Machine Learning in Medicine

This article explores the transformative role of machine learning (ML) in medicine, highlighting its applications, benefits, challenges, and future prospects. ML enhances diagnostic accuracy, optimizes personalized treatments, and improves operational efficiency within healthcare systems. Key applications include image analysis, predictive analytics, and robotic surgery. Despite its potential, ML faces challenges such as data privacy, biases, integration difficulties, and regulatory hurdles. Future advancements promise even greater impacts on global healthcare accessibility and disease management. The successful integration of ML in medicine will depend on addressing ethical and technical challenges through collaborative efforts between technologists, clinicians, and policymakers.

Empowering the Vulnerable: A Vaccination Outreach Program

On April 30, 2023, I led a hepatitis B vaccination outreach for female sex workers in Kolkata, in collaboration with the National Viral Hepatitis Control Program and the Durbar Mahila Samanwaya Committee. The program focused on a high-risk group often overlooked in healthcare, providing vaccinations and vital education about hepatitis B. Preparations ensured efficient execution, with a focus on empathy and clear communication to address concerns about side effects. The initiative not only improved individual health and knowledge but also contributed to broader public health goals by reducing disease transmission, demonstrating the powerful impact of targeted healthcare interventions.

Digitization during COVID-19: Adopting EMR at STM

An EMR system was adopted in the COVID-19 ICU of School of Tropical Medicine, Kolkata during the COVID-19 crisis to enhance patient care and operational efficiency. The EMR’s intuitive design facilitated a smooth transition from paper records, reducing virus transmission risk and streamlining data management. The initiative paved the way for ongoing digital transformations within the hospital. This experience highlights the importance of user-centric digital tools in healthcare, demonstrating how technology can effectively meet the evolving challenges in the sector and improve healthcare delivery and outcomes.

Happy Hypoxia in COVID-19

The blog post discusses "Happy Hypoxia" in COVID-19 patients, a condition where individuals experience severe hypoxia without typical symptoms like shortness of breath. It explains the physiological mechanisms, including the failure of the body’s response to low oxygen levels and the altered oxygen-hemoglobin dissociation curve. It highlights the importance of using arterial blood gas analysis over pulse oximetry for accurate monitoring. The post also covers the transition from initial asymptomatic stages to severe respiratory distress and the different lung phenotypes observed in COVID-19 pneumonia.

Platelet Transfusion in Dengue

The blog post discusses the necessity and guidelines for platelet transfusion in dengue fever management, highlighting that unnecessary transfusions are common despite clear guidelines against them. WHO and Indian National Guidelines recommend transfusions only for severe cases with massive bleeding or platelet counts below 10,000/mm³. Studies show no significant benefit from prophylactic platelet transfusions and note increased risks of adverse reactions. Overuse can deplete blood bank reserves and cause longer recovery times. The gap between guidelines and practice is driven by clinician caution and patient demands. Mass education and government intervention are needed for proper adherence.

Evidence Based Medicine

Evidence-Based Medicine (EBM) involves treating patients based on the best available evidence rather than solely on clinical experience. This blog discusses the evolution of EBM, its hierarchy of evidence (with systematic reviews and meta-analyses at the top), quality assessment tools, and the GRADE system for evaluating study importance. EBM ensures uniform clinical practices and reduces biases but is slow and affected by publication bias. Guidelines streamline clinical decision-making, though they must be adapted to specific cases. The blog also provides a quick-start guide for navigating medical literature.

Droplet Infection

This blog post on droplet infection explains that respiratory droplets are expelled during coughing, sneezing, or talking, potentially carrying pathogens like viruses, bacteria, and fungi. Droplets larger than 5 μm settle quickly, while smaller ones, called aerosols, travel further. Infections such as COVID-19, influenza, tuberculosis, and measles spread through these droplets. Preventive measures include respiratory hygiene, hand washing, isolation, and using personal protective equipment to limit transmission.

Cryptococcal Meningitis

Cryptococcal meningitis is a serious central nervous system infection mainly affecting immunocompromised individuals, presenting with headaches, fever, and visual deficits. Diagnosis involves CSF studies and antigen tests, while treatment includes a three-phase antifungal regimen and supportive lumbar punctures to manage CSF pressure. Despite treatment, prognosis remains poor, especially in cases with high CSF pressure or low glucose levels. Immune reconstitution inflammatory syndrome can occur with ART initiation.

Immune Reconstitution Inflammatory Syndrome

The blog post on Immune Reconstitution Inflammatory Syndrome (IRIS) discusses its occurrence in immunocompromised individuals, especially those with HIV after starting antiretroviral therapy. It details two types: paradoxical IRIS (worsening of treated infections) and unmasking IRIS (new opportunistic infections). The post elaborates on infective, autoimmune, and malignant causes, with a focus on TB IRIS, outlining its symptoms, diagnosis criteria, and management, emphasizing the importance of continuing antiretroviral and anti-tubercular treatments, along with symptomatic management using NSAIDs and corticosteroids.

Acid Base Disorders

The blog post explains the mechanisms and disorders related to acid-base balance in the human body. It details the roles of the respiratory and renal systems, the Henderson-Hasselbalch equation, and the significance of buffers. The post also covers the calculation of the anion gap and base excess, normal blood values, types of acid-base disorders (metabolic and respiratory), their compensatory mechanisms, and the interpretation of arterial blood gas (ABG) analysis. The post also emphasizes diagnosis and treatment approaches for various acid-base imbalances.

Gunshot injuries in Forensic Medicine

The blog post explains the forensic analysis of gunshot injuries. It covers the types and mechanisms of firearms, the ballistic behavior of bullets, and the detailed examination of gunshot wounds. It describes the characteristics of entry and exit wounds, the types of tissue damage caused, and how the examination of these wounds can help determine the type of firearm used, the range of shooting, and the circumstances of the incident. The post also addresses the procedures for examining gunshot victims, both living and deceased.

A very short guide to ECG interpretation

The blog post provides a concise guide to interpreting ECG strips, aimed at beginners. It explains the basics of ECG, including the different types of leads, views of the heart, and how to read the ECG strip. Key sections cover heart rate calculation, cardiac axis determination, interval measurement, identifying hypertrophy, assessing cardiac rhythm, detecting conduction blocks, and recognizing pre-excitation syndromes and coronary artery diseases. The guide emphasizes practical steps for initial ECG interpretation before more detailed study.

Clinical Decision Support System

Clinical Decision Support Systems (CDSS) are advanced tools designed to assist healthcare providers by enhancing diagnostic accuracy, ensuring treatment efficacy, and improving overall patient care. These systems, which can be rule-based or powered by artificial intelligence, help in various clinical tasks like monitoring drug interactions, analyzing patient history, and adhering to treatment protocols. Despite challenges in deployment, data management, and potential over-reliance, the integration of CDSS into clinical workflows is crucial. Addressing these challenges through seamless integration, rigorous testing, and modular design can harness the full potential of CDSS, making healthcare more efficient and patient-centered.

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