Hypertension guidelines: how much low?

Hypertension guidelines: how much low?

In an era that that ‘evidence-based medicine’ is facing challenges from many fronts, the benefits of blood pressure control have been shown to decrease morbidity and mortality and increase lifespan. The evidence is strong and there is no disagreement among clinicians and researchers. However, there is considerable uncertainty and debate as to how much reduction is needed in systolic blood pressure among the leading guidelines that look at the same evidence. The JNC 2018, AHA/ACC and now NICE guidelines vary with the recommendations. The page below gives the summary of guidelines available from JNC 8 (2014), ACC/AHA (2107) and ESC/ESH

How to get back from a disaster stricken mind

How to get back from a disaster stricken mind

ප්‍රහාරයෙන් බිඳුණු මනස යළි හදාගන්නේ කොහොමද? පාස්කු ඉරිදා සිදු වූ අමානුෂික ත්‍රස්ත ප්‍රහාරය හේතුවෙන් තුන්සියයකට ආසන්න පිරිසක් මිය ගොස් පන්සියයකට ආසන්න පිරිසක් තුවාල ලැබූහ. මියගියවුන් අතර කුඩා දරුවෝ හතළිස් පහකට ආසන්න පිරිසක් වූහ. තුවාල ලද දරුවන් සංඛ්‍යාවද බොහෝය. නොසිතූ මොහොතක ඇති වූ මේ දැවැන්ත ව්‍යසනය හමුවේ සමාජයේ ලොකු කුඩා කාහටත් දැඩි මානසික කම්පනයක් ඇති වූ බව රහසක් නොවේ. මේ ව්‍යසනයට මුහුණ පෑ එමෙන්ම එය දුටු සමස්තයේ අවසාන බලපෑම ඇති වන්නේ මේ හැම දෙනාගේම මනසටය. මෙයට විසඳුමක් ලෙස සමස්ත සමාජයේ මෙන්ම දරුවන්ගේ මානසික ව්‍යාකූලතා අවම කිරීම උදෙසා කළ යුතු හා කළ හැකි දේ මොනවාදැයි, අපි මනෝ චිකිත්සාව පිළිබඳ මහාචාර්ය අතුල සුමතිපාල

Grief and Bereavement in Adults

Grief and Bereavement in Adults

Grief is the response to bereavement, which is the situation in which a loved one has died [1]. Natural acute grief reactions are often painful and impairing with emotional and somatic distress, but should not be diagnosed as a mental disorder. However, bereavement is a stressor that can precipitate or worsen mental disorders (eg, unipolar major depression). In addition, complications (maladaptive thoughts, feelings, or behaviors) may occur, such that acute grief becomes intense, prolonged, and debilitating. This condition is called complicated grief, which is viewed as a unique and recognizable disorder that requires specific treatment. Ref -[UpToDate TERMINOLOGY The terms

Gene editing and Designer ‘CRISPR’ babies

Gene editing and Designer ‘CRISPR’ babies

  Gene editing or genome editing is the technique used to replace or cutting pieces of DNA [Ref]. Using a component known as  CRISPR to precisely pinpoint the sequence of DNA in the gene, an enzyme called Cas9 is used to cut through the part identified. It can also replace a removed part by another sequence of DNA. This technique can be used to replace a faculty gene or change a gene to make it behave differently. Gene editing can have very good effects like altering a disease gene or modifying a diseased gene to behave normally. However gene editing

Meet ‘Symptom Checkers’ – Isabel and Babylon

Meet ‘Symptom Checkers’ – Isabel and Babylon

People increasingly search the Internet regarding their health issues and a Google search may be the commonest in most instances. Even doctors ‘Google’ for a diagnosis [Ref]. Recently there has been a proliferation of more sophisticated programs called ‘symptom checkers‘ that attempt to more effectively provide a potential diagnosis for patients and direct them to the appropriate care setting. Many healthcare institutions provide symptom checkers such as  WebMD, Mayo Clinic,  HealthLine.   Isabel and Balylon are two different applications that use different programming techniques to provide people with their symptom evaluation. Isabel uses the orthodox text-searching. Babylon uses a ‘Chatbot‘

Technological Transformation

Technological Transformation

Technology has enabled bionics and artificial intelligence, each of which can have important applications in health care. As we continue to substitute body parts with machinery, however, we might wonder, “What makes us human?” This drawing interrogates the relationship between humanity and embodiment, specifically in neck and facial musculature and brain structures. This image represents humankind’s union with technology. It shows the brain turning into a collection of integrated computer circuits and the neck muscles evolving into mechanization-ready cables, pumps, and wires. In artificial intelligence (AI), boundaries distinguishing life and technology are challenged. We wonder, “Is it possible for machines

How Should Clinicians Engage With Online Health Information?

How Should Clinicians Engage With Online Health Information?

From the ‘AMA Journal of Ethics – Illuminating the Art of Medicine’ Many adults, physicians, and medical students search the internet for health information. Open access has many benefits, but the variable quality of internet health information—ranging from evidence based to false—raises ethical concerns. Using Wikipedia as a case study, this article argues that everyone engaging with internet health information has ethical responsibilities. Those hosting and writing for health websites should ensure that information is evidence based, accurate, up to date, and readable and be transparent about conflicts of interest. Health care professionals, including medical students, have both ethical responsibilities

Screening and General Health Checks in adults – the latest from Cochrane

Screening and General Health Checks in adults – the latest from Cochrane

Screening and prevention ‘Screening is a way of finding out if people are at higher risk of a health problem so that early treatment can be offered or information given to help them make informed decisions. Screening is a way of identifying apparently healthy people who may have an increased risk of a particular condition. The (NHS UK) offers a range of screening tests to different sections of the population. The aim is to offer screening to the people who are most likely to benefit from it. For example, some screening tests are only offered to newborn babies, while others

Phishing – stealing legitimate user credentials

Phishing – stealing legitimate user credentials

Phishing is a form of fraud in which an attacker masquerades as a reputable entity or person in email or other communication channels. The attacker uses phishing emails to distribute malicious links or attachments that can perform a variety of functions, including the extraction of login credentials or account information from victims. One common explanation for the term is that phishing is a homophone of fishing, and is so named because phishing scams use lures to catch unsuspecting victims, or fish. [LINK] Phishing attacks typically rely on social networking techniques applied to email or other electronic communication methods, including direct messages

What we learned in 2018 in Health & Medicine according to the NYT

What we learned in 2018 in Health & Medicine according to the NYT

Developments in medicine and health that we’re still thinking about at year’s end. It’s not easy to say that any particular development in health or medicine was the most important in a given year [Ref – NYT]. But if we had to choose some highlights, we’d opt for these unforgettable events and findings.       From left, Douglas A. Warner III, Memorial Sloan Kettering’s board chairman; Dr. José Baselga, its former chief medical officer; and Dr. Craig B. Thompson, its chief executive, at its charity ball in New York last year. Credit Rebecca Smeyne for The New York Times Conflicts of interest