Google Health for Medical Records

Google views its expansion into health records management as logical because its search engine already processes millions of requests from people trying to find information about injuries, illnesses and treatments. Before this public launch, Google stored medical records for a few thousand patients at the nonprofit Cleveland Clinic.

Google's online filing cabinet for medical records opened to the public, giving users instant electronic access to their health histories and worrying a privacy advocate.

Called Google Health, the service lets users link information from a handful of pharmacies and care providers, including Quest Diagnostics labs. Google plans to add more.

Similar offerings include Microsoft Relevant Products/Services Corp.'s HealthVault and Revolution Health, which is backed by AOL co-founder Steve Case.

Google Health differentiates itself from the pack through its user interface and things like the public availability of its application program interface, or API, said Marissa Mayer, the Google executive overseeing the service.

Mary Adams, 45, a Cleveland Clinic patient who participated in the Google Health pilot, said that she was initially concerned about the privacy of her medical information.

Still, she felt safe enough to enroll and has been using the service for about six months, linking it with an online health management tool from the Cleveland Clinic and adding information on prescriptions and doctors to her online profile.

"I hate pieces of paper lying around my house, so I love the fact that i can log on with my normal Google login info and see everything at a glance," she said, adding that with its public availability she'll try to get her sister to use it.

The service, still a non-final "beta" version, does not include ads. But Mayer said Google doesn't plan to start placing them to support the site. A search box on Google Health pages leads to standard Google search results pages, where there are advertisements.

Besides importing records from providers, users can enhance their password-protected profiles with details such as allergies and medications, they can search for doctors and they can locate Web-based health-related tools.

Mountain View-based Google Inc. views its expansion into health records management as logical because its search engine already processes millions of requests from people trying to find information about injuries, illnesses and recommended treatments.

Before this public launch, Google stored medical records for a few thousand patient volunteers at the nonprofit Cleveland Clinic.

The health venture provides fodder for privacy watchdogs who believe Google already has too much about the interests and habits of its users in its logs of search requests and its vaults of e-mail archives.

Pam Dixon, executive director of the World Privacy Forum, said services like Google Health are troublesome because they aren't covered by the Health Insurance Portability and Accountability Act, or HIPAA.

Dixon's group issued a cautionary report on the topic in February on such third-party services.

Passed in 1996, HIPAA set strict standards for the security of medical records. Among other things, the law requires anyone seeking a patient's records by subpoena to notify the patient and give the patient an opportunity to fight the request.

By transferring records to an external service, patients could unwittingly make it easier for the government, a legal adversary or a marketing concern to obtain private information, Dixon said.

"We are in uncharted territory here. A privacy policy, I don't think, is enough to protect what needs to be protected in a doctor-patient record," Dixon said.

Mayer said, however, that users medical records "are generally speaking as safe with Google as they would be with a HIPAA-regulated entity."

During a webcast Monday, she said users' health information is stored at Google's "highest level of security" on computers that are more secure than those used for the company's search functions.

Mayer said in an interview with The Associated Press that Google will not aggregate users' health information across services so activity on the health service will not show up in search results.

Blocked Nose In Infants

Blocked Nose In Infants

Blocking of nose is common in babies under six months old. It is usually due to normal mucus that collects in the nose, which is difficult for the baby to clear.

Causes

Blocking of nose is not caused by colds or infections. However an infection can make things from bad to worse. Feeding can become difficult if the baby cannot breathe well due to blocked nose.

General measures


Nothing needs to be done if the baby is comfortable and able to feed. If feeding becomes difficult, the following may help.

Gently stroke the inside of a nostril with a wisp of cotton wool. This may make the baby sneeze and clear the blocked mucus. This method may help clear the mucus from the baby's nostrils before feeds and before sleep.

Increase the humidity of the room where the baby sleeps by placing a bucket of warm water. This raises the humidity, which may help to loosen thick mucus.

Saline drops (salt water drops) may be useful if the above measures do not help. Saline drops thin out the mucus and make it easier for the baby to clear from the nose. Use saline drops just before feeds when the nose is blocked. If saline is used too often, the skin around the nose may become a little sore.

Ephedrine drops prescribed by your doctor is very good at drying up secretions in the nose. But ephedrine drops should only be used 2-3 times a day for a few days only. Rebound nasal congestion may develop if ephedrine drops are used frequently every day for more than a week, which can make the blocked nose worse.

Tests for Glucose

Tests for Glucose (Sugar) and HbA1c

Urine test for glucose

In a healthy non-diabetic person urine does not contain glucose. If blood glucose levels are high, glucose is excreted through urine. A simple dipstick test can detect glucose in urine sample. If the dipstick test shows the presence of glucose in urine, one may be having diabetes.

Some people have kidneys, in which glucose may get excreted, despite normal blood glucose levels. Therefore, if urine contains glucose, person should have a blood glucose test done to confirm or rule out diabetes.





Blood tests for glucose

Random blood glucose level

For a random blood glucose test, blood can be drawn at any time throughout the day, regardless of when the person last ate. A random blood glucose level of 200 mg/dL (11.1 mmol/L) or higher in a person suggests a diagnosis of diabetes.



Fasting blood glucose level
A glucose level below 200mg / dl on a random blood sample does not rule out diabetes. Fasting blood glucose level is a more accurate test.

This testing involves measurement of blood glucose after not eating or drinking for 8 to 12 hours (usually overnight). Fasting blood glucose is normally less than 100 mg/dL (5.6 mmol/L); values of 126 mg/dL (7.0 mmol/L) or higher are diagnostic of diabetes; the test must be repeated on another day to confirm the diagnosis of diabetes.



Oral glucose tolerance test
For this test, one fasts overnight. In the morning the person is given a drink, which contains 75g of glucose. A blood sample is taken two hours later. Normally, body should be able to deal with the glucose and blood level should not go too high. A glucose level of 200mg. / dL (11.1 mmol/l) or more in the blood sample taken after two hours indicates diabetes.



Home monitoring
A drop of blood from a finger prick is placed on a test strip, which has a chemical, impregnated which reacts with glucose. By using a color chart, or a small glucose meter machine, the blood level of glucose can be measured quickly.



The HbA1c blood test

This test is generally used in people with known diabetes .If one has diabetes, HbA1c level may be done 3 to 4 times a year. The test measures a part of the red blood cells. Glucose in the blood attaches to part of the red blood cells. More the glucose levels more will be the attachment of sugar to the red blood cells. This part can be measured and gives a good indication of average blood glucose over the last 2-3 months. Normal values for A1C are usually 6.1 percent or lower (indicating an average blood glucose of 120 mg/dL [6.6 mmol/L]).

Treatment for diabetes aims to lower HbA1c to below a target level. The target level is usually somewhere between 6.5% and 7.5%. If HbA1c is above target level then one may be advised to step up treatment to keep blood glucose level down. The step up treatment can be increasing the dose of medication, improving diet, etc.



Criteria for diabetes

The following criteria are used to define blood glucose levels as normal or indicative of diabetes.

Normal — Fasting plasma glucose (FPG) <100>

Diabetes mellitus — A person is diagnosed with diabetes if they have symptoms of diabetes and a fasting blood glucose level of 126 mg/dL (7 mmol/L) or higher,

Or if they have symptoms and a random blood glucose of 200 mg/dL (11.1 mmol/L) or higher.

These blood tests must be repeated to confirm that they remain abnormally high.



Pre diabetes – It means that the person is not diabetic but may become diabetic. This gives an indication or warning signal for the person to make necessary changes in lifestyle and to keep blood sugar test done every year.

Impaired fasting glucose - fasting plasma glucose between 100 and 125 mg/dL (5.6 to 6.9 mmol/L).

Impaired glucose tolerance - blood glucose level of 140 to 199 mg/dL, measured two hours after a 75-gram oral glucose tolerance test.

Chikungunya

Chikungunya

(This article is meant for education purpose only)

Chikungunya fever is a viral illness that is spread by the bite of infected mosquitoes. The disease resembles dengue fever, it is rarely life threatening. The name, chickungunya, comes from Swahili for stooped walk. This shows the condition of the patient suffering from the disease where joint pain is the major symptom. The disease is mainly seen in Africa, South-East Asia, southern India and Pakistan. It occurs principally during the rainy season.

Spread of Chikungunya

Chikungunya is spread by the bite of an Aedes mosquito, mainly Aedes aegypti. Humans are the major source of chikungunya virus for mosquitoes. The mosquito usually transmits the disease by biting an infected person and then biting someone else. An infected person cannot spread the infection directly to other persons i.e. it is not a contagious disease. Aedes aegypti mosquitoes bite mostly ujduring the daytime.

Symptoms

Symptoms are similar to those of dengue fever. The time between the bite of a mosquito carrying chikungunya virus and the start of symptoms ranges from 1 to 12 days.

Chikungunya is a debilitating illness characterized by sudden onset of:

- Severe headache

- High fever, which can go up to 104 degree Fahrenheit

- Joint pain (arthritis) is the most common feature of the disease, especially joints of hand and ankle. The joints of extremities may become swollen and painful to touch.

- Chills

- Rash

- Fatigue

- Nausea and vomiting

- Muscle pain

- The normal symptoms persist usually up to 3 days but in a few cases, they may be up to 2 weeks.

- Platelets (a type of blood cells) count may decrease till the disease persists.

- Neutropenia, a condition in which nuetrophil (white blood cells that help fight infection) count decreases can occur at times.

Sometimes, the infection causes no symptoms, especially in children.

Diagnosis

Chikungunya fever occurs mostly in epidemic. Usually the diagnosis is based on symptoms.

Chikungunya is diagnosed by blood tests (ELISA).

Since the clinical appearance of both chikungunya and dengue are similar, laboratory confirmation is important especially in areas where dengue is present.

Treatment

There is no specific antiviral treatment or vaccine available for chikungunya. Only symptomatic treatment to reduce joint pain, muscle pain and fever is given.

Non-steroidal anti-inflammatory drugs may help to ease symptoms of aching and joint pain.

Analgesics help relieve pain and fever. Analgesic like aspirin should be avoided.

The patients should take adequate rest and drink plenty of fluids.

Chikungunya fever is not a life threatening infection.

Infected persons should be isolated from mosquitoes to avoid transmission of infection to other people.

Prevention and control

Prevention depends upon taking steps to avoid mosquito bites and elimination of mosquito breeding sites.

To avoid mosquito bites: Wear full sleeve clothes and long dresses to cover the limbs. Use mosquito coils, repellents and electric vapor mats especially during the daytime. Use mosquito nets – to protect babies, old people and others, who may rest during the day. Mosquitoes become infected when they bite people who are sick with chikungunya. Mosquito nets and mosquito coils will prevent mosquitoes from biting sick people.

To prevent mosquito breeding: Drain water from coolers, tanks, barrels, drums and buckets, etc. Empty coolers when not in use. Remove from the house all objects, which have water collected in them. Do not allow storage of water for more than a week. Emptying and drying the water containers once in a week can achieve this.

Cancer

Cancer

Cancer is a disease of the cells in the body. There are many different types of cells in the body, and thereby many different types of cancer. In all types of cancer, cancer cells are abnormal and multiply uncontrollably. Some cancers are more serious than others, some are more easily treated than others (particularly if diagnosed at an early stage), and some have a better outlook than others. So, cancer is not just one condition. In each case it is important to know exactly what type of cancer has developed, how large it has become, whether it has spread, and how well it usually responds to treatment.

Normal body cells

The body is made up of billions of tiny cells. Different parts of the body such as organs, bones, muscles, skin, and blood are made up from different specialized cells. All cells have a center called a nucleus. The nucleus in each cell contains thousands of genes, which are made up from a chemical called DNA. The genes control the functions of the cell. For example, different genes control how the cell makes proteins, or hormones, or other chemicals. Certain genes control when the cell should multiply, and certain genes even control when the cell should die. Most types of cells in the body divide and multiply from time to time. As old cells wear out or become damaged, new cells are formed to replace them. Some cells normally multiply quickly. For example, millions of red blood cells are made each day as old ones become worn out and are broken down. Some cells do not multiply at all once they are mature, for example, brain cells. Normally, body only makes the right number of cells that are needed.

Abnormal cells

Sometimes a cell becomes abnormal. This occurs because one or more of the genes in the cell has become damaged or altered. The abnormal cell may then divide into two, then four, then eight, and so on. Lots of abnormal cells may then develop from the original abnormal cell. These cells do not know when to stop multiplying. A group of abnormal cells may then form. If this group of cells gets bigger, it becomes a large lump of abnormal cells called a tumour.

Tumours

A tumour is a 'lump' or 'growth' of tissue made up from abnormal cells. Tumours are of two types - benign and malignant.

Benign tumours

These may form in various parts of the body. Benign tumours grow slowly, and do not spread or invade other tissues. They are not 'cancerous' and are not usually life-threatening. They often do no harm if they are left alone. However, some benign tumours can grow quite large and may cause local pressure symptoms, or look unsightly. Also, some benign tumours that arise from cells in hormone glands can make too much hormone, which can cause unwanted effects.

Malignant tumours ('cancers')

Malignant tumours grow quite quickly, and invade into nearby tissues and organs, which can cause damage. The original site where a tumour first develops is called a primary tumour. Malignant tumours may also spread to other parts of the body to form 'secondary' tumours (metastases). This happens if some cells break off from the primary tumour and are carried in the bloodstream or lymph channels to other parts of the body. These secondary tumours may then grow, invade and damage nearby tissues, and spread again. All cancers do not form solid tumours. For example, in cancer of the blood cells (leukemia) many abnormal blood cells are made in the bone marrow and circulate in the bloodstream.

Causes

Each cancer first starts from one abnormal cell. Certain vital genes, which control how cells divide and multiply, are damaged or altered. This makes the cell abnormal. If the abnormal cell survives it may multiply uncontrollably into a malignant tumour. Everyone has a risk of developing cancer. Many cancers develop for no apparent reason. However, certain risk factors increase the chance that one or more of cells will become abnormal and lead to cancer.

Risk factors for developing cancer

A carcinogen is something that can damage a cell and increases possibility to turn into a cancerous cell. More the exposure to a carcinogen, the greater is the risk. Well known examples include:

Chemical carcinogens:

Tobacco smoke: Smokers are likely to develop cancer of the lung, mouth, throat, esophagus, bladder and pancreas. About 10% of smokers die from lung cancer. Heavier the smoker, the greater is the risk.

Workplace chemicals: Such as asbestos, benzene, formaldehyde, etc.

Age: Older people are more likely to develop a cancer. This is probably due to an accumulation of damage to cells in the body over time. Also, the body's resistance against abnormal cells may become weaker in older people. For example, the ability to repair damaged cells, and the immune system, which may destroy abnormal cells, may become less efficient with age. So, eventually one damaged cell may manage to survive and multiply uncontrollably into a cancer. Most cancers develop in older people.

Diet: Diet increases or decreases the risk of developing cancer. For example, eating fruit and vegetables reduces risk of developing certain cancers. These foods are rich in vitamins, minerals, and contain chemicals called 'anti-oxidants'. Antioxidants protect against damaging chemicals that get into the body. Fatty food possibly increases the risk of developing certain cancers. Obesity, lack of regular exercise, and drinking a lot of alcohol increases possibility of certain cancers.

Radiation: Radioactive materials and nuclear 'fallout' can increase the risk of developing leukemia and other cancers. Too much sun exposure and sunburn (radiation from UVA and UVB) increase the risk of developing skin cancer. Larger the dose of radiation, the greater is the risk of developing cancer.

Infection: Some viruses are linked to certain cancers. For example, persistent infection with the hepatitis B virus or the hepatitis C virus has an increased risk of developing cancer of the liver. However, most viruses and viral infections are not linked to cancer.

Immune system: People with a poor immune system have an increased risk of developing certain cancers. For example, people with AIDS, or people on immunosuppressive therapy.

Genetic make-up: In some people their genetic make-up is less resistant to the effect of carcinogens or other factors such as diet.

Combination of factors

In many cases it is likely that a combination of factors such as genetic make-up, exposure to a carcinogen, age, diet, the state of immune system, etc, play a part to trigger a cell to become abnormal, and allow it to multiply 'out of control' into a cancer.

Diagnosis

- Symptoms of abnormalities such as a lump under the skin or an enlarged liver.

- Tests such as X-rays, scans, blood tests, endoscopy, colonoscopy, bronchoscopy, etc, depending on where the suspected cancer is situated. These tests can often find the exact site of a suspected cancer.

- Biopsy: A biopsy is removal of small sample of tissue from a part of the body. The sample is then examined under the microscope to look for abnormal cells.

Treatment options

Treatment options vary, depending on the type of cancer and how far it has grown or spread. The three most common treatments are:

Surgery - It may be possible to cut out a malignant tumour.

Chemotherapy - Use of anti-cancer drugs to kill cancer cells, or to stop them from multiplying.

Radiotherapy – High energy beams of radiation are focused on cancerous tissue to kill cancer cells, or stop cancer cells from multiplying.

Other treatments include:

Bone marrow transplant. High dose chemotherapy may damage bone marrow cells and lead to blood problems. However, if patient receives healthy bone marrow after the chemotherapy then this helps to overcome this problem.

Hormone therapy. Drugs are used to block the effects of hormones. This treatment is useful for cancers that are 'hormone sensitive' such as some cancers of the breast, prostate and uterus.

Immunotherapy. Some treatments can boost the immune system to help to fight cancer. More specific immunotherapy involves injections of antibodies which aim to attack and destroy certain types of cancer cells

Gene therapy is a new area of possible treatments

Special techniques – cutting off the blood supply to tumours to kill it.

For some cancers, a combination of two or more treatments may be used. A range of other treatments may also be used to ease cancer related pain

Aims of treatment

The aims of treatment can vary, depending on the cancer type, size, spread, etc.

Cure (remission): With modern drugs and therapies, many cancers can be cured, particularly if they are treated in the early stages of the disease.

Control the cancer: If a cure is not realistic, with treatment it is often possible to limit the growth or spread of the cancer so that it progresses less rapidly.

Ease of symptoms: Even if a cure is not possible, a course of radiotherapy, an operation, or other techniques may be used to reduce the size of a cancer, which may ease symptoms such as pain.

Outlook

Some cancers are more 'aggressive' and grow quicker than others. Some cancers are more likely to spread to other parts of the body. Some cancers respond to treatment better than others. As a general rule, the outlook is usually better if cancer is detected earlier and treated.