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KERALA (Government of Kerala)



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By: J. Angir, M.B. B.CH. B.A.O., M.B.B.Ch., Ph.D.

Clinical Director, University of Nebraska College of Medicine

As a vehicle for applying medical knowledge to solving problems treatment joint pain buy generic domperidone online, the healthcare system has become increasingly cumbersome medications to treat bipolar disorder discount 10 mg domperidone free shipping, user- unfriendly symptoms to pregnancy buy domperidone master card, and expensive. When the Internet opened up new channels for consumers to access medical knowledge directly, it was rapidly flooded with users. According to a recent Harris poll, roughly 110 million Americans used the Internet to seek health information in 2002. According to Peter Drucker (see Note 1), large healthcare institutions, like urban academic health centers, may be the most complex organizations in human history. Not only do the medical problems presented at the point of service vary tremendously, but no inventory exists; health services are, for the most part, custom manufactured for individual patients on a “just in time” basis. For most healthcare, there is no template on which physicians can rely to make decisions about health. This is because professional consensus on what best practice is or ought to be is only now emerging. Perhaps most significantly, more complex, highly trained health professionals collide at the point of care than in any other business in our economy. Each profession has its own unique view of the patient’s needs, its own language for describing those needs, and an intensely territorial view of its involvement in care. Collaboration The Information Quagmire 7 among professionals is vital to effective care, yet professions compete for resources and control over patients. It is on the verge of revolutionizing medi- cal practice, dramatically improving communication among physi- cians and between physicians and patients. Whereas hospitals and major insurers have been connected elec- tronically for years through dedicated, high-bandwidth telephone conduits called T1 lines, the advent of the Internet has recently brought affordable broadband connect ivity to doctors and patients. The Internet has not only brought new options for physicians and patients to connect with one another, it has made possible con- nectivity to and networking with thousands of colleagues and tens of thousands of patients worldwide. Complex software can now be maintained efficiently at a single site on remote servers, which hospital and physician users can reach by way of a web browser and high-speed 8 Digital Medicine Internet connections. Clinical and financial information can be sent rapidly to remote locations and returned to the institutions or care- givers that need it to make care decisions. It markedly reduces the time and cost of finding answers to medical questions on the Internet and may be more important to medicine than any other knowledge domain. Computer-assisted Diagnosis Computer-assisted diagnosis will penetrate into the nucleus of hu- man cells, providing an extraordinarily detailed and highly personal map of a patient’s potential health risks, including the risks of various The Information Quagmire 9 forms of therapy. This in turn will enable the custom fabrication of therapies to control unique risks for disease and adverse reactions to treatment and eventually extinguish diseases before they flower into illness or threaten our lives. Genetic information will play a part in computer-assisted diagnosis, enabling physicians to reduce adverse drug reactions, adjust dosages to an optimal therapeutic result, and avoid wasting drugs on patients who are unlikely to re- spond to them. Genetic information will become an essential part of our health records and help provide a basis for a new, exquisitely personal, and proactive form of medicine. Powerful computing engines have dramatically enhanced mature diagnostic imaging technologies like magnetic resonance imaging and computed tomography. These technologies can today create live, three-dimensional images of internal organs that provide not only vivid anatomical detail, but also indicate whether the organs are functioning properly. These imaging technologies will be powerful enough to detect threatening molecular and genetic changes in our cells as they are occurring. Thanks to growing broadband Internet capacity and internal communications networks (or intranets), dig- ital images and their interpretations can be moved, literally at light speed, to the desktops of clinicians anywhere in the world without being translated into film or paper.


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Offer to listen to the concerns of the patient or fam- These stressors can cause diffculties in communication and ily member again medicine to stop diarrhea discount 10 mg domperidone amex. This chapter will outline some of the acknowledging that you can minimize the threat treatment episode data set purchase 10 mg domperidone overnight delivery. Encourage critical aspects of patient–physician confict and present strat- the person to put his or her concerns and desired outcomes egies to reduce risk treatment keloid scars order genuine domperidone on-line. Consider inviting a third party such as your chief resident or supervisor to help. Finally, respect any request to Verbal aggression make a complaint by directing the person to the appropriate Aggression can be triggered by many emotions, perhaps the channels and indicating that feedback is welcome. If a patient or family member becomes verbally aggressive, acknowledge their feelings gently Intimidation but clearly. It is important to have insight into your own responses to be- At the same time, ask them to help you by remaining calm. Some people are uncomfortable with confict and In other cases, verbal aggression may be a presenting sign to avoid confrontation become submissive. Others respond to bullying with certifcation program offered by the Crisis Prevention Institute a strong reaction that may be experienced by the patient as (www. Clearly explain that you In general, the least experienced members of the team are the want to work collaboratively with the patient, and offer the most at risk of being injured. Emphasize what you are, or are not, willing unless you have been appropriately trained. If appropriate, indicate that you can arrange for or family member represents a serious emergency; alert the the patient to be seen by another physician if he or she prefers. Finally, be mindful that any medi- member of the team to join you when you see the patient. Document your observations Critical incident debriefng and interventions and ensure that your supervisor is aware of Critical incidents can have a profound impact on everyone the situation. Critical incident debriefng is a voluntary process that allows individuals to discuss an incident from a personal Privacy issues or professional perspective. Facilitated by trained experts, such All of us leave a digital imprint wherever we go, and in some sessions are not about assigning blame or investigating errors. Rather, they allow for safe discussion of the incident and It is important to be aware of your imprint and the informa- normalization of the complex emotions they provoke. If highly personal information about you or are not included in a debriefng session that is relevant to you your loved ones is readily available on the web, it can be found and would like to have access to this service, make your wishes by others and used maliciously. Maximize your privacy by being cautious about the sort of personal information you put on the web, including social networking sites (e. Set your Case resolution privacy settings as high as possible and restrict access to The resident eventually reports the strained nature of the known friends or family members. Request that they do not relationship to their supervisor, who immediately arranges post information about you or your loved ones without explicit for a meeting between the patient, his family and the permission. With the patient’s permission, the hospital’s It is not uncommon for physicians to be surprised at the vol- Patient Representative is invited to attend. The meeting is ume of personal and professional information that can easily diffcult, but it reveals that the family had misunderstood be collected online.

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Te recent research on use of nano various unsolved problems such as sight-restoring therapy for patients particles in the treatment of Alzheimer’s disease is as shown in Figure with retinal degenerative disease [35] treatment 8th feb domperidone 10 mg generic. Tere is commercial non availability of the frst-line drugs pyrrolidone solution to form nanodispersion treatment centers of america buy domperidone with american express. Recent research [37] shows applications of various nanoparticulate Pharmaceutical industry faces enormous pressure to deliver high- systems like microemulsions treatment juvenile rheumatoid arthritis domperidone 10mg online, nanosuspensions, nanoparticles, quality products to patients while maintaining proftability. Terefore liposomes, niosomes, dendrimers and cyclodextrins in the feld of pharmaceutical companies are using nanotechnology to enhance the ocular drug delivery and also depicts how the various upcoming of drug formulation and drug target discovery. Nano pharmaceutical nanotechnology like nanodiagnostics, nanoimaging and nanomedicine makes the drug discovery process cost efective, resulting in the can be utilized to explore the frontiers of ocular drug delivery and improved Research and Development success rate, thereby reducing therapy. Surgery Application of Nanotechnology in Modifed Medicated Te technique developed by Rice University, two pieces of chicken Textiles meat is fused by a fesh welder, by placing two pieces of chicken touching each other. In this technique, green liquid containing gold- Using nanotechnology newer antibacterial cotton has been coated nano shells is allowed to dribble along the seam and two sides developed and used for antibacterial textiles. Tis method can be used arteries which have been using nanotechnology, new modifed antibacterial textiles have been cut during organ transplant. Application of conventional antimicrobial agents to textiles artery perfectly [38]. Tis technique has been advanced by a focus on inorganic nano structured materials that acquire good antibacterial Visualization activity and application of these materials to the textiles [41]. Drug distribution and its metabolism can be determined by tracking Conclusion movement. Tese dyes excited by light of a certain wavelength Nano materials have increased surface area and nano scale efects, to glow. As have unique physicochemical and biological properties as compared a result, sizes are selected so that the frequency of light used to make to their larger counterparts. Te properties of nano materials can a group of quantum dots fuoresce, and used to make another group greatly infuence their interactions with bio molecules and cells, due incandesce. For example, nano particles Tissue engineering can be used to produce exceptional images of tumor sites; single- In tissue engineering, nanotechnology can be applied to reproduce walled carbon nanotubes, have been used as high-efciency delivery or repair damaged tissues. Tere is a very bright future scafolds and growth factors, artifcially stimulated cell proliferation, in to nano technology, by its merging with other technologies and the organ transplants or artifcial implants therapy nano technology can be subsequent emergence of complex and innovative hybrid technologies. Biology-based technologies are intertwined with nanotechnology- nanotechnology is already used to manipulate genetic material, and Antibiotic resistance nano materials are already being built using biological components. Antibiotic resistance can be decreased by use of nano particles Te ability of nanotechnology to engineer matter at the smallest scale is in combination therapy. Zinc Oxide nano particles can decrease revolutionizing areas such as information technology cognitive science the antibiotic resistance and enhance the antibacterial activity of and biotechnology and is leading to new and interlinking these and Ciprofoxacin against microorganism, by interfering with various other felds. By further research in nanotechnology, it can be useful for proteins that are interacting in the antibiotic resistance or pharmacologic every aspect of human life. Immune response References Te nano device bucky balls have been used to alter the allergy/ 1. Tey prevent mast cells from releasing histamine oxide (f: SnO/sub 2/) thin flms for solar cell applications. Faculty of Engineering into the blood and tissues, as these bind to free radicals better than any & Technology. Wang Z, Ruan J, Cui D (2009) Advances and prospect of nanotechnology in stem cells. Hollmer M (2012) Carbon nanoparticles charge up old cancer treatment to bioactives. Wyss Institute (2012) Harvard’s Wyss Institute Develops Novel Nano therapeutic treatment of retinal and optic nerve diseases. Curr Opin Pharmacol 13: 134- that Delivers Clot-Busting Drugs Directly to Obstructed Blood Vessels.

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