Month: December 2013

Judge orders Calif. hospital to keep teen declared brain dead on ventilator

With a family fighting a hospital to keep their daughter who has been declared brain dead on life support, a California judge on Monday ordered the hospital to keep treating 13-year-old Jahi McMath for another week as a second medical evaluation is conducted.

Jahi experienced complications following a tonsillectomy at Children’s Hospital in Oakland.

As her family sat stone-faced in the front row of the courtroom, an Alameda County judge called for Jahi to be independently examined by Paul Graham Fisher, the chief of child neurology at Stanford University School of Medicine.

The judge also ordered the hospital to keep Jahi on a ventilator until Dec. 30, or until further order from the court.

The examination was expected to occur later on Monday, and early Tuesday.

Hospital staff and Fisher will conduct an electroencephalogram, or EEG, and tests to see if blood is still flowing to Jahi’s brain.

Doctors at Children’s Hospital concluded the girl was brain dead on Dec. 12 and wanted to remove her from life support.

Jahi’s family wants to keep her hooked up to a respirator and eventually have her moved to another facility.

The family said they believe she is still alive and that the hospital should not remove her from the ventilator without their permission.

“It’s wrong for someone who made mistakes on your child to just call the coroner … and not respect the family’s feeling or rights,” Sandra Chatman, Jahi’s grandmother who is a registered nurse, said in the hallway outside the courtroom.

“I know Jahi suffered, and it tears me up.”

The family’s attorney also asked Judge Evelio Grillo to allow a third evaluation by Paul Byrne, a pediatric professor at the University of Toledo. The hospital’s attorney objected to Byrne, saying he is not a pediatric neurologist.

The judge is expected to take up the request to use Byrne, and another hearing was scheduled for Tuesday morning.

Byrne is the co-editor of the 2001 book “Beyond Brain Death,” which presents a variety of arguments against using brain-based criteria for declaring a person dead.

In a phone interview, Byrne said he could not comment in detail because he had not seen any of Jahi’s medical records. But the fact that her ventilator is still functioning properly is a sign that she is alive, he said.

“The ventilator won’t work on a corpse,” he added. “In a corpse, the ventilator pushes the air in, but it won’t come out. Just the living person pushes the air out.”

Jahi’s family says the girl bled profusely after a tonsillectomy and then went into cardiac arrest before being declared brain dead.

Outside the courtroom, Dr. David Durand, chief of pediatrics at Children’s, said that staff have the “deepest sympathy” for the family, but that Jahi is brain dead.

“The ventilator cannot reverse the brain death that has occurred and it would be wrong to give false hope that Jahi will ever come back to life,” he said.

Durand said Jahi’s surgery was “very complex,” not simply a tonsillectomy.

“It was much more complicated than a tonsillectomy,” Durand said. He refused to elaborate, citing health care privacy laws.

Arthur L. Caplan, who leads the Division of Medical Ethics at NYU Langone Medical Center and is not involved in Jahi’s case, told The Associated Press that once brain death has been declared, a hospital is under no obligation to keep a patient on a ventilator.

source: abc news

The Health Benefits of Setu Bandhasana (Bridge Pose)

As you perform Bridge Pose, you will become more alert in both body and mind. This rejuvenating backbend will open your chest up and keep your spine flexible. While beginners can practice it safely, skilled practitioners can still experience its many benefits. Setu Bandhasana will also help to prepare you for more intense backbends.

This posture is relatively simple and quite exhilarating. If you find it difficult to hold the lift in your pelvis, slide a block or bolster beneath your sacrum and rest the pelvis on it for support. In contrast, if you are looking to deepen the stretch, lift your heels off the floor once in Bridge Pose and push your tailbone up towards the pubis. Once the tailbone is lifted, stretch the heels back to the floor.

Getting Into Bridge Pose:

Lie flat on your back with arms at your sides, palms down. Bend your knees and place your feet flat on the floor. Keep your feet hip width apart, parallel to each other, and as close to the buttocks as possible. Simultaneously, press your upper arms and feet into the floor and begin lifting your hips towards the ceiling. Try to distribute your weight equally on the inside and outside of your feet.

Now, move your breastbone towards your chin, keeping your chin lifted only slightly as not to flatten the back of the neck. Firm your tailbone in towards the pubis and move your pubis slightly towards the belly. In order to keep the lower back extended, keep the knees over the ankles, perpendicular to the floor. Your buttocks should be firm, but not clasped.

Lift your hips as high as you are able without breaking position. If you are having trouble holding posture, you can clasp your hands behind your back and firm you arms into the floor, shoulder blades shifted down along the spine. Hold this pose for 5 to 15 breaths.
To come out of Bridge Pose, release on an exhalation, rolling your spine slowly down onto the floor.

Benefits of Bridge Pose:

  • Stretches the chest, neck, spine, and hips
  • Strengthens the back, buttocks, and hamstrings
  • Improves circulation of blood
  • Helps alleviate stress and mild depression
  • Calms the brain and central nervous system
  • Stimulates the lungs, thyroid glands, and abdominal organs
  • Improves digestion
  • Helps relieve symptoms of menopause
  • Reduces backache and headache
  • Reduces fatigue, anxiety, and insomnia
  • Rejuvenates tired legs
  • Relieves symptoms of asthma and high blood pressure
  • Therapeutic for hypertension, osteoporosis, and sinusitis

Source: CNY Healing arts

Gene involved in response to cocaine identified

Scientists, led by an Indian-origin researcher, have identified a gene that may determine the intensity of our response to cocaine.

Researchers at the University of Texas Southwestern suspect that the newly identified gene, Cyfip2, determines how mammals respond to cocaine, although it is too soon to tell what the indications are for humans or for addiction.

The findings evolved from examining the genetic differences between two substrains of the standard C57BL/6 mouse strain: a ‘J’ strain from the Jackson Laboratory (C57BL/6J) in US and an ‘N’ strain from the National Institutes of Health (C57BL/6N).

The study, with Dr Vivek Kumar as the lead author, compared the two strains of mice and used their differential responses to cocaine to identify the causative gene.

“We found that the ‘N’ strain has accumulated mutations over time, one of which has a very strong effect on cocaine response,” said Dr Joseph Takahashi, chair of neuroscience and a Howard Hughes Medical Institute investigator at UT Southwestern and the senior author of the study.

“We propose that CYFIP2 – the protein produced by the Cyfip2 gene – is a key regulator of cocaine response in mammals,” he said.

“We identified this gene by first using a forward genetics strategy to search for differences in traits between the two mouse strains. We found a difference in cocaine response between them, with the C57BL/6N strain showing a reduced behavioural response,” Takahashi said.

“We then carried out genetic mapping and whole genome sequencing, which allowed us to pinpoint the Cyfip2 gene as the causative one in a rapid and unambiguous way,” he added.

The study was published in the journal Science.

Source: Deccan chronicle

Duke University scientists find women need more sleep than men

If the woman in your life woke up grumpy this morning, don’t be too hard on her. It is, apparently, only natural.

Scientists at Duke University in Durham, North Carolina discovered that women need more sleep than men. And chances are, she’s not getting enough.

In fact the best thing a loving husband or partner can do is perhaps persuade her to get a few extra hours snuggling under the duvet. Or face the consequences.

More relationship stories

Scientists say women suffer more than men, both mentally and physically, if they are forced to skimp on their sleep.

As well as a higher risk of heart disease, depression and psychological problems, sleep-deprived women have extra clotting factors in their blood, which can lead to a stroke.

They also have higher inflammation markers, which indicate developing health problems.
As inflammation markers are also linked to pain, sleep expert Dr Michael Breus explained that women can literally be in more pain when they wake up.

That’s enough to make any girl feel rather grumpy.

By contrast, the state of a man’s health does not appear to be closely linked to how much they sleep.

In the study, men showed no increased risk of developing the ailments that affect women when they are sleep deprived.

“We found that women had more depression, women had more anger, and women had more hostility early in the morning,” said Dr Breus.

If this sounds like someone you know, it can probably be blamed on sleep deprivation and the fact that women are particularly susceptible to the effects. What does Dr Breus advise?

If you don’t manage to get enough sleep at night, try taking strategic naps.
However, he warned that those naps should be either 25 minutes or 90 minutes long. Any other length will make the snoozer feel worse when they wake, he said.

This is not the first time experts have suggested that women need more sleep than men.
One of Britain’s leading authorities on sleep found that women actually need 20 minutes more shut-eye. This is because of the female multi-tasking brain.

“One of the major functions of sleep is to allow the brain to recover and repair itself,” said Professor Jim Horne, director of the Sleep Research Centre at Loughborough University, England.

“During deep sleep, the cortex – the part of the brain responsible for thought, memory, language and so on – disengages from the senses and goes into recovery mode.

“The more of your brain you use during the day, the more of it that needs to recover and, consequently, the more sleep you need.
“Women tend to multi-task – they do lots at once and are flexible – and so they use more of their actual brain than men do. Because of that, their sleep need is greater.

“A man who has a complex job that involves a lot of decision-making and lateral thinking may also need more sleep than the average male – though probably still not as much as a woman.”
source: news.com

India launches its indigenous cervical cancer screening device

India launched its first indigenously developed device for screening and early detection of cervical cancer, which kills over 74,000 women in the country every year.

Launching the low-cost “AV-Magnivisualiser” device developed by Indian Council of Medical Research (ICMR), Union Minister of Health and Family Welfare Ghulam Nabi Azad said it will help in early detection of cervical cancer among adolescent girls and women, thus helping in save many lives.

Designed and developed at Institute of Cytology and Preventive Oncology ( ICPO), Noida, working under ICMR, the device will cost about Rs 10,000 and is much lower as compared to the cervical cytology method used at present in medical colleges, the equipment of which costs over Rs eight lakh.

“I am extremely happy and I congratulate the scientists involved in the cutting-edge level. I hope the cost-effective device will be available in the market in the next eight months to help ensure ..

The Minister said with this device it will be easy to screen and detect cervical cancer in its early stages, thus making treatment more effective.

“We will also ensure proper training of nurses and manpower for using the device in the coming months,” he said, adding that screening for cervical cancer is available only in regional cancer institutes and medical colleges at present.

He said the equipment presently being used is expensive, as a result of which not many medical coll ..

Source: Economic Times

Three reasons why you should eat kiwi fruit

Other than its exotic taste, kiwi fruit contains numerous phytonutrients and well known vitamins and minerals that promote health.

Here are a few reasons why you should eat kiwi:

1. Aids digestion: A great source of fibre, kiwi prevents constipation and other intestinal problems. It also offers soluble fiber, providing bulk that promotes the feeling of fullness – a natural diet aid.

2. Reduces cardiovascular risk: Eating kiwi every day may help lower risk of blood clots and reduce the amount of fats (triglycerides) in the blood, thus promoting cardiovascular health. It is an excellent source of vitamin C, and polyphenols, and a good source of potassium, all of which may function individually or in concert to protect the blood vessels and heart. High level of potassium helps keep electrolytes in balance by counteracting the effects of sodium, thus helping manage blood pressure.

3. Good for asthma and diabetes sufferers: The high content of vitamin C confers significant protective effect against respiratory symptoms associated with asthma such as wheezing. Kiwifruit, as a very good source of dietary fiber is good for keeping the blood sugar levels of diabetic patients under control.

Source: Zee news

850 foreign doctors allowed to practice in India this year

Under the modified provisions of the Indian Medical Council Act 1956, which removed the restriction for granting temporary permission to foreign doctors only for the purpose of teaching, research and charitable work, 850 foreign doctors were granted temporary permission this year to practice in the country.

Foreign doctors are granted temporary permission by the Medical Council of India (MCI) on the basis of their applications received through the inviting institutions.

Union Health Minister Ghulam Nabi Azad informed the Lok Sabha on December 13 that 1289 foreign doctors sought permission between January 1 and December 10 this year, out of which 850 have been granted permission.

Maximum number of temporary permission was granted to foreign doctors to practice in Maharashtra (172) and Delhi (125). Tamil Nadu, an emerging medical hub, also received a huge number of permissions with approval to 114 foreign doctors.

The provisions of the Indian Medical Council Act 1956 allow temporary permission to foreign doctors for the purpose of teaching, research or charitable work for a specified period limited to the institution to which they are attached. Recently, the government, through the Indian Medical Council (Amendment) Second Ordinance 2013, removed the restriction for granting temporary permission to foreign doctors only for the purpose of teaching, research and charitable work.

Source: India Medical Times

High cost of medical education fuelling refer-and-earn system

As is commonly known, the Hippocratic Oath (horkos) is one of the most widely known of Greek medical texts. It requires a new physician to swear upon a number of healing gods that he will uphold a number of professional ethical standards.

The most important ethical standard to uphold for all doctors, is our duty to treat and cure. This is why we have the faith, to invoke the healing gods in the first place!

Hence, when a patient comes to us with a medical problem, it is our duty to guide the patient to the doctor best positioned to cure or treat the patient. While we make this reference, there is no question of commercial gain.

In fact, it is extremely clear, that a doctor, who is ready to give you a commercial consideration to refer a patient to him, is quite certain that patients and doctors will not choose him of their own free will; he is not sure about his clinical superiority and professional competence.

A recent article in the Lancet, further to Dr H S Bawaskar’s admirable stance, clearly says, “The ‘cut’ practice works at various levels: A medical specialist gives a cut to a general practitioner (GP); a diagnostic laboratory offers it to medical consultants; and hospitals to GPs and consultants. In the past decade, corporatisation of healthcare has changed this practice a bit.

Hospitals and diagnostic chains offer cuts as cheque payment under the title of “professional fees”.”

I, and many of my senior colleagues, had never heard of cuts till the last 15 years or so. This is a criminalisation of medical practice. And it has gained such momentum, and become so rampant that the doctors and hospitals who do not offer ‘cuts’ are alienated and laughed at – it’s a reverse moral ostracization!

As I write this column, the Supreme Court has agreed to reconsider the scrapping of NEET, the common medical entrance exam.

The concern raised by the petitioners was that giving out the responsibility of the entrance exam to private medical colleges would promote the corrupt practice, which enabled undeserving students to get admissions by paying huge capitation fees or donations. This could be a valid concern – I am also worried that children will have to run from city to city taking multiple entrance exams conducted by private medical colleges…in the absence of one common exam.

Whatever the process, the best students will get into good medical colleges, pay reasonable fees, work hard to become good doctors and do not have any debt burden on their shoulders.

What happens when your marks are poor? The families that insist on making their children doctors by paying huge capitation fee will be unknowingly responsible for the future moral debacle of their wards. They mortgage or sell a lifetime’s hard-gained assets to make their children a doctor. Today, the cost of one PG seat goes up to Rs3-5 crore, I’m told, depending on the specialisation.

After 10-15 years of study and work, most doctors are well into their 30’s before they begin to earn.

They start with 3-5 crore capitation fee debt on their balance sheet, at 32. Add to this, the cost of a house, which could range upwards of 1 crore. Their peers in other professions, have started earning a full decade earlier! Cuts, therefore seem essential to build a quick profitable practice.

India has just one doctor per 2,000 people, according to the ministry of health and family welfare estimates.

By severely restricting the number of post graduate seats; when there’s a huge demand for doctors, we have created an artificial demand supply imbalance.

The most important step to reduce this nuisance of cut practice, is that medical education MUST be made less expensive. Public investment in new medical colleges and liberalising infrastructure norms for setting new medical colleges will help. A better pay package for teachers will enhance the quality of faculty, thereby incentivising them and ensuring limited private practice for teachers.

Second, post graduate medical education needs to be liberalised and the number of seats increased by allowing larger public and private hospitals to impart post graduate education. This will help decrease the frightful cost to the family to educate a doctor. We need to remove black money from the PG seat in the system at the point of imparting education.

This is critical. The foundation has to be solid for the tree to grow. Other aspects such as monitoring of advertising expenses, audit control etc are possible- but self-monitoring is the only sure solution to this. The easiest thing is to blame doctors. The way I see it, doctors are as much a victim as the rest of society.

All doctors would like to support Dr Bawaskar and his rightful enthusiasm, when he says, “I am going to fight corruption in medicine till the last rupee from my savings is exhausted.” But let’s also clean the education system so that our support makes a difference to society.

Source: DNA India

Pre-Natal Care Goes Mobile in Uganda

Kampala — In Uganda, three students have invented a smartphone application that can measure the heartbeat of a fetus. The device could improve prenatal care in rural clinics, and may even help prevent deaths during childbirth.

Joshua Okello’s first love was medicine. He studied to be a doctor before quitting to pursue his second love: technology. However, his interest in medicine never left him. Last year, Okello and two other students at Kampala’s Makerere University invented a smartphone application that they think could change the face of maternal health care in Africa.

The app is called a WinSenga – “senga” is the local term for an aunt who helps out during pregnancy. It consists of a tiny microphone in a plastic horn, based on the Pinard horn used by midwives for centuries.

“It’s a long cone-shaped device with a hole through it and a flat top. The midwife places it on the belly and listens in. Every midwife in this country has seen it, and that is what they are trained with,” said Okello.

The sound the horn picks up is fed into a smartphone that records and analyzes the fetal heartbeat. From there, said Okello, the WinSenga suggests different courses of action.

“Say you have a baby and we detect that the heartbeat is less than 120 beats per minute. That is a problem. So immediately, we pop up something that says ‘Please, we suggest that you could do A, B, C, D,'” explained Okello.

The device is not yet fully functional, but last year Okello and his partners won a $50,000 grant from Microsoft – the “Win” in WinSenga is short for Windows. They are now developing their app from a Microsoft-funded technology incubator at the university, set up to encourage Uganda’s nascent tech sector.

Having a mobile device could make it easier for health care workers to reach women in remote villages, said Okello. The final result should also be cheaper than the machines currently in use.

“We are getting a solution that’s cheaper, which means that more clinics are going to get it. If we could get Huawei or I don’t know who to give us phones for free, we are looking at a solution that’s less than $100,” said Okello.

Juliet Birungi, an obstetrician who has tried the WinSenga, says she sees another use for it. In understaffed hospitals like the one she works in, she says, the WinSenga could be even more helpful if it is attached to a mother’s belly during labor and delivery, monitoring the state of the baby.

“You have so many mothers in labor, and we do not have enough staff. You find that while the mother is laboring here, the other one is delivering, the other one is bleeding. So when you come, you are able to look at the recording,” said Birungi.

An abnormal fetal heart rate can be a warning sign of labor complications, and could mean the difference between life and death, says Birungi. Uganda’s maternal mortality rate is so high, she adds, that a machine can only do so much.

“Just like all devices, they do not replace the need for a human being who is skilled. The need is still there, and it’s real and it has to be worked upon. But this device would make their work easier, and the outcome would be much better,” said Birungi.

The app could easily be adapted to other developing countries with similar problems, thinks Okello. With a little tweaking, he adds, it could even be used at home by pregnant women in developed countries.

For the moment, however, he and his team are busy preparing for a clinical trial in January, when WinSenga will finally be put to the test.

Source: All africa

1500 medical tourists seek treatment in Dubai every day

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Emirates Airlines is said to fly in 1,500 medical tourists daily to Dubai airport before they take onward flights to destinations such as India, Thailand, Malaysia or Singapore. If Dubai can tap a share of such travellers, it has scope to be a destination for medical tourism, for which strategic initiatives have already been launched.

Emirates is easily the most impressive success story about Dubai; if there is anything more successful, it is perhaps Dubai itself. Or the equation could be one of symbiosis, where one contributes or even leads to the betterment of the other in a continuous process.

So, the role played by Emirates in making Dubai what it is today needs no further explanation. But an interesting part is that the airline has acted as a change agent in innumerable other ways and in other parts of the world. It has helped the world discover hitherto unknown destinations and also connect travellers from around the world to Dubai, either through direct connections or by virtue of the emirate’s hub status.

In its inevitable march towards becoming the world’s biggest airline by 2020, a landmark in the evolution of Dubai on account of the Expo, Emirates has most effectively utilised the emirate’s geographical advantage, which brings over a third of the world’s population within four hours’ flight and two-thirds within an eight-hour flight.

Emirates already operates over 3,200 flights per week to over 135 destinations in more than 75 countries and hopes to fly 70 million passengers in the year of the Expo, pressing into service more than 250 wide-body aircraft.

Emirates is already a major catalyst of globalisation in many ways. A top Indian healthcare industry official pointed out the other day that Emirates’ flights alone bring 100 medical tourists daily to the group’s hospitals in four metropolises.

A major one was announced last year to unify all related procedures in Dubai in collaboration with Dubai Health Authority, Dubai Healthcare City, General Directorate for Residency and Foreigners Affairs (GDRFA) and Department of Tourism and Commercial Marketing (DTCM), among others. The Authority seeks to identify gaps in services, building capacity and raise the level of investments in the sector, including participation by the private sector.

The introduction of a three-month medical tourist visa was another important step. The visa, extendable twice, up to nine consecutive months, could be a major incentive for foreign patients to seek treatment in Dubai and other emirates. Similarly, the introduction of short-stay visas for specialist doctors for even a day has made it easier for hospitals to bring experts for consultations and special procedures.

The Dubai Health Strategy 2013-25 incorporates a masterplan aligned with the Dubai Strategic Plan 2015 to provide residents as well as visitors access to internationally recognised levels of healthcare and transform the emirate into a medical tourism hub

The head of Dubai Health Authority (DHA) believes that by the end of the decade the number of medical tourists receiving treatment here will be in the millions annually. It estimates that their numbers to increase 10-15 per cent each year. About 15 per cent of patients in Dubai Healthcare City are already medical tourists. The City is planning to create new specialist centres to enhance the city’s appeal, while DHA has announced plans to build additional hospitals and clinics to strengthen healthcare delivery.

Dubai’s medical tourism plans are now expected to be calibrated with the Dubai Expo 2020 infrastructure development, which will further help position it as a medical tourism destination of some standing.

Source: global travel industry news