Diagnostic Selling: The Sales Technique Your Doctor Prescribed

As an internet marketer, as well as someone who is involved with sales every day, I find myself always looking for the hidden undertones in advertising. This is especially true when I am actually looking to purchase something, where I find myself constantly grading the salesperson based in his or her ability to control the sales situation. It’s incredibly interesting to see how people conduct themselves during the sales process.

Diagnostic sales is nothing new. In fact, if you’ve ever been to a doctor or dentist, you’ve experienced its brutal efficiency firsthand. Diagnostic sales is so effective, in fact, that many of the top sales-oriented organizations in the world are transitioning their sales force from a “consultative” approach to a diagnostic one.

Why Diagnostic Sales is So Effective

If you consider how the sales process works it will only take you a second to realize that diagnostic sales is simply about providing a solution to your clients problem, whatever that problem winds up being. Whether that solution is the ideal pair of shoes for their ailing foot, or a multi-million dollar advertising campaign for their ailing sales, your role in the diagnostic process is to determine and recommend an effective solution.

The reason why it’s so effective is actually quite simple. People hate being sold things, but love being provided answers to their problems. It’s basic psychology: by shifting the sales process away from being a “sales” situation and instead a “solutions-focused” situation, you remove the psychological stigma of being “sold”.

Learn How to “Prescribe”

Utilizing the diagnostic sales process is actually quite easy- it just requires you to retool your sales vocabulary and thought process a bit.

The first step is removing any preconceived ideas about what the sale will wind up being. What makes the diagnostic approach so effective is that you take the time to listen to your clients needs and problems and only provide a solution once you have one that will solve them. Would you give a prescription your doctor gave you weight if they didn’t take the time to listen to your symptoms first?A

Step one: Take the time to completely listen to and understand your clients needs before making a recommendation.

The second step is to ask exploratory questions that flesh our your clients need or problem. For example, if your client is looking for a new car but is unsure of what type of vehicle to purchase, it would be a good idea to find out what they will be using their vehicle for. Will they be going off road? Do they have kids? Is speed and performance important to them? Do they need storage space? Questions like those will ensure you get the whole story, as well as ratify to your client that you’re there to help them.,

Step two: Ask questions to round out your needs analysis so you have a clear picture of what your client needs.

The third (and final) step is to create and present a recommendation that sufficiently handles your clients needs. Going back to our car analogy earlier, if your client said that they go camping, are planning on having kids in the next year, and need a vehicle that’s great in the snow you now know that a CUV/SUV is probably an ideal solution for them. Knowing that, you can comfortably and confidently make a recommendation that meets their needs.

Step three: Present your recommendation with confidence and explain to your client how it meets their needs.

Some Other Important Information

You’ll notice that price was never a topic of conversation during this process. The reason for that is simple: the right solution is the right solution, regardless of price. If you are recommending the right solution to your client, and your client knows and understands that you are doing so, price won’t be as much of a concern. If price does become an objection you can then move from there and respond accordingly.

Just remember this: people won’t care until they see how much you care. Aim to genuinely service your clients and your customer satisfaction, not to mention your overall sales performance, will take flight!

Prescription for Success: The Role of the Pharmacy Call in Pharmaceutical Sales

After the countless hours of product training and skill development and relationship building, your efforts culminate when a prescription is filled at the pharmacy.

When you consider that pharmacists talk to the same physicians that you talk to, about treating the same patients that you talk about treating, it’s obvious that pharmacists play a vital role in your success.

Why wait any longer to establish or improve your relationships with pharmacists in your territory?

A licensed pharmacist is a pharmaceutical specialist. Although physicians are experts in disease diagnosis and treatment, pharmacists are experts in pharmaceutical disease management.

Many physicians rely on pharmacists to train patients to use metered-dose inhalers, blood pressure monitors and injectable medications. Physicians also assume that pharmacists will monitor potential drug-drug interactions and recommend appropriate drug substitutions.

A pharmacist is a patient care provider. He or she is a link between patients and medical professionals, and can triage routine illnesses like a cough, cold or the flu. Patients count on their pharmacist to tell them how to take their medications, what outcome to expect, and how to react if something goes wrong.

A pharmacist is a pharmaceutical sales partner. Pharmacy support is crucial for successful pull-through programs, patient education, and supplemental physician contact. A pharmacist may be able to provide information about managed care formularies and drug pricing, as well as alert you to patient questions or concerns.

Pharmacy calls are sales presentations

Successful pharmaceutical sales reps prepare and execute pharmacy calls with the same care as they approach physician calls.

Conduct basic pre-call planning to identify your goal for the call. Do you need authorization to display prescription vouchers or coupons? Do you want to inform the pharmacy staff about a new drug launch? It should only take a few minutes to mentally outline what you hope to accomplish, but those few minutes make a difference.

Begin each call with an introduction and a statement of purpose. Most people recognize you before they remember your name, so until you have developed a relationship, put the pharmacist at ease by re-introducing yourself on each call.

Get right to the point of your visit. A clear statement of purpose will help the pharmacist assess how much time they need to spend with you, and whether or not they can afford that time right now. “May I have two minutes of your time to tell you about a new indication for Hoozlefritz extended release tabs?” is more helpful to a pharmacist than, “Hi! I’m the new Hoozlefritz rep.”

Deliver your information succinctly and factually. Pharmacists do not prescribe medications and do not want to be “sold” on the merits of your product. They do, however, want to know the indication, dosing, mechanism of action (MOA), pharmacokinetic and pharmacodynamic (PK/PD) profile, and occurrence of side effects. This is vital information for their consultations with physicians and patients.

Close your call by asking, “What can I do to be a resource for you and your customers?

Here are specific suggestions from pharmacists in three different settings that you are likely to encounter in your territory: retail chain, independent and hospital pharmacies.

Retail chain pharmacists’ recommendations:

Develop partnerships with pharmacists. Paul, a New York state-licensed pharmacist, points out that he and physicians and pharmaceutical reps all have the same goal: to provide excellent patient care. “We are all interdependent. The cycle starts with the drug companies and links to the physicians and the pharmacists, who link directly with the patients. We’re all in the patient care business.”

Suzanne, a licensed pharmacist in Tennessee, agrees. “My customers are the drug rep’s end customers. For both of us, “success” means making our customers healthier.”

Chain pharmacists across the country agree that pharmaceutical reps can be more effective if they DO:

o Provide the pharmacist with objective clinical information.

o Invite pharmacists to educational programs with physicians, or sponsor separate programs for their local pharmacy organization.

o Follow through on what they say they are going to do.

o Respect the pharmacist’s time.

o Offer your business card every time. Make it easy for pharmacy staff to contact you.

o Inform pharmacists of any prescription voucher, rebate or coupon programs ahead of time. This gives pharmacy staff time to learn the quirks of the program so that they can facilitate patient uptake.

Paul says, “One of the drug reps in the area launched a prior auth product in a crowded therapeutic class. I stocked her vouchers at each of my stores, and she informed her target physicians of this. Physicians appreciated the simplicity, patients were happy about getting a free trial, I benefited from the increase in customer traffic, and this rep led the country in sales.”


o Make pharmacy sales calls on Mondays or early in the morning.

o Ask a pharmacist to stock your product “to be ready for the first prescription”.

o Ask a pharmacist for confidential information, such as, “Which doctors are writing my product?”

Independent pharmacists’ recommendations:

Masood runs a small chain of independent pharmacies in southern California. To him, respect is the most important element of a sales call. “Some reps think that because I am not a big name chain that I am not as important, or maybe they do not need to be polite with me. But that is not the way to think of it. I am very busy here, with many customers every day. The smart reps know that I am a big business for them in this city.”

Consensus of independent pharmacists is that reps will be more successful if they DO:

o Provide NDC #’s.

o Understand that pharmacy customers are the first priority. Be patient.

o Educate the pharmacist about potential side effects.

o Ask for the opportunity to schedule an educational lunch presentation.

o Treat independent pharmacists as well as they treat chain pharmacists.

“I’ve worked in both settings, and I’ve seen a lot of drug reps overlook independent pharmacies”, says Alan, a pharmacist in Wisconsin. “Maybe they think that because we’re small we’re not “real” pharmacists. But we have the same educational background, and we have the same interactions with doctors and patients as any other licensed pharmacist.”


o Ask for confidential information.

o Ask a pharmacist to stock your product without a prescription.

o “Sell” the pharmacist.

Hospital pharmacists’ recommendations:

A hospital pharmacy may serve only inpatients, only outpatients, or a blend of the two. Inpatient pharmacies are usually restricted to stocking products that are on the hospital formulary. Hospital-based outpatient pharmacies operate like any other retail pharmacies. They are not usually restricted to the hospital formulary.

Tim is a hospital pharmacist in Maine who welcomes drug reps. “Reps are a great source of information for me. I know that if I tell a rep that a patient had an unusual reaction to their drug, the rep is going to pass that on to their company to investigate. Drug companies are highly motivated to check it out and follow up, which helps me serve my customers better.”

Recommendations for pharmaceutical reps when calling on hospital pharmacies. DO:

o Ask about scheduling an educational lunch presentation.

o Ask for information about the formulary process; offer yourself as a resource for information.

o Ask about the schedule for the hospital P&T committee.

o Know your drug. Be prepared to clarify and support any information that is included in your product PI.


o Ask for a list of physicians who are on the P&T committee.

o Pressure the pharmacist to stock product without a prescription.

o Make a sales call without a clear reason for the call.

Which brings us back to the bottom line: Pharmacy calls are sales presentations. And just like prescriber calls, pharmacy calls are powerful tools to improve patient care and drive your business.

If you make the effort to develop productive relationships, you will find that every pharmacist in your territory is an extra person on your sales team!

How To Eliminate Awful Or Painful Throat?

Unpleasant throat is a truly common unwellness that happens to many us on a common basis. It  results in one to feeling really uncomfortable and at times you could not be able to sleep comfortably. Alas for me, unpleasant throat haunts me all of the time since my childhood days. If I ate foods for instance drinking chocolate, potato fries, fried foods, I would suffer from unpleasant throat. Acquaintances around me would remark that I have a fragile immune system. It chanced on me a long time for me to understand how I can prevent myself from clouded with painful throat easily.

how come you’re tainted with awful Throat..

In the west medical reality, the physicians would infer that sore throat may either be induced by viral or bacterial transmission. Nevertheless, in the conventional Asian medical universe, the cause why we’re contaminated with sore throat is because there is excessively ‘heat energy’ in our body. They relate this as being ‘heaty’. Being ‘heaty’ would also add on to other common sicknesses like fever, coughing and phlegm.

Fundamentally, the commonest sore throat I am tainted on is the one and only once you attempt to swallow food or saliva, you would experience irritation at the throat.

There are couple of raw relieves which is rather of value in alleviating unpleasant throat. Below are many foods that you ought keep off when you experience painful throat.

    * Deep-fried food, oily food

    * Chocolates, biscuits

    * Chicken, eggs, ducks.

    * Really spicy food

    * Grilled food

    * Overcooked food

All these foods will sum up to the irritation of sore throat and you ought avoid consuming these foods till you’re better unless you wish your circumstance to aggravate.

Here are a a couple of earthy curatives because aggravating throat which I have in-person accepted and go through bore witness mighty.

When I am feeling weird at my sore throat, I would normally consume many bananas. However take note that whenever you experience phlegm like symptoms with your sore throat, avoid consuming bananas.

Bananas and plum fruits – These fruits are expert to protect your throat against painful throat.

In some web site*, Apple cider vinegar constitutes conceived to be having efficacious to defeat the virus in the throat. Consuming tried apple cider vinegar, I’d say that it’s a passing condition pacifier to the throat. Afterward boozing a couple of times throughout the daytime, it doesn’t actually mend the throat.

H2O with table salt – Gurgle a couple of times if your throat experiences unpleasant. While it doesn’t fully mend your throat, it unimpeachably soothes your throat.

Honey and lime/lemon water – This is by far among the most substantial repairs to exempt torturing throat. Barely pour out a few honey into a cup and muddle them comfortably with water. After breaking up the honey, you dismiss add up in lime or Citrus limon juice. Drinking this solvent several times throughout the daylight would in time mend the agony throat.

When you experience painfulness at your throat the following time, maybe before going to the physician, you can attempt all these natural relieves. You may experience that you may save the money and still feeling better.

Five Tips for Increasing Penis Sensitivity Without Drugs

Loss of penis sensation is a common problem, even in younger men. Manufacturers of impotence drugs and penile enhancements often use this to their advantage to market pharmaceuticals that are generally ineffective and may cause harmful side effects. What many men do not realize is that penis sensitivity can be treated without resorting to drugs and gimmicks by following a few simple tips. In addition, regular use of a formula containing penis-specific vitamins and minerals can help to maintain normal sensitivity of the penis and may even assist in restoring lost penile sensitivity. The following suggestions are often all that is needed to rejuvenate the penis skin and boost the enjoyment of sex.

Relax and enjoy the moment

Although the erogenous skin of the penis obviously plays a big role in sexual stimulation, research has shown that sexual desire and satisfaction is primarily a mental process. Men who are able to relax and enjoy the process of sex, rather than focusing on the end result, tend to have deeper and more satisfying orgasms.

Try something new

Men who find themselves in a rut, masturbating in the same manner every time or going for a jackrabbit effect during intercourse, are prone to loss of penis sensation. This problem may occur when the penis skin is desensitized by the constant friction, similar to the callouses that develop on the hands over time as a result of physical labor.

Mixing it up – using feathers or other toys, or just the tips of the fingers – to stimulate the skin on other parts of the body can create a new range of sensations that lead to arousal, giving the penis skin a break and allowing men to enjoy greater sensitivity and pleasure during sex.

Avoid tobacco use and limit the intake of alcohol

Chemical substances such as tobacco and alcohol can wreak havoc on the circulatory and nervous system. Regular smoking, in particular, can lead to desensitization of the penis and limit the ability to enjoy sex. Since smoking is bad for the health on many levels, there is nothing to lose and everything to gain by quitting. In addition, limiting alcohol consumption to no more than a few drinks each week can improve the body’s ability to heal and to rejuvenate damaged skin and nerve cells that may cause loss of penis sensitivity.

Wear soft, loose-fitting clothing

Wearing restrictive clothing can interfere with circulation, limiting the amount of blood flow to the penis and inhibiting penis sensation. In addition, rough fabrics that constantly rub against the penis skin can cause penile desensitization over time. Wearing looser, breathable clothing (all-natural fabrics are best) can improve blood flow to the area and prevent chafing and long-term damage to the skin.

Use a daily vitamin formula

Vitamins, minerals, antioxidants and amino acids are just as important to penis health as they are to the rest of the body. Here are just some of the nutrients that play an essential role in penis sensitivity and overall penis health:

– Vitamin A promotes youthful, supple penis skin that is receptive to tactile stimulation;

– Vitamin C supports the circulatory system and maintains the skin’s natural elasticity, as well as helping the body to fight off the effects of chemical damage from tobacco, alcohol and other harmful substances;

– Vitamin E creates a natural moisture barrier, preventing drying and dehydration of the penis skin that can cause the buildup of toughened skin cells that often results in loss of penis sensation.

– Natural oils such as shea butter moisturize the skin, leaving it smooth and responsive without irritation.

Choosing a penis sensitivity treatment

While numerous skin crèmes are available that contain some combination of the above ingredients, not all of these are appropriate for application to the penis. Many skin moisturizers contain fragrances and other chemicals that can actually cause irritation, which is a factor in penile sensation loss. In order to receive the maximum benefits of these and other essential vitamins and minerals, use of a penis health formula (most health professionals recommend Man1 Man Oil) that is applied directly to the target area is advised.

Ayurvedic Herbal Treatment for Bronchiectasis

Bronchiectasis is a medical condition involving an abnormal dilatation of the large airways in the lungs, resulting from chronic infections, obstruction in the lungs, hereditary diseases, and auto immune disorders. Abnormal dilatation of the airways causes symptoms of a chronic obstructive disease in which the lungs get inflamed easily, with collapse of the airways. The common symptoms of this condition include breathlessness, prolonged bouts of disabling cough, and impaired inability to clear the lung secretions, sometimes accompanied by hemoptysis. A major involvement of the lungs can cause considerable disability to the affected individual and significantly increase the morbidity and mortality from this disease.

The modern management of bronchiectasis involves treatment of infection using antibiotics, treatment of inflammation, the use of expectorant medication, and postural drainage in order to clear accumulated lung secretions. However, this treatment is mostly conservative and only treats the symptoms without actually curing the disease. The chronic disability resulting from this disease usually prompts affected individuals to seek alternative treatments, with the maximum number of patients looking towards Ayurvedic treatment for a remission of the symptoms of this condition.

Ayurvedic treatment has a significant role to play in the long-term management and treatment of bronchiectasis. Herbal medicines are known to have a specific action on the mucosa of the respiratory tract as well as the muscular walls of the airways in the lungs. These medicines have an anti-inflammatory effect and reduce inflammation, congestion and the production of excessive fluids in the lungs. Ayurvedic medicines also reduce the damage to the airways and bring about a significant reversal in the dysfunction cause due to this damage.

Ayurvedic treatment can bring about significant improvement in the breathing capacity of the affected individual in a very short period of time after commencement of therapy. Within four to six weeks, individuals affected with bronchiectasis notice a significant change in the symptoms and in the resulting disability from this condition. Symptoms like disabling cough and large amount of expectoration reduce significantly, and affected individuals experience an improvement in overall health and notice a definite feeling of well-being. The frequency of lung infections comes down significantly and the patient notices definite improvement in overall quality of life.

Most individuals affected with bronchiectasis require Ayurvedic treatment for about four to eight months in order to benefit significantly from treatment. Depending upon the severity of symptoms and associated medical conditions, treatment needs to be tailor-made according to the presentation of symptoms in each individual. Individualized treatment gives maximum positive results and long-term improvement in this condition, which usually does not have a clear-cut treatment in the modern system of medicine. Most individuals can stop treatment after this period and can carry on life at a normal pace, provided they take precautions to avoid infections and precipitate further lung damage. Some individuals may require booster doses of treatment ranging from 2 to 3 months in the following year or two, usually at the commencement of winter. Overall, the majority of patients affected with bronchiectasis experience a dramatic change in life after completing the prescribed course of Ayurvedic treatment.

7 Causes For Bad Breath In Children

Halitosis is an offensive odor which comes from the mouth, nose, or airway. It is also defined as exhaled air containing more than 75 parts per billion of odor-producing volatile sulfur compounds. Halitosis in children is often due to the decomposition of mucus secretions and debris which accumulate on the tongue, in the nose, and between the teeth. The commonly affected areas are the back of the tongue, space between two teeth and even the lining of the gum. Believe it or not, bad breath usually stays for as along as one does not brush his teeth properly. So, it is up to you to teach your child how to maintain proper dental hygiene. Besides consuming certain food items, there are also other causes of bad breath which can occur in your child. This article will provide you a fair insight of what they are.  

1. Oral fungal infection: Children who take antibiotics for a long time may develop a Candida infection in the mouth. Children undergoing chemotherapy, or who are immunosuppressed, are prone to develop oral fungal infections. Such oral yeast infections produce a characteristic sweet odor.

2. postnasal drip is the most common cause of bad breath in children, and may be caused by allergies, recurrent colds or chronic sinus infections.

3. Gut problems used to be blamed, and enemas and laxatives were often given as cures, but in fact these have very little to do with bad breath. Your stomach is shut off from your throat and mouth by a tight ring of muscle at the base of the foodpipe, so it is normally a closed tube. Therefore no odour escapes from the stomach, except if you belch, or regurgitate food (vomit).

4. If the child is experiencing anything like tooth decay, he can exhale bad breath. In cases when the decay has not yet reached the root of the affected tooth, the cause of bad breath would be hard to find, as the child would not experience pain, but due to the constant detrimental activities of the bacteria upon it, he may still have bad breath.

5. Children who do not properly brush or floss their teeth and tongues are more likely to experience bad breath, resulting from bacteria feeding on stagnant saliva and food particles in their mouths. Food particles can get trapped in the crevices of the tonsils of children who do not brush their teeth at least twice a day. Otherwise known as tonsillar stones, this condition is another reason for foul breath in children.

6. Gingivitis and periodontitis are the most common inflammatory diseases which cause halitosis. The resulting foul odor is very distinct. Gram-negative bacteria such as Veillonella, Fusobacterium nucleatum, and Porphyromonas gingivalis hide in diseased periodontal tissues, and produce foul gases.

7. Anything that dries the mouth makes bad breath worse, because saliva cleanses the mouth. Tricyclic antidepressant drugs (such as amitriptyline) reduce saliva. Alcohol, alcohol-containing mouthwashes, heavy exercise and fasting can all result in a dry mouth and worsen a bad breath problem.

The B Vitamin Family Explained


Vitamin B is a water soluble organic compound which is an essential nutrient needed by the body for everyday living, and the hundreds of processes your body carries out to enable it to function, Like all vitamins it cannot be manufactured by the body and must be derived from dietary sources or from supplementation in the case of known deficiencies. Because Vitamin B is water soluble a lot of it is secreted in the urine on a daily basis making the daily intake either through food sources in the diet or by taking supplements important for all the functions it is required for to enable the body to function.

There are now 8 main B Vitamins within the group, originally it was thought there was just one vitamin called vitamin B. As scientists investigated this vitamin it was realized there where over 22 vitamins which where chemically different to each other, but existed in the same foods. Over time it was realized that a lot of the 22 were not actually vitamins for a variety of reasons including they could be manufactured within the body, some were not organic and whilst some were not essential to humans they where required by other organisms. This is why there are gaps in the numbering system of what is now known as the B vitamin family, which consists of, B1, B2, B3, B5, B6, Biotin (B7), Folic Acid (B9) and B12.

3 substances which are sometimes referred to as being part of the B Vitamin family are Choline, Inositol and PABA.

Choline is is an organic compound, classified as a water-soluble essential nutrient,usually grouped with in the B Vitamin family, however it does not have a B number and is known as Bp.

Inositol is not technically a Vitamin because it can be synthesised by the body.

PABA, (para-aminobenzoic acid) is not essential to human health so is not technically a Vitamin

B Vitamin – – – – – – – – Name – – – – – – – – – – – -Dietary Source

B1 – – – – – – – – – – – – – -Thiamin – – – – – – – – – – brewers yeast, brown rice, wheat germ and soya beans

B2 – – – – – – – – – – – – – -Riboflavin – – – – – – – – -almonds, eggs liver and milk

B3 – – – – – – – – – – – – – -Niacin – – – – – – – – – – – -fish, eggs, brewers yeast, whole grains, millet, quinoa, almonds, wheat, pumpkin seeds, poultry, rice, brown rice, brussel sprouts, raspberries, artichoke, dates, celery, broccoli, mushrooms, dates and okra

B5 – – – – – – – – – – – – – -Pantothenic Acid – – – -mushrooms, avocado, broccoli, brown rice, oats and wheat

B6 – – – – – – – – – – – – – Pyroxidine – – – – – – – – -bananas, millet, buckwheat, wheat oats, brown rice, shellfish ie prawns, lobster, muscles, brown rice, chicken, spinach

B7 – – – – – – – – – – – – – Biotin – – – – – – – – – – – – egg yolk, liver, oysters, legumes and yeast

B9 – – – – – – – – – – – – – Folic Acid – – – – – – – – -barley, brown rice, wheat, sesame seeds, oats, chickpeas, lentils, mung beans, leeks, radishes, mushrooms, peaches, pears and yam

B12 – – – – – – – – – – – – Cobalamin – – – – – – – – -liver, fish, dairy products. there are no vegetable sources of B12

Choline – – – – – – – – – – Vitamin Bp – – – – – – – – -egg yolks, soy, beef, chicken, veal, turkey livers

Inositol – – – – – – – – – – -Vitamin B8 – – – – – – – – -nuts, seeds, brown rice, beans, whole grains, raisins, cantaloupe, bananas, citrus fruits

PABA – – – – – – – – – – – Vitamin Bx – – – – – – – – – liver, kidney, brewers yeast, molasses, whole grains, bran mushrooms, spinach

There are foods which are beneficial for several of the B Vitamins like: barley, game, eggs, sunflower seeds, peas, peppers and molasses

When food is cooked the high temperatures involved in the cooking process will result in most of the vitamin content being destroyed. The best method to cook food is steaming which will preserve more of the vitamin than boiling. With foods like nuts and grains which tend to be eaten raw the levels remain unchanged.

Vitamin B1 Thiamin

Deficiency results in the condition BeriBeri (common in the 19th century), which causes Oedama (water logging of the tissues) and Emaciation both of which have nerve damage associated with them. This condition occurs mainly in the tropics. The body must have B1 to be able to convert carbohydrates into energy, it does this by making thiamin pyrophosphate (TPP) which is the active form of Thiamin (B1). Every cell in your body needs Thiamin to be able to make adenosine triphosphate (ATP), this is the bodies main energy carrying molecule.

The bodies ability to absorb B1 is totally dependent on having enough B6, B9 and B12 already available within the body. Both smoking and consumption of alcohol interfere with absorption of thiamin.

Dietary sources are brewers yeast, brown rice, wheat germ and soya beans.

Vitamin B2 Riboflavin

A deficiency in this B Vitamin is associated with stunted growth in children. It is also responsible for inflammation of the tongue and lips with cracking in the corners of the mouth. Vitamin B2 is important in cell respiration and very beneficial in helping the liver clear excess oestrogen’s. These may be partly responsible for breast and ovarian cancer in women. Vitamin B2 transforms B9 and B5 into the neurotransmitters which are crucial for thinking and memory. People who have high levels of B2 tend to perform best at memory tests.

Dietary sources are almonds, eggs liver and milk.

Vitamin B3 Niacin

This comes in 2 forms Niacin (nicotinic acid) and Niacinamide (nicotinamide). Niacin causes flushing because it dilates blood vessels this action keeps blood pressure down protecting the cardiovascular system. Taking an Aspirin at the same time as Niacin will help to reduce the flushing. Niacinamide does not have the flushing side effects. A deficiency causes Pellagra (although the deficiency has to be extreme), which is characterized by diarrhea, skin eruptions and mental disturbances. This condition occurs mainly in the sub tropics. This B Vitamin can be formed in the human body in very tiny amount from the amino acid Tryptophan.

50 enzymes rely on B3 for their proper functioning.

Any amount of alcohol in the body will inhibit absorption of Vitamin B3.

Dietary sources are fish, eggs, brewers yeast, whole grains, millet, quinoa, almonds, wheat, pumpkin seeds, poultry, rice, brown rice, brussel sprouts, raspberries, artichoke, dates, celery, broccoli, mushrooms, dates and okra.

Vitamin B5 Pantothenic Acid

Being deficient can cause dermatitis. B5 is known to be involved in the breakdown of fats and carbohydrates. It increase HDL (High Density Lipoprotein) levels which improve the ratio between the good and bad cholesterol’s. B5 is needed to make hormones and healthy red blood cells. There is evidence that coenzyme A is converted from B5 which detoxifies the body.

Dietary sources are mushrooms, avocado, broccoli, brown rice, oats and wheat.

Vitamin B6 Pyroxidine

A low level of B6 is associated with skin disorders and problems with nerve damage and the central nervous system. Its main benefits are turning protein, fat and carbohydrate into energy and assisting in maintaining the nervous system, B12 is also very important in this role. Vitamin B6 enhances the white blood cells capability to attack offending pathogens. When B6 is synergistically in combination with B12, both will work together to prevent a build up of Homocysteine, by removing it from the blood, which can be partly responsible for atherosclerosis, (arteries furring up). Homocysteine is an amino acid found in meat, which causes blood cells to clump together and cling to arterial walls. It is very important to keep Homocysteine levels in check.

A lot of women take a B6 supplement to ease the symptoms associated with pre menstrual symptoms of bloating and cramping, although this use has not been studied and proven.

Dietary sources are bananas, millet, buckwheat, wheat oats, brown rice, shellfish ie prawns, lobster, muscles, brown rice, chicken and spinach

Vitamin B7 Biotin

B7 is more commonly known as Biotin, which is also known as Vitamin H. The body should be able to make its own from the bacteria which live in the intestines, if someone is taking antibiotics or who have a compromised immune system.

Deficiency can be responsible for dermatitis. It is essential for the breakdown of fats, carbohydrates, proteins and is beneficial for healthy hair, skin and nails. Because it is so key to the health of hair, skin and nails, brittle nails and hair along with hair loss may be a sign of Biotin deficiency. Cradle cap in infants may be due to Biotin deficiency, however it is important to consult with a doctor before giving supplements to children. Because of the importance of Biotin to hair health, many shampoos and conditioners have Biotin added to them.

Dietary sources are egg yolk, liver, oysters, legumes and yeast.

Vitamin B9 Folic Acid

This is essential for growth, energy and a strong immune system. B9 known as Folic Acid is also known as Folate or sometimes Folacin, is crucial to the good health of every cell within the body. B9 helps to form Dna and RNA in the genes, which are needed to regulate the formation of red blood cells, skin cells and the cells which line the small intestines.

Being deficient of B9 will causes anemia, because it is necessary for the formation of red blood cells. Without B9 the body will not be able to produce red blood cells.

Because B9 is so important in the making of DNA and RNA pregnant women are advised to supplement with B9 for the normal development of the fetus in the first 6 weeks of pregnancy.

There is evidence that B9 is better absorbed when it is taken with a B12 supplement and a Vitamin C supplement, as Vitamin C prevents the B9 from being broken down to quickly in your body.

Dietary sources are barley, brown rice, wheat, sesame seeds, oats, chickpeas, lentils, mung beans, leeks, radishes, mushrooms, peaches, pears and yam.

Vitamin B12 Cobalamin

The Cobal part of Cobalamin refers to the metal Cobalt in B12.

B12 can be produced by micro-organisms in the gut, however as we age our natural levels of B12 decrease. Being deficient in B12 will cause pernicious anemia (defective production of red blood cells) and a degeneration of the nervous system. Pernicious anemia is a stubborn form of anemia which does not improve when iron supplements are taken, this type of anemia occurs because the stomach fails to excrete a special substance called intrinsic factor. The body needs the intrinsic factor for efficient absorption of Vitamin B12

If the deficiency is severe signs of senility may be displayed. This B Vitamin is absolutely essential for the production and maintenance of the myelin sheath which insulates and protects the nerve fibers. B12 is important so the body can effectively use B9 (Folic Acid).

B12 is required for energy production, to make myelin, production of red and white blood cells, the removal of Homocysteine. It is available as Cyanocobalamin a stable form of Cobalamin which the body converts to Methylcobalamin, B12 can be bought as a supplement already in this form making it instantly bioavailable.

Total vegetarians (vegans) must take a vitamin B12 supplements or consume B12 -fortified foods, or they will eventually become deficient. Because there is no Vitamin B12 in vegetables the only sources are liver, fish and some dairy products.

Dietary sources are liver, fish, dairy products. there are no vegetable sources of B12

Choline Vitamin Bp

Choline works very closely with B12 and B9 in the breakdown of fats. Being deficient in Choline may result in the degeneration of the liver and hardening of the arteries. The main health benefit of Choline is when it is converted to Acetylcholine. This is an important neurotransmiter required in the brain for memory function, intelligence and mood. People who have Alzheimer’s usually have low levels of Acetylcholine in their brains.

Dietary sources are egg yolks, soy, beef, chicken and veal, turkey livers.

Inositol Vitamin B8

Inositol which is present in all cells, is also involved in the production of serotonin. Being deficient may be responsible for some forms of depression. The version Inositol Hexaphosphate, also known as IP6, is derived from Phytic Acid which is found in nuts, seeds, brown rice, beans, whole grains, raisins, cantaloupe, bananas and citrus fruits is obtained when the Phytic Acid combines with bacteria in the digestive tract. This is why it is not technically a vitamin.

Inositol combines with Choline to form Lecithin, a type of lipid which is needed to make healthy cell membranes. This is especially important for the brain, heart and liver.

Dietary source are nuts, seeds, brown rice, beans, whole grains, raisins, cantaloupe, bananas and citrus fruits.

PABA para-aminobenzoic acid Vitamin Bx

Paba assists the body in the manufacture of red blood cells, however its main reported benefits are in protecting against UVB rays. It has been found to delay the onset of wrinkles and keeps skin smooth. Because of these benefits it is taken by people who have conditions relating to the skin and connective tissues. Some studies suggest PABA mat be beneficial for people who suffer with hair loss because it is believed it protects the hair follicles.

Dietary source are liver, kidney, brewers yeast, molasses, whole grains, bran, mushrooms and spinach

A full range of B Vitamins [http://www.squidoo.com/vitb] available.

Best 5 Asian Countries That Host Good Hospitals

Medical Tourism is taking people to places and the best part is that they are being benefitted as they get treatment from the best doctors and are open to more options for treatments. Most of the medical tours are now within the budget. You go for whatever you can afford and yet get the best out of the industry. There are countries that are best known for their hospitals and medical treatments. The following is a list of Asian countries that host good hospitals in the world.

1. Malaysia: It is located in the South East Asia and its capital is Kuala Lumpur. The treatments offered by Malaysian Hospitals are Anti-Aging, Bariatric Surgery, Cardiology, Cosmetic or Plastic Surgery, Oncology, Dermatology, Neurology, Orthopedics, etc. The treatments are cost worthy and affordable. They offer great hospitality and the holiday advantages are ample as there are many tourist places as it is surrounded by places like Singapore, Thailand, Indonesia, etc. It has some of the best trained surgeons, dentists and specialists. English is widely spoken in Malaysia. About 600, 000 medical tourists visit Malaysia and the number continues to multiply. Prince Court Medical Center is one of the most renowned and popular hospital in Malaysia and has also been ranked number 1 in the year 2013. Giant KPJ and Sime Darby networks are other hospitals that are famous among hundreds of others.

2. India: It is located in the South of Asia and its capital is Delhi. It has grown to be famous for Medical Industry. It is widely known for cardiac bypass surgery. The other treatments include Oncology, Vertebroplasty, Disc Nucleoplasty, Laser Lithotripsy and other treatments for spine, cancer, etc. India is known for rehabilitation care and centers. It equips various medicinal treatments like Ayurveda, Homeopathy, Allopathic, etc. The treatments offered in India are of best quality, secure and cost effective. An estimated number of around 150, 000 medical tourists travel to India. The cities that offer medical treatments are Kerala, Chennai, Vellore, Mumbai, Delhi, Coimbatore, etc. The famous and widely known hospitals in India include KG Hospitals, Apollo Hospitals, Tata Memorial Hospital, Fortis Hospital, AyurvedaGram, etc.

3. Japan: It is an island nation located in the east of Asia and its capital is Tokyo. They have been investing money in the healthcare industry since 20 years almost and has mandated health insurance for each and every citizen of their country. It hosts some of the best hospitals in the world and are ahead in technology. Though the cost of medical treatment is high, the treatment is worth the price as it is of high quality and secure. It has created a brand image with its medical care facilities like examination, diagnosis, medical treatment, aesthetic care and plastic surgery. It is known for plastic surgery and dental care mostly. The Japanese Water therapy is a natural way of curing diseases like Diabetes, Arthritis, Cancer, TB, etc. Some of the best hospitals in Japan are Kameda Medical Center, Matsunami General, University of Tokyo Hospital, Osaka Medical Center, St. Luke’s International, etc.

4. Singapore: It is located in Southeast Asia and it is the capital of Asia. The Medical Tourism in Singapore is growing to be the hub and emerging as the major location for health travel in Asia. It attracts around 200, 000 patients every year to avail medical treatments of services at some of the best hospitals in the country. The treatments in Singapore include Laser Spine Surgery, Oncology, Ophthalmology, Cardiology, Dental Medical, Stem Cell Transplant, etc. Cancer Treatment is Singapore’s top specialty. The famous hospitals in Singapore are Camden Medical Centre, Mount Alvernia Hospital, Mount Elizabeth Hospital, Gleneagles Hospital, Parkway East Hospital, Johns Hopkins International Medical Center, etc.

5. Thailand: It is located in Southeast Asia and its capital is Bangkok. It accounts for 90% of the medical tourism market in Asia. It is a reputed, reliable and high-quality destination for health travel. Hospitals in Thailand are well equipped and have the latest technology. The cost of treatments is affordable and many doctors and physicians are certified and best at what they do. The treatments in Thailand comprises of Cosmetic Surgery, Dental Surgery, Ophthalmology, Dermatology, Heart Bypass, Hip Replacement, Breast Implant, etc. Bumrungrad International Hospital is listen among the top 10 best hospitals in Asia and is located in Bangkok. Other hospitals located in Thailand are Bangkok Hospital Group, Fort Suranaree Hospital, Samitivej Hospital, Laser Vision Lasik Center of Thailand, etc.

Modern Health Care in the Age of the Internet and Social Medicine

Are we are all “medical citizens,” embedded as potential or actual patients, with our physicians, insurer’s, pharmaceutical companies, government bodies and others in a system of societal, moral and organizational stakeholders?

Today, with the advent of the Internet, High Speed Bandwidth, Social Media, Support Groups and Self Care Protocols, patients for the first time in the history of medicine have the ability to alter the outcome of disease and illness for themselves, family members, friends and significant others.

This essay attempts to address a most compelling issue of our time. Are medical self-help groups and self-care methods helpful or are they challenges to the delivery of traditional medical care? How do they differ and what consequences arise from this debate?

Also, how has the advent of the Internet and Social media transformed the landscape of medicine? What limitations may exist in this new era of information technology and social communication? And to what degree do they challenge traditional care models? Can a patient or their advocate become more of an expert on their own medical conditions than their own physicians? The answer to this question is a resounding yes, if the patient uses all the tools now available to them.

Various published estimates unanimously indicate that hundreds of thousands of patients die and millions more are injured by medical procedures gone wrong, medication errors or their side effects and by medications improperly prescribed or not taken as directed by patients. And it is not just the infirm that suffer, but their families, their loved one’s, friends and employer’s who must suffer with the grief and change of lifestyle that so often comes with these mistakes.

Furthermore, on May 8, 2013 National Center for Policy Analysis, in a release, stated that first diagnosis error rates are increasing at an alarming rate:

• An estimated 10 percent to 20 percent of cases are misdiagnosed, which exceeds drug errors, and surgery on the wrong patient or body part, both of which receive considerably more attention.

• One report found that 28 percent of 583 diagnostic mistakes were life threatening or had resulted in death or permanent disability.

• Another study estimated that fatal diagnostic errors in United States intensive care units equal the number of breast cancer deaths each year — 40,500.

Therefore, second opinions are often necessary precautions, as are third opinions when the first two differ. In fact, Medicare and insurers often pay for third opinions under these circumstances as it saves them billions in the long run.

Prudence dictates that the “medical citizen” must beware of these pitfalls, as their lives may depend on it.

Also, with patient reviews and rating systems available right on our own smartphones, we must question whether or not physician decision making is being compromised as well. For instance, a surgeon knows that his or her treatment decisions can possibly either result in either saving a life or ending it resulting in damning social media judgements, whether legitimate or not, which can then hurt their medical practices? Does this introduce a bias that may alter or cloud a doctor’s judgement? There is no data to provide an answer as of yet.

So, are doctors becoming more risk adverse as a result of this new landscape? Physicians are now being compensated more and more based on better outcomes, lower costs, reduced re-admission rates and other variables – not staff friendliness or less waiting room times which many doctor review sites measure.

Often 5 star rating systems get few patient reviews despite the fact that the average doctor has some 2,000 patient charts (most healthy) and while it is human nature to complain when we don’t get the outcome we want, consumers are less likely to praise a positive experience because we naturally expect top service and thus neglect to post a positive patient review yet are rather far more likely to post a negative review to retaliate against the provider. So patient reviews are not a very good or objective source of fair and balanced overall rating of a doctor’s performance.

How can this dilemma be resolved especially when a surgeon does everything perfectly but the patient becomes a victim of medication errors, poor nursing compliance with medical orders or perhaps contracts a hospital born infection, or some other adverse event out of the doctor’s control even if the doctor’s work is excellent? Nevertheless these doctor review sites often blame the physician. So Patients need better tools to make judgements about their own healthcare whether it be which plan to select or which treatment option to go with given a choice.

If a patient does utilize a rating site, they should make sure it is a government site based on huge amounts of data or a private site wherein doctors nominate other doctors for their excellence and would use these “doctor’s doctors” to provide care for their very own friends and loved ones.

Doctor reviews by other sites using stupid criteria like waiting room times, friendliness of staff, waiting room decor and other questions that have nothing to do with best outcomes accomplish nothing but make money for their operators.

In modern day, it is not unusual for patients to challenge doctors when it comes to illness and disease. After all, according to Tejal Gandhi, MD, president of the National Patient Safety Foundation and associate professor of medicine, Harvard Medical School, “Preventable medical errors persist as the No. 3 killer in the U.S. – third only to heart disease and cancer – claiming the lives of some 400,000 people each year, at a cost of over a trillion dollars a year””.

Self-help groups and self-care probably date back to the dawn of civilization when people lived cooperatively in tribal settings. These groups dealt with all life issues related to the survival and political stability of the group. The dawn of medical ethics probably dates back some 2300 years with the publication of the Hippocratic Oath.

But now the game has dramatically changed due to major technological advances in medicine and with the great advances of the Internet now being the primary source of medical information for medical consumers. And with the explosion in social media, people have the ability to communicate and share information on a scale never before foreseen or imagined.

Add to this all the new stakeholders that have entered the fray such as insurance companies, employers, managed care organizations, Obamacare, biotech companies, governments and, of course, pharmaceutical companies and healthcare policy makers. The challenges faced by the medical citizen and social policy planners have never been so daunting.

Postmodern Medicine probably arose after the institution of Medicare in 1965 when Medicare was signed into law in 1965 by President Lyndon Johnson and third party payer insurance companies soon appeared thereafter. By the 1970’s the practice of medicine became the business of medicine and third party payment systems caused a surge in demand for services and the costs of healthcare delivery soared. Also, the debate over what is a disease and what is an illness now must be addressed in a sociological manner more than ever as it affects whether treatments are made available and what costs are covered by third party payers.

Self Help Groups are usually a group or set of people who all share or suffer from a similar malady which involves great personal cost and suffering for themselves and those who care for them.

Self-care is seemingly clear in meaning. We get a cut and we put a band aid on it. Have a headache, take an aspirin. But is it really so clear as pharmacy shelves that are now filled will medications that used to be available only by prescription and medical devices one can use for self-diagnosis and self-care which measure bodily functions and vital signs such as blood sugar levels, blood pressure, pulse oxygenation, etc. have resulted in patients self diagnosing and treating themselves, often without medical advice. Defibrillators are now a fixture in most large organizations where non-medical designated company personnel are trained and authorized to shock a worker’s heart in addition to CPR.

Supplies such as instant blood clotting powder, specialized bandages, diabetic compression socks that were not previously available in pharmacies, are now commonplace. But many of these products may do as much harm as good, if not used properly.

Self-care at least in many of its versions, usually includes some connection with the health care system, teaching people when they need a professional, how to do a self-examination and care for a condition without medical supervision. e.g. Changing wound dressings and bandages without the presence of a home care aid.

And with the advent of new and off-label use of FDA approved medications, televisions are awash with commercials advertising new drugs and therapies which espouse incredible benefits such as Viagra, which resulted in a stampede of male patients running to their doctors demanding buckets of the stuff, making Viagra one of the most profitable elective medications ever.

Television ads by pharmaceutical companies now target the consumer directly in order to create demand for their products, which can only be prescribed by a physician, are commonplace as well. Also, in fine print and muffled high speed speech, pharmaceutical companies attempt in these ads to disclaim liability for the fact that the medications advertised directly to consumers may have side effects that could seriously mess a person up or even cause death, while at the same time they are trying to get consumers to ask their doctors for these medications. This is a radical change in the supply chain and distribution of new pharmaceutical products and protocols.

So, what is a medical citizen to do? Turn to the Internet of course for information and Social Media discourse. The Internet is after all now the primary source of health and medical information as well as social communication.

Today, with over a hundred million American’s online with their computers, tablets, cellphones, and smart watches along with highly specialized apps, finding support is like reading a menu in a Greek diner. If can be hard to choose wisely.

The problem in discerning useful and credible information from garbage in, garbage out, or from commercial sites looking to sell goods and services targeting specific users based upon searches performed by the user and transmitted to advertisers via cookies and Flash Player LSOs.

Most people probably do OK and, undoubtedly, are using this resource responsibly. These resources can improve and maybe extend patient’s lives and allow them to find communities of other’s suffering from the same malady as them and can assist health care outcomes and help contain health care costs to society. We are now entering the world of virtualization, telemedicine, doctor and hospital rating websites and long distance robotic surgery as well as even fields like quantum medicine which seems like it comes right out of a sci-fi novel.

Where this will lead us in the future remains to be seen and cannot definitively be addressed in this essay.

This also leaves us with the issue of contested illness. As opposed to a disease, like a clogged artery that must be repaired with a stent in a catheterization laboratory by an interventional cardiologist, or an infection that must be treated with antibiotics by a physician, many illnesses are unexplained by traditional medicine, as opposed to diseases which are clearly recognized by healthcare providers. Illnesses are often easily dismissed by formal medicine resulting in denial of treatment or refusal of insurers to pay.

But the collective description of the same array of similar symptoms occurring among many thousands of individuals communicating with each other using self-help groups can lead to a change of heart in the medical establishment. Not to mention diseases that carry a social stigma with them where the patient is blamed for their own symptoms, like obesity, even though there are in fact diseases that cause obesity or depression, addiction and a host of illnesses that have not as yet been classified as diseases and for which there is no biomedical solution.

Online support groups can and have brought these conditions to the forefront, as in the case of fibromyalgia which is now recognized as a treatable disease, but for a long time was a contested illness dismissed by professionals as people too lazy to work or just seeking pain medication. What is certain is that online support groups provide people with opportunities to exchange information with each other and become experts on their medical problems.

Internet self-help groups are cost free and very effective. People helping people. It is a simple concept, especially in the age where the nuclear family is nearly extinct in western society, so people now seek out extended families. But self-help groups which are self contained and autonomous in theory are still predisposed to traditional group problems such as rivalry within the groups, inappropriate members, etc. They are also targets of commercial interests, for example when a user who does not know how to surf anonymously gets hundreds of cookies on the device they are using and then they start to receive unwanted ads by commercial interests or worse, spam and theft of private information.

Self-Help groups offer other benefits such as “Improved coping with Chronic Illness and Life Transitions, Friendship and Belonging, Spiritual Renewal, Increased Political Activism, Enhancing Civil Society and Reduced Healthcare Resource Use” (Humphreys, Keith, Social Policy, Spring 97, Vol 27 Issue 3 Pages 2-5)

That said, “social movements that consider themselves omnipotent and omniscient are often dangerous”. (Humphreys, Keith, Social Policy, Spring 97, Vol 27 Issue 3 Page 5)

You can bring a horse to water but you cannot make it drink. Many people are too set in their ways, too judgmental and have ulterior motives which can corrupt or disrupt the best intentions of the many.

Many medical professionals feel that patients playing doctor carries potentially serious risks as patients are not doctors or trained medical professionals. On the other hand, many would argue the same about professionals and professional groups which previously enjoyed unquestioned stature and in many instances took offense to being questioned or challenged.

But for a patient with a complex disease possibly accompanied by other co-morbid conditions, The Internet affords them unlimited access to research the latest medical treatments, pharmaceuticals and lot of other research that their internist may not be aware of.

With heavy patient loads a physician does not have the time to spend researching all of the worlds medical literature on new FDA approved medications and procedures. After a doctor sees a patient, often they don’t give that person’s situation another thought as they have 30 more patients to see that day plus hospital rounds.

But for the sick, if they have reasonably good intelligence and most likely they have much more time on their hands to research their specific disease or diseases that have devastated their quality or life, ability to work or career advancement, relationships all of which suffer, it is a logical assumption that with enough time and perseverance, the patient can find better treatment modalities or better doctors that can relieve most of their symptoms or possibly cure them completely.

If a patient remains docile, asks no questions, fails to review complex bills which even medical auditors cannot understand the billing codes used, then the patient will likely not receive the best possible outcome.

This issue has been thoroughly researched by the Institute of Medicine and the data resoundingly shows that informed patients consistently have better medical outcomes than patients that suffer in silence. The data is irrefutable!

So common sense dictates that patients should be proactive and learn as much as they can about their diseases or illnesses and work collaboratively with their doctors as a team, the goal being better medical care. Often physicians resist this in which case, a change of doctor may be in the best interest of the patient.

For example, mortality related to cardiac catheterization and angiography are significant enough that patients should be informed of the risks of death or major complications from the procedure or that there is an alternative called computed tomography angiography which can replace conventional coronary angiography in appropriate patients and is half the cost of the traditional procedure which is very lucrative for interventional cardiologists whereas computed tomography angiography is not. It is also a non-invasive procedure which will benefit those eligible at much less risk and a lower cost as well.

I am now speaking from personal experience because my own father, who died on Jan 26, 2006, suffered from complications that arose after a cardiac catheterization and angiography procedure that was unnecessary. A year prior to my father’s passing he had a stent placed in his left descending coronary artery which went flawlessly. Because my father was retired and living in NY he would visit all of his doctors prior to making his annual trip to Florida where he spent the winters in the sun.

This procedure was elective because his cardiologist suggested that the stent be checked before the trip. I should have known better and stopped him, since I was a patient and medical consumer advocate and researched and published reports for consumers and researched diseases for medical professionals for a living. The name of my company at the time was “Health Reports” a service of Multimedia Solutions Inc. a NY company I founded but due to later disability had to stop.

I accompanied my father on all of his doctor visits and when he went to the hospital he for this ambulatory procedure he was fine and he drove his own car to the hospital anticipating go home the same day.

His Interventional Cardiologist that did the procedure afterward said the stent was in beautiful condition but something went wrong because after the procedure my fathers extremities started turning blue from cyanosis. The doctor of course denied any relationship between the two events that happened within hours of each other.

The only possible conclusion that I could draw was that the catheter wire chipped of a piece of calcified plaque and lodged most likely in his lung as an embolism as he developed severe respiratory distress immediately after the angiogram. Now that had to be the greatest coincidence ever or a terrible medical mistake.

So a routine preventive screening where I was going to drive my dad home the same day turned into a week in the hospital after which he was moved into a step down rehabilitation facility and was expected to recover and go home.

On the evening before he was supposed to go home to continue his recovery at home, I visited him with my daughter and immediately saw something was very wrong.

Since there was only one doctor on the floor for about 50 adult residents, I practically had to physically drag the doctor to his room where his only suggestion was that he go back to the hospital. It took the ambulance 30 minutes to arrive to take hime to a major trauma hospital that was literally only a couple of hundred yards from where he was. I could have wheeled him over to the ER faster.

He died around 2 a.m. the next morning. They said he died from mesothelioma. I knew that was impossible because I never even heard the man cough once in his life or present with any of the symptoms of mesothelioma and I was in business with him for many years as well as his son.

Then, recently, when I was hospitalized in a Florida hospital for severe low potassium which was easily resolved over a few days of IV potassium infusion, a cardiologist walked into my room and said he wanted to do an angiogram just before my discharge, to check my stent that I had done a year earlier and I knew was fine and it literally became an argument because I questioned his authority. He finally admitted that the risk of death or complication during a cardiac cateterization were not insignificant. I finally agreed to a non-invasive Cardiac Ultrasound which showed absolutely nothing wrong.

And it had no relationship to why I was even in the hospital. I was released later that day and when I saw my regular cardiologist in New York, he called the other doctor a name I would rather not repeat and told me I may have saved my own life by contesting this man who I never saw before or since.

The odd thing is I only know this because I am an experienced Medical Literature Researcher but disabled.

Because too often patients are not informed of other treatment options for what ever ails them or for that matter the risks associated with many procedure options, because their doctors are simply unaware or don’t care or want to make the most money. Today, hiring an expert medical literature researcher is not a bad idea. And even a personal Patient Advocate which is a growing field for which no professional certification is required is a good idea if you can afford it because if your flat on your back and not in control and perhaps don’t even have family to help you, a personal Patient Advocate can be a good idea.

This is the new reality of healthcare. Its hard to be a practicing physician these days because of the rate of innovation, the problems of being a businessman, dealing with regulatory bodies, covering your hospitalized patients, litigation, etc. Many doctor’s can’t deal with it and quit medicine. And its getting harder.

Common sense also dictates that there is no longer a monopoly on medical information in this new era of instant information and mass communication and that transparency like revolution is a good thing once in a while.

In conclusion, as this essay attempts to address whether or not medical self help groups and self care alternatives are positive adjuncts or harmful challenges to medical care and how they contrast with one another as well as what consequences arise from such analysis, we can conclude with certainty that since the advent of the polio vaccine which brought about a tidal wave of medical advances available to help physicians cure disease, we are now in a new and ever evolving era of unprecedented advances in medicine, information and transparent social communication.

The costs of medical research and care have as a result of these advances skyrocketed to the point that medical resources have to be used in a more cost effective manner. Also, the issue of rationing medical care is one that social policy makers must give great weight to in their deliberations going forward since the implementation of the Affordable Care Act.

The issues are so complicated that consumers have a very difficult time making decisions as to how to best care for themselves and their families. Just picking a health plan can be a nightmare for families and professionals as different plans at different prices can work towards a families’ benefit or detriment depending on their socio-economic status, health history and lifestyles.

If these developments aren’t enough to contend with, the current power of the Internet as a source of both information and now also a powerful social medium in which people can connect with one another on a mass scale must be viewed as a benefit in a system that needs checks and balances due to the entry of so many stakeholders some of whom do not have the patient’s best interests at heart but instead are motivated by greed or are simply incompetent in their professions.

Self help groups, self care and the ability of a patient, or a loved one or an advocate to be involved in the management of illness and disease must work dynamically and cooperatively with their physicians, within this new medical landscape because the genie is now out of the bottle and we can’t look back but must look forward to a system of patients and caregivers working as a team towards the goal of healing and improving the quality of life of our citizens.

So what does the future hold. The last 30 years have seen an evolutionary leap more like one would likely see in a century or more. Now with new technologies such as 3-d copying and printing, and computer aided manufacturing and new medical fields like quantum medicine which uses the principles of quantum physics to better understand biology the future possibilities are mind boggling. The Civil war was only 152 years ago. Since then mankind has progressed from a way of life that sustained civilization for some 200,000 years at an astronomical rate. Can we absorb so much change so fast?

Gene Roddenberry foresaw a future beginning in 2236, 220 years from now with the release of Star Trek which has creating a self perpetuating movement. So what is our destiny, the view of Gene Roddenberry or perhaps, James Cameron’s “the Terminator” where mankind sparks an extinction level event by accident or by terrorism. Only time and man’s ingenuity will tell.

By Stuart J. Goltzman January 2, 2016 10:40 PM Eastern Time

All rights reserved, reproduction without alteration is authorized.

Cited Works:

(Humphreys, Keith, Social Policy, Spring 97, Vol 27 Issue3 Pages 2-5)

(Humphreys, Keith, Social Policy, Spring 97, Vol 27 Issue 3 Page 5)

History of Pipette and Pipetting

The pipette which is the most commonly used equipment in laboratories for extracting samples has a history of more than sixty years. Liquids and semi-solids are transferred using pipettes. Genetics, microbiology, chemical research such as pharmaceuticals etc are some other areas that make use of pipettes very frequently.

In earlier 50’s one of the major challenges faced by the laboratories was transferring of ideal volumes of liquid, but later in 1958 the revolutionary invention of pipette was done by one of the German scientist named Heinrich Schnitger but this invention was having a lot of limitations. The working of the pipette was by adding a spring to the syringe that would stop according to a set volume and the syringe’s needle was replaced with a plastic tip. The first pipette was called as Marburg pipette and it was supplied by the eppendorf medical supply company.

The first mechanical adjustable pipette was invented by Warren Gilson the Founder and Managing Director of Gilson medical electronics in the year 1978. The mechanical one is having strong resemblance with the one which is used in the labs now. This new invention led to increased accuracy, comfort, variable volume adjustments and lead to the invention of gilson pipetman. The first autclavable pipette was invented in 1984 by Capp Denmark manufacturers. More than 80% percentage of the pipettes used in the market today is autoclavable. Volume control knob was also invented by the same Denmark manufacturers. In 2002 the Vista labsystems technologies founded a new pipette which used state of art ergonomics. Vista lab also founded the first Ovation Bio Natural Pipette which actually reduced the risk of CTS and all other types of musculoskeletal disorders. Now the electronic pipette is replacing the mechanical pipette with ergonomics, precision and safety becoming an important factor in pipette usage.

The Safety of the pipette and the safety of the user using the pipette is given high importance now by the manufacturers. Each brand pipette is different to each other, the advantage now the customers have is that there is large varieties of pipettes in different brands, price etc. The customer can buy pipette according to his use and even some of the companies are making customized pipettes according to the orders from the customers. Never choose a pipette by looking on the price of the pipette. Buy the pipette according to the use of it first of all try to understand the differences between each pipette the main thing in that is the recalibration time for each one and free warranty of each pipette. If you are using pipettes frequently it is important to calibrate the equipment once in three months even if the The manufacturer claims that their product is having permanent calibration but if it is used frequently it will surely need recalibration in every 3 months. Almost every brand’s is giving warranties for their pipette. Clarify all the doubts regarding the warranty of the product at the time of purchase itself, mainly the time period of warranty and what all things comes under warranty.

Wound Dressings – Composites

Composite dressings are dressings that combine the advantages of multiple layers, providing more than one function in wound care management. Each layer of dressing is physiologically distinct. To learn how to use these dressings, and when not to, read on.

Product Overview

Most composite dressings have three layers. The bottom layer is usually composed of a semi- or non-adherent material, which allows moisture to travel though to the next layer while preventing the dressing from sticking to the freshly granulating tissue of the wound bed. The middle layer is generally composed of an absorptive material which pulls moisture away from the wound bed, keeping it moist but preventing maceration of the skin. It also helps to inhibit bacterial growth and assists in the process of autolytic debridement. The outermost layer protects the wound from bacterial invasion and allows air to circulate. The outer layer also prevents moisture from leaking through to the top layer of dressing, allowing for less frequent dressing changes.


  • Partial- and full-thickness wounds
  • Wounds that have minimal or heavy exudate
  • Wounds with granulating tissue
  • Wounds that are necrotic (have necrotic tissue)
  • Wounds that have a combination of necrotic and granulating tissue


  • Patients who are very dehydrated
  • Patients who have fragile skin ie. the elderly


  • Can be used as both primary and secondary dressings
  • Can be used on a variety of wounds with varying degrees of exudate
  • Easy to remove, as the bottom layer is usually non-adherent
  • Prevent maceration of the surrounding skin
  • Have antibacterial properties
  • Facilitates autolytic debridement
  • Shape well to different wounds on different parts of the body
  • Can be cost-effective, owing to less frequent dressing changes


  • Some of these dressings are not appropriate for use on infected wounds (check the manufacturer’s directions for use)
  • Composites with an adhesive border require that there be intact skin around the wound edges
  • Some insurers will not reimburse for these types of dressing when they are used as secondary dressings

As each of these dressings are different, it is important to read the manufacturer’s instructions for use. They should be changed when saturated, or when recommended by the manufacturer. To learn more about these dressings and others, you may want to consider becoming certified as a wound care specialist. The benefits to you and your patients are immeasurable, and WoundEducators.com is dedicated to helping you take this all-important step in your career. Because Medicare and other government entities are now holding health care professionals responsible for outcomes in wound care, the time has never been better to consider becoming a wound care specialist, able to handle any type of wound you may encounter in your practice. 

The Impact of the Hindu Marriage Act, 1955 on the Indian Society

The Hindu Marriage Act was enacted by the Indian Parliament in the year 1955, with the purpose of regulating the personal life among the Hindus, especially their institution of marriage, its validity, conditions for invalidity and applicability etc.

There are many salient features in the provisions of the act that makes and even prompt a person to consider it as rather conservative. The underlying note or we can say that the lifeline that runs throughout the act is that it duly recognizes the religious sentiments and values of the Hindus which they respectfully cherish and consider as valuable. Accordingly the Hindu Marriage Act has considered and treated the institution of marriage among the Hindus so sacrosanct as it evolved through ages among them, duly recognizing their time immemorial customs, traditions, sasthras that include their rituals and other practices as practiced and evolved by them over a long period.Above all the act by covering and encompassing all the people from the modern offshoots of Hinduism like Prarthana Samaj, Arya Samaj and Brahma Samaj also has a modern look by duly recognizing those modern offshoots of Hindu religion.

Therefore, the Hindu Marriage Act is applicable to all Hindus like saivites, vaishnavites, lingayats and the followers of Prarthana, Arya and Brahma Samajas and to others who comes within the fold of Hinduism like the Sikhs, Buddhists and Jains. Thus the Hindu Marriage Act applies to the religious folds that arose during the 6 th century B.C and also in 18 th and 19 th century A.D.Therefore, the Hindu Marriage Act essentially is acting as a bridge connecting ages. The credit of giving us such an ageless act goes to the Indian legal luminaries.

The conditions imposed by the Hindu Marriage Act for a valid marriage, though may look insignificant on a superficial look, actually have the modern elements and characteristics, of course with a far sightedness. So as to solemnize a marriage between two Hindus, the following conditions have been imposed:

5)(i)Neither party has a spouse living at the time of the marriage; which actually discourages plural marriages and in the present modern day context, the provision helps to prevent dissemination of incurable diseases like AIDS and other virulent form of venereal diseases in the society.

iii)The age of eligibility for getting married is fixed as 21 for bridegrooms and 18 for brides, which actually helps to prevent social evils like child marriages from the Indian Society.

iv) and v) prevents marriages between prohibited degree of relationships and sapindas. This provision has a scientific base because the prevention of a marriage between persons of prohibited degree of relationship or sapindas, will actually prevent the birth of physically deformed children or deaf, dumb and blind children, because the possibility of delivering such children is more in marriages between persons of prohibited relationship and sapindas.

In Section 7 of the Act, the ceremonies and customs of a Hindu Marriage are duly recognized, giving a sentimental value to the act. For example immediately after the marriage, both the bride and the bridegroom will take seven steps before the sacred fire, that will sanctify the marriage and that ceremony is known as Saptapadi. Even by going a step forward, the act stipulates that the marriage is not valid if Saptapadi is not performed.Thereby the Hindu Marriage Act also recognises the time immemorial customs and rituals followed by the Hindus.

Section 8 of the Hindu Marriage Act provides for the compulsory registration of marriages and even stipulates a punishment for violating the provision. This provision is actually an eye opener and it safeguards those hapless persons who may become victims of fraud marriages carefully maneuvered and planned by unscrupulous antisocial elements.

Section 13 of the Hindu Marriage Act has provisions which may serve as grounds of marriages for spouses who intend to file petitions seeking divorce from their spouses. When we consider these grounds, some of them have social relevance:-

For example if a spouse commits adultery with a person other than his or her spouse;

If a spouse ceased to be a Hindu by conversion;

If a spouse has been suffering from a virulent and incurable form of leprosy;

If a spouse has been suffering from a venereal disease in a communicable form;

The above provisions not only respect the religious feelings of the Hindus besides providing a ground for divorce. Similarly, the provision relating to adultery, virulent form of disease like leprosy or communicable form of VD etc are not only help the concerned spouses to seek divorce from their spouses, but also serve the cause and larger interests of the society, by preventing the spread of virulent and communicable form of venereal diseases

Thus the Hindu Marriage Act, though it contains only 30 sections and may even be considered a very small piece of legislation, it is a comprehensive Act by virtue of its utility not only to the Hindus but also in the general welfare and interest of the Indian Society as well.

Sleep deprivation and obesity

Beside good things, modern times gave us a bunch of very negative too. Rise of technology and everyday chase for money left us very little space for exercising and proper food intake. Therefore it’s not surprising that about 30 % of Americans have problem with obesity. However, there are at least one important factor for weight gain. Almost 50% of obese people don’t get the recommended eight hours sleep a night. Recent studies seem to have found that there is a link between sleep deprivation and obesity.

Sleep researchers from University of Chicago discovered the link between a lack of sleep and overeating. They found that sleep deprivation activates the part of the brain that is involved in appetite regulation. This particular part of the brain helps produce two hormones ghrelin and leptin. Ghrelin is an appetite stimulating hormone which force our body to require food, while Leptin is produced by the fat cells and tells the brain the current energy balance in the body. When leptin levels are high this tells us we are full Sleep deprivation produce hormonal imbalance with high ghrelin and low leptin levels in our body. By them,  it is certain that lack of sleep leads  to weight gain.

Sleep researchers from Stanford University agrees that there is a great hormonal change in the body due to sleep deprivation , but for them ,more important factor is lack of exercise. According to them, if the extra hours spent awake were used in a more productive manner such as, doing exercise, people would not see any distinctive weight gain. So, although there are certain changes in hormonal status , sleep deprivation does not necessarily lead to weight gain.

And this perfectly make sense for me. We should less rely on fast weight loss treatments and miracle pills and instead we should correct our diet , have regular exercise and of course enough of sleep during the night. If we all stick with those simple , but yet effective rules I believe rising obesity problem will be reduced. After all, it’s your life and you should make a decision.


How to Make Her Pass Out From Orgasm Pleasure Using 2 Deadly Tips

If you’ve always been mediocre in the art of making love to your woman then it is time that you learned about the two most deadly tips to make her pass out from orgasm pleasure. Read further to find out about these two tips and also learn to master them. These tips will change the way your girl looks at you after this.

Deadly Tip #1

For your very first tip you have to employ the art of oral sex. Unlike men, women have an intricate anatomy and each part needs to be taken care of to make certain that she passes out from her orgasm. Learn to lubricate her clitoris and keep teasing it during the whole time and when she does have her orgasm she will definitely pass out

Deadly Tip #2

During the actual penetration choose a position that gives you enough access to both her clitoris and her g-spot. Make sure you hit the g-spot well and stimulate the clitoris simultaneously. This will ensure that not only she passes out from orgasm pleasure but also passes out multiple times. If need be choose the missionary position because this position will help your body work on her clitoris while your penis works on her g-spot.

This position will also help you control your orgasm and give your girl long lasting pleasure. Try these two deadly tips and look at the transformation in your woman. She will start loving and respecting you more and she will want more of you and what you can do in bed.

Besides the Lungs, Other Organs Affected by Lung Cancer

Unfortunately for many sufferers, lung cancer is seldom diagnosed when it is in its early stages, and is usually only discovered by accident when either a routine chest X-ray, or a CT (computer tomography) scan is ordered by a doctor for another health issue. Some 25% of all lung cancer sufferers tend to show no signs of having lung cancer present, meaning that when the disease is eventually diagnosed, it is usually in its late and final stages. Other organs in the body at this stage have also usually been caused some degree of damage. This damage is usually permanent.

As the disease develops within the lung, the outer tissues of the lung are invaded by cancerous cells, as are other nearby tissues. This development enables the lung cancer to be able to spread to other organs in the body with relative ease. The disease can infiltrate the liver and adrenal glands, which often occurs over a period of time without any noticeable symptoms to the sufferer. When symptoms of visual problems begin to occur, it is usually because the lung cancer has spread to the brain, which may cause the sufferer to have a seizure. A loss of strength may also be noticed.

Bones can also be affected by lung cancer, usually noticeable with a discomfort in either the vertebrae (backbone), or the ribs and thighs. The nerves can also be attacked, which causes many sufferers to experience continuous aching pains in the (deltoids) shoulders, and a pain that runs along the outer side of the arm. Vocal chords may be affected when the cancer has spread to the esophagus (the conduit that connects the mouth and stomach) causing difficulty in swallowing. This is usually caused when a portion of the lung has collapsed, resulting in a severe, difficult to treat lung infection.

Other common symptoms caused by lung cancer are a lack of appetite, a noticeable weight loss (usually occurring rapidly), headaches, sluggishness, memory loss problems, bleeding and clotting. These symptoms often go untreated for long periods of time before a sufferer feels the need to deal with them, as they often get associated with other less serious health issues. When a sufferer has been diagnosed with late stage lung cancer, most of the damage has already been caused to the body, resulting in a sufferer having a low prognosis (life expectancy), usually under five years from when the disease was first diagnosed.