HYPERTENSION
DrSaroshKhanMD
CONSULTATION
Dr. Sarosh Ahmed Khan
Hypertension
IHD-Cholesterol-Ramadan
Acid Peptic Disease
Diabetes Mellitus-Obesity
PHOTOS
MODERN HOSPITAL
THE DOCTORS PAGE
New Abilities
HYPERTENSION
Hypertension which means raised blood pressure (BP) is a common disease. In India the incidence is around 5-10% whereas in Kashmir it goes as high as 15%. It is associated with diabetes in many and is a risk factor for Ischemic heart disease (IHD). Normal blood pressure fluctuates during the day and may rise above normal during stressful activities like running, weightlifting, and fright. However it is the persistent rise of blood pressure even at rest which is harmful and needs treatment. Most patients have primary hypertension where no cause can be found, whereas a minority has secondary hypertension which may be cured permanently when the cause is removed.
Symptoms and Signs: Majority of patients have no symptoms. It is only by chance that they are detected as hypertensives in a clinic. Patient may have visited the doctor for a minor illness when he is detected. All the same it is harmful. One never knows since when he is having the disease. It is diagnosed by checking at rest on two different times at the clinic or hospital. Untreated it is very harmful as it can lead to IHD, heart failure, renal failure, damage to the retina, strokes with paralysis etc.
Diagnosis is purely clinical, by the doctor. Blood is however tested for FBS, cholesterol, kidney function tests, ECG, X-ray chest, and Uric acid.
Course of the disease: Hypertension is a chronic disease which means that patient is almost with the disease throughout his or her life. When the control is good it may remain harmless, otherwise it can lead to various complications mentioned.
Treatment: Lifestyle modification is a must. Relaxation, less of salt intake, intake of fruits and salads, regular light exercise, weight reduction and strict intake of medicine is recommended. The choice of medicine is vast and the doctor decides which drug suits which case.
Advise: If you are forty plus get your BP checked.
HEPATITIS B INFECTION
What is hepatitis B virus ?
Hepatitis B virus (HBV) infects the liver. You can get HBV infection from blood and body fluids such as saliva and semen. If a pregnant woman is infected with HBV, her baby also may be infected at birth.
How can I tell if I have HBV infection?
Usually, you can't tell. Most people don't have any symptoms. You may feel tired, your stomach may hurt sometimes, or your skin may look yellow. Rarely, an infected person may get sick enough to go to the hospital.
What happens after HBV infection?
Most adults get better in a few weeks or a few months. Some adults (and more children and babies) feel like they are getting better, but the virus stays in their liver. These people have chronic HBV infection.
What health problems can chronic HBV infection cause?
Children and adults with chronic HBV infection can look healthy for years, but their liver cells are being slowly damaged. If enough damage happens, they get cancer of the liver or cirrhosis, which causes scars on the liver. (Say this: sir-row-sis). These diseases can be fatal.
How can I protect my liver if I have chronic HBV infection?
Don't drink alcohol. See your doctor regularly. Tell your doctor about all the medicines you are taking, including over-the-counter and herbal medicines. Some medicines can hurt your liver. Depending on the results of your blood tests, you may be able to take medicines to help stop the virus from causing more liver damage.
How can HBV infection be prevented?
Don't share needles or have sex with a lot of people.
There is a vaccine to prevent HBV infection. Most children in the United States get this vaccine now.
What if I have HBV infection and get pregnant?
Many women don't find out they have chronic HBV infection until they are tested during pregnancy. If you find that you are infected, your baby should be given hepatitis B immune globulin and the first dose of the hepatitis B vaccine before you go home from the hospital. This will lower your baby's chance of being infected with the hepatitis virus.
Breastfeeding is safe. You will not pass HBV to your baby in breast milk.
When should my baby get the hepatitis B vaccine?
The first dose of the hepatitis B vaccine should be given at birth, followed by a dose at one month of age and another dose at six months of age. Your baby should get the birth dose even if your doctor plans on giving your child combination vaccines that include the hepatitis B vaccine later on.
Is the vaccine safe?
Yes. Large studies have shown no long-term side effects.
This handout provides a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information on this subject, talk to your family doctor.
HEPATITIS C
Formerly also known as non A-non B hepatitis. Causes 25% of sporadic cases of acute viral hepatitis in adults, 90% of post transfusion hepatitis and 35% of fulminant hepatitis.
More than 50% of acute cases become chronic carriers with or without abnormal ALT values, 20% of whom develop cirrhosis or later hepatocellular carcinoma.
india with a general population carrier of 1-3% has approximately 20 million hepatitis C carriers.
Modes of Transmission
Transfusion = 6%
IV Drug abuse = 42%
Occupational exposure = 2%
Heterosexual = 6%
Dialysis = 0.6%
Unidentified = 42%
70-90% of several hemophiliacs are infected with hepatitis C virus
Clinical Presentation
Acute hepatitis presents with jaundice in 25% of patients. Common features are nausea and anorexia.
Extrahepatic manifestations are arthralgia, skin rash associated with transient agranulocytosis, aplastic anemia, and essential mixed cryoglobulinemia.
Diagnosis of HCV
Anti-HCV is 92-97% sensitive. A positive test in a patient with risk factors for infection is sufficient to make diagnosis. This can be confirmed by measurement of HCV RNA virus.
Anti-HCV reflects active viral replication and infectivity of the host rather than immunity. Therefore patient must be considered to be positive for HCV infection until proved otherwise. Detected only after 2-6 months of infection.
RIBA (Recmbinant Immunoblot Assay) a confirmatory 4 antigen test, reliable at least 97% RIBA positive are HCV-RNA positive.
Q-PCR is complicated, time consuming and not well standardized.
Interferences:
False Positives: Autoimmune, Rhematoid factor, Hypergammaglobulinemia, Paraproteinemias
False Negative: Early infection, Immunosuppression, Repeat freezing or thawing of the sample
Hypertension which means raised blood pressure (BP) is a common disease. In India the incidence is around 5-10% whereas in Kashmir it goes as high as 15%. It is associated with diabetes in many and is a risk factor for Ischemic heart disease (IHD). Normal blood pressure fluctuates during the day and may rise above normal during stressful activities like running, weightlifting, and fright. However it is the persistent rise of blood pressure even at rest which is harmful and needs treatment. Most patients have primary hypertension where no cause can be found, whereas a minority has secondary hypertension which may be cured permanently when the cause is removed.
Symptoms and Signs: Majority of patients have no symptoms. It is only by chance that they are detected as hypertensives in a clinic. Patient may have visited the doctor for a minor illness when he is detected. All the same it is harmful. One never knows since when he is having the disease. It is diagnosed by checking at rest on two different times at the clinic or hospital. Untreated it is very harmful as it can lead to IHD, heart failure, renal failure, damage to the retina, strokes with paralysis etc.
Diagnosis is purely clinical, by the doctor. Blood is however tested for FBS, cholesterol, kidney function tests, ECG, X-ray chest, and Uric acid.
Course of the disease: Hypertension is a chronic disease which means that patient is almost with the disease throughout his or her life. When the control is good it may remain harmless, otherwise it can lead to various complications mentioned.
Treatment: Lifestyle modification is a must. Relaxation, less of salt intake, intake of fruits and salads, regular light exercise, weight reduction and strict intake of medicine is recommended. The choice of medicine is vast and the doctor decides which drug suits which case.
Advise: If you are forty plus get your BP checked.
HEPATITIS B INFECTION
What is hepatitis B virus ?
Hepatitis B virus (HBV) infects the liver. You can get HBV infection from blood and body fluids such as saliva and semen. If a pregnant woman is infected with HBV, her baby also may be infected at birth.
How can I tell if I have HBV infection?
Usually, you can't tell. Most people don't have any symptoms. You may feel tired, your stomach may hurt sometimes, or your skin may look yellow. Rarely, an infected person may get sick enough to go to the hospital.
What happens after HBV infection?
Most adults get better in a few weeks or a few months. Some adults (and more children and babies) feel like they are getting better, but the virus stays in their liver. These people have chronic HBV infection.
What health problems can chronic HBV infection cause?
Children and adults with chronic HBV infection can look healthy for years, but their liver cells are being slowly damaged. If enough damage happens, they get cancer of the liver or cirrhosis, which causes scars on the liver. (Say this: sir-row-sis). These diseases can be fatal.
How can I protect my liver if I have chronic HBV infection?
Don't drink alcohol. See your doctor regularly. Tell your doctor about all the medicines you are taking, including over-the-counter and herbal medicines. Some medicines can hurt your liver. Depending on the results of your blood tests, you may be able to take medicines to help stop the virus from causing more liver damage.
How can HBV infection be prevented?
Don't share needles or have sex with a lot of people.
There is a vaccine to prevent HBV infection. Most children in the United States get this vaccine now.
What if I have HBV infection and get pregnant?
Many women don't find out they have chronic HBV infection until they are tested during pregnancy. If you find that you are infected, your baby should be given hepatitis B immune globulin and the first dose of the hepatitis B vaccine before you go home from the hospital. This will lower your baby's chance of being infected with the hepatitis virus.
Breastfeeding is safe. You will not pass HBV to your baby in breast milk.
When should my baby get the hepatitis B vaccine?
The first dose of the hepatitis B vaccine should be given at birth, followed by a dose at one month of age and another dose at six months of age. Your baby should get the birth dose even if your doctor plans on giving your child combination vaccines that include the hepatitis B vaccine later on.
Is the vaccine safe?
Yes. Large studies have shown no long-term side effects.
This handout provides a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information on this subject, talk to your family doctor.
HEPATITIS C
Formerly also known as non A-non B hepatitis. Causes 25% of sporadic cases of acute viral hepatitis in adults, 90% of post transfusion hepatitis and 35% of fulminant hepatitis.
More than 50% of acute cases become chronic carriers with or without abnormal ALT values, 20% of whom develop cirrhosis or later hepatocellular carcinoma.
india with a general population carrier of 1-3% has approximately 20 million hepatitis C carriers.
Modes of Transmission
Transfusion = 6%
IV Drug abuse = 42%
Occupational exposure = 2%
Heterosexual = 6%
Dialysis = 0.6%
Unidentified = 42%
70-90% of several hemophiliacs are infected with hepatitis C virus
Clinical Presentation
Acute hepatitis presents with jaundice in 25% of patients. Common features are nausea and anorexia.
Extrahepatic manifestations are arthralgia, skin rash associated with transient agranulocytosis, aplastic anemia, and essential mixed cryoglobulinemia.
Diagnosis of HCV
Anti-HCV is 92-97% sensitive. A positive test in a patient with risk factors for infection is sufficient to make diagnosis. This can be confirmed by measurement of HCV RNA virus.
Anti-HCV reflects active viral replication and infectivity of the host rather than immunity. Therefore patient must be considered to be positive for HCV infection until proved otherwise. Detected only after 2-6 months of infection.
RIBA (Recmbinant Immunoblot Assay) a confirmatory 4 antigen test, reliable at least 97% RIBA positive are HCV-RNA positive.
Q-PCR is complicated, time consuming and not well standardized.
Interferences:
False Positives: Autoimmune, Rhematoid factor, Hypergammaglobulinemia, Paraproteinemias
False Negative: Early infection, Immunosuppression, Repeat freezing or thawing of the sample
