Asthma

Posted on February 19, 2015 by admin
In Medical

Good control

  • Daytime wheeze < 2 /day
  • Need reliever < 2 /week
  • No limit on activity
  • No night symptoms or wheeze on waking

Poor control

  • Daytime symptoms > 3 /week
  • Need reliever   > 2 / :week
  • Limitation of activity
  • Night symptoms or on waking

Factors in involved in suboptimal asthma outcomes are :

  • Inhaler technique – a feview with your doctor is always worthwhile even if you are an experienced user
  • Medication timing (up to 50% of asthmatics do not take there preventer as prescribed)
  • C-o morbidities like allergies, sinusitis, nasal polyps reflux and obesity are common aggravating conditions

Chronic asthmatics on preventer medication should have regular eye checks every 1-2 years to minimize the risk of early cataract   formation and bone density test every 2 years to minimize the risk of osteoporosis in those on long term preventer medication

If your asthma is not optimally controlled see your doctor to maximize your capacity to breath.

Reducing the risk of gestational diabetes.

Posted on February 16, 2015 by admin
In Medical

Gestational diabetes occurs in 0ver 8% of pregnancies and is associated increased risk in pregnancy including large babies , obstructed or prolonged labour, premature births and maternal hypertension. Oral glucose tolerance testing is often requested for high risk patients , the obese, those with previous   gestational diabetes, older maternal age , family history of diabetes and ethnicities from Asia , the middle east , subcontinent , Hispanic or Pacific backgrounds.

Risk factors that can be modified include

  • reduction of weight for the obese consuming a nutritious diet tht does lead to excessive weight gain and minimizing excessive post meal blood glucose levels.
  • Exercise – hose women who are physically active before or during pregnancy have a lower   risk of developing gestation l diabetes – possibly 20% less risk

 

Breast feeding appears to improve subsequent   outcomes for mothers who have gestational diabetes or tending to develop postpartum type 2 diabetes.

Over active bladder symptoms

Posted on February 16, 2015 by admin
In Blog

This problem often presents as frequency of urination   or frequent episode of   needing to pass urine at night , or a sense of urgency to void sometimes accompanied by incontinence .involves the use of   anticholinergic   medications and third line referral to a urologist   for consideration of any surgical factors that might be corrected , interventions or consideration of newer therapies like botox.

Diabetes and urinary infection   should be excluded . Urodynamic studies or cystoscopy may be required to exclude rarer causes.

Bladder training and pelvic floor   exercises whilst avoiding caffeine and   treating constipation are the first phase of treatment . Subsequent   treatment