Articles on disease

Non-Alcoholic Fatty Liver Disease (NAFLD)

Dr. Naman Ajudiya, Ayurveda
Non-alcoholic fatty liver disease (NAFLD) is the term for a range of conditions caused by a build-up of fat in the liver. It's usually seen in people who are overweight or obese. A healthy liver should contain little or no fat. It's estimated that up to one in every three people in the UK has early stages of NAFLD where there are small amounts of fat in their liver. Early-stage NAFLD doesn't usually cause any harm, but it can lead to serious liver damage, including cirrhosis, if it gets worse. Having high levels of fat in your liver is also associated with an increased risk of problems such as diabetes, heart attacks and strokes.If detected and managed at an early stage, it's possible to stop NAFLD getting worse and reduce the amount of fat in your liver.  NAFLD develops in four main stages. Most people will only ever develop the first stage, usually without realising it. In small number of cases it can progress and eventually lead to liver damage if not detected and managed. The main stages of NAFLD are Simple fatty liver (steatosis) – a largely harmless build-up of fat in the liver cells that may only be diagnosed during tests carried out for another reason non-alcoholic steatohepatitis (NASH) – a more serious form of NAFLD, where the liver has become inflamed this is estimated to affect up to 5% of the UK population   fibrosis – where persistent inflammation causes scar tissue around the liver and nearby blood vessels, but the liver is still able to function normally    cirrhosis – the most severe stage, occurring after years of inflammation, where the liver shrinks and becomes scarred and lumpy; this damage is permanent and can lead to liver failure (where your liver stops working properly) and liver cancer It can take years for fibrosis or cirrhosis to develop. It's important to make lifestyle changes to prevent the disease from getting worse.Am I at risk of NAFLD?You're at an increased risk of NAFLD if you are obese or overweight particularly if you have a lot of fat around your waist (an "apple-like" body shape)    have type 2 diabetes    have high blood pressure    have high cholesterol   over the age of 50    smoke However, NAFLD has been diagnosed in people without any of these risk factors, including young children. Although it's very similar to alcohol-related liver disease (ARLD), NAFLD isn't caused by drinking too much alcohol. Symptoms of NAFLD There aren't usually any symptoms of NAFLD in the early stages. You probably won't know you have it unless it's diagnosed during tests carried out for another reason. Occasionally, people with NASH or fibrosis (more advanced stages of the disease) may experience a dull or aching pain in the top right of the tummy (over the lower right side of the ribs)fatigue (extreme tiredness) unexplained weight loss    weakness If cirrhosis (the most advanced stage) developsyou can get more severe symptoms such as yellowing of the skin and the whites of the eyes (jaundice) itchy skin swelling in the legs, ankles, feet or tummy.How NAFLD is diagnosed NAFLD is often diagnosed after a blood test called a liver function test produces an abnormal result and other liver conditions, such as hepatitis, are ruled out. However, blood tests don't always pick up NAFLD.The condition may also be spotted during an ultrasound scan of your tummy. This is a type of scan where sound waves are used to create an image of the inside of your body. If you're diagnosed with NAFLD, further tests may be needed to determine which stage you have. This may involve a special blood test or having another type of ultrasound scan (Fibroscan). Some people may also need a small sample of liver tissue (biopsy) taken using a needle to have it analysed in a laboratory.Treatment for NAFLDMost people with NAFLD won't develop any serious problems, but if you're diagnosed with the condition it's a good idea to take steps to stop it getting any worse. There's currently no specific medication for NAFLD, but making healthy lifestyle choices can help and treatment may be recommended for associated conditions (high blood pressure, diabetes and cholesterol) or complications.You may be advised to have regular appointments with your doctor to check your liver function and look for signs of any new problems.Healthy diet and lifestyle Adopting a healthy lifestyle is the main way of managing NAFLD. The following can all help  Lose weight – you should aim for a BMI of 18.5-24.9; use the BMI calculator to work out your BMI. Losing more than 10% of your weight can remove some fat from the liver and improve NASH if you have it.    Eat a healthy diet – try to have a balanced diet high in fruits, vegetables, protein and carbohydrates, but low in fat, sugar and salt. Eating smaller portions of food can help too.    Exercise regularly – aim to do at least 150 minutes of moderate-intensity activity, such as walking or cycling, a week. All types of exercise can help improve NAFLD, even if you don't lose weight.    Stop smoking – if you smoke, stopping can help reduce your risk of problems such as heart attacks and strokes.NAFLD isn't caused by alcohol, but drinking may make the condition worse. It's therefore advisable to cut down or stop drinking alcohol.MedicationSome Helpful Herbs Bhumyamalaki – Phyllanthus niruriAmalaki – Emblica officinalisSharapunka – Tephrosia purpureaKatuki – Picrorrhiza kurroaPunarnava – Boerhavia diffusaKakamachi – Solanum 

Simple Breathing Exercises for Chronic Obstructive Pulmonary Diseases

Dr. Radhika Bharath, Physiotherapist
What is COPD?Chronic Obstructive Pulmonary Disease (COPD) is characterized by breathlessness (short of breath) or getting tired while breathing. COPD is an umbrella term for conditions such as chronic bronchitis, emphysema or a combination of both.Exercises of COPD• Deep breathing exercise:1) Diaphragmatic Breathing:- Sit Upright with back support- Look straight with chin neutral.- Place both your hands (palms one over the other) on your stomach (mid- abdomen)- Now take a deep breath in through your nose and feel your stomach move out (like an air filled balloon)- Make sure your chest does not move while breathing.- Once you have breathed in maximum, slowly breath out only through your mouth (as you blow a whistle) and feel your abdomen going inside.- Repeat this 10 time x 3 times a day2) Collateral Breathing: - Sit upright with back support - Look straight- Place your hands on the side of your chest wall (one hand on either sides)- Now take a deep breath in through your nose and feel the walls of your chest (rib cage) moving outwards as your chest expands.- No upper chest movement to be performed.- Now blow out the air through your mouth (as you blow a whistle) and feel the chest wall coming inside.- Repeat it 10 times x 3 times a day3) Apical Breathing:- Sit upright with a back support- Look straight, chin up- Place your palm across your upper chest (as the tips of your finger touch the collar bone).- Breath in through nose and feel the upper chest moving up.- Now once you have completely breathed in, slowly blow out through your mouth (as you blow a whistle) and feel your chest coming down to normal.- Repeat it 10 times x 3 times a day• Chest Expansion Techniques:1) Sit straight on a chair with back support (can also be done in lying).- Keep both the arms stretched out in front of the chest.- Now take your arms to the side and breath in through nose.- Slowly bring back the arms back in front of the chest and breath out through mouth.- Repeat 10 times 3 times a day.2) Sit on a chair with back support.- Keep both the arms stretched over head.- Bring both the arms to your shoulder level and breath in through nose.- Now gently take the hand back over head and breath out through mouth.- Repeat 10 times x 3 times a day.STAY HEATH WITH REGULAR EXERCISE!! GOOD LUCK!!

Diabetic Kidney Disease - Your Awareness Guide

Dr. Ashwinikumar Khandekar, Nephrologist
India is the capital of kidney diseases in the world. Commonest cause of kidney disease in India is diabetes mellitus (DM).There are two types of diabetes. Type 1 is Insulin Dependent Diabetes Mellitus (IDDM), which manifests in childhood and depends only on insulin administration for sugar control.Type 2 where an adult, usually over 30 years of age is found to have diabetes and can be treated with oral medications (Non Insulin Dependent Diabetes Mellitus [NIDDM]).We will discuss common kidney problems in diabetes and their early detection and treatment.Anatomy and PhysiologyBefore we discuss how diabetes affects the kidney, the reader is suggested to review the pertinent anatomy. Click here for a brief overview.. What is Diabetic Kidney Disease ?When blood sugar levels are abnormally high for a long period of time, they cause changes in the small blood vessels including those that supply the kidneys.These changes significantly affect the blood vessels of the glomerulus altering its functional abilities.The affected filter leaks protein in the urine. If untreated, damage to the filter continues, kidneys begin to fail and when the function falls below 10% of normal, artificial means to purify blood (dialysis) are needed.However, if sugar control is achieved early and consistently, this damage can definitely be delayed by a long period of time.Can we detect it early?Even before protein loss is evident in urine, microscopic changes are already present in the kidney, especially in the glomerulus (the ‘filter’).The protein loss is in very small amounts and is detected by special tests. This stage is called the ‘Microalbuminuria’ stage and precedes the more advanced involvement of kidneys and therefore better amenable to interventions.If filtration capacity is measured at this early stage, it would be found to be paradoxically higher than normal.If intervened at this stage, severe damage can be prevented.How does the disease progress?This stage then evolves into varying degrees of protein losses in the urine, over the subsequent 5 to 10 years, before reaching the final stage where all the glomeruli undergo irreversible damage and manifest itself as advanced kidney failure.If not intervened at this stage, there is usually a steady downhill course hereafter and therein lies the importance of screening patients with diabetes for kidney involvement. In type 1 diabetes, approximately 10 – 20 % patients reach this stage by after 5 to 15 years of diagnosis.Type 2 diabetes patients are usually found to have complications of diabetes at diagnosis and rarely kidney failure may bring diabetes to notice.One symptom that is peculiar to kidney involvement is that, when kidneys begin to fail, sugar control improves. This is because insulin, the hormone that reduces blood sugar level & is normally destroyed by the kidney, is no longer destroyed in failing kidneys. Sometimes the sugar levels go abnormally low, occasionally needing hospitalization.So, when a long standing diabetic patient has an ‘improved’ sugar control or sugar levels fall ‘low’ too frequently, kidney involvement should be suspected.What is the relation with the eyes?Just as small blood vessels of kidney are affected by diabetes, so are the small blood vessels of the retina in eyes. This is detected by an ophthalmologist by a simple eye check done in the out patient department (OPD).Involvement of the eyes and kidney go hand in hand. If eye involvement is noted, evidence for kidney involvement must be actively sought and vice-versa.Conversely, if a diabetic has significant protein loss in urine, but blood vessels of the retina are normal, the involvement is less likely to be because of diabetes and other causes should be searched for.

Like TB,This Lung Disease Is Not Communicable-COPD

Dr. Neelam Nath Bhatia, General Physician
Pollution after festivals has crossed Limits. Some areas of Delhi have recorded Suspended particles>1000(normal is 60+).COPD is one of the illnesses caused by pollution & low levels of oxygen in the blood.Simply put COPD is narrowing of passages and baloons (bronchi &alveoli) within lungs. Breathing becomes measured and Difficult as these fibrosed elements carry oxygen we breathe in,resulting in coughing and breathlessness.COPD is Not Reversible like Asthma. It progresses slowly. Both of these respiratory illnesses can be Controlled but Not Cured Permanently.COPD-Chronic Obstructive Pulmonary Disease can be deadly if associated with Heart illness as-Both heart and lung is One Unit and cause Breathlessness ,confusing the Treating doctors.Before an open heart surgery getting clearance from Lung doctor is a Must.Heart function is Measured by Echo and Lung Function is measured by Spirometry machines.Both machines are expensive and every GP cannot have them in Routine GP Clinics.Health Ministry will soon release "New Delhi declaration on mitigating effects of air pollution" and it has decided to declare COPD in Non Communicable disease (NCD) programme.We as Doctors can keep a Breathometer in our clinics to measure Lung Capacity of every person suspected to be at Risk, like we check BP as a Routine.Yes it is that simple. Cost of 'machine' is just 300/-(three hundred) only. One has to breathe in and breathe out with full force.Calibrations are on equipment,which is of the size of a baby feeding bottle.It gives a reading about functions of lung in a similar way the mother knows about milliliters of milk drunk by baby !This Breathometer is easily available and it is worth keeping in clinics as Some among others can have good lung functions too.WHY SEND EVERY Person for expensive lung tests? (So that Doubts can be Put to rest or treatment started on time so that illness does not progress to next dangerous level) Disease Grows Slowly like Cancer.We do have a choice to FIGHT pollution, learn to Live with it till the time some measures are taken up by Government and Individuals.This Means that our government is serious and want to screen people like other NCD diseases like Diabetes, Hypertension,Cancer and others.Reason to make COPD as NCD.Assistance will be provided to have Spirometers ,Nebulizers, Bronchodilators and Relevant medicines Available.This type of programme was launched to eradicate Polio and Small Pox and was Successful in Eradication of these 2 illnesses.Despite Awareness and programmes,there is No Reduction in TB cases but an Awareness has been Generated.Our Patients themselves ask for TB tests in Private Charitable Clinics if they have no time for government hospitalsRemember Non Smoking women are as Vulnerable to get COPD. Stress aggravates. Medicines to carry out MTP at advanced stage has COPD and low grade fever as side effects. If given once, the effect wanes, if given every year, the effect stays for life.And Women Too Breathe the Same Polluted Air as Men

Things You Must Know About Sexually Transmitted Diseases

Dr. Parmjit Singh Walia, Dermatologist
Over the last few years, a lot of patients have been coming to our clinic who are actually not suffering from HIV or any other sexually transmitted disease but are still struggling to find a solution to their problems related to their private parts. A major part of their suffering is rather related to reading a lot of database from Google or finding tedious ways to treat them with naturopathy. The fear of getting a sexually transmitted infection (STI) is the one that perpetuates the vicious cycle of existence of these "NOT SO TALKED ABOUT"diseases. STIs are very common and easily transmitted through sexual contact. Many STIs are curable and all are treatable, but the only way to know if you have one is to talk about them, consult a dermatologist and get yourself tested if required.Common Symptoms of STIs:Talking to your doctor about your sex life might seem too personal to share but ideally seeing a dermatologist takes you to the fast track of solution of the problem. Here are some common symptoms that may alert you to the presence of an STI:Pain and/or burning sensation when urinating Discolored, smelly, or particularly heavy discharge Abnormal vaginal discharge Warts, lesions, or sores in the genital area Rash or itching in the genital area Painful intercourseLower abdominal pain, fatigue & Low back pain (females)Q: How can you protect yourself ? A: Protecting yourself sexually involves not only learning about STIs but practicing safer sex every time you engage in any sexual activity.Avoid or minimize direct oral, anal and genital contact by using a barrier method correctly and consistently. Avoidance of impulsive intercourse with a complete stranger Form a trusted, honest, and communicative relationship. Always examine your partner for any wart, ulcer or any other obvious lesion on the genital parts Limit your number of sexual partners. Talk to your partner about your STI status. Include STI testing as part of your regular medical check up. Learn the common symptoms of STI’s. Do not use drugs or alcohol in potentially intimate situations as they can inhibit your ability to make decisions and may affect your dexterity. Get vaccinated for Hepatitis B and C. Get vaccinated for HPV if you are a woman between the ages of 9 and 26.Q: How do you get tested for STIs? A: There is no one test for all STIs. Get yourself examined by a dermatologist and get the tests recommended as it saves money and avoid unnecessary investigations.Q: How are STIs treated? A: The treatment depends on the type of STI. Only use medicines prescribed or suggested by your doctor. There are products sold over the Internet that falsely claim to prevent or treat STIs but the safety of these products is not known. Consult your dermatologist to speak about how you can protect yourself or to get tested and treated accordingly.

Gingivitis: Correctable When Caught Early

Dr. Ishwari Bhirud, Dentist
Gingivitis, the earliest manifestation of gum disease, can cause redness, swelling, bleeding, and sometimes tenderness of the gums. Inflammation is usually limited to the surface tissue. If the inflammation is very mild, your dentist may detect it even before you notice any discomfort.Gingivitis usually results from poor oral hygiene. With no brushing at all, a previously healthy mouth will begin to show evidence of gingivitis in less than three weeks. Some factors can make gum disease more likely or accelerate its pace. These include:Hormonal changes associated with puberty, pregnancy, or menopauseCertain medications for epilepsy, heart disease, and other chronic conditionsPoor nutritionPoorly fitting braces, dentures, or restorationsSmokingDiabetesHIV infectionGingivitis is almost always correctable when it’s caught early. The first step is a thorough professional cleaning to remove plaque and tartar from the sulcus. This treatment, along with better brushing and flossing habits, usually does the trick.Several rare forms of gingivitis are brought on by factors other than plaque accumulation. These forms of the disease include:Acute necrotizing ulcerative gingivitis, also called trench mouth or Vincent’s infectionDesquamative gingivitis, a rare form targeting primarily postmenopausal womenGingivostomatitis, painful ulcers on the gums and oral mucosa caused by the herpes simplex virusPericoronitis, the inflammation of the gum around an impacted wisdom toothKnow more at:- www.care32dental.com

6 Frequently Asked Questions About Rheumatoid Arthritis

Dr. Pravin Patil, Rheumatologist
Arthritis is a broad term that describes inflammation of the joints (pain, swelling and redness). Rheumatoid arthritis (RA) is a disease of immune system. Patient with Rheumatoid arthritis suffer from multiple joint pains and swelling. In severe cases RA can affect eyes, lungs, heart, nerves or blood vessels.1. What are the symptoms of Rheumatoid arthritisThe most common symptoms of RA are:· Pain in multiple joints · Stiffness on getting up after a period of inactivity or in the morning · Swelling in one or more joints · Joint pains worse with rest, better with use· Fatigue /difficulty in performing routine activitiesThe most common joints involved are the hands, wrists and feet. The stiffness in the morning generally lasts longer than 45 minutes.2. How common is rheumatoid arthritis?In the general population about a 1 in 100 people develop RA. It is three times more common in women than in men. 3. What causes rheumatoid arthritis?RA is an autoimmune disease. An autoimmune disorder occurs when the immune system mistakenly attacks patient’s own healthy body tissue. In Rheumatoid arthritis body's immune system attacks normal joint tissues, causing swelling of the joint lining. Once the disease begins the joints become inflamed and, if untreated, the joints, cartilage, and bone can be damaged.4. Is rheumatoid arthritis hereditary?If you have a td family member with RA then your risk of developing RA is higher than the general population.You should see a rheumatologist if you have joint symptoms.5. Is RA a disease of old people?No. RA is most common in young and middle-aged adults but can also affect children and the elderly.6. Is there any relation with climate?Many people think that weather in winter may aggravate the arthritis. This is a misconception. Cold weather may cause more stiffness in the joints, but it will not aggravate or precipitate the arthritis.

Stronger Children Might Have Lower Risk of Diabetes and Heart Disease

Ms. Swati Kapoor, Dietitian/Nutritionist
It is a well known fact now that high levels of physical fitness lower the risk of many health problems. But recently, the first ever study to find the link between strength capacity in adolescents and reduced risk for diabetes, heart disease or stroke has been published in the journal Pediatrics.Staying fit is an essential habit that should be inculcated in youngsters. It will positively affect their long and short term health. For example, a recent study found that exercising during younger years helps bones become stronger and increases their longevity, even conferring benefits during aging.The researchers of this latest study, led by Mark D. Peterson, research assistant professor at the University of Michigan Medical School, note that previous studies have found low muscular strength in teen boys linked to several major causes of death in young adulthood, including suicide and cardiovascular diseases. Later it was seen that adolescents with stronger muscles have a lower risk of heart disease and diabetes, according to a new study that examined the influence of muscle strength in sixth grade boys and girls.It was found that physical activity or ay recreational activity done by adolescents helps them to have stronger muscle, which ultimately makes them strong as well as keeps them away from health problems like diabetes and heart disease. Stronger kids also have lower body mass index (weight to height ratio), lower body fat, smaller waist circumferences, and higher fitness levels, according to the study that suggests that muscle-strengthening activities may be important to kids' heart health.Muscle strength is equally important to children's cardiometabolic healthPeterson, one of the researchers from University of Michigan concluded that- “ It's a widely held belief that BMI [body mass index], sedentary behaviors and low cardiovascular fitness levels are linked to diabetes, heart disease and stroke, but our findings suggest muscle strength possibly may play an equally important role in cardiometabolic health in children."He also said the stronger the youngsters are and higher their muscle mass, the healthier they will be. “Exercise, sports and even recreational activity that supports early muscular strength acquisition, should complement traditional weight loss interventions among children and teens in order to reduce risks of serious diseases throughout adolescence," he adds.It is very important for children to adopt any moderate to intense physical activity on a daily basis to have higher muscle mass and strength, to improve their chances of being stronger and healthier throughout their lives.

Is Belly Fat Linked to Kidney Diseases?

Ms. Swati Kapoor, Dietitian/Nutritionist
Have you ever thought whether the processed foods you are eating are causing adverse health effects? Processed foods that are laden with phosphorus might increase the risk for kidney diseases.Researchers from Johns Hopkins claim that, “reducing your waist circumference and cutting down on dietary phosphorus has been linked to lower levels of protein in the urine (albuminuria). The presence of this protein in urine is one of the first indicators of kidney disease.” The study found that every one-unit increase in waist-to-hip ratio was linked to a loss of blood flow through the kidney's tiniest filters, the glomeruli, of about 4 milli litres per minute.Kidneys are the major excretory organs in our body. They are also known as the guardians of our body’s nutritional wealth. Phosphate is widely distributed in all the cells and body fluids, and plays a vital role in enzyme reactions and tissue metabolism. The metabolism of phosphate and calcium is closely linked, and these minerals usually occur together in food. The serum level of phosphorus increases in kidney failure.As dietary phosphorus is readily absorbed by the small intestine, any excess phosphorus absorbed is excreted by the kidneys. The regulation of blood calcium and phosphorus levels is interrelated through the actions of parathyroid hormone and Vitamin D.Some investigators are concerned about the increasing amounts of phosphates in our diet which can be attributed to phosphoric acid in soft drinks and phosphate additives in a number of processed foods. Serum phosphorus increases with a high phosphorus diet. High phosphate levels in the blood reduce the formation of the active form of Vitamin D (Calcitriol) in the kidneys, hence reducing the blood calcium. This further increases PTH released by the parathyroid glands and also decreases the urinary calcium excretion. Parathyroid hormone decreases tubular reabsorption of phosphate in the kidney, leading to increased excretion of phosphates.Processed foods high in phosphorus increase acidity in blood which triggers the release of stress hormones and these stress hormones increase insulin in the body. Increased level of sugar in the blood gets converted to fat and hence gets stored in the adipose tissues throughout the body. Apple-shaped people are at more risk of getting this disease than pear-shaped people.Hence, limiting the intake of processed food may help prevent risks of kidney diseases.

9 Kidney Damaging Habits

Dr. Richa Garg, Ayurveda
1. Lack of WaterThe kidney’s primary function is detoxification and this is done with the help of water. With insufficient water there is a build-up of toxins in the body, which can affect other functions.2. Excess Salt Salt increases blood pressure which in turn exerts a lot of pressure on your kidneys. Restrict your daily salt intake to around 5 grams a day, which is ideal.3. Restraining UrinationControlling yourself from urinating can increase urine pressure and lead to kidney stones. So be sure to relieve yourself without any delay.4. Excess SugarHigh sugar foods increase the protein content in your system which in turn exerts pressure on your kidneys. Protein amounts in one’s urine is a valid way to check kidney functioning.5. Excess Animal ProteinRed meat in particular increases the metabolic load on your body, especially the kidneys. Regular consumption of red meat can cause dysfunction or failure.6. Lack of SleepSleep deprivation can lead to several health problems including kidney disease. Your body repairs damaged kidney tissue while you sleep, so better sleep means better kidneys.7. Excess CaffeineHigh amounts of caffeine raises blood pressure and exercises the kidneys in excess. Regular consumption of caffeine can cause kidney damage.8. Painkillers They have become a regular in our day to day lives and are used for almost any sort of pain. These pills naturally deteriorate the kidney and liver.9. Alcohol ConsumptionThis legal toxin harshly exercises the kidney and liver so don’t go overboard.