Book Review: BMA Concise Guide to Medicines & Drugs

Following recent purchases, Lydia and I have decided to conduct a short book review on the British Medical Association's Concise Guide to Medicines & Drugs. We are both intending to follow different career paths and we therefore thought having both of our opinions in one article would allow for a more rounded review of the book.

Jonathan's Review:

The copy which
Jonathan uses.
With the intention of studying Medicine and pursuing a career as a Doctor, I decided to purchase this book to increase my awareness and knowledge about prescription and over-the-counter drugs; with a purchase price of £2.99 I found the opportunity hard to turn down!

The book features over 2,500 drugs with detailed information for each one including: general information, dosage instructions, adverse effects and conflicts with other medication. Not only this, but the book includes a simple to use indexing system which makes searching through the drugs fast to complete.

For the first 110 pages, the book explains the different major drug types there are, with information on how the drugs work within the body and what intentions the drug taking is meant to have. I found this section of the book highly useful as I believe that knowing why a drug is used is essential for professionals to confidently prescribe medication. One particular feature of this section which appeals to me is the use of tables to list common drugs for certain drug types - an example of this being the table on page 61 which lists antibiotics and the areas of the body which they can be used to treat (e.g. Co-trimoxazole being used for infections in the respiratory tract as well as the kidney and urinary tract).

Due to the sheer amount of information which is held within the book, as well as the simple to use index means that I enjoy using this book and means that I would happily recommend it to anybody interested in learning more about the drug types there are.


Lydia's Review:

The copy which
Lydia uses.
My aspiration is to study Pharmacy and therefore this book is well suited to my interests in learning about medicines and their action within the body. Intrigued by the the mechanism of action of drugs, I decided that this book would be ideal for me as it not only focuses on the chemical interactions of drugs, but it also explains the application of them. 

Through reading the detailed descriptions of each drug, I have learnt some new terminology and some of the nomenclature of drugs - an example of this being that antibiotics often end in 'cillin' (e.g. Amoxicillin). Adding to this, my edition of the book includes a small section of First Aid; despite this not being directly related to medicines and drugs, I find this section useful as a brief knowledge of general First Aid can link in with some drugs whilst also giving me the knowledge to help others in the case of an emergency.

The book also includes brand names for each generic drug - I found that by including this, the commonly mixed up names were clearly categorised into generic names and brand names. In addition to this, the book lists profiles for vitamins and minerals which explains the importance of each substance whilst also describing the symptoms of deficiencies; this is an area which I initially did not expect inside the book, however I have found it very interesting to read as these are lifestyle health issues which can often be reversed by changing a diet rather than through the use of medication.

Overall, I find this book extremely interesting to read and considering that the knowledge learnt from this book could benefit my future studies makes it a worthwhile purchase. The only improvement I can think of is for more diagrams and images to be included however this is not essential - I would definitely recommend this book!



ISBN - 10: 1405393939
Paperback - 480 pages

Technology Update: Transplant of a "Dead Heart"

The Heart-in-a-box machine.
Following a transplant procedure two months ago, surgeons in Sydney have confirmed that the operation was successful and could be the beginning of a new standard procedure.

Two months ago, surgeons in Sydney performed a heart transplant  using a heart which had stopped beating for up to 20 minutes; this is unusual as most heart transplants use hearts from donors with a heart which is still beating. The complication with using a 'dead heart' is that without the heart pumping, a lack of oxygen is supplied to the heart muscle cells and therefore the cells can die resulting in a heart which cannot function.

To avoid this, the new method includes a machine named "heart-in-a-box" which restores the beating of the heart whilst also supplying the heart with warmth and nourishing fluids; all of these factors should enable the heart cells to survive and this will allow for the heart to be used in a transplant. It is believed that using these methods could save many more lives by increasing the amount of available organs (organs which previously had been damaged my a lack of blood circulation can now be considered for use if the procedure is carried out).

If this procedure continues to prove successful through testing with different organs, the breakthrough could have significant effects across the globe. Having this could increase the number of organs which can be used for transplants - as organ donations are already in short supply, this increase in organs saved is highly important. Alternatives to organ transplants are not always suitable so without these precious organs, patients may not survive. The decision whether this procedure could become standard procedure depends upon many factors including: the further testing results, the financial implications and the availability of resources to continue this.


To join the Organ Donor Register, click on the image below:



For further reading, see:

The Independent Report: http://www.independent.co.uk/news/science/australian-surgeons-perform-first-successful-dead-heart-transplants-9816729.html

TransMedics' Website: http://www.transmedics.com/wt/page/index


First Aid Fridays - Toothache

Welcome to a series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article on Fridays explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.


The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.


Toothache develops when pulp inside a tooth becomes inflamed due to dental decay. If the condition is left untreated, the pulp may become infected which leads to a throbbing pain; the infection inside the pulp may also spread to the mouth and jaw if left untreated.

Recognition Signs:

- A throbbing feeling which causes pain in the mouth.


Procedure:
  1. To reduce the feeling of pain, painkillers may be given. If the casualty is an adult, they may take the recommended dose of paracetamol (or their usual painkillers); if the casualty is a child, they may take the recommended dose of paracetamol in either tablet or syrup form.
  2. Give the casualty warm compress which they can apply to the affected side of the face - ensure that the compress is not too hot otherwise burns may occur. Ideal compresses include hot water bottles wrapped in towels.
  3. If available, a plug of cotton wool can be soaked in oil of cloves and this can then be held against the affected tooth. The oil of cloves acts as a local anaesthetic.
  4. If the pain persists or worsens, advise the casualty to seek medical assistance from their dentist.

Apply a warm compress to the affected side.

For more information, see page 225 of the DK First Aid manual.

Could intestinal bacteria help catch criminals?

Earlier this year I was given the opportunity to observe at an embalmers. Whilst there I was surprised to find that many of the bodies had green abdomens and chests. This is as a result of the 'friendly' bacteria in our intestines.

There are more than 100 trillion bacterial cells within our intestines. They have a constant supply of food, but also aid in the breakdown of food as it passes through our digestive systems, and help to keep pathogens at bay by outcompeting them.


When we die, however, the muscles within the intestines relax and the bacteria is released. It colonises tissues, starting with the large and small intestines, and feed off of carbohydrates, amino acids and lipids secreted from dying cells. This can take anywhere between 24 hours and a week, but eventually gives the cadavers their gorey green colour.

The structure of a bacterial cell
However, a recent article in New Scientist divulged the results of an investigation into intestinal bacteria, or thanatomicrobiome, and how they behave after death. It was discovered that, since there is a lot of variation in thanatomicrobiome between individuals, this could be used in forensic sciences as a new form of identification.


Intestinal bacteria can be analysed and matched to bacteria found on the clothing of missing persons, for example. Furthermore, analysis could prove vital for murder trials; if bacteria surrounding a victim does not match their thanatomicrobiome it could be indicative that the body was moved.

While the investigation into thanatomicrobiome is ongoing, it has already made new breakthroughs. 'The microbiome of a cadaver is an unknown data set in biology' according to scientist Sibyl Bucheli and, even if no medical or forensic uses are proven, the investigation will allow for thousands of new species of bacteria to be catalogued and studied. I think that this is going to become an important new forensic technique and could yield many more new scientific discoveries in the future.

First Aid Fridays - Insect and Arachnid Bites

Welcome to a series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article on Fridays explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.


Following recent news stories about multiple spider bites which have been life threatening, I decided to publish today's article about insect and arachnid bites as they can be treated in a similar manner. Bites from some animals such as spiders and mosquitoes can cause serious illness and may even lead to death if not treated promptly and correctly. If the bite takes place in the mouth or throat, be aware that the swelling from the bite may obstruct the airways of the casualty.

Recognition Signs:

These signs can vary dependent upon the species of the biter.
- Pain, redness and swelling around the site of the injury.
- Nausea and vomiting.
- Headaches.
- Allergic reaction/anaphylactic shock.


Procedure: 
  1. Reassure the casualty and encourage them to either sit or lie down.
  2. Elevate the affected area and place a cold compress onto the injury. Apply this for at least 10 minutes to minimise the risk of swelling.
  3. Monitor the vital signs of the casualty for at least 15 minutes - if the casualty develops breathing difficulties or appears to have an allergic reaction, contact further medical assistance.
  4. Call for emergency medical assistance (by calling 999) if the casualty shows signs of anaphylactic shock or has been bitten by a red back spider or a funnel web spider.
Redness and swelling due to a
spider bite.

For more information, see page 213 of the DK First Aid Manual.

The Brain: Neurons and Glial Cells

The Brain is composed primarily of two different types of cell: The Neuron, which acts as a cable through which electrical impulses travel through the brain and the entire body, and Glial Cells, which perform many functions to support the neurons. 
Above is a diagram of a basic neuron and it's components. A neuron has many basic cell components such as mitochondria, endoplasmic reticulum and others that you may know about if you study AS Biology. Besides from these, neurons also have many unique organelles which I will now describe:

Dendrites - dendrites carry nerve impulses to the cell body.

Axon - an axon is the long fibre that makes up most of the length of a neuron. Electrical impulses travel away from the cell body and down the Axon to the terminal endings.

Myelin Sheath - this is, in essence, an extremely extended plasma membrane that is wrapped around the Axon. The Myelin Sheath electrically insulates the axon.

Nodes of Ranvier - The nodes of ranvier are gaps in the myelin sheath. Gaps are usually between two and three micrometers and occur ever one to three millimeters.

Terminal Endings - Terminal Endings (or Axon terminals) are where the electrical impulse leaves a neuron in a chemical form, which travels across a synapse and then to another neuron.


There are three main types of neuron:
- Sensory, transmits nerve signals from a receptor to a motor neurone.
- Motor, transmits signals from a sensory neurone to an effector such as a muscle.
-Immediate, transmit impulses between neurones.





Glial Cells
For a long time, glial cells were believed to be of not much use, but it is now believed that they perform quite a few important functions. The glial cells generally work to keep the brain in a good shape, which they do in a number of ways:
- Removing dead neurons
- Removing dead pathogens
- Supply neurons with vitals such as nutrients and oxygen
-Supporting the structure of the brains by keeping neurons in the correct place.



Medical Myths and Misconceptions: Week 1

Welcome to my new series on Medical Myths and Misconceptions. Fact and fiction surrounds us in our everyday lives, however;  how do we sort the truth from the lies?  Over the next ten weeks, I will be looking at some common medical myths and misconceptions, and why they simply are not true. So let us begin!

This week's myth: Waking a sleepwalker does harm to them.

Sleepwalking (also known as somnambulism or noctambulism) is a sleep disorder belonging to the parasomnia family.  Sleepwalkers arise from the slow wave sleep stage in a state of low consciousness and perform activities that are usually performed in a state of full consciousness. These activities can be as simple as sitting up in bed, walking to the bathroom, and cleaning, or as dangerous as cooking, driving, etc. Sleepwalking may last as little as 30 seconds or as long as 30 minutes.

Where does the myth come from?
The myth: 'Waking a sleepwalker does harm to them,' is an ancient belief. It was once widely thought that the soul leaves the body during sleep. Therefore, if a sleepwalker was to be woken up, they would be, in essence, a body without a soul. This led to the belief that if you were to wake up a sleepwalker, you would cause them significant harm, or even death.

Why is it not true?
We now know that waking a sleepwalker does not harm them. However, it is possible for them to become confused or disorientated for a short time. This is because, when waking someone from a deep sleep, they may suffer some cognitive impairment (sleep inertia). Furthermore, it is more likely for sleepwalkers to harm themselves if they trip over objects or lose their balance whilst sleepwalking, then for us to harm them. Such injuries are common amongst sleepwalkers.

What should I do then?
If you come across a sleepwalker, it is often recommended for you to gently guide them back to bed without waking them. In this way, you do not risk any harm to the sleepwalker, or to yourself.

Definitions
  • Parasomnia: A disorder categorized by abnormal or unusual behavior of the nervous system during sleep
  • Slow wave sleep: (SWS), often referred to as deep sleep, consists of stages 3 and 4 of non-rapid eye movement sleep
  • Sleep inertia: A phycological state characterized by a decline in motor dexterity and a feeling of grogginess immediately following an abrupt awakening.

Technology Update: TB Breath Test

This is a series featuring short posts about the latest advances in medical technology.

Tuberculosis.
Researchers from the University of New Mexico have investigated and developed a new method to recognising the presence of Tuberculosis in living organisms. Tuberculosis (abbreviated to TB) is a bacteria which is believed to infect around 8.6 million people a year; leading to 1.3 million deaths. This is the world's second largest killer, yet the bacteria can be overcome through early recognition and treatment using antibiotics.

The research team decided to utilise the fact that the TB bacteria emit a unique odour when exposed to antibiotics. Isoniazid is the
antibiotic used, the drug is activated by the TB enzymes and this is when the odour gases are released. The emitted odour is then analysed using a mass spectrometer - if the unique gas is present in the sample, then the organism has a TB bacteria infection.

Compared to current methods, it is obvious that this test is beneficial as it takes only 10-15 minutes for a result to be given whereas current methods can take up to six weeks. However, it has not yet been proven that this works within humans; testing has only occurred within rabbits so before this method could be implemented into hospitals, this further testing with humans must take place. Not only this, but it must also be considered that this test cannot be used on its own - the test only detects Isoniazid sensitivity and therefore it can only be used in conjunction with other tests.


For more information, read the published journal:
http://www.nature.com/ncomms/2014/140923/ncomms5989/full/ncomms5989.html

World's Biggest Coffee Morning

Today, Friday 26th September, is the World's Biggest Coffee Morning hosted by Macmillan Cancer Support. Macmillan is one of Britain's largest charities. It provides specialist health care, information and financial support to people affected by cancer. In this short blog post, I will be looking at the story behind Macmillan's Coffee Morning, and why you should support it.

Cancer is the toughest fight most of us will ever face. And as treatments improve, more people are living with it in their everyday lives. In order to help make sure that no one faces cancer alone, it is important for us to support these all important organizations.

In 2013, 154,000 people signed up to the World's Biggest Coffee Morning and raised a record £20 million. This year, however; it is important the we raise even more money to help further change the lives of people affected by cancer.

What is it all about?
The World's Biggest Coffee Morning is Macmillan's biggest fundraising event. They ask people across the UK to hold a coffee morning and raise money for people living with cancer. All donations on the day are made to Macmillan. These donations help support people, and their families, affected by cancer.

How did it start?
It started in 1990, when a local fundraising committee decided to hold a coffee morning. People came along to meet and mingle, as many people ordinarily do, but donate the cost of their coffee to Macmillan in the process. It was so effective that it was suggested that the model be taken up nationally. The first National World's Biggest Coffee Morning was in 1991. Since then it has raised over £113 million.

How do I get involved?
There are plenty of ways you can get involved. Although it might be too late to hold your own coffee morning, you can still support those in your local area. Here, at Ashby School, we are holding a coffee/cake sale. You could also donate to Macmillan.

And remember...

'Every coffee poured and every cake shared means someone facing cancer will have the Macmillan support they need'.

First Aid Fridays - Animal and Human Bites

Welcome to a series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article on Fridays explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.


This is an injury which is less common but can have severe consequences - bites from sharp teeth can cause deep puncture wounds that damage tissues and can introduce germs. As the skin is broken, prompt first aid is required due to the increased risk of infection. Medical advice should be seen immediately following a bite due to the possibility of infection leading to rabies, tetanus, hepatitis and even HIV/AIDS.

Recognition Signs:
- A skin breaking bite mark - try to identify the animal which performed the bite. 

Procedure:
  1. Wash the bite wound thoroughly with soap and warm water in order to reduce the risk of the infection.
  2. Elevate the wound and support it to reduce the blood flow in order to slow any bleeding. Pat it dry with a clean gauze swab and then apply a suitable sterile dressing.
  3. Arrange for the casualty to go to hospital if the wound is large or deep. If the casualty is not going to hospital, advice the casualty to seek medical advice regarding the risk of infection.


For more information, see page 211 of the DK First Aid manual.