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DISEASE PATTERN IN INDIA
BREATHING IN A PAPER BAG IN PRIVATE PRACTICE
OP Kapoor
Every practitioner must keep a paper bag like the ones provided in the aeroplane for vomiting. The following are the indications where the patient is told to breathe into this bag for a few minutes with dramatic response :
1. Patients having hiccups, not responding to other line of treatment.
2. Patients having aerophagy syndrome not responding to other line of treatment.
3. The most important indication is the use of paper bag in patients having hysterical dyspnoea.
Finally in patients having attacks of bronchial asthma, you will often see symptoms of panic (like any hysterical dyspnoea) when the patient complains of:
(a) Tingling and numbness of the limbs
(b) Cramps
(c) Carpopedal spasms
Before treating bronchial asthma, breathing in a paper bag relieves these panic symptoms, after which the asthma can be treated.
INCREASE IN BLOOD GLUCOSE PREDICTS MYOCARDIAL INFARCTION
An increase in blood glucose during antihypertensive treatment is an independent risk factor for myocardial infarction. Dunder and colleagues studied a cohort of 1860 Swedish men who had participated in a baseline investigation when aged 50 and who were re-examined at age 60. A significant interaction existed between proinsulin concentration at baseline and antihypertensive treatment on increase in blood glucose, suggesting that the metabolic impact of antihypertensives increases the risk of myocardial infarction in an insulin resistant state.
BMJ, 2003; 326 : 681.
