Offline Clinic fitness, health, beauty tips, exercise, gym, medical and surgery Tue, 25 Nov 2014 12:51:08 +0000 en-US hourly 1 Glucose Fever Tue, 25 Nov 2014 12:51:08 +0000 Glucose fever refers to the high grade fever resulting from hyperglycemia (or glucose infusion usually). In this article, we’ll discuss the common condition in which we can find the glucose fever and the ones incorrectly labelled by some as glucose fever.

Please note, if you have correction or feedback for this post please let me know via comments!

Glucose Fever in Addisons Disease

Glucose fever can occur in the patient suffering from addisons disease after glucose infusion. This is probably linked to the lack of glucocorticoid in patients with addisons disease and thus the glucose fever precipitates. It can lead to collapse and death if left untreated.

So if some patient is given glucose infusion and he or she develops fever while i/v glucose is being given to them, it might give the suspicion of addisons disease. However, other symptoms are to be checked for too! e.g., if you were giving them the glucose infusion because of hypoglycaemia, then it supports our suspicion and aids in diagnosing addisons. Additional tests should be performed in this direction to confirm.

Fever in Hyperglycaemia (HHS) is Glucose Fever?

In my opinion and understanding till now, NO (but confirm from your local professors on this and let me know too). Let me explain why and how.

Fever is one of the sign in HHS (hyperglycaemic hyperosmolar state) in which glucose is above 33 mmol/l (600 mg/dl) usually. Now it’s important to understand that this fever is due to the infection. The infection is the main cause of fever, as well as hyperglycaemia, due to insulin resistance.

So the “fever caused by infection” along with hyperglycemia in hhs is different from “fever caused by glucose” (sugar?), glucose fever, imho. Besides, both mechanism could be working in too!

glucose feverCommon MCQ

So next time when you’ll get a mcq in your medicine exam like this, what will you chose:

Q: Glucose fever is associated with:

  1. cushing syndrome
  2. addison disease
  3. dwarfism
  4. gigantism

I hope you’ve understood the glucose fever! let me know if you have any query or improvement to this article and explanation.

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First Ebola victim in Pakistan – Fake Rumor Mon, 24 Nov 2014 20:51:33 +0000 Sorry to ruin your evening, the new is fake. Yes you heard it right, the news about the “Trusted” media and “trusted” website probably ran by kids who don’t know how to confirm some news is Fake.

First ebola patient in Pakistan – was false news

I’m seriously sick of people confused about ebola’s first “suspected” victim in Pakistan. First of all, what’s the reason of making a news of “suspected” victim of some disease? let is be confirmed first!

Our media these days is so out of authentic news that it’s running false and fake rumors, that too just on the suspicion! wow! and what’s more? people, even doctors, who know medicine, are weeping over the “suspect”.

first case of ebola in pakistan fake rumor

There is no Suspect of Ebola in Pakistan – anymore

Confirmed from the doctors in the hospital which media is quoting as first ebola victim, he is not being managed or suspected for ebola anymore. He is being treated for Dengue hemorrhagic virus (a very common virus in Pakistan and region).

The news have been confirmed from the doctors and the hospital administration.

So guys, calm down, ebola might reach Pakistan too, but it’s not today!

Why was he suspected as Ebola patient?

Because he (Naeem) recently returned from Africa! seriously? that’s the only reason? wow! means anyone returning from usa had to be suspected of sars? ya right! :/

A few words about Ebola

Just to tell you, ebola was discovered and was “epidemic” in Africa for the first time in 1974. This is the third recorded outbreak of ebola virus since then.

So calm down, and let CDC, USA do the research of their product, EboBun (Patent US20120251502)

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Wound healing with sugar and honey Fri, 21 Nov 2014 20:40:30 +0000 Ever wondered how ancient people used to treat their wounds? There weren’t any antibiotics manufactured, there weren’t any fancy laboratories who tested their products first on the rats, then monkeys and then on humans themselves and then said, oops, it was bad one, lemme refine it!

So what did they have which helped them heal their wounds? They did survive! They had few, if any, resistant and dangeroud strains emerging in their environment as we have them today because of overuse, misuse and incorrect use of antibiotics!

sugar wound healing

Were ancient methods as effective as modern ones?

Well that’s a debatable topic. The methods were effective no doubt, but were they as effective as the modern day ones were, that can’t be said for sure.

Some might claim that the mortality rate was higher in those days, well which stats are you referring to? Please give me a link too!

One issue could be of authority of a doctor or physician. These days only a qualified physician can treat a person, at least in the modern and literate society, however in those times, everyone who knew something could try to do it on himself or the people around him, which could lead to a higher failure rate too!

Science have been there with humans for long, long before the crusaders burnt the libraries of the past.

Methods used in ancient medicine for wound healing

There are several methods used in past for wound healing. This included using herbs, mushrooms, honey and other sweet stuff, sugar for example.

Not sure if ancient or not, British doctors have experimented treating the wounds with “maggots” . . too in last century.

Wound healing with Sugar and Honey

Sugar and honey were effectively used in treating “specific” types of wounds in the past. Now it’s important to understand that they’re not helpful in treating every wound so don’t start pouring them on your wounds right now, stop, just keep them aside, don’t be the quake and go discuss with your doctor!

How does honey and sugar work in wound healing?

When they work, they’re considered to work through applying the osmotic pressure, making the wound bed dry and thus sort of disabling the bacterial life cycle. This also enhances the wound healing by pulling the nutrients out of the blood stream probably due to osmotic pressure, and by providing carbohydrates and energy directly at the wound site, obviously (last two are my own proposed phenomenon, let me know if you have anything against them).

Which type of wounds sugar and honey can heal?

Well we need to study more about them, as the authentic books and libraries were burnt by our fellow crusaders long ago, there’s no exact science known to us anymore. So until I’m sure enough, I won’t be commenting here about them though.

But why are European / British surgeons are using them again?

Because British and European surgeons originated from barbers (yes you read it right) so they don’t have that sense of responsibility and science as such. It’s good to avoid the ones who’re not able to explain what they’re doing scientifically and through source, specially the ones who prefer calling themselves Mister, and not doctors (not all though, some might just be doing so for a custom only, that barbers in Europe were called Mr., not Dr.)

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Winging of Scapula Thu, 13 Nov 2014 11:26:30 +0000 A winged scapula is also called scapula alata. This is a condition in which the shoulder blade formed by shoulder bones media end protrudes in an abnormal shape and position on persons back. The abnormal scapula gives the shape of a wing and thus called winged scapula.

This condition can be caused due to damage to several nerves or muscles. This posture can be normal in young children, but not in older children or adults.

Causes of Winging of Scapula

Winging of scapula can be due to:

  • Serratus anterior paralysis. This can be due to the damage to long thoracic nerve which supplies the serratus anterior muscle, located on the side of the thorax and acts by pulling the scapula forward. This injury to the long thoracic nerve can be either traumatic, non-traumatic or idiopathic
  • Trapezius and rhomboid palsy can also lead to winging of scapula in less common cases. The injury can be directly to the muscles involved or the nerves supplying them namely: accessory nerve and dorsal scapular nerve, respectively for both muscles.

The damage to the nerve or muscles causing winged scapula can be due to some injury due to blunt trauma or any surgical procedure.

Signs and Symptoms of Winged Scapula

The clinical presentation of winged scapula can vary depending upon the muscles and/or nerves involved. Pain isn’t present in all cases, however fatigue is common along with limitations of daily activities of the patient.

winging of scapula

There is clear deformity of back, specially in serratus anterior muscle involvement. While trying to contract the muscle it might clearly wing the scapula. This can be demonstrated by asking the patient to push against a resistance, such as a wall.

The patient might have limited ability to lift the arm above their head due to impairment of the movements involving scapula and scapular muscles.

Treatment of Winging of Scapula

Physiotherapy (physical therapy) is one of many treatments available for winging of the scapula, specially if there is weakness of the glenohumeral joint muscles. However if the physiotherapy fails in making the muscles strong enough to contract clinically and symptoms persists after 3-6 months of treatment, surgery is considered to be the next choice in correcting the condition.

Surgical fixation of the scapula is done for those who have isolated scapular winging. Other options include neurolysis, intercostal nerve transfer, scapulothoracic fusion, artherodesis or scapulothoracis fixation without arthrodesis.

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Scientific Weightloss Tips Tue, 11 Nov 2014 04:03:57 +0000 Every day a new brand or supplement is publicized on TV claiming to be the best possible weight loss technique. Most of them are 100% in effective. Even worse, some of them are even harmful to our bodies. It’s important to fully understand the mechanism by which any supplement or technique is going to work on your body to rely on it. Lets checkout some of the well known techniques for weight loss, well tested and confirmed by science.

scientific weightloss

Exercise and weight loss

There is no second opinion about it. Exercise is that magic technique which you were always looking for to lose weight!

In fact exercise can be the difference between being the sick, skinny slim and the healthy, powerful smart body.

Our bodies are made for exercise. Whole of our body is covered with numerous muscles and such an amazing musculoskeletal system. God must have provided it for some reason right?

Exercise forcing fats metabolism

During exercise, our body uses all the readily available energy in blood and local tissues. Glucose is the most readily available energy source in our body. During exercise the glucose is quickly utilized, forcing body to use the alternate energy sources available.

Now the muscles shift towards using the glycogen. Glycogen is stored in muscles as well as the liver. During exercise, this glycogen is used and depleted. It’s important to deplete this glycogen to start the real weight loss process.

Now when the glycogen is no more, body moves towards using fats. It’s important to note that once glycogen is depleted, our body energy levels go down, so we might be urged to stop, but this is the critical moment when exercise will actually burn the fats!

Even if you stop exercising, the body will burn fats, how? Well even at rest our body needs energy. After exercise, as you’ve depleted all other energy sources in it, it will ultimately use fats in the body for routine tasks too, including simply survival during sleep.

Exercise and Insulin

Insulin has a very major role in our body. It’s not only the diabetic patients who’re to worry about it!

What insulin does is, once we eat some high energy food, like food high in carbohydrates for example and sweets, insulin pushes this high energy food into the storage cells, fat cells mostly. Which means insulin is directly related to fat production. So we can either get our pancreas removed, which will lead to other issues, so not recommended -_-, or else we can simply avoid foods which release insulin! Ya! That seems simple right?

Now insulin not only moves the energy containing nutrients into the fats, but also in muscles. But during exercise, due to some magical changes, the body don’t need insulin to let muscles take up the glucose and other energy resources. What’s the benefit? Well it prevents the undesired storage of energy in fats during normal times. As there is no demand for the muscles for insulin, it will be released in lesser amounts, thus reducing fat production. Secondly, as muscles will use almost all the available carbohydrates and energy resources, there won’t be enough left in blood to require insulin and to side line it into the fats! Simple right?

Exercise causes weight loss even after we stop

Exercise induces the changes in the body due to which the body keeps losing weight even after the exercise session! What a relief, lose weight even at rest and while sleeping! Just after exercise!

Exercise and muscles formation

Simple enough, exercise promotes muscles development, which not only makes your body more gorgeous, but also utilizes a lot of bodily resources, again utilizing the energy available to be stored as excess fat!

Weight loss and breakfast

Now there is a huge difference between dieting and starvation. In diet, breakfast is important, just as exercise before breakfast is!

If you’re skipping the breakfast, you’re doing it wrong probably. Now it doesn’t mean you should eat halwa pori and nan cholay or paay in the breakfast. What it simply means is that there should be something going inside your body during the breakfast.

During diet e.g., you should take only boiled egg white, skimmed milk without sugar, etc.

As normal people don’t eat when they sleep, this makes 8 hours of no food intake, now combine it with skipping breakfast, going up to lunch e.g., it means almost 14+ hours of starvation everyday, which are quite enough to push the body into the starvation mode! So avoid doing this at all cost!

Proteins and weight loss

Well whatever you eat is probably energy and may lead to weight gain, correct, but if taken correctly, it will result in weight loss, and sometimes if there is no weight loss apparently, it might still be getting your body on the healthier side.

Proteins are helpful in weight loss. They release lesser amounts of insulin and mostly used in building our body tissues.

Now it doesn’t mean that you can eat proteins all day long. Excess of any energy resource will ultimately trigger the fat storage pathways and it will be stored. Keep an eye on your calories count too!

Water and weight loss

Water is the essential item in daily diet. We often overlook it. Although the logics that taking cold water will use body energy in warming in up are weird and I pray that people doing so grow up soon, but other than that water is needed by our body to maintain homeostasis.

Water helps clean all the excess debris and bad chemicals from our body, specially during dieting and exercise. It helps reduce load from the kidneys, otherwise the wastes to be removed would sort of clog our kidneys!


Herbs, chemicals, this that bla bla, there’s a lot around about weight loss. Some of might really be helpful too and we discuss that too, but these days media is so blind that they’re promoting anything that pays them to advertise, without understanding the truth about them and the possible outcomes.

Please be wise and use only the recommended methods of losing weight. Nothing beats exercise, add healthy diet with it which is not artificially manufactured and you’re on your way to healthy living!

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Reasons why Dettol is bad for health Sun, 19 Oct 2014 21:16:09 +0000 Dettol is a brand since 1950’s. Their product line includes a number of items they call hygiene products.

It’s a common myth that killing all the bacteria around you is good for your health. I don’t understand why humans are so fond of killing everything around them, including other humans too.

No, killing bacteria all around you isn’t safe and isn’t recommended at all. Why? Because every bacteria has a function and when you kill or destroy them, who’s gonna do that function for you? Your grandma? I don’t think so!

My friend who is addicted to Dettol

I won’t take the name though, but let me quote her words:

I wish I could drink Dettol too

Yes please continue! Who’s stopping you huh? So it adds to our list that humans want to kill everything, themselves too!

She is addicted to the phenomenon of being “Clean” with Dettol and not to mention, it’s smell and fumes are addicting to her too!

The bacteria on our skin are not bad for us? Really?

Well yes, really, except if you’ve just got your hand out of the sewerage line. Under normal conditions, our body is covered with bacteria. These bacteria are in harmony with our body and our body has effective resistance to them. They live there, they breed there, they die there and the cycle continues, and we remain protected from them in the safe way.

Why killing bacteria on your skin is bad for health

harmful effects of dettolSo after reading the paragraph above, someone might ask, they’re living on our skin for free, why not to kill them? Huh?

Sounds similar? The same logic why one country kills others? And it’s own minorities too? Well let me explain how killing those “Free” livers can be harmful for your health, and why letting them live there is safer.

Lets image your skin is a table, on which a lot of bacteria are placed. Now these are the “normal” bacteria that are living there for ages and haven’t killed you yet.

Now imagine that the “harmful” and killing bacteria are flying in the air and roaming around. As they are scattered in the air they sometimes come to the table, try to adjust, but despite being “powerful” they don’t get the place to sit on the table. It’s not that they’re weak or the bacteria already on the table are strong, it’s simply that the harmful ones aren’t finding any place to settle there!

Now imagine, you being a human and having human mentality of killing everyone, just everyone, kill those free livers on the table. What happens now, the “harmful” bacteria flying around in the air get a place to sit, on the empty table! Now they will be there yelling! “yay! We discovered this land” (not like Columbus discovered America, where already people lived :/ weird!) Now they will live there, they will breed there, and as they’re harmful, they will do their harm there! They will do the damage and disease process that they’re capable of.

Why can they cause the disease when the previous ones couldn’t? Well how innocent question it is J your body had developed resistance for the earlier ones for ages and was in harmony with them, but these are unknown to your defense mechanism. Plus they’re already powerful ones, so more dangerous than the ones that were living on your skin before.

Conclusion – don’t use dettol uselessly:

Well conclusion is, stop infecting yourself with dangerous bacteria and germs for which your body isn’t prepared at all! Stop following the media and ads that tell you to kill every single bacteria in and outside of your body. So that they can sell their other brand, yes medicines and supplements to counter the harmful affects caused by their own soaps and products!

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How head & shoulders CAUSES dandruff Sun, 19 Oct 2014 16:38:41 +0000 So you’ve been using head and shoulders shampoo since childhood, it works amazing fine on your head, but only until you keep using it! :O oh!

Couple of years back I was wondering, I have dandruff, my brother have dandruff, everyone of our generation have dandruff, but the ones elder to us had less of it, the grand elders had even less! So there’s something wrong going on!

why not to use head and shouldersMy guess at that time was that we might be using some product that’s leading to all this. This could be the branded milks, breads, white eggs, bla bla! Don’t know.

But recently I’ve come to a sort of conclusion that the anti dandruff shampoos might be the cause themselves for causing dandruff! Please note that I’m open to discussion and opinions on this idea but with some proper logic or explanation only.

What exactly anti dandruff shampoo do?

Certain organisms or “germs” on your skin of the head cause dandruff. What anti dandruff shampoo does is that they kill those germs and thus the dandruff production stops on your head.

Now there are two situations. One is the patient who has dandruff and needs to get rid of it. For them we can consider for now that well, anti dandruff shampoos are fine to go for! But then there is another category of people who don’t have dandruff but end up using those products because either someone else in their home uses it and it’s found in their washrooms shelf, or else just because of the ads and media they end up using them.

So what happens is, that the “normal” bacteria and germs which their body has become used to and resistant with get killed. So what? So this that the place is empty for opportunistic organisms to take over there and cause trouble. Specially fungi (often leading to sebhorrhic dermatitis).

Solution – don’t use head and shoulders uselessly?

We take bath and wash ourselves to clean ourselves from dirt and debris. Do that only. Stop the habit of killing everything around. Use the products which are not medicinal like head and shoulders!


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Fat below Umbilicus Tue, 16 Sep 2014 16:35:59 +0000 This post focuses on how to get rid of fat below umbilicus. A friend of mine requested that she had got excessive fat below belly button after the cesarian section for her last child birth. Although her overall weight is normal and bmi is in control, but her body is out of shape.

fat below umbilicusFirst of all its important to note that being over weight and being out of shape are although related, but still two entirely different things. So you don’t just have to lose weight but you have to get in a toned up and perfect body shape too after losing weight.

Check your bmi to check if you fall in normal body mass index. (19-25 is normal, try to be near 22.5). If your bmi is more than 25 then you need to focus on weight loss too, however if you’re not over weight then focus will have to be on exercise mainly. This doesn’t mean diet will be out of the scene, rather diet will be just modified to make it healthy but now crafted for weight loss during the toning up process.

Exercises to lose below umbilicus fat

It’s important to understand that fat loss isn’t local. I.e you can’t get rid of fat under the umbilicus directly and specifically just by doing some exercise involving muscles of that area. Although toning up might make it “look like” as if local fat has gone but that’t not the case.

So first let me enlist regular exercises for overall body fitness and toning up which help alot to tone up the belly (above and below umbilicus both):

  1. Jogging (at least 30 minutes)
  2. Pushups – yes pushups not only train your arms, shoulders and chest, but have a great, very great affect on your belly muscles.
  3. Pull ups / chin ups – they have a very strong affect in toning up your belly anteriorly, sides and back too, giving it the required shape and tone.
  4. Abdominals / sit ups (now this includes a set of many different types of exercises for lower and internal abdominal muscles specially)

Notice that I have mentioned abdominals / sit ups in the end of the list. This is for the reason that abdominals have minimum affect on toning up the muscles, at least initially. They are helpful specially once you have six packs visible and want to fine tune them.

One good abdominal exercise is straight leg rising and flapping like in swimming. Or you can go for swimming that will not just helpful in toning up the belly but you won’t be bored too!

Jogging reduces your belly, lower belly, hips and thighs, all. It’s one exercise thats great to just keep all your body fat in control. It beings the overall weight loss and toning up mechanism in your body and leads to many chemical changes in the body.

Pushup and pullups being related to abdomen and belly fat seem strange to some people but it’s not. They’re related quite simply due to how muscles are attached to each other and how body works.

It’s necessary to keep your body shape in proportion. So if one part hangs out, like lower belly fat, under the belly button, it seems quite odd. Hopefully these tips and exercises will help you get back in shape and getting rid of your fat below umbilicus.

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Anti-angiogenesis and weight loss Thu, 14 Aug 2014 02:03:37 +0000 There have been alot of studies going on in past decades related to the association of angiogenesis with cancers. During the research, one thing more has emerged that angiogenesis / anti-angiogenesis is not just related to cancer cells, but the anti-angiogenesis factors are also responsible for weight loss.

There are two types of anti angiogenesis factors, exogenous and endogenous.

Endogenous anti-angiogenesis factors

Endogenous factors performing anti-angiogenesis duty are the ones formed by the tissues inside the body.They’re normally formed along with the angiogenesis factors by normal cells of the body too to maintain normal body growth and to maintain homeostasis.

Exogenous anti-angiogenesis factors

Exogenous anti-angiogenesis factors are those which are acquired by the body from outside. These consist of two types of substances, drugs / medicines and food components with anti-angiogenic properties.

We will not discuss the medicines with anti-angiogenic effects here due to several reasons including their harmful effects (most if not all) and the potential of misuse.

Foods with anti-angiogenesis capability

Food components commonly found around us have very potent anti-angiogenesis properties. They’re mostly the ones which are considered otherwise healthy by most cultures but overlooked by the so called “educated” youth. Some of them are so potent that they can even cause severe weightloss.

These food components were originally studied to cure cancers with food. However their potent weight loss (as a side effect as a matter of fact) has made them important for weight loss purposes too.

It’s important to take them in normal quantities and have good exercise with diet and routine to keep the body in good health and shape.

Common foods and herbs with anti-angiogenesis capabilities and ability to induce weight loss are:anti-angiogenesis weight loss

  • Green tea
  • Strawberries
  • Blackberries
  • Raspberries
  • Blueberries
  • Red grapes
  • Bok Choy
  • Kale
  • Oranges
  • Grapefruit
  • Lemons
  • Pineapple
  • Apples
  • Cherries
  • Artichokes
  • Nutmeg
  • Turmeric
  • Soy beans
  • Ginseng
  • Mitake mushroom
  • Lavender
  • Pumpkin
  • Parsley
  • Garlic
  • Sea cucumber
  • Tuna
  • Olive oil
  • tomato
  • Grape seed oil
  • Dark chocolate

The list is exhaustive and continues! the items found in the list can be seen, they’re commonly found around us and some of them are in our kitchen on daily basis too, but missed and left considering them too sour or tasteless sometimes (most of them, some are tasty too!)

The list above is with reference to Dr Williams list of naturally occurring anti-angiogenic substances which he presented in TEDTalk.

While using these weight loss magic foods, the craving and appetite don’t increase and infact gets controlled. They’re all natural and thus obviously safe to use on daily basis. You can simply make them integral part of your favorite recipes!

Combing the healthy eating along with these wonderful anti-angiogenesis foods combined with proper and regular exercise will give fast and long lasting results of weight loss. The long list of food items will help fat people to rotate the items to eat, thus preventing the frustration and boredom of not being able to have variety in meals.

What’s are your favorite natural anti-angiogenesis food substances which you use for weight loss ? also share your favorite recipes with these ingredients!

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Diet for Ramadan to lose weight Tue, 01 Jul 2014 19:49:16 +0000 Ramadan is here again in 2014 ! First of all Ramadan Kareem to everyone specially all the Muslims around the world. May this month bring blessings and forgiveness to you and your family. ramadan dietRamadan is a month in which one can either gain weight or lose weight, depending upon how you utilize it and what you eat, other than your prayers :) In this post, I’ll be sharing my expected general routine for the month of Ramadan. Please note, it’s general routine, not a strict one, you can alter it depending upon your own situations. My aim for diet is to lose around 5-10 kg this month. Also note, mild exercise as discussed in the end is also important but you can alter it a bit from what I’m doing. Diet Sehri for Ramadan: The diet which I’m taking this Ramadan in Sehri is as follows:

  • Namkeen Lassi (salted) 2-3 glass. (although I’m not having sugar free yoghurt, having natural yoghurt, but you can have sugar free one to have more weight loss effect). Lassi helps you fight thirst during the day when you are Fasting :)
  • 2 boiled egg whites (no egg yolk) You can have any other protein if you like.
  • Half to full chapati / bread. You can also have bran bread for added weight loss.
  • Lots and lots of water.

Diet Aftari for Ramadan:

  • Khajoor / Dates (2-3)
  • Salted Lemon water (2-3 glass)
  • Fruit (melon or so, not mangoes ofcourse!)

After Aftari take a break, goto mosque for prayers, come back and have normal dinner which you will have otherwise or diet one. Exercise during Ramadan: Do some what exercise before Aftari. But not very strenuous, just casual exercise. Have some exercise after Aftari but before the dinner meal.

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