What is a stethoscope?

That is something you would see hanging down from the necks of doctors and even medical students, a photo of which you would see below:



The saying goes that a photo is worth a trillion words (my own version) so I don't think with the photo, we need to elaborate on what a stethoscope is.

Function of a stethoscope

Doctors uses the stethoscope to listen to sounds in the human body, sounds like heart beats, sounds from the lungs while breathing in and out, to flow of blood through veins and arteries. Medical students too will have to learn to use the stethoscopes for the same purposes. So do veterinarians who use them to listen to sounds in animal bodies. Those techies (people who like to use technical terms, my own interpretation) will call this process of listening to the internal sounds of the body "auscultation". The purpose of auscultation is to examine the respiratory system (heart sounds and breath sounds), circulatory system and the gastrointestinal system (bowel sounds). Auscultation is not an easy skill to acquire but requires lots and lots of clinical experience plus good listening skills. That is why you will even see medical students with those stethoscopes hanging round their necks.

Diagnostic uses of stethoscopes

Doctors listen for abnormal sounds including heart murmurs, gallops, other extra sounds coinciding with heartbeats plus the heart beats itself when auscultating the heart. When auscultating the lungs, doctors will watch out for sounds such as wheezes and crackles. Asthma is diagnosed when wheezing sounds are heard and depending on how serious, patients may be put on various medications such as putting them on inhalers. The best is to use a nebulizer where those suffering from wheezing get a mouth and nose piece covering their mouth and nose and breathe in air containing very tiny droplets of medication (mist) which can reach the very deep recesses of the lungs for direct action to stop the wheezing. In very serious cases, may even be hospitalized. My youngest son at a very tender age was hospitalized, and not only that, given steroids which I hate. But what to do. It was necessary to protect his life for severe cases of asthma can be life threatening.

There is now even an online training for auscultation

To purchase medications for asthma, you may try to purchase medications for asthma online. Please note the disclaimer in this and that site where you are advised to consult your doctor or doctors for medical problems and you would be wise to comply with the laws and regulations of your countries regarding prescription medications. Don't know about herbal medical medications.

Anyone who wants to keep up to date or frequently do research for their work needs access to peer-reviewed (for accuracy and confidence) Journals. However, one cannot afford to subscribe to too many journals or one will go broke.

Here is a heaven-sent: Open Access Journals where anyone can access the journals without having to pay for it. Any you have a Directory of Open Access Journals where various Open Access journals covering a very wide spectrum of subjects are listed in alphabetical order by title as well as by subject. There is also a search box to help you in your research.

Now we are interested in "Health Sciences" and in this page itself is divided into Open Access journals for

Dentistry	Nursing
Medicine (General)	Public Health

Let us have a look at the one for Medicine (General). What I see there are

Allergy and Immunology (17 journals)
Cardiovascular (41 journals)
Dermatology (10 journals)
Gastroenterology (18 journals)
Gynecology and Obstetrics (22 journals)
Internal medicine (141 journals)
Neurology (49 journals)
Oncology (28 journals)
Ophthalmology (10 journals)
Otorhinolaryngology (10 journals)
Pathology (16 journals)
Pediatrics (30 journals)
Pharmacy and materia medica (20 journals)
Psychiatry (31 journals)
Sports Medicine (9 journals)
Surgery (60 journals)
Therapeutics (36 journals)
Urology (14 journals)

Looks like when I want to research some topics, I now know where to go.

Arthritis is not a simple medical problem, but a a whole set of different medical conditions caused by inflamed joints where joints are damaged. There are some estimated 200 different forms of arthritis. It is a painful condition and one which is difficult to deal with.

A person suffering from arthritis will have stiff, swollen and painful joints which in severe cases can cause partial immobilization. The most common forms of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis

A patient with osteoarthritis has joints where protective cartilage have broken down and the exposed joint surfaces. As the joints rubbed against each other, it gets inflamed and thus painful. The most common joints to be affected by osteoarthritis are the finger joints, knee joints, hip joints, and spinal

joints. Less common are the wrist joints, elbow joints, shoulder joints, and ankle joints. It is often triggered by injury or over-use, but the exact causes are not known.

Symptoms of osteoarthritis

In the beginning, an affected person may just feel aches after physical work or exercises. As time goes by, this become a steady or intermittent pain as well as swelling and tenderness. If the patient is inactive, this progress further to joints stiffness. Crunching sound (bone rubbing on bone) may even accompany movements.

Rheumatoid arthritis

Rheumatoid arthritis is usually caused by inflammation of the lining of the joints (the lining of the joints are called synovium). Rheumatoid arthritis is usually a chronic, inflammatory autoimmune medical disorder where the immune system go crazy and start to attack the joints. It is a disabling disease which can lead to joint destruction. It can even affect the lungs, the blood and the heart itself. The diseased joined may even go out of shape with loss of normal movement.

Causes of rheumatoid arthritis

As mentioned above, rheumatoid arthritis is an auto-immune disease. The immune system whose function is to fight infections and other foreign invaders, malfunctions, and instead start to attack the body tissues itself. Nobody is clear about why it happen. It can be influenced by genetics, that is, it could be hereditary. In some cases, rheumatoid arthritis seem to be triggered by infection.

Symptoms of rheumatoid arthritis

Rheumatoid arthritis patients have stiff and swollen joints which may flare up suddenly, the recede. The symptoms may also be experienced over an extended period of time. Severe rheumatoid arthritis can lead to severe joints damage, misshaped joints and disability.

Treatment for arthritis

Treatment of arthritis is tough. Some says exercise can help. Others believe in a varied and balanced diet. In some cases, arthritis patients takes physical therapy. Some seeing no help in conventional medicine turns to alternative medicine like acupuncture.

Medications for arthritis

There are medications for arthritis, but they are for relief of symptoms and not a cure. Arthritis medication can be divided into 7 categories:

1. Traditional nonsteroid anti-inflammatory drugs (NSAIDs)


2. COX-2 specific inhibitors


3. Combination therapies


4. Pain relievers (analgesics)


5. Steroids


6. Disease-modifying antirheumatic drugs (DMARDs)


7. Biologic response modifiers

Surgery

Severe cases of arthritis may require surgery of which there are various procedures:

1. Arthrodesis


2. Arthroplasty


3. Arthroscopy


4. Osteotomy


5. Synovectomy

It is wise to know more about the drugs prescribed to you by physicians and there are various ways you can get them. Here are some of the ways:

Leaflets that accompany prescription drugs

Most prescription drugs, if you get it in the manufacturer's package, will contain a leaflet with information about the drugs and usually warnings about side effects and what kind of circumstances when it is not advisable to use the drug. Often, these leaflets may err on the cautious side where manufacturers' put in lots of warnings to protect themselves from being sued. There also have been cases where drug manufacturer have had to pay damages for withholding information from consumers about dangerous ill effects. Merck & Co., manufacturer of Vioxx (Rofecoxib), for example, had been accused of withholding information about increased risk of heart attack and stroke associated with long-term, high-dosage use.

Physicians' Desktop Reference

This is a reference often used by physicians and they have 2 websites, PDR online (free for US medical professionals only) and PDR Health (free consumer drug and medical information site). There are some controversy over Physicians' Desktop Reference as it is financed by drug manufacturers and with some saying it lack of reporting of updated and accurate drug dosages along with adverse drug effects. Oftentimes dosage information can be taken from phase 1 trial information where clinical drug information is incomplete, resulting in higher PDR-recommended dosages than therapeutically effective dosages for many medications.

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Wikipedia

I like to search for information on drugs from Wikipedia. For example, if I want information on the prescription Prozac, I will type the phrase "prozac wikipedia" into the Google search box above, tick the radio button beside WEB and click "Search".

With the appearance of alcohol-based hand gel, many doctors and nurses are skipping the soap and water scrub and using the alcohol-based hand gel instead to prevent the spread of infection-causing germs in hospitals. Guidelines from the Centers for Disease Control and Prevention says better hand hygiene by frequent washing or use of hand gels can cut the spread of hospital infections.

However, according to Dr. Mark Rupp, an infectious disease specialist at the University of Nebraska Medical Center who led a study at the adjoining Nebraska Medical Center, that is not sufficient to prevent spread of infections in hospitals. Dr. Mark Rupp says rings and fingernails are too long and hard to clean. Poor handling of catheters and treatment areas are thus not sanitized. Dr. Mark Rupp's study was published in the January issue of Infection Control and Hospital Epidemiology.

Dr. Rupp study showed hospital-borne infections cannot be stopped by better hand hygiene alone as spreading of infections are not caused by person-to-person contact alone. Dr. Rupp made the suggestion that hand gels should be complemented with additional measures such as better cleaning of hospital units, proper insertion and maintenance of catheters, and doctors only prescribing antibiotics when absolutely necessary so that we don't get the emergence of more drug-resistant bacteria.He further recommended that hospital workers should not wear rings plus trim their fingernails beyond the Centers for Disease Control's recommendation of no longer than a quarter of an inch. Dr. Rupp claimed that bacteria are present even when nails extended just beyond the fingertip.

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