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Blood transfusion- what is it and when is it indicated?

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Blood transfusion- Indications, Procedure, Cost, and Problems 

What is Blood Transfusion? Blood transfusion refers to transferring blood or its components into a human recipient’s vein for therapeutic purposes to replace the blood or compensate for those deficient blood components. It can be a lifesaving measure to replace the blood lost during surgery, severe traumatic injury, or burns. It can also be useful when the body cannot produce enough blood components or if the blood components produced are defective. For example, in severe anemia, when the Haemoglobin levels fall below 7gm per decilitre, blood transfusion, either whole blood transfusion or packed RBC transfusion, is advised. Similarly, in thalassemia patients, where there is defective hemoglobin chain synthesis, and as a result, there is hemolytic anemia, repeated blood transfusions are advised to prevent the delay in growth the predisposition to infections. The blood required is obtained from a donor or a blood bank. Thus, blood banks are responsible for collecting, testing, and storing blood. Normally, in most surgical and minor surgical procedures, the need for blood transfusion does not arise. One of the major focuses of modern-day surgery is to reduce blood loss and maintain the homeostasis of the body’s organ systems. However, surgical patients might require a blood transfusion, and it is better to keep the possibility in mind before consenting for surgery and planning for post-operative care. The need and indication and the risks of transfusion must be discussed with the treating physician. It is always advisable to begin the decision-making process as early as possible since there are time limitations and health restrictions.

Blood transfusion Types

The types of blood transfusion depend upon the donor, who has donated blood to the blood bank. By far, volunteers’ blood donations are the most common type of blood donations available in the blood bank. The blood from such donors is usually readily available and, with proper screening, has little risk of adverse outcomes. However, the likelihood of contracting infections, such as Hepatitis B and HIV, remains if there is improper testing. Autologous blood transfusion refers to the transfusion of one’s own blood. It is naturally only possible in pre-planned (elective) surgical procedures and needs to fulfill certain eligibility criteria. It is the safest method with practically no risks. Directed donor blood transfusion allows the patient to receive blood from family members or friends (known donors). However, it needs to be collected several days before the transfusion’s actual need to ensure testing and screening. However, the protocols for both blood donation and transfusion are specific for the respective hospitals. As mentioned above, blood transfusion is a life-saving procedure. However, one may refuse to provide consent for the same, leading to disastrous complications and even death. However, doctors may provide emergency blood transfusion to save the recipient’s life in case of emergencies.

Prerequisites: Blood transfusion

Before transfusing the blood, the healthcare provider ensures re-confirmation of the identity, the blood group, and the amount to ensure that blood is given to the correct patient. However, if during transfusion, one has symptoms of breathlessness (dyspnea) or itching and fever or chills (blood transfusion reaction), the healthcare provider must be alerted immediately. As mentioned above, blood source can be Autologous (one’s own) or Donor (someone else’s) blood. Autologous blood transfusion is further divided into Preoperative, Intra-operative, and Post-operative donation. Hemodilution is another method in which some blood is drawn during the surgery and is replaced with IV fluids. Later, after the surgery, the blood is filtered and returned to the body. However, large amounts of blood cannot be drawn by this method. Plasmapheresis: It is another variant in which platelets and plasma are withdrawn before surgery and returned to the body when there is a need to stop bleeding. However, it has limited applications. The second type is the donor blood, which can be volunteering-based (blood banks) or by designated donors (family and friends). The blood is screened for infectious agents and other noxious substances. However, the risk of infection remains, albeit minuscule.

Blood and its components:

A 60 kg human has around 5 liters of blood, which constitutes about 8% of the adult human body weight. Blood is a fluid connective tissue. It is composed of plasma (55%) and formed elements (45%). The formed elements include red blood cells, white blood cells, platelets, proteins, and coagulation factors. There are various blood groups. The blood group is determined by antigens’ presence (specialized proteins) on the red blood cells’ surface. Thus, a person with blood group A has A antigen, a person with blood group B has B antigen, and a person with blood group AB has both, A and B antigens on the surface of the red blood cells. Similarly, a person with O blood group has neither A nor B antigens on its surface. There is a presence of corresponding antibodies in the plasma of the patients. Thus, a person with blood group A will have an anti-B antibody (antibody directed against B antigen, since it is not present in the person). Similarly, a person with blood group B will have an anti-A antibody. A person with blood group AB will have no antibodies. Lastly, a person with blood group O will have both, A and B antibodies (since both the antigens are absent on the red blood cells). Another factor is the Rh factor, also referred to as the D antigen. Patients with D antigen are Rh-positive, while those who do not have the antigen are Rh-negative. Thus, an Rh-positive person can receive blood from both Rh-positive and Rh-negative persons. However, Rh-negative persons should only receive blood, which is Rh-negative. (Rh-negative blood is to be used for emergencies when there is no time to test a person’s Rh type)

Conclusion:

It is clear then that a person with blood group AB positive would be the universal recipient (since he has no antibodies in his plasma, and hence he can receive blood from any blood group person) The person with O negative would also be the universal donor since his RBCs have no antigens on its surface. They can be transfused into another person without the fear of an antigen-antibody reaction in the recipient. There may be whole blood transfusion, or only a part may be transfused, such as platelets (in dengue) or RBCs (in severe anemia).

Red Blood Cell Transfusions

RBCs or Red blood cells are the most commonly transfused component of the blood. RBCs are responsible for carrying oxygen from the lungs to the tissues and carrying carbon-dioxide back from the tissues to the lungs for expiration. RBC transfusion is indicated after surgery, severe injury, hemorrhage, or anemia. Anaemia refers to the decrease in the oxygen-carrying capacity of the blood due to a decrease in RBC number or decrease in hemoglobin concentration or both, below the normal levels for that particular age and sex. (Haemoglobin in the RBCs is responsible for oxygen transport and gaseous exchange in the body).

Platelets and Clotting Factors transfusion:

Both the products are useful in hemostasis to stop the bleeding (internal or external) and prevent hypovolemia and shock. They are also indicated in conditions where the body is unable to make sufficient platelets or clotting factors. E.g., In hemophilia, which is an X-linked recessive disorder, clotting factors are absent. As a result, there is excessive bleeding on minor trauma. There can be spontaneous internal hemorrhage in joints, knees, etc. Another disease in which it is indicated is thrombocytopenia, where there is a deficiency of platelets.

Plasma Transfusion:

As mentioned above, plasma is the liquid part of the blood. It is composed mainly of water, proteins, clotting factors, and nutrients such as glucose, vitamins, and minerals. It is generally indicated in patients with severe burns (who have extensive loss of plasma), chronic liver failure, or a severe sepsis infection.

What to expect: Blood transfusion

Before Transfusion:

You would be asked if you had something to eat before you came for transfusion. If not, biscuits and juice would be provided to maintain the blood sugar level and prevent a syncopal attack.
The technician will prick one’s finger, and the blood drops are placed on the slide. Alternatively, blood from one of the veins is dropped, and with the help of appropriate reagents, the blood group is determined, whether A, B, AB, or O, and whether it is Rh-positive or negative.
Only compatible blood is provided for transfusion to prevent the risk of antigen-antibody reaction and hemolysis. Also, to prevent allergic reactions, which may be genetically determined and hard to know beforehand, medicines may be prescribed to prevent such reactions.

During Transfusion:

A blood transfusion may occur in an in-patient ward, where the patient is admitted or during surgery in the Operation Theatre Complex or the emergency rooms. An appropriately sized needle is used to insert an IV cannula or an IV line into the blood vessels, and the other end is attached to a blood bag, from which the blood is transfused. It usually takes between 1 to 4 hours for transfusion. However, the time duration may vary depending upon the units of blood transfused and the components transfused. Throughout the transfusion, the vital signs are monitored, especially to watch out for signs of allergic reactions.

After Transfusion

Post-transfusion, vital signs are checked, such as temperature, blood pressure, heart rate, and oxygen saturation. The IV cannula is taken out. There may be bruising at the site of cannulation due to thrombophlebitis and some edema. However, it resolves within a day or two.

Blood transfusion: Allergic Reactions and Transfusion-associated complications

The majority of blood transfusions do not have any adverse effects. However, mild edema and pain at the injection site to more severe symptoms like systemic anaphylaxis can ensue.

Allergic Reactions:

They may occur even with the right type of matching blood transfusion.
  • They may be mild or severe, and the symptoms include:
  • Tachycardia (increase in heart rate) and palpitations
  • Anxiety and perspiration
  • Cold, clammy skin
  • Anxiety
  • Breathing difficulties (dyspnoea)
  • Nausea and vomiting
The transfusion stopped at the first sign of these allergic transfusion reactions. The severity of the reaction is assessed, and depending upon the need for treatment, transfusion may be restarted or aborted.

Viruses and Infectious Diseases:

The screening of blood is done to prevent the following diseases. The risk of HIV infection via blood transfusion is 1 in 2 million, much lower than road traffic accidents and other morbidity causes. The risk of Hepatitis B infection is 1 in 2,00,000, while Hepatitis C infection is 1 in 2 million. Variant Creutzfeldt-Jacod Disease, earlier referred to as Kuru disease, is a prion mediated fatal brain disorder. The possibility of it remains low, via a blood transfusion, but is a documented risk.

Fever:

Within a day or two of blood transfusion, one may develop a fever, which is the body’s physiologic response to the transfused White blood cells. However, it resolves over a period of 1-2 days or with over-the-counter NSAIDs such as paracetamol and diclofenac. Many times, WBCs are centrifuged and removed and not transfused. This makes the chances of a fever developing less likely.

Iron overload:

Repeated blood transfusions may lead to an iron buildup in the blood. This is especially true concerning hematological disorders like Beta-thalassemia. It can lead to iron overload(siderosis) and iron deposition into the liver, heart, and other vital internal viscera. Iron chelation therapy reduces the gut’s iron absorption in the form of desferrioxamine or intake with vitamin C. This helps to maintain the blood iron levels at a normal range.

Risks and Complications: Blood transfusion

Transfusion Associated Acute Lung Injury (TRALI):

Normally, during a blood transfusion, the vital parameters such as heart rate, blood pressure, and respiratory rate are monitored. In some patients, post-transfusion, there can be difficulty in breathing due to lung damage. However, it may be transient dyspnea, and the majority of patients recover. In 5-25% of those who develop symptoms, the damage may severely cause significant lung injury and death. It is more common with severely immunocompromised patients. It is postulated that plasma from women who have been pregnant might be responsible for antibodies that damage the lungs and disrupt respiration. Thus, male and female plasma is now being used differently in different centers.

Acute Immune Haemolytic Reaction:

This is a result of mismatched blood transfusion. As a result, the body’s host defense mechanisms attack and destroy the transfused RBCs. Hemolysis and hemoglobinuria, which, when deposited in the kidney, leads to acute tubular necrosis and acute renal failure. The symptoms include: Fever with chills Loin pain or pack pain Dark or cola-colored urine. It is an acute reaction, and blood transfusion is stopped at the first sign of acute hemolytic reaction.

Delayed hemolytic reaction:

As is evident in the name, in contrast to acute hemolytic reaction, the red blood cells are destroyed insidiously over time in delayed hemolytic reactions. Both acute and chronic reactions are common in patients who have had a previous blood transfusion history.

Graft versus host disease:

It is a hypersensitivity reaction in which the white blood cells from the donor plasma attack the antigens present in the recipient’s tissues and organs. Immunosuppression is a major risk factor for developing graft versus host disease. The symptoms generally start within a month of transfusion and include fever and body rash. To minimize the risk of developing GVHD, only RBCs are transfused, while WBCs are centrifuged and removed.

Alternatives to Blood Transfusions:

There are no alternatives to blood; however, some recombinant substances, which mimic the endogenous substances, have been produced, making red blood cells. For example, in patients with chronic kidney disease, recombinant erythropoietin is administered. It stimulates the bone marrow to produce more red blood cells, thus requiring fewer transfusions. With minimally invasive surgeries, such as laparoscopic and endoscopic surgeries, the amount of blood loss is minimized. Also, with optimum peri-operative and post-operative care, the risk of infections is reduced, and blood transfusions are seldom required.   Refer to other articles:  
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Sexual Dysfunction and Disorder

Factors affecting sexual health- Do’s and don’ts

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Sexual Health and Sexual Dysfunction

Sexual health is a state of complete physical and mental well-being concerning sexual maturity and sex organs. Thus, besides healthy sexual organs, a correct attitude regarding sexual practices and sound mental health is equally important. Thus, sexual dysfunction is a vague term, which includes a multitude of reasons: physical, social, and psychological, among others. Thus, it is a multi-factorial disorder with varying genetic susceptibility and environmental triggers upon a person’s sexual health.

While occasional disturbances and lack of adequate satisfaction are fairly common, the problem arises when the stress is prolonged. Often it causes long-term distress, which progresses to dysfunction and sexual disorder. It is thus, important to ask for professional help when the dysfunction leads to distress, which affects one’s daily life.

Often, sexual disorders are a manifestation of a physical or mental illness. For example, premature ejaculation, bedwetting is common in persons suffering from depression and other mood disorders. Consequently, the first-line drugs for such conditions are tricyclic anti-depressants or TCAs. Thus, it is important that secondary causes, if present, must be identified and treated to relieve sexual dysfunction associated distress.

Some of the other risk factors and warning signs associated with the first manifestation of sexual disorder are as follows:

Post-chemotherapy for perineal cancers (cervical, vaginal, bladder, rectal), women experience sexual side effects such as a reduction in sexual drive, vaginal dryness, and, as a result, painful coitus, which reinforces negative emotions associated with sex.

In men with pre-existing heart disease, a chronic inability to maintain an erection of the penis during sex (erectile dysfunction) may be the first sign. The corporal vessels of the penis, having a smaller lumen, are more vulnerable to damage by lipids, hypertension, and atherosclerosis than the other vessels. Thus, before the cardiac manifestations become apparent, erectile dysfunction may be the first presenting signs of impending heart disease.

The stigma associated with sexual health and its disorders is immense. A significant percentage of the population suffers from some of the other kinds of sexual distress. Thus, it is important to shun the taboo and ask for professional help, to prevent consequences and early diagnosis of disorders when they are amenable to treatment.

Read more:

Sexual Dysfunction: Classification of Sexual Disorders

After a brief overview of sexual health, its impact on other systems and the social factors associated with it, it is pertinent to know about the categories of sexual dysfunction. It is classified into the following types:

1. Arousal Disorders– Characterised by the inability to be aroused or excited by the thought or the act of sexual activity, which may not necessarily be limited to intercourse.

2. Desire Disorders– Characterised by low libido (sex drive) or impotency. It is different from sterility which means an inability to give rise to progeny and reproduce.

3. Orgasmic Disorders: Characterised by the inability to have an orgasm or difficulty in having and maintain an orgasm.

4. Painful sex: After a brief overview of sexual health, its impact on other systems, and the social factors, it is pertinent to know about the categories of sexual dysfunction. It is classified into the following types:

1. Arousal Disorders– Characterised by the inability to be aroused or excited by the thought or the act of sexual activity, which may not necessarily be limited to intercourse.

2. Desire Disorders– Characterised by low libido (sex drive) or impotence. It is different from sterility, which means an inability to give rise to progeny and reproduce. 

3. Orgasmic Disorders: Characterised by the inability to have an orgasm or difficulty having and maintaining an orgasm.

4. Painful sex

1.Arousal Disorders:

2.Desire Disorders

3.Orgasmic Disorders

4.Painful Sex 

Read more:

 

1.Arousal Disorders:

In arousal disorder, there is a lack of physical, emotional, or mental response to sexual stimulation.
As mentioned above, in men, the most common sexual dysfunction is erectile dysfunction, which increases with increasing age. According to the Male Aging Study, nearly half of the men reported experiencing erectile dysfunction between the 4th and 7th decade of life.


On the other hand, women may experience vaginal dryness, lack of stimulation and sensation, or no swelling of the clitoris during sexual activity. (Clitoris in females is homologous to the penis in males and is highly vascular. During sexual activity, the blood flow to both the organs increases, resulting in intumescence or swelling.


Such difficulties may lead to decreased sex or, in extreme cases, a total inability to have sex.
The converse of it is termed as ‘Persistent Genital Arousal Disorder.’ In males, it manifests as priapism, or an erect penis all the time, even in the absence of genital stimulation. In females, it results in orgasms throughout the day. Both of them can be reasons for significant distress.

2.Desire Disorders

Desire disorders mainly stem from emotional and hormonal issues. Depression, stress, anxiety affect the desire for sex in both genders. In general, women achieve menopause (stoppage of menstrual cycles) by the age of 45-50 years. It leads to decreased sex hormones, estrogen, and progesterone, thus affecting sexual desire.

Similarly, with increasing age, the amount of testosterone decreases, leading to impotence and low libido. The symptoms might include anhedonia (lack of pleasure in daily activities), lack of sexual desire, or erotic thoughts.


The most common sexual dysfunction disorder in women is low libido. Nearly one-quarter of women experience low libido in premenopausal age, the incidence of which nearly doubles after attainment of menopause. As discussed above, it may be associated with painful stimulation or vaginal dryness, which makes the act of sex undesirable and results in a decreased desire.

‘Hypoactive Sexual Desire Disorder’ is another term used to describe distress, causing emotions such as low libido, lack of sexual desires, and inability to satisfy the other partner. However, according to the latest guidelines, it has been clubbed with arousal disorders into one category: Female Sexual Interest Arousal Disorder, as many females experience both the symptoms of low libido and arousal disorders, albeit at different times. However, the classification remains controversial as it groups arousal and desire disorders into one.

The counterpart in men for lack of interest in sex is diagnosed as Male Hypoactive Sexual Desire Disorder.

3.Orgasmic Disorders

Orgasmic disorders cause significant distress, once in the act of coitus.

For women, of concern is Anorgasmia (seen in around 5% of women), which refers to difficulty in or a lack of orgasm and the passage of vaginal lubricating fluid. The specific concerns may vary: From not experiencing one to delayed orgasm.

For men, orgasm ends in ejaculation and the release of seminal fluid. The specific concerns in men include:

Premature ejaculation: It is a subjective term and refers to ejaculation within a few minutes of arousal, and sooner than what the opposite partner desires.

Retrograde Ejaculation: The semen, instead of coming out of the urethra (The urethra is the common passage for urine and semen in men), through reverse peristalsis enters the bladder. It results in inadequate and ineffective ejaculation, which can be a cause of infertility.

Delayed Ejaculation: It is the opposite of premature ejaculation. Long after arousal and erection

Delayed ejaculation is characterized by difficulty reaching orgasm.

4.Painful Sex

It is also referred to as dyspareunia and is more commonly experienced by women as compared to men. Sex, as a natural physiological mechanism, is supposed to give pleasure to both partners. Painful sex resulting from multiple factors is again a cause for sexual dysfunction.


In women, vaginismus is one of the common causes of painful sex, leading to involuntary squeeze or spasm of the pelvic floor’s supporting muscles. As a result, penile insertion or any tampon insertion is painful.


In men, Peyronie’s disease, in which the erections are bent, causes sexual discomfort, and may also lead to erectile dysfunction and other ejaculation disorders.

Causes of Sexual Dysfunction:

A large number of sexual disorders are due to widely different causes. Communication barriers, mistrust in the relationship, adultery, excessive consumption of pornographic material are some of the non-physical causes of sexual dysfunction complaints. The broad categories include:

Physical Health Problems: 

The following problems may predispose the person to develop sexual dysfunction disorders.

Cardiovascular disorders: Hypertension, Hyperlipidemia, and Hypercholestorelmia.

Endocrine disorders: Diabetes Mellitus, Hypothyroidism, Liver failure and Obesity

Urinary-Renal disorders: Kidney failure, Urinary tract infections, Benign prostatic hyperplasia, Vaginismus, and Peyronie’s disease.

Genital System Disorders: Pelvic wall weakness and prolapse of vagina/bladder/rectum, Uterine fibroids, and endometriosis

Neurological Disorders: Organic and inorganic brain diseases, epilepsy, spinal cord injuries, sleep disturbances

Cancer and cancer chemotherapy, chemoradiation.

Psychological Health Problems:

Depression, performance anxiety, stress, body dysmorphism, post-traumatic disorders, low self-worth, and unrealistic expectations due to the use of tamponade, pornographic material.

Substance use Problems:

They include therapeutic drugs such as antidepressants and anti-hypertensives.

They also include alcoholism, smoking (most common), and illicit drug use such as cocaine, cannabis, methamphetamines, mephedrone.

 

 

Diagnosing Sexual Dysfunction Disorders:

Generally, they are first noticed or experienced by the person himself or his/her partner. Considering the stigma attached, the majority of the people hesitate to have a consultation.

A sex-expert or other professionals such as Obstetric-Gynecologist, urologist, or a sex-therapist helps the treating physician come to a diagnosis, address the underlying physical and mental causes, and accordingly, initiate therapy.

A full-body checkup and tests (to rule out infertility), along with a detailed history and physical examination is the key to diagnosis. It may also point towards localizing a particular system as a cause of illness or some particular medication, contributing to the dysfunction.

Sexual Dysfunction: Treatment and Therapy

The treatment options and the goal of therapy depend upon the cause of sexual dysfunction.

For example, in men with Erectile Dysfunction, phosphodiesterase inhibitors like Sildenafil (by the trade name Viagra) increase blood flow to the penis and provide symptomatic relief tumescence during the act of intercourse. However, they do not address the root cause of the problem, such as an underlying cardiovascular or endocrine problem.

Also, lifestyle changes (like switching over to plant-based diets, less saturated fatty acids, and more antioxidant-rich fruits and vegetables) along with exercise (kegel exercises in men and women, 30 minutes of moderate exercise a day) helps improve mild ED and is also a protective factor for the development of ED.

Women with HSDD have two FDI approved drugs: Fibanserin and Bremelanotide to treat the condition. However, as mentioned earlier, the causes of sexual dysfunction are multifactorial, and hence drug therapy should be complemented with other forms of treatment options, such as counseling and behavioral training.

Some examples include Penile pumps and injections for helping with erection—laser therapy for regaining vaginal elasticity and improving lubrication, thereby reducing pain.

Hormone therapy is also used in the form of hormone replacement therapy. For example, in women, it includes estrogen and progesterone replacement after menopause, and in men, testosterone replacement for those who have a senile decrease in levels of the hormone. 

In conclusion, some Do’s and Don’ts include:

Do’s:

  • Stress relaxation techniques like yoga, meditation, breathing exercises.
  • Ensuring a healthy diet and adequate sleep and rest.
  • Exercising daily and being fit.
  • Spending quality time with friends and family.

Don’ts:

  • Having a sedentary lifestyle
  • Stressing out on things which are beyond one’s control
  • Do not avoid sexual activity or suppress urges, as it improves with practice.
  • Do not delay treatment so that the condition can be treated earliest, and complications do not develop.

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Sex education for teenagers and Its Importance

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Sex education for teenagers- How to deal with adolescent issues 

  Why study sex education in adolescence? Adolescence is the transition from childhood to adulthood. It is accompanied by hormonal changes, which also manifest themselves in physical changes in the bodies of boys and girls (Growth of genitalia, the appearance of axillary and pubic hair, a change in the pitch of voice, attraction towards the opposite sex, etc.). Also, there is impulsiveness and curiosity to indulge in acts, which are considered forbidden, without the adequate wisdom to control these impulses. Alarmingly, they have given rise to the following consequences, which can be controlled. Imparting sex education can lead to
  • Prevention of teenage pregnancies and unsafe abortions
  • Increased accessibility to methods of contraception and safer sexual practices
  • Control of sexually transmitted diseases such as AIDS, gonorrhea, and pelvic inflammatory disease may contribute to infertility later in life.
The rising incidence of sexual crimes, ranging from harassment and eave teasing to heinous crimes such as rape, arises from a lack of understanding and emotional maturity regarding the concepts of consent, inappropriate touch, and sexual violence.

What is Sexual Health? 

According to the World Health Organisation, Health is a state of complete physical, mental, and social well-being and not just an absence of disease or infirmity to lead a socially and economically productive life. Sexual health is an integral part of healthy living, starting from teenage and right to parenthood and beyond. However, many teenagers are unaware of the right kind of information concerning sexual organs, sexual maturity, the practice of sex, and the various kinds of contraception. Owing to a large amount of misinformation and, at times, legitimate information void, the youngsters, out of curiosity, refer to online web sources to understand sexuality and its varied aspects. However, there is no certainty that these may be authentic, and thus, they fall prey to misconceptions. These misconceptions at a young age might lead to catastrophic consequences later in life.

Current Status of Sex Education in India

In India, there is no uniform policy about sex education. It has faced many ups and downs after the NCERT implemented it. Currently, government institutions do not teach sex education to the students regarding good touch, bad touch, safe-sexual practices, and the medical and legal recourse in cases of emergencies. Private schools and institutions are, however, not covered under the restriction order from the government. They are free to conduct weekly or monthly lectures and seminars on sex education or not conduct them. According to recent government guidelines, sex education, under the revised Human Resource Development Ministry guidelines, operates on a pilot basis in select districts across India. However, uniform policy for implementation and roll-out is still lacking.

What exactly is sex education? What are the myths associated with it?

Sex education mainly comprises the skills, knowledge, and development of thought processes to make healthy and informed decisions related to all matters concerning sex. Before discussing them, parents themselves need to bust the myths while imparting sex education to their children. Some of the common myths of teenage sex education are as follows: Myth: Sex education will lead to teens indulging in sex more frequently Truth: Sex education does not promote promiscuity. Contrarily, it helps teenage children make more informed decisions regarding their sexual health and generate a feeling of being-in-charge. Also, comprehensive sex education reduces risky behaviors and promotes trust with a single partner.   Myth: There is no need for comprehensive sex education. Abstinence alone is sufficient. Truth: This is incorrect. Abstinence-only programs fail to realize the biological urges among teenagers. A comprehensive sex education program channelizes teenagers’ energy and concerns more productively and rationally, such that they take charge of their own sexual health.   Myth: Sex education will lead to an increased incidence of teenage pregnancies. Truth: Sex education provides female teenagers with more options and promotes safe sexual behavior using contraceptive methods.   Thus, investment in sex-education will reap rich dividends for the future generation in terms of the individual’s overall health status and the community as a whole. It needs to be liberated from the bedroom’s confines to the dining and living room, where there can be free-flowing open-ended discussions where all stakeholders can participate and feel cherished, valued, and confident.  

By whom and when?

Sex education is best provided by trained health professionals in schools and teachers. However, to come into action and have meaningful action, a healthy discussion with parents back at home is equally important. The social environment is filled with subtle cues related to sex: Horrific news of rapes and sexual perversions, intimate scenes in movies and other entertainment shows, and advertisements ranging from condoms to sanitary pads and iPills. It is important to build upon conversations that stem from such events, which act like springboards. Rather than thinking of sex education as an independent entity per se, it is important to consider it a part of an ongoing discussion that affects all the spheres of life: Personal, social, and cultural.
  • Initiating the Conversation: Casual moments such as a drive-through or a late-night walk provide much-needed privacy and opportunity to discuss the issues (which might have been raised during an advertisement or a news debate) kickstart a conversation regarding the complexities involved in the same.
 
  • Being honest and candid: At times, the children are uncomfortable to break the ice with the parents for fear of being judged adversely or simply feeling awkward. Reciprocally, the parents may feel the same if they are averse to the idea of discussing them with the child. What is required is an acknowledgment of the discomfort and being honest. If you don’t know the answer to a question, there is no harm in admitting so. One can always revert after looking up for a legitimate answer or jointly find it and then discuss it.
 
  • Being Direct: Brushing contentious issues under the carpet would do more harm than good. The questions would remain, and the queries would be unresolved. It is important then, to confront the issues heads on. For example, the risks of sexually transmitted diseases such as gonorrhea and HIV, amongst others. Their association with unsafe sexual practices and the adverse health impacts must be discussed.
 
  • Being Receptive: Discussions surrounding sex cannot be one-way. They need to be dynamic, with active participation between the parents and the child. It should not turn out to be a didactic lecture where the parent imposes his views. Rather, they should be receptive to his concerns, teenage pressures, and views regarding sexual maturity.
 
  • Being Socio-Culturally Relevant: Often, sex education discussions revolve around well-established facts and figures. However, it is equally important to discuss them in subjective values and attitudes, which one adopts in life. A case in point being premarital sexual intercourse. Beyond the scope of legal repercussions, the questions of ethics and responsibility must be deliberated along with personal beliefs.
 
  • Room for more: With evolving societies and globalization, there are conflicts between the older and newer generations—a case in point being sexuality. Sex is a biological concept, while gender is a social concept. With the emergence of LGBTQ movements, many teenagers are confused with regards to their sexuality. While discussing these issues might seem challenging, the conversation is the best way to deal with questions arising regarding the same. Whatever be the outcome of it, it is always prudent to express to them that you’d love them unconditionally irrespective of their choices and orientation.
Moreover, it is important to incentivize the teen’s queries with encouraging words such as ‘That’s a great question’ or ‘I am so glad that you finally brought it up!’  

Is it relevant to study sex education in developing countries?

If yes, some frequently asked questions: With increasing westernization, developing countries like India face emerging issues of consent, date rape, sexual orientation, among others. Some of the questions might be: The right age for sexual activity commencement: While peer pressure, curiosity, and various challenges might steer some teenagers into sexual activity, it is important to stress that sex is an adult activity. The Indian Penal Code classifies sexual intercourse with a female less than 18 years of age as statutory rape. Also, affection can be expressed through other means such as intimate talks, hand-holding, dates, or hugging and kissing. Consent for sexual activity: The importance of consent cannot be understated. Any form of forced sex (within or outside the ambit of a relationship) amounts to rape (However, the IPC does list marital rape as an offense). As is famously stated, ‘No means no.’ Also, drugs and alcohol are likely to impair judgment and reduce inhibitions, predisposing situations where rape is more likely. It is advisable to have abstinence from these substances.   Warning signs of Unhealthy relationships: Dating violence has come to the fore with increased awareness and reporting regarding the same. Parents must be vigilant to the warning signs of violence while dating/ in a relationship. They include:
  • Alcohol and secretive drug abuse
  • Social withdrawal from friends and family
  • Excusing the partner’s unacceptable behavior
  • Loss of interest in activities which were once enjoyable (anhedonia)
  • Bruises, scratch marks, or other unexplained injuries
  Abusive relationships have long term consequences. They include poor academic performance, addiction to illicit drugs, and alcohol and suicide attempts, besides leaving behind traumatic emotional scars on one’s psyche. Moreover, teenage undesirable emotions are linked with an increased likelihood of future unhappy and violent relationships. Thus, a healthy teenager is a sound foundation for a happy sexual life ahead.

Finetuning your response to the child’s sexual behavior:

While the importance of reinforcing the adult aspect of sexual activity cannot be understated, if the teen becomes sexually active, it is more important than ever to keep a vigil and to engage him in conversations. You need to state your concerns openly and imprint upon him the seriousness of the responsibilities which come along with it. Safe sex practices, barrier contraception, and exclusivity of a relationship (to avoid the risk of contracting STDs) must be communicated from time to time without being too intrusive. Once in a while, a check-up with the physician gives the child a much-needed opportunity to address his concerns in front of a medical professional confidentially and at his own comfort and leisure. Besides, the doctor’s words carry weight, which might positively influence the teen’s behavior regarding contraception and safe sex practices. Also, in teenage boys and girls, Human Papilloma Virus vaccination helps prevent genital warts and cancers of the cervix and the penis. Some worthwhile sites providing genuine information on sex and sexual health concerns include:
  • AMAZE
  • CRUSH
  • IT MATTERS
  • ONE IN THREE
  • REACH OUT
  References:        

Read More------

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Launch of Fit India Movement

Fit India Movement: promoting wellness among Indians

The Fit India Movement was launched by Prime Minister Narendra Modi on 29th August 2019, which happens to be the birth anniversary of Major Dhyan Chand, the hockey wizard, and is also celebrated as the National Sports Day. It aims to promote health and wellness among Indians of all ages by including physical activity and sports in everyday life.

Physical Inactivity: How does it affect humans?

Launch of Fit India Movement

Fit India

While launching the Fit India Movement, the prime minister emphasized the emerging threat of lifestyle diseases. India, as a developing country, is at the crossroads of emerging disease processes. It has a burden of existing infectious diseases, like tuberculosis, cholera, malaria, etc., and is also facing the brunt of non-communicable diseases like coronary artery disease, cancers, and stroke.

The rising incidence of Non-communicable lifestyle disorders- A cause for worry

India is regarded as the diabetic capital of the world. The incidence and prevalence of type-2 diabetes mellitus (insulin-resistant/insulin insensitive/maturity-onset diabetes mellitus) are steadily increasing.

Coronary artery disease is the leading cause of death among individuals in the productive age group of 25-60 years. Besides, the age at which the first episode of heart attack/myocardial infarction occurs is steadily declining. Also, thrombo-embolic episodes may result in brain stroke and paralysis. It contributes to significant morbidity and mortality as well.

Hypertension is another entity that has been termed the ‘Silent Killer’ along with Diabetes Mellitus. An elevated blood pressure predisposes an individual to develop atherosclerosis, myocardial infarction, hypercoagulable states, stroke, and other vascular disorders. Thus, they are becoming commoner in younger age groups.

Cancers are the second leading cause of death after coronary artery disease. Mouth and lung cancers in men and breast and cervical cancers in women are among the major contributor to cancer-related morbidity and deaths. Cancers have a genetic component and a contribution from the environmental factors as well.

Since non-communicable diseases have a multifactorial origin, there are two main categories of risk factors: Non-modifiable risk factors (Age, Gender, Ethnicity, Family history, and genetic makeup) and Modifiable Risk Factors (Diet, Lifestyle choices, Exercise, Smoking, Alcoholism, Obesity, Hypercholesterolemia, etc.)

Fit India

 

A major thrust of the Fit India Movement is to reduce the risk of non-communicable diseases like hypertension and diabetes mellitus by increasing the physical activity quotient of Indians. As more and more Indians work in white-collar jobs and the service industries, their lifestyle has become more sedentary, a notable risk factor for developing such diseases. (Read more: Common Lifestyle Disorders In Office Goers)

Fit India Movement promotes physical activity via various initiatives like marathons, jogging, runs to attain healthier body weight, and ward off inactivity and obesity, two major risk factors associated with developing diseases. (Read: Physical Inactivity: How does it affect humans?)

During the movement’s launch, the Prime Minister mentioned that Fit India aims to go beyond sports. It has to do with overall fitness and for people of all ages.

Fitness is not just about being fit but about being happy and healthy while contributing positively to society.

Fitness Protocols and Guidelines

These guidelines are issued jointly by various Ministries, including the Ministry of Health and Family Welfare, Ministry of Youth Affairs and Sports, and the World Health Organisation. The broad categories include fitness assessment benchmarks, various poses, and age-appropriate yoga protocols.

They are broadly divided into three main categories, according to the age:

  • Less than 18 years:
  • 18 to 65 years
  • Above 65 years

Fit India

 

Fit India Freedom Run: It was conducted from 15th August to 2nd October. The main concept behind the run was, “It can be run anywhere, anytime!” The main highlights were: Any route, at any time, at one’s own pace. After manually tracking the kilometers or tracking via the GPS, the participants could submit their data individually/via the organizer and download the certificate accordingly.

India Cycles4Change Challenge: It is a joint initiative of the Smart Cities Mission, Ministry of Housing and Urban Affairs, Government of India, to inspire and support Indian cities to quickly implement cycling-friendly initiatives in the wake of the COVID-19 pandemic. The Challenge aims to help cities connect with their citizens and provide them with expert inputs and guidance to develop a unified vision and promote cycling initiatives.

It is organized at the cities’ level to apply for the challenge by providing proposals such as pop-up cycle lanes and traffic-calmed or non-motorized zones, community-led cycle rental schemes, and extensive cycling networks. In the longer term, the Smart Cities Mission encourages cities to convert temporary interventions into permanent ventures.

High BMI- An early indicator of health risk

FIT India Monthly Plog event: Anyone can start a Plog Group by involving one’s organization, community, family, and friends. It combines two events: Jogging, which is great for personal health, and picking up plastic litter, which is great for the environment. The first run was initially organized on 2nd October 2019, as a tribute to the 150th birth anniversary of Mahatma Gandhi. Subsequent editions have ensued, in which the 2km-plog is conducted on the last Sunday of every month. It ensures that the vision of the Swachh Bharat Mission overlaps with the Fit India Mission.

Fit India Quiz: It is an initiative to create awareness among people across the country regarding fitness, health, indigenous sports, and nutrition. It is an interactive learning process in which participants attend multiple-choice questions based on fitness, healthy lifestyle choices, and Indian sports. It aims to test and enrich participants’ knowledge regarding fitness and award prizes to the winners while motivating them to be fit.

The Fit India Quiz’s end objective is to bring about physical and mental change among citizens to adopt a healthy lifestyle through the MyGov platform.

Fit India Dialogue: To celebrate the first anniversary of the launch of the Fit India Movement, Prime Minister Narendra Modi virtually interacted with sportspersons, fitness influencers, and citizens across India.

Owing to the COVID-19 pandemic, the participants (Milind Soman, Rutuja Divekar, and Virat Kohli, amongst others) virtually interacted with the PM and other attendees via a WebCast. PM Modi shared his ideas and anecdotes on his daily routine for keeping himself fit while exchanging ideas with the participants.

One important aspect brought about was ways to keep oneself fit during the lockdown in times of COVID-19, how to continue physical activity from the confines of one’s homes, and adopt healthy dietary plans over food fads. The focus was on inexpensive and doable techniques by everyone irrespective of age and therefore brought about a behavioral change that makes fitness an imperative part of every Indian’s life.

 

Weight Loss and the 7 Healthy Ways Regime

 

External Sources and references

Khelo India 

PM launches fit India movement.

 

 #FitIndiaMovement #FitIndia #Cycles4ChangeChallenge

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List of TOP 20 Diabetologist

List of  TOP 20 Diabetologist/TOP 20 Diabetologist in India

Here is the list of Top 20 Diabetologist.

1.Dr. Ashwani Jaiswal

Dr. Ashwani Jaiswal Diabetologist

Qualification:

  • MBBS (PMCH, Patna)
  • MD(RIMS, Ranchi)
  • DCP Pathology (DMCH, Darbhanga)

Brief Profile:

Dr. Ashwani Jaiswal is a famous diabetologist with rich experience in his field.

His expertise is:

  • Diabetes
  • Thyroid
  • Infectious Diseases
  • Critical care

He did a fellowship in Diabetology at MV Rao Institute of Diabetology, Chennai Best multi-specialty accredited Hospitals from Chennai.  In 2013, he also joined Narayana Health, Jamshedpur, after completing his MD. Presently he is working as HOD in General Medicine & Diabetology.

Highlights:

  • Ashwani Jaiswal is a member of the Indian Medical Association.
  • He is also an active member of the Cardiological Society of India.

 

2.Dr. Chythanya D C

Dr. Chythanya D C

Qualification:

  • MBBS
  • MD (Internal Medicine)

Brief Profile:

Dr. Chythanya is a famous consultant with experience of more than six years. After finishing his MBBS and MD in internal medicine. His particular interest in Internal Medicine and Diabetology.  His fields of Expertises are:

  • Diabetology
  • Infection Disease
  • Metabolic Diseases

Highlights:

  • Chythanya achieved various Professional Memberships and Certifications:
  • IMA at Life Time Member
  • API in Mysore Chapter at Life Time Member
  • He had also achieved Chairman’s Award in 2017

 

Hospital Website: https://www.narayanahealth.org/

 

3.Dr.Sundararajan Sridha

Dr. Sundararajan Sridhar

Qualification:

  • MBBS
  • MD
  • DM

Brief Profile:

Dr. Sundararajan Sridhar is a famous Endocrinologist and diabetologist, having experience of more than 35 years.

He offers the following service for patients.

Highlights:

  • Dr. Sundararajan Sridhar is setting up the Department of Endocrinology in hospitals of India and the UAE.
  • The doctor is an active member of various organizations.
  • Association of Physicians of India
  • Endocrine Society of India,
  • American Diabetes Association
  • Research Society of the Study of Diabetes.

Hospital Website:https://www.askapollo.com/

 

4.Dr. Rajendiran N

Dr. Rajendiran N

Qualification:

  • MBBS
  • MD

Brief Profile:

Dr. Rajendiran N is a famous Endocrinologist in Chennai. Now he is working as a Senior Diabetic Consultant in Apollo Hospitals, Chennai. He has an experience of over three decades. His expertise in diabetic consulting.

He Special interest in:

  • Gestational Diabetes
  • Type 1 Diabetes
  • Type 2 Diabetes 

Highlights:

  • Dr. Rajendiran N is the secretary of the Diabetes Association of India.
  • He is the founder President of the Madras Medical College Diabetes Alumni Association.

 

Hospital Website: https://www.askapollo.com/

 

5.Dr. Boochandran TS

Dr. Boochandran TS Diabetologist

Qualification:

  • MBBS
  • MSc

Brief Profile:

Dr. Boochandran T S is a famous Endocrinologist in Chennai with the experience of 25 years. He IS working as a consultant with the department of endocrinology at Apollo Greams Road, Chennai. He is working in the field of Diabetology and Endocrinology from 2001 and in General Medicine and Medical rotation from 1990.

His expertise lies in:

  • Thyroid P parathyroid disorder
  • Obesity
  • PCOD
  • Other related disorders

Hospital Website: https://www.askapollo.com/

 

6.Dr.Satish Kumar S

Dr.Satish Kumar S

Qualification:

  • MBBS (Bangalore Medical College, Bangalore)
  • Diploma (from the Institute of Healthcare Administration, Chennai)
  • MRCP(Royal College of Physicians of Edinburgh, UK)

Brief Profile:

Dr. Satish Kumar S is an endocrinologist, diabetologist, neuroendocrinologist, and bariatric physician and has more than 24 years of experience.

His expertise lies

  • Diabetes
  • Gestational diabetes
  • Type 1 diabetes
  • Weight management
  • Polycystic Ovarian Disease
  • Cholesterol problems
  • Hyper or Hypoparathyroidism
  • Osteoporosis
  • Vitamin D and B12 deficiency

Highlights:

  • Dr. Satish Kumar S has been awarded the Best Consultant Endocrinologist in Bangalore. Best Hospitals from Bangalore
  • He also achieved National Healthcare Excellence Awards in 2016.
  • He has presented many papers and publications.

Hospital Website:https://www.brlife.com/hospitals

 

7.Dr. PG Sundararaman

Dr. PG Sundararaman

Qualification:

  • MBBS
  • MD
  • DM

Brief Profile:

Dr. P G Sundararaman is a famous endocrinologist who has experience of more than 26 years. He has done MBBS, MD, and DM in Endocrinology specialty.

Highlights:

  • Dr. P G Sundararaman is an active member of various organizations:
  • Endocrine Society of India
  • Association of Physicians of India.
  • Dr. Sundararaman has given many lectures in national as well as international forums.

Hospital Website:https://www.askapollo.com/

 

8.Dr. Yash Pal Munjal

Dr. Yash Pal Munjal

Qualification:

  • MBBS (University of Delhi, Delhi)
  • MD(Post-Graduate Institute of Medical and Sciences, Chandigarh)

Brief Profile:

Dr. Yash Pal Munjal is a famous Endocrinologist who has more than 52 years of experience.

His expertise is

  • Hyperthyroidism
  • Hyperthyroidism
  • Thyroid Surgery
  • Pituitary gland problems.

Highlights:

Dr. Yash Pal Munjal has many publications, both national as well as international journals.

 

Hospital Website: https://www.artemishospitals.com/

 

9.Dr. Asim Siddiqui

Dr. Asim Siddiqui

Qualification:

  • MBBS
  • MD

Brief Profile:

Dr. Asim Siddiqui is a famous Endocrinologist in New Delhi Top 10 best hospitals in Delhi. Now he is working as a Senior Consultant in the Department of Endocrinology (Diabetes Care) at Indraprastha Apollo Hospitals, New Delhi.

His specialties in:

  • Diabetic
  • Thyroid
  • Obesity
  • Reproductive Disorder
  • Bone
  • Metabolism

His keen interests are in the field of Diabetes, especially in young and gestational diabetes & Post-transplant & post-metabolic surgery diabetes.

Highlights:

Dr. Asim Siddiquiis is an active member of the Royal College of Physicians (MRCP) and Royal College of Physicians of London.

 

Hospital Website:https://delhi.apollohospitals.com/

 

10.Dr. Jasjeet SinghWasir

Dr. Jasjeet SinghWasir Diabetologist

Qualification:

  • MBBS
  • MD

Brief Profile:

Dr. Jasjeet Singh Wasir is a famous Endocrinologist who has practice moreover 20+ years.

His specialties are:

  • Weight Management (Obesity) for Diabetes.
  • Assessment of Heart Attack risk for diabetes patients
  • Controlling and preventing Heart Attack for diabetes patients.

 

Highlights:

  • Dr. Jasjeet Singh Wasir is a faculty member of the Centre for Advanced Diabetes Therapy and Technology.
  • He plays a vital role in performing Weight Management Programme in Medanta.
  • He is also a member of the Medical Council of India.

 

Hospital Website:https://www.medanta.org/

 

11.Dr. Prashant Patil

Dr. Prashant Patil

Qualification:

  • MBBS
  • MD
  • Fellowship

Brief Profile:

Dr. Prashant Patil is a famous Pediatric Endocrinologist and has 33 years of experience in the field.

His special interests are

  • Type 1 diabetes mellitus
  • Obesity
  • metabolic syndrome
  • Growth disorders in children

He completed his ESPE clinical Fellowship in Pediatric Endocrinology & Diabetes from Alder Hey Children Hospital Liverpool, UK.

Highlights:

Dr. Prashant Patil has participated as a speaker in many conferences on Pediatric Endocrinology.

  • He is an active member of the European Society of Pediatric Endocrinology (ESPE).
  • International Society of Pediatric & Adolescent Diabetes (ISPAD).
  • Asia Pacific Pediatric Endocrine Society (APPES).
  • Indian Society of Pediatric and Adolescent Endocrinology (ISPAE).
  • Indian Academy of Pediatrics (IAP).
  • He has published many research papers.

 

Hospital Website:https://www.apollohospitals.com/

 

12.Dr. P S Lamba

Dr. P S Lamba

Qualification:

Brief Profile:

Dr. P S Lamba is a famous Endocrinologist who has experience of 41 years in his field.

His special interests are:

  • Endocrinology
  • Diabetes
  • Thyroid Disorders
  • Osteoporosis
  • Metabolic Bone Diseases
  • Pediatric Endocrinology
  • He also has a Lecturer at the Armed Forces Medical College.

Highlights:

  • He is an active member of various organizations.
  • Indian Medical Association.
  • Maharashtra Medical Council.
  • He awarded the General Srinagesh Gold Medal and Commendation from Flag Officer Commanding in Chief, Western Naval Command.
  • He has published more than 40 research papers.

 

Hospital Website: https://www.fortismumbai.com/

 

13. Dr. Arun Bal

Dr. Arun Bal

Qualification:

  • MBBS (University of Mumbai, Mumbai)
  • MS(University of Mumbai, Mumbai)

Brief Profile:

Dr. Arun Bal is the famous Endocrinologists in India and has more than 42 years of experience in the field. He is actively involved in Academics and Clinical research and is a teacher for the MUHS (Maharashtra University of Health Sciences) for the Fellowship in  Diabetic Foot.

Highlights:

  • Arun Bal is a member of the organizations.
  • Diabetic Foot Society of India.
  • Indian Medical Association.
  • Maharastra Medical Council.
  • He is the President of the Association for Consumers Action on Safety and Health.
  • He is an active member of the Forum for Medical Ethics and Ex-Editor of the Indian Journal of Medical Ethics.
  • Bal has invited in various national as well as international conferences.
  • He has written many publications for national as well as international journals like Diabetic Foot Care.

 

Hospital Website: https://www.fortismumbai.com/

 

14.Dr. Pradep Talwalkar

Dr. Pradep Talwalkar

Qualification:

Brief Profile:

Dr. Pradeep Talwalkar is a famous Endocrinologist who has more than 35 years of experience in his field. He has a Fellow of the Indian College of Physicians as well as the Diabetes Association of India.

Highlights:

  • Dr. Pradeep Talwalkar has got many conferences and  Medical Associations.
  • He is a Life Member of various organizations.
  • Association of Physicians of India.
  • Indian Medical Association.
  • Indian Society of Hypertension.
  • Indian Society of Clinical Pharmacology and Therapeutics.
  • Research Society for the Study of Diabetes.
  • Member American Diabetes Association.
  • He has also actively taken part in many conferences of the International Diabetes.
  • He has written over 50+ papers in national and international journals.

 

Hospital Website: https://www.fortismumbai.com/

 

15.Dr. Anoop Misra

Dr. Anoop Misra Diabetologist

Qualification:

  • MBBS
  • MD

Brief Profile:

Dr. Anoop Misra is a famous Endocrinologist and diabetologist. He has more than 40 years of experience in his field. He has worked in many medical institutions as a member of faculty at the Department of Endocrinology and Human Nutrition of the University of Texas Southwestern Medical Centre. Dr. Misra was a Fellow the World Health Organization at the Department of Diabetes and Cardiovascular Risk of the Royal Free Hospital, UK.  Along with that, he also has experience of moreover 30+ years in teaching, service, research, and other community health intervention programs. He has a lead investigator on body composition, like imaging of abdominal fat depots Liver & pancreatic fat in our country.

Highlights:

Dr. Anoop Misra has awarded the highest award for medicine in India like:

  • Dr. BC Roy award
  • National Honor
  • Padma Shree (2007).
  • Dr. Misra served 2 Indian Prime Ministers as an honorary and talented physician.
  • He has delivered many award lectures in many conferences.
  • He wrote many articles on the use of drugs and used insulin in India and has research collaborations with scientists from the USA, UK, and many countries.

 

Hospital Website: https://www.fortismumbai.com/

 

16.Dr. Debashish Saha

Dr. Denashish Saha

Qualification:

  • MBBS
  • MD

Brief Profile:

Dr. Debashish Saha is a famous Endocrinologist and has an experience of moreover 36+ years.

His expertise is:

  • Diabetes
  • Metabolic disorders
  • Osteoporosis
  • Menopause
  • Thyroid problems
  • Cancers of the endocrine glands

He is also famous for performing procedures like:

  • Liposuction
  • Medical management
  • Insulin treatment

Highlights:

  • Dr. Saha has got many awards for his achievements & contribution to Endocrinology, Internal medicine & Diabetology field.
  • He has published many medical journals.
  • He has attended seminars & workshops.

Hospital Website: https://www.amrihospitals.in/

 

17.Dr. C M Batra

Dr. C M Batra

Qualification:

  • MBBS
  • MD
  • DM

Brief Profile:

Dr. C. M. Batra is a famous diabetologist in India with the experience of 30 years. Now he is working as a Senior Consultant in the Department of Endocrinology at Indraprastha Apollo Hospitals, New Delhi.

His Specialities are:

  • Diabetic
  • Thyroid
  • Obesity
  • Reproductive Disorder
  • Bone and Metabolism

Highlights:

Dr. C. M. Batra is an active member of various organizations:

  • RSSDI
  • Endocrine Society of India
  • American Endocrine Society.

 

Hospital Website: https://www.apollohospitals.com/

 

18.Dr. Manoj Chwla

Dr. Manoj Chwla

Qualification:

  • MBBS
  • Diploma

Brief Profile:

Dr. Manoj Chawla is a famous Endocrinologist and diabetologist. He has more than 18 years of experience in his field. He is the Director and Consultant Diabetologist at Lina Diabetes Care & Mumbai Diabetes Research Centre. Dr. Chawla is also the Founder President of the United Diabetes Forum. He has the Principal Investigator for many global clinical trials for new antidiabetic drugs.

His particular interest in:

  • GCMS
  • Insulin Pumps.

Highlights:

  • Dr. Manoj Chawla is a member of the Maharashtra Medical Council, India representative at the IDF General Assembly.
  • He has awarded the “Best Consultant Diabetologist in Mumbai” Award.
  •  Dr. Chawla has written and presented various research papers at national as well as international symposia.

 

Hospital Website: https://www.fortismumbai.com/

 

19. Dr. Neeru Gera

Dr. Neeru Gera

Qualification:

  • MBBS
  • DM

Brief Profile:

Dr. Neeru Gera is a famous diabetologist in India with an experience of more than 17 years of experience in her field. Currently, she is working as a Consultant in Endocrinology & Diabetes department at Max Super Speciality Hospital, Saket His Speciality in General Endocrinology. Her Believes is to promoting health awareness and maintain a healthy lifestyle

Highlights:

  • Neeru Gera published many papers in India and out of India.
  • She is a member of many prominent medical organizations.

 

Hospital Website:https://www.maxhealthcare.in/

 

20.Dr. Richa Chaturvedi

Dr. Richa Chaturvedi Diabetologist

Qualification:

  • MBBS
  • MD
  • DM

Brief Profile:

Dr. Richa Chaturvedi is a famous diabetologist with the experience of more than 14 years. Now she is working as a Senior Consultant in the Department of Endocrinology & Diabetes at Max Hospital, Gurgaon Best multi-specialty accredited hospitals from Gurgaon.

Her keen Interests are:

  • Type 1 Diabetes
  • Type 2 Diabetes
  • Gestational Diabetes
  • Gigantism and Acromegaly
  • Cushing Syndrome
  • Hyperprolactinemia
  • Hyperthyroidism
  • Hypothyroidism
  • Polycystic Ovary Syndrome

Highlights:

Dr. Richa Chaturvedi is a member of various organizations:

  • Delhi Medical Council (DMC)
  • Medical Council of India (MCI)

 

Hospital Website: https://www.maxhealthcare.in/

Diabetes- Detection Prevention and Management

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List of Top 20 Eye Specialist/Ophthalmologists

List of Top 20 Eye Specialist/ Top 20 Ophthalmologists

Here is the list of top 20 Eye Specialist/Top 20 Ophthalmologists

.

1.Dr.V C Parthasarathy

Dr.V C Parthasarathy Ophthalmologists

Qualification:

  • MBBS
  • Fellowship

Brief Profile:

Dr. V C Parthasarathy is a famous Ophthalmologistand has 35 years of experience in this Ophthalmology field.

His special interest in:

  • Paediatric Ophthalmology
  • Squint
  • Micro Incision Cataract surgery.

He serves the clinical services at the Leela Eye Clinic in Chennai Best multi-specialty accredited Hospitals from Chennai .

His medical interests are

  • Anterior Segment Surgery
  • Cataract Surgery
  • Nasolacrimal Duct Obstruction
  • Phacoemulsification Surgery
  • Pediatric Eye Muscle Surgery
  • Teeth Straightening/Braces
  • Glaucoma Evaluation / Treatment
  • Diabetic Eye Check-up Age-Related Macular Degeneration Treatment
  • Avastin Injections Diabetic Retinopathy Screening/ Treatment
  • Yag Iridotomy
  • Visual Field Test
  • Optical Coherence Tomography (OCT)

Highlights:

Dr. V C Parthasarathy is actively working with many organizations such as:

  • All India Ophthalmological Society
  • Tamil Nadu Ophthalmologists Association
  • Royal College of Ophthalmologists, UK
  • American Academy of Ophthalmology (AAO)

 

Hospital Website:https://www.apollospectra.com/

 

2.Dr.Deependra V Singh

Dr.Deependra V Singh

Qualification:

  • MBBS
  • MD
  • Fellowship

Brief Profile:

Dr. Deependra V Singh is an ophthalmologist who has experience of more than 16 years and he has done 5000 vitreous surgeries.

He is a member of various organizations:

  • Indian Medical Association (IMA)
  • All India Ophthalmological Society
  • Vitreo Retina Society of India (VRSI)
  • Delhi Top 10 best hospitals in Delhi Ophthalmological Society (DOS)
  • Delhi Medical Council.

Highlights:

Dr. Deependra V Singh achieved various awards:

  • Best Resident Award
  • Special Social Service Award
  • DOS Teachers’ Award.

Dr. Singh has published over 50+ publications with 25 indexed in many international journals like:

  • Acta Ophthalmologica Scandinavica
  • Clinical and experimental ophthalmology
  • Ophthalmology (AAO)
  • American Journal of Ophthalmology

 

Hospital Website:https://www.eyeqindia.com/

 

3.Dr. Sudipto Pakrasi

Dr. Sudipto Pakrasi

Qualification:

  • MBBS(Maulana Azad Medical College)
  • MD (All India Institute of Medical Sciences)
  • DNB

Brief Profile:

Dr. Sudipto Pakrasi is one of the famous Ophthalmologist in Delhi. Has an experience of more than 27 years. He has worked in some of the famous hospitals in Delhi. His special interest lies in Cataract surgeries and Glaucoma.

Highlights:

Dr. Pakrasi  has seen in many noteworthy news media such as:

  • Times of India
  • India Today
  • Medical Dialogues

 

Hospital Website:https://www.medanta.org/

 

4.Dr.Pratik Ranjan Sen

Dr.Pratik Ranjan Sen

Qualification:

  • MBBS (Gujarat University)
  • MS (Gujarat University)
  • Diploma(Gujarat University)

Brief Profile:

Dr. Pratik Ranjan Sen is a famous ophthalmologist and has an experience of more than 22 years in the field of ophthalmology. He has done over 8000+ of Retinal detachment and other Vitreoretinal diseases.

Highlights:

  • Dr. Pratik Ranjan Sen is a member of the Indian Medical Association.

 

Hospital Website:https://www.askapollo.com/

 

5.Dr. Viswanathan P

Dr. Viswanathan P Ophthalmologists

Qualification:

  • MBBS (Stanley Medical College and Hospital)
  • MS (Stanley Medical College and Hospital)
  • MRCS(Royal College of Surgeons of Edinburgh, UK)

Brief Profile:

Dr. Viswanathan P is a famous ophthalmologist with experience of more than 18 years.

He provides several services which are:

  • Squint Surgery
  • Refractive Surgery
  • Eyelid Surgery
  • Oculoplastic Surgery.

Highlights:

Dr. Viswanathan P is an active member of various organizations:

  • Tamil Nadu Medical Council
  • All India Ophthalmological Society
  • Indian Medical Association (IMA)

 

Hospital Website:https://www.askapollo.com/

 

6.Dr. Sanjay Dhawan

Dr. Sanjay Dhawan

Qualification:

  • MBBS
  • MS

Brief Profile:

Dr. Sanjay Dhawan is a famous Ophthalmologist in New Delhi with the experience of more than 19 years. Currently, he is working as Director in Ophthalmology department with Max Super Speciality Hospital, Saket. He is 1st to popularize in the technique of SICS for mass application in New Delhi and 1st to introduce a Topical Anesthesia to perform SICS.

Highlights:

  • Dr. Sanjay Dhawanis awarded by Delhi University Gold Medal in1995 by the Former President of India Shri K R Narayanan.

 

Hospital Website:https://www.maxhealthcare.in/

 

7.Dr. Sudhir Bhatia

Dr. Sudhir Bhatia

Qualification:

  • MBBS
  • MS

Brief Profile:

Dr. Sudhir Bhatiais a famous Ophthalmologist in New DelhiCurrently associated as a Senior Consultant at Bharti Eye Hospital, New Delhi. He is specialized in Eye surgery and ophthalmology.

His special interests are:

  • Glaucoma
  • Medical retina
  • Cataract
  • Refractive surgery

Highlights:

Dr. Sudhir Bhatia an active member of famous organizations like:

  • All India Ophthalmological Society
  • Delhi Diabetic Forum
  • Delhi Medical Association

 

Hospital Website:https://www.bhartieye.com/

 

8.Dr. Vandana Khullar

Dr. Vandana Khullar

Qualification:

  • MBBS (Aligarh Muslim University, Aligarh)
  • MS(Aligarh Muslim University, Aligarh)

Brief Profile:

Dr. Vandana Khullar is a famous Ophthalmologist who has experience of more than 24 years.

Her expertise lies in:

  • Lasik
  • Sintemica
  • ophthalmologic examinations

Highlights:

Dr. Vandana Khullar is an active member of various organizations:

  • All India Society of Ophthalmology
  • Delhi Ophthalmology society

 

Hospital Website:https://www.psrihospital.com/

 

9.Dr. Dharitri Samantarav

Dr. Dharitri Samantarav

Qualification:

  • MBBS
  • MS

Brief Profile:

Dr. Dharitri Samantaravis a famous Ophthalmologist in New Delhi. Now she is working as an Ophthalmologist and Eye Surgeon in the ophthalmology department at Bharti Eye Hospital, New Delhi.

She is specialized in:

  • Cataract
  • Refractive Surgery
  • Medical Retina.

Previously she has worked as an Ophthalmologist at Jaslok Hospital, Mumbai (Best hospitals in Mumbai), and DDU Hospital, New Delhi.

Highlights:

Dr. Dharitri Samantaravis an active member of various organizations like:

  • All India Ophthalmological Society
  • The Orissa Council of Medical Registration
  • Delhi Medical Association

 

Hospital Website:https://www.bhartieye.com/

 

10.Dr. Sanjiv Mohan

Dr. Sanjiv Mohan Ophthalmologists

Qualification:

  • MBBS (SMS Medical College, Jaipur)
  • MS (Karnataka University)
  • Fellowship

Brief Profile:

Dr. Sanjiv Mohan is a famous ophthalmologist with an experience of more than 18 years.

He has huge experience in:

He has completed his advanced surgical training from Scotland UK.

Highlights:

Dr. Sanjiv Mohan has invited as a guest lecturer at many national as well as international conferences.

 

Hospital Website:https://www.venkateshwarhospitals.com/

 

11.Dr. Sunaina Arora

Dr. Sunaina Arora

Qualification:

  • MBBS
  • MD

Brief Profile:

Dr. Sunaina Arora is a famous Ophthalmologist who has more than 25 years of experience. She is famous in reputed institutions for cataract surgeries. She has also over 16+ years of experience in anterior segment and cataract surgery. She has taken part in the training for DNB Ophthalmology student.

Highlights:

  • Sunaina Arora attended many conferences, delivered lectures.
  • She is an active member of the Delhi Ophthalmic Society.

 

Hospital Website:https://www.fmri.in/

 

12.Dr. Anita Sethi

Dr. Anita Sethi

Qualification:

  • MBBS (Maulana Azad Medical College)
  • MD (AIIMS)
  • DNB
  • FRCS(Edinburgh, UK)

Brief Profile:

Dr. Anita Sethi is a famous Ophthalmologist and has experience of more than 22 years. & has established the ophthalmic services at Artemis health institute, Gurgaon Best multi-specialty accredited hospitals from Gurgaon, and Nova Specialty Hospitals, New Delhi.

Her expertise in:

  • Lasik Surgery
  • Phaco Eye Surgery
  • Refractive surgery
  • Ptosis
  • other Oculoplastic Surgery
  • Cornea treatment
  • Cataract treatment

Highlights:

  • Dr. Anita Sethi has chaired many sessions and conducted workshops at a national level.

 

Hospital Website:https://www.fmri.in/

 

13.Dr. Pankaj Katairia

Dr. Pankaj Katairia

Qualification:

  • MBBS (Assam Medical College, Dibrugarh)
  • MS (Army College Of Medical Sciences, New Delhi)

Brief Profile:

Dr. Pankaj Katairia is one of the famous and coveted Ophthalmologists with the experience of more than 28 years.

His keen interest lies in:

  • Cataract
  • Glaucoma
  • Corneal Disorders
  • Medical Retina in Posterior Segment disorders

Highlights:

He is an active member of various organizations such as:

  • Indian Medical Association, Faridabad
  • Delhi Ophthalmological Society (DOS)
  • All India Ophthalmological Society
  • Faridabad Ophthalmological Society
  • He has written for various national publications

 

Hospital Website:https://www.ibshospitals.com/

 

14.Dr. Nikhil S Sadar

Dr. Nikhil S Sadar

Qualification:

  • MBBS
  • DOMS

Brief Profile:

Dr. Nikhil S. Sardar is a famous Ophthalmologist at Nanavati Super Speciality Hospital, Mumbai. He has18 years of experience in Ophthalmology field. He started working at Nanavati Hospital, he has also worked with many famous medical institutions of India. He has independently conducted more than 1,000 surgeries.

 

Hospital Website:https://www.nanavatihospital.org/

 

15.Dr. Krishna Kumar Thakkar

Dr. Krishna Kumar Thakkar Ophthalmologists

Qualification:

  • MBBS
  • Diploma
  • Fellowship

Brief Profile:

Dr. Krishna Kumar is a famous Ophthalmologist with more than 40 years of experience in this field. He has vast experience in eye disorders surgically like trauma. He has also performed more than 3,000 cataract surgeries and refractive and glaucoma surgeries.

His medical interests are:

  • Ocular trauma
  • Reconstruction of the eyelid
  • Adnexa post-surgery/ trauma, watering eye
  • Dry eye
  • Vision correction

 

Hospital Website:https://www.columbiaindiahospitals.com/

 

16.Dr. Rupal Gupta

Dr. Rupal Gupta

Qualification:

Brief Profile:

Dr. Rupal Gupta is a famous opthalmologist and has more than 20 years of experience. She has done operated many successful Squint surgeries in which he has more than 15 years of experience. Previously, she was secretary of the Gurgaon Ophthalmological Society.

Her expertise lies in:

  • Squint
  • Glaucoma
  • Paediatric Ophthalmology

Highlights:

  • Dr. Rupal Gupta is a lifetime member of various organizations:
  • All India Ophthalmological Society
  • Gurgaon Ophthalmological Societies
  • Indian Medical Association

 

Hospital Website:http://w-hospital.in/

 

17.Dr. Sonia Bhalla

Dr. Sonia Bhalla

Qualification:

  • MBBS (LLRM Medical College)
  • MS

Brief Profile:

Dr. Sonia Bhalla is a famous Ophthalmologist and has more than 20 of experience. Her specialty in Medical Retina and she is interested in Diabetes. She is an expert in anterior segment surgery.

Highlights:

  • Dr. Sonia Bhalla has got a Gold Medal
  • She is an active member of various organizations
  • Delhi Ophthalomolical Society
  • All India Ophthalmological Society

 

Hospital Website:https://www.fmri.in/

 

 18.Dr. Aniel Malhotra

 Dr. Aniel Malhotra

Qualification:

  • MBBS
  • MS
  • DOMS

Brief Profile:

Dr. Aniel Malhotra is a famous ophthalmologist and has experience of more than 33 years.

His expertise in

  • LASIK Surgery
  • Laser Treatment
  • Squint
  • Cataract Surgery
  • Other treatments of the eyes

Highlights:

Aniel Malhotra is an active member of many medical organizations such as:

  • American Academy of Opthalmology
  • All India Opthalmic Society
  • Delhi Opthalmic Society
  • Delhi Medical Association.
  • He has got Fellowship from Sankara Nethralaya, Chennai

 

Hospital Website:https://delhi.apollohospitals.com/

 

19.Dr. Sougata Paul

Dr. Sougata Paul

Qualification:

  • MBBS
  • MS
  • DO
  • FRCS

Brief Profile:

  • Dr. Sougata Paul is a famous Ophthalmologist and has experience of more than 25 years. His medical interests are
  • Diabetic eye disease
  • Lasers treatment
  • Cataract surgery

Dr. Paul has worked as an Ophthalmologist at Royal Albert Edward infirmary near Manchester, UK.

 

Hospital Website:https://www.amrihospitals.in/

 

20.Dr. Dinesh Kumar Mehta

Dr. Dinesh Kumar Mehta Ophthalmologists

Qualification:

  • MBBS (University of Delhi)
  • MS(University of Delhi)

Brief Profile:

Dr. Dinesh Kumar Mehta is a famous ophthalmologist and has more than 43 years of experience.

His expertises are:

Highlights:

  • D K Mehta has many publications in both national as well as international journals.
  • He presented many scientific papers in both national as well as international conferences.

 

Hospital Website:https://www.artemishospitals.com/

 

 

 

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Impact of Air Pollution on Healthcare

How to Lessen the Damaging Effects of Air Pollution?

Air pollution affects 9 out of 10 people and is responsible directly and indirectly to about 7 million deaths every year. There are two main types of air pollution – ambient (outdoor pollution) and household (or indoor) air pollution. The latter refers to pollution generated by household combustion of fuels (caused by burning fuel such as coal, wood, or kerosene) using open fires or essential stoves in poorly ventilated spaces. Both are complementary since the polluted air moves freely between the indoor and the outside environment.

According to WHO, the significant harmful particles are those with PM size less than 2.5 microns. 7 out of 10 most polluted cities are in India, the majority of them being in North India.

The significant effects of polluted air are on the cardio-respiratory system. They include asthma, breathing difficulties, obstructive lung diseases, fibrosis, etc. In people with asthma, there may be wheezing, chest tightening, and further respiratory distress.

Air pollution affects the musculoskeletal system, as well. People living in highly polluted zones show weaker bone strength and more risk of osteoporosis and bone fractures.

Air pollution has shown to affect the reproductive functions of males and females alike. In males, there has been psychological distress, reduced libido, and more inferior sperm quality. In females, exposure to air pollution has a higher chance of congenital disabilities and congenital anomalies.

Following are how one can limit the effects of air pollution on one’s health:

Preventing and Minimising Indoor Air Pollution:

Impact of Air Pollution on Healthcare

Air purifiers have mixed scientific evidence with regards to their efficacy. They are particularly helpful to people with allergies. They are proposed to lower the levels of stress hormones, blood pressure, and insulin resistance, according to a study. They are efficient in removing dust, pollen, and smoke from the air.

Smoking must be banned, and the use of chulhas/ wood-fuelled gas stoves must be avoided. The smoking of tobacco is a crucial source of air pollution indoors and outdoors. Active smoking is not only harmful to the person who smokes but also to the close contacts and family members of such persons through passive smoking.

Automobile Pollution and High-traffic areas:

Avoid particle pollution. Combustion emissions from car and truck engines as well as from power plants release CO2, NO2, and SO2 in the atmosphere. The automobile industry, including the aviation industry, is the most significant contributor to air pollution. Thus, one must protect oneself if one lives in a highly polluted area. Wearing protective masks is advised in people living near coal-powered thermal power plants or dense traffic areas.

Outdoor exercises should be avoided. Keep Windows closed during the daytime during such traffic hours. During the night when pollution is relatively on the lower side, one can open them again for ventilation. Rural areas have relatively cleaner air. However, with massive urbanization, such divides are now obsolete.

In persons with Pre-existing disease:

Air pollution would have more health effects on those who have pre-existing heart disease or other cardio-respiratory problems. Such people are advised to take their medications regularly to decrease their susceptibility to the harmful effects of pollution.

Dietary Modification and Exercise:

An improvement in the diet by including more fruits, vegetables, whole grains, lean proteins would help to build a proper immunity. Besides, it would also provide the person with anti-oxidants and delay premature aging. Ant-oxidants destroy the free radicals generated during chemical reactions in the body and prevent damage to various organs. Regular exercise, up to 30 minutes a day or 3 hours a week, would release endorphins in one’s system. They lead to positive well-being and relieve stress. Also, they help in improving one’s lung ventilation and cardiac activity tolerance.

Impact of Water Pollution on Healthcare

 

Reducing one’s Carbon-Footprint:

In today’s era of global warming and climate change, concerted efforts are required at the individual, local and international levels. On a personal basis, one can choose cycling over bikes for short distances or use public transportations more frequently. Carpooling for a group of employees going to an everyday workplace will also help to cut down on emissions. At the governmental level, it has become mandatory in India, in metro cities to phase out diesel vehicles. These are replaced with CNG vehicles, including buses, autorickshaws, and taxis.

Also, from 1st April 2020, India has decided to adopt the Bharat Stage VI norms. Accordingly, all newly registered vehicles after 1st April would have a BS-VI certified engine with stricter emission norms. These would lead to more uniformity in global standards and make India at par with Euro VI standards.

 

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Impact of Water Pollution on Healthcare

How to Lessen the Damaging Effects of Water Pollution?

Around 71% of Earth’s surface is covered by water. However, most of it is unfit for drinking purposes or is inaccessible. Safe and potable drinking water is a fundamental human right of all citizens. According to the WHO, around 80% of infectious diseases are water-borne and contribute to 3.1% of global deaths.

Water pollution is defined as contamination of water bodies, which includes lakes, rivers, oceans, and groundwater. Water pollution is one of the leading causes of (2) global pollution.

The factors contributing to water pollution:

Impact of Water Pollution on Healthcare

  • Rapid industrialization and discharge of effluents from the factories
  • Unplanned urbanization with the discharge of effluents into water bodies
  • Excessive leaching of pesticides and agrochemicals in groundwater; due to the over-use of such chemicals
  • Radioactive seepage from power plants.

These wastes have adverse outcomes on human health. Different inorganic pollutants involving chemicals, heavy metals, and fertilizers; and organic pollutants involving bacteria, viruses, and parasites cause various diseases. It depends on their concentration and their mode of entry and multiplication in the human body. Water-borne diseases like typhoid, cholera, and bacterial dysentery are spread through contaminated water and may lead to epidemics. Regular examination of the physical and chemical properties of water is essential to ensure a safe supply of water and the prevention of water-borne diseases.

In addition to human lives, water pollution is harmful to aquatic life as well. It affects both aquatic vegetation and animals. Pesticides and insecticides when entering the water body, they are taken up by fishes, then through birds which feed on such fishes and other top-level consumers. As a result, the concentration of the chemical goes on increasing in the successive consumers involving humans. We know this as bio-magnification and is detrimental to human and environmental health.

The concentration of insecticides like DDT (though it is currently banned, it is still used illegally in some countries) is increasing along the food chain. These are harmful to humans and can lead to various problems such as decreased sperm count, infertility, nerve damage, immune suppression, among others.

Untreated domestic sewage causes nearly 80 % of water pollution. It includes bacterial contaminants, microplastics, solid contaminants, among others, and thus, if released before treatment, can lead to decreased flora and fauna of the aquatic environment.

The heavy metal pollution is caused by the mineral industries and is more harmful. The metals get deposited in the bodies and are not excreted out of it.

Fertilizer usage in excess also causes specific problems. About 2/3rd fertilizers are taken while 1/3rd are leached into the soil. These are rich in phosphorous and nitrates. They promote the growth of cyanobacteria or blue-green algae in water bodies. Gradually, they take up the entire area of the water body leading to eutrophication. Thus, the source of water is converted into vegetation. Residues of chemicals mix with river water due to flooding, heavy rainfall, excess irrigation, and enter the food pyramid. These chemicals contaminate the fruits and vegetables and thus enter the human body.

 

Impact of Air Pollution on Healthcare

 

Ways to Reduce Water Pollution

  • Using less plastic and opting for biodegradable alternatives
  • Reducing consumption, reusing utilities and recycling goods
  • Do not dispose of oils, medicines, and chemicals in sinks.
  • Not disposing of non-biodegradable things (wrappers, straws in water bodies)
  • Avoid using dishwashers or washing machines for a few utensils or a few pairs of clothes.
  • Limiting the use of bleaching powders and detergents
  • Eco-friendly gardening practices and water conservation through tanks
  • Use of bio-fertilizers and environmental methods instead of chemical insecticides.
  • Preventing oil spills
  • Using organically grown vegetables and fruits
  • Joining Water Conservation movements
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Personalized Medicine: Targeted Treatment for better Patient Outcome

Personalized Medicine: Targeted Treatment for better Patient Outcome

Personalized Medicine, is also known as precision medicine designed for individuals. Precision medicine separates peoples into a different category with the help of therapy, drugs given to the patients, and risk of disease development in individuals.

Personalized medicine is developed for selecting proper treatment based on the cellular analysis. Every person contains a unique human genome. Modern techniques in precision medicine depend on the patient to confirm the genome. DNA, RNA, or proteins are helpful to confirm the disease condition.

The precision medicine technique gives a new method of treatment. In precision medicine, there is no need for new drug development. Customization of the drug is conducted in precision medicine, which is helpful in the treatment of different category patients. In some conditions precision medicine targeted to the disease-causing agent instead of a patient’s genetic markup such as drug-resistant bacteria or viruses.

What is personalized medicine?

Personalized Medicine Concepts:

_Personalized Medicine

  • Disease Risk Management: – Precision medicine is helpful to control the genetic disorder. It is also helpful in the prediction of the risk of a patient for particular diseases. This approach uses the sequencing technology to focus on disease risk. By applying preventive therapy we can decrease the risk of that disease condition. For example type, two diabetics can prevent by using gene mutation therapy.
  • Application of precision medicine: – Advance personalized medicine will create unique treatment specific to the individuals and their genome. Precision medicine is a better diagnosis than other drug development and therapy.
  • Diagnosis and intervention: – Having the ability to customized therapy for individuals shows the more chances of treatment of disease. By using the genotyping process we can compare human DNA with the reference genome to identify the risk of the disease condition. Pharmacogenomics is helpful to provide more information on the patient genome which is helpful in drug prescription. The overall information about the patient genome is helpful to calculate the adverse effect of drug and risk factors of the drug to the individuals. Personalized medicine can use the diagnostic test guide therapy like MRI with contrast, Nuclear imaging agent, PET radiators including DNA sequencing.
  • Drug development and usage: – The process of drug development and storage of genomic information of an individual’s approval of the FDA is needed. If the patient is selected for the inclusion and exclusion of the genome for genetic makeup for the final stage clinical trial. Being able to identify the safety of patients and adverse outcomes from them also the cost of this therapy is must be small. Because of precision medicine, it is easy to understand the detailed information about a patient that guide to make the correct decision in treatment in prescription.
  • Respiratory proteomics: – Respiratory diseases like Asthma, Chronic Obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, and lung cancer are the most dangerous disease conditions. This disease requires early diagnosis. Precision medicine provides personalized treatment to individuals.
  • Cancer genomics: – Now a day’s cancer is a new challenge for the pharmaceutical industry. Cancer genomics also known as “Oncogenomics” is the application of genome in cancer research and treatment. Gene sequencing is used for the characterization of the genome associated with cancer. This method is helpful to understand pathology od cancer and helpful in drug and therapy development.
  • Challenges: – Nowadays of precision medicine practice increases. Physician happily accepting precision medicine because of its huge benefits. But for the rising of precision medicine, lots of challenges arise. Such as Intellectual property rights, reimbursement policies, patient privacy. Precision medicine is a field of medicine which required experts in specific fields of research like medicine, clinical oncology, biology, and artificial intelligence.

Benefits of precision medicine

  1. Precision medicine is helpful in the treatment of cancer and diabetes. Know more about Cancer.
  2. It helps to improve the recent development of genomics, proteomics, metabolomics, and cell diversion assay
  3. It is not only helpful to categorize the diagnosis of patients but also the strategies of the therapy.
  4. A large number of the biological data is saved and it’s helpful to improve the treatment of cancer.

Potential of precision medicine: –

Precision medicine shows initiatives in health and health care services. Precision medicine gives a new approach to the protection of patient history and confidential data. Improvement in the design of medical data is possible because of precision medicine. The innovation of new drugs ensuring more effectiveness and more safety is possible because of precision medicine. Precision medicine helpful to make the partnership between specialist scientists, universities pharmaceutical companies, and patients. It gives large scale opportunities in the scientific research field.

Precision medicine initiative and medical care: –

Precision medicine is the most important part of the healthcare industry right now, the short term goal of precision medicine is to expand the cancer genomics and develop better prevention and treatment methods. Precision medicine is helpful in prescribing improve and more effective the drug with fewer side effects. Precision medicine’s next target is to eliminate the side effects and reduce the time and cost of clinical trials. Precision medicine is helpful to eliminate trial and error inefficiencies and focus on patient care.

Personalized medicine in different types of cancer: –

Personalized medicine contains the whole study of genes. The study of different human genes is helpful in designing treatments for different cancers. This treatment has fewer side effects. The cancer treatment contains the development of cancer and screening test at less risk. Matching treatment for patient genes and cancer gene and risk recurrence. Targeted therapy is carried out for different types of cancer such as Bladder cancer, Brain cancer, breast cancer, cervical cancer, colorectal cancer, endometrial cancer, esophageal cancer, head and neck cancer, GIST, Kidney cancer, Leukemia, liver cancer, melanoma, multiple melanomas, Neuroblastoma, Neuroendocrine tumors, Pancreatic cancer, prostate cancer, soft tissue sarcoma, stomach cancer, thyroid cancer, and some childhood cancer. Researchers find new target cancer and create tests and new drugs for these cancers. Personalized treatment is not available for all types of cancer. Some treatments are only available in clinical trials, as well as its more expensive.

Targeted treatment in Breast Cancer: –

Breast cancer is the most common type of cancer that occurred in women. In earlier, chemotherapy, radiotherapy, mastectomy, and then lumpectomy were available for the treatment of breast cancer. But these therapies are not effective on everyone and many patients cause adverse drug reactions, which affected on morbidity and mortality of the patient. Retinoblastoma tumor suppresser pathways play an important role in the clinical aspect of breast cancer biology. When pathologists diagnose breast cancer, s/he studies size type and grade of cancer. Hormone receptor tests and HER2 receptor status tests are carried out. Tumor profiling test is helpful to give information about cancer cells. Test like Oncotype DX, PAM50, mama print is recommended for the American society of clinical oncology. HER2-targeted therapy is used as a drug treatment for breast cancer. PARP inhibitors used to treat metastatic breast cancer. It is FDA approved therapy for metastatic cancer. The therapy for breast cancer is depending on larger-scale clinical trial results.

WHY precision medicine is important: –

Precision medicine gives a new era to the health care industries. The following thing made precision medicine important now a day. Person to person genome is changing so the same treatment for individuals doesn’t work so precision medicine gives you customized treatment for individuals. An individual’s medical conditions and personal history is helpful to improve the therapy. Gene biology and environmental factors play an important role in disease etiology. Genomic makeup and gene sequencing play an important role in personalizes medicine. These therapies are helpful for the treatment of cancer. Also, precision medicine shows fewer side effects and more benefits. Large scale clinical trials show the beneficiary actions of precision medicine.

Precision medicine initiative in the United State:

In 2015 president Obama announced the launching of precision medicine initiative to improve health and treat disease. Precision medicine takes an innovative approach to take account of the individual’s genes, environment, and lifestyle. Precision medicine is helpful to treat the disease like cancer. Also, precision medicine enabling the physician to select a treatment with fewer side effects and improve the chances of survival. Precision medicine gives exciting ways to engage the patient’s physicians and researchers. Also, it helps to develop new therapy by including historical information and population research. Creation of workable models of information to connect the boundaries with proper securities and protections. It gives steps to increase research with high-quality data. And developed grand challenges and competitions for faster innovations.

References

  • Movafagh, Abolfazl. “Personalized medicine in modern era.” Asian Pacific Journal of Cancer Biology 1, no. 2 (2016): 31-32.
  • Mancinelli, Laviero, Maureen Cronin, and Wolfgang Sadée. “Pharmacogenomics: the promise of personalized medicine.” Aaps Pharmsci 2, no. 1 (2000): 29-41.
  • Collins, Francis S., and Harold Varmus. “A new initiative on precision medicine.” New England journal of medicine 372, no. 9 (2015): 793-795.
  • https://ghr.nlm.nih.gov/primer/precisionmedicine/potentialbenefits
  • https://www.cancer.net/navigating-cancer-care/how-cancer-treated/personalized-and-targeted-therapies/what-personalized-cancer-medicine
  • https://ww5.komen.org/BreastCancer/PrecisionMedicine.html
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196974/
  • ^Precision Medicine: Harnessing the Extraordinary Growth in Medical Data for Personalized Diagnosis and Treatment
  • https://obamawhitehouse.archives.gov/precision-medicine
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7 months ago Healthcare Buzz

Medicine and Healthcare: Knowledge Forum

Read to know more about “Medicine and Healthcare: Knowledge Forum”

1. What causes canaliculitis?

Canaliculitis is an infection caused by Actinomyces israelii, which is gram-positive bacillus with small branching filaments. Fungi like candida albinos and viruses like herpes simplex also cause of canaliculitis. Mild tenderness, redness of eyes, tearing discharge is the common symptoms of canaliculitis. A retained punctual plug can also cause canaliculitis. During an examination, the physician applied pressure to the lacrimal sac which causes secretion and a gritty sensation. Canaliculitis can be treated with antibiotics and surgery. Surgery is necessary to remove the foreign body. For canaliculitis treatment, first-generation cephalosporin or penicillinase-resistant synthetic penicillin may be used. Diagnosis of canaliculitis can be carried out by sign and symptoms, expression of turbid secretions with pressure on the lacrimal sac.

2. What are the symptoms of biliary atresia?

Biliary atresia is a liver and bile duct disease that occurs in infants. Symptoms of this disease can appear after two months of birth. The symptoms of biliary atresia are show symptoms like jaundice, the darkness in urine, clay-colored stools and weight loss. In jaundice, skin color changes into the yellow. Jaundice occurs because of the immature liver of the newborn baby. Dark urine caused by a breakdown of bilirubin from hemoglobin is filtered by the kidney and removes by the urine. An increase in biliary atresia also increases the level of jaundice.

3. What are the symptoms of strained tendon?

Strained is a stretch or tear on the tendons. It occurs when a single movement occurs repeatedly. There are two types of strain acute and chronic strain. The symptoms of chronic strain are muscle spasms, weakness, cramping, and immobility. Also, pain, bruising, and swelling are normal symptoms of strain. A symptom of strained occurs after eight to fifteen days.

4. Is Bartonella curable?

Bartonella is a gram-negative intracellular facultative bacterium. It’s also known as Cat scratch disease. It is commonly caused by Bartonella species. Bartonella’s disease is cured by time. The single antimicrobial agent helps to reduced symptoms of the disease. Commonly antimicrobial agents like Azithromycin, ciprofloxacin, gentamicin, trimethoprim-sulfamethoxazole, and rifampin. Bartonella is treated with oral Doxycycline 100mg for 6
weeks and gentamicin at 3mg/kg/day for 14 days. Bartonella infection can be treated with proper treatment and specific care. Prevention is better than cure Bartonella disease is prevented by wearing long sleeve and using repellents to avoid bites by flies.

5. Is Nocardia fatal?

Nocardia is also known as nacardiosis. Nocardia is bacterial infection cause by Nocardia bacteria. These bacteria attacked on the lungs, brain and skin. The people with low immune system get this bacterial infection. Fever, cough and chest pain are the symptoms of lungs nocardia. Headache, lethargy, confusion seizures and neurological problems are the symptoms of brain nocardia. The outbreak of the nacardiosis is occur in low immunity
people, or people who has connective tissue disorder, malignancy, bone marrow transplantation or organ transplantation (Know more about Organ Transplant), HIV/AIDS. The Diagnosis of nocardia is not so easy. Most of the uncomplicated Nocardia pneumonia is fatal. The fatality rate is increases when infection is increases.

6. Is throat cancer visible?

Throat is a hollow tube behind the nose and roof of mouth attached to the neck. Tobacco or excessive alcohol assumption is the main reason for throat cancer. Treatment of the throat cancer is depends upon the stage of cancer. Early stage cancer is treated with radiation therapy also precision medicine is also helpful to treat the cancer. Identification of stage of cancer is helpful for the treatment of cancer (All you need to know about Cancer). Early stage of cancer is not more than one inch and not spread through the lymph nodes. More than one inch spreading of cancer is local stage, in advance stage cancer cell increases above 3 inch, and metastatic cancer spread at any size. Throat cancer is visible by opening the mouth. Dentist can easily identify throat cancer.

7. What are the three different types of telemedicine?

Telemedicine is field of telecommunication which deals with health care. Telemedicine is helpful to interact with patient by the help of digital technologies. Telemedicine is also helpful in the surgery assistance. We can differentiate telemedicine in three types.
I. Store and forward telemedicine: – In this type of telemedicine is important for sharing health related information like lab report, imaging studies, videos and other record from health care professional to patients. Patient history is remaining safe and confidential. This method is useful for dermatology, ophthalmology and radiology.

II. Remote patient monitoring: – Remote patient monitoring is a process of monitoring patient health and activities by maintaining distance. This methods are useful for the high risk patient and the person who having chronic conditions. For example remote patient monitoring is helpful for tracking glucose level of diabetics.

III. Real-time telemedicine: – Real time telemedicine is video visit of patient with physician. It is popular for primary care urgent care follow up visit and the management of medications and chronic illness. Telehealth mast conducts the insurance portability and accountability act.

8. What are the five signs of emotional suffering?

Now days lots of people suffering from mental health. For identification of meanly ill person, following sign are helpful.
I. Personality changes: – sudden changes in person behavior can identify. Person starts to behave different than his personality. Behavior of person is not fit in their values.
II. Uncharacteristically angry, anxious, agitated, or moody: – Person gets angry on small things and don’t calm down easily. The extreme condition patients are unable to sleep. Person is get too moody and other persons are not able to handle this person.
III. Withdrawal or isolation from the people: – Persons who love to do parties are suddenly stopping parting. Person unable to do the work or schooling. Person avoids the public contact and get introvert.
IV. May neglect self-care and engage in risky behavior: – Person start drinking alcohol and engaged with the self-destructive movement. Person not follows the personal hygiene. Also he gets separated from the love one.
V. Overcome with hopelessness and overwhelmed by circumstances: – People start feel depressed and getting suicidal though in his mind. Also the person thing that he is useless and hopeless and start acting like that.

9. What causes bilharziasis?

Human bilharziasis is caused by S.haematobium, S.mansoni, S japonicum and S. mekongi. This infection is occurring when skin comes in contact with fresh water in which schistosomes infected snails are living. Also when infected people are urinate in water or schistosoma eggs are present in water. Schistosoma parasite penetrates into the skin while bathing swimming or washing the skin from contaminated water. After getting infected the person may develop rash itchy skin. Fever, chills, cough and muscle aches.in adults these egg travel though intestine, liver or bladder and cause infection to this organ. This parasite may get damage to the liver, intestine, lungs and bladder.

10. How is Nocardia transmitted?

Nocardiosis is a disease caused by opportunistic pathogen which is Nocardia bacteria. Nocardia bacteria are found in soil and plants. This bacterium is infecting to the people who has weak immune system. Nocardia bacteria spread when someone breathes in dust that contain bacteria .When soil and water carrying bacteria hit into the skin by cut or scrape. When infected person get treatment in the hospital and contaminate the medical equipment
and this used for the other patient transmit the infection to other patient.

11. How do I cure leucoderma?

Leucoderma is skin disorder in which white patches appear on the skin and the kin tends to lose its natural color. Closed patches formed on the skin because of disfigurement of the melanocytes in the body. White patches occur in smaller areas and the spread it all over the body. Skin changes noticeable between the ages 10 to 30 years.

  • Cause: – Leucoderma may be cause by auto-immune disorders like thyroid disorder, or genetic disorder, or may cause by congenital abnormalities like Tuberous Sclerosis, Partial albinism, Waardenenburg syndrome and Piebaldism. It also cause by the traumatic injuries like burn, accidental cuts on skin, Eczema,psoriasis and ulcers.
  • Symptoms: – White patches formation on skin part which is direct exposed to the sunlight, development of grey hair, grey eyelashes, gray beard, loss of color of mucosal membrane, loss of color of retina eyes. Also patient’s shows complications like loss of hearing, sunburns, loss of vision and increase in production of tear.
  • Treatment: – Physician focuses on the improvement of body metabolism which help improve the capability of the affected area. Result of leucoderma treatment is varying from person to person. Commonly medications like creams to improve the skin color and control the inflammation, and medicine for improvement of immunity of patient are used to treat leucoderma. Surgeries like skin grafting, blister grafting, and micropigmentation are useful to treat Leucoderma. Home remedies like application of mustard oil and turmeric oil, honey and margosa oil are helpful. Also yoga helps to build up immunity of the patient.

 

12. What is the easiest way to get rid of skin bruises?

Bruise is common skin disorder in which discoloration of skin occurs because of blood collection near skin surface due to damage blood cell.

  • Cause: – Bruise occurs when person heat something of something fall on the person. Its commonly occurs to sports persons while playing sports. Also older people common causes bruise because of thin skin also it may cause to the person who has taken blood thinner medicine.
  • Symptoms: – fresh bruise is reddish then it will turn blue to dark purple then yellow or green during healing. Pain occurs but when color get fades pain also goes away.
  • Treatment: – Massage of icepack helpful to heal bruise. Also Acetaminophen is given to relive the pain. There is no specific treatment for the bruise but these remedies helpful to get rid from bruise.

 

13.What disease is caused by Enterobius Vermicularis?

Enterobius Vermicularis is most common infection in the world. It is also known as Pinworm. This infection occurs only in humans. Pinworm is tiny thread like and whitish structure. Pin like tail is observe in the female worm.

  • Cause: – Pinworm infection transmitted by direct contact with the contaminated things. Also it transfers through the sexual contact. Pinworm infection is usually seen in children. Pinworm infection caused by ingestion of pinworm egg.
  • Symptoms: – itching and scratching, perianal pruritus.
  • Treatment: – Antihelminthic drugs are useful to treat pinworm. The following medication course is given to the patient.one time dose Abendazole 400mg empty stomach repeat after 15 days Or one time dose of  Mebendazole 100mg repeated in 15 days.  Young pinworms are resistant to the treatment that’s way two doses of medication is necessary.

 

14. What are the symptoms of Devic &39; s disease?

Devic disease is inflammatory condition which affect to the spinal cord and optic nerve. The protective covering of nerve calledmyelin. Devic disease attack on the myelin layer hence called Demyelinating disease. This disease affects above 40 year age peoples. There are two different types of Devic disease that is Relapsing NMO and Monophasic MNO. Relapsing MNO is attack of optic nerve and spinal cord for several years and Monophasic MNO is a limited attack for some day or weeks.

  • Symptoms: – Temporary or complete loss of vision, swelling of optic disc, eye pain, reduce sensitivity to color. Sensitivity to temperature, numbness, tingling and sensation of coldness or burning. Weak heavy limb, changes in urination patterns, constipation.
  • Cause: – Exact cause of Devic disease is not confirmed. But it is an autoimmune disorder in which autoimmune mistakenly attack on immune system.
  • Treatment: – Devic disease is difficult to diagnose because of similarities with the other neurological disorders like multiple sclerosis and other. Blood test, Lumbar puncture test, MRI scans helpful to identify the disease. Devic disease cannot be treated medication help to reduce the symptoms of the disease. Steroids are given to the patient such as injection of methylprednisone follow with oral steroid. The patient who does not respond to the steroid Plasma exchange therapy is given to them. In these therapy blood antibodies which cause the inflammation are remove. To reduce immune activity Azathioprine is given to the patient.

 

 

15. What cause black spot under my toenails?

Toenail is made up of keratin protein. Keratin protein makes them rough and resistant to tear and wear. Toenails function is protection of toes. Most of the time physical activity or friction of shoes cause the health problem to the toenails.

  • Causes of black spot:-Most of the injury to toenail is reason of black spot, such as nail stubbing to heard object or falling of heavy object on the toenails. Wearing tight fitting shoes also cause the injury to the toenail. Bacterial infection under nail also causes dark or green spot on toenails. Fungal infection is also one of the reasons for the black spot on toenails. The savior condition is cancer which produces black spot on the toenails.
  • Treatment: – Treatment of toenail blackspot is dependson the reason of black spot. Most of the time black spot on toenails are harmless. Black spot on the toenails due to fungal infection treated with antifungal pills also removal of pain may be recommended. Regular cleaning of feet and drying it, always wear a shoes or sandals on public places, do not share nail cutter and proper management of blood sugar level help to control the back spot on toenails.

 

16. What is Anti-malaria?

Anti-malaria is drugs which use to treat and prevent malaria. Malaria is serious topical disease spread by mosquitoes.

Symptoms:-Malaria shows symptoms like high temperature, feeling hot and cold, headache, vomiting, muscle pain, diarrhea.  These symptoms are seen with one or two weeks after person get infected.

  • Cause: – Malaria is cause by parasite known as plasmodium. These parasite spread through female anopheles mosquitoes which bite at night. It can also spread through blood transfusion.
  • Treatment: – Anti-malarial drugs are used to treat malaria. Type of medication and length of treatment is depend on the type of malaria, severity of symptoms, you take antimalarial to prevent malaria or not and patient is pregnant. Anti-malarial dugs are classified into three typesaccording to their structure and mode of actions
  1. Aryl amino alcohol compounds: – Quinine, quinidine, choloroquine, amodiaquine, mefloquinine, halofantrine, lumefantrine, piperaquine, tafenoquine.
  2. Antifolate compound: – Pyrimethamine, proguani, chlorproguanil, trimethoprim.
  3. Artemisinin compounds: – Atremisinin, dihydroartemisinin, artemether, artesunate

Antimalarial drugs show different pharmacokinetic action. So the doses of antimalarial drugs are varying. Also a different person shows different response to the antimalarial drug because drug response varies because of genetically determination, dietary factors another health conditions. Generally pharmacokinetic properties of antimalarial drug are similar in children and adults.

 

17.What are the sign and symptoms of Hantavirus?

Hantavirus is a viral infection cause by rodents. In Americas Hantavirus known as new worlds may cause Hantavirus pulmonary syndrome. In Europe and Asia found that Hantavirus hemorrhagic fever with renal syndrome.

  • Cause:-Hantavirus is cause by getting in exposure with the saliva and urine of infected rodents.
  • Symptoms: – Early symptoms of Hantavirus are fatigue, fever and pain in thigh hip back and shoulder muscle. Headache, dizziness, chills, and abdominal problems like nausea vomiting diarrhea, abdominal pain. After four to ten days symptoms like coughing, shortness of breath, tightness in chest and lungs feels like fluid.
  • Treatment: – Diagnosis of Hantavirus is difficult because its symptoms are same like influenza. Patient with such symptoms immediately concern with physician and tell him about rodent exposure. There is no specific treatment or vaccination for the Hantavirus infection. Infected patient receive the invasive care and intensive care unit. Patient given oxygen therapy to help him reduce respiratory distress. If patient feels full respiratory distress then treatment is not work on that patient.

 

 

18. How can Marfan syndrome be prevented?

Marfan syndrome is a genetic disorder which effects on the connective tissues which support and anchor the human organs to construct the organ system. Generally Marfan syndrome affect to the heart, eyes, blood vessels and skeleton. People with Marfan syndrome are tall with disproportionately long extremities.

  • Symptoms: – Marfan syndrome symptoms are vary from person to person that may include tall and slender build, disproportionately long arm, leg and figures. Breast bone pokes outwards or deep inwards. Heart murmurs, abnormally curved spine, flat feet.
  • Cause: – Marfan syndrome cause by defect in the genetic.
  • Diagnosis: – Connective tissue disorder and Marfan syndrome have same sign and symptoms and same family so it’s difficult to diagnose Marfan syndrome. To identify the Marfan syndrome ECG, CT, MRI may be helpful also eye exam like slit lamp test and eye pressure test also conducted. Genetic testing is rarely used to diagnose the Marfan syndrome.
  • Treatment: – Treatment is not available to cure the Marfan syndrome. So physician focus on prevention of complications of disease. Physician prescribed blood pressure lowering drug to prevent enlargement of aorta. Vision problem can cure with corrected glasses or lenses. Surgical procedures like Aortic repair, Scoliosis treatment, breastbone correction and eye surgeries also conducted. Providing emotional and practical support to such patient is important for survival of the patient.

 

19. What is the significance of liver echotexture?

Coarsened echotexture is ultrasound image which is taken to identify the liver abnormality or excessive fat saturation in the liver. Liver echotexture is helpful to identify the conditions like hepatic fibrosis, hepatitis, choledochal cysts, bile duct tumors, hepatic lymphoma, hepatic leukemia, small multiple biliary hamartomas or sickle cell disease, metabolic abnormalities like hepatic amyloidosis and glycogen storage disease.

 

20. What causes dacryocystitis?

Dacryocystitis is an inflammation of the nasolacrimal sac. Dacryocystitis infection may be acute or chronic and congenital or acquired. Dacryocystitis is located below the canthal tendon.

  • Cause: – dacryocystitis infection cause by blockage of lacrimal duct which allows bacterial growth inside the tear sac. Injury to nose or eye, nasal polyps, sinus inflammation, nasal surgery, foreign object in duct and cancer also causes dacryocystitis.
  • Symptoms: – pain redness and swelling on inside of eye, watery eye, swelling on nose side corner of eye. Pus formation on eye corner, fever on chronic condition teary discharge with little swelling is seen.
  • Diagnosis:-diagnosis of dacryocystitis is carried out on the base on symptoms and examination of eye, also CT scan of eye is conducted to see cause of blockage
  • Prevention: – To prevent dacryocystitis infection dacryocystorhinostomy is conducted. Also regularly drain the tear sac also helpful in prevention of tear duct infection.

21. Chest X-ray

X-ray is a medical test conducted by using radiograph. Chest X-ray performed to study heart, lungs, blood vessels and bones present in chest cavity. X-ray is oldest and mostly used technique to identify the abnormalities within the body.

  • Uses:-Chest X-ray is helpful to diagnose the symptoms like difficulty in breath, continuous cough, chest pain, chest injury, fever. Also chest x-ray helpful in the diagnosis the treatment pneumonia, heart failure, emphysema, lung cancer, position of medical device, fluid collection around the lung, or other medical condition.
  • Procedure: – Radiologist asks the patient to remove all metallic accessories and wear loose cloths. Pregnant woman must have to tell about their pregnancy to doctor before doing x-ray procedure. X-ray radiation form radio wave, the radio wave pass through the body and record the image on photographic frame. Most of the X ray-chest two views are taken for that radiologist ask patient to stand against the recording plate and then patient chest press against the image plate. Radiologist ask patient to hold the breath for few second white taking X-ray. Chest X-ray is not more than 20 minute procedure.

 

22. 12- Lead ECG

12 lead ECG records the heart activity. On the body surface heart activity is trace by using electrodes. EGC machine and the leads are two components which help to record the activity. In the 12 lead ECG placement the Placement of standardizes electrode is important to take accurate results.

  • Procedure: – Specialist cleans the patient skin properly, and sure skin is clean and dry. Specialist wipes the skin by alcohol wipe and places the electrodes. Patient must have to relax to stop the muscular tension which may interpret in the ECG recording. Patient’s chest and all four limbs should be exposed by the electrodes. Most of the time specialist use clavicular method for the ECG placement.

23. Catheterized angiography

Angiography is carried out in radiology department. Catheter angiography conducted by using Catheter. Use of catheter in the angiography help to combined diagnosis and treatment together. The clear and accurate images obtained by catheter angiography my reduced the need of surgery. Catheter is thin plastic tube which inserted into body by making small insertion in the body. The ECG electrodes may be place in the following position.

V1(C1) Fourth intercostal space at the right sternal border
V2(C2) Fourth intercostal space at the left sternal border
V3(C3)

 

 

Halfway between leads V2 and V4

 

V4(C4) Fifth intercostal space in the midclavicular line
V5(C5) Left anterior axillary line on the same horizontal plane as V4
V6(C6) Left midaxillary line on the same horizontal plane as v4 and v5
RA(R) Right arm (Inner wrist)
LA(L) Left arm (inner wrist)
RL(N) Right leg (inner ankle)
LL (F) Left leg (inner ankle)

 

V4 lead is place below the breast tissue in woman because breast tissue may impact on the ECG amplitude. Chest must be cover up with blanket to avoid exposed. ECG electrodes should be removed when there is no requirement of ECG.

  • Uses: – Catheter angiography is useful to study the blood vessels in the body organs like brain, neck, heart, chest, abdomen, pelvis, legs and feet, arms and hands. Also physician help to identify abdominal aortic aneurysm, abnormalities present in the chest. Detection of plaque in the carotid artery, it is also helpful in the kidney transplant procedure or stent placement procedure. It is helpful to identify the injuries happen in the arteries. To study the dissection of aorta.
  • Procedure: – Patient must have to inform the physician about their medication which being taken. Patient asks to wear loose cloths and remove all jewelry and metallic accessories. Pregnant woman must tell about her pregnancy to the physician. Also breastfeeding woman must have to ask physician about the procedure to avoid absorption of contrast material into breast milk. Patient must have to take a fast for 10 hours before exam. Technologist will insert IV line into small vein in arm. Small blood drops are removed before starting the procedure. The area of catheter insertion is must be clean and sterilized with local anesthetic. Technologists make small insertion and insert the catheter into the artery. When catheter is reached to the final destination then numbers of x-rays are taken. Then catheter is removed and incision area is closed by aping pressure for 15 minutes.

24. Artificial pacemakers

Pacemaker is battery operated devised used to correct irregular breathing of heart. Pacemaker is approximately 30 gram in weight having two parts one is generator with battery to control heart beat and another are leads which contain wires which connect heart and generator. Pacemaker is implant under the skin. Implantation of pacemaker is carried out in 60 minutes. Two types of pacemakers are used one is transcutaneous pacemakers and transvenous pacemakers.

  • Uses: – Artificial pacemakers are useful in the severe heart failure, bradycardia, and trachycardia.
  • Procedure: – Patient must have to tell about their medication to the physician before surgery. The day before surgery physician may ask to clean your body with special soap. The patient must have to take care to do not swallow anything for six hours before surgery. Small incision is made below the collarbone for the placement of pacemaker. By using live X-rays physician put leads into the incision into the veins it transfer into the heart. These leads connected to the generator. Incision closed with the stiches. Placement of artificial pacemaker is one day procedure.

25. Implantable defibrillators

Implantable defibrillators are small battery device which help in regulation of heart rhythm. Implantable cardioverter defibrillator is help to control the cardiac rhythm and irregular heartbeats.

  • Uses: – Implantable defibrillators helpful in the cardiac arrest, heart failure, ventricular trachycardia, and arrhythmias.
  • Procedure: – Doctors do various diagnostic tests to understand need to defibrillators implantation. The diagnostic tests like Electrocardiography, Echocardiography are performed. Before surgery patient ask to do not eat or drink anything for eight hours. The surgeon gives general anesthesia to the patient before starting surgery. One or more flexible wires are inserted into the veins near to the collar bone by the help of small insertion. By the help of live x-ray leads are secured into the heart and another end is secured to the generator. These is procedure may take long for few hours. After placement of defibrillator doctor check heart rhythm problem. After the procedure done patient should not move his left hand and shoulder for 15-20 days, it helpful in proper healing of leads.

26. Genetic screening

Genetic screening is application of test on the people for detection of genetic disease. For the genetic screening Approval of the patient family is necessary. Also study of family history is also necessary. Genetic counseling is necessary for the patient and patient family.  A complete cardiogenetic evaluation is necessary for confirmation of diagnosis. Detail and accurate format of patient and patient family is necessary.  Genetic screening is a public program, which help the people to prevent or early treatment of hereditary diseases .Genetic screening is secondary prevention strategy which help to identify the disease before starting symptoms. Genetic screening program is dividing into three types.

  1. Preconception screening: – This type of screening carried out before having a children.
  2. Prenatal screening: – This type of screening is conducted during pregnancy.
  3. Newborn screening: – this type of study is conducted after child birth.

27. Back X-ray( Spine X-ray)

Detailed examination of back bones and spine are conducted by using back X-ray. In the Back X-ray Separate images of cervical thoracic and spine are taken.

  • Uses: – spine X-ray is conducted to study the back injury. Also it is helpful in diagnosis of the fractures, tumors, Arthritis, Disc problem, deformities in the curved of spine, osteoporosis, or bone infection.
  • Procedure: – Patients ask to remove all the accessories and wear loose cloths. Pregnant woman must have to tell her doctor about pregnancy before procedure, also patient must have to tell the doctor if he is using insulin pump. Radiologist positioned the body against the x-ray films. X-ray of upper and lower spine is taken on while lying down on the table. For the cervical x ray radiologist may ask patient for open up the mouth. X ray is painless imaging technique.

28. Barium Enema

Barium Enema Exam is conducted to study abnormalities in intestine. Barium enema procedure is also called colon x-ray. Liquid injection is injected in the rectum by the help of small tube. Barium enema process is better than normal X-ray. Barium enema gives clear images of colon.

  • Uses: – Barium enema is helpful in the detection of polyps and inflammatory bowel disease. If patient shows symptoms like groin pain, rectal bleeding, changes in bowel habits, unexpected weight loss, chronic diarrhea, and persistent constipation doctors may suggest to do the barium enema.
  • Procedure: – Before one day of examination physician ask patient to empty colon. Doctor may ask you to take clear liquid the day before exam, and do not eat or drink anything after midnight before exam. Laxative is helpful to emptying the colon, the use of enema kit the few hours before exam help to remove the entire residue from the colon. Barium enema test is not conducted in the pregnancy. Patient must have to tell about their medication to the doctor before exam. Patient asks to wear a gown and remove all the metallic accessories. Patient asks to lie down on the examination table. For the confirmation of cleaning of colon X-ray is taken. Lubricant is apply on the enema tube and it insert into the rectum. Connected barium bag deliver the barium solution into the colon. If double contrast test is performed the air is pump through the same tube. Barium balloon helps to put barium inside the body, it may cause abdominal cramping. Patient may ask to hold to change the position of body for the full coating formation. The entire coating helps to evaluate all parts of the colon. Most of the barium is removing from the enema tube. White stool remove the all barium present in the body.

29. Barium Swallow

Barium swallow test is conducted to take close look of mouth and throat and esophagus. Barium swallow test is helpful in the diagnosis of abnormalities present in pharynx, esophagus, stomach or duodenum. Barium is chalky white substance with mixed with water this mixture is look like milkshake. Barium swallow milkshake form a coat inside the upper GI track.

  • Uses: – Barium swallow is helpful in the diagnosis of hiatal hernia, inflammation of GI track, blockages in GI track, Muscle disorder, Gastroesophageal reflux disease, ulcers, cancerous tumor and non- cancerous tumor.
  • Procedure: – Specialist asks to take a fast for six hours before exam. Patient must avoid the drinking and eating any liquid. Patient must have to tell his medical history to the specialist. It helps specialist to decide direction of study. Patient having medical conditions like bowel perforation, bowel obstruction, difficulty in swallowing, severe constipation should not conduct barium swallow test it may increase the complication. Barium swallow test is no longer than half hour. Specialist asks you to remove all the metallic accessories and wear median gown. Then specialist ask patient toile down on the table and move the body at certain position to take a standard x-rays. Then specialist give a barium drink to swallow and take single x- rays or a series of x-rays or fluoroscopy to watch movement of barium through pharynx. When exam is complete you patient allow taking normal diet and normal activities.

30. Biofeedback

Biofeedback is a therapy which is useful to get control in involuntary functions. Biofeedback gives relaxation to the body, which help to cure number of conditions.

  • Uses: – biofeedback therapy is helpful in the treatment of migraine headache, chronic pain, incontinence, high blood pressure.
  • Procedure: – In the biofeedback session electrodes get attached to the patient skin. Figure sensors also used if necessary. Skin attached electrodes passed the signals to the monitor which shows flashlight signals of heart rate, breathing rate, blood pressure, skin temperature, sweating or muscle activity. The any changes occur in the heart rate and muscle activities due to stress get recorded by monitor. Therapist help to practice relaxation and control the body functions. In biofeedback session relaxation exercise like deep breathing, muscle relaxation, mind relaxation therapy, mediation therapy is also conducted.

31. Biopsy

Biopsy is a process in which sample of body tissue is taken from the body to examination.

  • Uses: – Biopsy is carried out when physician seen abnormal growth of tissues in the body and physician have doubt of cancer, melanoma or other abnormalities.
  • Types of biopsies: – The following types of biopsies are carried out.
  1. Needle biopsy: – In needle biopsy needle is used to reach the suspicious tissue.
  2. CT-guided biopsy: – In CT guided biopsy CT scanner is used to detect the position of needle.
  3. Ultrasound-guided biopsy: – Ultrasound guided scanner is used to direct the needle into the lesion.
  4. Bone biopsy: – Bone biopsy id used for the bone cancer. Bone biopsy is carried out by orthopedic surgeon.
  5. Bone marrow biopsy: – The needle is used to enter the pelvis bone for collection of bone marrow. This biopsy is helpful to detect leukemia or lymphoma.
  6. Liver biopsy: – Needle is injected to the liver through the belly to capture the liver tissue.
  7. Kidney biopsy: – Needle inserted through back in the kidney.
  8. Aspiration biopsy: – A needle used to withdraw material out of mass, this procedure is known as fine needle aspiration.
  9. Prostate Biopsy: – Multiple needle biopsies are taken at one time from prostate gland.
  10. Skin Biopsy: – A Punch biopsy is main method of biopsy in this cylindrical shape skin tissue are collected.
  11. Surgical biopsy: – For the laparoscopic surgery it is necessary to obtain the biopsy of heard tissue.

32. Biopsy of the prostate

Prostate part is situated below the bladder and in front of rectum. Prostate is walnut shaped gland produces semen fluids and sperms in the testicles. Prostate biopsy is conducted to remove small samples from samples for cancer testing.

  • Procedure: – Prostate biopsy is a ten minute procedure. In this specialist insert needle through the wall of rectum into the prostate gland. Needle help to extract the cell for testing. After the procedure patient may notice blood in the pee or light bleeding from the bottom, or blood in the semen for one or two months. The collected tissue sample is tested in the lab.

33. Transrectal ultrasound

Transrectal ultrasound is carried out for the evaluation of prostate gland. Transrectal ultrasound is useful for the detection of cancer of colon.

  • Procedure: – For the Transrectal ultrasound, rectum emptying is more important. For rectum emptying specialist suggest patient to take suppository. Also patient counseling about the Transrectal ultrasound is done by the specialist before the exam. Specialist asks patient to put the body in the decubitus position in which knees are tucked with the chest. Then specialist inspects the area skin condition, and then insert the transducer which is cover with the get contain plastic sheath. Then insert the transducer slowly through the anus. When prostate is visible specialist stop applying the pressure.

34. Blood testing

Blood testing is a part of standard healthcare. It helps to diagnose the specific conditions.

  • Types: – The physician suggests the following types of blood test.
  1. Complete blood count:- In these blood test the variety of blood component like red blood cells, white blood cells, hemoglobin, platelets, mean corpuscular volume, hematocrit are identify. Complete blood count is helpful to identify disorders like anemia, blood clotting problem, inflammation, infection, or immune system disorder.
  2. Blood enzyme test: – Blood enzyme test is useful to detect the enzyme level in the body. This test is use for the identification of heart attack.
  3. Blood clotting test: – blood clotting test is help to identify the blood clotting disorders.
  4. Lipoprotein panel: – Lipoprotein panel is helpful to get information about low density lipoprotein cholesterol level, high density lipoprotein cholesterol level, triglycerides level in the blood.
  5. Basic metabolic panel: – Basic metabolic panel helpful for the identification of compound present in the blood plasma. It gives information about bones, muscles and organs. Blood metabolic panel give information about calcium level present in the body, glucose level, presence of waste product in the blood and electrolyte.

35. Bone Density Test

Bone density test is useful to detect osteoporosis. Bone density test is carried out by using x- rays. Hip bone, spine, and sometimes forearm bone is tested most of the time. Osteoporosis is happen because of past broken bone or weak bone.

  • Uses: – Bone density test is helpful for the identification of bone density before break the bone, and risk of bone fracture, confirmation of osteoporosis, and monitoring the treatment of osteoporosis. Doctor also recommended bone density test if persons having conditions like approximate 4cm lost in the height is seen it may happen because of spine fracture. Doctor suspect fragility fractures in the bone. If person having long term steroid medication. After menopause woman shows lowered sex hormone it may weaken the bone. The people who received the bone marrow transplant have highest risk of osteoporosis.
  • Procedure: – Patient must have to give knowledge to the doctor if he recently conduct barium exam. Patient must have to avoid taking calcium supplement before 24 hours. Patient asks to wear loose cloths and remove metallic accessories. Patient asks to lie down on the table and the mechanical arm of machine passes from the body. Small portable machine cover the small area like figure, wrist, heel. This procedure requires not more than half hour.

36. Bone marrow biopsy

Bone marrow is soft tissue present inside the bone which helps to produce RBC, WBC, platelets, fat, cartilages and bone. Two types of bone marrow present in the bone that is red bone marrow and yellow bone marrow. Red bone marrow finds in the flat bone and red bone marrow change color to yellow because of increase of fat cell. For the bone marrow biopsy specialist extract red bone marrow.

  • Uses: – Doctor suggests bone marrow biopsy when patient blood test shows anemia, bone marrow disease, leukopenia, thrombocytopenia, bone marrow cancer, hemochromatosis, infection or fever from unknown origin.
  • Procedure: – Patient must have to tell doctor about medical history, recent medical situation and medical supplement which he takes. Patient must have to follow doctor instruction. Generally bone marrow biopsy is conducted by oncologist. Before starting procedure specialist asks patient to wear hospital gown and sit on the table. Specialist check heart rate, blood pressure. Then specialist tell patient to lie on stomach. Then he applies the local anesthetic to the skin and biopsy will be carried out. Bone marrow biopsy is mostly conducted on hipbone or the chest bone. If patient feels symptoms like excess bleeding, increase pain, swelling, drainage or fever after biopsy, then he must have to contact with the specialist.

37. Abdominal CT scan

CT scan is computed tomography scan. It is special form of X-ray helpful in detection of cross sectional images of body. Body enters into the circular machine and images taken by machine send to the computer. These images viewed by technician. Abdominal CT scan is helpful to do study of organs, blood vessels and bone in abdominal cavity. It is possible to take multiple images by CT scan by different views. Abdominal abnormalities are detected by CT scan. When physician seen symptoms like groin pain, abdominal mass, kidney stones, unexpected weight loss, appendicitis or other infection, intestine inflammation, crohn’s disease, injuries due do fall, or abdominal cancer suspected patient physician suggest doing CT scan of abdomen.

  • Procedure: – Physician suggests to the patient not to eat for four hours before scan, and do not take any medication before scan. Patient must have to wear loose cloths. Patient has to remove all metallic accessories and electronic things like headphones, mobile etc. CT scan performed with or without contrast. According to the reason of doing CT scan physician decide which CT is performed. If Physician decides to do with contrast then large amount of liquid contained barium is given to patient orally. After drinking liquid patient lie down on the procedure table on the specific position. Technician may use pillow or cover for the adjustment of body in correct position. Patient must have to hold the breath during part of scan. Using remote control technician move the table into CT scan machine. After taking number of scan technician reviews images to sure it will be clear. The overall procedure is about to 10-15 minutes.
  • Precaution: – Before going to the CT scan patient must have share all details about his health like allergies, diabetes, or pregnancy.

38. Abdominal Ultrasound

Ultrasound imaging is carried out using sound wave to produced picture of the structure within the organ. Ultrasound is safe procedure to evaluate the organs. Abdominal ultrasound is conducted to study kidney, liver, gallbladder, bile duct, pancreas, spleen and abdominal aorta. Ultrasound is also known as sonography. Ultrasound carried out using transducer and gel. Gel is spread on the skin to carried ultrasound it may get skin dirty.

  • Uses: – Ultrasound abdomen is carried out to do complete study abnormalities in the kidney, liver, gallbladder, bile duct, pancreas, spleen, abdominal aorta. Also it is useful for the abdominal pain abnormal liver function test, enlarge abdominal organ, kidney cyst, kidney stone, gallstone, abdominal aortic aneurysm. Abdominal ultrasound is useful for guidance of surgeries like biopsies, blood clots, narrowing of vessels, tumors, abnormal flow of testes and ovary.
  • Procedure: – For ultrasound study patient must have to wear loose cloths. Patients may have to remove all jewelry and cloths for examination area. Preparation of ultrasound is depend upon type of ultrasound. For the study of liver, gallbladder, spleen and pancreas patient ask to eat fat free meal. For the study of kidneys patient ask to drink one liter water before test. For Ultrasound of the aorta patient must do fast for 12 hours. Ultrasound scanner contain computer console, video display screen with attached transducer. The transducer made up high frequency sound waves into the body with help to developed images. Ultrasound abdomen is carried out in 30 minute.
  • Benefits: – Ultrasound doesn’t need needle or injection. Ultrasound easy to use and less expensive method. Also it is painless and safe examination. Clear images are helpful to identify the soft tissue.

39. Abortion ( termination of pregnancy)

Abortion is a termination of pregnancy by taking medicine or by surgical procedure. Abortion is carries out before third trimester. Mostly abortion is carried out when child growth with severe disability or mother have risk of life. Abortion is safe procedure but this may cause some complications like infection of womb, excessive bleeding, and damage to the womb. Abortion is carried out medical and surgical treatment.

  1. Medical abortion: – Medical abortion is easy process of abortion. Medical abortion is carried out by taking pills. There are two types of pills available. Abortion pills use up to 10 weeks. These medicines helpful for the early termination of pregnancy. Abortion pills from 10 weeks to 24 weeks helpful for push out the pregnancy. It may require two clinic visit and second visit may require one night stay in hospital.
  2. Surgical abortion: – Surgical abortion is quick procedure. It may perform by two types. First one vacuum aspiration up to 15 weeks it conduct pregnancy by suction. Abortion is carried out within 14 weeks of pregnancy. It is conducted in one visit to clinic. Dilation and evacuation between 15 and 24 weeks it is carried out with general anesthesia. It is one day procedure.

40. Acupuncture

Acupuncture is ancient technique used to treat various conditions by triggering specific points on skin with the help of needle. This method is helpful in the improvement of functions of the body. Small injuries cause by needle may feel some discomfort. Acupuncture is helpful in the treatment like severe headache, allergies, depression, bone disorders like osteoarthritis, severe pain in neck back and knees, hypertension, insomnia, menstrual cramps, migraines, morning sickness, sprains and strokes. Also acupuncture is helpful in treatment of cancer and multiple sclerosis. The acupuncture session is carried out within one hour to ninety minutes. Acupuncture treatment gives different experiences to individuals some people feel depress and most of the population feel happy after acupuncture.

  • Procedure: – Acupuncture is can conduct by various styles. Selection of acupuncturist is important for the treatment. Acupuncturist examined the painful part of the body, texture and color of tongue, face color, pulse rate and strength of wrist. Points of acupuncture are spread all over the body. Acupuncturists plan the treatment and may ask to remove your clothes for the treatment. Acupuncturists insert the needles to various depths and points, insertion may cause little pain. Acupuncturists may move or twirl the needle after placement. After 10 to 20 minutes needles are remove, removal of needles don’t feel any pain. Results of procedure are seen after few weeks.

41. Amniocentesis

Amniocentesis is a process of removal of amniotic fluids from uterus for testing. Amniotic fluids help to protect and provide proteins to the child during pregnancy. Amniotic fluid is removing for the study of child health, but amniocentesis is a risky procedure. Amniocentesis is carried out for the various reasons. Amniocentesis is carried out for testing genetic conditions like Down syndrome, fetal lung maturity testing is also carried out by the help of amniocentesis. This procedure is also helpful to identify the baby’s health. When mother saturates too much amniotic fluids during pregnancy amniocentesis is help to remove excessive drainage. Also it is helpful to collect fetus DNA for the comparison with father DNA for the confirmation of paternity.

  • Procedure: – Amniocentesis procedure is conducted before 20 weeks of pregnancy. Before starting the procedure specialist suggest to drinks liquid. Before starting Amniocentesis sonography is conducted to find exact location of fetus in uterus. After identifying the fetus location specialist clean the abdomen by antiseptic, and then insert thin hollow needle through abdominal wall into uterus, and small amount of amniotic fluid is withdrawn into the syringe. After the procedure specialist check heart rate by using ultrasound. Loss of vaginal bleeding, uterine cramp, fever, redness or inflammation on side of needle insertion or abnormal fetal activity is seen the immediate concern with your doctor.

42. Anoscopy

Anoscopy is a procedure performs by the help of anoscope for the identification of abnormalities present in gastrointestinal track. Anoscope is made of plastic or stainless steel. It helps to study detail about tissues present in rectal and anal area. Anoscopy procedure is helpful to study abnormalities in lower parts of intestine.

  • Procedure: – Before starting the procedure bladder and bowel emptying is necessary. Anoscope is 5 inches long and two inches wide hollow tube equipped with light. Doctors insert anoscope with lubricated jelly into GI track from anus. After insertion doctor ask to boost muscles. After examine the area doctor remove the anoscope.

43. Bone marrow transplant

Bone marrow transplant is surgical procedure which performed for replacement of bone marrow. Bone marrow is soft fatty tissue present inside the bones. Bone marrow helps to create red blood cell, white blood cells and platelets. Bone marrow contains hematopoietic stem cells. These hematopoietic cells are helpful in formation of new blood cells. Bone marrow transplant is carried out when persons are unable to function properly. Also it is conducted when body shows disorders like aplastic anemia, leukemia, lymphoma or multiple myeloma. Bone marrow transplant shows various complications because of age, unhealthy body, and life threating disease. The short term complication like low blood pressure, headache, and nausea, shortness of breath, cold and fever are seen after bone marrow transplants. There are two type of bone marrow transplants are available that is Allogeneic transplant and Autologous transplant.

  1. Autologous transplant: – Autologous transplant is carried out by using persons own stem cell. In this process harvesting of the stem cell is carried out before beginning of damaging. Damage is control by chemotherapy and then return harvested stem cell in the body.
  2. Allogeneic transplant: – Allogeneic transplant is carried out by using donor stem cells. which shows closer genetic match. It is best way for bone marrow transplant.
  • Procedure: – Expert perform necessary test to understand which type of bone marrow transplant is conducted. All damage cells are treated with chemotherapy or radiation therapy. Then harvested or obtained from donor stem cells are transplant into the body.

44. Bone scan

Bone scan is conducted for the diagnosis of bone problems by the help of radioactive drug. Bone scan is helpful to understand problem related to the bone metabolism.

  • Procedure: – Radioactive substance is injected into vein which taken by the bone. After observation of some hours. After one to three hour doctor start taking imaging. The radioactive substance helpful to identify the damage by collecting the spots. Inserted radioactive substances are harmless to the body and easily remove from body after three to four days.
  • Uses: – Bone scan is helpful to identify abnormalities in bone. Also it is helpful to identify the breakage of bone. Also identification of bone cancer is easy with the help of bone scan. Also it is helpful in the conditions like arthritis, avascular necrosis, fibrous dysplasia, bone infection Paget’s disease of bone.

45. Breast ultrasound

Breast ultrasound is use to study the internal structure of breast. Breast ultrasound is useful to identify abnormalities present in the breast like lumps, cyst or nodules.

  • Uses: – Breast ultrasound is useful to detect breast abnormality. It is helpful in the study breast cancer screening. Also it is use for guidance in breast biopsy procedure.
  • Procedure: – Patient asks to remove all the metallic accessories and wear loose cloths.

The sonographer applies warm gel on body. Then sonographer place transducer and take images. Breast ultrasound is carried out in 30 minute.  It is painless procedure do not need insertion of needles.

46. Bronchoscopy

Bronchoscopy test is useful in the diagnosis of lung disease.  Bronchoscope is use to conduct the bronchoscopy.

  • Uses: – Bronchoscopy is useful in the diagnosis of lung disease, lung tumor chronic cough and lung infection.
  • Procedure: – Local anesthetic spray is spread to nose and throat and give sedative to feel relax while processing bronchoscopy. Doctor suggests avoiding eating or drinking for 6-12 hours before procedure is started. Also doctor may ask to stop the medication before surgery. Doctor inserted bronchoscope which passes down into throat and the bronchi. For collection of samples brush or needles are attached to the bronchoscope. When doctor finished the examination they remove the bronchoscope. Bronchoscopy is not more than 30 minute procedure.
  • Risk factors: – bronchoscopy may shows risk like Bleeding, lung infection, trouble breathing, and low blood pressure. Also fever, blood in cough, breathing problems may cause because of bronchoscopy. If any of these problems are seen then patient must concern with the doctor.  
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Genital Infection in Men: Symptoms and Treatment

Genital Infection in Men: Symptoms and Treatment

Much like women, men also have high chances of contracting a genital infection in their penial areas and the associated ducts. The most common of these are yeast infections. Normally known as thrush, it is a yeast infection affecting the head of the penis. Such infection if not treated can lead to a variety of problems and complications where the infection might enter your bloodstream and cause problems elsewhere.

Genital Infection in Men: Early visible symptoms include

Genital Infection in Men

  • a rash with itching and soreness at the head of the penis.
  • White, shiny patches might also be visible on the skin.
  • Other symptoms include a thick, white discharge that can be found under the foreskin or in the folds of the skin. This usually has an unpleasant odor.
  • The person may also find it painful to pull back his foreskin.
  • Pain during sexual intercourse and urination is also experienced.
  • It can also affect other areas of the skin, particularly in the mouth, and is then termed as oral thrush.
Genital Infection in Men: transmission

It is transmitted via a person with an existing infection or can also be caused by a lack of proper hygiene. The fungus can also thrive and grow in a moist environment if the area is not dried properly after washing. Poorly managed diabetes can also aid in fugal growth as they grow well in a high blood sugar atmosphere. Bath foams, soap gels, lubricants can disrupt the normal pH causing the fungus to grow and leaving the area open to infection. The immune system suppressing medications can also aid in fungal growth. Lack of proper diet and an existing condition of obesity might also put you at a higher risk of catching a yeast infection as the fat proves to be a good food source for bacterial growth.

Genital Infection in Men: The diagnosis

of such an infection is simple as one must be watchful for the symptoms and should contact their doctor if the symptoms persist. Medically, the doctor would ask for thorough health and sexual history and any previous infections and their treatment. The doctor might also take a swab test from around the head of your penis and under your foreskin to determine the appropriate course of medication to prescribe. Screening for Sexually Transmitted Diseases (STIs) may also be suggested. If the medical examiner finds any sores or ulcers that have not healed, a biopsy might be performed. Typically, these infections clear out on their own, but a medical screening is recommended.

Genital Infection in Men: The treatment

It is fairly simple for such infections and requires completing the prescribed dosage of clotrimazole, imidazole, or miconazole as prescribed by the doctor. Along with this, proper genital hygiene maintenance is a must and it is recommended to refrain from any sexual activity until the infections clear out. The medication can be prescribed in the form of tablets or anti-fungal creams.

If the infection is not treated effectively, it has very high chances of entering the bloodstream. This is seen commonly in men who prolong seeking medical treatment and the infection had spread away from the penis further into the body. In such cases a severe dosage of anti-fungal treatment is necessary.

Sexual Health: Physical, Mental and Social well-being

Prevention of Genital Infection in Men

In order to prevent the contraction of a yeast infection, it is advised to participate in protected sexual intercourse by using condoms. Also, maintaining a monogamous sexual relation is appreciated. If you are uncircumcised, it is advised to clean under the foreskin using soap and water and to return the foreskin to its usual position after cleaning and drying the area. In order to stop the spread of infection to other people, it is recommended to avoid any sexual contact until the infection is cleared, or the infection can be transferred back and forth between you and your partner/s.

Syphilis: Risk factors, Diagnosis, Treatment

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Birth Control or Contraception: Temporary and Permanent Methods

Birth Control or Contraception: Temporary and Permanent Methods

Birth control or contraception includes various methods that can be used in order to prevent pregnancy. It can be broadly categorized into temporary and permanent methods, that are as listed below :

Birth Control

1.TEMPORARY METHODS

  • Natural methods (behavioral) – not recommended as there are high chances of failure.
  • Barrier methods
  • IUCDs
  • Hormonal control

2.PERMANENT METHODS

  • Female sterilization – includes tubal ligation.
  • Male sterilization – Vasectomy
VARIOUS METHODS OF BIRTH CONTROL

There indeed are a wide range of options for birth control, and you may select the most suitable one, according to your preferences:

BARRIER BIRTH CONTROL

  • This method of birth control act by creating a barrier to prevent the sperm from reaching the egg.
  • Most of the barrier contraceptives do not require a prescription and are easily accessible.
  • Most common barrier contraception methods include :
  1. MALE CONDOM– These are most commonly made of latex rubber and may either be dry or pre-lubricated.
    • It is the most commonly practiced method of birth control by males.
    • Durable, reliable and affordable.
    • Also protective against sexually transmitted disorders.
    • NIRODH is the free condom supplied by the Government of India.
    • If used with utmost perfection, it offers almost 98% of protection against pregnancy.
  1. FEMALE CONDOM– It is a thin, flexible, polyurethane tube that is partially inserted into your vagina, creating a barrier.
    • Similar to male condoms, female condoms also provide protection against sexually transmitted infections.
    • These offer almost 80% efficiency against pregnancy.
    • It must be remembered that it is completely inadvisable to use male and female condoms together, as this increases the chances of slippage, breakage, and displacement.
  1. DIAPHRAGM– It is an intravaginal device made of latex.
    • A medical or paramedical professional is required for the accurate measurement of the diameter that is required.
    • A diaphragm is inserted 2 hours before sexual intercourse and is to be kept for at least 6 hours after the last coital act.
  1. VAGINAL CONTRACEPTIVE SPONGE– This too is an option of birth control that doesn’t require a prescription.
    • It’s basically a small piece of foam that is treated with spermicide and is inserted high up into the vagina.
    • It can be inserted up to 24 hours before intercourse.
  1. CERVICAL CAP– Dome-shaped reusable appliance that acts by preventing the entry of sperm into the cervix.
    • It is used along with a spermicide and can be inserted anytime before intercourse.
INTRA-UTERINE CONTRACEPTIVE DEVICE (IUCD)
  • IUCD is a small device that is inserted into the uterus in order to prevent pregnancy.
  • It offers almost 99% efficiency in the control of pregnancy.
  • IUCDs are basically a form of long-acting reversible birth control.
  • It requires a doctor or a nurse for the proper insertion of an intrauterine device and the procedure involved is quite simple and quick.
  • IUDs can be non-medicated (made of plastic or stainless steel) or medicated (that involves copper-containing IUDs and hormone-releasing IUDs).
HORMONAL CONTROL

Birth control

  • The main action of this method of birth control involves the release of hormones that prevent the fertilization of an egg by the sperm.
  • With proper and adequate use, hormonal birth control is more than 90% effective.
  • It requires a prescription for using this method of contraception.
  • Various types of hormonal contraceptives include:
  1. Oral contraceptive pills– It must be noted that combined OCPs are the most effective reversible methods of birth control.
  2. Injectable – DMPA is available in India and the dose has to be repeated every 3 months.
  3. Subdermal implants – injected into the upper arm and are active for many years.
  4. Transdermal patch
  5. Vaginal ring

PERMANENT BIRTH CONTROL

  • If you are certain that you don’t want to have a baby in the future, permanent birth control methods can be brought into use.
  • Each of these offers 99-100% efficiency.
  • In the case of females, tubal ligation is the method of choice in which the fallopian tubes are closed in order to prevent eggs from reaching the ovaries.
  • An ideal time of tubal ligation is following the menstrual period, in the proliferative phase.
  • This process is done under general anesthesia.
  • For males, the method used for permanent birth control option is vasectomy.
  • During this procedure, a permanent interruption is created in the vas deferens (the tube that allows the sperm to enter into the semen).
  • It is advisable to use additional contraceptive methods for 3 months until the semen becomes free of sperm.
What is Emergency Contraception?
  • This method is used in order to prevent pregnancy after unprotected sexual intercourse and should not be considered as a form of regular birth control.
  • Also known as ‘morning after contraception’.
  • Most of the methods of emergency contraception involve post-coital pills; however, copper-containing IUCDs can also be used for this purpose.
  • An IUCD needs to be inserted within 5 days of unprotected intercourse and is by far the best method of emergency contraception.

 

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Weight Loss and the 7 Healthy Ways Regime

Weight Loss and the 7 Healthy Ways Regime

7 Healthy ways and effective regime for losing weight

There certainly are plenty of diets circulating on the internet that claims to help you shed pounds quickly. But what must be kept in mind is the fact that all these “superfast” tricks just leave you feeling weak and nutritionally deprived. On top of that, the results are not permanent too! So, in order to get a body that is healthy and the weight loss is permanent, it is extremely important to go slow.

Image result for weight loss

Losing weight in a healthy way always involves the correct amalgamation of a balanced diet and an active lifestyle. The trick basically is to shed more pounds than you consume and also add to it the right diet that ensures fitness, health, nutrition, and strength. (Read more about lifestyle-related disorders)

weight loss

Below are some ways, that’ll help you shed those extra pounds in the most healthy and safest way possible:

Healthy Weight Loss Tip 1: Set smarter goals for weight loss

weight loss

Why tie your goals to weight loss itself? Instead, why not focus on actionable habits? It’s a straightforward, easy to incorporate changes to your lifestyle can help you lose weight.  These may include working out four times a week or just walking up the stairs to your office on the fourth floor every day. It is when you incorporate healthier tendencies in your daily routine and make them a part of your lifestyle that you’ll start to see numbers on the weight scale shift in the right direction.

Healthy Weight Loss Tip 2: Jogging aids in Weight Loss

JOGGING

A half-hour jog effectively burns around 300 calories. Jogging helps ease your digestive process, strengthens the metabolism and is definitely more beneficial than a casual walk. A healthy diet alongside regular jogging will melt those extra inches that you have for a long while been dying to shed. Jogging consumes fat as well as helps in proper weight management. There also is an after-burn impact as you will even now be consuming extra calories for the next 48 hours after your last jog. This is likewise one of the most proficient approaches to shed weight and get into shape. You will be able to achieve your fitness goals faster in comparison to other cardiovascular activities, for example, walking. (Refer Physical Inactivity: How does it affect humans?)

Healthy Weight Loss Tip 3: Skipping meals never helps

meal

Eating consistently for the entire day keeps your digestion running at full speed, avoid lowering of your energy levels, keeps you alert and centered, and can help keep your weight static by preventing over-indulgence in subsequent meals. Experts have always recommended eating every three to four hours. In the event that you don’t, there are various upsetting side effects you may experience. Without the strength you get from things like carbohydrates (sugars), your glucose levels will probably plunge which may lead you to feel languid and exhausted. What’s more, if you let yourself be hungry for long, craving instigating hormones like ghrelin may even cause you to end up feeling flimsy or sweat-soaked. Read how does eating disorders, like bulimia and anorexia, affect health?

Healthy Weight Loss Tip 4: Eat in moderation

When you’re longing for some chocolate brownie with an extra topping of Nutella, no measure of fat-free dessert will compensate for it. Dietary products and foods usually leave one feeling hungry and deceived.  Completely avoiding what you crave for, will surely make you consume an extra amount of it, after a week or so. And that is definitely going to spoil all your work out sessions. Just gorge on one scoop of the real deal and appreciate it. You’ll be fulfilled physically and mentally!

Healthy Weight Loss Tip 5: Don’t run away from CARBS!

Carbs should make up a little more than 33% of the food you consume. They usually comprise bread, potatoes, cereals, pasta, and rice. Opt for a high fiber or wholegrain range, for example, dark colored rice, whole-wheat pasta. They contain more fiber than the usual white or refined boring sugars and make you reach that satiety and you feel full for a longer time. A few people actually believe that carbs and sugars lead to weight gain, but gram for gram the starch they contain gives lesser than half the portion of the calories of fat. Keep an eye on the fats you include when you’re cooking or serving these sorts of food sources since that is the thing that builds the calorie content – such as, oil on chips, butter on bread and rich sauces on pasta.

Healthy Weight Loss Tip 6: Fresh fruits will make your day

It’s suggested that you eat at least 5 parts of fruits and vegetables each day. It’s a nutritious approach to fill your plate that is commonly low in calories. In addition to that, you can also keep a weekly check on how regularly you eat leafy foods.

Healthy Weight Loss Tip 7:Ever checked the nutrition label?

Flip it around for a genuine story. Don’t miss out on having a close look at the nutrition label. Just remember more are the ingredients; more are the chances that something artificial was mixed in. Furthermore checking the label is an extraordinary method to see whether there are superfluous ingredients in something apparently “nutritious”.

 

 

#weightloss #losingweight #healthyweightloss

High BMI- An early indicator of health risk

 

 

Bariatric Surgery Hospitals from India

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Thyroid Disorders: Types, Causes and Symptoms

Thyroid Disorders: Types, Causes, Symptoms and Risk Factors

The thyroid gland produces hormones like triiodothyronine (T3) and thyroxin (T4) which help in normal regulation of metabolism and also influence the control of vital functions, such as body temperature and heart rate. An imbalance of these hormones can have an enormous impact on health and lead to various disorders. The commonest of all thyroid disorders are:

1.HYPOTHYROIDISM

Hypothyroidism is a medical condition in which the thyroid gland doesn’t produce an adequate amount of thyroid hormones.

Causes

  • Autoimmune: Hashimoto’s thyroiditis (90%of the cases), spontaneous atrophic hypothyroidism, Graves’s disease.
  • Iatrogenic
  • Transient thyroiditis
  • Congenital disorders like dyshormogenesis or thyroid aplasia
  • Benign tumor of the pituitary gland.
  • Pregnancy
  • Iodine deficiency

Risk factors

Common risk factors are:

  • Female: Women are affected about six times more frequently than men.
  • Elderly (more than 60 years)
  • Family history of thyroid disease
  • History of an autoimmune disease (eg. type 1 diabetes or celiac disease)

Clinical features

  • Hypothyroidism may be asymptomatic in the early stages. But over time untreated hypothyroidism can lead to numerous health problems such as obesity, joint pain, infertility, and heart disease.

Symptoms

Thyroid Disorders

  • Cold intolerance (increased sensitivity to cold)
  • Weight gain
  • Fatigue, somnolence
  • Dry skin, dry hair
  • Menorrhagia
  • Constipation
  • Muscle stiffness or pain or swelling in the joints
  • Deafness
  • Depression or impaired memory
  • Alopecia
  • Psychosis (myxoedema madness)

Signs

  • Facial feature: Puffy face, purplish lips, malar flush, myxoedema(periorbital edema, loss of lateral eyebrows)
  • Hoarseness of voice
  • Carotenaemia (yellowing of the skin)
  • Hypertension
  • Slowed heart rate (bradycardia)

2.HYPERTHYROIDISM

Overactive thyroid (Hyperthyroidism) describes a constellation of clinical features arising from elevated circulating levels of thyroid hormone thyroxin. It can accelerate the body’s metabolism, causing unintentional weight loss and a rapid or irregular heartbeat.

Causes

  • Graves’ disease
  • Nodular goiter (toxic adenoma, toxic multinodular goiter or Plummer’s disease)
  • Thyroiditis both subacute (de Quervain’s) or post-partum
  • Follicular carcinoma

Risk factors

Risk factors for hyperthyroidism include:

  • Family history of Graves’ disease
  • Female
  • History of chronic diseases like type 1 diabetes, pernicious anemia, and primary adrenal insufficiency

Clinical features

Hyperthyroidism can cause a wide range of signs and symptoms like:

Symptoms

  • Weight loss despite normal or increased appetite
  • Heat intolerance: Increased sensitivity to heat
  • Palpitations: pounding of the heart
  • Dyspnea
  • Irritability, emotional lability
  • Fatigue, muscle weakness
  • Tremor: a fine trembling of hands and fingers
  • Osteoporosis
  • Diarrhea, steatorrhea
  • Angina
  • Periodic paralysis
  • Pruritus
  • Alopecia
  • Amenorrhea/oligomenorrhoea
  • Infertility
  • Spontaneous abortion
  • Loss of libido, impotence

Signs

  • Palmar erythema
  • Sinus tachycardia, irregular heartbeat (arrhythmia), atrial fibrillation, cardiac failure
  • Lid retraction, lid lag
  • Skin thinning with fine, brittle hair
  • Proximal myopathy
  • Pigmentation
  • Gynaecomastia
  • Nervousness, anxiety, and irritability
  • Sweating

Sometimes hyperthyroidism may be associated with Graves’ ophthalmopathy which causes eyeballs to protrude beyond their normal protective orbits (exophthalmos) and swelling extraocular muscles.

3.THYROID NODULE

Nodules are abnormal masses or lumps that form within the thyroid. Nodules can be caused by benign cysts, tumors or by cancers of the thyroid (rare).

Usually, thyroid nodules are asymptomatic but occasionally some nodules become so large that they can:

  • Be seen and palpated as a swelling at the base of your neck
  • Press on the trachea or esophagus, causing difficulty swallowing or shortness of breath

4.GOITER

Goiter refers to the enlargement of the thyroid gland. Usually, goiters are painless, although a large goiter can lead to cough and cause difficulty in swallowing or breathing.

Lack of iodine in the diet is the most common cause of goiters worldwide.

Risk factors

Some common risk factors for goiters include:

  • A lack of dietary iodine.People living in areas where iodine is a lack of iodine and those who don’t have access to iodine supplements are usually at higher risk of developing goiter.
  • Goiters are more common after age 40.

Causes

Some of the most common causes include:

  • Iodine deficiency.
  • Graves’ disease.
  • Hashimoto’s disease.
  • Solitary thyroid nodules.
  • Thyroid cancer.
  • Inflammation.

Symptoms

Usually, goiters are asymptomatic but a large goiter may show the following signs and symptoms:

  • Swelling at the base of the neck
  • Hoarseness
  • Coughing
  • Difficulty breathing
  • Difficulty swallowing
DIAGNOSIS OF THYROID DISORDERS
  • Physical examination: of the thyroid gland to check for enlargement, swelling and checking for tremors and pulse are part basic examination.
  • Thyroid profile: to check the levels of triiodothyronine (T3), thyroxin (T4) and TSH.
  • Blood tests
  • Radioiodine uptake test
  • Thyroid scan: a radioactive isotope is injected intravenously and then a scan is done for the thyroid gland.
  • Thyroid ultrasound.
  • CT Scan and MRI
  • Biopsy
TREATMENT
  • The daily requirement of iodine is about 150 micrograms. Using iodized salt or eating seafood like sushi about twice a week is helpful. Shrimp and other shellfish also have high iodine content.
  • Medications: thyroid hormone replacement therapy like levothyroxine (Levoxyl, Synthroid, and Tirosint) is used in case of hypothyroidism which also decreases the size of the goiter. While in the case of hyperthyroidism, medications to normalize hormone levels are required.
  • Surgery: Removing all or part of your thyroid gland (total or partial thyroidectomy) may be necessary.
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Bulimia: Eating Large Meals followed by Forceful Vomiting

Bulimia: Eating Large Meals followed by Forceful Vomiting

Bulimia nervosa or bulimia is an eating disorder. It is characterized by bouts of binge eating (large quantities are eaten in a short period of time) followed by guilt and regret (it is accompanied by forceful vomiting or purging)

Bulimia may be life-threatening in certain conditions. It is usually seen in patients who have a body dysmorphic disorder or are overly conscious about their appearance. They have an inherent urge to lose weight, which at times may be grossly excessive. It may result in various diseases, malnutrition and at times may be fatal.

Such people generally take the help of therapeutic medicines which are not intended to be used in healthy individuals. Use of vomiting-inducing agents, purgatives, laxatives, diuretics, all of them in the form of self-medication, amounts to drug abuse. Additionally, they may employ rigorous regimens such as fasting, adopting a strict dietary routine or various food fads.

Such people generally equate their self-worth with their body-image and thus, bulimia is very hard to overcome.

Bulimia signs and symptoms may include
  • Being overly sensitive as regards your body shape and weight.
  • A constant fear of weight gain
  • Repeated episodes of binge eating.
  • A feeling of inability to control your urge to eat, despite knowing the ill effects.
  • Rushing to the washroom immediately after meals
  • Forceful vomiting or purging after binge eating
  • Fear of eating in public places with others
  • Stealing or hoarding food in strange places
  • Drinks excessive amounts of water or non-caloric beverages
  • Using excessive amounts of mouthwash, mints, and gum to avoid foul breath
  • Hiding one’s body with baggy clothes
  • Self-medicating on laxatives, diuretics or enemas after eating
  • Strict fasting, restricting diet or avoiding certain foods between the cravings
  • Using dietary supplements, herbal products for losing weight

(The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months to be labelled as bulimia)

Bulimia Causes

Bulimia

Medical help from a general practitioner or a mental health professional is the first step towards treatment. It must not be confused with episodic guilt about obesity or weight gain. Bulimia is a multi-systemic disorder with a biological and a social component. Though the precise cause is not known, a variety of risk factors have been suggested and implicated in the pathogenesis of bulimia.

Genetics: Persons who have a first degree relative with bulimia are at an increased risk of developing bulimia. This shows a biological component. However, no specific genes have been identified yet.

Emotional Well Being: Bulimia is an anxiety disorder that manifests through the above symptoms. Psychological and emotional problems such as substance abuse, depression, mania are linked with an increased risk of developing bulimic tendencies.

Dieting: Persons who aggressively diet are more conscious and aware of their body image perception. They tend to be more receptive to social validation and are at a greater risk of developing bulimia.

Bulimia Complications

The complications resulting from untreated bulimia may manifest themselves in the form of various nervous system disorders and symptoms.

  • Low self-esteem and poor socializing tendencies
  • Severe dehydration leading to giddiness, vascular shock and kidney failure
  • Cardiac arrhythmia and low-output heart failure
  • Tooth decay and gum problems
  • Irregularity of menstrual cycles in females
  • Substance abuse in the form of alcohol and drugs
  • Depression and frequent mood swings, bipolar disorders
  • Self-harm or suicidal thoughts and tendencies.
Bulimia Prevention
  • Since it is a behavioral condition, a positive mindset as regards health and well-being are essential to prevent bulimia. Some suggestions and preventive measures include:
  • Enabling a healthy body image among one’s children, friends and accepting them the way they are.
  • Promoting positive discussions while having meals with family. One must avoid discussions about weight-gain and weight-loss.
  • Comparisons with other ‘ideal’ body-image stereotypes should be avoided. Everyone has a unique genetic make-up and a distinct metabolism
  • Discourage severe dieting and weight-control measures which negatively impact health. All kinds of supplementation, without medical advice, should be discouraged and avoided.

If it still affects you, confide in a close friend or a family member and seek medical advice.

 

Anorexia or Anorexia Nervosa: An Eating Disorder

 

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Diabetes- Detection Prevention and Management

Diabetes- Detection, Prevention and Management

Diabetes Mellitus refers to an elevated blood sugar level along with metabolic disturbances. Our body produces insulin, the pancreatic hormone which is responsible for the utilization of glucose by the cells. It helps in glucose uptake by the cells and thus reduces the blood glucose levels.

Diabetes mellitus is classified as

Diabetes

Type 1 is also known as Insulin-dependent or Juvenile Onset Diabetes Mellitus. It is characterized by the destruction of pancreatic cells by the body’s own white blood cells (autoimmune destruction). There is an absolute deficiency of insulin, leading to hyperglycemia. It thus requires treatment with insulin administration.

Type 2, is referred to as Insulin independent or Adult Onset Diabetes Mellitus. It is characterized by loss of tissue receptor sensitivity to insulin. Despite adequate insulin being produced by the pancreatic cells, the body’s cells do not respond to insulin.

Thus, despite an adequate amount of circulating insulin, due to the non-responsiveness of tissue receptors, hyperglycemia develops. It is treated with various oral anti-diabetic medications.

Tests and Diagnosis

  1. The normal blood sugar level is in the range of 70-110 mg/ dL. A fasting blood glucose level of more than 140 mg/dL or a post-prandial (1 hour after a meal) level of more than 200mg/dL is diagnostic of diabetes.
  2. Another good indicator is HbA1c also known as glycated hemoglobin. It is a marker of glycaemic control over the past 3 months. The normal range is 4-6 gm% (excellent control). Pre-Diabetes is 6-8 gm% (good control) and Diabetes is defined as above 8 gm% (poor glycaemic control).
  3. An oral glucose tolerance test may also be performed. A sugary solution is provided after 8 hours of fasting. Periodic blood glucose levels are checked at every half an hour for 3 hours)

(Pre-Diabetes refers to a blood glucose level between 120-140 mg/dL and Gestational Diabetes refers to hyperglycemia during pregnancy as a result of anti-insulin hormones from the placenta. The blood glucose level returns to normal after delivery.)

Diabetes Mellitus Symptoms

The general symptoms include:

  • Increased hunger
  • Increased thirst
  • Increased frequency of urination
  • Fatigue
  • Non-healing sores
  • In men, there may be associated loss of sexual drive, erectile dysfunction, and poor endurance.
  • In women, there may be frequent urinary tract infections, candida infections, and dry skin.
Diabetes Mellitus Causes and Risk Factors

Diabetes is caused by multiple factors that interact with each other. They are broadly divided into non-modifiable risk factors and modifiable risk factors.

For Type-1 disease, having a parent/sibling with diabetes and younger age are the major risk factors.

For Type-2 disease, the factors include:

  1. Increasing age: Age more than 45 years
  2. Race: Indian Americans, African Americans, Latino-Americans are at a greater risk
  3. Obesity: Characterized by an increased BMI (above 23 in the South Asian population and above 25 in the Pacific-West)
  4. Hypertension
  5. Hyperlipidemia
  6. Smoking and Alcoholism
  7. Physical inactivity
  8. Family History
  9. Gestational Diabetes Mellitus and Pre-Diabetes
Diabetes Mellitus Complications

Complications include wounds that do not heal, gangrene of lower foot or extremities, nephropathy, neuropathy and vasculopathy.

It may lead to optic nerve damage, heart disease, and dementia as well.

Diabetes Mellitus Treatment

ABCs to manage Diabetes

Type 1 diabetes

Insulin therapy is the main treatment for type 1 diabetes.

There are four types of insulin that are used based on the onset and duration of action.

  1. Rapid-acting insulin starts to work within 15 minutes and its effects last for 3 to 4 hours.
  2. Short-acting insulin starts to work within 30 minutes and lasts 6 to 8 hours.
  3. Intermediate-acting insulin starts to work within 1 to 2 hours and lasts 12 to 18 hours.
  4. Long-acting insulin starts to work a few hours after injection and lasts 24 hours or longer.

Type 2 diabetes:

It involves treatment with oral antidiabetic drugs if exercise and dietary control fail to maintain blood glucose. Fruits, vegetables, whole grains, polyunsaturated fatty acids, lean meat (fish, poultry), are to be promoted. Saturated fatty acids, refined carbohydrates are to be avoided.

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