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  • Hospital Acquired Infections (HAIs) or nosocomial infections are complex to treat and are a growing global burden. HAIs affect about one in 25 patients in the US and situation is worse in resource-poor nations. A prevalence survey conducted under WHO in 55 hospitals of 14 countries showed that ~8.7% of in-patients had HAIs. At any time, over 1.4 million people worldwide suffer from infectious complications acquired in hospital. HAIs contributes to increased economic burden, negatively affecting quality of life and deaths. 1,2 As per the existing methodologies direct observation is the gold standard to monitor compliance and to prevent or reduce HAIs. Frequent surveys, interviews and inspections are the other commonest methods implemented as prevention of HAIs. Indirect monitoring involves automated monitoring systems (video monitoring , real time location systems) monitoring hand hygiene product consumption). Hospitals with sophisticated information systems are in a position to streamline surveillance process through computer-based algorithms that identifies patients at highest risk of HAI.3 4 Computerized surveillance helps in better implementation of preventive strategies, but lower infection rates have not been proven conclusively. Conventional training methodologies have not proved to be significantly impactful in knowledge retention and message recall. A newer approach called Gamification is a positive and effective method to change behaviour. It can engage, motivate and influence people. It is a concept that has unknowingly been applied for years though the term was widely used only after 2010. A ‘serious game’ is defined as an ‘interactive computer application, with or without significant hardware component, that has a challenging goal, is fun to play and engaging, incorporates some scoring mechanism, and supplies the user with skills, knowledge or attitudes useful in reality. A hand hygiene improvement campaign in Edinburgh Royal Infirmary (Scotland, UK) using the SureWash gesture recognition system (SureWash, IRL) which concluded that...
  • Surgical practice has evolved over the centuries, more so in past 2 decades. However, continuing surgical education practices remain antique. Strongly dependent on hands-on-training, surgeons limitations of travel and time dedication, affects access to learning. Newer technologies for adaptive and immersive learning, including virtual reality and augmented reality has evolved over the past 5 years. It’s use might help to improve reach and quality of professional surgical education.  But some key questions to be answered are access to technology, adaptability and behaviour change. As an experiment, one year skill development program, Diploma in Minimal Access Surgery, with 80% of learning happening online and 20% offline was introduced for the first time in India to train surgeons on minimal access surgery. Online included the use of smart learning management system with AI, virtual reality, augmented reality, real time app based logbook, live surgery streaming and scheduled mentor interactions. Offline training included over the shoulder learning, hands-on and interactive class room learning over one week. Program enrolled 70 students in the first batch. In total 67/70 accessed the course (Ongoing). Over the period of 8 months, 34 video modules, 8 live interactions, including surgery streaming and one in person session with faculty, were conducted. Course received 100% attendance, with 3 or less reminders. A survey conducted at half time, to evaluate the effectiveness and net promoter,  73% responded (49/67). Average rating for the course stood at 4.35/5. Majority felt ‘Live Surgeries’ and ‘Virtual Contact Sessions’ were the most helpful ones. Ninetysix percent (96%: 47/49) said they either ‘agree/strongly agree’ that faculty provided all the necessary information during live surgeries and video lectures. When asked about ‘How likely are you to recommend the course to your peers?’, 47/49 rated either =or>7/10, and 26 responded 10/10. Providing the course a net promoter score of...
  • Author: Dr.T.V.Rao MD Medical education is in an era of transformation, and medical Colleges are beginning to innovate to prepare new physicians for the emerging new model of care. the regulator ( MCI ) realized what all taught in the past is non-productive and making least skilled doctors to make effective decisions in time of managing simple cases and emergencies, The true crisis are reflected when the fully qualified teachers who are supposed to be mentors to bring in change do not meet to the challenges Today certainly the medical profession under scanner for various reasons just not the fault of students, starting from admission process lacking   inclination to profession and lack of work culture in the professional colleges, and much added by the poor teaching talents of the so called highly qualified teachers just born to spend time in the colleges for sake of MCI records and personal gains which least talents . in the process Almost didactic teaching is dying as same old son sung by many however we are in for change and many curricular changes in medical syllabus wish to make the teachers productive and the students to be better in critical thinking and analytical skills to perform the profession Studying medicine is very much a marathon, not a sprint. It is a 5- or 6-year course, The reason the course is so long is because of the volume of material that needs to be learned; both the basic scientific principles and the clinical skills needed to apply them must be taught. BEGIN YOUR LIFE AS A POSITIVE THINKER – Being a medical student puts you in a very privileged position, among the very top students across the country. It generally seems to be the case that medics follow the mantra “work hard, play hard”. Most importantly,...
  • Author: Dr David Lee, MD Physicians have traditionally been individual thinkers and doers. Healthcare in general has been generally slow to adopt proven successful methods of processes and technologies employed with success in other sectors of society. Medical training from medical school through post-graduate education has been traditionally focused on the individual. Hospitals these days are driven by regulatory issues surrounding patient care. In reading about project management (PM), I have noticed that much of what I did as a practicing physician fit into standard PM teaching. However, it helps to frame a discussion around PM today in the context of healthcare, because of how fragmented care delivery is. 1. Collaborative interaction is a key component to success. It fosters constant and open communication, multidirectional input and conflict resolution as it occurs, not when it is too late. Team management of patients is catching on, but not universally practiced. Multidisciplinary hospital rounds including pharmacy, nursing, discharge planning are important to identify patients at high risk of readmissions, improve the relay of consistent and accurate information to the patient and caregivers, improve documentation and indirectly improve patient satisfaction and efficiency. Collaboration and communication among personnel in the operating room is especially important. According to one study, “communication failures in the OR…occurred in approximately 30 percent of team exchanges and a third of these resulted in effects which jeopardized patient safety by increasing cognitive load, interrupting routine and increasing tension in the OR.” Electronic health records and their interoperability are being implemented to facilitate collaborative interactions among different technologies and providers. There are even intra-office communications problems that have negative outcome implications for patients. There is a long way to go on that front, mostly due to non-technical issues. 2. Planning, execution and management are other important fundamentals of PM. One key to this...
  • “Computers are a mixed blessing, because the ease with which they can make data widely available poses new risks to individual privacy. Compared to paper-based medical records, electronic information is more easily manipulated and linked…. [and] also raises the specter of a huge national database of identifiable, comprehensive health information”…..  Rybowski (1998)  Telemedicine came into existence in the latter half of 90’s, mainly focusing upon patient data storage. Quite obviously it is linked to the growth of information technology across other sectors. However, the boundaries got stretched in the early Y2K period, when the online education trend was picking up. Also online training and certifications for physicians was the new trend. One of the first training programs I remember to be delivered online was on one of most difficult and important procedures, Cardio Pulmonary Resuscitation. That’s around the time legal barriers for telemedicine started kicking in. Legal barriers or rather laws around telemedicine got beefed up only recently also, this is when the actual online physician consultations or tele-radiology began. Tele-medicine or eHealth has for sure increased the access, adherence, and availability of healthcare services, but along with it raised many questions in the minds of healthcare providers, payers, enablers, and recipients. Is storing patient data electronically, ‘on the cloud’, as safe as it is perceived or projected to be? Are the online training or certifications for physicians the same as live or in person training? Are online physician consultations provided by qualified doctors? Is an online consultation equivalent to an in person visit to physician clinic? Does my insurance cover an online consultation? Can a physician practicing in a different country provide a tele-consult to a patient in a different country, without legal implications? Legal considerations remain as a major obstacle in successful implementation of tele-medicine across the globe....
  •   Professors David Armstrong and Charles Liu at first seemed to be an unlikely pair. But the podiatric surgeon and neurosurgeon clicked on a personal level and promptly realized they had a lot to offer each other as Keck School of Medicine of USC collaborators. Both were already studying how much information a person takes in through the nerves of the feet, how to preserve, repair or replace that information system, and how nerve damage can affect a patient’s mobility. Armstrong is interested in metabolic health, mobility and neuropathy — the loss of nerve sensitivity that can occur in patients with diabetes, Liu noted. “As a neurosurgeon, I’m interested in lower-extremity function and metabolic health, too,” he said. “In my work, I think about how to restore mobility to patients who can’t feel their legs. It’s a similar problem to diabetic foot ulcers.” Armstrong added: “We’re meeting in the middle, and it’s fun. It’s so common in medicine for people to silo, but you can’t let your ideas sit there alone. Whatever the other guy is doing will make your thing more interesting.” SMART INSOLE, SMART PHYSICIANS The two started looking for a project on which to collaborate. Oddly enough, they found it with a Canadian security company. The firm was working with the idea of capturing pressure signatures — the way weight is distributed across people’s feet as they walk — which are as distinctive as fingerprints. At the time, the company was working with technology that could signal if, for example, an unknown person walked into a secure room. The doctors soon saw that pressure signatures could be a way to spot changes in a person’s gait early on — a potential warning sign of a more serious problem. With their shared interest in wearable technology, Armstrong and Liu steered the company toward...
  • Antiretroviral therapy may soon be obsolete, as scientists have successfully used immune cells to kick the dormant form of HIV out of its hiding place and destroy it. The findings may soon lead to an HIV vaccine. According to recent estimates, around 1.1 million people in the United States have HIV. With the help of antiretroviral therapy, over half of these people now have a very low level of the virus. This means that they can no longer trasmit it to other people. Antiretroviral therapy can keep HIV in check so well that the virus is near-undetectable in the blood. However, HIV continues to “live” in latent form, so people with it must keep taking the medications to prevent it from flaring up. Antiretroviral therapy can have a host of side effects. These may include gastrointestinal problems, cardiovascular problems, insulin resistance, and bleeding events, as well as effects on bone density, liver health, and neurological and psychiatric health. So, the search for an HIV cure is ongoing. Now, new research may have found a way to “drag” the virus out of its hiding place and neutralize it. The findings may lead to a vaccine that would allow people living with HIV to stop taking antiretroviral medication every day. Senior study author Robbie Mailliard, Ph.D. — an assistant professor of infectious diseases and microbiology at the University of Pittsburgh Graduate School of Public Health in Pennsylvania — and colleagues have published their findings in the journal EBioMedicine. Using an entirely different virus to target HIV Mailliard explains the motivation for their study, saying, “A lot of scientists are trying to develop a cure for HIV, and it’s usually built around the ‘kick and kill’ concept — kick the virus out of hiding and then kill it.” He adds, “There are some promising therapies being developed for the...
  • Have you come across titles / abstracts from search results that sounded very promising, but when you read the article, the content did not match what you first saw? Or have you come across titles that did not mean anything, and there was no abstract? You obviously would not bother to trace and read that article – unless the author was your friend! In the days of information overload, if you want your paper to be read, it is important to frame the title and abstract so well that a) It is easily retrieved when one searches using relevant terms b) A reader would want to read the article, by reading the title and abstract The author of this article has highlighted the importance of writing clear titles and abstracts. And then has proceeded to list and describe the i) Importance ii) Types iii) Drafting iv) Checklists For both titles as well as abstracts A clear set of points makes it easy for any aspiring author to plan these steps right! Article Source: QMed
  • MUMBAI: A prescription by a doctor without a diagnosis first would amount to culpable negligence, said the Bombay high court while rejecting a pre-arrest bail plea of two doctors accused of culpable homicide not amounting to murder for death of a woman patient five days after child-birth. “The time has come for weeding out careless and negligent persons in the medical profession,” said Justice Sadhana Jadhav, while rejecting the plea made by the gynaecologist couple Deepa and Sanjeev Pawaskar, from Ratnagiri. The HC, however, stayed its order, and consequently their arrest, till August 2 to enable them to appeal. “When a doctor fails in his duty, does it not tantamount to criminal negligence? The courts cannot ignore the ethical nature of the medical law by liberally extending legal protection to the medical professionals. The ethical issues raised by failure to assist a person in need arises from positive duties. According to this court, the breach of these duties could fall within the realm of a criminal law of negligence,” said Justice Jadhav. The couple had said it was a civil case where compensation could be paid to the patient’s family. Can compensation buy a child her mother and beloved wife for a husband, asked the Judge The woman had delivered at Pawaskars’ hospital on February 6. She was discharged three days later, with no check-up and in their absence, as the doctors were out of town for a conference. The woman was re-admitted a day later, unable to keep anything down. Her treatment was done through telephonic instructions by Dr Deepa Pawaskar to her staff and an embolism went undiagnosed and untreated till it was too late, observed the HC. She had to be rushed to another hospital in a pre-dawn emergency and died there within hours. The widower filed an FIR in March...
  • The rise of bacteria that are resistant to multiple drugs highlights the urgency of developing new antibiotics to combat lower extremity infection. Accordingly, this author explores the potential of new pharmacological agents such as tedizolid, oritavancin, dalbavancin and delafloxacin, and discusses other agents in the pipeline. Since the introduction of penicillin as the first true antibiotic in 1928, a plethora of antibiotics has become commercially available and has had a profound impact on life. Antibiotics are manufactured worldwide at an estimated scale of about 100,000 tons annually but the common use of antibiotics for farm animals, aquaculture and human therapy has led to increased strains of pathogens becoming antibiotic resistant.1 Some pathogens have become resistant to multiple antibiotics and pharmaceutical agents, leading to the phenomenon of multidrug resistance. An example of such phenomenon is methicillin-resistant Staphylococcus aureus (MRSA). In addition to being resistant to methicillin, MRSA is usually also resistant to aminoglycosides, macrolides, tetracycline, chloramphenicol, lincosamides and disinfectants.1 Multidrug resistance in bacteria occurs secondary to one of two mechanisms. One is by the accumulation of multiple resistant genes within a single bacterial cell. This accumulation generally occurs on resistance plasmids or transposons of genes with each coding for resistance to a specific drug agent.1,2 Another mechanism is by the increased expression of genes that code for multidrug efflux pumps that essentially have the ability to extrude more than one drug type out of the bacterial cell.1 Researchers reported the first case of MRSA in Great Britain in 1961 and in the U.S. in 1968.2Interestingly, vancomycin, an antibiotic that was first discovered in the 1950s but bypassed in favor of other antibiotics deemed equally or more efficacious and less toxic, was resurrected in the 1980s for the treatment of MRSA and pseudomembranous enterocolitis.3This dramatic resurgence led to a 100-fold increase in the use of...

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  • Hospital Acquired Infections (HAIs) or nosocomial infections are complex to treat and are a growing global burden. HAIs affect about one in 25 patients in the US and situation is worse in resource-poor nations. A prevalence survey conducted under WHO in 55 hospitals of 14 countries showed that ~8.7% of in-patients had HAIs. At any time, over 1.4 million people worldwide suffer from infectious complications acquired in hospital. HAIs contributes to increased economic burden, negatively affecting quality of life and deaths. 1,2 As per the existing methodologies direct observation is the gold standard to monitor compliance and to prevent or reduce HAIs. Frequent surveys, interviews and inspections are the other commonest methods implemented as prevention of HAIs. Indirect monitoring involves automated monitoring systems (video monitoring , real time location systems) monitoring hand hygiene product consumption). Hospitals with sophisticated information systems are in a position to streamline surveillance process through computer-based algorithms that identifies patients at highest risk of HAI.3 4 Computerized surveillance helps in better implementation of preventive strategies, but lower infection rates have not been proven conclusively. Conventional training methodologies have not proved to be significantly impactful in knowledge retention and message recall. A newer approach called Gamification is a positive and effective method to change behaviour. It can engage, motivate and influence people. It is a concept that has unknowingly been applied for years though the term was widely used only after 2010. A ‘serious game’ is defined as an ‘interactive computer application, with or without significant hardware component, that has a challenging goal, is fun to play and engaging, incorporates some scoring mechanism, and supplies the user with skills, knowledge or attitudes useful in reality. A hand hygiene improvement campaign in Edinburgh Royal Infirmary (Scotland, UK) using the SureWash gesture recognition system (SureWash, IRL) which concluded that...
  • Surgical practice has evolved over the centuries, more so in past 2 decades. However, continuing surgical education practices remain antique. Strongly dependent on hands-on-training, surgeons limitations of travel and time dedication, affects access to learning. Newer technologies for adaptive and immersive learning, including virtual reality and augmented reality has evolved over the past 5 years. It’s use might help to improve reach and quality of professional surgical education.  But some key questions to be answered are access to technology, adaptability and behaviour change. As an experiment, one year skill development program, Diploma in Minimal Access Surgery, with 80% of learning happening online and 20% offline was introduced for the first time in India to train surgeons on minimal access surgery. Online included the use of smart learning management system with AI, virtual reality, augmented reality, real time app based logbook, live surgery streaming and scheduled mentor interactions. Offline training included over the shoulder learning, hands-on and interactive class room learning over one week. Program enrolled 70 students in the first batch. In total 67/70 accessed the course (Ongoing). Over the period of 8 months, 34 video modules, 8 live interactions, including surgery streaming and one in person session with faculty, were conducted. Course received 100% attendance, with 3 or less reminders. A survey conducted at half time, to evaluate the effectiveness and net promoter,  73% responded (49/67). Average rating for the course stood at 4.35/5. Majority felt ‘Live Surgeries’ and ‘Virtual Contact Sessions’ were the most helpful ones. Ninetysix percent (96%: 47/49) said they either ‘agree/strongly agree’ that faculty provided all the necessary information during live surgeries and video lectures. When asked about ‘How likely are you to recommend the course to your peers?’, 47/49 rated either =or>7/10, and 26 responded 10/10. Providing the course a net promoter score of...
  • Author: Dr.T.V.Rao MD Medical education is in an era of transformation, and medical Colleges are beginning to innovate to prepare new physicians for the emerging new model of care. the regulator ( MCI ) realized what all taught in the past is non-productive and making least skilled doctors to make effective decisions in time of managing simple cases and emergencies, The true crisis are reflected when the fully qualified teachers who are supposed to be mentors to bring in change do not meet to the challenges Today certainly the medical profession under scanner for various reasons just not the fault of students, starting from admission process lacking   inclination to profession and lack of work culture in the professional colleges, and much added by the poor teaching talents of the so called highly qualified teachers just born to spend time in the colleges for sake of MCI records and personal gains which least talents . in the process Almost didactic teaching is dying as same old son sung by many however we are in for change and many curricular changes in medical syllabus wish to make the teachers productive and the students to be better in critical thinking and analytical skills to perform the profession Studying medicine is very much a marathon, not a sprint. It is a 5- or 6-year course, The reason the course is so long is because of the volume of material that needs to be learned; both the basic scientific principles and the clinical skills needed to apply them must be taught. BEGIN YOUR LIFE AS A POSITIVE THINKER – Being a medical student puts you in a very privileged position, among the very top students across the country. It generally seems to be the case that medics follow the mantra “work hard, play hard”. Most importantly,...