I am a practicing physician, M.D., Medicine from Kanpur medical College, India, having my own nursing home in Delhi. It had been my long cherished dream to develop a software which could be called as clinician’s companion in true sense & help them in every respect to write a safe, fool proof & first rate prescription. After 10 years of hard work I think the dream has become reality now with the development of a prescription writing software called “PRESCRIPTION PAD”.
Prescription writing is not merely putting few drug names on a piece of paper rather it is an art which can be attained only after years of experience, hard work & sound knowledge of the basic subject. World over, there is stress on evidence based medicine which can be described as “the conscientious, explicit & judicious use of current best evidence in making decisions”. Professional organizations & government agencies are developing formal clinical practice guidelines in an effort to aid physicians & other caregivers in this endeavor. These guidelines can provide a useful framework for managing patients with particular diagnosis or symptoms. The challenge for the physician is to integrate into clinical practice the useful recommendations offered by the experts who prepare clinical practice guidelines without accepting them blindly or being inappropriately constrained by them.
A report from the Institute of Medicine, USA concluded that “to err is human” but called for an ambitious agenda to reduce medical error rates & improve patient safety by designing & implementing fundamental changes in health care system. Accordingly it is the responsibility of hospitals & health care organizations to develop systems to reduce risk & ensure patient safety.
We have designed our software on these general guidelines. The software at the moment has a database of more than 40,000 brands with full prescribing information, full information about nearly 24,00 drugs with their complete monographs to backup, information about 1500 diseases , their differential diagnosis, investigatory workup, many treatment guideline & protocols & other important pointers along with patients education material. The software automatically checks for drug interactions & drug safety for children & elderly, pregnancy, lactation, liver insufficiency, renal insufficiency, pulmonary insufficiency & gives you warning in case of any untoward effect. The software has capability of giving you useful pointers also from time to time while writing prescription. The software checks for the drug safety at the individual disease level too e.g. it gives you warning if any drug is not safe to give in PORPHYRIA or G6PD disease or in diabetes. In this way the software tries to ensure that you give out 100% safe, first rate & fool proof prescription to a patient by providing you all the related information automatically.
The complete details of the software features can be seen on the website www.prescriptionpad.in.
Drug interactions & drug safety is major issue in prescription writing especially in multi-organ diseases where large number of drugs are prescribed. In such situations this software can be very useful.
I am giving some common examples of drug interactions in day-to-day practice :
Ace inhibitors with Aspirin Reduces hypotensive effects of ace inhibitors
Quinolones with Nsaids CNS excitation
Eltroxin with Iron Poor absorption of Eltroxin
Zinc with Iron & other minerals
Quinolones,
Tetracyclines Poor absorption
Antacids with Antibiotics Poor absorption /chelation
The usefulness of the software is realized only when you start using it & I am sure it would encourage more & more clinicians to use computers & may change the in day-to-day practice : Ace
inhibitors with Aspirin Reduces hypotensive effects of ace inhibitors Quinolones
with Nsaids CNS excitation Eltroxin with Iron Poor absorption of Eltroxin Zinc
with Iron & other minerals Quinolones, Tetracyclines Poor absorption Antacids
with Antibiotics Poor absorption /chelation The usefulness of the software is
realized only when you start using it & I am sure it would encourage more & more
clinicians to use computers & may change the way doctors write prescription in
future.
Regards
Dr anil vij
Tuesday, March 16, 2010
Saturday, February 20, 2010
Tuesday, December 22, 2009
Monday, September 7, 2009
Are children at higher risk for swine flu?
A main difference between swine flu and seasonal flu is that people over 60 appear to have some immunity to swine flu, while younger people seem not to. And because children and young adults are more likely to gather in groups — at school and colleges — they are more vulnerable to catching all types of flu. So while the disease does not appear to be more severe than seasonal flu, a disproportionate number of young people will probably get it.
As with seasonal flu, some people will get very sick and some of them will die. Federal health officials report that at least 36 children in the United States have died of swine flu; most had nervous system disorders like cerebral palsy or developmental delays. Some, however, had been healthy; they died of bacterial infections that set in after the flu. Doctors speculate that children with nerve and muscle disorders can’t cough hard enough to clear the airways, putting them at higher risk for complications.
As with seasonal flu, some people will get very sick and some of them will die. Federal health officials report that at least 36 children in the United States have died of swine flu; most had nervous system disorders like cerebral palsy or developmental delays. Some, however, had been healthy; they died of bacterial infections that set in after the flu. Doctors speculate that children with nerve and muscle disorders can’t cough hard enough to clear the airways, putting them at higher risk for complications.
Thursday, September 3, 2009
Swine flu virus may not mix with other viruses: Study
The WHO predicts a third of the world's population will eventually be infected with swine flu.
The H1N1 swine flu virus out-competes all other strains of influenza viruses by reproducing on an average,twice as much within an infected body. This, scientists say, reduces the possibility that this superior H1N1 virus would interact and mix with other flu viruses to form a more virulent superbug.In a first study to examine how the pandemic virus interacts with other flu viruses, American scientists made three different flu viruses compete against the H1N1 inside ferrets.
"The results suggest that the 2009 H1N1 influenza may out-compete seasonal flu virus strains and may be more communicable as well. H1N1 causes more severe disease in animal studies, but it shows no signs of mixing with either of the two seasonal flu viruses to form a new so-called reassortant virus," said Dr Anthony Fauci of the National Institute of Allergy and Infectious Diseases.
On June 11, WHO declared a new H1N1 influenza pandemic -- the first in the last 41 years. This pandemic strain is as transmissible as seasonal H1N1 and H3N2 influenza A viruses. Major concerns facing this pandemic have been whether the new virus will replace, co-circulate and/or reassort with seasonal H1N1 and/or H3N2 human strains.
"Using the ferret model, we investigated which of these three possibilities were most likely. Our studies showed that the current pandemic virus is more transmissible than, and has a biological advantage over, prototypical seasonal H1 or H3 strains," the scientists said.
Some of the animals who were infected with both the new virus and one of the more familiar seasonal viruses (H3N2) developed not only respiratory symptoms but intestinal illness as well.
"It is reassuring that this virus does not seem to be in search of additional genes to become more powerful," Perez said.
The H1N1 swine flu virus out-competes all other strains of influenza viruses by reproducing on an average,twice as much within an infected body. This, scientists say, reduces the possibility that this superior H1N1 virus would interact and mix with other flu viruses to form a more virulent superbug.In a first study to examine how the pandemic virus interacts with other flu viruses, American scientists made three different flu viruses compete against the H1N1 inside ferrets.
"The results suggest that the 2009 H1N1 influenza may out-compete seasonal flu virus strains and may be more communicable as well. H1N1 causes more severe disease in animal studies, but it shows no signs of mixing with either of the two seasonal flu viruses to form a new so-called reassortant virus," said Dr Anthony Fauci of the National Institute of Allergy and Infectious Diseases.
On June 11, WHO declared a new H1N1 influenza pandemic -- the first in the last 41 years. This pandemic strain is as transmissible as seasonal H1N1 and H3N2 influenza A viruses. Major concerns facing this pandemic have been whether the new virus will replace, co-circulate and/or reassort with seasonal H1N1 and/or H3N2 human strains.
"Using the ferret model, we investigated which of these three possibilities were most likely. Our studies showed that the current pandemic virus is more transmissible than, and has a biological advantage over, prototypical seasonal H1 or H3 strains," the scientists said.
Some of the animals who were infected with both the new virus and one of the more familiar seasonal viruses (H3N2) developed not only respiratory symptoms but intestinal illness as well.
"It is reassuring that this virus does not seem to be in search of additional genes to become more powerful," Perez said.
Tuesday, September 1, 2009
Swine flu easily overtakes other strains
WASHINGTON - Put swine flu in a room with other strains of influenza and it doesn't mix into a new superbug — it takes over, researchers reported Tuesday.
University of Maryland researchers deliberately co-infected ferrets to examine one of the worst fears about the new swine flu. But fortunately, the flu didn't mutate. The researchers carefully swabbed the ferrets' nasal cavities and found no evidence of gene-swapping.
The animals who caught both kinds of flu, however, had worse symptoms. And they easily spread the new swine flu, what scientists formally call the 2009 H1N1 virus, to their uninfected ferret neighbors — but didn't spread regular winter flu strains nearly as easily.
University of Maryland researchers deliberately co-infected ferrets to examine one of the worst fears about the new swine flu. But fortunately, the flu didn't mutate. The researchers carefully swabbed the ferrets' nasal cavities and found no evidence of gene-swapping.
The animals who caught both kinds of flu, however, had worse symptoms. And they easily spread the new swine flu, what scientists formally call the 2009 H1N1 virus, to their uninfected ferret neighbors — but didn't spread regular winter flu strains nearly as easily.
Thursday, August 27, 2009
Delhi pvt labs begin swine flu tests
NEW DELHI: Private labs opened their doors to swine flu testing on Thursday, giving Delhiites an alternative to government-run screening centres for
detecting the disease. Three private labs have begun testing for the flu while another is expected to launch the facility from Friday.
The city government on Thursday gave permission to the fourth private lab - Super Religare Laboratories (SRL) - to test for H1N1 influenza, triggering a price war of sorts. SRL has priced the test at half of what the other three approved labs are charging.
The state health department is working out a mechanism for reporting positive H1N1 cases discovered by these labs. Meanwhile, these private centres have started collecting samples for testing. One lab, Auroprobe, began on Wednesday itself when it collected four samples. On Thursday, Auroprobe collected close to 20 samples, Dang's lab had eight and SRL got 4-5 samples. Dr Lal's pathlab will start from Friday. All four labs are promising results within 48 hours.
The three labs approved for testing on Tuesday had unanimously decided to charge Rs 9,000 flat for the test. But SRL announced that it would do the same test for Rs 4,500. ``It is a national emergency and we can't be fighting over the cost of the test. The test is expensive, as the reagents, testing kits and other material are imported and we are not exempted from custom duty. It is costing us close to Rs 8,000 or more,'' said Dr Navin Dang, director, Dr Dang's Lab.
According to sources in AIIMS, it costs the government around Rs 4,000-Rs 5,000 for each test. ``The custom duty on reagents, enzymes, testing kits etc used by us is less as compared to what private labs have to pay. The cost is high as the material used in testing is very expensive. The cost of the test is also high because we have to test for at least four factors - influenza A, swine A, swine H1 and RnT,'' said a senior doctor at AIIMS.
On being asked about the drastic difference in pricing, Dr Sanjeev Choudhry, CEO, SRL, said, ``Profit margins in these tests are very low. Our price is low as we are buying the reagents and kits in large quantities. Our testing capacity is also more and there are several other factors that affect the cost of any test.'' Choudhry said SRL would soon press 10 mobile vans into service for collecting samples.
The other three labs say that they are not likely to bring down the cost of the test any further. ``When it is costing the government close to Rs 5,000, how can it cost the private sector less? We have worked out the price after much debate and can't bring it down further,'' said Dr Arvind Lal, chairman and managing director, Dr Lal's Pathlabs.
Said Dr Nimrat Bawa, director, Auroprobe lab, which is offering home collection service, ``Our people have to wear personal protection equipment while taking the sample. If we collect samples from home, the PPE has to be discarded after taking one sample. There is no way that we can bring down the cost.''
The state health department, meanwhile, is concerned about the reporting mechanism of positive cases found by these labs. On Thursday, a 80-year-old woman who was admitted at Max hospital in Saket, tested positive for H1N1 influenza. Her sample was tested at Auroprobe lab. She was shifted to RML hospital late at night. The state health department is working out a way to ensure that positive cases from these labs are sent to government hospitals for treatment.
``We have to address this problem. At present, private hospitals are not allowed to keep any swine flu patient. Now that these labs will be testing samples, we will ask them to advice the patient to go to a government hospital. It is the government hospital doctor who will decide whether the patient needs hospital admission or can stay in home quarantine,'' said Kiran Walia, Delhi's health minister.
The health department also plans to increase the strength of its tracking teams. ``We have asked these private labs to report positive cases to us and our teams will then visit patient. We are thinking of increasing the strength of our tracking team. It is clear that private hospital doctors can't treat swine flu patients,'' said Walia.
detecting the disease. Three private labs have begun testing for the flu while another is expected to launch the facility from Friday.
The city government on Thursday gave permission to the fourth private lab - Super Religare Laboratories (SRL) - to test for H1N1 influenza, triggering a price war of sorts. SRL has priced the test at half of what the other three approved labs are charging.
The state health department is working out a mechanism for reporting positive H1N1 cases discovered by these labs. Meanwhile, these private centres have started collecting samples for testing. One lab, Auroprobe, began on Wednesday itself when it collected four samples. On Thursday, Auroprobe collected close to 20 samples, Dang's lab had eight and SRL got 4-5 samples. Dr Lal's pathlab will start from Friday. All four labs are promising results within 48 hours.
The three labs approved for testing on Tuesday had unanimously decided to charge Rs 9,000 flat for the test. But SRL announced that it would do the same test for Rs 4,500. ``It is a national emergency and we can't be fighting over the cost of the test. The test is expensive, as the reagents, testing kits and other material are imported and we are not exempted from custom duty. It is costing us close to Rs 8,000 or more,'' said Dr Navin Dang, director, Dr Dang's Lab.
According to sources in AIIMS, it costs the government around Rs 4,000-Rs 5,000 for each test. ``The custom duty on reagents, enzymes, testing kits etc used by us is less as compared to what private labs have to pay. The cost is high as the material used in testing is very expensive. The cost of the test is also high because we have to test for at least four factors - influenza A, swine A, swine H1 and RnT,'' said a senior doctor at AIIMS.
On being asked about the drastic difference in pricing, Dr Sanjeev Choudhry, CEO, SRL, said, ``Profit margins in these tests are very low. Our price is low as we are buying the reagents and kits in large quantities. Our testing capacity is also more and there are several other factors that affect the cost of any test.'' Choudhry said SRL would soon press 10 mobile vans into service for collecting samples.
The other three labs say that they are not likely to bring down the cost of the test any further. ``When it is costing the government close to Rs 5,000, how can it cost the private sector less? We have worked out the price after much debate and can't bring it down further,'' said Dr Arvind Lal, chairman and managing director, Dr Lal's Pathlabs.
Said Dr Nimrat Bawa, director, Auroprobe lab, which is offering home collection service, ``Our people have to wear personal protection equipment while taking the sample. If we collect samples from home, the PPE has to be discarded after taking one sample. There is no way that we can bring down the cost.''
The state health department, meanwhile, is concerned about the reporting mechanism of positive cases found by these labs. On Thursday, a 80-year-old woman who was admitted at Max hospital in Saket, tested positive for H1N1 influenza. Her sample was tested at Auroprobe lab. She was shifted to RML hospital late at night. The state health department is working out a way to ensure that positive cases from these labs are sent to government hospitals for treatment.
``We have to address this problem. At present, private hospitals are not allowed to keep any swine flu patient. Now that these labs will be testing samples, we will ask them to advice the patient to go to a government hospital. It is the government hospital doctor who will decide whether the patient needs hospital admission or can stay in home quarantine,'' said Kiran Walia, Delhi's health minister.
The health department also plans to increase the strength of its tracking teams. ``We have asked these private labs to report positive cases to us and our teams will then visit patient. We are thinking of increasing the strength of our tracking team. It is clear that private hospital doctors can't treat swine flu patients,'' said Walia.
Wednesday, August 26, 2009
WHO Says Confirmed H1N1 Deaths Worldwide Reach 1,799
http://patients-carecom.blogspot.com
According to the latest WHO report out Wednesday, the number of confirmed H1N1 (swine) flu deaths since its emergence in April has reached 1,799 - a jump from 1,462 deaths since the agency's last update, Agence France-Presse/the Australian reports. The WHO report also notes Ghana, Tuvalu and Zambia became the latest countries to confirm H1N1 cases for the first time, bringing the total number of countries with H1N1 to over 170 (8/20).
Also on Wednesday, the total number of deaths from H1N1 in Latin America rose above 1,300 - "more than 70 percent of the world's fatatlities" - after the country governments reported updates, the AFP reports in a separate story. "With vaccines against swine flu still more than a month away from being available -- and wealthy countries snapping up all available pre-orders from the big drug companies -- Latin American nations are looking at ignoring patents to produce their own," the news service writes, adding, Argentine President Cristina Kirchner on Tuesday appealed for pharmaceutical companies to "drop patent protection for their vaccines." "Given the laboratories' confession that they can't produce enough A(H1N1) flu vaccine for the whole world, the economic rights should be suspended to protect the health of mankind," Kirchner said (8/19).
Full Story on
http://www.patients-care.com/HealthNews.aspx
According to the latest WHO report out Wednesday, the number of confirmed H1N1 (swine) flu deaths since its emergence in April has reached 1,799 - a jump from 1,462 deaths since the agency's last update, Agence France-Presse/the Australian reports. The WHO report also notes Ghana, Tuvalu and Zambia became the latest countries to confirm H1N1 cases for the first time, bringing the total number of countries with H1N1 to over 170 (8/20).
Also on Wednesday, the total number of deaths from H1N1 in Latin America rose above 1,300 - "more than 70 percent of the world's fatatlities" - after the country governments reported updates, the AFP reports in a separate story. "With vaccines against swine flu still more than a month away from being available -- and wealthy countries snapping up all available pre-orders from the big drug companies -- Latin American nations are looking at ignoring patents to produce their own," the news service writes, adding, Argentine President Cristina Kirchner on Tuesday appealed for pharmaceutical companies to "drop patent protection for their vaccines." "Given the laboratories' confession that they can't produce enough A(H1N1) flu vaccine for the whole world, the economic rights should be suspended to protect the health of mankind," Kirchner said (8/19).
Full Story on
http://www.patients-care.com/HealthNews.aspx
Tuesday, August 25, 2009
Swine flu cases cross 3,000 mark
New Delhi: SwineFlu cases in the country on Tuesday crossed the 3,000-mark with 186 more people, including 41 in the national capital, testing positive for the disease.
With the fresh cases, the total number of cases rose to 3,095.
While Delhi reported 41 cases, Maharashtra had 34 fresh cases followed by Karnataka (29), Gujarat (23), Kerala (16), Tamil Nadu (12), Uttar Pradesh (9), West Bengal (4), Assam (2), Chandigarh (1); Haryana (1), Chhattisgarh (1) and Madhya Pradesh (1).
Of the 186 new cases reported during the day, nine have a travel history of visits abroad while the rest are indigenous cases.
Uttar Pradesh had reported 49 new Lab confirmed cases on August 24 from samples collected from 8-17 August 2009.
With the fresh cases, the total number of cases rose to 3,095.
While Delhi reported 41 cases, Maharashtra had 34 fresh cases followed by Karnataka (29), Gujarat (23), Kerala (16), Tamil Nadu (12), Uttar Pradesh (9), West Bengal (4), Assam (2), Chandigarh (1); Haryana (1), Chhattisgarh (1) and Madhya Pradesh (1).
Of the 186 new cases reported during the day, nine have a travel history of visits abroad while the rest are indigenous cases.
Uttar Pradesh had reported 49 new Lab confirmed cases on August 24 from samples collected from 8-17 August 2009.
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