Miracle cures – 1

Some of the diseases that present to us have instant cures. These pleasantly surprise the patient in that, it almost looks like magic, while it is just science.Hypoglycemia – this is one of the commonest presentation for magical cures. Diabetic brought in altered sensorium, sometimes unconscious, blood sugar shows sugar of 35 or 40mg/dL. (If sugars are high the patient is in trouble – something more sinister may be a hyperglycemic coma maybe a stroke) Give 25% Dextrose, within a few seconds, patient opens his eyes and in a few minutes wants to know how he landed up in the hospital. The lowest sugar i have seen in an adult is 22mg/dL. The only thing that should not be forgotten is renal and hepatic insufficiency other than oral hypoglycemic over dosages. The hepatic cause, i will never forget because once i saw a diabetic with recurrent hypoglycemia with biochemically normal liver and renal functions. On his third admission for hypoglycemia, there was a just palpable liver and an ultrasound showed a tumor. So that tumor – whatever – primary hepatoma or secondaries was preventing compensatory gluco-neo-genesis and was causing recurrent hypoglycemia.

The second condition that lends itself for miracle cure is hypokalemia. Suspected when patient presents with sudden onset quadri-paresis. It does not hurt to do a serum Potassium, if facility is available. A Ringer lactate infusion makes the quadri-paresis disappear. If it does not, patient is going to be in trouble – maybe an Acute inflammatory Demyelinating Polyneuropathy. And of course we should never forget to do a thyroid function to rule-out thyroid disease.

Drug-induced extra-pyramidal syndrome with bizarre, abnormal movements of face relieved by an intra-venous dose of Pheniramine maleate does give immediate relief to all parties involved- the patient, attendees and the doctor who gave the anti-emetic which precipitated the symptoms

Hysterical disorders with dramatic symptoms of unconsciousness, aphasia, “status epilepticus” and what not gets cured with a whiff of spirit of ammonia.

Seizures stop with an intravenous dose of Phenytoin most of the time but the recovery of consciousness is not as rapid and hence does not lend itself to dramatization.

i am sure injection of Flumazenil for benzodiazepine over dosage, or relief of myasthenic symptoms by a small dose of intra-venous edrophonium gives as much dramatic results. But i have never seen these being done.

As i remember more of them i am going to add those in a different post.

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