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Hospice And Palliative Medicine Health Feed

I had a spinal cord injury .the mri report says mild posterior bulge of d6-d7 sisc seen indenting the dural sac. 3 mm cyst lesion at d6-d7 left along nerve root likely perineural cyst.

Dr.Karuna Chawla 96% (107883ratings)
BHMS
Homeopathy Doctor, Noida
I had a spinal cord injury .the mri report says mild posterior bulge of d6-d7 sisc seen indenting the dural sac. 3 mm...
Below are exercises that strengthen the lower back and help manage lower back pain: 1. Bridges—lie on the ground and bend the knees, placing the feet flat on the floor hip-width apart. Press the feet into the floor, keeping the arms by the sides. Raise the buttocks off the ground until the body forms a straight line from the shoulders to the knees. Squeeze the buttocks with the shoulders remaining on the floor. Lower the buttocks to the ground and rest for a few seconds.Repeat 15 times and then rest for 1 minute.Do 3 sets of 15 repetitions.2. Knee-to-chest stretches— lie on the back on the floor. Bend the knees, keeping both feet flat on the floor. Use both hands to pull one knee in toward the chest. Hold the knee against the chest for 5 seconds, keeping the abdominals tight and pressing the spine into the floor. Return to the starting position. Repeat with the opposite leg. Repeat with each leg 2–3 times twice a day. 3. Lower back rotational stretches—lie back on the floor with bent knees and feet flat on the ground. Keeping the shoulders firmly on the floor, gently roll both bent knees over to one side. Hold the position for 5–10 seconds. Return to the starting position. Gently roll the bent knees over to the opposite side, hold, and then return to the starting position. Repeat 2–3 times on each side twice a day. 4. Draw-in maneuvers— lie back on the floor with knees bent and feet flat, keeping the arms by the sides. Breathe in deeply. While breathing out, pull the bellybutton toward the spine, tightening the abdominal muscles and keeping the hips still. Hold the position for 5 seconds. Repeat 5 times. 5. Pelvic tilts— lie back on the floor with knees bent and feet flat, keeping the arms by the sides. Gently arch the lower back and push the stomach out. Hold for 5 seconds, then relax. Flatten the back and pull the bellybutton in toward the floor. Hold for 5 seconds, then relax. Increase the number of repetitions daily, building up to 30. 6. Lying lateral leg lifts— lie on one side with the legs together. Keep the lower leg slightly bent. Draw the bellybutton into the spine to engage the core muscles. Raise the top leg about 18 inches, keeping it straight and extended. Hold the position for 2 seconds. Repeat 10 times. Turn onto the other side of the body and repeat, lifting the other leg. Perform 3 sets on each side. 7. Cat stretches— get onto the hands and knees with the knees hip-width apart. Arch the back, pulling the bellybutton up toward the spine. Slowly relax the muscles and allow the abdomen to sag toward the floor. Return to the starting position. Repeat 3–5 times twice a day. 8. Supermans— lie face down on the ground and stretch both arms out in front of the body, keeping the legs stretched out and flat on the ground. Raise both the hands and feet, aiming to create a gap of about 6 inches between them and the floor. Try to pull in the bellybutton, lifting it off the floor to engage the core muscles. Keep the head straight and look at the floor to avoid neck injury. Stretch the hands and feet outward as far as possible. Hold the position for 2 seconds. Return to the starting position. Repeat 10 times. For this homeopathic treatment is very effective consult online with details.
1 person found this helpful
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I am from madurai. 39 years old. I had a spinal cord injury seven years ago when I was swimming in the swimming pool. I can't stand alone. I can walk a few feet with a help of the walker support. Sometimes when I try to walk I feel my legs are trembling. I am constantly trying to medically. Can you heal me doctor.

Dr.S. Gomathi 90% (2526ratings)
BPTh/BPT
Physiotherapist, Bangalore
I am from madurai. 39 years old. I had a spinal cord injury seven years ago when I was swimming in the swimming pool....
It's due to spinal cord compression happening, get it treated thr medications to support the nerves and analgesics along with advanced physiotherapy, multivitamin suppliments along with calcium rich diet will help.
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I had cabg 18 months ago but I am still taking same medicine as follow. clopidogrel 75 mg ascard 75 mg rosuvastatin 10 mg atenolol 50 mg should I continue both clopidogrel and ascard?

Dr.Kumar Aditya 90% (39ratings)
MCh (CTVS), MS (Gen. Surgery), MBBS Bachelor of Medicine and Bachelor of Surgery
Cardiothoracic Vascular Surgery,
I had cabg 18 months ago but I am still taking same medicine as follow.
clopidogrel 75 mg
ascard 75 mg
rosuvastatin 1...
Yes please continue both clopidogrel and ascard 75 mg. These are blood thinners required lifelong after cabg surgery. If discontinued then the risk of graft blockage is high.
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Acute Coronary Syndrome - How To Diagnose And Manage It?

MBBS, MD - Medicine, DNB (Cardiology)
Cardiologist, Pune
Acute Coronary Syndrome - How To Diagnose And Manage It?

The word acute coronary syndrome refers to a group of symptoms that are caused by blockage of the blood flow to the heart muscles.  The most common result of this is myocardial infarction or heart attack as it is popularly called. Reduced blood flow leads to death of some portion of the heart muscle wall. While the word heart attack sounds almost fatal, it need not be the case. Knowing how to identify an attack and being aware of some simple measures can help save lives. 

Symptoms

The tell-tale signs of a heart attack are as follows:

- Chest pain and discomfort usually described as a tightness or burning in the chest region
- Pain along the left side of the shoulder and neck, going up into the jaw, down to the arm
- Nausea and vomiting 
- Profuse sweating 
- Difficulty breathing 
- Dizzy or fuzzy feeling 
- Tired, extreme fatigue
- Anxious, apprehensive feeling 

However, be also aware that there are a lot of people who experience a silent heart attack. Women, obese, elderly, and diabetic patients can have silent attacks, and depending on severity, either they go on with life as usual or can have a fatal attack.

Diagnosis

Once you are doubtful of a heart attack, the next step is to reach the closest medical facility for a diagnosis.  In addition to a detailed examination and history, the following two tests will be performed.

- Electrocardiogram (ECG): A 12-lead ECG will measure electrical activity of the heart and identify irregular electrical activity which is indicative of a myocardial infarction.

- Blood tests:  Presence of certain enzymes in the blood, CK-MB and troponin, are indicative of a heart attack.  A complete electrolyte profile also will be done, and increase or decrease of some electrolytes is helpful in diagnosing a heart attack.

- In addition to these two, chest radiography, cardiac angiography, echocardiogram, stress test, and computed coronary tomography may also be required to confirm the diagnosis.

Management

Once diagnosed, the first step would be to relieve the symptoms, negate the effects of reduced blood flow, and restore cardiac function. 

- Dissolve the clot - Using thrombolytics like clopedigrol 

- Nitroglycerin - To dilate the blood vessels and improve blood flow, especially to the heart muscles

- Anticoagulant therapy - Blood thinners are usually used to avoid blood clot formation; aspirin and heparin are the most commonly used agents.

- Blood pressure maintaining drugs like beta blockers and/or angiotensin-converting enzyme (ACE) inhibitors are also used

- Statins are used to reduce the amount of cholesterol in the blood and stabilize plaque deposits. In very severe cases, angioplasty and stenting or coronary bypass surgery may be required.

Educating people on how to identify a heart attack and manage it is very useful and can help save lives.
 

1600 people found this helpful

Coronary Artery Disease - How To Tackle It?

Dr.Anand Chopda 86% (48ratings)
MBBS, MD Medicine, DNB Cardiology, Fellowship in Cadiology (Non- Invasive )
Cardiologist, Delhi
Coronary Artery Disease  - How To Tackle It?

Coronary artery disease is one of the major killer diseases of modern society. It is not a solitary problem but brings with it a multitude of issues including obesity, diabetes, stroke, and other metabolic disorders. A thorough understanding of what causes it and how to manage it can help save thousands of lives.

Causes: The circulatory system is mainly made up of the heart and a complex network of arteries and veins. The inner walls of these are lined with smooth muscles, allowing for a free flow of blood. Gradually, over a period of time, given the density, the fat from the blood flowing through these vessels settles along the walls of these vessels. This attracts more fat, lipoproteins, and other inflammatory cells and so the process continues. This reduces the diameter of the blood vessels, therefore reducing the amount of blood supply to the target organs. If the target organ is a vital one like the brain or the heart, then it could lead to stroke or heart attacks.

Main causes of coronary artery disease include high blood pressure, high cholesterol, sedentary lifestyle, obesity, smoking, diabetes, and stress. Men are more prone than women, and family history and age puts them at higher risk.

Symptoms: Reduced blood supply to the target organ causes the following symptoms:

  1. Shortness of Breath: A person with coronary artery disease will feel short of breath and tired with most activities, even like walking a few meters.

  2. Chest Pain: A strong pressure sensation on the left side of the chest is an indication of coronary artery disease. Known as angina, it comes with stress and goes away once the stress is removed. It could sometimes radiate to the shoulder, down the arm, or up into the jaw also. These are classical symptoms of angina or heart attack and is considered an emergency. Of note, this is often mistaken for indigestion.

  3. Palpitations: A sensation where you are able to hear your heartbeat.

  4. Nausea and Excessive Sweating: Nausea and excessive sweating are also seen during angina.

Treatment: There are 3 modes to manage this.

  • Medications:

  • Surgical Procedures:  Surgical procedures including balloon angioplasty followed by placement of drug-eluting stents and coronary artery bypass surgery are done to manage more severe cases.

  • Lifestyle Change: Lifestyle changes including reduced fat consumption, decrease body weight, stop smoking, increased physical exercise, and reducing stress are highly important in preventing further damage.

Once suspected, coronary artery disease can be effectively managed and the extent of damage controlled using the above techniques.

4 people found this helpful

Acute Coronary Syndrome - How To Administer It?

Dr.Sanjib Patra 91% (18ratings)
Fellowship In Electrophysiology, Fellowship In Interventional Cardiology, DM - Cardiology, MD - Medicine, MBBS
Cardiologist, Kolkata
Acute Coronary Syndrome - How To Administer It?

The word acute coronary syndrome refers to a group of symptoms that are caused by blockage of the blood flow to the heart muscles.  The most common result of this is myocardial infarction or heart attack as it is popularly called. Reduced blood flow leads to death of some portion of the heart muscle wall. While the word heart attack sounds almost fatal, it need not be the case. Knowing how to identify an attack and being aware of some simple measures can help save lives. 

Symptoms:

 The tell-tale signs of a heart attack are as follows:
- Chest pain and discomfort usually described as a tightness or burning in the chest region
- Pain along the left side of the shoulder and neck, going up into the jaw, down to the arm
- Nausea and vomiting 
- Profuse sweating 
- Difficulty breathing 
- Dizzy or fuzzy feeling 
- Tired, extreme fatigue
- Anxious, apprehensive feeling 

However, be also aware that there are a lot of people who experience a silent heart attack. Women, obese, elderly, and diabetic patients can have silent attacks and depending on severity, either they go on with life as usual or can have a fatal attack.

Diagnosis:

Once you are doubtful of a heart attack, the next step is to reach the closest medical facility for diagnosis.  In addition to a detailed examination and history, the following two tests will be performed.

- Electrocardiogram (ECG): A 12-lead ECG will measure the electrical activity of the heart and identify irregular electrical activity which is indicative of myocardial infarction.

- Blood tests:  Presence of certain enzymes in the blood, CK-MB and troponin, are indicative of a heart attack.  A complete electrolyte profile also will be done, and increase or decrease of some electrolytes is helpful in diagnosing a heart attack.

- In addition to these two, chest radiography, cardiac angiography, echocardiogram, stress test, and computed coronary tomography may also be required to confirm the diagnosis.

Management:  

Once diagnosed, the first step would be to relieve the symptoms, negate the effects of reduced blood flow, and restore cardiac function. 

- Dissolve the clot - Using thrombolytics like clopidogrel 

- Nitroglycerin - To dilate the blood vessels and improve blood flow, especially to the heart muscles

- Anticoagulant therapy - Blood thinners are usually used to avoid blood clot formation; aspirin and heparin are the most commonly used agents.

- Blood pressure maintaining drugs like beta blockers and/or angiotensin-converting enzyme (ACE) inhibitors are also used

- Statins are used to reduce the amount of cholesterol in the blood and stabilize plaque deposits.
In very severe cases, angioplasty and stenting or coronary bypass surgery may be required.

Educating people on how to identify a heart attack and manage it is very useful and can help save lives.
 

962 people found this helpful

Radiotherapy To Deal With Cancer - Know How Vital It Is!

Dr.Neha Patel 88% (40ratings)
MBBS, MD Radiation Oncology
Oncologist, Surat
Radiotherapy To Deal With Cancer - Know How Vital It Is!

The branch of medicine dealing with the prevention, diagnosis and treatment of cancer is called oncology. The subdivisions of oncology include medical oncology, radiation oncology and surgical oncology. Cancer is an umbrella term for a group of diseases which involves abnormal cell growth causing potential invasion to other parts of the body and the branch of science dealing with the treatment of cancer is oncology.

Radiotherapy-
Radiotherapy is a kind of cancer treatment which involves the use of high energy rays, such as X-rays or rays of electrons to treat the disease. In this therapy, the cancer cells are destroyed using these rays. Normal cells along with the cancerous cells also get destroyed due to exposure to the strong rays. However, normal cells can restore themselves but cancerous cells cannot.
Radiotherapy is planned very carefully to avoid the damage to as many healthy tissues as possible. However, damage to some healthy tissues is inevitable, which is the major side effect of this treatment.

Usage of Radiotherapy-
A lot of patients with cancer have radiotherapy as a part of their cancer treatment. The reasons behind using radiotherapy could be-

  1. Curative reason- radiotherapy is suggested with the aim of destroying a certain tumor and thus curing cancer with it. This is also known as radical treatment.
  2. Palliative reason- radiotherapy is recommended to the patients when there is no possible way to cure cancer, but with this treatment. The further growth of the tumor can be controlled or the various symptoms such as pain or coughing can be relieved.

Ways of Radiotherapy Treatment-
There are two ways in which radiotherapy is commonly given-

  1. The radiotherapy which is given from outside the body is known as external beam radiotherapy.
  2. The radiotherapy given using a material that is placed inside the body is called internal radiotherapy.

The type of radiotherapy to be given to the patient depends on the type of cancer the patient has and the body part which is affected by it. Some cancers require both external and internal radiotherapy.

Chemo-Radiation-
In certain situations, chemotherapy is required to be given to the patients along with radiotherapy. This is called chemoradiotherapy or chemoradiation. Chemotherapy basically uses anti-cancer drugs which make the cancerous cells more sensitive to radiotherapy, thereby enhancing the treatment process. However, both these therapies are very powerful, each with their own side effects. Hence, chemoradiation can sometimes have worse side effects.

Technological Advances-

  1. IMRT: Intensity modulated radiation therapy (IMRT) is a new technology in radiation oncology that delivers radiation more precisely to the tumor while relatively sparing the surrounding normal tissues. IMRT is being used most extensively to treat cancers of the prostate, head and neck, and central nervous system. IMRT has also been used in limited situations to treat breast, thyroid, lung, as well as in gastrointestinal, gynecologic malignancies and certain types of sarcomas. IMRT may also be beneficial for treating pediatric malignancies.
  2. IGRT: Image-guided radiation therapy (IGRT) is the use of imaging during radiation therapy to improve the precision and accuracy of treatment delivery. IGRT is used to treat tumors in areas of the body that move, such as the lungs. Radiation therapy machines are equipped with imaging technology to allow your doctor to image the tumor before and during treatment. By comparing these images to the reference images taken during simulation, the patient’s position and/or the radiation beams may be adjusted to more precisely target the radiation dose to the tumor.
  3. Stereotactic radiation therapy is mainly used to treat small brain tumors that are either malignant or benign. It is used to treat:
    • Tumors deep within the brain: Tumours that are hard to reach or that cannot be removed by surgery because doing so would damage too much normal brain tissue
    • A recurrence or metastasis in the brain
  4. Stereotactic radiation may also be used to give an additional dose of radiation (boost) to the brain after conventional external beam radiation therapy to kill any remaining cancer cells.

This is just the basic overview of radiotherapy. One important thing that should be kept in mind is that radiotherapy treatments are planned depending on the condition of the patient. So even if two individuals suffer from the same type of cancer, the radiotherapy treatments might be different.

1028 people found this helpful

Postpartum Hemorrhage - How To Avert It?

Dr.Dimpy Irani 89% (13ratings)
MD - Obstetrics & Gynaecology, MBBS, DGO, DNB
Gynaecologist, Mumbai
Postpartum Hemorrhage - How To Avert It?

An expecting mother runs the risk of suffering from a range of complications during and after pregnancy. You were very wrong to think childbirth is about antenatal care and once the baby is born, the mother is safe from danger. Both C- Sections and vaginal deliveries take into account the hovering threat of impediments. Sudden problems like perineal lacerations, amniotic cavity issues, umbilical cord issues, abnormal fetal heart rate, and stalled labor might be experienced during giving birth to a child. Childbirth is again followed by another set of medical conditions. Postpartum Hemorrhage is one such condition that, if left unattended, can turn out to be fatal.

Postpartum Hemorrhage: An overview

Patients suffering from Postpartum Hemorrhage are subjected to loss of more than 500 mL of blood after delivery. In certain rare cases, women have been reported with a loss of more than 1000 mL of blood. Morbidity statistics say postpartum hemorrhage is the most common trigger to maternal morbidity in developed countries. Even after ensuring the efficacy of preventive measures to prevalent risk factors, lapses do exist. A loss of more than 1000 mL of blood can severely endanger your health. It may lead to hemodynamic instability. Treatment of Postpartum Hemorrhage should systematically concentrate on two important things; firstly, diagnosis and management of root causes resulting in hemorrhage and secondly, dealing with hypovolemic shock along with resuscitation of obstetric hemorrhage.

Preventive Measures

An exigency situation with regard to postpartum hemorrhage can be avoided or controlled in the following ways;

1. Detecting signs of acute anemia and thus rectifying the condition before delivery.

2. Routine episiotomy should be done away with.

3. The doctor should inquire of the mother's opinion on blood transfusions.

4. There should be frequent examinations of the person's vaginal flow and vital signs to check for slow and steady bleeding.

5. The risk of retained placenta in the third stage of labor can increase the chances of postpartum hemorrhage. Active management on part of the hospital can take care of this. Regulated cord traction, early cord clamping and cutting and most basic use of a uterotonic drug soon after the delivery of the anterior shoulder can prevent a prolonged third stage thus hindering a hemorrhage from occurring.

6. Oxytocin is an advisable drug to prevent the chances of a hemorrhage. Pregnant women may or may not give their consent to its use. It has very few side- effects. Prophylactic administration of this drug is known to reduce rates of postpartum hemorrhage by forty percent.

Management: excessive blood loss after childbirth can be tackled through hysterectomy. Women who wish to remain fertile can go in for B- lynch uterine compression sutures, artery litigations, uterine packing or tamponade procedures.

2696 people found this helpful

Heart Transplant - Know More About It!

Dr.Anand Chopda 86% (48ratings)
MBBS, MD Medicine, DNB Cardiology, Fellowship in Cadiology (Non- Invasive )
Cardiologist, Delhi
Heart Transplant - Know More About It!

There are many people worldwide who suffer from heart problems (irrespective of their age and sex). While in most cases, the condition improves with proper treatment and medications, in few, the condition is beyond treatment. A heart transplant comes as a saviour for such people. It gives them a new lease of life. The transplant involves replacing a heart that has stopped functioning normally (damaged or may be diseased) with a healthy heart (from the donor).

Over the years, heart transplant has undergone a sea of change. With the advancement of science and technology, the success rate in a heart transplant has seen an exponential rise.

People who need a heart transplant:
A heart transplant may be essential in the following cases.

  • A congenital heart disorder (a person born with a heart problem).
  • Defective or diseased heart valves.
  • Amyloidosis (a condition where amyloid fibrils get deposed in the tissues and organs of the body intracellularly or extracellularly).
  • Problems in the coronary artery.
  • Cardiomyopathy (A condition where the muscles of the heart become weak, thereby affecting the normal functioning of the heart).
  • A heart transplant that failed previously.
  • Ventricular Arrhythmias (a condition that originates in the ventricles, in ventricular arrhythmias, the heart rhythms are abnormally rapid).


However, under the following circumstances, a heart transplant may not be a wise idea

  • People with infections or chronic lung or kidney disorders.
  • A case of cancer in the past.
  • Age may be a deciding factor. The recovery from a heart transplant may not be 100% in an aged person.

The heart transplant procedure:
The first step in heart transplant is the availability of a suitable donor. In this case, a donor is a person whose brain is dead but the other organs, including the heart, is healthy and functioning properly. A surgeon performs three operations in a heart transplant.

  • The first operation is essentially the removal of the healthy heart from the donor body. The heart is kept in a cool place, preferably ice (to keep the heart alive and in good condition until the heart transplant takes place).
  • In the second operation, the recipient's damaged or diseased heart is operated out. The situation may, however, be complicated if the patient had heart surgery in the past.
  • The third and the final surgery involves implanting the donor heart into the recipient body (the recipient's upper heart chambers and the atrial back wall are however not removed).
  • Once the implantation takes place (without any complications), the surgeons sew the heart into place.
  • The blood vessels are then connected back to the heart and the lungs. The heart starts beating again once it is warmed up.
  • To enable the patient to receive the nutrients and oxygen (during the heart transplant), the patient is put on a heart-lung machine.
  • If no complications develop after the transplant, the patient is discharged within a fortnight.

In some unfortunate cases, there may be organ rejection. The condition arises when the recipient's immune cells see the transplanted heart as non-self (foreign agents). If left unattended, it may damage the heart. Immunosuppressant drugs can help avert rejection. However, it is important to monitor the patient closely for any infections that may arise to the administration of the immunosuppressants.

2 people found this helpful

HI, What are the steps to follow immediately after open-heart surgery? Like food, exercise etc.

Dr.Kapil Minocha 88% (118ratings)
MCh (CTVS), MS - General Surgery, MBBS
Cardiothoracic Vascular Surgery, Noida
HI, What are the steps to follow immediately after open-heart surgery? Like food, exercise etc.
Hello. My suggestion are you should take whatever healthy food for 1 month post surgery if you are non diabetic for your body to recover from major surgery. Exercises usually are respiratory like incentive spirometer and active limbs exercises. Take a walk without tiring yourself and slowly increase over days.
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