Friday, January 29, 2016

Vaccine FAQs India - Flu Vaccination for 6 month baby

Query : 
My daughter`s age is 6 months. Is she eligible for taking INFLUENZA Vaccine_? If yes, pls suggest me the brand and product name of the vaccination and vaccination schedule for the said vaccination.

Answer :
Influenza vaccine is recommended starting at the age of 6 months.

The brand I use is VAXIGRIP (0.25 ml up to 3 years age), and schedule is 2 doses one month apart, and then a booster every year, preferably before the onset of rainy season in India.

Wednesday, January 27, 2016

Does a Doctor using Computer reduce Patient Satisfaction?


Safety-net clinics serve populations with limited English language proficiency and health literacy. Communication barriers in these clinics may aggravate disparities in care and health.
Use of electronic health records in safety-net clinics may affect communication between patients and their healthcare providers. The goal of this study by Ratanawongsa and colleagues was to examine relationships between clinician computer use in safety-net clinics and communication with patients having a variety of chronic diseases.


Patients want their clinicians to look at them -- not their computer screens -- while in the examination room, a study has shown.
Clinicians in safety net hospitals who were assessed as high computer users during clinical encounters fared significantly worse than their low-computer-use counterparts in measures of patient experience, Neda Ratanawongsa, MD, MPH, from the Division of General Internal Medicine, University of California, San Francisco, and colleagues report in a research letter published online November 30 in JAMA Internal Medicine.[1]
In an observational study designed to assess associations between clinician computer use and communication with patients with diverse chronic diseases in safety net clinics, the researchers videotaped 71 encounters between 47 patients and 39 clinicians that took place from November 1, 2011, to November 30, 2013. Patients were interviewed by telephone before the videotaped visit, and again after the visit, and were asked to rate the quality of the care they received in the previous 6 months.
The researchers reviewed the videotaped encounters and assessed clinician communication behavior using the Roter Interaction Analysis System, and they categorized computer use as low, moderate, or high. Using multivariate analyses adjusted for length of visit, patient educational level, patient quality of life, and clinician demographics, they identified associations among computer use, communication variables, and patient experience ratings.
Fewer than half (48%) of the patients of clinicians with heavy computer use during clinical encounters rated the care they received as excellent on patient experience surveys, whereas the majority (83%) of patients whose clinicians were less engaged with their computers during the encounter felt that the care they received was excellent.
High computer use was also associated with observable communication differences, the authors report. Patients in appointments with high computer use engaged in more social rapport building ("chit chat"), whereas those in appointments with moderate computer use engaged in somewhat less rapport building but had a more positive demeanor. In contrast, clinicians with high computer use engaged in more negative rapport building, which involved statements that express disagreement or criticism.
"Although social rapport building can build trust and satisfaction, concurrent computer use may inhibit authentic engagement, and multitasking clinicians may miss openings for deeper connection with their patients," the authors write. Negative rapport building may be an unintentional consequence of the electronic health record, they explain, noting that completing it during the visit "may trigger disagreement by clinicians as they detect and clarify patient misunderstandings."
Because the implementation of electronic health records appears to influence communication between healthcare providers and patients, particularly those in safety net clinics serving populations with limited health literacy, educational and cultural improvement efforts should be undertaken to "support clinicians' use of the electronic health record in ways that enhance their capacity to communicate with and care for diverse patients," the authors write.
In an accompanying editorial,[2] Richard M. Frankel, PhD, from the Regenstrief Institute, Indiana University School of Medicine, and the Center for Healthcare Information and Communication at the Richard L. Roudebush VA Medical Center in Indianapolis, writes, "Our challenge is to find the best ways to incorporate computers in the examination room without losing the heart and soul of medicine: the physician-patient relationship."
To this end, Dr Frankel suggests a framework for developing and reinforcing good computer use habits. He describes the POISED mnemonic (prepare, orient, information gathering, share, educate, debrief), which he developed from a review of the available literature and his own research.
For example, clinicians can preserve face-to-face time with patients by revisiting "the time-honored habit of reviewing the patient's medical record before entering the examination room," Dr Frankel suggests. He also recommends spending the first couple of minutes of the visit engaged in dialogue with the patient without the computer.
"Using the computer during information-gathering segments of the visit is both appropriate and expected by patients," Dr Frankel explains. Routinely turning the screen to the patient so he or she can see what is being typed helps patients feel like partners in the care process, and it can also help with patient education, serve as a launching pad for discussions about health habits, and reinforce postvisit instructions.
"Being POISED for examination room computer use need not cost additional visit time. Used well, just the opposite is true," Dr Frankel concludes.
The authors and Dr Frankel have disclosed no relevant financial relationships.

Thursday, January 14, 2016

5 TIPS TO WINTERTIME HEALTH - How to stay healthy during the cold season...

In school and on the job, sickness has the tendency to spread like wildfire. Winter, regardless of the day-to-day weather, often brings about illnesses that can affect our productivity. Here are five ways to stay healthy through this season.
1. Eat well and drink plenty of water. It’s no secret that a healthy diet and hydration will help your immune system stay strong and fight the little bugs we encounter daily. Steamed and raw veggies, lean protein, and water, even when you aren’t thirsty, are fuel for a healthy immune system. Make sure you’re feeding your body these things, as they provide essential vitamins and nutrients needed to combat viruses.
2. Wash your hands. We encounter millions and billions of little microorganisms just from opening doors, pressing elevator buttons, paying for merchandise, etc. Soap and water, and hand sanitizer can keep the germ quantity down. One of my favorite products is a hand sanitizer moisturizer. I like it because it doesn’t dry your hands like the traditional alcohol-based gels. Those cracks in dry skin are another place for bacteria to reside.
3. Take a vitamin D supplement. If you are pregnant or trying to be, a solid prenatal vitamin (instead of a gummy vitamin) is recommended. Otherwise, nutritional research supports at least taking a vitamin D supplement since most of us are vitamin D deficient. I prefer solid vitamins and gel-caps over gummy vitamins. Gummies aren’t the best for your teeth, they have limited quantities of vitamins and many are not FDA regulated.
4. Get fresh air when you can. Indoor air pollution is real. The winter cold can discourage proper ventilation of our homes and offices. Mold and tobacco are serious contributors, however even household products, dust, and cooking fumes can add allergens and mild air pollutants that can lead to congestion and make you feel bad. Use your stove hood, bathroom vent, and periodically let a little fresh air into your home through windows or doors on milder weather days.
5. Get your vaccinations. Even Dr. Oz got a flu shot on the air. Vaccination against Influenza gives your body a blueprint to fight the flu virus if exposed. It’s like getting a hold of the other team’s playbook. Before they can even complete a play, you are there to intercept or block their progression. That’s IF you get the recommended vaccinations based on your age group and risk level, before the virus can take hold in your body your immune system kicks it out or at least fights it harder.
With work and the obligations of life, none of us can afford to get sick. Hopefully these tips will help you avoid being taken down by illness in the new year and all year round.
Wendy MD
Dr. Wendy Goodall McDonald is a board certified obstetrician and gynecologist practicing in the city of Chicago. She is a graduate of Xavier University of Louisiana and Northwestern University’s Feinberg School of Medicine and is always accepting new patients. Learn more at

Comments: While the tips have been posted by an  American Doctor, they are actually very relevant to Indian as well.
Studies have clearly shown that Indians are very deficient in Vit D, and up to 94 % Indian kids have low Vit D levels.
Taking Vit D supplement and the FLU Vaccine can be of great help to prevent winter throat and chest infections. A tasty vitamin toffee is available exclusively for Indian children to help them prevent Vit D deficiency. You can directly purchase Chubears from Amazon India as well.