Thursday, September 17, 2015

[12:55PM, 8/8/2015] ‪+91 91606 76849‬: infraction.
Septic shock, due to severe infection like peritonitis.
WATERY DIARRHOEA & HYPOTENSION
Start i.v drip of ringer’s lactate, with 18 no.needle, attach a 3-way, and push i.v. Fluids fast using a 20cc syring.



Push i.v fluids till B P rises above 100 mm
Inj.efcorlin 100 mg. X 1-2 vial i.v stat. Or inj.decadron or betnosol.
Inj.gentamycin 80 mg i.v 8 hrly.
Tab.lomotill 2 tds
Tab.spasmodan 1 tds
If B P does not raise after pushing 3-4 bottls,it is safer to refer the patient to a hospital.In a patient with diarrhoea & dehydration, never give D5%. Give electrolyte, DNS,RL, or NS.
The patient may be reqire 10 or more bottles of fluids, to be given within a short while.
WNEN B P IS >200 M M SYSTOLIC
Acute rise of blood pressure is potentially very dangerous, and can lead to hemiplegia due to cerebral haemorrhage
Immediate and complete bed rest.
Cap.depin 100 mg – punctured and aqueezed sublingually – (nifedipine) may be repeated after 15 mins. Or inj.reserpine 1 amp i.m stat or s o s
Inj.calmpose 2 cc i.m stat.
Simultaneously, start anti-hypertensive treatment, eg. Tab aten –50 1 b I d (atenolal = betablocker).or tab.envas 2.5 mg. 1 b.i.d (enalapril = ACE inhibitor )Subsequently :
Adjust the dose of anti – hypertensive drugs.
Salt free diet.
Instruct the patient o be regular in treatment & check up.
BREATHLESSNESS WITH WHEEZING
BREATHLESSNESS WITHOUT WHEEZINGacute exacerbation of bronchial asthma
inj.deriphyllin 2cc i.m stat
asthalin inhaler 1-2 pufs.
If no respone, or if attack is severe,
Inj.aminophyllin 1o ml + 25%glucose 10 ml i.v x very slowly or inj.adrenalin 0.5 ml subcut x children and young adult.
Oxygen by nasal catheter or mask.
If there is no relief in 10 minute,
Repeat inj.aminophyllin slow i.v or adrenalin s.c
Inj. Decadron 2 cc i.v or betamethasone or hydrocortisone.
Inj.gentamycin 80 mg i.v 8 hrly.
Inj.calmposed 1 stat & s o s
Oxygen by nasal catheter mask.
If there is relief still,
Refer to a physician.
Start aminophyllin drip-2 amps of aminophyllin in bottle of 5% dextrose x 20 drops/mins.
Inj.sodabicarb 50 ml x slow i.v injection.
Repeat inj.decadron as required.
After the attack subsides,start oral inhaled bronchodilator drug. If puls is very feeble-? Left ventricular failure. If liver is palpable, tender with leg edema-? C.C.F. If only lung signs-primary lung disease.
If I V F,
Oxygen
Inj. Morphin 15 mg I M or fortwin.
Inj.betnesol 2-4 amps i.v or decadron.
Lasix 1-2 amps i.v
Inj.aminophyllin 10 ml + 25% dextrose 10ml x slow i.v
Refer to hospital to rule out myocardial infract.
If C C F.
Propped up position.
Oxygen.
Inj.aminophyllin 10 ml + 25% dextrose 10ml x slow i.v or inj.deriphyllin 2 cc.i.m
Inj.lasix 2 amps i.v, (inj. i.m if B P is low).
Tab.lanoxin 3 stat, then 1 t d s x 3 days, then 1 od.
Tab.calmpose 5 mg 1 stat.
No I V fluids, no saline (no salt)
If lung disease,
Oxygen.
Inj.aminophyllin 10 ml + 25% dextrose 10ml x slow i.v or inj.deriphyllin 2 cc.i.m
Inj. Decadron 2 cc i.v or betamethasone or hydrocortisone.
Get x-ray chest as early as possible to decide further line of treatment.

SEVERE HEMETEMESIS OR HEMOPTYSIS

Step –1: quickly judge the source of bleeding
HemoptysisHemetemesis
If h/o cough, breathlessness expectoration.
If blood is coughed out & is mixed with sputum.
If blood is bright red, frothy with sputum.
Litmus paper = alkaline reaction.
If h/o epigastric ie, ulcer like pain. If h/o alcoholism & cirrhosis.
If blood is vomited out and is mixed with food particles.
If blood is coffee ground but it may be fresh red if variceal bleeding.
Litmus test = acid reaction.
Step-2 : start 18 no. I.V line
Start R-L or D N S, using 18 no.scalp vein needle and let the I.V run in very fast.
If lot of blood is lost, start hemacele/dextran (plasma expanders)
Make arrangements to shift the patient to a hospital with blood transfusion facilities.If hemetemisis,
Ryle’s tube and cold water stomach wash.
Inj.ranitidine 1-2 amps.I.VIf hemoptysis,
Inj.cefazolin 500 mg I.V 6 hrly.
x-ray chest and if hilar shadow, then bronchoscopy.
Anti-T B treatment, if tuberculosis.
Step-3 : measures to stop bleeding,
Inj.calcium gluconate 10 ml slow I.V stat.
Inj.dicynene 2 ml I.V stat. Or 4 hrly.(ethamsylate) or stryptohrome 2cc I M stat.(adrenochrome)
Inj.morphin 15 mg I M stat.
Inj.decadron 2 cc I V stat

SCORPION BITE (bichhu)
Patient present with very sever pain & sweating.
Inj. pethidine 100mg I.M/I.V stat. Or inj. fortiwin /norphin/morphin.
Inj. Local xylocain 2% : infiltrate at and around the site of bite (the site of bite is identified as pinpoint puncture spot, local sweating & edema ).
Tab. Prazopress 1 mg.stat. (prazocn = alpha bloker). Or ciplar 40 mg.stat. (propranolal ) In children, tab prazocin 1 mg x ½ -1/4 tab. Or tab.ciplor-10 mg. Tab. In most cases, where scorpion poison is mild, this treatment is sufficient. If there is systemic involvement,
Systemic involvement is indicated by – profuse sweating, ice cold extremities, priapism, hypersalivation, vomiting, hypertension, tachycardia & pulmonary edema.
Observe pulse rate, B P, & breathlessness, every 10 mins.
Tab. Prazopress 1 mg.stat ½ tab after 4 hrs, then ½ tab every 6 hrs till. Systemic symptoms & signs disappear, usually 24 to 48 hrs. or tab.ciplor 40 mg 1 stat.,1 after 4 hrs, then every 6 hrs.
Inj.fortwin 1cc I M/IV S O S if pain is severe.
I V. R L x if profuse sweating & dehydration.
If B P. > 150/100,
Tab. Depin 5 mg sublingual, to be repeated s o s after ½ -1 hrs (nifedipine).
If tachycardia >110/mins,
Inj.calmposed 2 cc I M or slow I.V
If breathlessness, fine fasal erepts i.e. pulmonary edema,
Propped up position.
Oxygen.
Inj. Lasix 2-4 amps I.V stat.
Inj. Efcorlin 100 mg I.V. stat
Inj. aminophyllin 10 ml + 25% dextrose 10ml x slow i.v or inj.deriphyllin 2 cc.i.m
In life threatening situations, with severe dyspnoea & frothing through mouth, give sodium nitroprusside drip till pulmonary edema is controlled.
Inj.pruside 50 mg in 5 ml x added to 500 ml D% x 15 drops/min x may be increased up to 40 drops /mins.

There is no specific antidote for scorpion poison. The magical effect of prazocin, which gives total protection against cardiac toxicity of scorpion bit was discovered by an Indian doctor, Dr. Bavaskar from mahad, raigad, district in maharashatra.

SNAKE BITE
First aid,
A reassurance is often the most important part of the panicked patient.
Tie a tourniquet above the site of bite on the limb, using a handkerchief or long piece of cloth, not too tight- just to occulude venous & lymphatic return.
Immobilize the limb with splint, because movements = more absorption.
If snake was poisonous, make the cruciate incision through the bite marks, and allow the blood to flow.Signs of poisoning.

Two puncture marks, 3/4-1 cm a part, should mark you suspicious of poisonous snakebite.
There are two type of poisons – paralytic type and hemolytic type
.
Paralytic type :
Stage- I : prosis.
Stage – II : difficulty in swallowing.
Stage – III: respiratory difficult & paralysis.

Hemolytic type:
Local swilling around the bite develops rapidly.
Blood collected in test tube does not clot.
If no signs of poison are seen,
Tab. Diazepam 1 stat (to relieve anxiety)
Tab. Disprin 1 stat (analgesic )
Inj. T.T. ½ cc I.M stat.
Reassure the patient.
Observe for 6 hrs, watch for the 4 signs of snake poison – local swelling, ptosis, dysphagia & respiratory difficulty. If signs of poison are seen,

Paralytic type:

Act immediate if ptosis or dysphagia is seen. If you do not have A.S.V, take the patient quickly to a hospital where A.S.V is available.remember that respiratory paralysis is imminent.
Inj.decadron 2 cc I.V stat
Inj. avil 1 amp. I.V stat
Inj. A.S.V. 1 to 4 vials, every 15 or 30 mins, till the signs start reversing (ASV-polyvalent). A.S.V. vial contains powder. Dissolve in 10 ml. distil water. Inj.½ cc I.V. as test dose. Wait for 2 mins. & Watch for urticaria. Then inject the full dose of a.s.v.
Inj. A.S.V.1 ml locally around the site of bite.
Inj. Neo stigmine 4 amps I.V preceded by inj. Atropin 2 amps i.v. (to counter excess salivation caused by n
[1:10PM, 8/8/2015] ‪+91 94818 85134‬: N no h/o Cox
[1:22PM, 8/8/2015] Abid Dr: Do not try the above treatment plz ...it should b carried on only in an ICU setup n under the guidance of a MD allopathy ....not by a unani graduate ....
[1:24PM, 8/8/2015] ‪+91 94818 85134‬: Its primary. Infertility case n no case of Cox
[1:27PM, 8/8/2015] ‪+91 90323 93573‬: Assalamualaikum
[1:27PM, 8/8/2015] ‪+91 90323 93573‬: Dr ghazala mam

I would like to know whether wet cupping is allowed on pubic region or not
[1:28PM, 8/8/2015] ‪+91 90323 93573‬: N also treatment for tubal blocakge
[1:32PM, 8/8/2015] ‪+91 99224 10312‬: Yes you can do wet cupping in pubic region.The same treatment for tubal block
[1:49PM, 8/8/2015] ‪+91 94818 85134‬: Thank you Madam
[1:50PM, 8/8/2015] ‪+91 94818 85134‬: Thank you Madam
[2:12PM, 8/8/2015] ‪+91 90323 93573‬: Jazakallah mAm
[2:12PM, 8/8/2015] ‪+91 96182 88115‬: Jazakallah mam
[2:15PM, 8/8/2015] ‪+91 96182 88115‬: Secondary infertility with pcod n having history of 2abortions wth 2 months
[2:16PM, 8/8/2015] ‪+91 96182 88115‬: Kya ap iska treatment bolsakty kya
[3:02PM, 8/8/2015] Shazia: Treatment for eczema in unani ?
[11:31PM, 8/8/2015] ‪+91 91460 77714‬: بیگ صاحب بہت خوب ماشاء اللّٰه مفرد ادویا سے علاج کا اپنا ہی مزہ ہے
[12:00AM, 8/9/2015] Sameer Dru: Jazakallah Dr ghazala mulla madam n Dr wahid sir
[12:25PM, 8/9/2015] Hussain Dd2: 👉I wish u all mothers and married sisters a happy and blessed BREAST FEEDiNG week
Your babies live hundred years ammeen
Regards
Dr India charitable trust 👉
[12:25PM, 8/9/2015] Hussain Dd2: Pls share it might help some mother
[1:25PM, 8/9/2015] ‪+91 85208 75083‬: Assalamualaikum
To all bros n sisters
Ye muhim maine pichle seven years se
Chalarahaun
AGAINST BOTTLE FEEDING N TOP FEEDING TECHNIQUES TO INFANTS N CHILDREN'S
AAPLOGON SE GUZARISH HAI AAPLOG BHI IS.PE TAWAJJUH DEIN
HUMAARA MOASHRA BEHTAR HOGA AUR BAD I KAAMYABI MILEGI
[5:54PM, 8/9/2015] ‪+91 85208 75083‬: Is pt ki tracheostomy hui hai kuch nhin karsaktehain bus allah sehet dein
[6:06PM, 8/9/2015] Hussain Dd2: Cupping therapy s recommended for slip disc ? L1 and s5 herniation
Pls say experts
[6:06PM, 8/9/2015] Hussain Dd2: Pls comment on this experts
[11:06AM, 8/10/2015] ‪+91 90082 30242‬: Really scary! Youths with eye cancer increased by 3%!

When lights are off at night, one must not view the handphone! Please share with friends urgently ~

Habitually using handphones b4 bedtime in the dark can lead to serious problems.

Recently, an increasing number of 30-40 year-old patients are seeking medical attention due to using handphones in the dark.

Professor Li Li, director of the Hospital of Ophthalmology said: direct glare of >30 minutes would cause irreversible eye macular degeneration that leads to rapid deterioration of vision.

Contracting maculopathy (eye cancer) means waiting for loss of sight because modern medicine cannot treat, let alone cure it.

The bright phone in the dark with close-up view & high-energy directed at the eyes will damage the macula of the eye.

Professor Li Li said that symptoms of macular degeneration is mostly experienced by old people, but lately patients are getting younger. Patients who are 30-40 years of age increased by 3 %, most are frequent users of handphones.

However, viewing the handphone in the dark not only causes macular degeneration. It initially causes dry eyes, cataracts and eventually loss of sight.

Early lesions of the eye have to be treated with laser or injection of steroids.

254 Hospital eye specialist Professor Li Li suggested that the most important thing is to get rid of the bad habit of using handphones in the dark. Because habitual use of handphones in thr dark b4 bedtime may cause a lifetime of harm.

Friends : In order to look after ourselves and our families, remember not to turn off the lights if viewing the handphone. Inform handphone users urgently that viewing handphones in the dark can easily lead to loss of sight!
[12:01PM, 8/10/2015] ‪+91 98869 33258‬: Dear dr/freinds.I am immensely pleased to invite u 4 the CME prgram organised by Mahaveer Jain Hosp in association with Karnataka Unani Medicine Graduates Association.
Topic:Basics of ECG & others topics related to cardiology.
Date :Saturday.15th August ,Time : 01:00 pm Lunch folowedby CME till 5pm. pm,Venue : A p I Bhawan ,next 2 Mahaveer Jain Hospital.vasanth nagar.B'lore.frm:Dr Shuhabuddin.President KUMGA & CCIM Exec Member.

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