All Scrubbed Up

More Ubuntu stuff soon... Keep reading! Some important news though... just in. It happened the other day. Anything 900g or less must breathe by itself or die. There are reasons of course, like not enough staff or intubators. Studies have also shown poor prognoses in lower grammages. Therefore those with a higher chance of surviving - will get the intubators. This one is 3500 grams. Makes you think. Doesn't it?

To all our readers... And a great New Year...

Andy eventually got me to sit down and give some prelim views. The trickiest thing, if you REALLY want to make a difference in South Africa is planning. There are a couple of lovely third world things that get in the way: *Politicans *Egos of management *Distribution *Concentrating on PATIENT MANAGEMENT, not financial management. * Training *Training *Training For instance, if the open source community can help with the situation I'm about to describe, and just this, you have no idea how much of a difference it will make to primary healthcare in this country. Build the "system" so it can be grown, sure. But little steps is the only way you'll get anywhere in a third world country. Here's the situation. Primary healthcare patients (GP-based needs, meant to go to clinics, both rural and metro BEFORE they get referred up to secondary and tertiary centres - where they would get seen by specialists and clog up already clogged hospitals) HAVE to carry around a green pie...

So far, our little post-on-a-whim "Ubuntu across the medical industry" idea has been featured on (and mighty thanks to!): Linux Today Centromimir.IT Centromimir LiveSpace Shashum.Com.Ar The Open Source Pimp Netscape Redtram Linux Medical News Africa By Art We've also started doing a bit of digging... nothing like a good idea to inspire some late night surfing-with-purpose... Mercy Hospital Opens Arms to Open Source... (Tina Gasperson) "For almost 100 years a group of women called the Sisters of Mercy have been instilling a spirit of excellence into Baltimore's biggest hospital, appropriately named Mercy. Right from the start, the Sisters have made it their goal to push the medical institution beyond the ordinary by creating teaching affiliations, feeding the hungry, building state-of-the-art emergency services, and launching a neighborhood health center for the inner-city poor. In today's world, all that excellence requires a solid technology infrastructure-...

Hello chaps... Thanks for all the interest shown in the Ubuntu story so far. We are quite serious about pursuing the merits / sustainability of such an idea - with a view to handing over implementation to a non-profit... Any feedback would be greatly appreciated. A special thanks to the first couple of people to prick up their ears: Mike Stopforth , Aaron and Farrel . We'll keep gathering interested parties together and see what happens. That's usually how these things start. Things we're particularly interested in, and will research for a couple of new year posts... 3rd World PC Projects. Who exports old PC's and to where? Sustainability. Nothing is for free anymore. If the idea on the table allows national collaboration in the medical field, and empowers the medical profession to be more efficient - who pays the bills? Software. I'll bring SA Doc into the fold here - we need to figure out firstly, what do hospitals / doctors / nurses ACTUALLY need in terms of soft...

The start of the argument about Health 2.0 got me thinking. As sexy, functional and efficient as the health software trend may be - I think we all agree on the fact that it's just not applicable in the African context... yet. So what might be applicable? SA Doctors need lab results, need to do research, need to store and retrieve patient records (on demand)... How do you get a connected, low cost, easy to use, low maintenance technology infrastructure into South Africa's hospital system? And then keep it there? We've been using Ubuntu Linux (a proudly South African distribution of the Linux operating system - with our very own billionaire Mark Shuttleworth as the brains) around the office a bit - mainly to do tricky techy stuff, but I've been absolutely blown away with the new version (6.06 I think). It's funky, it's African, it's VERY easy to use (provided you don't mess with settings / use installed packages - which are more than ample for everyday u...

Software like Click 4 Care is a great idea if you were trying to manage a million dollar medical aid company or private hospital. In fact I'm sure Discovery and Netcare already have something similar. But in the public sector (where management in this country is needed most) it would never happen. The Public Sector can't seem to even afford to keep the Pentium 1's running (and thus provide us with lab results)... How on earth would they manage to network entire systems and then control/manage them? Great idea in the 1st world.... but alas, Africa will just sit and look from the side line again.

It's arrived. Just when we're truly sick and tired of Web 2.0, Business 2.0, Consumer 2.0. Agh! Drumroll please... Health 2.0 Just what is it? Will have to find out. Here is, apparently, an example (got this off The Health Care Blog - worth a read). Click4Care is a relatively new software company (although a lot older than most of those Health 2.0 companies I've been featuring) that’s spent a lot of time building a very, very complex system for what can broadly be described as care management, sold primarily to plans and payers—with United HealthGroup being the marquee customer so far. Hmmm. Will wait for SA Doc to wash off the snot - and take a look at what this means in a South African context. (SIDEBAR: SA Doc is on call at Coronation Hospital tonight. Thinking I should encourage a blow by blow pictorial of 8pm to 7am in the scary kiddy ward?)

Har Har. Good one. More here .

No, we're not dead. Just too many Christmas snotty noses and Blogger Beta is giving us a LOT of hassles!

There's a dearth of medical news. SA Doc is treating snotty noses and stress... and I'M NOT EVEN A DOCTOR. But I can find funny doctor stuff. Har Har. This one's peachy. Artery - The study of paintings. Benign - What you be after you be eight. Bacteria - Back door to cafeteria. Barium - What doctors do when patients die. Cesarean Section - A neighborhood in Rome. Cat Scan - Searching for Kitty. Cauterize - Made eye contact with her. Coma - A punctuation mark. Dilate - To live long. Enema - Not a friend. Fester - Quicker than someone else. Fibula - A small lie. Hangnail - What you hang your coat on. Impotent - Distinguished, well known. Labor Pain - Getting hurt at work. Medical Staff - A Doctor's cane. Morbid - A higher offer than I bid. Nitrates - Cheaper than day rates. Node - I knew it. Pelvis - Second cousin to Elvis. Post Operative - A letter carrier. Rectum - Darn near killed him. Seizure - Roman emperor. Tablet - A small table. Tumor - Mo...

Har. Har. More here .

Vindicated! Yes! I wasn't as much of a zealot as I thought I was . The DSTV Streetpole ad series that featured pouty-lips Rihanna with a subheading 'Be Unfaithful' - of couse referring to decoders at a special special low price... has been changed. It now says Visit Paris . That's clever, while not encouraging promiscuity. Win win. PS. Buhle Dlamini wrote a piece for Business Day on the same subject. Published 5 December. Self-congratulatory pat on the Scrubbed Up back for scooping the story by 15 days !

Andy's post (Google Health... some thoughts) , although opinionated and not medically based - is correct. I understand and support the notion that a patient HAS to be educated. They take their pills regularly, they look after themselves, they’re more compliant patients if they understand what’s happening to them. But... What’s wrong with the Internet is that patients have no guidance on what they’re educating themselves with – what to hold onto vs. what to discard. They end up wrongly informed – which is far worse than not informed at all . I worry about Google's content rating system. You’re asking non-medical, ignorant people to judge the relevance of medical content. There’s a reason doctors study for 6 years and then practice for 2! It’s like me trying to make a judgement on the performance of the latest BMW – I just don’t have a clue! Prime Example . Had a patient the other day who’s 6 year-old daughter has rectal prolapse. She’s been seen by a GP and paediatricians and ...

Here's something. Reading an article on the Official Google Blog called " Health Care Information Matters ". This is a really fascinating argument that seems to be resurfacing. Interesting link back to the TV Doctor Showdowns that we've been doing... House MD has been making a LOT of jokes in Series 1 and Series 2 about the danger of patients diagnosing themselves. Ah, the Internet. Diagnosis tool of the future. No, you don't have "insert-ridiculously-rare-tropical-disease-name-here"! So, Google is getting in on the action. Their blog post says: In the end, one key part of the solution to these problems is a better educated patient. If patients understand their diseases better -- the symptoms, the treatments, the drugs, and the side effects, they are likely to get better and quicker care -- before, during, and after treatment. We have already launched some improvements to web search that help patients more easily find the health information they are l...

Just realised I don't know any more TV doctors. Well enough to write about them at least. Thinking of adding Dr. John Dorian (Scrubs) to the contestant list - but I used up my "Appletini, STAT!" picture... and that just ruins the comedic value of the post. I've got the one above, but those shifty eyes... Then there's George Clooney (so hot!) and a couple of others. Further research and some DVD box sets needed. The Showdown will continue at a later stage. In case you missed out, here are the current contestants, in order of merit: Dr Perry Cox (Practices in Scrubs and scored 6 / 10) Dr Gregory House (Practices in House MD and scored 5 / 10) Dr Meredith Grey (Practices in Grey's Anatomy and scored 4.25 / 10)

This word, STAT has always bemused me, being around Doctors so much. STAT. What is it? It sounds so doctory... We all know what it means, but can only the cool doctors say it? Or is it part of medical vocab and something more serious. Good 'ol SA Doc tells me it NEVER gets used in the South African context. Porter! Move that bleeding patient. STAT! Unlikely. So, turned to AskYahoo (nice service by the way) for an answer. We've all heard the harried medical team on ER call for something "stat." From the context, we knew it meant "quickly," but had no idea what the normal definition of the term was. We turned to the Net to cure our ignorance. After various searches on phrases like "stat terminology" and "stat meaning" failed to provide an answer, we sat down and rethought our strategy. Several of our searches had turned up acronyms for the term, and while they weren't what we were looking for, they did point us in a new direction. Reme...

Great fan of the NHS Blog Doctor - such a spoofy, yet real insight into a health system where you have to get a consent form before giving an injection! Here's to hoping that Dr John Crippen Esquire - take's a look at some of the fantastic medical blogs coming out of South Africa! Read more here... NHS Blog Doctor: The BritMeds Or take a turn by some of SA's finest... All Scrubbed Up (you're on it, wombat) Just up the Dose (angsty, studenty, funny) Try not to Kill yourself this Year (pity it's closing) I actually thought there were a couple more when starting this post. Hmm. Any others out there? I'm sure I'm missing a bunch...

This All Scubbed Up series gets underneath the fake blood, fake smiles and excessive use of shock paddals… Who? Dr Gregory House MD His Playground? House MD An impersonal genius who harks back to the glory days of chauvinistic medicine. Hot or Not: [3 out of 10] – No better looking than Dr Cox. I might get hit with the cane if he doesn’t like this answer. Apparent Medical Skill: [8 out of 10] – A few good ideas, and a lot of luck. Excessive use of trial and error method. The bugger often treats up to 6 differentials - poor patients end up undergoing numerous cardiac arrests, seizures and anaphylactic reactions. Seizure hit-rate way too high for one doctor! Bedside Manner: [3 out of 10] – Issues with race. Obsessed with white boards and black markers. Patients would hate him. Students would be amused… and then terrified. No-one likes the guy who says what we’re all actually thinking. Horrible rash, Dr House. Well, that’s fine, at least he won’t have to live with it for more than a...

Spotted in The Saturday Star , a wonderfully non-investigative lambasting of Energy Drink Cocktails. Hold on tight - this one's gonna get tabloid. Firstly, let's state the obvious. People who drink a lot, don't remember what happens to them. Duh. Yes, by adding stimulants like caffeinated energy drinks, you're slightly masking how drunk you really are. But the cold hard truth remains, it's not the energy drinks causing young girls to wake up in a stranger's bed - it's the 7 vodkas that got mixed with it. Nothing has changed . You drink 7 vodkas. You get plonked. So, let's analyse. The article reads like a high-school scare poster. BIG warnings about drinking energy drinks, going to the bathroom in pairs an avoiding scary men... but coffee and espresso cause the same medical issues! If you suffer from high blood pressure or pre-existing heart disease, even a wild afternoon in the coffee shop can be as dangerous. What they say is vague and generic enough t...

This All Scubbed Up series gets underneath the fake blood, fake smiles and excessive use of shock paddals… Who? Dr Perry Cox. His Playground? Sacred Heart Hospital , Scrubs . With quotable quotes like: “ God? My brilliance is becoming quite a burden… ” Ol’ Perry is fighting for first tee-off in the I-Am-God-Fourball (with Gregory House MD… of course). Hot or Not: [4 out of 10] – He takes his shirt off all the time. Which is OK. But doesn’t lift him out of the realms of George Clooney’s ugly cousin. In fact, he’s not the eye candy I watch the show for ( Dr. John Dorian has those crazy eyes!) Apparent Medical Skill: [8 out of 10] – It’s a swoop in, swoop out, recite the diagnosis and the differentials type affair. He’s the typical Physician who knows his stuff. Has uncanny ability to impart wise teachings while belittling the life out of you. Make him your doctor. Don’t beat him at basketball. Bedside Manner: [3 out of 10] – Has strange ability to extend one word into unusual am...

So, Google Maps just opened its warm capitalist arms to South Africa. We took a quick trip to show the world of blogging... Baragwanath Hospital. Old Bara is apparently the biggest hospital in the world by bed count. It's also the most multi-cultural Doctor-fest around. SA Doc had a Russian, Yugoslavian, Pakistanian, Congonese, Indian and 4 South Africans... just in one unit! Feast your eyes ladies and gents. Note size of shacks bottom left and houses middle top. Just under 2km in diameter - no wonder the porters laze off.

This All Scubbed Up series gets underneath the fake blood, fake smiles and excessive use of shock paddals… Who? Meredith Grey. Her playground? Grey's Anatomy . Something about Meredith is just so flaky. I don’t know whether it’s the raspy possum-like voice used to narrate her way around the pitfalls of sleeping with her colleagues… Or, the mousy I- wish -I-was-the-girl-next-door looks. Let’s be fair. It’s just the first season. Hot or Not: [6 out of 10] – You kinda think she would look hot. And then she kinda does, but kinda doesn’t. I just don’t know with this one. It’s hot, but condescending I-went-to-a-better-private-school-than you hot. Apparent Medical Skill: [5 out of 10] - Maybe as a psychiatrist she’d get a higher score. Although definite minus points for having a cry while shagging the shy doctor (George). Was expecting a better performance out of dear Meredith. With that name, and those “mature” looks – she must have bummed around as a Chicken Licken sales lady befor...

A DSTV StreetPole ad recently caught my attention. In true DSTV style, it offered out some big words, some sexy pictures and a great special on decoders. It was the words that got me thinking. Score Big. Go Wild. Be Unfaithful. DSTV R599. The Be Unfaithful portion of that ad came complete with smacker lips Rihanna looking seductive (pretty sure it was her). You can't really fault the ad (can you?) - because then you'd have to fault every magazine cover and E! Entertainment programme this side of 1989. But it does get you thinking though. In public media, where do you draw the line between sexy, suggestive tease and promoting unsafe behaviour? We live in a country that is more uneducated regarding sexual issues than we care to admit. Just where and when, I wonder, should the public start asking questions? Or am I just turning into an HIV zealot?

It’s nearing that time of year again. Med Students getting sweaty, trying to cram 6 years of lungs, guns and antibiotics into a mind already warped by the smell of formaldehyde. They’re dosing up on whatever they can get there hands on (with the imminent promise of Schedule 5+ if they can just… get… through… this). That’s because, after November at the University of Cape Town – 6th year medical students become DOCTORS. The class of 2003 used to mark these momentous yearly occasions with their own brand of cleansing ritual. The whole class, dressed to theme (Doctors by Day, Victoria Secret by Night was my personal favourite), would flock to an arbitrary building on the side M3. They would quickly and clinically get themselves boozed… and flash the traffic. This wasn’t any ordinary flashing of the traffic. With stethoscopes flying, lab coats swirling and SA’s finest wiggling their jiggly bit – the event made KFM news 3 years in a row, and was responsible for more than a few dented bump...

Recently spotted on BodyHack , a Wired Magazine blog about medical stuff. Raised the heckles a tad, no? "In some cases the best way to fight a fire is to light a fire of your own. But could the best way to fight AIDS possibly be with AIDS? Researchers at the University of Pennsylvania are testing the idea that a modified strain of the HIV virus, called a lentivirus, could be turned into a sort of anti-AIDS guided missile that could directly target the HIV virus already in patients. Naturally safety was the primary concern. The Scientist reports: One safety concern with using lentiviruses as gene delivery vectors is that they might form replication-competent lentiviruses, but Levine and his colleagues found no evidence of this in any of the patients. Another concern is vector mobilization, which the researchers saw in the first 60 days after injection, but not after that. This mobilization probably doesn't mean the vector isn't safe, said Richard Sutton of Baylor College o...

And to end of this Tuesday with a bang (and because no-one died today, or ran around parading a venereal disease) - here's some rather chuckly medical "notes" blunders... Pilfered from Medical Jokes . I guess this is what happens when the bad handwriting thing gets out of control. Note to self: Idea for further blog posts... Scan copies of scripts / notes and have a handwriting competition. Stereotypes, my ass. 1. The skin was moist and dry. 2. Rectal exam revealed a normal size thyroid. 3. The patient had waffles for breakfast and anorexia for lunch. 4. She stated that she had been constipated for most of her life until 1989 when she got a divorce. 5. Between you and me, we ought to be able to get this lady pregnant. 6. The patient was in his usual state of good health until his airplane ran out of gas and crashed. 7. The lab test indicated abnormal lover function. 8. The baby was delivered, the cord clamped and cut, and handed to the pediatrician, who breathed and cried...

Nope. Not part of the Anarchy Cookbook on interesting ways to heat up an anti-inflammatory - but rather some pharmaceutical DRM (that's Doctor Relationship Management for those in the know). The Wicked Food Cooking School played host to the latest round of Novartis talks on Prixige's Lumiracoxib - the Cox2 inhibitor (not as rude as it sounds) to end all Cox2 inhibitors - or so they tell me. The introductory speech washed over me like morphine - very few intelligent questions from the nonDoc. Except one interesting case scenario: 56 year old banker. Presenting with Osteo-Arthritis in the knee. Panado just wasn't cutting it because the poor bugger was walking 5km, 4 times a week. Stop me when it's starting to sound like crazy talk... but what 56 year old South African banker has the time to walk 20km a week!? God is in the details after all. Turns out the answer was easy. Prescribe Lumiracoxib . (PS. That's why doctors are so smart... you can only prescribe Lumirac...

Ran across this video on YouTube... And instead of making up a thousand reasons why I should link to it, it kind of brought up the whole issue of medical ethics. Our friend, Ali, goes on about cloning, euthanasia and plastic surgery - with his own unique brand of "bedside manner". He leaves out one of the most important issues though, one that people don't really think about. Do doctors strike? Can they? A couple of months ago, a whole bunch of Zim doctors went on strike - evidently $57 million a month was just not enough. It seems they had to bring their own scalpals to work, which cost $58 million. Ah, what can you do? Seriously though. Good on them. And better on them for sitting in the hospital pub for all but the most critical of patients! Do our hospitals even have pubs? A quick search revealed basically nothing. The closest we get is a pub 226m underground in a mine shaft in Gold Reef City. That shaft, used to have a hospital. I digress. Medical ethics is such a...

Right. As promised... the second post - bringing this whole sticky argument to a head. Cough. If you weren't convinced last time - three more points to try and sway it. 1. You will have a proven, lower risk of contracting STD's - not harbouring crawlies under there will help. 2. You therefore have a lower risk of contracting HIV. Less microtears. And, you did know that STD's and HIV like to hold hands? 3. And finally, come on guys, it just looks better! The "extra inch" it adds is more than compensated by the apparent increase in girth. Not much more we can say, aside from thanks for the comments that are still coming in about the first post. It's obviously a touchy issue. Cough. Some interesting foreskin envy links: - Artificial Foreskin - The Fate of the Foreskin: A Study of Circumcision? - Would you rather be circumcised or uncircumcised? - Speaking of Uncut - The Unkindest Cut of All: Circumcision no longer a popular choice?

Wah! Is this a joke? Is this a viral campaign? Is she a virus? No-one knows, but recently spotted on CherryFlava was a Manto video for the Pronto Condoms brand. She dicey, she's quick and she's more slippery than Zuma in the shower. Pranto Manto. Get the video here !

This is going to be a one-sided argument. Because I'm writing it. Do you have any idea the kind of gunk that can get underneath a foreskin? An unlopped, useless piece of disease-harbouring flesh? Shudder . Maybe I have weird friends, but this topic has come up more than once. There's always three sides. Don't cut it off. Have your parents cut it off. Have it be your decision whether you keep it or toss it (yikes!) Oh dear Lord, please don't start me on the pro-choice argument. Yes, we live in a world of free choice - but parents make medical decisions for their kids ALL THE TIME! Try immunisations on for size (yes - it's a choice, some people don't believe in the MMR shot). And to even name the foreskin argument over the much heftier Abortion Gig ? It's a whole different ballpark to the manky extra slinky inch. Do you really, really believe that having a foreskin gives you extra sexual pleasure? Aren't men battling to make the dreamy 10 minute mark anyw...

It's actually quite hard to find good medical cartoons on the Internet. A quick Google Image search yielded some horribly poor results. But... we try harder. A some good 'uns we did find! Hopefully courtesy of McHumor ! We don't have permission to reprint this - the nature of digital blog surgery being so quick and stuff - but kudos to the author / artist - and hope you like the publicity!

So, people are always bashing on our Minister of Health... including us on this blog, I suppose. But perhaps we should take a tiny step back, not slip on the magic condiments and have a look where Manto has actually done some good. For instance, when you're enjoying your next smoke-free dinner , courtesy of the glass cage that smokers are now confined to... Who do you have to thank? Manto! Did you also know? Our friend Manto is following through quite nicely on the process started by Zuma (not the showering one) to implement more Primary and Secondary level care in the country. Now, although that means less money pumped into ICU's, specialised surgery and specialised skills development - it does mean more access to primary medicines, increased immunisation and better preventative care. Small steps, but certainly the right direction. So, there's some Prozac at the end of the rainbow then? PS. Manto is still a complete idiot when it comes to HIV. The country despairs!

While she remains in the news , what has happened to that wonderful collection of wit, anger and HIV curing fruit? We lament the loss of www.firemanto.co.za . Why? Anyone know what's going on?

The South African Medical Fraternity has been buggered around for too long. We've been Manto'd through thick and thin. We've worked 90 hours a week. We've been stuck, jabbed, vomited on... and that was just yesterday! There's a story to tell. Just what exactly is underneath the gown? Join us to see the inner-panty of SA's non Cuban indsutry!