Issue#02  (Sep-Oct 2008)
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Published by CP for Pak Health Professionals in MENA Region

From the Editor's Desk

Welcome to the second issue of HeartBeat-The CP newsletter for Health Professionals.
We did not get many feedbacks about the first issue and similarly we did not get many articles. We concluded that there were two possibilities. Either ‘all was OK’ or ‘No body liked it’. Logically ‘All OK’ is impossible in the very beginning of this newsletter; therefore we worked on the hypothesis that ‘No body Liked it” and tried our level best to improve the second issue. We have added new sections and made improvements in some of the sections launched in the first issue.

From the feedbacks we would specially mention one; where one of our colleagues wrote that “no one will read HeartBeat for knowledge as there are plenty of renowned medical journals available”. Our response was this that firstly we have brought out a Newsletter, not a journal and secondly every renowned publication must make a start first to gradually become renowned! Similarly on another valuable feedback the name ‘Sister’s corner’ has been changed as it was not liked at all.

However our biggest handicap remains “not enough material to make a Newsletter”. We request all of you to kindly send us material to include in this news letter. We request representation of all the sectors of health sciences … Doctors, Nurses, Biomedical Engineers, Pharmacists, Technologists, Paramedics, Contemporary Medicine.

We make a special request to kindly send us your own hospital (or place of work) news and photographs, to make HeartBeat a proper Newsletter.

We are open to suggestions and we will love to have feedback from you to improve the quality and contents of the next issue.

With best regards

HeatBeat Team

Email: Medical@ContactPakistan.com

   

Title:              Emergency Congress

Venue:           Abu Dhabi National Exhibition Centre, Abu Dhabi, UAE

Dates:            26-28 October 2008

Website:        www.emergencycongress.com

 

Title:              Patient Safety: Infection Control Congress

Venue:           Abu Dhabi National Exhibition Centre, Abu Dhabi, UAE

Dates:            26-28 October 2008

Website:        http://www.abudhabimed.com

 

Title:              Primary Health Care Congress

Venue:           Abu Dhabi National Exhibition Centre, Abu Dhabi, UAE

Dates:            26-28 October 2008

Website:        http://www.abudhabimed.com

 

Title:             International Family Medicine Symposium

Venue:          Jeddah, Saudi Arabia

Dates:           27 to 28 October 2008

Website:       http://www.familymedicinejeddah.com

 

Title:             Frontiers in Surgical Pathology Symposium

Venue:          King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

Dates:           28-29 October 2008

Website:       www.kfshrc.edu.sa/symposia

 

Title:            Qatar Primary Health Care-2008

Venue:         Doha, Qatar

Dates:          1 to 4 November 2008

E-mail:         PHC.conf2008@nha.org.qa

 

 In this section we will present articles specially written for HeartBeat on current topics with an idea of continuing medical education (CME).

In this issue we are presenting an article specially written for HeartBeat by
Dr Mansoor A. Farooqi (FCPS, FRCSED) that will form basis for referral of patients with Myopia for LASIK surgery. This article is mainly directed towards general practitioners.

                                 

Nursing is the backbone of Medical Profession. Pakistani Nurses in the Middle East are a benchmark of quality in patient care. Nurses Special will be written, edited and managed by these sisters of ours who have truly made us proud of our country by their dedicated hard work.
 


 
Know the Place
 where WE Work

Hospital is apparently "just another building", made up of same steel, concrete, fiber and glass. However not everyone knows the complexities involved in planning and placing each and every brick of this highly sophisticate structure designed for catering to some of the most dangerous situations faced by humans. HeartBeat expert of hospital engineering will try to highlight these very complex issues in simple language.


 

Interaction with patients, patients relatives and general public is part of a health professional's life. This is usually coupled with immensely tense decision making moments for patients as well as health professionals. This gives rise to classical scenario for slip of tongue & interesting behaviors, both in health professionals and in patients. When we are free we recall these events to relax our tense nerves and "laugh it out".


 

HeartBeat Experts have selected a few abstracts from the most recent issues of reputed medical journals with an idea of continuing medical education (CME). This issue includes abstracts on following topics:

  • Estrogen in severe mental illness

  • Recombinant erythropoietin for neuroprotection

  • Serum carcinoembryonic antigen kinetic for chemotherapy monitoring in colorectal cancer.

  • Sildenafil treatment of women with antidepressant-associated sexual dysfunction

  • Immediate versus delayed axillary node dissection in breast cancer

  • Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction

  • Rapid, alternative methods to identify multidrug-resistant tuberculosis

  • Relation of iron and red meat intake to blood pressure

  • Drug-prescribing patterns during pregnancy in Pakistan

  • Effect of intermittent preventive treatment of malaria on health and education in schoolchildren

 


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  • Here's good advice for practice: go into partnership with nature; she does more than half the work and asks none of the fee.  (Martin H. Fischer)
  • When you treat a disease, first treat the mind.  (Chen Jen)
  • Symptoms are the body's mother tongue; signs are in a foreign language.  (John Brown)
  • A drug is that substance which, when injected into a rat, will produce a scientific report.  (Author Unknown)
  • Patients may recover in spite of drugs or because of them.  (J.H. Gaddum)
  • He's the best physician that knows the worthlessness of the most medicines.  (Benjamin Franklin)
  • When a lot of remedies are suggested for a disease, that means it cannot be cured. (Anton Chekhov, The Cherry Orchard)
  • The fact that your patient gets well does not prove that your diagnosis was correct. (Samuel J. Meltzer)
  • Our profession is the only one which works unceasingly to annihilate itself. (Martin H. Fischer)
  • On Judgment Day our profession will have a lot to answer for!  We might at least have withheld our hands instead of making them work against God. (Martin H. Fischer)
  • One doctor makes work for another. (English Proverb)
  • Doctors are just the same as lawyers; the only difference is that lawyers merely rob you, whereas doctors rob you and kill you, too. (Anton Chekhov, Ivanov)
  • Formerly, when religion was strong and science weak, men mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic. (Thomas Szasz, The Second Sin, 1973)

An AMA-convened expert commission offers recommendations to doctors about how to assess, treat and prevent excess pounds for their young patients
 

Comfort of sofa, Play Station, television, soda pop and super sized meals are causing children to put on excessive weight. In the US the statistics of the Centers for Disease Control and Prevention's are startling. Survey data taken in 1971 to 1974 and 2003 to 2004 show that the percentage of overweight children jumped from 5% to 13.9% for children ages 2 to 5, from 4% to 18.8% for ages 6 to 11, and from 6.1% to 17.4% for kids 12 to 19.

The American Medical Association in 2004 declared obesity in children (and adults) a major public health problem. The Association adopted policy promising to collaborate on recommendations to address the issue.

Now, that effort has borne fruit. Last month, the AMA-convened Expert Committee on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity released recommendations for physicians on how to help their young patients with weight problems. The project, which began in 2005, was co-funded in collaboration with the Centers for Disease Control and Prevention and the Health Resources and Services Administration.

The 22 recommendations cover assessment, treatment and prevention. The panel, consisting of representatives from 15 health professional organizations, says doctors should assess kids yearly for height, weight and body mass index and plot the results on standard growth charts.

It recommends that during well-child visits, physicians assess the dietary and physical activity patterns of all youngsters, not just those with weight problems, and discuss weight management and lifestyle with them and their caregivers. The full list of recommendations is online (www.ama-assn.org/ama/pub/category/11759.html).

 

Salsalate- A arthritis drug helps in diabetes

Doctors have turned back the clock more than 100 years to rediscover a drug that can help the more than 15 million people in the United States with type 2 diabetes. It's one drug that may provide twice the relief.

The drug called salsalate is currently approved to treat joint pain, but researchers say it may have a dual purpose for those with type 2 diabetes.

"We've shown that using the drug for short periods of time can lower blood sugars both before people eat and after they eat and their average blood sugar measurements over time," Allison Goldfine, M.D., clinical research head at the Joslin Diabetes Center in Boston, Mass., explained to Ivanhoe.

Researchers say just like it reduces inflammation in joints, salsalate does the same in other tissues. That in turn, may lower blood sugar levels in people with type 2 diabetes.

After a little more digging, doctors realized they had landed on a path that was forged more than 100 years ago. A medical journal dating back to 1876 reported using salicylate, the simple form of salsalate, to treat a patient with diabetes.

"It's one of those rare moments in doing science where we actually can say, 'Ah, ha! We made a discovery!' There's something new here," Steven Shoelson, M.D., Ph.D., a medical researcher at Joslin Diabetes Center said.

Researchers say salsalate has a good safety profile and is inexpensive. Broader studies on the drug were just completed in 13 states. Researchers plan to release the findings in a couple of months. A much larger trial is planned for later this year and will be conducted at 20 sites across the nation.

Rapid weight gain in children tied to higher blood pressure later

According to a study published online Sept. 2 in Hypertension: Journal of the American Heart Assn. infants and toddlers who add pounds quickly tend to have higher blood pressures as adults,

Researchers analyzed data on 679 participants in the Barry Caerphilly Growth study, a randomized controlled trial of infant nutrition from 1972 to 1974 in two small towns in Wales. Babies who were lighter at birth or gained weight rapidly in the first five months of life had higher systolic blood pressures as adults. Those who added significant weight from age 2 to 5 also had greater systolics.

The authors suggest that, although this study did not find that the rate of weight change affected an individual's long-term chance of developing hypertension, the increased risk for higher blood pressures may be important for population health.

"At an individual level, these changes would not be very important but in public health terms they are relevant," said Dr. Yoav Ben-Shlomo, lead author and professor of clinical epidemiology at the University of Bristol in England.

 Leave That Ear Wax Alone
New guidelines say most people don't need to remove it

 

Wax blockage in the ear

When it comes to ear wax, it's best to leave it alone, new national guidelines state.

While many people feel they need to remove ear wax—technically called cerumen and a mixture of secretion, hair and dead skin—it is actually protective since it has lubricating and antibacterial properties, said Dr. Peter Roland, an ear specialist at the University of Texas Southwestern Medical Center at Dallas. He chaired a panel that released new guidelines Friday from the American Academy of Otolaryngology–Head and Neck Surgery Foundation.

The guidelines are the first comprehensive clinical recommendations meant to help health-care professionals identify patients with impacted wax and treat them properly. Panel members reviewed scientific studies and sought expert opinion to create the guidelines.

"The conclusion is that the mere presence of ear wax does not require anything," Roland said. If the ears are functioning, and there is no problem, most people should do nothing. And that includes resisting the urge to use a cotton-tipped swab to clean out the ear, he said.

Using a swab can actually drive excess wax in further, he said, and then medical attention is often needed to remove it.

Certain people need to pay more attention to their ear wax status, he said. Those who wear a hearing aid, Roland said, "are much more likely to develop problems with ear wax." That's because the hearing aid "prevents the ear from doing its job," which is to clean out excess ear wax naturally.

As people age, ear wax problems are more common, too, he said, with those over age 65 more likely to have problems than younger people.

The guidelines, composed by a panel of experts from otolaryngology, family medicine, internal medicine, nursing, audiology, pediatrics and nursing, included some key points:

Ear wax is beneficial and self-cleaning.

Hearing aid wearers should get their ears cleaned once or twice a year by a health-care professional to avoid wax buildup, which can cause hearing aid feedback or even damage the device.

When ear wax blocks 80 percent or more of the ear canal diameter, it can result in reversible hearing loss.

About 12 million people in the United States seek medical care each year for impacted ear wax, according to the guidelines. The panel advises the use of wax-dissolving agents such as water and saline to dislodge it by a professional. Irrigation, manual removal with special instruments or ear syringes are other options.

The guidelines advise against the use of cotton-tipped swabs, oral jet irrigators and ear candling (the use of cone-shaped candles that are lit to draw out the wax).

These guidelines are followed already by the majority of ear-nose-throat doctors. The written recommendations may now help other specialists, such as pediatricians, care for patients with ear wax problems.

Source: American Academy of Otolaryngology–Head and Neck Surgery. (http://www.entnet.org/HealthInformation/earwax.cfm)

 

 

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