Thursday, December 13, 2012

On prescriptions and noncompliant patients

Prescriptions from doctors should be followed—this is, as far as the healthcare industry is concerned, a golden rule for patients.

Image credit: fansshare.com

However, there are always patients who do not take the medicines that were prescribed to them, intentionally or not. In the field of medicine, these people are described as noncompliant.

When patients are described as noncompliant, doctors usually think that they would only cause trouble, a mindset that should be stopped.

According to an article from The New York Times, the branding is loaded with implications and stereotypes, a label that, unfortunately, tends to stick to the patients.

Image credit: npr.org

This was backed up by a piece published in the Annals of Internal Medicine.

The author, Dr. John Steiner, notes that it is an immense oversimplification to base a patient’s compliance on whether he swallows a pill or not. He believes that there are numerous reasons why people forget to take their medicines.

For example, a patient, after receiving prescriptions from the doctor, may also be asked to cut down on certain food items, exercise three or four times a day, check his blood sugar, and go to doctors’ appointments. According to Dr. Steiner, remembering all of these can be difficult for some patients, making it difficult for them not to miss taking their meds on schedule.

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On that note, he also emphasized how important it is for doctors to take the time to know the situation of their patients.

“Be compassionate,” Dr. Steiner says to doctors. “Understand what a complicated balancing act it is for patients.”

Dr. Kamal Patel is an internist from Arlington Heights, Illinois. Get more updates about the healthcare industry, particularly on internal medicine, by visiting this Twitter page.

Monday, November 12, 2012

Malaria—Bedlam in the Blood

This article discusses Malaria, its causes, prevention, and how it became a global plague.


Written by: Michael Finkel
Article source: National Geographic



It begins with a bite, a painless bite. The mosquito comes in the night, alights on an exposed patch of flesh, and assumes the hunched, head-lowered posture of a sprinter in the starting blocks. Then she plunges her stiletto mouth-parts into the skin.

The mosquito has long, filament-thin legs and dappled wings; she’s of the genus Anopheles, the only insect capable of harboring the human malaria parasite. And she’s definitely a she: Male mosquitoes have no interest in blood, while females depend on protein-rich hemoglobin to nourish their eggs. A mosquito’s proboscis appears spike-solid, but it’s actually a sheath of separate tools—cutting blades and a feeding tube powered by two tiny pumps. She drills through the epidermis, then through a thin layer of fat, then into the network of blood-filled micro capillaries. She starts to drink. To inhibit the blood from coagulating, the mosquito oils the bite area with a spray of saliva. This is when it happens. Carried in the mosquito’s salivary glands—and entering the body with the lubricating squirt—are minute, worm like creatures. These are the one-celled malaria parasites, known as plasmodia. Fifty thousand of them could swim in a pool the size of the period at the end of this sentence. Typically, a couple of dozen slip into the bloodstream. But it takes just one. A single plasmodium is enough to kill a person.

The parasites remain in the bloodstream for only a few minutes. They ride the flume of the circulatory system to the liver. There they stop. Each plasmodium burrows into a different liver cell. Almost certainly, the person who has been bitten hardly stirs from sleep. And for the next week or two, there’s no overt sign that something in the body just gone horribly wrong.

We live on a malarious planet. It many not seem that way from the vantage point of a wealthy country, where malaria is sometimes thought of, if it is thought of at all, as a problem that has mostly been solved, like smallpox or polio. In truth, malaria now affects more people than ever before. It’s endemic to 106 nations, threatening half the world’s population. In recent years, the parasite has grown so entrenched and has developed resistance to so many drugs that the most potent strains can scarcely be controlled. This year malaria will strike up to a half billion people. At least a million will die, most of them under age five, the vast majority living in Africa. That’s more than twice the annual toll a generation ago.

The outcry over this epidemic, until recently, has been muted. Malaria is a plague of the poor, easy to overlook. The most unfortunate fact about malaria, some researchers believe, is that prosperous nations got rid of it. In the meantime, several distinctly unprosperous regions have reached the brink of total malarial collapse, virtually ruled by swarms of buzzing, flying syringes.

Only in the past few years has malaria captured the full attention of aid agencies and donors. The World Health Organization has made malaria reduction a chief priority. Bill Gates, who has called malaria “the worst thing on the planet,” has donated hundreds of millions of dollars to the effort through the Bill and Melinda Gates Foundation. The Bush Administration has pledged 1.2 billion dollars. Funds devoted to malaria have doubled since 2003. The idea is to disable the disease by combining virtually every known malaria-fighting technique, from the ancient (Chinese herbal medicines) to the old (bed nets) to the ultramodern (multidrug cocktails). At the same time, malaria researchers are pursuing a long-sought, elusive goal: a vaccine that would curb the disease for good.

Friday, October 12, 2012

Barium enema: Dr. Kamal Patel on examining problems in the colon

Dr. Kamal Patel image credit: buzzle.com


Barium enema, also called lower gastrointestinal series, is a medical procedure performed by internists, like Dr. Kamal Patel, to diagnose potential disorders in the colon (large intestine). X-ray pictures are taken while a substance called barium sulfate is inserted into the colon through the rectum.

Barium enema is used to examine the health of the bowel. It could determine the degree of inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. Other problems such as diverticulosis (small pouches formed on the colon wall that can become inflamed), intussusception (characterized by one portion of the bowel sliding into the next), and acute appendicitis may also be detected through this procedure.

Dr. Kamal Patel image credit: emedicinehealth.com


In a healthy colon, X-ray pictures show barium uniformly filling the colon and showing normal bowel contour, patency, and position. Dr. Kamal Patel, among other physicians, is able to monitor the flow of barium sulfate through a fluoroscope screen (resembling a television monitor). If the bowel has a certain injury, a water-soluble contrast is used instead of barium.

Because barium enema uses X-ray, strict monitoring and regulation are undertaken to provide the minimum amount of radiation exposure needed to produce the images. Pregnant women and children require greater care as they are more sensitive to the risks of ionizing radiation.

Dr. Kamal Patel image credit: lowergiseries.com


To learn more about Dr. Kamal Patel and the procedures he performs, read updates on this Facebook page.