Common Specialities
{{speciality.keyWord}}
Common Issues
{{issue.keyWord}}
Common Treatments
{{treatment.keyWord}}

Resistant Hypertension Tips

Hypertension - All You Need to Know

Dr. Anshu Jain 92% (515 ratings)
MBBS, DMCH, DEM
General Physician, Jaipur
Hypertension - All You Need to Know

High blood pressure or hypertension is a condition where the long term force induced by blood on the artery walls may lead to health complications. In some cases high blood pressure can be a chronic condition without any visible symptoms. The normal value of blood pressure is 120/80 mm Hg. Even if high blood pressure doesn't have any obvious symptoms, it can cause significant damage to cardiovascular health and blood vessels. Uncontrolled hypertension exposes you to the risks of stroke and cardiac arrest. Following are the causes and complications of hypertension:

Causes of Hypertension
The causes of hypertension vary depending on the two types of the condition namely primary hypertension and secondary hypertension. In case of primary hypertension there are hardly any identifiable causes. 

Recently diagnosed high blood pressure with following signs may be due to secondary hypertension: 

  1. High blood pressure not responding to blood pressure medications (resistant hypertension
  2. Very high BP — systolic blood pressure over 180 (mm Hg) or diastolic blood pressure over 120 
  3. Sudden-onset high blood pressure before age 30 or after age 55 Risk factors includes- 
  4. High blood pressure tends to run in families. 
  5. Being overweight or obesity, physically inactivity. 
  6. Using tobacco/ smoking or chewing tobacco, too much salt (sodium) in your diet, Drinking too much alcohol. 
  7. Having more than two drinks a day for men and more than one drink a day for women may affect your blood pressure. 
  8. Stress. High levels of stress /family history of high BP

Certain medications like contraceptives, painkillers and some other drugs

  1. Sleep disorders
  2. Problems related to the kidney
  3. Tumors in the adrenal gland
  4. Thyroid issues
  5. Congenital heart defects from birth
  6. Drug abuse
  7. Excessive consumption of alcohol
  8. Complications of hypertension

Persistent high blood pressure can result in atherosclerosis that is hardening of the arteries. This can severely wreck cardiovascular health and cause stroke, heart attack or other complications. Hypertension can also result in a disorder called aneurysm in which the blood vessels tend to swell and weaken. Rupture of an aneurysm can be fatal.

Heart failure is one of the most serious complications associated with hypertension. It becomes increasingly difficult for the heart to pump blood along with the high pressure. Consequently, the heart muscle thickens and leads to cardiac arrest. It can also lead to kidney problems. Narrowing and weakening of certain blood vessels present in the kidney can cause organ failure. It can also lead to eye problems and sometimes even loss of vision due to narrowing or thickening of blood vessels in the eye.

Metabolic syndrome, which refers to a cluster of deficiencies in the metabolism of your body including high triglycerides, low levels of good cholesterol (High density lipoprotein) and high levels of insulin. These metabolic disorders increase the risk of developing diabetes and other complications. Uncontrolled high blood pressure and interference with your ability to remember and think. It can trigger memory loss and affect your understanding and deriving skills. If you wish to discuss about any specific problem, you can consult a general physician.

4855 people found this helpful

Hypertension: Causes, Risk Factors and Treatment

lybrate
General Physician, Mumbai
Hypertension: Causes, Risk Factors and Treatment

Hypertension or high blood pressure can be defined as a condition wherein the thrust of the blood against the walls of the arteries is excessively high, thereby increasing chances of health hazards. The amount of blood that is pumped by the heart and the resistance put up by the arteries usually determine one’s blood pressure count. For instance, if the heart pumps excess amount of blood while the arteries shrink, the blood pressure can soar high. High blood pressure or hypertension may give rise to symptoms such as nosebleeds, short breaths or headaches.

Causes:
There are two types of hypertension, one is primary and the other is secondary. For essential or primary hypertension, there is no significant reason and the condition slowly develops over years. The secondary one appears all of a sudden as a result of a repressed condition such as thyroid or kidney problems, defective blood vessels and certain medications such as pain-killers, cold relievers, pills for birth control and others.

Other factors responsible for hypertension are:

  1. Age: The risks increase over the years
  2. Family history
  3. Being obese or overweight
  4. Being physically inactive
  5. Consuming too much of sodium or salt in your diet
  6. Little intake of potassium and Vitamin D in meals
  7. Being subject to high level of stress
  8. Chronic medical disorders such as diabetes
  9. Alcohol or drug abuse

Treatments:

Medications:

  • Thiazide diuretics can be administered. These help to flush out excess water and sodium from the body in order to reduce excessive volume of blood thrusting against the arteries.
  • Beta blockers: They ease the workload of the heart by opening up the blood vessels.
  • Angiotensin-converting enzyme (ACE) inhibitors help inhibit the production of chemicals narrowing the blood vessels
  • Angiotensin II receptor blockers (ARBs) are used to obstruct and curb the action of the chemicals contracting the blood vessels
  • Calcium channel blockers help to loosen the blood vessel muscles
  • Renin inhibitors can delay the production of an enzyme called ‘renin’ by the kidneys that increase one’s blood pressure

Lifestyle Changes:

  • One should follow a well-balanced diet that comprises of less salt.
  • There is no substitute to regular exercises. Exercising regularly helps one maintain a balanced body weight that further reduces the chances of this condition.
  • Abstaining from smoking and limiting alcohol intake helps provide that holistic cover to all the treatment modes mentioned above. In case you have a concern or query you can always consult an expert & get answers to your questions!
3806 people found this helpful

Hypertension: Causes, Risk Factors and Treatment

Dr. Jatin Soni 92% (39729 ratings)
MBBS
General Physician, Mumbai
Hypertension: Causes, Risk Factors and Treatment

Hypertension or high blood pressure can be defined as a condition wherein the thrust of the blood against the walls of the arteries is excessively high, thereby, increasing chances of health hazards. The amount of blood that is pumped by the heart and the resistance put up by the arteries usually determine one’s blood pressure count. For instance, if the heart pumps excess amount of blood while the arteries shrink, the blood pressure can soar high. High blood pressure or hypertension may give rise to symptoms such as nosebleeds, short breaths or headaches.

Causes
There are two types of hypertension, one is primary and the other is secondary. For essential or primary hypertension, there is no significant reason and the condition slowly develops over years. The secondary one appears all of a sudden as a result of a repressed condition such as thyroid or kidney problems, defective blood vessels and certain medications such as pain-killers, cold relievers, pills for birth control and others.

Other factors responsible for hypertension are:

  1. As you age it increases
  2. Family history
  3. Being obese or overweight
  4. Being physically inactive
  5. Consuming too much of sodium or salt in your diet
  6. Little intake of potassium and Vitamin D in meals
  7. Being subject to high levels of stress
  8. Chronic medical disorders such as diabetes
  9. Excessive alcohol consumption or drug abuse

Treatment

Medications:

  1. Thiazide diuretics can be administered. These help to flush out excess water and sodium from the body in order to reduce excessive volume of blood thrusting against the arteries.
  2. Beta blockers ease the workload of the heart by opening up the blood vessels.
  3. Angiotensin-converting enzyme (ACE) inhibitors help inhibit the production of chemicals narrowing the blood vessels.
  4. Angiotensin II receptor blockers (ARBs) are used to obstruct and curb the action of the chemicals contracting the blood vessels.
  5. Calcium channel blockers help to loosen the blood vessel muscles
  6. Renin inhibitors can delay the production of an enzyme called ‘renin’ by the kidneys that increase one’s blood pressure

Lifestyle changes:

  1. One should follow a well-balanced diet that comprises of less salt.
  2. There is no substitute to regular exercises. Exercising regularly helps one maintain a balanced body weight that further reduces the chances of this condition.
  3. Abstaining from smoking and limiting alcohol intake helps provide that holistic cover to all the treatment modes mentioned above. If you wish to discuss about any specific problem, you can consult a General Physician.
6613 people found this helpful

Hypertension - Signs You May Be Suffering From It!

Dr. Neeraj Gupta 94% (82 ratings)
MBBS
Sexologist, Jammu
Hypertension - Signs You May Be Suffering From It!

High blood pressure or hypertension is a condition where the long term force induced by blood on the artery walls may lead to health complications. In some cases high blood pressure can be a chronic condition without any visible symptoms. The normal value of blood pressure is 120/80 mm Hg. Even if high blood pressure doesn't have any obvious symptoms, it can cause significant damage to cardiovascular health and blood vessels. Uncontrolled hypertension exposes you to the risks of stroke and cardiac arrest. Following are the causes and complications of hypertension:

Causes of Hypertension
The causes of hypertension vary depending on the two types of the condition namely primary hypertension and secondary hypertension. In case of primary hypertension there are hardly any identifiable causes. 

Recently diagnosed high blood pressure with following signs may be due to secondary hypertension: 

  1. High blood pressure not responding to blood pressure medications (resistant hypertension
  2. Very high BP — systolic blood pressure over 180 (mm Hg) or diastolic blood pressure over 120 
  3. Sudden-onset high blood pressure before age 30 or after age 55 Risk factors includes- 
  4. High blood pressure tends to run in families. 
  5. Being overweight or obesity, physically inactivity. 
  6. Using tobacco/ smoking or chewing tobacco, too much salt (sodium) in your diet, Drinking too much alcohol. 
  7. Having more than two drinks a day for men and more than one drink a day for women may affect your blood pressure. 
  8. Stress. High levels of stress /family history of high BP

Certain medications like contraceptives, painkillers and some other drugs

  1. Sleep disorders
  2. Problems related to the kidney
  3. Tumors in the adrenal gland
  4. Thyroid issues
  5. Congenital heart defects from birth
  6. Drug abuse
  7. Excessive consumption of alcohol
  8. Complications of hypertension

Persistent high blood pressure can result in atherosclerosis that is hardening of the arteries. This can severely wreck cardiovascular health and cause stroke, heart attack or other complications. Hypertension can also result in a disorder called aneurysm in which the blood vessels tend to swell and weaken. Rupture of an aneurysm can be fatal.

Heart failure is one of the most serious complications associated with hypertension. It becomes increasingly difficult for the heart to pump blood along with the high pressure. Consequently, the heart muscle thickens and leads to cardiac arrest. It can also lead to kidney problems. Narrowing and weakening of certain blood vessels present in the kidney can cause organ failure. It can also lead to eye problems and sometimes even loss of vision due to narrowing or thickening of blood vessels in the eye.

Metabolic syndrome, which refers to a cluster of deficiencies in the metabolism of your body including high triglycerides, low levels of good cholesterol (High density lipoprotein) and high levels of insulin. These metabolic disorders increase the risk of developing diabetes and other complications. Uncontrolled high blood pressure and interference with your ability to remember and think. It can trigger memory loss and affect your understanding and deriving skills.

In case you have a concern or query you can always consult an expert & get answers to your questions!

6850 people found this helpful

Ways To Help You Manage Diabetic Hypertension!

Dr. Shefali Karkhanis 92% (461 ratings)
Dip.Diab, Fellowship Diabetology (Gold Medallist), MBBS
Diabetologist, Thane
Ways To Help You Manage Diabetic Hypertension!

Hypertension is commonly witnessed among patients suffering from type 2 diabetes as compared to those who do not have diabetes. Studies have revealed that arterial hypertension among patients suffering from type 2 diabetes is in the vicinity of 40-50 percent. What’s more, a patient suffering from hypertension and diabetes has an increased risk factor for certain other diseases such as left ventricular hypertrophy, dyslipidemia, elevated fibrinogen and hyperuricemia.

The measurement practice:
It is important to measure blood pressure in a person who is suffering from type 2 diabetes with or without hypertension and renal diseases. Blood pressure measurement should be repeated within a month, if the measurement is 150/190 mm Hg. BP should be measured within a couple, of months if BP is greater than 140/80 mm of Hg.

Lifestyle practices:
If a person is consistently suffering from type 2 diabetes and has a BP range of 140/80, the following life style practices should be maintained always:

  1. A daily exercise schedule: Hypertension coupled with diabetes can be a dangerous combination. To ensure that a person remains healthy it is imperative to maintain a daily exercise schedule for at least half an hour. Exercise consumes extra calories and helps a person maintain a steady blood-sugar level.
  2. Food habits: Food habit is yet another important criterion to maintain good health for a person suffering from diabetic hypertension. Avoiding starch, glucose, and food with high carbs should be a mandate. Refraining from processed food with a high density of condensed fat, sugar and oil will go a long way in maintaining good health. Consulting a nutritionist is the best way to go.
  3. Stress is yet another factor that drives diabetic hypertension: A person suffering from regular stress has a greater tendency to fall prey to cardiovascular and renal diseases. The only way to stay away from stress is to ensure that good lifestyle choice are made. A stress -free life can pay rich dividends to a person suffering from diabetic hypertension.

Drug treatment:
A doctor’s first line of treatment hovers around ACE inhibitors. A pregnant woman suffering from diabetic hypertension is typically prescribed a calcium blocker. This is an antihypertensive drug that helps to stabilize the pregnancy and keep complications at bay. For a person who is resisting to ACE Inhibitor, a doctor might subscribe angiotensin 2 receptor. If the BP is not reduced after the first line of treatment, a doctor adds a thiazide-related diuretic along with the ACE inhibitor to expedite the treatment process.

Even after a triple therapy if a person continues to suffer from high blood pressure, a doctor might prescribe an alpha-blocker, potassium blocker or a beta blocker.

In case you have a concern or query you can always consult an expert & get answers to your questions!

4189 people found this helpful

Hypertension

Dr. Kaptan Singh Verma 89% (157 ratings)
Diploma in Naturopathy & Yogic Science (DNYS), M. D. ( E. H. Medicine), Internship in Yog & Naturopathy, Ram Ratan Chikitsa Kendra , Agra
Yoga & Naturopathy Specialist, Agra
Hypertension

1- dip cotton cloth in cold water, touch on cord point (nabhi-sthan). 

2- wash with warm water.
3- use less salt food. Avoid fast and spicy food. 

2 people found this helpful

Are You Hypertensive?

Dr. Ruchita Sharma Sharma 89% (23 ratings)
DNB (General Medicine), MBBS Bachelor of Medicine and Bachelor of Surgery
Internal Medicine Specialist, Lucknow
Are You Hypertensive?

Are you hypertensive? 
Now aha has given new guidelines for diagnosing hypertension. If your blood pressure is more than 130/80 mmhg, it suggests hypertension / elevated bp. 
Diet modification and exercise is advised from beginning to the individual who has elevated blood pressure. Sometimes if one has high bp he may require medicine to control it. Sometimes just with diet and lifestyle modification it can be reduced.

Bp classification -

Normal <120 and <80
<!--120-->Elevated 120-129 and 80
<!--80-->Hypertension 
Stage 1.130-139or 80-89
Stage2. 140 or & 90 

For prevention of hypertension 
1. Avoid smoking
2. High salt in diet
3. Exercise regularly 
4. Weight reduction 

Check your blood pressure and start lifestyle modification from the beginning!

All about Hypertension

Dr. Sanchayan Roy 90% (225 ratings)
DNB (Medicine), MBBS
General Physician, Delhi
All about Hypertension

Hypertension or High Blood Pressure (HBP) is a long-term or chronic health condition where the pressure of the flow of blood is always high in the arteries. High blood pressure can develop over many years and affects everyone at some point in life but if not treated for a very long time, it can escalate the risks of a number of cardiovascular problems and chronic kidney disorders.

Types

1. Primary Hypertension - High blood pressure caused by genetic, prenatal or other natural causes like aging (people over 60 develop HBP) is known as primary hypertension.

2. Secondary Hypertension - Secondary hypertension is that which is caused due to specific conditions, like kidney disorders, lung disorders etc.

Causes

Blood pressure depends on the amount of blood pumped by the heart and the radius of the blood vessels. The delicate balance can get disturbed due to a number of factors.

Primary hypertension may be caused by genetic factors. There are 35 identified genetic loci related to blood pressure. Mutations in these can cause chronic HBP. Other factors like maternal smoking, deficiency of vitamin D, deficiency of calcium, insufficient breast milk consumption also increase the risk of HBP.

Secondary hypertension is caused by a variety of conditions like hypothyroidism, hypothyroidism, nephritis, asthma, sleep apnea, depression, pregnancy etc. Overconsumption of caffeine, alcohol, sodium and illegal drugs may also be responsible for high blood pressure.

Symptoms

Hypertension may not show any warning symptoms for several years while it continues to develop. A few tell-tale signs are frequent throbbing headaches, shortness of breath, nosebleeds, excessive sweating but these only occur when there is an extremely serious medical complication.

Treatment and Prevention

Hypertension is a common condition, especially after the age of 40. Medication may help control severely high blood pressure to an extent but certain lifestyle changes go a long way in both preventing and treating the disorder. Some of them are:

1. Taking regular blood pressure readings after the age of 25. A normal blood pressure is not more than 120/80 mm Hg.
2. Obesity causes hypertension. A normal Body Mass Index of 30kg/sq. m. is to be maintained.
3. The daily diet should include at least 4 to 6 portions of fruits and vegetables.
4. Salt intake is to be limited.
5. Drinking and smoking are to be minimized.
6. Stress and burnout should be avoided.

Related Tip: High Blood Pressure and Sex?

4512 people found this helpful

AntiBiotic Resistance on the rise very fast

Dr. Himanshu Shekhar 88% (517 ratings)
Post Graduate Diploma in Hospital and Healthcare Management, MD - Consultant Physician, Fellowship Critical Care Management
Internal Medicine Specialist, Faridabad
AntiBiotic Resistance on the rise very fast

In 5 Years, Threat Of Drug-Resistant Superbugs Doubles


A 72-year-old woman in Bengaluru consulted a hospital physician about a severe skin infection and fever. She had previously consulted a couple of general practitioners, who prescribed a course of penicillin for three days and fluoroquinolones—both antibiotics—for two days.

There was no relief.

So, the consultant ordered a culture sensitivity test of pus from the skin lesions to identify what was causing her ailment and figure out what antibiotics it would respond to.

Here’s what the report said:
Pathogen: Klebsiella pneumoniae
Susceptible to: No antibiotic
Resistant to: All antibiotics, including advanced drugs like fluoroquinolones, carbapenems and even the last resort combination usually reserved for severe cases of ICU infection, colistin-tigecycline.

With nothing to offer the patient, save a prescription for paracetamol to keep her fever in check, the doctor sent the patient home, and asked her to return after a week.

In such cases, sometimes, the body’s immunity kicks in and throws off the infection, the physician, Sheela Chakravarthy, consultant (internal medicine) at Fortis Hospital, Bengaluru, told IndiaSpend.

Sometimes, resistance to one or more drugs abates, allowing treatment to be resumed. Chances of that happening are greater at home, not in the hospital, which is a more infectious space where sepsis—a disproportionate and potentially life-threatening immune response by your body to an infection—could set in, she explained.

Most patients, however, succumb to the infection.

Chakravarthy faces situations where she has nothing to offer patients, not because they are suffering from terminal illnesses, such as some forms of cancer, but even when they present with what should be curable infections, “almost every day”, she said.

What Chakravarthy described is the consequence of rampant, inappropriate consumption of antibiotics, spurring the development of superbugs, as the recently released State of the World’s Antibiotics Report 2015 affirms.


India is fast becoming home to superbugs

Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus are three of the deadliest pathogens facing humanity, according to the World Health Organisation (WHO). And India is gradually but increasingly becoming home to multi-drug resistant strains of these pathogens, according to the State of the World’s Antibiotics Report 2015.

Escherichia coli is notorious for causing food poisoning and urinary tract infections.

In 2010, 5% of Escherichia coli samples in India were resistant to carbapenems, last-resort antibiotics for bacteria that are resistant to first-, second- and third-line drugs. By 2014, 12% of E. coli samples were similarly resistant.


Klebsiella pneumoniae causes pneumonia, septicaemia and infections in the urinary tract, lower biliary tract and at surgical wound sites, to name a few.

While 29% of Klebsiella pneumonia isolates were resistant to carbapenems in 2008, this increased to 57% in 2014.

For comparison, fewer than 10% of Klebsiella pneumoniae infections in Europe are carbapenem-resistant.

Staphylococcus aureus can cause skin and soft tissue infections, bloodstream infections, pneumonia and surgical site infections. A particularly nasty strain of, methicillin-resistant Staphylococcus aureus (MRSA), is common in India and increasingly hard to treat.

MRSA was responsible for 40% of post-surgical site infections, according to a 2013 study by the Jawaharlal Nehru Medical College and Hospital, Aligarh.

Between 2009 and 2014, the incidence of MRSA in India has risen from 29% to 47%.

People with MRSA are 64% more likely to die than people with a non-resistant form of the infection, according to the WHO.

How ignorance is spurring the development of superbugs

“My understanding of antibiotic is that it stops bacteria growing in body…I think amoxicillin is for throat infection.”

–An urban participant of a study of perceptions about antibiotic use and resistance among urban and rural doctors, pharmacists and public in Vellore.

Mox, short for amoxicillin, has become a household word across India.

A little knowledge, however, is a dangerous thing. It encourages self-medication, even when medicine is unnecessary, such as when people suffer viral infections—against which drugs are ineffective. Most viral fevers dissipate on their own after a few days with rest, hot fluids and a check on the fever.

Consuming too many antibiotics contributes to pathogen drug resistance.

“Resistance is an outcome of accumulated use,” said Ramanan Laxminarayan, vice president, Research and Policy, Public Health Foundation of India, and director and senior fellow, Centre for Disease Dynamics, Economics & Policy, US, and co-author of the State of the World’s Antibiotic Report 2015.

Indians often rely on corner pharmacists, whose knowledge of dosages may be limited.

Here’s what a rural pharmacist participant of the aforementioned Vellore study said: “Amoxicillin, 6 tablets is to be taken [for full course].”

Amoxicillin’s full course depends on the kind and severity of bacterial infection.

When an antibiotic of lower strength or fewer pills than needed is prescribed, the body cannot fully eradicate the pathogen. Sensing it has come under attack, the bacterium responds by evolving into more resilient, antibiotic-resistant strains.

But with a course of antibiotics, say generic Amoxicillin, costing about Rs 160, close to a day’s wage in many states, and a doctor’s consultation costing anywhere between Rs 100 and Rs 1,000, more than a day’s wage in most places, patients are bound to cut corners.

Another Vellore study participant summed up the situation thus: “If I have money I go to hospital. If not, I get medicine from pharmacy shop. If I get better, I stop and keep for future use.”

Stopping a course of drugs mid-way also contributes to antibiotic microbial resistance.

In a 2015 study in Chennai, 70% respondents confessed to stopping the medication when they felt better. Only 57% completed the antibiotic course.

“Less is more”: the key to preserving antibiotic efficiency

Educate health professionals, policy makers and the public on sustainable antibiotic use, says the State of the World’s Antibiotics Report 2015.

That is sensible advice.

Denmark and Sweden boast of low rates of antibiotic use and near-zero rates of antibiotic resistance because the risks of antibiotic overuse are widely known.

Instituting regulations on antibiotic use has reduced the proportion of MRSA in Europe and the US by about a fifth over the last eight years.

India requires more stringent regulations for antibiotic use.

It isn’t enough to tell physicians that they should prescribe antibiotics only when essential to cure bacterial infections. The right way is to order a culture sensitivity test, which costs money, and the patience to wait for the result.

“Patients want instant and cheap relief, and are willing to shop around for a doctor who obliges,” said Dr Himanshu Shekhar, medical director, SCI International Hospital, New Delhi.

“Some judge doctors on how fast the prescribed medicine cures. Practice pressures lead many doctors to prescribe advanced drugs, without getting a culture-sensitivity test done.”

So, it’s also not enough to have 24 advanced antibiotics, including third- and fourth-generation cephalosporins, carbapenems, and newer fluoroquinolones, under the ambit of Schedule H1 of the Drugs & Cosmetic Rules, 1945, with effect from March 1, 2014.

That means these drugs cannot be sold over-the-counter, but they are still freely prescribed.

Chakravarthy’s suggestion: “Make Schedule H antibiotics available only through hospitals and health centres.”

“Changing antibiotic usage behaviours is critical to preserve the efficacy of existing and new drugs,” proposed Laxminarayan.

India also sorely needs regulations to check antibiotic use in animals raised for human consumption, to meet the State of the World’s Antibiotic Report 2015 recommendation to reduce and eventually phase out sub-therapeutic antibiotic use in agriculture.

Sub-therapeutic use implies mixing antibiotics in animal feed to make them grow faster and to prevent infections from devastating the herd or flock.

India is among the world’s five biggest consumers of antibiotics for livestock. IndiaSpend has earlier reported increasing evidence of antibiotic-resistant bacteria in animals in India, and how this impacts humans.

“Using antibiotics to make animals fatter faster is a waste of a precious resource,” said Laxminarayan.

How surgeons contribute to antibiotic resistance

Surgical antibiotic prophylaxis refers to the prescribing of antibiotics before, during and after operations to prevent infection.

Between 19% and 86% of patients in hospitals in India receive “inappropriate antibiotic prophylaxis”, according to the State of the World’s Antibiotics Report 2015. A prophylactic is preventive treatment for a disease.

Ideally, antibiotic prophylaxis should be administered as a single dose within 60 minutes of the skin incision. However, a 2013 Mangalore-based study found timing adhered to in 22% of cases in a government hospital, 64.9% cases in a medical-college teaching hospital and 80.7% of patients in a tertiary care corporate hospital.

“Smart antibiotic prophylaxis also includes choosing narrow-spectrum antibiotics to target the organism most likely to present concerns based on the kind of surgery being performed, this avoids needless exposure to antibiotics for the other microbes and helps prevent resistance,” said Vimesh Mistry, assistant professor, Pharmacology, Baroda Medical College.

Staphylococcus aureus, which lives on the skin, is most likely to cause infection during surgery. But surgeons frequently make poor antibiotic choices.

“We found appropriateness of choice of antibiotic in 68% cases and 52% compliance with the in-house prophylaxis guidelines,” said Tanu Singhal, infectious diseases specialist, Mumbai, and co-author of another study on antibiotic prophylaxis conducted in PD Hinduja Hospital, Mumbai.

Other prophylaxis inaccuracies include the unnecessary prescribing of antibiotics, inaccurate dose and inaccurate duration of prescription.

“We logged 63% accuracy in prescription duration. Surgeons tend to prescribe antibiotics for too long fearing post-surgery infection,” said Singhal.

In the trade off between protecting the patient better and increasing the risk to society of a pathogen developing resistance, surgeons are choosing the former.

Needed: A back-to-the-basics approach to health

Reducing the need for antibiotics through improved water, sanitation and immunisation is another strategy recommended in the State of the World’s Antibiotics Report 2015.

“Vaccination against pathogens such as the diarrhoea-causing rotavirus and pneumonia-causing Klebsiella pneumoniae helps curtail antibiotic demand, thereby reducing the chances of resistant strains developing,” said Laxminarayan.

In Canada, the widespread use of pneumococcal conjugate vaccines for pneumonia in children has reduced the incidence of pneumonia caused by strains the vaccine covers.

However, just as antibiotic usage spurs the development of superbugs, vaccination is a double-edged sword.

Canada is seeing a rapid increase in the incidence of other strains of pneumonia not protected against by the vaccine.

So, it is better to focus on the basic constituents of health.

Making available clean drinking water and improving sanitation would prevent people from getting sick in the first place. India still has a lot to do on both these fronts.

Improving individual immunity is the best bet to ward off infections, and that is also achievable by healthier eating, exercising, healthier living and the better management of chronic conditions like diabetes and asthma that increase vulnerability to infections when they are not kept in check.


Dr Himanshu Shekhar
MD,Medicine
New Delhi
+919818433208
( Above Article , with My Inputs was published in a leading Health Magazine)
6 people found this helpful

Hypertension - Why It Is Bad For Your Sex Life?

Dr. Masroor Ahmad Wani 93% (4405 ratings)
MD
Sexologist, Srinagar
Hypertension - Why It Is Bad For Your Sex Life?

Blood pressure is basically what happens when the blood exerts force against the walls of the blood vessels. This force matches the cardiac output and also, the resistance experienced from the walls of the blood vessels a process that produces blood pressure. Hypertension is a condition that occurs when this pressure rises above the normal which is anything over 140 over 90 mHg. The symptoms of this condition will include hot flashes, dizzy spells, fatigue, accelerated heartbeat and other debilitating conditions. Sex is also an area that gets affected by hypertension.

Let us find out the causes and treatment for the same.

Hypertension and male sexuality: A chronic patient of hypertension will go through a depletion of the lining that flanks the blood vessels, which in turn, limits the flow of blood. This also means that there is less blood flowing towards the penis and surrounding areas that get activated during sexual intercourse. This makes it difficult for many hypertensive men to achieve and retain an erection for long enough to enjoy sexual activity. This problem is most commonly known as erectile dysfunction. Also, these blood pressure problems can have an effect on ejaculation which leads to lack of sexual satisfaction. Many drugs prescribed for such patients may also lead to this problem as a side effect, which causes further fear and anxiety for the patient.

Hypertension and female sexuality: While the effect of high blood pressure on a woman’s sexuality is not as conclusive as its effect on male sexuality, it is a medically proven fact that decreased blood flow due to high blood pressure will also lead to a reduction in the blood flow to the vaginal area. This can lead to many problems including vaginal dryness and pain during intercourse, lack of arousal, difficulty in achieving an orgasm and relationship as well as anxiety issues.

Treatment: For women, better lubrication for better arousal is one of the key factors. For men, the use of safe medication as far as hypertension is concerned, is crucial. Medicines like sildenafil and tadafil as well as vardenafil are not known to interfere with the blood pressure medication. Yet, it is important to contact the doctor before having any medication.

Therapy: Better responses can be garnered by building intimacy, an area that a sex therapist or sexologist can help you with. With the help of proper therapy, the patient can learn to relax and enjoy the act with lots of foreplay and experiences that will help in building closeness like taking a warm bath together and other such activities. Promoting overall health can also help in improving your sex life if you are a patient of hypertension.

In case you have a concern or query you can always consult an expert & get answers to your questions!

7006 people found this helpful
Icon

Book appointment with top doctors for Resistant Hypertension treatment

View fees, clinic timings and reviews