Friday, September 16, 2011

How technology is changing doctor-patient relationship in Chandigarh, India!

Today, there was a first in my decade long practice in Chandigarh. I am aware that Chandigarh has a large proportion of tech savvy educated parents. I received a call regarding some readability issues with one of my prescriptions. This is uncommon, not because my hand writing is good. It is terrible, like many male colleagues of mine! But I still get less than my fair share of the stick in this situation because I provide computerized prescriptions. However, occasionally when I write an additional drug with my hand, the chemists/ parents have some difficulty in going through it.

When I asked the parents to come to me (since I could not remember the drug whose name was illegible), the mother instead suggested sending me a scanned copy of the prescription on email!

She actually sent it across, and I am attaching the same here. For those who are interested, the word they could not get was “nostrils” where I had advised the application of Mupirocin (T Bact cream) so as to decrease chances of recurrent skin infection.

It just got me thinking about the increasing time-saving use of technology in the present day and age. I believe that the role of email will slowly increase as a communication tool, and hence doctors need to be up to date with this important means of instant communication. Things like medico-legal implications, charging for these online consultations, medical insurance issues, email storage for long term etc. are all issues that will challenge the physicians of the future in India, especially the metros, over the foreseeable future. In the meanwhile, I will enjoy my first scanned & emailed prescription, sent back to me, containing an illegible entry!

Wednesday, September 14, 2011

Vaccine Myths shattered !

In this modern era of Internet and net savvy parents, many of these concerned parents have some queries / objections regarding vaccines.
These are increasing on a daily basis due to many factors, including increasing number of newer vaccines, newspaper / media reports (generally factually incorrect, I may say) regarding potential side-effects, and genuine concerns regarding the effect of so many vaccines on the child's immune system.
I would like to shatter a few of the common misconceptions regarding vaccinations using this forum.

Myth: it’s better to develop natural immunity then get vaccinated.

Fact: the difference between vaccination and natural infection is the price paid for immunity. The price paid for natural immunity (infection) is the physical economical & mental agony the entire family goes through after one suffers from a disease. In comparison price paid for vaccination is negligible. Also it is important to remember that many of the diseases that we getting protected against can actually cause a large number of complications including death of a child. In fact thousands of children die in India every year due to vaccine preventable diseases, hence getting a vaccination done is preferable to allowing 'natural immunity' for most diseases.

Myth: by relying on vaccines, my child’s immune system becomes weak or does not develop at all.

Fact: No, vaccine do not weaken immune system. People generally believe that vaccines offer ready made protection. This is NOT the case. In fact the vaccines work like a 'mini-disease'. The body acts on vaccine germs and produces antibodies, which fight against disease germs when the child comes in contact with disease any time in future.

Myth; vaccines are known to cause serious side effects.

Fact: In most cases, vaccines cause no side effects or only mild reactions such as fever or soreness at the injection site. Very rarely, people experience more serious side effects like allergic reactions. Be sure to tell your doctor if your child has had any severe reaction to previous vaccine, or has health problems or known allergies to medications or food.

“Vaccines”- Yes But how many ?

As you know, prevention is always better than cure. Fortunately, due to progress in vaccine science & technology, it is possible to protect children against several serious diseases through vaccination; normally a baby is exposed to millions of germs daily. It is much better to protect them against diseases through vaccination then let them be at risk & suffer.

Myth: My child does not require vaccines, as he/ she is healthy, active & eats well.

Facts: vaccination is intended to help keep kids healthy, because vaccines work by protecting the body before disease strikes. If you wait until your child gets sick, it will be too late for the vaccine to work. The best time to immunize kids is when they’re healthy.

Myth: Combination vaccines cause more side effects.

Fact: Combination vaccines are as safe & effective as individual vaccines there are two practical factor in favor of giving a child several vaccines during the same visit. First, to immunize children as early as possible to give protection during the vulnerable early months of their lives.

Second, giving several vaccines at the same time will mean fever clinic visits & fewer injections, which saves parents both time and money and may be less traumatic for the child. There are studies done that show that the discomfort caused is less with combination vaccines as compared to individual shots.

Just think - what would you want for yourself - 3 injections separately or a single injection containing all 3 vaccines ?

Myth: It’s OK to skip certain vaccine.

Fact: In general skipping vaccines is not a good idea. This can leave your child vulnerable to potentially serious disease that could otherwise be avoided. If you have reservations about any particular vaccine, discuss your concerns with your child’s doctor, if your child falls behind the standard vaccination schedule, catch-up vaccination is also available.

Myth: If I have missed a dose of any vaccine, it is no longer needed later

Fact: For most vaccines, if the dose is missed on the due date, you still need to take it at any later date (catch - up vaccination). Talk to your doctor regarding when these doses should be completed.

Myth: Vaccine may not be 100% effective; so why vaccinate?

Fact: Vaccines indeed are the most effective weapons we have against diseases. They work in 85% to 99% of cases. Smallpox has been eradicated from the face of earth & a dramatic reduction in the incidence of diseases like Polio, Diphtheria, Pertussis, Measles & Mumps are evidence of power of vaccines. Vaccine failure is rare & in such a case the disease is usually milder.

Myth: vaccines are for babies only. There is no need to vaccinate after 2 to 4 years of the age.

Fact; Diseases continue to affects school going children, adolescents & adults. It is always better to keep your child protected. Few vaccines (like DPT) do not provide life long protection. Protective efficacy of these vaccines wanes off over a period of time so regular boosters are required.

There are some new vaccines (like HPV) for adolescent girls to prevent Cervical Cancer. Some vaccines (like Flu) need regular vaccination as the virus keeps changing. For most of the vaccines age is not a barrier. Ask your doctor if you have missed any vaccine as you can always catch-up.

A friendly reminder for parents:

Adults need vaccination too! Check with your doctor to know what vaccines you might need. Your baby is counting on you.


Vaccination Information Pamphlet by GSK

Monday, September 12, 2011

Frequently asked questions regarding vaccines

What is vaccination?

Vaccination protects children against serious diseases by stimulating the immune system against disease germs.

How does vaccine immunity differ from natural immunity?

Normally in most diseases the disease-germ enters the body, produces the disease & the body mounts fighting power against the germ and lastly one recovers from the disease. Here immunity against disease is produced after one has suffered from the disease.

A vaccine is nothing but whole or part of the disease germ, which has been processed or modified in such a way that it loses its capacity to produce disease but it can still induce fighting power in the body when administered. Hence by vaccination one develops immunity without suffering from the disease.

Rather than reinvent the wheel, I have decided to post a list of excellent detailed FAQs that interested parents can go to and read.

I would recommend the following links

1. CDC

2. Web MD

3. Medicine Net