BLACK OUT AND FALL ON GROUND ???

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                   Many come to the hospital with  a story that one of their apparently healthy looking  relation  fell down on ground suddenly.Actually it is possible that a hidden unhealthy process might be going on under ground.The causes are numerous and may range from much innocent ones to dangers ones.
                  Most common  are (a) Simple vasovagal attack (b) Hypertension (c)Heat Stroke (d) Brain Stroke (e) Heart Stroke (f)Absent Attack of Epilepsy and more diverse (G) Fracture of head of  thigh bone called Femur.
                 The vasovagal attack being more simple may occur after listening to very shocking news , seeing a dreaded scene  or sudden rising from a sitting posture .Simple measure like elevating the legs will normalize blood flow to the brain and patient gains consciousness.Other injuries are to be looked after.
                   Hypertensives especially undiagnosed ones and those dincontinued drugs against a medical advice or due to complication called hypertensive encephalopathey may suddenly fall down.They usually complain of reeling of head before the episode.Obviously the root cause is to be treated.Associated injuries in form if a traumatic haematoma of scalp has to be evaluated in the light of possible injury to brain.
                    Heat stroke is a tell tale diagnosis and has to be treated promptly.Main stray of treatment being rehydration  by intravenous fluid administration and cooling.
                     Juvenile epileptics especially experience absent attacks sustaining multiple injuries ,has to be treated accordingly.And they must be warned and guided not to go to dangers places like fire and water body.
                     A fracture of head of thigh bone ,femur mainly due to old age osteoporosis usually seen in  menopausal lady  and person falls on ground.Also pathological  fractures due to other causes  importantly a metastatic  cancer may cause it.A simple X-Rays will clinch diagnosis and guide the treatment.Post menopausal ladies should always  get calcium supplement to prevent osteoporosis.
                   Heart stroke and brain strokes are more dangerous usually associated with hypertension and/or diabetes.So the primary disease if known should be kept under control always and patient should not discontinue drugs without consulting treating doctor.If undiagnosed and these diseases suspected one tablet of aspirin 150 mg. ,if available should be started  at home and swiftly shifted to the nearest health centre even if small one.Because first-aid can be started which is similar everywhere.

                           



                             BESIDES THERE ARE SO MANY OTHER CAUSES OF BLACK OUT AND FALL ON GROUD, ARE OF ACEDEMIC INTEREST AND BY FAR ABOVE ONES TO BE KEPT IN MIND.