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Jun26
Diabetes and Cholesterol Connection
Triglycerides.These are fats from the food you eat that circulate in your body, which can be stored in fat cells. Triglycerides aren’t actually a type of cholesterol, but their levels are measured along with HDL and LDL to see if you are at risk for, or have, atherosclerosis. (That's when fatty deposits build up in your artery walls, restricting blood flow and leading to a variety of issues like aneurysms and heart attacks.)

The main risk from high cholesterol is coronary heart disease, which can lead to death from a heart attack. If your cholesterol level is too high, cholesterol can build up in the walls of your arteries.

If you have diabetes, that can upset the balance between levels of HDL, or “good” cholesterol, and LDL or “bad” cholesterol.

Take Care of Your Heart
These lifestyle changes can help lower your risk for heart disease or keep it from getting worse, as well as help you manage diabetes:
Follow a healthy diet.
Aim for a healthy weight.
Get active.
Manage your ABCs:
A: Get a regular A1C test to measure your average blood sugar over 2 to 3 months; aim to stay in your target range as much as possible.
B: Try to keep your blood pressure below 140/90 mm Hg (or the target your doctor sets).
C: Manage your cholesterol levels.
s: Stop smoking or don’t start.

Manage stress. Stress can raise your blood pressure and can also lead to unhealthy behaviors, such as drinking too much alcohol or overeating. Instead, visit a mental health counselor, try meditation or deep breathing, get some physical activity, or get support from friends and family.


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Jun26
J Vettukattil
https://scholar.google.com/citations?user=-0zHpywAAAAJ&hl=en
https://www.researchgate.net/profile/Joseph-Vettukattil


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Feb24
Regulation of Blood Pressure? Dr. Shriniwas Kashalikar
Regulation of Blood Pressure? Dr. Shriniwas Kashalikar

We are taught that throughout undergraduate and postgraduate medical career, that heart rate and blood pressure are regulated.

But is this true? and if this is true, on what basis a set point for these is decided?

The answer to these questions is:

What is regulated is the oxygen supply to the tissues on moment to moment basis according to their changing needs.. This decides the need of blood supply to different tissues and this decides the heart rate, stroke output, peripheral resistance and cardiac output. In turn, this decides the blood pressure.

In short, heart rate and blood pressure are not primarily regulated but get "regulated" as a byproduct of the regulation of oxygen supply to tissues, with priority to the oxygen needs of the vital organs.

It appears therefore, that use of terms such as "regulation of heart rate" and "regulation of blood pressure" would be eventually discarded and replaced by "Regulation of cardiovascular function to serve the oxygen needs of tissues".


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Apr03
Leaches in IHD & TVD
Jalaukaas in coronary block (Bypass to Bypass Surgery)

- Prof. Dr. Muralidhar P. Prabhudesai
M.F.A.M., A.V.P.
Ex- In-charge, Panchakarma Dept.,
Bhaisaheb Sawant Ayurvedic Medical College,
Sawantwadi, Dist. - Sindhudurga, Pin - 416510.

Case report of a pt. with IHD with TVD

Date - 9 March 1995
Name of the pt. xyz
Age 65yrs.
Sex M
Chief Complaints Dyspnoea on exertion (on walking a few steps, even after talking few words)
- Constipation, passes hard stools after 5-6 days interval
- Poor appetite
- Weakness
- Chest-pain
- Oedema over feet
- Hypertension
- Tingling in Lt. palm
- He used to get up in midnight due to chocking sensation in chest
- Feeling of some swelling (heaviness) in Lt. side of chest
- Consumes lots of Angised / Sorbitrate tabs. per day while walking or talking (20-22 tabs. in a day)
O/E B. P. 220/110, Pulse 102/min., Wt.- 59.5 Kgs., Jeevhaa Saam, Koshtha- Krur, Agni- Manda, Nidra- Khandita, Bala- alpa, Ubhaya Paad-shotha- ++, Twak-sparsha - rookshata ++
Psychologically he was so depressed; he thought that he will never come out.
Past History This pt. was serving in State Transport (Maharashtra) as Stand in charge. Due to tight schedule of duties, he was not able to pass urine, whenever mootra-vega was there. As a result of which he developed urinary stones. He had heart-attack in 1980. His CST revealed ischemia. For investigation, he had undergone angiography in Feb. 1982, in Bombay Hospital & he was found to have 12 coronary artery-blocks (five in Rt. Coronary & seven in Lt. Coronary). Due to so many blocks, he was not allowed to undergo bypass-surgery. He was kept on conservative treatment (11 types of tabs. per day) and was admitted in the hospital for 4 mths. & was advised Tab. Angised and/or Tab. Sorbitrate SOS. He resumed his duties as he got little relief.
Due to chronic constipation he used to take Tab. Dulcolax 4 + Patankar Kadha (Laxative) a cup + Kayam Churna (laxative) 1 tsf, very often. Even then he was not satisfied with his bowels (He got relieved temporarily).
After retirement (during 1992 - 1995) again the symptoms got aggravated for which he consulted many physicians but every time there was addition of medicines, without much relief.
He also was detected to have Diabetes mellitus.
Samprapti Sedentary work (no shareerayas) malavarodh & waramwar mootravarodh apaan vaigunya pratilom gatitah samaan vikruti aama nirmiti due to constant mental strain Kha-vaigunya" in heart (which is moolasthana of Rasavaha & Manovaha srotas) sthaan-sanshray of aama there resulting in blocks again malavarodh due to the medicines given for the ailment & the vicious circle went on. At the same time, Vyana Vayu-dushti (vyano hrudi sthitah) & Udan-dushti (urah sthanam udanasya) - resulting in bal-hani - shram-shwas & vikruti in vak-pravrutti, prayatna, bal, warna and as mind was involved, due to various tensions (Hrudayam manasah sthanam), he lost his confidence & urja.
Diagnosis - He was diagnosed to have IHD with triple vessel disease + diabetes
With all the medications above, he was not satisfied with the treatment; as he had no much relief.
After retirement again the dose of Tab. Angised & Tab. Sorbitrate was increased since last four years.
After going through his huge file we thought to put him on Shaman (conservatory) treatment, along with the treatment he was advised, initially.
Initial treatment: Abhyantara Chikitsa-
1) Gandharva Haritaki 500 mg. twice a day before meals (apaane)
2) Arogyavardhini Vati 500 mg. twice a day after half of meal (samaan kale as Munchan karya of Samana vayu was affected) thinking that Kutaki in the formula will do Bhedan of the hard stool. This drug is also Deepak & Pachak, which was expected in this patient.
3) Arjun & Punarnava-mool Quath, 4 tsf after meals (Vyaanodaane) with madhu (which is yogavahi), as anupan. Arjuna is well known for its specific role in Hrudroga. Punarnava is Shothghni & is useful in Hrudroga also (- Dhanwantari Nighantu). Hruday is awasthit sthan of vyana-vayu & this vayu is responsible for Ras-Rakta Samvahan. Vak-pravrutti, bal, urja (which were affected in this pt.) are under control of Udana-vayu, which has its awasthit sthan in Uroguha. So this medicine was given in vyaanodan kale)
4) Shankh Vati SOS ( as the pt. had aadhmaan due to malavarodha)
5) Snehan As the Pt. was Vata-prakruti according to his age & he had Krura Koshtha & the rutu that time was with vat-prakop (kaalatah) -
1. Abhyantar Ghrut Sevan (As usual, I had to spend about 15 minutes to convince the pt. about this concept)
2. Bahya - Mahamaash Taila
6) Siddha Jalapaan - Vidang-jeerak-siddha agnisanskaarit Jala (Vidang is Krimighna, which is needed in our area, where people used to drink water from well or river & Jeerak is deepak Pachak & grahi, so dravashoshak, as the pt. had pedal oedema (udakavah srotovikruti)
7) 4 tsf of Castor Oil at every night, with lukewarm water.
8) Aashwasan Chikitsa - This is very important to support pt.'s positive attitude, especially when dealing with chronic pts. Vaidya should always create confidence in pt.'s mind that he will definitely come out. This helps to modify the state of mind from 'heen' to 'pravar' Satwa. (This is little easier for senior, bald headed Vaidyas).
He was advised to have light meals till his appetite was improved.
After a fortnight when he came for follow-up he was little happy to have bit easy evacuation of his bowels. His appetite was also improved a little more. He was able to reduce the no. of Angised & Sorbitrate by about 12-15 per day.
The same treatment was continued for another fortnight. His symptoms got aggravated in May 1995 after eating Jambu-fal (which is madhur-kashaya rasa pradhan & kashay-ras is known to cause dhamani-sankoch), so he had to increase the dose of Angised & Sorbitrate & as he had a little choking sensation due to Durdin in June 1995, (because of which he had to increase dose of Angised & Sorbitrate) he was advised to fumigate his bedroom with Vacha & Dhoop.
Then he was admitted in our hospital for Basti-treatment. He was given snehan, swedan & matra-basti of ground-nut oil 60 ml. (in those days Siddha tailas were not available in our area, as nobody was practicing Panchakarma, so we decided to use this oil, as it was freshly prepared in our farms), while going to bed every night for five consecutive nights. (This matra-basti yojana was advised to his on the basis of his 'vat-pradhan age' & malavarodhajanya (i. e. margavarodhajanya) samprapti.) Then after a gap of 2 days (to avoid sneh-saatmya) again matra-basti was repeated for another five nights. After these two courses of matra-basti there was remarkable improvement in his complaints & could get confidence that he will come out of it, soon. But till May 1995, he was not relieved of his chest-pain & he still had to wake up in midnight due to uneasiness in chest & tingling in Lt. palm.
By that time, one of my friend sent me an article from Readers Digest (Aug. 1995) titled Welcome back little blood-sucker by Alan Road. My friend knew that we were applying leeches for various ailments, in our practice. The article said that Even though, the leech will suck for only 20-30 minutes bleeding may continue for several hours or so; clearing the most challenging blockage on page no. 82. "Their saliva contains a powerful enzyme capable of rapidly dissolving blood-clots", - on page no. 83. After going through these lines we remembered that our texts, Ashtanga-Hrudaya & Sushrut-Samhita mention the same
1) Avagadhe Jalaukasaa. - A. H., Sutra. 26/54
2) Grathitam Jalajanmabhi: ..- A. H., Sutra. 26/53
3) Awagadhe Jalauka syaat - Sushrut., Shareer., 8/26
Meaning that, leeches are indicated in cases of blood-clots or thrombus.
And then an idea struck my mind to apply leeches directly over the chest. We discussed our idea with many, but nobody had tried this type of application.
On 07/09/1995 - Pt. told that he was satisfied with his bowel-motions, even after consuming four tsf of Castor Oil, on alternate days. His B. P. was 150/80 mm of Hg.(in spite of stopping all his anti-hypertensive drugs; as he showed signs of hypotension on continuation of the drugs. May be because main cause of hypertension, i. e. tension about his own health, was reduced to a marked extent), Pulse-rate - 78/min. Wt. - 57 Kgs. (as he had no pedal oedema, any more)
We shared the above idea with the patient & after his written consent we decided to implement this novel idea.
On 25/09/1995 - Pt. was admitted in evening. We gave matra-basti of 50 ml. of groundnut-oil, at bed-time.
Next day, on 26/09/1995 we applied five leeches. The leeches left him after about 6 hours. But to our astonishment he had sound & undisturbed sleep that night.
Having encouraged by this result we applied leeches repeatedly after a gap of about a week or two and sometimes after a month even, & day by day the patient showed marked improvement.
Jalauka-application was repeated in Jan. 1996, Feb. 1996 & in April 1996. During all this period he was very happy with Shankh Vati. (It is very easy to know the 'Karmukatwa' of this Vati, as it created 'Vatanuloman' in this pt. so he got relieved with it.) He used to call it - 'a magic pill'.
Again his symptoms were aggravated in June 1996, when he went to meet his only son in Mumbai, so again dose of Angised/Sorbitrate was increased a little. This might be due to the atmospherically polluted conditions in Mumbai. This time we advised him to do Asanas like Pavanamuktasana, Shawasan, & Pranayamas.
By September 1996, his confidence & especially stamina was regained. Tingling sensation in his Lt. palm was stopped, he was able to enjoy undisturbed sleep at night and he was able to walk 5 kms. non-stop & he was able to climb about five stair-cases, initially after resting a while & then many a times without Angised or Sorbitrate. The intake of Angised & Sorbitrate was reduced to maximum two tabs. daily.
Encouraged by the results we decided to investigate the patient by repeating his angiography. After trying a lot we found a source. Fortunately, the head of cardiology department of KEM hospital agreed to carry it out through the donations collected every day, as a special case of research.
After the due schedule of appointment etc. the angiography was carried out, in June 1997, but to our astonishment the reports mentioned that all the previous blocks were increased in size. And naturally the HOD of the department was very annoyed, even though the patient was feeling relieved a lot than before.
After thinking a lot over this case, we came to realize that the previous angiography was done about 13 yrs. ago, when the pt. came to us for the first time. By that time, during those 13 years., many changes must have taken place, which were not on record. This was the main reason why we were unable to present the case, in a conference before Modern Medical Experts, even though there was marked clinical improvement.
This improvement was realized by a Senior Cardiologist in our area, whose advice was sought by the pt. repeatedly, before coming to us. While consulting the case before him, the Cardiologist remarked - "if this is proved, we will have to change all our concepts regarding modern anatomy & physiology".
The pt., who was told that his life span is not more than 6 months, was awarded a bonus life of 7 more years, that too a pleasant life without any physical or mental stress & he was able to enjoy marriage ceremony of his only son. All this was possible for him because of the Ayurvedic way of thinking. He passed away in 2002, peacefully and without any physical or mental strain.
Many a times it so happens that after Ayurvedic treatment the lab. reports remain unchanged, but the pt. is relieved symptomatically. So, the new entrants in Ayurvedic Stream should take a note of this.
Our Observations in this case -
1) We applied jalaukas for about 12 times, after a gap of at least 8 days.
2) We avoid to take pricks with needle, to apply jalaukas, as we do not like to interfere with their inherited wisdom ( of course, allotted to them, by the God) to seek the site to prick & surprisingly, all the jalaukas applied, sought left lateral part of sternum to suck the blood. Not a single pricked over the central or right lateral part of sternum.
3) The jalaukas took too much time to leave pricked area; many of them took even 7-8 hours, initially. The admitted pt. could move here & there, with one hand over the moist gauze-piece, used to cover the applied jalaukas. (We do not force the jalaukas to leave the site, by applying Haridra or similar.)
4) Almost all the jalaukas applied initially, vomited dark, very thick, sticky, tantumay & shleshmala blood, while squeezing. It was very difficult to to squeeze them to drain the vitiated blood sucked by them, as a result of which many of the jalaukas, applied initially, were dead after the very first application.
5) The initially squeezed jalaukas got globular & multiple sacs like appearance, as those were not drained properly.
6) Though the pt. was known diabetic healing of the tiny prick wounds took the same time, as in a normal person. (During my professional experience, for last 41 years only, I have come to the conclusion that usually, diabetes cannot be in the list of contraindication for Jalaukawacharan, except in pts. with very high BSL level (above 500 mg/dl.)
7) Not a single Jalauka pricked the same site again for sucking blood.
While concluding -
Whatever relief we could give in this case, the credit goes to the
- Our Gurujan, who gave us inspiration & the 'vision' while thinking about a disease, through Ayurvedic way
- The Samhita-granthas, which guided us from time to time
- "Bhishak-vashyataa" of the pt. who obeyed honestly, each & everything we advised, ( like consuming Eranda-taila daily, preparing quath every day, taking medicines regularly, performing daily asanas and pranayamas, observing the pathya very strictly) and
- The well-wishers like you all.
Actually, we had taken lot of risk to admit the pt. in our clinic, where no major emergency measures were available, there was no 'official' Dr. available in the area of 10 kms. radius, except us two, primary health care center was about 16 Kms. away. So, any emergency situation could have created lot of problems for us. With the blessings of The God Dhanwantari we did not had to face any problem.
To be frank, 'the bye-pass surgery' is a bye-pass to treatment, as the surgeons don't treat the cause. They just give a way to the obstructed flow of blood. They never give guarantee that surgery will prevent further blocks. If this is so, then why not try some other ways like one described here? Perhaps, this, low cost effective remedy, may prove to be an alternative for bypass surgery.
This was possible to accept this kind of case, because the pt. showed full faith with us & he had no other alternative because of his poor financial status.
If this story inspires anybody to try such cases, we will definitely help him/her with our limited capacity. I wished to get attachment to some institute with a large no. of OPD pts., to show positive results in various cases, but I failed to do it. (Dant-Chanak Nyaya).
So friends, I conclude here & wish you all the best in your general practice with Ayurvedic vision.
|| Sarve atra sukhinah santu ||


Contact :
Prof. Vd. M. P. Prabhudesai
Sawantwadi, Dist. - Sindhudurga.
Maharashtra, India. Pin - 416510
Mobile - +919422435323
e-mails - vdmurali13@gmail,com . . . . . . . . . . . . . . . . . . . . . . . . . dr_murali13@yahoo.co.in


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Mar28
SHORT TERM YOGA PRACTICE PROVEN USEFUL FOR OBESITY AND BLOOD PRESSURE.
Adulthood attained with paradigm shift in life style and its own stress leading to birth of many ailments of chronic nature. Hypertension and obesity considered to trigger many fatal diseases.

Yoga can be implemented as non pharmacological intervention in these problems. So to evaluate effect of yoga during short term yoga program on semi urban school teachers was carried out in a recent research study in Karnataka.

This research study was aimed to assess effect of yoga techniques on body weight, systolic and diastolic blood pressure during short term practice.

In this study 55 Semi urban school teachers between age group 20 to 55 years were subjected to one week Yoga program. Yoga training was given for 2 hrs from 6am to 8am. Yoga session included Asanas and Pranayam, Quick Relaxation Technique (Q.R.T). Weight, Blood Pressure was recorded before yoga session on first day and on last day after yoga performance.

The results were statistically analyzed.

During the study, significant result in Weight and Systolic Blood pressure were observed. But no significant result in Diastolic Blood pressure was observed.

Hence it was discussed that Asana like Surya Namaskara, Ardha Kati Chakrasana, Paada Hastasana etc may regulate lipid metabolism, calorie expenditure by muscles and soft tissue and also reduced fat accumulation may attributed to Weight reduction. Significant Drop in both systolic and diastolic blood pressure was may be due to Pranayama and Quick Relaxation Technique which helped in reducing stress and increase mental relaxation.

From this study it was concluded that
1.EVEN SHORT TERM YOGA PRACTICE HAS ITS BENEFICIAL EFFECT ON WEIGHT AND BLOOD PRESSURE.
2. HENCE YOGA THERAPY CAN BE CONSIDERED AS POTENTIAL ALTERNATIVE APPROACH FOR THE MANAGEMENT OF WEIGHT AND BLOOD PRESSURE.

(This study was conducted by researchers of S J G Ayurvedic Medical College & Hospital, P G Studies and Research Center, Koppal, Karnataka.)

(ये सूचना आयुर्वेद विज्ञान के बारे में आपके ज्ञान वर्धन व इसके वैज्ञानिक दृष्टिकोण को समझाने हेतु है.
किसी भी रोग से पीड़ित होने पर अपने चिकित्सक के परामर्श अथवा मुझसे drswastikjain@hotmail.com पर संपर्क करने के बाद ही कोई दवा लें.)


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Mar21
AYURVEDIC THERAPIES ŚHODHANA AND BASTI KARMA PROVED USEFUL IN HEALING VARICOSE ULCERS
Venous ulcers (stasis ulcers, varicose ulcers) are the wounds occurring due to inappropriate functioning of venous valves, usually of the legs. It is one of the most serious chronic venous insufficiency complications.

When a venous valve gets damaged, it prevents the backflow of blood, which causes pressure in the veins that leads to hypertension and, in turn, venous ulcers. Without cleaning and regular dressings, the ulcers usually spread quickly. Venous ulcers can be very painful and may limit mobility and quality of life.

The longer the duration of the venous ulcer, the more is the damage to skin and greater the difficulty in healing. Treating varicose ulcer is a difficult task to the physician and a nightmare for the suffering patient, though different types of treatment modalities are practiced in allied sciences.

In a recent research study ; patients with above conditions provided with Processed castor oil with Neem and Guduchi - 50 ml orally used for Nityavirecana with 50 ml Śunthikashāyam for 3 days. Nityavirecana is the specific therapy in Ayurveda in which the medicine may be processed in oil or as decoction is administered orally for cleansing the bowel and liver system.

This improves the Agni metabolism of the individual. This is the first and necessary step in any enema therapy.On day 4 of management, ManjisthādiBasti karma was started with BalagudūcyādiAnuvāsanaBasti (60 ml) in kālabasti pattern.

Noticeable improvement in the symptoms was seen, it was upto 60% in edematous swelling, burning sensation was reduced up to 40%, and pricking sensation was reduced up to 30% after Nityavirecana. Moreover, Basti karma, edematous swelling was reduced to 95%, Burning sensation to 70%, and pricking sensation was reduced to 80%. Healing of the ulcerous wound started with the proliferative stage by the 3 rd day of the Basti course and the wound got healed up to 90% after the whole course of Basti karma with no adverse event during the entire course of treatment.

Possible action of these therapies-Nityavirecana (bowel and liver system cleansing therapy) Basti karma (medicated drug enema):-
In Ayurveda, this condition is considered as dustavrana and better managed with specific śodhana therapy (Purification therapy).This can be treated successfully with śodhana (purification) and śamana (pacification) therapy. So, the fore mentioned benefits of Nityavirecana (liver and bowel cleansing therapy) and Manjishthābasti (decoction enema therapy) were assessed in alleviating the symptoms and in the healing process of varicose ulcer in the patient.

Digestive and assimilation capacity and enzymatic functions through the liver system was improved by the Nityavirecana. By the laxative actions it created osmotic effects in the gut to suck the extra fluid retained anywhere in the body and is ultimately helpful in the wound healing process. Three days of treatment with Nityavirechana resulted in good appetite, reduction in the edematous swelling around the foot, and starting of granulation tissue formation in the ulcerative wound.

This research concluded that AYURVEDIC THERAPEUTIC PROCEDURES, ŚODHANA (PURIFICATION THERAPY), LIKE NITYA VIRECANA (bowel and liver system cleansing therapy) AND BASTI KARMA (medicated drug enema)ACT ON NON-HEALING ULCERS AND HELP THEM HEAL.

(This research study was conducted by researchers of Department of Panchakarama, KLEU Shri B M K Ayurveda Mahavidylaya, , Belgaum, Karnataka and School of Pharmacy, Faculty of Medical Sciences, University of West Indies, Trinidad & Tobago, West Indies)


(ये सूचना आयुर्वेद विज्ञान के बारे में आपके ज्ञान वर्धन व इसके वैज्ञानिक दृष्टिकोण को समझाने हेतु है.किसी भी रोग से पीड़ित होने पर अपने चिकित्सक के परामर्श अथवा मुझसे drswastikjain@hotmail.com पर संपर्क करने के बाद ही कोई दवा लें.)


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Dec28
MEDICAL MISTAKES CANNOT BE EXCUSED -SO BE CAUTIOUS THEY NEVER OCCUR IN AN DOCTORS LIFE TREATING PATIENTS:-
SOME MEDICAL MISTAKES CANNOT BE EXCUSED -SO BE CAUTIOUS THEY NEVER OCCUR IN AN DOCTORS LIFE TREATING PATIENTS:------

DR.D.R.NAKIPURIA,drnakipuria@gmail.com,09434143550,09832025033

1- Joan Morris (a pseudonym) is a 67-year-old woman admitted to a teaching hospital for cerebral angiography. The day after that procedure, she mistakenly underwent an invasive cardiac electrophysiology study. After angiography, the patient was transferred to another floor rather than returning to her original bed. Discharge was planned for the following day. The next morning, however, the patient was taken for a open heart procedure. The patient had been on the operating table for an hour. Doctors had made an incision in her groin, punctured an artery, threaded in a tube and snaked it up into her heart (a procedure with risks of bleeding, infection, heart attack and stroke). That was when the phone rang and a doctor from another department asked what are you doing with my patient? There was nothing wrong with her heart. The cardiologist working on the woman checked her chart, and saw that he was making an awful mistake. The study was aborted, and she was returned to her room in stable condition.

-----------------------------

2- In what was, perhaps, the most publicized case of a surgical mistake in its time, a Tampa (Florida) surgeon mistakenly removed the wrong leg of his patient, 52-year-old Willie King, during an amputation procedure in February 1995.

It was later revealed that a chain of errors before the surgery culminated in the wrong leg being prepped for the procedure. While the surgeon's team realized in the middle of the procedure that they were operating on the wrong leg, it was already too late, and the leg was removed. As a result of the error, the surgeon's medical license was suspended for six months and he was fined $10,000. University Community Hospital in Tampa, the medical center where the surgery took place, paid $900,000 to King and the surgeon involved in the case paid an additional $250,000 to King.

-----------------------------

3- In St. Louis Park, Minnesota, a patient was submitted at Park Nicollet Methodist Hospital to have one of his kidneys removed because it had a tumor believed to be cancerous. Instead, doctors removed the healthy one.


"The discovery that this was the wrong kidney was made the next day when the pathologist examined the material and found no evidence of any malignancy," said Samuel Carlson, M.D. and Park Nicollet Chief Medical Officer. The potentially cancerous kidney remained intact and functioning. For privacy and family's request, no details about the patient were released.

-----------------------------

4- A West Virginia man's family claims inadequate anesthetic during surgery allowed him to feel every slice of the surgeon's scalpel - a trauma they believe led him to take his own life two weeks later. Sherman Sizemore was admitted to Raleigh General Hospital in Beckley, W.Va., Jan. 19, 2006 for exploratory surgery to determine the cause of his abdominal pain. But during the operation, he reportedly experienced a phenomenon known as anesthetic awareness -- a state in which a surgical patient is able to feel pain, pressure or discomfort during an operation, but is unable to move or communicate with doctors.

According to the complaint, anesthesiologists administered the drugs to numb the patient, but they failed to give him the general anesthetic that would render him unconscious until 16 minutes after surgeons first cut into his abdomen. Family members say the 73-year-old Baptist minister was driven to kill himself by the traumatic experience of being awake during surgery but unable to move or cry out in pain.

-----------------------------

5- When Nancy Andrews, of Commack, N.Y., became pregnant after an in vitro fertilization procedure at a New York fertility clinic, she and her husband expected a new addition to their family. What they did not expect was a child whose skin was significantly darker than that of either parent. Subsequent DNA tests suggested that doctors at New York Medical Services for Reproductive Medicine accidentally used another man's sperm to inseminate Nancy Andrews' eggs.

The couple has since raised Baby Jessica, who was born Oct. 19, 2004, as their own, according to wire reports. But the couple still filed a malpractice suit against the owner of the clinic, as well as the embryologist who allegedly mixed up the samples.


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Jul25
Affordable Health Care only possible with Value Based Medicine
India is a developing country and 80% of the population of our country cannot afford expensive healthcare. The facilities provided by the govt are miniscule in front of the giant problem. Shortage of doctors, basic infrastructure, paramedical staff and expensive medicines makes healthcare even more out of reach for a common man. That is the reason we are still struggling with the certain communicable diseases and now added to that is the burden of non- communicable diseases .India is going to be the world capital for heart disease in 2030 as per the WHO report. Diabetes is rampant and there is total lack of awareness about, prevention lifestyle management, hygiene levels, sanitation and the healthy living with the result we have huge load of patients whether it is communicable or non-communicable disease. Added to it is the shortage of man power to treat these patients. As per one study our country has only 20

doctors/10000 population as compared to 650/10000 population in U.S.A. The budgetary provisions for healthcare are so low that even the primary healthcare cannot be delivered efficiently with the result the rural population is the worst sufferers .That is how there is mushrooming of quacks and invaluable lives are at risk.
In such a dismissal scenario only alternative to improve upon the services and making each step in health care delivery more justified and economical we need to look at an evolving healthcare delivery system all over the world and even in developed countries like USA and that is Valve Based Medicine. So far we have been practicing Evidence Based Medicine where in based on the evidence of the disease, we treat it with the most costliest way of treatment. It ignores the logistic of benefit vs cost ratio whether it is concerned with writing costly medicines or adopting the most costliest intervention.
Valve based medicine concept is different from the evidence based medicine concept in the sense that we are treating human being and not symptoms or investigations. The treatment planned has to be based on the effective control of the disease with respect to the perception of the patient and his family in terms

of benefit ratio as compared to the cost involved in it. Lets say in heart disease a patient having coronary artery disease in two or three vessels can be treated with bypass surgery as well as ballooning and stenting. Now whereas stents will cost him a big money and will also not even be durable so bypass surgery becomes more economical and more durable. So what patient wants here is effective quality of life improvement with an economical and durable procedure .So of course bypass surgery is the best answer here. Similarly a sore throat can be effectively treated with low end antibiotic treatment, supportive therapy instead of expensive and high end antibiotics.
Valve based medicine is a mean to compare all health care interventions on the same scale and a measure that can be combined with the cost of an intervention to arrive at a cost utility ratio . It provides most effective assessment of the patient perceived worth of an intervention. It also measures quality of life and/or length of life. Irony of healthcare industry is that it is one of the few industries where purchasers or the patients are unable to measure the valve of that they purchase.


So Value Based Medicine allows highest quality care, maximization of healthcare rupee and incorporation of patient based perception of quality of life. The goal of Value Based Medicine is to promote what is best for the most important people in healthcare i.e. patients. It provides transparency backed by scientific opinion, communication by personal attention, no scare or fear by involving empathy, economics and 24x7 availability.
Similarly if we come to procedures, Beating Heart Surgery is value based medicine. Minimal invasive surgery goes a step further in that direction as it makes the patient up and about early and patient does not lose productive days of earning and is back to work at the earliest with less stress on the body. Also in terms of logistics there is less ICU stay, less hospital stay, less use of blood products. Value based medicine also incorporates all the forth coming evidence which is percolated to the patient level and helps in decision making for the patients. Now coming to Stent vs Surgery two major trials one in 2009 Syntax trial and the other in Nov, 2012 Freedom trail have clearly established and concluded that is multi-vessel disease and diabetes Bypass Surgery scores over drug coated stents in terms of death, second heart attack and second or repeat intervention.

And all patients with multi-vessel disease should be offered Bypass Surgery as the first option for durable economical treatment. So in this scenario Value Based Medicine promotes that when it come to coronary artery disease each and every patient should meet the surgeon with his angiography report to reach to a conclusion whether he needs to go for stents or surgery. The other thing which our country needs to incorporate into VBM is the availability of cost effective medicines, disposables and equipment. Still most of the equipment, disposables used in high end surgeries is being imported and thereby making huge loss and leading to escalation of prices of these essentials. The government has to encourage use of generic drugs availability of which should be free and easy and encourage manufacture of disposables and equipment our own country .It will do away the huge profit margin taken by the multinational companies when middle men and the dealers add to the cost. There are very innovative products available in India and effort should be done to produce them at mass level and promote it at all levels .In fact all hospital should be told to use them as the first priority.
The infrastructure resources for the primary ,secondary and tertiary healthcare delivery are very less so a policy need to be made where in govt. and private

sector should join hands in making the total available infrastructure at the disposal of all the patient population group. There should not be any differentiation and all available beds should be utilized to the maximum by one and all. It will help in reducing the waiting list and huge queues seen in govt. hospitals today. All it needs is rationalization of compensation to private sector .Today also many govt agencies are utilizing the private resources for tertiary care by reimbursing them the subsidized cost of treatment. Why not it can be applied to primary and secondary care? Public private partnership is another good concept of upgrading and brining secondary and tertiary care in all cities and rural areas. To promote health care delivery in rural area the doctor should be encouraged by arranging for them a good housing ,transport ,and good schooling for their children .In fact the concept of rural dispensaries should be abandoned and what we need is a good primary/secondary health care centre within a radius of 20 kilometers and that area on daily basic should be covered for OPD service by mobile vans with fixed hours backed by strong ambulance service which most states have already adopted. This will help getting the medical and paramedical manpower stationed at these centers as they will get basic facility and necessities of life for themselves and their family and doctor will able to deliver better

healthcare with better facility in terms of equipment and beds in an upgraded hospital environment .It will also help in running the various preventive healthcare programs in true earnest. And then these primary/secondary centres are backed by tertiary care centres whether in private or government sectors at treatment cost rationalized by a committee of experts consisting of knowledgeable people from government and private sector. We need to understand that health is the ultimate necessity of life and is very important for the economic growth of this country. Till we get developed this concept of value based medicine will see us through in building a healthy and capable society which in turn will produce a workforce which will work hard to take this country forward and will make it a world leader.


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Jun21
BLOOD BY STEM CELLS NO NEED OF BLOOD DONATIONS
BLOOD PRODUCTION BY STEM CELLS-BLOOD DONATION NOT REQUIRED

DRNAKIPURIA@GMAIL.COM

For years, Blood is very important,nothing can replace it and it can be achieved from human body only ,so it is a greatest donation of a "man for man" as when either due to any accident injuries or missile or blastic injuries or natural disaster or most plnned sugeries to save life and to overcome blood diseases we need BLOOD and if it is not available death is certain

So scientists are working day and night since stem cell isolation and harvesting was possible to make BLOOD FROM STEM CELLS. With stem cell researchers trying to figure out how to make new organs, it may also be possible for them to create blood cells. Though the organs are obviously vital, this may be more important as so many people are affected by blood loss. Currently, since only donors can give blood, there might be excess blood of one type but very little blood of another type, meaning that some patients in need of blood may not be able to get any, even if there seems to be a sufficient amount of it available. But with statistics and accurate planning, scientists may produce all blood types in an efficient manner, helping everyone in need instead of just a few. If this will soon be possible, it makes wonder what else is in the near future. Perhaps skin replacements for patients with severe burns? Whatever else is coming ? HEART,LUNG,BRAIN,KIDNEYS,LIMBS OR A COMPLETE REPLICA OF ONE PERSON A HUMAN CLONE EITHER MALE OR FEMALE BUT ORIGANTED FROM ONE PARENT ONLY,NO MIXTURE,PURE RECARNATION OF A PERSON,OR MAN BECOMES IMMORTAL, A MONSTER WHICH WILL NEVER DIE.

(Boston) A study led by Boston University School of Medicine has identified a novel approach to create an unlimited number of human red blood cells and platelets in vitro. In collaboration with Boston University School of Public Health (BUSPH) and Boston Medical Center (BMC), the researchers differentiated induced pluripotent stem (iPS) cells into these cell types, which are typically obtained through blood donations. This finding could potentially reduce the need for blood donations to treat patients requiring blood transfusions and could help researchers examine novel therapeutic targets to treat a variety of diseases, including sickle cell disease.
Published online in the journal Blood, the study was led by George J. Murphy, PhD, assistant professor of medicine at BUSM and co-director of the Center for Regenerative Medicine (CReM) at Boston University and BMC and performed in collaboration with David Sherr, PhD, a professor in environmental health at BUSM and BUSPH.
iPS cells are derived by reprogramming adult cells into a primitive stem cell state that are capable of differentiating into different types of cells. iPS cells can be generated from mature somatic cells, such as skin or blood cells, allowing for the development of patient-specific cells and tissues that should not elicit inappropriate immune responses, making them a powerful tool for biological research and a resource for regenerative medicine.

BLOOD DROPS ARTIFICIAL,FROM EYE NATURAL


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May14
deep vein thrombosis
DEEP VEIN THROMBOSIS


What is deep vein thrombosis (DVT)?

The blood circulation system in our body has arteries and veins. The arteries carry pure blood and veins carry impure blood. The vein system in our legs has two groups of veins; superficial veins and deep veins. The superficial veins are ones which we can see under our skin on legs; while deep veins our hidden in the muscles. The thrombosis means blockage of veins by blood clots. So when deep veins forms clot inside it is called deep vein thrombosis. This usually happens in the legs. When that happens suddenly; patient develops pain, catch in the muscles and swelling of the leg; depending on the extent of blockage. If the extent of blockage is large you will have pain, swelling, stiffness. If the extent of block is less you may complain only of cramp or stiffness with pain.
In a few cases these pieces of blood clots in veins can break away and deposit into the blood vessels of lungs. When that happens; person may suffer from breathlessness, chest pain, heart failure and sometimes results in death.




Causes of deep vein thrombosis

There are various causes of deep vein thrombosis. It can be due to slowing of blood due to various reasons like prolonged bed rest, long hours of sitting, dehydration, trauma, recent surgery. The economy class syndrome is the formation of blood clots in veins deep within the legs occurring during or just after a long airplane flight, especially in economy class due to prolonged immbolisation and lack of space.
Some patients has increased tendency to form clots. It may due to certain deficiency of blood components. These patients tend to form blood clots more than others. Such individuals have repeated attacks of deep vein thrombosis. In certain diseases persons have more frequency of deep vein thrombosis like cancer, obesity and kidney diseases. Pregnancy is one state where chances of deep vein thrombosis are high due to pressure from uterus and hormonal changes. Women who are taking contraceptive pills are again more prone to DVT due to hormonal changes. Old age, persons with severe infections and patients on chemotherapy are also more prone to DVT.




Treatment of deep vein thrombosis

Deep vein thrombosis can be detected by blood test called D-dimer. To know the extent of disease sonography of veins (Color Doppler) is done. This Sonography test will confirm the diagnosis and also it will tell us the extent of disease. In some cases MRI scan will be required.
Once detected one should start treatment early to get best results. If your disease is mild, you can be treated as OPD patient. Doctor will give you blood thinning injections two times daily for 5-7 days and start blood thinning medications. You will also need blood tests to see the appropriate level of medication required for blood thinning. It is better to take rest from your work. If your disease is significant doctor will admit and treat you. This would include blockage of veins in pelvis, migration of blood clot into lungs, old age, and other medical diseases.
If there is considerable disease involving major veins in thigh and pelvis; the blood clots can be melted with blood thinning medicines injected directly into affected veins and clots can be aspirated out of the veins. This treatment is called catheter directed thrombolysis. This procedure has to be done within two weeks of start of disease. This is a new method of treatment which has significantly improved the results of treatment. If there is increased risk of blood clot migrating into lungs then doctor can put a filter in inferior vena cava (the large vein in lower trunk formed by joining of both leg veins).
Your blood thinning tablet will continue for six months. You will also be investigated to find out if you have certain deficiency of blood components. Besides this you will be required to wear compression stockings in affected leg. These stockings you will have to wear for two years or more.
Discussion will not be complete without long term effects of deep vein thrombosis. In medical term it is called post thrombotic syndrome (PTS). Up to half of the patients who had DVT will suffer from PTS. The symptoms of PTS includes swelling of leg, pain, heaviness, itching, discoloration of skin, varicose veins and even ulcer on legs. It is to avoid these symptoms patients are advised to wear compression stockings for two years or more.
Deep vein thrombosis should be detected early and treated appropriately for early recovery, prevention of complications and decrease chances of long term effects.



Dr Sunil Bhargava MD, DNB, MNAMS
Consultant Interventional Radiology and Vascular Sciences
SevenHills Hospital, Andheri (E), Mumbai 400059
E mail drsunil.b@sevenhillshospital.com ,Mobile +919320182803

Dr Sunil Bhargava is an Interventional Radiologist with experience of over 17 years. He is an expert in endovascular treatment of vascular diseases. His areas of interest include venous ailments like varicose veins, deep vein thrombosis and congenital venous malformations.


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