In sarcoidosis, inflammatory cells occur in the form of nodules and are found in different organs. Sarcoidosis occurs in people who are in the age range of 20 to 40. Sarcoidosis can be asymptomatic also. In comparison to males, females are more prone to sarcoidosis. There are three types of sarcoidosis namely acute, subacute and chronic sarcoidosis.

Sign and symptoms of sarcoidosis

Sign and symptoms vary depending on what organs of the body are affected. Based on this many symptoms are possible and include the following:

• Coughing and shortness of breath, if lungs are involved
• Fatigue and anorexia, liver enlargement
• Pain in joints and other bone-rich areas such as feet and hands
• Formation of stones in kidney
• Blurred vision or red eyes
• Meningitis (inflammation of the lining covering the brain)
• Loss of hearing, hoarseness in voice
• Heart failure
• Lesions on skin

Causes of sarcoidosis

The cause of sarcoidosis is not presently known, but it seems to occur when the immune system of the body starts developing an unusual response to any foreign substance that may enter the body (auto immune disorders). Sarcoidosis can be inherited and there are many other factors that may lead to sarcoidosis such as environmental factors, immunological factors or if there is any infection in the body.  Generally, the work of the immune system is to protect the body from any foreign material but when sarcoidosis occurs, white blood cells respond very strongly to this foreign material leading and triggering inflammation in different parts of the body. These inflammatory nodules may further develop to fibrosis (formation of scar tissue).

Complications of sarcoidosis

Sarcoidosis may be self-limiting if mild; but it can also be cured in initial stages. If not treated promptly, sarcoidosis can progress into the chronic stage which may lead to more complications in various parts of the body. Complications that may occur in different body parts include:

• Lungs: If pulmonary sarcoidosis is not treated properly, it can harm air sac tissues which may lead to breathing discomfort.
• Heart: Sarcoidosis interrupts the heartbeat and may lead to unusual heart sounds.
• Kidney: Sarcoidosis can cause kidney failure.
• Eyes: Sarcoidosis can lead to glaucoma as well as cataract.

Besides these, sarcoidosis can also cause fertility complications, liver disease and skin problems.

Treatment of sarcoidosis

There is no fixed management for sarcoidosis, but usual tests such as X-ray of chest, biopsy, blood tests, examination of skin and eyes should be done. Certain medications such as oral corticosteroids (prednisolone), anti-malarial drugs, and TNF-alpha inhibitors and immunosuppressive medications can also be given. Here are a few tips to control sarcoidosis:

• Proper health checkup
• Balanced diet including green vegetables, fruits
• Proper intake of water
• Avoid smoking
• The patient should keep himself away from toxic chemical fumes, gases
• Food containing chemicals should also be avoided such as dairy rich substances
• Exercising regularly is a must

Photograph via Creative Commons

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Sarcoidosis – Causes, symptoms and treatment is a post from: mDhil

In the previous article, we discussed the causes and symptoms of coma. Today, we will learn more about the diagnosis and treatment for coma.

Diagnosis of coma

The doctors will take a complete history from the patient’s family or attenders. This includes history of past and present medical conditions (like hypertension and diabetes) and surgeries, person’s occupation, family history, history of doing adventure sports like mountaineering, history of alcohol or drug abuse, history of seizures, history of medications taken regularly.

Then a complete neurological and general examination is conducted. In liver failure, the liver may be enlarged and there may be other signs like small marks on the skin and free fluid in the abdomen. Swelling of the feet or dependent parts suggests heart failure or kidney failure.

The Glasgow coma scale is the reference used by physicians world-wide to grade the coma and decide the level of consciousness. The higher the number on the scale, the less severe is the coma and better is the chance of recovery.

Eye opening – if the score is one it means eyes are shut while four means eyes open spontaneously.

Voluntary movements if asked to perform – One means no movement, while six means obeys the command and acts accordingly.

Verbal response if asked – One means does not respond at all, while five means he is alert and can talk.

A total score of 8 or less than that implies that the person is in a deep coma while a score of 9 and above suggests a light coma and a better chance of recovery.

Investigations to diagnose coma

As a coma is a medical emergency, a battery of tests will be ordered to determine why the person went into a coma. Extensive blood tests including CBC, ESR, blood sugars, liver and kidney profile, electrolytes and other tests will be necessary.

Imaging tests like CT scan are useful to detect brain conditions like tumours or haemorrhage while an MRI is of value to detect blood vessel abnormalities in the brain as in a stroke. If meningitis is suspected, a lumbar puncture may be done to send the cerebrospinal fluid (fluid around the brain) for analysis.

Sometimes cerebral angiography may be done if a block in a major blood vessel of the brain is suspected to be the cause.

Treatment of coma

When the person is in a coma, the first line of treatment is to stabilise his vital signs. So the patient is kept in the intensive care unit of the hospital and his heart rate, blood pressure, sugar levels and urine output is monitored regularly. Nursing care is required to prevent bedsores and prevent infection. If the patient cannot breathe on his own, he will be put on a ventilator.

The investigations will enable the doctor to pinpoint the cause of the coma and then specific treatment is started. If infection is the reason, intravenous antibiotics and fluids are given. If there is haemorrhage, brain surgery can be done to remove the blood and relieve pressure on the brain and also find the bleeding vessel to stop the bleeding. If the cause is a brain tumour, again surgery is required to remove it if possible.

If the coma is due to alcohol or drug abuse it is important to consult a psychiatrist. Once the person is out of coma, he should be strongly medically advised to give up the drug as his life may be in danger and encouraged to join a support group and take medication to help give up the habit.

Hence, treating the cause will in most cases help to bring the patient out of coma. However, the doctors should counsel the family and gently tell them that some people never come out of coma and if the brain is dead, life support can be removed if the family so decides.

Photograph via sxc.hu

Written by Dr Nisreen Nakhoda, General Physician

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What is Syphilis?

Q. A 28-year-old from Jaipur writes in, “What syphilis? Is it true it can make you go crazy?”

A. Syphilis is an STI caused by bacteria and transmitted through oral, anal or vaginal intercourse with someone who is infected with syphilis sores. It is curable but if left untreated, there can be serious long term consequences, including brain damage.

There are 4 stages of syphilis with the first two being highly infectious:

Primary: One or more sores show up where syphilis entered the body, generally the penis. Sore is firm round and painless and can easily go unnoticed. It lasts 3-6 weeks and goes away on its own, regardless of treatment. However, it can progress to the next stage.

Secondary stage: Flu like illness, a non itchy rash covering the whole body or in patches, patchy hair loss, and white patches on the tongue or in the mouth are all symptoms.

Latent stage: If secondary stage syphilis is untreated it can turn into latent. Here, the primary and secondary stage symptoms all clear up even though the syphilis remains in the body. This latent stage can last for years before progressing.

Tertiary Stage: 15-30% of people infected with syphilis who don’t get treatment will go onto tertiary or late stage where the disease can damage your brain, eyes, heart, blood vessels and bones. These problems can occur many years after the original infection.

Doctors test for syphilis by a blood test. If positive, there are antibiotics to take. Do not use home remedies or over the counter medication.

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What is Syphilis? – The Naked Truth is a post from: mDhil

Fibre constitutes a very important part of our diet. But why does something which doesn’t even get absorbed into our bloodstream still hold a respectable place as a food essential in our regular and balanced diet? At the very basic level fibre is roughage that helps in binding and moving food ahead in the digestive tract and its presence in our diet ensures regularity of bowel.

But the other benefits of fibre consumption range from controlling overeating and fat absorption in the body to reducing cholesterol and chances of cancer. It also neutralizes blood sugar levels.

Top 10 High Fibre Foods

Pear: This fruit with edible skin is packed with fibre. A medium sized pear when consumed with the skin contains approximately five grams of fibre. Delicious to eat and easy to carry, a pear is a great option to curb that 4 pm hunger pang, while you are still at work.

Raspberries: Packed with fibre and bursting with that fruity flavour, raspberries appears on the list of yummy fibre options. One cupful of these superstars contains eight grams of fibre. To add to their goodness, these little beauties are powerful antioxidants as well.

Pistachio: A handful of “nut-ritious” pistachio are ideal for snacking as they are high in fibre and protein and low in fat. Toss a few in your regular salad or have them just like that. Try to avoid the salted version though.

Corn: Corn is an excellent  fibre source which is low in calories. Popcorn (of course without butter or caramel) while watching a movie, boiled sweet corn with chat masala and lemon, or baby corn in your salad, all works perfectly well in meeting your daily fibre requirement – deliciously!

Apple: An apple a day does keep the doctor away and also helps you to make regular visits to the loo by triggering off bowel movement.

Brown rice: Did you know that brown version of rice is way healthier than its polished white counterpart. One cooked cup contains 3.5 grams of fibre.

Green peas: Those little sweet green peas are loved by everyone and that’s why it is a great idea to have more and more of them, every now and then. Fresh or dried, cooked or frozen, include them all the time in your salads, soups and pulaos.

Beans: Nothing too exotic but our very own rajma (kidney beans) is also an ideal fibre rich food. There are several other varieties of beans available like lima beans, navy beans, lentils, mung beans,  french beans and pinto beans to choose from, depending upon the availability.

Broccoli: The look-alike of our very own cauliflower, broccoli is a rich source of dietary fibre. The best part is, once washed thoroughly; it can be eaten raw in a salad or can be cooked as well.

Wholegrains: Barley, corn, wheat, millet, oats, brown rice, and many others come under the category of whole grains, which means the grain has its husk, barn and endosperm intact. Whole grains are rich in fibre and high in complex carbohydrates, making it a healthy staple.

Photograph via sxc.hu

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Top 10 high fibre foods is a post from: mDhil

It is a medical emergency and if a person goes into a coma, he must be taken to a hospital immediately so that his brain life is saved.

Causes of coma

1. The most common cause of coma is lack of oxygen to the brain due to a cardiac arrest, drowning, stroke, brain trauma (after a vehicular accident) or brain haemorrhage.
2. Continuous seizures known as status epilepticus can lead to coma, but coma is unlikely after a single seizure.
3. Specific medical comas include diabetic coma due to too high or too low level of blood sugar, hepatic coma due to liver failure.
4. Toxins that are normally present in the body may accumulate due to a medical disorder and high levels of these substances can bring on a comatose condition. For e.g. carbon dioxide in an asthma attack and urea due to kidney failure can trigger a coma.
5. Infections such as meningitis or encephalitis if undiagnosed and untreated can lead to coma.
6. Locked in syndrome – this is a specific type of coma in which a person can only move his eyes. His brain is alert but the rest of his body is paralysed; it is a rare condition.
7. Persistent vegetative state – after a coma the person may go into a persistent vegetative state where he can breathe, can sleep and awaken but has no mental functions.

Signs and symptoms of coma

A person in coma will have closed eyes, irregular breathing, will be unresponsive to pain and pupils of eyes will not dilate in response to a torch shone on the eyes. He will be unable to move his limbs and will have no control over bladder and bowel functions.

He will have a low level of consciousness as his brain is not fully functioning.

Each coma is unique so it is difficult to make generalisations or predictions of the person’s recovery.

As the person cannot communicate, it is difficult to gauge how much he can understand of his surroundings. Coma can be deep or light. Initially, the coma may be deep, but after few days may be a light coma and gradually the person regains his mental functions, awareness of surroundings and his movements.

Pain may or may not be felt by a person in a coma. There may be facial movements like eyes opening, a grimace but the person generally slips back into comatose state.

Prognosis of coma

Comas may last from few days to few weeks. If they continue beyond four to six weeks, chances of recovery are slim. Recovery also depends on the cause of the coma. Diabetic comas are generally reversible, people get better after the sugar levels have stabilised. People going into coma due to poisonings or head injuries have higher chances of gaining consciousness than after a cardiac arrest.

If the coma is due to an infection or poisoning and medical treatment is given immediately, chances of recovery are good.

Most people may not be able to regain their full range of mental functions after a coma, but occupational therapy and physiotherapy can greatly improve their life quality.

In the next article we will describe investigations and treatment protocol in case of a coma.

Photograph via sxc.hu

Written by Dr Nisreen Nakhoda, General Physician

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Coma – Introduction and causes is a post from: mDhil

Dr. Devi Shetty, world renowned cardiologist tells us symptoms you should watch out for!


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Dr. Devi Shetty explains some basic symptoms of a heart attack. Keep them in mind if you have a history of heart diseases!

Symptoms of a heart attack:

• Mild discomfort across the chest whenever you exert yourself by walking fast or climbing stairs etc
• Pain and discomfort across the chest accompanied with breathing difficulties.
• Unexplained sweating, nausea and vomiting

Watch the video to know about what you should be doing if you or someone you know if having a heart attack!

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Symptoms of a Heart Attack – Malayalam is a post from: mDhil

Memory loss, as shown on television and in movies is far from dramatic as depicted on screen. One way to classify it is, short term and long term memory loss.

Doctors divide memory into immediate, short term and long term memory. Immediate memory is the ability to recall something that has just happened such as the blaring sound of an ambulance. Short term memory enables us to store about five to nine different pieces of information which we need for the task at hand while long term memory consists of childhood memories and enables us to process what we learnt at school and college in a useful manner. It is possible to improve short term memory by grouping things, attaching a name to them or using pneumonics to aid recall.

Common causes of memory loss

• Psychological causes include anxiety, depression, old age and severe stress. Sleep deprivation is also an important consideration; all these cause short term memory loss. Post-traumatic stress disorder happens due to a particular stressful event and the feeling of being unable to cope with the problem and may result in short term memory loss.
• Alcohol misuse, chain smoking, drug abuse and certain medications like anti-depressants, anti-anxiety drugs, tranquilisers and muscle relaxants among others may cause memory loss.
• Medical conditions like thyroid disorders, stroke, Alzheimer’s disease and infections like HIV, tuberculosis and syphilis can lead to memory loss. Schizophrenia generally causes short term loss of memory.
• A head injury, seizure, brain surgery or brain tumour can cause memory loss.
• Nutritional deficiency especially that of vitamin B1 and B 12 can affect memory. One example is Wernicke – Korsakoff syndrome which occurs due to deficiency of thiamine or vitamin B1 – it may lead to irreversible memory loss if untreated.

Short term memory loss

This type of memory loss is more common than long term memory loss in general. Elderly people will not remember where they put their glasses, but remember their childhood pranks quite clearly. This type of memory loss does not affect intelligence, judgment and things already learnt, but new information is not retained and stored in the memory bank.

Long term memory loss

Things can’t be learnt thoroughly as things in the short term memory do not move on to long term memory. Long term memory spans memory loss from a few days to a few years. In Alzheimer’s, at first short term memory is impacted, but in later stages even long term memory is not spared.

To conclude, most reasons for memory loss can be treated and memory loss returns, but no one can predict when. Brain games and strategies to increase memory recall help significantly if done regularly and correctly. If you find this symptom in your close family or friends circle, do get medical attention promptly so that the person can regain his ability to recall facts and events.

Photograph via sxc.hu

Written by Dr Nisreen Nakhoda, General Physician

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Memory loss – Causes and symptoms is a post from: mDhil

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Domestic Violence & Abuse

Q. A 27-year-old writes in, “I got really mad at my girlfriend the other day and I slapped her. She’s fine and I apologized, but she won’t let it go. What do I do?”

A. Everyone gets angry but using violence like slapping, pushing, hitting, choking, or biting even once, is completely wrong. You do not have any right to hit your partner, or anyone, at any time.

Domestic violence is about control and one person thinking that they have the right to control another through force or even verbal abuse, like tearing down the other’s self esteem and self worth.

Usually, a person starts small, by criticizing and restrictions their partners actions, for example, where they can go what they can wear. It increases to isolating the partner from friends and family, making them dependent on the abuser. It keeps escalating to various forms of physical abuse all followed by apologies and “good behavior”, to then later result in escalating abuse again. Sometimes, partners end up in the hospital or die. Many times, if someone abuses once, they will definitely abuse again.

A relationship should be warm and open and more importantly, you should feel safe with each other. Keeping someone through force and control is not a healthy relationship.

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Domestic Violence & Abuse – The Naked Truth is a post from: mDhil

The thyroid gland is responsible for producing hormones that help in regulating certain functions of the body such as heart rate, temperature of the body, body weight, growth of the body, fertility, and production of heat and the rate of respiration. Iodine is a substance which is present in food which helps the thyroid gland produce thyroid hormones. There are two hormones that are secreted by the thyroid gland namely, thyroxin (T3) and triiodothyronine (T4).

Types of thyroid cancer

• Medullary thyroid cancer
• Follicular thyroid cancer
• Papillary thyroid cancer
• Thyroid lymphoma
• Anaplastic thyroid cancer

Causes of thyroid cancer

The cause of thyroid cancer is unclear, but it can occur due to genetic conversions (mutations) in the cells as a result of fast multiplication and growth of the cells. These abnormal cells survive for longer periods and may lead to tumor development that may spread to other parts of the body.

Thyroid cancers can also be inherited which means that they can be transmitted from one generation to the other. Even people who’ve been exposed to excess radiation are at a higher risk of developing thyroid cancer.

However, rest assured, your yearly dental x-ray during the visit to the dentist is not going to increase your chances of getting thyroid cancer. But, if you’ve undergone radiation treatment (of head, neck or chest) in the past, especially during your childhood, you are more at risk.

Symptoms of thyroid cancer

You may have one or more of these symptoms:

• Swelling in the neck
• Pain in the neck and sometimes in the ear
• Constant cough not related to cold
• Trouble while swallowing
• Trouble while breathing or continuous wheezing
• Hoarse voice

 Tests to diagnose thyroid cancer

• Blood tests: This test helps in identifying the levels of T3, T4 and TSH (thyroid stimulating hormone) level in the body.
• Test via biopsy: A biopsy is done with the help of a needle. In this procedure, cells from the thyroid gland are taken to examine for cancerous cells under the microscope.
• Tests via imaging process: This test is performed by doing ultrasound of the neck. Besides ultrasound, a M.R.I. (magnetic resonance imaging) or computer tomography scan can also be done.
• Physical examination: A physical examination can help in identifying swelling in the neck or the presence of thyroid lumps.

Treatment of thyroid cancer

Treatment for thyroid cancer is mostly surgery with radioactive iodine. Patients almost never need a radiation therapy or chemotherapy. The treatment again depends on the type of thyroid cancer, the stage and also your age.

While removing the thyroid, your doctor may also remove lymph nodes from your neck to test them for cancer cells.

Photograph via Creative Commons

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Thyroid cancer – Types, causes and symptoms is a post from: mDhil

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All about the heart

Songs have been sung about it, poetry has been spouted – the heart it seems is on everyone’s mind! But besides it’s starring role in every romantic drama that takes place, the heart also plays a very important role in keeping a person fit and in ensuring a long and productive life.

We caught up with Dr Deepak Krishnamurthy, cardiologist at Fortis Hospitals in Bangalore to find out just why a healthy heart is so important. And also to discover that while as Indians, we are predisposed to heart disease (four times more than other populations), there’s a lot we can do to prevent heart attacks by adopting a healthier lifestyle.

Read more about our chat with Dr Deepak Krishnamurthy here.

How to Prevent Heart disease – In Telugu is a post from: mDhil

There’s so much health information we’re constantly exposed to that it becomes hard to distinguish facts from what are clearly myths. Take this simple quiz to test how well you know your health facts from myths. Ready? Get, set, go!

Fact or myth? All carbs are bad

Myth! No food group is all bad. And carbohydrates have really been unnecessarily vilified over the past few years as the main culprits of weight gain. Furthermore, it’s important to distinguish between simple and complex carbohydrates. Simple carbs (like white rice) convert to sugar faster and most nutritionists recommend complex carbohydrates (like whole wheat) instead. But cutting out carbohydrates completely is something no health expert will ever ask you to do.

Fact or myth? Microwave reheating kills nutrients

Myth again! Studies have shown that it’s only when you cook food at a very high temperature for a very long time, or if you use a lot of water to cook it that it loses nutrients. Going by that logic, microwave cooking, in a reasonable amount of water is actually a great way of conserving the nutrients.

Fact or myth? Men can also get osteoporosis

That’s a fact. And an important one at that. According to the World Health Organisation, In India, 1 in 8 males and 1 in 3 females suffer from osteoporosis. Which means that while it’s more prevalent amongst women, men are by no means immune to this disease that’s affecting more and more Indians every year.

Fact or myth? You should starve if you have diarrhoea 

This one is a myth. When you have diarrhoea or loose motions, your body is already losing a lot of fluids. This makes it imperative for you to replenish those fluids by drinking a lot of water, juices, buttermilk etc. You may want to eat light but definitely do not starve yourself completely.

Fact or myth? Brushing twice a day is not enough for dental hygiene

Fact. Ask your dentist and he or she will probably ask you to also floss, and use a tongue cleaner along with morning and night brushing. What you can skip on, according to most experts, is the mouthwash. Because while it does have some benefits like giving you fresh breath and protection from plaque, it can never replace teeth brushing.

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Fact or Myth – The Health Quiz is a post from: mDhil

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Understanding Rape

According to the dictionary, rape is defined as “any act of sexual intercourse that is forced upon someone.” Rape can happen to men, women, children, old, young, gay or straight.

When a woman or a man, is not consenting to any form of physical or sexual activity- oral, anal, vaginal, touching, heaving petty, kissing etc, making them engage in the activity is rape.

Rape is not about sex, rape is about power and dominance, as its about force and coercion. Many times those that dismiss rape as a small crime, use the argument that the rapist had a lack of control. However, rape is actually all about control. It is about trying to control the other person by violating their space, their body, and their ability to control their own actions. The victim’s needs, fears, and body is inferior to the rapist.

Regardless of how a person has been acting, flirting, how much they were drinking, the clothes that they are wearing, or their alleged “reputation” no one is asking to be raped.

In fact, “asking for it” goes against the very definition of Rape which again is an act forced on someone.

There are two types of rapes: stranger and date/acquaintance rape. Stranger rape is when the victim does not know her rapist, while the date or acquaintance rape is when the victim does.

Rape victims endure psychological trauma usually greater than the physical experience. Rape can lead to pregnancy and STD. Getting justice and facing social stigmas for victims can be revictimizing because of shame, self- blame, and guilt. Though, the rape was nottheir fault.

Is anyone asking to be mugged, stabbed, murdered, hurt, kicked, punched, or insulted? No one has the right to hurt another person. Therefore, it is time we understand boundaries and respect them in our fellow human, starting with the most scared- the body.

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Understanding Rape – The Naked Truth is a post from: mDhil

Summarised below are some of the symptoms and signs which when present, specifically point towards a psychiatric problem which should not be neglected and brought to the attention of the family doctor or psychiatrist.

Appearance and behaviour

A person with a psychiatric problem may have crumpled clothes, uncombed hair and a disheveled look. This is because the psychiatric problem is so severe that it takes centre stage in a person’s life and he forgets to pay attention to his appearance. Depressed people have certain signs too. In agitated depressives, the behaviour is restless and they are always fiddling with something and cannot sit still. Retarded depressives sit without moving, generally look at the floor and the posture is stooped with hunched shoulders.

Schizophrenia is relatively easy to spot as these patients exhibit certain uncharacteristic signs. They may have ‘mannerisms’ which are significant repeated movements such as repeatedly smoothing their hair; on the other hand stereotype are repetitive movements that do not seem to have any purpose such as wriggling their fingers or rocking while sitting. Negativism occurs when the person does the opposite of what is asked of them and echopraxia means imitating the health worker or doctor even though it has been requested not to do so.

Mood of a patient suffering from psychiatric disorder

• In many psychiatric disorders, mood changes occur – moods may fluctuate, the person’s nature changes for e.g. a person with a normally sunny disposition may snap at you repeatedly or the mood may be inconsistent (sometimes he may be back to his old self while at other times his mood may be unpredictable). Mood changes may be noticed in the following conditions.
• Anxiety – as the person is worrying about something, he may be impatient and show physical manifestations like breathing fast and shallow, palpitations and sweaty palms.
• Depression – the person feels low and sad, does not see the positive side of things; it may also affect his social behaviour, libido and energy levels.
• Elation – here the person feels excessively happy or ecstatic and may have high energy and show corresponding behaviour being excessively chatty and overactive.
• Apathy – this word is used to describe the complete absence of emotion or inability to take pleasure in anything.
• Inappropriate mood – the person may cry after hearing a joke instead of laughing or he may describe a sad event in a joyful manner.

Speech of a patient suffering from psychiatric disorder

You might get a clue to what the person is thinking based on what comes out of his mouth. There may be many thoughts flitting quickly through a person’s mind – this is called pressure of thought seen in mania while at the opposite end there may be no thoughts at all and the mind is blank known as poverty of thought; this is characteristic of depression. When a person’s thoughts and speech move quickly from one subject to another without even completing the thought or sentence, it is called flight of ideas; this occurs in mania. Perseveration means repetitive thoughts and could point to dementia.

Thought content of a patient suffering from psychiatric disorder

As the name suggests, this refers to the patients preoccupations and consist of obsessions – persistent and recurring thoughts or images that enter the mind even though the person tries to resist the thoughts. Compulsions are thoughts that force the person to act in a certain way such as repeatedly washing hands or checking the bolt on the door.

An important part of thought content is abnormal beliefs and their interpretation. We all have beliefs that we grew up with and are a part of us but abnormal beliefs for e.g. delusions are those which are false, cannot be modified or reasoned with and the person is absolutely convinced of it. Hallucinations are false perceptions of something that is not there; the person is convinced about it. Elementary hallucinations are hearing whistles or bangs while complex hallucinations are music, faces and voices being heard. In schizophrenia, a person may believe he is under the influence of an alien power.

Memory of a patient suffering from psychiatric disorder

Failure to remember is amnesia, while confabulation means remembering something that has not actually taken place. A feeling of `déjà vu’ means the sense having experienced something before when it has not actually happened while the opposite is `jamais vu’ which refers to inability to recognise something that has taken place.

Defence mechanisms

These are subconscious mental processes that the person may be unaware of unless pointed out by someone else.

• Regression – the person behaves in a way appropriate to that of an earlier stage of development. For e.g. an older person may behave like a child.
• Repression – certain emotions or memories are excluded as they may lead to anxiety and stress if they enter the conscious mind.
• Rationalization – in this case an acceptable but false explanation is thought of for unacceptable behaviour.
• Projection – the person attributes his emotions and thoughts to another person.

These are some of the signs and symptoms specific to psychiatric conditions.

Photograph via sxc.hu

Written by Dr Nisreen Nakhoda, General Physician

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Signs and symptoms of psychiatric disorders is a post from: mDhil

What is DASH diet

DASH stands for Dietary Approaches to Stop hypertension. DASH diet emphasises on eating more nutrients, and reducing the intake of food with no nutritional value. It also encourages you to have less sodium in your normal diet. Thus, this diet is designed for reducing hypertension.

This diet is not designed for weight-loss; it focuses on eating patterns that will make your heart healthy.

The theory behind DASH diet

Potassium, calcium, fiber, proteins etc. are good for the body and help in improving heart health. On the contrary, junk food, food with loads of sodium etc. are bad for your heart. DASH diet works on the principle of “eat healthy food”. It is more or less a balanced diet.

How does DASH diet work

First, you need to determine the calorie intake with accordance to age. Second deciding factor is the activity level. After taking these two parameters into consideration, you can decide the kind of food that is needed to get these calories. In addition to this, you also need to go easy on salt.

Is DASH diet for weight-loss

It can be! Yes, this diet isn’t primarily designed for weight-loss but if you stick to the healthy food regime, you will definitely lose some weight. DASH diet doesn’t promise weight-loss, it promises better health.

Pros and cons of DASH diet

It is a heart healthy diet and unlike other diets it is nutritionally sound. There are no cons as such, but it is a tough diet to follow and might be harsh on your pocket.

DASH diet and sodium

The aim of DASH diet is to reduce the sodium in the body. Sodium has a direct effect on your blood pressure and reducing the level of sodium can also reduce your blood pressure.

There are two versions DASH diets considering the amount of sodium:

1. Standard DASH diet: Consume maximum 2300 mg of sodium per day.
2. Lower sodium DASH diet: Consume maximum 1500 mg of sodium per day.

Fast fact: 100gms of table salt provides 38,000 mg of sodium and 100gms of French fries has 300 mg of sodium

Exercise and DASH diet

Exercise is recommended for a healthy body and weight-loss; it does not have any direct connection to the diet.

What to eat

DASH diet recommends grains, vegetables, fruits, nuts and seeds, lean meat, dairy etc. every day. The number of servings can differ from person to person. Also, it is important to cut back on oil and fat, sweets and alcohol.

DASH diet is not a diet for one disease – it is a diet for all diseases.

Photographs by sxc.hu

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All about DASH diet is a post from: mDhil

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All about the heart

Songs have been sung about it, poetry has been spouted – the heart it seems is on everyone’s mind! But besides it’s starring role in every romantic drama that takes place, the heart also plays a very important role in keeping a person fit and in ensuring a long and productive life.

We caught up with Dr Deepak Krishnamurthy, cardiologist at Fortis Hospitals in Bangalore to find out just why a healthy heart is so important. And also to discover that while as Indians, we are predisposed to heart disease (four times more than other populations), there’s a lot we can do to prevent heart attacks by adopting a healthier lifestyle.

Read more about our chat with Dr Deepak Krishnamurthy here.

How to prevent heart disease – In Tamil is a post from: mDhil

More often than not, psychiatric problems go unnoticed and undiagnosed in patients seeking treatment for some other health problem, their care-givers and the general population. Since most people are not aware that they have a psychiatric illness, they will not seek out a psychiatrist. Hence it is left to general physicians to detect a psychiatric illness in someone seeking medical attention, and they should probe to discover the problem.

Types of psychiatric disorders

1. Organic disorders – These are due to a definite structural problem in the brain for e.g. brain tumour, brain abscess or trauma to the brain.
2. Functional disorders – In conditions like schizophrenia and manic depressive illness, no damage to the brain is detected
3. Neurotic disorders – These are very common and are less severe than organic and functional disorders. They include dissociative disorders, anxiety neurosis and obsessive compulsive disorder
4. Personality disorders – These are many and are sub-classified into three clusters A, B and C. Examples of each cluster are paranoid disorder, narcissistic personality disorder, avoidant personality disorder.
5. Alcohol and drug dependence
6. Eating disorders – Bulimia and anorexia nervosa are the popular ones

Psychiatric history

When you first make an appointment with the psychiatrist, it may be a long one as the detailed history of the patient is taken. This includes history of childhood memories, growing up years, whether parents were together or separated/divorced and who the primary care-giver was. Nannies, teachers and grand-parents also leave impressions on a child whose parents were not around them fulltime. Studies have shown that disturbances when the baby was in the womb can also have negative effects later on for e.g. if a pregnant woman in beaten around the abdomen the foetus may suffer minor brain damage and this can show up later in life.

Interview of the patient

The person being brought for treatment may insist that he is fine and that his family is just making a fuss for nothing. This is called a lack of insight which is common as the person may be in denial or may have blocked out the stressful event. Hence it is important to conduct the patient’s interview separately and listen to the attendant’s concerns also separately. The former is called subjective data while the latter is called objective data.

The personal history must be detailed for e.g. age, whether right or left handed, marital status, educational qualifications, day to day life, type of work, career aspirations if any, religious beliefs, socio-economic status, residential address and social network.

While talking about the chief complaints, details like when was it first noticed, was the onset sudden or gradual etc. should be noted down. It should be noted whether the subjective data and the objective data match or if there are discrepancies.

Past history of any medical conditions like tuberculosis, meningitis or malaria should be noted, so also any fractures, dislocations or surgeries.

Family history of heart problems, diabetes, hypertension, cancer and hereditary disorders is a must. Some factors point towards a psychiatric condition or the chances of being affected are higher. These factors are described under three headings:

Predisposing factors

These are the factors that determine whether a person is vulnerable to a psychiatric ailment. They include the genes or genetic make-up of the person, whether as a foetus he was subjected to any adverse environment, his childhood and his personality.

All these factors are unique to everyone. Some personality types are more at risk of developing certain disorders for e.g. people who obsess about trivial things, may later on become depressive or have obsessive compulsive disorder. Till adolescence, a person can be moulded according to the major influences in his life, hence it is noticed that people who have a parent in jail are much more likely to be juvenile offenders rather than the rest of the population. In this manner, predisposing factors set the stage for a psychiatric problem in later life.

Precipitating factors

These are the factors that seemingly cause the ailment and could be physical, social or psychological. Physical precipitating factors are medical conditions that are life-long for e.g. hypothyroidism or cancer in late stage. Social factors like shifting to a new house, changing schools or workplace or disturbed family relations can precipitate a psychiatric disorder. Psychological factors that could result in a psychiatric ailment are loss of a job or separation from spouse.

Perpetuating factors

These factors occur after the psychiatric disorder has occurred. And may prolong the illness or make it more difficult to treat. For e.g. a former model who has abused drugs may feel ashamed to go back and walk the ramp because of negative publicity or the fact that her problem was recent news.

Photograph via sxc.hu

Written by Dr Nisreen Nakhoda, General Physician

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An introduction to Psychiatric disorders is a post from: mDhil

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All about the heart

Songs have been sung about it, poetry has been spouted – the heart it seems is on everyone’s mind! But besides it’s starring role in every romantic drama that takes place, the heart also plays a very important role in keeping a person fit and in ensuring a long and productive life.

We caught up with Dr Deepak Krishnamurthy, cardiologist at Fortis Hospitals in Bangalore to find out just why a healthy heart is so important. And also to discover that while as Indians, we are predisposed to heart disease (four times more than other populations), there’s a lot we can do to prevent heart attacks by adopting a healthier lifestyle.

Read more about our chat with Dr Deepak Krishnamurthy here.

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Heart Health: Indians and the need for a healthy heart – Tamil is a post from: mDhil

Hypertension or high Blood Pressure, as it is commonly called, is a condition in which the blood pressure in the arteries is chronically elevated.

With each heartbeat, heart pumps blood through the arteries to the body. Blood pressure is the pressure or force with which blood is pushed against the walls of the blood vessels.

If the pressure is too high, the heart has to pump harder which in turn can damage the body organ and cause illnesses like stroke, heart attack, heart failure, or renal failure. Hypertension in India is emerging as a major health problem, that is more prevalent in urban than in rural India.

Normal blood pressure is below 120/80, where 120 represents systolic measure (highest pressure in arteries) and 80 represents diastolic measure (lowest pressure in arteries). A pressure of 140/90 and above is considered hypertension.

Hypertension can be due to several factors:

1. Sedentary lifestyle
2. Lack of physical activity
3. Obesity or overweight
4. High salt intake
5. High intake of processed food items such as chips, bakery products, cheese etc.
6. Stress
7. Aging
8. Excessive alcohol consumption
9. Genetics and family history of hypertension

However, hypertension can be easy to control if diagnosed at an early stage and with lifestyle modifications. Changes in diet and increase in physical activity levels can have a great impact on controlling high blood pressure

Reduce salt intake

Salt is known to be an important cause of hypertension. Therefore, a diet low in sodium, viz. recommended sodium intake – 1500mg, which is equivalent to 6gm salt or one leveled teaspoon of salt, is suitable for body and heart. DASH (Dietary Approach to Stop Hypertension) diet that recommends 1500mg sodium intake, along with high intake of fruits and vegetables is known to have beneficial effects in controlling blood pressure.

Though the market is flooded with processed foods, they are a complete NO for hypertension or heart patients. Processed foods like breads, chips, nachos, processed cheese, ready-made soups, cookies, etc are high in sodium in the form of salt or baking soda (sodium bicarbonate). Now-a-days several food companies produce salts with “low sodium content”. However, they are excessively high in potassium, and excess of any mineral is detrimental to your body.

Fruits and vegetables

Fruits and vegetables have a positive impact in controlling and maintaining blood pressure within the recommended level. Fruits are primarily a source of minerals and most important amongst them is potassium. Besides minerals, the high fiber content is healthy for the heart.

Watch your weight

Diet rich in carbohydrates and fats is calorie dense. Excessive calorie intake and eventual weight gain is harmful to individuals with blood pressure. A diet with more complex carbohydrates, proteins from pulses or lean meat, high fruit and vegetable intake helps not just in maintaining weight but also keeps your heart healthy.

Products like chips, processed juices, cookies, instant noodles, cakes, pickles, papad, namkeens, nachos are high in salt/sodium and are not suitable for hypertensive individuals.

We know it’s difficult to eat salt-less food on daily basis. But, there are substitutes that can be added to your daily meal that will help make your food palatable and interesting. Salt can be substituted with lemon juice, vinegar, mint chutney (with raw mango and less salt), tamarind chutney to add taste to your meal.

Eating in moderation and physical exercise are mantra to a healthy life!

Photograph via sxc.hu

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Simple tips to lower your blood pressure is a post from: mDhil

Click to subscribe to our healthcare channel on Youtube!

All about the heart

Songs have been sung about it, poetry has been spouted – the heart it seems is on everyone’s mind! But besides it’s starring role in every romantic drama that takes place, the heart also plays a very important role in keeping a person fit and in ensuring a long and productive life.

We caught up with Dr Deepak Krishnamurthy, cardiologist at Fortis Hospitals in Bangalore to find out just why a healthy heart is so important. And also to discover that while as Indians, we are predisposed to heart disease (four times more than other populations), there’s a lot we can do to prevent heart attacks by adopting a healthier lifestyle.

Read more about our chat with Dr Deepak Krishnamurthy here.

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• Heart Health: Top 5 Nutrition Tips To Ensure A Healthy Heart
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Heart Health: Indians and the need for a healthy heart – Kannada is a post from: mDhil

Numerous studies have shown that people who think positive are less stressed, have strong immune systems and enjoy a better health overall. We know it’s difficult to look at the positive side of every situation – anxiety and negative thoughts do creep in all the time, making it impossible to remain optimistic.

Actually, positive thinking can be acquired with a little bit of motivation. Our top ten tips on how to be more positive are sure to help bust negativity and bring back happiness in your life!

Top ten tips to be more positive

1. Misinterpretation: Remember, negative thoughts are mostly based on misinterpreted situations. So, do a quick check – do you have your facts right? Are they based on pessimism? Are you jumping to the worse conclusions with no actual reason? Try moving your thoughts to more positive ones.
2. Keep a diary: Always learn from situations. You could keep a diary and jot down your thoughts, reactions and emotions along with the circumstances that created them. For example: If someone or something irritates you at work, write it down. Also, note down how you reacted to the situation and how you could have handled it better. Make sure you read the diary regularly and do a self-check to find out if you’ve started thinking positive.
3. Face your fear: Here’s one sure fire way to achieve long-term positivity. Question yourself as to why you are thinking negatively. What are you frightened of – breaking up with your partner, losing your family, losing your friends? All you have to do is face your fear – think about how you can cope in case such things happen, what you can do. Once you’ve faced your worst fear, these situations will instantly get less scary.
4. Take responsibility: Cut the drama, stop playing the victim. Stop saying things like – why me? I am stuck, there’s no way out. There is always a way out. You just have to make the right choice for the change to happen.
5. Make someone feel better: Help a person who is in need of it. Cook some food and donate it to the old age home close by. It will take your mind off the negative things and you will feel better when you see some happy faces enjoying the food you cooked.
6. You are unique: You are the way you are – there is no point in trying to be someone else. It’s just a losing battle to compare yourself to others. Why should you be ‘normal’ when you can be awesome! So, being positive and thinking positive lets you be your awesome self.
7. Express yourself freely: Being excited and enthusiastic is actually cool! So, be cool. If you are happy and laugh loudly, do so. Enjoy your life and express your happiness. This can be contagious and may even brighten someone else’s day!
8. Talk it out: If you are feeling down, it’s best to talk to someone about it – a friend, a family member or even a trusted colleague.
9. Find a solution: Instead of brooding over the problem you are facing, find a solution. Don’t let the problem beat you. Get a handle over your emotions and use the ‘I Can’ mantra instead of ‘I Can’t’. This will surely put you in a positive state of mind!
10. Stay close to positive people: Stay close to friends who are think positive – Friends who will be there for you when they need them and give you helpful advice. Being around negative people might increase your stress levels and may even make you doubt your own ability.

Photograph via sxc.hu

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Top ten tips to be more positive! is a post from: mDhil

OK, so you’re a mother now

There are lots of things you’re prepared to lose on becoming a mother. You’re prepared to lose sleep. And hair. And your figure. And free time.

But no one tells about how, along the way, you also completely lose clarity of vision. All babies are born essentially looking the same – red, scrunched up, and more than a little pissed off – but as a mother, you’re instantly convinced that not only is the baby beautiful, but also that you can spot strong resemblances to family members. Really? How many of your family members look like angry monkeys?

You lose your memory. One year ago you were complaining that Facebook was full of nothing but baby updates, and rolling your eyes at yet ANOTHER photo of someone’s offspring. Now you’re spamming your friends constantly with pictures of Baby on Day 1, Day 2, Day 3… and expecting them to respond cooingly each time.

You lose all sense of shame. New parents, and mothers especially, are the most shameless people I know. Not only are the baby’s bodily functions discussed at length and in excruciating detail, they’re also treated as though they were accomplishments of the highest order. Actions that, in a grown adult, would be frowned on (at the very least) are met with resounding praise and applause.

“Oh good boy – the bad gas went!”

“Oh, that was a nice BIG burp!”

You lose all sense of perspective. In a previous life you might have been a successful businesswoman, software engineer or lawyer, but in the first few months of motherhood, you lose track of all that. The only things you can think, read or talk about are nursing, sleep patterns and, of course, the above-mentioned bodily functions. And these days it’s gotten so bad that not only are you obsessed with those three, you are also competitive about them. If a mother friend of yours boasts that her baby slept for 4 hours at a stretch one night, you feel compelled to say that yours slept for FIVE. If a friend says that her baby rolled over at 3 months, yours rolled over at 2.5.

And yet, the clichéd, treacly truth is this – for all those many, many losses, you gain a tiny bundle full of  gurgles and gas, and strangely enough, it all balances out.

Written by Maya Chandrasekaran

Join many women, just like you on mDhil Diva. Check us out!

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Mother’s Corner: Motherhood, the Balance of Accounts is a post from: mDhil

Sukanya and me

Sometimes clichés hit the nail on the head – so l’ll resort to one: it seems like just yesterday that we brought our little bundle home. She was not chubby, she didn’t smile easily and her constitution was so delicate that she would have the loosies every single time a new food was introduced, such as a drop of mosambi juice or a smudge of cooked-to-hell daal. But for me, new mother at 36, Sukanya could not have been more perfect.

My daughter is nearly 16 now – and I feel like I’ve brought up at least five daughters! The charming, friendly 3-year-old transformed into a feisty 6-year-old who would argue with her school principal and get her Montessori classmates into programmes meant for children two years older. By nine, she was passionate about animal life and would dare to confront – hands on hips – a group of unthinking boys who were being cruel to a dog. At 13, shy and awkward, her friends circle shrank as she seemed to turn inwards. This full-of-beans child turned into a conformist by 15, looking and behaving exactly like every other 15-year-old. Sigh.

The only defiance now is shown to parents. Some examples:

Me: Sukanya, your exam is just a few days away. Please stop watching so much TV and open your books.
She: Ma, chill. Don’t go on and on. I studied for two hours this afternoon.

Me: Sukanya, please put on a t-shirt and don’t roam around in those strappy things. We’re in a village in Karnataka, not Sweden.
She: I’ll wear what I want! You can’t force me to do things your way!

Me: Sweetheart, why don’t you do some reading instead of spending so many hours on Facebook?
She: I’m not a reader like you. And I’m chatting with my friends.

Me: (at noon) Please get out of bed now. This is the 6^th time this morning I’ve tried to wake you up.
She: (Groan) Ma, please let me sleep. You don’t know how tired I am.

Me: Just two days to go for your exams. I hope you have studied enough to get an A.
She: Don’t irritate me, ma. I know what I’m doing.

I shall not go into what follows these typical beginnings of conversations (uh, confrontations?) and expose my own shortcomings as a mother. I’m told every teenager is saying exactly the same things to her parents these days but that doesn’t take away from the gnawing feeling that I’ve gone wrong somewhere. I’m not sure how many more daughters I will meet in my Sukanya but I have not a shred of doubt that there are several interesting years of parenting still ahead. This morning I found a soppy Mother’s Day card next to my pillow – she must have left it late at night after I fell asleep, ignoring my instructions to get to bed before 11pm!

And then there’s Shyam

To balance the roller-coaster ride that my daughter provides, fate has given me a son. Shyam is now nine, and very little has changed in his temperament since he was a fat little toddler. His love of sports is steady, his reluctance to read is constant, his interest in the kitchen unflagging, his general attitude to life sunny. Except when we have to study, there’s a peaceful connection. Four years to go before he hits teendom – but I’m not losing sleep over what might happen.

For if there’s one thing I’ve learnt about life as a parent, it is that NOTHING is predictable.

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Mother’s Corner: Mother of two, or perhaps 12 is a post from: mDhil

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Understanding Gonorrhoea

Q. A 25-year-old from Lucknow writes in, “How do I know if I have gonorrhoea?”

A.  Gonorrhoea is a curable STI, that is contracted by having vaginal, anal, or oral sex with someone infected.

Symptoms can appear 2-5 days after infection, but in men, symptoms make take up to a month to appear. In fact, some don’t even have symptoms.

Some symptoms for men are

1.  Burning when urinating and increased frequency
2.  Discharge from penis
3.  Sore throat
4.  Swollen opening of the penis
5.  Tender testicles

You will be given antibiotics for gonorrhoea. Take the entire medication as per your doctor’s prescription and infection should clear up within weeks. Refrain from sexual activity till your follow up test comes back negative.

If left untreated, gonorrhoea can spread to the blood and joints. For men, it can cause a painful condition in the tubes attached to the testicles and potentially cause infertility. For women, it can spread to the uterus.

Please remember that you can get gonorrhea again so always protect yourself by using condoms, having safe sex, getting tested, and being honest and open with your partner.

In women, symptoms can be very mild and vague, often mistaken for a different problem.

Diagnosing gonorrhoea is done by a doctor through a urine test, or taking a swab from a man’s urethra, the tube near the penis that carries urine from the bladder. If you are positive, please get tested for chlamydia and syphilis, related and other common STIs.

our next episode of The Naked Truth

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Understanding Gonorrhoea – The Naked Truth is a post from: mDhil

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Hypothyroidism & Weight loss

Nutrition expert Gauri Rokkam explains that sensible eating and sufficient exercise can help patients suffering from hypothyroidism lose weight.

Try to include lot of onions, carrots, garlic, small bananas along with the other fruits and vegetables.

Cruciferous vegetables like cabbage, cauliflower, turnips and radishes hinder the absorption of iodine. Peanuts and soyabean also work well to absorb iodine. Try not to have them raw but do not eliminate them from your diet as they contain many nutrients.

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Hypothyroidism and weight loss – Telugu is a post from: mDhil

This debate has been on for decades and the fact is that there are pros and cons to multitasking. Or is it OK to multitask in certain situations – like at home or classroom or sometimes at office?

Sure, you might be able to work on multiple tasks simultaneously and maybe even get it done, but what about the quality of work?

Let’s look at the pros and cons of multitasking;

Pros of multitasking

• It’s easy to multitask if you are doing simple chores like – cooking, watching TV and talking over the phone or checking your email, talking over the phone and listening to music. In such case, switching your mental focus from one task to another is easy and does not require much effort.
• Multitasking allows you to include different activities in your daily lives breaking the monotony.
• Moving back and forth between different projects prevents boredom, keeps you inspired and makes you more creative.
• Multitasking helps you learn how to deal with interruptions and distractions
• You develop the ability to cope even when there is chaos around you
• Even if the progress is minimal, you will manage to take more than one project or assignment to the next level, closer to your deadline.

Cons of multitasking

• Studies have shown that multitasking actually slows down progress, because the act of switching between two tasks takes a longer time mentally. Actually, when you begin working on a certain project/chore your brain decides how each thing is to be done. So, switching between tasks means closing one and opening another, which in turn means more time taken.
• When you multitask, you attention is divided between two tasks which means the quality of work suffers. When you focus on one task at a time, the quality of work is definitely much higher.
• Switching between two tasks also means, trying to remind yourself where you left off leading to waste of time. This might result in decrease in overall productivity.
• Multitasking might keep you busy, but at the end of the day, the question is how much have you accomplished. If it’s not much, your management might actually think that there is a drop in your efficiency level.
• Your brain, like any other muscle, can get taxed due to multitasking. Switching between tasks and making multiple decisions might tire your brain to an extent that you might end up being a poor or less-effective decision maker.

So, if you are updating your friend about the latest gossip in your office overphone, and at the same time ironing your clothes, it’s OK. However, if you are talking to your insurance agent about a policy and at the same time helping your kid solve a math problem, it could be very distracting, especially if all of you start quoting numbers!

Learn to prioritize

Having spoken about the pros and cons of multitasking, the key here is to learn to prioritize. Before you start multitasking, make a list of projects which are of high importance. As these tasks should be of high quality, make sure you give it all your attention and finish them in one or two sittings. And then there are the other tasks which can be completed in one sitting – do not waste time by going back and forth on them. Complete them in one sitting.

The projects/chore that you should take up for multitasking should be those which are of less importance and don’t need a lot of attention.

The list on pros and cons is by no means complete, and the cons seem to be weighing more heavily than the pros. At this point, it would be safe to say that people with attention issues should focus on just one task at a time, at least until they learn to cope with distractions.

Photograph via sxc.hu

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Pros and cons of multitasking is a post from: mDhil