HYDROXYCHLOROQUINE (HCQ) is an antimalarial and immunomodulatory drug for rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and cutanea tarda disease. Now it has come into action against COVID 19 (novel corona virus) virus based on initial data. we are using this drug for prevention and treatment of COVID 19 infected cases.
FDA and ICMR suggesting this drug in health care workers and household contacts of laboratory confirmed cases of COVID 19. Dose is 400 mg twice a day on day 1, and weekly for 7 weeks for healthcare workers ; for 3 weeks for household care takers.
Initial French study on 20 patients, declared on 16 march, suggested that COVID 19 viral loads has reduced or disappeared by HCQ. But later on little bigger an uncontrolled study on 80 hospitalized patients infected with COVID 19 is complementary and don’t fulfill the hope, though viral load is reducing on the drug but dear could not be prevented fairly.
Though we need more data, and some large randomized controlled studies are on to prove. At present we need to be reasonable about the usage of HCQ, in the light of side effects. All who are taking HCQ for prevention, and who are already taking for their RA, SLE should be aware of its side effects profile and how to use it.
HCQ comes in 200/400 mg tablet form. HCQ should be taken with food or milk.
SIDE EFFECT PROFILE:
It may cause headache, dizziness, irritability, muscle weakness.
It some cases it cause anemia, leucopenia and thrombocytopenia.
Side effects on eye cause impaired eye sight, colour blindness and others grave side effects like corneal and retinal deposits.
It causes prolonged QT interval and causes ventricular tachycardia or cardiac arrhythmia, especially more when used in combination with other drugs like azithromycin, which also prolongs QT interval, could increase the chances of cardiac arrhythmia.
On skin it can cause itching, skin pigmentation and allergic reaction.
It can cause deafness.
In diabetics it can cause low sugar stat- hypoglycemia.
On the hair it can cause alopecia, hair color change.
It also causes hepatitis, causing your liver enzyme rise.
Practice caution if you are allergic to HCQ, drinking alcohol, having liver disease, heart patients, especially already having fast, irregular heartbeats and diabetic patients.
Check your CBC (complete blood count), liver enzyme, renal function, blood sugar level, eye check up periodically.
HCQ is CATEGORY C drug for pregnancy and present in lactating mother’s milk. So during pregnancy and lactation only use when benefits outweighs risks. Don’t use in children under 15 years of age.
we decided to arrange an free medical camp on march,15 2020 for under privilege people- bind school in the Gandhinagar, sector 16. It was the first medical camp organized for privileged people under banner of the KAMDEHNU TRUST (REG.NO. E/22380/AHMEDABAD).
The day arrived , we all are very excited. It was very delightful to observe blind students. Some had the talents and confidence , never had been seen previously. They walk without aid for direction, in and around the examination room. students were crippling and cherishing the camp organized by them.
We had team of 6 person; three doctors, two nurses, one phlebotomist. It was general health check up camp with checking for blood sugar, ECG, Blood pressure, examination and investigation if needed. We examined 50 persons including 37 blind students and 13 staff of the blind school. Names of the examines will be given at the end, each one examined properly with care and given medicine for their ailments.
The camp followed by the lunch with all blind school members and student. We departed with successful camp; decided to do more such noble work for the underprivileged persons.
STUDENTS AND STAFF MEMBERS EXAMINED ON THE MEDICAL CAMP:
In terms of waist richness, actually is high waist circumference. today we see many obese people,if not obese many has only belly fat. Seeing these scenario heavy waist requires attention.
waist circumference is independent risk markers of many diseases like diabetes, hypertension, dyslipidemia and heart disease. Waist circumference indicates abdominal visceral fat. Though, there are other few modality to assess abdominal fatness like CT scan and MRI, it is costly affair. WC is easy to measure and cost effective
waist circumference measurement just takes measure tap. There are certain things took after 1) measure tap should snugly applied to the skin,not loose, not compressing the skin. 2) take a light breath and measure at the end of expiration 3) measure at the top pf the hip bone.
WC ( waist circumference) shall not more than 40” in male and 35” in female. Keeping waist circumference in normal value is more critical in the time of more metabolic diseases prevalence.
Swine flu is a respiratory disease caused by a new strain of influenza virus.
For most people, swine flu is mild. It comes on quickly and generally lasts a week. It causes fever, tiredness, cough and sore throat.
Other symptoms can include a headache, aching muscles, chills, sneezing, runny nose, loss of appetite, vomiting, and diarrhea.
Some people are more likely to be seriously ill with swine flu. These can include; people who have long term health condition, who are pregnant or whose immune system is affected by a disease.
They may need to go to the hospital and, in the very worst cases, some may die. That is why it is important to have a vaccine to prevent people from catching swine flu.
you can take everyday preventive actions like staying away from sick people and washing your hands and many. But Swine flu vaccine is the most effective and important step in protecting against this serious disease.
CDC recommends a yearly flu vaccine for everyone above 6 months of age. So Encourage your loved ones to get vaccinated. Vaccination is especially important for people at high risk for developing flu complications.
Taking swine flu vaccine is a really very good idea, as, regular seasonal influenza vaccine does not protect against swine flu, and
Swine flu vaccine not only Help you protect against swine flu but it
Help protect your family and other people who are close to you- as it is less likely that they will catch the virus from you.
It also, Help protect you against future waves of infection caused by the swine flu virus.
There are the certain high-risk group of the people who once infected, will have a serious course of illness. they need to get vaccinated first. They are;
Adults and children over 6 months of age who have a long term health condition, including Chronic lung disease, chronic heart disease, chronic kidney disease, chronic liver disease, DM, chronic neurological disease, immunosuppressive disease.
People who live in the same house with swine flu patient and
Health care workers and social care staff who can be in close contact with such patients
It is imperative to know, who can’t have the swine flu vaccine.
The vaccine should not be given to anyone who has had a severe allergic reaction to a previous dose of the vaccine or any component of the vaccine.
Let’s find out When you should get vaccinated.
You should get a flu vaccine before the flu begins to spread in your community. It takes about two weeks after vaccination to protect against flu. so make plans to get vaccinated early in fall, before flu season begins.
CDC recommends that people should get a flu vaccine by the end of October. Getting vaccinated later, however, can still be beneficial and vaccination should continue to be offered throughout the flu season, even into January or later.
Let’s talk about dosing recommendation.
The USFDA has approved the use of one dose of vaccine against 2009 h1n1 influenza virus for a person 10 years of age and older.
For children who are 6 months to 9 years of age, two doses of vaccines are recommended. These two doses should be separated by 4 weeks.
Infant younger than 6 months of age are too young to get any influenza vaccine.
As far as side effects are concerned,
All vaccinations can produce side effects such as redness, soreness and swelling at the site of the injection. The swine flu vaccine can cause symptoms like fever, headache and muscle aches,
but they are much milder than the flu itself and only last a day or so.
Remember THE VACCINE IS NOT LIVE AND CANNOT CAUSE SWINE FLU.
Currently, the majority of the Swine Flu vaccines protect against the three or four viruses, and they called trivalent vaccine or quadrivalent vaccine depending on the number of the viruses they protect against.
trivalent (three-component) vaccines protect against three viruses, type A, h1n1, type A h3n2 and type B Colorado like virus.
Quadrivalent (four-component) vaccines, which protect against all three in trivalent vaccine plus, the second lineage of type B Phuket-like viruses. without no doubt, the quadrivalent vaccine has an edge, as it has wider protection for swine flu.
there are many vaccines available for swine flu in the market. But you should Ask your doctor which one is better for you.
The pharma company, Sanofi has developed a new, quadrivalent vaccine, named FluQuadri®, to provide wider protection against this serious disease in India.
and here is the most unanswered question, How long you can be protected from getting flu by the swine flu vaccine.
Multiple studies have shown that the body’s immunity to influenza viruses declines over time. Older people and others with weakened immune systems may not generate the same amount of immunity after vaccination;
On an average Getting vaccinated each year provides the best protection against flu throughout that flu season. It is important to get a flu vaccine every season, even if you got vaccinated the earlier season.
If by any means you caught up with swine flu, don’t panic.
As swine flu is, generally a mild illness. If you get mild flu symptoms, in most cases, you should stay home and avoid contact with other people.
If, however, you have symptoms of flu and are at high risk of flu complications, or are very sick or concerned about your illness, contact your health care provider.
There are drugs your doctor may prescribe for treating swine flu called antivirals. These drugs can make you better faster and may also prevent serious complications.
Treatment with antivirals works best when begun within 48 hours of getting sick, but can still be beneficial when given later in the course of illness.
In the days of the total luxury and availability of all basic needs on the
couch humans are lacking vital thing, the fitness. The human body is most
sophisticated gadget on the earth that is required to carry out all outer world
activities. Fitness is the key to earn a fabulous body that helps you keep
going without illness and enjoy beautiful moments of the life. There are many
facts and myths about fitness, but we focus on time tasted core areas of
fitness. You cannot do any justice to the time spent working out or the
calories burnt if they do not lead to any kind of progress or learning in these
five core areas of fitness.
Following are the 5 core areas:
1. CARDIO-RESPIRATORY FITNESS: Ability of the heart and lungs (also called as cardiopulmonary fitness) to deliver oxygen and nutrients to working cells or muscles which are demanding them. Let’s say you are climbing stairs: your leg muscles will demand more blood supply, oxygen and nutrient delivery, and will need to remove or recycle waste products (like lactic acid).
2. MUSCULAR STRENGTH: The greatest amount of force (maximal effort) that a muscle or a group of muscles can exert at one time. The technical term in exercise physiology is ‘one rep max’ effect. Ever seen the one-inch punch of “Bruce lee” that is a perfect example of muscular strength.
3. MUSCULAR ENDURANCE: The ability of a muscle or group of muscles to perform a repeated activity over a period of time. For example, if you are running or playing tennis, then you will be using your muscular endurance.
4. FLEXIBILITY: Ability of the joints to move through their full range of motion (ROM).For example, a bowler would move her arm through a full range of her shoulder before the delivery. The Yogasana improves the flexibility through stretching and extending range of joint movement.
5. BODY COMPOSITION: This refers to the fat mass and lean mass (muscle and bone) that you carry as a total body mass you have.
High blood pressure affects more than 1 billion individuals and causes an estimated 9.4 million death per year. high blood pressure doubles the risk of heart disease, kidney disease, stroke, and peripheral arterial disease.
With the availability of a blood pressure measuring machine, it is easy to measure BP at home. These machines are fairly accurate and easy to operate. The question is how frequently is BP measured at home? HOME BP measuring is useful for the person who wants to just check if he is getting high blood pressure or not, and for the one who already has HIGH BLOOD PRESSURE to know if his BP is under control.
Anyone over the age of 40 should go for a blood pressure screening once a year.
Between 18 and 40 you can afford to go less often. During this period it’s a good idea to go for a screening every three to five years.
Certain people fall into the high-risk category before the age of 40. This includes:
People who are obese or overweight
People who aren’t active enough
People who drink too much
People who didn’t follow a healthy diet
People who suffer from kidney failure, heart disease, or diabetes
People with a family history of high blood pressure
People who don’t get enough sleep
People who consume too much caffeine
If you fall into any of these categories it’s a good idea to check your blood pressure checked more frequently.
When to Take Blood Pressure
Wait for at least 30 minutes after drinking alcohol or caffeine, smoking, or exercising before you take a reading.
Rest for at least 5 minutes before you take a reading.
Take your blood pressure twice a day for 7 days. The best time to take your blood pressure is in the morning (2-3 readings) before taking your medicines and in the evening. Each reading should be 2 minutes apart.
How to Take & Record Blood Pressure
Sit with your legs uncrossed, your back supported and your feet on the floor.
Rest your arm at heart level on a table.
Measure your blood pressure in both arms the first time you use a monitor.
Use the arm with the highest reading to take future readings.
Use a log to record your readings or print the numbers stored in your monitor.
Always take your log or bring your monitor with stored readings to show your doctor or nurse.
Mouth cancer is a very common cancer than other cancer. Oral cancer is more frequently seen in India and other southeast Asian countries. 10 out of 4 cancers are oral cancer. It kills lakhs of men annually.
Nowadays cases of oral cancer also affect the younger population. Oral cancer is caused by the addiction to tobacco and tobacco-related products. alcohol also increases the risk of oral cancer twice. 10% of the non-addicted persons also get oral cancer, unfortunately.
Oral cancer mostly presents as a non-healing ulcer in the oral cavity area. other presentation includes abnormal growth. If an ulcer does not heal in a 2-3 week period by medicine, one must check for cancer.
It is important to identify early and treat it well before spreading it to other body parts. The biopsy is the investigation to identify cancer. Surgery can cure cancer if done at an early stage.
To know more watch this video @Dr. brijesh baraiya and share it with others who need to know about this. We at param hospital, Nikol, Ahmedabad like to share this information in the public interest. You can contact us at +91-9054403510. Thanks
મોઢાનું કેન્સર એ અન્ય કેન્સર કરતાં ખૂબ જ સામાન્ય કેન્સર છે. મોઢાનું કેન્સર ભારત અને અન્ય દક્ષિણપૂર્વ એશિયાઈ દેશોમાં વધુ વખત જોવા મળે છે. તે વાર્ષિક લાખો માણસોને મારી નાખે છે. તેથી, શરીરના અન્ય ભાગોમાં ફેલાતા પહેલા તેની વહેલી ઓળખ કરવી અને તેની સારી સારવાર કરવી મહત્વપૂર્ણ છે. બાયોપ્સી એ કેન્સરને ઓળખવા માટેની તપાસ છે. જો પ્રારંભિક તબક્કે સર્જરી કરવામાં આવે તો કેન્સરનો ઈલાજ કરી શકાય છે. વધુ જાણવા માટે આ વિડિયો જુઓ અને અન્ય લોકો સાથે શેર કરો જેમને આ વિશે જાણવાની જરૂર છે. અમે પરમ હોસ્પિટલ, નિકોલ, અમદાવાદ ખાતે જાહેર હિતમાં આ માહિતી શેર કરવા માંગીએ છીએ. તમે અમારો 9054403510 પર સંપર્ક કરી શકો છો. આભાર
Kidney stone disease is common, with a worldwide prevalence of between 2 to 20%. Importantly, kidney stones are a recurrent disorder, with lifetime recurrence risk reported to be as high as 50%. In addition to the pain and suffering of an acute stone event, treatment incurs substantial cost, and additional cost from time lost from work.
Kidney stones are treated with shockwave, invasive endoscopic fashion with ureteroscopy, or percutaneous lithotomy surgery. For frequent stone former surgery is uncomfortable. Medical therapies and Non-pharmacological measures have been well demonstrated to significantly decrease stone recurrence rate. Non-pharmacological measures mainly of dietary management are of great help to the patients.
Approximately 70% of kidney stones are made up of calcium. All calcium stone formers should be counseled on dietary interventions to reduce stone progression and recurrence.
increase water intake with the goal urine output of more than 2 liters per day.
reduce salt ingetion ( less than 2300 mg sodium daily)
reduce animal protien intake ( no more than 2 meals daily with less than 6 to 8 ounces per day)
limit calcium intake less than1000 to 1200 mg per day ( milk, curd, cheese, dark green vegetables, almond )
moderate consumption of high oxalate content foods ( soy bean, beer, spinach, strawberries, nuts, dark chocolates, coffee, cocoa, brewed tea) with limited intake of vitamin c to less than 1000 mg daily
increase intake of citrate rich fluids (lemonade, orange juice)
Of all 17% of stones are made up of uric acid. Uric acid stone former may benefit from the above recommendations with emphasis on more fluid intake and reduced animal protein intake.
Of all 2-3 % of stones are made up of cystine. Cystine stone former will benefit from the above recommendations with emphasis on a substantially increased fluid intake with a goal urine output of more than 3 liters per day.
There was a reason we despised studying a particular subject in school, sitting through a mindless or ‘boring’ session or meeting at work or for that matter follow a healthy activity, such as exercising. Our brain is as smart as we are and when we are forced to do something we don’t actually enjoy doing, our brains decipher that too. Hence, it becomes difficult for us to concentrate or find the motivation to get going. But then, how do you manage?
Dopamine is a neurotransmitter produced in the brain which acts as a chemical messenger. Dopamine releases when you do an activity that is pleasurable or brings rewards. The more anticipation that builds up, the higher are the odds of dopamine being raised. Hence, this causes your brain to put more focus on the pleasurable activity. Think of it this way- why do you enjoy watching a series, cooking, or hanging out with your friends more than any task which is goal-oriented?
There is a reason why our brain can become so dependent on dopamine. Once it develops tolerance, it requires more and more dopamine, and normal tasks become difficult to complete. So, how do you reset your dopamine levels? By now we have understood that the only way to really enjoy something is when the brain sees some dopamine coming out of the activity. One way of going about is to go for a ‘dopamine detox’ i.e., devoid yourself of any activity which brings pleasure for the time being.
Dopamine detox is a concept which a lot of people follow. Consider it to be a detox, but for your brain. The simple rule to follow is to avoid engaging in any activity which you enjoy doing or which stimulates the brain-it could be browsing your phone, avoiding screentime, listening to music, or engaging in any hobby. The idea is- to devoid the brain of any good happy activity, that, in the end, even a boring activity ends up being fun. That way, the brain starts to love it.
The idea of following such a detox plan sounds radical, but there’s a smaller version of the plan which is easier to be followed. For one day each week, refrain from doing activities that seem pleasurable or have dopamine boosting. This is a method to recentre and refocus your brain on other activities which need attention. The detox plan is followed by a lot of high-thinkers and intellectuals, who credit this as a means of keeping sharp.
There’s also a variation of the plan which makes one use dopamine as ‘rewards’ for a tough activity you do. Spend time doing something which is difficult for you and at the end of successful completion, you can reward yourself with a small activity doing what you love. Does it actually work? Dopamine fasts are not just a fad but something which can cancel out the effects of all the time we spend on our digital medium. Too much screen time impacts our physical and mental well-being. Considering how screens and gadgets are the most popular dopamine driving triggers, a dopamine fast could be a means to actually catch a break. Going on occasional dopamine fast could reset and drive attention to a more fulfilling and fruitful activity.
However, the trick is to do it right. Follow a simple protocol, practice mindfulness and concentrate on doing more positive and meaningful activities which can raise dopamine levels naturally. It could be anything from gardening, doing chores, getting a massage, eating dopamine-boosting foods, exercising, catching enough sleep, without being addicted to it.
Do remember to chart your progress well. Regular dopamine fasts can increase your productivity levels, reduce distraction and make you healthier.
Normal thyroid report and free from symptoms of hypothyroidism let patients think that they are fine and their thyroid is normal. Normal thyroid (serum TSH 0.5-5.5) is interpreted as they are cured, and now they do not need thyroxine medicine. Although they forget that all credit goes to the medicine that they were taking. Once the thyroid pill is being stopped, all symptoms reappear gradually over weeks and thyroid tests again become abnormal.
This is a very common issue found during clinical practice. False assumption of cure puts symptoms back. Patient’s have hope of a cure, and they do not understand the nature of the disease well. They think after a few months of treatment thyroid has gone completely. But, hypothyroidism mostly remains lifelong.
Fortunately, one pill of thyroxine can control hypothyroid well. No need to take more medicine. Dosing also a single time in the morning, so you do not forget. even if you forget once or twice, it does not make it worse. So no polypharmacy, a single small tablet works.
One more thing to mention here, each patient has their own particular dose of thyroxine tablet. No single dose suits everybody. The dose that makes your thyroid function normal ( serum TSH normal) is the dose you should continue then after, and not reduce the dose. The dose of thyroxine tablet only to be reduced once your thyroid report falls in hyperthyroid stat ( serum TSH level less than low normal range / S.TSH less than 0.5)
This common mistake is avoidable. We can also avoid fluctuation in thyroid levels, the reappearance of symptoms, and mental suffering.
Not a single diabetic patient ready to start or continue insulin as a treatment. Why anyone wants needle pricks, when there are oral medications available for diabetes? But, there are some bitter facts that says insulin is necessity in many cases to control diabetes. Let’s go through some of the facts.
Basically diabetes is a result of either no insulin or non utilization of insulin. Broadly speaking you have to take insulin when you don’t have insulin that is the case of type 1 diabetes ( diabetes started in very young age). Type 1 diabetes is a condition where all insulin producing cells gets destroyed. Insulin is natural hormone transport glucose for utilization to muscle, adipose tissue, brain, and other body organs.
Even in type 2 diabetes, insulin is necessity after few years of oral drugs. When diabetes is diagnosed there are only 50% insulin left in pancreas. Oral drug takes care of utilization and more production of insulin from the present store of insulin. As years go on insulin store depletes and eventually insulin is necessity to control diabetes. Inevitably, when your oral drugs can not work after few years , insulin become necessity.
Insulin is also necessary in other condition where there is urgency like acute complication of diabetes (ketoacidosis, diabetic come), diabetes during pregnancy (gestational diabetes), brittle diabetes, patients having serious diseases with diabetes (end stage kidney disease, liver dysfunction, stroke, septicemia, systemic infections, heart dysfunction) and people who have erratic meal habits and lifestyle.
In short, do not hesitate or fear insulin. Insulin is a friend not enemy. Insulin is safe mostly and works better, when it needed. Yes, you need to accustom to take needle. Now-a-days insulin pens having micro-thin needle, assure very little pain. 🙂
How wonderful if you know you will suffer from diabetes in future in your healthy days. You actually become diabetic gradually before your pancreatic beta cell stopped producing insulin or insulin is not working even in normal quantity. Before announcing some one diabetic if we do HBa1c test we can identify prediabetes. Prediabetes is pretty reversible condition in most cases. Knowing prediabetes earlier helps in prevention and treatment.
HBA1c is glycated hemoglobin, means sugar part attached to heme containing protein. As hemoglobin of red blood cell last 2-3 months in body, we are having average blood sugar level of 2-3 months. An average blood sugar measurement of such a long period is very helpful in many ways.
1. HBA1c is useful in identifying prediabetes patient
2. HBA1c is useful in diagnosis of diabetes.
3. HBA1c is useful in checking control of sugar in already diabetes patient.
HOW TO TEST?
It is done by simple blood test, irrespective of the time of the day. A simple capillary or venipuncture blood is enough. It takes only couple of minutes.
4.0-5.6 % – normal
5.7-6.4 % – prediabetes
more than 6.5% – diabetes
So, if you fall in prediabetes range, start preventive measures that saves you from future diabetes. Do exercise, loos weight, reduce stress, eat carbohydrate and saturated fat less, take proper sleep and drug. Prediabetes is like window of opportunity to prevent diabetes occurring.
INDIA is on vaccination drive against covid 19 since 16 January 2021. People are excited to get vaccination but they are little in fear about unforeseen side effects. There are two vaccines available in India , COVAXIN from BHARAT BIOTEC and COVISHIELD from SERUM INSTITUTE OF INDIA. Both shares almost same common side effect profile.
I took vaccine COVISHIELD on January 22,2021 along with my healthcare colleagues and staff. Few of the vaccine recipients are suffering from headaches, body aches, weakness, chills, dizziness, injection site pain, and fever. Some recipients got such symptoms on the day of vaccination, some started a day after vaccination. FORTUNATELY not a single recipients having severe side effects, yet.
EVERYONE knows the benefits of the vaccination, now let us know about the possible side effects mild to severe. I gone through FACTSHEETS OF COVISHILED AND COVAXIN, and below are the side effects.
VERY COMMON( may affects more than 1 in 10 persons ):
pain, tenderness, swelling, redness, warmth at injection side.
chills or feverish
COMMON ( may affects up to 1 in 10 persons):
a lump at the injection site
UNCOMMON ( may affects up to 1 in 100 persons):
enlarged lymph nodes
excessive sweaty, itchy skin or rash.
SEVERE ALLERGIC REACTION:
difficulty in breathing
swelling of your face and throat
a fast heart beat
rash all over the body
It is to note that most side effects are mild and symptomatic medicine suffice like, Paracetamol tablet for headache, PAIN KILLER for pain/swelling will help. severe side effects as mention above need urgent medical attention.