Internal Medicine

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Most people infected with the virus will experience mild to moderate respiratory illness and recover without requiring special treatment. However, some will become seriously ill and require medical attention. Older people and those with underlying medical conditions like cardiovascular disease, diabetes, chronic respiratory disease, or cancer are more likely to develop serious illnesses. Anyone can get sick with COVID-19 and become seriously ill or die at any age.

The best way to prevent and slow down transmission is to be well informed about the disease and how the virus spreads. Protect yourself and others from infection by staying at least 1 meter apart from others, wearing a properly fitted mask, and washing your hands or using an alcohol-based rub frequently. Get vaccinated when it’s your turn and follow local guidance.

Infections involving the upper respiratory tract (ears, nose, throat, and sinuses) or lower respiratory tract (trachea, bronchial tubes, and lungs), are usually caused by a virus. Symptoms vary depending on which systems are affected. Antibiotics are necessary only if there is a secondary bacterial infection.

A chronic disease that affects the airways. In people with asthma, the airways are inflamed and sensitive to allergens or irritants. During an asthma attack, the airways get narrower, and less air flows to the lungs, causing symptoms like wheezing, coughing, chest tightness, and difficulty breathing. Asthma can be managed by avoiding things that bring on asthma symptoms and by taking medication to control symptoms and prevent attacks.

Inflammation of the airways that may be acute (short-term) or chronic (long-term). Acute bronchitis usually follows a viral respiratory infection. Chronic bronchitis is usually caused by smoking. Treatment depends on the type and duration of bronchitis. For acute bronchitis, simple measures include resting, drinking fluids, taking aspirin or Tylenol to reduce a fever, and using a humidifier. For chronic bronchitis, inhaled medicines may be needed to open the airways and clear mucus. Other drugs may be prescribed to treat an infection or reduce inflammation. Sometimes, home oxygen is required to treat low oxygen levels in the blood.

Severe, sudden chest pain- especially if it is accompanied by pain in the left upper arm, sweating, nausea, or severe shortness of breath- requires immediate medical attention, as it may indicate a heart attack. Other causes of acute chest pain include pneumonia, bronchitis, gastritis, esophagitis, and asthma. Chronic chest pain can arise from many causes, including angina, hiatal hernia, gallbladder disease, ulcers, and chronic bronchitis. Internal Medicine physicians are skilled in determining the source of chronic chest pain and prescribing therapies to address the underlying cause or alleviate the symptoms.

These are both lipid disorders in which the blood is carrying excess fatty substances. Lipid disorders increase the risk of heart attack and stroke. Treatment may involve a low-fat diet, exercise, and weight loss. Medication may be required to reduce LDL cholesterol (“bad” cholesterol) and/or triglycerides to safe levels. Drugs may also be prescribed to raise HDL cholesterol (“good” cholesterol).

Hypertension is defined as systolic blood pressure (the “top” number) over 140 mm Hg or diastolic blood pressure (the “bottom” number) over 90 mm Hg. While hypertension usually has no symptoms, treating it is important to reduce the risk of heart attack, stroke, kidney disease, and other serious conditions. Treatment may include dietary changes, exercise, weight loss, smoking cessation, and medication.

Lack of energy is a common symptom with many possible causes, including anemia, sleep disorders, an underactive thyroid gland, and depression. Fatigue may also accompany other illnesses, including diabetes, congestive heart failure, and mononucleosis. In some cases, fatigue is a symptom of chronic fatigue syndrome, a condition that begins with a flu-like system but persists for six months or longer. A physical examination, medical history, and blood tests may be recommended to determine the underlying cause of persistent fatigue.

An underactive thyroid gland. The thyroid gland regulates the body’s energy through thyroid hormones called T3 and T4. When the thyroid gland does not produce enough of these hormones, the body’s metabolism slows down. Symptoms include weight gain, tiredness, forgetfulness, dry skin and hair, and inability to stay warm. Hypothyroidism can be diagnosed with a simple blood test. The best thyroid doctor treats it with medication to restore adequate hormone levels.

A contagious respiratory illness caused by a virus. Symptoms include fever, headache, dry cough, sore throat, runny or stuffy nose, muscle aches, tiredness, and stomach symptoms. Complications of the flu can be very serious, including pneumonia, dehydration, and worsening of chronic medical conditions. The best way to prevent the flu is to be vaccinated in the fall.

Severe, often disabling headache. In some cases, a migraine is preceded by a warning sign (aura) such as flashes of light or a blind spot. In addition to intense pain, a migraine may cause nausea, vomiting, and extreme sensitivity to light and sound. There is no cure for migraines, but the frequency and severity of migraines can be reduced with medication.

Loss of bone density and thinning of bone tissue, resulting in fragile bones and an increased risk of fractures. Osteoporosis becomes more common with age, and it is more common in women than in men. The risk of osteoporosis increases for women after menopause when estrogen levels drop. Osteoporosis usually has no symptoms, but it can be diagnosed easily with a bone mineral density test called dual-energy x-ray absorptiometry (DEXA). Drugs for osteoporosis can prevent or slow the rate of bone loss and reduce the risk of fractures.

Inflammation of the lungs is caused by infection with bacteria, viruses, or other organisms. Pneumonia is most likely to occur when a person’s defenses are weakened by an upper respiratory infection or influenza. Symptoms include cough, fever, chills, chest pain, shallow breathing, and shortness of breath. Pneumococcal vaccine prevents the most common type of pneumonia and is recommended for adults aged 65 or older and people with heart disease, lung disease, kidney disease, and other conditions that increase vulnerability to pneumonia.

It is an infection caused by a virus. You can get it if an infected mosquito bites you. Dengue does not spread from person to person. It is common in warm, wet areas of the world. Outbreaks occur in the rainy season. Symptoms include a high fever, headaches, joint and muscle pain, vomiting, and a rash. In some cases, dengue turns into dengue hemorrhagic fever, which causes bleeding from your nose, gums, or under your skin. It can also become dengue shock syndrome, which causes massive bleeding and shock. These forms of dengue are life-threatening The definite diagnosis should be based on immunodiagnosis or viral study. Focusing on treatment, symptomatic and supportive treatment is the main therapeutic approach.

Many bleeding disorders require accurate diagnosis & treatment.

• Hemophilia: It is an inherited bleeding disorder due to deficiency of clotting factor VIII (Hemophilia A), IX (Hemophilia B). It is manifested by males & females are the carrier. Symptoms include bruising even from small accidents, hematoma, easy bleeding from nose, mouth, gums & minor injury, hemarthrosis (bleeding into joints) which can cause pain, immobility & deformity. It is diagnosed by measuring serum coagulation profile, genetic testing, and family history. This disorder is treated by transfusing Factor VIII or IX, blood transfusion. Severe cases with complications may require surgery, immobilization, rehabilitation of the affected joint with physical therapy & exercise. The complication of this disorder can be prevented by maintaining clotting factor levels in the blood, avoiding anticoagulants, intramuscular injections.
• Idiopathic Thrombocytopenic Purpura: It is an automatic disorder that causes a decrease in the number of platelets in the blood. In most cases, the cause is idiopathic but may follow a common viral illness. It is manifested by purpura, bruising, petechia, epistasis, uncontrolled bleeding. It is diagnosed by CBC, PBF & bone marrow aspiration. This disorder is treated with IV Immunoglobin & steroids, splenectomy.
• Leukemia: Leukemia is an increase in immature white blood cells in the bone marrow and compromises the production of other cell lineages. There are different types of leukemia like acute lymphoblastic leukemia, acute myeloid leukemia, chronic lymphocytic leukemia. It is diagnosed with the help of PBF & bone marrow examination. It is treated by chemotherapy, radiotherapy, targeted therapy by medicines, Immunotherapy & supportive care.
• Thrombocytopenia: It is a decrease in platelets in the blood. It is either due to increased destruction (ITP, post-transfusion purpura, Drug-induced), decreased production (Aplastic anemia, Myelodysplasia, HIV, Dengue, Scrub). Platelets are transfused via either random donor or single donor platelet in high-risk cases of bleeding.