Dr.Adil khan

awareness.

Platelet deficiency is not the cause of death in people suffering from Dengue

According to International guidelines, unless a patient’s platelet count is below 10,000, and there is spontaneous, active bleeding, no platelet transfusion is required. The outbreak of dengue in the City and Hospital beds are full and families are seen running around in search of platelets for transfusion. However what most people do not realize is that the first line of treatment for dengue is not platelet transfusion. It, in fact, does more harm than good if used in a patient whose counts are over 10,000.

The primary cause of death in patients suffering from dengue is capillary leakage, which causes blood deficiency in the intravascular compartment, leading to multi-organ failure. At the first instance of plasma leakage from the intravascular compartment to the extravascular compartment, fluid replacement amounting to 20 ml per kg body weight per hour must be administered. This must be continued till the difference between the upper and lower blood pressure is over 40 mmHg, or the patient passes adequate urine. This is all that is required to treat the patient. Giving unnecessary platelet transfusion can make the patient more unwell.

“While treating dengue patients, physicians should remember the ‘Formula of 20' i.e. rise in pulse by more than 20; fall of BP by more than 20; difference between lower and upper BP of less than 20 and presence of more than 20 hemorrhagic spots on the arm after a tourniquet test suggest a high-risk situation and the person needs immediate medical attention.”

Dengue fever is a painful mosquito-borne disease. It is caused by any one of four types of dengue virus, which is transmitted by the bite of an infected female Aedes aegypti mosquito. Common symptoms of dengue include high fever, runny nose, a mild skin rash, cough, and pain behind the eyes and in the joints. However, some people may develop a red and white patchy skin rash followed by loss of appetite, nausea, vomiting, etc. Patients suffering from dengue should seek medical advice, rest and drink plenty of fluids.

Paracetamol can be taken to bring down fever and reduce joint pains. However, aspirin or ibuprofen should not be taken since they can increase the risk of bleeding.

The risk of complications is in less than 1% of dengue cases and, if warning signals are known to the public, all deaths from dengue can be avoided.

DENGUE NS1-Best test is NS1

Cannot be false +ve

Is + from day 1 to 7 ideally.

If on day 1 is -ve, repeat it next day.

Always ask for ELISA based NS1 tests as card tests are misleading.

Value of IgG & IgM dengue-

In a pt with reduced platelets and looking "sick" on day 3 or 4 of illness, a very high titre of IgG with borderline rise in IgM signifies secondary dengue. These pts are more prone to complications.

In primary dengue IgG becomes + at end of 7 days, while IgM is + after day 4.

Immature Platelet fraction/IPF

A very useful test in Dengue for pts with thrombocytopenia.

If IPF in such a pt is > 10%, despite a pl count of 20, 000 he is out of danger & platelets will rise in 24 hrs

If its 6%, repeat the same next day. Now if IPF has increased to 8% his platelets will certainly increase within 48 hrs.

If its less then 5%, then his bone marrow will not respond for 3-4 days & may be a likely candidate for pl transfusion.

Better to do an IPF even with borderline low platelet count.

A low Mean Platelet volume

or MPV means platelets are functionally inefficient and such patients need more attention.

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Why lemon is the perfect food for people with diabetes?
A recent study has shown how lemon juice can significantly lower peak blood glucose.
Lemon is a powerhouse of Vitamin C, fibre, anti-inflammatory, and anti-oxidant properties and its low glycaemic index aids in lowering blood sugar levels significantly. Also, the nutrients present in lemon help in better metabolism.

If you have been suffering from diabetes and finding ways to control those sugar spikes that often come unannounced, the humble lemon could come to your rescue thanks to the abundant soluble fibre and Vitamin C that's found in the citrus fruit. A recent study has shown how lemon juice can significantly lower peak blood glucose and delay that peak by more than 35 minutes. This is not surprising as lemon has long been considered a superfood for diabetes even by American Diabetes Association.

Can diabetics eat meat?

If your sugar levels are not controlled, and you are a chronic patient of diabetes, it will be more dangerous for you to consume high protein and high fats diet on this Eid. For diabetic patients, the chances of having cardiac issues are more. So be cautious while eating the meaty meals.
Dr.Adil khan

وَرَفَعْنَا لَكَ ذِكْرَكَ ○
میرے نبی ﷺ کا ذکر ہمیشہ بلند رہے گا
❣️💯❣️

*ذیابطیس کے مریض اور گردے کی بیماریاں*

ذیابطیس کی وجہ سے مریض کے گردوں کو نقصان پہنچتا ہے جسے Diabetic Nephropathy کہا جاتا ہے۔

اس کی آغاز میں کوئی علامات ظاہر نہیں ہوتیں۔

لیکن Diabetic Nephropathy مریض کو گردے کی مزید سنگین بیماریوں میں مبتلا کر سکتی ہے۔

گردے ہمارے جسم میں خون کو کثافتوں اور نمک سے پاک کرتے ہیں۔گردے کی بیماریوں کا مطلب تمام جسم کو آلودہ خون کی ترسیل ہے۔

*۔Diabetic Nephropathy سے کیسے بچا جا سکتا ہے*

1۔ روزمرہ کی خوراک میں نمک کا استعمال کم کر دیں۔

2۔اگر آپ سگریٹ نوشی کرتے ہیں تو آج ہی اس کو ترک کر دیں۔

3۔اگر آپ کا وزن زیادہ ہے تو اس کو کم کریں۔

4۔ اپنے بلڈ پریشر کو 130/80 سے زیادہ نہ بڑھنے دیں۔

5۔ اپنی شوگر انڈر کنٹرول رکھیں۔

Prolonged use of proton pump inhibitors & risk of type 2 diabetes: results from large population-based nested case-control study
Conclusions: Regular & prolonged use of PPIs associated with higher risk of diabetes. should avoid unnecessary use of PPIs.

جب شوگر لیول ہائی ہو تو مندرجہ ذیل علامات ہوتی ہیں:

1۔ شدید پیاس لگنا
2۔ بار بار پیشاب آنا
3۔ کمزوری محسوس کرنا
4۔ الٹی اور متلی ہونا
5۔ سانس لینے میں دشواری محسوس کرنا
6۔ پیٹ درد
7۔ منہ خشک محسوس ہونا
8۔ دل کی دھڑکن کا تیز اور بے ترتیب ہونا

ایسی علامات کی صورت میں فوراً اپنی شوگر چیک کریں۔

اپنے معالج کی تجویز کردہ ادویات اور ہدایات پر عمل کرتے ہوئے اپنا شوگر لیول نارمل کریں۔

! مستقل ہائی شوگر لیول رہنا ایک خاموش بم ہے جو آپ کے تمام اندرونی اعضا اور سسٹم کو تباہ و برباد کر دیتا ہے۔

Wishing you and your family peace, harmony, happiness, good health, and prosperity on the auspicious occasion of Eid. Eid Mubarak to you and everyone.
Regard:#

According to a meta-analysis of 8 studies, the higher intake of sugary drinks was associated with a 30% higher risk of developing type-2 diabetes.

Type-2 diabetes is becoming a substantial economic burden worldwide, as well as in Pakistan.

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Those patients who can't manage their Omeprazole or esomeprazole intake before meal during ramadan, they can be switched to Dexlansoprazole- only PPI that can be taken after meal.

Fasting for over 14 hours has an impact on the homeostatic and endocrine processes of the body. So it is important for diabetic patients to consult with doctors before fasting in Ramadan.

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Ramadan Mubarak to all the muslims around the Globe.
May you be bestowed with all the energy you have to achieve & fulfil all of your aspirations.” I hope you have a blessed and enjoyable Ramadan.

According to a recent NCBI report, Pakistan has surpassed United States in the prevalence of Diabetes. As of now, approximately 33 million people are living with diabetes in the country whereas majority of people don’t have the awareness or facilities required to manage it.

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You can reduce your risk of type 2 by leading a healthy lifestyle:

🏃🏽‍♀️Be physically active.
👍🏽Maintain a healthy body weight.
🥗Eat healthy.
🚭Do not smoke and avoid harmful use of alcohol.

People with diabetes are vulnerable to infections in and around the nails, including Gram-negative bacteria or fungi.
Neuropathy and glycaemia increase the risk, as does damage to the nail or adjacent skin, for example by distorted or sharp-edged nails.
It is vital to have good nail care in both hands and feet.

Myth: I Am Worried About Diabetes Because I Eat A Lot Of Sugar.

Fact: It is always beneficial to cut down your sugar intake, but eating sugar does not lead to diabetes. It is one of the known myths about diabetes that often confuses people. The root is that whenever you consume food, your body converts it into a sugar called glucose. Glucose or blood sugar is the energy provider for the body. Insulin is the substance that takes glucose from the blood to the cells and generates energy. When you have diabetes, your body does not make the required insulin or fails to use it adequately.

Consuming extra can #Diabetes failure, , and strokes.
Reducing sugars intake to less than 10% of total energy: a strong recommendation.

Eat less walk more.....Let's join hand to prevent diabetes!!

A new data reveals that Pakistan becomes the 3rd country among the top 10 for diabetes prevalence list.Report that One in four adults in Pakistan are living with diabetes(26.7 per cent).
(These findings from the 10th Edition of the IDF Diabetes Atlas)
“In Pakistan, the situation regarding diabetes is alarming.
Need better public awareness of diabetes for prevention and treatment.

The sooner people find out they have prediabetes and take action, the better their chances of preventing type 2 diabetes ."

Your food choices matter a lot when you've got diabetes.

Major Complications of Diabetes.

Tests for Type 1 Diabetes, Type 2 Diabetes, and Prediabetes

Your health care advisor will have you take one or more of the following blood tests to confirm the diagnosis.

Gestational diabetes is diabetes diagnosed for the first time during pregnancy (gestation).

IF you have any of the risk factors, ask your health care advisor about getting your blood sugar tested.

Diabetes is a silent killer.
We need to take it seriously

Diabetes can be successfully prevented and managed by a healthy lifestyle. When not managed, it can lead to severe organ damage and death.”

Diabetes is not curable. It’s sustainable

UPDATES, GUIDANCE, AND BEST PRACTICES TO OPTIMIZE CARE FOR PATIENTS WITH DIABETES