Best Doctors in India

Single, Knee Replacement Surgery in Gurgaon for Osteoarthritis - Dr Anurag Awasthi

2013-10-31T21:51:00.004-07:00

Published on Sep 4, 2013

marked improvement after a total knee replacement surgery performed by Dr Anurag Awasthi & team in Gurgaon, India.

www.anuragawasthi.com

Knee Replacement Surgery in Rheumatoid Arthritis Patient- Gurgaon, India

2013-10-31T21:45:00.001-07:00

Published on Jul 13, 2013

Dr Anurag Awasthi & team performed a successful both knee replacement surgery in Gurgaon, India for a patient suffering with Advanced Rheumatoid Knee Arthritis

www.anuragawasthi.com

Discussing about Women Health Issues- DR Deepika Tiwari, Gynaecologist, Gurgaon, India

2013-10-31T21:43:00.000-07:00

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Dr Deepika Tiwari live on a TV news channel, talking about the best treatment guidelines related to women health issues. WWW.DEEPIKATIWARI.COM

Precautions to be taken by asthma patients during Diwali: Dr A K Singh, Chest Specialist, New Delhi

2013-10-31T21:41:00.000-07:00

Wednesday, 30 October 2013

Precautions to be taken by asthma patients during Diwali

Few tips to reduce the ill impact of air pollution during Diwali on lungs

Reduce or limit exercise or strenuous activities outdoors. Exercise indoors till pollution reduces to normal levels. If you are unusually sensitive (for example, people with more severe asthma), reduce prolonged or heavy outdoor exertion on Diwali night.
Remember that children are at particular risk even if they don’t have asthma. They tend to be more active, breathe faster, and expose their lungs to more pollutants.
The best way to protect your family at home is to avoid air pollution in the first place. Here are some of the most important steps you can take.

Make sure not to use too much of crackers.

Clean surfaces in your home next day of diwali with damp cloth and HEPA-filtered vacuum.

Keep humidity levels below 50 percent.

Keep doors and windows closed.

Aviod use of scented candles or fragrance laced incense sticks or dhoops inside rooms with less ventilation.

http://draksinghchest.blogspot.in/2013/10/precautions-to-be-taken-by-asthma.html

DON’T CHOKE YOUR NOSE THIS DIWALI: PREVENTION & TREATMENT OF NASAL PROBLEMS: Dr A K Singh, Chest Specialist, New Delhi

2013-10-31T21:39:00.003-07:00

Thursday, 31 October 2013

DON’T CHOKE YOUR NOSE THIS DIWALI: PREVENTION & TREATMENT OF NASAL PROBLEMS

Research suggests a strong relationship between air pollution and the increased incidence of allergic rhinitis and other allergic disorders. Air pollution has deleterious impact on nasal mucosal surface. It causes irritation of sinus and nose mucosa causing chronic rhinitis and allergic rhinitis as the injured mucosa is more predisposed to allergens.

Air pollution can also cause non-allergic rhinitis. Symptoms are decreased smell, nasal blockage, increased nasal secretion (with or without associated inflammation), and alterations in local immunity & more predisposed to influenza infection.

Fire cracker fumes in Diwali can cause both allergic and non-allergic rhinitis and sinusitis.

Prevention includes

Minimizing exposure to firecrackers.
Use steam which is very effective prevention and treatment.
Use of nasal douche or non medicated nasal saline sprays.
Preventive medications for allergic rhinitis- tablets, syrups & nasal sprays.

Treatment of rhinitis is simple and without side effects. So don’t live with a clamped choked nose or leaky nose.

http://draksinghchest.blogspot.in/2013/10/dont-choke-your-nose-this-diwali.html?spref=fb

Knee Pain and Arthritis treatment- Dr Anurag Awasthi, Gurgaon, India

2013-07-02T22:02:00.001-07:00

http://www.anuragawasthi.com
http://in.linkedin.com/in/anuragawasthi
http://www.dranuragawasthi.blogspot.in/
www.gurgaonorthopedic.webs.com

Dr A K Singh, Pulmonology & Chest Specialist, New Delhi

2013-02-02T10:02:00.000-08:00

Dr A K Singh

Consultant, Pulmonology at Fortis Healthcare

New Delhi Area, India

Health, Wellness and Fitness

Consultant, Pulmonology

Fortis Healthcare

Public Company; 10,001+ employees; Hospital & Health Care industry

August 2009 – Present (3 years 6 months)

I am a chest specialist who specialize in managing chest diseases, sleep disorders and critically ill patients. I am well versed in performing bronchoscopy

Consultant

Fortis Escorts hospital, Okhla road, New Delhi & Fortis Hospital, Vasant Kunj, New Delhi

Hospital & Health Care industry

August 2009 – Present (3 years 6 months)

I am a chest specialist who specialize in managing chest diseases, sleep disorders and critically ill patients. I am well versed in performing bronchoscopy. Experienced in managing lung issues in heart patients

Senior Resident

LRS Institute of Tuberculosis & Respiratory Diseases

2006 – 2009 (3 years)

Patient care in OPD and Indoors. Use to various procedures related to pulmonology and ICU. Was involved in research works.

Dr Anurag Awasthi, Orthopedic Specialist, Gurgaon

2013-01-30T10:00:00.000-08:00

DR. ANURAG AWASTHI ORTHOPEDIC SURGEON,GURGAON,NEW DELHI

BONE, JOINT & SPINE CLINIC; PH: 9718112112; WEBSITE : <www.anuragawasthi.com>

Gurgaon, India

Hospital & Health Care

Dr Anurag Awasthi has been working with Fortis Healthcare, New Delhi for over 3 years, and has earned the respect and affection of his patients. Dr Anurag Awasthi is a Medical graduate from the prestigious King George's Medical College, Lucknow. He is a National board trained Orthopaedic specialist with hands-on experience at state of art medical centres in Mumbai and New Delhi. He has assisted and performed complicated fracture surgeries, joint replacements and minimally invasive procedures including MIPPO techniques, Arthroscopy, and minimally invasive spine surgeries. He believes in offering extensive conservative treatment to his patients, especially those with chronic back pain and other spine disorders. Dr Anurag Awasthi has special interest in handling complicated Trauma cases, sports injury cases and joint disorders. He is widely known for putting a personal touch in his treatment therapy.

Orthopedic Surgeon

BHARAT FAMILY CLINIC, GURGAON

December 2012 – Present (2 months) DLF Golf course, Gurgaon

Specialties: Orthopaedic Trauma, Sports Injuries, Joint Disorders including advanced Arthritis, and Joint Replacements, Minimally invasive procedures for Spine problems,

Orthopaedics Specialist

Fortis Healthcare, New Delhi

Public Company; 10,001+ employees; Hospital & Health Care industry

March 2009 – Present (3 years 11 months)

Management of complex trauma and sports injury
Knee arthroscopy
Knee and Hip Replacement
Management of spine disorders, Arthritis, Osteoporosis, Ergonomy, Occupational disorders

Orthopedic Specialist

Artemis Health Institute, Gurgaon

Privately Held; 501-1000 employees; Hospital & Health Care industry

March 2008 – November 2008 (9 months) Gurgaon, India

Independent handling of Trauma and Accident victims
Fracture management
Sports injury management

Dr Deepika Tiwari, Gynecologist & Obstetrician, Gurgaon

2013-01-23T09:52:00.000-08:00

DR DEEPIKA TIWARI Gynaecologist (Gyne) Doctor, Gurgaon

Gynecologist @ Apollo Cradle; Bharat Family Clinic; Best Reviews

Gurgaon, India

Hospital & Health Care

Dr Deepika Tiwari has completed her medical education and specialist training in Obstetrics & Gynaecology from Grant Medical College, Mumbai. She has been working in Gurgaon as Consultant- Obstetrics & Gynaecology since 2008, and has earned respect among both the medical fraternity and her patients.

Dr Deepika focusses on individualized attention to every patient, and has designed special programs for complete pregnancy check and follow up. She has special interest in handling routine and precious pregnancies, infertility management, adolescent gynaecological disorders, menstrual dysfunctions, cancer screening, and peri-menopausal syndromes.

Consult For...High Risk Pregnancy, Painless Delivery, Laparoscopic Surgeries including hysterectomy, Premarital & Marital Counselling, Adolescent Problems,Contraception & Family Planning, Infertility Treatment, Management of Ovarian Cyst & Fibroids, Menstrual Problems, Cancer Screening & Management, Hormonal disturbance including Polycystic Ovaries, Menopause.

Obstetrician & Gynecologist

BHARAT FAMILY CLINIC, GURGAON

December 2012 – Present (2 months) DLF Golf Course Road, Gurgaon

Consult For...High Risk Pregnancy, Painless Delivery, Laparoscopic Surgeries including hysterectomy, Premarital & Marital Counselling, Adolescent Problems,Contraception & Family Planning, Infertility Treatment, Management of Ovarian Cyst & Fibroids, Menstrual Problems, Cancer Screening & Management, Hormonal disturbance including Polycystic Ovaries, Menopause.

Obstetrician & Gynecologist

Apollo Cradle, Gurgaon

October 2010 – Present (2 years 4 months) Sec 14 / Sec 56, Gurgaon

Consultations and medical care for Pregnancy and related conditions; Gynecological cancer screening; Preconceptional counselling; Contraception; Women Health Programme

Dr Anupam Roy, Nephrologist & kidney specialist, Gurgaon

2013-01-19T09:57:00.000-08:00

Dr Anupam Roy

Associate Consultant at Fortis Healthcare

Central Delhi, Delhi, India (New Delhi Area, India)

Hospital & Health Care

Dr Anupam roy is a Young, dynamic nephrologist with special interest in critical care nephrology and interventional nephrology.

Skilled in care of patients with kidney diseases and hypertension.
Special emphasis on prevention of kidney diseases.

Specialized in creation of vascular access (AV fistula, permacath) for dialysis.

Associate Consultant, Nephrology

Fortis Flt Lt Rajan Dhall Hospital

July 2011 – Present (1 year 7 months)

providing medical care to all patients.

Nephrology

Sir Ganga Ram Hospital

Privately Held; 1001-5000 employees; Hospital & Health Care industry

December 2009 – August 2010 (9 months)

Senior resident

Senior resident, Nephrology

Sir Ganga Ram Hospital

Privately Held; 1001-5000 employees; Hospital & Health Care industry

July 2006 – June 2009 (3 years) Sir Ganga Ram Hospital, New Delhi

DNB training in Nephrology

Nocturnal Hemodialysis

2013-01-08T09:55:00.001-08:00

Nocturnal hemodialysis (NDHD) or night hemodialysis is done at home or in-centre at night.

This is done with an aim to provide higher dose of dialysis. Nocturnal dialysis is therefore scheduled for 3-5 times a week, each session lasting for 6-8hrs.

Benefits of nocturnal dialysis include

Mimics native kidney function

· Blood pressure control improves allowing some patients to cut down their blood pressure pills

· Beneficial effect on cardiovascular function due to better hemodynamic profile

· Better nutritional status as appetite improves

· Symptoms like shortness of breath, itching, dry skin, tiredness disappear.

· Improved quality of life

· Sexual drive and function improve

· Requirement of erythropoietin may decrease

· Better control of phosphorus and reduced need for phosphate binders

· Reduced intradialytic problems like hypotension, cramps

Risks/ Drawback

Safety concern especially if done at home

· Initial investment for home sessions is considerable as renovations needed to establish setup

· Needs good infrastructure and backup.

DR. ANUPAM ROY, NEPHROLOGIST, GURGAON

Dietary Advice for Diabetics During Festivals

2013-01-05T00:27:00.000-08:00

The mantra to enjoy food during festivals for patients with diabetes is self control.

Diabetics should regulate and limit high calorie food intake during festivals. Small frequent meal pattern (the 6-meal pattern) facilitates easy absorption and helps keep blood sugar levels under control.

If you are making sweets yourself (kheer, ladoos etc), use of low fat ingredients- like low fat milk and other dairy products is recommended. Natural sweeteners like honey and dates may be used to make sweets.

There are plenty of recipes for diabetic patients available online and with the help of artificial sweetener you can make sweets and other traditional food items easily. Consult your doctor regarding the intake of artificial sweeteners.

Before eating snacks, drinking water maintains a feeling of fullness.

Fruits like papayas, oranges, apples, and grapes should be taken in each meal to supplement food as well as satisfy the taste buds.

Carbonated cold drinks are to be avoided. Instead, natural drinks like lemon juice, coconut water, butter milk or some other fruit juice are perfect thirst –quenchers.

Do not forget your diabetic medicines. Insulin or other medicines if prescribed, has to be taken regularly. Self monitoring of blood glucose is advised and the dose of insulin may be adjusted accordingly.

Exercise regularly to help burn out the extra calories.

DR ANUPAM ROY, GURGAON

Vascular Access for Dialysis

2012-12-30T00:25:00.002-08:00

For hemodialysis, blood is taken out of the body, passed through a filter to clean it and then returned to the body. This requires an access which can be used to remove and return blood into the body safely.

An arteriovenous (AV) fistula is the best means of access to the blood stream for long-term haemodialysis.

An arteriovenous fistula is surgically created by joining an artery to a vein. The blood vessels of the arm are chosen, either at the wrist or the elbow usually in the non-dominant arm. The blood from the artery goes straight into the vein, resulting in dilatation of the vein due to high arterial pressure, which then becomes bigger and firmer. This makes it possible to cannulate the vein for haemodialysis. The risk of infection is least. Very rarely, synthetic graft may be used to create the fistula.

An alternative to having an arteriovenous fistula is to have a temporary or permanent dialysis catheter. A dialysis catheter is inserted into one of the major veins in the neck or groin. The tube has two tubes joined together and blood can be taken out and returned after treatment using the same tube. It may be used as a temporary option when patient presents in an emergency or while a fistula is maturing. The major risk is infection, which can be potentially severe and life threatening. A tunneled dialysis catheter may be suitable for patients with multiple failed AV fistula.

Please consult your doctor for the best access suited for you.

DR ANUPAM ROY, GURGAON

Cartilage Injuries

2012-12-05T10:06:00.003-08:00

Lesions of the articular cartilage frequently occurs in athletes, who indulge in activities involving vigorous knee bending.
The articular cartilage gradually wears down, and the subchondral bone gets exposed. Damage to the cartilage causes pain in the knee, which gets aggravated with movements.
The wear of the articular cartilage has been classified by Outerbridge, and is widely accepted.
The treatment of such a case varies from physiotherapy to micro-fracturing; to mosaicplasty or sometimes Autologous Chondrocyte Implantation.
Patients with Outerbridge Grade 1 are best managed with supervised physiotherapy and protected weight bearing.
Patients with Outerbridge 2/3 need micro-fracturing or mosaicplasty, depending on the size of the lesion and condition of adjacent articular cartilage.
Micro-fracturing is done using a drill, and the bleeding bone surface is exposed to allow healing by formation of fibro-cartilage. This against the hyaline cartilage of articular margin, has poor tolerance to stresses.
On the other hand, mosaicplasty is best reserved for lesions between 5-12 mm, which are Outerbridge 3 or 4.
In Mosaicplasty, a portion of hyaline articular cartilage and subchondral bone is harvested, and inserted into the bed at recipient site.
Important to explain to the patient is - Prolonged and slow healing ; and necessity to prevent weight transmission across the operated joint. However, knee range of movements may be started early.

AIR TRAVEL DURING PREGNANCY

2012-07-19T21:27:00.002-07:00

Pregnant women & those contemplating pregnancy need special consideration because of specific nature of the potential health hazards of long distance flights.These include exposure to cosmic radiation, reduced arterial oxygen pressure, immobilization & unforseen medical & obstetrical emergencies encountered during flight.

More radiation shielding is provided by atmospheric air at lower altitudes.The dose received from cosmic radiation is usually lower during short haul flight since long haul flight are usually flown at higher altitudes.

The changes in heart rate & BP which are associated with decreased partial oxygen pressure may affect women with compromised pregnancies.

Increased risk of venous thrombosis may occur due to prolonged immobilization from cramped seats, which is called Economy class syndrome.

ADVICE

1. Pregnant women should use their seat belts continuously while seated.

2. Long distance flights are not recommended for women upto 36 wks gestation with singleton pregnancy & 32 wks with multiple pregnancies.

3. Travellers should be updated on routine immunizations including TT,Diptheria, Influenza, & other immunization based on geographic risk

4. Travel is not recommended at any time during pregnancy for women who have medical /obstetrical prblems that could result in emergencies

NOTE : Always consult your gynaecologist, whenever you are planning for air travel.

Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669

http://www.gurgaongynae.in/

Smoking in Pregnancy

2012-07-12T10:48:00.001-07:00

If you smoke and you are pregnant, or planning to become pregnant, you are strongly advised to stop smoking.
Smoking when you are pregnant increases the risk of: miscarriage; slowing the growth of the baby leading to a low birthweight; premature labour leading to the baby being premature (prem); stillbirth.
Even after the birth, children of smoking parents have an increased risk of developing chest infections, asthma, glue ear, and sudden infant death syndrome (cot death).

You and your baby will get most benefit, and the risks will be most reduced, if you stop before you become pregnant. Planning to become pregnant is a good incentive to stop smoking for many women, and is often a good time to persuade partners to give up too.

Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669
www.deepikatiwari.com

Hyperthyroidism in Pregnancy

2012-07-11T09:45:00.003-07:00

Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669

www.gurgaongynae.in
http://www.drdeepikatiwari.blogspot.com/
http://www.gurgaongynecologist.webs.com/

Thyroid disorders are second most common endocrine dysfunction in child bearing age group . Symptoms of hyperthyroidism include tremors, heat intolerance, weight loss ,emotional liability , persistently increased pulse rate, decreased menstrual flow, etc.

Most common complication of hyperthyroid in pregnant patient is thyroid storm & heart failure. Hyperthyroidism or thyrotoxicosis is associated with adverse outcome like miscarriage, growth restriction, premature labor, placental abruption, preecclapsia.Fetal thyrotoxicosis may lead to premature delivery , fetal craniosynostosis, exophthalmos, heart failure , hepato-splenomegaly , goitre & poly-hydraminos.

Diagnosis of hyperthyroidism include an elevated T4, T3 with supressed TSH level. To predict fetal thyrotoxicosis maternal TSH receptor autoantibodies with obstetric ultrasound is used to asses fetal growth , heart rate & goitre.

Hypothyroidism in Pregnancy

2012-07-10T09:45:00.002-07:00

Hypothyroidism affects 1% of pregnant patients. Defining symptoms of hypothyroidism include;

cold intolerance,

slow heart rate(Bradycardia) ,

delayed relaxation of tendon reflexes,

excessive menses (in non pregnant )

The most common cause of hypothyroidism is autoimmune.

Hypothyroidism is diagnosed with reduced free T4 concentration with increased TSH levels.

Most serious consequence of hypothyroidism in pregnancy is Myxedema Coma which is a medical emergency. Neuropsychiatric development is delayed in offsprings born to hypothyroid mothers . However correction of maternal hypothyroidism in first 12 wks of pregnancy might improve outcome.

Cretinism (deaf mutism, spastic motor disorders & hypothyroidism ) is distinct & severe form of brain damage caused by severe maternal iodine deficiency .

Patients with hypothyroidism should be counselled to delay pregnancy until maintenance level of T4 is achieved.

Hypothyroid in pregnancy requires treatment with thyroxine with thyroid function tests repeated every 3 months ( however they should be repeated every 4-6 wks if dosage changes are to be made).
Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669

www.gurgaongynae.in
http://www.drdeepikatiwari.blogspot.com/
http://www.gurgaongynecologist.webs.com/

Knee Replacement in Gurgaon

2012-07-06T00:13:00.000-07:00

Knee Replacement is a commonly performed surgery today. It is indicated for severe degenerative or inflammatory arthritis, which is not responding to an extended physiotherapy programme, and pain killer medicines.

Due to availability of latest implants and technology, it is possible to easily reproduce good results. However, this surgery should preferably be performed in an equipped set up, with adequate facilities for sterilization and infection control.
After surgery, the patients can be made ambulatory with walker support from 2nd post-operative day onwards. And the average time before the individuals can walk without support and feel fairly normal is 3 months. A supervised physiotherapy programme is essential to get good results.

Author' Comments :
Knee replacement is a successful surgery, provided the patient selection is good. Most patients coming to my clinic with pain after surgery, have single or multiple factors that are interfering with adequate rehabilitation.
It is therefore, of vital importance, that every patient must be counselled well, and made aware of the possible risks or limitation involved during and after surgery.
Making false claims of magical results or relief must be evaluated with caution.
Besides, informed consent is generally lacking.
The patient should be part of the decision making, while considering even a small procedure or treatment.
In my belief, every patient being considered for a knee replacement, must undergo a dedicated session of physiotherapy and conservative regimens, before being selected for surgery. The Orthopedic surgeon should be the key player in evaluating the progress, and recommending further course of treatment.
In my practice, 60-70 % of patients, who have been advised a knee replacement at various stages, are still doing good.

Author' Profile:
Dr Anurag Awasthi is a Medical graduate from the prestigious King George's Medical College, Lucknow. He is a National board trained Orthopaedic specialist with hands-on experience at state of art medical centres in Mumbai and New Delhi. He has assisted and performed complicated fracture surgeries, joint replacements and minimally invasive procedures including MIPPO techniques, Arthroscopy, and minimally invasive procedures for spine problems.

Pregnancy with Diabetes

2012-07-01T20:47:00.002-07:00

Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669

It is estimated that 3- 5 % of pregnancies are complicated by Diabetes mellitus.With increasing prevalence of Diabetes in young women, it is important to understand the common symptoms that a pregnant lady may suffer, to diagnose it early.

Some important features to be understood…

*Gestational Diabetes refers to the condition where in high blood glucose levels are monitored for the first time during pregnancy.

*Diabetes diagnosed before pregnancy may be insulin dependent (IDDM), or non- insulin dependent (NIDDM).

* During pregnancy, there is a physiological increase in insulin resistance, to satisfy the nutritional demands of foetus.

* High levels of maternal blood glucose levels, may lead to high levels of glucose in foetal blood.

* Patients who are already diagnosed with Diabetes, before getting pregnant, may develop high blood pressure during pregnancy, and increased susceptibility to infection; may increase the likelihood of caesarean section; large baby size (Macrosomia); shoulder dystocia etc.

*Increased risk of congenital abnormalities in the foetus, miscarriage, still birth, premature delivery.

Intensive control of glucose levels around the time of conception, can reduce the incidence of congenital abnormalities. In non diabetic subjects fasting glucose should be 70mg/dl- 126mg/dl .Diabetic subjects tend to have higher post prandial & sustained minor elevations of glucose,

WHEN TO CONSULT A DOCTOR

A higher fasting, postprandial sugar levels

An abnormal glucose challenge test

An abnormal Glycosylated Hemoglobin

Repeated infections especially urinary infections

Polyhydraminos (increased liquor )

H/o previous stillbirths, large babies, premature delivery, traumatic delivery

www.gurgaongynae.in
http://www.drdeepikatiwari.blogspot.com/
http://www.gurgaongynecologist.webs.com/

Best, Gynecologist in Gurgaon: Tips for Reaching the RIGHT DOCTOR for you

2012-06-26T18:11:00.003-07:00

There is enough dilemma about the choice of a good doctor. I have friend who changed up to 5-7 doctors in last one year, but could not reach the right one.
I believe that there should be some system to evaluate the quality of your doctor.
We should look for testimonials written for a doctor? They, in my opinion could be the best bet in finding the right doctor for you.
Besides, a doctor, who explains the disease or problem, you are suffering from, gives you enough time, and encourages you to ask questions, is probably the best one for you.
It is also a good idea to search the names of individual doctors, and see their activity across various independent sites (taking precautions, not to be looking into one of the paid sites, which will be endorsing advertisements).
Google search is another good way... Any doctor whose name is consistently visible on the first two pages, definitely has more follower base.. Health Magazines often show flashy advertisements.. so beware.

Good luck to all our readers...

PyoMyositis : Necrosis of the Muscles

2012-05-03T11:15:00.000-07:00

Dr Anurag Awasthi

Orthopedic & Spine Specialist, Gurgaon

Pyomyositis is common in tropical regions but is rarely reported in temperate climates. Staphylococcus aureus was the causative organism in 70 percent of cases.
It is often hematogenous in origin and typically associated with abscess formation.

Males appear to be more commonly affected than females. Most patients with tropical pyomyositis are otherwise healthy without underlying comorbidities, while most patients in temperate regions are immunocompromised or have other serious underlying conditions.
Predisposing factors for pyomyositis include immunodeficiency, trauma, injection drug use, concurrent infection, and malnutrition.

Normal muscle, if damaged, is susceptible to haematogenous invasion by bacteria with subsequent abscess formation. In 20%–50% of cases, a history of blunt trauma or vigorous exercise of the involved group of muscles is forthcoming.

In early stages of tropical pyomyositis, muscles show oedematous separation of fibres, followed by patchy myocytolysis progressing to complete disintegration. The fibres are surrounded by lymphocytes and plasma cells. Muscle fibres may heal without abscess formation or degenerate, progressing to suppuration with bacteria and polymorphonuclear leucocytes.

Maximum incidence is seen at 10–40 years of age with a male to female ratio of 1.5:1. Muscles frequently involved are quadriceps, glutei, pectoralis major, serratus anterior, biceps, iliopsoas, gastrocnemius, abdominal and spinal muscles. Usually, a single group of muscle is affected, but in 12%–40% of cases multiple groups are involved either sequentially or simultaneously.
In an asymptomatic patient with muscle mass and no other features of infection (fever, chills, erythema) but who has leucocytosis and raised erythrocyte sedimentation rate, pyomyositis should be suspected.

Surgical debridement and drainage, accompanied by parenteral antistaphylococcal β-lactamase resistant penicillin (cloxacillin 1–2 g every six hours), is the initial recommended treatment. For methicillin resistant staphylococcus, vancomycin in a dose of 15 mg/kg to a maximum of 1 g, given every 12 hours is a suitable alternative.

Secondary spread of metastatic infection from involved muscles usually requires four to six weeks of parenteral high dose antimicrobial therapy. Otherwise, treatment should be continued till wound is clean, the leucocyte count becomes normal, and the patient is afebrile for 7–10 days. Continuation or recurrence of fever after surgical drainage while the patient is receiving appropriate antimicrobials suggests the presence of other foci, development of drug resistance or, less commonly, drug fever.

Type 2 Diabetes Mellitus in Children

2012-01-22T14:28:00.000-08:00

Type 2 diabetes is a disease more commonly associated with adults. In fact, it used to be called adult-onset diabetes. But type 2 diabetes in children is on the rise, fueled largely by the obesity epidemic.
Symptoms may include,
Increased thirst and urination
Increased hunger
Weight loss
Fatigue
Slow-healing sores or frequent infections

Consultation with a pediatrician or Diabetes specialist is mandatory in case of co-existing high risk factors, like
High Body Mass index (BMI)
Positive family history
Signs of insulin resistance

Type 2 Diabetes mellitus, if left untreated, can damage almost every organ of the body.
Diagnosis can be made by doing the Random blood sugar levels, and Glycosylated Hemoglobin HbA1C

Treatment includes,
Dietary modifications
Physical Activity
Hypoglycemic drugs, oral and Insulin

Prostate Cancer

2012-01-21T14:26:00.000-08:00

Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.
Symptoms, may include any or more of the following

Trouble urinating

Decreased force in the stream of urine

Blood in your urine

Blood in your semen

Swelling in your legs

Discomfort in the pelvic area

Bone pain

Prostate cancer can spread to nearby organs or travel through your bloodstream or lymphatic system to your bones or other organs.
Most prostate cancer is discovered through routine screening.
Prostate screening tests might include:

Digital rectal exam (DRE). . If your doctor finds any abnormalities in the texture, shape or size of your gland, you may need more tests.
Prostate-specific antigen (PSA) test. A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that's naturally produced by your prostate gland. It's normal for a small amount of PSA to enter your bloodstream. However, if a higher than normal level is found, it may be an indication of prostate infection, inflammation, enlargement or cancer.

Prostate cancer can be diagnosed by a prostate biopsy. further evaluation is required to assess, the spread of the cancer.
Test done include,

Bone scan

Ultrasound

Computerized tomography (CT) scan

Magnetic resonance imaging (MRI)

Treatment depends on the stage of lesion and spread to other organs/ organ systems, and may include alone or a combination of Radiation Thjerapy / Hormonal therapy/ Surgery.
Ref : Mayo Clinic

Evaluation of a case of Fever (Pyrexia Unknown Origin- PUO)

2011-11-21T01:00:00.000-08:00

FEVER DIFFERENTIAL DIAGNOSIS

Dr Mohit Lathar, 9873662325

Intensivist and Internal Medicine Specialist;

Specialist in Critical Care/ Cardiology/Nephrology.

Sohna Road, Gurgaon; www.medconsult.in

DEFINITION

• TEMPORARY ELEVATION OF HYPOTHALAMIC SETPOINT

• AM TEMP.>37.2°C(98.9°F)

• PM TEMP. >37.7°C(99.9°F)

TYPES OF FEVER

• Low grade: 38 - 39 °C (100.4 - 102.2 °F)

• Moderate: 39 - 40 °C (102.2 - 104 °F)

• High grade: > 40 °C (> 104 °F)

• Hyperpyrexia: > 42 °C (> 107.6 °F) –A MEDICAL EMERGENCY

CAUSES

• infectious disease, e.g. influenza, common cold, HIV, malaria,

infectious mononucleosis, gastroenteritis, etc..

• Various skin inflammations such as boils, pimples, acne, abscess,

etc.

• Immunological diseases like lupus erythematosus, sarcoidosis,

inflammatory bowel diseases, etc..

• Tissue destruction, which can occur in hemolysis, surgery,

infarction, crush syndrome, rhabdomyolysis, cerebral hemorrhage,

etc..

• Drug fever

• directly caused by the drug (e.g. lamictal, progesterone,

chemotherapeutics causing tumor necrosis)

• as an adverse reaction to drugs (e.g. antibiotics, sulfa drugs, etc.)

• after drug discontinuation, like with heroin withdrawal

• Cancers such as Hodgkin disease (with Pel-Ebstein fever)

• Metabolic disorders like gout, porphyria, etc..

• Thrombo -embolic processes (i.e. pulmonary embolism, deep

venous thrombosis.

A proper evaluation of any high grade fever, or fever extending for more than 2-3 days, is MANDATORY