is tab meperate safe when pt is on anticoagulant nd stamlo nd prolomet xl

Very often we come across this situation ! MUST the patient be Fasting for a Lipid profile ? The answer, certainly depends upon what we want to measure. ! Surprised. ? Need not be! Let me explain ! Eating raises plasma triglycerides but only has a minimal impact on total cholesterol or HDL-C or apo-B. But LDL-C is a calculated number that depends on the level of plasma triglycerides and therefore requires a Fasting specimen. Yes , the patient must be Fasting if we want LDL-C. A Fasting sample is needed for the classical lipid profile ( total cholesterol, triglycerides, HDL-C and LDL-C ) because the treatment goals and proven benefits of treatment are targeted at LDL-C. But the patient need not fast if we want total cholesterol, HDL-C, non- HDL-C, or apo-B. Total cholesterol and HDL-C are the only Measurements we need to know to determine non- HDL-C. And non HDL-C includes All of the Cholesterol in all of the potentially atherogenic lipoproteins containing apo-B ( any lingering Chylomicron remnants, VLDL-C, IDL-C, LDL-C and Lp (a) ). Non HDL-C is useful Measure to consider when the triglycerides are in the range of 200 - 499 , but then cannot be calculated when the triglycerides exceed 500.

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The image given below shows a cut section of the heart of a patient with Rheumatic heart disease. Identify the lesion shown. A. mitral stenosis B. mitral regurgitation C. tricuspid stenosis D. tricuspid regurgitation

WHY IS IT IMPORTANT FOR US TO BE IN UNIFORM ?       Just imagine a situation, you are about to board a flight and you happen to see the pilots dressed in torn jeans( which are the current fad ) and flowery shirts !           Now, your confidence in the crew suddenly hits rock bottom, just because you fail to see an attitude of some professionalism and safety concerns. You have second thoughts in continuing in that flight. I am sure you shall agree with me !             Now , another scenario, your loved one is going for a major surgery and again, you happen to notice the surgeon and anaesthesia team walking in the street attire of jeans and t-shirts.  Once again, your mind gets clouded with negative thoughts, whether you can confide in these doctors and their skills.                 Because , our mindsets are fixed with some stereotypes and we give a lot of importance to these issues.          Is this why the CM of  UP has issued an order of banning casual wear like jeans and t-shirts in state government hospitals  ?            Observational studies have shown that a formal dressing with a white apron always creates an amicable atmosphere between a doctor and a patient , in addition it definitely prevents an animosity and any violence against the doctors.          Furthermore, A picture of doctor in a white coat is so perfect,dignified and holy that it refrains patients from any unruly behaviour. Interestingly, A white apron on the doctor's body also constantly reminds him or her about the dignity and strengthens him or her to behave politely and responsibly.          Even though most of medicos are aware of the significance of their dress while treating their patients , a few make the required change.        A study, TAILOR, published in BMJ 2014, observed that patients had strong preferences about what their doctors should wear to look presentable. Most of the patients preferred their doctors to wear formals with white aprons to appear more professional and expressed higher satisfaction.    It is not just that the kind of dress worn by the doctor makes an impact but the level of medical knowledge he possesses, the skills learnt, the honesty to talk about the severity of the illness and it's prognosis, to discuss about the relevance and results of investigations, the cost of his treatment, about his own limitations, the respect for other doctors, compassion, empathy, humbleness, always updating the patient's health to their near and dear, lastly never to offer false hopes and promises. We, the doctors should avoid playing the God !       To begin with, the first lesson, we have to learn that, to prevent any unruly mob action or even an unpleasant argument , the doctor's attire makes a vital difference. The public, by and large still respect the uniform as they do in case of police and other government officials. We should try to emulate the popular physical appearance of a doctor, as envisioned by the public to remain non controversial.

Good morning dear friends and colleagues, Today let's have a look at TREE MAN DISEASE. It is also known as Epidermodysplasia verruciformis is an autoimmune deficiency. It is failed response to Human papilloma virus type2 and believed to stem from genetic defect. It is a rare genetic and inherited disorder and creates wart like lesions any where on the body. It is caused by HPV virus and characterised by wide spread skin eruptions, wart like lesions and reddish brown pigmented plaques. It is seen between 1 to 20 years of life and some cases reported in middleaged people. No definite cure except surgery. With regards, Dr Sepuri Tirumala Devi.