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drneelesh — Wed, 12 Aug 2009 12:01:32 +0000

View more presentations from Neelesh Bhandari.

Medical consultation on the Move

drneelesh — Thu, 30 Jul 2009 12:49:00 +0000

A new mobile handheld technology developed by mVisum of Cedar Brook, NJ, is been tested. This communication tool boasts of providing off-site cardiologists access to EKGs that can then be used to prescribe immediate treatment.

The Department of Veterans Affairs is testing this new system which seemingly enables fast transfer of clinical data to a smartphone for review within minutes. The mVisum Medical Communication System is stated to be a communication tool which permits health-care personnel to securely receive, review and respond to a patient”s medical data recorded at the point of care. This transfer of information notably takes place through secure HIPAA compliant internet servers, later transmitting it via mobile technology to the smartphone of the physician. More so, this system is also loaded with the ability to be availability aware, so that the patient can refer to another physician in the absence of the original intended physician. The various types of medical data that can be sent through this technique include DICOM images, EKGs, CT scans, MRIs, X-rays, etc. Along with this, textual information relating to the patient may also be included in the message for the purpose of getting a broader idea about the condition of the patient.

The process begins with the recording of patient data at the point of care. Point of Care can include the physician’s office, medical center, hospital, or anywhere the patient is located and an system is installed.Data is transmitted securely and reliably to the physician’s mobile handheld device. The system has advanced technology that allows the system to be availability aware,so that another physician can immediately be contacted if the original intended physician is unavailable.Once received, the physician can review data and securely respond with medical opinion, prescription or other critical orders.

View more news videos at: http://www.nbcwashington.com/video

Prozac- Things to know before you use it.

drneelesh — Wed, 15 Jul 2009 11:41:00 +0000

: Image by drneelesh via Flickr

Prozac ( or Fluoxetine Hydrochloride ) is a commonly used antidepressant in clinical practice. Fluoxetine has been approved by the FDA for the treatment of major depression, obsessive compulsive disorder, bulimia nervosa and panic disorder. Used since mid-1970a, Eli Lilly’s patent on Prozac (fluoxetine) expired in August, 2001, prompting an influx of generic drugs onto the market. It has shown excellent results and is often used by people/patients even without proper prescriptions. The use , and abuse of Prozac has reached phenomenal proportions.Is Prozac safe?? What are the few things you must know before you start using it?

Below is a slideshow i have prepared detailing a few important facts about Prozac use. Also incorporated is a video which will further enhance comprehension about this widely used drug.

The History of Prozac (addiction-dirkh.blogspot.com)

Propofol as Drug of Abuse

drneelesh — Wed, 01 Jul 2009 06:20:00 +0000

Is Propofol, or Diprivan what Michael Jackson used for (drug) abuse?

According to Cherilyn Lee, a registered nurse who operates a Los Angeles-based nutritional counseling business, in California, “Jackson was complaining of insomnia and pleaded for her to get him some (Diprivan)”. Other reports claim Propofol was recovered from his residence. This conversation reportedly occurred in April of this year. Preliminary reports say that M.J died of cardiac arrest, which is within the possible effects of unmonitored Diprivan use. (A rapid bolus injection can result in undesirable cardiorespiratory depression including hypotension, apnea, airway obstruction, and oxygen desaturation.)

Diprivan is a general anesthetic, used to start or maintain anesthesia during certain surgeries, tests, or procedures. It is available in a white vial of 20, 50 and 100 ml (containing 10mg/ml.).Most adults require 2 to 2.5 mg/kg of the drug ( approx. 10 to 15 ml). DIPRIVAN Injectable Emulsion is an IV sedative-hypnotic agent and can cause potentiation of other narcotic drugs and benzodiazepines when used together. The most common side-effects include Change in mood or emotions; dizziness; drowsiness; lack of coordination. It is given intravenously, usually within the operation theater or in a clinic. It has a rapid onset of action ( within 1 min) and short duration of action (approximately 10 min but is dose dependent).It has direct cardiodepressant effects, leading to decreased blood pressure and heart rate in higher doses. Its actions causing decreased heart rate and respiratory rate mean that use of propofol is done only under continuous monitoring of vital signs.Diprivan is not meant for use in pediatrics and elderly population since its safety has not been established in these populations. Prolonged use of propofol results in accumulation of the drug in body tissues and increases the duration of action as well as chances of overdose.

Rarely, Cases of death due to propofol have been discussed in medical literature. All these cases have occurred in hospital settings only.It is definitely not meant for home use and this is the first time I have heard of Diprivan being used as a drug of abuse outside hospital settings.

Euphoria, sexual hallucinations and disinhibition have been described on recovery of propofol anaesthesia. These effects could explain the recreational use of the drug. Moreover, several experimental studies strongly suggest the potential for abuse and dependence on propofol,and few cases of abuse and dependency have been described, mostly in medical professionals. As propofol is generally not recognized as a substance of abuse, and because of its safe profile, it is important to remember that rare adverse reactions of propofol could produce death in a context of abuse, even at therapeutic dose range, in the absence of ventilatory and medical assistance.

British Journal of Anaesthesia 2006 97(2):268; doi:10.1093/bja/ael168I

Michael Jackson Suffers Cardiac Arrest (justjared.buzznet.com)
Propofol infusion syndrome (doctorrw.blogspot.com)

Using Virtual reality in Psychiatry

drneelesh — Tue, 30 Jun 2009 12:25:00 +0000

Post traumatic stress disorder(abbreviated PTSD) is an anxiety disorder that can develop after exposure to one or more traumatic events that threatened or caused great physical harm.It is a severe and ongoing emotional reaction to an extreme psychological trauma. This stressor may involve someone’s actual death, a threat to the patient’s or someone else’s life, serious physical injury, an unwanted sexual act, or a threat to physical or psychological integrity, overwhelming psychological defenses.

Vulnerability to PTSD presumably stems from an interaction of biological predisposition, early childhood developmental experiences, and trauma severity. Exposure-based therapy, in which recent trauma survivors are instructed to relive the troubling event, may be effective in preventing the progression from acute stress disorder to post-traumatic stress disorder, according to a report in the June issue of Archives of General Psychiatry (Arch Gen Psychiatry. 2008;65[6]:659-66). But it may not be practical to recreate the trauma or the precipitating circumstances. Like in cases of PTSD in soldiers back from the Iraq war and rehabilitation efforts.

The military is turning to the virtual world to treat traumatized veterans of the Iraq war, giving troops a high-tech way to confront and overcome mental war wounds.Virtual Iraq uses electronically re-created Iraqi environs that look like a video game, as well as the sounds and smells of deployment, to help those suffering from post-traumatic stress disorder revisit the events that affected them so profoundly.It is a joint venture of the Air Force, Navy and Army, along with the University of Southern California and Virtually Better Inc. The visual environs created for the therapy are based on the video game “Full Spectrum Warrior.”

There are about 40 Virtual Iraq systems in Defense Department and Veterans Affairs hospitals and clinics.Virtual Iraq helps PTSD patients access traumatic memories by replicating the war zone in a safe way that therapists can control.

With Virtual Iraq, a troop is back driving a Humvee down an Iraqi highway, or exploring a city on foot patrols. Ambient sound recordings including prayer calls, gunfire, men yelling and taunting, can be varied in intensity by the therapist.The smell of fire, diesel, cordite, body odor and burning rubber are also used to facilitate memory recall and emotional processing.

Mental health therapists hope that Virtual Iraq’s similarity to video games will help draw younger traumatized troops to the treatment.
For more information on PTSD , click here.

Generals share their experience with PTSD – CNN Article (untreatableonline.com)
Forces launch mental-health awareness campaign (thestar.com)
Medical Animation- How is it Used ? (medical-communication.blogspot.com)

Clinical quiz online from BMJ

drneelesh — Mon, 29 Jun 2009 13:03:00 +0000

Image by Pickersgill Reef via Flickr

A quiz is a form of game or mind sport in which the players (as individuals or in teams) attempt to answer questions correctly. Quizzes are also brief assessments used in education and similar fields to measure growth in knowledge, abilities, and/or skills.Online quizzes are a popular form of entertainment for web surfers. Online quizzes are generally free to play and can form an important medium of health information dispersion.

Best Practice is brought to you by the BMJ Evidence Centre – a division of the BMJ Group that is working to provide health care professionals with innovative new products and tools that make evidence useful in practice. Individuals can register online for a 30-day personal free trial. To access your trial you will require a BMJ MyAccount. You can register and then follow the steps to set up your free trial.

I found this quiz on the BMJ Best practices site. It lets you choose the speciality you want to be quizzed on and also times your answers, letting you score more for quick answers. It was fun, and i managed to score 80%. Their scoreboard showed a long list of quizzers with perfect 10 scores, so maybe i need to get back to my textbooks now.

BMJ Archives Video: Discovery of Anaesthetic (casesblog.blogspot.com)
How To Have Fun With Online Personality Quizzes (makeuseof.com)
Five Quizzes You Just Have to Take (totalbeauty.com)

Easy understanding of Cancer Chemotherapy.

drneelesh — Mon, 22 Jun 2009 08:44:00 +0000

Chemotherapy has become a household term referring to anti-cancer treatment. In the broad sense, most chemotherapeutic drugs work by impairing mitosis (cell division), effectively targeting fast-dividing cells. As these drugs cause damage to cells they are termed cytotoxic. Some drugs cause cells to undergo apoptosis (so-called “programmed cell death”).The first chemotherapeutic agent used for treatment of Cancer was, ironically, a WMD (Weapon of mass destruction), Mustard gas when its cytotoxic capabilities were noticed during World War 2.

The earlier agents used in chemotherapy were not selectively lethal to cancer cells and harmed many normally dividing cells like hair follicles and skin. But in recent times, scientists have produced novel drugs Targeted at specific molecules within cell cycles. This results in much less collateral damage to normal cells. Below is an interactive flash presentation (originally from newscientist.com) which explains the uses and mechanism of action of ten such therapies.

You can click on the left hand menu to visualize the exact intracellular mechanism of the drug.
Easy to create, easy to remember and fun to learn.

Designer molecules that seek and destroy cancer cells (geneticsandhealth.com)
Scientists discover how cancer cells survive a chemotherapy drug (biosingularity.wordpress.com)

Using Flash media for Medical communication

drneelesh — Mon, 08 Jun 2009 08:21:00 +0000

Here is a simple flash presentation prepared by me discussing the main issues involved in creating an effective health communication media. You can find other such useful presentations and documents also on my Scribd account.

How am i supposed to live without polymerase chain reaction

drneelesh — Fri, 01 May 2009 12:51:00 +0000

Image via Wikipedia

Polymerase chain reaction (PCR) is a technique to amplify a single or few copies of a piece of DNA across several orders of magnitude, generating millions or more copies of a particular DNA sequence. Primers (short DNA fragments) containing sequences complementary to the target region along with a DNA polymerase (after which the method is named) are key components to enable selective and repeated amplification. As PCR progresses, the DNA generated is itself used as a template for replication, setting in motion a chain reaction in which the DNA template is exponentially amplified.

Simply put, “Primers” are prepared complementary to target genes, Polymerses are added and they work together to produce millions of copies of the target genetic sequence.

A few uses of PCR include-

Genetic fingerprinting
Paternity testing
Detection of hereditary diseases
Cloning genes
Mutagenesis
Analysis of ancient DNA
Genotyping of specific mutations
Comparison of gene expression

But talking about PCR need not be so boring. This is a very creative music video created by BioRad to popularize and inform about the uses of PCR. Medical communications as i like it. Focus on the receiver and the message and break the boredom barrier.