Dr Sk Sabir Rahaman – General Physician & Diabetologist in Kolkata

By Dr. Sk Sabir Rahaman, MBBS , MD (Pharmacology), DFM(Family Medicine), FCFM, CCEBDM, CCLSD     🩺 What is Polypharmacy? Polypharmacy means the use of multiple medications by a single patient — including prescription drugs, over-the-counter medicines, and even herbal/home remedies . WHO definition: Use of “many drugs” or an “excessive number” of medications. Numerical definition: Most commonly, ≥5 concurrent medicines . 👉 While sometimes necessary, polypharmacy can become irrational and harmful if not carefully monitored. 👴 Who is Most Affected? The elderly are at highest risk due to: Multiple chronic diseases (DM, HTN, CAD, hypothyroidism, arthritis) Multiple specialists prescribing without coordination Age-related changes in how drugs are absorbed, metabolized, and eliminated ⚠️ Why Does Polypharmacy Happen? Cause Description Multimorbidity One patient, many diseases → many drugs Prescriber-related Inappropriate initiation, no periodic revi...

By Dr. Sk Sabir Rahaman, MBBS , MD (Pharmacology), DFM(Family Medicine), FCFM, CCEBDM, CCLSD     🌍 What Are Rare Diseases? Rare diseases affect only a small portion of the population but are often chronic, debilitating, and life-threatening . Definitions Around the World: WHO: ≤ 1 in 1000 people USA (FDA): < 200,000 individuals EU (EMA): ≤ 5 in 10,000 people Japan: < 50,000 patients India (NDCT Rules, 2019): ≤ 5 lakh persons 👉 Around 6000–8000 rare diseases exist, but 80% of cases come from just 350 diseases . Examples: Genetic: Cystic fibrosis, Huntington’s disease, Wilson’s disease Infectious: Leishmaniasis, Cryptococcal meningitis Neuromuscular: ALS, Duchenne muscular dystrophy 💊 What Are Orphan Drugs? An orphan drug is developed to treat rare diseases. India (NDCT 2019): For conditions affecting ≤ 5 lakh people USA (FDA): For diseases affecting < 200,000 people OR where sales won’t recover development costs ...

By Dr. Sk Sabir Rahaman, MBBS , MD (Pharmacology), DFM(Family Medicine), FCFM, CCEBDM, CCLSD     📝 What is Off-Label Use? Off-label drug use means prescribing a medicine in a way not officially approved by regulatory authorities . This can include: Using it for a different disease/condition Prescribing to a different age group (e.g., children) Giving it at a different dose Administering by a different route 👉 Example: Propranolol (approved for hypertension) is often used off-label for performance anxiety . ⚖️ Important: Off-label ≠ Illegal. It is a medically accepted practice in many countries, but it must be backed by scientific evidence and sound clinical judgment . 🎯 Why is Off-Label Use Important? Doctors turn to off-label use when: Standard treatments are ineffective, unavailable, or unsuitable. The disease is rare or has no approved drug options. Special groups (children, elderly, cancer patients) need alternatives. Most common in: ...

By Dr. Sk Sabir Rahaman, MBBS , MD (Pharmacology), DFM(Family Medicine), FCFM, CCEBDM, CCLSD       For rural healthcare workers, first responders, and clinicians in resource-limited settings, snakebite diagnosis often relies on simple, life-saving tools. The 20-Minute Whole Blood Clotting Test (20WBCT) is one such test — quick, cheap, and potentially lifesaving in detecting venom-induced coagulopathy . 1️⃣ What is the 20WBCT? The 20WBCT is a rapid bedside test that checks if whole blood clots within 20 minutes. Why it matters: Detects Venom-Induced Consumption Coagulopathy (VICC) caused by viper and some Australasian elapid venoms. In these bites, procoagulant toxins consume clotting factors, leading to dangerous bleeding risks. It’s often the only practical coagulation test available in rural settings before bleeding complications appear. 2️⃣ When is it Used? Indications: Suspected viper envenomation (Russell’s viper, saw-scaled viper, pit vipe...

By Dr. Sk Sabir Rahaman, MBBS , MD (Pharmacology), DFM(Family Medicine), FCFM, CCEBDM, CCLSD     Diabetes doesn’t just affect your blood sugar—it can also silently damage your eyes. Diabetic retinopathy (DR) is one of the leading causes of vision loss among working-age adults, and in India, the numbers are alarming. 📊 The Scale of the Problem India is home to one of the largest diabetic populations in the world— projected to reach 125 million by 2045 . As diabetes cases rise, so will diabetic retinopathy and related vision problems. Many cases of diabetes remain undiagnosed , increasing the risk of irreversible vision damage. 🩺 Risk Factors and Findings The SMART-India study highlighted key risk factors for vision loss among diabetics, including: Long-standing diabetes Poor blood sugar control Co-existing conditions like hypertension Presence of cataracts , which are more common in diabetics and can further obscure retinal assessment. 🔍 The...

By Dr. Sk Sabir Rahaman, MBBS , MD (Pharmacology), DFM(Family Medicine), FCFM, CCEBDM, CCLSD     When it comes to managing diabetes, timing is everything . From insulin shots to understanding morning blood sugar spikes, punctuality can make the difference between stable control and frustrating fluctuations. ⏰ 1. Optimal Timing for Insulin Administration Insulin works best when its peak action matches the rise in blood sugar after a meal. For regular insulin , inject ~30 minutes before eating . For rapid-acting insulin (e.g., lispro, aspart), inject just before or right after a meal . ✅ Why it matters: Perfect timing prevents post-meal sugar spikes and helps keep your readings steady. 🌅 2. Dawn Phenomenon & Morning Hyperglycemia Ever checked your fasting sugar in the morning and thought: “But I didn’t even eat!” 🤔 Two common reasons: Dawn Phenomenon – In the early morning hours, hormones like cortisol and growth hormone signal your liver to release ...

By Dr. Sk Sabir Rahaman, MBBS , MD (Pharmacology), DFM(Family Medicine), FCFM, CCEBDM, CCLSD       For people living with diabetes, foot care is not optional — it’s essential . High blood sugar can damage nerves and reduce blood flow, increasing the risk of wounds, infections, and even amputations. Here’s a practical, step-by-step guide to keep your feet healthy. 🧼 A. Daily Foot Care Routine Wash feet daily using warm, soapy water ( never hot water ). Inspect both feet carefully for cuts, blisters, redness, or swelling . Dry thoroughly, especially between toes. Apply a gentle moisturizer to keep skin soft — avoid the spaces between toes . ✂️ B. Toenail Maintenance Keep toenails trimmed straight across to avoid ingrown nails. Use an emery board to smooth sharp edges. If you have poor vision or difficulty trimming, seek help from a podiatrist . 👟 C. Choosing Proper Footwear Never walk barefoot , even indoors — wear socks and slippers....