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Cardiac stenting

2009-11-10T23:44:00.000-08:00

What is a cardiac stent. Watch this video to know about a stent. Recently, drug eluting stents are also available in the market.

How to read chest X-Ray

2009-10-17T00:22:00.000-07:00

How to read chest x-rays

Download free E-Book for pregnant women

2009-09-19T18:19:00.000-07:00

Pregnancy is a state of mixed feelings. The mother is anxious about each change that occurs inside her. Download this E-book free to know in detail about all the changes inside the pregnant mother week by week. It also has a checklist at the end of each chapter to decide whether the new symptom is alarming or not. Also gives a detailed report of baby's development inside the mother's womb. Read a description of the baby inside uterus at 27 weeks:

"By your 27th week, your baby looks like a thinner, smaller, redder version of what he or she will look like at birth. Your baby’s lungs, liver and immune system aren’t yet fully mature. If birth were to occur this week, your baby’s chances of survival would be at least 85 percent. Your baby may be starting to recognize your voice this week, as well as your partner’s. But it’s probably a little hard to hear clearly, given that his or her ears are covered with vernix, the thick, fatty coating that protects the skin from becoming chapped or scratched. It’s also hard for your baby to hear through the amniotic fluid in your uterus — similar to how hard it is to hear under water. At 27 weeks, your baby is three to four times as long as he or she was at 12 weeks."

DOWNLOAD IT FREE HERE.

CT and MRI

2009-08-26T22:48:00.000-07:00

Which one do I need to know about the condition of my prolapsed disc? CT or MRI. The answer for this is MRI. But if there is a bony injury to spine, which is better? - Then you have to go for a CT. Now when do you prefer a CT and when an MRI. The basic principle is CT for bones and MRI for soft tissues, but there are certain indications and contraindications for both and you have to know the principles involved in each of these. MRI is more costly. CT gives more radiation. Read about CT and MRI in the articles that follow below.
CT Scan
Mri

Skin diseases

2009-08-26T02:13:00.000-07:00

Read about common skin conditions like Acne, Warts, Moles, Eczema, Athlete's foot, Melasma, Psoriasis, Herpes Zoster, Skin tags, cold sores, Razor bumps, urticaria etc in the presentation that follows below. Remember that topical applications are not the remedy to all skin problems. Skin problems may be the 'tip of iceberg" of underlying major diseases. For eg Liver disease can present with various skin manifestations like itching, rashes etc. So don't take the skin diseases lightly.

ADULT SKIN PROBLEMS -

What to do in case of a sprained ankle ?

2009-08-25T00:49:00.000-07:00

Sprain means a ligament injury. The ligament can be partially or completely torn. At ankle you can sustain such an injury when you slip and foot gets folded inward or outwards. However, it must be remembered that there might be an underlying fracture also.

Remember to do the "RICE" - Rest, Ice application, Compression with bandage, Elevation of foot. Explanation follows below.

First and formost, you have to take rest, should not walk. The ankle swelling increases as you walk around. Also you may have sustained a fracture, which can be confirmed only after taking Xrays. In case you have a small fracture and walk, you fracture may get worse. You may convert the hairline fracture to a true fracture.

Secondly, apply ice over the ankle at the site of swelling and pain. You should not directly apply ice over the skin. Wrap the ice in a soft thin cloth and apply it for a few seconds and changing the position after a few seconds.

Thirdly, if you can get hold a compression bandage ( Crepe bandage / elastic bandage ) which should be at least 10 cm wide ( 15 cm is better for adults ), apply compression starting from the foot upto the lower third of your leg. The tightness should be just to your comfort. Don't use a non yielding bandage which will constrict the blood flow and cause more problems, even loss of blood flow to the foot.

Finally, never forget to keep the leg elevated over one or two pillows. This will facilitate the venous return. Ideally, you have to lie down so that the leg is at a higher level than your heart.

It is to be remembered that all these are first aid measures only. See the orthopedician at the earliest. If there are no fractures you will be prescribed analgesics. If it is severe ligamnet injury a below knee plaster cast might be required for 2 weeks or so.

Video of Child birth

2009-08-24T08:14:00.000-07:00

Quadriceps exercise

2009-08-22T22:15:00.000-07:00

Quadriceps is a group of 4 muscles on the front of the thigh. It extends the knee, forming a large fleshy mass which covers the front and sides of the femur and help in walking normally. This muscle gets wasted in conditions of prolonged immobilisation ( due to fractures, ligament injuries etc. when patient is put on a plaster ) or other diseases ( like Tuberculosis of the knee ). Those who sustained a fracture of knee or even leg will know that when they started walking after the plaster is removed a feeling of weakness of leg or "buckling" of knee will be complained. Some people complain about prominence of bone. All these are due to wasting of quadriceps muscle. For those complaining of bone prominence, just check again - the bone is prominent because the muscle is wasted.

Now, what to do about this problem?

The answer is not medicines but physiotherapy exercises. One way to do it while lying down is to press your knees by making them straight against a pillow placed below the knees, hold for around 10 seconds and relax. Repeat the exercise at least for 25 times in morning and 25 times at night. The more you do the better. Another simple way is to sit on a high chair or table, hang down the knees with thighs well supported on chair. Know straighten the knees as much as you can, hold them for around 10 seconds and release slowly. One you are confidently doing this, you can try lifting weights of 1 kg tied to your foot and lower leg and keep increasing the weights by half kg every week or so. However, it is not recommended to take weight exceeding 2.5 - 3 kg. Please get the opinion from your family doctor before you try out these exercises. Videos demonstrating quadriceps exercise are picked from YouTube below. These exercises are also very effective for osteoarthritis of knee.

Swine flu : Treatment

2009-08-21T23:56:00.000-07:00

Oseltamivir under trade name of "Tamiflu" is recommended for children above 1 year. Zanamavir is another drug under thetrade name of "Relenza" which can be used above 7 yrs. These drugs have to be used within 48 hrs of onset of symptoms to be effective for 5 - 7 days. Adverse drug reactions include nervousness, poor concentration, nausea, vomiting. Zanamavir is not recommended in asthmatic patients. Osteltamivir is more accepted in treatment.

Oselatmivir phosphate ( Tamiflu ) is available in tablets of 30, 45 and 75 mg for oral use and can be taken with or without food. For children, Tamiflu oral suspension is available at a strength of 15mg/ml. Dosage for adults and children above 40 kgs is 75 mg BD for 5 days.

Dosage of Oseltamivir in children is as follows ( for 5 days ):

15 - 23 kgs : 45 mg BD
24 - 40 kgs : 60 mg BD
> 40 kgs : 75 mg BD

Oseltamivir is not recommended for infants below 3 months. Dosage for infants (> 3 months):

between 3 - 5 months : 20 mg OD
6 - 11 months: 25 mg OD

The recommended dose for prophylaxis is 75 mg OD ( for adults and children above 40 kg ) to be started within 2 days of exposure following close contact with infected individual. For children below 40 kg, the dosage is OD dose of the therapeutic dose given above according to body weight. Oseltamivir prophylaxis is provided till 10 days after last exposure (maximum of 6 weeks).

Supportive treatment is given with Paracetamol / Brufen for fever, myalgia and headache. Salicylates / Aspirin are contraindicated.
Patients are monitored for clinical / radiological evidence of LRTI, hypoxia ( with level of conciousness, SPO2 levels, Respiratory rate )

Close contacts are adviced voluntary home quarantine for at least 7 days after last contact with case.

Adult patients are discharged at 7 days after their symptoms decrease and children after 14 days of relief of symptoms as they shed the virus for longer periods.

More details regarding Tamiflu is found at http://www.rxlist.com/tamiflu-drug.htm

Buy Swine flu protection mask

2009-08-21T09:25:00.000-07:00

Buy the N95 Mask to protect against Swine flu.

Swine Flu: Lab tests, info to Lab workers

2009-08-19T23:06:00.000-07:00

Lab tests for Swine flu include :

Rapid antigen test (less sensitive)
RT - PCR
Virus isolation
Virus genome sequencing
4 -fold rise in H1N1 virus specific neutralising antibody

The sample is collected from suspected cases by treating physician within first 4-5 days. The swabs have to be kept at 2-8 degree Celcius until they are placed at -70 degree Celcius. They are transported in dry ice in triple packages. In India, at present, samples are sent to NIV, Pune or NICD, Delhi within 24 hours.

Information for lab workers / staff: Tests should be performed only in BSL2 LAB with BSL3 practices.

Additional requirements:

Respirator protection - N-95 respirator or higher
Shoe cover
Closed front gown
Double gloves
Eye protection with goggles / face shield

Disinfectants used:

70% Ethanol
5% Lysol
10% Bleach

Swine Flu - General information

2009-08-18T21:38:00.000-07:00

Swine Flu, caused by influenza virus A, subtype H1N1, is a new type of Flu which causes illness in people all around the world. First detected in US (April 2009). It spreads from person to person like any other flu. If you eat cooked pork, you won't get it. 'Swine Flu' got it's name due to resemblance of the virus to that found in pigs in the North America. Further studies have shown that the virus is really different from that found in North America's pigs, but contain two genes from flu viruses that normally circulate in pigs in Europe and Asia, avian genes and human genes.

Symptoms of H1N1 (See the video below). Just remember that it starts like any other Flu, but later affects all systems of your body. There is no specific symptom by which you can say a person has swine flu. Children below 5 yrs, pregnant ladies and elderly people (above 65 yrs) are at higher risk of getting the infection.

Diagnosis is by taking nasopharyngeal and throat swabs.

Ordinary masks will not give from swine flu. N-95 Respirator or higher is required if you are in close contact with an infected person.

Drugs used in treatment, other than supportive measures are Oseltamivir and Zanamavir.

For more details on the diagnosis and treatment see the posts that follow.