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Monday, April 13, 2009

Common method used for the estimation of LDL cholesterol

Even though the 'Direct Estimation Methods' are more accurate and precise than the conventional methods,(ie Precipitation method for HDL-Cholesterol & Friedewald's formula for LDL-Cholesterol.)the direct methods are not commonly used by clinical laboratories because it is expensive, time consuming, and it requires equipment not commonly available in the clinical lab.

Friedwald’s Formula:It is the conventional method for the estimation of LDL-cholesterol in fasting specimen

The formula

LDL-cholesterol = Total cholesterol - HDL cholesterol - VLDL

VLDL=TRIGLYCERIDES /5


Limitation of Friedwald's formula

Friedewald formula is unreliable in the presence of chylomicronemia ,hypertriglyceridemia (when plasma triglyceride concentration exceeds 400 mg/dL or 4.52 mmol/L) and in patients with dysbetalipoproteinemia (type III hyperlipoproteinemia).

Further reading

http://www.clinchem.org/cgi/content/full/43/11/2183

Friday, April 10, 2009

World Homoeopathy Day

salutations to the master of homoeopathy on his birthday which is celebrated worldwide as world homoeopathy day.In recent times, the growing awareness of adverse side-effects of allopathy medicine is creating an increasing interest in alternative systems, especially Homoeopathy. It is a unique system of rational healing having no known harmful effects, based on natural laws and even considered as a link between orthodox medicine and holistic approach. Dr. Christian Freidrich Samuel Hahnemann discovered homoeopathy stating that the high and only mission of a physician is to restore the sick to healt in a rapid and gentle way.
Try homoeopathy ,it is safe!

Thursday, April 9, 2009

Essentials of Endocrinology -part 1

Muscle weakness in the absence of neurological diseases, is a feature of severe metabolic disorders like cushing syndrome,thyrotoxicosis,and vitamin D deficiency. Almost all cases of metabolic myopathies can have proximal muscle weakness especially the shoulder and hip girdle musculature. Symptomatically it is presented as difficulty in climbing stairs or rising from sitting posture. Out of all these conditions, vitamin D deficiency ,osteomalacia and hypothyroidism are painful myopathies.

Hyperhydrosis (increased sweating) may present as a constitutional abnormality. More recent increase in sweat secretion may be an early indication of thyroid overactivity. One must also consider Pheochromocytoma, a rare cause of hyperhydrosis.In autonomic dysfunction,there is an intermittent sweating pattern after meals(gustatory hyperhydrosis).Growth hormone excess(Acromegaly) can also have increase sweating.A case of hyperhydrosis has to be differentiated from flushing which is a common feature in menopausal age group.Flushing may be a presenting symptom in Seratonin secreting carcinoid tumors of gut .

Tremor:In Anxiety, the pattern of tremor is coarse and irregular with cold peripherals whereas in thyrotoxicosis, it is fine rapid resting tremor (with warm skin). Tremor in neurological diseases may present at rest with greater amplitude and slower rate.It may either present at rest(parkinson’s diseases) or in motion(cerebellar intention tremor)

Dizziness or postural unsteadiness on standing: Postural hypotension (a fall of diastolic blood volume on standing occurs with reduced blood volume.) may be the reason for majority of cases.But, in the absence of bleeding or gastrointestinal fluid loss adrenal insufficiency may be the common possibility. In long standing diabetis mellitus, postural hypotension may occur due to autonomic neuropathy.Moreover, it can also occur as a common complication of any hypertensive drug for essential hypertension.

Weight loss is the single most differentiating feature of insulin dependent diabetis from non insulin dependent diabetis.Thyroid over activity is always associated with a combination of increased appetite and weight loss in which the appetite may be stimulated more. Another common cause of weight loss in young little girls is anorexia nervosa where there is a peculiar history of low body weight in the absence of other features of illhealth.

Weight gain occurs as a result of reduced metabolic rate. So, it is a common feature of primary hypothyroidism.In Cushing syndrome,the pattern is truncal obesity and paradoxical thinning of the limbs.Occasionaly increased body weight can be a feature of hypothalamic lesions

Cold intolerance: A feature of hypothyroidism which has to differentiated from Raynauds diseases which is due to localized vasomotor symptoms(Vasospasm)

Source and links: Hutchison's clinical method,endocrineweb

Tuesday, April 7, 2009

World Health Day 2009

Save lives. Make hospitals safe in emergencies
World Health Day 2009 focuses on the safety of health facilities and the readiness of health workers who treat those affected by emergencies. Health centres and staff are critical lifelines for vulnerable people in disasters - treating injuries, preventing illnesses and caring for people's health needs. Often, already fragile health systems are unable to keep functioning through a disaster, with immediate and future public health consequences.This year, WHO and international partners are underscoring the importance of investing in health infrastructure that can withstand hazards and serve people in immediate need. They are also urging health facilities to implement systems to respond to internal emergencies, such as fires, and ensure the continuity of care

Monday, April 6, 2009

New study on Inflammatory Bowel Disease and folic acid

According to a new study led by researchers at the University of California, San Francisco and UC Berkeley. Chidren with newly diagnosed cases of IBD have higher concentration of folate in their blood than individuals without IBD.This new finding questions already existing theory that patients with IBD are prone to folate deficiency .(The only difference is that previous theory refered to adult IBD where as latest research refered to paediatric IBD)How ever it would certainly opens the way for additional research into the role of folic acid . Follic acid, A water soluble vitamin B helps to produce and maintain new cells, moreover it has shown to prevent changes to DNA that may lead to cancer and birth defects,


IBD refers to illnesses that cause chronic inflammation in the intestines, including ulcerative colitis, which manifests itself in the colon, and Crohn's disease, which can arise anywhere in the intestinal tract.IBD occurs in children of all ages and can cause abdominal pain, diarrhea, fever, bleeding and nutritional deficiencies.


SOURCE and links

The study appears in "American Journal of Clinical Nutrition"

Difference between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS)?'


Saturday, April 4, 2009

MESSAGE FROM PRESIDENT ON IHMA FORMATION DAY

Dear doctors,
We are very happy to inform that, IHMA is celebrating its 5 th anniversary on 4th april,2009. IHMA, a premier organization, got transformed from KHMGA(Kerala homoeopathic medical graduates association) which had been in the forefront for many years. Through our organization, we could bring forth some remarkable changes in the field of development of Homoeopathy. Our stand in cetain burning issues regarding homoeopathic eduction/practice were received wide appreciation. .On this occasion we express our gratitude to to all members of our national working committee and chapter office bearers for their valuable support to this organization..We expect, wholehearted cooperation from all enthusiastic homoeopaths around the world to lead this organization to great heights.

Thanking you

Yours in homoeopathy,
Ihma karunagappally chapter.

MESSAGE FROM SECRETARY ON IHMA FORMATION DAY





H
APPY BIRTHDAY IHMA.






TODAY
,INDIAN HOMOEOPATHIC MEDICAL ASSOCIATION IS CELEBRATING ITS 5TH BIRTHDAY.LET US WORK TOGETHER FOR THE GROWTH AND DEVELOPMENT OF HOMOEOPATHY BY JOINING IHMA.