Need of patient education about osteoarthritis.

Helping the patient to understand about osteoarthritis is important. It is a progressive wear and tear disease of old age. Poor understanding of the disease will lead to negative attitude in patients. For example ignorance about the disease may lead to lack of activity which further aggravate the disease. Patient education is an essential component of  treatment due to the following reasons.

Psychological and social factors will alter the effect of disease, proper education of the patient regarding the disease and effect will reduce the pain, distress, disability and it will improve the treatment compliance.

To protect the affected joint from excessive loading

1. Reduce the weight.

2. Patient should consume low fat, carbohydrate rich low calorie food for weight reduction.

3. Avoid inappropriate daily and occupational activities example knee lifts.

4. Use walking sticks.

5. Wear shock absorbing footwear.

6. Correct the disparity in leg length with shoe rise.

7. Tubular loose knee support may reduce the pain.

8. Use wedge insoles.

9. Proper advice should be given to maintain the normal joint function.

10.Advice aerobic fitness such as walking and swimming to maintain the joint motion and stability.

11. Do muscle strengthening exercise.

12. Regular physical activity.

13. Avoid over activity on good days because that may increase the pain and reduction of activities on subsequent days.

Proper modification of work place and home activities are required.

Advice regarding sexual activities should be given to the patient and the partner with hip osteoarthritis.

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How will you care heart attack patient ?

Heart attack is a common problem in the community, but majority of the people don’t know what are the precautions we should take after a major heart attack. Understanding of which is very important because it will help us to avoid further attack, and improve the quality of life. Patients and their relatives should take special attention in understanding this aspect. Millions of people are living with heart disease,but it is not easy to live with heart attack.Following are the tip for caregivers and patients.

1.Healthy food - Patient should take a balanced food.Predominantly vegetarian food is preferred,food should be rich in antioxidants.

2.Exercise - Daily exercise will help to protect the heart,only safe exercise is advised.

3.Stop smoking and heavy alcohol intake.

4.Ensure adequate sleep.

5.Patient should not stop drugs without doctors advise.

6.Patients can  take part in cardiac rehabilitation program  after dicussing with the treating doctor.

7.Caregivers should understand the psychological ,cultural and spiritual aspect of health and disease.

8.Avoid mental and physical stress.

9.CPR - Cardio pulmonary resuscitation  is called as chain of survival,it is important that care givers should learn it for their loved one.

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Drugs used for treatment of heart attack patients.

Heart attack occurs when there is reduced blood supply to heart. It is an emergency situation and immediate medical care is required. Here in this article we will tell you some of the drugs and their aims. It is always good to have these in your mind

Following are the aims of treatment.

1.Immediate stabilization of patient.

2.longterm symptom control.

3.Cure of the condition if possible.

Drugs used for the treatment are given below.

1. Antiplatelet drugs –Aspirin and Clopidogrel, it is a group of powerful drugs that will prevent the blood clotting.

2. Nitrates will help to reduce the pain

3. Betablockers decrease the heart rate, blood pressure and improve the oxygen supply to heart.

4. Statin will reduce the blood cholesterol. Stabilize the plaque so prevent further attack.

5. ACE Inhibitors- role is to reduce the blood pressure, dilate the blood vessels and increases the blood supply.

6. Angiotensin II Receptor Blockers will increase the blood supply to heart.

7. Clot lysis with streptokinase give immediate improvement.

8. Diuretics remove excess salt and water from the body so help the heart to work properly.

9. Digoxin improve the function of heart.

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Medicinal effect of garlic in heart patients.

Medicinal effects of Garlic (Allium sativum) is known from the ancient days itself. It is used for treatment and prevention of many disease. Heart attack patients get several benefits with garlic intake. 

Active ingredient is Allicin which is an odorous sulfurous compound that has several medicinal effect. Following are the benefit of Garlic in heart attack patients. The main abnormality in blood vessels in heart attack patients is atherosclerosis. 

• It helps to reduce the blood clotting. It produce irreversible inhibition of platelet aggregation ,which is a blood component. Major action of drugs given in heart attack patients is to inhibit the platelet, which is responsible for blood clotting.
• Reduction of cholesterol and triglycerides levels which is responsible for formation of atherosclerosis and plaque in blood vessels leading to reduction in blood supply.Several studies showed 9 to 12% reduction in cholesterol and moderate reduction of triglycerides levels with its use.
• Help to reduce blood pressure which is also a risk factor for heart attack .There will be an average reduction of 11mm of Hg in systolic and 6.5 mm of Hg diastolic blood pressure.
• Garlic has anti atherosclerosis action,which help to reduce the formation of new atherosclerosis lesion and prevent the progression of older lesions.

Garlic is available as fresh cloves, powders, extract, tablets. At least one-half garlic clove per day  is required for medicinal effects.Although the tablets and powders are convenient, the amount of active ingredient is insufficient.

Some people may experience gut (gastrointestinal system ) symptoms such as flatulence(gas), chest pain and abdominal pain after garlic intake.

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Lifestyle changes recommended for hypertension control

Healthy lifestyle will help to reduce the hypertension and pre-hypertension ,the effect is more on hypertensive than pre-hypertensive. Even if it wont completely eliminate the need of drugs this will reduce the number of drugs and their required dose.

Dietary modification that may  help to reduce the blood pressure are the following

1.Weight reduction

2.Decrease the salt intake.

3.Increased potassium intake.

4.Moderation of alcohol consumption.

5.Healthy diet.

1. Weight reduction.

This is important for reducing blood pressure and heart disease. Even moderate reduction in weight help to reduce blood pressure and increases the insulin sensitivity.With a reduction of 9.2 kg weight loss blood pressure decreases 6.3/3.1 mmHg. Blood pressure may be reduced by 30 minutes of moderately severe exercise such as brisk walking 6 to 7 days a week.

2. Decrease the salt intake.

Reduced  salt intake.Effect of reduction in salt intake show individual variation. If the salt intake is reduced to less than 6 gm a day it will decrease the blood pressure and long term risk of heart disease in pre-hypertensive people.

3. Increased potassium intake - Potassium and calcium supplements

Both have mild anti-hypertensive effect. Potassium supplements will  also help to reduce the death due to stroke.

4. Alcohol consumption and hypertension.

High alcohol consumption is associated with high blood pressure,reduction in alcohol consumption is associated with low blood pressure.

DASH diet (dietary approach to stop hypertension).

Diet given for 8 week period show promising results.

It will lower the blood pressure in people with high blood pressure.

5. Healthy diet 

Diet should be rich in

1.Fruits.

2.Vegetables.

3.Low fat dairy products.

• The effect of diet is augmented by salt restriction to less than 6 gms a day. 
• Fruits and vegetables are enriched with potassium ,magnesium and fiber
• Dairy product contain calcium.

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Advice for diabetic drivers

Driving is a complex activity which requires adequate vision,motor skill and proper judgement.It is required in day to day life.Diabetes can adversely affect driving by producing low blood glucose,decreased vision and neurological problems.

Following are the advice for diabetic drivers

1. Diabetic drivers should inform the licensing authority and motor insurer about the diabetes and its treatment.

2. If there is sudden deterioration in vision they should not drive.

3. Before starting journey they are advised to check the blood glucose (even before short journey) and in between long journey.

4. They should avoid alcohol.

5. Diabetic drivers should take frequent rests with snacks or meals.

6. For emergency use they are advised to keep fast and long acting carbohydrates in the vehicle.

7. All diabetic drivers should carry personal identification indicating that they are diabetic.

8. If they develop hypoglycemia they should stop driving ,switch off the engine and leave the driver seat for treatment.

9. They should not restart driving for 1 hour after  the blood glucose returned to normal level.

Reason for diabetic drivers to stop driving

1. Newly detected diabetic patients who are started on treatment particularly if on insulin shouldn't drive  unless they achieved diabetic control and proper vision.

2. If a diabetic patient develop recurrent severe daytime hypoglycemia.

3.If the diabetic patient has disabling unawareness of hypoglycemia.

4.Reduced vision in both eyes less than 6/12

5.Severe nervous system complication such as loss of pain and touch in limbs.

6.Severe peripheral blood vessel complication.

7. Lower limb amputation.

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