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EMERGENCY CASE OF THE WEEK

DEPARTMENT OF CARDIOVASCULAR MEDICINE

A CASE OF MALIGNANT HYPERTENSION
(Updated 19.2.2013)
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Patient Name: ****** Gupta aged: 33 years, Female

Diagnosis: Malignant Hypertension

Emergency Crisis: High Blood Pressure 

Patient reported to our Cardiology OPD on 24.6.2011 (1.30 PM) in a
quiet uneasy condition with her work colleague (Bank) and while
entering the clinic, near reception, she vomited and fell while her
colleague was getting the registration slip for the patient.

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On Emergency call, patient was made lie down on chair and was managed as per the presentation.
​
​
Case Presentation

Patient while entering the reception, suddenly vomited and fell on side without any known cause or complaint. The accompanying office colleague could interpret only that she complained of severe headache since morning and just 10 minutes back, she started complaining of nausea and was brought to us.

No symptoms (except headache), no past history and no drug history could be collected as patient was lying in painful condition and was unable to tell her symptoms.

Observation & Quick Clinical Examination was the only way out to make a diagnosis and to revive the patient.

Patient had severe headache since morning with nausea and now vomiting. There was profuse sweat on her forehead and body temperature was above normal. Patient was highly sensitive to light.

B.P. was 186/124 mmHg and Pulse was 94/m, full and hard with RR of 26/m and patient was unable to interpret her symptoms due to severe headache, nausea and dizziness. There were loud Heart sounds without any added sounds.

Not wasting much time, she was prescribed ADRENALINUM 0/1 (10 Drops – STAT) on tongue at interval of 5 minutes for next 15 minutes.
Patient felt comfortable within next 15 minutes and asked for water and initiated talk with attending consultant. She easily drank 2 glasses of water and within next 5 minutes interpreted the whole story that what actually happened to her in her own words.

B.P after 10 minutes noted was 170/120 mmHg and Pulse was 90/m.

Adrenalinum 0/1 was given after 10 minutes and B.P. could be noted (after 25 minutes from start) as 156/110 mmHg and patient was feeling much comfortable and was easily talking to her colleague and attending consultant.

After talking to her, it could be found that she is suffering from HTn since last 6 years and is regularly taking Allopathic Drug for Htn but still BP sometimes shoot up like this and she feels as if she would have brain hemorrhage.

She was kept under observation for next 30 minutes and blood pressure was monitored in final on discharge as 140/96 mmHg and patient went to her car walking with ease.
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Afterwards, she took treatment for same and was fully recovered from her HTn within 6 months and all allopathic drugs were tapered off within initial 20 days.



Link to websitepage: http://drbindras.wix.com/clc3795#!emergency-case-of-the-week/c9b1 

Emergency Case of the Week

EMERGENCY CASE OF THE WEEK

Homoeopathic Emergency Case Management where lives are saved within few minutes and hours..



A CASE OF ANURIA IN BENIGN PROSTATE HYPERTROPHY
DEPARTMENT OF UROLOGY
(Updated: 8.2.2013)

Patient Name: Ku****** Singh, aged: 67 years, Male

Diagnosis: Benign Prostate Hypertrophy (Grade III)

Emergency Crisis: Anuria (more than 48 hours)

Allopathic Urologist’s Advice: Immediate Surgical Intervention


Patient reported to our Urology OPD on 17.11.2012 (11.15 AM) in quite painful and critical condition as the patient had not passed urine for last 3 days and previously catheter was inserted for last 26 days (2 times) which caused localized inflammation and tenderness and had to be removed.

USG: Grade III Prostate enlargement (Volume 56 cm3) Residual volume: 500 ml
PSA: 11.82 ng/ml

Case Presentation

Patient suddenly stopped passing urine 1 month back and was taken to a urologist (allopathic) and on examination and USG it was reported that there is obstruction of urinary outflow due to enlarged prostate and was prescribed some medications for 2 days but with no help. After 2 days catheter was inserted to relive the patient and was advised to have a observation/wait for next 7 days.

No improvement after 9 days and patient approached a Homoeopath for help and he gave medicines for next 12 days but with no relief and finally patient was advised surgical intervention within next 2-3 days.

Patient approached our UROLOGY OPD with tearing pain in abdomen and anuria with nausea and loss of appetite. Patient was feeling drossy for last 2 days and there was raised blood pressure with palpitation.

On examination B.P. was 150/110 mmHg and HR was 94 bpm and ECG was done with findings of RBBB and RAD.

Taking into consideration the case presentation, Nux vomica 10M STAT (1 dose) followed by Pulsatilla 0/1 (1 hourly) was prescribed and patient was advised complete bed rest with diet restrictions.


Next morning patient’s attendant reported with joy that patient passed 450 ml urine since last noon (in 20 hours) and is feeling much relaxed and better now.

Pulsatilla 0/1 was continued 1 Hourly and was tapered to 2 hour/3 hour for next 2 days and after 4 days, a dose of Digitalis 1M was prescribed followed by Puls 0/2 and another USG & PSA was carried out on 31.12.2012 with marked improvement.

USG: Grade III Prostate enlargement (Volume 51 cm3) Residual volume: 150 ml
PSA: 4.63 ng/ml

The urine output was 700 ml/24 hour with intake of 1000-1200 ml/24 hour day by day.

This is how with 44 days of treatment, there is a remarkable improvement in lab reports and of course in patients condition.

The patient as of now is on cardiac/urology management and is comfortably performing his daily routine work with adequate diet and is symptom free.


Link to website: http://drbindras.wix.com/clc3795#!emergency-case-of-the-week/c9b1

Winter Alert for Hypertension Patients

"During cold weather, the body restricts blood flow in an effort to maintain temperature and retain heat," said Dr Manpreet Singh Bindra, Chief Cardiologist at Cardio Life Care, Ludhiana.

"In return, the survival mechanism restricts blood movement and causes blood pressure to rise." Dr. Bindra suggests the following winter weather tips:-

•Minimize outdoor activity. 
•Dress in several layers of loose-fitting wool, silk, or polypropylene clothing.
•Always get your head covered with turban/scalf/hat or mufler. 
•Wear mittens instead of gloves.
•Eat well-balanced meals.
•Avoid alcohol and caffeine because they cause the body to lose heat more rapidly.

Dr. Bindra notes that about five percent of patients in Punjab suffer from a vascular condition known as Raynaud's Phenomenon, in which cold temperatures or strong emotions cause blood vessel spasms that block blood flow to the fingers, toes, ears, and nose. People who have this heightened sensitivity to cold experience numbing of the fingers, toes, lips, nose, and ears, their body parts become red, white, or blue due to a shrinking of blood vessels and limited blood flow.

Raynaud's Phenomenon usually affects household working women. Smoking, some heart and blood medications and migraine medications can cause primary Raynaud's Phenomenon.

As the temperature is falling rapidly, we are getting hypertension patients with aggravation of symptoms in routine, said Dr. Bindra.

So patients are being advised to follow diet and regimen instruction to avoid any complications in coming winter days.

He further noted that Homoeopathy is best and safe of all in Hypertension as most of the patients suffering from High Blood Pressure are in high risk of side effects and withdrawl effects of Hypertension Allopathy Medicines. Once a patient starts allopathic medicine for Hypertension, he has to take it for whole life and it becomes addiction for the patient. Other side Homoeopathy Medicine has to be given for short duration of time and once patient recovers well, all medications are stopped with immediate effect and patients can live for so many years without any re-currence of symptoms and without any side effects or withdrawl effects, patient lives stress free and healthy life ahead.

Source: http://drbindras.wix.com/clc3795#!newswinter-alert/clwm

Diet and Nutrition Bulletin

Pistachios are among the most nutritious of nuts you can choose. They offer morefiber in fewer calories than many other varieties, including almonds, cashews, walnuts and macadamias. With healthy fats and satiating qualities, pistachios make a healthy snack.


NUTRITIONALLY DENSE: A 1-oz. serving (~50 kernals) contains 170 calories and as much fiber as a small bowl of oatmeal. They contain high levels of vitamin B6, potassium, magnesium and phosphorous. Pistachios also offer several of the B complex of vitamins, vitamin C, vitamin E, zinc, manganese, selenium and copper.

FAT FACTS: Although pistachios seem high in fat, most of it is the unsaturated variety. Consuming unsaturated fats instead of saturated and trans-fats may help to reduce cholesterol levels.

ARGININE: Pistachios are rich in arginine, a nutrient that is believed to reduce hardening of the arteries. Arginine helps the blood make nitric oxide, which helps keep the artery walls clean.

PHYSTOSTEROLS & ANTI-OXIDANTS: Pistachios also contain phytosterols, compounds found in plants that deter your body from absorbing dietary cholesterol. Pistachios also provide 398 mcg of lutein per 1-oz. serving. Lutein is an antioxidant that helps with eye and skin health and fights free radicals that promote aging.

DIABETIC FRIENDLY: The special antioxidants found in pistachios can prevent a harmful process called glycation. Glycation occurs when sugars bond inappropriately to proteins, making the proteins unusable. This is the process by which diabetes damages tissues, and its products are called AGE or Advanced Glycation End-products. So pistachios can be a powerful ally in the treatment of diabetes and its related syndromes.

*A snack of pistachios and fruit is healthier in every way than a snack of chips, fast food fries.
* Add some ground pistachios to your milkshakes or salads and chaats.

WARNING
Pistachios have many healthy qualities, but they do contain calories. Choosing salted varieties may raise your sodium intake to unhealthy levels. Eat unsalted pistachios in moderation and avoid over-indulging.

World Heart Day 2011

What Can I do to Avoid a Heart Attack or a Stroke?

Q: What can I do to avoid a heart attack or a stroke?

A: WHO estimates that more than 17.3 million people died of cardiovascular diseases such as heart attack or stroke in 2008. Contrary to popular belief, four out of five of these deaths occurred in low– and middle–income countries, and men and women were equally affected.

The good news, however, is that 80% of premature heart attacks and strokes are preventable. Healthy diet, regular physical activity, and not using tobacco products are the keys to prevention.

Eat a healthy diet: 
A balanced diet is crucial to a healthy heart and circulation system. This should include plenty of fruit and vegetables, whole grains, lean meat, fish and pulses, and restricted salt, sugar and fat intake intake.

Take regular physical activity: 
At least 30 minutes of regular physical activity every day helps to maintain cardiovascular fitness; at least 60 minutes on most days helps to maintain healthy weight.

Avoid tobacco use: 
Tobacco in every form is very harmful to health – cigarettes, cigars, pipes, or chewable tobacco. Exposure to second–hand tobacco smoke is also dangerous. The risk of heart attack and stroke starts to drop immediately after a person stops using tobacco products, and can drop by as much as half after one year.

Check and control your cardiovascular risk:

• Know your blood pressure:
  High blood pressure usually has no symptoms, but can cause a sudden stroke or heart attack. Have your blood pressure checked.
• Know your blood sugar:
  Raised blood glucose (diabetes) increases the risk of heart attacks and strokes. If you have diabetes it is very important to control your blood pressure and blood sugar to minimize the risk.
• Know your blood lipids:
  Raised blood cholesterol and abnormal blood lipids increase the risk of heart attacks and strokes. Blood cholesterol needs to be controlled through a healthy diet and, if necessary, by appropriate medications.

Source: WHO

TOP 25 REASONS TO GET RUNNING

Running is one of the best forms of exercise, not only for getting fit but for weight control too. A 30-minute run, three to four times a week, trims your waistline, strengthens the cardiovascular system, improves muscle tone and definition and helps foster a positive mental attitude. Running can also be a great social activity. Here are the top 25 tips on why you should start running today.

1. Running is the quickest way to cardiovascular fitness. You get fitter faster by running regularly.

2. Running is one of the cheapest forms of exercising. You only need a pair of running shoes and shorts and T-shirt to get started.

3. Running is easy to learn. Most people have run at some point in their life, either competitively or at school/college, so there is no steep learning curve involved.

4. Running makes you feel good, not only physically, but mentally as well.

5. Running is excellent for reducing stress levels. There is nothing better than a run to clear your head and concentrate the mind. Many great ideas have been formulated on training runs.

6. Running is one of the most flexible methods of training around. Wherever you are in the world, it is nearly always possible to get out for a run. You can jog, steady run or sprint depending on how you feel that particular day.

7. Running is good for your heart. It not only strengthens the heart but also reduces the actual resting heart rate.

8. Running is accessible to all. As long as you are physically able, you can go for a run virtually anytime and anywhere. There are no race barriers to running.

9. Running helps you to lose weight and tone muscles. The more your train and run, the more weight you will lose. Also by toning up, you are getting rid of the excess fat and converting it to muscle.

10. Running is for people of all ages. Old or young, everyone can benefit from running.

11. It is good for your sex life! By being more physically active you increase your sex drive.

12. When run training, you can get away with eating chocolate and legitimately say it is part of your training program.

13. Running is a great way to recover from a hangover. A run will help clear your head faster than sitting around feeling terrible.

14. Running is a great safety aid. Being able to run away from people puts you in a much better position if you are chased.

15. You can use running to change other people's lives. Run for a charity and raise money to help the needy or less able.

16. Running with friends gives you time to catch up on gossip and get fit at the same time.

17. Running is a time-efficient way to get fit and lose weight so you have more free time after exercising to enjoy yourself.

18. Running is a challenge that can be motivational and bring great personal satisfaction.

19. Running is a great way to see a new place if you have limited time available for sightseeing. Just think how much more of a place you can see when running around it compared to walking.

20. Running improves your concentration as you are forced to concentrate more when running. This in turn improves your concentration when you have to focus in other areas of life.

21. You nearly always work better after a run because you are still on a runner's high and feel ready for anything.

22. Running is a great way to meet people, especially if you join a club or enter a race.

23. There are no monthly subscriptions with running. You just put your running shoes on and go.

24. Endurance built-up through running can be transferred to other sports.

25. If you drink alcohol you can just run a little bit further the next day to work off the extra calories.