In an audience based interaction on paralysis, Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India, Dr. Vinit Suri, Senior Neurologist, Apollo Hospital and Dr. Vibha Sharma, Ayurvedic Consultant said that brain attach should be tackled like a heart attack. As time is brain, a patient with suspected paralysis/stroke or brain attack should be shifted to hospital at the earliest and given a clot dissolving therapy if the CT scan is negative for brain hemorrhage. Prevention for paralysis is the same as prevention for heart attack.
All
patients with paralysis should undergo testing for underlying heart disease and
all patients with heart diseases should undergo testing to detect blockages in
the neck artery which can cause future paralysis.
Facts
1. One should rule out brain hemorrhage
as soon as possible
2. Obtain emergent brain imaging (with CT
or MRI) and other important laboratory studies, including cardiac monitoring
during the first 24 hours after the onset of ischemic stroke
3. Check glucose and correct high or low
sugar. If the blood sugar is over 180 mg/dL start insulin
4. Maintain normothermia for at least the
first several days after an acute stroke
5. For patients with acute ischemic
stroke who are not treated with thrombolytic therapy, treat
high blood pressure only if the hypertension is extreme (systolic blood
pressure >220 mmHg or diastolic blood pressure >120 mmHg), or if the
patient has another clear indication (active ischemic coronary disease, heart
failure, aortic dissection, hypertensive encephalopathy, acute renal failure,
or pre-eclampsia/eclampsia)
6. For patients with acute ischemic
stroke who will receive thrombolytic therapy, antihypertensive treatment is
recommended so that systolic blood pressure is ≤185 mmHg and diastolic blood
pressure is ≤110 mmHg
7. Antithrombotic therapy should be
initiated within 48 hours of stroke onset.
8. For patients receiving statin therapy
prior to stroke onset it should be continued
Breast
Cancer is on the rise
In
another discussion organized by the Heart Care Foundation of India, Dr. KK
Aggarwal, President of the Foundation, Dr. P.K. Julka, Senior Cancer
Specialist, AIIMS and Dr. Anurag Srivastava, Breast Cancer Surgeon, in a joint
statement said that breast cancer is on the rise in the country. The doctors
said that breast cancer, prostate cancer and heart diseases are all linked to
obesity, eating refined carbohydrates, smoking and access of alcohol.
They
said that eating vegetarian diet with large amount of fruits and vegetables,
exercising regularly and no smoking and drinking in moderation can reduce the
chances of breast cancer.
a. Globally, breast cancer is the most
frequently diagnosed cancer and the leading cause of cancer death in females.
b. Risk factors have been associated with
female breast cancer are Age and gender; Race and ethnicity; Benign
breast disease; Personal history of breast cancer; Lifestyle and dietary
factors; Reproductive and hormonal factors; Family history and genetic factors;
Exposure to ionizing radiation; Environmental factors and Smoking
c. Men are more than one hundred times
less likely to get breast cancer than women.
d. Women can take to decrease their risk
of breast cancer. These include lifestyle changes: minimize use of
postmenopausal hormones, childbearing at a younger age, breastfeeding for at
least six months, avoidance of adult weight gain, limiting alcohol consumption,
avoidance of smoking, regular physical activity), chemoprevention and early
detection through screening mammography.
e. Breast cancer is the most common
female cancer
f. It is second most common cause of
cancer death in women
g. It is main cause of death in women
ages 40 to 59.
h. Important risk factors for breast
cancer are age, gender, hormonal factors, and family history.
i. The diagnostic evaluation of a patient
with suspected breast cancer includes diagnostic breast imaging and breast
biopsy.
j. All primary breast cancers should be
evaluated for expression of hormone receptors (estrogen [ER] and progesterone
[PR] receptors) and human epidermal growth factor receptor 2 (HER2) expression.
k. The treatment of early breast cancer
includes locoregional treatment with surgery, radiation therapy, or both, and
the treatment of systemic disease with one or a combination of chemotherapy,
endocrine therapy, or biologic therapy.
l. Many women have the option of
preserving a cosmetically acceptable breast with breast conserving therapy
(BCT) without sacrificing survival.
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