Syncope (Loss of Consciousness): A symptom, not a diagnosis..

Syncope, or fainting, is a form of sudden loss of consciousness caused by decreased or insufficient blood flow to the brain which can be of rapid onset, short duration, and spontaneous and complete recovery.  40% will experience syncope at least once in a lifetime. Syncope can occur when a normal reflex is overstimulated, which slows the heart rate and, along with dilation of blood vessels, lowers blood pressure and decreases blood flow to the brain.

Types of Syncope:

Vasovagal syncope is the most common type of fainting. It can be provoked by emotional or physical stress, for example, intense fear, prolonged standing in a crowded, warm room, or having blood drawn. It is often preceded by warning symptoms such as sweating, nausea, lightheadedness, and visual blurring.

Situational syncope occurs in relation to certain specific actions, most commonly urinating or straining with a bowel movement.

Carotid sinus syncope can occur with pressure on the carotid artery, often resulting from a tight-fitting shirt or shaving.

Orthostatic syncope Occurs immediately or up to 10 minutes after assuming upright posture from sleeping or sitting position. Orthostatic hypo-tension refers to low blood pressure that occurs while standing. This may result from dehydration, medications, or certain health conditions.

Cardiac Syncope(or cardiovascular) syncope is caused by arrhythmia and structural heart disease. These may occur in combination because structural disease renders the heart more vulnerable to abnormal electrical activity.

Disorders Mimicking Syncope

  • With loss of consciousness, i.e., seizure disorders, concussion
  • Without loss of consciousness, i.e., psychogenic “pseudo-syncope”

 

Evaluation:

  • The history and physical examination are the most important tools in the initial evaluation of syncope.
  • Details of the syncopal event must be evaluated in detail, including postural, exertional, or situational symptoms, palpitations or cardiac symptoms, use of medications, family history of sudden cardiac death and personal history of cardiac disease.
  • Patients who experience syncope with urination, defecation, coughing, swallowing, or while drawing blood have situational syncope.
  • Syncope related to ischemia is presumed when symptoms are present with ECG findings.
  • Monitoring blood pressure during and after attack are necessary to know if it is related to change in the blood pressure
  • Syncope in patients with coronary artery disease requires evaluation for arrhythmia and ischemia. The evaluation includes exercise stress testing, myocardial perfusion imaging, or cardiac catheterization, depending on the patient’s level of risk and specific findings
  • EEG, Head CT, Head MRI are rarely used, may help in diagnosing seizure and neurological causes.
  • Sugar levels are also tested to rule out hypoglycemic attacks which can mimic syncope.

 

Management:

After knowing the type of syncope and the cause for it, management will be based on the type.

  1. Acute intervention includes physical maneuvers, eg: crossing legs or tugging arms, lowering head, lying down
  2. If it is orthostatic syncope, moving feet and leg few minutes before rising, rising slowly and step-wise will help.
  3. Syncope due to cardiac issues must be treated accordingly based on the test reports.
  4. Reduce / stop exacerbating medication.
  5. Long-term prevention includes education, diet, fluids, salt, minimizing caffeine/alcohol, support hose, sleeping with head of bed elevated, drug therapy,cardiac pacing.

 

References:

https://www.healthline.com/health/syncopal-episode

https://www.webmd.com/brain/qa/what-causes-fainting

By,

Dr. Y. Alekhya

How important is oral health for overall health??

Maintaining good oral hygiene keeps the body healthy. Oral cavity consists of countless bacteria, if oral hygiene is not maintained properly, it may affect one’s overall health.

Your mouth is a window into what’s going on in the rest of your body, often serving as a helpful important point for detecting the early signs and symptoms of many medical conditions. Normally there is very less chance for bacteria in your mouth to enter into the bloodstream. However, some dental treatments which are invasive, sometimes even just regular brushing and flossing if you have gum disease can provide a way of entry for these bacteria. Some antibiotics and medications which reduce saliva flow disrupt the normal balance of bacteria and compromise your mouth’s normal defenses, allowing these bacteria to enter your bloodstream.

Bacteria from oral infections can enter the bloodstream or airways and travel to other parts of the body. These bacteria have the potential to worsen or increase the risk for other types of health problems such as heart disease, stroke and respiratory problems.  People living with diabetes are prone to a variety of bacterial infections, including gum disease.

Oral infections can make it difficult to control diabetes and cause complications, since the bacteria from severe gum disease may increase both blood sugar levels and the length of time the body struggles with high blood sugar.

It is important for pregnant women to take care of their oral health, as the bacteria from gum disease may trigger an inflammatory response that might induce premature labor and delivery. Poor oral health has been linked to sleeping problems, as well as behavioral and developmental problems in children. Regular visits to a dentist and effective oral care can prevent and control gum diseases or even reverse them in early stages.

Below are some tips to have a healthy mouth:

  1. Schedule dentist appointments, it is important to maintain good oral hygiene
  2. Brush twice a day for two minutes using a soft toothbrush and fluoridated toothpaste.
  3. Cleaning or flossing once a day to remove food and plaque is important.
  4. Clean or scrape the tongue daily.
  5. Using mouth rise after consulting your dentist is recommended.
  6. Check gums/mouth regularly and report any changes or signs of gum disease to a dentist.
  7. Conduct self-examinations for oral cancer. If anything abnormal is noted, you should consult a specialist
  8. Eat a nutritious, well-balanced diet and clean your mouth with water every time after eating
  9. Don’t smoke or use smokeless tobacco, it increases the risk of oral and many other types of cancers.

REFERENCES:

https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475

https://www.healthline.com/health/dental-and-oral-health

By,

Dr. Y. Alekhya

Are you at risk of vitamin B12 deficiency?

Are you a pure vegetarian and do not consume milk products? or

Are you a recently turned vegan? or

Are you above 50 years of age? or

Did you had a weight loss surgery?

 

Chances are that you might be having vitamin B12 deficiency and not have any symptoms.

Plants don’t make vitamin B12. The only foods that deliver it are meat, eggs, poultry, dairy products, and other foods from animals. Strict vegetarians and vegans are at high risk for developing a B12 deficiency if they don’t eat foods that have been fortified with the vitamin or take a vitamin supplement. People who have weight-loss surgery are also more likely to be low in vitamin B12 because the surgery interferes with the body’s ability to extract vitamin B12 from food. Elderly have less than normal absorption of B12 from the gut.

Vitamin B12 deficiency can be slow to develop, causing symptoms to appear gradually and intensify over time. It can be overlooked or confused with something else. Common symptoms are tingling, numbness or strange sensations in arms, legs or feet, difficulty in walking(staggering, balance issues), swollen tongue, weakness and memory loss.

Vitamin B12 deficiency can be easily detected by a simple blood test.

In many people,  vitamin B12 deficiency can be prevented. If you are a strict vegetarian or vegan, it’s important to eat breads, cereals, or other grains that have been fortified with vitamin B12.

If you are over 50 years of age, a standard multivitamin is usually recommended since you may not be able to absorb enough of the vitamin through foods.

Early detection and treatment is important. Your doctor may also prescribe tablets or injections if required. If left untreated, vitamin B12 deficiency can cause severe neurological problems and blood issues.
-Dr Prerna Gaur

LIFE WITH OBSESSIVE COMPULSIVE DISORDER AND HOW TO DEAL WITH IT.

It is a well-known fact that OCD or obsessive-compulsive disorder is a type of mental health problem.

As the name suggests, people with OCD can have either obsessive thoughts or urges or compulsive, repetitive behaviors. Some have both obsessions and compulsions.

In case of OCD, an obsession is an uncontrollable thought or fear that causes undue stress and compulsion is a repetitive rule-bound behavior that the individual feels must be performed in order to ease off from distressing situations, the relief, however, is temporary.

If these obsessions and compulsions interfere with daily activities, they may cause significant problems and distress.

If a person suffers from OCD, ignoring or trying to stop one’s obsessions may cause an increase in distress and anxiety and ultimately, there is a drive to perform compulsive acts to ease the stress.

Obsessions and compulsions often have a theme, for example, a fear of dirt and germs which causes a person to compulsively wash hands more than usual.

If you feel that you have OCD and it is causing disruption in your daily life, then talking to a trained health care professional can really help. OCD is usually treated with medication or psychotherapy such as cognitive behavioral therapy (CBT), or a combination of both.

Here are the things that can be tried to overcome OCD-

    1. Talk about your condition – Many people who live with OCD find that an important first step in self-help is to open up about their condition with friends and family to feel more comfortable about the condition, as well as feel less isolated.
    2. Relaxation– Stress, and anxiety worsen the symptoms of OCD. Therefore proper and timely management of stress is a really important coping strategy. It is important to know what your stressors are and learn to manage them well. Avoiding situations that can cause stress, learning how to cope up, taking breaks from stressful situations, taking up hobbies that help you relax are some good methods to deal with stress.
    3. Sleep – Studies have shown that mental health problems including OCD tend to flare up as a result of not getting enough sleep. So it is very important to stick to a healthy and consistent sleeping pattern. Avoiding coffee/tea late in the day, avoiding the use of electronic gadgets late in the evenings are some very important factors that affect sleep.
    4. Diet – It is very important to eat a healthy diet at all times, especially if you suffer from any mental health issue. A very important point is to maintain blood sugar levels. It is best if sudden blood sugar fluctuations are minimized. A sugar rush or a low blood sugar both are equally detrimental. It is therefore advisable to eat foods that release energy slowly. Nuts, seeds, pasta, rice, and cereal are some examples of foods that can be taken as they help to balance blood sugar levels.
    5. Regular Exercise – Regular exercise not only keeps the stress hormone cortisol, under control but also produce happy hormones- the endorphins.

 

 
https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432

https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/drc-20354438

https://www.webmd.com/mental-health/obsessive-compulsive-disorder#1

https://www.webmd.com/anxiety-panic/understanding-obsessive-compulsive-disorder-symptoms#1

https://www.webmd.com/mental-health/mental-tips-living-with-ocd#1

https://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm/

http://beyondocd.org/expert-perspectives/articles/ten-things-you-need-to-know-to-overcome-ocd

https://www.medicalnewstoday.com/articles/321341.php

PULMONARY FUNCTION TESTS

As the name suggests these are a group of tests done to see how the lungs are working. Pulmonary Function Tests are useful in understanding how well you are able to breathe and how effectively your lungs are bringing oxygen to rest of your body. These are valuable in diagnosing a respiratory disease. Not only in the diagnosis, pulmonary function tests are used to know the response for the treatment and based on these tests your doctor can change or continue the treatment plan. 

INDICATIONS:

  • To diagnose a condition if you have any lung disease related symptoms.
  • To know the disease severity and progression in 

Chronic Obstructive Pulmonary disease, Asthma, Sarcoidosis, Congestive Heart Failure, Congenital Heart Disease, Sarcoidosis, Myasthenia Gravis, Guillain-Barre syndrome, Multiple sclerosis etc.

  • To know the lung status before any major surgery. Eg: Cardiac surgery, Thoracic surgery, Organ transplantation etc.
  • If you are regularly exposed to some substances at workplace or environment.

Pulmonary function test performance technique:

  • A nose clip is placed when the patient is in sitting position. He needs to breathe in and breathe out several times before the actual test begins. They need to take deep breaths as much as they can.
  • Mouth should completely cover the mouthpiece. Ask him  to blow out as fast and quickly as they can.
  • After blowing out they need to take deep breaths. Whole test should be repeated thrice. Goal is to get a result which is consistent. You may need to repeat the test more than three times in order to obtain an internally valid test.

REFERENCES:

https://www.healthline.com/health/pulmonary-function-tests

https://www.ncbi.nlm.nih.gov/pubmed/622518

https://www.uptodate.com/contents/overview-of-pulmonary-function-testing-in-adults

 

Tips for having acne free skin

Acne is so common that it’s considered a normal part of growing from a kid to an adult.

But knowing that doesn’t make it easier when you look in the mirror and see a big pimple on your chin! The good news is that knowing about acne and taking some simple steps can help you deal better with Acne and prevent Acne.

  • Oil build up on your skin can lead to acne, wash your face once or twice a day with warm water along with a mild soap or cleanser.
  • Don’t scrub your face. Scrubbing can actually make acne worse by irritating the skin. Wash gently, using fingertips instead of a washcloth.
  • If you wore makeup, moisturizer, or sunscreen, make sure they are “oil-free” based and are “noncomedogenic”.
  • Hair sprays or gels can clog pores, try to keep them away from your face 
  • If you have long hair, keep it away from your face and wash it regularly to reduce oil.
  • Helmets and other hats can cause pimples along the hairline. Avoid them if you think your acne is getting worse by them.
  • Wash your face after you’ve been exercising and sweating a lot.
  •  Diet with a low glycemic (sugary)load may help.
  • Moisturizers containing aloe vera at a concentration of at least 10 percent can have a soothing and possibly anti-inflammatory effect.

  • Hold the mobile phone away from the face when talking, as it is likely to contain sebum. 
  • Clean spectacles often as they collect sebum, and skin residue.
  • Avoid anxiety and stress, as it can increase the production of cortisol and adrenaline, which aggravate acne.
  • Never pick. Picking may result in further inflammation and scarring.
  • Wear daily sunscreen since some acne medications may increase the skin’s sensitivity to sunlight.

We hope the tips given above will help you to have acne free skin. Remember that you’re not alone. Look around and you’ll see that most are in it together!

Dr Krishna Priya

References:
https://www.medicinenet.com/acne/article.htm

 

Skin tags

Skin tags, formally known as acrochordons, are small pieces of flesh that protrude from your skin. They’re attached through a stem or stalk. Skin tags are most commonly found in folds of skin i.e, around 

  • your neck
  • Armpits
  • and groin area

 usually, appear in people of middle age and both women and men get equally.

Causes and risk factors:

While the exact causes of skin tags are unknown. 

however, the risk factor includes

  1. Older people
  2. People who are obese
  3. Type 2 diabetic
  4. Pregnancy
  5. Family history
  6. Sex steroid imbalance especially if they are changes in estrogen and progesterone.

When to see a doctor:

Skin tags are usually harmless, non-contagious and non-cancerous benign growths but when it bleeds, itches, or changes colour, contact your doctor immediately.

Treatment:

Small and tiny skin tags may fall off on their own.

Most skin tags stay attached to your skin. In general, skin tags don’t require treatment.

skin tags are only a cosmetic concern, not a medical problem.

Various treatment methods include:

Cryotherapy: Where freezing the skin tag with liquid nitrogen.
Surgical removal: Removing the skin tag with scissors or a scalpel.
Electrosurgery: Burning off the skin tag with high-frequency electrical energy.
Ligation: Removing the skin tag by tying it off with surgical thread in order to cut off its blood flow.

Removing skin tags at home may cause heavy bleeding and infection hence not suggested.

Dr. Krishna Priya.

References:
https://www.webmd.com/skin-problems-and-treatments/rm-quiz-truth-skin-tags

 


 

 

Dark circles

Common causes of Dark circles are:

  1. Fatigue – sleeping very late, not getting adequate sleep can all cause dark circles.
  2. Eye strain – watching Television or staring into screens for long times cause significant stress on eyes.
  3. Dehydration – lack of water in our body sometimes manifests as sunken eyes. It may cause the area beneath the eyes to look dark.
  4. Unprotected exposure of sun – not covering oneself or not using sunscreen creams, may cause excessive melanin production, thus causing the area around the eyes to look darker than they actually are.
  5. Allergies – cause one to rub eyes recurrently and cause the area around the eyes to become dry and discoloured and may appear as dark.
  6. Hereditary factors and certain other inflammatory skin diseases such as eczema can cause dark circles.

Here are some tips that can help in preventing and dealing with dark circles-

  1. Make sure to have a good quality sleep – it means sleep early on a regular basis and have at least 6-7 hours of sleep.
  2. If you already have dark circles, applying cold compresses under your eyes such as by applying cucumber or potato slices on eyes can help in soothing the irritation caused by allergies and help in reducing dark circles.
  3. Applying cold tea bags to your eyes can improve their appearance. Tea contains caffeine and antioxidants that can help stimulate blood circulation.
  4. Sometimes, when dark circles are too stubborn, concealing them with makeup can help.
  5. Use eye protection in the form of anti-glare eyeglasses if and when long hours of work on screen are to be done and sunglasses when going out.
  6. Applying a sunscreen that suits you before going out in the sun is advisable.
  7. If none of the above are helpful, talking to dermatologist is important.

Dr.Afroze Fatima

https://www.mayoclinic.org/symptoms/dark-circles-under-eyes/basics/definition/sym-20050624

https://www.webmd.com/beauty/features/dark-circles

https://www.healthline.com/health/dark-circle-under-eyes

https://www.mdedge.com/dermatology/article/97850/dark-circles-under-eyes

https://www.mayoclinic.org/symptoms/dark-circles-under-eyes/basics/definition/sym-20050624

https://www.mayoclinic.org/symptoms/dark-circles-under-eyes/basics/causes/sym-20050624

https://www.mayoclinic.org/symptoms/dark-circles-under-eyes/basics/causes/sym-20050624?p=1

https://www.healthywomen.org/content/article/what-causes-under-eye-circles-and-how-get-rid-them

https://www.healthline.com/health/dark-circle-under-eyes

https://www.webmd.com/beauty/features/dark-circles

 

Good and Bad of emergency contraceptive

Emergency contraception also known as postcoital contraception is a form of birth control that may be used by women who have had unprotected sex or failure of usual birth control methods.The treatment generally is reserved for specific situations and is not a regular method of birth control. Emergency oral contraception is used in preventing pregnancy and should not be used to end one. 

The Good-

  • Emergency contraception is safe and effective in preventing pregnancy after unprotected sex.
  • Emergency contraception is private. It is your choice if you want your partner to know about it.

The Bad-

  • It has a limited time frame of 5 days following unprotected intercourse..
  • It may cause side effects including nausea, vomiting, stomach pain, and headache.
  • Emergency contraception is not helpful if the woman is already pregnant. Women who are suspecting  pregnancy or are pregnant should not use emergency contraception.
  • Emergency contraception does not provide protection against sexually transmitted diseases (STDs) including HIV.  Use of condoms is advised to reduce the risk of STDs.
  • There still remains a small chance of getting pregnant after emergency contraception.

So it is better to weigh the pros and cons and use it in situations such as above after a discussion with the gynecologist.

 

-Dr Prerna Gaur

 

SLEEPWALKING IN CHILDREN

Sleepwalking, or somnambulism is a behavior disorder that takes place during the deepest stage of dreamless sleep. 

Sleepwalking is very common in kids. They tend to sleepwalk within an hour or two of falling asleep. They may walk around for a few seconds to minutes. No matter what they’re doing, a sleepwalker will usually have their eyes open, with a confused, glassy stare. Even so, they’re really and truly asleep, which means they probably won’t remember anything about the incident if you ask them about it the next day.

It’s difficult to wake someone up while they are sleepwalking. When they are awakened they may feel groggy and disoriented for a few minutes.

Causes:

It’s common in kids than in adults. The condition may run in families.

  • lack of sleep or fatigue
  • irregular sleep schedules
  • illness or fever
  • some medicines
  • stress

 

What Happens During Sleepwalking?

Getting out of the bed and walking while sleeping is the commonest symptom. 

Other symptoms include 

  • sleep talk
  • be hard to wake up
  • seem dazed
  • be clumsy
  • not respond when spoken to
  • kids sit up and do repeated motions such as rubbing eyes 

 

Diagnosis:

Doctors generally don’t do any test to diagnose the condition. They take a detailed history of the child’s sleeping habits.

 

Treatment:

Children normally outgrow the habit of sleepwalking and treatment with medicines is not necessary.

It can be managed by lifestyle modifications:

  • Improving sleep hygiene to minimize fatigue
  • Avoiding stress and anxiety
  • modifying  the environment to reduce tripping hazards
  • Emptying the bladder before sleep

 

How to Keep a Sleepwalker Safe

Sleepwalking isn’t dangerous by itself. But it’s important to take precautions so that your sleepwalking child is less likely to fall down, run into something, and walk out the front door.

  • Don’t wake up the sleepwalker because it might scare them. Instead, guide them back to bed.
  • Make sure to lock the windows in your Childs room. Consider child safety locks on doors.
  • Don’t let the child sleep in the bunk bed to prevent falls from height 
  • Move the sharp objects or breakable things from your Childs room 
  • Keep dangerous objects out of reach.

 

  • Make sure to install safety gates outside your Childs room or at the top of any stairs.

 

By,

Dr.chandrashekar

 

Reference:

https://www.tuck.com/sleepwalking/

http://sleepeducation.org/sleep-disorders-by-category/parasomnias/sleepwalking/overview-facts

https://www.webmd.com/sleep-disorders/guide/sleepwalking-causes