Dr Rajiv Desai

An Educational Blog

EXERCISE

EXERCISE: _ _ Prologue: The big four “proximate” causes of preventable ill-health are: smoking, poor nutrition, lack of physical activity and alcohol excess. Of these, the importance of regular exercise is the least well-known. However, exercise is not a new concept. In 300 BC, Aristotle suggested that “a man falls into ill health as a result of not caring for exercise.”  These factors (smoking, nutrition, lack of physical activity and alcohol) are often described as lifestyle choices, yet many people do not have the finances, self-efficacy, environment or knowledge to be able to practice lifestyle choices correctly. We have moved towards a sedentary society with changing work and domestic habits & patterns. We now drive cars, sit in front of computers or TVs and use domestic appliances. There are far fewer manual jobs. This means that physical activity is not routine for most people. In 1949, 34% of miles travelled […]

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Novel Approach to Diabetes Mellitus

Novel Approach to Diabetes Mellitus: ________ The figure below shows diabetic patient self-administering insulin injection:   ________ My novel hypothesis on diabetes mellitus (DM): _ Everybody knows that insulin is the only treatment of type 1 diabetes mellitus (T1DM). However in type 2 diabetes mellitus (T2DM) diet, exercise, oral hypoglycemic agents (OHA) precede insulin therapy and only when OHA fails or severe diabetes at onset warrant insulin therapy. There are reports of short term early insulin therapy in all T2DM to protect b-cells of pancreas. I propose a hypothesis that every T2DM patient needs insulin treatment from day one of diagnosis and it ought to be continued indefinitely. By the time diagnosis of diabetes is made, 50 to 80 % of b-cells of pancreas are dead (dysfunctional). The logic is that exogenous insulin will reduce load on surviving b-cells of pancreas, protect surviving b-cells and achieve better glycemic control and […]

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PULSE OXIMETRY

PULSE OXIMETRY _____ Prologue: All of us know how important oxygen is for our survival. Hypoxia means low oxygen supply and/or utilization by organ or tissue. Hypoxemia means low oxygen content of arterial blood. Hypoxaemia invariably leads to hypoxia but hypoxia can occur even without hypoxaemia. Arterial blood oxygen saturation is now considered the 5th vital sign, joining: temperature, respiratory rate, heart rate and blood pressure. Hypoxemia can be present before recognizable signs of respiratory distress become evident and the traditional sign of circumoral cyanosis is a late indicator of decreased oxygenation. Blood gas analysis was for many years the only available method of detecting hypoxemia in critically ill patients, but this technique is painful, has potential complications, and does not provide immediate or continuous data. Pulse oximetry is an objective estimation of oxygenation, and it is simple, reliable, and accurate when used appropriately. It has the unique advantage of […]

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YOGA

YOGA: _ Marilyn Monroe performs dhanurasana (bow pose) in 1948: Indra Devi opened yoga studio in Hollywood in 1948 and discovered ready students among movie stars, who found yoga’s breathing and relaxation techniques useful to their work. Her students included Greta Garbo, Gloria Swanson and Marilyn Monroe. ______ Prologue: A considerable number of studies have identified prayer as a frequent and favoured coping method among patients providing each patient with comfort and strength. A variety of studies have attempted to test the efficacy of prayer and found no medical benefit. Prayers offered by strangers had no effect on the recovery of people who were undergoing heart surgery, a large and well-constructed study proved in 2006. The Cochrane Collaboration published a thorough review reaching the same conclusion in 2011 and counselled, “We are not convinced that further trials of this intervention should be undertaken and would prefer to see any resources […]

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NET NEUTRALITY

NET NEUTRALITY: _ _ I am reminded of Abraham Lincoln’s remark: “The world has never had a good definition of the word liberty. We all declare for liberty, but in using the same word we do not mean the same thing.”  Substitute ‘net neutrality’ for ‘liberty’, and that’s where we are today. The Internet has unleashed innovation, enabled growth, and inspired freedom more rapidly and extensively than any other technological advance in human history. Its independence is its power. Net neutrality means internet service providers (ISPs) should treat all data on internet equally. The ISPs have structural capacity to determine the way in which information is transmitted over the internet and the speed at which it is delivered.  And the present internet network operators, principally large telephone and cable companies—have an economic incentive to extend their control over the physical infrastructure of the internet to leverage their control of internet […]

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