BrightMed Session 3: Mental Health and Global Health

It's great to be back! Now I can update you on my BrightMed adventures!

This one is session 3 of this year; so we're going back a long time! I've got one more session to write about after this, and then our day trip out!

In the morning, our focus was on three mental health areas:

• Depression
• Anorexia Nervosa
• Schizophrenia

After a brief intro to mental health, we're discussing a few clinical cases, including anorexia, schizophrenia and depression.

— BrightMed BSMS (@BrightMed) January 21, 2017

First, let's take a look at the WHO's definition of mental health.

"Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community"

What do you think about this?

Some things to consider:

• How can one realise their own potential? What about viewing "beyond" your potential?
• What can we classify as "normal stresses of life"? What does this entail, and would it not differ for others?
• How do we quantify or simply productivity?
• If one doesn't make a contribution to community, do they not have a good state of mind?

Definitely food for thought!

The Thinker by Auguste Rodin

Some facts:

• 1 in 4 adults experience mental health problems every year
• Approximately 450 million people worldwide have a mental health problem
• 30% of GP consultations are for mental health

Previously, physicians used to separate the symptoms into two categories:

Neuroses → Depression, anxiety, etc
Psychoses → Hallucinations, delusions, etc

However, this is not generally used now. Now they use "DSM-V or ICD-10"

As a note, the word "Schizotypal" was brought up", which means that it doesn't necessarily indicate schizophrenia, (even though it displays similar characteristics), as it doesn't meet the full criteria.

Interesting point for further research; we came across a man named "Bryan Charnley" who documented the effects of schizophrenia as artwork.

Self-portrait by Bryan Charnley

Food for thought: perhaps exploring his artwork is a way of becoming more empathetic and understanding of mental health both for careers within medicine and in general life!

After this, we took a brief look at the "Global Burden of Disease Report", which according to the WHO:

"measures burden of disease using the disability-adjusted-life-year (DALY). This time-based measure combines years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health."

 Here were the leading few conditions within Disability Adjusted Life Years:

• Lower respiratory infections
• Diarrhoeal conditions
• Unipolar depressive disorders

 I'd like to look at this DALY further, as well as a general overview of the Global Burden of Disease report - so that's being added to my to-do list!

Next, we were told about Schizophrenia in more detail.

Here's some of the information I have compiled:

• The main presenting symptoms can be:
• Hallucinations
• Ideas of conspiracies - delusions 
• Withdrawn behaviour, nervousness, flattening of mood
• Delusion of passivity - as defined by biology-online.org: a delusion in which one experiences one's feelings, impulses, thoughts, or actions as not one's own, but as being imposed on by some external force

• There is a genetic predisposition
• Folie à deux - a shared psychosis
•  1% of the population in the UK
• The typical ages for being affected are:
• Male: 20-28
• Female: 26-32
• Males are more affect than females
• It's believed to have an African origin in inner city London
• It is more likely to occur if there was a problem during childbirth 

 We then looked at Depression

On discussing the main symptoms, we found that they were:

• Anhedonia - recieving no pleasure from hobbies
• Lack of energy
• Sadness
• Loss of libido

The risk factors are:

•  Stress
• Trauma
• Family history

It occurs at a ratio of men to women at 1:2.

Treatment can be:

• Cognitive Behavioural Therapy (CBT)
• Anti-depressants (We can look at these in more detail in the future)
• SSRI (Selective serotonin reuptake inhibitor)
• SNRI (Serotonin–norepinephrine reuptake inhibitor)
• TCA (Tricyclic antidepressants)
• MAOI (Monoamine oxidase inhibitors)
• E.C.T (Electro-compulsive therapy) 

You have to assess the "capacity" of patients when treating. This involves: understanding, retaining information, weighing up the pros and cons, and communicating.

Our next topic was Anorexia.

You can recognise anorexia by behaviour like:

•  Not wanting to eat
• Feeling full
• Feeling paranoid with calories
• Having a bad body image
• Scared of food consequences 

It is more diagnosed in women - potentially due to "social image".

The most important point in my opinion is that due to underfunding, people can be refused treatment because their BMI isn't low enough, which is absolutely terrible. Not only would this bring on an even further lack of body confidence, but also, we must remember that weight is not the only area affected by eating disorders.

In fact, anorexia is the psychiatric disorder with the highest death rate.

Our afternoon session was based all around Global Health

 This can be expanded to the:

• Biomedical sciences
• Public health
• Social sciences
• Environmental sciences

 We had a little look at health inequalities, refugee health, gender equity, and climate change. Again, I could do a little write up on this topic further in the future!

 

Stay tuned for my next post, with information about my London Day Trip!

Geeker

What's In My House?: Bedbugs!

What's in My House?

That's right, we've finally deduced what's wrong with Mr Bill!

Mr Bill was ill from the bed bugs, found in the bedroom, which cause: numerous bites in a line, intensely itchy welts, bloodstained sheets and reddened skin.

Bedbugs can live in the small cracks in your bed, particularly in the bed frame joints and in the seams of your mattress!

The worst part? Bedbugs can easily crawl and manoeuvre themselves around your house as soon as they enter your home - whether by you, or by someone else.

Once an infestation is found, you should call the British Pest Control Association to deal with your little creatures!

But, if you're adamant that you can dispose of them yourself, then the NHS recommends these steps:

• if clothes or bedlinen have become infested, wash them at 60C, or put them in a dryer on a hot setting for 30 minutes to kill the bugs
• dismantle your bed and furniture, and closely inspect every seam, crevice and joint using a bright torch
• use a vacuum cleaner with a hose to suck up any bugs you can see, but bear in mind you may not be able to find them all – dispose of the contents of the vacuum cleaner in a sealed bag
• to kill any remaining bugs, use insecticide spray specially designed for bedbugs – always read the label and never use this directly on clothing, linen or your mattress
• be prepared to throw away a mattress if it appears to be heavily infested

The only other things left to do? Treat the bites. You can do this by being prescribed some mild steroid creams, or by taking antihistamine tablets - recommended by your pharmacist.

Avoid the bedbugs! Keep your bedroom tidy! Avoid clutter! And finally, don't buy second hand mattresses.

What will Mr Bill have next?

- Geeker

What's In My House?! Itchy? Bites?

 What's In My House?!

It's time for a new guessing game; where I present to you our patient, Bill. Bill lives in a typical suburban house, but, he often gets ill. Bill will present to you with his symptoms that have been causing him discomfort?

Can YOU diagnose Bill?

Name the cause, where it's found, and advise on treatment! It's all in your hands!

This is his home: 

Patient Name: Mr Bill

Age: 28

Symptoms: 

Several bites in a line

Welts itch intensely

Blood stains on his sheets

Skin is red

   
- Geeker

We're Back!

 It's been a long month and thankfully we're now back and ready to post!

To compensate, here's a recent summary on a video I watched, by the TED Talks.

“This gel can make you stop bleeding instantly”

The concept of bleeding is one of the most significant aspects of care, treatment and even diagnostics in medicine.  For hundreds of years physicians have battled with preventing bleeds and treating severe cases of trauma. For this reason, the idea of an instant bleed-relief gel is absolutely incredible. Joe Landolina (an American inventor and biomedical engineer) introduces TED’s audience to the concept of this fascinating notion by plunging them into the field of war.

He requests for us to imagine being an injured soldier with a severe femoral bleed – and immediately addresses that this fatal wound can kill within three minutes. To make matters worse, the medic’s utensils and treatment methods can take up to five minutes to begin affect, leaving the possibility of death almost inevitable. With this idea accounted, Joe describes the Extracellular Matrix (ECM) and its role in the body; being responsible for healing. He accounts that other products on the market are only two-dimensional functioning on the ECM and does not ‘fit’ into its structure. Yet, his new product, Vetigel made from “small pieces of plant derived polymers” re-assembles itself into the wound and its local tissue – working with the body to clot in less than ten seconds.

Joe proposes that it should be out for release for human use within the “next year” (2015). To conclude, he refers back to the first initial image of the soldier and describes the simplicity of treatment that Vetigel could propose.

The concept is absolutely captivating and completely intrigues all members of the general public, with an interest of medicine or not.

Interested? Here's the video




- Geeker

First-Aid Friday: Passing Exams!

Good news! Yesterday, I passed my St John Ambulance first-aid exams!

Luckily I didn't faint, but I can't say the same for this week's casualty!


- Geeker