Tag Archives: Health

memory loss

_ _ _ _ Memory loss is a common complaint in the primary care setting. It is particularly common among the elderly but also may be reported by younger people. Sometimes family members rather than the patient report the memory loss (typically in an elderly person, often one with dementia). Clinicians and patients are often […]

brief psychotic disorder

_ Brief psychotic disorder consists of delusions, hallucinations, or other psychotic symptoms for at least 1 day but < 1 mo, with eventual return to normal premorbid functioning. It is typically caused by severe stress in susceptible people. Brief psychotic disorder is uncommon. Preexisting personality disorders (eg, paranoid, histrionic, narcissistic, schizotypal, borderline) predispose to its […]

falls in elderly

_ Falls in the Elderly Share This A fall results in a person coming to rest on the ground or another lower level; sometimes a body part strikes against an object that breaks the fall. Typically, events caused by acute disorders (eg, stroke, seizure) or overwhelming environmental hazards (eg, being struck by a moving object) […]

hypothyroidism

_ _ _ _ Hypothyroidism (Myxedema) Share This view related topics in this manual Hypothyroidism is thyroid hormone deficiency. It is diagnosed by clinical features such as a typical facies, hoarse slow speech, and dry skin and by low levels of thyroid hormones. Management includes treatment of the cause and administration of thyroxine. Hypothyroidism occurs […]

erectile dysfunction

_ _ Erectile dysfunction (ED) is the inability to attain or sustain an erection satisfactory for sexual intercourse. Most erectile dysfunction is related to vascular, neurologic, psychologic, and hormonal disorders; drug use can also be a cause. Evaluation typically includes screening for underlying disorders and measuring testosterone levels. Treatment options include oral phosphodiesterase inhibitors or […]

drug interaction

Drug interactions are changes in a drug’s effects due to recent or concurrent use of another drug or drugs (drug-drug interactions) or due to ingestion of food (drug-nutrient interactions—see Nutrition: General Considerations: Nutrient-Drug Interactions). A drug interaction may increase or decrease the effects of one or both drugs. Clinically significant interactions are often predictable and […]

lipids

Lipids are fats that are either absorbed from food or synthesized by the liver. Triglycerides (TGs) and cholesterol contribute most to disease, although all lipids are physiologically important. The primary function of TGs is to store energy in adipocytes and muscle cells; cholesterol is a ubiquitous constituent of cell membranes, steroids, bile acids, and signaling […]

hypoglycemia

Share This Hypoglycemia unrelated to exogenous insulin therapy is an uncommon clinical syndrome characterized by low plasma glucose level, symptomatic sympathetic nervous system stimulation, and CNS dysfunction. Many drugs and disorders cause it. Diagnosis requires blood tests done at the time of symptoms or during a 72-h fast. Treatment is provision of glucose combined with […]

Diabetes Mellitus

_ _ _ Diabetes mellitus (DM) is impaired insulin secretion and variable degrees of peripheral insulin resistance leading to hyperglycemia. Early symptoms are related to hyperglycemia and include polydipsia, polyphagia, and polyuria. Later complications include vascular disease, peripheral neuropathy, and predisposition to infection. Diagnosis is by measuring plasma glucose. Treatment is diet, exercise, and drugs […]

hyponatremia

Hyponatremia is decrease in serum Na concentration < 136 mEq/L caused by an excess of water relative to solute. Common causes include diuretic use, diarrhea, heart failure, and renal disease. Clinical manifestations are primarily neurologic (due to an osmotic shift of water into brain cells causing edema), especially in acute hyponatremia, and include headache, confusion, […]

stroke rehabilitation

Rehabilitation after stroke aims to preserve or improve range of motion, muscle strength, bowel and bladder function, and functional and cognitive abilities. Specific programs are based on the patient’s social situation (eg, prospects of returning to home or work), ability to participate in a rehabilitation program supervised by nurses and therapists, learning ability, motivation, and […]

clinical use of genetics

Genetics has advanced understanding of many disorders, sometimes allowing them to be reclassified. For example, classification of many spinocerebellar ataxias has been changed from one based on clinical criteria to one based on genetic criteria (see Movement and Cerebellar Disorders: Hereditary ataxias). The Online Mendelian Inheritance in Man (OMIM) database is a searchable catalog of […]

behavioral emergencies

_Patients who are experiencing severe changes in mood, thoughts, or behavior or severe, potentially life-threatening drug adverse effects need urgent assessment and treatment. Nonspecialists are often the first care providers for outpatients and inpatients on medical units, but whenever possible, such cases should also be evaluated by a psychiatrist. When a patient’s mood, thoughts, or […]

medical assessment of patient with psychiatric disorder

Medical assessment of patients with mental symptoms seeks to identify 2 things: Physical disorders mimicking mental disorders Physical disorders accompanying mental disorders Numerous physical disorders cause symptoms mimicking specific mental disorders (see Table 3: Approach to the Patient With Mental Symptoms: Selected Mental Symptoms Due to Physical Disorders). Other physical disorders may not mimic specific […]

drug categories of concern in elderly

Some drug categories (eg, analgesics, anticoagulants, antihypertensives, antiparkinsonian drugs, diuretics, hypoglycemic drugs, psychoactive drugs) pose special risks for elderly patients. Some, although reasonable for use in younger adults, are so risky as to be considered inappropriate for the elderly. The Beers Criteria are most commonly used to identify such inappropriate drugs (see Table 5: Drug […]

drug related problems in the elderly

Drug-related problems include Adverse effects Ineffectiveness Adverse drug effects are effects that are unwanted, uncomfortable, or dangerous. Common examples are oversedation, confusion, hallucinations, falls, and bleeding. Among ambulatory people ≥ 65, adverse drug effects occur at a rate of about 50 events per 1000 person-years. Hospitalization rates due to adverse drug effects are 4 times […]

pharmacodynamics in elderly

Pharmacodynamics is defined as what the drug does to the body or the response of the body to the drug; it is affected by receptor binding, postreceptor effects, and chemical interactions (see Pharmacodynamics: Drug-Receptor Interactions). In the elderly, the effects of similar drug concentrations at the site of action (sensitivity) may be greater or smaller […]

pharmacokinetics in elderly

Pharmacokinetics (see Pharmacokinetics) is best defined as what the body does to the drug; it includes absorption, distribution across body compartments, metabolism, and excretion. With aging, the metabolism and excretion of many drugs decrease, requiring that doses of some drugs be adjusted. Toxicity may develop slowly because levels of chronically used drugs tend to increase […]

neuromyelitis optica

Neuromyelitis optica affects only the eyes and spinal cord. It causes acute optic neuritis, sometimes bilateral, plus demyelination of the cervical or thoracic spinal cord. Neuromyelitis optica was previously considered to be a variant of multiple sclerosis (MS) but is now recognized as a different disorder. Symptoms include visual loss, paraparesis or quadriparesis, and incontinence. […]

ms

Multiple sclerosis (MS) is characterized by disseminated patches of demyelination in the brain and spinal cord. Common symptoms include visual and oculomotor abnormalities, paresthesias, weakness, spasticity, urinary dysfunction, and mild cognitive impairment. Typically, neurologic deficits are multiple, with remissions and exacerbations gradually producing disability. Diagnosis is by history of remissions and exacerbations plus clinical signs, […]

demyelinating disorders

Myelin sheaths cover many nerve fibers in the central and peripheral nervous system; they accelerate axonal transmission of neural impulses. Disorders that affect myelin interrupt nerve transmission; symptoms may reflect deficits in any part of the nervous system. Myelin formed by oligodendroglia in the CNS differs chemically and immunologically from that formed by Schwann cells […]

cerebellar disorders

Cerebellar disorders have numerous causes, including congenital malformations, hereditary ataxias, and acquired conditions. Symptoms vary with the cause but typically include ataxia (impaired muscle coordination). Diagnosis is clinical and often by imaging and sometimes genetic testing. Treatment is usually supportive unless the cause is acquired and reversible. The cerebellum has 3 parts: Archicerebellum (vestibulocerebellum): It […]

hyponatremia

_ _ _ Hyponatremia is decrease in serum Na concentration < 136 mEq/L caused by an excess of water relative to solute. Common causes include diuretic use, diarrhea, heart failure, and renal disease. Clinical manifestations are primarily neurologic (due to an osmotic shift of water into brain cells causing edema), especially in acute hyponatremia, and […]

intracerebral haemorrage

_ _ _ _ _ _ _ _ _ Intracerebral Hemorrhage Share This Intracerebral hemorrhage is focal bleeding from a blood vessel in the brain parenchyma. The cause is usually hypertension. Typical symptoms include focal neurologic deficits, often with abrupt onset of headache, nausea, and impairment of consciousness. Diagnosis is by CT or MRI. Treatment […]

schizoaffective disorder

Schizoaffective disorder is a mental illness. It includes a mix of the symptoms of schizophrenia, bipolar disorder, and depression. What is the cause? The cause of schizoaffective disorder is unknown. It seems to occur more in some families, and stress may trigger symptoms. About one person in 100 has schizoaffective disorder. What are the symptoms? […]

interview-dr harsh mahajan

so far as a doctor? I belong to Delhi as I was born here. My parents came from Punjab and settled in Delhi. I went to Delhi Public School, Mathura Road. After that I went to Maulana Azad Medical College and did my MBBS from there. After completing my MBBS, I did MD in radio […]

cognitive therapy

What is cognitive therapy? Cognitive therapy is a very active and direct type of therapy that works by changing negative thoughts that cause emotional distress. Although there are many kinds of cognitive therapy that go by different names, they all focus on your thoughts and beliefs as a primary cause of your symptoms. This type […]

snacks for diabetics

Snacks help prevent low blood sugar levels and provide energy between meals. Typical snacks contain 15 to 30 grams of carbohydrate. Below are some low-fat snack ideas to try. Snacks containing about 15 grams of carbohydrate: 1 medium apple or orange 18 small pretzel twists 2 popcorn cakes 1/2 small bagel with fat-free cream cheese […]

dr.pk gupta

deemagclinic

What is kleptomania?

What is kleptomania? Kleptomania is an impulse disorder. People who have this disorder are unable to resist an urge to steal, even though they know it is harmful. The urge makes them anxious, tense, or aroused. They may feel regret or guilt later. Normally, people who steal take something because it is worth money or […]

bipolar disorders in pregnancy,to treat or not to treat

salvatore_gentile@alice.it The real question is how to treat most effectively In a linked research paper (doi:10.1136/bmj.e7085), Bodén and colleagues analysed the risks for the fetus associated with treated and untreated bipolar disorder during pregnancy.1 They found that women with untreated bipolar disorder were at increased risk of producing offspring with microcephaly and neonatal hypoglycaemia, and […]

problem solving!

What are problems? A problem is the difference between what you have and what you want. You may want to get something, get rid of something, avoid something, or deal with something. Everyone has problems, no matter who they are or what they do. Problems don’t all go away by themselves, and they be more […]

living with mentally ill patient

Mental illness is a health condition that involves the brain. Mental illness causes problems with thinking, mood, or behavior that interfere with daily life and cause distress. If you are a family member or friend of someone who is mentally ill, you have probably been suffering too. You are likely to feel worried, frustrated, confused, […]

sibling rivalry

Most siblings argue and quarrel occasionally. They fight over possessions, space on the sofa, time in the bathroom, or the last donut. On most days, though, siblings are friends and companions instead of rivals and competitors. The ambivalence between love and hate is present in all close relationships. This ambivalence becomes more intense in siblings […]

Aging and sex

Aging brings changes in many aspects of life. There are emotional, social, and physical changes and diseases that may occur in later life. These changes also affect sexuality. Social and Family Changes Social and family changes can affect sexual function. As we age, we may have to adjust goals and desires. Goals set earlier in […]

Why is calcium so important?

Why is calcium so important? Calcium is the main mineral that strengthens bones. Getting enough calcium is important for everyone, but for children and teens, it is critical. These are the years that bones are growing fast and calcium is being stored in the bone to make them strong. Most of the stored calcium for […]

dementia

Regional volumetric analysis reveals distribution of neurofibrillary tangles Background Three subtypes of Alzheimer’s disease (AD) have been pathologically defined on the basis of the distribution of neurofibrillary tangles: typical AD, hippocampal-sparing AD, and limbic-predominant AD. Compared with typical AD, hippocampal-sparing AD has more neurofibrillary tangles in the cortex and fewer in the hippocampus, whereas the […]

debate on new mental health bill

Sagarika Ghose: Hi there. We are focusing in this show on a subject that concerns us all, mental illness. Currently 130 million Indians are diagnosed with some form of mental illness, including depression, bipolarity and schizophrenia, 90 per cent of these cases remain untreated. The government has come up with new Mental Health Bill 2012. […]

alternate therapies to manage pain.

There are many ways to help manage pain. Medicine is one way, but other methods can be used along with medicine. Sometimes these other approaches may be used without medicine to control pain. Many can be used any place or any time. Some do not cost anything. Acupuncture. Acupuncture is a procedure in which a […]

Medical Profession – Noble or Ignoble?

Medical Profession – Noble or Ignoble? Thursday, October 18, 2012 Dr O P Yadava CEO & Chief Cardiac Surgeon National Heart Institute, New Delhi Much brouhaha has lately been raised over corruption in society in general and in medicine in specific. Few months back, the Parliamentary Standing Committee on health looked at the irregularities in […]

Polymyalgia rheumatica

Polymyalgia rheumatica is a chronic, infl ammatory disorder of unknown cause that aff ects people over age 50 years. Classic symptoms include pain and long-term morning stiff ness of the neck, shoulders, hips, upper arms, and thighs. Although markers of infl ammation are often raised, no specifi c laboratory test exists for the disorder and […]

neutropenia

Neutropenia is a reduction in the blood neutrophil count. If it is severe, the risk and severity of bacterial and fungal infections increase. Focal symptoms of infection may be muted, but fever is present during most serious infections. Diagnosis is by WBC count with differential, but evaluation requires identification of the cause. If fever is […]

nebulizer

A nebulizer is a device used with a compressed air machine that turns liquid asthma medicine into a fine mist your child can easily breathe into his lungs. How is the home nebulizer used? Place the compressor on a hard surface. Make sure the filter is free of dust and dirt. If it is dirty, […]