Archive for the 'Medical' Category

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Preventing Malaria: Medications

Areas affected by malaria.

If you’re planning a trip to Africa, South/Central America, or Asia, malaria is a legitimate concern.  Malaria is a very serious parasitic infection that kills about 1 million people annually and is transmitted by mosquitoes.  However, there is good news. There are numerous ways to lower the chances of ever contracting malaria and even if you do, it is highly treatable.

One of the ways to mitigate the risk of contracting malaria is by taking a chemoprophylaxis, or antimalarial drug.  Below is a list of some common drugs prescribed for travel to areas of the world with malaria risks:

Lariam (Mefloquine) by Roche

  • Weekly tablet
  • Cheaper than Malarone (fewer pills to buy)
  • While extremely rare, a study reported higher adverse neuropsychiatric events (Dark Side of Lariam)
  • Have to start taking it 4-6 weeks prior to departure + 2 weeks after
  • Comprehensive Lariam Side Effects

Doxycyclin (general antibiotic)

  • Side effects that can be mitigated
  • Cheap, Generic
  • Daily tablet
  • Likely to sunburn faster
  • Nausea
  • Can lead to yeast infections

Malarone (atovaquone and proguanil hydrochloride) by GlaxoSmithKline

  • Causal prophylaxis
  • Abdominal pain, nausea, vomiting, and headache can occur
  • Can make you sick enough to discontinue use
  • Expensive

Chloroquine (Aralen) (can be found generically)

  • Resistance in parts of the world (map)
  • May worsen psoriasis

When it comes to effectiveness, they are all about equal.  However, daily pills put greater responsibility on the user to take it at the same time every day, otherwise the effectiveness decreases.  To make a proper choice for your needs, visit your local travel clinic and doctor.

This site also has lots of good info.

Look for part 2 of malaria prevention coming later this week!

This is Africa: Headlamp Surgery

Practicing medicine in the jungles of Africa requires a certain flexibility that is hard to imagine here in the U.S. or western Europe.  However, thanks to the existence of youtube, we can see the challenges that face doctors in remote places all over the world.

This particular video brings back memories of the surgical marathon that went on in Maboye, Cameroon last summer. Dr. Bwelle slept about 8 hours for an entire 48 hour period and at one point the generator went out mid-operation.  Dr. Bwelle had us all turn our headlamps on to light the surgical field and on we continued as the generator was repaired.  That’s the way it goes in Africa.

Donations: Putting Your Money to Work

Many large nonprofit humanitarian organizations are fortunate enough to receive donations that cover their costs as well as pay employee salaries. While this is great for the organization, it isn’t necessarily ideal for donors because a major portion of your gift is paying for prime Manhattan office space or the CEOs salary.

One common metric used to evaluate nonprofits is called the program ratio, which is the percentage of an organization’s total expenditures that is devoted to programs and services. If as an organization you spend $80 to buy food for resettled refugees, and then pay people $20 to to hand it out – your program service ratio is 80% ($80 / ($80 + $20)). While not a perfect measuring stick, the program ratio is a decent gauge for the efficiency of a charity or non-profit.
Smaller organizations tend to have higher program ratios than larger organizations because larger nonprofits require a greater level of organization and administration. Let’s take a look at some examples of how some donations were used:

American Red Cross

In 2009, the American Red Cross took in about $3.3 billion. That year they spent a total of $3.4 billion in all: $1.7 billion (50%) on salaries and compensation, $600 million (12%) on “other expenses,” and the other $1.1 billion (33%) directly on programs. If you count salaries of employees as program expenses then their ratio was a very handsome 91%, but if you don’t, the ratio drops to about 33%. (Form 990)

MSF

MSF Financials

Medecins sans Frontiers, or Doctors without Borders, is an apolitical organization that seeks solely to provide medical care to those in dire need, not only those who are in need on the news. Although they are a smaller organization, their finances are more focused on the end beneficiary rather than the middle man. They took in $143 million in 2009, spent a total of $145 million: $112 million on programs (77%), $13 million on salaries and compensation (9%), $18 million on fundraising (13%), and $2.2 million on management and general (1.5%). Any way you look at it, at least 77% of the donations go directly to those in need. (Form 990)

Ascovime USA

Ascovime is small and entirely composed of volunteers so we have no administrative costs or salaries to pay out. In fact, Dr. Bwelle spends most of his salary to keep Ascovime going. 97% of donations go directly to program costs and Paypal gets their 3% cut, so ideally send a check to cut out that middle man. (Donate here) 

I’m not advocating for or against making a charitable donation, but merely trying to present what happens to the impact of your donation as the receiving organization increases with size.  Next time you consider making a donation to any organization, think about giving to smaller, local organizations because they will use more of your money to directly help the cause, whatever it may be.

Further reading

Drexel University Medical Team Headed to Africa with Ascovime

For the third year in a row, a team of students from Drexel University College of Medicine are embarking on volunteer mission with Ascovime to Cameroon. This summer they will work with humanitarian leader Dr. Georges Bwelle, who is a Cameroonian surgeon, to give free health care to over 2,000 patients in four rural villages in the jungles of Cameroon. Find out more about what they will be doing.

So far, the eight-member team has raised over $1000 in a few short weeks and has been tirelessly collecting supplies and medications from hospitals in the Philadelphia area. On April 17th, the volunteers will be holding an Art for Health fundraiser hosted by the Waterworks restaurant from 4-8pm. If you can, show up and make a donation to the great cause – overall, the team is shooting for a goal of $10,000 in donations before they leave for Cameroon in June.

If you can’t make it to this particular fundraiser, keep your eyes’ peeled or RSS feeds open for more events to come. In early May, likely the 7th, a Beef n’ Beer event is scheduled at a sports bar in Philadelphia so be on the lookout.

Best of luck to the fine medical students and humanitarians!

Show your support for Ascovime on Facebook or follow us on Twitter

Ascovime Donations

I just wanted to thank everyone again for donating to Dr. Bwelle’s missions in Cameroon, especially those who heard the story on Dick Gordon’s “The Story” on NPR.  At the moment, he’s stocking up and preparing to start all of his upcoming missions and thanks you all for the contributions.

The jungle surgeons of Ascovime

Due to other previous donations, I was able to wire him $900.00 before Christmas to help buy supplies and medications.  This new series of donations will be essential in providing more of these expensive medications for all the patients Dr. Bwelle helps.  Again, 100% of your donations will go to the people that really need the help!

Keep spreading the word, we’re almost at 100 different donors and $5000!  Go here to donate.

Thanks again!

Managing Your Upcoming Hangover

New Year’s Eve might be one of the best nights of the year and for good reason as it is the last opportunity to rock out on behalf of the past 364 days.  While New Year’s Eve is euphoric, it comes into stark contrast with New Year’s Day – the most pounding, irritable, unpleasant day of the new year.  Of course it’s the only day of the new year at that point, but it’s also international hangover day.

The question I sought out to answer was how to minimize, cure, or eliminate the effects of the hangover.  Let me first explain generally how hangover symptoms happen.

Hangovers are relatively poorly understood compared to other disease states primarily because researchers are more interested in alcohol abuse and addiction.  What they do know is that alcohol affects your body in a few ways:

1)      Dehydration/Fluid loss

Alcohol inhibits the production of a hormone that helps you retain water and keep you hydrated called anti-diuretic hormone (ADH) sometimes called Vasopressin.  Blocking the secretion of this hormone causes you to urinate more often, thus losing water. Continue reading ‘Managing Your Upcoming Hangover’

Big Thanks to Global Links and MediFree

Donations for Christmas!

I traveled to Cameroon, a country on the Atlantic coast of Africa, this past May and June on a medical aid mission.  Upon my return, others have kept spreading the word of Ascovime, Dr. Georges Bwelle’s grassroots medical organization and have also continued donating.  NPR did a segment of “The Story” with Dick Gordon about Dr. Bwelle and Ascovime which helped bring in donations from all over the United States.  Along with many substantial monetary donations, others have expressed great interest in volunteering and donating medical supplies.

School and Medical Supplies

Global Links and MediFree have been generous enough to send two boxes worth of sutures (over 200), gauze, catheters, spinal needles, iodine swabs, as well as school supplies for African children.  This was all facilitated by the work of another small organization called Sutures Are A Human Right.  Please be sure to check these sites out and support.  Thanks again to Global Links, MediFree, and Sutures Are A Human Right!

Frontiers in Autonomic Neuroscience!

A great read I found this morning…

Non-Anesthetized Mouse Model for Recording Sensory Urinary Bladder Activity

Peter Zvara 1*, Andrew J. Wright 1, Kristopher Roach 1, Michal Ursiny 1, Bennett Shapiro 1, Lawrence M. Dagrosa 1, Mark T. Nelson 2 and Thomas J. Heppner 2

  • 1Surgery, University of Vermont, USA
  • 2Pharmacology, Univeristy of Vermont, USA

The goal of this study was to develop an in vivo awake mouse model for extracellular bladder sensory nerve recording. A bipolar 125-µm silver electrode was positioned under a single postganglionic bladder nerve. Efferent nerve signals were eliminated by tying off the postganglionic bladder nerve between the major pelvic ganglion and the recording electrode. Sensory nerve activity was measured in the conscious animals 48 hours after surgery during continuous intravesical infusion of 0.9% saline/0.5% acetic acid followed by 0.5% acetic acid with capsazepine (10 µM) at a rate of 0.75 ml/h. Continuous infusion of 0.9% NaCl led to a gradual increase in the frequency of sensory nerve firing that peaked upon reaching threshold pressure. Non-micturition contractions were observed in some animals during filling and other animals exhibited only minimal pressure fluctuations; both types of events were associated with a rise in sensory nerve activity. Intravesical infusion of 0.5% acetic acid reduced the intermicturition interval. This was associated with a 2.1-fold increase in bladder pressure during filling and a 2-fold increase at both threshold and micturition pressures. Concurrent with these changes, sensory activity increased 2.8-fold during filling and 2.4-fold at threshold pressure. Subsequent intravesical infusion of capsazepine in 0.5% acetic acid reduced filling and threshold pressures by 21% and 31.2%, respectively, and produced corresponding decreases of 36% and 23.4% in sensory nerve activity. The current study shows that multi-fiber sensory nerve recordings can be reproducibly obtained from conscious mice.

Full Article (PDF)

Burlington Free Press Writes About Trip to Cameroon

Under the headline “UVM graduate discovers career in rural Africa” the Burlington Free Press printed nice follow-up article about my trip to Cameroon.

He recently returned from an intense four weeks in the African nation of Cameroon helping surgeon Georges Bwelle minister to those unable to afford medical care.

Bwelle’s base is Yaounde, the capital of Cameroon, but every weekend during the dry season he and a team of volunteers head into the poorer, rural sections of the country to set up free temporary clinics. None of the volunteers are paid for their efforts, and Bwelle doesn’t have the money to recruit help. He relies on word of mouth and the generosity of others.

Full Article

An Important Lesson About Women

If you’re a lady you’re probably already thinking, whoa there buster, take it easy.  And if you’re a man, you’re probably thinking this is going to be interesting…

During my medical mission in Cameroon, I have learned a great deal about the cultural differences between the Western world and Africa.  However, as they say, the more things change, the more they stay the same.  It seems like they’re worlds away from an economic standpoint, but when it comes to inter-spousal relations, they’re right in our ballpark.

Exhibit A: our friend Philippe came to the hospital on our surgery day, when Dr. Georges and I typically don’t see patients.  However, the back story of his plight was just too much for us not to stay a little late and fix him up.

Continue reading ‘An Important Lesson About Women’