The improved Ovid Universal search

Wolters Kluwer Health, part of Wolters Kluwer, is a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health and pharmacy.One of its most popular tools is Ovid.

Ovid supports the diverse research needs of its 13 million users worldwide – academic, medical, and corporate professionals and students seeking fast, accurate answers to important questions that help to fuel discoveries, explore topics, or research new theories.

Ovid Universal Search enables users to search all of their institution’s subscribed content, regardless of whether that content is available via OvidSP or other content aggregators. It lets you search all your subscribed resources—from Ovid, from other aggregators, from publishers—simultaneously. Users can retrieve and manage their OvidSP and non-OvidSP (Universal Search) results within the OvidSP interface, eliminating the necessity of shifting between browser windows.

The improved Ovid Universal Search now lets you-

– View all retrieved Universal Search records in one consolidated results set

– De-duplicate Universal Search results

– Easily identify duplicates to view their research trail

– Link to full text from Universal Search results (when available)

– Use Search Aid functionality for Universal Search results

– Request additional Universal Search results beyond those already retrieved in the initial set

The tool was exhibited at this year’s Online Information conference, which iwas held from December 1st through December 3rd 2009 at London’s Olympia exhibition center. Conference attendees can also learn more about Nursing@Ovid, as well as new content offerings.

Global Healthcare advertising awards for Langland and Mother advertising

The IPA Best of Health Awards celebrate the best creativity in Healthcare advertising, a sector which embraces the promotion of brands to both healthcare professionals and consumers.This years awards took place on Thursday 9th July,2009 at Gilgamesh Studios in Camden.

Mother Advertising was awarded the ‘Best of Show’ for advertising to consumers, for their ‘Pablo campaign’ for Frank; the Government’s anti-drug website and telephone helpline that offers advice, information and support to anyone concerned about drugs. The television advertising campaign features Pablo the dog as a drugs mule witnessing first-hand the dark side of cocaine.

http://www.youtube.com/watch?v=K54-kgkPyek

Langland , founded in 1991, and claiming to be “largest independent health care advertising agency in the UK”, was awarded the ‘Best of Show’ for advertising to healthcare professionals, for their ‘Smell the stilton’ direct marketing piece for Nexavar; a drug used to treat renal cancer sufferers. Their book comprises a collection of the surprising and uplifting things people choose to do after being diagnosed with cancer.

And BTW, Langland is the same company In 2009 which produced an award-winning cinema commercial which showed a man pulling a dead rat out of his mouth 9 for Pfizer).

Medical multimedia for presentations

I get a lot of traffic on my blogs for search terms-”Medical multimedia“.

During one such back-links search, i came upon this neat list of medical multimedia links for use in your presentations.

Medical Multimedia Resources

Medical Multimedia Resources

Do you need a piece of clip art to spice up your PowerPoint or web presentation? Or an image of heart rupture, post-infarction? These links will take you to sites containing medicine/health related multimedia. Please note that most of the sites listed permit use of media for educational purposes. However, it is your responsibility to ensure that you comply with each site’s terms of use.

Clip art

• Cheryl’s Image Gallery has nice clip art related to disabilities: people in wheelchairs, crutches, sign language alphabet, parking signs etc.
• Clips Ahoy has some cartoon-like but well done clip art related to medicine and health.
• Cool Archive’s Science collection.
• Cool Archive’s Medicine/Health collection.
• Discovery School’s Clip Art Gallery has good cartoon-like black and white images (health and safety category).
• Disability access symbols from Medword.
• GEWIS, Clip art gallery–scroll down to medical.

Photographs and Realistic Illustrations

• Bristol BioMed Image Archive is an excellent resource. Search or browse by alphabetical listing. Requires free registration to view full size images.
• Vesalius Image Archive, a resource for surgical education. Images contain Vesalius watermark.

Others

• HONmedia has over 1,950 medical images and videos, pertaining to 1,350 topics and themes. Easy to use.
• Medical Images and Illustrations list from the Karolinska Institutet–nicely categorized.

Related article

The Best Websites For Free Clipart Downloads (makeuseof.com)

Better imaging with Optofluidics

What is Optofluidics ?

Optofluidics refers to manipulation of light using fluids, or vice-verse, on the micro to nano meter scale. Optical devices which incorporate liquids as a fundamental part of the structure can be traced at least as far back as the eighteenth century when rotating pools of mercury were proposed as a simple technique to create smooth mirrors for use in reflecting telescopes. The field of optofluidics is a “marriage” of nano-photonics and micro-fluidics! The introduction of liquids in the optical structure enables flexible fine-tuning and even reconfiguration of circuits such that they may perform tasks optimally in a changing environment.This allows for enhanced optical detection in lab-on-a-chip systems with a potentially strong impact on bio-technology, life-sciences, and bio-medical/health-care industries.It is used in a broad spectrum of military and civilian applications for imaging, spectroscopy, communications, sensing, and displays.

The technology has now allowed the introduction of an inexpensive and high-resolution microscope that has been engineered to fit onto a single chip ( See Optofluidic microscope shrinks to fit on a chip.) The performance of the device is comparable to a 20x microscope, but in terms of size, cost and ability to mass produce, the device has significant advantages.

• The lack of optical elements in the arrangement implies that there are no aberrations to worry about.
  
• This is an intrinsically space-conserving method.
  
• The entire chip is illuminated from above; sunlight is sufficient.

This portable and cheap device is particularly appealing for third-world applications where it could be used in the field to analyse blood samples for malaria or check water supplies for pathogens. In the future, the microscope chips could be incorporated into devices that are implanted into the human body. Pretty good.

An on-chip implementation of the optofluidic microscope.

In the set-up, a voltage of 25 V is applied across the inlet and outlet of a microfluidic channel that is 2.4 mm long, 40 µm wide and 13 µm high. The electric field draws the specimen across the aperture array in a steady stream. The array consists of 120 holes with a diameter of 0.5 µm and separation of 10.4 µm, fabricated on a 2D CMOS imaging sensor. The sensor comprises a grid lattice of 1280 x 1024 square pixels with a pixel size of 5.2 µm.

Also see – Developing optofluidic technology through the fusion of microfluidics and optics

Heres a list of microfluidics research groups

Improved E.M.Rs to support Health Rights for All.

Image via Wikipedia

Heres more evidence of how good use of Health care I.T can lower health care costs, and bring health care services closer to all, without discrimination. This study quantifies the enormous savings that can be generated by a simple introduction of one more option within Electronic Medical records to choose the lowest cost generic amongst a list of pre-selected generics ( to ensure quality).

” Electronic prescribing (e-prescribing) systems that allow doctors to select lower cost or generic medications could save $845,000 per 100,000 patients per year and possibly more system-wide, according to findings from a new study. Complete use among physicians of e-prescribing system with formulary decision support could reduce prescription drug spending by up to $3.9 million per 100,000 patients per year, according to the researchers”

Doctors using e-prescribing with formulary decision support, which accounted for more than 200,000 filled prescriptions in the study, increased their use of generic prescriptions by 3.3 percent. These changes were above and beyond the increased use of generics that occurred among all doctors and the already high rate of generic drug use in Massachusetts. Based on average costs for private insurers, study authors estimate that the use of e-prescribing could save $845,000 per 100,000 patients per year and generate even higher savings with greater use.

Researchers found that the doctors who wrote electronic prescriptions were slightly younger and more likely to be female than those who did not. In addition, internists, pediatricians, and family physicians made up nearly three-fourths of those who used e-prescribing. Of the 17.4 million prescriptions filled over the course of the study, about 212,000 were prescribed electronically. This study was funded in part by the Agency for Healthcare Research and Quality (AHRQ) (HS15175).”

More use of I.T in health care will have a cascading effect on Health Rights for all as it increases affordability, efficiency, quality and information accessibility of health services. And these are few of the basic requirements of Health Rights for All.

HR Health rights

Related articles

• E-prescribing leads to more, cheaper generic Rx fills
• Costs don’t just mean financial – EMRs and patient lives
• Brand-name drugs no better than generics
• Resistance To Use Of Generic Medications By Physicians ‘Discouraging,’ Editorial States

drneelesh-87117-health-rights-human-neelesh-bhandari-medrc-raksha-india-whatrhealthrights-others-misc-ppt-powerpoint

Kindle in Medicine

Kindle is a new device that is changing the face of reading. The best of the current lot of e-book readers, Kindle is a boon for medical students and professionals, allowing them access to hundreds of books on the go!. Kindle, now in its third avatar, the Kindle Dx (Deluxe) boasts of advanced features, like PDF support (experimental) , longer battery life, 5-way Controller and sleeker design.

Check out more features here.. You can view it from all angles, zoom into any area and look at its features.

Using Kindle in Medicine

* Easy for medical students to keep up with all their scheduled reading. You can download and read reference materials that you have read previously to refresh your memory.You can seek out new textbooks to look for answers too.
* Seeking out symptoms, conditions, and other relevant information is easy.You can view photos on the Kindle if you need to see pictures of various signs and symptoms conditions.
* Study medical texts and highlight portions of texts / make notes on the Kindle as you go. Zoom into images for micro details.Bookmark and annotate important portions.
* Research can be done on its built-in web browser ( experimental feature) , no need to carry a laptop to access the internet.It offers free Wireless access to Wikipedia
* .Multiple books can be read at once, no need to carry a JUMBO Grey”s anatomy or Robbin”s Pathology encyclopedias !! It boasts of storage capacity of 1500 / 3500 books, depending on the Model.
* You can listen to music while you read.
* Inbuilt Text-to-Speech feature lets you listen to your favorite books.

It has a clear policy for returning the instrument or any content bought ( within 7 days of purchase) and also One year limited warranty. The kindle library boasts of more than 300,000 books for download, and many more added regularly. Priced at 300 and 500 $$ , and weighing approx. 300 and 500 grams (depending on the model) it is still too pricey for open embracing of this technology. Some libraries have started lending out Kindles ( with preloaded content) to its patrons.

Personally speaking , i can see a lot of content being adapted for Kindle, provided the machine becomes less expensive.
Also , many more wireless features ( like chat, email, videos etc) need to be added. If more such functionality is added to justify its high prices, i expect a LARGE number of medical students turning to Kindle.

Related articles

• Video: What Can Amazon Kindle 2 Do for You? (casesblog.blogspot.com)
• Kindle Books: The Art of the Sample Chapter (poynter.org)

Swine Flu guidelines from India

On 14 th august, Friday night, after facing flake for the past two weeks on the bungled handling of Swine Flu epidemic in India, the government has come up with a better set of guidelines.The new guidelines allow ALL doctors to treat for Swine Flu (Believe it or not, earlier only designated hospitals and doctors  < and no other doctor> could treat Swine flu!!) The guidelines were finalized after a five-hour meeting chaired by Health and Family Welfare Minister Ghulam Nabi Azad.

The patients have been categorized as follows:

* Category A: Patients with mild fever plus cough/sore throat with or without body ache, headache, diarrhoea and vomiting. They do not require Oseltamivir and should be treated for the symptoms mentioned above. The patients should be monitored for their progress and reassessed after 24 to 48 hours by the doctor. No testing of the patient for H1N1 is required. Patients should confine themselves at home and avoid mixing with the public and high risk members in the family.

I agree with this

* Category B: (i) In addition to all the signs and symptoms of Category A, if the patient has high grade fever and severe sore throat, he/she may require home isolation and Oseltamivir; (ii) In addition to all the signs and symptoms of Category A, individuals having one or more of the following high risk conditions shall be treated with Oseltamivir: children under five, pregnant women, those above 65 years, those with lung diseases, heart disease, liver disease, kidney disease, blood disorders, diabetes, neurological disorders, cancer and HIV/AIDS; Patients on long term cortisone therapy. No H1N1 tests are required for Category-B (i) and (ii). Such patients should confine themselves at home and avoid mixing with the public and high-risk members in the family.

I think all such cases be tested for H1N1, and antiviral therapy started without delay

* Category C: In addition to the symptoms of Categories A and B, if the patient has one or more of the following: breathlessness, chest pain, drowsiness, fall in blood pressure, sputum mixed with blood, bluish discolouration of nails; irritability among small children, refusal to accept feed; worsening of underlying chronic conditions. Such patients require testing, immediate hospitalisation and treatment.(

All such patients should be started on antivirals without even waiting for test results!!, its already late!

)

During the meeting, various guidelines and protocols developed by the World Health Organisation, Geneva, the Centre for Disease Prevention and Control, Atlanta, United States, and the National Health Service, United Kingdom, were also discussed.The death toll has already reached 26 today, and is rising exponentially. Hope these guidelines help, but i really think its too little too late.

Related articles

• Inside the Fight Against a Flu Pandemic – TIME (time.com)
• Swine flu deaths go up in India (news.bbc.co.uk)

Indian hospitals ranked for Digital media use

The Cybermetrics Lab recently published their world ranking of hospitals, taking into account the institutional activities in field of e-knowledge and their use of digital media for communications

Supporting Open Access initiatives, electronic access to scientific publications and to other academic material are our primary targets…The Web covers not only only formal (e-journals, repositories) but also informal scholarly communication.

The Web indicators measure electronic contents, especially those used for scholarly communication, but also basic information about the hospital, its organization, services and personnel. The rank takes into account both the volume of information published and the impact or visibility of such contents measured by the number of external links the web pages receive from others. As expected, about 45 % of top 200 and 38% of top 1000 hospitals are situated in North America.

The Laparoscopy hospital at N.Delhi is the only Indian hospital to figure in the top 100 hospitals from Asia ( 47/100, Asia), and also the only Indian hospital in top 500 worldwide. Amongst the others, Sir Gangaram hospital scores much better than Apollo and Tata Memorial.

L.R.S Institute of Tuberculosis and respiratory diseases records a very enviable world rank of 19, in number of papers and citations visible on Google Scholar., a noteworthy list headed by The Institute of Cancer Research, London.

Below is the list of 9 hospitals from India amongst the first 2000 worldwide , and their world rankings ( as per Cybermetrics Lab).Individual Ranking in various categories for India

India         WORLD RANK	HOSPITAL
(1)                 279	laparoscopy Hospital		406	749	599	140
(2)                624	Sir Ganga Ram Hospital		2,351	788	1,834	225
—————————————————————————————————————————————————————
(3)                632	Amrita Institute of Medical Sciences & Research Centre		1,015	1,429	1,174	179
(4)                921	Aravind Eye Care System		1,567	2,717	766	146
(5)                1178	Sankara Nethralaya Hospital		2,690	984	1,224	2,200
(6)                1349	L.R.S. Institute of Tuberculosis & Respiratory Diseases		2,845	6,679	1,070	19
(7)                1407	Apollo Hospitals		3,045	938	3,453	2,200
(8)                1819	Tata Memorial Centre		2,459	3,469	322	1,497
(9)                1885	Sri Ramachandra University & Medical Centre		1,742	3,787	1,660	426

Use your cell phone to diagnose diseases.

Microscopy provides a simple, cost-effective, and vital method for the diagnosis and screening of hematologic and infectious diseases.It is an essential tool in disease diagnosis and widely used all over the world. Unfortunately, the EXPERTISE required to use the tool, and to evaluate the findings is not very common. One requires a pathologist with many years of experience to make sense of those seemingly random and confused pixels. ( I know, i am a pathologist

But the advent of digital imaging has solved many of our troubles. Telepathology made sure that we do not need a pathologist physically present at the site, to render a diagnosis. But microscopy and digital imaging of the biopsy/tissue fragment was still a hassle. Now we have done better. You don’t even need a microscope to send a microscopic image over the network!!Researchers from the Univ. of California worked with high-powered LED – which retails for just a few dollars – coupled with a typical camera phone to produce a clinical quality image sufficient for detecting in a field setting some of the most common diseases in the developing world.

The newly developed technology, CellScope, allows for average cell cameras to be retrofitted with powerful microscopes, able to detect malaria parasites, and even fluorescent marker-stained tuberculosis bacteria.Thus you have your humble cell-phone transformed into the “cell-scope”.

(a) Thick smear of Giemsa-stained malaria-infected blood. (b) Thin smear of Giemsa-stained malaria-infected blood. (c) Sickle-cell anaemia blood smear. White arrows point to two sickled red blood cells. Scale bars are 10 µm.

“The images can either be analyzed on site or wirelessly transmitted to clinical centers for remote diagnosis. The system could be used to help provide early warning of outbreaks by shortening the time needed to screen, diagnose and treat infectious diseases,” University of California in San Francisco (UCSF)/UCB Bioengineering Graduate Group graduate student David Breslauer adds

Physiology of Propofol in drug Abuse

Is Propofol, or Diprivan what Michael Jackson Used for ( Drug) Abuse ?

According to Cherilyn Lee, a registered nurse who operates a Los Angeles-based nutritional counseling business, in California, “Jackson was complaining of insomnia and pleaded for her to get him some (Diprivan)”. Other reports claim Propofol was recovered from his residence. This conversation reportedly occurred in April of this year. Preliminary reports say that M.J died of cardiac arrest, which is within the possible effects of unmonitored Diprivan use. (A rapid bolus injection can result in undesirable cardiorespiratory depression including hypotension, apnea, airway obstruction, and oxygen desaturation.)

Diprivan is a general anesthetic, used to start or maintain anesthesia during certain surgeries, tests, or procedures. It is available in a white vial of 20, 50 and 100 ml (containing 10mg/ml.).Most adults require 2 to 2.5 mg/kg of the drug ( approx. 10 ml). DIPRIVAN Injectable Emulsion is an IV sedative-hypnotic agent and can cause potentiation of other narcotic drugs and benzodiazepines when used together. The most common side-effects include Change in mood or emotions; dizziness; drowsiness; lack of coordination. It is given intravenously, usually within the operation theater or in a clinic. It has a rapid onset of action ( less than 1 min) and short duration of action (approximately 10 min but is dose dependent).It has direct cardiodepressant effects, leading to decreased blood pressure and heart rate in higher doses. Its actions causing decreased heart rate and respiratory rate mean that use of propofol is done only under continuous monitoring of vital signs.Diprivan is not meant for use in pediatrics and elderly population since its safety has not been established in these populations. Prolonged use of propofol results in accumulation of the drug in body tissue and increases the duration of action as well as chances of overdose.

Rarely, Cases of death due to propofol have been discussed in medical literature. All these cases have occured in hospital settings only.It is definitely not meant for home use and this is the first time I have heard of Diprivan being used as a drug of abuse outside hospital settings.

Euphoria, sexual hallucinations and disinhibition have been described on recovery of propofol anaesthesia. These effects could explain the recreational use of the drug. Moreover, several experimental studies strongly suggest the potential for abuse and dependence on propofol,and few cases of abuse and dependency have been described, mostly in medical professionals. As propofol is generally not recognized as a substance of abuse, and because of its safe profile, it is important to remember that rare adverse reactions of propofol could produce death in a context of abuse, even at therapeutic dose range, in the absence of ventilatory and medical assistance.

British Journal of Anaesthesia 2006 97(2):268; doi:10.1093/bja/ael168