Smart use of smart phone for the smart clinic - PCNI New Delhi, nov 2016

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Gaurav Gupta

Using Mobile Technology on Smart phones for Doctors and clinics. Presented in PCNI, New Delhi in Nov 2016,

WIIFY
• What can your smartphone do for your
practice NOW?
• What will your phone be able to do in the
near future?

Not covered
• Details of Apps (software based)
• Details of Health Apps and gadgets available
for general public

Doctors use smartphones more than
they use stethoscopes !
• Connect with medical
colleagues using Whatsapp
- both for patient care;
and for socialising
• Access the Internet
to remain up todate
• Medical apps

Smart use of smart phone for the smart clinic - PCNI New Delhi, nov 2016

Cloud based EMRs – patient
records at your fingertips

Automation
SMS
Appointments
Record Keeping
Calculators

Evidence
Convert Ordinary Stethoscope into Digital Stethoscope

Heartbuds – using the smartphone as a
stethoscope

Fundoscopy is now as easy as taking a
photo !
Peek Retina slips over smartphone’s camera.
Hold the phone close to someone’s eye and
the Peek app will auto-focus to show you
the retina on screen. www.peekvision.org

As Video Laryngoscope To Measure BLOOD
PRESSURE

http://www.vitadock.com
ThermoDock CardioDockGlucoDock
Each attachment cost Rs. 2500/-

Modular Smartphone Wearable Smartphone
3 D Holographic Smartphone Projector Smartphone

Seven components in all
> Air quality sensor
> CO2 monitor
> Light sensor
> EKG node that measures
heart activity
> Glucometer for glucose
tracking
> Breathalyzer
> Temperature
Lapka x Project Ara Medical Modular Smartphone

What is your opinion of using Smartphone in your practice ?

Missed something
docgaurav@gmail.com
www.slideshare.net/gauravg
Acknowledgments
• Dr Vipul Jain
• Dr Aniruddha Malpani
• Dr Anil Gulati

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To create a doctor podcast, one must first develop a clear concept focused on a specific medical area of interest. Then, choose an attention-grabbing name related to the topic and register the podcast on major platforms like Apple Podcasts and Spotify to reach a wide audience. Basic recording equipment like a computer and quality microphone are sufficient to produce clear audio. Promoting the podcast through one's website, social media, and practice's blog is key to growing the listener base.

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This document provides information on Rotavirus gastroenteritis (RVGE) and rotavirus vaccines in India, with a focus on vaccine 116E. It discusses how RVGE is a major cause of childhood diarrhea and mortality in India. It summarizes clinical trial results showing the 116E vaccine is effective at preventing severe RVGE, has a good safety profile with no increased risk of intussusception compared to other vaccines, and provides broad protection against circulating rotavirus strains in India. Phase 3 and 4 trials demonstrated 116E is well-tolerated and effective in preventing severe RVGE in Indian children when administered in a 3-dose schedule.

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The document discusses a new typhoid conjugate vaccine called Zyvac-TCV developed by Zydus Vaccines. It provides details of a phase II/III clinical trial conducted to evaluate the immunogenicity and safety of Zyvac-TCV compared to another licensed typhoid conjugate vaccine. The results showed that Zyvac-TCV was non-inferior in inducing seroconversion and had a comparable safety profile. No serious adverse events were reported for either vaccine. The document concludes that Zyvac-TCV met the immunogenicity and safety endpoints for efficacy.

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This document discusses meningococcal disease in India, including past outbreaks, current epidemiology and surveillance data, and recommendations for vaccination. It notes that while India has a poor surveillance system and diagnostic challenges, meningococcal disease is present and the country has seen outbreaks every 6-8 years. Surveillance data from 2012-2016 shows several states regularly report over 100 cases annually. Current recommendations from the Indian Academy of Pediatrics advise vaccination for high-risk groups, international travelers, and Hajj/African meningitis belt pilgrims. While antibiotics can treat the disease, vaccination is an effective prevention strategy given unknowns around antibiotic resistance and underdiagnosis.

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1) Japanese encephalitis (JE) is a viral disease spread by mosquitoes that is endemic in many parts of Asia and the Pacific. India reports the highest number of JE cases annually, with an estimated actual number between 15,000-20,000 cases per year. 2) JE vaccination is the most important preventive measure according to WHO and IAP guidelines. The national vaccination program in India recommends routine vaccination with two doses of JE vaccine for children up to 15 years of age in endemic areas. 3) While mosquito and pig control efforts have not proven reliable at controlling JE, vaccination is currently the single most effective public health approach for prevention in India given the disease burden.

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In healthcare, every day, millions of conversations fail. They fail to cover what’s really important, fail to resolve key issues, miss the point and lead to misunderstandings and disagreements. Clean Language is one approach that can improve things. It’s a set of precise questions – and a way of asking them – which help us all get clear on what matters, what we’d like to have happen, and what’s needed. Around 1000 people working in healthcare have trained in Clean Language skills over the past 20+ years. People are using what they’ve learnt, in their own spheres, and share anecdotes of significant successes. But the various local initiatives have not scaled, nor connected with each other, and learning has not been widely shared. This project, which emerged from work done by the NHS England South-West End-Of-Life Network, with help from the Q Community and especially Hesham Abdalla, aims to fix that.

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Chair and Presenter, Stephen V. Liu, MD, Benjamin Levy, MD, Jessica J. Lin, MD, and Prof. Solange Peters, MD, PhD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC/NCPD/AAPA/IPCE activity titled “Decoding Biomarker Testing and Targeted Therapy in NSCLC: The Complete Guide for 2024.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/4bBb8fi. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 1, 2025.

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In this insightful lecture, Dr. Faiza, an esteemed Assistant Professor of Physiology, delves into the essential concept of the ventilation-perfusion ratio (V˙/Q˙), which is fundamental to understanding pulmonary physiology. Dr. Faiza brings a wealth of knowledge and experience to the table, with qualifications including MBBS, FCPS in Physiology, and multiple postgraduate degrees in public health and healthcare education. The lecture begins by laying the groundwork with basic concepts, explaining the definitions of ventilation (V˙) and perfusion (Q˙), and highlighting the significance of the ventilation-perfusion ratio (V˙/Q˙). Dr. Faiza explains the normal value of this ratio and its critical role in ensuring efficient gas exchange in the lungs. Next, the discussion moves to the impact of different V˙/Q˙ ratios on alveolar gas concentrations. Participants will learn how a normal, zero, or infinite V˙/Q˙ ratio affects the partial pressures of oxygen and carbon dioxide in the alveoli. Dr. Faiza provides a detailed comparison of alveolar gas concentrations in these varying scenarios, offering a clear understanding of the physiological changes that occur. The lecture also covers the concepts of physiological shunt and dead space. Dr. Faiza defines physiological shunt and explains its causes and effects on gas exchange, distinguishing it from anatomical dead space. She also discusses physiological dead space in detail, including how it is calculated using the Bohr equation. The components and significance of the Bohr equation are thoroughly explained, and practical examples of its application are provided. Further, the lecture examines the variations in V˙/Q˙ ratios in different regions of the lung and under different conditions, such as lying versus supine and resting versus exercise. Dr. Faiza analyzes how these variations affect pulmonary function and discusses the abnormal V˙/Q˙ ratios seen in chronic obstructive lung disease (COPD) and their clinical implications. Finally, Dr. Faiza explores the clinical implications of abnormal V˙/Q˙ ratios. She identifies clinical conditions associated with these abnormalities, such as COPD and emphysema, and discusses the physiological and clinical consequences on respiratory function. The lecture emphasizes the importance of understanding these concepts for medical professionals and students, highlighting their relevance in diagnosing and managing respiratory conditions. This comprehensive lecture provides valuable insights for medical students, healthcare professionals, and anyone interested in respiratory physiology. Participants will gain a deep understanding of how ventilation and perfusion work together to optimize gas exchange in the lungs and how deviations from the norm can lead to significant clinical issues.

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Randomized controlled clinical trial is a prospective experimental study. It essentially involves comparing the outcomes in two groups of patients treated with a test treatment and a control treatment, both groups are followed over the same period of time. Prepare a plan of study or protocol a. Define clear objectives b. State the inclusion and exclusion criteria of case c. Determine the sample size, place and period of study d. Design of trial (single blind, double blind and triple blind method) 2. Define study population: Most often the patients are chosen from hospital or from the community. For example, for a study for comparison of home and sanatorium treatment, open cases of tuberculosis may be chosen. 3. Selection of participants by defined criteria as per plan: Selection of participants should be done with precision and should be precisely stated in writing so that it can be replicated by others. For example, out of open cases of tuberculosis those who fulfill criteria for inclusion may be selected (age groups, severity of disease and treatment taken or not, etc.) Randomization ensures that participants have an equal chance to be assigned to one of two or more groups: One group gets the most widely accepted treatment (standard treatment/ gold standard) The other gets the new treatment being tested, which researchers hope and have reason to believe will be better than the standard treatment Subject variation: First, there may be bias on the part of the participants, who may subjectively feel better or report improvement if they knew they were receiving a new form of treatment. Observer bias: The investigator measuring the outcome of a therapeutic trial may be influenced if he knows beforehand the particular procedure or therapy to which the patient has been subjected. Evaluation bias: There may be bias in evaluation - that is, the investigator(Analyzer) may subconsciously give a favorable report of the outcome of the trial. Co-intervention: participants use other therapy or change behavior Study staff, medical providers, family or friends treat participants differently. Biased outcome ascertainment: participants may report symptoms or outcomes differently or physicians Investigators may elicit symptoms or outcomes differently A technique used to prevent selection bias by concealing the allocation sequence from those assigning participants to intervention groups, until the moment of assignment. Allocation concealment prevents researchers from influencing which participants are assigned to a given intervention group. All clinical trials must be approved by Institutional Ethics Committee before initiation It is mandatory to register clinical trials with Clinical Trials Registry of India Informed consent from all study participants is mandatory. A preclinical trial is a stage of research that begins before clinical trials, and during which important feasibility and drug safety data are collected. Following points high.

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The uroculturome indicates the profile of culturable microbes inhabiting the urinary tract, and it is often required to do a urine culture to find an effective antimicrobial to treat UTIs. This study targeted to understand the profile of culturable pathogens in the urine of apparently healthy (128) and humans with clinical UTIs (161). In urine samples from UTI cases, microbial counts were 1.2×104 ± 6.02×103 colony-forming units (cfu)/ mL, while in urine samples from apparently healthy humans, the average count was 3.33± 1.34×103 cfu/ mL. In eight samples (six from UTI cases and two from apparently healthy people) of urine, Candida (C. albicans 3, C. catenulata 1, C. krusei 1, C. tropicalis 1, C. parapsiplosis 1, C. gulliermondii 1) and Rhizopus species (1) were detected. Candida krusei was detected only in a single urine sample from a healthy person and C. albicans was detected both in urine of healthy and clinical UTI cases. Fungal strains were always detected with one or more types of bacteria. Gram-positive bacteria were more commonly (OR, 1.98; CI99, 1.01-3.87) detected in urine samples of apparently healthy humans, and Gram -ve bacteria (OR, 2.74; CI99, 1.44-5.23) in urines of UTI cases. From urine samples of 161 UTI cases, a total of 90 different types of microbes were detected and, 73 samples had only a single type of bacteria. In contrast, 49, 29, 3, 4, 1, and 2 samples had 2, 3, 4, 5, 6 and 7 types of bacteria, respectively. The most common bacteria detected in urine of UTI cases was Escherichia coli detected in 52 samples, in 20 cases as the single type of bacteria, other 34 types of bacteria were detected in pure form in 53 cases. From 128 urine samples of apparently healthy people, 88 types of microbes were detected either singly or in association with others, from 64 urine samples only a single type of bacteria was detected while 34, 13, 3, 11, 2 and 1 samples yielded 2, 3, 4, 5, 6 and seven types of microbes, respectively. In the urine of apparently healthy humans too, E. coli was the most common bacteria, detected in pure culture from 10 samples followed by Staphylococcus haemolyticus (9), S. intermedius (5), and S. aureus (5), and similar types of bacteria also dominated in cases of mixed occurrence, E. coli was detected in 26, S. aureus in 22 and S. haemolyticus in 19 urine samples, respectively. Gram +ve bacteria isolated from urine samples' irrespective of health status were more often (p, <0.01) resistant than Gram -ve bacteria to ajowan oil, holy basil oil, cinnamaldehyde, and cinnamon oil, but more susceptible to sandalwood oil (p, <0.01). However, for antibiotics, Gram +ve were more often susceptible than Gram -ve bacteria to cephalosporins, doxycycline, and nitrofurantoin. The study concludes that to understand the role of good and bad bacteria in the urinary tract microbiome more targeted studies are needed to discern the isolates at the pathotype level.

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Descoperă Bucuria Vieții Sănătoase cu Jurnalul Fericirii Life Care - Iulie 2024! Gata să te bucuri de o vară vibrantă și plină de energie? Life Care îți vine în ajutor cu Jurnalul Fericirii din Iulie 2024, un ghid complet pentru o viață armonioasă și echilibrată. Pe parcursul a cateva de pagini pline de informații utile și inspirație, vei descoperi: Sfaturi practice pentru o alimentație sănătoasă: Rețete delicioase și ușor de preparat: Bucură-te de preparate gustoase și nutritive, perfecte pentru zilele călduroase de vară. Recomandări pentru o alimentație echilibrată: Asigură-ți aportul necesar de nutrienți esențiali pentru un organism sănătos și plin de vitalitate. Sfaturi pentru alegeri alimentare inteligente: Învață cum să faci cumpărături sănătoase și să eviți tentațiile nesănătoase. Trucuri pentru un stil de viață activ: Rutine de exerciții fizice adaptate nevoilor tale: Găsește antrenamente potrivite pentru a te menține în formă și energic pe tot parcursul verii. Idei de activități în aer liber: Descoperă modalități distractive de a te bucura de vremea frumoasă și de a petrece timp de calitate cu cei dragi. Sfaturi pentru un somn odihnitor: Asigură-ți un somn profund și reparator pentru a te trezi revigorat și pregătit pentru o nouă zi. Sfaturi pentru o stare de bine mentală: Tehnici de relaxare și gestionare a stresului: Învață cum să te relaxezi și să faci față provocărilor zilnice cu mai multă ușurință. Sfaturi pentru cultivarea optimismului și a gândirii pozitive: Descoperă cum să abordezi viața cu o perspectivă optimistă și să atragi mai multă bucurie în ea. Recomandări pentru a te conecta cu natura: Bucură-te de beneficiile naturii asupra stării tale mentale și emoționale. Bonus: Oferte exclusive la produsele Life Care: Beneficiază de reduceri și promoții speciale la o gamă largă de produse pentru o viață sănătoasă. Concursuri și premii: Participă la concursuri distractive și câștigă premii valoroase. Jurnalul Fericirii Life Care - Iulie 2024 este mai mult decât o simplă revistă. Este un ghid complet și personalizat pentru a te ajuta să obții o viață mai sănătoasă, mai fericită și mai plină de satisfacții. Nu rata această șansă de a te bucura de vară la maximum! Descoperă Jurnalul Fericirii Life Care - Iulie 2024 astăzi! Comandă-ți exemplarul acum și fă un pas important către o viață mai bună! #JurnalulFericirii #LifeCare #Iulie2024 #ViataSanatoasa #Bunastare #Fericire #Oferte #Concursuri #Premii

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Smart use of smart phone for the smart clinic - PCNI New Delhi, nov 2016

1. Smart use of Smart Phone for the Smart Clinic Dr. Gaurav Gupta, Consultant Pediatrician, Charak Clinics, Mohali

2. WIIFY • What can your smartphone do for your practice NOW? • What will your phone be able to do in the near future?

3. Not covered • Details of Apps (software based) • Details of Health Apps and gadgets available for general public

4. NOMOPHOBIA

5. Doctors use smartphones more than they use stethoscopes ! • Connect with medical colleagues using Whatsapp - both for patient care; and for socialising • Access the Internet to remain up todate • Medical apps

7. Cloud based EMRs – patient records at your fingertips

8. Automation SMS Appointments Record Keeping Calculators

10. The next generation !

11. Evidence Convert Ordinary Stethoscope into Digital Stethoscope

12. Heartbuds – using the smartphone as a stethoscope

13. Peek – Smartphone-based Eye-testing kit

14. Fundoscopy is now as easy as taking a photo ! Peek Retina slips over smartphone’s camera. Hold the phone close to someone’s eye and the Peek app will auto-focus to show you the retina on screen. www.peekvision.org

15. HemaApp

16. HemaApp

17. Hardware

18. Bilicam

20. As Thermometer As Pulse Oximeter

21. As Otoscope AliveCor as Portable ECG

22. As a Microscope As Glucometer IBGStar

25. As Video Laryngoscope To Measure BLOOD PRESSURE

26. As Spiro meter

27. http://www.vitadock.com ThermoDock CardioDockGlucoDock Each attachment cost Rs. 2500/-

28. Super Smartphones

29. Modular Smartphone Wearable Smartphone 3 D Holographic Smartphone Projector Smartphone

30. Seven components in all > Air quality sensor > CO2 monitor > Light sensor > EKG node that measures heart activity > Glucometer for glucose tracking > Breathalyzer > Temperature Lapka x Project Ara Medical Modular Smartphone

31. Risks

32. Risks

34. What is your opinion of using Smartphone in your practice ?

35. Missed something docgaurav@gmail.com www.slideshare.net/gauravg Acknowledgments • Dr Vipul Jain • Dr Aniruddha Malpani • Dr Anil Gulati

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