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Stones of the Kidney, Ureter and Bladder

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Stones in the urinary tract are common. Often these do not produce symptoms and are detected accidentally. Some of the conditions causing stones are genetic in nature. Recurrence of these stones is common, although difficult to diagnose correctly but if not treated in time may lead to permanent damage to the kidney. Recurrent stone disease should always be investigated thoroughly to find out the underlying cause. Investigations InvolveAnalysis of the stone if it has been passed spontaneously or removed surgically. Urine routine examination to look for crystals of oxalates, uric acid, cystine or other salts. Blood tests are done for levels of calcium, uric acid, oxalate, acid content, phosphorus, magnesium, parathormone levels etc. Kidney function also needs to be evaluated at the time. X Rays are carried out to know whether the stones are radioopaque (seen on X Rays) or radiolucent (seen only on USG). Urine tests are done to know specific gravity, acidity, calcium excretion, urate excretion…

Headache

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Headache is one of the commonest symptoms causing significant distress to patients. Chronic headaches may recur for years and cause economic, social, psychological and physical issues. 90% of the headaches are benign. Headache includes pain in the area above the neck including the face. Chronic headaches are common and affect about 40 to 45 % of the population. Chronic headaches may be called tension headaches, migrainous or cluster headaches. The pain may be cutting, shearing, burning, dull or sharp, deep or superficial, throbbing, waxing or waning and of many other types. Tension headaches often produce a band like sensation or tightness in the head. These are not due to tension in the muscles as is commonly believed. These are also not due to “ Tension or Stress”. The exact mechanism is not clear. Migrainous headaches are usually throbbing, maybe in one half or both sides, usually last for a few hours to 1 or 2 days, and may be relieved by vomiting or sleep. A patient may know few…

ASTHMA

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Asthma or Bronchial Asthma is a common disease. About 75 % cases start in childhood before 10 years of age. A large no of patients stop having symptoms at the time of puberty and some may again have the disease in the later years. It is uncommon after 50 years of age. It can be troublesome, disabling and if not treated properly may be dangerous.
The disease results from heightened reactivity of the airways in response to irritants, allergens, fumes and at times exercise. It is typically intermittent and a person feels well when there is no ongoing attack of asthma. Symptoms: Symptoms of asthma are shortness of breath, difficulty in breathing, cough and whistling sounds during breathing. These symptoms may also be seen in a no of heart, lung or infective conditions. Hence the diagnosis is usually made by experienced doctors after a few episodes have occurred! The important markers of the disease are rapid reversibility of the signs and symptoms with appropriate treatment or spontaneousl…

Nephrotic Syndrome

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Nephrotic Syndrome Kidneys receive approximately 1 liter of blood every minute. Of this, about 100 ml gets filtered in the kidney. This contains, small molecules and few large molecules. This is due to the intricate cellular structure that prevents proteins from getting filtered into the urinary space. A derangement of this filter results in passage of heavy amounts of proteins in urine. This condition is called HeavyProteinuria or Nephrotic syndrome or Nephrosis. Definition: In the urine, the protein excretion is > 3.5 gm/day or in children, it is >50mg/kg of body weight. In most cases, the serum albumin is <3gm/dl (normal>4), and passage of lipids in the urine. The lipids in the blood increase and swelling of face and feet also occur. Causes of Nephrotic Syndrome: In children, most cases are due to Minimal Change Disease, FSGS, MPGN etc. In adults, most cases are due to primary illness while upto 30% may be due to secondary illness. Clinical Features: Apart from Edema, ther…

Diabetes Care

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For patients suffering from type II /adult onset diabetes :In type II diabetes, diagnosis is often late (after the disease has already been present for some time). In early days T2DM (short for the adult type of diabetes) are often without symptoms. Hence the delay in diagnosis. This means complications will be seen early after diagnosis. Foot Care : Foot disease in diabetes may lead to difficulty in walking, pain and may lead to infections. If neglected amputation may be required. Inspect feet with a mirror before going to sleep every night. Use well fitting shoewear. Do not walk bare feet even in the house. Socks should be clean and correct size. In case of deformities of feet, special shoes can be worn. Eye Care : It is nowadays the commonest cause of blindness throughout the world.
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Second Medical Opinion / Advice

Blood Pressure

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How to measure BP: The Correct WayBP measured at home and clinics of doctors vary with the time of day or night, physical activity and methods of measuring. To reach a diagnosis of hypertension, various precautions are required. The following should be kept in mind while measuring BP. Methods used for Measuring BP.Mercury sphygmomanometers: Traditional and accurate. Requires correct training. Now not used due to a ban on the use of mercury due to environmental pollution.Aneroid sphygmomanometers: The cuff may be inflated manually. With a stethoscope, sounds are heard over the brachial artery.Automated oscillometric BP measurement: The most popular method nowadays. It has a battery operated system for inflating the cuff. The cuff deflates on its own and BP is displayed digitally.Ambulatory BP monitoring(ABPM): Measures Blood Pressure every 15 mins in the day and every 30 to 60 mins at night. The readings can be recorded and later displayed digitally via a computer. ABPM is the best and …

Fats in the Diet

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Each gram of fat provides 9 kcal of energy. Fats are essential for the human body as these make up the important part of all tissues and cells. The cell membrane is rich in lipids and brain is full of fat. In combination with proteins and phosphates, fats (lipids) for many important molecules. Linoleic and a-linolenic acids are essential fatty acids. Trans fats are usually of animal origin or provided by hydrogenation of oils. These are harmful for the body. Poly-unsaturated fats and Mono-unsaturated fats are associated with less risk to heart and brain compared to saturated fats. Fats of animal origin are more harmful compared to fats from vegetable sources. In terms of health benefits, olive oil, soya oil, sunflower and safflower oils rank high. In the body, lipids are measured in blood by the test of lipid profile (best done after 8-10 hrs of fasting). It measures S cholesterol (HDL or high density, LDL or low density and VLDL and IDL very low and intermediate respectively), Trigl…