Ac Pancreatitis. Fluid replacement is most important because a lot of fluid is collected in the third space. Few liters of fluid as bolus, then 250- 500ml / hour, monitoring the CVP, CWP + Pain management by inj Tramadol / Pentazosine / Morphine etc + inj Reglan / Ondansetron + Antibiotics ie Imipenem + Cilastatin + Parentaral nutrition, and start enteral nutrition through nasojejunal tube with low fat diet as early as possible within 48 hours. Treat Hyperglycaemia and associated hypocalcemia if present. Cholecystectomy if there is associated associated GB Stone / microlithiasis / sludge. ERCP and stenting of the pancreatic duct if there is injury and likage, percutaneous drainage of Pancreatic cyst / abscess etc
Acute Pancreatitis with B/L pleural effusion. NPO; IV Fluid, Inj. Pantoprazole, Inj. Tramadol, Injectable Antibiotics, Ryle's tube, antipyretic inj., Inj. Ondansetron SOS.
PANCREATITIS IS THERE AND ITS ACUTE. FEVER IS DUE TO INFLAMMATION. COULD BE DUETO INFECTION. RX IS ALAREADY POSTED BY VARIOUS DR. SOS NIV AND VENTI SUPPORT . FLUID THERAPY IS PRIME IMPORTANCE AS THERE IS 3D SPACE LOSS OF FLUID . CAUSE OF PANCREATITIS MUST BE SEARCHED AS 2 MC CAUSE ARE ALCOHOL AND GB STONE . AS THERE IS AGE ON HIGHER SIDE, SO ECHO , IVC MUST BE DONE TO GUIDE FLUID THERAPY AS FLUID THERAPY IS PRIME IMPORTANCE
It is a case of acute pancreatitis and it just requires i.v fluids and analgesics. No need of such high end antibiotics especially in first week of pancreatitis. Even CT is required by the third week to rule out complications. Best antibiotics to use in pancreatitis are fluoroquinolones and carbapenems. Get rfts done. Keep n.p.o. get central line inserted. I.v fluids according to c.v.p and urine output. Maintain vitals. Supportive treatment.
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Acute Pancreatitis with Bilteral pleural effusion. Consrtvative Management .with I V fluids, antibiotics injury. Tramdol.
It is a case of acute pancreatitis with pleural effusion. Do serum amylase , lipase. Conservative line of management. Nil oral Rules tube aspiration Abdomen girth monitoring IV fluids Inj. Pan I.v Inj . Tremadol i.m Antibiotics for fever. Vitals monitoring. Follow up with amylase, lipase levels
How about putting a drain orally and keeping the stomach a rest add inj octreotide 100 mcg 6 hourly There's been lot of controversy regarding antibiotics but Upton the treating physician Keep the patient orally nil till the patient passes flatus or stool then start with liquid diet add pancreatic enzymes like Creon 40000 twice daily and get an mrcp done once the patient is stabilised
Pancreatitis is a condition where both exocrine and endocrine functions is affected and more so with the exocrine function It'd would be quite unreasonable to say pancreatic enzymes are not required or has no role but it's your call as far as your patients are concerned
Byron Is pancreatic enzyme formulation I'm sure the patient will require when is stable
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Surprising Health Benefits Of Horse Gram (Kulthi) fashionlady.in Aug 18, 2017 5:57 PM ￼ Horse gram is a miracle super food and the food is widely consumed as a staple diet in the southern parts of India. Horse gram is rich in nutrients and have plenty of minerals too- phosphorus, calcium, protein and iron. Hence it is known to be very beneficial for human health, as much as it is useful for animal health too. What is Horse Gram or Kulthi? Scientifically called Macrotyloma uniflorum, horse gram according to the USDA says that the dark brown lentil which is flat and round in shape is known to bring us humans a lot of therapeutic properties. And this is exactly what we are going to talk about today. So please read on and be well informed. Learn about the benefits of horse gram, what it gives the body, the side effects and more. Take a look! Names in different languages VernacularBengaliKulthi, Kulttho-kalai. KutthiKannadaHurali/ Hurule.EnglishMadras horse-gram,HindiKulthiMaithaliMuthenifSanskritRahitha, Culutu,GujaratiMarathi Kulitha, KulthaPanjabRarat, 聽BotangKumaun Himalaya and GadhwalGahethTamilKolluTeluguWalawalli, Ulava, vulavalu.Marathikulitha, hulageArabHabulakultaKonkaniKulithu Nutritional Value of Horse Gram Here is the nutritional fact for 100 gm of this legume: NutrientsAmountsEnergy321聽 EcalsMoisture12 gmProtein22 gmFat0 gmMineral3 gmFiber5 gmCarbohydrates57 gmCalcium287 mgPhosphorous311 mgIron7 mg Here is what the esteemed NCBI research organization has to say about horse gram nutrition benefits: “Horse gram is an underutilized pulse crop grown in wide range of adverse climatic conditions. It occupies an important place in human nutrition and has rich source of protein, minerals, and vitamins. Besides nutritional importance, it has been linked to reduced risk of various diseases due to presence of non-nutritive bioactive substances. These bioactive substances such as phytic acid, phenolic acid, fiber, enzymatic/proteinase inhibitors have significant metabolic and/or physiological effects. The importance of horse gram was well recognized by the folk/alternative/traditional medicine as a potential therapeutic agent to treat kidney stones, urinary diseases, piles, common cold, throat infection, fever etc. The inception of nutraceutical concept and increasing health consciousness the demand of nutraceutical and functional food is increased. In recent years, isolation and utilization of potential antioxidants from legumes including horse gram are increased as it decreases the risk of intestinal diseases, diabetes, coronary heart disease, prevention of dental caries etc. Keeping in view the increasing demand of food having nutraceutical values, the present review ascribed with recent scientific knowledge towards the possibilities of exploring the horse gram, as a source of food and nutraceuticals compounds.” Now let us take a very good look and learn more about the benefits of horse gram for our overall health! Horse Gram Benefits: 1. Common Cold and fever Common cold and fevers happen to us when the body’s immunity system is attacked and when the viruses house themselves in our bodies. For this, the ancient scholars of ayurveda have recommended the consumption of horse gram when you have fever, coughs and cold, bronchial problems and asthma too. Horse gram should be consumed as soups, which helps relieve the congestion and makes the nasal tracts open up by allowing the mucus membranes to soften up and melt. This helps with easy breathing since the required nutrients are boosting the metabolism of the body and the immunity too. 2. Digestion After a hearty meal, should you feel acidic or don’t feel easy on the stomach within minutes to an hour or more; chances are you are suffering from indigestion pangs. This can lead to issues such as GERD and acid reflux, and this is what can make you feel uncomfortable too. This is why, horse gram is recommended to be had the first thing in the morning on an empty stomach. This helps stimulate the digestive tract and makes digestion an easy affair. 3. Weight Loss In Ayurveda it is said, if one consumes horse gram every day, weight loss happens for sure. This is only when you consume horse gram in powder form, and to this shall be added a dash of cumin seeds. The two should be mixed in a glass of water and drunk twice a day on an empty stomach at your own ease. Some prefer not to have horse gram for weight loss in this form, which is fine. In such cases, the legume can be had soaked and raw, or mixed with pepper and bengal gram to form a crunchy salad and eaten. ￼ 4. Diabetes According to sources from THE HINDU, a leading national daily, “Scientists from the Indian Institute of Chemical Technology have found that unprocessed raw horse gram seeds not only possess anti-hyperglycemic properties but also have qualities which reduce insulin resistance.” . This is possible since horse gram has the power to exhibit ways to combat the formation of hyperglycemic properties in the body. In turn, horse gram helps bring down insulin resistance in the body too. Blood glucose levels are brought down and controlled, and it can help reduce the carb digestion rates as well, in turn bringing down the levels of blood glucose too. This is why it is used as a super food to treat type 2 diabetes in most cases. 5. Asthma and Bronchitis The esteemed researchers at NCBI say “After critical assessment of nutritional and therapeutic aspect of horse gram, it can now be concluded that-it is a rich source of nutrient and antinutrient content. The nutritional value of horse gram is comparable with other pulse crop. Horse gram has high levels of antioxidant and radical scavenging activities in addition to their traditional role of providing proteins and carbohydrates. It has rich source of various natural bioactive substances such as phytic acid, fiber, phenolic acid etc. These bioactive substances have immense potential for curing varieties of diseases such as common cold, throat infection, fever, urinary stones, asthma, bronchitis, leucoderma, etc. BBIs, the proteinase inhibitors have been identified to treat anti-inflammatory, obesity and several degenerative and autoimmune diseases. However, there is a dearth of information on the specific health beneficial components in this lesser known legume. Thus, considering its immense potential as health benefit it needs to exploit as a source of nutraceutical and food industries.” 6. Menstrual Disturbances Menses problems are very harrowing, and unless one has them, one would not know how painful and energy draining it can be. Once again, you can either have the soup of horse gram for relief or have salads which would have horse gram in them, which helps bring down the levels of irritation associated with menstrual disturbances. When you have irregular menstrual cycles or excessive bleeding, it is the high iron content in horse gram which will help maintain the levels of hemoglobin in the body. This is why, holistic experts recommend horse gram to women with menses issues. 7. Leucorrhea Women suffering from Leucorrhea have a tough time managing their sanitation needs. Leucorrhea is known to be a common and a normal discharge from the vagina. It can have a change in its consistency or color, and often is associated with pains, infection and inflammation around the cervix and the vagina too. This happens when there is an irritation to the lining of the membrane, and the discharge can be foul smelling or thick, with a quantity increase when puberty hits or when sexual arousal is at its peak. Ayurveda opines, one should soak a handful of horse gram overnight in a bowl of water, and boil it the next day. This water should be consumed thrice a day to treat symptoms of leucorrhea. ￼ 8. Constipation If you have been sitting on the pot for too long and have no luck in releasing the bowels each morning, you are then a victim of constipation. Constipation can be caused because of a lack of fibre in the diet, lack of water intake, lack of minerals and also due to a unhealthy lifestyle, stress and many more reasons. This happens when the intestines and the stomach lining just above the duedoneum are not in a position to expand and contract normally for the waste matter to get released. Since horse gram has powerful nutrients in it and also has plenty of fibre too, it can help combat the problems of constipation. Horse gram in such cases should be pre-soaked and eaten as a salad embellishment in raw form. 9. Kidney stones Sources say, the consumption of horse gram on a daily basis can actually help bring down the occurrence of kidney stones or remove the same from the body too. Kidney stones are basically a concotion of a compound known as calcium oxalate. And horse gram can actually get kidney stones removed overnight. This is because, horse gram is rich in iron and has a high content of polyphenols in it as well. In addition to that, the antioxidant levels are high in kidney stones too. What one needs to do is to soak a cup of horse gram in a bowl of water and to consume it raw the next morning. Doing this for a week it seems shows good results. 10. Urinary Discharge Women suffering from urinary discharge can suffer from embarrassment too. This is especially when urinary discharge is thick, inconsistent at times, foul smelling and continuous in some cases. There could be pains, infection and inflammation around the cervix and the vagina too. This happens when there is an irritation to the lining of the membrane, and the discharge can be foul smelling or thick, with a quantity increase when puberty hits or when sexual arousal is at its peak. Ayurveda opines, one should soak a handful of horse gram overnight in a bowl of water, and boil it the next day. This water should be consumed thrice a day to treat symptoms of the same. 11. Ulcers In Ayurveda, it is said horse gram can be very beneficial in treating various forms of ulcers, but NOT GASTRIC ULCERS. There are lipids in horse gram that come in very handy when the legume is consumed by those that suffer from peptic and mouth ulcers. Research and studies on the same have been done on rats and the animals have healed, and the same have been done on humans too and the results were positive. Even in ayurveda, it is shown that mashed horse gram when consumed twice a day releases the lipids much needed for the body to heal itself from the ulcers. 12. Piles Piles happen when the veins in the rectum swell up and turn inflamed or painful. Instead of rushing to the pharmacy for medication and treatment, holistic experts suggest the use of horse gram. Soak a cup of horse gram overnight and consume the water the next day, and eat the horse gram raw as a salad embellishment too. The roughage in it along with the fibre helps treat piles. 13. Diarrhea Since horse gram has plenty of fibre in it, it helps with digestion and soaking up excess fluids from the intestine and the stomach. This brings down the occurrence of diarrhea and loose motion, and allows normal bowel movements to happen. One should have a handful of pre-soaked horse gram legumes early each morning, which stimulates the digestive system to work better. ￼ 14. Hemorrhage and Hemorrhoids NO INFORMATION AVAILABLE ON HOW IT WORKS 15. Skin Rashes and Boils Horse gram can be used very well as a topical face pack to treat rashes, boils and disorders of the skin to some extent as well. This is because it is antimicrobial and antibacterial, and has plenty of antioxidants in it along with minerals to nourish, replicate the healthy lipid layers of the skin and more. Crush a handful of pre-soaked seeds overnight, and apply it as a face pack the next day. Wait for half an hour and gently wash off with cold water. This would help exfoliate the dirt, grime, dead skin cells and also provide collagen boost to the skin and protect the skin from further harm and free radical attacks. 16. Cholesterol Horse gram helps bring down the levels of LDL or bad cholesterol in the bloodstream, says medical research studies. The bad cholesterol levels that have been stuck in the veins would be eliminated when horse gram is consumed, thanks to the levels of lipids in it that work its magic. One should consume a handful of pre-soaked horse gram seeds twice a day on an empty stomach, so that the lipid levels work at their best and cleanse the veins off the bad cholesterol levels or the LDL levels in the blood. 17. Conjunctivitis You can use rose water to wash your eyes with when you suffer from conjunctivitis, or what you could do is to pre-soak a handful of horse gram seeds overnight. The next morning, strain the seeds and use the water to wash your eyes with it. The antioxidant levels in the water would help combat the infection and keep the eyes soothed and calm, sans the irritation. Thrice a day the water should be used to wash the eyes with. ￼ Now that you know how horse gram has multiple benefits for the various needs of our body, let’s learn about how to use the same. Take a look! How to use Horse gram? When using horsegram, always remember that the legume can be heat producing for the body and that is why holistic experts ask you to have it with buttermilk or cumin seeds, so that the heat of the body can be balanced. You can consume horse gram twice a day, either by powdering the roasted seeds or by consuming the same as soup or with buttermilk. There are many tasty recipes for you to indulge in with horse gram, and they also bring in the benefits desired too. For soups Ingredients A cup of horse gram seedsSome curry leavesA green chill and a red chilliCooking oil and tamarind paste Preparation Pre-soak the seeds overnightNext morning cook until the seeds are softRemove the cooked seeds and cool offGrind seeds into pasteIn a pan heat the oil and the rest of the condimentsAdd tamarind paste and fryAdd a cup of waterAdd the paste of horsegram seedsStir for twenty minutes until a thick soup is formedGarnish with basil and coriander leaves and serve hot ￼ If you want to powder it Ingredients A cup of horse gram seedsTen red dry chilliesA teaspoon of cumin, black pepper seeds eachFour tablespoons of tur dal and urad dalA teaspoon of salt Preparation Dry and roast the seeds and keep asideDry and roast the dals until the color of the two changesDry roast the remaining spicesGrind everything together to form a powderAdd the salt and grind again until a coarse powder is formedStore in airtight container. ￼ If you like curries Ingredients Half a cup of pre-soaked horse gram seedsHalf a teaspoon each of coriander powder, black pepper, cumin and red chilli seeds each.A pinch of asafoetidaA tablespoon of coconut powderA small onion choppedHalf a teaspoon each of tamarind juice, mustard seeds, gheeCurry leaves and salt as per taste Preparation Dry roast all the dry ingredients on low flameAdd the onions and coconut powder and dry roast againAdd a little water and make a smooth pasteAdd the horse gram seeds and cook in itTamper the curry with tamarind juice and mustard seedsAdd salt and curry leavesGarnish with coriander and serve hot ￼ If you like porridge Ingredients Half a cup of horse gram seedsHalf a cup of moong dalGarlic pods to tasteCoconut powder to tasteSalt to taste Preparation Dry roast the coconut powder, moong dal and horse gram seeds.Remove from flame and dry grind to a coarse powderPlace the powder in a pressure cooker and add waterAdd the garlic and curry leaves and saltCook for ten minutes on pressureGarnish with coriander and serve hot ￼ Spicy water Spicy water is best for coughs, colds and fevers and bronchial issues too. What you need to do is to dry roast the seeds and add salt and asafetida to it. Dry grind them all and make a powder. Store it in a container and mix a teaspoon of it with warm water to drink twice a day. It helps with coughs and colds. If you want to lose weight, have it with buttermilk and cumin seeds twice a day too. We thus gave you ways on how to use horse gram the easiest way at home. Now let’s take a look at the side effects and who should not have horsegram seeds at all. Please read on and be well-informed. Side Effects and Risk Factors Please note, consuming horse gram is good and has benefits for the body, but there are side-effects to be wary about. Here we list some of them for your perusal and information. If you suffer from gastric ulcers and hyperacidity, you should not consume horse gram seeds since it would worsen the conditionHorse gram seeds according to ayurveda can worsen cases of bleeding problems. If you suffer from heavy periods, consult your doctor first and then consume horse gram seeds.If you suffer from a case of gout, horse gram is to be avoided as well. Ayurveda says it harms the rakta dhatu cycle.If you consume medication for anemia, horse gram should be avoided since it is a contra indicationFor liver issues and excess bile production issues, you should not consume horse gramExpectant mothers are asked to stay away from horse gram tooIf you have plethora and TB, you should not have horse gram as well These were the reasons why we asked you to be wary about horse gram consumption. Now let’s get more tips on horse gram benefits and consumption to make it easier to understand. Tips If you have localized swelling, the paste of horse gram can be used for relief. It is this paste that stimulates the cells and helps with sweating, by opening the pores of the skin and pushing the toxins out through it.To get relief from hiccups, burn a few horse gram seeds and inhale the smoke. It gives relief in a jiffyTo treat renal calculi, use the powder of horse gram seeds everyday. Consult a holistic expert on the dosage as per your body type for the same.To treat intestinal worms and piles or constipation too, horse gram seeds should be pasted and eatenBoil horse gram in water and drink the water, to bring down fever, coughs and coldsPaste boiled horse gram seeds and pepper and eat it, to bring down cough, cold and asthma problems ￼ Now we know that horse gram is a superfood quite bonafide. It is a special class of food that is nutrient dense and has a great load of antioxidants in them along with plenty of protein; the latter being more than what you would otherwise find in veggies. And since it has plenty of digestible starch in it, it is best for diabetics too, and for those that want to lose weight as well. What more do we need? We hope this mini guide on the many uses and benefits of using horse gram comes in handy. Report a problemDr. Tapan Kumar Sau7 Likes21 Answers