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Category : General Medicine
Medical Articles
Aug11
E - Learning in Medical Education
Posted by Dr. Gourishankar Patnaik on Thursday, 11th August 2011
There is a growing debate in this knowledge hungry society that doctors have not updated themselves with recent trends and newer developments in medicine. There is some truth in their concern. The growing number of medical schools and the equally large number of quacks have not helped in improving the health care in our country. The goal of this article is to introduce many of the aspects of e-Learning as it pertains to medical education.
Traditionally, medical education had as its foundation a combination of didactic instruction in the classroom and integrated, hands-on "Socratic Method" learning in the clinical setting. Of late, there has been an increase in the use of problem-based learning discussions (PBLD's) in an effort to integrate basic science knowledge and clinical decision making with a goal of teaching critical decision making skills to upcoming physicians and other health care providers. Most Medical schools these days are realizing the importance of incorporating newer modalities of teaching. In countries where the patient outflow is poor for students learning simulation techniques are of increasing usage.
Medical education, especially in the advances stages of training, has many unique problems such as the temporal and geographic distribution of students, residents, and the physician instructors. Further complications result from unpredictable schedules that are present in most areas of medicine leading to poorly attended or cancelled lectures. Learning is the sharing or transfer of information between two parties. It is the phasing dispensation of knowledge from people of integrity and higher learning with zeal of transforming their realized knowledge to deserving souls who have similar intentions of propagating the sacred knowledge. Of course the definition of knowledge changes with increasing tends of materialism as seen by mushrooming of various so called temples of learning .Over the course of time, many modalities and theories about learning have been elucidated with varying degrees of effectiveness. With an increasing prevalence of computers in and out of the classroom and the development of more sophisticated web-based tools, knowledge transfer is increasing going high-tech. Similar to prior methods of teaching and learning, computer-based, e-Learning, has its own set of problems and potential. Medical education, especially in the advances stages of training, has many unique problems such as the temporal and geographic distribution of students, residents, and the physician instructors. Further complications result from unpredictable schedules that are present in most areas of medicine leading to poorly attended or cancelled lectures. E-learning adds many dimensions to the educational process and if utilized well, has the potential to enhance both the students and instructors educational experience. One of the problems with traditional didactic lectures is that they often present information that targets one of the many learning style of the students involved. In addition, the time and resources required to deliver the material is high and often does not completely meet the needs of those who are participating. One benefit of e-learning allows students to access the lectures and other material when they are most attentive. In addition, students have the ability to review the material to the degree they feel necessary. It is my hope this article touches the surface of some of the current web tools available for use in the area of education. Many of these tools are nonspecific and can be integrated well into medical education. Blogs, short for web logs, are also easy to update and maintain web pages with a layout that resembles a journal. Students and instructors can utilize these web resources to discuss topics and concepts. In addition to journaling, others can interact with the material and leave comments. For those that are interested, many sites have been set up to host these web resources and are very easy to manage, even for those who have relatively minimal computer sophistication.
Today, Continuous Medical Education (CME) becomes a crucial factor, because the life of knowledge and human skills in the field of medicine is shorter than ever. That causes the increasing pressure to remain at the forefront of medical education throughout doctors’ career. E-learning comes with solutions and methods, which can be very helpful in supporting doctors with access to the up-to-date medical knowledge and achievements. It allows creation of interactive model of learning, which stimulates knowledge acquisition. Another advantage is that e-learning provides flexibility in both time and location, while accessing medical curriculum presented online. There is a possibility of collaboration between teachers and students from different universities, which allows exchange of knowledge and experiences.
Implementation of e-learning methods in medical education is needed to provide students with new ways of gaining knowledge. However certain steps must be taken to choose the solution, which is the best for the given learning area. To keep up to date with the latest scientific breakthroughs, current medical debates and state-of-the-art medical technology you don’t need to go on expensive further training seminars far away from your workplace. The only thing you need is a computer with online access – and the right links to e-learning (electronic learning) websites. These online resources offer a vast amount of possibilities in different medical fields tailor-made for a variety of users: Students can use it as well as trained physicians, employee workers or managers. Across the world many companies, universities and institutions maintain Virtual Academies. The providers strive for certification and international acknowledgment of this type of education.
We are just beginning to harness the power of the internet for the delivery and management of medical education. Even without a clear demonstration that e-learning is superior to traditional lectures; the use of online learning provides solutions that can overcome some problems with traditional education, especially in the area of medicine. With increasing constraints being placed on medical educators, one needs to explore other avenues for effective knowledge transfer to trainees in health care. The harnessing of computer technology, more specifically web-based tools open the door for collaboration amongst both students and teachers. One platform that harnesses the ability to deliver knowledge to students as well as collect information about the helpfulness of this information is the web-based Moodle e-learning platform.

Prof G S Patnaik is a consultant orthopedic and Trauma surgeon based in Bhubaneshwar.


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Aug04
Arnica Montana- Lot More than Mere an Injury Medicine!
Posted by Dr. Shreya Deshpande on Thursday, 4th August 2011
The credit of most widely used drug by lay people and non-homeopaths should go to Arnica Montana! I have seen innumerable orthopedic surgeons, physiotherapists, and general physicians prescribing Arnica in 200 or higher potencies for different types of bruised and contused wounds. Yes! This is what Arnica is famous for. Only the person who has experienced the magic of this wondrous drug can understand its therapeutic efficacy.

Just recently I had a skeptic comment to one of the articles in which use of Arnica was stressed. The commentator had ridiculed its use and said it is nothing more than a placebo in keeping the patient’s hope high after its intake. Well, as usual I had ignored it! The point of telling this here is the fact that the same skeptic after a few days wrote to me, (This is what he says exactly; have taken his permission to put this in his own words), “My son aged 6 years had a contused wound made by the hit of a stone to his right index finger 3 days back. I had given him the best of analgesic but he was still wailing in despair. There was marked swelling and he couldn’t move his terminal phalanx. While wondering what to do, I remembered about the bottle of Arnica 200CH I had bought on one of the occasions on insistence of my wife (but didn’t find it useful at all in one of the instance, so had kept it aside). Gave my son 3 globules of Arnica and miracle happened. Within next 2 hours, his swelling substantially reduced and next day he was absolutely free from pain. Perhaps, I had used it in wrong place earlier; so please excuse me for my earlier skeptic comment on it”. Certainly not too many skeptics have this big heart!

In short, Arnica Montana is a darling medicine for homeopaths and non-homeopaths alike, as it rarely refuses to act positively when homeopathically applied.

However, the purpose of this article is not to elaborate on the “INJURY” aspect of Arnica Montana but the other aspects of it other than injury! Yes, it is one of the very useful polychrest remedies in homeopathic material medica that needs to be studied in depth to utilize its finest of properties.

Let’s see—

• One of the most important symptoms of Arnica one should remember is- pain in the part that is used more. It is thus not only the contused wound pain but pain in any organ that is being used a lot. The fatigue from this over-use leads to sore pain. For example- if a person develops sore throat after talking incessantly for long hours, Arnica will help him get rid of this soreness almost immediately. If there is sudden rise of blood pressure in a person who has done loads of hard work, a dose of Arnica will help lower his blood pressure and no anti-hypertensive drugs will be necessary! This thus applies to any part or organ.

• Arnica is one of the important remedies also for depression! In many cases, the remedial diagnosis comes of Arnica when a homeopath might miss out on this wonderful drug to rouse the patient from his dreaded depressive spirits. The patient dreads to be talked to, hates any sort of conversation, imagines he is suffering from some heart problem and remains frightened; alternating with the state of fearlessness when he says there is nothing the matter with him! Lots of nightmares are usually present with fearful dreams. This usually happens is people who have gone through some sort of physical and/or mental shock. The depression is almost always associated with great soreness of body, because of which he dreads the thought of touching anyone. This painful uneasiness with restlessness permeates through all Arnica patients.

• Arnica is one of the good remedies for bleeding tendencies. Bluish red spots come suddenly on skin or on mucus membranes or any inflamed part tends to bleed easily. The expectorant is dotted with tiny red blood clots at times. Urine even is bloody especially after an accident and there can be bleeding from various orifices of the body. Arnica is the remedy that helps in early clotting of blood when given at right time.

• One of the great remedies for rheumatic diathesis. Bruised lame feeling in joints is the marked feature. Usually associated with mental despair and agony. History of joint injury can be traced back as early as in childhood. Sudden turning of joints with blue-black appearance is also one of the hallmarks of Arnica.

• Also the old cases of gout with extreme soreness and enhanced sensitivity respond very well to Arnica.

• Any inflammatory condition in the body pertaining to liver, kidneys, bladder or lungs (of course irrespective of the diagnosis) with sore bruised feeling all over the body responds well to very few doses of Arnica. Never doubt the use of Arnica in such cases (for example pneumonia), as the doubt might arise because possibly Arnica has very little sphere of action on lungs. That’s the beauty of holistic medicine like homeopathy that caters any and all symptoms effectively if the remedy selected is based on Law of Similars.

• Some gastric symptoms are very prominent in Arnica that one should never miss. There is marked aversion to meat, broth, and milk! Many inflammatory conditions in abdomen respond well to Arnica including appendicitis. Dr J T Kent says, “It is only deplorable ignorance that causes appendicitis to be surrendered to the knife. You need not run to a surgeon for every case of appendicitis if you know Bryonia, Rhus tox, Belladona, and Arnica!”

• Also, nightly diarrheas with very offensive smell respond well to Arnica with offensive eructation and flatus. Stools are usually mixed with blood with soreness of anus.

• During pregnancy, Arnica is one of the chief drugs to be thought of when the pregnant lady is overtly sensitive to carrying her fetus within her womb. Uterus, abdominal viscera and surrounding organs feel bruised and movements of the fetus worsen the soreness. After long labor, when the woman has dribbling urination, Arnica is one of the amazing drugs. Usually associated with coldness of the body with hot head.


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Jun26
REVIEW OF MY BOOK IN “ANNALS OF OTOLOGY, RHINOLOGY & LARYNGOLOGY”
Posted by Dr. Mubarak Khan on Sunday, 26th June 2011
REVIEW IN “ANNALS OF OTOLOGY, RHINOLOGY & LARYNGOLOGY”
http://www.annals.com/toc/auto_article_process.php?year=2011&page=422&id=15724&sn=0
Endoscopic Color Atlas of Ear Diseases is a first edition comprehensive review of common
ear diseases. The pictorial narrative of more than 250 photographs includes variations of
normal otoscopic anatomy. Khan and Parab use minimum prose and preface each section
with a brief overview of pathogenesis and tympanic membrane morphology accompanied by
references for the interested reader to pursue in other sources. It is clear that the atlas is
intended to supplement rather than replace more comprehensive otoscopic atlases.
This text is a valuable resource for residents seeking a basic tour of endoscopic pathology in
otologic disease processes. Deeper discussion of pathogenesis in select areas would have
bolstered the utility of this photo atlas. Sufficient explanation of pathology is provided in
each introductory section, and normal-anatomy section is equally important to orient the
reader.
David Conrad , MD
John Bent, MD
Bronx, New York


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Jun09
SUPER TOXIC BUG -NEW THREAT TO INDIA & WORLD
Posted by Dr. Dewat Ram Nakipuria on Thursday, 9th June 2011
Super Toxic Bug” of Escheritia Coli strain- H4 0104 is a new threat to India and whole world as it causes first a bloody diarrhoea due to infection of gut and platelets leading to loss of water and blood causing Anaemia and setting a kidney failure and later failure of Liver,Lung,Brain and Heart or Multi Systemic Organ Failure and Death. Its toxicity is more alarming as no good vaccine or medicine is available to check its infection as this BUG OR TOXIN is resistant to most widely used Antibiotics like NDM-1 BACTERIA.Name of toxin of this E.COLI STRAIN (STEC 0104:H4) IS SHIGA TOXIN.but nothing is of very serious concernas it affects mainly children in summer season and it is also very dangerous in few cases only and as mode of transmission is mainly contact contamination in form of water or polluted food so a hygenic check up at personal or comunity level will control it completely but in country like us once infected will have to suffer a lot due to our style of living and hugh population and will cost us very high due to unavailability of any medicine or vaccine resulting our dependance only merely supportive treatment.
India,A FASTLY GROWING ECONOMY LIKE WHOLE WORLD is on high alert against the deadly strain of Shiga toxin-producing E coli (STEC 0104: H4) as this strain has infected over 1823 cases across 12 European nations (Austria, Czech Republic, Denmark, France, Netherlands, Norway, Spain, Sweden, Switzerland, Britain and the United States) including 520 cases of hemolytic uremic syndrome (HUS). Twelve HUS cases were fatal, and 6 deaths were reported among non-HUS cases. (17 deaths in Germany and 1 in Sweden).
The Food Safety and Standards Authority of India has informed its officials to watch out for all food items, especially fruits and vegetables, coming in from Europe.The FOOD source is organic Spanish cucumbers. Cucumbers, tomatoes, and lettuce are top suspects.E coli is a common bacteria in the GI tract and part of the normal bacterial flora. However, some E coli strains produce a toxin that could produce serious infection. The infection is acquired by consuming contaminated food or water.The incubation period is 3-4 days in conventional strain but in the STEC 0104: H4 strain it is 7-12 days. Most patients' symptoms resolve within 5 to 7 days. However, HUS STEC 0104: H4 can develop a week after diarrhea begins.
Symptoms range from mild to severe bloody diarrhea, mostly without fever. The strain STEC 0104: H4 is causing severe symptoms, including stomach cramps, bloody diarrhea, vomiting, and fever. However, fever is not usually high.
As per WHO, this STEC 0104:H4 strain of E coli "is a unique strain that has never been isolated from patients before" and there may be "various characteristics that make it more virulent and toxin-producing".The hemolytic-uremic syndrome (HUS) is characterized by the simultaneous occurrence of a triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal injury.Microangiopathic hemolytic anemia: Hemoglobin levels are usually less than 8 g/dL. The Coomb's test is negative and the peripheral blood smear is characterized by the large number of schistocytes and helmet cells. There is no correlation between the severity of the anemia and the severity of the renal disease.Thrombocytopenia: Platelet counts are generally around 40,000/mm3. There is no correlation between the degree of thrombocytopenia and the severity of the renal disease.Acute renal injury: The severity of renal involvement ranges from hematuria and proteinuria to severe renal failure and oligoanuria, which occur in one-half of cases. Hypertension is also frequently observed. Although as many as 50 percent of those with HUS require dialysis during the acute phase, the prognosis for recovery of renal function is generally favorable.Up to 10% of patients with this latest infection with STEC 0104: H4 strain may develop HUS, with a case-fatality rate ranging from 3% to 5%.
Normally HUS is the most common cause of acute renal failure in young children but this strain (STEC 0104: H4) is affecting female adults above the age of 20.It can cause neurological complications like seizure, stroke and coma in 25% of HUS patients and chronic renal sequelae, usually mild, in around 50% of survivors.Usually HUS can be typical HUS or atypical HUS. Typical HUS is Shiga-like toxin (Stx)-associated HUS and atypical HUS is non-shiga toxin (NStx)-associated HUS.Typical Stx HUS occurs after a prodromal episode of bloody diarrhea. It normally affects children under the age of five years. On the other hand, atypical non-shiga toxin associated (NStx) HUS is a heterogeneous disorder distinguished clinically by the absence of diarrhea or Shiga toxin-producing E. coli infection, but with microangiopathic hemolytic anemia, thrombocytopenia, and acute renal injury.
Typical HUS primarily follows an infection with Shiga toxin producing strains of E coli. The most common serotype is O157:H7, which is found in 70 percent of cases. The annual incidence is 2 to 3 per 100,000 children less than five years of age. The current strain is different Shiga toxin–producing E coli O104:H4.This disorder is commonly observed during the summer.The differential diagnosis includes: Other enteric infections, Henoch-Schönlein purpura, systemic vasculitis, sepsis and disseminated intravascular coagulation.
There is no known effective therapy to prevent progression from the bloody diarrheal phase (acute infectious phase) to the post diarrheal phase of HUS.Therapy is supportive. One can give antibiotics but NOT anti-motility agents. Some research has shown that administering antibiotics may in fact increase their risk of developing HUS, but the CDC recommends that clinicians ultimately determine treatment according to each individual patient. There may be indications for antibiotics in patients with severe intestinal inflammation if perforation is of concern. Of note, isolates of STEC O104:H4 from patients in Germany have demonstrated resistance to multiple antibiotics.Patients may require red blood cell transfusions when the hemoglobin is below 6 g/dL.
Platelets are transfused when there is active bleeding or prior to a required invasive procedure in patients with platelet counts less than 30,000/mm3.Dehydration is corrected as per requirement.Dialysis is done as per standard indications.
Hypertension is managed by fluid restriction, antihypertensive agents, and dialysis if needed. Nifedipine is the drug of choice in initial phase to be substituted with ACE inhibitors later.
Parenteral diazepam, phenytoin, and fosphenytoin are used for seizures.One can try plasma exchange in cases with significant neurological symptoms.Do not use anti-thrombotic agents or oral Shiga toxin-binding agent.
In general, prognosis is excellent with mortality rates below 5%. Around 5% of patients will have significant long-term sequelae of either stroke or end-stage renal failure. In patients who require renal transplantation, recurrence of HUS is rare.
All stools submitted for testing from patients with acute community-acquired diarrhea should be cultured for STEC O157:H7. These stools should be simultaneously assayed for non-O157 STEC with a test that detects the Shiga toxins or the genes encoding these toxins.It is often difficult to isolate STEC in stool by the time a patient presents with HUS.
WHO does not recommend any trade restrictions related to this outbreak because it is not being spread as airborne infection as was SARS,SWINE FLU etc,so noquarantine checkup or isolation or any cholera type vaccination has been ordered but an immense research is going on world wide to develop vaccine against this toxin as we have got for typhyoid or paratyphoid bacteria or food sensitive Antibiotic to nip in the bud this wildly growing killer bug as called 'SUPER KILLING BUG OF THIS YEAR.-BY DR.D.R.NAKIPURIA,09434143550


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Mar02
IMMUNISATION SCHEDULE FOR OUR CHILDREN
Posted by Dr. Saurabh Ranjan on Wednesday, 2nd March 2011
1. BCG @ BIRTH or @ 6 weeks age

2. OPV @ BIRTH AND
@ 6
@ 10
@ 14 WEEKS AGE

3. DPT @ 6
@ 10
@14 WEEKS AGE
4. DPT AND OPV BOOSTER DOSE @ 24 MONTHS AGE

5. HEPATITIS B @ 6,10 AND 14 Weeks age

6.MEASLES @ 9 Months

7.Vitamin A @ 9 months and
@ 16, 24, 30, 36 th month age

8.DT Booster @ 5 years age

9.TT Booster @ 10 yr and 16 yrs age.

NOTE-PREGNANT MOTHERS SHOULD IMMUNISE THEMSELVES WITH TT @4TH AND 6TH MONTH OF PREGNANCY.


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Mar02
DIAGNOSING MEASLES AT HOME FOR URGENT INITIATION OF CARE
Posted by Dr. Saurabh Ranjan on Wednesday, 2nd March 2011
MEASLES.
I wish to enlighten n empower masses on basic medical illnesses so that common ppl can ensure minimal loss of work days ,arising out of those illnesses.U must be aware of symptoms so tat u can detect measles at an early stage,initiate immediate care n meet ur Doc @ the earliest.LOOK FOR

1.A fever for 2-3days (within a week of contact wid a known measles case in ur locality)
2.Weakness,Bodyache,Headache
3.Coughing,sneezing,running nose,watering of eyes
4.Redness of whitish portion of eyeballs.TOXIC LOOK ON FACE.
5.AND after 3days of fever,Multiple small red coloured,elevated rashes,in clusters, begin TYPICALLY from behind ur ears n forehead....,n THEN.... spreads 2 face..,chest n limbs...in that order.
6.Itching+/-
7.U also may,i said YOU MAY..(not definite).. experience loss of desire to eat anything at all,and u may have nauseating tendency too.This is where we ask u to maintain adequate fluid intake bcoz dehydration is a hallmark of viral fevers n needs care and attention.
YOU R DONE.
Take an initial PARACETAMOL Tablet twice a day course,since,if started early, its very handy in plugging viral illness right in its nascency.Take optimum fluids.Maintain hygiene clean.Keep patients belongings n washables separate as this is a highly contagious illness.Maintain separation until the crust falls n fever drops.This way,u can unburden our health care service delivery network in an efficient way so tat they can focus on bigger health concerns of our beloved people..

& MEET UR DOC so tat he investigates further for dreaded complications of measles like pneumonia,etc in children.
Immunise ur loved ones as per schedule.
Remember,-most viral illnesses need ur love care n compassion more than any treatment.Spread health awareness amongst ur loved ones so tat INDIA is a better place to live in.

LIVE HEALTHY. LIVE GOOD.
SAURABH RANJAN.


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Feb21
Gerson Therapy for Cancer
Posted by Dr. Vaman J N on Monday, 21st February 2011
Throughout our lives our bodies are being filled with a variety of disease and cancer causing pollutants. These toxins reach us through the air we breathe, the food we eat, the medicines we take and the water we drink. As more of these poisons are used every day and cancer rates continue to climb, being able to turn to a proven, natural, detoxifying treatment like the Gerson Therapy is not only reassuring, but necessary.

The Gerson Therapy is a powerful, natural treatment that boosts your body's own immune system to heal cancer, arthritis, heart disease, allergies, and many other degenerative diseases. One aspect of the Gerson Therapy that sets it apart from most other treatment methods is its all-encompassing nature. An abundance of nutrients from thirteen fresh, organic juices are consumed every day, providing your body with a superdose of enzymes, minerals and nutrients. These substances then break down diseased tissue in the body, while enemas aid in eliminating the lifelong buildup of toxins from the liver.

With its whole-body approach to healing, the Gerson Therapy naturally reactivates your body's magnificent ability to heal itself - with no damaging side-effects. Over 200 articles in respected medical literature, and thousands of people cured of their "incurable" diseases document the Gerson Therapy's effectiveness. The Gerson Therapy is one of the few treatments to have a 60 year history of success.

Although its philosophy of cleansing and reactivating the body is simple, the Gerson Therapy is a complex method of treatment requiring significant attention to detail. While many patients have made full recoveries practicing the Gerson Therapy on their own, for best results we encourage starting treatment at a Gerson Institute licensed treatment center.

The Gerson therapy has been developed by the German Physician Dr. Max Gerson to treat cancer and other diseases. It is based on the role of minerals, enzymes, and other dietary factors. There are 3 key parts to the therapy:

Diet: Organic fruits, vegetables, and whole grains to give the body plenty of vitamins, minerals, enzymes, and other nutrients. The fruits and vegetables are low in sodium (salt) and high in potassium.
Supplementation: The addition of certain substances to the diet to help correct cell metabolism (the chemical changes that take place in a cell to make energy and basic materials needed for the body's life processes).
Detoxification: Treatments, including enemas, to remove toxic (harmful) substances from the body.

The Gerson therapy is based on the idea that cancer develops when there are changes in cell metabolism because of the buildup of toxic substances in the body. Dr. Gerson said the disease process makes more toxins and the liver becomes overworked. According to Dr. Gerson, people with cancer also have too much sodium and too little potassium in the cells in their bodies, which causes tissue damage and weakened organs.

The goal of the Gerson therapy is to restore the body to health by repairing the liver and returning the metabolism to its normal state. According to Dr. Gerson, this can be done by removing toxins from the body and building up the immune system with diet and supplements. The enemas are said to widen the bile ducts of the liver so toxins can be released. According to Dr. Gerson, the liver is further overworked as the treatment regimen breaks down cancer cells and rids the body of toxins. Pancreatic enzymes are given to decrease the demands on the weakened liver and pancreas to make enzymes for digestion. An organic diet and nutritional supplements are used to boost the immune system and support the body as the regimen cleans the body of toxins. Foods low in sodium and high in potassium are said to help correct the tissue damage caused by having too much sodium in the cells.

How is the Gerson therapy administered?

The Gerson therapy requires that the many details of its treatment plan be followed exactly. Some key parts of the regimen include the following:

Drinking 13 glasses of juice a day. The juice must be freshly made from organic fruits and vegetables and be taken once every hour.
Eating vegetarian meals of organically grown fruits, vegetables, and whole grains.
Taking a number of supplements, including:
Potassium.
Lugol's Solution (potassium iodide, iodine, and water).
Coenzyme Q10 injected with vitamin B12. (The original regimen used crude liver extract instead of coenzyme Q10.)
Vitamins A, C, and B3 (niacin).
Flaxseed oil.
Pancreatic enzymes.
Pepsin (a stomach enzyme).
Taking coffee or chamomile enemas regularly to remove toxins from the body.
Preparing food without salt, spices, or oils, and without using aluminum cookware or utensils.

The following studies of the Gerson therapy were published:

In 1983-1984, a retrospective study of 38 patients treated with the Gerson therapy was done. Medical records were not available to the authors of the study; information came from patient interviews. These case reviews did not provide information that supports the usefulness of the Gerson therapy for treating cancer.
In 1990, a study of a diet regimen similar to the Gerson therapy was done in Austria. The patients received standard treatment along with the special diet. The authors of the study reported that the diet appeared to help patients live longer than usual and have fewer side effects. The authors said it needed further study.
In 1995, the Gerson Research Organization did a retrospective study of their melanoma patients who were treated with the Gerson therapy. The study reported that patients who had stage III or stage IV melanoma lived longer than usual for patients with these stages of melanoma. There have been no clinical trials that support the findings of this retrospective study.
A case review of 6 patients with metastatic cancer who used the Gerson therapy reported that the regimen helped patients in some ways, both physically and psychologically. Based on these results, the reviewers recommended that clinical trials of the Gerson therapy be conducted.

Dr. Vaman
www.medaku.com


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Jan01
Book : Endoscopic Color Atlas of Ear Diseases
Posted by Dr. Mubarak Khan on Saturday, 1st January 2011
BOOK DETAILS

Endoscopic Color Atlas of Ear Diseases
by: Khan
Printable Version

Buy Now Contents
ISBN: 978-93-5025-166-9
PRICE: Rs. 1495/-
EDITION: 1/e / 2011
PAGES: 190
SIZE: 8.5"×11"
ILLUSTRATIONS:
COVERTYPE: Hard Back
Publisher : Jaypee Brothers Medical Publishers (P) Ltd.
10% Shipping Charges Extra.

Contents
1. Normal Tympanic Membrane ...........................................................................................................................1
2. External Auditory Canal ..................................................................................................................................7
Wax .................................................................................................................................................................. 7
Otitis Externa ................................................................................................................................................... 9
Allergic otitis externa ................................................................................................................................ 9
Fungal otitis externa/otomycosis .............................................................................................................. 10
Furuncle/localized otitis externa .............................................................................................................. 13
Herpes zoster oticus ................................................................................................................................ 13
Malignant otitis externa with acute otitis media ...................................................................................... 16
Diffuse otitis externa with adhesive otitis media ...................................................................................... 17
Otitis externa with perforation ................................................................................................................. 17
Otitis externa with stenosis ...................................................................................................................... 18
Foreign Bodies ............................................................................................................................................... 19
Eardrop cap ............................................................................................................................................. 19
Pea-nut – before and after removal .......................................................................................................... 20
Live insect ............................................................................................................................................... 21
Metallic foreign body ............................................................................................................................... 22
Organic foreign body............................................................................................................................... 23
Perforation with sand particle .................................................................................................................. 24
Plastic tube – before and after removal .................................................................................................... 25
Pencil eraser ............................................................................................................................................ 26
Tobacco ................................................................................................................................................... 26
Miscellaneous foreign bodies ................................................................................................................... 27
External Auditory Canal Polyp ........................................................................................................................ 33
Keratosis Obturans ......................................................................................................................................... 34
External Auditory Canal after Keratosis Removal ............................................................................................ 35
3. Acute Otitis Media .........................................................................................................................................37
Stage of congestion ................................................................................................................................. 37
Stage of pre suppuration .......................................................................................................................... 39
Stage of perforation ................................................................................................................................. 40
Stage of resolution................................................................................................................................... 43
Acute Otitis Media with Otitis Externa ............................................................................................................ 44
Acute Otitis Media Post Tympanoplasty .......................................................................................................... 46
4. Safe Chronic Suppurative Otitis Media ..........................................................................................................48
Chronic Suppurative Otitis Media-active ......................................................................................................... 48
Chronic Suppurative Otitis Media - Inactive ................................................................................................... 52
Chronic Suppurative Otitis Media - Post Treatment ........................................................................................ 54
Endoscopic Color Atlas of Ear Diseases
xviii
5. Perforations ....................................................................................................................................................56
Anteroinferior Perforation ............................................................................................................................... 56
Anterosuperior Perforation .............................................................................................................................. 57
Posteroinferior Perforation .............................................................................................................................. 58
Posterosuperior Perforation ............................................................................................................................. 60
Medium Perforation........................................................................................................................................ 61
Large Central Perforation................................................................................................................................ 62
Subtotal Perforation ........................................................................................................................................ 64
Marginal Perforation ....................................................................................................................................... 68
Total Perforation ............................................................................................................................................. 69
Multiple Perforation ....................................................................................................................................... 70
Central Perforation with Tympanosclerosis ..................................................................................................... 71
Central Perforation with Otitis Externa ........................................................................................................... 73
Perforation with Discharge .............................................................................................................................. 74
Pseudoperforation........................................................................................................................................... 75
6. Traumatic Perforations ..................................................................................................................................76
7. Tympanosclerosis ...........................................................................................................................................84
Tympanosclerosis ............................................................................................................................................ 84
Tympanoscleroris with Acute Otitis Media ...................................................................................................... 89
8. Unsafe Chronic Suppurative Otitis Media ......................................................................................................90
Anterior Cholesteatoma .................................................................................................................................. 90
Attic Cholesteatoma........................................................................................................................................ 91
Attic Polyp ...................................................................................................................................................... 93
Atticoantral Cholesteatoma ............................................................................................................................. 96
Cholesteatoma in Post Tympanoplasy .............................................................................................................. 99
Cholesteatoma with Polyp ............................................................................................................................. 100
Early Attic Retraction without Cholesteatoma ............................................................................................... 101
Masked Cholesteatoma with Mastoiditis ....................................................................................................... 102
Natural Modified Radical Mastoidectomy...................................................................................................... 103
Posterosuperior Cholesteatoma ..................................................................................................................... 104
Posterosuperior with Attic Cholesteatoma..................................................................................................... 107
Extensive Cholesteatoma ............................................................................................................................... 108
Safe Chronic Suppurative Otitis Media Turning Unsafe ................................................................................. 110
Scutum Erosion ............................................................................................................................................ 111
External Auditory Canal Cholesteatoma........................................................................................................ 112
Congenital Cholesteatoma ............................................................................................................................. 114
9. Otitis Media with Effusion...........................................................................................................................115
10. Ventilation Tube (Grommet) .........................................................................................................................118
11. Granular Myringitis .....................................................................................................................................119
12. Hemotympanum...........................................................................................................................................120
Contents
xix
13. Pre and Post Operative Cases .......................................................................................................................122
Recurrent and Residual Perforations .............................................................................................................. 138
Postoperative Follow-up at 2 Years ................................................................................................................ 139
14. Tuberculous Otitis Media .............................................................................................................................143
15. Tympanic Membrane in Allergic Rhinitis .....................................................................................................145
16. Adhesive Otitis Media ..................................................................................................................................146
Grade 1 ......................................................................................................................................................... 146
Grade 2 ......................................................................................................................................................... 148
Grade 3 ......................................................................................................................................................... 150
Grade 4 ......................................................................................................................................................... 151
17. Barotraumatic Otitis Media ..........................................................................................................................152
18. Tumors .........................................................................................................................................................153
Hemangioma................................................................................................................................................. 153
External Auditory Canal Osteoma ................................................................................................................. 155
Papilloma...................................................................................................................................................... 157
Squamous Cell Carcinoma............................................................................................................................ 158
Glomus tumor .............................................................................................................................................. 159
19. Exploration of the Middle Ear ......................................................................................................................160
Bibliography ......................................................................................................................................................... 165
Index .................................................................................................................................................................... 167


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Dec15
My Book : endoscopic color atlas of ear diseases
Posted by Dr. Mubarak Khan on Wednesday, 15th December 2010
Dr. Mubarak Muhamed Khan and Dr. Sapna Ramkrishna Parab of Talegaon Dabhade- Pune, have authored a medical book entitled, “Endoscopic Color Atlas Of Ear Diseases”. The atlas was recently released by Jaypee Medical Publishers on 25th September 2010. This atlas consists of high quality color clinical 271 photographs obtained using exclusive endoscopic techniques. Dr. Khan is an Associate Professor and Dr. Parab is Assistant Professor in the Department of Ear, Nose and Throat of MIMER Medical College, Talegaon- D, Pune and take keen interest in teaching methodology.
This atlas, based on the clinical experience of the both the authors, gives a clear and lucid description of all the conditions of the ear represented in the photographs. By pictorial depiction of various ear conditions, the basic conceptual knowledge gets further augmented and supplemented. Appealing to the novice as well as the experienced professional, this atlas is a key resource to the undergraduate and the postgraduate students, the ENT fraternity, pediatricians and general practitioners. This atlas will definitely supplement the standard ENT textbooks for a further in depth pictorial depiction of the ear disorders and thus facilitate proper diagnosis for dispensing appropriate treatment for otological disorders. This atlas provides the sure foundation for the thorough and sound knowledge of ear disorders facilitating the proper diagnosis and thus correct treatment.
The atlas is foreworded by Prof. A.G. Pusalkar, an eminent and world renowned otologist; Dr. Suresh Ghaisas, Medical Director, MIMER Medical College; and Dr. Brig. GS Gopal, ex-Prof. and Head of ENT Department of MIMER Medical College.
This atlas is unique as it is the first of its kind in India. I would like to send this book for review.
Dr Mubarak khan

Mobile : +91 98226 462007
Information of the atlas is available online on the website:
http://www.jaypeebrothers.com/pgDetails.aspx?cat=s&book_id=978-93-5025-166-9


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Dec15
How to get rid of recurrent mouth ulcers? (Aphthous ulcers or stomatitis)
Posted by Dr. Shreya Deshpande on Wednesday, 15th December 2010
Painful eating is the presenting symptom usually when a person gets ulcers in the mouth. This apparently casual condition can be extremely troublesome and painful in some when occurs recurrently.

Causative factors-

(1) The major cause behind recurrent aphthous ulcers bad oral hygiene. The patient usually says that he has these types of ulcers since long, may be since childhood. Dental caries may accompany.
(2) Nutritional deficiency can also be a very important cause in patients from underdeveloped areas. Also bad eating habits and lack of vitamin rich food are the reasons. Especially in children, these types of ulcers are found frequently due to their eating fads.
(3) Gastric upset is also regarded as one of the causes for recurrent stomatitis. The bloating, belching, and constipation contribute to the trouble, though direct relation has not been verified.
(4) High doses of antibiotics are often associated with mouth ulcers, unless coupled with B-complex vitamin supplementation.
(5) Allergic reaction to certain toothpastes, mouth washes, dentures, etc are also blamed.
(6) Emotional stress is often found to exaggerate the symptoms of aphthous ulcers. (psychosomatic)
(7) Some women have been typically seen to have excessive ulcers prior to their menses, when it may be considered as the part of PMS.
(8) Some conditions like ulcerative colitis, celiac disease, Crohn’s disease are also associated with mouth ulcers.

Treating mouth ulcers with Homeopathic Medicines—

Here, the foremost thing one should understand is that unless the causative factor is dealt with, no treatment is going to be of help. Therefore, steer clear of bad oral hygiene, dental problems, nutritional deficiencies, etc. There are certain innate tendencies also those need to be addressed while treating anyone homeopathically for mouth ulcers. Even one may have tendency to have mouth ulcers in families.

The homeopathic medicines act in 3 steps to cure the problem of recurrent mouth ulcers—

• Alleviate the pain and suffering
• Improve oral health
• Prevent recurrence in future

The major medicines useful for the problem of aphthous ulcers are Merc sol, Kali chlor, Belladona, Hepar sulph, Sulphur, Phos, Lachesis, Natrum mur, etc. Apart from these, any other medicine may be indicated depending upon the constitution of the patient and his totality of symptoms of aphthous ulcers. Especially for chronic cases, homeopathy renders amazing cures and the patient feels blessed to be free from this troubling problem!

Auxiliary Treatment—

This is of prime importance in any such case and the homeopathic physician must educate the patient about these points.

(1) Maintain good oral and dental hygiene.
(2) Do not neglect any eruptions in mouth and consult your physician immediately
(3) Have nutritious diet and include sprouts, legumes, green vegetables in the diet so that one gets natural supplement of all vitamins and minerals.
(4) Drink adequate quantity of water. (at least 10 glasses per day)
(5) Take care of your gastric health and steer clear of hyperacidity, flatulence, constipation by seeking apt expertise.
(6) Do not consume high doses of medicines haphazardly without doctor’s advice.
(7) Have positive mindset and exercise regularly!


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