Ideal Medical Practice

14/10/2022

FOODS TO AVOID:

1. Fried and fatty foods
2. Full fat dairy products like butter, whole milk, cheese and sour cream
3. Cream sauces, gravies and creamy salad dressings
4. Desserts or snacks such as ice cream and potato chips
5. Chocolate
6. Fatty or fried cuts of beef, pork or lamb
7. Tomato, pineapple and citrus fruits like orange, lemon, lime and grapefruit
8. Mint
9. Onion and garlic
10. Refined flour products like breads, cakes and cookies

LIFESTYLE CHANGES:

1. Eat slowly and don’t overeat
2. Increase fibre in diet (fruits, vegetables, oatmeal, sprouts)
3. Stop smoking
4. Avoid alcohol
5. Remain upright for at least 2 hours after meals
6. Avoid tight clothing
7. Raise the head end of your bed by 4-6 inches
8. Maintain a healthy weight
9. Small, frequent meals. Avoid large gaps between meals
10. Antacids when needed

11/04/2022

13/01/2022

When to seek emergency medical care in Covid?

1. Oxygen saturation on the pulse oximeter is 93%
or below
2. Worsening shortness of breath
3. Lips or face turn bluish
4. Feeling of disorientation increases
5. Fever of more than 101°F (38°C) persists for
more than 3 days
6. Persistent pain or pressure in the chest.
7. Slurred speech or seizures
8. Unable to wake up or stay awake

10/01/2022

How to manage mild Covid at home

1. Isolate yourself in a separate room with attached
wash room if possible for 10 days and rest.
2. Wash your hands frequently with soap and water
and clean your room yourself with disinfectant or
soap
3. Open the windows for ventilation if possible
4. For fever do tepid sponging using tap water. Do
not use cold water.
5. Utensils/ dishes should be cleaned with soap or
detergent with water while wearing gloves.
6. Don’t share personal items with others
7. Keep your mind occupied by reading, watching
TV and keep in touch with friends and family over
video calls.
8. If you feel up to it do some light exercise
9. Wear a triple layered mask covering your nose
and mouth whenever you open the door. Your
caregiver should be wearing a triple layered
mask and gloves. Discard the mask after 8 hours
10. Monitor your oxygen levels every 6 hours or
more frequently if your breathing is fast. Monitor
at rest and again after a 6 min walk.
11. Measure your temp every 6 hours or more
frequently if you have a fever
12. Stay hydrated and eat well balanced nutritious
meals even if you have lost taste.
13. Seek medical advice on how to monitor and
manage symptoms. The doctor will also advise
you whether your symptoms can be managed at
home or you need hospitalisation.
14. Rest, relax, rest, relax.

08/01/2022

I or a family member has tested positive for Covid. What do I do?

1. Do not wait to get tested or get test results. Self
isolate immediately on feeling any symptoms.

2. Remain calm, do not panic. Remember that most
people recover from Covid 19 and do not require
hospitalisation. However home isolation should
be advised only after evaluation by a doctor.

3. Please inform your close contacts so they can
quarantine and test themselves. A close contact
is anyone who had face to face or other physical
contact with an infected person within 6 feet for
at least 15 mins. There are exceptions to this
criteria in cases where transmission chances are
higher e.g, contact sports or in the case of the
Omicron variant which is much more
transmissible.

4. For most individuals with Covid, symptom based
treatment is all that is necessary. Paracetamol for
fever, antihistamines and decongestants for cold
and budesonide inhalation for cough.

5. Do not self-medicate. Home concoctions like
garlic, camphor, Carom seeds ( ajwain) cannot
improve oxygen levels.

6. Drugs being widely prescribed for Covid in India
like Favipiravir, Azithromycin, Doxycycline and
other antibiotics, Ivermectin, HCQ, Vitamin C
and D, Zinc, Colchicine, Itolizumab,
Bevacizumab, Ritonavir-Indinavir, Interferon,
alpha 2B, convalescent plasma, Coronil and
other herbal medications have NO ROLE in the
treatment Covid and SHOULD NOT be used.

7. In some cases Monoclonal antibody cocktail or
the anti viral Molnupiravir is prescribed. Patients
should understand their limitations.

8. Monoclonal antibody cocktail currently available
in India are not effective against Omicron variant
which is likely to be the predominant variant in
the current surge.

9. Molnupiravir has limited efficacy, when it is used
early in unvaccinated high-risk individuals.
Whether it has any role in vaccinated individuals
is not known. In the largest trial done so far, it has
been shown to have no significant effect in
individuals who have had the SARS COV 2
infection in the past, those with low baseline viral
load and those with diabetes. There are serious
concerns with respect to teratogenecity,
potential of the drug to cause cancer and the
development of new variants. Molnupiravir
should not be used indiscriminately.

10. Blood tests should not be routinely advised.
Tests such as CRP, D Dimer, LDH, serum Ferritin
and IL 6 should not be routinely done as they
have no proven value.

08/01/2022

FAQs about Covid

My kid has symptoms. What should I do?

If someone at home is already infected and the child becomes symptomatic, assume the child is infected too. If no one at home is infected but the child becomes symptomatic, limit the child’s movement to a well-ventilated room and every person entering the room should wear an N 95 mask and sanitize their hands. The family members should be tested 5 days after the child becomes symptomatic.

07/01/2022

FAQs about COVID

I have had contact with someone who has tested positive. What do I do?

1) Self quarantine from the day the contact tests
positive.
2) If you have symptoms, test right away.
3) If asymptomatic wait 5 days from contact and
then test.
4) If symptoms occur earlier than 5 days, test then.

02/06/2020

We are officially past 200000 Covid patients!

India just became the 7th country to cross 2 lakh cases. We are seeing cases spiking everyday and given our population we may have the dubious distinction of having the maximum number of infected patients in the near future. We need to accept that a large number of the young will get infected. Our aim is to focus on protecting the elderly and vulnerable and ensure that the numbers of the seriously ill do not increase with alarming rapidity. Self-discipline is the key and we have to continue to maintain personal hygiene and physical distancing, which will be essential in halting transmission of the infection.

Practical measures to stay safe:

1. Wear a face mask at all times in public. This
protects everyone from the infected and the
infected from spreading the disease. A)The mask should be a good fit and cover your
nose and mouth.
B)Wash your hands before putting on the mask
and after discarding it.
C) Avoid touching the mask. Wear and disengage
the mask by using the elastic ear bands. D) Do not wash the surgical or N 95 masks.
Discard these masks if damp and do not reuse
single use masks.
E) Cloth masks on the other hand should be
washed daily.
F) Avoid using masks with a valve.
G) While this has not been recommended as
routine procedure, I find the most effective way
to using a mask is to double mask. Wear an N95
or indeed any mask and on top of that wear a
disposable mask or a cloth mask. The
disposable mask can be discarded daily or the
cloth mask can be washed daily while keeping
the inside mask pristine.
H) I also find that rather than leave the mask sitting
on any surface in the house, it’s a good idea to
hang it up from a hook in a discreet part of the
house where it is not accessible to children.
2. Maintain physical distance of at least 3 feet from
anyone who has a cold, cough or sneeze, or
some form of visible respiratory distress
3. Maintain hand hygiene by washing your hands
often and for at least 20 seconds with soap and
water. Where this is not possible use a sanitiser
with at least 60% alcohol content.
4. Avoid touching your eyes, nose and mouth.
5. Avoid all non-essential travel and stay away from
large groups of people.
6. Stay home if unwell. Seek immediate medical
advice if you develop fever, cough or breathing
difficulty.
7. When coughing use a tissue or cough into the
crook of your elbow. Discard the used tissue
immediately into a closed bin.
8. Clean your home regularly with water and
detergent particularly frequently touched
surfaces like doorknobs, refrigerator handles,
house keys, laptop and table tops.
9. Eat a well balanced whole grain plant based diet,
plenty of fresh fruits and vegetables and
stay hydrated.
10. Exercise regularly and follow your daily routine
including good sleep hygiene.

Empathise with and show solidarity with those affected. The people who are particularly vulnerable and we must protect are:
1. People older than 60 years of age
2. People with Diabetes
3. People with heart ailments
4. People with breathing disorder like Asthma or
lung fibrosis
5. People with deficient immunity due to chronic
diseases or cancers.
Help to insulate them from the outside and from people. Check on them often and help with providing nutritious meals, running errands, doing the grocery and laundry whilst being careful to maintain physical distancing guidelines. Here’s to emerging from this pandemic with minimum damage, maximum effect.

14/05/2020

22/03/2020

The following private labs can now test for Covid 19

1. Indraprastha Apollo Hospital, Delhi
2. Dang Lab
3. Dr Lal Path Lab
4. SRL Limited ,74, Paschimi Marg, Vasant Vihar, New Delhi
5. Max Lab, Max Super Speciality Hospital, Saket
6. SRL Limited, Fortis Escorts Heart Institute, Okhla Road, New Delhi
7. Fortis Hospital, A Block Shalimar Bagh, Delhi
8. SRL Ltd, Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, New Delhi
9. Lifeline Diagnostics, Green Park, Delhi
10. Oncquest Laboratories Ltd, Safdarjung Hospital, New Delhi-110029.
11. Metropolis Healthcare Ltd, Mohan Co-operative Industrial Estate, Mathura Road, New Delhi (Will be ready by 23 March 2020).

The test costs Rs 1500 for screening and Rs 3000 for confirmation. Maximum Rs 4500/-

19/03/2020

13/01/2020

A second on the lips, A lifetime on the hips!

25/11/2019

Five foods to manage high blood pressure in the winters

1. Methi/Fenugreek

Both fenugreek leaves and fenugreek seeds are packed with good amount of soluble fibre, which helps in reducing cholesterol, especially the bad cholesterol. High-fibre diet has been linked with steady blood pressure levels too. Additionally, methi leaves and seeds are very low on sodium too.

2. Radish/ Mooli

Radish is rich in potassium. Potassium helps relax the tension in your blood vessels and arteries; additionally it counters the ill-effects of sodium. You can use radish in your salads or even blend it in delicious and hearty soups.

3. Spinach/ Palak

Spinach is packed with potassium and lutein. Lutein prevents thickening of walls of arteries, thus reducing the risk of heart attacks. Moreover, spinach is packed with potassium, folate and magnesium, which further ensures that your blood pressure levels are in check. Spinach is extremely low in calories; you can toss it up in salads, sneak it in sandwiches and lasagna or blend it into smoothies.

4. Carrots/ Gajar

Carrots are packed with potassium. Potassium rich foods are known to have a blood pressure lowering effect. It also reduces the risk of atherosclerosis and strokes. You can include this veggie in broths, stews and juices.

5. Beetroot/ Chukandar

Beetroot has antioxidants that help lower blood pressure and cholesterol levels,while the B vitamins help improve nerve function. Studies have claimed that the high content of nitrates in beetroot produces a gas called nitric oxide. This gas helps to relax and dilate your blood vessels, which further improves blood flow and lowers blood pressure temporarily. Make yourself a fresh glass of beetroot juice or make a beetroot salad.

Include these winter veggies in your daily diet and see the change for yourself.

27/10/2019

No excuse to continue consuming dairy. It’s cruel for the cows, unhealthy for you and devastating for the environment.