Dr Manish Khokhar

  Increasing blood pressure affects one million people all over the world and comes to the top in the cause of death. blood pressure doubles the risk of heart disease, coronary disease, congestive heart disease, stroke, kidney failure, and peripheral artery disease. Though blood pressure lowering medication decrease risk. Epidemiology Blood pressure increases with age and vary among populations and even in the same country. S ystolic blood pressure increases with age >60 years and diastolic blood pressure is going to decrease after age 55. So, widening the pulse pressure. In the united-state increasing high blood pressure is due to obesity. The prevalence of blood pressure and stroke mortality is higher. Environmental and genetic factors may contribute to local and racial variations in hypertensive prevalence. Now, people are living in a more urbanized area so their lifestyle changes and leads to obesity. 60% of hypertensive are 20% overweight . High sodium intake an...

  The examination starts with full history and physical examination to confirm a diagnosis of blood pressure, screen for cardiovascular disease risk factors , and screen for secondary causes of blood pressure. Now  New android sphygmomanometers devices come for blood pressure measurement because of old devices with hazards of mercury toxicity. The initial assessment is required systemically in every blood pressure patient such as renal, endocrine, metabolic, and others. Treatment of blood pressure Lifestyle modification of blood pressure patient It has surely had a role in the prevention and treatment of hypertension and recommended for pre-hypertensive and adjuvant therapy . Modification ought to address cardiovascular risks, although these changes do not produce significant blood pressure reduction to cut down therapy. Weight reduction Maintain BMI<25 kg/m2 Salt reduction <6 g NaCl/day DASH diet More fruits, vegetables , low fat dairy product alcohol ...

  Goals The goals management of Diabetes mellitus are to 1) stop symptoms related to hyperglycemia (increase glucose) 2) reduce the long term microvascular and macrovascular complication of diabetes mellitus, and 3) normalized lifestyle as possible. The patient with diabetes mellitus needs education and medicines to keep a normal level of glucose, and management of diabetes related complications. Symptoms of diabetes mellitus are resolved when it normalized glucose levels. The management of diabetes mellitus patients need a multidisciplinary team. Patient’s input associated with primary care providers and need subspecialists to treat complications and management of diabetes mellitus are necessary. The ongoing aspect of comprehensive diabetes care We will discuss different terminology such as intensive insulin therapy, intensive glycemic control, and comprehensive diabetes care, to focus on optimal diabetic care. The morbidity and mortality can be prevented by getting over the...

Diabetes mellitus Diabetes mellitus is a group of metabolic disorders that manifests as increase glucose in the blood. Diabetes mellitus has many types and multiple etiology, mainly gene and environmental factors. There are mainly three reasons for increase blood glucose 1 . decrease insulin secretion 2 . Decrease glucose utilization 3 .increase production of glucose. Diabetes mellitus is a leading cause of the end-stage renal disease (ESRD), no traumatic lower-limb amputations, and adult blindness It is a high risk of cardiovascular disease. Classification DM is classified as a type 1 DM and type 2 DM . however, other types of diabetes in which molecular pathogenesis is better understood and associated with a single gene defect. Type 1 DM develops due to autoimmunity against beta cells which produce insulin so there is near no insulin. Type 2 DM develops due to multiple causes by insulin resistance, impaired insulin secretion, and increased liver glucose production. Typ...