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Dr. sabloks' medical centre, Opp. SBI(ADB), Bangran Road, Drive sabloks' medical centre, Paonta (2026)

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Opp. SBI(ADB), Bangran Road, Drive Sabloks' Medical Centre

28/04/2021

CRP, D Dimer, HbA1c Available Report in 4hrs.

26/04/2021

Sample collection, Processing and report generation

22/04/2021

Opening for Medical Lab Technician..
Contact 94 180 49424
Walk in interview..

15/06/2020

Telehealth services at centre. contact for teleconsultation with any specialist anywhere. 9418049424

07/08/2017

What Causes Dermatitis Herpetiformis?
From the sound of the name, many people think this rash is caused by some form of the herpes virus. This isn’t the case, as it has nothing to do with herpes. Dermatitis herpetiformis occurs in people with celiac disease. Celiac disease (also called celiac sprue, gluten intolerance, or gluten-sensitive enteropathy) is an autoimmune disorder characterized by intolerance to gluten. Gluten is a protein found in wheat, rye, and barley. It’s also sometimes found in oats that have been processed in plants that handle other grains.
According to the National Institutes of Health (NIH), 15 to 25 percent of people with celiac disease have DH. Celiac disease can also cause intense abdominal pain, constipation, nausea, and vomiting. People with DH typically don’t have any of the intestinal symptoms. However, even if they don’t experience any intestinal symptoms, 80 percent or more of people with DH still have intestinal damage, especially if they eat a diet that’s high in gluten, according to the National Foundation for Celiac Awareness (NFCA).
The intestinal damage and rash are due to the reaction of gluten proteins with a special kind of antibody called immunoglobulin A (IgA). Your body makes IgA antibodies to attack gluten proteins. When IgA antibodies attack gluten, they damage the parts of the intestines that allow you to absorb vitamins and nutrients. This sensitivity to gluten usually runs in families.
The structures formed when IgA attaches to gluten then enter the bloodstream. They begin to clog small blood vessels, especially those in the skin. White blood cells are attracted to these clogs. The white blood cells release a chemical called “complement” that causes an itchy, blistery rash.
Risk Factors
Who Is at Risk for Dermatitis Herpetiformis?
Celiac disease can affect anyone, but it tends to be more common in people who have another family member with celiac disease or DH.
Although more women than men are diagnosed with celiac disease, men are more likely to develop DH than women, according to the NIH. The rash usually begins in your 20s or 30s, though it can start in childhood. The condition more commonly occurs in people of European descent. It less commonly affects people of African or Asian descent.
Symptoms
What Are the Symptoms of Dermatitis Herpetiformis?
DH is one of the itchiest rashes possible. Common locations of the rash include:
elbows
knees
lower back
hairline
back of the neck
shoulders
buttocks
scalp
The rash is usually the same size and shape on both sides of the body and often comes and goes.
Before a full outbreak of the rash, you may feel the skin in a rash-prone area burn or itch. Bumps that look like pimples filled with clear liquid start to form. These are quickly scratched off. The bumps heal within a few days and leave a purple mark that lasts for weeks. But new bumps continue to form as old ones heal. This process can continue for years, or it can go into remission and then return.
While these symptoms are commonly associated with dermatitis herpetiformis, they can also be caused by other skin conditions such as atopic dermatitis, irritant or allergic contact dermatitis, psoriasis, pemphigoid, or scabies.
Diagnosis
How Is Dermatitis Herpetiformis Diagnosed?
DH is best diagnosed with a skin biopsy. A doctor takes a small sample of skin and examines it under a microscope. Sometimes, a direct immunofluorescence test is done, in which the skin around the rash is stained with a dye that will show the presence of IgA antibody deposits. The skin biopsy can also help determine if the symptoms are caused by another skin condition.
Blood tests to check for these antibodies in the blood may also be done. An intestinal biopsy may be performed to confirm the presence of damage due to celiac disease.
If the diagnosis is uncertain, or another diagnosis is possible, other tests may be performed. Patch testing is the best way to diagnose allergic contact dermatitis, which is a common cause of symptoms similar to dermatitis herpetiformis.
Treatments
What Treatments Are Available for Dermatitis Herpetiformis?
DH can be treated with an antibiotic called dapsone. Dapsone is a powerful medicine with serious side effects. The dose must be increased slowly over several months before it’s fully effective.
Most people see relief from taking dapsone, but side effects may include:
liver problems
sensitivity to sunlight
anemia
muscle weakness
peripheral neuropathy
Dapsone may also have negative interactions with other medications, such as aminobenzoate potassium, clofazimine, or trimethoprim.
Other drugs that may be used include tetracycline, sulfapyridine, and some immunosuppressive drugs. These are less effective than dapsone.
The most effective treatment that’s free of side effects is strict adherence to a gluten-free diet. This means you should completely avoid food, drink, or medicines containing the following:
wheat
rye
barley
oats
Although this diet can be difficult to follow....
By Dr. Rawlin MMC

12/04/2017

Vitamin D estimation in blood (25 hydroxy vit D levels) has become a very popular test all over the country. With the available test, a majority of the population is found to have lower levels.
Does this reflect a true deficiency of vitamin D3?
We have plenty of sunshine in our country and it seems paradoxical that people are deficient in vitamin D. So the main question is about the interpretation of the commercially available testa in our country. Vit D (cholecalciferol) is formed in the skin by the photolysis of 7 dehydrocholestrerol by ultra violet radiation from sunlight.
Cholecalciferol is hydroxylated to 25 hydroxy cholecalciferol in the liver. The present test estimates total 25 hydroxycholecalciferol consisting of 3 parts: a) the form bound to the vit D binding protein (85%); b) form bound to albumin (15%) and c) free or bio available form (0.03%).
What is important for bone health and vitamin D action is the free form. The protein bound form is determined genetically for storage purpose.
In Afro Americans, genetically, the protein-bound form is low since they were exposed to sunlight for generations. However, the free forms are quite normal. Hence, even though the total vitamin D3 level is low in their blood, they are not deficient in vitamin D since the free levels are normal.
In Harvard Medical School, it was found that Afro Americans had stronger bones in spite of lower total levels than Whites.
It is quite likely that we also have similar genetic backgrounds due to plenty of sunshine. Hence, the present test of total vitamin D3 does not reflect a deficiency. Unfortunately, the test is being done widely and is costly. It requires careful interpretation to avoid unnecessary vitamin D supplementation and its consequences.
Similarly, low levels of vitamin D 3 is found during a number of chronic diseases like heart attack, diabetes, hyper tension etc. Here again, it has been shown that it is not the cause of the chronic disease and supplementation does not help. It is only a marker of chronic disease.
(The article was contributed by Dr. Rajan Ravichandran, director, MIOT Institute of Nephrology.)

11/05/2016

Quality of drinking water and associated health risks

A new NIH study links arsenic in drinking water from private wells to bladder cancer

The quality of water has an important impact on public health. Presence of contaminants, either microbial or chemical, puts health of people at risk. Water-borne diseases such as diarrhea, cholera, dysentery, typhoid, worm infestations are well-recognized and constitute a major cause of mortality and morbidity worldwide.

It’s not only the surface water in rivers and lakes that is susceptible to contamination, groundwater or water in wells too is susceptible to contamination through poor management of industrial or agricultural waste. Groundwater may also be contaminated by naturally occurring chemicals. Drinking water requires appropriate treatment to remove the hazardous contaminants before it is fit for drinking.

Water sources that are unprotected are at a great risk of contamination and become unfit for drinking.

Arsenic is naturally present at high levels in the groundwater in many parts of the world. It is the only contaminant that has been shown to be the cause of human cancers following exposure through drinking water. In addition to occupational exposure, other important routes of arsenic exposure are oral intake of food and drinking-water. The goal for amount of arsenic in drinking water is usually less than 10 µg/L. But, in those areas in which drinking water contains arsenic levels greater than this, it becomes the major source of arsenic.

Findings from a recent NIH study further support an association between low-to-moderate levels of arsenic in drinking water and bladder cancer risk in Maine, New Hampshire and Vermont in the United States, where most people use private wells for their drinking water.

In the study published May 2, 2016, in the Journal of the National Cancer Institute, increasing cumulative exposure was found to be associated with an increasing risk of bladder cancer. Among study subjects who had used private wells, particularly wells that were dug during the first half of the last century, those who drank the most water had a 2-fold higher risk. These private wells are outside jurisdiction of federal regulations and are not maintained by municipalities. The water in these wells may contain low to moderate levels of arsenic due to use of arsenic containing pesticides.

Dug wells are less than 50 feet deep, and potentially susceptible to contamination from man-made sources.

28/01/2016

Controlling cholesterol levels can help regress heart disease
High blood cholesterol itself does not cause symptoms; so many people are unaware that their cholesterol level is too high.
Cholesterol lowering is important for everyone--younger, middle age, and older adults; women and men; and people with or without heart disease.
Lipid profile means measuring total Cholesterol, Triglycerides, LDL, HDL, VLDL and Non HDL Cholesterol. VLDL cholesterol is calculated by dividing value of triglycerides by five. LDL cholesterol is calculated by total cholesterol – HDL cholesterol – VLDL cholesterol
A standard serum lipid profile consists of total cholesterol, triglycerides, and HDL-cholesterol and rest are calculated values.
Foods of plant in origin contain no cholesterol. Almonds and nuts contain no cholesterol.
Food liquid at room temperature contains unsaturated fat. Food solid at room temperature is either saturated or a transfat.
Transfat increases bad cholesterol and reduces good cholesterol. Saturated vanaspati ghee increases bad cholesterol but does not reduce good cholesterol levels in the body.
A 1% rise in cholesterol leves can raise the chances of heart attack by 2%. 1% reduction of good HDL cholesterol increases the chances of suffering from a heart attack by 3%.
One yellow of an egg contains cholesterol equivalent to 10 tea spoon full of butter.
Regular exercise can increase the levels of good cholesterol in your body
Keep your total cholesterol lower than 160mg%. LDL is bad cholesterol and should be kept as low as possible, keep it lower than 80 mg/dl. HDL is good cholesterol, keep it more than 40mg%
Lipid profile is done on 8 -12 hours fasting (no calories) to minimize the influence of postprandial hyperlipidemia. Fast for 12 hours to get accurate readings of LDL ("bad" cholesterol), HDL ("good" cholesterol), and triglyceride levels. Avoid drinking alcohol for at least 24 hours before the test.
Serum total and HDL-cholesterol can be measured in fasting or nonfasting individuals. There are only small clinically insignificant differences in these values when measured in the fasting or non-fasting state. So for calculation of Non HDL cholesterol no fasting is required.
Having suffered from a flu or another illness shortly before the blood test can have a dramatic effect on ones cholesterol levels.
High levels of alcohol or carbohydrates taken in the last week can raise triglyceride
An underactive or overactive thyroid can affect cholesterol levels.
If there is a strong family history of heart disease, first Lipid profile should be done at the age of 5. If lipid profile is normal, is should be repeated every 5 years.
Blood lipid levels may exhibit mild seasonal variation with a peak in total cholesterol level in the winter and a trough in the summer. Amplitude of seasonal variation of total cholesterol concentration is 3.9 mg/dL in men and 5.4 mg/dL in women.
The total cholesterol can vary by 4 to 11 percent within an individual due to multiple factors including stress, minor illness, and posture.

03/11/2015

According to International guidelines, unless a patient’s platelet count is below 10,000, and there is spontaneous, active bleeding, no platelet transfusion is required. The outbreak of dengue in the City and Hospital beds are full and families are seen running around in search of platelets for transfusion. However what most people do not realize is that the first line of treatment for dengue is not platelet transfusion. It, in fact, does more harm than good if used in a patient whose counts are over 10,000.

The primary cause of death in patients suffering from dengue is capillary leakage, which causes blood deficiency in the intravascular compartment, leading to multi-organ failure. At the first instance of plasma leakage from the intravascular compartment to the extravascular compartment, fluid replacement amounting to 20 ml per kg body weight per hour must be administered. This must be continued till the difference between the upper and lower blood pressure is over 40 mmHg, or the patient passes adequate urine. This is all that is required to treat the patient. Giving unnecessary platelet transfusion can make the patient more unwell.

“While treating dengue patients, physicians should remember the ‘Formula of 20' i.e. rise in pulse by more than 20; fall of BP by more than 20; difference between lower and upper BP of less than 20 and presence of more than 20 hemorrhagic spots on the arm after a tourniquet test suggest a high-risk situation and the person needs immediate medical attention.”

Dengue fever is a painful mosquito-borne disease. It is caused by any one of four types of dengue virus, which is transmitted by the bite of an infected female Aedes aegypti mosquito. Common symptoms of dengue include high fever, runny nose, a mild skin rash, cough, and pain behind the eyes and in the joints. However, some people may develop a red and white patchy skin rash followed by loss of appetite, nausea, vomiting, etc. Patients suffering from dengue should seek medical advice, rest and drink plenty of fluids. Paracetamol can be taken to bring down fever and reduce joint pains. However, aspirin or ibuprofen should not be taken since they can increase the risk of bleeding.

The risk of complications is in less than 1% of dengue cases and, if warning signals are known to the public, all deaths from dengue can be avoided.
DENGUE NS1-Best test is NS1
Cannot be false +ve
Is + from day 1 to 7 ideally.
If on day 1 is -ve, repeat it next day.
Always ask for ELISA based NS1 tests as card tests are misleading.

Value of IgG & IgM dengue-
In a pt with reduced platelets and looking "sick" on day 3 or 4 of illness, a very high titre of IgG with borderline rise in IgM signifies secondary dengue. These pts are more prone to complications.
In primary dengue IgG becomes + at end of 7 days, while IgM is + after day 4.

Immature Platelet fraction/IPF
A very useful test in Dengue for pts with thrombocytopenia.
If IPF in such a pt is > 10%, despite a pl count of 20, 000 he is out of danger & platelets will rise in 24 hrs
If its 6%, repeat the same next day. Now if IPF has increased to 8% his platelets will certainly increase within 48 hrs.
If its less then 5%, then his bone marrow will not respond for 3-4 days & may be a likely candidate for pl transfusion.
Better to do an IPF even with borderline low platelet count.

A low Mean Platelet volume or MPV means platelets are functionally inefficient and such pts need more attention.**

20/10/2015

75% of Indians suffer vitamin deficiency
Chennai: More than seven out of ten Indians lack in vitamins, and most of them suffer from vitamin D deficiency that is linked to Alzheimer's disease, prostate cancer, erectile dysfunction and schizophrenia. Chennai-based Metropolis Healthcare studied 14,96,683 samples over three years and found an increasing trend of deficiency in vitamin D, vitamin B12 and vitamin B9 (Folic Acid) among all age groups of Indians. The samples tested across four zones showed that 75% of the population was deficient in three vital vitamins. While 21.02% were deficient in vitamin B12 and 15.06% deficient in vitamin B9, 81.28% of all samples were deficient in vitamin D. Dr Sonali Kolte of Metropolis said symptoms of vitamin D deficiency can be vague, with muscle or joint pain, weakness, and depression. "Vitamin deficiencies usually show slowly. Nowadays, it is observed that people deficient in Vitamin D are more likely to have diabetes, regardless of how much they weigh," Dr Sonali Kolte said… Lack of Vitamin B12 is so staggering that it is the culprit behind the suboptimal blood levels of nearly half the Indian population, said consultant nutritionist Dr Deepa Agarwal of Asian Bariatrics… The study found that Vitamin B9 or folic acid was deficient especially in the 20-40 age group. Vitamin B9 is vital for pregnant women to prevent anaemia and major birth defects in the baby… The study indicated that the majority of the population had poor practices and were ignorant of vitamin sufficiency… (Source: Times of India - Janani Sampath)

13/10/2015

Simple Dengue Fever:

Over ninety-five percent people suffer from simple dengue fever, which is not as threatening as severe dengue fever.
In simple dengue fever there is no capillary leakage, the person requires only oral fluids, 100 ml per hour, and is advised to visit a local doctor
Additionally, the patient is recommended to drink 500 ml water at the time of diagnosi Only those patients with dengue fever who have vomiting should consume intravenous fluids
Severe Dengue Fever:

Those suffering from severe dengue develop capillary leakage and intravascular dehydration. Also, they suffer from a rapid fall in the platelet count along with rapid rise in their hematocrit levels They will have rapid fall in platelets along with rapid rise in hematocrit levels
Persistent vomiting, nausea, extreme exhaustion and lethargy are some of the symptoms of dengue. Along with these symptoms, a victim might suffer unrelieved abdominal pain and mental irritability and confusion.
These people require close daily observation.
Dengue patients are kept under close observation and are recommended to consume 1500 ml fluids (20 ml per kg) immediately
And in case, when they cannot consume liquids orally, then intravenous fluids are a must

Formula of 20 to identify high-risk cases of Dengue fever:

If there is a rise in pulse by 20
Fall in upper blood pressure by 20
Rise in hematocrit by 20 percent
Rapid fall in platelets to less than 20,000
Petechiae (red spot) count of more than 20 in one inch after tourniquet test
If the difference between upper and lower blood pressure is less than 20, then such cases should be given 20 ml of fluid per kg immediately and then shifted to nearest medical center for medical assistance
What you need to do in case symptoms are prevalent?

The follow-up tests are required to witness the rise in hematocrit and significant fall in the level of platelets.
The tests are required to be screened simultaneously.
Platelets transfusions are not required unless there is active bleeding and platelet count is less than 10,000
Keep a tab on hematocrit levels are crucial as their count decides the adequate requirement of fluids required by the body
It is important to remember the following:

Capillary leakage only occurs when the fever is on the verge of subsidin
In the initial 48 hours, including 24 hours after fever is over, are crucial, and the patient requires plenty of fluids as a sub-treatment
Signs of itching or rash usually occur post the capillary leakage period is over
When is urgent admission required?

If the patient is unable to consume or tolerate the consumption of liquids
Pregnant women Underlying comorbid conditions
Infants or elderly people
Patients suffering from uncontrolled diabetes...

09/07/2015

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