New criteria to diagnose Diabetes !

In my office , I have seen so many get confused with this Diabetes diagnosis. There are different terminology, different diagnostic tests.. I know , nobody wants get labeled as diabetic, because once you get labeled as a diabetic, that’s it you are done for this life time, you have to have follow up every year( at least) with your eye doctor and primary care physician, no matter how old are you?

Here , I am trying to give you some simple terminology.

1. Impaired fasting glucose-  this is the starting phase for diabetes. Usually its always preferable to check the fasting blood sugar levels to diagnose Diabetes. So if your fasting blood sugar levels are less than < 126 mg per dl, you are diagnosed as Impaired fasting glucose. That means you are high risk for becoming a diabetic patient.  You don’t need any medication at this stage, except strict life style modification and diet changes.
2. Diabetes Mellitus:

1. If your 2 consecutive blood glucose levels are equal or more than >126 mg per dl you diagnosed as Diabetic.
2. If you have classic symptoms of Diabetes like polyuria, polydipsia, polyphagia, and weight loss with your random blood sugar levels equal or more than 200 mg per dl, you are a Diabetic.

Once you diagnosed as a diabetic, to certain extent you can manage with strict life style changes and diet control with out any medication, unless you really screwed up your blood sugar levels.

Once you primarily diagnose as a Diabetic, it takes 9 yrs from then , to use Insulin injections.

Hope I made it clear , at least for few people.

PAP smear test – Cervical cancer in Women

The most common cause for Cervical cancer is Human Papilloma Virus ( HPV 16,18).

Risk factors:  Early age of intercourse, Multiple sexual partners and Smoking.

The best screening test for cervical cancer is – PAP smear test.

When should it be started?

At 21 yrs or 3yrs after sexual onset. Either of one which ever comes first.

Center for disease control (CDC) recommends yearly Chlamydia testing along with Pap smear in certain population. 1. All sexually active women age 25 or Younger.

2. Older women with risk factors for Chlamydia infection, new sex partner, multiple sex partners. 3. all pregnant women.

How frequently do you screen for Pap test?

If patient is under 30 yrs every 1yr screening needed. If patient > 30 Yrs screen every 2 to 3 yrs if more then 3 annual pap smears are negative.

What is positive Pap and What is negative?

If they find regular normal cells, that’s negative Pap..If anything abnormal cells that’s Positive. ( Remember , not every positive pap is Cancer)

Positive pap means there are different type of abnormal cells..Depends on abnormality, you need to test further.

If it shows atypical squamous cells of undetermined significance( ASCUS ), this is primitive abnormality. The next best thing is better to repeat the Pap smear again after 4 to 6 months. Till you get 2 consecutive negative pap. But , if you get Positive pap again means you have to go for another test either HPV DNA testing or Colposcopy. ( Here they will do biopsy for further pathological studies.)

If your pap smear shows Low grade Squamous intra epithelial cells ( LSIL ) and High grade Squamous intra epithelial cells , the nest step is go for biopsy. If biopsy confirms the same thing, you have to managed by certain Ablative methods like Laser vaporization, cryotherapy, and electro fulgration OR Excisional procedures like Loop electro surgical excision and Cold knife conization.

Patients treated with either  Ablative methods or Excisional procedures need to have follow up with pap smear , HPV DNA testing every 4 to 6 months until 2 yrs.

Jai ho N. D. Tiwari!! Jai ho!!

Jai ho!! the greatest first person of A. P Mr. N. D. Tiwari.  There are so many reasons to appreciate you. Forget about effeciency, even at 85 you are trying to do something. This is the spirit we needed. You are ideal for so many young Indians.  Karo beta kuch karo, don’t give up!!

We all Andhraites are very thankful to you since you gave us a great relief from who got frustrated and bored with the meaningless bandhs and protests.

I am saluting to Indian National Congress, since they did not pick you as our first person of INDIA.. And I am very lucky for myself being born in Andhra Pradesh,  after all I brought up in a place where our leaders pass G. O s for their sexual pleasures and to raise their Swiss personal account balances.  Of course I do feel happy when look at the bright side, see you guys taught us about odds and how to survive? how to bluff? how to make fools? how to lead a shameless life?? and for many more… Our nation is saluting for you the shameless bastards!!

He is Back!!!

Merry Christmas and Happy holidays for everybody! And I am very happy to anounce “I am back again” to share my views and thoughts ( insight ) to outer world.  Since I want to improve y english writing skills and speaking skills, this time I would like to write all my posts in english.. Suggestions and comments are welcome.