Sunday, July 23, 2017

Cresentric Glomerulonephritis

In rapidly progressive Glomerular Nephruty (RPGN) also known as Crecentric Glomerulonephritis is due to proliferation of parietal epithelium of glomerulus and thickening of Basement membrane.

Why is it always in Crecentric shape? I mean - "Why not like a ring"?

Maybe the answer lies in the Gaussian curve? All points in the 360 degree of glomerulus has an equal chance of being affected by the injurious stimulus , and once affected the proliferation peak is the maximum at the point of injury and decreases evenly as we move away from that point ?

Having said that, I haven't been able to find a case of Rapidly Progressive Glomerular Nephritis which is not Crecentric in shape. 

Monday, July 17, 2017

Customised gifts? Now customised surgery...

With increasing amount of options being available to the consumer at their fingertips, they are spoilt for choice.
Also as the consumer becomes more literate, and more vigilant (thanks to so many activists campaigns), health care may just be the next step.

1 January, 1990 : no wraps or burgers
Post 1991 : just choose which meal you want to eat
2017:

At Subway : first choose your bread and its length, then specify the fillings and finally the sauces.
In the hospital : the patient Just gives his consent for the surgery without asking any question

Year 2037 :
While the subway story might still remain the same
There will be a revolution in doctor patient relationship
Here is how it may sound like....

Scene 1-
Doctor : You have right sided uncomplicated reducible inguinal hernia

Patient : what are the treatment options ?

Doctor :
Please create your account and log into our app, where you will have complete control over your healthcare.
I hope you have an Aadhar card, it's compulsory for registration you see. Else I can't treat you.

After registering, you will have to link your insurance details and bank account details to authorise bank transactions. The app will debit 50% of your amount directly, while the remaining 50% had to be paid in cash (hints as- under the table)

Please note that Hernia surgery has been placed under 18% GST. All life saving procedures are free, basic and common surgeries like trauma cases have 5% GST. And sinful cosmetic and luxurious surgeries have 28%.

Now,  select the date. We have preferential and a dynamic price system for booking the date. Just like it existed while booking flight tickets 20 years ago. Pay higher fee for a better date.

Choose whom you want to be operated by. You'll find the list of surgeons on the app. The surgeon with the highest user ratings will be the costliest.

Select the chain of Hospital, location of Hospital, type of room, other facilities in the room. You can use coupon codes of new upcoming Hospitals to get discount.  Use code "GET50OFF". Offer valid till 60 days.

Various suture materials are listed, with advantage and disadvantage of each along with the cost. Select which suits you.

The size of the incision. No brainer that you'll have to pay more for smaller incisions.

After every 30 mins in the OT, the surgery will stop and 2 mins of advertisement will be shown. If you do not wish to see ads, please use the "paid version of the app".

Give video consent on the same.

(The patient selects as per his budget and his needs, weighing pros and cons of each aspect using terabytes of evidence based medicine to customise his surgery for him)

At the end, he hits "submit" button and an acknowledgement message appears.
        "Your order has been accepted. Our customer service representative will get in touch with you shortly. THANK YOU FOR SHOPPING WITH US"