Dr KK Aggarwal
Dr BC Roy Awardee
Sr Physician and Cardiologist,
President, Heart Care
Foundation of India
Delhi Medical Council
Director, IMA AKN Sinha Institute (08-09)
FIRST NATIONAL DAILY MEDICAL NEWSPAPER OF INDIA
7th November Saturday
Fever with chills and rigors unless proved otherwise, is Malaria, Urinary tract infection or Filaria.
- Malaria chills are usually in the afternoon and filaria chills are usually in the evening.
- Malaria fever patients invariably will be non-toxic in between fever attacks and typhoid patients will be toxic.
- Fever with single episode of chills unless proved otherwise is pneumococcal pneumonia.
- Abrupt high grade fever with pain in the eye movement is dengue.
- Fever with pain in joins which improves with flexion is Chikungunia.
- In viral Hepatitis, jaundice will always appear after fever subsides. If patient has fever and jaundice together, look for other causes.
- In SLE fever patients will always have negative CRP. Positive CRP, look for associated TB
- Evening rise fever lasting more than 6 weeks invariably is TB. These patients may have mild derangement of SGOT and SGPT.
- In dengue fever, SGOT will be more than SGPT by day 3.
- In dengue, only after fever subsides, capillary leakage syndrome starts.
- No fever no flu. No cough no flu.
- Viral fever will invariably last 7 to 10 days.
- Fever with rash with lymph nodes behind the ear, unless proved otherwise, is Rubella.
- Nasal discharge and cough rules out Rheumatic fever. Rheumatic sore throat will have red anger looking throat, throat pain while swallowing food, fever and enlargement of lymph nodes around the jaw.
- Fever only responding to indomethacoin, look for Hodgkin?s disease.
- ESR more than 100, look for TB, pus collection inside the body or cancers
- Fever low grade, chronic diarrhea, weight loss, rule out HIV-AIDS.
- High fever no sweating: sense danger
- Hypothermia no chills : sense danger
- Pulse will rise by 10 for every one degree rise of temperature. Relative bradycardia look for typhoid
- Absence if fever in sepsis is a bad sign
- Rectal temperature is more reliable for hypo and hyperthermia.
- Do not give NSAID for fever in children less than 18 years of age. It can cause fatal liver damage.
- Chloroquine has anti-viral properties. It is now being investigated for HIV also.
- In dengue fever, do not give NSAID as with low platelets it can precipitate bleeding.
Formula of 20 in dengue
- Platelet count lower than 20000
- Rise in pulse by 20
- Fall in Blood Pressure by 20
- Pulse pressure lower than 20
- Rise in Hematocrit by 20%
- More than 20 petechiae in tourniquet test in one inch.
- During capillary leakage, give 20 ml per kg per hour of fluid till pulse pressure is 40 or patient passes adequate urine.
Dr K K Aggarwal
Hypertension, Markers of Inflammation In the Blood More Common in Offspring of Parents With AD
High blood pressure, evidence of arterial disease, and markers of inflammation in the blood in middle age appear more common in individuals whose parents have Alzheimer's disease than in individuals without a parental history of the condition, according to a study published in the November issue of Archives of General Psychiatry. SOURCE: Archives of General Psychiatry
Alcohol Does Not Appear to Increase Acetaminophen-Related Acute Liver Failure: Presented at AASLD
While alcohol use is common in acetaminophen related acute liver failure, it does not appear to increase acetaminophen related mortality or the need for liver transplantation, according to research presented here at the Liver Meeting 2009, the 60th Annual Meeting of the American Association for the Study of Liver Diseases.
Olmesartan Delays Occurrence of Microalbuminuria in Type 2 Diabetes: Presented at Renal Week 2009
Olmesartan conferred vascular protection by delaying the occurrence of microalbuminuria (risk reduction of 23%) and controlling blood pressure in patients with type 2 diabetes, according to recent trial results released here at the American Society of Nephrology (ASN) Renal Week 2009.
Influenza Vaccination During Pregnancy Can Improve Outcomes for Babies: Presented at IDSA
Vaccinating pregnant women against influenza virus results in a lower risk of having a premature or low birth weight baby, researchers stated here at the 47th Annual Meeting of the Infectious Diseases Society of America (IDSA). Unvaccinated mothers were 56% more likely to have a premature baby (born <37 weeks gestation) than women who had been vaccinated (P = .001), according to Saad B. Omer, PhD, Global Health, Emory University, Atlanta, Georgia.
Death Risks Reduced for Patients on Statins Hospitalised With Influenza: Presented at IDSA
Patients on statin therapy who are hospitalised with seasonal influenza have about a 50% reduced risk of dying from the viral infection, researchers stated here at the 47th Annual Meeting of the Infectious Diseases Society of America (IDSA).
Pioglitazone Provides More Benefits for Hypertensive Patients With Type 2 Diabetes Than Metformin Monotherapy: Presented at IDF
Pioglitazone is therapeutically beneficial for hypertensive patients with type 2 diabetes, compared with metformin, reducing urinary albumin excretion when supplied as an adjunct to renin-angiotensin system (RAS) inhibitors including angiotensin II receptor blockers (ARBs) or angiotensin converting enzyme-1 (ACE-1). This was the conclusion of the multi-institute Asahikawa Prospective Pioglitazone in Microalbuminuria Effect (A-PRIME) study presented here October 20 at the 20th World Diabetes Congress of the International Diabetes Federation (IDF).
C-Reactive Protein May Predict MI and Early Death, But Not Stroke
People with high levels of C-reactive protein (CRP) may be at higher risk for myocardial infarction (MI) and death, but not stroke, according to a study published in the October 20 print issue of the journal Neurology.
The researchers found that people with CRP levels greater than 3 mg per liter were 70% more likely to suffer a MI and 55% more likely to die early compared with people who had levels of 1 milligram per liter or less of the protein in their blood. ( Sent by Dr Maj Prachi Garg)
ACL Injury (Clinical Context) Sent by Dr G M Singh
- ACL injuries are associated with the development of OA in the long term.
- Loss of muscle function is a predictor of OA in patients with ACL injury.
- Patients with ACL injury who undergo training with and without surgical reconstruction have similar muscle strength and functional performance at 2 to 5 years after injury.
- ACL injury is associated with reduced muscle strength and lower limb performance 2 to 5 years after injury.
Mistake of the day
A pateint took 80 mg of amlopress when the phone order was Amlopress AT. While giving phone orders spell the drug.
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Lettor to editor
1. e medinews is good. regards. Dr Ggyan Cand Ptni
2. Dear All: Dr.KK is a very dear friend. We must all encourage such colleagues world over....who DARE to take Our Profession to Newer Heights....like this. He is truely a Capable Person, a Wonderful Human being and a very dear friend. I can write so much in his praise...that he may say he feels emberrased. God Bless him.
Having one child makes you a parent; having two makes you a referee.
Real friends are the ones who survive transitions between address books.
Brighten your day with a positive thought
The wisdom of the wise and the experience of the ages is preserved into perpetuity by a nation's proverbs, fables, folk sayings and quotations...William Feather
It is a good thing for an uneducated man to read books of quotations. Bartlett's Familiar Quotations is an admirable work, and I studied it intently. The quotations when engraved upon the memory give you good thoughts. They also make you anxious to read the authors and look for more....Sir Winston Churchill
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