The Silent Killer

"I Don't Need Drugs To Get High,A Slice Of Pizza Will Do"

A personal Anecdote;My Father Who Himself Was A Doctor With Running Profession had a little injury b/w his Great Toe and 2nd digit.Days Passed with dressing the wound thoroughly but it wouldnt lay down/heal.And a nasty swelling with tiny pus opening appeared someway distal(at a distance from the original wound).So he with All Aseptic Precautions did undergo incision.

And what we as family & what my father went through after that both are called "SHOCK" but, Mine Fathers was a Septic Shock that was later confirmed to be associated with diabetes.

THE BIGGEST MYTH ABOUT HIGH BLOOD SUGAR IS;THAT ITS DUE TO EATING SUGAR

                        DONT BE THE CAT!!!SHE STILL MOVES      SWIFTLY$$$

The Only culprit about diabetes is the sedentary lifestyle(Sometimes Genetics too.)

STATS: Its estimated that every 7th patient that comes to docotr in OPD in india is diabetic(due to sitting lifestyle;known as type2 diabetes mellitus).

According to WHO 35 lac people in india are Diabetic.Its projected by 2025 it will 55 lac.

Past Lesson: In 2000's 14/100 urbanites had diabetes; which was type2 diabetes mellitus.And that we now know is due to becoming a "COUCH POTATO".

Our Accomplishment On Above Credits is that India is declared by WHO as DIABETIC CAPITAL OF WORLD.

DETECTING DIABETES AT LARGE: Its more of a incedental finding,meaning we visit for some infection and out of all the test doctor also performs blood glucose/urine sugar:

out of the above two;blood glucose monitoring serves both purposes of identifying the disease and later on keep a check about it.

MUST KNOW:

SIGNS YOU SHOULD NOT FORGET:

WHAT TYPE OF DIABETES YOU HAVE??               

There is another type of dabetes known as Gestation Diabetes Mellitus seen during Pregnancy and it disappears after delivery,but these women can get Diabetes later on. 

HOW CAN WE DIAGNOSE TYPE2 DIABETES MELLITUS?

Fasting Blood Sugar Level:ideal parametre ,done every month

Post Prandial/Random Blood Sugar Level: Not Reliable.

Urine Diastix:To check Control

GHbA1c: Done Every 6 month,should be <7%

Weight Record Parametre: Good 

How to Manage Type2 Diabetes Mellitus:

1)Role Of Exercise

2)Role of Diet

3)Oral Anti-Diabetic Drugs 

4)Role of Insulin

   

          

1) Role Of Exercise: 

Patient: Doctor I have no time for exercise due to busy schedule!!

And even after lot of persuasion patient doesnt end up doing exercise.But the real benefit of exercise in type 2 diabetes person are:

a. it decrease the blood glucose

b. it decreases dependency anti-diabetic

c. it decreases weight

d. for mild diabetic its sufficient alone to control it.

e. increases (good cholestrol) HDL 

 

Precautions  While Doing Exercise: 

a. always eat 2 biscuits before exercise or carry glucose powdeer in his pocket.

b. should not take insulin on moving part i.e. thighs

c. should not exercise during peak insulin time, i.e. 3 hours after taking intermediate acting.

ideal time to exercise: Morning after a light breakfast.

Which Type Of Exercise Should WE do???

Yoga is not an Ideal Exercise as it dosenot burn CALORIES.

1.Dynamic: Walking/Jogging/Cycling/Swimming/.Playing badminton,Tennis.

2.Static: Weight Lifting(can't burn calories) thus its not a ideal exercise , same is the scenario with Gymnasium

Then what's Ideal?? dynamic exercise for 45 minutes/day for 5 times a week.

How fast should we jog?? By Keeping Pulse Rate within the Target Heart Rate Zone i.e. 60-80% of mximum hear rate.

 

For the LAZY LADS/LADDIES: 

a. Avoid Lifts-Take Stairs

b. Park your vehicle far away from your destination

c. Involve in household activities

d. Sit, instead of lying

e. Stand, instead of sitting down.

2) Importance Of  Diet:

30% of type2 Diabetes Mellitus cases are managed by diet alone.

Myth related: No Sugar/Avoid Potato/Little Rice

Have You Heard About the NEW METHOD!1! No Rigid Diet Plan!!

Foods That Can Be Taken Liberally: wheat, jowar, bajari, pulses, green leafy vegetables, salads. 

Advice: 3 major meals, 2 small meals

How To Reduce Bad Cholestrol In Blood??? 

1. Can Have Any Vegetable Oil Except Coconut Oil as cooking media.

2. Avoid Egg Yolk, Meat

3. Avoid Ghee, Butter, Vanaspati

4. Use Milk after removing cream.

5. Avoid Deep Fried Food

Method to Calculate Ideal Weight: Height in cm - 100 e.g. if your weight is 170cm the ideal weight would be 170-100=70 kg.

 Calculating Ideal Calorie Intake: 

weight = normal, type of work is heavy thus the calorie intake is 60kg x 35= 2100Kcal

weight= over weight, type of work is sedentary thus calorie intake is 60x 20=1200Kcal

  

Our Goal: 

a. Life style Modification

b. Strict Blood Sugar Control

c. Optimum BP control

d. Screening and Early Detection

e. Eye Checkup

f. Urine Examination

g. Regular Foot Examination

Last Word is to maintain a good glycemic control, its half the battle won.Smoking cessation/ moderation alcohol use are & should be stressed upon.

INDIAN SWEET OVER CHOCOLATES!! A DEBATE WE MUST HAVE

Sweet Temptations 

This Blog is more about the comparison between use of Chocolate vs Traditional Indian Sweets use in Celebrations. It's not long when TV commercials in early 90's started showing the use of chocolate in everything good😕.

So recently the Chocolate TV commercial showed; if you are about to start something new(sort of new venture) you must sweeten the mouth, this struck me and i being brought up in hosuehold where my mother use to make us eat SWEET CURD,so does really putting chocolate in every sphere possibe and propagated by commercials neccessary.

Some basic facts about chocolate :-

• most used popular food type and flavour in the world.
• mostly the  constituent of desserts,cakes,puddings,mousse,brownies,syrups,ice creams.
• chocolate bars,either made of solid chocloate/ingredient coated in chocolate are now eaten as sancks.
• gifts of chcoloate molded into different shapes(eggs, hearts,coins) are increasingly becoming traditional.
• most liked drinks eg. milkshakes and beverages are a talking trend of DIY
• most of people are now turning up for hot chocolate milk with choco chip as there daily driving force for outing. 

What Constitutes Chocolate:-

Chocolate are of 3 types: Dark , Milk  & White

Dark Chocolate:- Phenylethylalanine,Theobromine.It has highest amount of cocoa solids.Its toxic to dogs.

Milk Chocolate:- Vanillin( confectioners use it to enhance its flavour),Butyric Acid( gives it the sour taste).

White Chocolate:- It DOSENOT contain any COCOA SOLID.It Only contains COCOA BUTTER which only has large amounts of fats, mainly Stearic Acid and Palmitic Acid(both contribute in high levels of cholestrol).

Chocolate Effect On Brain:-

1)Dark Chocolate contains amino acid TRYPTOPHAN which brain uses to produce neurotransmitters i.e. SEROTONIN; this causes increase in overall feeling.

2)Cacao in Dark Chocolate releases ENDORPHINS from brain(which normally are released by brain during exercise)which lowers stress and gives general sense of well being.

3)Polyphenols an ANTI-OXIDANT, in Dark Chocolate reduces ANXIETY & DEPRESSION.

4) Phenylethylalanine in it produces "FEELING OF LOVE".

5) Theobromine natural component of CACAO is similar to caffiene, gives you an "HIGH" after consuming Dark Chocolate. For COCOA caffeine is added in it for the same effect.

YOU MIGHT SAY IF ALL THAT IS ACHIEVED BY CHOCOLATE THEN WHY AM I DEBATING  AGAINST ITS USE,BASICALLY ANY THING DOESNT COME FOR FREE; THE ECSTATIC SENSE ACHIEVED BY IT WILL ONLY MAKE YOU CRAVE FOR MORE, AND AS SAYING GOES"EXCESS OF EVERYTHING IS BAD".

CHOCOLATES CAUSE DEPRECIATION IN EMOTIONS:-

Daily we see as with gadgets the repeated use of any feature initially excites us but later on it seeps in us sense of being lost and boredom.

Same is with gifting Chocolates ; it feels cool but is it? You can ask yourself this by seeing same packaging shuffling around in all hoseholds,this results in EMOTIONAL BLUNTING a hard word to use but it has relevance here,as you will see: 

INDIAN TRADITIONAL SWEETS, is more apt for DIY culture, has innate sense of feeling connected to the culture, Ocassional demand, Made out Ghee which is all in all healthy, Mostly has a variety or i would say spectrum of sorts to choose from,every sweet has veriety of ingredients added to it.

         where as; CHOCOLATES, all of the same looking,similar tastes,no variety as in basic ingridient is same which ever form you may select,no sense of being connected to culture(its a trend and trends dont stay for too long).Moreover you can't just wrap chcocolate around cashews & almonds and replace it on shelves instead of sweets.

  KUCH SWAAD HAI ZINDAGI MEIN? WHO AM I TO SAY, IT'S UP TO YOU TO DECIDE?

 

Falls Prevention Day Every Year 24th Of September

                 Ultimate Fall Prevention Check List  👀🧐   

By:- Dr Ekta Bhushan

 

       

            A Stumble May Prevent A fall

About 10% of hospital Emergencies is injuries with  FALL being the 2nd leading cause.

Almost 1/3rd that’s 36% of fall related presentations were found in Age group of 0 -14 years.

And 76% fall cases are seen in males

Fall related injuries like Fall from Height and Slips in elderly are major contributors of Hospital emergencies.

       KIDS WILL BE KIDS👶

1. Screens will not hold your child’s weight and keep them safe
2. Keep furnitures away from windows to prevent climbing
3. Move toys away from windows to entice your child to play elsewhere
4. Do not permanently screw windows shut as this prevents evacuation in emergency

Talk with older children about window safety as it relates to their younger siblings

FALLS INCREASE WITH AGE👴👵

 Falls with or without injury also carry a heavy quality of life impact a growing number of older adults fear falling as a result it limits there activities and social engagement. This results in further physical decline, depression, social isolation and feeling of helplessness.

TOP 5 CAUSES:-

 PREVENTING A FALL INCLUDES A SPECTRUM OF ACTIVITIES :-

Now, importance of cane and walkers: to know how to use them is of as much importance as it is to prevent a fall:

THOSE WITH ATAXIA NEED UTMOST CARE

SO, folks remember help preventing a fall and you can save a life👮

Asthma Management

Asthma...the emergency missed!!

By: Dr. Ashish Sharma 

               Have you ever thought if a child 4y/o suddenly presents with wheeze(musical                                             high pitch sound)while talking.This may be the only presenting symtom.

                In a child it can be most common underlying                                           diagnosis of RECURRENT PNEUMONIA!!!

                                        

                                                                                 

                     Cough in an adult while exercising is a sign of nocturnal(night) asthma

                      i.e. in early hours of morning.It may be associated with complaint                                        of  chest tightness.

Typical symptom: Shortness of Breath, Cough, Chest pain 

        Timing of Onset of Symptoms: If Exercise continued  for >10 minutes                                                                                                  

 Now , on how can we differentiate between the symptoms of asthma for deciding severity of the case is as follows:

                

                                                    

       1) Mild: Breathlessness on physical activity(walking,talking,).Patient may feel                                     agitated.HR<100bpm.Fall in systolic blood pressure on inhalation.                                                                                                                                                                                 2)Moderate: Breathlessness,supraclavicularand intercostal retraction.HR>100bpm,Infants show feeding difficulty with soft and shorter cry. Patient prefers a sitting position.                                                                                                                                                      

                                                             

                                         

                                                        

            3)Severe: Breathlessness during rest,Can't sit,talks in words,agitation.Suprasternal retraction,HR>120bpm,increased respiratory rate, loud musical breathing, patients often accquired tripod position.                                                                                                                                                            

                                                                 

                                               RESPIRATORY ARREST?????

                        In children: Drowsy, Confused

                         

                       In Adoloscent:                                                                                          No Wheezing,RespiratoryFailure,Bradycardia

                      

     Status Asthmaticus:-

                     -No Wheezing

                    -Respiratory Muscle Fatigue

                    -Profuse Sweating

                    -Struggle for Air

                    -Confused with Agitation

                    -Phrase"i can't breath"

                    -Wanting to lie 

 All these are life threatening signs with almost no breath sounds heard

            Night Time Symptoms: Chest tightness with Breathlessness is maximum at 4:00am - 6:00am, this is the time of highest mortality.

 

         Other Manifestations: Skin Allergy known as Atopic Dermatitis, Nasal Polyp, Allergic Rhinitis, Transverse crease on nose.

                                 PATIENT  WORKUP!!!!!!!

        

-BLOOD TEST: EOSINOPHILLS>4%(300-400/uL),>8% are observed in patient with asthma associated with atopic dermatitis

-Serum IgE: >100IU

-ABG: Respiratory Alkalosis

-Pulse Oximetre: In all patient of asthma,in children it is used to describe the grading of  asthma; 

                  O2 Saturation 97%:- mild asthma

                 O2 Saturation 92%-97%:- moderate asthma

                  O2 Saturation <92%:- severe asthma

-Chest Radiograph: 

-Bronchoprovocation:

Methacholine/Histamine test: Done when spirometry is normal mostly in patient with nocturnal/exercise induced asthma.

-Histology Finding:

                      

                           

     Management of Patient:-

 -long-term goals of asthma management are risk reduction and symptom control.

- management cycle:-   

                                   

   -modifying risk factors:-

                 1) self-monitoring of symptoms and/or peak expiratory flow, a written                                 asthma action plan, and regular medical review.

                 2) avoiding exposure to tobacco

                 3) confirm food allergy

                 4) smoking cessation

                 5) Engage patient in regular physical aactivity

                 6) Ask patient of work h/o

                 7) Avoid Aspirin to prevent Aspirin Induced Asthma

-Treatment Algorithm:

          

The only purpose of the blog is to just create awareness, to serve people better.

                                                THANK YOU