eradication.

Emedinews:Inspiration:A lesson for a lifetime

When I arrived at 6 a.m. in the large hospital kitchen, Rose was already checking name tags on the trays against the patient roster. Stainless steel shelves held rows of breakfast trays which we would soon be serving.
"Hi, I'm Janet." I tried to sound cheerful, although I already knew Rose's reputation for being impossible to work with. "I'm scheduled to work with you this week."
Rose, a middle-aged woman with graying hair, stopped what she was doing and peered over her reading glasses. I could tell from her expression she wasn't pleased to see a student worker. "What do you want me to do? Start the coffee?" Rose sullenly nodded and went back to checking name tags.
I filled the 40-cup pot with cold water and began making the coffee when Rose gruffly snapped, "That's not the way to make coffee." She stepped in and took over. "I was just doing it the way our supervisor showed us to do it," I said in astonishment. "The patients like the coffee better the way I do it," she replied curtly.
Nothing I did pleased her. All morning her eagle eyes missed nothing and her sharp words stung. She literally trailed me around the kitchen. Later, after breakfast had been served and the dishes had been washed, I set up my share of trays for the next meal. Then I busied myself cleaning the sink. Certainly Rose couldn't criticize the way I did that.
When I turned around, there stood Rose, rearranging all of the trays I had just set up! Totally exhausted, I trudged the six blocks home from the University of Minnesota Hospital late that June afternoon. As a third year university student working my way through school, I had never before encountered anyone like Rose.
Fighting back tears, I wrestled with my dilemma alone in my room. "Lord, what do you want me to do? I can't take much more of Rose." I turned the possibilities over in my mind. Should I see if my supervisor would switch me to work with someone else? Scheduling was fairly flexible. On the other hand, I didn't want to be a quitter. I knew my older co-workers were watching to see if my actions matched my words.
The answer to my prayer caught me completely by surprise -- I needed to love Rose. Love her? No way! Tolerate, yes, but loving her was impossible. "Lord, I can't love Rose. You'll have to do it through me."
Working with Rose the next morning, I ignored the barbs thrown in my direction and did things Rose's way as much as possible to avoid friction. As I worked, I silently began to surround Rose with a warm blanket of prayers. "Lord, help me love Rose. Lord, bless Rose."
Over the next few days an amazing thing began to happen. As I prayed for this irritating woman, my focus shifted from what she was doing to me, and I started seeing Rose as the hurting person she was. The icy tension began to melt away.
Throughout the rest of the summer, we had numerous opportunities to work together. Each time she seemed genuinely happy to see me. As I worked with this lonely woman, I listened to her--something no one else had done. I learned that she was burdened by elderly parents who needed her care, her own health problems, and an alcoholic husband she was thinking of leaving.
The days slipped by quickly as I finished the last several weeks of my summer job. Leaves were starting to turn yellow and red, and there was a cool, crispness in the air. I soon would be returning as a full-time university student. One day, while I was working alone in one of the hospital kitchens, Rose entered the room. Instead of her blue uniform, she was wearing street clothes.
I looked at her in surprise. "Aren't you working today?" "I got me another job and won't be working here no more," she said as she walked over and gave me a quick hug. "I just came to say good-bye." Then she turned abruptly and walked out the door.
Although I never saw Rose again, I still remember her vividly. That summer I learned a lesson I've never forgotten. The world is full of people like Rose - irritating, demanding, unlovable - yet hurting inside. I've found that love is the best way to turn an enemy into a friend.