IAM A 40 YRS. OLD WORKING WOMAN I SUFFERS FROM DIARRHOEA and vomiting for a long period but now I have developed tremors, depression, confusion and sometimes hallucinations. For this problem I consulted a physician, after taking history and on the basis of symptoms and investigations physician diagnosed me as a case of magnesium deficiency. I want to know about this problem in detail.
Disorders of magnesium metabolism are occasionally responsible for otherwise puzzling clinical features and are susceptible to therapeutic control. The most frequent cause of magnesium deficiency is prolonged diarrhoea or vomiting, which has been treated with parenteral fluid without magnesium supplements. It is associated with chronic diarrhoea and severe under nutrition, such as occurs in protein- energy malnutrition and the malabsor ption syndrome. Uncontrolled diabetes mellitus, aldosteronism, hyperpara thy roidism, the diuretic phase of acute renal failure and chronic alcoholism lead to magnesium deficiency from excessive urinary loss. It occasionally follows on continued diuretic therapy. Clinical features are predominantly neuromuscular with tremor, choreiform movements and aimless plucking of the bedclothes. Mental depression, confusion, agitation, epileptiform convulsions and hallucinations also occur. The diagnosis can be confirmed by finding the concentration of magnesium in the plasma to be less than 0.75 m mol/ L. Magnesium deficiency is best treated parenterally 50 m mol of magnesium chloride may be added to 1 litre of 5 percent glucose or other isotonic solution and given over a period of 12 to 24 hours. The infusion should be repeated daily until the plasma concentration remains within the normal range.
MY MOTHER IS ABOUT 70 YRS OLD, SINCE LAST TWO TO THREE years she is suffering from pain in the back, sometimes generalised pain and sometimes a sharper pain of sudden onset. Her body has bent forward. We have consulted on orthopedic surgeon, he told us that she is suffering from senile osteoporosis. I want your opinion about the disease.
Senile osteoporosis is characterised by diffuse osteoporosis of unknown cause. It affects the elderly, especially women but it may be seen also in patients of middle age. It may possibly have an endocrine basis. The whole skeleton is affected but the changes in the spine are more obvious than those elsewhere. There is a reduction of total bone mass compressing fracture of one or more of the vertebral bodies is liable to occur from only trivial violence. Even without fracture the thoracic vertebrae tend gradually to become wedge shaped so that the spine bends forward to produce a rounded kyphosis. The long bones are also prone to fracture easily. The patient is often a woman of over 60. The osteoporosis may be symptomless and may be found only by chance. In other cases there is pain in the back. The pain occurs in two forms, a mild generalised ache and a sharper pain of sudden onset, denoting a compression fracture. Examination reveals a rounded kyphosis in the thoracic region. The trunk is shortened and there is a transverse furrow across the abdomen. X- Ray shows the reduced density of the vertebral bodies, which become concave at their upper and lower surfaces from pressures of the intervertebral discs. Metabolic balance studies may show a negative calcium balance. Treatment is rather unsatisfactory. It may be possible to restore the patient to positive calcium balance by calciums supplements to the diet but the gain is usually small and a dramatic improvement in the readiographic appearance can not be expected. In the belief that the disorder has an endocrine basis oestrogen and androgen therapy has been used but with doubtful benefit. If back pain is troublesome a light spinal brace should be prescribed.
● I AM 25 YRS OLD WOMAN AND HAVE FIVE MONTHS PREGNANCY. From the begining of pregnancy I am suffering from watery vaginal discharge. I want your opinion about this problem.
A watery vaginal discharge is uncommon, apart from obvious causes such as urinary fistulae where the high urea contents of the discharged fluid is diagnostic. Discharges of this kind have been described in the condition known as hydrops tubae profluens when a hydrosalpinx has been supposed to discharge its contents through the interstitial portion of the tube into the cavity of uterus. In carcinoma of the fallopian tube the discharge has been aptly described as amber coloured. During pregnancy a watery discharge is more frequent. In hydrorrhoea gravidarum the watery discharge is probably due to leakage of the liquor amnii through rupture of the membranes above the level of the internal os.
● I AM A 50 YEARS OLD LADY, LAST YEAR I DEVELOPED SMALL, SLIGHTLY elevated and blue black lesions on my hands. I consulted a skim specialist. He told me that you are suffering from blue nevi. Skin specialist told me that if these lesions are growing or may feel any change in the lesions than it has to be evaluated to rule out cancer. What is you opinion.
Blue navi are small, slightly elevated and blue-black lesions. They are common in persons of Asian descent and an individual patient may have several of them. If present without change for many years, they may be considered benign ( Non Cancerous), since malignant ( cancerous) blue nevi are rare. However blue black papules and nodules that are new or growing must be evaluated to rule out nodular melanoma (Cancer).
– Dr Sanjay Teotia.
“Leave me….. leave me.” Get your filthy hands off me I cry as loud as I can. Suddenly my mother wakes me up, hands me a glass of water and calms me down. I have been sweating because of the nightmare. Again the same dream? My mother inquired, to which I nodded my head. “I don’t get why do you get such dreams again and again, how many times have I told you to stop watching those nonsense crime shows, they’re just polluting your brain,” mom scolded me. And then, she slept next to me so that I feel safe. How funny that she was just calming me down a minute before she started scolding me instantly and before I could realise she was sleeping next to me to comfort me. Mothers are the best creatures on Earth. They can be ruthless and sweet at the the same time. A friend when you need advice, a philosopher when you are lost.
But sadly there are some secrets deep down in our hearts which we are unable to share even with them. Sorry, mom, sorry I never shared with you the reasons behind my nightmares, because I fear its outcome. How would you and dad react; what will I say in my defence; and after these many years will it even matter to anyone like it does to me?
It has been seven years, and still seems a thing of yesterday. Those were my school days and I was hardly 15 years old. I had some first experiences even those which I never wanted and one such was “Sexual harassment”. It was when I was in class 10 and just like other days after coming back from school as the clock struck 4, I left my home for coaching classes. It was a 15minute walk from my apartment, and I loved walking alone.
26 December, I stepped out of my apartment and crossed the road like I usually did. There’s one thing with our town, all shops and markets are shut between 3 and 5pm for lunch break. So, as usual, there was no crowd on the road, no honking of vehicles and the sun was shining bright. The road was empty as far as I could see, it was at that time I felt somebody whistled from the back. I turned to have a look at that scoundrel when someone out of nowhere came and ripped my Tshirt from the right shoulder. I was shocked and instantly put that hand away. But by the time I could do anything he was gone. The road was still empty and I could only see a bike racing in the opposite direction very far. I froze in that moment, tears started to roll down my eyes and I wanted to run away. But more than that I wanted to know who did it, who tried to touch me. More than the fact that I was molested, I was unaware of the person doing it made me lose my senses.
Time was running and I was still standing there and figuring out what just happened and what I should do now. It was then I realised I shouldn’t be standing there alone and that man could come back anytime. The thought of it sent chills down my spine. And I decided to adjust my T- shirt, covering it with the strap of my bag and headed back home. On reaching back I opened the door with my key as my mother took a nap at that time rushed into my room and changed my clothes. On being asked I made a reason of having headache and cried myself to sleep. The next day I did not share it with anyone, I didn’t want my parents to worry and my brother to get disturbed during his exams. I let the time pass. But, as we say, time heals everything and that phase also went. I am an independent girl today, working and career oriented. I travel alone most of the time fearlessly and that’s because I know I can fight back any bad situation. – Saumya Shresth, New Delhi.