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GENERAL MEDICINE DEPARTMENT |
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SPECIAL CLINICS
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The department is running three speciality clinics since few years. The aims of
the special clinics are to provide focused & comprehensive care to the
particular groups of patients who attend such clinics. |
DIABETIC CLINIC
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India has the largest and the fastest growing Diabetic population in the world.
Today, there are 33 million diabetic patients and the number is likely to rise
to 57 million by 2025. The fear of Diabetic Epidemic looms large ..... So is the
fear of complications arising from Diabetes. Uncontrolled sugar adversely
affects various organs of our body namely- Kidneys, Eyes, Heart and Feet. |
The most devastating complication in a diabetic patient is foot infections and
foot ulcers. On a rough estimate 20% of all hospital admission of a diabetic
patients are due to foot problems. Proper foot care needs a team approach
comprising Diabetologist, surgeon, orthopedician, podiatrist and an
orthotist.Many amputations can be avoided if proper treatment and care is given
at the right time.
In our hospital we are working as a team and trying our best to save people
from trauma of amputation. |
"The patient who
knows
the most lives the longest".
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The greatest
weapon in our crusade against diabetes is knowledge. The mission of this website
is to provide patients with appropriate information which when imbibed would
help them assess their risk of diabetes, motivate them to seek proper treatment
and inspire them to take charge of their disease. Awareness and knowledge would
remove diabetes illiteracy and make people their own doctors and help them lead
a happy and secure life.
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GUIDELINES TO BE FOLLOWED TO PREVENT DIABETES
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- Accept the fact that you have Diabetes.
- Diabetes is a life long disease.
- Regular follow ups are a part of your treatment.
- No two people are alike and so is their Diabetes.
- Tight control of sugar, all the time, can save you from complications
- If you have complications already, regular and appropriate treatment can arrest
their progression.
- Diet, exercise, oral medication and insulin injections are the four modalities
of your treatment.
- Stop smoking and alcohol
- Ask your Doctor the targets of your treatment and try to achieve them.
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IDEAL TARGETS |
- FBS - 80-110
- 2hr PPBS - 120-140
- BP (mm of hg) - < 130/80
- CHOLESTEROL - <180
- TRIGYCERIDES - <150
- HDL - >45
- LDL - <100
- BMI - 20-23
- WAIST - <85cm (Females) <90cm (Males)
- WHR - <0.8cm (Females) <0.9cm (Males)
- HbAIC - <7
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FREQUENCY FOR CHECKUPS |
- If your sugar is under control, monthly check-up from a doctor is still advised.
- If you are using tablets for Diabetes, check your sugar once in a week with the
glucometer and once in a month from the lab.
- If you are using insulin, ideally you should check your sugar on alternate days
or as and when need be.
- Urine exam- every month.
- S. Creatinine- every three months till it is normal, if abnormal then as
frequently as advised by your doctor.
- HbAIC- Every three months.
- Lipid profile- once a year if normal, if abnormal-3 monthly after starting
treatment.
- Urine for microalbumin- 6 monthly or as advised by your doctor.
- Eye check up- once in a year or as and when any abnornmal symptom appears.
- Foot check–up-qualitative check up at every monthly visit, and quantitative
footexam annually. Even if your feet are seemingly normal, you must get your
feet checked once in a year with special machines like biothesiometer, hand
Doppler and monofilatment to know the foot at risk.
- Heart check-up-every monthly visit, ECG may be done as and when symptoms
suggest. Base line ECG and echo may be done in elderly diabetics and when ever
any symptoms appear.
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EPILESPSY CLINIC |
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Fits/attacks of unconsciousness can occur at any age to different reasons and in
various situations. Sometimes it causes difficulty in proper diagnosis and
management. In addition, there are lot of associated notions and misconceptions.
There are some common Queries which come to the mind while we talk about fits |
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FREQUENTLY ASKED QUESTIONS |
Q. What is fit?
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Usually
fit is referred to be people as sudden attack of disturbed consciousness or
behaviour with or without other associated features |
Q. What is the usual age at
which fit occur?
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Fits can occur at any age, depending upon the
underlying cause. e.g. epileptic fits usually start in the childhood whereas the
hysterical attacks are seen more commonly in young adults under stress. Fits
occurring in older age are due to some other organic illnesses |
Q. What are the common
causes?
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As already said, the causes differ at different age at which attacks start. In children, the commonest cause is EPILEPSY; though other causes may be encountered occasionally. With increasing stresses even in childhood, psychogenic or hysterical attacks are also seen in children.
In adulthood - Variety of conditions can manifest as fits or seizures. Simple reasons like exhaustion due to stress (mental or physical) or heat or lack of sleep can cause fits. Commonest at this age is psychological disorders-may be in form of hysterical fit, panic attacks or anxiety attack. Other less common causes include some heart diseases, due to some medicines in diabetics, in alcoholics a type of migraine or strokes, all can cause seizures, though these causes are usually seen in older age |
Q. How common is epilepsy?
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Epilepsy usually starts in childhood and is fairly common. it has been seen in various studies world over that about 0.3 to 0.5 percent of people suffer from this condition |
Q. Are all fits in childhood epileptic?
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No, As earlier mentioned, majority of seizures/fits in childhood are epileptic fits but other uncommon causes like breath holding attacks (while excessive crying ), anxiety/ panic attacks, migraine, hysterical attacks are seen in children |
Q. How to recognize an epileptic fit?
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the manifestation of an epileptic fit may vary in different individuals/situations. But usually the classical epileptic attack consists of unconsciousness, abnormal movements of limbs and face, eyes rolled up or turned to one side, passage of urine/stools in clothes, clenching of teeth, frothing from mouth, tongue bite and sometimes there is shriek/cry just at the onset. The patient usually falls down and may injure himself/herself. This lasts for few minutes followed by a period of sleep/abnormal behaviour.
It is not a must that every patient has this classical presentation. Depending upon the type of epilepsy, the symptoms/ signs can be different e.g. in case of focal epilepsy, there may not be present though the patients can minic them well. After seeing an attack, the physician can most of the time judge what type of attack is it |
Q. What should be done immediately on seeing a person in epileptic attack?
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There are some important do's and don's during an epileptic attack.
* Turn the patient to one side.
* To maintain the airway, put a padded spoon in between the teeth. Don't put your finger, it may get bitten.
* Remove - if spectacles or artificial teeth are there.
* Loosen the patients tight clothes.
* Do not have a crowd him/her.
* Do not try to given him/her anything by mouth.
* Let the patient rest/sleep after the convulsion.
The attack usually lasts few minutes
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Q. Are the attacks alike?
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No, Even a patient of established epilepsy can have different types of attacks at different times. It may be epileptic attack of other type or it could be psychogenic attack in addition |
Q. What investigations are diagnostic of epilepsy?
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The most important thing for diagnosis of an attack of epilepsy is the history of patient. Some times investigation like ECG, CT Scan/MRI of brain, some blood tests may be needed. But this should be decided by physician. |
Q. Can epileptic patients lead a normal life i.e. Education and Career?
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The most important thing for diagnosis of an attack of epilepsy is the history of patient. Some times investigation like ECG, CT Scan/MRI of brain, some blood tests may be needed. But this should be decided by physician. |
Q.Do the children of epileptic patients must have epilepsy?
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No. But the risk of having epilepsy definitely increases if one or both parents are epileptics. |
Q .How long the patents of epilepsy require medication?
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In about 85-90% patients, after an attack free interval of 4-5 years, medicines are tapered and stopped. But rest of cases amy need maintenance dose of medicines life long. |
Some myths & facts
about Epileptic Fits
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Epileptic Myths
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Epileptic Facts
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1. Epilepsy is caused due to the effect of evil
spirits. |
1. No Epilepsy is caused by some disturbed
electro-physiological activity in brain. |
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2. Epilepsy ia a contagious problem. |
2. No. If is not infectious/contagious disease. An
epileptic can mix up and share with other people normally. |
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3. All fits are epileptic fits. |
3. No. All fits are not necessarily epileptic.
There are other causes and diseases which can cause fits. Let the physician
decide about the cause of fit. |
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4. Marriage is the remedy for fits in young girls. |
4. No epileptic fits are due to some organic
disturbance in the brain therefore marriage can not help it. However, in some
psychogenic fits where the young individual wants to get married, it may prove
beneficial to some extent. |
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5. Sadhus/Ojhas/Tantriks/Religious people can cure
epilepsy, without medicines.
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5. No. As epilepsy is a disease, it requires
proper medication and guidance of expert physician and can not be cured by
quacks. |
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6. During a fit, administering some pungent odour
(e.g. shoe etc. in front of nose) can stop the fit? |
pungent odour (e.g. shoe etc. in front of
nose) can stop the fit? 6.
No. These is no logical basis for such
action. |
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7. During a fit administering water/liquids by
mouth helps |
7. No. On the contrary, nothing should be given by
mouth to an unconscious person during fit as it my go the air passages and cause
complications. |
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8. Once a person is diagnosed as epilepsy, he
should rest in bed and not go to work. |
8. No. A person after being diagnosed epileptic
should try to lead as normal as possible life with regular routine work but
should take proper medicine and guidance from a physician. |
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9. Medicines for epilepsy are habit forming. |
9. No, the medicines have to be taken for a long
period (few years) but under guidance of physician, they are stopped at
appropriate time. |
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10. All epileptic children are dull/weak in
studies/ have low I.Q. |
10. Though there are some causes where low I.Q. and
epilepsy is present in same patient e.g. mental retardation, cerebral palsy etc.
but properly controlled epilepsy does not cause low I.Q. |
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CARDIOLOGY CLINIC |
Department of medicine had achieved tremendous status in the field of diabetes
and cardiac care.Under the able guidance of Dr.B.S.Chopra, Department of
medicine is ever in news for its warmth and proficiency.Though we pray for well
being of every human being on earth,nevertheless we promise to provide A class
medical care to the sufferers.
Our medicine department offers comprehensive executive cardiac health checkup
including various routine investigations e.g X-Rays, ECG, Echocardiography and
TMT study.
Cardiac disease is are of the most commonest cause of death in recent times,
which is progressively increasing. Cardiac diseases has got wide range of
symptoms, which may be range from asymptotic to severe chestpain or
breathlessness. Other common symptoms related to cardiac ailments are
palpitations, increase of pain & breathlessness excretion, abdominal discomfort,
marked sweating etc. This disease needs expert deititician advise/care or
hospitalization. |
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FREQUENTLY ASKED QUESTIONS |
Q. What is
meant by Heart attack?
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When the blood supply to a portion of the heart muscle is disturbed or decreased, that portion of heart muscle becomes dead and results in symptoms of heart attack
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Q. What are the symptoms of heart attack?
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There can be variety of presentations in these patients.
* Commonest is pain in the centre of chest, or left side of chest with or without radiation to left arm. A typical presentation of pain could be on the right side of chest, in upper abdomen, neck or lower jaw.
* There may be burning sensation or uneasiness in upper abdomen or dyspepsia (gas) sometimes.
* Suddenly experiencing breathing difficulty, choking sensation or suffocation.
* Sometimes associated cold sweating is there.
* Sometimes associated palpitation or irregularity in heartbeat is present.
* Sometimes the symptoms may not be acute but the patient experiences above symptoms only on exertion.
* Occasionally, the patient may not complain of any symptoms but just collapses
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Q. What do we mean by "Angina"?
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When a person get transient chest pain or discomfort on exercise and gets relieved by resting, it is known as 'effort angina'. This is due to a clogged blood vessel or spasm of blood vessel of heart
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Q. Who are more prone to get heart attack?
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Anyone can get heart problem but presence of following factors can increase the incidence:-
* Obesity
* Smoking
* Diabetes mellitus
* High Blood Cholesterol level
* High Blood Pressure
* Positive family history
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Q. Should one get check up and investigations even without any symptoms?
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After the age of 40 years, routinely, check up should be done once a year, particularly if any of the above risk factor is present. Investigations should be done if the physician advises
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Q. Is ECG a sure test for diagnosis of ischaemic heart disease?
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No, ECG may be normal in about 50% of cases. Sometimes serial ECG's may be required .Sometimes, in high clinical suspicion, further investigations are needed
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Q. What is TMT or Stress ECG test?
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In patients, where resting ECG is normal , TMT is done. Here, graded exercise is given to the patient and simultaneously ECG recording is done. The amount of exercise to be given and how long, has to be decided by the physician
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Q. What is coronary angiography and is it a must to be done in all case of ischaemic heart disease?
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Coronary angiography is an investigation where a dye is injected into the blood vessels of the heart to directly visualise them for any blockage. It should be done in cases of clinically high suspicion with normal investigation and recurrent unstable angina. It is 100% diagnostic
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Q. Tell us something about the preventive aspects of ischaemic heart disease?
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Most important is the life style modification:-
* Stop smoking.
* Control Your weight.
* Exercise regularly - walk 45 minutes per day.
* Control Diabetes, High blood pressure properly.
* Give up dried food, animal meat, egg yolk and milk cream.
* Decrease blood tensions.
* Control blood cholesterol.
* If your close relations have had heart attack, take precautions.
* Get the advice of a physician if need be
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Q. Is there any beneficial role of yoga/medication?
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Yes, Yoga and meditation are useful tools in de-stressing yourself. as we know that the heart attack is more common in and can be precipitated by stress and tension, practicing yoga and medication may prove beneficial.
In the end, I will suggest that if there is any suspicion appropriate clinicians should be consulted.
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