? VASOVAGAL .. SYNCOPE.. MANAGEMENT .. AVOID TRIGGERING FACTORS.. IV..FLUIDS.. CORTICOSTEROIDS.. SSRI'S.. SYMPTOMATIC T/T..WITH CLINICAL CORRELATION..
That is grief reactions...due to acute stress situations due to event. is a natural response to losing someone or something that’s important to you. You may feel a variety of emotions, like sadness or loneliness. And you might experience it for a number of different reasons. Maybe a loved one died, a relationship ended, or you lost your job. Other life changes, like chronic illness or a move to a new home, can also lead to grief. Everyone grieves differently. But if you understand your emotions, take care of yourself, and seek support, you can heal. Stage of grief reactions. Denial Anger Acceptance Bargaining Depression. There’s no “normal” amount of time to grieve. Your grieving process depends on a number of things, like your personality, age, beliefs, and support network. The type of loss is also a factor. For example, chances are you’ll grieve longer and harder over the sudden death of a loved one than, say, the end of a romantic relationship. With time, the sadness eases. You’ll be able to feel happiness and joy along with grief. You’ll be able to return to your daily life. Instead, try these things to help you come to terms with your loss and begin to heal: Give yourself time. Accept your feelings and know that grieving is a process. Talk to others. Spend time with friends and family. Don’t isolate yourself. Take care of yourself. Exercise regularly, eat well, and get enough sleep to stay healthy and energized. Return to your hobbies. Get back to the activities that bring you joy. Join a support group. Speak with others who are also grieving. It can help you feel more connected.
Agree with Dr Kute Sir Make patient supine with foot elevation to 45 cm. Check vitals. ECG if indicated. Inj Hydrocortisone 100mg im/iv Anxiolytic once the patient regains consciousness. Manage grieving on further visit.
Hysterical unconsciousness Examine and ensure no systemic disease is present Counseling Tranquillisers
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patient 65 yrs old male... suddenly suffered from unconsciousness for 2 min with inability to recognize family members with b.p 170/100...this just run for 5 min duration, then patient become normal having no other symptoms with b.p 150/100...then within 1 hr 130/80... h/0 diabetes , hypertension.. depression... on tab Amlodepin AT for 4 years and tab glyciphage and daily needs rivotril 5 mg please suggest dx rxDr. Priyanka Singh Tomar5 Likes22 Answers
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A middle-aged male was found lying on the road. Ambulance transposrt was arranged and in the emergency they briefly could not find pulses, and gave a short period of CPR without shock was given. BP was 180/100, HR 130, Oxygen saturations 84%. He was intubated. A bedside ultrasound showed poor global function and B-lines of pulmonary edema. Here was the first ECG:Dr. Manish Malhotra8 Likes18 Answers
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A young male aged 30 years p/w history of multiple Syncope wenever he do some physical exertion....history of sudden cardiac death is present in family....relate the characteristic ECGDr. Hardik Ahuja3 Likes9 Answers
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We can appropriately conclude that we have within us a fluid that is analogous to the waters of that primitive ocean from which all life sprang. Mother Ocean is within us, surging and swelling with the waves and tides of our emotions. Nat mur is truly the MINERAL OF OUR EMOTIONS, and when called for can heal a broken heart. Mother Ocean is not like Mother Nature. She is not like the apple tree, which gives shade and bears fruit in abundance: a nurturing, protecting image. Walk to the point of a rocky promontory, jutting out into the ocean, and gaze down at the sea and rocks in conflict below. Cast your eyes out to sea on a windy, heavily overcast day and look into the depths of your mother. She is chill and forbidding. Unlike Mother Nature the ocean is an aloof, impersonal and often harsh mother. She does not cosset or spoil her children; she stands back and leaves them to fend for themselves. She appears distant, cold and unfeeling and applies discipline with uncompromising strictness and severity. To spare the rod is to spoil the child. It is often the lot of the Nat mur child to be born into a family in which these qualities are valued and applied; in which emotions are not expressed, sympathy and love are not demonstrated, and a stiff upper lip is expected. The child is encouraged to achieve independence without the sheltering warmth of maternal nurturing. There is a lack of mothering. Paradoxically, this mother whose maternal instincts are so repressed, is often herself manifesting a Mother Ocean archetype – Nat mur or Sepia. The Nat mur personality The role of the mother figure is particularly critical in the healthy development of the Nat mur personality. There is a deep and often unfulfilled need for the security and warmth of maternal love, protection and nurturing in the Nat mur being, with an inability or unconscious reluctance to solicit, attract or accept the very sustenance they long for. The conditioning that it is weak to reveal dependency and needfulness compounds this. As a result they experience a sense of having been rejected or forsaken, left to their own fate, and therefore feel that they must be unimportant, unworthy of love and unlovable. In Nat mur this conclusion is attended by a persistent, even life-long feeling of resentment and grievance. There is no warmth in the childhood memories of mother, possibly only an awareness of indifference, criticism, harsh discipline and even neglect or abuse. The “absence” of the mother may be experienced pre-natally if the mother emotionally rejects the baby within her, or feels great disappointment when being told the sex of the baby after a scan. A most important cause is when incubation of the baby becomes necessary. This occurs at a time when bonding with the mother is so vital. The infant perceives the mother as absent; however good the supporting care it receives, this cannot compensate or substitute for the lack of maternal nurturing, warmth and love, which is so important to the Nat mur child. Other causes of “absence” may be due to failure to breast feed, illness of the mother, such as postpartum depression, a working mother, or an indifferent mother who is too busy with her own life to lavish affection and attention upon her newborn. Boarding school is often as important as incubation, especially when the separation from the family occurs in the primary school years. In the typical Nat mur household a child is not permitted to participate in decision-making, explanations are not given and input from the child is not invited; the child is expected to conform to parental wishes and emotionalism is frowned upon. “Big boys don’t cry.” “Children must be seen and not heard.” The family are not only undemonstrative and unemotional; they are also often serious, conservative, proper, moral and principled. To be proper and mature, all emotions must be controlled or hidden – there may be no tears, no fears and no outer manifestations of longing, need, anger or passion. This is a breeding ground for secrecy, deceit, guilt and abuse. In such families there are often hidden and repressed emotions, which despite appearances seethe and smoulder beneath the surface. Sexual abuse, incest and rape are often the cause of severe emotional trauma in Nat mur. Their upbringing often leads to walling-up of the experience and secretiveness. They suffer alone, in silence, turning to no one for help and taking on guilt and shame, which can warp their emotional life forever. Often there is a history of frequent quarrels and serious and traumatic fights with parents, especially at the time of puberty when the Nat mur ego is expanding and asserting itself. This may lead to grievances that are harboured for a lifetime. The death of a family member, often a beloved and supportive grandparent early in the child’s life, can leave profound effects. In the Biblical story of the destruction of Sodom and Gomorrah, Lot’s wife did not heed the warning, not to look back, as she fled with her husband from the burning cities. She was turned into a pillar of salt. This is the personal tragedy of the salt child and the salt adult. They are constantly looking back, often unconsciously, at their past hurts, their grief and their guilt. They cannot forgive others or themselves, they cannot forget, let go or move on; their emotions and their unshed tears crystallise into a pillar of salt, sometimes hidden deep within the unconscious mind, which weighs them down and may crush them, unless they receive a dose of salt in homeopathic potency. In myths, idioms and sayings, the intuitive mind reveals its perception of these cryptic correspondences. So it is that if you wish to prevent a bird from flying away, throw salt on its tail – the bird being an emotion; if you want to freshen up and feel the pain of an old wound, rub salt in it; if you wish to spare yourself the consequences of having spilt salt – of having spilt an emotion, throw a pinch of salt over your left shoulder – over and behind your heart! Salt preserves and it retains – not only fluids, but also old emotions, and unfortunately hoards them like a miser hoards his gold (and Aurum is so similar). Like salt to the palate, Nat mur given to a salt patient restores their appetite and taste for life, and aids the digestion of life’s tribulations. If the salt energy of the body is increased, fluid retention results, with lymphoedema, swelling of the subcutaneous tissues; panty, bra and sock lines that remain forever; rings that no longer fit and a face that is puffy in the morning; the dreaded cellulite appears; there is unwanted weight gain; sebaceous glands become overactive producing oily hair and a greasy skin with blackheads and acne; watery or milky discharges develop; the blood pressure tends to rise, especially in the presence of prolonged stress and suppressed emotions; and they may develop anaemia. Nat mur is a wonderful remedy for people who abuse the salt cellar, for those who even before tasting their food, powder it liberally with salt. Never a wise thing to do! The Nat mur subject may crave salt and take it neat. As a result they often suffer from immoderate thirst and drink prodigiously. Chocolate is another of their fancies, often used to pacify them when tense, or as a reward when they have been through some ordeal. Others simply cannot do without it, despite the fact that it increases their thirst and their catarrh, and may give them a headache. If the salt energy is diminished they become dried out, the skin appears prematurely aged, withered, dry and scaly; the hair is dry, lustreless and falls out alarmingly; the scalp is dry and produces large amounts of dandruff; the face becomes hollowed and haggard; a crack may characteristically develop in the middle of the lower lip; the lips and corners of the mouth become dry, ulcerated and cracked; mucous membranes are dry and vaginal dryness may become a problem, especially at the menopause. In women a growth of fine, downy hair may appear along the sides of the face. They are very inclined to develop recurrent fever blisters and mouth ulcers. They progressively lose weight even though eating well, and often the weight loss is particularly about the face and neck, which becomes scrawny, and about the shoulders, arms and chest, whilst the lower body may remain rounded and full. Much to her discomfort, the Nat mur woman, may notice that her breasts have shrunk or lost their tone. They too have increased thirst, and often an excessive hunger, which is satisfied after only a few mouthfuls. Others may show a mixed salt picture, with irregular distribution of fluids; some parts having an excess production of fluid, such as watery eyes and nose, others having a lack of fluid, such as dryness of the skin and hair, or there may be swelling of the face and extremities with dry eyes and mouth. They are also “the salt of the earth” – often the wounded healer, unable to help themselves, but so able in counselling others. Unable to confide, others readily confide in them, and find an understanding and compassionate ear. They know what suffering is, they have experienced it themselves, and are deeply and sincerely empathetic and give good advice. They feel very responsible for the welfare of others. This sense of duty and service may extend to animals and even become a global concern for the sufferings of the world. They may sublimate their own grief by caring for others. They disguise their pain by immersing themselves in the pain of those they help. They are able to cry for others whilst finding it hard to cry for themselves. They need to appear strong, to show no weakness, but inside they are exceedingly vulnerable and afraid of being hurt. Often there is a history of a broken relationship, a love disappointment. Since that time they have never permitted anyone to get too close to them emotionally. They will even avoid getting into a position where someone might get attached to them. It is not the attachment that they fear, but the outcome, which they anticipate with dread: the end of the relationship, the betrayal, the disappointment, the terrible loss, the grieving and the humiliation. In this we can fully understand the symbolic significance of the “fear of robbers” in the psychology of Nat mur. Their deepest fear is the violation and theft of their emotional trust and happiness; by constantly “looking back” and by hanging on to the past they seek to protect themselves from the present. When you detect sadness in them, and imagine a tear in their eye, and when in reply to your concern they avow that there is nothing wrong, take their words with a “pinch of salt”. Schooled in self-control and the suppression of emotions, they are uncomfortable with sympathy and avoid it lest it should break down their composure and resolve. If pushed it may arouse them to anger. Yet in Nat mur there is always a silent solicitation for the love, sympathy and nurturing that they possibly never received in their childhood or in their marriage. With care and patience you may reach out and touch their wound. At first they will avoid your eyes and remain silent, possibly gazing at their hands which are tightly clenched or fiddling agitatedly with some object, and then they will look up, their eyes wide and staring, as if in shock. At that moment the floodgates of their suffering open. Suddenly their eyes are swimming with tears and their body is racked by sobs, which seem to come from the depths of their being. It is then that you may take them in your arms and comfort them.Dr. Sumayya Alansari Ibrahim Kt2 Likes8 Answers
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Female,35 yrs sudden syncope,brought immediately,had tachycardia on monitor,breathlessness,perspiration,blood pressure not recordable, couldn't be resuscitated,dies within minutes,this was her ecg,please comment,had 3 mt amennorrea,had some history s/0 leg modems before 3 years no reports awailable,Dr. Prakash Dharodiya2 Likes6 Answers