Email OF The Day: March 2019

Sunday, 31 March 2019

[www.keralites.net] Indian Doctors

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Indian Doctors and Hospitals… This is how doctors earning now a days…

The numbers speak of Chennai's rise as a medical capital: More than two lakh cataract surgeries in a year, a two-fold jump in caesarean section, a sharp spiral in hysterectomies. They also belie an uncomfortable truth: Doctors are increasingly becoming scalpel-happy.

If your doctor asks you to undergo a cataract surgery, hysterectomy, gall bladder or tonsils removal, or an operation of the lower-back, please take a second opinion. Wide-ranging interviews with surgeons who testified before an NGO on corrupt practices in hospitals told TOI that often patients are forced to undergo unnecessary surgeries.
A senior orthopedic surgeon in a corporate hospital explained the reason behind this unsettling trend: "We have a quota to meet every month. Many of us see patients as a potential candidate on our operating table. Only two out of five, however, agree. Many go for a second opinion - and don't return."
The surgeon is among the 78 medical practitioners who provided testimony to Pune-based NGO SATHI (Support for Advocacy and Training to Health Initiatives) that compiled a report on unethical practices and corruption in healthcare. From Chennai, 12 doctors testified.
SATHI coordinator Dr Abhay Shukla said elective surgeries (that do not involve a medical emergency) are the most popular. "Many of these surgeries don't involve too many risks, while at the same time fetches more revenue for the hospitals," he said.
SATHI in February compiled a report on corrupt practices in healthcare. "A doctor said he was pulled up by the hospital administration for having only a 10% 'conversion rate' - referring to the number of patients who were advised to undergo surgery," said Dr Shukla. "To be fair, the doctors are not entirely at fault. For a Rs2 lakh surgery, the doctor, probably gets Rs25,000, while the rest goes to the hospital," he said.

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Saturday, 30 March 2019

[www.keralites.net] What Causes swollen feet in Diabetes

What Causes Swollen Feet In Diabetics?
By Sunaina Shenoy+

I'm a diabetic and I'm getting swelling on my feet and ankles. Why does it happen?
You must have heard people in your social circle discuss about diabetes and swollen feet.
Diabetes is a condition caused by lack of a hormone in the body called insulin. In individuals with Type 1 Diabetes no insulin is produced at all and they require regular insulin injections. In individuals with Type 2 Diabetes though there is some insulin produced which is insufficient. Also, the body shows resistance to the effects of insulin. In both the cases, blood glucose levels are elevated.
Diabetics are more prone to certain complications that involve the eye (retinopathy), kidney (nephropathy) and nerves (neuropathy).
Edema (swelling)
Edema is a build up of fluid in the body i.e. water retention that leads to swelling. This could happen for different reasons including:
standing or walking for a long period
due to certain medications
due to an injury, for example, an ankle injury
Edema may affect any part of the body, be it the legs, ankles, and feet or even the hands.
Swelling and Diabetes
Extra care and caution is needed for people who have edema and diabetes. Too much sugar in the blood from diabetes can cause nerve damage and poor blood flow, which can lead to serious foot problems. For a diabetic, swelling of the ankles could also be a sign of a serious problem that needs immediate medical attention. Anytime a new swelling is seen, report to the doctor and go for an examination. Preventing foot complications is more critical for a diabetic as poor circulation impairs the healing process. It increases the risk of infections and severe complications like foot ulcers and gangrene. Gangrene might even lead to limb amputation.
Neuropathy (damage to the nerves) is a common problem with diabetes. Due tocirculation problems, the heart fails to circulate adequate amounts of blood, the kidneys retain sodium to help the body hold on to water and increase the volume of blood. This leads to swelling and is a precursor to congestive heart failure.
What to do if you have Edema and Diabetes
Elevate your feet – Using extra pillows keep your feet above the heart level for at least 15-20 minutes everyday. This helps to reduce the swelling as it drains out excess fluid from the surrounding tissues.
Wear stockings – wear stockings that apply gentle pressure on your legs. It helps to get rid of the excess fluid and also can help move blood through your legs to prevent swelling and improve blood circulation.
Lower dietary salt intake – It is advisable to reduce the salt in your daily diet as salt increases blood pressure.
Foot massage – Massaging your feet with a diabetic foot cream often helps to reduce swelling and the associated pain.
Daily foot care can prevent serious problems
Avoid long hours of continuous sitting, standing or walking.
Check your feet everyday for cuts, sores, blisters, red spots, swelling, or infected toenails and consult your physician immediately in case these don't heal in a day.
Wear sturdy, comfortable shoes and avoid walking barefoot as much as possible.
Exercise regularly to improve bone and joint health in your feet and legs.

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[www.keralites.net] Low Blood Sugar

When Your Blood Sugar Gets Too Low

In this article
Symptoms
Diabetes Drugs Linked to Hypoglycemia
Diet and Hypoglycemia
Treatment
When You Have Low Blood Sugar
If You Pass Out
Do Not Drive When You Have Low Blood Sugar
Preventing Hypoglycemia
People with diabetes get hypoglycemia (low blood sugar) when their bodies don't have enough sugar to use as fuel.
It can happen for several reasons, including diet, some medications and conditions, and exercise.
If you get hypoglycemia, write down the date and time when it happened and what you did. Share your record with your doctor, so she can look for a pattern and adjust your medications.
Call your doctor if you have more than one unexplained low blood sugar reaction in a week.
Symptoms
Most people feel symptoms of hypoglycemia when their blood sugar is 70 milligrams per deciliter (mg/dL) or lower.
Each person with diabetes may have different symptoms of hypoglycemia. You'll learn to spot yours.
Early symptoms include:
Confusion
Dizziness
Feeling shaky
Hunger
Headaches
Irritability
Pounding heart; racing pulse
Pale skin
Sweating
Trembling
Weakness
Anxiety
Without treatment, you might get more severe symptoms, including:
Poor coordination
Poor concentration
Numbness in mouth and tongue
Passing out
Nightmares or bad dreams
Coma
Diabetes Drugs Linked to Hypoglycemia
Ask your doctor if any of your medicines can cause low blood sugar.
Insulin treatment can cause low blood sugar, and so can a type of diabetes medications called "sulfonylureas."
Commonly used sulfonylureas include:
Glimepiride (Amaryl)
Glipizide (Glucotrol)
Glibenclamide (Glyburide, Micronase)
Gliclazide
Older, less common sulfonlyureas tend to cause low blood sugar more often than some of the newer ones. Examples of older drugs include:
chlorpropamide (Diabinese)
nateglinide (Starlix)
repaglinide (Prandin)
tolazamide (Tolinase)
tolbutamide (Orinase)
You can also get low blood sugar if you drink alcohol or take allopurinol(Zyloprim), aspirin, Benemid, probenecid (Probalan), or warfarin(Coumadin) with diabetes medications.
You shouldn't get hypoglycemia if you take alpha-glucosidase inhibitors, biguanides (such as metformin), and thiazolidinediones alone, but it can happen when you take them with sulfonylureas orinsulin.
Diet and Hypoglycemia
You can get low blood sugar if you take too much insulin for the amount of carbohydrates you eat or drink.
For instance, it can happen:
After you eat a meal that has a lot of simple sugars
If you miss a snack or don't eat a full meal
If you eat later than usual
If you drink alcohol without eating any food
Don't skip meals if you have diabetes, particularly if you're taking diabetes medications.