Clinical Conundrum

1. A Midsummer Night’s Dream

Nightmares are a curious common occurrence that people often dismiss as inconsequential. However, at times there could be a concern for negative medical outcomes based on certain patterns of nightmares that must not be ignored to avoid long term impact. This chapter is an account of the significance of nightmares and examines the implications in the context of a patient with recurring nightmares that could be dangerous.

2. The Sad Story of Dementia

Aging is a process that no one has any control over, whether it’s physical or mental. The author confronts the psychosocial impact of dementia in the elderly as she describes her own experience with a close family member. Dementia has been stated as the silent killer and in this chapter the author probes the moral dilemma that providers and families face when a loved one is afflicted with it.

3. Alcohol Abuse Disorder and Pedigree

Substance abuse has no age, gender, race, ethnicity, or social status. It affects people widely and alcoholism is an incredibly common disorder that has its basis in genetic and environmental factors combined. This chapter explores how family history is a red flag that can predict success or failure in the rehabilitation of an addict.

4. Is Gluten Intolerance a Myth?

Digestive disorders are common and some pose a diagnostic dilemma for providers and patients alike. The symptoms of many conditions overlap and are ambiguous enough to cause confusion. Gluten is an ubiquitous food additive in the western world that has been blamed for a wide spectrum of disorders and the author clarifies in minute detail how people can suspect they may have a gluten disorder.

5. The Clinical Challenge of Jehovah’s Witness

Every culture and religion has its own rules and guidelines that patrons want to adhere to in the practice of faith in daily life. Clinicians in America face the challenge of transfusion of blood and its products in this particular faith and the author discusses the social and legal aspects of caring for a Jehovah’s Witness patient.

Prologue: The Tempest

The introduction is a first person account of the author’s personal struggle with endometriosis for fifteen long years, most of which was spent dealing with intense pain and undergoing different kinds of treatments with little success. It was written after she was recommended urgent surgery at a time in her life when she was at the peak of her career and overwhelmingly committed to many projects that in her mind demanded that she find excuses to disregard her health needs for others.

Women’s Health

6. Hypoactive Sexual Desire Disorder in Women

Female sexuality has been a taboo topic for discussion and recently became a topic of debate with the approval of the ‘pink Viagra’ flibanserin. The author examines the slim scientific evidence behind the drug and its controversial marketing by pharmaceutical companies.

7. Breast Cancer Genetics and Treatment Options

Recent high visibility celebrities’ struggle with early hereditary breast cancer has brought into focus the often confusing questions that women need answers to regarding screening, prevention and treatment of breast cancer. The author’s expertise in cancer genetics is utilized to explain the risk for breast cancer and what steps need to be taken in those women who have a strong family history.

8. High Heels and Health: The Stiletto Confidential

Women love wearing heels. So does the author. However, heels are detrimental to health in more ways than one. This chapter describes the history of heeled footwear and probes its health impact as well as other safety advice.

Advocacy

9. Sexual Violence – A Sinister Public Health Problem

Sexual violence against women and children of both genders is a deeply disturbing occurrence in current times and is a global issue under intense scrutiny. The author investigates some of the literature and practices in different parts of the world that are worrisome.

10. When Justice Fails: Violence, Prison and African Americans

Social disparity based on race and ethnicity has existed from time immemorial. Correctional facilities have more than their fair share of inequality in the US and remain a source of concern due to deep psychosocial and economic impact. Almost half of innocent prisoners in the country are black. The author searches for answers to this after one of her patients casually told her he had been in prison for thirty years for a crime he did not commit.

11. Transgender Health Disparities – In Between

Healthcare equity in the LGBT community has been troublesome for a long time. Discrimination and abuse are sources of unique health problems in a population that already needs special care. As an HIV specialist in a large LGBT center in Chicago, the author had the opportunity to understand these needs and expresses her outlook on what the transgender world is like.

12. Absconding from hospitals: Absconders – What Makes Them Leave?

People usually do not walk out of hospitals after they have been admitted before their treatment is complete. However, public hospitals may witness more such events than private. The author conducted a robust study to evaluate the prevalence and predictors of patients who abscond from hospitals without staff permission. She discusses the short and long-term ramifications of such risky behavior and what guidelines institutions could follow to prevent it.

13. Notes From a ‘Third World’ Country

We often consider medical care in the western world as the best and most appropriate and worry about lack of proper care in the developing countries. However, this may not be true. Does it matter how patients get treatment as long as the outcome is good? The author describes her experiences with three family members in India who fell sick at the same time and how she was able to manage them in their resource limited settings without complications.

Modern Medicine

14. Medical Marijuana – Hashing the Hashish Myth

Marijuana has been classified as a schedule 1 drug in the US meaning that is highly addictive and without medical value. However, scientists and healthcare providers have questioned this label and are trying to prove that there may be critical medicinal properties that we have ignored. The author has described the various medical disorders for which marijuana may be a worthwhile treatment.

15. Electronic Cigarettes – Beauty or Beast?

Smoking remains the number one preventable cause of death in the world and smoking cessation strategies are critical to improve global population health. Electronic cigarettes have been touted as the next best thing for smokers but they have harms of their own. This concern is outlined in this chapter with detailed explanation of what an e-cigarette is.

16. The Lochness Monster – Health Insurance in the United States

Health insurance coverage remains the most important component of medical care in the US. There are millions uninsured, Obamacare is controversial, underinsured have unique problems of high deductibles and out of pocket expenses, even the insured have issues with access to care. It’s all discussed in a simple style.

17. All The World’s a Stage – For Telemedicine

Access to affordable high quality care can be enhanced with telemedicine, the delivery of medical care virtually over the phone, video or Internet. Due to the high cost of care, telemedicine is gaining popularity across the world and in the US millions will get coverage through Medicare, Medicaid, and private insurance. What is it and how does it impact cost of care and overall health? Dr Tanu S. Pandey illustrates this new field of medicine with examples of her experiences in her career.

18. An Ode to County – And The Sounds of a Stethoscope