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Showing posts from August, 2017

Should I take protein supplement on rest day? Weight Training.

When you work out, the production of muscle protein is enhanced for the next 24 to 48 hours. It is  important to provide essential building blocks for protein synthesis. These building blocks called amino acids must be already available for the protein synthesis, if you train hard but do not provide your body with the appropriate amount of proteins to repair the damage caused by the hard training of muscles, then it doesn’t provide any benefit to your body, instead, you may end up with muscle pains, fatiguability, and weakness that may last for a long time. Therefore, intake of readily available proteins is advised to those people who actively workout with an aim to build their muscle mass. Eggs are a great natural source of readily available and easily digestible proteins. Egg contains all the essential amino acids, that is why the intake of eggs is advised to all bodybuilders. But a single egg contains 3 – 6 g of proteins, you may need to take more than a dozen eggs to meet the dai

Safe Anti-Epileptics - Not Enzyme Inducers or Inhibitors - Dr. Adil Ramzan

Sometimes it becomes difficult to choose a drug in those patients who have multiple co-morbidities. That is are suffering from more than one disease and physician needs to choose a few out of many drugs to avoid drug-drug interactions. Anti-epileptic drugs, or the drugs which are used to treat seizures, do interact with other drugs.  Carbamazepine, phenytoin, phenobarbital, oxcarbazepine, topiramate and primidone are enzyme inducers. Enzyme inducers decrease the efficacy of a drug which is metabolized by the induced enzymes because more concentration of the enzyme will be available and the drug will be quickly metabolized and removed from the system.  Valproic acid, felbamate, rufinamide, and stiripentol, on the other hand, are enzyme inhibitors.  Therefore, we can't give these drugs to a patient who is taking a drug for any medical problem which is metabolized by the liver enzymes (eg cytochrome p450 enzyme system).  The anti-epileptic drugs which are not an enzyme induc

4 signs of pericardial effusion - Dr. Adil Ramzan

Pericardial effusion is the collection of fluid around the heart. In this brief article, we will be discussing the signs of pericardial effusion on physical examination. Following are the 4 signs of pericardial effusion.  1. Pulsus Paradoxus.      Pulsus Paradoxus means a decrease in systolic blood pressure of more than 10mm of Hg during inspiration. The fall occurs due to increase in intrathoracic negative pressure during inspiration. In cardiac tamponade, Pulsus Paradoxus is exaggerated and a fall of more than 10 mm of Hg occurs during inspiration. An arterial line for blood pressure measurement is a good tool to measure inspiratory and expiratory blood pressures.  2. Ewart's sign     In case of a large pericardial effusion, dullness is present below the left scapular angle along with bronchial breathing. this sign is called Ewart's sign.  3. Increased Cardiac dullness.      The area of cardiac dullness increases upon the percussion of the anterior chest due to a large p