Articles on need to know

Chikungunya - Everything You Need to Know

Dr. Deepak Rathi, Ayurveda
What is ChikungunyaChikungunya is a viral disease transmitted to humans by the bite of an infected Aedes aegypti and aedes albopictus mosquitoes. The disease is closely similar to dengue fever. The word "Chikungunya" comes from the word “kungunyala” in Makonde language which means “that which bends up” or "Bent over in Pain". Outbreaks are most likely to occur in post-monsoon period when the vector (mosquitoes) density is very high. Symptoms of ChikungunyaSymptoms usually begin 3‒7 days after being bitten by an infected mosquito. Common Symptoms are - 1. Fever : The fever varies from low grade to high grade, lasting for 24 to 48 hours. Fever rises abruptly in some, reaching 39-40 degree Celcius, with shaking chills and rigor and usually subsides with use of antipyretics. 2. Pain in Joints : Pain and sweling in one or more joints may be there. Knee, Wrist, Small joints og Fingers are commonly affected. The joint pain tends to be worse in the morning.  The pain may remit for 2-3 days and then reappear. 3. Backache. 4. Headache. 5. Muscle Pain. 6. Nausea. 7. Rashes.Some facts about the Mosquito • Aedes species mosquitoes transmit chikungunya virus. • This mosquito breeds in clean stagnant water and takes eight to 10 days to mature from larvae. • The Aedes  mosquito  breeds  in  domestic  settings  such  as  flower vases, water-storage containers, air coolers, etc. and peri-domestic areas such as  construction  sites, coconut  shells, discarded  household  junk  items  (tyres, plastic and metal cans, etc.). • These same types of mosquitoes transmit dengue virus • The adult female mosquito rests in cool and shady areas in domestic and peri-domestic settings • These mosquitoes bite mostly during the daytime.When to seek medical help?• Fever persisting for more than five days. • Intractable pain. • Postural dizziness, cold extremities. • Decreased urine output.• Any bleeding under the skin or through any orifice. • Incessant vomiting Treatment of Chikungunya • There is no specific medicine to treat Chikungunya. It is treated symptomatically. • Medicines are given to reduce the fever and pain. If you have Chikungunya Infection, follow these instructions ♦ Take plenty of rest.♦ Drink fluids to prevent dehydration. You can take ORS Powder or Lemon Water.♦ Consult your doctor. He may give you medicine such as  paracetamol to reduce fever and pain.♦ Do not take aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS until dengue can be ruled out to reduce the risk of bleeding).♦ If you are taking medicine for another medical condition, talk to your doctor before taking additional medication.♦ During the first week of infection, chikungunya virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites. An infected mosquito can then transmit the virus to other people.♦ To prevent further spread of the virus, it is important for people to avoid mosquito bites during the first week of illness.     Illness Course and Outcomes • Most patients starts feeling better within a week. • Some people may develop long-term joint pain. • Chikungunya disease does not often result in death, but the symptoms can be severe and disabling. • Hospitalisation is rarely required. • People at increased risk for severe disease include newborns exposed during delivery, older adults (≥65years), and people with medical conditions such as high blood pressure, diabetes, or heart disease. Diagnosis of Chikungunya • The symptoms of chikungunya are similar to those of Dengue and Zika, diseases spread by the same mosquitoes that transmit chikungunya. • See your doctor if you develop the symptoms described above and have visited an area where chikungunya is found. • If you have recently traveled, tell your healthcare provider when and where you traveled. • Your doctor may order blood tests to look for exact cause of fever. It may include blood testing for chikungunya, Dengue, Malaria, Typhoid etc. • Symptoms can be very like those of dengue fever, so suspect cases will need to have a blood test to check for these and chikungunya antibodies. DO NOT SELF DIAGNOSE. See your doctor if you think you or a family member might have chikungunya. Where can I order Chikungunya Virus testing..? • Diagnostic blood testing is available in almost all Pathology laboratories. • The Delhi government has put a cap on the prices of chikungunya test. The Chikungunya Serology IgM test, which can confirm a case of chikungunya five to six days after the fever, has been capped at Rs 600/-. The test costs between Rs 800 and Rs 1,000 at private facilities. • The price of the test that can confirm Chikungunya Virus a bit earlier – RT PCR (Reverse transcription polymerase chain reaction) – has been capped at Rs 1,500/-. The test costs between Rs 3,500/- and Rs 4,000/- at private facilities. Prevention of Chikungunya • There is no vaccine or medication to prevent chikungunya virus infection or disease. • People at increased risk for severe disease should consider not traveling to areas with ongoing chikungunya outbreaks. • If you are sick  with chikungunya, avoiding mosquito bites will help prevent  further spread of the virus. Protect Yourself from Mosquito Bites • Use air conditioning or window/door screens to keep mosquitoes outside. If you are not able to protect yourself from mosquitoes inside your home or hotel, sleep under a mosquito bed net. • Help reduce the number of mosquitoes outside your home by emptying standing water from unattended containers such as flowerpots, cans or buckets. • When weather permits, wear long-sleeved shirts and long pants. • Use mosquito repellents on exposed skin. • Wear permethrin-treated clothing • Support local vector control programs.

Pregnancy Diet: Things You Need to Know!

Dr. M.L.Kothari, Pediatrician
Foods to eatDuring pregnancy, the goal is to be eating nutritious foods most of the time, Krieger told Live Science. To maximize prenatal nutrition, she advises emphasizing the following five food groups: fruits, vegetables, lean protein, whole grains and dairy products. When counseling pregnant women, Krieger recommends they fill half their plates with fruits and vegetables, a quarter of it with whole grains and a quarter of it with a source of lean protein, and to also have a dairy product at every meal. Fruits and vegetables: Pregnant women should focus on fruits and vegetables, particularly during the second and third trimesters, Krieger said. Get between five and 10 "tennis ball"-size servings of produce every day, she said. These colorful foods are low in calories and filled with fiber, vitamins and minerals. Lean protein: Pregnant women should include good protein sources at every meal to support the baby's growth, such as meat, poultry, fish, eggs, beans, tofu, cheese, milk and nuts, Krieger said. Whole grains are an important source of energy in the diet, and they also provide fiber, iron and B-vitamins. At least half of a pregnant woman's carbohydrate choices each day should come from whole grains, such as oatmeal, whole-wheat pasta or breads and brown rice, Krieger said. Dairy: Aim for 3 to 4 servings of dairy foods a day, Krieger suggested, such as milk, yogurt and cheese, which provide good dietary sources of calcium, protein and vitamin D. In addition to a healthy diet, pregnant women also need a daily prenatal vitamin to obtain some of the nutrients that are hard to get from foods alone, such as folic acid and iron, according to ACOG. For women who take chewable prenatal vitamins, Krieger advised checking the product labels because chewables might not have sufficient iron levels in them.Foods to avoidAlcohol: Avoid alcohol during pregnancy, Krieger advised. Alcohol in the mother's blood can pass directly to the baby through the umbilical cord. Heavy use of alcohol during pregnancy has been linked with fetal alcohol spectrum disorders, a group of conditions that can include physical problems, as well as learning and behavioral difficulties in babies and children, according to the Centers for Disease Control and Prevention (CDC).Fish with high levels of mercury: Seafood such as swordfish, shark, king mackerel, and tilefish are high in levels of methyl mercury, according to the Academy of Nutrition and Dietetics, and should be avoided. Methyl mercury is a toxic chemical that can pass through the placenta and can be harmful to an unborn baby's developing brain, kidneys and nervous system. Unpasteurized food: According to the USDA, pregnant women are at high risk of getting sick from two different types of food poisoning: listeriosis, caused by the Listeriabacteria, and toxoplasmosis, an infection caused by a parasite.The CDC reports that Listeria infection may cause miscarriage, stillbirth, preterm labor, and illness or death in newborns. To avoid listeriosis, the USDA recommends forgoing the following foods during pregnancy: Unpasteurized (raw) milk and foods made from it, such as feta, Brie, Camembert, blue-veined cheeses, queso blanco and queso fresco. Pasteurization involves heating a product to a high temperature to kill harmful bacteria. Hot dogs, luncheon meats and cold cuts unless heated before eating to kill any bacteria. Store-bought deli salads, such as ham salad, chicken salad, tuna salad and seafood salad. Unpasteurized refrigerated meat spreads or pates.Raw meat: A mother can pass a Toxoplasma infection on to her baby, which can cause problems such as blindness and mental disability later in life, reports the CDC. To avoid toxoplasmosis, the USDA recommends avoiding the following foods during pregnancy: Rare, raw or undercooked meats and poultry. Raw fish, such as sushi, sashimi, ceviches and carpaccio.Raw and undercooked shellfish, such as clams, mussels, oysters and scallops.Some foods may increase a pregnant woman's risk for other types of food poisoning, including illness caused by salmonella and E. coli bacteria. Foodsafety.gov lists these foods to avoid during pregnancy, and why they pose a threat. Raw or undercooked eggs, such as soft-cooked, runny or poached eggs. Foods containing undercooked eggs, such as raw cookie dough or cake batter, tiramisu, chocolate mousse, homemade ice cream, homemade eggnog, Hollandaise sauce. Raw or undercooked sprouts, such as alfalfa, clover. Unpasteurized juice or cider.Pregnancy diet misconceptions:Morning sickness: When a mother-to-be is experiencing morning sickness, the biggest mistake she can make is thinking that if she doesn't eat, she'll feel better, Krieger said. The exact causes of morning sickness are not known, but it may be caused by hormonal changes or lower blood sugar, according to the Mayo Clinic. It can bring on waves of nausea and vomiting in some women, especially during the first three months of pregnancy. And "it's definitely not happening only in the morning," Krieger said. "It's any time of day." It's better to eat small amounts of foods that don't have an odor, since smells can also upset the stomach, she suggested.Food cravingsIt is common for women to develop a sudden urge or a strong dislike for a food during pregnancy. Some common cravings are for sweets, salty foods, red meat or fluids, Krieger said. Often, a craving is a body's way of saying it needs a specific nutrient, such as more protein or additional liquids to quench a thirst, rather than a particular food, she said. Eating for twoWhen people say that a pregnant woman is "eating for two," it doesn't mean she needs to consume twice as much food or double her calories." A woman is not eating for two during her first trimester," Krieger said. During the first three months, Krieger tells women that their calorie needs are basically the same as they were before pregnancy, because weight gain is recommended to be between 1 and 4 pounds in this early stage of pregnancy. Krieger typically advises pregnant women to add 200 calories to their usual dietary intake during the second trimester, and to add 300 calories during their third trimester when the baby is growing quickly. Weight gain during pregnancy, "Weight gain during pregnancy often has an ebb and a flow over the nine months," Krieger said. It's hard to measure where pregnancy weight is going, she said, adding that a scale does not reveal whether the pounds are going to a woman's body fat, baby weight or fluid gains. When it comes to pregnancy weight gain, Krieger advises mothers-to-be to look at the big picture: During regular prenatal checkups, focus on that the baby is growing normally rather than worrying about the number on a scale. The total number of calories needed per day during pregnancy depends on a woman's height, her weight before becoming pregnant, and how active she is on a daily basis. In general, underweight women need more calories during pregnancy; overweight and obese women need fewer of them. The Institute of Medicine (IOM) guidelines for total weight gain during a full-term pregnancy recommend that: Underweight women, who have a Body Mass Index (BMI) below 18.5, should gain 28 to 40 lbs. (12.7 to 18 kilograms). Normal weight women, who have a BMI of 18.5 to 24.9, should gain 25 to 35 lbs. (11.3 to 15.8 kg). Overweight women, who have a BMI of 25.0 to 29.9, should gain 15 to 25 lbs. (6.8 to 11.3 kg).Obese women, who have a BMI of 30.0 and above, should gain 11 to 20 lbs. (5 to 9 kg). Rate of weight gain: The IOM guidelines suggest that pregnant women gain between 1 and 4.5 lbs. (0.45 to 2 kg) total during their first trimester of pregnancy. The guidelines recommend that underweight and normal-weight women gain, on an average, about 1 pound every week during their second and third trimesters of pregnancy, and that overweight and obese women gain about half a pound every week in their second and third trimesters of pregnancy. Twins: The IOM guidelines for pregnancy weight gain when a woman is having twins are as follows:Normal weight: 37 to 54 lbs. (16.7 to 24.5 kg). Overweight: 31 to 50 lbs. (14 to 22.6 kg). Obese: 25 to 42 lbs. (11.3 to 19 kg). This article is for informational purposes only, and is not meant to offer medical advice.

All You Need To Know About Flat Feet

Dr. Sarika Jambhulkar, Physiotherapist
"The human foot is a masterpiece of engineering and a work of art."                                                                                                                     -Leonardo Da Vinci26 bones, 33 joints, 107 ligaments & 19 muscles work together to balance your whole body. No wonder this great artist has named it as a masterpiece.¼ of all bones in the human body are in the feet.Standing in the kitchen for cooking, walking down to buy vegetables, playing any sort of sports or dancing - all of these activities we can do because of our feet.Healthy feet are key for active lifestyle. Human feet are designed to walk on natural surface like soil and sand, but instead of that we are walking on hard surfaces like pavements, marbles. That’s why Incidence of foot problems is increasing. At least 80 % of general population has foot problem. Out of all flat feet is most common and unnoticed problem. If it is not diagnosed at the right age, it can lead to serious complications in future.I get many patient saying, “My physiotherapist told me I have flat feet & my family doctor says I don’t have flat feet, I don’t know what exactly flat feet means”.WHAT IS FLAT FEET?We have small gap on the inner side of feet when we stand, when this gap is not there it’s called as flat feet. Everybody is born with flat feet, as a child starts walking his/her arch starts developing. First five years of age are crucial for the arch development.EFFECT OF FLAT FEET ON POSTURE:All joints in our body work together. As feet are the base of our body it affects the entire posture. CAUSES:Ligament laxityMuscle weakness/Hypotonia of musclesFracture/ trauma around ankle joint which can cause injury to tendon Family historySYMPTOMS:Tired achy legsHeel pain, Knee paint & back painRecurrent ankle sprain(Poor Balance)Early osteoarthritis of jointsCorn & calluses etc.TREATMENT:Orthotics: Custom made orthotics is the main line of treatment for flat feet. People always try to get some off the shelf orthotics & of course it doesn’t help for their problem. Orthotics correction should be based on lots of variables like severity of flat feet, age,weight, lifestyle alignment of proximal joints etc. Thus off the shelf things are not advisable. Podiatrist is a right person to prescribe the orthotics.Podiatry is a branch of medicine specialized in ankle & foot problems.Podiatrist doctor will do thorough assessment of your alignment, diagnose the problem & then provide a customized solution for the same.Supportive shoes: The person with flat feet should use shoes with firm ankle control. Sports shoes are best. In many brands there is option of anti-pronatory shoes.Exercise: To strengthen foot and ankle muscles.Maintain Ideal body weight.

Skin Lightening : What You Need to Know?

Dr. Sasikumar Muthu, Hair Transplant Surgeon
Some clients look forward to change their skin color using injectable products marketed to whiten or lighten their complexion. These products are potentially unsafe and ineffective, and might contain unknown harmful ingredients or contaminants. Beyond the potential harm from the product itself, improper or unsafe injection practices may transmit disease, cause infection and result injury. The Injectables available in the market today are not regulated. As a consumer you may not be aware that these products aren't approved for skin lightening at all. The promises they make are unrealistic too and comes with a price. The ingredients present in it include Glutathione, vitamin C, collagen and even human placenta. These can cause serious side effects to the consumer. So try to avoid experimenting with unapproved drugs sold through the spas and online drug stores.There are approved medications in form of creams for skin lightening and removing certain pigmentation that are quite safe. If you are looking for one of those consult your Doctor rather than buying it over the counter because the creams need to be customised to your needs and skin type.Before you go for skin lightening treatments get to SIMPLE & SAFE  Healthy Skin Routine to restore your skin.Then meet your Doctor who will help you in:Choosing an appropriate cleanser & Sunscreen with SPF 30+Choosing a moisturiser and a leave on night serum Avoid frequent change of productsConclusion:Indian skin types are well protected by nature. Once you focus on healthy skin routine the tone and colour will be restored with minimal effort. Keep it Simple & Safe always when choosing a skin treatment.

Depression: Things You Need to Know

Dr. Suhasini Das, Psychiatrist
Depression is a very common psychiatric disorder. According to World Health Organization report (WHO, 2016), about 350 million people are affected by depression. Untreated depression leads to decreased productivity, affects interpersonal relationships, alcohol, and substance abuse, and in extreme cases, to suicide. Depression can affect at any age group, from infants to the elderly. Hence, it is very necessary that you identify the signs of depression and take early interventions.Signs and symptoms of depression:Mood symptoms: Low mood, irritability, anger outbursts, crying spells, feeling very low in the morning hoursDecreased interest in usually pleasurable activities like hobbies, work, socializationLow energy, easy fatigabilityDecreased attention and concentrationDisturbed sleep and appetiteWeight gain or lossThoughts of hopelessness, helplessness, worthlessness, guilt, sinSuicidal thoughts or attemptsDecreased libidoAnxiety symptoms like panic attacks worry etc.In depression, most of these symptoms will be present together, for at least > 2 weeks. Depression can be an independent disorder or a part of Bipolar affective disorder, in which cases treatment will differ.Depression in childhood and adolescents:At times, children and adolescents present depression differently than in adults. They may not complain of depression but commonly present with decreased academic performance or refusal to go to school, irritability or anger outbursts, decreased interaction with family and friends or spending more time in solitary activities like on mobile or laptop, disturbed sleep and appetite, headaches and other bodily complaints etc.Depression in women:At any given point, females are more prone to depression than males. The most vulnerable periods are between 15-30 years of age, during pregnancy and after delivery and around menopause. Causes of depression:Biological, due to neurotransmitter imbalance.Social: Death of close family members or friends, divorce or separation, loss of a job or financial loss, immigration or relocation to different places, major natural disasters like earthquakes, following war etc.Physical illness: Hypothyroidism, stroke, heart attack, diabetes, cancer and its treatment, organ transplantation etc.Treatment:Both medication and psychotherapies like cognitive-behaviour therapy, interpersonal therapy, and others are effective in treating depression. The best results are obtained with the combination of medication and therapy. You need to continue it for at least 4-6 months to sustain the effects and prevent relapse.To summarize, depression is a common disorder. Identifying it correctly and proper treatment will improve your overall mental and physical health, your relationships and your productivity and efficiency in the long run. Be happy :). 

6 Things You Need to Know About Lubricants

Dr. Adil Hingora, Homeopath
Sex reduces stress, relieves pain, and that after-sex glow even makes you look younger. You can take advantage of these and other health benefits of sex while maximizing your pleasure by using a lubricant. In fact, women who used lubricants during sexual activity had more pleasurable and satisfying sex, according to a 2009 Indiana University study.“Lubricants are chosen by many couples to enhance sexual pleasure by decreasing friction and irritation,” says Matthew Wosnitzer, MD, urologic surgeon specializing in male infertility, and instructor at Weill Cornell Medical College/New York-Presbyterian Hospital.In fact, more than half of men and women have used lubricants during sex, according to two studies published in the Journal of Sexual Medicine.Here are six things to consider before you use a lubricant, straight from the experts.1. Pain Means Something. Lubricants often contain lidocaine and benzocaine to lessen discomfort, said Rachel Needle, PsyD, Center for Marital and Sexual Health of South Florida, and executive director of the Whole Health Psychological Center in Florida.“However, these ingredients can dull or numb the skin and lower pain perception. But pain tells us if something is tearing in our body. This is important to know as someone can end up being hurt and because possible tears can increase the risk of transmission of STIs [sexually transmitted infections],” adds Dr. Needle.2. Watch for Sugars. “I don’t think there’s a particular lubricant that everybody should avoid, [but] there are some ingredients that affect women,” says Hilda Hutcherson, MD, associate dean for diversity and multicultural affairs at Columbia University College of Physicians and Surgeons and clinical professor of obstetrics and gynecology at Columbia Medical Center in New York City.“For instance, glycerin, which is a sugar derivative, can cause increased yeast infections in women who are susceptible to yeast infections.” Lubricants with other sugars, like some flavored lubricants, can also be irritating for some women.Dr. Hutcherson recommends AstroGlide, which now has a non-glycerin variety, the KY brand of lubricants, and Lelo.3. You Can Still Conceive. “The ideal lubricant is one which does not harm sperm and mimics the cervical mucus pH (acidity level) and consistency, and has antioxidants that may be helpful to sperm,” says Dr. Wosnitzer.Pre-Seed lubricant is one of the few lubricants with clinical studies to support its safe use in couples trying to conceive, he adds.4. Consider Your Sensitivity. “There are some lubricants that are warming, tingling that have menthol-like components and for some women that is extremely irritating,” says Hutcherson.“For women who are not sure, I would say use a tiny bit on one side of your labia as a test; and if you find that it irritates, it burns, it’s uncomfortable, then don’t use any more of it,” says Hutcherson. “Never use something for the first time during intercourse. Test it before if you’re concerned that it might be an issue.” She recommends buying a variety pack of lubricants with different ingredients and textures to determine which one works best for both of you.5. Try Au Naturel. “People have certainly used coconut oil and other household oils — the biggest complaint being that you can’t use a condom when you have that kind of oil because it breaks down latex condoms. The other thing is it messes up your sheets,” says Hutcherson. If you do decide to use a household oil as a lubricant, be sure to use a non-latex condom, she adds.“Petroleum-based lubricants like Vaseline and mineral oil are not really great to use internally as they take quite a while to get out of the system and can cause irritation,” says Needle. However, natural oil-based lubricants like vegetable oil or corn oil are safe, she says.Want to go au naturel but not use household oils in the bedroom? Try drinking lots of water. “If you’re dehydrated you’re going to have difficulty making lubrication,” says Hutcherson.6. It’s Totally Normal. Some people find that applying lubricants interrupts sex while others are worried about what their partner will think of them if they cannot lubricate on their own.“I think that everybody needs to have lube — everybody is going to need it at some point and it’s not unnatural to need it," Hutcherson says. "Just make it available and on those days when you feel you need it just incorporate it into foreplay and don’t be afraid of it, and try different types. Have fun with it.”

Everything You Need to Know About Dandruff

Dr. Apoorva Shah
Dandruff, also known as seborrhea, is a common-contagious condition of skin areas rich in oil glands (the face, scalp, and upper trunk) marked by flaking (overproduction of skin cells) and sometimes redness and itching (inflammation) of the scalp, varying in severity from mild flaking of the scalp to scaly, red patches.Dandruff - those dry, white flakes of skin you brush off your collar or shoulders - is essentially harmless. But it can be embarrassing and itchy. Dandruff really isn't about your hair, or how often you wash it. Instead, it's about the skin on your scalp.The normal skin yeast, Pityrosporumovale, lives in oil-rich skin regions and plays a role in this condition. Skin cells that grow and die off too fast are the problem. Exactly why that happens isn't clear. A very common fungus called malassezia may contribute to dandruff. This fungus lives on the scalp of most healthy adults without causing any problems. One theory is that the immune system of someone with dandruff may overreact to that fungus.Dandruff may be worse with stress, winter, and infrequent shampooing. Although there is no "cure" for dandruff, control is usually possible with frequent wash or medicated shampoos.Risk FactorsDandruff occurs in 15–20% of the population. The problem affects all races, may be a bit worse in men, and starts after puberty (although babies have a version called cradle cap). Dandruff peaks around the age of 40 and then may improve. Severe dandruff is frequently seen in people with Parkinson's disease and others with central nervous system problems, as well as in those with HIV infection.Signs and SymptomsThe scalp is itchy and flaky.One or more of the following areas may have patches of red, scaly skin: the scalp, hairline,forehead, eyebrows, eyelids, creases of the nose and ears, ear canals, beard areas, breastbone, mid back, groin, or armpit.Mild dandruff – only some flaking with or without redness in a few small areasModerate dandruff – several areas affected with bothersome redness and itchSevere dandruff – large areas of redness, severe itch, and unresponsive to self-care measuresCare GuidelinesMost cases of dandruff are easy to control. These include:Frequent (daily)shampooing or a longer lather time.Stopping use of any hair styling products.If it is mild flaking then apply oil to the scalp 3 times a week and wash it with the same frequency. But if it is associated with oily scalp then daily wash with mild scalp cleanser is advisable. It is not advisable to use oil in seborrheic oleosa or in condition of psoriasis.If all self care measures fail, get your scalp checked by a Trichologist.

Depression: What You Need to Know

Akshata Bhat, Psychiatrist
Depression is becoming increasingly common. Due to increased awareness, more people are beginning to realise that it is something that requires attention, and it ‘won’t go away by itself’ and is not something that can be treated ‘by being happy and positive’.What is depression?Depression is a serious mental health condition. One in every four women and one in every ten men experience depression at least once in their lifetime.What are the signs of depression?Feeling low, sad, irritable or angry for a prolonged period of timeDecreased interest in pleasurable activitiesFeelings of guilt, hopelessness, worthlessnessLow energy, fatigueUnexplained physical symptomsDecreased concentration and attentionPsychomotor retardation or agitation (decreased or increased physical activity)Disturbed sleep or appetiteRecurrent thoughts and/or attempts of suicide or self-harmWho can develop depression? Any person, irrespective of gender or age, can develop depression at any point during their lifetime.What are the risk factors for depression?Family history of depression/any mental illnessWomen during postpartum period and menopausePhysical illnessPoor coping strategiesPhysical, emotional or sexual abuseMarital or familial disharmonyDeath of a close oneDifficult life eventsStressWhat is the cause of depression?Neurotransmitter imbalance, particularly that of serotonin, is identified as the cause of depressionGenetic susceptibility: increased risk of depression in those who have a family history of depression or any other mental illnessShould you seek help for depression?Yes. Feeling hopeless or worthless can make a person feel that there is nothing worth living for. This leads to an increased risk of suicide and self-harm. Also, there is significant social, functional and occupational dysfunction, leading to poor quality of life.Is depression treatable? How?With the right medication and counselling, depression can be treated. A psychiatrist should be consulted for that. In addition, lifestyle modifications with attention to nutrition and exercise should be incorporated to achieve a better outcome.  

Vertigo : What You Need to Know

Dr. Vinay S Bhat, Ear-Nose-Throat (ENT) Specialist
Vertigo or giddiness is a very common symptom encountered in routine practice. Its estimated that more than 10% of population of all age groups will suffer from this at least once in their life time. Its also one symptom which is very difficult to diagnose and treat and many patients with vertigo tend to consult multiple doctors of multiple specialties without much of benefit. One has to understand that vertigo is not a disease per se. Its a symptom of many diseases related to inner ear, brain, eye and sensory system. Inner ear diseases contribute to more than 80% of patients complaining of vertigo.True vertigo is defined as sensation of spinning of surroundings. it should not be confused with sensation of imbalance, unsteadiness, weakness or blackouts. This article is intended to give information about common causes for vertigo and imbalance which are mainly due to inner ear related diseases which is one of the important organ which maintains balance of an individual, technically termed as vestibular system.Below are the common inner ear related diseases which can cause vertigo and imbalanceBPPV (benign Paroxysmal Positional vertigo): Its a harmless condition commonly involving one of the inner ears. In this condition patients will complain of Short lasting multiple episodes of vertigo which occurs during particular position of the head. It will never stay for more than few minutes and will occur repeatedly in a day. Without Treatment it may continue to occur for many days to weeks. Usually no predisposing diseases can be identified except for few patients who will have history of head injury. Meniere's Disease : Its a common condition where patients will have sudden attacks of severe vertigo with sensation of ear fullness and ringing sensation in the ear. Many patients with recurrent attacks can even complain of hearing loss. Symptoms of vertigo are usually severe and associated with vomiting sensation or vomiting. Vertigo usually lasts for 20 minutes to a day unless treated early. Patients can have such attacks every few days or few months depending on the severity.Vestibular Neuronitis: This is a viral Infection of part of nerve connected to inner ear which Carries balance sensation to brain. Vertigo in these patients will be sudden and severe. symptoms may last for few days to weeks if not treated appropriately. This condition is usually devoid of any ear related problems. This is one condition where vertigo is continuous all through the day for many days and its very disabling.Labyrinthitis: Its a uncommon condition nowadays and is usually because of untreated middle ear infections. It usually will be severe and most commonly is associted with long standing ear discharge. Vestibular migraine (Migrainous vertigo): This a type of a headache disorder known as migraine. In this condition patients will have recurrent vertigo associated with features of migrainous headache. Patients will have disabling vertigo and imbalance during, before or after an attack of migraine.Vestibular paroxysmia: This is a rare disorder occurring in young adults and old aged patients mimicking BPPV. Thorough evaluation by a specialist is required to differentiate between the two.Phobic Postural vertigo: Its more of a functional disorder where patients complain more of imbalance when they are in crowded places. Its type of Phobic disorder and requires specific treatment and counselingDrug Induced vertigo: Certain medicines can injure inner ear especially commonly used antibiotics such as gentamycin and streptomycin. Apart from these common causes there are many rare vertigo and imbalance disorders which can exist. Vertigo can also be a symptom of many central nervous system (brain) diseases such as Acoustic neuroma, cerebellar stroke, cerebellar tumors, Brain stem disorders, degenerative brain disorders etcIts should be noted that unless the cause of vertigo is established its not possible to treat the symptom. Patients who suffer from vertigo are advised to consult specialist who has special interest in management of these diseases. Otolaryngologist (ENT Specialist) and Neurologist are usually specialized in this subject and patients are advised to consult these specialists. Patients should avoid self medication of anti vertigo drugs as they can cause severe side effects and sometimes aggravate symptoms of vertigo and imbalance.

Eye Donation: What you need to know and do.

Dr. Quresh Maskati, Ophthalmologist
Q. Who can be an eye donor?A. Anyone can be an eye donor, irrespective of age, sex, religion, caste, creed or blood group.Q. Do religious authorities approve of eye donation?Yes, all religious faiths support this vital sight restoration programme.Q. Is the whole eye used for transplant?A. No, only the thin transparent layer in front of the iris, called the cornea is used for transplant, to replace the diseased or opaque cornea in the eye of the patient (recipient).Q. Do cataracts or the use of spectacles render the cornea unfit for donation?A. No, both these conditions relate to the lens of the eye and not the cornea. In fact, people who have been successfully operated for cataracts or glaucoma or even retinal detachments can also donate their eyes after death. In fact there have been instances of those who have received a corneal transplant themselves donating their corneas after death! All that is required is that the donor have a clear, transparent, healthy cornea at the time of death.Q. Does eye donation disfigure the donor’s face? A. No, the removal of the eyes does not produce disfigurement nor interferewith the customary funeral arrangements.Q. Does the human body reject the transplanted donor’s cornea? How successful are corneal transplants?A. The human cornea does not have any blood supply; hence the risk of rejection is very low. Rejection, if it does occur can be suppressed by timely medication. In general, the chances of success are greater than 80%. In deep anterior lamellar transplants, where the inner lining of the cornea called the endothelium, is not transplanted, the success rate is as high as 95%!Q. What conditions render the cornea unfit for donation?A. Corneas of patients suffering from AIDS, rabies, syphilis, tetanus, septicaemia and certain viral diseases are considered unfit for use for transplant purposes.Q. What about diabetes, hypertension or cancer?A. People with these conditions can also donate their eyes. Eyes from a cancer patient are not used for transplant only if the cancer had a blood borne spread.Q. Is there any use for corneas which are for some reason unfit for transplant?A. Corneas, which for some reason cannot be used for vision restoring corneal transplants, are invaluable for research and training programmes.Q. How will my donation be used?A. After the eyes are removed, they will be evaluated, processed, screened and then supplied to the eye surgeon for transplant.Q. Do corneal transplants guarantee sight to all blind people?A. No, transplants only help when the loss of sight is solely due to corneal defects and the rest of the eye mechanism is intact.Q. How quickly should eyes be removed after death?A. As soon as possible, but eyes can be removed up to 6 hours after death. However, in places where the climate is hot such as most parts of India, a shorter duration, preferably 2 to 4 hours after death is advisable.Q. Is it necessary to transport the donor to the hospital after death?A. No, eye banks have personnel who will come to the donor’s home or place of death and remove the eyes.Q. What is an eye bank?A. An eye bank is the link between the donor and recipient/eye surgeon. It is an organization recognised by the government to collect and distribute human eyes to those who require corneal transplants.Q. What is to be done when a relative expires?A. 1.Keep the death certificate or its copy to show to the eye bank team. They do not need to take it away. You do not need to look for a photocopier machine to make a photocopy in the middle of the night. The eye bank team only needs to look at the certificate to determine:a) The patient is really dead andb) The cause of death, to determine if the eyeball can be useful.    2. Contact your nearest eye bank – in India, most cities have 1919 as the eye bank contact number. Otherwise, check the local telephone directory – most eye banks are listed in the emergency numbers list. The eye bank team will arrive in the next 30-60 minutes, provided you have given them an accurate address with landmarks. The procedure will take only around 30-40minutes.    3. Close the eye lids, while waiting for the eye bank team and put off any overhead fan, to prevent drying of the cornea. However, if there is an air-conditioner, switch it on, if possible.    4. Cover the closed lids with moist cotton wool (if readily available in the house, otherwise do not bother).     5. Raise the donor’s head by 6 inches, by placing 2 pillows under it.Q. Is there any cumbersome paperwork or time consuming formalities?A. None whatsoever. The eye bank team will come with a form, which they will fill themselves. They will only need the signatures of 2 close relatives, giving consent. It does not matter whether the donor had pledged his eyes for donation during his lifetime or not.Q. I believe some blood is also collected?A. Yes, according to WHO guidelines, the team will also collect some blood from the donor, for testing for HIV, hepatitis etc. They will withdraw this from a large vessel or from the heart with a needle puncture.Q. Is there a real need for Eye Donation?A. Yes, in India there are lacs of patients awaiting corneal transplant.. in some eye banks patients wait over a year for their turn. Every year barely 30,000 corneas are donated, so the waiting list keeps growing!Q. Finally, is there any money to be paid?A. No, no monetary transaction is done. Most eye banks recover their running costs by charging a small processing fee to the recipients.Q. If it does not cost to donate eyeballs after death and the procedure is so easy, and encouraged by every religion, why are there such few donors?A. Good question. You tell me! You go around spreading the message of the nobility of eye donation and how easy and hassle free it is and maybe by the time I write next year, this question will need deletion!