PREPARING A PLATFORM:

                                               If you want to do any clinical project , an important step is  creating a proforma.

WHY IS PROFORMA REQUIRED

1. It will help in easily filling up the required details
2. we wont forget the important information need to be collected in our research.
3. It helps in easy interpretation of our data by the other observer
4. EQUIVALITY OF ALL THE DATA, HELPS IN PERFORMING OUR ANANLYSIS EASILY

SO WHAT ALL SHOULD A PROFORMA CONTAIN:

1. Demographic info of the patients.
2. HISTORY if required.
3. Investigation to be collected. Should be exhaustive. better in tabular column. with the date in one column and it helps in easily adding our data to the sheet.
4. Detail about the drugs given including indication, requirement, dosage, route, rate of infusion, indication

THE KNOWLEDGE OF EXCEL:

             
                                               EXCEL here refers to the Microsoft Excel programme. In order to compute our data for research and also in order to do a lot of Pharmacokinetic evaluation excel will come as a handy help for us.

                               Excel will also help to organise many works in our profession and will also help us to manage the budget of our research. I will strongly recommend you to go for the original version of Excel.
                                In order to learn the excel I will suggest the following idea

1. Try to solve and see yourself in excel. Let it be wrong by this way you will learn the fastest.
2. Look out for the videos for Excel learning in the YouTube
3. Join any workshop of the Pharmacokinetic evaluation.

ARE THEY SINNED TO DIE:

                               Pharmaceutical research companies mostly invest in disease which are very common. Rare diseases are mostly excluded from the research activities owing to the poor market available for the  marketing of the drug once it is developed. It is known and well accepted fact that it takes millions for developing a particular drug. But in this era of 20 th century HUMANITY ALSO SHOULD BE TAKEN INTO CONSIDERARTION AND DRUGS NEED TO BE DEVELOPED FOR THE RARE DISEASE TOO.

                                 THESE ARE RARE DISEASES BY DEFINITION BUT A WELL NUMBER OF PEOPLE DIE ALL AROUND THE WORLD. Example of some of the rare diseases are like Rabies where a well over than 50,000people die each year and it has 100%moratlity rate.

                           And we even doctors are not interested in treating the rare disease patient stating that there is no treatment available. There might some research being done and some data might be present in the world. We as doctors should be aware of those data while treating those kind of patient and should try those procedures , so that further data are available for framing a treatment in the future.
Here is a list of rare diseases of India

Acromegaly

Alkaptonuria

Alpha-1 Anti-Trypsin Deficiency

Autism Spectrum Disorders

Coarctation of the Aorta

Ehlers-Danlos Syndrome

Epstein's Anomaly

Gaucher's Disease 

Graves' Disease

Handigodu Syndrome

Kyasanur Forest Disease

Madras Motor Neuron Disease

Marfan Syndrome

Lupus

Myasthenia Gravis

Muscular Dystrophy

Osteopetrosis

Parkinson's Disease

Porphyria Cutanea Tarda

Pulmonic Valvular Stenosis

Tetralogy of Fallot

Rabies

Sporotrichosis

Wilson's Disease

Wiskott-Aldrich Syndrome

 

BIOSTATISTICS IN MEDICINE:




                                                  One of the biggest drawbacks which we face while reading the scientific journals is that we don't get to understand the biostatistics part of the article. The thing is we are not taught about the biostatistics in our undergraduate curriculum, nor we are given quality training in the post graduation.


                           We as doctors are forced to go to the biostatiscians for the analysis of the data . Its not wrong   but knowing statistics by ourselves will help to put our expertise in the quality output of the data


SOME OF THE ADVICE FOR US TO EASY LEARN ABOUT THE BIOSTATISTICS:

1.  Stanford university videos of biostatistics
2. BIOSTATISTICS BASIC CONCEPTS AND METHODOLOGY OF HEALTH SCIENCES BY WAYNE W. DANIEL

 

        

                                        


                                    

CRO --- THE DIFFERENT HOSPITAL:


                                    WHAT IS CRO???


The full form is CONTRACT RESEARCH ORGANIZATION(CRO)/// They are also known as SITE MANAGEMENT ORGANIZATION. Clinical trial of the drugs during their process of development are conducted by this CRO .


We as doctors have job opportunity in this hospitals as Principal Investigator and Co investigator. Since millions are invested in developing a particular drug, the investigator are paid handsomely in lakhs for their jobs


For the list of the CRO'S available have a look at the website
http://www.aicrindia.com/list-clinical-research.html




There are CRO'S which are so large and multinational and they coordinate the multicentric trials in different countries during the Phase 3 trail of the drug.

FEAR IN HERBAL DRUGS:

                                             Today I came across one of the article which said that WHOLE PLANT EXTRACT ARTEMESIN IS BETTER IN PREVENTING RESISTANCE AND IMPROVES OUTCOME IN MALARIA PATIENT. My doubt over here arises how can we say that it is the artemisin in the whole plant which caused this effect??? it could be some other active compound in the extract which could have done the magic.

Though above mentioned case is a positive example whatever it is there are negative side of it too.

                                         What happens with herbal medication is that the disease might be cured but at the same time there are some million of other compound which could have different effect in the varying sites of the body.

MOST OF THE HERBAL MEDICATION ARE NOT WELL STUDIED AND RESEARCHED TOO...

YES THERE MIGHT BE POSITIVE IMPROVEMENT WITH THE HERBAL DRUG BUT AT THE SAME TIME YOU WILL HAVE TO KEEP YOUR LIVER AND KIDNEY AT STAKE!!!!!

                                   

 

PHASE 1  TRAIL --THE MOST THRILLEST EXPERIENCE YOU CAN HAVE:


                     when you give a drug for any condition , you will know for sure what is going to happen. For eg ) you know that when you give phenytoin, you knew that  the seizure will stop.


                 But here comes an interesting condition of phase 1 trial, YOU ARE GOING TO GIVE A DRUG FOR THE FIRST TIME IN A HUMAN, THE RESULT CAN BE ANYTHING.
yes it is true that the drug is already tested in animals and the probable effect is guessed. BUT IT IS STILL A MILLION DOLLAR QUESTION THAT WHAT WILL HAPPEN WHEN WE ADMINISTER IT IN HUMANS


         And it takes a lot of courage for the volunteers to come forward for the drug to be tested on them. we as doctors should salute those healthy volunteers who had so much belief on us and came forward to test our drug on them. it is because of those good souls that we have a lot of drugs in the world today.


I FEEL THAT  CONDUCTING PHASE 1 TRAIL IS THE MAXIMUM THRILL RIDE A DOCTOR CAN HAVE....

I DONT CLAIM PROPERTY TO THIS PHOTO-PRAVEEN

HOW IT FEEL TO SHARE WITH YOUR LOVED ONES THE LAST 48 HOURS :

                                               Head injury one of the leading cause of mortality in the world. The neurosurgery done in patient with GCS or less is seldom effective in saving the patient.

1. Mostly patient live for 48 hours with Intubated ventilation and ionotropic support. little is known whether this surgery is responsible for even this futile extension
2. surgery mostly gives a mental satisfaction to the near ones

NEED OF THE HOUR

1. Novel drugs which can stop the secondary injuries from occurring in the brain
2. Drugs which can improve the golden time from 12 hours to 48 hour.

AS A DOCTOR WE FEEL THAT WE COULD DO NOTHING IN THE LAST 48 HOURS FOR THAT PATIENT .
AND FOR THE LOVED ONES ITS THEIR DEAR ONES RIGHT IN FRONT OF THEIR EYES BREATHING BUT NO MORE CAN AWAKE AND TALK WITH THEM

 

ARE WE CURING THE DISEASE OR TREATING THE SYMPTOM:

 

              This is one doubt which comes in the mind of each and every doctor. For considerable number of diseases , our main aim is not to treat the disease but to alleviate the symptom.  We don't aim for curing the disease as there are no medication available. Man is the biggest wonder of nature. The most intelligent of all races. Yet in this century where man has reached moons and mars, we are not able to save our own race from dying.

 

               ARE WE NOT INTELLIGENT TO FIND CURE???

 

My answer is definitely a big NO.

 

There are millions of doctors around the world. But only a few thousands of doctors among this thinks that they have to find a cure for the disease by research or any other modality.

 

WE AS DOCTORS ARE HAPPY WITH SAVING PATIENTS WHO ARE CURABLE AND DONT TAKE A BIG DEAL IN LOSING SOME PATIENTS WHO ARE INCURABLE.

 

THIS ATTITUDE MUST CHANGE.

 

We all should start thinking why cant I find a cure for one deadly or incurable disease before I die????

 

I praveen , don't claim rights for this photo.

 

 

       

MEDICINE BOOKS ARE OUTDATED

                           In the first 3 months I have realised one thing that  most of the things published even in the most standard books like HARRISON , GOODMAN GILMAN are well some 6 years back to what currently is happening in the world.


                           As researchers and doctors we ought to KNOW WHAT IS CURRENTLY DONE AT THIS SECOND IN THE WORLD . JUST THINK, WILL YOU LIKE ANY OLD MOVIE WHICH IS ALREADY RELEASED SOME 6 YEARS BEFORE. Similarly in order to keep ourselves ambitious and to be in par with the world we have to go for sources other than our medical textbook.

1. GO FOR SCIENTIFIC JOURNAL. IF ONE I WILL TELL TO GO FOR ALL JOURNAL OF NATURE PUBLISHING GROUP  nature.com. They are world class.
2. Become member of good scientific committee in internet.
3. Go for websites like uptodate.com , medscape.com.
4. AND MOST IMPORTANT IS CURIOSITY TO GIVE BEST POSSIBLE TREATMENT TO OUR PATIENTS CURRENTLY AVAILABLE.
5. AND REMEMBER DOCTORS AND RESERCHERS IN DEVELOPED COUNTRIES ARE ALREADY DOING THIS PRACTICE. WE ARE LEFT BEHIND IN THE RACE. ITS TIME TO PROVE THE BRILLANCE OF INDIAN DOCTORS...

COPYRIGHT TO THE RESPECTIVE OWNER. I DONT CLAIM.

ANIMALS SACRIFE THEMSELVES FOR US:

                                         What I realised with so much wonder that what ever being done today today in medicine field is because of tremendous research being carried out for centuries. THE SCIENTIST WHO HAVE DISCOVERED ARE HEROES IN OUR MEDICAL BOOKS. BUT DID WE EVER THINK OF THE NUMBER OF ANIMALS WHICH HAVE SACRIFICED THEIR LIVES FOR THE BETTERMENT OF OUR HUMAN RACE


Sadly the answer including  me is no. The puny rats, rabbits, guinea pigs, monkeys  have all given their lives in the discovery of number of drugs for us. Their death in researches alone would amount millions.

And in future too the betterment of health of human race will depend entirely on these species

          

SIDE EFFECTS OF DRUGS??? DO YOU CARE ABOUT IT???

There is a big Pharmacovigilance program undertaken by the Government of India. It keeps constant vigilance on the various adverse effects of the drugs which are occurring in the people. The identity of the reporter is kept confidential. SO I FEEL ITS THE DUTY OF THE DOCTORS LIKE US TO REPORT ABOUT THESE SIDE EFFECTS  TO THE NEAREST PHARMACOVIGILANCE CENTER OF YOUR HOSPITAL


Also think like this na that you will be the first to report any side effects in this world if you suspect it for the first time. HOW MANY PEOPLE HAVE YOU SAVED BY REPORTING IN EARLY???. THIS IS COOL.


Other benefit for you is that for rare side effect you can PUBLISH AS AN ARTICLE . THUS ADDING TO YOUR ACADEMIC CREDENTIAL.


SO LETS BE VIGILANT FROM TODAY....

COPYRIGHT IS TO MICHEAL SLOAN.

DOUBLE ANAEROBIC COVERAGE

 

                                     We go for cocktail of antibiotics to save the patient at any cost. But what we have to realise is that on going for two antibiotic which has same coverage we are doing more bad than good to the patient.

 

A MORE COMMON MISTAKE WHICH WE DO IN PRACTICE IS THAT WE ADD METROGYL WITH ALMOST MOST OF THE ANTIBIOTIC IN ORDER TO KILL THE ANEROBES. BUT THIS IS BIG MISTAKE.

 

For example Piperacillin Tazobactam is added with Metrogyl. In this Tazobactam component has good anaerobic coverage. So what is the need for adding metrogyl with this???

 

This unnecessary addition of double anaerobic coverage has even the risk that the organism may develop resistance against Piperacillin...