Diabetes

Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body's cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty (polydipsia) and hungry (polyphagia).

Types of diabetes:-

There are three types of diabetes:

1) Type 1 diabetes

The body does not produce insulin. Some people may refer to this type as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. People usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years.

Type 1 diabetes is nowhere near as common as type 2 diabetes. Approximately 10% of all diabetes cases are type 1.

Patients with type 1 diabetes will need to take insulin injections for the rest of their life. They must also ensure proper blood-glucose levels by carrying out regular blood tests and following a special diet.

2) Type 2 diabetes

The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance).

Approximately 90% of all cases of diabetes worldwide are type 2.

verweight and obese people have a much higher risk of developing type 2 diabetes compared to those with a healthy body weight. People with a lot of visceral fat, also known as central obesity, belly fat, or abdominal obesity, are especially at risk. Being overweight/obese causes the body to release chemicals that can destabilize the body's cardiovascular and metabolic systems.

3) Gestational diabetes

This type affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose.

Diagnosis of gestational diabetes is made during pregnancy.

The majority of gestational diabetes patients can control their diabetes with exercise and diet. Between 10% to 20% of them will need to take some kind of blood-glucose-controlling medications. Undiagnosed or uncontrolled gestational diabetes can raise the risk of complications during childbirth. The baby may be bigger than he/she should be.

All types of diabetes are treatable. Diabetes type 1 lasts a lifetime, there is no known cure. Type 2 usually lasts a lifetime, however, some people have managed to get rid of their symptoms without medication, through a combination of exercise, diet and body weight control.

Hello frnds...I think ki last article kaafi helpfull rha hoga...aaj m btane ja rha hu Blood Pressure k baare m...

What is Blood Pressure?

Blood pressure is the force that moves blood through our circulatory system.

It is a life force because, without blood pressure, the following two basic provisions would not be pushed around our circulatory system to feed tissues and organs:1

Oxygen

Nutrients.

Blood pressure is vital also because it delivers white blood cells and antibodies for immunity, and hormones such as insulin.

What is normal B.P?

Cardiologists do not really talk about a normal range - instead they work on the basis of when blood pressures should be considered too high, figures that continue to be refined by the medical research. The National Institutes of Health cites normal blood pressure to be below a certain level:5

No greater than 120 mmHg systolic and 80 mmHg diastolic.

Maintaining a healthy blood level:-

Keep a healthy body weight

Eat a diet rich in fruits, vegetables, and low-fat dairy products

Cut down on sodium intake (salt in the diet)

Take regular aerobic exercise (eg, brisk walking) at least 30 minutes a day, most days of the week

Moderate your alcohol drinking - keep under a maximum of 2 drinks a day for men and 1 drink a day for women/men of lighter weight (one drink having a half ounce of alcohol).

Measuring blood pressure-

The devices in use now still have a mouthful of a name - sphygmomamometer (from the Greek for pulse, sphygmo) - but you would recognize the typical rubber armband, the cuff that is inflated by hand or machine pump.

Once the cuff is inflated enough to stop the pulse, a reading is taken, either electronically or on an analogue dial.4

The reading is expressed in terms of the pressure it takes to move mercury round a tube against gravity in traditional scientific manometers - hence the unit, millimetres of mercury, that is abbreviated to mmHg.

The Mayo Clinic offers a video to show sphygmomamometry in action - it can be done by patients themselves, and modern blood pressure devices can also be used at home for people who need a more representative record of their blood pressure than the one given by a one-off clinic reading.

Systolic and diastolic readings:-

A stethoscope - another of those longstanding devices used by doctors - identifies the precise point when the pulse sound returns as the pressure of the cuff is slowly released. Using the stethoscope enables the person measuring the blood pressure to listen out for the two points at which to look at the gauge for the BP readings.

Hello frnds.....today v learn about heart attack...their symptoms...diagnosis ...nd treatment...so let's start nd read this article carefully....

What is heart attack?

Heart attack is the death of a segment of heart muscle caused by the loss of blood supply.

The blood supply is usually lost because a coronary artery, one that supplies blood to the heart muscle, is blocked by a blood clot (coronary thrombosis).

If some of the heart muscle dies, the patient experiences chest pain and electrical instability of the heart muscle tissue.

This article will cover information about how and why heart attacks occur, how they are treated, and how to prevent them.

Symptoms

The following are signs and symptoms for diagnosing a heart attack:

Chest discomfort, mild pain

Coughing

Nausea

Vomiting

Crushing chest pain

Pressure tightness, pain, squeezing or aching in the chest or arms that spreads to the neck, jaw, or back

Dizziness

Dyspnea (shortness of breath)

Face seems gray

A feeling of terror that your life is coming to its end

Feeling really awful (general feeling)

Restlessness

Feeling clammy and sweaty

Shortness of breath

Causes

The following are possible factors associated with increased risk of heart attack.

Age: Risk increases when a man is over 45, and a woman is over 55.

Angina: An illness where not enough oxygen reaches the heart, causing chest pain resembling a heart attack, but it resolves after taking medication. Angina raises the risk of a heart attack.

High blood cholesterol levels: Increases the risk of developing blood clots in the arteries.

Diabetes: People with diabetes have a higher risk of developing several diseases and conditions, many of them contribute to a higher risk of heart attack.

Diet: Someone who consumes large quantities of, for example, saturated fats, will eventually have a higher risk of having a heart attack.

Genes: You can inherit a higher risk of heart attack.

Heart surgery: Patients who have had heart surgery have a higher risk.

Hypertension (high blood pressure).

Obesity, overweight.

Physical inactivity: More active people have a lower risk.

Previous heart attack: Anybody who has already had a heart attack is more likely to have another one, compared with people who have not.

Smoking.

HIV: People who are HIV positive have a 50 percent higher risk of heart attack.

Work stress: Individuals with stressful jobs, or shift workers have an increased risk of heart attack.

Diagnosis

ECG (Electrocardiograph): Monitors the electrical activity of the heart muscles

Cardiac enzyme tests: Blood tests detect enzymes produced during a heart attack

Chest X-ray: To look for swelling of the heart.

Treatment

Manual chest compressions - continuous chest compressions to the heart at about 100 beats per minute.

Defibrillator - the defibrillator sends electric shocks across the patient's chest - the aim is to use electricity to shock the heart back into proper activity.

Aspirin - often given to patients during a heart attack. Aspirin will help stop the clot in the artery from growing.

Thrombolytics - these dissolve blood clots.

Painkillers - morphine is sometimes injected into the patient to control the pain and reduce anxiety.

Manual chest compressions - continuous chest compressions to the heart at about 100 beats per minute.

Defibrillator - the defibrillator sends electric shocks across the patient's chest - the aim is to use electricity to shock the heart back into proper activity.

Aspirin - often given to patients during a heart attack. Aspirin will help stop the clot in the artery from growing.

Thrombolytics - these dissolve blood clots.

Painkillers - morphine is sometimes injected into the patient to control the pain and reduce anxiety.

Minimizing your chances of having a heart attack

Don't smoke

Eat a balanced, healthy diet

Get plenty of exercise

Get plenty of good quality sleep

Keep diabetes under control

Keep alcohol intake down

Keep blood cholesterol at optimum levels

Keep blood pressure at safe levels

Maintain a healthy body weight

Avoid stress where possible

Learn how to manage stress

Hello frnds.....I wish ki last artical aapke sb k liye kaafi helpful rha hoga....
Nd now I wanna tell you all that how can we examine a patient....so please read it carefully....nd I think this artical is also going to b very helpfull to all....
                General Examination

Environment, general appearance
Hydration
Posture, weight, body shape
Vital signs
Nails, hands
Head
Examination tips
Environment

General appearance

Pre-exam checklist: WIPE:
• Wash your hands
• Introduce yourself to pt
• Position pt
• Expose the area
Always examine from the R side of the pt.
Ask pt. if tenderness anywhere, before start touching them.
Skin colors. See Skin Colors Reference.
Posture, weight, body shape

If pt. enters, examine gait. See Gait.
Posture, stature, height..
Obesity [BMI = kg/m^2. Normal <25].
Limb amputations, deformities.
Physique expected for age.
Hydration

Sunken orbits.
Mucus membrane dryness.
Axillae.
Skin turgor [pinch skin: normal returns immediately].
Postural hypotension [less BP when sit, stand].
Peripheral perfusion [press nose, time capillary return].
Examine weight loss over hours.
Vital signs

Often logged on ward chart.
See Taking Vital Signs Reference.
Nails

Clubbing.
Nail signs.
Nail fold.
See Nails Reference.
Hands

Palms:
• Palmar erythema (cirrhosis, polycythaemia, pregnancy).
• Pigmentation of crease (Addison's, but normal in asians, blacks).
• Pallor of palmar crease. Better results if hyperextend fingers, or stretch skin on either side of crease (anemia).
• Dupuytren's contracture [fibrosis, contracture of palm's fascia] (liver dz, epilepsy, trauma, elderly).
Joints:
• Herberdens, Bouchards (OA).
• Swollen PIP, distal PIP spared (RA).
Head

Hair: deficiency, excess.
Facial hallmarks (Down's, Grave's, acromegaly, Cushing's, etc).
Teeth: nicotine stains.
Examination tips

Initial examination is from the foot of the bed.
Always ask if any part tender, before touching pt.
Watch pt's head as palpate, to look for pain flinches.
Percussion is R middle finger hitting middle of middle phalynx of L middle finger.
To measure circumference of limbs, choose the bony landmark on each, measure down the correct distance, then take the circumference at that point.

Dear friends , ab jo m btane ja rha hu vo specially un students k liye h jo intern m jaane wale h ya intern kr rhe h..

I want to teach you how to take history of the patient nd what the history means to adoctor.

                        History of the patient

History taking is an art, which a doctor learns over tha years by repeated practice nd experience. History is the record of medical events that have already taken place in tha patient. 

A good history  must record the following information in a systematic order÷

1- Biodata of the patient- this should include name, age , sex, address, occupation, religion nd marital status of the patient.

2-Complaints of the present illness- the complaints with which tha patient has come should be recorded in chronological order and the duration should be noted.

3- Origin , duration nd progress:- details of each symptom must be recorded separately. The mode of onset , whether sudden or gradual , the duration of each symptom nd it's progress nd finally the present status of the symptom must be noted .

4-  History of the post illness:- similar illness in the past with their time of occurrence , duration nd results should be noted.

5- Personal history:- patients appetite, food habits, type of diet, bowel nd micturition habits, sleep nd addictions like alcohol, smoking,tobacco, charas, ganja must be inquired into. 

6- Family history:- any illness in the family must be recorded. The state of health of parents,peers nd children should be noted. If any member is deceased , the cause of death should be noted.

Ab yaha pr kuch common symptoms btaye ja rhe h jo ki patient doctor ko btate h:-

1-weight loss:- fasting, inappropriate diet, chronic infections{infective endocarditis,T.B, fungal infection, hiv infection etc} ,acute infections{viral hepatitis, typhoid} ,malignancy, malabsorption syndrome .

2-weight gain:-increased water retention, increased tissue mass{obesity, endocrine disease's, hypothalamic diseases, drugs eg- steroids}

3-anorexia :-chronic wasting diseases, endocrine disease's, T.B}

4-fever

5-chest pain:- ischaemic heart disease, pericarditis, infective endocarditis, pleurisy, pneumothorax, pulmonary hypertension, rib fracture, vertebral collapse.

6-dyspnea:- mountaineers, exercise, anaemia,airway instructions, bronchial asthma, chronic obstructive lung disease, pulmonary infections, diabetes ,uremia, 

7-cough

8-hemoptysis

9- palpitations:- exercise, emotional or sexual excitement, excessive tea , coffee, tobacco, alcohol consumption, over dose of insulin , hypoglycemia.

10- syncope:- vasovagal syncope, postural hypotension.

11- polyurea :- excessive water drinking , diuretic therapy, stress, diabetes mellitus, diabetes individual, chronic renal failure , compulsive water drinking.

12- pyuria:- pyelonephritis, renal tuberculosis, hypersensitivity nephritis,lead poisoning, urethritis.

Dear friends, I'm new here.  This is my first blogging site I have launched.this blogging site is specially dedicated to  medical students nd doctors.i wish this site will be very helpful to the site visitors.                                Thanx..