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DIABETIC DOCTORS IN MAHALAKSHMI LAY OUT BANGALORE. Diet and Nutrition A healthy diet for Nephrotic Syndrome patients consists of low salt, low fat and low cholesterol, with emphasis on fruits and vegetables. The amount of protein and fluid a patient with Nephrotic Syndrome should have depends on the patient’s current condition, age and weight. It is very important that a nephrologist be consuldieted. . . Healthy Diet: 1. Low sodium (salt) – helps with swelling in the hands and legs 2. Lots of fresh fruit and vegetables – fiber such as whole grains, fruits and vegetables can help lower total and LDL cholesterol 3. Low fat (1% or skim) dairy products Lean cuts of meat, less red meat, more chicken and fish SOMETIMES fluids should be restricted, as determined by a nephrologist.
CARDIOLOGISTS IN DEVARABESANAHALLI BANGALORE Complex congenital heart disease: Fontan repair Anatomy and physiology Babies with a single ventricle or equivalent defect are often treated during childhood with a palliative operation to connect venous return directly to the pulmonary arteries—a Fontan repair. The prognosis is usually good: 75% of these patients survive at least 20 years. Complications Problems develop because of failure of the systemic ventricle, obstruction of the venous to pulmonary connection, atrial enlargement and AV valve regurgitation. Atrial arrhythmias become increasingly common. Sinus node dysfunction may necessitate pacing, which requires an epicardial electrode in most cases. Follow-up Echocardiography allows assessment of ventricular function and the AV valve. Obstruction in the Fontan connections can be examined with Doppler. MRI is increasingly useful for this assessment. Treatment Severe AV valve regurgitation, cyanosis and ventricular dysfunction are indications for intervention, including transplant or revision of the Fontan. Atrial arrhythmias can be treated with radiofrequency ablation. Pregnancy and contraception Pregnancy is possible in some patients with excellent Fontan function, good LV function and minimal AV valve regurgitation. Maternal risk is high if the Fontan is failing. There may be problems with the need to withdraw ACE inhibitors and with anticoagulation.
Diabetologists in Vidyaranyapura, Bangalore • Secondary causes of dyslipidaemia System Disorder Lipoprotein elevated Pattern Endocrine Diabetes VLDL, chylomicrons IV Cushing’s syndrome VLDL IV Acromegaly VLDL IV Hypothyroidism LDL IIa Anorexia nervosa LDL IIa Porphyria LDL IIa Drugs Alcohol Chylomicrons, VLDL IV Oestrogen-containing Chylomicrons, VLDL IV contraceptive pill Glucocorticoids LDL, VLDL Renal Uraemia VLDL IV Nephrotic syndrome LDL, VLDL Hepatic Primary biliary cirrhosis LDL Acute hepatitis VLDL Immune Systemic lupus erythematosus (SLE) Chylomicrons Monoclonal gammopathy Chylomicrons, VLDL Injury Burns, acute myocardial infarction (AMI) LDL
Diabetologists in Vidyaranyapura, Bangalore • Secondary causes of dyslipidaemia System Disorder Lipoprotein elevated Pattern Endocrine Diabetes VLDL, chylomicrons IV Cushing’s syndrome VLDL IV Acromegaly VLDL IV Hypothyroidism LDL IIa Anorexia nervosa LDL IIa Porphyria LDL IIa Drugs Alcohol Chylomicrons, VLDL IV Oestrogen-containing Chylomicrons, VLDL IV contraceptive pill Glucocorticoids LDL, VLDL Renal Uraemia VLDL IV Nephrotic syndrome LDL, VLDL Hepatic Primary biliary cirrhosis LDL Acute hepatitis VLDL Immune Systemic lupus erythematosus (SLE) Chylomicrons Monoclonal gammopathy Chylomicrons, VLDL Injury Burns, acute myocardial infarction (AMI) LDL
Cardiologist in yelahanka New Town, Bangalore • Pulmonary stenosis The loud murmur of pulmonary stenosis usually ensures that significant stenosis is diagnosed in childhood and corrected. The preferred method is balloon valvotomy and this should be recommended once echocardiography reveals a significant gradient (> 30 mmHg at rest) and signs of abnormal right ventricular function (abnormal septal motion, RV dilatation). Complications of valvotomy include significant pulmonary regurgitation, but severe regurgitation is uncommon. Successful valvotomy is associated with an excellent long-term prognosis. Infrequent follow-up by transthoracic echo is appropriate to monitor for restenosis or regurgitation. Patients do not need to restrict their sporting activities, and pregnancy is usually managed routinely unless there is severe untreated stenosis. Atrial arrhythmias can complicate cases where right ventricular failure has supervened
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