Computerised system helps speed up medical treatment at CMCH

http://www.hindu.com/2008/02/28/stories/2008022852730300.htm

Special Correspondent

Photo: M. Periasamy

NEW INITIATIVE: District Collector Neeraj Mittal shows the bar-coded outpatient registration slip while launching e-governance at the Coimbatore Medical College Hospital on Tuesday. Dean of the hospital Hemalatha Ganapathy (right) is in the picture. –

COIMBATORE: It took just 10 minutes for R. Shanmughavel, suffering from coughing fits, to register his name at the outpatient counter on Tuesday, get a bar-coded slip, undergo an examination by a doctor and get a diagnosis before obtaining medicines from the pharmacy.

This happened at the Coimbatore Medical College Hospital, and not at a corporate multi-speciality clinic.

E-governance in the outpatient department was launched by Collector Neeraj Mittal and demonstrated with Mr. Shanmughavel’s case.

“I have come here earlier, and it used to take more than an hour for the whole process,” Mr. Shanmughavel told the Collector after getting the medicines and a computer-printed copy of the prescription.

The Collector said this was the first such initiative in the State.

Soon after Mr. Shanmughavel got the outpatient slip with a bar-coded sticker containing his name, age and registration number, he went to the doctor for diagnosis.

When the doctor scanned the slip, the patient details appeared on the screen of one of the 20 laptop computers provided for this project.

The doctor checked the patient and made out a prescription on the computer itself. One of the factors that helped save time was the elimination of a handwritten prescription.

“There is no need now to write the names of the medicines and dosage,” the Collector said. The patient gave only the outpatient slip to the staff at the pharmacy.

When the bar code was scanned, the prescription appeared on the computer.

Along with the drugs, a copy of the prescription was given to the patient.

“What makes this system patient-friendly is that the medicines in stock are displayed on the doctors’ computers. They can look for alternatives if the ones they want to prescribe are out of stock,” the Collector said.

Previously, only at the pharmacy would patients come to know that the medicines prescribed were out of stock, and they would have to go back to the doctor to get an alternative prescribed.

After inquiring with the pharmacy staff, the Collector said, “The manual stock-taking takes three hours after the pharmacy closes every day. Now the stock position is available, in real time, on the integrated system.”

The Collector said the postgraduate doctors wanted even the diagnosis to be made an e-record.

Patients

M. Selvaganesh, who demonstrated the system, said that until now four postgraduate doctors in each wing could handle 250-300 outpatients from 8 a.m. to noon. The new system would help increase the number to 450.

“Apart from saving time, the new system will help ensure that the details in the records are accurate,” Professor of Medicine P. Jambulingam said. Mr. Mittal said only the paediatric, medicine and surgery wings were brought under the system; the other wings would be covered gradually.

The computers and other equipment had been provided at a cost of Rs.10 lakh.

Of this, close to Rs.6 lakh had come from contributions made by philanthropists.

Tie-ups with private hospitals benefit CMCH

http://www.hindu.com/2008/02/28/stories/2008022851790300.htm

The Coimbatore Medical College Hospital (CMCH) appears to be benefiting from a social commitment on the part of private medical institutions in the city. E-governance, guest lectures and training of nursing staff/students are some of the areas of cooperation, says Dean Hemalatha Ganapathy.

A significant and latest contribution is the assistance in e-governance from the Kovai Medical Center and Hospital (KMCH), one of the corporate, super speciality institutions. Its President U.K. Ananthapadmanabhan had studied for days the manual procedures at the CMCH to identify areas where e-governance can reduce wastage of time on paperwork. “He spent many hours taking pictures of the system in our hospital,” says the Dean.

After spending 15 to 20 hours at the CMCH, spread over five to six trips, Mr. Ananthapadmanabhan had shown the bar code system in his hospital and the filmed procedures at the CMCH to District Collector Neeraj Mittal. “I made a power point presentation before the Collector, showing areas where e-governance had a vital role to play in improving the functioning in the Government hospital,” he says.

“What has been initiated at the medical college hospital will be a model for the public healthcare sector in the State and even the entire country,” says Mr. Ananthapadmanabhan.
Data

Now, the Hospital Information System wing headed by Assistant Resident Medical Officer at the CMCH will monitor patient coverage, drugs stock and send data to the Director of Medical Education in Chennai.

While the Dean appreciates a private hospital’s keenness to contribute to a Government medical college hospital’s improvement, Mr. Ananthapadmanabhan says: “This initiative involves a lot of selfishness on my part. I learnt a lot from the patient load on the CMCH. I could understand the psychology of 6,000 patients.”

The primary aim of the e-governance is cutting down time consumption at the CMCH. On further improvements, he says biometrics is the next stage that hospitals have to aim for. This will help avoid running costs of bar coding.

On the interface with other private hospitals, Dr. Hemalatha Ganapathy says this happens through a lot of academic programmes.

India plans multi-purpose national ID card for citizens

The Government of India proposed to issue Multi-purpose National Identity (smart) Card (MNIC) to the citizens in the country.

In a communication sent to the Rajya Sabha, the Minister of State in the Ministry of Home Affairs Manikrao H Gavit said that the project envisages providing unique national identity number (NIN) to each person in the National Population Register.

However, keeping in view the complexities involved both in the processes and technology, a pilot project has been under implementation covering a population of 30.95 lakh in the selected areas in 12 states and one Union Territory.

“Under the pilot project, identity smart cards are being issued to the citizens of age 18 years and above,” the Minister said.

Gavit informed that the production and distribution of identity cards to be completed by March this year has been undertaken through central public sector undertakings (PSUs).

He further added it has been decided that the implementation of the scheme in the entire country would be based in the light of the experiences gained and lessons learnt from the pilot project.

Sleep Apnea Increases Crash Rate

The potential driving hazards caused by sleep apnea, a condition that restricts breathing during sleep, have been brought to light by a study published in Thorax, an international journal on respiratory medicine.


The two-year study by Vancouver Coastal Health Region and the University of British Columbia, compared the driving records of 800 drivers who have sleep apnea with 800 drivers who did not have the disorder.

It was found that the drivers with sleep apnea, were more likely to get into a car crash, and also three to five times more likely to be involved in a major collision causing serious injury.

"A lot of sleepiness-related crashes tend to be more severe... where you fall asleep at the wheel and you hit a tree or you cross the median and hit an on-coming car," said study author Dr. Najib Ayas of the Vancouver Coastal Health and associate professor of medicine at UBC. "Even if you do not fall asleep at the wheel, it has been shown that patients with sleep apnea or sleep deprivation have reduced motor function. It affects coordination, dis-tractability or vigilance,” he said.

Dr. John Fleetham, a UBC professor of medicine said, "Car accidents are more common and more serious with people with sleep apnea. If you fall asleep at the wheel, you are more likely to be at risk for a head-on collision. It's not an act of God. It's related to conditions that can be treated and prevented." Dr.Fleetham co-authored the study with Dr. Najib Ayas.


Previous studies have linked sleep apnea to an increased risk of car crashes but this recent study is the largest of its kind and the first to focus on the severity of the collisions.


One out of eight, that is, four million Canadians admit to “nodding off ” at the wheel at least once in the past 12 months, according to the Traffic Injury Research Foundation in 2005.

Sleep apnea is a disorder that is also linked to obesity and cardiovascular disease. In Canada alone, it is estimated that between five and 10% of people older than 30 suffer from sleep apnea, but most of the cases are undiagnosed.

Some of the signs of sleep apnea affecting driving include, drooping eyelids, blurry vision, nodding off, drifting between lanes, missing traffic signs, and continuous yawning.

According to the researchers, the results of the study “can also be applied to people who work with heavy machinery and at risk of occupational safety hazards.”

Source-Medindia
THK/L

Obesity Boosts Cancer Risk

An overweight person's chances of developing five different types of cancer escalate by 50 percent confirms a new study.


Researchers at the University of Manchester discovered that those who put on weight equal to a five-point increase in the body mass index (BMI) were at considerable risk of contracting cancer of the colon, breast, skin, thyroid.

The researchers said that there was a 50 percent increase in the chances of developing the cancers if a person's weight goes up by more than two stones.

For the study, the team combined data from more than 200 sets of data, including more than 282,000 people that considered the impact of weight on 15 cancer sites.

Increased weight was most strongly linked to an increased risk for cancer of the esophagus in men and women and for endometrial and gallbladder cancers in women.

A modest association was found between excess weight and the risk for more common malignancies such as postmenopausal breast cancer in women, colon cancer in men, and blood cancer in both sexes.

But carrying extra weight was not associated with an increase in risk for prostate cancer in men, premenopausal breast cancer and ovarian cancer in women, and lung cancer in men and women.

"We were surprised to find associations to both common and less common cancers. We also saw very clear differences between [obesity-related] risk at different sites between the sexes," the Telegraph quoted lead researcher Andrew G. Renehan, as saying.


Renehan and colleagues used body mass index (BMI) measures from the studies to assess risk.


BMI is a numerical measure of fatness based on a person's weight relative to height. A BMI of 18.5 to below 25 is considered normal weight, while 25 to just under 30 is considered overweight, but not obese. Someone is considered obese if they have a BMI of 30 or above.

In men and women, each 5-point increase in BMI was associated with a roughly 50 percent increase in relative risk for esophageal adenocarcinoma.

They also found that men who gained more than two stones were 50 per cent more likely to develop oesophageal cancer and a third more likely to suffer thyroid cancer. Their chances of getting colon and kidney cancer increase by 24 per cent; they are also at a smaller but significant risk of rectal and skin cancer.

Women who are similarly overweight increased their chances of cancer of the womb lining and gallbladder by 59 per cent. They also have more than a 50 per cent increased risk of oesophageal cancer and are a third more likely to develop kidney cancer.

Source-ANI
SPH/L

Experts Warn of Rising Infertility Rates in Future Generations

Experts have warned that infertility levels may rise in the generations to come.


While writing in British Medical Journal, experts have said that that infertility levels may rise in the future generations due to increase in the use of assisted reproductive techniques.

About 6pct of children are conceived through assisted reproductive techniques in some countries.

However, the authors also suggest since fertility is determined by social, behavioural, and biological factors so it would be difficult to interpret these trends based on retrospectively collected data.

They predict that fecundity is expected to decline over time, even if no environmental causes are identified due to assisted conception.

The experts also predicted that the subfertile couples may have as many children as fertile couples, so genetic factors linked to infertility will become more prevalent in the future generations.

They believe that it is now essential to have more direct markers of fecundity and include it in ongoing representative health surveys.

The authors said that the best way to counteract infertility and help couples to have children naturally is to deal with the avoidable causes of subfecundity.

Source-ANI
SRM/M

New Drug can Help Alcoholics to Overcome Addiction

A new drug can help alcoholics overcome their addiction by reducing stress-induced cravings, a study released Thursday has found.


There is already a drug on the market, Revia, which treats alcoholism by reducing the body's ability to enjoy its effects.

This new drug cuts cravings by taking the edge off of stressful situations which might push recovering alcoholics to pick up the bottle again.

Behavioral stress is a major factor in extending the "vicious cycle" of alcoholism, said lead author Markus Heilig, clinical director of the National Institute on Alcohol Abuse and Alcoholism.

That's because alcohol deprivation causes depression and increased sensitivity to stressful situations such as an argument with a spouse or tension at work.

"Alcohol is a particularly nasty drug because it actually makes you feel better, but it pushes you to feel worse once you're without alcohol," he told AFP.

The drug Heilig and his team tested targets an area of the brain, the neurokinin 1 receptor, which mediates responses to behavioral stress. It had previously been shown to reduce social anxiety but did not enter the market because results were inconsistent.

Helig and his team first tested its effectiveness on mice and then on a group of 50 alcoholics with anxiety problems who had been through detox and remained hospitalized for the four weeks of the trial.

Half were given a placebo and the other half were given the drug.


Cravings declined over time for all patients in the protected inpatient environment and were minimal in the majority of patients by the end of the study period.


However, those who had been drug showed a more marked improvement in the severity of their cravings when measured by self-reporting questionnaires, the assessment of their clinicians, and tests where they were exposed to socially stressful situations and then told to touch a bottle and smell their favorite alcohol.

Interestingly, there was no impact on anxious or depressive psychopathology which suggests that "the improvements observed might be specific for brain processes related to alcoholism," the study published online in Science Express concluded.

The drug also led to increased brain responses to positive imagery and lessened responses to negative imagery, something which a recent study showed predicts less alcohol consumption over the next six months, tests using MRI mapping showed.

The next step is larger clinical trials to see if the drug can be of assistance to alcoholics who do not suffer from anxiety problems.

Source-AFP
SRM/M

Blood Pressure Drug may Prevent Risk of Heart Attack, Stroke

Researchers at University of Kentucky have found that blood pressure drug, Aliskiren, not only reduces blood pressure but also lowers artery-clogging lesions.


Artery-clogging lesions are a leading cause of heart attack and stroke and death worldwide.

Dr. Lisa Cassis and Dr. Alan Daugherty found the possible added benefit of the new drug in animal studies.

"In my many years of atherosclerosis research, this is one of the most striking effects I have seen on preventing the disease under experimental conditions," said Daugherty.

"This contributes to our knowledge of the underlying disease that causes heart attack and stroke," he added.

“Our data shows that renin inhibition is an effective approach to both lowering blood pressure and directly inhibiting atherosclerosis.

“It will be interesting to determine whether this approach is more effective than the two other commonly used classes of drugs in the angiotensin system; ACE inhibitors and ARBs," he said.

Source-ANI
SRM/L

New Class of Effective Drugs on the Anvil for Asthma and Allergy

Researchers from Barts and The London School of Medicine and Dentistry have moved a step closer to developing a new class of effective asthma and allergy drugs.


The researchers found an important target that holds significant promise for millions of people suffering from allergies, asthma, rheumatoid arthritis and a range of other inflammatory diseases.

The study showed that a key component of the body's own response to allergy-causing agents (allergens) can be targeted to reduce allergic reactions in mice.

In the study, the researchers found that by targeting a molecule called p110delta it is possible to interfere in the allergic reaction before symptoms occur, and without shutting down the immune system.

p110delta is a member of a family of eight proteins called PI3Ks, which control important biological functions. Their activity is implicated in many different diseases including cancer, and they are an important target for drugs.

However, drugs that act on all PI3K family members tend to be toxic in the body. For this reason the researchers used genetic techniques to find out which PI3K family members are linked to specific diseases.

By gaining a better understanding of each PI3K researchers hope to target drugs more specifically and reduce the potential for side effects.

The p110gamma member of the PI3K family had earlier been implicated in allergic reactions and was thought to be more important than p110delta.

However, in the current study, it has been confirmed that p110delta, but not p110gamma, is important for allergic reactions in a mouse model.


The new findings will help to inform and drive decisions in industry to prioritise which PI3K family members should be targeted for further investment and development.


The next step is to develop p110delta blockers is now ongoing in industry, and is expected to proceed into the preclinical arena in humans in the near future.

" This work shows that we have the potential to take control of the body's reaction to an allergen and prevent symptoms from occurring," said lead author of the study, Dr Khaled Ali.

Professor BartVanhaesebroeck added: "This work confirms our previous findings and shows once and for all that in an allergic reaction it is p110delta that is the key player among the PI3K molecules.”

“We are very hopeful that a drug for human patients can be developed in the very near future. This approach offers the potential for therapies for asthma and allergies that target the real causes, not just symptoms," Vanhaesebroeck added.

The study is published in The Journal of Immunology.

Source-ANI

A Potential Drug Against Alcohol Found

National Institutes of Health researchers already knew that the drug, called LY686017 neutralizes the action of a protein called NK1R (neurokinin-1 receptor), which is involved in the stress response in the brain.


The first hint that the drug might be useful in cutting alcohol cravings surfaced when the investigators noticed that mice who didn't have NK1R seemed to have less desire to consume alcohol.

To test their qualms, the researchers gave the NK1R-blocking drug to 25 recovering alcoholics, while giving 25 others an ineffective placebo treatment.

The analysis revealed that those who received the drug reported about 50 percent fewer alcohol cravings.

In the study, the alcoholics who were given LY686017 reported fewer spontaneous cravings for alcohol than did those who received the placebo. But the patients were kept in a hospital, away from the behavioural triggers such as social stress that are present in the outside world.

“They may get into a fight with their spouse or at work, and after that they may abstain for some period of time, but then they go past the bar where they used to drink. We wanted to mimic that in the lab,” Nature quoted Heilig, as saying.

In order to create a stressful situation, the research team led the patients into a room and told them that they had to give a five-minute improvized talk to a committee of people in white coats, as if they were interviewing for their dream job.


“No one made it beyond 1.5 minutes. Everyone dried up after that. We had stern-looking people on the committee say ‘Your time is not yet up’,” Heilig said.


Patients were then allowed to smell alcohol.

Patients who had received LY686017 produced less of the stress hormone cortisol in response to this challenge did than those on placebo.

“This might be an approach that could be used for people who drink to relieve stress in their lives, or have anxiety disorders,” said Raymond Anton, director of the Centre for Drug & Alcohol Programs at the Medical University of South Carolina in Charleston.

Source-ANI
SPH/L

You Have Caused Us Pain by Prosecuting the Pill Mill Doctor, Say US Patients

In the normal course anyone would be pleased over the prosecution of a doctor who built his empire through massive prescription of harmful painkillers. But no, US patients in Kansas state charge they have been denied legitimate pain relief by an overzealous government and are to sue it.


According to the indictment of Dr. Stephen J. Schneider (54) and his wife, nurse Linda K Schneider (49), more than fifty of their patients had died of drug overdoses in the last five years.

Charges against the couple were include conspiracy, unlawful distribution of a controlled substance resulting in death, health care fraud, illegal money transactions, and money laundering.

The doctor and his assistants wrote unlawful prescriptions for narcotic painkillers, muscle relaxers and other drugs. Drugs mentioned in the indictment included Fentanyl, Methadone, Morphine and Oxycodone.

The Pain Relief Network that is heading the lawsuit move asserts that the state authorities have put patients in mortal danger and created a public health disaster by prosecuting the doctor.

The state last month has suspended Schneider's license to practice, which forced him to close his Haysville clinic.

The lawsuit, a copy of which was obtained by The Associated Press, seeks an emergency temporary restraining order. It contends the Board of Healing Arts and a Kansas district court ignored the danger to 1,000 medically vulnerable patients who have been forcibly abandoned and must now fend for themselves. The group contends pain is a significant cause of death, including progressive brain damage.


"Withdrawal for people who are sick is catastrophic," Siobhan Reynolds, president of the Pain Relief Network.


Patients held a candlelight vigil Monday night outside Wesley Medical Center, where one of Schneider's former patients was hospitalized four days after she ran out of prescription painkillers. The hospital would say only that she was stable.

"She was lying in an ICU bed crumpled up, incoherent. ... She was in a very weakened state. She looked very, very ill," said Reynolds, who visited Collins at the hospital over the weekend.
The Network contends that the suspension of Schneider's license served no legitimate government interest but harmed his patients because it forced the closure of his clinic. Since Schneider's arrest, other doctors have been reluctant to take on his patients, the group said.

The group seeks an emergency order forcing the Board of Healing Arts to restore Schneider's medical license. It also seeks to restrain the Justice Department from harassing a new clinic to be opened under a different doctor, Dr. Joseph M. Sack, at Schneider's now-shuttered Haysville facility.

The group wants an injunction against the Justice Department prohibiting it from confiscating patient files or taking any other actions to impede its treatment of patients in severe pain. It also asks that prosecutors return to the clinic patient files taken in what the group alleges is a violation of federal law.
The lawsuit also asks the court to appoint a special master to oversee the reopened clinic's financial operations to protect it from charges of money laundering.

Source-Medindia
GPL/L

Singapore Plans to Use Valentine's Day to Boost Birth Rate

Worried that a low birth rate could threaten the country's very survival Singapore's government is playing Cupid, using Valentine's Day to promote romance and marriag