How to receive speedy Medical
Opinion from Mediescapes India ?.

1. Write to us your country / city name from where you are seeking medical opinion with your full contact details.

2. Send by email or by post copy of recent clinical observations / diagnosis / medical report translated into English.

3. Send images in JPEG file format.

4. Send us recent X-Ray's / CT Scan / MRI Scan's / Echocardiogram / Angiogram / Pathological Reports or a summery of observations on them.

“I found out that I needed an operation for a back problem which was causing severe pain to my left leg from the sciatic nerve. After speaking to my GP and realizing I was getting nowhere I decided to take the matter into my own hands as I could hardly walk. After speaking to private consultants and realizing that without private medical insurance I was not going to be seen to in this country without shelling out around £20,000 I decided to look elsewhere. I decided to look into having the operation privately in India and was fortunate to come across Mediescapes India. From my initial enquiry when I e-mailed my MRI results to Mediescapes India I was amazed ..more.”
- A Patient from UK

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How to Convert X-Rays to Digital Format to attach to an Email?

X-Rays on a CD in Dicom or .dcm Format

If you have your x-rays in a digital format on a CD,  then you can convert the DICOM  or .DCM images to .jpg images as follows:

Search the CD for any files having .DCM as the extension, you could write a search for *.DCM. If that returns files, then those are the ones that you need.

You can then download and install the little viewer "Irfanview"   http://www.irfanview.com  Also download the plugin for "DCM" that is available. Now you will have a perfect viewer and conversion program at your disposal.

Once you have opened the .DCM files from your CD with Irfanview, you can then save all the .DCM files in the popular .JPG format. The created .JPG files (named anything that you prefer) would ideally need to be brought down to a size of around 300Kb or make the width or height less than 600 pixels.  You can use Irfanview to resize the files or a photo editing program.  

If you can't find any DCM files on the CD, then hopefully some program is present on that CD that actually has a viewer and conversion ability.  

There are different varieties of software. If yours show a dotted or dashed line around the image, with a small dotted or dashed square in the bottom right corner, then it is an earlier DICOM software versions that you have to click on that square before you could export or save.  

Additional Free DICOM Converters

ABC Amber DICOM Converter     http://www.processtext.com/abcdicom.html 

You Convert It - Free media converter   http://www.youconvertit.com

X-Rays in standard film format

You can take a digital camera with you to the doctors and just take photos of the x-rays while they are on the fluorescent viewing box. 

You can also take digital photos of the x-ray film by holding the x-rays up to a window.  Put a sheet of white paper behind the x-ray if it is too bright. Choose a window where there is no direct sunlight.

The photos should be sized with either the height or width no greater than about 600 pixels. Use your favorite photo editor to resize the photos.

Save your photos in a .jpg format and attach to an email to send to a doctor.


Facts about Operating Room Line -up

Patients often do not put any thought into who will actually be in the operating room (OR) during their surgery. It may be surprising to know, that it takes a pretty large staff to perform even the "simplest" of surgeries:

  • Primary Surgeon - The physician who performs your surgery and is responsible for your overall care.
     
  • Second Surgeon ("Second Scrub") - A physician who "scrubs in" to assist your primary surgeon.
     
  • Surgical Assistant - A medical practitioner with surgical training, often employed by the surgeon.
     
  • Surgical Technician - A nurse with surgical training, often employed by the hospital to assist in the OR.
     
  • Anesthesiologist - The physician who is responsible for your medical care while you are under anesthesia.
     
  • Nurse Anesthetist - A nurse who assists in administering anesthesia, usually in the operating room.
     
  • Scrub Nurse - A nurse who "scrubs in" to assist surgeons with sterile procedures at the operating table.
     
  • Circulating Nurse - The nurse who is responsible for non-sterile tasks in the operating room.
     
  • Holding Room Nurse - The nurse who receives patients and prepares them for surgery in the preoperative area.
     
  • Recovery Nurse - The nurse who cares for patients in the post-anesthesia care unit (PACU) after surgery.

It is important to note that anyone present during a surgery is noted in the medical record and a patient does have the right to know who was present and what organization they are associated with.
(Hill, A.J., MD, PhD. The Patient's Guide to Anesthesia. New York: Kensington, 1999.)

About Anesthesia
Anesthesia can be defined as the loss of normal sensation or feeling. Anesthesiologists use drugs to produce this loss of feeling or awareness.

Types of Anesthesia

  • Infiltration - A local anesthetic is injected directly into the tissue where the surgery will take place. Many people encounter this technique in the emergency department, when a doctor injects local anesthetic before sewing up a cut. The same method can be used for a variety of minor procedures in the operating room, too. In these cases, although the injections may be performed by the surgeon him or herself, an anesthesiologist is often needed to monitor the patient and to give sedation or other medications that may be required during the operation.
  • Regional Anesthesia - Local anesthesia is injected around a major nerve bundle. This anesthetic method produces temporary numbness in a limited area of the body by blocking nerve impulses from that area. There are two types of regional anesthesia: peripheral nerve blocks, which involve a relatively small part of the body, such as an arm or a foot; and spinals and epidurals, which can involve the entire lower portion of the body.

"It's important to note that neither local infiltration nor regional anesthesia puts you to sleep. This means that, using either of these forms of anesthesia, you can have surgery comfortably while wide awake."

  • General Anesthesia - When most people think surgery, they picture this type of anesthesia, in which patients are put temporarily into a deep sleep. In practice, general anesthesia ranges from the relatively light levels used during minor surgery to the deepest levels used in major operations. The defining characteristics of general anesthesia is that, unlike infiltration and regional anesthesia, it acts primarily on the brain rather than on the nerves leading to the brain.

Anesthesia Care Team
The anesthesia care team is made up of an anesthesiologist and a nurse anesthetist. An anesthesiologist is a physician who has gone through four years of medical school plus an additional four years of training in medicine and anesthesia. A certified registered nurse anesthetist completes two years of nursing school after college plus two additional years of training in anesthesia. Normally, the nurse anesthetist stays through the entire surgery to make sure that no complications occur during the procedure.
(Source: Hill, A.J., MD, PhD. The Patient's Guide to Anesthesia. New York: Kensington, 1999.)

Mediescapes India

Patient Care after Surgery
Once a patient is moved from the operating room (OR), they will normally be taken to the post-anesthesia care unit (PACU). Most patients are awake during this transfer, though they hardly remember it. When the patient first begins to wake up, they will be confronted with a lot of strange sights and sounds. Often, the voice of a nurse is the first sound to be heard by the patient.

Patients will notice that they are attached to several monitoring machines, including a blood pressure cuff, which will squeeze their arm at intervals. They may also notice a loop of plastic tubing that passes over their lip and blows oxygen into their nose.

The main focus while a patient is in the PACU is monitoring their safety and comfort during their immediate surgical recovery.

In-Patient Care After the PACU
When a patient is moved from the PACU to their hospital room, it is common that their IV stays with them. "There are several reasons for this. Patients who have had major operations affecting their abdomen may not be able to eat or drink until their digestive systems recover, several days after surgery. During this time the IV can be used to supply them with fluids and nutrition. Intravenous medications can also be an effective method for pain relief after surgery."

Out-Patient Care After the PACU
Patients who have had an outpatient surgery performed are often moved to a secondary recovery area where they can relax and complete their recovery until they are ready to go home. Friends and family are usually welcome in these areas, which are designed for comfort. The IV will be removed when the nursing staff determines that the patient is ready to go. The staff should review the discharge statements with the patient and the responsible adult designated to take the patient home. If you are scheduled for an outpatient surgery, it is imperative that you have someone scheduled to pick you up from the hospital and stay with you at home until you are fully recovered from the anesthesia.
(Hill, A.J., MD, PhD. The Patient's Guide to Anesthesia. New York: Kensington, 1999.)

Know about MRI Imaging
MRI means Magnetic Resonance Imaging. MRI is one of the newer imaging techniques. MRI produces detailed image of inside of your body, without using x-rays. This is a totally painless, safe examination that has no known side effects. MRI scans are more specific in identifying soft tissue lesions. It is performed to investigate certain suspected soft tissue diseases of the brain and spinal cord, as well as other parts of the body.

MRSA Facts (METHICILLIN RESISTANT STAPH . AUREUS)

++ MRSA killed nearly 1,000 people in British hospitals in 2004.

++ 1% to 1.5% of the total population in European Patients get infected with
     MRSA in the hospitals.

++ The European Commission will circulate the findings of the project and its
     recommendations to hospitals in Europe.

++ The worst is in the South Europe. Turkey is the worst offender but the UK
     is not far behind.

++ The MRSA affects less than 0.05% of the patients treated in the Top
     Indian Hospitals.

Demystifying Medical Tests (Myocardial Perfusion Scan)

The Test
Myocardial Perfusion Scan is a noninvasive study using radio-isotopes which indicates the blood flow in m vessels of the heart. The amount of radioactive substance injected is also totally excreted from the body by 24 hours and radiation exposure to the patient is also less.

The Purpose
This is a non-invasive method where the blood flows to the major vessels that supply the important areas of the heart are known. Besides, other important parameters like movement of the chambers of the heart, the percentage pumping capacity of the heart among others can also be found. For patients who have had a heart attack, this test gives an insight to the operating surgeons on how best he will improve after a bypass or angioplasty.

Precaution
Pregnant and lactating women are advised not to undergo this test as it involves the injection of a radioactive isotope. Apart from this there are no definite contra-indications for this test.

Procedure
This test consists of two components, one during exercise and the other during rest. A radioactive isotope is injected intravenously into the patient during exercise on treadmill to reflect pattern of blood flow and the images are acquired half an hour later. Two hour later the same isotope is injected intravenously when the patient is at rest and the images are acquired. After this a comparison is made between the blood flow to the heart during the exercise and resting state.

Preparation:
Patients are advised to be fasting for a minimum of four hours on the day of the heart and avoid diabetic medications on the day of the test. Some heart medicines are advised to be withheld for 24-48 hours depending on their duration of action.

What is Incentive Care?
Intensive Care Units (ICUs) are places in a hospital that care for the sickest of patients. A seriously ill or dying patient would require a degree of care that would not be possible in a normal hospital ward. This would involve very close monitoring of the functioning of vital organs of the body such as the heart and breathing function, kidney function, etc. If any of these vital functions fail, an appropriate form of support would be required to keep them going till such time as they can recover. For instance, consider someone with a severe infection of the lung that is bad enough to make him unable to breathe well enough. This person would need the help of a breathing machine that would support his breathing till such time as the lung infection gets better. Similarly, if the heart and blood circulation becomes inadequate, there are specific drugs as well as mechanical devices that provide support. If the kidneys fail, toxic waste products cannot be removed from the body. In this instance, a machine is used to do the job for the kidneys till such time as they recover. All this requires machines and men with specialized skills to manage such patients on a day-to-day basis. This involves specially trained doctors, (intensivists) nurses and other ancillary staff round the clock to keep track of events on a minute-to-minute basis and take appropriate actions as and when required.
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