MT News Desk

Dr. Vidya Shaju

Dr. Rema Valsala

AN OUNCE OF THE

MIRACLE DRUG

Take a moment to imagine a scientist discover a drug that could cure 70 % of diseases.  The media would go delirious with excitement!

That benefit could be achieved even WITHOUT that kind of a drug! All you need is an ounce of ‘prevention’.

In this newsletter, we begin a new column on disease prevention.

Test

Recommendation

Blood pressure check

Check your blood pressure at every exam and at least every one to two years.

Fasting lipid profile (to check for total cholesterol, LDL, HDL, and triglycerides)

Do you smoke? Do you have diabetes? Are you overweight? Do you have a family history of heart disease/ high blood pressure or high cholesterol? If yes’ have a fasting lipid profile every 5 years starting at age 20.

Are you a man, 35 years old or above?  If ‘yes’, take this test every 1-3 years until age 65.

Are you a woman, 45 years old and above? If ‘yes’, take this test every 1-3 years until age 65.

Electrocardiogram (EKG)

Are you 40 years old or above? Do you have the risk factors for heart disease mentioned above? Are you about to start a vigorous exercise program? If yes, have an EKG test.

Highly sensitive C-reactive protein test (hs-CRP)

This is a new test to detect levels of C-reactive protein (CRP) in the blood for people at intermediate risk for heart disease. You can ask your doctor to ascertain what level of risk you are in.

WHAT YOU NEED TO KNOW ABOUT YOUR HEART

Exercise - The heart is like any other muscle.  It is more efficient if you use it and if you don’t, it just doesn’t work as well. Those who have an active lifestyle have a 45% lower risk of developing heart disease compared to those who do not exercise.

Smoking- We know that smoking is clearly associated with heart disease. In fact, according to the Center for Disease Control, nearly 160,000 men and women die each year of cardiovascular disease attributed to smoking. There are over 4,800 chemicals found in tobacco smoke, 69 of which are cancer causing. They can actually damage the heart and cause narrowing of the blood vessels caused by a buildup of plaque in the walls of the arteries ( atheroscherosis).

Fats- Stay away from saturated fats, pay attention to total calories, incorporate fish oils, maintain balance and proportion. Eat less red meat, eggs, butter, cream cheese, and sugary desserts. “Healthy snacking”viz., eating small portions of healthy food, several times a day can be better than eating two or three big meals and can even lead to weight loss.  Choose soy, poultry and fish protein (which have more unsaturated fat) over meat (which is high in the "bad" saturated fat).

Stress management also plays an important role in maintaining a healthy heart.  Taking some time out of our day to focus on ourselves and reduce our stress, could prove to be more productive and healthier for us.

Genetics- Finally, genetics plays a significant role in developing heart disease.  We cannot change genetics but we can change our risk factors by modifying our lifestyles and having regular checkups and tests.

The Medical Transcriptionist – a Medical Language Specialist

Medical transcription plays a role in all facets of the medical field. Doctors rely on transcriptionists for the accuracy of medical records and the speed of recording. A transcriptionist, sometimes functions as a word detective, trying to decipher a doctor’s rapidly-dictated terms and phrases!  Most of the time, a transcriptionist, as a healthcare provider’s aide, interprets the provider’s dictation either verbatim or with changes per the context.  An example of how a transcriptionist may need to record something not verbatim is when he/ she would need to expand some contracted or abbreviated forms.

Here are some terms to be expanded when dictated in the contracted form.

Watch out for more such terms in the next issue!!

FAQ

Q: What is IV piggyback?

Ans: Piggybacking refers to something that is riding on the back of something else.

Many of the medications that intensive care unit (ICU) patients receive must be given intravenously.  Medications may be given by "IV push" where the nurse injects the medication directly into the IV line while other medications need to be given more slowly.  Medications needing more time to be given may be slowly infused into the patient through a small IV bag (called an IV piggy-back or IVPB) attached to the main IV line.

The piggyback technique eliminates the need for another venipuncture and dilutes the medication to reduce irritation.  Peak blood levels are achieved in 30 to 60 minutes for most drugs.  The following drug classes can be compounded as piggybacks.

-         Antibiotics

-         Antiemetics

-         Antivirals

-         Analgesics

-         Chemotherapy

Q: What is a Cam Walker boot?

Ans: A Cam Walker boot is an example of an orthotic device.   A Cam Walker is a walking boot that limits the movement of the ankle and/ or foot.

A walking boot is designed to enhance mobility and/or serve as a cast replacement for sprains, strains, and some types of fractures from the mid-tibia or fibula (middle of the lower leg) to the mid-foot area.  Many boots have unique rocker designs which allows a patient to closely simulate a normal gait.  Some walkers have foam lining, while others use air bladders to reduce swelling.  Some walkers also have adjustable hinges to allow for controlled rehabilitation.

Q: Which is correct ‘neural foraminal’ or ‘neuroforaminal’?

Ans: Neural foraminal

        QUESTIONNAIRE

Q.  The term used for normal sensory perception of the extremities is ____________.

a. abarognosis

b. acrognosis

c. atopognosis

Q.  The medical term for relapse or recurrence of a disease is ___________.

1. palikinesia
2. pallesthesia

3. palindromia

Q. Fill in the blanks with the suitable word given in brackets:

1.  An appointment was made in _________ with the patient's schedule. (confirmation, conformation)

2.  The patient required IV __________ of diazepam to control his seizures.

(infusion, effusion)

3.   She was asked to _________ his hand for the test. (extent, extend)

4.   The patient developed erythema and __________ of his skin.

(induration, induration)

5.   The fixation screws were found to be __________.  (lose, loose)

Q.  Find the meaning of these homonyms:

•  Allude and allure

·        Arthrosis and orthosis

·        Coastal and costal

Watch out for answers in the next issue!!!!

Procedure of the Month

Knee Arthroscopy

Knee arthroscopy is a procedure in which an arthroscope is inserted into a joint and is used to look directly into joints. It is made up of a tiny lens, a light source and a video camera. This makes it useful for both diagnosis and treatment. The arthroscope contains a pathway for fluids and coated glass fibers that beam an intense, cool light into the joint. A camera attached to the arthroscope allows the doctor to see a clear image of most areas of the knee joint on a monitor.

Arthroscopy comes from 2 Greek words –‘arthro’ meaning ‘joint’ and ‘skopein’ meaning ‘to examine’

Some common medical terms and surgical equipment encountered in knee arthroscopy reports -

• medial and lateral portals

• inferolateral portal

• suprapatellar pouch

• anterior cruciate ligament (ACL)

• posterior cruciate ligament (PCL)

• medial collateral ligament

• lateral collateral ligament

• medial meniscus

• lateral meniscus

• medial compartment

• lateral compartment

• patellofemoral articulation

• patellar articulating surface

• medial gutter

• arthroscopic probe

• tourniquet

• motorized debrider

• basket forceps

• curved clamp

                  MEDICAL

                             CROSSWORD

Clues

Across:

1.        Suffix meaning ‘pain’.

3.     Popular term for flexion-extension injury.

4.     A female hormone produced by the ovaries

6.        Maze-like series of canals in the inner ear

9.          In humans, the right ____ is slightly larger than the left and is divided into three lobes

11.    Cavity within a bone (e.g., cranial and facial bones)

13.    The fleas of which rodent, were the cause of Black Death?

14.    Shells, frequently made from plaster, encasing a limb or large portions of the body to  hold a broken bone in place until it has healed.

16.      Popular term for skin eruption

Down:

2.       An _____ is a dull continuous pain.

3.       Verruca.

5.       Chickenpox and _____ are caused by the same virus, varicela zoster.

7.       Binge eating, followed by self-induced vomiting and other weight reducing measures

8.       The tough band of fiber that connects muscle to bone

       10.  A contractile tissue of the body

12.    Inclination to scratch

16.  Distention (dilation) of the kidney with urine.

17.  Involuntary oscillatory movements of the eyeballs

Check your answers with the solved crossword given at the end of the newsletter.

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Americanisms

*    *    *    *    *    *    *    *

Thank God It Is Monday !!!

‘Long weekend’ is a term used in the US to denote a weekend that is at least three days long (a three-day weekend) due to a holiday falling on either a Friday or a Monday.

Let us look at some of the federal holidays in the US that fall on Mondays when most people do not have to awaken to those Manic Monday Morning Blues!   (Not all federal holidays are state holidays)

Labor Day:  A legal holiday, commonly the first Monday in September, in honor of labor.

Memorial Day: A day set aside in memory of dead members of the armed forces of all wars; now officially observed on the last Monday in May; also called Decoration Day.

Martin Luther King Day: A day set aside to commemorate Martin Luther King, Jr.,; observed on the third Monday in January.

Presidents’ Day: The third Monday in February; commemorating the birthdays of George Washington and Abraham Lincoln.

Columbus Day: a day in honor of the discovery of the New World by Columbus and his landing in the West Indies on October 12, 1492 observed as the second Monday in October.

MEDICAL CROSSWORD

                                                   SOLVED!!!

M2 Software Development & Exports Pvt. Ltd

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Health Tip of the Month

 The bad guy clobbered Popeye until Popeye ate spinach. Now, Popeye was real smart!

Spinach is a powerhouse of vitamins & minerals, especially vitamin B, iron, and folate.  Spinach is low in calories - only 41 calories per cup!

Eat at least two cups of spinach every week.  Work spinach into your menu and use it as a topping, or in curries, or as a stir-fry or in breads, salads,soups, and what not!

ESL KORNER

Transcriptionists and doctors alike would like to know how an ESL (English as a Second Language) speaker would sound when compared to an American speaker.

Let us examine different situations.

Asian Style:  The head office is in New York.

American Style:  The main office is in New York.

Asian Style:  Did you shift to Vegas recently?

American Style: Did you move to Vegas recently?

Asian Style:  Today is hot.

American Style:  It is hot today.

Asian Style:  What is the total sum?

American Style:  How much does it come to?

Asian Style:  His temperature went down.

American Style:  His temperature came down.

RX Fives

5 DRUGS APPROVED BY THE FDA WITHIN THE PAST 5 MONTHS

Azor (amlodipine besylate; olmesartan medoxomil); For the treatment of hypertension; Approved September 2007

Fenofibrate: For the treatment of hyperlipidemia, dyslipidemia and hypertriglyceridemia; Approved August 2007

Somatuline Depot (lanreotide

acetate); For the treatment of acromegaly; Approved August 2007

Ixempra (ixabepilone); For the treatment of breast cancer; Approved October 2007

Mircera (methoxy polyethylene glycol-epoetin beta); For the treatment of anemia associated with chronic renal failure; Approved November 2007

A piggyback setup

A Cam Walker Boot

Transcription   Bloopers

Now, Ms.Transcriptionist was trying to be religiously verbatim with the doctor or was she ….? !!!

             The baby was delivered, the cord clamped and cut, and handed to the pediatrician, who breathed and cried immediately.

    The patient is     numb from her toes down.

           The patient has chest pains if she lies on  her left side for over a year.

Salient features of knee arthroscopy in pictures

Anatomy of the knee  -                                    

Procedure 1 -

Procedure 2 -

Rx

Humor; one tablet, once a month

"Doctors at a hospital in Brooklyn, New York have gone on strike. Hospital officials say they will find out what the Doctors' demands are as soon as they can get a pharmacist over there to read the picket signs!"

Answers to the Questionnaire in the previous issue

Falling of an elevated temperature or abatement of fever is termed defervescence.

The idiom, "To talk turkey" means --To talk seriously.

The patient became nauseated and began to retch.

She had a callus on her left foot.

The abdomen is tense with ascitic fluid.

Numerous urticarial wheals were noted.

Tenting of the skin is a sign of dehydration.

Cecal:  relating to the cecum (part of the large intestine).

The patient has a history of cecal cancer.

Thecal:  relating to the tendon sheath.

Thecal sac was entered deliberately by lumbar puncture.

Overly:  to an excessive degree.

When he presented to the ER, he was noted to be overly drunk.

Overtly:  not secret or hidden.

The patient overtly performs action contrary to the command of the examiner.

Scar:  a mark left by healing.                                   

The patient had a prior sternotomy scar.

Eschar: thick coagulated crust of skin.

The eschar over the wound measured about a centimeter across.