Dr Rajiv Desai

An Educational Blog

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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VACCINE

_____ VACCINE: The figure above shows a victim of smallpox. ______ Prologue: “You let a doctor take a dainty, helpless baby, and put that stuff from a cow, which has been scratched and had dirt rubbed into her wound, into that child. Even, the Jennerians now admit that infant vaccination spreads disease among children. More mites die from vaccination than from the disease they are supposed to be inoculated against.” –George Bernard Shaw, 1929. The world has come a long way since George Bernard Shaw fulminated against vaccination in the 1920s. Small pox was declared eradicated from world in 1980 largely due to small pox vaccine. In 2008, Barack Obama called science on vaccines ‘inconclusive’. But in 2015, the same Barack Obama called science on vaccines “indisputable”. Vaccination was voted by readers of the British Medical Journal in 2007 as one of the four most important developments in medicine of […]

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REFRACTIVE ERROR

________________ REFRACTIVE ERROR: ________ Prologue: Way back in 1973 when I was 12 years old and studying in 7th standard, I noticed that I could not read black-board from last bench. Initially I thought that everybody must be finding difficult to read black-board from last bench but it was not the case. Soon I visited eye doctor who found that I have refractive error and he prescribed -4 (minus 4) eyeglasses for me. Since then I have been wearing glasses. Refractive errors are usually present in the childhood and continue in the adult life. Unfortunately, they are not given much importance in our society which is evident from the fact that there is no effective system of pre-school visual examination of children either in the government sector or in the private sector. The earth was formed 4 billion years ago. Society has been around for about twenty thousand years. Spectacles […]

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