How many of us have heard about Extracorporeal Membrane Oxygenation (ECMO) before Tamil Nadu, Chief Minister late J Jayalalithaa was put on it for recovery? Hardly a handful. Patients who are placed on the device have 50-50 chance of survival and while it could not help the late Chief Minister, her condition put a spotlight on ECMO.

What is ECMO?
ECMO is a life support device that is put in place when a patient's heart and lungs stop functioning completely post a cardiac arrest. When the patient does not respond to Cardio Pulmonary Resuscitation (CPR), the patient is put on ECMO.

Function of ECMO
The core function of the device is to separate carbon dioxide from the blood and add oxygen into it. It takes the load off from heart and lungs, providing critical time to the body organs for its treatment and recovery.
Patients are only put on ECMO, if there is a chance that the condition can be reversed.

How does ECMO work?
The device drains blood from a vein, which is attached to an oxygenator machine. The machine then removes carbon dioxide from the blood and adds oxygen to it. Depending upon the condition of the patient, the warm blood is either pumped into the body with the help of the machine or is transferred back into the body through an artery.

How long a patient can be on ECMO?
After seven days of being put on ECMO,there are chances of patient getting an infection.
In case the patient contracts an infection, it is recommended to take the patient off ECMO support.

All About ECMO - Extracorporeal Membrane Oxygenation 

Stroke is one of the major reasons for disability in adults. In the US alone, 7 million people suffer from a stroke in a year. After a stroke, the affected individual suffers from lots of health issues. They feel week and fatigued. An ache in one side of the body, inability to walk, and social disability are experienced. Emotional and cognitive functioning is disturbed. Continuum care is recommended for the affected individuals and they need interdisciplinary care to ensure they can do things independently. This is where occupational therapy plays a vital role.

What does the therapist do? 

Using a range of evidence-based methods, the occupational therapists can address the physical, emotional, and mental challenges caused by the stroke. Occupational therapy does not concentrate only on the ailment. It takes into account the emotional needs, desires, limitations, and activities of the stroke survivors. It helps them to recoup the skill to get the daily chores done independently. An occupational therapist surveys the home of the stroke survivor and evaluates the risk of hazards. The practitioner also helps the affected individuals in coping with the loss of vision and memory. The physical strength and fortitude are augmented. The major focus will be on making the affected reach the heights of performance in the valued occupations.

How does it help? 

Studies prove that occupational therapy does not only help one to recover faster, but also prevents worsening of the condition further. The stroke survivor, who receives the occupational therapy, is independent when it comes to daily living chores. Wouldn t it be a great improvement on the emotional health when the affected feels he or she can get things done with little or occasional help? Also, this reduces the caregiver burden. The family is relieved that the survivor can eat, bath, and take a few things without someone having to sit closer and help. This mentally boosts the caregivers and the family to motivate the survivor. The stroke survivor also looks forward to the rehabilitation treatment as the occupational therapy makes them feel great.

Transitional and community integration services can make sure that the patients are engaged in their specific environments, once they get back home after occupational therapy in the specialized care center. After a certain period, when the stroke survivors show considerable improvement, the practitioner again evaluates to find if activities like driving can be resumed by the clients. Community mobility of different choices is recommended if the client is not fit for driving. There are driver rehab programs and the driving skills can be regained.

An occupational therapist spends more time with the client than any other healthcare professional. This is because the practitioner is responsible for alleviating the challenges faced by the affected individual emotionally and physically. The practitioner not only helps the client to achieve the goals but also ensures that the client is psychologically motivated whenever he or she is discouraged. Rehabilitation can reverse the damage done to the brain. But it takes lots of efforts to learn the things to do them in a different way. An occupational therapist makes this goal easier for his or her clients.

Occupational Therapy For People Recovering From A Stroke! 

SGLT2 (sodium-glucose-co-transporter 2) inhibitor is an oral tablet used in conjunction with exercise and diet to improve blood glucose control in Type 2 diabetes mellitus patients.

The medication works by targeting and helping prevent sodium-glucose transport proteins from allowing glucose that has been filtered by the kidneys to be reabsorbed into your bloodstream.

Who is SGLT2 Inhibitor suitable for?

This drug is not suitable for everyone. Selection of the right patients is crucial to understand the mechanism of the medication and see improvement in the condition.

SGLT2 Inhibitor is given to patients with Type 2 diabetes mellitus as a second-line drug in case the first line of treatment, metformin, fails to keep high blood sugar levels in check.

If the patient has hyperglycemia i.e. high, uncontrolled blood sugar, and a Body Mass Index (BMI) equal to or greater than 30 due to the accumulation of fat in the abdominal region (central obesity), then SGLT2 Inhibitor could be a useful medication. The drug not only works to reduce high blood glucose but also helps with weight loss. However, in patients with normal BMI, the medication does not induce weight loss.

SGLT2 Inhibitor may not be suitable for patients with a history of urinary tract infection. Hence, it is advisable for all patients to undergo a urine test before starting with the dosage. If the test results are normal, then only you can discuss the dosage with your doctor/healthcare provider and start taking the prescribed medications immediately.

Benefits of Taking SGLT2 Inhibitor :

The benefits of using SGLT2 Inhibitor are as follows  

Helps reduce excess weight if the patient is obese. If taken in the correct dosage as prescribed, you can lose up to 5 Kgs in about three months.

Helps reduce Systolic blood pressure   if a diabetic is living with hypertension, SGLT2 Inhibitor can bring down systolic blood pressure.

As an anti-diabetic drug, SGLT2 Inhibitor works to control high blood glucose and improves glycemic control. Thus, with the help of the drug, Type 2 diabetes mellitus patients can keep their HbA1c levels at 7% or less.

Side Effects

One major side effect of SGLT2 Inhibitor is urinary tract infection. SGLT2 Inhibitor drug filters excess blood sugar from the body in the form of urine. Frequent urination or filtering of wastes through the urethra may lead to infections. Therefore, it is imperative that patients are informed about the mechanism of the drug and its probable side effects before taking the medication. One way to avoid urinary tract infections is to maintain good hygiene   wash and clean your private areas after urination.

SGLT2 Inhibitor can also cause dehydration in the patient, as a lot of fluid is drained out of the body. Patients are advised to have a glass or two of water more than what they usually drink.

SGLT2 Inhibitor is an effective oral medication for Type 2 Diabetes mellitus. Speak with your doctor and get yourself thoroughly checked before you start taking the drug.

SGLT2 Inhibitor - Know Merits & Demerits Of It!

For a long time cholesterol in totality was seen as a bad thing for your body although the truth was a little more complicated than that. Cholesterol primarily is divided into two types, one of which can be categorized as bad cholesterol and the other as good cholesterol. Let's have an in-depth look at both the categories.

Ldl or low density lipoprotein aka bad cholesterol: cholesterol is a wax like chemical which is found all over the body and it has important functions to perform. Cholesterol is carried all over the body by lipoproteins. The low density lipoproteins are denoted as bad cholesterol as they can accumulate on the walls of the blood vessels and cause blockages resulting in many ailments. Ldl levels of 190 and above are considered dangerous. 

Some of the risks associated with it are:
1. Heart disease
2. Stroke
3. Atherosclerosis
4. Peripheral artery disease among many others

Hdl or high density lipoprotein aka good cholesterol - this is a form of cholesterol which is usually desired in higher quantities as it removes ldl from the system by dislodging it from the arteries and then carrying it through the bloodstream into the liver. The liver then breaks it down and removes it from the body. Thus, higher number of hdl cholesterol is always desirable. Some of the ideal numbers for hdl cholesterol within the body are:

For women - ideal: 60 mg/dl, dangerous: 50 mg/dl or lower
For men - ideal: 60 mg/dl, dangerous: 50 mg/dl lower

The role of triglycerides
Good and bad cholesterol levels also depend on the levels of triglycerides within the body and not just ldl or hdl cholesterol. Triglycerides are another type of fat which are used to store energy within the body, but can also affect your health. It is most associated with atherosclerosis when the levels of triglycerides are high within the body. 

Some habits that contribute to high levels of it are
A. Lack of physical activity
B. Obesity or being overweight
C. Excesses in alcohol consumption
D. Smoking
E. Bad diet and others

Thus the good cholesterol vs bad cholesterol war also includes other factors, most of which can be easily changed by making subtle changes in lifestyle and incorporating healthier habits. This will increase the good cholesterol and the other relevant elements and reduce the bad.

Good Cholesterol Vs Bad Cholesterol

Peripheral Artery Disease (PAD) is a disease of blood vessels that are located outside the heart and brain. The condition develops due to fatty deposits in the arteries and veins that stops the blood flow to the heart and mind as the case may be. It narrows the artery and restricts the blood flow, which causes problems to other organs of the body such as kidney, liver, and stomach.


Symptoms of Peripheral Artery Disease-
Peripheral Artery Disease is the most common type of condition in people. Some people may not even notice the symptoms. The symptoms include:

Pain in the hips and lower leg area.
Brittle toenails.
Short breath while taking stairs.
Pain in the calf.
Numbness and coldness in the leg around a calf
Hair loss on legs and feet
Erectile dysfunction in men
Repeated sores and ulcers in legs
Causes of Peripheral Artery Disease-
The most common cause of Peripheral Artery Disease is the deposit of fatty substances inside the arteries. The fatty deposits build in the arteries gradually with a process called Atherosclerosis. Most of the time people do not know that they are facing the problem of Atherosclerosis. With time deposits increase and the arteries become narrow. It restricts the blood flow and causes problems for other organs.
Another cause for Peripheral Artery Disease is clot created in the arteries due to diabetes. Also, this problem is common in diabetic patients and increases with old age.

The risk factors that contribute to the development of Peripheral Artery Disease are high blood pressure, bad cholesterol, obesity, and diabetes.

Diagnosis of Peripheral Artery Disease-
The primary way to test and diagnose Peripheral Artery Disease is to check the blood pressure in the arm and ankles. If the pressure is low as compared to arm in the ankles, one might be facing Peripheral Artery Disease. It is commonly known as the ankle-brachial index. Other ways to determine Peripheral Artery Disease are CT scans, angiography, and blood tests. Since the disease is prevalent and gradually progress, most of the time it remains undetected.

It is essential that Peripheral Artery Disease gets detected and treated well in time. If the condition persists for a more extended period of time, it may result in loss of leg, increased chances of coronary artery disease and carotid atherosclerosis.

Treatment for Peripheral Artery Disease-
The only way to treat Peripheral Artery Disease is to indulge in physical activity. A regular regime of exercise and physical work will help a person to burn fat and makes the arteries fat free. Doctors suggest that daily 30 minutes of walking or gyming will help treat Peripheral Artery Disease with significant effects. One may notice the signs in just a couple of months.

Along with exercise, one also needs to monitor the weight and eating habits. Foods that are rich in fats and bad cholesterol should be avoided. Make changes in the lifestyle and eat a healthy balanced diet. Include fruits and fresh vegetables in the diet and follow a low carb diet for regular food intake. If a person is addicted to smoking and alcohol, then he/she should consider leaving the bad habits for their own good health.

Take Away-
Above are some of the common and tried treatments. However, it is advisable to consult a doctor before opting for any of these options as these treatments are depended upon the condition of the patients.


Learning In depth About Peripheral Artery Disease!

My child complains of Chest Pain. Should you be worried?

Chest pain is a common complaint among children. For a parent, it can be worrisome because there is a natural tendency to associate chest pain with the heart. The good news is, in more than 95% of cases, chest pain is non-cardiac in origin.

What signs will tell me that the pain may be related to the heart?

Chest pain that occurs in association with certain pointers needs a thorough evaluation. Some of the features that may suggest a heart-related condition include:

Associated breathing difficulty or dizziness
Chest pain that is brought on by exercise
When cardiac disorders run in the family or there have been sudden deaths at a young age in the family
A past medical condition like Kawasaki disease or connective tissue disorder
The following features suggest that a non-cardiac cause is likely:

If the pain follows direct trauma to the chest or is worsened on local pressure: the muscles or bones that form the chest wall are the likely origin of pain
Wheezing or fever and cough: a lung problem is likely
A burning pain beneath the breastbone, especially in relation to certain types of food: may be related to the digestive system
A stressful situation at school or home: a psychological cause of chest pain may be considered.
What can I expect at the doctor s visit?

If your child complains of chest pain, it is important to take him or her to the doctor. Your doctor will first take a detailed history and examine the child. ECG, a record of the electrical activity of the heart, gives an initial idea whether or not the pain may be related to the heart. Other tests that may be ordered include a chest XRay, a  heart-scan  (echocardiogram), a stress test, or further tests based on the findings on evaluation.

Chest Pain In Children - Should You Be Worried?

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