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Treatment of type two Diabetes (NIDDM) – By Dr. Gnana Sankaralingam

Provision of Critical Care in hospitals – By Dr. Gnana Sankaralingam

Myocardial Ischaemia and Infarction – By Dr. Gnana Sankaralingam

Diabetic Complications and Emergencies – By Dr. Gnana Sankaralingam

Treatment of type two Diabetes (NIDDM) – By Dr. Gnana Sankaralingam

Treatment of type two Diabetes (NIDDM) – By Dr. Gnana

Provision of Critical Care in hospitals – By Dr. Gnana Sankaralingam

Provision of Critical Care in hospitals – By Dr. Gnana

Myocardial Ischaemia and Infarction – By Dr. Gnana Sankaralingam

Myocardial Ischaemia and Infarction – By Dr. Gnana Sankaralingam Heart

Diabetic Complications and Emergencies – By Dr. Gnana Sankaralingam

Treatment of type two Diabetes (NIDDM) – By Dr. Gnana Sankaralingam Type two diabetes is either due to lack of sufficient insulin or inability to utilise available insulin. It onsets in middle aged obese individuals, but elderly patients may be thin. In the diagnosis of diabetes, two values are used, viz base line level (fasting) and two hours after a meal (post-prandial). WHO criteria for diabetes is 7 mmol/l for fasting and 11 mmol/l for post prandial. Between 6 to 7 mmol/l or 10 to 11 mmol/l are considered as pre-diabetic. Three methods are available in the tretment : diet alone, diet and oral hypoglycaemic drugs, and diet and insulin. About 50% of new cases could be controlled adequately by diet alone, 20 to 30% will need oral hypoglycaemic drug and 20 to 30% will require insulin. Person could be labelled diabetic depending on one of three blood tests. Raised ...

Jan 6, 2025 Posted by eLanka admin In Articles, Dr. Gnana Sankaralingam Tagged Basal Bolus Insulin Regimen, Controlling Blood Sugar Levels, Diabetes Lifestyle Changes, Diabetes Management Strategies, Diet for Diabetes Control, Insulin Dose Adjustment, Insulin Therapy for Diabetes, Latest Innovations in Diabetes Treatment, Managing Diabetes in Obese Patients, Non-Insulin Dependent Diabetes Mellitus (NIDDM), Pre-Diabetes Management, Tirzepatide (Mounjaro) for Diabetes, Type 2 Diabetes Treatment

Provision of Critical Care in hospitals – By Dr. Gnana Sankaralingam Hospital patients are grouped together by major speciality, according to specific organ dysfunction, which may not quite be appropriate for initial management of critically ill ones, because there is often no established diagnosis. Grouping of patients together in units according to their severity of illness, overcomes problem of givng close care to specific need. Critical care in hospitals is given in intensive care units (ICU), High dependency units (HDU), post-operative recovery rooms, coronary care units (CCU), acute admission wards and A+E resuscitation bays. This set up confers benefit in getting multiple expert opinion. Admission and discharge guidelines need to be followed when moving patients in and out of these units. Every case should be evaluated on its own merits and rigid rules to cover admission or discharge from ICU or HDU is destined to fail. Admitting those who ...

Dec 30, 2024 Posted by eLanka admin In Articles, Dr. Gnana Sankaralingam Tagged Admission and discharge guidelines ICU, Critical care in hospitals, Dr.Gnana Sankaralingam, Enteral nutrition ICU, High dependency unit (HDU), Intensive care unit (ICU), Managing shock in ICU, Mechanical ventilation in ICU, Organ failure in critical care, Patient monitoring in critical care, Post-operative recovery care

Myocardial Ischaemia and Infarction – By Dr. Gnana Sankaralingam Heart muscle must receive sufficient blood supply through its own network of arteries, called coronary arteries. Those that supply heart muscle with oxygenated blood are the left and right coronary arteries. Left coronary has two major branches, circumflex which travels to the upper lateral wall of the ventricle and the anterior descending which tracks to the anterior portion of the heart. Right coronary curves around right ventricle and separates into a variable number of branches. Base of the left ventricle is supplied by both. Narrowing of coronary artery often caused by atherosclerosis, results in diminished blood supply to the heart. During rest these narrowed coronary arteries may deliver sufficient blood supply, but with exertion the rapidly pumping thick left ventricle will require a greater blood supply, and will be the chamber to suffer by reduction in blood flow. Lack of adequate ...

Dec 26, 2024 Posted by eLanka admin In Articles, Dr. Gnana Sankaralingam Tagged Acute Coronary Syndrome (ACS), Angina and Chest Pain, Blood Clots and Heart Attack, Coronary Artery Disease (CAD), ECG in Myocardial Infarction, Heart Muscle Damage and Recovery, Left Coronary Artery Anatomy, Left Ventricular Ischaemia, Myocardial Infarction, Myocardial Ischaemia, Q Waves in ECG, Right Coronary Artery Anatomy, ST Segment Depression, Troponin Levels in Heart Attack

Diabetic Complications and Emergencies – By Dr. Gnana Sankaralingam Diabetes is a multi-system disorder affecting several parts of the body. It is a result of either body unable to produce adequate insulin or body not able to utilise available Insulin. Diabetes is a syndrome characterised by chronic high blood sugar (hyperglycaemia). High level of glucose in blood produces osmotic diuresis leading to increased urinary output (polyuria) and thirst (polydypsia). It also causes increased carbohydrate craving (polyphagia) and despite it, there is weight loss. Diabetes is classified into insulin dependant (IDDM) and non-insulin dependant (NIDDM). IDDM has acute onset in youth, where Insulin treatment is mandatory, while NIDDM is of insidious onset usually in middle aged related to obesity, but older patients may be non-obese. Other rare causes are secondary to pancreatic disease or steroid induced. Those of impaired glucose tolerance may progress to diabetes. Complications of diabetes is categorised ...

Dec 20, 2024 Posted by eLanka admin In Articles, Dr. Gnana Sankaralingam Tagged Cardiovascular disease in diabetes, Cataracts and diabetes, Diabetes and stroke, Diabetes emergencies, Diabetic Complications, Diabetic eye diseases, Diabetic foot ulcers, Dr.Gnana Sankaralingam, Foot care for diabetes, Gangrene in diabetes, Glaucoma in diabetics, Heart attack risk in diabetes, Symptoms of diabetes, Types of diabetes, What is diabetes

Aches and Shakes in the Elderly – By Dr. Gnana Sankaralingam Aches and pains in muscles and joints are common occurrences in the elderly. Similarly shakes (tremors) and unsteadiness are phenomenon seen in the process of ageing. While aches and pains could cause disturbance of sleep patterns, tremors and unsteadiness could cause balance problems resulting in falls. Commonly affected are hip and knee joints. Blood supply to muscles in the elderly is compromised due to thickening of the arteries and the resulting ischaemia causing pain due to lactic acid accumulation. Joint pains are due to degenerative changes which results in stiffness due to damage to cartilage which gives low friction surface and reduction of fluid important for lubrication of joint space. Tremors and unsteadiness are caused by problems of neurological and muscular co-ordination. Tremors could involve head, arm or leg, while that of the leg affect manner of walking. Osteoarthritis ...

Dec 16, 2024 Posted by eLanka admin In Articles, Dr. Gnana Sankaralingam Tagged Aches and shakes in the elderly, Age-related muscle pain, Common joint pains in seniors, Elderly health issues, How to improve balance in seniors, Osteoarthritis symptoms and treatment, Parkinson’s disease tremors, Waddling gait causes

Interpreting Electrocardiography – By Dr. Gnana Sankaralingam First step in interpretation is determining rate and rhythm. For this the rhythm srtip is used, which is recording of lead 2. Heart rate is the number of beats occuring in one minute. ECG paper is run at a speed of 300 big squares in a minute. Look at QRS complexes and measure the number of big squares between two adjacent R waves. If 300 is divided by this distance, it gives the heart rate. If the beats do not occur at regular intervals, then heart rate is irregular, which could be regularly irregular or irregularly irregular. Normal ranges for heart beats is 60 to 100 per minute. If it is more than 100 it is termed tachycardia, and if it is less than 60 it is termed bradycardia. Heart beat begins in SA node with the P wave followed by QRS complex ...

Dec 12, 2024 Posted by eLanka admin In Articles, Dr. Gnana Sankaralingam Tagged AV blocks, ECG, Interpreting Electrocardiography, QRS complexes, rhythm abnormalities

Understanding Electrocardiography – By Dr. Gnana Sankaralingam An electrocadiogram (ECG) is a recording of the electrical activity of the heart each time it contracts. Heart is a muscular organ whose purpose is to pump blood to tissues to supply them with oxygen. This is accomplished by four chambers, two smaller upper ones called Atria and two bigger lower ones Ventricles. Right atrium receives blood from the body while left atrium receives oxygenated blood from the lungs. They pump blood into right and left ventricles respectively. When ventricles contract, to prevent blood coming back to atria there are valves called mitral on left side and tricuspid on right side. Ventricles pump blood out of the heart, right to the lungs and left along entire circulatory system. To prevent blood returning back to ventricles there are valves, pulmonary on right side and aortic on left side. This is termed the cardiac ...

Dec 5, 2024 Posted by eLanka admin In Articles, Dr. Gnana Sankaralingam Tagged Atrioventricular, Dr.Gnana Sankaralingam, ECG, Electrocardiography, mechanical function

Abdomen and Bleeding from the Gut – By Dr. Gnana Sankaralingam Abdomen is bounded above by chest separated by diaphragm, a muscular dome shaped structure and below by pelvic muscle floor. Diaphragm supplied by phrenic nerves is vital for breathing, and transection of spinal cord in neck injury above sixth cervical vertebra will end in death. On the front surface, abdomen is marked into regions: Epigastric which is just below the end of breast bone (Sternum), hypogasgtric above navel, hypochondrium on both sides below rib cage, liver in right segment and spleen in left. Stomach and Pancreas lie in hypogastrium. Around the navel is called circumumbilical, which is important as referred pain from small intestine is felt there. Iliac fossa is on both sides above pelvis, with appendix being on right and lower colon on left. Area above pelvis at the middle is supra-pubic where the bladder is, and under ...

Nov 18, 2024 Posted by eLanka admin In Articles, Dr. Gnana Sankaralingam Tagged Abdomen Anatomy, Bleeding from the Gut, Digestive System Overview, Epigastric and Hypogastric Regions, Gastrointestinal Health, Gut Bleeding Diagnosis, Large Bowel Cancer Symptoms, Peristalsis in the Gut, Regions of the Abdomen

Breathlessness and Breathing Support – By Dr. Gnana Sankaralingam Breathing is a natural phenomenon of inhalation of air for the supply of oxygen to the body and exhalation to get rid of carbon dioxide from the body. It is under control of a center in the brain, which increases or decreases the rate as per necessity. Breathlessness or dyspnoea is a distressing situation that occurs when oxygen supply is perceived as not to be satisfactory to demand. It manifests as increased rate of breathing due to either increase in demand as in strenous exercise or due to inavailabilty of adequate amounts of oxygen to the body as in obstruction of air passage or accumulation of fluid in lungs. Oxygen is carried mainly in combination with haemoglobin, and when lacking as in Anaemia, person becomes breathless. It can also be the result of faulty heart beats, acidosis and panic attacks. ...

Nov 11, 2024 Posted by eLanka admin In Articles, Dr. Gnana Sankaralingam Tagged breathing stronger, Breathing Support, Breathlessness, Dr.Gnana Sankaralingam, gas diffusion, inhalation, perfusion, ventillation

Prostate, Bladder and Urinary Incontinence – By Dr. Gnana Sankaralingam Prostate is a gland located at the neck of the bladder surrounding the urethra in men. It starts enlarging after the age of 50, obstructing the outflow of urine by compressing, and distorting the urethra to produce symptoms. It produces fluid which mixed with sperms produced by testicle, makes up the semen, which is passed into the urethra by the action of muscles of the prostate. It also converts Testestorone into biologically active form. Prostate enlargement occurs in the elderly males, probably due to diminishing hormonal (androgen) effect. It presses urethra producing symptoms like difficulty to initiate urination, increased frequency, weak stream, stopping and starting (intermittency) several times during passing urine, dribbling at the end of urination and difficulty to empty bladder. Enlarged prostate does not always cause problem. Severity of symptoms depends on extent of obstruction of the ...

Nov 3, 2024 Posted by eLanka admin In Articles, Dr. Gnana Sankaralingam Tagged Dr.Gnana Sankaralingam, Prostate, Prostate enlargement occurs in the elderly males, Urinary Incontinence