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  • New CPR technique

    Cardio Pulmonary Resuscitation

    This months issue of American Journal of Emergency Medicine describes a new method of resuscitation by abdominal compressions only. As is quite well known CPR by itself is not very effective: succeeding in only a percentage of patients when instituted. The purpose of study was to determine the amount of coronary perfusion obtainable with OAC-CPR during VF compared with the coronary perfusion with the normally beating heart in the same animal. A second objective was to determine coronary perfusion during VF using standard chest-compression CPR and to compare it with the coronary perfusion for the normally beating heart in the same animal. A third objective was to compare the OAC-CPR ratios with the ratios obtained with standard chest-compression CPR. This latter comparison was designed to quantitate the superiority of OAC-CPR over standard chest-compression CPR.

    Rhythmic abdominal compression-CPR works by forcing blood from the blood vessels around the abdominal organs, an area known to contain about 25 percent of the body’s total blood volume. This blood is then redirected to other sites, including the circulation around the heart.

    The advantages listed for only abdominal compressions(OAC) includes-OAC-CPR eliminating the possibilities of rib fractures. It also provides substantially more coronary perfusion than standard chest-compression CPR. With OAC-CPR, Ao(aortic arch) pressure exceeds RA(Right Atrial) pressure during almost the entire compression-decompression cycle, thereby providing a high coronary perfusion. With standard chest-compression CPR, there is some retrograde coronary flow because RA pressure exceeds Ao pressure during a portion of the compression-decompression cycle. In this preliminary study, there was no evidence of damage to visceral organs found by the researchers. Read the whole article here Via Elsevier

    A summary of the arcticle can also be found at Reuters health

  • Making a diagnosis

    Automated programmes capable of diagnosis and suggesting further investigations or workup is just waiting in the wings. I suppose this is one of the initial events in that direction.

    You want machines second-guessing you? by ZDNet‘s Dana Blankenhorn — But what if insurers start trusting the software over the physician, using it to question a doctor’s calls? What if doctors feel forced to follow Isabel’s recommendations, knowing this to be true? What if lawyers start using Isabel diagnoses to file malpractice claims?

  • Me no Doctor!

    This here is a very interesting question from a pre-med who is sure he isn’t made out to be a doctor- I don’t want to be a doctor!-

    This has been further picked up and taken apart word by word and then some at the Sepia.

    I think everyone goes through these phase of life like Typical Confused College Student here. Really nice reverse engineering here of the issue.

  • Doctor’s Factory ?

    http://www.jha.in/Pics/green.jpg
    It is a fact that a large number of Indian medical graduates leave India for abroad. US is the prefered destination followed by UK and Australia. Do you think that they should be barred from going out? The present Health Minister does think so. After the recent fracas and then strike by residents in AIIMS this is what he had to say that the premier institute was slowly becoming a “doctors’ factory” for foreign countries and not for the needy Indians.

    “Over 60 percent of the AIIMS passouts are going outside India. It’s becoming a doctors’ factory that is producing talent for foreign countries and not for the poor Indians,”

    This debate is age old i suppose. And at the same time i think the quantum of medical graduates going out has gone done. what with difficult to get visa and poor working environment in those countries. what would be your opinion?
    Rest of the stories continues here

  • Good news for me


    Now this is a welcome news for me. Published in this months Hepatology

    In an meta-analysis of 10 studies reviewed by Dr. Francesca Bravi from Milan’s Istituto di Ricerche Farmacologiche “Mario Negri” and colleagues included 2,260 cases of HCC. Collectively, the results showed a 41 percent reduction in the risk of liver cancer (or hepatocellular carcinoma, HCC) among coffee drinkers compared to those who never drank coffee.

    Low to moderate coffee drinkers — defined in some studies as those who drank less than 3 cups per day and in others as less than 1 cup per day — had a 30 percent lower risk of HCC compared to coffee abstainers. High coffee consumption — defined in some studies as 3 cups or more each day and in others as 1 cup or more per day – had a 55 percent lower risk of HCC.

    Earlier i had been wringing my heart while enjoying my cup. I will wait for the next news over my cuppa.

  • A Case of Intestinal Perforation

    So this 24 year old is brought by his relatives and neighbours at 2.00 am on a hot muggy july night. He was having fever for last 15 days and complains of increasing pain in abdomen since last five days. He was looking worse than before so they brought him to the hospital emergency. The patient is obviously in pain with sweat covering his forehead holding his stomach. Look for his radial pulse; hardly palpable. His arms and legs are cold and clammy-of couse – he is in shock. His abdomen is tense and tender. He is suffering from peritonitis and that is most likely due to perforation in his gut. X-ray of abdomen shows presence of free gas under the diaphragm confirming the clinical impression.

                         

     This requires an urgent operation- a laparotomy  to repair the defect. So on to the operating table after preparation  (will be subject of another post). Abdomen is full of gut content with foul smell. The mess is cleaned and peritoneal cavity washed with warm saline. Rent in the ileum is repaired and abdomen closed after inserting a drain. Keep fingers crossed in the post operative period as the patient recovers and improves in the next 4 to 5 days. A seemingly simple task with many a pitfalls successfully completed. 

  • A Suitable Boy

    The BCCI continues to search for a suitable coach for the indian cricket team. Former Bangladesh coach Dav Whatmore was tipped to succeed Greg Chappell but now the field is open once more (inside story anyone?). Ranatunga and South African Graham Ford are other candidates being considered for the post. Whosoever will be filling Chappell’s shoes will have a tough job dealing with a team in disarray what with a number of players being out of form. Apparently Gavaskar is more in favour of Sri lankan Arjun Ranatunga as the next coach. read at HT

    Graham Ford

  • Flash in the pan

    After winning the first test match against the proteas, the men in blue were back to their dismal self losing the next two matches without much fight. They started the third test quite well but the urge of shooting themselves in foot was too much to resist; losing the match by five wickets! And to add insult to the injury apparently they are being billed for the revelry after their first win. Guru Chappel is rightly miffed with all his plans for the forth coming world cup collapsing in front of him. He was heard darkly muttering these words “Looking at the tour as a whole, there are more questions than answers. Over the next week or so, when we get back to India and have a chance to digest what’s happened and discuss and debrief, we’re going to have to make some decisions on which direction we go. There will be a few guys under a bit of pressure, there’s no doubt.” full story here
    In deep water

  • Return of the Dada

    The indian team cannot be written off so easily. So to infuse hope in diehard fans, they have performed credibly and have done quite well at Wanderers. Sreesanth has really bowled well and dada is in form. Hoping they are able to finish this one on a happy note tomorrow. link to Score and comments

  • Speechless Wonder-alias- Indian Cricket Team

    Trust Indians to be the perfect guests and bringing smiles on their host’s faces.Against all odds and with meticulous inefficiency the indian team have made a mess of themselves in South Africa. bringing great. Having lost the one day series 4-0 our team is looking forward to the test series. A diehard fan hopes that they are able to atleast salvage their pride. The shirt is long gone!! Ki dada?! site