World Heart Day - 29 September 2020
Did you know?? 1 in 4 deaths in India is because of Cardiovascular Diseases with Ischemic Heart Disease and Stroke contains >80% of this burden. Why India is at higher risk for Cardiovascular Diseases as compare to other western population? Share your views with us in the comment section.
There are various reasons behind higher risk for CVD; Lacking awareness among people in India, illiteracy of the people or we can say that people thought that medical professionals are always try to do business with them and tell more fearful things even though for small heart disease in the name of heart a vital organ. Like that many more reason are also available. Both( Government and publics) sections are responsible for it.
Informative and educative post. People awareness and govt and community participation and regular exercise with consumption of healthy balanced diet may reduce incidence.
Most of population are not health conscious, There are lac of knowledge or health education, unhealthy diets habits, less exercise or no exercise are the causes for increasing heart disease risk in India
Lethargic life with not taking treatment properly under superficiality & believe on quakes In India everyone dedicated towards money instead of health In India smoking & alcoholism not taken in proper quantity as comparison to western These are some reason which increase chances of heart disease
No facilities at rural areas like minimum ecg Not aware of excercises More belief on rmp than a doctor
People will not follow the instructions regarding the diet and exercises as advised by the doctors More diabetic patients when compared to other countries and uncontrolled sugar levels Streeful life No emergency management possible in several rural areas Less awareness about the condition and illiteracy
See, If you are not COVID-19 TRAINED & CERTIFIED PLEASE DONT MESS WITH SUCH CASES THIS IS A REQUEST. Secondly, you have not posted Lab reports
Nice informative post Doctor
India is at Higher high bcoz one of the major cause is prolong SITTING.. Imbalanced diet These two increase the chances of diabetes , arteriosclerosis which leads to CVD
There are some reason behind higher risk for CVD Unhealthy lifestyle Unhealthy diet Five bad habits Smoking Dining out every night Not staying active Getting too stressed out Having a few too many cocktails
Cases that would interest you
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Association Between the Frank Sign and Cardiovascular Events Saleh Nazzal, MD; Arnon Blum, MD DISCLOSURES South Med J. 2018;111(8): Abstract Clinicians have attempted to find early preclinical physical diagnosis signs to detect vascular diseases at the preclinical stage and to prevent clinical deterioration in time. An interesting example of such signs is the Frank sign, which was first described by Dr Sonders T. Frank in 1973. Our goal was to summarize the clinical trials and observational studies that had examined the association between the Frank sign and cardiovascular diseases. Summarizing the 57 studies we found showed that this association could be used for early diagnosis of coronary and vascular diseases in the preclinical stage and that they were found in different populations around the world. Autopsy studies also found a strong association between the Frank sign and cardiovascular causes of death in both sexes. Cardiovascular causes of death included ischemic and hypertensive heart disease, calcific valvular stenosis, ruptured dissecting aneurysm of the thoracic aorta, and ruptured atheromatous aneurysm of the abdominal aorta. The Frank sign was correlated with increased intima-media thickness and stroke and was found in patients with peripheral vascular disease and with cardiovascular risk factors. The Frank sign could serve as a physical sign to help clinicians diagnose cardiovascular diseases. Introduction In the last decade physicians have learned to rely on advanced technology to detect subclinical stages of atherosclerosis. Cardiovascular diseases are among the most common causes of morbidity and mortality worldwide. They constitute approximately 31% of all deaths globally every year, or 17.5 million individuals annually.[1] Clinicians have attempted to find early preclinical physical diagnosis signs to detect vascular diseases at the preclinical stage and to prevent clinical deterioration in time.[2] There remains, however, great debate about the accuracy and reliability of such "natural" means. An interesting example is the Frank sign, which was first described by Dr Sonders T. Frank in 1973. It is a diagonal earlobe crease at a 45° angle, in varying depths, that starts from the tragus and extends to the edge of the auricle. Frank made a clinical observation that 19 of 20 patients with the crease had at least one of the known cardiovascular risk factors.[3] The Frank sign can be classified by the length of the crease. It is considered complete when it crosses the entire earlobe, whereas it is considered incomplete when it is visible only partly through the earlobe (Figure 1). The Frank sign also can be evaluated by its depth. Mild is graded when it is visible as a superficial wrinkling on the earlobe, moderate when it is seen as a sulcus with visible base, and severe when the sulcus is so deep that the base is not visible (Figure 2).[4] In addition, a stronger association between the Frank sign and coronary heart disease was found when the sign existed in both ears, not only in one ear.[5–7] Figure 1. The Frank sign classification according to length: complete (A) and incomplete (B). Figure 2. The Frank sign classification according to depth: (A) mild is graded when it is visible as a superficial wrinkling on the earlobe, (B) moderate is graded when it is seen as a sulcus with visible base, and (C) severe is graded when the sulcus is so deep that the base is not visible. The Frank sign has been documented in sculptures from the time of ancient Rome. The earliest work of art is believed to date to the Roman emperor Hadrian (76–138 CE; Figure 3); it was described by Patrakis, who found an association between the Frank sign in this ancient statue and the medical history of Hadrian, who experienced recurrent events of epistaxis and hypertension.[8] Recently, Charlier and Deo[9] identified bilateral earlobe creases in the 1880 death mask of French novelist Gustave Flaubert (1821–1880), who died at age 59 years from brain hemorrhagic stroke, and Galassi et al identified numerous instances of the Frank sign in Renaissance art.[10] Figure 3. Roman emperor Hadrian (76–138 CE). The arrow points to the Frank sign. Our goal was to summarize the clinical trials and observational studies that had examined the association between the physical sign, the Frank sign, and cardiovascular diseases. We searched PubMed and MEDLINE from 1973 to July 2017 using combinations of the following key words: earlobe crease, ear lobe crease, ear-lobe, crease, ear crease, ear creases, and Frank's sign. Randomized controlled trials, original papers, review articles, and case reports were included in the present review. We found 57 papers that summarized clinical observations and clinical retrospective and prospective studies that looked into this interesting association between a physical sign detected during a medical physical examination and the clinical events that follow. In a study that examined 215 Indian patients from different communities, the bilateral Frank sign was significantly associated in patients with documented coronary artery disease (CAD; P < 0.001). The prevalence of the Frank sign increased with advancing age. The combined presence of the Frank sign and ear canal hair represented a more sensitive index of CAD.[5,6] The association between the Frank sign and CAD was studied prospectively among 956 patients with ischemic heart disease who underwent coronary intervention. The Frank sign was associated with ischemic heart disease mainly in patients with more than four cardiovascular risk factors. An increased rate of cardiovascular complications was found following coronary intervention in patients who had a bilateral Frank sign.[7] The first controlled study that examined the relation between the Frank sign and cardiovascular disease found that 47% of 531 patients who had acute myocardial infarction also had the Frank sign (unilateral or bilateral), which is significantly greater than the 30% rate of the Frank sign observed among 305 age-matched control subjects with no clinical evidence of CAD (P < 0.001).[11] A Spanish study found that the association between the Frank sign and CAD was mainly positive and relevant among subjects between the ages of 30 and 60 years.[12] A prospective study that examined 222 patients with CAD found that the prevalence of the Frank sign among patients with coronary disease was significantly higher than those without (82% vs 38.5%). Patients with the Frank sign were prone to develop intraoperative cardiovascular complications (42.6% with vs 4.9% without) and postoperative cardiovascular complications (24.9% with vs 4.9% without).[13] Another prospective study of 286 patients with CAD who underwent coronary angiography because they demonstrated typical symptoms of angina pectoris found that of the 286 patients, 200 had critical stenosis in at least one coronary artery (>50% stenosis). There was a significant higher prevalence of the Frank sign in patients with CAD (72% vs 21%, P < 0.001). The Frank sign was detected in older patients and patients with an increased severity of coronary disease but not with other classic risk factors of coronary disease such as diabetes mellitus, hypertension, smoking, obesity, and hyperlipidemia.[14] Prospective cohort studies found that the Frank sign was associated with increased all-cause and cardiac morbidity and mortality. Patients with the Frank sign had more coronary events and were cautioned to reduce cardiac risk factors, even if they did not have any diagnostic evidence of CAD at the time of examination.[15] The Copenhagen City Heart Study tested the hypothesis that visible age-related signs may be associated with risk of coronary disease, myocardial infarction, and death independent of chronological age. Male pattern baldness, the Frank sign, and xanthelasmata predicted an increased risk of ischemic heart disease and myocardial infarction independent of chronological age and other well-known cardiovascular risk factors.[16] In a Brazilian study of 1464 patients, Tranchesi Júnior et al found that the Frank sign was present in 220 of 338 patients (65%) with CAD (>70% stenosis of ≥1 coronary artery documented by angiography) and that this prevalence was significantly greater compared with patients with the Frank sign but without coronary disease (28% of 1086 patients, P < 0.0001).[17] Both the Frank sign and CAD increased with advanced age (P < 0.0001 for both). This association remained statistically significant in all decades, except for patients older than 70 years. The presence of the Frank sign also was associated with the extent of coronary disease as measured by the number of narrowed major arteries (P = 0.015). The observed sensitivity of the sign for the diagnosis of coronary disease was 65%, with a specificity of 72%, a positive predictive value of 42%, and a negative predictive value of 87%. The Frank sign also was related to the severity of CAD. In stenosis in one to three coronary arteries, the prevalence of the Frank sign increased from 55% (when patients had 1-vessel CAD) to 78% (when patients had 3-vessel CAD, P = 0.015).[17] This association was found in different populations around the world; a significant association between the Frank sign and CAD was found in populations in Croatia,[18] Japan,[19] and Turkey.[20,21] In 2011 an Israeli review described the diagonal earlobe crease as an indicator of ischemic heart disease,[22] and similar results were found by a Chinese group 1 year later.[23] The association between CAD and the Frank sign was studied in 430 individuals without a history of coronary heart disease using coronary computed tomography. The Frank sign was present in 71% of the patients with documented CAD (a 50% stenosis at least in one of the coronary arteries). The prevalence of coronary significant lesions in 307 patients with the Frank sign was 77%, significantly greater compared with 55% of 123 patients without the Frank sign (P < 0.001). The sensitivity, specificity, and positive and negative predictive values for the Frank sign to diagnose any CAD were 78%, 43%, 77%, and 45%, respectively.[24] Adding the Frank sign to the cardiovascular risk assessment of patients with angina pectoris improved the prediction of CAD beyond the Diamond-Forrester classification
Dr. Gaurav Chhaya1 Like5 Answers - Login to View the image
Interpret the ECG !! List come on causes ? How this patient should be managed ?
Dr. Neeraj Mangla10 Likes26 Answers - Login to View the image
40 year old male presented with grade 3 dyspnea. No chestpain/ palpitations/ orthopnea/pnd Interpret the ecg
Dr. Radha Krishna Telagareddy9 Likes26 Answers - Login to View the image
Friends today I am discusing about Fatty Liver problem . A number of health problems today are caused by an unhealthy lifestyle. One such condition is a fatty liver or collection of fat in the liver. The buildup of fats in the liver is known as Fatty Liver. The liver processes everything that you eat or drink and filters harmful substances from the blood. If too much fat has accumulated in the liver, this process gets interfered with. These fat cells cause inflammation of the liver tissues which in time can lead to scarring and liver fibrosis. On its own, a fatty liver is relatively harmless, but when it reaches this stage, it can be life threatening. The reasons for Fatty Liver can be alcoholism, incorrect diet, obesity, diabetes, or even excess use of medication. If ignored or left untreated, many liver diseases will lead to permanent and irreversible damage to the liver and can be a significant threat to your health. But, there is no standard form of treatment for a fatty liver. If diagnosed in its early stages, treating the underlying cause can stop the progression of the disease and even resolve it. Homeopathy addresses the underlying causes of a disease and hence is an ideal form of treatment for a fatty liver. It can reduce the symptoms of this disease, improve liver functioning and even reverse the condition if treatment is started early. The Homeopathic medicines, which are made of natural substances, are given to patients after studying the unique symptoms experienced by each individual. Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. Homoeopathy is very proficient in managing all the symptoms of Fatty liver disease and furthermore plays a vital role in preventing relapse of the condition. Some of the most common homeopathic medicines for fatty liver are Chelidonium: This is often used to treat a fatty liver accompanied by right upper abdominal pain. In such cases, the liver may be enlarged and the patient also usually suffers from constipation or experience nausea and vomiting. The patient will also probably suffer from excessive weakness and have a desire for hot food and drinks. Lycopodium: A fatty liver accompanied by acidity can be treated with this type of homeopathic medication. In such cases, the patient will also complain of bloating and belching with a burning sensation. These symptoms tend to worsen n the evening and the patient may have an intense craving for sweets and hot drinks. Phosphorus: This is used to treat cases of fatty acid which triggers regurgitation accompanied by sour belching. In some cases, the patient may also experience pain in the liver and excessive flatulence. Vomiting may also occur along with weakness while passing stool. Calcarea carb: Obese patients suffering from this condition can be treated with calcarea carb. These people often have a distended abdomen, are lactose intolerant and suffer from chronic constipation. They are also overly sensitive to cold air and sweat excessively from the head. Nux Vomica: homeopathic remedy for fatty liver with pain in abdomen after eating. Nux vomica is great for any abdominal problem including fatty liver caused by excessive consumption of alcohol. These patients often suffer from abdominal pain a few hours after eating with sour or bitter tasting belches. They may constantly feel the urge to pass stool but are unable to do so. Though homeopathic remedies have negligible side effects when taken in low dosages, they should never be self-prescribed. If you suffer from a fatty liver, consult a homeopathic doctor immediately who can diagnose it properly and treat you accordingly.
Dr. Rajesh Gupta4 Likes16 Answers - Login to View the image
45m diabetic on OHA,controlled,bp normal rarely upto140/90 has no any complaints ecg after 5killometer walking routine checkup…… plz expert opinion if there is any future warning…………… history only genetical diabetics
Dr. Dinesh2 Likes27 Answers
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