Friday, December 25, 2009

Christmas and Medicine...Merry Christmas to all! #medtweeps #christmas

Christmas is in the air! I was just wondering how Christmas relates to medicine...Sounds crazy!! But I ended up getting this, an eponymously named disease, clinical signs, radiological signs, a connection to toxicology and few other interesting stuff which is related to Christmas.....Post any further additions to the list in comments..

Christmas disease- aka hemophilia B...Is a blood clotting disorder caused by a mutation of the Factor IX gene, leading to a deficiency of Factor IX(Christmas factor). It is the less common form of haemophilia, rarer than haemophilia A. It has nothing to do with Christmas though, it is called Christmas disease after Stephen Christmas, the first patient described with this disease.

Christmas tree pattern- Seen in Pityriasis Rosea a scaling dermatological disorder, characterized by often widespread papulosquamous, hyperpigmented, scaling lesions that develop a "Christmas tree" pattern on the back.

Christmas tree deformity- A radiological sign seen sometimes in Intestinal atresia..In over 10% of patients with intestinal atresia the mesentery is absent, and the superior mesenteric artery cannot be identified beyond the origin of the right colic and ileocolic arteries. The ileum coils around one of these two arteries, giving rise to the so-called Christmas tree deformity on contrast radiographs.

CO toxicity from leaking electric Christmas tree lights -CO toxicity has also been reported as a result of inhaling methyl chloride vapor, which is a component of paint stripping solutions, or from leaking "bubble" electric Christmas tree lights

Tropical Sporotrichosis is common in those involved in Christmas tree farming- Sporotrichosis is a subacute or chronic subcutaneous infection caused by the fungus Sporothrix schenckii.Diagnosis should be considered when a cutaneous lesion is found on a patient involved with Christmas tree farming, landscaping, rose gardening, berry picking, baling of hay, and in veterinarians.

doodle.png  on Aviarydoodle.png on Aviary.

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Thursday, December 17, 2009

My 100th post on blogger: TOP TEN POSTS OF 'INQUISITIVES' BLOG

Its a very special moment for me.This is the 100th post of Inquisitives blog on blogger.Its made special by three reasons.One is that the 100th post coincides with my father's birthday.Second is that frankly i never thought i will come this long(to be frank i didnt even know exactly what a blog was, let alone blogging when i started the blog).And a 100 posts after, i have to say,Blogging has become a very special hobby for me.Its very satisfying, that it helps me to increase my knowledge and has given the opportunity to interact with lots of special frens from around the globe.Third reason is that Inquisitives's posterous, which i use to create and autopost to blogger and other social sites registered 10,000 page views today(since september 2009).

In this post i will enlist the Top Ten Posts of my blog(ones which have got the highest pageviews since Sept.2009, thats when i started using google analytics)

1)Identify the Skin lesion and Diagnose the clinical condition

2)My blog 'Inquisitives' is Apture-enhanced now!Have a look at this screencast to know how.

3)Sagittal T1-weighted MRI scan in an 11-day-old boy- Diagnosis?

4)What disease does this picture speak about?

5)Identify all the pictures.Connect the three pictures.And give me the diagnosis.

6)Histopathological picture of mature Ovarian cystic teratoma-Identify what the arrow is pointing at (#quiz #medtweeps)

7)What is the radiological abnormality in this T2-weighted MRI of Cervical spine?

8)Identify the radiological sign and the probable diagnosis

9)Young male presented with history of cough and hemoptysis.Connect the two images and give the diagnosis.

10)Identify the Pathology and Diagnose

I thank all my frens who have kept me going and everyone who reads my posts.I am all ears to your suggestions in improving the blog.Finally i dedicate this post to my loving father.
Looking forward to active participation from everyone...

Wednesday, December 16, 2009

Newly approved drugs(FDA November-December 2009)

Romidepsin- Histone deacetylase (HDAC) inhibitor indicated the treatment of cutaneous T-cell lymphoma.Romidepsin is a natural product obtained from the bacteria Chromobacterium violaceum.

Wilate- a von Willebrand Factor/Coagulation Factor VIII Complex (Human) indicated for the treatment of spontaneous and trauma-induced bleeding episodes in patients with severe von Willebrand disease (VWD).

Ecallantide- Plasma kallikrein inhibitor indicated for treatment of acute attacks of hereditary angioedema in patients 16 years of age and older.


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Tuesday, December 1, 2009

Lazarus Effect-Someone on death's door can be brought back to life with treatment costing around 40 cents a day! #WorldAIDSday


3800 people die everyday froma preventable and treatable disease- HIV/AIDS...Treatment costs around 40 cents a day.The results are nothing short of miraculous.Someone on death's door can be brought back to life. In as little as 90 days.This transformation is called the Lazarus Effect.


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Sunday, November 8, 2009

Thursday, October 29, 2009

Newly approved drugs(FDA September-October 2009)

  • Here are some newly approved drugs, vaccines and some new indications for old drugs.
CD20-directed cytolytic monoclonal antibody indicated for the treatment of patients with chronic lymphocytic leukemia.

kinase inhibitor indicated for the treatment of patients with advanced renal cell carcinoma

human papillomavirus bivalent (types 16 and 18)
preventative cervical cancer vaccine for the prevention of cervical pre-cancers
and cervical cancer associated with oncogenic human papillomavirus
(HPV) types 16 and 18 in girls and young women (aged 10-25)

Berinert (C1-esterase inhibitor (human)
plasma derived C1 Esterase Inhibitor indicated for the treatment of acute abdominal or facial attacks of hereditary angioedema (HAE) in adult and adolescent patients.

human monoclonal antibody for the treatment of moderate to severe plaque psoriasis.

folate analogue metabolic inhibitor indicated for the treatment of patients with relapsed or refractory peripheral T-cell lymphoma (PTCL)

Influenza A (H1N1) 2009 Monovalent Vaccine
 is an inactivated influenza virus vaccine indicated for active immunization of persons ages 18 years of age and older against influenza disease caused by pandemic (H1N1) 2009 virus

bactericidal, once-daily injectable antibiotic for the treatment of complicated skin and skin structure infections (cSSSI) caused by susceptible Gram-positive bacteria, including Staphylococcus aureus, both methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) strains.

antihistamine and mast cell stabilizer for treatment of the symptoms of allergic conjunctivitis.

a nonstimulant selective alpha-2A-receptor agonist for the treatment of children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD)


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Wednesday, October 28, 2009

Histopathological picture of mature Ovarian cystic teratoma-Identify what the arrow is pointing at (#quiz #medtweeps)

This is a histopathological slide of a biopsy from Mature Ovarian cytic teratoma from a young female. Identify what the arrow is pointing at.

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Thursday, October 22, 2009

Personalized search(Preferred sites from Google experimental)- Search from sites that you want.

Nobody can disagree that Google search has become a very important part of the way we use information from the web. Although its very good and gives the most appropriate results if given the right inputs, it will be more awesome if u can search from your favourite sites, the ones you think will have the infrmation you are looking for. Well, interested in making your search more personal? Heres the answer- 'Preferred sites' from 'Google experimental'

Heres what you gotta do-

Go to

After you join the experiment, you will be asked to give some preferred sites, which will be given high priority next time when you search.

I recommend these sites for medical students or if you are interested in medical/health related search,,,,,,

You can give any site address which matches your interests.The more sites you add the better chances of hitting the results you want.

After you are done, just search and see...Your Search is Personalized!

Please give feedback in the comments section.Let me know that you visited.(Right now the only way i know people come here is Google Analytics, which is so boring!)




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Wednesday, October 21, 2009

What is the radiological abnormality in this T2-weighted MRI of Cervical spine?

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Firefox add-ons for those who study/research online

Welcome to wonderful world of Firefox Add-ons(If you dont use Firefox as your browser, think again, because you are missing a world of goodies that firefox offers). This is the first in the series of Add-ons i am posting, which i think drastically reduce time wasted in doing routine things.These add-ons i am going to post are especially useful to students who study/research online. Its going to be a great help to medical students/doctors who have to manage a flood of information each day.

Perma tabs- While browsing, you may have noticed that we use a few sites pretty regularly, sometimes its in a tab always.

Perma tabs helps in making these fave tabs permanent.

It lets you choose a color of your choice for these fave tabs.

They dont have a close button, so no fear of accidentally closing them.

The fave tabs are opened always at startup.

They will open even after browser crashes/power failure.

Another cool feature is u can force all links in the fave tab-web page to open in a new tab, when you click on them.You have the freedom to enable/disable this feature.Take a look at the screenshot below.

Heres what you have to do-

In Firefox- Go to

It will ask you to allow adding the experimental add-on. Check the box. Click on the 'Add to firefox' button.

After the add-on is installed, restart the browser.

After this right click on any tab, in the context menu, there will be option to make the tab permanent.

Hope You like this..

Heres how your tabs will look like..I have made the Wikipedia and emedicine tabs permanent, because i use them regularly.

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Tuesday, October 20, 2009

Identify the abnormality and give the diagnosis-Hematology

Identify the abnormality in the picture.Give the diagnosis.This patient was asymptomatic and this abnormality was found on routine blood work-up.What is the next line of management?

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Sunday, October 18, 2009

Identify what the arrow is pointing at in this plain abdominal radiograph.

This is a plain abdominal radiograph of an elderly man who presented with acute onset abdominal pain.Identify what the arrow is pointing at and give the differential diagnosis.
Click on the image to get the whole, clear picture.Image too big to fit in some computers with low resolution modes.

"Where the Silver Lining is a Dark Cloud" - Make this deepavali more meaningful!

For more lesser known, shocking facts like this visit Because you have the power to change things, to make this Deepavali a meaningful one. One that is full of health and happiness in the real sense.

Saturday, October 17, 2009

“There is not enough darkness in all the world to put out the light of even one small candle”

Wishing Everyone a Happy Deepavali-the festival of lights...and i pray God to bring you health, happiness and prosperity!

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Friday, October 16, 2009

Vitamin D for Cancer Prevention.

  • Higher serum levels of the main circulating form of vitamin D, 25-hydroxyvitamin D (25(OH)D), are associated with substantially lower incidence rates of colon, breast, ovarian, renal, pancreatic, aggressive prostate and other cancers.
  • new model of cancer etiology that accounts for these actions of 25(OH)D and calcium.
  • Its seven phases are disjunction, initiation, natural selection, overgrowth, metastasis, involution, and transition (abbreviated DINOMIT).
  • Vitamin D metabolites prevent disjunction of cells(Upregulates E-Cadherins,Catenins and intercellular junctions) and are beneficial in other phases.
  • It is projected that raising the minimum year- round serum 25(OH)D level to 40 to 60 ng/mL (100–150 nmol/L) would prevent approximately 58,000 new cases of breast cancer and 49,000 new cases of colorectal cancer each year
  • Such intakes also are expected to reduce case-fatality rates of patients who have breast, colorectal, or prostate cancer by half.
  • There are no unreasonable risks from intake of 2000 IU per day of vitamin D3, or from a population serum 25(OH)D level of 40 to 60 ng/mL.

Ref- Ann Epidemiol. 2009 Jul 1;19(7):468-483, CF Garland, ED Gorham, AR Mohr, FC Garland

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Monday, October 12, 2009

Midsagittal MRI of the brain.Identify the pathology.And the peculiar sign.

 Clue- The Patient is a 66 yr old male.He presented with history of repeated falls.

Leukocyte Alkaline Phosphatase levels- Clinical significance.

Leukocyte Alkaline Phosphatase-

  • enzyme found in all tissues
  • located in neutrophils, involved in intracellular metabolism
  • important in distinguishing between chronic granulocytic leukemia and leukemoid (leukemia-like) reactions

Decreased levels-

  • nephrotic syndrome
  • chronic granulocytic leukemia
  • infectious mononucleosis
  • paroxysmal nocturnal hemoglobinuria
  • chronic myelogenous leukemia
  • thrombocytopenic purpura
  • sickle cell anemia.

Elevated levels-

  • polycythemic vera                                                                                                                                                                             
  • leukemoid reactions                                                                                                                                                                         
  • myelofibrosis
  • Hodgkin's disease
  • aplastic leukemia
  • thrombocytopenia
  • multiple myeloma.

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Sunday, October 11, 2009

Oxygen therapy relieves headache pain in the ED, cuts length of stay, drug use.

Giving high-flow oxygen therapy for 15 minutes to emergency department patients with headaches provides rapid relief and reduces hospital stays, use of CT scans, and headache pharmacotherapy, according to a pilot study.

Dr. Boris Veysman of the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School reported the results on Monday at the annual meeting of the American College of Emergency Physicians in Boston.

"Very often, when a patient comes to the emergency department with one complaint being headache, they're uncomfortable and symptomatic and they have to wait for a workup before anyone can determine the cause. A diagnosis may not even be made in the emergency department," Dr. Veysman told Reuters Health. "So we approached it from a different perspective and asked, 'What if therapy were the first thing you did (for a headache) before attempting to find a cause?' And so we tried giving oxygen therapy, because it's so widespread and safe."

In the placebo-controlled study, 17 patients were randomized to 100% oxygen at 15 L/min for 15 minutes; 14 received high flow air for 15 minutes; and 17 received no intervention prior to standard treatment. Headache intensity was assessed using a 10-point visual analog scale.

Median times to relief were significantly shorter for patients treated with oxygen (40 minutes) compared with those treated with high flow air (110 minutes) or nothing (120 minutes). Median length of stay was also significantly shorter for patients treated with oxygen (57.5 minutes) than for those treated with air (210 minutes) or nothing (180 minutes).

In addition, CT scans were ordered less frequently: for four of 17 patients (24%) who received oxygen; 11 of 14 (79%) who received air; and eight of 17 (47%) who got nothing.

Medication was given to 29% of those who received oxygen, 86% of those who received air, and 82% of those who received no treatment.

Headache intensity was significantly reduced at both 15 minutes and 30 minutes after initiation of treatment, with patients treated with oxygen realizing the greatest reductions.

The conclusion is what interested me(Lines in the screenshot)



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The arrow is pointing at an RBC.Identify the peculiarity and diagnose the clinical condition.

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Friday, October 9, 2009

Remembering John Lennon....

Yesterday was John Lennon's Anniversary.Belated wishes John.You live through your music.Enjoy his song 'Imagine'...

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Thursday, October 8, 2009

October 8-World Sight Day 2009 "Gender and Eye Health – equal access to care" #WSD09

VISION 2020 - World Sight Day 2009

  • World Sight Day 2009
  • The theme of World Sight Day 2009 (WSD09) is: Gender and Eye Health – equal access to care
  • Global Key Messages for WSD09 Nearly two-thirds of blind people worldwide are women & girls In many places, men have twice the access to eye care as women Equal access to eye care could substantially reduce blindness in poor countries* Simple and effective strategies can and do successfully address this inequity within VISION 2020: The Right to Sight
  • Don't forget: 80% of blindness is avoidable - either treatable, curable or preventable 90% of blind people live in low-income countries Cataract is the leading cause of blindness – yet it is curable by a simple, cost-effective operation 8 million people worldwide are blind due to uncorrected refractive errors. A simple sight test and glasses could restore sight to most of these people
  • Up to 80% of the world's blindess is avoidable.

    Avoidable blindness is defined as blindness which could be either treated or prevented by known, cost-effective means. Although there are many other causes of vision impairment, VISION 2020 seeks to address the main causes of avoidable blindness, in order to have the greatest possible impact on vision loss worldwide.

    The target disease areas for VISION 2020 are:




    Childhood Blindness

    Refractive Error

    Low Vision


    Diabetic Retinopathy

    Age Related Macular Degeneration

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Wednesday, October 7, 2009

2009 Nobel Prize in Chemistry to Venkatraman Ramakrishnan, Thomas A. Steitz and Ada E. Yonath

  • 2009 Nobel Prize in Chemistry to Venkatraman Ramakrishnan, Thomas A. Steitz and Ada E. Yonath
  • The Royal Swedish Academy of Sciences has decided to award the 2009 Nobel Prize in Chemistry jointly to Venkatraman Ramakrishnan, MRC Laboratory of Molecular Biology, Cambridge,United Kingdom Thomas A. Steitz, Yale University, New Haven, CT, USA Ada E. Yonath, Weizmann Institute of Science, Rehovot, Israel
  • "for studies of the structure and function of the ribosome"
  • The knowledge about the ribosome's inner workings is put to practical use in many of today's antibiotics which cure diseases by blocking the function of bacterial ribosomes. Bacteria cannot survive without functional ribosomes, so ribosomes are an important target for new antibiotics.
  • They used a method called X-ray crystallography to map the position for each and every one of the hundreds of thousands of atoms that make up the ribosome.  They have generated 3D models that show how different antibiotics bind to the ribosome. These models are now used to develop new antibiotics, directly assisting the saving of lives and decreasing humanity's suffering.

This is a screenshot of the official Nobel website.I am disappointed that they have not cared to acquire and post the image of Sir Venkataraman.

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WHO pain relief ladder in cancer palliation therapy

  • WHO has developed a three-step "ladder" for cancer pain relief.
  • If pain occurs, there should be prompt oral administration of drugs in the following order
  • nonopioids (aspirin and paracetamol)
  • then, as necessary, mild opioids (codeine)
  • then strong opioids such as morphine, until the patient is free of pain.
  • To calm fears and anxiety, additional drugs – “adjuvants” – should be used.
  • To maintain freedom from pain, drugs should be given “by the clock”, that is every 3-6 hours, rather than “on demand”
  • This three-step approach of administering the right drug in the right dose at the right time is inexpensive and 80-90% effective.
  • Surgical intervention on appropriate nerves may provide further pain relief if drugs are not wholly effective.
  • (image)

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Dont be scared by its looks!This is a boon to medicine.Tell me how.

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Hematology- Identify the abnormality.Give the differential diagnosis.

The arrow is pointing at something.Identify the cell, abnormality, and give differential diagnosis.

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Monday, October 5, 2009

American trio get nobel prize for medicine(2009)for discovering 'Telomerase'.

  • Three Americans Share Nobel Prize for Medicine
  • Americans Elizabeth H. Blackburn, Carol W. Greider and Jack W. Szostak won the 2009 Nobel Prize in medicine on Monday for discovering a key mechanism in the genetic operations of cells, an insight that has inspired new lines of research into cancer.
  • The first time two women have been among the winners of the medicine prize
  • The trio solved the mystery of how chromosomes, the rod-like structures that carry DNA, protect themselves from degrading when cells divide.
  • Telomeres that are often compared to the plastic tips at the end of shoe laces that keep those laces from unraveling.(What a beautiful analogy!)
  • Blackburn and Greider discovered the enzyme that builds telomeres -- telomerase -- and the mechanism by which it adds DNA to the tips of chromosomes to replace genetic material that has eroded away.
  • Some inherited diseases are now known to be caused by telomerase defects, including certain forms of congenital aplastic anemia, in which insufficient cell divisions in the stem cells of the bone marrow lead to severe anemia. Certain inherited diseases of the skin and the lungs are also caused by telomerase defects.


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Display "ECO-SAFE Merit Badge" n provide environment friendly printing alternatives

Let's Change the World

We can change the world by using each of our own unique voices. By placing the ECO-SAFE Merit Badge on your website or blog, you are using your voice and empowering others to participate in environmentally friendly behaviors on the web. The ECO-SAFE Merit Badge is a symbol of hope and love for the world we all live in.

Websites displaying the "ECO-SAFE Merit Badge" are providing environmentally friendly printing alternatives for their website visitors. As a collective group of people who use the Merit Badge, we are actively reducing the staggering number of web pages printed daily.

We believe in our individual power and the collective power of all of us. Together we can change the world. I can, you can, we can. Here and now, from this day forward.

Live Total ECO-SAFE Merit Badge Interactions: 15,800,097

Join today, help the environment, and change the world

I put this up on my blog...Check it out here And tested it too..Works awesome...

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Friday, October 2, 2009

Finally! Orkut Promote available to Indian users!

After a long wait, Orkut promote feature is now available for Indian users..Its really pathetic that its release is delayed so much in India, which has the second largest userbase for orkut, next only to brazil..Its a big relief..Hey Google,dont make us feel 'third world'!

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Sagittal T1-weighted MRI scan in an 11-day-old boy- Diagnosis?

Identify the structures marked by small arrow, large arrow, and 'b' and the Diagnosis...

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Gandhi Jayanthi wishes to everyone- Google doodle commemorating Gandhi #quote

"Be the change you wish to see in the world"- Mahatma Gandhi

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Thursday, October 1, 2009

Identify all the pictures.Connect the three pictures.And give me the diagnosis.

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Emailing, texting may harm you- Really!I will email this right away to all my frens:)

Experts have warned that the increasing popularity of social networking sites, emailing and texting may be injurious to public
Games on computer
Networking sites, emailing, texting may prove injurious to public health (Getty Images)

Nada Kakabadse, a professor at Northampton University, says that these technologies are leading to anxiety, reduced productivity and a generation of smartphone orphans.

She points out that people these days are increasingly becoming obsessed with information from an ever growing number of sources. "One third of our sample suffer from technological addiction. They are addicted to their gadgets - phones, BlackBerries, laptops. It is a problem. It has negative consequences on their family life, their health and their social life," Sky News quoted her as saying.

Nada says that “pop-up alerts” often interrupt netizens from their primary task in favour of reading emails, and then direct them to other online links. She says that people then suddenly feel low energy, become clumsy and have a spatial disorder.

The expert says that even though people become exhausted, they may check other stacked up behind the new one, have a quick look on Facebook, Twitter or something else, and it may be half an hour before we’’re back to that primary task. "You can not any more do effectively the task you were originally doing, even if it was routine. You will suddenly feel low energy, you become clumsy and you have a spatial disorder. You become exhausted," Nada said.

In a survey of 4,000 email users that the US firm AOL recently conducted in America, 46 per cent described themselves as being "hooked" on email. Nearly 60 per cent had checked email in the bathroom, 15 per cent checked it in church, and 11 per cent had hidden the fact that they were checking it from those around them.

And this is said to have given rise to the phenomenon of BlackBerry orphans, children who desperately fight to regain their parents’’ attention from the devices. Susan Bailey, a principal lecturer at Northampton University, says that she need look no further for a techno-addict than herself. "I probably only sleep four hours a night. And immediately when I wake up I feel that I have to connect. My family would say it is a problem. I am trying to manage it," she said.

The answer, according to digital strategist Andrew Grill, is techno-management.

"I think it wouldn’t hurt to have people to help us understand how to relax with all this digital information," he said. "I read an interesting tweet the other day about someone who learnt how to turn off the flashing light on their BlackBerry and it had apparently changed their life.

They are now regulating their usage because they don’t feel the need to pick it up every time it flashes," he added.

He says that it is about simple management and a little self control.

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