Dr Rajiv Desai

An Educational Blog

SWEATING

SWEATING: _____ _____ Prologue: Sweating is an essential and natural biological process that starts soon after we are born. Sweat is a weak salt solution produced by the sweat glands of skin. These are distributed over the entire body but are most numerous on the palms and soles.  Since the time of the ancient Greeks, the significance of sweating has been recognized, whereas our understanding of the mechanisms and controllers of sweating has largely developed during the past century. Heat dissipation is vital for our survival during exercise and heat stress.  In humans, the primary mechanism of heat dissipation, particularly when ambient temperature is higher than skin temperature, is evaporative heat loss secondary to sweat secretion from sweat glands. Normally humans produce as much as one liter of sweat per day; however most of this evaporates as soon as it is produced so we don’t notice it. The body produces […]

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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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