Sir, I am 67 years old heart patient and was operated for cabg from escorts heart institute and research centre, new delhi in 2002. After this heart by-pass operation, I am perfectly fine in health. I am doing morning walk 6 km and evening 4 km without any rest regularly and also doing physical exercise, as and when needed and not having any sort of addiction habits, with no any breathing problem. I am diabetic since about 2 years back for which I wanted to have nature cure treatment, for which concerned nature cure hospital, desired my 2d echo report and the same was done on 19.03. 2015 from hero dmc heart institute, ludhiana. From the observations of 2d echo report, my lvef was observed 45% (50-80%) (mod. Simpson) which has put my mind on full tension due to some abnormal report. I visited fortis escorts heart institute, new delhi on 9.5. 2015 and had dobutamine- stress echo test, my particulars are as under: name of patient devinder kumar age 67 years. Gender male date of birth 20/12/1947. Height 5 ft 8 inch. Weight 83 kg. Blood group b + positive current medical problem as regards heart, I have no physical problem but since the observation of 2d echo report my lvef is below the normal range, which is causing full tension/feeling risk for life. Other diagnosed medical problems. 2nd problem is diabetic for which I am taking treatment. My main anxiety is:- whether my lvef will improve with medicines, or will remain as is and the medicines so prescribed will continue permanently and in this case the medicines may kindly be preslvef is below the normal range,cribed, earlier medicines taken by me are not reliable. Whether morning/evening walk/exercise is permitted or to be avoided? any risk/precautions? as mentioned in escorts heart institute dobutamine- stress ehco report: ------- lvef 45% at baseline and lvef 52% at peak dose needs clarification. Impression: dobutamine stress echo test is negative for reversible myocardial ischaemia may kindly be clarified please. Any surgery or other procedure recommended. In view of latest dobutamine-stress echo I want to seek fresh prescription from your side, which will improve my lvef, for which I fully hope that I will be fully helped and I convey my thanks for this act of kindness. Present medicines taken by me are not reliable. With deepest regards, yours sincerely.
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In some cases, repeated examination and screening yield no positive results, yet the patient still complains of vaginal discharge. It is then appropriate to explore with the patient the nature of the discharge and relate this to normal physiological discharge, to review personal hygiene habits (advise to avoid douches, perfumed products and tight synthetic clothing) and to explore the possibility of the hidden complaint, such as depression, anxiety or psychosexual dysfunction. Graphotes - profuse, thin, white mucous discharge which comes in gushes with associated back and lower abdominal pain, discharge is more profuse in the morning on rising, constantly cold.
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