Parkinson’s Disease

Parkinson’s disease is a progressive neurodegenerative condition that is brought about by the loss or lack of dopamine in nerve cells. The subsequent loss of dopamine means that people are unable to complete usual tasks including moving as it becomes harder, movement becomes slower. The loss of nerve cells in the substantia nigra in the brain causes Parkinson’s symptoms to appear.

One in every 500 people will suffer from Parkinson’s disease. most of these people are older than around 40 years of age, but sufferers can be younger. Men are slightly more likely to develop Parkinson’s than women.

There are three main symptoms of Parkinson’s disease:

  1. Tremors
  2. Rigidity
  3. Postural Instability
  4. Bradykinesia (Slowness of movement)

Those with Parkinson’s may also suffer from chronic pain, depression, insomnia, balance problems, loss of smell and constipation. The risk of dementia is also 2-6 times higher in people with Parkinson’s than in those without it.

These symptoms can be controlled using a combination of drugs, therapy and surgery.

Many clinic trials are used to combat Parkinson’s, stem cell treatment is now being explored in parts of the United Kingdom.

However, in some cases Parkinson’s may be difficult to diagnose as its signature tremors are often misinterpreted. Therefore, rigorous testing needs to be done. In the United Kingdom, the NICE guideline is used.

 

 

References:

http://www.pdf.org/about_pd

https://www.parkinsons.org.uk/content/nice-guideline-parkinsons

http://www.nhs.uk/conditions/parkinsons-disease/Pages/Introduction.aspx

Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a personality disorder that affects mood. It is thought that less than 1% of the population are diagnosed with BPD and of those diagnosed 3/4 are women.

Symptoms:

  • Emotional instability
  • Impulsive behaviour
  • Worry of abandonment
  • Very intense emotions
  • Don’t have a strong sense of who you are
  • Feelings of emptiness and loneliness.
  • Struggle to control anger

There are many more symptoms and people who have BPD, may or may not experience some of these symptoms.

Causes of BPD:

Some schools of thought believe that BPD can develop after significant trauma or after a dysfunctional childhood. However, there are other triggers such as a combination of biological and environmental factors.

Treating BPD:

Individual and group psychological therapies can be carried out by trained professionals.

 

References:

http://www.mind.org.uk/information-support/types-of-mental-health-problems/borderline-personality-disorder-bpd/#.WA5js5MrK9Y

http://www.nhs.uk/Conditions/Borderline-personality-disorder/Pages/Introduction.aspx

http://www.bpdworld.org/theories-and-causes.html

 

 

Further Insight into Strokes

The role of nitric oxide in the pathophysiology of stroke

The main effects of nitric oxide on ischemic stroke is controversial as opposite effects have been observed on a number of models. The short half life of nitric oxide makes detection in the brain incredibly difficult.

 

 

Basic First Aid

Thousands of people die each year from accidents and emergencies, in many cases these deaths could have been prevented by using first aid.

First aiders are taught to use DRSABC, an acronym.

D: Danger

First, first aiders should assess the situation before them. If the situation will cause them any danger they should not proceed.

R: Response

If safe, a first aider should talk loudly or possibly shout, to attempt to gain the casualties attention. They should also tap on the casualties collar bones.

S: Shout for Help

The first aider should now attempt to shout for help in order to attract attention and have someone call an ambulance if the patient is unconscious/ unresponsive.

A: Airway

In order to check a casualties airway, first open it by placing two fingers on their chin and your other hand on the casualties forehead, opening up their neck. This allows the airway to be opened. It is vital to check for any obvious obstruction, in children this can be food or toys, in adults it may not be as obvious.

B: Breathing

Then lay your head parallel to the casualty and look down their body to see if their chest is moving up and down. At this point you should be able to feel the heat of the casualties breath on your cheek if they are breathing, hear it and see the chest moving.

C: Circulation

Touch the extremities of the casualty by touching their arms, body and legs in order to see if their are any objects sticking out of the casualty. If there is heavy bleeding a bandage is necessary.

 

However, if the patient is not breathing as their airways may be blocked, immediate attention is required. For an adult two rescue breaths should be given by, keeping the air way open and then pinching the nose of the casualty and breathing in.

Then, 30 chest compressions are done, at around 2 inches deep. It is vital that the compressions are hard enough to actually have an effect, yet not too hard to cause serious damage. If a rib is broken during the course of the CPR, this is fine, however in geriatric and younger casualties this can lead to complications later.

In children, five rescue breaths are given and the CPR is given by only using one hand rather than the two for adults.

In some cases a casualty may be conscious and require bandaging, in these cases a first aider may proceed to do so. If there is protruding flesh bandages are used to secure the object taking care to not move it too much to prevent further damage.

The Junior Doctor Crisis

The BMA (British Medical Association) originally began the negotiations regarding the junior doctor contract in 2013 with the aim to ensure the safety of doctors and patients in hospitals. The BMA wished to ensure that junior doctors were rewarded for all of the hours they work. These hours include coming into hospitals early in order to review notes from the night staff and to prepare for the day in terms of patient files. At the start and end of each day, medical personnel often spent over an extra hour at work ensuring that the hospital runs efficiently, but this overtime was rarely formally recognised.

At the forefront of the negotiations was pay.

  1. Banding

At first, junior doctors are paid a standard salary based on working 40 hours a week. However, if you spent over 40 hours in the hospital, as many doctors do you would be given a pay band. A pay band is a ‘pro rata percentage of basic salary’. For example, if a doctor worked for 48 hours they would receive a pay band of 20%.

Furthermore, if a doctor works outside the social hours: Monday to Friday, 7am to 7pm. However, this banding means that doctors working a varying number of unsocial hours may be paid the same.

Under the new model, junior doctors would be paid differently:

  • An average increase in basic pay increase of 10-11%
  • Enhanced pay for nights.
  • A pay supplement for weekend working.

However, pay is not the only issue surrounding the need for change.

The maximum number of working hours at the moment for junior doctors is 91 hours a new proposal suggest that this should be cut down to 72 hours; a doctor can only work 4 consecutive nights in a row rather than 7.The basic starting salary is also planned to be raised to £27,000 rather than £22, 636 . In addition the average basic salary will experience an increase of 13.5 per cent.

The over-time compensation is also set to change:

  • Doctors receive time plus 30 per cent for any hours worked between 5pm-9pm on Saturday and 7am-9pm on Sunday
  • Doctors working one in four Saturdays or more will receive a pay premium of 30 per cent for all Saturday hours
  • Doctors receive time and a half for any hours worked Monday – Sunday between 9pm – 7am

 

The outrage towards the treatment of junior doctors has led to a series of strikes throughout England. Despite the obvious need for a strike, to address concerns surrounding the treatment of the people who work to ensure that we, as patients receive the best healthcare, many are opposed to strikes. One reason why people oppose strikes is due to the obvious need for junior doctors in hospitals. Not having junior doctors in hospitals has and will prove to be catastrophic in most hospitals in England. Junior doctors keep hospitals running efficiently, so their absence will work to get people to pay attention to what they are working towards.

Many doctors support striking, however some experience an ethical dilemma, between patient care and ensuring that doctors are heard. Many are uncomfortable with leaving patients, however there has to be change in the system in place. Unfortunately, this need for change may only be taken seriously, with the use of strikes.

 

 

 

References:

http://www.bbc.com/news/health-34775980

https://www.bma.org.uk/connecting-doctors/my_working_life/b/weblog/posts/the-new-junior-doctor-contract-explained-a-guide-for-junior-doctors-and-medical-students

https://www.themedicportal.com/junior-doctor-contract-what-you-need-to-know/

http://www.telegraph.co.uk/news/2016/03/16/how-much-are-junior-doctors-paid-and-why-are-they-threatening-to/