Wednesday 14 May 2014

NOTHING-a short poetry !!!

nothing !

November 27, 2013 at 7:49pm
nothing more could i ask for,
what would one be satisfied with ?
disillisioned mind wakes ,
once you think you will......
life was not meant to be an uncontinuable saga,
until you realise how fragile you are,
the child is never going to give up....
not until he reaches his starting point !!!

No miracle cures !!!

NO MIRACLE CURES.

this is just my opinion regarding one of the TV shows where I was said, that an ayurvedic doctor claimed "he cured rheumatoid arthritis and diabetes", and one of my senior doctors commented like this about that incident "in this modern era any layman can study medicene, only quacks can make such tall claims".....
Sincerely pals, I do ask you a question, Do QUACKS exist among us, the BAMS ?...... Or is the system illgoverned, because I do hear many of such disturbing news, another such instance of an ayurvedic doctor doing unethical medical practise where , he employed a massuer who has some hereditary lineage towards treating back pain, or what people think or he claims, where the patient got paralysed......what is the future of many genuine doctors who look forward to this profession as something equal to allopathic medicene,
AYURVEDA IS NO MIRACLE CURE......any tall claims that may be made like.......Curing RA, DM which even ayurveda classifies between yapya and asadhya rogas,
Using mantr, astrology, palmistry in treating or including them too in ayurveda,
Curing alcohol induced hepatitis,
Curing psoriasis which again is auto immune,
Using so called divine spells, chicken cure for snake poison,.....
Makes a fool of us before the world.....
Please be rational......
There is no miracle cure......
There is no spontaneous recovery.....

NEW JNC 8 HYPERTENSION GUIDELINES DRAW CRITICISM

NEW JNC 8 HYPERTENSION GUIDELINES DRAW CRITICISM

Controversial new guidelines on the management of hypertension released by the 8th Joint National Committee (JNC 8) recommend higher blood pressure (BP) thresholds for treatment, prompting a mix of responses with some experts even calling for their retraction.

Essentially, the new guidelines recommend treating anyone over 60 years of age if they have a BP of ≥150/90 mmHg. For younger individuals and patients with diabetes or kidney disease regardless of age, they suggest treatment should be initiated when BP is 140/90 mm Hg or higher. [JAMA 2013; doi:10.1001/jama.2013.284427]

The major difference between the new guidelines and the previous JNC 7 guidelines focuses on whether target BP treatment goals should be more conservative. The JNC 7 recommended a target BP of <140/90 mmHg in adults and <130/80 mm Hg in those with chronic kidney disease or diabetes.

While the new guidelines raise the BP threshold, it doesn’t mean clinicians should ease up on treatment in patients doing well on medications recommended by the JNC 7 guidelines, said JNC 8 panel co-chair Dr. Paul A. James from the University of Iowa in Iowa City, Iowa, US. “We’re not saying that if someone’s [systolic] BP is 140 or 135 mm Hg on medicine and they’re doing well that you need to take them off medicines and get their BP closer to 150. If you can consistently get people’s BP below 150 mm Hg, you really are improving their health outcomes.”

The updated guidelines also backed away from recommending only thiazide diuretics as initial therapy and suggest that an angiotensin-converting enzyme (ACE) inhibitor, an angiotensin-receptor blocker (ARB), or a calcium channel blocker (CCB), are reasonable choices.

If BP goal is not reached within a month of treatment, the recommendation is to increase the dose of the initial drug or add a second drug from the same list. If the targeted BP is not reached within 2 months, a third drug from the same list can be added and titrated. However, an ACE inhibitor and an ARB cannot be used concurrently in the same patient.

Antihypertensive drugs from other classes can be used if BP goal is not reached using only three drugs from the list. If this strategy fails, patients can be referred to hypertension specialists.

The recommendations were based on RCT evidence and differ from other guidelines that recommended treatment based on observational studies. Other guidelines, including those from the European Society of Hypertension, recommend a BP goal of <150 mmHg, but in patients >65 years of age.

Dr. Eric Peterson from the Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, said the new recommendations simplify the treatment targets and remove the lower thresholds for diabetes and kidney disease. [JAMA 2013; doi:10:1001/jama.2013.284430]

He added larger RCTs are needed to compare BP thresholds in different populations as well as a national consensus group to draft a new comprehensive practice guideline that would harmonize hypertension guideline with other cardiovascular risk guidelines. Finally, patients and physicians should work together to achieve BP goals.

While JNC 8 has gone extensive review by experts, it has not been evaluated or sponsored by any specialty societies such as the AHA and the ACC, a departure from the usual practice which has sparked some discussion.

In an accompanying editorial, Dr. Harold Sox of the Dartmouth Institute for Health Policy and Clinical Practice in Hanover, New Hampshire, US, said some aspects of the external review process may undermine public confidence. He said the guideline was not published in draft form to elicit public comments. [JAMA 2013; doi:10.1001/jama.2013.284429]

JAMA editor-in chief Dr. Howard Bauchner, in another editorial, acknowledged the areas of controversy and said that he anticipates debates and discussions regarding its clinical application. [JAMA 2013; doi:10.1001/jama.2013.284432]
 — in Tiruchirappalli.

GITA AND AHIMSA !

GITA AND AHIMSA !

being inspired by the gita, but somebody pointed out the fact that more than it being a metaphysical viewpoint of the human life and behaviours, gita situationally is a pro violent philosophy if not entirely, that being said to arjuna in war front when he was about to withdraw his weapons, where krishna advices to go to war with your teachers and spouses, who are for your very own land and kingdom, this philosophy bearing a contradiction to the gandhis ahimsa and satya, both which krishna says can be trespassed if it affects ones own survival,
this tatwa might be the driving force behind godse and all the hindutwa vadis, but we do fail to understand the fact that hindutwa is the guardian to all religion, the source from which all emanated, and so it bears testimony to the primal human instincts of 'HUNTING, WAR, COMPETITION' all the animal instincts i say, so a rational approach towards preserving our temples and country and scriptures would be beneficial for the future generations to live in a tolerant india....

Clinical diagnosis of OA:

Clinical diagnosis of OA:

diagnose osteoarthritis clinically without investigations if a person:
is 45 or over and
has activity-related joint pain and
Enhanced by Zemantahas either no morning joint-related stiffness or morning stiffness that lasts no longer than 30 minutes
Notes:

be aware that atypical features, such as a history of trauma, prolonged morning joint-related stiffness, rapid worsening of symptoms or the presence of a hot swollen joint, may indicate alternative or additional diagnoses. Important differential diagnoses include gout, other inflammatory arthritides (for example, rheumatoid arthritis), septic arthritis and malignancy (bone pain).
Orthopaedic appliances

GALENGA OFFICIONALIS

GALENGA OFFICIONALIS

G. officinalis has been known since the Middle Ages for relieving the symptoms of diabetes mellitus. Upon analysis, it turned out to contain compounds related to guanidine, a substance that decreases blood sugar by mechanisms including a decrease in insulin resistance, but were too toxic for human use. Georges Tanret identified an alkaloid from this plant, galegine, that was less toxic, and this was evaluated in unsuccessful clinical trials in patients with diabetes in the 1920s and 1930s.[3][2]

Other related compounds were being investigated clinically at this time, including biguanide derivatives. This work led ultimately to the discovery of metformin (Glucophage), currently used for the management of diabetes[4] and the older agent phenformin.[5] The study of galegine and related molecules in the first half of the 20th century is regarded as an important milestone in the development of oral antidiabetic pharmacotherapy.[6]