Understanding Molecular Medicine and Its Major Advantages

Molecular medicine is a broad concept and it incorporates the study of molecular structures, identifying genetic errors for the cause of a disease, use medical nanotechnology to correct them. The fundamental concept of molecular medicine is the distribution of medicine to the body cells and it is similar to the assimilation of oxygen by a healthy human being. The discipline (molecular medicine) is new. It combines medical studies of modern times with biochemistry. It offers a bridge between today’s medical science and biochemistry. The course of molecular biology includes disciplines like biochemistry, immunology, and biotechnology. Nanotechnology in medicine has many advantages like it leads to diminished costs of treatment, cost-effective and yet high quality drugs. Nanotechnology in medicines help in effective diagnosis and treatment of diseases, it will lead to modern treatment methods, treating complicated medical problems can become simplified.

Benefits of molecular medicine

Molecular medicines and nanotechnology in medicine have their own advantages. These include the following:

  • Molecular medicines can lead to the invention of elegant and cheap surgical/diagnostic tools.
  • Medical diagnosis and research can become effective and efficient.
  • Nano medical devices can be implanted permanently to treat specific medical conditions.
  • Many medical conditions can be prevented.
  • Unknown diseases can be treated effectively.
  • This can lead to semi-automated diagnosis and treatment.
  • The nanotechnology in medicines help to reduce mortality rate, improve health.
  • Using gene therapy or similar treatment methods, organs can be replaced easily.
  • The different biological systems in the body can be improved.

When nanotechnology is applied in medicine then it is known as Nano medicine. It caters to the improvement of human health using Nano tools (tools at the molecular level) of the human body. Such technology in medicine encompasses areas like drug delivery using nano-particles.

The human body comprises of molecules, the use of molecular nanotechnology enhances progress in the human medical services. The Nano medicine helps to understand the functioning of the biological machinery inside the living cells. This understanding helps medical professionals to cater to complicated medical conditions like AIDS, cancer, ageing. All these help to bring a significant improvement of the natural human biological structure. The understanding helps to reduce mortality rate, ensure proper functioning at the molecular level of the humans.

The understanding of the molecular medicine has resulted in developing Nano particles/molecules to help transfer medicine to each cell of the body. For a sick or unhealthy entity, such developments in molecular biology lead to effective treatment of complicated diseases. Using Nano medicine, malignant cells within a human body can be tracked and then treated. This entire process includes targeting of bacteria/viruses/tumors within the body by Nano particles, treating infections, diseases.

Molecular medicine advantages

Other advantages of using Nano medicines are given as follows:-

With Nano medicines, treatment is gentle and advanced. Most of such treatments are non-invasive. Powerful drugs may have side effects which cannot be ignored. By using molecular medicines, one can reduce the effects of the drugs. Since the use of Nano medicines does not involve surgery therefore it is less painful. Another important advantage of using Nano medicine is that it involves small yet highly sensitive diagnostic tools which accounts for better treatment of diseases. Treatments using Nano technology in medicines are cost effective. It is effective to treat complicated medical conditions like cancer.

Nano medicine disadvantages:

Nano-particles used as part of nanotechnology in medicines uses biochemical pathways, affect the different biological processes of the human body. Under such circumstances, a lack of knowledge about the effects of the nano-particles on the human body, it processes can be a disadvantage. The researchers who deal with design of the nano-particles remain concerned about their toxicity and characterization on their exposure to the biological pathways. If the nano-particles are toxic then they can pose severe threat to the humans and the environment. The researchers remain concerned as the people part of the society use the molecular medicine. In certain instances, researchers remain in doubt of the possible outcome of the use of certain Nano medicines.

Nanotechnology in medicines have revolutionized medical treatment. The doctors now see a ray of hope to treat medical conditions and diseases which were not treatable earlier. Nano medicines have their own advantages. However, researches are on to make the most of nanotechnology in the days to come.

Cosmetic Medicines Ordering, Storage, Supply and Incident Reporting

This article gives an overview of the systems and processes that must be followed by cosmetic clinics when supplying prescription medicines.

A prescription medicine or drug legally requires a qualified doctor, dentist, nurse or pharmacist to write a prescription for a named patient. The list of drugs and prescribing qualifications may vary in different countries.

A cosmetic clinic must ensure that all medicines are ordered, stored and supplied within the legislative and other relevant pharmaceutical guidelines available.

Therefore ordering, storage and supply of medicines for use within the practice must be undertaken according to appropriate procedures and guidelines to ensure all relevant legislation and pharmaceutical information is adhered to.

Any medicines stored within a typical cosmetic clinic are those used for aesthetic purposes, this includes drugs such as Botox ® and Hyaluronidase. These must be stored according to manufacturer’s guidelines in a locked refrigerator or locked cabinet as appropriate. The temperature of the refrigerator should be monitored and documented daily. If the temperature is found to be outside the recommended range the pharmacy supplier must be informed as soon as possible and if necessary the medicines are returned to the supplier and a new supply obtained.

Supply of Medicines and Maintaining Patient Records for Cosmetic Clinics

The Medical Practitioner is responsible for maintaining a record of medicines obtained from the supplier for use during treatment. A copy of the prescription is retained in the patient’s notes and the following information is noted in the Medicines IN register. The Medical practitioner must include the following details:

– the name of the medicine (generic)

– the dose provided by the pharmacy

– the amount provided by the pharmacy

– the format of the medicine (oral I IM etc)

– the batch numbers and expiry dates

The Medical Practitioner is responsible for ensuring that details of the medicines administered are recorded in the patient notes, including:

– the name of the medicine (generic)

– the dose provided

– the route of administration

– the batch number and expiry date of the medicine

– the date and time of administration

The Medical Practitioner must also document in the Medicines OUT register the name of the patient the medicine was administered to and the date and time of administration. This will ensure an audit trail is available for each practitioner.

All medicines not used or expired must be returned to the pharmacy.

In conclusion only a medical professional should be accepted on a cosmetic training course. This will ensure all practitioners have experience with the use of prescription only medicines and record keeping. The medical practitioner who facilitates a cosmetic intervention should be a qualified doctor, dentist, nurse or pharmacist. These specialists have the prerequisite medical experience plus understand their legal and ethical requirements in prescribing, dispensing and administration of such drugs.

Any errors with the medication must be recorded and reported.

Reporting a Medication Incident

A cosmetic clinic must ensure that all medication incidents follow local legislative and other guidelines for your country of practice. The following is based on the UK CQC guidelines.

All practitioners involved with medication prescribing, dispensing or administration must be aware of the procedures to be followed in the event of a medication error or near miss.

Medication errors or near misses will occur despite having risk procedures in place, and all personnel involved in medication prescribing, dispensing or administration are at risk of being involved an error or a near miss. Because of this, comprehensive reporting of all medication incidents is crucial to enable the organization to learn from mistakes and improve practice wherever possible.

All incidents involving medication prescribing, dispensing or administration, ‘near misses’ and serious drug reactions must be documented on the Incident Report Form. A medication error is a preventable incident or omission that results in an increase in the risk of patient harm. A ‘near miss’ is a medication error that is discovered before it reaches the patient, thus preventing harm to the patient.

What to Report

The following are some of the issues that require an incident report:

– incorrect dose administered (both over and under dosing)

– incorrect route of administration

– incorrect rate of administration

– incorrect drug administered

– administration to the wrong patient

– failure to document administration in the patient’s medical notes

– administration of an expired drug

– prescribing errors

– incorrect labels

– allergies not recorded

– serious adverse effects including allergic reactions

Near Misses will also be recorded on the Incident Report form.

How to Report Medication errors

Medication errors involving administration to a patient will be documented in the patient’s notes. The Medical Practitioner should inform the patient.

The incident should be documented fully before the end of the day. This report form must be completed by the Medical Practitioner and given to the Practice Manager without delay.

Follow Up Procedures for Medication Errors

A follow-up is undertaken by the Medical Practitioner to ensure the safety of the patient. If necessary the patient must be referred to the nearest Emergency department for further review. The Practice Manager must undertake an investigation into the event ensuring a statement is taken from those involved.

The incident must be discussed at the next Clinical Governance meeting and an action plan developed to aim to prevent recurrence; this may include further training for the personnel involved.

Any severe medication incident must be reported to the within 24 hours of it occurring.

I hope you enjoyed the article. For more information about medicines and their regulations you can check with the Department of Health and MRHA in the UK. In the USA please refer to The Food and Drug Administration (FDA).

Knowing More About Injections for Low Back Pain

Dealing with lower back pain can be tough for some patients. At times, the pain is hard to manage, and painkillers might not be the right solution. Depending on the facts of the case, doctors may use epidural steroid injections. In this post, we will discuss some of the aspects of such injections in detail.

What’s an epidural steroid injection?

The use of injections for low back pain is limited to certain cases, but this is certainly one of the many ways to treat chronic pain. An epidural steroid injection essentially contains an anesthetic drug for pain relief with a corticosteroid. For the uninitiated, corticosteroid is a form of steroids known to have anti-inflammatory benefits. The injection helps in reducing the pressure from the nerves and surrounding areas and muscles, which can offer considerable respite, while the painkiller ensures immediate relief. Corticosteroids may work independently for pain relief, but since most patients want immediate effects, an anesthetic medicine is used.

Knowing the procedure

Please note that you cannot ask your doctor for epidural steroid injections. Unless the patient has stopped responding to nonsurgical treatments, doctors don’t try ESIs. In most cases, certain imaging tests are done, so as to find the right spot where the nerve roots at pressed or have a problem. In some cases, a x-ray machine may be used by the doctor, just to find the right point where the needle must be placed.

The need for epidural steroid injections

Typically, epidural steroid injections are used as the last resort to offer pain relief, especially in cases of extreme pain, often related to a condition known as “lumbar spinal stenosis”. This condition mainly starts from the lower spine and often spreads to the legs. There is limited information on how these injections may work in the long run, but like most steroid injections, this too offers relief for the next few weeks. It is always best to talk to your doctor, who can suggest more details in this regard. However, in cases of lumbar spinal stenosis, other treatments are tried and used as well.

What are the side effects?

There can be a few side effects with ESIs, but that varies from case to case. In most cases, the focus is on reducing the pain, so the minimal adverse effects are ignored. However, if you have issues with breathing or have swelling on your facial area, do contact your doctor immediately. There can be some pain at the injection site, but if that doesn’t subside in the next couple of days, check with your doctor. For immediate swelling at the injection site, you can use ice, which will also offer some relief from the associated pain.

Pain management clinics have a lot of information on epidural steroid injections. If you need to know more about lumbar spinal stenosis, you should consult a doctor at the earliest. With early intervention, other treatments may work more effectively for you, but it also depends on how you respond to the standard treatment plans.

Journey of a Drug: Design to Market Seller

Where do the medicines we take from chemists come from? How do the doctors know which drug is good for which disease? How the medicines really are able to cure a particular ailment they have been prescribed for? Do these questions come to your mind, whenever you buy any medicine?

Come, let us today know about the medicine development from the beginning

The development of medicine is called a Clinical Research and has different Phases. Phases of the clinical research are the steps of experiments with a health intervention in an attempt to find enough evidence for a process which the scientists think would be helpful in medical treatment.

The pharmaceutical study starts its journey from a drug design and drug molecule discovery which further progresses into animal testing and then human studies to see the drug’s effectiveness.

Drug undergoes many trials- Preclinical, Phase 0, Phase I, II, III and IV. Sometimes combined trials also are undertaken to reduce the time of development, like Phase I/II and II/III.

Pre-Clinical Study

When the drug molecule is identified, it undergoes many in vitro (test tube or cell culture) and in vivo (animal) experiments. These experiments are conducted to know the preliminary efficacy, toxicity, and pharmacokinetics of the various doses of the drug. Many drug molecules are designed at a time and these pre-clinical studies let the pharmaceutical companies decide which molecule has a greater potential in further studies.

Design of the Studies:

Trials are always conducted by following the set of steps, called the protocol, developed by the researchers to find the specific questions related to the medical product. Information from the prior studies become the base for the researchers to develop research questionnaire and objectives:

  • Participant selection
  • Number of participants
  • Duration of the study
  • Controlled or not
  • How and what dosage will be given
  • What and when the data will be collected
  • Review and analysis time

Phase 0 Study

It is also called micro-dosing trials, 10-15 human subjects are taken and single sub-therapeutic doses are administered to gather the pharmacokinetic (PK) data of the drug. This enables the company in deciding to go or no go for the further development of the drug, based on more relevant human data instead of animal data.

Such trials exceed the speed of promising drug development by establishing whether or not the drug acts on humans as expected in pre-clinical studies.

After the company decides to take the molecule of the drug forward in development, it will have to submit the data of its preliminary studies to the FDA called Investigation New Drug (IND) application filing.

Phase I Study

Also called First-in-man studies as these are the first stage of human testing studies. These are the studies which are designed to determine the maximum dose that can be administered without showing adverse effects.

Contract Research Organizations (CROs) conduct such studies in the clinical trial clinics where medical staff provides full-time attention to 2-100 healthy subjects enrolled for the study and collects the data.

These studies determine the safety (pharmacovigilance), tolerability, pharmacokinetics (PK)and pharmacodynamics (PD) of the drug. The design of Phase I studies is dose-ranging also called dose escalation studies conducted in controlled clinics called Central Pharmacological Units (CPUs).

Usually, healthy subjects are hired but sometimes terminally ill patients like of cancer and HIV and also those who have already tried and failed to improve on existing medications.

There are two divisions for Phase I study:

Phase Ia: Single ascending dose

Phase Ib: Multiple ascending dose

Phase II Study

More than 100 diseased subjects are enrolled for a longer period study, to know the benefits of the drug along with its safety which includes genetic testing. These studies are also called as “Proof of Concept or Pilot” studies.

This is the phase when the drug’s development can fail due to toxicity or less than expected results.

Two divisions of this phase are:

Phase IIa: Pilot study, to determine the clinical efficacy or the biological activity.

Phase IIb: Dose-finding study, to check the biological activity with minimal side-effects.

A combined trial determining the efficacy as well as toxicity are Phase I/II trials.

Phase III Study

These are pre-registration trials means the data of this study is submitted to the regulatory agency through New Drug Application (NDA) for its registration. Also called Pre-marketing or Pivotal trials.

Such studies are multi-central, randomized, in large diseased population (more than 500) with much longer duration of treatment and short follow up period, to determine the long-term safety and efficacy of the drug.

Even if the regulatory submission is pending, the drug is received by the patients in case it’s a lifesaving drug until the drug can be purchased.

‘Label expansion’ that is drug can treat an additional disease, other than the disease for which the drug is already approved, may also be the reason for running the Phase III trial.

It is said that for FDA (United States Food and Drug Administration) and MHRA (United Kingdom’s Medicines and Health products Regulatory Agency) needs at least two trials of successful trials data to register the drug.

After these trials, the drug is approved for market selling.

Phase IV Study

These are Post Market Safety Monitoring studies done after the drug is registered. Also called Late Phase or Confirmatory trials.

This kind of study determines the long-term adverse effects on the much larger population for a very long duration (at least 2 years). If harmful effects are detected in this study, then the drug is disapproved and the company has to retrieve the drug from the market as it can no longer be sold.

The entire journey of the drug from a molecule to a market selling product takes around 15-20 years.

An Analgesic Pill a Day Keeps the Chills and Aches Away

Over The Counter (OTC) Analgesics or painkillers are drugs that act at different levels of the pain transmission pathway. Aspirin and other non-steroidal anti-inflammatory agents (NSAIDs) and many others act peripherally, while some others agents, such as opioids act on the central nervous system (CNS). While anticonvulsants act on neurogenic pain, muscle relaxants act on pain due to muscle spasm. These analgesics are helpful in pain management; however, they also have adverse effects.

The reasons for the growth of the OTC analgesics market

  • Increasing demand for topical analgesics, which are available as pain-relieving creams, lotions, rubs, gels, and sprays. This has increased the sale of analgesics by 18%, according to Kline Nonprescription Drugs USA report.
  • Increasing global geriatric population is expected to generate higher demand for pain relief products. In the United States, about 23% of the people were expected to cross 55 years of age in 2015.
  • Product innovation to improve performance, in terms of speed and strength, and further, improve the length of the effect.
  • Cost saving, as there would be no need to visit a doctor/physician. It is estimated that the US healthcare system saves USD 6-7 for every USD 1 spent on OTC medicines.

However, anything in excess can take a toll and it is no different with OTC analgesics. The common side-effects include constipation, drowsiness, dizziness, upset stomach, heart attack or stroke. These drugs can cause serious changes in the brain and body. Long-term use of painkillers increases addiction and dependency on the drugs. In the United States, painkillers are the second most abused substances, after marijuana. Pain, in some form or the other, is part of one’s daily life, hence, the need for painkillers.

A report by a market research firm estimates a double-digit growth rate for the Global OTC Analgesics Market, estimated to become a market worth USD 20.79 billion by 2022.

The OTC analgesics market is driven by the better performance of premium-priced branded products as compared to generic OTC analgesics.

Hurdles for the market include:

Uncontrolled prescription of opioids, drug abuse, and unregulated government policies are acting as hurdles for this market.

The Way Ahead:

Innovation in OTC analgesics, like absorption dimension that drives a fast action of analgesics, improved performance, multi-action of analgesics, and high specialization in reducing symptoms of specific ailments, are expected to drive market in the future. Availability of various analgesic drugs in online, owing to increasing number of online pharmacies, is driving the OTC analgesics market.

A Few Things To Know About Sport Physicals

Many parents choose to have a sports physical conducted on their children during the summer. This makes sure they are ready for another activity filled sports season while last minute, mad rushes to the physician are avoided. Although most parents know that they need to get a sports physical conducted on your child, in order for him/her to participate in athletics, there are still a few unanswered questions.

How Should I Prepare Myself For This Checkup?

Make a list of questions about your child’s health and well being, should you experience any concerns or alarming signs. Ask your child if there is anything they s/he would like to ask the examiner. Take the medical history of your family and your child’s medical history reports with you.

Do Parents Need To Be Present At This Check Up?

Minors under the age of 18 require parental consent in order to have a sports physical performed. Parents also need to fill up the health history portion of the form. All in all, it is best that you are present for your child’s physical.

Is It Required For School Sports?

Yes, most schools do need a pre-participation checkup before enrolling students into their many athletic programs.

For How Long Is The Report Valid?

The report that you get is generally valid for one year. You need to pay special attention to this duration. Students who fail to go for this checkup can be disallowed from participating in sport and athletic activities.

What Should You Expect During The Procedure?

During a procedure, a child’s blood pressure, height and weight are checked. The physician will also look at the lungs, heart and spine. The immunization schedule will be reviewed and signs of puberty will also be taken into consideration.

What Is The Difference Between An Annual And Sports Physical?

Although an annual physical is the same as a sports physical, you go in for a sports physical when your child wants to involve himself/herself in a sport or physical activity. In such cases, the sports physical can be incorporated into the annual physical.

How Can I Prepare My Child For The Upcoming Check Up?

Sit down and have a thorough conversation with your child. Tell him/her about the procedure that is to be conducted and that there is nothing to worry or be fearful about.

These are just a few answers to some of the most frequently asked questions about this checkup.

Knowing the Basics of Interventional Pain Management

Anyone, who is dealing with chronic and/or acute pain, knows the “pain” associated with the condition. In most cases, patients spend a considerable amount of time with primary care doctors, physical therapist, and specialists, hoping to find a more permanent solution. Interventional pain management is a practical alternative in such cases, where the concerned patient has tried all other treatment options.

Understanding interventional pain management

Interventional pain management is a specialized field in medicine that deals with the diagnosis and treatment of chronic and/or acute pain and other related disorders. This is more of a “multidisciplinary” approach, which is offered by a team of experienced doctors and healthcare professionals. With interventional pain management, doctors aim to reduce chronic and or acute pain, besides focusing on better living. The treatment is entirely different from other forms of pain management because there is no direct dependency on pain-relief medications. In most cases, a physician may refer the matter to a pain management doctor, who will decide on the line of treatment, depending on the facts of the case. In case of interventional pain management, pain management physician will work together with chiropractors, physical therapists, occupational therapists, psychologists, neurologist, and orthopaedic surgeon as needed to treat the condition by utilizing minimally invasive procedures such as epidural injections, facet blocks, trigger point injections, etc.

Things worth knowing

Interventional pain management is particularly beneficial for patients who are suffering from neck and back pain. Physicians may use more than one approach to the condition, depending on the diagnosis. The use of steroidal injections in the joints and epidural space is quite common, while injections are also used to treat a spinal nerve root, which is diagnosed as the source of pain. Branch blocks are also used for diagnostic purpose followed by radiofrequency ablation, while doctors may also use additional injections in the facet joints. Discography is also utilized to find the possible cause of pain, and in this procedure, a special dye is used in an injectable form into a disc to understand the pathology better.

In some cases, minimally-invasive procedures like “Radiofrequency Ablation” can be used for the medical branches, so as to restrict the movement of pain signals. Doctors may also suggest the use of heated electrodes for certain nerves that carry the pain signals, and this process is also known better as Rhizotomy. Not to forget, physical therapy and other forms of occupational therapies are also used for the treatment. Doctors also suggest lifestyle changes to patients, if they find any hope for better health.

The first appointment

You need to visit an Interventional Pain Management specialist, who will do a thorough exam to understand the possible concerns and issues related to the condition. Doctors may also suggest a few tests including x-rays and MRI for accurate diagnosis. You must also discuss the other kinds of treatments you have tried for your condition, and as required, doctors may suggest a line of therapy, after discussing the expectations, costs and other aspects.

Ethical Dilemmas Doctors Have to Confront

The ethics and professionalism in medicine are of core importance when it comes to the role of the physician in his code of conduct.

With the great prestige and nobility in this profession comes the great responsibility in doctor’s hand, as they have to go through quandary in situations when it comes to cases like euthanasia, abortion, making a decision of who even makes it onto a waiting list for organ transplant, quick and life-changing decisions, psychological pressure from the loved ones of the patient, the patients family blame the doctors if the patient is unable to make during surgery, they should understand that death is imminent and the doctors do, whatever they can to save a life.

The doctor must explain the procedure to the patient and give him full information about the benefits, risks, positive and negative effects, leaving up to the patient to make the choice about undergoing the surgical procedure. The doctor should not perform the surgical intervention, only taking into consideration his personal gains and benefits. His first priority always has to be the patients’ health and to act in the best interest to protect the patient from any kind of harm. The doctor should be impartial when it comes to the selection of deserving cases and their needs, and on the basis of their degree of sickness.

The one of the most important and foremost ethical concern is taking an informed consent. Informed Consent is taken in advance from the patient, it is an agreement or a gesture to permit the doctor to have his medical history, undergo examination procedure, diagnosis, treatment, and intervention. The patient should be competent, well aware; mentally and emotionally stable. In some cases, the patient in spite, of his serious condition, refuse to agree with the intervention or surgical procedure, where then doctors have to make a decision for the welfare of the patient.

The information of the patient can only be breached if:

  1. himself asks the physician.
  2. In the case of children, the information is conveyed to the parents; as they are very
    young to handle their condition.
  3. There is a need of the help of the healthcare team in solving the case. Whether, the disclosure is for the criminal investigation of crime or harm to others, assault case, protecting the vulnerable; such as in child abuse case.
  4. For research purposes but only as anonymous and after taking consent from the patient.
  5. When it comes to public interests it may be breached when a patient has a highly contagious disease such as tuberculosis; the doctor has to inform the patients family so that precautionary measures can be taken. If the patient has a sexually transmitted disease, let’s say HIV which is a communicable disease, the doctor may disclose his disease to his partner in order to protect from the risk of getting the disease.
  6. State registries where officials keep track of cases like diabetes, cancer, HIV/AIDS, Alzheimer disease, Amyotrophic lateral sclerosis, and many other diseases.

It is the duty of the doctor to act in his best interest while dealing with a case, abide by the principles in common clinical situations, and work in the beneficence of the patient and do no harm in the treatment procedure.
The common ethical conundrums that doctors’ have to face in their course of profession:-

1- Euthanasia:

Euthanasia or physician-assisted suicide is considered as one of the supreme problems when it comes to ethics of patients treatment. The decision of euthanasia by the patient or his family is made in order to reduce the suffering of the patient in his terminal sickness. It can be voluntary or involuntary. When the patient makes a decision, it is voluntary. When the physician makes a decision it is involuntary. However, may it be voluntary or involuntary, it is unethical.

The World Medical Association issued the following declaration on euthanasia:-

“Euthanasia, that is the act of deliberately ending the life of a patient, even at his own request or at the request of his close relatives, is unethical. This does not prevent the physician from respecting the will of a patient to allow the natural process of death to follow its course in the terminal phase of sickness.”

2- Staying within their boundaries:

Doctors have to work long hours, off work, and even operate in odd hours in hospital settings and have to treat patients irrespective of their age, gender, and other attributes. They have to work in coordination with other staff members, the nurses, anesthesiologist, interns, assistants and many related members. Personal relationship or intimate relationship between the doctor and any other member like, his fellow, intern, other staff member is unethical and is prohibited. Patients often offer gifts to the doctors when their treatment intervention has been successful, or when the surgery goes well. It is quite fine, to accept those gifts as long as they are in the form of sweets or bouquet. The patient who brings gifts during the intervention may cause trouble, it may be the sign the patient needs more of the doctors’ attention. The physician should simply show reluctance to such presents and should not accept them by justifying that its’ against the ethics of their respective field.

3- Organ transplant:

Unfortunately, the availability of the transplant organs is far less, than their demand. Doctors have to make a tough decision here, that who will receive the next available organ and who will not, keeping in view the whole scenario, and what criteria is used for determining the donor. The surgeon should opt to give the transplant organ to the deserving patient on the list, on the basis of his health condition.

The physician should be approachable, equitable, able to communicate effectively and compassionately respecting the dignity of the patient regardless of his race, ethnicity, cast, choice of lifestyle. He should be dedicated to his profession, attenuate the pain of the patient by all means, preserving the health and enhancing the quality of life.

The Weakness of Contemporary Cultural Medicine

The term Cultural Medicine is used to refer to changes to a medical system provided specifically to reach out to and serve a diverse culture. The title is applied differently than Integrative Medicine. Integrative Medicine acknowledges that there are different preventive and reactive ways to address issues of preventive health, health maintenance, disease, injury and medical care (IntgMed), many of them cross-cultural. Cultural Medicine is applied to all that is not specifically IntgMed. Rather, it is that which supports underlying layers of infrastructure required to deliver ever-expanding, culture-specific positions, products and services, rather than focused, inclusive services.

An example of inclusive delivery is recognition that the national language is English. A focused, nationally oriented, fully integrative system of medicine would acknowledge the beneficial elements of all IntgMed, but it would be delivered in English (except non-translatable elements). This approach encourages all citizens to learn and excel in English and markedly limits the cost of IntgMed products/services components delivery. If for example, government-paid and/or delivered services focus on delivering a more culture-neutral, English-based IntgMed service only, costs would be markedly reduced and all citizen-consumers would be encouraged to become more English-language proficient. As an aside, pharmaceutical products, medical technologies, acupuncture needles, physical therapeutic manipulations and exercises, and other key elements of IntgMed do not recognize the human body as gender, ethnicity or culture-specific – they simply perform functions. Such subdivisions are behaviors of service providers.

One of the primary sets of questions ignored by state and U.S. governmental agencies are:

  1. Who is most qualified to determine if a proposal or intervention should be that in which we should invest given all other needs, ideas, and proposals?
  2. Who should be responsible for payment for this proposal/intervention if we proceed with it?
  3. Define success. What does it look like?
  4. When (initial and follow-up) and how shall we measure the effectiveness of the subsequent program, service, or intervention?
  5. Is it not appropriate for payers (e.g., public taxpayers) to receive easily accessible, unbiased reporting of interim services delivery progress and performance measurements?”, and
  6. What will we do if measured results are not as expected and desired (e.g., inadequate Return on Investment)?

If you took your car in for service, paid for the services, and only fifty percent of the claimed fixes were effective, would you be satisfied? No, you would not be satisfied. If the same automotive repair company employed you, yet still provided you and your peers with the above-described poor service, would you then be satisfied and recommend to your friends that they should be satisfied in similar circumstances? You should respond, “No.” You should not be favorably biased toward the repair company simply because it employs you. However, government initiatives usually provide many millions, if not billions of dollars to the recipients of their investments, including the creation of well-paying jobs. And, unlike as would be the case in private industry, recipients of these public windfall monies and opportunities are loath to give up your tax money, and are often willing to publicly denigrate you for demanding that they be held accountable (e.g., fix the entire car as promised versus aren’t you satisfied with partial function?)

There are numerous governmental pseudo-medical/medical programs that are abysmal failures, that continue to expand. In spite of their prolonged failures at missions to curtail drug abuse, misuse, pharmaceutical products-related deaths, decrease STD/STI incidence, minimize gender-critical maladies, and social disruptions due to related issues, the programs and funding persist. With grand budgets and swollen senses of importance and entitlement, no one receives good answers to above listed six questions from these program representatives. Such are the effects and weaknesses of contemporary Cultural Medicine. Everyone in the culture, position-empowered or not, rich and poor, citizens or not, payers or not, aware of and sensitive to current budget constraints or not, believes that they should receive timely, broad-based, sometimes very expensive, individualized care and financing of their programs. And, numerous cultural subgroups (geographic, ethnic, gender-specific, age-specific, financial, religious, secular, other) with sufficient financing and/or sophisticated representation, lobby for special consideration. To suggest that they do not have the right to do so would be politically incorrect and insensitive, right?

Contact your local, regional, state and national government representatives to determine how they are addressing the weakness of contemporary Cultural Medicine in your neighborhood.

Kidney Transplant – Patient Assessment Factors

When kidneys stop working effectively, you either have an option of a dialysis or a kidney transplant. Dialysis ensures that you get rid of the waste products from your body but it does not replace all the functions of the kidneys. When you are diagnosed with failing kidneys, treatment can sometimes prevent or at least delay their complete failure.

However, with a transplant, your body can continuously remove the waste products of metabolism, and excess fluid. Kidneys also help in the production of a natural hormone called erythropoietin that prevents anemia. It also helps convert the vitamin D in food into an active compound that helps keep bones healthy. Moreover, it helps excretion of some toxic drugs. Finally, it plays an important role in helping control blood pressure.

Kidneys normally undertake all these functions. It is a known fact that kidney transplant provides patients with a better quality of life than dialysis.

Assessment for kidney transplant

There are a few very important factors to be checked before you undergo kidney transplant surgery. To begin with, you will be referred to transplant only when you are nearing or have started dialysis.

  • There is no dependency on age factor or ethnic background when it comes to assessment for a transplant. It all depends on whether you are fit enough to have the operation and deal with all the after effects of the surgery.
  • Some of the factors checked are evidence of heart disease, chest conditions and other problems. Special investigations are conducted to assess whether these risk factors are too great for transplant.
  • Next there will be a thorough discussion between the specialists such as the surgeons, nephrologist, cardiologist and the physician before the decision is finalized.
  • Once you are considered fit enough for a transplant, the specialists will explain all the risks and benefits to you.
  • Many times there is a waiting list for a transplant.
  • There will be a number of tests conducted to check whether you have had certain virus infections.
  • Well, the specialists will also ask you whether you have any close friends or family who are willing to be live donors.
  • Live donor transplants are known to give the kidneys a better chance of long term survival as compared to diseased donor transplants.

Whether you receive a particular donor kidney or not is determined initially by the blood group. It is pretty difficult to get two people to be perfectly alike, because the genes are different. It is however possible to achieve a good enough match for a successful transplant. The surgery takes around three hours and appropriate care needs to be taken post operation too.