? OBESITY WITH .. HT .. AND .. TACHYCARDIA .. MANAGEMENT .. * DIURETICS .. * ANXIOLYTIC..SOS.. * SALT RESTRICTIONS .. * REGULAR EXERCISE .. * FOLLOW UP ..
Hypertensive Adv wt management Correction of BMI Antihypertensive Tab metaprolol 50mg+hydrochlorthiazide Assess lipid profile and consider antilipids Investigate rest ofie ecg 2decho and lab investigations
Obese ,redue wt by regular exercise and diet control .Reduce salt intake . Watch BP on regular intervals. Cut out other risk factors such as smoking and high cholesterol etc.
Metoprolol 12.5 mg once daily It will take care of tachycardia with slightly high blood pressure
Obesity Hyper tension Tachycardia Ad wt reduction Diet Exercise Consult Endocrinologist
REGULAR EXERCISE , EARLY AWAKENING , MAINTAIN DIETARY PLAN FIXED TIME , SCHEDULE MAINTAINING REFER TO CARDIOLOGIST FOR BETTER DIAGNOSIS.
Adv thyroid functions tests fat free diet
Inj Lasix 20mg I/v stat. F/b BP/PR monitoring 30mins. F/U adv- general measures for Hypertensive patient( *reduction of salt, diet monitoring, regular exercise, )
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A 37-year-old male presented to the ED with two days of chest pain . constant, rated at a level of 3 (on a scale of 0 to 10), and slightly worsening on deep inspiration. He described increased shortness of breath with exertion and a cough productive of clear sputum but denied fevers, chills, nausea, lightheadedness or sweating. The patient was a pale, obese male who appeared in no acute discomfort .temp - 97.5◦F ,1 Rr18 beats/minute BP 102/72 mmHg RR 18 Spo2 -96% CVS s1s2+ Rs : Rales at the lung bases bilaterally P/a Soft, nontender, nondistended. CNS Nonfocal. TLC 18 K/μL with 90% neutrophils, hematocrit - 31% creatinine - 1.5 mg/dL positive D-dimer. troponin I - normalDr. Mahesh Mareddy10 Likes19 Answers
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A female aged 50 years p/w complaints of Giddiness and pain Epigastrium since last 1 week... she is a hypertensive well controlled on treatment.... comment on her ECG and discuss the findingsDr. Hardik Ahuja2 Likes15 Answers
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Morbidly obese middle aged male presents after syncope with SOB and diaphoresis. EKGs are two days apart. What do you see?Dr. Vedant Sharma4 Likes29 Answers
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FATTY LIVER Nonalcoholic fatty liver disease is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of nonalcoholic fatty liver disease is too much fat stored in liver cells. Nonalcoholic steatohepatitis, a potentially serious form of the disease, is marked by liver inflammation, which may progress to scarring and irreversible damage. This damage is similar to the damage caused by heavy alcohol use. At its most severe, nonalcoholic steatohepatitis can progress to cirrhosis and liver failure Nonalcoholic fatty liver disease is increasingly common around the world, especially in Western nations. In the United States, it is the most common form of chronic liver disease, affecting an estimated 80 to 100 million people. Nonalcoholic fatty liver disease occurs in every age group but especially in people in their 40s and 50s who are at high risk of heart disease because of such risk factors as obesity and type 2 diabetes. The condition is also closely linked to metabolic syndrome, which is a cluster of abnormalities including increased abdominal fat, poor ability to use the hormone insulin, high blood pressure and high blood levels of triglycerides, a type of fat. Causes Experts don't know exactly why some people accumulate fat in the liver while others do not. Similarly, there is limited understanding of why some fatty livers develop inflammation that progresses to cirrhosis. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis are both linked to the following: · Overweight or obesity · Insulin resistance, in which your cells don't take up sugar in response to the hormone insulin · High blood sugar (hyperglycemia), indicating prediabetes or actual type 2 diabetes · High levels of fats, particularly triglycerides, in the blood These combined health problems appear to promote the deposit of fat in the liver. For some people, this excess fat acts as a toxin to liver cells, causing liver inflammation and nonalcoholic steatohepatitis, which may lead to a buildup of scar tissue (fibrosis) in the liver. Symptoms Nonalcoholic fatty liver disease usually causes no signs and symptoms. When it does, they may include: · Enlarged liver · Fatigue · Pain in the upper right abdomen Possible signs and symptoms of nonalcoholic steatohepatitis and cirrhosis (advanced scarring) include: · Abdominal swelling (ascites) · Enlarged blood vessels just beneath the skin's surface · Enlarged breasts in men · Enlarged spleen · Red palms · Yellowing of the skin and eyes (jaundice) Risk factors A wide range of diseases and conditions can increase your risk of nonalcoholic fatty liver disease, including: · High cholesterol · High levels of triglycerides in the blood · Metabolic syndrome · Obesity, particularly when fat is concentrated in the abdomen · Polycystic ovary syndrome · Sleep apnea · Type 2 diabetes · Underactive thyroid (hypothyroidism) · Underactive pituitary gland (hypopituitarism) Nonalcoholic steatohepatitis is more likely in these groups: · Older people · People with diabetes · People with body fat concentrated in the abdomen It is difficult to distinguish nonalcoholic fatty liver disease from nonalcoholic steatohepatitis without further testing. Complications The main complication of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis is cirrhosis, which is late-stage scarring (fibrosis) in the liver. Cirrhosis occurs in response to liver injury, such as the inflammation in nonalcoholic steatohepatitis. As the liver tries to halt inflammation, it produces areas of scarring (fibrosis). With continued inflammation, fibrosis spreads to take up more and more liver tissue. If the process isn't interrupted, cirrhosis can lead to: · Fluid buildup in the abdomen (ascites) · Swelling of veins in your esophagus (esophageal varices), which can rupture and bleed · Confusion, drowsiness and slurred speech (hepatic encephalopathy) · Liver cancer · End-stage liver failure, which means the liver has stopped functioning About 20 percent of people with nonalcoholic steatohepatitis will progress to cirrhosis. HOMOEOPATHIC REMEDIES Homoeopathic remedies are safe remedies for the treatment of fatty liver. Some of the important remedies are given below-- CHELIDONIUM Q- Chelidonium is the top Homeopathic medicine for Fatty Liver treatment. The marked symptom for using this medicine is pain in right upper abdomen and pain under right shoulder. There may also be an enlargement of liver.The person is usually constipated. The stool passes in the form of hard balls. A distended abdomen with nausea and vomiting is also experienced. The patient suffers from excessive weakness. In case of jaundice in a patient with Fatty Liver too, Chelidonium is the best Homeopathic remedy. Desire for very hot drinks and hot food CARDUS MARIANUS Q—.Pain in the liver region . Left lobe is very sensitive. Fullness and soreness with moist skin. Constipation. Stool hard, difficul and knotty. Alternates with diarrhea. Golden colored urine Nausea, vomiting of green acid fluid BOLDO Q- Congestion of liver . Burning weight in liver and stomach. Bitter taste , no appetite LYCOPODIUM CLAVATUM 200- Lycopodium is another remedy of great help for treating Fatty Liver with gastric symptoms and acidity. The patient complains of distension or bloating of abdomen soon after eating anything. The abdomen feels full of gas. Burning belching is also experienced. Even eating a little causes fullness in abdomen. The patient feels heaviness and pain in the right upper part of abdomen. Usually the symptoms get worse towards the evening. Farinaceous food makes the person worse. An unusual craving for sweets and hot drinks in excess may be present. PHOSPHOROUS 200-Phosphorus is the best Homeopathic medicine for patients of Fatty Liver who feel as if the food is coming upwards after eating. This is accompanied by sour belching. Vomiting may also occur in a few cases, along with pain in liver. The stool and flatus are very offensive. The patient feels weak after passing stool. The craving for peculiar things in diet is an important indication for using this medicine in Fatty Liver patients. These peculiar things include ice creams, cold drinks and refreshing items like juices. CALCAREA CARB 30- Calcarea Carb is a very beneficial Homeopathic medicine for mainly obese Fatty Liver patients. The person is fatty, flabby with excess fat in liver and whole abdomen. This Homeopathic remedy successfully helps in burning excess fat in liver.The digestion is very slow in such persons with a long-standing constipation. The abdomen always remains distended. Milk is not suitable for these persons. Desire for boiled eggs or strange things like chalk and pencils. Sensitivity to cold air and excessive sweating on the head. NUX VOMICA 30- Nux Vomica is the best fatty liver remedy in homeopathy when the cause is over consumption of Alcohol . It is prescribed when pain in abdomen begins a few hours after eating, with a feeling of stone in abdomen. Sour or bitter belching accompanies the pain. A very significant symptom for selecting Homeopathic remedy Nux Vomica for Fatty Liver is constipation with an ineffectual urge to pass stool or poop. The stool, however, is insufficient and unsatisfactory. The passing out of stool gives some relief from the pain in abdomen but the urge to pass stool is renewed soon after. The patient craves for fattyfood, spicy food, coffee and alcoholic drinks in diet.Dr. Azher Ansari5 Likes16 Answers
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A 38yrs/f suffering from joints pain(big) with puffy face and pedal oedema since 2 months. Pt is obese and hypertensive(on telmisartan+amlodipine) since last 10 yrs. Increased frequency of micturition with lower abd pain since 6 month. Non diabetic. Usg w/a reveals thickening of uterine endometrium and gr | fatty liver. Urine exam- WNL. Plz suggest treatment acordingly.Dr. Fizu Alom3 Likes17 Answers