48yrs old male....chest pain since 2days , left sided chest , severity pain 2/5, heaviness in left upper limb....know case of hypothyroidism old syncope 2yrs back ...since then tab ecosprin atorin ..thyronorm .Bp110/70 and sapo298. Blood invest...creatine kinase 250, troponin i elevated..rest normal limit...

Friends today I am discussing about a problem known as Thyroid Disease & Pregnancy. Thyroid disease is a group of disorders that affects the thyroid gland. The thyroid is a small, butterfly-shaped gland in the front of your neck that makes thyroid hormones. Thyroid hormones control how your body uses energy, so they affect the way nearly every organ in your body works—even the way your heart beats. The thyroid is a small gland in your neck that makes thyroid hormones. Sometimes the thyroid makes too much or too little of these hormones. Too much thyroid hormone is called hyperthyroidism and can cause many of your body’s functions to speed up. “Hyper” means the thyroid is overactive. Too little thyroid hormone is called hypothyroidism and can cause many of your body’s functions to slow down. “Hypo” means the thyroid is underactive. If you have thyroid problems, you can still have a healthy pregnancy and protect your baby’s health by having regular thyroid function tests and taking any medicines that your doctor prescribes. What role do thyroid hormones play in pregnancy? Thyroid hormones are crucial for normal development of your baby’s brain and nervous system. During the first trimester—the first 3 months of pregnancy—your baby depends on your supply of thyroid hormone, which comes through the placenta . At around 12 weeks, your baby’s thyroid starts to work on its own, but it doesn’t make enough thyroid hormone until 18 to 20 weeks of pregnancy. Two pregnancy-related hormones—human chorionic gonadotropin (hCG) and estrogen—cause higher measured thyroid hormone levels in your blood. The thyroid enlarges slightly in healthy women during pregnancy, but usually not enough for a health care professional to feel during a physical exam. Thyroid problems can be hard to diagnose in pregnancy due to higher levels of thyroid hormones and other symptoms that occur in both pregnancy and thyroid disorders. Some symptoms of hyperthyroidism or hypothyroidism are easier to spot and may prompt your doctor to test you for these thyroid diseases. Another type of thyroid disease, postpartum thyroiditis, can occur after your baby is born. Hyperthyroidism in Pregnancy Some signs and symptoms of hyperthyroidism often occur in normal pregnancies, including faster heart rate, trouble dealing with heat, and tiredness. Other signs and symptoms can suggest hyperthyroidism: fast and irregular heartbeat shaky hands unexplained weight loss or failure to have normal pregnancy weight gain Causes of hyperthyroidism in pregnancy Hyperthyroidism in pregnancy is usually caused by Graves’ disease and occurs in 1 to 4 of every 1,000 pregnancies in the United States.1 Graves’ disease is an autoimmune disorder. With this disease, your immune system makes antibodies that cause the thyroid to make too much thyroid hormone. This antibody is called thyroid stimulating immunoglobulin, or TSI. Graves’ disease may first appear during pregnancy. However, if you already have Graves’ disease, your symptoms could improve in your second and third trimesters. Some parts of your immune system are less active later in pregnancy so your immune system makes less TSI. This may be why symptoms improve. Graves’ disease often gets worse again in the first few months after your baby is born, when TSI levels go up again. If you have Graves’ disease, your doctor will most likely test your thyroid function monthly throughout your pregnancy and may need to treat your hyperthyroidism.1 Thyroid hormone levels that are too high can harm your health and your baby’s. Pregnant woman having her blood drawn If you have Graves’ disease, your doctor will most likely test your thyroid function monthly during your pregnancy. Rarely, hyperthyroidism in pregnancy is linked to hyperemesis gravidarum —severe nausea and vomiting that can lead to weight loss and dehydration. Experts believe this severe nausea and vomiting is caused by high levels of hCG early in pregnancy. High hCG levels can cause the thyroid to make too much thyroid hormone. This type of hyperthyroidism usually goes away during the second half of pregnancy. Less often, one or more nodules, or lumps in your thyroid, make too much thyroid hormone. Untreated hyperthyroidism during pregnancy can lead to miscarriage premature birth low birthweight preeclampsia—a dangerous rise in blood pressure in late pregnancy thyroid storm—a sudden, severe worsening of symptoms congestive heart failure Rarely, Graves’ disease may also affect a baby’s thyroid, causing it to make too much thyroid hormone. Even if your hyperthyroidism was cured by radioactive iodine treatment to destroy thyroid cells or surgery to remove your thyroid, your body still makes the TSI antibody. When levels of this antibody are high, TSI may travel to your baby’s bloodstream. Just as TSI caused your own thyroid to make too much thyroid hormone, it can also cause your baby’s thyroid to make too much. Tell your doctor if you’ve had surgery or radioactive iodine treatment for Graves’ disease so he or she can check your TSI levels. If they are very high, your doctor will monitor your baby for thyroid-related problems later in your pregnancy. An overactive thyroid in a newborn can lead to a fast heart rate, which can lead to heart failure early closing of the soft spot in the baby’s skull poor weight gain irritability Sometimes an enlarged thyroid can press against your baby’s windpipe and make it hard for your baby to breathe. If you have Graves’ disease, your health care team should closely monitor you and your newborn. How do doctors diagnose hyperthyroidism in pregnancy? Your doctor will review your symptoms and do some blood tests to measure your thyroid hormone levels. Your doctor may also look for antibodies in your blood to see if Graves’ disease is causing your hyperthyroidism. Learn more about thyroid tests and what the results mean. How do doctors treat hyperthyroidism during pregnancy? If you have mild hyperthyroidism during pregnancy, you probably won’t need treatment. If your hyperthyroidism is linked to hyperemesis gravidarum, you only need treatment for vomiting and dehydration. If your hyperthyroidism is more severe, your doctor may prescribe antithyroid medicines, which cause your thyroid to make less thyroid hormone. This treatment prevents too much of your thyroid hormone from getting into your baby’s bloodstream. You may want to see a specialist, such as an endocrinologist or expert in maternal-fetal medicine, who can carefully monitor your baby to make sure you’re getting the right dose. Doctors most often treat pregnant women with the antithyroid medicine propylthiouracil (PTU) during the first 3 months of pregnancy. Another type of antithyroid medicine, methimazole , is easier to take and has fewer side effects, but is slightly more likely to cause serious birth defects than PTU. Birth defects with either type of medicine are rare. Sometimes doctors switch to methimazole after the first trimester of pregnancy. Some women no longer need antithyroid medicine in the third trimester. Small amounts of antithyroid medicine move into the baby’s bloodstream and lower the amount of thyroid hormone the baby makes. If you take antithyroid medicine, your doctor will prescribe the lowest possible dose to avoid hypothyroidism in your baby but enough to treat the high thyroid hormone levels that can also affect your baby. Antithyroid medicines can cause side effects in some people, including allergic reactions such as rashes and itching rarely, a decrease in the number of white blood cells in the body, which can make it harder for your body to fight infection liver failure, in rare cases Stop your antithyroid medicine and call your doctor right away if you develop any of these symptoms while taking antithyroid medicines: yellowing of your skin or the whites of your eyes, called jaundice dull pain in your abdomen constant sore throat fever If you don’t hear back from your doctor the same day, you should go to the nearest emergency room. You should also contact your doctor if any of these symptoms develop for the first time while you’re taking antithyroid medicines: increased tiredness or weakness loss of appetite skin rash or itching easy bruising If you are allergic to or have severe side effects from antithyroid medicines, your doctor may consider surgery to remove part or most of your thyroid gland. The best time for thyroid surgery during pregnancy is in the second trimester. Radioactive iodine treatment is not an option for pregnant women because it can damage the baby’s thyroid gland. Hypothyroidism in Pregnancy Symptoms of an underactive thyroid are often the same for pregnant women as for other people with hypothyroidism. Symptoms include extreme tiredness trouble dealing with cold muscle cramps severe constipation problems with memory or concentration Woman with a coat shivering outdoors You may have symptoms of hypothyroidism, such as trouble dealing with cold. Most cases of hypothyroidism in pregnancy are mild and may not have symptoms. What causes hypothyroidism in pregnancy? Hypothyroidism in pregnancy is usually caused by Hashimoto’s disease and occurs in 2 to 3 out of every 100 pregnancies.1 Hashimoto’s disease is an autoimmune disorder. In Hashimoto’s disease, the immune system makes antibodies that attack the thyroid, causing inflammation and damage that make it less able to make thyroid hormones. How can hypothyroidism affect me and my baby? Untreated hypothyroidism during pregnancy can lead to preeclampsia—a dangerous rise in blood pressure in late pregnancy anemia miscarriage low birthweight stillbirth congestive heart failure, rarely These problems occur most often with severe hypothyroidism. Because thyroid hormones are so important to your baby’s brain and nervous system development, untreated hypothyroidism—especially during the first trimester—can cause low IQ and problems with normal development. How do doctors diagnose hypothyroidism in pregnancy? Your doctor will review your symptoms and do some blood tests to measure your thyroid hormone levels. Your doctor may also look for certain antibodies in your blood to see if Hashimoto’s disease is causing your hypothyroidism. Learn more about thyroid tests and what the results mean. How do doctors treat hypothyroidism during pregnancy? Treatment for hypothyroidism involves replacing the hormone that your own thyroid can no longer make. Your doctor will most likely prescribe levothyroxine , a thyroid hormone medicine that is the same as T4, one of the hormones the thyroid normally makes. Levothyroxine is safe for your baby and especially important until your baby can make his or her own thyroid hormone. Your thyroid makes a second type of hormone, T3. Early in pregnancy, T3 can’t enter your baby’s brain like T4 can. Instead, any T3 that your baby’s brain needs is made from T4. T3 is included in a lot of thyroid medicines made with animal thyroid, such as Armour Thyroid, but is not useful for your baby’s brain development. These medicines contain too much T3 and not enough T4, and should not be used during pregnancy. Experts recommend only using levothyroxine (T4) while you’re pregnant. Some women with subclinical hypothyroidism—a mild form of the disease with no clear symptoms—may not need treatment. Pregnant woman with a pill in one hand and a glass of water in the other Your doctor may prescribe levothyroxine to treat your hypothyroidism. If you had hypothyroidism before you became pregnant and are taking levothyroxine, you will probably need to increase your dose. Most thyroid specialists recommend taking two extra doses of thyroid medicine per week, starting right away. Contact your doctor as soon as you know you’re pregnant. Your doctor will most likely test your thyroid hormone levels every 4 to 6 weeks for the first half of your pregnancy, and at least once after 30 weeks.1 You may need to adjust your dose a few times. Postpartum Thyroiditis What is postpartum thyroiditis? Postpartum thyroiditis is an inflammation of the thyroid that affects about 1 in 20 women during the first year after giving birth1 and is more common in women with type 1 diabetes. The inflammation causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage raises the hormone levels in your blood, leading to hyperthyroidism. The hyperthyroidism may last up to 3 months. After that, some damage to your thyroid may cause it to become underactive. Your hypothyroidism may last up to a year after your baby is born. However, in some women, hypothyroidism doesn’t go away. Not all women who have postpartum thyroiditis go through both phases. Some only go through the hyperthyroid phase, and some only the hypothyroid phase. What are the symptoms of postpartum thyroiditis? The hyperthyroid phase often has no symptoms—or only mild ones. Symptoms may include irritability, trouble dealing with heat, tiredness, trouble sleeping, and fast heartbeat. Symptoms of the hypothyroid phase may be mistaken for the “baby blues”—the tiredness and moodiness that sometimes occur after the baby is born. Symptoms of hypothyroidism may also include trouble dealing with cold; dry skin; trouble concentrating; and tingling in your hands, arms, feet, or legs. If these symptoms occur in the first few months after your baby is born or you develop postpartum depression , talk with your doctor as soon as possible. What causes postpartum thyroiditis? Postpartum thyroiditis is an autoimmune condition similar to Hashimoto’s disease. If you have postpartum thyroiditis, you may have already had a mild form of autoimmune thyroiditis that flares up after you give birth. Woman holding her baby. Postpartum thyroiditis may last up to a year after your baby is born. How do doctors diagnose postpartum thyroiditis? If you have symptoms of postpartum thyroiditis, your doctor will order blood tests to check your thyroid hormone levels. How do doctors treat postpartum thyroiditis? The hyperthyroid stage of postpartum thyroiditis rarely needs treatment. If your symptoms are bothering you, your doctor may prescribe a beta-blocker, a medicine that slows your heart rate. Antithyroid medicines are not useful in postpartum thyroiditis, but if you have Grave’s disease, it may worsen after your baby is born and you may need antithyroid medicines. You’re more likely to have symptoms during the hypothyroid stage. Your doctor may prescribe thyroid hormone medicine to help with your symptoms. If your hypothyroidism doesn’t go away, you will need to take thyroid hormone medicine for the rest of your life. Is it safe to breastfeed while I’m taking beta-blockers, thyroid hormone, or antithyroid medicines? Certain beta-blockers are safe to use while you’re breastfeeding because only a small amount shows up in breast milk. The lowest possible dose to relieve your symptoms is best. Only a small amount of thyroid hormone medicine reaches your baby through breast milk, so it’s safe to take while you’re breastfeeding. However, in the case of antithyroid drugs, your doctor will most likely limit your dose to no more than 20 milligrams (mg) of methimazole or, less commonly, 400 mg of PTU. Thyroid Disease and Eating During Pregnancy What should I eat during pregnancy to help keep my thyroid and my baby’s thyroid working well? Because the thyroid uses iodine to make thyroid hormone, iodine is an important mineral for you while you’re pregnant. During pregnancy, your baby gets iodine from your diet. You’ll need more iodine when you’re pregnant—about 250 micrograms a day.1 Good sources of iodine are dairy foods, seafood, eggs, meat, poultry, and iodized salt—salt with added iodine. Experts recommend taking a prenatal vitamin with 150 micrograms of iodine to make sure you’re getting enough, especially if you don’t use iodized salt.1 You also need more iodine while you’re breastfeeding since your baby gets iodine from breast milk. However, too much iodine from supplements such as seaweed can cause thyroid problems. Talk with your doctor about an eating plan that’s right for you and what supplements you should take. Learn more about a healthy diet and nutrition during pregnancy . Homeopathy provides remedies which treat not just the above symptoms but the person as a whole. Sepia Officinalis: Used when the patient presents with the following symptoms. Weak, slightly yellow appearance Tendency to faint, especially when in cold temperatures Extreme intolerance to cold, even in warm surroundings Increased irritability Hair loss Increased menstrual flow that occurs ahead of schedule Constipation Increased desire for pickles and acidic foodstuff Calcarea Carbonica: This popular medicine is useful when patients present with the following symptoms. Fat, flabby, fair person Increased intolerance to cold Excessive sweating, especially in the head Aversion to fatty foods Peculiar food habits including craving for eggs, chalk, pencils, lime, Increased menstruation that is also prolonged and is associated with feet turning cold Lycopodium Clavatum: Useful in patients who present with these symptoms: Physically weakened Increased irritability Excessive hair fall Face is pale yellow with blue circles around the eyes Craving for foods that are hot and sweet Acidity that is worse in the evenings Gastric issues including excessive flatulence Constipation with painful, hard, incomplete stooling Graphites: Presenting symptoms where Graphites are mainly used include: Obesity Intolerance to cold Depressed emotionally, timid, indecisive, weeping, listening to music Bloated, gassy abdomen Chronic constipation with hard, painful stooling process Lodium: Good appetite but lose weight quickly Tendency to eat at regular intervals Excessive warmth and need to stay in a cool environment Anxiety about present Excessive palpitations Lachesis Mutus: These patient present with the following symptoms: Feeling extremely hot, so inability to wear tight clothes Generally sad with no inclination to do any work Tendency to stay aloof and alone Excessive talkativeness Women around menopausal age

36 yrs male came today 12:30Am with complain of sudden onset of headache with blood pressure sutap no nausea and vomiting no chest pain palpitations no other significant complain . No/h/o htn/dm/ihd O/e *BP 240/150 Hgt 130 Spo2 96 Pul 116 CVS /cns nad Rs clear CT brain done -wnl Cxr -wnl WBC 10,100 Hb 14 Pcv 41.6 Plt 223000 Shot 19 / PT 40 Creat 1.5 blood urea 38 Cardiac marker -wnl Rx given after admission Stamlo 5 dipin10 lasix 40mg alprex 0.5 NTG 25/50 .5ml/hr repeat *dipin10mg at 5am Inj perfolgan stat 11:30am lasix 20mg stat dipin 10mg alprex 0.5 mg stat 11:30am Tab ecosprin 300+clop300+atorva80 Inj clexan 0.6 mg s/c BD 2pm .Met-xl 50mg at 4pm BP not control and unable to sleep kindly give your openion

Friends today I am discussing about diabetes and erectile dysfunction. Which can be co related. Diabetes and Erectile Dysfunction (ED): Is There a Connection? Although diabetes and erectile dysfunction (ED) are two separate conditions, they tend to go hand-in-hand. ED is defined as having difficulty achieving or maintaining an erection. Men who have diabetes are two to three times more likely to develop ED. When men ages 45 and under develop ED, it may be a sign of type 2 diabetes. Diabetes occurs when you have too much sugar circulating in your bloodstream. There are two main types of diabetes: type 1 diabetes, which affects less than 10 percent of those who have diabetes, and type 2 diabetes, which accounts for over 90 percent of diabetes cases. Type 2 diabetes often develops as a result of being overweight or inactive. Approximately 30 million Americans have diabetes, and about half of them are men. An estimated 10 percent of men ages 40 to 70 have severe ED, and another 25 percent have moderate ED. ED tends to become more common as men age, though it isn’t an inevitable part of aging. For many men, other health conditions, such as diabetes, contribute to the likelihood of developing ED. What the research says The Boston University Medical Center reports that about half of men who are diagnosed with type 2 diabetes will develop ED within five to 10 years of their diagnosis. If those men also have heart disease, their odds of becoming impotent are even greater. However, the results of a 2014 study suggest that if you have diabetes but adopt a healthier lifestyle, you may reduce your diabetes symptoms and improve your sexual health. These lifestyle habits include eating a balanced diet and getting regular exercise. What causes ED in men with diabetes? The connection between diabetes and ED is related to your circulation and nervous system. Poorly controlled blood sugar levels can damage small blood vessels and nerves. Damage to the nerves that control sexual stimulation and response can impede a man’s ability to achieve an erection firm enough to have sexual intercourse. Reduced blood flow from damaged blood vessels can also contribute to ED. Risk factors for erectile dysfunction There are several risk factors that can increase your chance of diabetes complications, including ED. You may be more at risk if you: have poorly managed blood sugar are stressed have anxiety have depression eat a poor diet aren’t active are obese smoke drink excessive amounts of alcohol have uncontrolled hypertension have an abnormal blood lipid profile take medications that list ED as a side effect take prescription drugs for high blood pressure, pain, or depression Diagnosing erectile dysfunction If you notice a change in the frequency or duration of your erections, tell your doctor or make an appointment with a urologist. It may not be easy to bring up these issues with your doctor, but reluctance to do so will only prevent you from getting the help that you need. Your doctor can diagnose ED by reviewing your medical history and assessing your symptoms. They will likely perform a physical exam to check for possible nerve problems in the penis or testicles. Blood and urine tests can also help diagnose problems such as diabetes or low testosterone. They may be able to prescribe medication, as well as refer you to a healthcare professional specializing in sexual dysfunction. Several treatment options exist for ED. Your doctor can help you find the best option for you. If you haven’t experienced any symptoms of ED, but you have been diagnosed with diabetes or heart disease, you should discuss the possibility of a future diagnosis with your doctor. They can help you determine which preventive steps you can take right now. Check out: Blood tests for erectile dysfunction » Treating erectile dysfunction If you’re diagnosed with ED, your doctor will likely recommend an oral medication, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra). These prescription medications help improve blood flow to the penis and are generally well-tolerated by most men. Having diabetes shouldn’t interfere with your ability to take one of these medications. They don’t interact negatively with diabetes drugs, such as Glucophage (metformin) or insulin. Although there are other ED treatments, such as pumps and penile implants, you may want to try an oral medication first. These other treatments typically aren’t as effective and may cause additional complications. Diabetes is a chronic health condition that you will have for life, though both type 1 and type 2 diabetes can be well-controlled through medications, proper diet, and exercise. Although ED can become a permanent condition, this typically isn’t the case for men who experience occasional erectile difficulties. If you have diabetes, you may still be able to overcome ED through a lifestyle that includes sufficient sleep, no smoking, and stress reduction. ED medications are usually well-tolerated, and can be used for many years to help overcome any ED problems. How to prevent erectile dysfunction There are several lifestyle changes that you can make to not only help with diabetes management, but also to lower your risk of ED. You can: Control your blood sugar through your diet. Eating a diabetes-friendly diet will help you better control your blood sugar levels and lessen the amount of damage to your blood vessels and nerves. A proper diet geared at keeping your blood sugar levels in check can also improve your energy levels and mood, both of which can help reduce the risk of erectile dysfunction. You may consider working with a dietitian who is also a certified diabetes educator to help adjust your eating style. Cut back on alcohol consumption. Drinking more than two drinks per day can damage your blood vessels and contribute to ED. Being even mildly intoxicated can also make it hard to achieve an erection and interfere with sexual function. Stop smoking. Smoking narrows the blood vessels and decreases the levels of nitric oxide in your blood. This decreases blood flow to the penis, worsening erectile dysfunction. Get active. Not only can adding regular exercise to your routine help you control your blood sugar levels, but it can also improve circulation, lower stress levels, and improve your energy levels. All of these can help combat ED. Get more sleep. Fatigue is often to blame for sexual dysfunction. Ensuring that you get enough sleep each night can lower your risk of ED. Keep your stress level down. Stress can interfere with sexual arousal and your ability to get an erection. Exercise, meditation, and setting aside time to do the things that you enjoy can help to keep your stress levels down and lessen your risk of ED. If you’re developing symptoms of anxiety or depression, consult your doctor. They may be able to refer you to a therapist who can help you work through anything that is causing you stress. Homoeopathic medicines Uranium Nitricum Uranium Nitricum is indicated when diabetes mellitus co-exist with hypertension and heart failure. Anyone of these three conditions is capable of causing ED in any individual. With the three conditions together in one individual, Sexual Dysfunction is almost always ensured. The patient who needs Uran-n complains of copious urination, with urine that smells fishy. It is aggravated mainly at night. He has excessive thirst, nausea and vomiting. His appetite is great; eating is followed by bloating of the abdomen and flatulence. He is emaciated; has ascites and is debilitated. The generative organs feel cold, relaxed and are sweaty. Lycopodium Clavatum Generally Lycopodium is indicated in deep-seated, progressive, chronic disease. It would be indicated in Diabetes where there is emaciation accompanying other typical diabetic symptoms in a Lyc. patient, such as: Dryness of mouth, throat and tongue without thirst for water. There is a desire for sweet things and warm drinks. The polyuria is predominantly at night; the urine may be red with sediment. Appetite is usually absent, or he may be hungry to the extent of waking up at night to eat. He often complains of heartburn, sour eructations and flatulence. On the sexual sphere, Lyc. more often, has erection failure when he is with his wife. He performs relatively better with a new partner. Although he has a strong sexual desire, he suffers from incomplete erections; sometimes falling asleep during an embrace. Diminished sexual power is mainly due to cold, relaxed sexual organs. Iodium The Iodine patient is the one suffering from profound debility. He emaciates to a skeleton despite a voracious appetite and eating well. In this patient, both the thirst and appetite are increased considerably; he feels better from eating. The slightest effort induces profuse perspiration. There is frequent and profuse urination; the urine is dark yellowish-green and thick. Furthermore, the patient who needs Iodine suffers from atrophy of the testicles, when all other glands enlarge, eg: the prostate gland. This atrophy is the factor associated with the loss of sexual power. Phosphoricum Acidum The Ph-ac. patient has a pale sickly complexion. His hair has turned grey. He has a hopeless, haggard look. His eyes are sunken and surrounded by blue rings. His state of debility is attributed to loss of body fluids and the effects of chronic grief. He has profuse urination of clear, watery urine, especially at night. It tends to be milky at times. Ph-ac. suffers from seminal emissions without erections. He is debilitated from loss of body fluids. The patient feels depressed and apathetic. He has a history of sexual excesses. Semen is discharged without an erection or shortly after erection. He experiences dragging pains in the testicles. Argentum Metallicum Arg-met is indicated for Diabetes Mellitus that is concomitant with joint problems, and complicated by Sexual Dysfunction. This is particularly in view of its affinities for the joints and the sex organs. It has affinities particularly for the small blood vessels; closing them up; hence its indications for sexual dysfunction. The urine is profuse, turbid and has a sweet odour. There is frequency of urination and polyuria. The subject emaciates gradually; he is easily worn-out; forcing him to lie down. He has seminal emissions without sexual excitement or erection. There is atrophy of the penis and crushing pains in the testicles. Phaseolus Nanus Phase has an elective affinity for the heart and the prostate gland. Boericke describes it as being indicated for diabetes that is accompanied by heart symptoms such as “fearful palpitations and a feeling that death is approaching”. There is oedema of the extremities with irregular action of the heart. Clinically, prostate disease, heart disease and diabetes are factors known to individually contribute to sexual dysfunction. On the basis of “Like Cures Like”, it is not surprising that Phase has been found to be effective in the treatment of ED due to Diabetes Mellitus. The remedy is indicated for all three conditions in the same person, symptoms agreeing. Coca Coca is regarded as a specific remedy for Erectile Dysfunction due to Diabetes mellitus. Although many practitioners can back up the latter statement with clinical data, not many authorities have written about their experience with this remedy, nor is it well documented in the various works of Materia Medica. The Diabetes symptoms recorded are: Frequency of micturition Bad effects of alcohol and tobacco Loss of appetite The most important symptom that always comes up implying loss of libido is the sensation “As if the penis were absent” Moschus Moschus, like Coca, has been acclaimed for curing Sexual Dysfunction due to diabetes. Lippe describes it as having special effects on the sexual organs and nerves of motion. Profuse urine with a strong odour; great thirst and emaciation. Debility that is felt more at rest than during motion. Vertigo on least motion The Materia Medica quotes that its Impotence is associated with Diabetes. There is violent desire and intensive sexual excitement with involuntary emissions of semen; and poor performance. In extreme cases, there is total loss of sexual desire.

24 yrs male patient presented with Left parieto-occipital headache with chest pain/palpitation off n on since last 6 months.ECG normal except sinus tachycardia. B.P .162/100,Pulse 108,SPo2 97. Sometimes c/o low backache,burning micturition.Vision normal. No giddiness, vomiting. Appetite /sleep normal. How to manage this case medically n what other investigations needed to label this as secondary hypertension as the age of patient is only 24 yrs.???