Why do pharma companies not make IV or liquid formulations of their drugs for people who have dysphagia (difficulties swallowing pills)?

Tiny market.
Any competent pharmacist can prepare an IV/liquid formulation of any given drug.

I’ve had bad side effects to vaccines in the past. Can I get a medical exemption somehow?

Your doctor, who undoubtedly has:

all the details of these bad side effects, written up in your medical records,
all the details of all the medical treatment you received as a result of the bad side effects recorded in your medical records, and
all the results of investigations into the precise cause of all these bad side effects attached to your medical records,

should be able to advise you on whether you qualify for an exemption, and will be able to give you an official certificate of your exemption from vaccination.

I wanted to become a psychologist but I’m scared about finding work and the salary as I want to make decent money to help my family in the future. Should I lean more towards psychiatry if both fields interest me?

If money is your main concern, then neither psychiatry nor psychology is a good fit for you. You should probably consider accountancy or tax law, which both attract excellent compensation.

Here in the UK, there’s not a vast difference in salary between psychiatrists and clinical psychologists. The basic training is roughly the same length – 6 years’ medical school plus specialist training for psychiatry, 3 years BSc + 3–6 years PhD and ongoing CPD for clinical psychologists. The opportunities for private practice, academic research and lecturing and so on are not dissimilar, either. I’m not sure what the situation is where you are, but you should check for yourself.

I went into psychology intending to be a clinical psychologist, but went off the idea and wound up an experimental psychophysicist. Even at the start, though, I had zero interest in psychiatry, partly because I saw it as extremely limiting, partly because slogging through medical school and all the pointless and irrelevant medical training to get there seemed, well, pointless and irrelevant. YMMV.

But if money is more important than career satisfaction to you, there are better, and less potentially damaging, routes to wealth than working with vulnerable individuals.

As the vaccines currently available proved to be little effective against the new variants, is it humanly possible to run after each Covid-19 variants engineering every time a new vaccines?

The vaccines currently available are HIGHLY effective against all variants so far, so you’re wrong there.

It is true that the vaccines are somewhat less effective against some new variants. You’ve clearly heard about Delta and Omicron, but you probably haven’t heard of Beta, Gamma, Epsilon, Zeta, Eta, Theta, Kappa, or Lambda: Why? Because they weren’t as infectious and the vaccines stopped them. There’s room in the Greek alphabet for another half-dozen or so variants before the scientists have to come up with a new system of naming them.

The massive achievement of mRNA vaccines is that they can be bootstrapped: that is, we can change the targeted RNA in the mRNA vaccines in days, rather than months/years. That means the only delays are in (1) testing the new vaccine, and (2) production and distribution. Now, because I understand how mRNA works, I personally would be quite happy to consider the mRNA technology proven, and to take a re-jigged mRNA vaccine without further testing – so, for people like me, the only delay should be production and distribution. But not everyone is like me: even scientifically literate people could be wary of a new mRNA vaccine that hasn’t been formally tested, and I can’t say I blame them. The vaccine-hesitant and the antivaxxers, however, would go totally apeshit – more apeshit than they are currently. So, in reality, we’d end up waiting another year before new vaccine would be ready to go in arms, like we had to wait on the vaccines we currently have.

In another post, I likened the pandemic to a war. Right now, we’re in between VE Day – when WWII ended in Europe – and VJ Day – when Japan surrendered, three months later. We’ve beaten the main enemy forces with the vaccines we have. But Omicron – Japan – is still fighting us. We might have to “go nuclear” with a new vaccine for that. However, just because VE Day and VJ Day signalled the end of WWII, it didn’t mean that the fight was fully over. There were still pockets of resistance that had to be rooted out: the last Japanese soldier surrendered in 1974; the most recent Nazi trial for war crimes began 2 months ago.

Ideally, we’d be able to gradually root out the variants with bootstrapped vaccines. Unfortunately, there’s a large and determined resistance in the antivaxxers, so we’ll probably end up fighting this pandemic for another 76 years until the last one dies with a ventilator in their throat, still denying that they’ve committed crimes against humanity.

As a man, I want to understand one thing about periods. Are they actually that bad? Or are they sometimes used as an excuse, maybe for work or tasks we don’t want to do, for creating sympathy on the other side? (Just asking, no offense)

Mine were awful.

Once, I collapsed in school, and the school nurse thought I was having a seizure. I was lying on the floor, twitching, unable to stand up or speak. OMG embarrassing. Painkillers, even those designed for period pain, couldn’t even touch it.

I later came to realise that my stupid body had fooled itself into thinking I was in labour. The pain came in waves, gradually increasing in frequency. I read up on natural childbirth, and tried the techniques I read about – breathing, staying active as much as possible, etc. That helped, though it still meant I couldn’t do much else, like study or work. And once the pain resolved itself, I was so knackered all I could do was sleep.

Eventually, a doctor listened, and recommended I had a D&C. After that, I never had that kind of pain again. I still had pain, but it was occasional, and only uncomfortable. I never had to take time off from my normal schedule to deal with it.

Since then, I had a baby. It ended in an emergency c-section, but up until that, I had natural labour, no pain relief or anything, just walking around and breathing exercises. It was a piece of cake compared to my period pain.

Is it possible for the world to become medically aseptic?

The human body contains more micro-organisms than human cells: estimates vary from 3 to 10 times as many. These microbes include bacteria, archaea, protists, fungi and viruses.

Most of these are ‘good’, and perform important tasks in the body; others are neutral co-travellers, and a few are bad. The bad microbes are relatively few in number – unless you’re ill – and many are kept in check by the good microbes. Some microbes are only bad if they get somewhere they’re not meant to be: poliovirus is a fairly benign creature in the intestine, but if it is transferred via faeces to the upper digestive system, it can cause poliomyelitis. Escherichia coli (E. coli) is an important bacterium in maintaining a healthy gut, but a few variants of E. coli can cause food-poisoning, diarrhoea and some forms of dysentery, and hemolytic uremic syndrome (a type of kidney failure).

Antibiotics are used to treat bacterial infections, but they are not a magic bullet that only attacks the ‘bad’ bacteria. While specific antibiotics are prescribed for different infections, most will kill other bacteria as well – including the ‘good’ bacteria. You’ll doubtless have heard of people suffering from thrush (candidiasis) after a course of antibiotics, because the antibiotics killed the ‘good’ bacteria which kept the Candida fungus in check.

Which is a roundabout way to say – we couldn’t survive making our own bodies aseptic, much less the world.

Link

Why does the NHS cover the cost of levothyroxine in the UK?

The NHS provides a medical exemption certificate to people who need levothyroxine, waiving the standard prescription charge that patients have to pay for most other drugs. Other medications covered by the certificates are for serious life-threatening conditions like cancer and diabetes.

Just posting to give the perspective of someone who actually suffers from an underactive thyroid.

I first realised that there was something seriously wrong with me when I fell asleep at the wheel of my car, driving down the M6 in England.

I wasn’t tired. It was around 9 o’clock in the morning, and I’d had a good night’s sleep. I had been driving less than 20 minutes.

Luckily, I came to almost immediately, and was able to get off the motorway swiftly. I parked up, and sat there drifting in and out of consciousness for the next four hours. I filled up on coffee and continued my journey without incident.

I saw my GP as an emergency, and within a few days was on levothyroxine. Amongst the many other benefits provided by this medication – and there are many – I’ve never fallen asleep driving since.

I would consider levothyroxine to be most definitely a life-saving medication: the lives saved, however, are not limited to my own.

You’re transported back to the medieval era and suffer a sword wound. Using all the knowledge of the modern era, how would you prevent infection?

Heh. The Viking treatment for a sword to the gut was garlic porridge.

After a suitable time, if the wound smelled of garlic, the intestine was perforated and you sent the wounded person to Valhalla. Otherwise, you sewed up the wound and hoped for the best.

A lot depends on where the wound is, and how deep. Gut wounds were – and still are – the worst, leading to a slow, agonising death. Next worst are/were pierced or collapsed lungs – drowning in your own blood or of asphyxiation. Sometimes the best treatment was to help the injured on their way.

However, there’s a lot that can be done for more minor wounds. People died of relatively minor wounds, due to infection. Boiling water and soap will deal with a huge number of pathogens. The astonishing thing is that we didn’t realise simple hygiene’s protective value before we did (even Florence Nightingale didn’t believe in washing her hands between patients). Cleaning out the wound with nothing else would be a good start.

Honey can be used to semi-seal a wound and stop further infection, as can pitch. Vinegar, pure alcohol (vodka, for preference), and salt can also help disinfect. A hot bread or bread-and-milk or onion poultice can help draw out infection and any detritus in the wound.

Once you’re reasonably certain the wound is clean, sew it up and, if necessary, continue washing, using poultices, alcohol and/or honey, changing dressings as necessary. Be prepared to have people think that you’re mad for doing so, or a witch for succeeding.

You could try making your own antibiotic from waste food in the village midden (don’t do this), or a bacteriophage solution from your nasal mucus (DON’T DO THIS), but, really, you’re already going to be under suspicion of Satanic collusion just for washing the wound out. Surviving a sword wound only to be burned at the stake isn’t a victory for modern science.

How do I prevent someone from dying to a shot to the jugular?

Assuming a person was shot by a rifle, and the bullet stays in 2 / 3rds of the way out. The bullet being in 9mm for this hypothetical. How does an experienced or in experienced person prevent the shot person from dying?

Jugular vein trauma is easier to deal with than damage to the carotid artery. Well, relatively, anyway: arteries spurt, veins leak.

Personally, I would leave the bullet where it was, assuming it was stopping blood exiting the vein, and seek medical help. Don’t try to remove it – if anything, support it as best you can.

If the bullet fell out or got dislodged, treat it like any other puncture to a blood vessel: cover the hole with a dressing (preferably one that is air- and liquid-proof), apply pressure (not too much, obviously – you only want to stop blood escaping), call for help. You’d need to move fairly fast. Clapping a hand over the bullet hole will do at a pinch, while you find something more suitable.

If the zombie apocalypse has arrived and and there’s no medical help to be had because all the medics are out looking for brains, superglue is probably the best way to seal the wound quickly. The patient may die anyway from shock, infection, etc.