Monday, March 2, 2015

Mysteries Surround Kids' Top Acquired Heart Disease "Kawasaki "

2015-02-11-0130FeatureAmericanHeartMonthV2_Blog.jpgThe patient came in complaining of a high fever that had persisted for about a week.
He was a little boy, just a few months past his fourth birthday.
The whites of his eyes were red. The inside of his mouth was redder than usual. So were his lips; they also were cracked, with a little bleeding. The side of his neck was painfully swollen.
It was 1961, and Dr. Tomisaku Kawasaki of the Red Cross Hospital in Tokyo had never seen anything like it in his 10 years as a pediatrician. He couldn't find anything written about it.
A year later, he saw it again.
Within a few years, he'd seen it in about 50 children. He referred to it as GOK -- "God Only Knows."
The root of the problem turned out to be inflamed blood vessels. In extreme cases, it affected various organ systems, including the heart. It could even be fatal.
Once Dr. Kawasaki began documenting cases, he found more and more. He published a paper on it in 1967, in his native language, Japanese. An English version arrived in 1974, and American doctors soon began to recognize cases, too. "GOK" soon got a new name based on its documenter; thus the title, Kawasaki disease.
Today, we have a much greater understanding of this condition.
We know it manifests in a fever that lingers at least five days, and includes at least two of these symptoms: body rash, reddened and/or swollen hands and feet, and the symptoms evident in Dr. Kawasaki's initial patient -- bloodshot eyes, reddened tongue, reddened and cracking lips, and a swollen lymph node in the neck. There is no test for it, so doctors diagnose it after eliminating other possibilities and by observing those symptoms.
We know that heart problems develop in as many as 1 of 5 patients. Those problems can include aneurysms in the coronary arteries, or a weakened heart muscle. Those less than a year old are the most at risk for serious heart problems.
We know that it's rarely seen in kids over 8; the vast majority of cases (80 percent) are 5 years old or younger. We know it strikes more boys than girls (by about 2 to 1), and it strikes mostly in winter and early spring. We know it happens in Japan more than any other country, followed by Taiwan and Korea; in the United States, we know that most patients are children of Asian-American descent.
Best of all, we know how to treat it. Aspirin can reduce the fever, rash, joint swelling and pain, and also can help prevent the formation of blood clots. Severe heart problems can usually be avoided if a type of IV treatment is given soon enough.
But there's a lot we don't know, including two of the most important things:
  • What causes it?
  • How can we prevent it?
Lacking those answers, Kawasaki disease has become the leading cause of acquired heart disease among children in developed countries. Phrased another way, it is the No. 1 heart problem among kids born with a healthy heart in the United States and other, similar countries.
Clearly, this is a growing problem, and a challenge for cardiovascular researchers.
Earlier this month -- which also happens to be American Heart Month -- about 400 medical professionals from around the world gathered in Honolulu for four days of meetings about this illness. It was called the International Kawasaki Disease Symposium, an event that began in 1984 and is now held every three years.
2015-02-11-Dr.Kawasaki.jpgDr. Kawasaki himself made the trip to Hawaii from Japan. He turned 90 the day after the conference, but in an interview with Dr. Elliott Antman, the president of the American Heart Association, Kawasaki recalled his initial case with the clarity of someone he'd met only days before.
"I was very much impressed by the signs I had seen on his face," Kawasaki said. As he detailed the symptoms, he gestured often -- pointing to his eyes, making circles around his mouth, extending his tongue and tilting his neck. He later touched his heart.
With the aid of a translator, the conversation ventured from 1961 to 2015, from the first patient he saw to our current understanding of Kawasaki disease.
So far, data suggests that that Kawasaki disease is not hereditary or contagious. In fact, it's rare for more than one child in a family to develop it.
Investigators also believe it's caused by an infection. The mystery is whether it is just one strain, or multiple strains coming together.
Another mystery is the long-term effect. While most patients who are treated see their heart problems clear up within six weeks, there's not enough research on their chances of developing heart problems as adults.
"What I really want is to protect children from getting Kawasaki disease -- prevention, prophylaxis," Kawasaki said. "But in order to find a way to do that, we have to first identify the cause of Kawasaki disease and that is very difficult. We are not able to do that yet. But I understand that many excellent scientists are working very hard to find the cause of Kawasaki disease. Therefore, I really look forward to the day we are able to prevent it, or treat it also."
All of us at the American Heart Association want that, too, and are proud to be working toward it by hosting events such as the International Kawasaki Disease Symposium and funding research. We've invested more than $3.7 billion on treating, beating and preventing cardiovascular diseases, including $100 million annually since 1996. Only the federal government spends more.
The effort is there. Soon, the answers will be, too.
Program for IKDS 2015 signed to Dr. Elliott Antman by Dr. Tomisaku Kawasaki
  CEO, American Heart Association

Monday, May 6, 2013

Top 10 Reasons to be a Doctor !!

Top 10 Reasons to be a Doctor 

1) Respect

Doctors are kept at a position compatible to god by people of this world. Huge respect is given to doctors from ancient times to till now. They are called as life savers. The degree “Doctor of Medicine” still carries huge power in our society. With this power, there comes responsibility as a doctor. Doctors have to maintain their respect. There is huge pride in this field of medicine.
Despite of all the respect, many doctors feel that they are overworked, underpaid and underappreciated but it’s really not the case. Patients trust and respect their doctors and their decisions. Patients should behave well with their doctors and should be open in front of them. I conclude this by saying that doctors are essential, so value them.

2) Secure jobTheir job is very secure as compared to other jobs. There can’t be any recession in medical sector. Thus, a doctor’s job is safe. Even those doctors, who lose a job can get a new job easily, they won’t stay out of work for long time as doctors are needed everywhere.

3) Serve for public
It’s a genuine service for the benefit of the public. You are actually saving someone’s life what else good you can do. You have your patient’s wishes with you for your whole life what else you need!!! Patients compare their doctors to god. There is nothing bigger than that, that they can achieve in their entire life. That’s why doctors always walk with pride.

4) Training for self-disciplineIs you are on the verge on becoming a doctor and you are graduating from a med college then you are definitely a disciplined person. Doctors are taught to be disciplined. The way they talk, the way they react in abnormal situations and things is far different from a normal being. They are trained to be polite and calm in difficult situations during any kind of surgery. They are also likely to be a good decision maker in life.

5) They can do things what normal people can’t doA doctor has to study each and every body parts of human beings, plants, animals, birds etc, it depends on their field. Thus, they have every right to cut open living people to conduct their study or to perform some operations or some surgery. They work with the most incredible technology which is never imaginable. Doctors can perform any operation on a dead body too in order to teach their new interns. Isn’t it cool to do these things, you will have a lifetime experience. But unluckily, only doctors can do that.

6) UnderstandingDoctors can simply ease more than just the physical pain of their patients. They can read their minds while treating them. If they find their patients’ immune to not just disease but also to fear, loneliness or anxiety, they will offer them help and guide them the way. They can address their patient’s problems easily and can relieve their patients from them by their awesome advice.

7) Lots of optionsIf you are a doctor, you have flexibility of options. You can have the MD degree or the DO degree, the basic sciences, consulting, etc. And if you are not comfortable with working for anyone else in a hospital then you can open your own clinic and can earn a better amount than working for a hospital.

8) InfluenceIt’s not an easy task to become a doctor. Doctors are smart, skilled and proficient. They have power to change the world through science. People will listen to them and will definitely take their words seriously. Thus, doctors somehow have some influence over people.

9) Can diagnose their familyNothing can be as good as having a doctor in your family. You will trust him more than any other doctor and you have him all time with you so that if you get into some trouble regarding your health, there is no need to call a doctor or run for a doctor as you already have a doctor at home. Moreover, a doctor can diagnose himself; can take the best decisions for himself and obviously, he/she trusts his/her actions.

10) Never boredDoctor’s love their job. They never get bored. They interact with people or their kids talk to them, play with them or direct them. They get to know people well and they like that. They can work virtually anywhere they want. They have much freedom. Lab coats or scrubs never go out of fashion. People dream to wear that someday. So, they are lucky to have them all the time with them.

Sunday, February 17, 2013

أول طبيبة أمراض باطنة في مصر!!

فى 1930 تأهلت هيلانة سيداروس - إبنة طنطا - فى مجال الطب بـ مدرسة لندن الطبية وأصبحت أول طبيبة مصرية تفتتح عيادة خاصة فى مصر وأجرت عمليات جراحية وعمليات توليد فى المستشفى القبطى ..

أول طبيبة أمراض باطنية ..
فى ديسمبر 1954 أعلنت كلية الطب بجامعة القاهرة عن حاجتها إلى طبيبين نائبين بقسم الأمراض الباطنية ، فتقدمت الخريجة نازلى محمد جاد المولى بطلب للحصول على وظيفة نائب ، ولكنها سمعت زملائها وأساتذتها يهمسون فى أذنها ، وينصحونها بالعدول عن الفكرة .. وقال لها بعض الأساتذة بالحرف الواحد : بلاش لعب عيال .. كفاية عليكم علاج الأطفال .

صحيح أن مجموع درجاتها بعد سنة الإمتياز فى أقسام الأطفال وأمراض النساء والأمراض الباطنية بلغت 495 من 500 وكان ترتيبها الـ 24 بين زملائها خريجى دفعة ديسمبر 1952 البالغ عددهم 211 خريج ، ورغم أن مجموع درجاتها يعطيها الحق فى التعيين بوظيفة نائب ، وأن أستاذ القسم رشحها للوظيفة ، لكن قوانين ولوائح تعيينات الأطباء تحرم على الفتيات أن يشغلن هذه الوظيفة .

وفى 17 يناير 1955 إجتمع مجلس الكلية لفحص طلبات المتقدميين للوظيفتيين ، وتبين أن " نازلى " فى المقدمة وهنا بدأت المشكلة .. ثار بعض الأعضاء وهددوا بالإستقالة وإنقسم المجلس بين مؤيد ومعارض .
وفى 3 فبراير 1955 طلب عميد الكلية " دكتور أحمد حندوسة " أن تؤخذ الأصوات لحل المشكلة فرجحت كفة معسكر المؤيدين بعد أن أعطى عميد الكلية صوته للجانب المؤيد ، وصدر قرار المجلس بتعيين نازلى أول نائبة للأمراض الباطنية من الطبيبات كما تقرر منح الطبيبات نسبة 20% من وظائف النواب ..

تدرجت دكتورة نازلى فى العديد من الوظائف وكان لها إنجازات هامة ومنها..
انشأت وحدة علاج الأورام للأطفال بقسم طب الأورام بالمعهد القومي، وأنشأت وحدة زرع نخاع العظام بالقسم، ولها 60 بحثا في مجال العلاج الكيميائي والهرموني للأورام منشورة في المجلات العلمية المصرية الأمريكية والاوروبية.

المصدر: تراث مصرى


Thursday, January 10, 2013

Medical students during conflict: a personal experience #Gaza

This blog was submitted by Belal on 8th January 2013.
Tagged with Gazaconflict
Monday, November 19th, 2012, was the fifth day of the bombardment on Gaza. The number of casualties took a sharp increase in the past 24 hours. In total, more than 90 have been killed and 700 injured. It was time for me to join the medical staff at Shifa hospital. I made a few calls and the decision was taken: Two of my colleagues and I are going there as volunteers.
Shifa hospital ER entrance
I was in the ER when suddenly the sirens went on and several ambulances rushed out one after another. They received information that drones had targeted a building and there were many casualties at the scene. The target was 'Al-Shorooq Tower'. Despite my medical training, I was worried about what I was about to witness; this was my first hospital duty under such circumstances, which were nothing similar to those of regular medical practice. I didn’t know what to expect.
Minutes later, the paramedics were rushing in with the first casualty. It was a man who sustained large shrapnel, which penetrated his back and settled within the abdomen. After going through emergency room triage he was taken to the intensive care unit, and a team started resuscitation and assessment of the injuries. He was critical, Ultrasonography showed bleeding in the abdomen and air in the thoracic cavity, urgent surgical intervention was being prepared. Seconds later, another casualty was rushed into the ICU, a little girl under the age of eight whose face was covered with blood and she was unconscious. Her injuries were directly to the head and she was in a critical condition, too. A second team started working on her immediately. They were racing with time to stop the bleeding as fast as possible to save her life, and fast enough to get ready to handle the other casualties coming on the way. In the middle of this tense atmosphere I was standing, observing and learning how to work under pressure. In the corner was a man in a sweater. His face was expressionless, but his feet could barely support him. He was the girl's father.
Suddenly there was noise coming from outside. I was heading towards the door of the ICU room when the door opened wide and a stretcher was pushed in. A couple of seconds had to pass before I could realize that what looked like a black wooden sculpture was in fact a charred body. It was my first time to see such sights. I could have collapsed as two journalists immediately did on the spot, but I was holding on. I was inspecting the body as it was being taken to the morgue when the doctor besides me advised me not to look, "You'd better save your strength for later", he said. I believe he was right.
Back to the emergency room, dressings were in shortage and some types of sutures were missing. But there were few children who needed stitches which had to be done anyway. The children's parents used several approaches to keep them calm during the process, the youngest ones received money while encouragement statements were used with older ones. Among all that was a doctor who hid a box of fancy chocolate bars. Whenever wounded children arrived, she would give them a bar or two. It may not have cheered up the crying children a lot, but it certainly soothed the worried parent.
Time quickly passed by and It was getting dark. My two friends and I evaluated the situation fast and decided that we would go home for the night. On the way home, the streets were completely deserted except from ambulances on the major crossings.
In my short experience I have discovered how everyone can make humble but significant contributions to their society in ways they did not think were important. The paramedics spending the night out in the open, the doctor with the chocolate box, the taxi driver who refused to take the fees, and the minimarket owner who opened his shop despite the risk, they were all examples of this. With this lesson and many others, my experience which lasted for a little over five hours affected me in many ways that will last forever.

I power

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