[wildsdi5530]

Originally Posted by Blow Horn Ok

Hello. A query for orthopaedic surgeons. Attaching the x-ray for reference.

Attachment 1843320

Attachment 1843321

Seeking valuable suggestions from the doctors. Main criteria for the treatment is to prevent any pain, arithritis and stiff/deformed joints in future.

I am an orthopedic surgeon (Joint Replacement) based out of Bangalore. This is called a Volar Barton's fracture. This needs surgery with a plate and screws. This will be unstable in a cast or even with wires. Please opt for surgery.

[Epic]

Dear Doctors,

So I had visited a pulmonologist to diagnose and treat a snoring problem I had had for a few years now. I was suggested to take a sleep study test and was diagnosed with Obstructive Sleep Apnea (OSA). I do not have any of the symptoms of sleep apnea like sleepiness during the day, tiredness, dozing while driving, etc but this was still the diagnosis post the sleep study.

I have now been advised to use a CPAP machine which according to the doctor is the best and most effective way to eliminate snoring and get a better night's sleep.

I need advise on which is the best machine / brand I should buy. I do know that ultimately what matters is the right mask from the comfort point of view but since these machines are nothing less than 50k, I want to ensure I buy something that is a quality product and has good after sales service. I have done a bit of research and come across the following:

1. ResMed AirSense 10 Autoset
2. Philips Respironics Dreamstation Auto
3. ResMed Airmini

I have also come across brands like Transcend and HDM which claims to have the world's smallest CPAP called the Z1. However, I am not sure of their presence in India.

I think it would be advisable to buy an Auto CPAP with a built in humidifier and which is small and light so that it is easily portable during travel.

I would be happy if anyone can guide me on the above.

[T Y A G I]

Team,

Can some Cardiologist suggest what sort of diet is to be given to a person who just got Angiotherapy done.I learnt from my Sis in Law that my brother who's admitted in Fortis Vasant Kunj is being given diet like Kadhai Paneer, Rajma Chawal, Moong Dal Halwa etc.

Regards,
Lalit Tyagi

[Jaguar]

I am looking for alternatives to Pepto Bismol in India. I have had immediate relief from severe acidity using Pepto Bismol tables when I had visited US. Was thinking of buying and keeping it in my emergency medicine kit but it is not available in India. Is it available in India under a different brand or can someone suggest a good alternative?

Originally Posted by T Y A G I

my brother who's admitted in Fortis Vasant Kunj is being given diet like Kadhai Paneer, Rajma Chawal, Moong Dal Halwa etc.

Wonder what's with hospital foods these days. My mom was admitted for a couple of days for suspected dengue, and both lunch & dinner would contain a pack of cold curd, that too in winter

[carboy]

Originally Posted by Jaguar

I am looking for alternatives to Pepto Bismol in India. I have had immediate relief from severe acidity using Pepto Bismol tables when I had visited US. Was thinking of buying and keeping it in my emergency medicine kit but it is not available in India. Is it available in India under a different brand or can someone suggest a good alternative?

Pepto Bismol is not available in India under any brand name. Alternative is Gelusil liquid/tablets. Another alternative is Mucaine Gel but it's probably more potent than the others, so consult a doctor first.

[Cedia2013]

Originally Posted by carboy

Pepto Bismol is not available in India under any brand name. Alternative is Gelusil liquid/tablets. Another alternative is Mucaine Gel but it's probably more potent than the others, so consult a doctor first.

Bismuth subsalicylate is not available in India. But it is not superior either. Better tablets like “HAPPI-L” “ RAZO-D” are the drug of choice for heart burns. If you can elaborate your symptoms I can suggest you specific drug. Else you can choose one from above. You can also try syrup GAVISCON (10ml after good) if you have burns only after heavy spicy feast.

[Jaguar]

Originally Posted by carboy

Alternative is Gelusil liquid/tablets. Another alternative is Mucaine Gel but it's probably more potent than the others, so consult a doctor first.

Originally Posted by Cedia2013

Bismuth subsalicylate is not available in India. But it is not superior either. Better tablets like “HAPPI-L” “ RAZO-D” are the drug of choice for heart burns. If you can elaborate your symptoms I can suggest you specific drug. Else you can choose one from above. You can also try syrup GAVISCON (10ml after good) if you have burns only after heavy spicy feast.

Thanks. I am not looking to treat any specific symptom, just wanted to something as an emergency go-to for an upset stomach or acidity/acid-reflux when traveling. Was leaning towards Pepto because the relief was immediate.

[aadya]

Originally Posted by T Y A G I

Team,diet like Kadhai Paneer, Rajma Chawal, Moong Dal Halwa etc.

Originally Posted by Jaguar

I am looking for alternatives to Pepto Bismol in India.
Wonder what's with hospital foods these days. My mom was admitted for a couple of days for suspected dengue, and both lunch & dinner would contain a pack of cold curd, that too in winter

There are some alternative to pepto bismol available but rarely in regular shops. Better to use Gelusil/Digene chewable tablets.

As somebody who has run-ins with the patients regarding diet. Most bigger hospital has a team of nutritionist looking after the diet. Usual complaints are due to low salt, lack of deep frying and low spice. Other way around patients with sore mouth will complain of heavy spice and burning.

Homogenisation of the food for a diverse country like India is a very tough task. Usually the nutrition part like Fat, Carbs, Salt and Protein would be within reasonable limits and the diet team try to make is as normal as somebody's home, but they can't be right always.

Paneer and Halwa are entirely acceptable if the patient is not severely ill or having high sugars. Its the quantity which is usually limited.

Skimmed Curd is a well advised and safe food for most patients(if not allergic), its served cold to avoid turning sour. All we have to do is wait and consume it. I even reprimand my staff if curd is not available round the clock for patients under my care.

[Astonite]

Dear Docs,

One fine day (2005 diwali), I woke up from the middle of my sleep - my hands were out of my control, I tried resisting and they did what they wanted to do and I fainted and wake up after hours - my first episode of Seizure.

Similar incidents have happened about 4 times now. Tried different docs, had Valparine Chrono 500 (if I remember correctly) for about 3 years and things started getting worse and not any better. Stopped taking medicines and I thought I was fine. In 2015 when I was returning from Dubai, had this in Emirates flight. I fainted in less than an hour of starting from Dubai and when I woke up, flight had landed in Chennai with a blanket over me (this was the last incident and I haven't had such an episode till date).

Now, my hands jerk all of a sudden and I drop whatever is there in my left hand. My medicine - I smoke a couple of cigarettes and I am fine.

If anyone can provide directions on what to be done, it would be great. Did MRI, EEG, and all sorts of tests - being given medicines which just aggravates it.

[sagarpadaki]

Originally Posted by Epic

1. ResMed AirSense 10 Autoset
2. Philips Respironics Dreamstation Auto
3. ResMed Airmini

Although I am not a doctor, I would like to add 2 cents.

I have a similar problem WRT to snoring and even I was given the same recommendation by the doc.

One of my acquaintance who followed the CPAP regime to reduce snoring did not find any improvement after using for 6 months. He paid around 38K for a second hand machine. Later he started following a regime of Pranayama daily and after 3 months there is a noticeable improvement in him and he can feel the difference.

With the mask on it is very cumbersome when you sleep on your side or on your stomach. It is convenient only if you sleep upright. I would suggest you take the pranayama approach for a few months before you invest on a CPAP machine.

[carboy]

Originally Posted by SS-Traveller

We quit sunflower oil and switched to olive oil and mustard oil (as applicable for different preparations) a few years ago

Recently read some articles about how Palm oil is good because it has very less Omega 6 as compared to seed oils. Butter, Coconut oil etc has no Omega 6 so obviously it's better but among other oils, Palm oil seems to have low omega 6.

I know we import a lot of Palm oil in India and it's also cheap but I don't see any palm oil in my grocery shop or on Bigbasket. Where do we get Palm oil?

[FrozeninTime]

Originally Posted by carboy

Recently read some articles about how Palm oil is good because it has very less Omega 6 as compared to seed oils. Butter, Coconut oil etc has no Omega 6 so obviously it's better but among other oils, Palm oil seems to have low omega 6.

I would recommend against using Palm oil. Use of Palm oil increases cardiovascular risk and is also bad for environment. Widespread deforestation in South East Asia due to Palm tree cultivation.

[JMaruru]

Originally Posted by FrozeninTime

I would recommend against using Palm oil. Use of Palm oil increases cardiovascular risk and is also bad for environment. Widespread deforestation in South East Asia due to Palm tree cultivation.

The best would be 'cold pressed coconut oil'. It's time tested by generations of folks as their cooking oil, down south.

[carboy]

Originally Posted by FrozeninTime

I would recommend against using Palm oil. Use of Palm oil increases cardiovascular risk.

That was the old thought. The new thought is that it reduces cardiovascular risk.

[SS-Traveller]

Originally Posted by Epic

So I had visited a pulmonologist to diagnose and treat a snoring problem I had had for a few years now. I was suggested to take a sleep study test and was diagnosed with Obstructive Sleep Apnea (OSA). I do not have any of the symptoms of sleep apnea like sleepiness during the day, tiredness, dozing while driving, etc but this was still the diagnosis post the sleep study.

OSA leads to lowered SpO2 levels, and only those with levels below a certain percentage are recommended for PAP machines by sleep medicine specialists. However, there are multiple reasons for OSA, and you need to consult different specialties to rule out things like a deviated nasal septum, a malpositioned hyoid bone, flaccid soft palate, macroglossia, or even excess body weight, which can be treated surgically or otherwise, before opting for a PAP machine. Consult an ENT specialist and an orthodontist specializing in sleep apnea, before taking the plunge for a PAP machine, which is pretty much a lifelong commitment.

Originally Posted by Epic

I need advise on which is the best machine / brand I should buy. I do know that ultimately what matters is the right mask from the comfort point of view but since these machines are nothing less than 50k,

I think it would be advisable to buy an Auto CPAP with a built in humidifier and which is small and light so that it is easily portable during travel.

I would be happy if anyone can guide me on the above.

PAP, or Positive Airway Pressure can be administered, broadly. through 3 types of machines:
CPAP: Constant PAP - the first generation of machines, which have a constant air pressure, which needs to be set by titrating your requirement in a sleep clinic setup. These are the cheapest.
BiPAP: Bi-level PAP - the machine reduces the pressure on the exhalation cycle, making it easier to breathe out. More comfortable than CPAP, but the air pressure on inhalation is still constant.
APAP: Automatic PAP - the latest generation of machines, costing 60-80k, these automatically titrate the air pressure based on your breathing pattern. Some have a heated tube as well as a humidifier, some don't. More the facilities, more the comfort.

Masks are also of 3 types:
1. The full face mask, that covers both the mouth and nose. Very restrictive, and most hate using it on a day-to-day basis, but it's the most durable variety;
2. The nasal mask, which only covers the nose. More comfortable, and still reasonably durable; and
3. The nasal pillow. This is certainly the most comfortable mask if there is no nasal obstruction, but it needs changing in less than a year of regular use.

Originally Posted by Epic

I have done a bit of research and come across the following:

1. ResMed AirSense 10 Autoset
2. Philips Respironics Dreamstation Auto
3. ResMed Airmini

I have also come across brands like Transcend and HDM which claims to have the world's smallest CPAP called the Z1. However, I am not sure of their presence in India.

PAP machines require servicing routinely, so it's best not to buy little-known brands with iffy service support. Philips and Resmed are the two main PAP machine sellers in India, with assured service support internationally. My wife bought a Resmed Airsense 10 with heated tubing and humidifier, mainly because it is manufactured in Australia (comes with an Australian power plug), and in an emergency it would be easy to get service support in Australia when she travels there.

Also note: PAP machines are not considered part of standard cabin baggage, and can be carried as a separate unit (not limited to the 7kg weight restriction) as life-saving equipment. Keep your prescription handy when travelling by air.

Originally Posted by carboy

I know we import a lot of Palm oil in India and it's also cheap but I don't see any palm oil in my grocery shop or on Bigbasket. Where do we get Palm oil?

Well, I hate the flavour of palm oil. And no, I haven't seen palm oil on supermarket shelves in a long, long time. I believe the pakodawalas use palm oil and it is only available in bulk packages (17-kg tins) nowadays.