medical insight

  The medical-insight on this page has been taken  from various most reliable sources of recently published medical literature  all around the world.Team Tracemydoctor perceives these publications in its own meaningful perspective and expresses their utility in its own words so that our cherished readers could relate them easily with their relative medical situation/conditions. 

 Team Tracemydoctor’s vision for such medical-insight is to orient their clients/laymen to the leading  advances in  the field of medicine in simple words so as to make him/her understand his/her medical condition  at a higher level.This orientation on the part of patients should enable them participate in advanced discussion in decision -sharing with their doctors. 

This section would also help the busy physicians as a reminder of latest clinical advances related to a distinct issue therefore helping them in decision-making with their patients.

The medical-insight here mainly comprises of a nutshell  overview of most recent publications about researches, clinical trials/meta-analyses and various other latest studies in the field of medicine reproduced after a thorough study of the published medical literature. 

The most useful and beneficial medical-insight is published here as perceived and judged  by Team Tracemydoctor.A particular insight is further built upon as the related and relevant latest evidences pour in about the same.Readers are requested to trace and follow a particular insight/s healthful to them.

DISCLAIMER: The advice attached here is given solely by Team Tracemydoctor and it has no concern with any external advisory resources.The readers are requested to take final decision regarding their medical conditions by consulting their doctors. The advice here is targeted mainly to educate and orient the patients about their condition in addition to giving a handy information to busy doctors. 

Readers are requested to visit the websites of various publishers in the field of medicine for a deeper insight.

THYROID DYSFUNCTION

1. Serum  Cholesterol levels remain high despite LT4 (levothyroxine) therapy for Hypothyroidism and a normalised TSH (Thyroid stimulating hormone) after treatment. 

Advice-  Check your lipid profile.There is still lot to do besides bringing TSH back to normal.

2.  A recent online survey conducted by the American Thyroid Association judged the degree of dissatisfaction among the hypothyroid patients regarding the effects of medical intervention with LT4(levothyroxine),LT4+LT3(liothyronine) and DTE(dessicated thyroid extract) on their impaired lifestyle due to the disease.

The overall degree of satisfaction was 5 on a scale of 1-10.Individuals taking thyroid extract(DTE) showed highest level of satisfaction at 7 whereas the LT4 group was the lowest on satisfaction scale.Individuals on DTE also showed better results with the problems of weight management,mood swings,memory and energy/fatigue levels.

Advice -As the study shows that a fairly large proportion of patients with hypothyroidism gets a better response with DTE, it is advisable on the part of our cherished clients to discuss with their  physicians about the prescribed medication combating the ills of hypothyroidism.Preference for DTE over LT4 and LT4+LT3 therapyshould clearly be understood for achieving the desired goals.

 BODY FAT AND YOUR FITNESS

1. A new equation has arrived in place of BMI (body mass index) for estimating body fat mass.It is RFM (relative fat mass) which is based on height-to-waist ratio in place of weight to square of height ratio as in BMI. It is showing promising results in categorizing obesity in both sex groups.

  Advice – Try it, you may be obese.

 

 SEXUALLY TRANSMITTED DISEASES

1. A critically missed opportunity is noted in health-clinics as the physicians are screening only around 10% of adolescents for STD (sexually transmitted disease) reporting to their clinics. 

Advice – Insist on a STD – screening with your doctor if you have any definite doubts.

 

 LIFESTYLE AND PROSTATE CANCER

  1.Researchers have found a three-fold increase in prostate cancer in heavy drinkers. 

Advice – Cut  it down sharply you oldies.

PREGNANCY AND CARDIOVASCULAR DISEASE

1. A new guideline for pregnancy regarding cardiovascular disease has been issued by European society of cardiology.The guidelines insist on counselling for woman with CVD contemplating pregnancy.

Advice – Always go for counselling before planning pregnancy.

TREATMENT OF DIABETES

1. WHO has released new guidelines for treatment of Diabetes for countries having poor resources.It  has five key features.

Advice – Go through it,consult your doctor, you  may save some money.

 RHEUMATIC DISEASES

1. Doctors are cautioned  to  follow the Hippocratic oath and  avoid over-treatment in chronic diseases like Rheumatoid arthritis and other rheumatic states.

Advice – Kindly ask your doctor to avoid overtreatment if you feel a standstill in  a case despite increasing doses of medicines.You may request him to refer you to some other therapeutic methods for a try.

ALCOHOL AND HIGH BLOOD PRESSURE

1..Prazosin, used to  treat high blood  pressure may also be useful in the treatment of heavy alcohol addicts.

Advice – If you are a heavy regular drinker having high blood pressure too, then you may check the possibility of getting Prazosin prescribed by your physician.

MEDICATION ERRORS

1. Seven strategies defined for physicians to improve medication reconciliation efforts to reduce harm by minimizing medication errors,especially in elderly patients.

Advice – Insist on a focused conversation about prescription with your physician, he may be working on these strategies to curb down medication errors.

 LEFT VENTRICULAR EJECTION FRACTION

1. Substantial mean absolute difference of about 6% was found in the value of LEVF(left ventricular ejection fraction) from different measuring techniques namely echocardiography, Cardiac CT and Cardiac MRI .This variability adds doubt to the eligibility for a coronary bypass decision making in clinical practice.

Advice – The level (6%) of this variability should not confuse you if your LEVF is measured by different methods because relating the cut-point with these different values in  the final decision making in such a critical situation, doesn’t  put you at a lesser risk.But you may increase the reliability of the exact value of LEVF by following one same imaging modality throughout the followup .Discuss it with your doctor if he advises for a new measuring technique for measuring your LEVF.

 

BLOOD PRESSURE

1. The risk prediction of cardiovascular disease would be more accurate if in place of a single current value of BP measurement, a cumulative measurement process is used.The risk prediction algorithm  for a cardiac risk may misfire if one of the variables in it i.e.  BP, is taken from a single latest measurement. The cumulative measurement of BP and its mean helps in  predicting the accurate risk.

Advice – Keep your records carefully in these times of electronic record system, as a cumulative measurement of various biomedical variables is going to help your physician predict any associated risk more correctly  in the risk prediction algorithms. 

2. The white-coat effect on office readings can exaggerate the BP measurements to an average of about 32/10 mmHg as found in HYVET(hypertension in very elderly trial) study.This finding further adds to an already existing doubt in the controversial and paradoxical treatment strategies for treating hypertension in elderly above 75 yrs . Although a significant reduction of about 27% in all cause mortality is observed in the SPRINT hypertension  trial in elderly population over 75yrs, nevertheless many physicians are still reluctant in treating hypertension in the very elderly as a notion based on previous meta-analyses still prevails among them making them avoid intense intervention.Even a frailty index and physical activity  of daily living (ADL) of the elderly can guide the physician to overcome this dilemma, only to a certain extent.

AdviceFirst of all, home BP readings of all elderly above 75yrs. should only be relied upon for judging appropriate intervention. So provide your doctor with cumulative home – readings.Discuss in  detail with your doctor about your daily physical activity  and frailty. And never forget that if you are surviving at this age, you have some resilience against hypertension.

 Talk openly with your physician to help him overcome an already existing dilemma in his mind regarding dosage of your  hypertension medication.After all he doesn’t reside in your body,he needs your cooperation.