By: eris

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DIABETES – A CLOSER LOOK

Diabetes mellitus (simply called Diabetes) is a metabolic disease where the blood sugar levels are higher than the normal range. Diabetes mellitus is a metabolic condition that prevents your body from properly using the energy from the food you eat because you can’t make insulin or because you can’t use it correctly, resulting in high blood glucose levels (Hyperglycemia) that can lead to health Chronic hyperglycemia is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.

Type FPG (mg/d L) PPG(mg/d L) A1c (%)
Normal < 100 < 140 5.7
Prediabetes > 100 – < 126 > 140 – < 200 > 5.7 – < 6.5
Diabetes > 126 > 200 > 6.5

To check your blood glucose a doctor may ask you to do various tests like fasting plasma glucose (FPG) should be done when you are fasting more than 8 hours and FPG less than 110 mg/dL will be considered as normal; a fasting blood sugar ranges between 100 to 125 mg/dL is considered as prediabetes or borderline to develop diabetes and is your FPG range is above 126 mg/dL then you will be considered as diabetic.

Your doctor may ask you to one more test called postprandial plasma glucose (PPG) this test should be done 2 hours after the meal and if your blood glucose will more than 200 mg/dL then you are considered as diabetic.

Also, your doctor may deploy a sensor of Continuous Glucose Monitoring System (CGMS) for 6- 14 days. The CGMS is modern technology for diabetes monitoring in this technique CGM works through a tiny sensor inserted under your skin, usually on your belly or arm. The sensor measures your interstitial glucose level, which is the glucose found in the fluid between the cells the sensor will be applied on your body (five fingers away from your belly button or back side of your shoulder). This sensor will record your blood glucose every 5 minutes interval and record 288 blood glucose reading per day. After 6-14 days the sensor will be removed and the report will be generated and accordingly, the doctor will prescribe you lifestyle modification or medications.

The amount of glucose in your bloodstream is tightly regulated by the hormone insulin. Insulin is always being released in small amounts by the pancreas. When the amount of glucose in your blood rises to a certain level, the pancreas will release more insulin to push more glucose into the cells. This causes the glucose levels in your blood to drop. Insulin also helps to store glucose in fat cells (Adipose tissue) and liver (for further use when you are not eating) and it increases the usage of glucose from your peripheral muscles.

Diabetes is caused if your body cannot produce insulin or your body cannot utilize insulin properly (Insulin resistance).

Type of diabetes

Gestational diabetes: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy

Diabetes Complications

High blood glucose for a prolonged period may damage your micro-blood vessels of the eye (retinopathy), kidney (nephropathy), and nerves (neuropathy) and macro-blood vessels of the heart (coronary heart disease), brain (stroke) and lower extremities (peripheral vascular disease).

Prevention and management

Lifestyle changes such as losing weight, eating healthy and engaging in regular, moderate physical activity may reduce the progression of Type 2 diabetes. The key to eating with diabetes is to eat a variety of healthy foods from all food groups, in the amounts your meal plan outlines.

The food groups are

    • Vegetables
      • nonstarchy: includes broccoli, carrots, greens, peppers, and tomatoes
      • starchy: includes potatoes, corn, and green peas
    • Fruits—includes oranges, melon, berries, apples, bananas, and grapes
    • Grains—at least half of your grains for the day should be whole grains
      • includes wheat, rice, oats, cornmeal, barley, and quinoa
      • examples: bread, pasta, cereal, and tortilla
  • Protein
    • lean meat
    • chicken or turkey without the skin
    • fish
    • eggs
    • nuts and peanuts
    • dried beans and certain peas, such as chickpeas and split peas
    • meat substitutes, such as tofu
  • Dairy—nonfat or low fat
    • milk or lactose-free milk if you have lactose intolerance
    • yogurt
    • cheese
You should follow advice
  • Eat Regular meal

 

  •  Eat a variety of foods

 

  • Eat less salt
  • Eat less fat

 

  • Eat less sugar

 

  • Avoid or consume less alcohol
  • Eat fruits having a low glycemic index

 

  • Eat food having low glycemic index

 

  • Quiet smoking

Exercise

When you have type 2 diabetes, physical activity is an important component of your treatment plan.  It’s also important to have a healthy meal plan and maintain your blood glucose level through medications or insulin, if necessary.

If you stay fit and active throughout your life, you’ll be able to better control your diabetes and keep your blood glucose level in the correct range. Controlling your blood glucose level is essential to preventing long-term complications, such as nerve pain and kidney disease.

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“It is easier to build strong children than to repair broken men”

“IT IS EASIER TO BUILD STRONG CHILDREN THAN TO REPAIR BROKEN MEN” – Frederick Douglass

What is Paediatrics?

Paediatrics is the medical specialty that deals with clinical care of children – starting from birth through to the age of 18 years. This specialty operates with a focal objective on enhancing the health and well-being of children by reducing their death rates and diminishing the infectious and non-infectious morbidity amongst them.

Role of Paediatricians

Ensuring the health and well-being of children requires specialised care since their bodily functions are not the same as those of adults. Paediatricians are the doctors who are specialised in managing all three aspects of child health: physical, behaviour and mental. Their fundamental roles include:

  • Provision of medical care to newborns, infants, children and adolescents.
  • Examination and detection of a broad range of diseases and/or injuries amongst pediatric patients.
  • Guidance on and administration of necessary immunisations for children to prevent the occurrence of infectious disease right from birth.
  • Monitoring the growth and development of children, in physical and mental terms, through regular follow-ups.
  • To collaborate with specialty expert in case of involvement of specific organ/system deterioration in order to provide the best possible care.
  • To guide and teach the parents as to how they can contribute to the well-being of their child: eating habits, exercise, personal hygiene, etc.
Conditions covered under paediatrics

Paediatricians manage the issues relating to developmental, behavioural, educational and family problems in childhood. Thus, they have an invaluable and lifelong impact on children’s well-being. Specific child health issues that are managed by paediatricians are as below:

  • Neonatal issues (conditions of newborns)
  • Injuries
  • Infections
  • Genetic and congenital (diseases present since birth) conditions
  • Cancers
  • Dysfunctions of specific organs (lungs, liver, kidney, etc.)
  • Developmental delays and/or disorders
  • Behavioural issues
  • Functional disabilities
  • Mental health issues
Importance of Pediatric Care

Pediatric care is a dedicated field of medical care for children, with prime focus on the right growth and development of children by the means of proper nutrition as well as prevention and treatment of illnesses. The core purpose of paediatric care is to improve the quality of life for both the kid and the family. It enables the child to grow and become an asset to society through three-step holistic care as depicted below.

1. Health Optimization at every Milestone
  • Pediatric care begins right from the birth of the child.
  • Heath optmization includes the vaccination of the child from life-threatening infections as well as provision of growth chart for the developmental milestones to be achieved at every stage of childhood.
2. Health Management
  • Assessment of any structural and functional anomalies
  • Diagnosis of underlying health issues that may affect child’s well being
  • Treatment of health conditions as well as congenital problems in collaboration with supervision of other specialists to ensure utmost quality of care
3. Nutrition and Wellness
  • Guidance on meeting the nutritional demands
  • Advising parents on their role in promoting the well-being of children

Health Optimization at every Milestone

  • Pediatric care begins right from the birth of the child.
  • Heath optmization includes the vaccination of the child from life-threatening infections as well as provision of growth chart for the developmental milestones to be achieved at every stage of childhood.

Health Management

  • Assessment of any structural and functional anomalies
  • Diagnosis of underlying health issues that may affect child’s well being
  • Treatment of health conditions as well as congenital problems in collaboration with supervision of other specialists to ensure utmost quality of care

Nutrition and Wellness

  • Guidance on meeting the nutritional demands
  • Advising parents on their role in promoting the well-being of children
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Hypertension: Take control before it’s too late

HYPERTENSION: TAKE CONTROL BEFORE IT’S TOO LATE

Hypertension or raised blood pressure is one of the most important modifiable risk factors for cardiovascular diseases7. The disease of hypertension affects nearly 1 in 4 men and 1 in 5 women throughout the world in 20151. If not controlled it can cause cardiovascular diseases likes atherosclerosis (clogging of arteries), heart attacks, heart failure, brain related conditions like stroke, kidney diseases like kidney failure, and many other diseases.

Nearly, 10.8% of all deaths in India are attributed to hypertension9. Data from 1950 to 2014 showed that the overall prevalence of hypertension in India is 29.8% .

Hypertension is a growing problem in India and causes significant burden on the health system. According to data from the GBD (Global Burden of Disease) study of 2016, hypertension led to 1.63 million deaths in India in the year 2016 alone11. GBD data also showed that over half of the deaths due to ischaemic heart disease (54.2%), stroke (56.2%) and chronic kidney disease (54.5%) were attributable to high systolic BP12.

Hypertension prevalence is common even among younger age groups, with one out of every 10 individuals aged 18-25 yrs. suffering from it14.

The hypertension epidemic in India is further complicated by the fact that a large proportion of individuals is unaware of their hypertension status. The increasing prevalence of hypertension is attributed to population growth, ageing and behavioural risk factors, such as an unhealthy diet, harmful use of alcohol, lack of physical activity, excess weight and exposure to persistent stress. There is 1.5 – 2 times greater prevalence of hypertension in patients with diabetes than those without diabetes, nearly 33% of patients with hypertension get diabetes later in their life. And in those patients with both hypertension and diabetes it is double edged sword especially for kidney patients as kidney plays important role in regulating blood pressure15.

What is high blood pressure or hypertension?

High blood pressure has no symptoms. So best way to check blood pressure is first getting it done from healthcare provider like general practitioner or other doctors during visit.

Office BP measurement is when it is measured at clinic/hospital by healthcare personal.

HBPM or Home BP measurement is when patient measures their own BP by self or assisted by BP measuring devices at home.

ABPM or Ambulatory BP monitoring is 24 hrs measurement of BP by a oscillometric, validated device as attached to patient to get complete view of whole day of BP patterns.

BP when measured in clinic/hospital (office BP)5
Category Systolic(mm Hg) Diastolic (mm Hg)
Normal BP <130 And <85
High-normal BP 130–139 and/or 85–89
Grade 1 hypertension 140–159 and/or 90–99
Grade 2 hypertension ≥160 and/or ≥100
Criteria for Hypertension Based on Office-, Ambulatory (ABPM)-, and Home Blood Pressure (HBPM) Measurement5
Systolic BP/Diastolic BP, mm HG
Office BP ≥140 and/or ≥90
ABPM
24-h average ≥130 and/or ≥80
Day time (or awake) average ≥135 and/or ≥85
Night time (or asleep) average ≥120 and/or ≥70
HBPM ≥135 and/or ≥85
Types of Hypertension

The form of hypertension that by definition has no other identifiable secondary cause is called primary or essential hypertension.

If it occurs as a result of another medical condition or use of other medicines, it is called secondary hypertension.

Why do we need to worry about hypertension?

A person with hypertension may not notice any symptoms that’s why it is often called the “silent killer.” When blood pressure stays high, there is higher effort needed by heart to pump it to other end organs.

Also the end organs receive high amount of blood leading to symptoms like: difficulty in breathing, chest pain, blood in urine, or pounding in the chest, neck, or ears.

Is hypertension difficult to diagnose?

A reason why hypertension gets misdiagnosed or difficult to manage is that neither SBP nor DBP is static; both are affected by the activities of the entire cardiovascular system. A person with normal BP (normotensive), has a distinct pattern called “circadian” rhythm.

Continuous invasive or intra-arterial BP monitoring has shown that during a 24-hour period, normotensives experience a peak in BP in the mid-afternoon followed by a steady fall in pressure through the night. The pressure will reach its lowest point usually between midnight and begin to rise a few hours before the person wakes up.

The greatest and most volatile change in BP occurs in response to the external environment. Depending on the physical activity, psychological stress and environmental factors, BP is known to fluctuate considerably throughout the day. All these effects are under the control of various hormones likes melatonin and cortisols.

What is Masked Hypertension?

When you check your BP at the clinic it shows normal; however when you check BP at home, readings show higher. This condition is more serious and you should immediately inform your doctor about this.

What is white coat hypertension?

When you check your BP in the clinic it shows on the higher side which could be due to anxiety however when you check your BP at home reading shows normal.

Reference
  • https://www.who.int/news-room/fact-sheets/detail/hypertension
  • https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.15026
  • https://medlineplus.gov/highbloodpressure.html
  • R. Gupta and S. Yusuf, “Towards better hypertension management in India,” The Indian Journal of Medical Research, vol. 139, no. 139, pp. 657–660, 2014.
  • Gakidou E, Afshin A, AlemuAbajobir A, Hassen Abate K, Abbafati C, Abbas KM, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: A systematic analysis for the Global Burden of Disease study 2016. Lancet 2017; 390 : 1345-422.
  • GBD Compare | IHME Viz Hub. Global; both series, all ages, 2017, DALYS.
  • Available from: https://vizhub.healthdata.org/gbd-compare/
  • Geldsetzer P, Manne-Goehler J, Theilmann M, Davies JI, Awasthi A, Vollmer S, et al. Diabetes and hypertension in India: A nationally representative study of 1.3 million adults. JAMA Intern Med 2018; 178 : 363-72
  • Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et al. Hypertension in India: A systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens 2014; 32 : 1170-7
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Get Healthy with a “Healthy Gut”

GET HEALTHY WITH A “HEALTHY GUT”

Gastroenterology is a medical specialty that has emerged as a specialised practice as recently as 20 years ago. It encompasses diagnosis and management of the ailments of hepatological as well as luminal organs of the gastrointestinal (GI) tract.

What is Gastroenterology?

The luminal organs (oesophagus, stomach, small intestine, colon, rectum) and the hepatological organs (pancreas, gallbladder, bile ducts and liver) are studied (mainly their normal functions and disease states) under the umbrella of gastroenterology: There are five basic functions of the GI tract:

1. Motility

Movement of the consumed food through lumen

2. Digestion

Conversion of food into absorbable material; in stomach and small intestine with the help of liver and pancreas

3. Absorption

Absorption of nutrients and water through large intestine

4. Excretion

Defecation of waste material from rectum through anus

Motility
Movement of the consumed food through lumen
Digestion
Conversion of food into absorbable material; in stomach and small intestine with the help of liver and pancreas
Absorption
Absorption of nutrients and water through large intestine
Excretion
Defecation of waste material from rectum through anus
Gut microbiota

The gut microbiome is made up of essential bacteria, protozoa, fungi and viruses which naturally occurs inside the luminal organ of GIT and are termed as ‘Normal microflora’. This microbiome plays an important role in immune modulation, regulation of various hormones and neurotransmitters, along with the production of antioxidants and metabolites. They play important role in regulating obesity, inflammation, diabetes development and even cancers if disturbed.

Gastrointestinal Disorders

The integrity of the GI tract is crucial for the maintenance of these physiological functions. Any hindrance in the structure or function of the GI tract may result in multiple disorders. Some of the common GI diseases are described below along with the means to prevent them.

A) Constipation

It’s a common GI disorder that usually involves difficulty in passing stools or decreased and/or incomplete bowel movements. Constipation can be prevented or treated by increased dietary fibre and fluid intake as well as regular physical activity. An important strategy to avoid constipation is not to resist the urge to defecate. If not alleviated with these strategies, constipation is required to be treated with the use of medication under the instructions of a doctor.

B) Diarrhoea

Three or more bowel movements per day with very loose or watery stool are distinct features of diarrhoea. Abdominal cramps, nausea, bloating, weakness and fever may also be seen in patients with diarrhoea. It could be a consequence of infection, dietary change, specific intestinal disorder or even a side effect of medication/s. Treatment of diarrhoea often includes fluid restoration through consumption of water and juices and anti-diarrhoeal medicines. Since disturbance in GI microbiota is a common phenomenon associated with diarrhoea, probiotics are an important part of the treatment approach to correct GI microbial environment.

C) Peptic Ulcer Disease or Acidity

Overproduction of acids or damage to the epithelial lining in the stomach leads to a condition called gastritis or acidity as commonly known. Ulcers are actually “sores” occurring in the internal lining of the stomach and often affect the duodenum as well in uncontrolled or untreated gastritis. Helicobacter pylori bacteria, analgesic medications (pain killers i.e. NSAIDs like aspirin, ibuprofen etc.) and anti-inflammatory steroids are among the common causes of stomach ulcers. These medications prevent the outermost cells of the stomach to protect against the damage of self-produced acids. Other frequent causative factors are cigarette smoking, psychological stress and excessive alcohol consumption. These factors may accentuate the development of ulcers or even hinder with its healing. The patients with ulcers commonly experience upper abdominal pain. The management of ulcer involves early intervention with antacids, acid suppressant drugs and antibiotics against H.pylori bacteria, which when taken at right time effectively manages ulcers. However, those who don’t take proper medications developed advanced ulcerative disease diminishing significant food digestion, which requires specific diagnostic procedure – through endoscopes – that enables the examination of presence and severity of ulcers and provide rigorous medical treatment and in some surgical interventions are also required.

D) Acid Reflux Disease or Heartburn or GERD (Gastro-Esophageal Reflux Disease)

Regurgitation (or reflux) of acidic contents from stomach back into the oesophagus is referred to as acid reflux disease. It is most commonly experienced as “heartburn.” The patients most often experience a sense of burning in their chest and sour belching. Moreover, the fullness of stomach and abdominal pain are also common symptoms. Acid reflux disease can be helped with lifestyle changes such as smoking cessation, avoidance of fatty food, reducing caffeine uptake, withdrawing from certain medications as well as averting heavy lifting exercises. The condition is treated with the drugs that dampen the production of stomach acid and/or stimulate GI motility.

E) Irritable Bowel Syndrome (IBS)

It is a functional disorder in which the muscles of the colon (large intestine) contract more frequently than in normal condition. It could be due to certain food items or a side effect of medicines. Psychological stress may also trigger this condition.

IBS patients usually experience a change in bowel habit, abdominal pain and abdominal bloating and/or distension. They present with either of major characteristics like

  • Constipation with hard stools or infrequent defecation not responding general laxatives.
  • Diarrhoea with loose stool with preceded cramps in small volumes, or with frequent normal defecation with cramps.

Such patients often experience an urgency to pass stools after food intake. The patients are advised to minimise the stress through coping strategies, reduce the intake of caffeine and enhance fibre intake to reduce the disease severity. Moreover, the mainstay of treatment is the specific diet change and medications as prescribed by gastroenterologists, which may include drugs to regulate GI motility and reduce the pain.

F) Inflammatory Bowel Disease (IBD)

As the name suggests, this condition involves inflammation of the bowel (both small and/or large intestines) due to dysregulated immune response to individuals change in intestinal microbiota. The patients experience loose stool, bleeding through rectum, sharp pain/cramps in the abdominal area; some may also present with weight loss and fever.
IBD is categorized into two types:

  1. Ulcerative colitis – the inflammation generally begins in the rectum and ascends upward up till the large intestine,
  2. Crohn’s disease – herein, the inflammation is of more patchy appearance, it may begin and spread through any part of the GI tract.

IBD is treated with drugs that diminish inflammation. Additional therapy includes a special diet, including probiotics. Serious cases of IBD may also require a surgical approach.

Hepatological/Liver Disorders

Hepatology is the branch of medicine that focuses on diagnosis and treatment of diseases of hepatological organs (the liver, gallbladder, biliary tree and pancreas) that are not the part of luminal GI tract but are crucial for digestive health and homeostasis. Some of the common diseases covered under hepatology are enlisted below:

  • Alcoholic liver disease
  • Fatty liver disease and Non-alcoholic Steatohepatitis
  • Hepatocellular carcinoma (liver cancer)
  • Viral hepatitis A, B, C & E
  • Acute pancreatitis
  • Chronic pancreatitis
  • Pancreatic cancer
Consulting a Gastroenterologist

Following a healthy lifestyle (through diet and physical care) and maintaining proper bowel habits may avert many of the GI conditions. However, once established, these conditions require to be managed by gastroenterologists, who perform endoscopic procedures to make the appropriate diagnosis and treat the condition with a specific approach. However, with advances in the science of nutrition and their role in disease pathology, expert nutritionists are also required in the panel for treatment of these conditions.

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Neurology

Neurology is the branch of medical science that deals with structure, functions and diseases of the nervous system. It involves the central nervous system (brain and spinal cord) and the peripheral nervous system (organs, nerves, limbs, muscles, skin and other sensory receptors).

While neurology is a nonsurgical field of medicine, surgical intervention of neurological disorders is known as neurosurgery. A neurologist is a specialist who diagnoses and treats neurological disorders.

Some of the most common and debilitating neurological disorders are epilepsy, dementia, Alzheimer’s, migraine, multiple sclerosis, neuroinfections, traumatic brain injuries, stroke, movement disorders and brain tumors.

Neurological disorders are also associated with improper nutrition and lifestyle, mood swings and depression, environment, genetics and infections (bacterial, viral, fungal and parasitic).

If ignored and left untreated, the consequences of neurological disorders can be serious with long-term disability and even death, as, few of these conditions are reversible. A quick diagnosis and treatment, such as medical care in the first ‘golden hour’ for a stroke patient, can arrest the progression of the disorder.

Although neurological disorders are prevalent in every strata of society and come with a high burden on patients and their families, there is an acute lack of awareness among the general public, especially the poor and the underprivileged.

The acronym STAND (Symptoms, Treatment, Advice and Assessment, Neurology, Determine), can be a thumb rule that can help both patients and their caregivers understand, manage and treat many neurological disorders.

Symptoms

Physical symptoms can be as simple as muscle weakness, numbness and headaches and/or as serious as partial or complete paralysis with loss of sensation. Emotional symptoms are hard to recognize but can include depression and delusions. Consult a medical professional in case of recurring symptoms such as fatigue and migraine, and especially if you experience tingling and numbness, changes in coordination, loss of balance, blurry vision and slurred speech.

Treatment

A number of specialized tests, such as electroencephalogram (EEG), genetic screening and brain scans, enable a neurologist to diagnose the problem and start treatment. With rapid advances in pharmaceutical and medical technology, various drugs and treatment options are now available to treat neurological disorders.

Advice and Assessment

While self-assessment can lead to awareness of a possible disorder, it is crucial that the person seeks immediate medical advice and treatment. Self-medication should be avoided as it can lead to side effects and even prove fatal.

Neurology

Although a neurological disorder can be frightening, a heart-to-heart talk with your doctor will give you a proper understanding of the condition, its symptoms and treatment options. Knowing that the condition can be treated will also put you at ease.

Determine

Determine to lead a healthy and active life, both physically and emotionally, and keep many disorders at bay. In the event of a neurological problem, your determination will help you fight the condition.

Knowledge, awareness and certain behavioral changes can help manage and treat many diseases and disorders.

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BONE HEALTH

BONE HEALTH

  • The bones provide the structural framework for the support of organs and facilitate the movement of the body. The bones protect organs like the brain, lungs and, heart from injury. With help of muscles and tendons attached, they bring about movement.
  • Minerals like calcium and phosphorous are stored in bones. Under the control of bone cells, they help in maintaining the bone density and are absorbed from or released into the blood as per the body requirements.
  • Bones being the living tissue undergoes constant remodeling throughout our lifespan.
  • Most individuals start to lose bone density (bone mass) and its strength with age, particularly women after menopause.
  • It is vital for us to get enough calcium, vitamin D and exercise to have strong bones and to prevent bone loss.
  • Avoiding smoking and excessive alcohol drinking is additionally necessary to guard bone health.
Impact of Nutrition on bone health

A healthy diet and exercise could be key to prevent and manage age-related bone loss and other musculoskeletal disorders.

  • Around 52% of the Indian population suffers from nutritional bone disease.1
  • Bone diseases can make your bones weak and prone to fracture.

The most common bone problems are:

  • Low bone density and osteoporosis: this condition makes your bones weak, making them more susceptible to breaks/fractures.
  • Rickets: It affects children and leads to the softening and weakening of bones. It is caused by the deficiency of Vitamin D and calcium
  • Osteoarthritis: It is a condition in which inflammation of joints occurs. It can be due to excessive wear and tear or injury leading to damage of protective cartilages in the joints, the inflammation reaches out to bones in the joint. Thus reducing their function and movement.
  • Broken bones (called fractures): Excessive stress due to injury or mild stress with bone diseases causes breakage of bones called a fracture. Immobilisation of joint or surgery is the choice of treatment. However, when seen with bone diseases, correction of disease is followed by fracture correction.
  • Osteogenesis imperfecta: It is a genetic disorder of connective tissues in body and bones, which makes your bones very brittle.
  • Bone infections: These are commonly seen during injuries or spread from surrounding tissue infection of immune-compromised individuals. Aggressive antibiotic treatment is the mainstay of management.
Ways to improve your bone health

1. Have a well-balanced diet rich in calcium and vitamin D

  • Good sources of calcium include low-fat dairy products, green leafy vegetables and soya products, nuts and seeds and fishes.
  • Good sources of vitamin D include sunlight and food sources like egg yolk, saltwater fish, liver, and milk.
  • In order to get enough calcium and vitamin D, some people may need to take nutritional supplements.
  • The recommended dietary allowance (RDA) of calcium and vitamin D is 1000 milligrams (mg) and 600 International Units (IU) a day respectively for adults.

2. Other Important nutrients for bone health

  • Protein: Adequate dietary protein is essential for an optimal bone mass gain and also for preserving bone mass with aging
  • B Vitamins: Vitamins B6 and B12, as well as folic acid have a protective role to play in bone loss.
  • Other nutritional supplements essential for bone health includes: Magnesium, Phosphorous, Vitamin A, Vitamin K, Vitamin C and Zinc.

3. Get plenty of physical activity

  • Weight-bearing activities and strength training exercises are important for making your bones stronger.
  • Always consult your doctor, before adding any new exercise to your daily regimen!

Bones are actually pretty complicated. But our strategies don’t have to be. With the above simple steps, we can help ensure our skeleton stays strong and springy for life.

Before starting any nutritional supplements, you should always consult your doctor!!)

Reference
  • Indian J Med Res 2008 Mar;127(3):219-28
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REDUCING THE RISK OF CARDIOVASCULAR DISEASES – IMPORTANCE OF REGULAR LIPID SCREENING

REDUCING THE RISK OF CARDIOVASCULAR DISEASES – IMPORTANCE OF REGULAR LIPID SCREENING

Lipids are fat or fat derived molecules that are part of various cells of our body, energy store house and plays an important function in cellular signalling. The commonly known form is cholesterol or transportation form of fat in human body, other major forms are triglyceride (forms 95% of dietary fat and important storage form) and phospholipids which are structural lipids.

The transport lipids or cholesterol as well as triglycerides are commonly increased in blood circulation in conditions like obesity, hypertension, diabetes and metabolic syndrome. A lipid screening is essential to measure the levels of cholesterol in the blood to help assess the cardiovascular risk of individuals.

Monitoring the levels of these lipids and keeping them normal is important for maintaining minimal cardiac risk. Lipid disorders (dyslipidaemia) often refer to abnormally high levels of cholesterol (hypercholesterolemia) and triglycerides (hypertriglyceridemia) in the blood.

There are different types of cholesterol: low-density lipoprotein (LDL or bad cholesterol) and high-density lipoprotein (HDL or good cholesterol) and VLDL (Very Low Density Lipid are also bad cholestrols). Having high cholesterol generally refers to high LDL levels.

cardiology-2

While the human body produces the cholesterol required for proper functioning of our body (endogenous), the food we eat is the source for certain cholesterols (exogenous). The consumption of a diet rich in saturated fats and trans fats can result in a high level of cholesterol in the blood.

Atherosclerosis

These high amounts of cholesterol can deposit as plaques on the inner walls of the blood vessels and can narrow or eventually block the blood vessels, leading to hardening of the arteries (atherosclerosis) thereby increasing the risk of numerous diseases, including heart disease and stroke.

Test

The American Heart Association recommends that everyone over the age of 20 should get lipids analysed to know their cholesterol levels and take the necessary action as per medical practitioners’ advice. Healthcare providers prescribe a blood test that indicates the level of cholesterol that is carried in the bloodstream. Healthcare providers could also prescribe what is called a lipid profile that tests the following parameters:

  • Total cholesterol
    • LDL levels
    • HDL levels
    • VLDL levels and triglycerides
    • Non-HDL cholesterol
  • Ratio between cholesterol and HDL
  • Ratio between LDL and HDL
  • Triglycerides

Based on the lipid profile, a detailed risk assessment could be done through the ASCVD risk calculator available online:  These calculators include the major risk factors to estimate a person’s chances of developing atherosclerotic cardiovascular disease (ASCVD). The risk factors include smoking, blood pressure, cholesterol levels, diabetes, and age (because atherosclerosis progresses with time, therefore age counts as a risk factor). Patients with higher levels of LDL cholesterol or with the presence of cardiovascular disease need immediate intervention with lifestyle modifications and drugs. Lifestyle is the first thing that needs modification in order to reduce the chances of heart attack and stroke.

Lifestyle Modifications

Lifestyle modifications include regular exercise coupled with nutritious diet. A moderate intensity exercise on most days of the week is generally recommended which could include brisk walk for 30 minutes at least 5 days a week or swimming or yoga etc.

A cholesterol-lowering diet can bring down cholesterol by up to 30%. The food habits observed in the general population are usually variable, but the nutrient value could be maintained if the following options are considered:

When it comes to drugs, the most commonly prescribed class of drug is statin, which lowers the LDL cholesterol and prevents the risk of cardiovascular events. It is important to note that the dose of statin is individualized and is recommended only by a practicing physician.

It is worth bearing in mind that early screening and treatment of lipid disorders with statins can decrease the chance of developing symptomatic CVD or having a heart attack or stroke in the future. Regular screening together with lifestyle modifications can not only prevent the disabling effects of cardiovascular disease but can also enhance the quality of life.

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Pain Management

Pain is a complex, subjective and confusing phenomenon. Every person reacts differently to pain, depending on his or her awareness and capacity to bear it. Chronic or intense pain can be the result of an underlying condition and can cause acute distress to the sufferer. Some people have a high pain threshold, which means they can tolerate pain better than others. The capacity to endure pain reduces as one grows older; though, with a strong mind, one can overcome the debilitating effects of pain at any age.

The International Association for the Study of Pain defines the condition as

“An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

Pain can be managed and resolved with various treatment options, including medication, surgery, therapy, and mind-body techniques such as yoga and its associated disciplines.

Pain is broadly categorized into acute pain and chronic pain.

While acute pain is usually short term and treated with medication, chronic pain is often resistant to medical treatment. Pain is mostly associated with damage caused to the skin, tissue, muscles, bones, visceral organs, joints, tendons and nerves.

The severity of pain and the complications thereof depend on the injury or another health condition. To a large extent, complications can be avoided with proper understanding, diagnosis and management of pain. Doctors often treat symptoms of pain because they cannot find the cause. This can delay medical treatment and prolong a patient’s suffering.

In most situations, Pain Management is possible by simply being MOBILE:

M: Movement is a must. Doctors and physiatrists recommend movement and advise against sitting still (except in a few cases) to overcome injury-related pain. This improves blood circulation to the affected area, strengthens tissues and muscles, and speeds up the healing process.

O: Avoid self-medication or being your own doctor. Popping painkillers without a prescription will ease the pain temporarily and even lead to drug dependency. Besides, painkillers, when combined with other medicines, can have either a synergic or a contrary effect on the body. This can result in side-effects and even prove fatal.

B: A better understanding of various treatment options helps overcome the injury and pain faster. It is also possible to treat injuries with little or no medication, by relying on physical therapy, psychotherapy and counseling.

I: While interventional treatment options are available in severe cases, one should avoid these unless recommended by the doctor. The first line of treatment should be to let the injury heal itself.

L: Lifestyle modification such as a change in diet and exercise can provide relief from physical pain. Ask a qualified nutritionist for a list of foods that can aggravate pain. Then make a conscious effort to avoid eating blacklisted food, however tasty it may be.

E: Never hesitate to seek expert medical advice. Trust a medical professional enough to deal with the problem.

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Mobility Patron

We started the Mobility Patron initiative to assist doctors in focussing on diagnosis and treatment by setting up Mobility Centers across their clinics. Our trained medical representatives at these centres guide and counsel the patients with basic information regarding pain management.

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Watch How it Works

This video describes how the Mobility Patron initiative works with descriptions of processes and areas covered under this initiative. If you suffer from ailments related to either pain or mobility issues, we suggest you take a quick look at this video and understand how our program can help.

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