White Coat Wizardry – A for Alchemy

Family gatherings are kind of rebarbative in themselves.

They are even more incommodious for the yet-to-be-docs. (For me it involves measuring BP of at least 10 various aged relatives and making each of them individually understand the ‘normal’ BP).
But, they are totally horrifying if you have a hypochondriac relative who has unlimited internet access.

The festive season calls for gatherings and the last one was irksome enough to get me up in front of my computer and write about it. So coming up is a painful comedy circus.

Though I have (quite eventfully) swam across the first year at med-school and have been officially relieved from the clutches of Anatomy, yet, the first question with which my happy-faced relatives welcome me is, “ kire, kota mora katli?”[Hey, how many cadavers did you slaughter?]! Even before I start explaining to them that my cadaver-mutilating days are over, the topic of discussion takes a sharp turn. Now they are bothered about whether I want to become a Pediatrician like my elder sister or ‘something else’. I immediately get an outburst of random irrefutable points showing why, how and where I should pursue a particular specialization! As far as I could make out from the chaos, an ‘MS in Heart’ sounded like the best option available.

However, all this was just the beginning. As soon as I had made myself a bit comfortable and was about to grab a bite, one of my relatives, whose identity I will respectfully keep hidden behind the ever-so-useful alphabet X, kick started. X takes 8 drugs a day, around one for each system, topped with a few vitamins and amino acid supplements. Not only that, he loves prescribing drugs to every innocent man, willing to believe in him.

I heard him explaining to someone about a new compound, ‘beta-lactam (!)’ that is being added to every new antibiotic, nowadays, to replenish the 500 types of microbes residing in our stomach and hence these antibiotics are totally ‘side-effect’-free! He went on aptly advising people on how to get rid of their insistent problems of ‘gas’, indefatigable pains and the season-change-febricities with various combinations of allopathic, homeopathic and ‘biochemic’ drugs completed with dietary suggestions.

I could do nothing more than giving baffled expressions throughout the process because all my attempts to interrupt were interrupted by scowls and frowns from the ardent listeners. The final blow came when I was unanimously suggested to keep quiet and follow his words because they might teach me a bit more than I am taught at the college.
I have been to the OPD and seen how most of the patients do not seem to like the method of the treatment they are offered and how reluctantly they accept the regimen of drugs that are suggested (I know there are some nice co-operative patients, but the majority looks at the prescription with a somewhat screwed up face). So, I was taken aback to see the ease with which these people accepted all his suggestions!

For yet another time, the functioning of human brain seemed thoroughly out of the bounds of my understanding. Though that isn’t much of a problem but, in the recent pharmacology classes, it has become too hard to concentrate on the long lists of drugs with their specific mechanisms of action as my mind simply drifts off to imagine how much easier it would be to treat people with concoctions made of leaves and roots.

I guess I will start up on the ‘A for Alchemy’ campaign as soon as possible, as the ‘elixir of life’ as well as ‘panacea’ doesn’t seem much out of our reach.

White Coat Wizardry is our weekly series by guest blogger Chandrima Naskar who happens to be a bumbling medical student in love with Harry Potter and cats and who seemingly loves aprons?!!? and a red backpack?!!

White Coat Wizardry

And there inside my faded red backpack, sits cozily an un-ironed white apron. Rather, ‘The’ un-ironed white apron, I should say. Its presence, there, gives me an unexplainable sort of superpower-ish strength. I can always flank it on my shoulders, put my chin up and walk right into anywhere and get all the eyes looking up at me with an expression of awe.

Ok, ok, I know it’s a bit of an exaggeration. But still, for a doctor-to-be, there’s nothing much to show off to people (unlike the superfluous little magazines from literature or the mind-boggling super-codes from engineering departments), other than that white coat.

While the doctors (yeah, those who can write that precious ‘Dr.’ before their name) don’t really bother to put on an apron and prefer the stethoscope dangling o’er their shoulders to mark their ‘Dr.’ness, we, the struggling ‘would-be’s, wrap our coats tight around us.

Be it smelly, crumpled, washed-once-a-month or perfectly glowing and ironed, every white coat is equally worthy. And here I am, a bearer of such a white coat, a member of the cult, rambling about what a white coat faces daily. It is all about the expeditions of that coat, sitting in my faded red backpack.

White Coat Wizardry is our weekly series by guest blogger Chandrima Naskar who happens to be a bumbling medical student in love with Harry Potter and cats and who seemingly loves aprons?!!? and a red backpack?!!

The Case is dismissed…..

My mom had dry cough for about 4 days. We all were pretty easy going about the cough as it seemed like a normal URTI. The doctor prescribed some anti-allergics with a usual cough syrup. Oh! that was pretty easy! Every doc does that. Doesn’t he?  Who knew what was going to happen next!

Well, the cough was becoming worse. She was taken to an ENT doc, he said “its asthma you see..  avoid dust, perfume, going out, you are fine.. it’s nothing.”Now she started with breathlessness, and what I was doing? Well thinking of how to put that together so as to present a case (I was a new second year student, super excited about taking history and presenting them all the time).

Anyway, I jotted down the history in my mind “BLN with chest pain… acute onset..grade- 4, exacerbated by lying down… preceded by dry cough for 4 days…no H/O fever, rigors, chills, bluish discoloration of skin….” While the ENT docdidn’t think a chest X-Ray was required, because my dad insisted, we got an appointmentwith a good pulmonologist in the city. He immediately  asked for a chest X ray andall I could infer was that “the heart looked bigger”. Wish I had read, “Chest X-Raysmade easy” back then.

My mom was diagnosed with right sided pneumothorax and was immediately admitted. All tests were done and a chest tube was put. Now the question that everybody was asking was,  “HOW DID IT HAPPEN??”. The  doc had raised eyebrows when he first saw the X-Ray saying its seen in men, who are smokers. In women, its rare. If seen,  those are usually a few tall women.  “Then HOW DID IT HAPPEN?”  was my next question. To which I got another reply,  “TB has to be ruled out, we already did that.”

Again I asked “but hmm… HOW DID IT HAPPEN?”

To which I got a final answer and the meeting was dismissed “Whatever happened… happened, forget  about that….”.  I dared not to ask again and till now I still wonder at times ” What must have actually happened?” . May be its because of watching HOUSE all the time or is it what our system lacks, I still have to figure out but hey I have atleast observed in our opd’s what do we do when we don’t know, “why/how is it happening?”

We prescribe antibiotics+ anti inflammatory+ becosules, and then as usual

CASE DISMISSED!!

– Aakriti Pandita

P.S – She joins the ASMJ Hivemind. Atleast Her case was not dismissed!!

 

Should doctors marry within their own fraternity?

Over hundreds of years, medical science has evolved from being experimental and barbarically invasive to the present state of the art medical and surgical interventions and minimally invasive techniques. What has also changed dramatically is the gender dynamic of the medical profession, which now houses an equal representation of both genders from the once primarily male dominated science.

This change has paved the way for a rising number of inter-doctor marriages. The number of such dual-doctor families is fast increasing and is soon expected to form half the population of US medical professionals, which raises the question, should doctors marry within their own fraternity?

Marriage, which according to George Washington can be the most ‘interesting’ event of one’s life; the foundation of happiness or misery, calls for complete merger of lives of those tying the knot   With similar topics to discuss at the dinner table and a better understanding of the other half’s occupational life, dual doctor couples benefit from having a similar background, environment, and a greater possibility of common interests. And once a midnight call breaks this Utopian harmony, who could be more understanding of the nature and necessity of such a call than a doctor oneself?

As a financial upside, dual doctor families earn higher family incomes as was found by Sobecks N.W. et. Al. in their study published in the Annals of Internal Medicine. One could also start the vicious circle of referring one’s patients to his/her other half but this perpetual source of income could attract lawsuits and is something we definitely would not recommend, for family life is unquestionably affected when one of the family members goes behind bars. 😉

Members of a dual doctor couple, nevertheless, do have to settle for lesser personal goals and incomes with the burden of child bearing affecting the mother more than the father. Work place anecdotes once replaced with professional competition, specialty dissimilarity and work place politics on the dinner table can lead to unpleasant or possibly hostile conversations.

Doctors marrying doctors has its own pros and cons. ‘A successful marriage,’ in the words of Mignon McLaughlin, ‘requires falling in love many times, always with the same person.’ Thus, what decides the fate of a marriage in due course is how comprising one is willing to be in the direction of avoiding all the drawbacks and enjoying the pros of a dual doctor family life.

– Asfandyar Yousuf

Booked for life?

Booked for life!-

Is the use of Medical textbooks In Medical education out-of-date?

“Well, man, what all did you do at the BMS (Best Medical School)?”

“Books. I know all there is to know about medicine in books.”

-Samuel Shem, The House of God.

This above Sketch taken from our College Magazine, “Chrysalis” of the year 2006 is the only one in that issue that, rather mysteriously, is indelibly etched in my memory. Our magazine had several sketches and cartoons on the medico life, several were very funny but this sketch was, curiously, my favorite. I say curiously because it was only after completing my M.B.B.S and having a strenuous Internship year behind me that I could truly fathom why this particular, somewhat puerile, effort at Medical humor had flashed repeatedly into conscious memory at different stages in my training. Now, five-and-a-half years and one M.B.B.S later, as I look at it again through the prism of the years that have passed since I first saw it , I see why it had appealed to me and my fellow Second year students so much.

With Seven continuous-three hour long-written-theory examinations in the offing, threatening to test us on topics ranging from the histopathology of Cardiomyopathy to the physical evidence of Anal rape, the only thing that most of us had on our minds were …well…..books. And so, quite naturally a cartoon that featured a naive medical student who chooses medicine because he has a passion for helping, treating and if possible saving ‘people’ but encounters instead a tower of brick-thick tomes, had to appeal to us. Especially, I think, the snap that has a harried Medico placing his Stethoscope on the book tower was a perfect visual-metaphor for our book-worming plight.

However, in the midst of our cram fest, in the few lucid moments that human physiology necessitates and friendly company induces my thoughts would often turn to this sketch. Weren’t we doing something wrong, wasn’t something not right? Seriously “not right’? I felt we had lost touch with what we had set out to achieve in the first place- train to be competent, considerate, confident Doctors. Doctors who would someday have to talk to, treat and cure “people” not deliver ten page disquisitions on Pathophysiology or scalp a tricky MCQ .This led me to ponder the more general question of whether  ‘books’ had become the dominant presence in the  life of most Medico’s , to the exclusion and at the expense of genuine patient interaction?

Research seems to suggest that Clinical teaching makes better Doctors as compared to Didactic teaching.⁽¹⁾Furthermore, in an electronic age better, more convenient alternatives help Doctors keep up with the latest developments in their respective fields.⁽²⁾ In a world in which today’s ‘evidence’ is frequently discredited by tomorrows research , Online resources like UpToDate were better suited to the challenges of mastering the basics of Medical science .⁽³⁾

And what about all the Multimedia, don’t symptoms and signs mean sights, sounds, colours- requiring one to hone ones senses rather than ones Harrisons? Does it make any sense to “read about” a Murmur rather than “hear” it,”look up” a skin lesion when you can “look at it” with a single tap on a keyboard? I am inclined to answer yes and many medical students, especially from developed countries seem to agree with me. ^{(4, 5, 6)}On the other hand inefficient though, textbook learning may be, Multimedia and Online resources have their disadvantages too –

1. Their content quality varies widely. ⁽⁵⁾

2. They may not be as accessible in remote parts of the world, especially in the developing countries.

3. They may not provide for uniform and consistent course material.

Their disadvantages notwithstanding, the days of ‘reading’ medicine as opposed to ‘learning’ it, seem to be numbered.

And I, like our senior in the cartoon, certainly won’t be complaining!

References

1. Coomarasamy A, Khan KS. What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review. BMJ 2004; 329:1017.

2. Blumenthal D, Glaser JP. Information technology comes to medicine. NEngl J Med 2007; 356:2527-34.

3. Kim S, Willett LR, Murphy DJ, et al. Impact of an evidence-based medicine curriculum on resident use of electronic resources: a randomized controlled study. J Gen Intern Med 2008; 23:1804-8.

4. Leff B, Harper GM. The reading habits of medicine clerks at one medical school: frequency, usefulness, and difficulties. Acad Med 2006; 81:489-94.

5. Peterson MW, Rowat J, Kreiter C, Mandel J. Medical students’ use of information resources: is the digital age dawning? Acad Med 2004; 79:89-95.

6. Edson RS, Beckman TJ, West CP, et al. A multi-institutional survey of internal medicine residents’ learning habits. Med Teach 2010; 32:773-5.

 

Syed Faizan
New Member Of The ASMJ Hivemind

 

 

 

 

 

Harry Potter And Medicine Part II

And We Present The Concluding Chapter When Harry, Ron And Hermione Had Their Tryst With Medicine And Lived To Tell The Tale…

Herbs and medicines: the pharmacology of Mandrakes

Mandrakes, the plants with roots resembling human babies, were the source of the potions used to treat petrification (a complete paralysis with unconsciousness) and common cold in the Harry Potter books.

A review of medical botany yields that Mandrake is actually a plant belonging to the Solanaceae family with a long association with magic and traditional healing. It causes parasympathetic depression (the roots contain hyoscine, scopolamine and atropine), delirium and hypnosis.[9] It was used in the early days of surgery as well as a mild sedative.

Presence of atropine could probably explain the use of Mandrake in curing petrification (which in all probabilities is a neuromuscular blockade, of apparently non-depolarizing type). Anticholinergic drugs are frequently used as over-the-counter medications for cough and cold due to their effectiveness in decreasing secretions.

Charms and spells: The obvious medical links

‘Obliviate’ the memory-erasing spell induces a short-term memory loss in the victim, akin to temporary amnesia seen in myriads of reasons; the very trauma of being hit by a spell may lead to traumatic amnesia for instance! However this is different from the ‘false memory charm’ which replaces a person’s memories with false memories, a picture very similar to the phenomenon of ‘confabulation’ in psychiatry. ‘Anapneo’, expectedly, is the spell to treat choking (apnea); ‘ferula’ for fractures (Latin ferula meaning stick) reminds us of our orthopedics splinting procedures, and ‘ossio dispersimus’ of bone-removing surgeries. And what else could ‘Furnunculus’ produce except deep folliculitis!

Dragonpox

A contagious and potentially fatal disease of the wizardry world, Dragonpox reminds us of our world’s smallpox. Smallpox, prior to its eradication in 1978, was as highly contagious and as potentially lethal as Dragonpox might have been. Also, like smallpox, Dragonpox was treated in the isolation ward of the Wizard hospital and left pock-marks years after the person recovered from it.

Potions and Serums

Veritaserum was the truth serum used in the Potter world, which could force the drinker to blurt out the truth; however, though powerful enough, it could be resisted by ‘antidote’ and ‘occlumency’ (the procedure of rendering mind indifferent to external influence).This is strikingly similar to the use of intravenous barbiturates as ‘truth drugs’ in narcoanalysis to obtain vital information, or the use of polygraph to detect lying. Both truth drugs and polygraphy have been criticized for their lack of reliability and sensitivity and their potential to be manipulated.[10, 11]

A blood replenishing potion is used in the story in managing acute blood loss from snakebite (vasculotoxic?), a ‘skele-gro’ potion is used for regrowing broken bones suggesting neo-osteogenesis [12, 13] (and mesenchymal stem cells?) and the list may go on.

Conclusion:

The article is an attempt to sort out the medically relevant portions of the literary phenomenon and to dissect those portions with the background medical knowledge of the authors. The examples and the explanations given in the text are by no means exhaustive or absolute; they just serve the purpose of giving a glimpse of this novel idea of exploring popular media for continuing medical education. Other popular media sources could be analyzed in the same manner in an interactive way and the discussions surrounding the medicine in the virtual world might actually translate into better appreciation of the context in the real world.

9      http://www.entheology.org/edoto/anmviewer.asp?a=60 (Accessed on 21^st September, 2011)

10        Redlich FC, Ravitz LJ, Dession GH. Narcoanalysis and truth. Am J Psychiatry1951;107: 586–93.

11       Piper A Jr. ‘Truth serum’ and ‘recovered memories’ of sexual abuse: a review of the evidence. J Psychiatry & Law 1993;3:447–71.

12       Centeno CJ, Kisiday J, Freeman M, Schultz JR. Partial regeneration of the human hip via autologous bone marrow nucleated cell transfer: A case study. Pain Physician 2006;9(3):253–6.

13        Johnstone B, Yoo JU. Autologous mesenchymal progenitor cells in articular cartilage repair. Clin Orthop Relat Res 1999;367(Suppl):S156–62.

– Dr. Pranab Chatterjee, Adrija Datta, Tamoghna Biswas, Kaustav Bera, Dr. Parijat Sen
   Medical College Kolkata.

5th NATIONAL CONFERENCE ON STUDENTS MEDICAL RESEARCH Day 2

ASMJ Presents A Series Of guest blogs to present

5^TH NATIONAL CONFERENCE ON STUDENTS MEDICAL RESEARCH 13^TH AND 14^TH, JANUARY 2012,

DEPARTMENT OF COMMUNITY MEDICINE, MEDICINE COLLEGE , THIRUVANANTHAPURAM.

                                                     “  Translational medicine “

 

The 2^nd day of the conference was the great day of presentations of the studies of the participants. The presentations were held in 3 sessions at 5 venues simultaneously. The sessions were  about general health, reproductive health, child health, ENT, Opthalmology, Communicable and Non communicable disease, Mental health, TB/HIV, Post Graduate sessions. Each session was chaired by 3 to 4 chair persons ,renowned in their own fields and research. A quiz was conducted and the winner awarded cash prize. The winner was…Dr Anjitha from Trivandrum medical college. Best papers from each session were selected and awarded. The list is as follows:

NAME	COLLEGE	TITLE
S.VINEELA	GANDHI MED COLLEGE,ANDHRA PRADESH	MENSTRUAL DISORDERS IN ADOLESCENCE- INFLUENCE OF LIFE STYLE , NUTRITION AND OTHER FECTORS.
RITU THAKUR	GANDHI MED COLLEGE, BHOPAL	PREVALANCE OF URINARY STRESSINCONTINENCE IN ADULT FEMALE POPULATION OF URBAN SLUM
TINKU WILSON	DR SMCSI MEDICAL COLLEGE KARAKONAM	PROPORTION OF KNOWN RISK FACTORS AMONG LOW BIRTH WEIGHT BABIES BORN IN RHTC KAZHAKUTTOM
K. SRIVATSA	GANDHI MED COLLEGE,ANDHRA PRADESH	INFLUENCE OF PARENTHOOD ON MYOPIA- A CASE CONTROL STUDY
RESHMA PADMARAN	DR SMCSI MEDICAL COLLEGE KARAKONAM	PREVALENCE OF ALCOHOLISM AND TOBACCO USE IN COASTAL POPULATION OF KERALA
ANNMARY GEORGE	GOVT MEDICAL COLLEGE,THIRUVANANTHAPURAM	COMPLIANCE TO FULL COURSE OF ORAL ANTIBIOTIC THERAPY AS PRESCRIBED BY PHYSICIAN AMONG PATIENTS VISITING PANGAPPARA PHC
DEEPTHI N RAO	VIMS,BELLARY	PROFILE OF HIV POSITIVE PATIENTS ON ART AT VIMS, BELLARY
ANN SARA GEORGE	DR SMCSI MEDICAL COLLEGE KARAKONAM	PREVALENCE OF ORAL LEISONS IN RELATION TO TOBACCO USE: A CROSS SECTIONAL STUDY
KEERTHI BRAR	GANDHI MED COLLEGE, BHOPAL	ATTITUDE AND BELIEF REGARDING ORGAN DONATION
SREESANKAR	GOVT MEDICAL COLLEGE,THIRUVANANTHAPURAM	RISK FACTORS OF INFERTILITY IN WOMEN OF REPRODUCTIVE AGE GROUP IN A TERTIARY CARE SETTING
NAINA MARY SIMON	DR SMCSI MEDICAL COLLEGE KARAKONAM
DR. SREELAKSHMI PR	GOVT MEDICAL COLLEGE,THIRUVANANTHAPURAM	COMPLIANCE TO PHARMACOLOGICAL TREATMENTAND HEALTH SEEKING BEHAVIOUR AMONG DIABETIC SUBJECTS
DR. PREESHA BALAN	GOVT MEDICAL COLLEGE,THIRUVANANTHAPURAM	COMPARATIVE STUDY ON CYTOLOGY AND HISTOPATHOLOGYIN SALIVARY GLAND TUMOURS

 

Programme was concluded with vote of thanks by Dr. K Vijayakumar, Head and Professor, Dept. of Community Medicine, Govt Medical College, Trivandrum.

 

5th NATIONAL CONFERENCE ON STUDENTS MEDICAL RESEARCH Day 1

ASMJ presents the first day of NATCON in a series of guest blogs…

5^th NATIONAL CONFERENCE ON STUDENTS MEDICAL RESEARCH 13^TH JANUARY 2012

DEPARMENT OF COMMUNITY MEDICINE, GOVERNMENT MEDICAL COLLEGE, TRIVANDRUM.

The conference revolved around the theme “Translational medicine” with around 150 participants and faculties from various states like Andhra Pradesh, Karnataka, Kerala, Madhya Pradesh, Tamil Nadu  and Uttar Pradesh.

The conference was inaugurated by Dr. K. Mohandas, The Vice-Chancellor of Kerala university of health sciences and the presidential address was delivered by Dr. V. Geetha, The director of medical education, Kerala, in the presence of eminent personalities in the field of research like Dr.K.R.Thankappan  (Professor, Achutha Menon Centre for health sciences), Dr. C. C. Kartha (Prof. of eminence, Rajiv Gandhi centre for biotechnology), Dr. Ramdas Pisharody (Principal, Medical college, Thiruvananthapuram), Dr. D.Dalus (Prof. Internal medicine, Medical college, Thiruvananthapuram), Dr. K. Vijayakumar  and Dr.Thomas Mathew (Profs. Community medicine, Medical College, Thiruvananthapuram).

The plenary sessions which followed were about the relevance of inter disciplinary approach in Translational medicine, by Dr. K. Mohandas, translational research in medicine, by Dr.Ramdas Pisharady, translational research in public health, by Dr. V. Ramankutty  and dissemination of medical research by Dr. Joy Philip (Principal, SUT Medical college, Thiruvananthapuram). The sessions inspired and motivated the students to translate the fruits of medical research into benefits to mankind. The great need in the present day world, for researches, to find effective ways to translate the scientific knowledge into attitudes and practices, was stressed.

The Dr. C.R Soman memorial award  for the best post graduate thesis was presented to Dr. P.V. Lisha, department of pulmonary medicine, medical college, Calicut, for the study titled ‘Evaluation of new smear positive pulmonary tuberculosis patients, 5 years after initiation of treatment under DOTS programme’. The first day ended with the presentation of the above mentioned study.

Harry Potter And Medicine Part I

Harry Potter has been a phenomenon in the world of fiction literature for more than a decade. Ever since the appearance of the first novel in June 30, 1997 till the release of the last movie in 2011, the world has watched in awe as J.K.Rowling’s protagonist took on the battle against the darker sides of magic. This anthology of fantasy created a magical world which not only inspired Potter-lovers throughout the globe but also spurred debates and conversations on the possible reflections of the global socio-political and economic eventualities in the series.

Researchers have found it as an object of scientific interest. Studies have reported the effects of Harry Potter on adolescent development,[1] the decrease in trauma cases(among children 7-15years of age) in the emergency room during the time of the release of the Harry Potter books,[2] or even the possible learning points for clinical teachers from the Harry Potter series.[3] Harry’s chronic persistent headache has been diagnosed as probable migraine [4] and the connection between his traumatized past and his psychic development has been explored.[5]

In this article, the authors identify a few areas of relevant bio-medical interest in the Harry Potter anthology. This list is by no means exhaustive, and is intended to be a primer for further research on such literature-based learning resources.

Harry Potter and Corynebacteria: Microbiology meets Magic

Readers familiar with Harry Potter will remember Golpalott’s Third Law, which dictates the preparation of antidotes. It states: “The antidote for a blended poison will be equal to more than the sum of the antidotes for each of the separate components. “ In plain English, it means more antidote is needed to neutralize poisons when they are mixed.

This is eerily reminiscent of the Ehrlich and Danysz Phenomena [6] associated with corynebacterial toxins.

Ehrlich’s phenomenon states that more than one unit of toxin needs to be added to a neutral mixture of toxin and antitoxin to leave behind one unit of toxin active in the mix. This is just like Golpalott’s Law stated in a roundabout manner. The Danysz Phenomenon is also similar. It states that when one unit of toxin is added to one unit of anti toxin in one go, there is, by definition, neutralization of the toxin. If, however, the toxin is added in small, divided doses, then one unit of antitoxin neutralized more than one unit of toxin.

Looks like Ms. Rowling studied early Microbiology works to reproduce academic authenticity!

The Full Body-Binder Curse: Locked-in syndrome?

In the Harry Potter series we frequently see the full body binder curse or the body-freezing spell (Petrificus Totalus) which renders the victim unable to move but does not impair his consciousness or awareness. However breathing and sight remain practically unaffected.

This is very similar to the ‘locked-in’ syndrome(cerebromedullospinal disconnection, also called as ‘coma vigilante’) [7] where the patient is immobile and quadriplegic due to paralysis of almost all voluntary muscles, however the consciousness and awareness is retained, and so is the vision. Locked-in syndrome may be a sequel of Traumatic Brain injury, metabolic derangements, vascular insufficiencies, etc.

Werewolves and Lycanthropy: Legends meet Medicine

Remus John Lupin, one of the series’ important characters was a werewolf (which probably was the reason of him being named ‘Lupin’ after ‘Lupus’ which means wolf in Latin). Legends say that werewolves transform during a full moon night while they are perfectly humane at other times, which may be oddly similar to the periodic remissions and exacerbations of the Lupus (Systemic lupus erythematosus) patients who meanwhile are also usually photosensitive. The ‘lupus’ in SLE has traditionally been thought to be due to the butterfly rash and wolf-like facies.

Lycanthropy is supposedly the infection caused to a human bitten by a werewolf, transmitted by saliva and blood. Lupin suffered from lycanthropy. Oddly enough, lycanthropy is also a distinct clinical entity where the patients suffer from zoomorphism and behave in a manner befitting their psychotic delusion that they have been converted to an animal.[8]

References

1 Rosegrant J. The deathly hallows: Harry Potter and adolescent development. J Am Psychoanal Assoc 2009;57(6):1401-23. Epub 2009 Nov 19.

2 Gwilym S., Howard D.P.J., Davies N., Willett K. Harry Potter casts a spell on accident prone children. BMJ 2005;331(7531):1505-6.

3 Conn JJ. What can clinical teachers learn from Harry Potter and the Philosopher’s Stone? Med Educ 2002;36(12):1176-81.

4 Sheftell F, Steiner TJ, Thomas H. Harry Potter and the curse of headache. Headache 2007;47(6):911-6.

5 Subkowski P. [Harry Potter–the trauma as a drive for psychic development]. Prax Kinderpsychol Kinderpsychiatr 2004;53(10):738-53.

6 Cinader B. The Danysz effect: an investigation of the reaction between an enzyme and its antibody. Br J Exp Pathol 1957;38(4):362-76.

7 http://www.ninds.nih.gov/disorders/lockedinsyndrome/lockedinsyndrome.htm (Accessed on 21st September 2011)

8 Fahy TA. Lycanthropy: a review. J R Soc Med 1989;82(1):37–9.

Image by Jakovche used under Creative Commons Attribution-Share Alike 3.0 Unported License.

– Dr. Pranab Chatterjee, Adrija Datta, Tamoghna Biswas, Kaustav Bera, Dr. Parijat Sen
   Medical College Kolkata.

THIS ENDS PART 1. STAY TUNED FOR THE CONCLUDING PART COMING SOON!!!

Is That A Christmas Tree?

Don’t be too glad  if you see a Christmas tree in your Grandma’s eye* . It’s no divine indication that she will attain sainthood. In fact it is an indication of her failing vision.

Medical Science which never fails to wonder us all actually has something called Christmas Tree Cataract in which a Christmas tree with all its ornamentations develops in the eye lens.(See Picture) . Cataract is a disease characterised by the clouding of our eye lens due to various physico-chemical reasons. Christmas tree cataract consists of highly refractile, iridescent¹ multicoloured “needles” crisscrossing the lens fibers of the deep cortex². The colours vary according to the angle of the incident light¹.

The exact nature of how a Christmas tree is formed in the lens is not clear. It was observed³ that Christmas tree cataract crystals are in tubular cavities whose double refraction corresponded to that of cholesterol. Hence researchers propounded the theory of it developing as a result of high cholesterol levels in the blood. However a study ⁴ found no such association and it was hence presumed that it was due to intrinsic defects in the lens metabolism. It was then postulated that cystine is the most likely candidate for the Christmas tree needles and that the needles probably are formed as the result of an age-related aberrant breakdown of crystallins induced by elevated Ca++ levels.² Current theory is that Christmas tree cataracts results from the accelerated breakdown of membrane associated proteins. The peptides and amino acids accumulate in the lumen of the reticular meshwork, and cystine is concentrated beyond the level of crystallisation, hence giving rise to growing crystals ¹.

Christmas tree cataract has  been seen in relation to the most common form of muscular dystrophy in adults –myotonic dystrophy^5..

*You cannot see Christmas tree cataract through the naked eye .. 😉

Soumyadeep Bhaumik,
Medical Sub Editor,
Journal of Indian Medical Association, Kolkata.

________________________________________________________

PictureCourtesy: http://www.flickr.com/photos/mieruzena/6255918232/in/photostream/

References:

1. Obi E, & Weir C. A Christmas tree cataract. BMJ. 2010;341:6644.
2. Shun-Shin GA, Vrensen GF, Brown NP, Willekens B, Smeets MH, Bron AJ. Morphologic characteristics and chemical composition of Christmas tree cataract. Invest Ophthalmol Vis Sci. 1993 Dec;34:3489-96.
3. Pau H.Christmas tree decoration” crystals in the lens. Klin Monbl Augenheilkd. 1983;182:15-8.
4. Anders N, Wollensak J.Christmas tree ornament cataract–an indication for disordered lipid metabolism?Klin Monbl Augenheilkd. 1992 ;201:30-3.
5. Reiter C, Gramer E.Anticipation in patients with iridescent multicoloured posterior capsular lens opacities (“Christmas tree cataract”) : The Role in the diagnosis of myotonic dystrophy.Ophthalmologe. 2009;106:1116-20.The ASMJ Hivemind Hopes You Had A Wonderful Christmas. Spread The Festive Spirit.