Situation: An adult undergoing bronchoscopic biopsy developed infective endocarditis.
Reaction: Oh my God! Why was IE prophylaxis not given?
Lesson: Make sure, that all procedures of the respiratory tract that involve incision or biopsy of the respiratory mucosa include IE prophylaxis.
Friday, 6 January 2012
Emedinews:Inspiration:How to conquer the fear of failure?
When we have to start a new venture, we often feel fear of failure. Before exams, we feel fear of low marks or may be failure! At times when we have to decide between two or more choices, we feel afraid. Fear of failure is natural and overcoming this fear is natural too!. People feel the fear of failure at different stages in life but there is good news.
Good news: We all can overcome the fear of failure. The question: How can we overcome this fear of failure?
We can learn from those people who successfully overcame the fear of failure and have shared their experiences with us. One of the persons who has shared the technique of overcoming failure is an Olympic athlete Guy Drut. I would like to narrate a story from Mark Mc Cormack international best seller: What they don't teach you at Harvard Business School which guides us on one of the most important tools to overcome the fear of failure.
This is true story of a French Olympic player Guy Drut. In summer of 1976, he was the only hope of France for win in Olympic track-and-field medal. Naturally, he was afraid. He had the burden of carrying nation's pride on his shoulders. One of his friends Jean Claude Killy advised him how to overcome the fear of failure.
Killy's advice was very simple.
Killy advised Drut to repeat a few words in his mind over and over again. Killy told Drut that he was the only one who can use his body and mind for peak performance. He should keep on saying to himself: "I have done every thing to get ready for this race and if I win, every thing will be great. But even if I don't win, my friends will still be my friends, my enemies will still be my enemies and the world will still be the same"
Drut says that he took Killy's advice to his heart. He repeated this sentence in all his practice exercises, during breaks and in between the semi-finals and finals. He kept saying the sentences to himself over and over and it blocked out every thing else. Drut says: I kept on repeating it to such an extent that I was still repeating it when I went up to receive the gold medal!
We all can get benefit of this advice. Our self-talk reflects our expectancy from our lives. Positive self talk is more than a positive mental attitude. It is an evidence of determination in our future.
Good news: We all can overcome the fear of failure. The question: How can we overcome this fear of failure?
We can learn from those people who successfully overcame the fear of failure and have shared their experiences with us. One of the persons who has shared the technique of overcoming failure is an Olympic athlete Guy Drut. I would like to narrate a story from Mark Mc Cormack international best seller: What they don't teach you at Harvard Business School which guides us on one of the most important tools to overcome the fear of failure.
This is true story of a French Olympic player Guy Drut. In summer of 1976, he was the only hope of France for win in Olympic track-and-field medal. Naturally, he was afraid. He had the burden of carrying nation's pride on his shoulders. One of his friends Jean Claude Killy advised him how to overcome the fear of failure.
Killy's advice was very simple.
Killy advised Drut to repeat a few words in his mind over and over again. Killy told Drut that he was the only one who can use his body and mind for peak performance. He should keep on saying to himself: "I have done every thing to get ready for this race and if I win, every thing will be great. But even if I don't win, my friends will still be my friends, my enemies will still be my enemies and the world will still be the same"
Drut says that he took Killy's advice to his heart. He repeated this sentence in all his practice exercises, during breaks and in between the semi-finals and finals. He kept saying the sentences to himself over and over and it blocked out every thing else. Drut says: I kept on repeating it to such an extent that I was still repeating it when I went up to receive the gold medal!
We all can get benefit of this advice. Our self-talk reflects our expectancy from our lives. Positive self talk is more than a positive mental attitude. It is an evidence of determination in our future.
Thursday, 5 January 2012
Emedinews:What is exhumation?
• Exhumation is the removal of a corpse from the earth. The grave must be identified by relatives and the official in charge of the graveyard.
• The word exhumation literally means ‘out of ground.’ The word ‘exhumation’ comes from Latin words ‘ex’ meaning ‘out of’, and ‘humus‘, meaning ‘ground’ The dead body can only be exhumed when there is a written order from executive magistrate or Higher Court of Law of the land.
• Exhumation is necessary, when the first post–mortem was inadequate, and it is thought that a second postmortem may bring some more facts to light means exhumation combined with doing a second meticulous postmortem. After exhumation, the postmortem examination must be done in a well-equipped morgue only and preferably in presence of first team of doctors who have already examined the body.
• In case of exhumation the concerned police official should approach the appropriate government hospital in writing along with the order of exhumation to constitute a medical board of at least three qualified and experienced doctors with written clarity of objectives of postmortem examination. Material found in exhumation/spot and further examination should be done as per law.
• Resting places and the norm of many cultures is that the dead should not be disturbed. However, for a variety of reasons, they are disturbed through the process of exhumation.
(Reference Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology Volume 2, Number 2, July-December 2001)
• The word exhumation literally means ‘out of ground.’ The word ‘exhumation’ comes from Latin words ‘ex’ meaning ‘out of’, and ‘humus‘, meaning ‘ground’ The dead body can only be exhumed when there is a written order from executive magistrate or Higher Court of Law of the land.
• Exhumation is necessary, when the first post–mortem was inadequate, and it is thought that a second postmortem may bring some more facts to light means exhumation combined with doing a second meticulous postmortem. After exhumation, the postmortem examination must be done in a well-equipped morgue only and preferably in presence of first team of doctors who have already examined the body.
• In case of exhumation the concerned police official should approach the appropriate government hospital in writing along with the order of exhumation to constitute a medical board of at least three qualified and experienced doctors with written clarity of objectives of postmortem examination. Material found in exhumation/spot and further examination should be done as per law.
• Resting places and the norm of many cultures is that the dead should not be disturbed. However, for a variety of reasons, they are disturbed through the process of exhumation.
(Reference Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology Volume 2, Number 2, July-December 2001)
Emedinews:Makesure:A diabetic patient died of flu pneumonia.
Situation: A diabetic patient died of flu pneumonia.
Reaction: Oh my God! Why was flu vaccine not given?
Lesson: Make sure that all diabetics are given flu vaccine every year.
Reaction: Oh my God! Why was flu vaccine not given?
Lesson: Make sure that all diabetics are given flu vaccine every year.
Emedinews:Inspiration:Trust Your Relationship
When you've seen a couple fighting or having a pithy argument, what is the first thing that comes in your mind?
Probably you think that you will never allow arguments to set in your relationship (especially when you get married), or will never think to start one, but arguments seem to come naturally.
You argue about the brand of coffee, or what to eat at lunch, who will do the dishes, etc. Sometimes, more than that, but regardless of your reasons for the argument (or fight), patching up a troubled relationship and having a solution is very important.
Second to God, our partners are a believer's most valuable asset. Companions provide a listening ear for our troubles, support for our dreams, and a safety net when we fall. They give us love, even when we are unlovable. They are and must be our friends. Inevitably, though, sometimes we go through troubled periods and a solution should be sought through the following steps:
1. Address the situation. Acknowledge to your partner that something is amiss and needs to be fixed.
2. Determine the problem. Together, discuss where the relationship veered off course and what wrongs may have been spoken or committed. Be honest and let your honesty be in its proper place. Remember, you are talking to your partner, another half of yourself.
3. Apologize. As believers we accept responsibility for our actions and seek forgiveness.
4. Refuse to blame. In addition, we must avoid defending ourselves. There could be a temptation to argue over who did what; however, the goal is not proving who is right but saving the relationship.
5. Begin repairs. Ask, "What can I do to rebuild our closeness?" The key here is to do willingly whatever is requested.
6. Commit to rebuilding. Immediately start investing your time, energy, and love in restoring the relationship.
7. In order to have the blessing of a good relationship, with a partner who accepts and loves us, we must be willing to pay the high price of patching things up. Walking away might seem easier, but in the long run, we would lose a valuable treasure. God bless you both.
Probably you think that you will never allow arguments to set in your relationship (especially when you get married), or will never think to start one, but arguments seem to come naturally.
You argue about the brand of coffee, or what to eat at lunch, who will do the dishes, etc. Sometimes, more than that, but regardless of your reasons for the argument (or fight), patching up a troubled relationship and having a solution is very important.
Second to God, our partners are a believer's most valuable asset. Companions provide a listening ear for our troubles, support for our dreams, and a safety net when we fall. They give us love, even when we are unlovable. They are and must be our friends. Inevitably, though, sometimes we go through troubled periods and a solution should be sought through the following steps:
1. Address the situation. Acknowledge to your partner that something is amiss and needs to be fixed.
2. Determine the problem. Together, discuss where the relationship veered off course and what wrongs may have been spoken or committed. Be honest and let your honesty be in its proper place. Remember, you are talking to your partner, another half of yourself.
3. Apologize. As believers we accept responsibility for our actions and seek forgiveness.
4. Refuse to blame. In addition, we must avoid defending ourselves. There could be a temptation to argue over who did what; however, the goal is not proving who is right but saving the relationship.
5. Begin repairs. Ask, "What can I do to rebuild our closeness?" The key here is to do willingly whatever is requested.
6. Commit to rebuilding. Immediately start investing your time, energy, and love in restoring the relationship.
7. In order to have the blessing of a good relationship, with a partner who accepts and loves us, we must be willing to pay the high price of patching things up. Walking away might seem easier, but in the long run, we would lose a valuable treasure. God bless you both.
Wednesday, 4 January 2012
Emedinews:Insights on Medicolegal issues:Forceful/Artificial feeding and hunger strike: What is the role of doctor?
It has been observed that generally the hunger strikers do not wish to die but it cannot be ruled out that some may be prepared to do so to achieve their aims. The doctor needs to ascertain the individual's true intention, especially in collective strikes or situations where peer pressure may be a factor. An ethical dilemma for the doctor arises when hunger strikers who have apparently issued clear instructions/consent not to be resuscitated or even any medical intervention reach a stage of cognitive impairment. The principle of beneficence urges physicians to resuscitate them but respect for individual autonomy restrains physicians from intervening when a valid and informed refusal has been made. An added difficulty arises in custodial settings because it is not always clear whether the hunger striker's advance instructions were made voluntarily and with appropriate information about the consequences. I too have faced this dilemma during the case of Medha Patekar hunger strike at Jantar Mantar in Delhi. Such situations are resolved in India by the police by arresting the hunger strikers under section 309 IPC for committing suicide. The doctor treats the person to save his life as a legal obligation with ethical precaution that it should be restricted and limited only for life saving.
Emedinews:Makesure:An asthmatic patient became worse after receiving a painkiller.
Situation: An asthmatic patient became worse after receiving a painkiller.
Reaction: Oh my God! Why was he not put on zafirlukast?
Lesson: Make sure that a patient with asthma is not given aspirin or he is put on zafirlukast or montelukast
Reaction: Oh my God! Why was he not put on zafirlukast?
Lesson: Make sure that a patient with asthma is not given aspirin or he is put on zafirlukast or montelukast
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