Conditions and Diseases

Atherosclerosis: Thickening of Arterial Wall

Some years back, one of my friends asked me that a person known to him is having pain in the left arm while walking, compelling him to take a break; and gets back the pain sometimes after resuming his walk. I suggested an electrocardiogram (ECG), and as expected by me a coronary artery disease was diagnosed. This symptom is somewhat a tale tell story of angina pain of heart. In my childhood, I have seen dancing of some superficial arteries of old aged persons and surprised over it; now, I am clear about its cause i.e. it is due to thickening of wall of peripheral arteries from atherosclerosis. In atherosclerosis; there occurs deposit of cholesterol, calcium, some blood cells and some other components in the inner layer of blood vessels called intima. This is equally seen larger as well as smaller blood vessels in the body. Smoking is an important cause of atherosclerosis.

Recently, researchers have found out the role of immune cells in the formation of atheroma after triggering an inflammation in the intima of blood vessels. Drugs targeting these cells also cause harm to useful effects of these cells. So, now they are targeting research, how to destroy the bad effect of cells leaving ahead the good effects. They also found out one molecule that switches on the harmful effect of these immune cells. The new research will be focusing more on blocking the action of the molecule.

Pot bellied persons due excess abdominal fat; the apples are prone to develop atherosclerosis than the pears; persons having fat deposit around hip, researchers say. Smoking, alcohol, sedentary life style and more saturated fat consumption are some of the contributing factors for atherosclerosis. Measurements of waist circumference (WC), waist to hip ratio (WHR) and Body mass index (BMI) are some of predictors of risk of heart attack. Waist circumference >32 inches in female and >37 inches in male have the risk of heart attack. Persons having WHR > 0.7 and BMI >30 are at the risk of developing atherosclerosis.

Filed under: atherosclerosis — Tags: Add new tag, Angina pectoris, Artery, atherosclerosis, Body mass index, Cardiovascular Disorders, Conditions and Diseases, Health, Heart disease — Dr.Prahallad @ December 28, 2009 7:01 pm

Pain Upper Mid-Abdomen-1

: Interior Of Stomach

Pain in middle of upper abdomen in a commonly encountered complain from patients in any hospital.There are vast nuber of causes for it.Many of them are for academic interest.Among the most commonly encountered conditions Acid Peptic disease is one.

Here there is pain in the middle of upper abdomen .This pain may come in empty stomach or after taking food.It is typically colicky in nature,sometimes subsides after taking food or aggravated after taking food.It my appear seasonally in the winter.Gradually this timing of pain changes and pain is always felt. There may appear vomiting which may contain freshly eaten food to stale food, blood and bile.Some times there occurs blood vomiting and passing of black stool.Some times patient may present in the emergency with a complication called perforation of stomach or duodenum.

This disease may be seen in the stomach,duodenum,Lower esophagus or in a mackel’s diverticulum.The symptoms and signs may differ according to the site of disease. To-day we will see the disease of stomach and duodenum.

: Endoscopy Image of Stomach Ulcer

Hydrochloric acid secretion is an integral part of stomach inner layer called gastric mucosa.There in also secretion of protein digesting enzyme called pepsinogen.The digestion of own gastric mucosa hangs on a fine balance between the secretions and mucosal defense. Mucosal defense rests on the amount of bicarbonate and mucus present in the stomach.There are various means to dis-balance it.It my be stress and strain,Ingestion of analgesics and steroid,Severe trauma lading to blood loss and infection by a microbe called H.Pylori. There may occur inflammation to ulcerations in mucosa and may progress to other layers of stomach and duodenum.

The disease can very nicely be diagnosed by an endoscopy.This can be treated by newer proton pump inhibitor drugs.This drug has left the surgical option for this disease limited to the complications only.If drug treatment fails nice surgical options are available.

Upper Endoscopy (Gastroscopy) Procedure, Video, Pictures, Cost (healthhype.com)

Filed under: Stress and Diseases — Tags: Conditions and Diseases, Digestion, Digestive Disorders, Esophagus, Health, Hydrochloric acid, Peptic ulcer, Stomach — Dr.Prahallad @ August 27, 2009 7:19 pm

Vomiting Stale Food

: Flexible Endoscope.

One patient came to me in great distress with hiccup,pain in the abdomen and inability to stand. Apart from this ,patients present to a doctor with complains of vomiting of stale food some hours or days of taking food.There is loss of appetite ,weakness,malnutrition,hiccup and desire to induce vomiting to get relief from pain.

These are the cardinal symptoms of obstruction to passage of food from stomach called Pyloric obstruction/Duodenal stenosis.Causes are varied.Important common cause are development of stenosis after a benign duodenal or pyloric ulcer,a cancer obstructing the passage from stomach and a foreign body such as leaves or hair ball(eaten) seen in psychotics.After invent of stomach acid suppressing drugs these cases are seldom seen.But the patient in question was a road side vendor with irregular and bad eating habit.The patient said that he is in empty stomach .So to find out the cause in hope of some interesting findings the endoscope was put. (more…)

Filed under: General — Tags: Cancer, Conditions and Diseases, Digestive Disorders, Endoscopy, Health, Peptic ulcer, Pylorus, Stomach — Dr.Prahallad @ August 22, 2009 5:08 pm

About H1N1 Influenza

: Image by harold.lloyd (won’t somebody think of the bokeh?) via Flickr

My friend in PeerPower.com has sent this message to me requesting for wide circulation.I would like to add a few things a few here.As regards the mask and precautions he is right.But using a mask is better to no use.What I called something is better than nothing.Moreover it will obstruct other secondary bacterial invasion to cause a pneumonia in the already immune compromised patient.It may be helpful to the patient if not to the contacts.Tamiflu is a virostatic drug which will prevent rapid proliferation.I can conclude that confining the less sever cases to home with usual precautions is a good strategy.And sever cases be treated at hospital.

: Oseltamivir

———- Forwarded message ———-
From: Sanjib Kumar <no-reply@peerpower.com>
Date: 2009/8/18
Subject: PeerPower Message – HINI Precautions
To: drppanda@gmail.com

Subject: HINI Precautions

: H1N1 Virus

Image by groovelock via Flickr

Message:
Dear All
A very logical and constructive solution to prevent you from getting infected with H1N1..Plz share it to all friends and relatives.
The hype in media about the utility of face masks and N95 respirators as a tool for general protection against H1N1 can’t be deplored enough. Please realize that this is not an official advice, especially the one about face masks or N95.
·Most N95 respirators are designed to filter 95% particulates of 0.3µ, while the size of H1N1 virus is about 0.1µ. Hence, dependence on N95 to protect against H1N1 is like protecting against rain with an umbrella made of mosquito net.

·Tamiflu does not kill but prevents H1N1 from further proliferation till the virus limits itself in about 1-2 weeks (its natural cycle).

: Image by ■ Guerry via Flickr

about 1-2 weeks (its natural cycle).
H1N1, like other Influenza A viruses, only infects the upper respiratory tract and proliferates (only) there. The only portals of entry are the nostrils and mouth/ throat. In a global epidemic of this nature, it’s almost impossible not coming into contact with H1N1 in spite of all precautions. Contact with H1N1 is not so much of a problem as proliferation is.
While you are still healthy and not showing any symptoms of H1N1 infection, in order to prevent proliferation, aggravation of symptoms and development of secondary infections, some very simple steps – can be practiced:
1. Frequent hand-washing (well highlighted in all official communications)..
2. “Hands-off-the-face” approach. Resist all temptations to touch any part of face (unless you want to eat, bathe or slap).
3. Gargle twice a day with warm salt water (use Listerine if you don’t trust salt). H1N1 takes 2-3 days after initial infection in the throat/ nasal cavity to proliferate and show characteristic symptoms.
Simple gargling prevents proliferation. In a way, gargling with salt water has the same effect on a healthy individual that Tamiflu has on an infected one. Don’t underestimate this simple, inexpensive and powerful preventative method.

: Image by Rescue Dog via Flickr

4. Similar to 3 above, clean your nostrils at least once every day with warm salt water. Not everybody may be good at Jala Neti or Sutra Neti (very good Yoga asanas to clean nasal cavities), but blowing the nose hard once a day and swabbing both nostrils with cotton buds dipped in warm salt water is very effective in bringing down viral population.
5. Boost your natural immunity with foods that are rich in Vitamin C (Amla and other citrus fruits). If you have to supplement with Vitamin C tablets, make sure that it also has Zinc to boost absorption.
6. Drink as much of warm liquids as you can. Drinking warm liquids has the same effect as gargling, but in the reverse direction. They wash off proliferating viruses from the throat into the stomach where they cannot survive, proliferate or do any harm.
Happy breathing!

ppanda

Filed under: General — Tags: Conditions and Diseases, Health, Infection, Infectious disease, Influenza A virus subtype H1N1, Influenzavirus A, Oseltamivir, Virus — Dr.Prahallad @ August 19, 2009 8:04 pm

Injury To Achilles Tendon

: Image via Wikipedia

Some times some people do not avail a chance and let that go. A folk tale in Orissa,India describes how people ignore the opportunities.Once “Lord Shiva and His wife Goddess Parbati“were in the sky to observe the people of earth.They saw a poor man in skeletons begging for food but was not getting anything.Parbati became felt pity for him and asked Shiva to see this and also asked why people created by them should suffer like this.God replied to it with a smile that some do not like a grab an opportunity and are lazy ,consequently suffer.And He wanted to show that to Goddess Parbati then and there.The god put a pot full of gold coins on the road of the beggar .But the beggar at that moment wanted to mimick a blind man and walked closing his eyes.He gave a kick to the pot and walked past to open his eyes later .Consequently he missed the gold filled pot.Then the god asked his wife to interpret it and they went on the voyage.

Something of the sort happened to-day in our hospital.A person injuring his Achilles tendon came to me.Since ours is a private hospital only for port trust employees ,other people have to pay for the service with a token price only.I inspected the injury and asked him to deposit the required fees to get the tendon repaired .But the person expressed his inability to pay.I suggested him if he does not have the money he can pay it later also.He was not willing for that also.But on humanitarian ground I offered him to repaired it free of cost using material we get as physician’s sample but he has to get admitted to the hospital for some time.And to my utter surprise he declined for that and went away. Instantly my staffs reminded me of the story I just narrated.
The thick tendon through which the calf muscles get anchored to the heel bone is called Achilles tendon named after the Greek mythological hero Achilles.This is a tough tendon in the body.This tedon lifts the body weight off the ground while walking.

: Image by Simon Barratt via Flickr

This tendon gets severed mainly by accidents,assault or in collagen diseases.When partially torn the person can walk limping and disability is more severe if completely torn.The person can not stand on toes of the affected foot.And if completely severed a distinct gap can be felt over an intact skin or the end can be seen if skin is cut.The upper end of severed tendon usually is dragged by the calf muscles to an upper level and may not be seen.Tendon repair is a special procedure and done under aseptic conditions .It can be performed under local.regional or general anaesthesia.The repair is done using a non-absorbable suture material.After repair a plaster of paris cast is given to immobilise the foot for 6 weeks.After that period a gentle physiotherapy makes the patient fit for duty.The results are good.