Statin Therapy Reduces Future Risk of Lower-Limb Amputation in Patients With Diabetes and Peripheral Artery Disease

Lowering cholesterol has been important for a while now. It not just prevents heart disease, it can also lower your stroke risk.

There are those that use supplements as a way to lower cholesterol, but statins remain the gold standard in management.

Preamble: Although there is evidence to support the beneficial effects of statins on major cardiovascular events, few studies address the protective effect of statins on limb outcome.

Hsu CY et al. aimed to investigate whether the use of statin is associated with a risk reduction in lower extremity amputation in type 2 diabetes mellitus (DM) patients with peripheral arterial

disease (PAD).

Design: Observational cohort study.

Setting: A nationwide DM database in Taiwan from 2000 to 2011.

Patients: A total of 69,332 patients aged ≥ 20 years with DM and PAD were identified.

Intervention: Patients were divided into three groups: 11,409 patients were statin users, 4430 patients used non-statin lipid-lowering agents, and 53,493 patients were nonusers.

Main Outcome Measures: The primary outcome was lower-extremity amputation. Secondary outcomes were in-hospital cardiovascular death and all-cause mortality.

Results:

·    Compared with nonusers, statin users were associated with lower risks of lower-extremity amputation [adjusted hazard ration (aHR), 0.75; 95% confidence interval (CI), 0.62 to 0.90], in hospital cardiovascular death(aHR, 0.78; 95% CI, 0.69 to 0.87), and all-cause mortality (aHR, 0.73; 95% CI, 0.69 to 0.77).

·    In the propensity score matching analysis, the effect of statin on the risk of lower-extremity amputation was consistent. Only statin users were associated with the risk reduction of lower-extremities amputation (HR, 0.77; 95% CI, 0.61 to 0.97) and cardiovascular death (HR, 0.78; 95% CI, 0.68 to 0.89) when taking competing risk of death into consideration.

The authors concluded that compared with statin nonusers who were never treated with lipid-lowering drugs, statin users had a lower risk of lower-extremity amputation and cardiovascular death in patients with DM and PAD.

What Is Your Heart Disease Risk? Heart Doctor Vivek Baliga Discusses..

Heart disease affects millions of people across the globe. These days, one of the most common reasons why young people visit doctors is not just for the common cold or flu, but also to find out what their chances of developing heart disease are.

Years ago, a group of researchers started looking into whether an individual’s risk of developing heart disease could be estimated. 

Looking at normal parameters such as high blood pressure, diabetes, heart disease in the family and a history of high cholesterol and smoking were all well and good, but there was no way to know what exactly a person’s risk was in years to come.

In 1946, scientists embarked on the Framingham Heart Study. 

This remains, to date, one of the largest heart studies performed all over the world. This study was so robust and remarkable, that to this day we use data published from this to determine an individual’s heart disease risk. 

Not only that, the study also provided valuable insights into how various risk factors affect the heart and how one can make changes to reduce their risk.

The risk scoring system takes into account various parameters including age and gender, and churns out a 10 year risk score. 

This risk score determines what a person’s chances are of having a heart attack in 10 years time. 

Those who have a low risk score have a 10% chance of heart disease in 10 years, those with an intermediate risk score have a 10 – 20 % risk while those with a high risk score have a >20% risk.

Since the Framingham risk score emerged, a number of different scoring systems are being used not only to predict chances of developing heart disease, but also outcomes of patients following a heart attack. 

The Q-risk score is being used more widely these days. Similarly, the GRACE score and CHADS2VASc scoring systems are also used for patients with heart disease.

It must be remembered that these scoring systems are arbitrary. They apply to majority of individuals but not to all. Ask your doctor about what your heart disease risk is today.

How Is Your Cognitive Reserve? Dr Vivek Baliga Writes...

Okay, so this topic may be a little complicated for you, but let me try and explain. Have you heard of cognitive reserve?

In the 1980’s, scientists and researchers were baffled to find that post mortem specimens of the human brain had changes suggestive of Alzheimer’s disease in subjects who had led completely normal lives and had not had any memory problems when alive. 

This is when the phenomenon of cognitive reserve emerged.

Cognitive reserve is a phenomenon where the brain fights the development of the any damage. It is the resistance against damage. 

Imagine you are driving a car. An ambulance starts to siren behind you, and you must move your car. You change gears and speed up to move to a location where the ambulance has sufficient room to pass through.

Similarly, at times of need, the brain has the ability to ‘change gears’ to function at a higher capacity. This can occur despite there being brain damage or age-related change. 

This capability is cognitive reserve.

Medically, it is the ‘hypothesized capacity of mature adult brain to sustain the effects of disease or injury without manifesting clinically'. 

'It accounts for individual differences in the cognitive processes and neural networks which allow one to cope better than others with the brain damage'.

Those with a better reserve tend to avoid developing problems such as Alzheimer’s, Parkinson’s disease and similar problems. They can manage unexpected life events such as financial stress, loss of a loved one and similar scenarios in a better manner. 

These circumstances require your brain to function differently, and this depends on how good your cognitive reserve is.

So how can you build your cognitive reserve? Well, there are many ways to improve your memory.

Learning a new skill, reading, continuing your work for as long as possible, exercising your body and your mind and eating a healthy diet are all linked to your brain’s reserve function. 

Enjoy your hobbies. They will keep your mind active and sharp for years to come!!

A FOURIER Analysis for Evaluation of Evolocumab for Reducing Cardiovascular Events in Diabetic Patient - Dr Vivek Baliga

Hospitalization for Heart Failure and Death in patient with/without prior CVD in New Users of SGLT-2 inhibitors: a CVD-REAL Study

T2DM patients with CVD on sodium glucose co-transporter 2 inhibitor (SGLT-2i) have shown reduction in cardiovascular death and hospitalization for heart failure (HHF).

This study used clinical practice data from 2012-2016 and compared HHF and death in patient with/without prior CVD or heart failure in new users of SGLT-2i vs other glucose lowering drugs (oGLD).

HHF and deaths were collected via medical records, medical claims, electronic health and death records, and national register; Hazard ratio (HR) for HHF, death and the composite endpoint (HHF or death) was calculated as average.

Overall, 306,156 patients with >150,000 person year(PY) 100,947 PY for SGLT-2i; 89,208 PY for oGLD) and 950 new HHF events were analyzed.

SGLT-2i was associated with significant lower rates of HHF with/without prior CVD (HR 0.69;95% CI 0.59-0.80) compared with oGLD (HR 0.55, 95% CI 0.34-0.88).

Similarly, death and composite endpoint was significantly lower for SGLT-2i when compared to oGLD, irrespective of heart failure or CVD.

SGLT-2i was associated with significant reduction in HHF and death vs oGLD in both with/without prior CVD or heart failure patients, which shows the beneficial effect of SGLT-2i over broad range of patient population with T2DM.

Checking Your Blood Pressure The Right Way - Dr Vivek Baliga Advice

Many of you reading this blog have high blood pressure. If you don’t, then you are in that small category of people in India that do not suffer from the problem. 

Aptly called the ‘silent killer’, high blood pressure affects many individuals across India and carries a great deal of mortality and morbidity. If you have been diagnosed with high blood pressure, your doctor will prescribe for you certain medications that will not only help control the BP but will also reduce your chances of developing complications in the future. 

High blood pressure is associated with heart disease, stroke, kidney disease and eye disease in addition to a number of other medical problems. Making sure that you follow the right lifestyle changes such as salt reduction and regular exercise are paramount to achieving adequate control.

An important aspect of management of BP is monitoring it at home. Numerous BP measuring devices are now available on the market and are quite accurate when compared to what your doctor measures in their clinic. It is therefore advisable to own one of these machines at home if you have high blood pressure as they can be invaluable in times of need especially if you are calling the doctor for advice. 

However, there are certain aspects of checking the BP at home that you need to be aware of so that the reading you obtain is as accurate as possible. Here are some simple steps that can guide you on how to check your blood pressure correctly.

1. Don't drink a caffeinated beverage or smoke for at least 30 minutes before the test. Doing so can affect the BP recordings.

2. Sit quietly for five minutes before the test begins. If possible, do not talk to anyone and just close your eyes and concentrate on your breathing.

3. During the measurement, sit in a comfortable chair with your feet on the floor and your arm supported so your elbow is at about the level of your heart.

4. The inflatable part of the cuff should cover at least 80% of your upper arm, and the cuff should be placed directly on the skin, not over any clothing. Make sure that the tubing that accompanies the cuff is placed over the inner aspect of the forearm so that it falls upon the brachial artery. The BP that is recorded is that of the brachial artery.

5. Don't talk during the measurement. When the machine is inflating the cuff, do not look at the readings as this can sometimes cause a slight amount of stress. This can falsely increase the BP which could get you even more stressed!

6. Have your blood pressure measured twice, with a brief break in between. It is recommended that you wait around 10 minutes before the next reading. If the readings are different by 5 points or more, have it done a third time. If you wish to, you may take an average of the three readings.

When recording the BP at home, it is important to bear in mind that there will be a slight difference between the machine readings and one which your doctor gets in the clinic. 

Currently, this is a well-known fact by the medical authorities and it is often assumed that a small difference between the manual readings and the machine readings is acceptable. 

In fact, a difference of about 10 mmHg either way would be regarded as acceptable. If you find that multiple readings that have been taken over a space of time are always elevated, it is advisable to contact your doctor to get further advice.

It is not uncommon for BP recordings to fluctuate throughout the day. BP readings may be high prior to taking medicines and may settle after taking medicines. 

There is no clear guideline as to when to check the BP but we often tell our patients to check it at least two hours after they have taken their medicines. 

This way, we can assess whether the medicines that have been prescribed are working effectively or not. If the BP readings at home taken at the suggested times match the BP readings that are obtained in the clinic, then it is safe to assume that the medicines are working effectively and that no further adjustments are required or necessary.

Try and maintain a diary of your BP either on your phone or in a scribble pad. Use this diary to also record your day-to-day activities and dietary patterns. 

Show this to your doctor every time you visit them. It will help guide them on further management. Use an approved device that has a good reputation and review online. 

Dr. Vivek Baliga, Baliga Diagnostics, Bangalore

An accomplished medical professional, Vivek Baliga began his education at Sri Aurobindo Memorial School, located in Bangalore, India. Excelling in and out of the classroom, Dr. Baliga participated in the school's organized basketball team. Following grade school, he matriculated at Bangalore's National College Jayanagar.

Concentrating on pre-university science courses, Dr. Baliga continued playing sports and earned recognition as a badminton champion for his college in 1994.

After two years, Vivek Baliga successfully completed his studies and enrolled in Manipal Academy of Higher Education in 1995. Anticipating a career in medicine, Dr. Baliga pursued his Bachelor of Medicine, Bachelor of Surgery (MBBS) degree and graduated in 2000. 

During his time at the academy, he played on the basketball team, which clinched championships in 1999 and 2000. Today, he continues to play from time to time as a hobby. Loves the 3 points still!!!

Dr. Baliga continued to expand his education by working toward a doctorate with a focus on cardiovascular research. He is currently a member of the Royal College of Physicians and of the Indian Academy of Echocardiography, of which he is the secretary of the Karnataka Chapter.

 Since beginning his career, Vivek Baliga has published several articles in various medical journals. In 2009, he co-authored an article for Prescriber, a periodical devoted to prescribing and medicine management. His article concerned advice for managing acute coronary syndrome. 

His article on Diabetes and heart failure was the most downloaded article on Sage publications two years in a row.

Dr. Baliga also co-penned a piece for the American Heart Association regarding the effect of insulin receptor levels and other factors contributing to insulin sensitivity on the endothelial cells, a thin layer of cells found on the interior of certain vessels.

 Vivek Baliga also contributes to the medical community as a philanthropist. In 2011, he took part in the 10-kilometer Bupa Great Manchester Run, accepting donations for the Desk & Chair Foundation. He was also part of a team of doctors in Mangalore which provided education to teachers and children about malaria prevention.

Dr Vivek Baliga is  the author of a number of different articles across different medical specialties. He is an expert author on ezine articles, has published numerous article for his newsletter Sowkhya Magazine and has published articles in peer reviewed journals as well.

In addition to authoring number of articles online, Dr Vivek is also an expert author on Medlife.com. His articles are published on their blog and also in their patient magazine. You can also finding him tweeting health tips here.

A Mango A Day Keeps The Doctor Away - Dr Vivek Baliga Writes

Mango season is upon us, and the sweet fruit is pretty much on every one’s mind.

But mangoes are just not delicious to taste; they also have many additional health benefits. Let’s take a brief look at these and understand why they really are the ‘king of fruits’!

Mangoes are rich in anti-oxidant compounds.

These are powerful fighters of free radicals that are responsible for skin damage and cancer. It is believed that eating mangoes can reduce your risk of colon cancer and prostate cancers.

These compounds include quercetin, isoquercitrin, astragalin, fisetin, gallic acid and methylgallat, as well as the many enzymes.

The high level of fiber in mangoes can help combat high cholesterol levels. They can lower bad LDL cholesterol levels.

Mangoes are also rich in vitamin A, which is essential for your eyes to remain healthy. In fact, one cup of sliced mango provides you with 25% of the required amount of vitamin A you need daily.

We often advice patients with diabetes to avoid mangoes, but if your blood sugar levels are well controlled, it is okay to have 3 or 4 small pieces of this fruit. Around 15 grams is okay. Mango also contains vitamin C that can boost immunity and fight infections.

Enjoy in moderation, but make sure you do!

For more articles on health by Dr Vivek Baliga, visit here.

Was Popeye Right About Spinach? Dr Vivek Baliga Writes

In this article, Dr Vivek Baliga writes about Spinach and how it can help you.

For those of you who are cartoon enthusiasts (like me!), I always waited for Popeye the sailor man to munch down on a can of spinach, suddenly develop huge biceps (in seconds) and beat down the villain to save his girlfriend Olive.

Well, spinach seems to have quite a few health benefits, and indeed Popeye was right to scoff down on this time and again. Firstly, spinach is a dark green leafy vegetable, and is low in calories. Previously referred to as the ‘Spanish Vegetable’, spinach is now widely used in fresh salads, soups and even in our Indian curries.

Spinach is rich in niacin and zinc as well as protein, fiber, vitamins A, C, E and K, thiamin, vitamin B6, folate, calcium, iron, magnesium, phosphorus, potassium, copper, and manganese. In other word, it’s loaded with good things for every part of your body! It is packed with flavonoids which has powerful anti-oxidant properties. It can fight harmful free radicals that are generated through metabolic processes in the body, thus protecting the heart and the other vital organs.

Spinach is rich in folate which can help you maintain a healthy heart. Magnesium can help control your blood pressure and keep it low. The iron content can raise your haemoglobin and is a good natural treatment for anemia. Spinach also improves your memory power and brain function. Make you have some every day! 

For more information, visit http://heartsense.in. 

Canagliflozin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with Type-2 Diabetic Mellitus

Dr Vivek Baliga short review on parts of the Canvas Study. You can view Dr Vivek's profile online here.

1. CANVAS Program was a pre-specified combined analysis of 2 trials, CANVAS and CANVAS-R, involving a total 10,142 patients with type 2 diabetes and high cardiovascular risk. The combined analysis was done as per the USFDA requirements.

The CANVAS patients were randomized 1:1:1 to canagliflozin 300 mg or 100 mg or placebo, and the CANVAS-R patients to 100 mg (with option to increase to 300 mg after week 13) or placebo. Mean follow-up was 188weeks (median, 126.1 weeks).

Globally the trial was conducted in 30 countries at 667 sites.

2. CANVAS Program included patients with type 2 diabetes and HbA1c >7.0% to <10.5% eGFR >30 mL/min/1.73 m2, age >30 years and history of prior CV event or established CVD patients (65%) or age >50 years with >2 CV risk factors (35%).

The Primary Outcome was Major adverse cardiovascular event (MACE) which included the composite of CV death, nonfatal myocardial infarction or nonfatal stroke.

The secondary outcomes included total mortality and cardiovascular mortality whereas the exploratory outcomes included nonfatal MI, nonfatal stroke, hospitalization for HF, hospitalization for HF or CV death, total hospitalizations, albuminuria progression, albuminuria regression and renal composite including 40% reduction in eGFR, end-stage renal disease, or renal death

3. Canagliflozin achieved a 14% reduction in the risk of MACE and demonstrated the CV safety and superiority compared to placebo. Canagliflozin was safe in terms of CV death and non fatal MI.

Moreover, Canagliflozin was not associated with an increased risk of stroke. Canagliflozin also resulted in 33% reduction in Hospitalization for Heart Failure and 22% reduction in CV Death or Hospitalization for Heart Failure.

4. In terms of renal outcomes, Canagliflozin induced sustained lowering of albuminuria, prevented progression in albuminuria, induced regression in albuminuria and reduced renal function loss events.

No increase in the risk of Hypoglycemia, Acute Kidney Injury, hyperkalaemia, cancer, pancreatitis was seen with Canaglilozin vs placebo. Adverse events leading to discontinuation was similar to placebo.

Understanding The Stage Just Before You Get Diabetes

Prediabetes is highly prevalent in India, with millions of people suffering from the problem. With over 65 million people in India already suffering from diabetes, it is clearly evident that the numbers will only rise at time passes. It is expected that over 100 million people in India will have diabetes by the year 2030.

This condition is often misunderstood and is not taken too seriously by the Indian population. Many people with prediabetes fail to realise that it can cause problems.

So, in order to clear up some misconceptions, here are some facts about it that you should know.

1. Prediabetes has the same risk as diabetes when it comes to developing complications. Kidney disease, tingling in the hands and feet, eye problems, heart problems and other complications are similar to those with diabetes.

2. If your blood sugar levels are mildly elevated, there is a 60% chance you will develop diabetes in the near future. This may be within the first year of diagnosis or later on.

3. In prediabetes, the fasting blood sugar levels lie between 100 – 126 mg/dL. The average blood glucose levels i.e. HbA1c lie between 5.7 – 6.4%.

4. Taking probiotic agents can help reduce the conversion of prediabetes to diabetes. Similarly, taking high quantities of soluble fiber can reduce the quantity of glucose absorbed from the gut into the blood stream. This reduces the chance of prediabetes turning into diabetes.

5. If you have even slightly elevated blood sugars, you will have to follow the same diet as you would do if you had diabetes. This includes stopping sweets, rice and rice related products and other sugary foods.

6. Low vitamin D levels have been linked to prediabetes. Get your levels checked, and if they are found to be low, ask your doctor for a suitable supplement. Just spending time under the sun may not be sufficient.

7. Losing 5 – 7% of your body weight can reduce your risk of prediabetes getting converted to diabetes. Similarly, exercising 150 minutes or more a week can have a beneficial effect in preventing the progression of prediabetes to diabetes.

Don’t ignore prediabetes. Take the right steps to ensure you delay it from getting converted to diabetes.

Understanding Irritable Bowel Syndrome

Irritable bowel syndrome is a troublesome condition. In this presentation, Dr Vivek Baliga discusses the symptoms and signs along with the basic treatment options.

Irritable Bowel Syndrome Part 1 - Dr Vivek Baliga from Dr Vivek Baliga

Dr Vivek Baliga - Myths In Diabetes

Diabetes affects over 65 million people across India. Despite this, the understanding of diabetes is poor, with many people believing in myths rather than facts. Many fail to understand that a simple diet and good exercise plan can prevent diabetes from occurring or worsening.

It is this belief that makes managing diabetes a lot more difficult for both doctors and patients. 

So what are some of the common diabetes myths? Here are some...

1. Eating a lot of sugar causes diabetes

This is not true. Eating sugary foods does not cause diabetes, but it can worsen diabetes. Diabetes is usually caused due to genetic problems or a family history of diabetes. Being overweight can increase the risk. However, it is still important that you keep a check on your sugary food intake, as these can cause weight gain.

2. Diabetes is not a serious problem

You may not believe it, but a large proportion of the population suffering from diabetes tend to ignore it as they feel diabetes is not a serious problem. After all, they may not have any symptoms, so it must not be serious, right? 

Wrong! Diabetes can silently affect the kidneys, eyes, heart and nerves and can cause debilitating disease if left untreated or ignored.

3. Insulin is a bad thing

It is a common belief that if you need insulin for diabetes, then it is a bad thing; a sort of taboo, so to speak. The fact is insulin helps achieve excellent control of your blood sugar levels, and it is easy to self manage blood sugar levels through altering your dose of insulin. After all, all you

are taking is a hormone that is produced in lesser quantities in your body. 

4. Thin people do not get diabetes 

Another common myth. While most people with type 2 diabetes are overweight, there are many people who are thin and who have diabetes. This is related to the presence of ‘invisible fat’ that is inside the abdomen.

Cellulitis - What Is It? Dr Vivek Baliga Writes

Have you ever experienced a condition where the skin in the lower part of your leg or any other part of the body becomes warm and quiet tender? Then you may have experienced a condition called cellulitis.

Cellulitis is a bacterial infection of the tissue that lies beneath the skin. It is a common infection in people who suffer from diabetes. The portal of entry is often from a break in the skin. This break in the skin is usually seen in between the toes or from an infected toenail. Sometimes, an injury to the skin can lead to cellulitis. Cellulitis can also be seen in the arm or any other part of the body. There is usually a preceding event that leads to its development.

What Causes Cellulitis?

Cellulitis is caused by a bacterial infection. The most common bacteria that cause cellulitis are called streptococcus or staphylococcus. Sometimes, more serious organisms such as methicillin resistant staphylococcus aureus, or MRSA, can lead to cellulitis. The entry point for these bacteria is usually a break in the skin. This break may be due to trauma or injury. An insect bite can also create an entry point for bacteria to enter. Dry skin can lead to skin breaks and tears, which in turn allow bacteria to pass through.

Once bacteria enter, it creates a home in the tissue just under the skin (Called subcutaneous tissue). Here, with the help of fresh blood that is rich in sugar, the bacteria grow and the infection begins to spread. If left untreated, cellulitis can involve deeper tissues such as muscle and bone as well. This can sometimes be life-threatening and may require amputation.

Are There Any Risk Factors?

There are quite a few really. If you have diabetes, your risk of cellulitis is very high. This is the reason why doctors always advise good foot care in all diabetes patients. A previous history of cellulitis is also another risk factor. Advancing age, poor immune system, skin problems such as eczema and chickenpox and being overweight are also risk factors.

What Are The Symptoms?

People with cellulitis experience swelling in the affected area, along with redness, warmth and tenderness as well. A high fever may accompany the illness.

Tests and Diagnosis

If you are suffering from cellulitis, your doctor may advise a few tests. Blood tests may reveal a high white cell count and ESR, indicative of a bacterial infection. An x-ray may be done to see if the bone is involved. If there is pus oozing out, a pus culture test may be performed. If you have a high fever, a blood culture test may be done to determine if the bacteria has entered the blood stream.

Treatment

Cellulitis is effectively treated with antibiotics. In the early stages, oral antibiotics are usually sufficient. However, if the condition is severe, then admission and intravenous antibiotics may be used. If the swelling is large and painful, small surgical incisions may be made over the skin to allow the pus to drain. This can expedite the healing process.

After the treatment has concluded, patients will be asked to take good care of their feet and to maintain good personal hygiene.

Closing Remarks

Cellulitis is a common problem, and can be quite serious if ignored, especially if you have diabetes. Make sure you take the right steps towards maintaining good personal hygiene, and protecting your feet when you are out walking.

Find Dr Vivek on LinkedIn here.

Dr Vivek Baliga Review

Over the years, Dr Vivek Baliga has been writing articles for his blog HeartSense and Making Sense of Diabetes.

With a keen interest in academics and education, Dr Vivek, a consultant in Internal medicine and cardiovascular sciences at Baliga Diagnostics, Bangalore, has been involved in writing patient information articles for over 8 years. He has been a top article writer on Fiverr.com and has ghost written a number of articles for clients over the world.

His interest is in the management and treatment of diabetes and its cardiovascular complications, particularly heart failure. He is currently pursuing a degree in lipid management from Middlesex university, UK.

You can view the articles on Making Sense Of Diabetes here.

The Basics About Diabetes - Dr Vivek Baliga Article

Weight loss in diabetes is an important aspect of getting your blood sugar levels under control. Obesity is a well recognised aspect of diabetes management.

If you are thinking as to why your blood sugar levels are elevated, then one thing you must think about is your body weight.

In an article written by Dr Vivek Baliga, weight loss is regarded as one of the most important aspects in the management of diabetes.

You can read this article here.

Is Losing Weight Too Hard?

If you have been struggling to lose weight, then some simple tips might help you.

Here are 7 simple ways to lose weight in 2017.

Article by Dr Vivek Baliga - Click here.

Evidence For Dyslipidemia - Dr Vivek Baliga

Dr Vivek Baliga of Baliga Diagnostics discusses an evidence based approach for the management of dyslipidemia.

Dyslipidemia management an evidence based approach from Dr Vivek Baliga

Find Dr Baliga online here.   

Is Chest Pain Always Due To The Heart? Dr Vivek Baliga Article

Chest pain is a worrying problem. Many wonder if chest pain is cardiac in origin and rush to the doctor.

Sometimes however, chest pain is not cardiac in origin. In other words, there are other reasons why chest pain may occur.

In an article by Dr Vivek Baliga on Baliga Diagnostics website, the different causes of chest pain have been listed and discussed in detail.

Causes such as high levels of acidity, muscular chest pain, teitze syndrome are some common ones.

You can check out this article in detail by clicking on the link below.

http://baligadiagnostics.com/non-cardiac-chest-pain/

Find Dr Vivek On Slideshare - Click here

Dr Vivek Baliga Video - Diuretics

In this presentation, Dr Vivek Baliga discusses the use of diuretics in clinical practice and their side effects.

Dr Vivek Baliga Presenation on Diuretics - What... by drvivbaliga

Patient articles - http://heartsense.in/author/dr-vivek-baliga-b/

Managing Diabetes When Travelling - Dr Vivek Baliga Article

 Dr Vivek Baliga, Consultant Internal Medicine writes this article on managing diabetes when traveling. This is only an excerpt. If you wish to read more, click here.

Managing diabetes can be a daunting task, especially when you are traveling. When should I take my insulin, what should I eat on a long journey and can I carry my injections on a flight are some of the commonly asked questions.

The truth is that it only takes a few simple measures to keep your blood sugar levels under control. Be it travel by car or by flight, the general principles remain the same.

Read here if you wish to learn more about managing diabetes when traveling.

 For more articles by Dr Vivek Baliga, visit http://heartsense.in/author/dr-vivek-baliga-b/

Organ Donation - Be A Part Of The FORT Program - Dr Vivek Baliga article

In this presentation, Dr Vivek Baliga discusses the reasons why you should list yourself for organ donation, and why you need to be a part of the FORT program.

Dr Vivek Baliga - Organ Donation And The FORT Program from Dr Vivek Baliga

You can read this article online by visiting  http://heartsense.in/organ-donation-fort-program/

Connect with Dr Vivek Baliga on LinkedIn -  https://www.linkedin.com/in/dr-vivek-baliga-7b59b0125

For more articles on health by Dr Vivek Baliga, click here