Hello friends,
I am pleased to post to you a case which I saw about 5 years ago which I still vividly remember.
That was a Sunday morning. My free day. I don’t give appointment. Still I used to go to my clinic for some reading and browsing. As soon as I entered my clinic I had a call from my doctor friend who is a general practitioner in the town. He is also from Madras but from Stanley Medical College, three years junior to me. He is very healthy conscious. Used to attend gym and karate classes. He told me that his karate master who was with him that morning was complaining of a little tiredness and otherwise no obvious difficulty noted. He asked me whether I could see him at once and advise. Since the caller was my close colleague I could not refuse. But I told him since the tiredness was of sudden onset you better get a blood sugar and ECG done locally and send him to my clinic as being a holiday I had no staff in the lab attached to my clinic. Around 11 am the man arrived in my clinic. He sat in front of me and told me that the tiredness which he had about an hour ago was better now and that he had no other symptoms at that time. He was with normal physique and a teetotaller and non-smoker. He used to undergo regular medical check-ups and they used to be normal only. His BP and pulse rate were normal. Nothing else except that when I held his forearm to take his pulse I found his limb unusually cold, more so distally. His blood sugar was normal. I looked at his ECG. At one stroke I wanted to dismiss it as a normal tracing. But when I had a second look, the V 1 and V 2 leads were calling my extra attention. The biphasic T wave with a slightly elevated ST segment in V1 and an unusually tall T in
V2 told me that all was not well. And this and the cold periphery also prompted me that he needed close observation. I told him to get admitted immediately. He was reluctant since he had no obvious symptoms at that time. He told me that he would go home and take rest and come and see me next day. He had a friend with him and he also was in agreement with his friend. But I told them that somehow a suspicion had entered my mind and that I need to watch him for a day or two before I dispose him of. When they noted that I was a little serious, they agreed. I gave an admission slip and a prescription for acute coronary syndrome including heparin. He asked me whether he could go home and refresh himself before going to the hospital. I refused and told him that he should go to the hospital at once without wasting any time and that he should not exert at all and asked his friend to bring their vehicle close to my clinic. And they left.
Hello friends,
Before I tell the second part of this story I need a break. And I want you people to give your opinion about this case and my dealing with this case. You must remember that I am in a peripheral taluk area with limited facilities.

Raheem 2008 Feb 24 Image011.jpg
Raheem 2008 Feb 24 Image012.jpg

With regards and wishes

UA Mohammed

?