Posted in Health Education on April 4, 2009 by R Vivek


I see my patients, friends and family searching on the net for information about their health.

As Most of us know internet is like a garbage, so you should know how to pick out the most appropriate information. Sometime it might scare you for which you need not.

The information and recommendations appearing on this blog are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, I suggests that you consult your physician.

You can ask for specific health information in the comments in the first page.

– Dr.R.Vivek MD.,DNB(General Medicine)


Gastroesophageal reflux disease (GERD)

Posted in GI, Health Education on June 25, 2011 by R Vivek

Gastroesophageal reflux disease (GERD) is caused by frequent backflow of food and acid into the esophagus (a tube connecting the mouth with stomach). This can occur in healthy people occasionally but is a frequent problem in those with GERD. Stomach contents are normally prevented from moving to the esophagus by the esophageal sphincter (a valve-like ring of muscle at the end of the esophagus). When this muscle relaxes and allows reflux or is generally weak, GERD may occur. GERD can affect people of any age or sex.


Because reflux from the stomach consists of acid, a main symptom of GERD is frequent heartburn or acid indigestion and a bitter acid taste in the mouth. If stomach fluid reaches the larynx (breathing tube), coughing spells also develop. These symptoms of GERD can be aggravated by certain foods such as chocolate, citrus fruits, spicy and tomato-based foods, caffeine, and alcohol or by eating just before going to bed. Heart attack and stomach ulcers may mimic heartburn.


  • Hiatal hernia, an opening in the diaphragm that allows the stomach to partly move into the chest cavity

  • Obesity

  • Pregnancy

  • Cigarette smoking



Chronic GERD may lead to

  • Esophagitis (inflammation of the esophageal lining)

  • Narrowing of the esophagus due to scarring

  • Ulcers in the esophagus

  • Barrett esophagus (change in the cells of the esophageal lining, with an increased risk of cancer.



Persistent symptoms of GERD, especially occurring more often than 2 times a week for a longer time, require treatment. Based on symptoms, your physician may recommend lifestyle changes such as smoking cessation, avoiding certain foods, losing weight if necessary, and eating not later than 3 hours before going to sleep or lying down. Also, he or she may start you on over-the-counter antacids or a medication that diminishes production of acid in the stomach, such as H2 receptor antagonists or proton pump inhibitors. If the symptoms persist, additional diagnostic procedures include upper endoscopy (examination of the esophagus and stomach through a flexible tube with a camera) or barium (radiological contrast) swallow test. In some cases it may be necessary to do a pH-monitoring test (for stomach acidity) and manometry test (to measure the strength of the esophageal sphincter). Both of these tests involve passing a tube up the nose and down the throat to the end of the esophagus. These tests can confirm GERD and suggest the necessity of additional medical or surgical treatment.



GERD symptoms usually resolve completely or almost completely within weeks of treatment. However, GERD is a chronic disease and may require lifelong treatment to prevent recurrence of symptoms or development of Barrett esophagus or cancer.

Mitral Valve Prolapse (MVP)

Posted in Cardiac, Health Education with tags on September 16, 2009 by R Vivek

Mitral valve prolapse (MVP) occurs when the valve between the heart’s upper and lower chambers do not open and close properly. MVP is also referred to as Barlow’s syndrome, floppy mitral valve, billowing mitral valve, and systolic click-murmur syndrome. MVP can be heard as a heart murmur and is a result of the backflow of blood. MVP may or may not cause symptoms. It may not require treatment or may be treated with medications and surgery.MVP


Your heart is divided into four sections called chambers. The chambers are separated by the septum, a thick muscle wall. The two top chambers are called atria, and they receive blood coming into the heart. The two bottom chambers are called ventricles, and they send blood out from the heart.

Your heart contains two pumping systems, one on its left side and one on its right side. The left-sided pumping system consists of the left atrium and the left ventricle. The mitral valve regulates blood flow between the left atrium and left ventricle. Your left atrium receives blood that contains oxygen, which comes from your lungs. Whenever you inhale, your lungs move oxygen into your blood. The oxygenated blood moves from the left atrium to the left ventricle. The mitral valve has two flaps that keep blood from back flowing. The left ventricle sends the oxygenated blood out from your heart to circulate throughout your body.


Mitral valve prolapse occurs when the mitral valve does not open and close properly. The valve’s flaps may collapse into the atrium, allowing the backflow of blood. MVP can be an inherited condition. It may occur if a person is born with a hole in the septum or certain chest wall deformities. It is associated with some sydromes.


MVP may not cause any symptoms or symptoms may develop slowly. It may cause heart palpitations, abnormal heart rhythms, or chest pain. You may feel tired and cough. You may have difficulty breathing after activity or when lying down.


Your doctor can begin to diagnose MVP by reviewing your medical history and conducting a physical examination and some tests. Your doctor will use a stethoscope to listen to your heart to hear if you have a heart murmur. There are several tests that can be used to diagnose mitral valve prolapse.


In most cases, treatment is not necessary for mitral valve prolapse. In severe cases, surgery may be used to correct or replace the valves. Medications may be used to treat symptoms or a leaky valve. Prior to surgery or dental work, your doctor will prescribe antibiotics to prevent infection.


Mitral valve prolapse usually cannot be prevented. You should tell your dentist and health care providers that you have mitral valve prolapse. Your doctor will prescribe antibiotics before dental work or surgery to prevent infection.


Posted in Eye, Health Education with tags on June 20, 2009 by R Vivek

Cataracts are the leading cause of blindness worldwide. They can occur at any age, but most cataracts occur in people over40 years old and are considered an age-related eye disease. A cataract is a clouding of the lens in the eye. The lens is a transparent disc located behind the pupil (dark opening in the center of the eye) and the iris (the distinctly colored part around the pupil). The lens helps to focus light on the retina, located at the back of the eye, where nerve signals are created and transmitted to the brain to create the visual image for what is seen. The lens is made of water, proteins, and polysaccharides. As we age, some of the proteins begin to clump together and the area in the lens associated with theseproteins becomes cloudy. This results in a gradual change in the lens from transparent to yellowish brown. Light passingthrough a lens with a cataract is not clearly focused on the retina, so images received from the brain may be blurred orbrown tinged. Cataracts may progress over a number of years and do not require treatment unless they compromise vision orprevent examination or treatment for other eye disorders.



  • Normal aging
  • Diabetes
  • Smoking
  • Excessive alcohol use
  • Eye injury
  • Cumulative exposure to the ultraviolet (UV) radiation from sunlight
  • Certain medications, particularly long-term use of corticosteroids


  • Blurred vision
  • Brown-tinted vision
  • Colors appear faded
  • Halo around objects
  • Glare around lights
  • Poor night vision
  • Double vision


  • If you smoke, quit.
  • Keep your blood sugar under control if you have diabetes.
  • Wear full-spectrum UV protection sunglasses on your eyes when outdoors, or a wide-brimmed hat to shade your eyes from the sun.
  • Have a dilated eye examination by an ophthalmologist (a physician specializing in diseases of the eyes) beginning at age 40, then have regular eye examinations guided by the advice of your ophthalmologist.


  • A complete medical history and ophthalmologic examination is required for diagnosis so recommendations can be made for the best treatment plan for each individual.
  • A change in eyeglass prescription may help for an early cataract.
  • Surgery to remove the cataract, usually replacing it with an intraocular lens, a clear plastic device that requires no care and becomes anintegral part of the eye



Migraine Headache

Posted in Health Education, Migraine with tags on June 9, 2009 by R Vivek

Unless they have personally experienced a migraine headache, most people do not realize how incapacitating the pain of a migraine can be. This pain can keep a person from functioning normally and performing daily activities.





(Every individual is different and may
experience some symptoms and not others,
or in various combinations.)
• Headache pain that is moderate to
severe and lasts for 4 hours to 72 hours,
sometimes longer
• Throbbing pain that can be located on
one side of the head; it can start on one
side and spread to the other side or be
on both sides
• Nausea (an upset stomach)
• Vomiting
• Sensitivity to light, sound, or odors
• Pain becomes worse when you move
Some of the above symptoms can signal
even more serious conditions, so consult



(Every individual is different and may experience some symptoms and not others, or in various combinations.)

• Headache pain that is moderate to severe and lasts for 4 hours to 72    hours, sometimes longer.

•  Throbbing pain that can be located on one side of the head; it can start on    oneside and spread to the other side or be on both sides

• Nausea (an upset stomach)

• Vomiting

• Sensitivity to light, sound, or odors

• Pain becomes worse when you move Some of the above symptoms can signal even more serious conditions, so consult with a doctor.




Some possible “triggers” for those susceptible to migraine headaches 

• Exposure to bright lights or loud noises

• Feeling overly tired

• Hormonal changes in women

• Lack of sleep

• Some foods, such as chocolate and some types of cheese

• Some food additives, such as nitrites, nitrates, and monosodium glutamate

• Some alcoholic beverages, such as red wine

• Stress



Migraine aura refers to neurological disturbances that occur before the migraine headache begins. The neurological disturbances are usually visual, such as seeing flashing lights or experiencing small blind spots; less commonly ringing in the ears or feelings of numbness may occur. Not all people with migraine headaches experience auras.



A diary of when you have a headache may help you determine what may influence your headaches and could give you an idea of what “triggers” you may want to eliminate or avoid. A diary can also help you see how well your medication and lifestyle changes are working



If you have severe headaches, it is important to see a doctor for evaluation and diagnosis. Medications may be used to relieve pain and restore function during attacks. Stress management strategies such as exercise, relaxation training, biofeedback, and avoiding triggers may also have a role in treatment.


Folic Acid

Posted in Health Education, Nutrients with tags on June 8, 2009 by R Vivek

Folic acid (also called folate) is one of the B vitamins (substances essential in very small quantities for nutrition). Leafy vegetables such as spinach and turnip greens, dried beans and peas, avocados, bananas, oranges, and asparagus provide us with natural sources for this vitamin. Folate is essential for the body. It is involved in the synthesis, repair, and normal functioning of DNA (deoxyribonucleic acid—the molecular basis for heredity). Folate is necessary for the production and maintenance of new cells. This is especially important during periods of rapid cell division and growth that occurs during pregnancy and in the development of young children.

Folic Acid

Folic Acid


Prevention of Birth Defects—In 1996, the FDA published regulations requiring the addition of folic acid to enriched breads, cereals, flours, and other grain products. This was specifically targeted to reduce the risk of neural tube defects (malformations of the spinal cord) in newborns. The Centers for Disease Control and Prevention reported in 2004 that since the addition of folic acid to grain-based foods, the rate of neural tube defects has dropped. 

Prevention of Cancer—Scientific evidence suggests that low blood levels of folate may result in damage to DNA and may lead to cancer. Long-term folic acid supplementation has been shown to be helpful in preventing breast and colon cancers.  

Treatment of Noncancerous Diseases—Methotrexate is a powerful drug used to treat a variety of diseases such as rheumatoid arthritis, lupus, psoriasis, asthma, sarcoidosis, and inflammatory bowel disease. It can deplete folate stores and cause side effects that are similar to folate deficiency. Both high-folate diets and supplemental folic acid may help to reduce toxic side effects of methotrexate without decreasing its effectiveness. 

Prevention of Heart Disease—Low blood concentrations of folate, vitamin B12, and vitamin B6 may increase the level of homocysteine, an amino acid normally found in the blood. There is evidence that an elevated homocysteine level is an independent risk factor for heart disease and stroke. The effects of folic acid supplementation in lowering the risks of such heart and blood vessel disease are still being evaluated. 


Although folic acid is generally accepted as safe, there are concerns that its use as a dietary supplement may have adverse effects in certain groups of individuals

Bronchial Asthma

Posted in Bronchial Asthma, Health Education on May 19, 2009 by R Vivek

Mostly people tend to avoid this term and say they have esophillia or allergy


You often have trouble breathing, especially when you exercise orcleaning your house. But it also happens when you’re no exercising.  Sometimes you even wake up wheezing during the night. Your doctor tells you that you have asthma, a long-term disease that affects millions of men, women, and children in the India.

What is asthma?

Asthma is a disease in which a person’s airways become inflamed, swollen, and narrowed, making it difficult for air to flow into and out of the lungs. When the airways are swollen, breathlessness and other symptoms of asthma occur.

What are the symptoms of asthma?

People with asthma may have chest tightness, coughing, wheezing, or shortness of breath. Children with asthma may have noisy breathing and may appear very tired after normal play or exercise.

What causes asthma?

No one knows exactly why some people have this condition. What is known is that asthma usually flares up in response to “triggers,” which can be ordinary things in the environment at home, school, and work. For example, an asthma attack may occur when someone with asthma comes into contact with a pet, cigarette smoke, or pollen. Other common triggers include dust mites, mold and mildew, paint fumes, chalk dust, and cockroach parts and droppings. Symptoms that occur in asthma sometimes happen in people who have a viral or sinus infection or heartburn. These symptoms can also be caused by emotional stress, exercise, breathing cold air, taking certain drugs, or eating some types of food.


Who is most likely to have asthma?

People who have a parent with asthma are 40% more likely to have asthma. Also, people who have allergic rhinitis, a condition that is commonly called hay fever, are likely to have asthma.  

There is no way to predict the course of a person’s asthma. Some children with asthma get better when they reach their teens, but othersexperience worsening symptoms that continue into adulthood. Some people have their first symptoms of asthma in adulthood.


How is asthma treated?

There is no cure for asthma, but preventive steps and medications can help people breathe easier. The first step is to eliminate or reduce your exposure to asthma triggers, which may involve cleaning your house more often, finding another home for your pet, or quitting smoking. Not only does smoking make existing asthma worse, it can lead to breathing difficulty for children exposed to the smoke.

Your doctor may prescribe an asthma drug. These medications include steroids, bronchodilators, antileukotrienes, and nonsteroidal  inflammatory drugs in liquid, tablet, or capsule form. Some drugs are taken with a device, such as a metered-dose inhaler or a dry-powder inhaler, a spacer unit that attaches to the inhaler, or a nebulizer that delivers the drug in a mist.

It is important to use asthma drugs exactly as directed. Many of these drugs are made to be used daily—even when you have no symptoms. If you begin having symptoms, take your medication as directed to prevent a serious second attack. Pregnant women with asthma need to carefully follow their doctor’s advice to avoid harm to their baby.

 If you have moderate or severe asthma, your doctor may recommend that you use a device called a peak flow meter to measure your airflow as you breathe out and that you chart the meter’s readings to track your asthma’s progress. You and your doctor can use these measurements to find out how well your asthma is being controlled.

If you follow your doctor’s directions carefully and still have trouble breathing, tell your doctor. He or she may prescribe a different medication, recommend another way to take your medication, or suggest other steps that can help you breathe easier.



Posted in Diabetes on April 14, 2009 by R Vivek

My favorite field, I feel strongly only a person sound with general medicine can manage diabetes rather than studying it alone.vivekblog


What is Diabetes?

Diabetes is a group of conditions in which sugar

levels in the blood are abnormally high. It occurs

when your body attacks and destroys the cells in

the pancreas that produce insulin (type 1) or your

body can’t properly use the insulin your body

produces (type 2). Insulin is a hormone your body

needs to properly metabolize digested foods.

Without it, your body can’t control blood levels of

sugar. The 3 main types of diabetes are:

Type 1 (Insulin-dependent) – about 5% to 10%

of all diabetes; usually occurs in children or

young adults

Type 2 (Noninsulin-dependent) – about 90% to

95% of all diabetes; usually occurs in adults over

age 40 and most commonly in overweight people

Gestational diabetes – occurs in about 2%-3%

of pregnant women; temporary form of insulin

resistance that usually occurs halfway through a

pregnancy; women are then at increased risk of

developing type 2 diabetes later in life



• Family members of people with diabetes

• Overweight people (talk to your doctor about

what constitutes “overweight” for you)

• People over age 65

• Indians

• People with high blood pressure or very high

cholesterol or triglyceride levels

• Women with unexplained miscarriages,

stillbirths, or who have had babies weighing 3.5 kg or more at birth




Having diabetes can mean major changes in a person’s daily life. Because of the body’s inability to control sugar levels in blood and convert the sugar into the biological energy needed by all the body’s cells, people with diabetes must take active control of many aspects of everyday living. 

Although managing diabetes can be demanding, people with the disease can guard against a host of other associated conditions and can lead long, active lives. Approximately above 12%  of our population have diabetes (known as diabetes mellitus or sugar diabetes), and it is the one of  leading cause of death from a disease.

Successful management of the disease involves following a daily routine, which may include monitoring blood sugar levels, taking insulin or other medications, following a healthy diet and exercising regularly. Diabetes can lead to other serious conditions, such as heart disease, stroke, blindness, kidney disease, nerve damage, and amputations.


Heart disease is a common problem in people with diabetes and is the leading cause of diabetes-related deaths.