Emedinews:Makesure:A patient intolerant to penicillin was denied rheumatic prophylaxis.

Situation: A patient intolerant to penicillin was denied rheumatic prophylaxis.
Reaction: Oh my God! Why was he not put on sulfa?
Lesson: Make sure that patients who cannot tolerate penicillin are put on sulfadiazine or sulfisoxazole. This antibiotic class is effective for preventing group A streptococcal (GAS) infection although it cannot be used to achieve eradication.

Emedinews:Inspiration:How are you building your life?

An Inspirational Story

An elderly carpenter was ready to retire. He told his employer-contractor of his plans to leave the house building business and live a more leisurely life with his wife enjoying his extended family. He would miss the paycheck, but he needed to retire. They could get by.

The contractor was sorry to see his good worker go and asked if he could build just one more house as a personal favor. The carpenter said yes, but in time it was easy to see that his heart was not in his work. He resorted to shoddy workmanship and used inferior materials. It was an unfortunate way to end his career.

When the carpenter finished his work and the builder came to inspect the house, the contractor handed the front-door key to the carpenter. “This is your house,” he said, “my gift to you.” What a shock! What a shame! If he had only known he was building his own house, he would have done it all so differently. Now he had to live in the home he had built none too well. So it is with us. We build our lives in a distracted way, reacting rather than acting, willing to put up less than the best. At important points we do not give the job our best effort.

Then with a shock we look at the situation we have created and find that we are now living in the house we have built. If we had realized, we would have done it differently. Think of yourself as the carpenter. Think about your house. Each day you hammer a nail, place a board, or erect a wall. Build wisely. It is the only life you will ever build. Even if you live it for only one day more, that day deserves to be lived graciously and with dignity. The plaque on the wall says, “Life is a do-it-yourself project.” Who could say it more clearly? Your life today is the result of your attitudes and choices in the past. Your life tomorrow will be the result of your attitudes and the choices you make today.

Emedinews:Insights on Medicolegal Issues:The doctor must preserve broken fragments of weapon if found in wounds to identify the weapon or connect the accused person with the crime.

• Death due to sharp force violence is the most common cause of homicide in India, in many parts of Europe, as well as in Africa and Asia. It also accounts for 30% of fatal and non–fatal family assaults in the USA
• The doctor conducting the postmortem examination must keep in mind that the shape and size of the wound suggests the width and type of weapon, whether it is single–edged or otherwise. The depth of the wound will indicate the length of weapon, the directions and dimensions of the wound indicate the relative position of the assailant and the victim, and the position, direction and number of wound may indicate manner of production, i.e., suicide, accident or homicide.
• I have conducted medicolegal postmortem of 29 cases of deaths due to stab wound from South Delhi in the year 2010.
• A stab wound is produced by long narrow instruments with blunt or pointed ends such as knife, dagger, nail, needle, spear, arrow, screw driver etc. into the depths of the body; the wound is deeper than its length and width on the skin.
• The wound is caused by driving the object into the body or from the body’s pressing or falling against the object and object penetrate due to the momentum of the body.
• The wound is called punctured wound when it enters a body cavity only one way; when the weapon enters the body on one side and comes out from the other side, it is called perforating wound.
• The entry wound is larger and the exit wound is smaller due to tapering of the blade in stab wounds which is contrary to fire arm missile entry and exit wounds.
• The doctor must preserve for police, broken fragment of weapon if found; it will identify the weapon or connect the accused person with the crime.

Emedinews:Inspiration:The miracle of love, true story

An Inspirational Story

Like any good mother, when Karen found out that another baby was on the way, she did what she could to help her 3-year-old son, Michael, prepare for a new sibling. The new baby was going be a girl, and day after day, night after night, Michael sang to his sister in Mommy’s tummy. He was building a bond of love with his little sister before he even met her.

 The pregnancy progressed normally for Karen, an active member of the Creek United Methodist Church in Morristown, Tennessee, USA. In time, the labor pains came. Soon it was every five minutes, every three, every minute. But serious complications arose during delivery and Karen found herself in hours of labor.

 Finally, after a long struggle, Michael’s little sister was born. But she was in very serious condition. With a siren howling in the night, the ambulance rushed the infant to the neonatal intensive care unit at St. Mary’s Hospital, Knoxville, Tennessee.

The days inched by. The little girl got worse. The pediatrician had to tell the parents there was very little hope. Be prepared for the worst. Karen and her husband contacted a local cemetery about a burial plot. They had fixed up a special room in their house for their new baby they found themselves having to plan for a funeral.

Michael, however, kept begging his parents to let him see his sister. “I want to sing to her,” he kept saying. Week two in intensive care looked as if a funeral would come before the week was over. Michael kept nagging about singing to his sister, but kids are never allowed in Intensive Care.

 Karen decided to take Michael whether they liked it or not. If he didn’t see his sister right then, he may never see her alive. She dressed him in an oversized scrub suit and marched him into ICU. He looked like a walking laundry basket. The head nurse recognized him as a child and bellowed, “Get that kid out of here now. No children are allowed.”

 The mother rose up strong in Karen and the usually mild-mannered lady glared steel-eyed right into the head nurse’s eyes, her lips a firm line, “He is not leaving until he sings to his sister.” Then Karen towed Michael to his sister’s bedside. He gazed at the tiny infant losing the battle to live. After a moment, he began tossing. In the pure-hearted voice of a 3-year-old, Michael sang:

 “You are my sunshine, my only sunshine; you make me happy when skies are gray.” Instantly the baby girl seemed to respond. The pulse rate began to calm down and became steady. “Keep on singing, Michael,” encouraged Karen with tears in her eyes. “You never know, dear, how much I love you, please don’t take my sunshine away.”

 As Michael sang to his sister, the baby’s ragged, strained breathing became as smooth as a kitten’s purr. “Keep on singing, sweetheart.” “The other night, dear, as I lay sleeping, I dreamed I held you in my arms”. Michael’s little sister began to relax as rest, healing rest, seemed to sweep over her. “Keep singing, Michael.” Tears had now conquered the face of the bossy head nurse. Karen glowed. “You are my sunshine, my only sunshine. Please don’t take my sunshine away…” The next day…the very next day…the little girl was well enough to go home.

 Never give up on the people you love. Love is so incredibly powerful.

 This is a true story happened in 1992 in Tennessee, USA. The baby girl’s name is Marlee. As of 2012, Marlee is 20 years old and she thinks she is normal like any other girl.

 Source: http://academictips.org/blogs/the-miracle-of-love-true-story/

Emedinews:Insights on Medicolegal Issues:The injuries produced by a blunt weapon on tense skin covering the bones, as on scalp, eyebrow, iliac crest, shin, perineum, knee or elbow looks like incised

·         While preparing the MLC report, the doctors should keep in mind that he has to provide clues about the weapon used (sharp-edged or otherwise), the direction of the force, the duration of injury, and the location of the wound which may suggest mode of production i.e. suicide, accident, homicides along with whether the injury is fabricated or otherwise

·         The wounds produced by a blunt weapon or by a fall on the hard surface, object, on tense structures/skin covering the bones, such as the scalp, eyebrow, iliac crest, shin, perineum, knee or elbow when the limb is flexed look like incised wound. But lacerated wounds, also called split lacerations, are caused by blunt force and create confusion in the mind of doctor, public and police official about sharp weapon.

·         When the incised looking wounds are examined by doctor under magnifying lens, the edges of such wounds are found to be irregular with bruising and wounds are produced by blunt weapon.

·         Neatly incised laceration is considered as incised wound and broken glass as dangerous weapon.

·         An incised wound, cut, slash, and slice is a clean cut through the skin may or may not underlying tissues and structures caused by sharp edged instruments, which is longer than the depth of wound. It is produced by infliction of an object having a sharp cutting edge such as knife, razor, blade, scalpel, sword over the body.

Emedinews:Makesure:A patient on amlodipine developed severe gum hypertrophy.

Situation: A patient on amlodipine developed severe gum hypertrophy.
Reaction: Oh my God! Why was amlodipine not stopped?
Lesson: Make sure that all patients on amlodipine are watched for gum hypertrophy. Gingival hyperplasia is a known side effect of amlodipine.

Emedinews: Inspiration: Dearest Grandmamma

An Inspirational Story

 Hi all, I would like to share a story with you, a person who has been a source of inspiration to each and every one of our family member.

 She is (was rather, she is no more) my grandmamma. She was an affectionate woman who could win over anyone with her undying love, no matter what. Let me narrate to you, the story of her life, the trauma that no woman should ever undergo! She was the eldest of a family of 7 girls and 1 boy. Of these, 2 children died shortly after birth. Right now, only 2 of them are alive.

 At the age of 16, my grandma got married as a second wife to a 40 year old man. She lost her husband 1 year after her wedding. By God’s grace she had a son whom she considered a solace. But that didn’t last, as the son passed away shortly too! Ultimately, by the age of 25 she lost her entire family! Nevertheless, she then dedicated her life towards the upbringing of each and every child in the family. This was the reason she was loved and respected by everyone in our family.

 Last year, by this same time, my marriage was fixed. Being the oldest grandchild in my family, she was very happy and said she would bring up my kid too! I was in tears and said of course you will have to! Shortly before my engagement, she had a fall one night when sleeping. It left her right hand fractured. There began all the trouble. She was 83 years old by then. At my engagement function, all she could do was sit quietly in one place. It was a hard hitting reality for all of us since we got used to seeing her doing the entire household chores all by herself!

There was hardly a month left for my wedding. She developed a strange mental depression since that time, imagining things, fearing death, longing to see my wedding and the like. All of us assured her that she would be the first person to bless me at my wedding. But nature is inevitable as we all know. She was admitted in the ICU for nearly 20 days. All day we would stay at the hospital, praying for her. One fine day it happened-what we all feared. She was no more, and left all of us teary-eyed.

 My dad was the eldest child in the family, so naturally he had to do the rites. But our family stopped him since I had my wedding the next month. We (me, dad, mum and sis) weren’t allowed to even see her face! Imagine our plight! At my wedding, her garlanded photo was in front of me and my husband. I was speechless, moved to tears. I knew, my dearest grandmamma will bless me as ever!

 Even today, we don’t feel her loss; I only feel why she isn’t around to share our joys and sorrows. I’d like to conclude by saying not only parents; grandparents need our affection and care! They are precious; do not lose them at any cost!!

 Source: http://academictips.org/blogs/dearest-grandmama/