MediZens

In India, around 12 lakh people are diagnosed with cancer every year. Sadly around 8 lakh die of the same, every year. Cancer has a case fatality rate of over 66%. One woman dies of cervical cancer every 8mins in our country. But as of May 25, two months into the lockdown, only around 1.4 lakh people  have been tested positive for Covid19, and of them, only 4021 have died which brings the case fatality rate to 2.87%. So, Is corona really the killer virus, or Is it overrated? Remember, We have arrived at the present figure only because of all the strict measures taken such as lockdown, social distancing, personal protection, quarantine, testing, isolation etc. But what would have happened if the virus was allowed to follow its natural course? Lets look at some statistics. On March 25, at the beginning of lockdown, there were 562 active cases. Lets consider there was only one case who was not isolated. Preliminary studies have estimated a global R0 value of 2-3. Let us consider the one p

Tachyarrhythmia: Broadly Tachyarrhythmias are classified based on their origin into two main types. SUPRA VENTRICULAR VENTRICULAR Supraventricular Tachyarrhythmia: As the name implies, the impulse originates above the level of AV node. Sinus Tachycardia: HR more than 100 with upright P wave followed by QRS complex is termed as Sinus Tachycardia. It has a variety of causes and the most probable cause of  each case should be identified. Atrial Fibrillation: Absent P wave with an irregularly irregular rhythm may indicate Atrial fibrillation. The more specific term is Atrial fibrillation with rapid ventricular response when the HR is more than 100. When the patient is connected to an ECG monitor, You will find the heart rate fluctuating to a wide range from 100-160. Atrial Flutter: Atrial flutter can be easily identified on an ECG from the presence of Flutter waves which gives a saw tooth appearance. The baseline could not be identified. PSVT: When the term Paroxysmal Supraventricular Tach

The heart beats at a regular rate of 60-100bpm with the impulse originating from the SA node and ending at the ventricular musculature traversing the AV node, Bundle of His and Purkinjee fibres. Any defect in this circuit resulting in irregular beating of the heart is termed as Arrythmia. Lets look at some arrythmias, We commonly encounter in clinical practice. Classification: Broadly Arrythmias can be classified into Sinus Arrhythmia Brady Arrhythmia Tachy Arrhythmia Extra Systole Sinus Arrhythmia: It is mostly physiological, characterised by by irregular R-R interval, i.e lenghtheing and shortening of R-R interval, corresponding to the respiratory cycle. P wave is normal in size and morphology Every P wave is followed by QRS complex PR interval is normal and constant Bradyarrhythmia: Sinus Bradycardia: HR less than 60bpm with otherwise normal ECG morphology is termed as sinus bradycardia. It is declared physiological after ruling out all pathological causes. Trivia: The lowest heart

The one finding on an ECG, which you can never afford to miss, and may cost dear life, if missed is Myocardial Infarction, i.e ST-T changes. Timely diagnosis with the simple ECG, which is cheap and easily available may save precious lives. Lets get started, Never ever to miss an MI. Who needs an ECG: There are many instances where We miss an MI, simply because We did not order for an ECG. Diabetics may not have chest pain, so called silent MI. Inferior wall MI may present with epigastric pain mimicking Peptic Ulcer disease. Its always better to "Make Sure" than to "Be Sure". Following are some instances, where we must order an ECG, Any case with chest discomfort-left sided/crushing/radiating to arm or jaw/associated with sweating/palpitation Sudden onset of pain in the epigastrium Radiating pain in the left arm Profuse Sweating Palpitation/Breathlessness Giddiness/Syncope Hypotension/Hypertension Old age and those with co-morbidities with any of the above symptoms W

P wave: P wave denotes atrial contraction. Look for P wave in lead II.  Normal P wave measures 2.5mm tall and 3mm wide. Absent P wave with an irregularly irregular rhythm may indicate Atrial Fibrillation. Tall peaked P wave is called P pulmonale and indicates Right Atrial Enlargement. Broad Biflid P wave is called P mitrale and indicates Left Atrial enlargement. Inverted P wave indicates Atrial ectopic If PR interval is less than 3 small boxes, the origin of ectopic is AV node If PR interval is more than 3 small boxes,the origin is elsewhere from the atrium. PR Interval: It is measured between beginning of P wave to beginning of QRS complex. It represents spread of impulse from SA node to the ventricular tissues. It measures about 3-5 small boxes. The significance of PR interval is diagnosis of heart blocks. Heart Blocks: 1st Degree Heart block: Prolonged PR interval more than 5 small boxes indicate 1st degree Heart block. 2nd Degree Heart block:(Mobitz Type 1): This is characterised b