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Tuesday, December 4, 2012

Patient Assistance Programs and Social Security Supplemental Security Income

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Patient assistance programs, or prescription support programs, can make prescription drugs more affordable for consumers. Patient assistance programs are funded by pharmaceutical companies and government agencies to help qualified patients get prescription medicines for free or at a significantly reduced cost. Most patient assistance programs require that an individual be uninsured or under-insured and have a low income in order to qualify for free or discount medications.

Social Security Supplemental Security Income makes monthly payments to people who have low income and few resources and are:
Age 65 or older;
Blind; or
Disabled.
The basic Social Security Supplemental Security Income  amount is the same nationwide. However, many states add money to the basic benefit. You can call us to find out the amounts for your state. If you are applying for Social Security Supplemental Security Income, you can complete a large part of your application by visiting www.socialsecurity.gov. You also can call toll-free at 1-800-772-1213 to ask for an appointment with a Social Security representative.





For more information please click here

Thursday, November 22, 2012

Patient Assistance Programs: Saving Money on Your Diabetes Medicine


Patient assistance programs, or prescription support programs, can make prescription drugs more affordable for consumers. Patient assistance programs are funded by pharmaceutical companies and government agencies to help qualified patients get prescription medicines for free or at a significantly reduced cost. Most patient assistance programs require that an individual be uninsured or under-insured and have a low income in order to qualify for free or discount medications.



Diabetes Supplies: How to Get Help

Diabetes care is best provided by a multidisciplinary team of health professionals with expertise in diabetes, working in collaboration with the patient and family. Management includes the following:
· Appropriate goal setting
· Dietary and exercise modifications
· Medications
· Appropriate self-monitoring of blood glucose (SMBG)
· Regular monitoring for complications
· Laboratory assessment
Ideally, blood glucose should be maintained at near-normal levels (preprandial levels of 90-130 mg/dL and hemoglobin A1C [HbA1c] levels < 7%). However, focus on glucose alone does not provide adequate treatment for patients with diabetes mellitus. Treatment involves multiple goals (ie, glycemia, lipids, blood pressure).


Pregnant with Diabetes


What can be done to prevent health problems related to diabetes during pregnancy?

1. Plan your pregnancy. If you have diabetes, it is very important for you to get your body ready before you get pregnant. If you are already pregnant, see your doctor right away.

2. See your doctor. Your doctor needs to look at the effects that diabetes has had on your body already, talk with you about getting and keeping control of your blood sugar, change medications if needed, and plan for frequent follow up.

3. Monitor your blood sugar often. Pregnancy affects your blood sugar control. You will probably need to check your blood sugar more often than when you are not pregnant. Talk with your doctor about how often to check your blood sugar.

4. Take your medications on time. If medications are ordered by a doctor, take them as directed.

5. Control and treat low blood sugar quickly. Having tight blood sugar control can lead to a chance of low blood sugar at times. Keep a ready source of sugar, such as glucose tablets or gel or hard candy, on hand at all times. Talk with your doctor about how to treat low blood sugar.

6. Follow up with the doctor regularly. You will need to see your doctor more often than a pregnant woman without diabetes. Together, you can work with your doctor to prevent or catch problems early.

7. If you had gestational diabetes, talk with your doctor about getting your blood sugar checked after delivery and every 1 - 3 years. About half of all women who had gestational diabetes develop type 2 diabetes later.




For more information please click here

Diabetes: What About My Baby

If you have gestational diabetes, your baby may be at increased risk of:

1. Excessive birth weight. Extra glucose in your bloodstream crosses the placenta, which triggers your baby's pancreas to make extra insulin. This can cause your baby to grow too large (macrosomia). Very large babies are more likely to become wedged in the birth canal, sustain birth injuries or require a C-section birth.

2. Early (preterm) birth and respiratory distress syndrome. A mother's high blood sugar may increase her risk of going into labor early and delivering her baby before its due date. Or her doctor may recommend early delivery because the baby is growing so large. Babies born early may experience respiratory distress syndrome — a condition that makes breathing difficult. Babies with this syndrome may need help breathing until their lungs mature and become stronger. Babies of mothers with gestational diabetes may experience respiratory distress syndrome even if they're not born early.

3. Low blood sugar (hypoglycemia). Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high. Severe episodes of hypoglycemia may provoke seizures in the baby. Prompt feedings and sometimes an intravenous glucose solution can return the baby's blood sugar level to normal.

4. Jaundice. This yellowish discoloration of the skin and the whites of the eyes may occur if a baby's liver isn't mature enough to break down a substance called bilirubin, which normally forms when the body recycles old or damaged red blood cells. Although jaundice usually isn't a cause for concern, careful monitoring is important.

5. Type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
Untreated gestational diabetes can result in a baby's death either before or shortly after birth.



For more information please click here

Diabetes: When to Call the Doctor


Call 911 or other emergency services right away if you are:
- Unconscious or you suddenly become very sleepy or confused. You may have low blood sugar, called hypoglycemia.
- Sleepy, confused, breathing very fast, or your breath smells fruity. You may have a life-threatening condition called diabetic ketoacidosis.

Call a doctor right away if:
- Your blood sugar is 300 mg/dL or higher (or it is higher than the level your doctor has set for you).


Call a doctor if you:
- Are sick and having trouble controlling your blood sugar.
- Have had vomiting or diarrhea for more than 6 hours.
- Often have problems with high or low blood sugar levels.
- Have trouble knowing when your blood sugar is low (hypoglycemia unawareness).
- Have questions or want to know more about diabetes.



Webmd has great article on this issue. For more information please click here

Protect Your Kidneys


Keeping blood pressure under control helps to keep your kidneys healthy. Once you have kidney damage, you can slow it down or stop it from getting worse by controlling your blood glucose and blood pressure. Taking an ACE inhibitor or an ARB is important for both controlling your blood pressure and reducing kidney damage. However, if you are pregnant, you should not take an ACE inhibitor or ARB.
If you have diabetes, you should have your urine and blood tested regularly to see how well your kidneys are working. The test results should be given to you as your urine albumin and GFR results.




For more information please click here

Stop Diabetes Before It Starts


Losing Weight with Diabetes


Smoking with Diabetes




If you smoke and think you are otherwise in good health, think again. According to a study published in the American Journal of Epidemiology, smoking 16 to 25 cigarettes a day increases your risk for Type 2 diabetes to three times that of a non-smoker. The more risk factors a person has, the greater the chances are of developing diabetes.

In addition, substantial evidence supports inclusion of the prevention and cessation of tobacco use as an important component of state-of-the-art clinical diabetes care. Smoking is a health hazard for anyone, but for people with diabetes or a high risk of developing the disease, lighting up can contribute to serious health complications. Research has shown when added to human blood samples, raised levels of hemoglobin A1c (HbA1c) by as much as 34%.



Diabetic journal has great article on this issue. For more information please click here
Time.com has great article on diabetes-Smoking. For more information please click here


Sick Days with Diabetes


Tips to Control Cholesterol and Diabetes


Diabetes and Depression


Diabetes and Your Eyes


Diabetes and Your Teeth


Diabetes and Your Heart


Diabetes and Stress


Diabetes and Your Waist


Diabetes Risk in United States

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Signs of Diabetes


Type 2 Diabetes and Insulin Resistance


Diabetes and Support Groups


Blood Sugar Goals


Symptoms of Low Blood Sugar


Medicine for Diabetes


Blood Sugar and Ketone Tests


Complications of High Blood Sugar


What is Diabetes Page 3


What is Diabetes Page 2


What is Diabetes Page 1


What is Diabetes?

Diabetes means you have too much sugar in your blood. High blood sugar problems start when your body no longer makes enough of a chemical, or hormone, called insulin. 


Wednesday, November 14, 2012

Printing Human Liver - Cirrhosis


The therapy of choice for end-stage liver disease is whole-organ liver transplantation, but this option is limited by a shortage of donor organs. Following recent advancements of stem cell research, the potential for organ regeneration using somatic stem cells as an ultimate therapy for organ failure has increased. However, anatomically complicated organs such as the liver have proven more refractory to stem cell-based regenerative techniques.

Cell-based therapies and hepatic tissue engineering have been considered as alternatives to liver transplantation, but neither has proven effective to date. A regenerative medicine approach for liver replacement has recently been described that includes the use of a three-dimensional organ scaffold prepared by decellularization of xenogeneic liver.

Research is underway to gain a better understanding of the healthy liver and how new cell therapies could work. Scientists are also developing more effective ways to grow large numbers of liver cells (hepatocytes) from embryonic stem cells or induced pluripotent stem cells in the lab. Such research is not only useful for potential new therapies. In the shorter term, lab-grown hepatocytes are likely to play an important role in the development of new drugs and artificial liver machines.

Regenerative medicine has been called the “next evolution of medical treatments,” by the U.S. Department of Health and Human Services. With its potential to heal, this new field of science is expected to revolutionize health care.

For more information please click here


Friday, November 9, 2012

Liver Failure & Cirrhosis



Few days ago, I admitted a middle aged male patient to medical ICU for elevated liver function tests. He had been previously diagnosed with a hepatic mass suggestive of hepatocellular carcinoma. On this admission, his liver function tests were over 5000 which showed he was in full liver failure.

Patients with liver failure have many comorbidites and require a dedicated physician to spend ti and meticulously manage their health and wellbeing.

Having received a diagnosis of cirrhosis, you may feel afraid and confused. Many people are not prepared to deal with their diagnosis and find it difficult to obtain information and support. It is important to remember that being diagnosed with cirrhosis is not the end of the world. People with cirrhosis can have completely normal liver function and remain well for many years. Progression from cirrhosis to more advanced liver disease or liver cancer
(hepatocellular carcinoma) does not happen in every case.

How will cirrhosis affect my health?

• A rise in blood pressure in the veins coming from the intestines to the liver.
Blood tries to get back to the heart by bypassing the liver through connecting veins, which are not normally open. These veins are found in the gullet (oesophagus), stomach and lower bowel. Increased pressure can lead to rupture and life-threatening bleeding.

• Increased fluid retention in your abdomen - a condition called ascites.
Ankle swelling can also occur. This results from increased blood pressure plus a reduction in blood protein levels normally produced by the liver.

• Easy bruising and bleeding because clotting factor levels in the liver platelets are also reduced.

• The liver may no longer be able to clear drugs from the bloodstream, causing some people to become more sensitive to the effects of pharmaceutical and illicit drugs.

• The liver may lose the ability to clear waste products from the blood. One of the effects of this can be confusion or coma when such wastes affect the brain. This is called encephalopathy. Jaundice is the name given to the yellow pigmentation of the skin and eyes, which occurs when the liver cannot clear bilirubin from the body.

• ‘Fatty liver’ or steatosis. This is where excess fat is deposited in the liver.

Don’t be afraid to ask your specialist or doctor for further information about your condition. If you don’t understand what they are saying, ask them to explain it until you do understand. Cirrhosis can be a serious condition and it is important that any concerns you have about your health are clarified and your questions are answered. People close to you are often in the best position to provide you with support because they care for you.

Hepatitis Councils in the states and territories can provide you with information and, in some cases, link you with other people with cirrhosis who are interested in sharing their experiences. This type of support can be beneficial – it can help you realize you are not alone and also provide you with a different perspective or suggestions about how to manage your health and lifestyle.





For more information please click here

Tuesday, November 6, 2012

Effective Ways to Spend Your Money in Health Care



The Affordable Care Act that the Supreme Court recently upheld extends health care coverage to over 30 million uninsured Americans but actually does very little to make health care affordable. Since 1970, health care spending has grown 9.8% annually, more than twice the rate of inflation. Medical costs now consume 17.3% of our gross domestic product. That’s $8,086 for every American or about twice as much per capita as most developed countries spend.  Although we pay more for medical care than any other country, America currently ranks 19th in the world in preventable death, 26th in life expectancy, and 31st in infant mortality.

Here are few ways to be spend your money more effectively in medicine:

1. Make sure the medicines you are taking are needed and appropriate.

2. Don’t Assume Herbal Supplements Are Safe or Adequate

3. Use generic drugs when possible.

4. Consider using a mail-order pharmacy

5. Look Into Splitting Higher-Dose Pills

6. Ask your pharmacist or doctor about ways to lower your medications costs. Pharmacists, in particular, may have suggestions on how you can spend less money but still keep healthy.

7. Ask if you still need to take a medication. Sometimes people remain on a medicine long after it is needed or can lower their need for medicines through healthy lifestyle changes.

8. For medications you take long-term, get 90 days supplies!  Many insurance companies and pharmacy drug programs offer lower prices when you get 90 days supplies.

9. Ask your doctor for samples. This can be a good way to save money when you are first trying a new medicine.

10. Look for coupons on the internet.  Here are two websites to try:

http://www.optimizerx.com/
http://www.internetdrugcoupons.com/

11. There are many prescription assistance programs that provide free prescription medicines for people without prescription insurance. Checking these websites:

http://www.needymeds.org/
http://www.pparx.org/

12. You may be eligible for low-cost medications under the Medicare and Medicaid programs.  Use this website to see if you are eligible

http://www.benefitscheckup.org/.  

13. Consider ordering online
One way to use the Internet to save money on prescription drugs is to go to the BidRx Web site. Free registration is required to use the Web site. BidRx is a secure Web site that links consumers with pharmacies, manufacturers, prescribers, and payers so all can make better decisions when purchasing prescription drugs. It is an Internet auction site for prescription drugs. BidRx provides the information consumers need and allows consumers to define pharmacies they want to compete for their prescription business. Click here for more information.


PBS has great article on this issue. For more informations please click here

Sunday, October 21, 2012

Using Positive Psychology and Science of Happiness in Treating Chronic Medical Problems

http://pinterest.com/amashhadian/positive-psychology-science-of-happiness/
Happiness encompasses many different emotional and mental phenomena. Positive Psychology is the scientific study of the strengths and virtues that enable individuals and communities to thrive. This field of psychology has seen tremendous growth over the past decade.

Happiness tended to spread through close relationships like friends, siblings, spouses, and next-door neighbors, and the researchers reported that happiness spread more consistently than unhappiness through the network. Moreover, the structure of the social network appeared to have an impact on happiness, as people who were very central (with many friends, and friends of friends) were significantly more likely to be happy than those on the periphery of the network. People who are close with others that are happy are more likely to be happy themselves. Overall, the results suggest that happiness can spread through a population like a virus. Having a best friend buffers one's negative life experiences. When one's best friend is present Cortisol levels are decreased and feelings of self-worth increase.

There is evidence suggesting that negative emotions can be damaging. In an article titled "The undoing effect of positive emotions", Barbara Fredrickson et al. hypothesize that positive emotions undo the cardiovascular effects of negative emotions. When people experience stress, they show increased heart rate, higher blood sugar, immune suppression, and other adaptations optimized for immediate action. If individuals do not regulate these changes once the stress is past, they can lead to illness, coronary heart disease, and heightened mortality. Both lab research and survey research indicate that positive emotions help people who were previously under stress relax back to their physiological baseline. Other research shows that improved mood is one of the various benefits of physical exercise.

During new few weeks, I will write on different aspects of happiness and will provide you with step by step guide to help you accomplish daily activities with more positive energy.

Here are 5 ways to become more successful / winner:

1. Be proactive. For example, before going to the party evaluate where,why, who - what if you did not like it?
2. Find new friends
3. Be a roll model
4. Be concise - don't drag a small issue for ever.
5. Keep your brain bussy with stuff you are passionate about.





http://www.authentichappiness.sas.upenn.edu has great resources on improving happiness. Please take few minutes and do the self assessment tests for free. Click Here

Wikipedia.org has more information about the history of positive psychology. For more information please click here
What can you do to feel more successful/winner?

Saturday, October 6, 2012

Common RISK FACTORS of Osteoporosis in Young Ages



http://pinterest.com/amashhadian/osteoporosis/
Please click here for accessing patient tutorial 
Osteoporosis is a common condition where bones become weak, affecting both men and women, mainly as they grow older. It is a "silent" condition where the bones are weak and prone to fracture.

While osteoporosis is most common in older people, it sometimes affects young people, including premenopausal women in their 20s, 30s and 40s. One of the most common causes of low bone density in premenopausal women is low peak bone mass. 

Female gender is a risk factor for low peak bone mass. In addition, certain ethnicities (especially Caucasian and Asian women) are more likely to have lower peak bone mass than African American women. Knowing your family history is important. If either of your parents had osteoporosis, you are more likely to have lower peak bone mass. Eating a well-balanced diet that contains enough calcium is important for people of all ages, especially children, teenagers and young adults. To absorb calcium, the body also needs vitamin D. Girls and young women who do not get enough calcium and vitamin D may have low peak bonemass. Weight-bearing and muscle-strengthening exercises can help girls and young women have strong and healthy bones. E

Other risk factors include:
- Low body weight
- Infrequent menstrual periods/Low estrogen levels
Not getting enough physical activity
- Smoking and drinking alcohol. Smoking is bad for your bones
Past medical history of certain digestive disorders, hyperthyroidism and depression
- Taking certain medicines such as prednisone and cortisone



Rheumatology.org has great patient educational material on osteoporosis. For more information please click here

What age were you diagnosed with osteoporosis and what are you doing to improve your health?

Sunday, September 30, 2012

Low Back Pain

Back pain affects 80% of Americans at some time in their lives. It comes in many forms, from lower back pain, middle back pain, or upper back pain to low back pain with sciatica. Common back pain causes include nerve and muscular problems, degenerative disc disease, and arthritis. Many people find relief from symptoms of back pain with pain medication or pain killers.

Low back pain is one of the most common reasons for outpatient visits to physicians. Medical costs related to low back pain have increased disproportionately to the prevalence of the condition, with no associated improvement in outcomes. Total costs related to back pain, including imaging, are estimated at $100 billion per year in the U.S.


Chronic low back pain is a common problem in primary care. A history and physical examination should place patients into one of several categories:
(1) nonspecific low back pain;
(2) back pain associated with radiculopathy or spinal stenosis;
(3) back pain referred from a nonspinal source;
(4) back pain associated with another specific spinal cause.

For patients who have back pain associated with radiculopathy, spinal stenosis, or another specific spinal cause, magnetic resonance imaging or computed tomography may establish the diagnosis and guide management.

Because evidence of improved outcomes is lacking, lumbar spine radiography should be delayed for at least one to two months in patients with nonspecific pain.

Acetaminophen and nonsteroidal anti-inflammatory drugs are first-line medications for chronic low back pain. Tramadol, opioids, and other adjunctive medications may benefit some patients who do not respond to nonsteroidal anti-inflammatory drugs.

Acupuncture, exercise therapy, multidisciplinary rehabilitation programs, massage, behavior therapy, and spinal manipulation are effective in certain clinical situations. Patients with radicular symptoms may benefit from epidural steroid injections, but studies have produced mixed results. Most patients with chronic low back pain will not benefit from surgery.

A surgical evaluation may be considered for select patients with functional disabilities or refractory pain despite multiple nonsurgical treatments.





Webmd.com has great slide show about low back pain. For more information please click here for the slide show

American Family Physicians has great and detailes information for low back pain. please click here



Monday, September 24, 2012

7 Ways to Manage Arthritis Pain


Here are a few self-management tips to help you cope with arthritis pain.
1. Rest from repetitive activities and straining postures.
2. Heat application—hot packs, hot shower/bath; ice therapy for acute flare-ups or with inflammation.
3. Light-to-moderate exercise; start with pain-free range of motion.
4. Controlled and proper exercise. Overtraining and poor form can lead to injuries, and faster degeneration.
5. Weight control, which is important in preventing back, hips and knees arthritis.
6. Posture awareness, such as your sleeping position and sitting posture.
7. Improved diet and/or supplementation—Glucosamine with Chondroitin, fish oils, antioxidants, rich fruits and vegetables.


lifestyle.inquirer.net has great article on this issue. For more information please Click Here

Sunday, September 23, 2012

Link Between Sugar-Sweetened Beverages and Expanding U.S. Waistlines


Three studies published Friday September 21, 2012 in the New England Journal of Medicine represent the most rigorous effort yet to see if there is a link between sugar-sweetened beverages and expanding U.S. waistlines.

A report released this week projected that at least 44 percent of U.S. adults could be obese by 2030, compared to 35.7 percent today, bringing an extra $66 billion a year in obesity-related medical costs.

New York City adopted a regulation banning the sale of sugary drinks in containers larger than 16 ounces at restaurants and other outlets regulated by the city health department.

Sugary drinks are in the crosshairs because from 1977 to 2002 the number of calories Americans consumed from them doubled, government data show, making them the largest single source of calories in the diet.

About a quarter of the kids stopped drinking the beverages. Among those who stuck it out for 18 months, the sugar-free kids gained less body fat, 2.2 pounds (1 kilogram) less weight, and 0.36 units less BMI than the sugary-drink kids, the researchers report in the NEJM.

Why? There is good evidence that liquid sugar does not produce a feeling of fullness that other calories do. "When children substituted a sugar-free drink, their bodies did not sense the absence of calories, and they did not replace them with other food or drinks," said Katan.

Hispanic teens benefited the most: Those receiving no-cal deliveries gained 14 fewer pounds after one year and almost 20 fewer pounds after two. That raised the possibility that genetic factors influence the effect of sugary drinks.





Reuter has great article on this issue. For more information please Click Here









Sugar-Sweetened Beverages and Genetic Obesity Risk
September 21, 2012 | Q. Qi and Others
(DOI: 10.1056/NEJMoa1203039)

Sugar-free Drinks in Normal-Weight Children
September 21, 2012 | J.C. de Ruyter
and Others | (DOI: 10.1056/NEJMoa1203034)

Calories from Soft Drinks — Do They Matter?
September 21, 2012 | S. Caprio
(DOI: 10.1056/NEJMe1209884)

Sugar-Sweetened Beverages and Adolescent Weight
September 21, 2012 | C.B. Ebbeling
and Others | (DOI: 10.1056/NEJMoa1203388)


Manage Erectile Dysfunction in Patients with Hearth Disease - High Risk Patients


The Princeton guidelines define High Risk as patients with:
High risk: defer resumption of sexual activity until cardiological assessment and treatment
Unstable or refractory angina
 -> Increased risk of MI
Uncontrolled hypertension
  -> Increased risk of acute cardiac and vascular events (i.e., stroke)
CHF (NYHA class III, IV)
  -> Increased risk of cardiac decompensation
Recent MI (<2 weeks)
  -> Increased risk of reinfarction, cardiac rupture, or arrhythmias, but impact of complete revascularization on risk is unknown
High-risk arrhythmias
  -> Rarely, malignant arrhythmias during sexual activity may cause sudden death
  -> Risk is decreased by an implanted defibrillator or pacemaker
Obstructive hypertrophic cardiomyopathies
  -> Cardiovascular risks of sexual activity are poorly defined
  -> Cardiological evaluation (i.e., exercise stress testing and echocardiography) may guide patient management
Moderate to severe valve disease
  -> Use vasoactive drugs with caution


Manage Erectile Dysfunction in Patients with Hearth Disease - Intermediate Risk Patients


The Princeton guidelines define Intermediate Risk as patients with:
Intermediate or indeterminate risk: evaluate to reclassify as high or low risk
Asymptomatic and ≥3 CAD risk factors (excluding gender)
  -> Increased risk for acute MI and death
  -> ETT may be appropriate, particularly in sedentary patients
Moderate, stable angina pectoris
  -> ETT may clarify risk
MI >2 weeks but <6 weeks
  -> Increased risk of ischemia, reinfarction, and malignant arrhythmias
  -> ETT may clarify risk
LVD/congestive heart failure (CHF) (NYHA class II)
  -> Moderate risk of increased symptoms
Cardiovascular evaluation and rehabilitation may permit reclassification as low risk
Non-cardiac atherosclerotic sequelae (peripheral arterial disease, history of stroke, or transient ischemic attacks)
  -> Increased risk of MI
  -> Cardiological evaluation should be considered

The full article can be find at:  Click Here

Saturday, September 8, 2012

Manage Erectile Dysfunction in Patients with Hearth Disease - Low Risk Patients


Erectile dysfunction and cardiovascular disease share similar risk factors, and erectile dysfunction may precede or be a marker for cardiovascular disease.

The Princeton Consensus Conference guidelines for the management of erectile dysfunction in the cardiovascular patient can be used to determine the need for further cardiac evaluation.

The Princeton guidelines define Low Risk as patients with ability to perform exercise of modest intensity without symptoms. These patients do not have any heart related complaints and less than 3 major risk factors (age, hypertension, diabetes mellitus, cigarette smoking, high cholesterol, sedentary lifestyle, and family history of premature CAD).

In addition, low risk patients have controlled blood pressure (it worth mentioning Beta-blockers and thiazide diuretics may predispose to erectile dysfunction). 

In patients with mild, stable angina pectoris, noninvasive cardiac evaluation is recommended. In addition, the anti-anginal drug regimen may require modification.

In patients with post-revascularization (after CABG or cardiac stents) and without significant residual ischemia, exercise tolerance test may be beneficial to assess risk.

If patient is more than six to eight weeks post-revascularization and has no exercise tolerance test-induced ischemia, intercourse may be resumed 3–4 weeks post-

Other low risk patients include those with mild valvular disease, New York Heart Association class I heart failure and left ventricular dysfunction.

If the patient does not respond to an adequate trial of the phosphodiesterase inhibitor, it would be reasonable to obtain a testosterone level. However, a testosterone level does not need to be obtained at the time of the initial evaluation unless there is decreased libido or physical signs suggestive of small testicles.

The full article can be find at:  Click Here

Tuesday, August 28, 2012

14 Proven Strategies to Quit Smoking Especially for the First Hard Days


1. Sip cold water and eat small meals
2. Recognize instant emotional and financial rewards
3. Brush your teeth frequently
4. Avoid alcohol
5. Find your own non-smoking areas. 
6. Embrace your reasons for quitting
7. Be physically active every day
8. Engage in activities that are enjoying ful for your and your significant other.
9. Put something else in your mouth
10. Ask someone to be there for you when you need support
11. Limit your caffeine
12. Avoid negative emotions
13. Avoid troublemakers.
14. Be patient 

Webmd has great step by step information on this topic. For more information please Click Here

Wednesday, August 22, 2012

Obesity Biggest Risk Factor for Diabetes Among Poor - British Medical Journal

Obesity is the most important risk factor for type 2 diabetes among poor people, according to a new study that also says lifestyle changes are the key to reducing diabetes in this population.

In the study, researchers examined long-term data collected from about 7,200 British civil servants to assess the link between socioeconomic status and several major risk factors for type 2 diabetes.


During an average follow-up period of 14 years, more than 800 people in the study were diagnosed with diabetes. Those in the lowest job category had a 1.86 times greater risk of developing diabetes than those in the highest job category.

Usnews.com has great article about this issue. For more information, please Click Here

Tuesday, August 21, 2012

Weight, Cholesterol, High blood pressure and Decline in Brain Function


People who are obese and also have high blood pressure and other risk factors called metabolic abnormalities may experience a faster decline in their cognitive skills over time than others, according to a study published in the August 21, 2012, print issue of Neurology, the medical journal of the American Academy of Neurology.


Those individuals who were both overweight and diagnosed with some type of metabolic issue experienced a 22% faster decline in mental function than the other subjects during the time of the study.



The study involved 6,401 people with an average age 50 at the start of the study. Information on body mass index (BMI) and the risk factors was gathered at the beginning of the study. The participants took tests on memory and other cognitive skills three times over the next 10 years.

Over the 10 years of the study, people who were both obese and metabolically abnormal experienced a 22.5 percent faster decline on their cognitive test scores than those who were of normal weight without metabolic abnormalities.

There is a very nice article by , in Examiner.comFor more information Click HereThe original article can be find Here

Sunday, August 19, 2012

Steps You Can Take to Improve Your Doctor's Bedside Manner


You'll better understand why your doctor lacks bedside manner if you understand his point of view. Remember, he has insurance constraints, a waiting room full of patients, the rent and power bills are due on his office space, and he promised his daughter he would be there for her soccer game after school, and just had an argument with his wife (or variations thereof!). The point is that doctors are people, too, who have similar frustrations to yours and mine.
Here are some steps you can take to encourage a better bedside manner from your doctor:
1. When you have an appointment, be prepared. Bring a list of questions, and keep them concise. 
2. Limit your questions to the top three or four. If you have more than that, then plan to make a second appointment to cover them. 
3. Break the ice. Don't chat aimlessly about something that's not important. Rather, briefly mention something friendly, benign and short like the weather, an upcoming holiday, a local sports team, or something humorous that happened in the news. Doctors spend their whole day under stress and time limits, and breaking that tension might be just what it takes to lighten the mood and free up your doctor to show his friendly side. 
4. Once the ice has cracked or broken, remember to continue being respectful of your doctor's time. 
5. If you feel as if you've experienced that compassion and friendliness you've looked for, then thank your doctor. Shake his hand. A thank you from you for being the kind of doctor whose bedside manner you appreciate may improve your chances of seeing that good bedside manner again.
About.com has great article about this issue. For more information please Click Here

10 Signs That You Need a New Doctor

Many people also find that they feel a bit intimidated by their physicians, and once with a doctor, don't feel they have the right to switch, or worry that they will offend the doctor. 

Remember – in a doctor-patient relationship, YOU are the client, and the doctor is providing a service. And if that service is not meeting your needs, the best thing you can do for your health is to find the right doctor who will meet your needs.

How do you know when it's time for a new doctor? Here are some signs. 

1. Your doctor doesn't respond to calls or faxes. 
2. Your doctor's office is unresponsive, disorganized, or rude. 
3. Your doctor dismisses the Internet as a source of quackery and nonsense. 
4. Your doctor is unwilling to explore your ideas.
5. Your doctor is interested in selling expensive products or services.
6. Your doctor doesn't listen.
7. Your doctor doesn't see the bigger picture.
8. Your doctor is influenced by a pharmaceutical company.
9. Your doctor is arrogant or rude.
10. Your doctor is not your partner in wellness.

About.com has great article regarding this issue and explains each sign in more details. For more information Click Here

Have you ever dealt with difficult doctor? what was the situation and how did you handle it?

Diabetes Mellitus and Sexual Dysfunction in Women

Sexual dysfunction in diabetic women was reported in the August 2012 edition of the journal Obstetrics and Gynecology. Researchers affiliated with the University of California (San Francisco) and Kaiser Permanente Northern California (Oakland) reported on the impact of diabetes on sexual satisfaction in women.


The authors concluded that, compared with non-diabetic women, diabetic women are more likely to report low overall sexual satisfaction. They noted that prevention of end-organ complications may be important in preserving sexual activity and function in diabetic women.
End-organ complications are more common in diabetics with poor control; thus, this study points to one more problem that can occur in diabetic women. Good control of diabetes plus appropriate lifestyle choices (i.e., avoidance of obesity, healthy diet, and exercise) will facilitate a longer and more satisfactory life.

More more info Click Here

Male Sexual Dysfunction with Larger Waist Size

In fact, the results of a comprehensive British study announced earlier this month, shows that men with larger waist lines who suffered through lower urinary tract symptoms (LUTS) also experienced increased sexual dysfunction. It’s the first such study that connects the dots between obesity and sexual health problems.

Most of us were aware that an earlier onset of diabetes was one of the most striking consequences of large girth in men (and many women), because waist size reflects belly fat and fat around the internal organs that is strongly linked with type 2 diabetes. But the addition of far more frequent sexual dysfunction adds yet another aspect of physical and lifestyle impairment to the woes felt by individuals who carry what is known in delicate British clinical parlance as “central obesity as measured by weight circumference.” In other words, those 2.5 inches of extra width can have an impact larger than their relatively diminutive size.

Read more: http://www.voxxi.com/male-sexual-dysfunction-waist-size/#ixzz241JwpOso


Viagra and Alcohol Intake


In some dance clubs, young men are mixing Viagra and alcohol or other drugs like Marijuana or Ecstasy, to allow men to have sex while high.  Viagra should never be taken with alcohol, illegal drugs or any other prescription drugs, since this can lower heart rate and blood pressure to dangerously low levels.  This illegal use of Viagra is leading to an increase in sexually transmitted diseases, unintended pregnancies, and performance anxiety.  Performance anxiety occurs when a man believes he needs Viagra to get and or maintain an erection.  He believes that if he doesn’t use it, he can’t perform.  When a person believes this, it can actually occur.
People who drink excessively or use drugs are more likely to experience symptoms of erectile dysfunction, because drugs and alcohol have an effect on the central nervous system.  Young men who began smoking cigarettes as children or in their teens have a higher instance of developing impotence at a young age.  As children engage in these unhealthy activities at a younger age, the likelihood of developing erectile dysfunction at a younger age increases.

Erectile Dysfunction in Young Men


As more young people under the age of 20 develop obesity due to poor diet and lack of exercise, this causes serious health effects.  Obesity can lead to several medical conditions, including heart disease, high blood pressure, hypertension, high cholesterol and diabetes.  These conditions can result in erectile dysfunction.  As more children develop obesity, the likelihood increases that these young men in their 20’s and 30’s can develop medical problems that result in erectile dysfunction.
Another reason erectile dysfunction can develop in the young is when they use Viagra that’s not prescribed for them.  Young people should not take this medication if they do not have an issue achieving or maintaining an erection suitable for sexual intercourse.  While it can seem fun to take Viagra to see how it can improve the erection, taking such medication can cause damage to the blood vessels and nerves in the penis, which can cause permanent erectile problems.  This is due to the dangers of an erection lasting longer than 2-4 hours.

Common Causes of Erectile Dysfunction

Most erectile dysfunction occurs to men over 40.  The causes are varied and include heart disease, diabetes, side effects of medication, and age related sexual dysfunction issues.

There are dangers in buying Viagra without a prescription over the internet.  Viagra can be expired and may not be effective, or it can be counterfeit Viagra made in illegal labs in China, Russia or elsewhere, using unknown and even unsafe dangerous ingredients.  Seized counterfeit Viagra made in China was found to contain lead, which can be deadly if consumed.