Friday, August 31, 2018

33 Google Maps Tricks You Need to Try

Google Maps has changed the way we navigate the world. Its desktop and mobile apps have become not just a way to get from point A to B via car, public transportation, or on foot. The ubiquitous Google service is also a geospatial search engine for the world around us.
Google continues to revamp and improve its map product with features like augmented reality and contextual location suggestions, but there are a ton of customizable tools and hidden functions already baked into Google Maps that you may not know about. Check out our tips for how to maximize your Google Maps power.

Monday, July 24, 2017

Source:Levine GN. Balancing Ischemic and Bleeding Risks of Prolonged Dual Antiplatelet TherapyJAMA.2017;318(2):194-195. doi:10.1001/jama.2017.6698 

Dual antiplatelet therapy (DAPT) combines aspirin with a P1Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) to decrease the risk of coronary thrombosis. [start-highlighting]Compared with antiplatelet therapy with aspirin alone, DAPT after a myocardial infarction (MI) or percutaneous coronary intervention (PCI) reduces the risk of spontaneous MI and coronary stent thrombosis[end-highlighting] (Audio).1However, the addition, intensification, or prolongation of antiplatelet therapy necessitates a trade-off between decreasing ischemic risk and increasing bleeding risk.1 In addition to this trade-off, consideration also must be given to the implications of ischemic or bleeding events, how patients are selected for treatment with DAPT and its duration, and what can be done to reduce bleeding risk.

Saturday, July 22, 2017

The Aging Physician and the Medical Profession

Source:http://jamanetwork.com/journals/jamasurgery/fullarticle/2644000 

Abstract
Importance  The issue of the aging physician and when to cease practice has been controversial for many years. There are reports of prominent physicians who practiced after becoming dangerous in old age, but the profession has not demonstrated the ability to prevent this. A mandatory retirement age could be discriminatory and take many competent physicians out of practice and risk a physician shortage. An increasing body of evidence regarding the relationship between physicians’ age and performance has led organizations, such as the American College of Surgeons, to revisit this challenge.
Observations  Since 1975, the number of practicing physicians older than 65 years in the United States has increased by more than 374%, and in 2015, 23% of practicing physicians were 65 years or older. Research shows that between ages 40 and 75 years, the mean cognitive ability declines by more than 20%, but there is significant variability from one person to another, indicating that while some older physicians are profoundly impaired, others retain their ability and skills. There are age-based requirements for periodic testing and/or retirement for many professions including pilots, judges, air traffic controllers, Federal Bureau of Investigation employees, and firefighters. While there are not similar requirements for physicians, a few hospitals have introduced mandatory age-based evaluations.
Conclusions  As physicians age, a required cognitive evaluation combined with a confidential, anonymous feedback evaluation by peers and coworkers regarding wellness and competence would be beneficial both to physicians and their patients. While it is unlikely that this will become a national standard soon, individual health care organizations could develop policies similar to those present at a few US institutions. In addition, large professional organizations should identify a range of acceptable policies to address the aging physician while leaving institutions flexibility to customize the approach. Absent robust professional initiatives in this area, regulators and legislators may impose more draconian measures.

Thursday, July 31, 2014

Five Asean countries hail dengue vaccine advance | Bangkok Post: news

Five Asean countries hail dengue vaccine advance | Bangkok Post: news



Thailand and four other Asean countries have developed a new dengue vaccine that could mitigate the disease's severity by 88.5%, according to the Pediatric Infectious Disease Society of Thailand (PIDST).
PIDST president Usa Thisyakorn made the announcement at the sixth national vaccine conference in Bangkok yesterday.

The vaccine was developed under joint research between five countries — Vietnam, the Philippines, Indonesia, Malaysia and Thailand, she said.

Ms Usa said the vaccine can prevent and mitigate the impact of dengue and is the world's first advance against the disease.

"The vaccine was found to prevent dengue infection by 56.5% and mitigate its severity by 88.5%," the PIDST president said.

She said the vaccine was developed during experiments on more than 10,000 children, aged between two and 14.

The vaccine can prevent four strains of dengue, she added.

The research was first conducted at Photaram Hospital and Banpong Hospital in Ratchaburi and Kamphaeng Phet provincial hospital in 2009, areas which are prone to the disease, she said.

Those involved in the development phase of the vaccine will be followed for the next three years in line with World Health Organisation rules, Ms Usa said.

Five Latin American countries are also expected to announce successful development of their own dengue vaccine over the next few months, she said. Their research was conducted among more than 20,000 young people.

Department of Disease Control director-general Sophon Mekthon said the Asean dengue vaccine could be deployed in Thailand in two years' time.

It is now in the process of being registered with the Food and Drugs Administration (FDA), he said.

Dr Sophon said four public health campaigns encouraging people to come forward to be vaccinated will be announced
shortly.

They are the vaccine to prevent the human papilloma virus which causes cervical cancer; the vaccine to prevent diarrhea in children; the vaccine to prevent diphtheria and tetanus in adults; and vaccinations of adults and medical personnel to prevent influenza and other diseases.

First glimmer: After Asian success, dengue vaccine trials come to India | The Indian Express

First glimmer: After Asian success, dengue vaccine trials come to India | The Indian Express



With no treatment in line for dengue, unlike malaria, control and prevention of this disease has posed a major challenge.
 
A dengue vaccine, tested on 10,275 children in the age-group of 2-14 years in Asia, has shown an overall efficacy of 56.5 per cent, according to study reported in The Lancet. More trials of the vaccine are now being conducted in India.
While leading company Sanofi Pasteur is the main funder, the chief investigator has been identified as Dr Maria Rosario Capeding of the Research Institute for Tropical Medicine, Philippines.
India has witnessed a dramatic rise in dengue from 18,860 cases recorded in 2011 to 75,454 cases reported last year, according to data from the National Vector Borne Disease Control Programme (NVBDCP). Following the promising results of the study, another trial of the vaccine is now being conducted in India to examine its success.
According to officials from the NVBDCP, the compilation of the trial results will be done by Sanofi Pasteur in December this year, while the results will be announced in 2015.
Dr A C Dhariwal, director of NVBDCP, told The Indian Express, “It is good news for us. The trial is now going on in India and we will examine the results before making it part of our dengue prevention measures.”
The vaccine trial in Asia, which was in its phase III, was conducted in five countries — Indonesia, Malaysia, Thailand, Philippines and Vietnam — for 25 months. Children were given a three-dose vaccination schedule with an interval of six months. The trial results showed 88.5 per cent reduction in dengue haemorrhagic fever (a nearly fatal stage of dengue) and 67 per cent drop in need for hospitalisation due to dengue.
According to Sanofi Pasteur, the vaccine trial will now be conducted in Latin America and the Caribbean on over 20,000 children aged nine to 16 years.
The World Health Organisation (WHO) estimates close to 100 million dengue infections, caused by mosquito Aedes Aegypti, every year, of which maximum are reported from Asia and Latin America.
With no treatment in line for dengue, unlike malaria, the control and prevention of this disease has posed a major challenge.
Dr Om Srivastava, director of department of infectious diseases at Jaslok Hospital (Mumbai), said, “The count of dengue cases in the country is huge. Though the efficacy of the trial is not very high, it will still reduce the burden of dengue to some extent.”
According to the research in The Lancet, the vaccine has shown varying effects on the four different dengue serotypes with efficacy ranging from 34.7 to 72.4 per cent. Experts said dengue control through this vaccine can vary depending on the serotype.
Dr Kalpana Baruah, joint director at NVBDCP, said, “In India, serotype-1 is the most common dengue virus. We are keenly awaiting the results of the trial in India because it will help in prevention of the disease. Our focus is more on prevention than treatment as there is only supportive treatment for dengue.”
This year till June-end, there have been 3,763 dengue cases reported from all over the country, including two deaths recorded in Kerala. Last year, there were 167 deaths due to dengue.
 

Thursday, July 03, 2014

Task force lists its priorities

PUTRAJAYA: The National Commit-tee on Dengue will meet on July 14 to tackle the current dengue epidemic. One item on the agenda is to get access to neglected buildings that are locked-up.
Health Minister Datuk Seri Dr S. Subramaniam said such premises com­­prised 30% of the places to be inspected for dengue.
“This will be among the issues raised in the coming meeting,” he told a press conference here yesterday.
Noting that 80% of dengue cases were spotted in houses or the surrounding areas, he urged people to clean up their living environment.
The national task force, which will be chaired by Deputy Prime Minister Tan Sri Muhyiddin Yassin, includes several ministries – Health, Urban Wellbeing, Housing and Local Go­­vernment, Works and Human Re­­sources.
It will work closely with state governments, local councils and re­­levant agencies to curb the scourge and implement effective preventive measures.
Dr Subramaniam also said that dengue infection was more serious than before with more multi-organ failures such as of the heart and kidneys.
“We are studying to find out if the serotype has changed or if the dengue virus has become more virulent,” he added.
There were 44,518 dengue cases reported this year up to June 28, compared to 12,858 in the same pe­­riod last year, an increase of 246% or 31,000 cases.
There were 85 and 27 deaths for the same period respectively.
Last week, 2,289 dengue cases and three deaths were reported nationwide. The total was an increase of 13% (268 cases) over the week before.
Dr Subramaniam said neighbouring countries were also experiencing a high number of dengue cases, with Singapore reporting 600 cases a week.

Wednesday, July 02, 2014

Number of dengue fever cases hits highest level in eleven years: CDC (Taiwan)

Number of dengue fever cases hits highest level in eleven years: CDC



The Centers for Disease Control (CDC) announced yesterday that 24 more cases of dengue fever were diagnosed last week, which, together with 61 existing patients in Taiwan since May, reached a record-breaking 11-year high.

The director of the CDC, Liu Ding-ping, said that because there have been thunderstorms recently, stagnant water will often become a sanctuary for mosquito reproduction, therefore the cases of dengue fever increased significantly. Last week 24 more patients from Taiwan and five more people who were infected in other countries were confirmed as having dengue fever, with the majority of patients from Kaoshiung City and one from Chiayi City.

There have been a total of 162 confirmed cases of dengue fever this year, with 87 people infected abroad and 75 in Taiwan. Since May 13 there have been 61 more cases. Statistically speaking, from 2003 to 2014, the number of confirmed cases peaked this summer, according to the CDC.



The CDC warned that as dengue fever is currently at its highest level, people who are experiencing fevers, headaches, eye pain, muscle and joint pains, or any similar symptoms, should seek medical attention immediately.