Heat stroke: Prevention of heat stroke

Dr Nisreen Nakhoda answers all your questions on heat strokes and how you can prevent them.

What is a heat stroke?

A heat stroke is when the body temperature gets elevated to a higher level from a normal of 98.4 degrees Fahrenheit. It happens more in athletes, infants, the elderly and workers who are always out in the sun.

What are the symptoms of heat stroke?

The symptoms of a heat stroke include

• Nausea or vomiting
• Increase in body temperature
• Agitation or disorientation
• Dizziness
• Halluciantions
• Excessive sweating

Prevention of heat strokes

• Always wear a wide brimmed hat or carry an umbrella when you are stepping out in the sun
• Avoid synthetic and tight fitting clothes
• Stay hydrated, carry a bottle of water
• Avoid caffeine or alcohol

First aid when someone is suffering from a heat stroke

• The most important thing is to cool the person down
• Cool the person under a tap or any other source
• Just fanning the victim with a newspaper also helps
• Keep the victim hydrated
• If the victim can’t take water, its important to shift him to a hospital.

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Heat stroke: Prevention of heat stroke is a post from: mDhil

Choosing the right hairbrush

Round or flat, comb or brush - which hairbrush is right for you?

Oval hairbrush – This hairbrush is used primarily for smoothening the hair. If you have a fringe, use this hairbrush to style it.

Cushioned hairbrush – Oval and rectangular hairbrushes often come with cushioned bases. These are great for people with long hair as the cushioning helps prevent the hair from being stretched or broken.

Ceramic round hairbrush – Ever wondered how beauty salons manage to give your hair volume and bounce that’s nearly impossible to replicate at home? The secret is the ceramic round brush that can works wonderfully well for styling and volumising hair.

Wooden round hairbrush – This hairbrush is pretty multi-functional and can work on multiple hair textures. Avoid using it while your hair is dropping wet though, and allow it to be nearly dry before you style it with this brush. In general, round hairbrushes are the best for styling straight hair.

Nylon hairbrush – Nylon hairbrushes come in many types and their efficacy depends mostly on their bristles. Stiffer bristles that are closed placed together give you better control over your hair. Bristles that are set far apart are better for detangling and light brushing.

Wide-toothed comb – If you’ve got curly hair, one way to make the best of your curls and avoid frizz is to use a wide-toothed comb to untangle it while it’s wet and then just let it dry. Many curly haired women prefer to not even use the wide-tooth comb and only use their fingers to comb through their hair.

Hairbrushes with metal bristles – These are best avoided as they are too inflexible to use on human hair.

Photographs via sxc.hu

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What is an epidural? 

Epidural anaesthesia or an epidural, is used to block pain by injecting drugs through a catheter placed in the epidural space (the space outside the spinal canal, which contains spinal fluid).

The objective is to block transmission of signals from the spinal nerves that arise from that point. This numbs the lower back, thighs and legs.

Other names for an epidural are intraspinal anaesthesia, epidural block and peridural anaesthesia.

Epidural procedure

• If an epidural is planned, you will be advised to avoid drugs like aspirin, which are blood thinners and interfere with blood clotting, a few days before the procedure.
• The lower back area will be cleaned thoroughly with an antiseptic solution in the operation theatre.
• The doctor will ask you to bend forward so that your back is curved in a convex shape. After giving local anaesthesia, a needle is inserted into the epidural space, just outside the spinal canal. The analgesic drug is then injected into it to block the nerve responsible for pain to the lower body. The drug takes 10 to 20 minutes to produce numbness.
• The needle is taken out but a catheter is kept in the epidural space to inject additional medicine at a later time.

This is a completely safe procedure when done by an experienced anaesthesiologist.

Why choose an epidural?

• It is a type of regional anaesthesia, which can substitute  general anaesthesia — which is more complex and has a longer recovery time — in possible situations.
• It is advised when labour pain cannot be borne by the woman. The main advantage is that it does not interfere with the progress of labour. It can be given continuously throughout labour and the woman can remain alert and awake as it does not cause drowsiness.
• It is also used for surgery in the pelvis and legs. If you need to have a Caesarian section, an epidural can numb the area quickly and effectively.

Risks associated with an epidural 

• Allergy to medicine: The person may develop an allergic reaction to the drug used to give pain relief.
• Infection: Meningitis or an abscess may form.
• Hematoma: A collection of blood called hematoma may form around the site of injection.
• Urinary problems: After this procedure there may be difficulty in urinating.
• Hypotension: There is a mild chance of having a drop in blood pressure after an epidural. This could affect the heart rate of the baby.
• Headaches: Severe headaches may occur for days after an epidural.

Epidural anaesthesia precautions

1. Getting up suddenly from a lying down position into a sitting or standing position may cause dizziness, light-headedness and fainting. Therefore, one must change positions slowly to avoid this.
2. You may not be able to walk to the bathroom or move around after an epidural is given. Discuss this with your gynaecologist beforehand.
3. You may not be able to feel the contractions and push voluntarily. This increases the chance of an assisted delivery by means of forceps or vacuum.
4. It is important to monitor the faetal heart rate after an epidural as hypotension (abnormally low blood pressure) in the woman can cause slowing of the heart rate of the baby.
5. If the baby is born before the effect of the epidural medication wears off, the baby may have breathing difficulty and grogginess. However, it can be reversed with another drug

Photograph via sxc.hu

Written by Dr Nisreen Nakhoda, General Physician

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Q. I am 30 years old woman suffering from a severe acne problem. I have consulted a dermatologist, but in vain. The treatment prescribed is effective till I take the medicines and follow other regimen but I am looking for a permanent solution.

- Seema

A. Acne is an inflammatory disorder of pilosebaceous unit. You need to apply some of topical creams to get acne under control. If you are having hormonal problem like polycystic ovarian disease, then please see a gynecologist. Ask your dermatologist for starting Isotretinoin if you are not planning a pregnancy as Isotretinoin can damage the fetus.

Write into webinfo@mdhil.com with your queries

Dermatology Q&A: Permanent solution to get rid of acne is a post from: mDhil

Wear proper-fitting shoes and sandals to prevent an ingrown toenail.

What is an ingrown toenail?

An ingrown toenail is a painful condition where the corner of the nail goes into the skin beneath it. If neglected, conservative treatment may not work and it has to be surgically removed.

Causes for an ingrown toenail

• It generally occurs in adults and rarely in children. Men are more likely to get an ingrown toenail in comparison to women.
• Repeated injury to the toes for e.g. while playing football or an acute injury to the nail may lead to ingrown toenail.
• If someone in the family has had an ingrown toenail, the chances of one getting it are higher.
• Wearing high heels or tight-fitting shoes for long periods of time leads to pressure on the nail, which then may then grow abnormally.
• A fungal infection of the toes may lead to a thickened or wide toenail predisposing one to this condition.

 Symptoms and signs of an ingrown toenail

• It generally occurs on the outer edge of the big toe, but it can occur on any edge of any toe.
• The condition is characterised by pain, swelling and redness, initially, which are signs of an inflammation. The pain is moderate to severe in intensity.
• It is unusual to get fever unless the patient is a diabetic.
• In later stages, it may become infected causing pus to accumulate in the area. It may become impossible to wear closed shoes.

Diagnosing an ingrown toenail

The physician may ask for a history of any injury to the toe, kind of footwear worn and about the pain. It is easy to diagnose based on examination of the foot.

Treating an ingrown toenail

Prompt treatment is important in case of an ingrown toenail. In initial stages, home remedies are useful but in later stages surgery may be the only option.

Home treatment for an ingrown toenail:

• Soak foot in warm water four times a day.
• Wash the foot with soap and water twice a day. Keep the foot area dry throughout the day.
• If you are diabetic, ask your doctor for tips to prevent foot problems.
• Take a small piece of cotton wool and roll into a wick. Try to insert this between the nail and skin after soaking the foot. Doing this repeatedly will encourage the nail to grow in a direction away from the skin and lessen the pain.

Surgical treatment for an ingrown toenail:

• It is done as an out-patient procedure in the doctor’s clinic or in the hospital. A tetanus injection is given before the procedure if it has not been taken in the last five years.
• An anesthetic is injected to numb the affected toe.
• An incision is made to drain the abscess. Any extra tissue in the area is removed. A portion of the nail is also removed to help the area heal properly.
• In case of recurrent ingrown toenails, phenol may be applied to the nail-bed, as it prevents the nail from growing and causing the problem.
• Another procedure called lateral matriectomy is considered where a part of the nail bed is removed; this is for recurrent ingrown toenails.

Preventing ingrown toenails

• Toenails should be clipped carefully straight across and not rounded. The nail should project beyond the skin to avoid it irritating the skin.
• Footwear should fit properly and not be too tight.
• Feet should be kept dry and clean.

Photograph via sxc.hu

Written by Dr Nisreen Nakhoda, General Physician

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The Dhuaa effect:

In India, some of the commonly used tobacco products are beedis, hookah, cigarettes, gutka, pipes, cigars, cheroots, dhumti, chuttas, chiium, hooklis, pan masala, mawa, Manipuri rabacco, khaini, mishri, suns, gul, bajjar and some in the sniffing and chewing forms.

If you use or plan to use one of these products, maybe you should check out these statistics first:

(Statistics according to a study conducted by the National Institute of Health)

Still feel like lighting a cigarette?

Cigarette smoke and ash are harmful

Hang on! Below is a list of the devils it feeds:

• Cancer of all sorts: lung, mouth, penis, urinary & gall bladder, pharynx, larynx, stomach, cheeks-oral, kidney
• Heart & blood vessels diseases, heart attack, angina or chest pain, sudden cardiac death, stroke, peripheral vascular disease (gangrene of legs), paralysis
• Various lung diseases like chronic bronchitis, tuberculosis and emphysema. It also damages the lining of the arteries.
• It reduces blood flow to heart, increases blood pressure, increases risk of diabetes and reduces good cholesterol.
• It decreases physical fortitude which affects our stamina for physical activity.
• Impotence, early menopause and decreased oestrogen levels are also by-products of heavy smoking. Combining them with birth control pillsincreases the chance of stroke for women.
• Cosmetically, smoking is one of the fastest ways you can age yourself. It leads to stained teeth, darkened lips, hair loss and wrinkling of the skin. And then there’s the bad breath and smelly clothes that smokers suffer from that tend to be real turn-offs.

It doesn’t stop here!

Don’t smoke but live with a smoker? Well, passive smoking is equally dangerous. About two packets of passive-smoking is equivalent to about three cigarettes a day, as detected in urine nicotine levels.

Third-hand smoke

While the concept of second-hand smoke has been around for a while, researchers now point towards third-hand smoke. This includes smoking residue found on carpets and other upholstery; lifts and rooms with smokers. Infants are especially susceptible to the third-hand smoke as they crawl and come in contact with this hidden residue.

Startling huh? It’s never too late to stop smoking. So look around, read more, talk to friends and family, reach out for help and free yourself of this life-threatening addiction – NOW!

Photograph by Seb Creane, via sxc.hu

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Say no to tobacco

The urgent need to quit smoking

AC Neilson, a global market research company’s recent survey on Indian smoking habits revealed, that while 85% of those polled believed smoking caused lung cancer and more than 4/5^th of adults believed that second-hand smoke caused serious ailments among non-smokers — quitting remained a challenge. According to the report, about 47% of current smokers and 46% of smokeless tobacco users want to quit their tobacco use, but only a meagre 2% succeed.

Quitting is all about mind over matter. So once you decide to quit, it would be wise for you to seek support from family, medication, alternative therapies or counselling.

How to quit smoking

Here are some tips that might help you quit:

1) Counselling:

There is a school of thought that emphasises that any form of substance abuse is triggered by underlying anxiety or depression. So, get some counselling, identify the cause and ease the process.

2) Alternative therapies:

If you are up to experimenting with alternative techniques then try hypnotherapy or emotional freedom technique.

Like counselling, clinical hypnotherapy also works on unearthing the cause for your addiction.

Emotional Freedom Technique (EFT), a relatively lesser-known technique in India, is a combination of acupressure and psychology. It relies on the notion: what the mind believes, the body delivers. Here, one taps on the acupressure points in the body using fingertips, while thinking about the specific problem (in this case addiction to tobacco use).
See what works for you!

3) Removing nicotine and tar:

Removing nicotine residue (an addictive substance) found in tobacco products from the body can go a long way in helping you quit the use of tobacco.

Epsom Salt (magnesium sulphate), easily available with your neighbourhood chemist is known to help remove nicotine and tar residue from the body.
So, if you have the luxury of a bathtub, add a handful of Epsom salt in your bathwater and soak your body in it for 10 minutes. Otherwise mix a spoonful of Epsom salt in a little water and rub it on to your body, leave for a few minutes and shower.
In fact, if you use a light-coloured towel, you’ll be able to see a brownish residue after you dry yourself.

4) Aids to quit smoking:

i) Chewing on liquorice root:

The liquorice plant, a legume is a natural throat lozenge referred to as ‘mulaithi’ in Northern India. The natural sweet flavour of liquorice has been used to mask the more bitter flavours of nicotine by tobacco companies for long. While the quantity of liquorice used in tobacco products is small, the smoker unconsciously associates the act of smoking a cigarette with the flavour of liquorice. And this is exactly where chewing on liquorice root might help you.

b) Nicotine Replacement therapy:

Once you overcome the psycho-social need to use tobacco, nicotine replacement therapy can gradually help relieve your nicotine dependence. Nicotine patches or gum will supply clean ‘nicotine’, minus the harmful additives like tar and carbon monoxide, thus helping you quit. But, do check with your doctor before use.

Photographs by Vivek Chugh and Abel Leemans via sxc.hu

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What is a hookah?

The hookah, also known as sheesha or goza, was once seen only in Bollywood movies, being puffed at by spoilt nawabs and patrons of the nautch girls. Today, this age-old tradition has come back as a trendy hobby for young people unwinding at coffee shops or hookah bars. While, this tradition has been around for many years and is, in fact, a part of many Asian cultures, it does have health issues that one should be be aware of.

Anatomy of a hookah

Most hookahs consist of a water pipe attached to a smoke chamber. Tobacco used in hookahs is specially prepared, making it possible for the smoke to pass easily through water.

Many young people smoke hookahs for their fruity flavours and are under the impression that hookahs do not contain any tobacco. This is in fact, not true. While most modern hookahs do come with a fruity aroma, tobacco is also used and has the same ill-effects as any other form of tobacco.

Ill effects of hookah smoking

According to the World Health Organization, hookah contains numerous toxicants known to cause lung cancer, heart disease and other diseases. If you’re into hookahs, be aware of the ways in which it can be harmful to you:

• A hookah session may expose the smoker to more smoker over a longer perod of time than when smoking a cigarette.
• Hookahs are typically smoked for a longer time than regular cigarettes. Cigarette smokers typically take 8 to 12, 40-75 ml puffs over 5 – 7 minutes and inhale 0.5 to 0.6 litres of smoke. In contrast, hookah smoking sessions last 20 – 80 minutes, during which the smoker may take 50 – 200 puffs which range from 0.15 to 1 litres of smoke each.
• Also, the reduced concentration of nicotine in the waterpipe smoke may result in smokers inhaling higher amounts of smoke.
• There is no filter in a hookah and the water in a hookah can’t filter out lethal tobacco ingredients.
• Another health hazard the hook presents is in the form of its pipes and bowls. As these are typically not cleaned for long periods of time, they become a hotbed for spreading infectious diseases amongst users.

Are hookahs safe for teens?

In one word, no. Smoking hookahs is as harmful as cigarette smoking. It leads to the inhalation of many toxic compounds like tar, carbon monoxide and heavy metals, making it a major cancer risk.

It can also cause lung or oral disease, heart disease and other critical illnesses in youngsters. Worse, it could lead to a non-smoker getting addicted to nicotine.

 Are hookahs safer than cigarettes?

• That hookahs are safer than cigarettes is one of the biggest misconceptions that’s lead to their popularity. Hookahs are as dangerous or maybe even more harmful than cigarettes. The long duration (typically 40 minutes) as well as the absence of any filter makes them highly unsafe. So if you want to stay away from tobacco, as you should, then stay away from hookahs as well.

Hookahs that use herbal molasses

Some hookah bars offer tobacco-less hookah, using herbal molasses instead. These are definitely safer than regular hookahs, but do check with the hookah bar first if they offer this option.

Hookah Smoking – Dangers you should be aware of is a post from: mDhil

Urophilia

The act of urinating upon or being urinated upon by a sexual partner, which adds to sexual excitement, is called urophilia. It is also known as urolagnia, urophagia, and in slang terminology as ‘golden shower’ or ‘water sports’.

Symtoms of a urophiliac include bathing in urine, smelling urine soaked underwear and drinking urine. Others may enjoy keeping their bladder full and may be attracted to people who regularly keep their bladders full (bladder desperation), and those who wet their pants.  Urophilia may be seen in sadism or masochism where urine serves as an object of fetishism and/or a way of humiliating the partner.

In some cases, men have been known to insert foreign objects like safety pins, wires, cylindrical batteries and magnets into their urethra for sexual gratification. However, such practices can cause serious urinary tract infection and may lead to sepsis and even death if untreated.

Coprophilia

The act of getting sexually excited watching a person defaecate on someone else or defaecating on a sexual partner, or in rare cases being defaecated upon is termed coprophilia. In extremely rare cases like schizophrenia, people eat their faeces and that is called coprophagia. This carries a serious health risk of getting hepatitis.

Coprophilia is seen in normal individuals and also in people with a mental imbalance, schizophrenia or sadomasochism. It is a sexual deviation or paraphilia only if it interferes with interpersonal relationships, jeopardises one’s career or causes legal involvement and significant distress.

Some researchers feel that excretion of faeces is seen as a phallic symbol (resembling the penis) and is a defense put by the person against castration anxiety (when a person irrationally feels like his penis will be cut off).

Necrophilia

Also known as necrolagnia and necrophilism, necrophilia refers to the act of having sex with a dead person or corpse for pleasure. It is common among grave diggers and mortuary workers, who , it is said choose this profession so that they can spend time with corpses. Necrophilia is an extremely sadistic act and may be associated with cannibalism (eating body parts of a corpse) and vampirism (drinking the blood of a human or animal).

In ancient times, sailors who brought back the bodies of people from wars for their funeral rites were accused of necrophilia. Most necrophiles (people who commit necrophila) are sadists, psychotic or not capable of having a consenting partner. Some so-called romantic necrophiles have been known to mummify body parts of their partner. The romantic necrophiles are necrophiles for a short span of time and stop the behaviour once they accept that their loved one is no more.

Somnophilia

This is a paraphilia in which a person obtains sexual gratification by caressing, fondling or having sexual intercourse with a person who is asleep. This is typically done with a stranger and without the use of violence or force. Some people have been known to give their partner a sleeping pill so that the latter can sleep through the entire act; this is usually in the case of a consenting sexual partner. If the partner wakes up the fetish and the fantasy is lost, then there may not be the desire for sex.

Somnophilia is a mild perversion and is considered a paraphilia only if it causes distress to the person and interferes with his/her social, emotional and professional areas of life.

Photograph via sxc.hu

Written by Dr Nisreen Nakhoda, General Physician

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An interview with psychiatrist, Dr BR Madhukar on paedophilia 

What is paedophilia?

Paedophilia is a sexual disorder, classified under Paraphilias. Paedophiles are adults, who erotically and romantically prefer children or young adolescents. Some paedophiles have highly age-specific and sex-specific tastes, others are not so.

How is paedophilia diagnosed?

For a diagnosis, a person should have — over a period of 6 months — had recurrent, intense sexually arousing fantasies, sexual urges or behaviours involving sexual activity with a pre-pubescent child.

Is paedophilia categorised as a mental disorder?

Yes, paedophilia comes under the broad heading of mental disorder. It is considered as a disorder of intention, characterised by unusual eroticism and socially destructive behaviours, such as sex with children, rape, exhibitionism, voyeurism, masochism, sexual touching of strangers.

Have you come across cases of paedophilia? 

Yes, I have seen cases of paedophilia during my stint in the National Health Service in England. He was a middle-aged man, convicted of the offence and had been admitted in a Medium Secure Unit for Rehabilitation. He also had a history of psychotic illness and was on medication and long-term psychotherapy.

Is paedophilia more common in men? Are paedophiles attracted to children of the same or different sex?

It is more common in men. Though there are cases of women paedophiles.

It can be attraction towards same sex or opposite sex.

Can an adult who has previously been involved with another adult be a paedophile?

Yes, an adult with no previous paedophilic tendencies can develop this disorder. This can occur following a disturbed marriage, sexual deprivation, substance misuse and also in people with personality disorder.

Can paedophilia be treated?

Treating paedophilia is a prolonged course, involving psychotherapy. The role of medication is limited. The person has to be sufficiently motivated to change. The success also depends on the presence of a highly specialised service with skilled staff. With the best of facilities it’s still a challenge to the mental health services.

What are the common modes of treatment? 

Individual psychodynamic psychotherapy can be highly useful. Cognitive behavioural interventions with a focus on social skills training, assertiveness training will be of help. Aversion therapy is also used to treat this disorder.

If one finds that he/she has paedophilic tendencies, what should one do? 

If one has such thoughts, it mustn’t be neglected. It’s better to seek help at the earliest. One should consult a psychologist/psychiatrist for a detailed evaluation. It is important to understand why one is getting such thoughts. Any underlying problems should be identified and addressed. A supportive family will go a long way in helping with the treatment.

Photograph via sxc.hu

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A skin infection is an infection of the skin, including hair, scalp, and nails. The infection can be caused by various bacteria, fungi or viruses affecting any of the three separate layers of skin.

Bacterial skin infections

Generally, thousands of bacterial species live on the skin without entering. These bacteria create colonies on the skin and are considered as regular and healthy, but over exposing the skin to pollution, natural trauma, pre-existing skin illnesses, and poor hygiene, can result in the bacteria entering deeper layers of the skin and cause infections.

Different types of bacterial skin infections and treatment

Boils are bacterial infection of hair follicles, which results in painful swollen area on the skin caused by an accumulation of pus and dead tissue. Cluster of boils together is called carbuncle.

Carbuncles are large, painful, round bumps under the skin, which are filled with pus. They mostly occur on the neck, face and buttocks. They collect pus around the hair of the infected area. Fever may occur when infection is deep. These may be treated with warm compresses to promote natural drainage of pus, as well as with antibiotic cream and tablets.

Cellulitis is characterised by redness, warmth, swelling and tenderness. They mostly occur on the legs and arms. It occurs when bacteria enter through cracks in skin like abrasions, cuts, burns, insect bites, etc.

Fungal skin infections

Fungi can cause many kinds of skin infections on almost any part of the skin. Some typical skin infections caused by fungi are athlete’s foot, jock itch, and yeast infections. Typical symptoms include constant itching sensation, flaking of the skin, and eruptions on the skin. Without proper care they can become extremely hard to clear up.

Another very common fungal illness is ringworm, which cause typical enlarging raised red rings over body.  Ringworm usually infects the region of the groin where it is slightly wet, though it can infect almost all parts of the body.

Treatment for skin infections

There are many different skin infections, which can vary from mild to severe. Most of the infections are treated by locally applying anti-microbial creams but when infections are deep then medicines are also given.

Preventing skin infections

• Personal hygiene is very important, take a bath regularly and do not share towels.
• Wear loose fitting clothes to allow your skin to breathe.
• Cover and treat any trauma to the skin, including, cuts, scrapes, burns, new tattoo etc..
• Do not touch any infection. Wash your hands immediately if you do touch an infection.
• Fungi like to live in damp and dark places. So keep your room light and dry to prevent fungi settlements.
• Avoid sharing clothing, sports equipment, towels, or sheets to prevent infection.
• Eat healthy food, as diet can play a huge role in keeping your skin healthy.

Photograph via sxc.hu

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If you want your core to work better, or you want to trim down your tummy you need to do exercises that force you to use your core as a whole. Fareed Maheed highlights some of them in this fitness video.

Some exercises to help you build core strength

• The plank: Its an effective exercise and should be performed at the end of every training session. It forces you to use your body as one unit. The plank helps you in building core stability. You can start off by practicing the plank for about a minute. An ideal time frame, once you are comfortable with it would be around 5 minutes.
• Overhead lifting: This works well because you are supposed to stabilise your core. Squatting with something over your head is a great way to exercise your core.
• Any explosive movement: Like sprinting, whether you are jumping in a pool or running helps to work your core because you need to hold your spine really rigid.

Fitness video: Building core strength

• Helps you in becoming a stronger person.
• It translates into better body co-ordination
• It helps in stabilising your spine.

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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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What are breathing-related sleep disorders?

Marked by sleep disruption, breathing-related sleep disorders result in excessive sleepiness or insomnia due to abnormal breathing during sleep.

Types of breathing-related sleep disorders

1. Obstructive sleep apnoea syndrome

The most common type of breathing-related sleep disorder, it is characterised by abnormal pauses in breathing or instances of abnormally low breathing during sleep. Most patients with this disorder are overweight and their symptoms often grow worse as the weight increases. In patients who are not overweight narrow breathing passages cause this problem.

Symptoms of obstructive sleep apnoea syndrome:

• Frequent episodes of upper-airway obstruction during sleep.
• Patients alternate between loud snores and silent periods.

2. Central sleep apnoea syndrome

It is characterised by episodes of airway blockade or stoppage of breathing during sleep because of cardiac or neurological conditions affecting airflow regulation. It mostly occurs in elderly patients.

Symptoms of central sleep apnoea syndrome:

• Patients experience periods when the lungs temporarily stop giving oxygen to blood, but do not suffer any obstruction.
• Patients may have mild snores during sleep.

3. Central alveolar hypoventilation syndrome

It is a condition where some brain disorders affect breathing, which leads to decreased exchange of oxygen in blood during breathing. It is a rare condition which may be present at birth, or may develop due to severe damage to the brainstem. It is common in people who are overweight.

Symptoms of central alveolar hypoventilation syndrome:

• Drowsiness
• Fatigue
• Headaches
• Inability to sleep at night
• Respiratory arrest during sleep
• Shallow breathing often occurs when people are awake

Diagnosing breathing-related sleep disorder

A diagnosis of breathing-related sleep disorder usually requires:

• Thorough physical examination of the upper respiratory tract of the patient by specialist doctor
• Followed by observation of the patient in a sleep clinic where breathing patterns are recorded by an instrument called polysomnogram
• Interviews are also conducted with the patient and his or her partner

Treatment for breathing-related disorders

General treatment measures for breathing-related sleep disorders include:

• Weight loss is a key to effective treatment of breathing-related sleep disorders in overweight people. Weight loss is often considered the first step in treating any disorder involving sleep apnoea. Increased exercise and reduced-calorie diets are the most important components of an effective weight loss regimen.
• Respiratory stimulants and depression medication (in case of depression or anxiety) are usually prescribed for patients suffering from breathing-related sleep disorders.
• Surgery is increasingly preferred by many patients. It includes procedures to   increase upper-airway size, to bypass upper airway, and surgery to aid weight loss.

Other treatments for breathing-related disorder:

• Behaviour  modification aimed at improving sleep hygiene
• Avoidance of ethanol and sedative medicines
• Use of a dental appliance
• Avoid lying flat on back during sleep
• Successful treatment of other conditions, such as obesity, cardiac or neurological conditions in the elderly or enlarged tonsils in children

Preventing breathing-related sleep disorders

• Effective weight management
• Good general health
• Treatment of related physiological conditions

Photograph via sxc.hu

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Breathing-related sleep disorder is a post from: mDhil

Also read: Cleft lip — Time To Raise an alarm

What is a cleft palate?

A cleft palate is a split or opening in the roof of the mouth. It can involve the hard palate (the bony front portion of the roof of the mouth), and/or the soft palate (the soft back portion of the roof of the mouth).

Causes and incidence of cleft palate

Combined cleft lip and palate is the most common presentation (50%), followed by isolated cleft palate (30%).

Children with a positive family history of cleft palate, exposure in early pregnancy to cigarette smoke, alcohol or illicit drugs and malnutrition are more likely to have cleft palate. Cleft palate can be associated with syndromes too.

Problems associated with cleft palate and suggested lifestyle modifications

Feeding difficulties: Infants with a cleft palate have feeding difficulties. Using a special cleft feeding equipment, and altering the rate and method of feeding will thus be of help. With regard to positioning, a semi upright or upright position is best while feeding babies with a cleft palate.

Ear infections/hearing loss: Kids with a cleft palate are prone to ear infections and hearing loss. Ensure regular hearing checkups. Special tubess placed in the eardrums to aid fluid drainage may be required.

Dental problems: Crooked, poorly shaped or missing teeth and deformities of the upper jaw are seen in kids with cleft palate. Regular dental checkups are a must to monitor development of face and teeth.

Frequent burping:  It may be beneficial to give the baby smaller feeds, as babies tend to take in a lot of air with sucking.

Airway obstruction: Airway obstruction is another problem associated with kids who have a cleft palate. This can be avoided by placing the child in a prone position to prevent prolapse of the tongue.

Speech problems: Special appliances are fabricated to help close the nose from the mouth so that speech sounds more normal.

Treatment for cleft palate

• Children with a cleft palate may need to wear a man-made palate to help them eat properly and ensure that they are receiving adequate nutrition until surgical treatment is provided.
• Surgery is typically carried out when between 9 to 12 months of age. Various procedures may be used to close the separation and rebuild the hard and soft palate (roof of the mouth). The repair is then stitched and closed, usually along the mid-line of the roof of the mouth.
• A bone graft may also be needed, to fill in the upper gum line so that it can support permanent teeth. Multiple surgeries are often required over the course of 18 years. The whole treatment needs multiple specialists during the developmental phase.
• Currently, optimising treatment and surgical repair programmes to rehabilitate patients in an integrated manner and prepare them for normal social life, free from prejudice and discrimination, is an important objective, to address ‘the ignored problem’!

Photograph via sxc.hu

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Ragi - A humble grain that is a true natural wonder

Ragi – the humble grain

Ragi, also called finger millet, is a cereal crop. India is a major cultivator of this crop, with the state of Karnataka being the largest producer of ragi in the country. Being a cheap crop, it is widely used by the poorer sections of the society.

The nutritional benefits of ragi

Nutritionally, when ragi is used as a whole grain, it is higher in protein and minerals in comparison to rice.  Red millet is primarily a source of energy in the diet with each serving of ragi (20g) providing 66kcal. It is also rich in fibre and therefore suitable for people trying to lose weight. Ragi, unlike wheat does not contain gluten (a protein found in wheat), and can be easily consumed by people with wheat intolerance.

Ragi is a wonder cereal grain as it has numerous health benefits:

Good source of calcium – Amongst cereals, ragi is particularly rich in calcium, a mineral essential for good bone health. It is a very good source of natural calcium for growing children and older adults, and helps improve bone strengthening.

Energy for weight watchers – Finger millet is a good source of energy for weight watchers, as it contains the amino acid tryptophan that reduces the appetite. Besides, being high in fibre, it provides a feeling of fullness when consumed, and keeps the urge to eat frequently under control.

Beats high sugar and cholesterol – Ragi is beneficial for diabetics as well as those with high cholesterol, as the high fibre content of Ragi makes it a food item with low glycaemic index. That is, it results in slow increase in blood sugar level.

Find out about the glycaemic index of different foods.

Good mix of amino acids – Due to a good amino acid mix in ragi, it is beneficial for tissue repair, relieving migraine, improving the metabolic rate of the body, optimal muscle coordination, and helps reduce the bad cholesterol (LDL-cholesterol). The amino acids lecithin and methionine eliminate excessive fat from the liver, and in turn reduce the cholesterol content of the body.

Source of iron – Being a good source of iron, it is beneficial of individuals with low haemoglobin level.

Excellent baby food – As ragi is low in fat, and is gluten free, it is easily digested. It is therefore, given as first foods to babies in the form of Ragi Seri. Being a good source of calcium in the diet, it is good for bone development in babies.

Also good for new moms – Besides, it is also given to new mother to improve the haemoglobin levels. Lactating mothers are made to eat green ragi, as it improves milk production.

Ragi mudde is a common preparation of ragi eaten with sambar. Being high in fibre, ragi is incorporated in multi-grain biscuits and bread to enhance the fibre content of the product. Ragi can be used to make porridge, upma, cakes, biscuits, dosas and many other preparations.

Though a cheap crop, but it is high in nutritive value and extremely beneficial.

Image through Wiki Commons

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Get your posture right!

Whatever your age, it is never too late to adopt good practices to correct posture. Good posture makes you look taller, breathe deeper and feel fitter. Whatever activity you’re doing, beware of your posture and consciously make the required changes to get into the right posture, every time!

Top ten tips to maintain good posture

1. Be ergonomically smart: At the workplace, use an ergonomic chair, support your lower back with a small cushion and ensure that your legs reach the floor or the foot rest comfortably. Knees should be at level or slightly higher than the hips, and the elbows must rest on the armrest.
2. Buy the right kind of sofa: Spend the maximum you can afford on a good sofa set when doing up the house. Buy sofas that support your back instead of the ones people sink into. Also, put a lot of cushions on them, which can be used to get comfortable and support the back.
3. When working at the desk, don’t slouch or curve your back. Sitting up straight is important to keep muscles and ligaments in top form and prevent neck strain.
4. A good posture while standing is to keep the feet apart at shoulder distance with the body weight resting more on the balls of the feet rather than the heels. Arms should hang by the sides and the knees should not be locked.
5. If you’re standing for long periods of time, shift your body weight from one leg to another or rock to and fro from heels to toes at regular intervals. If possible, use a small stool to rest each foot on the stool for a while and change over.
6. While walking, look straight ahead with the head in a comfortable position, not leaning forward and shoulders upright but not too far back.
7. When it comes to getting a good night’s rest, your mattress and pillow play an important role. Choose a firm but not hard mattress that supports your body but doesn’t sink in. Use a soft or small pillow for neck support. Beware: Using more than one pillow can strain your neck muscles.
8. A good sleeping posture to adopt is to sleep on the back or on your side. A cushion placed under the knees while sleeping on the back is recommended. If you’re sleeping on one side, place the cushion between your knees so that the knees do not touch. This helps balance the body’s weight, and prevents stress.
9. While lifting heavy weights, hold it close to the chest. While bending, keep your back straight and bend from the knees, and not from the waist. When carrying a handbag on one shoulder, keep it light and sling it on alternate shoulders to avoid strain on one shoulder.
10. While driving, keep your back firmly on the back-rest of your seat. Also, remember to adjust the seat so that your legs can comfortably reach the pedals. Ensure that the back of the head touches the middle of the headrest.

Written by Nisreen Nakhoda, General Physician

Photograph via sxc.hu

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What are thyroid disorders?

It’s safe to say that you probably know someone or have heard of someone who’s suffering from a thyroid disorder. And chances are, that person is probably female. After all, women are 4 times more prone to thyroid disorders than men.

Thyroid disorders are amongst the most baffling disorders faced by the medical community. These autoimmune diseases have no real known cause and while doctors see some link between them and diabetes, the sudden rise in incidence has got them worried.

Meet the thyroid gland

The thyroid gland is a very vital part of the human body. It is found below the neck and below the thyroid cartilage (popularly referred to as the Adam’s apple). The thyroid is one of the larger glands in the human endocrine system and is invaluable for the proper functioning of the human body. Its primary role is to secrete thyroid hormones that regulate production of other hormones and also affect the growth and metabolism of many other systems in the human body. The thyroid controls the body’s metabolism, use and generation of energy and sensitivity to other hormones.

The thyroid’s function is in turn controlled by a hormone secreted by the pituitary gland called the Thyroid Stimulating Hormone (TSH). Additionally, the hypothalamus in the brain releases a hormone called Thyrotropin Hormone (TRH) that also controls the thyroid.

 Thyroid Disorders

The two most common disorders associated with the thyroid are hypothyroidism and hyperthyroidism. An under active thyroid condition is termed ‘Hypothyroidism’ and an over active thyroid is called ‘Hyperthyroidism’.

Other than these, an enlargement of the thyroid is caused by iodine deficiency is called goitre. This could happen in cases of hypothyroidism, hyperthyroidism or even cancerous thyroid nodules. Though thyroid nodules are common, about 5% of these are cancerous.

Thyroid disorders not only leave a person feeling exhausted and weak, but if untreated, they can also cause infertility and miscarriages amongst women.

Signs and symptoms of thyroid disorder

Symptoms of Hypothyroidism

Hypothyroidism in infants manifests itself by lowered growth rate, constipation, inadequate feeding, excessive tiredness and jaundice (yellowing of eyes and skin).

In children and adults, fatigue and poor performance at work and school are also signs of hypothyroidism.

Early symptoms in adults include:

• Exhaustion
• Constipation
• Intolerance to lower temperatures
• Wrist pains
• Numbness of hands.

At later stages, the symptoms become more pronounced:

• Fatigue or lack of energy
• Weight gain despite poor appetite
• Hair loss
• Skin dryness
• Puffiness around eyes
• Hoarsening of voice
• Worsened intellectual ability
• In females, irregular or missed menstrual cycles are a sign of hypothyroidism

Symptoms of Hyperthyroidism

Hyperthyroidism is identified by a declining performance at work or school and or behavioral concerns.

Symptoms among adults include:

• Nervousness
• Hand tremors
• Insomnia
• Frequent bowel movements
• Excessive sweating
• Weight loss in spite of large appetite
• Joint pains
• Bulging eyes
• Females may experience lowered or a complete stop of menstrual activity

Amongst the older population, worsening chest pains, shortness of breath and weakening of shoulder and thigh muscles are indications of hyperthyroidism.

Both conditions exhibit a range of symptoms and often symptoms like tiredness and fatigue are attributed to a person’s lifestyle without suspecting a medical root.  A medical diagnosis is recommended to ensure proper treatment of any thyroid disorder.

Read about diagnosing and treating thyroid disorders

Photograph by Liskina Nora, via sxc.hu

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What are paraphilias?

Paraphilias, the medical term for sexual deviations, refer to recurrent sexual thoughts, urges and behaviour that involve objects or situations not considered sexual by others. Paraphilia lead to problems in other spheres of a person’s life including social, emotional, health and professional. The person’s sex life is hampered because the paraphilia is regarded essential to sex.

Paraphilias are also called compulsive sexual disorder, nymphomania, hypersexuality or hypersexual disorder.

Causes of paraphilias

1. Imbalance in certain brain chemicals called neurotransmitters for e.g. dopamine, serotonin and norepinephrine may cause compulsive sexual behaviour. These are mainly feel-good chemicals, which also regulate mood.
2. Androgens are sex hormones that are present in men and women and play a role in sexual desire and libido. Research is on-going to find out their role in paraphilia.
3. Certain medical conditions like epilepsy, multiple sclerosis and dementia lead to the person getting obsessed with certain sexual patterns.
4. Changes in brain connections may also cause a paraphilia. Any activity done repeatedly over a period of time if pleasurable causes changes in the nerve pathways and forms circuits. These slowly become permanent and so does the behaviour.

Symptoms of paraphilia

1. If the person is driven to perform certain acts during sex, even if they do not necessarily give pleasure, it falls under the bracket of a compulsive sexual disorder.
2. If the individual cannot have sex with a partner without the accompanying urge or behaviour, or if sex is no longer enjoyable, even though it was before.
3. If the person feels that his sexual fantasies are intense and beyond his control, it may be a symptom of a paraphilia.
4. If the behaviour puts the person’s partner at risk of contracting a STI or perseveres in a particular behaviour despite warnings of a broken home and loss of job, it points to compulsive sexual behaviour.
5. In some cases, a paraphilia is a desperate attempt to hide other problems like loneliness, depression, undue stress or anxiety.
6. If sex is constantly on the person’s mind and he hides his sexual urges from his near and dear ones, it is time to sit up and take note.

Diagnosis of paraphilias

It is best to seek the help of a trusted family physician or a good psychiatrist. The work of the physician is to understand the person’s motive for the paraphilia and suggest alternate measures to control the urges and impulses. Hence a good past and personal history and any medical conditions, past or present should be recorded.

Treatment of paraphilias

Treatment options include a combination of psychotherapy, drugs and counselling. It is important to check for alcohol or drug abuse or psychiatric conditions like depression or anxiety and these should be treated appropriately.

Psychotherapy is of different types like psychodynamic psychotherapy (increases insight and awareness), cognitive behaviour therapy (which trains to replace negative thoughts and actions with positive ones), group therapy (people with similar problems share their stories) or marriage counselling.

Drug therapy includes anti-depressants, anti-androgens that inhibit sex hormones, mood stabilisers like lithium and naltrexone which is used to treat alcoholics and blocks the pleasure receptors in the brain.

Prevention of paraphilias

Since the exact cause of compulsive sexual behaviour is not fully understood, it is difficult to say what exactly triggers it. However it is better to follow these tips to prevent or catch the problem at an early stage:

• Get professional help if you were a victim of childhood sexual abuse.
• Get professional help for mental health problems, alcohol and drug abuse.
• Keep away from bars, pubs or other places where sex is easily available. Also block related sites on the Internet.
• If you think your sexual preferences are getting unusual or bizarre, consult a physician or psychiatrist as soon as possible to prevent from getting addicted.

Written by Dr Nisreen Nakhoda, General Physician

Photograph via sxc.hu

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Paraphilia – Causes, Symptoms, Diagnosis, Treatment, Prevention is a post from: mDhil