Differential justice- Evaluation & compensation of ‘hundreds of healthy deaths’ vs one hospital death #Odisha-train-accident

But the evaluation and compensation of ‘Death’ in this new era of consumerism has become a story of paradox. Compare the situation when someone is admitted in hospital for a serious ailment to a healthy person who is travelling happily in train. It doesn’t require an Einstein’s brain to compare, who is more at risk for death. Although death in both situation is sad but the differential compensation formulas applied by courts and justice systems require a relook in these both the situations. Accidents can happen everywhere. It can be on roads, trains or in the air and more possible in the hospital, when doctors are trying to save a critically sick patients. Chances are more in hospital as situation is akin to as doctors are trying to fly a defective aeroplane. Medical accidents are usually interpreted as medical negligence. Ironically, genuine mistakes or even a natural poor outcome, an impression is created as if the doctors have killed a healthy person and is assumed as a doctor’s fault. Not uncommonly doctors become punching bags as a revenge in case of a hospitalized death. The

Death is the inevitable conclusion of life, a universal destiny that all living creatures share. Death can occur through conflict, accident, natural disaster, pandemic, violence, suicide, neglect, or disease. But the evaluation and compensation of ‘Death’ in this new era of consumerism has become a story of paradox. Compare the situation when someone is admitted in hospital for a serious ailment to a healthy person who is travelling happily in train. It doesn’t require an Einstein’s brain to compare, who is more at risk for death. Although death in both situation is sad but the differential compensation formulas applied by courts and justice systems require a re-look in both the situations.

Accidents can happen everywhere. It can be on roads, trains or in the air and more possible in the hospital, when doctors are trying to save a critically sick patients. Chances are more in hospital as situation is akin to as doctors are trying to fly a defective aeroplane.

Medical accidents are usually interpreted as medical negligence. Ironically, for genuine mistakes or even a natural poor outcome, an impression is created as if the doctors have killed a healthy person and is assumed as a doctor’s fault. Not uncommonly doctors become punching bags as a revenge in case of a hospitalized death. The death is more perceived as failure of medical treatment rather than an invincible power or a certain final event. But all these issues are variable and depend upon understanding level and wisdom of people. What is surprising is the non-uniformity of courts and justice systems in evaluating and compensation of death. For hospital death alleged due to medical negligence – compensation formula is applied that is not used for other hundreds of healthy deaths.

Coromandel –Odisha- train accident

An unfortunate incident of train accident causing hundreds of untimely deaths happened yesterday. In fact the burden of negligence here (like a train accident- hundreds of deaths) in healthy deaths is massive and these deaths are unpardonable.

It will be interesting to see how courts apply the formula for compensation in hundreds of healthy deaths due to negligence as is applied in cases of medical negligence when someone has poor outcome.

That brings forth a fundamental question. Why compensation to death is not uniform? Why medical profession is handed over a harsher punishment and pays a higher compensation (while trying to treat) for a death which is more natural and consequence to some disease? Why for compensation in hundreds of healthy deaths that was completely unnatural – same formula is not applied?

Such differential evaluation and compensation of death is not only illogical and unreasonable but a grave injustice to medical profession. Point to ponder- if trying to save someone’s life raises a risk of heavy compensations, why should doctors do it?

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

Exorbitantly expensive medical education and lowered merit

June 4, 2023 10

Award of Medical Degree – Get Label of ‘Thief’ or ‘Butcher’ #NO-TO-RTH

Has the time come to say ‘no to medical profession’? At least paying millions and becoming a doctor is not worth it.

Movements like #NO-TO-RTH are result of long standing humiliation of medical profession.

Social media and celebrities have rewired the people’s mind against medical profession. It has created a terrifying picture about the harm that doctors do to patients. The turmoil against medical profession in the society is linked to social media that exploits the deep wired craving of patients to know more about the “realities”. This hot emotion, generating a sense of threat to them in hospitals, is exactly what they are designed to provoke. Especial comments- facts or not- produces entirely different reactions. The analytical comments about the possible harm awaken negative thinking, tribal instinct, and hardens opinion one way or other.

Media, celebrities and others are getting away with making disparaging remarks and doctors have no mechanism to retaliate. The hurtful blabber continues at will. By theatrically deriding hard work of doctors, they grabbed eyeballs to be at the centre stage of health care and prove their relevance to the system.

Among millions of patients being treated every day, there are bound to be few handfuls of adverse events, poor outcomes. Media, lawyers and other opportunistic elements sniff those few incidents and discuss it with distorted version that rewards are instantaneous.

Talking about death, negligence in medical care on media is a frightening topic and not without consequences. Ethical lines are crossed frequently. Negative emotions are generated like hate, anger and hurt and usually instigating against the medical profession. By use of few provocative words, the media can be set on metaphorical fire; the populism statistics hit the roof. The negative projection played in a peculiar way rules the internet and television. The media journalist hits an instantaneous stardom.

In the mad game for popularity, cross ethical lines and create rifts. They embellish it with more provocative words and share it with their name hoping to drive more engagement.

With no strong retaliation from doctors’ associations, shrugging and ignoring by individual doctors has made medical profession not only a scapegoat but a medium to gain cheap popularity for everyone who can publically bash the medical community. Doctors’ associations have failed to fight to save dignity and pride of their members.

In such unfavourable and hostile circumstances, medical students paying crores to get medical college seat is like getting into a trouble zone and getting entrapped into a system of exploitation and may be a self-bought disaster. Someone paying for being a doctor in millions and crores is an absurd thought and highly ill advised. For the candidates who are not financially strong, it may be difficult to even recover the money spent, what to say about the time and youth wasted in getting a degree which may or may not be that worth.

The painful aspect is that after a medical student is awarded a degree, he becomes part of the community that is labelled as ‘thief’ or ‘butcher’ or ‘worst’ on various platform openly by media and prominent people. Sadly no action is taken for their public humiliation and passed as a routine issue. Courts and human right commission also remain silent on grave injustice to this educated and hard working community.

Has the time come to say ‘no to medical profession’? At least paying millions and becoming a doctor is not worth it.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

Exorbitantly expensive medical education and lowered merit

March 31, 2023 0

Struggle for professional independence: #RTH-Rajasthan doctors are global leaders

In the present era, Doctors are ebbed from all sides, need to earn back the dignity of profession and resist oppression. The phenomenon of oppression in the name of medical- regulation is a global issue. The oppressive schemes in the misleading names like #RTH Rajasthan (RIGHT TO HEALTH) are prevalent everywhere globally in some form or another.

Doctors and nurses have been reduced to no more than moral and economical slaves either by industry or administrators, not infrequently pulled by legal bridle in their noses.

Doctors in Rajasthan India have shown first of its kind revolt, that is just waiting to happen globally at some stage.

Will Rajasthan’s Right to health bill do more harm than Good?

It is not easy to practice as doctor these days. Media full of doctors bashing, credibility crisis and regulators perpetually hounding doctors, who are forced to work under imposed medico-legal sword. There is no day that passes when system does not perpetuate negativity against medical profession.

By certain laws and Acts like RTH, an effort is on to place medicine under State control. Acquiring kind of skill , the years of passionate, merciless excruciating medical learning is placed at the disposal of administrators, who themselves have already failed to develop a good health care system in real sense.

Doctors have become soft targets for populist attention mongering and transforming social nuisance into messiah of the deprived by administrators -by sprouting the fraudulent generalities.

All the calculations that usually precede the enslavement of medicine, everything gets discussed by administrators and industry – except the well-being of the doctors and nurses.

Doctors have often wondered at the smugness with which administrators assert their right to enslave them, to control their work, to force their will, to violate their conscience, to stifle their mind. Irony is that while administrators do this, still they depend on the same doctors for saving lives -whose life they have throttled, who resent the treatment meted out to the health care workers. Like the failed medical system, administrators have failed to realize that all the negativity perpetuated against doctors, who are working with the burden of mistrust under medico-legal sword is going to make them less safe.

Administrators, who have never treated a patient in their lifetimes, not only try to control treatment of thousands of patients, but project themselves messiah by demonizing doctors. Lowly educated celebrities and administrators have found a new easy way to project themselves on higher pedestrian by publicly insulting highly educated but vulnerable doctors. The biggest tragedy to the medical profession in the present era is the new fad of administrators to discourage and demonize the medical profession for their popularity gains.
Being so distant from the ground reality, their role should not have been more than facilitators, but they have become medical administrators. To control the health system, administrators have a tendency to pretend that shortcomings in the patient care can be rectified by punishing the doctors and nurses.

Slow or acute revolt is long due. Doctors have only two ways- either to persist, fight or perish. Silently quitting their beloved profession is going on for some time all over the world. Even in developed countries, there has been a fading enthusiasm to be a doctor. But doctors of Rajasthan have shown the way. The way to persist and resist the indignity handed over to medical profession. The have shown that the struggle was not that difficult that it looked to be. They have chosen the correct path of struggle for Independence (Professional). That makes them global leaders without any doubt.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

Exorbitantly expensive medical education and lowered merit

March 25, 2023 0

Pearl harbour Anaesthesia Tragedy- Historical Significance

Up to the end of World War II, less than 10% of the general anaesthetics administered were with intravenous barbiturates. The remaining 90% of anaesthetics given in the USA were with diethyl ether. In the United Kingdom and elsewhere, chloroform was also popular. Diethyl ether administration was a relatively safe and simple procedure, often delegated to nurses or junior doctors with little or no specific training in anaesthesia. During the Japanese attack on the US bases at Pearl Harbor, with reduced stocks of diethyl ether available, intravenous Sodium Pentothal(®), a most ‘sophisticated and complex’ drug, was used with devastating effects in many of those hypovolaemic, anaemic and septic patients. The hazards of spinal anaesthesia too were realised very quickly. These effects were compounded by the dearth of trained anaesthetists. The anaesthesia tragedies at Pearl Harbor, and the discovery in the next few years of many other superior drugs that caused medical and other health professionals to realise that anaesthesia needed to be a specialist medical discipline in its own right. Specialist recognition, aided by the foundation of the National Health Service in the UK, the establishment of Faculties of Anaesthesia and appropriate training in pharmacology, physiology and other sciences soon followed. Modern anaesthesiology, as we understand it today, was born and a century or more of ether anaesthesia finally ceased.

It was estimated that the use of sodium thiopentone (Pentothal®) anaesthesia caused 1178 perioperative deaths in the hundreds of casualties who required emergency surgery in the 24 hours following the attack.

The World War II medical tragedies, especially those at Pearl Harbor, were a wake-up call for surgeons and the medical profession generally throughout the world. There was a realisation that it was no longer appropriate for any junior doctors or nurses to administer ‘sophisticated’ anaesthetic drugs for many types of surgeries and to critically ill patients. This had been known for many years in thoracic surgery and neurosurgery, but in the years after the war it was clear that appropriately trained anaesthetists were required, who had the knowledge and skills to use advanced drugs such as thiopentone and the new techniques and equipment which had rapidly developed in the 1940s.

The significance of the results of attempts of nurse and doctor anaesthetists to use thiopentone anaesthesia in military casualties who were hypovolaemic was very clear. Cardiovascular collapse and respiratory arrest with a lack of oxygen supplies, resuscitative skills and knowledge of thiopentone’s pharmacology and dosage, along with the insufficient numbers of skilled anaesthetists, clearly resulted in many tragedies. Some spinal anaesthetics also contributed to the perioperative mortality. So it was not too long during that fateful day in 1941 before surgeons and others reverted to using ‘drip ether’ as the principal anaesthetic technique and restricted the use of the available local anaesthetics, procaine and tetracaine, to infiltration only—mainly in burns patients. Exactly how many anaesthetic deaths resulted from intravenous thiopentone and hexobarbital will probably never be known as there were no defined classifications of such deaths as we have today.

In summary, the greatest significance of the anaesthetic events at Pearl Harbor, and more broadly throughout World War II, was that the surgeons, the medical profession generally and health authorities recognised the need for appropriately trained and skilled specialist practitioners of anaesthesia. Modern anaesthesia, or anaesthesiology as I believe we should refer to it, was born soon after Pearl Harbor and World War II, and the ‘ether century’ began to expire, although ether continued to be used into the 1970s for many simpler surgeries in less developed centres.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

Exorbitantly expensive medical education and lowered merit

March 13, 2023 0

What are Psychedelics? Ancient history and future possibilities

Psychedelics (serotonergic hallucinogens) are powerful psychoactive substances that alter perception and mood and affect numerous cognitive processes. They are generally considered physiologically safe and do not lead to dependence or addiction.

Their origin predates written history, and they were employed by early cultures in many sociocultural and ritual contexts. After the virtually contemporaneous discovery of (5R,8R)-(+)-lysergic acid-N,N-diethylamide (LSD)-25 and the identification of serotonin in the brain, early research focused intensively on the possibility that LSD and other psychedelics had a serotonergic basis for their action.

Psychedelics are a subclass of hallucinogenic drugs whose primary effect is to trigger non-ordinary mental states (known as psychedelic experiences or psychedelic “trips”) and/or an apparent expansion of consciousness.Sometimes, they are called classic hallucinogens, serotonergic hallucinogens, or serotonergic psychedelics. True psychedelics cause specific psychological, visual, and auditory changes, and oftentimes a substantially altered state of consciousness. The “classical” psychedelics, the psychedelics with the largest scientific and cultural influence, are

Mescaline,

LSD,

Psilocybin,

DMT.

LSD in particular has long been considered the paradigmatic psychedelic compound, to which all other psychedelics are often or usually compared.

Most psychedelic drugs fall into one of the three families of chemical compounds: tryptamines, phenethylamines, or Lysergamides (LSD is considered both a tryptamine and lysergamide).

Many psychedelic drugs are illegal worldwide under the UN conventions, with occasional exceptions for religious use or research contexts. Despite these controls, recreational use of psychedelics is common.

Legal barriers have made the scientific study of psychedelics more difficult. Research has been conducted, however, and studies show that psychedelics are physiologically safe and rarely lead to addiction. Studies conducted using psilocybin in a psychotherapeutic setting reveal that psychedelic drugs may assist with treating depression, alcohol addiction, and nicotine addiction. Although further research is needed.

List of psychedelic drugs

LSD (Lysergic acid diethylamide)
Psilocin (4-HO-DMT)
Mescaline (3,4,5-trimethoxyphenethylamine)
DMT (N,N-dimethyltryptamine)

2C-B (2,5-dimethoxy-4-bromophenethylamine)

Uses

Traditional

A number of frequently mentioned or traditional psychedelics such as Ayauasca (which contains DMT), San Pedro, Peyote, and Peruvian torch (which all contain mescaline), Psilocybin mushrooms (which contain psilocin/psilocybin all have a long and extensive history of spiritual, shamanic and traditional usage by indigenous peoples in various world regions, particularly in Latin America, but also Gabon, Africa in the case of iboga. Different countries and/or regions have come to be associated with traditional or spiritual use of particular psychedelics, such as the ancient and entheogenic use of psilocybe mushrooms by the native Mazatec people of Oaxaca, Mexico or the use of the Ayauasca brew in the Amazon basin, particularly in Peru for spiritual and physical healing as well as for religious festivals.

Although people of western culture have tended to use psychedelics for either psychotherapeutic or recreational reasons, most indigenous cultures, particularly in South America have seemingly tended to use psychedelics for more supernatural reasons such as divination.

Psychedelic therapy

Psychedelic therapy (or psychedelic-assisted therapy) is the proposed use of psychedelic drugs to treat mental disorders. As of 2021, psychedelic drugs are controlled substances in most countries and psychedelic therapy is not legally available outside clinical trials, with some exceptions.

The procedure for psychedelic therapy differs from that of therapies using conventional psychiatric medications. While conventional medications are usually taken without supervision at least once daily, in contemporary psychedelic therapy the drug is administered in a single session (or sometimes up to three sessions) in a therapeutic context.

As of 2022, the body of high-quality evidence on psychedelic therapy remains relatively small and more, larger studies are needed to reliably show the effectiveness and safety of psychedelic therapy’s various forms and applications.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

Exorbitantly expensive medical education and lowered merit

March 12, 2023 0

Obesity-a growing epidemic & relation to climate

Twelve years from now, 4 billion people, or more than half the world’s population, will be overweight or obese, according to a recent report. While obesity is an issue more commonly associated with high-income countries, the World Obesity Federation (WOF) points out that lower income countries are facing rapid increases in its prevalence. The economic and environmental costs of obesity aside, there is also the impact on the climate to contend with in the battle of the bulge. A $4tn crisis

The World Obesity Atlas 2023 says the cost of obesity-related issues would be more than $4 trillion globally by 2035. Apart from health, high BMI – obesity is defined as a Body Mass Index (BMI) equal to or more than 30 – also impacts economic productivity, including through premature retirement or death. The biggest presence of obese people will continue to be in high-income countries, the report says, but it is the low and lower middle income countries that are likely to experience major increases in the prevalence of obesity by 2035. The total economic costs linked to a rise in obesity in these countries would be more than $350 billion but the burden for upper middle and high income countries would be close to $4 trillion. The share of obese people in middle-income countries could jump to 66% among men and 70% for women even as the rate of increase in obesity prevalence appears to be slowing down in some rich countries. The chief reasons for rising obesity in poorer countries include a shift towards more highly processed foods and greater levels of sedentary behaviour.

What climate change has to do with it.

Rising temperature and rainfall due to climate change could lead to higher obesity rates by hampering physical activity, studies say. The impact of extreme weather on fruit and vegetable production could also make it harder to maintain a healthy diet owing to rising prices. Higher prices could prompt a shift towards processed foods, which are linked to obesity. A 2019 Lancet report says severe food insecurity and hunger are associated with lower obesity prevalence, but mild to moderate food insecurity is “associated with higher obesity prevalence”. Another 2019 study says obesity is linked to about “20% greater GHG emissions compared with the normal weight state”. The total impact of obesity “may be extra emissions of (about) 700 megatons per year of CO2 equivalent. about 1. 6% of worldwide GHG emissions”.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

Exorbitantly expensive medical education and lowered merit

March 9, 2023 0

All about Holi colours, Harms, Removal and Prevention

We all love playing with Holi colours, but do they leave any harmful side-effects?

With the festival of colours just around the corner, we are all bound to be excited about having fun with family and friends.

However, as Holi is played with lots of colours, it’s important to keep safety in mind and take proper care to control the damaging effects of colours.

HOLI COLOURS

The market is flooded with a variety of colours – paste, dry and watercolours. Rather, industrial dyes being cheap and bright are widely used to make them. However, these can have detrimental effects on humans as they were never meant for playing Holi.

Metallic pastes: These pastes are used for a silver, golden and/or black effect. While it’s a very popular practice in youngsters, the use of metallic pastes during Holi is highly discouraged in view of the harmful effects.

Dry colours: Commonly called as gulaal, dry colours are a mix of toxic heavy metals like lead, chromium, cadmium, copper, mercury, nickel, and asbestos.

Water Colours: These colours commonly use gentian violet dye as colourant. Gentian violet is a hazardous chemical that can cause many serious health problems. The water colours used in Holi fare no better.

Harmful effects of colours

All these are known to cause skin allergies, dermatitis and a host of other issues including problems with the scalp.

Metallic pastes- These colours can cause eye allergies, blindness, skin irritation, skin cancers, and even kidney failure.

The colored powders used during Holi can cause various respiratory problems when inhaled. This can lead to conditions such as bronchitis, asthma, and allergies.

Being exposed to these colors can cause irritation and inflammation of the eyes, nose, and throat, and can also trigger asthma attacks in people with pre-existing respiratory conditions.

Long-term exposure to these chemicals can lead to chronic respiratory problems such as bronchitis, emphysema, and lung cancer.

Other problems include conjunctivitis and hair loss.

Additionally, the colours, if inhaled can irritate the delicate tissues in the nose and throat, causing inflammation and discomfort.

If Holi is played out in the sun, it can further damage the skin, causing depletion of moisture and sun tan, leaving your skin dry and dull.

HOW TO PREVENT THE HARMFUL EFFECTS OF HOLI COLORS?

To apply sunscreen 20 minutes before going out in the sun. Make sure to use sunscreen for SPF 30 and above. Most sunscreens have built-in moisturizers. For the hair, apply a hair serum or leave-in conditioner. Alternatively, you can use pure coconut oil and massage it lightly into the hair.

REMOVAL OF COLOURS

Appropriate removal of colours is equally important to get rid of the damaging effects of playing Holi. To begin with, rinse your face with plenty of water, followed by a cleansing cream or lotion, and lastly, wipe off with moist cotton wool. In case you experience itching, add two tablespoons of vinegar to a mug of water and use it as a last rinse.

Cleanse the area around the eyes. While bathing, gently scrub the body and apply a moisturiser on the face and body immediately after while the skin is still damp.

He said that if itching continues or you see a rash and redness, make sure to consult a doctor as there may be an allergic reaction to the colour. For the hair, use plenty of water to wash away the dry colours and tiny mica particles. Then use a mild shampoo and massage the scalp gently and rinse thoroughly with water again. Lastly, condition your hair with a mild conditioner.

Prevention

Instead, opt to use eco-friendly colours made of flower petals, herbs, vegetable extract, and turmeric.

Keep an eye out for any of these symptoms post your Holi party.

If you experience fever, nausea, vomiting, red eyes, difficulty seeing, skin eruptions, burning skin, dizziness, confusion, inability to concentrate, headaches, and/or blurred vision consult a doctor immediately.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

Exorbitantly expensive medical education and lowered merit

March 8, 2023 0

How Heart (Cardiovascular) Disease in Women differs from that of Men #Sushmita-Sen-Angioplasty

A long-held belief has been that women are less prone to heart attacks, because of their so-called oestrogen advantage. Heart attacks in men is much higher than women. By classic teaching women have an advantage of 10 years in terms of getting cardiovascular disease (CVD), usually around the age of 55, compared to men who can get a CVD around the age of 45. That is partially correct as well, but one should be extra careful about the hugely increased vulnerability of post-menopausal women. More recent research findings that even younger #Sushmita Sen shared that she has had to undergo angioplasty, much public surprise centred on her age.

As a Lancet global commission has emphasised, despite being responsible for causing 35% of deaths in women each year, their cardiovascular disease remains understudied, under-recognised, under-diagnosed, and under-treated, with women also under-represented in clinical trials.

Heart disease may be considered by some to be more of a problem for men. Because some heart disease symptoms in women can differ from those in men, women may not know what to look for.

The following discussion is about the differences in cardiovascular disease between men and women.

How is the cardiovascular system different in women vs. men?

Researchers have found many sex-related differences in the cardiovascular system. These complex differences, often at a microscopic level, can affect how women and men experience heart disease. A few examples include:

Anatomy. Women have smaller blood vessels and heart chambers. The walls of their ventricles are also thinner.
Blood count. Women have fewer red blood cells. As a result, women can’t take in or carry as much oxygen at any given time.
Cardiovascular adaptations. Changes in altitude or body position (like quickly standing up after lying down) affect women more than men. Women are more likely to have sudden drops in blood pressure or faint.
Hormones. Estrogen and progesterone dominate in women and people AFAB, while testosterone dominates in men and people AMAB. These hormones can impact many aspects of heart health and overall health.

Heart attack symptoms for women

The most common heart attack symptom in women is the same as in men — some type of chest pain, pressure or discomfort that lasts more than a few minutes or comes and goes.

But chest pain is not always severe or even the most noticeable symptom, particularly in women. Women often describe heart attack pain as pressure or tightness. And it’s possible to have a heart attack without chest pain.

Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

Neck, jaw, shoulder, upper back or upper belly (abdomen) discomfort
Shortness of breath
Pain in one or both arms
Nausea or vomiting
Sweating
Lightheadedness or dizziness
Unusual fatigue
Heartburn (indigestion)

These symptoms may be vague and not as noticeable as the crushing chest pain often associated with heart attacks. This might be because women tend to have blockages not only in their main arteries but also in the smaller ones that supply blood to the heart — a condition called small vessel heart disease or coronary microvascular disease.

Compared with men, women tend to have symptoms more often when resting, or even when asleep Emotional stress can play a role in triggering heart attack symptoms in women.

Because women’s heart attack symptoms can differ from men’s, women might be diagnosed less often with heart disease than are men. Women are more likely than men to have a heart attack with no severe blockage in an artery (nonobstructive coronary artery disease).

Heart disease risk factors for women

Several traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — affect both women and men. But other factors may play a bigger role in the development of heart disease in women.

Heart disease risk factors for women include:

Diabetes. Women with diabetes are more likely to develop heart disease than are men with diabetes. Also, because diabetes can change the way women feel pain, there’s an increased risk of having a silent heart attack — without symptoms.
Emotional stress and depression. Stress and depression affect women’s hearts more than men’s. Depression may make it difficult to maintain a healthy lifestyle and follow recommended treatment for other health conditions.
Smoking. Smoking is a greater risk factor for heart disease in women than it is in men.
Inactivity. A lack of physical activity is a major risk factor for heart disease.
Menopause. Low levels of estrogen after menopause increase the risk of developing disease in smaller blood vessels.
Use of Contraceptives – They do tend to increase a woman’s blood pressure. If a woman has other risk factors for heart disease, taking birth control pills can compound that risk of heart disease.
Pregnancy complications. High blood pressure or diabetes during pregnancy can increase the mother’s long-term risk of high blood pressure and diabetes. These conditions also make women more likely to get heart disease.
Family history of early heart disease. This appears to be a greater risk factor in women than in men.
Inflammatory diseases. Rheumatoid arthritis, lupus and other inflammatory conditions may increase the risk of heart disease in both men and women.

Women of all ages should take heart disease seriously. Women under age 65 — especially those with a family history of heart disease — also need to pay close attention to heart disease risk factors.

Lifestyle remedies

Living a healthy lifestyle can help reduce the risk of heart disease. Try these heart-healthy strategies:

Quit smoking. If you don’t smoke, don’t start. Try to avoid exposure to secondhand smoke, which also can damage blood vessels.
Eat a healthy diet. Opt for whole grains, fruits and vegetables, low-fat or fat-free dairy products, and lean meats. Avoid saturated or trans fats, added sugars, and high amounts of salt.
Exercise and maintain a healthy weight. If you’re overweight, losing even a few pounds can lower heart disease risks. Ask your health care provider what weight is best for you.
Manage stress. Stress can cause the arteries to tighten, which can increase the risk of heart disease, particularly coronary microvascular disease. Getting more exercise, practicing mindfulness and connecting with others in support groups are some ways to tame stress.
Avoid or limit alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
Follow your treatment plan. Take medications as prescribed, such as blood pressure medications, blood thinners and aspirin.
Manage other health conditions. High blood pressure, high cholesterol and diabetes increase the risk of heart disease.

Exercise and heart health

Regular activity helps keep the heart healthy. In general, aim for at least 30 minutes of moderate exercise, such as walking at a brisk pace, on most days of the week. If that’s more than you can do, start slowly and build up. Even five minutes a day of exercise has health benefits.

For a bigger health boost, aim for about 60 minutes of moderate to vigorous exercise a day, five days a week. Also do strength training exercises two or more days a week.

It’s OK to break up your workouts into several 10-minute sessions during a day. You’ll still get the same heart-health benefits.

Interval training — which alternates short bursts of intense activity with intervals of lighter activity — is another way to maintain a healthy weight, improve blood pressure and keep the heart healthy. For example, include short bursts of jogging or fast walking into your regular walks.

You can also add exercise to your daily activities with these tips:

Take the stairs instead of an elevator.
Walk or ride your bike to work or to do errands.
March in place while watching television.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

Exorbitantly expensive medical education and lowered merit

March 6, 2023 0

Medical Education #NEET & Termite of Corruption, Legalities, Touts

Med admission season sees flood of legal cases Our society has failed itself to develop a robust system of choosing and nurturing good doctors and therefore itself responsible for decline in standards of medical profession. Therefore the quality of doctors who survive and flourish in such system will be a natural consequence of how society chooses and nurtures the best for themselves. A complicated admission process of NEET counselling has spawned a micro industry of medical education counsellors- nothing more than mediators and touts. Imagine, an opportunity is available to a patient, to decide the doctor as based on his route or marks for entry into medical college. Whether patient will like to get treated by a doctor, who secured 20% marks, 30 % marks or 60% marks or 80% marks for medical college. Even an illiterate person can answer that well. But strangely for selection of doctors, rules were framed so as to dilute the merit to the minimum possible. What is the need to dilute and shortlist around half a million for few thousand seats? Answer to that is simple. To select and find only those students from millions, who can pay millions to become doctors?

Our society has failed itself to develop a robust system of choosing and nurturing good doctors and therefore itself responsible for decline in standards of medical profession. Therefore the quality of doctors who survive and flourish in such system will be a natural consequence of how society chooses and nurtures the best for themselves.

A complicated admission process of NEET counselling has spawned a micro industry of medical education counsellors- nothing more than mediators and touts.

Imagine, an opportunity is available to a patient, to decide the doctor as based on his route or marks for entry into medical college. Whether patient will like to get treated by a doctor, who secured 20% marks, 30 % marks or 60% marks or 80% marks for medical college. Even an illiterate person can answer that well. But strangely for selection of doctors, rules were framed so as to dilute the merit to the minimum possible. What is the need to dilute and shortlist around half a million for few thousand seats? Answer to that is simple. To select and find only those students from millions, who can pay millions to become doctors?

Doctors are just as offshoots of a tree called as society. They essentially are the same as rest of the society. It is a specialized branch of tree which helps other offshoots of tree to save others. As part of same tree, they resemble the parent society, of which they are part. Society needs to choose and nurture a force of doctors carefully with an aim to combat for safety of its own people.

Exorbitantly expensive medical education and lowered merit has hollowed the quality of doctors like termite. Aspiring doctors are now forced to pay exorbitant fee, in millions. Many go under heavy debt to pay medical colleges fee. Children with lower ranks in merit pay millions and can become doctors. The real problem here is that real deserving will be left out.

Medical students from the very onset, are victims and witness to these practices and exploitation. They see their parents pay this unreasonable fee through their noses or take loans. Such blatant injustice will have an everlasting effect on the young impressionable minds.

The paradox- Society and armchair preachers give doctors lessons about corruption and exploitation.

Medical admission season sees flood of legal cases

Mumbai TIMES OF INDIA: Chief Justice of India D Y Chandrachud, while speaking at a recent event in a Delhi hospital, called for reforms in medical education, referring to the sheer volume of cases that have made their way to the Supreme Court. It is no exaggeration, as the Directorate of General of Health Services’ Medical Counselling Committee (MCC), under the umbrella body of the union ministry of health and family welfare, alone has to deal with nearly 400 cases every year. From high courts to the apex court, the admission season is marred by litigation, from students aspiring to be doctors to doctors aspiring to be specialists and super-specialists. Sometimes, there are other stakeholders too and the stakes are indeed high. The National Eligibility and Entrance Test (NEET) for undergraduate courses, for instance. In the past four years, the number of MBBS aspirants registering for the test rose almost by 25%. Around 17.6 lakh students appeared for NEET-UG in 2022 —the highest for any competitive exam. On the contrary, the number of aspirants for engineering (registering for JEE-Main) dropped in the corresponding four years—from 11.5 lakh in 2019 to 9.05 lakh in 2022. If one takes into account the direct ratio of students to medical seats, 33 are vying for a single seat in a government college. It is further skewed if one considers the pool of seats in each category. The number of seats shrink at PG level. “The competition is fierce for students in the lower rank bracket. Eligibility issues are also a concern in lawsuits. There is a lot of emphasis on students bagging a PG degree, from parents, even colleges.

More students going for higher studies give colleges brownie points in the accreditation process. There is a general sense of feeling that only an MBBS degree is of no consequence. After all of it, if students lose their seat over a technical point, they will prefer moving court over losing a year, he said. Even as thousands of students appear for their NEET-PG today, courts saw several litigation seeking postponement of the exam till last week. “There is no uniformity in the schedule followed by different states, even as there is one central exam for all. Students have to mandatorily complete their internship to be eligible for a PG seat, but the internship deadline in states differ. What is the point of completing the exam in March and waiting till July for the counselling round? Such policy decisions are not student-friendly, and therefore are met with opposition,” said parent representative. Former member (board of governor), erstwhile Medical Council of India and dean (projects) at Tata Memorial Hospital, Dr Kailash Sharma, said clarity from National Medical Commission, from MCC, government of India, is expected. “Similar cases in lower courts should be bundled and heard by the apex court that will also reduce time on each case,” said Sharma. Meanwhile, a complicated admission process has spawned a micro industry of medical education counsellors. The process is complicated for an 18-year old to manage on his own.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.

Exorbitantly expensive medical education and lowered merit

March 5, 2023 0

End of Life issues- ‘Hold on’ or ‘Let go’ #Tom-Sizemore

A difficult decision near death- try to ‘hold on’ or ‘let go’

The eternal human wish is to fight hard against age, illness, and death and holding on to life, to our loved ones, is indeed a basic human instinct. However, as an illness advances, “raging against the dying of the light” often begins to cause undue suffering, and “letting go” may instead feel like the next stage.

Tom Sizemore has no hope of recovery after he suffered a brain aneurysm, his family has said, confirming they are making an end-of-life decision for the Saving Private Ryan actor. The 61-year-old has been in a coma in the intensive care unit of Providence Saint Joseph Medical Center in Los Angeles since he was hospitalised on 18 February. On Monday night, Sizemore’s representative, Charles Lago, issued a statement revealing that there was no chance for his recovery. “Today doctors informed his family that there is no further hope and have recommended end of life decision. The family is now deciding end of life matters and a further statement will be issued on Wednesday,” Lago said.

Humans have an instinctive desire to go on living. We experience this as desires for food, activity, learning, etc. We feel attachments to loved ones, such as family members and friends, and even to pets, and we do not want to leave them.

When we realize that the end of life may be approaching, other thoughts and feelings arise. Fears arise, and may be so strong that they are hard to think about or even admit to: fear of change, of the dying process, of what happens after death, of losing control, of dependency and more. Both the person who is ill and the caregiver might also experience resentment, guilt, sadness, and anger at having to do what neither wants to do, namely face death and dying.

As death nears, many people feel a lessening of their desire to live longer. This is different from depression or thoughts of suicide. Instead, they sense it is time to let go. They may reach a point where they feel they have struggled as much as they have been called upon to do and will struggle no more. Refusing to let go can prolong dying, but it cannot prevent it. Dying, thus prolonged, can become more a time of suffering than of living.

Family members and friends who love the dying person may learn to accept a life limiting illness, and then accept the possibility of a loved one dying. They may see that dying is the better of two choices and accept the inevitability of death.

The dying may be cause distress and grief for those who love them. If a stage has reached when treatments are no longer working as well as before, and everyday life maintaining activities are becoming more and more burdensome. In a sense, life is disappearing. One has to look beyond the fears and wishes. What is really best for the one who is dying, and for the others around? Given that death is unavoidable, what is the kindest thing to do? It might be holding on or it might be letting go.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

Medical-Consumer protection Act- Pros and Cons

Expensive Medical College seat- Is it worth it?

NEET- Not so Neat- percentile system

The Myth of cost of spending on medical education needs to be made transparent.