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Dr Hemalata

Dr Hemalata Arora  |201 Answers  |Ask -

General Physician - Answered on Jun 21, 2024

Dr Hemalata Arora is a senior consultant who practises internal medicine at Mumbai’s Nanavati Max Super Speciality Hospital.
In a career spanning over 24 years, she has focused on managing infectious diseases, critical illnesses and lifestyle disorders.
Dr Arora completed her MBBS and MD from the King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College in Mumbai.
She is ECFMG certified, accredited by the American Board of Internal Medicine, Diplomate of the National Board and a DNB faculty.
She was honoured with the Paul Bunn award for her promising performance in the field of infectious diseases at SUNY Upstate Medical University, New York.... more
Suresh Question by Suresh on Jun 05, 2024Hindi
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I am 77 years old. I was taking medicine for high BP from the age of 50 years.I was very active doing yoga regularly in the morning and doing walk in the evening. I do not smoke and do not drink as well. I am a person with height weight normal as per the standard chart. I was very active doing my job and never use to get tired. I worked for six years in Central Govt, thirty years in PSU and seventeen years in Private Organisations. I used to believe that " a Person should never retire from work". I stopped going to work from March 2020 after the Covid 19 spread in India. During a routine check up, my doctor mentioned on my prescription as "Stable Angina". I asked about it but he replied, it is nothing, do not worry. I was not having any pain etc. But this remark of Stable Angina. was written on my prescription on every visit. In June 2022, I got a CT Angiography done just to know the deposits in my arteries. It was found to be more in all the five arteries. But I had no symptoms of any pain or breathlessness while moving or working.In August 2022, I got some problem in my left eye, went to eye specialist, he observed a little deposit in eye nerve. He tried to break it but could not. I went for Angiography. All the arteries were found with deposits but still I had no pain etc. I was operated for Heart By pass Surgery on 22.9.22 and released from Hospital on 1.10.22. I was put on High Protein Diet. During Jan 23 to July 23, my Blood Urea Nitrogen & Urea got up the required level.High Protein Diet was stopped and advised take more Fruits. BUN & Urea came normal. More fruits were being taken. It caused potassium level to go up. Then in fruits also restriction imposed on banana, coconut water & citrus fruits. Now I am on restricted diet. BUN & Urea are normal but potassium remains fluctuating. Now I am alright but feel very weak. I do little walk but get tired soon. I am not able to do yoga due to low energy. Vitamin supplements are being taken but not getting strength. Even feels stability problem. While standing feels giddiness and feels that i may fall. I am also feeling severe pain in my arms muscles. Now I am taking medicines for BP, Cholesterol, Blood Thinner, Enlarged Prostrate Gland, Vitamin supplement. I always think why I am feeling so many problems after Heart Bye Pass Surgery. Please advise.

Ans: I feel you need your medications adjusted. They're probably making you feel like this.
DISCLAIMER: The answer provided by rediffGURUS is for informational and general awareness purposes only. It is not a substitute for professional medical diagnosis or treatment.
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Dr Ashit

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Consultant Physician, Internal Medicine and Critical Care Expert - Answered on May 30, 2023

Asked by Anonymous - May 27, 2023Hindi
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Hello Doctor, I am 44. I was suffering from gastric issues Somewhere in Oct 2021, i started feeling anxious and all negative thoughts. As a nature, i take good care of self. But due to this anxiouness, i was unable to sleep well or even concentrate well. I thought to consult a MD and he took my BP reading, which was in range of 142/90. He avoided started any medications and advised for lifestyle changes to alter this situation, to which i stared with certain life-style changes like, - sun-bath in morning. - walking - morning & evening - meditation - in evening. i continued this till Dec 2021 and again revisited the MD in Jan 2022, to which he advised to continued with the same routine. By March 2022, i was feeling better. Again, the same story repeated in Sep2022 and this time, with lot of gastric issues, sleep troubel and feeling of fear and anxiety and again i visited him in Nov 2022, was getting more anxious. Looking at my condition he started with beta-blocker. The condition was not very much improving and i took the blood tests on my own in Nov 2022 end, to which, Lipid profile was bit out of range, HaB1c - in pre-diabetic zone and in liver tests - SGPT was 62. I visited to the MD with report and he advised me to continue with beta- blocker and to start with the statins daily 10 mg, after dinner. I continued this for Dec 2022 with life style change with yoga and meditation routines along with walks. In Jan 2023, the tests were repeated and it was all NORMAL. The doctor advised to stop the medicines wef Jan 2023 and again advised to repeated tests in Feb 2023. In Feb 2023, all parametere were normal , but Lipid profile was again out of range. The MD again started with the same medicines from March 2023 onwards ie 1 beta - blocker in morning after break-fast and 10 mg statin after dinner. I repeated the tests in April 2023 and it was again all NORMAL. Now, the MD reduced the statin drug to 5 mg from 10 mg and continued with beta - blocker. I am leading a healthy life with yoga, meditation, diets with more fibres and less oily or say no oil deits to the extent possible. I have stopped eating any outside food and fully on home made food only now. benefits till now, - Sleep paterrn improved - Gastric issues has gone - IBS gone, - better mood My questions to you sir, - The MD is again planning to stop the medications in next visit, since all reports are normal and i feel normal. is that okay? - Again, i may develop the symptoms? - I am following a better life style - yoga, meditation, walkings, proper diets, are there chances that i would remain off medicine always? - What are the benefits and disadvantages of station and beta -blockers, if at all, i have to take it? thanks.
Ans: Beta blockers have probably been prescribed for your symptoms of anxiety but they can increase the levels of the lipids. You need to consult a psychiatrist about the best treatment for anxiety.
Ideally statins need to be taken for long because the lipid levels are bound to go up once you stop the statin. We need to decide however whether you really need a statin at your age. Do you have a family history of premature heart disease. If you do not have a family history of premature heart disease, you can probably stop statins for a few years . Can consider doing a CT Coronary calcium score

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Dr Hemalata

Dr Hemalata Arora  |201 Answers  |Ask -

General Physician - Answered on Jun 07, 2023

Asked by Anonymous - Jun 01, 2023Hindi
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Hello Doctor, I am 44. I prefer healthy life and all nice in terms of health, except that I was suffering from gastric issues, IBS and related issues. I had covid also in April 2021 and somewhere in Oct 2021, i started feeling anxious and all negative thoughts. In about Aug 2021, i noticed that my heartbeats is high than normal, which initially i tried to control with routine meditation. But somehow, was not feeling that well from within and mind was like getting anxious, as if , something is happening which i could not understand, what. I visited to MD - Medicine, in Oct 2021. As a process, the vitals were taken and BP reading was taken which was 145/90. The concern MD, which after going through the reading, did not tagged me as BP patient and advised me to have changes in lifestyle with yoga, walking, meditation and dietary changes. I throughly followed the advised and started feeling better from Jan 2022 onwards and it was all nice. Again from Sep 2022 onwards, i started feeling the same issues. And i visited the MD in Oct 2022. From Nov 2022, he put me on 25mg dose of beta-blocker , daily in the morning after breakfast. While, i was on beta-blocker, i was still not feeling that nice from within and i unilaterly took the decision to go for complete blood tests in Nov 2022 end. The results were, - Lipid profile - was disturbed. - Sugar : I was in pre-diabetic range. - Uric Acid : I was on borderline high. I visited the MD with the report and he add another dose of 10 mg of Statins from Dec 2022 onwards. I followed the medication along with dietary changes, yoga & meditation routine and took the tests in Jan 2023, which shows the results as under, - Lipid : Normal - Sugar: I was back to Non-Diabtic range from pre-diabetic. - uric acid - normal. And all other parameters improved too like Hemoglobin - 15 and all other paramters of cbc was normal, thyroid - normal , Liver function - normal - when certain times SGPT was bit on higher sides, but normal in this report. With this report the MD stopped the statin drug from Feb 2022 onwards and advised me to continue with beta-blocker of 12.50 mg instead of 25 mg. I followed the same routine for full Feb 2022 and again took the test in March 2023, and results were as under, - Sugar : non-diabetic - all other paramters - normal - Lipid - Not normal. So again from March 2023, the MD started with the same statin dose of 10 mg and beta- blocker of 25 mg. I took the test in April 2023 and again the reports were normal, so now, again he reduce the statin dose to half ie 5 mg and continued with the same dose of beta-blocker 25mg. My questions: 1. AT present, i follow proper diet schedule as prescribed by dietcian , have been doing meditation and yoga on regular basis. 2. Stress level is minimum. 3. I am feeling overall better. 4. BP levels are always normal 5. Gastric issues, IBS seems to have gone. 6. Sleep patern is improved. My question: a. I feel, in the next visit the MD may stop the statin. Can the lipid profile remain in normal range , when i am follwing all diet patterms , with yoga and exercise. Why the lipid profile became abnormal, previously even when i was following all routine very property ? b. Is it okay to consume beta - blocker 25mg regularly, even after doctor told me to stop statin or may stop my statin in next visit? c. Is there any way to know, to find, if i am feeling better normally or due to medicine? as i am feeling normal and unable to check, what after i stopped beta-blocker? Any other care which i should take and lead a healthy life.
Ans: Hello. These are good questions and a lot of people go through the same stages. Cholesterol levels are generally genetically determined and don't change much from dietary or lifestyle changes. It can be reduced by medications. However if it is the only risk factor for heart disease/stroke, then it need not be corrected unless it is very high, LDL> 160. On the other hand the B blocker, if it was taken only for BP, may be stopped if BP comes down and remains normal. A closer monitoring may be required for that. If BP stays normal or low on taking the medicine, reduce the medicine and recheck, if it still stays low or normal, stop and see. Take it slow.

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Dr Karthiyayini

Dr Karthiyayini Mahadevan  |886 Answers  |Ask -

General Physician - Answered on Jun 26, 2024

Asked by Anonymous - May 09, 2024Hindi
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I am 54 years M ,having Diabetes and High BP (HTN) since the past 13 years. At times it has been in poor control also like in May 2021 the HbA1c was 10.10 which gradually went down to 7.70 and then remained constant between 7.90 and 8.10 with the medications and 'not so strict' diet regime. Plus the body weight was also increasing and i gained around 10 kgs (101.2 Kgs) in a span of around 06 months. Recently in March 2024, the test reports indicated it as 8.70 causing me some concern and in April 2024 the reports showed a value of 9.20, which made me think about the reliablity of Lab report as well as made me change the doctor. My medicines were changed from Glimepiride (2 mg),Metformin (500 mg) Pioglitazone (15 mg) and METFORMIN-500MG + VILDAGLIPTIN-50MG twice daily ( taking for about 20 months) to GLIMEPIRIDE-2MG + METFORMIN-500MG + VOGLIBOSE-0.2MG and Dapagliflozin 5 mg+Metformin 500 mg twice daily recently in Mid April 2024. I was asked by the doctor to report after a month with Fasting and PP readings. However after few days,I started realising that my blood sugar was approaching higher and then I experienced needle like sensations in feet and hands plus sticky urine with a heavy head and hot face. I again went for a checkup three days back and the randomn sugar was 291 mg/dl. The medications have again been changed to Dapagliflozin (10mg) + Metformin (500mg) + Sitagliptin (100mg) + Saroglitazar (4mg) in the morning and METFORMIN-500MG + VILDAGLIPTIN-50MG since yesterday (08.05.2024) and I have been asked to take daily readings and report after 10 days. All this has lead to a panicky feeling in me, resulting in increased HTN. I am worried that how this hit and trial or permutations and combinations will help me in achieving a perfect set of medicines to lower my blood sugar to normal levels. Kindly advice. I shall be highly obliged.
Ans: Medicines alone cannot work in these Lifestyle diseases.
Lifestyle modification plays a vital role
So start with your dietary discipline. Strict no to Sugars and refined carbohydrates.
Have less portion of Carbohydrate in a complex form
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I wanted to invest in SIP, but I dont have much of knowledge in it. Can anyone suggest some good funds and details aboit how to select the funds.
Ans: Investing in SIPs is a great choice for building wealth. SIPs allow you to invest a fixed amount regularly in mutual funds.

Evaluating Fund Options

Choosing the right funds is crucial. You should aim for a balanced portfolio with various fund types.

Benefits of Actively Managed Funds

Actively managed funds are handled by experts. These funds often perform better than index funds. The professional management helps in optimizing returns and reducing risks.

Disadvantages of Direct Funds

Direct funds require more knowledge and active management. They lack professional guidance. Investing through a Certified Financial Planner (CFP) ensures better decisions and better portfolio management.

Steps to Select Good Funds

Assess Your Goals: Understand your financial goals. This will help in choosing the right fund types.

Risk Appetite: Know your risk tolerance. Different funds have different risk levels.

Performance Track Record: Look at the fund's historical performance. Consistency over the years is key.

Fund Manager: Check the experience and track record of the fund manager. Experienced managers often deliver better results.

Expense Ratio: Lower expense ratios can lead to higher returns. But, ensure it doesn’t compromise on quality management.

Recommendations

Seek Professional Advice: Consult a CFP. They can guide you in selecting the best funds based on your goals and risk appetite.

Diversify: Invest in a mix of large-cap, mid-cap, and balanced funds. Diversification reduces risk and improves returns.

Final Insights

Investing in SIPs is a smart way to grow your wealth. Choose actively managed funds for better performance. Consult a Certified Financial Planner to ensure your investments align with your financial goals.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

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DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

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