Doctor’s blog

Field of medicine has many allied branches, such as nursing, first aid, emergency care etc. Nursing is a very important part of health care and as important as service provided by doctors, if not more important. Nursing care also has allied branches which provide necessary help to nursing professionals in healthcare delivery, such as Certified Nursing Assistants. Certified Nursing Assistants undergo training of 100 to 120 hours, which consist of both practical aspect as well as some basic theory aspects in health care. Certified Nursing Assistants help by assisting and discharging their duty in providing health care.

The Certified Nursing Assistant (CNA) course is a growing field as the requirement of this nursing allied service is increasing rapidly. Many health care service providers are training manpower for these free of cost (if done privately, the Certified Nursing Assistant course may cost anywhere between $400-$1000) with a signed contract that after training, the individual will work for the health care service provider for a particular length of time.

CNA Training Classes are conducted to provide the basic healthcare skills required to help the nursing professionals, in health care delivery. Some of the basic healthcare skills taught in Certified Nursing Assistant course are providing first aid, CPR (cardiopulmonary resuscitation), etc.

It is a time of economic recession and many people are losing their jobs and need to rethink the carrier they have opted. If you are in this category or just new in the job world without high skill, it may be the time for you to think of doing a Certified Nursing Assistant course and start your carrier.

Some of the advantages of doing Certified Nursing Assistant course are short duration course (only 6-12 weeks duration), can be done free of cost in many government sponsored health care facilities, growing demand, opportunity to advanced courses (there are opportunities to become registered nurse or licensed practical nurse) etc.

Gout is a metabolic disorder which commonly affects postmenopausal women and men of middle age to older age group. The metabolic disorder results in increase in uric acid level in blood (serum) and hyperuricemia (increased uric acid excretion in urine). Increased uric acid level in serum can result in deposition of uric acid crystals (monosodium urate or MSU crystals) in the joints, especially in the smaller joints such as joints of toes (interphalangeal joints and metatarsophalangeal joints of toes, especially big toes) and fingers (interphalangeal joints and metacarpophalangeal joints of fingers) which are known as “tophi”. There is also risk for deposition of monosodium urate crystals in kidney interstitium or uric acid nephrolithiasis.

What are the clinical features of gout?

Common clinical manifestations of gout are arthritis (usually involving single joint, most commonly the metatarsophalangeal joint of big toe, initially and become multi joints later on) and the first attack of acute arthritis is generally severe and painful swelling of the affected joint commonly at night which wakes up the patient. The initial attack subsides within 3-10 days even without treatment and later become intermittent with remissions and exacerbations.

How gout is diagnosed?

Clinical picture is strongly suggestive of gout and the diagnosis of gout is confirmed by needle aspiration of acutely or chronically involved joints or MSU deposits. Sometimes MSU crystals may also be demonstrated in the aspirates from inflamed joints.

Serum uric acid level may be high, normal or low during acute attacks of gout, although the serum uric acid level is generally elevated in gout and estimation of serum uric acid level can be used to decide and guide the course of the therapy.

Treatment of gout:

The mainstay of treatment of acute gout is use of NSAIDs (such as indomethacin, piroxicam etc.), colchicine, or glucocorticoids. Once the acute condition subsides the mainstay of treatment is hypouricemic agent allopurinol (a xanthine oxidase inhibitor drug) at the dose of 100-300 mg per day initially and may need up to 800 mg per day.

You may be using contact lens because you do not want to wear glasses or you may have an eye problem which is best managed with contact lens. Whatever may be the reason of your use of contact lens you should always consider using disposable contact lens, as use of disposable contact lens has several advantages, some of which are health advantages such as lower rate of infection and some are the comfort of use and no need of maintenance.

If you can afford (which most people can afford these days) disposable contact lenses you should go for disposable contact lenses. Before you start to use a specific brand of disposable contact lens, you should always compare contact lens with other brands that are available in your local market. The comparison should include not only price (although price is the most important factor to consider) but also the trustworthiness (it is important to use a well trusted brand, as you are dealing with eyes) of the brand you decide to use, and advice of your doctor (ophthalmic surgeon).

Availability of cheap contact lens (reusable as well as disposable contact lenses) has made use of disposable contact lens within affordable limit of most of the individuals who use contact lens. If you are using contact lens for therapeutic purpose or for cosmetic purpose you should use the contact lens which are of best quality and should not consider the cost, in other words quality should guide you to select the contact lens you will use and not price or other minor factors.

These are the personal view and opinion of the author and you should always use your discretion before you decide to use disposable contact lens for any purpose.

Contact lenses are used for correction of refractive errors of the eye, for therapeutic purpose (such as to deliver a particular drug to cornea or to protect the cornea from further damage due to friction of eyelids), cosmetic purpose etc. The commonest use of contact lens is for corrective purpose, instead of using glasses which may be cumbersome at times and many individuals do not want to wear glasses and prefer to use contact lens, which allows certain advantages over use of glass.

Disposable Contact Lens has gained popularity vary rapidly and still gaining popularity as the price of disposable lens is going southwards. Disposable contact lens or simply Disposable Contacts have several advantages over non disposable contact lenses. The biggest advantage of using disposable contact lens is the freedom from maintenance the disposable contact lenses provide and in this fast track and modern life many individuals do not find time to keep the contact lenses clean by cleaning the contact lenses with proper cleaning solutions. Another great advantage of disposable contact lens is the reduced chance of infection with the use of disposable contact lens. The disposable contact lens is not reused which reduce the chance of infection greatly. Infection can be a problem with use of non disposable contact lens as they need to be cleaned properly and everyday and if the cleaning is not proper it may cause infection or it may irritate the cornea due to presence of some debris on the contact lens.

The availability of Cheap Disposable Contact Lenses has made the life of contact lens user very simple and at affordable cheap rate. The user can use the disposable contact lens and just throw it and forget it and present generation wants exactly the same type products.

There are several different types of cleaning solutions available for cleaning contact lenses. For cleaning your contact lens, use of any type (should be used properly) can serve the purpose of cleaning contact lenses.

The main aim of cleaning contact lens is to keep the contact lens clear or transparent and to keep it free from microorganisms. Presence of microorganisms can cause infection to the eye. The different microorganism will cause different type of infection.

The commonly used cleaning solutions for cleaning the contact lens are saline solution, multipurpose solution, hydrogen peroxide solution, enzymatic cleaner etc.

Saline solution:

The saline solution is for rinsing the contact lens after cleaning it with other cleaning solution and used before inserting/using contact lens. Saline solution can not disinfect contact lens.

Multipurpose solution:

This is the most commonly used and also most popular cleaning solution for cleaning contact lenses. Multipurpose solution is used for cleaning, disinfection, and storing contact lenses. It can also be used for rinsing contact lens instead of saline solution. Use of multipurpose solution can serve all the purposes of cleaning in general. Newer multipurpose solution can remove bacteria, fungi and other microorganisms.

Hydrogen peroxide solution:

It is mainly used for disinfecting. But saline solution must be used for rinsing to wash off hydrogen peroxide from the contact lens after disinfecting with hydrogen peroxide solution; otherwise it may cause intense pain in the eye. Because of the need to rinse with saline solution, hydrogen peroxide solution is not very popular.

Enzymatic cleaner:

It is used for cleaning protein deposits from lens surface which may get deposited after using contact lens for few days. Generally enzymatic cleaner is used once a week. If there is any protein deposit in the contact lens, it makes wearing contact lens uncomfortable and also makes disinfection difficult and incomplete.

When there is “male pattern of hair growth in females” it is called hirsutism and if hirsutism is aggressive form with additional signs and symptoms like voice become male type (deep voice), breasts become smaller, and clitoris becomes enlarged, there is increased in muscle bulk etc. it is called virilization. In other words virilization is severe form of hirsutism or next stage of hirsutism. There is also increased libido in virilization. Generally virilization is an ominous sign and suggests a high possibility of an ovarian or adrenal tumor.

Hirsutism is fairly common problem among females and affects approximately 10% of female population. But hirsutism is only a variation of normal hair growth and generally do not cause any significant physical problem, although it can cause considerable psychological problem among females. Very rarely hirsutism is indicative of serious underlying pathology, but commonly virilization is indicative of serious underlying pathology.

The cause of hirsutism is commonly idiopathic (unknown cause) and in most of the cases the commonest pathology involved is androgen excess (like in case of congenital adrenal hyperplasia or CAH and polycystic ovarian syndrome or PCOS).

The sites which are involved in male pattern of hair growth are upper lip (mustache), chin (beard), chest, abdomen, upper back, lower back, upper arms, pelvis and thighs. These are the nine areas of human body which are sensitive to androgen and excess androgen causes growth of hairs in these areas to cause hirsutism in females. In general males have higher levels of androgens and that’s why males have male pattern of hair growth like beard and mustache. The clinical assessment of hirsutism is also done by taking into account of these nine androgen sensitive areas.

The importance of exercise to remain fighting fit is known to all, but unfortunately not many of us do regular exercise. The reasons of not doing regular exercise are many and it is different for different individuals. We all should try to find out our own as what is the major obstacle for us for not doing regular exercise. The reason may be lethargy, lack of motivation, inability to find and adjust time for exercise etc.

If you are not doing regular exercise you can try going to gym for motivation and also you will get many equipments which are not available at home. You can also find some like minded persons who go for a jog daily in the morning or evening. The reason of your need for regular exercise may also be different from others. If you have low backache or backache problems you should try using equipment for back exercise like teeter hang ups inversion table, which are very good for exercise for backache. Teeter 550 has some additional features over other hang ups inversion tables, like new flex technology bed which gives comfort to your back along with exercising your back to relieve back pain.

The hang ups inversion tables are very helpful for relieving back pain, which use earth’s natural gravity to relieve back pain. These hang ups inversion tables also help in improving circulation and lymph flow, improves flexibility of muscles and range of movements at the joints, and also reduces muscular tension if present and one of the causes of back pain.

Most important is to continue doing exercise which is best for you, especially if you have any medical problem for which you need regular exercise. But at the same time you should be aware that wrong type of exercise may harm you instead of good, so consult your doctor or fitness expert for advice regarding you exercise and the type of gym equipment you should use.

The main use of contact lens is corrective, i.e. to correct the refractive errors of the eye like myopia (short sightedness where the individual is unable to see objects far from him/her), hypermetropia (near sightedness where the individual is unable to see objects which is nearer to him/her), astigmatism (a condition where light rays do not fall on retina due to curvature problem of lens), presbyopia (where individual is unable to adjust his/her eyes fast while seeing near and fast objects very fast). But these days of fashion many individuals are using contact lenses for cosmetic reason, to make eyes more beautiful or to change the appearance of the eyes or simply to experience the different looks of the eyes. For many individuals contact lenses may serve dual purpose of correcting vision as well as cosmetic purpose.

The USFDA (United States Food and Drug Administration) terms the cosmetic contact lenses as “decorative contact lenses”. Cosmetic contact lenses can cause irritation, especially in the initial stage but on long term use the eyes get accustomed with the lenses and cause no more irritation or discomfort to the eye. But still, experts advise not to use cosmetic lenses for very long time although several research and studies has found no correlation of cosmetic contact lenses with any form of permanent eye damage.

Although use of cosmetic contact lenses is in the rise still they constitute very small percentage of total use and constitute less than 5% of total contact lens use. If you use contact lens, it should be used strictly with aseptic precaution; otherwise it may give rise to many complications like infection and injury to the cornea.

We all know about contact lenses and the uses of contact lenses as a replacement of glasses or spectacles to correct vision problems or refractive errors of eye. The common refractive errors of the eye are myopia, astigmatism, hypermetropia etc. As there are several uses of contact lenses, there are also several types of contact lenses e.g. hard contact lens, soft contact lens or simply soft lens etc.

Although the main use of contact lens is correction of vision and it started for this purpose. But these days contact lenses are used for many other purposes like cosmetic use of contact lenses. For cosmetic purpose contact lenses are available in different (as you desire) colors, although the commonly used contact lenses are of faint blue color for making the contact lens more visible in the washing or cleaning solution as well as in storage solution.

Contact lens has to be used and stored with care and to overcome this storage problem disposable contact lenses are available. Soft contact lenses have several advantages in compare to hard contact lenses, although the soft contact lenses are costlier in compare to hard contact lenses. Soft contact lens is easier to use and are much more comfortable to the eye and can be worn for longer duration without much discomfort, which can be a problem with hard contact lens. Disposable soft lenses are very commonly used due to the comfort and ease to use them.

The cosmetic contact lenses are used for changing the appearance of the eye. Cosmetic contact lenses not only change the appearance according to your desire, but it can correct your vision too, if you have vision problem and serve dual purpose of correcting vision and at the same time makes you look better.

Health care systems are different in different countries. In some countries health care systems are mostly privatized and in some countries health care systems are mostly public sector maintained. Both the systems (public or private) has there advantages and disadvantages. Not only health care systems, health care information systems are also different in different countries and in many developing and underdeveloped countries the health care information system may not be functioning properly or in some cases it is almost non existence.

Canada 411 is information system which Canadian Health Care system follows. Canada 411 has many merits and better than the information system that many countries follow, including many developed countries.

Canadian Health Care is one of the best in the world and that is the reason health care indices like IMR (infant mortality rate) is among the lowest in the world in Canada. Infant mortality rate is the most sensitive indicator of health and reflect the effectiveness of the health care system in a country or a region, which is lowest in best health care systems and highest in the worst systems. IMR is used as an indicator of health care delivery system by most of the health care organizations like WHO (World Health Organization). High infant mortality rate indicate there is need to improvement of health care delivery system and there is need to infuse more fund to the health care delivery system and rationalize the distribution of resources so that there is equal distribution of funds for health care in cities and rural areas as well as in different regions of a country. Canada has one of the lowest infant mortality rate (IMR), which indicate the health care system followed in Canada is one of the best in the world.