Friday, February 25, 2011
Wednesday, February 23, 2011
Tuesday, February 22, 2011
Monday, February 21, 2011
Saturday, February 19, 2011
Saturday, February 5, 2011
Save your parents there by save your self.......
The main thought behind this blog was-----
we often hear patients talk about there doctor..
saying they do not give enough time to them....
well thats true ...
in India the proportion of patient and doctor is highly inadequate......
so there by reducing the contact time...
we bring you a site where you can pose questions or we will act as if you have asked a question..
and will answer to them
a site for the people with the people......
the second objective is
to act on time
a stitch in time saves nine
if we had to give royality for sentences to used on our sites and elsewhere
this statement would have got the maximum money he would have been competing for top spot in The Time.
in that stream we would like to say
save your parents,
know there illness better
like diabetes , blood pressure, heart disease
since they have it , we should not leave to them to understand and follow the treatment rules
they feel alone and suffering
but if you try to know about the disease
its mechanism and treatment
two people will be helped and saved
you and your parents
i cannot see more profitable business than this.......
you will know about so you try to prevent it and parents will enjoy taking medicines and diet and exercise
So save your parents automatically you will save your self.........
we often hear patients talk about there doctor..
saying they do not give enough time to them....
well thats true ...
in India the proportion of patient and doctor is highly inadequate......
so there by reducing the contact time...
we bring you a site where you can pose questions or we will act as if you have asked a question..
and will answer to them
a site for the people with the people......
the second objective is
to act on time
a stitch in time saves nine
if we had to give royality for sentences to used on our sites and elsewhere
this statement would have got the maximum money he would have been competing for top spot in The Time.
in that stream we would like to say
save your parents,
know there illness better
like diabetes , blood pressure, heart disease
since they have it , we should not leave to them to understand and follow the treatment rules
they feel alone and suffering
but if you try to know about the disease
its mechanism and treatment
two people will be helped and saved
you and your parents
i cannot see more profitable business than this.......
you will know about so you try to prevent it and parents will enjoy taking medicines and diet and exercise
So save your parents automatically you will save your self.........
Hypertension is not controlled in many patients beware and check at regular interval
This study we had presented in Jan 2009 in International Stroke Update
Showed that many patient who come for follow up do not have controlled blood pressure after there first stroke.
if patient had stroke and inaddition he has diabetes then his blood pressure was further less likely to controlled causing further ongoing damage.
Friday, February 4, 2011
Hypertension or increased blood pressure
Problem Statement :
Recent population based studies have shown of the three poeple walking on road in th productive age group(20-60years of age ) one has hypertension i.e 1/3 . That figure increases to one in two as the age advances above 40years and ahead. (http://www.whoindia.org/LinkFiles/NMH_Resources_National_CVD_database-Final_Report.pdf)
Story:
I would like to introduce all the blogs with story of one my patients and questions they asked me, so that even you may find your answers.
Mr Vijay(Name changed for privacy) , 42 years old gentleman works for a reputed MNC at administrative post. He was apprently well 4days back when he developed sudden episode of inability to speak or write and mild paralysis/weakness of the right hand which improved completely over a period of 30minutes. He was seen by us on the same day, investigated. He was told that he had minor stroke as his MRI was showing some lesion. He did not have family history of similar events. He was smoker and noted to have hypertension. His rest of investigation were reported to be normal. He was discharged after 3days. While discharge we had chat with him to know his views and doubt. We allied his fears of recurrence.
Mr Vijay: what is hypertension? why did i developed it ?
Dr: here the word tension means the pressure in the blood vessels,
some amount of pressure is reqiured to push the blood from the heart to variuos part of body uniformly.
This is generated by property of the Heart and blood vessel tensile strength.
it is controlled by varoius known and unknown factors in the blood and blood vessels.
It usually increases while doing physical activity, during cold season, hightened emotional states but immeditely is controlled automatically by the body.
But when these controlling mechanism fail there is a steady increase in blood pressure.
This increase in blood pressure if mild early may not cause any external symptoms for the patient who may not have any problem. outside But will develop problem in long run.
Because our body has ability to bear this increased tension to some extent but the organs like heart, kidneys, eyes and brain get slowly affected.
The normal blood pressure range is 90-130 for the systolic(upper) blood pressure and 60-80 for diastolic ( lower) blood pressure. When ever any doctor tells you about blood pressure he mentions to values upper and lower in simple langauge. Both are equally important. By increase in blood pressure it means systolic above 130 and diastolic above 80. When it reachs above 140/90 we call them hypertensive. But the target changes if patient has both diabetes and hypertension then above 130/80 is considered as hypertension.
Myth: with age, blood pressure increases and we dont have to treat it.
Truth: Any increase of blood pressure at any age has to be treated by doctor.
Well for the reason why it happened to you it is a very difficult question there is interplay of various genetic/polygenetic and environmental factors, the environmental factors consist of the stress related to work family for long duration, excess salt intake, smoking, excess alcohol intake, improper sleep due to work or snoring etc. The genetic factors are equally myraid and are still be explored. If family history is positive in one or more family members first degree that is father, mother, siblings then more likely to have it. Its the loss of balance between the protective and increasing factors. Like in your case smoking could be the cause.
Mr Vijay: How can I treat it?
Dr: As we talked yesterday about the circle approach (Refer to the contents ---blog post)
you should know about the disease, exercise, diet and drugs this four pronged method can help you.
Mr Vijay: Which drugs are best?
Dr: There is no fixed receipe , it has to be taken with consultation of cardiologist or Internal medicine consultant i.e MD Physician.
Usually few test will required before start of treatment. I
f the problem is mild that is 140-160 systolic then you doctor might ask
life style modification ( to be elaborated in coming blogs ) and see for next two three months
if the blood pressure is controlled then viola no need of medication
if not controlled then we have to start some medication.
we are starting medication in your case because your admission blood pressure was very high and its persisting to be high we have started two medication for you. Now your blood pressure is controlled.
Mr Vijay: What should I do prevent further problem?
Dr: This is best question you have asked.
Because this suggest that you are motivated
as motivation on the part of the patient is of utmost important for successfull treatment.
The first and fore most advice is stop smoking
and follow the instruction given by the doctor.
Check your blood pressure first every 15days for first 6mnths
so that if it is more than you report to your physician and make changes.
Once your blood pressure is controlled then a monthly blood pressure log would be good
always make it a note in you treatment book or separate notebook.
Mr Vijay : Thank you doctor
Dr: My pleasure
Recent population based studies have shown of the three poeple walking on road in th productive age group(20-60years of age ) one has hypertension i.e 1/3 . That figure increases to one in two as the age advances above 40years and ahead. (http://www.whoindia.org/LinkFiles/NMH_Resources_National_CVD_database-Final_Report.pdf)
Story:
I would like to introduce all the blogs with story of one my patients and questions they asked me, so that even you may find your answers.
Mr Vijay(Name changed for privacy) , 42 years old gentleman works for a reputed MNC at administrative post. He was apprently well 4days back when he developed sudden episode of inability to speak or write and mild paralysis/weakness of the right hand which improved completely over a period of 30minutes. He was seen by us on the same day, investigated. He was told that he had minor stroke as his MRI was showing some lesion. He did not have family history of similar events. He was smoker and noted to have hypertension. His rest of investigation were reported to be normal. He was discharged after 3days. While discharge we had chat with him to know his views and doubt. We allied his fears of recurrence.
Mr Vijay: what is hypertension? why did i developed it ?
Dr: here the word tension means the pressure in the blood vessels,
some amount of pressure is reqiured to push the blood from the heart to variuos part of body uniformly.
This is generated by property of the Heart and blood vessel tensile strength.
it is controlled by varoius known and unknown factors in the blood and blood vessels.
It usually increases while doing physical activity, during cold season, hightened emotional states but immeditely is controlled automatically by the body.
But when these controlling mechanism fail there is a steady increase in blood pressure.
This increase in blood pressure if mild early may not cause any external symptoms for the patient who may not have any problem. outside But will develop problem in long run.
Because our body has ability to bear this increased tension to some extent but the organs like heart, kidneys, eyes and brain get slowly affected.
The normal blood pressure range is 90-130 for the systolic(upper) blood pressure and 60-80 for diastolic ( lower) blood pressure. When ever any doctor tells you about blood pressure he mentions to values upper and lower in simple langauge. Both are equally important. By increase in blood pressure it means systolic above 130 and diastolic above 80. When it reachs above 140/90 we call them hypertensive. But the target changes if patient has both diabetes and hypertension then above 130/80 is considered as hypertension.
Myth: with age, blood pressure increases and we dont have to treat it.
Truth: Any increase of blood pressure at any age has to be treated by doctor.
Well for the reason why it happened to you it is a very difficult question there is interplay of various genetic/polygenetic and environmental factors, the environmental factors consist of the stress related to work family for long duration, excess salt intake, smoking, excess alcohol intake, improper sleep due to work or snoring etc. The genetic factors are equally myraid and are still be explored. If family history is positive in one or more family members first degree that is father, mother, siblings then more likely to have it. Its the loss of balance between the protective and increasing factors. Like in your case smoking could be the cause.
Mr Vijay: How can I treat it?
Dr: As we talked yesterday about the circle approach (Refer to the contents ---blog post)
you should know about the disease, exercise, diet and drugs this four pronged method can help you.
Mr Vijay: Which drugs are best?
Dr: There is no fixed receipe , it has to be taken with consultation of cardiologist or Internal medicine consultant i.e MD Physician.
Usually few test will required before start of treatment. I
f the problem is mild that is 140-160 systolic then you doctor might ask
life style modification ( to be elaborated in coming blogs ) and see for next two three months
if the blood pressure is controlled then viola no need of medication
if not controlled then we have to start some medication.
we are starting medication in your case because your admission blood pressure was very high and its persisting to be high we have started two medication for you. Now your blood pressure is controlled.
Mr Vijay: What should I do prevent further problem?
Dr: This is best question you have asked.
Because this suggest that you are motivated
as motivation on the part of the patient is of utmost important for successfull treatment.
The first and fore most advice is stop smoking
and follow the instruction given by the doctor.
Check your blood pressure first every 15days for first 6mnths
so that if it is more than you report to your physician and make changes.
Once your blood pressure is controlled then a monthly blood pressure log would be good
always make it a note in you treatment book or separate notebook.
Mr Vijay : Thank you doctor
Dr: My pleasure
Thursday, February 3, 2011
Contents of the blog
My plan for the blog is to comprehensively address the issues related to
prevention of stroke and other vascular illness like heart attack
which have similar repertiore of causative factors.
First we would go about problem statement of each risk factor-
for example hypertension
it will be described in easy words so that everybody can understand
and later in second part we will discuss the treatment issues
which will include
the circle appraoch
this was thought to us during our MBBS days by our teacher Dr Neglur Sir
he had told this for Diabetes patient
but i found in last 10years that it is universally useful in varying proportions for most of the diseases.
Principle
if we consider treatment required for any disease is 100%
then what are its content and what are there respecrive proportions
1. Education about the disease is the first step and each person has to know what illness heor she has why it happened to them how can they prevent the further progress of it this forms 25% of the disease therapy
2. Exercise : its a must we will be describing in detail what it means it again forms 25%
3. Diet: every care has to be taken to understand the dietary needs and it has to be followed it form 25% of the therapy proportion.
4. Drugs/medication: this is the last part of any therapy , and comprise the remaining 25% of the therapy , so if you taking medication regularly you are only doing 25% of the therapy, if the medication also your not taking properly then even that 25% is lost
who wins who loses we have to ponder
see you in coming blogs
i stop for today.
prevention of stroke and other vascular illness like heart attack
which have similar repertiore of causative factors.
First we would go about problem statement of each risk factor-
for example hypertension
it will be described in easy words so that everybody can understand
and later in second part we will discuss the treatment issues
which will include
the circle appraoch
this was thought to us during our MBBS days by our teacher Dr Neglur Sir
he had told this for Diabetes patient
but i found in last 10years that it is universally useful in varying proportions for most of the diseases.
Principle
if we consider treatment required for any disease is 100%
then what are its content and what are there respecrive proportions
1. Education about the disease is the first step and each person has to know what illness heor she has why it happened to them how can they prevent the further progress of it this forms 25% of the disease therapy
2. Exercise : its a must we will be describing in detail what it means it again forms 25%
3. Diet: every care has to be taken to understand the dietary needs and it has to be followed it form 25% of the therapy proportion.
4. Drugs/medication: this is the last part of any therapy , and comprise the remaining 25% of the therapy , so if you taking medication regularly you are only doing 25% of the therapy, if the medication also your not taking properly then even that 25% is lost
who wins who loses we have to ponder
see you in coming blogs
i stop for today.
Do you love your self?
Well the answer though your tongue is saying yes, most of day-to day action are always on the contrary.
The lack of exercise.
The improper breakfast.
The untimely and inadequate lunch.
The late night drinking and seeing movies.
Above all the lack of sleep.
More than 50% of todays youth are involved in these kind of activities.
Well its time to wake. Shake your self of that junk habits.
Because you sure get your self into trouble.
Please read the blogs coming to what each of the above means what we can do to
avoid them
The lack of exercise.
The improper breakfast.
The untimely and inadequate lunch.
The late night drinking and seeing movies.
Above all the lack of sleep.
More than 50% of todays youth are involved in these kind of activities.
Well its time to wake. Shake your self of that junk habits.
Because you sure get your self into trouble.
Please read the blogs coming to what each of the above means what we can do to
avoid them
Wednesday, February 2, 2011
Stopstroke: INTERSTROKE trial
Stopstroke: INTERSTROKE trial: "Hello this is my first post Well the aim and purpose of this blog is discuss about prevention treatment and rehabilitation of stroke or sudd..."
INTERSTROKE trial
Hello this is my first post
Well the aim and purpose of this blog is discuss about prevention treatment and rehabilitation of stroke or sudden hemiparalysis occurring due to the clogging or blocking of the brain blood vessels pipes carrying blood to the brain, due to varoius reasons.
It is truly a devastating disease affecting the family the patient and our human society as a whole.
But there is good news its in our hand individually and collectively to prevent this malady.
This recent study has pointed out that ten risk factors/causative agents/things which can lead to stroke are taken care/ properly treated we can reduce the risk/possibility of its occurrence by 90%.
that means with our effort we can prevent 90% of stroke.
Ten modifiable risk factors are:
1. Treat and prevent Hypertension/ increased blood pressure
2. avoid and stop Smoking
3. Reduced weight specifically the waist line
4. Healthy diet- Indian diet with reduced salt and fat is acceptable with more servings of fruit
5.Regular Physical exercise
6.Control your Diabetes
7. Reduce your alcohol intake and stop
8. Treat cardiac problem valvular heart disease
9. Hyperlipidemia
10. Psychosocial factors--stress and depression
Reference
1.Donnell MJ, Xavier D, Liu L, et al. Risk factors for ischemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): A case-control study. Lancet 2010; DOI:10.1016/S0140-6736(10)60834-3. Available at: http://www.thelancet.com.
Well the aim and purpose of this blog is discuss about prevention treatment and rehabilitation of stroke or sudden hemiparalysis occurring due to the clogging or blocking of the brain blood vessels pipes carrying blood to the brain, due to varoius reasons.
It is truly a devastating disease affecting the family the patient and our human society as a whole.
But there is good news its in our hand individually and collectively to prevent this malady.
This recent study has pointed out that ten risk factors/causative agents/things which can lead to stroke are taken care/ properly treated we can reduce the risk/possibility of its occurrence by 90%.
that means with our effort we can prevent 90% of stroke.
Ten modifiable risk factors are:
1. Treat and prevent Hypertension/ increased blood pressure
2. avoid and stop Smoking
3. Reduced weight specifically the waist line
4. Healthy diet- Indian diet with reduced salt and fat is acceptable with more servings of fruit
5.Regular Physical exercise
6.Control your Diabetes
7. Reduce your alcohol intake and stop
8. Treat cardiac problem valvular heart disease
9. Hyperlipidemia
10. Psychosocial factors--stress and depression
Reference
1.Donnell MJ, Xavier D, Liu L, et al. Risk factors for ischemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): A case-control study. Lancet 2010; DOI:10.1016/S0140-6736(10)60834-3. Available at: http://www.thelancet.com.
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