Post traumatic Stress Disorder

Definition: Post traumatic stress disorder may be defined as a mental health condition that follows a traumatic or a terrifying experience in life. It is characterized by feelings of stress and being frightened even though they are no longer in a danger situation.

Many people who go through a traumatic event have a difficulty adjusting and coping with normal life for a while but they do not necessarily have post traumatic stress disorder. If the symptoms get worse, may last for months or years and interfere with normal functioning then it is an illness known as post traumatic stress disorder (PTSD)

Physiology Behind PTSD: When a person is in danger or is experiencing a traumatic event like death of a loved one it is natural to feel afraid and stressed out. This fear triggers changes in the body that can help oneself to defend or avoid the danger situation. This ‘fight or flight’ response is a normal healthy physiological response of the human body but in PTSD this response gets changed or damaged. The person with PTSD may have suffered a harm to oneself or have seen a harm done to a loved one or even strangers but now when he/she is no more in the danger situation still they have feelings of being stressed and frightened.

How Was This Condition known in Medical Science: PTSD was first brought in and discovered in relation to the condition of war veterans who have been in the war or in a prison and then could not recover the feelings of fright and stress they have been through. Now it is known that it can occur following a variety of traumatic events like mugging, rape, torture, kidnapping, car accidents, bombings, plane crashes, earthquakes etc.

Signs And Symptoms: A patient suffering from a post traumatic stress disorder may experience:

Managing Diabetes In The Elderly Patients

As the medical care is advancing and the life expectancy is increasing there are now more people who are now elderly and are patients of type 2 diabetes mellitus. Although the pharmacological treatment options are almost the same for the older patients as those in the younger adults but the elderly need some specific care and management if they have diabetes. Also it is important to take note of the fact that diabetes is not the only disease that may be affecting the patient because elderly people above the age of 70 have more than one chronic diseases that are present at the same time.

The overall goal of management of diabetes in the elderly patients includes maintaining optimal glycemic control as well as managing the associated risk factors due to advanced age.

1 Educating about the disease: Studies have shown that patients who know their diseases well are able to manage it more properly than those who are not educated about the disease. This is especially very important in case of diabetes. Elderly patients may not be able to remember properly about their drugs and doses or may forget about the nutritional care. It is important to educate them as well as their primary care givers.

2. Preventing and Recognizing Hypoglycemia: The risk of hypoglycemia is much more in the older adults and the symptoms may be missed or confused and so the hypoglycemic episodes are not properly reported in the elderly patients. Even a mild hypoglycemia that caused dizziness may lead do major problems like a fall and resulting fracture that is very difficult to heal due to the age factor. Thus it is important to take care and prevent hypoglycemia to occur at the first place.

3. Care for Proper Nutrition: Senior patients with diabetes should always be helped by a proper dietitian for the nutrition care. They should be advised to take protein rich food as protein slows sugar absorption.

4. Choosing the Medications: It is important to consider different factors like weight, mobility,

Introduction To Atrial Fibrillation

Atrial Fibrillation is the most common irregular heart rhythm and is characterized by irregular, disorganized electrical signals that cause the upper two chambers of the heart -the atria to contract very fast and irregularly.

The Physiology:
In order to understand atrial fibrillation it is important to explain the normal physiology of the heart’s electrical system. Each heart beat occurs due to the spread of the electrical signals that originate in the sino-atrial node located in the upper part of the right atrium, from where it travels to the right and the left atria and then to the atrio-ventricular node. After a slight delay the signals then pass to the ventricles.

In atrial fibrillation the signals do not generate in the sino-atrial node , instead they arise from another part of the atria and they do not travel normally. Theses abnormal signals spread through out the atria in a rapid disorganised way causing the atria to fibrillate meaning to contract fast and irregularly. Because of this faulty spread of the signals the atria and ventricles do not contract in a coordinated way , creating a fast , irregular heart rhythm.

The heart rate may reach up to 100 to 175 beats per minute in contrast to a normal heart rate of 60 to 100 beats per minute, and the ventricles cannot pump the blood to the body in a normal pattern.

Causes And Risk factors For Atrial Fibrillation:Damage to the heart’s electrical system causes atrial fibrillation. There are several conditions that may lead to atrial fibrillation like:

Alprazolam- A Brief Introduction

Alprazolam belongs to a group of drugs known as benzodiazepines. It is a short acting anxiolytic drug. It is commonly used to treat anxiety and panic disorders.

Mode of Action: It acts by binding on the GABA receptors of the brain leading to inhibitory or calming effects. After oral administration it is readily absorbed and its metabolites are excreted primarily in urine.

Clinical uses: Alprazolam is used in the treatment and management of conditions like:

• Anxiety disorders
• Panic attacks ( not a first line drug )
• Anxiety conditions with co morbid depression
• Chemotherapy induced nausea and vomiting.

Side effects: Patients taking alprazolam may experience adverse effects like:

• Drowsiness
• Lightheadedness
• Headache
• Dizziness
• Dry mouth
• Nausea
• Urinary retention
• Skin rash
• Anterograde amnesia
• Problem concentrating
• Unusual changes in behavior and mood.

Phenytoin – Anticonvulsant Drug.

Introduction: Phenytoin is a drug that is used to control,treat and prevent certain type of seizures. It is an anti-epileptic drug also known as the anticonvulsant drug.

Mechanism of Action: Phenytoin acts by blocking voltage dependent sodium channels and thus prevents seizures to occur. Its anticonvulsant activity is through blocking sustained high frequency repetitive firing of the action potentials. Its primary site of action appears to be in the motor cortex where it prevents the spread of the seizure activity.

Clinical Uses: Phenytoin is widely used in medicine for conditions like:

• Complex-partial seizures
• Generalized tonic clonic seizures
• Status epilepticus
• As an antiarrythmic drug to control an abnormal heart beat.
• Arrythmias caused by digoxin toxicity.
• Second choice for trigeminal neuralgia.

Precaution while Using Phenytoin:

• Phenytoin has a narrow therapeutic index and needs monitoring of plasma concentration.