Interstitial Cystitis

Interstitial Cystitis is also known as BPS or Bladder Pain Syndrome. It causes pain in the pelvis or urinary bladder, producing an urgent need and frequent need to void. This disorder commonly occurs in women.
Method of Diagnosis

In order to diagnose whether there is Interstitial Cystitis, your health care giver will use a Cystoscopy, which is a thin tube, which has a light at the end of the tube. This cystoscopy will be inserted into the bladder to enable the doctor to study the bladder for signs of interstitial cystitis. An additional test, a urine analysis may be performed to rule out urinary tract infections. 

Causes

No clear cause has been, as yet, identified. However, it is thought that the abnormal change in the lining of the bladder causes BPS. Consequently treatment is focused more on treating the symptoms, rather than the cause. 

Symptoms of BPS

The origin of the pain, which can be mild and could progress to be severe, is either in the pelvis or bladder region and often goes away after voiding. BPS also produces other symptoms such as:

• Need to frequently urinate during the day as well as in the night
• A discomfort and constant feeling of pressure on the bladder, consequently causing a feeling of a need to urinate
• Pain in the lower abdomen or pelvic region

In some cases it is possible for those affected by BPS to experience no pain for several days / weeks. 

Treatment

• Bladder Control – Note the frequency of when you urinate. Say if it is every 20 to 30 minutes. Then try holding on for another ten or fifteen minutes and then urinate. Continue this pattern for a week and slowly keep increasing the time limit to an hour, then an hour and half and finally try and bring it to 2 ½ hours. 
• Physical Therapy – A physical therapist who is trained in pelvic floor exercises, can help you with exercises that will help relax the muscles in your buttocks, groin and lower abdomen. 
• Medications – Medications both oral and insertions in the bladder may be prescribed to kill the pain and improve bladder control
• Electrical Simulations = Mild electrical pulses are used to block nerve pain
• Other forms of treatment – these other forms of treatment have helped some people – Acupuncture, biofeedback and transcutaneous electrical nerve stimulations. 
• Surgery – if none of the other treatment methods can resolve BPS, then surgery may be performed to repair the bladder or alleviate the nerve pain 

Managing Chronic BPS

• Maintain an active lifestyle which does not generate pain. Walk, perform yoga or Pilates
• If sitting for long periods causes pain then using a standing posture to do work or any other activity, may help
• Eat those foods which help avoid the pain from occurring. Spicy foods may be avoided, together with alcohol and coffee
• Lower stress levels by listening to calming music, meditate, or take warm water baths

Don’t forget to consult your doctor and follow his / her advice. 

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Types of spinal problems and treatments

The spine is made up of small bones which are placed one on top of the other. Any misalignment in these bones or the discs between them can cause spinal problems.

Common spinal problems

Lordosis - This is also referred to as swayback. This occurs when the spine curves inwards on the lower back.
Kyphosis - This occurs when the curve of the spine on the upper back is more than 50 degrees.
Scoliosis - The spine is curved sideways and can be S or C shaped.

Causes of spinal problems?

Lordosis - Causes

• Spondylolisthesis occurs when a vertebrae slips forward
• Osteoporosis happens when the vertebrae become fragile and can shatter
• Obesity
• Achondroplasia is when bones grown abnormally
• Discitis occurs when the discs between vertebrae get infected and inflamed.
•  Juvenile lordosis (occurs in children)

Kyphosis – Causes

• Poor posture
• Scheuermann's disease
• Arthritis
• Osteoporosis
• Spina bifida
• Spine infections
• Spine tumors

Scoliosis – Causes

• Hereditary
• Injury
• Infection

Symptoms of spinal problems

• Severe pain to upper or lower back
• Pain radiating down the back of the leg
• Pain in the neck or radiating to shoulders
• Sudden incontinence
• Sudden, uncontrollable bowel movement
• Unbearable abdominal pain
• Severe pain when bending or lifting things
• Pain when sitting or getting up

Different kinds of spinal surgeries
Doctors usually suggest spinal surgery if there is no other treatment. But many spinal problems can only be treated with surgery. These are usually elective. Examples of common spinal surgeries include:

Minimally Invasive / Endoscopic Spine Surgery like:

• Lumbar Microdiscectomy
• Anterior Cervical Discectomy and Fusion
• Spinal Decompression
• Posterior Cervical Foraminotomy

Congenital Paediatric anomalies like:

• Split Cord Syndrome (Diastemetomyelia)
• Lipomyelomeningocele
• Open myelomeningocele

Spinal Cord Tumours like: 

• All Intradural Spinal Cord Tumours
• Brain Stem and Foramen Magnum Tumours

Complex Spinal procedures like:

• Minimal invasive trans-thoracic discectomy
• Trans-oral and Trans-mandibular approach to anterior CVJ
• Occipito Cervical fusion and C1-2 procedures
• Degenerative scoliosis and Anterior Lumbar procedures

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Getting ready for Summer ’17 – Let’s beat the heat

On December 12th 2016, Chennai was hit by Cyclone Vardah. Trees were uprooted, and most of the city’s green cover was destroyed. It is safe to say that the city will experience one of the worst summers in known history. There is a call to arms to plant more greenery in place of what we lost to help the ecosystem of Chennai bounce back in time. But for now, we have all got to do what we can to get through the summer. Here are a few tips on how to beat the heat and save power and water, this summer.

Image Courtesy - hindustantimes.com

Keep cool

These ten tips will help you keep cool even if it feels like the sun is out to get you.

1. Keep hydrated – Constant sweating in the heat can dehydrate you. Make sure that you drink plenty of water.
2. Wear cotton clothes – Cotton absorbs sweat and is comfortable in the summer heat.
3. Eat plenty of water based fruits like watermelon, musk melon etc.
4. Eat more cooling vegetables like cucumber, pumpkin etc.
5. Drink plenty of liquids – fruit and vegetable juices, and buttermilk and tender coconut water.
6. Use a spritzer – A spritzer bottle with cold water to spray your face with is a great way to feel refreshed.
7. Cook early in the morning before it gets too warm or late in the evenings after the sun goes down.
8. Eat more fresh salads and simpler foods that need minimum cooking.
9. Avoid spicy food and baked and roasted food (Using an oven heats up the house)
10. Rubbing ice cubes on the wrist and neck (cooling points in your body) will cool you down.

Save power

Though it will be extremely warm, it is our duty to avoid using too much power for coolers and air conditioners. Instead of running the units the entire day, once you cool down the room with air conditioner, try these tips:

1. Put wet curtains on the window.
2. Keep bowls of water in the room. This keeps the room cool.
3. Put thattis outside your windows and wet them.
4. Splash a little water on the terrace over the room.

Save water

Yes, we do use more water in the summer, but we can help conserve water in small ways.
1. Make sure that you don’t have leaky taps or faucets.
2. Use a mug to dispense water when you brush your teeth or wash your face rather than keep the tap running.
3. Don’t shower. Fill water in a bucket and bathe using a mug.
4. Don’t use sprinklers in the garden. Water the garden using a pipe.
5. Make sure that your building has rain water harvesting.
6. Wait for clothes to pile up and do one large load rather than many small loads of laundry.
7. Make sure to keep an eye on the water pump when pumping to the overhead tank and ensure that it doesn’t overflow.
8. Have a water butt on the overhead tank drainpipe to catch any overflow which can be used for the garden.

Hopefully, with a little care, we can get through the summer in an environmentally friendly way!

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Doctor, I have heard about the harmful impact of Meningitis. Could you give me a clear picture of this illness?

Meninges are the three membranes that cover and protect the brain and the spinal cord. Meningitis is the inflammation of the meninges caused by injury or infection. There two types of meningitis: the first is caused by a virus and the second by bacteria, the latter being the more virulent. Infections caused by viruses most often get better on their own, but if infected by bacteria, it is very important to seek treatment immediately. Bacterial meningitis can cause death or brain damage unlike viral meningitis.

In addition to the viral and bacterial types, meningitis can also be caused by the following triggers:

• Parasites
• Fungi
• Chemical irritations
• Tumours

There are many types of viruses which can cause meningitis, some of which include:

• Enteroviruses (which cause intestinal illnesses as well)
• West Nile Virus – spread by a species of mosquitoes causing viral meningitis
• Mumps and HIV viruses – cause a type of meningitis called aseptic meningitis
• Herpes virus – causes Herpes meningitis. This is the same type of virus that causes genital herpes and cold sores, though people with cold sores or genital herpes do not necessarily develop meningitis.

Late summer, into the East Monsoons is generally the time when viral meningitis may occur. Children and adults under the age of 30 are the most vulnerable to an attack of viral meningitis.

Symptoms to watch out for:

• Severe headache
• Fever and shivers (particularly in children and newborns)
• Agitation
• Changes in mental status
• Photophobia
• Meningismus (stiff neck)
• Vomiting and Nausea
• Decreased alertness
• Rapid breathing
• Head and neck arched backwards
• Bulge in the fontanelles in babies (soft spot on the skull)

If you observe one or more of these symptoms, or suspect that it could be an attack of meningitis, then consulting a doctor immediately and seeking urgent medical treatment is very important.

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Dealing with Sports Injuries

With people getting into fitness in a big way, sports injuries have gotten more common. Some injuries that occur often are:

• Shin splints
• Knee injuries
• Groin pulls
• Hamstring injury
• Shoulder and neck strains
• Ankle sprains

What causes sports injuries?

Apart from fractures which are injuries to the bone, injuries occur to ligaments and tendons.

Ligaments injuries - Ligaments are the elastic bundle of tissues connecting bones and they stretch and retract when the joints bend. Too much strain on them can tear or snap them, leading to many knee and ankle injuries.

Tendon injuries - Muscle fibres, also called tendons are bundles of tissues which attach muscle to bone. When they are stretched too much they can twist and tear.

Treating common sports injuries

If the injury is mild, the most useful treatment is the RICE treatment.

R - Rest

I - Ice

C - Compression

E - Elevation

When you feel pain or there is swelling after a particularly strenuous work out or game, using the RICE treatment and resting the area can alleviate pain.

When to see a doctor

• If the pain has not subsided in a day or two

• If the pain increases

• If the swelling doesn’t come down

• If unable to move the limb

Preventing sports injuries

• Make sure that you warm up well before starting the activity (Warming up increases blood flow)
• Increase the activity at a gradual pace (Don’t do a 100 squats on Day 1-your body isn’t ready for it)
• Stop when you know you are straining your body
• Use protective gear like helmets, knee and ankle guards etc.
• Cool down after a game (Your stretched muscles need it)
• Don’t play when you are injured

By being careful, you can ensure that you can do sports activities longer and with less chance of injury.

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World Health Day 2017 – “Depression, Let’s Talk”

“A healthy outside starts from the inside” – Robert Urich

April 7th, 2017 is World Health Day and this year the theme is a topic that many are still unwilling to talk about and others are sceptical of, depression. People associate the term with mental disorder and insanity and do not like to admit that they are suffering from depression. This year, the World Health Organization has decided to help raise awareness about depression and how talking about it can help people get through it.

In other countries, help for people who are suffering from depression is available more easily as the topic has been in the forefront for a while now. Indians still hesitate to come out in the open and talk about their problem. It has taken the courage of certain celebrities to bring this illness out in the open and the fact that they are talking about it openly and admitting that they are suffering has helped raise awareness. Earlier, people dismissed those suffering from depression as seeking attention or making up problems. 

“Get over it”, was the attitude. Instead of helping them by listening, they have had to suffer alone and in silence. The now famous open letter by Deepika Padukone has changed people’s opinion. 

James Chau, an internationally renowned news presenter and ambassador for WHO has released this touching video about his personal fight against depression, as a lead up to World Health Day - https://www.youtube.com/watch?v=Jo0NHx2MIk8&feature=youtu.be

It’s time to talk about depression

On World Health Day, hospitals, NGOs and support groups in India will join in the effort to raise awareness and have events where current health concerns and topics will be discussed. This year, among other concerns, panels will be discussing depression and how organizations can help. So, in keeping with this year’s theme if you are suffering from depression or know someone who is, let’s talk!

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Kidney Stones – Causes, Symptoms and Treatment

A kidney stone is a hard, crystalline substance formed in the kidney or urinary tract

What causes kidney stones?

• Not drinking adequate amounts of water
• Accumulation of dissolved minerals in the kidney
• Calcification in kidneys or urethra
• Decreased urine output
• Diet and hereditary factors
• Medication or supplements

Symptoms of presence of kidney stones

• Unbearable pain in the groin or on the side above the thigh
• Traces of blood when passing urine
• Vomiting and nausea
• Pus when passing urine
• Decreased urine output
• Burning sensation when urinating
• Persistent urge to urinate
• Fever
• Chills
• Infection
• Incontinence

Treatment for kidney stones

• In mild cases, when the stones are small, they could be flushed out with constant hydration (Pain management may be needed)
• Lithotripsy – In this treatment, a shockwave is sent into the kidney stone to break it up into smaller pieces (Pain management and anti inflammatory treatment may be needed)
• Large stones which do not respond to above treatment may need surgical procedures like percutaneous nephrolithotomy (removing stone through an incision in the back) or ureteroscopic stone removal (removing stone by inserting a thin tube into the urethra)

Preventing occurrence of kidney stones

• Drink adequate amounts of water (at least 8 to 10 glasses a day)
• Sip water throughout the day
• Consume less oxalate-rich foods
• Maintain a low sodium diet
• Decrease protein rich foods
• Consult with doctor on calcium supplements

Risks associated with kidney stones

1. Kidney stones have the chance of re-occurring.
2. People who are prone to kidney stones have a higher risk of other kidney problems.

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What is geriatric rehabilitation?

People are living longer. The average mortality rate has gone up by almost twenty years over the last century. Advancement in technology, medical procedures and treatment has made this possible. The need now is to make sure that the quality of life for the aged doesn’t degrade. That is the purpose of geriatric rehabilitation. It offers the aged a means to live a quality life for as long as they can.

How does geriatric rehabilitation help?

Communication, movement and non impairment of mental faculties are what the aged require. As people get old, their hearing and eyesight become impaired. Their movement may get restricted due to wear and tear in the joints, osteoporosis and other age related factors. Another cause for concern for geriatrics is malnutrition. Older people need an excess of certain nutrients to balance their health. Good nutrition promotes healing and provides energy and improves quality of life. Life slows down for the aged, and for the active, this can lead to a feeling of not being a useful contributor to society. This, in turn, can lead to depression. Hence, attending to the mental health of geriatrics is as important as managing physical health. 

Different kinds of geriatric rehabilitation

The geriatric rehabilitation includes a wide range of treatments and medical help for a variety of ailments that the aged face.

1. One of the major problems that geriatrics deal with is decrease in movement. Earlier, stiffness in the joints, and aches and pains were taken as part and parcel of getting old. But these days, with joint replacement procedures, and physical therapy the aged can get past these problems.

2. Loss of hearing and vision can be addressed these days with simple procedures like laser treatment, advanced hearing aids etc., that help restore or at least better eyesight and hearing. 

3. There are specialized dieticians for geriatrics who will prescribe a food plan that includes foods and supplements to ensure that they are getting all the nutrients their body requires. 

4. As a person ages, small activities like eating or bathing become difficult. Occupational therapy focuses on helping the aged stay independent. The goal is to help them learn to help themselves.

5. The awareness among doctors and the aged that geriatric mental health needs to be addressed is a boon to the aged. Counselling is available for older people and this can help them adjust to a difference in lifestyle.

Focused geriatric attention

Many hospitals have geriatric departments which focus completely on geriatric health and rehabilitation. They take a holistic approach to the health and wellness of the aged. They have regular medical check-ups for older people and a complete and comprehensive battery of tests that will keep an eye on the person’s health so that preventive action can be taken at the first sign of an illness. This is a boon to the patients as they can live their life comfortably in the knowledge that their health is in safe hands.

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Nutrients older people need for health and wellness

As people get older their metabolism changes, there is a decrease in hormones produced in the body and they need a well balanced diet with enough supplements to stay healthy

A healthy geriatric diet plan should include:

• A variety of fruits(for vitamins and fibre)
• A variety of vegetables(for vitamins and fibre)
• Meat or lentils(for proteins)
  *Meat eaters should stick to lean meat to ensure that they get proteins without the calories
  *Vegetarians should have a large helping of protein rich foods like lentils
• A sufficient quantity of milk
• Water

*Older people have less muscle mass and so they need less calories in the food they eat. They also metabolize food slower and hence it takes them longer to burn calories. The amount of activity they do is less and they should have a low fat diet to prevent them putting on weight.

Geriatric diet supplements: Why?

• The aged absorb nutrients from food at a slower rate.
• The amount of nutrients required by geriatrics increases
• Due to their age, geriatrics require certain supplements that is not easily available in the food we eat

Necessary supplements for geriatrics include:

• Omega 3 Fatty acids: Decreases the risk of heart disease, cancer and arthritis (found in flax seeds, walnuts, and fish)
• Calcium: Preserves bone health and it lowers blood pressure (found in milk and dairy products. For the lactose intolerant, there are fortified non-dairy milks like almond or soy, and fortified orange juice)
• Potassium: Keeps bones strong. Antidote for depression, reduces blood pressure and risk of kidney stones (found in bananas)
• Magnesium: Helps the immune system and the heart. Older people sometimes use diuretics and this flushes out the magnesium in the body (found in dried fruits, and leafy vegetables)
• Fibre: Helps digestion. As people age, digestion and ridding the body of waste becomes difficult (found in fruits and vegetables)
• Vitamin B12: This is important for the red blood cells and for maintaining nerve function. This may have to be taken as a supplement as fresh food does not contain enough.
• Folate/Folic Acid: Prevents anaemia. Certain vegetables are rich in folates but geriatrics may need to take a supplement
• Vitamin D: This helps maintain bone density, helps the body absorb calcium and prevents osteoporosis.

*Young, healthy adults get their dose of Vitamin D naturally from the sun. But as we get older, due to lifestyle and decrease in the rate of absorption, the Vitamin D in the body gets less and will have to be supplemented. 

Tip: Consult your physician before you pop in supplements. 

Diet tips for geriatrics

• Lessen salt in food
• Avoid very sugary treats
• Keep hydrated
• Have smaller, more frequent meals
• Have an early dinner
• Sip water through the day
• Avoid fatty food and deep fried food

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Difficulty in breathing - What it could mean and emergency response

Breathing - The process

When we take a breath, we take in oxygen through our nose, down the trachea, through the bronchi and into our lungs. It helps our body take in oxygen and other gases and disperses it into the bloodstream and it absorbs and expels carbon dioxide. A number of small processes using different parts of the respiratory system make this intricate process work. A problem with any one of these processes could result in difficulties in breathing.
What are the common causes for breathing difficulties?

Sometimes the cause of a breathing problem could be congestion due to a simple cold, sinusitis, a mild allergy or asthma. This can be eased with inhalation and medication at home. But since breathing is an important process, a severe cold or wheeze could necessitate hospitalization and more aggressive treatment.

Serious causes of breathing difficulties could include:

• Congestive heart failure
• Respiratory infections like pneumonia, croup, and whooping cough etc.
• Chronic obstructive pulmonary disease
• Pericardial or pleural effusion.
• A very severe allergic reaction could cause the throat to swell up, and block it, preventing breathing.

In these cases, emergency response and immediate hospitalization would be required.

Emergency response

Remember that any sort of breathing difficult should always be treated as an emergency. The first response is to call a hospital and get an ambulance. While you wait for the ambulance here are some things that you should do and should not do.

1. Loosen the clothing (Tight clothing can restrict breathing. Check the under clothing too)

2. If there is prescribed medication that has to be taken in an emergency, administer it immediately (Sometimes the person may just need a puff from their inhaler to free the airway)
3. Make them sit up straight. This extends the respiratory tract and frees the airway.
(Never make them bend over or put a pillow under their heads as this restricts air flow)

4. Check to see if they have any other accompanying symptoms like nausea or dizziness, pain, sweating, rapid heartbeat or wheezing. (This could explain the reason for the breathlessness and if they faint on the way to the hospital or are unable to articulate the symptoms, you can notify the doctor)

5. Do not give them food or anything to drink if they are in severe distress

6. Check to see if there are any open wounds
(If there is an open wound and bleeding, especially in the head and neck, and if bubbles appear, staunch the blood flow at once and apply a bandage. Try to do this without moving them)

7. Check for visible rashes. You can inform the doctor as soon as you reach the hospital

8. In severe cases, you may have to do CPR till the ambulance gets there

It is important to call an ambulance from a hospital as it will be better equipped and will arrive with experienced medical staff that can monitor the patient along the way.

Accompany the ambulance to the hospital so that you can update the doctor on what happened and if any help or medication was given. Carry the patient’s medical records with you, so the doctors on call can check the patient’s medical history before starting treatment.

Image Courtesy - Reference.com

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Fire Accident - Emergency Procedures

Types of fire accidents

• Kitchen accidents like burns from hot liquids, steam, hot oil, gas explosions
• Fire due to faulty appliances from heaters, irons, faulty wiring etc.
• Smoking – related fires
• Burns due to chemicals, radiation and electric current

Categories of burns

The category of a burn depends on the severity of tissue damage.

1. First degree burns symptoms

• They are superficial
• There may be swelling, redness, pain
• There may be small blisters
• Appearance of white skin around the burn area

Emergency response

• Remove clothing from around the affected area
• Pour cold water over affected area till burning subsides (this reduces the chance of blisters)
• Pat dry and apply a topical antibiotic prescribed for burns (do not rub dry-you could peel away skin)
• It is better to see a doctor and get the wounds checked and to take a tetanus vaccination

2. Second degree burns symptoms

• The burned area stretched to the dermis
• There may be swelling, redness and pain
• Large blisters may form, which may ooze liquid
• There could be scarring and tightening of skin
• Dehydration may occur
• Movement may be restricted if it is around a joint

Emergency response

• Remove clothing from around the affected area
• Keep the area dry/ use sterile cotton to avoid infection
• Keep the burnt area raised to avoid swelling
• Keep the injured hydrated
• Take the injured to the emergency care in a hospital immediately or call for an ambulance

3. Third degree burns symptoms

• The damage goes through all three layers of skin
• Nerve endings may get damaged causing lack of pain
• Will not turn white and there will be no blisters
• Skin may be discolored and becomes leathery
• Injured could go into shock
• Dehydration may occur

Emergency response

• Do not move the injured
• Do not give the injured anything to eat or drink
• Do not try to remove clothing. You may inadvertently remove skin
• Call a hospital ambulance as the injured may need emergency assistance on the way to the hospital
• Take the victim’s medical records and inform the doctor of the precise nature of the accident

Tips to prevent fire accidents

• Get your gas cylinder checked when it is delivered and get the pipeline checked regularly
• Get the wiring in your home checked in case of water damage or leaks
• Make sure your appliances are working properly
• Stop smoking or be careful with smoking accessories

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Geriatric Health Care

Thanks to advances in medicine and health care, people today are living longer than ever before and their senior years can be active and fulfilling. However, that does not mean that your body is the same now as it was when you were 20. Your body has changed over the years, often in ways you do not notice or realize. Just as there are medical specializations dealing with children’s’ health, women health, sports medicine and so on, there is also a specialization in the health of senior citizens. It is known as geriatric medicine and it focuses on the medical issues and diseases associated with aging.

The Problems With Aging

As you age, you will find that there are activities that you could easily do in the past that are now becoming increasingly difficult. Generally speaking, this is normal and not a cause for concern. However, because your body is aging, they could also be signs of health issues that need to be addressed to prevent them from escalating into more serious concerns. Remember, an older body is less able to fight off and recover from sickness and injury than a younger one.

There are some health issues that are common as you age. Getting regular checkups from a geriatric specialist will allow for treatment to begin early so as to minimize the effects and maximize the speed and quantum of recovery. Among these are:

•          Arthritis
•          Osteoporosis
•          Vision loss
•          Hearing loss
•          Heart disease
•          Constipation and incontinence
•          Cognitive impairment
•          Balance and equilibrium issues
•          Respiratory diseases
•          Cancer
•          Diabetes
•          Obesity
•          And more

Age Is Not Just A Number

Common sayings like “You are as old as you feel” and “Age is just a number” reflect the active lives that seniors now live. But they are only partially true.  If you are near or over 60, your body has changed and its medical needs are different. Getting the health care you need from a specialist in geriatric medicine will enable you to remain as active as possible and assist in the recovery from sickness and injury. Listen to your body and when the signs of problems arise, have them checked up. Often there may be signs of age-related problems that you may not notice but which your family members do. Listen to what they have to say and consult a geriatrician. The signs of aging are not things to be frightened of or hidden. They are part of the natural life cycle. With the right medical care and treatment, controlling them and living a comfortable and active life is possible.

If you are over 60, your primary health care should be given to a geriatric specialist. He will be able to evaluate your health based on age-related factors and prescribe the treatment that is right for you or, if required, refer you to a specialist. A hospital with a specialized geriatric care clinic will offer the most comprehensive health care for senior citizens to enable them to maintain, and often improve, the quality of their lives. 

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Food Poisoning - Causes, Symptoms, and Treatment

How does food get contaminated?

Food can get contaminated at any time from harvesting, processing, shipping or even when it is being prepared. Cross contamination which is the transfer of harmful bacteria from one surface to the other is quite often the cause. The popular belief that food cooked at home cannot cause food poisoning is erroneous. If not washed or prepared well, even home cooked food can be harmful.

Tips to prevent food poisoning

• Wash all fresh foodstuffs well 
• Make sure that canned food is well within its expiry date
• Keep raw food and canned food separate
• Refrigerate food if you plan to eat it later
• Make sure food is fully thawed when reheating
• Pick good restaurants when you eat out
• Don’t eat food from road side carts
• Carry water with you when you go out
• Make sure that the food prepared at home is cooked well

Foods that can cause food poisoning

• Meat and poultry that are infected
• Raw or undercooked eggs
• Canned food that have not been packaged well
• Shellfish and seafood can be contaminated by chemicals in seawater
• Leafy vegetables can be ridden with worms
• Fresh vegetables that have been sprayed by pesticide
• Milk and milk products that haven’t been processed well

Symptoms of food poisoning

• Diarrhoea
• Nausea and vomiting
• Fever
• Stomach cramps
• Blood in vomit or stools
• Headache

Most at risk

• Infants and young children: Immune systems may be more susceptible
• Geriatrics: Older people may have compromised immune systems
• Pregnant woman: Hormonal changes cause them to be risk prone to food poisoning
• People with illnesses are weaker and their immune system may be compromised

*This doesn’t mean that healthy adults don’t get affected. Anyone can fall prey to food poisoning if they don’t take precautions

Immediate treatment

• Keep the person hydrated. Water with electrolytes should be given at regular intervals. It is important to flush out the system
• Bland food with less oil should be given.
• Food stuff high in acidity should be avoided
• Rest is essential since dehydration can cause fatigue

If the person has any of the following symptoms, they should be taken to a hospital:

• Blood in stools
• Increased heart rate
• Fainting or dizziness
• Decreased urination
• Difficulty in breathing
• Diarrhoea and vomiting for more than a day
• Extreme dehydration
• High fever

At the hospital:

• Give the attending doctor a list of things that the person ingested the day before. It can help narrow down the cause and help decide treatment
• Let the doctor know if the person is allergic to anything specific
• Give the doctor the history of what treatment was given before bringing the patient to the hospital.

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Benefits of Joint replacement

When to consider joint replacement?

You should consider joint replacement

• When stiff joints restrict movement
• If there is considerable pain in the joints
• If normal day to day activities are restricted
• If you have to depend on others for routine tasks
• If pain medication and physiotherapy doesn’t help
• If you quality of life is decreased in any way

Procedure for joint replacement

In a joint replacement surgery

• the damaged cartilage and corresponding bone will be removed from the joint.
• a prosthetic component will replace the original bone.
• the prosthesis will be in the shape of the natural joint and will move as easily.

Types of joint replacements

• Total Hip Replacement
• Total Knee Replacement
• Unicompartmental Knee Replacement
• Shoulder Joint Replacement
• Reverse Total Shoulder Replacement
• Total Elbow Replacement
• Wrist Joint Replacement (Wrist Arthroplasty)

Benefits or joint replacement

• Increased Mobility: Stiffness due to injuries or arthritis or age will be relieved
• Pain relief: There is considerable decrease in pain to no pain at all
• Independence: Dependence on others decreases as the person is able to handle activities on their own without stiffness or pain
• Less expenditure in the long run: Weigh the cost of the surgery against years of doctor’s bills and physiotherapy and you will find that replacing the joint is less expensive.

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Advantages of choosing a hospital with an ICU

What is an ICU?

The acronym ICU stands for Intensive Care Unit. These are special hospital areas to look after people who are very ill. The ICU staff will be specially trained to handle emergencies and the room is usually secluded from the usual hustle bustle of the hospital. 

Why is it important to choose a hospital with an ICU in case of an emergency?

An ICU is different from other units of a hospital. It is a much more specialized place where

1. Seriously ill patients are closely monitored
2. Special equipment is available to aid in patient monitoring, stabilizing and recovery
3. Specially trained nurses work around the clock
4. The ratio of nurse to patient is 1:2 usually
5. There are resident doctors on call around the clock 

What kind of facilities does an ICU have?

Usually the equipment in an ICU would include:

• a ventilator (This is a machine that helps with breathing. It uses a tube that is placed in the mouth, nose, or through a small cut in the throat)
• monitoring equipment ( These are used to continuously monitor heart rate, blood pressure, the level of oxygen in the blood and other organ functions)
• IV lines and pumps (These include tubes that will be inserted into the vein to provide blood, fluids and medication)
• feeding tubes (Most patients in the ICU may be unable to eat normally, so tubes will be inserted in the nose, or through a small cut made in the tummy, or into a vein to ensure that the person gets adequate nutrition)
• drains and catheters (Patients may be unable to release bodily waste normally and hence drains are tubes are used to remove any build-up of blood or fluid from the body)
• other equipment like dialysis machines for patients with kidney failure, ECMO for people with heart failure etc.
• some types of movable equipment like scanning and X-ray machines may also be brought to the room for use. 

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Don't let your scars define your life

In a world that reveres perfection in every form, living with scars can be quite difficult. Very often, scars are caused by accidents and can be a depressing reminder. It is not necessary to live with this memory. With a little help, most scars can be removed easily and efficiently.  Most people view plastic surgery as an all cosmetic procedure used to pander to vanity. That isn’t so. Plastic surgery is a boon to people who have lived with scars that have made them shun social contact and lead reclusive lives. 

Why do we get scars?

Scarring is actually the skin’s way of healing and is a good thing. Unfortunately some of us scar worse than others. There are a few lucky people for whom scars fade away without leaving a mark, but for most of us, scars are an ugly reminder.

Types of scars

• Keloids: When your skin heals aggressively, this is the type of scar that you could end up with. These scars not only cover the area of the wound but may extend over it, making the scar larger, darker and bulbous. Sometimes, in particularly large scars, keloids can even hamper movement.
• Contracture scars: These are caused by burns and when healing, contract tightening the skin. The area around the skin also gets wrinkled due to the stretching of the skin.
• Hypertrophic scars: These are like keloids but are not bigger than the injury.
• Acne scars: There are a variety of acne scars and the scars depend on the severity of the acne. They can range anywhere between deep pit like holes, to blackish facial blemishes, depending on the type of acne.

Procedures to remove scars

Many over the counter treatments promise to remove scars, but these work mostly on mild facial scars caused by pimples. These usually fade away over time with or without the help of topical creams. But most deep scars need more aggressive procedures. Some of the most common procedures include:

• Dermabrasion: This is basically like exfoliating your skin. The procedure peels away old skin, so that fresh healthy skin replaces it. Along with the peeled skin, surface scars can be removed. This is used mostly for superficial scars.
• Laser surgery: If the scars have penetrated several layers of skin, laser surgery could be the solution. It is painless and quick and once the skin heals, your skin will be unblemished.
• Plastic surgery: If you have very bad scarring, you may need to have plastic surgery, which may include skin grafts, where layers of healthy skin from other parts of the body are used to cover the scars. This is a more complicated procedure, but is well worth it.

Plastic surgery for scar removal
The type of surgery for scar removal would depend on the scar.

• Scars may be raised or recessed
• They could be different in color or texture from surrounding healthy tissue
• They could be particularly noticeable due to their size, shape or location.
• Your general health and age would also be considered when making a decision.

Usually, plastic surgery will be an in-patient procedure, though if you are responding well, your hospital stay won’t be too long.

Before making the decision to have plastic surgery, do some research, talk to the doctors to get all your questions answered, so that you know what the procedure is and what to expect. With the right hospital, experienced doctors and safe procedures, you can kiss your scars goodbye.

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The Importance Of Choosing The Right Hospital After An Accident

Before calling the hospital:

• The first thing you should do if you are involved in an accident is to check if you are unhurt and can move without much pain.
• If there are others in the vehicle who may be injured, try not to move them, but check to see if they are responding by calling out to them.
  
  (If the accident has occurred in a populated area, there will probably be people around whom you can approach for help. If you are in a remote area, you may have to flag down a passing car for help) 

The next task and an important one is choosing the right hospital.

Many people mistakenly call doctors they know or their general physician after an accident. Most of the accident victims need a hospital even if they seem uninjured and this includes you. In a well-equipped hospital, the medical staff would be able to assess the injuries with the required equipment and decide on the best course of action. This is why the hospital you pick is important.

Some hospitals specialize in certain departments. So, if there is a head injury, a hospital with a neurosurgery department is important. For badly broken bones, a good orthopedic department is necessary. If there are kids involved, they should be taken to a hospital with a good pediatric wing. If a pregnant woman was one of the injured, a neonatal wing in the hospital is a wise idea.

Why a multi-specialty hospital?

• Multi-specialty hospitals deal with a variety of issues.
• These hospitals have many departments, each with experienced doctors, who are specialists in their field.
• Another advantage of multi-specialty hospitals is that specialists can consult with one another.
  
  (For example, if the accident victim has heart problems and a head injury, they may need to consult with a cardiologist and a neurologist. The patient does not have to be moved to consult the different doctors)
  
• The tests done on a patient are also available on the hospital database and the doctor can pull them up on their screen to study them. 
• In the OR, if an emergency consult is needed due to some unforeseeable problem, a specialist is only minutes away and can get to the operating room in no time at all, to pitch in. 

Amenities the hospital should have:

1. Testing equipment like scans, MRI etc. So, all tests can be done in the hospital, minimizing moving the injured patient. (Since the testing is in-house, the results will be given swiftly in case of an emergency if the consulting specialist requests for it. Any follow up tests can also be done in the same place, making sure there is no location discrepancy.)

2. Well-equipped Operation Theatres.

3. Well-equipped and well-staffed ICU (This is vital because most accident victims more often than not need to be kept in an ICU till they are stable.)

4. A good laboratory (Microbiology, Biochemistry, Pathology) Department
As you can see, it is absolutely important to get an accident victim to a good hospital to make sure that they receive the best possible care.

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