Medical Errors!

There is concern about the medical errors in the hospitals in developing countries and developed countries. India is going to increase the number of hospital beds. The number of hospital admissions will increase in the coming years and so are the medical errors. The US Institute of Medicine's landmark 1999 report, To Err is Human: Building a Safer Health System, estimated that avoidable medical errors contributed annually to 44 000—98 000 deaths in US hospitals. Hospital-based errors were reported as the eighth leading cause of death nationwide, ahead of breast cancer, AIDS, and motor-vehicle accidents. The report put medical errors under the national spotlight.
Who or what is to blame for medical errors and their consequences? Overworked providers, an unnecessarily complex medical system, or uninformed patients? Patients are often handed from one doctor to another and, in the process, communication between providers can break down. Time spent filling out paperwork is time not spent with patients improving the quality of their care. Decision making often does not involve informing a patient about the balance between benefits and harms of individual treatments, or incorporating patients' goals into planned treatment. And it does not help that existing guidelines allow medical residents in the USA to work on average 28 h more per week than junior doctors in countries of the European Union. In  India we need to follow the guidelines more strictly and teams should adhere to the standard protocols to reduce the medical errors.
The medical errors can turn out to be very expensive to the society and hospitals. Hospitals must develop protocols and check lists to prevent the medical errors. 

Transdermal cutaneous Oxygen therapy ( EPIFLO)

We are looking for the newer and simpler therapies for treating the chronic non healing ulcers. In the recent past negative pressure wound therapy (NPWT) has been made available in Indian hospitals. Hyperbaric oxygen therapy is used in very few centers in India for treating the non healing ulcers. But the new concept of delivering the oxygen (3 ml/hour) directly in to the wound through a small device which concentrates the oxygen from the atmosphere seems to have advantages over the other methods available to us.  This device ( Fig) is small and can be tied to the extremity very easily and patient can be mobile and expect good healing of wound within 15 to 30 days. There seems to be a definite place for this device in the vascular surgeon's clinical practice. 

World Malaria Day -25th April

According to World Health Organisation statistics, Malarial parasite infected around 225 million and killed nearly 800,000 people worldwide in 2009. They seem to be developing resistance to the available drugs. In the recent studies it was found that the parasite is dependent on the kinases in the cells ( liver, RBCs) for their survival and multiplication. If these kinases are inhibited then it becomes a halt for parasite. Now there is a new hope that the newer Cancer drugs can kill malaria parasite Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites reproduce in the liver, and then infect and multiply in red blood cells. Joint research by few organizations showed that, in order to proliferate, the malaria parasite depends upon a signalling pathway present in the host's liver cells and in red blood cells. They demonstrated that the parasite hijacks the kinases (enzymes) that are active in human cells, to serve its own purposes. When the research team used cancer chemotherapy drugs called kinase inhibitors to treat red blood cells infected with malaria , the parasite was stopped in its tracks.