Hello Doc,

As you must be knowing, Heart attack also called as Myocardial infarction is due to a coronary thrombus or a blood clot in lay man terms which does originate in few minutes obstructs the blood supply in any coronary artery to the myocardium. This whole scene can stretch for about 6 to 10 hours where the myocardium cries out for blood supply creating Angina. If the blood supply reaches the Myocardium in time, the cardiac muscle is saved, if not, the heart muscle is damaged leading to reduction in EF.

The risk factors involved in coronary thrombus initiation include smoking, diabetes mellitus, hypertension, hyperlipidemia, stress, and family history of atherosclerosis. A fissure in the atherosclerotic patch can lead to bleeding and thus form a thrombus.

As you know CABG and PTCA are revascularization therapies for Atherosclerosis and dont reduce even a single percent chance of future MI. Click this link to understand more from Harvard university What can Angioplasty do for you?

If you want to understand about What are the chances of Heart attack after Angioplasty…. Read COURAGE trial where 2 groups of 1000 patients each, were compared with each other. One group underwent only medical management and other underwent Angioplasty. At the end of 4.6 years, death rate due to MI was 18.5% in medical group and 19% in Angioplasty group.

Is Angioplasty better than Medical therapy? Click this link for COURAGE trial.

I hope this answers your question.

Hello Doc,

The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement.

People who’ve had prolonged immobility or reduced mobility of the shoulder are at higher risk of developing frozen shoulder. Though Diabetes can be the major reason for it, frozen shoulder may be the result of many factors, including:

• Rotator cuff injury
• Broken arm
• Stroke
• Recovery from surgery
• Diabetes
• Overactive thyroid (hyperthyroidism)
• Underactive thyroid (hypothyroidism)
• Cardiovascular disease
• Tuberculosis
• Parkinson’s disease and many more unknown factors.

Now question arises, how to treat Frozen shoulder patients?

Active exercises related to the ligaments, muscles and capsule of the shoulder joint can be the best effective mode to treat Frozen shoulder. You can prescribe the 90 days Frozen shoulder care plan in the MIB Pulse application. Patient has to go to his Pulse application, pay online in the app itself and his exercise plan begins after 24 hours of payment. Everyday patient has to spend only 30 to 45 minutes on this Pulse app to perform exercise, watching the online exercise videos. Believe me, they are very effective.

I have prescribed it to several of my patients, its comfortable and convenient for the patients to perform exercises at their home for short duration everyday. Patients can experience improvement in his range of mobility of his shoulder joint from the 7th day itself. In a months time, the ROM of shoulder joint has been seen to improve drastically.

If required, additional medicines can be prescribed to reduce down the inflammation around the joint.

All the best!