Yes Mam , Sarpagandha, Shankhpushpi, Jatamansi, Ashwagandha help alleviate cognitive dysfunction, which is often affected by Sleep Apnea Intake of these medicines will reduce stress-conditions, anxiety, and prevent obstructive Sleep apnea .
NEED'S.. SARPAGANDHA .. ASHWAGANDHA .. SHANKHPUSHPI .. JATAMANSI ..
Sleep Apnea is commomly appears in Obese patients.. Weight reduction should be in the plan of treatment and vamana karma is also helpful in this condition and wellness of respiratory tract by using kanakassava or drakshasava...
Tagar jatamansi shankhpuspi brahmi Ashwagandha mix take half to 1 ts with milk 1 hr before going to sleep..
Aswegandha And sasvetarishest
Please advise the patient to undergo Nasya with Shadbindu taila for 7 days Orally advise Tab Immunocin OD Cap Aswal plus 2 at night after food
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B M I n O B E S I T Y BMI is commonly used to diagnose overweight and obesity, often in conjunction with measurement of waist circumference. Leading guidelines, such as those produced by the American Association for Clinical Endocrinology (AACE),the UK National Institute for Health and Care Excellence (NICE), and the European Association for the Study of Obesity (EASO),consider a BMI of 30 kg/m2 to be the threshold for obesity, and describe 3 classes of obesity, rising in severity from low-risk/class 1 (between 30.0 and 34.9 kg/m2), through moderate-risk/class 2 (between 35.0 and 39.9 kg/m2), to high-risk/class 3 (≥40.0 kg/m2). Lower BMI thresholds may be recommended for black African, African-Caribbean, and Asian (particularly South Asian) populations in order to trigger action to reduce the risk for comorbid conditions. For example, in the NICE guidelines, a BMI of 23.0 kg/m2 in these groups indicates increased risk for type 2 diabetes mellitus (T2DM), and 27.5 kg/m2 indicates a high risk. Obesity is a global epidemic and its prevalence more than doubled between 1980 and 2014. In 2014, more than 1.9 billion adults (≥18 years), which is 39% of all adults, had overweight. More than 600 million had obesity, representing 13% of all adults. The fundamental cause of obesity and overweight is an imbalance between calories consumed and expended. Changes in dietary and physical-activity patterns worldwide have led to the increase in obesity and overweight.Obesity is a serious chronic condition that is associated with multiple comorbidities and decreased life expectancy.An increase in BMI increases a person's risk for cardiovascular disease (CVD), and obesity is an independent risk factor for CVD.It also increases the risk for T2DM; fatty liver disease; musculoskeletal disorders, in particular osteoarthritis; and some cancers, including breast, colon, kidney, and pancreatic cancer.Higher BMIs are also associated with cognitive/mood disorders, obstructive sleep apnea, gallstones, and gastroesophageal reflux. Classes 2 and 3 obesity are associated with significantly higher all-cause mortality than class 1 obesity and normal weight.Other factors, such as waist circumference, also contribute to the increased risk for obesity-related disease. As well as fat accumulation, fat distribution is related to obesity-related mortality and morbidity. Central obesity, also known as the apple shape, confers a higher risk than general obesity for several chronic diseases.In recent years, there has been a broadening of focus from BMI alone, so that the management of obesity-related comorbidities is also a priority Physical-activity counseling is an integral part of obesity management, but would not be effective on its own. EASO guidelines recommend that pharmacological therapy is considered in patients who are overweight or who have class 1 obesity if they also have comorbidities. Treatment guidelines recommend that the first stage in managing patients with obesity is to assess their views of their weight and the diagnosis, as well as the possible reasons for weight gain. Failure to engage patients and to convince them of the benefits of lifestyle interventions aimed at weight loss is likely to result in the lifestyle interventions being less effective. Therefore, this is an important first step. Eating patterns and physical-activity levels should be explored, as well any beliefs about diet, exercise, and weight gain that may be unhelpful to the patient. The physician should find out if the patient has already tried to lose weight and how successful these efforts were. They should assess the patient's confidence and willingness to engage in a weight-loss program. The health and other risks of obesity should be explained, as well as the benefits of weight loss and increasing physical-activity levels. The physician should be aware that a patient's feelings about obesity and other health problems, such as surprise or denial, may reduce their willingness or ability to change. For this reason, it may help to stress that obesity is a clinical condition with specific implications for health, rather than something that focuses on how a patient looks. It has reported a divergence in the perception of obesity between people with obesity and the clinicians treating them. For example, 65% of people with obesity consider obesity to be primarily a lifestyle disease and 44% think it is possible to have obesity and be healthy, compared with 88% and 4%, respectively, for clinicians. Barriers can be motivational, such as lack of willpower, emotional/personal, such as eating habits, or practical/systemic, such as medication costs or lack of support services. A comprehensive lifestyle intervention is a fundamental part of the management of obesity. This consists of lifestyle/behavioral training, a dietary calorie-reduction plan, and increased physical activity.When developing a weight-loss plan for a patient, the main requirement is that total energy intake is less than total energy expenditure.This will help address the imbalance of energy regulation that characterizes obesity. Obesity develops when the body's weight and energy regulatory mechanisms do not work properly, leading to an elevated body fat "set point," ie, the amount of fat the body wants to retain. The energy intake behavior of an individual is determined by whether he or she is at, above, or below the set point. Diets with a daily deficit of 600 kcal, leading to a 5% to 10% reduction in current body weight over 6 months, are considered to be realistic and have proven health benefits.Lower-calorie diets with an intake of 800 to 1600 kcal/day can be considered, but they are less nutritionally complete. Very low-calorie diets (<800 kcal/day) should not be routinely used to manage obesity. Evidence from systematic reviews suggests that, although initial weight loss is more rapid with very low-calorie diets, weight change after 1 year is not very different from comprehensive approaches. Physical activity is part of a comprehensive lifestyle intervention. Although it may have only modest effects on weight loss, it will bring other benefits, such as a reduction in the risk for T2DM and CVD.Physical activity also helps to preserve fat-free mass during weight loss and promote weight maintenance. People who have had obesity but have lost weight may need to do 60 to 90 minutes of activity per day to avoid regaining weight. Weight loss is difficult to achieve for most patients with obesity because a desire to restrict caloric intake is counteracted by biological responses to weight loss. The reduction in energy expenditure and increase in appetite that occur after weight loss are associated with changes in several hormones. Some of the hormonal changes result in altered physiology that leads to weight gain, whereas other changes lead to improvements in hormonal systems as the patient gets closer to a healthy weight. Weight-loss medications aim to reinforce the patient's efforts to change eating behaviors and produce an energy deficit.Most promote weight loss through their effects on appetite -- increasing satiety and decreasing hunger. It is possible that satiety signaling and inhibitory control are weaker in people who are prone to obesity. Many treatment guidelines recommend that weight-loss medication is considered for patients with a BMI ≥30 kg/m2 or a BMI ≥27 kg/m2 if they also have 1 or more comorbidities and a history of failure to lose weight.The inclusion of comorbidities in the criteria reinforces the benefits of weight loss for people with obesity-related disease. ORLISTAT Unlike most weight-loss medications, orlistat is a reversible gastric and pancreatic lipase inhibitor that blocks absorption of 30% of ingested fat from a 30% fat diet when taken at the recommended dosage (120 mg 3 times per day). It is approved for use in adults and adolescents, is considered one of the safest drugs in its category, and is available in most countries around the world. However, it has well-documented GI adverse events, such as fecal leakage, which limit its popularity. NALTREXONE/BUPROPION This is a sustained-release combination of an opioid receptor antagonist (naltrexone) and a noradrenaline reuptake inhibitor (bupropion). Naltrexone has a minimal weight-loss effect on its own,but it acts synergistically with bupropion to stimulate central melanocortin pathways and antagonize inhibitory feedback loops that limit weight reduction. This leads to improved energy expenditure and a reduction in appetite.The maximum total daily dose is 32 mg naltrexone/360 mg bupropion.Naltrexone/bupropion is associated with increased BP, so it should be avoided in patients whose hypertension is not controlled, and BP should be monitored in the initial phase of therapy. The most common adverse events are nausea, headache, vomiting, anxiety, and insomnia. The risk for GI events can be minimized by gradual titration. Other anti obesity drug is Liraglutide but this and Naltrexone are not available n approved in India by FDA .Only Bupropion is available but at present is used in smoking cessation n in depression.Dr. Girish Dahake12 Likes21 Answers
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I'm 35 Yrs old and these reports are of mine. I'm apparently healthy except grade I truncal obesity. I have Isolated Diastolic Hypertension diagnosed 7 days ago on routine measurement of BP at 10 O'clock at night which have been confirmed checking it up for consecutive 3 days at 8 AM and 10 PM. SBP is varying between 122 and 130 but diastolic is between 90 and 100. I am non alcoholic, don't intake tobacco in any form. Don't like to take sweet food items. Don't take egg yolk. Mutton, Tandoori, Biryani, Fried and Grilled items are my favourites but neither eat frequently nor in excess. My daily food items content much of carbohydrates. Don't use much oil and salts in curries. My mother had hypothyroidism, type 2 DM, hypertension and died in AMI at the age of 60. My two maternal uncles also died of heart diseases at the age of 60 and 68 one of them was diabetic. One of my maternal aunt also had heart disease (probably MI). My Grandmother died of osteosarcoma. Waiting for your advices and suggestions.Golam Mortuza2 Likes12 Answers
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60y/o male with essential thrombosis high platelets on 1000mg Hydra/d and 75mg Aspirin/d presented with severe mouth cankers largest 10mm on the tongue, patient has difficulty eating and taking fluids. He tried the usual mouthwash and OTC gels but little success. Suggestions, please!Dr. Nitin Jaiswal2 Likes16 Answers
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Friends today I am discussing about a very common problem occurs in change of weather known as tonsillitis. What is tonsillitis? Tonsils are the two lymph nodes located on each side of the back of your throat. They function as a defense mechanism. They help prevent your body from infection. When the tonsils become infected, the condition is called tonsillitis. Tonsillitis can occur at any age and is a common childhood infection. It is most often diagnosed in children from preschool age through their midteens. Symptoms include a sore throat, swollen tonsils, and fever. This condition is contagious and can be caused by a variety of common viruses and bacteria, such as Streptococcal bacteria, which causes strep throat. Tonsillitis caused by strep throat can lead to serious complications if left untreated. Tonsillitis is easily diagnosed. Symptoms usually go away within 7 to 10 days. Find a internist or a pediatrician or an ENT near you. Causes of tonsillitis Tonsils are your first line of defense against illness. They produce white blood cells to help your body fight infection. The tonsils combat bacteria and viruses that enter your body through your mouth. However, tonsils are also vulnerable to infection from these invaders. Tonsillitis can be caused by a virus, such as the common cold, or by a bacterial infection, such as strep throat. According to the American Academy of Family Physicians (AAFP), an estimated 15 to 30 percent of tonsillitis cases are due to bacteria. Most often it's strep bacteria. Viruses are the most common cause of tonsillitis. The Epstein-Barr virus can cause tonsillitis, which can also cause mononucleosis. Children come into close contact with others at school and play, exposing them to a variety of viruses and bacteria. This makes them particularly vulnerable to the germs that cause tonsillitis. Symptoms of tonsillitis There are several types of tonsillitis, and there are many possible symptoms that include: a very sore throat difficulty swallowing or painful swallowing a scratchy-sounding voice bad breath fever chills earaches stomachaches headaches a stiff neck jaw and neck tenderness due to swollen lymph nodes tonsils that appear red and swollen tonsils that have white or yellow spots In very young children, you may also notice increased irritability, poor appetite, or excessive drooling. There are two types of tonsillitis: recurrent tonsillitis: multiple episodes of acute tonsillitis a year chronic tonsillitis: episodes last longer than acute tonsillitis in addition to other symptoms that include: chronic sore throat bad breath, or halitosis tender lymph nodes in the neck When to see a doctor In rare cases, tonsillitis can cause the throat to swell so much that it causes trouble breathing. If this happens, seek immediate medical attention. See a doctor if you experience the following symptoms: fever that’s higher than 103˚F (39.5°C) muscle weakness neck stiffness sore throat that doesn’t go away after two days While some tonsillitis episodes go away on their own, some may require other treatments. How tonsillitis is diagnosed Diagnosis is based on a physical examination of your throat. Your doctor may also take a throat culture by gently swabbing the back of your throat. The culture will be sent to a laboratory to identify the cause of your throat infection. Treatment for tonsillitis A mild case of tonsillitis does not necessarily require treatment, especially if a virus, such as a cold, causes it. Treatments for more severe cases of tonsillitis may include antibiotics or a tonsillectomy. Antibiotics will be prescribed to fight a bacterial infection. It’s important you complete the full course of antibiotics. Your doctor may want you to schedule a follow-up visit to ensure that the medication was effective. Surgery to remove the tonsils is called a tonsillectomy. This was once a very common procedure. However, tonsillectomies today are only recommended for people who experience chronic or recurrent tonsillitis. Surgery is also recommend to treat tonsillitis that doesn’t respond to other treatment, or tonsillitis that causes complications. If a person becomes dehydrated due to tonsillitis, they may need intravenous fluids. Pain medicines to relieve the sore throat can also help while the throat is healing. Home care tips to ease a sore throat drink plenty of fluids get lots of rest gargle with warm salt water several times a day use throat lozenges use a humidifier to moisten the air in your home avoid smoke Also, you may want to use over-the-counter (OTC) pain medications, such as acetaminophen and ibuprofen. Always check with your doctor before giving medications to children. Tonsillitis complications People who experience chronic tonsillitis may start to experience obstructive sleep apnea. This happens when the airway swells and prevents a person from sleeping well. It’s also possible the infection will worsen and spread to other areas of the body. This is known as tonsillar cellulitis. The infection can also cause a person to develop a buildup of pus behind the tonsils, which is known as peritonsillar abscess. This can require drainage and more surgery. If a person doesn’t take a full course of antibiotics or the antibiotics don’t kill off the bacteria, it’s possible a person could develop complications. These include rheumatic fever and poststreptococcal glomerulonephritis. Preventing tonsillitis Tonsillitis is highly contagious. To decrease your risk of getting tonsillitis, stay away from people who have active infections. Wash your hands often, especially after coming into contact with someone who has a sore throat, or is coughing or sneezing. If you have tonsillitis, try to stay away from others until you are no longer contagious. Outlook for tonsillitis Swollen tonsils may cause difficulty breathing, which can lead to disturbed sleep. Tonsillitis left untreated can result in the infection spreading to the area behind the tonsils or to the surrounding tissue. Symptoms of tonsillitis caused by a bacterial infection usually improve a few days after you begin taking antibiotics. Strep throat is considered contagious until you have been taking antibiotics for a 24-hour period. Strep Throat Strep throat is a bacterial infection that causes inflammation and pain in the throat. This common condition is caused by group A Streptococcus… Diphtheria Diphtheria is a bacterial infection that affects the throat and nose. Get the facts on causes, symptoms, treatment, and prevention. What’s the Difference Between Tonsillitis and Strep Throat? Tonsillitis can be caused by various viruses or bacteria. Strep throat is only caused by group A Streptococcus bacteria. Tonsillectomy A tonsillectomy is a surgical procedure to remove the tonsils, which are located in the back of your throat. Sometimes they can become infected. Here there are some common homeopathic medicines given for tonsillitis Belladonna – belladonna is the most common and hugely prescribed homeopathic medicines for tonsillitis. Belladonna has the best anti inflammatory action and thus helps a lot to relief the symptoms both in acute and chronic condition. The key symptoms by which belladonna is prescribes are – pain in throat at the time of wallowing, red congested and swelling of tonsils, mild to moderate fever associates with tonsillitis, headache and malaise also present. The tonsils are been affected by taking any cold things like chilled drink or ice cream or cold drink or exposing to cold air etc. The throat pain is slightly relieved after taking any sort of warm drink. If all those symptoms are prominently found in a tonsillitis patient then belladonna is the suitable medicine for that person. Mercurius Solubis- Here is another best hoemopathy medicine for tonsillitis. The key symptoms to prescribe tonsillitis are – pain in throat, congestion of tonsils and unable to drink or eat anything. There is more salivation from mouth. The pain is worse in the night time in compare to day time. There is swelling of tonsils and also swelling of other lymph nodes in neck and sub mandibular regions. There is mild to moderate fever and the person feels thirsty though there is more salivation. If the above symptoms are prominent in any tonsillitis patient this medicine is most suitable medicine for that person Phytolacca- it is also one of the important homeopathic medicine for tonsillitis. The tonsils are dark red or bluish red in colour. There is much pain at the root of tongue, soft palate. The tonsils are swollen. There is a sensation of a lump in throat. While taking any food the throat feels rough, narrow, and hot. The Tonsils are swollen, especially of right side. There is a sharp shooting pain into ears on swallowing anything. There is much pain when swallow anything hot. The pain of phytolacca is burning type of pain. The person cannot swallow anything even water. Hepar Sulphur- Hepar Sulphur is one of the best Homeopathic medicines for tonsillitis. The tendency to suppuration is most marked, and has been a strong guiding symptom in tonsillitis. When swallowing, sensations as if a plug and of a splinter like sensation in throat. There is quinsy with suppuration of tonsils. When swallowing there is stitching type of pain in throat extending to the ear. There is mild to moderate fever and chilliness is feeling during the tonsillitis affection. The person is very chill and cannot tolerate any cold air or cold water. Calcarea Carb –It is a medicine for chronic tonsillitis problem.The person is bulky, obese, gaining weight easily. He is though fatty but very weak in stamina. Exhausted or tired on slightest physical activity. He/she sweats a lot on slightest physical exertion. He is very susceptible to catch cold. the tonsils are large, swelled and get acutely affected on slightest exposure to cold. The throat appearance itself is not always sufficient to prescribe on, but the complaints in the throat are those that come on in persons taking cold so frequently. On every cold he will have cough, tonsil affection, appetite lost. The calcarea carb child is very lazy and lethargic in nature. he takes cold from every, draft, from very exposure, and from damp weather. There are little red patches in the throat, this extends to the roof of the mouth, a sore tongue, and a constant dry, choking feeling in the pharynx, covering the tonsils. The throat is very painful on swallowing. Baryta Carb – it is one of the 1st grade medicine for chronic tonsillitis. The tonsils are inflamed, swelled and very painful in acute condition. After the acute attack passed on the tonsils looks larger than with the last cold. The child is weak, not fatty like calcarea carb. Physically and also mentally he is week. He/she has a tendency to catch cold very easily. But the most important symptom is whenever he catch cold first it attack to the tonsil or throat. So it is written in allens materia medica that every cold settles in the throat. The person sweats more from the feet. Every cold change inflames the tonsils, and in children they very soon enlarge. Children with enlarged tonsils, and with enlarged glands in other places, somewhat weak intellectually, slow to learn.The throat is very painful on swallowing.On every cold change of the weather, and on every exposure to the cold, he gets rattling respiration.Dr. Rajesh Gupta22 Likes38 Answers
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A 28-year-old woman presents for evaluation of excessive daytime sleepiness since she was a teenager. She complains of falling asleep at traffic lights, and she has had five to six near-miss accidents. She admits to three naps per day, two in the afternoon and one in the evening. Associated symptoms choking sensation at night, morning headaches, and vivid dreams at sleep onset. Her sleep habits include going to bed around 12 AM with a latency to sleep within 5 minutes, and getting out of bed at 7 AM. Past medical history is significant only for hyperlipidemia. She is not presently taking any medications. Investigation: PSG -Total sleep time: 474 minutes; Time in bed: 479 minutes; Sleep efficiency: 99% Latency to sleep onset: 1 minute; Latency to REM sleep 58.5 minutes %Stage 1: 8.3, %Stage 2: 72.3, %Slow wave 3.4, %REM 16.0 AHI 7.5/hr (NREM AHI 10.3/hr; REM AHI 6.9/hr; supine AHI 7.5/hr; non-supine AHI 7.0/hr) %TST spent with SaO2<90%: 0% PLMI 0.0/hr Please guide what can be done?Dr. Anusha Verma3 Likes18 Answers