Month: March 2016

Point of care testing (POCT)

Point of care testing (POCT) can be defined as the provision of a test when the result will be used to make a decision and to take appropriate action, which will lead to an improved health outcome. The basic objective of POCT is to produce a result swiftly yet reliably.

According to Accreditation Canada POCT refers to “any testing conducted outside a lab, in a hospital, in a clinic or by a health care organization providing ambulatory care. This includes testing performed at sites outside the traditional lab dedicated to medical biology, near where care is delivered to the client. POCT results may lead to a change in the care of the client. It ranges between three levels of complexity, from simple procedures such as glucose testing, moderate‐complexity procedures including provider performed microscopy procedures like used in TB or high‐complexity procedures such as influenza testing.”

The healthcare system is changing so quickly. Everyone has to run at that high speed just to keep up. Having a good health is just like happiness, can’t remain constant and whomsoever looking to maintain the status quo should not be in or go into healthcare as a profession. The change process shows no sign of slowing down.

In fact, all aspects of this field are moving equally fast like automobile industries, various new technologies like robotics and information technologies (IT). IT boosted so much in recent decade. Economics is also improving as well etc. It is no wonder that POCT is moving quickly ahead as one of the major approaches to solving what seems to be the major challenge that is how to do more with less.

What is the purpose of POC and why it is important?

1. The result of POCT is so quick that it can be done within seconds, to minutes to a few hours while the patient waits. At least result should be given on the same day depended on the complexity range of the diseases.

2. It provides rapid turn-around results that affects the clinical management of referral system, follow up of patient, treatment decisions and decision to discharge the patient.

3.The results of POCT are very useful in clinical decision making for any doctor. As the final diagnosis helps doctor to take appropriate action for the treatment without any further delay.

4. It is convenient for the patients and care providers as well. It mainly derives from the fact that the diagnostic process is achieved with in the same clinical encounter. And the patients do not have to come back for testing or go far away for some testing in medical laboratory.

australia-will-be-switching-to-a-new-medical-service-provider-for-migrant-screening-later-this-month_499x288

Common POCTs are:
Blood-glucose testing,
Electrolytes analysis,
Rapid coagulation testing (PT/INR, Alere, Microvisk Ltd),
Rapid cardiac markers diagnostics (TRIAGE, Alere)
Drugs of abuse screening,
Urine strips testing,
Pregnancy testing,
Faecal occult blood analysis,
Food pathogens screening,
hemoglobin diagnostics (HemoCue),
Infectious disease testing
Cholesterol screening (cholesterol, VLDL, LDL)

SUPPLEMENTARY FOOD FOR INFANTS

At no other time of life food is so important as in the first year of life (infancy). The kind, amount and sanitation of this food as well as the manner of feeding require particular attention which plays dividends in the form of a healthy, happy to baby. The nutrient requirements are high per unit of body weight because of rapid growth. In fact, in no other period of life growth is so rapid as in infancy.

Every mother is aware of that food prepared for adults are not always suitable for infants. But most of mothers do not realise that foods suitable for them can be easily prepared. They go for expensive baby foods which are sometimes beyond their reach.
Satisfactory foods can be planned and prepared for infants and children at home without using much expensive food stuffs.

We all know that breast milk is best food for the baby. But after 6 months, breast milk alone is not sufficient to meet the growing needs of the infants. Certain other food need to be provided  along with breast milk so as to supplement the short fall in the nutrients. The right time to start with supplements is after six months as per the guidelines. If we start too early, the child always at an increased risk of diarrhoea and if too late there is a constant fear of malnutrition.
Please note: Breast feeding has to be continued with supplementary foods.

The texture of consistency of the supplements can be modified according to the age of the infants, thus providing them with liquid supplements between 8-12 months. Liquid supplements include fruit juice, vegetable soups, soupy dal and cattle milk. In early stafes awe can start  with half ounce and gradually this amount can be increased upto 3 ounces per feed.

As the child grows, from liquid supplements there is a gradual transition to semisolid foods. The semisolid foods are mostly porridges made out of the stable food of the community (wheat, rice, maize, jowar, etc) These cereals are generally cooked with milk and sugar.  Some commonly used porridges are ‘Dalia’, ‘Rice Kheer’, ‘Suji Kheer’, ‘Ragi Kanjee’, ‘Sabudana Kheer’ etc. The porridge should be such that the child can swallow it easily. To ensure that the porridge is not thick and to reduce its build ARF (Amylase Rich Food) is added to porridge.

6032136875_d75a3835d5_z

The ARF is nothing but flour obtained from germinated grain like wheat, bajra, jowar, maize etc. Germinated grain flour contains a lot of amylase which makes the porridge soft , thin and easy to eat. Grains can be germinated, drained in Sun, powdered and the stored in air tight containers. Quarter to half tea-spoon of ARF powder can be added to the cooked porridge  when it is still hot (around 70*C). Other than porridge, boiled and mashed and given as such where as had fruits like apple, pineapple, peaches, banana etc. need to be first stewed and mashed before being served. Boiled dals, egg yolk, boiled fish and meat can also be given along with a little salt and butter.

When the baby starts teething around 8 months, it is the right time to introduce thick solid foods. The foods which were boiled and mashed earlier should now be just boiled and cut into small pieces. Boiled rice and small pieces of chapaties may also be given. Hard and crunchy foods are liked by the infants during the time of teething biscuits, toast, rusk, raw carrot, apple, cucumber are ideal food items for the child to chew.

Various food mixtures prepared from cereals, pulses, fruits,  nuts, animals foods, vegetables, milk and its products during this period. It has been noticed that children who are brought up on a variety of foods lives healthier and have much healthier tastes than those of brought up just milk and biscuits, fruits juice and vitamins. A mixed diet will not only upgrade the protein quality but will also prevent the development of vitamin and mineral deficiencies. By the age of one year the baby can take all solid foods. In fact the child can eat all the foods prepared for family meals.

Most of the problems of food acceptability in children being around one year of age. The problem in fact starts with the mother, who thinks the child should be well fed and tried to feed the child more food that its  needs. The mother should have patience and should help the child in developing good food habits gradually. Learning is a slow process and here the child learning to eat new foods one after the another.
So, have patience, be supportive and the result will be happy, healthy baby.

 

 

Life is about to get started

Life is about to get started, Life is about to get started
It is just to be started in just few moment
Once again I coming out of the womb
The life is going to slap me again in my arse

Finally I am getting out of here
They cut all my past connections
Where the Earth I am going?
Bright Sun light blowing my dark hideous screams

Love me again for a bat of an eye
All that phony pleasures that you can flow
Give me some toys and clothes to see my giggles
Do whatever that can make me safe and calm

Life doesn’t happens for me, it happens to me
With only have two choices astronaut or scientist
Whatever big that your can imagine, force me
with smiles, for all that joys or sorrows saith

I will crave, I will cry, make you do anything
To full fill all my god damn desires
Fill my eyes with dreams again and put blinkers
Make me learn to eat but don’t teach me how to live

It all looks good because I am new with shine
Joy nor sorrow knows not from each other
Some says I am black, some says I am white
But does it really matter anyhow to anyone?

Send me school, send me classes, send me college
Send me anywhere that assure things others do
Be slave of each other for few coins that defines success
I will run again till wherever my path make me go

Doubts, Worry, Fear and Sadness makes everyone feel alive
Where goes the happiness? Remains inside likes and comments
Or a swipe right and go for plastic dinner again?
Life is about to get started, Life is about to get started!

 

India, the country of road accidents

Do you know? India has the highest number of road accidents in the world.

Every hour, 40 people under the age of 25 die in road accidents around the globe.

India stands out miserably in the latest World Health Organisation’s (WHO) “Global Road Safety Report-2015” with an estimated 2,07,551 deaths on roads and around 4.5 lacs crashes. That is actually much more than the number of people killed in all our wars put together.
In 2015, one person dies every 4 minutes in roads accidents in India, according to NGO ‘Indians for Road Safety’.
People left injured were also the highest levels since the recording in India with 4.8 lacs injured people, some of them even faced permanent disability.
According to the WHO, this is the second most important cause of death for 5 to 29 year old ones after is road accident. A 16-year-old has 3 times the crash risk of an 18-year-old and 7 times the crash risk of a 25-year-old.

48129040.jpg
“In New Delhi, the capital of India, frequency of traffic collisions is 40 times higher than the rate of London, the capital of the United Kingdom.”

Among 53 mega cities of India, capital city Delhi itself registered the highest number of fatalities Delhi with 2,199. That is like 6 lives end on Delhi’s roads everyday!
Chennai second recorded 1,046 such deaths
Bhopal ranked third with 1,015
Jaipur fourth with 844 lost lives

fatboyke (Luc)Photo URL    : http://www.flickr.com/photos/fatboyke/2668411239/

1. Safety Education & Good Roads:
One should know and follow traffic rules obediently. Uneducated people don’t know about the rules and the educated people ignores them. Preference to pedestrians and children should be first. As per Indian standards, left side should be chosen.
Caution signs should be placed. Government should provide good fund and management for the maintenance of road. Generous luminescence in the dark, street lights in working condition. Cross roads and speed breakers should be made in risky areas.

2. Safety Measurements:
Cars should be driven with seat belts as they protect body parts including brain and spinal cord. It is estimated 15,000 lives are saved each year in USA with the help of wearing seat belts.
Bikes should be only allowed on the roads if the person is wearing a well certified helmet. Youngsters avoid wearing to look cool and adventurous. End up buried under the grave. Helmet saves up to about 50% of cranial injuries.
Government should favor compulsory cars with airbags, ABS (anti-breaking system), fog lamps and rear defogger glasses.
There should be rule of not allowing kids to the age of 15 to be allowed to sit even in co-passenger seat with driver. It is followed in some countries but not in India.

3. Enforcement of Laws:
License should be strictly given after a road test under an official and it should be retested after a period of 5 years at least for renewal. Speed limit, medical fitness tests, compulsory seat belt and helmet rule should be applied. 
There should be strict laws against
a) bad driving,
b) taking and texting on mobile phones,
c) crossing the speed limit,
d) roadside alcohol and drugs intake checkup,
e) illegal street racing, and
f) under-age driving (below 18)

4. Preventive Care with Medical & Rehabilitation Facilities
The person who faced minor or major accident should be provided with ambulance to the nearest hospital for the management of any trauma. Hospital should provide fully specialized Intensive Care Unit (ICU) and Intensive Critical Care Unit (ICCU) facilities can save the life of the person.
Other than that if the person get impairment or disability, he or she should be rehabilitated to avoid being a handicap person. This include medical, social, psychological and occupational rehabilitation.

5. Psychological factors should be avoided
One should not drive in any of these following conditions:
a) Lack of experience with driving a vehicle.
b) Trying to be adventurous and taking raking risks.
c) Impulsive behavior or mood.
d) Defective judgmental behavior.
e) Delay in decision taking.
f) Ability of poor perception.
g) Driving with family dysfunction.
h) Alcohol or any other drug addiction.

Dedicated to my cousin Ankit who lost his life last month on road accident. May the lord rest his soul in peace.

References: TOI, NDTV, Hindu, K.Park’s Preventive & Social Medicine