Question 1

I'm really worried about my brother Jiten, who was in the cardiac care unit recently. He's just 28 and now that he's home, his blood pressure keeps dropping in the evening, and he starts vomiting. After that, his skin turns pale and he experiences pain in his right calf. I'm also noticing that he's coughing a bit. The hospital stay was stable after his procedure with the AICD implant, but I'm worried about these symptoms popping up. His meds include things like concor, aldactone, and levoflox among others. Could you advise on what might help him recover better and keep these symptoms in check?

Accepted Answer

To address the symptoms of low blood pressure, vomiting, pale skin, calf pain, and cough, the following adjustments can be made to the medication regimen: 1. **Low Blood Pressure and Vomiting**: Given the symptoms of low blood pressure and vomiting, it is important to review the medications that may be contributing to these side effects. In this case, Dytor 10mg (Torsemide) is a diuretic that can lower blood pressure and cause electrolyte imbalances leading to vomiting. It may be advisable to reduce the dosage of Dytor or consider an alternative diuretic. 2. **Pale Skin and Calf Pain**: The symptoms of pale skin and calf pain could be indicative of poor blood circulation. To address this, it is important to ensure adequate hydration and blood flow. Aldactone 25mg (Spironolactone) can sometimes cause electrolyte imbalances leading to symptoms like calf pain. Monitoring electrolyte levels and adjusting the dosage of Aldactone may be beneficial. 3. **Cough**: If the cough persists, it may be related to heart failure or respiratory issues. Dapaone 10mg (Dapagliflozin) is a medication used to treat heart failure. However, if the cough is persistent and bothersome, a review of the medication regimen and potential respiratory evaluation may be necessary. 4. **Overall Recommendation**: Considering the symptoms described, it may be beneficial to consult with the healthcare provider who prescribed the medications. Adjustments in medication dosages or alternative medications may be necessary to address the symptoms of low blood pressure, vomiting, pale skin, calf pain, and cough effectively. Please note that any changes to the medication regimen should be done under the supervision and guidance of a healthcare professional. Regular monitoring and follow-up with the healthcare provider are essential for optimal management of these symptoms.

Question 2

I take Tazloc Trio 40 mg in the morning right after breakfast, and I've noticed that about 10-15 minutes later, when I start driving to work, I get this drowsy feeling. It's a bit concerning, especially because I do an intense workout on my bike for an hour before breakfast, and my heart rate is usually around 145-150 bpm. Sometimes I don't sleep well at night because of restless legs, but I still push myself to cycle every morning before taking my medication. My blood pressure used to be pretty high at 160120, and my doctor switched me from CETANIL M 50 to Tazloc Trio. Could this drowsiness be related to the medication or my morning routine? What should I do about it?

Accepted Answer

According to the World Health Organization's (WHO) new guidelines, the number of doses required for the rabies vaccine has been reduced.

- *Pre-exposure prophylaxis*: 2 doses of rabies vaccine are recommended for individuals at high risk of exposure, given on days 0 and 7 .
- *Post-exposure prophylaxis (PEP)*: For individuals who have not been vaccinated against rabies before, 4 doses of rabies vaccine are recommended over 2 weeks, given on days 0, 3, 7, and 14. Additionally, rabies immunoglobulin is recommended on the day of the first dose or soon after .
- *Intradermal vaccination*: WHO recommends a one-week, 2-site intradermal PEP schedule with 0.1mL of vaccine injected on days 0, 3, and 7 .

It's essential to consult with a healthcare professional for personalized advice on rabies vaccination.

Question 3

I'm curious about some symptoms I've been experiencing. A few months back, I did an echo report and a TMT, which came back negative. Lately, though, I've been having this pressure and a burning sensation in my chest, plus a lot of burping. I'm a bit worriedis this something heart-related? Should I consider getting more tests done to check my heart health? Would love to hear your thoughts.

Accepted Answer

based on your symptoms of pressure in chest, burping, burning sensation, and pain in chest, it is important to further evaluate your heart health. In addition to the echo report and negative TMT, I would recommend a few more tests for a comprehensive heart evaluation. 1. **ECG (Electrocardiogram)**: To assess the electrical activity of your heart. 2. **Holter Monitor**: To monitor your heart's activity over a period of time. 3. **Cardiac CT Scan or MRI**: To get detailed images of your heart's structure and function. 4. **Blood tests**: Such as lipid profile and cardiac enzymes to check for any abnormalities. Based on the results of these tests, further treatment or management can be determined.

Visit Physician for evaluation and appropriate management

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