General Health - Best Private Hospital in Dubai Al Mankhool | IMH Dubai

Protect the eyes of the apple of your eyes!

What can you do to protect your child’s gift of vision?

Without an iota of doubt, babies born these days are ranking much higher in Intelligence Quotient compared to the previous generations. They are superfast when it comes to learning numbers, languages and for that matter anything under the sun. The millennial babies are grasping their ABCs much before their parents ever could.

However, everything is not rosy with this generation. With the fast-paced life globally, kids these days are falling prey to illness which was a rarity previously. Mum and dad both being busy, kids are being introduced to screens pretty early on whether to calm down their cranky mood or to make them eat their food faster. Research has shown that this is leading to a generation of screen addicts with a high chance of multiple vision problems.

In this article we will try to figure out how parents can secure their child’s gift of vision.

1. Minimum exposure to Electronic Devises:

Ophthalmologists recommend that children take a break after every 30 minutes of reading, writing or playing games on screens like smartphones and tablets. Doctors especially emphasis on reducing the time spent on electronic devices like the later.

According to the American Academy of Pediatrics (AAP), entertainment media should be made available to children for a maximum of 1 to 2 hours a day. Television, laptop and other entertainment media should be avoided for children and infants below the age of 2 since a child’s brain develop rapidly during these years and children learn best by interacting with people, not screens.

2. Incorporating more Outdoor Activity for kids:

Research shows that children who spend more time outdoors have fewer chances of suffering from myopia. Hence, increasing a child’s time spent on outdoor activities like playing in a park, swimming or cycling is helpful. These outdoor activities not just improve physical fitness and socialization skills but improves hand-eye coordination as well. However, it is recommended to avoid outdoors during the hot and humid summer months, especially during the hottest part of the day, typically from 11 am to 4 pm.

3. Protection against sun damage:

To protect your child’s vision from the harmful rays of the sun, invest in good quality sun-gears like sunglasses with 100% UV Protection, umbrellas and hats are also to be incorporated in to our daily outdoor wear.

4. Proper diet:

Vegetables and fruits that are high in lutein and zeaxanthin are helpful in protecting the eyes against free radical damage. These nutrients are found in spinach, kale, avocado, brussels sprout, egg yolk, corn, orange, grapes, kiwi, zucchini etc. Eating fatty fish that are high in Omega 3 fatty acid like salmon and tuna also helps in the development of the eyes.

5. Regular eye check-ups:

health care, medicine, people, eyesight and technology concept – optometrist with trial frame checking girl patient vision at eye clinic or optics store

Good vision is extremely important to a child’s overall well-being. Doctors highly recommend regular vision check-up for children right after they are born, during infancy (between 6 months to 1 year) and throughout their pre-school and school going years, failing which at least once around age of 4-5, when child starts going to school and any refractive intervention can reverse any visual deficiency.

6. Develop and incorporate healthy eye-care habits:

Ensure there is adequate light when your child is reading or playing. Keep your child 30cm to 40 cm away from the book while he or she reads. The distance between your child’s eye and any electronic device should be minimum 50 cm. Also, it is important to rest your child’s eyes and get at least 8 hours of sleep in a day to avoid putting strains on the eyes.

If you have further queries about how to safeguard your child’s gift of vision, want regular check-ups or looking for treatment, kindly reach out to our experts at IMH. International Modern Hospital Ophthalmology Department offers treatment of eye diseases with high level medical technology including diagnostic, surgery and non-surgical treatment by highly trained and accredited ophthalmologists. Your little one’s window to the world is safe in our hands!

Dr. Kapil Anant Das, Specialist Opthalmologist

Prostate Cancer: Early Detection

As with any other form of cancer, the key to saving lives and faster recovery for prostate cancer patients lies in the early detection of the disease. To detect prostate cancer early on, a screening test is done before the symptoms show up. Screening helps detect cancer early when they are likely to be easier to treat.

Screening aims to look for the signs of cancer before the development of any symptoms or signs. If cancer is detected during screening, it is mostly at the earlier stage. This in turn means the success rate is high for the treatment of the disease. The overall goals of prostate cancer screening can be listed down as follows:

  • Promote a proactive approach to screening based on the age group (typically 50+), those with a family history (for men over 40), and also based on the risk/benefit factor for those at an advanced age.
  • Bring down the mortality rate or eliminate the chance of death from cancer
  • Bring down the number of cancer cases

 

Prostate Cancer Screening

Screening is done to check for cancer in otherwise healthy men. Two commonly used tests for screening of prostate cancer are as follows:

  • Digital Rectal Examination (DRE): This test is done by the doctor by inserting a gloved, lubricated finger into a man’s rectum. The doctor feels the surface of the prostate through the bowel wall for any irregularities.
  • Prostate Specific Antigen (PSA) Blood Test: The cells in the prostate gland (both non-cancerous and cancerous cells) make a protein which is known as prostate-specific antigen or PSA. According to medical experts, the chances of having prostate cancer is directly linked to the PSA level in blood. The higher the PSA level in blood, higher are the chances of having prostate cancer.  PSA test comes handy for detecting prostate cancer at an early stage which makes it possible to treat the cancer before it further grows and spreads. Also, PSA screenings can detect conditions like BPH which is not cancer including prostate cancers growing at a very slow rate which does not threaten the patient’s life. Hence, there is a controversy about the effectiveness of PSA test to detect prostate cancer in men with no symptoms. Screening for prostate cancer with this test may sometimes result in surgery and other medical procedures which can be done without. This in turn can cause side effects that’s affects the patient’s quality of life.

 

Case Study:

Recently, a 44 year old gentleman visited my clinic with complaints of difficulty while urinating and blood stained urine. Upon consultation, it was known that he had a family history of prostate cancer. Further to a clinical examination, PSA test, and MRI he was diagnosed with prostate cancer. Thankfully, since we caught it an an early stage, a complete recovery was possible. This highlights the importance of promoting awareness on the risks, signs and symptoms as well as screening for Prostate Cancer.

In Conclusion:

It is not always easy to predict the chances of having prostate cancer in men with no symptoms of the disease. Hence, it is always recommended to get a screening done for early detection. Men should discuss their conditions with doctors to test for any personal risk for prostate cancer and work together towards making an informed decision.

It Is Good To “Hydrate Wisely” for Healthy Kidneys.

Keep your kidneys healthy by taking adequate amount of liquids. This means drinking the right amount of water for you. A common misconception is that everyone should drink eight glasses of water per day, but since everyone is different, daily water needs will vary by person. How much water you need is based on differences in age, climate, exercise intensity, as well as states of pregnancy, breastfeeding, and illness.

About 60-70% of your body weight is made up of water, and every part of your body needs it to function properly. Water helps the kidneys remove wastes from your blood in the form of urine. Water also helps keep your blood vessels open so that blood can travel freely to your kidneys, and deliver essential nutrients to them. But if you become dehydrated, then it is more difficult for this delivery system to work. Mild dehydration can make you feel tired, and can impair normal bodily functions. Severe dehydration can lead to kidney damage, so it is important to drink enough when you work or exercise very hard, and especially in warm and humid weather.

Here are 6 tips to make sure you’re drinking enough water and to keep your kidneys healthy:

  1. Eight is great, but not for all. There is no rule that everyone needs at least 8 glasses of water a day. This is just a general recommendation, because we continually lose water from our bodies, and that we need adequate water intake to survive. It is estimated that men need approximately 13 cups (3 liters) of fluid daily, and that women need approximately 9 cups (2.2 liters) of fluid daily on an average.

  2. Less is wise, if you have kidney failure (end stage kidney disease). When the kidneys fail, people don’t excrete enough water, if any at all. For those who are receiving dialysis treatment, water must actually be strictly controlled.

  3. It’s possible to drink lots of water. hydrate_for_healthy_kidneyAthletes and sportsmen / sportswomen may drink large amounts of water and thereby dilute the sodium level in their blood, resulting in a dangerous condition called hyponatremia which may even cause rapid brain damage.

  4. Your urine says it all. Drinking enough water or other healthy fluids, such as unsweetened juice or low fat milk to quench thirst will keep your urine light yellow or colorless. When your urine is dark yellow, this indicates that you are dehydrated. In the ,idle east, especially in hot and humid conditions, one should be making at least 2 liters of urine daily.

  5. H2O helps prevent kidney stones and UTIs. Kidney stones and urinary tract infections (UTIs) are two common medical conditions that can hurt the kidneys, and for which good hydration is very much essential. Kidney stones form less easily when there is sufficient water available to prevent stone-forming crystals from sticking together. Water helps dissolve the antibiotics used to treat urinary tract infections, making them more effective. Drinking enough water also helps produce more urine, which helps to flush out infection-causing bacteria.

  6. Beware of medications. Drinking extra water with certain medications or before and after procedures with contrast dye may help prevent kidney damage. Read medication labels and ask questions before undergoing medical procedures involving contrast dyes. Always consult with your healthcare provider first though, especially if you are on a fluid restriction.

Gestational Diabetes

Gestational diabetes is a condition in which your blood sugar level becomes high during pregnancy, affecting up to 10% of pregnant women, diagnosed by a blood test done at 24 to 28 weeks of pregnancy. Women with gestational diabetes don’t have diabetes before their pregnancy – and it usually goes away after giving birth.

What causes gestational diabetes?

Hormones produced by the placenta cause a build-up of glucose in the blood. Usually, enough insulin is produced to control blood sugar levels. However, if the body is unable to produce insulin or stops using it, then the blood sugar levels rise, causing gestational diabetes.

Who’s at risk of gestational diabetes?

At your first antenatal appointment, a healthcare professional should check if you’re at risk of gestational diabetes.
The likelihood of getting gestational diabetes increases if you:
• were overweight before you got pregnant.
• have had gestational diabetes in the previous pregnancy.
• have had a large baby in earlier pregnancy (4.5kg/10lb or more)
• have a family history of diabetes – parent or sibling.
• come from a South Asian, Black or African Caribbean or Middle Eastern background.
• have high blood pressure .
• have given birth to a stillborn baby.
• are older than 30 years.
Having gestational diabetes increases your risk of developing it again in future pregnancies. It also increases your risk of developing Type 2 diabetes later in life. You can reduce the risk of developing gestational diabetes by managing your weight, eating healthily and keeping active before pregnancy.

Gestational diabetes symptoms.

Women with gestational diabetes don’t usually have symptoms. Most find out that have it during a routine screening.
You may notice that:
• You’re thirstier than usual
• You’re hungrier and eat more than usual
• You urinate more than usual

Gestational diabetes tests and diagnosis.

Gestational diabetes is diagnosed by routine screening, called Oral Glucose Tolerance Test, also known as an OGTT. The OGTT is done when you’re between 24-28 weeks pregnant. If you’ve had gestational diabetes before, you’ll be offered an OGTT as soon as possible, and another OGTT between 28-32 weeks if the first test result is normal.

How do you manage gestational diabetes?

The goal is to reduce blood glucose to the normal levels exhibited by a woman without gestational diabetes.

This involves:
• Measuring your blood sugar level four times a day
• Eating a healthy and balanced diet
• Performing moderate physical activity for about 150 minutes per week (Running, walking and swimming are good options)
• Reducing stress as much as possible.

These measures must be taken while continuing regular checkup with your doctor and adjusting them as needed. Changes in habits will sometimes not be enough; in such cases, metformin or insulin injections should be used during the pregnancy.

Target blood sugar levels in pregnancy:
• Before a meal: 95mg/dl or less
• An hour after a meal: 140mg/dl or less
• Two hours after a meal: 120mg/dl or less

Tips for eating well with gestational diabetes:
• Eat regular meals.
• There’s no need to ‘eat for two’. Portion size will have the most significant effect on your blood glucose level.
• Include carbohydrates but look for low GI (glycemic index) options and keep the consumption to the optimum level
• Get your five vegetables a day for vitamins, minerals and fibre.
• Cut back on salt, too much salt is associated with high blood pressure, which increases the risk of diabetes complications.
• Stick to water or sugar-free drinks.

What are the potential complications?

In the child:
• Macrosomia (above-average weight)
• Risk of being born with low blood sugar levels and respiratory problems
• Risk of obesity and type 2 diabetes later in life

In the mother:
• Risk of a difficult delivery, possibly by C-section, depending on the baby’s weight
• Surplus of amniotic fluid, which could trigger premature delivery
• Gestational hypertension & Preeclampsia
• Risk of developing type 2 diabetes later
• Risk of suffering from gestational diabetes again in a future pregnancy

Most of the complications can be prevented with appropriate treatment.
In conclusion, in the vast majority of cases, gestational diabetes is easy to control, with your blood sugar levels likely to normal in about six weeks after childbirth. However, the risk of developing gestational diabetes in the next pregnancy increases, with the women also likely to develop type 2 diabetes in the future. It would help if you got follow-up tests every year. Many problems can be avoided through healthy lifestyle habits. Don’t panic and talk to your doctor to see how you can put the odds in your favour.

Be Smart. Don’t Start.

31st May of every year is observed as No Tobacco Day. In present world where everyone talks about COVID, let’s look in to some of the aspects related to smoking which is connected to COVID-19.

Tobacco smokers (cigarettes, waterpipes, bidis, cigars, heated tobacco products) may be more vulnerable to contracting COVID-19, as the act of smoking involves contact of fingers (and possibly contaminated cigarettes) with the lips, which increases the possibility of transmission of viruses from hand to mouth. Smoking waterpipes, also known as shisha or hookah, often involves the sharing of mouth pieces and hoses, which could facilitate the transmission of the COVID-19 virus in communal and social settings.

Smoking any kind of tobacco reduces lung capacity and increases the risk of many respiratory infections and can increase the severity of respiratory diseases. COVID-19 is an infectious disease that primarily attacks the lungs. Smoking impairs lung function making it harder for the body to fight off coronaviruses and other respiratory diseases. Available research suggests that smokers are at higher risk of developing severe COVID-19 outcomes.

Using smokeless tobacco often involves some hand to mouth contact. Another risk associated with using smokeless tobacco products, like chewing tobacco, is that the virus can be spread when the user spits out the excess saliva produced during the chewing process.

Given the risks to health that tobacco use causes, WHO recommends quitting tobacco use. Quitting will help your lungs and heart to work better from the moment you stop. Within 20 minutes of quitting, elevated heart rate and blood pressure drop. After 12 hours, the carbon monoxide level in the bloodstream drops to normal. Within 2-12 weeks, circulation improves and lung function increases. After 1-9 months, coughing and shortness of breath decrease. Quitting will help to protect your loved ones, especially children, from exposure to second-hand smoke.

Precautions

• Do not share devices like waterpipes and e-cigarettes.
• Spread the word about the risks of smoking, using e-cigarettes and using smokeless tobacco.
• Protect others from the harms of second-hand smoke.
• Know the importance of washing your hands, physical distancing, and not sharing any smoking or e -cigarette products.
• Do not spit in public places

#TobaccoExposed

• Tobacco products kill more than 8 million people every year. Tobacco and related industries must continuously find new consumers to replace the ones that their products are killing to maintain revenue.
• Tobacco companies spent over USD 9 billion in marketing and advertising and the world lost 8 million lives from causes related to tobacco use and exposure to second-hand smoke.
• We want to create a generation that is free from tobacco and second-hand smoke and the death and disease that they cause.
• Break free from the tobacco and related industries’ manipulation by becoming educated on their tactics and the harm caused by their products.
• Tobacco use is responsible for 25% of all cancer deaths globally. Use of nicotine and tobacco products increases the risk of cancer, cardiovascular and pulmonary disease.
• Over 1 million people die from second-hand smoke exposure every year.
• Children and adolescents who use e-cigarettes at least double their chance of smoking cigarettes later in life.
• E-cigarette use increases your risk of heart disease and lung disorders.
• Nicotine in e-cigarettes is a highly addictive drug and can damage children’s developing brains.
• Smoking shisha is just as harmful as other forms of tobacco use.

Glaucoma – the ‘sneak thief of sight’

Glaucoma is a serious eye condition that can cause blindness. It damages the optic nerve, which carries information from your eyes to the visual center in your brain. This damage can result in permanent vision loss. The most common type of glaucoma has no early warning signs and can only be detected during a comprehensive eye exam. If Undetected and untreated glaucoma first causes peripheral vision loss and eventually can lead to blindness. Glaucoma is caused by higher than normal pressure inside the eye. By the time you notice vision loss from glaucoma, it’s too late. The lost vision cannot be restored, and it’s very likely you may experience additional vision loss, even after glaucoma treatment begins.

What are the Types of Glaucoma?

  1. Angle Closure Glaucoma : The drainage angle is too narrow or begins to close, impeding the normal outflow of aqueous humor.
  2. Congenital Glaucoma : Some children are born with a defect in the drainage angle that prevents the aqueous fluid from exiting the eye normally.
  3. Secondary glaucoma : Develops due to complications of certain conditions (eg: Trauma, Diabetes), Side effects of medications or because of other eye conditions.

What are the Symptoms of Glaucoma?

• Blurred vision
• Seeing colored rings around lights
• Eye pain
• Headache
• Light sensitivity
• Redness in Your Eye
• Nausea and vomiting in later stages

How is Glaucoma Diagnosed?

• Detailed medical History (including family history)
• Tonometry –Eye pressure check
• Pachymetry – Corneal thickness check
• Perimetry – Visual field test
• Optical Coherence Tomography- Optic Nerve scan

Who is at the risk of Glaucoma?

• Age- People over 60 are at increased risk of glaucoma
• Eye Problems-Chronic eye inflammation, Trauma, thin cornea
• Family History
• Medical History-High Blood pressure, Heart disease, Diabetes
• Use of Certain Medicine-Corticosteroids for extended periods

How is glaucoma Treated?

• Medications- mild to moderate stage
• Surgery- severe stage

Can Glaucoma be prevented?

Glaucoma can’t be prevented. But it is still important to catch it early so treatment can begin in the early phase that will help prevent it from worsening

MYTHS AND FACTS OF LASER HAIR REMOVAL

MYTH: laser hair removal has not been safe.
FACT: It is absolutely safe to do the lasers with FDA Approved machines after consulting certified Dermatologists. It has to be done by skilled or trained laser technician.
MYTH: Laser hair removal exposes you to radiations and thereby can be a risk for causing cancer.
FACT: Lasers approved by FDA do not emit radiation ,thus no risk of radiation exposure and no risk of cancer at all.
MYTH: Laser causes burns.
FACT: While it”s rare and temporary,Burns from laser can occur particularly if you have dark skin though its rare and it’s absolutely correctable.
MYTH: Lasers are too much painful to endure.
FACT: Some people might feel discomfort ,while some can have pain,but with advanced cooling systems ,pain is not very much now a days.
MYTH: You can get discolored from laser hair removal treatment.
FACT: Lasers won’t change your skin colour.
MYTH: Laser can grow more hair after the treatment.
FACT: Laser can not grow the hair if it is done in a properly selected patient with optimal required laser parameters .
MYTH: You can get hair removed forever and completely.
FACT: After the required sessions of lasers,Hair will be very thin,sparse and will take very long time to grow again compared to earlier.So Maintenance sessions are needed every 4-5 month.
MYTH: Laser hair removal is done only for women.
FACT: Laser is not only a female thing,can also be done for men.More and more men are opting for it now in Razor bumps,ingrown hair,beard shaping,chest,neck,back,arms etc.
MYTH: You cant get lasers done in Summer.
FACT: It can be done in summers also.Only Use of sunscreen is always mandatory post procedure.
MYTH: All lasers are equal.
FACT: While many lasers are available now a days in the market,but not all produce the same results.Our team at IMH uses BIOS FROM ITALY(Nd:yag ALEXANDRITE MIXED)technology to give the fast and the best results so far.

PCOS (Polycystic Ovarian Syndrome)

PCOS (Polycystic Ovarian Syndrome) is the most common endocrine disorder among women between the ages of 18 and 44. It is a condition that affects almost 1 in 5 women and the incidence is rising. Exact cause is not known but there is genetic tendency and Life style changes are contributors for development of PCOS.
In PCOS, there is hormonal imbalance in woman’s sex hormones with increase in male hormone levels and insulin resistance in body. This leads to spectrum of symptoms in PCOS. Symptoms vary from person to person but common are Menstrual irregularities with tendency to delay menses ,missed periods or medicines to get periods ,Acne , Excessive hair growth on face ,body and hair loss on scalp ,Weight Gain and difficulty in losing weight .


PCOS also causes difficulty in conceiving and is the leading cause of anovulatory infertility. On ultrasound, there will be multiple small cysts seen in ovary like string of pearl. These cysts are actually immature follicles. In normal menstrual cycle, follicle develops and grows to form an egg which ovulates, but in PCOS follicular development is arrested at early stage due to disturbed ovarian function and they form multiple cysts
How do we treat PCOS?
PCOS can be controlled mainly by Change in life style with opting for healthy food habits and regular exercise keeps normal BMI (Body mass index). Gynecologist can prescribe medicines to increase the insulin sensitivity or pills to regularize cycles.
If fertility is a concern then further treatment to form egg may be required.
PCOS not only affects appearance, fertility but has long term health risks associated with metabolic effects like developing Diabetes, High blood pressure, dyslipidemia, heart disease and also risk of endometrial hyperplasia and endometrial (womb) cancer.
Regular health checkups are recommended to control PCOS and its long term effects.

Ever wondered what the 15 in SPF 15 stands for?

The sun is meant to be enjoyed – To lounge in, to play in, to bask in. But, you have to know the basics to make your time in the sun safer.

UVA and UVB rays from the sun can be damaging to the skin. If the proper sunscreen protection isn’t worn during sun exposure, this leads to aging, can cause unsightly skin damage and even skin cancers. While UVA rays go deeper into the skin causing damage to collagen leading to aging, wrinkles, and even skin cancers, UVB impacts superficially causing sunburn and skin cancers as well.

Sunscreens have ingredients that help in absorbing or scattering UV rays. These products are formulated to provide various levels of protection from UVA, UVB and Infrared radiation. The Sun Protection Factor (SPF) indicates how much longer an individual can be in the sun before being sunburnt when using a sun protection product than if he/she was not using it. It measures the protection only against UVB rays and not UVA. For instance, a fair skinned person who would normally start to feel the effect of sunburn after 10 minutes in the sun would receive 15 times the protection with an SPF 15 product i.e. 150 minutes of protection. If a person with darker skin takes longer to get sunburnt without protection, say 20 minutes, an SPF15 would give him/her 300 minutes of protection.

Most people do not apply enough sunscreen. An adult should use 2 tablespoons of sunscreen if they intend to protect the entire body while wearing a swimming costume. This should be applied 30 minutes prior to going outside. Apply 2 teaspoons full if only for the face, neck, and arms.

Some sunscreens may have an expiry date written on the box, however the active ingredients in the sunscreen deteriorate over time and this would happen faster if you leave it in direct sunlight, heat, or humidity. If it looks or smells differently or the texture is clumpy, then it might be expired.

Are dental treatments just to treat your pain?


Traditionally dental treatments are done to treat your pain and to prevent oral and general health issues. But now dentistry has advanced beyond the space. Do you know something fascinating? About 47% of people notice your smile when they meet you first. Hard to believe? Try cropping your eye brows and black out one of your front tooth in a picture. What do you notice first? And look at the drastic change that does to your face. Not only smiling makes you attractive, it can also make you look younger. How? The muscles we use to smile also lift the face making a person look younger. Your teeth and smile are one of the most important factors to boost your confidence. An interview, a photo shoot, a public speaking engagement, official meetings, you name it, but your confidence starts with your smile. These days the brides and grooms-to-be visiting the dentist before the wedding ceremonies has become an inevitable part of the wedding preparations. There are plenty of options these days to beautify your smile without compromising your oral health.

For instance,
Did your teeth get chipped off?

Go for a tooth colored filling.

Are your teeth crowded or proclined? Or are they irregular?

Go for an orthodontic treatment.

Do you have yellow/cream/black deposits in your teeth, especially in the inner portion of your lower teeth? Or tea/coffee stains which dull your smile?

Go for a professional teeth cleaning and polishing.

Are your teeth yellow?

Go for a teeth bleaching.

Are your teeth irregular in shape/size? Do you have spacing between your teeth? Are they badly stained? And do you want to get it fixed permanently?

Then veneers are made for you!

Veneers are of two types based on the material used, composite and ceramic veneers. No tooth preparation (trimming/shaving of the tooth structure) is done for the composite veneer while a minimal preparation is required for the ceramic veneers. Composite veneer can serve you for up to 5 years while ceramic veneers can last for a very long time depending upon how you maintain your oral hygiene. Veneers are thin shells made to mimic the shape of your teeth. They are fabricated in a different shape and size which you desire, in a whiter and attractive shade you choose. The chalk white shade of veneer many a times referred to as ‘The Hollywood Smile’ is the talk of the town among the models and actors especially in the Middle East. But there are natural pearl white shades as well which is the best loved among the people who want a natural attractive smile. These are as thin as the contact lens and are bonded onto the front side of your teeth. These are permanent and the happy news is that a very minimal tooth shaping is needed and that too just the front portion of your teeth unlike the crown.

Are these painful?  – Absolutely not!

Now, if you already have a gorgeous smile, do you want to be the center of attraction in a crowd of charismatic people? Or do you simply want to make your smile more fetching?

Go for a tooth jewel / tooth gem. Though they come in different colors and shapes, tiny diamond shaped white stones are always in style and are always magnificent.

Why should you compromise your smile and looks when you have so many options to improve it?

Consult your dentist to choose the right treatment or makeover for your teeth. Smiling is the key to self confidence. So keep smiling ,

Say-Teeth!

 

Are women more prone to kidney disease?

Although kidney disease can affect people of all ages and ethnicities, women are prone to face more specific challenges tied to kidney disease. The incidence of Chronic Kidney Disease (CKD) is at least as high in women as in men and may even be higher. Studies have shown that CKD affects approximately 195 million women worldwide and is currently the 8th leading cause of death in women. There is a risk of morbidity associated with CKD and in many cases it progresses towards kidney failure, necessitating kidney replacement therapy i.e. dialysis and/or kidney transplantation.

Types of kidney diseases that are more common in women

Lupus Nephritis is a disease that leads to kidney damage, caused by an autoimmune disease called systemic lupus erythematosus (SLE). The disorder causes the body’s immune system to attack the body’s own cells and tissues. Kidney disease due to lupus may worsen over time and can lead to kidney failure. SLE is much more common in women often striking during the child-bearing years. It is estimated that 9 in 10 people diagnosed with SLE are women.

Pyelonephritis (kidney infection) is a kind of urinary tract infection (UTI) most commonly caused by bacteria which starts in the lower urinary tract. If untreated, it can move upstream to one or both of the kidneys. Kidney infections can cause sepsis, which can be life threatening. Due to their anatomy, UTI is more common in women and girls.

Health challenges that are unique to women

Conception – CKD is considered as a risk factor that affects fertility, especially in its advanced stage, when dialysis is required. While it may be challenging, conception is still possible while on dialysis and the results have been shown to improve with intensive treatment of daily or closely frequent sessions. The use of contraceptive pills as a birth control method is generally discouraged for women with CKD as it may cause an increase in blood pressure and blood clots that can make kidney disease worse.
Pregnancy-related complications – CKD may be caused by both Acute Kidney Injury (AKI) and preeclampsia (PE – a complication in pregnancy which can lead to high blood pressure and kidney damage in the mother). It not only poses a threat to maternal health, but is also associated with fetal mortality, preterm birth and restricted intrauterine growth.
If the mother has any pre-existing kidney disease it can negatively affect the pregnancy and may pose a threat to the health of both the mother and the fetus. Increased chances of adverse pregnancy outcomes including preeclampsia, AKI, progression of CKD, spontaneous abortion, stillbirth, malformations, and other long-term issues have been observed.

While Pregnancy offers an opportunity for diagnosis of kidney disease, it is also a state where acute and chronic kidney diseases may develop which may impact the health of future generations.

As individuals, it is important for women to be aware of how important your kidneys are to your overall health and how you can prevent or slow down the progression of kidney disease.

Key questions to ascertain your risk
  • Do you have high blood pressure?
  • Are you diabetic?
  • Do you smoke?
  • Are you overweight?
  • Do you have a family history of kidney disease?
  • Are you over 50?
  • Are you of African, Hispanic, Asian or Aboriginal descent?

If your answer is yes to one or more of these questions, it is advisable to discuss with your doctor. Early chronic kidney disease is silent and has no signs or symptoms. By treating kidney disease early, you can help delay or prevent kidney failure.

WINTER SKIN CARE TIPS

Winter winds and dropping temperature reduce our skin’s moisture levels and depletes its natural defenses. The changes can make your skin itchy, flaky, dry, irritated and red. The condition worsens as we enjoy all the winter comforts like heaters, blowers, being in the sun, bathing with hot water.

There are certain tips which you can follow to keep your skin super happy during winter which are as follows:

drink water in winter to keep yourself hydrated1. STAY HYDRATED: As cold winds take away your moisture, you always need to drink more water to keep your skin healthy.

2. CHOOSE THE CORRECT CLEANSER AND MOISTURIZER: Choose gentle fragrance free cleansers and moisturizers. Avoid masks, astringents, products that contain alcohol as they make your skin dry during the winter.

3. WEAR SUNSCREEN: The warm sun feels pleasant; however UV rays can still damage your skin. Choose the correct sunscreen which has zinc oxide or titanium dioxide.

4. DON’T FORGET THE HANDS: As the skin of your hands has fewer oil glands compared to other body parts, moisturize your hands every day.

5. CARE FOR YOUR FEET: Choose glycerin or petroleum jelly based moisturizers for feet.

6. AVOID HOT WATER SHOWERS: It is very tempting to go for hot and long showers when the temperature is dipping, but if you love your skin avoid this practice. Instead use lukewarm water to shower and wash your face. Moisturize your skin just after showering to lock the existing moisture of your skin.

7. EXCERCISE REGULARLY: Yes! I know it’s hard to leave the warmth and coziness of the blanket behind and get moving on chilly mornings. But do so, if you love your skin. Exercise will pump up your heart rate thereby pumping more blood to your organs and skin.

8. GRAB A SOOTHING FACE MIST: They aren’t just something you fancily spritz on while you’re poolside, apparently they can be super useful in winter months too. You can either pick up one or even make your own with coconut water and green tea in a spray bottle.

Pneumonia is fourth leading cause of death globally

Beware of Pneumonia?

Pneumonia is a leading cause of hospitalization in both children and adults in the United Arab Emirates. It is a major cause of death among all age groups and is the 4th leading cause of death in the world.

1) What is pneumonia?
Pneumonia is a common lung infection caused by bacteria, a virus or fungi.
The infection causes inflammation of the lungs' air sacs, leading to collection of
fluid or pus there.
2) What are the symptoms?
The symptoms of pneumonia can range from mild to severe, and include cough with phlegm, fever, chills, breathing difficulty and chest pain. With pneumonia, you may cough up phlegm that is yellow, green, or sometimes bloody.

3)  What are the risk factors?
The people most at risk to develop pneumonia are:

  • Infants and young children
  • Adults 65 or older
  • Pregnant women
  • People taking medications that suppress the immune system
  • People with diseases that weaken the immune system, such as cancer, HIV, and AIDS
  • People with lung and respiratory conditions, such as asthma.

4) How is pneumonia transferred from person to person?
Pneumonia can be spread by way of someone sneezing or coughing. When a person sneezes or coughs, little droplets spread throughout the air. These droplets contain the infectious organism. They are then inhaled and may, in some instances, cause pneumonia.

5) How Is Pneumonia Diagnosed?
Pneumonia is diagnosed based on your medical history, a physical exam done by doctor, and some tests. Investigations include blood tests- to confirm the infection and to try to identify the germ that is causing your illness. Chest X-ray to look for the location and extent of inflammation in your lungs. Sputum tests are done on a sample of phlegm taken after a deep cough; to look for the type of the infection. In some special circumstances additional tests may also be performed. This includes, CT scan of the chest to get a better view of the lungs and look for complications. Arterial blood gas test, to measure the amount of oxygen in a blood sample also performed. Bronchoscopy is a procedure used to look into the lungs' airways to see whether something else is affecting your airways, such as a blockage. They may also take fluid samples or a biopsy of lung tissue via bronchoscope.

6) How Is Pneumonia Treated?
Because pneumonia comes in different forms, treatment plans vary widely. Some people may only need bed rest, while others may require hospitalization. If your pneumonia is so severe that you are treated in the hospital, you may be given intravenous fluids and antibiotics, as well as oxygen therapy, and possibly other supportive treatments.

7) What are the Complications of pneumonia?
Severe pneumonia may cause, spread of infection to other parts of the body, collection of fluid around the lungs, respiratory failure and death.

8) How to Prevent Pneumonia?
You can reduce your risk of getting pneumonia by vaccination, following good hygiene practices, quitting smoking and staying away from sick people, if possible.

Dr. Muhammed Aslam
Specialist Pulmonologist
International modern hospital Dubai

Self-Examination.. an easy tool for early detection of testicular cancer

Testicular cancer is the most common cancer for men aged between 15 and 45 Fortunately, it’s one of the most treatable cancers and with good survival rates. The incidences of testicular cancers are increasing in incidence worldwide. It is important to identify testicular cancer early to improve the chances for successful treatment.

This cancer may not cause noticeable symptoms until a late stage. That is why self-examination is so important – it is often the only way to catch testicular cancer at an early stage .

The most common symptom is

  • a painless lump
  • swelling appearing on the testicles.

 

Until proven otherwise, any lump or firm part of the testicle should be considered a potential tumor. The testicle may also seem to be larger than usual. Other symptoms include a dull ache or a feeling of heaviness in the scrotum. Unfortunately, it is common for men not to reveal about these signs for up to an average of 5 months. Since the tumor can spread during that time, it is vital to reach out to your doctor right away.

 

The factors that increase the risk of testicular cancers are

  • Undescended testicles
  • Family history
  • previous history of testicular cancer

 

Men with undescended testicles are about three times more likely to develop testicular cancer than men whose testicles descend at birth or shortly after. Generally men are unaware about the disease and they have a psychological inhibition for self-examination. Monthly testicular self-examination helps us to Identify changes in testicle early and should be done after a warm shower,when the skin of the scrotum is relaxed. Stand in front of the mirror and look for any swelling on the skin of the scrotum and then examine each testicle separately.

Hold your testicle between your thumbs and fingers and roll it gently between your fingers.

Look and feel for any hard lumps or nodules or any change in the size,shape, or consistency of your testicles.
It’s normal for one testicle to be slightly larger than the other, and for one to hang lower than the other. If you have any concerns, get an expert opinion from your specialist.

Testicular cancer is diagnosed by

  • the physical examination
  • ultrasound
  • blood tests that measure tumor markers.

 

Surgical removal of the involved testicle is the first line of treatment followed by chemotherapy and radiotherapy depending on the stage of the disease. Around 95 % of all men with testicular cancer make a full
recovery after receiving treatment. Testicular cancer treatment can cause infertility. Patients may consider sperm banking (freezing sperm and storing it) if they want children after their testicular cancer treatment. Other
side effects are due to radiation and chemotherapy.

Follow-up is necessary because testicular cancer may recur. Follow-up treatment involves regular tumour marker blood tests and possibly CT scans.A quantitative study conducted in the UAE in efforts to test the level of awareness regarding general knowledge on testicular cancer and self- examination practices among residents revealed that nearly 50% either never or rarely self-examined. This study suggested that the general public in the region currently possesses little information regarding the symptoms, risk groups and self-examination practices Monthly testicular self-examination is a good tool to pick up changes in testicle early and thus detecting cancer in the initial stage. Programs for improving the level of awareness regarding the disease and importance of testicular self-examination is highly recommended.

 

Dr. Shameer Hameed

MBBS, MS (General Surgery), DIP. LAP, MCh (Urology) FECSM (Sexual Medicine)

Specialist Urologist writes in Khaleej times and now available in our blog.

 

testicular cancer
testicular cancer

Cataract and Its treatment– Everything you need to know!

Cataract & Its treatment– Everything you need to know!

What is a cataract?
The lens is a clear disc that receives light through the pupil and focuses it on the retina and
helps produce a clear image. Lens is mainly composed of water and proteins. As we age these
proteins may begin to clump together and cloud the lens. This clouding is called cataract.

What are the causes of Cataract?
Apart from age related, cataracts can also be caused by ultraviolet radiation, obesity, smoking,
eye injury, high myopia, steroid medications and family history.
What are the Symptoms of Cataract? How is cataract diagnosed?
Symptoms include blurred vision, double vision, increased glare, appearance of halos around lit
objects, and faded appearance of colors. It is diagnosed at a comprehensive eye exam.

Blurred Vision Glare at night

When should I have cataract surgery?
A cataract needs to be removed only when vision loss interferes with your daily activities, such
as driving, reading, or watching TV. You and your doctor can make this decision together. Once
you understand the benefits and risks of surgery, you can make an informed decision. In most
cases, delaying cataract surgery will not cause long-term damage to your eye. You do not have
to rush into surgery.

At times a cataract may need to be removed even if it does not cause visual problems. For
instance, a cataract extraction is necessary if it prevents examination or treatment of retinal
disorders (age-related macular degeneration or diabetic retinopathy) and Glaucoma (Lens
induced).

Why should I have cataract surgery?
Cataract-related vision loss is reversible with cataract surgery, which is one of the safest
surgeries in Ophthalmology.

What should I expect on the day of surgery?
Before surgery you will be given eye drops to dilate the pupil, the area around your eye will be
washed and cleansed and a local anesthetic maybe injected in the area surrounding your eye.
You may be offered a sedative to help you relax. Cataract surgeries generally last less than 30
minutes.

What does cataract surgery involve?
Common method used is Phacoemulsification. In this procedure the surgeon looks through an
operating microscope and makes three small incisions, less than one inch long, in or near the
cornea. An opening is made in the capsule of the lens and an ultrasound probe is used to break
the lens into tiny fragments. These fragments are aspirated out with the probe. A customized,
transparent artificial prescription lens called an intraocular lens made of silicone or acrylic
compounds, is inserted. The incisions are so small stitches are generally not required.

Is there any further advance in technique?
Femtosecond Laser Assisted Cataract surgery (FLACS) is a recent development in cataract
surgery. Femtosecond Laser is utilized to make the incisions, the opening in the lens capsule as
well as for fragmentation of the cataract nucleus. FLACS can offer greater level of precision and
to some extent can increase patient safety and outcome especially in cases like Fuch’s and
subluxated lens.

Cost of this procedure is significantly high.

What happens after the surgery?
Patient improves notably almost immediately after the surgery. After the procedure your eye
maybe patched for a day. Cataract surgery is an outpatient procedure and you can be
discharged on the same day. You can resume normal activities within a day or two. Exposure to
bright light may initially be uncomfortable, do not plan on driving immediately following the
procedure.

You may feel mild pain for a day or two which will alleviate with the eye drops and painkillers
prescribed.

Is there any alternative to surgery?
No. Don’t delay in getting an eye-exam.

Dr. Vidhi Majithia
Specialist Ophthalmology

TO know more http://bit.ly/30eGiE7
For Appointment : Call +971 4 406 3000 /02

 

Cataract Its treatment– Everything you need to know!
Cataract Its treatment– Everything you need to know!

 

 

HEALTHY RAMADAN

Fasting is a very healthy thing to do and has a good effect on the body. Studies have shown that
it can decrease cancer and improve your immune system. It increases insulin sensitivity, enhances
cardiovascular health, boosts brain function and improves immunity and metabolism that aid overall
well-being. Ramadan fasting should help you to lose weight. Ramadan also is a good time for person to
quit smoking. There is medication available for withdrawal symptoms if required, that will help them
turn in to a nonsmoker. Fasting can be beneficial for people with acid reflux disease and functional
bowel disorders if we do not over eat. Benefits of smoking cessation, weight loss, heightened spiritual
involvement help to reduce stress and blood pressure.
With a little planning, you could finish the month in a healthier condition than when you began.
It would be safer to choose dishes that are low in fat, rich in fiber when dining out. One should aim to
eat three to four small, balanced meals. A balanced meal would consist of third portion of fruit and
vegetables, a third portion cooked meat and carbohydrates, and third portion of fluids. Eat dates to end
the fast, and then pray so your body gets rest, after that drink a little water and continue with your
meal. If you don’t over eat you will not get acid reflux and acidity. Choose quality lean proteins and
healthy fats in sensible portions. Start your day with fast acting carbs like refined wheat and wheat
products, rice, starches, honey, avoiding sugar cereals and toasted white bread. Strive for a good
balance of macronutrients: At iftar make sure to include all the major macronutrients -ensure half your
plate is filled with fruits and vegetables, a quarter with protein, a quarter with grains. Also include
serving of dairy. A good balance of macronutrients comprises complex carbohydrates (vegetables and
whole grains), lean protein (fish, white meat and legumes) and healthy fats (nuts, seeds, avocado etc.),
in additions to fruits. Since sugar is not an essential nutrient, recommendation of sugar is about six
teaspoons or 25grams. Stay hydrated-drink plenty of water- at least three liters between Iftar and
suhoor. Avoid caffeinated and carbonated drinks.
Maintaining regular sleeping pattern throughout the month is also an important part of a
successful Ramadan. Exercises moderately about two to three hours after you break your fast.
Exercise during fasting stimulates the body to burn fat and raises the level of mental activity.
Recommended sports are brisk walking, bike riding, and moderate exercise at the gym.
Many medical conditions require special attention during Ramadan like diabetes, hypertension,
kidney disease, heart disease and pregnancy. Patients is on medications should discuss with their
physician about how best to adjust the doses. People with chronic health conditions are exempted
from fasting, but still can do it as long as they consult with their doctors. Patients on
medications for hypertension can generally continue to fast, since most medications are given
once or twice daily. Although there is risk associated with fasting for diabetes, patients can fast
especially if they are taking long acting medications and their blood sugar is well controlled. If
you feel dizzy or faint, you have to end your fast and drink some beverage or eat light snack,
such as orange juice or dates.
Pregnant women should discuss her fasting with her doctor based on her personal
health.

For children it’s best to eat dates and drink water or milk followed by short break before
having the main meal. Children are encouraged to drink at least to four to six cups of water
between iftar and suhoor and avoid sugary drinks. The iftar meal does not have to be very
heavy and should be equal to regular lunch or dinner. One healthy snacks such as whole fruits,
dates, yoghurt, milk or a smoothie can be offered before sleep. A normal breakfast meal should
be scheduled as close as possible to dawn.

50 Years Young!

50 Years Young!

Women spend a lifetime looking after their families and often ignore their own wellbeing. It is important for women to take care of themselves. As time passes, our bodies change. Each one of us is unique and hence aging touches us in different ways. Thanks to the growing awareness and advances in medicine and nutrition, we are seeing higher life expectancies and healthier lives(average life expectancy of a US woman is 82 years).To be healthiest,we need to know our family medical history, understand our body changes, integrate beneficial habits into our lifestyle and keep up with routine preventive health screenings.

50s Body Basics:

Menopause:-Menopause:-For most women, her 50s mean menopause. But it is not really a pause at all. Menopause is more like a shift. Your hormone levels shift and change, and your body shifts out of its childbearing years into a new state of balance. Before that, you may experience hot flashes and night sweats, upset sleep and stress, mood swings, irritability, or depression.
Due to drop in estrogen, you may also notice other changes. Reduced vaginal lubrication can make sexual intercourse difficult, even painful, and increase your risk of urinary and vaginal infections.

Estrogen dips also cause you to lose bone density – putting you at risk of osteoporosis – and have been linked to a gain in belly fat.

Belly fat, in turn, may boost your risk of heart disease, diabetes, and cancer. To lose this fat, you may need to bump up your workouts and lower your caloric intake.

Your risk of colorectal cancer increases during this decade, so screening becomes crucial.

Weakened pelvic muscles may play a role in urination issues like incontinence and in some women a condition called pelvic prolapse. Women who are obese or have had children are more susceptible.

 TOP CONCERNS

Other than Menopause, the main health concern are:-

Heart disease

Heart disease is the leading killer of both men and women. In women, the condition is responsible for about 29% of deaths, reports the CDC. Although more men die of heart disease than women, females tend to be underdiagnosed, often to the point that it’s too late to help them once the condition is discovered.

The earlier people adapt healthier behaviors, the lower their overall risk for heart disease or stroke outcomes.

Osteoporosis

Osteoporosis threatens 44 million Americans, of which 68% are women, reports the National Osteoporosis Foundation. Osteoporosis is largely preventable. The behaviors that women develop in their childhood and early adult years play a significant role in the development of the disease. That’s because bodies build up most of bone mass until age 30. Then new bone stops forming and the focus is on maintenance of old bone. It is never too late to keep bones strong and avoid fractures. Your body will do what it can to repair bone damage, but you have to provide the tools for it, such as adequate calcium consumption and weight-bearing physical activity

When you age, your body absorbs your old bone tissue faster than it can create new bone tissue, which makes your bones weaker. This condition is called osteoporosis. The bones become so thin and fragile that they can easily break when you fall or sometimes, while you are going about your daily lives. It is estimated that 1.5 million fractures happen every year because of osteoporosis. Women are more susceptible to osteoporosis because they lose more bone mass right after menopause.

Flu/Pneumonia:  the elderly are more susceptible to it because the immune system does become weaker with the passing years. It also means that the flu can lead to pneumonia, if not treated on time. The research done by Centers for Disease Control and Prevention, US, believes that 71–85 percent flu-related deaths in occur in people around the age of 65 or more

Diabetes:

In countries like the USA, more than 25 percent people over the age of 60 have this health condition. When a person has diabetes, they have a very high level of blood sugar, which leads to complications like damage to the kidneys, nerves, eyes as well as stroke or heart disease. Some of the early signs to look out for are fatigue, extreme thirst or hunger, blurry eyesight, and a frequent need to urinate.

Incontinence: Women over the age of 50 are more likely to have urinary incontinence. This is because the pelvic muscles lose strength, and aren’t able to control the bladder as well as they did before. Some of the other reasons for incontinence after menopause include less elasticity in the vaginal tissue and thinning of the lining of the urethra. This leads to a few types of incontinence: stress incontinence, which means that you leak out some urine when you laugh, sneeze or cough; urge incontinence, when the need to urinate comes very suddenly; nocturia, where some women feel the need to use the bathroom several times at night; and, painful urination, which may happen because urinary tract infections that some may get more frequently after menopause.

Breast Cancer

It is second to lung cancer as the leading cause of death for women..

The American Cancer Society lists the following as risk factors for breastcancer:

American Cancer Society recommends controlling your weightexercising, quitting smoking, and talking to your doctor about your risk and appropriate screening for breast cancer.

  • “Just because your mother didn’t have breast cancer, it does not mean you are immune to this problem,”. At the same time, it’s also important to note that some women who have one or more risk factors never get breast cancer.

 

Depression / Anxiety

Depression appears to affect more women than men. The National Institute of Mental Health reports that about 12 million women are affected by a depressive disorder each year compared to about 6 million men. Many women suffer silently as they battle with depression, which also impairs their daily functioning. Post-menopausal women are more prone to suffering from depression because when there is a dip in the level of estrogen in the body, mood-regulating brain chemicals like norepinephrine, dopamine and serotonin also get disrupted.

Anxiety is one of the least talked about health issues that women over 55 suffer from. Often undiagnosed or undertreated, studies in the US show that 18 percent of people over 60 suffer from anxiety issues. Women have more anxiety disorders than men due to chemical differences, hormonal changes and different responses to neurotransmitters. The affected person cannot stop worrying about a problem, situation or even the future, to the extent that sometimes it can hamper day-to-day living. Anxiety can even lead to panic attacks, high blood pressure, palpitations, dizziness and insomnia. If you suffer from any of these symptoms or suspect that you have an anxiety disorder, do not hesitate to reach out for help.

 

 

50s: healthy habits

Nutritional needs of your changing body.

As you pass through menopause, your changing body may require fewer calories. At the same time, you might contend with a slowed metabolism and become more prone to belly fat. Switch out high-fat foods for lower-fat options, and slice into leaner sources of protein, like chicken, fish, beans, or quinoa. Give your body an antioxidant advantage by increasing your intake of fruits and vegetables, and support healthy cholesterol and digestion with plenty of fiber.Cut back on salt and processed foods-aiming for 1500mg of salt(halfteaspoon/day).Eat colorful foods. It’s important for women over 50 to get plenty of fruits and vegetables. And eat more fatty fish (like salmon) to get heart-healthy omega-3 fatty acids. Learn to love whole grains, lentils, and skinless lean protein. Treat yourself to sweets, but only occasionally. When you use oils, lean toward the good ones,like extra-virgin olive oil.

Get fit

50-something fitness should focus on maintaining a healthy weight, supporting strong bones, and building muscles to boost a lagging metabolism. Cardiovascular exercise will help keep your heart strong, but you also need flexibility and muscle strengthening training like yoga or Pilates to help keep your joints mobile. You also need strength training or a weight-bearing workout like climbing stairs, jogging, lifting weights, to help bump up your calorie burn and support your bones and muscles. Keep up with regular physical activity, and you’ll be more likely to sleep well and to handle stress.

Medications:

Your first bone density test may occur in your 50s. Your mid-60s is when you are at a greater risk for osteoporosis, so you should work now to fortify and protect your bones. If you cannot reach your daily calcium quota of the recommended 1,200 mg from the foods you eat, consider supplements. And pair your calcium with vitamin D to get the full benefits. Some vitamin D can be found in foods you eat, but you may need to take supplements to get the 800 IU of vitamin D per day that is recommended for osteoporosis prevention. You could also spend about 5 to 15 minutes outside, 2 or 3 times a week, to soak up vitamin D from the Sun. Generally always wear sunscreen to help prevent skin damage that can lead to skin cancer. You can also add B12 supplements to your diet.

Mental health

Meditate, pray, visualize your day. Read something that inspires you. Focus on self-renewal.#Set aside quiet time every morning. Be optimistic. Take time to understand what you want out ofyour life. Find thepurpose and meaningin your life. Then spread the joy to others.#Have fun. Go bungee jumping, rock climbing, backpacking, skiing, and dancing,whatever makes you happy. Act like you feel, and you’ll feel youthfulness. Find a creative outlet. It helpsto prevent depression and depression affects memory. Having a creative outlet helps stimulate your mind. Take up painting. Create a wonderful garden. Engaging your creativity stimulates your brain more than reading, and certainly more than TV. Eliminate clutter. Fill your home with great music, books, and friends. Withdraw and recharge when you need to. Associate with positive-focused people. They will not drain your valuable energy with complaints. They will help you pursue the best that life has to offer.

Maintain proper Hydration

Skin care regimen should include moisturizing creams

Ensure adequate Sleep Maybe you got along with four hours a night when you were 40, but your body can’t take that abuse when you’re older.

Quit smoking

Stop or limit alcohol

Reach and maintain healthy weights.

Maintain protection from the Sun

Screening check-ups

 

 

Your 50s: checkup checklist

  • Bone density test:You may get your first bone density test during your 50s. Some people who fall into particular risk categories may need one sooner or more regularly. Taking certain medications may speed bone loss, and certain medical conditions can compromise bone density as well. Ask your doctor if you are concerned about osteoporosis, especially if it runs in your family.
  • Diabetes screening:If you are in your 50s, you may be at risk for type 2 diabetes. Your doctor can screen your risk by testing your levels of Hemoglobin A1C (a blood test that reflects your average blood glucose levels over the last 3 months) or your blood glucose levels. How often you need to be screened for diabetes will depend on your risk of diabetes. If you are overweight, your risk of diabetes will probably be higher and you should be tested earlier and/or more often. Ask your doctor how often you should be screened for diabetes.
  • Blood pressure and cholesterol:Anytime you go in for any health care visit, your blood pressure will be taken, and you should get a cholesterol work-up every 1 to3 If you fall into certain risk groups, your doctor may screen your levels more frequently. You may be at risk if you have diabetes or a large waist circumference, or if you smoke or are inactive or eat an unhealthy diet.
  • Colorectal cancer screening:A Fecal Occult Blood Test (FOBT) helps to identify polyps before they become cancerous. When caught early, 90% of colorectal cancers can be cured. This test should be conducted every 2 years. A flexible sigmoidoscopy or double-contrast barium enema may be done every 5 years as an alternative to the FOBT. Another screening option is a colonoscopy, which should be done at 50 and every 10 years after. If you have certain risk factors, you may need this test every 1 to 5 years.
  • Pap test and pelvic exam:You should be having routine pelvic exams and Pap tests every 2 to 3 years. Pap tests screen for cervical cancer, while the pelvic exam allows your health care provider to examine your cervix and vagina and to get a sense of the health of your uterus. Your health care provider might also look for signs of infections.
  • Breast exam:Breast cancer is a very common cancer among women. Your health care provider may do an exam when you go in for your Pap test and pelvic exam. If not, ask your doctor if you should have a clinical breast exam and, if so, how often? You should also become familiar with the look and feel of your breasts so you know what’s normal for you. If you fall into a high-risk category for breast cancer, your doctor may suggest you have a mammogram every year or so. Otherwise, mammograms should be done every 2 or 3 years when you are in your 50s.
  • Skin check:Anyone at any age can develop skin cancer. In addition to minimizing your risk with healthy sun habits, your health care provider should do a thorough skin check annually to screen for new or changed moles or marks. You can also do a skin check yourself (or with a helpful partner) each month.
  • Dental check-ups:Visit your dentist for preventive check-ups and routine cleanings. The frequency of visits will really depend on individual needs, though most authorities on the subject recommend at least once or twice a year.
  • Eye exams:Even if your vision is 20/20, you should have your eyes examined every 1 to 2 years. After all, optometrists check for other things besides how good your vision is – like signs of glaucoma. If you have a condition like diabetes or high blood pressure, or a family history of vision problems, your optometrist will let you know if you need more frequent eye exams and check-ups.
  • Immunizations:
  • Get shots to protect you from measles, mumps, and rubella (MMR)if you’ve never had the vaccination before.
  • The tetanus, diphtheria, and pertussis (Tdap)vaccine is recommended for everyone, once in adulthood (you may have received vaccinations against these in childhood). The Td (tetanus and diphtheria) vaccine is recommended every 10 years.
  • Each year, get the influenza vaccine.
  • Consider being vaccinated against meningitisand hepatitis A and B.

 

  U.S Preventive Guidelines- 

50 Years Young!

Guidelines are based on current U.S Preventive services Task Force (USPSTF) recommendations.

Article on Prostate Cancer by Dr. Shameer Hameed , Specialist Urologist

50 year old gentleman, asked me; “Doctor, what are the possibilities for me to have prostatic malignancy? My father was diagnosed with prostatic malignancy when he was 72 and we couldn’t do much after that. Are there any ways to detect it early?” Prostate cancer is second onlyto skin cancer in men with regards to numbers. It is probably one of the most common leading causes of cancer death among men. Approximately 4,500 new cases of cancer are reported in a year in the UAE and the country aims to bring down cancer fatalities by nearly 18 per cent by 2021. Who should be worried about? There are certain modifiable and non-modifiable risk factors. Risk factors for prostate cancer include: • Age. Approximately 60 percent of all prostate cancer diagnoses occur in males aged 65 or older. • Genetics. The highest rates of prostate cancer occur in African-American men, followed by men who are Caucasian, Hispanic, American Indian/Alaska Native, and Asian, respectively. • Diet. A diet rich in fat and low in fruits and vegetables increases the risk of prostate cancer. • Environment. Exposure to some industrial chemicals also increases this risk. • Family history.Prostate cancer run in some families, which suggests that in some cases there may be an inherited or genetic factor. Still, most prostate cancers occur in men without a family history of itHaving a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. Regular testing is crucial as the cancer needs to be diagnosed before metastasis. Prostate cancer can be found early using a simple blood test and digital rectal examination but it’s not clear if the benefits of testing all men for prostate cancer outweigh the risks, such as finding and treating cancers that probably never would have caused any problems. Because of this, it’s important to talk to the doctor about the uncertainties, risks, and potential benefits of prostate cancer screening before deciding whether or not to be tested. The most significant challenge for medical professionals is late detection and treatment. When the cancer is localised to the prostate, it is curable. Once it spreads, it becomes difficult to cure and treat.

What should I use after injury ? Cold or Heat?

Orthopedic Care DubaiInjury to the extremities and   trunk is quite common  which  almost everybody gets by normal activities or  by an accident like playing football, lifting heavy weight etc.. There seems to be the confusion about application of ice or hot pack  and how long one should use after the injury.

It is advised to  use ice in the acute stage of an injury (within the first 24-48 hours), or whenever swelling is develops. Ice helps to reduce inflammation and swelling by decreasing

Orthopedic Care in Dubai

blood flow to the area that is injured. One should  apply ice indirectly (not directly on the skin) for 10 to 20 minutes, remove the ice for at least 20 minutes, and repeat as necessary. Heat increases blood flow, which helps promote pain relief after inflammation and swelling subside. Heat is also used to assist in warming muscles up prior to exercise, any physical activity, or physical therapy.

Children in Kindergarten

Keep in mind, every child is unique and some will speak very early, some will be late. Children will reach speech milestone in different ways and times. Inborn ability to learn language, other skills they learn, amount of input they get, and your response to their communication are the key factors which speed up or slow down the development of speech & language skills.

Bear in mind , the language spoken at home & cultural norms can influence the way that we communicate.

As always, if you have any questions or concerns about the child’s speech or language skills, please contact a speech-language pathologist.

What should I expect my child’s speech and language development by the end of kindergarten?

What does (s) he understand?

  • (s)he follows 2 step directions. For eg. Go to granny’s room and bring her mug. Glue the picture and press down.

  • (s)he understands a simple age appropriate stories read loud.

What does (s) he speak?

    • His/her speech is clear. can be understood by strangers.
    • (s)he can answer simple “wh” questions(what, where, who, Why for an extent)
      What did you eat for breakfast?….Who got you this bag?
    • (s)he can retell the story you read aloud to him/her.
    • (s)he is really interested in telling the events happened in class and in the play ground.

You observe: your child actively participates, initiates conversation and enjoys it.

Reading & Writing Skills

  • The child knows to use a book(e.g. reading form left to right and top to bottom in English)
  • Tries to read letter by letter.
  • Can identify rhyme words( cat & bat, mat & pat)
  • Can understand big (capital) and small (simple) letters. Some words can be matched with the pictures. It is obvious to see the child imitate reading by talking about the picture (s)he sees.

  • Can copy down his/her name, may jumble big and small letters. Tries writing down, but often ends up unclear.

Development in social skills

  • Social skills are how the child learn to express his emotion, understand others emotions feelings & facial expressions

  • Good social skills provide them ability to solve problem & conflicts occur in the playground, class room. Obey simple rules, Follow instructions, Build good interaction with other children and adults. Participate in common activities. Uses words thank you, please to adjust with a new environment, Ask for help and help others too, Demonstrate good discipline and self control. Respect others and value him/herself.

How to help the child?

  • Let the child feel reading is very important and fun, provide him/her with interesting, favorite small story books. Read the story aloud. Have an interesting conversation with the book and the story. Encourage him to tell you what would be the story or picture. More involvement with books encourages reading.

  • Explore the opportunities to have a wealthy conversation with the child .sing songs, do some games while bathing, cooking with the child.

  • Emphasize the concepts of yesterday, today and tomorrow.

How to help my toddler (between 3-4 years of age)?

What does (s) he understand?help my toddler

  • His or her complexity of understanding keeps extending. He / She now understands simple WHO? WHAT? And WHERE? Questions and hears you when you call from another room.
  • This is the crucial age where hearing difficulties may become evident. If you are in a doubt of his/her hearing, it’s wise to consult an audiologist.

how to help my toddlerWhat does (s) he speak?

  • (S)he talks about many things to you, what happened in preschools, what type of play they did, how is teacher to him/her, what are his/her friends, what funny, and new (s)he experiences, and also his imaginations.
  • His/her sentences are becoming longer and longer as (s) he combines four, five or more words. His /her speech is usually clear and fluent and easily understood by the strangers most of the time.
  • They become very loud and unstoppable.

How can I help my child?

  • Mix categories e.g. mix animals with picture of baby, cookies, ice cream. And make the child to sort them out and show what doesn’t belong to the category. Tell him/her that he is correct baby doesn’t belong to cat, dog, category because baby is not an animal.
  • Draw, glue a car without wheels, favorite cartoon with a mistake, glue a dog in driving seat and talk about how silly the pictures and encourage him/her to talk about what is missing, and what is correct.
  • Act out typical scenarios with the child like going to doctor with the pet, teacher and student, acting like the mother at home, cooking food, making baby dress up, superman. Allow her/him to guide you in acting. Be the student and let your child teach a lesson. Ask the child questions; make him repeat if you have not understood completely.
  • Expand the child’s vocabulary by acting, storytelling, singing, filling the blanks. Talk about new games, new ideas you and your child can do and have fun.How can I help my child?
  • Find out a simple and interesting story book read line by line, ask simple WH questions (what, Where, Who, Why).Talk about favorite part in the story, in the cartoon. This is the best time to talk about favorite things with the child talk about his/her favorite game, food, rhymes and tell him/her also your choices.
  • Bring your family album to the bed. Talk about the photo and ask the child can you remember this photo. Help him to explain what happened.
  • Do silly mistakes in game, apologize for your mistakes, and ask his/her help to play correctly.

Leave interesting books and materials lying around for your child to explore.

How to help my toddler (between 2-3 years of age)?

What does the toddler understand?

  • By now (s)he will understand two steps commands take your shoe off and keep on rack.how to help toddler
  • And also understand opposites like hot/cold, stop/go, nice/ugly.(s)he hears ringing of the telephone , door bell and may become excited, get you to answer or tries to answer themselves

What does (s)he speak?

  • Your toddler’s vocabulary is going to explode. They seem to have a word for almost everything. Their sentence contains of one, two or three words.
  • Speech is probably not very clear, but family members can easily understand them.
  • Your toddler loves to hold your attention of what they hear and see.
  • They may draw your attention to something by naming it, for an example, Bus, Candy, Big, Hot, Wow, see.

How can I help my child?

  • Children learn by imitating adults. Use clear, simple words & sentences what is easy to imitate .Show your interest to their speech. When the child says doggie!!! ; Expand his/her word, Oh yes it’s a doggie, Doggie is running. Doggie says bow bow. It is black. Does Anny love doggie?
  • Have his/her help to arrange cloths, toys, food at home. These are what Anny eats put all into this bucket. Foods are here. We will put Anny cloths in this bucket. Teach the child basic function, features and class of objects with examples.Help toddler
  • Encourage the child to increase the length of speech. Which puzzle do you want? Try to give him/her open ended questions than close ended. For e.g. rather than asking Do you want rice? Do you want bread? Ask would you like to eat rice or bread? This will simply limit Yes & No answers.
  • Reinforce the child effectively .Positive reinforcement is the key for the successful communication. How good Anny speaks, Thank you Anny, mommy understood.
  • Introduce books, picture books, games & activities to expand your child’s vocabulary. Use colorful picture books and name object with the child. And describe the object using a simple sentence. Create the situation to use newly learned words in context. E.g. his is an Apple. Anny eats apple./ Apple is red
  • Have the child have the habit of collecting pictures from magazines, books. Help him/her to glue then paste or write the name under each object.

 

Attention Deficit Hyperactivity Disorder

Attention deficit / hyperactivity disorder (ADHD) is a highly prevalent condition in children that has generated considerable public interest and debate. It is a chronic, pervasive childhood disorder characterized by developmentally inappropriate activity level, low frustration tolerance, impulsivity, poor organization of behavior, distractibility, and inability to sustain attention and concentration (American Psychiatric Association, 2000)which occurs in 3% to 7% of school-age children (Egger et al., 2000).

Boys are at least four times as likely as girls to develop the disorder (4:1); indeed some studies have found that boys with ADHD outnumber girls with the condition by nine to one (9:1), possibly because boys are genetically more prone to disorders of the nervous system. In children between ages 5 and 15 years it was found that 3.62% of boys and 0.85% of girls have ADHD (Ford et al., 2003). In adults 3.4 % (1.2 to 7.3 %) are presented with ADHD, in individuals aged 18 – 44 years in low-income countries (1.9%) and in high-income countries (4.2%). (Fayyad et al., 2007; Barkley R et al., 2006). 0.6 –1.2% of adults retains the childhood diagnosis ADHD by the age of 25 years.

The causes of attention deficit hyperactivity disorder still remain unknown. It is transmitted in families and most likely is due to the influence of multimodal factors, e.g., the result of a complex set of factors including genetic inheritance, environmental factors, function in several brain regions and level of neurotransmitter activity. It is believed that mutations in several genes that are normally very active in the prefrontal cortex and basal ganglia, tends to play role in the genesis of ADHD. The right prefrontal cortex, vermis region of the cerebellum, caudate nucleus, and the globus pallidus are significantly smaller in children with ADHD than the normal children. Parents of children with ADHD are often noted to be experiencing mental difficulties, high levels of stress, and conflict- laden parent – child interactions. Non-genetic factors that are known to be linked to ADHD include premature birth, maternal alcohol and tobacco use, complications during pregnancy or birth and illnesses of early infancy, exposure to high levels of lead in early childhood, brain injuries that involve prefrontal cortex, overstimulation hypothesis, and metabolic dysfunction of the central nervous system.

The essential features of ADHD continue to include the triad of inattention, impulsivity, and hyperactivity. There are three subtypes: predominantly hyperactive –impulsive type, the predominantly inattentive type (PI), and the combined type. The DSM IV criteria indicate that symptoms must be present for at least 6 months, with onset before age 7. Attention span and sitting tolerance increases with the age of child. Inattention appears to be more evident in girls. The symptoms of the disorder can cause problems in learning; socialization and behavior for those individuals afflicted with it and put them at high risk for serious psychopathology in adulthood. There is growing literature on the ADHD- PI subtype with even later age of onset. These children have lower comorbidity with disruptive disorders, and higher levels of substance abuse, anxiety and mood disorders.

There are developmental differences in the presentation of symptoms. Given below are some of them:

Preschoolers:

  • Gross motor hyperactivity- running, climbing
  • Difficulty remaining quiet
  • Non-compliant
  • 3-5 years onset – 50% of them continue to have ADHD

 

School age:

  • Difficulty focusing
  • Losing things
  • Forgetfulness
  • Poor Organizing
  • Adolescents
  • Incomplete assignments and projects
  • Academic under-performance
  • Conflicts with peers, teachers and parents
  • Poor planning, organizing skills

Management involves two phases: Assessment and Treatment

Assessments are usually multimodal: Interview: Parent and Child, Observation, School workbook, Individual testing: cognitive functions, Rating Scale- Parent, Teacher, Self-report (e.g., Conners rating scale; Vanderbilt scale)
Treatment: Psychological and pharmacological Intervention of child ADHD

Evidence based treatments for ADHD include behavioral interventions such as parent behavior management training, contingency management, and cognitive- behavior therapies, administered individually or in group settings, or pharmacologic treatment, with a variety of stimulant formulations and the non-stimulant atomoxetine approved for this indication. For many patients, the optimal treatment is multimodal, meaning the combination of medication and psychosocial treatments addressing all the impaired areas of life.

Conclusion: Despite considerable progress over the past three decades, much is to be learned regarding the neurophysiological basis and genetics of ADHD. Psychological Assessment can serve to essentially validate the diagnosis of ADHD in children and Adults. There have been considerable advances in psychosocial, pharmacological and multimodal treatment of ADHD.

How to help my toddler (between 1-2 years of age)?

What does the toddler understand?

  • Her his receptive vocabulary is increasing day by day
  • The child points to pictures in a book when you name them, and also (s)he points to a few body parts when asked(nose, eyes, tummy, head).
  • She or He follows simple commands like push the chair, don’t touch, it’s hot, wash hands and understand simple questions (where is daddy, what is your frock, who is bunny).
  • Their interest shift from singing songs or say rhymes to simple story telling.
  • Your toddler now likes to listen to simple stories over songs.
  • This is the stage where you become exhausted with repeating the same story, game, rhymes many many times. But (s)he wants to listen the same again & again.

What does the toddler speak?

  • His/her expressive vocabulary keep increasing.,(s)he accumulating more and more words as each month passes.

  • (S)he can even combine 2 words and questions like mama ball, what is that, give me chocos, more chips, all gone, doggie ,daddy poo(car).

How to help my toddler?

Talk to the child while doing household things, going out or performing any activity. For an example Baby is going to bathe, run the tap. Water is coming ( put toys in the tub)Duckie is swimming, push push dickiee. Second example. I see a doggie, Doggie is running. It’s a big dog, Doggie says bow wow .Keep your language grammatically correct and easy to imitate. Talk about present activities what the child What does the toddler understand?sees around him/her. Use rhymes such as jonny jonny yes papa. Encourage the child to say hahahahaa/aaaaaa with you. Associate the object with sound e,g introduce the clock to the child, t-t-t-t-t clock, ding- dong- ding-dong .pi pi pi pi daddy car. Make him listen to the sounds of objects and create a sound associated with the object. mow mow mow mow cow. Use the sound like p-p-p-p-, m-m-m-m-, b-b-b-b-b, brooo-brooo, grrrr- ggrr while bathing, playing with toys, pampering him/her. These sounds will help him to learn better in preschool and kindergarten. Expand on words what the child says, for an example, if (s)he says car or sound likes car. Expand on words saying oh! yes it is a CAR, Biiig CAR, Big red CAR! Show the child big colorful picture book with large pictures. Name them, read aloud and talk about the picture. Wait your child to explore the picture, Ask him/her what is this and you answer. Make him/her point to picture Repeat the same several days. You would be surprised one day hearing(s)he names the picture.

Depression in children and adolescents: an overview

Depression – Let’s talk”, the World Health Day theme 2017 ring an alarm bell in our heart about the presence of this disorder amid our dear n’ near ones. Depression was once thought to be a disease of adults. It is no more considered rare among the children and adolescents, with an incidence of 2 – 4% and 4 – 8 % respectively. A youngster who appears withdrawn and lonely is most likely going through a period of “intense internal emotional turmoil”. They often feel sad and may consistently understand their plight as hopeless. They may frequently show poor concentration, lack of initiation; poor sleep and eating habits, negativity, get tired easily, feel guilty or worthless etc. Depression In ChildrenSubsequently, this often results in chronic depression, poor scholastic performance, psycho-social problems, substance abuse and even suicide. It’s equally prevalent in both sexes during pre-puberty stage whereas more in females with a ratio of 2:1 post-puberty. Mean duration of an episode of depression is 7 to 9 months. 70 to 80 % recover at the end of one year. Increased chance of recurrence is seen in children with early onset and those with the history of previous episodes, co-morbid psychotic symptoms, poor drug compliance, negative life events and positive family history in parents. 20 to 30 % of depressive children develop manic episodes (Bipolar Disorder) on follow up.
Majority of them may reach the general practitioner or the pediatrician with vague so called ‘functional symptoms’. A recent change in behavior with sad or irritable mood lasting for more than 2 weeks indicates a depression. Unfortunately, these disorders often go unrecognized by families and physicians alike. Early diagnosis and treatment of depressive disorders are critical to healthy emotional, social and behavioral development.
Clinical presentation varies according to the developmental stage of the child. They can be seen as given below:
Preschool child: apathetic, refuses food, unhappy and irritable, looks miserable, frequent crying spells, ‘failure to thrive’, insecure and unhappy child without any physical abnormality.
Middle childhood (Pre-adolescence): Apathy, verbal and motor retardation, and loss of appetite are the classic features of depression in this age group. Other features are: psychosomatic symptoms (e.g., head ache or pain abdomen); decline in academic performance with poor attention and concentration, irritability and social withdrawal, low self-esteem (I am not good enough compared to others), feeling bored and lack of interest in usual activities, sleep and appetite disturbances may be present though less common.
Adolescence: Clinical features are more similar to those of adult depression. Feeling sad, apathetic, lack of energy; sleep and appetite disturbances are more common. Bodily preoccupation, worries over his/her appearance or minor health problems (e.g., acne); suicidal thoughts are relatively common.
Etiology: There are multiple factors which individually or in combination with other factors, could contribute to depression. Depression In Children and adolescentsFew predisposing factors/ vulnerability factors are: Genetic; biological factors (neurotransmitters -monoamine metabolism and endocrine abnormalities); and temperament (e.g. quiet children with regular habits and slow to adapt to new experiences). Chronic life adversities are also likely to contribute to develop depression – broken homes, parental alcoholism, abuse, rejection etc. Undesirable life events in previous 12 months are important e.g., an event at home, or school and experience of loss.
Some points to be considered by a parent or caregivers to alleviate emotional disturbances:

  • Use positive reinforcement while disciplining them; avoid overprotecting and over directing.
  • Don’t expect absolute compliance. Don’t use your child to fulfill your own unachieved goals.
  • Take the problem seriously. It will be important to them and give them a feel of being understood.
  • Encourage them to talk to other people (may be a trusted adult friend or grandparents) as well as to you.
  • Treatment strategies for Depression – right time; right way; right people

A proper assessment is needed to establish depression – understand the nature, extent and Depression in Children: Symptoms, Causes, Treatmentsdisability by obtaining the history from all available sources; to explore into the stressors in the school/home; to consider differential diagnosis – Physical conditions like hypothyroidism; psychosis; normal reactive feelings of sadness and unhappiness; look for co morbid condition.
Treatment can include a combination of pharmacological management and various psychotherapeutic approaches – Supportive counseling and ways to relieve stress; Cognitive behavior therapy; Interpersonal therapy.
To conclude, Depression is a treatable emotional/behavioral condition. What is needed is treatment by “right technique at right time by right people” (trained mental health professionals).

INDIGESTION AND DYSPEPSIA CAN BE SIGN OF CANCER

Routinely people feeling dyspepsia and indigestion are consulting doctor and taking medications. Many patient taking medicines over the counter first considering dyspepsia is normal. But, dyspepsia and indigestion can be alarming symptoms of your inside pathology.Indigestion And Dyspepsia

Here in IMH, Dubai, a 52 year old male, resident of Pakistan, attended hospital with symptoms of bloating of abdomen and burning in upper abdomen, for 1 year, for which he was taking antacid and medicines off and on. He consulted Dr. Anoop Kumar Joshi, Specialist Gastroenterologist in IMH, who did his Helicobacter pylori test which was positive. Then he did Gastroscopy which revealed swelling, erosions and tiny ulcerations with thickened fold in the fundus of the stomach. Overall picture is suggestive of Gastritis only, but, Doctor felt it was not a routine gastritis. So he took biopsy. Biopsy report suggestive of a rare type of cancer that is MALOTMA (Mucosa associated lymphoid tissue) Lymphoma. Worldwide and in UAE, very limited number of cases has been reported.Indigestion And Dyspepsia Can Be Sign Of Cancer
This disease is a type of cancer and this is caused by bacteria that is Helicobacter pylori. 14 days of medicines may eradicate bacteria. This treatment can give cancer free life up to 75-80% of the cases.
After 14 days, H. pylori laboratory test was repeated and the result was negative. Patient symptoms improved completely. He had a follow-up with the Doctor once again. He also advised to consult Cancer Specialist. This patient gives an insight that simple symptoms of dyspepsia and burning in abdomen should not be treated blindly and patient should go at least once consult Gastroeneterologist to rule out any major disease.
GastroeneterologistH. pylori can be detected by simple laboratory test and Gastroscopy. H. pylori can cause serious abdominal problems with simple symptoms of indigestion diseases like ulcers and cancers. In International Modern Hospital, the facility for detection of H. pylori and treatment of ulcer and associated cancers are available with simple tests of H. pylori and Endoscopy.

How To Prevent Common ENT Disorders

There are many ways to prevent ENT disorders, though it is not always possible, as in the case of congenital conditions. However, multiple ENT disorders can be prevented. Here are some things you can do to prevent ENT disorders. Frequent hand washing is the single most important thing you can do to prevent infection. Avoid exposure to illness, and practice good hygiene, such as covering your mouth when you cough and staying at home when you are sick.
Since it is difficult to teach good hygiene to small children, toddlers who attend daycare or preschool are at a higher risk of developing chronic ENT disorders.

Preventing Ear Infections

Preventing Ear Infections

 

Ear infections are a common ENT disorder. They occur when germs enter the ear and become trapped there. Due to their infectious nature, there are many things you can do to prevent ear infections. Certain inherited traits, though, make some people, especially children, more prone to ear infections.

Here are a list of ways to prevent ear infections:
• Avoid exposure to cigarette smoke.
• Identify and treat allergies.
• Keep your child’s immunizations up to date.
• Do not remove earwax unless your physician tells you to.

Preventing Sinus Infections
Preventing Sinus InfectionsSinus infections occur when germs enter one of the hollow cavities in the skull surrounding the eyes and nose. A sinus infection may feel like a very bad cold that doesn’t go away after the usual 2 to 3 weeks.

Here are some ways you can protect yourself.
• If you have a cold, use a saline nasal spray (available over the counter) to keep your nasal passages from becoming blocked.
• Do not fly if you have a cold. If you must fly, consider use of a decongestant and nasal spray 30 minutes before take-off.
• Identify and treat allergies; long-term sinusitis is usually caused by allergies, while acute sinusitis is usually caused by bacteria.
• Try using saline nasal spray daily for chronic sinusitis.

Preventing Sore Throat
Preventing Sore ThroatThere are many causes of sore throat, including infections, acid reflux, sleep apnea or more severe and rare disorders, such as cancer. A very common cause of sore throat is a bacterial or viral infection, so practicing good hygiene, such as frequent hand washing, is a good way to prevent sore throat. Here are some other suggestions:
• Get plenty of rest and exercise to bolster your immune system.
• Avoid exposure to cigarette smoke.
• Do not spend long periods of time outside when the air quality in your area is poor.
• Treat esophageal reflux.

Preventing Snoring and Sleep Apnea

Preventing Snoring and Sleep ApneaSleep apnea is a condition where a person stops breathing for brief periods of time while asleep. It is very common in the United Arab Emirates and can be harmful if left untreated. Fortunately, there are many treatments available, and sleep apnea can often be cured. Here are some good ideas to prevent or keep sleep apnea at bay.
• Maintain a healthy body weight.
• Avoid alcohol or sedatives at bedtime.
• Identify and treat tonsillitis, nasal polyps or other disorders that can cause airway obstruction.
• Quit smoking.

Not all ENT disorders can be prevented. Many depend on inherited traits; however, following these suggestions may serve to keep you healthier in the future. Hand washing remains at the forefront of disease prevention, along with other isolation practices, including coughing in to your sleeve and staying at home while you are sick. These guidelines can also help strengthen your immune system, decreasing the likelihood of catching an illness and limiting the amount of time you spend sick.

Not paying attention to your nasal symptoms may turn your sinusitis chronic

Headache disorders Info Graphics in circle.Vector illustrationsApproximately 20% of the UAE population suffers from Chronic Sinusitis. Symptoms range from stuffy nose, nasal blockage, headache, facial pain, postnasal discharge, cough and bad breath. These are all symptoms of chronic sinusitis. The weather in UAE plays a significant role in the development of these symptoms. Fine sand in the air, humidity, allergies, sudden temperature changes too trigger it. Deviation of the nasal septum and nasal polyps too can lead to chronic sinusitis.

KNOW YOUR SYMPTOMS

When you have chronic sinusitis, the mucous membrane of the nose, sinuses and throat get inflamed, possibly from a pre-existing upper respiratory tract infection or allergies. Swelling obstructs the sinus opening and prevents normal mucous drainage, causes mucous and pressure to buildup.

Symptoms include – thick greenish post nasal discharge, nasal stuffiness, and pain around the eyes, cheeks, nose and forehead. There could be an associated reduced sense of smell and or taste.This condition if not treated on time can lead to Bronchitis, asthma or other respiratory diseases,

Many people with sinusitis either silently suffer or opt for self medication, making the problem worse leading to a chronic ailment. A common cold is usually caused by a viral infection and it gets better in approximately a week’s time. If it lasts for more than that, you need to see a Doctor.

HOW TO GET WELL

sinus-1Visual inspection, nasal endoscopy and CT scan, paranasal sinuses can help screen for chronic sinusitis. A CT scan can accurately diagnose chronic sinusitis. Once diagnosed, it is treated with nasal decongestants, steroid nasal sprays, antihistamines, antibiotics etc.
Sinus surgery may be required when conservative treatment fails. Endoscopic sinus surgery is done under local or general anesthesia. The main aim of the surgery is to enlarge the natural opening of the sinuses and to restore the normal sino-nasal ventilation and drainage.

HOME REMEDIES THAT CAN HELP

  • Steam inhalation
  • Saline spray
  • Pain in the nose and sinuses can be relieved by warm compress.

TIPS TO AVOID SINUSITIS

  • Keep yourself hydrated – Drinking water prevents mucus from thickening and blocking the sinuses.
  • Avoid smoking – Smokers are more prone to suffer from sinusitis.
  • Consult a Doctor if a cold persists for more than 10 days.
  • Complete prescribed course of antibiotics. When indicatedHeadache disorders Info Graphics in circle.Vector illustrations

Stuttering

What is stuttering? 

Stuttering is a communication disorder in which the  smooth continuous flow of speech is broken by repetitions (I- I -I want), prolongations (lllllet  me go), or abnormal stoppages (no sound silence pauses) of sounds and syllables . There may also be unusual facial and body movements associated with the effort to speak. Stuttering is also called to as stammering. But if you talk effort fully, with multiples disruptions that should be taken into consideration.stutter-2

What causes stuttering? 

There are four factors most likely to contribute to the development of stuttering:

Genetics (approximately 60% of those who stutter have a family member who does also);

Child development (children with other speech and language problems or developmental delays are more likely to stutter);

Neurophysiology (recent neurological research has shown that people who stutter process speech and language slightly differently than those who do not stutter);

and family atmosphere  (high expectations and fast-paced lifestyles can contribute to stuttering).

What is the ratio of males to females who stutter?

Males are affected four times more than females.

I think my child is beginning to stutter.

Should I wait or seek help? It is best to seek ways that you, the parents. How can I help him/her as soon as possible? If the stuttering persists beyond three to six months or is particularly severe, you may want to seek help from a speech-language pathologist who specializes in stuttering right away.

Can stuttering be treated?

Yes, of course there are a variety of successful approaches for treating both children and adults. In general, the earlier, the better……

Shot of a little boy talking to a psychologist

I read about a new cure for stuttering. Is there such a thing? 

There are no instant miracle or treatment cures for stuttering. However, a specialist in stuttering can help not only children but also teenagers, young adults and even older adults make significant progress toward fluency.

Good Sleep is a Reachable Dream

sleep-2

Sleep:

Natural periodic state of rest for the mind and body, in which the eyes usually close and consciousness is completely or partially lost, so that there is a decrease inbodily movement and responsiveness to external stimuli.

Why to Sleep?

It plays a vital role in good health and well-being throughout your life. It protects your mental health, physical health, quality of life, and safety. We spent 33% of our lives in sleep.

Normal requirement:
3   to 5   yrs  —-  10 to 13  hrs
6   to 13 yrs  —-  9   to 11  hrs
14 to 17 yrs  —-  8   to 10  hrs
Adults           —-  7   to 9    hrs

Stages of Sleep

sleep-1Sleep follows a pattern of alternating REM (rapid eye movement) and NREM (non-rapid eye movement) sleep throughout a typical night in a cycle that repeats itself about every 90 minutes. NREM (75% of night): As we begin to fall asleep, we enter NREM sleep, which is composed of stages 1-4. REM (25% of night).

Numbers!
Almost 60 % of total population reports sleep problems at any point of their life time. Roughly 1/3 of general population are having sleep problems at any given time.

Common Sleep Disorders:

Insomnia (initial, middle, terminal insomnias or non restorative sleep).
Sleep apnea.
Restless legs syndrome.
Narcolepsy.

Impacts of Poor Sleep:

sleep-3Persons get irritable and exhausted, easily distracted and often don’t make sound decisions. Sleep deprivation negatively impacts the immune system, may also lead to weight gain, high blood pressure, cancer, heart disease, stroke, diabetes, bone loss and depression Sleep deprivation may also impair learning, memory, alertness, concentration, judgment, problem solving and reasoning, as well as increase your risk of accidents.

Assessment:

    • Keep a sleep log, Polysomnography (sleep lab)
    • How to treat?
    • Sleep hygiene
    • Medicines
    • Behavioral treatments
    • Surgery (OSA)

Sleep Hygiene:

  • Avoid napping during the day.
  • Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime.
  • Exercise can promote good sleep.
  • Food can be disruptive right before sleep.
  • Ensure adequate exposure to natural light.
  • Establish a regular relaxing bedtime routine. Associate your bed with sleep.
  • Make sure that the sleep environment is pleasant and relaxing.

Medications: What to know about it?

  • Avoid as much as possible.
  • Always with advice from the specialist.
  • Be cautious about addiction.
  • Avoid driving while on medications.

“Sleep is that golden chain that ties health and our bodies together”

(Thomas Dekker)

Language Problem or Late Talking?

 Our parents are smart. They are really concern about their child talk and how he / she communicate. They also listen to his or her peers who are at same age and may compare what older brothers and sisters did at the same age. This is how our parents mentally compare their child’s performance with other children. They immediately create an impression of whether the child is developing speech & language at normal rate or not.

st3If parents feel that development is slow, they check their impression with the other parents, relatives, and their pediatrician. You probably get an answer such as Oh!! Don’t worry, he / she will outgrow it. Look at my child she was so quiet and now she is a chatter box, give him/her time.

But…… suppose he / she doesn’t? Even after giving adequate time. 

st2You would feel guilty waiting and then finding out that I should have acted earlier. Waiting is so hard, why we have to be frustrated at last . We want the best for our child. What’s a parent to do?

But……. You’re not sure of what to do.

st1It’s hard to say the exact age when they hit speech and language milestones. It varies a lot on factors such as the child’s inborn ability to learn language, other skills the child is learning, the amount speech and language input he/she gets. and how others respond to his/her communication attempts .

Do you praise him/her? Listen to him/her carefully?

These factors can slow down or accelerate the speed of speech and language development of our children. Be aware of the certain factors that may increase the risk of late-talking child in the 18 to 30 month old age range even with normal intelligence.

The sooner The Better

If you are concerned about your child’s speech and language development, you should see a speech-language pathologist. The speech-language pathologist may suggest on early intervention program with follow up sessions. It’s important to have formal therapy sessions in case of severe problems.

Do you really want to wait for him/her to outgrow???Don’t leave a chance which leads you to feel guilty that I would have done with everything I could

To undergo treatment, you have to be very healthy !!!

Drug Safety (Rational and Safe use of Medicines)

“To undergo treatment you have to be very healthy, because apart from your sickness you have to withstand the medicine” (Molière)

pharmacovigilanceDrug safety ( Pharmacovigilance) – The science and activities relating to the detection, evaluation, understanding and prevention of adverse drug reactions or any other drug-related problems.

Why drug safety? – Adverse Drug Reactions are among the top ten causes of mortality. The percentage of hospital admissions due to drug related events in some countries is about or more than 10%. Economic impact Drug related morbidity and mortality expenses exceeded US$ 177.4 billion in the USA in 2000.ADR database shows- No of reports: more than 3.5 million, each year increase ~160,000 / year.safe

Drug safety heavily focuses on Adverse Drug Reactions (ADR), which are defined as any response to a drug which is noxious and unintended. ADR is considered serious if it meets one or more of the following criteria:

  1. Results in death or is life-threatening;
  2. Requires inpatient hospitalization or prolongation of existing hospitalization;
  3. Results in persistent or significant disability or incapacity;
  4. Results in a congenital anomaly (birth defect)

FDA drug categories – A, B, C, D or X

Category A

Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy

Category B

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.

Category C

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category D

There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category X

Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

Eg: atorvastatin, warfarin, methotrexate,

Pharmaceutical companies perform clinical trials, testing new drugs on people before they are made generally available to see their risk / benefit profile

Specific Patient Populations

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Pregnant and lactating women

A pregnant woman must not take any medication without consulting a specialist about the safety of the medication as it may affect the formation of the fetus. During the period of lactation, mothers should consult professionals before use of any medication because some medications can be excreted in breast milk, which may have a negative impact on the infant.

Children

We should take extreme caution when using any medications for children. The reasons are- the lack of scientific studies and clinical trials needed to evaluate the safety of these medications in this age group and also their vital organs are not mature, and thus exposure to certain medications may lead to toxic side effects as the body is mostly unable to fully metabolize or excrete the drugs.

Old people

This group is considered to be most vulnerable to the effect of medications and so it is very important to consider their health status before prescribing any medication, for several reasons. The physiological functions of many body organs decline with age, especially important organs such as the liver and kidneys. Older people can suffer from many chronic illnesses, such as high blood pressure, diabetes, and high blood cholesterol and lipids, possibly necessitating the chronic use of multiple medications, which may conflict with each other.

Drug interactions

Every patient must ensure they are aware of all necessary information regarding those drugs, as well as the possibility of interactions with other drugs or certain food types, through consulting the pharmacist or physician. Groups that are at extreme risk and exposure to those drug interactions include: Patients who use multiple medications, Elderly patients, Patients with multiple chronic diseases and illnesses

Ensuring drug safety

Drug safety is the main aspect of medical therapy that can play a major role in deciding which drug should be given to a patient. Considering the concept of benefit–risk balance drugs with a high risk profile should be avoided unless needed. Personalized medicine should be considered when medications are given to patients.

It is possible to avoid these side effects by using the drug in the proper way, and by following the instructions included in the drug leaflet or provided by the pharmacist or the physician. Knowing the necessary information about a medicine is considered the first step in avoiding side effects.

The risks from medications could be minimized through patient education about drug safety and openness with the patient, allowing him/her to ask questions related to their disease or medications. A good relationship between the medical team and the patient is one of the most important determinants for drug safety.

“Dying from a disease is sometimes unavoidable. But, dying from an adverse drug reaction is unacceptable”(Dr. Vladimir Lepakhin)

Myths About Mental Illness

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Mental illnesses can affect anyone. We all likely know someone who has experienced a mental illness at some point. Yet there are still many hurtful attitudes around mental illnesses that fuel stigma and discrimination and make it harder to reach out for help. It’s time to look at the facts. Here are ten common myths about mental illnesses.

psychiatry-myth-n-fact-1Myth #1: Mental illnesses aren’t real illnesses.
Fact: Mental illnesses are not the regular ups and downs of life. Mental illnesses create distress, don’t go away on their own, and are real health problems with effective treatments. People who experience mental illnesses should be treated with the same concern and respect shown to a cancer patient or a person with pneumonia.

psychiatry-myth-n-fact-2Myth #2: Mental illnesses will never affect me.
Fact: All of us will be affected by mental illnesses. You may not experience a mental illness yourself, but it’s very likely that a family member, friend, or co-worker will experience challenges.

psychiatry-myth-n-fact-3Myth #3: Mental illnesses are just an excuse for poor behavior.
Fact: It’s true that some people who experience mental illnesses may act in ways that are unexpected or seem strange to others. We need to remember that the illness, not the person, is behind these behaviors. No one chooses to experience a mental illness. People who experience a change in their behavior due to a mental illness may feel extremely embarrassed or ashamed around others.

psychiatry-myth-n-fact-4Myth #4: Bad parenting causes mental illnesses.
Fact: No one factor can cause mental illnesses. Mental illnesses are complicated conditions that arise from a combination of genetics, biology, environment, and life experiences. Family members and loved ones do have a big role in support and recovery.

psychiatry-myth-n-fact-5Myth #5: People with mental illnesses are violent and dangerous.
Fact: People who experience a mental illness are no more violent than people without a mental illness. It’s also important to note that people who experience mental illnesses are much more likely to be victims of violence than to be violent.

psychiatry-myth-n-fact-6Myth #6: People don’t recover from mental illnesses and should be kept in hospital for life.
Fact: People can and do recover from mental illnesses. Today, there are many different kinds of treatments, services, and supports that can help. No one should expect to feel unwell forever. The fact is, people who experience mental illnesses can and do lead productive, engaged lives. They work, volunteer, or contribute their unique skills and abilities to their communities. Even when people experience mental illnesses that last for a long time, they can learn how to manage their symptoms so they can get back to their goals. If someone continues to experience many challenges, it may be a sign that different approaches or supports are needed.

psychiatry-myth-n-fact-7Myth #7: People who experience mental illnesses are weak and can’t handle stress.
Fact: Stress impacts well-being, but this is true for everyone. People who experience mental illnesses may actually be better at managing stress than people who haven’t experienced mental illnesses. Many people who experience mental illnesses learn skills like stress management and problem-solving so they can take care of stress before it affects their well-being.

psychiatry-myth-n-fact-8Myth #8: People who experience mental illnesses can’t work.
Fact: Whether you realize it or not, workplaces are filled with people who have experienced mental illnesses. Mental illnesses don’t mean that someone is no longer capable of working. Most people who experience serious mental illnesses want to work but face systemic barriers to finding and keeping meaningful employment.

psychiatry-myth-n-fact-9Myth #9: Kids can’t have a mental illness like depression. Those are adult problems.
Fact: Even children can experience mental illnesses. In fact, many mental illnesses first appear when a person is young. Mental illnesses may look different in children than in adults, but they are a real concern. Mental illnesses can impact the way young people learn and build skills, which can lead to challenges in the future. Unfortunately, many children don’t receive the help they need.

psychiatry-myth-n-fact-10Myth #10: Everyone gets depressed as they grow older. It’s just part of the aging process.
Fact: Depression is never an inevitable part of aging. Older adults may have a greater risk of depression because they experience so many changes in roles and social networks. If an older adult experiences depression, they need the same support as anyone else.

These myths—and many more—exclude people with mental illnesses from our communities and create barriers to well-being. If we want to reduce the impact of mental illnesses on our communities, we need to learn the facts and start with our own assumptions and behaviors.

Mammography

What is mammography?

Mammography is pro-bably the most important tool doctors have to help them diagnose, evaluate, and follow women who’ve had breast cancer and also for screening women for breast cancer.

Safe and highly accurate, a mammogram is an X-ray photograph of the breast. The technique has been in use for about thirty years. It can detect most breast cancers at an early stage, before symptoms develop. Routine mammography is not available to women under 30 unless you have a first degree relative (mother or sister) who has had breast cancer at a young age.

Why is mammography important?

digital-mammographyMammography saves lives. About 1 in 12 women develop breast cancer at some stage in life, mostly over the age of 50. The earlier breast cancer is detected, the better the chance of a cure.

Finding breast cancers early with mammography has also meant that many more women being treated for breast cancer are able to keep their breasts. When caught early, localized cancers can be removed without resorting to breast removal. Research studies have shown that mammography screening has significantly reduced the number of deaths from breast cancer.

When to get a mammogram?

There’s a lot of confusion about when and how often to get a mammogram. For now, the recommendation is that women get a mammogram once a year, beginning at age 40. If you’re at high risk for breast cancer, with a strong family history of breast or ovarian cancer, or have had radiation treatment to the chest in the past, it’s recommended that you start having annual mammograms at a younger age (often beginning around age 30).

What if there is an abnormality?

Most women have a normal mammogram. Some women are asked to attend again if the X-ray picture is not clear, or to look more closely at a special area of the breast which needs a further detailed check. A small number are found to have early breast cancer and are offered referral to a surgeon for treatment. If any abnormality is detected, the patients would be advised to have an ultrasound of the breast with FNAC (A small needle would be put through the area of abnormality with or without ultrasound guidance, where cells would be taken from that site and sent for microscopic evaluation for cancer cells.)

Three important things to know about mammograms

1. They can save your life. Finding breast cancer early reduces your risk of dying from the disease by 25-30% or more. Women should begin having mammograms yearly at age 40, or earlier if they’re at high risk.

2. Don’t be afraid. It’s a fast procedure (about 5-10 minutes), and discomfort is minimal. The procedure is safe: there’s only a very tiny amount of radiation exposure from a mammogram. To relieve the anxiety of waiting for results, go to a centre that will give you results before you leave.

3. It is our most powerful breast cancer detection tool. However, mammograms can still miss 15-20% of breast cancers that are simply not visible using this technique. Other important tools-such as breast self-exam, clinical breast examination, ultrasound, and MRI can and should be used as complementary tools, but there are no substitutes or replacements for a mammogram.

Easy Mouth Exercises To Help Stop Your Snoring

250px-tonsils_diagramSnoring is the vibration of respiratory structures and the resulting sound due to obstructed air movement during breathing while sleeping. In some cases, the sound may be soft, but in most cases, it can be loud and unpleasant. Snoring during sleep may be a sign, or first alarm, of obstructive sleep apnea (OSA).

The following excercises could help you either stop or control snoring to some extend.

1. Push the tip of your tongue against the roof of your mouth and slide it backward 20 times.

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2. Suck your tongue upward against the roof of your mouth 20 times.

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3. Push the back of your tongue down while keeping the tip touching the inside of your front teeth 20 times

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4. Lift your soft palate and uvula 20 times

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5. Using your index finger, press your cheek muscle away from your teeth 10 times on each side

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6. When you’re eating, bite down, and then lift your tongue to the roof of your mouth as you swallow, without tightening your cheek muscles.

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Just like with any exercises, if you don’t keep up with them, you don’t get the benefits

Alzheimer’s Disease

anigif_sub-buzz-22090-1465935906-25Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks. Alzheimer’s is a type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

Symptoms

The most common early symptom of Alzheimer’s is difficulty remembering newly learned information.

Just like the rest of our bodies, our brains change as we age . Most of us eventually notice some slowed thinking and occasional problems with remembering certain things. However, serious memory loss, confusion and other major changes in the way our minds work may be a sign that brain cells are failing.

The most common early symptom of Alzheimer’s is difficulty remembering newly learned information because Alzheimer’s changes typically begin in the part of the brain that affects learning. As Alzheimer’s advances through the brain it leads to increasingly severe symptoms, including disorientation, mood and behavior changes; deepening confusion about events, time and place; unfounded suspicions about family, friends and professional caregivers; more serious memory loss and behavior changes; and difficulty speaking, swallowing and walking.

imagesPeople with memory loss or other possible signs of Alzheimer’s may find it hard to recognize they have a problem. Signs of dementia may be more obvious to family members or friends. Anyone experiencing dementia-like symptoms should see a doctor as soon as possible. At International Modern Hospital, we offer specialised care for such patients under the guidance of our psychiatrist, Dr. Shaju George

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Alzheimer’s is not the only cause of memory loss.

Many people have trouble with memory — this does NOT mean they have Alzheimer’s. There are many different causes of memory loss. If you or a loved one is experiencing symptoms of dementia, it is best to visit a doctor so the cause can be determined.

The role of plaques and tangles

 Plaques and tangles tend to spread through the cortex as Alzheimer’s progresses.

Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells.

healthyvsadPlaques are deposits of a protein fragment called beta-amyloid (BAY-tuh AM-uh-loyd) that build up in the spaces between nerve cells.

Tangles are twisted fibers of another protein called tau (rhymes with “wow”) that build up inside cells.

Though most people develop some plaques and tangles as they age, those with Alzheimer’s tend to develop far more. They also tend to develop them in a predictable pattern, beginning in areas important for memory before spreading to other regions.

Scientists do not know exactly what role plaques and tangles play in Alzheimer’s disease. Most experts believe they somehow play a critical role in blocking communication among nerve cells and disrupting processes that cells need to survive.

It’s the destruction and death of nerve cells that causes memory failure, personality changes, problems carrying out daily activities and other symptoms of Alzheimer’s disease.

 Diagnosis of Alzheimer’s Disease

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Doctors use several methods and tools to help determine whether a person who is having memory problems has “possible Alzheimer’s dementia” (dementia may be due to another cause) or “probable Alzheimer’s dementia” (no other cause for dementia can be found).

To diagnose Alzheimer’s, doctors may:

  • Ask the person and a family member or friend questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality
  • Conduct tests of memory, problem solving, attention, counting, and language
  • Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem
  • Perform brain scans, such as computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET), to rule out other possible causes for symptoms.

These tests may be repeated to give doctors information about how the person’s memory and other cognitive functions are changing over time.

Alzheimer’s disease can be definitely diagnosed only after death, by linking clinical measures with an examination of brain tissue in an autopsy.

Treatment of Alzheimer’s Disease

Alzheimer’s disease is complex, and it is unlikely that any one drug or other intervention can successfully treat it. Current approaches focus on helping people maintain mental function, manage behavioral symptoms, and slow or delay the symptoms of disease. Researchers hope to develop therapies targeting specific genetic, molecular, and cellular mechanisms so that the actual underlying cause of the disease can be stopped or prevented.blog-alz

Know the noise around you !!!

You can lose some hearing after being exposed to loud noises for too long, for example by standing close to speakers at a nightclub. Or hearing can be damaged after a short burst of explosive noise, such as gunshots or fireworks.

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If you work or frequently spend time in a noisy place or listen to loud music a lot, you could be losing your hearing without even realising it.

The best way to avoid developing noise-induced hearing loss is to keep away from loud noise as much as you can.

Here’s a guide to some typical noise levels, measured in decibels (dB). The higher the number, the louder the noise. The Health and Safety Executive (HSE) says noise levels above 105dB can damage your hearing if endured for more than 15 minutes each week. But lower levels, such as between 80dB and 90dB can also cause permanent damage if you’re exposed to them for hours every day. Find out some of the common noise levels around you which you may come across daily

  • normal conversation: 60-65dB
  • a busy street: 75-85dB
  • lawn mower/heavy traffic: 85dB
  • forklift truck: 90dB
  • hand drill: 98dB
  • heavy lorry about seven metres away: 95-100dB
  • motorbikes: 100dB
  • cinema: some films regularly top 100dB during big action scenes
  • disco/nightclub/car horn: 110dB
  • MP3 player on loud: 112dB
  • chainsaw: 115-120dB
  • rock concert/ambulance siren: 120dB

Ways to Protect Your Ears and Hearing Health

  1. Use earplugs around loud noises – Clubs, concerts, lawnmowers, chainsaws, and any other noises that force you to shout so the person next to you can hear your voice all create dangerous levels of sound. Earplugs are convenient and easy to obtain. You can even have a pair custom fitted for your ears by your local hearing healthcare provider.
  2. Turn the volume down – According to the World Health Organization, 1.1 billion teenagers and young adults worldwide are at risk for noise-induced hearing loss from unsafe use of audio devices.If you like to enjoy music through headphones or earbuds, you can protect your ears by following the 60/60 rule. The suggestion is to listen with headphones at no more than 60% volume for no more than 60 minutes a day. Earbuds are especially dangerous, as they fit directly next to the eardrum. If possible, opt for over-the-ear headphones.Don’t forget that any loud music, not just music played through headphones, presents a risk for noise-induced hearing loss. If you’re hosting a social event, keep the music at a volume which won’t force people to shout in order to hold a conversation
  3. Give your ears time to recover – If you are exposed to loud noises for a prolonged period of time, like at a concert or a bar, your ears need time to recover. If you can, step outside for five minutes every so often in order to let them rest.
  4. Stop using cotton swabs in your ears – It’s common for people to use cotton swabs to clean wax out of their ear canal, but this is definitely not advisable. A little bit of wax in your ears is not only normal, but it’s also important. The ears are self-cleaning organs, and wax stops dust and other harmful particles from entering the canal. Plus, inserting anything inside your ear canals risks damaging sensitive organs like your ear drum.
  5. Take medications only as directed – Certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDS) like aspirin, ibuprofen and naproxen, can sometimes contribute to hearing loss. Discuss medications with your doctor if you’re concerned that they’ll impact your hearing ability and take them only as directed.
  6. Keep your ears dry – Excess moisture can allow bacteria to enter and attack the ear canal. This can cause swimmer’s ear or other types of ear infections, which can be dangerous for your hearing ability. Be sure you gently towel-dry your ears after bathing or swimming. If you can feel water in the ear, tilt your head to the side and tug lightly on the ear lobe to coax the water out.
  7. Get regular checkups – Ask your primary care physician to incorporate hearing screenings into your regular checkups. Because hearing loss develops gradually, it’s also recommended that you have annual hearing consultations with a hearing healthcare professional. That way, you’ll be more likely to recognize signs of hearing loss and take action as soon as you do.

Taking action is important because untreated hearing loss, besides detracting from quality of life and the strength of relationships, has been linked to other health concerns like depression, dementia, and heart disease.

Make Sure Kids’ Eyes and Vision Are Perfect This School Year

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With schools back in progress, parents may think they have crossed everything off on their checklist, but our eye specialist want to remind parents on their children’s eye health. Good vision and overall eye health are vital to learning and academic success. Because children are still growing, being vigilant about eye health is important. The earlier problems are identified; the sooner they can be addressed to the ophthalmologist. Dr.Tarek Makhlof, Ophthalmologist @ International Modern Hospital, recommends the following tips to for healthy eyes and vision:

  1. rubWatch for signals of eye problems– Parents should be alert to symptoms that could indicate an eye or vision problem, such as complaints of eyestrain, headaches and squinting when reading or performing other common activities like regular rubbing of the eye etc. Other symptoms to look for include a white or grayish-white coloring in the pupil, one eye that turns in or out, or eyes that do not track in sync together.
  2. Wear protective eyewear when playing sports– Eye injuries while playing sports can cause serious damage. Hence wear protective eye wears as a protective measure.
  3. Get regular childhood vision screenings 
    Children’s eyes change rapidly, making regular vision screenings an important step in detecting and correcting eye problems in early stages. eyetestFor school-age children, a vision screening, which is less comprehensive than a dilated eye examination by an ophthalmologist,can be performed by a pediatrician, family physician, nurse or trained technician during regular checkups. If the screening detects a problem, the child may need to see an ophthalmologist — an eye physician and surgeon.
  4. Know and share your family eye health history– Everyone should find out whether eye conditions or diseases run in their family. Parents should share that information with the person performing the screening when possible. Examples of common eye conditions include refractive errors (nearsightedness, farsightedness, astigmatism) crossed eye, known as strabismus, and lazy eye, known as amblyopia. If crossed eye and lazy eye are not treated in childhood, they can sometimes cause permanent vision loss in one or both eyes.
  5. kid-with-tablet_opt-100623783-primary.idgeBeware of television on hand held devices– It is now becoming more and more common for children to suffer from eye strain after staring at screens for hours and hours. This is sometimes known as computer vision syndrome. Watch out for dry, red and sore eyes. Sometimes, children may experience blurry vision and have problems with words moving on the screen because their eyes are not properly aligned. You can avoid eye problems setting in at an early age by making sure that sessions involving near screen work are limited to 30 minutes a time. Make sure that there are plenty of breaks and that outdoor activity is not neglected.

Weaning foods for children

babyIntroducing your baby to solid foods – sometimes called weaning or complementary feeding – should start when your baby is around six months old.It’s a really important step in their development, and it can be great fun to explore new flavours and textures together.

Three signs your baby is ready for thir first food

There are three clear signs that, together, show your baby is ready for solid foods alongside breast milk or formula. It’s very rare for these signs to appear together before your baby is six months old.

  1. They can stay in a sitting position and hold their head steady.
  2. They can co-ordinate their eyes, hands and mouth so they can look at the food, pick it up and put it in their mouth, all by themselves.
  3. They can swallow food. Babies who are not ready will push their food back out with their tongue, so they get more round their face than they do in their mouths.

Some signs that can be mistaken for a baby being ready for solid foods:

  • chewing fists
  • waking in the night when they have previously slept through
  • wanting extra milk feeds

These are normal behaviours and not necessarily a sign of hunger or being ready to start solid food. Starting solid foods won’t make them any more likely to sleep through the night. Extra feeds are usually enough until they’re ready for other food.

When can I introduce weaning foods to my baby?

The World Health Organization (WHO) recommends exclusive breast feeding alone up to the age of 6 months. After 6 months babies need complementary feeding to provide adequate supply of nutrients.

Step 1: Your baby is now 6 months old (completed 6 months)

  • Purées of vegetables such as carrots, pumpkin , potato, sweet potato
  • Purées of fruits, such as ripe cooked apple, pear , or mashed banana
  • Gluten-free baby cereals, such as rice cereal mixed with baby’s usual milk

Milk is still a major part of the baby’s diet. If you are breastfeeding, you can continue breastfeeding till baby is two years old.

Purées may be easiest for your baby at first. However, babies can quickly learn to chew soft, lumpy food even if they have no teeth. Ensure the food is well mashed and gradually make the food a thicker consistency.

Try to limit the number of sweet or cereal purées to one a day, and always include a vegetable purée. 

Don’t add salt or sugar, honey or other sweeteners to your baby’s food. 

Step 2: Baby is taking puréed food well

If baby is taking puréed food well, time to increase the variety in their food.

  • Purées of lean meat or poultry
  • Purées of lentils or split peas 
  • Purées of mixed vegetables with potatoes or rice
  • Purées which include green vegetables, such as peas, cabbage , spinach or broccoli
  • Full cream milk, yoghurt, cream cheese, paneeror custard.

Do not give cow’s (or goat or sheep’ milk) as baby’s main milk till they are atleast one year old. 

Make changes in child’s diet when they are well. This is to avoid attributing the symptoms of illness to change in diet.

Some foods are more likely to cause allergies than others. These should be introduced one at a time. These foods are:

  • Milk products such as cheese, yoghurt, fromage frais, paneer etc (Use full fat variety)
  • Fish and shell fish
  • Soya beans
  • Citrus fruit (including orange juice)
  • Wheat, rye and barley based foods such as bread, flour, pasta, some breakfast cereals and rusks.
  • Nuts, especially if your family has a history of allergies.

Step 3: Baby food from seven to nine months

Now is the time to introduce more variety in baby’s food.

Remember that most baby food can be easily made at home. 

  • Mashed or minced food, not purées. Be sure to include some lumps.
  • A wider range of starchy foods such as khichdi suji upmasuji kheersabudaana kheerdalia, bread. Baby breadsticks, breakfast cereals, oats, in addition to cornmeal, potatoes, rice and millet are also good options. Give two to three servings a day of starchy foods.
  • Cooled, filtered and boiled waterfrom a sipper with a soft spout, when she is thirsty. This is in addition to her daily breastmilk or 500-600 mls of formula.
  • Keeping juice to meal times helps with iron absorption and reduces the risk of damage to emerging teeth.
  • Citrus fruits, such as oranges (santara), kinnow (keenu) and sweetlime (mosambi).
  • Fish, lean red meat, poultry and lentils. Aim for one serving of protein-rich food a day.
  • Nut butters as long as there is no family history of allergic diseases. Use unsalted smooth versions, or make your own.
  • Dairy products, such as paneer, yoghurt and cheese. You should wait until one year to introduce cow’s milk as a drink. However, it can be used in small amounts for cooking foods.
  • Follow-on formula, if you wish.
  • Finger foods such as cooked green beans (frans been) or carrots (gajar), cubes of cheese, slices of banana (kela) or soft pear (nashpati).

If you are buying canned food, do ensure they do not contain excess salt or sugar. Adult canned food is not recommended for babies as it contains excess salt or sugar.

Step 4: Meals from 10 months

Meals should be more adult-like now. They should be chopped or minced. You may like to follow a two to three meal a day pattern along with one or two snacks. Continue to offer breastmilk or 500-600mls of formula milk. 

At this stage your baby should be having:

  • three or four servings of starchy foods, such as khichdi, rice, daldalia, or potatoes, a day
  • one serving of meat, fish, well-cooked eggs, or two of pulses (lentils, peas, beans) or nut butters
  • one to two servings of cheese, paneeror yoghurt as well as breastmilk or formula milk.

What foods should I not give my baby if she is under a year?

  • Salt: Adding salt to baby food is neither needed nor recommended in the  first year of life
  • Honey. Even if she has a cough, your baby shouldn’t have honey until she’s one.
  • Sugar. Try sweetening desserts with mashed banana or a purée of stewed dried fruit. Or you could use expressed breast milk or formula milk.
  • Artificial sweeteners. Diet drinks or squashes containing artificial sweeteners are not suitable for your baby. They are not nutritious and can encourage a<style=”color: #000000;”>sweet tooth.
  • Whole nuts.These are a choking hazard.
  • Tea or coffee. The tannin in tea may prevent her from absorbing the iron in her food properly. Any caffeinated drink is unsuitable for your baby.
  • Low-fat foods. Single or double toned milk, yoghurts and reduced-fat cheeses aren’t right for your baby. Always offer your baby the full-fat versions. She needs the calories.
  • Foods which may carry a risk of food poisoning; such as soft mould-ripened cheeses (brie, camembert), liver pâté, and soft-boiled or raw eggs.
  • Cow’s (or goat’s or sheep’s) milkas a main drink under one year. 

You Can Control Your Asthma

Asthma affects more than 300 million people worldwide. It is characterized by recurrent difficulties with breathing, including symptoms such as shortness of breath, wheezing, chest tightness, and coughing. Asthma symptoms vary over time, and also from individual to individual. Although asthma cannot be cured; it can be treated and controlled. Good asthma control means no, or very minimal, symptoms, and a low risk of asthma attacks or other poor outcomes. A person whose asthma is under good control can go to work or school, exercise, and participate fully in life.WAD-2016-Logo-01-1

What can I do to prevent my asthma from getting out of control?

Medications: Take your asthma medication exactly as your doctor tells you. Work with your doctor to find a treatment plan Carry your relief/rescue inhaler with you at all times and follow the directions on your Action Plan for when to use it.

Regular visits to your doctor: Keep your regularly scheduled visits with your doctor so that your asthma can be monitored and treated before it gets out of control. Be sure to know how to contact your doctor and know what to do in case of an emergency.

Stay healthy: Eat nutritious foods and get regular exercise. Avoid people who smoke and those that may have an infection, especially a cold or the flu.

Prevent the flu and pneumonia: Get a yearly flu shot (vaccine) and a vaccine for pneumonia, as recommended by your doctor.

Cope with stress: Learn new ways to cope with stress. Coping with stress can help prevent and control your asthma.

By taking an active role in the management of your asthma by partnering with your doctor, you can breathe easier and live a healthier life

Anorexia

 

What is Anorexia?

Male-AnorexiaAnorexia Nervosa is a psychological and possibly life-threatening eating disorder defined by an extremely low body weight relative to stature (this is called BMI [Body Mass Index] and is a function of an individual’s height and weight), extreme and needless weight loss, illogical fear of weight gain, and distorted perception of self-image and body.

Additionally, women and men who suffer with anorexia nervosa exemplify a fixation with a thin figure and abnormal eating patterns. Anorexia nervosa is interchangeable with the term anorexia, which refers to self-starvation and lack of appetite.

Types of Anorexia

There are two common types of anorexia, which are as follows:

  • Anorexia Nervosa Binge / Purge Type – The individual suffering from anorexia nervosa binge / purge type, will purge when he or she eats. This is typically a result of the overwhelming feelings of guilt a sufferer would experience in relation to eating; they compensate by vomiting, abusing laxatives, or excessively exercising.
  • Restrictive Anorexia Nervosa – In this form of anorexia nervosa, the individual will fiercely limit the quantity of food consumed, characteristically ingesting a minimal amount that is well below their body’s caloric needs, effectively slowly starving him or herself.

Causes 

Anorexia is not a simple disorder. It has many symptoms and effects, and its causes are complex as well

  1. Environmental factors

The effects of the thinnessculture in media, that constantly reinforce thin people as ideal stereotypes

  • Professions and careers that promote being thin and weight loss, such as ballet and modeling
  • Family and childhood traumas: childhood sexual abuse, severe trauma
  • Peer pressure among friends and co-workers to be thin or be sexy.
  1. Biological factors
  • Irregular hormone functions
  • Genetics (the tie between anorexia and one’s genes is still being heavily researched, but we know that genetics is a part of the story).
  • Nutritional deficiencies

Signs and Symptoms 

Living with anorexia means you’re constantly hiding your habits. This makes it hard at first for friends and family to spot the warning signs. When confronted, you might try to explain away your disordered eating and wave away concerns. But as anorexia progresses, people close to you won’t be able to deny their instincts that something is wrong—and neither should you.

food behavior signs and symptoms

  • Dieting despite being thin – Following a severely restricted diet. Eating only certain low-calorie foods. Banning “bad” foods such as carbohydrates and fats.
  • Obsession with calories, fat grams, and nutrition – Reading food labels, measuring and weighing portions, keeping a food diary, reading diet books.
  • Pretending to eat or lying about eating – Hiding, playing with, or throwing away food to avoid eating. Making excuses to get out of
  • Preoccupation with food – Constantly thinking about food. Cooking for others, collecting recipes, reading food magazines, or making meal plans while eating very little.
  • Strange or secretive food rituals – Refusing to eat around others or in public places. Eating in rigid, ritualistic ways.

appearance and body image signs and symptoms

  • Rapid weight loss with no medical cause.
  • Feeling fat, despite being underweight – You may feel overweight in general or just “too fat” in certain places, such as the stomach, hips, or thighs.
  • Fixation on body image – Obsessed with weight, body shape, or clothing size. Frequent weigh-ins and concern over tiny fluctuations in weight.
  • Harshly critical of appearance – Spending a lot of time in front of the mirror checking for flaws. There’s always something to criticize. You’re never thin enough.
  • Denial that you’re too thin – You may deny that your low body weight is a problem, while trying to conceal it (drinking a lot of water before being weighed, wearing baggy or oversized clothes).

purging signs and symptoms

  • Using diet pills, laxatives, or diuretics – Abusing water pills, herbal appetite suppressants, prescription stimulants, ipecac syrup, and other drugs for weight loss.
  • Throwing up after eating – Frequently disappearing after meals or going to the bathroom. May run the water to disguise sounds of vomiting or reappear smelling like mouthwash or mints.
  • Compulsive exercising – Following a punishing exercise regimen aimed at burning calories. Exercising through injuries, illness, and bad weather. Working out extra hard after bingeing or eating something “bad.”

Steps to recovery

  • Admit you have a problem. Up until now, you’ve been invested in the idea that life will be better—that you’ll finally feel good—if you lose more weight. The first step in anorexia recovery is admitting that your relentless pursuit of thinness is out of your control and acknowledging the physical and emotional damage that you’ve suffered because of it.
  • Talk to someone. It can be hard to talk about what you’re going through, especially if you’ve kept your anorexia a secret for a long time. You may be ashamed, ambivalent, or afraid. But it’s important to understand that you’re not alone. Find a good listener—someone who will support you as you try to get better.
  • Stay away from people, places, and activities that trigger your obsession with being thin.You may need to avoid looking at fashion or fitness magazines, spend less time with friends who constantly diet and talk about losing weight, and stay away from weight loss web sites and “pro-ana” sites that promote anorexia.
  • Seek professional help. The advice and support of trained eating disorder professionals can help you regain your health, learn to eat normally again, and develop healthier attitudes about food and your body.

The difference between dieting and anorexia

Healthy Dieting

Anorexia

Healthy dieting is an attempt to control weight. Anorexia is an attempt to control your life and emotions.

Your self-esteem is based on more than just weight and body image.

Your self-esteem is based entirely on how much you weigh and how thin you are.
You view weight loss as a way to improve your health and appearance. You view weight loss as a way to achieve happiness.
Your goal is to lose weight in a healthy way.

Becoming thin is all that matters; health is not a concern.

Learn to tolerate your feelings

Identifying the underlying issues that drive your eating disorder is the first step toward recovery, but insight alone is not enough. Let’s say, for example, that following restrictive food rules makes you feel safe and powerful. When you take that coping mechanism away, you will be confronted with the feelings of fear and helplessness your anorexia helped you avoid.

Challenge damaging mindsets

People with anorexia are often perfectionists and overachievers. They’re the “good” daughters and sons who do what they’re told, try to excel in everything they do, and focus on pleasing others. But while they may appear to have it all together, inside they feel helpless, inadequate, and worthless.

Develop a healthier relationship with food

Even though anorexia isn’t fundamentally about food, over time you’ve developed harmful food habits that can be tough to break. Part of recovery is developing a healthier relationship with food.

Medical treatment

The first priority in anorexia treatment is addressing and stabilizing any serious health issues. Hospitalization may be necessary if you are dangerously malnourished or so distressed that you no longer want to live. You may also need to be hospitalized until you reach a less critical weight.

Chronic Kidney Disease (CKD)

Chronic kidney disease (CKD) is a condition characterized by a gradual loss of kidney function over time. The term chronic is used to refer to a condition which is permanent and irreversible. In addition, it progressively worsens even with treatment. This will eventually, over a period of time lead to need for dialysis or renal transplantation.
This is associated with complications such as high blood pressure, weak bones, low blood dialysis-access-management-the-miller-procedure-for-steal-syndromeDialysis-Treatment    hemoglobin and cardiac and nerve and brain damages.
Causes of Chronic Kidney Disease
The two main causes of chronic kidney disease are Diabetes mellitus and High blood pressure. These two diseases together are responsible for up to two-thirds of the cases.
High blood pressure, if uncontrolled, or poorly controlled, can be a leading cause of heart attacks, strokes and chronic kidney disease. Also, chronic kidney disease can cause high blood pressure.
Several other conditions can cause chronic kidney disease.
• Glomerulonephritis:A group of diseases that cause inflammation and damage to the kidney’s filtering units. These are unique diseases which generally affect the kidneys primarily and as a result of kidney damage can cause damage to other organs of the body. These disorders are the third most common type of kidney disease.
• Polycystic kidney disease An Inherited diseases, which causes large cysts to form in the kidneys and damage the surrounding tissue.
• Malformations and developmental abnormalities that occur during intrauterine development.
• Systemic lupus erythematosos and other diseases that affect the body’s immune system.
• Obstructions to urine flowcaused by problems like kidney stones, tumors or an enlarged prostate gland in men.
• Repeated urinary infections.
Most people may not have any symptoms until their kidney disease is advanced. However, the following symptoms occur as the disease progresses.
Tiredness and feeling less energetic in day to day activities; have trouble concentrating have a poor appetite and have difficulty in sleeping. These are non-specific symptoms and occur very slowly and are difficult to recognize in the beginning.
In addition patient may also have certain specific symptoms like swelling in the feet, and puffiness of the face especially around the eyes more so in the morning. Decrease in urination sometimes associated with the need to urinate more often at night occurs.
In severe cases and advanced renal failure patients have breathing difficulty, headache, convulsions, visual disturbances, and loss of consciousness. This warrants emergency treatment.
Detection of chronic kidney disease: Important tests of kidney function.
The earlier kidney disease is detected, the better the chance of slowing or stopping its progression.
Blood Urea Nitrogen: This is a chemical which accumulates in the body during day to day activities. It is normally excreted by the kidney and it accumulates in the blood in patients in whom the kidney function is reduced.
Serum Creatinine: this is also a waste material which accumulates in the body and if not cleared by the kidneys its blood levels raise. A raised blood urea and creatinine levels generally indicate kidney failure; however the values need to be interpreted taking in to account several other variables. Generally both blood urea and serum creatinine levels are to be considered.
If these tests are abnormal then several other chemicals in the body need to be measured to decide on the severity of the disease and to guide the treatment.
It is important to note that these tests indicate the severity of the disease and cannot confirm whether the disease is reversible or permanent.To decide if the damage is permanent or reversible renal scan is necessary
Ultra sound scan or CT scan of the kidneys will give information regarding the size of the kidneys and presence or absence of obstruction
In patients with Chronic kidney disease the kidney size is usually reduced to less than 9cms which is the normal size. In addition the appearance of the kidneys in the scan also is abnormal.
Kidney Biopsy:
In some patients if the kidney size is normal taking a small bit of kidney tissue though a needle and studying the microscopic structure may be necessary
Additional tests may be necessary to detect the complications or response to treatment measures.
Salient points:
Early detection can help prevent the progression of kidney disease to kidney failure.
Heart disease is the major cause of death for all people with Chronic kidney disease.
Hypertension can causechronic kidney disease and chronic kidney disease can cause hypertension
Persistent proteinuria (protein in the urine) means Chronic kidney disease is present and may in some cases lead to kidney failure.
High risk groups include those with diabetes, hypertension and family history of kidney failure.
Two simple tests can detect Chronic kidney disease: blood pressure, urine albumin and serum creatinine.
Treatment options

These include the following:
Supportive treatment in the early stages:
Renal replacement therapy when the disease is advanced:
Supportive treatment:
This is started when the patient has kidney failure but the degree of failure is not severe and the patient can be managed with medications and diet.
The aim of therapy is to
1. Control the symptoms
2. To delay the progression of kidney failure
3. To prepare the patient for eventual dialysis support.
Control of Symptoms:
These include medication to control blood pressure, blood sugars in patients with diabetes, and some medications to alleviate the problems due to alterations in electrolytes, water content of the body and the bone minerals. With strict control of blood pressure the progression of kidney failure can be significantly slowed down.
Diet:
Salt restriction:to control blood pressure and fluid accumulation in the body.
Fluid restriction: to control swelling and fluid accumulation
Low protein: Protein in the diet acts as an additional burden on the already malfunctioning kidneys. Moderate reduction in dietary protein intake is known to reduce the progression of the kidney failure.
Fruits; generally fruits are very rich in a mineral called potassium. This is normally excreted only through the kidneys. In conditions where kidneys are unable work normally potassium accumulates in the body. High blood potassium levels are harmful to the heart and require urgent treatment.
Dietary advice from an experienced dietician is very helpful.
Renal Replacement therapy:
There are two treatment options for kidney failure:
Dialysis (hemodialysis or peritoneal dialysis) and kidney transplantation
Briefly Dialysis means removing the waste products from the blood periodically with the help of an artificial kidney or the patient’s own abdominal membrane.
Transplantation involves placing a normal kidney surgically from a donor either living or cadaver.

Hemodialysis
Hemodialysis is a treatment that removes wastes and extra fluid from the blood.During hemodialysis, the blood is pumped through soft tubes to a dialysis machine where it goes through a special filter called a dialyzer (also called an artificial kidney). After the blood is filtered, it is returned to the bloodstream.-peritoneal-dialysis-catheter
Dialysis is necessary if the kidneys no longer remove enough wastes and fluid from your blood to keep the body healthy. This usually happens when there is only 10 to 15 percent of kidney function left. The patient usually has severe symptoms such as nausea, vomiting, swelling and fatigue. However, one can still have a high level of wastes in the blood that may be toxic to the body and yet have minimal symptoms. Your doctor is the best person to tell you when you should start dialysis.
Blood is removed from the body using needles placed in the veins or through tubes inserted in to major veins. This is called dialysis access
(Images)
For the peripheral veins to give good amount of blood for cleaning a small surgery to connect the vein to the artery is required. This needs to be done several weeks before dialysis is anticipated.
Dialysis is generally required 3 times a week each time lasting for 4-5 hours. This can be done as an outpatient procedure and the patients usually can get back to work after the session is over. Blood tests are done monthly to assess the adequacy of dialysis.
Peritoneal dialysis:
In this process a small soft rubber tube is placed in the abdomen and once the wound heals sterile fluid can be instilled in to the abdominal cavity through this tube. The fluid is left in place for 3-4 hours and during this time it takes up the waste material from the blood and it can then be removed through the same tube. This is called one exchange. Usually 3-4 exchanges are required daily and the patient is trained to do the same at home. The quality of dialysis is assessed monthly by the Nephrologist.
Renal Transplantation:
This is the most physiological way of replacing the kidney function. It involves placing a new kidney in the patient’s body usually the lower abdomen. The kidney can be donated by a close relative or it can also be from a brain dead person. The donor and recipient pair undergo a series of tests to confirm mutual compatibility and matching. The recipient will require medications life long and close and frequent monitoring.

ABDOMINOPLASTY (TUMMY TUCK)

Hanging abdomen with an apron is unsightly and uncomfortable for any woman. Not able to wear the dress of their choice is so depressing to anyone. The self esteem gets down with every morning seeing the self profile. But they can be happy that there is a sure way out.
Causes of hanging abdomen
1) Overweight or obesity : General adiposity (excess fat) as part of increase in Body Mass Index can cause an increase in abdominal circumference. The ideal BMI is 18-23. Once it is above 23 till 27.5 it is overweight and 27.5 onwards is obesity. BMI is calculated as weight in Kg/Ht in M2 e.g. If a person has 100kg weight and 2m height, BMI= 100kg/ 2m x 2m=25 Kg/M2

2) Truncal Obesity (Abdominal obesity) : Increasing abdominal obesity is more dangerous than the overall increase in weight. Ideally, the abdominal circumference at umbilical level should be below 80 cm in women. The increase in BMI and abdominal circumference leads to various medical illness like Diabetes, hypertension (increase in blood pressure), dyslipedemia (increase in cholesterol), sleep apnoea (breathing difficulty/ snoring with respiratory arrest), PCOS (Polycystic ovarian disease) and fatty liver. It also increase the risk of cancers of breast and ovary.

3) Divarication Recti (separation of muscles of abdominal wall) : This happens mainly and commonly following pregnancy when there is excessive stretch of abdominal wall muscles making it fall apart from the midline. This leads to bulging of abdomen and patient will have a state similar to pregnancy look. This is highly distressing to any woman. The abdominal bulge will be such that it projects out and comes anterior than breast level in a profile view.

4) Ventral hernia : muscle defect with herniation/ projection of abdominal contents in to the sac formed at the muscle weakness. The intestines or omentum get trapped in this defect and can cause life threatening problems.

5) Sagging fat and skin : The lower abdominal wall fat and skin is redundant (extra) and hangs down in an unsightly manner. The skin sagging may be unrelated to the muscle weakness. The pulling down of the abdominal wall by the weight of this apron itself will be causing discomfort and muscle weakness. The disfigurement in these patients is unexplainable.

Assessment
Patients need to consult a surgeon who is well-versed with the problem and its corrective measures. Detailed physical examination with abdominal girth, height, weight, BMI, BP, Pulse, oxygen saturation to be checked. The co-existing problems like diabetes, hypertension, snoring, respiratory difficulty with walking, menstrual irregularities, stress incontinence and psychological problem (mainly depression).
The psychological impact of these illness on the patient is very significant. They will be always worried about and other is depression seeing the bad body contour every day. Being not able to wear the dress they like and not able to move around comfortably also keeps them introverts and less sociable. Many jobs also demand people with normal BMI and body shapes. Even promotions are jeopardized by these abnormalities. The associated medical problems and the need for medication for the same will also be making patients uncomfortable and dissatisfied in life.

Treatment Options
Those who have increased BMI should be advised for weight reduction. To a good extend it is possible by diet regulations and exercise. There are some drugs available to reduce weight but it helps in reducing weight around 4-5 kg only. Those with higher BMI will be benefitted by intra-gastric balloon placement or by bariatric surgery of which sleeve gastrectomy is the best. Abdominal obesity also gets controlled to a great extent by these procedures.
Divarication of recti (the separation of muscle in the central abdomen), the ventral hernia and sagging skin with fat (the abdominal apron) needs tummy tuck (abdominoplasty). The exercises to tone the abdominal wall, weight reduction or application of any kind of solutions or application of slim devices like vibrators are not going to give any kind of benefit to these patients.
The procedure of tummy tuck involves a pre-hospitalization checkup including blood tests. Ultrasound abdomen is performed to rule out any other surgical problem in abdomen like an ovarian cyst or gall bladder stones which can be talked at the same time. The necessary consultations will also be done with other specialists as needed.
The operation is done under anaesthesia, either general or regional, so that patient will be comfortable. The incision will be made at the lowest skin crease of abdomen to give excellent cosmetic outcome. The skin and subcutaneous fat will be mobilized. The muscles which are far apart will be brought together. In case of hernia a net like material (mesh) will be used to give additional strength. The excess fat and skin will be removed and wound closed. The wound closure is also done in a careful manner with no stitches outside. This also will add to the perfect healing with very minimal scar. The scar will be completely hidden by the smallest of dress.
Patient needs to be in hospital for 2-3 days and can resume normal activities after that. All kinds of job can be started within two weeks time. Wearing an abdominal binder during this period will give additional comfort.
The outcomes are such great that patients get immediate results and regain self esteem. The profile changes and any modern dress will suit the person. The medical issues related to the divarication like dragging pain in abdomen and backache due to the abnormal posture and weight of ventral hernia will also get resolved. In those with higher BMI and sagging abdomen the procedure to reduce weight (sleeve gastrectomy) is done along with the tummy tuck thereby avoiding scars of the bariatric surgery and unnecessary second hospitalization. Combination of these procedures is an innovative method developed at our centre to give maximal benefit for patient with superior quality of life.

Feedback:
Dear Dr Padmakumar

My tummy tuck (abdominoplasty) was done in september 2013. I was very uncomfortable and had very strong inferiority complex due to my sagging abdomen and hernia. My friends are asking me ” oh you are pregnant again”. After my tummy tuck surgery , ” I can’t believe , all tummy had gone and I was flying in heights”.

Now am happy that I can wear any kind of dress I wish and my confidence level increased.

Thank you all doctors “you are all so special in my life”

Mrs. Liji Chandran

Untitled

Dr. R. Padmakumar MBBS, DNB, MNAMS, DipALS, FAIS
Specialist Surgeon , International Modern Hospital, Dubai

Senior Consultant Surgeon & Medical Director, Sunrise Hospital, Cochin (Specialist in Laparoscopy, Hernia, Cancer, Endoscopic Thyroid Surgery,
Thoracoscopy, Obesity and Diabetic Surgery)

GC Member – Association of Surgeons of India
National President Elect – Indian Hernia Society
Jt. Secretary – Indian Association of Endocrine Surgeons
Founder Member – Obesity and Metabolic Surgery Society of India &
Association of Minimal Access Surgeons of India
International Faculty of IASGO on Hernia and Diabetic Surgery
International Faculty of IFSO on Ileal Interposition (Diabetic Surgery)

Mob : +919447230370 (India) ; 00971567581025 (UAE)
Email : drrpadmakumar@gmail.com
Websites:
www.drrpadmakumar.com
www.diabetescuresurgery.com
www.obesitysurgeonkerala.com
www.endoscopythyroid.com

Winter Lipcare

Having healthy lips in winter, maybe a dream come true for many. The skin on your lips is very thin and has no oil glands to prevent it from chapping. So it is completely your potential to keep them healthy. Even the most expensive lipstick will not cure the dryness of your lips. Protecting your lips from dryness is not just important for appearance, but also for health. You may end up with bacterial infections, cold sores and other problems if they are chappy. They will also effect your smile and damage your self esteem..

Lip-balm-dries-lips-winter

Causes For Chapped Lips:
There are different reasons for chapped lips, but here are a few that are extremely common:
1. Weather change – heat or cold
2. Aging plays a very important role in causing dry lips
3. Biting your lips will result in bleeding and cracked lips
4. Licking your lips is the worst habit!
5. Touching lips with fingers will transfer the bacteria on your hands to your lips and cause infections ( also aggravate chapped lips)
6. Dehydration
7. Usage of excessive chemicals (Lipsticks)
8. Any form of alcohol can provoke skin irritation
9. Any product with chemical preservatives
10. Leaving the lipstick on, while going to sleep
11. Using lip balms with alcohol, retinol and menthol
Women who like to chew on their lips wearing lipstick, will consume about 4 to 9 pounds of lipstick in their life time! All these may seem common but they affect your health, severely. They make the skin on the lips dry, rough and sensitive.

Protecting Your Lips:
For a long lasting moisture on the lips, you need to treat them from outside as well as from the inside. It is extremely important to consume plenty of water everyday. This will keep your lips moisturized from within, as it nourishes and protects the skin. If your diet has low levels of vitamin B, you are more prone to chapped lips. Including red meat, fortified cereals, skim milk, Swiss cheese, eggs and silken tofu to your diet will bring about a great change in your lips. The most important points to protect your lips are:
1. Quit smoking! It will completely spoil your lips and it may become too late to regain the color and texture of your lips.
2. Always keep your lips moisturized by applying a natural lip balm.
3. Apply lip balm before going to bed.
4. Licking your lips is a bad habit. Yes, it may look like it is keeping your skin moisturized for a moment, but it worsens the situation! The wind will dry your lips in a minute and you have to keep licking them. This process is unending and will become a major condition, by spreading away from the lips. So it is better to keep them moisturized with a lip balm.
5. For the winter season, you need to choose lip balms with extra moisturizing agents. The lip balms you choose should have a long lasting effect. They will keep your lips moisturized for a longer period of time. It is an added advantage if the lip balm contains SPF in it. The lip balms which contain the following are the best for your lips.

 Shea Butter: Shea butter acts as a natural sun block and it has allantoin, which is a healing agent. This is the best ingredient to have in a lip balm. It gives a soothing effect to the lips.
 Aloe Vera: As we all know, Aloe Vera consists of anti-inflammatory and anti-bacterial agents which protect the skin from any kind of infections. Aloe Vera is also very soothing and moisturizing, when applied on the lips.
 Glycerin: Glycerin is a natural skin softer and it holds agents that bind moisture and skin together.
 Jojoba Oil: It is one of the best nourishing oils for the skin. It softens and lubricates the skin, when it is applied.
 Vitamin E: It is a powerful antioxidant and moisturizing agent. It protects the lips from the sun.
 Coconut oil: Coconut oil relieves dry and itchy skin. It also softens and moisturizes the lips.
 Beeswax: It is a non allergic skin softener, that moisturizes and nourishes the skin. It consists of anti-inflammatory and anti-bacterial agents that guard and protect the skin.
 Vitamin A and D: These are pro-active vitamin complexes that are skin friendly. They contain fatty acids that are easily absorbed into the skin. They help to soothe and heal the skin effectively.

6. If you are in a habit of using lipstick everyday, choose the ones with moisturizing ingredients. It is better to avoid lipstick, especially in winter. Instead, you can use a moisturizing lip balm, with a tint of lip color.
Home Remedies To Treat Chapped Lips:
The golden secrets of gaining fresh, soft and luscious lips are by using home remedies. They are cheap, surely available and accessible at any time. If you use these secret tips, your lips will look moisturized and healthy, even without using lipsticks or lip balms. So try these simple remedies to cure your lips and enjoy an ever lasting moisture.
Honey:
Using honey to moisturize your lips is the best. You need to apply this in the night, before going to bed. It is the best way to clean your lips. It will also cure dark lips, caused due to sun exposure.
Ghee:
Ghee has the same effect on the lips as honey. You need to apply a few drops of ghee on your lips, before going to sleep. It will give you smooth and soft lips, within no time.
Green Tea Bags:
The oldest home remedy followed by many is green tea bags. Press one used green tea bag, against your lips for at least 4 minutes. You need to do this everyday to increase the moisture of your lips. This is the best natural remedy used to cure chapped lips.
Lemon Juice:
This remedy will help to prevent aging of the skin. It nourishes the sensitive skin on your lips, leaving them smoother and softer than before. Take a small bowl and mix one teaspoon of cream (milk) with 3 drops of lemon juice. Place the bowl in the fridge for an hour. Remove the mixture and apply it on and around the lips, before going to sleep. If you repeat this procedure for three days, you will notice best results. You can also continue it everyday to prevent the lips from aging.
Rose Water and Glycerin:
Rose water and glycerin is a great combination. It provides glowing and amazing skin, with regular use. You need to take a tablespoon of glycerin and rose water. The measurement may vary according to the need of each person. You need to take equal quantities of both the ingredients. Mix it together and apply this mixture to your lips, as well as your whole face, before going to sleep. You will see mind blowing results in 5 days time!
Glycerin and Honey:
Honey and glycerin will help to prevent wrinkles and dry skin. You need to take a teaspoon of honey and add very few drops of glycerin to it. Apply this mixture on the lips and leave it on for 15 minutes. Wash it off with normal water. Apply a few drops of glycerin again and leave it over night. This tip is extremely useful and prevents the lips from wrinkling.
Jojoba Oil:
This remedy gives a natural instant relief from severely chapped lips. All you need to do is take a few drops of jojoba oil and apply it on the affected area. You need to leave it on for about 15 minutes. Jojoba oil helps in a speedy recovery of your lips. It will get the moisture back into your lips, by nurturing the skin cells in the lips. It helps in building new skin cells which will repair the skin immediately.
Cucumber:
Cucumber is a vegetable with all the goodness in the world. You need to take a peeled cucumber and crush it. Extract the juice and apply this onto your lips. Leave it on for 20 minutes and wash off with normal water. You will see a major difference if you use this remedy regularly.
Sugar Scrub:
You can exfoliate your lips by using a good scrub. Even a small brush will do to remove the dead cells on your lips. But the best scrub for lips is sugar. It is easily accessible from your kitchen. You can take 1/2 teaspoon of sugar and add 2 drops of olive oil to it. Scrub your lips gently with this mixture. After 3 to 5 minutes of scrubbing, you can wash it off with normal water. Apply a good lip balm after wiping your lips with a cloth. This remedy will make you lips shiny and softer than before.

Don’t Procrastinate with Pelvic Pain

If you have recurring pain in your pelvis or bladder, you probably don’t think “interstitial cystitis.” It’s a long name for a condition that can be difficult to diagnose because it can have multiple, interrelated causes.

Interstitial cystitis, or “IC,” is a chronic health issue in which patients feel pain or pressure in the bladder area. An estimated 4 million people in the U.S. suffer from IC, approximately 80 percent of them female.

Pelvic Pain Women

Several different conditions – or combinations of conditions – can cause IC. That’s why it’s important to consult with your physician if you’re experiencing pelvic pain. A proper diagnosis may require time and you don’t want to suffer any longer than necessary.

To further complicate the diagnosis, symptoms range from mild to severe and vary from person to person. Any of the following could indicate IC:

  • Pain ranging from ‘nagging’ to ‘intense’ in the bladder and surrounding pelvic region
  • A sense of urgency and/or increased frequency of urination
  • Pain that worsens during menstruation
  • Painful sexual intercourse for women
  • Pain or discomfort in the scrotum or penis
Pelvic Pain Man

For many, IC feels like a bladder infection, though antibiotics make no impact because there’s no infection to treat. The exact cause of pain with IC is actually not clear, but several theories exist. These range from an allergic response to autoimmune reaction to an excessive inflammatory response to even the slightest stimulus which would not generally be perceived as painful in a patient who does not have IC.

IC can frustrate patients because besides a challenging diagnosis, not everyone responds the same way to the same treatment. In addition, IC treatments can take several weeks to several months to provide relief.

If you suffer from pelvic pain, begin with an open discussion with your physician. Whether or not you are diagnosed with IC, you can start to work toward solutions to your condition. Treatment options, such as pharmaceuticals, nerve stimulations or surgery can be evaluated and your doctor can help you decide on the appropriate approach for you.

Balloon Sinuplasty – An escape from chronic Sinus problems

Balloon Sinuplasty is a minimally invasive Endoscopic Surgical procedure for the treatment of blocked nasal sinuses.

Balloon Sinuplasty

Patients diagnosed with chronic sinusitis who are unresponsive to medical management may be advised to undergo this procedure.

In Balloon Sinuplasty, inflamed sinuses are opened in a similar way as the Doctor opens a blocked artery during balloon angioplasty.

In acute or chronic Sinusitis, the sinu- nasal mucous membrane becomes inflamed thereby blocking the sinus openings and hampering the mucocilliary flow.

Balloon Sinuplasty helps open up these blocked orifices.

The operation involves using a soft tissue guide wire equipped with a laser light and with a tiny balloon that is threaded upto the blocked area under endoscopic vision.

Once the presence of the laser lit guide wire is confirmed in the sinuses, the balloon is inflated just enough to open the passageway and the sinuses are flushed off the mucous.

The advantage of Balloon Sinuplasty lies in its ability to preserve the Normal Sinus Anatomy.

Dr. Rohit Gulati,
MBBS, DNB (Otorhinolaryngology)
Specialist ENT

FEELING HAPPY IN LIFE !

Key  Points :-

  • Feeling good makes you healthy.
  • Chemistry of body and mind interacts.
  • You can’t buy happiness – it is free!

When you  feel  happy, your body chemistry acts in ways  that make you feel  better able to cope with pain and stress and to ward off  illness. Some volunteers visit hospitals where they  make patients smile and laugh. Their visits are eagerly anticipated by both patients and  staffs , who say they make their world look brighter. It is all about feeling better in oneself and having an optimistic outlook.

We all know of those  who are  faced with adversity  or sickness, unemployment or just bad luck. For them it is a major challenge to keep optimistic and cheerful. It may be that,  they need an external catalyst to help them do so. Effects  of happiness on your health  are enormous and when you smile you certainly draw people to you rather than push them away .The fact is that if you are happy, you are likely to live longer and more satisfying life.

Many people work because they have to; but not many go to work  because  they just love what they do. There is no doubt that performance and productivity would be 100 per cent if  “work is love” made visible n words of famous poet, Khalil Gibran. When you care  for those in your family , they feel loved,  reassured and secure. So why can’t  it be the same  within  the  company which is also a family. Of course, this is not easy particularly at times of restructuring; but, the challenge is upon everyone to try to introduce a feeling of community in their work place. This will ward off pressure at work to a great extent.

Few steps to feel Happy:-

  1. Use Self Talk: When you have negative thoughts, talk to yourself as to how you could re-frame them  into positive emotion. Think of what you do have, not the things that you have not.
  2. Help others: Give your time to others less fortunate than yourself and by doing so, you give additional meaning to your own life.
  3. Enjoy the environment: Instead of walking around with your eyes closed, look at the natural beauty that is around you.
  4. Talk to others: Indulge in conversation in a sincere and genuine way. By listening others, you will also gain.
  5. At the end of the day, don’t just sit and watch the TV. Spend time playing with the children or go for a walk with the family or friends.
  6. Exercise or play some sports: A sure way to beat sadness  and depression is to stretch your body physically, because your mind also benefit at the same time. Body and mind go together. There is a chemistry, they interact each other to an extra ordinary degree.
  7. Having right attitude. If you only see doom and gloom, that is what there will  But if you see positive aspects of that are going on in your life and build on these, then your  whole  personality can change overnight.
  8. Enjoy fun: Just sit and watch some  funny show or film with your friends or children and enjoy a good laugh. Laughter is a good medicine that will make you instantly better.

 

Dr. (Mrs.) Remadevi Unnikrishnan

Abdominoplasty or Tummy Tuck

Abdominoplasty or “tummy tuck” is a cosmetic surgery procedure used to make the abdomen thinner and more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. This type of surgery is usually sought by patients with loose or sagging tissues after pregnancy or major weight loss.

Even individuals of otherwise normal body weight and proportion can develop an abdomen that protrudes or is loose and sagging. The most common causes of this include:

  • Aging
  • Heredity
  • Pregnancy
  • Prior surgery
  • Significant fluctuations in weight

abdominoplasty tummy tuck-International-modern-hospital

Procedures

Abdominoplasty operations vary in scope and are frequently subdivided into categories. Depending on the extent of the surgery, a complete abdominoplasty can take from 1 to 5 hours. A partial abdominoplasty (mini-tuck abdominoplasty) can be completed between 1 to 2 hours.

Reconstruction of the umbilicus (belly button) following an abdominoplasty surgery. The original umbilicus is sutured into a new hole created by the surgeon.

Complete abdominoplasty

In general, a complete (or full) abdominoplasty follows these steps:

  1. An incision is made from hip to hip just above the pubic area.
  2. Another incision is made to free the navel from the surrounding skin.
  3. The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures.
  4. Liposuction is often used to refine the transition zones of the abdominal sculpture.
  5. A dressing and sometimes a compression garment are applied and any excess fluid from the site is drained.

 

Full abdominoplasty consisting of musculofascial plication abdominal dermal lipectomy, suction-assisted lipectomy of hips.

Partial abdominoplasty

A partial (or mini) abdominoplasty proceeds as follows:

  1. A smaller incision is made.
  2. The skin and fat of the lower abdomen are detached in a more limited fashion from the muscle fascia. The skin is stretched down and excess skin removed.
  3. Sometimes the belly button stalk is divided from the muscle below and the belly button slid down lower on the abdominal wall.
  4. Sometimes a portion of the abdominal muscle fascia wall is tightened.
  5. Liposuction is often used to contour the transition zone.
  6. The flap is stitched back into place.

The completely sutured area where nearly 100 square centimeters of skin was removed during a combination abdominoplasty and liposuction procedure (also known as a “lipo-tuck”). Note the “neo”-umbilicus (belly button) that was reattached to a newly created hole.

Extended abdominoplasty

An extended abdominoplasty is a complete abdominoplasty plus a lateral thigh lift. The resulting scar runs from the posterior axillary line (when placing your open hands on your hips, the thumbs lie along the posterior axillary line.) The operation does all of the abdominal contouring of a complete abdominoplasty and allows further improvement of the flank (waist), as well as smoothing the contour of the upper lateral thigh.

High lateral tension tummy tuck

This is an advanced technique that takes a little more than four and half hours to perform. Conventional abdominoplasty tightens muscles in a vertical line. In this new method, known as high lateral tension abdominoplasty, in addition to vertical-line tightening, muscles are tightened horizontally. The final result with this technique is a dramatically flat abdomen with significantly better-defined waistline.

Floating Abdominoplasty or FAB Technique

This new technique, also known as an extended mini abdominoplasty, allows for tightening and shaping through a smaller incision that isn’t placed around the belly button. Through this smaller incision, excess skin is removed and the belly button is temporarily detached, floating above the muscles during this process. The muscles are tightened and reshaped from sternum to pubic area. The skin is then tightened and the belly button is reattached, or moved down one or two cm if desired. Liposuction may also be performed to achieve desirable results.

Circumferential abdominoplasty

A circumferential abdominoplasty is an extended abdominoplasty plus a buttock lift. The resulting scar runs all the way around the body, and the operation is also called a Belt Lipectomy or Body Lift. This operation is most appropriate for patients who have undergone massive weight loss.

Combination procedures

An abdominoplasty is a component of a lower body lift and can be combined with liposuction contouring, breast reduction, breast lift, or occasionally hysterectomy, depending on the reason for the hysterectomy. A popular name for breast enhancement procedures performed in conjunction with an abdominoplasty is a “mommy makeover”. Recent literature in MEDLINE also has noted implementation of barbed suture in these procedures.

Recovery

  • Depends on the problem to be treated, surgical technique(s), and other factors. Can take one to four weeks and patients are advised to take at least a portion of this recovery time off from work.
  • Heavy activity especially is best avoided during this time.
  • Initially there may be bruising and discomfort.
  • A supportive abdominal binder or compression garment can minimize swelling / bruising, and support the repaired tissues. This compression garment is also effective in helping the skin in the treated area conform to its new shape.
  • Patients are advised to avoid all forms of nicotine for a month or longer prior to surgery and also during the recovery period.
  • Full recovery takes 3–6 months, with further fading of scars thereafter. Scars may appear red and prominent at first, but with proper care, they heal into a thin, silvery line.

Who Are the Best Candidates For a Tummy Tuck?

A tummy tuck is suitable for men and women who are in good health.

Women who have had several pregnancies may find the procedure useful for tightening their abdominal muscles and reducing skin.

A tummy tuck is also an option for men or women who were once obese and still have excess fat deposits or loose skin around the belly.

Dr. Rohit Kumar
Specialist General Surgeon
Laparoscopic Surgeon

Comparision – Laparoscopic Surgery Vs Open Surgery

Laparoscopic surgery or keyhole surgery is minimally invasive surgery that is associated with several advantages over traditional open surgery

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Dr. Rohit Kumar
Specialist General Surgeon
Laparoscopic Surgeon

Diet And Acne – What Your Doctor Isn’t Telling You

Diet And Acne – What Your Doctor Isn’t Telling You

acne-and-diet

Acne is caused by a combination of the skin producing too much sebum and a build-up of dead skin cells which clog the pores and leads to a localized infection or spot. It is thought that excess sebum production is caused by hormonal fluctuations, which explains why around 80% of teenagers experience bouts of acne throughout adolescence. While there is no danger from the spots themselves, severe acne can scar as well as lead to anxiety, low self-esteem and depression.
For ages there’s been an exception to ‘you are what you eat’ saying- ‘Acne’. Doctors scoff at the idea and the web is littered with diet acne myth articles. But is it really so?
A landmark overview of research carried out over the past 50 years has found that eating foods with a high glycaemic load (GL) and dairy products not only aggravated acne, but in some cases triggered it, too.

Current diet-acne scenario

A positive correlation exists between consumption of dairy products and acne. A 2005 analysis titled “High school dietary dairy intake and teenage acne explored the possible associations between dairy-related foods and the incidence of physician-diagnosed acne. In an analysis of more than 47,000 teens, a positive correlation was found between acne and the intake of milk. The study noted that there was no difference seen between full-fat versus low-fat milk intakes in relation to breakouts. In other words, regardless of the type of cow’s milk, acne was still seen prevalently in the participants’ skin.
A similar analysis study conducted in 2006 titled “Milk consumption and acne in ` adolescent girls reviewed the affects of dairy on visible breakouts in young women from 9–15 years of age. Researchers concluded that greater consumption of milk was associated with higher prevalence of acne.”
Both studies also pointed to the hypothesis that the association with milk may be because of the presence of hormones and bioactive molecules, as well as its effect through the insulin like growth factor (IGF-1) pathway. Through these pathways, dairy intake may aggravate acne on a number of levels, including an increase in oil production, inflammation and abnormal hormonal activity.

2. A low-glycemic load diet has a positive correlation in the reduction of acne.

Regular consumption of high-glycemic load foods elevates insulin levels and may, in turn, stimulate sebum production and sebaceous cell prolifer¬ation. It concluded that the improvement in acne and insulin sensitivity after a low-glycemic load diet suggests that nutrition-related lifestyle factors may play a role in the pathogenesis of acne. This includes whole foods, such as fruits, greens, vegetables, brown rice and nuts.

3. Fruits and vegetables may help minimize signs of acne.

Rural cultures with diets high in fruits, nuts and root vegetables have been observed to have a very minimal incidence of acne. Studies point to whole foods, such as fruits and vegetables, as having a positive correlation with clear skin. This makes sense: Plants are, by and large, some of the strongest anti-inflammatory food sources available. By increasing daily intake of fruits, greens and vegetables, clients biologically increase their immunity and could potentially decrease signs of acne.

Choosing low Glycemic load (GL) foods

  • Only carbohydrates have a GL rating.
  • Because the body takes longer time to break lower GL foods hence they help you feel fuller for longer too.
  • High GL foods include sugary fizzy drinks, cakes, pastries, chocolate, white bread, potatoes etc.
  • Low GL foods include fruit and vegetables, wholegrain options such as brown pasta, brown rice, pulses etc.
  • Not overcooking your pasta and vegetables helps lower the GI.

Encourage and educate
Physicians are often first in line to work with clients suffering from acne. With the subject of diet and skin care becoming more mainstream, it is important that those working in the skin care community arm themselves with the information and know-how to advice clients about such matters.

• Keep a binder of studies in the waiting area. Allow clients easy access to such information, perhaps even highlighting important areas of note.
• Inform clients that research shows a positive correlation between high glycemic load diet/ dairy consumption and acne.
• Encourage healthy eating by suggesting an increase of more fruits, greens and vegetables. On average, a person eat less than two servings of fruits and vegetables a day, which is far below the minimum daily recommended serving size of 5–13. Plant-based foods are some of the richest anti-inflammatory resources available. An increase in these foods may decrease visible signs of inflammatory skin disorders, such as acne.

By bringing to light the diet-acne connection, the wheels start turning for clients to consider how their food choices affect their skin. It is important for skin care professionals to be at the forefront of emerging research and understand the nutritional connections to skin health. Providing sound and honest advice about skin care is crucial to enriching your individual practice. The more you are able to share with your clients, the deeper your relationships with them will grow.

Bibliography:
1. CA Adebamowo, et al, High school dietary dairy intake and teenage acne, J Am Acad Dermatol 52 2 207–214 (Feb 2005)

2. CA Adebamowo, et al, Milk consumption and acne in adolescent girls, Dermatol Online J 12 4 1 (May 2006)

3. RN Smith, et al, A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial, Am J Clin Nutr 86 1 107–115 (Jul 2007)

4. ML Nagpal, et al, Human chorionic gonadotropin up-regulates insulin-like growth factor-I receptor gene expression of Leydig cells, Endocrinology 129 6 2820–2826 (Dec 1991)

5. L Cordain, et al, Acne vulgaris: a disease of Western civilization, Arch Dermatol 138 12 1584–1590 (Dec 2002
6. http://howtostoyno.altervista.org/diet-and-acne/ (Accessed April 30 , 2015)

7. O Schaefer, When the Eskimo Comes to Town, Nutrition Today 6 6 8–16 (Nov/Dec 1971)

 

Dr. Rahul Chaudhary

M.B.B.S, MD(Dermatology)

Specialist Dermatology

Benefits of quitting smoking

Benefits of quitting smoking

Within 20 minutes after you smoke that last cigarette, your body begins a series of changes that continue for years

Girl kicking a cigarette butt

20 Minutes After Quitting
Your heart rate drops.

12 hours After Quitting
Carbon monoxide level in your blood drops to normal.

2 Weeks to 3 Months After Quitting
Your heart attack risk begins to drop.
Your lung function begins to improve.

•1 to 9 Months After Quitting
Your coughing and shortness of breath decrease.

•1 Year After Quitting
Your added risk of coronary heart disease is half that of a smoker’s.

•5 Years After Quitting
Your stroke risk is reduced to that of a nonsmoker’s 5-15 years after quitting.

•10 Years After Quitting
Your lung cancer death rate is about half that of a smoker’s.
Your risk of cancers of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases.

•15 Years After Quitting
Your risk of coronary heart disease is back to that of a nonsmoker’s.

Snoring and Sleep disorders

Most snoring is simply limited to a bedroom annoyance. However, for 4-10 percent of adults, snoring is an indication of a potentially life-threatening sleep disorder called obstructive sleep apnea. Snoring and sleep apnea are on a spectrum of sleep breathing.

apnea
Snoring is caused by turbulence and resistance in the back of the throat, usually as a result of excess soft tissues. As we go to sleep, the muscles that keep the airway open begin to relax. The area that is outlined by the uvula, tongue, and lateral pharyngeal walls comes closer together creating a narrowing and increased wind resistance, which leads to turbulence and the snore sound.

Risk factors for snoring include increased weight, advanced age, male gender, body position, and alcohol use. In children, large tonsils are often the culprit.

There are several treatment options for snoring and obstructive sleep apnea. Modifying some of the above variables often has a beneficial impact.
For simple snoring, there are several oral appliance options that are available. Stop Snoring snore guards, and antisnoring mouthpieces work by moving the jaw forward, which opens the back of the oral airway, which reduces snoring.

For sleep apnea, treatment options may include CPAP, CPAP supplies, weight loss if overweight, surgery, andsleep apnea mouthpieces, mouth guards.

Reference : American Sleep Association
Dr. Unnikrishnan Thamarassery,
MS ENT, MRCS ENT Edinburgh
Specialist Otolaryngology

WHEN SLEEP IS SOUND, HEALTH AND HAPPINESS ABOUND

“WHEN SLEEP IS SOUND, HEALTH AND HAPPINESS ABOUND”

Most sleep disorders are preventable or treatable, yet less than one-third of sufferers seek professional help. Sleep problems constitute a global epidemic that threatens health and quality of life for up to 45% of the world’s population

The three elements of good quality sleep are:

A. Duration- The length of sleep should be sufficient for the sleeper to be rested and alert the following day.

B. Continuity- Sleep cycles should be seamless without interruption.

C. Depth- Sleep should be deep enough or sufficiently sound to be restorative and refreshing.

A recent American study on sleep shows(correlates well with world statstics)

General Statistics

Adults require an average of 8 to 8.5 hours of sleep each night

Sleep problems add an estimated $15.9 billion to national health care costs

84 classifications of sleep disorders exist

Insomnia Statistics

20-40% of all adults have insomnia in the course of any year

1 out of 3 people have insomnia at some point in their lives

Over 70 million Americans suffer from disorders of sleep and wakefulness

Of those, 60% have a chronic disorder

Sleep Apnea Statistics

Over 18 million Americans suffer from sleep apnea

An estimated 10 million Americans remain undiagnosed

Over 50% of all apnea cases are diagnosed in people aged 40 and over

More prevalent in men than women

4 to 9% of middle-aged men suffer from apnea

2 to 4% of middle-aged women suffer from apnea

Narcolepsy Statistics

Affects as many as 200,000 Americans

Fewer than 50,000 are diagnosed

8 to 12% have a close relative with the disease

Affects men slightly more than women

20 to 25% of people with narcolepsy have all four symptoms
(excessive daytime sleepiness, sudden loss of muscle function, sleep paralysis, hallucinations)

Restless Leg Syndrome Statistics

Affects as many as 10% of Americans

Can begin at an early age and worsens with age

Pregnancy or hormonal changes can temporarily worsen this disorder

Children & Sleep Statistics
Over 2 million children suffer from sleep disorders

Estimated that 30 to 40% of children to not sleep enough

Children require an average of 9 to 10 hours of sleep each night

Women & Sleep Statistics
Women are twice as likely as men to have difficulty falling and staying asleep

Pregnancy can worsen sleep patterns

Menopause and hormone changes cause changes in sleep

Older Adult Statistics
Over half of those over the age of 65 experience disturbed sleep

Those over 65 make up about 13% of the US population, but consume over 30% ofprescription drug and 40% of sleeping pills

10 COMMANDMENTS OF SLEEP HYGIENE

1. Set a consistent bed time and an awakening time.
2. If you are in the habit of taking naps, try not to exceed 45 minutes of daytime sleep.
3. Avoid excessive alcohol ingestion four hours before bedtime and do not smoke.
4. Avoid caffeine six hours before bedtime. This includes coffee, tea and sodas, as well as chocolate.
5. Avoid heavy, spicy or sugary foods four hours before bedtime. A light snack before bed is acceptable.
6. Exercise regularly, but not right before bed.
7. Use comfortable bedding.
8. Find a comfortable temperature setting for sleeping and keep the room well ventilated.
9. Block out all distracting noise and eliminate as much light as possible.
10. Reserve the bed for sleep. Don’t use the bedroom as an office, workroom or recreation room

IMH SLEEP CLINIC(MIND WELLNESS CLINIC)

We are here to Identify, Assess, and Advice

Dr.Shaju George
Specialist psychiatrist
International modern hospital
Mind Wellness Department
Burdubai,Dubai
Appointments : 971 4 406 3000

Vitamin D deficiency

Vitamin D deficiency

Why children and adults need vitamin D

Children need vitamin D for bone growth and development. So do babies developing in the womb. This is because vitamin D helps us absorb calcium,
Serious vitamin D deficiency can cause Rickets, delayed motor development, muscle weakness, aches and pains, and fractures.

Vitamin D deficiency in adults has also been linked to osteoporosis, some cancers, heart disease and diabetes
If women don’t get enough vitamin D during pregnancy, their children might develop neonatal hypocalcaemia (not enough calcium in the blood) or rickets later in childhood.

Vitamin D and sunlight

You need sunlight on your skin for your body to make vitamin D. You get about 80% of your vitamin D this way.
No matter where you live, you have to be careful about how much sun you get on your skin. Too much sun can lead to sunburn, skin damage and even skin cancer.

Other factors affecting how much sun you need

People with naturally very dark skin need 3-6 times more sun to make vitamin D than the amount fair-skinned people need.
It’s important to note that there is no conclusive Australian or New Zealand data on how much sun children need for good levels of vitamin D.
To get more information and advice about how much sun is right for you, speak with your GP.

Be sun smart

Spending too long in the sun isn’t good for your skin, so it’s important to use sun protection.
During summer, especially between 10 am and 4 pm, make sure your child is safe in the sun with sunscreen, a hat, sunglasses, clothing that keeps the sun off and access to plenty of shade.

Vitamin D and food

Most children won’t get enough vitamin D from food alone.

But food with lots of vitamin D can add to the vitamin D your child gets from sunshine.

Foods naturally containing vitamin D include fresh fatty fish (salmon, herring, mackerel and sardines), liver, mushrooms and egg yolks. Some of the best food sources of vitamin D:

• 1 ounce salmon: 102 IU
• 6 ounces fortified yogurt: 80 IU
• 1 ounce canned tuna, drained and packed in oil: 66 IU
• 1/2 cup orange juice, fortified with 25 percent of daily value for vitamin D: 50 IU
• 1/2 cup fortified milk (whole, low-fat, or skim): 49 IU
• one slice fortified American cheese: 40 IU
• 1/2 cup fortified, ready-to-eat cereal: 19 IU
• 1 ounce mackerel: 11.6 IU
• 1/2 large egg yolk: 10 IU
• 1/2 teaspoon fortified margarine: 10 IU
• 1/2 ounce Swiss cheese: 6 IU

The amount of vitamin D in a food varies somewhat, depending on the brand of the product.

Some foods have vitamin D added to them. These include margarine and some low-fat milk and dairy products. All infant formula contains vitamin D.

You can boost the benefits of being out in the sun for a little while each day by doing some physical activity while you’re there. This is because daily exercise helps your body make vitamin D.

Vitamin D deficiency

Children might be at risk of vitamin D deficiency if they:

• keep all their skin covered
• spend most of their time indoors and don’t get much or any sun
• have a condition affecting how the body controls vitamin D levels – for example, liver disease, kidney disease, problems with absorbing food (such as celiac disease or cystic fibrosis and some medicines can affect vitamin D levels
• have darker skin
• have been breastfed for a long time and have a mother whose vitamin D is low.

Signs of vitamin D deficiency include rickets, delayed motor development, muscle weakness, aches and pains, and fractures.

How much vitamin D does my child need?

Infants up to 12 months old need 400 international units (IU), or 10 micrograms (mcg), a day. Children older than 1 need 600 IU, or 15 mcg, a day.

Treating vitamin D deficiency

Talk with your Pediatrician if you’re worried about your child’s vitamin D levels, or you’re pregnant and think you might have low vitamin D.

Your Pediatrician can order a blood test, which is the best way to check vitamin D levels.

For mild deficiencies, your Pediatrician might say that your child needs to get a bit more sun.

If you or your child has a severe vitamin D deficiency, your GP might say you or your child should take vitamin D supplements, as well as getting more sun.

If you or your child can’t get more sun, the pediatrician might say that taking vitamin D supplements is the best thing to do. You might take a vitamin D supplement in one large, single dose, or you might take a supplement for several weeks or month.

Solariums aren’t recommended as way to improve vitamin D levels or to treat vitamin D deficiency. Solariums can cause skin cancer.

Vitamin D, pregnancy and breastfeeding

A baby’s vitamin D stores go up during development in the womb and go down after birth until the baby starts getting vitamin D from sunlight along with diet.
If a pregnant woman has low levels of vitamin D, she might not pass on enough vitamin D to her baby.
Breastfeeding babies don’t get much vitamin D from breast milk, because breast milk doesn’t have much. And if a breastfeeding mum has low vitamin D, it can be even harder for her baby to get enough vitamin D.
If you have any concerns about whether your baby is getting enough vitamin D, you can talk with your pediatrician about using a vitamin D supplement. Doctors often say a daily supplement of 400 micrograms is good for mothers who are breastfeeding babies at risk of vitamin D deficiency.
It’s still OK for you to breastfeed your baby if you’re taking a vitamin D supplement.
Infant formula has higher levels of vitamin D, so formula-fed babies don’t usually need a supplement.

Iron deficiency anemia

Anemia is one of the commonest illness found in both adult and children .
Most common anemia in children is Iron deficiency anemia and more than 1/3rd of world population is affected by Iron deficiency anemia.

Iron Deficiency Anemia

What is Anemia?
Anemia is defined by reduction in Hb Concentration, Hct Concentration or RBC count
• WHO criteria is Hb < 13 g/dl in men and Hb < 12 g/dl in women

• UK : Hb<13.5 g/dl or Hct<41% (M)
Hb<12 g/dl or Hct<37% (F)

• Pregnancy
11/10.5/10g/dl

Iron rich foods

High iron sources
• Iron fortified cereals and other foods
• Organ meat like liver and kidney
• Shell fish
• Prune juice

Moderate iron sources
• All bran cereal
• Dried beans and peas
• Beef, lamb, chicken
• Dried peaches, prunes
• Peanuts, nuts, sun flower seeds (not recommended <3 yrs because of risk of choking)
• Raisins
• Green leafy vegetables

Preventive Measures
• Ensure iron rich food in the diet
• Mixing heme and nonheme source – increases absorption of non heme iron
• Give vitamin C rich foods along with iron rich food
• Try to avoid iron inhibitors along with iron rich foods
• The phytates can be significantly reduced in beans by soaking them overnight in warm water and discarding the water before cooking them.
• Avoid drinking tea within 2 hours of a meal
• Avoid taking iron rich food along with milk or calcium supplements
• Avoid cow’s milk before 1 year of age
• Restrict unmodified cow’s milk to less than 600ml/day for children above one year
• Follow the guidelines

CDC Guidelines for Prevention
• For girls ages 12-18 years and non pregnant women of childbearing age : Screen every 5 years Screen every 1 year if risk factors

• Pregnancy : Low dose (30 mg/d)at first prenatal visit
Screening for ID at first visit

• Men and postmenopausal women: No routine screening IDA : complete evaluation

Dr. Anil Grover
Dr. Anil Grover,
MBBS,MD
Specialist Internal Medicine
Appointments Call : 971 4 406 3000

Guidelines for Prevention of Adult Heart Disease in Early Life

A family at risk = a member with:
Myocardial infarction(heart attack) before age of 60
Hypertension or Stroke
High level of LDL
Low level of HDL
Obesity
Adult-onset diabetes
Smoking habit

Risk Reduction Strategies

Smoking cessation
Weight reduction
Physical activity
Specific dietary interventions
Blood pressure control
Lipid control
Diabetes control
Interventions for psychologic factors
Prophylactic medication in selected patients

 

Prevention of Heart Disease with Diet and Lifestyle changes:  Attributes to Define Low-risk

1) Diet
Good fat: low saturated and trans-fat, high polyunsaturated fat, high fish oil
Good carbohydrates: low glycemic load, high fiber (whole grains)
High folate (vegetables, fruit)
2) Not currently smoking
3) Moderate alcoholic beverage drinking
4) Regular exercise
One half-hour daily (eg, 2 miles per hour walking)

5) Body mass index < 25 kg/m2 (optimal < 21 kg/m2)

Dr. Anil Grover,
MD, MBBS
Specialist Internal Medicine

 

 

10 strategies for supportive and effective assistance with school assignments


This school year, your children’s homework may be challenging for everyone. Discover which methods are best for helping them learn how to study and complete assignments.

“What’s the answer?” may be the question your child expects you to resolve. But handing over the answers will not help in the long run. Doing their homework for them will not earn them the top grades they’re seeking, even if it is tempting and seems easier.
The point of homework is to reinforce classroom material, add information, improve study habits and test knowledge. Your job is to ensure your children meet these goals in order to improve their grades and retain the knowledge. It’s the reason for education.
The following methods of assisting with homework are beneficial for developing long-lasting skills.

1. Stick with a schedule

Schedule specific times for homework—whether after school or after dinner, it should be free from television viewing, video games, texting or other social functions, even if they prefer to multitask. It’s proven that they aren’t as focused. Stick consistently with the same time and be flexible with other activities.

2. Pick a location

Whether at a desk in their room, the dining room or kitchen table, with siblings or alone, find out which space has the least distractions and is most conducive to productivity. Some kids prefer sound in the background in order to focus, but keep television, phone, internet (except for research) and other tech stuff off-limits.

3. Help them find the answer

“Look it up, you’ll remember it longer,” is a wise remark passed on over generations. Don’t do homework for your child just because you know how. Do one problem together and let them do the rest on their own. This helps them learn and problem solve, a critical skill to acquire. Show interest and be available. This improves a student’s performance.

4. Review work

Follow up to see how your child scored on an assignment and look over mistakes. Mistakes are opportunities for discussion to see if they understand the material. Suggest tips for remembering facts, use flash cards to review material or review concepts. An interactive way of learning is effective, perhaps with an older sibling or fellow student.

5. Meet with teachers

Parent involvement shows teachers that there’s a supportive environment at home that gives a student an advantage in the learning process. If your child lags behind, show concern and teachers will have suggestions to encourage your child and perhaps recommend supplemental studies with a tutor in a subject. Maybe other students don’t understand a lesson either, and the teacher needs to know a method needs reinforcement.

6. When you don’t know the answer

Ask questions. Your child’s homework is also an opportunity for you to learn. Do some research to find out the answers even though you won’t hand them over. Like a reference librarian, be a valuable resource to show kids how to research answers. Be sensitive to their needs. How do your child learn—are they a visual or audial type—by seeing or hearing or both?

7. Make a plan

Get an assignment schedule calendar. When the workload increases and kids are juggling various assignments, your support with timemanagement skills will offer valuable guidance in working through difficult tasks and completing homework. Find out about long-term projects in order to schedule and develop a work plan and get necessary supplies to avoid a last-minute rush to finish.

8. Offer incentives

Motivate children and show them how to prioritize their workload, such as studying for tests. If they receive good scores and maintain grade averages, give them certain privileges.

9. Set an example

Read books. Discuss ideas. Go to a science museum together. Augment their studies with relevant information, such as word and math games. Your actions speak volumes when advice may be ignored.

10. Offer praise

Show off work well done—a test with a high grade, an art or science project. Encourage your kids. If you show you believe in them, it builds confidence. Complimenting children gives them a sense of pride in their academic accomplishments.

Preventive Healthcare for You

Prevention is better than cure. All of us have been taught about this right since our school days and yet when it comes to practice, we seem to forget about it! Basic reason appears to be an inherent belief that “illness is not for me”, till it catches us and then we start repenting the missed opportunities and start doing what is known as secondary prevention. Let us resolve now to systematically approach our lives and start Primary and Primordial Prevention.

Prevention is a habit and has to develop in all spheres of our lives, be it wearing a helmet, fastening car seat belt properly, avoiding tobacco consumption, knowledge of safe limit of alcohol intake, safe sex, preserving proper vision, avoiding osteoporosis etc.

Broadly, ailments are divided into Communicable and Non-communicable diseases. The latter e.g. obesity, diabetes, high blood pressure, coronary heart disease, cancers etc are on the rise. Incidence of obesity and overweight is around 70% in US today! The average American waistline has increased by 3-5 cm. in last 10 years. To prevent all this, one should strictly follow a healthy lifestyle, which essentially means a balanced diet and an increase in physical activity. In a recent survey, thanks to media campaigns, in last 30 years, there has been a significant increase in physical activity from 20% to 40 % among US adults and a similar drop in smoking status! Simple measures like reducing salt intake in diet decreases incidence of strokes by 35% and heart attacks by 20%!

The earlier one starts prevention, the better are the results. It is estimated that a long-term reduction in serum cholesterol concentration of 10% (which is in the range of lifestyle change) lowers the risk of coronary heart disease (CHD) by 50% at age 40, falling to 20% at age 70.

Lots of new and effective vaccines are now available. Our awareness about vaccines is pathetically low. It is unfortunate that we do not have a Global Adult Vaccination Program.

International Modern Hospital, Dubai, has introduced, for the first time, an Adult Vaccination Initiative. It is sincerely hoped that more and more people will use these guidelines to their greatest advantage.

Needless to say, preventive health checkups are very useful in early detection of all types of illnesses and risk factors. In the preventive checkup program at Mayo clinic, 5% people were found to have a life threatening disease and another 30% had a previously undiagnosed severe disease condition.

Lately, large numbers of big corporations are encouraging their employees to undertake Preventive Health Check. There is enough data to show that employees undertaking regular health checks have 45% lesser absenteeism and their medical reimbursements are 20% less. Net return on investment for the organization, purely in financial terms, is
2.3: 1.

To conclude, preventive healthcare is for YOU. The earlier one starts, the better it is for major gains. Follow the global slogan of Sir K George Alberti, Former President of International Diabetes Federation –“EAT LESS, WALK MORE”, and of course GET VACCINATED.
Dr SUSHUM SHARMA
MD(Med),MNAMS,FICP
FIACM,FISE,FIMSA
Specialist-Internal Medicine,
International Modern Hospital, Dubai

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