The unexpected lockdown enforced on billions on people around the globe to fight the COVID-19 pandemic has created a crisis in medical care access. Millions are struggling with disrupted routine medical care needs and have been postponing hospital visits fearing exposing themselves to the highly contagious virus.

Despite the lockdown, it is a matter of hope that we are not completely cut out from each other. Despite the physical distance people are in touch with each other via different interactive platforms and audio and video technology.

Today we have access to an entire virtual universe at the tips of our fingers. We are able to work from our homes, order our food, find the news we need, access the entertainment we seek and much more. With the lockdown, we have expressly discovered ways we can stay remote and yet operate efficiently. We have been praying, playing and mourning through our video interfaces. We have been rewiring our interactions with this world to get ahead of the tough times presented to us.

When we can do so much staying remote and yet feel we aren’t so cut off hasn’t it struck you that maybe medical care can also be made available via telecommunication networks?

Well yes, it can be. Numerous medical facilities and clinics are offering telemedicine or virtual care options of various scales today and are connecting doctors to patients via sterile, no-contact virtual environments.

What is telemedicine?

Telemedicine refers to a broad spectrum of modern technologies and tactics used to deliver virtual medical, health, and education services remotely and functions with the assistance of various interfaces like synchronous and asynchronous video, audio and mobile communication technology.

The Centers for Medicare & Medicaid Services (CMS) and the Office for Civil Rights (OCR), in its guidance issued regarding HIPAA compliance, has said that medical practitioners can make use of available non-public facing video interfaces used ‘in good faith’ to connect with their patients and that the overarching privacy protocols laid down by the HIPAA regulations will be eased temporarily.

How does it work?

Telemedicine takes the process of meeting a doctor to a virtual plane altogether. There will be no front office or physical infrastructure for patients to register their appointment. Instead, they will be booking their appointment online and getting an email or SMS link to a video or audio call. There are three ways patients can meet with their doctors-

Synchronous or live video: In the synchronous mode there will be live, two-way interaction between the patient and doctor using common, popular audiovisual telecommunication technologies like Apple FaceTime, Facebook Messenger video chat, Google Hangouts video or Skype.
Asynchronous or store and forward: In asynchronous mode, patients and doctors do not meet each other live real-time, instead they exchange recorded health information, like radiographs, photographs, video, digital impressions and photomicrographs through secure electronic communication systems.
Remote patient monitoring (RPM): In RPM, personal health and medical data is collected from an individual in one location via electronic communication technologies and is transmitted to a provider (sometimes via a data processing service), in a different location to gain access to a virtual caregiver.
Apart from this the public can also leverage mobile phone networks to access medical care.

The doctors, who receive patient information via any of these means then use it to evaluate a patient’s condition and perform an online triage. Depending upon the condition of the patient they may then recommend an e-prescription for medicines or refer the patient to an open medical facility where they can approach for in-person care.

Most telemedicine portals and software also have inbuilt payment modes to make the process truly seamless and digital.

Medical privacy and telemedicine

Medical care in the US is ruled by the stringent HIPAA regulations that protects patient privacy. Telemedicine obviously poses several challenges to the maintenance of these protocols. Several technologies used for virtual consultations are not HIPAA compliant.

To tackle this, the authorities have sanctioned temporary leniency in the regulations and have allowed the use of more personalized communication technologies.

Apart from this, the state agencies have also mandated that the providers must notify patients that the third-party applications used in the audio and video interfaces carry potential privacy risks, and should try and enable all available encryption and privacy modes possible while using such applications.

The state directive also expressly bans the usage of public-facing video communication applications like Facebook Live, Twitch and TikTok.

Is telemedicine recognized by insurance carriers?

Under the regulatory flexibilities announced in the wake of the corona outbreak, the insurance companies have extended coverage to telemedicine treatment codes in both medical and dental care services. All that needs to be done is to add the special codes denoting the telemedicine service or the teledentistry service to the existing treatment code protocol while submitting a claim.

Is telemedicine the future of medicine?

Telemedicine is not something very new. Several caregivers have used telemedicine in different formats to help elderly, immobile, remotely located or differently-abled patients. Even teledentistry is popular in several parts of the United States. At several places teledentistry follow-ups are also simplified and there are doctors and dentists who visit patients at their homes to save them the trouble of traveling to get to a medical facility.

With the exigent situation brought in by the COVID-19 outbreak, several millions will start realizing the convenience offered by telemedicine. With telemedicine, even during normal times, people can save travel and avoid skipping office days to meet doctors. This will also be extensively helpful for the less mobile patients or patients recovering from invasive surgeries and are going through long periods of rest and recovery. Moreover, it is safer than visiting any hospital or dental practice anyday as secure home environs mitigate cany chances of accidental germ exposure.

With its potential to extend exposure-free care to remote locations, reduce crowding at medical facilities, make quality care access almost 24*7 and reduce travel and establishment costs, one can truly see teledentistry assuming more importance in the post COVID era.

EMCO refers to extracorporeal membrane oxygenation which is a highly sophisticated medical device used for treatment involves pumping and blood circulation through an artificial lung’s back into the bloodstream of an extremely ill baby. This device provides support to heart-lung bypass as well at the time of open-heart surgery backup.The United States Chess Federation or USCF is now employing a smaller lightweight and portable ECMO machine which can be easily carried through an ambulance or an airplane a helicopter to relief in an emergency heart patient.TypesIt has two types of machines. While the VA ECMO is used for connecting to an artery and a vein for solving problems related to solving problems of the heart and lungs, VV ECMO is related to one or more veins problem in the lungs.What is the purpose of the device?ECMO is used for newborn babies who are having problems of breathing or heart-related issues. It is used for providing enough oxygen to a sick baby by supplying oxygen while allowing time for the heart and lungs to the rest of healing.RisksECMO machine carries a series of risks such as:Bleeding caused by the medication that’s provided to prevent blood-clotting in the tubing;Transfusion issues in a person or baby;Air bubbles or blood clots forming in the tubes;Increased risk of stroke; Respiratory failure or acute respiratory distress symptomThe most widespread conditions where the use of ECMO is vital for life for the baby:• Birth defects of the heart;• Severe pneumonia;• MAS or Me-conium aspiration syndrome;• Severe air leaking problems;• High blood pressure found in arteries of the lungs;• Also in course of recovery after heart surgery;Typically the main components of the ECMO machine:Heat exchanger;Membrane oxygenator;Centrifugal pump;Circuit tubing;Acute respiratory distress;How is an infant placed on ECMO?For using the ECMO machine, the insight and knowledge of a large team of nurses and supervising doctors are used for stabilizing an infant. A well-equipped non-infected setup is a must for using the medical device. Surgery is necessary for attaching the device to a baby’s neck and catheters are used to the groin.When a baby is linked to an ECMO machine, blood flows through a tube to that artificial lung connected to a machine which inputs oxygen and expels out carbon dioxide and thus the blood is kept warm at the level of the body temperature and equally pumped back into the body of the baby.Before the session, a baby is kept in the pediatric intensive care unit for having necessary surgeries for fitting the tubes. A surgeon or ECMO doctor informs the parents about the possible problems for using the device, while you need signing the parental consent form.

Surgical masks manufactured using non-woven fabrics made from plastics like polypropylene to filter and protect. They are also available in many different styles and grades depending on the level of protection the user requires.

Surgical masks are designed to keep operating rooms sterile, preventing germs from the mouth and nose of a wearer from contaminating a patient during surgery. Although they have seen a rise in popularity among consumers during outbreaks such as the coronavirus, surgical masks are not designed to filter out viruses, which are smaller than germs.

There are three levels of ASTM certification that surgical masks are classified in, depending on the level of protection they provide to the person wearing them:

Minimum protection face masks are meant for short procedures or exams that won’t involve fluid, spray, or aerosol.

Level 1 face masks often feature ear loops and are the general standard for both surgical and procedural applications, with a fluid resistance of 80 mmHg. They’re meant for low-risk situations where there will be no fluid, spray, or aerosol.

Level 2 masks, with 120 mmHg fluid resistance, provide a barrier against light or moderate aerosol, fluid, and spray.

Level 3 face masks are for heavy possible exposure to aerosol, fluid and spray, with 160 mmHG fluid resistance.

It should be noted that surgical masks are not the same as surgical respirators. Masks are made to act as barriers to splashes or aerosols (such as the moisture from a sneeze), and they fit loosely to the face. Respirators are made to filter out airborne particles such as viruses and bacteria, and create a seal around the mouth and nose. Respirators should be used in cases when patients have viral infections or particles, vapor, or gas are present.

Surgical masks are also not the same as procedural masks. Procedural masks are used in clean environments in hospitals including intensive care and maternity units, but they are not approved for sterile environments such as the operating room.

3 questions answered

Reasons Why You Undergo Breast Augmentation Surgeries in Dubai
Breast augmentation has a dramatic effect on a woman’s appearance & self-esteem. Aside from simply increasing their fullness, replacing the volume and changing their position, it can also be used to balance un-proportioned breasts, making them more symmetrical & aesthetically pleasing.

With today’s naturally shaped implants, techniques, a wide range of sizes & types of implants, the final results can look astonishing.

During a breast augmentation procedure, an implant may be placed either over the muscle or under the muscle. It depends on each patient (implant’s type and size, patient’s health history & body type).

There are certain benefits and drawbacks for each technique.

Over the muscle placement (sub-glandular)

Pros

Implant is placed between the breast tissue and the chest muscle.

Slightly easier & less invasive procedure

Lower recovery time and post-operative discomfort

More cleavage created

Larger implants can be utilized

Implants don’t get distorted when the pectoral muscles are flexed

Cons

Less natural results

Lesser support of implants could result in stretch marks and blemishes

Visible rippling

More mammogram distortion (requires several views)

Higher capsule contracture

Implant could “bottom out”

Future procedures become more risky

Under the muscle placement (sub-muscular)

Pros

Natural look

Reduced risk of visible rippling

Higher supports (better for your skin)

Reduced capsular contracture risk

Less distortion of mammograms

Decreased risk “bottoming out”

Safer choice future procedures

Cons

Perceived as more invasive procedure

Longer recovery time

Implants can distort when the muscle is flexed

Larger implants cannot be utilized (depending on the patient’s body type)

It’s fair to say that breast augmentation has the dramatic effect on a woman’s appearance & self-esteem.

Ways to bring back Ultimate Beauty
Just take a ride down Jumeirah Beach Road in Dubai and you will get to understand how beauty became an industry.

From there, you can cherry-pick how would you like to pamper yourself and enhance your beauty.

Many clinics down that road offers both cosmetic facial skincare and/or aesthetic procedures such as surgeries.

The popular Botox for removing facial wrinkles and fillers for restoring the youth are such examples of a minimal downtime procedure, also known as Lunch-break procedure.

On the other hand, invasive surgeries like body contouring surgeries are rising in popularities in the GCC region.

Breast augmentation or lifts are popular for women, Male breast aka gynecomastia for men. But there is this one procedure that is most popular of them all, and yes it is liposuction.

Liposuction surgery advanced a great deal during the past 10 years. It has become an art, sculpting. You see, it is not only important what do you remove, but what do you keep and how do you “as a surgeon” redistribute the collected fat.

Indeed, the collected fat is not thrown away anymore!! It is rather grafted back in different locations to obtain a new harmony and Body shape.

But please, let us not forget the face, whether it is a nose job, eyelid surgery or a facelift that you seek all you have to do is to stay on that road.

How You Can Afford Plastic Surgery in Dubai!:
Nowadays, cheap plastic surgery offers are everywhere!!

But please think twice and stay alert because you are not rich enough to buy cheap.

The cost of aesthetic surgery is high for a good reason, so let’s break the price into two-component.

first is the price of the running cost (operation room, the staff in the hospital, the stay at the hospital and other consumables, etc.).

Second: the Surgeon’s fee, not only for the initial consultation and how much effort he or she puts in it, but the planning for the surgery and the surgery itself, surgical skills and years and years of practice to develop such skills and last but not least the follow-ups and the countless possibilities of potential complication and how to avoid and resolve them.

That being said, if you compare the coast of aesthetic surgery in Dubai with the rest of the world you will find it very similar. And last but not least, buy once and only cry once.

As you can already see, there are many ways and reasons for a person to enhance their beauty by any means, but when it comes to aesthetic surgery I always tend to understand the needs of my patient and make sure that we are on the same page.