Investigation ruteen with b12 d3.. Control dm HTN and back pain Then Bramhi vati Sarasvatarishta Shirodhara and katibasti
Hypersomnolence/Narcolepsy Dd. Hyponatremia Hypothyroidism Chronic debilitating diseases.. diabetes.. renal impairment... IHD Cortical atrophy. Sug. Serum sodium.. potassium.. bicarb... chloride Tfts Glycemic status Ecg Urine re.. acr.. BUN.. s. Creat. Ct. Brain.
Here are differentials DM with DKA Hypothyrodism Hyponatremia Narcolepsy Alzemers diease
Hypersomnia in this case may be due to chronic hypoglycemia . Need to check BSF and PP and HbA1c. Other general causes are Hypothyroidism OSA Chronic nocturnal insomnia,and hypnotic drug abuse . Narcolepsy 3red ventricle tumour , pituitary tumors Need investigations, including polysomnography.
Rule out organic disorders like Electrolyte disturbances Hypothyroidism Alzheimer's disease Uncontrolled DM and Hypertension. Auto- brewery syndrome If above disorders are ruled out It is a case of NARCOLEPSY without catapexy . Treatment is CNS stimulants like Amphetamine Dextroamphetamine Modafinil A newer drug - Solriamfetol is promising
? SLEEP APNOEA .. ? DIBETES RELATED INSOMNIA.. NEED'S.. EXPERTS OPINION
Diabetic PT with sleep apnea. At night time, sarpghanda vati,Brahmi vati, tab mentaid, saraswatarisht, helpful. In daytime, medication,yoga, Pranayam helpful.with a control at Diabetes and other ailments..
Diabetic pt c/o sleepiness Hyperkalemia/hyponatremia Electrolyte imbalance need to r/o DKA Secondaly hypothyroidism Yes sleep apnoea also to be r/o just check sp02 pt may be hypoxic
Sleep Apnea I think shirodhara is best for this condition. And avoiding vatakar ahar vihar. Pranayama and asana like sarvangasan, halasan are good.
Thyroid function hb electrolytes and blood sugar
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A 43yrs old female pt. complaining of fatigue. on examination vitals stable, weight 68kg. routine investigations are normal(hb-11mg/dl) but patient FT4 slightly low with normal TSH(report attached). what is further management of this case please help meDr. Mahaveer Jakhar2 Likes14 Answers
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3 year male child..suffring from constipation.. abdominal tenderness.. abdominal pain irritable crying since 3 day.... plzz.dx and rx i was given proctolysis enema yesterday and today..stool pass but in small quantity..and hard... urine pass..colour dark yellowDr. Nitin Deshmukh2 Likes18 Answers
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Hyperthyroidism Hyperthyroidism (overactive thyroid) is a condition in which the thyroid gland produces the high level of the hormone thyroxine. In other words, it can be called as overreactive thyroid. The thyroid gland is an organ located in the front of your neck and releases hormones that control your metabolism (the way your body uses energy), breathing, heart rate, nervous system, weight, body temperature, and many other functions in the body. When the thyroid gland is overactive (hyperthyroidism) the body’s processes speed up and you may experience nervousness, anxiety, rapid heartbeat, hand tremor, excessive sweating, weight loss, and sleep problems, among other symptoms. Pathophysiology In hyperthyroidism, serum T3 usually increases more than does T4, probably because of increased secretion of T3 as well as the conversion of T4 to T3 in peripheral tissues. In some patients, only T3 is elevated (T3 toxicosis). T3 toxicosis may occur in any of the usual disorders that cause hyperthyroidism, including Graves’ disease, multinodular goitre, and the autonomously functioning solitary thyroid nodule. If T3 toxicosis is untreated, the patient usually also develops laboratory abnormalities typical of hyperthyroidism (ie, elevated T4 and 123I uptake). The various forms of thyroiditis commonly have a hyperthyroid phase followed by a hypothyroid phase. Causes A variety of conditions can cause hyperthyroidism. Graves’ disease, an autoimmune disorder, is the most common cause of hyperthyroidism. It causes antibodies to stimulate the thyroid to secrete too much hormone. Other causes of hyperthyroidism include: Excess iodine, a key ingredient in T4 and T3 Thyroiditis, or inflammation of the thyroid, which causes T4 and T3 to leak out of the gland Tumours of the ovaries or testes Benign tumours of the thyroid or pituitary gland Large amounts of tetraiodothyronine taken through dietary supplements or medication Risk factors Have a family history of thyroid disease Have other health problems, including Pernicious anaemia, a condition caused by a vitamin B12 deficiency Type 1 diabetes Primary adrenal insufficiency, a hormonal disorder Eating large amounts of food containing iodine, such as kelp, or use medicines that contain iodine, such as amiodarone, a heart medicine Older than age 60, especially if you are a woman Pregnant within the past 6 months Clinical manifestations The symptoms of hyperthyroidism include the following: An enlarged thyroid gland (goitre), which may appear as a swelling at the base of your neck Fatigue or muscle weakness Light periods or skipping periods. Weight loss Hand tremors Mood swings Rapid heartbeat Nervousness or anxiety Trouble sleeping Protruded eyeballs Skin dryness fine, brittle hair Heart palpitations or irregular heartbeat Increased frequency of bowel movements Breast development in men Complications Heart problems include atrial fibrillation and congestive heart failure An irregular heartbeat that can lead to blood clots, stroke, Brittle bones like osteoporosis Graves’s ophthalmology may exhibit eye problems including bulging, red or swollen eyes, sensitivity to light, and blurring or double vision. Red, swollen skin. Thyrotoxic crisis. Diagnosis and Test Thyroid function blood test Thyroid function test is performed using a sample of blood obtained from the patient with hyperthyroidism. It is used to check the levels of: Thyroid-stimulating hormone (TSH) – a hormone produced by the pituitary gland (a gland at the base of the brain) that controls the production of thyroid hormones Triiodothyronine (T3) – one of the main thyroid hormones Thyroxine (T4) – another of the main thyroid hormones Your levels will be compared to what’s normal for a healthy person. A low level of TSH and high levels of T3 and/or T4 usually means you have an overactive thyroid. Radioactive Iodine Uptake Test To detect the way thyroid gland takes in and absorbs the orally given iodine dose and uses it to produce thyroid hormones. Conclusions are drawn based on the results obtained in this test. Thyroid scan A dye-injection or oral iodine dose test that enables visualization of the thyroid gland, which is seen on a computer. It helps to detect whether a region of the thyroid gland or the entire gland is affected. Ultrasound Scan – To detect the enlargement of the thyroid gland and surrounding structures. CT or MRI Scan – Scanning specified region if a tumour is suspected. Treatment and Medications No single treatment is best for all patients with hyperthyroidism. The appropriate choice of treatment will be influenced by your age, the type of hyperthyroidism that you have, the severity of your hyperthyroidism, other medical conditions that may be affecting your health, and your own preference. Antithyroid Drugs: Drugs known as antithyroid agents-methimazole (Tapazole®) or in rare instances propylthiouracil (PTU)-may be prescribed to treat the hyperthyroidism by blocking the thyroid glands to secrete thyroid hormones. Methimazole is preferred due to less severe side-effects. These drugs work well to control the overactive thyroid, and do not cause permanent damage to the thyroid gland. Radioactive Iodine: Another way to treat hyperthyroidism is to damage or destroy the thyroid cells that make thyroid hormone. Because these cells need iodine to make thyroid hormone, they will take up any form of iodine in your bloodstream, whether it is radioactive or not. The radioactive iodine used in this treatment is administered by mouth, usually in a small capsule that is taken just once. Once swallowed, the radioactive iodine gets into the bloodstream and rapidly it is taken up by the overactive thyroid cells. The radioactive iodine that is not taken up by the thyroid cells disappears from the body within days over a period of several weeks to several months (during which time drug treatment may be used to control hyperthyroid symptoms), radioactive iodine destroys the cells that have taken it up. The result is that the thyroid or thyroid nodules shrink in size, and the level of thyroid hormone in the blood returns to normal. Thyroid surgery: Hyperthyroidism can be permanently cured by surgical removal of all or most of the thyroid gland. This procedure is best performed by a surgeon who has experience in thyroid surgery. An operation could be risky unless the hyperthyroidism is first controlled by an anti-thyroid drug or a beta-blocking drug, usually for few days before surgery, a surgeon may prescribe to take drops of nonradioactive iodine-either Lugol’s iodine or supersaturated potassium iodide (SSKI). This extra iodine reduces the blood supply to the thyroid gland and thus makes the surgery easier and safer. Beta-Blockers: Beta blockers do not stop thyroid hormone production but can reduce symptoms until other treatments take effect. Beta blockers act quickly to relieve many of the symptoms of hyperthyroidism, such as tremors, rapid heartbeat, and nervousness. Most people feel better within hours of taking beta blockers. Propranolol (Inderal®) was the first of these drugs to be developed. Some physicians now prefer related, but longer-acting beta-blocking drugs such as atenolol (Tenormin®), metoprolol (Lopressor®), nadolol (Corgard®), and Inderal-LA® because of their more convenient once- or twice-a-day dosage. Prevention and Cure Patients being treated for hyperthyroidism need to follow-up with the physician for regular monitoring. For weight loss, fatigue and other complaints a proper nutritional plan is essential. To prevent further weakness, bone thinning and to maintain good health, it is necessary to follow a proper diet plan and healthy routine as advised by the physician. Taking calcium and vitamin D supplements may be considered with medical advice. Regular exercise can help to improve bone and heart health. For those suffering from eye disturbances or Grave’s ophthalmology, special care of the eyes can help. Some measures include wearing sunglasses, applying cool eye compresses, using lubricating eye drops and raising the head while sleeping to relieve pressure on the eyes.Dr. Shailendra Kawtikwar13 Likes24 Answers
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30yrs male swelling of both legs R>L. Since 4days no other complete no pallor no sob / urine problem /no htn dm .. now bp 160/110. PR 75 bmn. Tempr normal..Dr. Vijaykumar Bagale6 Likes24 Answers
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20 Best Benefits Of Cilantro (Dhaniya) For Skin, Hair And Health stylecraze.com Oct 23, 2017 11:51 AM ￼ Cilantro, also known as coriander or (dhania patta/dhaniya) in Hindi, ‘Kothimeera’ in Telugu, ‘Kothamalli’ in Tamil, ‘Malliyila’ in Malayalam, ‘Kottambari Soppu’ in Kannada, ‘Kothmir’ in Gujarati, ‘Kothimbir’ in Marathi and ‘Dhonia Pata’ in Bengali. Here we are going to talk about impressive benefits of cilantro leaves. Read on to know more. What is cilantro? Cilantro is an aromatic herb with wide, delicate lacy leaves and a pungent smell. It belongs to the apiaceous family also known as the carrot family which comprises of plants like celery, parsley, cumin, parsnip and carrot. This herb has its origin in the Mediterranean and Asia Minor (Turkey) regions (1). The plant grows up to a height of 1 to 2 feet and possesses dark green, hairless, soft leaves having a variable shape which are broad at the base of the plant, and slender and feathery higher on near the flowering stems. All parts of the plant are edible. Its fresh leaves and dried seeds are most widely used in cooking. Cilantro seeds are round to oval in shape, yellowish brown in colour with a flavour that is aromatic, sweet and citrus as well as slightly peppery. These seeds are commonly used as spice. This Mediterranean herb forms a part of savoury dishes both in modern as well as traditional cuisines. Ancient Greeks used cilantro essential oil as an ingredient in perfumes whereas the Romans used this herb to mask the smell of rotten meat. Apart from its culinary uses, it has been found to possess certain notable plant derived chemical compounds which have disease preventing and health promoting properties. The leaves, roots and stems of cilantro plant have been found to have antiseptic and carminative properties. Health Benefits Of Cilantro: In addition to its fresh and aromatic flavour, cilantro is rich in vital vitamins and antioxidants like beta-carotene, vitamin C and folates, thus offering a variety of cilantro benefits given below. 1. Cardiovascular Health: Cilantro herb is cholesterol free but rich in antioxidants, essential oils, vitamins and dietary fibre which help in lowering LDL or bad cholesterol and increasing HDL or good cholesterol levels. Thus, it is beneficial for cardiovascular health (2). It also helps dissolve cholesterol build up in the arteries, thus helping those suffering from atherosclerosis and heart disease. 2. Lowers Blood Pressure: Apart from lowering LDL cholesterol, one of the benefits of cilantro can also reduce hypertension by lowering blood pressure. The herb is a good source of potassium, magnesium, calcium, manganese and iron as well as low in sodium. This high potassium and low sodium ratio helps control heart rate and blood pressure. Iron is vital for red blood cell production and manganese is used as a co factor for the antioxidant enzyme, superoxide dismutase. 3. Treats Anxiety: Due to its muscle relaxing qualities, cilantro may act as a mild laxative. It helps in calming the nerves, thus relieving anxiety (3) and reducing the harmful effects of stress. Drinking cilantro juice mixed with cucumber and celery juices towards the end of the day is a great way to replenish your body with B vitamins to help calm the mind and enable you to de-stress. 4. Facilitates Peaceful Sleep: By reducing anxiety and stress, cilantro helps in improving the quality of your sleep as it is a calming herb (4). 5. Digestive Aid: Cilantro leaves offer relief from indigestion problems as well as feelings of nausea. They enable the digestive tract to produce digestive enzymes as well as more digestive juices, thus preventing flatulence and settling queasy stomach (5). This herb also stimulates digestion through peristaltic action. Its antioxidant properties help in promoting healthy liver function. Cilantro leaves are a good source of roughage and fibre which help in relieving gastrointestinal problems. 6. Heavy Metal Detoxifier: Cilantro is a remarkable heavy metal detoxifier or “chelation agent” as it has been found to remove heavy metals from the body. These metals usually enter the body through consumption of non-organic food, using conventional water supplies, eating fish, using deodorants, smoking, cooking in aluminum vessels or aluminum foil, taking over the counter drugs like antacids, using vaccines or metal fillings in teeth. They cause serious heart problems like cancer, brain deterioration, emotional problems, heart, kidney and lung diseases, and weak bones. Cilantro has the ability to mobilize mercury from the brain and central nervous system by separating it from the fat tissue and transferring it into the blood and lymph where it gets removed safely in combination with blue green algae called spirulina. This combination provides relief from mercury poisoning and toxicity. Various chemical compounds in cilantro bind to toxic metals and facilitate their removal by loosening them from the tissues. 7. Anti-diabetic Properties: Cilantro has been traditionally referred to as an “anti-diabetic” herb (6) due to its ability to lower cholesterol and blood sugar levels. It is particularly beneficial for diabetic patients as it helps in regulating and keeping their blood sugar stable due+ to its high potassium and low sodium ratio. 8. Anti-inflammatory Effects: Cilantro possesses powerful anti-inflammatory capacities which can alleviate inflammatory conditions like arthritis (7) as well as reduce minor swelling. It also prevents conjunctivitis. 9. Antioxidant Properties: The antioxidant properties of cilantro (8) can be attributed to the presence of an antioxidant called quercetin among others. These antioxidants protect your cells from against oxidative stress caused by free radicals, thus delaying the ageing process and preventing chronic diseases later on in life. The antioxidant activity in cilantro provides protection against the most degenerative diseases such as cancer, diabetes, macular degeneration, Alzheimer’s disease and heart disease. 10. Anti-bacterial and Anti-fungal Properties: Cilantro contains an anti-bacteria compound called dodecenal which can kill salmonella bacteria and prevent salmonella poisoning (9). Its anti-bacterial properties help to improve oral health. The anti-microbial substances present in it help prevent and cure small pox as well as relive diarrhea if caused by fungal or microbial infections. 11. Natural Deodorant: Cilantro acts as a natural internal deodorant as it contains a large amount of chlorophyll that can detox the body from the inside out. By flushing out toxins from the liver, kidney and digestive tract, it helps to remove excess bacteria from the body that would otherwise set out and accumulate in your armpits and feet. Chlorophyll can inhibit bacteria due to its high oxygen content and therefore, this herb helps your body deodorize and smell great. 12. Aids in Weight Loss: This herb is great for obese people as it helps in the reduction of fats and therefore, aids in weight loss (10). 13. Treatment of Menstrual Disorders: Cilantro seeds are a good source of linoleic acid, ascorbic acid, steric acid and palmitic acid. They support proper secretion of hormones and prevent menstrual disorders. For this purpose, they should be soaked overnight in water and consumed the next morning to get maximum benefits. 14. Other Benefits: Cilantro is a great source of essential vitamins and minerals. It is rich in iron which is beneficial for people with lower haemoglobin levels and cures anaemia. Magnesium, on the other hand, facilitates proper functioning of the nervous system and strengthens the bones. Chewing of raw cilantro leaves is helpful for people suffering from bronchitis and asthma (11). The oil extracted from cilantro has antiseptic properties that help in curing mouth ulcers. ￼ Image: Getty Cilantro: Skin Benefits We all long for a healthy glowing skin and it is a well-known fact that skin health depends upon internal health to a great extent. Just like the rest of the body, our skin also needs proper nutrition to maintain its health and minimize skin problems. For this purpose, it is important to maintain a balanced diet. Besides, certain external factors also adversely affect our skin such as exposure to UV rays, harsh chemical treatments, prolonged illness etc. As far as cilantro is concerned, it can be beneficial in skincare as it contains certain vital nutrients and minerals that are needed for a healthy skin. 15. Treatment of Blackheads and Acne: Cilantro juice is quite effective in getting rid of blackheads and acne (12). For this purpose, you can mix 1 teaspoon of cilantro juice with 1 teaspoon of lime juice. Apply it on the affected areas and leave for an hour. Wash off with warm water. 16. Treatment of Skin Disorders: Cilantro acts as a natural antiseptic and anti-fungal agent in the treatment of skin disorders like dermatitis (13) and eczema. It possesses anti-microbial substances which can prevent and cure small pox too. 17. Good for Oily Skin: Cilantro can absorb excess oil from your face. If you have an oily skin, you can apply cilantro juice on your face and wash off after an hour. 18. Anti-ageing Benefits: As stated earlier, cilantro is rich in several antioxidants that prevent the free radicals from damaging the skin cells. Vitamin A is an important fat soluble vitamin and antioxidant that is vital for maintaining healthy mucus membranes and skin. Vitamin C is a powerful natural antioxidant that fights free radicals, thus preventing signs of ageing (14) such as wrinkles, sagging skin and pigmentation. 19. Lightens Dark Lips: If you are suffering from dark lips, you can apply cilantro juice on your lips to lighten their colour. Cilantro: Hair Benefits Proper supply of nutrients to the hair follicles is the key to maintaining a healthy scalp with lustrous locks. Though it seems unlikely, consuming and applying cilantro can be beneficial for your hair as well. 20. Combats Hair Loss: Cilantro juice is a wonderful remedy for promoting new hair growth and combating hair loss as it contains essential vitamins and proteins which help in hair growth. You can make a paste from fresh cilantro leaves using few drops of water and extracting its juice. Apply this on your scalp for an hour before shampooing. This pack should be used twice a week for 2 to 3 weeks to get effective results. Alternatively, you can infuse your hair oil with a powder made from cilantro seeds while massaging your hair. You can also prepare a hair rinse by boiling a bunch of cilantro leaves in water and cooling it. Cilantro Nutritional Facts Check out here the nutritional value of cilantro: Cilantro (Coriandrum sativum), Fresh, Nutrient value per 100 g(Source:USDA National Nutrient databasePrincipleNutrient ValuePercentage of RDAEnergy23 Kcal1%Carbohydrates3.67 g3%Protein2.13 g4%Total Fat0.52 g2%Cholesterol0 mg0%Dietary Fiber2.80 g6.5%VitaminsFolates62 µg15.5%Niacin1.114 mg7%Pantothenic acid0.570 mg11%Pyridoxine0.149 mg11%Riboflavin0.162 mg12%Thiamin0.067 mg5.5%Vitamin A6748 IU225%Vitamin C27 mg45%Vitamin E2.50 mg17%Vitamin K310 mcg258%ElectrolytesSodium46 mg3%Potassium521 mg11%MineralsCalcium67 mg7%Iron1.77 mg22%Magnesium26 mg6.5%Manganese0.426 mg18.5%Phosphorus48 mg7%Selenium0.9 mg2%Zinc0.50 mg4.5%Phyto-nutrientsCarotene-α36 µg—Carotene-ß3930 µg—Crypto-xanthin-ß202 µg—Lutein-zeaxanthin865 µg— Cilantro has an amazing nutritional value (15). This herb is loaded with vitamins A, K and C, minerals, such as iron, calcium and magnesium, and has more antioxidants than most fruits and vegetables. Its nutritional value is explained below. Calories: Cilantro is calorie and fat free. Nine sprigs of this herb provide just 5 calories. Antioxidants: The leaves and stem tips of this herb are rich in antioxidant polyphenolic flavonoids such as quercetin, kaempferol, rhamnetin and egignenin. These phytochemicals as well as essential oils render it usable in many traditional medicines as an analgesic, antispasmodic, carminative, deodorant, depurative, digestive, fungicidal and stimulant. Vitamins: Cilantro contains many vital vitamins like folic acid, riboflavin, niacin, vitamin A, vitamin C, vitamin K and beta carotene. Vitamin C is a powerful antioxidant. A 100 grams serving of cilantro leaves provide 30% of the recommended daily allowance (RDA) of vitamin C. It also provides 6748 IU of vitamin A which is about 225% of RDA. Cilantro is one of the richest herbal sources of vitamin K with 100 grams of this herb providing 258% of the RDA. Vitamins A and flavonoids provide protection from lung and oral cavity cancers. Vitamin K plays an important role in bone mass building by promoting osteotropic activity in the bones Minerals: Cilantro is a good source of minerals like potassium, calcium, manganese, iron and magnesium. Volatile Oils: The leaves and seeds of cilantro contain essential volatile oils such as borneol, cineol, linalool, cymene, terpineol, dipentene, phellandrene, pinene and terpinolene. Hope you like this post on benefits of cilantro leaves. Do how you enjoyed reading the post in the comment section below. Recommended Articles:Dr. Tapan Kumar Sau8 Likes20 Answers